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)

We studied the relationship of retinal and/or renal microvascular complications and duration of disease with altered finger skin microcirculation in insulin-dependent diabetic (IDDM) subjects. Short-term and long-term IDDM subjects without complications or with proliferative retinopathy or incipient nephropathy were investigated with laser-Doppler fluxmetry. An increased resting flux in skin microcirculation was found in short-term (median: 34 perfusion units, PU) and uncomplicated long-term IDDM subjects (25 PU) as compared with age-matched healthy controls (18 PU), which suggests a generalized dilatation of the microcirculation throughout the body. In long-term IDDM subjects with retinopathy we also observed an increased resting flux (37 PU), but in subjects with incipient nephropathy resting flux was decreased (17 PU) relative to the other diabetic subjects, to a level not different from the healthy control group. Post-occlusive hyperaemic peak flux was decreased in patients with incipient nephropathy relative to the other diabetic patients, which suggests a defect in maximal arteriolar vasodilatation. No differences were found between the groups in the venoarteriolar reflex during venous occlusion. In conclusion, IDDM patients demonstrated increased red blood cell flux. However, with the occurrence of incipient nephropathy the resting flux and the maximal post-occlusive vasodilatation decreased, which suggests that development of nephropathic changes in diabetes is representative of a more generalized alternation of microvascular flow regulation. Local neurogenic microvascular control appears to be unaffected in these patients.
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PMID:Skin blood cell flux in insulin-dependent diabetic subjects in relation to retinopathy or incipient nephropathy. 155 44

After more than 60 years of active investigation, the role of intensive treatment regimens in preventing and ameliorating diabetes complications is close to being resolved. Currently available intensive regimens do not achieve normoglycemia and are associated with significant complications. Moreover, they are dependent on a high level of patient motivation and adherence and may not be widely applicable in the IDDM population. Given these limitations, it is critical that their benefit, if any, be documented before they are introduced widely into clinical therapy. If the glucose hypothesis proves to be true, the benefits of intensive therapy will outweigh all of its limitations. Although previous trials have failed to document benefits with regard to retinopathy (the decrease in the progression from incipient nephropathy to clinical proteinuria is of unknown clinical significance), the DCCT has adequate power to define the role of intensive therapy. If the DCCT demonstrates a salutary effect of intensive therapies, a rationale for such efforts finally will have been established. The goal for the next generation of clinical investigation will be to develop new means of intensive therapy that have less risk and are more accessible and acceptable to all persons with diabetes.
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PMID:The rationale for glucose control in diabetes mellitus. 161 66

Diabetic nephropathy is the most important complication of diabetes, because it is a major cause of morbidity and mortality for diabetic subjects. Since not all subjects with diabetes are at risk of developing this complication, we conducted a study to determine if heredity might be a possible risk factor for diabetic nephropathy in non-insulin dependent diabetes. Twenty-one factors including inheritance of nephropathy and hypertension were investigated in 109 individuals with NIDDM: 50 patients without proteinuria (Group I), 20 patients with intermittent proteinuria (Group II), and 39 patients with continuous proteinuria (Group III) matched for age and duration of diabetes. Of those patients, 55 patients with inheritance of diabetes were also divided into three groups: 29 patients without proteinuria (Group I), 9 patients with intermittent proteinuria (Group II), and 17 patients with continuous proteinuria (Group III). Individuals in Groups II and III has significantly higher frequency of inheritance of diabetic nephropathy than those in Group I, and also individuals with inheritance of diabetic nephropathy had significantly higher frequency of diabetic nephropathy than those without it. Frequency of hypertension, retinopathy and body mass index in the past were significantly higher in subjects in Groups II or Group III than in those in Group I. There were no significant differences between subjects in Groups II and III. These findings suggest that susceptibility to diabetic nephropathy in NIDDM may be hereditary, although hypertension and obesity may also be important risk factors for diabetic nephropathy.
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PMID:[The possibility of hereditary factors in the susceptibility to diabetic nephropathy in NIDDM]. 163 29

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

Three hundred and fifty seven subjects (178 males and 179 females) with insulin dependent diabetes mellitus were evaluated for the presence of limited joint mobility of the interphalangeal joints. Sixty six subjects (19%) had stage 1 and 26 subjects (7%) had stage 2 involvement of their interphalangeal joints. The presence of contractures was significantly related to mean longitudinal glycated haemoglobin (HbA1) concentrations, duration of diabetes, age of onset, mean longitudinal cholesterol concentrations and blood pressure. Limited joint mobility was also significantly associated with early diabetic retinopathy and raised albumin excretion rates. Limited joint mobility remained a significant factor in the logistic regression model for albuminuria and grade of retinopathy when controlled for smoking, cholesterol concentrations, duration of diabetes, age, gender, and blood pressure. However, limited joint mobility was only significantly associated with diabetic retinopathy when the effect of HbA1 concentrations was included in the multivariate model.
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PMID:Limited joint mobility in subjects with insulin dependent diabetes mellitus: relationship with eye and kidney complications. 173 47

In order to provide further insights into the conflicting reports of associations between diabetes and uric acid metabolism, we studied 175 adult diabetic patients (56 IDDM, 119 NIDDM) and 114 matched control subjects. Plasma uric acid (PUA) concentrations were not significantly different between diabetic and control subjects, despite increased urinary urate in diabetic patients. There were no significant associations, in diabetic patients, between PUA and (i) type of diabetes, (ii) glycaemic control, (iii) retinopathy and (iv) proteinuria. Plasma urate did not correlate with the KG constant for glucose disposal rate during IVGTT, thus indicating that PUA may not be related to insulin action. In a separate study, PUA rose sharply, peaking at 30 min, and fell subsequently in both newly diagnosed NIDDM patients (n = 20) and subjects with impaired glucose tolerance (n = 15) in response to standard OGTT, in contrast to normal controls (n = 35) in whom PUA rose gradually to a peak at 120 min. Mean rise in PUA from baseline to peak was significant (P less than 0.05) in the diabetic group only. These differences in PUA response during an OGTT between subjects with abnormal glucose metabolism and normal controls may be a feature in the metabolic evolution of diabetes and need further investigation.
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PMID:Plasma urate in diabetes: relationship to glycaemia, glucose disposal, microvascular complications and the variations following oral glucose. 175 87

Only a few studies have investigated vestibular function in diabetes mellitus (DM), showing contradictory results. We have performed an electronystagmographic (ENG) evaluation of 46 individuals with type I DM and 37 healthy controls. No patient reported subjective vestibular symptoms. Duration of caloric-induced nystagmus (DN) was significantly lower (2.1 +/- 0.7 vs. 2.6 +/- 0.4 min, p less than 0.01), and central nystagmus frequency of caloric response also nonsignificantly tended to be decreased (37.4 +/- 16.5 vs. 41.7 +/- 12.7 beats/30s, p = 0.21) in DM patients, as compared to controls. The latter comparison achieved significance after exclusion of newly diagnosed diabetic patients (33.4 +/- 16.1 vs. 41.6 +/- 12.7 beats/s, p less than 0.05). Depressed caloric reactions were seen in 21.8% of patients. DN was lower in patients with microalbuminuria and retinopathy, but this was not observed after exclusion of newly diagnosed diabetic patients, all of whom had normal ENG responses and no chronic diabetic complications. The existence of a lower DN and central nystagmus frequency should be borne in mind when interpreting ENG tracings in patients with long duration type I diabetes mellitus.
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PMID:Asymptomatic electronystagmographic abnormalities in patients with type I diabetes mellitus. 178 72

Juvenile diabetics have severe loss of beta cell function and require replacement therapy with insulin. Insulin antigenicity can produce anti-insulin antibodies resulting in allergic reactions and insulin resistance. The role of insulin-anti-insulin antibody complexes in the development and progress of chronic diabetic complications like microangiopathy is not very clear. In the present study, there was statistically a significant trend of higher insulin antibody binding levels in IDDM patients who developed retinopathy. Though there was a trend of higher insulin antibody in IDDM patients with retinopathy, there was no association between insulin antibody and HLA antigen which some authors have reported.
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PMID:Anti-insulin antibodies and retinopathy in juvenile onset type-1 diabetes. 181 Aug 80

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 present study was conducted on 25 patients with Diabetes Mellitus (DM) having positive indication of diabetic retinopathy on ophthalmoscopic examination. The patients were examined clinically, ophthalmoscopically and with Fluorescein Angiography (FA). It was found that the maximum number of patients with retinopathy were in their 5th and 6th decade and that retinopathy was more common in Non Insulin dependent diabetics (NIDDM) than Insulin dependent Diabetics (IDDM). It was also seen that retinopathy takes longer time to develop in IDDM patients (16.37 years vs 11.7 years). Proliferative diabetic retinopathy was more common with patients having poor glycemic control and in IDDM patients. FA was very helpful in detecting microaneurysms and for exact localization of neovascularization, and other microangiopathic lesions as well as for permanent record.
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PMID:Diabetic retinopathy: a clinical study with special reference to fluorescein angiography. 184 1


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