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)

Although insulin has been proposed to mediate the dietary regulation of pancreatic amylase, its interaction with diet in the regulation of amylase and lipase is not well understood and was examined in diabetic rats fed diets high in carbohydrate (HC), protein (HP), or fat (HF) and treated with insulin. Diabetes, independent of diet, decreased amylase content (97%; P < 0.0001) and mRNA (90%; P < 0.0001), but insulin only restored amylase content and mRNA to respective dietary control values. Diabetes, independent of diet, also increased lipase mRNA 1.6-fold (P < 0.004) but interacted (P < 0.0003) with diet on lipase content, resulting in opposite effects in HC- (increased 202%) and HF-diabetic rats (decreased 40%). Insulin partially restored lipase content and mRNA to respective dietary control values. Diet, independent of diabetes, regulated amylase content (P < 0.0001) and mRNA (P < 0.0003), which were three- to fourfold greater in HC- than in HF-fed rats, and lipase content (P < 0.001) and mRNA [rat pancreatic lipase 1 (rPL-1), P < 0.04; rPL-3, P < 0.0001], which were 1.8-fold greater in HF- than in HC- or HP-fed rats. Insulin failed to stimulate maximal amylase gene expression in HP- or HF-fed diabetic rats, suggesting that it is necessary, but not sufficient, for this dietary regulation. Differential regulation of lipase activity and mRNA by diet and insulin raises the possibility that lipase gene expression is regulated by a complex interaction of diet and insulin.
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PMID:Regulation of pancreatic amylase and lipase gene expression by diet and insulin in diabetic rats. 752 47

To elucidate the mechanism responsible for histological derangement of pancreas in diabetic patients, pure pancreatic juice (PPJ) aspirated directly from pancreatic duct was analyzed before and after strict glycemic control on poorly controlled diabetic patients without clinical exocrine pancreatic dysfunction. PPJ obtained from 18 diabetics showed a significantly decreased amylase activity compared with ten healthy subjects (109 +/- 4 versus 168 +/- 9 U/mg protein, p < 0.005) in spite of negligible changes in lipase activity, protein concentration, bicarbonate concentration, and its volume. PPJ showed higher concentrations of prostanoids in diabetic patients than in healthy subjects (TXB2, 259 +/- 48 versus 118 +/- 30 pg/mL, p < 0.05; 6-keto-PGF1 alpha, 52.6 +/- 11.5 versus 38.5 +/- 7.5 pg/mL, p > 0.05). Ratio of 6-keto-PGF1 alpha/TXB2 of PPJ in diabetic patients was significantly lower than in healthy subjects (0.195 +/- 0.016 versus 0.422 +/- 0.041, p < 0.005). After strict glycemic control for 1-3 months on nine of 18 diabetic patients, amylase activity of PPJ was significantly higher than that before the control (112 +/- 4 versus 128 +/- 7 U/mg protein, p < 0.01), but still significantly lower than that of healthy subjects (p < 0.005). Lipase activity showed no significant difference between before and after the control. TXB2 and 6-keto-PGF1 alpha concentrations were decreased.(ABSTRACT TRUNCATED AT 250 WORDS)
J Diabetes Complications
PMID:Subclinical exocrine pancreatic derangement in human diabetic patients evaluated from pure pancreatic juice. 754 Dec 59

To determine the mechanisms of increase in plasma triacylglycerol concentrations after high dietary intakes of carbohydrates, 10 men with non-insulin-dependent diabetes mellitus (NIDDM) were fed an isoenergetic high-carbohydrate diet (55% of energy as carbohydrate and 30% as fat) and a high-monounsaturated-fat diet (45% of energy as fat and 40% as carbohydrates) for 6 wk in a randomized, crossover manner. The high-carbohydrate diet raised fasting plasma triacylglycerol concentrations by 26% (P = 0.007) but did not affect postheparin lipoprotein lipase (P = 0.2) or hepatic lipase activities (P = 0.9). The oral-fat-tolerance test labeled with retinyl palmitate also revealed no differences in postprandial plasma triacylglycerol (P = 0.37) or retinyl palmitate clearances (P = 0.34) between the two diets. We conclude that the increase in plasma triacylglycerol concentrations with high-carbohydrate diets in men with NIDDM is not due to reduced lipolysis or diminished postprandial clearance of triacylglycerol-rich lipoproteins but is primarily due to increased hepatic secretion of very-low-density-lipoprotein triacylglycerols.
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PMID:Mechanisms of increase in plasma triacylglycerol concentrations as a result of high carbohydrate intakes in patients with non-insulin-dependent diabetes mellitus. 757 48

To establish a new experimental model of chronic pancreatitis (CP) with diabetes, we investigated pancreatic endocrine function, blood flow, and histopathology in CP induced by repetition of cerulein injection plus water immersion stress in rats. CP rats were treated with water immersion stress for 5 hr and two intraperitoneal injections of 20 micrograms/kg body weight of cerulein once a week for 16 weeks. In the CP group, pancreatic contents of protein, amylase, elastase, and lipase significantly decreased to 64, 38, 23, and 68% of the control group, respectively. In oral glucose tolerance test (glucose 2 g/kg body wt), blood glucose level in the CP group was 212.1 +/- 97.8 mg/dl (mean +/- SD) at 30 min and was significantly higher than the control group (126.3 +/- 15.4 mg/dl)(P < 0.05). Two of seven rats in the CP group showed an obvious diabetic insulin in the CP group was 640.1 +/- 148.7 pM, significantly lower than in the control group (1133.4 +/- 242.0 pM)(P < 0.001). However, insulin content in the pancreas was 12.37 nmol/pancreas). In CP rats, winding and dilatation of surface blood vessels and gland atrophy were evident. Marked fibrosis, fatty changes, and destruction of lobular architecture were also demonstrated microscopically, although the structure of each pancreatic islet was preserved and each islet was fully stained with anti-insulin antibody. In the CP group, pancreatic blood flow by the hydrogen gas-clearance method was 197.6 +/- 33.0 ml/min/100 g, which was significantly less than the control group (276.2 +/- 19.1 ml/min/100 g) (P < 0.001). Thus, we conclude that the CP model induced by cerulein plus stress is a new CP model with diabetes in rats, in which the glucose tolerance was impaired without loss of insulin reserve.
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PMID:New chronic pancreatitis model with diabetes induced by cerulein plus stress in rats. 758 14

We have studied low density lipoprotein (LDL) subclass distribution in a group of male patients with non-insulin-dependent diabetes mellitus (NIDDM) and investigated its relationships to fasting and postprandial triglyceride (TG)-rich lipoproteins, insulin resistance, lipoprotein lipase (EC 3.1.1.3; LPL), hepatic lipase (EC 3.1.1.34; HL), lecithin:cholesterol acyl transferase (EC 2.3.1.43; LCAT) and cholesteryl ester transfer protein (CETP) activities. LDL was subfractionated by density gradient ultracentrifugation. Postprandial lipoproteins were measured after an oral fat load using retinyl palmitate as a marker for intestinal TG-rich lipoproteins. Hypertriglyceridaemic NIDDMs (HTG) had a preponderance of small dense LDL particles present in the plasma and reduced amounts of large buoyant species when compared to normotriglyceridaemic patients (NTG) and controls. Both groups of diabetics were more insulin resistant than the controls (P < 0.05) and had raised concentrations of proinsulin (P < 0.05), although insulin content did not differ significantly. 32-33 split proinsulin (SPI) was the major insulin-like molecule present in HTG and was present in significantly higher amounts in these patients (P < 0.05) than either NTG or control subjects and correlated significantly with the presence of small dense LDL particles. After a test meal, the postprandial chylomicron response was greater in HTG than either NTG diabetics or controls (P < 0.05). Chylomicron remnants were present to a greater extent in HTG than in NTG and controls (P < 0.05), although in this case NTG also contained more chylomicron remnants than control subjects (P < 0.05). There was no difference in the LPL activity, CETP and LCAT between diabetics and controls, whereas an increase in hepatic lipase activity was seen in the HTG diabetics (P < 0.05). Both CETP and LCAT activities increased postprandially. Multivariate analysis showed that TG, HDL content and HL activity were the most important determinants of small dense LDL concentration in the fasting state (R2 = 67%). Postprandially, chylomicron remnant clearance, HL and insulin resistance were the major determinants (R2 = 61%) of LDL-III.
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PMID:Fasting and postprandial determinants for the occurrence of small dense LDL species in non-insulin-dependent diabetic patients with and without hypertriglyceridaemia: the involvement of insulin, insulin precursor species and insulin resistance. 760 66

Ketonaemia is well documented as a consequence of prolonged starvation, acute alcoholism, and uncontrolled diabetes mellitus. However, its occurrence in acute pancreatitis has not been described. In this report, three patients who manifested ketoacidosis at the time of presentation of acute pancreatitis are described. In none of these patients could ketoacidosis be attributed to any of the well known pathogenetic factors such as ethanol, diabetes mellitus or prolonged starvation. In one patient, both the serum ketone titres and increased anion gap persisted for several days during the recovery period, despite appropriate therapy (including restriction of oral intake or nasogastric suction, intravenous fluids, and analgesic administration), before declining in parallel with a decrease in serum lipase levels, and became undetectable following near normalisation of serum lipase. Therefore, we believe that pancreatic ketosis or ketoacidosis may be a distinct syndrome with ketogenesis being promoted and maintained by extremely high circulating pancreatic lipase concentrations.
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PMID:Pancreatic ketoacidosis: ketonemia associated with acute pancreatitis. 770 90

A promising method for diabetes treatment is the implantation of immunoisolated cells secreting insulin in response to glucose. Cell availability limits the application of this approach at a medically-relevant scale. We explore the use of transformed cells that can be grown to large homogeneous populations in developing artificial pancreatic tissues. We also investigate the use of NMR in evaluating, non-invasively, cellular bioenergetics in the tissue environment. The system employed in this study consisted of mouse insulinoma beta TC3 cells entrapped in calcium alginate/poly-L-lysine (PPL)/alginate beads. The PPL layer imposed a molecular weight cutoff of approximately 60 kDa, allowing nutrients and insulin to diffuse through but excluding high molecular weight antibodies and cytotoxic cells of the host. We fabricated a radiofrequency coil that can be double-tuned to 1H and 31P, and an NMR-compatible perfusion bioreactor and support circuit that can maintain cells viable during prolonged studies. The bioreactor operated differentially, was macroscopically homogeneous and allowed the acquisitions of 1H images and 31P NMR spectra in reasonable time intervals. Results indicated that entrapment had little effect on cell viability; that insulin secretion from beads was responsive to glucose; and that the bioenergetics of perfused, entrapped cells were not grossly different from those of cells never subjected to the immobilization procedure. These findings offer promise for developing an artificial pancreatic tissue for diabetes treatment based on continuous cell lines.
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PMID:Towards the development of a bioartificial pancreas: immunoisolation and NMR monitoring of mouse insulinomas. 776 50

High density lipoprotein (HDL) subfractions (2b, 2a, 3a, 3b, and 3c) separated by gradient gel electrophoresis (GGE) and defined by Gaussian summation analysis, and the compositions of HDL2 and HDL3, separated by preparative ultracentrifugation, were studied in four groups of men with or without non-insulin-dependent diabetes mellitus (NIDDM) and coronary artery disease (CAD): group 1 (DM+CAD+, n = 50); group 2 (DM-CAD+, n = 50); group 3 (DM+CAD-, n = 50); and group 4 (DM-CAD-, n = 31). HDL GGE subfraction distributions, available in 125 subjects, were not significantly different among the groups. In contrast, dividing the whole study population into quartiles of serum triglyceride (TG) concentration showed that high TG levels were significantly associated with low HDL2b and high HDL3b concentrations. In a multivariate linear regression model, postheparin plasma hepatic lipase (HL) activity, and fasting serum insulin and TG concentrations were all associated independently and inversely with low HDL2b, but lipoprotein lipase or cholesteryl ester transfer protein activities were not correlated with HDL2b concentrations. Group 1 tended to have the smallest mean particle sizes in the HDL subfractions, significantly (P < 0.03, CAD vs. non-CAD) for HDL2b and for HDL2a. These differences were independent of TG, insulin and HL, but lost their significance when adjusted for beta-blocker therapy. Both HDL2 and HDL3 particles in group 1 were significantly depleted of unesterified cholesterol, and their HDL2 was TG-enriched (P = 0.053). A high HL activity, hyperinsulinemia and hypertriglyceridemia are independently associated with low levels of HDL2b and generally small HDL particle size. HDL particles in subjects with NIDDM and CAD are small-sized and have a low free cholesterol content. Both these characteristics may be markers of impaired reverse cholesterol transport.
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PMID:High density lipoprotein subfractions in non-insulin-dependent diabetes mellitus and coronary artery disease. 777 69

The pancreas is frequently involved during HIV infection, especially by disseminated infections or neoplasms. These lesions are generally asymptomatic and are discovered at autopsy. However, hypoglycaemia secondary to massive pancreatic infiltration by a tumour or tuberculous necrosis may occur. The most important cause of pancreatic dysfunction in HIV-infected patients is a drug toxic effect (intravenous pentamidine, didanosine, zalcitabine). Hypoglycaemia, which may or may not be followed by diabetes, can develop during intravenous pentamidine therapy. In cases with increased serum amylase and/or lipase levels, potentially toxic drugs must be promptly discontinued to avoid major pancreatic involvement.
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PMID:Pancreatic lesions in HIV-infected patients. 781 Dec 27

In dealing with a lethal disease such as cancer of the pancreas, an all out attack is necessary for an early lesion. The general trend seems to be toward radical en bloc resections, usually, but not always, with a total pancreatectomy. A digestive supplement with a higher proportion of lipase provides better nutrition. Diabetes can be controlled in patients with no pancreas. Reports of long-term survivors should be better documented as to details of previous reporting, care, procedure and pathology.
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PMID:Survival 13 years after pancreatectomy for ductal adenocarcinoma of the head of the pancreas. 807 95


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