Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 50 normotonic patients with type 2 diabetes (NIDDM) and controls matched for sex and age with NIDDM and hypertension a statistically significant difference was found as regards S-peptide values on fasting, cholesterol, triglycerides, BMI and atherogenic index (cholesterol/HDL, p < 0.01). C-peptide values correlated positively with values of the systolic and median BP and the atherogenic index in both groups. In normotonic diabetics there was also a positive correlation with the BMI and in hypertonic subjects with the triglyceride levels. The results confirm the hypothesis that in NIDDM there is a direct relationship between arterial hypertension, unfavourable lipid parameters and insulin resistance and compensatory hyperinsulinism resp. The authors discuss possible mechanisms by which hyperinsulinism mediates a rise of BP, hyperlipoproteinaemia, hyperglycaemia and hirsutism (hormonal metabolic syndrome X and 5H resp.). These phenomena are the main risk factors of cardiovascular diseases and lead via heart attacks and cerebrovascular attacks (IHD and stroke) to a high cardiovascular morbidity and mortality in our population. The morbidity and mortality is steadily increasing and thus we are among civilized countries among those with the highest morbidity and mortality.
 ...
PMID:[Insulin resistance and arterial hypertension. Hyperinsulinism as a basic etiopathogenic factor in essential arterial hypertension and associated phenomena]. 148 85

In one third of patients who suffered an infarction NIDDM and arterial hypertension are present. In the absolute majority of patients with IHD, as apparent from the IRI and C-peptide response after a glucose load, hyperinsulinism is present. The blood sugar response can have the character of diabetes or of impaired glucose tolerance, the curve may be very flat or normal while the IRI and C-peptide response are excessive. Hyperinsulinism has a hypersecretory origin as suggested by the concurrently elevated C-peptide level but also reduced insulin utilization in the liver and peripheral target organs. Hyperinsulinism is thus a regular associated phenomenon of IHD and is a special risk factor independent on hyperglycaemia and associates with the other main risk factors of IHD such as arterial hypertension, HPLP (android obesity), hyperglycaemia (NIDDM) and hirsutism as a manifestation of a hyperandrogenic state in the female organism with the syndrome of polycystic ovaries. Hyperinsulinism plays an indirect role in the pathogenesis of coronary syndrome via the main risk factors (5H syndrome--hyperinsulinism, hypertension, HPLP, hyperglycaemia, hirsutism) and also directly by its action on endothelial paracrine mechanism of the coronary circulation where in the early stage vasoconstrictor factors predominate (endothelin-1, PGF2-alpha) over physiological vasodilatating factors (EDRF-NO, PGE2, PGI2) and this leads then to functional spasms. It seems that also the coronary X syndrome develops very frequently on the background of the hormonal metabolic X syndrome or the 5H syndrome.
 ...
PMID:[Hyperinsulinism and the coronary syndrome]. 149 68

Prospective studies have shown a relationship between hyperinsulinaemia, an indirect index of insulin resistance, and IHD in men with normal glucose tolerance. In NIDDM this association is less clear possibly due to the poor significance of insulin and C-peptide concentrations as an index of insulin resistance. Therefore, only a direct measurement of insulin sensitivity could clarify the possible relationship between insulin resistance and IHD in NIDDM. We have evaluated insulin sensitivity, by means of an ITT, and some risk factors for IHD in 72 men with NIDDM, 36 with and 36 without IHD, attending our out-patient Diabetic Clinic. The two groups were of similar age, duration of diabetes, glycaemic control and body composition. Subjects with IHD were more insulin resistant (K(ITT) index 2.45 +/- 0.18 vs 3.12 +/- 0.13% per min, in patients with and without IHD, respectively, p < 0.004), had higher total (p = 0.011) and LDL serum cholesterol levels (p = 0.010) and greater prevalence of hypertension (p = 0.001) compared to subjects without IHD. Using step-wise logistic regression analysis, insulin resistance (odds ratio 2.57, 95% CI 1.87-3.28, p = 0.008), hypertension (odds ratio 8.17, 95% CI 6.86-9.48, p = 0.002), total serum cholesterol levels (odds ratio 1.02, 95% CI 1.005-1.035, p = 0.015) and BMI (0.79, 95% CI 0.67-0.97, p = 0.049) were independently associated with IHD. After adjustment for age and duration of diabetes, only insulin sensitivity was directly related to the age of onset of IHD, independently from other clinical and metabolic parameters (p < 0.015).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Evidence of higher insulin resistance in NIDDM patients with ischaemic heart disease. 792 45

Magnesium ions (Mg2+) are pivotal in the transfer, storage and utilization of energy; Mg2+ regulates and catalyzes some 300-odd enzyme systems in mammals. The intracellular level of free Mg2+ ([Mg2+]i) regulates intermediary metabolism, DNA and RNA synthesis and structure, cell growth, reproduction, and membrane structure. Mg2+ has numerous physiological roles among which are control of neuronal activity, cardiac excitability, neuromuscular transmission, muscular contraction, vasomotor tone, blood pressure and peripheral blood flow. Mg2+ modulates and controls cell Ca2+ entry and Ca2+ release from sarcoplasmic and endoplasmic reticular membranes. Since the turn of this century, there has been a steady and progressive decline of dietary Mg intake to where much of the Western World population is ingesting less than an optimum RDA. Geographic regions low in soil and water Mg demonstrate increased cardiovascular morbidity and mortality. Dietary deficiency of Mg2+ results in loss of cellular K+ and gain of cellular Na+ and calcium ions (Ca2+). Blood normally contains Mg2+ bound to proteins, Mg2+ complexed to small anion ligands and free ionized Mg2+ (IMg2+). Most clinical laboratories only now assess the total Mg, which consists of all three Mg fractions. Estimation of the IMg2+ level in serum or plasma by analysis of ultrafiltrates (complexed Mg + IMg2+) is somewhat unsatisfactory, as the methods employed do not distinguish the truly ionized form from Mg2+ bound to organic and inorganic anions. Because the levels of these ligands can vary significantly in numerous pathological states, it is desirable to directly measure the levels of IMg2+ in complex matrices such as whole blood, plasma and serum. Using novel ion selective electrodes (ISE's), we have found that there is virtually no difference in IMg2+, irrespective of whether one samples whole blood, plasma or serum. These data demonstrate that the mean concentration of IMg2+ in blood is about 600 mumoles/litre (0.54-0.65 mmol/L, 95% Cl); 65-72% of total Mg being free or biologically-active Mg2+. Use of the NOVA and KONE ISE's for IMg2+ on plasma and sera from patients with a variety of pathophysiologic and disease syndromes (e.g., long-term renal transplants, liver transplants, during and before cardiac surgery, ischemic heart disease [IHD], headaches, pregnancy, neonatal period, non-insulin dependent diabetes (NIDDM), end-stage renal disease [ESRD], hemodialyse [HEM], and continuous ambulatory peritoneal dialysis (CAPD), hypertension, myocardial infarction [AMI] and after excessive dietary intake of Mg), has revealed interesting data. The results indicate that long-term renal transplant patients, headache, pregnant, NIDDM, ESRD, HEM, CAPD, AMI, hypertensive, and IHD subjects exhibit, on the average significant depression in IMg2+ but not TMg. Use of 31P-NMR spectroscopy on red blood cells, from several of these disease states, to assess free intracellular Mg ([Mg2+]i demonstrates a high correlation (r = 0.5-0.8) between IMg2+ and [Mg2+]i. Increased dietary load of Mg, for only 6 days, in human volunteers, resulted in significant elevations in serum IMg2+ but not TMg. Correlations between the clinical course of several of the above disease syndromes and the fall in IMg2+ and [Mg2+]i were found. The ICa2+/IMg2+ ratio appears, from our data, to be an important guide for signs of peripheral vasoconstriction, ischemia or spasm and possibly atherogenesis. Overall, our data point to important uses for ISE's for IMg2+ in the diagnosis and treatment of disease states.
 ...
PMID:Role of magnesium in patho-physiological processes and the clinical utility of magnesium ion selective electrodes. 886 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

Several epidemiological studies have suggested that sleep-disordered breathing is a risk factor for cardiovascular disease, particularly hypertension, stroke and IHD. The relative risk for IHD among obstructive SAS(OSAS) patients is 1.2 to 6.9 higher compared with the general population. The prevalence of SAS with an apnea-hypopnea index(AHI) of 10 and over was 35 to 40% in IHD, while 23.8% of SAS patients had IHD. These evidence suggests that IHD is an important prognostic factor in SAS patients. Characteristic pathophysiological conditions such as sleep apnea-induced hypoxemia and sympathetic activation may play an important role in the genesis of nocturnal angina pectoris. Most patients with OSAS are obese, and the complication of non-insulin dependent diabetes mellitus is quite a few. Insulin resistance is also attracting great attention as a cause of the cardiovascular complication of SAS.
 ...
PMID:[Sleep apnea syndrome (SAS) and ischemic heart disease (IHD)]. 1094 39

Surgical treatment of morbid obesity is a recognized method of proceedings in patients who did not obtain any positive results in conservative therapy. In October and November 1998 laparoscopic implantation of the SAGB was performed among ten morbid obesity patients with mean BMI of 41.9 +/- 3.6 kg/m2. It was the first experience in Poland. In this group we observed also non-insulin dependent diabetes mellitus in five, hyperlipidemia in eight and hypertension in three patients. In this series, there was no mortality and no perioperative morbidity. The mean operation time was 158 +/- 51 min. The mean hospital stay was four days after the operation. Median BMI reduction after four months was 4.7 +/- 1.6 kg/m2. Parallel to the reduction in body weight, there occurred a significant reduction in plasma concentration of glucose (111.0 +/- 38.5 vs. 90.2 +/- 20.8 p < 0.01), total cholesterol (223.8 +/- 42.0 vs. 192.7 +/- 21.3 p < 0.005), and LDL-cholesterol (140.4 +/- 34.0 vs. 121.7 +/- 25.2 p < 0.01). Hypertension was still observed only in one patient. Nowadays laparoscopic gastric banding represents the least invasive surgical treatment of morbid obesity. In our series laparoscopic implantation of SAGB seems to be an effective surgical method for the treatment of obesity. Substantial reduction in body weight was associated with improvement in metabolic control. Absence of mortality and morbidity is one of the main aims in bariatric surgery which was achieved in our study. The results of the present, first in Poland, preliminary study confirm previous observations that gastric banding is an effective treatment of obesity.
Med Sci Monit
PMID:Swedish adjustable gastric band (SAGB) implanted laparoscopically in the treatment of morbid obesity--the first experience in Poland. 1123 66

According to the latest prognoses, 300 million people are expected to suffer from diabetes (particularly type 2) in 2025; diabetes will become a new epidemics of the coming century. Therefore it is so important to get acquainted with the pathomechanism of diabetes-related disorders and the possibilities of effective treatment. During the last decade, numerous prospective epidemiological studies have been completed, which have considerably extended our knowledge of the pathomechanism of disturbances and their effect on late complications of diabetes. Resistance to insulin has an important role in the etiology of type 2 diabetes. However, there is substantial evidence indicating that impairment or regression of rapid insulin secretion phase at the early stage of the disease is a factor of no lesser importance. The lack of appropriate insulin concentration after the stimulation by food ingestion (first 30 min after the meal), leads to permanent, treatment-resistant hyperglycemia. The postulated attempts to obtain a 'nearly normoglycemic' condition, as well as the results of prospective epidemiological studies proving that achieving this aim improves the prognosis of diabetic patients, prompt the researchers to search for the drugs or treatment schedules, which could effectively restore the impaired insulin secretion, and its early phase in particular, in type 2 diabetes. Human insulin analogs and their pre-formulated commercially available mixtures seem very promising in this respect.
Med Sci Monit
PMID:How recombinant insulin analogs improve insulin therapy of diabetes mellitus: pathophysiology, clinical practice and recommendations. 1143 20

Infrared laser therapy (300 Hz) combined with balneotherapy and patients' education is more effective than standard sanatorium rehabilitation in patients with ischemic heart disease associated with diabetes mellitus type 2. 81.8% patients showed good response manifesting in less frequent anginal attacks, episodes of pain and painless ischemia and lower doses of antianginal drugs. Systolic and diastolic arterial pressure lowered by 18 and 10 mm Hg on the average, respectively. Multimodality rehabilitation of IHD patients with type 2 diabetes mellitus improves hemostasis, carbohydrate and lipid metabolism. Coronary circulation response lasted for 24 weeks.
 ...
PMID:[Use of infrared laser therapy in patients with ischemic heart disease associated with diabetes mellitus type 2 in health resort]. 1238 May 22

Type 2 diabetes is the most common form of hyperglycemia. The disease exists in all populations, but in developed societies, the prevalence has risen as the population ages and above all becomes more obese. In the prediabetic state, type 2 diabetes involves two defects, peripheral insulin resistance and hyperinsulinemia, which is followed by the failure of insulin secretion to compensate for the insulin resistance. As with nearly any disease, it is likely that multiple environmental and genetic factors are involved in the development of insulin resistance. An acquired pathogenic factor is obesity, particularly visceral obesity. Compelling evidence suggests that progressive dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, with elevated levels of circulating cortisol, is implicated in the development of visceral obesity. The HPA axis perturbations associated with visceral obesity can be accounted for, in part, by increased environmental stress that destabilizes the hypothalamic-pituitary system in individuals with genetic susceptibility.
Med Sci Monit 2003 Feb
PMID:Stress induced disturbances of the HPA axis: a pathway to Type 2 diabetes? 1260 4


1 2 3 4 5 6 7 8 9 10 Next >>