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

Based on an analysis of data obtained in a group of 145 men and women with type 2 diabetes perssiting for 10.1 +/- 6.6 years who were hospitalized on account of unsatisfactory compensation of diabetes, the authors provided evidence that the fasting blood sugar level is associated with a reduced response of C peptide to an alimentary stimulus, while the excessive weight of the patients has a bearing on the elevated concentration of C peptide on fasting and causes their insulin resistance. The body weight has a bearing on the level of risk factors, i.e. HDL cholesterol, uric acid and in women also triacylglycerols. The elevated blood sugar level influences in a mirror image manner the sodium and potassium level. The relations between the blood sugar level and glomerular filtration draw attention to the interference with the water economy even at blood sugar levels which are still tolerated. The trend of rising potassium levels must be foreseen in case of a poor compensation even in case of insulin treatment of diabetes. The risk of elevated potassium should be taken into account also with regard to indications of antihypertensive treatment. The authors also draw attention to the need of acloser compensation of type 2 diabetes. Early adjustment of the energy metabolism in diabetics deserves priority. When insulin treatment is needed, the all-day requirement should be met by 2-3 doses.
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PMID:[The effect of elevated blood glucose levels and body weight on the metabolic profile in type 2 diabetes after long-term therapy]. 233 13

The diminished insulin secretion of type 2 diabetes might result from abnormal regulation of the potassium permeability which leads to beta-cell depolarization. The possibility of a generalized defect has been investigated in vitro by the stimulation of 86Rb efflux from red cells of type 2 diabetic patients by calcium ionophore and its inhibition by quinine. Diabetic subjects and control subjects had identical 86Rb efflux stimulated by 0.2-0.6 microM calcium ionophore A23187 and identical inhibition by quinine with mean Ki 6 microM and 4 microM quinine respectively for 0.2 microM ionophore and mean Ki 38 microM and 37 microM quinine respectively for 0.6 microM ionophore.
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PMID:Normal calcium-activated potassium channel in red cells in type 2 diabetes. 244 19

The impact of type 2 diabetes heredity on nutrient intake was studied, by means of dietary histories, in 51 normoglycaemic, non-obese men, aged 54-59 years; 29 with familial aggregation of type 2 diabetes, and 22 with no such family history. The average daily intake of energy, macronutrients and minerals was almost identical in the two groups. Mean energy intake was approximately 2400 kcal/d, about 15 per cent of the energy deriving from protein, 35 per cent from fat, 45 per cent from carbohydrate and 5 per cent from alcohol. The average daily intake or dietary fibre was approximately 17 g, or 7 g/1000 kcal. Mean daily sodium and potassium intake, estimated from food sources, was about 3000 and 4000 mg, respectively. The findings provide no support for the existence of any relationship between type 2 diabetes heredity and dietary habits or nutrient intake.
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PMID:Type 2 diabetes heredity and nutrient intake. A dietary history assessment in non-obese normoglycaemic men. 254 18

One hundred and twenty-eight surgical operations in diabetic patients have been studied to assess the effectiveness, under routine clinical conditions, of a management regimen based on the use of glucose-insulin-potassium infusion (GIK). Forty-four non-insulin-dependent diabetic (NIDDM) and 41 insulin-dependent diabetic (IDDM) patients received GIK. Mean blood glucose on the day of operation was 9.3 +/- S.D. 2.2 mmol/l in NIDDM and 8.9 +/- 2.3 mmol/l in IDDM patients. Acceptable control on the day of operation (defined as mean blood glucose 5-12 mmol/l without hypoglycaemia) was achieved in 70 (82%) patients. Eleven of 15 failures were attributable to incorrect implementation of the protocol. Though 10 units Soluble insulin/500 ml 10% glucose (0.32 units/g glucose) was needed in 61% of patients, 26% required a higher and 13% a lower dose. Plasma potassium concentration did not change after 24 h of GIK infusion, but sodium concentration fell (136 +/- 5 to 132 +/- 5 mmol/l; p less than 0.01), with 12 of 32 patients having post-operative values less than 130 mmol/l. Forty-three NIDDM patients undergoing minor surgery were managed without insulin, and acceptable control was achieved in 40 (93%). We conclude that the regimen described is a satisfactory routine means of managing diabetes during surgery, but that optimal results depend on careful monitoring with appropriate alteration of therapy.
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PMID:Management of diabetes during surgery with glucose-insulin-potassium infusion. 295 Nov 40

Erythrocyte sodium, potassium and water contents and sodium fluxes were measured in both normotensive and hypertensive patients with either insulin dependent or non-insulin dependent diabetes mellitus. Hypertensive patients were studied again after two months' treatment with captopril. There were no differences in erythrocyte ion contents or concentrations but sodium fluxes may have been lower in insulin dependent patients and in hypertensive patients. The most marked erythrocyte defects associated with hypertension were low erythrocyte water content and increased potassium concentration in non-insulin dependent diabetic patients. Treatment with captopril caused an increase in erythrocyte water and a decrease in ion content and concentration. In non-insulin dependent diabetic patients, who had the greatest increases in erythrocyte water and falls in potassium concentration, frusemide-sensitive sodium-potassium co-transport activity was reduced. The reduction in blood pressure with captopril treatment was related to the initial erythrocyte sodium content.
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PMID:Hypertension and diabetes mellitus: erythrocyte electrolytes and the effect of captopril treatment. 307 39

The concentrations of magnesium, potassium and zinc were determined in plasma, erythrocytes, muscle biopsies, and in urine collected during 24 hours, in 18 subjects with type II diabetes mellitus (DM). Magnesium was also determined in mononuclear cells. The results were compared with those in 35 (magnesium and potassium analyses) or 26 (zinc analyses) healthy controls. Subjects with type II DM had lower concentrations of magnesium (3.79 +/- 0.32 vs. 4.29 +/- 0.22 mmol/100 g FFDS), potassium (40.5 +/- 5.17 vs. 46.1 +/- 3.81 mmol/100 g FFDS) and zinc (231 +/- 29 vs. 247 +/- 23 ng/mg FFDS) in skeletal muscle. Furthermore, the urinary excretions of magnesium and zinc were higher, as compared with those in healthy controls (5.00 +/- 2.68 vs. 3.62 +/- 1.47 mmol/24 hours, and 683 +/- 285 vs. 326 +/- 205 micrograms/24 hours, respectively). The contents of magnesium, potassium and zinc plasma did not correlate with the corresponding concentrations in skeletal muscle or circulating blood cells, as investigated in healthy controls, diabetics and in all subjects together, implying that the plasma concentrations are not useful in the assessment of electrolyte status. Hence, deficiency of electrolytes frequently occurs, and should be looked for, in subjects with type II DM.
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PMID:Magnesium, potassium and zinc deficiency in subjects with type II diabetes mellitus. 320 15

To determine the effects of very-low-calorie diets on the metabolic abnormalities of diabetes and obesity, we have studied 10 obese, non-insulin-dependent diabetic (NIDDM) and 5 obese, nondiabetic subjects for 36 days on a metabolic ward during consumption of a liquid diet of 300 kcal/day with 30 g of protein. Rapid improvement occurred in the glycemic indices of the diabetic subjects, with mean (+/- SEM) fasting plasma glucose falling from 291 +/- 21 to 95 +/- 6 mg/dl (P less than 0.001) and total glycosylated hemoglobin from 13.1 +/- 0.7% to 8.8 +/- 0.3% (P less than 0.001) (normal reference range 5.5-8.5%). Lipid elevations were normalized with plasma triglycerides reduced to less than 100 mg/dl and total plasma cholesterol to less than 150 mg/dl in both groups. Hormonal and substrate responses were also comparable between groups with reductions in insulin and triiodothyronine and moderate elevations in blood and urinary ketoacid levels without a corresponding rise in free fatty acids. Electrolyte balance for sodium, potassium, calcium, and phosphorus was initially negative but approached equilibrium by completion of the study. Magnesium, in contrast, remained in positive balance in both groups throughout. Total nitrogen loss varied widely among all subjects, ranging from 70 to 367 g, and showed a strong positive correlation with initial lean body mass (N = 0.83, P less than 0.001) and total weight loss (N = 0.87, P less than 0.001). The nondiabetic group, which had a significantly greater initial body weight and lean body mass than the diabetic group, also had a significantly greater weight loss of 450 +/- 31 g/day compared with 308 +/- 19 g/day (P less than 0.01) in the diabetic subjects. The composition of the weight lost at completion was similar in both groups and ranged from 21.6% to 31.3% water, 3.9% to 7.8% protein, and 60.9% to 74.5% fat. The contribution of both water and protein progressively decreased and fat increased, resulting in unchanged caloric requirements during the diet. This study demonstrates that short-term treatment with a very-low-calorie diet in both obese diabetic and nondiabetic subjects results in: safe and effective weight loss associated with the normalization of elevated glucose and lipid levels, a large individual variability in total nitrogen loss determined principally by the initial lean body mass, and progressive increments in the contribution of fat to weight loss with stable caloric requirements and no evidence of a hypometabolic response.
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PMID:Metabolic consequences of very-low-calorie diet therapy in obese non-insulin-dependent diabetic and nondiabetic subjects. 351 Sep 22

We examined the hypothesis that patients with impaired glucose tolerance or type II diabetes mellitus have reduced glucose-induced thermogenesis and that this perpetuates obesity in them by reducing energy expenditure. The thermic response after a 75-g glucose meal for 150 minutes was significantly lower in five obese women with diabetes (7.18 +/- 1.8 kcal) and five other obese women with impaired glucose tolerance (6.4 +/- 0.8 kcal) than in five obese women with normal glucose tolerance (16.7 +/- 2.4 kcal) and five lean healthy control subjects (14.0 +/- 2.2 kcal, P less than 0.05). However, obese women with diabetes or impaired glucose tolerance had a significantly higher resting metabolic rate (RMR) (307.0 +/- 9.7 mL O2/min) than predicted for them on the basis of their age, body weight, and total body potassium (274.8 +/- 8.0 mL O2/min, p less than 0.01). The predicted RMR in obese women with normal glucose tolerance test (GTT) (286.0 +/- 5.0 mL O2/min) was not different from their observed RMR (272.0 +/- 6.0). Thus the total energy expenditure during the meal of obese women with diabetes (254 +/- 32 kcal/150 min) and obese women with impaired glucose tolerance (221 +/- 5 kcal/150 min) was higher than that of obese women with normal glucose tolerance (201 +/- 9 kcal/150 min). All three obese groups had a higher total energy expenditure than the lean group (158 +/- 4 kcal/150 min, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of impaired glucose tolerance and type II diabetes on resting metabolic rate and thermic response to a glucose meal in obese women. 352 18

The effects of tripamide and hydrochlorothiazide on blood pressure and glucose tolerance were studied in 20 hypertensive patients, half of whom had type II diabetes mellitus. Each patient underwent intravenous glucose tolerance testing before and after 4 weeks of treatment with tripamide, 10 mg, and, at a separate time, hydrochlorothiazide, 50 mg. Both tripamide and hydrochlorothiazide lowered blood pressure; for both drugs, the magnitude of the reduction in mean arterial pressure was positively correlated with the pretreatment mean arterial pressure. Hydrochlorothiazide produced a greater fall in serum potassium than did tripamide. In the nondiabetics, neither drug produced a significant change in the glucose disappearance curve or the plasma insulin response. In the diabetics, hydrochlorothiazide produced an increase in serum glucose levels, but the plasma insulin response, which was blunted in comparison to the nondiabetics, did not change. Tripamide did not affect serum glucose or plasma insulin levels in either group of patients. Tripamide at a dose of 10 mg daily does not affect glucose tolerance in either nondiabetic hypertensive patients or patients with type II diabetes mellitus.
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PMID:Effect of tripamide on glucose tolerance in patients with hypertension. 353 May 89

In a retrospective study, glycaemic control on the day of surgery in 68 diabetic patients, managed by a diabetes team (group A), was compared with that in 44 managed by the surgeon and/or anaesthetist alone (group B). Group A insulin dependent patients and NIDDM undergoing major operations were treated by glucose-insulin-potassium infusion (16 units rapid-acting insulin + 10 mmol potassium chloride/500 ml 10% dextrose at 100 ml/h) modified according to blood glucose values (59 cases); well controlled NIDDM undergoing minor operations received no specific therapy (9 cases). Group B patients were treated by a wide variety of regimens. Blood glucose was measured on average 5 times on the operative day in team-managed patients and only twice in the other patients. One-third of the latter group had no glucose measurements at all. Blood glucose values were lower in team-managed patients. Adequate diabetic control, defined as mean blood glucose on the operation day below 216 mg/dl, without hypoglycaemia, was obtained in 82% of team patients but only in 58% of non-team patients. Control was particularly poor in NIDDM under-going major operations and not treated with GIK. Mortality and morbidity were similar in the two groups. We conclude that better glycaemic control was obtained in patients managed by a diabetic team using a glucose insulin potassium infusion. This approach is suitable for any general hospital which offers a diabetic service.
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PMID:Management of diabetes during surgery. A retrospective study of 112 cases. 637 86


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