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)

The effect of a 4-month exercise program on measures of cardiovascular disease (CHD) risk was observed in women (mean age = 59.2 +/- 3.9 years) of postmenopausal years with NIDDM, who demonstrated fair to normal control of blood glucose control. The women were randomly assigned to either an exercise (n = 5) or control (n = 5) group. Initially, both groups had a similar body mass index, resting heart rate and blood pressures, blood glucose and hemoglobin A1. After 4 months, the exercise group demonstrated a 32% increase (P less than 0.03) in both absolute and relative maximum oxygen uptake (VO2) while the control group remained unchanged. Significant differences were found between the exercisers and non-exercisers for absolute (F(1,8) 4.94, P = 0.057) and relative (F(1,8) 7.67, P = 0.024) maximum VO2 from pretest to posttest. Body weight (kg) and body fat (%) remained unchanged for both groups. Although total cholesterol was found to be reduced by 13% for the exercise group (P less than 0.03) and 11% for the controls (P less than 0.01), a 15% decrease (P less than 0.03) in high-density lipoprotein (HDL) was observed for the control group, only. Hence, a marked difference (P less than 0.03) in the risk ratio was observed between the exercise and control groups. These data suggest that physical exercise may play an important role in the maintenance of HDL mass and in the reduction of CHD risk factors in women of postmenopausal years with NIDDM.
 ...
PMID:Effects of exercise on cardiovascular disease risk in women with NIDDM. 264 39

NIDDM is the predominant form of diabetes mellitus in all populations, almost exclusively so in some. Its prevalence varies enormously, with particularly high rates in populations whose lifestyle has drastically changed since World War II. Epidemiologic data from the developed countries of Europe and North America are not adequate to determine whether their incidence rates have also increased. Genetic factors are clearly implicated in the etiology of NIDDM, but their location and mode of expression remain to be determined. The two variables most strongly related to the incidence of NIDDM are age and degree of obesity, although there is emerging evidence of an independent association with fat distribution. Whether the nature of the habitual diet and the degree of physical activity influence the incidence of NIDDM remains uncertain and should be further researched. Cardiovascular disease is strongly associated with NIDDM in most populations, but there are between-population differences in the degree of association and the relative excess in the two sexes. There is increasing evidence, in particular for coronary heart disease, that increased risk precedes the onset of hyperglycemia; the implication of this is that NIDDM and atherosclerosis share common antecedents. The specific complications of NIDDM--eye and renal disease--are important causes of morbidity and mortality and for those populations, often relatively poor, in which NIDDM is already or is becoming very common will pose substantial problems in provision of health care.
 ...
PMID:Epidemiology and public health aspects of non-insulin-dependent diabetes mellitus. 268 May 53

Reports of renal replacement therapy in diabetes usually refer to patients with insulin-dependent diabetes mellitus (IDDM) only, and little is known about renal failure in non-insulin-dependent diabetics (NIDDM). A high proportion, 46/141 (32%), of the diabetics treated at our unit since 1974 had NIDDM. They were older at treatment (56 +/- 9 years, mean +/- SD) compared to the IDDM patients (39 +/- 10 years, p less than 0.001), and had a shorter duration of diabetes (13 +/- 8 years versus 23 +/- 8 years, p less than 0.001). Asians and Afro-Caribbeans accounted for 48% of the NIDDM patients (22/46) compared to only 7% of those having IDDM (6/95, p less than 0.0001). Non-diabetic renal disease accounted for the renal failure in 32% (15/46) of the NIDDM patients but only in 10.5% (10/95) of the IDDMs (p less than 0.001). Despite these differences the prevalence of other diabetic complications (retinopathy, neuropathy, and cardiovascular disease) was similar. Patient survival after transplantation was poorer in NIDDM than IDDM (23% and 57%, respectively, at 2 years). Survival on dialysis was equally poor in NIDDM and IDDM. Thus, NIDDM patients treated for renal failure are more commonly non-European and more often have non-diabetic renal disease. Yet other diabetic complications occur to the same extent in both IDDM and NIDDM patients with diabetic nephropathy.
 ...
PMID:Non-insulin-dependent diabetes and renal replacement therapy. 296 85

In type 2 diabetes with "secondary failure of sulfonylurea therapy" good metabolic control can seldom be achieved by insulin therapy even with high insulin doses. Hyperinsulinemia however is a possible risk factor of cardiovascular disease in type 2 diabetes. Maintaining the effects of sulfonylurea action insulin should be added in as small amounts as possible to avoid hyperinsulinemia and to ameliorate hyperglycemia. 16 type 2 diabetics with "secondary failure" were treated either with insulin alone (group A; n = 8) or with 3.5 mg b.i.d. glibenclamide plus small amounts of intermediate insulin (group B; n = 8) in a randomised order. After the inpatient period outpatient control was performed monthly up to six months, later on four times a year up to two years. Both groups were comparable with regard to age, duration of diabetes, body weight and metabolic control. The daily insulin dose was 14 +/- 2 IU (means +/- SEM) after one month and 19 +/- 2 IU after two years in group B. In contrast 30 +/- 3 IU and 43 +/- 5 IU respectively were needed in group A (p less than 0.001). All patients B were treated with one daily injection, all patients A needed two injections. Resulting in nearly identical metabolic control in group A basal insulin levels exceeded those in group B after two years significantly (28.6 +/- 3.7 vs. 18.6 +/- 1.6 mcU/ml; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Combination therapy with insulin/sulfonylurea in the long-term therapy of type II diabetes following "secondary failure"]. 314 87

Non-insulin-dependent diabetes (NIDDM) is a major cause of premature morbidity and mortality among adults. Macrovascular disease of coronary and peripheral vessels is the primary cause of death in these patients. Numerous experimental and epidemiologic studies have suggested that hyperinsulinemia accelerates the development of atherosclerosis. In experimental models, insulin promotes diet-induced lesion development and overrides lesion regression and estrogen protection against atherosclerosis. Local hyperinsulinemia induced by selected arterial infusion accelerates atherosclerosis in the perfused artery. Insulin has been shown to stimulate subintimal smooth muscle and fibroblast cells in culture, and to increase the uptake and local synthesis of lipid by these cells. Insulin may also induce inhibition of fibrinolysis. Several prospective studies performed on nondiabetic patients show that either fasting or postprandial insulin levels are a sensitive predictor of the development of coronary disease independent of other risk factors. Two recent studies in NIDDM patients confirm this finding and suggest that glycemic control may not be a significant factor in the development of macrovascular disease. Diseases of carbohydrate tolerance, ie, NIDDM, impaired glucose tolerance, obesity, are frequently associated with elevated circulating insulin levels, either physiologically or secondary to treatment. Given the high prevalence of cardiovascular disease in these populations, modifying therapy to minimize hyperinsulinemia should be an important consideration in a treatment program. Use of oral agents such as glipizide or gliclazide, which induce less diurnal hyperinsulinemia, may be advantageous when compared to traditional oral agent or insulin therapy.
 ...
PMID:Atherosclerosis in diabetes: the role of hyperinsulinemia. 327 13

We studied the long-term outcome (after four years) in 233 patients with type I and 136 with type II diabetes mellitus treated with long-term dialysis between 1966 and 1982. The seven-year cumulative survival improved from 12% before 1976 to 20% after 1976. Sixty-eight of the patients survived for more than four years, and 25 are still alive. Of deaths, 51% were due to cardiovascular disease, 24% to the discontinuation of dialysis, 14% to infections, and 11% to other causes. Over the course of the study, older and sicker patients were increasingly accepted for dialysis, and younger and healthier patients were increasingly accepted for transplantation. The 25 patients who are still alive and undergoing dialysis were hospitalized 1.4 times per patient year for 19 hospital days per patient year the first year and for eight days per patient year after that. Two became blind, three had amputations, seven worked full-time. The results of long-term dialysis in patients with diabetes have improved greatly over the last two decades.
 ...
PMID:Long-term follow-up of 369 diabetic patients undergoing dialysis. 327 71

Non-insulin-dependent diabetes mellitus (NIDDM) is the most common form of diabetes in the civilized world. Its consequences include microvascular and macrovascular disease, both of which appear to evolve from a common background of obesity and physical inactivity. The current study was undertaken in obese patients with NIDDM to see whether improvements could be made in glycemic control as well as in many cardiovascular risk factors (obesity, hypertension, lipid abnormalities, and physical inactivity) that are typical of this condition. Fifteen obese insulin-using patients with NIDDM (average body mass index, 34.0) were treated with a 500-calorie formula diet for eight to 12 weeks. Administration of insulin and diuretics was discontinued at the onset of the study. A eucaloric diet was begun at eight to 12 weeks and maintained until Week 24. A behaviorally oriented nutrition-exercise program was instituted at the beginning of the study. Glipizide or placebo was added (randomized) at Week 15 if the fasting plasma glucose level in patients exceeded 115 mg/dl. Patients lost an average of 22 pounds over the course of 24 weeks. Frequency and duration of physical activity increased significantly from baseline, as did the maximal oxygen consumption rate. Glycemic control by 15 weeks (without insulin) was similar to baseline (with insulin). With the addition of glipizide at Week 15, both fasting plasma glucose and glucose tolerance improved significantly. This improvement was not observed with placebo. In addition, both systolic and diastolic blood pressure decreased by about 10 mm Hg. There were no significant changes in the levels of serum lipids or glycosylated hemoglobin. In conclusion, a multifaceted intervention program, employing weight reduction, exercise, diet, and glipizide therapy, can be instituted in insulin-using patients with NIDDM, with improvement in glycemic control and in certain risk factors (hypertension, obesity, physical inactivity) for cardiovascular disease.
 ...
PMID:Achieving therapeutic goals in insulin-using diabetic patients with non-insulin-dependent diabetes mellitus. A weight reduction-exercise-oral agent approach. 330 4

Hyperinsulinaemia is of great importance, being a primary risk factor for cardiovascular disease and non-insulin dependent diabetes (NIDDM). Furthermore, unwanted effects of increased exposure of tissues to insulin are known. Hyperinsulinaemia may, in principle, be caused by primary hypersecretion, or be a secondary consequence of diminished effectiveness of insulin in the periphery. Obesity is the commonest condition characterized by insulin resistance, which is seen most frequently when excess adipose tissue is localized to the abdominal region. Insulin resistance in obesity is found in several tissues, however, with liver and muscle being quantitative the most important. Muscle insulin sensitivity is regulated by genetic factors, hormonal effects, and the influence of free fatty acids, as well as the state of physical activity. There is evidence for the action of each of these factors in obesity. The pathogenetic mechanisms linking hyperinsulinaemia with cardiovascular disease and NIDDM are unknown. Comparisons between development of NIDDM in experimental animal models and in humans in prospective studies however, provide useful hypotheses for further studies.
 ...
PMID:Adipose tissue distribution, plasma insulin, and cardiovascular disease. 330 69

The major premise by which weight reduction is used as a medical therapy is the fact that obesity is a primary risk factor in the onset and severity of many medical diseases. Hypertension, coronary artery disease, adult onset diabetes mellitus, complications of major abdominal and thoracic surgery, cancer of the breast and colon, and degenerative joint disease are prevalent diagnoses. The data to support weight reduction use as a medical therapy derive primarily from studies of cardiovascular disease. These studies show lowering of blood pressure and reduction of risk factors for glucose intolerance, angina, and hyperlipidaemia. The magnitude of weight loss (percent reduction in excess body weight) is important; 10 per cent reduction is a firm threshold in obese patients (greater than 130%- less than 200% ideal body weight). Success at achieving this medical therapy is most frequent using very low calorie diets which average 30-40% reduction of excess body weight. Mild and moderate hypertension will respond in 90% of patients. Type II diabetes mellitus patients can become free of exogenous insulin requirement. Response to general anaesthesia and control of respiratory distress syndrome will improve if preoperative weight loss is achieved. Improved cardiovascular fitness and relief of exertional dyspnoea are other clinically important outcomes of very low calorie diet therapy. A high priority exists to investigate the use of comprehensive professional weight control therapy as medical treatment.
 ...
PMID:Benefits of reducing--revisited. 624 29

1. It has become clear over the past 25 years that Aborigines in Western Australia (WA) now experience very high rates of type 2 diabetes mellitus and its complications as well as hypertension and cardiovascular disease; these disorders are often associated with obesity and abnormalities of plasma lipids. 2. This experience is similar to that of Aboriginal people in other parts of Australia and to other previously traditional societies now in transition to an urbanized, Westernized existence; this is widely attributed to lifestyle factors and genetic susceptibility. 3. This so-called 'New World Syndrome' is responsible for disproportionately high levels of morbidity and mortality in the Aboriginal population of WA; prevention and improved methods of screening, detection and management are needed to reduce this problem.
 ...
PMID:New World syndrome in Western Australian aborigines. 755 19


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