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

In 249 individuals of different age groups, taking a high fibre diet naturally, glucose tolerance studies were done after a standard glucose load (1.73 g/kg body weight or 100 g glucose). A group of 156 of the subjects were also studied after a standardized hospital meal (258 g carbohydrate, 14 g fat, 47 g protein and 32 g fibre). Mean blood glucose values after the high fibre mixed meal were lower than after the glucose load. The mean 2-h postprandial blood glucose was 2-4 mmol/l lower compared to that observed in other studies using less carbohydrate. The postprandial blood glucose pattern is likely to be as a result of (a) the large amount of carbohydrate and fibre in the test meal (b) the fat and protein content of the test meal (c) the habitual intake of such a meal and (d) the nature and type of fibre consumed in the meal. Among the subjects 1.2 per cent were found to have non-insulin dependent diabetes mellitus while 2 per cent had impaired glucose tolerance. This prevalence of non-insulin dependent diabetes mellitus in subjects, who came predominantly from a rural or semi-rural background, is lower than that found in urban areas of Northern India. The effect of age on glucose tolerance was clearly seen after the glucose load (0.4 mol/l/decade) and after the mixed meal (0.1 mmol/l/decade). These findings suggest the potential of the constituents of a typical North Indian diet in improving glucose tolerance.
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PMID:Glucose tolerance in north Indians taking a high fibre diet. 285 48

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

Insulin resistance occurs in a variety of conditions, including diabetes, obesity and essential hypertension, but its underlying molecular mechanisms are unclear. In type 2 (non-insulin-dependent) diabetes mellitus, it is insulin-resistance in skeletal muscle, the chief site of insulin-mediated glucose disposal in humans, that predominantly accounts for the low rates of glucose clearance from the blood, and hence for impaired glucose tolerance. Human type 2 diabetes is characterized by a decrease in non-oxidative glucose storage (muscle glycogen synthesis), and by the deposition of amyloid in the islets of Langerhans. Amylin is a 37-amino-acid peptide which is a major component of islet amyloid and has structural similarity to human calcitonin gene-related peptide-2 (CGRP-2; ref. 8). CGRP is a neuropeptide which may be involved in motor activity in skeletal muscle. We now report that human pancreatic amylin and rat CGRP-1 are potent inhibitors of both basal and insulin-stimulated rates of glycogen synthesis in stripped rat soleus muscle in vitro. These results may provide a basis for a new understanding of the molecular mechanisms that cause insulin resistance in skeletal muscle.
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PMID:Pancreatic amylin and calcitonin gene-related peptide cause resistance to insulin in skeletal muscle in vitro. 305 May 30

In 1984, the Japan Diabetes Society organized a committee to collect data on diabetic twins in Japan. Within 3 years, through correspondence with Society members and hospitals, the Committee had contacted 87 pairs of twins, one or both of which had diabetes mellitus or glucose intolerance. Sixty-three pairs were monozygotic and 24 dizygotic. The probands, who had been diagnosed as diabetic or glucose-intolerant earlier, included 21 patients with insulin-dependent diabetes mellitus (IDDM), 56 with non-insulin-dependent diabetes (NIDDM), one with an unknown type of diabetes, and nine with glucose intolerance. Concordance between monozygotic twins was 45% for IDDM and 83% for NIDDM; between dizygotic twins, concordance was 0% (0/10) for IDDM and 40% (4/10) for NIDDM. Concordance was significantly greater in NIDDM than in IDDM, and in monozygotic than in dizygotic twins. Concordance was greater among twins in which one twin had developed diabetes after the age of 20 than among twins in which the age of onset had been earlier. There was no evidence that the period of discordance was shorter in the discordant pairs than in the concordant pairs. About 90% of the IDDM twin pairs lived together, against 20% of the NIDDM pairs, probably due to the later age of onset of NIDDM. The frequency of diabetes in family members other than the twins was higher in NIDDM than in IDDM regardless of concordance. In concordant pairs the presence or absence of various complications agreed in 68-97%; a few pairs were discordant for the severity of retinopathy, which may have resulted from differences in duration and hyperglycemic degree. A 75-g glucose tolerance test administered to the 'normal' discordant twins revealed borderline glucose intolerance in two of six IDDM co-twins and six of eight NIDDM co-twins. The early-phase insulin response was low in two of six IDDM co-twins and four of six NIDDM co-twins. These results are generally consistent with previous reports of diabetic twins in Western countries, reinforcing the importance of genetic factors in the pathogenesis of diabetes. Heredity has a particularly strong influence in NIDDM.
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PMID:Diabetes mellitus in twins: a cooperative study in Japan. Committee on Diabetic Twins, Japan Diabetes Society. 306 9

Asian patients comprise greater than 8% of our diabetic clinic. Retrospective analysis of the case notes of 22 Asian patients and 20 white patients with NIDDM or impaired glucose tolerance (IGT) attending our combined diabetic/antenatal clinic during 1985-1987 confirmed the reported advantages of pre-conception counselling. Those Asian patients with NIDDM or IGT had higher corrected birthweight than a parity matched Asian control group (3,472.3 +/- 595 g v 2,798.6 +/- 672.3 g p less than 0.001). Those Asian patients who had preconception counselling had, however, significantly smaller babies (3,270.8 +/- 445.1 g v 3,714.4 +/- 727.1 g p less than 0.05). An increase in foetal and maternal complications has been documented in cases of gestational diabetes, but the glucose levels that predict an increased risk have not been clearly defined. In the Asian patients with NIDDM/IGT there was one neonatal death and two congenital abnormalities, although these mothers did not have significantly higher glycosylated haemoglobin levels. HbA1 was not a good diagnostic test for glucose tolerance. Subjects with any degree of glucose intolerance should be managed as carefully as established diabetics and preconception counselling for high risk groups may be beneficial.
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PMID:Pre-conception counselling in Asian women with non insulin dependent diabetes and impaired glucose tolerance. 322 93

Non-insulin-dependent diabetes (NIDDM) is a major cause of premature morbidity and mortality among adults. Macrovascular disease of coronary and peripheral vessels is the primary cause of death in these patients. Numerous experimental and epidemiologic studies have suggested that hyperinsulinemia accelerates the development of atherosclerosis. In experimental models, insulin promotes diet-induced lesion development and overrides lesion regression and estrogen protection against atherosclerosis. Local hyperinsulinemia induced by selected arterial infusion accelerates atherosclerosis in the perfused artery. Insulin has been shown to stimulate subintimal smooth muscle and fibroblast cells in culture, and to increase the uptake and local synthesis of lipid by these cells. Insulin may also induce inhibition of fibrinolysis. Several prospective studies performed on nondiabetic patients show that either fasting or postprandial insulin levels are a sensitive predictor of the development of coronary disease independent of other risk factors. Two recent studies in NIDDM patients confirm this finding and suggest that glycemic control may not be a significant factor in the development of macrovascular disease. Diseases of carbohydrate tolerance, ie, NIDDM, impaired glucose tolerance, obesity, are frequently associated with elevated circulating insulin levels, either physiologically or secondary to treatment. Given the high prevalence of cardiovascular disease in these populations, modifying therapy to minimize hyperinsulinemia should be an important consideration in a treatment program. Use of oral agents such as glipizide or gliclazide, which induce less diurnal hyperinsulinemia, may be advantageous when compared to traditional oral agent or insulin therapy.
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PMID:Atherosclerosis in diabetes: the role of hyperinsulinemia. 327 13

We recently demonstrated that normal subjects given mixed test meals of varying fatty acid composition showed significantly greater serum insulin responses to meals enriched with polyunsaturated fat as compared to those in which the fat content was derived from saturated fatty acids. To determine if a similar phenomenon occurs in subjects with non-insulin dependent diabetes mellitus (NIDDM), serum glucose, insulin, C-peptide, and gastric inhibitory polypeptide (GIP) responses to three mixed test meals of varying fatty acid composition were assessed in twelve subjects with NIDDM. Baseline means (+/- SEM) fasting serum glucose concentration was 205 +/- 15 mg/dl and mean glycosylated hemoglobin was 8.5 +/- 0.5%. Fatty acids in the test meals were either saturated fats, or polyunsaturated fats derived from vegetables or fish. Each test meal provided 40% of the subjects' calculated daily caloric requirement and contained approximately 45% carbohydrate, 40% fat, and 15% protein. No appreciable differences in serum glucose, insulin, and C-peptide responses occurred during the three mixed test meals. Although GIP values were higher in the saturated fat and the vegetable meals when compared to the fish meal, the differences did not reach statistical significance. The inability of NIDDM subjects to evoke a greater insulin response to polyunsaturated fatty acids than to saturated fatty acids suggests another pathogenetic factor contributing to their glucose intolerance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of source of dietary fats on serum glucose, insulin, and gastric inhibitory polypeptide responses to mixed test meals in subjects with non-insulin dependent diabetes mellitus. 328 95

Diabetes mellitus is composed of a heterogeneous group of disorders characterized by high blood glucose levels. Four major types of diabetes have been defined by the National Diabetes Data Group. Insulin-dependent diabetes (IDDM), also called type I diabetes, is characterized by abrupt clinical onset, insulinopenia, proneness to ketosis even in the basal state, and dependence on exogenous insulin to sustain life. Non-insulin-dependent diabetes (NIDDM), also called type II diabetes, may remain relatively asymptomatic for years. Insulin levels may be normal, lower than normal, or elevated as a consequence of insulin resistance. Ketosis is not part of the general clinical picture except in times of metabolic stress, although the classic complications of diabetes can be expected to develop in long-duration diabetics. Gestational diabetes (GDM) refers to the recognition of abnormal glucose intolerance in pregnancy, although unrecognized abnormal tolerance may indeed have predated the pregnancy. Rates of macrosomia are higher than in non-GDM pregnancies, but fetal mortality and congenital anomalies appear to be no greater than in the general population. Other types of diabetes include a number of diverse conditions in which glucose intolerance is a feature and in which it may be etiologically related. Impaired glucose tolerance (IGT) is a class that encompasses persons whose glucose tolerance is intermediate between normal and diabetic. These individuals do not manifest the microvascular complications of diabetes, but they appear to have higher rates of macrovascular disease associated with the known cardiovascular risk factors. Two statistical risk categories have also been defined that replace the older terms prediabetes, potential diabetes, and latent diabetes. Diabetes can be diagnosed by the presence of classical signs and symptoms of diabetes and unequivocally elevated blood glucose levels; by a fasting plasma glucose greater than or equal to 140 mg/dl; or by an abnormal oral glucose tolerance test, with a venous plasma glucose value greater than or equal to 200 mg/dl at 2 hours after 75 grams oral glucose, being a hallmark criterion for diabetes. For the latter two criteria, the abnormality should be reconfirmed at a later occasion before a definitive diagnosis of diabetes is made. The oral glucose tolerance test has been standardized at a 75-gram glucose (or carbohydrate equivalent) load, given in the morning after an overnight fast. Glucose should be determined for two hours after administration of the challenge.
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PMID:Classification and diagnostic criteria for diabetes mellitus and other categories of glucose intolerance. 329 Sep 16

Aggregation of diabetes and hearing loss in a family is observed in some hereditary disease. All members of the present family are affected with sensory hearing loss and diabetes mellitus. Diabetes types observed were insulin dependent diabetes mellitus (IDDM) in the proposita and the sister, non-insulin dependent diabetes mellitus (NIDDM) in the brother, and impaired glucose tolerance in the mother. The combination of hearing loss and diabetes and the concordant expression of IDDM or NIDDM in the siblings have not hitherto been described in any hereditary syndrome. This family may exhibit a new hereditary syndrome which is characterized by diabetes and hearing loss.
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PMID:A familial case of insulin dependent or non-insulin dependent diabetes mellitus associated with hearing loss. 341 89

The relative effects of obesity alone, and in combination with fasting hyperinsulinemia and glucose intolerance, on the peripheral action of insulin in adipose tissue were investigated in twenty-four 60-yr-old men, who had been followed for 10 yr. They were divided into four groups of six subjects each on the basis of the following criteria: (1) normal body weight, normal fasting insulin level, and normal glucose tolerance; (2) moderate obesity, normal fasting insulin level, and normal glucose tolerance; (3) moderate obesity, fasting hyperinsulinemia, and normal glucose tolerance; and (4) moderate obesity, fasting hyperinsulinemia, and newly developed, moderate, untreated fasting hyperglycemia and/or glucose intolerance (i.e., mild type II diabetes mellitus). Specific adipocyte insulin binding and the effects of the hormone on adipose tissue lipolysis and glucose oxidation were determined. Insulin receptor binding per cell and per cell surface area were similar in all four groups. Regarding antilipolysis, the insulin sensitivity was the same in all groups and the maximum effect was significantly increased in the three obese groups, as compared with the normal-weight control group. In groups 1-3, insulin stimulated adipose tissue glucose oxidation in a dose-dependent way, and the sensitivity and responsiveness to insulin were comparable. In contrast, in the obese glucose-intolerant subjects (4) there was no significant effect of insulin on glucose oxidation when the hormone was added in increasing concentrations of less than or equal to 35 nmol/L. The basal glucose oxidation was similar in all four study groups. The in vivo insulin tolerance was gradually reduced in groups 2-4, as compared with the normal-weight control group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of obesity, hyperinsulinemia, and glucose intolerance on insulin action in adipose tissue of sixty-year-old men. 351 39


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