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

Peripheral nerve involvement is a frequent complication of type 1 and type 2 diabetes, and can induce major disability. Almost all types of clinical or electrophysiological disturbances may be present: mononeuropathy involving cranial nerves or a limb; multiple mononeuropathy; proximal acute radiculopathy; distal, symmetric, sensory polyneuropathy; autonomic neuropathy. Physiopathology intricates probably several mechanisms but metabolic dysregulation and ischemia are mainly involved. Despite numerous controlled clinical trials no treatment has demonstrated efficacy for peripheral neuropathy, excepting the optimization of diabetes equilibrium. However, symptomatic treatments are available, particularly for the management of neuropathic pain.
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PMID:[Diabetic neuropathies]. 1179 22

The insulinotropic hormone glucagon-like peptide-1 (7-36)-amide (GLP-1) has potent effects on glucose-dependent insulin secretion, insulin gene expression, and pancreatic islet cell formation and is presently in clinical trials as a therapy for type 2 diabetes mellitus. We report on the effects of GLP-1 and two of its long-acting analogs, exendin-4 and exendin-4 WOT, on neuronal proliferation and differentiation, and on the metabolism of two neuronal proteins in the rat pheochromocytoma (PC12) cell line, which has been shown to express the GLP-1 receptor. We observed that GLP-1 and exendin-4 induced neurite outgrowth in a manner similar to nerve growth factor (NGF), which was reversed by coincubation with the selective GLP-1 receptor antagonist exendin (9-39). Furthermore, exendin-4 could promote NGF-initiated differentiation and may rescue degenerating cells after NGF-mediated withdrawal. These effects were induced in the absence of cellular dysfunction and toxicity as quantitatively measured by 3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and lactate dehydrogenase assays, respectively. Our findings suggest that such peptides may be used in reversing or halting the neurodegenerative process observed in neurodegenerative diseases, such as the peripheral neuropathy associated with type 2 diabetes mellitus and Alzheimer's and Parkinson's diseases. Due to its novel twin action, GLP-1 and exendin-4 have therapeutic potential for the treatment of diabetic peripheral neuropathy and these central nervous system disorders.
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PMID:A novel neurotrophic property of glucagon-like peptide 1: a promoter of nerve growth factor-mediated differentiation in PC12 cells. 1186 4

Although peripheral neuropathies are commonly observed in patients with non-Hodgkin's malignant lymphomas (NHML), Guillain-Barre syndrome (GBS) belongs to the occasional complications of lymphoproliferative disorders. It appears in less than 0.3 per cent of NHML. It is worthy of note that in the reported case there occurred three independent risk factors of peripheral neuropathy: Burkitt's lymphoma, chemotherapy and type 2 diabetes mellitus. Based on clinical course, EMG finding and neuropathological examination, in spite of normal cerebrospinal fluid protein content, GBS as a paraneoplastic disorder was diagnosed. It was assumed that chemotherapy and diabetes mellitus conduced to severe neuropathy.
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PMID:Guillain-Barre syndrome in patient with Burkitt's lymphoma and type 2 diabetes mellitus. 1192 1

This report presents the results of a systematic review of the effectiveness and economic efficiency of disease management and case management for people with diabetes and forms the basis for recommendations by the Task Force on Community Preventive Services on the use of these two interventions. Evidence supports the effectiveness of disease management on glycemic control; on screening for diabetic retinopathy, foot lesions and peripheral neuropathy, and proteinuria; and on the monitoring of lipid concentrations. This evidence is applicable to adults with diabetes in managed care organizations and community clinics in the United States and Europe. Case management is effective in improving both glycemic control and provider monitoring of glycemic control. This evidence is applicable primarily in the U.S. managed care setting for adults with type 2 diabetes. Case management is effective both when delivered in conjunction with disease management and when delivered with one or more additional educational, reminder, or support interventions.
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PMID:The effectiveness of disease and case management for people with diabetes. A systematic review. 1198 33

Bimoclomol (BML), a symptomatic antidiabetic agent, has been developed by Biorex R & D Co. to treat diabetic neuropathy and retinopathy. BRX-220, an orally active member of the BRX family, has been developed to treat diabetic complications and insulin resistance (IR) as a follow-up compound. The effect of BRX-220 on peripheral neuropathy was examined in rats with diabetes (type 1) induced by administration of a beta-cell toxin, streptozotocin (STZ, 45 mg/kg iv). Nerve functions were evaluated by electrophysiological measurements of muscle motor and sensory nerve conduction velocities (MNCV and SNCV, respectively). MNCV and SNCV decreased in diabetic rats by 25% (p < 0.001). A 1-month preventive treatment with BRX-220 (2.5, 5, 10, and 20 mg/kg po) dose-dependently improved diabetes-related deficits in MNCV (51.3%, 71.3%, 86.1%, and 91.3%) and SNCV (48.9%, 68.5%, 86.1%, and 93.2%). Insulin sensitivity was measured using the insulin tolerance test (ITT), both in STZ diabetic and in Zucker diabetic fatty (ZDF) rats (model of type 2 diabetes). Severe IR was detected in STZ diabetic and ZDF rats. This resistance was significantly (p < 0.05) reduced by BRX-220 treatment.
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PMID:Effect of BRX-220 against peripheral neuropathy and insulin resistance in diabetic rat models. 1207 78

To investigate the influence of the succinic acid treatment on geriatric patients with type 2 diabetes. Succinic Acid has some positive biological properties. One of its is a neglecting of an aerobic glycolysis. In this study we evaluated the efficacy of the combination of the succinic acid ("MITOMIN") on treating of diabetic neuropathy of geriatric patients with type 2 diabetes. The analysis was carried out using 26 patients (aged 60-76 years). The duration of diabetes was 9.15 +/- 1.43 years. Biomedical parameters were measured by standard methods; microalbuminuria was measured by "Micral-Test". Quality of life (psychosocial disorders) was estimated with the help of "SANDOZ"-scale for geriatric assessment. The therapy was assigned 1.5 g of mitomin per day during a month. All patients were examined on having late diabetic complications: 7.69%--had diabetic retinopathy; 11.54%--diabetic nephropathy; 73.08%--diabetic neuropathy; 46.15%--chronic failure of brain vessels; 11.5%--macroangiopathy of lower extremities and 100%--had ischeamic heart disease of different levels. Mitomin therapy improved basal and postprandial glycemic control (NS), variance of pallesthesia (p < 0.001), parameters of quality of life, i.e. depression (p < 0.001), anxiety (p < 0.01), short memory (p < 0.05) and emotionality (p < 0.001). Mitomin therapy plays a positive role in management of elderly patients with type 2 diabetes. It improves glycemic control, pallestesia and quality of life. Combination of succinic acid renders central and peripheral neuropathy protective efficacy.
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PMID:[Diabetes mellitus in the elderly: succinic acid compounds in treating diabetic neuropathies]. 1209 44

The study investigated whether the effects of dermal replacement therapy on wound healing are associated with an increase in blood flow at the base of diabetic foot ulcers treated with Dermagraft. Seven full-thickness ulcers were assessed in five patients with type 2 diabetes mellitus and peripheral neuropathy. All lesions had been present for at least 3 months with no recent change in size, despite routine foot care and protective dressings. Dermal replacement therapy was applied weekly to the base of each wound for 8 weeks, after which regular dressing was resumed. Microvascular blood flow was assessed using laser Doppler imaging immediately before and after 2, 5, and 8 weeks of treatment. Blood flow increased by an average of 72% in the base of five out of the seven ulcers studied. Five of the lesions healed by 12 weeks and the other two reduced in size by approximately 25%. The changes in blood flow observed in this pilot study might reflect angiogenesis in the newly formed granulation tissue and/or vasodilatation of existing vessels, processes that are possibly enhanced by the intervention.
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PMID:Blood flow changes in diabetic foot ulcers treated with dermal replacement therapy. 1219 13

Non-insulin-dependent diabetes mellitus (NIDDM) is considered to predispose impaired gallbladder function and an increased prevalence of gallbladder disease. The aim of this study was to evaluate the gallbladder function of patients with NIDDM by quantitative technetium-99m-labeled imino-diacetic acid analogue (Tc-99m DISIDA) cholescintigraphy. One hundred and forty-five NIDDM patients (100 males, 45 females; age: 58.7+/-9.5 years) with the absence of autonomic or peripheral neuropathy and without gallbladder or liver disorders were enrolled in this study. The patients were categorized by blood sugar control (HbA(1c)> or =10% as a poor blood sugar control group and HbA(1c)<10% as a good blood sugar control group) and disease duration (diabetic duration > or =10 years as a longer-duration group and diabetic duration <10 years as a shorter-duration group). In addition, 60 normal controls (38 males, 22 females; age: 59.1+/-10.2 years) were also studied for comparison. All NIDDM patients and normal controls underwent Tc-99m DISIDA cholescintigraphy, and the filling fraction (FF) and ejection fraction (EF) of gallbladder were calculated. The results showed significant difference between (1) NIDDM patients versus normal controls in FF and EF, (2) poor versus good blood sugar control of NIDDM patients in FF and EF, and (3) longer versus shorter disease duration of NIDDM patients in FF and EF. Our study, including a large number of subjects, showed that gallbladder function of patients with NIDDM is more impaired than the normal controls; and impaired gallbladder function in NIDDM patients is related to disease duration and blood sugar control.
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PMID:Evidence of impaired gallbladder function in patients with non-insulin-dependent diabetes mellitus by quantitative cholescintigraphy. 1220 79

Type 2 diabetes is the most common form of diabetes in the United States and is associated with significant long-term morbidity and increased mortality. Patients with diabetes are at much higher risk for development of both microvascular and macrovascular complications, including peripheral neuropathy, nephropathy, ophthalmic abnormalities, and cardiovascular disease. Not surprisingly, direct and indirect healthcare costs associated with diabetes totaled $98 billion in 1997. Studies have shown that improving glycemic control leads to reductions in healthcare utilization and a decrease in overall costs. Notably, early and aggressive treatment may delay or even prevent many of the complications associated with diabetes, leading to improved quality of life and reduced expenditures in patients with type 2 diabetes. This article will provide a review of recent findings on the impact of diabetes on healthcare costs.
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PMID:Long-term consequences of type 2 diabetes mellitus: economic impact on society and managed care. 1240 7

Thirty-eight patients of NIDDM, 12 of IDDM and 10 healthy age matched controls were subjected to seven standardised autonomic reflex function tests. A scoring criteria was utilised for diagnosing and grading the severity of dysautonomia. Eight patients of IDDM and 24 of NIDDM had dysautonomia. One-third of the patients in each group had grade IV autonomic dysfunction. Severity of autonomic dysfunction was directly related to the duration of disease in NIDDM whereas in IDDM this relation was not seen. Peripheral neuropathy was almost always associated with dysautonomia in NIDDM. On the contrary, in IDDM dysautonomia was independent of peripheral neuropathy. Charcot's arthopathy, dysphagia, constipation and nocturnal diarrhea were always associated with evidence of dysautonomia. Other symptoms viz. gustatory sweating, postural dizziness and impotence did not necessarily indicate dysautonomia.
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PMID:Clinical dysautonomia in diabetes mellitus--a study with seven autonomic reflex function tests. 1252 Oct 82


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