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

A questionnaire survey of 40 Asian and 31 British non-insulin dependent diabetics attending a hospital clinic showed that both groups remembered receiving education about diabetes (90%) but Asian diabetics knew less about glucose monitoring and diabetic complications. Asians also had a more negative attitude towards the clinic, feeling they were made to wait longer than the British. They were frustrated by a lack of communication with the staff. Forty per cent of both Asian and British diabetics felt that diabetes prevented them from leading a normal lifestyle. Twenty seven per cent of both Asian and British diabetics used herbal or alternative medicines, but Asians differed in that they used these medicines specifically for diabetes. A further sample of 50 Asians had poorer glycaemic control than a sample of British diabetics matched for age, sex and type of diabetes. It is concluded that despite receiving the same education as British diabetics, Asians did not understand it as well. The education was often not relevant to their diets or customs. This may contribute to their poorer glycaemic control. Diabetic clinic facilities need to be improved for Asian diabetics, to improve their understanding of diabetes.
Br J Gen Pract 1990 Jun
PMID:Asian diabetics attending a British hospital clinic: a pilot study to evaluate their care. 211 48

1. The influence of alloxan-induced diabetes was studied on spontaneously beating rat atria. Diabetic atria were found to have decreased rates, increased contractility and decreased responsiveness to both inotropic and chronotropic effects of isoprenaline. 2. Thyroid hormone levels were significantly reduced in diabetic animals. This revealed that the decrease in atrial beta-adrenergic responses was associated with a reduction in serum levels of thyroid hormones. 3. Insulin treatment of diabetic rats for 10 days corrected the changes observed in diabetic atria. Serum levels of thyroid hormones returned to normal following insulin treatment as well. 4. Administration of insulin to thyroidectomized-diabetic rats did not reverse the diabetes-induced changes suggesting that thyroid hormones are needed for insulin to normalize the alterations observed in diabetic atria.
Gen Pharmacol 1990
PMID:Thyroid hormones mediated effect of insulin on alloxan diabetic rat atria. 217 37

1. Castration and streptozotocin-induced diabetes produce significant decreases in serum testosterone levels accompanied by decreased vas deferens weights, a decreased responsiveness to nerve stimulation, and altered contractile responses to carbachol and phenylephrine. 2. Treatment of castrated rats with testosterone for 8 weeks prevented the decreased vas deferens weights and contractile changes associated with castration. 3. Treatment of diabetic rats with testosterone for 8 weeks prevented the decreased vas deferens weights and the supersensitivity to contractile agonists associated with diabetes. Testosterone treatment only partially prevented the decreased response to nerve stimulation. 4. Treatment of diabetic rats with testosterone plus insulin for 8 weeks prevented the decreased vas deferens weights and decreased the sensitivity to carbachol and phenylephrine compared to controls. Testosterone plus insulin treatment prevented the decreased response to nerve stimulation. 5. There were no differences in the IC50 values for nitrendipine among any of the groups studied, suggesting that the contractile changes observed in vasa deferentia following castration or diabetes are not the result of changes in calcium movements. 6. The results suggest that decreased testosterone levels are at least partially responsible for the changes in contractility of the vas deferens of streptozotocin-diabetic rats.
Gen Pharmacol 1990
PMID:The effects of testosterone or insulin treatment on contractile responses of the rat vas deferens following castration or streptozotocin-induced diabetes mellitus. 219 97

The Nederlands Huisartsen Genootschap (NHG), the college of general practitioners in the Netherlands, has begun a national programme of standard setting for the quality of care in general practice. When the standards have been drawn up and assessed they are disseminated via the journal Huisarts en Wetenschap. In a survey, carried out among a randomized sample of 10% of all general practitioners, attitudes towards national standard setting in general and to the first set of standards (diabetes care) were studied. The response was 70% (453 doctors). A majority of the respondents said they were well informed about the national standard setting initiatives instigated by the NHG (71%) and about the content of the first standards (77%). The general practitioners had a positive attitude towards the setting of national standards for quality of care, and this was particularly true for doctors who were members of the NHG. Although a large majority of doctors said they agreed with most of the guidelines in the diabetes standards fewer respondents were actually working to the guidelines and some of the standards are certain to meet with a lot of resistance. A better knowledge of the standards and a more positive attitude to the process of national standard setting correlated with a more positive attitude to the guidelines formulated in the diabetes standards. The results could serve as a starting point for an exchange of views about standard setting in general practice in other countries.
Br J Gen Pract 1990 Sep
PMID:National standard setting for quality of care in general practice: attitudes of general practitioners and response to a set of standards. 226 1

1. Endothelial cells of blood vessels generate factors which can modulate underlying smooth muscle tone, inducing vasorelaxation, (endothelium-derived relaxing factor, EDRF, and endothelium-derived hyperpolarizing factor) and/or vasoconstriction (endothelium-derived contracting factors, EDCFs, including the peptide endothelin). 2. EDRF is nitric oxide (NO) or a RNO compound from which this oxide is released. Its half-life is very short (6-50 sec), and it produces rapid vasodilations and inhibits platelet aggregation. 3. NO is formed from the terminal guanidino of L-arginine, but not of D-arginine. NO effects and NO formation are inhibited by NG-monomethyl-L-arginine (L-NMMA), but not by D-NMMA. These inhibitory effects are blocked by L-arginine. 4. Removal of endothelium or pathological situations that can induce endothelial dysfunction (atherosclerosis, diabetes, hypertension or subarachnoid hemorrhage) cause increases on the vascular contractility elicited by agonists (noradrenaline, serotonin, EDCFs, etc.). These findings suggest that EDRF produces a physiological inhibitory modulation of vascular smooth muscle tone and its alteration produces or facilitates the development of diseases such as hypertension or coronary and cerebral vasospasm.
Gen Pharmacol 1990
PMID:Role of endothelium-formed nitric oxide on vascular responses. 227 79

1. The in vivo whole bladder preparation was used to correlate bladder volume with the ability of urinary bladders from control, sucrose-drinking, and diabetic rats to develop pressure in response to bethanechol or nerve stimulation. 2. Both streptozotocin-induced diabetes mellitus and sucrose-diuresis caused an increase in rat urinary bladder capacity and mass. 3. There were significant decreases in the ability of bladders from control rats to develop pressure in response to bethanechol at 1.0 ml intravesical volume, but no change in responsiveness of bladders from sucrose-drinking or diabetic rats at different intravesical volumes. Bladders from sucrose-drinking and diabetic rats developed significantly less pressure in response to bethanechol stimulation at low intravesical volumes than did bladders from control rats. 4. Bladders from diabetic rats developed significantly less pressure in response to 32 Hz stimulation at 0.2 ml intravesical volume compared to larger volumes, however, there were no differences in the responses of bladders from sucrose-drinking or control rats at any intravesical volume. 5. Bladders from control and sucrose-drinking rats had a reduced ability to empty in response to bethanechol and field stimulation at large intravesical volumes. 6. Bladders from 8-week streptozotocin-diabetic rats are able to contract and empty efficiently in response to nerve stimulation and bethanechol over a wide range of intravesical volumes.
Gen Pharmacol 1990
PMID:The influence of intravesical volume upon contractile responses of the whole bladder preparation from streptozotocin-diabetic rats. 227 86

BioBreeding Worcester diabetes-prone (BBdp) rats develop insulin-dependent autoimmune-driven diabetes mellitus spontaneously and intravenous administration of 1 x 10(7) p.f.u. of lymphocytic choriomeningitis virus (LCMV) to young adult mice prevents disease. The virus is lymphotropic, binding to and replicating in such cells. BBdp rats fail to generate virus-specific major histocompatibility complex-restricted cytotoxic T lymphocyte (CTL) responses when challenged with this dose or other doses of LCMV, Pichinde virus or vaccinia virus. Yet such rats clear virus effectively and show no evidence of persistent infection. Associated with this clearance of virus and establishment of immunity is the production of neutralizing antibodies. In contrast, diabetes-resistant (BBdr) rats generate virus-specific CTL responses. Furthermore LCMV binds to fewer lymphoid cells of BBdr rats (in comparison to those of BBdp rats) and replicates in fewer lymphocytes (by one order of magnitude) from these rats. Thus, unlike mice in which CTLs play a dominant role in the control of LCMV infection, BBdp rats do not overcome this infection via CTLs. In addition, both the BBdp rats and their BBdr counterpart may provide useful models for determining whether or how individual lymphocyte subsets function in the induction of CTL responses, for the analysis of virus-induced immunosuppression and for the use of viruses or their products as therapeutic modalities.
J Gen Virol 1990 Apr
PMID:Cytotoxic T lymphocytes do not control lymphocytic choriomeningitis virus infection of BB diabetes-prone rats. 232 8

A randomized controlled trial was conducted to determine whether an education program specifically designed for patients with non-insulin-dependent diabetes and limited literacy could improve and sustain glucose and weight control. From a referral clinic, 120 obese (greater than 130 per cent of ideal body weight) diabetic patients who were not taking insulin were recruited. Of these, 55 per cent were female and 49 per cent were black; the mean age was 53 years. Mean glycosylated hemoglobin (HbA1%) was 10.2 per cent. Each subject was assigned to one of three groups: monthly group sessions with videotapes for diabetic persons with low literacy skills; monthly group sessions without videotapes; or no monthly sessions. After seven months, there had been 16 dropouts (13 per cent). Differences in weight changes between groups were significant (p less than 0.05); group 1 lost a median of 1 kg of weight (p less than 0.05) compared with a 0.1-kg loss and no change in groups 2 and 3, respectively. This weight loss was not sustained at 11 months. There was no significant change in HbA1%. Age, education, and compliance beliefs did not predict outcome. The authors conclude that the patient education programs did not result in sustained glucose or weight control.
J Gen Intern Med
PMID:Evaluation of an Audiovisual Diabetes Education Program: negative results of a randomized trial of patients with non-insulin-dependent diabetes mellitus. 244 Oct 13

The effect of diabetes-induced chronic tyrosine (Tyr) deficiency on dopamine (DA) synthesis in different areas of the mesotelencephalic DA system was examined. Diabetes was induced using streptozotocin. In vivo Tyr hydroxylation was used as an index of DA synthesis. The brain areas examined were prefrontal cortex (PFC), pyriform cortex (PYR), olfactory tubercle (OT), caudate-putamen (CP), substantia nigra (SN), and ventral tegmental area (VTA). Significant decreases in Tyr hydroxylation were observed in PFC, CP, and PYR. The largest decrease was seen in the PFC. Variations in tissue Tyr levels were shown to account for 62% of the variability in Tyr hydroxylation in the PFC, and 23% of the variability in the CP; a significant correlation between Tyr levels and Tyr hydroxylation was not seen in the other brain areas. The mechanisms underlying this regionally selective effect, and possible clinical relevance are discussed.
J Neural Transm Gen Sect 1989
PMID:Regionally-specific alterations in mesotelencephalic dopamine synthesis in diabetic rats: association with precursor tyrosine. 252 83

A sample of 77% of the non-insulin dependent diabetics aged 30-70 years from two urban practices offering no structured diabetic care were interviewed. The 55 patients (mean age 60 years) were asked about their experiences and expectations of diabetes and the health professionals involved in their care. Twenty-six patients attended the hospital diabetic clinic regularly but 13 patients received no review at all; 46 patients wanted their general practitioner to be involved in future care and only six wanted to continue with hospital review alone. Patients gave hospital doctors and general practitioners similar high ratings for knowledge of diabetes and its management but general practitioners and practice nurses were rated more highly for communication and accessibility. The aspect of care valued most was being given clear information about diabetic management. Twenty two patients thought that diabetes would have a significant impact on their future health and 35 rated regular diabetic review as extremely important in keeping themselves healthy. Most patients felt it likely that they would have a high blood glucose level most of the time and develop diabetic complications. Little difference was found between the views of clinic attenders and non-attenders, and there was no evidence that non-attenders had actively rejected review. These non-insulin dependent diabetics considered diabetes to be a serious disorder warranting regular care and expressed confidence in the primary care team's ability to provide such care.
J R Coll Gen Pract 1989 Aug
PMID:Diabetes and its care--what do patients expect? 255 59


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