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)

Atherosclerotic changes have not been demonstrated directly in asymptomatic hyperglycaemic non-diabetic subjects, although high mortality due to coronary heart disease has been reported. We measured arterial wall thickness non-invasively, in order to directly demonstrate atherosclerosis of the carotid arteries of hyperglycaemic non-diabetic subjects and to evaluate its risk factors. The thicknesses of the intimal plus medial complex (IMT) of the carotid arteries of 112 asymptomatic hyperglycaemic non-diabetic subjects (aged 22-81, 95 males and 17 females) were compared with those of 55 healthy male subjects and 211 non-insulin-dependent NIDDM male diabetic patients. The subjects were subgrouped into impaired glucose-tolerant (IGT) subjects who had a 2-h glycaemic level of more than 7.8 mmol/l, and non-IGT subjects whose 2-h glycaemic levels were within 6.7-7.7 mmol/l. Non-IGT and IGT subjects showed significantly greater IMTs than age-matched healthy males and showed no significant differences compared to age-matched NIDDM patients. Multivariate analysis demonstrated that the risk factors for IMT of non-IGT and IGT subjects were age and systolic blood pressure. According to data on the accumulation of atherogenic risks (hypertension, dyslipidaemia, and smoking), IMT increased linearly in non-IGT and IGT subjects. However, non-IGT and IGT subjects without hyperlipidaemia, hypertension, or smoking risk still had significantly greater IMT than age-matched normal males (1.019 +/- 0.063 vs 0.770 +/- 0.111 mm, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Asymptomatic hyperglycaemia is associated with increased intimal plus medial thickness of the carotid artery. 748 42

The characteristics of NIDDM seen in Japanese is coexistence of diminished insulin secretion and the impaired sensitivity to insulin in the target tissues. Thus, insulin resistance does not mean hyperinsulinemia. To investigate the organ-specific insulin action on glucose homeostasis, we developed an innovative non-invasive method, using an euglycemic hyperinsulinemic clamp combined with oral glucose load. With this procedure, we could reveal muscle glucose uptake and hepatic glucose uptake following oral glucose load, quantitatively, separately and simultaneously. The effect of strict glycemic control in non-obese NIDDM who were secondary failure to sulfonylurea with 3 times prandial regular insulin injections, on glucose disposals are investigated. Glucose disposal by peripheral tissues was not altered (clamped blood glucose and insulin concentration are, 90 mg/dl and 200 microU/ml, respectively). The ratio of splanchnic glucose disposal to the amount of ingested glucose, on the other hand, significantly increased to 33.1% from 14.5%. Therefore, short-term strict glycemic control appears to improve glucose handling by splanchnic tissues without affecting insulin sensitivity of peripheral tissues in NIDDM. This method would be feasible to investigate whether insulin resistance seen in hypertensive patients, is located only in peripheral tissues or is also in the liver. To find patients with asymptomatic atherosclerosis, we routinely apply a noninvasive maneuver using high resolution B-mode imaging of the carotid artery, to determine atherosclerosis quantitatively. Impaired glucose tolerance (IGT) male subjects showed significantly greater thickness of the intimal plus medial complex (IMT) than age-matched healthy males and showed no significant differences compared to age-matched NIDDM patients. Among IGT, those with exaggerated insulin secretion (average serum insulin concentration was 100 microU/ml at 1 and 2 h after), in other words, insulin resistant, showed thicker IMT. The characteristics of IGT groups with high insulin level were, BMI more than 25, diastolic blood pressure more than 83 mmHg, serum triglyceride more than 215 mg/dl. Thus, among mildly obese, mild hypertensive, mild glucose intolerant, slightly hypertriglyceridemic Japanese male subjects, there exist advanced atherosclerotic subjects.
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PMID:Insulin resistance seen in non-insulin dependent diabetes mellitus and hypertension. 924 Jul 67

Vascular cell adhesion molecule-1 (VCAM-1) has been shown to be highly expressed in atherosclerotic lesions. Although the soluble form of VCAM-1 (sVCAM-1) is detected in human sera, the relation between the degree of atherosclerosis and serum sVCAM-1 level has not been defined. In the present study, sVCAM-1 concentrations were measured in sera from 101 Japanese NIDDM patients. The mean +/- SD serum sVCAM-1 concentration in 26 patients with symptomatic atherosclerotic vascular diseases (789 +/- 187 ng/ml) was higher than that in 75 patients without the disease (664 +/- 175 ng/ml). Among the 101 NIDDM patients, 56 had atherosclerotic change of the carotid arteries, based on the evaluation by high-resolution B-mode ultrasonography. Their sVCAM-1 level was 759 +/- 201 ng/ml, higher than that in 45 patients without any detectable atherosclerosis of the carotid arteries (619 +/- 130 ng/ml). In addition, there was a positive correlation between sVCAM-1 concentration and thickness of the intimal plus medial complex (IMT) of the carotid arteries in the NIDDM patients (r = 0.41, P < 0.0001). Multivariate regression analysis revealed significant predictors of mean IMT value to be sVCAM-1 concentration (F = 62.88, P = 0.0001) and age (F = 9.59, P = 0.0026). By contrast, sVCAM-1 concentration was not increased in nondiabetic patients with atherosclerotic change of the carotid arteries (668 +/- 191 ng/ml; n = 36) compared with those without the atherosclerotic change (632 +/- 177 ng/ml; n = 28), and there was no correlation between sVCAM-1 level and IMT of the carotid arteries in the nondiabetic subjects. These results indicate that circulating sVCAM-1 may be a marker of atherosclerotic lesions in NIDDM patients with symptomatic and asymptomatic atherosclerosis.
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PMID:Circulating vascular cell adhesion molecule-1 (VCAM-1) in atherosclerotic NIDDM patients. 1044 41

Incidence of atherosclerotic cardiovascular diseases in diabetics is known to be 2-4 times higher than in nondiabetic subjects. Intima-media-thickness of common carotid artery (IMT ACC) measured by B-mode sonography positively correlates with the severity of atherosclerotic changes in coronary arteries. This study compares sonographically assessed IMT ACC in patients with type 2 diabetes mellitus (27 patients, mean age 66.57 +/- 6.06 years) vs. 66 nondiabetic subjects (mean age 63.58 +/- 9.09 years). Intima-media thickness in diabetics was significantly higher when compared with the control group (0.826 +/- 0.29 mm vs. 0.647 +/- 0.26 mm). In the whole cohort of investigated subjects IMT ACC positively correlates with age. When adjusted for age, the mean IMT ACC level was significantly higher in men than in women.
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PMID:[Sonographic measurement of intimal thickness of the common carotid artery in diabetics]. 1104 44

Stiffening and thickening of arterial wall are two important components of atherosclerosis. The purpose of this study was to evaluate the effects of femoral artery wall stiffness on clinical manifestation of peripheral vascular disease (PVD) in type 2 diabetes mellitus. The subjects were 315 patients with type 2 diabetes. Presence of intermittent claudication and/or leg pain at rest and reduced ankle-brachial blood pressure index (ABI<0.9) were used as a subjective and an objective index of PVD, respectively. Femoral artery intima-media thickness (FA-IMT) and stiffness parameter beta (FA-stiffness beta) were measured by ultrasound methods. Symptomatic patients (N=58) showed greater values for both FA-IMT and FA-stiffness beta than those without symptom (N=257). Similarly, patients with reduced ABI (N=56) had greater FA-IMT and FA-stiffness beta than those without (N=259). However, correlation between FA-IMT and FA-stiffness beta was not impressive, especially in the symptomatic patients. To evaluate the effect of FA-stiffness beta on PVD symptoms, the subjects were divided into three subgroups according to FA-IMT, and then FA-stiffness beta was compared between those with and without PVD symptoms in each subgroup. The symptomatic patients had greater FA-stiffness beta values than the asymptomatic subjects in all the three subgroups. Multiple logistic regression analysis indicated that the presence of PVD symptoms was associated more closely with increased FA-stiffness beta than with increased FA-IMT, whereas reduced ABI was associated more closely with FA-IMT than with FA-stiffness beta. These data suggest that stiffening of arterial wall has a significant impact on PVD manifestations, particularly on the leg symptoms, in patients with type 2 diabetes.
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PMID:Femoral artery wall thickness and stiffness in evaluation of peripheral vascular disease in type 2 diabetes mellitus. 1150 Jan 93

If a strong association between intima-media thickness of the common carotid artery (CCA-IMT) and ischemic stroke can be determined in diabetic subjects, it may be a useful predictor to help identify patients at high risk of ischemic stroke. To investigate the relative contribution of CCA-IMT to ischemic stroke in patients with type 2 diabetes, we measured CCA-IMT and other conventional risk factors in 438 Japanese patients with type 2 diabetes, including 45 with ischemic stroke and 393 controls. Stroke patients were characteristically and significantly older with higher body mass index, longer duration of diabetes, likely to be smokers, higher blood pressure, and higher total cholesterol compared with the controls. CCA-IMT in stroke patients (1.23 +/- 0.04 mm) was significantly greater than in control patients (0.95 +/- 0.01 mm, P <.01). CCA-IMT in stroke patients was still significantly greater than controls after adjustment for age, sex, body mass index, and smoking status (P <.05). A 0.1-mm increase in CCA-IMT was associated with 1.80-fold increase in the odds ratio of stroke in diabetic patients (95%confidence interval [CI], 1.49 to 2.17; P <.01). Four independent factors were found to correlate significantly with CCA-IMT: age, systolic blood pressure, HbA(1c), and high-density lipoprotein (HDL) cholesterol. Thus, thickening of the intima-media of common carotid arteries is associated with ischemic stroke in type 2 diabetic patients. To prevent ischemic stroke, strict control of diabetes, hypertension, and dyslipidemia and monitoring of CCA-IMT may be important.
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PMID:Correlation between common carotid arterial wall thickness and ischemic stroke in patients with type 2 diabetes mellitus. 1183 56

Affections of the structure of the major blood vessels can be assessed non-invasively by ultrasound. The authors assessed the thickness of the intima-media (IMT) and distensibility (D) of the carotid arteries in patients with ischaemic heart disease (IHD) and a cerebrovascular attack (CVA). Duplex sonography was used in 234 patients (145 patients with IHD and 89 patients with CVA) incl. assessment of IMT and D. 59 patients had type 2 diabetes and 64 had atrial fibrillations. D was evaluated according to Raneman's formula (mm/100 mm Hg). Diabetic subjects had a poorer D in the group with IHD (0.16 vs. 0.20, p < 0.05) as well as in the CVA group (0.14 vs. 0.17, p < 0.05) and the finding correlated with IMT. Insulin treatment as compared with PAD treatment did not influence D in a significant way (0.15 vs. 0.16, NS). Th presence of atrial fibrillation in patients with IHD did not affect the investigated parameters (IMT 0.72 vs. 0.74 mm, NS, D 0.19 vs. 0.18, NS). In patients with CVA, as compared with patients with a sinus rhythm, better IMT findings were recorded (0.67 mm vs. 0.79 mm, p < 0.05) and D (0.19 vs. 0.10, p < 0.05). The results indicate that IMT an D correlate indirectly and this is made more apparent by the presence of diabetes. In patients with CVA the different findings in relation to the presence of atrial fibrillation indicate the possibility to use these parameters to differentiate an embolic and thrombotic etiology of the attack. The results assembled by the authors do not support a better informative value of D as compared with IMT.
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PMID:[Importance of measurement of carotid artery distensibility]. 1272 92

The prevalence of peripheral vascular disease (PVD) in diabetic patients is manyfold higher than that of age- and sex-matched nondiabetic subjects. This study was designed to evaluate the relationship between quantitatively determined peripheral circulation in the lower extremities and arterial wall thickness or stiffness in 68 patients with type 2 diabetes. Peripheral circulation during treadmill-exercise was monitored by transcutaneous oxygen tension (TcPO2) and was expressed as percentage of post-exercise TcPO2 adjusted by that of pre-exercise (TcPO2 index). Arterial wall thickness (intima-media thickness; IMT) and stiffness (stiffness beta) were measured by ultrasonography. TcPO2 index was negatively (r=-0.350, P=0.0007) correlated with stiffness beta, not with IMT, of the femoral artery. In patients without insulin therapy (n=52), both fasting plasma insulin concentration (r=-0.323, P=0.0023) and HOMA IR, an insulin resistance index, (r=-0.281, P=0.0084) were negatively correlated with TcPO2 index. Multiple regression analyses showed that association of stiffness beta of the femoral artery or HOMA IR with the TcPO2 index was independent of other factors including age, smoking index, ankle brachial pressure index and IMT of femoral artery. Thus, arterial wall stiffness of femoral artery appears to be a major determinant of peripheral circulation in patients with type 2 diabetes.
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PMID:Arterial wall stiffness is associated with peripheral circulation in patients with type 2 diabetes. 1295 86

The aim of the present study was to investigate the independent association of the intimal-medial thickness of carotid and femoral arteries (CA-IMT and FA-IMT), a marker of atheroscelosis, with insulin resistance in type 2 diabetic patients. We evaluated CA-IMT and FA-IMT by high-resolution ultrasonography and insulin resistance determined by euglycemic hyperinsulinemic clamp in 119 type 2 diabetic subjects, 71 males and 48 females (age, 54 +/- 12 (SD) years). In simple regression analyses, CA-IMT and FA-IMT were significantly inversely correlated with insulin sensitivity index (CA-IMT, r = -0.225, p = 0.010; FA-IMT, r = -0.186, p = 0.043, respectively). Multiple regression analysis was performed with the logarithm of CA-IMT or FA-IMT as a dependent variable and insulin sensitivity index as an independent variable along with known clinical risk factors. Insulin sensitivity index exhibited a significant independent contribution to log (CA-IMT) (beta = -0.204, p = 0.033) and to log (FA-IMT) (beta = -0.237, p = 0.010) in these models (CA-IMT, R(2) = 0.347, p < 0.0001; FA-IMT, R(2) = 0.398, p < 0.0001, respectively). In conclusion, insulin resistance is associated with both CA-IMT and FA-IMT in type 2 diabetic patients, suggesting that it is an independent risk factor for the development of atherosclerosis in type 2 diabetes.
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PMID:Arterial wall thickness is associated with insulin resistance in type 2 diabetic patients. 1456 88

To investigate the anti-atherogenic effect of metformin, we prospectively evaluated the effect of metformin treatment on common carotid intima-media thickness (CCA-IMT) in patients with type 2 diabetes. A 2-year open prospective study was performed. Thirty-six patients were treated with metformin (500-750 mg per day). CCA-IMT was measured after 1- and 2-year treatment. Changes in CCA-IMT were compared with control patients. After 2-year metformin therapy, the progression of CCA-IMT was significantly less than 56 control patients (0.02+/-0.08 mm versus 0.07+/-0.08 mm, P<0.01). Metformin therapy did not alter body weight, blood pressure, HbA1c, and serum lipids relative to the control. Thus, metformin attenuates the progression of CCA-IMT. This anti-atherogenic effect is not mediated through changes in classical cardiovascular risk factors.
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PMID:Metformin attenuates progression of carotid arterial wall thickness in patients with type 2 diabetes. 1512 12


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