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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Medical records of the Pima Indian population aged 0--24 yr were reviewed for a diagnosis of diabetes before initiation of glucose tolerance testing. None of 1556 subjects below age 15, but 6 of 657 aged 15--24, had a previous diagnosis. Of the six known diabetics, five had been treated with insulin and four had had ketoacidosis. Subsequently, plasma glucose levels were determined after a 75-g oral carbohydrate load in 1712 subjects aged 5--24 yr, which is about 78% of the eligible population. Previously diagnosed diabetes and asymptomatic hyperglycemia were more frequent in subjects 15--24 yr old than were reported in other populations. Glucose intolerance in young Pimas was associated with obesity. In Pima offspring, the presence of diabetes in both parents was related to glucose tolerance in those above but not below the age of 15 yr. Both asymptomatic hyperglycemia and insulin-requiring diabetes occurred frequently in young Pimas, suggesting that these syndromes represent the clinical spectrum of a single disease in the Pima Indian.
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PMID:High prevalence of diabetes in young Pima Indians: evidence of phenotypic variation in a genetically isolated population. 47 85

Blood sugar and IRI were followed for 24 hr in healthy patients, young and adult diabetics, and in subjects with apparently primary obesity on a standard, normal calorie diet. Morning and nocturnal insulin positivity peaks were noted in the normal subjects, though circadians variations in these parameters were mainly related to meals. This periodicity was altered in young diabetics, for whom insulin responsivity was ruled out, and in the adult diabetics, who displayed deficient insulin secretion in the morning, and delayed secretion after the afternoon meal, and in the obese subjects, the quality of whose response was close to that of the previous group. The usefulness of this type on examination in the planning of diet and drug management, quite apart from diagnosis and prognosis, is stressed.
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PMID:[Circadian variations in glycemia and IRI in normal subjects, young and adult diabetics and in obese subjects]. 48 87

The basis of different diets for insulin dependent and maturity onset obese diabetics is discussed. The results achieved by strict calorie control in obese diabetics are compared with those in a group of patients with simple obesity and shown to be superior. The value of very low carbohydrate lager is assessed. It is concluded (a) that there is no case for severe carbohydrate restriction in diabetic diets unless there is a need for total calorie restriction and (b) 'Diet' low carbohydrate lager offers no particular advantages over ordinary lager in the diabetic diet.
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PMID:The dietary therapy of diabetes. 48 94

Twenty-one nondiabetic subjects, their weights ranging from 56 to 165 kg, received an infusion of glucose (420 mg/min), insulin (0.77 mU/kg/min), and somatostatin (500 microgram/h) for 150 min. A steady state level of plasma insulin and glucose was attained after 90 min. Endogenous insulin secretion determined by C-peptide measurement, and glucagon secretion remained suppressed throughout the period. With similar steady state levels of plasma insulin (SSPI) maintained in all subjects, the height of the steady state plasma glucose concentration (SSPG) was considered an index of total body sensitivity to insulin-mediated glucose uptake. A positive correlation between SSPG and the degree of obesity, as determined by the body mass index (BMI), was demonstrated (r = 0.70, P less than 0.001). No correlation was found between SSPI and BMI. The fasting plasma insulin concentration correlated with BMI (r = 0.82, P less than 0.0001) and SSPG (r = 0.80, P less than 0.0001). This method provides a simple safe measure of total body insulin resistance over a wide range of obesity and is independent of endogenous insulin secretion.
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PMID:A simplified method using somatostatin to assess in vivo insulin resistance over a range of obesity. 48 47

Because of the doubts cast on the safety of the sulphonylureas we analysed 1000 consecutive referrals to a diabetic clinic to identify the number of new patients equally suitable for treatment with a sulphonylurea or insulin. After excluding previously diagnosed and treated diabetics and those with a non-diabetic glucose tolerance test there were 531 new diabetics. Youth and insulin dependency, old age or obesity accounted for 390. A further 40 required diet alone, 50 had concomitant disease or socio-domestic circumstances influencing treatment choice, and 10 had secondary diabetes. Thus, only 41 diabetics (7.7% of new patients or 4.1% of total clinic referrals) appeared suitable for optional sulphonylurea or insulin therapy. We conclude that there are relatively few diabetics for whom the questionable safety of the sulphonylureas poses a therapeutic problem, and equally few who would be available for any further long-term, random-allocation trials of their effects upon the cardiovascular system.
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PMID:Sulphonylureas and cardiovascular disease: a problem for few diabetics. 49 26

1) Protein restricted diets decrease basal plasma insulin levels in obesity. 2) This effect occurs even in the presence of sufficient calories to maintain body weight and while the diet is high in carbohydrate. 3) The decrease in insulin is accompanied by a fall in plasma glucose and in the I/G ratio, suggesting an increase in insulin sensitivity. 4) Excessive protein intake, in addition to carbohydrate, may play a role in the pathogenesis of the hyperinsulinemia and insulin resistance found in obesity.
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PMID:Suppression of insulin secretion by protein deprivation in obesity. 49 74

We studied the effect of physical training on in vivo tissue sensitivity to insulin and insulin binding to monocytes in six previously untrained healthy adults. Physical training (one hour of cycle-ergometer exercise four times per week for six weeks) failed to alter body weight but resulted in a 20 per cent increase (P less than 0.02) in maximal aerobic power (VO2 max) and a 30 per cent increase (P less than 0.01) in insulin-mediated glucose uptake (determined by the insulin clamp technique). The increase in insulin sensitivity correlated directly with the rise in VO2 max (P less than 0.05). Binding of [125I]insulin to monocytes also rose by 35 per cent after physical training (P less than 0.02), primarily because of an increase in the concentration of insulin receptors. Our data indicate that physical training increases tissue sensitivity to insulin in proportion to the improvement in physical fitness. Physical training may have a role in the management of insulin-resistant states, such as obesity and maturity-onset diabetes, that is independent of its effects on body weight.
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PMID:Increased insulin sensitivity and insulin binding to monocytes after physical training. 50 13

Following Yalow and Berson's basic research on the binding of polypeptide hormones to plasma proteins, an integrated picture of hormone-receptor interaction and biological activity has been proposed for insulin in experimental models and in man. The extracellular interaction of the insulin molecule with the cell membrane structure modifies the intracellular metabolism, and it has been suggested that this occurs through the activation of a second messenger or the transduction of an insulin fragment into the cell. The use of monoiodoinsulin has made it possible to perform a series of experiments on cells isolated from the blood (monocytes) or from the tissues (adipocytes) and on plasma membranes prepared by ultracentrifugation. The existence of specific receptor sites for insulin in all cases, both in animals and in man, has been confirmed by mathematical analysis of the binding curves; their non-linear course, as plotted by Scatchard's method, may depend on negative cooperation or on different classes of receptor. From an evaluation of recent studies on human obesity, particularly on adipocytes and circulating monocytes, a new approach to the problem of 'insulin resistance' in obesity has been proposed, and this has shown that a reduction in the number of receptors on the target cells may contribute to peripheral insulin insensitivity. This phenomenon, which seems to be characteristic of the static phase of obesity, is reversible during fasting or weight reduction and may be a compensatory mechanism for hyperinsulinaemia. These results are an example of the significance and applicability of the experimental method of detecting insulin binding to target cells, and suggest a wide application in different endocrinological fields.
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PMID:Insulin binding to target cells (general survey, problems and results in spontaneous obesity). 50 97

The blood glucagon concentration (fasting and in insulin hypoglycemia) was determined by radioimmunoassay in diabetic patients, relatives of diabetic patients with a normal glucose tolerance test, patients with obesity and a group of normal weight subjects. The index of glucagon rise above the fasting level and glucagon release rate were estimated. In relatives of diabetic and obese patients the initial blood glucagon concentration did not differ from that of healthy subjects. However, during insulin hypoglycemia, glucagon secretion was significantly reduced, and in relatives of diabetic patients it also proved to be delayed. A comparison of glucagon and somatostatin changes in the above mentioned patients allows to suggest participation of the somatostatin mechanism in disorders of glucagon secretion.
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PMID:Glucagon secretion in subjects with prediabetes, diabetes mellitus and obesity. 50 63

Worldwide diabetes epidemiology studies have shown quite marked differences in diabetes prevalence rates between ethnic groups. This pattern holds true in the Pacific region and provides unique opportunities for comparative studies. Diabetes is rare in Melanesians, and also in Polynesians, Micronesians, and Australian Aboriginals who retain their traditional life-style. High prevalence rates of insulin-independent diabetes have been demonstrated in Polynesians, Micronesians, and Australian aboriginals who have adopted a Western life-style. Along with the Pima Indians, the Micronesian population of Nauru have the highest diabetes prevalence yet reported--40% of people aged 20 yr and over. As diabetes is rare in traditional living Polynesians and Micronesians, yet high in westernized populations of these ethnic groups, it appears these people may have a "diabetic genotype" that is unmasked by the change in life-style. Obesity, a high caloric Western diet, and reduced physical activity may be the major precipitating factors. Bimodality of glucose tolerance distributions has been demonstrated in both westernized Polynesians and Micronesians. The frequency distributions of both fasting and 2-h postload glucose levels allow separation of these populations into normal and hyperglycemic groups. The optimal cut-off levels between the two groups were a fasting plasma glucose congruent to 140 mg/dl and a 2-h level of congruent 20 mg/dl. These findings provide a valid basis for the diagnosis of diabetes mellitus to be based on the above levels. Only sparse information exists on the prevalence of microvascular and macrovascular complications of diabetes in these populations. However, there is clear evidence that they are occurring and they are similar in nature to the complications seen in Caucasian diabetic patients. Coronary artery disease is not yet a major problem in Pacific Islanders although most of the major risk factors are not present in urbanized communities. However, with increasing westernization, and given more time for the pathologic process of atheroma to develop, it can be expected that coronary artery disease will become a major cause of morbidity and mortality in Polynesians, Micronesians, and the Australian aboriginal.
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PMID:Epidemiology of diabetes and its macrovascular manifestations in Pacific populations: the medical effects of social progress. 52 Jan 18


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