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)

Involvement of the retinal microvascular vessels is an almost inevitable consequence of long standing diabetes. In the only large scale epidemiology study of a Caucasian population Klein et al. found some degree of retinopathy in up to 97% of patients with insulin dependent diabetes mellitus (IDDM) after about 15 years diabetes duration and in about 60% of insulin treated patients of older onset, presumably non-insulin dependent diabetic patients (NIDDM). The presence of retinopathy does not indicate impending visual loss in all patients. Thus in IDDM the sight threatening forms of retinopathy is most commonly associated with neovascularization; up to 60% of patients develop this lesion after 20 years diabetes duration, while in the older age group new vessels are far less common. In clinic populations the commonest cause of visual loss in NIDDM is associated with macular oedema but in the population studies of Klein, prevalence of macular oedema was almost as common in IDDM as in NIDDM patients.
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PMID:Diabetic retinopathy. 247 10

The peptide C, polypeptide secreted by the pancreas at the same time as insulin, presents a great interest in the evaluation of diabetic patients. First it allows a differentiation between insulin dependent diabetes (IDD) and non insulin dependent (NDD). A low and non stimulated levels of peptide C signifies an insulin dependence. Within the group of IDD patients the peptide C was low when the diabetes was discovered at a younger age and its secretion diminished as the diabetes progresses. The peptide C has also a prognostic interest in IDD. Low and non stimulable levels of peptide C signifies a difficult control of diabetes which needs two injections per day while high and stimulable levels will be seen in diabetes easy to control with one injection of insulin. Finally, values of peptide C does not permit to predict the onset of diabetic complications (retinopathy, acidocetosis) as well as the control of patients.
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PMID:[Importance of peptide C determination in diabetes]. 251 29

We examined ten patients with type I diabetes mellitus and ten age- and sex-matched healthy controls. Median duration of diabetes was 7 years (range 0.5-24). None of the diabetic patients had hypertension, microalbuminuria, or proliferative retinopathy. Maximal specific binding capacity for angiotensin II to thrombocytes was significantly increased in diabetics (Bmax 11.9 +/- 1.6 sites per cell vs 7.0 +/- 0.9 in controls; P less than 0.01). In contrast, maximal binding for atrial natriuretic factor tended to be lower in type I diabetics (8.84 +/- 1.25 sites per cell vs 16.8 +/- 2.97; P less than 0.07). There was no difference of apparent dissociation constant (KD) for either receptor. Angiotensin II values (RIA) were greater in diabetics (16.2 +/- 1.5 pg/ml vs 8.5 +/- 1.4 in controls; P less than 0.02) and concentrations of atrial natriuretic factor (RIA) were not significantly different. The data suggest increased angiotensin II binding despite high angiotensin II concentrations in non-nephropathic type I diabetic patients. These findings may be relevant when considering the evolution of hypertension and microangiopathy lesions.
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PMID:Specific binding of angiotensin II and atrial natriuretic factor in non-nephropathic type I diabetes mellitus. 252 55

The retinal vessel calibre responses to systemic sympathetic stimulation, were studied in 22 randomly selected diabetic patients (mean age +/- SEM: 54.7 +/- 2.59 years, range 25-73; 13 IDDM, 9 NIDDM; 4 females), using sustained isometric muscle contraction as the stimulus. At a different session the integrity of the autonomic nerve function in these diabetic patients was assessed using 3 standard tests of autonomic nerve function, based on cardiovascular reflexes. Diabetic patients with an intact autonomic nervous system: Group 1, (n = 11, mean age: 54.9 +/- 4.55 years, 7 IDDM 4 NIDDM) showed a mean arteriolar constriction of 9.2% (SEM 2.89, p less than 0.01) and a mean venule constriction of 5.1% (SEM 1.73, p less than 0.02), for a mean rise in diastolic blood pressure of 23.7 mmHg (SEM 2.19 range: 13-33). There were no significant mean retinal vessel responses however, in diabetics with autonomic dysfunction (Group 2): mean arteriolar constriction of 1.2% (SEM 1.38 p greater than 0.05) and venule constriction of 2.1% (SEM 1.38, p greater than 0.05); for a mean rise in diastolic blood pressure of 19.8 mmHg (SEM 4.49, range: 2-50). There was no correlation between the rise in diastolic blood pressure and the retinal arteriolar constriction in the 2 groups (Group 1:r = 0.45, p greater than 0.01 and Group 2: r = 0.56, p greater than 0.05). Duration, type and control of diabetes were not significantly different between the 2 groups. The severity of retinopathy was slightly worse in Group 2 compared to Group 1. These results point to an association between autonomic neuropathy and failure of regulation of retinal blood flow.
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PMID:Responses of the retinal circulation to systemic autonomic stimulation in diabetes mellitus. 259 97

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

Overnight albumin excretion rates were measured in 940 diabetic patients, 416 with insulin dependent and 524 with non-insulin dependent diabetes, and in 106 healthy volunteers. A significantly higher number of non-insulin dependent diabetic patients had abnormal albumin excretion compared with the insulin-dependent group (X2 = 15.2, p less than 0.002). Ten per cent of non-insulin-dependent and 7 per cent of insulin-dependent diabetic patients had albumin excretion rates in the range 30-150 micrograms/min and thus were at risk of the cardiovascular and renal complications of diabetes. Six per cent of non-insulin-dependent and 5 per cent of insulin-dependent diabetic patients had albumin excretion rates above 150 micrograms/min and thus were entering the phase of clinical diabetic nephropathy. Multivariate analysis revealed that male sex and retinopathy in insulin-dependent diabetes, and systolic blood pressure and retinopathy and peripheral vascular disease in non-insulin-dependent diabetes, were significantly related to albumin excretion. Only one patient with insulin-dependent diabetes of less than 5 years known duration had an albumin excretion rate in the range 30-150 micrograms/min, whereas such an excretion rate indicating patients at risk was observed at all durations of non-insulin-dependent diabetes. It is possible that during the long silent phase of non-insulin-dependent diabetes, before diagnosis, significant renal damage occurred.
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PMID:Comparison of the prevalence and associated features of abnormal albumin excretion in insulin-dependent and non-insulin-dependent diabetes. 259 49

Factors to be checked concerning local and systemic condition were studied statistically in order to clarify the methodology for clinical management of diabetic retinopathy. NIDDM (n = 1517) and IDDM (n = 30) persons participating in baseline and follow-up examinations were included. The vitreous fluorophotometric values were selected for local check factors. Glycosylated hemoglobin was selected for systemic check factors. To determine the retinopathy status at both the baseline and follow-up examinations, all fundus photographs were graded in a masked fashion, using the author's classification scheme (1983) which specified six levels of retinopathy for each excepted from the interrupted proliferative retinopathy. Level 0: no retinopathy, Level 1: microaneurysms only (AI), Level 2: microaneurysms and retinal hemorrhages (AII), Level 3: preproliferative retinopathy (soft exudates, increased capillary occlusion and intraretinal microvascular abnormalities) (BI), Level 4: neovascularization elsewhere (BII), Level 5: neovascularization of the disc (BIII), Level 6: vitreous hemorrhages or proliferative tissue (BIV, V). A positive correlation between the progression of retinopathy and glycosylated hemoglobin or vitreous fluorophotometric values were observed. The coefficient of correlation was 0.67 between posterior vitreous fluorophotometric values and levels (scores) of retinopathy. The coefficient of correlation was 0.41 between glycosylated hemoglobin and levels of retinopathy. These data suggest that these two factors can predict the progression of diabetic retinopathy.
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PMID:[Clinical management of diabetic retinopathy]. 261 Jan 68

The relationship between glycemic control and complications of insulin-dependent diabetes mellitus (IDDM) remains controversial. With the use of glycosylated hemoglobin (HbA1) to assess glycemic control from diagnosis onward, the Pittsburgh Prospective Insulin-Dependent Diabetes Mellitus Cohort Study prospectively evaluated 80 new cases of IDDM diagnosed at Children's Hospital of Pittsburgh. This study presents findings in 62 patients at 5 yr postdiagnosis. Only 7 patients, all girls, had any retinopathy (microaneurysms). These subjects had an elevated 5-yr mean HbA1 compared to those with no retinopathy (13.0 vs. 11.7%; P less than .05). Six female subjects who had an elevated albumin excretion rate (AER; greater than or equal to 20 micrograms/min) had a higher 5-yr mean HbA1 (13.3%) than the 26 subjects with AER less than 20 micrograms/min (11.8%; P less than .05). Current HbA1 was correlated with AER (r = +.36, P less than .05) and systolic blood pressure (r = +.49, P less than .01) in females. However, these associations were not observed in males. Positive correlations were found between HbA1 (5-yr mean and current) and serum triglyceride and cholesterol, but only in females was HbA1 inversely related to high-density lipoprotein cholesterol. However, HbA1 was independent of sex, HLA-DR type, and urine C-peptide status. Age adjustment did not change the above results. These analyses suggest that glycemic control is related to AER, systolic blood pressure, presence of microaneurysms, and serum triglyceride and cholesterol concentrations during the first 5 yr of IDDM. However, these associations appear to be predominant in girls.
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PMID:Diabetes complications and glycemic control. The Pittsburgh Prospective Insulin-Dependent Diabetes Cohort Study Status Report after 5 yr of IDDM. 261 4

The contribution of diabetes duration, both pre- and postpuberty, to the development of microvascular complications and mortality in diabetic subjects was investigated in three study populations from the Children's Hospital of Pittsburgh Insulin-Dependent Diabetes Mellitus (IDDM) Registry. Life-table analyses by total and postpubertal IDDM duration were used to evaluate differences in the prevalence of microvascular complications and diabetes-related mortality in subjects diagnosed before and during puberty, as defined by an age at IDDM onset marker of 11 yr for girls and 12 yr for boys. The prevalence of retinopathy and overt nephropathy in 552 White adult diabetic subjects (population 1, mean IDDM duration 20.8 yr was significantly greater in subjects diagnosed during puberty compared with those diagnosed before puberty. However, similar analyses by postpubertal duration showed no difference in microvascular complication prevalence between the two groups. These findings did not appear to be due to a confounding effect of age. Additional analyses of 239 adolescent diabetic subjects (population 2, mean duration 8.3 yr) revealed the same trend for the prevalence of retinopathy. Finally, results concerning the risk of diabetes-related mortality in a cohort of 1582 subjects (population 3, mean duration 12.9 yr) indicated that postpubertal duration of IDDM may be a more accurate determinant of the development of microvascular complications and diabetes-related mortality than total duration, and it is suggested that the contribution of the prepubertal years of diabetes to long-term prognosis may be minimal.
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PMID:Contribution of diabetes duration before puberty to development of microvascular complications in IDDM subjects. 261 3

The incidence of IDDM in children in Japan was found to be approximately 6 out of 100,000 in the child population of 6 to 15 years old. This prevalence is very low compared with those in Caucasian countries. Therefore, the history of management of childhood diabetes in Japan is short compared with that of western countries. Three studies which were carried out in Japan are reported and discussed in this report. The complications and prognosis of Type-1 Diabetes in Japan concluded as follows, 1) The long-term outcome of childhood diabetes was very poor. 2) The prevalence of microvascular complications were strongly related to the age of patients and the duration of diabetes. 3) The prevalence of retinopathy was dependent on the degree of diabetic control. But now, in Japan, we are using the intensive insulin therapy universally for childhood diabetes, and during recent ten years, the management and education of patients progressed rapidly. Therefore, the prognosis of childhood diabetes in Japan will improve.
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PMID:Long term prognosis: juvenile onset IDDM in Japan. 263 86


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