Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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

Acarbose is an alpha-glucosidase inhibitor proposed for the treatment of diabetic patients. It acts by competitively inhibiting the alpha-glucosidases in the intestinal brush border. The principal action of these enzymes is to convert nonabsorbable dietary starch and sucrose into absorbable monosaccharides (e.g. glucose). Enzyme inhibitors delay this conversion, slowing the formation and consequently the absorption of monosaccharides, and thus reducing the concentration of postprandial blood glucose. Both starch and sucrose are influenced, whereas lactose and glucose are not. Many studies in experimental animals, healthy volunteers and patients with non-insulin-dependent diabetes mellitus (NIDDM) have shown that acarbose decreases postprandial blood glucose, with a lesser reduction of fasting blood glucose, plasma triglycerides and postprandial insulin levels. In long term studies in NIDDM patients, acarbose significantly reduced glycosylated haemoglobin levels. Acarbose is only minimally absorbed from the gut and no systemic adverse effects have been demonstrated after long term administration. The drug allows undigested carbohydrates to pass into the large bowel where they are fermented causing flatulence, bloating and diarrhoea. These symptoms, which occur in approximately 30 to 60% of patients, tend to decrease with time and seem to be dose-dependent. They are minimised by starting therapy with low doses (such as 50mg 3 times daily) which may be effective in many patients. An increase in serum hepatic transaminases observed in earlier studies in the US, where doses of acarbose up to 900mg daily were used, has been not reported with the lower doses of the drug actually recommended [150 to 300mg (up to 600mg) daily]. In conclusion, acarbose may be useful in patients with NIDDM when diet alone is no longer able to maintain satisfactory blood glucose control. Furthermore, it may be a valid alternative to sulphonylurea or biguanide therapy when these drugs are contraindicated and insulin administration may be delayed. Acarbose seems also to be a useful adjunct to hypoglycaemic oral agents but its precise role in this field has not been fully clarified.
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PMID:A risk-benefit appraisal of acarbose in the management of non-insulin-dependent diabetes mellitus. 772 53

From Jan. 1987-Jun. 1993, 37 cases of insulin dependent diabetes mellitus (IDDM) pregnant women and 10 gestational diabetes mellitus (GDM) mothers requiring regular insulin (RI) treatment during pregnancy were recruited. A comparative study of the daily RI requirement was carried out in women breast-feeding (BF) or not (non-BF) at different periods: before pregnancy, during gestation, postpartum and at present. Results showed no difference of RI requirement between BF and non-BF groups before pregnancy, during gestation and currently, but a significant decrease of RI requirement (P < 0.05) among BF mothers in postpartum period. Of the 10 GDM cases, 3 of them who did not breast feed their babies required further RI for 4-7 days in the postpartum period, whereas 7 BF mothers did not need any RI after delivery with blood glucose levels remaining within normal range. Based on the above analysis one may conclude that BF can reduce the RI requirement of IDDM and GDM mothers in the postpartum period. It is thought that more energy is needed in the process of producing milk, and serum glucose is the main substance for lactose synthesis, thus blood glucose level of BF mother is decreased, and so is the RI requirement. Therefore, mothers with diabetes mellitus are encouraged to breast feed their babies.
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PMID:[Breast-feeding in reducing regular insulin requirement in postpartum for insulin dependent diabetes mellitus and gestational diabetes mellitus]. 808 26

Galactose usually is ingested as lactose, which is composed of equimolar amounts of glucose and galactose. The contribution of galactose to the increase in glucose and insulin levels following ingestion of equimolar amounts of galactose and glucose, or lactose, has not been reported in people with non-insulin-dependent diabetes mellitus (NIDDM). Therefore, we studied the effects of galactose ingestion alone, as well as with glucose either independently or in the form of lactose, in subjects with untreated NIDDM. Eight male subjects with untreated NIDDM ingested 25 g glucose, 25 g galactose with or without 25 g glucose, or 50 g lactose as a breakfast meal in random sequence. They also received 50 g glucose on two occasions as a reference. Water only was given as a control meal. Plasma galactose, glucose, glucagon, alpha-amino nitrogen (AAN), nonesterified fatty acids (NEFA), and serum insulin and C-peptide concentrations were determined over a 5-hour period. The integrated area responses were quantified over the 5-hour period using the water control as a baseline. Following ingestion of 25 g galactose, the maximal increase in plasma galactose concentration was 1 mmol/L. The mean maximal increases in plasma galactose concentration following ingestion of 25 g galactose + 25 g glucose or following 50-g lactose meals were similar and were only 12% of that following ingestion of galactose alone (P < .05). The mean galactose area response over the water control for the 25-g galactose meal was 0.95 +/- 0.31 mmol.h/L.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of glucose, galactose, and lactose ingestion on the plasma glucose and insulin response in persons with non-insulin-dependent diabetes mellitus. 824 70

Diabetes may affect the secretion of prolactin, the principal lactogenic hormone. Because adequate amounts are critical to the establishment of lactation, we assessed the prolactin status of 33 women with insulin-dependent diabetes mellitus (IDDM), 33 women without diabetes, and 11 reference women participating in a study of lactation from 2 to 84 d postpartum. Circulating concentrations of serum prolactin declined temporally for all women and did not differ significantly among any of the groups. During the first postnatal week, milk immunoreactive prolactin concentrations were lower for women with IDDM than for control and reference women and the inverse relationship between lactose and milk prolactin, which was significant at day 2 postpartum for reference women, was delayed until day 14 postpartum for women with IDDM. Early breast-feeding activity, increased breast-feeding frequency, and good glycemic control enhance prolactin secretion and should be promoted during lactation in women with IDDM.
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PMID:Prolactin concentrations in serum and milk of mothers with and without insulin-dependent diabetes mellitus. 831 89

Breast milk lactose, total nitrogen, conductivity, osmolality, and intake by infants of 33 women with insulin-dependent diabetes mellitus (IDDM), 33 control women without diabetes, and 11 reference women were determined in a 3-mo study of lactation. Milk of women with IDDM had significantly lower lactose and higher total nitrogen (2-3 d postpartum), and their infants had significantly less milk intake (7-14 d postpartum) than did control or reference women. Total nitrogen was negatively correlated with milk lactose for women with IDDM at all times and for control women through day 14 postpartum. The data indicate delayed lactogenesis for women with IDDM, which was more likely to occur with poor metabolic control. Differences in milk composition of women with IDDM do not preclude them from breast-feeding their infants.
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PMID:Delayed lactogenesis in women with insulin-dependent diabetes mellitus. 831 90

The composition of macro- and micronutrients in milk from six patients with tightly controlled insulin-dependent diabetes mellitus [median glycosylated hemoglobin concentrations at parturition of 5.2% (range 4.9-5.3%, reference range 4.9-6.6%) and 6 wk thereafter of 6.1% (range 5.0-6.3%, reference range 5.0-6.4%) was compared with that from five control subjects. Milk samples were collected halfway through a single breast-feeding at days 3-5 (colostrum); 7, 9, and 10 (transitional milk); and 12, 15, 17, 21, 25, 29, and 35 (mature milk). We found no abnormalities in macronutrient (triglycerides, lactose, and protein), cholesterol, glucose, and myoinositol concentrations or fatty acid composition. Two of three longitudinally studied patients showed rather constant ratios between glucose concentrations in milk and capillary blood. The present data suggest that tight control corrects a multitude of milk abnormalities associated with moderate and poor control.
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PMID:Milk of patients with tightly controlled insulin-dependent diabetes mellitus has normal macronutrient and fatty acid composition. 850 65

The effects of a clinically used purified micronized flavonoid fraction (S5682) containing 90% diosmin and 10% hesperidin on increased microvascular permeability induced by histamine, bradykinin and leukotriene B4 (LTB4) were investigated by intravital microscopy in the cheek pouch preparation of diabetic hamsters. We also investigated the effects of S 5682 on macro- molecular permeability increase and leukocyte adhesion during ischemia-reperfusion using the same preparation. Diabetes was induced by an intraperitoneal injection of streptozotocin (50 mg/kg). S 5682, suspended in 10% lactose solution, or vehicle (10% lactose) was administered orally for 25 days at 20 mg/kg/day (10 mg/kg twice a day), starting 5 days after the streptozotocin injection. Fluorescein isothiocyanate-labelled dextran (molecular weight 150,000) was given intravenously, 30 min after completion of the cheek pouch preparation. The leukocytes were stained by continuous intravenous infusion of acridine orange (0.5 mg/ kg/min). Histamine (2 microMs), bradykinin (1 microM), and LTB4 (0.01 microM), applied topically for 5 min, increased the number of fluorescent vascular leakage sites in postcapillary venules. A temporary ischemia (duration: 30 min) with total circulatory arrest of the cheek pouch was obtained by clamping the neck of the everted pouch. The maximum number of leaky sites (per cm2 in the prepared area) which occurs either at 5 min after the beginning of each topical application or 10 min after the onset of reperfusion was quantified in UV light microscopy. The results from 60 animals divided into ten groups of 6 animals each are presented as means +/- SEM. In comparison with vehicle, S 5682 significantly inhibited the macromolecular permeability increasing the effect of histamine (343.8 +/- 18.5 vs. 91.0 +/- 8.2 leaks/ cm2; p > 0.001), bradykinin (347.0 +/- 14.6 vs. 110.3 +/- 8.5 leaks/cm2; p < 0.001) and LTB4 (323.0 +/- 15.5 vs. 161.3 +/- 13.8 leaks/cm2; p < 0.001). At reperfusion, after 30 min ischemia, S 5682 significantly decreased the observed macromolecular permeability (168.5 +/- 19.7 vs. 52.7 +/- 6.3 leaks/cm2; p < 0.01). Flavonoid-treated animals also tended to have a lower number of leukocytes adhering to the venular endothelium (104.8 +/- 11.0 vs. 75.8 +/- 9.7/6 mm2; p > 0.05). These results demonstrate that oral administration of S 5682 for 25 days at 20mg/kg body weight/day has a protective effect on leakage of macromolecules after application of permeability-increasing substances and during ischemia-reperfusion in the cheek pouch microvasculature of diabetic hamsters. In conclusion, the present data illustrating the inhibitory effect of a clinically relevant doses of S 5682 on the inflammatory processes induced in this in vivo model of microcirculation may serve as a rational basis to explain its clinical efficacy.
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PMID:Effects of oral administration of purified micronized flavonoid fraction on increased microvascular permeability induced by various agents and on ischemia/reperfusion in diabetic hamsters. 872 38

The hypoglycemic effect and the alpha-glucosidase activity inhibition of acarbose (AC:alpha-glucosidase inhibitor) were investigated in normal and KK-Ay mice, an animal model of noninsulin-dependent diabetes mellitus (NIDDM). AC improved hyperglycemia after an oral administration of maltose or sucrose, dose dependently in normal mice (1, 10, and 50mg/kg body weight) and in KK-Ay mice (50mg/kg). Furthermore, AC (50mg/kg) significantly inhibited maltase and sucrase activities in the small intestines of normal and KK-Ay mice (inhibitory efficacy: sucrase > maltase). The enzymatic inhibition in KK-Ay mice is stronger than in normal mice. However, AC (50 mg/kg) did not suppress the blood glucose in oral lactose tolerance and did not inhibit the lactase activity in either normal or KK-Ay mice. These findings indicate that the AC effect on the inhibition of alpha-glucosidase activity is selective for sucrase and maltase in normal and NIDDM mice.
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PMID:Effect of acarbose (alpha-glucosidase inhibitor) on disaccharase activity in small intestine in KK-Ay and ddY mice. 974 58

Fructo-oligosaccharides (FOS) are soluble fibres which exert various effects in the gastrointestinal tract, and induce metabolic and endocrine changes. The effects are favourable in diabetes mellitus, and may be favourable in veal calves, which during late periods of fattening often develop hyperglycemia, glucosuria and insulin resistance, especially during high lactose intake. Based on this we have studied metabolic, endocrine and haematological traits in veal calves (Simmental x Red Holstein) fed FOS (10 g/day; group GrF) or no FOS (group GrC). Whole milk and milk replacer in both groups, on a kg body weight basis, were fed in identical amounts. Experiments, lasting for 3 weeks, started when calves were 10 weeks old and weighed 117 kg. During week 3 lactose was supplemented to enhance post-absorptive glucose loads. Feed intakes were similar in both groups, but weight gain tended to be higher in GrF than GrC. The post-prandial increase of glucose concentrations was significantly smaller, of lactate tended to be smaller, and growth hormone peak frequency tended to be lower, whereas maximal insulin concentrations reached post-prandially were significantly higher in GrF than GrC. Eosinophil granulocytes increased during FOS feeding. In conclusion, FOS had basically similar effects on metabolic and endocrine traits in veal calves as in animals and humans with diabetes mellitus, but changes were small, albeit more prominent after lactose loads.
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PMID:Fructo-oligosaccharide supplementation: effects on metabolic, endocrine and hematological traits in veal calves. 1084 59

The initiation of lactation (lactogenesis II) by the mother must be synchronized to the delivery of the infant, permitting the transition of the newborn from continuous nourishment from the umbilical cord to comparable but intermittent life support from its mother's breasts. The onset of lactogenesis II can be adversely affected by a variety of factors. Over 80% of women who have delivered prematurely and are expressing milk for their infant had a compromised initiation of lactation, that is one or more lactogenesis II markers (lactose, citrate, sodium and total protein) in their milk > 3 SD from the mean of the full-term women on d 5 postpartum. Similarly, the lactogenesis II markers (lactose, citrate and total nitrogen) in the milk of women with insulin-dependent diabetes mellitus take an additional 24 h to attain the concentrations of normal women. The mechanisms that lead to the development of delayed or compromised onset of lactogenesis II in women are poorly understood and require additional research.
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PMID:Lactogenesis and the effects of insulin-dependent diabetes mellitus and prematurity. 1169 39


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