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

We evaluated the prevalence of peripheral neuropathy by clinical and electrophysiological criteria and the prevalence of autonomic parasympathetic nerve dysfunction by heart-rate variation during deep breathing (expiration-to-inspiration ratio [E:1]) in 132 newly diagnosed non-insulin-dependent diabetic (NIDDM) subjects aged 45-64 yr and 142 randomly selected nondiabetic control subjects. The relationship of nerve dysfunction to the degree of hyperglycemia and insulin-secretion capacity were also investigated. Single and scattered symptoms and signs of peripheral neuropathy were found in both diabetic and control subjects. Symptomatic polyneuropathy was found in 1.5% of diabetic subjects but none of the control subjects. Polyneuropathy defined by clinical signs was found in 2.3% of the diabetic subjects and 1.4% of the control subjects. No subjects with both symptoms and signs were seen. Nerve conduction velocities (NCVs) were significantly slower in diabetic than control subjects. Polyneuropathy according to electrophysiological criteria was found in 15.2% of diabetic subjects but was not found in any control subjects. Electromyographic abnormalities were more common in diabetic than control women, but not significant differences were found in men. The resting heart rate was higher in diabetic than control women, but no significant difference was found in men. The mean E:I was significantly lower in diabetic men and women than control men and women. An abnormally low E:I was found in 9.2% of the diabetic men, 3.3% of the control men, 3.3% of the diabetic women, and none of the control women. NCV parameters, but not E:I, were inversely correlated with fasting blood glucose and glycosylated hemoglobin levels. A positive correlation between NCV and fasting and postglucose serum insulin levels was found in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Prevalence of neuropathy in newly diagnosed NIDDM and nondiabetic control subjects. 255 61

To investigate whether pain and paresthesias could identify two different subclasses of small-fibre diabetic neuropathy, and to evaluate their relation to the metabolic control, we tested nerve conduction velocity (NCV) of median nerve (sensitive-SM, and motor-MM) and deep peroneal nerve (DP) in 48 diabetics (24 IDDM, 24 NIDDM) reporting pain (group A) or paresthesias (group B) that might be due to diabetic polyneuropathy. Glycated haemoglobin (HbA1c) was also assessed. No difference between group A and group B was found either in NCV, in all nerves tested, or in HbA1c. No relation was observed between NCV of nerves tested and HbA1c, duration of diabetes, age and type of diabetes in both groups.
 ...
PMID:Neuroelectric procedure does not discriminate between painful and paresthetic diabetic neuropathy. 273 2

Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease) is characterized by chronic degeneration of peripheral nerves and roots, resulting in distal muscle atrophy, beginning in the feet and legs and later involving the hands. The association of this disease with diaphragmatic dysfunction has not been reported. We studied a patient with hereditary motor and sensory neuropathy type 1 (Charcot-Marie-Tooth disease) and type 2 diabetes mellitus who had severe diaphragmatic impairment. Some of the clinical findings are similar to the sleep apnea syndrome, which could lead to incorrect diagnosis and delay in the administration of appropriate therapy. Transdiaphragmatic pressure studies on the subject's brother, who also has Charcot-Marie-Tooth disease and type 2 diabetes mellitus, revealed subclinical impairment of diaphragmatic function. These findings suggest that phrenic nerve involvement may be part of the spectrum of polyneuropathy in Charcot-Marie-Tooth disease in association with diabetes mellitus.
 ...
PMID:Diaphragmatic dysfunction in siblings with hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease). 382 50

Insulin resistance of skeletal muscle glucose uptake is a prominent feature of Type II diabetes (NIDDM); therefore pharmacological interventions should aim to improve insulin sensitivity. Alpha-lipoic acid (CAS 62-46-4, thioctic acid, ALA), a natural occurring compound frequently used for treatment of diabetic polyneuropathy, enhances glucose utilization in various experimental models. To see whether this compound also augments insulin mediated glucose disposal in NIDDM, 13 patients received either ALA (1000 mg/Thioctacid/500 ml NaCl, n = 7) or vehicle only (500 ml NaCl, n = 6) during a glucose-clamp study. Both groups were comparable in age, body-mass index and duration of diabetes and had a similar degree of insulin resistance at baseline. Acute parenteral administration of ALA resulted in a significant increase of insulin-stimulated glucose disposal; metabolic clearance rate (MCR) for glucose rose by about 50% (3.76 ml/kg/min = pre vs. 5.82 ml/kg/min = post, p < 0.05), whereas the control group did not show any significant change (3.57 ml/kg/min = pre vs. 3.91 ml/kg/min = post). This is the first clinical study to show that alpha-lipoic acid increases insulin stimulated glucose disposal in NIDDM. The mode of action of ALA and its potential use as an antihyperglycemic agent require further investigation.
 ...
PMID:Enhancement of glucose disposal in patients with type 2 diabetes by alpha-lipoic acid. 757 50

We recorded median nerve action potentials in 40 healthy individuals and 40 patients with type II diabetes mellitus by means of microneurography. The latter group included 20 patients complicated by dysesthesia of distal extremities (mean diabetic history: 12.4 years), and another 20 patients without dysesthesia (mean diabetic history; 5.5 years). Mean age of each group was about 60 years old and had no significant difference among three groups. Patients and healthy controls gave an informed consent for participation in this study. A tungsten microelectrode with a tip diameter of about 1 micron was inserted percutaneously into the median nerve trunk at elbow without anesthesia. With supramaximal electric stimulation on the median nerve at wrist, the largest compound nerve action potential was recorded. In healthy controls the median nerve action potential showed a large triphasic wave (positive-negative-positive, 400 microV in average amplitude) followed by small multiphasic waves. In diabetics maximal conduction velocity (NCV) and amplitude of this triphasic wave (Amp) were decreased and multiphasic waves became more prominent. Reproducibility of potentials in the same subject was acceptable. The differences among three groups were most conspicuous in Amp, and the amplitude of the multiphasic wave was increased in diabetic patients with dysesthesia. Thus, the diminution of Amp appeared to be associated with temporal dispersion due to segmental demyelination. In diabetic polyneuropathy NCV and Amp decreased along with the disease progression; in patients with advanced disease and subjective symptoms, small Amp and prominent multiphasic waves became apparent.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Electrophysiological analysis of diabetic polyneuropathy with microneuronography]. 837 Jan 98

A total of 40 patients with diabetes mellitus without anginal episodes and equivalents were studied. 24-hour monitoring identified 2 groups of patients: (1) 13 patients with recorded silent myocardial ischemic episodes and (2) 23 patients without episodes. Four patients were found to have stress-echocardiographic silent myocardial ischemia. Silent myocardial ischemia was detected in 42.5% of patients with diabetes mellitus. The patients from Group 1 exhibited more frequently Type II diabetes mellitus whose duration was over 9 years and concurrent retino- and polyneuropathies. There was a relationship between silent myocardial ischemia to heart failure and myocardial hypertrophy as evidenced by two-dimensional echocardiography. The patients from Group 1 had a higher pain sensitivity threshold than those from Group 2. Autonomic polyneuropathy was observed in 46% of Group 1 patients and in 21% of Group 2 patients.
 ...
PMID:[Silent myocardial ischemia in patients with diabetes mellitus without the clinical manifestations of ischemic heart disease]. 837 56

Although the detailed pathogenesis of diabetic polyneuropathy is not known, several mechanisms appear to be involved and may occur sequentially. Hence, the early and much researched activation of the polyol-pathway appears to secondarily affect nonenzymatic glycation, perturbation of vasoactive substances, the immune system and neurotrophism. These metabolic abnormalities may be differentially expressed in the neuropathy occurring in insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) diabetes. This notion is supported by differences in the structural abnormalities of the neuropathies in the two types of diabetes. Distinct and characteristic nodal changes occur in IDDM but not in NIDDM neuropathy, which also shows a milder axonal atrophy. On the other hand, nerve fiber loss which characterizes diabetic neuropathy tends to be focal in the older NIDDM patients, suggesting a more prominent vascular genesis. A further characteristic feature of diabetic neuropathy is blunted fiber regeneration, which probably is consequent to impairments of the necessary immune response and local synthesis of neurotrophic factors. Nerve biopsies from diabetic patients, although not necessary for diagnosis, provide valuable tissue for biochemical and molecular analysis of underlying mechanisms, the detailed elucidation of which will facilitate the design of targeted therapies.
 ...
PMID:Neuropathology of diabetic neuropathy and its correlations with neurophysiology. 935 80

Thirty patients with juvenile insulin dependent diabetes mellitus (IDDM) were electrophysiologically evaluated. In addition to the conventional motor and sensory nerve conduction studies, intrafascicular microneurography was performed in the median nerve. In this method a tungsten microelectrode was inserted into the median nerve trunk at the elbow, and a compound nerve action potential (CNAP) was recorded with supramaximal electrical stimulation at the wrist. The subjects' age ranged from 8 to 31 years with an average (SD) of 15.4 (6.2) years; the disease duration varied from 1 to 23 years with an average (SD) of 8.3 (5.8) years. Polyneuropathy index (PNI), expressed as a mean percentage of the normal for twelve indices over the four nerves obtained by motor conduction studies, was 93.9% on the average in patients with IDDM. The mean amplitude of CNAP obtained by intrafascicular microneurography was 417 microV. These results indicate that neuropathy in IDDM is milder than that in adult non-insulin dependent diabetes mellitus (NIDDM). The mean value of PNI decreased at a rate of 0.56% per year; the mean glycosylated hemoglobin (A1c) level was as high as 8.2 +/- 0.9%, findings consistent with those of the previous analysis of adult patients with NIDDM. The PNI value had a significant negative correlation with the duration of diabetes mellitus (p < 0.001) and with mean glycosylated hemoglobin (A1c) level (p < 0.01). CNAP amplitude had a tendency to correlate with duration of diabetes mellitus (p < 0.1). In patients with IDDM we can tell exactly when the disease occurred. Progression of neuropathy in juvenile IDDM was identical to that of adult NIDDM. Careful management of diabetes mellitus is of importance to prevent the progression of neuropathy.
 ...
PMID:[Electrophysiological evaluation of polyneuropathy in juvenile insulin dependent diabetics]. 939 28

We describe six patients with non-insulin dependent (Type 2) diabetes mellitus (NIDDM) and thermal foot injury admitted to the Burn Centre in Rotterdam. They were all male with a mean age of 56.8 (range 47-63) years. The median patients' delay before admission was 27 (range 1-56) days. Five patients needed amputation. Healing of the wounds took a mean period of 9.5 (range 2-27) months. In two patients healing of the wounds took more than 1 year; these two patients also had recurrent foot burns. Neurological evaluation in four patients confirmed severe polyneuropathy and severe loss of heat pain, warmth, and cold sensation.
 ...
PMID:Diabetic patients with foot burns. 945 38

The effects of the aldose reductase inhibitor epalrestat (150 mg/day) on electrophysiological function were examined in 22 NIDDM patients with diabetic polyneuropathy for 6 months. Although no significant differences were observed in sensory (the sural nerve) or motor (the posterior tibial nerve) conduction velocities and amplitude, only F wave conduction velocities were significantly improved at 3 and 6 months after the treatment. There were no significant changes in CV-RR, vibration threshold and laboratory data. No serious side effects were observed during the therapeutic trial. This study suggests F wave is appropriate for the assessment of diabetic neuropathy and for therapeutic trials.
 ...
PMID:[Effects of the aldose reductase inhibitor on diabetic polyneuropathy--the efficacy of F wave measurement]. 978 4


1 2 3 4 5 6 7 8 9 10 Next >>