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La Enfermedad Renal en Personas con Diabetes(Kidney Disease in People with Diabetes).  

National Technical Information Service (NTIS)

Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD). Diabetes is the most co...



Efectos antidiabéticos de liposomas cargados con glibenclamida en ratas con diabetes inducida por alloxan Antidiabetic Activity of Glibenclamide Loaded Liposomes in Alloxan Induced Diabetic Rats  

Microsoft Academic Search

The antidiabetic activity of Glibenclamide loaded liposomes was investigated in model of alloxan-induced diabetes in rats. The blood glucose level was measured at 0 h and 1, 2, 4, 6, 8, 10, 12, 14 and 16h after the treatment. The alloxan - diabetic rats showed signifi cant reduction in blood glucose level, after treatment with Glibenclamide loaded liposomes and orally




Microsoft Academic Search

Non-alcoholic fatty liver is a common disease closely related to the increasing prevalence of obesity and type 2 diabetes in the general population. The eSS rats display a non obese type 2 diabetic syndrome with an insulin resistant state characterized by hyperglycaemia, hypertriglyceridemia and hyperinsulinemia. In 12 month-old eSS males glycaemia, fructosamine, triglyceridemia and reactive species to oxygen were evaluated,

Stella Maris Daniele; Juan Carlos Picena; Silvana Marisa Montenegro; María Cristina Tarrés; Stella Maris Martínez




... It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. A blood test can show ...



NSDL National Science Digital Library

Diabetes, in a variety of forms, affects many Americans and is the 4th leading cause of death by disease in the US. Diabetes is fundamentally a disease in which the body cannot produce or effectively use a critical hormone called insulin. Untreated / unmanaged diabetes can lead to blindness, kidney failure, heart disease, loss of limbs and stroke.

Dr. Leslie Nader (MSMR)





... Frequent or recurring skin, gum, bladder or vaginal yeast infections People who have type 2 diabetes may ... in the armpits, high blood pressure, cholesterol problems, yeast infections and skipped or absent periods in teen ...


Prescripción y tipo de ejercicio físico recomendado para pacientes con diabetes Prescription and type of exercise recommended for patients with diabetes  

Microsoft Academic Search

Regular physical exercise is recommended as one of the most im- portant aspects in the treatment of diabetes mellitus. In the case of the diabetic patient, the correct prescription of physical exercise is essential to maximize the benefits, while decreasing the risks asso- ciated with each type of activity. This prescription must be fraction- ated to focus on the different

S. Murillo; A. Novials


Documento de consenso sobre tratamiento con infusión subcutánea continua de insulina de la diabetes tipo 1 en la edad pediátrica  

Microsoft Academic Search

This article reports on the Spanish Position Statement for the Diabetes Pediátric Group for the Spanish Pediatric Endocrinology Society (SEEP) on continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. The practical issues about their indications, appropriate candidates, feasibility, and limits are outlined. The conclusions are based on the comprehensive review and balanced assessment of the evidence

R. Barrio Castellanos; B. García Cuartero; A. Gómez Gila; I. González Casado; F. Hermoso López; C. Luzuriaga Tomás; M. Oyarzabal Irigoyen; I. Rica Etxebarria; M. Rodríguez Rigual; M. Torres Lacruz



Coste-efectividad de exenatida en comparación con insulina glargina en pacientes con obesidad y diabetes mellitus tipo 2 en España  

Microsoft Academic Search

Background and objectivesExenatide, a GLP-1 receptor agonist for adjuvant treatment of type 2 diabetes mellitus (T2DM), has been shown to be as effective as insulin glargine (IG) for reducing glycated hemoglobin levels combined with metformin or\\/and sulphonylureas. Exenatide is associated to weight reduction and a higher incidence of gastrointestinal adverse events.The objective of this study was to assess the cost-effectiveness

Gordon Goodall; María Costi; Louise Timlin; Jesús Reviriego; José Antonio Sacristán; Jayne Smith-Palmer; Tatiana Dilla




NSDL National Science Digital Library

This booklet summarizes what health professionals know about type 2 diabetes what it is, who is at risk for it, how it can be prevented, and how it is treated. It describes how researchers study the disease and what individuals can do to help reduce the rising number of diabetes cases now affecting millions of children and adults around the country.The Science Inside e-book series is ntended to be a bridge between the consumer health brochure and the scientific paper, the booklets in this series focus on the science that is inside of, or behind, the disease its cause, its possible cure, its treatment, promising research, and so on. These booklets are designed to appeal to people who have not had the opportunity to study the science and to understand why they may have been given some of the advice that they have been given through some of the more consumer-oriented materials.

American Association for the Advancement of Science (;)




NSDL National Science Digital Library

This booklet summarizes what health professionals know about type 2 diabetes what it is, who is at risk for it, how it can be prevented, and how it is treated. It describes how researchers study the disease and what individuals can do to help reduce the rising number of diabetes cases now affecting millions of children and adults around the country.The Science Inside e-book series is intended to be a bridge between the consumer health brochure and the scientific paper, the booklets in this series focus on the science that is inside of, or behind, the disease its cause, its possible cure, its treatment, promising research, and so on. These booklets are designed to appeal to people who have not had the opportunity to study the science and to understand why they may have been given some of the advice that they have been given through some of the more consumer-oriented materials.

American Association for the Advancement of Science (American Association for the Advancement of Science;)



Pro's and Con's of the Early Use of Insulin in the Management of Type 2 Diabetes: A Clinical Evaluation  

PubMed Central

Purpose of Review Recently, there have been increasing calls for insulin to be used as the initial treatment of type 2 diabetes, and if not then, soon after its onset. The underlying reason given is that insulin will slow apoptosis of pancreatic ?-cells which is increased in type 2 diabetes. This review will examine the clinical evidence supporting this recommendation. Recent Findings Several observational studies in which newly diagnosed type 2 diabetic patients are intensively treated for a short time with insulin which is then stopped have shown that approximately half of these patients retain good control without pharmacological therapy for up to a year. However, Hb A1c levels in patients who have to be started on oral anti-diabetic drugs (OAD) are similar to the values in those who do not. Hb A1c levels are similar in patients randomized to initial therapy with insulin or OAD. There is no clinical evidence yet for an effect of insulin on ?-cell apoptosis. Summary The primary goal is to achieve and maintain Hb A1c levels of <7.0%. Given the extra demands on both patients and physicians when starting insulin compared to OAD and the many subsequent years in which patients have diabetes, the arguments for using insulin initially, or in patients who have achieved the target Hb A1c level, are not convincing. However, as soon as OAD therapy cannot meet this goal, insulin must be introduced.

Davidson, Mayer B.



Colonias y campamentos de verano para niños y jóvenes con diabetes. La alimentación: cara a cara, teoría y práctica  

Microsoft Academic Search

Although it is obvious that educating the boy\\/girl with diabetes has to be a personalized and sustained process, summer holiday camps are considered a very appropriate instrument (as suggested by the World Health Organization, the WHO, in the St. Vincent Declaration of 1989) for taking educational action both in what concerns self-control techniques and as psychological help for accepting the

Gemma Salvador; Maria Manera; Montserrat Soley




Microsoft Academic Search

Objectives. To compare the efficacy of two treatments of the diabetes mellitus: insulin glargine, an analogue of long-acting insulin (Lantus®), and intermediate acting isophanic insulin (NPH insulin). Method. Modelized retrospective cost-utility analysis, from the pers- pective of the Spanish Health System (considering the direct health costs). It was simulated the evolution during 9 years of the patients with type 1

Carlos Rubio-Terrés; Javier Rodríguez; Bjorn Bolinder; Pedro de Pablos; REES Vol; Cian Magenta; Amarillo Negro



Microsoft Academic Search

Diabetes is a global health problem with a growing number of individuals with diabetes mellitus in the world. Information and communication technologies (ICT) could play an important role in this group of patients. Objective. To report the use and perceptions regarding ICT in patients with diabetes. Material and methods. During August 2008, previously validated surveys were applied to patients with

Walter H. Curioso; Ernesto Gozzer; María Valderrama; Juan Rodríguez-Abad; Jaime E. Villena; Arturo E. Villena


Estado actual y recomendaciones sobre la utilización de los sistemas de monitorización continua de glucosa en niños y adolescentes con diabetes mellitus tipo 1  

Microsoft Academic Search

Glucose monitoring methods have made great advances in the last decade with the appearance of the continuous glucose monitoring systems (CGMS) that measure the glucose levels in the interstitial liquid, providing information about glucose patterns and trends, but do not replace the self-monitoring of capillary glucose.Improvement in diabetes control using the CGMS depends on the motivation and training received by

M. Torres Lacruz; R. Barrio Castellanos; B. García Cuartero; A. Gómez Gila; I. González Casado; F. Hermoso López; C. Luzuriaga Tomás; M. Oyarzabal Irigoyen; I. Rica Etxebarria; M. Rodríguez Rigual



Women and Diabetes -- Diabetes Medicines  


Women and Diabetes - Diabetes Medicines Click here for the Color Version (PDF 518 KB) Diabetes can make it hard to control how much ... Warning Signs Diabetes Medicines Learn More about Diabetes Diabetes Tips Talk to your doctor before you change ...


What should be the antihypertensive drug of choice in diabetic patients and should we avoid drugs that increase glucose levels? Pro and Cons.  


It has long been known that antihypertensive drugs may affect blood glucose in a differential manner. In particular new onset diabetes is significantly increased in association with the use of thiazides or beta-blockers, respectively, compared to placebo, whereas treatment with angiotensin-conversion-enzyme-inhibitors or angiotensin-receptor-blockers is associated with a lower than expected frequency, as also assessed in several meta-analyses. In line with these notions, the NAVIGATOR Trial was the first to report a significant preventive effect of an angiotensin-receptor-blocker on new onset diabetes evaluated as a primary outcome in a prospective randomized study. Hence, and in view of the fact that comparable blood pressure lowering with any of the five major classes of antihypertensive drugs, including calcium-channel-blockers, give comparable benefits in reducing cardiovascular complications, unless there are specific indications or contraindications for an individual drug, caution should be exercised, therefore, to use beta-blockers or thiazides as first-line drugs for blood pressure lowering indications in subjects at high risk to develop diabetes, especially in patients with so called metabolic syndrome. The potential of glycemic worsening in overt diabetic patients with thiazides or beta-blockers has less well been studied systematically, yet paradigmatically in UKPDS evaluating a randomized comparison of a beta-blocker with an angiotensin-conversion-enzyme(ACE)-inhibitor. Not only was there HbA1c worsening with beta-blocker use which required additional blood glucose lowering therapy, but also significantly more weight gain which still was detectable at the 20?year follow-up. On the other hand, the overall cardiovascular outcomes were comparable in the two treatment groups irrespective whether therapy was based on the beta blocker atenolol or the ACE-inhibitor captopril. Awareness of these facts and highly individualized therapy seem to be the way forward. PMID:23280868

Standl, Eberhard; Erbach, Michael; Schnell, Oliver



Diabetes Insipidus  


... Z List of Topics and Titles : Diabetes Insipidus Diabetes Insipidus On this page: What is diabetes insipidus? ... Hope through Research For More Information What is diabetes insipidus? Diabetes insipidus (DI) is a rare disease ...


Diabetes - resources  


Resources - diabetes ... The following sites provide further information on diabetes : American Diabetes Association - Juvenile Diabetes Research Foundation International - National Center for Chronic Disease Prevention and Health Promotion - ...


Diagnósticos de enfermagem identificados em pessoas com diabetes tipo 2 mediante abordagem baseada no Modelo de Orem1 Nursing diagnosis identified in people with diabetes type 2 by means of an approach based on Orem's model Diagnósticos de enfermería identificados en personas con diabetes tipo 2 a través de abordaje basado en el modelo de Orem  

Microsoft Academic Search

This research aimed to describe some of the basic conditioning factors to self-care and analyze the nursing diagnosis of the North American Nursing Diagnosis Association among diabetes type 2 carriers by means of an approach based on Orem's theory. Seven diabetic people took part in this study; they were evaluated during the period of May to June of 2006. The

Alyne Coelho Moreira Milhomem; Fabiane Fassini Mantelli; Graziela Aparecida; Valente Lima


Diabetic Neuropathy  


NINDS Diabetic Neuropathy Information Page Table of Contents (click to jump to sections) What is Diabetic Neuropathy? Is there any treatment? ... Organizations Additional resources from MedlinePlus What is Diabetic Neuropathy? Diabetic neuropathy is a peripheral nerve disorder caused ...


Diabetes Medicines  


Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...


Diabetes Insipidus  


... even wet the bed. Causes & Risk Factors What causes diabetes insipidus? Diabetes insipidus has several causes. In some ... either the hypothalamus or the pituitary gland can cause diabetes insipidus. This can occur after a head injury, ...


Gestational diabetes  


Gestational diabetes is high blood sugar ( diabetes ) that starts or is first diagnosed during pregnancy. ... woman's blood. You are at greater risk for gestational diabetes if you: Are older than 25 when you ...


Diabetic neuropathy  


Nerve damage - diabetic; Diabetes - neuropathy ... the heart, bladder, stomach, and intestines (called autonomic neuropathy) ... develop: Bladder or kidney infection Diabetes foot ulcers Neuropathy that may hide the symptoms of angina, chest ...


Diabetes Overview  


... insulin to body tissues. Other Genetic Syndromes Sometimes Associated with Diabetes Many genetic syndromes are associated with diabetes. These conditions include Down syndrome, Klinefelter’s syndrome, ...


Kidney Disease and Diabetes  


... Introduction Cardiovascular Disease & Diabetes Peripheral Artery Disease & Diabetes Kidney Disease & Diabetes Cholesterol Abnormalities & Diabetes • Understand Your Risk for Diabetes • Symptoms, Diagnosis & ...


A new look at viruses in type 1 diabetes  

Microsoft Academic Search

Type 1 diabetes results from the destruction of pancreatic beta cells. Genetic factors are believed to be a major com- ponent for the development of type 1diabetes, but the con- cordance rate for the development of diabetes in identical twins is only about 40%, suggesting that non-genetic factors play an important role in the expression of the disease. Viruses are

Hee-Sook Jun; Ji-Won Yoon



Diabetes Complications  


If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can cause problems with other body ... as your kidneys, nerves, feet, and eyes. Having diabetes can also put you at a higher risk ...


Diabetes Insipidus  


Diabetes insipidus (DI) causes frequent urination. You become extremely thirsty, so you drink. Then you urinate. This ... is almost all water. DI is different from diabetes mellitus (DM), which involves insulin problems and high ...


Diabetic Ketoacidosis  


... diabetes. Complications Diabetic ketoacidosis is treated with fluids, electrolytes — such as sodium, potassium and chloride — and insulin. ... and check for complications. Tests may include: Blood electrolyte tests Urinalysis Chest X-ray A recording of ...


Diabetic neuropathy  

Microsoft Academic Search

Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical neuropathy is the commonest accounting for 75% DN. Asymmetrical neuropathies may involve cranial nerves, thoracic or limb nerves; are of acute onset resulting from ischaemic infarction of vasa nervosa. Asymmetric neuropathies in diabetic patients

V Bansal; J Kalita; U K Misra



Monogenic Diabetes  


... and new genetic causes are still being discovered. Neonatal diabetes This rare condition occurs in the first 6 months of life. ... for their age. The two types are • Permanent neonatal diabetes, a lifelong condition • Transient neonatal diabetes, which goes away during infancy ...


Diabetic diarrhea.  


Diabetic patients with diarrhea may present clinical challenges in diagnosis and treatment. Particular diagnoses are more prevalent in diabetic patients than in the general population. Medications are often a culprit for chronic diarrhea, and the medication list should always be carefully scrutinized for those with diarrhea as a side effect. In diabetic patients, metformin is a common cause of diarrhea. Diabetic patients are more likely to have associated diseases (eg, celiac sprue and microscopic colitis) that present with diarrhea as the sole complaint. Ingested sugar-free foods that may contain sorbitol or other agents can cause diarrhea in diabetic patients. Finally, diabetic enteropathy can itself cause diarrhea. The various etiologies can be diagnosed with a thorough history and appropriate diagnostic tests. This article focuses on the etiologies of diarrhea that are seen with higher incidence in diabetic patients. PMID:19765362

Gould, Milena; Sellin, Joseph H



Diabetes Numeracy  

PubMed Central

OBJECTIVE Understanding the reasons and eliminating the pervasive health disparities in diabetes is a major research, clinical, and health policy goal. We examined whether health literacy, general numeracy, and diabetes-related numeracy explain the association between African American race and poor glycemic control (A1C) in patients with diabetes. RESEARCH DESIGN AND METHODS Adults with type 2 diabetes (n = 383) were enrolled in a cross-sectional study at primary care and diabetes clinics at three medical centers. Data collected included the following: self-reported race, health literacy, general numeracy, diabetes-related numeracy, A1C, and sociodemographic factors. A series of structural equation models were estimated to explore the interrelations between variables and test for mediation. RESULTS In model 1, younger age (r = ?0.21, P < 0.001), insulin use (r = 0.27, P < 0.001), greater years with diabetes (r = 0.16, P < 0.01), and African American race (r = 0.12, P < 0.01) were all associated with poorer glycemic control. In model 2, diabetes-related numeracy emerged as a strong predictor of A1C (r = ?0.46, P < 0.001), reducing the association between African American and poor glycemic control to nonsignificance (r = 0.10, NS). In model 3, African American race and older age were associated with lower diabetes-related numeracy; younger age, insulin use, more years with diabetes, and lower diabetes-related numeracy were associated with poor glycemic control. CONCLUSIONS Diabetes-related numeracy reduced the explanatory power of African American race, such that low diabetes-related numeracy, not African American race, was significantly related to poor glycemic control. Interventions that address numeracy could help to reduce racial disparities in diabetes.

Osborn, Chandra Y.; Cavanaugh, Kerri; Wallston, Kenneth A.; White, Richard O.; Rothman, Russell L.



Causes of Diabetes  


... Topics and Titles : Causes of Diabetes Causes of Diabetes On this page: What is diabetes? What causes ... through Research For More Information Acknowledgments What is diabetes? Diabetes is a complex group of diseases with ...


American Diabetes Association  


... Research Diabetes Journals Clinical Trials We welcome Lilly Diabetes to Drive to Stop Diabetes! Drive to Stop Diabetes, featuring NASCAR driver Ryan ... today! Exciting Health Insurance Changes for People with Diabetes! Health Insurance Marketplaces are now open, offering new ...


Air Travel and Diabetes  


... Please visit Living with Diabetes Discrimination Public Accommodations Air Travel and Diabetes What Can ... today. Home > Living with Diabetes > Know Your Rights > Discrimination > Public Accommodations > Air Travel and Diabetes Air Travel ...


Diabetic diarrhea  

Microsoft Academic Search

Diabetic patients with diarrhea may present clinical challenges in diagnosis and treatment. Particular diagnoses are more\\u000a prevalent in diabetic patients than in the general population. Medications are often a culprit for chronic diarrhea, and the\\u000a medication list should always be carefully scrutinized for those with diarrhea as a side effect. In diabetic patients, metformin\\u000a is a common cause of diarrhea.

Milena Gould; Joseph H. Sellin



Diabetic Neuropathy  

Microsoft Academic Search

Polyneuropathy is one of the commonest complications of the diabetes and the commonest form of neuropathy in the developed\\u000a world. Diabetic polyneuropathy encompasses several neuropathic syndromes, the most common of which is distal symmetrical neuropathy,\\u000a the main initiating factor for foot ulceration. The epidemiology of diabetic neuropathy has recently been reviewed in reasonable\\u000a detail (1). Several clinic- (2,3) and populationbased

Solomon Tesfaye


Diabetes Insipidus  


... is unknown. This damage disrupts the normal production, storage and release of ADH. Nephrogenic diabetes insipidus. Nephrogenic diabetes insipidus occurs when there's a defect in the kidney tubules — the structures in your kidneys that cause water to be excreted or reabsorbed. This defect makes ...


Diabetes Myths  


... has about 150 calories and 40 grams of carbohydrate. This is the same amount of carbohydrate in 10 teaspoons of sugar! One cup of ... 100 calories (or more) and 30 grams of carbohydrate. Myth: People with diabetes should eat special diabetic ...


Diabetes Collection.  

National Technical Information Service (NTIS)

This is a collection of fact sheets and reports dealing with information on diabetes. Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into ener...



Diabetic embryopathy.  


Diabetic embryopathy reflects a scientific enigma--how does a seemingly rich intrauterine environment manage to disturb the development of the embryo? Which compounds in that environment may be teratogenic--and how shall we find them? How can we investigate a putative dose-response nature of the teratogen, i.e., how can we monitor the effects of varied severity of the diabetic state (which can be varied in a number of metabolic ways) on the embryonic development? Here, the whole embryo culture (WEC) technique provides an excellent tool for such studies. WEC is thus currently used to investigate the effect of graded levels of diabetes (e.g., hyperglycemia, hyperketonemia, increased branched chain amino acid (BCAA) levels), and putative antiteratogenic agents (antioxidants, folic acid, arachidonic acid, inositol), as well as the effect of different embryonic genotypes on diabetes-induced (mal)development. WEC is the only method, which is able to couple specific embryonic maldevelopment to precise changes in substrate levels or the (epi)genotype of the embryo. Using this method, we have been able to demonstrate that a diabetic environment--culture of embryos in serum from diabetic animals or in serum with increased levels of glucose, ?-hydroxybutyrate or ?-ketoisocaproic acid (KIC)--causes increased embryonic maldevelopment, and that this dysmorphogenesis is blocked by the addition of ROS scavenging agents to the culture medium. Genetically, others and we have demonstrated that Pax-3 downregulation predisposes for diabetes-induced dysmorphogenesis. PMID:22669680

Eriksson, Ulf J; Wentzel, Parri



Effect of Paternal Diabetes on Pre-Diabetic Phenotypes in Adult Offspring  

PubMed Central

OBJECTIVE Paternal and maternal type 2 diabetes, exclusive of gestational diabetes, may influence risk factors in the offspring differently (through possible epigenetic effects of parental diabetes) and are difficult to identify without accurate dates of diagnosis. We aimed to examine a metabolic phenotype in three different groups of offspring to see distinct paternal versus maternal effects. RESEARCH DESIGN AND METHODS We examined body composition and insulin action (M) in nondiabetic subjects and insulin secretion tested via acute insulin response (AIR) in normal glucose-tolerant full-heritage Pima Indian adults categorized by disparate parental diabetes status: 1) offspring of fathers with early-onset diabetes (age <35 years) and nondiabetic mothers (ODF; n = 10), 2) offspring of mothers with early-onset diabetes (age <35 years), not exposed to diabetes in utero with nondiabetic fathers (OMED; n = 11), and 3) a control group of offspring of parents without diabetes until >50 years of age (CON; n = 15). RESULTS ODFs were leaner than CONs and OMEDs (percent of body fat [%BF]: least-squares means adjusted for age and sex [95% CI]: 27.3 [23.3–31.3] in ODFs vs. 35.4 [32.2–38.5] in CONs and 32.4 [28.8–36.1] in OMEDs, P = 0.04). ODFs were more insulin sensitive (had a higher M) than OMEDs or CONs, but not after adjustment for age, sex, and %BF. AIR adjusted for M, age, sex, and %BF was lower in ODFs versus CONs and OMEDs (P < 0.05). CONCLUSIONS Adult ODFs were leaner and had lower early insulin secretion, despite being equally insulin sensitive after adjustment for body fat compared to the other groups, indicating a paternal imprinted effect.

Penesova, Adela; Bunt, Joy C.; Bogardus, Clifton; Krakoff, Jonathan



Pharmacological Management of Type 2 Diabetes Mellitus: Rationale for Rational Use of Insulin  

Microsoft Academic Search

Type 2 diabetes mellitus is a chronic metabolic disorder associated with high morbidity and mortality from long- term microvascular and macrovascular complications. Evidence from randomized controlled trials indicates that aggressive treatment directed at improving glycemic con- trol reduces the incidence of diabetes-related microvascu- lar complications. Traditionally, oral monotherapy for type 2 diabetes is initiated when diet and exercise do not




Diabetes Warning  

MedlinePLUS Videos and Cool Tools

... alarm, after analyzing the most recent findings from the ongoing TODAY study, which stands for Treatment Options for Type 2 Diabetes in Adolescents and Youth. The findings, published in a special ...


Diabetic neuropathy.  


Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical neuropathy is the commonest accounting for 75% DN. Asymmetrical neuropathies may involve cranial nerves, thoracic or limb nerves; are of acute onset resulting from ischaemic infarction of vasa nervosa. Asymmetric neuropathies in diabetic patients should be investigated for entrapment neuropathy. Diabetic amyotrophy, initially considered to result from metabolic changes, and later ischaemia, is now attributed to immunological changes. For diagnosis of DN, symptoms, signs, quantitative sensory testing, nerve conduction study, and autonomic testing are used; and two of these five are recommended for clinical diagnosis. Management of DN includes control of hyperglycaemia, other cardiovascular risk factors; alpha lipoic acid and L carnitine. For neuropathic pain, analgesics, non-steroidal anti-inflammatory drugs, antidepressants, and anticonvulsants are recommended. The treatment of autonomic neuropathy is symptomatic. PMID:16461471

Bansal, V; Kalita, J; Misra, U K



Diabetic neuropathy  

PubMed Central

Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical neuropathy is the commonest accounting for 75% DN. Asymmetrical neuropathies may involve cranial nerves, thoracic or limb nerves; are of acute onset resulting from ischaemic infarction of vasa nervosa. Asymmetric neuropathies in diabetic patients should be investigated for entrapment neuropathy. Diabetic amyotrophy, initially considered to result from metabolic changes, and later ischaemia, is now attributed to immunological changes. For diagnosis of DN, symptoms, signs, quantitative sensory testing, nerve conduction study, and autonomic testing are used; and two of these five are recommended for clinical diagnosis. Management of DN includes control of hyperglycaemia, other cardiovascular risk factors; ? lipoic acid and L carnitine. For neuropathic pain, analgesics, non?steroidal anti?inflammatory drugs, antidepressants, and anticonvulsants are recommended. The treatment of autonomic neuropathy is symptomatic.

Bansal, V; Kalita, J; Misra, U K



Diabetic Retinopathy  

Microsoft Academic Search

Diabetic retinopathy (DR) is a microvascular complication that eventually afflicts virtually all patients with diabetes mellitus\\u000a (DM) (1). Despite decades of research, there is presently no known cure or means of preventing DR, and DR remains the leading cause\\u000a of new-onset blindness in working-aged Americans (1). Several nationwide clinical trials have demonstrated that scatter (panretinal) laser photocoagulation reduces the 5-year

Lloyd Paul Aiello; Jerry Cavallerano


Diabetic Neuropathies  

Microsoft Academic Search

Diabetic neuropathies (DN) are a heterogeneous group of disorders that include a wide range of abnormalities. They can be\\u000a focal or diffuse, proximal or distal, affecting both peripheral and autonomic nervous systems, causing morbidity with significant\\u000a impact on the quality of life of the person with diabetes, resulting in early mortality. Distal symmetric polyneuropathy,\\u000a the most common form of DN,

Aaron I. Vinik


Diabetes and Pregnancy  


Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When ... pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the ...


Diabetes and Kidney Disease  


... Home Kidney Disease A to Z Health Guide Diabetes and Kidney Disease Diabetes mellitus, usually called diabetes, ... of your body. Are there different types of diabetes? The most common ones are Type 1 and ...


Diabetes insipidus - nephrogenic  


Nephrogenic diabetes insipidus; Acquired nephrogenic diabetes insipidus; Congenital diabetes insipidus ... Nephrogenic diabetes insipidus (NDI) occurs when the kidney tubules do not respond to a chemical in the body called ...


Type 1 diabetes  


Insulin-dependent diabetes; Juvenile onset diabetes; Diabetes - type 1 ... Type 1 diabetes can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults. Insulin ...


"Stop Diabetes Now!"  


... this page please turn Javascript on. Feature: Diabetes "Stop Diabetes Now!" Past Issues / Fall 2009 Table of ... American Diabetes Association is launching an educational campaign, "Stop Diabetes," to persuade more Americans to understand and ...


Diabetic cardiomyopathy.  


Individuals with diabetes are at a significantly greater risk of developing cardioymyopathy and heart failure despite adjusting for concomitant risks such as coronary artery disease or hypertension. This has led to the increased recognition of a distinct disease process termed as "diabetic cardiomyopathy." In this article, we perform an extensive review of the pathogenesis and treatment of this disease. From a clinical perspective, physicians should be aware of this entity, and early screening should be considered because physical evidence of early diabetic cardiomyopathy could be difficult to detect. Early detection of the disease should prompt intensification of glycemic control, concomitant risk factors, use of pharmacologic agents such as ?-blockers and renin-angiotensin-aldosterone system antagosists. From a research perspective, more studies on myocardial tissue from diabetic patients are needed. Clinical trials to evaluate the development of diabetic cardiomyopathy and fibrosis in early stages of the disease, as well as clinical trials of pharmacologic intervention in patients specifically with diabetic cardiomyopathy, need to be conducted. PMID:21111987

Murarka, Shishir; Movahed, Mohammad Reza



Diabetes Travel Tips Video  

MedlinePLUS Videos and Cool Tools

... here: NDEP Home > Resources > Diabetes Travel Tips Video Diabetes Travel Tips Video Diabetes doesn’t keep David from traveling. But he ... about some of David’s tips for traveling with diabetes. Diabetes Travel Tips Subtitle Diabetes Travel Tips Transcript ...


Diabetic mastopathy.  


Diabetic mastopathy is an uncommon condition found in patients with long-standing diabetic mellitus (DM). Although benign in nature, it can sometimes not be distinguishable from breast carcinoma, and may lead to unnecessary anxiety or intervention. Clinicopathologic features of 10 patients were reviewed in detail. Only three of the 10 patients had type I DM. All patients had over a 10-year history of DM, and presented with unilateral, solitary, palpable breast mass, ranging in size from 1.5 to 5 cm. Radiologic and pathologic features of each patient were described. None of the patients in our series developed malignancy during the follow-up period. Diabetic mastopathy is a benign condition and not unique to type I DM. Surgeons should be aware of this distinct fibroinflammatory breast condition and its association with long-standing DM. PMID:23895671

Chan, Chiu-Lung Richie; Ho, Ronnie S L; Shek, Tony W H; Kwong, Ava



Diabetic retinopathy.  

PubMed Central

Diabetic retinopathy is the commonest cause of blindness amongst individuals of working age. The onset of retinopathy is variable. Regular ophthalmic screening is essential in order to detect treatable lesions early. Retinal laser therapy is highly effective in slowing the progression of retinopathy and in preventing blindness. As the sufferers of diabetes mellitus, the commonest endocrine disorder, now constitute approximately 1-2% of Western populations, concerted multidisciplinary effort must be made towards cost-effective community screening by the medical community. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7

Infeld, D. A.; O'Shea, J. G.



SatisfacciÛn marital en pacientes con artritis reumatoide. Estudio comparativo con otras enfermedades crÛnicas y controles sanos  

Microsoft Academic Search

SUMMARY Objective: to assess marital satisfaction (MS) in patients with rheumatoid arthritis (RA) and com- pare it with other chronic diseases and normal con- trols. Material and methods: we studied 50 patients with RA and compared them with 50 patients with systemic lupus erythematosus (SLE), 50 patients with diabetes mellitus (type 2), and 50 normal controls. We applied a marital

Barile Fabris


Breastfeeding and Diabetes  

Microsoft Academic Search

\\u000a As diabetes becomes more prevalent in younger women, diabetes and maternal-child health issues such as breastfeeding coexist\\u000a with increasing frequency in clinical practice. Women with diabetes of any kind including type 1 diabetes (DM1), type 2 diabetes\\u000a (DM2) or gestational diabetes (GDM) should be strongly encouraged to breastfeed because of the maternal and pediatric benefits\\u000a specific to obesity and diabetes

Julie Scott Taylor; Melissa Nothnagle; Susanna R. Magee


[Diabetic gastroparesis].  


Diabetic gastroparesis corresponds to symptomatic as well as asymptomatic gastric retention without organic abnormality of stomach, pylorus or gut. This complication associated with autonomic neuropathy is found in about 50% of patients with type 1 and type 2 diabetes. It may be clinically important when it is associated with gastrointestinal symptoms limiting quality of life, alterations in glycaemic control and changes in oral drug absorption. In addition, acute changes in blood glucose concentration affect gastric motor function: gastric emptying is slowed down during hyperglycaemia and accelerated during hypoglycaemia. The diagnosis of gastroparesis may be confirmed by scintigraphy assessment of gastric emptying, preferably using a solid meal. Unfortunately, treatment options remain limited and often unsatisfactory. They first rely on life-style and dietary modifications. If necessary, pharmacological agents (metoclopramide, domperidone, cisapride, and erythromycin) may be considered. Cisapride is actually the most powerful agent for chronic use, but the risk of cardiac toxicity (increase of QT with "torsade de pointe") limits its general use. In some diabetic patients, gastroparesis may contribute to erratic glucose excursions, with precocious postprandial hypoglycaemia, late hyperglycaemia, and/or delayed recovery from hypoglycaemia after carbohydrate ingestion. Sometimes, the initiation of intensive insulin therapy and the use of prokinetic drugs could lead to significant improvement of blood glucose control in patients with diabetic gastroparesis. PMID:16035319

Stassen, M P


Diabetic Dermopathy  


... If necessary, a physician will likely stress the importance of controlling blood sugar and reiterate that appropriate diabetes ... Community: Discussion Forum Skinmatters Blog About Us | Terms of Use | Contact Us © 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site ...



Technology Transfer Automated Retrieval System (TEKTRAN)

Diabetic vascular complications such as atherosclerosis complicate the treatment of diabetes. We hypothesized that moderate supplementation with B-carotene might help prevent diabetic vascular complications through its impact on cholesterol metabolism. Forty Sprague-Dawley rats were fed AIN-76 con...


Tips for Kids with Type 2 Diabetes: What Is Diabetes?  


... life. Q * To learn more about diabetes American Diabetes Association 1-800-DIABETES (342-2383) Juvenile Diabetes Research Foundation International 1-800-223-1138 • www. ...


Tips for Teens with Diabetes: What Is Diabetes?  


... Teens > What is Diabetes? Tips for Teens with Diabetes: What is Diabetes? Download This Publication (NDEP-63) Want this item ... life. Last reviewed: 11/01/2012 What is diabetes? Diabetes means that your blood glucose , also called ...


Diabetes Care: 10 Ways to Avoid Diabetes Complications  


... be reprinted for personal, noncommercial use only. Diabetes care: 10 ways to avoid diabetes complications By Mayo ... share your e-mail address Sign up Diabetes care: 10 ways to avoid diabetes complications Diabetes care ...


Niveles Plasmáticos de Insulina y Glucosa en Diabéticos Tratados con Glibenclamida y Clorpropamida  

Microsoft Academic Search

Riassunto  Sono stati studiati due gruppi di pazienti con diabete stabile dell’età matura, ciascuno costituito da 4 soggetti: il primo\\u000a (gruppo « A ») era stato trattato con glibenclamide durante 20,0 ± 1,1 mesi, il secondo (gruppo « B »), con clorpropamide\\u000a durante 44,2 ± 15,4 mesi. Dopo 3 determinazioni preliminari della glicemia (metodo di Somogyi-Nelson) e dell’insulinemia (metodo\\u000a di Meade

Carlos Aiello; Diego Turner; Néstor J. I. Aparicio; Elda A. de Turner; Alberto Vazquez



Diabetic Ulcer (Neurogenic Ulcer)  


... may prescribe. Trusted Links MedlinePlus: Diabetic Foot References Levin ME: Pathogenesis and general management of foot lesions in the diabetic patient. Levin and O'Neal's The Diabetic Foot. Bowker JH, ...


Access: Diabetes Research  


... more information, Please visit News & Research Research Research Database Research Discoveries Support Our Research ... News & Research > Research > Access: Diabetes Research Access: Diabetes Research Listen patientINFORM is a program that provides patients ...


Diagnosing Diabetes and Prediabetes  


... Control Avoiding extremes is key to managing your diabetes. Food & Fitness Food Recipes MyFoodAdvisor Planning Meals What Can ... Pledge Join us in the movement to Stop Diabetes! Food & Fitness Natural Diabetes Meals Create delicious meals with ...


Diabetes Risk Test  


... Control Avoiding extremes is key to managing your diabetes. Food & Fitness Food Recipes MyFoodAdvisor Planning Meals What Can ... Pledge Join us in the movement to Stop Diabetes! Food & Fitness Natural Diabetes Meals Create delicious meals with ...


Have Diabetes. Will Travel.  


Have Diabetes. Will Travel. By the National Diabetes Education Program Heading out of town? Leaving your troubles behind? Off on an important business trip? Whenever you travel, your diabetes comes along with you. And while ...


Diabetes diet - type 1  


Diet - diabetes - type 1; Type 1 diabetes diet ... If you have type 1 diabetes , it is important to know how many carbohydrates you eat at a meal. This information helps you determine how much insulin ...


Diabetes diet - type 2  


Type 2 diabetes diet; Diet - diabetes - type 2 ... If you have type 2 diabetes , your main focus is often on weight control. Most people with this disease are overweight. You can improve blood sugar (glucose) ...


Diabetes Report Card  

MedlinePLUS Videos and Cool Tools

... the lower right-hand corner of the player. Diabetes Report Card HealthDay April 25, 2013 Related MedlinePlus Pages Blood Sugar Cholesterol Diabetes Transcript Managing diabetes is a daily challenge. Now, ...


Diabetes Prevention Program  


National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ...


Introduction to Diabetes  


National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ...


Women and Diabetes  

MedlinePLUS Videos and Cool Tools

... Consumer Information by Audience For Women Women's Health Topics Mammography Women and Diabetes Birth Control Heart Health for Women Pregnancy Menopause Other Women's Health Topics ? - Resources for You Diabetes - MedlinePlus It's ...


Living with Diabetes: Driving  


... Control Avoiding extremes is key to managing your diabetes. Food & Fitness Food Recipes MyFoodAdvisor Planning Meals What Can ... Pledge Join us in the movement to Stop Diabetes! Food & Fitness Natural Diabetes Meals Create delicious meals with ...


Diabetes Care and Treatment.  

National Technical Information Service (NTIS)

The major goals of this continuing project are the establishment of a telemedicine system for comprehensive diabetes management and the assessment of diabetic retinopathy that provides increased access for diabetic patients to appropriate care, that centr...

D. Birkmire-Peters D. S. Vincent J. Humphry K. Parisi



Diabetes - tests and checkups  


... active lifestyle when you take control of your diabetes care. Still, you must have regular health checkups and ... Association. Standards of medical care in diabetes -- 2012. Diabetes Care . 2012 Jan;35 Suppl 1:S11-63. In ...


Tuberculosis and Diabetes  




Depression and Diabetes  


... 2 diabetes and depression. Arch Gen Psychiatry . 2009 Mar; 66(3):324–30. 4. Egede LE, Zheng ... expenditures in individuals with diabetes. Diabetes Care . 2002 Mar; 25(3):464–70. 5. Anderson RJ, Freedland ...


Nephrogenic Diabetes Insipidus  


... block the action of antidiuretic hormone, such as lithium Some Trade Names LITHOBID . Also, high levels of ... Pronunciations amyloidosis antidiuretic hormone diabetes insipidus diabetes mellitus lithium medulla nephritis nephrogenic nephrogenic diabetes insipidus pituitary polycystic ...


Discrimination (Based on Diabetes)  


... help you take action to stop the discrimination. Facebook Chat on Diabetes and Discrimination – Transcript Posted On ... January 30th, the American Diabetes Association held a Facebook Chat on diabetes discrimination, as a follow up ...


Diabetes and kidney disease  


Kimmelstiel-Wilson disease; Diabetic glomerulosclerosis; Nephropathy - diabetic; Diabetic nephropathy ... a higher risk for kidney problems. People of African-American, Hispanic, and American Indian origin are also more ...


Diabetic Nerve Problems  


... the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get it. ... change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling ...


How to Treat Gestational Diabetes  


... today. Home > Diabetes Basics > Gestational How to Treat Gestational Diabetes Listen Because gestational diabetes can hurt you and ... you, and a healthy start for your baby. Gestational diabetes – Looking ahead Gestational diabetes usually goes away after ...


Diabetes Diagnosis  

NSDL National Science Digital Library

In this inquiry-based lesson, students learn about diabetes mellitus and explore techniques for diagnosing and monitoring the disease. Students must propose a plan for testing two different case study patients, then carry out their plan using artificial samples from each patient. This teaching resource was developed by a K-12 science teacher in the American Physiological SocietyÃÂs 1999 Frontiers in Physiology Program. For more information on this program, please visit

Ms. Marcy Hotchkiss (Landsdowne High School)



Diabetic Encephalopathy  

Microsoft Academic Search

Diabetes and its treatment are associated with functional and structural disturbances in the brain. Acute disturbances are\\u000a related to acute hypoglycemia or severe hyperglycemia and stroke. These acute metabolic and vascular insults to the brain\\u000a are well known and beyond the scope of this chapter, which will focus on changes in cerebral function and structure that develop\\u000a more insidiously. These

Geert Jan Biessels


Diabetes, Type 2  


... disease. As a result of research proving their benefits, Medicare now covers blood glucose self monitoring materials and diabetes education services, helping people to better control their diabetes. ...


Tips for Teens with Diabetes: About Diabetes  

ERIC Educational Resources Information Center

|Diabetes is a serious disease. It means that one's blood glucose, also called blood sugar, is too high. Having too much glucose in a person's blood is not healthy. This paper offers tips for managing diabetes.|

National Diabetes Education Program (NDEP), 2010



Preventing diabetes in women with gestational diabetes.  


The immediate consequences of gestational diabetes on pregnancy are well known but the complications decades later for the mother and child are just now emerging. This trio of papers discuss the long-term consequences of gestational diabetes, the importance of screening this high risk group of women for type 2 diabetes, and the evidence for lifestyle, medications and breastfeeding for the prevention of type 2 diabetes in these women. PMID:22228710

Feig, Denice



Oral Diabetes Drugs (Treating Type 2 Diabetes)  


If You Have Type 2 Diabetes When you have diabetes, you have too much glucose, or sugar, in your blood. Th is can cause serious health problems, ... as heart disease, stroke, and blindness. People with diabetes who do not lower their blood sugar usually ...


Neuroprotection in Diabetic Encephalopathy  

Microsoft Academic Search

Increasing evidence has shown that diabetes may be associated with learning and memory deficits in humans. These cognitive disorders, called ‘diabetic encephalopathy’, can impair the daily performance of diabetic individuals. In recent years, some neuroprotective measures have been proposed to prevent diabetic neuropathology. This review attempts to show a summary of different experimental measures that have been described to improve

Seyyed Amirhossein Fazeli



Diabetes in Elderly Adults  

Microsoft Academic Search

Diabetes is common in the elderly population. By the age of 75, approximately 20% of the population are afflicted with this illness. Diabetes in elderly adults is metabolically distinct from diabetes in younger patient populations, and the approach to therapy needs to be different in this age group. Diabetes is associated with substantial mor- bidity from macro- and microvascular complications.

Graydon S. Meneilly; Daniel Tessier



Diabetes in pregnancy  

Microsoft Academic Search

Diabetes is the most common medical condition to complicate pregnancy and includes pregestational type 1 and type 2 diabetes and gestational diabetes, defined as glucose intolerance first diagnosed during pregnancy. Risks for the fetus include malformation, spontaneous abortion, stillbirth, neonatal death, macrosomia and intrauterine growth retardation. Risks for the mother include severe hypoglycaemia, diabetic ketoacidosis, progression of eye or renal

Rosemary Temple



Vanadium and diabetes  

Microsoft Academic Search

We demonstrated in 1985 that vanadium administered in the drinking water to streptozotocin (STZ) diabetic rats restored elevated blood glucose to normal. Subsequent studies have shown that vanadyl sulfate can lower elevated blood glucose, cholesterol and triglycerides in a variety of diabetic models including the STZ diabetic rat, the Zucker fatty rat and the Zucker diabetic fatty rat. Long-term studies

Patrick Poucheret; Subodh Verma; Marc D. Grynpas; John H. McNeill



Diabetes Education Process  

Microsoft Academic Search

Diabetes self-management is well recognized as the cornerstone of a person’s diabetes care. A person with diabetes must have\\u000a the knowledge and skills to successfully manage his diabetes. The healthcare team is an integral part of a person’s diabetes\\u000a treatment plan. The team typically consists of a physician, a nurse educator, and a dietitian, although other healthcare providers\\u000a may be

Amy P. Campbell; Elaine D. Sullivan


Diabetic Peripheral Neuropathy  

Microsoft Academic Search

Diabetic peripheral neuropathy is the most prevalent peripheral neuropathy in the Western world. It has been reported to affect\\u000a nearly 50% of people with diabetes (1,2). It is responsible for a significant proportion of the mortality and morbidity that accompany diabetes and ranks third in\\u000a lifetime expenditures associated with diabetic complications (3). Diabetic peripheral neuropathy was until recently thought to

Rachel Nardin; Roy Freeman


Diabetes and Pregnancy  

Microsoft Academic Search

Diabetes mellitus is the most common complication in pregnancy, affecting nearly 8% of all pregnancies. Nearly 90% of women\\u000a with diabetes develop the condition during pregnancy; diabetes in the other 10% antedated the pregnancy. Since the discovery\\u000a of insulin, perinatal mortality rates for women with diabetes have decreased, however, infant morbidity remains higher than\\u000a in the nondiabetes pregnant population.\\u000a \\u000a Diabetes

Alyce M. Thomas


Effect of Uncontrolled Diabetes on Plasma Ghrelin Concentrations and Ghrelin-Induced Feeding  

Microsoft Academic Search

Plasma levels of the orexigenic hormone, ghrelin, decrease rapidly on nutrient ingestion and yet are paradoxically ele- vated in rats with hyperphagia induced by streptozotocin- induced diabetes (STZ-DM). In the current work, we investi- gated the mechanisms underlying the relationships among uncontrolled diabetes, food intake, and plasma ghrelin con- centrations in an effort to clarify whether increased ghrelin signaling contributes




The development and evaluation of written medicines information for Type 2 diabetes  

Microsoft Academic Search

Written Medicines Information (WMI) is regarded as a key component in diabetes con- sumer education. In Australia, there is a paucity of WMI that specifically tailors to the extensive array of medicines used for the lifelong man- agement of Type 2 diabetes. This research pro- ject aimed to employ a novel framework, the 'Consumer Involvement Cycle', to investigate consumer perspectives

D. Y. L. Lee; C. Armour; I. Krass



Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment1-3  

Microsoft Academic Search

Background: Type 2 diabetes is an epidemic that is affecting an ever-increasing proportion of the US population. Although con- sumption of refined carbohydrates has increased and is thought to be related to the increased risk of type 2 diabetes, the ecologic effect of changes in the quality of carbohydrates in the food supply on the risk of type 2 diabetes

Lee S Gross; Earl S Ford; Simin Liu


Teenage pregnancy in type 1 diabetes mellitus.  


Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p < 0.02). Glycaemic was worse in TG compared to CON at 13, 26 and 35 weeks gestation, despite higher insulin doses. First trimester miscarriage rate did not differ between groups. Major congenital anomaly rate was 6.2% (1/16) compared to 3.2% in CON. This preliminary study has demonstrated that pregnant teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes. PMID:19968816

Carmody, David; Doyle, Aoife; Firth, Richard G R; Byrne, Maria M; Daly, Sean; Mc Auliffe, Fionnuala; Foley, Micheal; Coulter-Smith, Samuel; Kinsley, Brendan T



Diabetes in Children and Teens  


... type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is ... TV, computer, and video Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes ...


Type 2 diabetes - risk factors  


Risk factors for Type 2 diabetes; Diabetes risk factors ... You have a higher risk for diabetes if you have any of the following: Age greater than 45 years Diabetes during a previous pregnancy Excess body weight (especially around ...


Healthy Eating with Diabetes Video  

MedlinePLUS Videos and Cool Tools

... Healthy Eating with Diabetes Video Healthy Eating with Diabetes Video Making changes in the way you eat ... help you manage your weight. Healthy Eating with Diabetes Subtitle Healthy Eating with Diabetes Transcript Healthy Eating ...


Introduction to Type 2 Diabetes (Revised).  

National Technical Information Service (NTIS)

Contents: What is Type 2 Diabetes; The Cycle of Type 2 Diabetes; Tupe 1 vs Type 2; Risk Factors for Type 2 Diabetes in American Indians; Diagnosing Diabetes; Diagnostic Criteria for Diabetes Mellitus, Impaired Glucose Tolerance, and Gestational Diabetes; ...

B. Drabant K. Acton B. Tolbert



Indian Health Service Complications Series, Diabetes Curriculum.  

National Technical Information Service (NTIS)

Contents: High Blood Pressure and Diabetes; Periodontal Disease and Diabetes; Your Heart and Blood Vessels; Diabetes and Nerve Damage (Neuropathy); Diabetes and Your Kidneys (Nephropathy); Diabetes and Your Eyes (Retinopathy); Diabetes and Sexual Health f...



Type 1 Diabetes: What Is It?  


Type 1 Diabetes: What Is It? KidsHealth > Kids > Diabetes Center > What's Diabetes? > Type 1 Diabetes: What Is It? Print A A ... What is it? Let's find out. What Is Diabetes? Diabetes is a disease that affects how the ...


Type 2 diabetes  


... are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of ... high levels of sugar build up in the blood. This is called hyperglycemia. Type 2 diabetes usually occurs slowly over time. Most ...


Tight Diabetes Control  


... Diabetes > Treatment & Care > Blood Glucose Control Tight Diabetes Control Listen Keeping your blood glucose levels as close ... and it involves hard work. What Does Tight Control Mean? Tight control means getting as close to ...


Diabetes - eye care  


... 2010 Mar 2;152(1):ITC1-16. Inzucchi SE, Sherwin RS. Type 1 diabetes mellitus. In: Goldman ... Philadelphia, Pa: Saunders Elsevier; 2011:chap 236. Inzucchi SE, Sherwin RS. Type 2 diabetes mellitus. In: Goldman ...


Your Diabetic Diet.  

National Technical Information Service (NTIS)

Designed to be used for patients who have diabetes mellitus. Brief explanations of the disease and of carbohydrate metabolism are provided prior to discussion of basic principles of dietary control. The six exchange lists utilized in planning the diabetic...



Hyperinsulinemia: Is It Diabetes?  


Type 2 diabetes Basics In-Depth Multimedia Expert Answers Expert Blog Resources What's New Reprints A single copy of this article ... for personal, noncommercial use only. Hyperinsulinemia: Is it diabetes? By Mayo Clinic staff Original Article: http://www. ...


If I Had - Diabetes  

MedlinePLUS Videos and Cool Tools

... Than Known Risk Factors for Predicting Type 2 Diabetes (Interview with Dr. James Meigs, MD, MPH, Massachusetts General Hospital) If I Had - Diabetes - Dr. David M. Nathan, MD, Massachusetts General Hospital; ...


Staying Healthy with Diabetes  


... Favorites Delicious Digg Google Bookmarks Staying Healthy with Diabetes On This Page What routine medical examinations and ... examinations and tests are needed for people with diabetes? Your doctors should— Measure your blood pressure at ...


Diabetes food pyramid (image)  


The Diabetes Food Pyramid divides food into six groups, which vary in size to show relative amounts of servings for ... Guide Pyramid released by the USDA. In the Diabetes Food Pyramid, the groups are based on protein content ...


Asian Americans and Diabetes  


... out that there are still barriers to proper diabetes care for Asian Americans. The root of the problem " ... nutrition therapy that acknowledges differences. Patient perspectives on diabetes care Cheung says that many Asian American patients think ...


Diabetes - foot ulcers  


... Type 2 diabetes mellitus. In: Goldman L, Schafer AI, eds. Cecil Medicine . 24th ed. Saunders; 2011:chap ... Type 1 diabetes mellitus. In: Goldman L, Schafer AI, eds. Cecil Medicine . 24th ed. Philadelphia, Pa: Saunders ...


Genetics Home Reference: Diabetes  


... deafness permanent neonatal diabetes mellitus Tangier disease thiamine-responsive megaloblastic anemia syndrome type 1 diabetes Wolfram syndrome ... Reference. Links to web sites outside the Federal Government do not constitute an endorsement. See Selection Criteria ...


Diabetic Kidney Problems  


... too high. Over time, this can damage your kidneys. Your kidneys clean your blood. If they are damaged, waste ... in your blood instead of leaving your body. Kidney damage from diabetes is called diabetic nephropathy. It ...




... blood pressure A history of gestational diabetes Being African-American, American Indian, Asian-American, Pacific Islander or Hispanic ... blood sugar levels will probably eventually rise to diabetic levels. Once this happens, medication is usually required ...


Diabetes and Pregnancy Project.  

National Technical Information Service (NTIS)

In order to enhance the state's Diabetes and Pregnancy program, the project developed, tested, and implemented a model regional perinatal data system which collected, analyzed, and reviewed information on pregnancies complicated by diabetes, and developed...

L. Headley




Microsoft Academic Search

Summary. Diabetes is the disorder most often linked with development of end-stage renal disease (ESRD) in the USA, Europe, South America, Japan, India, and Africa. Kidney disease is as likely to develop in long-duration non-insulin dependent diabetes (type 2) as in insulin-dependent diabetes mellitus (type 1). Nephropathy in diabetes — if suboptimally managed — follows a predictable course starting with

Eli A. Friedman


Diabetes Care in Oman  

PubMed Central

Diabetes has become one of the most challenging chronic diseases with its prevalence increasing in most countries worldwide. The Arabian Gulf countries face a similar increasing prevalence of diabetes. Diabetes care requires not only the support of the health authorities, but the contribution of all the sectors of the community and requires good financial support. In Oman, there are many factors which affect the care of diabetes. In this article, these factors are addressed and recommended solutions discussed.

Alyaarubi, Saif



Diabetic heart disease  

PubMed Central

Diabetes mellitus is responsible for a spectrum of cardiovascular disease. The best known complications arise from endothelial dysfunction, oxidation, inflammation, and vascular remodelling and contribute to atherogenesis. However, the effects on the heart also relate to concurrent hypertensive heart disease, as well as direct effects of diabetes on the myocardium. Diabetic heart disease, defined as myocardial disease in patients with diabetes that cannot be ascribed to hypertension, coronary artery disease, or other known cardiac disease, is reviewed.

Marwick, T H



Nam Con Son Basin  

Microsoft Academic Search

The Nam Con Son basin is the largest oil and gas bearing basin in Vietnam, and has a number of producing fields. The history of studies in the basin can be divided into four periods: Pre-1975, 1976-1980, 1981-1989, and 1990-present. A number of oil companies have carried out geological and geophysical studies and conducted drilling activities in the basin. These

N. T. Tin; N. D. Ty; L. T. Hung



The Con Test  

ERIC Educational Resources Information Center

|In this article, the author describes the format of the Con Test, an Australian television game show which followed the same general rules and game play as the UK show PokerFace. At the end of each round a contestant needs to decide whether or not he or she should fold. A contestant needs to know how likely it is that he or she is in last place.…

Fletcher, Michael



Emesis in diabetes mellitus.  


It is estimated that 20-40% of patients with diabetes, particularly those with prolonged duration of type 1 diabetes mellitus with other complications develop gastroparesis .We present in a picture quiz format the interesting case of an elderly lady presenting with diabetic gastroparesis in a tertiary care hospital in India. PMID:22944318

Varghese, Ron Thomas; Mahesh, D M; Oommen, Regi; Prasad, Jayavelu Hariram D; Unnikrishnan, L S; Thomas, Nihal



Diabetes Type 2  


Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not ... You have a higher risk of type 2 diabetes if you are older, obese, have a family ...


Diabetes Type 1  


Diabetes means your blood glucose, or blood sugar, levels are too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is ... kidneys, nerves, and gums and teeth. Type 1 diabetes happens most often in children and young adults ...


[Diabetes case management].  


Diabetes case management and self-care education can effectively improve patient clinical outcomes and quality of life. Diabetes case management should be provided by an interdisciplinary team. Diabetes education has evolved from its previous focus on "teaching proper content" to "achieving successful patient outcomes" in line with the current emphasis in health education on patient-centered goals. Behavioral changes are facilitated based on these goals. Behavioral change directed at successful diabetes self-care was adopted as one of the desired outcomes of diabetes case management. The American Association of Diabetes Educators developed seven diabetes self-care behaviors as behavior objectives and evaluation indicators of diabetes education. These indicators include healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks. The process of diabetes case management includes assessment, expected outcome identification, planning, implementation, evaluation, and documentation. In Taiwan, the Diabetes Share Care Network has promoted the advantages and techniques of diabetes case management. Based on network recommendations, the improvement program of National Health Insurance payment for diabetes medical treatment under the Bureau of National Health Insurance now provides package payment and requires quality interdisciplinary care and case management. PMID:19319800

Yeh, Mei Chang



Diabetes in Pregnancy  

Microsoft Academic Search

A review of present practices in the assessment and treatment of diabetes during pregnancy is presented, including preconception\\u000a counseling, insulin therapy, nutrition and exercise therapy of patients with pre-existing diabetes, care of patients with\\u000a gestational diabetes, and post-partum care for infants and mothers of both conditions.

Elizabeth S. Halprin


The Diabetic Foot Syndrome  

Microsoft Academic Search

Summary The diabetic foot syndrome (DFS) is an important diabetic complication. The typical lesion is a neuropathic plantar foot ulcer which heals well when treated properly. However, complications resulting from deep infections of soft tissue or bone, together with a reduced peripheral blood flow, may necessitate amputation of the lower limbs. In general, diabetic patients have a 10-fold higher risk

Thomas Kästenbauer; Karl Irsigler




EPA Science Inventory

The Diabetes Prevention Program (DPP) was a major clinical trial, or research study, aimed at discovering whether either diet and exercise or the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in people with impaired glucose toleranc...


National Diabetes Information Clearinghouse: The Diabetes Dictionary.  

National Technical Information Service (NTIS)

This dictionary defines words that are often used when people talk or write about diabetes. It is designed for people who have diabetes and for their families and friends. The words are listed in alphabetical order. Some words have many meanings; only tho...



The Role for Endoplasmic Reticulum Stress in Diabetes Mellitus  

Microsoft Academic Search

Accumulating evidence suggests that endoplasmic reticulum (ER) stress plays a role in the pathogenesis of diabetes, con- tributingtopancreatic-celllossandinsulinresistance.Com- ponents of the unfolded protein response (UPR) play a dual role in -cells, acting as beneficial regulators under physio- logical conditions or as triggers of -cell dysfunction and ap- optosis under situations of chronic stress. Novel findings sug- gest that \\

Decio L. Eizirik; Alessandra K. Cardozo; Miriam Cnop



Zuni Diabetes Project.  

PubMed Central

Widespread type II diabetes among North American Indians and certain other populations is a relatively recent medical phenomenon. Increased prevalence of diabetes appears to be related to sudden cultural shifts toward sedentary lifestyle and increased caloric intake. These changes, super-imposed on a genetic predisposition to diabetes, pose a community health threat to the Zuni and similar populations. Regular aerobic exercise is clearly beneficial to most type II diabetics. The key public health issue is how to establish community participation in effective aerobic activity. The Zuni Diabetes Project, fully described here, serves as a model in this respect.

Leonard, B; Leonard, C; Wilson, R



[Diabetes and osteoporosis].  


Diabetes alters bone mass and/or quality and increases fracture risk. However, in type 2 diabetes, bone mineral density (BMD) is usually not diminished, pertaining to increased weight and fat mass, which complicates the diagnosis of osteoporosis by DXA (T-score <-2.5). Similarly, estimates of fracture probability by FRAX may underestimate fracture risk in type 2 diabetes. Adequate glycemic control with insulin and/or oral antidiabetics decreases fracture risk, whereas thiazolidinediones increase it. Eventually, osteoporosis drugs such as bisphosphonates and SERMs seem to have similar efficacy in diabetic and non-diabetic patients. PMID:23821843

Ferrari, S



Diabetes and pancreatic cancer.  


Epidemiological studies clearly indicate that the risk of pancreatic cancer (PC) is increased in diabetic patients, but most studies focus on overall diabetes or type 2 diabetes mellitus (T2DM), and there are few studies on the risks of type 1 and type 3c (secondary) diabetes. Possible mechanisms for increased cancer risk in diabetes include cellular proliferative effects of hyperglycemia, hyperinsulinemia, and abnormalities in insulin/IGF receptor pathways. Recently, insulin and insulin secretagogues have been observed to increase the PC risk, while metformin treatment reduces the cancer risk in diabetic subjects. In addition, anticancer drugs used to treat PC may either cause diabetes or worsen coexisting diabetes. T3cDM has emerged as a major subset of diabetes and may have the highest risk of pancreatic carcinoma especially in patients with chronic pancreatitis. T3cDM is also a consequence of PC in at least 30% of patients. Distinguishing T3cDM from the more prevalent T2DM among new-onset diabetic patients can be aided by an assessment of clinical features and confirmed by finding a deficiency in postprandial pancreatic polypeptide release. In conclusion, diabetes and PC have a complex relationship that requires more clinical attention. The risk of developing PC can be reduced by aggressive prevention and treatment of T2DM and obesity and the prompt diagnosis of T3cDM may allow detection of a tumor at a potentially curable stage. PMID:22843556

Cui, YunFeng; Andersen, Dana K



Pancreatic diabetes mellitus.  


Diabetes mellitus caused by pancreatic exocrine disease is a unique clinical and metabolic form of diabetes. The diagnosis of pancreatic diabetes caused by chronic pancreatitis may be elusive because it is occasionally painless and often not accompanied by clinical malabsorption until after hyperglycemia occurs. Diabetic patients with pancreatic calcification or clinically demonstrable pancreatic exocrine dysfunction will manifest the unique aspects of pancreatic diabetes described herein. Like other forms of diabetes, the primary hormonal abnormality in pancreatic diabetes is decreased insulin secretion. Patients with this disorder are unique in that they have low glucagon levels that respond abnormally to several physiological stimuli, blunted epinephrine responses to insulin-induced hypoglycemia, and malabsorption. In addition, they often have concomitant alcohol abuse with hepatic disease and poor nutrition. These characteristics result in increased levels of circulating gluconeogenic amino acids, decreased insulin requirements, a resistance to ketosis, low cholesterol levels, an increased risk of hypoglycemia while on insulin therapy, and the clinical impression of brittle diabetes. Retinopathy occurs at a rate equal to that of insulin-dependent diabetes but may be less severe in degree. Other complications of pancreatic diabetes have been less well studied but may be expected to be seen more frequently as these patients survive longer. The characteristics of pancreatic diabetes suggest that a conservative approach be taken in regard to intensive insulin therapy and tight blood glucose control. PMID:2693011

Sjoberg, R J; Kidd, G S


Animal Models of Diabetic Uropathy  

Microsoft Academic Search

PURPOSE: Diabetes mellitus is a group of debilitating and costly diseases with multiple serious complications. Lower urinary tract complications or diabetic uropathy are among the most common complications of diabetes mellitus, surpassing widely recognized complications such as neuropathy and nephropathy. Diabetic uropathy develops in individuals with types 1 and 2 diabetes, and little is known about the natural history of

Firouz Daneshgari; Edward H. Leiter; Guiming Liu; Jay Reeder



Diabetes and periodontitis  

PubMed Central

The main aim of this review is to update the reader with practical knowledge concerning the relationship between diabetes mellitus and periodontal diseases. Exclusive data is available on the association between these two chronic diseases till date. Articles published on this relationship often provide the knowledge of definitions of diabetes mellitus and periodontal diseases, prevalence, extent, severity of periodontal disease, complications of diabetes along with the possible underlying mechanisms. The authors reviewed human epidemiological studies, cross-sectional observations and longitudinal cohort, case control that evaluated variables exclusively over the past 30 years and the predominant findings from the “certain” articles are summarized in this review. This review clarifies certain queries such as 1) Do periodontal diseases have an effect on the metabolic control of diabetes? 2) Does diabetes act as a risk factor of periodontitis? 3) What are the possible underlying mechanisms relating the connection between these two chronic diseases? 4) What is the effect of periodontal intervention on metabolic control of diabetes? After a thorough survey of literature, it was observed that diabetes acts as a risk factor in development of periodontitis as periodontitis is significantly aggravated in patients suffering from diabetes having long term hyperglycemia. Different mechanisms underlying the association between the accelerated periodontal disease and diabetes are emerging but still more work is required. Major efforts are required to elucidate the impact of periodontal diseases on diabetes. At the same time, patients are needed to be made aware of regular periodontal maintenance schedule and oral hygiene.

Deshpande, Kalyani; Jain, Ashish; Sharma, RaviKant; Prashar, Savita; Jain, Rajni



Diabetic Retinopathy and VEGF  

PubMed Central

Diabetic retinopathy remains the leading vascular-associated cause of blindness throughout the world. Its treatment requires a multidisciplinary interventional approach at both systemic and local levels. Current management includes laser photocoagulation, intravitreal steroids, and anti-vascular endothelial growth factor (VEGF) treatment along with systemic blood sugar control. Anti-VEGF therapies, which are less destructive and safer than laser treatments, are being explored as primary therapy for the management of vision-threatening complications of diabetic retinopathy such as diabetic macular edema (DME). This review provides comprehensive information related to VEGF and describes its role in the pathogenesis of diabetic retinopathy, and in addition, examines the mechanisms of action for different antiangiogenic agents in relation to the management of this disease. Medline (Pubmed) searches were carried out with keywords “VEGF”, “diabetic retinopathy”, and “diabetes” without any year limitation to review relevant manuscripts used for this article.

Gupta, N; Mansoor, S; Sharma, A; Sapkal, A; Sheth, J; Falatoonzadeh, P; Kuppermann, BD; Kenney, MC



Diabetic retinopathy: preventive care assurance for high risk diabetics.  


African Americans have a prevalence of diabetes mellitus nearly twice that of whites and are at greater risk of long term complications of diabetes such as diabetic retinopathy, a leading cause of visual loss and impairment among diabetics. The nurse in primary health care systems must play a more fundamental and aggressive role in assuming the consistent incorporation of preventive care and services for diabetics at high risk of diabetic retinopathy. Strategies for improving preventive care assurance are suggested to aid the nurse in identifying high risk diabetics, facilitating secondary prevention as recommended by the American Diabetes Association (ADA) and monitoring of preventive care outcomes and status. PMID:7696642

Padonu, G B


Family Health History and Diabetes  


... Health History and Diabetes Family Health History and Diabetes En español Family health history is an important ... Four Questions You Should Ask Your Family About Diabetes & Family Health History Knowing your family health history ...


National Diabetes Fact Sheet, 2011  


... Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian ...


Guiding Principles for Diabetes Care.  

National Technical Information Service (NTIS)

The National Diabetes Education Program (NDEP) has developed these Guiding Principles for Diabetes Care to help the health care team manage the disease effectively. The principles outline seven essential components of quality diabetes care that form the b...



Living with Type 1 Diabetes  


... Exercise is also a key component of proper diabetes care. Along with all of the other benefits you ... often initially considered, plays a key role in diabetes care. Connecting with other people living with diabetes that ...


Quiz for Teens with Diabetes  


... time for you to do something about your diabetes care, read NDEP’s Dealing With the Ups and Downs ... Diabetes Nutrition Educator, University of Washington Medical Center, Diabetes Care Center, Seattle, WA reviewed this quiz for technical ...


Diabetes and Depression  

Microsoft Academic Search

\\u000a Diabetes mellitus affects about 20% of adults older than 65 years of age and its prevalence among Americans is reaching epidemic\\u000a proportions. In cross-sectional studies, diabetes mellitus has been associated with various complications and comorbid conditions,\\u000a especially psychiatric disorders. The relationship between diabetes and depression is particularly complex. Evidence demonstrates\\u000a high co-occurrence of these disorders, with associated poorer medical outcomes.

Maria D. Llorente; Julie E. Malphurs


Zinc and diabetes mellitus  

Microsoft Academic Search

Diabetes mellitus is a group of metabolic disorders, the incidence of which varies widely throughout the world. The treatment\\u000a of diabetes mellitus includes insulin, oral antidiabetic agents, and dietary regimens. Although the emphasis is on macronutrients\\u000a intakes, there is strong evidence that there is an abnormal metabolism of several micronutrients in diabetic individuals.\\u000a Zinc is one of the essential micronutrients

Maria J. Salgueiro; Nancy Krebs; Marcela B. Zubillaga; Ricardo Weill; Eric Postaire; Alexis E. Lysionek; Ricardo A. Caro; Tomas De Paoli; Alfredo Hager; Jose Boccio



Type 1 Diabetes Risk  

Microsoft Academic Search

\\u000a Type 1 diabetes (T1D), usually diagnosed in childhood, is a lifelong chronic disease requiring daily insulin injections for\\u000a survival. Also called childhood or juvenile diabetes, T1D is one of the most common chronic diseases of childhood, affecting\\u000a approximately 1 in every 523 US children (SEARCH for Diabetes in Youth Study Group, 2006), and is increasing worldwide (DIAMOND\\u000a Project Group, 2006).

Suzanne Bennett Johnson


Osteopenia in juvenile diabetes  

Microsoft Academic Search

Summary  The bone mineral status of fifty-one children with diabetes mellitus was studied by single photon absorptiometry. The mean\\u000a bone mineral content was 13% below values predicted by age, sex, height, and weight. Those children whose diabetes was one\\u000a year or less in duration were as osteopenic as those whose diabetes was of longer duration. The demineralized children received\\u000a a higher

Richard M. Shore; Russell W. Chesney; Richard B. Mazess; Philip G. Rose; Gerald J. Bargman



Diabetes and psychiatric disorders  

PubMed Central

Interface of diabetes and psychiatry has fascinated both endocrinologists and mental health professionals for years. Diabetes and psychiatric disorders share a bidirectional association -- both influencing each other in multiple ways. The current article addresses different aspects of this interface. The interaction of diabetes and psychiatric disorders has been discussed with regard to aetio-pathogenesis, clinical presentation, and management. In spite of a multifaceted interaction between the two the issue remains largely unstudied in India.

Balhara, Yatan Pal Singh



Epidemiology, mechanisms, and management of diabetic gastroparesis.  


Recent evidence of the significant impact of gastroparesis on morbidity and mortality mandates optimized management of this condition. Gastroparesis affects nutritional state, and in diabetics it has deleterious effects on glycemic control and secondary effects on organs that increase mortality. First-line treatments include restoration of nutrition and medications (prokinetic and antiemetic). We review the epidemiology, pathophysiology, impact, natural history, time trends, and treatment of gastroparesis, focusing on diabetic gastroparesis. We discuss pros and cons of current treatment options, including metoclopramide. Second-line therapeutic approaches include surgery, venting gastrostomy or jejunostomy, and gastric electrical stimulation; most of these were developed based on results from open-label trials. New therapeutic strategies for gastroparesis include drugs that target the underlying defects, prokinetic agents such as 5-hydroxytryptamine agonists that do not appear to have cardiac or vascular effects, ghrelin agonists, approaches to pace the stomach, and stem cell therapies. PMID:20951838

Camilleri, Michael; Bharucha, Adil E; Farrugia, Gianrico



Anästhesie und Diabetes mellitus  

Microsoft Academic Search

.   There are two types of diabetes mellitus. Type?I, insulin-dependent diabetes (IDDM), which becomes manifest before the age\\u000a of 40, is the result of an absolute deficiency of insulin. Type?II, the non-insulin-dependent diabetes (NIDDM), develops in\\u000a the elderly and is caused by a relative insulin deficiency. Patients with type-I diabetes are prone to the development of\\u000a ketoacidosis, while type?II causes

T. Brüssel



Cardiac electrophysiology in diabetes.  


Patients with diabetes mellitus are at higher risk of cardiac arrhythmias and sudden death. Although there are several animal and human studies on this topic, the pathophysiology of the increased electrical vulnerability in diabetes is complex and remain undefined. It is conceivable that an interplay of several concomitant factors may facilitate the occurrence of arrhythmias. Atherosclerosis as well as microvascular disease, which are increased in diabetic patients, may facilitate myocardial ischemia that predisposes to cardiac arrhythmias and sudden death. In addition, autonomic neuropathy and/or cardiac repolarization abnormalities such as prolonged QT interval and altered T-waves of the diabetic heart also increases electrical instability. Therefore, all these factors may simultaneously contribute to create an electrical instability leading to cardiac arrhythmias and sudden cardiac death. Recently, we have demonstrated that diabetes is the strongest predictor of atrial fibrillation (AF) progression and that diabetic patients frequently have asymptomatic episodes of AF with silent arrhythmia progression. Another recent study has reported that patients with type 2 diabetes and AF are at substantially higher risk of death of any cause compared with those without AF. These seminal studies emphasize that AF in diabetic patients should be regarded as a prognostic marker of adverse outcome and then a prompt aggressive management of all risk factors is required. In conclusion, diabetes mellitus significantly alters the cardiac electrophysiology throughout several complex mechanisms greatly contributing to create an electrical instability of the heart, which may lead to potentially life-threatening arrhythmias and sudden cardiac death. PMID:20440255

Pappone, C; Santinelli, V



Thyroid disease in diabetics.  

PubMed Central

Among a diabetic clinic population of 5,000 there were 113 patients (1.1%) with concurrent clinical thyroid dysfunction (56 hyperthyroid, 57 hypothyroid). Seventy-one (62.8%) of these patients were insulin-dependent and diabetes preceded thyroid disease in 85 (75.2%). Twenty patients were given carbimazole for two or more years and of these 15 (75%) relapsed, a percentage not significantly different from that seen in non-diabetic patients. The value of screening diabetic patients for evidence of thyroid dysfunction is discussed.

Sugrue, D. D.; McEvoy, M.; Drury, M. I.




PubMed Central

The clinical manifestations of diabetic nephropathy, proteinuria, increasing blood pressure, decreased glomerular filtration rate and are similar in type 1 and type 2 diabetes; however the renal lesions underlying renal dysfunction in the two conditions may differ. Indeed, although tubular, interstitial and arteriolar lesions are ultimately present in type 1 diabetes, as the disease progresses, the most important structural changes involve the glomerulus. In contrast, a substantial subset of type 2 diabetic patients, despite the presence of microalbuminuria or proteinuria, have normal glomerular structure with or without tubulo-interstitial and/or arteriolar abnormalities. The clinical manifestations of diabetic nephropathy are strongly related to the structural changes, especially with the degree of mesangial expansion in both type 1 and type 2 diabetes. However, several other important structural changes are involved. Previous studies using light and electron microscopic morphometric analysis have described the renal structural changes and the structural-functional relationships of diabetic nephropathy. This review focuses on these topics, emphasizing the contribution of research kidney biopsy studies to the understanding of the pathogenesis of diabetic nephropathy and the identification of patients with higher risk of progression to end stage renal disease. Finally, the evidence is presented that reversal of the established lesions of diabetic nephropathy is possible.




Treatment of obese diabetics.  


Fat accumulation is a typical phenomenon in the pathogenesis of Type 2 diabetes. Also Type 1 diabetics are getting obese these days living in an environment with typical caloric overfeeding and low physical activity. Weight reduction is an important part of therapy in all obese diabetic patients. Orlistat is the only accessible antiobesity drug today. Weight neutral antidiabetics like metformin and DPP-4 inhibitors can be also used. Incretin analogues (exenatide and liraglutide) are also very important drugs inducing weight loss in diabetic and also in nondiabetic patients. Insulin therapy causes mostly weight gain. Long acting insulin analogues are able to induce small weight loss in Type 1 diabetes or only a small weight increase or weight loss in Type 2 diabetic patients. Procedures of bariatric surgery are very important in the treatment being able to induce remission of Type 2 diabetes. Weight reduction can be supported also using the new class of antiadiabetic drugs- SGLT inhibitors which are blocking glucose absorption in kidneys. The use of new incretine analogues injected at the interval of one to two weeks is the most important strategy for the treatment of obese Type 2 diabetic patients and perhaps also of Type 1 diabetic patients even in combination with insulin. PMID:23393696

Svacina, Stepán



Diabetic Retinopathy: Nature and Extent.  

ERIC Educational Resources Information Center

|The authors discuss the incidence and prevalence of diabetic retinopathy in juvenile and maturity onset diabetics, background and proliferative retinopathy, and current modalities of treatment. (Author)|

Coughlin, W. Ronald; Patz, Arnall



Endothelial glycocalyx damage coincides with microalbuminuria in type 1 diabetes.  


Chronic hyperglycemia underlies microvascular complications in patients with type 1 diabetes. The mechanisms leading to these vascular complications are not fully understood. Recently, we observed that acute hyperglycemia results in endothelial glycocalyx damage. To establish whether glycocalyx is associated with microvascular damage, we performed glycocalyx perturbation volume measurements in type 1 diabetic patients with microalbuminuria (DM1-MA group; n = 7), without microalbuminuria (DM1-NA group; n = 7), and in age-matched control subjects (CON; n = 7). Systemic glycocalyx volume was determined comparing intravascular distribution volume of a glycocalyx-permeable tracer (dextran 40) to that of a glycocalyx-impermeable tracer (labeled erythrocytes). Sublingual capillaries were visualized using orthogonal polarization spectral microscopy to estimate microvascular glycocalyx. Patients and control subjects were matched according to age and BMI. Glycocalyx volume decreased in a stepwise fashion from CON, DM1-NA, and finally DM1-MA subjects (1.5 +/- 0.1, 0.8 +/- 0.4, and 0.2 +/- 0.1 l, respectively, P < 0.05). Microvascular glycocalyx in sublingual capillaries was also decreased in type 1 diabetes versus the control group (0.5 +/- 0.1 vs. 0.9 +/- 0.1 microm, P < 0.05). Plasma hyaluronan, a principal glycocalyx constituent, and hyaluronidase were increased in type 1 diabetes. In conclusion, type 1 diabetic patients are characterized by endothelial glycocalyx damage, the severity of which is increased in presence of microalbuminuria. PMID:16567538

Nieuwdorp, Max; Mooij, Hans L; Kroon, Jojanneke; Atasever, Bektas; Spaan, Jos A E; Ince, Can; Holleman, Frits; Diamant, Michaela; Heine, Robert J; Hoekstra, Joost B L; Kastelein, John J P; Stroes, Erik S G; Vink, Hans



Diabetic hand infections.  


Compared with the limited experience reported in the literature to date, analysis of the authors' clinical series of hand infections demonstrates that more than one third of the patients are diabetic. This can be attributed to the population of African-Americans in Washington, DC, the high incidence of diabetes in this particular race, and the inherent susceptibility of diabetics to develop an infection of the hand. The most severe infections occur in insulin-dependent diabetic patients or those with chronic renal failure because of protein depletion, poor wound healing, neuropathy, and ischemia. Although a similar spectrum of infections is encountered in diabetic and nondiabetic patients, some characteristic presentations are somewhat unique to the diabetic population. Gram-negative and mixed organism infections are particularly common in diabetic patients. Despite the poor prognosis of diabetic hand infections in general and the unsatisfactory outcome in patients on renal dialysis, most diabetic patients successfully heal following early and appropriate intervention. Early diagnosis and aggressive and adequate surgical drainage and tissue excision or amputation (if indicated) are key principles. The authors have learned that the surgical incision must extend along the entire area of erythema and induration because the infection often is more extensive than suspected both before and during the initial surgery. Observation, local wound care, and the administration of antibiotic agents are not acceptable substitutes for surgical decompression in the diabetic patient with a hand infection. In the subgroup of diabetic patients most prone to develop hand infections (i.e., associated renal dialysis), the surgeon must recognize that ongoing tissue loss is commonplace, repeat wound debridements are required, and an eventual amputation is highly likely. PMID:9884901

Gunther, S F; Gunther, S B



Retinopathy in Diabetes  

Microsoft Academic Search

iabetic retinopathy is the most fre- quent cause of new cases of blind- ness among adults aged 20 -74 years. During the first two decades of dis- ease, nearly all patients with type 1 diabe- tes and 60% of patients with type 2 diabetes have retinopathy. In the Wisconsin Epidemiologic Study of Diabetic Retinopa- thy (WESDR), 3.6% of younger-onset pa-




J type diabetes revisited.  

PubMed Central

J type diabetes is grouped as a subtype of type III or malnutrition-related diabetes, known as protein-deficient pancreatic diabetes, (PDPD). J type diabetes has not been reported recently, but a clinical picture called phasic insulin-dependent diabetes mellitus (PIDDM) has been elaborated in Jamaica, the same home country of PDRD and appears to be a "formes frustes" syndrome. The following comparative studies were performed on a group of diabetic patients and normal controls: insulin receptor binding; renal, hepatic, and pancreatic function; and abdominal ultrasonography. The results show a considerably decreased white and red blood cell binding to insulin (P less than .05), extensive kidney damage (P less than .05), and increased pancreatic echogenicity in PIDDM, supporting a separate identity of this latter syndrome from types I and II diabetes mellitus. Also, the features of relative insulin resistance, absence of ketosis even in the presence of severe hyperglycemia, and intermittent insulin requirement suggests that PIDDM, J type diabetes, and PDPD are one and the same syndrome.

Morrison, E. Y.; Ragoobirsingh, D.



Nephrogenic Diabetes Insipidus  

NSDL National Science Digital Library

Physiology in Medicine review article. This articles describes how a patient gets diabetes insipidus, the effects of this disease on a patient, and the therapy to control this disease. This article also describes vasopressin, aquaporins, and the Bartter system, and their relationships with diabetes insipidus.

MD Jeff M Sands (Emory Univ Sch Med Dept Med, Renal Div); MD Daniel G. Bichet (University of Montreal Dept of Medicine)




Technology Transfer Automated Retrieval System (TEKTRAN)

Research on the effects of resistance exercise training in diabetes is minimal compared to that involving endurance exercise. Resistance training, which preferentially targets muscle mass, has potential to improve diabetes management. Skeletal muscle plays a pivotal role in maintaining glucose hom...


Cognitive impairment and diabetes.  


The aim of this manuscript is to provide a brief review of the link between diabetes mellitus with cognitive impairment, the possible pathophysiology linking the two, and some possible therapeutic interventions for the treatment of this condition. The prevalence of diabetes increases with age, so also dementia increases in later life. As the population ages, type 2 diabetes and AD are increasing. Both diseases are chronic and are the leading causes of morbidity and mortality. Recent studies showed that older people with type 2 diabetes have a higher risk of cognitive decline. The precise mechanism linking the two remains to be found out. Several hypothetical mechanisms have been postulated. Type 2 diabetes is a risk factor for AD and vascular dementia. The association between diabetes and AD is particularly strong among carriers of the APOE ?4. Several studies have linked dementia to diabetes. Impaired fasting glucose and impaired glucose tolerance and insulin resistance have also been associated with poor cognitive performance and at risk of developing cognitive impairment. Studies have suggested that metabolic syndrome may be linked to vascular dementia, while contrasting findings showed the role of metabolic syndrome to AD. In this review, how diabetes and cognitive impairment and Alzheimer's disease are mutually linked, possible mechanism linking the two and some possible therapeutic interventions with some patents that seem to be good therapeutic targets in future are discussed. PMID:23489242

Dash, Sandip K



Diabetic ketoacidosis in pregnancy  

Microsoft Academic Search

The occurrence of diabetic ketoacidosis in pregnancy compromises both the fetus and the mother. It usually occurs in the later stages of pregnancy and is also seen in newly presenting type 1 diabetes patients. Despite improvement in its incidence rates and outcomes over the years, it still remains a major clinical problem since it tends to occur at lower blood

D Kamalakannan; V Baskar; D M Barton; T A M Abdu



Diagnosing Diabetic Retinopathy  


... and have diabetes Retinal imaging The Retasure retinal imaging device is a new tool that allows you to be screened for diabetic retinopathy at a primary care physician's office. The device takes a quick, painless digital photo of the macula and optic nerve. This ...


Diabetes in Sports  

PubMed Central

Context: Exercise is recommended for individuals with diabetes mellitus, and several facets of the disease must be considered when managing the diabetic athlete. The purpose of this article is to review diabetes care in the context of sports participation. Evidence Acquisition: Relevant studies were identified through a literature search of MEDLINE and the Cochrane database, as well as manual review of reference lists of identified sources. Results: Diabetics should be evaluated for complications of long-standing disease before beginning an exercise program, and exercise should be modified appropriately if complications are present. Athletes who use insulin or oral insulin secretogogues are at risk for exercise-induced immediate or delayed hypoglycemia. Diabetics are advised to engage in a combination of regular aerobic and resistance exercise. Insulin-dependent diabetics should supplement carbohydrate before and after exercise, as well as during exercise for events lasting longer than 1 hour. Adjustment of insulin dosing based on planned exercise intensity is another strategy to prevent hypoglycemia. Insulin-dependent athletes should monitor blood sugar closely before, during, and after exercise. Significant hyperglycemia before exercise should preclude exercise because the stress of exercise can paradoxically exacerbate hyperglycemia and lead to ketoacidosis. Athletes should be aware of hypoglycemia symptoms and have rapidly absorbable glucose available in case of hypoglycemia. Conclusion: Exercise is an important component of diabetes treatment, and most people with diabetes can safely participate in sports at recreational and elite levels with attention to appropriate precautions.

Shugart, Christine; Jackson, Jonathan; Fields, Karl B.



Invigorated barley in diabetes  

Microsoft Academic Search

With over 41 million diabetics, India has become diabetes-capital of the world. The country is also a leader in the prevalence of metabolic syndrome and obesity, with hypertension to join the list soon. Historical evidences suggest that the ancient Indian physicians were able to stabilize dia- betes, obesity and related metabolic syndrome effectively through recommendations, which are not different from

Ashok K. Tiwari


Diabetes Technologies and Their Role in Diabetes Management  

ERIC Educational Resources Information Center

|The 1993 Diabetes Complications and Control Trial (DCCT) showed that controlling blood glucose prevents and delays the progression of long term complications of diabetes. New diabetes technologies can make control of diabetes possible and safer. This paper reviews these technologies used to monitor blood glucose, administer insulin and evaluate…

Kollipara, Sobha; Silverstein, Janet H.; Marschilok, Katie



Reversible nervous abnormalities in juvenile diabetics with recently diagnosed diabetes  

Microsoft Academic Search

Summary  It has been well documented that diabetic patients retain vibratory perception during a longer period of ischaemia than non-diabetics. This neurological abnormality is present at the time of the clinical appearance of diabetes and can be normalized by treatment with insulin. — In the present study the vibratory perception threshold was studied during ischaemia in six diabetics before and after

A. B. Terkildsen; N. J. Christensen



Evolving Pandemic Diabetic Nephropathy  

PubMed Central

The expanding impact of chronic kidney disease (CKD) due to pandemic diabetes mellitus is recounted emphasizing its epidemiology that has induced global socioeconomic stress on health care systems in industrialized nations now attempting to proffer optimal therapy for end stage renal disease (ESRD). Strategies to delay and perhaps prevent progression of diabetic nephropathy from minimal proteinuria through nephrotic range proteinuria and azotemia to ESRD appear to have decreased the rate of persons with diabetes who develop ESRD. For those with ESRD attributed to diabetes, kidney transplantation affords better survival and rehabilitation than either hemodialysis or peritoneal dialysis. It is likely that advances in genetics and molecular biology will suggest early interventions that will preempt diabetic complications including renal failure.

Friedman, Eli A.



Diabetes and cancer relationships ().  


Diabetes and cancer are both heterogeneous and multifactorial diseases with tremendous impact on health worldwide. Epidemiologic evidence suggests that certain malignancies may be associated with diabetes, as well as with diabetes risk factors and, perhaps, with certain diabetes treatments. Numerous biological mechanisms could account for these relationships. Insulin-like growth factor (IGF)-1, IGF-2, IGF-1 receptors, insulin, and the insulin receptor play roles in the development and progression of cancers. Although evidence from randomized controlled trials does not support or refute associations of diabetes and its treatments with either increased or reduced risk of cancer incidence or prognosis, consideration of malignancy incidence rates and the magnitude of the trials that would be required to address these issues explains why such studies may not be readily undertaken. PMID:23574745

Wang, Tiange; Ning, Guang; Bloomgarden, Zachary



Diabetic amyotrophy: current concepts.  


Diabetic amyotrophy is a disabling illness that is distinct from other forms of diabetic neuropathy. It is characterized by weakness followed by wasting of pelvifemoral muscles, either unilaterally or bilaterally, with associated pain. Sensory impairment is minimal in the cutaneous distribution sharing the same root or peripheral nerve as affected musculature. Most commonly, the onset is in middle age or later, although it may occur in youth. A concomitant distal predominantly sensory neuropathy may be present. Electrodiagnostic studies are most often consistent with a neurogenic lesion attributable to a lumbosacral radiculopathy, plexopathy, or proximal crural neuropathy. The natural course of the illness is variable with gradual but often incomplete improvement. The site of the lesion and the pathogenesis of diabetic amyotrophy remain controversial. Recent studies suggest a role for immunomodulating agents in certain types of diabetic neuropathy, including diabetic amyotrophy. PMID:8987131

Sander, H W; Chokroverty, S



Race/Ethnic difference in diabetes and diabetic complications.  


Health disparities in diabetes and its complications and comorbidities exist globally. A recent Endocrine Society Scientific Statement described the Health Disparities in several endocrine disorders, including type 2 diabetes. In this review, we summarize that statement and provide novel updates on race/ethnic differences in children and adults with type 1 diabetes, children with type 2 diabetes, and in Latino subpopulations. We also review race/ethnic differences in the epidemiology of diabetes, prediabetes, and diabetes complications and mortality in the United States and globally. Finally, we discuss biological, behavioral, social, environmental, and health system contributors to diabetes disparities to identify areas for future preventive interventions. PMID:24037313

Spanakis, Elias K; Golden, Sherita Hill



Diabetes and diet: food choices  

Microsoft Academic Search

This thesis reports on the food choices of diabetic patients. Two studies were undertaken considering the barriers these patients experience with the diabetic diet. Furthermore, the changes in food choices during the first years after the diagnosis of insulin-dependent diabetes as well as patients, food choice motives were investigated. It is concluded that despite thebarriers diabetic patients experience with their

A. C. Niewind



Diabetes induces apoptosis in lymphocytes  

Microsoft Academic Search

The occurrence of DNA fragmentation in lymphocytes obtained from alloxan-induced diabetic rats and diabetic patients was investigated. A high proportion of apoptotic lymphocytes in diabetic states may explain the impaired immune function in poorly controlled diabetic patients. Rat mesenteric lymph node lymphocytes were analysed for DNA fragmentation by using flow cytometry and agarose gel, and for chromatin condensation by Hoescht

R Otton; F G Soriano; R Verlengia; R Curi



Acute renal failure in diabetics  

Microsoft Academic Search

Acute renal failure in diabetic patients occurs, as a result of certain specific conditions. The most common of these are hyperglycaemic hyperosmolar ‘coma’, diabetic ketoacidosis, the use of radiocontrast media, and renal papillary necrosis. The management of diabetics with acute renal failure is essentially the same as for non-diabetic patients but may be complicated by the problems of metabolic control,

A. Grenfell



Subclinical Inflammation and Diabetic Polyneuropathy  

PubMed Central

OBJECTIVE Subclinical inflammation represents a risk factor of type 2 diabetes and several diabetes complications, but data on diabetic neuropathies are scarce. Therefore, we investigated whether circulating concentrations of acute-phase proteins, cytokines, and chemokines differ among diabetic patients with or without diabetic polyneuropathy. RESEARCH DESIGN AND METHODS We measured 10 markers of subclinical inflammation in 227 type 2 diabetic patients with diabetic polyneuropathy who participated in the population-based MONICA/KORA Survey F3 (2004–2005; Augsburg, Germany). Diabetic polyneuropathy was diagnosed using the Michigan Neuropathy Screening Instrument (MNSI). RESULTS After adjustment for multiple confounders, high levels of C-reactive protein and interleukin (IL)-6 were most consistently associated with diabetic polyneuropathy, high MNSI score, and specific neuropathic deficits, whereas some inverse associations were seen for IL-18. CONCLUSIONS This study shows that subclinical inflammation is associated with diabetic polyneuropathy and neuropathic impairments. This association appears rather specific because only certain immune mediators and impairments are involved.

Herder, Christian; Lankisch, Mark; Ziegler, Dan; Rathmann, Wolfgang; Koenig, Wolfgang; Illig, Thomas; Doring, Angela; Thorand, Barbara; Holle, Rolf; Giani, Guido; Martin, Stephan; Meisinger, Christa



Purinergic signalling and diabetes.  


The pancreas is an organ with a central role in nutrient breakdown, nutrient sensing and release of hormones regulating whole body nutrient homeostasis. In diabetes mellitus, the balance is broken-cells can be starving in the midst of plenty. There are indications that the incidence of diabetes type 1 and 2, and possibly pancreatogenic diabetes, is rising globally. Events leading to insulin secretion and action are complex, but there is emerging evidence that intracellular nucleotides and nucleotides are not only important as intracellular energy molecules but also as extracellular signalling molecules in purinergic signalling cascades. This signalling takes place at the level of the pancreas, where the close apposition of various cells-endocrine, exocrine, stromal and immune cells-contributes to the integrated function. Following an introduction to diabetes, the pancreas and purinergic signalling, we will focus on the role of purinergic signalling and its changes associated with diabetes in the pancreas and selected tissues/organ systems affected by hyperglycaemia and other stress molecules of diabetes. Since this is the first review of this kind, a comprehensive historical angle is taken, and common and divergent roles of receptors for nucleotides and nucleosides in different organ systems will be given. This integrated picture will aid our understanding of the challenges of the potential and currently used drugs targeted to specific organ/cells or disorders associated with diabetes. PMID:23546842

Burnstock, Geoffrey; Novak, Ivana



Inflammation in Diabetic Nephropathy  

PubMed Central

Diabetic nephropathy is the leading cause of end-stage kidney disease worldwide but current treatments remain suboptimal. This review examines the evidence for inflammation in the development and progression of diabetic nephropathy in both experimental and human diabetes, and provides an update on recent novel experimental approaches targeting inflammation and the lessons we have learned from these approaches. We highlight the important role of inflammatory cells in the kidney, particularly infiltrating macrophages, T-lymphocytes and the subpopulation of regulatory T cells. The possible link between immune deposition and diabetic nephropathy is explored, along with the recently described immune complexes of anti-oxidized low-density lipoproteins. We also briefly discuss some of the major inflammatory cytokines involved in the pathogenesis of diabetic nephropathy, including the role of adipokines. Lastly, we present the latest data on the pathogenic role of the stress-activated protein kinases in diabetic nephropathy, from studies on the p38 mitogen activated protein kinase and the c-Jun amino terminal kinase cell signalling pathways. The genetic and pharmacological approaches which reduce inflammation in diabetic nephropathy have not only enhanced our understanding of the pathophysiology of the disease but shown promise as potential therapeutic strategies.

Lim, Andy K. H.; Tesch, Gregory H.



[Diabetes in the youth].  


In contrast to adults Diabetes mellitus type 1 (DMT1) is the most frequent form of diabetes mellitus during childhood and adolescence (> 95 %). After diagnosis, the management of these DMT1-patients should take place in specialized paediatric centres, not in a primary care setting. The lifelong substitution of insulin is the cornerstone of therapy, the form of insulin-therapy should be adapted according to the age of the patient (conventional, intensified or pump therapy). Diabetes education is also an essential part in the management of diabetes patients and their families. The ISPAD (International Society for Paediatric and Adolescent Diabetes) recommends an HbA1c < 7.5 rel.%(IFCC < 58 mmol/mol) as good metabolic control, although it might be difficult to achieve this goal during different phases of life (e.g. toddlers or puberty). The aim of diabetes education and management is avoidance of acute and late diabetes related complications, as well as achievement of normal growth and psychosocial development and wellbeing. PMID:23250456

Rami-Merhar, Birgit; Fröhlich-Reiterer, Elke; Hofer, Sabine; Schober, Edith



Alcoholism and Diabetes Mellitus  

PubMed Central

Chronic use of alcohol is considered to be a potential risk factor for the incidence of type 2 diabetes mellitus (T2DM), which causes insulin resistance and pancreatic ?-cell dysfunction that is a prerequisite for the development of diabetes. However, alcohol consumption in diabetes has been controversial and more detailed information on the diabetogenic impact of alcohol seems warranted. Diabetes, especially T2DM, causes dysregulation of various metabolic processes, which includes a defect in the insulin-mediated glucose function of adipocytes, and an impaired insulin action in the liver. In addition, neurobiological profiles of alcoholism are linked to the effects of a disruption of glucose homeostasis and of insulin resistance, which are affected by altered appetite that regulates the peptides and neurotrophic factors. Since conditions, which precede the onset of diabetes that are associated with alcoholism is one of the crucial public problems, researches in efforts to prevent and treat diabetes with alcohol dependence, receives special clinical interest. Therefore, the purpose of this mini-review is to provide the recent progress and current theories in the interplay between alcoholism and diabetes. Further, the purpose of this study also includes summarizing the pathophysiological mechanisms in the neurobiology of alcoholism.

Kim, Soo-Jeong



Breastfeeding and diabetes.  


The present review outlines the role of breastfeeding in diabetes. In the mother, breastfeeding has been suggested to reduce the incidence of type 2 diabetes mellitus, the metabolic syndrome and cardiovascular disease. Moreover, it appears to reduce the risk of premenopausal breast cancer and ovarian cancer. In the neonate and infant, among other benefits, lactation confers protection from future both type 1 and type 2 diabetes. Whether lactation protects women with gestational diabetes mellitus and their offspring from future T2DM remains to be answered. Importantly, for diabetic mothers, antidiabetic treatment itself may affect breastfeeding. There is not enough data to allow the use of oral hypoglycaemic agents. Therefore, insulin currently remains the optimal antidiabetic treatment during lactation. In conclusion, breastfeeding could be considered a modifiable risk factor for the development of diabetes and even a potential protective lifestyle measure from future cardio-metabolic and malignant diseases. Therefore, health care professionals should encourage both women with and without diabetes to breastfeed their children. PMID:21348815

Gouveri, E; Papanas, N; Hatzitolios, A I; Maltezos, E



[Hypertension and diabetes mellitus].  


Numerous surveys have shown that in industrial countries diabetic subjects develop hypertension more frequently than non-diabetic persons. In fact, three typical hypertension forms in these patients can be discerned: essential, renal, and isolated systolic hypertension. In type 2-diabetes (NIDDM) hypertension can be seen in close association with obesity, glucose intolerance, lipid changes, and insulin resistance within the framework of the metabolic syndrome. The increased incidence of hypertension in type 1-diabetes (IDDM) is a result of development of diabetic nephropathy. In the elderly type 2-diabetics particularly frequently isolated systolic hypertension is present which reflects increased arterial stiffness and loss of vascular distensibility. In hypertension progression of both macrovascular disease and microangiopathy is increased whereby interaction of hyperglycemia and hypertension seems to be the main risk factor. In most hypertensive diabetic patients drugs will be necessary to lower blood pressure in a therapeutical range. There are several effective substances available which should be prescribed individually according to the needs and accompanying conditions in these patients. PMID:8475640

Janka, H U



Gestational diabetes: diagnosis and management  

Microsoft Academic Search

Purpose:To review the diagnosis and management of gestational diabetes.Epidemiology:In the United States, approximately 2 to 5% of all pregnant women have gestational diabetes. Those women with a family history of type 2 diabetes mellitus, Asian or native American race, Latina ethnicity or obesity are at higher risk for developing gestational diabetes.Conclusion:Women with gestational diabetes who are treated appropriately can achieve

Y W Cheng; A B Caughey



Diabetic ketoacidosis precipitated by thyrotoxicosis  

PubMed Central

We report two patients with type 1 diabetes mellitus, previously well controlled with good compliance, presenting with unexplained diabetic ketoacidosis. Following initial correction of the metabolic disorder, persisting tachycardia lead to the diagnosis of thyrotoxicosis. In both cases, treatment with propranolol and carbimazole helped in the stabilization of their metabolic states. Although thyrotoxicosis is known to destabilise diabetes control, we can find no reports of it precipitating diabetic ketoacidosis.???Keywords: diabetic ketoacidosis; thyrotoxicosis

Bhattacharyya, A; Wiles, P



Diabetic angiopathy and angiogenic defects  

PubMed Central

Diabetes is one of the most serious health problems in the world. A major complication of diabetes is blood vessel disease, termed angiopathy, which is characterized by abnormal angiogenesis. In this review, we focus on angiogenesis abnormalities in diabetic complications and discuss its benefits and drawbacks as a therapeutic target for diabetic vascular complications. Additionally, we discuss glucose metabolism defects that are associated with abnormal angiogenesis in atypical diabetic complications such as cancer.



Multiple Myeloma and Diabetes  

PubMed Central

Multiple myeloma is a malignant plasma cell disorder that accounts for approximately 10% of all hematologic cancers. It is characterized by accumulation of clonal plasma cells, predominantly in the bone marrow. The prevalence of type 2 diabetes is increasing; therefore, it is expected that there will be an increase in the diagnosis of multiple myeloma with concomitant diabetes mellitus. The treatment of multiple myeloma and diabetes mellitus is multifaceted. The coexistence of the two conditions in a patient forms a major challenge for physicians.

Issa, Zeinab A.; Zantout, Mira S.; Azar, Sami T.



Diabetic ketoacidosis in pregnancy  

PubMed Central

The occurrence of diabetic ketoacidosis in pregnancy compromises both the fetus and the mother. It usually occurs in the later stages of pregnancy and is also seen in newly presenting type 1 diabetes patients. Despite improvement in its incidence rates and outcomes over the years, it still remains a major clinical problem since it tends to occur at lower blood glucose levels and more rapidly than in non-pregnant patients often causing delay in the diagnosis. This article illustrates a typical case of diabetic ketoacidosis in pregnancy and reviews the literature to provide an insight into its pathophysiology and management.

Kamalakannan, D; Baskar, V; Barton, D; Abdu, T



[Diabetes and social deprivation].  


Background: Diabetes prevalence is frequently associated with low socioeconomic status (SES), but little is known about the relationship between SES and diabetes control, follow-up and quality of life. We evaluated SES by using the EPICES score, an individual index of deprivation (Evaluation de la Précarité et des Inégalités de Santé dans les Centres d'Examen de Santé; Evaluation of Precariousness and Inequalities in Health Examination Centers). A total of 1686 subjects aged from 25 to 85 years were selected at random in Montpellier and 154 in Narbonne, of whom 126 were managed by a care network including diabetologists, general practitioners and nurses. Capillary glycemia, the body mass index (BMI), waist circumference (WC), and blood pressure were measured in all the subjects. HbA1c was measured in subjects with above-normal glycemia. Five hundred sixty-four subjects from the study population (190 diabetic patients, 292 subjects with non diabetic hyperglycemia, and 86 euglycemic subjects) were clinically evaluated and asked to complete a questionnaire covering socioeconomic status and diet. The data were then compared between deprived and non deprived subjects. One hundred sixty-one diabetic patients had a clinical examination and completed a detailed questionnaire including their history, therapy, control and follow-up of diabetes, perception of diabetes, quality of life, socioeconomic status and diet. The data were then compared between deprived and non deprived patients. One hundred twenty-six diabetic subjects managed by the AUDIAB care network were compared with 163 diabetics recruited in Montpellier, based on the same investigations and the same questionnaires. The data were compared between the overall patients and between deprived and non deprived patients. In the overall population, deprived subjects were younger and more frequently smokers, and had higher BMI than non deprived subjects. The overall prevalence of type 2 diabetes was 8.1%. Among patients younger than 65 years, deprived subjects had a higher prevalence of diabetes and non diabetic hyperglycemia than non deprived subjects (6.9% vs 4.4% and 22.8% vs 19.5%). More are unmarried males and 33% present with a significant level of education (secondary or university). Deprivation was associated with transport difficulties, vehicle acquisition, living in a private house, employment. More have few income to buy food and a large number use economic stores. They eat few proteins, fresh vegetables, fruits, dairy products and more often rice, pasta, tea, coffee and soft drinks. Most have their meals outside in economic restaurants. Dental problems are very common. 161 diabetic patients were evaluated Deprived diabetics were younger, more frequently males, more smokers with an increased BMI and WC. Among deprived diabetic patients, diabetes was diagnosed later on and less often by a systematic inquiry than in the non deprived group. Deprived patients presented with a poorer glycaemic control, more hypoglycaemic and ketosis events than non deprived subjects. They present with more difficulties to accept dietary and antidiabetic drugs. Insulin was less frequently used. Quality of life was impaired with an increased prevalence of anxiety and depression. Diabetic patients treated in the "Réseau de soins AUDIAB" presented with a better control of their disease and a better quality of life than patients treated out of the "Réseau". These data were confirmed whatever the level of deprivation. PMID:23550455

Jaffiol, Claude; Fontbonne, Annick; Vannereau, Denyse; Olive, Jean-Paul; Passeron, Serge



Center for Food Safety and Applied Nutrition (CFSAN)

Text Version... 160°F Pavo, Pollo 165°F CARNE FRESCAS DE RES, CERDO, TERNERA, CORDERO 145°F con 3 minutos de descanso CARNE DE AVE ... More results from


Tablet and insulin therapy in type 2 diabetes in the elderly.  

PubMed Central

There are a range of therapeutic options available for the management of type 2 diabetes in the elderly. Diet remains the mainstay of treatment although this must be realistic. If diet alone is unsuccessful then, for most patients, short-acting sulphonylurea agents are the treatment of choice. Second line agents include the biguanide, metformin, or an alpha-glucosidase inhibitor. A significant proportion of type 2 diabetic patients will, however, eventually require insulin to alleviate symptoms of poor control and improve glycaemia. In this article I discuss the therapeutic options available for diabetic management in the elderly, with particular emphasis on the pros and cons of insulin treatment.

Barnett, A H



Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study1-3  

Microsoft Academic Search

Background: The results of some epidemiologic studies con- ducted by using questionnaires suggest that dietary fat composi- tion influences diabetes risk. Confirmation of this finding with use of a biomarker is warranted. Objective: We prospectively investigated the relation of plasma cholesterol ester (CE) and phospholipid (PL) fatty acid composi- tion with the incidence of diabetes mellitus. Design: In 2909 adults

Lu Wang; Aaron R Folsom; Zhi-Jie Zheng; James S Pankow


Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Postmenopausal Women The Women's Health Initiative Randomized Controlled Dietary Modification Trial  

Microsoft Academic Search

Background: Decreased fat intake with weight loss and increased exercise may reduce the risk of diabetes melli- tus in persons with impaired glucose tolerance. This study was undertaken to assess the effects of a low-fat dietary pattern on incidence of treated diabetes among gener- ally healthy postmenopausal women. Methods: A randomized controlled trial was con- ducted at 40 US clinical

Lesley F. Tinker; Denise E. Bonds; Karen L. Margolis; JoAnn E. Manson; Barbara V. Howard; Joseph Larson; Michael G. Perri; Shirley A. A. Beresford; Jennifer G. Robinson; Beatriz Rodriguez; Monika M. Safford; Nanette K. Wenger; Victor J. Stevens; Linda M. Parker



The timing of re-institution of good blood glucose control affects apoptosis and expression of Bax and Bcl2 in the retina of diabetic rats  

Microsoft Academic Search

Hyperglycemia initiates a sequence of events that leads to the development of diabetic retinopathy. We explored the effect\\u000a of re-institution of good blood glucose control on apoptosis and apoptosis related genes (Bax and Bcl-2) in the retina of\\u000a diabetic rats. Fifty male Wistar rats randomly divided into five groups : normal control group (CON), diabetic rats with high\\u000a blood glucose

Xin-Yuan Gao; Hong-Yu Kuang; Wei Zou; Xiao-Min Liu; Hong-Bin Lin; Yi Yang



Type 2 Diabetes  


... main source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to ...


Diabetes and Cancer  


Prevention Lower Your Risk Small Steps for Your Health Healthy Eating Overweight All About Cholesterol Physical Activity High Blood Pressure High Blood Glucose Smoking Gestational Diabetes Age, Race, Gender & Family ...


Diabetic retinopathy in children.  


The risk of developing diabetic retinopathy (DR), the leading cause of vision loss among working-aged individuals, depends largely upon the duration of diabetes. Pediatric populations would appear to be at low risk for DR but it has been discovered in patients as young as 5.5 years and devastating cases of blindness have been reported in adolescents. Microvascular complications of diabetes, including DR, frequently develop during puberty, thereby making the detection of retinopathy important during these years and those of later adolescence. Retinopathy screening protocols have been written by several organizations but adherence by patients and physicians remains poor. Improved understanding of the risk factors for retinopathy, including many of the recently identified genetic abnormalities, may enable more effective and targeted screening of the diabetic population. Furthermore, advances in imaging technology promise to improve physicians' ability to effectively screen patients for retinopathy within their offices. PMID:23539833

Forlenza, Gregory P; Stewart, Michael W


Diabetes and exercise  


Exercise is an important part of managing your diabetes. It can help you lose weight, if you are overweight. It also helps prevent weight gain. Exercise helps lower your blood sugar without medicines . It ...


Diabetes and Travel  

PubMed Central

Travel can be therapeutic, but for the diabetic patient, it necessitates careful preparation. The family physician should be coordinator of the team that prepares the patient for the trip. The patient is a central member of this team, and must know as much as possible about the places to be visited, modes of transportation, facilities, etc. Current medication must be reviewed, and possible medical problems anticipated, taking climate and change of exercise pattern into account. Careful attention must be paid to current medical problems with good education concerning potential emergencies. Diabetes therapy during travelling times and the holiday must be carefully reviewed with the patient. The necessary referrals to other physicians and health professionals involved in the care of diabetes should be arranged well in advance of the holiday. Every assistance must be given to the patient to help him travel with diabetes—not from it.

Ross, Stuart A.



Diabetes and eye disease  


... that prevent abnormal blood vessels from growing, and steroid drugs injected into the eyeball are possible new treatments for diabetic retinopathy. If you cannot see well: Make sure your home is ...


Diabetes and Hispanic Americans  


... Index > Data/Statistics > Hispanic/Latino Profile Diabetes and Hispanic Americans According to national examination surveys, Mexican Americans are ... factors are Obesity and Overweight – See Obesity and Hispanic Americans Hypertension – See Heart Disease and Hispanic Americans High ...


Diabetes and Celiac Disease  


... done by a simple blood test. What is celiac disease? - A malabsorption disease caused by eating gluten - a ... 100 people in the United States. Diabetes and celiac disease: The link - There is a genetic link between ...


Central Diabetes Insipidus  


... of the base of the skull; a tumor; sarcoidosis or tuberculosis; an aneurysm (a bulge in the ... hypothalamus meningitis nephrogenic nephrogenic diabetes insipidus pituitary polyuria sarcoidosis thalamus vasopressin Back to Top Previous: Hypopituitarism Next: ...


Diabetes - retinal conditions  

MedlinePLUS Videos and Cool Tools

Diabetes may affect the retina by causing the formation of whitish patches called exudates. Other indications may include tiny enlargements of the blood vessels resulting in microaneurysms and hemorrhages.


[Diabetes and kidneys].  


Diabetic nephropathy is the leading cause of end-stage renal disease all over the world. Diagnosis is confirmed by measuring urin albumin excretion and calculated renal function (eGFR). Once the diagnosis is confirmed there should be a search for confounding cardiovascular risk factors and even established cardiovascular disease because of the associated high cardiovascular risk. In type 1 diabetes metabolic control is the main issue. In case of renal impairment and in patients with type 2 diabetes a multifactorial approach is necessary, which consists of dietary advise, metabolic control, lowering elevated blood-pressure, cessation of smoking, ASS and lipid-lowering drug-therapy. Special drugs for the treatment of diabetes-induced renal disease are not available. PMID:23613374

Gäckler, D; Jäkel, S; Fricke, L; Reinsch, B; Fischer, F



National Diabetes Information Clearinghouse  


... 738–4929 Email: Internet: NIH...Turning Discovery Into Health ® Privacy Statement | Disclaimers | Accessibility | PDF versions require the free ...


Diabetes Health Concerns  


... have high rates of cholesterol and triglyceride abnormalities, obesity, and high blood pressure, all of which are ... Diabetes Prevention Program Other Chronic Disease Topics Nutrition Obesity Physical Activity Heart Disease Stroke File Formats Help: ...


[Update on diabetic macroangiopathy].  


Current findings from the literature on the multifactorial genesis of macroangiopathy of diabetes mellitus (DM) were compiled using the PubMed database. The primary aim was to find an explanation for the morphological, immunohistochemical and molecular characteristics of this form of atherosclerosis. The roles of advanced glycation end products (AGE), defective signal transduction and imbalance of matrix metalloproteinases in the increased progression of atherosclerosis in coronary and cerebral arteries as well as peripheral vascular disease are discussed. The restricted formation of collateral arteries (arteriogenesis) in diabetic patients with postischemic lesions is also a focus of attention. The increased level of prothrombotic factors and the role of diabetic neuropathy in DM are also taken into account. Therapeutic influences of AGE-RAGE (receptor of AGE) interactions on the vascular wall and the effects of endothelial progenitor cells in the repair of diabetic vascular lesions are additionally highlighted. PMID:22576595

Kunz, J



"Diabetes has instant consequences…"  


... 2009 Table of Contents Photo: Christopher Klose Maddie Kuhn, 19 Washington, DC Type 1 Diagnosed with type 1 diabetes in the third grade, Madeleine "Maddie" Kuhn doesn't let the disease inhibit her. The ...


[Eye changes in diabetes mellitus].  


In ophthalmological examinations on 820 diabetics in 32% a diabetic retinopathy I or II was found. The frequency of retinopathy correlates with the duration of diabetes. A glaucoma (4.8%) or an increased intra-ocular pressure, respectively, was statistically significantly more frequent in diabetics than in the total population. Among 714 patients with glaucoma about 17% of diabetics were found. Compared with the morbidity of diabetes of adequate age groups of the total population this is statistically significant. The intraocular pressure of patients with glaucoma and diabetes is therapeutically worse to be influenced than in patients with glaucoma without diabetes. They need a particularly attentive control and therapy. By means of electon-microscope examinations as a possible cause for the association of glaucoma and diabetes mellitus similar changes in the iridocorneal angle could be found in the two diseases. PMID:1199268

Schlote, H W; Altrock, M



Management of Diabetic Ketoacidosis  

Microsoft Academic Search

Diabetic ketoacidosis (DKA), a life-threatening complication of diabetes mellitus (DM), occurs more commonly in children with\\u000a type 1 DM than type 2 DM. Hyperglycemia, metabolic acidosis, ketonemia, dehydration and various electrolyte abnormalities\\u000a result from a relative or absolute deficiency of insulin with or without an excess of counter-regulatory hormones. Management\\u000a requires careful replacement of fluid and electrolyte deficits, intravenous administration

Sindhu Sivanandan; Aditi Sinha; Vandana Jain; Rakesh Lodha



Diabetes in Canadian Women  

Microsoft Academic Search

HEALTH ISSUE: Diabetes mellitus (DM) is a chronic health condition affecting 4.8% of Canadian adults ? 20 years of age. The prevalence increases with age. According to the National Diabetes Surveillance System (NDSS) (1998–1999), approximately 12% of Canadians aged 60–74 years are affected. One-third of cases may remain undiagnosed. The projected increase in DM prevalence largely results from rising rates

Catherine Kelly; Gillian L. Booth



Management of diabetic gastroparesis.  


Diabetic gastroparesis is a long term complication of diabetes mellitus which could basically be defined as dysregulated gastric emptying leading to various pathological, biochemical and clinical changes in absence of any structural changes. Symptoms include nausea, vomiting, bloating, epigastric pain, anorexia, weight loss and so on. For symptomatic gastroparesis prokinetic drugs like metoclopramide, domperidone, cisapride, erythromycin and itcopride are used. Itopride is currently emerging as a prokinetic drug of choice. There is also scope of surgery. PMID:16173296

Mukhopadhyay, Pradip; Basu, A K



Cardiac Denervation in Diabetes  

Microsoft Academic Search

Evidence for vagal denervation of the heart as a feature of diabetic autonomic neuropathy has been obtained by monitoring beat-to-beat variation in heart rate. Nine diabetics with autonomic neuropathy were assessed; each showed a marked reduction or absence of beat-to-beat variation in comparison with controls. Beat-to-beat variation in normal subjects is abolished by parasympathetic blockade but unaffected by sympathetic blockade.

Timothy Wheeler; P. J. Watkins



Diabetes and Depression  

Microsoft Academic Search

In a context of the potentially epidemic nature of both diabetes mellitus and depression, and the negative effects reported\\u000a in cases of comorbidity, this review suggests that the association of the two conditions is multifaceted. Increased risks\\u000a of prevalent depression and incident depression among diabetic patients have been reported in community studies. Even more\\u000a consistent is the finding supporting psychosomatic

Antonio Campayo; Carlos H. Gómez-Biel; Antonio Lobo



Menopause and Diabetes Mellitus  

Microsoft Academic Search

\\u000a Around the time of menopause, there are important changes in body composition and insulin sensitivity, which may impact both\\u000a the risk for diabetes mellitus as well as glycemic control in individuals with established diabetes. Furthermore, these parameters\\u000a may be affected by the use of hormone replacement therapy, a common treatment for menopausal vasomotor symptoms. Changes in\\u000a body composition, beyond changes

Emily D. Szmuilowicz; Ellen W. Seely


Vanadium Effects in Diabetes  

Microsoft Academic Search

\\u000a Over the past twenty years vanadium compounds have garnered much attention with respect to the treatment of diabetes. Vanadium’s\\u000a attraction as a hypoglycaemic agent lies in its oral route of administration. Several different vanadium salts have been used\\u000a to treat both Type 1 and Type 2 diabetes in vivo, including sodium orthovanadate, sodium meta-vanadate and vanadyl sulphate.\\u000a In addition to

TOD A. Clark; GRANT N. Pierce


Diabetes Mellitus Overview  

Microsoft Academic Search

Diabetes mellitus, the most common metabolic disorder affecting the population, has many clinical and psychological implications\\u000a for the patient. The provider must address these issues comprehensively. This chapter will describe the global burden and\\u000a cost of diabetes mellitus, define its classifications and diagnosis criteria, detail its current treatment options, address\\u000a associated complications including depression, fear of hypoglycemia, and fear of

Catherine Carver; Martin Abrahamson


Indian Health Service Basic Series, Diabetes Curriculum.  

National Technical Information Service (NTIS)

Contents: Diabetes and American Indians; Diabetes and American Indians; Using the Health Care System; Diabetes and Your Feelings; Body Weight and Diabetes; Eat Less Food; Eat Less Sugar; Eat Less Fat; Complications; What is Home Blood Glucose Monitoring; ...



Type 2 Diabetes Widespread in Adults  


... version of this page please turn Javascript on. Type 2 Diabetes Widespread in Adults Past Issues / Fall 2006 Table ... pre-diabetes have an increased risk for developing type 2 diabetes, the most common form of diabetes, and for ...


Type 2 Diabetes and TZDs (Thiazolidinediones)  


... Diabetes and TZDs Share: Questions and Answers Type 2 Diabetes and TZDs April, 2012 Download PDFs English ... Leiter, MD Julio Rosenstock, MD What is type 2 diabetes? When you have type 2 diabetes, your ...


How Is Diabetes Treated in Children?  


... Products Tobacco Products Vaccines, Blood & Biologics How Is Diabetes Treated in Children? Search the Consumer Updates Section ... as diabetes gets worse over time. Type 2 Diabetes Type 2 diabetes is most often diagnosed in ...


Diabetes in American Indians and Alaska Natives  


... 8 times higher than those without diabetes. Source: Diabetes Care 2003;26(12):3342-3348 (http://care.diabetesjournals. ... would be in the absence of diabetes. Source: Diabetes Care 2008;31(3):596-615 (http://care.diabetesjournals. ...


Diabetes update: population management.  


To optimally care for diabetes patients, physicians must adopt a systematic approach to managing the entire panel. At the heart of excellent care is a multidisciplinary health care team working in a patient-centered environment. Options to supplement traditional office visits include shared medical appointments (ie, group visits), patient self-management education, and social media for patient support and education. Educating patients about diabetes is associated with more frequent recommended screening, improved objective measures, cost savings, and improved short-term quality of life, especially when behavioral goal setting is incorporated. Participation in a nurse-led diabetes management program or an outreach program is associated with reduced health care costs and increased receipt of recommended screening and testing for patients with diabetes; implementation of an electronic database or registry system also is associated with these benefits. Some studies show that these interventions are associated with improvements in A1c; however, outcomes data are limited. Formats for group visits vary. Evidence suggests that patients with diabetes who participate in a group education program have lower A1c levels, improved lipid profiles, higher quality of life scores, and improved knowledge about diabetes and problem-solving ability. PMID:23690376

Erlich, Deborah R; Slawson, David C; Shaughnessy, Allen



Rheumatological manifestations in diabetes mellitus.  


Rheumatological manifestations of Diabetes Mellitus may be classified in: non articular, articular and bone conditions. Among non articular conditions, diabetic cheiroarthropathy, frequent in type I diabetes, the most important disorder related to limited joint mobility, results in stiff skin and joint contractures. Adhesive capsulitis of the shoulder, flexor tenosynovitis, and Duputryen's and Peyronie's diseases are also linked to limited joint mobility. Diffuse skeletal hyperostosis, due to calcification at entheses, is frequent and early, particularly in type 2 diabetes. Neuropathies cause some non articular conditions, mainly neuropathic arthritis, a destructive bone and joint condition more common in type I diabetes. Algodistrophy, shoulder-hand and entrapment syndromes are also frequent. Mononeuropathy causes diabetic amyotrophy, characterised by painless muscle weakness. Among muscle conditions, diabetic muscle infarction is a rare, sometimes severe, condition. Among articular conditions, osteoarthritis is frequent and early in diabetes, in which also chondrocalcinosis and gout occur. Rheumatoid arthritis (RA) and diabetes I have a common genetic background and the presence of diabetes gives to RA an unfavourable prognosis. Among bone conditions, osteopenia and osteoporosis may occur early in type 1 diabetes. Contrarily, in type 2 diabetes, bone mineral density is similar or, sometimes, higher than in non diabetic subjects, probably due to hyperinsulinemia. PMID:18220648

Del Rosso, Angela; Cerinic, Marco Matucci; De Giorgio, Francesca; Minari, Chiara; Rotella, Carlo Maria; Seghier, Giuseppe



Prognosis in diabetic nephropathy.  

PubMed Central

OBJECTIVE--To assess the effect of long term antihypertensive treatment on prognosis in diabetic nephropathy. DESIGN--Prospective study of all insulin dependent diabetic patients aged under 50 with onset of diabetes before the age of 31 who developed diabetic nephropathy between 1974 and 1978 at Steno Memorial Hospital. SETTING--Outpatient diabetic clinic in tertiary referral centre. PATIENTS--Forty five patients (20 women) with a mean age of 30 (SD 7) years and a mean duration of diabetes of 18 (7) years at onset of persistent proteinuria were followed until death or for at least 10 years. INTERVENTIONS--Antihypertensive treatment was started a median of three (0-13) years after onset of nephropathy. Four patients (9%) received no treatment, and 9 (20%), 13 (29%), and 19 (42%) were treated with one, two, or three drugs, respectively. The median follow up was 12 (4-15) years. MAIN OUTCOME MEASURES--Arterial blood pressure and death. RESULTS--Mean blood pressure at start of antihypertensive treatment was 148/95 (15/50) mm Hg. Systolic blood pressure remained almost unchanged (slope -0.01 (95% confidence interval -0.39 to 0.37) mm Hg a year) while diastolic blood pressure decreased significantly (0.87 (0.65 to 1.10) mm Hg a year) during antihypertensive treatment. The cumulative death rate was 18% (8 to 32%) 10 years after onset of nephropathy, in contrast to previous reports of 50% to 77% 10 years after onset of nephropathy. As in previous studies, uraemia was the main cause of death (9 patients; 64%). CONCLUSIONS--The prognosis of diabetic nephropathy has improved during the past decade largely because of effective antihypertensive treatment.

Parving, H. H.; Hommel, E.



Diabetic parturient - Anaesthetic implications  

PubMed Central

Pregnancy induces progressive changes in maternal carbohydrate metabolism. As pregnancy advances insulin resistance and diabetogenic stress due to placental hormones necessitate compensatory increase in insulin secretion. When this compensation is inadequate gestational diabetes develops. ‘Gestational diabetes mellitus’ (GDM) is defined as carbohydrate intolerance with onset or recognition during pregnancy. Women diagnosed to have GDM are at increased risk of future diabetes predominantly type 2 DM as are their children. Thus GDM offers an important opportunity for the development, testing and implementation of clinical strategies for diabetes prevention. Timely action taken now in screening all pregnant women for glucose intolerance, achieving euglycaemia in them and ensuring adequate nutrition may prevent in all probability, the vicious cycle of transmitting glucose intolerance from one generation to another. Given that diabetic mothers have proportionately larger babies it is likely that vaginal delivery will be more difficult than in the normal population, with a higher rate of instrumentally assisted delivery, episiotomy and conversion to urgent caesarean section. So an indwelling epidural catheter is a better choice for labour analgesia as well to use, should a caesarean delivery become necessary. Diabetes in pregnancy has potential serious adverse effects for both the mother and the neonate. Standardized multidisciplinary care including anaesthetists should be carried out obsessively throughout pregnancy. Diabetes is the most common endocrine disorder of pregnancy. In pregnancy, it has considerable cost and care demands and is associated with increased risks to the health of the mother and the outcome of the pregnancy. However, with careful and appropriate screening, multidisciplinary management and a motivated patient these risks can be minimized.

Pani, Nibedita; Mishra, Shakti Bedanta; Rath, Shovan Kumar



Exercise and diabetes.  


Diet and exercise form the foundation of a healthy lifestyle. These are especially important for people living with diabetes mellitus, as they are the most practical non-pharmacological means by which patients may significantly improve their blood glucose levels. Exercise increases insulin sensitivity (both short and long term), lowers blood sugar levels, reduces body fat and improves cardiovascular (CV) function. Because of this, exercise offers enormous benefit to patients with diabetes. Blood glucose levels can significantly drop during and after physical activities, due to the increased utilisation of glucose as a fuel during exercise and the up-regulation of glucose transport into working muscles. Therefore, patients (especially those with type 1 diabetes) must account for the effects of exercise and adjust their medications and nutrition accordingly. Improvements in real-time continuous glucose monitoring and optimisation of basal insulin dosing may offer significant benefit to preventing hypoglycaemia in patients with type 1 diabetes who regularly exercise. Diverse exercise programmes and devices can also assist patients in monitoring their activities as well as motivating them to achieve their exercise goals. For patients with type 1 diabetes, questions such as how much, how long, how strenuous and what kind of exercise must be addressed in order for healthcare professionals to offer maximum benefit to their patients. Additionally, since patients with type 2 diabetes often have other significant co-morbidities such as obesity and CV disease, care providers must evaluate each patient's risk factors before designing an exercise programme. Several publications in the last year have addressed these issues and may serve as a valuable resource to provide safe and effective recommendations to patients and their healthcare providers. To be included in the Exercise and Diabetes chapter for the 2010 YEARBOOK, we reviewed leading peer-reviewed manuscripts that were published in the period July 2009 to June 2010. PubMed was used in the initial screening of articles. PMID:21323815

Zisser, H; Gong, P; Kelley, C M; Seidman, J S; Riddell, M C



Type 1 Diabetes: What Is It? (For Parents)  


Type 1 Diabetes: What Is It? KidsHealth > Parents > Diabetes Center > Diabetes Basics > Type 1 Diabetes: What Is It? Print A A ... in learning to live with the disease. About Diabetes Diabetes is a disease that affects how the ...


How obesity causes diabetes in Zucker diabetic fatty rats  

Microsoft Academic Search

The mechanisms of adipogenic diabetes in Zucker diabetic fatty (ZDF) rats, a model of obesity complicated by diabetes, are reviewed. In ZDF rats, a mutation in the leptin receptor, OB-R, is associated with leptin resistance, obesity, and increased fat content of islets. Exaggerated nitric oxide (NO) generation, attributed to high intracellular levels of long-chain fatty acids, impairs ?-cell function and

Roger H. Unger



Peripheral Artery Disease and Diabetes  


... Why does diabetes increase the risk for developing PAD? Individuals with diabetes are already at an increase ... or bypass surgery ) or stroke Prevention & Treatment of PAD A number of the risk factors mentioned here ...


Early Treatment of Diabetic Neuropathy.  

National Technical Information Service (NTIS)

Treatment of diabetic neuropathy is a difficult clinical problem. In this paper, clinical experience on managing 120 newly discovered, untreated, noninsulin dependent cases is presented. Besides strict control of diabetes, the therapeutic effect of differ...

X. Zhong B. Zheng G. Hu X. Zhu Z. Hu



Diabetes and cassava in Dominica.  


A study of 110 non-insulin dependent diabetics and 110 controls failed to find evidence that chronic consumption of cassava flour containing significant amounts of cyanide, predisposes to diabetes mellitus. PMID:3188221

Cooles, P



What is Diabetic Eye Disease?  

MedlinePLUS Videos and Cool Tools

... United States, there are 14 million people with diabetes and while most will not lose their vision ... good deal higher among people with Type I diabetes -- the type that usually begins in childhood and ...


Diabetes: Unique to Older Adults  

MedlinePLUS Videos and Cool Tools

... Incontinence Related Video Aging & Health A to Z Diabetes Unique to Older Adults This section provides information ... care and improve or maintain quality of life. Diabetes and Other Conditions Having high levels of sugar ( ...


Reducing Risk of Diabetic Retinopathy  


... 45 the figure rises to 70 percent. Ethnicity. Diabetic retinopathy is more common among some ethnic groups than others. For example, African Americans and Latino Americans with type 2 diabetes have ...


Diabetes and Your Eyesight (Glaucoma)  


... those belonging to certain ethnic groups. Persons of African, Native American, Japanese, Latino or Polynesian descent are more at risk. Diabetic Eye Disease A common complication of diabetes is ...


Diabetes and Hepatitis B Vaccination  


Diabetes and Hepatitis B Vaccination Information for Diabetes Educators What is hepatitis B? Hepatitis B is a contagious liver disease that ... as liver failure or liver cancer. How is hepatitis B spread? The hepatitis B virus is usually ...


Emergency Meal Planning for Diabetics  


... Avoid high potassium fruit juices (orange juice). THREE-DAY DIABETIC GROCERY LIST FOR EMERGENCIES Item Amount (per ... Other Distilled water 5 one gallon jugs THREE-DAY DIABETIC MEAL PLAN FOR EMERGENCIES The sample meal ...


Financial Help for Diabetes Care  


... Help for Diabetes Care Financial Help for Diabetes Care On this page: Medicare Medicaid State Children's Health ... dol/topic/health-plans/consumerinfhealth.htm . [ Top ] Health Care Services The Bureau of Primary Health Care, a ...


American Association of Diabetes Educators  


... community. More AADE Blog: Diabetes Goal Tracker Mobile App Looking to set and track goals related to managing your diabetes? Well, there's an app for that! AADE blogger Karen Kemmis shares her ...


Gastrointestinal complications of diabetes.  


Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. The diagnosis of diabetic gastroparesis is made when other causes are excluded and postprandial gastric stasis is confirmed by gastric emptying scintigraphy. Whenever possible, patients should discontinue medications that exacerbate gastric dysmotility; control blood glucose levels; increase the liquid content of their diet; eat smaller meals more often; discontinue the use of tobacco products; and reduce the intake of insoluble dietary fiber, foods high in fat, and alcohol. Prokinetic agents (e.g., metoclopramide, erythromycin) may be helpful in controlling symptoms of gastroparesis. Treatment of diabetes-related constipation and diarrhea is aimed at supportive measures and symptom control. Nonalcoholic fatty liver disease is common in persons who are obese and who have diabetes. In persons with diabetes who have elevated hepatic transaminase levels, it is important to search for other causes of liver disease, including hepatitis and hemochromatosis. Gradual weight loss, control of blood glucose levels, and use of medications (e.g., pioglitazone, metformin) may normalize hepatic transaminase levels, but the clinical benefit of aggressively treating nonalcoholic fatty liver disease is unknown. Controlling blood glucose levels is important for managing most gastrointestinal complications. PMID:18619079

Shakil, Amer; Church, Robert J; Rao, Shobha S



Treating the obese diabetic.  


Type 2 diabetes and obesity are intimately linked; reduction of bodyweight improves glycemic control, mortality and morbidity. Treating obesity in the diabetic is hampered as some diabetic treatments lead to weight gain. Bariatric surgery is currently the most effective antiobesity treatment and causes long-term remission of diabetes in many patients. However, surgery has a high cost and is associated with a significant risk of complications, and in practical terms only limited numbers can undergo this therapy. The choice of pharmacological agents suitable for treatment of diabetes and obesity is currently limited. The glucagon-like peptide-1 receptor agonists improve glycemia and induce a modest weight loss, but there are doubts over their long-term safety. New drugs such as lorcaserin and phentermine/topiramate are being approved for obesity and have modest, salutary effects on glycemia, but again long-term safety is unclear. This article will also examine some future avenues for development, including gut hormone analogues that promise to combine powerful weight reduction with beneficial effects on glucose metabolism. PMID:23473594

Kenkre, Julia; Tan, Tricia; Bloom, Stephen



Depression in Type 2 Diabetes  

Microsoft Academic Search

Diabetes patients have a twofold increased risk of suffering from depression as compared to individuals without diabetes.\\u000a This commonly overlooked comorbidity affects about a quarter of the diabetic population. Because depression among diabetes\\u000a patients has been associated with decreased metabolic control, poor adherence to medication and diet regimens, a reduction\\u000a in quality of life, it is of importance for health

Miranda A. L. van Tilburg; Anastasia Georgiades; Richard S. Surwit


Diabetic ketoacidosis: diagnosis and management.  


The objective of this manuscript is to review the clinical manifestations, diagnosis and management of diabetic ketoacidosis, one of the most common acute complications of diabetes mellitus. We performed a medline search of the English-language literature using a combination of words (diabetic ketoacidosis, hyperglycemic crises) to identify original studies, consensus statements and reviews on diabetic ketoacidosis published in the past 15 years. Emphasis was placed on clinical manifestations of diabetic ketoacidosis, its diagnosis and treatment.Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus that can be life-threatening if not treated properly. Once thought to occur only in patients with type 1 diabetes, diabetic ketoacidosis has also been observed in patients with type 2 diabetes under certain conditions. The basic underlying mechanism for diabetic ketoacidosis is insulin deficiency coupled with elevated levels of counterregulatory hormones, such as glucagon, cortisol, catecholamines, and growth hormone. Diabetic ketoacidosis can be the initial presentation of diabetes mellitus or precipitated in known patients with diabetes mellitus by many factors, most commonly infection. The management of diabetic ketoacidosis involves careful clinical evaluation, correction of metabolic abnormalities, identification and treatment of precipitating and co-morbid conditions, appropriate long-term treatment of diabetes, and plans to prevent recurrence. Many cases of DKA can be prevented by better access to medical care, proper education, and effective communication with a health care provider during intercurrent illness. Provision of guidelines will also reduce mortality. Resources need to be redirected towards prevention by funding better access to care and educational programs. PMID:18939392

Fasanmade, O A; Odeniyi, I A; Ogbera, A O



Heart disease in diabetic patients  

Microsoft Academic Search

Both type 1 and type 2 diabetic patients have an increased incidence of ischemic heart disease and congestive heart failure.\\u000a Cardiovascular disease accounts for up to 80% of the excess mortality in patients with type 2 diabetes. The burden of cardiovascular\\u000a disease is especially pronounced in diabetic women. Factors that underlie diabetic heart disease include multiple vessel coronary\\u000a artery disease,

Mihaela C. Blendea; Samy I. McFarlane; Esma R. Isenovic; Gregory Gick; James R. Sowers



Experimental diabetic neuropathy: an update  

Microsoft Academic Search

Diabetic neuropathy consists of several clinical syndromes affecting motor, sensory and autonomic nerves. Of these the most\\u000a common is distal symmetric sensory polyneuropathy usually referred to as diabetic neuropathy. Animal studies, mainly in diabetic\\u000a rodents, have contributed tremendously to our understanding of this disease. From these it is clear that the pathogenesis\\u000a of diabetic neuropathy is multifactorial involving sequentially occurring

A. A. F. Sima; K. Sugimoto



Transient and permanent neonatal diabetes  

Microsoft Academic Search

Neonatal diabetes, which may be transient or permanent, is rare. Most patients are full-term but small- for-date infants. Typical symptoms of diabetes mellitus occur within the first 4 weeks of life, requiring insulin therapy and very strict blood glucose monitoring. Subsequent growth and psychomotor development are usually normal. In about 33% of these patients the diabetes remains permanent; the transient

Stephan Fösel



Diabetes Education in Tribal Schools  

ERIC Educational Resources Information Center

Diabetes is a prevalent disease in the United States. The emergence of Type 2 diabetes among children and adolescents within the American Indian/Alaska Native (AI/AN) communities brings increased public health and quality of life concerns. In this article, the authors describe an initiative titled "Diabetes Education in Tribal Schools K-12…

Helgeson, Lars; Francis, Carolee Dodge



Case 22:Type II diabetes  

Technology Transfer Automated Retrieval System (TEKTRAN)

Diabetes mellitus is characterized by elevated blood glucose levels. It is composed of two types depending on the pathogenesis. Type I diabetes is characterized by insulin deficiency and usually has its onset during childhood or teenage years. This is also called ketosis-prone diabetes. Type II diab...



EPA Science Inventory

The Diabetes Prevention Trial--Type 1 (DPT-1) is a nationwide study to see if we can prevent or delay type 1 diabetes, also known as insulin-dependent diabetes. Nine medical centers and more than 350 clinics in the United States and Canada are taking part in the study....


Type 1 diabetes in Japan  

Microsoft Academic Search

Type 1 diabetes is a multifactorial disease which results from a T-cell-mediated autoimmune destruction of the pancreatic beta cells in genetically predisposed individuals. The risk for individuals of developing type 1 diabetes varies remarkably according to country of residence and race. Japan has one of the lowest incidence rates of type 1 diabetes in the world, and recognises at least

E. Kawasaki; N. Matsuura; K. Eguchi




Microsoft Academic Search

A comparative and correlational study was made of 50 juvenile diabetics and 50 individually matched controls. Evaluation included psychiatric interview, psy- chological testing, interviews in home with parents, and medical rating of diabetic control. For clinical ratings, the diabetics showed significantly more pathology on psychiatric classification, dependence-independence balance, self- percept, manifest and latent anxiety, sexual identification, constriction, hostility, and oral




Sequelae of unrecognized gestational diabetes  

Microsoft Academic Search

OBJECTIVE: Prior studies have suggested that macrosomia is the only morbid condition associated with gestational diabetes and that this association is the result of confounding by maternal obesity rather than a result of gestational diabetes itself. We sought to determine whether unrecognized gestational diabetes is an independent predictor of macrosomia and other perinatal morbid conditions after controlling for confounding variables.

Kristina M. Adams; Hongzhe Li; Roger L. Nelson; Paul L. Ogburn Jr.; Diana R. Danilenko-Dixon



Diabetic nephropathy in African Americans  

Microsoft Academic Search

Diabetic nephropathy (DN) is the number one cause of end-stage renal disease in United States and is highly prevalent in African Americans. We have found that among African Americans in Mississippi diabetic nephropathy appears to affect females more than males, which may be related to increased rates of obesity and diabetes in African American women. Glycemic control and control of

Errol D. Crook



Diabetes Education in Tribal Schools  

ERIC Educational Resources Information Center

|Diabetes is a prevalent disease in the United States. The emergence of Type 2 diabetes among children and adolescents within the American Indian/Alaska Native (AI/AN) communities brings increased public health and quality of life concerns. In this article, the authors describe an initiative titled "Diabetes Education in Tribal Schools K-12…

Helgeson, Lars; Francis, Carolee Dodge



Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus in Korea  

PubMed Central

Diabetic peripheral neuropathy (DPN), a common and troublesome complication in patients with type 2 diabetes mellitus (T2DM), contributes to a higher risk of diabetic foot ulcer and lower limb amputation. These situations can negatively impact the quality of life of affected individuals. Despite its high prevalence and clinical importance, most diabetes mellitus patients not only do not recognize the presence of diabetic neuropathy, but also do not report their symptoms to physicians or other health care providers. Therefore, DPN is usually under diagnosed and undertreated. For early detection and appropriate intervention for DPN, a careful history, physical with neurologic examination, and prompt treatment are needed in T2DM patients.

Ko, Seung-Hyun



Glycation in diabetic nephropathy.  


The kidney is an extremely complex organ with broad ranging functions in the body, including but not restricted to waste excretion, ion and water balance, maintenance of blood pressure, glucose homeostasis, generation of erythropoietin and activation of vitamin D. With diabetes, many of these integral processes are interrupted via a combination of haemodynamic and metabolic changes including increases in the accumulation of proteins modified by advanced glycation, known as advanced glycation end products (AGEs). Indeed, hyperglycaemia and the redox imbalances seen with diabetes are each independent accelerants for the production of AGEs, which synergistically combine in this disorder. In addition, as kidney function declines, characterised by a loss of glomerular filtration, the excretion of AGEs is decreased, possibly exacerbating renal injury by further elevating the body's tissue and circulating AGE pool. Therefore, it has become apparent that decreasing the accumulation of AGEs or interrupting their downstream effects on the kidney, are desirable therapeutic targets for the treatment of diabetic renal disease. PMID:20963456

Forbes, Josephine M; Cooper, Mark E



Diabetes and periodontal disease  

PubMed Central

Diabetes mellitus is a systemic disease characterized by increased blood glucose levels and abnormalities of lipid metabolism due to absence or decreased level of insulin. It affects all the body organs and their functions either directly or indirectly. Every dentist should have a basic understanding of the etiopathogenesis, oral and systemic manifestations of this disease. The periodontal diseases are a consequence of extension of the gingival inflammation into the underlying supporting structures of the periodontium, initiated by the presence of plaque and its products on the surfaces of the teeth and the adjoining structures. The progression of periodontal disease is influenced by variety of factors like microorganisms, host response, systemic background, and genetic makeup of the host. Amongst them, diabetes mellitus tops the list. Diabetes and periodontitis influence the clinical outcome of each other and control of both influences the clinical improvement of each.

Daniel, Rajkumar; Gokulanathan, Subramanium; Shanmugasundaram, Natarajan; Lakshmigandhan, Mahalingam; Kavin, Thangavelu



[Diabetes in liver cirrhosis].  


The prevalence of overt diabetes mellitus (DM) in liver cirrhosis is about 30%. However, DM or impaired glucose tolerance can be observed in 90% after an oral glucose tolerance test in patients with normal fasting plasma glucose. Type 2 DM may produce cirrhosis, whereas DM may be a complication of cirrhosis. The latter is known as «hepatogenous diabetes». Overt and subclinical DM is associated with liver complications and death in cirrhotic patients. Treating diabetes is difficult in cirrhotic patients because of the metabolic impairments due to liver disease and because the most appropriate pharmacologic treatment has not been defined. It is also unknown if glycemic control with hypoglycemic agents has any impact on the course of the liver disease. PMID:23628170

García-Compeán, Diego; Jáquez-Quintana, Joel O; González-González, José A; Lavalle-González, Fernando J; Villarreal-Pérez, Jesús Z; Maldonado-Garza, Hector J



[Zinc and diabetes mellitus].  


In patients with type 1 and 2 diabetes was frequently found: low blood zinc levels, high zincuria, severe and ubiquitous cellular depletion of zinc, increased basal and after loading blood mineral clearance, and hyperglycaemia due to the reduction of pancreatic insulin secretion and to the reduced biological action of the hormone on liver, as a consequence of chronic zinc deficit. Strong endocellular zinc depletion in diabetics; low insulin secretion; insulin biological action decrease for zinc deficit; IG-I concentration decrease, that happens in this condition; insulin and IGF-I resistance; insulin and IGF-I receptors depletion in diabetics: are strong arguments for zinc pharmacological supplementation, in gastric protective formulation, to avoid gastroenteric problems. PMID:8622809

Ripa, S; Ripa, R



[Therapy of diabetic nephropathy].  


New pathophysiological insights in the last few years on the development of diabetic nephropathy have led to a change in therapeutic measures. The emphasis is put on preventive considerations for the insulin-dependent diabetic patient. Strict control of glycemia and the early use of an angiotensin-conversion inhibitor are of importance. Therapy of the manifest diabetic nephropathy is based on strict metabolic control combined with reduced protein intake. Furthermore, an often co-existing hypertension needs to be treated. Normotensive blood pressure should be obtained. ACE-inhibitors and Ca-antagonists have been proven to be very effective, although there seem to exist differences in the type of Ca-antagonists regarding effectiveness on albuminuria. The combination of ACE-inhibitors and Ca-antagonists seems to have an additional beneficial impact on albuminuria. A significant decrease in the loss of glomerular function and a decrease in albuminuria can be obtained by consistent consideration of these therapeutic strategies. PMID:8147061

Stahl, R A; Schoeppe, W; Thaiss, F



Diagnosing and Treating Diabetic Foot Infections Diyabetik Ayak ?nfeksiyonlarinin Tani ve Tedavisi  

Microsoft Academic Search

Persons with diabetes often develop foot wounds, which frequent- ly become infected. Infections typically involve soft tissues at fi rst, but can spread to underlying bone. These infections cause con- siderable morbidity and are often the proximate cause of lower extremity amputation. Many studies in the past few years have improved knowledge of the most appropriate ways to diagnose and

Benjamin A. Lipsky


Diabetes in Canadian Women  

PubMed Central

Health Issue Diabetes mellitus (DM) is a chronic health condition affecting 4.8% of Canadian adults ? 20 years of age. The prevalence increases with age. According to the National Diabetes Surveillance System (NDSS) (1998–1999), approximately 12% of Canadians aged 60–74 years are affected. One-third of cases may remain undiagnosed. The projected increase in DM prevalence largely results from rising rates of obesity and inactivity. Key Findings DM in Canada appears to be more common among men than women. However, among Aboriginal Canadians, two-thirds of affected individuals are women. Although obesity is more prevalent among men than women (35% vs. 27%), the DM risk associated with obesity is greater for women. Socio-economic status is inversely related to DM prevalence but the income-related disparities are greater among women. Polycystic ovarian syndrome affects 5–7% of reproductive-aged women and doubles their risk for DM. Women with gestational diabetes frequently develop DM over the next 10 years. Data Gaps and Recommendations Studies of at risk ethnic/racial groups and women with gestational diabetes are needed. Age and culturally sensitive programs need to be developed and evaluated. Studies of low-income diabetic women are required before determining potential interventions. Lifestyle programs in schools and workplaces are needed to promote well-being and combat obesity/inactivity, together with lobbying of the food industry for needed changes. High depression rates among diabetic women influence self-care ability and health care expenditures. Health professionals need further training in the use of effective counseling skills that will assist people with DM to make and maintain difficult behavioural changes.

Kelly, Catherine; Booth, Gillian L



Diabetes foot disease: the Cinderella of Australian diabetes management?  

PubMed Central

Diabetes is one of the greatest public health challenges to face Australia. It is already Australia’s leading cause of kidney failure, blindness (in those under 60?years) and lower limb amputation, and causes significant cardiovascular disease. Australia’s diabetes amputation rate is one of the worst in the developed world, and appears to have significantly increased in the last decade, whereas some other diabetes complication rates appear to have decreased. This paper aims to compare the national burden of disease for the four major diabetes-related complications and the availability of government funding to combat these complications, in order to determine where diabetes foot disease ranks in Australia. Our review of relevant national literature indicates foot disease ranks second overall in burden of disease and last in evidenced-based government funding to combat these diabetes complications. This suggests public funding to address foot disease in Australia is disproportionately low when compared to funding dedicated to other diabetes complications. There is ample evidence that appropriate government funding of evidence-based care improves all diabetes complication outcomes and reduces overall costs. Numerous diverse Australian peak bodies have now recommended similar diabetes foot evidence-based strategies that have reduced diabetes amputation rates and associated costs in other developed nations. It would seem intuitive that “it’s time” to fund these evidence-based strategies for diabetes foot disease in Australia as well.



[Diabetes in elderly people].  


The treatment of elderly diabetic people concerns not only doctors but also paramedical professionals. As these patients represent a heterogeneous group, treatment must be adapted to each person. The frequent occurrence of physical, sensory and cognitive disabilities must be taken into account in order to define the objectives and method of treatment. Therapeutic education must enable the patient or the carers to have a better understanding of the pathology and the therapy in order to avoid the occurrence of complications and accidents. The paramedical guide for the care of elderly diabetic people brings together all the information enabling caregivers to improve their knowledge and their practices. PMID:22533281

Bauduceau, Bernard; Bertoglio, Jocelyne



Diabetes mellitus and sports.  


The adolescent with insulin-dependent diabetes mellitus (IDDM) can safely participate in sports activities without interference from the disease. To ensure safe and successful participation, clinicians must appreciate how diabetes may alter the physiologic adaptation to strenuous exercise and how an individualized self-care plan can empower the adolescent with IDDM to effectively manage meal planning, blood glucose testing, and insulin injections. Various types of insulin, insulin schedules, and insulin delivery devices that may suit a wide variety of training and activity regimens are described. PMID:9928460

Draznin, M B; Patel, D R



Diabetes and heart failure.  


Heart failure affects more than five million Americans. It is a health and financial burden on the US health care system. The 5-year mortality of heart failure with diabetes is about 50%. This article discusses the treatment of heart failure in the patient with diabetes, including developing effective communication skills between physicians and nurses, developing an effective plan for transitioning the patient between care settings, documenting patient visits consistently and clearly, and performing medication reconciliation at each visit. This article also discusses the need for monitoring readmission for heart failure, length of stay, discharge on beta-blocker, and vaccination rate. PMID:23410648

Glover, Talar L; Galvan, Esperanza



Colour vision of diabetics.  

PubMed Central

The Farnsworth-Munsell 100-hue test has been assessed as a screening test for the detection of diabetic retinopathy likely to benefit from laser photocoagulation therapy. Two hundred and thirty-two diabetic eyes of 126 patients were tested. The results were assessed both for total error score relative to age and for the presence of polarity. Although the incidence of abnormal colour discrimination was found to correlate with the severity of retinopathy, the test was not sufficiently selective to be of value as a screening test in the detection of retinopathy requiring treatment.

Green, F D; Ghafour, I M; Allan, D; Barrie, T; McClure, E; Foulds, W S



Antioxidants and diabetes  

PubMed Central

Hyperglycemia promotes auto-oxidation of glucose to form free radicals. The generation of free radicals beyond the scavenging abilities of endogenous antioxidant defenses results in macro- and microvascular dysfunction. Antioxidants such as N-acetylcysteine, vitamin C and ?-lipoic acid are effective in reducing diabetic complications, indicating that it may be beneficial either by ingestion of natural antioxidants or through dietary supplementation. However, while antioxidants are proving essential tools in the investigation of oxidant stress-related diabetic pathologies and despite the obvious potential merit of a replacement style therapy, the safety and efficacy of antioxidant supplementation in any future treatment, remains to be established

Bajaj, Sarita; Khan, Afreen



[Gestational diabetes mellitus].  


Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes. GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birthweight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e.g. glucosuria). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140 mg/dl) insulin therapy should be initiated. Maternal and fetal monitoring is required in order to minimize maternal and fetal/neonatal morbidity and perinatal mortality. After delivery all women with GDM have to be reevaluated as to their glucose tolerance by a 75 g OGTT (WHO criteria) 6-12 weeks postpartum and every 2 years in case of normal glucose tolerance (Evidence level B). All women have to be instructed about their (sevenfold increased relative) risk of type 2 diabetes at follow-up and possibilities for diabetes prevention, in particular weight management and maintenance/increase of physical activity. Monitoring of the development of the offspring and recommendation of healthy lifestyle of the children and family is recommended. PMID:23250453

Kautzky-Willer, Alexandra; Bancher-Todesca, Dagmar; Pollak, Arnold; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund



[Atherosclerosis, alcohol and diabetes].  


Diabetes is a known risk factor of atherosclerosis, moderate consumption of alcohol was reported to reduce the cardiovascular morbidity and mortality. This review presents information on the possible mechanisms of the antiatherogenic effect of alcohol and data of the effect of moderate alcohol drinking on the prevention of cardiovascular diseases. Red wine contains polyphenols with an antioxidant effect, alcohol is metabolized to acetaldehyde which was proved to inhibit the formation of advanced glycation endproducts (AGE) and lipoprotein oxidation. Diabetic patients may benefit from moderate consumption of alcohol beverages only if the risk of hypoglycemia is safely excluded. PMID:12132355

Bartos, V



Diabetic and endocrine emergencies  

PubMed Central

Endocrine emergencies constitute only a small percentage of the emergency workload of general doctors, comprising about 1.5% of all hospital admission in England in 2004–5. Most of these are diabetes related with the remaining conditions totalling a few hundred cases at most. Hence any individual doctor might not have sufficient exposure to be confident in their management. This review discusses the management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, hypercalcaemia, thyroid storm, myxoedema coma, acute adrenal insufficiency, phaeochromocytoma hypertensive crisis and pituitary apoplexy in the adult population.

Kearney, T; Dang, C



Controlling diabetes, controlling diabetics: moral language in the management of diabetes type 2  

Microsoft Academic Search

Contemporary management of diabetes places heavy emphasis on control, particularly control of blood sugars and of food consumption. Interviews with people living with diabetes type 2 show how identity and social relationships are negotiated through what is often a contradictory language of control, surveillance, discipline and responsibility. People frequently discuss diabetes-related behaviour in terms that position themselves or others as

Dorothy Broom; Andrea Whittaker



Rheumatic manifestations in diabetic patients  

PubMed Central

Diabetes mellitus (DM), a worldwide high prevalence disease, is associated with a large variety of rheumatic manifestations. For most of these affections, pathophysiologic correlations are not well established. Some of them, such as diabetic cheiroarthropathy, neuropathic arthritis, diabetic amyotrophy, diabetic muscle infraction, are considered intrinsic complications of DM. For others, like diffuse idiopathic skeletal hyperostosis or reflex sympathetic dystrophy, DM is considered a predisposing condition. In most cases, these affections cause pain and disability, affecting the quality of life of diabetic patients, but once correctly diagnosed, they often respond to the treatment, that generally requires a multidisciplinary team. This article reviews some epidemiological, clinical, diagnostic and therapeutic aspects of these conditions.

Serban, AL; Udrea, GF



Diabetes mellitus and periodontal disease.  


A sample of 54 patients with diabetes mellitus were subjects to detailed assessment of periodontal disease levels using standard indices. In order to determine whether the severity of periodontal disease was related to the severity of diabets mellitus, a series of parameters of the diabetes mellitus population was simultaneously studied. There were no significant relationships between the levels of periodontal disease and the duration of diabetes, the type of treatment and the frequency of systemic complications. Periodontal disease in the diabetic appeared to the affected by the same etiologic factors [plaque, calculus, neglect] as would be expected in nondiabetic patients. Further studies with larger population samples would be appropriate. PMID:276596

Nichols, C; Laster, L L; Bodak-Gyovai, L Z



Mucormycosis Caused byRhizopus microsporusvar.microsporus: Cellulitis in the Leg of a Diabetic Patient Cured by Amputation  

Microsoft Academic Search

Mucormycosis accompanied the development of bacterial infection in the leg of a diabetic African-American man. Local injury, diabetic ketoacidosis, renal insufficiency, and antimicrobial therapy were factors that con- tributedtothepathogenesisofthemucormycosis.ThecellulitiswascausedinpartbyRhizopusmicrosporusvar. microsporusandwascuredbyamputation.Wereportthisunusualcaseofmucormycosistoemphasizethevalue of fungal identification, to illustrate a dramatic and successful clinical result, and to draw attention to an apparentroleforbacterialinfectionanditstreatmentinthepathogenesisofmucormycosis.Itisthethirdcase report of mucormycosis in a human in whichR. microsporusvar.microsporuswas definitively identified as




Diabetes and Risk of Cancer  

PubMed Central

Diabetes and cancer represent two complex, diverse, chronic, and potentially fatal diseases. Cancer is the second leading cause of death, while diabetes is the seventh leading cause of death with the latter still likely underreported. There is a growing body of evidence published in recent years that suggest substantial increase in cancer incidence in diabetic patients. The worldwide prevalence of diabetes was estimated to rise from 171 million in 2000 to 366 million in 2030. About 26.9% of all people over 65 have diabetes and 60% have cancer. Overall, 8–18% of cancer patients have diabetes. In the context of epidemiology, the burden of both diseases, small association between diabetes and cancer will be clinically relevant and should translate into significant consequences for future health care solutions. This paper summarizes most of the epidemiological association studies between diabetes and cancer including studies relating to the general all-site increase of malignancies in diabetes and elevated organ-specific cancer rate in diabetes as comorbidity. Additionally, we have discussed the possible pathophysiological mechanisms that likely may be involved in promoting carcinogenesis in diabetes and the potential of different antidiabetic therapies to influence cancer incidence.

Habib, Samy L.; Rojna, Maciej




PubMed Central

Introduccion La diabetes mellitus y las demencias constituyen dos problemas crecientes de salud entre la población adulta mayor del mundo y en particular de los paises en desarrollo. Hacen falta estudios longitudinales sobre el papel de la diabetes como factor de riesgo para demencia. Objetivo Determinar el riesgo de demencia en sujetos Mexicanos con diabetes mellitus tipo 2. Materiales y Metodos Los sujetos diabéticos libres de demencia pertenecientes al Estudio Nacional de Salud y Envejecimiento en México fueron evaluados a los dos años de la línea de base. Se estudió el papel de los factores sociodemográficos, de otras comorbilidades y del tipo de tratamiento en la conversión a demencia. Resultados Durante la línea de base 749 sujetos (13.8%) tuvieron diabetes. El riesgo de desarrollar demencia en estos individuos fue el doble (RR, 2.08 IC 95%, 1.59–2.73). Se encontró un riesgo mayor en individuos de 80 años y más (RR 2.44 IC 95%, 1.46–4.08), en los hombres (RR, 2.25 IC 95%, 1.46–3.49) y en sujetos con nivel educativo menor de 7 años. El estar bajo tratamiento con insulina incrementó el riesgo de demencia (RR, 2.83, IC 95%, 1.58–5.06). Las otras comorbilidades que aumentaron el riesgo de demencia en los pacientes diabéticos fueron la hipertensión (RR, 2.75, IC 95%, 1.86–4.06) y la depresión (RR, 3.78, 95% IC 2.37–6.04). Conclusión Los sujetos con diabetes mellitus tienen un riesgo mayor de desarrollar demencia, La baja escolaridad y otras comorbilidades altamente prevalentes en la población Mexicana contribuyen a la asociación diabetes-demencia.

Silvia, Mejia-Arango; Clemente, y Zuniga-Gil



Altered bile in diabetic diarrhoea.  

PubMed Central

The size and composition of the bile-salt pools in a group of diabetics with neuropathy but no diarrhoea and a group with "diabetic diarrhoea" were compared with those in a group of stable, uncomplicated diabetics. The diabetics with neuropathy had significantly more dihydroxy bile salts, a larger bile-salt pool, and a higher faecal excretion of bile than the controls. The diabetics with diarrhoea had significantly more dihydroxy bile salts, a higher glycine to taurine ratio, a smaller bile-salt pool, and increased excretions of 14C-tracer and total bile salts. We conclude that considerable alterations occur in the bile of diabetics with neuropathy or diarrhoea, and we suggest that in some cases at least these abnormalities may indicate a mechanism for diabetic diarrhoea.

Molloy, A M; Tomkin, G H



The Spectrum of Diabetic Neuropathies  

PubMed Central

Diabetes mellitus is associated with many different neuropathic syndromes, ranging from a mild sensory disturbance as can be seen in a diabetic sensorimotor polyneuropathy, to the debilitating pain and weakness of a diabetic lumbosacral radiculoplexus neuropathy. The etiology of these syndromes has been extensively studied, and may vary among metabolic, compressive, and immunological bases for the different disorders, as well as mechanisms yet to be discovered. Many of these disorders of nerve appear to be separate conditions with different underlying mechanisms, and some are directly caused by diabetes mellitus, whereas others are associated with it but not caused by hyperglycemia. We discuss a number of the more common disorders of nerve found with diabetes mellitus. We discuss the symmetrical neuropathies, particularly generalized diabetic polyneuropathy, and then the focal or asymmetrical types of diabetes-associated neuropathy.

Tracy, Jennifer A.; Dyck, P. James B.



78 FR 26641 - National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes Mellitus Interagency...  

Federal Register 2010, 2011, 2012, 2013

...and Kidney Diseases, Diabetes Mellitus Interagency...Workshop SUMMARY: The Diabetes Mellitus Interagency...DMICC) will hold a 2-day workshop on June...Executive Secretary of the Diabetes Mellitus Interagency...emerging opportunities for type 1 diabetes research...



Diabetes Report Card 2012: National and State Profile of Diabetes and Its Complications  


... Favorites Delicious Digg Google Bookmarks Diabetes Report Card 2012: National and State Profile of Diabetes and Its ... Campaign Materials Reports and Guides Diabetes Report Card 2012 Purpose of This Report Opportunities for Better Diabetes ...


Tips for Teens with Diabetes: Dealing with the Ups and Downs of Diabetes  


Tips for Teens with Diabetes: Dealing With the Ups and Downs of Diabetes Download This Publication (NDEP-81) Want this item now? Download it here: Tips for Teens with Diabetes: Dealing With the Ups and Downs of Diabetes ( ...


[The infected diabetic foot].  


Infections in the diabetic foot are regularly the consequence of neuropathic, ischemic, or combined neuropathic-ischemic ulcerations which cause substantial morbidity including a high rate of major amputations. Diabetic foot infections are responsible for substantially high costs of diabetic treatment and induce an increased rate of mortality. An early diagnosis on the basis of clinical presentation, laboratory results, and radiologic imaging together with an adequate classification of the severity of infection represents the key for a successful intervention strategy. Severe infections in diabetic feet have a poorer prognosis than mild or moderate infections. A guideline which includes a multifaceted approach to infection control by débridement, antibiotic therapy, and revascularization before definitive reconstruction of the defect may aid in reducing the risk of amputation and improving the quality of life and mobility of the patient. This can be realized by multidisciplinary cooperation. Additional preventive measures such as osseous and soft tissue reconstructions during the infection-free period to establish a plantigrade and ulcer-free foot together with education and routine follow-up controls provide the basis for a long-term reduction of ulcer and infection recurrence with progressive deterioration of the prognosis. PMID:21424434

Mittlmeier, T; Haar, P



The neuropathic diabetic foot  

Microsoft Academic Search

Diabetic foot problems are common throughout the world, and result in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are likely to be of neuropathic origin and, therefore, are eminently preventable. Individuals with the greatest risk of ulceration can easily be identified by careful clinical examination of their feet: education and frequent follow-up

Andrew JM Boulton; Haris M Rathur



Diabetic foot ulcers  

Microsoft Academic Search

In this review, we describe the epidemiology, pathogenesis, and management of diabetic foot ulceration, and its effect on patients and society. The condition deserves more attention, both from those who provide care and those who fund research. Epidemiology Incidence and prevalence Although accurate figures are difficult to obtain for the prevalence or incidence of foot ulcers, the results of cross-

William J Jeffcoate; Keith G Harding



Controversies around gestational diabetes  

Microsoft Academic Search

ABSTRACT OBJECTIVE To summarize some of the issues facing primary care physicians who are seeing increasing numbers of patients with gestational diabetes mellitus (GDM) and to explore new developments in use of oral hypoglycemics during pregnancy. QUALITY OF EVIDENCE All the literature on screening for GDM off ers level III evidence. Much of the literature on treatment is also level

Len Kelly; FCFP Laura Evans; MCP David Messenger


Vegetarian Diets and Diabetes  

Microsoft Academic Search

A large body of evidence suggests that vegetarian and plant-based diets provide exceptional health benefits, including a reduced risk of obesity, diabetes, heart disease and some types of cancer, and increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy

Kate Marsh; Jennie Brand-Miller



Management of diabetic gastroparesis.  


Symptoms suggestive of gastroparesis occur in 5% to 12% of patients with diabetes. Such a complication can affect both prognosis and management of the diabetes; therefore, practicing clinicians are challenged by the complex management of such cases. Gastroparesis is a disorder characterized by a delay in gastric emptying after a meal in the absence of a mechanical gastric outlet obstruction. This article is an evidence-based overview of current management strategies for diabetic gastroparesis. The cardinal symptoms of diabetic gastroparesis are nausea and vomiting. Gastroesophageal scintiscanning at 15-minute intervals for 4 hours after food intake is considered the gold standard for measuring gastric emptying. Retention of more than 10% of the meal after 4 hours is considered an abnormal result, for which a multidisciplinary management approach is required. Treatment should be tailored according to the severity of gastroparesis, and 25% to 68% of symptoms are controlled by prokinetic agents. Commonly prescribed prokinetics include metoclopramide, domperidone, and erythromycin. In addition, gastric electrical stimulation has been shown to improve symptoms, reduce hospitalizations, reduce the need for nutritional support, and improve quality of life in several open-label studies. PMID:21372345

Aljarallah, Badr M


Diabetic Wound Care  


... in the appropriate treatment of a diabetic foot ulcer: Prevention of infection Taking the pressure off the area, called “off-loading” Removing dead skin and tissue, called “debridement” Applying medication or dressings to the ulcer Managing blood glucose and other health problems Not ...


Diabetes: The Science Inside  

NSDL National Science Digital Library

The purpose of this book is to provide basic information about type 2 diabetes: what causes it, how it affects the body, and how it can be prevented and treated. Supported byScience Education Partnership Award (SEPA)from the National Center for Research Resources Grant # 5R25RR15601.

Healthy People Library Project;



Vitamin D and diabetes  

Technology Transfer Automated Retrieval System (TEKTRAN)

On the basis of evidence from animal and human studies, vitamin D has emerged as a potential risk modifier for type 1 and type 2 diabetes (t1DM and t2DM). Vitamin D is thought to have both direct (through activation of the vitamin D receptor) and indirect (via regulation of calcium homeostasis) eff...


Management of diabetic hypertensives  

PubMed Central

Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP) reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives.

Ganesh, Jai; Viswanathan, Vijay



Diabetes and Inflammation  

Microsoft Academic Search

In the last 50 years health care systems throughout the world have faced a new epidemic dual disease: cardiovascular disease (CVD)-diabetes mellitus. Nowadays, CVD is the leading cause of death in all western countries, and 60% of deaths for ischemic heart disease and stroke occur in developing countries with fixing resources. The striking association between CAD, stroke, peripheral artery disease

Francesco Cosentino; Gabriele Egidy Assenza



Diabetes and Behavior.  

ERIC Educational Resources Information Center

|Suggests that the problem of effective care of diabetes mellitus presents an opportunity for the emerging field of health psychology. Discusses behavioral interventions that aid in treatment of this disease by reducing its energy mobilizing effects on the nervous system. (Author/AOS)|

Surwit, Richard S.; And Others



Surgery for Diabetic Retinopathy  

Microsoft Academic Search

Surgery for diabetic retinopathy addresses late secondary complications of a primary microvascular disease. Since surgery is not a causative therapy, the functional outcome of surgery depends on the degree of retinal ischemia and may be disappointing even in technically and anatomically successfully operated eyes. Typical indications for vitrectomy are vitreous hemorrhage, tractional retinal detachment, combined tractional rhegmatogenous retinal detachment and

Horst Helbig



Ghrelin, obesity and diabetes  

Microsoft Academic Search

The high prevalence of obesity and diabetes will lead to higher rates of morbidity and mortality. The search for drugs to treat these metabolic disorders has, therefore, intensified. The stomach-derived peptide ghrelin regulates food intake and body weight. Recent work suggests that ghrelin also controls glucose metabolism. In addition, current evidence suggests that most of the actions of ghrelin could

Petra Wiedmer; Rubén Nogueiras; Fabio Broglio; David D'Alessio; Matthias H Tschöp



Kidney Disease of Diabetes.  

National Technical Information Service (NTIS)

Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD). Diabetes is the most co...



Diabetes: Eat Right  


... Right - Other Resources Take Charge of Your Diabetes The Eagle Books – for kids Email page link Print page Get e-mail Updates Subscribe to RSS Listen to audio/Podcast View page in: Español (Spanish) Contact Us: Centers for Disease Control and Prevention 1600 Clifton ...


Painful diabetic neuropathy management.  


Diabetic neuropathy is the most common complication of diabetes as it affects a significant number of patients. The management of patients with diabetic neuropathy is complicated by several factors including the varied symptoms and response to the various treatments available. Strict blood glucose control remains the key to the management thus far nonetheless; it is associated with complications such as hypoglycaemia. In order to provide the most up-to-date evidence-based clinical recommendations pertinent to the management of diabetic neuropathy, several databases and clinical practice guidelines were searched for this evidence-based report. The main outcome measures are reduction in pain associated with diabetic neuropathy and the number of withdrawal rates due to adverse effects of the medications both of which are discussed in this report. Various pharmacological and non-pharmacological treatments are available with varying degrees of success in pain relief. The current evidence suggests that use of tricyclics antidepressants and conventional anticonvulsants for the short term of pain relief is beneficial. Combination therapy of opioids and anticonvulsants has also been found to be superior to monotherapy. Other treatment modalities such as the use of alpha-lipoic acid as an antioxidant and evening primrose oil through increased PGE1 synthesis have also been trialled with evidence of improvement in neuropathic pain. Evidence also supports non-pharmacological treatment such as the use of percutaneous electrical nerve stimulation. There is a scope for further improvement of the reporting of rating pain scales and including various outcomes measures such as quality of life and physical function when trialling new therapies for better evaluation of future treatments. PMID:23448333

Khalil, Hanan



Nutrition Recommendations and Interventions for Diabetes–2006  

Technology Transfer Automated Retrieval System (TEKTRAN)

Medical nutrition therapy (MNT) is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing, the rate of development of diabetes complications. It is, therefore, important at all levels of diabetes prevention. MNT is also an integral component of diabetes sel...


What the Teacher Should Know About Diabetes.  

ERIC Educational Resources Information Center

|This short manual is designed to provide the practicing teacher with basic information on diabetes, and the role (s)he plays in providing health supervision and care for the diabetic child in his/her classroom. The document consists of four pages, describing (1) components of diabetes management and symptoms of diabetes; (2) emergency diabetic

Johnston, Harriet, Ed.; Rolloff, Charlene, Ed.


Ageing and diabetes: implications for brain function  

Microsoft Academic Search

Diabetes mellitus is associated with moderate cognitive deficits and neurophysiological and structural changes in the brain, a condition that may be referred to as diabetic encephalopathy. Diabetes increases the risk of dementia, particularly in the elderly. The emerging view is that the diabetic brain features many symptoms that are best described as “accelerated brain ageing.” The clinical characteristics of diabetic

Geert Jan Biessels; Lars P van der Heide; Amer Kamal; Ronald L. A. W Bleys; Willem Hendrik Gispen



Gestational Diabetes Mellitus: A Positive Predictor of Type 2 Diabetes?  

PubMed Central

The aim of this paper is to consider the relative benefits of screening for type two diabetes mellitus in women with a previous pregnancy complicated by gestational diabetes mellitus. Recent studies suggest that women who experience GDM are at a greater risk of developing type 2 diabetes within 10–20 years of their index pregnancy. If considered as a stand-alone indicator of the risk of developing type 2 diabetes, GDM is a poor diagnostic test. Most women do not develop GDM during pregnancy and of those that do most do not develop type 2 diabetes. There is, however, a clear need for better early detection of predisposition to disease and/or disease onset to significantly impact on this global pandemic. The putative benefits of multivariate approaches and first trimester and preconception screening to increase the sensitivity of risk assignment modalities for type 2 diabetes are proposed.

Rice, Gregory E.; E. Illanes, Sebastian; Mitchell, Murray D.



MicroRNAs in diabetes and diabetes-associated complications.  


Diabetes mellitus due to its high prevalence and associated complications is a major socioeconomic health problem. Diabetes is characterized by multiple macro- and microvascular complications (e.g. diabetic nephropathy, cardiomyopathy, neuropathy, retinopathy). Research efforts aim to elucidate pathophysiological mechanisms contributing to the disease process. MicroRNAs are endogenous small single stranded molecules regulating targets through mRNA cleavage or translational inhibition. MicroRNAs regulate many biological cellular functions and are often deregulated during diseases. The aim of the present article is to summarize the current knowledge of the impact of microRNAs on the development of diabetes and its associated complications including endothelial and vascular smooth muscle cell dysfunction, diabetic cardiomyopathy, diabetic nephropathy, regulation of pancreatic beta cell function as well as skeletal muscle and hepatic involvement. PMID:22664916

Lorenzen, Johan; Kumarswamy, Regalla; Dangwal, Seema; Thum, Thomas



Living With Diabetes: The Role of Diabetes Education  

Microsoft Academic Search

Living with diabetes can be challenging. The treatment is complex with significant lifestyle demands and fearsome acute and\\u000a chronic complications. Both the disease and its treatment can impact the family as well as the person with diabetes. Many\\u000a physicians, other health care professionals, and payors recognize the importance of diabetes education in supporting people\\u000a in the efforts to realize treatment

Katie Weinger; Ashley Leighton


The Diabetes Prevention Program  

PubMed Central

OBJECTIVE The Diabetes Prevention Program (DPP) is a 27-center randomized clinical trial designed to evaluate the safety and efficacy of interventions that may delay or prevent development of diabetes in people at increased risk for type 2 diabetes. RESEARCH DESIGN AND METHODS Eligibility requirements were age ?25 years, BMI ?24 kg/m2 (?22 kg/m2 for Asian-Americans), and impaired glucose tolerance plus a fasting plasma glucose of 5.3–6.9 mmol/l (or ?6.9 mmol for American Indians). Randomization of participants into the DPP over 2.7 years ended in June 1999. Baseline data for the three treatment groups—intensive lifestyle modification, standard care plus metformin, and standard care plus placebo—are presented for the 3,234 participants who have been randomized. RESULTS Of all participants, 55% were Caucasian, 20% were African-American, 16% were Hispanic, 5% were American Indian, and 4% were Asian-American. Their average age at entry was 51 ± 10.7 years (mean ± SD), and 67.7% were women. Moreover, 16% were <40 years of age, and 20% were ?60 years of age. Of the women, 48% were postmenopausal. Men and women had similar frequencies of history of hypercholesterolemia (37 and 33%, respectively) or hypertension (29 and 26%, respectively). On the basis of fasting lipid determinations, 54% of men and 40% of women fit National Cholesterol Education Program criteria for abnormal lipid profiles. More men than women were current or former cigarette smokers or had a history of coronary heart disease. Furthermore, 66% of men and 71% of women had a first-degree relative with diabetes. Overall, BMI averaged 34.0 ± 6.7 kg/m2 at baseline with 57% of the men and 73% of women having a BMI ?30 kg/m2. Average fasting plasma glucose (6.0 ± 0.5 mmol/l) and HbA1c (5.9 ± 0.5%) in men were comparable with values in women (5.9 ± 0.4 mmol/l and 5.9 ± 0.5%, respectively). CONCLUSIONS The DPP has successfully randomized a large cohort of participants with a wide distribution of age, obesity, and ethnic and racial backgrounds who are at high risk for developing type 2 diabetes. The study will examine the effects of interventions on the development of diabetes.



Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan  

Microsoft Academic Search

Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan.BackgroundWhether the type of diabetes, race, and year and age of diagnosis affect the incidence of diabetic vascular complications is unknown. That both type 1 and type 2 diabetes occur in the young Japanese population prompted us to investigate whether the type of

Hiroki Yokoyama; Maki Okudaira; Toshika Otani; Akiko Sato; Junnoske Miura; Hiroko Takaike; Hitomi Yamada; Kazuko Muto; Yasuko Uchigata; Yasuo Ohashi; Yasuhiko Iwamoto



[Syndrome of optic nerve atrophy, diabetes mellitus and diabetes insipidus].  


The paper is concerned with a case of a familial variant of the hereditary De Lawter syndrome, optic nerve atrophy coupled with diabetes mellitus and insipidus. Double diabetes was detected in two brothers. Their uncle suffered from deaf-mutism. Diabetes mellitus was insulin-dependent, diabetes insipidus responded well to adiurekrin, pituitrin, chloropropamide; optic nerve atrophy was characterized by white discs with clearly defined borders. Apparently, the syndrome is based on several mutant genes the action of which manifests as isolated and in different combinations as well. PMID:2084933

Kolomo?skaia, M B



Diabetes in the competitive athlete.  


Diabetes mellitus is the most common group of metabolic diseases and is characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Most patients with diabetes are type 2 (90%); the remaining patients have type 1 disease. Athletes with diabetes range from the athlete participating in various youth sports to the competitive Olympic athlete and present a significant challenge to themselves and the medical staff who care for them on a daily basis. Each sport and the type of exercise have their own effects on diabetes management with numerous factors that significantly affect glucose levels, including stress, level of hydration, the rate of glycogenolysis and gluconeogenesis, and the secretion of counter-regulatory hormones. This article provides a general overview of diabetes mellitus, the effects of exercise on glucose levels, and a detailed review of the potential complications encountered in the management of diabetes in the athlete. PMID:23147019

Harris, George D; White, Russell D


Research updates on type 2 diabetes children.  


Major research trials have provided insight into the scope of type 2 diabetes in youth. The National Diabetes Education Program offers resources to help school nurses support children with or at risk for type 2 diabetes. PMID:23767228

Linder, Barbara; Imperatore, Giuseppina



Genetics Home Reference: Type 1 diabetes  


... literature OMIM Genetic disorder catalog Conditions > Type 1 diabetes On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed March 2013 What is type 1 diabetes? Type 1 diabetes is a disorder characterized by ...


A1C Test and Diabetes  


National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ...


Living Your Best Life: Diabetes and Insulin  

MedlinePLUS Videos and Cool Tools

... . Living Your Best Life: Diabetes and Insulin The Endocrine System | What is an ... a diabetes educator here . Living Your Best Life: Diabetes and Insulin What other topics would you find ...


Sexual and Urologic Problems of Diabetes  


National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ...


Prevent Diabetes Problems: Keep Your Eyes Healthy  


National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ...


Gestational Diabetes: What You Need to Know  


National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ...


Genetics Home Reference: Neurohypophyseal diabetes insipidus  


... Recent literature OMIM Genetic disorder catalog Conditions > Neurohypophyseal diabetes insipidus On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed April 2010 What is neurohypophyseal diabetes insipidus? Neurohypophyseal diabetes insipidus is a disorder of ...


Discussing Diabetes with Your Healthcare Provider  


... of this page please turn Javascript on. Feature: Diabetes Discussing Diabetes with Your Healthcare Provider Past Issues / Fall 2009 Table of Contents Diabetes Medicines—Always Discuss Them with Your Healthcare Provider ...


Genetics Home Reference: Permanent neonatal diabetes mellitus  


... literature OMIM Genetic disorder catalog Conditions > Permanent neonatal diabetes mellitus On this page: Description Genetic changes Inheritance ... definitions Reviewed July 2011 What is permanent neonatal diabetes mellitus? Permanent neonatal diabetes mellitus is a type ...


Genetics Home Reference: Nephrogenic diabetes insipidus  


... Recent literature OMIM Genetic disorder catalog Conditions > Nephrogenic diabetes insipidus On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed April 2010 What is nephrogenic diabetes insipidus? Nephrogenic diabetes insipidus is a disorder of ...


Long-Term Complications of Diabetes  


... shoes or because you've had a minor sports injury, you should tell your doctor. To prevent ... More Common in People With Type 1 Diabetes Sports, Exercise, and Diabetes Weight and Diabetes When Being ...


Type 2 Diabetes: What Is It? (For Parents)  


Type 2 Diabetes: What Is It? KidsHealth > Parents > Diseases & Conditions > Endocrine Glands, Growth & Diabetes > Type 2 Diabetes: What Is It? Print ... in learning to live with the disease. About Diabetes Diabetes is a disease that affects how the ...


Matters of the Heart: Support a Loved One with Diabetes  


... of the Heart: Support a Loved One with Diabetes By the National Diabetes Education Program Diabetes is ... a stroke, or other problems. Understand your sweetheart’s diabetes . Each person’s experience with diabetes is different. Learn ...


Gestational Diabetes: A Review  

PubMed Central

Gestational diabetes mellitus is a relatively common complication of pregnancy. The incidence varies from 1.6% to 13%, depending on the criteria used for evaluating glucose tolerance in studies where universal screening was employed. The glucose-challenge screening test produces many false-positive results; the patients thus identified are then subjected to further unpleasant oral glucose-tolerance tests to make the diagnosis. The diagnosis labels many pregnant patients as “high risk” and exposes them to a cascade of interventions. The author examines the basis in the literature for universal screening practices. The recommendations of the Second International Workshop-Conference on Gestational Diabetes Mellitus are presented. The author discusses risks and benefits of alternative screening approaches, diagnosis, control, and reviews the current literature.

Levitt, Cheryl



Neonatal Diabetes Mellitus  

PubMed Central

An explosion of work over the last decade has produced insight into the multiple hereditary causes of a nonimmunological form of diabetes diagnosed most frequently within the first 6 months of life. These studies are providing increased understanding of genes involved in the entire chain of steps that control glucose homeostasis. Neonatal diabetes is now understood to arise from mutations in genes that play critical roles in the development of the pancreas, of ?-cell apoptosis and insulin processing, as well as the regulation of insulin release. For the basic researcher, this work is providing novel tools to explore fundamental molecular and cellular processes. For the clinician, these studies underscore the need to identify the genetic cause underlying each case. It is increasingly clear that the prognosis, therapeutic approach, and genetic counseling a physician provides must be tailored to a specific gene in order to provide the best medical care.

Aguilar-Bryan, Lydia; Bryan, Joseph



Diabetes: An Investor's Perspective  

PubMed Central

Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise. Moreover, the baby boomer demographic is anticipated to place an enormous burden on the health care system and employer-based health insurance premiums were increased at rates as high as 10% per year in 2006. The quest to address these challenges has also created opportunities for investment, particularly in the fields of telemedicine, health care information technology, and medical technology. The author shares his business perspective, informed by years of experience as a physician and astronaut at NASA, and describes new applications of exciting technologies that deliver effective and efficient health care to diabetes patients, no matter where they may be.

Harris, Bernard



Cardiac Surgery and Diabetes Mellitus  

Microsoft Academic Search

Diabetes mellitus (DM) is an established risk factor for the development and progression of cardiovascular disease (CVD).\\u000a The prevalence of coronary artery disease (CAD) has been estimated as high as 55% in the diabetic population. It has been\\u000a shown that diabetes is a major independent risk factor for CVD after adjustment for risk factors such as age, hypertension,\\u000a hypercholesterolemia, and

Tanveer A. Khan; Pierre Voisine; Frank W. Sellke


Hypoglycemia, Diabetes, and Cardiovascular Disease  

PubMed Central

Abstract Cardiovascular disease (CVD) remains the leading cause of death in people with diabetes, and the risk of CVD for adults with diabetes is at least two to four times the risk in adults without diabetes. Complications of diabetes, including not only CVD but also microvascular diseases such as retinopathy and nephropathy, are a major health and financial burden. Diabetes is a disease of glucose intolerance, and so much of the research on complications has focused on the role of hyperglycemia. Clinical trials have clearly demonstrated the role of hyperglycemia in microvascular complications of diabetes, but there appears to be less evidence for as strong of a relationship between hyperglycemia and CVD in people with diabetes. Hypoglycemia has become a more pressing health concern as intensive glycemic control has become the standard of care in diabetes. Clinical trials of intensive glucose lowering in both type 1 and type 2 diabetes populations has resulted in significantly increased hypoglycemia, with no decrease in CVD during the trial period, although several studies have shown a reduction in CVD with extended follow-up. There is evidence that hypoglycemia may adversely affect cardiovascular risk in patients with diabetes, and this is one potential explanation for the lack of CVD prevention in trials of intensive glycemic control. Hypoglycemia causes a cascade of physiologic effects and may induce oxidative stress and cardiac arrhythmias, contribute to sudden cardiac death, and cause ischemic cerebral damage, presenting several potential mechanisms through which acute and chronic episodes of hypoglycemia may increase CVD risk. In this review, we examine the risk factors and prevalence of hypoglycemia in diabetes, review the evidence for an association of both acute and chronic hypoglycemia with CVD in adults with diabetes, and discuss potential mechanisms through which hypoglycemia may adversely affect cardiovascular risk.

Wadwa, R. Paul



Proteasome activity in experimental diabetes  

Microsoft Academic Search

Numerous studies have indicated that oxidative stress contributes to the development and progression of diabetes and other\\u000a related complications. Since the ubiquitin-proteasome pathway is involved in degradation of oxidized proteins, it is to be\\u000a expected that alterations in proteasome-dependent proteolysis accompany diabetes. This paper focuses on the role of the proteasome\\u000a in alloxan-induced experimental diabetes. The changes in proteasomal activity

Albena Alexandrova; Lubomir Petrov; Margarita Kirkova



Imaging of the Diabetic Foot  

Microsoft Academic Search

Foot infections are among the most common causes of hospitalization in the diabetic population, accounting for 20% of all\\u000a diabetes-related admissions. Complicated foot infections may require treatment by amputation—as many as 6–10% of all patients\\u000a with diabetes will undergo amputation for treatment of infection (1–3), accounting for 57% of nontraumatic lower extremity amputations (4–6). The scope of the problem is

Mary G. Hochman; Yvonne Cheung; David P. Brophy; J. Anthony Parker


Blood groups and diabetes mellitus  

PubMed Central

Eight hundred and sixty-five patients with diabetes mellitus showed ABO blood group frequencies closely similar to those expected from the controls. Six hundred and sixteen patients with diabetes mellitus showed frequencies of secretion and non-secretion of the ABH(O) substances in the saliva closely similar to those expected from the controls. Four hundred and fifty-three patients with diabetes mellitus gave MN blood group frequencies very similar to those expected from the controls.

Macafee, A. L.



Contraception for Women with Diabetes  

Microsoft Academic Search

\\u000a Today, diabetic women have an increasing variety of safer and effective contraceptive methods. While more contraceptive trials\\u000a in diabetic women are needed, data from existing studies and extrapolation from clinical trials in healthy women support the\\u000a use of most contraceptive methods. This chapter will review contraception in women with type 1 (DM1) and type 2 (DM2) diabetes\\u000a mellitus, with or

Siri L. Kjos


Diabetic Foot Ulcers  

Microsoft Academic Search

The Wagner system describes the diabetic foot ulcer as a full thickness wound extending to tendons or deeper subcutaneous\\u000a tissue but without bony involvement or osteomyelitis [1]. The university of Texas system refers to levels of ischemia [2]\\u000a and infection while the SAD system [3] attends to size, area, depth, arteriopathy and any neuropathic involvement. The breadth\\u000a of classification system

Andrew Boulton; Frank Bowling


Diabetes and Oxidant Stress  

Microsoft Academic Search

Diabetes is associated with chronic micro- and macrovascular complications. Oxidative stress has been defined as ‘a “shift\\u000a in the pro-oxidant – antioxidant balance in the pro-oxidant direction’.” Oxidant stress may initiate and exacerbate vascular\\u000a (endothelial) damage through excess production of reactive oxygen species, depletion of nitric oxide, and damage to lipids,\\u000a proteins, and DNA. Experimental results and theoretical constructs suggest

Alicia J. Jenkins; Michael A. Hill; Kevin G. Rowley


[The diabetic foot].  


Problems of the diabetic foot are frequent. The magnitude of the clinical picture and morbidity mirrors the severity and complexity of the underlying pathobiology. The three pathogenetic mechanism involved are ischemia, neuropathy and infection. Seldom do these mechanisms work in isolation, rather most foot problems result from a complex interplay among all three. The clinical picture of the diabetic foot reaches from the neuropathic deformity with diminished or absent sensation of pain to limited gangrene or superficial ulcer. The polymicrobial infection leads to extensive tissue destruction (plantarphlegmone) with osteomyelitis. The patients often notes no pain and may become aware of the infection only through the presence of drainage or a foul odor. These infections are usually more extensive than would be predicted by clinical signs and symptoms. These lesions must be debrided and drained promptly and completely. This often requires amputations of one or more toes, combined with an incision along the entire course of the infected track on the plantar or dorsal aspect of the foot. Cultures should be taken from the depth of the wound. Initial treatment should be with broad-spectrum antibiotics, with subsequent adjustment based on culture results. The diabetic foot is a clinical problem that can be solved with a high degree of success when the approached by an interdisciplinary team (specialists in infectious and vascular disease, podiatry and diabetology). Arterial reconstruction should be designed to restore maximum perfusion to the foot. The most effective result can be obtained with infra-inguinal vein bypass with distal anastomosis to the most proximal artery with direct continuity to the ischemic territory. The single most important factor in the achievement of the reduction of amputation is the autologous vein bypass. The overall outcome in the diabetic patient in terms of graft patency and limb salvage is equal to that in the nondiabetic. PMID:9828701

Stirnemann, P; Z'Brun, A; Brunner, D



Idiopathic and diabetic gastroparesis  

Microsoft Academic Search

Opinion statement  The management of both diabetic and idiopathic gastroparesis often represents a substantial clinical challenge. In formulating\\u000a recommendations for therapy, it should be recognized that these are based on less than optimal evidence; in particular, there\\u000a are substantial deficiencies in current knowledge relating to the pathophysiology of gastroparesis, as well as the natural\\u000a history of gastrointestinal symptoms, and the majority

Deirdre O’Donovan; Christine Feinle-Bisset; Karen Jones; Michael Horowitz



Diabetic gastroparesis: Therapeutic options  

Microsoft Academic Search

Gastroparesis is a condition characterized by delayed gastric emptying and the most common known underlying cause is diabetes\\u000a mellitus. Symptoms include nausea, vomiting, abdominal fullness, and early satiety, which impact to varying degrees on the\\u000a patient’s quality of life. Symptoms and deficits do not necessarily relate to each other, hence despite significant abnormalities\\u000a in gastric emptying, some individuals have only

Uazman Alam; Omar Asghar; Rayaz Ahmed Malik



Type 1 Diabetes Mellitus  

Microsoft Academic Search

Autoimmune diseases affect 10% or more of the North American and European populations. In organ-specific autoimmune diseases,\\u000a an organ is targeted by an aggressive immune response, which can damage and even destroy it. Type 1 diabetes mellitus (T1DM),\\u000a one such organ-specific autoimmune disease, is because of the destruction of the insulin-secreting beta cells in the islets\\u000a of Langerhans of the

Huriya Beyan; R. David G. Leslie


Diabetic ketoacidosis following mumps.  


A-13-year-old girl presented with diabetic ketoacidosis with convincing clinical signs of parotitis (fever, drooling of saliva, inability to swallow with development of bilateral parotid swelling) and pancreatitis (fever, abdominal pain and vomiting), along with high serum amylase and positive mumps IgM titer. This suggests that mumps virus may have been the causative factor, probably as a result of concomitant involvement of the pancreas. PMID:23255702

Agrawal, Manish; Goel, S P; Prakash, Ashish



Obesity and Diabetes Epidemics  

Microsoft Academic Search

The prevalence of overweight (body mass index, BMI, between 25 and 30 kg\\/m2) and obesity (BMI of 30 kg\\/m2 or higher) is increasing rapidly worldwide, especially in developing countries and countries undergoing economic transition\\u000a to a market economy. One consequence of obesity is an increased risk of developing type II diabetes.\\u000a \\u000a Overall, there is considerable evidence that overweight and obesity

Anette Hjartåker; Hilde Langseth; Elisabete Weiderpass


Gestational diabetes survey  

Microsoft Academic Search

OBJECTIVE: Our purpose was to determine how residents in obstetrics and gynecology and fellows in maternal-fetal medicine are currently being trained to diagnose and manage gestational diabetes mellitus.STUDY DESIGN: Questionnaire were mailed to 202 obstetrics and gynecology residency program directors and 78 maternal-fetal medicine fellowship directors.RESULTS: Sixty-four (82%) of the maternal-fetal medicine directors versus 142 (70%) of the residency directors

John Owen; T. Phelan; Mark B. Landon; Steven G. Gabbe



Pirfenidone for Diabetic Nephropathy  

PubMed Central

Pirfenidone is an oral antifibrotic agent that benefits diabetic nephropathy in animal models, but whether it is effective for human diabetic nephropathy is unknown. We conducted a randomized, double-blind, placebo-controlled study in 77 subjects with diabetic nephropathy who had elevated albuminuria and reduced estimated GFR (eGFR) (20 to 75 ml/min per 1.73 m2). The prespecified primary outcome was a change in eGFR after 1 year of therapy. We randomly assigned 26 subjects to placebo, 26 to pirfenidone at 1200 mg/d, and 25 to pirfenidone at 2400 mg/d. Among the 52 subjects who completed the study, the mean eGFR increased in the pirfenidone 1200-mg/d group (+3.3 ± 8.5 ml/min per 1.73 m2) whereas the mean eGFR decreased in the placebo group (?2.2 ± 4.8 ml/min per 1.73 m2; P = 0.026 versus pirfenidone at 1200 mg/d). The dropout rate was high (11 of 25) in the pirfenidone 2400-mg/d group, and the change in eGFR was not significantly different from placebo (?1.9 ± 6.7 ml/min per 1.73 m2). Of the 77 subjects, 4 initiated hemodialysis in the placebo group, 1 in the pirfenidone 2400-mg/d group, and none in the pirfenidone 1200-mg/d group during the study (P = 0.25). Baseline levels of plasma biomarkers of inflammation and fibrosis significantly correlated with baseline eGFR but did not predict response to therapy. In conclusion, these results suggest that pirfenidone is a promising agent for individuals with overt diabetic nephropathy.

Ix, Joachim H.; Mathew, Anna V.; Cho, Monique; Pflueger, Axel; Dunn, Stephen R.; Francos, Barbara; Sharma, Shoba; Falkner, Bonita; McGowan, Tracy A.; Donohue, Michael; RamachandraRao, Satish; Xu, Ronghui; Fervenza, Fernando C.; Kopp, Jeffrey B.



Diabetes in pregnancy 1985  

Microsoft Academic Search

The art of obstetrics is not a subject which is often discussed in the pages ofDiabetologia. However, as the care of the diabetic mother and her offspring is rightly an interdisciplinary responsibility between obstetrician,\\u000a diabetologist and neonatologist, it is important that each has s. close understanding of the various problems. Dr. M.I. Drury\\u000a (Dublin), speaking as an internist, raises a

D. R. Hadden



Cell transplantation for diabetes  

PubMed Central

For 30 years there has been experimental work aimed at transplanting islets for the treatment of diabetes with a view to curing the disease and preventing the secondary complications. Many technical difficulties were experienced, first in isolating the islets without damaging them, and second in finding a suitable place to inject them, but until recently the results of a vascularized pancreas transplant have been superior to islet transplantation. In 2000, the group in Edmonton, headed by Shapiro, published encouraging results using a different immunosuppression in transplanting patients earlier in the course of their disease than had been attempted previously. The results were excellent at a year and good at 2 years in patients with Type I diabetes, however there was the rather worrying attrition at five years. Nevertheless, the Edmonton observations were proof of concept and have intensified interest in treating diabetes and other diseases where a specific protein synthesis was required by cell transplantation and/or genetic engineering. The recent interest in embryonic stem cells extenuated these efforts and progress is being made in defining the difficulties, which are greater than most workers would have predicted. In this review, the subject is discussed explaining where progress needs to be made in order to provide treatment that would be of value to patients.

Calne, Roy



The Charcot Foot in Diabetes  

PubMed Central

The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity.

Rogers, Lee C.; Frykberg, Robert G.; Armstrong, David G.; Boulton, Andrew J.M.; Edmonds, Michael; Van, Georges Ha; Hartemann, Agnes; Game, Frances; Jeffcoate, William; Jirkovska, Alexandra; Jude, Edward; Morbach, Stephan; Morrison, William B.; Pinzur, Michael; Pitocco, Dario; Sanders, Lee; Wukich, Dane K.; Uccioli, Luigi



New concepts in diabetic embryopathy.  


Diabetes mellitus is responsible for nearly 10% of fetal anomalies in diabetic pregnancies. Although aggressive perinatal care and glycemic control are available in developed countries, the birth defect rate in diabetic pregnancies remains higher than that in the general population. Major cellular activities (ie, proliferation and apoptosis) and intracellular metabolic conditions (ie, nitrosative, oxidative, and endoplasmic reticulum stress) have been shown to be associated with diabetic embryopathy using animal models. Translating advances made in animal studies into clinical applications in humans requires collaborative efforts across the basic research, preclinical, and clinical communities. PMID:23702113

Zhao, Zhiyong; Reece, E Albert



Dental findings in diabetic adults.  


The dental status of dentate diabetic adults (n = 299) and its associations with diabetes-related factors was explored in Tehran, Iran. Presence of diabetes-related complications made no difference in mean values of DMFT, but was associated with a higher number of decayed and missing teeth, and fewer filled teeth. Higher level of HbA1c was associated with higher DMFT for men, but not for women. In conclusion, the results suggest a possible association between the level of metabolic control of diabetes mellitus and cumulative caries experience. PMID:18042985

Bakhshandeh, S; Murtomaa, H; Vehkalahti, M M; Mofid, R; Suomalainen, K



Help Prevent Diabetes with Exercise  

NSDL National Science Digital Library

This animated video segment adapted from the Centers for Disease Control and Prevention, featuring American Indian characters, explains how children can help prevent diabetes through regular physical activity.

Foundation, Wgbh E.



Thermal burns in diabetic feet.  


Many patients with diabetes can lead a full life without developing diabetic lesions in their feet. This is because these patients have avoided the precipitating factors of which the most important is mechanical trauma and infections. We present five cases of diabetic patients who, out of ignorance, listened to bad advice by using hot therapy to treat their peripheral neuropathy. This resulted in burns and secondary infections. All of them required large surgical debridement and prolonged costly hospital stay to treat their condition. Fortunately, none of them required amputation. This paper hopes to highlight the dangers of self treatment and medication in diabetic foot lesions. PMID:10489498

Thng, P; Lim, R M; Low, B Y



The Diabetes Pearl: Diabetes biobanking in The Netherlands  

PubMed Central

Background Type 2 diabetes is associated with considerable comorbidity and severe complications, which reduce quality of life of the patients and require high levels of healthcare. The Diabetes Pearl is a large cohort of patients diagnosed with type 2 diabetes, covering different geographical areas in the Netherlands. The aim of the study is to create a research infrastructure that will allow the study of risk factors, including biomarkers and genetic determinants for severe diabetes complications. Methods/design Baseline examinations began November 2009 and will continue through 2012. By the end of 2012, it is expected that 7000 patients with type 2 diabetes will be included in the Diabetes Pearl cohort. To ensure quality of the data collected, standard operation procedures were developed and used in all 8 recruitment centers. From all patients who provide informed consent, the following information is collected: personal information, medication use, physical examination (antropometry, blood pressure, electrocardiography (ECG), retina photographs, ankle-brachial index, peripheral vibration perception), self-report questionnaire (socio-economic status, lifestyle, (family) history of disease, and psychosocial well-being), laboratory measurements (glucose, A1c, lipid profile, kidney function), biobank material (storage of urine and blood samples and isolated DNA). All gathered clinical data and biobank information is uploaded to a database for storage on a national level. Biobanks are maintained locally at all recruitment centers. Discussion The Diabetes Pearl is large-scale cohort of type 2 diabetes patients in the Netherlands aiming to study risk factors, including biomarkers and genetic markers, for disease deterioration and the development of severe diabetes complications. As a result of the well-designed research design and the national coverage, the Diabetes Pearl data can be of great value to national and international researchers with an interest in diabetes related research.



[Drug-induced diabetes].  


A carbohydrate disturbance or diabetogenic effect may occur even in people with normal metabolism as an undesired side effect with a great number of drugs. According to present nomenclature a distinction should be made between a "decrease of glucose tolerance" and the appearance of a (manifest) "diabetes mellitus." Instead the term "borderline diabetes" is often used in American literature. Particularly with already existing glucose tolerance disturbances, or hereditary disposition, a further deterioration can lead to diabetes mellitus that may not always disappear after discontinued use of the drug. In this context, the glucocorticoids, the saluretics and the oral contraceptives have special clinical interest. In a table are listed several drugs having a minor, or only sporadically observed, or questionably unfavorable influence on glucose tolerance. Some contain diabetogenic toxins and chemical substances that are used for experimental diabetes inducement (in animals). Extensive literature concerning the influence of female sexual hormones or oral contraceptives on the carbohydrate metabolism seems contradictory. Several mechanisms are discussed: peripheral insulin resistance, increased secretion of growth hormones and insulin, increased peripheral insulin decomposition, and inhibition of glucose decomposition via the pentose-phosphatic shunt. Glucose tolerance disturbances caused by oral contraceptives are described by some authors as occurring in 25% to 75% of all cases. Other authors found no or only rarely such an effect. The composition of the test group, the kind of ovulatory inhibitor, and the length of usage period evidently play a great role. Earlier, the estrogens, especially for higher dosages, were attributed a diabetogenic effect. However, lately the gestagens have come more to the fore. After many years of pill usage, a greater incidence of pathological glucose tolerance was registered for combination than for sequential preparations. It would appear that for (younger) diabetics (without late complications) that the most suitable contraceptive should consist of a sequential preparation with a low estrogen admixture (below 50 mg). Which gestagen and which dosage would result in the smallest long-term effect on glucose tolerance remains to be clarified. PMID:2894732

Schatz, H



Idiopathic and Diabetic Gastroparesis.  


The management of both diabetic and idiopathic gastroparesis often represents a substantial clinical challenge. In formulating recommendations for therapy, it should be recognized that these are based on less than optimal evidence; in particular, there are substantial deficiencies in current knowledge relating to the pathophysiology of gastroparesis, as well as the natural history of gastrointestinal symptoms, and the majority of pharmacologic trials have been short term and associated with methodologic limitations. Although the etiologic factors differ, the overall management principles are similar in the two conditions. Maintenance of adequate nutrition is pivotal, and parenteral nutrition may be required in severe cases associated with malnutrition. In patients with diabetes, rigorous attempts should be made to optimize glycemic control--hyperglycemia slows gastric emptying and may exacerbate symptoms and attenuate the effects of prokinetic drugs. Despite the relatively poor predictive value of symptoms, it is reasonable to suggest a trial of prokinetic therapy for about 4 weeks, rather than initially establishing the diagnosis by measurement of gastric emptying. However, it should be recognized that there is a substantial placebo response, a lack of evidence to support the cost effectiveness of such an approach, and that most patients will require prolonged therapy. In type 1 diabetic patients, prokinetic therapy may potentially benefit glycemic control, and this forms an additional rationale (albeit not established) for therapy. Some patients with diabetes and idiopathic gastroparesis with severe vomiting are unable to tolerate oral medication; in such cases subcutaneous metoclopramide may prove useful. Patients with intractable symptoms should be hospitalized and given intravenous erythromycin. The repertoire of prokinetic agents available in the United States is limited and includes metoclopramide, erythromycin, and cisapride (available by special program from its manufacturer); all of these drugs are associated with side effects. The use of metoclopramide may represent the first choice for chronic oral therapy, although it has been studied less comprehensively than cisapride. Combination therapy may be potentially more efficacious than the use of single agents. Dehydration and metabolic derangements should be corrected. The choice of chronic medical therapy should be individualized, taking factors such as age, presence of diabetes, concurrent medications, and comorbidities into account. In a small number of patients in whom medical treatment fails, surgery should be considered, and, if performed, done in a specialized center. A number of novel therapies, including gastric electrical stimulation, are currently being evaluated. PMID:12846939

O'Donovan, Deirdre; Feinle-Bisset, Christine; Jones, Karen; Horowitz, Michael



Informal Caregiving for Diabetes and Diabetic Complications Among Elderly Americans  

Microsoft Academic Search

Objectives: Little is known regarding the amount of time spent by unpaid caregivers providing help to elderly individuals for disabilities associated with diabetes mellitus (DM). We sought to obtain nationally representative estimates of the time, and associated cost, of informal caregiving provided to the elderly with diabetes, and to determine the complications of DM that contribute most significantly to the

Kenneth M. Langa; Sandeep Vijan; Rodney A. Hayward; Michael E. Chernew; Caroline S. Blaum; Mohammed U. Kabeto; David R. Weir; Steven J. Katz; Robert J. Willis; Mark Fendrick



Influence of menopause on diabetes and diabetes risk  

Microsoft Academic Search

Many postmenopausal women live with diabetes mellitus; however, little information is available about how the changes that occur around the time of menopause might uniquely affect management of diabetes mellitus in this population. Although the weight gain that commonly occurs during the menopausal transition is largely attributable to aging rather than the transition itself, changes in body composition have been

Emily D. Szmuilowicz; Cynthia A. Stuenkel; Ellen W. Seely



Gestational Diabetes in Korea: Incidence and Risk Factors of Diabetes in Women with Previous Gestational Diabetes  

PubMed Central

Korean women with a history of gestational diabetes mellitus (GDM) have a 3.5 times greater risk of developing postpartum diabetes than the general population. The incidence of type 2 diabetes mellitus in early postpartum is reported as 10-15% in Korean women. A prospective follow-up study on Korean women with GDM showed that approximately 40% of women with previous GDM were expected to develop diabetes within 5 years postpartum. Independent risk factors for the development of diabetes in Korean women with previous GDM are pre-pregnancy body weight, gestational age at diagnosis, antepartum hyperglycemia on oral glucose tolerance test, low insulin response to oral glucose load, and family history of diabetes. Women with postpartum diabetes have greater body mass indexes, body weight, and waist circumferences than women with normal glucose tolerance. Multiple logistic regression analysis has revealed that waist circumference is the strongest obesity index along with systolic blood pressure and that triglyceride levels are a major independent risk factor for developing diabetes. These results in Korean women with previous GDM underline the importance of postpartum testing in Korean women diagnosed with GDM, and demonstrate that impaired B-cell function, obesity, and especially visceral obesity, are associated with the development of diabetes.



Diabetic Mastopathy: An Uncommon Complication of Diabetes Mellitus  

PubMed Central

Introduction. Whilst most consequences of diabetes mellitus are well recognized, breast-related complications remain obscure. The term diabetic mastopathy (DMP) attempts to describe the breast-related consequences of diabetes. Methods. We report the clinicopathologic findings in a patient with DMP and review the literature on this uncommon entity. Results. A 33-year-old woman with type 1 diabetes had excision biopsy of a 2?cm breast lump. Histopathologic evaluation revealed classic features of DMP: parenchymal fibrosis; keloid-like hyalinization of interlobular stroma; adipose tissue entrapment; lobular compression; dense chronic inflammatory cell infiltration; and lymphoid follicle formation. Conclusion. Clinicians should be aware of DMP as a differential for breast disease in women with uncontrolled diabetes.

Kirby, R. X.; Mitchell, D. I.; Williams, N. P.; Cornwall, D. A.; Cawich, S. O.




PubMed Central

Background: The metabolic complications and pathologic changes that occur in diabetes mellitus (DM) influence the occurrence of various dermatoses. Aim: To study the impact of control of diabetes on the pattern of cutaneous disorders. Materials and Methods: A cross-sectional descriptive study of patients attending diabetic clinic in a tertiary care hospital. A total of 500 consecutive patients were studied. Detailed history, clinical examination and relevant investigations were done to diagnose diabetic complications and cutaneous disorders. Dermatoses with or without known pathogenesis were correlated with age, gender, fasting plasma glucose (FPG), duration of diabetes, and complications of DM. Statistical analysis was carried out using Student “t” test and Chi-square test with 5% confidence interval (P value 0.05). Results: Majority of patients had well-controlled (FPG<130 mg/ml, 60%) type 2 DM (98.8%). No statistically significant difference (P>0.05) between the patients with or without DM specific cutaneous disorders was noticed with reference to age and gender distribution, duration of DM and FPG. Signs of insulin resistance, acrochordon (26.2%), and acanthosis nigricans (5%) were common, followed by fungal (13.8%) and bacterial (6.8%) infections. Eruptive xanthoma (0.6%), diabetic foot (0.2%), diabetic bulla (0.4%), diabetic dermopathy (0.2%), generalized granuloma annulare (0.2%), and insulin reactions (6.2%) and lipodystrophy (14%) were also seen. Conclusion: Well-controlled diabetes decreases the prevalence of DM-specific cutaneous disorders associated with chronic hyperglycemia. It is necessary to have a dermatologist in the diabetic clinic for early detection of potentially grave or predisposing conditions.

Ragunatha, Shivanna; Anitha, Bhaktavatsalam; Inamadar, Arun C; Palit, Aparna; Devarmani, Shashidhar S



Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet  

PubMed Central

OBJECTIVE To test the effects of two Mediterranean diet (MedDiet) interventions versus a low-fat diet on incidence of diabetes. RESEARCH DESIGN AND METHODS This was a three-arm randomized trial in 418 nondiabetic subjects aged 55–80 years recruited in one center (PREDIMED-Reus, northeastern Spain) of the Prevención con Dieta Mediterránea [PREDIMED] study, a large nutrition intervention trial for primary cardiovascular prevention in individuals at high cardiovascular risk. Participants were randomly assigned to education on a low-fat diet (control group) or to one of two MedDiets, supplemented with either free virgin olive oil (1 liter/week) or nuts (30 g/day). Diets were ad libitum, and no advice on physical activity was given. The main outcome was diabetes incidence diagnosed by the 2009 American Diabetes Association criteria. RESULTS After a median follow-up of 4.0 years, diabetes incidence was 10.1% (95% CI 5.1–15.1), 11.0% (5.9–16.1), and 17.9% (11.4–24.4) in the MedDiet with olive oil group, the MedDiet with nuts group, and the control group, respectively. Multivariable adjusted hazard ratios of diabetes were 0.49 (0.25–0.97) and 0.48 (0.24–0.96) in the MedDiet supplemented with olive oil and nuts groups, respectively, compared with the control group. When the two MedDiet groups were pooled and compared with the control group, diabetes incidence was reduced by 52% (27–86). In all study arms, increased adherence to the MedDiet was inversely associated with diabetes incidence. Diabetes risk reduction occurred in the absence of significant changes in body weight or physical activity. CONCLUSIONS MedDiets without calorie restriction seem to be effective in the prevention of diabetes in subjects at high cardiovascular risk.

Salas-Salvado, Jordi; Bullo, Monica; Babio, Nancy; Martinez-Gonzalez, Miguel Angel; Ibarrola-Jurado, Nuria; Basora, Josep; Estruch, Ramon; Covas, Maria Isabel; Corella, Dolores; Aros, Fernando; Ruiz-Gutierrez, Valentina; Ros, Emilio



Synthetic slings: pros and cons.  


Historically, the choice of sling material for the treatment of urinary incontinence has been based on the surgeon's preference and experience. In general, pelvic surgeons have not differentiated artificial graft materials by their inherent qualities or for biocompatibility in the female pelvis and vaginal wall. The introduction of new artificial graft materials and new methods of implantation for the correction of genuine stress incontinence has generated renewed interest in the "pros and cons" associated with nonabsorbable material use. In this review, we discuss and differentiate sling materials and techniques. We consider some of the physical and biologic qualities of artificial graft materials, present theories and practices associated with the successful use of permanent grafts, and discuss the natural evolution of artificial graft slings to the current use of the tension-free vaginal tape and Suprapubic Arc Sling System (American Medical Systems, Minneapolis, MN). PMID:12354353

Staskin, David R; Plzak, Louis



¡Truco Con Agua!  

NSDL National Science Digital Library

En esta actividad los aprendices aprenderán un truco de magia donde la magia es la presión del aire. Los participantes tomarán un vaso de agua medio lleno y lo taparán con un pedazo de plástico o cartón. Sosteniendo la tarjeta contra el vaso, lo voltearán boca abajo y cuando quiten la mano debajo del vaso, ¡abracadabra! no se caerá el agua. En la tira cómica, Mateo explica a los aprendices que la presión que hace el aire en todas las direcciones es la que sostiene la tarjeta.

Science, Lawrence H.



Genetics of type 1 diabetes  

Microsoft Academic Search

Type IA diabetes is an autoimmune disease with genetic and environmental factors contributing to its etiology. Twin studies, family studies, and animal models have helped to elucidate the genetics of autoimmune diabetes. Most of the genetic susceptibility is accounted for by human leukocyte antigen (HLA) alleles. The most-common susceptibility haplotypes are DQA I *0301-DQB I *0302 and DQA I *OS01

George K Papadopoulos; Mark I McCarthy



1 Diabetes and the Eye  

Microsoft Academic Search

Since the invention of the direct ophthalmoscope by Helmholtz in 1851 and von Yaeger's first description of changes in the fundus of a person with diabetes 4 years later, there has been increasing interest in the retina as it contains the only part of the vasculature affected by diabetes that is easily visible. Interestingly, these first retinal changes described in

Kevin Shotliff; Grant Duncan


Morgan: A Case of Diabetes  

NSDL National Science Digital Library

This case teaches about the causes and effects of Type 2 diabetes by working through the various options available to a young Native American woman suffering from the disease. The case can be used in a variety of settings, including nutrition classrooms, herbal drug courses, physiology courses, medical schools, nursing schools, pharmacy schools, diabetes workshops, and even weight loss clinics.

Rubin, Lisa M.; Herreid, Clyde F.



Psychosocial Predictors of Diabetes Management  

ERIC Educational Resources Information Center

|Objective: To investigate whether a perception of responsibility for disease onset and self-blame might influence disease management in people with diabetes. Methods: Our survey assessed perceived responsibility for disease onset, self-blame, anger, social support, and disease management in a sample of 46 individuals with diabetes. Results: As…

DePalma, Mary T.; Rollison, Julia; Camporese, Matthew



Diabetes risk: antioxidants or lifestyle?  

Technology Transfer Automated Retrieval System (TEKTRAN)

The global prevalence of type-2 diabetes and its associated cardiovascular disease is increasing, possibly due to the present pandemic of obesity and overweight. It is projected that by the year 2025, more than 300 million people worldwide will have diabetes. In the United States, between the two NH...


Diabetes and contact lens wear.  


The literature suggests that diabetic patients may have altered tear chemistry and tear secretion as well as structural and functional changes to the corneal epithelium, endothelium and nerves. These factors, together with a reported increased incidence of corneal infection, suggest that diabetic patients may be particularly susceptible to developing ocular complications during contact lens wear. Reports of contact lens-induced complications in diabetic patients do exist, although a number of these reports concern patients with advanced diabetic eye disease using lenses on an extended wear basis. Over the past decade or so, there have been published studies documenting the response of the diabetic eye to more modern contact lens modalities. The results of these studies suggest that contact lenses can be a viable mode of refractive correction for diabetic patients. Furthermore, new research suggests that the measurement of tear glucose concentration could, in future, be used to monitor metabolic control non-invasively in diabetic patients. This could be carried out using contact lenses manufactured from hydrogel polymers embedded with glucose-sensing agents or nanoscale digital electronic technology. The purpose of this paper is to review the literature on the anterior ocular manifestations of diabetes, particularly that pertaining to contact lens wear. PMID:22537249

O'Donnell, Clare; Efron, Nathan



Compliance of adolescents with diabetes  

Microsoft Academic Search

The purpose of this article is to describe the compliance of adolescents with diabetes and some factors connected to it. Altogether, 300 individuals aged 13 to 17 years were randomly selected from the Finnish Social Insurance Institution's register. Every fifth person on the list was included in the sample. Ninety-seven percent (N = 289) of the adolescents with diabetes returned



Reducing Risk of Diabetic Retinopathy  


... with diabetes. Risk Factors Every person who has diabetes, whether it's type 1 or type 2, is at risk of developing ... to be more severe, though, among those with type 1 disease. As with all ... out orders from a gene called, fittingly enough, the VEGF-A gene. Scientists ...


Juvenile Diabetes and Rehabilitation Counseling.  

ERIC Educational Resources Information Center

|Severe complications of diabetes are more likely to occur with the juvenile diabetic and problems of psychosocial adjustment are recurring and difficult. Implications for the rehabilitation counselor are discussed in terms of employment considerations, the effects of complications, genetic counseling, and cooperation with other professionals.…

Stone, J. Blair; Gregg, Charles H.



Diabetes Mellitus ve Oksidatif Stres  

Microsoft Academic Search

Oxidative stress in diabetes mellitus may play an important role in the pathogenesis of early and long term complications of human diabetes, like microangiopathy and neuropathy. Protein glycation and glucose autoxidation can generate free radicals that can catalyze lipid peroxidation. Other potential mechanisms of oxidative stress include the reduction of anti-oxidant defense. In this paper, the free radicals and anti-oxidant

Nilgün Altan; Aylin Sepici Dinçel; Cemile Koca


[Erythropoietin administration in diabetic patients].  


This paper presents the role of erythropoietin application in diabetic patients with accompanying renal failure. The main cause of anemia in diabetics are: nephropathy, structural lesions of erythrocyte membrane and blood loss connected with diagnostic and therapeutic actions. There are publications which demonstrate that in patients with diabetes type 1 or 2 with accompanying nephropathy, anemia appears more frequently than in the group of patients with chronic renal failure caused by other factors. It is supposed, that the impaired erythropoietin synthesis in diabetics can be caused by autonomic neuropathy. Erythropoietin administration in case of diabetic nephropathy has a beneficial influence on fat metabolism, immune response and reduction of insuline resistance. Erythropoietin because of reduction of vascular endothelial growth factor synthesis blocks the development of diabetic retinopathy and macroangiopathy. Erythropoietin reduces the risk of the left-ventricular hypertrophy caused by anemia. Very important is that the erythropoietin resistance is lower in diabetics. Scientists who are adverse to erythropoietin administration in patients with diabetic nephropathy maintain, that it can lead to vascular complications and the deterioration of glycemia control. PMID:14974347

Zukowska-Szczechowska, Ewa; Tomaszewski, Maciej; Sedkowska, Agnieszka; Grzeszczak, W?adys?aw



Spices and type 2 diabetes  

Microsoft Academic Search

Purpose – The paper is a review of current research on phytochemicals and how they may alleviate type 2 diabetes by improving insulin activity in the body. Design\\/methodology\\/approach – Literature searches were conducted to find a link between common household spices and type 2 diabetes. Only common household spices were researched so that any link found between spices and type

Abigail Kelble



Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.  


The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. PMID:21838769

Goenka, N; Turner, B; Vora, J



Euglycemic diabetic ketoacidosis in pregnancy.  


Diabetic ketoacidosis (DKA) can be a catastrophic event during pregnancy, complicating almost nine percent of diabetics in pregnancy. It induces both maternal and fetal mortality. Ketosis has been implicated in fetal distress and causes adverse neurological outcome. DKA with a relatively low blood sugar levels is called euglycemic DKA, which is a rare entity and reported usually in type I diabetic patients. A 37-year-old Saudi female patient known to have type II diabetes developed euglycemic [blood glucose level 4.3 mmol/L (78 mg/dl)] DKA while in her fifth pregnancy. She responded to intravenous dextrose and insulin with gradual improvement. Euglycemic DKA should be considered in type II diabetics during pregnancy and treated promptly. PMID:17951948

Tarif, Nauman; Al Badr, Wisam



Physical activity and diabetes mellitus.  


Diabetes mellitus (DM), a metabolic syndrome consisting of two main groups, type 1 and 2, is characterized by absolute or relative insulin deficiency or insulin resistance. Individuals with DM take part in physical activity for health promotion, disease management, and or recreational or competitive sports. Several studies confirm the beneficial role of physical activity in favorably altering the prognosis of DM. Exercise as a therapeutic strategy has potential risks, too. Hence, sports medicine physicians caring for athletes with diabetes have several important responsibilities. Diabetic education; pre-participatory evaluation for vascular, neurological, retinal or joint disease; diabetic status and control; promotion of blood glucose self-monitoring; and individualized dietary, medication, and physical activity plans are essential to achieve safe and enjoyable outcomes in individuals with diabetes who are embarking on physical activity. PMID:16407610

Bhaskarabhatla, Krishna V; Birrer, Richard



Diabetic nephropathy in African Americans.  


Diabetic nephropathy (DN) is the number one cause of end-stage renal disease in United States and is highly prevalent in African Americans. We have found that among African Americans in Mississippi diabetic nephropathy appears to affect females more than males, which may be related to increased rates of obesity and diabetes in African American women. Glycemic control and control of blood pressure is essential to prolong renal survival and to protect against cardiovascular events. Angiotensin-converting enzyme inhibitors reduce cardiovascular mortality in diabetics and are tolerated in advanced renal disease. The impact of glycemic control, appropriate antihypertensives, and the optimal level of blood pressure control in African Americans with advanced DN require further study. This article reviews the impact, clinical characteristics, risk factors, and treatment of diabetic nephropathy in African Americans. PMID:11411748

Crook, E D



AGEs, RAGE, and diabetic retinopathy.  


Diabetic retinopathy is a major diabetic complication with a highly complex etiology. Although there are many pathways involved, it has become established that chronic exposure of the retina to hyperglycemia gives rise to accumulation of advanced glycation end products (AGEs) that play an important role in retinopathy. In addition, the receptor for AGEs (RAGE) is ubiquitously expressed in various retinal cells and is upregulated in the retinas of diabetic patients, resulting in activation of pro-oxidant and proinflammatory signaling pathways. This AGE-RAGE axis appears to play a central role in the sustained inflammation, neurodegeneration, and retinal microvascular dysfunction occurring during diabetic retinopathy. The nature of AGE formation and RAGE signaling bring forward possibilities for therapeutic intervention. The multiple components of the AGE-RAGE axis, including signal transduction, formation of ligands, and the end-point effectors, may be promising targets for strategies to treat diabetic retinopathy. PMID:21590515

Zong, Hongliang; Ward, Micheal; Stitt, Alan W



Arterial Stiffness Using Radial Arterial Waveforms Measured at the Wrist as an Indicator of Diabetic Control in the Elderly  

Microsoft Academic Search

Although current technique of photoplethysmogra- phy (PPG) is a popular noninvasive method of waveform con- tour analysis in assessing arterial stiffness, data obtained are frequently affected by various environmental and physiological factors. We proposed an easily operable air pressure sensing sys- tem (APSS) for radial arterial signal capturing. Totally, 108 sub- jects (young, the aged with or without diabetes) were

Hsien-Tsai Wu; Chun-Ho Lee; An-Bang Liu; Wei-Sheng Chung; Chieh-Ju Tang; Cheuk-Kwan Sun; Hon-Kan Yip



[Diabetes and diet revisited].  


In the treatment of diabetes the diet has an important role complementary to the pharmaceutical treatment. The diet must provide the right amount of nutrients and calories in order for the individual to reach and maintain the ideal weight, stabilize the blood glucose levels close to the norm, and attain an optimal lipid profile. The daily caloric intake is represented by 55-60% of carbohydrates with a preference for nutrients rich in fiber and with a low blood glucose index. Of the daily caloric intake 10% may include sucrose as long as it is consumed in the context of a balanced meal. A moderate use of fructose is allowed, and an increased intake of fiber is encouraged. The consumption of proteins represents about 10-15% of the daily caloric intake. A consumption close to the lower limits of the range (about 0,8 gr/kg of body weight) is required for diabetes patients with nephropathy, while a daily intake of 0,6 gr/kg of body weight is considered to be the malnutrition risk factor for lower levels. The total intake of fats required is < or = 30%, of which saturated fatty acids are less than 8-10% (with a further restriction to 7-8% for individuals with LDL cholesterol of > or = 100mg/dl and other cardiovascular risk factors), the polyunsaturated fatty acids less than 10%, and the monounsaturated fatty acids at 10-15% of the total caloric intake. The intake of cholesterol through the diet should be <300 mg/die and still lower (< 200 mg/die) for individuals with high levels of LDL cholesterol. Multivitamin supplements are recommended only for certain categories of diabetic patients that may be at risk of micronutrient deficiency. A moderate quantity of alcohol (5-15 gr/die) is allowed in the case of stabilized diabetes and lack of hypertrigliceridemia. Although the diet may determine a ponderal decrease of up to 10% of the initial weight, it is good to insert a correct nutritional program into a well defined behavioral program that, other than a reduced caloric intake, takes into consideration an increased energetic expenditure through physical activity. PMID:17147053

Miggiano, G A D; Gagliardi, L


Dissecting autoimmune diabetes through genetic manipulation of non-obese diabetic mice  

Microsoft Academic Search

Type 1 diabetes results from a genetically and immunologically complex autoimmune process that is specifically directed against the pancreatic beta cells. Non-obese diabetic mice spontaneously develop a form of autoimmune diabetes closely resembling the disease in humans. This happens because, like human diabetic patients, non-obese diabetic mice have an unfortunate combination of apparently normal alleles at numerous loci associated with

Y. Yang; P. Santamaria



For People with Diabetes. Seven Principles for Controlling Your Diabetes for Life.  

National Technical Information Service (NTIS)

Contents: Principle 1: Learn as Much as You Can About Diabetes; Principle 2: Get Regular Care for Your Diabetes; Principle 3: Learn How to Control Your Diabetes; Principle 4: Take Care of Your Diabetes ABCs; Principle 5: Monitor Your Diabetes ABCs; Princi...



Risk Factors for Type 2 Diabetes Among Women with Gestational Diabetes: A Systematic Review  

Microsoft Academic Search

We conducted a systematic review of studies examining risk factors for the development of type 2 diabetes among women with previous gestational diabetes. Our search strategy yielded 14 articles that evaluated 9 categories of risk factors of type 2 diabetes in women with gestational diabetes: anthropometry, pregnancy-related factors, postpartum factors, parity, family history of type 2 diabetes, maternal lifestyle factors,

Kesha Baptiste-Roberts; Bethany B. Barone; Tiffany L. Gary; Sherita H. Golden; Lisa M. Wilson; Eric B. Bass; Wanda K. Nicholson



Clinical features of non-diabetic renal diseases in patients with type 2 diabetes  

Microsoft Academic Search

Although persistent proteinuria is characteristic of diabetic nephropathy (DN), it is important to differentiate non-diabetic renal diseases (NDRD) in diabetic patients with proteinuria. In order to re-evaluate the indications for renal biopsy in the diabetic patients, we retrospectively analyzed the relationship between clinical features and histological diagnosis in 97 Japanese patients with type 2 diabetes manifesting overt proteinuria. Renal biopsy

Atsuhito Tone; Kenichi Shikata; Mitsuhiro Matsuda; Hitomi Usui; Shinichi Okada; Daisuke Ogawa; Jun Wada; Hirofumi Makino



Effects of aspartame on diabetic rats and diabetic patients.  


The effects of aspartame (L-aspartyl-L-phenylalanine methyl ester) on plasma glucose and insulin levels were investigated in diabetic rats and patients with non-insulin-dependent diabetes mellitus. The oral administration of 0.45 mg aspartame per 100g body weight, which is equivalent to 150 mg of glucose in sweetness, to streptozotocin-induced diabetic rats had no effect on the plasma glucose or insulin levels. Also, 225 mg oral aspartame loading, which is equivalent to 75 g of glucose in sweetness, to patients with non-insulin-dependent diabetes mellitus did not increase plasma glucose or insulin levels, although 75 g of oral glucose loading increased plasma glucose and insulin levels in diabetic patients as expected. Aspartame ingestion for three days at a dose of 24-48 mg per day and the intake of snacks flavored with 240 mg of aspartame also did not increase fasting plasma glucose levels. These results suggest that acute administration of aspartame has no influence on plasma glucose or insulin levels in diabetic rats and patients with non-insulin-dependent diabetes mellitus. PMID:3908628

Shigeta, H; Yoshida, T; Nakai, M; Mori, H; Kano, Y; Nishioka, H; Kajiyama, S; Kitagawa, Y; Kanatsuna, T; Kondo, M



Protocol for treatment of diabetic foot ulcers  

Microsoft Academic Search

Each year, 82,000 limb amputations are performed in patients with diabetes mellitus. The majority of these amputations could be avoided by following strict protocols. The collective experience treating patients with neuropathic diabetic foot ulcers of 4 major diabetic foot programs in the United States and Europe were analyzed. The following protocol has been developed for patients with diabetic foot ulcers:

Harold Brem; Peter Sheehan; Andrew J. M Boulton



Effect of electroconvulsive therapy on diabetes mellitus.  


Of fourteen patients with diabetes mellitus, eight had complete remission of diabetic symptoms after one or two applications of elctroconvulsive therapy (ECT). In those who benefited the diabetes was of recent onset and non-insulin-dependent. One patient remains free from diabetes 14 years after ECT. PMID:6107455

Fakhri, O; Fadhli, A A; el Rawi, R M



The genetic predisposition to fibrocalculous pancreatic diabetes  

Microsoft Academic Search

Summary  Fibrocalculous pancreatic diabetes (previously known as tropical pancreatic diabetes) is a rare cause of diabetes confined to countries within the tropical belt. The aetiology of fibrocalculous pancreatic diabetes is thought to be environmental although the agent(s) is unknown. We have investigated a possible genetic basis of this disease by looking for restriction fragment length polymorphisms of genes implicated in the

P. K. Kambo; G. A. Hitman; V. Mohan; A. Ramachandran; C. Snehalatha; S. Suresh; K. Metcalfe; B. K. Ryait; M. Viswanathan



Transient Nephrogenic Diabetes insipidus Associated with Pregnancy  

Microsoft Academic Search

The coexistence of diabetes insipidus and pregnacy is uncommon and can be associated with worsening of the diabetes insipidus. We report a patient who developed a transient nephrogenic diabetes insipidus associated with a pregnancy complicated by preeclampsia. The diabetes insipidus resolved spontaneously within several days after delivery.Copyright © 1985 S. Karger AG, Basel

Stephen M. Korbet; Howard L. Corwin; Edmund J. Lewis



Dietary magnesium intake in type 2 diabetes  

Microsoft Academic Search

Background: Magnesium deficiency is common in type 2 diabetes and may have a negative impact on glucose homeostasis and insulin resistance, as well as on the evolution of complications such as retinopathy, thrombosis and hypertension.Objective: To assess the dietary magnesium intake of patients with type 2 diabetes in Zurich, Switzerland and to compare the magnesium intake of diabetic and non-diabetic

MK Wälti; MB Zimmermann; GA Spinas; S Jacob; RF Hurrell



Diabetes Epidemic Among Hispanics/Latinos  


... is called acanthosis nigricans.) ? Gestational diabetes develops during pregnancy. Women who have had gestational diabetes have a 40 to 60 percent chance of developing diabetes, mostly type 2, in the next five to 10 years. HOW MANY HISPANICS/LATINOS HAVE DIABETES? ? 10.4 percent of Hispanics/ ...


Diabetic Nephropathy - Misreading the Tea Leaves?  

Microsoft Academic Search

One of the most feared complications of diabetes is kidney disease, also called diabetic nephropathy (DN). DN is the leading cause of end-stage renal disease in the U.S., and the incidence of DN is poised to double over the next ten years due to the rapid rise in the number of cases of diabetes, particularly type 2 diabetes. The expected

Evan David Rosen


Use of anti-diabetic drugs and glycaemic control in type 2 diabetes—The Hong Kong Diabetes Registry  

Microsoft Academic Search

In this report, we examined the usage of anti-diabetic treatments including oral anti-diabetic drug (OAD) and\\/or insulin and their combination from baseline data of a consecutive cohort of 7549 Chinese type 2 diabetic subjects in the Hong Kong Diabetes Registry. Pattern of usage of anti-diabetic treatment and corresponding glycemic control was analyzed. OAD failure was defined as the need to

Peter C. Y. Tong; Gary T. C. Ko; Wing-Yee So; Sau-Chu Chiang; Xilin Yang; Alice P. S. Kong; Risa Ozaki; Ronald C. W. Ma; Clive S. Cockram; Chun-Chung Chow; Juliana C. N. Chan



Exendin-4 Modulates Diabetes Onset in Nonobese Diabetic Mice  

PubMed Central

Activation of the glucagon-like peptide-1 receptor (GLP-1R) is associated with expansion of ?-cell mass due to stimulation of cell proliferation and induction of antiapoptotic pathways coupled to ?-cell survival. Although the GLP-1R agonist Exenatide (exendin-4) is currently being evaluated in subjects with type 1 diabetes, there is little information available about the efficacy of GLP-1R activation for prevention of experimental type 1 diabetes. We examined the consequences of exendin-4 (Ex-4) administration (100 ng once daily and 2 ?g twice daily) on diabetes onset in nonobese diabetic mice beginning at either 4 or 9 wk of age prior to the onset of diabetes. Ex-4 treatment for 26 wk (2 ?g twice daily) initiated at 4 wk of age delayed the onset of diabetes (P = 0.007). Ex-4-treated mice also exhibited a significant reduction in insulitis scores, enhanced ?-cell mass, and improved glucose tolerance. Although GLP-1R mRNA transcripts were detected in spleen, thymus, and lymph nodes from nonobese diabetic mice, Ex-4 treatment was not associated with significant changes in the numbers of CD4+ or CD8+ T cells or B cells in the spleen. However, Ex-4 treatment resulted in an increase in the number of CD4+ and CD8+ T cells in the lymph nodes and a reduction in the numbers of CD4+CD25+Foxp3+ regulatory T cells in the thymus but not in lymph nodes. These findings demonstrate that sustained GLP-1R activation in the absence of concomitant immune intervention may be associated with modest but significant delay in diabetes onset in a murine model of type 1 diabetes.

Hadjiyanni, Irene; Baggio, Laurie L.; Poussier, Philippe; Drucker, Daniel J.



Slow Rewarming Has No Effects on the Decrease in Jugular Venous Oxygen Hemoglobin Saturation and Long-Term Cognitive Outcome in Diabetic Patients  

Microsoft Academic Search

The purpose of this study was to examine the effects of rewarming rate on internal jugular venous oxygen he- moglobin saturation (Sjvo2) during the rewarming pe- riod, and long-term cognitive outcome in diabetic pa- tients. We studied 30 diabetic patients scheduled for elective coronary artery bypass graft surgery. As a con- trol, 30 age-matched nondiabetic patients were identi- fied. The

Yuji Kadoi; Shigeru Saito; Fumio Goto; Nao Fujita



Diabetic gastroparesis: Therapeutic options.  


Gastroparesis is a condition characterized by delayed gastric emptying and the most common known underlying cause is diabetes mellitus. Symptoms include nausea, vomiting, abdominal fullness, and early satiety, which impact to varying degrees on the patient's quality of life. Symptoms and deficits do not necessarily relate to each other, hence despite significant abnormalities in gastric emptying, some individuals have only minimal symptoms and, conversely, severe symptoms do not always relate to measures of gastric emptying. Prokinetic agents such as metoclopramide, domperidone, and erythromycin enhance gastric motility and have remained the mainstay of treatment for several decades, despite unwanted side effects and numerous drug interactions. Mechanical therapies such as endoscopic pyloric botulinum toxin injection, gastric electrical stimulation, and gastrostomy or jejunostomy are used in intractable diabetic gastroparesis (DG), refractory to prokinetic therapies. Mitemcinal and TZP-101 are novel investigational motilin receptor and ghrelin agonists, respectively, and show promise in the treatment of DG. The aim of this review is to provide an update on prokinetic and mechanical therapies in the treatment of DG. PMID:22127672

Alam, Uazman; Asghar, Omar; Malik, Rayaz Ahmed



[Patophysiology of diabetic retinopathy].  


Diabetic retinopathy (DR) is the affection of the retina in patients with diabetes mellitus (DM). The basic causative factor is prolonged hyperglycaemia. DR is microangiopathy, ie impairment of retinal capillaries. Pathophysiology of DR is very complex and there are involved in many factors. The first and most fundamental factor is the failure blood-retinal barrier (BRB). The major mechanism causing malfunction of BRB are advanced glycation end-products (AGE). In the failure of the inner BRB are involved losses of endothelial cells in capillaries, together with the losses of pericytes. A very important role in the failure of BRB plays too increased adhesivity of leukocytes. Further important role play also AGE and their receptor RAGE. They stimulate cascade of pathological processes damaging BRB. The second important factors in the pathophysiology of DR are vasoactive factors. The most important is vascular endothelial growth factor (VEGF), further than protein kinase C (PKC), histamine, angiotensin II, matrix metaloproteinases. The third important factor in the pathophysiology of DR is the vitreoretinal interface. There plays important role detachment of posterior vitreous, cortical vitreous, internal limiting membrane. PMID:23713183

Kolár, P



[Screening, diagnosis and management of diabetes mellitus and diabetic complications].  


Diabetes mellitus comprises a group of metabolic disturbances that are characterized by hyperglycemia. In 1997 the American Diabetes Association (ADA) proposed new criteria for the diagnosis and classification of diabetes mellitus, which was also adopted by WHO. Although the criteria is the same, the ADA puts emphasis on the use of the fasting plasma glucose (FPG) for screening and diagnosis, whereas WHO maintains the use of the OGTT and recommends the FPG only if an OGTT can not be performed. Different pathogenetic processes are involved in the development of diabetes ranging from autoimmune destruction of beta-cells resulting in an absolute insulin deficiency to insulin with a defect on insulin secretion. The new classification is based on the etiology of the disease. Diabetes is classified into one of four categories: Type-1, type-2 Diabetes mellitus, specific forms of diabetes, and gestational diabetes. For screening and diagnosis FPG or the two hour value after the OGTT can be used. Glycosylated hemoglobin is not suitable for screening and diagnosis of diabetes despite some contradictory statements. For many decades clear evidence was missing that chronic hyperglycemia caused diabetic late complications; complications including dysfunction or failure of several organ systems, in particular eyes, kidneys, nerves, and the cardiovascular system. The results of two large prospective trials--the Diabetes Control and Complications Trial (DCCT; 1993) and the United Kingdom Prospective Study (UKPDS; 1998)--that were recently published provided the final proof that normoglycemia prevents or delays the progression of these late complications. Due to the insidious nature of these complications they are often not diagnosed and have to be looked for in each patients with diabetes and have to be controlled regularly. Based on the results of the UKPDS and other studies, evidence based therapeutic goals could be defined. Multifactorial interventions with increased physical activity, cessation of smoking, aspirin treatment, lowering of HbA1c, blood pressure, and lipids in patients with type 2 diabetes have been proven to drastically reduce the risk of developing diabetic nephropathy or cardiovascular complications drastically. We recommend the following treatment strategy for patients with type 2 diabetes in clinical practice: 1) Treatment should be individualized. 2) Treatment should be started step by step to document efficacy of treatment and compliance of patients. 3) Plasma glucose and blood pressure should be normalized in all patients with type 2 diabetes (up to an age of 70 years), since there are no threshold values for HbA1c and blood pressure. 4) Therapeutic goals should be checked every three to six months. 5) In the case that therapeutic goals can not be met, treatment should be intensified. Often a combination therapy with many different drugs is required. 6) A specialist for diabetes should be consulted, if the therapeutic goals can not be met over a period of six months. PMID:10667077

Lehmann, R; Spinas, G A



Pomegranate and type 2 diabetes.  


Over the last decade, various studies have linked pomegranate (Punica granatum Linn), a fruit native to the Middle East, with type 2 diabetes prevention and treatment. This review focuses on current laboratory and clinical research related to the effects of pomegranate fractions (peels, flowers, and seeds) and some of their active components on biochemical and metabolic variables associated with the pathologic markers of type 2 diabetes. This review systematically presents findings from cell culture and animal studies as well as clinical human research. One key mechanism by which pomegranate fractions affect the type 2 diabetic condition is by reducing oxidative stress and lipid peroxidation. This reduction may occur by directly neutralizing the generated reactive oxygen species, increasing certain antioxidant enzyme activities, inducing metal chelation activity, reducing resistin formation, and inhibiting or activating certain transcriptional factors, such as nuclear factor ?B and peroxisome proliferator-activated receptor ?. Fasting blood glucose levels were decreased significantly by punicic acid, methanolic seed extract, and pomegranate peel extract. Known compounds in pomegranate, such as punicalagin and ellagic, gallic, oleanolic, ursolic, and uallic acids, have been identified as having anti-diabetic actions. Furthermore, the juice sugar fraction was found to have unique antioxidant polyphenols (tannins and anthocyanins), which could be beneficial to control conditions in type 2 diabetes. These findings provide evidence for the anti-diabetic activity of pomegranate fruit; however, before pomegranate or any of its extracts can be medically recommended for the management of type 2 diabetes, controlled, clinical studies, are needed. PMID:23684435

Banihani, Saleem; Swedan, Samer; Alguraan, Ziyad



Gestational Diabetes and Thyroid Autoimmunity  

PubMed Central

Background. About 10% of pregnancies are complicated by previously unknown impairment of glucose metabolism, which is defined as gestational diabetes. There are little data available on prevalence of thyroid disorders in patients affected by gestational diabetes, and about their postgestational thyroid function and autoimmunity. We therefore investigated pancreatic and thyroid autoimmunity in gestational diabetic patients and in women who had had a previous gestational diabetic pregnancy. Methods. We investigated 126 pregnant women at the time of a 100-g oral glucose tolerance test: 91 were classified as gestational diabetics, and 35 were negative (controls). We also studied 69 women who had delivered a baby 18–120 months prior to this investigation and who were classified at that time gestational diabetics (38 women) or normally pregnant (31 women; controls). Results. Our data show no differences for both thyroid function and prevalence of autoimmune disorders during pregnancy; however, a significant increase in thyroid autoimmunity was seen in women previously affected by gestational diabetes. This increased prevalence of thyroid autoimmunity was not associated with the development of impaired glucose metabolism after pregnancy. Conclusions. Our data suggest that maternal hyperglycemia is a risk factor for the development of thyroid autoimmunity, a conclusion that should now be confirmed in a larger cohort of patients.

Vitacolonna, Ester; Lapolla, Annunziata; Di Nenno, Barbara; Passante, Annalisa; Bucci, Ines; Giuliani, Cesidio; Cerrone, Dominique; Capani, Fabio; Monaco, Fabrizio; Napolitano, Giorgio



Management of ischemic diabetic foot.  


Diabetic foot pathology represent the more disabling complication of diabetes. More the 1 million of diabetes patients undergo a lower limb amputation per year; 85% of these amputation are preceded by un ulcer that can be avoided by a prevention program. Critical limb ischemia (CLI), the only independent cause of major amputation in diabetic population, can be correctly treated when an early diagnosis is made. Both endoluminal and surgical revascularization procedures can be applied in diabetes with high rate of success when performed by skilled operator. Infection of diabetic foot, in particular in patients suffering from peripheral artery disease (PVD), may rapidly evolves in severe local or systemic infection putting the patient at high risk of major amputation or death. Together with an early diagnosis of infection and ischemia it is mandatory to apply a correct medical and surgical treatment protocol with the aim to control infection and to improve blood perfusion to the foot. In case of infection surgical procedure should be applied first while revascularization procedure will follow soonest. Antibiotic therapy should be chosen considering different local biological pattern and different type of infection. Reconstructive surgery, the last step in treatment of any diabetic foot lesion, must obtain a functional residual foot or a stump that will allow the patient to go back walking soonest with residual good walking capacity. PMID:24126511

Caravaggi, C; Ferraresi, R; Bassetti, M; Sganzaroli, A B; Galenda, P; Fattori, S; De Prisco, R; Simonetti, D; Bona, F



Diabetes in African Americans: Unique pathophysiologic features  

Microsoft Academic Search

Type 2 diabetes is an increasing public health problem among African Americans, especially children. Several features make\\u000a type 2 diabetes among African Americans unique. First, African-American adults with type 2 diabetes, or Flatbush diabetes,\\u000a present with diabetic ketoacidosis. Patients are insulin resistant with acute, severe defects in insulin secretion and no\\u000a islet cell autoantibodies. Following treatment, some insulin secretory capacity

Mary Ann Banerji



Trigger digits and diabetes mellitus.  


The problem of finger in the patient with diabetes mellitus is important consideration in diabetology. Generally, peripheral neuropathy that manifests with finger paresthesia is common. However, some recent reports mention the concern on trigger digits in diabetic patients. In this brief article, the authors focus review and discussion on this specific topic. The searching of standard database, PubMed, on available publication on this area selecting by keywords trigger digits and diabetes mellitus was done and all derived papers were extracted and further synthesized in this review article. Epidemiology and management of the condition are the mainly focused reviewed areas and presented in this article. PMID:22454822

Wiwanitkit, Somsri; Wiwanitkit, Viroj



Trigger Digits and Diabetes Mellitus  

PubMed Central

The problem of finger in the patient with diabetes mellitus is important consideration in diabetology. Generally, peripheral neuropathy that manifests with finger paresthesia is common. However, some recent reports mention the concern on trigger digits in diabetic patients. In this brief article, the authors focus review and discussion on this specific topic. The searching of standard database, PubMed, on available publication on this area selecting by keywords trigger digits and diabetes mellitus was done and all derived papers were extracted and further synthesized in this review article. Epidemiology and management of the condition are the mainly focused reviewed areas and presented in this article.

Wiwanitkit, Somsri; Wiwanitkit, Viroj



Diabetic mastopathy: a case report.  


Diabetic mastopathy (DMP) is an uncommon collection of clinical, radiological, and histological features, classically described in premenopausal women with long-term insulin-dependent diabetes mellitus. This entity can mimic breast carcinoma, but, in the appropriate clinical and imaging setting, the diagnosis can be made by core biopsy, avoiding unnecessary surgeries. We report the case of a 34-year-old female, with a 12-year history of type 1 diabetes, who presented with bilateral breast lumps. Mammography, ultrasonography, and magnetic resonance imaging could not exclude the suspicion of malignancy, and a core biopsy was performed showing the typical histologic features of DMP. The literature is briefly reviewed. PMID:23154017

Francisco, Carla; Júlio, Catarina; Fontes, Ana Luísa; Silveira Reis, Inês; Fernandes, Rosário; Valadares, Sara; Sereno, Pedro



Diabetes Education in Tribal Schools  

NSDL National Science Digital Library

American Indian/Alaska Native (AI/AN) populations are in the midst of a Type 2 diabetes epidemic. To address this crisis, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) began funding a national initiative titled "Diabetes Education in Tribal Schools (DETS) K-12 Curriculum Project." The lesson plans are structured in the 5E learning cycle and instructional model--Engage, Explore, Explain, Elaborate, and Evaluate because it supports a constructivist teaching strategy and is based on how student learning occurs.

Francis, Carolee D.; Helgeson, Lars



Children and Diabetes: SEARCH for Diabetes in Youth  


... function or high rate of beta cell loss, obesity accelerates T1 DM onset. In addition, low birth ... Waitzfelder B, Kahn HS. Prevalence of overweight and obesity in youth with diabetes in USA: the SEARCH ...


Vascular adhesion protein-1 regulates leukocyte transmigration rate in the retina during diabetes.  


Vascular adhesion protein-1 (VAP-1) is an endothelial adhesion molecule that possesses semicarbazide-sensitive amine oxidase (SSAO) activity and is involved in leukocyte recruitment. Leukocyte adhesion to retinal vessels is a predominant feature of experimentally induced diabetic retinopathy (DR). However, the role of VAP-1 in this process is unknown. Diabetes was induced by i.p. injection of Streptozotocin in Long-Evans rats. The specific inhibitor of VAP-1, UV-002, was administered by daily i.p. injections. The expression of VAP-1 mRNA in the retinal extracts of normal and diabetic animals was measured by real-time quantitative polymerase chain reaction (PCR). Firm leukocyte adhesion was quantified in retinal flatmounts after intravascular staining with concanavalin A (ConA). Leukocyte transmigration rate was quantified by in vivo acridine orange leukocyte staining (AOLS). In diabetic rats, the rate of leukocyte transmigration into the retinal tissues of live animals was significantly increased, as determined by AOLS. When diabetic animals were treated with daily injections of the VAP-1 inhibitor (0.3 mg/kg), leukocyte transmigration rate was significantly reduced (P < 0.05). However, firm adhesion of leukocytes in diabetic animals treated with the inhibitor did not differ significantly from vehicle-treated diabetic controls. This work provides evidence for an important role of VAP-1 in the recruitment of leukocyte to the retina in experimental DR. Our results reveal the critical contribution of VAP-1 to leukocyte transmigration, with little impact on firm leukocyte adhesion in the retinas of diabetic animals. VAP-1 inhibition might be beneficial in the treatment of DR. PMID:19635478

Noda, Kousuke; Nakao, Shintaro; Zandi, Souska; Engelstädter, Verena; Mashima, Yukihiko; Hafezi-Moghadam, Ali



Vascular Adhesion Protein-1 Regulates Leukocyte Transmigration Rate in the Retina During Diabetes  

PubMed Central

Vascular adhesion protein-1 (VAP-1) is an endothelial adhesion molecule that possesses semicarbazide-sensitive amine oxidase (SSAO) activity and is involved in leukocyte recruitment. Leukocyte adhesion to retinal vessels is a predominant feature of experimentally induced diabetic retinopathy (DR). However, the role of VAP-1 in this process is unknown. Diabetes was induced by i.p. injection of Streptozotocin in Long–Evans rats. The specific inhibitor of VAP-1, UV-002, was administered by daily i.p. injections. The expression of VAP-1 mRNA in the retinal extracts of normal and diabetic animals was measured by real time quantitative polymerase chain reaction (PCR). Firm leukocyte adhesion was quantified in retinal flatmounts after intravascular staining with concanavalin A (ConA). Leukocyte transmigration rate was quantified by in vivo acridine orange leukocyte staining (AOLS). In diabetic rats, the rate of leukocyte transmigration into the retinal tissues of live animals was significantly increased, as determined by AOLS. When diabetic animals were treated with daily injections of the VAP-1 inhibitor (0.3mg/kg), leukocyte transmigration rate was significantly reduced (P<0.05). However, firm adhesion of leukocytes in diabetic animals treated with the inhibitor did not differ significantly from vehicle-treated diabetic controls. This work provides evidence for an important role of VAP-1 in the recruitment of leukocyte to the retina in experimental DR. Our results reveal the critical contribution of VAP-1 to leukocyte transmigration, with little impact on firm leukocyte adhesion in the retinas of diabetic animals. VAP-1 inhibition might be beneficial in the treatment of DR.

Noda, Kousuke; Nakao, Shintaro; Zandi, Souska; Engelstadter, Verena; Mashima, Yukihiko; Hafezi-Moghadam, Ali



Effect of Gender on Counterregulatory Responses to Euglycemic Exercise in Type 1 Diabetes  

Microsoft Academic Search

A marked sexual dimorphism in neuroendocrine and meta- bolic responses to moderate, prolonged exercise occurs in healthy humans. It is unknown whether similar differences occur in type 1 diabetes mellitus (T1DM). Fifteen patients with T1DM (7 women and 8 men) were studied during 90 min of euglycemic exercise at 50% of the maximum rate of O2 con- sumption. Men and



Troglitazone Monotherapy Improves Glycemic Control in Patients With Type 2 Diabetes Mellitus: A Randomized, Controlled Study  

Microsoft Academic Search

To assess the effects of troglitazone monotherapy on glycemic con- trol in patients with type 2 diabetes mellitus, we carried out a 6-month, randomized, double-blind, placebo-controlled study in 24 hospital and outpatient clinics in the United States and Canada. Troglitazone 100, 200, 400, or 600 mg or placebo once daily with breakfast was administered to 402 patients with type 2




Diabetes Control: Why It's Important  


... and stay healthy. Continue What Causes Blood Sugar Levels to Be Out of Control? Managing diabetes is ... Can I Get (and Keep) My Blood Sugar Levels Under Control? Keeping blood sugars close to normal ...


Hoe ontstaat diabetes type 2?  

Microsoft Academic Search

Bij het ontstaan van diabetes type 2 spelen twee factoren een belangrijke rol: de insulineproductie is niet voldoende én het\\u000a lichaam is ongevoelig voor de kleine hoeveelheid insuline die nog wel geproduceerd wordt.

P. G. H. Janssen; M. J. P. Avendonk


Chromatin modifications associated with diabetes.  


Accelerated rates of vascular complications are associated with diabetes mellitus. Environmental factors including hyperglycaemia contribute to the progression of diabetic complications. Epidemiological and experimental animal studies identified poor glycaemic control as a major contributor to the development of complications. These studies suggest that early exposure to hyperglycaemia can instigate the development of complications that present later in the progression of the disease, despite improved glycaemic control. Recent experiments reveal a striking commonality associated with gene-activating hyperglycaemic events and chromatin modification. The best characterised to date are associated with the chemical changes of amino-terminal tails of histone H3. Enzymes that write specified histone tail modifications are not well understood in models of hyperglycaemia and metabolic memory as well as human diabetes. The best-characterised enzyme is the lysine specific Set7 methyltransferase. The contribution of Set7 to the aetiology of diabetic complications may extend to other transcriptional events through methylation of non-histone substrates. PMID:22639343

Keating, Samuel T; El-Osta, Assam



Quality measurement in diabetes care.  


This study aimed to evaluate diabetes quality measurement efforts, assess their strengths and areas for improvement, and identify gaps not adequately addressed by these measures. We conducted an environmental scan of diabetes quality measures, focusing on metrics included in the National Quality Measures Clearinghouse or promulgated by leading measurement organizations. Key informant interviews were also completed with thought leaders who develop, promote, and use quality measures. The environmental scan identified 146 distinct measures spanning 31 clinical processes or outcomes. This suggests a measurement system that is both redundant and inconsistent, with many different measures assessing the same clinical indicators. Interviewees believe that current diabetes measurement efforts are excessively broad and complex and expressed a need for better harmonization of these measures. Several gaps were also found, including a lack of measures focusing on population health, structural elements of health care, and prevention of diabetes. PMID:19848568

Leas, Brian F; Berman, Bettina; Kash, Kathryn M; Crawford, Albert G; Toner, Richard W; Goldfarb, Neil I; Nash, David B



Peptides and methods against diabetes  


This invention relates to methods of preventing or reducing the severity of diabetes. In one embodiment, the method involves administering to the individual a peptide having substantially the sequence of a on-conserved region sequence of a T cell receptor present on the surface of T cells mediating diabetes or a fragment thereof, wherein the peptide or fragment is capable of causing an effect on the immune system to regulate the T cells. In particular, the T cell receptor has the V.beta. regional V.beta.6 or V.beta.14. In another embodiment, the method involves gene therapy. The invention also relates to methods of diagnosing diabetes by determining the presence of diabetes predominant T cell receptors.

Albertini, Richard J. (Underhill Center, VT); Falta, Michael T. (Hinesburg, VT)



Efficiency Estimation in Diabetes Care.  

National Technical Information Service (NTIS)

The purpose of this research project was to examine Data Envelopment Analysis (DEA) in diabetes care and assess effectiveness of the multidisciplinary care team. Validity of technical efficiency is examined together with means for case-mix adjustment and ...

M. C. Christensen



[Eating disorders and diabetes mellitus].  


Numerous empirical studies indicate a higher frequency of eating disorders such as anorexia or bulimia nervosa in young female diabetic patients compared to the normal population. The comorbidity of the two syndromes usually leads to a continuous metabolic disorder bearing high risks of acute metabolic failure or early microangiopathic lesions. In addition to "restraint eating" as an essential element of diabetic therapy a premorbid neurotic malformation and/or poor coping strategies are further predisposing aspects for the development of an eating disorder. The inpatient treatment of a 22 year old patient suffering from both diabetes mellitus and bulimia nervosa demonstrates the association of neurotic malformation, poor coping style and the directive function of diabetic therapy. PMID:8560950

Herpertz, S; von Blume, B; Senf, W



Recent Advances (in Diabetes Research)  


... Honored with Prestigious Massachusetts Award The Association congratulates James A. Hamilton, PhD, of Boston University School of ... increase the risk of diabetes in women. Tamarra James-Todd, PhD, and her mentor Janet Rich-Edwards, ...


Second Annual Diabetes Technology Meeting.  

National Technical Information Service (NTIS)

The Second Annual Diabetes Technology Meeting on October 31 - November 2, 2002 at the Atlanta Hyatt Regency Hotel was co-sponsored by the Technologies for Metabolic Monitoring Joint Program, Centers for Disease Control and Prevention, NASA, Juvenile Diabe...

D. C. Klonoff



Carbohydrates and Diabetes (For Parents)  


... many kids with diabetes take to stay healthy. Carbohydrates and Blood Sugar The two main forms of ... and the carbs in food. Back Continue Balancing Carbohydrates In addition to serving a balanced diet of ...


[Sport and type 1 diabetes].  


Physical activity is recognised to be an efficient measure in improving glycemic control in the treatment of type 2 diabetes. This evidence is lacking in type I diabetes but type 1I diabetics benefit from the same advantages like the general population. For many type I diabetics, especially younger patients, sport represents an important modality in the treatment of their disease but also of their quality of life. However, this is often a challenge for the patient as well as for the physician regarding the metabolic consequences (hypo- but also hyperglycemia) which can appear in relation with physical activity. There are existing general recommendations concerning the intake of carbohydrates and the reduction of insulin doses but those have to be adapted individually for each patient and depend significantly on different sports and on the intensity of sport. PMID:23798190

Büsser, C; Meyer, P; Philippe, J; Jornayvaz, F R



Nodular lesions and mesangiolysis in diabetic nephropathy.  


Diabetic nephropathy is a leading cause of end-stage renal failure all over the world. Advanced human diabetic nephropathy is characterized by the presence of specific lesions including nodular lesions, doughnut lesions, and exudative lesions. Thus far, animal models precisely mimicking advanced human diabetic nephropathy, especially nodular lesions, remain to be fully established. Animal models with spontaneous diabetic kidney diseases or with inducible kidney lesions may be useful for investigating the pathogenesis of diabetic nephropathy. Based on pathological features, we previously reported that diabetic glomerular nodular-like lesions were formed during the reconstruction process of mesangiolysis. Recently, we established nodular-like lesions resembling those seen in advanced human diabetic nephropathy through vascular endothelial injury and mesangiolysis by administration of monocrotaline. Here, in this review, we discuss diabetic nodular lesions and its animal models resembling human diabetic kidney lesions, with our hypothesis that endothelial cell injury and mesangiolysis might be required for nodular lesions. PMID:23100177

Wada, Takashi; Shimizu, Miho; Yokoyama, Hitoshi; Iwata, Yasunori; Sakai, Yoshio; Kaneko, Shuichi; Furuichi, Kengo



Vascular reactivity in diabetes mellitus  

Microsoft Academic Search

Cardiovascular disease is responsible for 70% of the deaths in diabetes mellitus. Endothelial dysfunction occurs early in\\u000a atherosclerosis and can now be assessed accurately and reproducibly by noninvasive means. Hyperglycemia, insulin resistance,\\u000a microvascular complications, and coexistent conditions have been shown to impair endothelial function in diabetes. Resistance\\u000a to insulin's vasodilatory effect and increased free radical generation are probable mechanisms responsible

Ajay Chaudhuri



Infections in diabetic foot ulcers  

Microsoft Academic Search

Foot ulcers and infections are common in diabetic patients. A 30-month-long descriptive study was conducted in our hospital in which we analyzed microbiological isolates of all patients admitted with diabetic foot infections. The predominant flora identified were Staphylococcus aureus and coagulase-negative Staphylococcus, followed by Enterococcus spp., Streptococcus spp., and enterobacteriaceaes. In 27 positive cultures (42%) polymicrobial flora were found. There

F. J. Candel González; M. Alramadan; M. Matesanz; A. Diaz; F. González-Romo; I. Candel; A. Calle; J. J. Picazo



Epidemiology of Type 1 Diabetes  

Microsoft Academic Search

\\u000a Type 1 diabetes is thought to be caused by both genetic and environmental factors, each of which accounts for approximately\\u000a 50% of a person’s risk. The incidence of type 1 diabetes is increasing around the world, and evidence suggests that changing\\u000a environmental factors may be responsible for the observed increase. Viral infections, nutritional exposures, perinatal factors,\\u000a childhood growth, and other

Molly M. Lamb; Jill M. Norris


Technological advancements in diabetes care.  


Technologic advancements in the past decade have greatly improved our ability to manage diabetes, and made it practical to achieve tight control while providing a more flexible schedule and diet for children and their families. In this article, we discuss the recent advances in blood glucose monitoring, insulin analogues, and insulin delivery, as well as the new lexicon used by patients and the diabetes team. PMID:20568560

Christiano, Ann S; Shessler, Erik M



Pathogenesis of Human Diabetic Neuropathy  

Microsoft Academic Search

Experimental studies have provided multiple mechanisms for the development of diabetic neuropathy, yet very few findings have\\u000a been replicated in patients. Hyperglycemia mediated nerve damage may begin very early even prior to overt diabetes as evidenced\\u000a by several recent studies in patients with impaired glucose tolerance. Polyol pathway abnormalities have been exhaustively\\u000a explored in animals, but studies in man are

Rayaz Ahmed Malik; Aristides Veves


Psychosocial issues in pediatric diabetes  

Microsoft Academic Search

Although the majority of diabetic patients exhibit mild depression, anxiety, and somatic complaints at the time of diagnosis,\\u000a these symptoms are usually temporary and resolve within 6 to 9 months. However, in some patients, depressive symptoms may\\u000a increase with the duration of diabetes. Anxiety seems to increase and to be more prevalent in girls than in boys. Depression\\u000a and self-esteem

Alicia Schiffrin



Oxidative Stress in Diabetic Nephropathy  

PubMed Central

Diabetic nephropathy is a leading cause of end-stage renal failure worldwide. Its morphologic characteristics include glomerular hypertrophy, basement membrane thickening, mesangial expansion, tubular atrophy, interstitial fibrosis and arteriolar thickening. All of these are part and parcel of microvascular complications of diabetes. A large body of evidence indicates that oxidative stress is the common denominator link for the major pathways involved in the development and progression of diabetic micro- as well as macrovascular complications of diabetes. There are a number of macromolecules that have been implicated for increased generation of reactive oxygen species (ROS), such as, NAD(P)H oxidase, advanced glycation end products (AGE), defects in polyol pathway, uncoupled nitric oxide synthase (NOS) and mitochondrial respiratory chain via oxidative phosphorylation. Excess amounts of ROS modulate activation of protein kinase C, mitogen-activated protein kinases, and various cytokines and transcription factors which eventually cause increased expression of extracellular matrix (ECM) genes with progression to fibrosis and end stage renal disease. Activation of renin-angiotensin system (RAS) further worsens the renal injury induced by ROS in diabetic nephropathy. Buffering the generation of ROS may sound a promising therapeutic to ameliorate renal damage from diabetic nephropathy, however, various studies have demonstrated minimal reno-protection by these agents. Interruption in the RAS has yielded much better results in terms of reno-protection and progression of diabetic nephropathy. In this review various aspects of oxidative stress coupled with the damage induced by RAS are discussed with the anticipation to yield an impetus for designing new generation of specific antioxidants that are potentially more effective to reduce reno-vascular complications of diabetes.

Kashihara, N.; Haruna, Y.; Kondeti, V.K.; Kanwar, Y.S.



Lactation, diabetes, and nutrition recommendations  

Microsoft Academic Search

Human milk is recommended for infants throughout at least the first year of life. Breastfeeding is also recommended for infants\\u000a of women with preexisting diabetes or gestational diabetes. Dietary Reference Intakes (DRIs) 2002 provides recommendations for energy and macronutrients for all ages and for pregnancy and lactation. During the\\u000a first 6 months, infants receive an average of 500 kcal\\/d from

Diane Reader; Marion J. Franz



Nutrition therapy for diabetic gastroparesis  

Microsoft Academic Search

The management of diabetic gastroparesis often represents a significant clinical challenge in which the maintenance of nutrition\\u000a is pivotal. Gastric emptying is delayed in 30% to 50% of patients with longstanding type 1 or type 2 diabetes and upper gastrointestinal\\u000a symptoms also occur frequently. However, there is only a weak association between the presence of symptoms and delayed gastric\\u000a emptying.

Diana Gentilcore; Deirdre O'Donovan; Karen L. Jones; Michael Horowitz



Check Your Risk for Developing Type 2 Diabetes  


... Google Bookmarks Check Your Risk for Developing Type 2 Diabetes Did you know that type 2 diabetes ... your routine. Are You at Risk for Type 2 Diabetes? Almost everyone who develops type 2 diabetes ...


42 CFR 410.18 - Diabetes screening tests.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Diabetes screening tests. 410.18 Section...Other Health Services § 410.18 Diabetes screening tests. (a) Definitions...the following definitions apply: Diabetes means diabetes mellitus,...



42 CFR 410.18 - Diabetes screening tests.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Diabetes screening tests. 410.18 Section...Other Health Services § 410.18 Diabetes screening tests. (a) Definitions...the following definitions apply: Diabetes means diabetes mellitus,...



Diabetes in Older People - A Disease You Can Manage  


... can do to lower your risk. What Is Diabetes? Our bodies change the food we eat into ... people with diabetes, called an endocrinologist. Types Of Diabetes There are two kinds of diabetes that can ...


Ten Ways Hispanics and Latinos Can Prevent Type 2 Diabetes  


... 2 Diabetes Ten Ways Hispanics and Latinos Can Prevent Type 2 Diabetes Hispanics and Latinos are at ... diabetes, but there is good news. You can prevent or delay type 2 diabetes by making small ...


Implementation of Screening and Exams for Diabetic Retinopathy.  

National Technical Information Service (NTIS)

Diabetes is the leading cause of legal blindness in the US. Diabetic retinopathy is preventable if caught early and sight saving treatment is given; nevertheless, many diabetics simply don't have regular eye exams. Juvenile Diabetes Research Foundation (J...

R. A. Goldstein



Type 2 diabetes and pregnancy.  


Type 2 diabetes is a growing concern, with the number of new cases increasing and occurring at a younger age due to obesity. Consequently the number of cases arising in women of child-bearing age is increasing, and the condition will be encountered more frequently in the antenatal clinic. Type 2 diabetes is often perceived as a benign form of diabetes, but this is not the case when one examines pregnancy outcomes. Rates of perinatal mortality (25/1000) and congenital malformation (99/1000) are significantly greater than those in background populations and at least as poor as those in type 1 diabetes. The rates of hypertension, pre-eclampsia and postpartum haemorrhage are greater than the general maternity population, as is the rate of operative delivery. To improve outcomes we need to dispel the myth that type 2 diabetes is a benign condition. Educational programmes, population screening, and strategies to help vulnerable groups access the services available will increase our ability to identify and counsel women with type 2 diabetes early enough to make a difference. PMID:15921969

Dunne, Fidelma



Diabetic colon preparation comparison study.  


The purpose of the present study was to establish an optimal colon preparation for persons with diabetes who are undergoing colonoscopies. Specifically, the aim was to compare the difference between an experimental and standard preparation. Adequacy of bowel preparation is critical for good bowel visualization. Compared with nondiabetic patients, persons with diabetes have slower gastric emptying, colonic transit, and colon evacuation. Inadequate preparations may lead to suboptimal colonoscopy resulting in overlooked pathology, repeated examinations with associated risks, and organizational inefficiencies. Using a single-blind experimental design, 198 persons with diabetes who were scheduled to receive colonoscopies were randomly assigned to either the experimental (diabetic colon preparation) or the control (standard colon preparation) group. Patients in the diabetic colon preparation group had 70% good colon preparations compared with 54% in the standard group, and this finding was significant (? = 5.14, p = 0.02). Results indicate that diabetic patients receiving 10 ounces of magnesium citrate 2 days prior to their colonoscopies followed by 10 ounces of magnesium citrate and 4-L polyethylene glycol the day prior to the procedure had cleaner colons than those receiving standard preparation of 10 ounces of magnesium citrate and 4-L polyethylene glycol the day prior to procedure. This colon preparation is safe, feasible, well-tolerated, and effective. PMID:21979399

Hayes, Ann; Buffum, Martha; Hughes, Joyce


The endothelium in diabetic nephropathy.  


The long-term complications of diabetes are characterized by pathologic changes in both the microvasculature and conduit vessels. Although the fenestrated glomerular endothelium classically has been viewed as providing little in the way of an impediment to macromolecular flow, increasing evidence illustrates that this is not the case. Rather, hyperglycemia-mediated endothelial injury may predispose to albuminuria in diabetes both through direct effects and through bidirectional communication with neighboring podocytes. Although neo-angiogenesis of the glomerular capillaries may be a feature of early diabetes, particularly in the experimental setting, loss of capillaries in the glomerulus and in the interstitium are key events that each correlate closely with declining glomerular filtration rate in patients with diabetic nephropathy. The hypoxic milieu that follows the microvascular rarefaction provides a potent stimulus for fibrogenesis, leading to the glomerulosclerosis and tubulointerstitial fibrosis that characterize advanced diabetic kidney disease. Given the pivotal role the endothelium plays in both the development and the progression of diabetic nephropathy we need effective strategies that prevent its loss or accelerate its regeneration. Such advances likely will lead not only to improved tissue oxygenation and reduced fibrosis, but also to improved long-term renal function. PMID:22617769

Advani, Andrew; Gilbert, Richard E



Diabetic heart and the cardiovascular surgeon.  


The importance of diabetes mellitus (diabetes) as a cause of mortality and morbidity is well known. The number of patients increases alongside aging of the population and increase in the prevalence of obesity and sedentary life style. Diabetes affects approximately 8% of the USA population. Type I (insulin-dependent) diabetes occurs in 20% of cases, and type II (insulin-independent or maturity onset) diabetes occurs in 80% of the diabetic population diabetes mellitus type II is preceded by longstanding asymptomatic hyperglycemia, which accounts for the development of long-term diabetic complications. The main macrovascular complications for which diabetes has been a well established risk factor throughout the cardiovascular system, are: coronary artery disease (CAD), peripheral vascular disease (PVD), increased intima-media thickness (IMT) and stroke. Considering the cardiovascular surgeon, diabetes is associated with an increased rate of early and late complications following coronary artery bypass grafting. Diabetic patients have also been known to have an increased incidence of complications after elective major vascular surgery such as carotid endarterectomy (CEA) and leg amputations due to PVD. Cardiovascular surgeons frequently treat diabetic patients either because diabetes is incidental to another disease requiring surgery, or due to diabetes-related complication such as occlusive vascular disease, neuropathy or infection. Approximately 50% of diabetics undergo one,or more operations during their lifetime. This paper reviews the relationship between diabetic patients and their cardiovascular surgeons. In order to understand this relationship, one must first examine the underlying mechanisms by which hyperglycemia causes hazardous pre and post operative consequences. Then, one must examine the existing evidence of how diabetes correlates with these cardiovascular consequences, followed by the need for multidisciplinary team work which helps the surgeon to cope with diabetic patients. PMID:18537602

Yosefy, Chaim



Smoking and Type 2 Diabetes Mellitus  

PubMed Central

Cigarette smoking is a well-known risk factor in many diseases, including various kinds of cancer and cardiovascular disease. Many studies have also reported the unfavorable effects of smoking for diabetes mellitus. Smoking increases the risk of developing diabetes, and aggravates the micro- and macro-vascular complications of diabetes mellitus. Smoking is associated with insulin resistance, inflammation and dyslipidemia, but the exact mechanisms through which smoking influences diabetes mellitus are not clear. However, smoking cessation is one of the important targets for diabetes control and the prevention diabetic complications.



Gender Differences in Living with Diabetes Mellitus  

PubMed Central

Conflict of interest: none declared. The aim of this review is to discuss the gender difference among diabetic population. Metabolic control, age and gender significantly affect their psychosocial responses to disease. Psychosocial problems may also occur secondary to negative diabetes related experiences including diagnosis, increased stress and onset of complications. Although significant problems do not occur in all diabetic population, they occur in few patients. More work is needed in the area of identifying those patients having adjustment difficulties to diabetic related challenges. This review indicates that male diabetics are observed to be living more effectively with diabetes, lesser depression and anxiety but more energy and better positive wellbeing

Siddiqui, Muhammad A; Khan, Mannan F; Carline, Thomas E



Genetic polymorphism of CON 1 and CON 2 salivary proteins detected by immunologic and concanavalin a reactions on nitrocellulose with linkage of CON 1 and CON 2 genes to the SPC (salivary protein gene complex)  

Microsoft Academic Search

Two new genetic protein polymorphisms (CON 1 and CON 2) were identified in parotid saliva. Genetic polymorphisms of salivary CON 1 (concanavalin A) and CON 2 proteins are determined by autosomal inheritance of one expressed (dominant) and one unexpressed (recessive) allele for each gene. Autosomal inheritance is supported by studies in 26 families including 105 children for CON 1 and

Edwin A. Azen; Pao-Lo Yu



[Diabetes mellitus in the elderly].  


The prevalence of diabetes increase in the elderly. Ageing is one of the most important factors contributing to development of glucose intolerance (insuline resistance). NHANES II data showed that in the poppulation over 65 years 18.7% has got overt diabetes and 22.8% glucose intolerance. Similar data were obtained among ageing inhabitants of the city of Bialystok (downtown). The criteria of diagnosis of diabetes in the elderly are the same like in the younger population. However, in the elderly the clinical symptoms are not characteristic and scanty (limited). The period without symptoms is long. Very often, the diabetes is diagnosed for the first time in patient with the heart infarct, brain stroke, diabetic foot or even hyperosmolar coma. There may occur two critical situations in the elderly diabetic persons, namely non-ketotic hyperosmolar coma and hypoglycameia. The non-ketotic hyperosmolar coma is a result of a considerable elevation in the blood concentration of glucose, sodium and urea. This, in turn, is a consequence of osmotic diuresis which is non balanced by elevation in the volume of water intake. Factors facilitating development of the coma include: nontreated diabetes, infirmity, inadequate care, diuretics, stroke, hyperthermia. Hypoglycaemia in the elderly is a very serious problem. It can cause arrhythmia, a rise in the blood pressure, unconsciousness, falls and injuries. The most often reason of hypoglycaemia in the elderly are: long-acting derivatives of sulphonylurea, treatment with insulin and irregular meals. The major aims of treatment of diabetes in the elderly are: reduction of hyperglycaemia, reduction in the development of complications and minimizing of the risk of hypoglycaemia. An elderly patient with diabetes should have each year a check-up which would include examination of the eyes, kidneys, feet. The elderly patient with diabetes is often crippled, indolent and lives often alone. Therefore, such a patient should be taken care of by a team of people. The most important role in the team should be played by a family physician and a social nurse. PMID:12183966

Górska, Maria



Endothelial dysfunction as a potential contributor in diabetic nephropathy  

Microsoft Academic Search

The mechanisms that drive the development of diabetic nephropathy remain undetermined. Only 30–40% of patients with diabetes mellitus develop overt nephropathy, which suggests that other contributing factors besides the diabetic state are required for the progression of diabetic nephropathy. Endothelial dysfunction is associated with human diabetic nephropathy and retinopathy, and advanced diabetic glomerulopathy often exhibits thrombotic microangiopathy, including glomerular capillary

Katsuyuki Tanabe; Byron P. Croker; Richard J. Johnson; Maria B. Grant; Tomoki Kosugi; Qiuhong Li; Takahiko Nakagawa



Vegfa Protects the Glomerular Microvasculature in Diabetes  

PubMed Central

Vascular endothelial growth factor A (VEGFA) expression is increased in glomeruli in the context of diabetes. Here, we tested the hypothesis that this upregulation of VEGFA protects the glomerular microvasculature in diabetes and that therefore inhibition of VEGFA will accelerate nephropathy. To determine the role of glomerular Vegfa in the development and progression of diabetic nephropathy, we used an inducible Cre-loxP gene-targeting system that enabled genetic deletion of Vegfa selectively from glomerular podocytes of wild-type or diabetic mice. Type 1 diabetes was induced in mice using streptozotocin (STZ). We then assessed the extent of glomerular dysfunction by measuring proteinuria, glomerular pathology, and glomerular cell apoptosis. Vegfa expression increased in podocytes in the STZ model of diabetes. After 7 weeks of diabetes, diabetic mice lacking Vegfa in podocytes exhibited significantly greater proteinuria with profound glomerular scarring and increased apoptosis compared with control mice with diabetes or Vegfa deletion without diabetes. Reduced local production of glomerular Vegfa in a mouse model of type 1 diabetes promotes endothelial injury accelerating the progression of glomerular injury. These results suggest that upregulation of VEGFA in diabetic kidneys protects the microvasculature from injury and that reduction of VEGFA in diabetes may be harmful.

Sivaskandarajah, Gavasker A.; Jeansson, Marie; Maezawa, Yoshiro; Eremina, Vera; Baelde, Hans J.; Quaggin, Susan E.



Common crossroads in diabetes management  

PubMed Central

The prevalence and impact of type 2 diabetes are reaching epidemic proportions in the United States. Data suggest that effective management can reduce the risk for both microvascular and macrovascular complications of diabetes. In treating patients with diabetes, physicians must be prepared not only to tailor the initial treatment to the individual and his or her disease severity but also to advance treatment as necessary and in step with disease progression. The majority of patients with diabetes are not at goal for glycated hemoglobin A1C, fasting plasma glucose, or postprandial plasma glucose levels. Although lifestyle changes based on improved diet and exercise practices are basic elements of therapy at every stage, pharmacologic therapy is usually necessary to achieve and maintain glycemic control. Oral antidiabetic agents may be effective early in the disease but, eventually, they are unable to compensate as the disease progresses. For patients unable to achieve glycemic control on 2 oral agents, current guidelines strongly urge clinicians to consider the initiation of insulin as opposed to adding a third oral agent. Recent research suggests that earlier initiation of insulin is more physiologic and may be more effective in preventing complications of diabetes. Newer, longer-lasting insulin analogs and the use of simplified treatment plans may overcome psychological resistance to insulin on the part of physicians and patients. This article summarizes the risks associated with uncontrolled fasting and postprandial hyperglycemia, briefly reviews the various treatment options currently available for type 2 diabetes, presents case vignettes to illustrate crossroads encountered when advancing treatment, and offers guidance to the osteopathic physician on the selection of appropriate treatments for the management of type 2 diabetes.

Valitutto, Michael



The diabetic foot: a review.  


Diabetic foot ulceration (DFU) is among the most frequent complications of diabetes. Neuropathy and ischaemia are the initiating factors and infection is mostly a consequence. We have shown in this review that any DFU should be considered to have vascular impairment. DFU will generally heal if the toe pressure is >55 mmHg and a transcutaneous oxygen pressure (TcPO2) <30 mmHg has been considered to predict that a diabetic ulcer may not heal. The decision to intervene is complex and made according to the symptoms and clinical ?ndings. If both an endovascular and a bypass procedure are possible with an equal outcome to be expected, endovascular treatments should be preferred. Primary and secondary mid-term patency rates are better after bypass, but there is no difference in limb salvage. Bedridden patients with poor life expectancy and a non-revascularisable leg are indications for performing a major amputation. A deep infection is the immediate cause of amputation in 25% to 50% of diabetic patients. Patients with uncontrolled abscess, bone or joint involvement, gangrene, or necrotising fasciitis have a "foot-at risk" and need prompt surgical intervention with debridement and revascularisation. As demonstrated in this review, foot ulcer in diabetic is associated with high mortality and morbidity. Early referral, non-invasive vascular testing, imaging and intervention are crucial to improve DFU healing and to prevent amputation. Diabetics are eight to twenty-four times more likely than non-diabetics to have a lower limb amputation and it has been suggested that a large part of those amputations could be avoided by an early diagnosis and a multidisciplinary approach. PMID:24126512

Ricco, J B; Thanh Phong, L; Schneider, F; Illuminati, G; Belmonte, R; Valagier, A; Régnault De La Mothe, G



Automedicarse con antibióticos puede perjudicar su salud  

Center for Drug Evaluation (CDER)

... Automedicarse con antibióticos puede perjudicar su salud. (poster). ... Consulte a su médico oa un profesional de la salud antes de usar antibióticos. ... More results from


Automedicarse con antibióticos puede perjudicar su salud ...  

Center for Drug Evaluation (CDER)

... Automedicarse con antibióticos puede perjudicar su salud (PSA). ... Consulte a su médico oa un profesional de la salud antes de usar antibióticos. ... More results from


IHS Introduction to Type 2 Diabetes. A Guide for Health Care Providers (Revised).  

National Technical Information Service (NTIS)

Contents: What is Type 2 Diabetes; The Cycle of Type 2 Diabetes; Type 1 vs. Type 2 Diabetes; Risk Factors for Type 2 Diabetes in American Indians; Diagnosing Diabetes; Diagnostic Criteria for Diabetes Mellitus, Impaired Glucose Metabolism, and Gestational...



Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients  

Microsoft Academic Search

BACKGROUND: This study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR) in type 2 diabetic patients and their contributing factors. METHODS: 199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break

Masoud Reza Manaviat; Maryam Rashidi; Mohammad Afkhami-Ardekani; Mohammad Reza Shoja



Diabetic complications are associated with liver enzyme activities in people with type 1 diabetes  

Microsoft Academic Search

This study was performed to clarify if diabetic complications are associated with liver enzyme activities in type 1 diabetic outpatients. Elevated activities of serum aminotransferases are a common sign of liver disease and are observed more frequently among people with diabetes than in the general population. Many studies have shown an association between specific diabetic complications and disturbances in various

Perttu E. T. Arkkila; Pertti J. Koskinen; Ilkka M. Kantola; Tapani Rönnemaa; Eila Seppänen; Jorma S. Viikari



Anti-diabetic effects of rice hull smoke extract in alloxan-induced diabetic mice  

Technology Transfer Automated Retrieval System (TEKTRAN)

We investigated the protective effect of a liquid rice hull smoke extract (RHSE) against diabetes in alloxan-induced diabetic mice. Anti-diabetic effects of RHSE were evaluated in both the rat insulinoma-1 cell line (INS-1) and diabetic ICR mice induced by inraperitoneal (ip) injection of alloxan. ...


Overview of Diabetes in Children and Adolescents. A Fact Sheet from the National Diabetes Education Program  

ERIC Educational Resources Information Center

|Type 1 diabetes in U.S. children and adolescents may be increasing and many more new cases of type 2 diabetes are being reported in young people. Standards of care for managing children with diabetes issued by the American Diabetes Association in January 2005 provide more guidance than previously given. To update primary care providers and their…

National Diabetes Education Program (NDEP), 2006



Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in southern India  

Microsoft Academic Search

OBJECTIVEThe aim of this study was to determine the prevalence and risk factors for microalbuminuria among south Indian type 2 diabetic patients attending a diabetes centre.METHODSOne thousand four hundred and twenty five type 2 diabetic patients attending a diabetes centre in south India were recruited for the study. Urinary albumin concentration was measured by immunoturbodimetric assay. Microalbuminuria was diagnosed if

A Varghese; R Deepa; M Rema; V Mohan



Michigan Diabetes Outreach Networks: A Public Health Approach to Strengthening Diabetes Care  

Microsoft Academic Search

This study describes a statewide public health approach to strengthen diabetes care; evaluates diabetes-related processes of care for individuals enrolled in the Michigan Diabetes Outreach Network (MDON) program; and, examines MDON in the context of priorities for diabetes care and public health policy. Organizational information was obtained through semi-structured interviews. Program outcomes are examined using data from client intake and

Sarah L. Krein; Mandi L. Klamerus



Diabetes mellitus, diabetes insipidus, and optic atrophy. An autosomal recessive syndrome?  

Microsoft Academic Search

Twenty-one families were selected from the published reports in which the propositus had the triad of juvenile diabetes mellitus, diabetes insipidus, and optic atrophy. The data were consistent with the hypothesis of an autosomal gene which, in the homozygote, causes juvenile diabetes mellitus and one or more of diabetes insipidus, optic atrophy, and nerve deafness. Heterozygotes appear to have an

F C Fraser; T Gunn



Diabetes meanings a mong those without diabetes: explanatory models of immigrant Latinos in rural North Carolina  

Microsoft Academic Search

The prevalence of type 2 diabetes is increasing in the United States, particularly among minority individuals. Primary prevention programs for diabetes must be designed to address the beliefs of the populations they target. Little research has investigated the beliefs of those who do not have diabetes. This analysis uses in-depth interviews collected from Latino immigrants, not diagnosed with diabetes, living

Thomas A. Arcury; Anne H. Skelly; Wilbert M. Gesler; Molly C. Dougherty



Prevention of Gestational Diabetes  

PubMed Central

OBJECTIVE To examine the feasibility of an individualized exercise program to prevent gestational diabetes mellitus (GDM) in obese pregnant women. RESEARCH DESIGN AND METHODS The study was a pilot randomized controlled trial with obese pregnant women (intervention group, individualized exercise program [n = 25]; control group, usual care [n = 25]). Average weekly energy expenditure (MET hours per week and kilocalories per week) of exercise-specific activity was assessed during pregnancy using the Pregnancy Physical Activity Questionnaire. Fasting glucose and insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed at baseline and 20, 28, and 36 weeks' gestation. RESULTS Of the women in the intervention group, 16 of 22 (73%) achieved more than 900 kcal/week of exercise-based activity at 28 weeks compared with 8 of 19 women in the control group (42%), P = 0.047. However, insulin resistance (HOMA-IR) did not differ between the groups. CONCLUSION This intervention was feasible and prompted a modest increase in physical activity. However, we are not confident that this intervention would be sufficient to prevent GDM.

Callaway, Leonie K.; Colditz, Paul B.; Byrne, Nuala M.; Lingwood, Barbara E.; Rowlands, Ingrid J.; Foxcroft, Katie; McIntyre, H. David



Controversies around gestational diabetes  

PubMed Central

OBJECTIVE To summarize some of the issues facing primary care physicians who are seeing increasing numbers of patients with gestational diabetes mellitus (GDM) and to explore new developments in use of oral hypoglycemics during pregnancy. QUALITY OF EVIDENCE All the literature on screening for GDM offers level III evidence. Much of the literature on treatment is also level III, but newer studies offer level I evidence and are more useful for daily practice. Existing research leaves many important questions unanswered; research findings are inconsistent among studies, and treatment strategies are challenging to implement. MAIN MESSAGE Recent studies have clarified that rates of neonatal mortality and congenital malformations are not higher among the offspring of mothers with GDM. Treatment might affect birth weight, but whether treatment is associated with reductions in rates of shoulder dystocia and cesarean section is unclear. Several level I studies conclude that the oral hypoglycemic glyburide can be used safely and effectively during the second and third trimesters of pregnancy. CONCLUSION Management of GDM remains a controversial area in obstetric care. It is a growing area of research, and new developments that might clarify risk and simplify treatment are expected in the coming years.

Kelly, Len; Evans, Laura; Messenger, David



Diabetes mellitus and obesity.  


Numerous vitamins, herbs, supplements, and other agents are readily available for the treatment of diabetes and obesity. Many of these products have little evidence-based medical support to prove the efficacy of these supplements. The physician must be aware that their patients are using these products and must be knowledgeable about their side effects and drug-herb interactions. Our patients have tremendous access to medical information in the lay literature and on the internet. They are using this information to gain access to various diet therapies. Numerous fad diets consisting of various combinations of protein, carbohydrate, and fat are widely publicized but not grounded in evidence. Liquid diets and supplements are readily available and widely used by the public with little long-term beneficial effects on obese patients. Other alternative methods, such as hypnotherapy, acupuncture, biofeedback, and electrogalvanic therapy, have become widely available and seem to have little adverse reaction, but whose benefits remain to be proved. The physician must recognize the widespread use of these products and work with patients and alternative practitioners to deliver comprehensive quality care. Physicians who become comfortable with these products should consider their judicious use while monitoring for side effects and drug interaction. It is hoped that with further evidence-based study many of these products and techniques will enter mainstream medicine. PMID:12391712

Roth, Alan



Diabetes Education Multimedia for Vulnerable Populations.  

National Technical Information Service (NTIS)

The purpose of this research is to develop and evaluate a clinic-based multimedia tool for diabetes education, targeting underserved populations. There are multiple barriers recognized to providing diabetes education. These include: lower health literacy,...

B. Gerber



Living with Diabetes: Sexual Health (Men)  


... Living with Diabetes > Complications > Men's Health > Sexual Health Sexual Health Listen Sex is an important part of life and relationships. But diabetes can affect a man's sex life. It is important to understand that there ...


Investigation on Ocular Complication of Diabetes.  

National Technical Information Service (NTIS)

A five year study on the ocular complications of diabetes compared results of eye examinations and biochemical analyses of diabetics with eye disease to nondiabetics with the same prognoses. For the same two populations, results of cataract surgery and po...

T. H. Kirmani



Third Annual Clinical Diabetes Technology Meeting.  

National Technical Information Service (NTIS)

The Third Annual Clinical Diabetes Technology Meeting was presented by the Diabetes Technology Society at the San Diego California Marriott Mission Valley Hotel on April 20-21 2007. The attendance was 378 healthcare providers and scientists. The first day...

D. D. Klonoff



Overview of Diabetes in Children and Adolescents  


... insulin production, insulin action, or both. Diabetes is associated with serious complications and premature death, but timely diagnosis ... as celiac disease and autoimmune thyroiditis are also associated with type 1 diabetes. Management. The basic elements of ...


Depression with Diabetes May Speed Mental Decline  


... sharing features on this page, please enable JavaScript. Depression with diabetes may speed mental decline (*this news ... 2013) Friday, August 23, 2013 Related MedlinePlus Pages Depression Diabetes Type 2 Mild Cognitive Impairment By Veronica ...


Diabetes: five keys to better care.  


Hospitals that are pushing the envelope on diabetes care are taking a population health mangement approach that involves five critical components. This is the latest installment in our yearlong Diabetes Management series. PMID:23700756

Aston, Geri



Diabetes: A National Plan for Action.  

National Technical Information Service (NTIS)

Currently, more than 18 million Americans have diabetes and are at risk for related complications like heart disease, stroke, blindness, amputations and kidney disease. On average, every 25 seconds, someone in the United States is diagnosed with diabetes....



Hyperglycemic Diabetic Stupor: A Spectrum of Disorders.  

National Technical Information Service (NTIS)

Cases of diabetic hyperglycemic stupor are presented to illustrate the spectrum extending from diabetic ketoacidosis with minimal hyperglycemia to severe hyperglycemia without ketoacidosis. The recognition of lactic acidosis, a non-ketotic acidosis, with ...

J. W. Anderson



Consequences of alcohol use in diabetics.  


The hormone insulin, which is produced in the pancreas, is an important regulator of blood sugar levels. In people with diabetes, the pancreas does not produce sufficient insulin (type 1 diabetes) or the body does not respond appropriately to the insulin (type 2 diabetes). Alcohol consumption by diabetics can worsen blood sugar control in those patients. For example, long-term alcohol use in well-nourished diabetics can result in excessive blood sugar levels. Conversely, long-term alcohol ingestion in diabetics who are not adequately nourished can lead to dangerously low blood sugar levels. Heavy drinking, particularly in diabetics, also can cause the accumulation of certain acids in the blood that may result in severe health consequences. Finally, alcohol consumption can worsen diabetes-related medical complications, such as disturbances in fat metabolism, nerve damage, and eye disease. PMID:15706798

Emanuele, N V; Swade, T F; Emanuele, M A



Diabetes and Menopause: A Twin Challenge  


Diabetes Basics In-Depth Multimedia Expert Answers Expert Blog Resources What's New Reprints A single copy of ... may be reprinted for personal, noncommercial use only. Diabetes and menopause: A twin challenge By Mayo Clinic ...


Food Safety for People with Diabetes  

Center for Food Safety and Applied Nutrition (CFSAN)

... Food Safety for People with Diabetes. Food Safety for People with Diabetes (PDF - 2.78MB). A need-to-know guide for those ... More results from


Epidemiology of Diabetes Mellitus in Japan.  

National Technical Information Service (NTIS)

The clinical and epidemiological features of diabetes mellitus in Japan have been compiled and compared with data from other countries. Diabetes is basically the same in Japan as elsewhere: however, consideration of important differences has led to the fo...

W. G. Blackard Y. Omori L. R. Freedman



Women and Diabetes: Frequently Asked Questions  


... Resources: Women's Health FREE Diabetes Support On Your Cell Phone Receive ... Why are women with diabetes pre-disposed to developing recurrent yeast infections? The glucose (sugar) in your body is ...


[Risk of the development of diabetes mellitus in the relatives of diabetics becoming ill after 35].  


A genetic-epidemiological study of 1300 diabetes mellitus patients who developed the disease over the age of 35, was conducted. The risk of diabetes mellitus development was calculated among siblings with relation to therapy type the presence of obesity in the probands without defining the types of diabetes mellitus in the siblings. Among the siblings of the patients with insulin-independent diabetes mellitus, diabetes mellitus incidence was lower than among the siblings of the entire sample. Differences in diabetes mellitus incidence among the siblings of the probands with insulin-independent diabetes mellitus with regard to the presence or absence of obesity were undetectable. PMID:3952069

Mazovetski?, A G; Kuraeva, T L; Sergeev, A S; Kerimi, N B


Current concepts in diabetic gastroparesis.  


Diabetic gastroparesis is a common and debilitating condition affecting millions of patients with diabetes mellitus worldwide. Although gastroparesis in diabetes has been known clinically for more than 50 years, treatment options remain very limited. Until recently, the scientific literature has offered few clues regarding the precise aetiology of gastric dysfunction in diabetes.Up to 50% of patients with diabetes may experience postprandial abdominal pain, nausea, vomiting and bloating secondary to gastric dysfunction. There is no clear association between length of disease and the onset of delayed gastric emptying. Gastroparesis affects both type 1 (insulin dependent) and type 2 (non- insulin dependent) forms of diabetes. Diagnosis requires identifying the proper symptom complex, while excluding other entities (peptic ulcer disease, rheumatological diseases, medication effects). The diagnosis of gastroparesis may be confirmed by demonstrating gastric emptying delay during a 4-hour scintigraphic study. Treatment options are limited and rely on dietary modifications, judicious use of available pharmacological agents, and occasionally surgical or endoscopic placement of gastrostomies or jejunostomies. Gastric pacing offers promise for patients with medically refractory gastroparesis but awaits further investigation. Current pharmacological agents for treating gastroparesis include metoclopramide, erythromycin, cisapride (only available via a company-sponsored programme) and domperidone (not US FDA approved). All of these drugs act as promotility agents that increase the number or the intensity of gastric contractions. These medications are not uniformly effective and all have adverse effects that limit their use. Cisapride has been removed from the open market as a result of over 200 reported cases of cardiac toxicity attributed to its use. Unfortunately, there is a paucity of clinical studies that clearly define the efficacy of these agents in diabetic gastroparesis and there are no studies that compare these drugs to each other. The molecular pathophysiology of diabetic gastroparesis is unknown, limiting the development of rational therapies. New studies, primarily in animals, point to a defect in the enteric nervous system as a major molecular cause of abnormal gastric motility in diabetes. This defect is characterised by a loss of nitric oxide signals from nerves to muscles in the gut resulting in delayed gastric emptying. Novel therapies designed to augment nitric oxide signalling are being studied. PMID:12825960

Smith, D Scott; Ferris, Christopher D



Trace Elements in Diabetes Mellitus  

PubMed Central

Introduction: Diabetes Mellitus is the commonest major metabolic disease and most prevalent diseases worldwide.Its related morbidity is due to its micro and macro angiopathic complications. Aim: The aim of this study was to measure and compare the serum levels of zinc and magnesium in normal individuals and in diabetic patients. Method: Analysis of minerals was done in plasma by using a Varian Spectra AA 220 model atomic absorption spectrophotometer. Result: Our observations showed a definite lowering of serum magnesium (p<0.001) and serum zinc levels (p<0.001) were significant in diabetic group. Conclusion: The cause of diabetic hypomagnesaemia is multifactorial. An altered metabolism, a poor glycaemic control and osmotic diuresis may be contributory factors. Decreased serum zinc levels in diabetes may be caused by an increase in urinary loss. These decreased levels of trace elements cause disturbances in glucose transport across cell membrane lead to insufficient formation and secretion of insulin by pancreas which compromise in the antioxidant defense mechanisms.

S., Praveeena; Pasula, Sujatha; Sameera, K.



Diabetes, insulin and cancer risk  

PubMed Central

There is a consensus that both type 1 and type 2 diabetes are associated with a spectrum of cancers but the underlying mechanisms are largely unknown. On the other hand, there are ongoing debates about the risk association of insulin use with cancer. We have briefly reviewed recent related research on exploration of risk factors for cancer and pharmacoepidemiological investigations into drug use in diabetes on the risk of cancer, as well as the current understanding of metabolic pathways implicated in intermediary metabolism and cellular growth. Based on the novel findings from the Hong Kong Diabetes Registry and consistent experimental evidence, we argue that use of insulin to control hyperglycemia is unlikely to contribute to increased cancer risk and that dysregulations in the AMP-activated protein kinase pathway due to reduced insulin action and insulin resistance, the insulin-like growth factor-1 (IGF-1)-cholesterol synthesis pathway and renin-angiotensin system, presumably due to reduced insulin secretion and hyperglycemia, may play causal roles in the increased risk of cancer in diabetes. Further exploration into the possible causal relationships between abnormalities of these pathways and the risk of cancer in diabetes is warranted.

Yang, Xi-Lin; Chan, Juliana CN



Trace elements in diabetes mellitus.  


Introduction: Diabetes Mellitus is the commonest major metabolic disease and most prevalent diseases worldwide.Its related morbidity is due to its micro and macro angiopathic complications. Aim: The aim of this study was to measure and compare the serum levels of zinc and magnesium in normal individuals and in diabetic patients. Method: Analysis of minerals was done in plasma by using a Varian Spectra AA 220 model atomic absorption spectrophotometer. Result: Our observations showed a definite lowering of serum magnesium (p<0.001) and serum zinc levels (p<0.001) were significant in diabetic group. Conclusion: The cause of diabetic hypomagnesaemia is multifactorial. An altered metabolism, a poor glycaemic control and osmotic diuresis may be contributory factors. Decreased serum zinc levels in diabetes may be caused by an increase in urinary loss. These decreased levels of trace elements cause disturbances in glucose transport across cell membrane lead to insufficient formation and secretion of insulin by pancreas which compromise in the antioxidant defense mechanisms. PMID:24179883

S, Praveeena; Pasula, Sujatha; Sameera, K



Diabetes and alpha lipoic Acid.  


Diabetes mellitus is a multi-faceted metabolic disorder where there is increased oxidative stress that contributes to the pathogenesis of this debilitating disease. This has prompted several investigations into the use of antioxidants as a complementary therapeutic approach. Alpha lipoic acid, a naturally occurring dithiol compound which plays an essential role in mitochondrial bioenergetic reactions, has gained considerable attention as an antioxidant for use in managing diabetic complications. Lipoic acid quenches reactive oxygen species, chelates metal ions, and reduces the oxidized forms of other antioxidants such as vitamin C, vitamin E, and glutathione. It also boosts antioxidant defense system through Nrf-2-mediated antioxidant gene expression and by modulation of peroxisome proliferator activated receptors-regulated genes. ALA inhibits nuclear factor kappa B and activates AMPK in skeletal muscles, which in turn have a plethora of metabolic consequences. These diverse actions suggest that lipoic acid acts by multiple mechanisms, many of which have only been uncovered recently. In this review we briefly summarize the known biochemical properties of lipoic acid and then discussed the oxidative mechanisms implicated in diabetic complications and the mechanisms by which lipoic acid may ameliorate these reactions. The findings of some of the clinical trials in which lipoic acid administration has been tested in diabetic patients during the last 10?years are summarized. It appears that the clearest benefit of lipoic acid supplementation is in patients with diabetic neuropathy. PMID:22125537

Golbidi, Saeid; Badran, Mohammad; Laher, Ismail



[Nutritional therapy in diabetes mellitus].  


Most aspects of the nutritional therapy of diabetes mellitus apply equally to IDDM and NIDDM patients and are also appropriate for people with high risk of cardiovascular diseases. A restriction of energy, a reduction of saturated fatty acids as well as of alcoholic drinks and simple sugars are the most important measures. This modification of nutritional intake together with increased fibre consumption is not only appropriate to avoid hyperglycaemia in diabetic patients but has also its benefits in patients presenting with the metabolic syndrome (possible reduction of hyperinsulinaemia, hypertension and hyperlipoproteinaemia). Diabetic patients should have regular screening for microalbuminuria. At first signs of an early stage of nephropathy patients should be advised to restrict their protein intake. About 50% of daily energy intake should be derived from carbohydrates and fat intake should be no more than 35% of total energy (saturated fatty acids less than 10% of energy). Carbohydrate exchange units are usually not necessary in NIDDM patients. In addition diabetes specialty foods are not an essential part of the nutritional therapy. The success of the nutritional therapy in diabetic patients is substantially dependent upon qualified counselling and education of the patients by the physician (as far as possible with the assistance of a dietitian). PMID:8475634

Toeller, M



Coffee, diabetes, and weight control.  


Several prospective epidemiologic studies over the past 4 y concluded that ingestion of caffeinated and decaffeinated coffee can reduce the risk of diabetes. This finding is at odds with the results of trials in humans showing that glucose tolerance is reduced shortly after ingestion of caffeine or caffeinated coffee and suggesting that coffee consumption could increase the risk of diabetes. This review discusses epidemiologic and laboratory studies of the effects of coffee and its constituents, with a focus on diabetes risk. Weight loss may be an explanatory factor, because one prospective epidemiologic study found that consumption of coffee was followed by lower diabetes risk but only in participants who had lost weight. A second such study found that both caffeine and coffee intakes were modestly and inversely associated with weight gain. It is possible that caffeine and other constituents of coffee, such as chlorogenic acid and quinides, are involved in causing weight loss. Caffeine and caffeinated coffee have been shown to acutely increase blood pressure and thereby to pose a health threat to persons with cardiovascular disease risk. One short-term study found that ground decaffeinated coffee did not increase blood pressure. Decaffeinated coffee, therefore, may be the type of coffee that can safely help persons decrease diabetes risk. However, the ability of decaffeinated coffee to achieve these effects is based on a limited number of studies, and the underlying biological mechanisms have yet to be elucidated. PMID:17023692

Greenberg, James A; Boozer, Carol N; Geliebter, Allan



Vaccination against type 1 diabetes  

PubMed Central

The clinical onset of type 1 diabetes or autoimmune diabetes occurs after a prodrome of islet autoimmunity. The warning signals for the ensuing loss of pancreatic islet beta cells are autoantibodies against insulin, GAD65, IA-2, and ZnT8, alone or in combinations. Autoantibodies against e.g. insulin alone have only a minor risk for type 1 diabetes. However, progression to clinical onset is increased by the induction of multiple islet autoantibodies. At the time of clinical onset, insulitis may be manifest, which seem to reduce the efficacy of immunosuppression. Autoantigen-specific immunotherapy with alum-formulated GAD65 (Diamyd®) show promise to reduce the loss of beta-cell function after the clinical onset of type 1 diabetes. The mechanisms are unclear but may involve the induction of T regulatory cells, which may suppress islet autoantigen reactivity. Past and on-going clinical trials have been safe. Future clinical trials, perhaps as combination autoantigen-specific immunotherapy may increase the efficacy to prevent the clinical onset in subjects with islet autoantibodies or preserve residual beta-cell function in newly diagnosed type 1 diabetes patients.

Larsson, Helena Elding; Lernmark, Ake



How to revascularize patients with diabetes mellitus—  

Microsoft Academic Search

Summary  The diabetic patient is at high risk for coronary artery disease. Incidence as well as severity of the disease is highly increased\\u000a in comparison to non–diabetic patients. The revascularization of the diabetic patient is a great challenge, since the longterm\\u000a results are disappointing when compared to non–diabetic patients. The success of coronary artery bypass grafting is limited\\u000a by increased perioperative

Albrecht Elsässer; Helge Möllmann; Holger M. Nef; Christian W. Hamm