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

In connection with two observations histologically proved on a metastasic territory of osteomalacia appeared during osteocondensing metastases of prostatic origin, the authors underline the responsibility of sudden increase of osteoformation in the hypocalcemia genesis and put the emphasis on the transitory aggravating function of the given high doses of estrogen within negative calcium balance. A D vitamin deficiency, frequent among old patients, could increase osseous manifestation of calcium supply insufficiency responsible of an authentic osteomalacia. This deficiency is not secondary to a phosphorus diabetes and is amended by an important calciu addition and by the administration of D vitamin metabolites as proved by repeated osseous biopsy with dynamic and histomorphometric studies.
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PMID:[Vitamin-sensitive osteomalacia in condensing bone metastases of prostatic origin. Apropos of 2 cases]. 725 62

Streptozotocin-induced diabetes was studied in male and female rats weighing 188 and 145 g, respectively, at the start of the experiment. After 79 days in the diabetic condition the weights and lengths of different bones were less in the diabetic rats than in two nondiabetic control groups, i.e., ad libitum fed and a group restricted in food intake to achieve the same body weight as the diabetic rats. The concentrations of calcium, phosphorus, and sodium were similar in the diabetic and nondiabetic groups, whereas the concentrations of iron and zinc were higher in the diabetic rats. Results for the concentration of potassium, magnesium, and chromium showed a less uniform pattern between groups and between males and females. It is concluded that the length and weight of bones in diabetic rats are less than nondiabetic rats of the same body weight. This results in a lower total amount of calcium, phosphorus, sodium, potassium, magnesium, and chromium. This observation was similar in all three bones studied. Therefore, prolonged streptozotocin-induced diabetes does interfere with the normal pattern of bone mineralization.
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PMID:Mineralization of different bones in streptozotocin-diabetic rats: study on the concentration of eight minerals. 728 93

Renal elimination of uric acid, calcium, phosphorus, sodium, potassium, chloride and magnesium and urinary acidification capacity were determined in ten insulin-dependent diabetics and in ten matched control subjects. The diabetics showed excessive excretion of uric acid, sodium, potassium, chloride and ammonia. Sodium, chloride and ammonia excretion fractions was also increased with respect to controls. The enhanced excretion of these substances in diabetics failed to relate to glomerular filtration rate, glycosuria or insulin requirements. These findings might be explained on the basis of glomerular filtration rate elevation, tubular response to this increment, and the underlying metabolic disturbances of diabetes.
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PMID:Renal tubular function and urinary acidification capacity in early juvenile diabetes. 730 70

Following previous work showing that i.v. arginine induces a fall in blood phosphorus and an increase in blood potassium in normal subjects, investigation of the mechanism underlying these metabolic changes was extended to a group of 14 insulin-dependent diabetics and a further 6 normal volunteers. In the diabetics, arginine (0.5 g/kg body weight) in 30 min caused a slight, but significant fall in blood phosphorus (delta = -0.40 +/- 0.04 mg/ml p less than 0.01). This was well below the fall noted in the normal subjects, which, as demonstrated in the earlier study, is to a great extent mediated by insulin. The increase in blood potassium was much more marked than in the normal subjects (delta = + 1.42 +/- 0.15 mEq /l; p less than 0.001) and rose to pathological levels (5.6 to 6.5. mEg/l) in 9 out of 14 patients. There were no significant changes in blood pH, plasma osmolality, or plasma aldosterone. Inhibition of the glucagon response to arginine by means of a priming dose of 250 micrograms somatostatin, followed by infusion of 1,500 micrograms/hr, did not abolish the rise in blood potassium. These findings indicate that insulin protect against arginine-induced hyperkalaemia and that this metabolic alteration does not depend on glucagon, acidosis, enhance plasma osmolality, nor the suppression of aldosterone secretion. Persons with low insulin secretion due, for example, to stress or diabetes, run the risk of pathological hyperkalaemia if subjected to i.v. infusion of arginine.
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PMID:The risk of pronounced hyperkalaemia after arginine infusion in the diabetic subject. 731 14

A graded sieving procedure was used to isolate glomeruli and tubules from renal cortex of men of premature age up to 80 years and of 4 patients suffering from Zellweger syndrome, congenital nephrotic syndrome, polycystic renal disease or diabetes mellitus. Glomerular and tubular basement membranes (GBM and TBM, respectively) were obtained with a detergent procedure. Purity of basement membrane preparations was controlled with light and electron microscopy and by estimating total phosphorus content. Amino acid and carbohydrate composition of the basement membranes were determined and statistically evaluated. Comparison of GBM and TBM from the same kidneys showed at all ages that GBM contains more 3-hydroxyproline, neuraminic acids and mannose. These differences may contribute to the different immunogenic properties of the two basement membranes reported in the literature. Significant changes with age in the chemical composition were found, suggesting that the proportion of collagenous peptide moieties increases and that of noncollagenous peptide moieties decreases with age in both GBM and TBM. In addition, the hydroxylation grade of proline and lysine increases significantly with age reaching an adult level for GBM after 4-6 months of age and for TBM at late childhood. The age-related changes in basement membrane composition may influence functional properties of these extracellular renal structures. The chemical composition of GBM and/or TBM of the 4 patients showed some differences in comparison to control preparations from persons with ages approximating that of the patients.
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PMID:Variations in chemical composition of human glomerular and tubular basement membranes with age and disease. 732 36

We investigated the effects of ingesting 75g of glucose on urinary excretion of electrolytes in patients with chronic glomerulonephritis (CGN) and diabetes mellitus (DM) over a 4-hour period. Creatinine clearance did not change in patients with either disease following glucose ingestion. Fractional excretion of sodium (Na), chloride (Cl) and potassium (K) decreased significantly, while that of calcium (Ca) and magnesium (Mg) increased significantly in both groups. The change in fractional excretion of phosphorus (P) differed between patients with CGN and DM. Fractional excretion of P increased initially, then decreased significantly in patients with CGN, while it decreased steadily in patients with DM. In diabetic patients, significant positive relationships were observed between cumulative filtered glucose and cumulative urinary excretion of Ca (r = 0.47, p < 0.05) and P (r = 0.54, p < 0.05). In addition, cumulative plasma IRI concentration was correlated inversely with cumulative urinary excretion of K (r = -0.54, p < 0.05) in diabetic patients. In nephritic patients. however, no significant relationship was observed among these variables. In conclusion, renal tubular reabsorption of Na, K and Cl was enhanced, while that of Ca and Mg was inhibited after glucose ingestion in both CGN and DM patients. Moreover, filtered glucose may be involved partially in the inhibitory effect on tubular reabsorption of Ca and P in diabetic patients.
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PMID:[Effects of glucose ingestion on urinary excretion of electrolytes: comparison between patients with chronic glomerulonephritis and diabetes mellitus]. 760 10

Renal osteodystrophy in diabetic patients on maintenance hemodialysis is characterized by a higher prevalence of low bone turnover and is associated with a relative deficiency of parathyroid hormone (PTH) as compared with non-diabetic hemodialysis patients. The goal of the study was to evaluate how diabetes affected the development of secondary hyperparathyroidism (2 degrees HPT) and bone disease in azotemic rats. Three groups of 5/6 nephrectomized, pair-fed male Wistar rats maintained on a high phosphorus (1.2%) diet were studied: (1) the control group, non-diabetic azotemic rats (NDR); and two streptozotocin-induced diabetic azotemic groups, (2) poorly-controlled diabetic rats (PCDR) which received only enough NPH insulin to maintain the blood glucose between 300 and 400 mg/dl, and (3) well-controlled insulin-treated diabetic rats (IDR) which received a continuous insulin infusion for 14 days via a subcutaneously implanted miniosmotic pump. Serum calcium, phosphorus and creatinine levels were similar among the three groups. Blood glucose levels were greater in the PCDR group than the IDR and NDR groups (358 +/- 11 vs. 83 +/- 9 and 87 +/- 8 mg/dl, respectively; P < 0.001). Rats in the PCDR group weighed less at sacrifice as compared with the IDR and NDR groups (P < 0.05). Serum PTH levels (normal 47 +/- 2 pg/ml) were elevated, but not different among the three groups (136 +/- 34, 147 +/- 21 and 98 +/- 8 pg/ml in the PDCR, IDR and NDR groups, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Development of secondary hyperparathyroidism and bone disease in diabetic rats with renal failure. 764 45

The present study was undertaken to determine whether improvement of hyperglycemia alters calcium and phosphorus handling, parathyroid hormone (PTH) secretion and bone turnover in patients with non-insulin-dependent diabetes mellitus (NIDDM). We measured serum and urinary mineral levels, serum intact PTH and osteocalcin on admission and at discharge (38 +/- 3 days later, Means +/- SEM) in 28 patients with poorly-controlled NIDDM (63 +/- 2 years old, 13 males and 15 females). During the hospitalization period, glycemic control was markedly improved. Serum calcium levels remained unchanged, but serum phosphorus increased. Urinary calcium and phosphorus excretion decreased. Serum intact PTH decreased from mid-normal (30.0 +/- 2.2 ng/l) to low normal values (24.0 +/- 1.3 ng/l) (P < 0.01, normal values: 10-65 ng/l). Serum osteocalcin increased from 4.14 +/- 0.35 to 4.92 +/- 0.40 micrograms/l (P < 0.01, normal values: 2.5-13 micrograms/l). On admission, urinary calcium and phosphorus excretion showed a positive correlation with urinary glucose excretion. Serum calcium levels showed a negative correlation with serum intact PTH (r = -0.46, P < 0.05). Moreover, the change in serum calcium during the hospitalization was negatively correlated to the change in serum intact-PTH (r = -0.45, P < 0.05). Serum phosphorus concentrations showed a positive correlation with the renal threshold for phosphorus excretion on admission (r = 0.86, P < 0.01). These results indicate that hyperglycemia causes excess urinary calcium and phosphorus excretion in patients with NIDDM. In response to urinary calcium loss, PTH secretion is mildly stimulated. Bone formation seems to be suppressed in the hyperglycemic state in spite of increased PTH secretion.
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PMID:Effect of glycemic control on calcium and phosphorus handling and parathyroid hormone level in patients with non-insulin-dependent diabetes mellitus. 767 May 67

A 50-year-old man was admitted to our hospital for the evaluation of hypocalcemia and the treatment of diabetes mellitus. Seven months before admission, he sometimes felt thirst and polyuria, and 4 months before admission, he went to a doctor to check his blood glucose and was diagnosed as having diabetes mellitus which had suddenly developed. At that time he was treated with sulfonylurea, but his diabetic control was very poor. At the time of admission to our hospital, the patient's serum calcium (Ca) level was 5.7 mg/dl, phosphorus (P) 5.0 mg/dl, and fasting blood glucose 308 mg/dl, but urinary ketone bodies were not detected. High sensitive assay of parathyroid hormone (HS-PTH), intact PTH and C-terminus PTH concentrations were under the level of detection. TSH level was slightly high (6.1 mu U/ml) with positive antimicrosomal and antithyroglobulin antibodies but thyroid hormone levels were within normal limits. TRH test showed over-response of TSH. Based on Ellsworth-Howard test, we made the diagnosis of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus. He was treated with insulin twice a day and reached good control, and he was also administered 1 alpha-OH-D3 and calcium lactate resulting in an increase of serum Ca level after 2 weeks. These findings suggest that this case may be a polyglandular autoimmune (PGA) syndrome type 1 reported by Neufeld, which is very rare in Japan. The type of diabetes mellitus of this case is controversial. It is, however, necessary to pay attention to the decrease of the patient's insulin-secreting activity because autoimmune disorders are accompanied by this case.
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PMID:[A case of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus]. 795 10

Distal penile gangrene associated with renal failure is a rare entity with only 3 cases reported in the literature. Certain physiological abnormalities are commonly found in association with this condition, including secondary hyperparathyroidism, diabetes and peripheral vascular disease. We report our experience with 7 patients who presented with this condition. All patients had end stage renal disease with 5 on hemodialysis, 1 on peritoneal dialysis and 1 with a functioning cadaveric renal transplant. Six patients had diabetes mellitus and all had derangements of the calcium and phosphate metabolism, with the calcium-phosphorus product being greater than 70. Five patients were treated expectantly with resolution of gangrene in 2 and stable disease in 3. Three of the 5 patients managed expectantly and both patients treated with penectomy died of unrelated causes within 3 months. We conclude that there is no advantage to aggressive surgical treatment of penile gangrene associated with renal failure, since the outcome is the same. The overall mortality for this group is high due to associated co-morbid disease regardless of the type of treatment. Furthermore, subtotal parathyroidectomy is not indicated, since spontaneous improvement and mortality rates reported in our series were similar to those of previously reported cases. Expectant management of affected patients affords the best treatment.
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PMID:Penile gangrene associated with chronic renal failure: report of 7 cases and review of the literature. 766 14


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