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

Captopril is a suitable drug to treat high blood pressure in diabetic patients. This Angiotensin-Converting Enzyme Inhibitor (ACEI) is a vasodilator without tachycardia and saline retention. Furthermore, captopril is one of antihypertensive drugs with less adverse effects. It does not induce metabolic changes, improves glucose tolerance and brake the evolution of renal insufficiency. About 50-60% of patients are under control (DBP < 90 mmHg) with captopril monotherapy. In the present paper, were included 64 women and 16 men with diabetes mellitus and mild-moderate hypertension, I-II phase WHO. The average age (mean +/- S.D.) was 66.6 +/- 9.2 years. All patients were treated with 25 mg/12 h of captopril, for one month. If blood pressure was not under control, captopril treatment enhanced to 50 mg/12 h during second month. After this period of two months, patients under control were got out of this study. 37 patients (46.25%) needed a second drug. In randomized form, 20 patients associated 25 mg HCTZ one time a day (CAP + HCTZ); and 17 patients associated 20 mg/12 h of nifedipine retard (CAP + NIF). The study continued for 4 months more. Both treatments reduced blood pressure in significant form without changes statistical significant in the heart rate, weight, glycemia, cholesterol, triglycerides, c-HDL, uric acid, creatinine, Na+ and K+ blood levels. CAP + HCTZ controlled (DBP < 90 mHg) 85% and CAP + NIF 81.25% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Captopril + hydrochlorothiazide versus captopril + nifedipine in the treatment of arterial hypertension in diabetes mellitus type II]. 143 67

A clustering of metabolic disturbances has been indicated in hypertension. The distribution of such factors was assessed among hypertensives and normotensives in a general population sample of 644 men aged 67 years. Fasting serum insulin, glucose and triglyceride levels were measured. In this study hypertension was defined as DBP > or = 95 mmHg or present use of antihypertensives. Impaired glucose tolerance (IGT) or diabetes mellitus, hyperinsulinaemia (> or = 20 mU l-1) and hypertriglyceridaemia (> or = 2.3 mmol l-1) were defined as metabolic disturbances. When all these disturbances were present simultaneously a complete 'metabolic syndrome' was considered to be present. Hypertension was found in 185 (29%) men, IGT in 15%, diabetes mellitus in 11%, hyperinsulinaemia in 18% and hypertriglyceridaemia in 19%. Among hypertensives, 11 (6%) men had a 'metabolic syndrome', compared to 12 (3%) men in the normotensive group (P = 0.039). At least one metabolic disturbance was present in 109 (59%) of the hypertensive men, and in 173 (38%) of the normotensive men (P < 0.001). The prevalence rates of metabolic disturbances did not differ significantly between lean (BMI < 26 kg m-2) and obese (BMI > or = 26 kg m-2) hypertensives. Only hypertriglyceridaemia was more frequent in obese than in lean hypertensives (20% vs. 37%, P = 0.015). The 'metabolic syndrome' was found in 6% of all hypertensives, which was twice as common as in the normotensive population. The 'metabolic syndrome' was uncommon in both lean and obese hypertensives (5% vs. 7%, NS). These findings indicate that hypertension and metabolic disturbances may have a common underlying cause, at least in some individuals.
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PMID:Metabolic disturbances in hypertension: results from the population study 'men born in 1913'. 145 22

We applied a simplified version of the method suggested by Sugihara-May (Nature 1990: 344: 734-41) to study the control of heart rate (HR) in subjects with diabetes mellitus. The method aims to predict the future of an observation, if a series of observations on the same phenomenon is available. The method quantifies the fact that the series is predictable more or less longtime in the future. A random series is only shortly predictable in the future. HR and blood pressure were measured from beat to beat (by the Finapres system) for about 0.5 hours in 11 subjects with diabetes mellitus and normal blood pressure (group D) and in 10 controls subjects (group N). The subjects were sitting in a temperature-controlled quiet room, isolated from all external stimuli. The 2 groups were matched for age, and had the same weight and height. No difference was observed in mean-value and standard deviation (SD) of BP and HR between the 2 groups. Groups N/D: SBP = 112 +/- 11/123 +/- 11 mmHg, NS; DBP = 64 +/- 9/67 +/- 12 mmHg, NS; HR = 70 +/- 10/69 +/- 7 b/min, NS. Standard deviation of PAS = 5.5 +/- 1.6/5.7 +/- 1.9 mmHg, NS and SD of DBP = 3.5 +/- 0.9/3.4 +/- 1.2 mmHg, NS. The SD of HR (3.0 +/- 0.5/2.3 +/- 1.0 b/min in groups N/D) was somewhat lower in diabetics than in control subjects but the difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chaotic aspect of heart rate and blood pressure in diabetic patients]. 148 56

We have followed prospectively, 46 obese, type 2 diabetic patients for a 55-week period, in order to evaluate the efficiency of an educational programme based on behaviour modification to enhance weight loss and changes of other cardiovascular risk factors. No patient received pharmacological treatment during the study. At the end of the follow-up the patients obtained an average weight loss of 9.250 kg (range: 0.500-17.500 kg); the BMI was reduced from 34.2 +/- 0.8 kg/m2 to 30.6 +/- 1.1 kg/m2 (P less than 0.01); fasting serum glucose descended from 7.9 +/- 0.4 to 6.1 +/- 0.5 mM (P less than 0.05); SBP (systolic blood pressure) decreased from 145.7 +/- 3 to 126.4 +/- 5.1 mmHg (P less than 0.01); DBP (diastolic blood pressure) decreased from 83.5 +/- 2.5 to 65 +/- 2.6 mmHg (P less than 0.01); triglyceride levels were lowered from 164.5 +/- 12 to 109.7 +/- 10 mg/dl (P less than 0.01); HDL-cholesterol levels increased from 1.27 +/- 0.05 to 1.53 +/- 0.12 mM (P less than 0.01). Serum glucose 2 h after a 75 g glucose oral load decreased from 14.9 +/- 0.6 to 12.7 +/- 0.9 mM (P less than 0.05) on week 35 of follow-up. Twelve patients no longer presented a diabetic curve (8 normal oral glucose tolerance test (OGTT) curves, and 4 impaired glucose tolerance (IGT) curves). No significant changes in the parameters studied were obtained in the group of patients on conventional treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Res Clin Pract 1992 Feb
PMID:Behaviour modification in obese subjects with type 2 diabetes mellitus. 156 32

To clarify the long-term effects of alpha-adrenergic blockade on blood pressure, glucose, and lipid metabolism, a selective alpha 1-adrenergic inhibitor (prazosin, 1.0 to 2.0 mg/day in divided doses) was administered as a single antihypertensive agent to 10 (four men and six women, aged 52 to 76 years) hypertensive patients (systolic blood pressure [SBP] greater than or equal to 150 mm Hg or diastolic blood pressure [DBP] greater than or equal to 90 mm Hg) with non-insulin-dependent diabetes mellitus (NIDDM) for up to 20 weeks. Blood pressure, glucose tolerance and immunoreactive insulin (IRI) response to 75 gm oral glucose load, hemoglobin A1 (Hb A1), serum lipid profile, and serum apolipoprotein were examined before and after treatment. SBP and DBP were significantly reduced at 20 weeks after treatment with the selective alpha 1-adrenergic inhibitor (SBP 167 +/- 6 mm Hg versus 152 +/- 7 mm Hg; DBP 81 +/- 3 mm Hg versus 76 +/- 3 mm Hg, (p less than 0.05 and p less than 0.01, respectively). Glucose tolerance and IRI response to glucose load were not significantly changed at 4 and 12 to 20 weeks after selective alpha 1-inhibitor treatment compared with the baseline data before treatment; the level of Hb A1 was not significantly changed at 4 and 20 weeks after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of alpha-adrenergic blockade on blood pressure, glucose, and lipid metabolism in hypertensive patients with non-insulin-dependent diabetes mellitus. 167 75

The prevention of coronary disease in hypertensive patients will see progress in the years to come. It is clearly too much, however, to expect this progress to come exclusively from the application of new therapies, as the incidence of coronary disease in hypertensive patients depends on several factors, which are, essentially, the persistence and severity of hypertension and the major cardiovascular risk factors associated with arterial hypertension, including hypercholesterolemia, diabetes, and nicotine abuse. Which new solutions to this problem can a novel therapy for arterial hypertension using calcium antagonists in general and diltiazem in particular thus provide? The majority of patients consulting their doctor for arterial hypertension also present with other risk factors associated with increased blood pressure, mostly hypercholesterolemia and diabetes. The antihypertensive efficacy of diltiazem can no longer be doubted; moreover, diltiazem monotherapy with single daily doses is of great advantage for compliance in hypertensive patients. As diltiazem has been in use for more than 10 years and its dosage has been gradually diminished, the risk of a new long-term iatrogenic pathological process is becoming less and less conceivable. Sustained-release diltiazem is effective as monotherapy at single daily doses of 300 mg as evidenced by an effect/dose study in 105 patients: DBP = -17 mm Hg with 300 mg (72% of the patients responded to this dosage).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sustained-release diltiazem and prevention of cardiovascular risk in hypertensive patients. 170 10

We investigated the urinary albumin excretion and renal hemodynamics of normotensive nonobese patients with impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) in an early microalbuminuric stage (defined by albuminuria less than 30 mg/day). In comparison with normal subjects, a significant increase in urinary albumin excretion was observed already in the IGT stage [U-albumin/U-creatinine: NL (20 subjects), 5.3 +/- 1.7 mg/g Cr; IGT (23 subjects), 11.9 +/- 6.7 mg/g Cr; DM (20 subjects), 12.8 +/- 5.7 mg/g Cr]. A 3-week diet therapy combined with physical exercise prescribed for 53 normotensive non-obese mild NIDDM patients resulted in improvement in glucose tolerance, concomitant with lowered systemic blood pressure and a decrease in urinary albumin excretion (SBP: 128.4 +/- 13.0 to 106.4 +/- 10.2 mm Hg, p less than 0.01; DBP: 78.2 +/- 10.8 to 66.0 +/- 8.0 mm Hg, p less than 0.01; U-albumin: 19.4 +/- 10.3 to 10.1 +/- 9.1 mg/day, p less than 0.01). However, glomerular filtration rate, renal plasma flow, filtration fraction and urinary beta 2-microglobulin excretion remained unchanged. From these results, we hypothesized that focal glomerular hyperperfusion increases urinary albumin excretion in patients with early NIDDM.
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PMID:Urinary albumin excretion in patients with non-insulin-dependent diabetes mellitus in an early microalbuminuric stage. 185 79

This prospective study was designed: 1. to determine both the mean level and the intrinsic variability of blood pressure (BP) and heart rate (HR) in normotensive patients with insulin-dependent diabetes mellitus (IDDM), by using a nonambulatory recorder; 2. to look for a relationship between these parameters and the indices of diabetic target-organ damage. The patient group consisted of 21 subjects with IDDM (6 females, 15 males), aged 19 to 70 years, who were normotensive according to WHO criteria. The duration of the diabetics ranged from 1.5 to 32 years. A control group of 17 age and sex-matched normal volunteers was also examined. Each subject underwent a 24 h non ambulatory BP recording, a 2-dimensional echocardiography and a pulsed doppler examination; furthermore, an index of autonomic nervous system dysfunction was established, as well as an index of microangiopathy. Twenty-four hour BP and HR mean levels appeared to be slightly higher in IDDM patients than in control group, but the difference was significant for night SBP and 24 h DBP only. No difference was found with regard to BP and HR absolute variabilities; the relative variability of night DBP was slightly lower in IDDM group (p less than 0.05). A loss of nocturnal decline in BP was noted in 2 control subjects and in 9 IDDM patients: 8 out of these IDDM patients had an autonomic dysfunction. An abnormal HR circadian pattern was seen in 1 control and in 2 IDDM subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Average level and variability of 24 hour blood pressure in the normotensive insulin-dependent diabetic patient]. 195 55

In a double-blind crossover study, the influence of bisoprolol and placebo was tested in 20 noninsulin-dependent diabetics with concomitant essential hypertension. A 2-week washout placebo period was followed by two treatment periods of 2 weeks each with 10 mg bisoprolol or placebo. Compared with placebo, bisoprolol did not change blood glucose, haemoglobin A1 (HbA1), and glucosuria. No hypoglycaemia was observed. Serum cholesterol and triglyceride levels remained constant. Systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were significantly (p less than 0.01) reduced after 2 weeks of bisoprolol therapy, compared with placebo. It was concluded that bisoprolol, in a dose therapeutically effective in essential hypertension, has no influence on carbohydrate and lipid metabolism in noninsulin-dependent patients with diabetes mellitus; and 10 mg bisoprolol is effective for the normalisation of SBP and DBP in mildly hypertensive diabetics. Since bisoprolol was well tolerated in the dosage studied, it can be recommended for noninsulin-dependent diabetics with hypertension.
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PMID:Influence of bisoprolol on blood glucose, glucosuria, and haemoglobin A1 in noninsulin-dependent diabetics. 243 8

The present study demonstrates the relationship between urinary albumin excretion rate (AER) and renal structural changes in patients with non-insulin-dependent diabetes mellitus (NIDDM) without clinical proteinuria. Resting AER in 30 control subjects and 67 NIDDM patients were 10.4 +/- 4.8 (mean +/- SD) micrograms/min (range 4.3-21.1 micrograms/min) and 26.4 +/- 32.3 micrograms/min (range 0.4-155 micrograms/min), respectively. Persistent normoalbuminuria (less than 20 micrograms/min) and microalbuminuria (20-200 micrograms/min) were found in 43 (Group A) and 24 (Group B) diabetics. There were significant differences in age, diabetes duration, and frequency of retinopathy (background and proliferative) as well as that of proliferative retinopathy between Groups A and B, but not in the other clinical parameters such as body mass index, HbA1, Ccr, or systolic and diastolic blood pressure (SBP, DBP). When compared with 11 normoalbuminuric patients of similar age and equal diabetes duration to those in Group B, the sole difference in clinical parameters was the existence of proliferative retinopathy in Group B. Renal structural changes were investigated by light microscopy in 14 people in Group A and 13 people in Group B, and additionally in 5 NIDDM patients with both macroalbuminuria (greater than or equal to 200 micrograms/min) and normal or nearly normal renal function (Group C). The diffuse glomerular lesion (Gellman's classification) was grade I or II in A, II or III in B, and III in C.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relationship between urinary albumin excretion rate and renal histology in non-insulin-dependent diabetes mellitus: with reference to the clinical significance of microalbuminuria. 252 62


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