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

In a cross-sectional study of diabetic patients diagnosed at or after 30 years, and with different stages of retinopathy, factors such as duration of diabetes, treatment mode, metabolic control, blood pressure, and clinical signs of nephropathy were examined. The different stages of retinopathy used were absence of retinopathy, simplex, and severe retinopathy. Patients with simplex and severe retinopathy were older than those without retinopathy (p less than 0.001, and p less than 0.01, respectively). They also had a longer duration of diabetes (p less than 0.001), and were more often treated with insulin (p less than 0.001) and in larger doses (p less than 0.001). Their glycosylated haemoglobin levels were higher (p less than 0.01). Their systolic blood pressure was higher (p less than 0.01), but the diastolic blood pressure did not differ, and the number of patients treated for hypertension was similar in all groups. Albumin clearance was higher (p less than 0.01 and p less than 0.001), as were urinary albumin levels (p less than 0.001). The only variables that distinguished patients with simplex from those with severe retinopathy were albumin clearance (p less than 0.01) and urinary albumin levels (p less than 0.05).
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PMID:Putative risk factors associated with retinopathy in patients with diabetes diagnosed at or after 30 years of age. 253 9

125I-bovine serum albumin (BSA) permeation of the vasculature of 3-wk-old granulation tissue (induced by subcutaneous implantation of polyester fabric) formed in the diabetic milieu was assessed in female BB/W, spontaneously diabetic rats and in male, Sprague-Dawley rats with streptozocin-induced diabetes as well as in corresponding nondiabetic controls. Albumin permeation of new granulation tissue vessels was markedly increased in both groups of diabetic animals relative to that of nondiabetic controls, while albumin permeation of vessels in most other tissues did not differ for controls and diabetics. These observations indicate that the functional integrity of new vessels formed in the diabetic milieu is impaired: (1) to a greater extent than that of older vessels formed before induction of diabetes and (2) relative to new vessels in nondiabetics. The implication of these observations is that molecular constituents of vessels synthesized in the diabetic milieu are quantitatively and/or qualitatively abnormal and/or their incorporation into vessels is defective.
Diabetes 1985 Apr
PMID:Albumin permeation of new vessels is increased in diabetic rats. 257 4

To evaluate the therapeutic efficacy of continuous ambulatory peritoneal dialysis (CAPD) in diabetic uremic patients and compare it with that of non-diabetics, this study presents the results obtained from CAPD usage in a 3-year period. From December 1984 through December 1987, 12 non-insulin dependent diabetic patients (3 men and 9 women aged 65.5 +/- 3.4 years and with a treatment duration of 12.8 +/- 2.7 months, M +/- SE) and 11 non-diabetics (6 men and 5 women aged 45.0 +/- 5.3 years and with a treatment duration of 9.8 +/- 1.9 months) received CAPD treatment. In most of the patients, diabetes was complicated by significant cardiovascular diseases. None of them exchanged the CAPD bag by themselves. After CAPD treatment, subjective improvements were noted in both groups of patients but were more marked in the non-diabetic group. The BUN and creatinine levels were kept in an acceptable range except that higher creatinine levels were noted in the non-diabetic patients. Serum cholesterol levels rose mildly while triglyceride levels rose markedly in the diabetic patients. Albumin levels returned to normal in the non-diabetic group but remained low in the diabetic group. All patients except for one used the traditional subcutaneous route of insulin administration and blood sugar control was poor. The electrolyte profile was improved in both groups. The BP could be controlled but medication was still necessary. After CAPD most of the non-diabetic patients returned to their previous work while the diabetic patients remained dependent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of therapeutic efficacy of continuous ambulatory peritoneal dialysis between diabetic and non-diabetic patients: three years of experience. 269 88

Twenty-four-hour, four-hour (8 to 12 am), and overnight urine collections were examined for their ability to detect microalbuminuria in 292 patients with insulin-dependent diabetes mellitus (IDDM). Albumin excretion rate (AER) was measured and also estimated from the product of the urinary albumin/creatinine ratio (A/C) and the calculated 24-hour creatinine excretion. The fractional excretion of albumin (FEA) was also determined in aliquots from each urine sample. The correlation coefficients between measured 24-hour AER and estimated AER were 0.940 and 0.956 for four-hour and overnight collections, respectively (significance of each correlation, P less than 0.001). There was no advantage in using the FEA over the A/C ratio in predicting measured AER. Urinary A/C ratios (mg/mg) between 0.03 and 0.31 in the four-hour collections were highly predictive of microalbuminuria and of measured AER in the 24-hour collections: AER24-h (microgram/min/1.73 m2) = 2.74 + 0.870 x A/C4-h (all log10 values). In a subgroup of 175 patients having all three collections validated, 34 (20%) had microalbuminuria defined as AER 20 to 200 micrograms/min/1.73 m2 in at least two of the three samples and 44 (25%) had overt nephropathy (greater than 200 micrograms/min/1.73 m2). The ability of the AER in one urine collection to predict microalbuminuria in at least one of the other two collections was assessed in these 175 patients. Compared with the overnight urine collection, the four-hour collection had greater sensitivity while affording similar specificity and positive predictive value. Based on these data, the A/C ratio from a morning urine sample following initial AM voiding would seem adequate for the detection and monitoring of microalbuminuria in patients with IDDM.
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PMID:Choice of urine sample predictive of microalbuminuria in patients with insulin-dependent diabetes mellitus. 270 50

212 insulin dependent young diabetics with mean age of 16 yr and mean diabetes duration of 9 yr, have been examined for prevalence of subclinical signs of microvascular disease. Prevalence of retinopathy is increased in subjects of older age when matched for diabetes duration. Subclinical abnormalities of peripheral nervous system, identified by neurophysiological techniques, are present in about 20% of patients. These abnormalities are mainly related to metabolic control as evaluated by HbA1c determination. Albumin excretion rate over 10 mcg/min is observed in about 40% of subjects and is related to increased blood pressure values and poor metabolic control.
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PMID:Early diagnosis of subclinical complications in insulin dependent diabetic children and adolescents. 280 82

There is evidence to suggest that renal function may alter in the presence of autonomic neuropathy. Albumin excretion rate (AER) and sodium excretion rate (NaER) in timed daytime (erect) and night-time (supine) urine collections were assessed in 20 insulin-treated diabetics with and in 20 without established autonomic neuropathy, matched for age, sex, duration of diabetes, diabetic control, and systolic blood pressure. All patients were free of proteinuria on albustix testing and had normal serum levels of urea and creatinine. AER based on daytime and pooled 24-hour collections was higher, but not significantly so, in the group with autonomic neuropathy. The nocturnal AER on the other hand was significantly elevated in the group with autonomic neuropathy (p less than 0.02) as was the nocturnal urine volume (p less than 0.01) and sodium excretion rate (p less than 0.05). The corrected nocturnal albumin/creatinine ratio was likewise greater in this group (p less than 0.02). These findings suggest that autonomic neuropathy can independently affect renal function and that nocturnal renal haemodynamics and glomerulotubular balance may be deranged in insulin-treated diabetics with autonomic neuropathy.
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PMID:The relationship between autonomic neuropathy and urinary sodium and albumin excretion in insulin-treated diabetics. 295 Nov 95

This study was undertaken to clarify whether antihypertensive treatment has any effect on the rate of progression of kidney disease in patients with incipient diabetic nephropathy. Six insulin-dependent diabetic men with incipient nephropathy (urinary albumin excretion above 15 micrograms/min and total protein excretion below 0.5 g/24 h) were first given metoprolol (200 mg daily) with the subsequent addition of hydroflumethiazide. At the start of antihypertensive treatment, mean patient age was 32 +/- 4.2 years (SD) and mean duration of diabetes was 18 +/- 1.2 years. The patients were followed with repeated measurements of urinary albumin excretion for a mean of 5.4 +/- 3.1 years prior to, and for 4.7 +/- 1.3 years (SD) during treatment. Mean arterial blood pressure declined significantly during treatment, e.g., the values at 6 months before initiation of treatment being compared with values during the last 6 months of treatment fell from 107 mmHg +/- 7.6 to 93 +/- 3.8 (2p = 1.5%). Albumin excretion decreased from 131.0 micrograms/min X/divided by 2.9 (geometric mean X/divided by tolerance factor) to 41.7 micrograms/min X/divided by 2.9 (2p = 1.2%). Albumin clearance in per cent of glomerular filtration rate decreased from a mean of 0.0030 +/- 0.0019% (SD) to 0.0011 +/- 0.0010% (2p = 4.6%). The mean yearly increase in urinary albumin excretion before treatment was 18.0 +/- 17.0% (mean +/- SD); during treatment urinary albumin excretion decreased 19 +/- 10% per year (2p = 0.7%). No changes were seen in renal plasma flow (516 +/- 31.0 ml/min to 520 +/- 66 ml/min (n = 5)).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antihypertensive treatment: long-term reversal of progression of albuminuria in incipient diabetic nephropathy. A longitudinal study of renal function. 296 1

The effects of islet transplantation on diabetes-induced increases in vascular permeability and collagen solubility were examined in new granulation tissue vessels and collagen formed after induction of streptozotocin diabetes in male Lewis rats. Albumin permeation was increased by 50% (p less than 0.001) and collagen solubility was decreased by 50% (p less than 0.001) in granulation tissue from untreated diabetic animals as compared with controls. The islet transplants reversed diabetes-induced vascular permeability increases in tissues formed prior to islet transplantation (tissue to blood isotope ratio = 2.1 +/- 0.1 - SD for controls, 3.2 +/- 0.2 for diabetic rats and 2.0 +/- 0.2 for diabetic rats given islets) and prevented permeability increases in new tissues formed following transplantation (tissue to blood isotope ratio = 2.1 +/- 0.1 for controls, 3.3 +/- 0.8 for diabetic rats and 1.9 +/- 0.2 for diabetic rats given islets). In contrast, while islet transplants prevented diabetes-induced decreased collagen solubility in tissues formed after transplantation (controls = 24%, diabetic rats = 12%, and diabetic rats given islets = 24%), collagen solubility in tissues formed prior to islet transplantation was virtually unaffected. These findings indicate that collagen changes induced by the diabetic milieu are not nearly as readily reversed by normalization of the diabetic milieu as (diabetes-induced) alterations in vascular functional integrity.
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PMID:Islet transplants in diabetic Lewis rats prevent and reverse diabetes-induced increases in vascular permeability and prevent but do not reverse collagen solubility changes. 309 37

The role of hypertension for the combined occurrence of incipient diabetic nephropathy and diabetic retinopathy (RP) was evaluated in 155 insulin-dependent diabetic patients (74 male/81 female); mean age 32.4 +/- 12.2 STD years; means diabetes duration 12.8 +/- 10 STD years). Albumin excretion rate (AER) was measured in 24 hours urine samples by RIA, retinal status was determined by both, fundoscopy and fluorescein angiography. Analysis of the data revealed a statistically significant correlation between the duration of disease and elevated AER (p less than 0.012), and the occurrence of retinopathy (p less than 0.0001). Although there was a close correlation between retinopathy and elevated AER (p less than 0.0001), it is remarkable that 31% of the patients with normal AER (less than 15 micrograms/min) showed signs of non proliferative RP. On the other hand 30% of patients without retinal changes showed an elevated AER (less than 15 micrograms/min). In the group of microalbuminuric patients (greater than 15 micrograms/min) systolic (p less than 0.004) and diastolic (p less than 0.04) blood pressures were significantly higher than in normoalbuminuric patients (less than 15 micrograms/min). Patients with proliferative retinopathy showed significantly higher systolic and diastolic (p less than 0.015) blood pressures compared to patients without retinal changes, though albumin excretion rates were not different in both groups of patients. In conclusion, our results show that diabetic nephropathy and diabetic retinopathy do not develop simultaneously in a representative number of insulin-dependent diabetic patients, but hypertension may be a major risk factor for the development of both microangiopathic complications.
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PMID:[Significance of arterial blood pressure for the development of microalbuminuria and retinopathy in type I diabetes mellitus]. 323 57

The metabolism of albumin and fibrinogen was studied in 24 long-term diabetic Type 1 (insulin-dependent) patients, using a double tracer technique. The patients were divided into three groups according to their urinary albumin excretion. Group 1 had normal albumin excretion (less than 30 mg/24 h), group 2 had persistent microalbuminuria (30-300 mg/24 h), and group 3 had clinical nephropathy (greater than 300 mg/24 h). Eight normal persons served as control subjects. Except for slightly lower distribution fractions of both proteins (intravascular mass/total mass), group 1 did not differ from normal subjects. In groups 2 and 3 the relative catabolism of albumin was increased, as denoted by an increase in the fractional catabolic rate. Albumin synthesis was unaltered, resulting in lower plasma concentrations and lower intravascular and total body masses of albumin. Oppositely, fibrinogen synthesis was augmented, leading to an increase in plasma fibrinogen concentration and total fibrinogen body mass, in spite of increased catabolism. The fractional catabolic rates were unaltered. The study demonstrates that long-term diabetic patients with normal urinary albumin excretion have normal albumin and fibrinogen metabolism, but that grave alterations in plasma protein metabolism are present in patients with only slightly increased urinary albumin excretion.
Diabetes Res 1988 Apr
PMID:Metabolism of albumin and fibrinogen in type 1 (insulin-dependent) diabetes mellitus. 340 66


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