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

Subjects with insulin-dependent diabetes mellitus (IDDM) have an increased incidence of coronary heart disease. Several studies have suggested that Lp(a) levels may be increased in IDDM subjects, although these studies have been limited by the lack of information on apo(a) phenotype and urinary albumin excretion. We compared Lp(a) concentrations in 66 children with IDDM and 18 non-diabetic children; all were non-Hispanic whites and none had detectable albuminuria. Lp(a) concentrations (mg/dl) were lower in subjects with IDDM than in non-diabetic subjects (12.0 +/- 2.2 vs. 20.0 +/- 6.1, respectively), although these means were not significantly different (P = 0.276). Postpubertal subjects, particularly males, had increased Lp(a) concentrations relative to prepubertal subjects (P = 0.041). Higher apo(a) molecular weight was associated with decreased Lp(a) concentrations in both diabetic and non-diabetic subjects. However, apo(a) size was not different in diabetic and non-diabetic subjects. Lp(a) concentrations were not significantly correlated with glycosylated hemoglobin levels in diabetic subjects (r = 0.11, P = NS). We also found similar Lp(a) concentrations in postpubertal IDDM subjects compared with adult non-Hispanic white non-diabetic subjects (n = 208) from the San Antonio Heart Study, a population-based study. These observations do not support increased Lp(a) concentrations in young normoalbuminuric IDDM subjects.
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PMID:Lp(a) concentrations and phenotypes in children with insulin-dependent diabetes mellitus. 818 17

Researchers and care providers must recognize that different centers are not automatically comparable in results because the geographic location, the demographic characteristics of the patient population, and the program strategy will alter the rate of patients assigned to insulin therapy and adverse pregnancy outcome. For example, in San Antonio, Texas, with a chronic health problem of obesity and diabetes, the prevalence of GDM is approximately 11%, whereas the general reported rate is 2% to 3%. Despite the disparity in the prevalence of the disease in different demographic areas, pregnancy outcome should be comparable for all centers when a proper management approach has been used. Utilizing our management approach in a large-scale program resulted in an incidence of macrosomia comparable to that in the general population. As a general rule, because constant evaluation of glycemia in pregnancy is the best gauge of the efficacy of the treatment, the use of verified self-monitoring of blood glucose has become a principal component of management. Appropriate assignment of patients to treatment modality utilizing verified blood glucose determinations and targeting mean blood glucose levels throughout pregnancy to 95 mg/dL (5.3 mmol/L) that is similar to normal nondiabetic blood glucose levels will result in pregnancy outcome comparable to the general population.
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PMID:Management of gestational diabetes. 822 72

Although many studies show that increased androgenicity is associated with increased triglyceride (TG) and decreased high density lipoprotein cholesterol in both pre- and postmenopausal women, relatively few data are available on the association of sex hormones to lipids and lipoproteins in men. We examined the association of sex hormone-binding globulin (SHBG), total and free testosterone, dehydroepiandrosterone sulfate (DHEA-SO4), and estradiol with lipids and lipoproteins in 178 nondiabetic men from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. The TG concentration was significantly inversely related to SHBG (r = -0.22), free testosterone (r = -0.15), total testosterone (r = -0.22), and DHEA-SO4 (r = -0.16). High density lipoprotein (HDL) cholesterol was significantly positively correlated to SHBG (r = 0.21), free testosterone (r = 0.15), total testosterone (r = 0.17), and DHEA-SO4 (r = 0.16). Total testosterone was significantly related to total cholesterol (r = -0.17) and low density lipoprotein cholesterol (r = -0.15). After adjustment for age, body mass index, waist to hip ratio, and glucose and insulin concentrations, TG concentrations remained significantly related to SHBG (r = -0.20), free testosterone (r = -0.15), and DHEA-SO4 (r = -0.18), and HDL cholesterol remained significantly associated with SHBG (r = 0.17), free testosterone (r = 0.15), total testosterone (r = 0.14), and DHEA-SO4 (r = 0.16). In conclusion, we observed a less atherogenic lipid and lipoprotein profile with increased testosterone concentrations. This was not explained by differences in glucose or insulin concentrations. However, sex hormones explained only a small percentage of the variation in total TG and HDL cholesterol concentrations. These findings are in striking contrast to data from women, in whom increased androgenicity is strongly associated with increased TG and decreased HDL cholesterol levels.
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PMID:Relationship of sex hormones to lipids and lipoproteins in nondiabetic men. 826 49

An unfavourable body fat distribution may cause metabolic abnormalities including diabetes and dyslipidemia. These effects may be mediated by alterations in sex hormones. In women the available data suggest that upper body adiposity is related to increased androgenicity (especially as indicated by low concentrations of sex hormone binding globulin). Few data, however, are available on these relationships in men. We therefore examined the association of total testosterone, free testosterone, oestradiol, dehydroepiandrosterone sulphate (DHEA-SO4) and sex hormone binding globulin (SHBG) to waist-to-hip ratio (WHR) and conicity index in 178 men from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. The conicity index is equal to the abdominal circumference divided by 0.109 x the square root of (weight/height). The conicity index and WHR were significantly inversely related to DHEA-SO4 and free testosterone. SHBG was only weakly associated with body mass index (r = -0.18, P < 0.05). After adjustment for age and body mass index, DHEA-SO4 remained inversely correlated with WHR (r = -0.22, P < 0.01) and conicity index (r = -0.31, P < 0.001) and free testosterone remained inversely associated with conicity index (r = -0.21, P < 0.01). Thus, in men, the association between unfavourable body fat distribution and increased androgenicity is inverse in contrast to the situation in women.
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PMID:Obesity, body fat distribution and sex hormones in men. 828 Dec 22

Mexican Americans have an increased prevalence and incidence of non-insulin-dependent diabetes mellitus (NIDDM). In addition, Mexican American diabetic subjects have an increased prevalence of retinopathy relative to Caucasian diabetic subjects. In Mexican American diabetic subjects, established risk factors may have a stronger effect on diabetic retinopathy, compared to Caucasian diabetic subjects. In this report, we compare the effect of established risk factors (age at examination, gender, age at diagnosis of diabetes, duration of diabetes, glycemia, type of therapy, systolic and diastolic blood pressure, and hypertension prevalence) between Caucasian diabetic subjects (n = 478), a low-risk population for NIDDM (Wisconsin Epidemiologic Study of Diabetic Retinopathy), and Mexican American diabetic subjects (n = 231), a high-risk population for NIDDM (San Antonio Heart Study). Retinopathy was classified into two categories (any or none) as assessed by seven standard stereoscopic retinal photographs read at the University of Wisconsin Reading Center. Mexican American diabetic subjects in Texas had an increased prevalence of any retinopathy (odds ratio = 1.71, 95% confidence interval: 1.25, 2.34), compared to Caucasian diabetic subjects in Wisconsin. Longer duration of diabetes, more severe glycemia, earlier age at diagnosis, and insulin therapy were associated with diabetic retinopathy in both Mexican Americans and Caucasians. Socioeconomic status was not associated with prevalence of retinopathy. Moreover, the effect of risk factors for retinopathy was similar in both ethnic groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is there an ethnic difference in the effect of risk factors for diabetic retinopathy? 828 52

Sex hormones may influence risk factors for noninsulin-dependent diabetes mellitus (NIDDM). Decreased sex hormone-binding globulin (SHBG; an indirect measure of androgenicity) is associated with hyperinsulinemia and insulin resistance. We measured SHBG concentrations in 58 subjects who later converted to diabetes and 107 subjects who remained normoglycemic throughout the 8 yr of follow-up of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Among premenopausal women, SHBG concentrations (nanomoles per L) were significantly lower in converters than in nonconverters (41.6 +/- 12.4 vs. 74.4 +/- 10.0; P = 0.004), but corresponding differences were not observed in postmenopausal women or in men. Since, however, analysis of variance suggested no significant interaction between menopausal status and conversion to NIDDM, we pooled pre- and postmenopausal women. Subsequent analysis indicated that SHBG concentrations predicted the development of NIDDM in women independently of glucose and insulin concentrations. We conclude that increased androgenicity, as assessed by decreased SHBG concentrations, is an important independent risk factor for NIDDM in women.
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PMID:Decreased sex hormone-binding globulin predicts noninsulin-dependent diabetes mellitus in women but not in men. 832 60

Recent data suggest that proinsulin is strongly associated with cardiovascular risk factors in diabetic subjects. However, this relationship has not been examined in nondiabetic subjects. Therefore, we examined the relation of proinsulin to lipids, obesity (body mass index), and waist-to-hip ratio in 260 nondiabetic individuals from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Proinsulin was measured by radioimmunoassay, and insulin was measured by a Linco radioimmunoassay that does not cross-react with proinsulin. Fasting insulin was significantly associated with body mass index (0.42), waist-to-hip ratio (r = 0.30), triglyceride (r = 0.29), high-density lipoprotein cholesterol (r = -0.20), and systolic blood pressure (r = 0.16) but not significantly related to diastolic blood pressure (r = 0.11). Fasting proinsulin was significantly associated with body mass index (r = 0.19), waist-to-hip ratio (r = 0.25), triglyceride (r = 0.41), systolic blood pressure (r = 0.19), and diastolic blood pressure (r = 0.15). Proinsulin was more strongly related to increased triglyceride than insulin despite its weaker relationship to obesity. In multivariate analyses, proinsulin continued to be significantly related to triglyceride concentrations (explaining 23.1% of the variance) and to systolic blood pressure (explaining 4.0% of the variance), even after adjusting for insulin. These observations suggest that proinsulin should be measured in addition to insulin in epidemiological studies. Proinsulin may be a marker for metabolic decompensation in prediabetic subjects.
Diabetes 1993 Sep
PMID:Relationship of proinsulin and insulin to cardiovascular risk factors in nondiabetic subjects. 834 41

Compared with non-Hispanic whites, Mexican Americans have a higher prevalence of diabetes, greater adiposity, and an unfavorable body fat distribution. The prevalence of hypertension, however, is similar or lower in Mexican Americans than in non-Hispanic whites. There is little information on the level of blood pressure control in Mexican Americans. We compared the mean blood pressure levels of Mexican American and non-Hispanic white hypertensive subjects in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Hypertension was defined as one or more of a systolic blood pressure > or = 160 mm Hg, a diastolic blood pressure > or = 95 mm Hg, and current use of antihypertensive medications. Three hundred and fifty-eight Mexican Americans and 241 non-Hispanic whites met these criteria. Poor hypertension control was defined as a systolic blood pressure > or = 160, a diastolic blood pressure > or = 95 mm Hg, or both. After adjustment for age, gender, obesity, body fat distribution, and level of educational attainment, Mexican American hypertensive subjects were in significantly poorer control than non-Hispanic white hypertensive subjects. The reasons for their poorer control are unknown, but our findings emphasize the importance of hypertension in this ethnic group.
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PMID:Level of control of hypertension in Mexican Americans and non-Hispanic whites. 841 27

Hypertension often occurs in association with NIDDM and IGT. We examined the association of hypertension at baseline to the 8-yr incidence of NIDDM and IGT in 1471 subjects who participated in the San Antonio Heart Study. Subjects who were hypertensive at baseline had a higher incidence of NIDDM (8.9 vs. 4.9%, P = 0.041) and IGT (25.2 vs. 10.0%, P < 0.001) than subjects who were normotensive at baseline. After adjusting for age, sex, ethnicity, obesity, body fat distribution, fasting glucose, and insulin, this excess was eliminated for NIDDM, but not for IGT. Specifically, the adjusted OR for NIDDM in hypertensive versus normotensive patients was 0.73 (95% Cl 0.34-1.58), whereas the adjusted OR for IGT was 1.87 (95% Cl 1.08-3.22). The excess risk of NIDDM in hypertensive patients can be explained by their greater age, obesity, more unfavorable body fat distribution, and hyperinsulinemia, whereas the excess risk of IGT is independent of these factors.
Diabetes 1993 Jan
PMID:Incidence of NIDDM and impaired glucose tolerance in hypertensive subjects. The San Antonio Heart Study. 842 Aug 12

In subjects with insulin-dependent diabetes mellitus, microalbuminuria has been associated with increased triglyceride and lipoprotein (a) (Lp[a]) concentrations and increased blood pressure. However, few studies have examined whether this association is present in subjects with non-insulin-dependent diabetes mellitus (NIDDM). We measured lipids, lipoproteins, Lp(a), blood pressure, and albumin excretion in 234 subjects with NIDDM from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Seventy-two subjects had microalbuminuria (> or = 30 mg/dl). These subjects had increased systolic and diastolic blood pressures and higher fasting glucose concentrations relative to subjects without microalbuminuria. However, there were no significant differences between subjects with and without microalbuminuria with respect to lipids, lipoproteins, Lp(a), self-reported myocardial infarction, obesity, or body fat distribution. Subjects with diabetic retinopathy had increased microalbuminuria. In multivariate analysis both glycemia and blood pressure continued to be significantly related to the presence of microalbuminuria. We conclude that NIDDM subjects with microalbuminuria have elevated blood pressure and more severe glycemia but do not have a significantly more atherogenic pattern of lipids, lipoproteins, or Lp(a) than subjects without microalbuminuria.
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PMID:Cardiovascular risk factors in non-insulin-dependent diabetic subjects with microalbuminuria. 842 56


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