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)

In order to evaluate the effect of cyclosporine (CsA) versus FK506 on glucose and lipid metabolism, an oral glucose tolerance test (OGTT) was performed in 101 patients after orthotopic liver transplantation (OLT) (mean interval after OLT: 511 days). The liver graft recipients had been randomized prospectively to two groups prior to OLT to receive either immunosuppression with CsA, azathioprine, and corticosteroids (CsA group) or FK506 and corticosteroids (FK group). Along with the OGTT, serum insulin, insulin C-peptide and glucagon as well as serum lipids were monitored. There was no statistically significant difference in the occurrence of impaired glucose tolerance (IGT) or manifest diabetes mellitus disease between the two groups. In fact, not a single patient developed new-onset diabetes in any group. In male and female patients, serum levels of cholesterol and triglycerides increased significantly under FK506 and CsA treatment after OLT. Cholesterol was significantly higher in the CsA group in men, in women this was marked, but not significant. While triglycerides were significantly higher in women on CsA treatment, there was no such difference in men. In conclusion, both CsA and FK506 proved to have similar effects on glucose metabolism, while there was a different spectrum of serum lipid alterations.
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PMID:The effect of FK506 versus cyclosporine on glucose and lipid metabolism--a randomized trial. 752 3

To investigate the efficacy and mechanism of action of sodium metavanadate as an oral hypoglycemic agent, five insulin-dependent diabetes mellitus (IDDM) and five noninsulin-dependent diabetes mellitus (NIDDM) patients were studied before and after 2 weeks of oral sodium metavanadate (NaVO3; 125 mg/day). Glucose metabolism measured during a two-step euglycemic insulin clamp was not significantly increased by vanadate therapy in patients with IDDM, but was improved by 29% during the low dose (0.5 mU/kg.min) insulin infusion and 39% during the high dose (1.0 mU/kg.min) in patients with NIDDM. The changes in glucose metabolism were largely accounted for by an increase in nonoxidative glucose disposal, as measured by indirect calorimetry. Basal hepatic glucose production and suppression of hepatic glucose production by insulin were unchanged by vanadate therapy. There was a significant decrease in insulin requirements in the patients with IDDM (39.1 +/- 6.6 to 33.8 +/- 4.7 U/day; P < 0.05). Cholesterol levels significantly decreased in both IDDM (4.53 +/- 0.16 vs. 4.27 +/- 0.22 mmol/L; P = 0.06) and NIDDM (6.92 +/- 0.75 vs. 5.28 +/- 0.46 mmol/L; P < 0.05). After NaVO3 therapy, there was a 1.7- to 3.9-fold increase in basal mitogen-activated protein and S6 kinase activities in mononuclear cells from patients with IDDM and NIDDM that mimicked the effect of insulin stimulation in controls. The most common adverse effect of oral NaVO3 was mild gastrointestinal intolerance. These data suggest that vanadate or related agents may have a potential role as adjunctive therapy in patients with diabetes mellitus.
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PMID:Metabolic effects of sodium metavanadate in humans with insulin-dependent and noninsulin-dependent diabetes mellitus in vivo and in vitro studies. 759 44

In order to evaluate the effect of a combined kidney-pancreas (KP) transplantation in insulin-dependent diabetes mellitus (IDDM) patients on the lipid and lipoprotein profile, 15 KP patients were compared with 11 kidney (K)--transplanted IDDM patients, 19 IDDM patients on hemodialysis (HD), and 15 nondiabetic control subjects. Cholesterol, triglycerides, apo AI, and apo B were measured in total plasma and in VLDL, LDL, and HDL of all participants. VLDL cholesterol, VLDL-triglycerides, and VLDL-apo B were significantly lower in KP patients, but not in K patients, than in HD patients. In addition, patients in the K, but not in the KP, group showed high levels of apo B in LDL and an increased triglyceride/apo B ratio in VLDL, compared with patients in the HD group. The percentage of apo AI associated with HDL was significantly higher in both transplanted groups than in the HD group. However, compared with a nondiabetic control population, an increase in VLDL particles and in triglyceride content in LDL and HDL still persisted following combined KP transplantation. Insulin resistance (probably due to steroid therapy) associated with high peripheral and potentially low hepatic insulin levels (due to the systemic drainage of the transplanted pancreas) could be the main causes of the remaining lipoprotein abnormalities.
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PMID:Lipoprotein profile after combined kidney-pancreas transplantation in insulin dependent diabetes mellitus. 762 78

The Strong Heart Study, a study of cardiovascular disease among American Indians, was conducted to determine cardiovascular disease rates and the prevalence of risk factors among members of 13 tribal groups in South Dakota/North Dakota (SD/ND), southeastern Oklahoma, and Arizona. From 1989 to 1992, 4,549 tribal members aged 45-74 years (62% of eligible participants) were surveyed and examined for cardiovascular disease and its risk factors. Mean total cholesterol concentrations were over 20 mg/dl lower among the men and 27 mg/dl lower among the women than national mean levels for the same age groups. Cholesterol levels varied by tribal group; Arizona Indians had mean levels more than 20 mg/dl lower than those of SD/ND Indians. The prevalence of hypercholesterolemia was almost twice as high among SD/ND Indians as among Arizona Indians, but the rates for all three groups were much lower than total US rates (all races). Mean levels of high density lipoprotein cholesterol were lower among Indian men and women than in the US population as a whole. The prevalence of hypertension among Arizona and Oklahoma Indians was higher than that for the entire United States. SD/ND Indians had significantly lower mean blood pressures and prevalence rates of hypertension than Oklahoma and Arizona Indians and the United States as a whole. The prevalence of cigarette smoking was higher for all Indian groups except Arizona women in comparison with US rates. Smoking rates were highest in SD/ND and lowest in Arizona. Indian smokers smoked fewer cigarettes per day than the average US smoker. Arizona Indians had the highest prevalence of diabetes mellitus; over 60% of those participants were diabetic. In Oklahoma and SD/ND, one third of the men and over 40% of the women were diabetic. In addition, 13-20% of the participants had impaired glucose tolerance. Proteinuria was also a common problem; almost half of the Arizona Indians had micro- or macroalbuminuria, and 20% of Oklahoma and SD/ND Indians had significant proteinuria. The prevalence of obesity was high in all three groups, with Arizona Indians having the highest rates and the highest mean body mass indices. The prevalence of current alcohol use was lower among Indians than in the nation as a whole, but binge drinking was common among those who used alcohol. These results indicate that cardiovascular disease risk factors vary significantly among tribal groups. Prevention programs tailored toward decreasing the prevalence of risk factors are recommended for long-term reduction of cardiovascular disease rates in American Indian communities.
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PMID:Cardiovascular disease risk factors among American Indians. The Strong Heart Study. 763 31

The National Cholesterol Education Program's guidelines for the detection, evaluation, and treatment of high serum cholesterol in adults were employed in screening 155 Southeast Asian refugees in a primary care clinic in Seattle, Washington. In order to determine the need for a therapeutic intervention, information also was collected on the presence of other coronary heart disease (CHD) risk factors. Male gender (39%), cigarette smoking (27%) and hypertension (26%) were the most common CHD risk factors; diabetes mellitus, obesity, a family or prior history of CHD or cerebral/peripheral vascular disease were each noted in less than 10%. The mean serum total cholesterol was 194 mg/dl. Thirty-seven (24%) patients required further lipoprotein analysis based on cholesterol level, history of CHD and risk factors for CHD. Twenty-one (66%) of 32 patients who underwent lipoprotein analysis (14% of all patients) were candidates for a therapeutic intervention for hypercholesterolaemia. Additionally, 14 (44%) patients undergoing lipoprotein analysis had depressed high-density lipoprotein levels (< 35 mg/dl). We conclude that CHD risk factors including hypercholesterolaemia are common in Southeast Asian refugee clinic patients and that in many, a therapeutic intervention may well be justified. Southeast Asian refugees should be routinely screened for hypercholesterolaemia and other CHD risk factors in accordance with the National Cholesterol Education Program's guidelines.
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PMID:Prevalence of hypercholesterolaemia and coronary heart disease risk factors among southeast Asian refugees in a primary care clinic. 765 79

This present study is one part of the project "Atherosclerotic cardiovascular diseases, lipemic disorders, hypertension, obesity and diabetes mellitus in a population of the metropolitan area of S. Paulo, Brazil" undertaken in Cotia county. An alimentary inquiry based on the alimentary history of the individual was carried out among a subsample of the population (568 individuals). The objectives of the inquiry are the following: a) the identification of the atherogenic potential of the diets of different human groups, stratified according to social class and b) the analysis of consumption differentials of some nutrients, which confer atherogenicity to the diet, as between social classes. The consumption differentials were analyzed as between men and women, by social class and taking the 50th percentile (P50) of the sample as the standard of reference, with regard to the following dietary constituents: energy, total proteins, proteins of animal origin, percentages of protein calories (P%), fatty acids, fats (F%) and carbohydrates (CH%). Also, according to this criterion, some diet profiles were analyzed in the light of the recommendations of the National Cholesterol Education Program (NEP) as regards the calorie supplied by fats (F%), saturated fatty acids (SFA%), carbohydrates (CH%) and cholesterol (> 300 mg/day). The following were the findings obtained: the consumption differentials were more pronounced among the men. The social class which presented the largest percentages above the P50 of the sample, with regard to energy, total proteins, fats and carbohydrates, were the non-specialized workers, i.e. the manual laborers who have a high expenditure of energy, an that of small property owners and shop-keepers who lead a sedentary life. The class of the greatest acquisitive power and highest educational level presented a moderate consumption of these constituents. On the other hand, the consumption of the proteins of animal origin, above the P50, among men and women, maintained a direct relationship with socioeconomic level. The proportion of calories coming from fats (F%) and protein (P%) was directly proportional to the acquisitive power of the class, while that of carbohydrates (CH%) presented an inverse relationship. On the other hand, the consumption of cholesterol in excess of 300 mg/day was found to between 37 and 50% and 20 and 32% for men and women, respectively. The percentage of diets with more than 30% of calories coming from fats (F%) varied from 25 to 40% for men and 45 to 50% for women. The participation of the saturated fatty acids (SFA%) in proportions greater or equal to 10 was relatively low for both sexes: being of 5 to 17% for the men and of less than 10% for the women. The percentages of cases in the relationship saturated to unsaturated fatty acids (SFA/UFA) maintaining values less than 1% was also low for the population in general, being of 7 and 22% for the men and less than 10% for the women. It is concluded that diet probably is an important risk factor in cardiovascular diseases, lipemic disorders, obesity and hypertension, for a large part of the population, mainly for the small property owners and shop-keepers, is viable.
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PMID:[Atherogenic food habits of population groups in a metropolitan area of southeastern Brazil]. 766 37

We compared the effectiveness of selectively screening pharmacy data bases to identify patients with hypercholesterolemia with that of mass cholesterol screening. Screening data bases of four community pharmacies yielded 426 patients filling prescriptions for beta-blockers, thiazide diuretics, oral hypoglycemics, insulin, sublingual nitroglycerin, nicotine gum, or nicotine patches. They were invited to attend a cholesterol screening. Eighty-eight of the contacted patients attended, as did 97 walk-in persons. Cholesterol readings were higher in the contacted group (p = 0.017). Borderline-high cholesterol levels (200-239 mg/dl) were reported in 36.3% of the contacted group and 29.8% of the walk-in group. High cholesterol levels (> 239 mg/dl) were reported in 31.8% and 18.6%, respectively. Targeting certain drugs that directly contribute to raising cholesterol or indicate other risk factors for coronary artery disease (e.g., diabetes mellitus) was an effective method of identifying patients with hypercholesterolemia.
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PMID:Community pharmacy data bases to identify patients at high risk for hypercholesterolemia. 766 64

Coronary heart disease (CHD) remains the number one killer in the United States. This article summarizes the recommendations for cholesterol screening of children and adolescents by the American Academy of Pediatrics and the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Screening of children and adolescents is selective, and the determination to screen is based on past medical, family health, and health behavior histories. Children or adolescents with a family history of peripheral vascular disease or coronary artery disease in primary relatives under 55 years of age, or parents with high blood cholesterol levels, are considered to be at risk for high blood cholesterol and in need of screening. Children or adolescents who are obese, inactive, have hypertension or diabetes, or who smoke are also considered to be at risk. A universal approach to the prevention of CHD through diet and lifestyle is also described.
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PMID:Toward the prevention of coronary heart disease: screening of children and adolescents for high blood cholesterol. 771 64

CBL/57 strain db/db mice exhibit type II (noninsulin-dependent) diabetes. The affected mice are markedly hyperinsulinemic, hyperglycemic, and hypercholesterolemic, and their serum K+ levels are decreased. The brains of the diabetic mice are significantly smaller than those of their lean, control littermates, but the protein concentration is normal. The low brain weight is accompanied by a loss of major fatty acid components within the whole brain, nerve endings, and mitochondrial membranes. Cholesterol levels are low in whole brain but are not significantly different from normal in the synaptosomal membranes. The phospholipid concentration is significantly decreased in whole brain homogenates, crude synaptosomal membranes, and crude mitochondrial membranes of the diabetic mice. In addition, the specific activities of membrane-bound synaptosomal acetylcholinesterase, Na+,K(+)-ATPase, and Mg(2+)-ATPase are decreased in crude synaptosomal membranes of the diabetic mice. The specific activities of carnitine palmitoyltransferase I and carnitine acetyltransferase are significantly increased in the crude mitochondrial fraction isolated from the brains of the type II diabetic mice, whereas the specific activity of pyruvate dehydrogenase complex is decreased. The specific activities of two other mitochondrial enzymes--monoamine oxidase B and citrate synthase--and a cytosolic enzyme--lactate dehydrogenase--are unaltered. The ability to synthesize cyclic AMP is markedly decreased in the brains of the diabetic mice. The concentrations of carnitine and of the amino acids, glutamate, aspartate, glutamine, and serine are unaltered, whereas glycine levels are significantly elevated in the brains of the db/db mice. The data suggest that in vivo the brains of the diabetic mice exhibit a decreased capacity for glucose oxidation and increased capacity for fatty acid oxidation. This hypothesis is supported by the finding that cerebral mitochondria isolated from the db/db mice oxidize [1-14C]palmitate to 14CO2 at a rate almost twice that of control mitochondria. The present findings emphasize the potentially serious alteration of brain metabolism in uncontrolled type II diabetes.
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PMID:Lipid metabolism and membrane composition are altered in the brains of type II diabetic mice. 772 1

Coronary artery disease is the leading cause of death among black women in the United States. Black women also demonstrate a greater prevalence of coronary risk factors and a higher mortality after myocardial infarction than white women. To evaluate the clinical profile and outcome of black women in an urban-based cardiac rehabilitation program, 35 black women (aged 54 +/- 13 years) and 47 white women (aged 57 +/- 10 years) were prospectively studied. Black women had similar admitting diagnoses as white women, with recent myocardial infarction being the most common (37%). Coronary risk factors were more prevalent in black women than white women in the program: hypertension (71% vs 53%; p = 0.09) diabetes mellitus (46% vs 26%; p = 0.06), obesity (74% vs 49%; p < 0.05). Cholesterol and high-density lipoprotein levels were similarly elevated in black (251 +/- 53 mg/dl) and in white (248 +/- 52 mg/dl) women, whereas 34% of black and 21% of white women were active smokers. There was no significant difference in initial exercise capacity at program entry. Fewer black women (51%) completed the 12-week program than white women (64%), p = NS. Comparison of initial and follow-up exercise tests after 12 weeks of moderate to high-intensity dynamic exercise demonstrated significant and similar improvements in functional capacity in both black (4.2 +/- 1.6 vs 5.6 +/- 1.7 METs; p < 0.001) and white (4.8 +/- 2.2 vs 5.7 +/- 2.2 METs; p < 0.01) women. Among obese patients, only the white women lost weight.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of outcome of cardiac rehabilitation in black women and white women. 773 96


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