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

To study the effects of improved control of blood glucose on markers of renal glomerular and tubular function, we initially determined, by radioimmunoassay technics, urinary excretion rates of albumin and beta2 microglobulin in 17 nondiabetic subjects and in 43 insulin-dependent, clinically nonproteinuric diabetic patients. Duration of diabetes ranged from six months to 39 years, and the patients were studied while receiving conventional therapy. Mean urinary albumin excretion was significantly elevated in the diabetics, but beta2-microglobulin excretion rates were not different from those of the controls, suggesting that the increased albumin excretion was due to increased transglomerular loss of albumin. Seven patients with long-term diabetes (duration of six to 33 years), selected because of elevated albumin excretion, were studied before and during a continuous, subcutaneous insulin infusion for a period of one to three days. Urinary albumin excretion was significantly reduced during the insulin infusion, but mean beta2-microglobulin excretion did not change. Strict control of blood glucose, even in the short term, may reverse a functional renal abnormality in long-duration, insulin-dependent diabetes.
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PMID:Effect of control of blood glucose on urinary excretion of albumin and beta2 microglobulin in insulin-dependent diabetes. 8 36

A study was made of 52 patients with lichen planus. Abnormal oral glucose tolerance was found in 19 (36%), including 5 with overt diabetes. The criteria for abnormality were based on an age-related score method. A family history of diabetes was found to be present in 14 (26%). The most common abnormality observed in the glucose tolerance test was an elevation of the blood glucose level 2 hours after administration of the glucose. These results further support the supposition of a disorder in carbohydrate metabolism associated with lichen planus.
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PMID:Abnormal glucose tolerance associated with lichen planus. 8 97

To determine whether abnormalities of lipid and aminoacid metabolism observed in diabetes are corrected when plasma-glucose levels are restored to normal, eight insulin-dependent diabetics were treated for 7-14 days with a portable infusion pump which delivers insulin subcutaneously in basal (between-meal) doses with pulse-dose increments before meals. Mean plasma-glucose (206 +/- 24 mg/dl during conventional insulin treatment) fell to 89 +/- 3 mg/dl at day 7 and 84 +/- 2 mg/dl at day 14 of pump treatment; glycosuria was eliminated. Plasma cholesterol, triglycerides, and free fatty acids were elevated during conventional insulin treatment but fell to normal after 7 days of pump treatment. Plasma-levels of branched-chain aminoacids were 50-60% above control levels during conventional treatment but fell to normal after 7 days of pump therapy. Aminoacids were reduced from their high postprandial levels to normal values after insulin-pump treatment. In addition to restoring plasma-glucose to normal, treatment of diabetes with a portable insulin-infusion system results in restoration of normal lipid and aminoacid metabolism. Long-term use of this system may determine whether metabolic changes resulting from insulin lack cause the complications of diabetes.
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PMID:Restoration of normal lipid and aminoacid metabolism in diabetic patients treated with a portable insulin-infusion pump. 8 25

Men who participated in the Whitehall survey and were found to be glucose intolerant have been studied 6--8 years later, together with a control group of men with normal screening blood-sugar levels. Ophthalmoscopically visible microvascular retinal disease was confined to men diagnosed as probably diabetic after the survey because their 2 h blood-sugar level (after a 50 g oral glucose load) in the survey examination or during a subsequent standard oral glucose-tolerance test was greater than or equal to 200 mg/dl (11.1 mmol/l). The lowest blood-sugar in a "diabetic" subsequently found to have retinopathy was 229 mg/dl. Men with lesser degrees of glucose intolerance, including 34 who had "worsened to diabetes", did not have visible retinovascular disease at follow-up. If diabetes implies a risk of specific microvascular complications in the medium term, then the findings in this study support proposals for the revision of diagnostic criteria based on glucose-tolerance tests.
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PMID:Oral glucose-tolerance tests and the diagnosis of diabetes: results of a prospective study based on the Whitehall survey. 8 97

When diabetes and cardiovascular disease were first classed as possible fibre-deficiency diseases, laboratory and clinical evidence was lacking. Subsequent studies indicated that the gums and viscous types of fibre (e.g., guar and pectin) are more effective than other fibres in slowing carbohydrate absorption and hence in reducing the postprandial rise in blood glucose and serum insulin. This effect has longer term metabolic consequences. In addition, gums and viscous fibres reduce serum cholesterol, possibly by mechanisms other than simply increasing bile-salt loss. If these potential therapeutic effects of fibre are to be exploited, palatable formulations must be developed. The effect of fibre in whole foods should also be determined.
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PMID:Dietary fibre, diabetes, and hyperlipidaemia. Progress and prospects. 9 93

In man and in rat, the diabetic state is associated with diseases of exocrine pancreatic function. In this work, streptozotocin diabetes was shown to lead to a 95% decrease in the amylase to lipase ratio in rats. Diabetes was reversed by either pancreas transplantation or insulin treatment. Transplantation of neonatal pancreases was successful in reversing the diabetic-induced alterations of exocrine pancreatic function. To assess whether insulin acts directly on the exocrine pancreas, or through the enhancement of glucose utilization, animals were fed either a low-fat diet or a high-fat diet during insulin treatment; this latter diet is well known to impair insulin's effect on glucose metabolism. When diabetic rats were fed a low-fat diet, insulin treatment was able to correct the hyperketonemia and to reverse the amylase to lipase ratio to the prediabetes level. In contrast, the insulin treatment failed to restore the amylase to lipase ratio when the diabetic rats were fed the high-fat diet. Despite insulin treatment, the hyperketonemia worsened implying that glucose utilization remained low as would be expected on high-fat diet. The dependence of the insulin effect upon diet composition demonstrates that the rate of glucose metabolism is the primary factor in the regulation of amylase to lipase ratio.
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PMID:Diet composition and insulin effect on amylase to lipase ratio in pancreas of diabetic rats. 9 21

The historical development of research on islets transplantation is briefly reviewed followed by a description of a technique using Ficoll gradient separation to obtain islets of Langerhans from the rat pancreas. It was possible to increase the number of islets obtained with this procedure by modifying it in several ways. The islets were then transplanted in an isologue manner into rats with streptocotocin-induced diabetes. The effect of transplantation on glucose metabolism in these rats was evaluated both by determination of the general symptoms typical for diabetes as well as by the performance of such functional tests as IVGTT, GAC and tolbutamide test. The islets could be transplanted into various locations, but it was found that positive results were obtained only if the liver was the site of application and if than 2100 islets were used. Three hours after transplantation normalization of blood sugar levels and serum insulin could be observed; these levels remained stable over 18 months. It was possible to transplant in the same animal several times. This had an effect on the metabolism which was equivalent to the sum of the separate transplants. By means of both light and electron microscope examination the morphological changes which the transplanted islets underwent at the site of transplantation were observed.
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PMID:[Transplantation of isolated islands of Langerhans for the treatment of diabetes mellitus]. 9

Effects of intravenous endotoxin and glucose administration on circulating leukocyte populations were compared in seven normal subjects and seven patients with juvenile-onset diabetes by means of automated cytochemical differential counting to quantitate each cell type. Both groups had comparable control cell counts that were unaffected by glucose tolerance testing but altered significantly by endotoxin. Different patterns of response to endotoxin were observed for different circulating cell types. The response of diabetics was parallel to that of normals but showed lower neutrophil and monocyte rebound, longer lasting depression of lymphocytes and eosinophils, and greater rebound of basophils on the day following endotoxin exposure. Characterization of distinctive normal response patterns of circulating leukocyte populations to endotoxin and comparison with responses in diabetes revealed abnormalities under conditions of stress that may impair the diabetic's ability to cope with acute infection.
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PMID:Effects of acute endotoxemia and glucose administration on circulating leukocyte populations in normal and diabetic subjects. 9 90

McN-3495, a new compound unrelated strucuturally to the sulfonylureas or phenformin, has been found to produce a hypoglycemic effect in nondiabetic rats, dogs, mice, and monkeys. The minimum effective dose of McN-3495 that lowers fasting blood glucose and improves glucose tolerance was found to be about 2.5 to 5 mg-per kilogram, per os, except in fasted monkeys, in which a tenfold greater potency was observed. When McN-3495 was given repeatedly for three to five days, no tolerance to the hypoglycemic activity occurred and no changes in other biochemical parameters were observed. In addition to being three to four times more potent than tolbutamide, McN-3495 also differs from the sulfonylureas in lowering blood glucose concentrations of streptozotocin-diabetic rats and db/db mice, and, moreover, oral administration to normal fasted dogs did not produce the characteristic rise in insulin concentrations observed with tolbutamide. Furthermore, unlike the biguanides, McN-3495 can lower dog and rat fasting blood glucose concentrations and can improve glucose tolerance whether the glucose is administered orally or parenterally. However, McN-3495, as phenformin, fails to work in totally depancreatized dogs.
Diabetes 1978 Aug
PMID:A pharmacologic profile of McN-3495 [N-(1-methyl-2-pyrrolidinylidene)-N'-phenyl-1-pyrrolidinecarboximidamide], a new, orally effective hypoglycemic agent. 9 77

The treatment of diabetes is still a problem more than a half-century after the discovery of insulin. Patients are now living significantly longer but until the development of oral hypoglycemic agents, the only direct treatment modalities were exercise, diet, and insulin. Before evaluating the effectiveness of treatment, a therapeutic goal must be determined. While there are no absolutely "hard" facts proving that "good control" is beneficial in preventing chronic complications of diabetes, increasing accumulation of "soft" data strongly suggests that normal blood glucose levels are most desirable, when possible, but not at the cost of severe or disabling hypoglycemic reactions. The development of the oral agents was a great public health advance in that many persons with early diabetes, but fearful of insulin injections, had less dread of "the pills" and sought treatment. The oral agents simplified care but this very simplification process often undermined the need for proper diet and good fundamental care. This often led to mediocre diabetes care. While useful, the oral agents have marked limitations and in some are effective only temporarily. The presently available oral agents are sulfonylureas and require a viable beta-cell system for success. This limits the number of diabetics responsive to such treatment. The general indications for tolbutamide, chlorpropamide, acetohexamide and tolazamide are in maturity-onset diabetics, generally beyond the age of 40 with diabetes of less than 10 years. They are contraindicated in juvenile-onset diabetics, in pregnant women, and usually in patients undergoing major surgery, and can become ineffective during periods of extreme stress or during severe infection. They can lower blood glucose levels if used in proper doses in properly selected patients. Contrary to several decades of documentation, it has become popular to suggest that the oral agents are not effective. They can be effective but for many reasons apparently were not in their use by the U.G.D.P. researchers. This might not be the fault of the oral agent used. If ineffective, they should be discontinued. Many, but not all, patients may respond to diet therapy, which is then the treatment of choice. Obviously insulin, though difficult to use for many persons and in itself able to induce several severe reactions if not used properly, is the only treatment (with diet) for the severe diabetic. There is a large spectrum of patients inbetween in whom the oral agents may be useful. The use of phenformin (phenethyl-biguanide) has been effectively curtailed because of many reported cases of lactic acidosis, and while it is doubtful that phenformin alone, in the absence of complicating factors, is the causative factor, it is capable of being an augmenting influence when other conditions, such as decreased kidney function, prevail...
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PMID:Oral hypoglycemic agent update. 9 75


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