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

The definition of prediabetes by genetic criteria alone has limitations since not all such subjects progress to overt diabetes. Sequential oral glucose tolerance testing in a population has enabled the identification of 14 "true prediabetic" subjects with baseline two-hour plasma glucose levels smaller than 160 mg. per 100 ml. who subsequently developed unequivocal diabetes (two-hour plasma glucose level larger than 275 mg. per 100 ml.). All but one were matched for baseline two-hour plasma glucose and relative weight with a subject whose glucose tolerance remained unchanged during a mean follow-up period of 4 years. Fasting insulin levels and responses at 1/2, 1, and 2 hour sampling times were similar in both group and matched pair analysis at baseline. No evidence was found that subjects destined to develop diabetes have either excessive or diminished insulin secretion.
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PMID:Insulin responses to oral carbohydrate in true prediabetics and matched controls. 4 45

A 53 year old woman presented with diabetes mellitus, hyperglucagonemia (600 to 1,500 pg/ml), clinical hyperparathyroidism and an abdominal mass diagnosed on biopsy as an islet cell carcinoma. Glucagon content of the tumor was 0.78 mug/g wet weight. Hourly blood samples during a 24 hour period revealed a direct correlation between plasma glucose and glucagon. The oral administration of glucose paradoxically increased whereas the intravenous administration decreased plasma glucagon. Circulating glucagon levels were markedly increased with arginine and epinephrine infusion. Both short- and long-term administration of alpha adrenergic blockade depressed the glucagon response to epinephrine infusion. In contrast, long-term alpha adrenergic blockade increased glucagon secretion despite improved glucose tolerance during a second 24 hour study. Although the patient demonstrated overt clinical and chemical findings of hyperparathyroidism, parathyroid hormone (PTH) was not detected in her plasma. The pattern of tumor growth was consistent with an origin from pancreatic islets. We conclude that (1) the tumor was responsive to physiologic stimuli known to affect glucagon secretion; (2) elevations of plasma glucagon levels with oral and dietary glucose suggest regulation of secretion by intestinal factors; and (3) improvement of glucose tolerance with alpha adrenergic blockade may be related to increased insulin secretion.
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PMID:Uncontrolled diabetes mellitus and hyperglucagonemia associated with an islet cell carcinoma. 4 4

The development of diabetes in a small percentage of female beagles receiving large doses of synthetic progestogen for one year is described. The abnormalities in blood sugar and plasma insulin responses to oral glucose arising during induction of diabetes are presented. After a two-year period of diabetes, two animals were examined histologically. Lesions in the kidney and retina, similar to early lesions associated with human diabetic nephropathy and retinopathy, were present. Histologic changes related to the diabetes were also seen in the pancreas and pituitary. The means of induction of the diabetes is discussed. The study supports the view that the dog is a useful species in which to study the long-term pathology of diabetes,
Diabetes 1975 Apr
PMID:Progestogen-induced diabetes in the dog. 4 86

Circulating antibodies to live tissue-cultured human-insulinoma cells were identified in 34 out of 39 insulin-dependent diabetic patients by an indirect immunofluorescent technique. The antibodies were unrelated to insulin therapy since 8 of 9 sera obtained before insulin-replacement treatment were antibody positive and the test results were not influenced by prior addition of porcine insulin to sera. The antibodies were of the IgM and IgG classes. The findings suggest that autoimmune mechanisms are important in the pathogenesis of most cases of insulin-requiring diabetes.
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PMID:Antibody to cultured human insulinoma cells in insulin-dependent diabetes. 4 25

Oral glucose-tolerance test (O.G.T.T.) plasma sugar and insulin levels were measured in 118 newly diagnosed maturity-onset diabetic patients before and after treatment with diet alone for periods of 2 and 6 months. The results of glucose-tolerance tests carried out during treatment could be predicted from the initial test and the weight reduction between the tests. This prediction was not improved by the addition of further variables, including age, obesity, and plasma-insulin levels during the first test. The change in O.C.T.T. plasma-insulin between the first and second tests was predicted by the result of the initial tests, the improvement of glucose tolerance between the two tests, and the degree of weight reduction. 95% of the group achieved some improvement of glucose tolerance after 2 months of dietary treatment, and 59% of the group achieved adequate diabetic control by this time. It is concluded that treatment with diet alone should be the first-line management for patients with newly diagnosed maturity-onset diabetes mellitus.
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PMID:Influence of treatment with diet alone on oral glucose-tolerance test and plasma sugar and insulin levels in patients with maturity-onset diabetes mellitus. 4 96

Serum-lipid concentrations and their relationship to blood-glucose and serum-insulin were examined in non-insulin-requiring diabetics, 62 with and 45 without retinopathy. The age, sex-body-weight, and duration of known diabetes was comparable in the two groups. All were treated by diet only or diet and oral hypoglycaemic agents. Patients with retinopathy had higher fasting serumtriglyceride and serum--cholesterol levels than those without. Compared with a non-diabetic population, significantly more diabetics with retinopathy had raised derum-lipids. The lipid concentrations did not correlate with body-weight, serum-thyroid-stimulating-hormone levels, renal involvement, or fasting blood-sugar. While the blood-sugar concentrations were similiar in the two groups the absolute insulin increment and the relative insulin response to a 50 g. oral glucose load were significantly lower in those with retinopathy than in those without. The impairment of insulin response correlated significantly with the frequency of hyperlipidaemia. It is suggested that insulin deficiency with secondary hyperlipidaemia is characteristic of diabetic patients with retinopathy.
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PMID:Plasma-lipids and glucose/insulin relationship in non-insulin-requiring diabetics with and without retinopathy. 4 69

Serial human placental lactogen (H.P.L.) determinations were carried out in 98 diabetic women during the third trimester of pregnancy. H.P.L. levels were consistently higher than those in normal pregnant women. When patients were classified according to the severity of their diabetes (White classification), no significant differences in H.P.L. were detected between groups. Changes in blood-sugar during the day did not affect H.P.L. readings, and insulin requirements during pregnancy could not be related to H.P.L. levels. 10 pregnancies ended in fetal death, and in 4 of them H.P.L. levels were persistently below 4 mug. per ml. Of these 4 infants only 1, whose intrauterine death remains unexplained, could have been saved, 2 having fatal malformations and another infant having died during an episode of maternal ketoacidosis. Among the 6 unsuccessful pregnancies in which H.P.L. levels were greater than 4 mug. per ml., congenital malformations accounted for 5 losses and hyaline-membrane disease for a single neonatal death. These results indicate that H.P.L. determinations probably have a very limited role in the successful management of diabetic pregnancy.
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PMID:Serial determinations of human placental lactogen in the management of diabetic pregnancy. 4 51

A previous hypothesis in which myasthenia gravis was explained by an immune response to acetylcholine receptors has been validated, and is here extended to cell receptors in general. Receptors on target cells, being accessible to circulating trophic hormones or transmitters, must also be accessible to antibodies which compete with the natural mediator for access to the site. To detect anti-receptor antibodies, physiological assay systems would be more sensitive than conventional immunological assays. Autoimmune responses to receptor sites would require a genetic predisposition to failure of immunological tolerance such as occurs in various autoimmune diseases. This hypothesis is supported by recent findings in hyperthyroidism and a type of insulin-resistant diabetes mellitus, and is applicable to other endocrinopathies, diseases in which dysfunction at receptor sites can be postulated, and regulatory functions within the immune system itself.
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PMID:Vulnerability of cell-surface receptors to autoimmune reactions. 5 55

Accumulation of acetylcholinesterase (AChE) and choline acetylase (ChAc) activities proximal to a tie placed on the sciatic nerve was measured in control, untreated diabetic, and insulin-treated diabetic rats. In the diabetic animals AChE accumulation was reduced by about 20% and ChAc accumulation by about 40%. Insulin treatment eliminated the impairment. It remains an open question whether these reversible functional changes in rat have any counterpart in the diabetic neuropathy of man.
Diabetes 1975 Dec
PMID:Fast and slow axoplasmic flow in sciatic nerve of diabetic rats. 5 67

The proposition that glucagon plays an essential part in maintaining hyperglycaemia in diabetes has been investigated by the study of 5 totally pancreatectomised subjects and 5 age and sex matched insulin-dependent diabetic patients. True basal glucagon values were obtained by the use of a new affinity chromatography technique. The mean fasting plasma-glucose levels of the pancreatectomised subjects was 251 +/- 46 mg/dl. The mean fasting plasma-glucagon level was not significantly elevated above zero (1-3 +/- 0-6 pmol/l) and showed no change following arginine. In the 5 insulin-dependent diabetics the mean fasting plasma-glucagon level of 17-2 +/- 5-3 pmol/l rose to a maximum at 25 minutes of 103-6 +/- 27-5 pmol/l during infusion of arginine. These findings imply the absence of a significant number of normally functioning alpha cells in extrapancreatic sites in man and demonstrate that pronounced hyperglycaemia may occur in the absence of glucagon. Glucagon is probably not of primary importance in the hyperglycaemia of insulin-dependent diabetics.
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PMID:Pancreatectomised man: A model for diabetes without glucagon. 5 31


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