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

Previously the authors have observed a reduction of the ventricular fibrillation threshold (VFT) in a mild diabetic model. This investigation examines the role of more severe hyperglycemia in altering the ventricular fibrillation threshold and how the sympathetic nervous system modulates the response. Alloxan diabetes was induced in eight male mongrel dogs 3-5 years of age (Group 2), for comparison with matched controls (Group 1). Hemoglobin A1c rose from 2.9 +/- .4-7.8 +/- .3% and body weight was maintained with daily insulin. After 1 year, anesthesia was induced with chloralose and an electrode catheter placed at the right ventricular apex. VFT was 41.7 +/- 1.8 ma in Group 1 and 27.8 +/- 2.1 ma in the diabetics of Group 2 (p less than .001). There was significantly greater decline of VFT in response to epinephrine infusion in Group 2. The threshold in diabetics rose to normal levels after infusion of the beta-blocking agent, esmolol. Subsequently, the response of the cardiac sympathetic system was assessed during ventricular pacing at 200 beats/minute. Serial paired blood samples were taken from catheters in the aorta and coronary sinus for catecholamine assay by HPLC. Both groups had similar coronary blood flow responses by the thermal method, as well as changes in arterial pressure. While no change occurred in Group 1, a progressive rise of norepinephrine (NE) concentration was observed in coronary venous effluent of Group 2 (p less than .01). The basal arterial-coronary sinus difference was-123 +/- 52 pg/ml, which rose during pacing in Group 2 to a peak of -376 +/- 9.3 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ventricular vulnerability in diabetes and myocardial norepinephrine release. 280 57

It is estimated that between 1971 and 1987 the number of carotid endarterectomies has increased from 15,000 to over 85,000 per year. Unless the procedure can be performed safely with a combined morbidity and mortality which is below the yearly risk of stroke (5%) for patients with symptomatic carotid artery disease, one should reconsider this operation as a therapeutic option. We review our experience with 891 carotid endarterectomies performed between January 1979 and June 1987. There were 579 (65%) men and 312 (35%) women of ages from 34 to 82 (median 65); risk factors included diabetes mellitus 213 (14%), hypertension 603 (68%), and smoking 630 (70%). Clinical presentation consisted of transient ischemic attacks 506 (57%), cerebral infarction with minimal neurological residual 252 (28%), stroke in evolution 3 (0.3%) and, asymptomatic stenosis 130 (15%). All patients were operated on under endotracheal anesthesia with transoperative monitoring of intra-arterial pressure, central venous pressure and arterial blood gases. Thiopental (3-5 mg/kg) and lidocaine (1 mg/kg) were given for induction and at 15 minute intervals during carotid cross-clamping. Intraluminal shunts were used in 13 (2%). A conventional (open) endarterectomy was performed in 561 (63%) and a limited endarterectomy (closed) in 330 (37%). Complications included 11 (1%) deaths, 26 (3%) developed a major neurological deficit that persisted, 30 (3%) had perioperative TIA's which resolved completely. Of the patients with preoperative neurological deficits, 33 (4%) recovered. Therefore, at one month after surgery, 854 (96%) were either as well or better than preoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pitfalls during carotid endarterectomy. 284 25

Rats were given streptozotocin to induce insulin-dependent diabetes or citrate buffer alone in two experiments. Initially, the effect of 5 wks of dietary gamma-linolenic acid (GLA) plus eicosapentaenoic acid (EPA) on cutaneous nerve conduction velocity (CV) was examined. CV was determined by direct stimulation and recording from saphenous nerve under urethane anesthesia. Secondly, a 5 weeks study of supplementing the diet with GLA, GLA and EPA, or hydrogenated coconut oil (HC) was done. In addition, motor nerve CV was determined by directly stimulating sciatic nerve and recording from gastrocnemius muscle. The acute diabetes led to weight loss, and elevated blood glucose and glycosylated hemoglobin levels. Essential fatty acid (EFA) supplementation had no effect on any of these measures of severity of diabetes. In diabetic rats without EFA supplementation, CV of the myelinated fibers fell by 19-21%, while those receiving both GLA and EPA had normal CV. In diabetic rats receiving GLA alone, CV fell by 5-7%, which was significantly less than those without EFA supplementation (p less than 0.01 for cutaneous, and p less than 0.001 for motor nerves).
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PMID:Essential fatty acids prevent slowed nerve conduction in streptozotocin diabetic rats. 285 65

A case is described in which Fournier's gangrene was the presenting feature of diabetes mellitus and in which extensive subcutaneous emphysema prevented the use of spinal anaesthesia for debridement. In the literature four cases have been reported in which Fournier's gangrene was the presenting feature in patients with diabetic ketoacidosis. Diabetes may predispose to a form of Fournier's gangrene in which subcutaneous gas formation is marked, though subcutaneous emphysema to the degree described in this case has not previously been reported in this condition. Diabetes mellitus and subcutaneous emphysema must be sought in patients with Fournier's gangrene as both may have a profound influence on management.
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PMID:Diabetes mellitus and Fournier's gangrene. 295 Nov 85

Surgical procedure and anaesthesia commonly induce severe diabetes maladjustment. In these circumstances, optimal insulin administration is crucial and has been shown to prevent hyperglycaemia which is mostly due to insulin-counteracting hormones. We report the results obtained in 12 diabetic patients treated with a new method during various surgical procedures. The method consists of constant rate intravenous administration of a 5% glucose solution associated with intravenous insulin infusion delivered by an electric syringe at the rate of 1/2 U of insulin per hour for each glycaemic variation of 50 mg/dl. With this simple method, blood glucose concentrations remain close to physiological levels, and no hypoglycaemia occurs.
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PMID:[Control of diabetes in the perioperative period]. 295 46

The aim of this study was to determine whether diabetes enhanced the sensitivity of the myocardium to the deleterious effects of in vivo-administered Escherichia coli. Diabetes was induced in two groups of animals. One group received 70 mg/kg streptozotocin (iv) and exhibited a severe diabetes with elevated fasting and fed blood glucose concentrations and a markedly abnormal response to an oral glucose load. The second group received 45 mg/kg streptozotocin, was mildly diabetic (termed "latent" diabetes), and was characterized by normal fasting blood glucose but slightly elevated fed blood glucose and an abnormal response to a glucose load. A third group of rats received vehicle and served as time-matched control animals. Four weeks after induction of diabetes, all animals were catheterized under ether anesthesia and some received intraperitoneal injections of live E. coli. In vitro myocardial performance was assessed using the isolated, perfused working heart preparation. Ventricular function curves were generated by changing left atrial filling pressure and measuring changes in heart rate, cardiac output, and aortic peak systolic pressure. Cardiac performance in the severe diabetic group was depressed at the highest preload but was unchanged at lower preloads. Function in the latent diabetic group was not different from control. Sepsis induced a slight decrease in cardiac performance in the control group and resulted in larger reductions in the latent and severe diabetic groups. A depression in aortic flow was the major consequence of sepsis in the latent diabetic group, whereas decreased coronary flow was the primary change in the severe diabetic group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Enhanced myocardial depression in diabetic rats during E. coli sepsis. 295 96

To assess the effects of imposition of moderate diabetes on in vivo cardiac performance in gradually proceeding hypertension, spontaneously hypertensive (SHR) and Wistar-Kyoto rats (WKY) were treated with streptozotocin (40 mg/kg) or vehicle at 8 weeks of age. Four and 20 weeks later, with the rats under ether anesthesia, peak cardiac output and stroke volume were measured during volume loading and peak left ventricular developed pressure and maximum rate of rise of pressure (dP/dtmax) were determined during aortic occlusion. Additionally, passive pressure-volume relations were obtained during saline infusion in potassium-arrested hearts, and the chamber stiffness constant was derived from one exponential function. There was a mortality of 16.1% in the diabetic SHR only. While basal and stressed cardiac performance was unchanged despite the already decreased mean arterial pressure and left ventricular weight at 4 weeks, the diabetic SHR revealed significant decreases in peak cardiac pumping indexes, peak left ventricular developed pressure, and dP/dtmax, with unchanged resting cardiac function, at 20 weeks. Changes seen in the diabetic WKY were reduced left ventricular weight at 4 weeks and reduced peak left ventricular dP/dtmax at 20 weeks. The chamber stiffness was unaltered with strain or diabetes. These data show that imposition of even moderate diabetes substantially influences the stress-loaded in vivo cardiac performance in the SHR, whereas it produces only minor changes in the WKY.
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PMID:Effects of moderate diabetes on cardiac performance in spontaneously hypertensive and Wistar-Kyoto rats. 296 78

This study was designed to test the hypothesis that the decreased early survival rate of diabetic rats submitted to acute experimental myocardial infarction could be improved by a previous training program. Male Wistar rats (+/- 200 g) were rendered diabetic with the i.v. injection of streptozotocin (45 mg/kg) but only those presenting one week later a tail-blood glucose value between 250-400 mg/dl were retained in the protocol. Diabetic and control rats were either kept sedentary or submitted to a progressive 10-week program of treadmill running. The left coronary artery was then ligated under ether anesthesia. Adequate occlusion was confirmed by an elevation of plasma CK-MB levels four hours later or by a toluidine blue injection technique in rats which died earlier. Since the first 20 minutes after such a procedure represents a most critical period for sudden death, the early survival rate was calculated for each group of rats and significance in differences was established with the Fisher's test. While the 27% early survival rate observed in sedentary diabetics was significantly lower (p = 0.02) than the 49% found in sedentary controls, this was completely alleviated by previous training in diabetic animals (50%; p = 0.018 vs sedentary diabetics and 0.623 vs sedentary controls). This beneficial effect of training was not found in nondiabetic animals.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Res 1988 Sep
PMID:Exercise training improves early survival rate in diabetic rats submitted to acute coronary artery ligation. 307 43

The effects of an aldose reductase inhibitor (M79175) on electroretinogram (ERG) oscillatory potential abnormalities was studied in rats with streptozotocin fructose-induced diabetes. The ERG oscillatory potential was recorded under scotopic conditions without general anesthesia in the diabetic rats, before and 4, 8 and 12 weeks after administration of M79175. The ERG tracings were analyzed for peak latencies, peak intervals and amplitudes; the peak latencies and intervals were prolonged and the amplitudes were reduced in untreated diabetic rats, but the prolongation of the peak latencies and intervals were suppressed in diabetic rats receiving M79175. The amplitudes were reduced in the treated rats as in the untreated rats. The results of this investigation suggest that M79175 is effective to suppress progression of diabetic retinopathy in its early stage.
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PMID:Effects of aldose reductase inhibitor (M79175) on ERG oscillatory potential abnormalities in streptozotocin fructose-induced diabetes in rats. 311 85

25 female sheep of the Texel breed were made hyperglycaemic by administration of alloxan monohydrate (ALX) in early pregnancy and 15 ewes served as controls. Average venous glucose levels (mean +/- standard deviation) increased from 3.5 +/- 0.2 to 14.0 +/- 1.8 mmol/l. All hyperglycaemic sheep were treated with long-acting insulin in doses adjusted individually (0.2-1.0 U/kg per day) to keep glucose levels above 8 mmol/l. After a temporary significant increase, maternal venous concentrations of urea and creatinine returned to normal levels. One sheep died on day 6 after administration of ALX. Another hyperglycaemic sheep died at induction of anaesthesia. Eight hyperglycaemic ewes aborted between days 90 and 128 of gestation. Between days 103 and 135 of gestation the remaining hyperglycaemic (n = 15) and control (n = 15) ewes were operated upon and the fetuses were provided with EEG, nuchal EMG and ECG electrodes and catheters in the trachea, amniotic fluid, jugular vein and carotid artery. Use of the chronic sheep preparation for the study of diabetes mellitus and fetal reactions was successful in 10 out of 25 cases, as in the diabetic group postoperative intra-uterine fetal survival varied between 2 and 19 days and in 10 cases was at least 5 days. Postoperative intrauterine fetal survival in the controls was significantly longer and varied between 4 and 28 days, and in 13 cases was at least 5 days. A highly significant correlation (P less than 10-6) between maternal and fetal blood glucose levels was seen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alloxan-induced diabetes mellitus in pregnant sheep and chronic fetal catheterization. 328 Aug 70


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