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

Type 1 diabetes mellitus is frequently associated with autoimmune thyroid disease (ATD).Genetic susceptibility for autoantibody formation in association with ATD and type 1 diabetes mellitus has been described with varying frequencies, but there is still debate about its prevailing situation in Iran. We have therefore investigated the prevalence of anti-thyroid peroxidase (anti-TPO) and anti thyroglubolin (Anti TG) antibodies in type 1 diabetic patients, and compared the effect of age and sex on the thyroid autoimmunity in patients with type 1 diabetes mellitus in Iran.Ninety one subjects with type 1 diabetes mellitus and one hundred and sixty three unrelated normal controls under the age of thirty years were recruited for the detection of anti-TPO and anti-TG. Radio Immuno Assay and chemiluminescence methods were used for anti-TPO and anti-TG detection respectively.Among 91 type 1 diabetic patients, 36 (39.6%) were positive for anti-TPO and 27(30%) were positive for antiTG. Anti-TPO antibodies were detected only in 6.7% of control group. Comparing with those without thyroid autoimmunity, there was a female preponderance for the type 1 diabetic patients with thyroid autoimmunity (female: male, 28:14 vs. 28:20 respectively). Among the type 1 diabetic patients those with thyroid autoimmunity, tended to be older (p: 0.04) and to have higher TSH concentration (p: 0.03). Patients with high anti-TPO levels had longer duration of diabetes (P: 0.02).The presence of anti-TPO in 39.6% of our type 1 diabetic patients comparing with 8.5% of normal subjects confirmed the strong association of ATD and type 1 diabetes mellitus.
Iran J Allergy Asthma Immunol 2008 Mar
PMID:Thyroid function and anti-thyroid antibodies in Iranian patients with type 1 diabetes mellitus: influences of age and sex. 1832 10

Dependence is an unusual, but potentially serious complication of corticosteroid use. Two cases of prednisone dependence are reviewed; the first involving a patient with inflammatory orbital pseudotumor who developed a dependent pattern of prednisone use that persisted years after the resolution of the acute episode. The second case involves a patient with factitious disorder who attempted to obtain corticosteroids from multiple clinicians, despite the absence of any clinical indication for them, manipulating elements of her medical history to influence the prescription of corticosteroids. Both patients exhibited tolerance and withdrawal symptoms, and both developed serious systemic effects from the corticosteroids, including cataracts, diabetes mellitus, and cushingoid signs. Both patients also exhibited dependence upon other substances. A MEDLINE search was conducted, and the case literature regarding corticosteroid dependence was reviewed. Twenty-six cases of potential corticosteroid dependence were identified, and 22/26 (85%), retrospectively, met criteria for DSM-IV substance dependence involving corticosteroids. Prednisone was the most frequently implicated corticosteroid, but cases involving ACTH, cortisone, and high-dose inhaled dexamethasone and beclomethasone were also identified. Asthma was the most common underlying medical condition for which the corticosteroids were prescribed, but a variety of allergic and inflammatory conditions were also reported. Corticosteroids may induce dependence based on their propensity to induce euphoria as well as a characteristic withdrawal syndrome, in addition to directly influencing reward circuitry. Clinicians should be aware of the possibility of prednisone dependence when confronted with patients who exhibit vigorous insistence on corticosteroids out of proportion to objective signs and symptoms of inflammation.
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PMID:Drug dependence involving prednisone: two cases and a review of the literature. 1836 78

To better understand risk factors associated with current asthma in a low-income, ethnically diverse population, we analyzed pooled data from the 2004-2006 Behavioral Risk Factor Surveillance System survey conducted in Salinas, CA. We were particularly interested in modifiable risk factors, as the survey was conducted as part of a large community-based intervention that addresses asthma, obesity, and diabetes. We also conducted semi-structured interviews with key informants involved with the clinical, school, and community aspects of the intervention to inform the intervention's progress, and adapt practices and programs to reach those most in need. Of the 4925 adults in this analysis, 51% were Mexican-American and 32% lacked a high-school diploma; 227 women and 84 men had current asthma, and 194 were parents of children with current asthma; prevalences of 7.7%, 4.3%, and 7.0% respectively. Over 20% of women and men with asthma were current smokers and/or exposed to passive smoking, more than 50% reported less than the recommended 60 minutes or more of physical activity per day, and approximately 40% were obese or morbidly obese (42% of women and 36% of men compared to 26% of adults without asthma). Two of the strongest modifiable risk factors associated with current asthma and identified by the stepwise multiple regression models were: could not afford prescription medication(s) in the past 12 months (OR 2.5, p < 0.001 for adults with asthma, OR 1.8, p < 0.01 for parents of children with asthma) and morbid obesity (OR 3.4, p < 0.001 for adults with asthma). Among adults who reported one or more episodes of asthma in the past 30 days, 28% of women and 30% of men had not used a preventive medication, and 48% of women and 57% of men had not used a prescription asthma inhaler (20% had not used either). This study adds to the scarce body of literature on the prevalence of asthma and related risk factors in a predominately Mexican-American, semi-rural community, and illustrates how survey and key informant data can enhance knowledge of local study populations and guide interventions to improve asthma control and treatment.
J Asthma 2008 Sep
PMID:Evaluation of risk factors and a community intervention to increase control and treatment of asthma in a low-income semi-rural California community. 1877 28

Thromboembolic, cardiovascular and cerebrovascular events are age-dependent. They are extremely rare in young women. In contrast to the progestogen-only pills, oral contraceptives (OC) increase the risk of venous thrombosis. However, decisive ist the genetic predisposition. In healthy non-smokers of less than 35 years of age, the risk to suffer from a myocardial infarction or a cerebrovascular accident is not increased by OC. Risk factors play a major role in the etiology of cardiovascular diseases. A detailed personal and family history is therefore mandatory before OC are prescribed. Very rarely, blood pressure is increased by OC. Although the incidence of such an increase is very low, blood pressure has to be measured regularly in pill users. Inspite of a current opinion, weight increase is rare in OC users. It depends mainly on the individual predisposition. An increased water retention can be reduced by a combined OC containing a progestagen with an antimineralocorticoid activity. Changes in insulin and blood sugar induced by low-dose OC are minimal so that they have no clinical relevance. OC do not increase the incidence of diabetes. Adrenal and thyroid function are not influenced by OC, there is no increased incidence of prolactinomas. Asthma is no contraindication against OC. If there is a cycle-dependent aggravation of the disease, OC might be beneficial. OC have no side-effects on the eye or the ear. In women suffering from lupus erythematodes having no renal participation, no increased antiphospholipid-antibodies and showing a stable or inactive disease, low-dose OC might be used.
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PMID:[Contraception in women with special problems]. 1918 Apr 32

Insulin dependent diabetes mellitus (IDDM) results from irreversible loss of beta cells (beta-cells) of the pancreas. A Streptozotocin (STZ)-induced diabetes in animal model mimics, in some aspects, recent onset IDDM. This study was conducted to investigate the effect of nicotinamide on experimentally-induced IDDM. Thirty Spraque Dawley rats were divided into 3 groups; a control group, a diabetic group which received an intraperitoneal (i.p.) injection of 55 mg/kg STZ and a nicotinamide group (1g/kg/day) which were dosed orally for 3 days followed by (i.p.) STZ (55 mg/kg) with the nicotinamide treatment continuing for an additional 14 days. Rats receiving STZ became diabetic after 2 weeks. This diabetic group showed hyperglycemia, and a very low level of C-peptide. Furthermore, pancreatic islets exhibited increased nitric oxide (NO) production together with an increased apoptotic index (as detected by TUNEL and electron microscopy). Nicotinamide treatment prevented STZ-induced diabetes, it also antagonized an increase in NO, and inhibited beta-cell apoptosis. Fasting blood glucose, serum insulin and serum C-peptide were all within the normal range in the nicotinamide group. The nicotinamide protection of beta-cells may be facilitated via inhibition of apoptosis and nitric oxide generation. It is suggested that nicotinamide might be considered an effective agent for the prevention and treatment of IDDM in prediabetic, and early stages, of IDDM.
Iran J Allergy Asthma Immunol 2009 Mar
PMID:Effect of nicotinamide on experimental induced diabetes. 1927 54

Ritonavir and atazanavir (ATZ) are protease inhibitors (PI) that inhibit the P450 3A4 cytochrome. They are used together to boost ATZ levels and reduce pill burden in human immunodeficiency virus infection, but association with medications metabolized by this cytochrome can cause serious adverse effects. Several cases of Cushing's syndrome have been reported when patients received inhaled therapy with fluticasone for asthma, sometimes complicated by secondary adrenal failure after stopping fluticasone. We report a case of Cushing's syndrome associated with onset of diabetes mellitus in a patient treated with boosted PI (ATZ and ritonavir) for HIV 2 (CD4360/ml). Asthma was treated with inhaled fluticasone 1500mug/day for several months that was stopped at admission. A few days later, typical secondary adrenal failure developed and was confirmed by dosage of cortisol and ACTH, both low. Hydrocortisone replacement treatment resulted in rapid improvement of symptoms. Diabetes was initially treated with insulin then sulfonyluraes, but repeated hypoglycemias lead to diet alone. Physicians should be aware of the potential danger of the association of "boosted" IP and some kind of inhaled corticotherapy.
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PMID:[Iatrogenic Cushing's syndrome, diabetes mellitus and secondary adrenal failure in a human immunodeficiency virus patient treated with ritonavir boosted atazanavir and fluticasone]. 1941 10

Over the last few decades, inhaled corticosteroids (ICs) became the cornerstone in the treatment of persistent asthma. Their use improved asthma control, decreased mortality and also minimized adverse reactions associated with systemic steroid. Esophageal candidiasis is a rare complication resulting from the use of ICs. Although, in recent years, as their prescriptions has increased, more cases have been reported, especially in Japan. Listed are 4 case reports regarding esophageal candidiasis in asthmatic patients associated with inhaled budesonide administration. In the cases reported herein, the use of a different device of dry powder budesonide might have favored esophageal drug deposition and Candida infection. Patients denied using systemic corticosteroids in the previous 6 months. Furthermore, none of the patients presented Diabetes mellitus, malignant disease, HIV infection, or other immunosuppressive conditions. We conclude that patients treated with high doses of ICs are at higher risk of developing esophageal candidiasis. These patients should undergo upper gastrointestinal endoscopy whenever they present symptoms. Nevertheless, we must keep in mind that infection might also be asymptomatic and esophageal candidiasis prevalence may be higher than that reported thus far.
J Asthma 2009 May
PMID:Esophageal candidiasis--an adverse effect of inhaled corticosteroids therapy. 1948 77

The PedsQL Measurement Model was designed as a modular approach to measuring pediatric health-related quality of life, and developed to integrate the relative merits of generic and disease-specific approaches. The PedsQL 4.0 Generic Core Scales have been translated into over 60 languages, with published data on over 25,000 children and adolescents in more than 75 peer-reviewed journals since 2001 for healthy children and numerous pediatric chronic health conditions. The PedsQL Disease and Condition-Specific Modules were designed to measure health-related quality-of-life dimensions specifically tailored for pediatric chronic health conditions, and include the PedsQL Asthma, Arthritis/Rheumatology, Cancer, Diabetes, Cardiac and Cerebral Palsy Modules, as well as the generic PedsQL Multidimensional Fatigue Scale, Pediatric Pain Questionnaire, Family Impact Module and Healthcare Satisfaction Module. The PedsQL has demonstrated reliability, validity, sensitivity and responsiveness for child self report for ages 5-18 years and parent proxy report for ages 2-18 years. The PedsQL has been shown to be related to other key constructs in pediatric healthcare such as access to needed care, healthcare barriers and quality of primary care. Future advances in the PedsQL() Measurement Model include web-based electronic administration (ePedsQL), integration into the electronic medical record, further efficacy and effectiveness outcome trials, including PedsQL ResourceConnect(SM) and PedsQL TIPS(SM), the development of the generic PedsQL Infant Scales for ages birth to 24 months and disease and condition-specific modules for other pediatric chronic health conditions.
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PMID:The PedsQL as a pediatric patient-reported outcome: reliability and validity of the PedsQL Measurement Model in 25,000 children. 1980 13

Diabetes mellitus (DM) has been found to be associated with cardiovascular disease. The goal of this study is to evaluate the prevalence of asthma in patients with type II DM after adjusting for other comorbid conditions. We used patient treatment files of inpatients' admissions containing discharge diagnosis (Classification of Mental and Behavioural Disorders (ICD)-9 codes) from Veterans Health Administration Hospitals. The patients were divided into two groups: ICD-9 code for DM and a control group with hypertension but no DM. ICD-9 codes for asthma were used to study the prevalence of asthma in DM patients versus the control. We performed uni- and multi-variable analysis adjusting for comorbid conditions. Asthma was present in 13 242 (4.5%) of DM patients versus 16 038 (2.9%) in the control group. Using multi-variable analysis, DM remained independently associated with asthma (odds ratio: 2.99; confidence interval: 2.92-3.06; P < 0.0001). The prevalence of asthma is significantly higher in hospitalized patients with type II DM independent of other comorbid conditions. The pathogenesis of this association is not known warranting further investigation.
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PMID:The occurrence of asthma in hospitalized patients with type 2 diabetes mellitus. 2063 36

Little is known about the general healthcare needs of detainees in police custody. The aims of this study were to: determine the level of general health issues, diseases and/or pathology for detainees in police custody, and to determine how well those general health issues, diseases and/or pathology are being managed. This was done by a detailed analysis of healthcare issues of a cohort of detainees and reviewing intended and prescribed medication needs with current medication availability. In August 2007, a prospective detailed, anonymised, structured questionnaire survey was undertaken of 201 detainees in police custody in London, UK. Of these 83.6% consented to participate in the study. 85.1% of subjects were male; mean age was 33.9 years; 70.8% had English as a first language; 13.7% were of no fixed abode; 70.2% were registered with a general practitioner (primary care physician); 25% were already in contact with other healthcare teams; 7.1% had previously been sectioned under the Mental Health Act 1983; 16.7% had previously intentionally self-injured; 33.9% were dependent on heroin, 33.9% on crack cocaine; 25% on alcohol, 16.6% on benzodiazepines and 63.1% on cigarettes. 56% of subjects had active medical conditions; of those with active medical conditions 74% were prescribed medication for those medical conditions; only 3/70 had their medication available. 28/70 were not taking medication regularly, and many were not taking it at all. Three subjects who had deep vein thromboses were not taking their prescribed anticoagulants and six subjects with severe mental health issues were not taking their anti-psychotic medication. Mental health issues and depression predominated, but there was a very large range of mixed diseases and pathology. Asthma, epilepsy, diabetes, deep vein thrombosis, pulmonary embolism, hepatitis, and hypertension were all represented. The study has achieved its aims and has also shown that--in part because of the chaotic lifestyle of many detainees--appropriate care was not being rendered, thereby, putting both detainee, and potentially others coming into contact with them, at risk.
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PMID:Healthcare issues of detainees in police custody in London, UK. 2008 45


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