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

A 14%, simple random sample of the King Saud University Community consisting of students, faculty and staff was screened for diabetes mellitus. The screening procedures used consisted of urine testing by means of the urine dipstick and blood glucose estimation in the fasting state by means of the reflomat glucose, a glucose oxidase meter. Participants whose fasting blood glucose (FBG) were 140 mg/dl or more were referred to the diabetes clinic for further evaluation and possible inclusion into the subsequent retrospective study. A period prevalence of 6.0% was observed for FBG greater than 140 mg/dl and all the referrals were confirmed for adult onset diabetes mellitus. The prevalence was similar to that in the USA and suggested that the rapid socio-economic changes in Saudi Arabia made a minimal contribution to the prevalence of diabetes mellitus.
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PMID:Epidemiologic studies of diabetes mellitus in Saudi Arabia--Part I--Screening of 3158 males in King Saud University. 212 87

Interest in sweetening agents is encouraging manufacturers and researchers to find a safe substance to maintain the life quality of diabetics. The popularity of sweetened food items has increased recently in Taiwan. The glycemic index of fructose has been reported to be 20%, much lower than most carbohydrate foods. A high-fructose corn syrup (HFCS) has come onto the market of sweetening agents and has been proposed as a low-cost substitute for fructose in dietetic management of diabetes. The aim of this study was to compare the glycemic effects of HFCS and glucose to see if there is a place for high-fructose corn syrup in diabetic management. In 8 normal and 21 non-insulin dependent diabetes mellitus (NIDDM) subjects, we performed oral tolerance tests. After an overnight fast, the subjects were given either 75g of glucose or an equivalent amount of HFCS containing 75g of carbohydrate. Blood was sampled before and at 30, 60, 90, 120 and 180 minutes after the glucose load. Blood glucose was analyzed by the glucose oxidase method using YSI 23 A (Yellow-Springs Intrument). The insulin and C-peptide were measured by RIA kits from Daiichi. The area under the curves (AUC) was calculated for plasma glucose, immunoreactive insulin (IRI) and immunoreactive C-peptide (IRCP). The results showed that the glycemic effect of HFCS was 73% of glucose. The AUC of IRI after HFCS was 56% of that of glucose. The AUC of IRCP after HFCS was 57% of that of glucose. The high glycemic index of HFCS in our study does not support the use of HFCS as a substitute for fructose.
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PMID:Effects of high-fructose (90%) corn syrup on plasma glucose, insulin, and C-peptide in non-insulin-dependent diabetes mellitus and normal subjects. 269 93

New small, light-weight and fast-acting meters for measuring blood glucose have been developed recently. To determine their accuracy and precision we compared Accutrend, Companion 2, Glucometer 3 and One Touch II with the reference glucose oxidase method. For determination of accuracy 150 measurements were performed on two meters of each brand, together with measurement on the Beckman 2 Analyzer, which served as our reference. Capillary blood samples were obtained from patients with type 1 and type 2 diabetes attending our outpatient clinic. All measurements were performed by one experienced technician. Precision in series was determined by 15 measurements of venous EDTA samples. The coefficient of variance was used for statistical analysis. Accuracy was evaluated according to recommendations of the American Diabetes Association and clinically useful criteria such as the error grid analysis. We found that One Touch II performed best overall, followed by Accutrend. Companion 2 and Glucometer 3 showed higher deviations in both accuracy and precision, but nonetheless met the clinical criteria of accuracy and reliability measured by error grid analysis in 87% and 90.5% of measurements, respectively. In conclusion, all four blood glucose meters can safely be used, after proper training, by patients and medical staff for self-measurement of blood glucose.
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PMID:[Clinical evaluation of the blood glucose monitors Accutrend, Companion 2, Glucometer 3 and One Touch II in comparison with the glucose oxidase reference method]. 785 78

Intravenous glucagon-like peptide (GLP)-1 [7-36 amide] can normalize plasma glucose in non-insulin-dependent diabetic (NIDDM) patients. Since this is no form for routine therapeutic administration, effects of subcutaneous GLP-1 at a high dose (1.5 nmol/kg body weight) were examined. Three groups of 8, 9 and 7 patients (61 +/- 7, 61 +/- 9, 50 +/- 11 years; BMI 29.5 +/- 2.5, 26.1 +/- 2.3, 28.0 +/- 4.2 kg/m2; HbA1c 11.3 +/- 1.5, 9.9 +/- 1.0, 10.6 +/- 0.7%) were examined: after a single subcutaneous injection of 1.5 nmol/kg GLP [7-36 amide]; after repeated subcutaneous injections (0 and 120 min) in fasting patients; after a single, subcutaneous injection 30 min before a liquid test meal (amino acids 8%, and sucrose 50 g in 400 ml), all compared with a placebo. Glucose (glucose oxidase), insulin, C-peptide, GLP-1 and glucagon (specific immunoassays) were measured. Gastric emptying was assessed with the indicator-dilution method and phenol red. Repeated measures ANOVA was used for statistical analysis. GLP-1 injection led to a short-lived increment in GLP-1 concentrations (peak at 30-60 min, then return to basal levels after 90-120 min). Each GLP-1 injection stimulated insulin (insulin, C-peptide, p < 0.0001, respectively) and inhibited glucagon secretion (p < 0.0001). In fasting patients the repeated administration of GLP-1 normalized plasma glucose (5.8 +/- 0.4 mmol/l after 240 min vs 8.2 +/- 0.7 mmol/l after a single dose, p = 0.0065). With the meal, subcutaneous GLP-1 led to a complete cessation of gastric emptying for 30-45 min (p < 0.0001 statistically different from placebo) followed by emptying at a normal rate. As a consequence, integrated incremental glucose responses were reduced by 40% (p = 0.051). In conclusion, subcutaneous GLP-1 [7-36 amide] has similar effects in NIDDM patients as an intravenous infusion. Preparations with retarded release of GLP-1 would appear more suitable for therapeutic purposes because elevation of GLP-1 concentrations for 4 rather than 2 h (repeated doses) normalized fasting plasma glucose better. In the short term, there appears to be no tachyphylaxis, since insulin stimulation and glucagon suppression were similar upon repeated administrations of GLP-1 [7-36 amide]. It may be easier to influence fasting hyperglycaemia by GLP-1 than to reduce meal-related increments in glycaemia.
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PMID:Effects of subcutaneous glucagon-like peptide 1 (GLP-1 [7-36 amide]) in patients with NIDDM. 896 Aug 41

In a community based survey of gestational diabetes in 18 rural villages of the eastern zone of Tigray administrative region, northern Ethiopia, a total of 890 pregnant women with gestational age of 24 weeks and above were examined for gestational diabetes mellitus based on WHO criteria. A 75 gm oral glucose tolerance test was performed on each subject with measurement of glucose at 0 and 2 h. Blood glucose was determined by glucose oxidase method using capillary blood (Accutrend alpha, Boehringer Mannheim). The mean age of the mothers was 27.4 +/- 7.1 years. Forty four percent of the subjects were multiparas. The prevalence rate of gestational diabetes mellitus was found to be 3.7% (95% CI 2.5-4.9). The mean blood glucose 2 h after glucose load in those pregnant diagnosed to have gestational diabetes mellitus was 154.6 +/- 14.4 mg/dl (J.W. Rich-Edwards, G.A. Colditz, M.J. Stampfer, W.C. Willett, M.W. Gillman, C. Hennekens, F.E. Speizer, J.E. Manson, Birth weight and the risk for type 2 diabetes mellitus in adult women, Annu. Intern. Med. 130 (1999) 278-284). The prevalence of gestational diabetes mellitus in this region of the country is high as compared to other parts of Africa. The possible role and contribution of exposure of the general population in this area to chronic malnutrition as a result of prolonged famine, drought and war, to the high prevalence of gestational diabetes mellitus warrants further study.
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PMID:Prevalence of gestational diabetes mellitus in rural pregnant mothers in northern Ethiopia. 1062 91

The purpose of this study was to investigate the changes of serum free fatty acids (FFA) in fasting state and absorptive state and the relationship between FFA changes and insulin resistance in the patients with type 2 diabetes (DM2). 75 g of glucose were given to 60 patients with DM2. Fasting serum FFA, serum insulin levels and the same parameters 2 h after glucose load were measured by calorimetric and RIA methods. Fasting and 2 h after oral glucose tolerance test (OGTT) plasma glucose(PG) levels were also assessed by using glucose oxidase method. The results showed the levels of serum FFA, PG and insulin of fasting and after glucose load in the patients were significantly increased and their insulin-sensitive (ISI) was remarkably decreased as compared with those in 30 normal controls, P < 0.05. Multiple stepwise regression analysis showed that the FFA level of 2 h after OGTT was negatively correlated with ISI, P = 0.0304. The results suggest that in patients with DM2, the levels of fasting and absorptive FFA are significantly elevated, which is negatively correlated with the decline of ISI, implying the association of abnormal fasting and absorptive FFA and insulin resistance in patients with type 2 diabetes.
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PMID:[Relationship between the changes of serum free fatty acids and insulin resistance in type 2 diabetics]. 1251 47

Glucose is the main physiological stimulus for insulin biosynthesis and secretion by pancreatic beta-cells. Glucose-6-phosphatase (G-6-Pase) catalyzes the dephosphorylation of glucose-6-phosphate to glucose, an opposite process to glucose utilization. G-6-Pase activity in pancreatic islets could therefore be an important factor in the control of glucose metabolism and, consequently, of glucose-dependent insulin secretion. While G-6-Pase activity has been shown to be present in pancreatic islets, the gene responsible for this activity has not been conclusively identified. A homolog of liver glucose-6-phosphatase (LG-6-Pase) specifically expressed in islets was described earlier; however, the authors could not demonstrate enzymatic activity for this protein. Here we present evidence that the previously identified islet-specific glucose-6-phosphatase-related protein (IGRP) is indeed the major islet glucose-6-phosphatase. IGRP overexpressed in insect cells possesses enzymatic activity comparable to the previously described G-6-Pase activity in islets. The K(m) and V(max) values determined using glucose-6-phosphate as the substrate were 0.45 mm and 32 nmol/mg/min by malachite green assay, and 0.29 mm and 77 nmol/mg/min by glucose oxidase/peroxidase coupling assay, respectively. High-throughput screening of a small molecule library led to the identification of an active compound that specifically inhibits IGRP enzymatic activity. Interestingly, this inhibitor did not affect LG-6-Pase activity, while conversely LG-6-Pase inhibitors did not affect IGRP activity. These data demonstrate that IGRP is likely the authentic islet-specific glucose-6-phosphatase catalytic subunit, and selective inhibitors to this molecule can be obtained. IGRP inhibitors may be an attractive new approach for the treatment of insulin secretion defects in type 2 diabetes.
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PMID:Enzymatic characterization of the pancreatic islet-specific glucose-6-phosphatase-related protein (IGRP). 1472 2

Glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide (GIP) are important factors in the pathogenesis of type 2 diabetes and have a promising therapeutic potential. Alterations of their secretion, in vivo degradation, and elimination in patients with chronic renal insufficiency (CRI) have not yet been characterized. Ten patients with CRI (aged 47 +/- 15 years, BMI 24.5 +/- 2.2 kg/m(2), and serum creatinine 2.18 +/- 0.86 mg/dl) and 10 matched healthy control subjects (aged 44 +/- 12 years, BMI 24.9 +/- 3.4 kg/m(2), and serum creatinine 0.89 +/- 0.10 mg/dl) were included. On separate occasions, an oral glucose tolerance test (75 g), an intravenous infusion of GLP-1 (0.5 pmol. kg(-1). min(-1) over 30 min), and an intravenous infusion of GIP (1.0 pmol. kg(-1). min(-1) over 30 min) were performed. Venous blood samples were drawn for the determination of glucose (glucose oxidase), insulin, C-peptide, GLP-1 (total and intact), and GIP (total and intact; specific immunoassays). Plasma levels of GIP (3-42) and GLP-1 (9-36 amide) were calculated. Statistics were performed using repeated-measures and one-way ANOVA. After the oral glucose load, plasma concentrations of intact GLP-1 and intact GIP reached similar levels in both groups (P = 0.31 and P = 0.87, respectively). The concentrations of GIP (3-42) and GLP-1 (9-36 amide) were significantly higher in the patients than in the control subjects (P = 0.0021 and P = 0.027, respectively). During and after the exogenous infusion, GLP-1 (9-36 amide) and GIP (3-42) reached higher plasma concentrations in the CRI patients than in the control subjects (P < 0.001 and P = 0.0033, respectively), whereas the plasma levels of intact GLP-1 and GIP were not different between the groups (P = 0.29 and P = 0.27, respectively). Plasma half-lives were 3.4 +/- 0.6 and 2.3 +/- 0.4 min for intact GLP-1 (P = 0.13) and 5.3 +/- 0.8 and 3.3 +/- 0.4 min for the GLP-1 metabolite (P = 0.029) for CRI patients vs. healthy control subjects, respectively. Plasma half-lives of intact GIP were 6.9 +/- 1.4 and 5.0 +/- 1.2 min (P = 0.31) and 38.1 +/- 6.0 and 22.4 +/- 3.0 min for the GIP metabolite (P = 0.032) for CRI patients vs. healthy control subjects, respectively. Insulin concentrations tended to be lower in the patients during all experiments, whereas C-peptide levels tended to be elevated. These data underline the importance of the kidneys for the final elimination of GIP and GLP-1. The initial dipeptidyl peptidase IV-mediated degradation of both hormones is almost unaffected by impairments in renal function. Delayed elimination of GLP-1 and GIP in renal insufficiency may influence the pharmacokinetics and pharmacodynamics of dipeptidyl peptidase IV-resistant incretin derivatives to be used for the treatment of patients with type 2 diabetes.
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PMID:Secretion, degradation, and elimination of glucagon-like peptide 1 and gastric inhibitory polypeptide in patients with chronic renal insufficiency and healthy control subjects. 1498 49

Patients on chronic ambulant peritoneal dialysis (CAPD) are increasingly likely to be treated with a new solution of corn starch-derived glucose polymers called icodextrin. This solution involves a very low carbohydrate absorption leading to a better glycemic control in diabetic patients. However these glucose polymers pass to the blood and are metabolized to oligosaccharids which interfere with blood glucose in distinct capillary glucose analyzers leading to overestimation of glycemia. We assessed the accuracy of glucose measurements with the three most commonly used glucose analyzers compared to venous plasma glucose measurement at our institution in 8 patients (4 patients with type 2 diabetes) on CAPD using icodextrin. Glycemia was measured simultaneously in plasma of venous blood using a reference laboratory method and in capillary blood using Accu-Chek sensor (Rotkreuz, Switzerland) (glucose dehydrogenase method), Glucotrend 2 (Rotkreuz, Switzerland) (glucose-dye-oxyreductase method) and Ascensia elite (Zurich, Switzerland) (glucose oxidase method) glucose analyzers. Only glucose readings with Ascensia elite correspond correctly with venous plasma glucose results (+0.3 mmol/l; n. s.), whereas glycemia was significantly overestimated by Accu-Chek sensor (+4.3 mmol/l; p<0.0001) and Glucotrend 2 glucose analyzers (+3.7 mmol/l; p<0.0001). Thus we conclude that distinct glucose analyzers overestimate real blood glucose concentration and are not suitable for monitoring glycemia in patients on CAPD with icodextrin. On the basis of our results, these patients should use glucose analyzers using glucose oxidase methods. All glucose analyzers should be cross-checked with a laboratory reference method before the application in patients on CAPD with icodextrin is recommended.
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PMID:Inaccurate self-monitoring of blood glucose readings in patients on chronic ambulatory peritoneal dialysis with icodextrin. 1663 78

The objective of this work was to investigate the insulin sensitivity (SI) and the beta cell function (BCF) in different glucose tolerance statuses in a comparative cross-sectional study. Eighty-four patients with different glucose tolerance statues were classified as normoglicemic-control group (NC) patients without family history of type 2 diabetes (DM2) or hypertension (HTN); normoglicemic-patients with familiar history of DM2 or HTN (FPDM2); patients with glucose intolerance (IGT group) and patients with diagnostic of DM2 <10 years (DM2 group). In each patient was obtained a clinical history and an oral glucose tolerance test (75 g) was performed. Glucose (GOD-PAP) and insulin (RIA) were quantified. Insulin Sensitivity (IS) (Whole Body Insulin Sensitivity Index), Insulin resistance (IR) (HOMA) and BCF (insulinogenic index) were evaluated. The statistical analysis was realized in SPSS v. 10.0. It was found that glucose was similar among NC, FPDM2 and IGT groups. Insulin was higher in the FPDM2 (26.71 +/- 22.25 microU/mL), and IGT (34.10 +/- 34.98 microU/mL) in comparison with NC (22.83 +/- 21.26 microU/mL) (p < 0.01). IS was different among NC and IGT group (0.74 +/- 0.43 to 0.29 +/- 0.18, p < 0.05) and among IGT and DM2 (0.29 +/- 0.18 to 0.86 +/- 0.55, p < 0.001). BCF was different among the DM2 and NC (0.051 +/- 0.05 to 1.28 +/- 1.99 microU.mL/mg.dL, p < 0.05), DM2 and FPDM2 group (0.051 +/- 0.05 to 1.23 +/- 1.51 microU.mL/mg.dL, p < 0.01), DM2 and IGT (0.051 +/- 0.05 to 2.64 +/- 2.22 microU.mL/mg.dL, p < 0.001). SI was inversely related to corporal weight and IMC (r = -0.38, p = 0.001 and r = -0.33, p = 0.004, respectively). BCF was related to age (r = -0.27, p = 0.016), the area under curve of glucose (r = -0.30, p = 0.010) and body weight (r = 0.34, p = 0.002). In conclusion, the decrease of glucose tolerance was associated with the lowering of Insulin Sensitivity (IS). The beta cell function (FCB) was lower in the diabetic patients group in comparison with the TGA and FPDM2 groups. These measurements need to be included in patients with high risk for early identification and changes in life style to protect the normal functioning of beta cell and to prevent the onset of IGT or DM2.
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PMID:[Insulin sensitivity and beta cell function in different glucose tolerance status]. 1688 77


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