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)

Blood glucose levels were continuously monitored in 70 subjects during a 75 g oral glucose tolerance test (OGTT). Subjects were divided into normal (N = 15), borderline (N = 31), diabetes with fasting glucose levels below 140 mg/dl (DM1) (N = 15) and diabetes with levels above 140 mg/dl (DM2) (N = 9). Three patterns of blood glucose curves were observed in each subject group; domed, biphasic and upward. The frequency of blood glucose patterns in each class of glucose tolerance group was as follows: in the normal group; domed 33.3%, biphasic 66.7%; in the borderline group; domed 67.7%, biphasic 29.0%, upward 3.2%; in the DM1 group; domed 66.7%, biphasic 13.3%, upward 20.0%; in the DM2 group; domed 77.8%, upward 22.2%. The frequency of patients with a biphasic pattern was significantly higher in the normal group than in the other groups. In the borderline group, almost all patients with a biphasic pattern were young or middle aged (< 60 years old). When the patients with fasting glucose levels below 140 mg/dl were analyzed, the mean peak time and peak value of blood glucose levels were significantly higher in patients with domed patterns than those with biphasic patterns. Indices of early insulin response to glucose load were significantly lower in patients with domed patterns than in those with a biphasic pattern. In conclusion, the pattern of the glucose curve in an OGTT is mainly dependent on the patient's early insulin response. Glucose intolerance with aging resembles diabetes from the standpoint of the pattern of glucose tolerance curves.
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PMID:[Oral glucose tolerance test using a continuous blood sampling technique for analysis of the blood glucose curve]. 793 56

The present study was undertaken to evaluate the effects of a selective thromboxane synthetase inhibitor (OKY-046) on urinary prostaglandins (PGs) excretion and renal parameters such as endogenous creatinine clearance rate (Ccr) and urinary protein excretion in streptozotocin (STZ)-induced diabetic rats. STZ-diabetic rats were divided into two groups; one fed standard chow (DM1) and the other, standard chow mixed with 0.1% OKY-046 (DM2) for 24 weeks. Male Wistar rats were fed standard chow for 24 weeks as control (C). Urinary thromboxane B2 (TXB2) and 6-keto-PGF1 alpha excretions significantly increased in STZ-induced diabetic rats (DM1 and DM2) compared with C after 24 weeks. The increased urinary TXB2 excretion in DM2 was significantly reduced (p < 0.05) compared with that in DM1 (261.1 +/- 18.6 ng/gCr versus 380.0 +/- 48.4 ng/gCr, mean +/- SEM). No significant difference could be found in urinary protein excretion between DM1 and DM2, which was significantly higher in both diabetic groups than C after 12 and 24 weeks. Ccr in both DM1 and DM2 significantly increased (p < 0.05) compared with C after 12 weeks. In contrast, after 24 weeks, Ccr in DM1 fell down to 0.18 +/- 0.02 mL/min 100 g body weight (BW), thus being significantly lower (p < 0.05) than that in C (0.27 +/- 0.03 mL/min 100 g BW) and DM2 (0.25 +/- 0.02 mL/min 100 g BW). Electron microscopic findings in diabetic rats after 24 weeks were the typical change of early diabetic nephropathy, whereas there were no obvious differences between DM1 and DM2.(ABSTRACT TRUNCATED AT 250 WORDS)
J Diabetes Complications
PMID:Effects of thromboxane synthetase inhibitor (OKY-046) on urinary prostaglandin excretion and renal function in streptozotocin-induced diabetic rat. 806 49

Type I Diabetes mellitus (DM1) is the effect of T cell dependent autoimmune destruction of insulin producing beta cells in the pancreas islet. T cells are activated in response to islet dominant autoantigens, the result being the development of DM1. Insulin is one of the islet autoantigens responsible for activation of T lymphocyte functions, inflammatory cytokine production and development of DM1. The experiments reported in this study have shown the spontaneous increase of CD95 molecule expression on lymphocytes of the first-degree relatives of DM1 patients. The autoantigen insulin is responsible for stimulation in vitro of potentially hazardous 'memory' lymphocytes to produce interleukin-6 (IL-6) and interleukin-10 (IL-10) interleukins. Insulin induced stimulation of lymphocytes in vitro was observed in patients at high risk of developing diabetes mellitus (prediabetics). Phytohaemagglutinin (PHA) stimulates lymphocytes of all groups in the same way. Stimulated lymphocytes in second cultures undergo apoptosis induced with anti-Fas specific antibodies. The deletion in vitro of resting peripheral lymphocytes is nonfunctional. Insulin activated T lymphocytes, which undergo apoptosis were not observed in peripheral blood of healthy people and in patients with DM1. This observation suggests that insulin is involved as autoantigen in DM1 progression in patients with high risk of diabetes type I. The autoreactive T lymphocytes may persist in peripheral blood of patients with high risk DM1. Defective elimination of autoreactive T cells may result in autodestructive damage of islets beta cells in the prediabetic stage and disease progression to DM1.
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PMID:Activated T lymphocytes from patients with high risk of type I diabetes mellitus have different ability to produce interferon-gamma, interleukin-6 and interleukin-10 and undergo anti-CD95 induced apoptosis after insulin stimulation. 1116 80

The incidence of hypoglycaemic episodes in patients with type 1 diabetes mellitus (DM1) is frequent. They experience 1-2 symptomatic hypoglycaemias per week. 10-20% of the patients suffer from at least one severe hypoglycaemia per year. The incidence of severe hypoglycaemia in a group of intensely treated patients is about three times as high as compared with standard treatment and 55% of all episodes occur during sleep. Prevention of hypoglycaemia, and restoration of euglycaemia resp. include disappearance of metabolic effects of insulin and activation of glucose contraregulating systems among which there is a certain hierarchy. The phenomenon of unaware hypoglycaemia (FNH) is defined as failure to diagnose autonomous warning symptoms, and their non-appearance before the development of neuroglycopenia. The incidence of FNH in the population with DM1 is frequent. Based on a standardized insulin diffusion test 26% of patients with DM1 suffer from it which means that every fourth patient is affected. In the pathogenesis of FNH various factors and mechanisms were suggested as predisposing. Most probably a defect at the level of the central nervous system is involved caused by: 1. a reduced ability to recognize the decline of the blood sugar level by the CNS (altered function of the hypothalamic glucostat and/or glucose transport across the haematoencephalic barrier), 2. reduced secretion of neurotransmitters, 3. reduced tissue response to adequate neurotransmitter secretion. The theory of etiopathogenesis must explain and define its association with the persistence of diabetes mellitus, strict metabolic control, autonomous neuropathy and repeated episodes of hypopglycaemia. The contemporary hypothesis of the pathogenesis of FNH is the mechanism of repeated frequent hypoglycaemia which leads to general adaptative changes at the level of the CNS by increased glucose transport across the haematoencephalic barrier which leads to reduced hormonal responses and reduction of symptoms. Thus a dangerous circulus vitiosus is created where hypoglycaemia induces unawareness of hypoglycaemia. This condition is at least partly reversible. The presence of FNH should influence the decision of the physician before using an intensified insulin regimen in diabetics.
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PMID:[The phenomenon of unawareness of hypoglycemia]. 1139 72

The anthropometric status and metabolic control of 51 recently diagnosed Brazilian schoolchildren with type 1 diabetes (DM1), during the first 5 years of the disease, were compared with those of normal children (60 girls and 132 boys) belonging to the same environmental condition and pubertal stage. Metabolic control was evaluated on the basis of fasting plasma glucose (FPG) and HbA1c levels. The criteria of the National Center for Health Statistics were used for anthropometric evaluation. FPG (205 +/- 51 mg/dl for girls vs 200 +/- 34 mg/dl for boys) and % above upper normal limit of median HbA1c (1.8% for girls vs 2.5% for boys with diabetes) were not significantly different during follow-up. The Z-score of the last height evaluation was lower in the girls' group (-0.14 vs -0.53, P<0.05). By forward stepwise analysis, the Z-score of the initial height was statistically significant as a determinant factor for height at the end of the study in both girls and boys with DM1. The Z-score of weight at last evaluation was not different from that at diagnosis in either sex. However, analysis according to pubertal stage showed a tendency to a weight increase in the girls. The weight recovery and height loss in girls with DM1 follows the trend of the normal Brazilian population.
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PMID:Development according to pubertal stage in Brazilian children and adolescents with short-term diabetes. 1159 7

A delayed chylomicron (CM) clearance rate, a known risk factor for atherosclerosis, has been described in adults with diabetes type 1 (DM1). We determined the CM clearance rate in late teenagers with DM1, and the relationship between CM clearance rate and elevated plasma lipid concentrations in DM1 teenagers in poor metabolic control (as characterized by HbA(1c) percentage). Plasma lipids and CM clearance were determined in nine patients with DM1 (mean age +/- SD: 17.5 +/- 0.6 y) and four healthy controls (mean age +/- SD: 20.1 +/- 0.8 y), by measuring breath (13)CO(2), plasma triglyceride, retinyl palmitate, and (13)C-labeled oleic acid concentrations, after oral administration of a fat-rich meal together with vitamin A and (13)C-oleic acid. In patients with DM1, fasting triglyceride and cholesterol concentrations were positively correlated with HbA(1c) percentage (p < 0.05). Neither in DM1 patients, nor in controls, was an elevated triglyceride concentration (above 1.7 mmol/L) found. Yet, in 22% of DM1 patients, cholesterol concentration was above 5.2 mmol/L, but not in any of the controls. CM clearance rate in DM1 patients was similar to that in controls and did not significantly correlate with HbA(1c) percentage. Fasting lipid concentrations in DM1 patients were not significantly correlated with CM clearance rate. Present data indicate that elevated lipid concentrations in late teenagers with DM1 are not attributable to a delay in CM clearance rate. A delayed CM clearance rate at late teenager age is not a risk factor contributing to the increased risk for atherosclerosis in DM1.
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PMID:Postprandial chylomicron clearance rate in late teenagers with diabetes mellitus type 1. 1164 56

Innate immunity includes neutrophil inflammatory function, tissue destruction and regulatory cytokine production. Programmed cell death (apoptosis) is postulated to be a key mechanism for neutrophil elimination during inflammation. The aim of the present study was to evaluate the neutrophil apoptosis in relation to IL-8, IL-10 and IL-12 production in vitro by neutrophils of patients suffering from diabetes mellitus (DM)1 and the first-degree relatives of patients with DM1. The early stage of neutrophils apoptosis was assessed morphologically, and the later stage by DNA-binding dye propidium iodide, both after treatment with lipopolysaccharide (LPS), insulin or anti-CD95 antibody (Ab) as stimulators. CD16 (FcgammaRIII) receptor expression was also evaluated. Production of IL-8, IL-10, and IL-12 cytokine was evaluated in supernatant after neutrophil incubation for 21 h in culture medium alone, in medium in the presence of LPS, insulin or anti-CD95 antibody (Ab). Cytokine concentrations were measured by enzyme-linked immunosorbent assay (ELISA) method using commercially available kits. Our study demonstrates that LPS inhibits the early stage of apoptosis (as evaluated morphologically) of healthy donors' neutrophils. The LPS-dependent early apoptosis inhibition of neutrophil of patients with DM1 or in prediabetics was decreased in comparison with control. The later stage of apoptosis of neutrophils treated in vitro with anti-CD95 Ab of patients suffering from DM1 was decreased in comparison with prediabetics and healthy donors (propidium iodide (PI) staining). LPS-induced production of anti-apoptotic cytokines IL-8, IL-10 by neutrophils of prediabetic and patients with DM1 was increased. The formyl-methionyl-leucyl-phenylalanine (fMLP)-induced proapoptotic reactive oxygen intermediates (ROI) production was significantly higher in DM1 patients. We have concluded that neutrophils from prediabetic and diabetic patients demonstrated the misbalance in anti-apoptotic IL-8 and IL-10 cytokine and proapoptotic ROI production. LPS-dependent IL-12 overproduction by neutrophils is responsible for the switch in T helper Th1/Th2 balance to Th1 and in this way may participate in inflammation and autoimmune DM1 progression.
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PMID:The effect of LPS on neutrophils from patients with high risk of type 1 diabetes mellitus in relation to IL-8, IL-10 and IL-12 production and apoptosis in vitro. 1189 38

Diabetic nephropathy may be effectively prevented and treated by controlling glycemia and administering angiotensin-converting enzyme (ACE) inhibitors. However, strict metabolic control can be difficult, and ACE inhibitors may be poorly tolerated and only partially effective, particularly in diabetes mellitus type 2 (DM2), warranting the search for ancillary treatment. Sulodexide is a glycosaminoglycan, a new class of drug that has demonstrated nephroprotective activity in experimental investigations. The Di.N.A.S. study was a randomized, double-blind, placebo-controlled, multicenter, dose-range finding trial to evaluate the extent and duration of the hypoalbuminuric effect of oral sulodexide in diabetic patients. A total of 223 microalbuminuric and macroalbuminuric DM1 and DM2 patients with serum creatinine < or =150 micromol/L and stable BP and metabolic control were recruited. They were randomly allocated to one of four groups: 50 mg/d, 100 mg/d, or 200 mg/d sulodexide daily or placebo for 4 mo (T0 to T4), with 4 mo of follow-up after drug suspension (T4 to T8). Treatment with 200 mg/d sulodexide for 4 mo significantly reduced log albumin excretion rate (logAER) from 5.25 +/- 0.18 at T0 to 3.98 +/- 0.11 at T4 (P < 0.05), which was maintained till T8 (4.11 +/- 0.13; P < 0.05 versus T0). Moreover, the sulodexide-induced percent reductions in AER at T4 were significantly different from the placebo value at T4 and approximately linear to dose increments (30% [confidence limits, 4 to 49%], P = 0.03; 49% [30 to 63%], P = 0.0001; and 74% [64 to 81%], P = 0.0001 in the sulodexide 50, 100, and 200 mg/d groups, respectively. At T8, the sulodexide 200 mg/d group maintained a 62% (45 to 73%) AER significant reduction versus placebo (P = 0.0001). Subanalysis by type of diabetes (DM1 versus DM2, microalbuminuric versus macroalbuminuric, or on concomitant ACE inhibitors versus not on ACE inhibitors) demonstrated similar findings. These effects were obtained without any significant variation in metabolic control and BP or serum creatinine. Very few adverse events were reported; none were serious. In conclusion, a 4-mo course of high doses of sulodexide significantly and dose-dependently improves albuminuria in DM1 and DM2 patients and micro- or macroalbuminuric patients with or without concomitant ACE inhibition. The effect on albuminuria is long-lasting and seemingly additive to the ACE inhibitory effect.
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PMID:Oral sulodexide reduces albuminuria in microalbuminuric and macroalbuminuric type 1 and type 2 diabetic patients: the Di.N.A.S. randomized trial. 1203 91

190 patients with diabetes mellitus (DM) were examined: 24 patients with DM type 1 and 166 with DM type 2. Frequency of arterial hypertension (AH) in diabetics is higher than in population. AH in different DM types varies by pathogenesis. Symptomatic renal AH is typical for DM1, essential AH combining with renal one in 1/3 of cases--for DM2. Treatment of AH and DM often provokes hypothyroidism which can be iatrogenic because of continuous intake of sugar reducing and antihypertensive drugs with antithyroid and strumogenic actions. Hypothyroidism aggravates an AH course: arterial pressure becomes high and resistant to hypotensive therapy. DM makes difficulties in selection of hypotensive drugs as many of them alter metabolism and due to negative attitude of the patients to continuous intake of sugar reducing, antihypertensive drugs, thyroid hormones. Therefore, hypertensive diabetics should be prepared for treatment psychologically and receive only prolonged hypotensive drugs. In DM with AH medication of choice is ACE inhibitors as they are nephroprotective, had no negative effect on carbohydrate, fat metabolism and thyroid system.
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PMID:[Role of thyroid pathology in pathogenesis of arterial hypertension in diabetes]. 1247 32

Accelerated glycoxidation takes part in the development of diabetic complications. We determined advanced glycation end-products (AGEs) and advanced oxidation protein products (AOPP) in the sera of 52 patients with diabetes mellitus (DM) - 18 with DM Type 1 and 34 with DM Type 2 and examined their relationship to the compensation of the disease. AGEs were estimated spectrofluorimetrically (350 nm/440 nm) whereas AOPP were determined spectro-photometrically (340 nm). AGEs were elevated only in DM Type 2 (DM2 5.11+/-1.15 x 10(3) AU/g vs controls 4.08+/-0.71 x 10(3) AU/g, p<0.001, vs DM1 4.14+/-0.86 x 10(3) AU/g, p<0.005, DM1 vs controls were not significant). AOPP were elevated significantly in both types of DM with higher levels in DM Type 2 (DM2 157.50+/-75.15 micromol/l vs healthy subjects 79.80+/-23.72 micromol/l, p<0.001, vs DM1 97.50+/-30.91 micromol/l, p<0.005, DM1 vs controls p<0.05). There was a tight correlation between AGEs and AOPP in both types of DM (DM1 r=0.75, DM2 r=0.47 (p<0.05)) and both AGEs and AOPP correlated with triglycerides. In DM Type 1 only, AGEs correlated with HbA1c r=0.47 (p<0.05) and with blood glucose. Slight but not significant differences in AGEs and AOPP levels were observed in patients with or without diabetic complications. Oxidative stress is increased in both types of DM, more in Type 2 where it contributes to the formation of glycoxidation products.
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PMID:Advanced glycation end-products and advanced oxidation protein products in patients with diabetes mellitus. 1251 Nov 84


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