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)

High blood pressure, one of the most common chronic diseases in industrialized societies, is a primary risk factor for cardiovascular disease, heart failure, renal disease and stroke. Data from both epidemiologic surveys and clinical trials have shown that calcium metabolism is altered in persons with hypertension, indicating a primary role of calcium in the etiology, prevention, and treatment of hypertension. Investigative efforts throughout the world have identified abnormalities in a number of biochemical parameters of calcium metabolism and a consistently low intake of dietary calcium in persons with high blood pressure. Calcium supplementation trials have reported varying results in terms blood pressure response, and it is generally concluded that many hypertensive patients may benefit from increased calcium intake. The blood pressure-lowering effect of calcium may be of particular benefit to the elderly, people of African origin, and pregnant women. Interactions between dietary nutrients have been shown to be critical in the effect of calcium on blood pressure, particularly sodium and potassium. Finally, based on the body of data that has accumulated in this area, calcium intake is postulated to have clinical application in the treatment of sodium-sensitive, alcohol-associated, and pregnancy-induced hypertension, and type II diabetes mellitus; and adequate, long-term calcium intake may be a means of preventing the development of hypertension.
 ...
PMID:Calcium metabolism in hypertension. 858 22

Hypercoagulability may increase the risk of cardiovascular disease (CVD) in diabetic patients with albuminuria. Plasma thrombin-anti-thrombin III complex (TAT) levels, representing a functional state of clotting system, were studied in one hundred and fifteen non-insulin-dependent diabetic (NIDDM) patients. The patients were divided into three groups according to the urine albumin index (UAI: mg/g Cr): Group A; UAI < 30, Group B; 30 < UAI < 300, Group C; UAI > 300. The effect of albuminuria on plasma TAT levels was significant (p < 0.02). Ethyl icosapentatenoate (EPA: 1800 mg/day) for 4 weeks significantly (p < 0.0005) decreased plasma TAT levels. These data indicate that the degree of diabetic albuminuria is related to plasma TAT levels in NIDDM patients and that treatment with EPA may reduce TAT levels and possibly therefore the rate of development of CVD in patients with NIDDM.
 ...
PMID:Increased plasma thrombin-antithrombin III complex levels in non-insulin dependent diabetic patients with albuminuria are reduced by ethyl icosapentatenoate. 860

There is limited evidence that raised hematocrit levels may be associated with insulin resistance, which links cardiovascular disease with NIDDM. The association between hematocrit level at screening and the subsequent development of physician-diagnosed NIDDM during 12.8 years of follow-up was examined in a prospective study of 7,735 middle-aged men drawn at random from general practice in 24 British towns. With the exclusion of men with missing hematocrit data and men with diabetes at screening, data were available for 7,193 men, in whom there were 187 new cases of NIDDM during follow-up. The risk of NIDDM increased significantly with increasing hematocrit levels. There was more than a fourfold increase in relative risk (RR) of diabetes among men with a hematocrit of > or = 48% relative to those with a hematocrit <42%, adjusted for age and BMI (RR 4.5; 95% CI 2.5-6.3). On further adjustment for predictors of NIDDM with which hematocrit is correlated, there remained a strong linear association with the risk of diabetes. There was a nearly fourfold increased risk of NIDDM in the highest relative to the lowest hematocrit group in the fully adjusted proportional hazard model (RR 3.6; 95% CI 1.7-7.6). The strong positive association between hematocrit level and risk of diabetes was seen even after exclusion of men with preexisting ischemic heart disease. The findings suggest that a raised hematocrit level, which is a major determinant of whole blood viscosity, should be added to the cluster of risk factors that link NIDDM with atheromatous, vascular disease.
 ...
PMID:Hematocrit and risk of NIDDM. 862 Oct 6

Insulin resistance appears to be central to obesity, NIDDM, hyperlipidemia, and cardiovascular disease. While obese women with abdominal (android) fat distribution are more insulin resistant than those with peripheral (gynecoid) obesity, in nonobese women, the relationship between abdominal fat and insulin resistance is unknown. By measuring regional adiposity with dual-energy X-ray absorptiometry and insulin sensitivity by euglycemic-hyperinsulinemic clamp in 22 healthy women, with a mean +/- SE body BMI of 26.7 +/- 0.9 kg/m2 and differing risk factors for NIDDM, we found a strong negative relationship between central abdominal (intra-abdominal plus abdominal subcutaneous) fat and whole-body insulin sensitivity (r = -0.89, P < 0.0001) and nonoxidative glucose disposal (r = -0.77, P < 0.001), independent of total adiposity, family history of NIDDM, and past gestational diabetes. There was a large variation in insulin sensitivity, with a similar variation in central fat, even in those whose BMI was <25 kg/m2. Abdominal fat had a significantly stronger relationship with insulin sensitivity than peripheral nonabdominal fat (r2 = 0.79 vs. 0.44), and higher levels were associated with increased fasting nonesterified fatty acids, lipid oxidation, and hepatic glucose output. Because 79% of the variance in insulin sensitivity in this heterogeneous population was accounted for by central fat, abdominal adiposity appears to be a strong marker and may be a major determinant of insulin resistance in women.
 ...
PMID:Abdominal fat and insulin resistance in normal and overweight women: Direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM. 862 Oct 15

This study reports 11-year all-cause and cause-specific mortality rates according to baseline glucose tolerance for a population-based sample of adult Melanesian and Indian Fijians (n = 2638), first surveyed in 1980. Risk factors for all-cause and cardiovascular disease (CVD) mortality in subjects with non-insulin-dependent diabetes (NIDDM) are also described. The baseline survey included 75 g oral glucose tolerance tests, measurements of blood pressure, body mass index, and triceps skinfold, assays of plasma cholesterol and triglycerides, electrocardiograms, and details of smoking habits and physical activity. Mortality status was ascertained for 2546 subjects through surveillance of death certificates, medical records and interview of subjects (or relatives). Mortality rates were increased in diabetic men and women of both ethnic groups: relative risks compared to subjects without diabetes at baseline were 1.7 (CI:0.9-3.1) and 2.0 (1.1-3.7) in Melanesian and 4.2 (2.7-6.5), 3.2 (1.9-5.7) in Indian men and women, respectively. A large proportion of mortality among diabetic subjects was attributed to CVD (62%, 66% in Melanesian and 54%, 58% in Indian men and women, respectively). Mortality rates tended to be higher in Melanesians than Indians, except for diabetic men where Indians had higher total and cardiovascular disease rates. In contrast to non-diabetic Fijians, diabetic women of both ethnic groups lost their relative protection from coronary heart disease (CHD). Cox regressions for diabetic subjects showed age and fasting plasma glucose to be independent predictors of all-cause mortality in men, and age, body mass index (inversely) and systolic blood pressure in women, but lipid concentrations, and cigarette smoking were not related. After accounting for conventional CVD risk factors, diabetes conferred significantly increased risk of total, CVD, and CHD mortality. The mortality experience of Melanesian and Indian Fijians with NIDDM is similar to that documented in developed populations, with excess mortality due to cardiovascular causes.
 ...
PMID:Non-insulin-dependent diabetes and 11-year mortality in Asian Indian and Melanesian Fijians. 864 Nov 16

Consensus has not been reached about the optimal treatment of type 2 diabetes, and several authors have questioned the use of insulin for this disorder. The reasons are that an association has been found between hyperinsulinaemia and cardiovascular disease in non-diabetic men, and the sparse evidence of a beneficial effect from tight glycaemic control in prevention of late complications in type 2 diabetes. We discuss the pathophysiology of atherosclerosis in type 2 diabetes, and review some of the recent literature. We find it likely that, in the metabolic cardiovascular syndrome found in many patients with type 2 diabetes, insulin resistance is more important than the accompanying hyperinsulinaemia. Furthermore, evidence is emerging of a strong association between hyperglycaemia and atherosclerotic vascular disease in patients with type 2 diabetes. We conclude that insulin treatment should be used in type 2 diabetic patients when the hyperglycaemia cannot be controlled by oral agents.
 ...
PMID:[Insulin treatment is of value--also in type 2 diabetes]. 865 97

Diabetes is frequently associated with the combination of hypertriglyceridemia and low HDL cholesterol level, a known risk factor for cardiovascular disease. We evaluated the frequency of elevated serum triglyceride and the reduced HDL cholesterol levels in Japanese male NIDDM patients. Hypertriglyceridemia (>1.69 mmol/l) and low HDL cholesterol level (<0.91 mmol/l) were frequently found in Japanese male (NIDDM patients (30.4 and 14.2%, respectively). The combined abnormality, i.e., hypertriglyceridemia with concomitant low HDL cholesterol level, was more common in patients with poor glycemic control. We observed that inpatient diet therapy markedly reduced serum triglyceride but serum HDL cholesterol did not change significantly. This is in marked contrast to primary hypertriglyceridemia, in which HDL cholesterol level generally increases in parallel with a reduction in serum triglyceride level. We discuss the defective removal of triglyceride-rich lipoproteins and ineffective HDL production caused by lipoprotein lipase (LPL) deficiency. We also discuss possible correction of this combined abnormality by certain maneuvers that increase LPL activity.
 ...
PMID:Hypertriglyceridemia and low HDL cholesterol in Japanese patients with NIDDM. 867 78

To elucidate the effect of glucose intolerance on cardiovascular disease in the current Japanese population, we performed a 75-g oral glucose tolerance test in 2,427 Hisayama residents aged 40-79 years in 1988, who were free from a previous history of stroke or myocardial infarction, and followed them prospectively for 5 years. The prevalence of diabetes (NIDDM) among men was 13% and that of impaired glucose tolerance (IGT) was 20%; the corresponding values for women were 9 and 19%, respectively. The age- and sex-adjusted incidence of cerebral infarction (6.5 per 1,000 person-years, P < 0.01) and coronary heart disease (5.0 per 1,000 person-years, P < 0.05) was significantly higher in subjects with NIDDM than in those with normal glucose tolerance (1.9 and 1.6 per 1,000 person-years, respectively). In addition, subjects with IGT and NIDDM had a higher risk of cardiovascular disease including stroke and coronary heart disease than did those with normal glucose tolerance after adjustment for age and sex, namely the relative risk for IGT was 1.9 (95% CI 1.2-3.2), and the relative risk for NIDDM was 3.0 (95% CI 1.8-5.2). These associations remained significant even after controlling for six other risk factors including hypertension in multivariate analysis. Our data suggest that NIDDM is a significant risk factor for both cerebral infarction and coronary heart disease and also that IGT itself is a risk factor for cardiovascular disease in the general Japanese population today.
 ...
PMID:Diabetes and cardiovascular disease in a prospective population survey in Japan: The Hisayama Study. 867 81

Subjects with fasting and/or postprandial plasma glucose levels that are higher than those in normal subjects but less than those in patients with manifest NIDDM are at increased risk of cardiovascular disease (CVD). This association between glucose intolerance and cardiovascular disease was first hypothesized in the 1950s but was not substantiated until the results of several long-term prospective studies became available. The results suggest that there is not a continuously variable association between blood glucose levels and the risk of CVD but that the risk of CVD becomes evident at the upper end of the distribution of glucose tolerance, though different studies yield different threshold levels. With the introduction of the descriptive term Impaired Glucose Tolerance (IGT), studies were undertaken to establish the relations between IGT and CVD. To date most data refer to people of European origin. In several populations CVD has been observed to be more prevalent in subjects with IGT and/or the incidence of CVD is higher in subjects with IGT than in normoglycaemic controls. A causal link between hyperglycaemia and CVD seems unlikely from the published evidence. The most probable explanation of the association is "a common soil', that is, a number of associated metabolic abnormalities which may lead to CVD and IGT/NIDDM or both.
 ...
PMID:The cardiovascular risk associated with impaired glucose tolerance. 868 56

There is much evidence to link impaired glucose tolerance (IGT) with the risk of developing non-insulin dependent diabetes mellitus (NIDDM) and of cardiovascular disease. However, it is unclear whether IGT is merely a marker or a risk factor or whether it is causally related to the development of these conditions. It is also unclear whether all individuals with IGT have an equal probability of developing NIDDM or cardiovascular disease. The exact pathogenetic relationship between IGT and these disease has important implications for preventive therapy which might be offered to such people. Patient compliance, physician motivation and supportive health-care funding will be greater if IGT is seen to be a definite stage in the development of a serious disease rather than simply a risk factor with statistically defined predictive power. As yet, there are insufficient data to justify routine therapy of subjects with IGT but further research into this condition and the development of effective preventive therapies could lead to widespread treatment.
 ...
PMID:Summary and perspectives on impaired glucose tolerance. 868 60


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