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

Dietary cod-liver oil containing eicosapentaenoic acid is effective on microvascular albumin leakage in diabetic patients with albuminuria. We determined the long-term effects of oral pure eicosapentaenoic acid ethyl (EPA-E: 900 mg/day) administration on diabetic nephropathy in non-insulin dependent diabetic (NIDDM) patients. The effects of EPA-E were determined by observing the changes of the index of urine albumin excretion level/urine creatinine (Cr) excretion level (UAI), the ratio of beta 2-microglobulin excretion level/urine Cr excretion level (beta 2-MG/Cr) and the ratio of N-acetyl-D-glucosaminidase excretion level/urine Cr excretion level (NAG/Cr) at 3, 6 and 12 months after the start of the treatment. Oral EPA-E administration immediately improved the increased UAI at 3 months after the start of treatment. A significant improvement of the UAI by EPA-E was sustained 12 months later. EPA E administration also tended to decrease the urine beta 2-MG/Cr ratio from 6 months, but the difference was statistically not significant. However, the urine NAG/Cr ratio was not changed by EPA-E administration. EPA-E administration did not affect blood pressure levels, glycemic control and lipid metabolism in these patients. The present data indicated that EPA-E administration improved increased albumin excretion in NIDDM patients with nephropathy and its effects on albuminuria sustained for at least 12 months after the start of treatment. However, tubular factors were not influenced by EPA-E administration.
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PMID:Long-term effect of eicosapentaenoic acid ethyl (EPA-E) on albuminuria of non-insulin dependent diabetic patients. 758 10

There are few data on the risk factors for diabetic nephropathy in the Asian Indian population, although several studies have shown a high prevalence of the disease in this ethnic group. This study also aimed to assess the role of hyperglycaemia and hypertension in the causation and course of nephropathy in this population, which has low rates of obesity. Retrospective analysis of two groups of non-insulin dependent diabetic (NIDDM) patients, one without proteinuria (< 100 mg/day, n = 25) and the other with proteinuria (> or = 500 mg/day, n = 25), matched for age, sex, duration of diabetes and body mass index (BMI) was done to study the factors predisposing to proteinuria and also its progression during a 2 year follow-up. Logistic regression analysis showed that the factors contributory to proteinuria were initial HbA1 and initial systolic blood pressure. The average proteinuria during the follow-up was dependent on the initial and average systolic and diastolic blood pressure values. No correlation was seen between cholesterol or triglyceride values and the change in proteinuria. Creatinine clearance deteriorated in the proteinuric group and this was related to the presence of proteinuria and initial diastolic blood pressure. This study emphasizes the importance of blood pressure in the progression of diabetic nephropathy, even in people who have low BMI. Therefore, good control of blood pressure has an important role to play in the management of this condition.
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PMID:Proteinuria in NIDDM in south India: analysis of predictive factors. 758 11

Neurobehavioral and electrophysiologic studies were carried out to determine the effect of diabetes mellitus on brain function. Fifty one non-insulin-dependent diabetic patients were compared with 30 nondiabetic controls that are equally matched in age, sex and educational level. The aim of this study was to determine the change of brain function in diabetics, and to evaluate the correlation between brain function and clinical factors. The results showed: In the diabetic group, 'the Clinical Memory Test' performances on MQ, the five subtests were respectively lower than those of the controls. 'The Fourth Exception Test', 'the Motor Stability Test' and 'the Hospital Anxiety and Depression Scale' results were significantly disordered, too. The latencies of wave I, III, V of BAEP, wave N65 P100 N125 P160 of VEP, wave P1 N1 P2 N2 N3 P4 of SEP and the interpeak latency of I-V of BAEP were prolonged significantly compared with the controls. Within the diabetics, there was correlation between I-V interpeak latency of BAEP, P100 peak latency of VEP and serum creatinine. These results demonstrate that brain dysfunction are present in NIDDM, and these brain dysfunction correlate with the kidney function.
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PMID:[Decreased brain function in patients with non-insulin-dependent diabetes mellitus]. 760 81

We studied renal function of 194 black subjects with duration of diagnosed NIDDM from 1 month to 36 years to determine the interaction of hypertension and diabetes on nephropathy. Renal function was assessed by isotopic GFR and RPF studies, and serum creatinine. One hundred seventeen of the 194 subjects had 24-hour urinary albumin excretion (AER). AER > 300 mg/24 h correlated with longer duration of NIDDM, decrease in GFR and RPF, and rise in serum Cr, and all subjects were hypertensive. AER 30 to 300 mg/24 h also correlated with a longer duration of NIDDM and 80% had hypertension. When 194 subjects were grouped according to duration of NIDDM and the presence or absence of hypertension, subjects who remained normotensive had normal renal function. In hypertensive subjects a decrease in GFR occurred with duration of NIDDM > 1 year and decrease in RPF with duration of NIDDM > 5 years. In hypertensive subjects with NIDDM > 10 years, 36% had impaired renal function (GFR < 80 ml/min/1.73 m2 or serum creatinine > 1.4 mg/dl) and 75% had microalbuminuria or clinical proteinuria. Within this group, those subjects who developed hypertension after their diagnosis of diabetes were likely to have evidence of nephropathy as compared to those subjects whose hypertension was diagnosed prior to or simultaneous with their diabetes: 17 of 20 (85%) versus 7 of 13 (54%), respectively (P = 0.05). These data provide insight into the relationship between hypertension and diabetes in the development of nephropathy in black NIDDM individuals.
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PMID:Interaction of hypertension and diabetes on renal function in black NIDDM subjects. 764 39

The histopathological characteristics of the kidney using light microscopy and immunofluorescence studies in samples obtained by renal percutaneous biopsy in 19 women and 7 men with non-insulin dependent diabetes mellitus (NIDDM) (mean of age: 55.07 +/- 9.04 yr and mean of "known" diabetes duration: 7.50 +/- 6.87 yr) were studied. The relationship with age, blood pressure, diabetic retinopathy and other complementary diagnostic methods such as serum creatinine (Cr), creatinine clearance (CrC), renal plasma flow (RPF), proteinuria and filtration fraction (FF) were also determined. Light microscopy studies detected 92.3% of patients with renal lesions of different degrees of severity. The presence and severity of glomerulopathy and arteriolopathy were related to diabetes duration (r: 0.764) and they were related to each other (rs: 0.773). In 2 patients, lesions were not observed and in 11 out of 14 patients with less than 5 yr of diabetes duration, mild lesions were detected. However, the histological changes became worse after that period. The glomerulopathy was also statistically correlated with Cr, CrC, RPF, proteinuria and FF. By immunofluorescence, fibrinogen, IgA and C3 were the most frequent and intense precipitates observed. They increased with diabetes duration and were located predominantly in the wall and the periphery of the glomerules and in renal tubules, suggesting that they originated by trapping. There were no precipitates in the mesenchyma, they were scarce in the interstice, Bowman's capsule and arterioles. Statistical correlation between diabetic histopathological renal changes and retinopathy was found. These results confirm that lesions in the kidney and retina in non-insulin dependent diabetic patients generally appear and evolve in a similar manner. Hypertension was diagnosed in 80.76% of patients, without statistical correlation between blood pressure and renal lesions. This suggests that at the onset, in non-insulin dependent diabetic patients hypertension and nephro-pathy are caused by different and independent pathogenic mechanisms. However, at an end stage, it seems that both situations can influence each other in a way that their evolution becomes more severe. Nephropathy in non-insulin dependent diabetes mellitus displayed scarce clinical signs and poor laboratory evidence except when the renal lesions become too severe. The lack of correlation between renal lesions and patients' age and blood pressure suggests the participation of diabetes at the onset of kidney structural impairment.
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PMID:[Histopathological and functional study of the kidney in non-insulin dependent diabetes mellitus]. 771 26

Progression of diabetic nephropathy from the stage of macroproteinuria with near-normal renal function until start of dialysis was compared in 16 patients with type I and 16 patients with type II diabetes mellitus. The mean creatinine clearance at the beginning of the study was 89 +/- 13 ml/min/1.73 m2 in patients with type I and 81 +/- 6 ml/min/1.73 m2 in those with type II diabetes. Dialysis was started after a mean interval of 77 (44-133) months, when creatinine clearance had decreased to 8 +/- 2 ml/min/1.73 m2 in type I diabetic patients. The respective figures for type II diabetic patients were 81 (40-124) months and 7 +/- 2 ml/min/1.73 m2. The mean rate of decrease in creatinine clearance was 1.05 +/- 0.45 ml/min/month in type I and 0.91 +/- 0.41 ml/min/month in type II diabetes. The mean rate of decrease was 1.46 +/- 0.30 ml/min/month in type I diabetic patients with a systolic BP > 160 mmHg versus 0.80 +/- 0.42 ml/min/month with < 160 mmHg (P < 0.01). In the type II diabetics the respective figures were 1.38 +/- 0.40 ml/min/month versus 0.78 +/- 0.15 ml/min/month (P < 0.01). During the observation period the prevalence of coronary heart disease increased from 6 to 50% in type I and from 31 to 87% in type II diabetes. In conclusion, the rate of progression of diabetic nephropathy during the predialytic phase is similar in type I and type II diabetes; BP adversely affects the rate of progression to the same extent in both groups.
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PMID:Similar rate of progression in the predialysis phase in type I and type II diabetes mellitus. 780 Feb 7

Proteinuria was estimated in 600 non-insulin dependent diabetes mellitus (NIDDM) patients in 24 hrs collection of urine. The test was repeated at least twice in a year to confirm the persistence of proteinuria. Mild proteinuria (200-500 mg/d) occurred in 94 (15.7%) and nephropathy (> 500 mg/d) in 112 (18.7%) patients. Nephropathy commonly occurred with long-standing diabetes (> 10 years). Development of proteinuria correlated directly with the duration of diabetes, diastolic and systolic blood pressure, age of the patients, serum creatinine and inversely with creatinine clearance. Retinopathy was seen in 75% of those with nephropathy. It is concluded that proteinuria occurs in one third of NIDDM patients and the risk of nephropathy increases with duration of disease.
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PMID:Prevalence of proteinuria in non-insulin dependent diabetes. 787 49

The association of apolipoprotein E (apo E) genetic polymorphism, particularly apo E2, with renal failure (plasma creatinine > or = 1.4 mg/dl, and urinary albumin excretion index > or = 300 mg/g.creatinine and/or persistent proteinuria) was investigated in 57 non-insulin-dependent diabetic (NIDDM) patients. Apo E2 allele frequency was significantly higher in diabetic patients with renal failure (9.6%) than in diabetic patients without renal failure (3.2%) and in the general Japanese population (3.7%). This finding suggests that apo E2 is associated with renal failure in NIDDM. In addition, to elucidate the association of apo E2 with lipid abnormalities, plasma lipid and lipoprotein levels were compared among the apo E2 (E2/2 and E3/2) and E3/3 groups of NIDDM with renal failure (n = 27) and the apo E2 (E3/2) and E3/3 groups of NIDDM with normoalbuminuria (n = 34). In diabetic patients, the apo E2 group with renal failure had significantly higher levels of plasma total cholesterol (T-chol), very-low-density lipoprotein (VLDL)-chol, triglyceride (TG), VLDL-TG and apo E than the apo E3/3 group with renal failure, and had significantly higher levels of plasma T-chol, VLDL-chol, TG and VLDL-TG than the apo E2 and E3/3 groups with normoalbuminuria. Furthermore, the apo E2 group with renal failure had significantly higher ratios of VLDL-(chol/TG) and VLDL-chol/TG (an index of remnants in plasma) than the apo E3/3 group with renal failure and the apo E2 and E3/3 groups with normoalbuminuria. These results suggest that apo E2 leads to the accumulation of TG-rich lipoprotein and remnants in plasma. It is concluded that apo E2 is associated with renal insufficiency in NIDDM and that apo E2 may be a factor that aggravates lipid abnormalities in NIDDM with renal failure.
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PMID:Apolipoprotein E2, renal failure and lipid abnormalities in non-insulin-dependent diabetes mellitus. 798 Jun 94

The effects of aerobic exercise training on diabetes control and the development of renal microvascular disease were studied in the obese Zucker rat, an animal model of noninsulin dependent diabetes mellitus (NIDDM). Training consisted of 12 weeks of treadmill running, beginning at six weeks of age. Eight trained obese Zucker rats were compared to 15 obese sedentary controls and to 22 sedentary lean nondiseased littermates. Fasting blood glucose, percent of glycated hemoglobin, serum insulin, serum total cholesterol, body weight and kidney weight, creatinine clearance, urine total protein excretion, urine albumin excretion, and morphometric analyses of cortical glomeruli by light and electron microscopy were performed to evaluate metabolic control, renal function, and structure. Training was associated with less albuminuria, less mesangial volume expansion, and less glomerular basement membrane thickening compared to obese sedentary NIDDM animals. These results suggest that exercise training reduces the glomerular ultrastructural lesions and attenuates the albumin excretion rate in this rat model of obesity-related diabetes.
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PMID:Aerobic training and diabetic nephropathy in the obese Zucker rat. 804 99

To study the relationship between aging and development of diabetic nephropathy, we studied the time until the development of microalbuminuria in old onset (> 50 years old, n = 21) and young onset (< 40 years old, n = 26), normotensive NIDDM patients. Microalbuminuria which is associated with the early stage of diabetic nephropathy was defined as urinary albumin index (UAI; mg/g.creatinine) of more than 10mg/g.creatinine, using timed overnight urine. In these two groups, there were no significant differences in duration of diabetes, observation periods, glycemic control, systolic diastolic blood pressure, body mass index and creatinine clearance at the time of the last observation. Mean UAI +/- standard deviation of the two groups were 37.5 +/- 78.2 mg/g.cr and 93.0 +/- 127.2 mg/g.cr in the young onset group and the old onset group, and prevalences of microalbuminuria were 38% and 76% in the young onset and old onset group, respectively. Thus, UAI and prevalence of microalbuminuria in the old onset group are significantly higher than those of the young onset group (P < 0.05). These results suggest that aging, in itself, is one of the significant risk factors for the development of diabetic nephropathy in NIDDM patients.
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PMID:Effect of age on the development or progression of albuminuria in non-insulin-dependent diabetes mellitus (NIDDM) without hypertension. 807 44


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