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

Albumin excretion rate was determined by radioimmunoassay in overnight urine from 102 normotensive patients with insulin-dependent diabetes mellitus of more than 10 year's duration. Based on two samples, 16 patients (16%) exhibited microalbuminuria, defined as a mean excretion rate greater than 20 micrograms/min. Microalbuminuric patients were significantly younger at onset of diabetes but did not differ from normoalbuminuric patients concerning age or duration of diabetes. Nonetheless, diastolic and mean arterial blood pressures were significantly higher in the microalbuminuric group. The existing glycemic control, assessed by glycosylated hemoglobin (HbA1c) was better in normoalbuminurics, but not significantly so. The albumin excretion rate in microalbuminuric patients correlated significantly (p less than 0.01) to diastolic (r = 0.69) and to mean arterial blood pressure (r = 0.69), but did not correlate to HbA1c. Thus, it is concluded that even normotensive patients with signs of early diabetic nephropathy, i.e. microalbuminuria, exhibit small, but significant increases in blood pressure.
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PMID:Microalbuminuria in long-term insulin-dependent diabetes mellitus. Prevalence and clinical characteristics in a normotensive population. 342 86

Urinary albumin, measured by radioimmunoassay, was evaluated as a method to assess early renal impairment in 76 insulin (IDD) and 36 noninsulin (NIDD)-dependent diabetic patients. Mean albumin excretion in IDD and NIDD patients was significantly higher at 23 and 12 micrograms/100 ml glomerular filtrate (GF) respectively, compared to 4 micrograms/100 ml GF in normal subjects (P less than 0.001 and P less than 0.05). Abnormal albumin excretion from 20 to 200 micrograms/100 ml GF was observed in 30% of IDD patients (P less than 0.001) and 15% of NIDD patients (P less than 0.03). Albumin excretion was significantly increased in hypertensive IDD and NIDD patients. Significant correlations between albumin excretion and age, duration of diabetes and creatinine clearance were observed, but albumin excretion did not correlate with hemoglobin A1C. These data indicate that (1) 30% of IDD patients not clinically recognized as having renal impairment have abnormal albumin excretion, (2) albumin excretion may reflect renal impairment, since albumin excretion levels independently correlate with duration of diabetes and hypertension in both diabetic subgroups and to glomerular function in NIDD patients, and (3) measurement of urinary albumin by radioimmunoassay may be the most sensitive test to evaluate early renal disease in diabetes.
Diabetes Res Clin Pract 1986 Apr
PMID:The interrelationships of radioimmunoassayable urinary albumin, renal function and diabetes. 372 Apr 98

The effects on renal function of moderate restriction in protein intake were studied in 14- to 20-yr-old type I diabetic patients who had no clinical renal disease or hypertension; matched normal subjects served as controls. After assessment of protein intake and renal function, studies were conducted at the completion of each of two consecutive dietary periods of 1 wk. Diets containing 3.5 and 1.5 g X kg-1 X day-1 protein were provided during the first and second periods, respectively. Baseline protein intakes were substantial in both controls (1.86 g X kg-1 X day-1) and diabetics (2.17 g X kg-1 X day-1). Baseline creatinine clearance was increased in diabetics (P = .043). At the end of the high-protein intake period, both diabetics and controls showed similar high values of glomerular filtration rate (GFR) and renal plasma flow (RPF). GFR and RPF decreased markedly (P less than .001) and to a similar degree in both groups after normal protein intake. GFR and RPF in diabetics were not higher than in controls at this point, but filtration fraction was increased in diabetics. Albumin excretion rates were similar in both groups and not influenced by renal function changes. GFR and RPF values correlated significantly with the quantity of protein intake, as estimated from the urea nitrogen appearance rate in both groups. The results suggest that the functional response to variations in protein intake is not altered in the diabetic kidney. In addition, increased renal function in diabetics may be related partly to the excessive protein content in commonly prescribed diabetic diets.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1987 Jan
PMID:Effect on renal function of change from high to moderate protein intake in type I diabetic patients. 379 65

Albumin synthesis in rat liver in vivo decreased from 12.7 to 2.2% of total protein synthesis during the first 3 days after the induction of diabetes and then remained relatively constant at this depressed rate for another 3 days. Insulin treatment begun on the 3rd day after the induction of diabetes restored albumin synthesis to control values within 3 days. Hybridization of total polyadenylate-containing RNA with a specific albumin cDNA probe revealed a close correspondence between the relative abundance of albumin mRNA and the relative rate of albumin synthesis after induction of diabetes and in response to insulin treatment. The apparent half-life of albumin mRNA, based on the rate of change of the message from one steady-state level to another, was approximately 22 h in both diabetic and insulin-treated diabetic rats. Diabetes of 3-day duration had no effect on the average sizes of total and albumin-synthesizing polysomes or on the ribosomal half-transit time for total protein and albumin. However, the number of albumin-synthesizing polysomes decreased as a result of diabetes to approximately one-third the number found in control livers. Taken together the results indicate that albumin synthesis was regulated by the availability of albumin mRNA and not by alterations in degradation, sequestration, or translation of message.
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PMID:Time course of changes in albumin synthesis and mRNA in diabetic and insulin-treated diabetic rats. 389 May 55

The aim of the study was to clarify whether antihypertensive treatment with a selective beta blocker would have an effect on the progression rate of kidney disease in patients with incipient diabetic nephropathy. Six male patients with juvenile-onset diabetes with incipient nephropathy (urinary albumin excretion above 15 micrograms/min and total protein excretion below 0.5 g/24 hr) were treated with metoprolol (200 mg daily). At the start of the antihypertensive treatment the mean age was 32 years +/- 4.2 (SD). The patients were followed a mean 5.4 years +/- 3.1 (SD) with repeated measurements of urinary albumin excretion before and during 2.6 years +/- 1.0 (SD) of treatment. The blood pressure was depressed by the treatment (systolic blood pressure from 135 mm Hg +/- 8.6 to 124 mm Hg +/- 6.2, NS; mean blood pressure from 107 mm Hg +/- 7.6 to 97 mm Hg +/- 3.4, 2p less than 0.05; diastolic blood pressure from 93 mm Hg +/- 9.1 to 84 mm Hg +/- 3.6, 2p less than 0.05. Albumin excretion decreased (131.0 micrograms/min X/divided by 2.9 [geometric mean X/divided by tolerance factor] to 56.1 micrograms/min X/divided by 3.7, 2p less than 0.02). The mean yearly increase in urinary albumin excretion before treatment was 18 +/- 17 (mean +/- SD). Albumin excretion decreased during treatment: 17% +/- 15 per year (mean +/- SD, 2p less than 0.02). No changes were seen in glomerular filtration rate or renal plasma flow (149 ml/min +/- 5.8 vs 144 ml/min +/- 11.1, and 516 ml/min +/- 31.0 vs 541 ml/min +/- 68.5 respectively [n = 5]).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of antihypertensive treatment on progression of incipient diabetic nephropathy. 390 17

Urinary N-acetyl-beta-D-glucosaminidase (NAG), a proximal tubule lysosomal enzyme, has been used as an indicator of subtle renal injury. Since it has been positively and significantly correlated with hemoglobin A1c and microalbuminuria, it has been suggested that this enzyme may also reflect metabolic control. Albumin excretion is exacerbated in adult diabetic individuals during exercise; such exercise-induced albuminuria may be a forerunner of diabetic nephropathy. Metabolic control, degree of exertion, and duration of diabetes have been suggested to influence this increase in albuminuria during exercise. Studies of children are few and have produced inconsistent results. Thus we studied 28 insulin-dependent diabetic children ranging in age from 5 yr to 16 yr and 27 age-matched controls using treadmill exercise; two exercise periods consisting of (1) graded increases in speed and grade at 3-min intervals until exhaustion and (2) a constant speed and grade necessary to produce 2/3-3/4 maximal heart rate for 30 min were performed. Capillary blood glucose, urinary NAG/creatinine (cr) ratios (UNAG/Ucr) and urinary albumin/creatinine ratio (Ualb/Ucr) were measured before and after each exercise period; hemoglobin A1c was also measured. The latter averaged 11.8 +/- 0.6% (mean +/- SEM); contrary to previous studies, this was not correlated with pre- or postexercise UNAG/Ucr. During both exercise periods, blood glucose dropped 271 +/- 19 mg/dl to 213 +/- 21 mg/dl (period 1) and 230 +/- 22 mg/dl to 157 +/- 21 mg/dl (period 2).(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Care
PMID:Effect of exercise on urinary N-acetyl-beta-D-glucosaminidase activity and albumin excretion in children with type I diabetes mellitus. 405 33

Glomerular basement membranes were isolated from kidneys of human diabetics and non-diabetics. Albumin and immunoglobulin G content of glomerular basement membranes as determined after protease digest was higher in the diabetic group while lower values were obtained for heparan sulphate. Nonenzymatic glucosylation of whole glomerular basement membranes and tendon tissue was significantly elevated in diabetic subjects. Correlation of the determined parameters suggest that charge and size selective properties are altered in diabetic glomeruli. Serum albumin and albumin deposited in glomerular basement membranes showed the same content of nonenzymatically bound glucose in a normal and in a diabetic subject, respectively. Thus it would appear that in human diabetes the glucosylated albumin does not underly increased transcapillary transport as was reported in vitro.
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PMID:Changes of human glomerular basement membrane in diabetes mellitus. 672 20

A single antibody radioimmunoassay has been used to measure albumin excretion in 3 groups of female Wistar rats. Two groups had streptozotocin diabetes and were treated daily with insulin for 6 months. In one of the diabetic groups good glycaemic control was attempted and throughout the 6 months plasma glucose levels were fairly close to normal (92 +/- 33 mg/100 ml at 2300 h and 186 +/- 9 mg/100 ml at 0800 h). In the other diabetic group poor control was intended and the group had consistent high plasma glucose levels (576 +/- 89 mg/100ml and 460 +/- 43 mg/100 ml). The third group was a non-diabetic control group. -- Albumin excretion was measured on two occasions: before the induction of diabetes and after 6 months of diabetes. The geometric mean albumin excretion increased from 0.38 to 2.56 mg/24 h in the 18 non-diabetic controls. In the 20 diabetic rats in "good" control the geometric mean albumin excretion increased from 0.37 to 1.58 mg/24 h (NS compared with controls) and in the group of 22 rats in poor control albumin excretion increased from 0.35 to 6.54 mg/24 h. -- The increase in albumin excretion in rats in poor control differed significantly both from that of the non-diabetic controls (2p = 0.023) and from that of the "well-controlled" diabetic rats (2p = 0.00011).
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PMID:Prevention of diabetic glomerulopathy in streptozotocin diabetic rats by insulin treatment. Albumin excretion. 700 May 94

Albumin clearance and proteinuria selectivity were studied in 61 patients with diabetes mellitus of different severity by means of disc-electrophoresis. It was shown that the total protein excretion and albumin clearance are not dependent on the disease severity, but they are more intensive in patients with pronounced nephropatic symptoms. 3 degrees of proteinuria selectivity were detected in the patients examined: high, moderate and low (39.3, 44.3 and 16.4% of the patients, respectively). The extent of proteinuria selectivity was not dependent on diabetes severity and decreased in the process of the renal affection development, showing the change in the glomerular basal membrane permeability. The studies of proteinuria selectivity may serve as an additional criterion for early glomerulosclerosis diagnosis and therapy in diabetes mellitus.
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PMID:[Comparative study of dysproteinemia and proteinuria in diabetic nephroangiopathies]. 729 Nov 57

The traditional methods in urinalysis (visual microscopy, qualitative test strip screening) were compared with automated microscopy (UA-1000, TOA-medicals, Japan) and quantitative single protein analysis in 562 fresh morning urine samples. Albumin served as "glomerular" and alpha 1-microglobulin as "tubular" markers measured by turbidimetry. The test strip delivered at least one positive result in 60% of the urine for blood (21%), leukocytes (27%), or protein (34%). In only 4% casts or renal cells were found by traditional microscopy, whereas automated microscopy was positive for these findings in 28% of the urine. Quantitative urine protein analysis alone exhibited results outside the reference interval in 52% of the urine. Combination of the test strip procedure for blood and leukocytes with urine protein analysis increased the number of positives to 73%. Thirteen percent of these additional findings were classified as glomerular (64%) and tubular (72%) proteinurias. In 7% of the urine a false positive protein test strip result was confirmed by quantitative albumin determination. Of 157 urine samples, positive in mechanized video recorded screening, 60 (38%) were normal in single protein analysis. The results allow for the conclusion that the advanced techniques are superior to traditional screening procedures in detecting abnormal urine composition. It is suggested that traditional urinalysis should be supported or replaced by quantitative determination of albumin and alpha 1-microglobulin. This recommended strategy is able to exclude or detect tubulo-interstitial nephropathies or microalbuminuria in earlier phases of renal complications, such as in diabetes mellitus, hypertension or in nephrotoxic injury. A fully mechanized version is suggested to meet appropriate quality criteria and economic needs.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnostic strategies in urinalysis. 753 39


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