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

Sixteen adult-onset diabetics, who were thought by current criteria to be well controlled on diet alone, had substantially elevated overnight, basal plasma glucose concentrations. Chlorpropamide had a sufficiently prolonged stimulatory effect on the beta cells such that normal basal plasma glucose levels were obtained in 13 patients. Both basal plasma C-peptide levels and the C-peptide response to meals became normal, with improved postprandial glycemia. Diurnal plasma triglyceride levels were reduced. Plasma growth hormone levels were normal both before and after therapy. When diet alone is insufficient to maintain basal normoglycemia in mild diabetes, chlorporpamide is as effective as basal insulin supplements in producing normal basal plasma glucose levels.
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PMID:Basal normoglycemia attained with chlorpropamide in mild diabetes. 56 57

Diurnal variation of blood sugar, C-peptide immunoreactivity (CPR), free insulin and total insulin were measured in 10 insulin requiring diabetics after obtaining adequate control of diabetes with commercial lente insulin treatment. Following these tests, insulin treatment were changed to monocomponent insulin (MC-insulin) from commercial lente insulin treatment in all subjects and the same tests were performed at 7th day of MC-insulin treatment. Diurnal variations of blood sugar in both groups were not changed significantly. Also changes in CPR of both groups were nearly same magnitude and endogenous insulin secretion in these insulin treated diabetics were suggested except a case of juvenile diabetic subject. However personal variation were great in diabetics with high antibody titer, diurnal variations of total extractable insulin in both groups were quite comparable. And mean diurnal changes in free insulin were resemble to that of CPR. All of these data suggested that clinical effects of MC-insulin and commercial insulin treatment on insulin requiring diabetics were comparable except insulin antibody or proinsulinspecific antibody production.
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PMID:[Clinical effects of monocomponent insulin and commercial insulin preparations on insulin requiring diabetics (author's transl)]. 57 32

The effect of insulin administration on blood pressure has been investigated in eight diabetes with autonomic neuropathy. Systolic and diastolic pressures fell considerably after insulin in all of them. This effect was aggravated by tilting to the vertical position. Five patients fainted when upright with systolic blood pressures less than 50 mm. Hg. This hypotensive effect of insulin occurs whether it is administered intravenously, intramuscularly, or subcutaneously. The onset of the effect is almost immediate after intravenous insulin, is progressive, and may last for several hours. It coincides with a falling blood glucose level and occurs before hypoglycemic levels are reached, and it may be present when the blood glucose level is still elevated. Diurnal variations of postural hypotension have been recorded in some patients, the standing blood pressure falling with the onset of insulin action and rising again as the latter declines. Some of our patients were unable to differentiate between symptoms of hypoglycemia and hypotension. Postural hypotension may account for some episodes of sudden loss of consciousness without warning, usually attributed to hypoglycemia.
Diabetes 1976 Feb
PMID:Provocation of postural hypotension by insulin in diabetic autonomic neuropathy. 94 32

Diurnal plasma glucose profiles and oral glucose tolerance during pregnancy were studied in normal women, chemical diabetics, and insulin-requiring diabetics. In normal women the mean diurnal plasma glucose rose by only 0.22 mmol/1 (4 mg/100 m1) during pregnancy. Mild chemical diabetes resulted in an increase in both the mean diurnal glucose concentration and the fluctuation of plasma glucose levels during the day. Fluctuation in glucose concentration in insulin-dependent diabetics was about three times that found in non-diabetic women of similar gestation, with relative hyperglycaemia during the day and hypoglycaemia at night. In non-diabetic women and those with chemical diabetes the mean dirunal glucose correlated closely with the total area under the three-hour oral glucose tolerance curve and significantly, but less closely, with the two-hour glucose tolerance test value.
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PMID:Carbohydrate metabolism in pregnancy. Part I. Diurnal plasma glucose profile in normal and diabetic women. 117 10

Localized proton magnetic resonance (MR) spectroscopy was used to define biochemical changes in gray and white matter of the cerebral cortex in 22 patients with diabetes mellitus (DM), including 10 episodes of diabetic ketoacidosis (DKA), compared with MR spectra in 30 healthy subjects. Five distinct metabolic abnormalities were identified: Concentrations of glucose (Glc) (P greater than or equal to .002), ketone body or bodies, myo-inositol (P greater than or equal to .003) (with or without glycine), and choline (Cho) metabolites were increased in both white and gray matter, whereas a significant reduction of N-acetyl metabolites was found in the parietal cortex (P greater than or equal to .003). Diurnal variations in the intracerebral concentration of Glc were demonstrated in a patient with DM whose condition was stable. Elevated concentrations of ketones were detected in three episodes and excess Cho in two episodes of DKA. Evidence obtained with hydrogen-1 MR spectroscopy favors acetone rather than acetoacetate as the ketone present in the brain, which is a major target of biochemical change in DM.
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PMID:Cerebral metabolic disturbances in patients with subacute and chronic diabetes mellitus: detection with proton MR spectroscopy. 131 74

Diurnal variations in insulin-induced hypoglycemia and in plasma counterregulatory hormone concentrations were explored in eight insulin-dependent diabetic and six healthy subjects during a 100-min iv insulin infusion performed at 0300 h and 1500 h. In healthy subjects, plasma glucose concentrations (mean +/- SD) fell by 35 +/- 2% during the daytime test and by 26.5 +/- 2% during the nocturnal test (P less than 0.01). Plasma cortisol, GH, and epinephrine concentrations increased more during the daytime than during the nocturnal test. In contrast, plasma glucagon concentrations rose more during the nocturnal tests. In insulin-dependent diabetes mellitus patients, insulin infusion had to be interrupted in three subjects because plasma glucose fell below 1.9 mmol/L 80 min after the beginning of the test. In the other five patients plasma glucose fell by 34 +/- 5% during the daytime test while no significant decrease in plasma glucose was observed in any of the eight patients during the nighttime test. Counterregulatory hormone concentrations were consistent with the results of plasma glucose, with no change during the nocturnal test and significant increases in cortisol, GH, and epinephrine during the daytime test. These results show that insulin sensitivity is decreased at night in comparison to midafternoon in healthy subjects and that in insulin-dependent diabetes mellitus patients this phenomenon is exaggerated, even in patients with defective counterregulation to hypoglycemia.
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PMID:Decreased hypoglycemic effect of insulin at night in insulin-dependent diabetes mellitus and healthy subjects. 161 96

Thermal testing was carried out on 55 healthy subjects in order to establish normal results and reproducibility of warm and cold thresholds. Diurnal variations of thresholds were investigated in a further 30 normal subjects. Then the sensitivity of different testing procedures was investigated in 33 patients with diabetes mellitus, but without severe polyneuropathy. Forced choice testing takes 6 times longer than the method of limits, and the results are not considerably different. It is thought that the forced choice algorithm does not provide a method for clinical routine. Another new approach, the double random staircase method, may help to exclude bias without taking too much time.
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PMID:Thermal discrimination thresholds: a comparison of different methods. 222 Mar 12

In order to examine the physiological variation in blood pressure and heart rate that occurs during normal activities in patients with diabetes, 24-h profiles were constructed from continuous ambulatory recordings. Isometric and dynamic tests were also performed. The patients were subdivided into 25 uncomplicated cases, 11 with peripheral neuropathy and 6 with autonomic neuropathy. These were compared with a 'control' group of 22 normal subjects. Abnormal 24-h blood pressure profiles were found particularly in the patients with autonomic neuropathy. This group had attenuation or reversal of the usual diurnal rhythm, blood pressure often rising during the night and falling in the early morning. Diurnal heart rate variation was reduced in all three groups of patients. Blood pressure responses to both forms of exercise were also significantly reduced in the autonomic neuropathy group (maximum change in systolic blood pressure during isometric exercise was 10 +/- 4 mmHg vs 36 +/- 3 mmHg in the control group, p less than 0.003). Patients with peripheral neuropathy also had some impairment of exercise-induced blood pressure changes, but to a lesser degree.
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PMID:Ambulatory blood pressure and heart rate in diabetic patients: an assessment of autonomic function. 252 97

Hormonal studies of pituitary-testicular function in insulin-dependent diabetes mellitus were examined at rest and during moderate exercise to assess whether diabetes per se caused abnormalities of nocturnal penile tumescence and androgen function in men with normal sexual function. The present study compared 10 healthy men and eight men with Type I diabetes mellitus in whom normal sexual function was determined by clinical history. Urinary gonadotropin excretion, semen analysis and diurnal variation of serum glucose, prolactin, testosterone and free testosterone were determined in both groups. In addition, the serum levels of testosterone, free testosterone, prolactin, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured at rest, during 45 minutes of exercise on a bicycle ergometer at 50% of the subjects previously determined maximal oxygen uptake (VO2 max) and during a 30-minute recovery period. Nocturnal penile tumescence and parameters of semen analysis were similar in both groups. Urinary FSH excretion and serum FSH were higher (P less than or equal to 0.01) in the diabetic subjects while urinary LH excretion was similar. Diurnal variation of serum prolactin, testosterone and free testosterone were similar in both groups. Exercise produced a significant (P less than or equal to 0.01) increase in maximal free and total testosterone in both groups without changes in serum FSH or LH. Prolactin increased significantly (P less than or equal to 0.01) during exercise in the diabetic group only. We conclude that, for the most part, the pituitary-testicular axis and nocturnal penile tumescence under basal conditions and the pituitary-testicular axis during moderate exercise are similar in healthy males and insulin-dependent diabetic males with normal sexual function.
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PMID:The pituitary-testicular axis at rest and during moderate exercise in males with diabetes mellitus and normal sexual function. 313 19

Complete normalization of the blood glucose concentration is the ideal goal in patients with diabetes. Because of deficiencies in therapeutic modalities for diabetes, achievement of approximation of normoglycemia is usually a satisfactory result. Generally, blood glucose ranges of 70 to 120 mg/dl preprandially and less than 160 to 180 mg/dl 90 minutes postprandially in nonpregnant patients with diabetes are considered appropriate. Diurnal variations in glycemia can be caused by the size and composition of meals, the time of day a meal is eaten, stress, and exercise. Self-monitoring of blood glucose by the patient and measurement of glycosylated hemoglobin have been useful in achieving control of diabetes.
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PMID:What is "tight control" of diabetes? Goals, limitations, and evaluation of therapy. 352 92


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