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

Although an elevated blood pressure has been proposed as one of the major risk factors for the development and acceleration of diabetic retinopathy, demonstration of an unequivocal association between high blood pressure and retinopathy is lacking. Recent epidemiologic, cross-sectional studies indicated a close relationship between elevated systolic blood pressure and diabetic retinopathy, particularly in NIDDM subjects. In IDDM patients, the association with diastolic blood pressure was more pronounced. In the few prospective studies with sufficient number of individuals and acceptable documentation of retinal changes, in addition to poor metabolic control elevated blood pressure emerged as one of the best predictors of the development of severe deterioration of diabetic eye disease. In the Joslin study the risk of progression to severe forms of diabetic retinopathy increased exponentially with hemoglobin A1c and was dramatically different in patients with diastolic blood pressure below versus above 70 mmHg. It was hypothesized that a very low diastolic blood pressure is associated with some mechanisms which are protective against progression of eye lesions. Treatment and adequate control of hypertension is strongly recommended in all diabetic patients, the optimal level of blood pressure reduction, however, is yet to be determined.
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PMID:Impact of blood pressure on diabetic retinopathy. 269 52

Results of the multicentric investigation of therapeutic efficacy of glycvidon were presented in this paper. The investigation was performed in 15 centres and comprised 768 patients with type 2 diabetes mellitus. A considerable improvement in metabolic regulation was attained which led to the reduction in glycemia level on an empty stomach and after the meal, to the reduction or elimination of glycosuria and to the significant decrease in glycolized hemoglobin. A parallel improvement in serum lipid levels was also registered. Tolerance of glycvidon was good and hypoglycemic incidents were very rare and as a rule of mild degree.
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PMID:[Multicenter study of the therapeutic efficiency of glycvidone (Beglynor)]. 270 90

Bone mineral density (BMD) was assessed in 28 women with type II diabetes mellitus and compared to 207 age-matched nondiabetic women. Mean BMD, as measured by dual-photon absorptiometry, 1.12 +/- 0.3 g/cm2 (+/- SEM), was similar to the mean BMD of control subjects, 1.06 +/- 0.1 g/cm2. Only 1 of the 28 diabetic patients had a BMD less than 0.95 g/cm2 ("fracture threshold"), whereas 25% of the control subjects had a BMD below that level. When diabetic and control subjects were matched for weight as well as age, the data continued to show similar BMD among both groups. Moreover, the disparity between the proportion of weight-matched controls (25%) and diabetic subjects (1 of 28) with a BMD below the fracture threshold persisted. Among the group of 17 diabetic subjects receiving insulin, there was a positive relationship between BMD and insulin dose. There was no significant relationship between BMD, duration of diabetes, or hemoglobin Alc. Thus, women with type II diabetes are not at increased risk for diminished BMD and may be protected against bone loss.
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PMID:Bone mineral density in women with type II diabetes mellitus. 271 84

The majority of zinc, copper and magnesium is either intracellular or associated with the bones. It is therefore unlikely that the plasma concentration of these trace elements will reflect their whole body content. Blood cells might be more representative of lean tissue and are also easy to obtain. The concentration of zinc, copper and magnesium was measured in the leukocytes and hemoglobin of 42 subjects with non insulin dependent diabetes mellitus (NIDDM) and in 22 subjects with insulin dependent diabetes mellitus (IDDM) and was compared with that of 44 age-matched healthy volunteers. Zinc was found to be deficient in the serum (p less than 0.001), leukocyte (p less than 0.001) and hemoglobin (p less than 0.05) of the IDDM subjects, while copper and magnesium were increased in the serum, leukocytes and hemoglobin of the IDDM subjects (p less than 0.001). There was no zinc deficiency in the leukocytes of NIDD subjects. These results are opposite to the findings on zinc concentration in various tissue of animal models for IDDM and NIDDM and with our present knowledge on zinc status in IDDM and NIDDM subjects. Thus, we conclude that the concentration of zinc in blood cells of diabetic subjects might not reflect its concentration in various tissues.
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PMID:Trace elements in blood cells of diabetic subjects. 275 38

Noninsulin-dependent diabetes mellitus (NIDDM) is associated with decrements in several cognitive functions. Among the variables that apparently contribute to the decline in cognitive performance is poor glucose control, as measured by hemoglobin A1c. Elevated levels of triglycerides in diabetics may also contribute to this cognitive decline through the increased incidence of atherosclerosis in these patients. The authors examined the relationship between triglycerides and cognitive performance in 246 NIDDM outpatients, aged 55-74 years. The relationship between triglyceride levels and performance on three cognitive tasks and on a test of reaction time was measured. Elevated levels of triglycerides were associated with significant decrements in performance on the digit symbol substitution test, digit span (backward) test, and on a reaction time measure. High levels of triglycerides, independent of chronic glucose control, appear to contribute to the decreased ability to perform short-term memory tasks in NIDDM.
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PMID:Triglyceride levels affect cognitive function in noninsulin-dependent diabetics. 297 65

The present study assesses the impact of variations in the amount of fiber in high carbohydrate diets on carbohydrate and lipid metabolism in NIDDM. The amount and source of carbohydrate, and source of dietary fiber, were held constant. Two 4-wk diet periods were randomly assigned and all subjects completed both dietary periods. Diets were identical in the proportion of carbohydrate, fat, protein, P/S ratio, and cholesterol. The normal fiber diet contained 11 g/1000 kcal, while the high fiber diet contained 27 g/1000 kcal. The results showed no significant difference in fasting plasma glucose and insulin, day-long glucose and insulin, fasting hemoglobin AIc, or 24 h urinary glucose. Fasting plasma triglyceride and VLDL-triglyceride, as well as fasting plasma cholesterol, LDL-cholesterol, and HDL-cholesterol were also unchanged. In conclusion, an increase in the fiber content from 11 to 27 g/1000 kcal did not lead to measurable improvements in overall plasma glucose, insulin, or lipid metabolism.
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PMID:To what extent does increased dietary fiber improve glucose and lipid metabolism in patients with noninsulin-dependent diabetes mellitus (NIDDM)? 300 63

The influence of sulfonylurea drugs in enhancing the effect of endogenous insulin is well documented. Furthermore, combination therapy with sulfonylurea and insulin is effective in the treatment of type II diabetes mellitus. Therefore, to assess the efficacy of this type of combination therapy in type I diabetes, we conducted a double-blind clinical trial with tolazamide and insulin in 15 subjects with type I diabetes. The diagnosis of type I diabetes was confirmed by previous episodes of diabetic ketoacidosis and undetectable C-peptide levels in serum samples from blood drawn from patients two hours after breakfast. During the study protocol, placebo or tolazamide was randomly added to insulin and the combination therapy was continued for three months. In the placebo group, levels of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) did not alter significantly at the end of the study period. However, in the tolazamide group, levels of FPG and HbA1c markedly improved after administration of tolazamide (FPG levels before therapy, 10.8 +/- 0.9 mmol/L [mean +/- SEM]; after therapy, 6.7 +/- 0.4 mmol/L; HbA1c levels before therapy, 10.9% +/- 0.6%; after therapy, 9.6% +/- 0.5%). Therefore, adjuvant therapy with tolazamide and insulin may be beneficial in achieving adequate metabolic control in type I diabetes mellitus.
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PMID:Improved metabolic control in insulin-dependent diabetes mellitus with insulin and tolazamide. 304 37

Present treatment of type II diabetes mellitus often fails to normalize post-prandial glucoses. A placebo-controlled, double-blinded design tested the effects of combined glyburide-insulin therapy over 4 months in 20 patients after achieving good control of fasting glucose with diet and intermediate insulin alone. Insulin requirements significantly decreased in both groups during the initial hospitalization when drug or placebo was added, presumably because of enforced dietary compliance. Thereafter, post-prandial glucoses worsened in the placebo group, as did hemoglobin A1c; neither of these parameters changed on the glyburide group by week 16, except for modest reduction of the 2h post-lunch glucose. Thus, while combined therapy provides little advantage beyond what can be accomplished with effective doses of intermediate insulin alone, it did reduce the need for this exogenous insulin.
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PMID:Combined glyburide and insulin therapy in type II diabetes. 312 16

We recently demonstrated that normal subjects given mixed test meals of varying fatty acid composition showed significantly greater serum insulin responses to meals enriched with polyunsaturated fat as compared to those in which the fat content was derived from saturated fatty acids. To determine if a similar phenomenon occurs in subjects with non-insulin dependent diabetes mellitus (NIDDM), serum glucose, insulin, C-peptide, and gastric inhibitory polypeptide (GIP) responses to three mixed test meals of varying fatty acid composition were assessed in twelve subjects with NIDDM. Baseline means (+/- SEM) fasting serum glucose concentration was 205 +/- 15 mg/dl and mean glycosylated hemoglobin was 8.5 +/- 0.5%. Fatty acids in the test meals were either saturated fats, or polyunsaturated fats derived from vegetables or fish. Each test meal provided 40% of the subjects' calculated daily caloric requirement and contained approximately 45% carbohydrate, 40% fat, and 15% protein. No appreciable differences in serum glucose, insulin, and C-peptide responses occurred during the three mixed test meals. Although GIP values were higher in the saturated fat and the vegetable meals when compared to the fish meal, the differences did not reach statistical significance. The inability of NIDDM subjects to evoke a greater insulin response to polyunsaturated fatty acids than to saturated fatty acids suggests another pathogenetic factor contributing to their glucose intolerance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of source of dietary fats on serum glucose, insulin, and gastric inhibitory polypeptide responses to mixed test meals in subjects with non-insulin dependent diabetes mellitus. 328 95

Non-insulin-dependent diabetes mellitus (NIDDM) is the most common form of diabetes in the civilized world. Its consequences include microvascular and macrovascular disease, both of which appear to evolve from a common background of obesity and physical inactivity. The current study was undertaken in obese patients with NIDDM to see whether improvements could be made in glycemic control as well as in many cardiovascular risk factors (obesity, hypertension, lipid abnormalities, and physical inactivity) that are typical of this condition. Fifteen obese insulin-using patients with NIDDM (average body mass index, 34.0) were treated with a 500-calorie formula diet for eight to 12 weeks. Administration of insulin and diuretics was discontinued at the onset of the study. A eucaloric diet was begun at eight to 12 weeks and maintained until Week 24. A behaviorally oriented nutrition-exercise program was instituted at the beginning of the study. Glipizide or placebo was added (randomized) at Week 15 if the fasting plasma glucose level in patients exceeded 115 mg/dl. Patients lost an average of 22 pounds over the course of 24 weeks. Frequency and duration of physical activity increased significantly from baseline, as did the maximal oxygen consumption rate. Glycemic control by 15 weeks (without insulin) was similar to baseline (with insulin). With the addition of glipizide at Week 15, both fasting plasma glucose and glucose tolerance improved significantly. This improvement was not observed with placebo. In addition, both systolic and diastolic blood pressure decreased by about 10 mm Hg. There were no significant changes in the levels of serum lipids or glycosylated hemoglobin. In conclusion, a multifaceted intervention program, employing weight reduction, exercise, diet, and glipizide therapy, can be instituted in insulin-using patients with NIDDM, with improvement in glycemic control and in certain risk factors (hypertension, obesity, physical inactivity) for cardiovascular disease.
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PMID:Achieving therapeutic goals in insulin-using diabetic patients with non-insulin-dependent diabetes mellitus. A weight reduction-exercise-oral agent approach. 330 4


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