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Query: UMLS:C0086543 (cataract)
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413 NIDDM Sudanese patients were studied. The patients' ages at the onset of diabetes ranged from 20-72 years, with the majority of patients (44%) developing diabetes at the age between 40-50 years. Female to male ratio was 1.9:1. 46.2% of patients were obese and a family history of first degree relatives was obtained in 63% of patients. Complications of diabetes in this study were as follows: Neuropathy (31.5%), retinopathy (17.4%), cataract (16%), nephropathy (9.2%), coronary heart disease (5.1%), cerebrovascular disease (4.4%) and peripheral vascular disease (3.4%). Microangiopathic complications of diabetes were significantly related to the duration of diabetes and the degree of hyperglycaemia (P less than 0.001 using chi 2 test). Macroangiopathic complications were significantly related to aging and hyperglycaemia. Patients with good metabolic control (blood glucose less than 160 mg%) had less prevalence of complications than uncontrolled patients. We conclude that NIDDM is a common type of diabetes in our diabetic clinic. It is a disease with severe complications and morbidity and needs more attention regarding metabolic control, since good control reduces the prevalence of diabetic complications.
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PMID:Features of non-insulin-dependent diabetes mellitus (NIDDM) in the Sudan. 201 36

In order to identify previously undiagnosed cases of non-insulin dependent diabetes (NIDDM) in general practice, we measured non-fasting blood-glucose in all risk patients (n = 1,790) between 35-69 years old belonging to 29 general practices in Kolding. Patients at risk for NIDDM were defined as those suffering from one or more of the following: overweight, arterial hypertension, coronary heart disease, hyperlipidaemia, stroke, gout, cataract, Dupuytren's contracture, peripheral atherosclerosis or recurrent urinary- or skin-infections. A positive result, defined as a non-fasting blood-glucose of > or = 8.0 mmol/l using the same stix-lot-nr. on Refloflux S machines, was found in 86 individuals. These were then followed up with two fasting blood-glucose measurements carried out in a central laboratory, whereby 34 patients with NIDDM were identified. The newly-diagnosed NIDDM patients mostly suffered from diseases related to the insulin resistance syndrome, and we thus recommend measurement of non-fasting blood-glucose as a screening procedure in such patients. When carrying out measurements in general practice, it is important to know the precision and accuracy of the apparatus used.
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PMID:[Selective screening for non-insulin-dependent diabetes mellitus. A study among 35-69 year-old patients at risk in general practice in Kolding]. 801 51

On the whole, diabetic microangiopathy can be understood as the clinical renal-retinal syndrome. About 10% of all diabetics die of end-stage renal failure, more frequent in IDDM. With an incidence of 14% diabetic retinopathy is one of the major causes of blindness in adulthood. In the non-proliferative state, the pathological changes are limited to the retina, whereas the alterations affect both retina and vitreous in the proliferative state. Photocoagulation is the treatment of choice. If photocoagulatory treatment is not possible because of cataract, vitreous surgery (pars-plana vitrectomy) could improve visual prognosis. The clinical features hypertension, proteinuria and finally renal failure define the term "diabetic nephropathy". The increased intraglomerular pressure is the main pathological alteration of incipient nephropathy. Microalbuminuria essentially determines the prognosis: in IDDM it concerns the incidence of a manifest nephropathy, in NIDDM the excessively increased incidence of cardiovascular mortality. Sonographically, the kidneys are large with bright and wide parenchyma. Along with the development of end-stage renal disease the kidney size diminishes. According to Mogensen, nephropathy is divided into five stages: Stage 1, the early stage, is defined by hypertrophy and hyperfiltration. Stage 2 shows incipient structural changes without any clinical findings. Stage 3 is characterised by persistent microalbuminuria. Stage 4 leads to increasing renal failure and stage 5 to end-stage renal disease and the necessity of dialysis treatment. Incipient nephropathy demands a strict treatment of both hypertension and diabetes. In the meantime, ACE inhibitors are the treatment of choice. In case of dialysis treatment continuous ambulant peritoneal dialysis (CAPD) is usually preferred.
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PMID:[Diabetic microangiopathy]. 847 38

Eye lens cataract can develop by various mechanisms the details of which are not completely known. Increased level of glucose in patients with diabetes mellitus represents one of the factors accelerating cataract development. As the lens does not depend on insulin, cataract formation is induced by hyperglycaemia both in IDDM and NIDDM patients. Glucose attacks free aminogroups of proteins and glycation products are formed by multistep non-enzymatic reactions. We can discriminate early and late products. The latter are often called as advanced glycation endproducts (AGE). They can accumulate inside the lens and interfere with its optical properties. With regard to the fact that glycation reactions are accompanied by autooxidation reactions, the overall process is usually referred to as glycoxidation. Free radical oxidations of membrane lipids give similar products as do glycation reactions, and there is synergy between these two pathways. Development of eye cataract is accompanied by a decrease in lens antioxidant capacity. A new class of glycation inhibitors has been observed recently. They are called Amadorins and they have therapeutic potential in the cataract treatment.
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PMID:[Role of nonenzymatic glycation and oxidative stress on the development of complicated diabetic cataracts]. 1095 2

Dexamethasone-cyclophosphamide pulse (DCP) is the prefered mode of therapy in pemphigus in India because it is relatively free from the side effects seen with heavy doses of daily oral steroids. One hundred forty-six pemphigus patients treated with DCP were observed for side effects of this regimen. One hundred forty mg of dexamethasone was administered IV in 200 ml of 5% dextrose over a period of 60-90 minutes on 3 consecutive days. Five hundred mg of cyclophosphamide was added on first day of the pulse and 50 mg given orally daily in the intervening period. DCP was repeated every 4 weeks and continued for 6 months after subsidence of the disease (no new lesions). Flushing over the face was the most common event recorded during the adiministration in 78 subjects followed by palpitations in 11, hiccups in 9, and numbness of feet in 6. Fourteen patients had polyurea, and 3 developed skin rash. Shivering, shooting pains along thighs, breathlessness, seizure and unilateral limb edema were observed in one patient each. Generalized weakness/malaise was the most troublesome delayed side effect in 81 (55.4%) patients; it lasted for 8-15 days after the pulse. Thirty-six (24.6%) had inadequate sleep syndrome, 23 (15.7%) had headache, 21 (14.3%) complained of arthralgias, 19 (13%) experienced alteration in taste, and 13 (9%) had diffuse hair loss. 28 females developed menstrual disturbances, and 14 (9.5%) had blurring of vision (glaucoma in 3 and posterior subcapsular cataract in 1). Thirteen of eighteen diabetics had an increase in blood sugar requiring higher doses of insulin. Five NIDDM patients needed insulin. Four (2.7%) developed hypertension. Pulse therapy is not absolutely free from side effects. Hypertension and diabetes occur less frequently as compared to conventional steroid therapy. Generalized weakness, flushing, headache and taste alteration occur exclusively with pulse therapy.
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PMID:Immediate and delayed complications of dexamethasone cyclophosphamide pulse (DCP) therapy. 1468 52