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

Atherosclerosis, presenting as macrovascular complications of diabetes mellitus, produces approximately 80% of all diabetic mortality, whether the patient has Type I insulin-dependent diabetes (IDDM) or Type II non-insulin dependent diabetes mellitus (NIDDM). Specifically, 75% of this atherosclerotic macrovascular mortality flows as the outcome of coronary atherosclerosis, which is increased approximately two-fold in men and four-fold in women with diabetes as compared with otherwise matched populations with entirely normal carbohydrate tolerance. The remaining 25% of this atherosclerotic mortality in patients with diabetes mellitus is the result either of accelerated cerebrovascular or of peripheral vascular complications of diabetes, both of which are increased four-fold and five-fold, respectively, in patients with diabetes mellitus, regardless of type. Furthermore, atherosclerosis is the principal cause of hospitalizations for patients with diabetes mellitus. Admissions for this complication account for approximately 77% of total hospitalizations for diabetes owing to complications. Aside from mortality data alone, atherosclerosis is obviously a leading cause of diabetic disability, since it produces patients who are chronic cardiovascular, peripheral or cerebrovascular cripples, perhaps for many years before their ultimate demise. Small blood vessel or microvascular complications of diabetes mellitus, while formerly thought to be the end-stage in the unfolding of the diabetic process, do not appear to have the potential for mortality as do the atherosclerotic large blood vessel complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Clin Cardiol 1992 Oct
PMID:Effective treatment of hypertension in patients with diabetes mellitus. 135 76

In order to assess a possible relationship between left ventricular (LV) function and cardiac autonomic involvement in type-1 insulin dependent diabetes, we performed M-mode echocardiograms and autonomic function tests in 21 patients (mean age +/- SD, 38 +/- 11 years, range 18-55, 16 male and 5 female). In 7 patients and in 21 age-matched controls the echocardiogram was also recorded before and during handgrip. At rest, ventricular function abnormalities were found only in 4 subjects, and no significant correlation was found between echocardiographic parameters and autonomic function tests. Unlike controls, during handgrip diabetic subjects failed to increase peak Vcf and peak filling rate, and increased their left ventricular end-systolic diameter. The changes in LV parameters during handgrip were significantly correlated with resting autonomic function tests (p less than 0.025). Our results suggest that resting cardiac function may be normal in diabetics despite high incidence of abnormal autonomic tests. Latent abnormalities of left ventricular function can be unmasked by acute haemodynamic challenges such as handgrip, and are correlated with abnormalities in autonomic function tests.
Acta Cardiol 1992
PMID:Noninvasive assessment of the relationship between cardiac and autonomic function in diabetes. 163 31

Nephron loss is a common progression of a diverse range of kidney diseases. Recent experimental models of chronic renal disease have suggested that hemodynamic and nonhemodynamic mechanisms play key roles in progressive renal injury. Extensive renal ablation in the rat was followed by development of altered glomerular hemodynamics. Albuminuria and histologic damage leading to focal glomerulosclerosis were preceded by the development of increased glomerular pressures and were prevented by interventions such as severe dietary protein restriction and angiotensin-converting enzyme (ACE) inhibitor therapy. Both experimental interventions ameliorated glomerular hypertension. It was therefore concluded that these interventions ameliorated injury by glomerular hemodynamic effect. Similar findings were obtained in a rat model of type I diabetes mellitus induced by streptozotocin in which glomerular hemodynamic factors appeared important to the development of progressive renal disease. Recent studies have suggested that nonhemodynamic factors have important roles in the progression of glomerular injury. For example, although the predominant effects of ACE inhibitor therapy appear to be hemodynamically mediated, data are emerging which suggest that these agents may also influence growth/proliferation of glomerular cells. Because hyperplasia/hypertrophy may influence glomerular susceptibility to injury, this may also be a potential mechanism whereby ACE inhibitor therapy influences glomerular damage. In addition, a variety of studies have suggested that hyperlipidemia, which is frequent accompaniment of glomerular disease, is an important modulator of glomerular injury independent of glomerular hemodynamic effects. Coagulation factors, calcium phosphorus balance, as well as the genetic susceptibility of the glomerulus to injury, all appear to contribute to progressive nephron destruction.
Am J Cardiol 1990 May 22
PMID:Renal protective effects of angiotensin-converting enzyme inhibition. 218 11

Insulin-dependent diabetes mellitus (IDDM) results from an inflammatory process leading to destruction of the insulin-producing beta cells of the pancreas. Genetically mediated autoimmune processes are considered the most likely explanation for IDDM in humans, while viral infections, toxic agents, nutritional alterations and stress are also considered possibilities. The precise mechanisms by which autoimmunity, infections, toxins or other agents produce beta cell damage are not known. Toxin-induced diabetes in animals can be prevented by antioxidant therapy, while an agent that inhibits hydroxyl radical formation, desferrioxamine, extends the survival time of free allotypic islets in nonobese diabetic mice. The BB/W rat develops IDDM secondary to a pervasive autoimmune defect. This well-studied animal model develops IDDM with a highly predictable frequency and timing. This study describes the effects of the potent antioxidant, probucol, on the development of diabetes in BB rats by introducing it into standard rat chow at a 1% concentration at the time of weaning, and continuing this feeding schedule through 160 days of life. Control rats from split litters received standard chow only. Diabetes developed in 86.2% of the control rats at a mean age of 90.4 days. Probucol administration was associated with a reduction to 62% and a delay in diabetes diagnosis to 99.6 days. These very preliminary results suggest that probucol may be altering the inflammatory process, resulting in beta cell destruction in these genetically diabetes-prone rats.
Am J Cardiol 1988 Jul 25
PMID:Effect of probucol on development of diabetes mellitus in BB rats. 339 50

Noninvasive studies in patients with type 1 diabetes mellitus suggest subclinical left ventricular (LV) impairment, but the studies differ with regard to methods, patient selection and results. Thus, digitized M-mode echocardiograms were recorded in 24 persons younger than 50 years with long-term (more than 12 years) type 1 diabetes but without overt heart disease and in 28 control subjects. To improve accuracy, measurements were adjusted for body surface area, LV size and the influence of heart rate, as appropriate. Diabetics had a higher heart rate and systolic and diastolic blood pressure than control subjects. LV end-diastolic and stroke dimensions were smaller, duration of systole longer and preejection period/LV ejection time ratio higher than in control subjects, whereas fractional shortening and peak shortening rate were similar. In diabetics, diastole was shorter, peak filling rate was lower and the rapid filling period was prolonged, while percent filling during the rapid filling period and atrial contribution to filling were higher. Thus, in a well defined study population of relatively young persons with long-term type 1 diabetes, subclinical LV systolic and diastolic dysfunction were found. The diastolic abnormalities suggest reduced LV compliance, while those in systole may be secondary to an increased afterload or decreased myocardial contractility.
Am J Cardiol 1987 Jul 01
PMID:Subclinical left ventricular abnormalities in young subjects with long-term type 1 diabetes mellitus detected by digitized M-mode echocardiography. 360 27

Using digitized M-mode ecocardiography, 26 young subjects with type I diabetes mellitus of at least three years duration, without any clinical evidence of heart disease have been studied, searching for subclinical impairment of left ventricular function. Patients have been divided in two groups according to the presence (Group I, N degrees 7 patients) or absence (Group II, N degrees 19 patients) of retinopathy. The time interval from the shortest left ventricular diameter to the onset of mitral valve opening was significantly increased as compared with the control Group (10.20 +/- 8.88 control Group; 29.21 +/- 12.99 Group II, p less than 0.001; 41.00 +/- 12.29 Group I, p less than 0.001). Furthermore, a close correlation between the above named time interval and the duration of diabetes was found (r = 0.496, p less than 0.01). Finally, the change of left ventricular dimension during the time interval from the shortest left ventricular diameter to the onset of mitral valve opening, expressed as a percentage of left ventricular end-diastolic diameter, was increased (3.20 +/- 3.43 control Group; 8.21 +/- 5.51 Group II, p less than 0.02; 12.43 +/- 5.56 Group I, p less than 0.001). Our results suggest an impairment of ventricular relaxation due to increased wall stiffness. We conclude that there are often subclinical cardiac abnormalities in young diabetics resulting in impairment of diastolic function that is correlate with the duration of diabetes and with the presence of clinical complications such as retinopathy.
G Ital Cardiol 1984 Nov
PMID:[Altered diastolic function of the left ventricle in juvenile diabetes. Computerized echocardiographic study]. 652 99

The transtelephonic electrocardiographic system started in the 70's and it was used mainly in the study of heart disease, cardiac arrhythmias, syncope and sudden death. This report, include 3434 electrocardiogram (ECG) of patients whom visit the emergency room at the General Hospital and private clinic, using three different forms of transtelephonic monitors. The total population were 1715 males and 1719 females with average age of 52.2 +/- 28.8 years. 26.9% had was present in history of systemic hypertension, non-insulin dependent diabetes 12.3% and myocardial ischemic disease in 5.3%. The main ECG indications were chest pain 38.7%, most of them atypical angina, palpitations in 6.9% and dyspnea in 6.5%. 50.1% of the ECG were abnormal. The most important diagnosis were: tachyarrhythmias (25.2%), intraventricular conduction abnormalities (17.7%), myocardial ischemic disease (16%), and premature ventricular and supraventricular beats (11.6%). We concluded that the transtelephonic electrocardiographic system is a very useful method, and available now in Mexico. We detected a high percentage of electrocardiographic abnormalities, it was possible to give the right diagnosis of arrhythmias, acute myocardial infarction, old infarction, and to evaluate the pacemaker functionality. Finally, it helped to get in brief time the diagnosis and treatment in cases of acute myocardial infarction or severe arrhythmias.
Arch Inst Cardiol Mex
PMID:[Transtelephonic electrocardiography in Mexico. A report of the first 3434 cases]. 757 20

A case-control study was carried out in a tertiary referral teaching hospital to evaluate left ventricular contractility in children and adolescents with type 1 diabetes and to study factors influencing left ventricular contractility. Thirty-four children and young adults with type 1 diabetes (age 10.8-21.8 years) were randomly selected from approximately 400 patients of the same age range in the outpatient department and compared with 16 non-diabetic controls (age 7.3-21.2 years). The relation of end-systolic wall stress to velocity of circumferential fiber shortening as a standard deviation score (SDS) from the normal range described by Colan et al. was used to assess left ventricular contractility. In the diabetic group the effect of age, duration of diabetes, metabolic control, insulin dose, and autonomic function on left ventricular contractility were studied. It was found that the end-systolic wall stress-velocity of circumferential fiber shortening relation was not different between diabetic subjects and controls [+0.52 (SEM 0.21) vs +0.90 (SEM 0.26) SDS, p = 0.3]. In the diabetic subjects, the end-systolic wall stress-velocity of circumferential fiber shortening relation was positively correlated with glycated hemoglobin (r = 0.37, p = 0.03) and insulin dose per kilogram of body weight (r = 0.36, p = 0.04). Those two variables together explained 24% of the variability in the end-systolic wall stress-velocity of circumferential fiber shortening relation. Twenty-eight of the diabetic subjects were also assessed for cardiac autonomic function. Disturbances of cardiac autonomic function were not associated with increased contractility.(ABSTRACT TRUNCATED AT 250 WORDS)
Pediatr Cardiol
PMID:Echocardiographic load-independent indices of contractility in children and adolescents with type I diabetes: effect of metabolic control and insulin on left ventricular performance. 775 93

In cross-sectional studies of asymptomatic diabetic patients, multiple abnormalities in left ventricular (LV) function have been found. Long-term significance of these abnormalities is unknown because follow-up studies have not been previously performed. LV ejection fraction (EF) by radionuclide angiocardiography was examined in middle-aged control subjects (n = 44), in patients with insulin-dependent (IDDM) (n = 32) and non-insulin-dependent (NIDDM) (n = 32) diabetes mellitus at baseline and after 4-year follow-up. At baseline, all study subjects were free from cardiovascular disease. LVEF at rest did not differ between the groups at baseline. The decrease in LVEF at rest during follow-up was 1.1 +/- 1.1% (mean +/- SEM) in control subjects, 3.1 +/- 1.3% (p = NS, compared with control subjects) in patients with IDDM, and 7.2 +/- 1.4% (p < 0.01) in patients with NIDDM. At follow-up examination, abnormally low LVEF at rest (< 50%) was found in 7% of control subjects, 13% of patients with IDDM (p = NS), and in 31% of patients with NIDDM (p < 0.05). Compared with control subjects, the prevalence of an abnormal LVEF response to exercise (an increase by < 5%, or a decrease) was higher in diabetic groups at both examinations. This prevalence increased in control subjects from 10% at baseline to 26% at follow-up examination.(ABSTRACT TRUNCATED AT 250 WORDS)
Am J Cardiol 1994 Jun 15
PMID:Left ventricular systolic function in middle-aged patients with diabetes mellitus. 820 39

To determine whether QT interval is influenced by genetic factors and whether QT-interval prolongation occurs in type 1 diabetes or is related to diabetic autonomic neuropathy, QT intervals were measured, and autonomic function was assessed in 44 pairs of identical twins who were discordant for type 1 diabetes. Twins were compared with 44 normal control subjects of similar age and sex. QT intervals were corrected for heart rate (QTc). QTc in diabetic twins correlated with that in their nondiabetic co-twins (r = 0.41; p = 0.006). Diabetic twins had significantly longer QTc than did their nondiabetic co-twins and control subjects (416 +/- 18 vs 407 +/- 16 and 403 +/- 19 ms, respectively; p < 0.005). A greater number of abnormal autonomic function tests were detected in diabetic twins than in their nondiabetic co-twins and control subjects (8 vs 2 and 0%, respectively; p < 0.01). Diabetic twins with disease duration > 14 years (n = 22) had longer QTc than did their nondiabetic co-twins (420 +/- 17 vs 402 +/- 14 ms; p < 0.0005). Twins with diabetes for > 14 years had a greater frequency of abnormal autonomic function tests than did those with diabetes < 14 years (15 vs 2%; p < 0.001). QTc did not correlate with autonomic function in diabetic twins. It is concluded that QT interval is influenced by genetic factors, and in type 1 diabetes, QTc can be prolonged independently of autonomic neuropathy.
Am J Cardiol 1993 Aug 01
PMID:Information on type 1 diabetes mellitus and QT interval from identical twins. 834 9


1 2 3 4 5 6 7 8 Next >>