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

Acarbose (Bay g 5421, Glucobay; CAS 56180-94-0) inhibits alpha-glucosidases of the small intestine and thus delays glucose release from complex carbohydrates. It is therefore efficient as a first-line drug in the treatment of noninsulin-dependent diabetics (NIDDM) insufficiently treated with diet alone. Information is scarce whether under acarbose treatment the lipid metabolism can also be improved. Therefore the changes of triglycerides, cholesterol and HDL-cholesterol were analyzed in a randomized double-blind placebo-controlled trial. In brief, 94 NIDDM aged 43 to 70, after a pretreatment period of at least 3 months, were treated with 100 mg acarbose t.i.d. or placebo for 24 weeks. The patients were recruited after a 4-week screening phase with reinforcement of diet. The most impressive results of acarbose treatment were lowering of blood glucose and insulin, especially in the postprandial state, and of HbA1 (glycosylated hemoglobin). Results on lipids: The initial serum cholesterol levels showed a broad spectrum. Low concentrations remained unchanged under acarbose, while high concentrations (the upper tercile) decreased from 273 to 251 mg/dl. This effect was statistically significant compared to placebo. HDL-cholesterol levels increased continuously under acarbose and placebo as well thus indicating some study effect. Similarly, fasting triglycerides leveled down under acarbose and placebo. However, drastic differences appeared in postprandial triglycerides which were checked 1 and 5 h after a test meal given at entry and at finish of the study. The lowering by acarbose compared to placebo was highly significant for the 1 h postprandial concentrations. It is concluded that acarbose treatment can reduce elevated cholesterol concentrations and postprandial triglyceride concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Beneficial effects on serum lipids in noninsulin dependent diabetics by acarbose treatment. 177 63

The effects of gemfibrozil on apolipoproteins C II and C III (apo C II, C III) were observed in 20 NIDDM hyperlipidemic patients. All of the patients continued their anti-diabetic treatment, gemfibrozil 900 mg/day for 4 weeks. The results revealed no significant change in fasting plasma glucose (FPG) and HbA1 before and after the study. But after the treatment with gemfibrozil, the following parameters changed significantly: total cholesterol (TC) decreased by 18.64% (P less than 0.01), total triglyceride (TG) decreased by 65.05% (P less than 0.001), VLDL-C decreased by 63.19% (P less than 0.001), HDL-C increased by 44.23% (P less than 0.001), apo C III decreased by 31.38% (P less than 0.02), and the ratio of apo C III/C II reduced by 35.49% (P less than 0.01). These findings suggest that gemfibrozil has excellent effect on decreasing apo C III and the ratio of apo C III/C II, thus facilitates the metabolism of chylomicron and decreases TG level in hyperlipidemic diabetic patients.
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PMID:[The effect of gemfibrozil on serum apo C II and C III in diabetic hyperlipidemia]. 181 23

In order to assess whether insulin concentration or plasma lipolytic activity has any role in the regulation of HDL cholesterol concentrations in type 2 diabetes, fasting plasma C-peptide and HDL2-cholesterol concentrations and the post-heparin plasma activities of lipoprotein lipase and hepatic endothelial lipase were measured in 148 patients with type 2 diabetes (76 male, 72 female). HDL2-cholesterol was related negatively to hepatic lipase activity in men (r = -0.49, p less than 0.001) and women (r = -0.43, p less than 0.001) and positively to lipoprotein lipase activity in men (r = -0.33, p less than 0.01) and women (r = 0.36, p less than 0.01). A significant inverse relationship was confirmed between C-peptide and the HDL2-cholesterol subfraction in both sexes (men, r = -0.40, p less than 0.001, women r = -0.51, p less than 0.001). This persisted after adjustment for the effects of alcohol intake, mode of hypoglycaemic treatment, plasma glucose and body mass index. The relationship was lost in men and greatly diminished in women when hepatic lipase activity was included in multiple linear regression analysis, whereas the inclusion of lipoprotein lipase activity in the analysis had little effect on the relationship between C-peptide and HDL2-cholesterol. We suggest that hepatic lipase may be partly responsible for the commonly observed inverse relationship between measures of insulin secretion and HDL-cholesterol concentrations. We speculate that this may occur through a direct stimulatory effect of insulin on the enzyme's activity.
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PMID:Association of high density lipoprotein cholesterol with plasma lipolytic activity and C-peptide concentration in type 2 diabetes. 181 5

The well known association between non-insulin dependent diabetes mellitus (NIDDM) and hyperlipoproteinemia (HLP) is one of the leading causes of high incidence and mortality for cardiovascular disease of diabetic patients. For auspicious and effective treatment of NIDDM and its complications, secondary prevention, that is, an early detection, plays a major role. At the same time high concern should be given to the benefits of early detection and treatment of atherogenic HLP at early stages of diabetes mellitus, for their occurrence in borderline impairment of glucose tolerance (G-OGT) is still evasive. The investigation on the occurrence and incidence of HLP in G-OGT was carried out in 576 adults (310 men and 266 women) with recently detected G-OGT. The results were compared with those obtained in the non-G-OGT group (50 men and 52 women). Values of total LDL cholesterol as well as triglycerides in the blood of the subjects of either sex highly exceeded recommended values and were higher than in the controls. HDL cholesterol was significantly decreased while the values of the LDL cholesterol/HDL cholesterol ratio and total triglycerides were significantly higher. Atherogenic hyperlipoproteinemia was evidenced in 52.58% of men and 50.75% of women with G-OGT and in 36.00% of men and 32.69% of women with normal G-OGT. After a one-year dietetic regimen all the lipid parameters evidently improved in both men and women, while the incidence of atherogenic hyperlipoproteinemia fell to 40.82% of the men and 31.32% of the women.
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PMID:[The lipoprotein status in persons with borderline glucose tolerance impairment before and after a reducing diet]. 182 43

We studied the levels of cardiovascular risk factors in a population sample of 511 men and 920 women aged 65-74 years and living in East Finland. Altogether 312 men and 515 women had normal glucose tolerance, 84 men and 158 women impaired glucose tolerance (IGT), 33 men and 59 women newly diagnosed non-insulin-dependent diabetes (NIDDM) detected at the survey, and 82 men and 188 women previously diagnosed NIDDM. Subjects with IGT or newly diagnosed NIDDM had higher levels of total triglycerides and apolipoprotein B and lower levels of HDL cholesterol and apolipoprotein A1 than subjects with normal glucose tolerance, similarly as in previously diagnosed NIDDM. Furthermore, subjects with IGT or newly diagnosed NIDDM were more obese, had higher waist-hip ratio, and more frequently hypertension than subjects with normal glucose tolerance. Thus, asymptomatic hyperglycemia in the elderly is not a benign phenomenon, but is associated with similar adverse changes in cardiovascular risk factors as in middle-aged subjects.
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PMID:Asymptomatic hyperglycemia and cardiovascular risk factors in the elderly. 189 82

Abnormalities in cholesteryl ester transfer (CET) may play a role in the development of diabetic arterial vascular complications. To assess this important step systematically in reverse cholesterol transport, we have studied 20 treated, clinically stable, normolipidaemic patients. Contrary to the impairment in CET described previously in NIDDM, the mass of CE transferred from HDL to VLDL + LDL was significantly greater in IDDM patients than in controls at 1,2, and 4 h (P less than 0.001). When the d less than 1.063 plasma fractions from IDDM subjects were combined with controls d less than 1.063 fractions, an accelerated CET response was observed which was identical to that found in intact IDDM plasma. This finding, which indicates that this disturbance in CET was associated with the acceptor lipoproteins, was confirmed when we found that it was reproduced by the addition of IDDM VLDL and not LDL to control d greater than 1.063 fractions. Changes observed in lipoprotein core lipid composition were consistent with accelerated CET occurring in IDDM in vivo: the TG/CE core lipid ratio was decreased in VLDL from six subjects (diabetic 9.5 +/- 0.8 vs control 12.9 +/- 3.4; P less than 0.1) and increased in their HDL (diabetic 0.55 +/- 0.11 vs control 0.42 +/- 0.04; P less than 0.025). No correlation was demonstrable between estimates of diabetic control (glycoalbumin, fasting glucose) and CET. These data indicate that CET may be abnormally increased in normolipidaemic IDDM patients. A defect of this type may be atherogenic because it increases the number of lipoprotein particles in plasma which resemble cholesteryl ester-enriched chylomicron and VLDL remnants but whose normal receptor-mediated catabolism may be altered.
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PMID:Accelerated cholesteryl ester transfer in patients with insulin-dependent diabetes mellitus. 190 28

Hyperinsulinaemia links non-insulin dependent diabetes (NIDDM), obesity, and hypertension, each an insulin-resistant state in its own right. Insulin resistance predicts the occurrence of NIDDM, and plays a major role in its pathogenesis. We tested the hypothesis that hyperinsulinaemia may also predict hypertension in a sample (n = 2905) of the mixed population of San Antonio, in which hyperinsulinaemia and NIDDM are more prevalent among Mexican-Americans than non-Hispanic whites. Whilst in the whole sample the hypertensives had significantly (P less than 0.001) higher plasma insulin concentrations than the normotensives, high blood pressure was significantly (P less than 0.01) more frequent among non-Hispanic whites than Mexican-Americans regardless of diabetes status. After adjusting for factors (age, sex, body mass, and body fat distribution) known to affect insulin levels, a direct relationship between post-glucose plasma insulin concentrations and prevalence of hypertension was still present in both ethnic groups. In Mexican-Americans, however, the standardized prevalence of hypertension was significantly (P less than 0.001) lower at any given insulin concentration. Post-glucose plasma glucose levels also were directly related to hypertension prevalence in both groups; again, the regression line was shifted downward and, furthermore, less steep (P less than 0.02) in Mexican-Americans, suggesting relative protection against the negative effect of hyperglycaemia on blood pressure. Dyslipidaemia (higher total cholesterol and triglyceride, and lower HDL-cholesterol concentrations) was strongly associated with hyperinsulinaemia and blood pressure in both ethnic groups. After adjusting for plasma insulin, only hypertriglyceridaemia was associated with high blood pressure, with no inter-ethnic difference.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High blood pressure and insulin resistance: influence of ethnic background. 190 31

The cardiovascular risk profile was assessed in all 208 diabetics accepted for dialysis in 28 German dialysis centres from 1985-1987 (104 men, 104 women, mean age 60 [22-82] years). 71 patients had type 1 and 128 type 2 diabetes, and 9 maturity onset diabetes of the young. Of 169 patients, 164 (97%) had hypertension (median systolic blood pressure at start of dialysis 200 [120-280] mm Hg). Only 74 patients (44%) were on continuing anti-hypertensive medication. Median serum cholesterol was 225 (66-424) mg/dl, LDL-cholesterol 158 (43-335) mg/dl and HDL-cholesterol 32 (10-67) mg/dl. In patients with a history of myocardial infarction (n = 26) the median cholesterol concentration was 269 (126-424) mg/dl, while in those with no history of myocardial infarction (n = 132) it was 221 (66-280) mg/dl (P less than 0.05). Only 5% of the patients had received lipid lowering therapy. Out of 175 patients, 65 (37%) had a history of smoking, and 25 (14%) were still smokers at the start of dialysis. There was a strong association between smoking history and amputations. Only 98 of 208 patients (47%) had had a specialist ophthalmological examination in the 12 months preceding the start of dialysis. Proliferative retinopathy was present in 33 out of 53 (62%) type 1 and 15 out of 98 (15%) type 2 diabetics. Out of 22 patients with unilateral or bilateral blindness, 2 (10%) had received no photocoagulation. - This investigation reveals a need for better medical care of diabetics with pre-end-stage renal failure.
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PMID:[Does the care of diabetic patients with renal failure in the predialysis phase need improvement?]. 191 32

A 12-week double-blind placebo-controlled trial to study the effects of metformin on lipoprotein concentration and composition was performed in forty patients with NIDDM and hyperlipoproteinemia. A significant decrease occurred in VLDL-apo B and all lipid components of VLDL, indicating a decreased number of circulating VLDL, while LDL-apo B was unchanged. Moreover in VLDL the relative TG content increased, the cholesterol content decreased, while in LDL the TG content decreased and the cholesterol content increased, indicating a change in the particle distribution over the spectrum VLDL-IDL-LDL. The initially enhanced TG-content in HDL was reduced. While a reduction in VLDL is observed with all methods improving glucose control the observed compositional changes in VLDL and LDL have not been described before and may be a specific effect of metformin.
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PMID:Effects of metformin on dyslipoproteinemia in non-insulin-dependent diabetes mellitus. 193 74

Resistance to insulin-stimulated glucose uptake is associated with an increased rate of synthesis and secretion of VLDL-triglycerides and, in the absence of adequate removal capacity, with hypertriglyceridemia. Subjects with a low glucose disposal rate or a high degree of insulin resistance (as measured by the euglycemic hyperinsulin clamp technique) have also decreased HDL cholesterol levels. The recent developments in the chemistry of lipoproteins indicate that the physicochemically defined lipoproteins such as VLDL, IDL, LDL or HDL are both chemically and metabolically heterogeneous. According to the Alaupovic concept, the plasma lipoprotein system consists of a mixture of particles, each of which is characterized by a unique apolipoprotein composition. Using enzyme-linked differential antibody immunosorbent assay and differential electroimmunoassay, we have discovered that the determination of lipoprotein particle profiles is essential for further clarification of the diagnostic value of measuring apo B and apo A-I. The metabolism of apo B and apo A-I containing lipoprotein particles seems to be affected primarily by their corresponding apolipoprotein composition. Some particular subpopulations of apo B containing lipoprotein particles, such as LpB containing only apo B, LpB:E containing apo B and (a) have been identified as important risk factors in atherosclerosis. We have also recently demonstrated that the protective effect of HDL is due to particles containing apo A-I but not apo A-II (LpA-I), while have little or have no effect those containing apo A-I and apo A-II (LpA-I:A-II). Non-insulin-dependent diabetic patients (NIDDM) are characterized by increased concentrations of cholesteryl ester rich LpB and triglyceride rich LpB:C-III and LpB:E.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Insulin-resistance and lipoprotein abnormalities. 193 84


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