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

In a study over one year, it was observed that mortality amongst hospitalised patients with non insulin dependent diabetes mellitus (NIBDM) was nearly 20%. Those dying within 24 hr were classified as group A, between one day and one week as B, between one week and one month as C, and those after one month as D. There were 31 patients each in groups A and B, 14 in C, and 4 in D. The mean age at death was 61 years in the first three groups. The prevalence of cerebro-vascular accident as a terminal event was similar i.e. 32.2, 35.5 and 35.7 per cent in groups A, B and C respectively; 48% of patients in group A suffered from ischaemic heart disease. Diabetic ketoacidosis was equally prevalent amongst groups A, B and C. Infection was significantly more common in group B (45.2%) than A (P less than 0.05). Nephropathy was observed in 57% of patients in group C as compared to 22.5% in A (P less than 0.02). Cerebrovascular accident and infection were the major causes of mortality in groups B and C (80.7% and 71.4%), whereas ischaemic heart disease and cerebrovascular accident accounted for 80% of deaths in group A.
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PMID:Mortality events amongst non insulin dependent diabetes mellitus patients in Orissa. 180 Apr 90

Using an historical cohort study design with a 12 year follow-up, we found that 77 Navajo adults with type II diabetes mellitus were hospitalized at a rate of 335 hospitalizations per 1000 patient years compared to a rate of 167 hospitalizations per 1000 patient years for 77 age, sex, and residence matched non-diabetic controls, yielding a risk ratio of 2.0. Using matched pairs analysis (sign test), the observed difference in number of hospital admissions is statistically significant (z = 2.30, p less than 0.05). The average duration of hospitalization, however, was not statistically different in matched pairs analysis (z = 0.95, p greater than 0.05). The 136 excess hospitalizations of the diabetic subjects included 45 admissions for poor metabolic control of diabetes, 50 excess admissions for infectious disease, and 26 excess admissions for conditions of the heart, eye, kidney, or non-traumatic amputation. In multivariate analyses, variables found to be associated with greater hospitalization experience among the 77 diabetic subjects in the 12 years follow-up period included older age at entry to the study, poorer metabolic control early in the study period, and presence of diabetic complications.
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PMID:Hospitalization experience of Navajo subjects with type II diabetes and matched controls: an historical cohort study. 221 78

The way of life in many developing countries in the tropics is in a state of transition--from traditional to "modern", with its associated industrialisation, urbanisation and cultural readjustment. Infectious diseases are giving way to non-communicable diseases, such as cardiovascular diseases, adult onset diabetes, cancers, trauma and non-infectious respiratory diseases, as major causes of morbidity and premature mortality. The epidemiology, causality, prevention and treatment of these conditions is summarised in the context of developing countries.
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PMID:Non-communicable diseases in the tropics. 841 97

We evaluated 725 diabetic haemodialysis (HD) patients, inducted into HD from 1967 to 1993 in Niigata University Hospital and its affiliated hospitals, to clarify the relationships among the clinical course and features including diabetes mellitus treatment. The glucose metabolism was also studied during HD with dialysis fluids containing different glucose concentration. At the time of HD induction, diabetic patients showed lower serum creatinine and more frequent overhydration, compared with those with glomerulonephritis. Heart failure was the leading cause of (53%) among the symptoms as the direct cause of HD induction. The survival rate in Japan, particularly in our group, was more prolonged than that in USA and Europe. The rate was lower in patients with cardiac complications than in those with gastrointestinal problems, and also lower in older patients (more than 70 years old) than in younger patients. Among the patients less than 70 years old, the survival period was longer in patients with serum HbA1c values of less than 7.5%, compared to those with greater than 7.5% Cerebro- and cardio-vascular involvements and infectious diseases were three major causes of death, and cerebro- and cardio-vascular disorders and diabetic gangrene were three major complications. Serum HbA1c was not different among patients with or without these causes of death or complications. In 18.1% of non-insulin-treated NIDDM patients insulin was needed one year after HD induction, while 32.1% of insulin-treated NIDDM patients before HD induction became free from insulin, who showed body weight loss on average of 10 kg. In 33.6% of insulin-treated patients, insulin doses increased from 2 to 20 units/day on the non-dialysis day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The treatment of the uraemic diabetic. Are we doing enough? A view from Japan. Fumitake Gejyo and Collaborate Study Group. 857 79

The glycerol phosphate shuttle consists of FAD-linked mitochondrial glycerol 3-phosphate dehydrogenase (mGPDH) and its cytosolic NAD-linked isoform (cGPDH). Impaired mGPDH activity has recently been suggested to be one of the primary causes of insulin secretory defects in beta-cells. We found that mGPDH and cGPDH activities in MIN6 cells are comparable to those of isolated islets and higher than those in HIT cells by eightfold and threefold, respectively. Therefore, we selected the MIN6 cell line as a beta-cell model with normally regulated insulin secretion and normal shuttle enzyme activities and the HIT cell line as a beta-cell model with impaired insulin secretion and lower activities of these enzymes. The role of these dehydrogenases in glucose-stimulated insulin secretion was addressed by examining the effects of overexpression of mGPDH and/or cGPDH via recombinant adenoviruses in these cells. Infection with recombinant adenovirus with a cDNA encoding the Escherichia coli beta-galactosidase gene resulted in expression of its gene in 90% of MIN6 and HIT cells. Infection with a recombinant adenovirus with mGPDH cDNA (Adex1CAmGPDH) caused 2.1-fold and 5.7-fold increases in dehydrogenase activity as compared with those of control MIN6 and HIT cells, respectively. Infection with a recombinant adenovirus with cGPDH cDNA (Adex1CAcGPDH) caused a more than 50-fold increase in activity in both cell lines. Glycerol phosphate shuttle flux, as estimated by [2-3H]glycerol conversion to [3H]H2O, was increased to 120-130% by infection with Adex1CAmGPDH, but not with Adex1CAcGPDH infection, in both MIN6 and HIT cells. No further increase in flux through the glycerol phosphate shuttle was detected when the cells were infected with Adex1CAmGPDH together with Adex1CAcGPDH. Furthermore, neither [U-14C]glucose oxidation nor the insulin secretory response to glucose was affected in either cell line. Thus, mGPDH abundance in MIN6 and HIT cells is not directly related to their insulin secretory capacity in response to glucose, and reduced expression of mGPDH is not the primary cause of abnormal insulin secretory responses in HIT cells. The present data indicate that the emerging hypothesis pointing to mGPDH deficiency as a possible cause of NIDDM needs to be carefully evaluated.
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PMID:Effect of mitochondrial and/or cytosolic glycerol 3-phosphate dehydrogenase overexpression on glucose-stimulated insulin secretion from MIN6 and HIT cells. 877 29

In this prospective analysis we investigated the clinical characteristics of black South African diabetic patients admitted to hospital with hyperglycaemic emergencies. The study cases were selected from the medical admissions to an urbanized, Johannesburg academic hospital over a period of 12 months. Only patients with severe diabetic ketoacidosis (DKA) or hyperosmolar non-ketotic hyperglycaemia (HNKH) as defined in the text were included. Over the study period, we identified 58 patients with severe DKA (M: 32, F: 26) and 24 with HNKH (M: 14, F:10). Thirty-two of the patients with DKA (55.2%) were classified as having non-insulin dependent (Type 2) diabetes mellitus (NIDDM). Compared to the 26 subjects with insulin-dependent (Type 1) diabetes mellitus (IDDM), the NIDDM patients were older (51.7 vs 27.7 years) and had a significantly higher body mass index (BMI) (29.4 vs 23.5 kg m(-2), p = 0.002), and glucose levels 47.5 vs 34 mmol l(-1) p = 0.004). Mortality from DKA was 6.8 % and from HNKH 16.6%. Infection was the leading precipitating factor for both DKA and HNKH, followed by first presentation and noncompliance. We conclude that the majority of urban African patients admitted to hospital with DKA have NIDDM. Mortality from DKA among the black Africans in Johannesburg is low and comparable to the mortality in western Europe.
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PMID:Clinical characteristics and outcome of hyperglycaemic emergencies in Johannesburg Africans. 922

Non-insulin-dependent diabetes mellitus is one of the most common non-infectious diseases in Hungary. Oral hypoglycaemic agents, especially sulfonylurea drugs are basic therapeutic tools in the treatment of the disease. The cellular effects of sulfonylurea drugs are continuously investigated as their mode of hypoglycaemic action remains controversial despite the large number of experimental trials. According to the immediate or progressive nature of its insufficient blood glucose lowering effect, early (primary) and late (secondary) sulfonylurea failure can be distinguished. There are no exact criteria for the secondary sulfonylurea failure state. Having excluded causes other than drug failure, blood glucose profiles, and, if possible, serum or urinary C-peptide measurements should be carried out. Once sulfonylurea failure has been established other classes of antihyperglycaemic drugs in combination with insulin therapy or insulin therapy alone are to be introduced, respectively.
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PMID:[Delayed sulfonylurea resistance in non-insulin-dependent diabetes mellitus]. 944 Dec 64

Forty-three cases of diabetic ketosis were analysed to determine the mode of presentation, treatment modalities and outcome. Among these cases 62.8% were non-insulin dependent diabetes mellitus (NIDDM) patients and 37.2% belonged to the insulin dependent diabetes mellitus (IDDM) group. Six patients had blood glucose levels of more than 250 mg/dl but less than 300 mg/dl who were grouped separately for analysis under the term "euglycaemic diabetic ketoacidosis (EGDK)". Infection was the commonest precipitating factor in diabetic ketosis in all groups. Abdominal pain and vomiting occurred with NIDDM and EGDK cases. Drowsiness was common and coma was rare. Acute myocardial infarction (MI) and pulmonary oedema occurred with NIDDM cases. Shock, acidosis, acquired respiratory distress syndrome (ARDS) and mucor mycosis were seen with IDDM cases. Mortality was 7 out of 43(16.3%). Saline requirement was lower in NIDDM and EGDK cases. Intensive insulin therapy with hourly intravenous doses were needed for IDDM cases while majority of NIDDM cases could be managed with 6 hourly doses of insulin given subcutaneously or intramuscularly.
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PMID:Changing profile of diabetic ketosis. 956 97

Type 2 (non-insulin-dependent) diabetes is emerging as a leading chronic non-communicable disease among the adult Kuwaiti population. Based on the World Health Organization and similar reports the projected estimates for subjects suffering from type 2 diabetes by the years 2000 and 2010 show a striking tendency to high rates of the disease in our area. We report the prevalence rates of glucose intolerance among a relatively young adult Kuwaiti population below 50 years of age and the effect of implementing the recent 1997 American Diabetes Association diagnostic criteria on the frequency of type 2 diabetes, impaired glucose tolerance and impaired fasting glucose among this group. The overall prevalence rate for the three categories of glucose intolerance reached as high as 15.8% (95% CI, 14.2 to 17.4). Age, though all subjects were below 50 years, parental history of type 2 diabetes, diastolic blood pressure and serum triglycerides were found to be significant associated risk factors for the development of type 2 diabetes. Obesity was an apparent significant factor associated with the three forms of glucose intolerance (p < 0.001). Obesity and physical inactivity were documented in both non-diabetic and more so in diabetic Kuwaiti adults, which should form the basis of any immediate intervention programme. An integrated approach to the prevention of the described critical risk factors associated with type 2 diabetes is highly recommended in Kuwait. Research, focused on genetics of type 2 diabetes in the highly susceptible Kuwaiti population, should be planned.
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PMID:Impact of the 1997 American Diabetes Association criteria on classification of glucose intolerance among Kuwaitis below 50 years of age. 1066 17

The Asia-Pacific region is at the forefront of the current epidemic of diabetes. There are currently more than 30 million people with diabetes in the Western Pacific region alone. The World Health Organization predicts that this number will rise dramatically by the year 2025, by which time India and China may each face the problem of dealing with 50 million affected individuals. The problem in the region results from a combination of large population size with rapidly rising prevalence rates, particularly of type 2 diabetes mellitus. Although much heterogeneity exists, rising prevalence rates are being seen throughout the region and appear to be closely associated with westernisation, urbanisation, and mechanisation. The risk for diabetes appears to result from a combination of genetic predisposition and lifestyle change. The most important lifestyle changes relate to changes in dietary habits and physical activity and diabetes risk, particularly in younger individuals, is associated with the development of obesity and particularly central obesity. In some populations, for example Chinese, the relationship between diabetes and weight gain begins to appear at levels of body weight that would not be conventionally regarded as representing obesity. The increasing trend for type 2 diabetes to develop in young people is of particular concern. In children and adolescents in some parts of the region, type 2 diabetes now outnumbers type 1 diabetes by a ratio of 4:1. In view of the severity of the long-term complications of diabetes, the health consequences of this epidemic will become increasingly devastating and threaten to overwhelm the health care systems in the most vulnerable countries. There is an urgent need for prioritisation of diabetes as a key issue by governments throughout the region. Diabetes prevention programmes can be justified on economic, as well as humanitarian grounds. At the level of primary prevention, such programmes can be linked to other non-communicable disease prevention programmes which also target lifestyle-related issues.
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PMID:The epidemiology of diabetes mellitus in the Asia-Pacific region. 1079 2


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