Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Polycystic ovary syndrome is one of the most common endocrine disorders affecting women across the lifespan. The consequences of PCOS are far reaching and affect reproductive, metabolic, and cardiovascular health. For many girls, the initial manifestations of this polygenic multifactorial disorder appear during childhood with PP. Yet not all girls with PP develop PCOS. Investigation into the factors that predict progression from PP to PCOS will provide insights regarding fundamental mechanisms contributing to the development of PCOS. Since disease prevention is a longstanding pediatric mission, ie, vaccines to prevent infectious diseases, mechanisms to detect individuals at risk for PCOS, IGT, and type 2 diabetes mellitus during childhood can only benefit the individual, their families, and society.
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PMID:Polycystic ovary syndrome. 1723 36

Several large-scale clinical trials have assessed the efficacy of atorvastatin in the primary and secondary prevention of cardiovascular events in patients with diabetes mellitus and/or metabolic syndrome. In primary prevention, CARDS (Collaborative Atorvastatin Diabetes Study) showed that atorvastatin 10 mg/day (vs placebo) reduced relative risk of the composite primary endpoint (acute coronary heart disease [CHD] events, coronary revascularisation, or stroke) by 37% (p = 0.001). This decrease was similar to decreases in major cardiovascular events in the ASCOT-LLA (Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm) trial and HPS (Heart Protection Study). However, in CARDS, atorvastatin efficacy was evident as early as 6 months after starting treatment, whereas in HPS, simvastatin efficacy was noticeable only from about 15-18 months after starting treatment. In the ASCOT-LLA trial, in 2226 hypertensive diabetic patients without previous cardiovascular disease, atorvastatin (vs placebo) reduced the relative risk of all cardiovascular events and procedures by 25% (p = 0.038). In secondary prevention, substudies of the GREACE (GREek Atorvastatin and Coronary-heart-disease Evaluation), TNT (Treating to New Targets) and PROVE-IT (PRavastatin Or atorVastatin Evaluation and Infection Therapy) trials reported results for the approximately 15-25% of study participants who had diabetes. In the GREACE substudy, atorvastatin (vs physicians' standard care) significantly reduced the relative risk of total mortality by 52% (p = 0.049), coronary mortality by 62% (p = 0.042), coronary morbidity by 59% (p < 0.002) and stroke by 68% (p = 0.046). In the TNT substudy, incidence of the primary endpoint was significantly lower in diabetic patients treated with atorvastatin 80 mg/day rather than 10 mg/day (13.8% vs 17.9%; relative risk 0.75; p = 0.026). In the PROVE-IT substudy, a significantly lower incidence of acute cardiac events was reported for atorvastatin versus pravastatin recipients (21.1% vs 26.6%; p = 0.03) and, therefore, an absolute risk reduction of 5.5% was associated with atorvastatin therapy. ASPEN (Atorvastatin Study for Prevention of coronary heart disease Endpoints in Non-insulin-dependent diabetes mellitus) - a mixed primary and secondary prevention trial in diabetic patients - found that a 29% lower low-density lipoprotein-cholesterol level was seen with atorvastatin than placebo at endpoint (p < 0.0001); however, the reduction in composite primary endpoint of major cardiovascular events (cardiovascular mortality, nonfatal major cardiovascular event or stroke, and unstable angina requiring hospitalisation) with atorvastatin (13.7% vs 15.0% with placebo), and reduction in acute myocardial infarction relative risk of 27% with atorvastatin were not statistically significant. In CHD patients with metabolic syndrome (n = 5584) in a sub-analysis of the TNT trial, intensive versus lower-dosage atorvastatin therapy reduced the relative risk of major cardiovascular and cerebrovascular events by 29% (p < 0.0001). The analysis also revealed that CHD patients with, rather than those without, metabolic syndrome had a 44% greater level of absolute cardiovascular risk, thus clearly underscoring the clinical feasibility of administering intensive lipid-lowering therapy to CHD patients with metabolic syndrome. In summary, several patient populations, from definitive, large-scale studies, are now available to corroborate the integral place of atorvastatin--in line with various regional and internationally accepted disease management guidelines--in the primary and secondary prevention of cardiovascular events in patients with diabetes and/or metabolic syndrome.
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PMID:Atorvastatin efficacy in the prevention of cardiovascular events in patients with diabetes mellitus and/or metabolic syndrome. 1791 May 20

The recent United Nations (UN) Resolution on diabetes sets a precedent by recognising a non-communicable disease, type 2 diabetes mellitus (T2DM), as a serious epidemic requiring urgent steps to improve management and prevent disease development. There is now a wealth of evidence that management of diabetes can be substantially improved by strategies of intensive glycaemic control, and these data must not be ignored. This article reviews this emerging evidence, including results of long-term intervention showing that durable glycaemic control in T2DM is possible. Urgent steps must be taken globally to intensify diabetes treatment as well as to develop rationale to prevent new cases. It is essential that all members of society are made acutely aware of the impending threat that the T2DM epidemic poses to society and that action is taken to control it without delay.
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PMID:We have the evidence, we need to act to improve diabetes care. 1799 Nov 86

The communication between the central nervous system and the immune system occurs via a complex network of bidirectional signals linking the nervous, endocrine and immune systems. The field of psychoneuroimmunology (PNI) has provided new insights to help understand the pathophysiological processes that are linked to the immune system. Work in this field has established that psychological stress disrupts the functional interaction between the nervous and immune systems. Stress-induced immune dysregulation has been shown to be significant enough to result in health consequences, including reducing the immune response to vaccines, slowing wound healing, reactivating latent herpesviruses, such as Epstein-Barr virus (EBV), and enhancing the risk for more severe infectious disease. Chronic stress/depression can increase the peripheral production of proinflammatory cytokines, such as interleukin (IL)-6. High serum levels of IL-6 have been linked to risks for several conditions, such as cardiovascular disease, type 2 diabetes, mental health complications, and some cancers. This overview will discuss the evidence that psychological stress promotes immune dysfunction that negatively impacts human health.
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PMID:Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. 1804 Aug 14

Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed.
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PMID:Epidemiological and nutrition transition in developing countries: impact on human health and development. 1823 35

Breast feeding is the best way to nurture healthy newborns of healthy mothers. A number of studies have shown that breast feeding may protect against the later development of obesity and related metabolic diseases. Using data from our own meta-analysis as well as studies by other groups, in this review we systematically examine the current state of evidence regarding this topic. Breast feeding, in general, is shown to be associated later in a child's life with decreased risk of overweight, decreased blood cholesterol and blood pressure, and a reduced risk of developing type 2 diabetes. Additionally, we review data of our Kaulsdorf Cohort Study (KCS) showing, however, that these effects might be reversed when the mother is affected by a non-communicable disease such as diabetes mellitus, which alters the composition of breast milk. In particular, exposure to breast milk from diabetic mothers during the first days of life (first week; early neonatal period) seems to increase rather than decrease risk of overweight and, consecutively, impaired glucose tolerance in childhood. Taken together, current findings show clearly that breast feeding is effective in lowering the risk of developing key features of the metabolic syndrome in later life, and should therefore be promoted. With increasing prevalence of overweight and diabetes in women, however, more research is urgently needed to clarify whether breast feeding might even have negative consequences for risk of overweight and diabetogenic disturbances when the mother suffers from a metabolic disorder. From a more general perspective, breast feeding and its long-term consequences are an important paradigm for "perinatal programming" of health and disease.
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PMID:Breast feeding and the risk of obesity and related metabolic diseases in the child. 1837 Jul 91

It is traditionally believed that genetic susceptibility and adult faulty lifestyle lead to type 2 diabetes, a chronic non-communicable disease. The "Developmental Origins of Health and Disease" (DOHaD) model proposes that the susceptibility to type 2 diabetes originates in the intrauterine life by environmental fetal programming, further exaggerated by rapid childhood growth, i.e. a biphasic nutritional insult. Both fetal under nutrition (sometimes manifested as low birth weight) and over nutrition (the baby of a diabetic mother) increase the risk of future diabetes. The common characteristic of these two types of babies is their high adiposity. An imbalance in nutrition seems to play an important role, and micronutrients seem particularly important. Normal to high maternal folate status coupled with low vitamin B(12) status predicted higher adiposity and insulin resistance in Indian babies. Thus, 1-C (methyl) metabolism seems to play a key role in fetal programming. DOHaD represents a paradigm shift in the model for prevention of the chronic non-communicable diseases.
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PMID:Maternal nutrition, intrauterine programming and consequential risks in the offspring. 1866 Dec 41

Horizons in Medicine is a series produced annually by the Royal College of Physicians. Volume 19 is based on their Advanced Medicine Conference held in 2007 and offers updates on a wide range of topics in clinical medicine. This 'review of reviews' covers developments described in a selection of chapters. The chapters summarised include: Contemporary management of acute myocardial infarction; Imported infectious disease emergencies; New therapies in the management of type 2 diabetes; Stress and adrenal insufficiency; Making sense of a 'funny thyroid function test'; Myeloproliferative disorders: management and molecular pathogenesis; Drug allergies; Osteoporosis; Rheumatoid arthritis; Understanding migraine from bench to bedside.
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PMID:Aspects of general medicine. 1884 Sep 10

As a proportion of all deaths in India, cardiovascular disease (CVD) will be the largest cause of disability and death, by the year 2020. At the present stage of India's health transition, an estimated 53% of deaths and 44% of disability-adjusted life-years lost are contributed to chronic diseases. India also has the largest number of people with diabetes in the world, with an estimated 19.3 million in 1995 and projected 57.2 million in 2025. The prevalence of hypertension has been reported to range from 20 to 40% in urban adults and 12-17% among rural adults. The number of people with hypertension is expected to increase from 118.2 million in 2000 to 213.5 million in 2025, with nearly equal numbers of men and women. Over the coming decade, until 2015, CVD and diabetes will contribute to a cumulative loss of USD237 billion for the Indian economy. Much of this enormous burden is already evident in urban as well as semi-urban and slum dwellings across India, where increasing lifespan and rapid acquisition of adverse lifestyles related to the demographic transition contribute to the rising prevalence of CVDs and its risk factors such as obesity, hypertension, and type 2 diabetes. The underlying determinants are sociobehavioral factors such as smoking, physical inactivity, improper diet and stress. The changes in diet and physical activity have resulted largely from the epidemiological transition that is underway in most low income countries including India. The main driving forces of these epidemiological shifts are the globalized world, rapid and uneven urbanization, demographic shifts and inter- and intra-country migrations--all of which result in alterations in dietary practices and decreased physical activity. While these changes are global, India has several unique features. The transitions in India are uneven with several states in India still battling the ill effects of undernutrition and infectious diseases, while in other states with better indices of development, chronic diseases including diabetes are emerging as a major area of concern. Regional and urban-rural differences in the occurrence of CVD are the hallmark. All these differences result in a differing prevalence of CVD and its risk factors. Therefore while studying nutrition and physical activity shifts in India, the marked heterogeneity and secular changes in dietary and physical activity practices should be taken into account. This principle should also apply to strategies, policies and nutrition and physical activity guidelines so that they take the regional differences into account.
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PMID:Regional case studies--India. 1934 64

In a number of applications, more than one drug has to be prescribed to achieve the desired therapeutic goal. Most often, it is the treatment of chronic diseases (like hypertension, type 2 diabetes mellitus, allergic asthma, but also chronic infectious diseases like tuberculosis or AIDS) which requires the combination of drugs with different mechanisms of action. Multimorbidity, often present in old age, increases the number of drug intakes per day while the ability to do so correctly declines. It appears thus plausible that a fixed combination of drugs, by decreasing the number of drug intakes per day, may lead to an improved compliance and eventually to an improvement of clinical endpoints. However, there is scarce evidence that this assumption is generally valid. For each of the above diseases the use of fixed combinations has to be evaluated separately with respect to an improvement in clinical endpoints as well as to an increased risk of adverse effects. Finally, the pharmacoeconomic aspect as to how the cost of fixed combinations compares to that of free combinations has to be taken into account.
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PMID:[Fixed drug combinations--the pros and the cons]. 1944 71


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