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

Diabetes mellitus is the second most prevalent chronic disease in children in the U.S. It is associated with severe manifestations which include blindness and circulation deficiencies as well as markedly increased risk of death. The etiology of diabetes mellitus remains a mystery although both genetic and environmental factors have been implicated. The geneticist is confronted with a number of obstacles in his attempts to unravel this problem, including differences in the definition of affected individuals. This matter was certainly clarified by the separation of noninsulin-dependent diabetes (NIDDM) and insulin-dependent diabetes mellitus (IDDM) into two separate disease entities. Twin studies, however, show that IDDM cannot be entirely due to genetic causes as concordance is no more than about 50%. Although the disease is then clearly not inherited per se, the "susceptibility" to diabetes seems almost surely inherited and, provided this susceptibility, the disease can be brought on by environmental factors. Until the underlying mechanism causing IDDM is completely ascertained, we have to rely on genetic markers to approach the study of the inheritance thereof. Since, in the early 1970s, research by Nerup's and Cudworth's groups revealed associations between the HLA-B locus and IDDM, the HLA markers are considered the classical genetic markers for IDDM susceptibility. In this paper, we review the nature of the genetic susceptibility to IDDM and the possible environmental factors which can bring on the disease.
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PMID:Immunogenetics of insulin-dependent diabetes mellitus in humans. 257 May 96

The San Luis Valley Diabetes Study was undertaken to determine the prevalence, risk factors, and complications of non-insulin-dependent diabetes mellitus in Hispanics and Anglos (non-Hispanic whites), using a geographically based case-control design. The study was conducted in two southern Colorado counties that include 43.6% Hispanic and 54.9% Anglo persons. Medical practice records were reviewed to identify medically diagnosed diabetics. Controls without diabetes were identified by a two-stage random sample of households. Diabetics (n = 343) and controls (n = 607) attended a clinic where an oral glucose tolerance test or current hypoglycemic therapy confirmed or diagnosed non-insulin-dependent diabetes mellitus. The age-adjusted prevalence of confirmed non-insulin-dependent diabetes mellitus was 21/1,000 in Anglo males and 44/1,000 in Hispanic males, accounting for non-response. For Anglo females, the prevalence was 13/1,000 compared with 62/1,000 for Hispanic females, accounting for nonresponse. Previously undiagnosed non-insulin-dependent diabetes mellitus was also higher among Hispanics. There was a 2.1-fold excess of confirmed non-insulin-dependent diabetes mellitus among Hispanic males and a 4.8-fold excess among Hispanic females, consistent with the excess non-insulin-dependent diabetes mellitus among Hispanics reported from comparable studies. Non-insulin-dependent diabetes mellitus is a major chronic disease problem for persons of Hispanic ethnicity.
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PMID:Methods and prevalence of non-insulin-dependent diabetes mellitus in a biethnic Colorado population. The San Luis Valley Diabetes Study. 291 42

Vigorous exercise is currently being encouraged for health maintenance. There is much evidence that a moderate amount of exercise is needed for the maintenance of functional integrity of the cardiovascular system, muscles, bones, and ligaments. There is also fragmentary evidence of a preliminary nature suggesting that regularly performed exercise may protect against and have beneficial effects on coronary artery disease, diabetes, and hypertension. However, the scientific evidence that strenuous exercise has long-term health benefits or slows aging is meager and unconvincing. Even in the case of coronary artery disease, diabetes, and hypertension, the majority of studies have provided either negative or inconclusive results or have resulted in only minor improvements. Taken together, available evidence is inadequate to serve as a basis for recommending regular participation in strenuous exercise for middle-aged and older individuals. This is particularly true because the theories that exercise may accelerate the aging process as a result of increases in metabolic rate and stress hormone production have never been disproved. Therefore, because of the major public health implications of exercise, large-scale, well-controlled studies of the effects of exercise on coronary artery disease, adult onset diabetes, hypertension, and various aspects of the aging process are urgently needed. Important barriers to progress in this area are the current dearth of exercise physiologists interested in research on health maintenance and well trained in human exercise physiology and the lack of an appropriate research funding mechanism for large-scale, interdisciplinary studies of the effects of exercise on chronic disease processes and aging.
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PMID:Exercise, health, and aging: a need for more information. 684 18

Non-insulin dependent diabetes mellitus (NIDDM) is an important cause of morbidity and mortality, both in developed as well as in developing countries. The eyes, kidneys, and cardiovascular and neurological systems are predominantly affected by this chronic disease, leading to loss of employment and sometimes life. The most common setting is uncontrolled glycaemia after dietary restriction, exercise and oral hypoglycaemic drug therapy. Insulin may be needed for treating NIDDM some time during the course of the disease. Insulin therapy results in improved beta-cell function, a decrease in the hepatic glucose output and an improvement of the lipoprotein profile. Some of these beneficial effects are due to nullification of 'glucose toxicity'. Objective evidence of a link between tight metabolic control and chronic complications of NIDDM is still not established, despite the results of recent trials. Many insulin regimes have been tried. Recently, attention has been focused on combination therapy with sulphonylureas and insulin, using long-acting insulin at bedtime only. This regime improves the glycaemic profile (due to a reduction of hepatic glucose output), using lower doses of insulin and sulphonylureas. However, experience with this regime suggests that it is only suitable for a subset of NIDDM patients. Adverse effects of insulin therapy include weight gain and hypoglycaemia, which can usually be easily managed. It is hyperinsulinaemia, with its complex array of adverse metabolic effects, that has recently concerned physicians. Acceleration of atherosclerosis, hypertension and worsening of the lipoprotein profile have been cited as possible adverse effects. The presence of such dysregulation is included in the recently described syndrome X.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Insulin treatment in non-insulin dependent diabetes mellitus. 763 12

Non-insulin-dependent diabetes mellitus (NIDDM) is a chronic disease which may take several years to develop, presumably starting in most cases with genetic susceptibility. Development of NIDDM is influenced by obesity and physical inactivity. As these risk factors can be altered by behavioral modification, and some of the physiologic abnormalities predicting diabetes, such as insulin resistance and impaired glucose tolerance, can be improved by behavioral modification and with drugs, NIDDM is potentially preventable. This potential needs to be demonstrated by randomized clinical trials.
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PMID:Prevention of non-insulin-dependent diabetes mellitus. 784 42

The aim of this study was to assess the prevalence of diabetes mellitus in France, the existing treatment used and the effect of this chronic disease on everyday life patterns of the diabetic population. A survey was undertaken by Lilly laboratories and SOFRES medical institute from November to December 1992, which involved randomly screening 20,000 french families. After the screening questionnaire was sent at to the 20,000 families, the following feedback was obtained: 996 patients have been identified. More than 80% of the patients (that is, 122 were insulin treated and a further 674 were identified as NIDDM) replied to the second self assessment questionnaire. It was possible to make an estimation of the prevalence of diabetes mellitus in France that is to say: 1.9% of the general population. The general practitioner makes the primary diagnosis in more than 80% of the cases, and treats 97% of the NIDDM patients and 74% of the insulin treated diabetic patients. The diabetic patients have an average of 8 consultations per year with their general practitioners and 3-4 consultations per year with the endocrinologist. Therapeutic management of the NIDDM patients is based mainly on diet (82%) alone or in association with drugs. 32% of patients primary treated by drugs and secondary by insulin are not satisfied with their glycemic control (vs 22% of IDDM patients and 15% of NIDDM patients). Less than 35% of diabetic women are current users of contraception. More than one third of children who were born from a diabetic mother had a birth weight above 4 kgs.
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PMID:[The French diabetic population. Results of a study using a representative sample]. 820 83

Vigorous exercise is currently being encouraged for health maintenance. There is much evidence that a moderate amount of exercise is needed for the maintenance of functional integrity of the cardiovascular system, muscles, bones, and ligaments. There is also fragmentary evidence of a preliminary nature suggesting that regularly performed exercise may protect against and have beneficial effects on coronary artery disease, diabetes, and hypertension. However, the scientific evidence that strenuous exercise has long-term health benefits or slows aging is meager and unconvincing. Even in the case of coronary artery disease, diabetes, and hypertension, the majority of studies have provided either negative or inconclusive results or have resulted in only minor improvements. Taken together, available evidence is inadequate to serve as a basis for recommending regular participation in strenuous exercise for middle-aged and older individuals. This is particularly true because the theories that exercise may accelerate the aging process as a result of increases in metabolic rate and stress hormone production have never been disproved. Therefore, because of the major public health implications of exercise, large-scale, well-controlled studies of the effects of exercise on coronary artery disease, adult onset diabetes, hypertension, and various aspects of the aging process are urgently needed. Important barriers to progress in this area are the current dearth of exercise physiologists interested in research on health maintenance and well trained in human exercise physiology and the lack of an appropriate research funding mechanism for large-scale, interdisciplinary studies of the effects of exercise on chronic disease processes and aging.
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PMID:Exercise, health, and aging: a need for more information. 1983. 849 79

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

Non-insulin-dependent diabetes mellitus (NIDDM) may be the most rapidly-growing chronic disease in the world. Its long-term complications, including retinopathy, nephropathy, neuropathy, and accelerated macrovascular disease cause major morbidity and mortality. Although therapy that normalizes glycemia may prevent the development and delay the progression of long-term complications in NIDDM, as has been demonstrated in insulin-dependent diabetes mellitus (IDDM), no direct data exist to support the efficacy of "intensive therapy" in NIDDM. An alternative approach to preventing the development of long-term complications may be to intervene more distally, i.e., inhibit the mechanism(s) by which elevated glucose levels cause complications. Potential pathogenic mechanisms include the accumulation of sorbitol and other biochemical changes in tissues with aldose reductase, and the modification of proteins by glycation. Pharmacologic probes, including aldose reductase inhibitors and glycation inhibitors such as aminoguanidine, are currently under study and may provide an efficient means of preventing complications, independent of the ambient glycemic level.
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PMID:Prevention of long-term complications of non-insulin-dependent diabetes mellitus. 854 21

Many Americans, knowingly or unknowingly, are afflicted with diabetes. Because of a lack of awareness or a disbelief that aggressive treatment benefits patients on the part of both patients and physicians, diabetes, particularly NIDDM, remains underdiagnosed and undertreated despite complications that can dramatically diminish quality of life. Increasing evidence that good glycemic control forestalls if not prevents these outcomes makes it the primary care physician's imperative to diagnose diabetes before complications develop. Physicians, through targeted screening and aggressive treatment of patients in whom they diagnose this chronic disease, can markedly reduce diabetes-related morbidity and mortality.
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PMID:Preventing complications in diabetes mellitus: the role of the primary care physician. 861 81


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