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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixteen young patients with type 1 diabetes mellitus and rapidly progressive severe retinopathy were examined regarding serum levels of growth hormone before and after the i.v. administration of 200 micrograms thyrotropin-releasing hormone (TRH). Serum IGF I, HbA1c, blood pressure, urinary albumin, and serum creatinine levels were also measured. The control group consisted of type 1 diabetic patients matched for age, duration of diabetes and metabolic control with no or minimal background retinopathy. The results show that basal growth hormone levels were above normal in both groups, and that there was a paradoxical increment in growth hormone levels after TRH stimulation (p < 0.05) in patients with severe retinopathy, but the values did not differ from patients with background retinopathy. IGD I levels were normal in all patients but one, and no differences were seen between the two groups. HbA1c, serum creatine, blood pressure, and urinary albumin levels were similar in the groups but patients with severe retinopathy were treated with more insulin (p < 0.001). Thus, neither abnormal growth hormone levels, nor IGF I, seems to be associated with the development of severe retinopathy in young type 1 diabetic patients.
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PMID:Growth hormone levels in the basal state and after thyrotropin-releasing hormone stimulation in young type 1 (insulin-dependent) diabetic patients with severe retinopathy. 128 43

The fibrinolytic system was studied in 96 patients with type I diabetes mellitus. Patients were grouped according to their degree of retinopathy; 38 patients with no evidence of retinopathy, 28 patients with background retinopathy and 30 patients with proliferative retinopathy. Thirty healthy individuals served as controls. The basal fibrinolytic activity as measured by clot lysis time and t-PA activity was increased in diabetic patients. This was associated with low levels of plasminogen activator inhibitor. Increased levels of D-dimer in diabetic patients further indicate enhanced in vivo fibrinolysis. The increase in fibrinolytic activity was highest in diabetics without retinopathy, and decreased with increasing retinopathy. Endothelial release of t-PA after venous occlusion was not different between controls and all diabetic groups. These findings suggest that in type I diabetics the fibrinolytic system is in an activated state. With worsening of retinopathy this increase in fibrinolytic activity diminishes.
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PMID:Enhancement of spontaneous fibrinolytic activity in diabetic retinopathy. 144 70

Macular recovery, recorded by nyctometry, has been studied in children and adults with IDDM. Impaired macular recovery was found only in a few eyes with normal visual acuity without visible signs of retinopathy, in more than one third of the eyes with slight background retinopathy, in the majority of eyes with advanced background retinopathy, and in all eyes with proliferative retinopathy, suggesting that severe neurosensory disturbance accompanies visible vasculopathy in the retina. A significant correlation between impairment of macular recovery and reduction of the oscillatory potentials of the electroretinogram was found in groups with slight background retinopathy, severe background retinopathy, and proliferative retinopathy, suggesting that changes in these two neurosensory variables concurrently reflect abnormalities in the inner part of the retina corresponding to second order interneuronal connections. Near-normal blood glucose control obtained by continuous subcutaneous insulin infusion (CSII) significantly enhanced both normal and impaired macular recovery. This effect was more pronounced in patients with short duration of IDDM; no effect was found by short-term treatment of a selected group of patients with long-standing metabolic dysregulation and long disease duration. Young patients with normal or slightly impaired macular recovery might possibly benefit from sustained near-normal blood glucose control. Large-scale and long-term studies are needed to confirm this assumption. In a 3-year investigation with CSII, progression into proliferative retinopathy could not be prevented in those patients initially displaying severely impaired macular recovery. However, visible retinopathy did not progress in eyes, in which improvement of within normal or slightly reduced recovery performances had been recorded 6 months in advance. It is suggested that a state of irreversibility, 'point of no return', of retinal pathology, indicated by a certain severe impairment of neurosensory function, might exist. Prospective investigations, 5 years with adults, and 6 years with children, revealed progressive decline in recovery performances during the years of observation, even in eyes with no or slight deterioration of the retinal appearance; and in some eyes retaining no or slight retinopathy, severe impairment of performance developed. Both investigations showed significant differences of initial macular performance between the groups developing proliferative retinopathy and the groups remaining non-proliferative in the periods of observation, suggesting that abnormally reduced recovery performance precede by months or a few years the development of proliferative retinopathy. The development into proliferative retinopathy is generally preceded by increasing stages of background retinopathy running parallel to increasingly reduced macular recovery. The present study has demonstrated large variances of performances both in normal and diabetic individuals.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Macular recovery recorded by nyctometry in insulin-dependent diabetes mellitus. 166 59

beta-Hexosaminidase and its isoenzyme patterns were investigated in plasma from patients with Type 1 diabetes mellitus. The patients were divided into three main groups matched for duration of diabetes: (a) proliferative retinopathy (b), progress of retinopathy within a two-year period (c) and with no background retinopathy. When all patients were compared to a reference group, a significant increase of plasma beta-hexosaminidase activity was found. Patients with proliferative retinopathy had significantly increased activity of plasma beta-hexosaminidase compared to the reference group but not compared to the other diabetic patients. The isoenzyme distribution was not different in any of the diabetic subgroups compared to the reference group. It was also shown that various degrees of diabetic nephropathy did not influence total plasma Hex or the isoenzyme pattern.
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PMID:The association between plasma beta-hexosaminidase and its isoenzyme patterns and retinopathy in type 1 diabetes mellitus. 182 17

The effect of strict metabolic control for 5 years on renal function and retinal morphology was estimated in 24 insulin-dependent diabetic individuals (age 29 +/- 8 years, diabetes duration 10 +/- 6 years) with albustix negative urine and minimal or no background retinopathy before the study. They were randomized to conventional insulin treatment (CIT) or continuous subcutaneous insulin infusion (CSII) with a portable pump. During CSII treatment the metabolic status was significantly improved. HbA1c fell from 8.9 +/- 2.0 to 7.4 +/- 1.3% (p less than 0.01) whereas HbA1c was unchanged during CIT treatment. The mean value of urinary albumin excretion (UAE) was not statistically significantly changed (from 12 +/- 10 mg/24 h to 13 +/- 5 mg/24 h in CSII patients and from 14 +/- 12 to 11 +/- 6 mg/24 h in CIT patients (p greater than 0.1). On the other hand, the elevated GFR values were significantly reduced in both CSII and CIT patients, 129 +/- 17 to 120 +/- 9 and 129 +/- 18 to 119 +/- 12 ml/min.1,73m2, respectively (p less than 0.05). Both the number of microaneurysms, haemorrhages and exudates tended to increase mor in CIT patients than in CSII patients during the 5 year study period, but the differences did not reach statistically significance (p greater than 0.1). Pump treatment did not induce proliferations or "cotton wool" exudates. We conclude that no statistically significantly differences between GFR values, UAE rates, and progression of background retinopathy was observed between normoalbuminuric IDDM patients treated for 5 years with CIT and CSII, respectively. However, due to the size of the material a type II error must be taken into consideration.
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PMID:Effect of near normoglycemia for 5 years on progression of early diabetic retinopathy and renal involvement. 213 7

The life expectancy and quality of life of diabetic patients are largely determined by the long-term complications. Convincing evidence exists to show that the complications are secondary to the altered internal milieu caused by inappropriate insulin action--insulin deficiency in type 1 diabetes and insulin resistance in type 2 diabetes. Genetic factors play only a minor role in the process with the exception of diabetic nephropathy. Of the many metabolic disturbances present in diabetes hyperglycaemia seems to be the most important in this respect. Long-term it has a cumulative effect on the development of background retinopathy in the whole diabetic population and a similar effect on diabetic nephropathy in a genetically predisposed subset. The role of hyperglycaemia in the pathogenesis of macroangiopathy is less clear. Since diabetic microangiopathy is not related to diabetes itself but is secondary to its metabolic consequences, it is--at least in principle--preventable. That this is true has been shown in animal experiments but it has not been proved in human diabetes. There is, however, much evidence suggesting that the incidence of diabetic complications may be diminished when diabetes is well controlled. When the known facts about the rise and fall of the diabetic complications are taken into account the treatment of hyperglycaemia remains as one of the most essential aspects of managing diabetic patients.
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PMID:Why should we treat hyperglycaemia? 239 56

The prevalence of diabetic retinopathy was assessed by direct and indirect ophthalmoscopy in a group of patients with insulin dependent diabetes mellitus (IDDM). Fourteen percent of patients had retinopathy. Proliferative retinopathy and severe background retinopathy including maculopathy were both seen in four percent of patients. It is possible that the lower prevalence rates for these complications is due to the shorter duration of diabetes in our patients.
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PMID:Retinopathy in insulin dependent diabetes mellitus (IDDM) in south India. 259 27

Abnormalities of platelet aggregation and coagulation have been reported in insulin dependent diabetes mellitus (IDDM), although there is controversy concerning their relationship to microangiopathy. We have studied platelet function and haemostasis in 55 patients with IDDM, 23 without, 14 with mild (background retinopathy) and 18 with severe (proliferative retinopathy, or background retinopathy plus proteinuria) complications. Studies were done on 2 occasions 8 weeks apart and the results compared with 28 control subjects. There was evidence of increased in vivo platelet aggregation in the diabetic group v controls shown by raised values of beta-thromboglobulin (61 +/- 42, mean +/- SD, v 18 +/- 14 micrograms/ml, p less than 0.001), platelet factor 4 (62 +/- 76 v 14 +/- 11 micrograms/ml, p less than 0.01), and platelet micro-aggregates (20 +/- 16 v 12 +/- 11%, p less than 0.01). There was no significant difference in fibrinogen and fibrinopeptide A levels, nor in 'in vitro' tests of platelet aggregation between the groups. Dilute whole blood clot lysis time was increased in the diabetic group v controls (6.4 +/- 2.6 v 4.8 +/- 0.5 hours, respectively, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Platelet aggregation and coagulation factors in insulin dependent diabetics with and without microangiopathy. 295 Dec 19

Thirty-eight patients with insulin dependent diabetes mellitus who had background retinopathy and no residual endogenous insulin secretion as assessed by plasma C-peptide determinations, were randomized to either conventional insulin treatment or to more intensive glucose control using ultralente insulin as basal cover and soluble insulin at mealtimes and were followed for five years. Plasma glucose profile and glycosylated hemoglobin were determined every eight weeks. Eye examinations were performed at the start of the study and after one, three and five years. Age, duration of diabetes, insulin dosage, glycemic control were comparable in the two groups. The mean plasma glucose profile was similar at entry in both groups and did not change in the conventionally-treated group. Mean plasma glucose profile 11.2 +/- 1 mmol/l with glycosylated hemoglobin level 10.7 +/- 0.3% fell to 7.9 +/- 0.4 mmol/l and 8.7 +/- 0.5% respectively during intensive treatment. Retinal morphology deteriorated during the follow-up with no significant differences between patients under unchanged conventional treatment and intensive insulin regimen. Proliferative retinopathy developed in six patients--three of these were under intensive insulin treatment. These data suggest that substantial long-term improvement of glycemic control does not affect progression of background retinopathy even when it is mild. The evolution of established retinopathy in insulin dependent diabetic patients is not only a function of poor glycemic control; other factors, either intrinsic or environmental, must also be important.
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PMID:Long-term correction of hyperglycemia and progression of retinopathy in insulin dependent diabetes. A five-year randomized prospective study. 306 50

The degree of random orientation of excited diphenylhexatriene molecules in isolated erythrocyte membrane ghosts was investigated in order to determine the possible effect of lipid disorders on membrane structure in children suffering from type I diabetes mellitus with and without diabetic retinopathic lesions. A decrease of cholesterol in the antiatherogenic fraction HDL (1.17 +/- 0.06 in retinopathy vs 1.24 +/- 0.065 in controls) and its increase in atherogenic LDL fraction (3.88 +/- 0.23 vs 2.63 +/- 0.26) as well as developing erythrocyte membrane rigidization in diabetes and retinopathy (0.193 +/- 0.008 and 0.204 +/- 0.014 vs 0.161 +/- 0.008 in controls) were observed. Considerable fluctuations in plasma and membrane cholesterol:phospholipid ratio were most pronounced in subjects exhibiting diabetic background retinopathy. The content of membrane cholesterol compared significantly with both membrane fluidity (r = 0.677), cholesterol of LDL (r = 0.667) and cholesterol:phospholipid ratio in HDL (r = 0.693) which suggests a destructive effect of lipid disorders on cell membrane structure in diabetics.
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PMID:Analysis of membrane fluidity alterations and lipid disorders in type I diabetic children and adolescents. 363 May 35


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