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

To clarify a possible mechanism whereby the perception of thirst may be associated with diabetes mellitus, we measured plasma levels of vasopressin (AVP), angiotensin II (ANG II), atrial natriuretic peptide (ANP) and plasma renin activity (PRA) in non-insulin-dependent (NIDDM) diabetic patients with or without thirst. Thirteen male NIDDM patients complaining of thirst had a significantly high blood hematocrit, plasma urea nitrogen and creatinine concentrations and plasma osmolality, indicating a reduction in plasma volume. In addition, the patients had a significantly high mean plasma concentrations of AVP (3.20 +/- 1.27 pmol/l) ANG II (33.8 +/- 31.4 pmol/l) and PRA, but a low mean plasma ANP concentration (8.9 +/- 4.5 pmol/l). After treatment with diet and/or sulfonylurea, plasma levels of AVP, ANG II and PRA decreased with a concomitant increase in plasma volume and disappearance of thirst. In contrast, 13 NIDDM patients (9 females and 4 males) without thirst had normal plasma urea nitrogen and creatinine concentrations, and the hematocrit did not change significantly after treatment. Plasma AVP (0.95 +/- 0.34 pmol/l), ANG II (14.7 +/- 8.8 pmol/l) and ANP (10.7 +/- 4.9 pmol/l) concentrations, and PRA were normal in this group of patients. There was no significant difference between the two groups of patients, however, in fasting glucose concentration and HbA1c. We conclude from these results that a reduction in plasma volume may be the major factor responsible for the induction of thirst sensation and for increased AVP secretion in NIDDM patients. The mechanism underlying a reduction in plasma volume remains unclear.
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PMID:Thirst and plasma levels of vasopressin, angiotensin II and atrial natriuretic peptide in patients with non-insulin-dependent diabetes mellitus. 182 24

Prolonged hypoglycemia induced by acetohexamide (AH) in a patient with noninsulin dependent diabetes mellitus accompanied by primary hypothyroidism was presented. A 74-year-old man who had been treated with AH (500mg, daily) for diabetes mellitus since 1973 was admitted to our hospital in Oct. 1988 because of hypoglycemic coma. On admission, the level of blood glucose was 20mg/dl. Continuous intravenous administration of 10 per cent glucose solution led to improvement in the mental state on the second day. However, the level of blood glucose remained between 30 to 45mg/dl for four days after admission. On the fifth day, a fasting blood glucose level finally reached 75mg/dl. In a thyroid function test, the serum levels of thyroid hormone showed the following decreases: T3 68ng/dl, T4 2.8 micrograms/dl, free T4 0.3ng/dl, while basal TSH levels increased to 50.3 microU/ml. Since anti-thyroid microsomal antibody was positive and thyroid 99mTc-pertechnetate uptake was slightly elevated, the hypothyroidism in this patient was considered to be caused by chronic thyroiditis. Urinalysis was positive for protein. In a renal function test, the blood urea nitrogen was 26.7mg/dl and creatinine 1.7mg/dl, and creatinine clearance decreased to 22ml/min. After thyroid function returned to euthyroid, creatinine clearance improved (41 ml/min). To clarify the relationship between hypothyroidism and the metabolism of AH, the serum levels of AH and its metabolite hydroxyhexamide (HH) following oral administration of AH (500mg) were evaluated before and after thyroxine replacement therapy. The blood glucose level before therapy was lower than that after therapy, and hypoglycemic symptoms were observed early in the second and third morning after AH administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A case of acetohexamide-induced hypoglycemia: the influence of hypothyroidism on the metabolism of acetohexamide. 201 45

A total of 121 inpatients with insulin and noninsulin dependent diabetes mellitus were investigated. The patients with noninsulin dependent diabetes mellitus were divided into 2 groups with relation to the presence or absence of secondary resistance to sulfonyl urea derivatives. Changes in the plasma and lipoprotein concentration of cholesterol (ChS) and triglycerides (TG) were analyzed. According to the author's classification, changes in lipoprotein patterns were distributed in some phenotypes of dyslipoproteinemias (DLP) and their prevalence was studied among the examinees. DLPs were detected in 84.3% of the patients (59.8% were latent). The patients demonstrated a high frequency of hypocholesterolemia of very low density lipoproteins (57.8%) and hypertriglyceridemia of low density lipoproteins (31.4%). These intralipoprotein variations were shown to be the chief element of phenotypical characterization of II (c, d), IV (b, c) and VI (a, b, c) DLP types, not included in Fredrickson's classification.
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PMID:[The phenotypic characteristics and incidence of dyslipoproteinemias in diabetic patients]. 208 61

Effects of two winter nutritional levels (LOW, MOD) and two summer pastures (bahiagrass, BG; perennial peanut, PP) on plasma IGF-I, and the relationship between IGF-I and average daily gain (ADG), thyroid hormones, plasma urea, packed cell volume (PCV) and steer type were determined in 101 steers (217 kg) varying in breed composition, frame size and initial condition. Relationships between body composition or composition of gain and IGF-I were determined in 11 contemporary steers assigned directly to the feedlot. Initial IGF-I (57.9 +/- 3.5 ng/ml) was positively correlated (P less than .05) to initial condition, estimated percentage of Brahman and plasma T3, but not related to subsequent ADG. During the 126-day wintering period, ADG was .21 kg for the LOW winter treatment and .47 kg for the MOD winter treatment. Concentration of IGF-I in the wintering period was affected (P less than .01) by nutritional level (LOW = 71.8 ng/ml, MOD = 150.6 ng/ml) and was positively related to winter ADG in MOD steers (P less than .01) but not in LOW steers. Concentration of IGF-I in winter was also positively related to condition at the end of the winter period (P less than .01), T3 (P less than .05) and T4 (P less than .05). There were no effects of winter treatment on IGF-I during the subsequent summer pasture period. During the 145-d summer period, ADG was .53 kg for BG and .68 kg for PP. Concentration of IGF-I during the summer period was affected (P less than .05) by pasture treatment (BG = 138.6 ng/ml, PP = 181.9 ng/ml), was positively related (P less than .01) to PCV and percentage of Brahman, and was negatively related (P less than .05) to estimated percentage of English breeding. In steers assigned directly to the feedlot, IGF-I was correlated with empty body (EB) weight (r = -.59, P less than .10), EB water (r = -.59, P less than .10) and EB protein (r = -.60, P less than .10) at slaughter, and with days on feed (r = -.65, P less than .05), but was not correlated with ADG or rate of component gain. These data indicate that IGF-I is related to nutritional status in steers as in other species, that there may be significant breed or cattle type differences in circulating concentrations of IGF-I, and that circulating concentration of IGF-I may be functionally related to plasma concentration of thyroid hormones.
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PMID:Effects of winter nutrition and summer pasture or a feedlot diet on plasma insulin-like growth factor I (IGF-I) and the relationship between circulating concentrations of IGF-I and thyroid hormones in steers. 226 59

Vibratory and cooling detection thresholds (VDT and CDT) were determined at both the palmar aspect of the distal phalanx of the right index finger (upper limb) and the plantar aspect of the distal phalanx of the right great toe (lower limb) in 53 consecutive patients with diabetes mellitus (NIDDM), in order to analyze the frequency of the abnormality of each threshold and the relationship between each threshold and the clinical or laboratory findings. VDT in the lower limb was statistically correlated with age, duration of diabetes mellitus, and blood urea nitrogen value of each patient, but not with fasting blood glucose and hemoglobin A1C levels. VDT in the lower limb was significantly greater in the groups of patients with each of the subjective sensory disturbances, peripheral neuropathy (based on our criteria), retinopathy, and proteinuria. Forty-seven per cent of the patients showed clinically peripheral neuropathy, and the frequencies of the abnormality of VDT, CDT and VDT or CDT were 34, 26 and 45%, respectively. VDT and CDT reflect the abnormality of different populations of the peripheral nerve fibers and seem to be affected separately. The determination of both VDT and CDT is useful for the evaluation of the neuropathic state of diabetic patients.
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PMID:[Vibratory and cooling detection thresholds in diabetes mellitus]. 238 92

The ability of empirical formulae to predict K.t/V based on the ratio (R) of the postdialysis (Ct) to predialysis (Co) plasma urea nitrogen levels was tested. In 256 patients, 336 three-point modeling sessions were performed. The K.t/V and NPCR were derived by interative solution of equations for V and G according to the variable volume single-pool model. The modeled K.t/V values were compared to K.t/V predicted from the formula: K.t/V = -ln (R - 0.008.t-UF/W), where R is the Ct/Co ratio, t the session length (h), UF the ultrafiltrate volume (liters) and W the postdialysis weight (kg). Further, the ratio-derived K.t/V was used in conjunction with the Gotch nomogram for 3/week dialysis to estimate NPCR (NPCR-R/N); the latter value was compared to the NPCR from standard 3-point modeling (NPCR-MOD). The two K.t/V values were quite similar, although statistically separable: modeled K.t/V, 0.97 +/- 0.22 (SD), ratio-derived K.t/V 0.96 +/- 0.23, p less than 0.001. The mean percent error was -0.73% +/- 2.5 (range - 11 to + 4.8), and the correlation coefficient was 0.994, slope 1.01, int -0.016. Modifications of the prediction formula which incorporated UF/V instead of UF/W, and/or which weighted the UF/V term according to the expected K.t/V, produced only slight improvement in accuracy. The two values of NPCR were less similar, but still highly correlated: NPCR-MOD, 1.04 +/- 0.26 g/kg/day, NPCR-R/N, 0.94 +/- 0.23, p less than 0.001; mean percent error, - 8.2 +/- 16; r = 0.78, slope = 0.68, int = 0.23.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The post: pre dialysis plasma urea nitrogen ratio to estimate K.t/V and NPCR: validation. 237 73

We examined clinical and laboratory features retrospectively in 402 patients at the start of chronic hemodialysis in order to define better the "uremic syndrome" in the dialysis era. The information gathered included demographic data, renal diagnoses, uremic symptoms, biochemical values, and prevalences of hypertension (69%), diabetes mellitus (23%) and ischemic heart disease (16%). Unexpected findings were the wide ranges of serum creatinine levels (3.5 to 35 mg/dl) and blood urea nitrogen levels (35 to 345 mg/dl), and the frequency of hyponatremia (27%), hypoalbuminemia (52%), and anion gaps above 25 mg/dl (5%). There were higher hematocrits in males and diabetics, lower serum creatinine levels in females, diabetics and older patients, and lower blood urea nitrogen levels in blacks. The time interval from diagnosis of diabetes mellitus to initiation of dialysis in patients with diabetic nephropathy due to juvenile-onset diabetes mellitus (20.6 +/- 6.8 years) was twice that in adult onset diabetes mellitus (10.3 +/- 8.3 years).
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PMID:Clinical and laboratory features of patients with chronic renal disease at the start of dialysis. 292 Apr 71

Zinc is required for normal immune function and taste acuity and enhances the in vitro effectiveness of insulin. Impaired immune function and taste have been reported in diabetic subjects, and decreased serum zinc levels and hyperzincuria occur in some diabetic subjects and animals. Subjects with type II diabetes were examined to determine whether the similar effects of zinc depletion and diabetes are causally related. Low serum zinc levels were found in 16 of 180 subjects (9 percent). There was no correlation between serum zinc and glycosylated hemoglobin levels. Natural killer cell activity did not differ between diabetic subjects (n = 28) and control subjects (n = 38) and did not correlate with serum zinc levels. T lymphocyte response to phytohemagglutinin was lower in diabetic subjects than in control subjects (70 +/- 10 versus 103 +/- 7 X 10(3) counts per minute) but was not lowest in those with the lowest zinc levels. Taste thresholds for hydrochloric acid, sucrose, sodium chloride, and urea were elevated in diabetic subjects (n = 28) versus control subjects (n = 10), but thresholds did not correlate with glycosylated hemoglobin or serum zinc levels. Zinc supplementation in nine diabetic subjects had no effect on the glycosylated hemoglobin level, natural killer cell activity, or taste thresholds, but it did increase mitogen activity in those with the lowest initial phytohemagglutinin responses. It is concluded that zinc deficiency occurs in a subset of subjects with type II diabetes but is not related to diabetes control and does not explain decreased taste acuity. Zinc deficiency may play a role in abnormal immune function in type II diabetes mellitus.
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PMID:Role of zinc supplementation in type II diabetes mellitus. 372 55

Mutations in the mitochondrial gene were recently identified in a large pedigree of diabetes mellitus and deafness. As the mitochondrial gene is materially inherited, Japanese diabetic patients whose mothers were also diabetic were screened, using peripheral leucocytes, for an A to G transition at nucleotide pair 3243 of the mitochondrial gene, a tRNA(Leu(UUR)) mutation. This mutation was identified in four pedigrees from among 300 unrelated patients who were screened. Diabetes co-segregated with the mutation, except in one young subject, and was maternally inherited. The apparent onset of disease occurred between 11 and 68 years of age. Some of the affected members developed hearing impairment and congestive heart failure due to cardiomyopathy, though generally long after the onset of diabetes, and these patients had therefore not been diagnosed as having a specific form of diabetes. The duration of sulphonyl-urea treatment was not more than 8 years in these pedigrees and affected members were prone to progression to insulin-requiring diabetes. Thus, these patients were secondary sulphonylurea failures. Long-term follow-up revealed that the underlying disorder in affected members is a progressive impairment of insulin secretion. Some were initially diagnosed as having IDDM based on an apparent acute onset in youth and the clinical severity of their diabetes. Others were regarded as having MODY with an aggressive course. The mitochondrial gene mutation or diabetes is not transmitted to all offspring of the affected mothers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mitochondrial diabetes mellitus: prevalence and clinical characterization of diabetes due to mitochondrial tRNA(Leu(UUR)) gene mutation in Japanese patients. 805 89

Diabetes mellitus type II-NIDDM--is characterized by insulin insufficiency and insulin resistance. The main therapeutic aim is to mitigate symptoms, achieve and maintain desirable body weight, achieve a normal blood sugar level and treat complications. The main principle of NIDDM therapy remains an adequate dietary programme with reduction of the total energy intake. The greatest problem of successful therapy remains dietary non-compliance of the patient. Oral antidiabetics--in particular sulphonyl urea, have been the basis of therapy for more than 30 years. But even on this point there are some controversial views. The author discusses some problems of the pharmacodynamics and pharmacokinetics of SU, clinical effectiveness, reasons for primary and secondary failure and presents a list of sulphonyl urea derivatives of the second generation.
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PMID:[The past, present and future of treatment of type II diabetes mellitus]. 807 48


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