Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixteen patients with type I diabetes were randomly assigned to two groups to evaluate the utility of computer-assisted insulin dosage decision-making. All patients used the same solid-phase reagent strip system for glucose measurement and the same pump. The standard group (n = 9) used standard algorithms for insulin adjustment, whereas the computer group (n = 7) relied on interactive instruction from a small, inexpensive (less than $100) computer. At the beginning of the study, there were no significant differences between groups in C-peptide level, hemoglobin A1c level, age, or duration of diabetes. Mean blood glucose level during the study for the computer group was 121 mg/dl (6.7 mM), which was significantly lower (p less than 0.01) than glucose levels charted by the standard group: 148 mg/dl (8.2 mM). Mean number of blood glucose values charted by the computer group (58 per week) was significantly (p less than 0.01) greater than the number charted by the standard group (51 per week). Hemoglobin A1c values at six weeks correlated with the mean number of blood glucose values charted per week of the study. There was no difference between groups in symptomatic hypoglycemic episodes. Computer-assisted insulin dose decision-making is feasible, safe, and effective in enabling persons with type I diabetes mellitus to achieve lower mean blood glucose values over a six-week period while initiating pump therapy.
 ...
PMID:Randomized trial of computer-assisted insulin delivery in patients with type I diabetes beginning pump therapy. 352 26

Infants of insulin-dependent diabetic mothers are at risk for neonatal polycythemia, hyperbilirubinemia, respiratory distress syndrome (RDS), and hypoglycemia. The purpose of this study was to determine whether labor and delivery management of diabetes may influence the rate of these complications. We hypothesized a priori that: infants of diabetic mothers delivered by cesarean section have a lower rate of neonatal polycythemia and hyperbilirubinemia, but a higher rate of RDS, than infants of diabetic mothers delivered by vaginal route, and poor glycemic control during labor increases the rate of neonatal hypoglycemia. We therefore prospectively studied 122 pregnancies in 100 well-controlled insulin-dependent diabetic mothers. Intravenous glucose and/or insulin was infused during labor to maintain capillary glucose concentration between 70 and 100 mg/dl. Fifty-six pregnancies were concluded by primary or elective cesarean section (group 1), 36 by cesarean section following spontaneous or induced labor (group 2), and 30 by spontaneous or induced vaginal delivery (group 3). Hemoglobin A1, birthweight, and gestational age were similar in all three groups. The rate of neonatal polycythemia was significantly lower in the cesarean section subjects, groups 1 and 2, as compared to group 3 (P less than 0.04). The rate of neonatal hyperbilirubinemia was significantly lower in group 1 (P less than 0.05) as compared to groups 2 and 3. The rate of RDS was higher in group 1 (versus groups 2 or 3), but did not reach significance on initial analysis (P = 0.06); however, group 1 was associated with a significant risk for RDS when corrected for the confounding variables of gestational age and neonatal asphyxia as defined by Apgar scores.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Management of the insulin-dependent diabetic during labor and delivery. Influences on neonatal outcome. 355 73

The purpose of this study was to determine whether measures of anxiety, stress, and means of coping with stress differ in diabetic adolescents in good, fair, and poor metabolic control. Trait anxiety, perceived daily stress, and coping responses to a recent stressful event were assessed in 27 adolescents with Type 1 diabetes mellitus. Information also was obtained regarding the type of stressful events that subjects referred to in completing the coping measure, as well as their appraisals of the events. Hemoglobin A1 (HbA1) obtained at the time of the study was used as a measure of antecedent metabolic control. Based upon their HbA1, patients were divided into three metabolic control subgroups: good control (M = 8.4%; n = 8), fair control (M = 10.9%; n = 9), and poor control (M = 13.3%; n = 10). Patients in these subgroups were similar with regard to age, disease duration, and socioeconomic status. Results indicated that the subgroups did not differ on the anxiety and stress measures; however, analyses of the coping data indicated that patients in poor control employed significantly more wishful thinking and avoidance/help-seeking than did patients in good metabolic control. Furthermore, the metabolic control subgroups differed in the type of stressful events reported and their appraisals of the stressful events. These results support the hypothesis that the ways in which individuals with diabetes appraise and cope with stress is related to their metabolic control. The findings are discussed in relation to methodological issues and treatment implications.
 ...
PMID:Stress and coping in relation to metabolic control of adolescents with type 1 diabetes. 359 81

Muscle capillary basement membrane width is a sensitive marker for the presence of diabetic microangiopathy. Studies have indicated that genetic factors and alterations in glucose metabolism influence muscle capillary basement membrane width. To define the role of these factors we have measured muscle capillary basement membrane thickness in controls, insulin dependent diabetics, and individuals with diabetes secondary to the ingestion of Vacor, a rat poison, which results in hyperglycemia. Hemoglobin A1 concentrations were increased in both diabetic groups, but hemoglobin A1 levels and the duration of diabetes were similar in the two diabetic groups. The muscle capillary basement membrane width was increased to a similar extent in the insulin-dependent diabetics (control, 1,781 +/- 46 vs. IDD, 2,287 +/- 144 A, P less than 0.001) and in the Vacor diabetic group (2,320 +/- 149 A, P less than 0.001). In the insulin-dependent diabetic group, 63% of the patients had a muscle capillary basement membrane width greater than two standard deviations above the mean of the controls, while in the Vacor diabetic group this figure was 56%. Despite the relatively short duration of diabetes (6.2 +/- 0.3 yr), 44% of the Vacor diabetic patients had retinopathy and 28% had proteinuria. The present study provides strong evidence that even in the absence of genetic diabetes mellitus, hyperglycemia or some other abnormality related to insulin lack can cause microvascular changes.
 ...
PMID:Muscle capillary basement membrane width in patients with vacor-induced diabetes mellitus. 372 72

The relationship between repetitive hemoglobin A1 values and daily blood glucose tests performed by 20 insulin-dependent diabetic outpatients was assessed over a six-week period using a modified reflectance meter capable of storing blood glucose determinations automatically. An average of four and a half determinations per subject per day was recorded with a range of average blood glucose values between 82 +/- 2 mg/dl and 316 +/- 5 mg/dl (mean +/- SE). The relationship between average blood glucose and hemoglobin A1 values was significant when hemoglobin A1 values at the end of the six-week period were correlated with the mean blood glucose level over that period (r = 0.55, p less than 0.02), but improved when a more remote hemoglobin A1 value obtained at 10 weeks was used (r = 0.64, p less than 0.005). Hemoglobin A1 values covering two-week intervals were extremely poor in reflecting average glycemia. The average fasting blood glucose level in these subjects was highly correlated with the overall daily blood glucose values (r = 0.89, p less than 0.0001), although the coefficients of variation of these parameters averaged 43 +/- 3 percent and 47 +/- 2 percent, respectively, and were greater than that of the hemoglobin A1 values over six weeks (10 +/- 2 percent). It is concluded that labile blood glucose control in patients with insulin-dependent diabetes is accurately reflected by the average fasting blood glucose level, although multiple determinations must be employed. Satisfactory assessment may be made by use of hemoglobin A1 value provided that the hemoglobin A1 determination follows a sufficiently long period of time, presumably related to the turnover of glycosylated hemoglobin.
 ...
PMID:Assessment of long-term glycemia in type I diabetes using multiple blood glucose values stored in a memory-containing reflectometer. 372 5

This study was performed to examine the relationship between postmortem biochemical values and cause of death. The follow samples were taken from 399 corpses: cerebrospinal fluid (CSF; n = 376, suboccipital), blood (n = 158, femoral vein), and urine (n = 101, at autopsy). (See Table 1 for causes of death) All samples were stored at -80 degrees C. A further 100 samples of blood were later taken and stored at +4 degrees C before testing. Biochemical determinations made were: glucose in CSF, blood, and urine (hexokinase method); lactate (LDH/GPT) and free acetone (HS-gas chromatography) in CSF; hemoglobin A1 in blood (microcolumn technique). In 34 cases fatal diabetic coma was considered verified by morphological and chemical findings. One hundred cases of sudden cardiac death were chosen as the main control group. In 32 of the 34 cases defined above, the value of the formula of Traub (glucose + lactate in CSF) exceeded 415 mg/dl. It is not influenced significantly by hyperglycemia or hyperlactatemia due to factors other than diabetes (i.e., carbon monoxide, asphyxia). After death the value rose till the 30th hpm, then remained stable for at least 1 week. Fatal coma was defined as the ketoacidotic form if free acetone in CSF ranged above 21 mg/l. In these cases, CSF glucose and free acetone correlated positively. Hemoglobin A1 remained stable after death. Its amount was independent from postmortem blood glucose, postmortem interval and total hemoglobin. Furthermore, the manner of storage (-80 degrees or +4 degrees C) had no significant influence on its values. In 29 of 34 cases of fatal coma, Hb A1 exceeded 12.1%. Analysis of urine glucose showed elevated levels (over 500 mg/dl) in diabetic comas. On conclusion, fatal diabetic coma seems indicated as the cause of death if measured values of postmortem biochemistry exceed the following limits: CSF-Traub 415 mg/dl, free acetone (CSF) 21 mg/l; Hb A1 12.1%; urine glucose 500 mg/dl. Most important are the Traub formula and hemoglobin A1. Usually, in fatal coma both values are elevated. If both of them are normal, diabetic coma can nearly be excluded. Combined evaluation of all values is absolutely necessary. Morphology must also always be taken into account. Consequently, a diagnosis of fatal coma can be obtained by a process of elimination.
 ...
PMID:[Biochemical measurements of glucose metabolism in relation to cause of death and postmortem effects]. 376 99

Childhood or insulin-dependent diabetes is a life-long illness, placing complex and daily demands on the patient and the family. Some studies were carried out in order to investigate the relationship between health status, behavioral and psychological variables. The Hemoglobin A1 was used to index glycemic control. A newly developed diabetes knowledge test and a questionnaire on diabetic related beliefs were administered. The results indicate that diabetic control improves with age. General knowledge of diabetes increases with age, but relates not to diabetic control. But considering age and the particular subtests of knowledge as predictors 59.44% of the variance in diabetic control can be estimated. Perceived barriers to implementing self-care and feelings of disruptiveness culminate in the age of 12 to 13 years. Feelings of stigmatization and the affection by the disease loose weight as disturbing factors with increasing age and knowledge. Increased attention to the child's cognitive developmental level is suggested and methods for improving the effectiveness of patient intervention programs are discussed.
 ...
PMID:[Behavioral medicine aspects of juvenile diabetes]. 381 78

In an attempt to detect early evidence of hemochromatosis-induced diabetes mellitus, hemoglobin Alc (Hgb Alc) levels were determined in four patients treated with chronic transfusions. All four were found to have significantly elevated Hgb Alc levels on several occasions. On further investigation, it was discovered that elevated levels of glycosylated hemoglobin were present in donor blood stored in dextrose solutions, thus leading to a higher level in the recipients. Hemoglobin Alc levels appear to be unreliable in patients receiving large amounts of transfused blood.
 ...
PMID:Chronically transfused patients with increased hemoglobin Alc secondary to donor blood. 394 27

We examined prospectively the relationship of psychosocial factors to glycemic control in a program of self-glucose monitoring (SGM). Measured intelligence (IQ), educational level, and socioeconomic status (assessed by the Two-Factor Index of Social Position) were determined in 25 patients who were followed during 6 months of self-glucose monitoring. Personality categories, reflecting degrees of psychological disturbance, were assigned using the Minnesota Multiphasic Personality Inventory (MMPI). None of the measured psychosocial variables correlated significantly with initial Hgb A1 values. In contrast, after 6 months of SGM, Hgb A1 levels correlated significantly with both socioeconomic status (r = 0.42, p less than 0.05) and educational levels (r = -0.42, p less than 0.05). Hemoglobin A1 levels also correlated significantly with the recorded frequency of SGM (r = -0.65, p less than 0.01), a measure of patient compliance. No significant correlation between IQ and Hgb A1 levels was seen, either initially or during follow-up. High A1 values differed significantly among groups classified by MMPI testing. Patients with severe psychological abnormalities had higher (p less than 0.05) mean Hgb A1 levels. We conclude that psychosocial factors, but not measured intelligence, have an important bearing on patient success in a program of SGM.
Diabetes Res 1985 Mar
PMID:Effect of psychosocial factors on success in a program of self-glucose monitoring. 404 33

To determine if semisynthetic human insulins are useful in the outpatient management of insulin-dependent diabetes, the conditions of eight patients were evaluated for three months using short- and intermediate-acting insulins. No complications of either insulin preparation were observed. Hemoglobin A1c levels were decreased from 8.4% to 6.9% during human insulin use, and, in addition, normal hemoglobin A1c levels were maintained in patients using portable insulin infusion pumps. These results were achieved because of the health care provision team and were not directly the result of human insulin. Semisynthetic human insulins were also associated with lower levels of circulating insulin antibody. These data indicate that both short- and intermediate-acting semisynthetic human insulins are effective in stringent diabetes metabolic control, provided adequate health care provision is available.
 ...
PMID:Outpatient use of intermediate- and short-acting semisynthetic human insulins. 633 49


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>