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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early effects of insulin and essential fatty acids on nerve conduction were studied. Insulin-dependent diabetes was induced in rats using streptozocin (65 mg/kg, i.p.); control rats were treated with buffer. Five weeks later, diabetic rats were divided into 5 groups. Two groups were given oral essential fatty acids (75% linoleic and 9% gamma-linolenic acids) for a further 3 and 5 days, respectively. Two other groups received subcutaneous insulin for a further 3 or 5 days. A group of diabetic rats were left without further treatment. Motor nerve conduction velocity was measured terminally in all rats by stimulating the sciatic nerve and recording EMGs in the gastrocnemius muscle under urethane anaesthesia. Sensory nerve conduction velocity was measured by stimulating and recording from the saphenous nerve trunk. Diabetic rats had significantly slowed motor and sensory nerve conduction velocities after 5 weeks (16.7%, P less than 0.001). Three days treatment with either insulin or fatty acids corrected the slowed motor nerve conduction velocity to a normal level. Conduction velocity in myelinated sensory nerves was still 10% slower in diabetic rats treated with insulin for 3 days (P less than 0.01). It was above the control level by 11% in diabetic rats treated with fatty acids for the same period (P less than 0.01). Conduction velocities in both sensory and motor nerves were normal in diabetic rats treated with either insulin or fatty acids for 5 days. It was concluded that both insulin and essential fatty acids had early effects on nerve conduction in diabetic rats. The speed of their actions, and the magnitudes of responses were different in sensory and motor nerves.
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PMID:Comparison of short-term effects of insulin and essential fatty acids on the slowed nerve conduction of streptozotocin diabetes in rats. 166 93

The case of a non diabetic 6-year-old boy affected by Down's syndrome, who developed hyperosmolar hyperglycemic non-ketotic coma following the infusion of hypertonic dextrose solution during general anesthesia for a surgical procedure for cryptorchidism is reported. Following surgery, the patient remained deeply comatose and generalized seizures occurred. Hyperosmolarity due to hyperglycemia and acidosis were reduced by administration of insulin at low rate, hypotonic saline and sodium-bicarbonate solutions. The patient's clinical conditions promptly improved following normalization of blood glucose levels. An oral glucose tolerance test performed three months later was normal. The authors emphasize the potential risk of hyperosmolar hyperglycemic non-ketotic coma also in non diabetic patients treated with hypertonic dextrose solutions, during surgery events.
Diabetes Res 1991 Sep
PMID:A case of hyperglycemic hyperosmolar non-ketotic coma during anesthesia: a possible cause of failed re-awakening. 168 69

Patients on chronic hemodialysis for end-stage renal disease (ESRD) may develop anorectal problems necessitating surgery. From January 1984 to December 1987, 18 ESRD patients underwent anorectal surgery. During this period, a mean of 215 patients underwent dialysis. Patients with ESRD present with characteristic problems: chronic constipation, need for dialysis pre- and postoperatively with heparin infusion, anemia, anticoagulation secondary to the consequences of uremia, and significant medical problems including coronary artery disease, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease (COPD). Two patients had concomitant anal fissure, two had fistula-in-ano, and one had an acute perianal abscess. In two patients, the postoperative course was complicated by hemorrhage and, in one patient, by abscess formation. There was no delay in wound healing compared with a cohort group. The essentials of perioperative management are discussed with respect to timing of dialysis, methods of anesthesia and pain management, coagulation screening, and complications. Patients on well-managed chronic dialysis will tolerate anorectal surgery without undue jeopardy.
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PMID:Is anorectal surgery on chronic dialysis patients risky? 173 84

A patient is described with a history of coronary artery disease and diabetes showing unilateral continuous jerking limb movements immediately after general anaesthesia. Carotid territory hypoperfusion is assumed to be the pathogenetic factor of these involuntary limb movements. 2 days after administration of 1000 mg Aspirin these movements ceased, supporting this trial prior to invasive surgical procedures especially in high risk patients.
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PMID:[Treatment of acute manifestation of hemichorea with aspirin. A case report]. 176 81

In 23 patients with diabetes mellitus, the effectiveness of anesthesiologic support of the operations on the aorta and major vessels, which was based on combined epidural anesthesia performed using the conventional technique, was analysed. Sugar concentration in the blood was maintained at a level of no more than 11 mmol/l. Use of the method permitted to provide an adequate anesthesia, stable concentration of glucose in the blood, constant aqueous-electrolyte balance and acid-base state.
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PMID:[Anesthesiologic management of surgery of the aorta and the major vessels in patients with diabetes mellitus]. 177 72

We report a case of Fournier's gangrene affecting a 77-year-old man. The patient was found to have decompensated diabetes mellitus that had been ignored before the onset of the disease. Several authors have described earlier a dramatic, explosive disease, leading to severe prostration within a few hours. Most of the recent cases, like this patient, have had a more insidious course, with symptoms beginning several days before hospitalization. Forty-five days after surgical debridement under spinal anesthesia and daily local treatment the scrotum was completely healed. The etiology and pathogenesis of this infrequent disease are discussed.
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PMID:Fournier's disease. Report of a case and review of the literature. 179 51

A simple classification of the more common neuropathies is presented. The most frequent disorder in diabetes is a symmetrical sensory polyneuropathy in the lower limbs. Acute sensory polyneuropathies frequently follow sudden metabolic disturbance although there may be little evidence of neurological abnormalities on clinical examination. Similar symptoms occur with chronic sensory polyneuropathy but onset is gradual and this condition may persist for years with only minor symptoms. A significant proportion of patients with chronic polyneuropathies have few if any symptoms and are only diagnosed by careful clinical examination. An approach to the diagnosis and management of symptomatic sensory polyneuropathy is suggested. Sensory loss, and the possible complication of vascular dysfunction, greatly increases the risk of insensitive foot lesions in diabetic patients. Some may progress to the insensitive foot without prior evidence of neuropathy. Regular and thorough examination is therefore the only way to identify patients at risk who then require education in preventative foot care. The identification of such patients and the clinical presentation and management of foot ulcers is discussed.
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PMID:Clinical presentation and management of diabetic neuropathy and foot ulceration. 182 59

Maternal and neonatal acid-base status and glucose metabolism were studied in 20 patients with insulin-dependent diabetes mellitus (group 1) undergoing elective cesarean section under lumbar epidural anesthesia. All patients were given glucose/insulin infusion before delivery. Fifteen healthy patients with iatrogenic hyperglycemia (group 2) and 15 healthy euglycemic patients (group 3) served as controls. Results were expressed as mean +/- 1 SE and were analyzed using analysis of variance and chi 2 analysis at P less than 0.05. No significant differences were seen at delivery either in maternal arterial and neonatal umbilical venous and arterial blood acid-base status or in neonatal Apgar scores among the three groups. Patients in groups 1 and 2 had larger blood glucose concentrations than those in group 3 (P = 0.01). Diabetic mothers and their neonates had a 25%-50% reduction in pyruvate concentration in maternal venous, and neonatal umbilical venous and arterial blood compared with that in the other two groups (P = 0.001). Postpartum neonatal hypoglycemia (less than 30 mg/dL) developed in seven of the group 1 neonates (P = 0.05). Thus, epidural anesthesia in diabetic women is associated with normal acid-base status in the mother and in the neonate. The data also show an increased incidence of neonatal hypoglycemia and altered maternal and neonatal glycolysis in patients with diabetes mellitus.
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PMID:Perioperative maternal and neonatal acid-base status and glucose metabolism in patients with insulin-dependent diabetes mellitus. 185 24

A certain effect of surgical intervention on glucose, insulin and cortisol content has been shown in patients without concomitant endocrine pathology operated on for urological and gynecological diseases under epidural anesthesia. At the same time rational manifestations of the adaptation mechanisms of carbohydrate metabolism were retained. The use of epidural anesthesia has demonstrated the lack of carbohydrate hypermetabolism excess in the intra- and postoperative periods in patients with concomitant diabetes mellitus. This makes the epidural anesthesia a method of choice during surgery in patients with concomitant diabetes mellitus.
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PMID:[Carbohydrate metabolism in patients with diabetes mellitus under epidural anesthesia]. 186 55

To assess the effect of chemical stimulation of the central nervous system (CNS) on ketogenesis, we injected neostigmine (5 x 10(-8)mol) into the third cerebral ventricle in normal rats fasted for 48 h and fed rats with diabetes induced by streptozotocin (STZ, 80 mg/kg). The hepatic venous plasma levels of ketone bodies (3-hydroxybutyrate and acetoacetate), free fatty acids (FFA), and glucose were measured for 120 min after the injection of neostigmine under pentobarbital anesthesia. In the normal rats, plasma glucose levels were significantly increased but neither ketone bodies nor FFA were affected by CNS stimulation with neostigmine. In contrast the plasma levels of ketone bodies and FFA were significantly increased in STZ-diabetic rats, while glucose levels remained unchanged. The intravenous infusion of somatostatin (1.0 microgram/kg/min) suppressed the increase in plasma ketone bodies following CNS stimulation in STZ-diabetic rats. These findings suggest that CNS stimulation with neostigmine may accelerate ketogenesis by promoting the lipolysis, which may be induced by glucagon, in fed diabetic rats but not in normal fasted rats.
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PMID:Reciprocal changes of plasma glucose and ketone bodies in fasted and acutely diabetic rats after CNS stimulation. 189 76


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