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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirteen cats with diabetes mellitus were evaluated. Clinical signs included polydipsia, polyuria, polyphagia, lethargy, and weight loss. Results of physical examination included obesity, hepatomegaly, mild seborrhea sicca, muscle wasting, and dehydration. One cat walked plantigrade and was suspected of having a diabetic neuropathy. Persistent hyperglycemia, glucosuria, high liver enzyme activities, hypercholesterolemia, hyperproteinemia, and low electrolyte concentrations were the common laboratory findings. In 3 cats diabetes mellitus developed after megestrol acetate therapy; 2 of these cats required only temporary insulin treatment. In a 3rd cat, which had no history of receiving diabetogenic drug therapy, remission of diabetes mellitus also was observed. Serum insulin and plasma glucose concentrations were determined in 6 cats after administration of an intermediate-acting insulin (isophane insulin) and in 3 cats after administration of a long-acting insulin (protamine zinc insulin). The insulin concentration peaked 2 to 6 hours after the injection of intermediate-acting insulin and 6 to 12 hours after the injection of long-acting insulin. The lowest glucose concentration was recorded 4 to 8 hours after injection of intermediate-acting insulin, and 6 to 12 hours after injection of long-acting insulin. It was concluded that, although insulin therapy must be adjusted to the individual, the diabetic cat usually requires twice-daily administration of isophane insulin; however, the protamine zinc insulin can be given once daily for satisfactory control.
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PMID:Insulin therapy in cats with diabetes mellitus. 629 64

Adiposis dolorosa (Dercum's disease) is a syndrome of painful adipose tissue which occurs most often in post-menopausal women and is associated with obesity, asthenia, and emotional disturbances. The etiology is uncertain, but is probably multifactorial. Numerous treatments to relieve the pain have generally been unsuccessful. A patient with adiposis dolorosa was treated with intravenous infusions of lidocaine over a two-year period. Relief from pain lasted from two to 12 months after each infusion. A single-blind placebo infusion did not relieve the pain. Lidocaine infusions did not relieve the pain of diabetic neuropathy or of angina in this patient. The mechanism of relief of pain of adiposis dolorosa by lidocaine is uncertain, but previously reported central effects of lidocaine suggest that alterations in the central nervous system may be responsible.
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PMID:Intravenous lidocaine for the treatment of intractable pain of adiposis dolorosa. 712 48

The aim of the study was to find whether the type of diabetes and the duration of this disease causes any influence on gallbladder (GB) emptying, after exclusion of possible effect of obesity and a hyperglycaemia over 7 mmol/l (126 mg%) on this phenomenon. The investigations were carried out in 44 subjects with diabetes mellitus, among them 22 with type I and 22 with type II. These groups were divided according to disease duration: shorter or longer than 3 years. Two control groups (CI, CII) comprised each 20 healthy subjects. The age of CI and CII corresponded to the age of diabetes groups type I and II, respectively. All subgroups as well as the control groups were matched according to sex percentage structure, body mass index (BMI) and body surface (BS). In groups with type I and II diabetes, the number of cases with diabetic neuropathy was comparable. There was not found any significant (p > 0.05) influence of diabetes on the interdigestive GB volume, neither non-standardized nor standardized with regard to standard BS (1.73 m2). In comparison to the control groups, after a test meal, there was in all diabetic groups a statistically significant (0.001 > p < 0.05) reduction of GB emptying observed. This diminution was most expressed in the group with long-lasting type I diabetes.
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PMID:[Interdigestive gallbladder volume and and meal-induced gallbladder emptying in patients with diabetes]. 747 52

Neuropathy is the most common symptomatic chronic complication in diabetic patients and accounts for substantial morbidity in the diabetic population. It is predominently a disease of the older diabetic population, and shows a progressive course with limb amputation as the final end-point of the disease. Pathologically the disorder is characterised by progressive degeneration as well as impaired regenerative ability of peripheral nerve fibers, resulting in a progressive loss and dying-back of the longest nerve fibres innervating the distal limbs. These changes are associated with progressive impairment of nerve function leading to impaired sensitivity in the limbs, which sometimes is associated with troublesome pain. Qualitatively similar but much milder functional and structural changes occur during normal aging processes, which potentially could make elderly diabetic patients more susceptible to an additional hyperglycaemic insult. The mechanisms underlying the development of diabetic neuropathy involve hyperglycaemia-induced metabolic abnormalities of peripheral nerve fibres and the supporting nutritive vascular supply. One of the major abnormalities involves activation of the polyol pathway with subsequent impairments in nerve function and vascular supply. Since hyperglycaemia appears to be the major culprit in the development of diabetic neuropathy, good glycaemic control is paramount in the long term treatment of diabetic patients to attenuate the development and/or progression of the disorder. Furthermore, elimination of risk factors such as obesity, smoking and excessive alcohol (ethanol) consumption, as well as patient education, are all important factors in the care of diabetic patients. In symptomatic neuropathic patients, including those with painful neuropathy, symptomatic and palliative measures are often effective. Stepwise addition of antidepressants to simple analgesics has proven to be effective in patients with troublesome pain. During recent years a class of drugs have been developed that inhibits the activation of the polyol pathway in diabetic nerves. These so-called aldose reductase inhibitors hold promise for a targeted treatment regimen in the near future. The aldose reductase inhibitors are already available in several European countries and in Japan.
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PMID:Diabetic neuropathy in the elderly. 771 59

Although simultaneous pancreas and kidney transplantation (SPK) achieves normoglycemia and correction of uremia in type I diabetic patients with renal failure, little data are available on long-term outcome and clinical determinants of recovery of peripheral neuropathy. In this prospective study, 219 electrophysiological studies using a standardized protocol were performed before and up to 8 years after SPK in 44 patients. Nine control diabetic recipients with functioning kidney but nonfunctioning pancreas transplants were studied on 35 occasions. Patients were 38.5+/-7.9 years old (mean+/-SD) with pretransplant diabetes present for 25.2+/-7.6 years. Significant polyneuropathy (total nerve conduction scores [NCS] <-1.0) was present in 89% before transplantation, which correlated with body weight (r=0.628, P<0.001). Two distinct patterns of neurological recovery were observed after SPK. Conduction velocity (CV) improved in a biphasic pattern, with a rapid initial recovery followed by subsequent stabilization. In contrast, the recovery of nerve amplitude was monophasic, and continued to improve for up to 8 years. Initial improvement in NCS was primarily due to an increase in CV (P=0.002 vs. baseline), and was best in shorter and younger patients. Recovery of total NCS at 6 months after SPK, assessed by multivariate analysis, was least in obese recipients and when performed in patients who had started dialysis before SPK, and was associated with lower transplant kidney isotopic glomerular filtration rate and HLA mismatch (P<0.05 to 0.001). Subsequent improvement was associated with less severe initial neuropathy, smaller body weight, and longer duration of diabetes (P<0.01 to 0.001). Fasting hyperinsulinemia was associated with impairment of initial recovery and subsequent NCS after SPK, but was worse in the control group. Recovery of nerve action potential amplitudes was predicted by better initial amplitudes and HLA mismatch, lower body weight, and the use of nifedipine (P<0.05 to 0.001). Nifedipine was used for hypertension in 33% of SPK and was associated with better CV and amplitudes, particularly in the upper limbs, where there was less neuropathy. The use of angiotensin-converting enzyme inhibitors also appeared beneficial, but this was confined to the lower limbs. SPK resulted in a gradual, sustained, and late improvement in nerve action potential amplitudes, consistent with axonal regeneration and partial reversal of diabetic neuropathy. These data suggest that early transplantation of uremic diabetic patients before onset of severe neuropathy, minimizing obesity and optimizing renal transplant function, maximizes neurological recovery after SPK. Furthermore, the preliminary data support randomized clinical trials for evaluation of nifedipine and angiotensin-converting enzyme inhibitors in diabetic neuropathy.
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PMID:Diabetic neuropathy after pancreas transplantation: determinants of recovery. 908 22

Neural disturbances are observed in the peripheral and central nervous systems of patients with insulin-dependent diabetes mellitus (IDDM) and non-IDDM (NIDDM). Insulin-like growth factors (IGFs) are neurotrophic growth factors that can support nerve regeneration and neuronal survival in the types of neurons known to be afflicted in diabetes. We tested the hypotheses that IGF gene expression is reduced in neural tissues and liver of spontaneously diabetic obese Zucker (fa/fa) rats and that IGF treatment can prevent neuropathy. There was a significant early reduction in IGF-II mRNA content as measured per mg of wet tissue or per poly(A)+ RNA in sciatic nerves, spinal cord and brain from spontaneously diabetic obese (fa/fa) vs. nondiabetic lean (+/+) adult rats. In addition, IGF-I mRNA content was reduced in liver but not nerve or spinal cord of NIDDM rats. Pain/pressure thresholds were abnormal (hyperalgesia) in diabetic (fa/fa) vs. nondiabetic (+/+) rats, and subcutaneous infusion of IGF-II restored thresholds toward normal. The low dose of IGF-II that prevented hyperalgesia in contrast had no effect on hyperglycemia or obesity. These data suggest that IGF treatment may provide rational therapy for diabetic neuropathy and that therapy may be effective even in patients unable to adequately control their hyperglycemia.
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PMID:Insulin-like growth factor (IGF) gene expression is reduced in neural tissues and liver from rats with non-insulin-dependent diabetes mellitus, and IGF treatment ameliorates diabetic neuropathy. 933 45

The aim of our study was to estimate selected parameters of hemostasis and fibrinolysis in diabetic patients with vascular complications and obesity. The investigation was carried out in 23 type 1 diabetic subjects aged 17-56 ys, in 25 type 2 diabetic patients aged 41-69 ys and in 38 healthy persons: 16 "young"--aged 32.5 +/- 13.2 ys and 22 "old"--aged 56.2 +/- 9.4 ys. The following parameters were determined: glycaemia, HbA1c, blood level fibrinogen, euglobulin clot lysis time, plasminogen activator inhibitor (PAI-1) activity, microalbuminuria, triglyceride, total, HDL- and LDL-cholesterol concentration. Plasma fibrinogen level was elevated in type 2 diabetic subjects, and the highest concentrations were noted in patients with retinopathy or arterial hypertension, in overweight persons and--surprisingly--in type 1 diabetic subjects with nephropathy and coronary vascular disease (CVD). There were also positive correlations between fibrinogen level and systolic blood pressure (r = 0.3413, p < 0.02), diastolic blood pressure (r = 0.3809, p < 0.002) and microalbuminuria (r = 0.3552, p < 0.05). The mean euglobulin clot lysis time was prolonged in type II diabetics in comparison to the control group, especially in obese subjects. The highest activity of PAI-1 was found in overweight controls (28.87 +/- 6.24 Au/ml, p < 0.002). PAI-1 activity was also slightly increased in type 1 diabetic patients, especially with the symptoms of diabetic neuropathy, nephropathy or CHD, in comparison to the other groups. Our results seem to confirm the disturbed balance between coagulation and fibrinolysis--towards and increased risk of a prothrombotic state --in both--obese and diabetic patients--especially with advanced vascular complications.
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PMID:[Some parameters of hemostasis and fibrinolysis in diabetic patients]. 1010 28

Detailed clinicofunctional examination of anginal patients with NIDDM using variation pulsometry and electrophysiological cardiac tests in 110 patients (89 females and 21 males aged 36-79 years, mean 64.3 +/- 5.2 years) has revealed that atypical cardialgia, arterial hypertension, obesity was present in 28.1, 76.4 and 85.4% of anginal patients with NIDDM. Sympathicotonia was registered in autonomic heart regulation of 83% of them. Anginal patients exhibited also suppression of sinus node automatism and sinoatrial conduction. When NIDDM is severe, pacemaker activity of the sinus node intensified suggesting development of cardial diabetic neuropathy.
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PMID:[Features of angina pectoris in patients with non-insulin-dependent diabetes mellitus (NIDDM)]. 1068 14

Natural supplements are widely used in the United States and, while claims of their therapeutic effects abound, medical research does not always support their effectiveness. St. John's wort acts as a weak selective serotonin reuptake inhibitor with fewer side effects. S-Adenosylmethionine (SAMe) has enough of an antidepressant effect to warrant further research. More human studies are needed before garlic, bitter melon, soy and fenugreek supplements can be recommended for the management of diabetes, although chromium may be a promising treatment in some cases. Alpha lipoic acid is used in the treatment of diabetic neuropathy. The effects of ma huang/guarana combinations in obesity have not been well studied. These combinations may have potentially serious side effects but may also offer some benefit. The combination of hydroxycitric acid and garcinia has proved no more effective than placebo.
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PMID:Alternative therapies: Part I. Depression, diabetes, obesity. 1099 30

The presence of long-standing diabetes mellitus leads to the development of a number of typical end organ complications. These complications include coronary heart disease, stroke, peripheral arterial disease, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy and diabetic cardiomyopathy. From an epidemiological and clinical standpoint, cardiovascular disease remains the most important complication of diabetes. Cardiovascular complications are the most common causes of morbidity and mortality in diabetics, accounting for up to 85% of the mortality in diabetic patients. The increasing prevalence of obesity and sedentary lifestyle in Western society are leading to an increase in the prevalence in diabetes. As such diabetes is an increasing cause of cardiovascular disease.
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PMID:Diabetic heart dysfunction: is cell transplantation a potential therapy? 1287 29


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