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)

The use of EN in diabetics is problematic due to the rapid absorption of the nutrients and difficulties in controlling glycemia. The purpose of this study is to evaluate the clinical tolerance and effects of a special diet for patients unable to tolerate glucose on glycemia and insulin requirements, containing 50% of its caloric intake in the form of fats (mainly monounsaturated fatty acids) and a high fibre content. This diet was used on a group of Intensive Care patients with stress diabetes, comparing it to a high protein diet in terms of Nitrogen Balance and evolution of circulating proteins. 35 patients admitted to Intensive Care with traumas or sepsis were studied. The patients received EN for a period of 14 days. They were divided into two groups at random. Group A received a high protein diet and Group B the special diet for patients with intolerance to glucose. In Group A, the levels of glycemia and insulin requirements were significantly higher than those of Group B. There were no significant differences in albumin, transferrin, prealbumin and RBP levels in both groups. Cholesterol levels remained normal, although on day 14 they were higher in Group B patients. Group A patients had higher triglyceride levels. The nitrogen balance was only higher on days 6 and 7 in Group A patients, with and accumulated Balance for the 14 days of 11.54 +/- 3.5 g. In Group A compared to 6.24 +/- 2.63 g. in Group B. Clinical tolerance to the diet was satisfactory, with the usual problems in critical patients.
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PMID:[Experience with an enteral diet with fiber and a high fat content in ICU patients with glucose intolerance]. 132 77

Serum albumin, transferrin, transthyretin (prealbumin), and retinol binding protein concentrations were determined in 74 children with insulin-dependent diabetes mellitus before and after a 10-day camp session during which blood glucose concentrations were controlled. Initial concentrations of albumin and transferrin in the subjects were not different from those in 21 children and adults without diabetes, and did not change during the study period. Transthyretin and retinol binding protein concentrations were lower in subjects with diabetes than in the control population, and increased from 182 +/- 49 mg/l and 42.5 +/- 13.4 mg/l to 232 +/- 71 mg/l and 47.2 +/- 13.5 mg/l, respectively. We observed correlations between the changes in transferrin, transthyretin, and retinol binding protein. Although reductions in glycated albumin and transferrin indicated improvement in blood glucose control, there was no correlation between changes in the glycated markers and the concentrations of serum transport proteins. Thus, serum protein concentrations were influenced by the metabolic control of diabetes, but did not directly reflect blood glucose.
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PMID:Effect of metabolic control on serum protein concentrations in diabetes. 175

Plasma levels of retinol binding protein (RBP), prealbumin, total protein, albumin, transferrin and ferritin were estimated in three groups of diabetic patients seen at a diabetes centre in S. India. The groups consisted of patients with fibrocalculous pancreatic diabetes (FCPD), non-insulin-dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM). Mean RBP levels were lower in FCPD and IDDM patients compared to controls but this did not reach statistical significance. Prealbumin levels were normal in FCPD patients, but low in IDDM compared to controls (P less than 0.005) and NIDDM (P less than 0.05). FCPD patients had lower transferrin levels compared to controls (P less than 0.05). There were no differences in the levels of total protein, albumin and ferritin in any of the study groups. The study shows that biochemical evidence of undernutrition is seen in FCPD and IDDM patients while NIDDM patients are not significantly different from non-diabetic control subjects.
Diabetes Res Clin Pract 1991 Mar
PMID:Nutritional profile of fibrocalculous pancreatic diabetes and primary forms of diabetes seen in southern India. 203 42

In this study therapeutic effect of total parenteral nutrition (TPN) for the patients undergoing total gastrectomy was evaluated and following results were obtained. Both incidence and cure rate of anastomotic leakage after total gastrectomy had markedly improved, in spite of increased resection rate and curative operation for the patients with advanced gastric cancer by introducing TPN routinely to the nutritional management. It is important to maintain serum albumin level above 3.0 g/dl to give enough calories and protein (40-50 kcal/kg/day). TPN using a combined carbohydrate solution such as the ratio for glucose, fructose, xylitol (4: 2: 1) seems to have a beneficial effect on the patients with surgical diabetes status. It is suggested that serum albumin is a most promising parameter in nutritional assessment of the preoperative period. But in the early postoperative period, rapid turnover protein such as prealbumin might be more accurate parameter. TPN during chemotherapy as an adjunct to surgery leads to diminished morbidity, and possibly to prolonged survival time in the patients undergoing gastrectomy for gastric cancer.
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PMID:[Nutritional management of the patients after total gastrectomy using total parenteral nutrition (TPN)]. 643 85

Serum biochemical markers suggestive of undernutrition are directly correlated with mortality in hemodialysis and peritoneal dialysis patients. In particular, serum albumin is the most powerful predictor of survival. We have prospectively examined the relationship of single baseline measurements of serum albumin, cholesterol, creatinine, apoproteins, and prealbumin in 250 hemodialysis patients and 140 patients maintained on continuous ambulatory peritoneal dialysis (CAPD) monitored up to 7 years (1987 to 1994). Other variables studied included age, race, gender, diabetes, and number of months on dialysis. Observed survival was computed by the Kaplan-Meier method. Cox's proportional hazards model was used to determine independent predictors of mortality risk. Age, diabetes, prior months on dialysis, and low levels of serum albumin, creatinine, and cholesterol were important and independent predictors of mortality risk in hemodialysis patients. For peritoneal dialysis patients, the independent predictors of mortality risk were age, diabetes, and low serum albumin and serum creatinine. Prealbumin, a serum protein with rapid turnover and relatively small pool, was an important and independent risk predictor in both hemodialysis and CAPD patients. In addition, prealbumin was more highly correlated with other nutritional markers than was albumin. In summary, these findings suggest that biochemical measures associated with visceral and somatic protein depletion are predominant long-term mortality risk factors in patients maintained on hemodialysis and CAPD.
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PMID:Markers for survival in dialysis: a seven-year prospective study. 761 Dec 54

Serum markers of visceral and somatic protein status are directly correlated with the survival of hemodialysis patients. We prospectively examined the relationship of single baseline levels of serum albumin, cholesterol, creatinine, and urea to prognosis in 80 continuous ambulatory peritoneal dialysis patients monitored for up to 33 months. Other variables tested included age, race, gender, diabetes, cause of end-stage renal disease, and number of months on dialysis. The Cox proportional hazards model was used to determine independent predictors of mortality risk. In a subgroup of 33 patients followed for up to 21 months, the predictive value of single measurements of baseline serum prealbumin also was tested. Overall, 29 patients died during the study. Independent predictors of mortality risk included serum albumin (P = 0.024) and creatinine (P = 0.006), diabetes (P < 0.06), prior months on dialysis (P < 0.05), and older age (P = 0.18). In a subgroup of 33 patients with prealbumin measurements, there were nine deaths over 21 months. A serum prealbumin level less than 30 mg/dL was associated with an increased mortality rate compared with higher prealbumin values (odds ratio, 3.8; P = 0.09). We conclude that markers of visceral and somatic nutrition are important and independent predictors of mortality risk in continuous ambulatory peritoneal dialysis patients. We are unable to suggest whether the relationship is causal or causative. However, the predictive value of these single baseline markers were valid for up to 33 months. We also note that patients with diabetes are at an increased risk even after adjusting for somatic and visceral protein status.
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PMID:Predictors of survival in continuous ambulatory peritoneal dialysis patients: the importance of prealbumin and other nutritional and metabolic markers. 828 3

The high morbidity and mortality of hemodialysis patients has led to a search for early markers of risk. Because cardiovascular and nutritional risk are prevalent in this population, we examined the prognostic value of the serum levels of two markers of risk in the general population: (1) lipoprotein(a) [Lp(a)], a low-density lipoprotein-like particle linked to myocardial infarction and coronary bypass stenosis, and (2) prealbumin, a marker of visceral protein status, with a shorter half-life than that of serum albumin. Baseline demographics, clinical information, dialysis prescription, and serum biochemistry measurements of 125 hemodialysis patients followed for up to 14 months were recorded on enrollment. Vascular access events and deaths were recorded prospectively. The hypotheses tested were that increased serum Lp(a) levels would predict cardiovascular mortality and vascular access stenosis and thrombosis, and that reduced serum prealbumin levels would predict mortality risk independently of established risk predictors. Cross-sectional analysis of serum Lp(a) demonstrated a skewed distribution with a median value of 38.3 mg/dL (upper tertile, > or = 57 mg/dL). Lipoprotein(a) was significantly higher in black patients (P < 0.001) and was significantly correlated (P < 0.005) with total cholesterol and apoprotein B (apoB), but not with a history of prior coronary disease. Serum prealbumin was strongly correlated with serum albumin (r = 0.49, P < 0.001). However, prealbumin correlated (P < 0.001) more strongly with other serum nutrition markers (total cholesterol, apoB, creatinine, urea) than did serum albumin. Fourteen-month cumulative survival was 80%. Age, diabetes, and serum levels of albumin, prealbumin, creatinine, total cholesterol and apoB, but not Lp(a), were correlated with survival in univariate analysis. Using the Cox proportional hazards model, independent predictors of mortality risk were prealbumin less than 15 mg/dL versus higher values (relative risk [RR] = 4.48, P < 0.01), apoB (RR = 0.97 per 1 mg/dL increase, P < 0.02), creatinine less than 10 mg/dL versus higher values (RR = 3.51, P = 0.04), and age (RR = 1.04 per year, P = 0.10). Thirty-eight patients experienced at least one vascular access thrombosis (n = 33) or stenosis (n = 5) during the study. Patients with Lp(a) > or = 57 mg/dL had decreased vascular access event-free survival compared with patients with Lp(a) less than 57 mg/dL (56% v 73%, P < 0.06). This trend was increased in magnitude and statistically significant for white and Hispanic patients (31% v 79%, P < 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prealbumin and lipoprotein(a) in hemodialysis: relationships with patient and vascular access survival. 832 86

Plasma prealbumin levels have been used as a sensitive biochemical index in the assessment of nutritional status. The present study was undertaken to determine if diabetic children with uncontrolled diabetes are at greater nutritional risk than those with controlled glycemia. Plasma prealbumin was determined using a radial immunoassay in 42 diabetics and 20 age-matched normal volunteers. Results (mean +/- SE) show that prealbumin levels are significantly (p < 0.02) lower in diabetics (21.5 +/- 1.0) than in normals (25.8 +/- 1.3). Compared with normals, prealbumin levels in controlled diabetics are similar; whereas uncontrolled diabetics have significantly lower (p < 0.05) prealbumin levels. Prealbumin levels were 20.4 +/- 1.7 in uncontrolled diabetics (GHb > 9.00), 21.8 +/- 2.3 in intermediately controlled diabetics (GHb 7.0-9.0), and 22.2 +/- 1.5 in controlled diabetics (GHb < 7.0). The data suggest that diabetics in good control are nutritionally similar to the normal population and that patients in poor control have significantly lower prealbumin than the normal population indicating that metabolic derangement may result in malnutrition.
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PMID:The effect of glycemic control on plasma prealbumin levels in type-1 diabetic children. 845 4

While depressed circulating zinc levels constitute a well-characterized part of the acute phase response, relatively little attention has been paid to the changes in urinary zinc excretion, although urine zinc output has been reported to be elevated in various disorders, mainly those known to be accompanied by inflammatory phenomena. In order to assess the significance of urinary zinc loss and its relationship with the acute phase response, zinc concentration was determined by atomic absorption spectrophotometry together with creatinine in urine samples of patients with different disorders. Plasma zinc, C-reactive protein, alpha-1 acid glycoprotein, haptoglobin, prealbumin, transferrin, and iron have also been determined in some patients. In accordance with the results of previous studies, we report an increase in urinary zinc, notably in solid tumors, hematologic malignancies, autoimmune rheumatic disorders, bacterial infections, diabetes mellitus and nephropathy. We also found a significant positive correlation between urinary zinc and acute phase proteins alpha-1 acid glycoprotein (rs = 0.4649, P < 0.005), haptoglobin (rs = 0.4688, P < 0.005) and C-reactive protein (rs = 0.3636, P < 0.025), as well as a negative correlation with plasma zinc (rs = 0.3640, P < 0.025). As the role of lipid peroxidation in renal tubular cell injury has been proposed, the increased urinary levels of zinc, which has antioxidant properties, may be an important protecting mechanism, representing a part of the acute phase response in the kidney.
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PMID:Urinary zinc excretion in patients with different disorders: the acute phase response in the kidney. 859 75

Patients undergoing dialytic therapy for end-stage renal disease (ESRD) have greater morbidity and mortality than age-matched individuals with similar demographics in the general population. Risk factors for early death during treatment for ESRD include advanced age, diabetes, hypertension, and malnutrition. We questioned whether the level of serum prealbumin at the start of uremia therapy might serve as a marker of subsequent survival in patients treated with maintenance hemodialysis (HD) and peritoneal dialysis (PD). Study cohorts included 111 HD and 78 PD patients followed for up to 5 years. Selected demographic characteristics and biochemical variables were tested for correlation with survival in each cohort. Variables evaluated included age, race, gender, diabetic status, and serum concentrations of albumin, creatinine, cholesterol, and prealbumin. For comparison, expected survival was calculated with Cox proportional hazards analysis, which accounts for confounding variables. We found that a higher relative risk (RR) of death in HD patients correlated with older age, the diagnosis of diabetes, and a serum prealbumin < 30 mg/dL. In PD patients, older age and the presence of diabetes correlated with a higher RR of death than in the standard population. When nutritional variables were analyzed separately, prealbumin < 30 mg/dL was the strongest variable that predicted mortality in HD patients (RR = 2.64, P = 0.002) and also predicted increased risk of mortality in PD patients (RR = 1.8, P = 0.035). Observed and expected survival was significantly higher in patients with enrollment prealbumin greater than 30 mg/dL in both HD and PD. The serum prealbumin level correlated significantly with other measures of nutrition, including serum albumin, serum creatinine, and serum cholesterol, in both HD and PD patients. Among tested markers of nutritional status, prealbumin level appears to be the single best nutritional predictor of survival in ESRD patients.
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PMID:Prealbumin is the best nutritional predictor of survival in hemodialysis and peritoneal dialysis. 942 74


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