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

In an open label, two period cross-over study we compared the ocular tolerability of NODS vs. Isopto-NaturaleR eye drops. Thirty healthy volunteers were asked to rate the application system they were using for ocular discomfort, utilizing a visual analog scale in which 100 = no ocular discomfort and 0 = severe ocular discomfort. In addition each subject had to answer a questionnaire and underwent a full ophthalmic control before, at day 7, at day 14 and at day 21 of the study. Each application form had to be applied to one eye only once a day for 7 days, followed by a washout period of 1 week. The type of application form was then changed and again had to be applied to one eye only for 7 consecutive days, followed by a final ophthalmic examination. The mean irritation score was recorded at day 7 and at day 21 of the study. Volunteers had no history of eye disease, no acute pathology of the eye, no contact lenses, no conditional foreign body of the cornea within the last four weeks prior to the study or within the study, no local therapy, no systemic therapy, no diabetes, no pregnancy. Informed consent was obtained. At day 1 one of the two application forms was given to each volunteer in a randomized order. 29 volunteers finished the protocol (16 male, 13 female); mean age: 26 years (range 20-32 years). The mean irritation score of NODS: 35 (2-81); the mean irritation score of Isopto-NaturaleR: 80.4 (45.5-99).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The ocular tolerability of a new ophthalmic drug delivery system (NODS). 796 Apr 9

Some retrospective nonrandomised or cross-sectional studies have shown that higher blood glucose levels are associated with more pronounced microvascular complications in patients with insulin-dependent diabetes mellitus (IDDM). The prospective randomised studies had, until recently, been less definitive. Intensified treatment, and thus lower blood glucose levels, has led to an initial worsening of retinopathy, but this tendency towards more advanced retinopathy has been transient. Albuminuria and manifest neuropathy have been retarded to some extent. Today, 2 long term randomised studies, the Stockholm study and the Diabetes Control and Complications Trial (DCCT), have proven that a lowering of mean blood glucose levels, measured as a lower glycosylated haemoglobin (HbA1c) value, retards or halts retinopathy, nephropathy and peripheral neuropathy. Intensified treatment, whether performed with multiple injections or insulin pumps, leads to some weight gain and a 3-fold increase in the frequency of severe hypoglycaemic episodes. Hypoglycaemia did not cause long term reduced cognitive function in either study, but was unpleasant to the patients. A great majority of patients in the Stockholm study stated that their well-being had increased while participating in the study. The Stockholm programme required 35 minutes extra per patient per month, and a physician and a nurse could tutor 400 patients. This would bring a significant reduction of serious complications and a gain in terms of patient discomfort and cost. A programme of intensified treatment for IDDM is generally indicated and is possible to carry out.
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PMID:A risk-benefit assessment of conventional versus intensive insulin therapy. 804 22

The package leaflets of hormone preparations used for Hormone Replacement Therapy (HRT) in hypoestrogenaemic women contain contraindications, which are taken from the package insert of oral contraceptives: Clots in the blood vessels (thrombotic disorders), high blood fats, severe diabetes, abnormal red blood cells, deterioration of inherited deafness and jaundice not explained by infections, disturbances of the liver function and of existing or treated hormone-dependent tumours of the breast or of the lining of the womb. Numerous epidemiologic, animal-experimental and also clinical studies proved that the cardiovascular risk, hepatic discomfort and the influence on the blood system of oestradiol 17-beta have to be evaluated completely differently compared to the ethinyloestradiol used in oral contraceptives; therefore, many of the listed contraindications must be reconsidered. In our review we try to emphasise this postulation by scrutinizing recent publications.
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PMID:[Drug information in hormone substitution drugs]. 815 Feb 48

Charcot neuroarthropathy is one of the most devastating complications of diabetes causing much discomfort and disability and sometimes leading to amputation. The current therapies are disappointing and fail to address the underlying disease process. In order to try and halt the underlying bone resorption we have studied the action of the bisphosphonate, pamidronate, in six diabetic patients with active Charcot neuroarthropathy. The treatment was associated with improvement in the patients' symptoms and a reduction in Charcot activity as measured by temperature of the affected foot which fell from 3.4 +/- 0.7 (SE) degrees C to 1.0 +/- 0.5 degrees C above the intact foot (p = 0.05). There was a significant reduction in bone turnover as judged by alkaline phosphatase activity which fell by 25 +/- 3% (p < 0.001). These preliminary data suggest that bisphosphonates may be the first definitive treatment for active Charcot neuroarthropathy and that controlled trials are now indicated.
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PMID:Bisphosphonates: a new treatment for diabetic Charcot neuroarthropathy? 818 Dec 48

The capillary filtrate collector (CFC) contains 30,000 molecular weight cut-off, hollow fiber ultrafiltration membranes that are placed below the skin. A transcutaneous tube leads to an evacuated glass tube that provides a vacuum to pull ultrafiltrate at 40-60 microliters/hr from blood, through the fibers, and past a sampling port to the glass tube. Long-term (1-6 months) animal and clinical studies have shown that the ultrafiltrate concentration of chemicals such as glucose and a variety of drugs is exactly the same as that of the blood plasma water when the ultrafiltrate is created. In this study, the device was placed in six home monitored diabetics and four in-center hemodialysis diabetic patients. Over the following month, blood glucose concentrations were compared to CFC glucose concentrations. In spite of difficulties in diluting and assaying small samples of filtrate, there was a good correlation between blood and CFC glucose levels. A flow-through enzymatic glucose sensor has been tested and shown to accurately measure glucose in CFC filtrate. When placed in the transcutaneous tubing near the skin, this should allow a small external device to continuously monitor glucose levels in brittle or out of control diabetes with high accuracy and little risk, discomfort, or cost.
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PMID:A subcutaneous capillary filtrate collector for measurement of blood chemistries. 826 28

The recent literature concerning Raynaud's syndrome is reviewed. Raynaud's syndrome is as common as hypertension and diabetes. In spite of its generally benign character, it causes a lot of discomfort to individuals and sickness absenteeism to society, especially in the colder regions of the world. The etiology remains an enigma 130 years after its first description, perhaps even more so than ever before, the many new theories proposed in the literature. Clearly, in a condition where seventy different etiologic theories are advocated, the culprit lesion is obviously missing, or there is not a culprit lesion but an accumulation of conditions having nothing in common but a few symptoms. Moreover a Raynaud attack may result, not from a single event, but from a cascade of events, just as, for example, hemostasis does. Controversy about diagnosis exists all over. For example, how does one make a diagnosis? Patient history has been considered unreliable. A standardized cold test, though highly reproducible in the authors' hands, is far from common property. Raynaud's syndrome is a condition for which thirty-eight therapies have been advocated in the last three years, but the curative answer is still to come.
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PMID:Raynaud's syndrome, an enigma after 130 years. 844 29

We studied the results for seventeen patients (eighteen feet) who had had a triple arthrodesis at an average age of sixty-six years (range, fifty-two to eighty years). There were twelve women and five men. The procedures had been performed to correct deformities of the hindfoot and midfoot caused by an untreated rupture of the posterior tibial tendon in ten patients; by rheumatoid arthritis in three patients (four feet); and by neuropathic arthropathy (associated with diabetes mellitus), trauma, old poliomyelitis, and a stroke in one patient each. The average duration of follow-up was forty-two months (range, twenty-seven to 156 months). At the most recent follow-up examination, three patients had a non-union (one, of the talonavicular joint and two, of the calcaneocuboid joint), six patients (seven feet) had progressive degenerative joint disease involving the ankle, seven had progressive degenerative changes in the mobile joints of the feet, two had had an infection but both infections had healed, and one had had postoperative collapse of the foot because of premature, unauthorized weight-bearing. In one patient, a staple across the subtalar joint had been removed because of pain caused by impingement of the staple on the tip of the fibula. Over-all, fourteen of the seventeen patients were satisfied with the result of the operation. All seventeen had less pain postoperatively, but eleven still had some discomfort.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Triple arthrodesis in older adults. Results after long-term follow-up. 844 13

Selective control of cell function by applying specifically configured, weak, time-varying magnetic fields has added a new, exciting dimension to biology and medicine. Field parameters for therapeutic, pulsed electromagnetic field (PEMFs) were designed to induce voltages similar to those produced, normally, during dynamic mechanical deformation of connective tissues. As a result, a wide variety of challenging musculoskeletal disorders have been treated successfully over the past two decades. More than a quarter million patients with chronically ununited fractures have benefitted, worldwide, from this surgically non-invasive method, without risk, discomfort, or the high costs of operative repair. Many of the athermal bioresponses, at the cellular and subcellular levels, have been identified and found appropriate to correct or modify the pathologic processes for which PEMFs have been used. Not only is efficacy supported by these basic studies but by a number of double-blind trials. As understanding of mechanisms expands, specific requirements for field energetics are being defined and the range of treatable ills broadened. These include nerve regeneration, wound healing, graft behavior, diabetes, and myocardial and cerebral ischemia (heart attack and stroke), among other conditions. Preliminary data even suggest possible benefits in controlling malignancy.
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PMID:Beneficial effects of electromagnetic fields. 849 42

This study examined attitudes and beliefs about exercise among 83 persons with non-insulin-dependent diabetes who had completed outpatient diabetes counseling. An adaptation of the Health Belief Model, labeled the Exercise Behavior Model, guided perceptual measures. Fifty-two percent of the subjects were exercising 3 or more days per week. Those with a greater length of time since diabetes counseling were more likely to be currently exercising. Positive and negative attitudes toward exercise characterized the group; however, only negative attitudes were related to exercise. Both exercisers and nonexercisers perceived barriers to exercise. Other people, chance happenings, physical discomfort, and perceptions of fitness, weight, and appearance played a role in whether the subjects exercised. The results indicate that providing assistance in identifying support for exercise and overcoming perceived barriers to exercise may increase compliance to this important aspect of the diabetes regimen.
Diabetes Educ
PMID:Attitudes and beliefs about exercise among persons with non-insulin-dependent diabetes. 854 57

Autonomous neuropathy in patients with diabetes is associated with dysmotility and abdominal discomfort. The disturbances resemble to some extent those seen in patients with functional dyspepsia. To gain further insight into the disorders, we compared patients with long-standing diabetes, patients with functional dyspepsia, and healthy individuals with respect to abdominal symptoms, width of gastric antral area, and autonomic nerve function. We investigated 42 type I diabetic outpatients by structured interview for abdominal discomfort, ultrasonography of the gastric antrum, assessment of vagal and sympathetic nerve function by respiratory sinus arrhythmia and skin conductance, and measurement of blood sugar and HbA1c. Immediately after a standard meal of soup with meat, 21 (50%) of the 42 patients with diabetes complained of abdominal discomfort (pain, bloating, fullness), which was significantly less frequent (95% CI of difference 0.03-0.5) than previously seen in patients with functional dyspepsia (76%), and significantly more frequent (95% CI of difference 0.3-0.6) than that seen in healthy individuals (4%). Bloating was the most marked postprandial complaint. Mean fasting antral area was significantly wider in patients with diabetes (mean 4.9 cm2, SD 1.7) compared to healthy individuals (mean 3.5 cm2, SD 1.2), 95% CI of difference 0.6-2.2 cm2. Mean postprandial antral area was 14.8 cm2 (SD 4.6) in the patients with diabetes, which is insignificantly wider than in patients with functional dyspepsia (mean 13.0 cm2, SD 4.0) but significantly wider (95% CI of difference 1.9-6.5 cm2) than that seen in healthy individuals (mean 10.6 cm2, SD 3.8). The mean respiratory sinus arrhythmia was 0.7 beats/min (SD 0.7) in the patients with diabetes, which was insignificantly lower than that seen in patients with functional dyspepsia (2.1 beats/min, SD 4.5), and significantly lower (99% CI of difference 3.8-7.1 beats/min) compared to healthy individuals (6.2 beats/min, SD 3.8). It is concluded that patients with diabetes have a wider gastric antrum and more discomfort after a meal than healthy individuals. Compared to patients with functional dyspepsia, patients with diabetes have a wider postprandial antrum but fewer symptoms. The very low vagal tone seen in patients with diabetes may play an important role in the pathogenesis of their gastric motility disturbance and postprandial abdominal discomfort.
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PMID:Wide gastric antrum and low vagal tone in patients with diabetes mellitus type 1 compared to patients with functional dyspepsia and healthy individuals. 856 73


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