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Query: UMLS:C0011860 (
type 2 diabetes
)
57,723
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Nearly 50% of individuals with
type II diabetes mellitus
are over the age of 65 years. There are numerous reasons to maintain blood glucose levels below 11.1 nmol/L (200 mg/dl) in older persons, and there are a number of changes often seen with advancing age that persons, and there are a number of changes often seen with advancing age that may interfere with the management of diabetes mellitus, e.g. hypodipsia, anorexia, visual disturbance, altered renal and hepatic function, depression, impaired basoreceptor response and multiple medications. Hyperglycaemia appears to produce cognitive impairment which may lead to poor compliance. It is often difficult to manipulate diet in older people, and in fact dietary changes can lead to severe protein energy
malnutrition
. High maximum voluntary oxygen intake has been correlated with increased glucose disposal, but there is little evidence that physical exercise can improve diabetic control in the elderly. Oral sulphonylurea hypoglycaemic agents are extremely useful in the treatment of diabetes in these patients, but it should be remembered that they are more liable to develop hypoglycaemia than are younger diabetics. The role of metformin in the management of older diabetic patients is poorly studied. Many older persons can cope well with insulin therapy, but those with visual disturbances often make errors when drawing up insulin and require special attention. Combination therapy of insulin with oral hypoglycaemic agents is not recommended in this group of patients, and serum fructosamine is preferred to glycated haemoglobin to monitor control. Successful management of elderly diabetic patients thus requires an interdisciplinary team approach.
...
PMID:The management of diabetes mellitus in older individuals. 171 59
In developing countries diabetics frequently suffer from varying grades of
malnutrition
. The combined effect of
malnutrition
and non-insulin dependent diabetes (
NIDDM
) on the drug metabolising enzyme system has been evaluated using antipyrine as a protodrug. All the patients were under treatment and their plasma glucose values were within normal limits. The AUC of antipyrine was similar in all the groups. Although none of the kinetic parameters was altered in normal diabetics, the clearance of antipyrine was decreased and its half life was prolonged, with an increase in volume of distribution, in undernourished diabetics compared to undernourished controls. The results indicate that diabetes per se may not influence antipyrine kinetics when the blood glucose is well under control, but in the presence of undernutrition, it significantly alters the disposition of the drug.
...
PMID:Antipyrine kinetics in undernourished diabetics. 180 53
Anthropometric studies were carried out in three groups of diabetics seen in southern India, namely fibrocalculous pancreatic diabetes (FCPD) (n = 49) (a subtype of
malnutrition
related diabetes), insulin dependent diabetes mellitus (IDDM) (n = 55) and
non-insulin dependent diabetes mellitus
(
NIDDM
) (n = 104). Both FCPD and IDDM had significantly lower body mass index, skinfold thickness (triceps, biceps, subscapular and suprailiac), mid-arm circumference and fat mass compared to controls and
NIDDM
patients, (p less than 0.001 for all parameters). FCPD and IDDM males did not show any significant differences in any of the anthropometric parameters studied. Among the females, FCPD had lower triceps skinfold measurements (p = 0.007) and mid-arm circumferences (p less than 0.05) compared to IDDM patients. Patients with
NIDDM
did not show any significant difference compared to the control group. This study shows that both FCPD and IDDM patients have lower body mass and fat mass compared to
NIDDM
patients and control subjects.
...
PMID:Anthropometric studies in diabetes in the Tropics. 186 92
In this review, the relationship between hypertension and abnormal carbohydrate metabolism is explored. A review of the current literature reveals that people with hypertension are also likely to suffer from insulin resistance, glucose intolerance, and hyperinsulinemia. Likewise, hypertension is prevalent in obese and diabetic patients.
Deficiency
of insulin at the cellular level may be a common mechanism in the development of hypertension in patients with type I or
type II diabetes mellitus
. Essential hypertension appears to be an insulin-resistant state. Insulin resistance may engender hypertension by increasing peripheral vascular resistance as well as by increasing salt retention at the level of the kidney. Therefore effective antihypertensive therapy should include agents that do not adversely affect carbohydrate metabolic abnormalities. Commonly used antihypertensive agents, such as thiazide, thiazide-like diuretics, and beta-blockers, are associated with glucose intolerance and increased insulin resistance. In contrast, angiotensin-converting enzyme inhibitors, calcium antagonists, and peripheral alpha-blockers (such as prazosin and terazosin) do not adversely affect glucose tolerance or insulin sensitivity. In addition, alpha-blockers have a positive effect on the serum lipid profile. The entire multifactorial cardiac risk profile must be considered when choosing therapeutic agents for conditions that have an impact on cardiovascular disease.
...
PMID:Is hypertension an insulin-resistant state? Metabolic changes associated with hypertension and antihypertensive therapy. 187 73
The prevalence, age at diagnosis, clinical characteristics and treatment of young diabetics, younger than 40 years were determined on the basis of a cross-sectional study of medical records of 2 health districts in Pahang, Malaysia. There were only 20 insulin-dependent diabetics (IDDM), prevalence 0.07 per 1000 inhabitants. There were 84 non-insulin-dependent diabetics (
NIDDM
), prevalence 0.3 per 1000 inhabitants. Three of the
NIDDM
patients could have
malnutrition
-related diabetes. Many
NIDDM
patients were asymptomatic which is an important reason why many of them remain undetected in the community. Seventy-four percent of the patients below the age of 30 years at diagnosis had
NIDDM
, 56% of the patients below the age of 20 years at diagnosis also had
NIDDM
and 54% of the
NIDDM
patients had a strong family history of diabetes. Many
NIDDM
patients were misdiagnosed as IDDM, especially if they were underweight, leading to considerable overuse of insulin. This study confirms that IDDM is rare in Malaysia, as in other Asian countries. Most young diabetics have
NIDDM
and have a strong family history. This pattern of diabetes in the young is unlike that seen in the West.
...
PMID:Prevalence, age at diagnosis, clinical characteristics and treatment of diabetes in the young in Pahang, Malaysia. 188 50
The prevalence and clinical features of diagnosed mellitus secondary to chronic pancreatitis (CP) were assessed from northern (Hokkaido) to southern (Okinawa) Japan by means of a questionnaire to elucidate whether WHO-classified
malnutrition
-related diabetes mellitus (MRDM) exists in Japan. Of a total 17,500 diabetic patients, only two (0.011%)-one fibrocalculous pancreatic diabetes (FCPD) and one protein-deficient pancreatic diabetes (PDPD) - exhibited MRDM characteristics. A total of 649 CP were collected and classified into 268 cases with chronic alcoholic pancreatitis (CAP), 150 cases with chronic calcified pancreatitis (CCP) and 231 cases with other CP. The prevalence of diabetes mellitus was found to be 50.7% in CAP, 72.7% in CCP and 22.8% in other CP. Among all diabetics, 56.6% was noninsulin-dependent (
NIDDM
) and 26.4% insulin-dependent (IDDM). IDDM was most frequent in CP. Satisfactory and less than satisfactory glycemic control was obtained in approximately three quarters of all subjects. Only one quarter showed poor glycemic control. Insulin treatment was frequent in CAP (52.2%) and CCP (61.7%), but less in other CP (27.5%). The prevalence of diabetic retinopathy was observed in 33.1% of all subjects, nephropathy 21.0% and neuropathy 36.3%, respectively. The prevalence of complications, including macroangiopathy tended to be higher in CAP and CCP (40.3 and 56.9%) than in other CP (31.4%).
...
PMID:Prevalence and clinical features of diabetes mellitus secondary to chronic pancreatitis in Japan; a study by questionnaire. 224 5
Published "normal" values of some hormones have an excessively wide range and unequal mean values because the material on which these values are based is from subjects suffering from different diseases which only apparently are not associated with the investigated hormone, or else the specimens are obtained under non-standard conditions (
malnutrition
, stress, alcohol etc.). This wide range of normal values may hide incipient pathological processes and is not suitable even as control group. The investigation is based on the assessment of insulin, growth hormone (GH), cortisol, thyroxine (T4) and triiodothyronine (T3) in a group of blood donors. The assembled results were compared with two other groups of blood donors and a group of obese subjects. The following findings were assembled: We recommend to lower the upper borderline of "normal" insulinaemia from the recommended value of 26 to 20 i.u./l, as the original range may comprise milder forms of hyperinsulinism which is recently assumed to participate in the genesis of
type 2 diabetes
, hypertension, coronary ischemia and polycystic ovaries. Elevated normal values of serum insulin may be obtained also from blood donors who usually have breakfast before the blood is collected. The wide range of cortisolaemia is due to the diurnal rhythm. The basal value is raised by a declining blood sugar level, alcohol, obesity and of course, varying forms of stress. The upper range of cortisolaemia at 8 a.m. should not be beyond the range of 140-690 nmol/l. GH secretion is governed by an individual 3.5-hour cycle as well as changes of the blood sugar level, e. g. during the OGTT: the declining blood sugar level raises the GH level.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Factors affecting normal levels of insulin, cortisol, STH, thyroxine and triiodothyronine]. 226 67
Plasma lipid profiles--total cholesterol (TC), LDL-cholesterol, HDL-cholesterol, triglycerides and phospholipids--were studied in relation to two parameters of diabetic control (fasting blood sugar (FBS) for short-term control and glycosylated haemoglobin (HBA1C) for long-term control) in 46 diabetic patients (22 insulin-dependent (IDDM) and 24 non-insulin dependent (
NIDDM
] and 22 non-diabetic control subjects. We confirmed the positive correlation between FBS and HBA1C. All diabetic patients had significantly higher triglyceride levels (P less than 0.05) than controls, which were not influenced by degree of glycaemic control.
NIDDM
patients tended to have higher than normal TC levels (P less than 0.05). In IDDM, TC level was positively correlated with HBA1C (r = 0.37, P less than 0.05), and negative correlations were established between FBS and HDL-cholesterol (r = -0.46, P less than 0.02) and the HDL-cholesterol:TC ratio (r = -0.49, P less than 0.01), suggesting an increased atherogenic risk with poorer diabetic control. It is concluded that lipoprotein abnormalities exist in Nigerian diabetics, though not as consistently as in Caucasians. The differences may be due to, among other factors, differences in genetic make-up, diet (typical African diet being rich in plant fibre and poor in cholesterogenic nutrients) and aetiology of the diabetic state (tropical diabetes being highly heterogeneous and now thought to be linked to
malnutrition
).
...
PMID:Plasma lipid profiles in relation to diabetic control in Nigerians. 255 Nov 65
Serum magnesium was measured in 100 patients of
type II diabetes mellitus
(40 without retinopathy, 40 with non-proliferative and 20 with proliferative retinopathy) without
malnutrition
, hepatic or renal disease or albuminuria and in 100 age and sex matched controls. The serum magnesium levels were lower in diabetics than in controls (P less than 0.001), and the levels in diabetics with non-proliferative and proliferative retinopathy were significantly lower than in those without retinopathy (P less than 0.001). These data seem to point towards an association between hypomagnesemia and diabetic retinopathy.
...
PMID:Association of hypomagnesemia with diabetic retinopathy. 261 41
Diabetes mellitus is a state of absolute or relative insulin deficiency leading to hyperglycemia and profound changes in the body lipids and proteins. The World Health Organisation (WHO) classification of diabetes distinguishes between: insulin dependent diabetes mellitus (IDDM),
non-insulin dependent diabetes mellitus
(
NIDDM
) and
malnutrition
related diabetes mellitus (MRDM). In childhood the overwhelming majority is due to an autoimmune betacell disease leading to IDDM.
...
PMID:Definition and classification of diabetes. 263 89
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