Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esophageal motility abnormalities, neuropathy, and psychiatric illness were independently determined in 30 patients with type 1 or type 2 diabetes mellitus to clarify the interrelationship of these findings in diabetics. Fifteen patients (50%) were found to have esophageal contraction abnormalities, a specific cluster of manometric derangements. Diagnoses of depression, dysthymia, or generalized anxiety disorder were made in 87% of those with contraction abnormalities but in only 21% of the patients with normal manometric patterns (p = 0.002). Log-linear analysis confirmed that this association was independent of neuropathy effects (p less than 0.001). Several changes in individual manometric parameters related to neuropathy alone were appreciated only when the patients with psychiatric illness were excluded from the analysis. These data indicate that some of the esophageal neuromuscular dysfunction observed in diabetics is independent of neuropathy yet is strongly associated with psychiatric disorder. Such findings help to clarify the discrepant relationship of motility disturbances to neuropathy noted in prior reports. We conclude that consideration should be given to psychiatric illness as well as to neuropathy when interpreting manometric features suggestive of autonomic dysfunction in diabetic patients.
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PMID:Correlation of esophageal motility abnormalities with neuropsychiatric status in diabetics. 395 33

The purpose of this study was to evaluate the influence of psychiatric symptoms and illness status on the health-related quality of life (HRQOL) of out-patients with Type I and Type II diabetes mellitus. Using a two-stage design, all patients were assessed by two measures of quality of life (Diabetes Quality of Life Measure; Medical Outcome Study Health Survey) and a psychiatric symptoms checklist (SCL-90R). Patients scoring 63 or greater on the global severity index of the SCL-90R and 30% below this cutoff were then evaluated using the Structured Clinical Interview for the DSM-III-R (SCID). Quality of life in both Type I and Type II diabetes was influenced by the level of current psychiatric symptoms and presence of co-morbid psychiatric disorder, after controlling for number of diabetic complications (e.g. effect of lifetime psychiatric illness on diabetes-related HRQOL; F = 46.8; df = 3, 135; p < 0.005). These effects were found consistently across specific domains. Both recent and past psychiatric disorders influenced HRQOL. Separate analyses comparing patients with and without depression showed similar effects. No interaction effects between diabetes type, number of complications, and psychiatric status were found in analyses. Finally, increased severity of psychiatric symptoms was correlated with decreased HRQOL in patients without current, recent, or past psychiatric diagnosis. This study shows the consistent, independent contribution of psychiatric symptoms and illness to the HRQOL of patients with a co-existing medical illness. Thus, psychiatric interventions addressing common conditions, such as depression, could improve the HRQOL of patients without changing medical status.
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PMID:The effects of psychiatric disorders and symptoms on quality of life in patients with type I and type II diabetes mellitus. 906 37

The current study evaluated the association of glycemic control and major depression in 33 type 1 and 39 type 2 diabetes mellitus patients. Type 1 patients with a lifetime history of major depression showed significantly worse glycemic control than patients without a history of psychiatric illness (t = 2.09; df = 31, p < 0.05). Type 2 diabetes patients with a lifetime history of major depression did not have significantly worse control than those with no history of psychiatric illness. Findings from this study indicate different relationships between lifetime major depression and glycemic control for patients with type 1 and type 2 diabetes. Treatment implications for glycemic control in type 1 and type 2 diabetes patients are discussed.
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PMID:Glycemic control and major depression in patients with type 1 and type 2 diabetes mellitus. 1040 77

Optimal patient selection for laparoscopic adjustable gastric banding with the LAP-BAND (INAMED Health, Santa Barbara, CA) enables maximization of results for patients most suited to the procedure and avoidance of unsatisfactory outcomes for inappropriate candidates. We have investigated potential predictors of outcomes in our patients to look for associations with weight loss. We have also reviewed published data for additional predictors. This analysis has revealed a number of conditions associated with a significantly lower percent excess weight loss (%EWL) than experienced in the overall group. These include increasing age, increasing body mass index (BMI), hyperinsulinemia, insulin resistance, type 2 diabetes, and polycystic ovary syndrome. There was also less weight loss if the SF-36 quality-of-life measure showed a poor physical activity score, high pain score, or poor general health score. However, in all these conditions, the effect was small in comparison with the benefits achieved by these patients, and was judged insufficient to preclude this approach to treatment of their obesity. A number of conditions were found to have no relation to weight loss after LAP-BAND placement. These included sex, presence of mental illness, most comorbidities except those linked to insulin resistance, previous bariatric surgery, and sweet-eating behavior. The value of psychologic assessment to predict outcomes could not be established. The superobese (BMI >50) achieved a lower %EWL at 1 year after LAP-BAND placement compared with those with BMI <50, but there were no differences at the 2-, 3-, and 4-year follow-ups.
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PMID:Selecting the optimal patient for LAP-BAND placement. 1252 45

Diabetic and psychiatric symptoms often appear in patients with Wolfram syndrome, and obligate carriers of WFS1 have increased prevalence of type 2 diabetes and are more likely to require hospitalization for psychiatric illness including bipolar disorder. To identify the polymorphisms in Japanese, we examined a region of approximately 50 kb covering the entire WFS1 gene, and evaluated the patterns of linkage disequilibrium. We found a total of 42 variations including 8 novel coding single nucleotide polymorphisms (A6T, A134A, N159N, T170T, E237K, R383C, V412L, and V503G), 14 novel non-coding polymorphisms, and 2 linkage disequilibrium blocks. We also performed association studies in patients with type 2 diabetes mellitus and patients with bipolar disorder. The haplotype comprising R456 and H611 was most associated with type 2 diabetes (p = 0.013) and the haplotype comprising g. -15503C/T and g. 16226G/A was most associated with bipolar disorder (p = 0.006), but neither reached significant difference after multiple adjustment. These genetic variations and linkage disequilibrium patterns in WFS1 in Japanese should be useful in further investigation of genetic diversities of WFS1 and various related disorders.
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PMID:Genetic variations in the WFS1 gene in Japanese with type 2 diabetes and bipolar disorder. 1523 38

Alongside other risk factors for the development of type 2 diabetes, the presence of severe mental illness is often overlooked. A person with schizophrenia has a two to four times greater risk of developing diabetes than the general population and the prevalence of type 2 diabetes is between 15 and 18% in the schizophrenia population. A full understanding of this issue is vital.
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PMID:Understanding schizophrenia and diabetes. 1533 Mar 51

In the United States, the risk of type 2 diabetes is currently growing to epidemic proportions, with many physicians unaware that disorders such as schizophrenia and bipolar disorder naturally place patients at an increased risk for diabetes. Another serious concern for physicians is the development of metabolic syndrome, also known as syndrome X, in patients suffering from schizophrenia. Metabolic syndrome often encompasses medical conditions such as weight gain, hypertriglyceridemia, and increased insulin, glucose, and low-density lipoprotein cholesterol levels. Treatment with atypical antipsychotics may increase the risk of metabolic syndrome and diabetes, and physicians need to be proactive when treating patients with schizophrenia. Physicians should be aware that the treatment of schizophrenia involves the right balance for the patient in terms of adverse effects versus benefit, and failing to treat a patient's mental illness because of potential medical problems may place the patient at an increased risk for more serious problems.
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PMID:Metabolic changes associated with antipsychotic use. 1600 Oct 95

This article reviews the epidemiology of weight gain and diabetes mellitus in general and in patients with severe mental illness in particular. Body mass index is defined, and possible predictors for weight gain in patients receiving antipsychotic medications are also enumerated. Information on risk of association with type 2 diabetes mellitus is described, as well as information on dyslipidemias within the rubric of the metabolic syndrome. Recent consensus panel reports and their recommendations for ongoing patient monitoring are reviewed. The issue of switching antipsychotic medication in the context of a developing metabolic disorder is discussed with regard to appropriately balancing risk and benefits. Collaborative treatment between a psychiatrist and an endocrinologist is encouraged. The primary care physician may be required to fulfill both roles.
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PMID:Metabolic issues in patients with severe mental illness. 1610 40

Type 2 diabetes is an important medical condition associated with serious mental illness. The authors studied the disease-specific knowledge about diabetes in a sample of 201 psychiatric outpatients with a diagnosis of schizophrenia or major mood disorders, all of whom had type 2 diabetes. In a multivariate analysis, disease-specific diabetes knowledge was associated with higher cognitive functioning, a higher level of education, and recent receipt of diabetes education. Disease-specific diabetes knowledge predicted lower levels of perceived barriers to diabetes care. Gaps in diabetes knowledge may be reduced by specialized interventions that take into account the cognitive deficits of persons with serious mental illness.
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PMID:Diabetes knowledge among persons with serious mental illness and type 2 diabetes. 1614 86

Based on findings regarding gender differences in the experience and complications of diabetes, we studied coping strategies in men and women with type 2 diabetes in relation to their demographic, medical, socio-economic and psychosocial situation. Altogether 232 Swedish-born type 2 diabetes patients aged 35-64 years at four primary health care centres in Stockholm County were studied, 121 men and 111 women. Coping strategies were assessed by the General Coping Questionnaire (GCG), which describes five orientations dichotomised into positive and negative opposites: self-trust/fatalism; problem focusing/resignation; cognitive revaluation/protest; social trust/isolation; and minimisation/intrusion. Socio-economic and medical data were taken both from a questionnaire and from medical records. Gender differences for the coping strategies resignation, protest and isolation were found (p<0.05), with higher scores for women. The most important medical factor associated with coping strategies was HbA1c. Other significant factors detected in the multivariate analyses were psychiatric disorder, cohabitation and daily smoking. Thus, coping strategies and gender are important factors that should be addressed more in diabetes health care.
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PMID:Coping strategies in men and women with type 2 diabetes in Swedish primary care. 1624 6


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