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

The association between diabetes mellitus and primary glaucomas is evaluated. Diabetes is specifically associated with narrow-angle categories of primary glaucoma: closed-angle glaucoma and narrow-angle patients with ocular hypertension or open-angle glaucoma. The prevalence of diabetes mellitus in wide-angle glaucoma patients is not significantly different from normal age-matched control subjects. The association between diabetes and glaucoma is restricted to non-insulin dependent diabetes mellitus and impaired glucose tolerance; the prevalence of insulin-dependent diabetes mellitus in the primary glaucomas is equivalent to age-matched normal values. These conclusions are supported by 75-gram oral glucose tolerance testing, estimation of glycosylated haemoglobin, retrospective analysis of positive diabetic family history, and prospective follow-up examining progression of impaired glucose tolerance to diabetes mellitus in patients with primary glaucoma.
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PMID:Diabetes mellitus in primary glaucomas. 275 Dec 36

In 375 patients aged 68.5 +/- 9.4 years (mean +/- 1 SD) with primary glaucoma subdivided by irido-corneal angle configuration into closed-angle glaucoma (123 cases), ocular hypertension (186 cases), and open-angle glaucoma (66 cases), diabetic status was determined by standard 75 g oral glucose tolerance tests. In 63 patients with impaired glucose tolerance who were retested one year later, 16% had progressed to diabetes mellitus. The results confirm a significant association between non-insulin dependent diabetes mellitus and primary glaucoma which may result from autonomic dysfunction in parasympathetic tone causing anterior chamber angle closure.
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PMID:Progression of impaired glucose tolerance to diabetes mellitus in patients with primary glaucoma and ocular hypertension. 295 Nov 74

The prevalence of diabetes mellitus in the family history of 371 patients with primary glaucoma--closed-angle glaucoma, ocular hypertension and open-angle glaucoma--and 85 age- and sex-matched control subjects was determined. There was a significantly-increased prevalence of familial type 2 diabetes mellitus (non-insulin dependent diabetes mellitus) in patients with closed-angle glaucoma (p = 0.004) and ocular hypertension (p = 0.02). Primary glaucoma was not associated with familial type 1 diabetes mellitus (insulin dependent diabetes mellitus). The implications are discussed.
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PMID:The prevalence of diabetes mellitus in the family history of patients with primary glaucoma. 395 66

The prevalence of glaucoma and ocular hypertension was investigated in an epidemiological study of diabetics traced by registration of prescriptions on insulin and oral hypoglycaemic agents (OHA) on the island of Falster (inhabitants 44 498), Denmark. Among 533 diabetics (227 insulin- and 306 OHA-treated) the prevalence rate of primary open angle glaucoma and ocular hypertension was 6.0% and 3.0%, respectively. Neovascular glaucoma occurred in 2.1% of all diabetics and in 21.3% of diabetics with proliferative retinopathy. Open angle glaucoma was more prevalent (P less than 0.01) in type 2 diabetes mellitus compared with type 1 diabetes mellitus. No difference in the prevalence of neovascular glaucoma was found between type 1 and type 2 diabetics. The occurrence of open angle glaucoma correlated positively (P less than 0.01) to the current age (greater than 65 years) in both groups and the diabetes onset age (greater than 40 years) in insulin-treated diabetics. Neovascular glaucoma correlated positively (P less than 0.05) with diabetic macrovascular complications in total (myocardial infarction, ischemic heart disease, arterial hypertension, cerebrovascular stroke, gangrene/amputation), neuropathy and severe microvascular complications (proliferative retinopathy, retinovascular occlusion). Diabetics with open angle glaucoma and ocular hypertension showed a higher frequency (P less than 0.05) of ischemic heart disease, arterial hypertension and retinovascular occlusion compared with diabetics without glaucoma or ocular hypertension.
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PMID:The prevalence of glaucoma and ocular hypertension in type 1 and 2 diabetes mellitus. An epidemiological study of diabetes mellitus on the island of Falster, Denmark. 663 28

Since diabetes is a major health problem in Malta a study was conducted to gain a better insight into one of its most common complications, that of retinopathy. A random sample of 200 cases of adult onset diabetes with retinopathy who attended the main hospital's diabetes clinic was assessed by an experienced ophthalmologist. Non-proliferative retinopathy was subdivided into three degrees of severity according to the number of microaneurysms, haemorrhages, exudates, and intraretinal microvascular abnormalities present while proliferative retinopathy included also advanced eye disease. Data on medical and family histories was gathered from personal interrogation and counterchecked from hospital files. A medical examination searched for other concomitant disease. The 124 females and 73 males were similarly aged with a mean of 59.5 +/- 11.5 years. The mean age at onset of diabetes was 44.4 +/- 7.9 years: no significant differences were seen between the grades of retinopathy or the sexes. Onset of eye disease was first detected at a mean age of 56.9 +/- 7.0 years. The great majority (82%) of retinopathy cases occurred after 10 years of diabetes. Males appeared to develop eye disease (especially non-proliferative) at a younger age (53.4 +/- 7.6 vs 58.9 +/- 6.6 years, p < 0.01) and after a shorter duration of diabetes (10.1 +/- 6.6 vs 14.0 +/- 7.8 years, p < 0.001) than females. Severity of retinopathy was strongly associated (p < 0.001), in females rather more than in males, with poor glycaemic control, use of insulin, presence of proteinuria and decreasing vision; and less markedly (p < 0.01) with duration of diabetes of more than 10 years, neuropathy and glaucoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Retinopathy in Maltese type 2 diabetic patients. 764 10

The medical literature of the last decade enables us to estimate survival of diabetics. Insulin dependent diabetic (IDDM) present a 3 to 6-fold mortality and die after age 30, the most frequent causes being end stage renal and vascular diseases. Non insulin-dependent diabetic (NIDDM) mortality is 1.4 to 3.7 times that of non-diabetics. Cardiovascular events and strokes are the major causes of death. Pancreatic carcinoma occurs twice as frequently in NIDDM compared to non-diabetics. Early markers of late severe complications are hypertension and proteinuria. Retinopathy has little influence on morality if other risk factors are considered. Yet, glaucoma and lens changes are associated with three- and twofold mortalities. One of five IDDM with microalbuminuria progresses to overt nephropathy in 5 years. In NIDDM micro-albuminuria predicts cardiovascular disease with a mortality of up to 2 times. Careful treatment of cardiovascular risk factors and of microalbuminuria combined with optimal metabolic control substantially reduces mortality of diabetics.
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PMID:Diabetes mellitus--long time survival. 1018 35

Dexamethasone-cyclophosphamide pulse (DCP) is the prefered mode of therapy in pemphigus in India because it is relatively free from the side effects seen with heavy doses of daily oral steroids. One hundred forty-six pemphigus patients treated with DCP were observed for side effects of this regimen. One hundred forty mg of dexamethasone was administered IV in 200 ml of 5% dextrose over a period of 60-90 minutes on 3 consecutive days. Five hundred mg of cyclophosphamide was added on first day of the pulse and 50 mg given orally daily in the intervening period. DCP was repeated every 4 weeks and continued for 6 months after subsidence of the disease (no new lesions). Flushing over the face was the most common event recorded during the adiministration in 78 subjects followed by palpitations in 11, hiccups in 9, and numbness of feet in 6. Fourteen patients had polyurea, and 3 developed skin rash. Shivering, shooting pains along thighs, breathlessness, seizure and unilateral limb edema were observed in one patient each. Generalized weakness/malaise was the most troublesome delayed side effect in 81 (55.4%) patients; it lasted for 8-15 days after the pulse. Thirty-six (24.6%) had inadequate sleep syndrome, 23 (15.7%) had headache, 21 (14.3%) complained of arthralgias, 19 (13%) experienced alteration in taste, and 13 (9%) had diffuse hair loss. 28 females developed menstrual disturbances, and 14 (9.5%) had blurring of vision (glaucoma in 3 and posterior subcapsular cataract in 1). Thirteen of eighteen diabetics had an increase in blood sugar requiring higher doses of insulin. Five NIDDM patients needed insulin. Four (2.7%) developed hypertension. Pulse therapy is not absolutely free from side effects. Hypertension and diabetes occur less frequently as compared to conventional steroid therapy. Generalized weakness, flushing, headache and taste alteration occur exclusively with pulse therapy.
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PMID:Immediate and delayed complications of dexamethasone cyclophosphamide pulse (DCP) therapy. 1468 52

We present an 84-year-old man with a history of chronic obstructive pulmonary disease, type 2 diabetes, hypertension, glaucoma, and bladder cancer who presented to the emergency department after the police found him disoriented and confused. Metformin therapy began 3 days before, and he denied any overdose or suicidal ideation. Other daily medications included glipizide, fluticasone, prednisone, aspirin, furosemide, insulin, and potassium supplements. In the emergency department, his vital signs were significant for hypertension (168/90), tachycardia (120 bpm), and Kussmaul respirations at 24 breaths per minute. Oxygen saturation was 99% on room air, and a fingerstick glucose was 307 mg/dL. He was disoriented to time and answered questions slowly. Metformin was discontinued, and by day 3, the patient's vital signs and laboratory test results normalized. He has been asymptomatic at subsequent follow-up visits. Metformin-associated lactic acidosis is a well-known phenomenon. Respiratory alkalosis may be an early adverse event induced by metformin prior to the development of lactic acidosis.
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PMID:Metformin-associated respiratory alkalosis. 1513 41

The multiple pharmacological actions of a unique compound are a prerequisite for classifying drugs as highly efficacious, because the multiple pharmacological actions offer the possibility of treating various symptoms of chronic diseases as described below. 1) Sustained hyperglycemia induces macrovascular and microvascular complications in type 2 diabetes mellitus. Antihyperglycemic medication and the control of postprandial hyperglycemia are essentially important for normalizing plasma glucose level. Gymnemic acid IV isolated from Gymnema sylvestre (Asclepiadaceae) leaves has antisweet, antihyperglycemic, glucose uptake inhibitory, and gut glycosidase inhibitory effects. Most of these pharmacological effects may synergistically contribute to alleviating type 2 diabetes-related symptoms. 2) Diabetic skeletal and vascular smooth muscles are hypersensitive to chemical transmitters, cytokines and autacoids. The sensitivity of neuromuscular synapses is enhanced in diabetes, which seems to be closely associated with neuropathy as one of the diabetic complications. beta-Eudesmol found in Atractylodes lancea rhizome has a desensitizing channel blocking action to nicotinic acetylcholine receptors, anti-angiogenic action in vascular endothelium, and neuronal differentiation actions. These multiple pharmacological actions are favorable for treating angiogenic diseases possibly including the complications of diabetes, namely, retinopathy and nephropathy, and cancer. 3) Nipradilol is clinically utilized as a topical antiglaucoma drug. The ocular hypotensive effects of this compound are brought about by its alpha1 and beta-adrenergic receptor blocking actions, and nitric oxide (NO) releasing action. NO directly activates cyclooxygenases. All these pharmacologic effects are beneficial for treating glaucoma. The selectivity and specificity of drug action are required for treating acute diseases, infections or for acting as useful reagents. The pleiotropic actions of natural compounds and their derivatives serve as important clues for developing new drugs for various chronic diseases.
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PMID:Medical benefits of using natural compounds and their derivatives having multiple pharmacological actions. 1650 37

We evaluated morphological changes in several pathologies using computerized videocapillaroscopy, and related hemorheological patterns using the laser assisted optical rotational red cell analyzer (LORCA). In addition, tissue oxygenation was measured using two oximeters with Combi sensors (Periflux 5000, Perimed). The study included four groups of patients (pts) that were compared with a control group. Group A Controls (n=25: 15 males [M] and 10 females [F] aged 36 +/- 3 years); Group B Diabetic pts n=32 (IDDM pts n=20: 12 M and 8 F aged 43 +/- 4 years; NIDDM pts n=12: 6 M and 6 F aged 45 +/- 3 years); Group C Glaucoma pts n=30 (16 M and 14 F aged 42 +/- 5 years); Group D Liver failure pts n=6 (3 M and 3 F aged 44 +/- 5 years); Group E Hypertensive pts n=50 (smokers n=28: 12 M and 16 F aged 40 +/- 4 years, and nonsmokers n=22: 12 M and 10 F aged 38 +/- 3 years). In all patients hemorheological measurements were made using the LORCA (including red blood cell [RBC] deformability and aggregability), morphology was evaluated using computerized videocapillaroscopy (magnification 200 x), and transcutaneous oxygen partial pressure measurements (TcpO2) were made with the Periflux 5000. In patients with diabetic microangiopathy: the capillary loops in 50% (16/32) of these pts showed formations such as 'deer horns', 72% (23/32) showed formations such as 'elephant nose', and in 45% (14/32) formations such as a 'cork screw'; in diabetics with POAD an important capillary rarefaction was found in 26% (9/32) of the pts. In glaucoma patients, in 84% (25/30) we observed 'capillary meandering' and images such as 'a comb'. In patients with more complicated pathology capillary rarefaction was found in 70% (21/30) of the patients. An improvement in the perfusion of non-functional loops was found in deceased patients who had suffered liver failure one week after liver transplantation in 90% (5/6) of the studied cadavers. In non-smoking hypertensives morphological changes were found in 25% (6/22) of the patients, and in hypertensive smokers in 47% (13/28). RBC deformability was detected using LORCA and expressed as the Elongation Index (EI), and RBC aggregability was detected using LORCA and expressed in t 1/2 (seconds) indicating the RBC aggregability peak. Group A controls: EI 0.59 +/- 0.02; t 1/2 3 +/- 1 sec; Group B: IDDM EI 0.55 +/- 0.01; t 1/2 : 2 +/- 0.5 sec p < 0.05; NIDDM EI 0.56 +/- 0.01; t 1/2 2 +/- 0.2 sec p < 0.04; Group C glaucoma: EI 0.56 +/- 0.01; t 1/2 2 +/- 0.3 sec p < 0.05; Group D liver failure: EI 0.56 0.02; t 1/2 2 +/- 0.4 sec p < 0.03; Group E hypertensives: smokers EI 0.56 +/- 0.02; t 1/2 2 +/- 0.6 sec p < 0.04; non-smokers EI 0.57 +/- 0.02; t 1/2 2 +/- 0.6 sec p < 0.04 compared with controls. We also measured the TcpO2 at the dorsum of the right foot as a standard site representing peripheral control of microvasculature perfusion. Group A 96 +/- 11 mmHg; Group B IDDM 74 +/- 9 mmHg p < 0.05; NIDDM 76 +/- 8 mmHg p < 0.05; Group C glaucoma 75 +/- 9 mmHg p < 0.05; Group D liver failure 69 +/- 6 mmHg p < 0.05; Group E hypertensives: smokers 70 +/- 5 mmHg p < 0.05, non-smokers 77 +/- 9 mmHg p < 0.05 compared with controls. This study presents an interesting and complete methodology to evaluate the microcirculation in different pathologies that induce changes in the microvasculature.
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PMID:Hemorheological aspects in the microvasculature of several pathologies. 1772 41


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