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

The aetiology of erectile dysfunction in men with diabetes remains unclear and is likely to be multifactorial. To explore clinical factors of possible aetiological relevance, 59 men with diabetes and erectile dysfunction (ED), referred to a sexual problem clinic, were compared with an age-matched group of non-diabetic clinic attenders with ED. Sexual interest was both higher and correlated negatively with age in the diabetic groups. There were differences in the sexual problems experienced by partners in the two groups. Both groups had received nocturnal penile tumescence (NPT) monitoring and the majority had received intracavernosal injections of PGE1 to assess capacity for erectile response. Twenty-nine percent of the diabetic men had satisfactory NPT, and most of these had other evidence of psychogenic causation. The men with diabetes were more likely to have a satisfactory response to intracavernosal injections of PGE1, and this was particularly the case among those with impaired NPTs. This difference requires explanation and may be of aetiological relevance.
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PMID:Erectile dysfunction in men with and without diabetes mellitus: a comparative study. 891 90

Prostaglandin I2 (PGI2) produces greater vasodilating and anti-platelet effects than PGE1, but is chemically unstable. Beraprost sodium, a stable analog of PGI2, was given orally, 120 micrograms daily for 12 weeks, to 15 patients with non-insulin-dependent diabetes mellitus to evaluate its effect on autonomic function. The effect of the drug on heart rate (HR) was evaluated in response to standing, rest, and deep breathing. The drug had a significant effect on HR in response to standing, but not during rest or deep breathing. Nine patients without preproliferative or proliferative retinopathy, and in whom factor analysis suggested the drug was effective with respect to autonomic nerve dysfunction, showed a significant improvement in their response to the three tests after beraprost administration for 12 weeks. Blood glucose was unaffected. Results thus indicate that beraprost sodium alleviates autonomic nerve dysfunction in diabetic patients in the absence of severe retinopathy.
Diabetes Res Clin Pract 1996 Mar
PMID:Effect of beraprost sodium on response to tests of autonomic control of heart rate in patients with diabetes mellitus. 879 11

Erectile impotence is more common in the diabetic than the general population, occurs at a younger age, and is often associated with ejaculatory problems. For these, and possibly for other more subtle reasons, fertility may be a problem for men with diabetes. The symptoms of erectile and ejaculatory dysfunction are frequently not discussed between patient and doctor. Psychological factors are important but the vast majority of diabetic patients have an organic basis for their impotence. Both neurogenic and vascular factors are important in the pathogenesis of erectile failure. Autonomic neuropathy is almost certainly the cause of the ejaculatory failure that may be present in up to 40% of men with diabetes. The final biochemical mediator of erection within the penile erectile tissue is nitric oxide and a key enzyme in its degradation is phosphodiesterase (type V). Drugs that affect the metabolism of this enzyme are being developed to treat erectile failure. At present, the self injection of intra-cavernosal erectogenic agents (such as prostaglandin E1) provide the main form of therapy for erectile failure. Vacuum devices are a simple alternative and venous ligation surgery may be effective for a properly selected cohort of patients. Prosthetic implants are a final option for patients in whom all else has failed. Fertility problems, particularly when associated with ejaculatory failure can be overcome with modern assisted reproductive techniques. Nowadays, these will frequently involve gamete micro-manipulation.
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PMID:The aetiology and management of erectile, ejaculatory, and fertility problems in men with diabetes mellitus. 886 43

Erectile impotence may be of neuropathic, vascular, psychogenic and hormonal origin or may be caused by their combination. This impotence occurs in up to 10% of sexually active men. The injection of prostaglandin E1 (PGE1) into the penile cavernous bodies results in venous occlusion warranting maximal erection. Edex (PGE1) was given to 23 patients aged 43-68 years (mean age 58.9 years) suffering from impotence as a result of prostatic cancer (5 cases), postprostatic adenomectomy condition (8 cases), chronic prostatitis (4 cases), diabetes mellitus (4 cases), chronic alcoholism (1 case), spinal trauma (1 patient). The dose (from 5 to 20 micrograms) was adjusted individually. Good, satisfactory and poor effects were achieved in 86.2, 13.0 and 4.3% of the patients, respectively. In prostatic cancer males on hormone therapy and after adenomectomy the effect was obtained in 76.9% (in 10 of 13 males). An old age is not a contraindication for intracavernous injections of Edex.
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PMID:[The intracavernous injection of Edex (prostaglandin E1) in the treatment of erectile impotence in persons in older age groups]. 903 6

Injury of endothelial cells (EC) has been postulated as the initial trigger of the progression of atherosclerosis in patients with diabetes mellitus. We previously reported that decrease in a novel endothelium-specific growth factor, hepatocyte growth factor (HGF), by high D-glucose might be a trigger of endothelial injury. However, the physiological role of the local vascular HGF system has not yet been clarified. To investigate the role of HGF in endothelial injury, we initially examined the effects of HGF on endothelial injury induced by serum deprivation. Decrease in EC number by serum deprivation was significantly attenuated by addition of HGF as well as recombinant basic fibroblast growth factor, whereas vascular endothelial growth factor showed no effect. Apoptotic changes in EC induced by serum deprivation were also significantly attenuated by addition of HGF (p < 0.01). Given the protective action of HGF, we next studied the physiological role of local HGF production in endothelial regulation. We focused on the protective actions of prostaglandin (PG) I2, PGE and a phosphodiesterase type 3 inhibitor (cilostazol) on endothelial injury by high glucose, since these agents are widely used in the treatment of peripheral arterial disease which is frequently observed in diabetic patients. Treatment of human aortic EC with PGE1, PGE2, and a PGI2 analogue (beraprost sodium) as well as cilostazol stimulated EC growth. HGF concentration in conditioned medium from EC treated with PGE1, PGE2 or PGI2 analogue as well as cilostazol was significantly higher than that with vehicle (p < 0.01). Interestingly, treatment with PGI2 analogue or cilostazol attenuated high D-glucose-induced EC death, which was abolished by neutralizing anti-HGF antibody. Moreover, decreased local HGF production by high D-glucose was also significantly attenuated by PGI2 analogue or cilostazol. Finally, we tested the effects of PGE, PGI2 analogue and cilostazol on local HGF production in human aortic vascular smooth muscle cells (VSMC). Although high D-glucose treatment resulted in a significant increase in VSMC number, PGI2 analogue and/or cilostazol treatment had no effects on VSMC growth. However, the decrease in local HGF production by high D-glucose was significantly attenuated by addition of PGI2 analogue or cilostazol. Overall, this study demonstrated that treatment with PGE, PGI2 analogue or cilostazol prevented aortic EC death induced by high D-glucose, probably through the activation of local HGF production. Increased local vascular HGF production by prostaglandins and cilostazol may prevent endothelial injury, potentially resulting in the improvement of peripheral arterial disease.
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PMID:Role of hepatocyte growth factor in endothelial regulation: prevention of high D-glucose-induced endothelial cell death by prostaglandins and phosphodiesterase type 3 inhibitor. 930 Feb 42

Oxidation of lipoproteins, and, in particular, low-density lipoproteins (LDL), has been shown to play a significant role in the pathogenesis of atherosclerosis. Oxidized LDL are endocytosed via scavenger receptors to form lipid-laden foam cells. The non-enzymatic reaction of glucose with proteins and lipoproteins results in a modified LDL involved in the pathogenesis of late complications in diabetes mellitus. In the present paper, the influence of various E-series prostaglandins (PGE1; 13,14-dihydro PGE1; 13,14-dihydro 15-keto PGE1; and PGE2) on oxidation of native and glycated LDL was investigated. The effect of these agents in the concentration range from 1 pg/mL to 1.6 micrograms/mL on copper-induced oxidation of native and glycated LDL was tested. The concentration of each agent causing the maximal effect on oxidation of native LDL, as measured by the formation of thiobarbituric acid-reacting substances, was chosen to estimate the effect on 2, 4, 8, and 24 h oxidation of glycated LDL. The study was performed with LDL isolated by sequential ultracentrifugation from normolipidemic individuals. LDL (0.25 mg protein/mL) was oxidatively modified with 5 microM CuSO4. The glycosylation of LDL was performed by incubation of LDL with 500 mM glucose for varying periods of time ranging from 10 to 31 days. Our results show that only 13,14-dihydro PGE1 significantly inhibits copper-induced oxidation of native LDL, while the other examined E-series prostaglandins in vitro are ineffective as reducing agents in LDL-oxidation.
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PMID:Do E-series prostaglandins and their metabolites influence oxidation of native and glycated low-density lipoproteins? 966 Dec 19

We have investigated the influence of PGE1 (alprostandil--"Prostavasin"--Schwarz Pharma company) on the erection in the group of 34 men with erectile disfunction (28 with and 6 without diabetes mellitus) treated in period from 1996 to 1998. Other diseases were excluded in all patients. The concentrations of FSH, LH, T, PRL, T3 and T4 were in normal range. The applied dose of PGE 1 varied from 5 mg to 20 mg maximum three times a week. The effect of the treatment was estimated according to subjective symptoms. The effectiveness of the treatment varied from 50% to 67%. The most effective dose was the maximal one (20 mg). The minimal effective dose of alprostadil was 10 mg.
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PMID:[The evaluation of efficiency of PGE 1 (alprostadil) during intracavernous injection in the treatment of erectile dysfunctions]. 969 77

We report a 49-year-old woman with severe diabetic scleredema (DS). The patient had non-insulin-dependent diabetes mellitus (NIDDM) for 9 years and noticed thickened skin on her back 3 years previously. Her DS rapidly extended to her back and extremities with pain and immobility. Her symptoms of DS improved dramatically after establishing strict glycemic control and intravenous administration of prostaglandin E1 (PGE1). However, the histological findings of her skin biopsy did not change even after the treatment for 12 weeks, and her symptoms worsened again after discontinuation of glycemic control and PGE1 treatment. The causes of DS have been considered to be metabolic abnormalities associated with hyperglycemia and hypoxia in the skin due to diabetic microangiopathy. PGE1 was an effective treatment for DS in our patient. Strict control of hyperglycemia and PGE1 treatment may be sufficient to manage DS, although a very long treatment period is necessary.
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PMID:Severe diabetic scleredema with extension to the extremities and effective treatment using prostaglandin E1. 984 Jul 9

We report a case of renal papillary necrosis with diabetes mellitus which was treated with prostaglandin E1. An intravenous infusion of 40 mg/day prostaglandin E1 was given for 14 days in an attempt to improve renal circulation. Treatment resulted in an improved creatinine clearance, renal plasma flow and renogram, and proteinuria was decreased. The administration of prostaglandin E1 produced an improvement in renal haemodynamics and can be considered as a possible therapy for renal papillary necrosis in diabetic patients.
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PMID:Prostaglandin E1 for renal papillary necrosis in a patient with diabetes mellitus. 1044 96

A 56-year-old female, who had been suffering from heart failure and diabetes mellitus, underwent posterior instrumentation in the prone position and anterior interbody fusion in the right lateral decubitus position for pyogenic spondylitis between the fourth and fifth lumbar spine under general and epidural anesthesia. We induced hypotensive anesthesia by using continuous infusion of dopamine, prostaglandin E1 and nitroglycerin in order to prevent heart failure and reduce the blood loss. After the operation, the patient complained of upper abdominal pain, nausea and vomiting. We found high levels of serum amylase and other pancreatic enzymes. The massive gas of small intestine was pooled in abdominal X-P, and the pancreatic head was slightly swollen in abdominal CT and US. Therefore we came to the diagnosis of postoperative acute pancreatitis. We administered a single bolus intravenous infusion of ulinastatine and continuous venous infusion of gabexate mesilate. As the serum amylase level gradually decreased, the patient improved. We suspect that postoperative pancreatitis was due to invasive anesthetic and surgical stress on the patient who had had pancreatitis in the preoperative period.
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PMID:[A case of acute pancreatitis that occurred after an operation of the lumbar spine]. 1088 49


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