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Query: UMLS:C0011860 (
type 2 diabetes
)
57,723
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Forty-three cases of diabetic ketosis were analysed to determine the mode of presentation, treatment modalities and outcome. Among these cases 62.8% were
non-insulin dependent diabetes mellitus
(
NIDDM
) patients and 37.2% belonged to the insulin dependent diabetes mellitus (IDDM) group. Six patients had blood glucose levels of more than 250 mg/dl but less than 300 mg/dl who were grouped separately for analysis under the term "euglycaemic diabetic ketoacidosis (EGDK)". Infection was the commonest precipitating factor in diabetic ketosis in all groups. Abdominal pain and vomiting occurred with
NIDDM
and EGDK cases.
Drowsiness
was common and coma was rare. Acute myocardial infarction (MI) and pulmonary oedema occurred with
NIDDM
cases. Shock, acidosis, acquired respiratory distress syndrome (ARDS) and mucor mycosis were seen with IDDM cases. Mortality was 7 out of 43(16.3%). Saline requirement was lower in
NIDDM
and EGDK cases. Intensive insulin therapy with hourly intravenous doses were needed for IDDM cases while majority of
NIDDM
cases could be managed with 6 hourly doses of insulin given subcutaneously or intramuscularly.
...
PMID:Changing profile of diabetic ketosis. 956 97
In a woman aged 80 years arriving in the Emergency Room with progressive malaise, anorexia and
somnolence
, a large resistance was found in the lower abdomen, which proved to be due to cystitis emphysematosa. The patient was known to suffer from
non-insulin dependent diabetes mellitus
. Imaging revealed a large accumulation of gas in the urinary bladder, which was treated successfully with catheterization and antibiotics. Cystitis emphysematosa is a rare condition, characterized by collection of gas in the bladder and bladder wall and brought about by gas-forming micro-organisms that decompose glucose. In patients with diabetes mellitus optimal regulation of the blood glucose levels, with a view to preventing glycosuria, is a condition of speedy recovery. Although cases with a fatal outcome have been reported, the prognosis in general is favourable.
...
PMID:[A diabetic patient with cystitis emphysematosa]. 986 38
TNF-alpha (so-called cachectin), IL-1 and 6 are important regulating agents in the homeostasis of energy in the organism, as among others they control processes of apoptosis and thus also the volume of adipose and muscular tissues. They are produced not only in immunocompetent cells but also in adipocytes and muscle cells. The cytokine system is then activated not only in tumours and infections but elevated values were found also in obesity,
NIDDM
, in myocardial infarction and in advanced decompensated cardiac patients. By acting on phosphorylation of IRS-1 and PI-3 kinase TNF-alpha promotes significantly insulin resistance, causes deterioration of diabetes, as well as elevated body temperature,
sleepiness
and anorexia. In a group of 65 patients, mostly with android obesity, in hyperleptinaemic and insulin resistant probands with coronarographically confirmed microvascular angina pectoris (n = 22) or IHD, mostly after a myocardial infarction (n = 43) with one or more significant stenoses on the epicardial coronary arteries in half the patients positive or elevated TNF-alpha was found and in 28% also IL-6. This increase did not correlate however with BMI, the percentage of body fat, IRI and C peptide levels nor with cortisol and leptin levels. Insulin resistant subjects had more frequently elevated homocysteine and Lp(a) values which are further two independent risk factors of atherothrombogenesis. Hyperhomocysteinaemia can be favourably influenced by vitamin fortification of the diet or by administration of folate and pyridoxine (1 tablet per day) involving negligible financial costs.
...
PMID:[Relation between cytokines (TNF-alpha, IL-1 and 6) and homocysteine in android obesity and the phenomenon of insulin resistance syndromes]. 1042 20
The sleep apnoea/hypopnoea syndrome (SAHS) is characterized by repeated upper airway narrowing or collapse during sleep. The obstruction is caused by the soft palate and/or base of tongue collapsing against the pharyngeal walls because of decreased muscle tone. These episodes are accompanied by hypoxaemia, surges in blood pressure, brief arousal from sleep and pronounced snoring. Individuals with occult disease are at heightened risk of motorway accidents because of excessive
sleepiness
, sustained hypertension, myocardial infarction, and stroke. The signs and symptoms of SAHS may be recognisable in the dental practice. Common findings in the medical history include daytime
sleepiness
, snoring, hypertension, and
type 2 diabetes
mellitus. Common clinical findings include male gender, obesity, increased neck circumference, excessive fat deposition in the palate, tongue (macroglossia) and pharynx, a long soft palate, a small recessive mandible and maxilla, and calcified carotid artery atheromas on panoramic and lateral cephalometric radiographs. Dentists who recognise these signs and symptoms have an opportunity to diagnose patients with occult SAHS. After confirmation of the diagnosis by a physician, dentists can participate in the management of the disorder by fabricating mandibular advancement appliances that enlarge the retroglossal space by anterior displacement of the tongue and performing corrective upper airway surgery that prevents recurrent airway obstruction.
...
PMID:Dentistry's role in the diagnosis and co-management of patients with sleep apnoea/hypopnoea syndrome. 1097 58
Possibly the most important outcomes of bariatric surgery involve changes in obesity-related illness, quality of life (QOL), and psychologic well-being. Dramatic improvement or resolution of serious medical comorbidity accompanies the weight loss following laparoscopic adjustable gastric banding with the LAP-BAND (INAMED Health, Santa Barbara, CA). There are major improvements in the conditions of the metabolic syndrome, which is characterized by impaired glucose tolerance, dyslipidemia, and hypertension. Improvement in insulin sensitivity and pancreatic beta-cell function associated with weight loss induces remission in the majority of type 2 diabetics and reduces the risk of others developing
type 2 diabetes
. Improvement in dyslipidemia is characterized by raised high-density lipoprotein cholesterol and lower triglyceride concentrations. Together with lower blood pressure, these changes provide a substantial reduction in cardiovascular risk. Other medical conditions caused or aggravated by obesity are also significantly improved, including sleep apnea, daytime
sleepiness
, asthma, and gastroesophageal reflux. Weight loss is associated with improved fertility and more favorable pregnancy outcomes. All aspects of QOL improve substantially, especially physical disability, and post-weight-loss QOL measures approximate those of the general population. There are also major improvements in body image and reduction in depressive illness. These changes provide perhaps the most compelling data regarding the value of LAP-BAND surgery and underlie the great satisfaction experienced by patients.
...
PMID:Changes in comorbidities and improvements in quality of life after LAP-BAND placement. 1252 52
Rapidly accumulating evidence shows that sleep apnea is a major factor influencing personal health and public safety. Diagnosis and treatment of this syndrome may well result in significant preventive medicine outcomes. The prevalence of sleep apnea is so high that evaluation and treatment must become the province of the primary care physician. Accurate, appropriate history, physical assessment and clinical management are the mainstays of care, with the judicial application of technology. A history of snoring, particularly when it is intermittent, interrupted by snorts, and accompanied by restless sleep or daytime
sleepiness
suggests the need for further evaluation. When co-morbid conditions such as hypertension, cardiovascular disease or
type 2 diabetes
are present, formal evaluation and consideration of treatment are needed. If initial evaluation reveals severe obstructive sleep apnea with observed apneas, together with excessive daytime
sleepiness
, clinical management with empirical application of continuous positive airway pressure (CPAP) may suffice in experienced hands.
...
PMID:Diagnosis of sleep apnea. 1267 67
An active cortex is necessary for intact cognitive function. In a sleepy individual, the cerebral cortex is to some extent deactivated; a sleep-deprived person will experience reduced physical and mental activity and productivity, more errors on the job, more risk for motor vehicle accidents, and psychosocial problems. Hormone levels can become imbalanced from excessive daytime
sleepiness
(EDS), and treatments for conditions unrelated to EDS can be hampered. Whether sleep restriction is voluntary or not, those who experience it habitually are at greater risk of obesity and
type 2 diabetes
. While an accurate history is necessary to diagnose sleep disorders, all too often a patient's chronic daytime
sleepiness
is never mentioned. EDS will not show up in most blood chemistries either. It is important that primary care providers ask patients about their sleep and its quality. Other screening tools include questionnaires, which are easily administered and can be sensitive. To determine the basis of EDS, formal sleep studies may be necessary.
...
PMID:Patient-management strategies. 1804 75
Sleep-disordered breathing (SDB) has been associated with insulin resistance and glucose intolerance, and is frequently found in people with
type 2 diabetes
. SDB not only causes poor sleep quality and daytime
sleepiness
, but has clinical consequences, including hypertension and increased risk of cardiovascular disease. In addition to supporting the need for further research into the links between SDB and diabetes, the International Diabetes Federation Taskforce on Epidemiology and Prevention strongly recommends that health professionals working in both
type 2 diabetes
and SDB adopt clinical practices to ensure that a patient presenting with one condition is considered for the other.
...
PMID:Sleep-disordered breathing and type 2 diabetes: a report from the International Diabetes Federation Taskforce on Epidemiology and Prevention. 1854 48
Nominal group technique was used with persons with
type 2 diabetes
to identify and rank the severity of problems associated with being sleepy. Participants were adults who were subjectively sleepy according to the Epworth
Sleepiness
Scale. Daytime
sleepiness
was associated with a general decrease in motivation to engage in activities that are important to the management of diabetes. Because decreased motivation may have a negative influence on psychological well-being, it is important that health care providers assess not only for how well their patients' diabetes is being controlled, but also for sleep disturbances and the patients' general state of psychological well-being.
...
PMID:Daytime sleepiness, diabetes, and psychological well-being. 1885 51
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Although frequently undiagnosed, OSA is highly prevalent and presents most often with excessive daytime
sleepiness
(EDS). While obesity is the major predisposing factor, patients with OSA and EDS are at increased risk of other conditions, including cardiovascular disease,
type 2 diabetes
, cognitive impairment, and depression. Significant consequences include morbidity and mortality from the associated conditions in addition to personal and societal consequences of cognitive impairment, such as driving and workplace accidents. Primary care physicians are ideally placed to screen for OSA and EDS in patients who present with commonly comorbid conditions such as obesity, cardiovascular disease, metabolic syndrome, and depression. Conversely, treatment of OSA and associated EDS might help alleviate significant comorbidities and their clinical and societal consequences.
...
PMID:Clinical and societal consequences of obstructive sleep apnea and excessive daytime sleepiness. 1917 16
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