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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Structural changes in both biliary tract and pancreas have been assessed with endoscopic retrograde cholangiopancreatography in 100 diabetic patients divided into subgroups depending on the type of diabetes mellitus, i.e. type I, type II and III-pancreatic. Control group included 100 randomly selected patients without diabetes mellitus in whom endoscopic retrograde cholangiopancreatography has been performed for various indications. Structural changes in the biliary tract and pancreas have been more frequent in diabetic patients than in the control group (47 and 75% vs 32 and 30%, respectively). Cholelithiasis has been noted in 27.8% of patients with type II diabetes mellitus and in 11.3% of patients with type I diabetes mellitus; obesity has been found in 57 and 12% of patients, respectively. Other biliary tract disorders, mainly in the form of segmental stenosis or dilatation of the common bile duct, have been more frequent in patients with type II diabetes mellitus. Pancreatic disorders, assessed with the aid of Cambridge classification, have been noted in all patients with pancreatic diabetes and in 80.7% of patients with diabetes mellitus type I. Incidence of so-called doubtful and mild disorders has been more frequent (22.2 and 24.1%, respectively) in patients with diabetes mellitus type II whereas "moderate" and "severe" disorders have been significantly less frequent (7.4 and 1.9% of patients). The results indicate, that endoscopic retrograde cholangiopancreatography is useful in the assessment of bile ducts structure and pancreatic exocrine activity in diabetic patients in whom disorders are more frequent.
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PMID:[Anatomic changes in the biliary tract and pancreas in patients with diabetes mellitus diagnosed by endoscopic retrograde cholangiopancreatography]. 143 89

Obesity is common in populations that are overnourished and can become a significant public health problem. Obesity predisposes to non-insulin dependent diabetes mellitus, hypertension, dyslipidemia, cholelithiasis, some malignancies and osteoarthritis. These consequences that most directly affect the cardiovascular system are dyslipidemia and hypertension. Nations in which obesity is rare should learn from the experience of the countries where it is prevalent, that prevention of obesity is a public health measure rather than weight reduction.
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PMID:Cardiovascular consequences of obesity. 149 63

Over the past 20 years, obesity has represented a significant focus of research conducted in Clinical Research Centers (CRCs) in the United States. This review will focus on the progress in our understanding of the disease that CRC-based research has produced; therefore, the reference list is not exhaustive and consists primarily of CRC-based research. Obesity is defined as an excess of body fat as measured by triceps skinfold thickness. The time of onset of obesity is an important factor; for example, early onset is associated with an increase in the number of fat cells. Weight loss reduces the size but not the number of fat cells. Type II diabetes mellitus is a common complication in obese adults; this condition has been related to fat cell size and, in women, to predominantly upper-body fat distribution. Pregnant obese women and their babies are at risk for a number of problems. Abnormalities commonly found in obese persons include increased plasma lipid levels, hyperinsulinism, increased cholesterol synthesis, high frequency of gallstones, and hypertension. Under a variety of experimental conditions, the only difference in the response of obese and normal weight subjects to food was that the obese subjects appeared to consume more, but other data suggest that the obese may have greater energy needs. Carbohydrate intake has been studied extensively. Metabolic rate increases with over-feeding, especially in response to carbohydrate. Basal metabolic rates are higher in obese adults and rise in response to overfeeding; they decrease after weight reduction. This decrease can be counteracted with sucrose, perhaps because sucrose maintains triiodothyronine levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Obesity. 268 26

The Mexican-American population of south Texas has been shown previously to have elevated frequencies of gallbladder disease, based on medical history. In the present study, ultrasonography was employed to screen 1004 randomly selected individuals aged 15 to 74 years. Among women, the frequency of previous cholecystectomy was 10.0%; the frequency of stones on ultrasound was 12.2%. In men, the respective frequencies were 1.7% and 6.3%. Highest frequencies of gallbladder disease occurred among those aged 45 years or above: 40.2% and 19.2% among women and men, respectively. Non-insulin-dependent diabetes mellitus, obesity, and hypertension were also markedly elevated in this population. Overall, more than 40% of the population had either gallbladder disease, non-insulin-dependent diabetes, obesity, or hypertension. Among those older than 45 years, 70% had one or more of these chronic conditions. Examining the associations of gallbladder disease with other chronic diseases or measures of lipids, lipoproteins, and apolipoproteins demonstrates that factors predictive of or associated with cholecystectomy are different from those for gallstones by ultrasound. Diabetes and obesity show the strongest associations with cholecystectomy among women under 45 years (women with diabetes being 6.8 times as likely to have had a cholecystectomy than those without diabetes). Testing an extensive array of lipid-related measures resulted in no clear patterns, with the possible exception of alpha-lipoprotein and related measures. That the Mexican-American population is relatively young and experiencing extremely rapid growth indicates that the burden of chronic disease in general and gallbladder disease in particular will increase dramatically in the coming years.
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PMID:An ultrasound survey of gallbladder disease among Mexican Americans in Starr County, Texas: frequencies and risk factors. 850 3

We investigated the association of non-insulin-dependent (Type 2) diabetes mellitus and depression symptoms in a representative community-dwelling elderly population independently of other conditions such as gender, age, status, disability, cognitive impairment and a number of chronic medical conditions such as chronic obstructive lung disease, degenerative joint disease, heart disease, cirrhosis of the liver, cholelithiasis, peptic ulcer and kidney stones. A total of 1339 elderly subjects living in southern Italy were randomly selected from electoral rolls and evaluated. All subjects were tested by the Geriatric Depression Scale to detect depression, the Mini-Mental State Examination to study cognitive function and the Activity Daily Living Index to evaluate disability. Non-insulin-dependent diabetes mellitus affected 14.7% of our sample. Depression was more prevalent in women over 75 years of age than in younger women (15.9 vs 8.1%, p < 0.001). In multiple linear regression analysis, diabetes mellitus was found to be significantly associated with depression independently of age, gender, loneliness, cognitive impairment, chronic obstructive lung disease, degenerative joint disease, heart diseases, cancer, kidney disease, cirrhosis of the liver and cholelithiasis. It is concluded that non-insulin-dependent diabetes mellitus is significantly associated with depression in the elderly, which may have clinical implications for the achievement of sufficient blood glucose control.
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PMID:Non-insulin-dependent diabetes mellitus is associated with a greater prevalence of depression in the elderly. The Osservatorio Geriatrico of Campania Region Group. 889 92

Diabetics are known to have an increased prevalence of gallstones. The aim of this study was to investigate whether diabetics have increased gallbladder volumes that would predispose to stasis, nucleation of cholesterol crystals, and gallstone formation. The gallbladder volume of 271 diabetic subjects and 277 controls was determined by ultrasound using the ellipse formula. Gallbladder volume was also determined by the sum of the cylinders method in 143 cases with a strong correlation (r = 0.89) between the two methods. Using analysis of variance, gallbladder volume was influenced by both diabetic type (NIDDM = 33.68 cm3, IDDM = 26.84 cm3, controls = 29.05 cm3; P = 0.018) and the presence of gallstones (gallstones = 32.04 cm3, no gallstones = 27.58 cm3; P = 0.018). The variation in gallbladder volume between NIDDM, IDDM, and control subjects was influenced by the presence of gallstones (P = 0.024, interaction term from ANOVA). Significant differences (P < 0.001) were only found between NIDDM vs IDDM and NIDDM vs control in the nongallstone group (NIDDM = 34.33 cm3, IDDM = 25.08 cm3, control = 25.17 cm3). Males had significantly larger gallbladder volumes than females: 31.98 cm3 vs 27.74 cm3 (P = 0.023). After the inclusion of BMI, HDL cholesterol, triglyceride, and age in a statistical model with gender and diabetic type in those without gallstones, significant differences were still found between NIDDM and IDDM (P = 0.013) and NIDDM and controls (P = 0.005), demonstrating that NIDDM is an independent predictor for increased gallbladder volume.
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PMID:Gallbladder volume: comparison of diabetics and controls. 951 28

Familial hypobetalipoproteinemia is caused by mutations in the apolipoprotein (apo) B gene. We identified a 57-year-old woman whose plasma total cholesterol and apoB levels were 2.17 mmol/L and 0.03 g/L, respectively. Separation of plasma lipoproteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed the absence of apoB-100 and the presence of a faster-migrating form of apoB with an apparent Mr of 195 kDa. Direct sequencing of a polymerase chain reaction-amplified fragment of the patient's apoB gene DNA revealed a single C-->T transition at nucleotide 5472 that converts glutamine 1755 (CAA) to a stop codon (TAA). We predict this novel nonsense mutation of the apoB gene to produce a truncated protein that contains 1754 amino-terminal amino acid residues of apoB-100. We designated this mutant form of apoB apoB-38.7 by following the centile nomenclature of the apoB species. The same mutation was found in both of her children. The proband revealed clinical findings of retinitis pigmentosa, acanthocytosis, and loss of deep tendon reflexes that are characteristic of severe hypobetalipoproteinemia. In addition, the proband had type II diabetes mellitus with nephropathy, anemia, cholelithiasis, hepatic hemangioma, bronchiectasis, and extensive calcification of major arteries including, the celiac, splenic, and renal. In summary, we have found a novel truncated apoB, apoB-38.7, in a patient with an unusual presentation of hypobetalipoproteinemia that includes diabetes mellitus and extensive arterial calcification.
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PMID:A truncated species of apolipoprotein B (B-38.7) in a patient with homozygous hypobetalipoproteinemia associated with diabetes mellitus. 971 41

We performed a cost-effectiveness simulation of acipimox, bezafibrate, fenofibrate and gemfibrozil in patients with hyperlipoproteinaemia type IIb and IV (Frederickson). A distinction was made between patients with HLP type IIb and IV and HLP associated with diabetes mellitus type II (NIDDM). Direct costs were assessed as those incurred by social security for the treatment, and indirect costs were not taken into account. In appropriate dosages, all 4 substances can be considered equally efficacious in lowering lipid levels, although gallstones occur 3 times more frequently in patients treated with fibrates than in those treated with acipimox. Acquisition costs of the 4 drugs under consideration are comparable. Thus, when hospitalisation costs for treatment of gallstones are taken into account, therapy with acipimox is more cost effective than fibrate therapy.
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PMID:Cost-effectiveness study of a lipid-lowering therapy in hyperlipoproteinaemia type IIb and type IV (Frederickson). 1014 61

Age, female sex, and obesity are well-known risk factors for gallstones; in contrast the possible role of type 2 diabetes mellitus (type-2 DM) is controversial. One reason for this discrepancy might be that type 2 DM is often accompanied by obesity. Therefore, the aim of this study was to evaluate the importance of obesity and of type 2 DM, separately and together, as risk factors for gallstones. In all, 203 obese patients with normal glucose tolerance (obese NGT), 446 obese patients with type 2 DM (obese type 2 DM), 269 lean patients with type 2 DM (lean type 2 DM) and 250 lean subjects with a normal glucose tolerance (lean NGT) were evaluated by ultrasonography for the presence of gallstones. At univariate analysis patients with gallstones (177) were older and were more frequently affected by both obesity and type 2 DM, and had higher triglycerides and fasting blood glucose levels. At multiple logistic regression analysis, only age and obesity, both in the presence or in absence of type 2 DM, were strongly associated with gallstones (P < 0.001); diabetes alone had a lower level of statistical significance (P = 0.07). These data suggest that obesity is a stronger risk factor for gallstones than type 2 DM.
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PMID:Association of obesity and type II diabetes mellitus as a risk factor for gallstones. 1111 74

The incidence of obesity (especially childhood obesity) and its associated health-related problems have reached epidemic proportions in the United States. Recent investigations suggest that the causes of obesity involve a complex interplay of genetic, environmental, psychobehavioral, endocrine, metabolic, cultural, and socioeconomic factors. Several genes and their protein products, such as leptin, may be particularly important in appetite and metabolic control, although the genetics of human obesity appear to involve multiple genes and metabolic pathways that require further elucidation. Severe obesity is frequently associated with significant comorbid medical conditions, including coronary artery disease, hypertension, type II diabetes mellitus, gallstones, nonalcoholic steatohepatitis, pulmonary hypertension, and sleep apnea. Long-term reduction of significant excess weight in these patients may improve or resolve many of these obesity-related health problems, although convincing evidence of long-term benefit is lacking. Available treatments of obesity range from diet, exercise, behavioral modification, and pharmacotherapy to surgery, with varying risks and efficacy. Nonsurgical modalities, although less invasive, achieve only relatively short-term and limited weight loss in most patients. Currently, surgical therapy is the most effective modality in terms of extent and duration of weight reduction in selected patients with acceptable operative risks. The most widely performed surgical procedure, Roux-en-Y gastric bypass, achieves permanent (followed up for more than 14 years) and significant weight loss (more than 50% of excess body weight) in more than 90% of patients.
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PMID:Current status of medical and surgical therapy for obesity. 1117 43


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