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

Diabetes can produce a state of hypothyroidism which is known to alter adrenoceptor activity in rat hearts. We studied the effect of six-week STZ-induced diabetes on responsiveness to adrenergic agonists and also determined if tri-iodothyronine (T3) treatment for 6 weeks could modify these responses. T3 treatment produced a marked tachycardia and a slight but significant decrease in serum glucose and serum lipids in diabetic rat. Methoxamine produced positive inotropic and positive chronotropic effects in untreated control left and right atria, respectively. These effects were significantly increased in untreated diabetic preparations. T3 treatment for 6 weeks in diabetic rats prevented this effect. Isoproterenol also produced a dose-dependent positive inotropic and positive chronotropic effect in untreated control left and right atria, respectively. These responses were attenuated in untreated diabetic preparations. T3 treatment by itself decreased the responsiveness to isoproterenol in control left atria and further decreased the responses to isoproterenol in diabetic left atria. Similarly, in diabetic right atria T3 treatment did not produce any alteration in the responses to isoproterenol. The results indicate that only some of the diabetes-induced alterations in adrenoceptor activity can be associated with hypothyroidism.
Gen Pharmacol 1987
PMID:Effect of tri-iodothyronine on cardiac responses to adrenergic-agonists in STZ-induced diabetic rats. 360 94

An intervention package was examined to determine its effectiveness in increasing office visits and in reducing the incidence of nonelective hospitalizations (those for urgent or emergent reasons). The intervention included mailings of information, appointment reminders, and intense follow-up by telephone of visit failures for rescheduling. Eight hundred fifty-four patients receiving drug therapy for diabetes mellitus were stratified by risk of nonelective hospitalization and randomly assigned to the control group or the intervention group. After two years, the intervention group averaged 9.1 per cent more kept scheduled visits per month than the control group (0.371 vs. 0.340, p = 0.02). However, the mean incidence of nonelective hospitalizations per month was not significantly different between intervention and control groups (0.040 vs. 0.041, p = 0.9), nor was there a difference in nonelective hospital days per month (0.443 vs. 0.425, p = 0.7). The authors conclude that while mailings and telephone calls can increase office visits, the intervention is not sufficient to reduce morbidity necessitating nonelective hospitalizations of diabetic patients.
J Gen Intern Med
PMID:A controlled trial to increase office visits and reduce hospitalizations of diabetic patients. 361 44

A notes survey was undertaken by a group of eight general practitioners in seven Southampton practices to study the mode of presentation and follow-up of the diabetic patients on the lists of 24 doctors. The 431 known diabetic patients were classified as non-insulin-dependent (67%), insulin-dependent (20%), or, if they had commenced their insulin more than a month after the diagnosis had been made, 'insulin-treated' (13%). This classification allowed characterization of the truly insulin-dependent and non-insulin-dependent patients.Non-insulin-dependent diabetics were older than insulin-dependent diabetics and had first presented at a greater age. Most patients in each treatment group presented with classical diabetic symptoms, diabetes-related infections, or recognized complications. The majority of these were diagnosed in general practice. However, over half of the asymptomatic non-insulin-dependent diabetic patients had been diagnosed by routine blood or urine testing in hospital. After 1979 fewer non-insulin-dependent diabetic patients were referred to hospital for follow-up at diagnosis than before 1975.Most non-insulin-treated diabetics were followed up in general practice whereas most patients treated with or dependent on insulin were followed up in hospital clinics. Twenty-two per cent of all patients received diabetic care from both their general practitioner and hospital outpatient departments but 20% received no regular diabetic follow-up at all. One year after the initial study, 4% of patients were still without regular review, and 27 more patients had been identified who would have qualified for the original audit.
J R Coll Gen Pract 1987 Feb
PMID:Who cares for the patient with diabetes? Presentation and follow-up in seven Southampton practices. 366 35

Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients in the validation series, 19% were readmitted within 90 days. Twenty-six per cent of the readmissions occurred within ten days of discharge, and 57% within 30 days. Readmitted patients were older, had longer hospitalizations, and had greater hospital charges (p less than 0.01). The discharge diagnoses of AIDS, renal disease, and cancer were associated with increased risks of readmission regardless of patients' demographics or test results. The relative risks (95% confidence interval) associated with these diagnoses were: AIDS, 3.3 (1.4-7.8); renal disease, 2.3 (1.7-3.0); cancer, 2.8 (2.4-3.4). Other patients at increased risk were those with diabetes, anemia, and elevated creatinine (2.1; 1.6-2.8) and those with heart failure and elevated anion gaps (2.2; 1.7-2.8). For patients without one of these diagnoses, a normal albumin and no prior admission within 60 days identified patients at reduced risk for readmission (0.4; 0.3-0.4). Thus, commonly available clinical data identify patients at increased risk for emergency readmission. Risk factor profiles should alert physicians to these patients, as intensive intervention may be appropriate. Future studies should test the impacts of clinical interventions designed to reduce emergency readmissions.
J Gen Intern Med
PMID:Predicting emergency readmissions for patients discharged from the medical service of a teaching hospital. 369

This study evaluated objectively the relationship between recent life events, social support systems, and blood glucose control in diabetic patients using both short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] measures of control. We found that a higher number of life events was associated with a higher percentage of abnormal FBS and Hgb A-1C results, and that improved social support was associated with a smaller percentage of abnormal Hgb A-1C scores. These pilot findings are discussed in connection with a biopsychosocial approach to the understanding and management of diabetes mellitus.
Gen Hosp Psychiatry 1986 May
PMID:The role of recent life events and social support in the control of diabetes mellitus. A pilot study. 371 Jan 57

With the use of medical records and the Consultation-Liaison Outcome Evaluation System, we studied psychiatric consultation to 52 hospitalized patients with type I diabetes mellitus having onset of disease by age 25 years. The distribution of psychiatric diagnoses assigned to this sample of patients with "early-onset" diabetes did not differ from those of patients with other medical and surgical illnesses. Three features did distinguish consultation to patients having type I diabetes: the diabetics were referred unusually early in the hospital course; psychotropics were seldom utilized; and consultants' recommendations for diagnostic studies were not followed in more than 90% of cases. The study indicates that the primary medical diagnosis is a critical variable governing consultees' use of and responses to psychiatric consultation.
Arch Gen Psychiatry 1987 Feb
PMID:Psychiatric consultation to inpatients with 'early-onset' type I diabetes mellitus in a university hospital. 381 13

To examine the feasibility of using antidepressant medication to treat major depressive syndromes in the hospitalized medically ill, we reviewed a series of psychiatric consultations meeting the following criteria: the consultant diagnosed a major depressive syndrome, treatment with an antidepressant was advised, the consultee initiated the antidepressant, and hospitalization had been prompted by a major medical illness. The final sample of 50 consultations, representing less than 5% of the case reviewed, was assessed by retrospective study of entries in the medical record. Judgments regarding response were thus a function of routine clinical observation and care. Drugs were not randomly assigned; rather, the choices represented ongoing clinical usage patterns. Two major points emerge from the data of the study. First, 32% of the trials were terminated due to side effects judged to be unacceptable by the physicians or consultants. Delirium accounted for half of such side effects; cardiotoxicity, however, was not evident. Second, only 40% of patients with medical illnesses, including malignant neoplasm, insulin-dependent diabetes, and epilepsy, responded to treatment. The trials of antidepressants in medical-surgical inpatients did not achieve the pattern of therapeutic responses routinely characterizing comparable interventions in psychiatric patients with primary affective disorder.
Arch Gen Psychiatry 1985 Dec
PMID:The outcome of antidepressant use in the medically ill. 407 8

Six months following the induction of diabetes by streptozotocin (50 mg/kg i.v.) diabetic rats exhibited elevated levels of plasma glucose and glycosylated hemoglobin. Plasma insulin levels were 50% of control and diabetic animals weighed significantly less than control. Using a working heart preparation it was found that (+) and (-) dP/dt and left ventricular pressure development (LVDP) was decreased in hearts from diabetic animals. Insulin treatment (9 U/kg/day s.c. of protamine zinc insulin) for 4 weeks prior to sacrifice restored body weight and plasma insulin to normal. Plasma glucose and glycosylated hemoglobin levels were significantly decreased towards normal in insulin treated diabetic rats. LVDP and (+) dP/dt was also partially returned to normal in insulin treated diabetic rats while (-) dP/dt was completely reversed to normal. Thus, 4 weeks of insulin treatment to rats previously diabetic for 5 months partially or totally reversed the changes produced by diabetes.
Gen Pharmacol 1984
PMID:Effect of insulin treatment on long-term diabetes-induced alteration of myocardial function. 639 59

Metabolic effects of pancreatectomy and hypophysectomy are investigated in the yellow American eel, Anguilla rostrata, fasted for 6 months. The results are compared with the findings in freshly captured eels subjected to the same operations. In intact animals, fasting causes a statistically significant decrease in serum amino acid nitrogen (AAN), serum urea, and relative liver weight, and an increase in serum free fatty acids (FFA), serum cholesterol, and tissue hydration. Serum glucose, liver and muscle glycogen, liver and muscle fatty acids, and abdominal fat stores do not show significant alterations. The absence of diabetes mellitus after pancreatectomy, seen in previous studies, is confirmed. However, pancreatectomy affects fewer parameters in fasting eels than in fed ones. After hypophysectomy, the situation is similar; only serum AAN shows an impact of the operation in fasted eels. As in freshly captured eels, surgical stress seems to affect almost all metabolic parameters. It appears that the smaller impact of both pancreatectomy and hypophysectomy in fasted eels reflects the reduced role of hormones in the state of lowered metabolism.
Gen Comp Endocrinol 1984 Aug
PMID:Effects of fasting, pancreatectomy, and hypophysectomy in the yellow eel, Anguilla rostrata. 647 66

To investigate the specificity of the dexamethasone suppression test (DST) for the diagnosis of major depression in patients with diabetes mellitus, we administered 1 mg of dexamethasone to 30 nondepressed diabetics and to 58 normal controls at 11 PM. Diabetic subjects received hemoglobin A1 (Hb A1) determinations, the Hamilton Rating Scale for Depression (HRSD), and five to eight blood glucose determinations during the 48 hours surrounding the DST. Results demonstrated a significantly higher rate of nonsuppression (plasma cortisol level, greater than or equal to 5 micrograms/dL) at 4 PM the following day among diabetics (43%) than among controls (7%) but no difference between these groups in the rate of nonsuppression at 8 AM. Plasma cortisol level at 4 PM correlated with Hb A1 level but not with duration of illness, HRSD score, mean blood glucose level, or maximum blood glucose excursion. These results suggest that the results of the DST used as a diagnostic test for major depression must be interpreted with caution in patients with diabetes.
Arch Gen Psychiatry 1984 Nov
PMID:Abnormal results of dexamethasone suppression tests in nondepressed patients with diabetes mellitus. 649 71


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