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)

Still, there are a lot of questions about the pathogenesis of neonatal diabetes mellitus. In the author's opinion neonatal diabetes mellitus is a distinct entity which differs from the well-known types of diabetes in children (type 1 diabetes, MODY-diabetes) and transient neonatal hyperglycemia regarding pathogenesis, pathophysiology and prognosis. Casuistics of three children two of whom were sibs are reported in detail to demonstrate the characteristics of neonatal diabetes mellitus. Regarding the reported sibs we suppose genetic origin of the disease. Autosomal-recessive mode of inheritance must be assumed.
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PMID:[Neonatal diabetes mellitus and microcephaly. Indications for autosomal recessive inheritance]. 147 Jan 85

The importance of renal function as both a marker of and risk factor for cardiovascular disease is increasingly recognized. This link is apparent even in the earliest stages of renal dysfunction, at levels that are conventionally considered "normal." These findings are of considerable importance, given the prevalence of high-normal levels of albuminuria (i.e., 10 to 20 mg/L) in the general population. There is also a close link between the progression of albuminuria and the development of insulin resistance and type 2 diabetes mellitus, such that kidney disease--far from being simply a consequence of the metabolic syndrome--may be considered a component of it. It may be hypothesized that minor derangements of renal function, such as microalbuminuria or reduced glomerular filtration rate, can lead to dysfunction of the endothelium, with the consequence of sensitizing the vasculature to the injurious effects of hypertension, dyslipidemia, and other risk factors. The renin-angiotensin system (RAS) is highly activated in patients with the metabolic syndrome, and this presumably is also true for the intrarenal RAS systems. Both angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are known to reduce the progression of renal damage. Still to be resolved, however, is the optimal dosage; several recent studies indicate that the dosage required for maximal blood pressure reduction is insufficient to provide maximal renoprotection.
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PMID:Heart and kidney: fatal twins? 1656 46

The revised guideline 'Diabetes mellitus type 2' contains several improvements. The HbA1C target level has been lowered to 7% or less. The universal first step in oral therapy has become metformin. The target level for the treatment of hypertension is now a systolic pressure below 140 mmHg. Statins should be prescribed to almost every patient. Finally, ACE-inhibitors are now suggested for all patients with microalbuminuria and hypertension. Some choices made in the present guideline are not evidence-based, e.g. the advice to prescribe pioglitazone to patients with both a body mass index above 27 kg/m2 and cardiovascular disease, but without heart failure. Still, in general, the updated guideline is an important document which has been greatly improved in comparison to the former one.
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PMID:[The practice guideline 'Diabetes mellitus type 2' (second revision) from the Dutch College of General Practitioners; a response from the perspective of internal medicine]. 1709 45

Polycystic ovary syndrome (PCOS), the main androgen disorder in women. Recently, it has been suggested that the condition is hereditary and that women with PCOS have disturbances, such as hyperandrogenism and additional metabolic abnormalities as hyperinsulinaemia, increased insulin resistance, dyslipidemia. Polycystic ovary syndrome (PCOS) usually arises during puberty and is marked by hyperinsulinemia and hyperandrogenism. Adolescents with PCOS are at an increased risk of developing health problems later on in life such as type 2 diabetes, cardiovascular disease, and infertility. Furthermore, the physical signs of PCOS can be detrimental to a teenage girl's self-image. Early diagnosis and treatment of PCOS in adolescents are essential in ensuring adulthood health and restoring self-esteem. Treatment for an adolescent with PCOS includes diet and exercise, metformin, and oral contraceptive pills. Still, surgery is not indicated in teenagers. Furthermore, psychological factors must be taken into consideration as well.
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PMID:[Early metabolic abnormalities--insulin resistance, hyperinsulinemia, impaired glucose tolerance and diabetes, in adolescent girls with polycystic ovarian syndrome]. 1708 Jul 48

Statins, angiotensin-converting enzyme inhibitors, and combination therapies have been shown to reduce the cardiovascular event rate in susceptible individuals, albeit with remaining significant residual risk. Some of the sources of residual risk, such as genetics and epigenetic phenomena, are not easily modifiable. Still, the risk imposed by these factors may be lowered by implementation of dietary, behavioral, and pharmacologic interventions. Abdominal obesity has emerged as one element in the cluster of factors linked to increased propensity for cardiovascular disease and type 2 diabetes. It is a potential therapeutic target to reduce residual cardiometabolic risk. Waist circumference has been shown to be a strong correlate of abdominal obesity, and measurement is a useful tool for the assessment of cardiometabolic risk.
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PMID:The relationship among risk factor clustering, abdominal obesity, and residual risk for cardiovascular events. 1740 Dec 97

Non-alcoholic fatty liver disease or NAFLD is a chronic liver condition characterized by hepatic steatosis and associated with insulin resistance and type 2 diabetes mellitus (T2DM). In many patients fat accumulation leads to steatohepatitis (NASH) with chronic necrosis, inflammation, and fibrosis, and eventually to the development of cirrhosis. Obese and T2DM patients are at the greatest risk for NASH and progressive disease. New diagnostic techniques, such as magnetic resonance imaging and spectroscopy (MRS), have enhanced our way to non-invasively quantify liver fat and suggest that the epidemic of NAFLD is much larger than previously believed. However, the diagnosis of NAFLD for clinicians remains difficult due to a number of factors: limited awareness, non-specific symptoms, few laboratory findings, and the need for a liver biopsy to confirm the diagnosis. Traditional treatment approaches have centered on weight loss, but data are limited on its long-term efficacy, and the overall compliance is poor. Recently, pioglitazone has been shown to be safe and effective in patients with NASH and may radically change our approach to the disease. Still, many aspects remain poorly understood. Taken together, wider use of new diagnostic methods and treatment approaches appears to signal the dawn of a new era in the management of NAFLD.
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PMID:New diagnostic and treatment approaches in non-alcoholic fatty liver disease (NAFLD). 1935 60

Overall lowering of glucose is of pivotal importance in the treatment of diabetes, with proven beneficial effects on microvascular and macrovascular outcomes. Still, patients with similar glycosylated hemoglobin levels and mean glucose values can have markedly different daily glucose excursions. The role of this glucose variability in pathophysiological pathways is the subject of debate. It is strongly related to oxidative stress in in vitro, animal, and human studies in an experimental setting. However, in real-life human studies including type 1 and type 2 diabetes patients, there is neither a reproducible relation with oxidative stress nor a correlation between short-term glucose variability and retinopathy, nephropathy, or neuropathy. On the other hand, there is some evidence that long-term glycemic variability might be related to microvascular complications in type 1 and type 2 diabetes. Regarding mortality, a convincing relationship with short-term glucose variability has only been demonstrated in nondiabetic, critically ill patients. Also, glucose variability may have a role in the prediction of severe hypoglycemia. In this review, we first provide an overview of the various methods to measure glucose variability. Second, we review current literature regarding glucose variability and its relation to oxidative stress, long-term diabetic complications, and hypoglycemia. Finally, we make recommendations on whether and how to target glucose variability, concluding that at present we lack both the compelling evidence and the means to target glucose variability separately from all efforts to lower mean glucose while avoiding hypoglycemia.
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PMID:Glucose variability; does it matter? 1996 12

Obesity is becoming increasingly common, with at least 400 million obese adults worldwide and the World Health Organization (WHO) projecting that this statistic will reach 700 million in another five years. Ironically, despite the fact that a majority of adults in developed nations are overweight or obese, society stigmatizes the obese severely. Still, obese people have more than just social motivations for losing weight; obesity commonly goes hand in hand with life-threatening comorbidities like cardiovascular disease and type 2 diabetes and some forms of cancer. It severely threatens quality of life, limiting the ability to move and work, navigate public places, and provide care for others and is a factor in musculoskeletal disorders like osteoarthritis. Both obesity and its comorbidities lead obese patients to hospitals at greater rates than patients of normal weight, and these factors, along with social pressures, motivate patients and their physicians to pursue solutions for obesity, its comorbidities, or both.
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PMID:Biomedical engineering and the obesity epidemic: treatments for weight reduction. 2017 18

Interleukin (IL)-1 was first cloned in the 1980s, and rapidly emerged as a key player in the regulation of inflammatory processes. The term IL-1 refers to two cytokines, IL-1alpha and IL-1beta, which are encoded by two separate genes. The effects of IL-1 are tightly controlled by several naturally occurring inhibitors, such as IL-1 receptor antagonist (IL-1Ra), IL-1 receptor type II (IL-1RII), and other soluble receptors. Numerous IL-1 inhibitors have been developed and tested primarily in rheumatoid arthritis, with only modest effects. By contrast, the use of IL-1 antagonists has been uniformly associated with beneficial effects in patients with hereditary autoinflammatory conditions associated with excessive IL-1 signaling, such as cryopyrinopathies and IL-1Ra deficiency. Successful treatment with IL-1 blockers has also been reported in other hereditary autoinflammatory diseases, as well as in nonhereditary inflammatory diseases, such as Schnizler syndrome, systemic-onset juvenile idiopathic arthritis and adult Still disease. The role of microcrystals in the regulation of IL-1beta processing and release has provided the rationale for the use of IL-1 inhibitors in crystal-induced arthritis. Finally, preliminary results indicating that IL-1 targeting is efficacious in type 2 diabetes and smoldering myeloma have further broadened the spectrum of IL-1-driven diseases.
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PMID:IL-1 pathways in inflammation and human diseases. 2017 98

Genome Wide Association (GWA) studies resulted in discovery of genetic variants underlying several complex diseases including Chron's disease and age-related macular degeneration (AMD). Still geneticists find that in majority of studies the size of the effect even if it is significant tends to be very small. There are several factors contributing to this problem such as rare variants, complex relationships among SNPs (epistatic effect), and heterogeneity of the phenotype. In this work we focus on addressing phenotypic heterogeneity. We introduce the problem of identifying, from GWAS data, separate genotypic markers from overlapping mixtures of clinically indistinguishable phenotypes. We propose a generative model for this scenario and derive an expectation-maximization (EM) procedure to fit the model to data, as well as a novel screening procedure designed to identify skew specific to certain phenotypic regimes. We present results on several simulated datasets as well as preliminary findings in applying the model to type 2 diabetes dataset.
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PMID:Mixture model for sub-phenotyping in GWAS. 2217 91


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