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

The aim of our investigation was to study the influence of high levels of endogenous and exogenous insulin on the complications of type 2 diabetes and metabolic parameters. 62 patients with DM2 (mean age - 50,2+/-9,7 years) have been investigated. The parameters of carbohydrate metabolism, HOMA-indices, parameters of lipid metabolism, blood pressure, BMI and waist circumference have been determined. I group consisted of 19 patients with high levels of endogenous insulin (C-peptide - 3,3+/-0,5 ng/ml) and daily exogenous insulin doses (65,2+/-17,7 units); II group - 26 patients with moderate levels of endogenous insulin (C-peptide - 1,6+/-0,8 ng/ml) and daily exogenous insulin doses (48,7+/-11,7 units); and III group - low levels of endogenous insulin (C-peptide - 0,4+/-0,4 ng/ml) and daily exogenous insulin doses (36,3+/-5,7 units). The IHD frequency was significantly higher in I group in comparison with II and III [OR=6,00 (1,54-23,30) and OR=5,36 (1,24-23,21), respectively]; and sum of macrovascular complications was significantly frequent in I group [OR=10,20 (2,50-41,39) and OR=8,13 (1,87-35,23)). In patients with high levels of serum C-peptide and daily doses of exogenous insulin HOMA indices, triglycerides, HDL-cholesterol levels, body mass index and waist circumference were significantly differed from analogous parameters of patients of other groups. High values of endogenous and exogenous insulin significantly impact on the development of macrovascular complications of DM2 and significantly worsen the parameters of lipid metabolism and body mass. On the basis of obtained data we conclude that in addition to the good glycemic control the important goal of the treatment of DM2 is the control of insulinemia.
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PMID:[The influence of high levels of endogenous and exogenous insulin on the complications of type 2 diabetes and metabolic parameters]. 1832 89

An analysis of some features of heart arrhythmias in patients with myocardial infarction (MI) and type 2 diabetes mellitus (DM2) was performed. The study revealed that arrhythmias (usually extrasystoles or atrial fibrillation) were more common in patients with DM type 2 (42.1% in DM2, and 30.4% in non-DM patients, p = 0.0041) and demonstrated a direct correlation with coronary and myocardial dysfunction. In patients with DM2, arrhythmias were associated with the duration of DM and HbA1c level. In severe metabolic decompensation (HbA1c > 8.5%) and in cases with a relatively low HbA1c level (< 7%) arrhythmias were more frequent than in patients with an HbA1c level between 7.0% and 8.5%. In patients with an HbA1c level < 7.0%, the threat of hypoglycemia is increased, often due to insulinotherapy, as a possible arrhythmogenic factor associated with a relative elevation of immunoreactive insulin and C-peptide and diabetic nephropathy (DN). Severe DM decompensation (HbA1c > 8.5%) was associated with metabolic disturbances and toxic effect of hyperglycemia. Cardiac arrhythmias, systolic dysfunction, and DN are prognostically unfavorable factors influencing the survival rate in patients with MI and DM2.
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PMID:[Factors associated with cardiac arrhythmias in patients with type 2 diabetes mellitus and myocardial infarction]. 1832 78

The informative value of functional diagnostic methods in the revealing of the initial stage of essential hypertension (EH) in patients with high risk of cardiovascular complications (CVC) and type 2 diabetes mellitus (DM2) was studied. The subjects of the study were 186 men considering themselves practically healthy, with high risk of CVC according to SCORE scale. Mean age of the subjects was 47.9 +/- 0.87 years; persons with various metabolic disorders prevailed. The patients were divided into two groups according to body mass index (BMI): group 1 patients (n = 142) had a BMI of > or = 25 kg/m2 (29.16 +/- 0.49); group 2 (n = 46) patients had a BMI of < 25 kg/m2 (22.95 +/- 0.37). The patients underwent clinical and laboratory examination including the measurement of biochemical parameters of lipid, carbohydrate, and purine metabolism. ECG, EchoCG, and 24-hour blood pressure monitoring (BPM) were performed. Office BP levels, 24-hour BMP data, and signs of left ventricular hypertrophy (LVH) according to ECG and EchoCG were evaluated. The study found that in persons with excessive body weight stable 24-hour arterial hypertension with both systolic and diastolic BP increased prevailed, while in subjects with normal body weight systolic arterial hypertension prevailed. The use of milder LVH criteria (left ventricular myocardial mass index > 116 g/m2) increased the number of persons with stage 2 EH. The prevalence of the initial stage of EH according to 24-hour BPM (87.4%) is 2.8 times higher than that according to office BP measurement (31.3%).
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PMID:[Outpatient diagnostics of the initial stage of essential hypertension]. 1832 85

The aim of this study was to evaluate the acute effect of the transdermal administration of nicotine on insulin sensitivity in healthy individuals with and without family histories of type 2 diabetes mellitus (DM2) in the first branch. A randomized, double-blind, cross-over, placebo-controlled clinical trial with two parallel groups was carried out in 12 healthy individuals, six with a family history of diabetes and six without such family history. The volunteers were randomly assigned to administration of a nicotine or placebo patch and were crossed-over with a difference of at least 3 days between each patch. The insulin sensitivity was estimated by means of the total glucose metabolism, which was obtained with the euglycemic- hyperinsulinemic clamp technique before the randomized assignment and on the following day for the corresponding patch. At the beginning of each clamp technique procedure, the metabolic and hepatic profiles were measured. We found that the total glucose metabolism value was not modified with the administration of nicotine, either in the group with a family history of DM2 (3.9 +/- 1.0 vs. 3.5 +/- 0.7 mg/kg/min; p = 0.60) or in the group without such a family history (5.4 +/- 2.0 vs. 5.1 +/- 1.6 mg/kg/min; p = 0.34). The administration of placebo did not modify the insulin sensitivity in either group. We conclude that acute transdermal administration of nicotine did not modify insulin sensitivity in healthy individuals with or without a family history of DM2 in the first branch.
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PMID:Acute effect of the transdermal administration of nicotine on insulin sensitivity in healthy individuals with and without a family history of type 2 diabetes mellitus in the first branch. 1837 Jun 91

This paper reports a 5-year follow-up from a study aimed at evaluating whether an intervention which focused on patients' personal understanding of their illness was more effective than conventional diabetes care with regard to metabolic control among patients with type 2 diabetes mellitus (DM2). The study was conducted within Swedish primary health care and included 102 patients (mean age 63 years). At clinic level they were randomised into control or intervention groups. The intervention directed at patients consisted of ten two-hour group sessions over 9 months, focusing on patients' own needs and questions. The mean HbA1c at baseline was 5.71% (S.D. 0.76) in the intervention group and 5.78% (S.D. 0.71) in the control group. At the 5-year follow-up, the mean HbA1c in the intervention group still was 5.71% (S.D. 0.85) while among the controls it had increased to 7.08% (S.D. 1.71). The adjusted difference was 1.37 (p<0.0001). Treatment upgrade, BMI, total cholesterol, HDL, LDL and triglycerides at baseline did not influence the difference in HbA1c. These findings indicate that group sessions in patients with DM2 focusing on patients' personal understanding of their illness are more effective than conventional diabetes care with regard to metabolic control.
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PMID:Improvements in HbA1c remain after 5 years--a follow up of an educational intervention focusing on patients' personal understandings of type 2 diabetes. 1837 74

A case-control study was carried out on a sample of 15 Mexican patients (40-56 years old) with type 2 diabetes mellitus (DM2) that had developed five years and been treated with oral hypoglycemic drugs (sulfonylurea and/or metformin), with no microvascular or macrovascular complications. The aim of this study was to assess whether Mexican patients with DM2 differed from a control group in the frequency of micronuclei (MN). A control group of 10 individuals without DM2 (38-54 years old) was included. The frequency of MN in binucleated lymphocytes was analyzed according to the Fenech criteria. At time being this investigation should be considered as a preliminary study in which the influence of potential confounders cannot be adequately assessed. However, our result showed a MN frequency significant increase in DM2 patients (6.53 +/- 2.03 per 1000 cells) relative to that of the control group (3.10 +/- 1.79 per 1000 cells). MN may constitute a possible component of a panel of biomarkers for the risk of DM2. This cytogenetic damage also indicates an enhanced risk of cancer, as has been found in previous studies. These results should be validated by other researchers.
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PMID:Frequency of micronuclei in Mexicans with type 2 diabetes mellitus. 1839 62

Risk determinants for the life threatening complication of metformin-associated lactic acidosis are frequently disregarded. Our first aim was to investigate the prevalence of risk determinants in subjects with type 2 diabetes mellitus (DM2) taking metformin compared to subjects with nonmetformin treatment. Our second aim was to estimate the proportion of subjects with alternative drug-treatment, and no risk determinants, which would probably benefit from metformin. The Study of Health in Pomerania is a population-based health survey including 322 DM2 subjects. Risk determinants were assessed by personal interview, ultrasound, and laboratory analysis. Among the subjects with DM2 n=92 (28.6%) were treated with metformin, n=162 (50.3%) with alternative medication, and n=68 (21.1%) with diet. The prevalence of at least one risk determinant was 65% [corrected] for metformin-users. There was no difference in number and type of risk determinants. Heart failure, angina pectoris, and liver disorders presented the most frequent risk determinants. Current risk determinants for metformin-associated lactic acidosis are largely disregarded. Improved selection of patients can result in safe metformin utilization in one quarter of subjects on DM2 related drug treatment. Risk determinants need to be revised. A more practical definition of risk determinants would improve prescription adherence.
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PMID:Prevalence of risk determinants for metformin-associated lactic acidosis and metformin utilization in the study of health in pomerania. 1840 38

The presence of fibrillar protein deposits (amyloid) of human islet amyloid polypeptide (hIAPP) in the pancreatic islets of Langerhans is thought to be related to death of the insulin-producing islet beta-cells in type 2 diabetes mellitus (DM2). The mechanism of hIAPP-induced beta-cell death is not understood. However, there is growing evidence that hIAPP-induced disruption of beta-cell membranes is the cause of hIAPP cytotoxicity. Amyloid cytotoxicity by membrane damage has not only been suggested for hIAPP, but also for peptides and proteins related to other misfolding diseases, like Alzheimer's disease, Parkinson's disease, and prion diseases. Here we review the interaction of hIAPP with membranes, and discuss recent progress in the field, with a focus on hIAPP structure and on the proposed mechanisms of hIAPP-induced membrane damage in relation to beta-cell death in DM2.
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PMID:Recent insights in islet amyloid polypeptide-induced membrane disruption and its role in beta-cell death in type 2 diabetes mellitus. 1848 16

The insulin-responsive glucose transporter 4 (GLUT4) plays a key role in glucose uptake and metabolism in insulin target tissues. Being a rate-limiting step in glucose metabolism, the expression and function of the GLUT4 isoform has been extensively studied and found to be tightly regulated at both mRNA and protein levels. Adaptation to states of enhanced metabolic demand is associated with increased glucose metabolism and GLUT4 gene expression, whereas states of insulin resistance such as type 2 diabetes mellitus (DM2), obesity, and aging are associated with impaired regulation of GLUT4 gene expression and function. The present review focuses on the interplay among hormonal, nutritional, and transcription factors in the regulation of GLUT4 transcription in health and sickness.
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PMID:Transcriptional regulation of the insulin-responsive glucose transporter GLUT4 gene: from physiology to pathology. 1849 67

Human islet amyloid polypeptide (hIAPP), a pancreatic islet protein of 37 amino acids, is the main component of islet amyloid, seen at autopsy in patients with type 2 diabetes mellitus (DM2). To investigate the roles of hIAPP and islet amyloid in DM2, we generated transgenic mice expressing hIAPP in their islet beta cells. In this study, we found that after a long-term, high-fat diet challenge islet amyloid was observed in only 4 of 19 hIAPP transgenic mice. hIAPP transgenic females exhibited severe glucose intolerance, which was associated with a downregulation of GLUT-2 mRNA expression. In isolated islets from hIAPP males cultured for 3 weeks on high-glucose medium, the percentage of amyloid containing islets increased from 5.5% to 70%. This ex vivo system will allow a more rapid, convenient, and specific study of factors influencing islet amyloidosis as well as of therapeutic strategies to interfere with this pathological process.
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PMID:Human islet amyloid polypeptide transgenic mice: in vivo and ex vivo models for the role of hIAPP in type 2 diabetes mellitus. 1849 71


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