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

Whether there is a diabetic osteopathy" or osteopathy in diabetes mellitus", is still unclear. Epidemiological studies show in part discrepant results: bone mass was diminished in some studies, unchanged in others--even more positive trends were reported. Increases in osteoporotic fractures were observed in smaller collectives whereas no general trends for fracturing bones were found in diabetics. There are many in part favouring, in part impairing factors to be taken into consideration: Diabetes mellitus type I is a disease including immune phenomena. As inflammation leads to bone loss (inflammation-mediated osteopenia = IMO), peak bone mass may be influenced by such a process. The lack of insulin-like growth factors may be decisive, too. Complications of diabetes mellitus include hypogonadism--this may be disadvantageous for the skeleton. Diabetic complications like retinopathy, neuropathy, and angiopathy may influence the fracture event independently from bone mass. On the other hand, diabetes mellitus type II may be somehow protected against bone loss: Increased adipose tissue in connection with the frequently seen overweight yields metabolically active steroid hormones, insulin related growth factors may stimulate bone formation (e.g. in Forestier's disease). Older diabetics do not show diminished life expectancy any more due to their regular medical care--whether this includes the risk of bone diseases, is not yet clear. It may be worth to further analyse these "positive" effects seen in bones of type II diabetics because they may be useful in osteoporosis even in non-diabetics.
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PMID:Diabetes mellitus and bone metabolism. 149 Jul

Eight hundred patients with alopecia areata (AA) responded to a detailed questionnaire that was compiled, distributed, and analyzed by Help Alopecia International Research, Inc. (HAIR). Among those responding, 28% were men and 72% were women. Fifty percent had localized alopecia, 30% had alopecia totalis, and 20% had alopecia universalis. Forty-eight percent developed their initial onset before the age of 20. A very strong family history of 42% was found. There were 333 additional family members with AA. Many patients and relatives had concurrent atopic diseases (seasonal rhinitis, bronchial asthma, and atopic dermatitis). Associated autoimmune diseases including vitiligo, thyroid disease, and collagen vascular disease in patients and relatives appeared consistent with previous reports. Insulin dependent diabetes mellitus (IDDM) was not increased in patients but greatly increased in relatives. Additional analysis suggests a genetic association between the two diseases where expression of AA may prevent the development of IDDM.
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PMID:Profile of alopecia areata: a questionnaire analysis of patient and family. 156 16

Lipase activities were measured at pH 4 and pH 8 in the placentas of rats made diabetic by streptozotocin treatment and also in the placentas of women classified as having 1) impaired glucose tolerance or type 2 diabetes, 2) type 1 diabetes with no associated vascular complication, and 3) type 1 diabetes with associated vascular disease. In both sets of experiments, the placentas were compared with normal control groups. The placental lipase activity measured at pH 8 was not significantly different in either streptozotocin-treated rats or impaired glucose tolerance/diabetic women as compared with controls, whereas the lipase activity measured at pH 4 increased significantly as compared with controls in both species. Furthermore, in the women there was a significant correlation between placental lipase activity at pH 4 and birth weight in impaired glucose tolerance/type 2 diabetes. It is suggested that the increased placental lipase activity may contribute to the increased fetal weight in human diabetic pregnancy, by contributing to the increased fat transfer across the placenta from mother to fetus.
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PMID:The effects of diabetes on placental lipase activity in the rat and human. 180 50

ION typically affects the older population with a sudden decrease in vision, altitudinal visual field loss, and a swollen optic nervehead. Systemic hypertension and diabetes mellitus are the most commonly associated medical problems. Occlusion of the posterior ciliary arterial blood supply to the retrolaminar optic nerve leads to axoplasmic stasis and further compromise of vessels in the nerve substance, which causes the typical funduscopic appearance. Although there is no recognized medical treatment that can reverse the visual loss, a recent report suggests optic nerve sheath decompression for a select group of patients with a gradual decline in vision due to ION may be beneficial. When ION occurs in persons less than 50 years of age, such etiologies as juvenile diabetes mellitus, antiphospholipid antibody-associated clotting disorders, collagen-vascular disease, and migraines should be considered. Rarely, complications of intraocular surgery or acute blood loss may cause an ischemic event in the optic nerve.
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PMID:Ischemic optic neuropathy. 201 Nov 5

Reproducibility of noninvasive ultrasound methods for vascular diagnosis was studied in 36 patients with Insulin Dependent Diabetes Mellitus. The vascular examination included a) the measurement of ankle systolic arterial pressure and ankle/arm pressure index (c.w. Doppler), b) Echo-Doppler examination of iliac arteries with measurement of maximum systolic frequency, systolic spectrum width and diastolic reverse flow component. A grading of iliac artery stenosis was also performed. The examination was repeated after one month according to a blind protocol. The coefficients of variation were as follows: 8% for ankle pressure; 8% for ankle/arm pressure index; 9% for the maximum systolic frequency; 18% for the spectrum width and 15% for the reverse flow component. The reproducibility of the grading of iliac artery stenosis based on the combined use of the three Echo-Doppler parametres was measured by the Kendall coefficient (W = 0.865). These results confirm that non invasive methods are suitable and reliable for investigating vascular disease in diabetic patients. Accurate estimates of reproducibility are essential pre-requisites for the planning of studies on the natural history of vascular disease and on progression-regression of arterial lesions.
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PMID:Reproducibility of non-invasive vascular diagnosis in patients with diabetes mellitus. 266 46

Patients with insulin dependent diabetes mellitus who develop proteinuria may die prematurely, whereas those who do not develop this complication have a comparatively normal life span. The excess mortality in diabetics with proteinuria is from cardiovascular as well as renal disease, but the reason is unclear. Risk factors for vascular disease were therefore assessed in 22 insulin dependent diabetics with proteinuria, but not renal failure, who were matched for sex, age, duration of diabetes, and glycated haemoglobin (HbA1) values with a similar number who had normal urinary albumin excretion rates. Macrovascular disease (ischaemic heart disease and peripheral vascular disease) was present in 10 patients with proteinuria but in only three with normal albumin excretion rates, and proliferative retinopathy was detected in 11 and four patients in the two groups. There was no significant excess of smokers in the group with proteinuria. Blood pressure was, however, higher in the patients with proteinuria--mean systolic pressure 161 (SD 18) mm Hg compared with 135 (19) mm Hg (95% confidence interval of difference between means 15 to 38 mm Hg); mean diastolic pressure 90 (SD 12) mm Hg compared with 79 (15) mm Hg (confidence interval 3 to 19 mm Hg). The concentration of serum high density lipoprotein (HDL) cholesterol isolated by precipitation was lower in the patients with proteinuria (confidence interval 0.02 to 0.41 mmol/l). Their concentration of HDL2 cholesterol isolated by ultracentrifugation was also decreased (confidence interval 0.02 to 0.40 mmol/l), whereas HDL3 cholesterol tended to be increased (confidence interval -0.01 to 0.23 mmol/l). There was also a trend for serum cholesterol concentrations to be higher in the presence of proteinuria (confidence interval -0.39 to 1.20 mmol/l). The aggregation of risk factors for atherosclerosis in insulin dependent diabetes mellitus complicated by proteinuria helps to explain the increased prevalence of ischaemic heart disease and peripheral vascular disease reported in these patients. Early renal disease in insulin dependent diabetes may have an important role in hypertension and altered lipoprotein metabolism.
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PMID:Influence of proteinuria on vascular disease, blood pressure, and lipoproteins in insulin dependent diabetes mellitus. 311 68

Of 340 patients with anterior uveitis, 20 (6%) had diabetes mellitus. This is significantly higher than the prevalence of 1.4% in the normal Dutch population (P less than .001). Of 128 patients with idiopathic anterior uveitis, 16 (12.5%) had diabetes mellitus compared to only four (1.9%) of 212 patients with anterior uveitis with an established specific ocular diagnosis (P less than .001). Of the 16 diabetic patients with idiopathic anterior uveitis, ten (63%) had type I diabetes mellitus and 12 (75%) suffered from severe diabetic complications as angiopathy, nephropathy, and neuropathy. The onset of diabetes mellitus preceded the onset of anterior uveitis in all cases. Whether or not uveitis in diabetic patients is a true inflammation rather than an ischemic phenomenon is still unknown.
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PMID:Uveitis and diabetes mellitus. 339 64

Therapy for diabetes mellitus, especially type I diabetes mellitus, is changing rapidly. Several developments and discoveries have contributed to this change. Most important, the data relating to the relationship between vascular disease and neuropathy and control of blood sugar and the developments in monitoring of glucose control have had a major impact on concepts of therapy. The development of new and purer insulins and new delivery systems have also improved diabetic control. The major concept that has evolved in recent years has been that the vascular disease and neuropathy of diabetes are related to control of the blood glucose and, therefore, it is important to deliver insulin in a physiologic way that duplicates the pattern of control found in nature. Techniques to better accomplish this goal are now evolving.
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PMID:Self-monitoring of blood glucose: an important adjunct to diabetes therapy. 351 58

The retinae of 137 patients were examined ophthalmologically and for visual acuity at diagnosis of non-insulin dependent diabetes and again in 1982 and 1983, approximately 7 and 8 years later, when colour photographs were also taken. In 1983, 46% were without detectable retinopathy, 32% had haemorrhages (including microaneurysms) only, 4% exudates alone and 18% both lesions. Those with haemorrhages were more hyperglycaemic than those without retinopathy and those with exudates only. Indeed, those with exudates alone had lower mean glucose levels than those without retinopathy (p less than 0.05). Patients with exudates (+/- haemorrhages) had a lower percentage of the fatty acids of plasma cholesterol esters as linoleate than those without (p less than 0.05) but this did not hold for those developing haemorrhages. Different risk factors appear to operate in different features of diabetic retinopathy. In some respects exudate formation may be more akin to macro than to micro angiopathy.
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PMID:Diabetic retinopathy: different risk factors for exudates and haemorrhages. 372 7

Fasting plasma zinc levels were determined in 45 IDDM and in 40 NIDDM patients. Mean values were similar in both groups, but diabetic men showed a significantly higher plasma zinc (p less than 0.05) than diabetic women. In patients with diabetic nephropathy a lower zinc level was associated with decreased plasma albumin as compared to patients without complications (p less than 0.001). Neuropathy and macro-angiopathy were also associated with lower zincemia (p less than 0.05) but in the presence of normal albumin levels. In IDDM without nephropathy a significant positive correlation was found between plasma zinc and plasma glucose, albumin, branched chain amino acids and glutamine, while in NIDDM without nephropathy a significant positive correlation exists between plasma zinc and the amino acids glutamine, valine, histidine and lysine.
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PMID:Plasma zinc levels in diabetes mellitus: relation to plasma albumin and amino acids. 375 14


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