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

Several clinical and physiologic associations between depression and diabetes mellitus have been reported. In this study, a potential neuroendocrine association was studied by measuring hypothalamic-pituitary-adrenocortical (HPA) axis activity in patients with diabetes mellitus. Plasma cortisol levels and response to dexamethasone administration were determined in 54 diabetics. Twenty-three (55%) of forty-two 1-mg dexamethasone suppression tests (DSTs) performed in 34 subjects, with eight repeated tests, and two (10%) of twenty 2-mg DSTs demonstrated a blunting of normal suppression. None of a variety of potential demographic, physiologic, or mood factors predicted nonsuppression. This study replicates prior findings that HPA dysfunction occurs in association with diabetes, and invalidates the use of the 1-mg DST as a diagnostic marker for melancholia in patients with diabetes.
Arch Gen Psychiatry 1984 Nov
PMID:Hypothalamic-pituitary-adrenocortical activity in patients with diabetes mellitus. 649 72

For this pilot study 349 patients aged between 20 and 64 years were seen following their consultations with their own general practitioners. The recommendations of the recent RCGP report on the prevention of arterial disease in general practice were carried out. An average of seven minutes was spent with each patient. A considerable number of patients had risk factors for arterial disease; 25 per cent of the sample were smokers, 32 per cent were obese and 15 per cent had a single blood pressure reading greater than 150/90. Two new cases of diabetes were discovered.Case-finding for risk factors for arterial disease, as recommended in the RCGP report, was considered worthwhile but might be most effectively carried out by a suitably trained practice nurse.
J R Coll Gen Pract 1983 Mar
PMID:Evaluation of the RCGP report on the prevention of arterial disease. 684 34

A mailed questionnaire was used to identify people with diagnosed diabetes in a population of approximately 14,000. A response rate of 90 per cent was obtained and the prevalence of diabetes was found to be 0.8 per cent. The questionnaire method compared favourably with other methods of identifying diabetics in the area.Eighty-two diabetics were interviewed and examined for diabetic complications and 55 of these completed a questionnaire on their attitudes to diabetes and its care.The medical records of all 108 diabetics identified were examined. A greater proportion of patients who attended either a general practice mini-clinic or a hospital diabetic clinic had examination for complications recorded than patients attending their general practitioner in ordinary surgery time. Patients attending on demand were seen less often and had fewer observations recorded when they came.Comparison of measures of control between hospital and general practice patients showed that hospital patients tended to be more tightly controlled even though most were on insulin and likely to have more severe diabetes.Half of non-insulin diabetics and a quarter of those on insulin considered that their diabetes should be managed solely by their general practitioner.This was a pilot study and caution should be exercised in interpreting results from comparatively small numbers. The study has since been extended to a larger population. f10sl60
J R Coll Gen Pract 1983 Mar
PMID:A community study of diabetes in Oxfordshire. 684 36

With the primary objective of examining the practice of prescribing oral contraceptives (OCs), a questionnaire was sent to 180 general practitioners and 45 community health doctors involved in family planning. 6 case histories were listed and doctors were asked to report their prescribing practice in 36 different hypothetical situations. They could choose 1 of 3 options--to prescribe the combined pill, the progestogen-only pill, or not prescribe OCs. They were also asked about changes in their prescribing practice, the 3 OCs prescribed most often, when a progestogen-only would pill be prescribed in preference to the combined pill, and views on the role of others in prescribing OCs. Completed questionnaries were returned by 124 (69%) general practitioners and 45 (80%) of family planning doctors. All were least likely to prescribe OCs in cases of hypertension or family history of ischemic heart disease. Diabetes and headache were each seen as less of a contraindication, and few doctors saw either age or fibrocystic disease of the breast as increasing the risk. Within each case history, smoking emerged as the most important contraindication. Almost all doctors reported changes in their prescribing practice; these related to enhanced understanding of the risks of OCs and to the availability of newer preparations. The 3 most commonly used OCs were the 30 mcg estrogen preparations (low and high progestogen) and the progestogen-only pill. Nearly all the doctors replied that they would prescribe the progestogen-only pill but not the combined pill in certain circumstances, the most commonly cited being when the woman was over age 35, was breastfeeding, had risk factors for cardiovascular disease, or smoked. The 2 groups of doctors showed different attitudes towards the role of other staff in prescribing OCs. Although 2/3 of the general practitioner group felt that prescribing should be limited to doctors, this view was shared by only 1/4 of the family planning group.
J R Coll Gen Pract 1983 Apr
PMID:Prescribing of oral contraceptives in Oxfordshire. 688 88

The goals of pancreatic transplantation are to improve the quality of life for the diabetic patient, reverse the metabolic abnormalities of diabetes, and prevent the dreaded secondary complications. Although transplantation of the whole pancreas is the only therapy that reliably achieves euglycemia, the complications associated with this procedure and the need for immunosuppression make it undesirable except to a select subpopulation of type I diabetic patients. Islet cell transplantation is the exciting alternative; however, insulin independence has been achieved in only 10% to 20% of patients. Although advances in technology could make islet transplantation the treatment of choice for type I diabetic patients, islet transplantation currently remains an experimental procedure. Diabetes is not commonly considered a surgical disease, but surgeons have made major contributions to its treatment and must remain active in the development of new treatment modalities for this debilitating disease.
Curr Opin Gen Surg 1994
PMID:Whole-organ versus islet pancreatic transplantation. 758 61

Several new developments promise to improve the lot of the morbidly obese. Perhaps the most important of these is the gradual recognition that morbid obesity is a serious illness that is not the result of immorality or gluttony but is, in most cases, a disabling genetically determined handicap. The second advance was the agreement at the National Institutes of Health Consensus Conference, March 25-27, 1991 that medical therapies generally fail to control severe obesity and that surgery should be considered for those individuals who have a body mass index over 40 and, if the comorbidities of obesity, such as diabetes or sleep apnea, are present, to consider surgical intervention when the body mass index is greater than 35. The third development has been the improvement of bariatric surgery, ie, the surgery for morbid obesity, with better operations, better quality controls, and rigorous follow-up. This article reviews the newer concepts of morbid obesity as a disease, delineates the indications for surgery, describes the currently recommended operations, and presents the risks and benefits of these procedures.
Curr Opin Gen Surg 1993
PMID:The surgical treatment of morbid obesity. 758 66

In diabetic patients, nonhealing cutaneous ulcers are a significant clinical, social, and healthcare problem. Based on more than 10 million diabetic patients in the United States and an estimated prevalence of 15% for chronic cutaneous ulcers, there are approximately 1.5 million patients with this problem. These nonhealing cutaneous ulcers result in a high rate of lower extremity amputations in the diabetic population. Patients with diabetes have many complications that cause chronic cutaneous ulcers. These include peripheral vascular disease, autonomic and sensory neuropathy, impaired host defense against infection, and delayed wound repair. To treat diabetic patients with chronic cutaneous ulcers effectively all the complicating factors must be addressed. In this review we discuss the surgical care of these patients and the use of growth factors in combination with a comprehensive treatment algorithm.
Curr Opin Gen Surg 1993
PMID:Growth factors and comprehensive surgical care of diabetic wounds. 758 2

1. In non-insulin-dependent diabetes mellitus, the pancreatic B-cell displays a preferential impairment of its secretory response to D-glucose. 2. A number of agents could be used to restore secretory activity in the diseased B-cell. 3. In this respect, esters of carboxylic nutrients, such as succinic or glutamic acid, present the advantages of stimulating both proinsulin biosynthesis and insulin release, remaining efficient in models of B-cell glucotoxicity, augmenting the secretory response to hypoglycemic pharmacological agents, protecting the B-cell against cytotoxic aggressions, and exerting a long-term beneficial effect upon the secretory potential of the endocrine pancreas. 4. Potential limitations of this new therapeutical approach, such as the generation of methanol from the esters, their postulated inefficacy after enteral administration, or the occurrence of extrapancreatic metabolic effects may be circumvented. 5. The esters of carboxylic nutrients could even be used in other cells endangered by ATP depletion.
Gen Pharmacol 1995 Oct
PMID:The esters of carboxylic nutrients as insulinotropic tools in non-insulin-dependent diabetes mellitus. 759 Jan 1

1. We examined the effect of the alpha-glucosidase inhibitor acarbose on urinary albumin excretion (UAE) in streptozotocin diabetic rats. 2. Treatment with acarbose for 8 weeks after induction of diabetes prevented the significant increase in UAE observed in untreated diabetic rats relative to nondiabetic controls. 3. Acarbose significantly reduced integrated glycemia, which correlated with albumin excretion rates, and exerts a salutary effect on diabetic renal dysfunction.
Gen Pharmacol 1995 Oct
PMID:Treatment with acarbose, an alpha-glucosidase inhibitor, reduces increased albumin excretion in streptozotocin-diabetic rats. 759 Jan 31

The development of diabetes in mice induced by encephalomyocarditis (EMC) virus provides the best experimental evidence that viruses have an aetiological role in the pathogenesis of this disease. The major capsid protein (VP1) of EMC virus is important for both the attachment of the virus to pancreatic beta cells and for the determination of antigenicity. This experiment was initiated to clone the gene for the major capsid protein, VP1, of the diabetogenic EMC (EMC-D) virus, express the VP1 protein, and test whether the recombinant VP1 protein can prevent development of EMC-D virus-induced diabetes in mice. We successfully cloned the VP1 gene of the EMC-D virus in the expression vector pRSET and subsequently expressed the protein in Escherichia coli. The recombinant VP1 protein was then purified by affinity chromatography. Five- to six-week-old male SJL/J mice were immunized intraperitoneally with purified VP1 protein and then challenged after various intervals with highly diabetogenic EMC-D virus. None of the VP1-immunized mice developed diabetes, irrespective of the interval between immunization and virus challenge, whereas 80 to 95% of the EMC-D virus-infected control mice did develop diabetes. All of the VP1-immunized mice showed intact pancreatic islet architecture, whereas most of the infected control mice showed severe beta cell necrosis and lymphocytic infiltration of their pancreatic islets. On the basis of these observations, we conclude that the recombinant VP1 protein of EMC-D virus can completely prevent the development of EMC-D virus-induced diabetes in mice.
J Gen Virol 1995 Oct
PMID:Cloning and expression of the VP1 major capsid protein of diabetogenic encephalomyocarditis (EMC) virus and prevention of EMC virus-induced diabetes by immunization with the recombinant VP1 protein. 759 59


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