Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Geographic/population variation in the prevalence of diabetic nephropathy is well recognised. In a study of 'native' Indians, we screened 102 non-proteinuric diabetes mellitus patients (64 NIDDM, 38 IDDM; mean age and diabetic duration 48.7 and 6.5 years, 21.6 and 6.2 years, respectively) with blood pressure less than or equal to 170/105 and without congestive heart failure, ketonuria or urinary tract infection, for the presence of microalbuminuria (albumin excretion rate greater than 20 micrograms/min). Fifty-six patients (34 NIDDM, 22 IDDM) also underwent detailed fundus examination. Seventeen NIDDM (26.6%) and 3 IDDM (7.9%) patients had microalbuminuria. Glycated hemoglobin was significantly higher in microalbuminurics in the NIDDM group (P less than 0.05). Diabetic retinopathy tended to occur more frequently in microalbuminurics (NIDDM and IDDM).
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PMID:The prevalence of microalbuminuria in diabetes: a study from north India. 187 3

A pedigree with maternally transmitted diabetes mellitus, deafness, and cardiomyopathy is described. A A-->G mutation at nucleotide pair 3243 in mitochondrial gene was detected by Apa I digestion of PCR amplified genomic DNA from 3 brothers and their mother. The proband, suffering from CHF, showed unique fine granular pattern of hyperechogenic cardiomyopathy as his brother and their mother did. Although he is recently treated with insulin, he was initially NIDDM treated by sulfonylurea. His urinary CPR excretion decreased gradually to as low as less than 10 micrograms/day in these 3 years. The insulin response to oral glucose was decreased in all other family members with the mutation. It is suggested that the defective insulin secretion exists in this family with the mutation and the progressive decrease in insulin secretion might resulted in IDDM in the proband.
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PMID:[A pedigree with maternally transmitted diabetes mellitus, deafness and cardiomyopathy]. 798 86

Mutations in the mitochondrial gene were recently identified in a large pedigree of diabetes mellitus and deafness. As the mitochondrial gene is materially inherited, Japanese diabetic patients whose mothers were also diabetic were screened, using peripheral leucocytes, for an A to G transition at nucleotide pair 3243 of the mitochondrial gene, a tRNA(Leu(UUR)) mutation. This mutation was identified in four pedigrees from among 300 unrelated patients who were screened. Diabetes co-segregated with the mutation, except in one young subject, and was maternally inherited. The apparent onset of disease occurred between 11 and 68 years of age. Some of the affected members developed hearing impairment and congestive heart failure due to cardiomyopathy, though generally long after the onset of diabetes, and these patients had therefore not been diagnosed as having a specific form of diabetes. The duration of sulphonyl-urea treatment was not more than 8 years in these pedigrees and affected members were prone to progression to insulin-requiring diabetes. Thus, these patients were secondary sulphonylurea failures. Long-term follow-up revealed that the underlying disorder in affected members is a progressive impairment of insulin secretion. Some were initially diagnosed as having IDDM based on an apparent acute onset in youth and the clinical severity of their diabetes. Others were regarded as having MODY with an aggressive course. The mitochondrial gene mutation or diabetes is not transmitted to all offspring of the affected mothers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mitochondrial diabetes mellitus: prevalence and clinical characterization of diabetes due to mitochondrial tRNA(Leu(UUR)) gene mutation in Japanese patients. 805 89

In group of 1026 patients with recent myocardial infarction (from program "Streptokinase in acute myocardial infarction"--patients below 70 years old, up to 12 hours from the onset of the symptoms) we analyzed the influence of diabetes on clinical course and hospital mortality. In this group were 77 patients with noninsulin-dependent diabetes (NIDDM), and 21 patients were insulin-dependent diabetes (IDDM). The risk factors of coronary heart disease and myocardial infarction in the past were significantly more often in patients with diabetes than in subjects without diabetes. In hospital mortality was significantly higher (p < 0.05) in group of patients with diabetes (17.3%) than in group without diabetes (9.5%). Reinfarction in the hospital period occurred significantly more often in diabetes group (p < 0.01). Congestive heart failure was observed in 50% patients with diabetes and in 32.3% cases without diabetes (p < 0.01), the left ventricle aneurysm occurred accordingly 9.8% i 5.2% (N.S.). Early ventricular fibrillation and atrio-ventricular blocks occurred with the same frequency in the both groups. We analyzed also the influence of thrombolytic therapy on clinical course in patients with diabetes proving the benefit of this treatment.
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PMID:[Influence of diabetes on the clinical course and hospital mortality of patients with recent myocardial infarction]. 847 43

1. Insulin-dependent diabetes mellitus is a known risk factor for congestive heart failure and an early diastolic dysfunction has been described. In order to see if diabetes itself and not complications like hypertension, nephropathy or ischaemic heart disease can be considered responsible for the abnormal diastolic function of the left ventricle, 17 young patients with uncomplicated insulin-dependent diabetes mellitus and 12 control subjects were exposed to a cold pressor test. 2. Blinded echo-Doppler examination was performed before and during the test. During basal conditions, left ventricular dimensions and volumes were smaller in diabetes and atrial contributions to left ventricular filling were increased. 3. During the cold pressor test, isovolumic relaxation time increased, peak early filling velocity (E) decreased, E deceleration time decreased and atrial contribution (A) increased significantly in diabetes, while only A increased in the control group. A marked increase in left atrial ejection force was seen in diabetes only (P < 0.002). This difference was seen in spite of comparable reductions in mitral area and atrioventricular compliance in the two groups. 4. The hyperfunction of the left atrium in diabetes is hypothesized to be due to reduce size of the left ventricle combined with incipient autonomic neuropathy.
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PMID:Abnormal left ventricular diastolic function during cold pressor test in uncomplicated insulin-dependent diabetes mellitus. 854 59

Distensibility of large and middle size arteries is a function of major significance for the cardiovascular system. This paper will describe data obtained by measurements of local distensibility in hypertension and other cardiovascular diseases. Isolated systolic hypertension is characterized by a diffuse reduction of arterial distensibility, while essential hypertension by a reduced distensibility in large elastic arteries, but an unchanged distensibility of middle size arteries. Other conditions associated with a marked reduction of arterial mechanical functions are familial hypercholesterolemia, the association of mild hypertension and mild hypercholesterolemia, congestive heart failure and type 1 diabetes mellitus. In most of these conditions, however, appropriate therapy is able to reverse the deranged arterial distensibility. Finally, epidemiological data suggest that it is justified to focus on pulse pressure, i.e. on an indirect indicator of a reduced arterial distensibility, when assessing the overall cardiovascular risk.
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PMID:Arterial distensibility and pulse pressure. Measurements and clinical significance in hypertension. 1042 87

Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinically overt diabetes. Impaired left ventricular function has been reported in young patients with diabetes mellitus type 1 (IDDM), but severe cardiomyopathy as the first early major complication of IDDM is very rare. We report a 14 year-old girl with a 5-year history of IDDM and very poor compliance with treatment and follow-up. She was referred to our clinic upon the development of congestive heart failure and dilated cardiomyopathy was diagnosed based on clinical findings, electrocardiogram, chest X-ray and echocardiography. She had no evidence of other major complications of IDDM such as retinopathy, nephropathy or neuropathy.
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PMID:Dilated cardiomyopathy as the first early complication in a 14 year-old girl with diabetes mellitus type 1. 1108 94

BACKGROUND: There is a need for additional studies of the quality of life (QOL) of elderly depressed subjects with medical comorbidity. METHOD: We conducted an 8-week, open trial of bupropion sustained release (SR) in 18 elderly (60-81 years) subjects with DSM-IV major depressive disorder and one or more serious medical illnesses (e.g., congestive heart failure, type 1 diabetes mellitus, irritable bowel syndrome) with a week-12 follow-up interview. The intent-to-treat method with the last observation carried forward was used to analyze depression and QOL measures. Dosing was initiated at 100 mg once daily and increased at weekly intervals to a maximum of 150 mg twice daily as clinically indicated. RESULTS: Bupropion SR treatment was associated with reductions in Clinical Global Impressions-Severity of Illness scale (p <.0001) score and in the 17-item Hamilton Rating Scale for Depression (HAM-D) total score (p <.0001). QOL as measured by the Medical Outcomes Study Short Form-36 (SF-36) also tended to improve with treatment. The SF-36 "mental health" (p <.01) and "social functioning" (p <.0006) domains improved significantly by week 4. "Vitality" (p <.03) improved significantly by week 12. On the HAM-D, statistically significant improvement was noted on "depressed mood" (p <.0001), "feelings of guilt" (p <.01), "work and activities" (p <.001), "hypochondriasis" (p <.02), and "insomnia" (p <.01) at week 8. The mean dose of bupropion SR at endpoint was 222 mg/day, and the drug was relatively well tolerated. Two subjects dropped out owing to adverse events and 2 owing to other reasons. No drug-drug interactions occurred. CONCLUSION: These data suggest that bupropion SR is well tolerated and may improve depression, insomnia, somatic symptoms, work functioning, and certain quality-of-life measures in elderly depressed subjects with medical disorders. A randomized, placebo-controlled study is warranted to confirm these promising findings.
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PMID:Effect of Bupropion SR on the Quality of Life of Elderly Depressed Patients With Comorbid Medical Disorders. 1501 68

Data on the long-term prognosis of acute myocardial infarction (AMI) in young patients are limited. This study investigated long-term survival and risk predictors in a series of 108 consecutive patients </=40 years old who represented 4% of 2,644 patients who presented with AMI at a single center between June 1986 and April 1992. Four patients died soon after admission. The overall mortality rate of the 104 survivors was 25.5% at 15 years. The mortality rate was higher in patients who had type 1 diabetes mellitus (p = 0.01), long-term excessive alcohol intake (p = 0.035), peripheral arterial disease (p = 0.004), previous AMI (p = 0.04), anterior AMI (p = 0.01), and depressed left ventricular ejection fraction (p <0.0001). Cumulative survival rates (Kaplan-Meier analysis) at 1, 5, 10, and 15 years were 99%, 95%, 86%, and 75%, respectively. Event-free survival rates (death, AMI, coronary intervention, severe angina pectoris, malignant arrhythmias, and congestive heart failure) at the same times were 88%, 76%, 60%, and 43%, respectively. The strongest independent predictors of the long-term mortality rate were ejection fraction </=45% (odds ratio 4.4, 95% confidence interval 1.6 to 12.4, p <0.001) and peripheral arterial disease (odds ratio 45.9, 95% confidence interval 3.79 to 555, p <0.0001). These data suggest that the long-term prognosis and functional status of young patients who have AMI are not benign, especially when ejection fraction is decreased or peripheral atherosclerotic disease is present.
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PMID:Long-term prognosis of patients having acute myocardial infarction when </=40 years of age. 1547 9

Uterine fibroid admissions in the nation's hospitals have grown more than 20 percent over the past five years. Substantial variations exist in inpatient treatment patterns. In spite of this dramatic growth, there are no national studies of the hospital costs associated with the treatment of uterine fibroids in the hospital setting. Using 11 years of data (1993-2003) from the Healthcare Cost and Utilization Project, a nationally representative 20 percent sample of the nation's inpatient admissions, trends in hospital charges, costs, and lengths of stay (LOSs) are reported. For 2001 to 2003, determinants of hospital costs and LOS for inpatients with a primary diagnosis of uterine fibroids were analyzed using univariate analyses and regression techniques. Hysterectomies for women with a primary diagnosis of uterine fibroids have in-hospital costs of over $1.5 billion. Among the major procedures for treating uterine fibroids, in 2003, total abdominal hysterectomy had the longest LOS, averaging 2.9 days with a mean cost of $6331. In contrast, the treatment with the shortest LOS, 1.72 days, was laparoscopically assisted vaginal hysterectomy but it had the highest mean costs of $7108. In 2003, supracervical hysterectomies and myomectomies had mean costs of $6809 and $6707, respectively. Multivariate results show that patient characteristics and structural aspects of the hospital are strong predictors of lengths of stay and cost per day but there are major differences across some of the surgical procedures. Although the patient characteristics-insulin-dependent, non-insulin dependent diabetes, obesity, morbid obesity, smoker, hypertension, congestive heart failure, chronic obstructive pulmonary disease-all have significant impacts on LOS and cost per day for some of the major uterine fibroid treatments, they are not consistent. Compared with white women, black, Hispanic, and Asian/Pacific Island women all had higher lengths of stay and costs per day. Bedsize and teaching status are generally positively associated with lengths of stay and costs per day; for-profit status always had a significant positive association with LOS and cost per day. Hospital costs for treating women with uterine fibroids are continuing to grow. Further research on the determinants of the resource utilization could be helpful in predicting and alleviating these costs and improving patient care.
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PMID:National trends and determinants of hospitalization costs and lengths-of-stay for uterine fibroids procedures. 1917 28


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