Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Restoration of near-normal glucose metabolism with the insulin pump reduces retinal fluorescein leakage and microalbuminuria in diabetes. However, it is not known whether these functional changes reflect a true reversal of diabetic retinopathy or nephropathy. To evaluate this question, we studied the effect of 1-2 yr of insulin pump treatment on clinical endpoints in 17 type I diabetic patients. In each patient, plasma glucose and total glycosylated hemoglobin levels fell to normal or near-normal levels. The total daily dose of insulin given during the first month of pump treatment (52 +/- 5 U/day) was comparable to that given during conventional treatment (44 +/- 3 U/day) and varied little over the 1-2 yr period of observation. Ten eyes without retinopathy at the start of the study remained without retinopathy after 15-23 mo of pump treatment. One of eleven eyes with background retinopathy developed proliferative retinopathy and 3 of 13 eyes with proliferative retinopathy progressed during pump treatment. Similarly, no improvement in renal function was observed in the six patients with diabetic nephropathy on entry to the study. In the first month of pump treatment, proteinuria consistently fell to values 30% below prepump levels (P less than 0.005). However, the diminution in proteinuria was not sustained and all remain proteinuric after 13-18 mo of pump therapy. Serum creatinine rose slightly and creatinine clearance did not significantly change. These data suggest that insulin pump treatment does not reverse established diabetic microvascular complications, despite a sustained improvement in metabolic control for up to 2 yr.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Long-term improvement of metabolic control with the insulin pump does not reverse diabetic microangiopathy. 718 47

This study evaluates the wall thickness of common carotid arteries and the atherosclerotic involvement of the carotid bifurcations in patients with noninsulin-dependent diabetes mellitus (NIDDM), with and without microvascular complications. Seventy subjects affected by NIDDM, and 17 healthy controls were evaluated by means of high-resolution echo-Doppler scan. Twenty-six diabetics (Group A) and complications (overnight proteinuria > 500 mg, background retinopathy, sensory neuropathy), while 44 (Group B) had no complications. The two groups were comparable for age, sex, plasma lipid profile, and smoking habit. Arterial hypertension was present in 15 of 26 (58%) complicated patients (Group A) and in 18 of 44 (41%) uncomplicated patients (Group B). None of the patients had a history of cerebrovascular disease. The authors found that the wall thickness of the common carotid artery was greater and atherosclerotic lesions of the carotid bifurcation were more frequent in diabetic patients with microvascular complications than in uncomplicated diabetics (who had a similar distribution of other risk factors for atherosclerosis) and in nondiabetic controls. These data on the one hand confirm the role of diabetes as an independent risk factor for carotid atherosclerosis and, on the other hand, indicate a correlation between microvascular lesions and early atherosclerosis in diabetes.
 ...
PMID:Wall thickening of common carotid arteries in patients affected by noninsulin-dependent diabetes mellitus: relationship to microvascular complications. 766 82

In order to evaluate patients with necrobiosis lipoidica diabeticorum and to compare them with age, sex, and duration of diabetes matched controls, 15 patients with necrobiosis were each matched with 5 control subjects with diabetes mellitus. Complications of diabetes, glycaemic control, and proteinuria were measured. Patients with necrobiosis (mean age 40, range 18-74 years) had a mean duration of diabetes of 14 (range 3-36) years; 8 patients were male, and 7 were female. For necrobiosis versus controls, background retinopathy (67% vs 27%, p = 0.009), proteinuria (53% vs 17%, p = 0.006), and smoking (60% vs 20%, p = 0.003) were all more common with necrobiosis. There were no significant differences between patients with necrobiosis and control patients in the prevalence of vascular disease and neuropathy. Glycosylated haemoglobin concentrations were higher in patients with necrobiosis (p = 0.02). Blood pressure measurements were similar in both groups. We conclude that smoking, proteinuria, and retinopathy were more prevalent in diabetic patients with necrobiosis; the skin lesion may therefore share common aetiological factors which affect the microvascular circulation, leading to damage to basement membranes and vascular endothelial cells.
 ...
PMID:Necrobiosis lipoidica diabeticorum: association with background retinopathy, smoking, and proteinuria. A case controlled study. 826 54

In Caucasian patients with insulin-dependent diabetes mellitus (IDDM) proliferative diabetic retinopathy (PDR) and persistent proteinuria (PP) are associated, and major risk factors for development of microangiopathy have been identified. The aim of the present study was to evaluate whether these risk factors are also relevant and whether an association exists between the microangiopathic complications in Japanese IDDM-patients. A clinic-based cohort of 324 Japanese IDDM-patients was followed (a mean follow-up of 7 years). Annual examination for development of PDR and PP was performed. Fifty-eight patients developed PDR and 24 developed PP. Development of PDR was associated to high HbA1c-levels, i.e., the 4th quartile (RR 7.9, P < 0.0001), background retinopathy at admission (RR 9.9, P < 0.0001), high age at diabetes onset (RR 2.9, P < 0.0001) and female gender (RR 1.7, P < 0.05). Development of PP was associated to high HbA1c-levels (RR 2.8, P < 0.001) and background background retinopathy at admission (RR 7.9, P < 0.0001). The risk of developing PP was 9 times higher in patients developing PDR than in patients not developing PDR (P < 0.0001). The effect of metabolic control in our cohort was similar to that found in the DCCT and SDIS studies. In conclusion, development of PP is closely associated with PDR, also in Japanese IDDM-patients. The effect of metabolic control is the same as in Caucasian patients. Development of malignant angiopathy in IDDM-patients is not confined to Caucasian IDDM-patients, and the incidence rates are comparable to those found in Caucasian IDDM.
 ...
PMID:Metabolic regulation and microangiopathy in a cohort of Japanese IDDM-patients. 859 14

Microvascular diabetic complications are the most common causes of morbidity and mortality of patients with type 1 disease. Diabetic nephropathy is becoming the single most common cause of end stage renal failure, while diabetic retinopathy is the most common cause of blindness in working-age population. The main aim of the study was to evaluate the progression of late microvascular complications in type 1 diabetic patients treated by conventional or intensified insulin regimen over the period of 10 years. We selected a random sample of 32 patients, including 14 males and 18 females, aged 30,6 +/- 11,8 years, with average duration of the disease of 4,8 +/- 3,2 years. They did not show signs of overt diabetic nephropathy, while 5 patients had background retinopathy. All the patients had their fasting and postprandial glycaemia, HbAlc, 24/hour proteinuria, blood pressure, height and weight measured and body mass index calculated (BMI). There was a trend towards increasing values of HbAlc (6.9 +/- 0.8 vs. 7.4 +/- 1.0 %, p < 0.05), fasting glycaemia (6.8 +/- 08 vs. 7.8 +/- 1.2 mmol/l, p < 0.05), postprandial glycaemia (9.2 +/- 1.5 vs. 11.3 +/- 1.9 mmol/l, p <0.01), systolic and diastolic blood pressure values (120.0 +/- 10.8 vs. 128.5 +/- 16.8 mmHg, p<0.05; and 73.4 +/- 8.1 vs. 79.8 +/- 9.8 mmHg, p< 0.05) although no hypertensive patient was diagnosed. There were 11 persons (34.4%) with persistent proteinuria of 200 mg/24 hour or more and significant difference in overall proteinuria in 10 yrs period (121.3 +/- 37.3 vs. 312.8 +/- 109.9 mg/24 h, p< 0.001). Overall, 9 persons (28.1%) were diagnosed with simple, background retinopathy, but 6 of them (18.8%) had signs of proliferative form of the disease. The results indicate significant changes in progression of proteinuria in both groups although retinopathic progression was observed but was not significant in the intensively treated group.
 ...
PMID:Development of microvascular complications in type 1 diabetic patients 10 years follow-up. 1687 13

A case of a 26-year-old patient with acute myocardial infarction and hypertension, hyperlipidaemia as well as type 1 diabetes from 18 years complicated by background retinopathy and nephropathy in the state of proteinuria is described. State of metabolic compensation of the diabetes was poor. The patient did not perform regular self-monitoring of glycaemia, smoked, and used oral contraception. Early diagnosis of vascular lesions in young persons with long-lasting of type 1 diabetes as well as the introduction of proper preventive and treatment methods may improve prognosis in these high-risk patients.
 ...
PMID:[Myocardial infarction in a 26-year-old patient with diabetes type 1]. 1805 87


<< Previous 1 2