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

To evaluate hemoglobin AIc (Hb AIc) as an indicator of prolonged glucose control in pregnant diabetics, four groups of subjects were studied--16 pregnant diabetic, 13 pregnant nondiabetic, 12 nonpregnant diabetic, and 18 healthy control subjects. Hb AIc was significantly lower in the pregnant diabetic than in the nonpregnant diabetic subjects, 7.8% +/- 1.6 vs, 9.9% +/- 1.9 (mean +/- SD). No difference was present in the nondiabetic groups (4.0% +/- 0.7 vs. 4.3% +/- 0.8, respectively). Hb AIc correlated significantly with the average glucose concentrations of the preceding 60 days in both diabetic groups, suggesting that the lower concentration of Hb AIC in pregnant as compared with nonpregnant diabetic patients was because of better control of blood glucose. This was also borne out by the average of fasting glucose levels being 6.1 +/- 1.7 mmol/L in the pregnant diabetic and 10.7 +/- 2.2 mmol/l in the nonpregnant diabetic subjects.
Diabetes 1979 Jul
PMID:Hemoglobin AIc as an index of long-term blood glucose regulation in diabetic pregnancy. 44 24

Seven patients with diabetes mellitus were hospitalized and their blood sugar concentrations regulated as a result of fasting blood sugar, sugar around meals, urinary sugar, and hemoglobin AIC assays. Erythrocyte half-life as measured by 51 Cr increased in all patients from a mean of 27 days to 31 days, while hemoglobin AIC levels decreased from a mean of 10.1% to 5.6%. Leukocyte adherence increased in all patients from a mean of 28% to 51%. Most striking were the changes observed in platelet function in response to epinephrine. The length of the secondary lag phase of platelet aggregation, after a stimulus with final concentration of 70 muM of epinephrine, increased from a mean of 19 seconds to 65 seconds. Studies in additional patients confirmed an inverse correlation between hemoglobin AIC concentration and the secondary lag phase (r = 0.87, P less than 0.001). These studies found that certain secondary sequelas of diabetes can be corrected by strict carbohydrate control and confirmed that hemoglobin AIC assays provide a useful means of showing the degree of control of glucose metabolism in diabetic patients.
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PMID:Reversible hematologic sequelae of diabetes mellitus. 84 4

An asymptotic lifetime growth model of height is introduced by modifying a fundamental growth model considering a relative measure of maturity. This model is compared with the Preece-Baines model and the Jolicoeur et al. model for 365 Japanese females collected in Hiroshima. The pooled residuals and the amount of the AIC can evaluate the goodness of fit to the longitudinal growth records. The proposed growth model is the best among three models from a viewpoint of the goodness of fit. Some special points of growth curve are characterized mathematically and the estimates of these points are compared with ones of other growth models. The larger the value of growth velocity at take-off is, the higher the final height is. An empirical Bayesian approach is applied to an asymptotic lifetime growth prediction of an insulin-dependent diabetes mellitus patient.
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PMID:On a growth model of human height. 209 15

This study reviews the new diagnostic criteria for diabetes mellitus proposed by NIH. We measured insulin levels during 75 g oral glucose tolerance test (75 g OGTT) and hemoglobin AIC levels in patients diagnosed as having impaired glucose tolerance (IGT) or non-insulin dependent diabetes (NIDDM) according to the NIH criteria. In a 75 g oral glucose tolerance test, there was no significant difference in insulin-glucose ratio between nonobese IGT and nonobese NIDDM who had fasting blood glucose levels of less than 120 mg/dl (NIDDM-A group). However, in nonobese NIDDM with fasting blood glucose higher than 120 mg/dl (NIDDM-B group), the insulin-glucose ratio was significantly lower than in the IGT or NIDDM-A group. The NIDDM-B group had a higher hemoglobin AIC levels than the IGT and NIDDM-A groups, with no significant difference between the levels of the two latter groups. These observations suggest that the impairment in the function of pancreatic B cells and the state of chronic hyperglycemia are the same in IGT & NIDDM-A groups. Therefore, the NIH standards do not appear refined enough to truly differentiate between IGT and nonobese NIDDM with fasting blood glucose of less than 120 mg/dl.
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PMID:An assessment of the new NIH diagnostic criteria for diabetes mellitus according to insulin response in a 75 g oral glucose tolerance test and levels of hemoglobin AIC. 675 57

Recently, a minor component of normal adult hemoglobin has been discovered. This hemoglobin is referred to as glycohemoglobin or Hgb AI, and it is made up of subgroups A-E (Hgb AIA-AIE). As the name implies, these hemoglobins are simply Hgb A with a hexose residue attached to each of the beta chains. The most important of the subgroups is Hgb AIC wich has a glucose molecule attached to the beta chains. The degree of glycosylation of Hgb A is directly dependent upon the concentration of blood glucose. Hgb AIC and total glycohemoglobin levels have been found to be two to three times greater in diabetics than in nondiabetics. It has also been determined that Hgb AIC and glycohemoglobin levels are reduced to near normal values when the blood glucose is well controlled. Since glycosylated hemoglobin levels represent a time-averaged blood glucose level, it is considered to be a better indicator of control than individual blood glucose levels. The glycohemoglobins are eluted quite easily before the major Hgb A component on ion exchange columns. Although Hgb AIC can be isolated by column exchange, most methods separate total glycohemoglobins, not just Hgb AIC. Thus, glycohemoblobin levels by ion exchange column separation may become the test of choice in monitoring treatment of diabetes mellitus.
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PMID:Glycosylated Hemoglobin: a literature review. 741 94

Between November 1986 and January 2000, 28 patients with insulin-dependent diabetes mellitus were enrolled in the implanted insulin pump study at Johns Hopkins Hospital. An additional two patients underwent pump implantation under compassionate use guidelines due to apparent resistance to subcutaneously administered insulin uptake. The mean patient age was 44 +/- 10.5 years. Eleven patients (39%) were female and the mean duration of diabetes was 25.7 +/- 8.9 years. Diabetic retinopathy, neuropathy, and nephropathy were present in 43%, 25% and 11 % of patients, respectively. The insulin pumps functioned safely for a total of 189 patient years. Mean pump life was 26 +/- 1.2 months. There was no mortality. Morbidity was limited to pump-site infections [n=y (4%) of all pumps placed], one case of pump migration and skin erosion, and one small bowel obstruction associated with the pump catheter. Mean serum hemoglobin AIC levels before and after pump placement were 9.0 +/- 2.9% and 7.5 +/- 0.7% (P=0.0023), respectively. Correspondingly, the mean daily blood glucose levels decreased from l61 +/- 40 mg/dl before placement to 141 +/- 27 mg/dl after pump placement (P=0.0063). Intraperitoneal delivery of insulin by a mechanical pump appears to be an attractive alternative for the treatment of insulin-dependent diabetes mellitus.
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PMID:Intraperitoneal delivery of insulin via mechanical pump: surgical implications. 1112 19

Exercise improves insulin sensitivity. As AMP-activated protein kinase (AMPK) plays an important role in muscle metabolism during exercise, we investigated the effects of the AMPK activator 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside (AICAR) on insulin action in insulin-resistant high-fat-fed (HF) rats. Rats received a subcutaneous injection of 250 mg/kg AICAR (HF-AIC) or saline (HF-Con). The next day, euglycemic-hyperinsulinemic clamp studies were performed. Glucose infusion rate during the clamp was enhanced (50%) in HF-AIC compared with HF-Con rats. Insulin-stimulated glucose uptake was improved in white but not in red quadriceps, whereas glycogen synthesis was improved in both red and white quadriceps of HF-AIC rats. HF-AIC rats also showed increased insulin suppressibility of hepatic glucose output (HGO). AICAR-induced responses in both liver and muscle were accompanied by reduced malonyl-CoA content. Clamp HGO correlated closely with hepatic triglyceride content (r = 0.67, P < 0.01). Thus, a single dose of AICAR leads to an apparent enhancement in whole-body, muscle, and liver insulin action in HF rats that extends beyond the expected time of AMPK activation. Whether altered tissue lipid metabolism mediates AICAR effects on insulin action remains to be determined. Follow-up studies suggest that at least some of the post-AICAR insulin-enhancing effects also occur in normal rats. Independent of this, the results suggest that pharmacological activation of AMPK may have potential in treating insulin-resistant states and type 2 diabetes.
Diabetes 2002 Oct
PMID:AICAR administration causes an apparent enhancement of muscle and liver insulin action in insulin-resistant high-fat-fed rats. 1235 23

AMP-activated protein kinase (AMPK) plays a key role in regulating metabolism, serving as a metabolic master switch. The aim of this study was to assess whether increased concentrations of the AMP analog, 5-aminoimidazole-4-carboxamide-1-beta-D-ribosyl-5-monophosphate, in the liver would create a metabolic response consistent with an increase in whole-body metabolic need. Dogs had sampling (artery, portal vein, hepatic vein) and infusion (vena cava, portal vein) catheters and flow probes (hepatic artery, portal vein) implanted >16 days before a study. Protocols consisted of equilibration (-130 to -30 min), basal (-30 to 0 min), and hyperinsulinemic-euglycemic or -hypoglycemic clamp periods (0-150 min). At t = 0 min, somatostatin was infused and glucagon was replaced in the portal vein at basal rates. An intraportal hyperinsulinemic (2 mU . kg(-1) . min(-1)) infusion was also initiated at this time. Glucose was clamped at hypoglycemic or euglycemic levels in the presence (H-AIC, n = 6; E-AIC, n = 6) or absence (H-SAL, n = 6; E-SAL, n = 6) of a portal venous 5-aminoimidazole-4-carboxamide-ribofuranoside (AICAR) infusion (1 mg . kg(-1) . min(-1)) initiated at t = 60 min. In the presence of intraportal saline, glucose was infused into the vena cava to match glucose levels seen with intraportal AICAR. Glucagon remained fixed at basal levels, whereas insulin rose similarly in all groups. Glucose fell to 50 +/- 2 mg/dl by t = 60 min in hypoglycemic groups and remained at 105 +/- 3 mg/dl in euglycemic groups. Endogenous glucose production (R(a)) was similarly suppressed among groups in the presence of euglycemia or hypoglycemia before t = 60 min and remained suppressed in the H-SAL and E-SAL groups. However, intraportal AICAR infusion stimulated R(a) to increase by 2.5 +/- 1.0 and 3.4 +/- 0.4 mg . kg(-1) . min(-1) in the E-AIC and H-AIC groups, respectively. Arteriovenous measurement of net hepatic glucose output showed similar results. AICAR stimulated hepatic glycogen to decrease by 5 +/- 3 and 19 +/- 5 mg/g tissue (P < 0.05) in the presence of euglycemia and hypoglycemia, respectively. AICAR significantly increased net hepatic lactate output in the presence of hypoglycemia. Thus, intraportal AICAR infusion caused marked stimulation of both hepatic glucose output and net hepatic glycogenolysis, even in the presence of high levels of physiological insulin. This stimulation of glucose output by AICAR was equally marked in the presence of both euglycemia and hypoglycemia. However, hypoglycemia amplified the net hepatic glycogenolytic response to AICAR by approximately fourfold.
Diabetes 2005 Feb
PMID:Portal venous 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside infusion overcomes hyperinsulinemic suppression of endogenous glucose output. 1567 95

The effect of treatment for hepatitis C viral infection on hemoglobin A(1c) (A1C) levels is not well described in the literature. We describe a 59-year-old man with type 2 diabetes mellitus whose A1C level became falsely low when ribavirin and peginterferon alfa-2b therapy were started for treatment of hepatitis C. After treatment was discontinued, the patient's A1C returned to its previous baseline value. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's low AIC level and his ribavirin-peginterferon alfa-2b therapy. Clinicians should be aware that combination therapy for hepatitis C may affect A1C values. To maintain accurate glucose control in patients with diabetes who are receiving treatment for hepatitis C, it is important that they self-monitor their blood glucose levels in conjunction with A1C data, especially when A1C values become falsely low.
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PMID:Falsely low hemoglobin A1c levels in a patient receiving ribavirin and peginterferon alfa-2b for hepatitis C. 1911

Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with diabetes who develop hand sepsis in the tropics.
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PMID:The tropical diabetic hand syndrome: a surgical perspective. 2215 88


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