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

Recent prospective, epidemiological research has demonstrated the power of an increased waist/hip circumference ratio (WHR) to predict both cardiovascular disease (CVD) and non-insulin dependent diabetes mellitus (NIDDM) in men and women. Obesity, defined as an increased total body fat mass, seems to interact synergistically in the development of NIDDM, but not of CVD. Increased WHR with obesity (abdominal obesity) seems to be associated with a cluster of metabolic risk factors, as well as hypertension. This metabolic syndrome is closely linked to visceral fat mass. Increased WHR without obesity may instead be associated with lift style factors such as smoking, alcohol intake, physical inactivity, coagulation abnormalities, psychosocial, psychological and psychiatric factors. Direct observations show, and the risk factor associations further strengthen the assumption, that abdominal (visceral) obesity is more closely associated to NIDDM than CVD, while an increased WHR without obesity may be more closely linked to CVD than NIDDM. It remains to be established to what extent, if any, an increased WHR in lean men, and particularly in lean women, indicates fat distribution. Other components of the WHR measurement might be of more importance in this connection.
 ...
PMID:Abdominal fat distribution and disease: an overview of epidemiological data. 157 56

Several studies have demonstrated an association between variation in the apolipoprotein (apo) B gene, principally as detected by the XbaI and EcoRI restriction fragment length polymorphisms (RFLPs), and lipoprotein levels or cardiovascular disease. We have examined the frequency of the EcoRI and XbaI RFLPs of the apoB gene in 95 white Type 2 diabetic patients aged between 45 and 80 years in order to ascertain whether variation in this gene may be influencing the development of Type 2 diabetes and associated atherosclerosis through obesity. Neither of the two RFLPs had a significant association with clinically defined cardiovascular disease or with body mass index in our sample. However, while XbaI displayed no association with circulating levels of lipids, lipoproteins or apolipoproteins, the presence of the rare (R2) alele of EcoRI (absence of cutting site) was associated with significantly higher levels of circulating triglycerides. Furthermore, the EcoRI R2 allele was over-represented in the diabetic sample when compared to a healthy control group. Our findings support previous studies which have shown an effect of variation at the apoB gene on circulating lipid levels; additionally, variation in this gene may contribute to the development of Type 2 diabetes mellitus.
 ...
PMID:Variation in the apolipoprotein B gene and development of type 2 diabetes mellitus. 168 48

The efficacy and safety of gliclazide (Diamicron) were studied in 29 NIDDM patients (19 men and 10 women aged 25-68 years) who failed to improve with diet or with diet plus a sulfonylurea. All patients were overweight and had fasting blood glucose levels consistently above 150 mg/dl (8.24 mmol/l). After withdrawal of oral hypoglycemics where applicable, they received 40 mg Diamicron three times daily with meals. The dose was increased by 40-80 mg/day until optimum control was obtained or up to a maximum of 320 mg/day. Treatment lasted for 12 months. At the end of this period the mean fasting blood glucose level had fallen by 35% from 238 to 154 mg/dl and the mean 2-h postprandial blood glucose level had fallen by 28% from 237.7 to 195 mg/dl. The mean glycosylated hemoglobin level also fell by 30% from 10.10 to 7.02%, i.e. within the normal range. In addition, there was a 19% fall in triglyceride and a 10% fall in cholesterol levels, with no change in body weight. No changes were observed for serum insulin, C-peptide and glucagon levels, thyroid function tests, blood counts, liver and kidney function tests, uric acid, electrolytes, blood pressure or heart rate. No clinical or ECG abnormalities were observed in patients with or without cardiovascular disease. There were two presumptive hypoglycemic reactions, but these did not require treatment. Adverse effects were reported by 22 patients, including dizziness and light-headedness, diarrhea, nausea, palpitations and pruritus, but none required modification of Diamicron therapy. The results therefore show that Diamicron is safe, effective and well tolerated in suitably selected NIDDM patients.
 ...
PMID:Evaluation of the efficacy and safety of Diamicron in non-insulin-dependent diabetic patients. 179 70

The well known association between non-insulin dependent diabetes mellitus (NIDDM) and hyperlipoproteinemia (HLP) is one of the leading causes of high incidence and mortality for cardiovascular disease of diabetic patients. For auspicious and effective treatment of NIDDM and its complications, secondary prevention, that is, an early detection, plays a major role. At the same time high concern should be given to the benefits of early detection and treatment of atherogenic HLP at early stages of diabetes mellitus, for their occurrence in borderline impairment of glucose tolerance (G-OGT) is still evasive. The investigation on the occurrence and incidence of HLP in G-OGT was carried out in 576 adults (310 men and 266 women) with recently detected G-OGT. The results were compared with those obtained in the non-G-OGT group (50 men and 52 women). Values of total LDL cholesterol as well as triglycerides in the blood of the subjects of either sex highly exceeded recommended values and were higher than in the controls. HDL cholesterol was significantly decreased while the values of the LDL cholesterol/HDL cholesterol ratio and total triglycerides were significantly higher. Atherogenic hyperlipoproteinemia was evidenced in 52.58% of men and 50.75% of women with G-OGT and in 36.00% of men and 32.69% of women with normal G-OGT. After a one-year dietetic regimen all the lipid parameters evidently improved in both men and women, while the incidence of atherogenic hyperlipoproteinemia fell to 40.82% of the men and 31.32% of the women.
 ...
PMID:[The lipoprotein status in persons with borderline glucose tolerance impairment before and after a reducing diet]. 182 43

In this review, the relationship between hypertension and abnormal carbohydrate metabolism is explored. A review of the current literature reveals that people with hypertension are also likely to suffer from insulin resistance, glucose intolerance, and hyperinsulinemia. Likewise, hypertension is prevalent in obese and diabetic patients. Deficiency of insulin at the cellular level may be a common mechanism in the development of hypertension in patients with type I or type II diabetes mellitus. Essential hypertension appears to be an insulin-resistant state. Insulin resistance may engender hypertension by increasing peripheral vascular resistance as well as by increasing salt retention at the level of the kidney. Therefore effective antihypertensive therapy should include agents that do not adversely affect carbohydrate metabolic abnormalities. Commonly used antihypertensive agents, such as thiazide, thiazide-like diuretics, and beta-blockers, are associated with glucose intolerance and increased insulin resistance. In contrast, angiotensin-converting enzyme inhibitors, calcium antagonists, and peripheral alpha-blockers (such as prazosin and terazosin) do not adversely affect glucose tolerance or insulin sensitivity. In addition, alpha-blockers have a positive effect on the serum lipid profile. The entire multifactorial cardiac risk profile must be considered when choosing therapeutic agents for conditions that have an impact on cardiovascular disease.
 ...
PMID:Is hypertension an insulin-resistant state? Metabolic changes associated with hypertension and antihypertensive therapy. 187 73

An unfavorable body fat distribution is associated with many metabolic abnormalities including a high prevalence and incidence of noninsulin dependent diabetes mellitus and decreased high density lipoprotein cholesterol and increased triglyceride levels. One mechanism for the effect of body fat distribution on metabolic variables may be through sex hormones. We examined the relationship of body mass index (BMI), ratio of subscapular-to-triceps skinfold ratio (centrality index) and ratio of waist-to-hip ratio (WHR) to sex hormone binding globulin (SHBG) (an in vivo measure of androgenicity) in 101 postmenopausal Mexican-American and non-Hispanic white women from the San Antonio Heart Study, a population based study of diabetes and cardiovascular disease. SHBG was significantly correlated with BMI (r = -0.440, P less than 0.001), WHR (r = -0.255, P less than 0.01) and centrality index (r = -0.210, P less than 0.05). In a multiple linear regression analysis, SHBG remained significantly associated with BMI (P less than 0.001) and WHR (P less than 0.05) but not with age, ethnicity or centrality index. This work suggests that in postmenopausal women overall adiposity and an unfavorable body fat distribution are associated with increased androgenicity as measured by a lower SHBG concentration. Our finding may help to explain the association of body fat distribution with diabetes and cardiovascular risk factors in older women.
 ...
PMID:Increased upper body and overall adiposity is associated with decreased sex hormone binding globulin in postmenopausal women. 189 24

1. Aborigines from all over Australia develop unusually high prevalence rates for obesity, non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease when they make the transition from their traditional hunter-gatherer lifestyle to a Westernized lifestyle. 2. There is no evidence that they experienced these diseases as hunter-gatherers. Data from the few extant traditionally orientated groups in very remote areas of northern Australia indicate that they were very lean (BMI less than 20 kg/m2), with low blood pressure, and that neither blood pressure nor BMI rose with age. 3. In addition, fasting glucose and cholesterol levels were low (usually below 4 mmol/L). However, in view of their extreme leanness and regular physical activity, fasting insulin and triglyceride levels were inappropriately elevated, suggestive of insulin resistance. 4. When Westernized diabetic Aborigines reverted temporarily to a traditional hunter-gatherer diet and lifestyle, all of the metabolic abnormalities of diabetes were greatly ameliorated (fasting glucose and triglyceride levels fell markedly and glucose tolerance and insulin secretion improved). In addition, they lost weight and there was a reduction in the major risk factors for cardiovascular disease (reduction in hypertriglyceridaemia and blood pressure, increase in bleeding time). 5. The hunter-gatherer lifestyle was associated with increased physical activity and a low-fat, high-fibre diet of low-energy density and high-nutrient density derived from very lean wild meat, and uncultivated vegetable foods. It has important therapeutic implications for the treatment and prevention of many of the chronic degenerative diseases of affluent Western societies.
 ...
PMID:Cardiovascular disease risk factors in Australian aborigines. 202 81

Prospective studies have shown that increased urinary albumin excretion is a risk factor for cardiovascular morbidity and mortality in patients with Type 2 diabetes mellitus, but the nature of the association remains unknown. Eighty-five patients aged less than 65 years and not treated with insulin were studied. The overnight albumin excretion rate (AER) was measured in each patient and analysed in relation to several putative risk factors for cardiovascular disease. AER was used both as a continuous variable and after dividing patients into high-risk (AER greater than or equal to 10 micrograms min-1) and low-risk (AER less than 10 micrograms min-1) groups. By both methods of analysis AER was significantly correlated with both seated and supine diastolic blood pressure levels and with resting heart rate. Body mass index and waist-hip ratio appeared higher and HDL-cholesterol lower in the at-risk group, but differences were not statistically significant. The level of Factor VII was not significantly lower in the at-risk group. Little of the cardiovascular risk associated with raised AER can be attributed to associations with conventional risk factors.
 ...
PMID:Microalbuminuria and cardiovascular risk factors in type 2 diabetes mellitus. 213 50

Several epidemiological studies have reported that the regional distribution of body fat is a significant and independent risk factor for cardiovascular disease (CVD) and related mortality. Although these associations are well established, the causal mechanisms are not fully understood. Numerous studies have, however, shown that specific topographic features of adipose tissue are associated with metabolic complications that are considered as risk factors for CVD such as insulin resistance, hyperinsulinemia, glucose intolerance and type II diabetes mellitus, hypertension, and changes in the concentration of plasma lipids and lipoproteins. The present article summarizes the evidence on the metabolic correlates of body fat distribution. Potential mechanisms for the association between body fat distribution, metabolic complications, and CVD are reviewed, with an emphasis on plasma lipoprotein levels and plasma lipid transport. From the evidence available, it seems likely that subjects with visceral obesity represent the subgroup of obese individuals with the highest risk for CVD. Although body fat distribution is now considered as a more significant risk factor for CVD and related death rate than obesity per se, further research is clearly needed to identify the determinants of body fat distribution and the causal mechanisms involved in the metabolic alterations. It appears certain, however, that an altered plasma lipid transport is a significant component of the relation between body fat distribution and CVD.
 ...
PMID:Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. 219 40

Non-insulin-dependent diabetes mellitus (NIDDM) is being increasingly diagnosed as its importance as a risk factor for the development of cardiovascular disease continues to be recognised. Good metabolic control remains a major goal of drug therapy as it decreases the severity and incidence of diabetic complications. Many drugs have been known to interfere with glucose control, either in a beneficial or, more commonly, in a deleterious fashion. Unfortunately in many instances drug-induced effects have not been looked at specifically in NIDDM. Thiazide diuretics have been shown to cause a deterioration in glucose control not only in the general population but especially in patients who have impaired glucose tolerance. While the effect appears less with potassium supplementation and the lower dosage employed nowadays, thiazide diuretics are best avoided in diabetic patients. Loop diuretics have been reported to reduce glucose control to a lesser extent than thiazides. Although indapamide would appear not to interfere with blood sugar control in NIDDM, higher doses that cause potassium loss may cause a deterioration. beta-Adrenoceptor antagonists have been reported to cause a rise in blood sugar and glycosylated haemoglobin in NIDDM. The effect may be more marked in patients on oral hypoglycaemic agents as opposed to diet alone and in those on concomitant thiazide diuretics. The greatest effect was seen with propranolol, and the least with cardioselective and the less lipophilic beta-blockers. It is of interest that alpha-blockade with prazosin seems to antagonise beta-adrenoceptor blocker-induced deterioration in glucose control. The calcium antagonists have differing effects which may be structure related. In some, but not all, studies use of the dihydropyridines such as nifedipine has been associated with a deterioration in glucose control in NIDDM. Long term studies are needed to assess definitively their effect on glucose control. Verapamil, on the other hand, has in 1 small study been found to have a beneficial effect on glucose control in NIDDM. Centrally acting alpha-agonists such as the antihypertensive drug clonidine have not been shown to result in a deterioration in glucose control when used in NIDDM, although there are isolated case reports. Long term therapy with the more specific agonist guanfacine was reported in 1 uncontrolled study to have a beneficial effect on glucose tolerance in NIDDM. Uncontrolled studies suggest that phenothiazines may aggravate diabetic control. The significance of a number of recent observations is not fully clear.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Effects of drugs on glucose tolerance in non-insulin-dependent diabetics (Part I). 220 83


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>