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)

It is well-known that diabetic patients develop peripheral and autonomic neuropathy, and recent review has also suggested the occurrence of central pathway abnormality in diabetics. In this article, we conducted the BAEP study on 61 cases of NIDDM and 11 cases of IDDM. Peak latency, interpeak latency (IPL) and peak amplitude of BAEPs were analyzed in each case. For further correlation, the motor and sensory nerve conduction velocities of median nerve, the blood sugar, the serum HbA1c were measured. Two nondiabetic groups, age and sex matched with NIDDM and IDDM groups, were used as control. In NIDDM group, the results showed prolongation of all peak latency and IPL except peak latency of wave II and wave IV in the left side and bilateral IPL III-V. There was no statistically significant amplitude difference between NIDDM and age-matched control group. The result of IDDM group revealed prolongation of all peak latency and IPL, except the right IPL III-V. As for amplitude, waves III and V in the right side and waves I and V in the left side were reduced as compared with the age-matched young control group. There was no statistically significant difference in all peak latencies and IPLs between NIDDM and IDDM groups. In both groups of NIDDM and IDDM, the MNCV and SNCV of median nerve were significantly delayed in conduction. The prolongation of III and V peak latency had a linear correlation with their amplitude reduction. In conclusion, both peripheral and central conduction dysfunction occur in both IDDM and NIDDM patients.
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PMID:[Brainstem auditory evoked potentials in diabetes mellitus]. 131 48

24-hour ambulatory blood-pressure measurements were obtained according to criteria of the German Hypertension League in 61 non-insulin-dependent diabetic patients after admission to hospital under clinical routine conditions. 30 patients had no signs of nephropathy; 15 patients showed signs of proteinuria of more than 0.5 g/d and/or renal insufficiency, and 16 patients were on chronic hemodialysis renal replacement therapy. Despite antihypertensive therapy, the majority of NIDDM patients with nephropathy and/or dialysis therapy were hypertensive. Hypertension of non-nephropathic patients showed a better response to therapy. About 50% of all patients with nephropathy had a higher mean arterial blood pressure at night than during the daytime. In about 25% of all diabetics with nephropathy, we found, during night time, an especially pronounced increase of both systolic and diastolic blood pressure of more than 5% above the daytime values. Diabetic patients without nephropathy already show a reduced night/daytime variation of blood pressure, however, inverse circadian rhythm as a sign of prognostically non-favorable autonomic neuropathy was found almost exclusively in the nephropathic diabetic patients.
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PMID:[24-hour blood pressure measurement in type-2 diabetic patients with and without nephropathy]. 151 18

Gastric emptying time was measured by ultrasonography in 18 NIDDM patients with and without autonomic neuropathy, evaluated by cardiovascular autonomic tests and in 10 controls before and after a physiologic test meal. Six neuropathic subjects showed gastrointestinal symptoms such as fullness and early satiety. Blood glucose, gastrin and pancreatic polypeptide were evaluated before and up to 200 min after the test meal. The gastric emptying rate was similar in controls (275 +/- 45 min) and in diabetic patients without (260 +/- 49 min) and with autonomic neuropathy (257 +/- 48 min) (p = ns), while diabetic symptomatics showed a significant reduction of gastric emptying rate (420 +/- 19.7 min) (p less than 0.001). Basal serum glucose concentration was similar in all diabetic patients (132 +/- 18 mg/dl, 166 +/- 52 mg/dl, 161 +/- 61 mg/dl, p = ns). A basal value of serum gastrin was similar in all groups while the test meal produced a rise with a peak at 40' significantly higher only in symptomatics (195 +/- 58 pg/ml vs control 107 +/- 88 pg/ml, diabetics without and with autonomic neuropathy: 98 +/- 12 pg/ml and 88 +/- 22 pg/ml respectively; p less than 0.01). Basal and stimulated PP values were similar in all groups. In conclusion ultrasonography is a simple, reliable method to evaluate gastric emptying rate without any interference in the mechanism of digestion and absorption of nutrients. The presence of non specific symptoms, such as nausea and gastric fullness, may indicate an early gastric involvement as supported by sonographic evidence of impaired emptying.
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PMID:Gastric emptying rate and hormonal response in type II diabetics. 181 17

Type II (noninsulin-dependent) diabetes (NIDDM) can be preceded by a relatively long period of disturbed glucose metabolism. Therefore, the prevalence of neuropathy and its possible relationship to metabolic abnormalities were investigated in 95 newly diagnosed type II diabetics (upper age limit was set at 55 years) with a mean age of 49.7 years (men/women ratio 1:1). The study program was as follows: Detailed history, clinical investigation of peripheral nerves, sensory assessment to touch and pain (pinprick), vibration sensation using established techniques, and motor nerve conduction velocities (MNCV) of the fibular (peroneal) and ulnar nerves. Three cardiovascular autonomic function tests were performed: the Valsalva maneuver, standing (ratio between RR-intervalmax: RR-intervalmin), and deep breathing (maximum/minimum heart rate). Vascular diseases were diagnosed using a conventional 12-lead resting electrocardiogram (ECG) and impedance measurement of the lower extremities. The results were as follows: abnormal vibration sensation in 80.0%, abnormalities of MNCV in 15.7%, abnormal sensations to touch or pinprick in 14.7%, and loss of reflexes in 13.6%. If peripheral neuropathy was defined as having at least three of the four abnormalities plus neuropathic symptoms, the prevalence was 6.3% (6 of 95 patients). Abnormalities of the three cardiovascular autonomic function tests were much less prevalent in type II diabetic patients (2.1-7.3%). In conclusion, the study showed that peripheral and autonomic neuropathy is not common at diagnosis in middle-aged type II diabetic patients without signs of microvascular or macrovascular complications.
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PMID:Prevalence of peripheral and autonomic neuropathy in newly diagnosed type II (noninsulin-dependent) diabetes. 183 Mar 12

To assess the prevalence of autonomic neuropathy (AN) in non-insulin dependent diabetes mellitus (NIDDM) and its relationships with other diabetic complications, duration of diabetes, and obesity, we evaluated 51 NIDDM patients (age 41-59 years, mean 49 years, duration of diabetes 0-15 years, mean 6.9 years). AN tests included a deep breathing test (E/I ratio) and an orthostatic tilt table test (acceleration and brake (25 of 51, 49%) and the most frequent disturbance was an impaired E/I ratio (18 of 25; 72%). There were no obvious correlations between AN indices and the duration of diabetes, symptoms of AN, peripheral neuropathy or retinopathy. However, an influence of obesity on AN was suggested. Patients with AN showed a significantly higher BMI than patients without AN (31.0 +/- 0.9 vs. 27.5 +/- 0.8; P less than 0.01).
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PMID:Autonomic neuropathy in non-insulin dependent (type II) diabetes mellitus. Possible influence of obesity. 240 80

The retinal vessel calibre responses to systemic sympathetic stimulation, were studied in 22 randomly selected diabetic patients (mean age +/- SEM: 54.7 +/- 2.59 years, range 25-73; 13 IDDM, 9 NIDDM; 4 females), using sustained isometric muscle contraction as the stimulus. At a different session the integrity of the autonomic nerve function in these diabetic patients was assessed using 3 standard tests of autonomic nerve function, based on cardiovascular reflexes. Diabetic patients with an intact autonomic nervous system: Group 1, (n = 11, mean age: 54.9 +/- 4.55 years, 7 IDDM 4 NIDDM) showed a mean arteriolar constriction of 9.2% (SEM 2.89, p less than 0.01) and a mean venule constriction of 5.1% (SEM 1.73, p less than 0.02), for a mean rise in diastolic blood pressure of 23.7 mmHg (SEM 2.19 range: 13-33). There were no significant mean retinal vessel responses however, in diabetics with autonomic dysfunction (Group 2): mean arteriolar constriction of 1.2% (SEM 1.38 p greater than 0.05) and venule constriction of 2.1% (SEM 1.38, p greater than 0.05); for a mean rise in diastolic blood pressure of 19.8 mmHg (SEM 4.49, range: 2-50). There was no correlation between the rise in diastolic blood pressure and the retinal arteriolar constriction in the 2 groups (Group 1:r = 0.45, p greater than 0.01 and Group 2: r = 0.56, p greater than 0.05). Duration, type and control of diabetes were not significantly different between the 2 groups. The severity of retinopathy was slightly worse in Group 2 compared to Group 1. These results point to an association between autonomic neuropathy and failure of regulation of retinal blood flow.
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PMID:Responses of the retinal circulation to systemic autonomic stimulation in diabetes mellitus. 259 97

Fourteen diabetic patients (13 males, 1 female, 7 IDDM and 7 NIDDM) were tested during wakefulness with a battery of tests examining parasympathetic and sympathetic control of the cardiovascular system. Subsequently sleep recordings including EEG, EOG, submental, left and right anterior tibialis EMGs, ECG, nasal airflow, thoracic and abdominal respirograms, nocturnal penile tumescence, were performed in each subject. The assessment of cardiovascular functions during sleep was based on the following parameters: Rbm, R-wake, apnea index, adequate penile tumescence during phase REM. Parasympathetic and sympathetic control of cardiovascular system were both impaired during wakefulness in only one patient, who also showed a low Rbm index indicative of ascertained autonomic neuropathy. Indices Rbm sufficiently low to be considered an evidence of probable autonomic neuropathy were found in 5 patients (3 IDDM and 2 NIDDM); all but one with normal cardiovascular tests during wakefulness. Five patients showed gross deficiency upon nocturnal penile tumescence monitoring. In comparison with a control group the patients showed a significantly lower overall Rbm index (p less than 0.001). IDDM patients showed an increased plasma GH response to insulin-induced hypoglycemia compared to NIDDM and normal subjects. Increased GH secretion was furthermore confirmed by GH values obtained in blood samples drawn during the first REM stage of the night in IDDM patients. The evaluation of the variables taken into consideration during sleep appears to be crucial for the assessment and prevention of autonomic neuropathies and neuroendocrine dysregulation in diabetic patients.
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PMID:Wake and sleep cardiovascular reflex tests and GH profiles in diabetic patients. 261 29

24-hour continuous electrocardiographic ECG monitoring and standardized tests were performed to detect cardiac autonomic neuropathy in diabetic patients. Thirty-eight patients, with a mean duration of diabetes of 10 years, twenty-five IDDM and thirteen NIDDM, and thirty-two controls, with no illness or treatment which could alter the heart rate (HR), were studied. Five standardized tests were performed. Three tests investigated parasympathetic function: variations of HR during Valsalva manoeuvre, deep breathing and standing. The other two tests investigated sympathetic function: detection of orthostatic hypotension and blood pressure response to sustained handgrip. Parasympathetic HR control was impaired in twenty-nine patients, together with impaired sympathetic cardiovascular control in seven. According to the 6 indices studied, 24-hour ECG monitoring detected abnormalities in only eight patients. Mean minimum 24-hour HR and mean sleeping HR were elevated in the group of patients whose five standardized tests were normal and in the group of patients with impairment of both parasympathetic and sympathetic cardiovascular control, but not in the group of patients with only impaired parasympathetic HR control. This study suggests that 24-hour ECG monitoring is a less sensitive test of cardiac autonomic neuropathy than standardized tests. Moreover, it shows HR abnormalities that are not specific to cardiac autonomic neuropathy.
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PMID:[Comparative value of 24-hour ECG monitoring and standardized maneuvers in the detection and exploration of cardiac autonomic neuropathy in diabetics]. 360 22

Heart rate variability (HRV) during deep breathing was studied with a neonatal heart monitor in 143 control subjects and 218 patients with diabetes (102 with IDDM and 116 with NIDDM). In the control group HRV decreased after age 20 by 4-5 beats per decade (from 29.7 +/- 5.8 beats at age 20-29 to 11.8 +/- 5.4 beats at age 60+). In all age groups HRV in IDDM was lower than in the controls, and both age and duration of diabetes played a role in the decrease of HRV (from 21.5 +/- 5.3 beats at age 20-29 to 6.3 +/- 5.4 at age 60+). In NIDDM aging seemed to play a less important role, and the influence of the duration of the disease was not statistically significant. In both groups of patients the frequency of HRV below the 2.5th percentile was 82% in those with symptoms and/or signs of autonomic neuropathy, 64% in patients with peripheral neuropathy only, and 36% in those who had no obvious signs or symptoms of neuropathy. Interindividual variability was pronounced, and age and duration of the disease together accounted for only 36% of the observed differences between IDDM and the controls. Determination of HRV with a standard neonatal heart monitor presents an easy, simple, and nonstressful test of cardiac autonomic neuropathy. The norms of the test are age related.
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PMID:Heart rate variability in diabetes: relationship to age and duration of the disease. 397 50

Disturbed gastric and small intestinal motility is an often overlooked clinical problem. Delayed gastric emptying of liquid and/or solid food in patients with type 1 and type 2 diabetes (gastroparesis diabeticorum) occurs in approximately 50% of the patients. Also, the interdigestive gastric and small intestinal motility is often affected. There is only a weak correlation between symptoms and objectively measurable motor disturbances. Patients with severe upper gastrointestinal symptoms usually have disturbed motility, but most patients with impaired motility are asymptomatic. Recent studies have clearly shown that, in addition to autonomic neuropathy, acute metabolic derangements are likely to contribute to disturbed motility. Elevated glucose levels impair gastric and small intestinal motility during fasting and after food intake. Hyperinsulinemia per se has effects similar to hyperglycaemia on the stomach and small bowel, and may be a mediator of the effects of hyperglycaemia in healthy subjects. The impact of insulin on motility in diabetic patients is still unclear. Treatment of the gastric motility disorder should include a stabilization of gastric emptying. Different therapeutic modes may be useful, e.g. application of prokinetic drugs and optimizing the metabolic situation.
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PMID:Gastrointestinal motility disorders in patients with diabetes mellitus. 771 64


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