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

Diabetic relatives and obese subjects are at increased risk for development of diabetes mellitus, and therefore are classed as potential abnormality of glucose tolerance (POT-AGT). Disturbances of lipid and purine metabolisms have been reported in diabetic and obese non-diabetic subjects. In obese subjects above alterations are probably due to hyperinsulinemia. This study aimed at verifying whether similar metabolic abnormalities could be found in relatives of non-insulin dependent diabetic patients and whether they could be related to possible glucose intolerance. We have studied 10706 outpatients and 95 hospitalized subjects, aged between 20 and 50 years. We have selected 4 groups according to diabetic relationship and body mass index: A (normal weight subjects), B (obese subjects), C (normal weight NIDDM-relatives), D (overweight NIDDM-relatives). The NIDDM-relatives showed higher prevalence of hyperglycemia, as expected; furthermore the relatives with normal glucose tolerance had higher glucose area during OGTT. Serum levels of uric acid and insulin response to oral glucose were increased in all obese subjects, but abnormalities of lipid metabolism and fasting hyperinsulinemia were found only in obese NIDDM-relatives. These results suggest that family history of diabetes mellitus can be a risk for metabolic disturbance even in absence of glucose intolerance. Furthermore some metabolic disorders observed in obese subjects could be due to an associated and not sufficiently investigated family history of diabetes.
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PMID:Metabolic abnormalities in first-degree relatives of type 2 diabetics. 208 58

Obesity is a common problem in Type 2 diabetes mellitus, and reduction of weight in obese diabetic patients will lead to an improvement in glucose tolerance. Despite the importance of weight loss, obese diabetic patients often fail to lose weight with advice on dietary restriction. Frequent visits to see the dietician provide the best chance of successful weight loss, and should be an important part of the management of the overweight patient. If this line of treatment is unsuccessful, then drug therapy may be considered to assist the patient in adhering to the dietary restriction. Over the past decade, drug therapy for weight loss has fallen into disrepute in the wake of the abuse of amphetamines and thyroid hormones by both patients and doctors. For this reason, the only drug commonly used in the diabetic clinic to assist patients to lose weight is metformin because of its putative therapeutic effect on obesity. However, currently available anorectic agents have much less potential for abuse by patients than their predecessors, and new drugs are being developed in this field.
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PMID:Drug treatment of obesity in type 2 diabetes mellitus. 213 66

The composition of the diet of the type II-diabetics should correspond to the principles of a lactovegetarian diet: relatively many carbohydrates, vegetables, fruits and little fat, in particular little animal fats. By such a pathogenetically orientated nutrition one is at the earliest able to treat successfully preventively and therapeutically the development of the arteriosclerosis which is connected with the type 2 diabetes and with metabolic syndrome. Thereby the weight reduction is of course integrated into such a dietary prescription. The number of meals a day should not routine-like be established to 5 to 6, and only in a bad metabolic condition the subdivision into many smaller meals is necessary. In the calculation of the food type 2 diabetics with overweight stabilised on diet alone should estimate the energy of food and reduce it. At this stage the calculation of carbohydrates is not necessary. Only when a blood sugar decreasing therapy is added (insulin and perhaps sulfonylureas) we have additionally to begin the calculation of carbohydrates. In order to obtain a useful compliance unnecessary reglementations must be removed so that only there where necessary a strict discipline is observed.
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PMID:[New knowledge of diet therapy of type 2 (non-insulin-dependent) diabetes]. 220 10

The effects on cardiac function of feeding a diet high in sucrose to male Wistar rats over an extended period of time (15 months) was examined. This diet produced a diabetic condition which resembled noninsulin dependent diabetes mellitus. Resting hyperglycemia, high circulating insulin and triglyceride levels were observed in these animals. Further, the sucrose fed animals were overweight in comparison to chow fed control animals. Contractile protein Ca2+-ATPase activity was measured as a biochemical estimate of cardiac contractile function. Myosin and actomyosin Ca2+-ATPase activities of isolated myofibrillar fractions from hearts of experimental animals were depressed in comparison to chow fed control rats. Myosin K+-EDTA activity was also altered. The results demonstrate for the first time a defect in contractile protein Ca2+-ATPase activity in rat hearts using a model of noninsulin dependent diabetes mellitus. As the animals were euthyroid, thyroid hormone alterations in these animals were unlikely to influence the results. The results also demonstrate that insulin could not be a direct factor associated with cardiac pathology in diabetes. Instead, cardiac dysfunction may be associated with other, as yet undefined, metabolic abnormalities which accompany the diabetic state.
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PMID:Cardiac contracile protein ATPase activity in a diet induced model of noninsulin dependent diabetes mellitus. 252 35

We examined the association of degree and duration overweight, dietary habits and exercise with non-insulin dependent diabetes mellitus risk in a defined population of 886 men and 1114 women who were aged 50 years and older when examined in 1984-1987. After an oral glucose tolerance test, 142 men and 142 women were classified as diabetic using WHO criteria. Compared to those with appropriate childhood weight, reported underweight as a child significantly increased the rate of diabetes as an adult (RR = 1.3, P less than 0.05). Underweight as a teenager was also associated with an increased rate (RR = 1.3, P less than 0.05). Underweight as a teenager was also associated with an increased rate (RR = 1.4, P less than 0.01). In adults with current body mass indices (weight/height2) greater than 26, the diabetes rate was significantly higher for those underweight as children (RR = 1.7, P less than 0.01). A multivariate logistic regression analysis of adult diet and weight behaviors, adjusting for age and current smoking, found that a weight gain or fluctuation between the ages of 40 and 60 of 10 lbs or more significantly increased the diabetes rate (RR = 1.4, P less than 0.05; RR = 1.7, P less than 0.01). Weight gain between age 18 and the 1984-1987 visit also significantly increased the rate (RR = 1.4 per 17.3 percent, P less than 0.001). Exercise as the only means to control weight was associated with a significantly reduced diabetes rate (RR = 0.05, P less than 0.05).
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PMID:The association of lifetime weight and weight control patterns with diabetes among men and women in an adult community. 258 26

The frequency of secondary failure to oral hypoglycaemic agents (OHA) in patients with non-insulin dependent diabetes (NIDDM) is still unknown, despite more than 30 years of use of OHA. The term secondary failure should be limited to patients who, despite maximal dosages of OHA and despite full compliance with diet and therapy, are no longer controlled and require insulin to obtain an acceptable glucose metabolism. We evaluated 248 out-patients, either on OHA, or on insulin because of poor metabolic control with OHA, in order to assess duration of treatment with OHA since diagnosis, by means of actuarial curves (Mantel-Cox test). Patients with low relative body weight (RBW less than or equal to 100) experienced secondary failure earlier and more often than obese patients (RBW greater than 120) or overweight (RBW 101-120) patients. In 66 of the above out-patients, 33 OHA-treated and 33 insulin-treated, matched for age at onset and duration of disease, islet-cell-antibodies (ICA) and C-peptide release at fasting, 6 min after i.v. glucagon and post prandially were evaluated. Only among lean and overweight patients, was C-peptide release significantly lower in insulin-treated than in OHA-treated patients; differences disappeared in obese patients. ICA were found in only 7 patients (10.6%). HLA phenotype was different from that of healthy blood donors for the loci HLA B5, B13, CW4, with no differences between OHA-treated and insulin-treated patients. These data indicate that secondary failure is more frequent in lean patients with NIDDM, and is related to reduced insulin release.
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PMID:Secondary failure to oral hypoglycaemic agents in non-obese patients with non-insulin-dependent diabetes is related to reduced insulin release. 266 Dec 81

In this study, 16 overweight or obese NIDDM patients with a long period of stable weight and dietary surveillance were treated with 150 mg t.i.d. of Benfluorex per os for 3 months. A significant improvement occurred in the fasting and post-meal glucose levels and in the HbA1C values, regardless of weight changes that occurred throughout the study. No significant changes were found in the fasting or meal-stimulated insulin (IRI) levels and in the glucose:IRI molar ratios. On the contrary, there were no significant variations in C-peptide levels while the glucose:CPR ratio appeared to decrease while on Benfluorex. In basal conditions, 11 patients presented insulin insensitivity (as measured by the glucose-insulin-somatostatin technique) which was unaffected by the pharmacological treatment. Benfluorex may therefore ameliorate metabolic control in overweight or obese NIDDM patients, but our data do not clarify whether its effects are mediated by an improvement in the action of insulin in peripheral tissues.
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PMID:Benfluorex action on metabolic control and insulin sensitivity in type 2 non-insulin dependent diabetics. 268 69

VLCD is an effective and safe measure to reduce overweight in NIDDM. It substantially improves glucose control and corrects associated coronary risk factors, in particular dyslipoproteinaemia and hypertension. Both insulin secretion and insulin resistance were ameliorated by perfect glucose control with VLCD. Reliable data on long term efficacy and factors determining weight loss and success in permanent glucose control are urgently needed.
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PMID:Very low calorie diet therapy in obese non-insulin dependent diabetes patients. 269 83

Poorly controlled type 2 diabetes represents a major therapeutic problem. A classification of the disease, based on body weight and presence or absence of adequate insulin-secretion capacity, may be helpful in the choice of correct treatment. Calorie reduction is the most important therapeutic intervention in overweight patients. In the diabetic diet digestible carbohydrates should comprise at least 50 energy%, while the fat content should be reduced below 30 energy%. Controlled clinical studies show that the blood glucose control can be improved and the urinary glucose excretion be diminished by addition of dietary fibre. In obese type 2 diabetics supplemented fasting may be useful to achieve a rapid weight loss and an improved metabolic control. Although our knowledge with regard to the patho-physiology of type 2 diabetes and the effects of dietary treatment has increased during recent years, several important questions remain unanswered. Also there is a great need for education and training programmes to achieve improved compliance to the dietary advice given.
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PMID:Diet therapy for poorly controlled type 2 (non-insulin-dependent) diabetes mellitus. 301 Jun 32

Diabetes mellitus is a heterogenous syndrome. Insulin dependent type I diabetes is characterised by progressive beta-cell-loss, resulting in a deterioration of insulin secretion. Cause of the beta-cell-destruction is a chronic autoimmune process, which starts already months to years before manifestation of the disease. New advances in the diagnosis of the autoimmune mechanisms, which are responsible for type I diabetes might help to prevent type I diabetes by immunization or immunosuppressive therapy in the near future. At the moment multiple daily insulin injections are the substitution therapy of the choice in type I diabetes mellitus. This kind of therapy is designed to imitate the physiologic dynamics of insulin secretion in healthy subjects. In non insulin dependent diabetes a defect in insulin action seems to be the primary cause of the disease although there are also defects in insulin secretion in type II diabetes mellitus. Most type II diabetics are overweight at the beginning of the disease and the primary goal of therapy in these patients is normalization of bodyweight and improvement of peripheral and hepatic insulin sensitivity. Regular exercise is seen as a cornerstone in the treatment of type I and type II diabetes. Besides the acute blood glucose lowering effect of exercise, regular exercise has beneficial effects on the circulatory system and muscle system, leads to an increase in insulin sensitivity, to a decrease of the daily insulin dosage and to a stabilization of metabolic control. Furthermore beneficial effects of exercise on plasma lipids and lipoproteins are reported. In overweight diabetics regular exercise facilitates normalization of body weight.
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PMID:[Pathogenesis and therapy of type I and type II diabetes mellitus]. 306 11


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