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  1. Insulino-mimetic and anti-diabetic effects of zinc.

    PubMed

    Vardatsikos, George; Pandey, Nihar R; Srivastava, Ashok K

    2013-03-01

    While it has long been known that zinc (Zn) is crucial for the proper growth and maintenance of normal biological functions, Zn has also been shown to exert insulin-mimetic and anti-diabetic effects. These insulin-like properties have been demonstrated in isolated cells, tissues, and different animal models of type 1 and type 2 diabetes. Zn treatment has been found to improve carbohydrate and lipid metabolism in rodent models of diabetes. In isolated cells, it enhances glucose transport, glycogen and lipid synthesis, and inhibits gluconeogenesis and lipolysis. The molecular mechanism responsible for the insulin-like effects of Zn compounds involves the activation of several key components of the insulin signaling pathways, which include the extracellular signal-regulated kinase 1/2 (ERK1/2) and phosphatidylinositol 3-kinase (PI3-K)/protein kinase B/Akt (PKB/Akt) pathways. However, the precise molecular mechanisms by which Zn triggers the activation of these pathways remain to be clarified. In this review, we provide a brief history of zinc, and an overview of its insulin-mimetic and anti-diabetic effects, as well as the potential mechanisms by which zinc exerts these effects.

  2. [Diabetes mellitus].

    PubMed

    Bosi, E

    2003-01-01

    Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes is a serious health concern. The number of cases of diabetes mellitus is estimated to grow at a rate of 50% between 2000 and 2010. There are several types of diabetes: type 1 diabetes, type 2 diabetes, gestational diabetes, and other specific types of diabetes. Beta cell dysfunction plays a key role in the physiopathology of diabetes, even when insulin resistance, which is often present in several diabetes-related diseases, is considered among the causes of hyperglycemic type 2 diabetes. The prolonged hyperglycemia that is peculiar to all kind of diabetes has long term complications on several organs and systems. The diagnosis of diabetes is based on the evaluation of glucose plasma levels performed under fasting conditions or two hours after the oral ingestion of 75 grams of glucose. Currently, achieving and maintaining normal plasma levels of glucose are the aims of therapy for both type 1 and type 2 diabetes. Particularly, the therapy for type 1 diabetes is based on the administration of insulin, whereas that of type 2 diabetes changes over the time: diet and physical activity are the first treatments; oral hypoglycemic drugs are used as a second therapeutic step; and the administration of insulin is the last therapeutic option. The principal therapeutic innovation of the past ten years is represented by the tight and flexible control of glucose plasma level obtained by using the insulin analogues produced by recombinant DNA technology.

  3. Diabetes mellitus and dementia.

    PubMed

    Ninomiya, Toshiharu

    2014-01-01

    Growing epidemiologic evidence has suggested that people with diabetes mellitus are at an increased risk for the development of dementia. However, the results for the subtypes of dementia are inconsistent. This review examines the risk of dementia in people with diabetes mellitus, and discusses the possible mechanism underpinning this association. Diabetes mellitus is associated with a 1.5- to 2.5-fold greater risk of dementia among community-dwelling elderly people. Notably, diabetes mellitus is a significant risk factor for not only vascular dementia, but also Alzheimer's disease. The mechanisms underpinning the association are unclear, but it may be multifactorial in nature, involving factors such as cardiovascular risk factors, glucose toxicity, changes in insulin metabolism and inflammation. The optimal management of these risk factors in early life may be important to prevent late-life dementia. Furthermore, novel therapeutic strategies will be needed to prevent or reduce the development of dementia in people with diabetes mellitus.

  4. Diabetes mellitus and suicide

    PubMed Central

    Sarkar, Siddharth; Balhara, Yatan Pal Singh

    2014-01-01

    Relationship of diabetes mellitus (DM) with metal health disorders such as depression has been explored extensively in the published literatures. However, association of diabetes mellitus with suicidal tendencies has been evaluated less extensively. The present narrative review aimed to assess the literature relating to diabetes mellitus and suicide. As a part of the review, Pubmed and Google Scholar databases were searched for English language peer reviewed published studies with keywords relating to diabetes and suicide. Additional references were identified using cross-references. The available literature suggests that suicidal ideas and attempts are more frequent in patients with diabetes mellitus than healthy or medically ill controls. Although, a few studies report evidence to the contrary. Suicide accounts for a large proportion of deaths in patients with diabetes mellitus type I (T1DM), and their mortality rate is higher than that of age matched control population. Psychological morbidity, including depression, precedes suicidal ideas and attempts; though many other factors can be hypothesized to impact and modulate this association. A common method of suicide attempt in patients with diabetes includes uses of high doses of insulin and its congeners or medications to treat the disease. Regular screening and prompt treatment of depression and suicidality is suggested for patients with DM. PMID:25143900

  5. Diabetes mellitus prevention.

    PubMed

    Allende-Vigo, Myriam Zaydee

    2015-01-01

    The aim of this study was to review lifestyle modification interventions and pharmacological clinical studies designed to prevent diabetes and provide evidence-based recommendations for the prevention of Diabetes Mellitus. A review of relevant literature compiled via a literature search (PUBMED) of English-language publications between 1997 and 2010 was conducted. It is found that people at increased risk of developing type 2 diabetes mellitus can halt the development of the disease. Lifestyle modification intervention with reduction of 5%-10% of excess body weight and increase in moderate physical activity by 150 min/wk has consistently proven to reduce the appearance of diabetes in different at-risk populations. Pharmacologic interventions have also demonstrated the prevention of the appearance of diabetes in persons at risk. Bariatric surgery has decreased the appearance of diabetes patients in a select group of individuals. The progression from prediabetes to diabetes mellitus can be prevented. Lifestyle modification intervention changes with weight loss and increased physical activity are currently recommended for the prevention of diabetes.

  6. Bioreactors addressing diabetes mellitus.

    PubMed

    Minteer, Danielle M; Gerlach, Jorg C; Marra, Kacey G

    2014-11-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies. © 2014 Diabetes Technology Society.

  7. Bioreactors Addressing Diabetes Mellitus

    PubMed Central

    Minteer, Danielle M.; Gerlach, Jorg C.

    2014-01-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies. PMID:25160666

  8. [Early onset diabetes mellitus].

    PubMed

    Busiah, K; Vaivre-Douret, L; Yachi, C; Cavé, H; Polak, M

    2013-12-01

    Neonatal diabetes mellitus is a rare condition (1/90,000 to 1/260,000 live births) defined as mild-to-severe hyperglycemia within the first year of life. Permanent neonatal diabetes mellitus requires lifelong therapy, whereas transient form resolves early in life but may relapse later on. Two main physiopathological mechanisms may explain this disease: β cell functional impairment or absence (pancreas agenesis or β cells destruction). The main genetic causes of β cells impairment are 6q24 abnormalities and mutations in ABCC8 or KCNJ11 potassium channel (KATP channel) genes. Compared to the KATP subtype, the 6q24 subtype had specific features: developmental defects involving the heart, kidneys, or urinary tract, intrauterine growth restriction, and early diagnosis. Remission of neonatal diabetes mellitus occurred in 51% of probands at a median age of 17 weeks. Recurrence was common at pubertal age, with no difference between the 6q24 and KATP-channel groups (82% vs 86%, p=0.36, respectively). Patients with mutations in ABCC8 or KCNJ11 genes had developmental delay with or without epilepsy but also developmental coordination disorder (particularly visual-spatial dyspraxia) or attention deficits in all of those who underwent in-depth neuropsychomotor investigations.

  9. [Pregestional diabetes mellitus and pregnancy].

    PubMed

    Bělobrádková, Jana

    2016-01-01

    There is a groving number of women with pregestational diabetes mellitus. Additionaly, nowadays therapy of diabetes mellitus type I allows gravidity even in patients in whom diabetes manifested itself during their early childhood. Presence of chronic complications of diabetes increases risk of complications during pregnancy. There is incerasing number of patients with DM type II and appearence of it shifts into younger age group. Perinatal mortality and morbidity of children of mothers with pregestional diabets is higher than in comparison with common population and pregnancy planning is important measure to their decrease.Key words: pregnancy - diabetes mellitus - embryopathy - fetopathy.

  10. [Diabetes mellitus and dementia].

    PubMed

    Kopf, D

    2015-05-01

    Diabetes mellitus, particularly type 2 diabetes, is a risk factor for dementia and this holds true for incident vascular dementia and Alzheimer's disease. Cerebrovascular complications of diabetes and chronic mild inflammation in insulin resistant states partly account for this increased risk. In addition, cellular resistance to the trophic effects of insulin on neurons and glial cells favor the accumulation of toxic metabolic products, such as amyloid and hyperphosphorylated tau protein (pTau). Weight loss frequently precedes overt cognitive symptoms of Alzheimer's disease. This results in an increased risk of hypoglycemic episodes in stable diabetic patients who are on suitably adjusted doses of oral insulin or insulinotropic antidiabetic drugs. In turn, hypoglycemic episodes may induce further damage in the vulnerable brains of type 2 diabetes patients. Patients with unexplained weight loss, hypoglycemic episodes and subjective memory complaints must be screened for dementia. Once dementia has been diagnosed the goals of diabetes management must be reevaluated as prevention of hypoglycemia becomes more important than tight metabolic control. As weight loss accelerates the rate of cognitive decline, nutritional goals must aim at stabilizing body weight. There is no available evidence on whether drug treatment of diabetes in middle-aged persons can help to prevent dementia; however, physical exercise, mental activity and higher education have preventive effects on the risk of dementia in later life. In addition, nutritional recommendations that are effective in preventing cardiovascular events have also been shown to reduce the risk of dementia.

  11. [Gestational diabetes mellitus].

    PubMed

    Senat, M-V; Deruelle, P

    2016-04-01

    While the prevalence of gestational diabetes mellitus (GDM) was estimated between 5 and 10% in 2010, the application of new thresholds recommended by IADPSG and adopted in 2010 by CNGOF seems to significantly increase the number of patients affected by this pathology. A prospective single-center French study estimated in 2014 the prevalence of gestational diabetes at 14% with these criteria, making it one of the most frequent complications during pregnancy. However, to date, there is no published study using these criteria to show a benefit to the health of women and children. If a diagnosis of GDM or type 2 diabetes during pregnancy is definitively an important risk factor for maternal as well as newborn and child complications, it is probably not the case for moderate hyperglycemia discovered during pregnancy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Diabetes mellitus and periodontal disease.

    PubMed

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

    1978-02-01

    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.

  13. Rheumatologic manifestations of diabetes mellitus.

    PubMed

    Crispin, José C; Alcocer-Varela, Jorge

    2003-06-15

    Diabetes mellitus has been linked to disorders of bones and joints, including neuroarthropathy, limited joint mobility, and hyperostosis. Some of the relations have known pathogenic mechanisms, but most are based on epidemiologic findings. This article reviews the associations between diabetes mellitus and its putative rheumatologic manifestations, and proposes a classification composed of four categories: consequences of diabetic complications, consequences of metabolic derangements inherent to diabetes, syndromes that may share etiologic mechanisms with microvascular disease, and probable associations. This approach may facilitate a clearer understanding of the musculoskeletal conditions that are prevalent in patients with diabetes mellitus.

  14. Diabetes mellitus in elderly

    PubMed Central

    Chentli, Farida; Azzoug, Said; Mahgoun, Souad

    2015-01-01

    Diabetes mellitus (DM) frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60–65 years old), DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is “go slowly and individualize” to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin. PMID:26693423

  15. Diabetes mellitus and inflammation.

    PubMed

    Lontchi-Yimagou, Eric; Sobngwi, Eugene; Matsha, Tandi E; Kengne, Andre Pascal

    2013-06-01

    Type 2 diabetes mellitus (T2DM) is increasingly common worldwide. Related complications account for increased morbidity and mortality, and enormous healthcare spending. Knowledge of the pathophysiological derangements involved in the occurrence of diabetes and related complications is critical for successful prevention and control solutions. Epidemiologic studies have established an association between inflammatory biomarkers and the occurrence of T2DM and complications. Adipose tissue appears to be a major site of production of those inflammatory biomarkers, as a result of the cross-talk between adipose cells, macrophages, and other immune cells that infiltrate the expanding adipose tissue. The triggering mechanisms of the inflammation in T2DM are still ill-understood. Inflammatory response likely contributes to T2DM occurrence by causing insulin resistance, and is in turn intensified in the presence of hyperglycemia to promote long-term complications of diabetes. Targeting inflammatory pathways could possibly be a component of the strategies to prevent and control diabetes and related complications.

  16. [Obesity and diabetes mellitus].

    PubMed

    Tron'ko, N D; Zak, K P

    2013-12-01

    New literature data and the results of own researches concerning the role of excessive body weight and the development of type 2 diabetes mellitus in humans are presented in the analytical review. Inaccordance with current insights, obesity and type 2 diabetes are considered diseases of inflammatory nature, characterized by systemic chronic low-grade inflammation, where different kinds of cytokines are cardinally involved. Unfavourable life style, i.e. excessive, high-energy, and irrational nutrition--an excessive consumption of animal fats and foods containing the high amount of glucose and starch with an insufficient use of high fiber vegetables, fish and vitamin D, and also sedentary, inactive life style leads to adipocyte hypertrophy and migration of M1 macrophages into the adipose tissue (AT). As a result, there is a low-grade inflammation accompanied by an increased production of proinflammatory cytokines (IL-1, IL-6, TNF-α, etc.), adipokines (leptin, resistin, visfatin etc.) and chemokines (CCL2, CCL5, CCL26 and CX3C). Under the influence of these cytokines, on the one hand, IR "is emerged", and on the other--there is apoptosis of the β-cells, that should be followed by the occurrence of clinically diagnosed type 2 diabetes. However, there is also the opposite system in humans, protecting the organism from the development of type 2 diabetes, and including an increase in the formation of M2 macrophages and the increased formation of secretion of antidiabetic cytokines (IL-4, IL-10, IL-13, etc.) and adiponectin.

  17. [Mental disorders and diabetes mellitus].

    PubMed

    Abrahamian, Heidemarie; Kautzky-Willer, Alexandra; Rießland-Seifert, Angelika; Fasching, Peter; Ebenbichler, Christoph; Hofmann, Peter; Toplak, Hermann

    2016-04-01

    Psychiatric disorders and psychological problems are common in patients with diabetes mellitus. There is a twofold increase in depression which is associated with suboptimal glycemic control and increased morbidity and mortality. Other psychiatric disorders with a higher incidence of diabetes mellitus are cognitive impairment, dementia, disturbed eating behaviour, anxiety disorders, schizophrenia, bipolar disorders and borderline personality disorder. The coincidence of mental disorders and diabetes mellitus has unfavourable influences on metabolic control and micro- and macroangiopathic late complications. Improvement of therapeutic outcome is a challenge in the modern health care system. The intentions behind this position paper are to rise awareness of this special set of problems, to intensify cooperation between involved health care providers and to reduce incidence of diabetes mellitus as well as morbidity and mortality from diabetes in this patient group.

  18. Diabetes mellitus and periodontal disease.

    PubMed

    Zachariasen, R D

    1991-05-01

    One of the most commonly reported oral manifestations of diabetes mellitus is the increased prevalence and severity of periodontal disease. Whereas the periodontal disease of the diabetic patient is clinically similar to that found in nondiabetic individuals, the condition appears to be more severe and poses very serious health problems for the diabetic patient. This article will review the current state of knowledge concerning the relationship of diabetes mellitus to periodontal disease, and will examine the reported incidence and etiology of periodontal disease in the diabetic patient.

  19. Gestational diabetes mellitus.

    PubMed

    Landon, Mark B; Gabbe, Steven G

    2011-12-01

    Gestational diabetes mellitus (GDM) represents a heterogeneous group of metabolic disorders, which result in varying degrees of maternal hyperglycemia and pregnancy-associated risk. The frequency of GDM is rising globally and may also increase further as less-stringent criteria for the diagnosis are potentially adopted. The additional burden placed on the health care system by increasing cases of GDM requires consideration of diagnostic approaches and currently used treatment strategies. Debate continues to surround both the diagnosis and treatment of GDM despite several recent large-scale studies addressing these controversial issues. As many now have come to reassess their approach to the management of GDM, we provide information in this review to help guide this process. The goal for each health care practitioner should continue to be to provide optimum care for women discovered to have carbohydrate intolerance during pregnancy.

  20. Gestational diabetes mellitus

    PubMed Central

    Alfadhli, Eman M.

    2015-01-01

    Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. It is associated with maternal and neonatal adverse outcomes. Maintaining adequate blood glucose levels in GDM reduces morbidity for both mother and baby. There is a lack of uniform strategies for screening and diagnosing GDM globally. This review covers the latest update in the diagnosis and management of GDM. The initial treatment of GDM consists of diet and exercise. If these measures fail to achieve glycemic goals, insulin should be initiated. Insulin analogs are more physiological than human insulin, and are associated with less risk of hypoglycemia, and may provide better glycemic control. Insulin lispro, aspart, and detemir are approved to be used in pregnancy. Insulin glargine is not approved in pregnancy, but the existing studies did not show any contraindications. The use of oral hypoglycemic agents; glyburide and metformin seems to be safe and effective in pregnancy. PMID:25828275

  1. Diabetes mellitus in centenarians.

    PubMed

    Davey, Adam; Lele, Uday; Elias, Merrill F; Dore, Gregory A; Siegler, Ilene C; Johnson, Mary A; Hausman, Dorothy B; Tenover, J Lisa; Poon, Leonard W

    2012-03-01

    To describe the prevalence of diabetes mellitus (DM) in centenarians. Cross-sectional, population-based. Forty-four counties in northern Georgia. Two hundred forty-four centenarians (aged 98-108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Centenarian Study (2001-2009). Nonfasting blood samples assessed glycosylated hemoglobin (HbA(1c)) and relevant clinical parameters. Demographic, diagnosis, and DM complication covariates were assessed. 12.5% of centenarians were known to have DM. DM was more prevalent in African Americans (27.7%) than whites (8.6%, P < .001). There were no differences between men (16.7%) and women (11.7%, P = .41) or between centenarians living in the community (10.2%) and in facilities (13.9%, P = .54). DM was more prevalent in overweight and obese (23.1%) than nonoverweight (7.1%, P = .002) centenarians. Anemia (78.6% vs 48.3%, P = .004) and hypertension (79.3% vs 58.6%, P = .04) were more prevalent in centenarians with DM than in those without, and centenarians with DM took more nonhypoglycemic medications (8.6 vs 7.0, P = .02). No centenarians with HbA(1c) of less than 6.5% had random serum glucose levels greater than 200 mg/dL. DM was not associated with 12-month all-cause mortality, visual impairment, amputations, cardiovascular disease, or neuropathy. Thirty-seven percent of centenarians reported onset before age 80 (survivors), 47% between age 80 and 97 (delayers), and 15% aged 98 and older (escapers). Diabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  2. Platelets and diabetes mellitus.

    PubMed

    Santilli, Francesca; Simeone, Paola; Liani, Rossella; Davì, Giovanni

    2015-07-01

    Platelet activation plays a key role in atherothrombosis in type 2 diabetes mellitus (T2DM) and increased in vivo platelet activation with enhanced thromboxane (TX) biosynthesis has been reported in patients with impairment of glucose metabolism even in the earlier stages of disease and in the preclinical phases. In this regards, platelets appear as addresses and players carrying and transducing metabolic derangement into vascular injury. The present review critically addresses key pathophysiological aspects including (i) hyperglycemia, glycemic variability and insulin resistance as determinants and predictors of platelet activation, (ii) inflammatory mediators derived from platelets, such as soluble CD40 ligand, soluble CD36, Dickkopf-1 and probably soluble receptor for advanced glycation-end-products (sRAGE), which expand the functional repertoire of platelets from players of hemostasis and thrombosis to powerful amplifiers of inflammation by promoting the release of cytokines and chemokines, cell activation, and cell-cell interactions; (iii) molecular mechanisms underpinning the less-than-expected antithrombotic protection by aspirin (ASA), despite regular antiplatelet prophylaxis at the standard dosing regimen, and (iv) stratification of patients deserving different antiplatelet strategies, based on the metabolic phenotype. Taken together, these pathophysiological aspects may contribute to the development of promising mechanism-based therapeutic strategies to reduce the progression of atherothrombosis in diabetic subjects.

  3. [Gestational Diabetes Mellitus].

    PubMed

    Krejčí, Hana

    2016-01-01

    is taken over by specialist centres. The early and appropriate treatment of gestational diabetes demonstrably reduces the risk of complications. The base for therapy is formed by regimen-related measures: the therapeutic diet and increased physical activity. The best results of the dietary therapy are achieved with foods low on glycemic index and glycemic load that can also act as efficient prevention of GDM and subsequent development of T2DM. A small number of cases require adding of pharmacological therapy: insulin and newly also metformin. Metformin is the drug of choice primarily in obese patients, however in almost half of the cases insulin must be added. Medication, in particular with insulin, must be introduced carefully, following re-education and elimination of dietary mistakes. The aim of the treatment is not only to achieve normoglycemia, but also to improve, or at least to not further worsen insulin resistance. Insulin resistance alone without diabetes, e.g. due to obesity or a great weight gain, may lead to macrosomia and epigenetic changes. In this regard, the prevention within the whole population of pregnant women needs to be improved and the vicious circle of the causation of metabolic disorders among the population needs to be broken.Key words: recommended procedure - epigenetic changes - gestation diabetes mellitus - macrosomia - screening.

  4. Diabetes mellitus and cognitive impairments

    PubMed Central

    Saedi, Elham; Gheini, Mohammad Reza; Faiz, Firoozeh; Arami, Mohammad Ali

    2016-01-01

    There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Insulin signaling dysregulation and small vessel disease in the base of diabetes may be important contributing factors in Alzheimer’s disease and vascular dementia pathogenesis, respectively. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications. In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings. PMID:27660698

  5. [Diabetes mellitus and periodontal disease].

    PubMed

    Sliz, Monika; Olszewska-Czyz, Iwona; Kantorowicz, Malgorzata; Chomyszyn-Gajewska, Maria

    2013-01-01

    Scientific studies confirm correlation between periodontitis and systemic diseases such as: arteriosclerosis, diabetes, heart diseases, stroke, diseases of the respiratory system, kidney diseases, osteoporosis, rheumatoid arthritis, premature birth and low birth weight. The interaction between periodontitis and diabetes mellitus is described, based on the literature.

  6. Type 1 diabetes mellitus.

    PubMed

    Katsarou, Anastasia; Gudbjörnsdottir, Soffia; Rawshani, Araz; Dabelea, Dana; Bonifacio, Ezio; Anderson, Barbara J; Jacobsen, Laura M; Schatz, Desmond A; Lernmark, Åke

    2017-03-30

    Type 1 diabetes mellitus (T1DM), also known as autoimmune diabetes, is a chronic disease characterized by insulin deficiency due to pancreatic β-cell loss and leads to hyperglycaemia. Although the age of symptomatic onset is usually during childhood or adolescence, symptoms can sometimes develop much later. Although the aetiology of T1DM is not completely understood, the pathogenesis of the disease is thought to involve T cell-mediated destruction of β-cells. Islet-targeting autoantibodies that target insulin, 65 kDa glutamic acid decarboxylase, insulinoma-associated protein 2 and zinc transporter 8 - all of which are proteins associated with secretory granules in β-cells - are biomarkers of T1DM-associated autoimmunity that are found months to years before symptom onset, and can be used to identify and study individuals who are at risk of developing T1DM. The type of autoantibody that appears first depends on the environmental trigger and on genetic factors. The pathogenesis of T1DM can be divided into three stages depending on the absence or presence of hyperglycaemia and hyperglycaemia-associated symptoms (such as polyuria and thirst). A cure is not available, and patients depend on lifelong insulin injections; novel approaches to insulin treatment, such as insulin pumps, continuous glucose monitoring and hybrid closed-loop systems, are in development. Although intensive glycaemic control has reduced the incidence of microvascular and macrovascular complications, the majority of patients with T1DM are still developing these complications. Major research efforts are needed to achieve early diagnosis, prevent β-cell loss and develop better treatment options to improve the quality of life and prognosis of those affected.

  7. Erythropoietin and diabetes mellitus

    PubMed Central

    Maiese, Kenneth

    2015-01-01

    Erythropoietin (EPO) is a 30.4 kDa growth factor and cytokine that governs cell proliferation, immune modulation, metabolic homeostasis, vascular function, and cytoprotection. EPO is under investigation for the treatment of variety of diseases, but appears especially suited for the treatment of disorders of metabolism that include diabetes mellitus (DM). DM and the complications of this disease impact a significant portion of the global population leading to disability and death with currently limited therapeutic options. In addition to its utility for the treatment of anemia, EPO can improve cardiac function, reduce fatigue, and improve cognition in patients with DM as well as regulate cellular energy metabolism, obesity, tissue repair and regeneration, apoptosis, and autophagy in experimental models of DM. Yet, EPO can have adverse effects that involve the vasculature system and unchecked cellular proliferation. Critical to the cytoprotective capacity and the potential for a positive clinical outcome with EPO are the control of signal transduction pathways that include protein kinase B, the mechanistic target of rapamycin, Wnt signaling, mammalian forkhead transcription factors of the O class, silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae), and AMP activated protein kinase. Therapeutic strategies that can specifically target and control EPO and its signaling pathways hold great promise for the development of new and effective clinical treatments for DM and the complications of this disorder. PMID:26516410

  8. Erythropoietin and diabetes mellitus.

    PubMed

    Maiese, Kenneth

    2015-10-25

    Erythropoietin (EPO) is a 30.4 kDa growth factor and cytokine that governs cell proliferation, immune modulation, metabolic homeostasis, vascular function, and cytoprotection. EPO is under investigation for the treatment of variety of diseases, but appears especially suited for the treatment of disorders of metabolism that include diabetes mellitus (DM). DM and the complications of this disease impact a significant portion of the global population leading to disability and death with currently limited therapeutic options. In addition to its utility for the treatment of anemia, EPO can improve cardiac function, reduce fatigue, and improve cognition in patients with DM as well as regulate cellular energy metabolism, obesity, tissue repair and regeneration, apoptosis, and autophagy in experimental models of DM. Yet, EPO can have adverse effects that involve the vasculature system and unchecked cellular proliferation. Critical to the cytoprotective capacity and the potential for a positive clinical outcome with EPO are the control of signal transduction pathways that include protein kinase B, the mechanistic target of rapamycin, Wnt signaling, mammalian forkhead transcription factors of the O class, silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae), and AMP activated protein kinase. Therapeutic strategies that can specifically target and control EPO and its signaling pathways hold great promise for the development of new and effective clinical treatments for DM and the complications of this disorder.

  9. Hemorheological Disorders in Diabetes Mellitus

    PubMed Central

    Cho, Young I.; Mooney, Michael P.; Cho, Daniel J.

    2008-01-01

    The objective of the present study is to review hemorheological disorders in diabetes mellitus. Several key hemorheological parameters, such as whole blood viscosity, erythrocyte deformability, and aggregation, are examined in the context of elevated blood glucose level in diabetes. The erythrocyte deformability is reduced, whereas its aggregation increases, both of which make whole blood more viscous compared to healthy individuals. The present paper explains how the increased blood viscosity adversely affects the microcirculation in diabetes, leading to microangiopathy. PMID:19885302

  10. Diabetes mellitus and the skin*

    PubMed Central

    Mendes, Adriana Lucia; Miot, Helio Amante; Haddad Junior, Vidal

    2017-01-01

    Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes. PMID:28225950

  11. Baroreceptor sensitivity and diabetes mellitus.

    PubMed

    Rowaiye, Olumide Olatubosun; Jankowska, Ewa Anita; Ponikowska, Beata

    2013-01-01

    Diabetes mellitus (DM) is a disease of increasing incidence and prevalence. Arterial baroreceptors are stretch-sensitive receptors, which in a reflex manner are involved in the homeostatic control of arterial blood pressure. Diabetic subjects have depressed baroreflex sensitivity (BRS), although the exact pathomechanisms are unclear. In this review, we discuss the features, clinicaland prognostic implications of reduced BRS for diabetic patients and the potential involvement of cardiovascular autonomic neuropathy and atherosclerosis. Finally, we demonstrate evidence on interventions (e.g. pioglitazone, alpha-lipoic acid, leptin, fluvastatin, physicaltraining etc.) which could improve BRS and ameliorate cardiovascular autonomic dysfunction in diabetic patients.

  12. Pathogenesis of feline diabetes mellitus.

    PubMed

    Lutz, T A; Rand, J S

    1995-05-01

    Cats are one of the few species that develop a form of diabetes mellitus that is clinically and histologically analogous to human type 2 diabetes mellitus. Figure 9 summarizes the etiologic factors thought to be involved in the development of feline and human type 2 diabetes. The main metabolic characteristics of type 2 diabetes mellitus are impaired insulin secretion and resistance to the action of insulin in its target tissues. Impaired beta cell function occurs before histologic changes become evident. The characteristic histologic finding in cats with type 2 diabetes is deposition of amyloid in pancreatic islets. Amyloid deposition occurs before the onset of clinical signs, but does not seem to be the primary defect. Pancreatic amyloid is derived form the recently discovered pancreatic hormone amylin. Amylin is synthesized in pancreatic beta cells, and is co-stored and co-secreted with insulin. Amylin has been postulated to be involved in the pathogenesis of feline diabetes mellitus both through its metabolic effects, which include inhibition of insulin secretion and induction of insulin resistance, and via progressive amyloid deposition and beta cell degeneration. Increased amylin concentration has been documented intracellularly in cats with impaired glucose tolerance and in the plasma of diabetic cats, and supports the hypothesis that amylin is involved in the pathogenesis of type 2 diabetes. Obesity is a common finding in diabetic felines and is a contributing factor to the insulin resistance present in type 2 diabetes. Clinical signs of diabetes develop once total insulin secretion decreases to 20% to 25% of normal levels. Many diabetic cats have been treated successfully with oral hypoglycemics, but 50% to 70% of diabetic cats are insulin dependent. Based on histologic evidence, this is the result of extensive amyloid deposition and subsequent beta cell degeneration, rather than autoimmune destruction of pancreatic beta cells associated with type 1

  13. Rheumatological manifestations in diabetes mellitus.

    PubMed

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

    2006-11-01

    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.

  14. Rare types of diabetes mellitus.

    PubMed

    Mihai, B; Mihai, Cătălina; Cijevschi-Prelipcean, Cristina; Lăcătuşu, Cristina

    2012-01-01

    Diabetes mellitus is a heterogenous disorder characterized by chronic hyperglycemia and induced by a large number of etiopathogenic conditions. Beside type 1 and type 2 diabetes, which account for almost 90% of all cases, practitioners may encounter patients with more infrequent forms of diabetes, as those induced by mutations of a single gene, atypical immune disorders or neonatal diabetes. Monogenic diabetes is represented by genetic disorders in the structure of the beta-cell (the MODY syndromes and the mutations of mitochondrial DNA) or in the insulin's action (type A insulin resistance syndrome, Rabson-Mendenhall syndrome, leprechaunism, lipodystrophies). The rare forms of immune diabetes are determined by antibodies against insulin or insulin receptor or appear as a component of the "stiff man syndrome". Neonatal diabetes is induced by mutations in genes that control beta-cell development and function and may have a transient or permanent nature. Knowledge of the uncommon forms of diabetes mellitus enables physicians to apply the optimal treatment, to estimate the evolution of the patient and to apply a complete family screening in order to diagnose all other blood relatives as soon as possible.

  15. Diabetes mellitus in cats.

    PubMed

    Rand, Jacquie S; Marshall, Rhett D

    2005-01-01

    Feline diabetes is a multifactorial disease with genetic and environmental factors, including diet, excess body weight, and physical inactivity, involved in its pathogenesis. Although type 2 diabetes is most common in cats, most cats are insulin-dependent at the time of diagnosis. If good glycemic control can be achieved early after diagnosis, a substantial proportion of diabetic cats go into clinical remission. Diabetic remission may be facilitated by using a low-carbohydrate-high-protein diet combined with a long-acting insulin, such as glargine, administered twice daily. Rather than just controlling clinical signs, these new treatment modalities make curing feline diabetes a realistic goal for practitioners.

  16. Diabetes Mellitus and Heart Failure.

    PubMed

    Lehrke, Michael; Marx, Nikolaus

    2017-06-01

    Epidemiologic and clinical data from the last 2 decades have shown that the prevalence of heart failure in diabetes is very high, and the prognosis for patients with heart failure is worse in those with diabetes than in those without diabetes. Experimental data suggest that various mechanisms contribute to the impairment in systolic and diastolic function in patients with diabetes, and there is an increased recognition that these patients develop heart failure independent of the presence of coronary artery disease or its associated risk factors. In addition, current clinical data demonstrated that treatment with the sodium glucose cotransporter 2 inhibitor empagliflozin reduced hospitalization for heart failure in patients with type 2 diabetes mellitus and high cardiovascular risk. This review article summarizes recent data on the prevalence, prognosis, pathophysiology, and therapeutic strategies to treat patients with diabetes and heart failure. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Diabetes Mellitus and Heart Failure.

    PubMed

    Lehrke, Michael; Marx, Nikolaus

    2017-07-01

    Epidemiologic and clinical data from the last 2 decades have shown that the prevalence of heart failure in diabetes is very high, and the prognosis for patients with heart failure is worse in those with diabetes than in those without diabetes. Experimental data suggest that various mechanisms contribute to the impairment in systolic and diastolic function in patients with diabetes, and there is an increased recognition that these patients develop heart failure independent of the presence of coronary artery disease or its associated risk factors. In addition, current clinical data demonstrated that treatment with the sodium glucose cotransporter 2 inhibitor empagliflozin reduced hospitalization for heart failure in patients with type 2 diabetes mellitus and high cardiovascular risk. This review article summarizes recent data on the prevalence, prognosis, pathophysiology, and therapeutic strategies to treat patients with diabetes and heart failure. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  18. [Diabetes mellitus in acute pancreatitis].

    PubMed

    Díaz-Rubio, José Luis; Torre-Delgadillo, Aldo; Robles-Díaz, Guillermo

    2002-01-01

    Exocrine and endocrine components of pancreas are interrelated anatomically and functionally. Exocrine pancreatic dysfunction often accompanies endocrine pancreatic impairment and vice versa. Diabetes mellitus resulting from alterations of exocrine pancreas, such as acute or chronic pancreatitis, is known as pancreatic diabetes. Hyperglycemia during acute pancreatitis (AP) can be due to abnormalities in insulin secretion, increase in counterregulatory hormones release, or decrease in glucose utilization by peripheral tissues. Causal association is suggested between diabetic ketoacidosis and AP and is attributed to alternation in metabolism of triglycerides. High blood glucose levels are associated with severe AP and constitute factor of worst prognosis. Some patients are discharged with diabetes after AP episode, while others develop diabetes during first year of follow-up. Origin and frequency of glycemic abnormalities associated with AP have not been settled yet accurately. Also, predictive factors for diabetes development and persistence after AP have not been recognized to date.

  19. Diabetes mellitus and periodontal diseases.

    PubMed

    Mealey, Brian L; Oates, Thomas W

    2006-08-01

    The purpose of this review is to provide the reader with practical knowledge concerning the relationship between diabetes mellitus and periodontal diseases. Over 200 articles have been published in the English literature over the past 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of diabetes and periodontitis and different clinical criteria applied to prevalence, extent, and severity of periodontal diseases, levels of glycemic control, and complications associated with diabetes. This article provides a broad overview of the predominant findings from research published in English over the past 20 years, with reference to certain "classic" articles published prior to that time. This article describes current diagnostic and classification criteria for diabetes and answers the following questions: 1) Does diabetes affect the risk of periodontitis, and does the level of metabolic control of diabetes have an impact on this relationship? 2) Do periodontal diseases affect the pathophysiology of diabetes mellitus or the metabolic control of diabetes? 3) What are the mechanisms by which these two diseases interrelate? and 4) How do people with diabetes and periodontal disease respond to periodontal treatment? Diabetes increases the risk of periodontal diseases, and biologically plausible mechanisms have been demonstrated in abundance. Less clear is the impact of periodontal diseases on glycemic control of diabetes and the mechanisms through which this occurs. Inflammatory periodontal diseases may increase insulin resistance in a way similar to obesity, thereby aggravating glycemic control. Further research is needed to clarify this aspect of the relationship between periodontal diseases and diabetes.

  20. Entrapment neuropathies in diabetes mellitus

    PubMed Central

    Rota, Eugenia; Morelli, Nicola

    2016-01-01

    Neuropathy is a common complication of diabetes mellitus (DM) with a wide clinical spectrum that encompasses generalized to focal and multifocal forms. Entrapment neuropathies (EN), which are focal forms, are so frequent at any stage of the diabetic disease, that they may be considered a neurophysiological hallmark of peripheral nerve involvement in DM. Indeed, EN may be the earliest neurophysiological abnormalities in DM, particularly in the upper limbs, even in the absence of a generalized polyneuropathy, or it may be superimposed on a generalized diabetic neuropathy. This remarkable frequency of EN in diabetes is underlain by a peculiar pathophysiological background. Due to the metabolic alterations consequent to abnormal glucose metabolism, the peripheral nerves show both functional impairment and structural changes, even in the preclinical stage, making them more prone to entrapment in anatomically constrained channels. This review discusses the most common and relevant EN encountered in diabetic patient in their epidemiological, pathophysiological and diagnostic features. PMID:27660694

  1. Diabetes mellitus and electrolyte disorders

    PubMed Central

    Liamis, George; Liberopoulos, Evangelos; Barkas, Fotios; Elisaf, Moses

    2014-01-01

    Diabetic patients frequently develop a constellation of electrolyte disorders. These disturbances are particularly common in decompensated diabetics, especially in the context of diabetic ketoacidosis or nonketotic hyperglycemic hyperosmolar syndrome. These patients are markedly potassium-, magnesium- and phosphate-depleted. Diabetes mellitus (DM) is linked to both hypo- and hyper-natremia reflecting the coexistence of hyperglycemia-related mechanisms, which tend to change serum sodium to opposite directions. The most important causal factor of chronic hyperkalemia in diabetic individuals is the syndrome of hyporeninemic hypoaldosteronism. Impaired renal function, potassium-sparing drugs, hypertonicity and insulin deficiency are also involved in the development of hyperkalemia. This article provides an overview of the electrolyte disturbances occurring in DM and describes the underlying mechanisms. This insight should pave the way for pathophysiology-directed therapy, thus contributing to the avoidance of the several deleterious effects associated with electrolyte disorders and their treatment. PMID:25325058

  2. Diabetes mellitus and electrolyte disorders.

    PubMed

    Liamis, George; Liberopoulos, Evangelos; Barkas, Fotios; Elisaf, Moses

    2014-10-16

    Diabetic patients frequently develop a constellation of electrolyte disorders. These disturbances are particularly common in decompensated diabetics, especially in the context of diabetic ketoacidosis or nonketotic hyperglycemic hyperosmolar syndrome. These patients are markedly potassium-, magnesium- and phosphate-depleted. Diabetes mellitus (DM) is linked to both hypo- and hyper-natremia reflecting the coexistence of hyperglycemia-related mechanisms, which tend to change serum sodium to opposite directions. The most important causal factor of chronic hyperkalemia in diabetic individuals is the syndrome of hyporeninemic hypoaldosteronism. Impaired renal function, potassium-sparing drugs, hypertonicity and insulin deficiency are also involved in the development of hyperkalemia. This article provides an overview of the electrolyte disturbances occurring in DM and describes the underlying mechanisms. This insight should pave the way for pathophysiology-directed therapy, thus contributing to the avoidance of the several deleterious effects associated with electrolyte disorders and their treatment.

  3. Vitamin D and diabetes mellitus.

    PubMed

    Danescu, Liviu G; Levy, Shiri; Levy, Joseph

    2009-02-01

    Better understanding of the physiological role of the vitamin-D system, in particular its potential effects on inflammatory and autoimmune conditions as well as on insulin secretion and possibly also on insulin resistance, increased the interest in its potential role in prevention and control of the diabetic condition, both type-1 and -2 diabetes. Both these conditions are associated with inflammation and type-1 diabetes also with an autoimmune pathology. Indeed, animal and human studies support the notion that adequate vitamin-D supplementation may decrease the incidence of type-1 and possibly also of type-2 diabetes mellitus and may improve the metabolic control in the diabetes state. However, the exact mechanisms by which vitamin-D and calcium supplementation exert their beneficial effects are not clear and need further investigation.

  4. [Impaired hypoglycemia awareness in diabetes mellitus].

    PubMed

    Brož, Jan; Piťhová, Pavlína; Janíčková Žďárská, Denisa

    Impaired hypoglycemia awareness is defined at the onset of neuroglycopenia without the appearance of autonomic warning symptoms. Impaired hypoglycemia awareness is disorder which affects aprox. one third of patients with type 1 diabetes mellitus and 8-10 % of patients with type 2 diabetes mellitus who are treated with insulin. The most dangerous consequence is 6 times higher frequency of severe hypoglycemia in patients with Type 1 diabetes mellitus and 17 times higher in Type 2 diabetic patients treated with insulin. Treatment of impaired hypoglycemia awareness is complex, based on a multifactorial intervention of clinical care and structured patient education. diabetes mellitus - hypoglycemia- impaired hypoglycemia awareness.

  5. [Infection complicated with diabetes mellitus].

    PubMed

    Nemoto, Ken-ichi; Maegawa, Hiroshi

    2015-12-01

    Patients with diabetes mellitus are believed to be suspected to be immunocompromized hosts. Many reports have pointed out that diabetic patients are susceptible to certain infections such as surgical site infections, malignant otitis externa, mucormycosis, and necrotizing fasciitis. But their etiology seems to be non-uniform, heterogenous and individualized. Above all, obesity-related infections are also increasing accompanied with the recent rising incidence of obesity. Further studies should be addressed about the relationships between infections and diabetes which include the factors of body mass index, life style, degree of diabetes complications, and poor glycemic control duration. They could live a normal life the same as healthy subjects if good glycemic control is achieved without hypoglycemia.

  6. Ocular complications of diabetes mellitus

    PubMed Central

    Sayin, Nihat; Kara, Necip; Pekel, Gökhan

    2015-01-01

    Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

  7. Diabetes insipidus in a patient with diabetes mellitus.

    PubMed

    Paulose, K P; Padmakumar, N

    2002-09-01

    The association of Diabetes Mellitus (DM) and Diabetes Insipidus (DI) without any congenital defects is very rare and we report here a case of type 2 diabetes mellitus (NIDDM) whose blood sugar was controlled by insulin, developing central diabetes insipidus 2 years later, which could be successively controlled by synthetic vasopressin.

  8. [Medicinal plants and diabetes mellitus].

    PubMed

    Suchý, V; Zemlicka, M; Svajdlenka, E; Vanco, J

    2008-04-01

    Diabetes mellitus is a group of chronic metabolic disorders. Hyperglycaemia and other related disturbances in the body's metabolism can result in serious damage to many of the body's systems, especially the blood vessels and nerves. Across the globe, there are an estimated 150 million people suffering from diabetes mellitus, which causes about 5 % of all deaths globally each year. From many reports it is clear that diabetes will be one of the major diseases in the coming years. Existing treatment options are costly, and have limited palliative effects. It stimulates finding new medicines or suitable prophylactic treatments. Plant-based medicinal products known since ancient times have been used to control diabetes in the traditional medicinal systems. Numerous medicinal plants have been studied and validated for their hypoglycaemic properties using diabetic animal models but not so often in clinical studies. Testing of many plant extracts and plant substances continue. This review paper presents selected information on the hypoglycemic and antihyperglycaemic activities of tested preparations of plant origin.

  9. Diabetes mellitus and birth defects

    PubMed Central

    Correa, Adolfo; Gilboa, Suzanne M.; Besser, Lilah M.; Botto, Lorenzo D.; Moore, Cynthia A.; Hobbs, Charlotte A.; Cleves, Mario A.; Riehle-Colarusso, Tiffany J.; Waller, D. Kim; Reece, E. Albert

    2016-01-01

    OBJECTIVE The purpose of this study was to examine associations between diabetes mellitus and 39 birth defects. STUDY DESIGN This was a multicenter case-control study of mothers of infants who were born with (n = 13,030) and without (n = 4895) birth defects in the National Birth Defects Prevention Study (1997–2003). RESULTS Pregestational diabetes mellitus (PGDM) was associated significantly with noncardiac defects (isolated, 7/23 defects; multiples, 13/23 defects) and cardiac defects (isolated, 11/16 defects; multiples, 8/16 defects). Adjusted odds ratios for PGDM and all isolated and multiple defects were 3.17 (95% CI, 2.20–4.99) and 8.62 (95% CI, 5.27–14.10), respectively. Gestational diabetes mellitus (GDM) was associated with fewer noncardiac defects (isolated, 3/23 defects; multiples, 3/23 defects) and cardiac defects (isolated, 3/16 defects; multiples, 2/16 defects). Odds ratios between GDM and all isolated and multiple defects were 1.42 (95% CI, 1.17–1.73) and 1.50 (95% CI, 1.13–2.00), respectively. These associations were limited generally to offspring of women with prepregnancy body mass index ≥25 kg/m2. CONCLUSION PGDM was associated with a wide range of birth defects; GDM was associated with a limited group of birth defects. PMID:18674752

  10. [Gestational diabetes mellitus].

    PubMed

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

    2012-12-01

    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

  11. Gastrointestinal complications of diabetes mellitus

    PubMed Central

    Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

    2013-01-01

    Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

  12. The Pathogenesis of Diabetes Mellitus - USSR -.

    DTIC Science & Technology

    1960-05-09

    Our ideas of the pathogenesis of diabetes mellitus have changed considerably during the past 40 years. Our current concept result from the...acquisition of new data on the role of the central nervous and endocrine systems in the pathogenesis of diabetes mellitus ; new data on the metabolic processes... diabetes mellitus develops basically as the result of pancreatic insufficiency, it is impossible at the present time to visualize the pathogenesis of

  13. 77 FR 3549 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-24

    ... [Docket No. FMCSA-2011-0368] Qualification of Drivers; Exemption Applications; Diabetes Mellitus AGENCY... from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  14. 77 FR 64181 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA). ACTION: Notice of applications for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA... with insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in...

  15. 77 FR 59447 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-27

    ... [Docket No. FMCSA-2012-0281] Qualification of Drivers; Exemption Applications; Diabetes Mellitus AGENCY... from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  16. 75 FR 69734 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... [Docket No. FMCSA-2010-0355] Qualification of Drivers; Exemption Applications; Diabetes Mellitus AGENCY... from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  17. Self testing for diabetes mellitus.

    PubMed Central

    Davies, M; Alban-Davies, H; Cook, C; Day, J

    1991-01-01

    OBJECTIVE--To develop a simple, economically viable, and effective means of population screening for diabetes mellitus. DESIGN--A postal request system for self testing for glycosuria with foil wrapped dipsticks. Preprandial and postprandial tests were compared with a single postprandial test. The subjects were instructed how to test, and a result card was supplied on which to record and return the result. All those recording a positive test result and 50 people recording a negative result were invited for an oral glucose tolerance test. SETTING--General practice in east Suffolk, list size 11534. PATIENTS--All subjects aged 45-70 years registered with the practice were identified by Suffolk Family Health Services Authority (n = 3057). The 73 subjects known to have diabetes from the practice's register were excluded, leaving 2984 subjects, 2363 (79.2%) of whom responded. 1167 subjects completed the single test and 1196 the two tests. MAIN OUTCOME MEASURES--Response rate and number of patients with glycosuria. Sensitivity, specificity, and positive predictive value of a single postprandial test and preprandial and postprandial tests. Number of new cases of diabetes identified and cost of screening. RESULTS--Of the patients completing the single postprandial test, 29 had a positive result, an oral glucose tolerance test showed that eight (28%) had diabetes, six (21%) impaired glucose tolerance, and 14 (48%) normal glucose tolerance. 44 of the group who tested before and after eating had a positive result; nine (20%) had diabetes, five (11%) impaired tolerance, and 26 (11%) normal tolerance. Screening cost 59p per subject and 81 pounds per case detected. Of the 17 people with previously undiagnosed diabetes, eight were asymptomatic and 11 had not visited their general practitioner in the past three months. CONCLUSIONS--A postal request system for self testing for postprandial glycosuria in people aged 45-70 is a simple and effective method of population screening for

  18. Neonatal Diabetes Mellitus

    PubMed Central

    Aguilar-Bryan, Lydia; Bryan, Joseph

    2008-01-01

    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 β-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. PMID:18436707

  19. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Bancher-Todesca, Dagmar; Berger, Angelika; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund

    2016-04-01

    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 (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). 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 birth weight > 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. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140 mg/dl) insulin

  20. Diabetes mellitus in older adults.

    PubMed

    Mooradian, Arshag D; Chehade, Joe M

    2012-03-01

    The prevalence of diabetes mellitus increases with age and causes significant morbidity and poor quality of life in older adults. To review the current literature on the diagnosis and management of diabetes in the elderly, the relevant manuscripts were identified through a MEDLINE (2000-September 1, 2010) search of the English literature. The key phrase used was diabetes in older adults or diabetes in the elderly. The literature search was limited to core clinical journals that have accessible full texts. A total of 480 manuscripts were reviewed. Managing diabetes in older adults is a challenging task. Some features of the disease are unique to the older patient. Several new antidiabetic agents are now available for clinical use, and yet very few clinical trials have been carried out in this age group. For many older adults, maintaining independence is more important than adherence to published guidelines to prevent diabetes complications. The goals of diabetes care in older adults are to enhance quality of life without subjecting the residents to inappropriate interventions.

  1. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Bancher-Todesca, Dagmar; Birnbacher, Robert

    2004-01-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations in the diabetic range. In case of a high risk for GDM/type 2 diabetes (history of GDM or prediabetes [impaired fasting glucose or impaired glucose tolerance]; malformation, stillbirth, successive abortions or birth-weight > 4500 g in previous pregnancies) performance of the OGTT (120 min; 75 g glucose) is recommended already in the first trimester and--if normal--the OGTT should be repeated in the second/third trimester. In case of clinical symptoms of diabetes (glucosuria, macrosomia) the test has to be performed immediately. All other women should undergo a diagnostic test between 24 and 28 gestational weeks. If fasting plasma glucose exceeds 95 mg/dl, 1 h 180 mg/dl and 2 hrs 155 mg/dl after glucose loading (OGTT) the woman is classified as GDM (one pathological value is sufficient). In this case 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 < 130 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).

  2. Diabetes mellitus and hypertension: a dual threat.

    PubMed

    Oktay, Ahmet Afşin; Akturk, Halis Kaan; Jahangir, Eiman

    2016-07-01

    The following is a review of the current concepts on the relationship between hypertension (HTN) and diabetes mellitus with a focus on the epidemiology and cardiovascular prognostic implications of coexistent HTN and diabetes mellitus, shared mechanisms underlying both conditions and pathophysiology of increased risk of cardiovascular disease, treatment of HTN in individuals with diabetes mellitus, and effects of anti-diabetic medications on blood pressure (BP). Diabetes mellitus and HTN often coexist in the same individual. They share numerous risk factors and underlying pathophysiologic mechanisms, most important of which are insulin resistance and inappropriate activation of the rennin-angiotensin-aldosterone system. Recently updated guidelines recommend a BP goal of 140/90 mmHg in most individuals with diabetes mellitus. A new class of anti-diabetic medications, sodium-glucose co-transporter 2 inhibitors, has shown favorable effects on BP. HTN affects the majority of individuals with diabetes mellitus. Coexistence of diabetes mellitus and HTN, especially if BP is not well controlled, dramatically increases the risk of morbidity and mortality from cardiovascular disease. BP control is an essential part of management of patients with diabetes mellitus, because it is one of the most effective ways to prevent vascular complications and death.

  3. Diabetes Mellitus: Screening and Diagnosis.

    PubMed

    Pippitt, Karly; Li, Marlana; Gurgle, Holly E

    2016-01-15

    Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, but may not reduce rates of end-organ damage. Randomized trials show that screening for type 2 diabetes does not reduce mortality after 10 years, although some data suggest mortality benefits after 23 to 30 years. Lifestyle and pharmacologic interventions decrease progression to diabetes in patients with impaired fasting glucose or impaired glucose tolerance. Screening for type 1 diabetes is not recommended. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, and repeating testing every three years if results are normal. Individuals at higher risk should be considered for earlier and more frequent screening. The American Diabetes Association recommends screening for type 2 diabetes annually in patients 45 years and older, or in patients younger than 45 years with major risk factors. The diagnosis can be made with a fasting plasma glucose level of 126 mg per dL or greater; an A1C level of 6.5% or greater; a random plasma glucose level of 200 mg per dL or greater; or a 75-g two-hour oral glucose tolerance test with a plasma glucose level of 200 mg per dL or greater. Results should be confirmed with repeat testing on a subsequent day; however, a single random plasma glucose level of 200 mg per dL or greater with typical signs and symptoms of hyperglycemia likely indicates diabetes. Additional testing to determine the etiology of diabetes is not routinely recommended.

  4. Periodontitis and risk of diabetes mellitus.

    PubMed

    Gurav, Abhijit; Jadhav, Varsha

    2011-03-01

    Diabetes mellitus (DM) is a complex disease with varying degrees of systemic and oral complications. The periodontium is also a target for diabetic damage. Diabetes is a pandemic in both developed and developing countries. In recent years, a link between periodontitis and diabetes mellitus has been postulated. The oral cavity serves as a continuous source of infectious agents that could further worsen the diabetic status of the patient and serve as an important risk factor deterioration of diabetes mellitus. The present review highlights the relationship between diabetes mellitus and periodontitis. The potential mechanisms involved in the deterioration of diabetic status and periodontal disease are also discussed. © 2011 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

  5. Oral hypoglycemics in cats with diabetes mellitus.

    PubMed

    Palm, Carrie A; Feldman, Edward C

    2013-03-01

    Diabetes mellitus is a common disease in cats. Similar to people, cats with diabetes mellitus often have type 2 disease. Oral hypoglycemic drugs can be a potential treatment option for affected cats, especially when cats or owners do not tolerate administration of injectable insulin. Several classes of oral hypoglycemic drugs have been evaluated in cats but these drugs have not been commonly used for treatment of diabetic cats. With the advent of newer oral hypoglycemic drugs, and a better understanding of diabetes mellitus in cats, further investigation may allow for better diabetic control for feline patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. [Adhesion molecules and diabetes mellitus].

    PubMed

    Urso, C; Hopps, E; Caimi, G

    2010-01-01

    Adhesion molecules play a significant role in leukocyte migration across the endothelium and are also involved in regulating immune system. It is shown that diabetic patients have an increase of soluble adhesion molecules (sICAM-1, sICAM-2, sVCAM-1, sE-selectin, sL-selectin, sP-selectin) considered an integral part of inflammatory state. This inflammation is responsible for the increased cardiovascular risk of these patients. There is a close link between hyperglycemia, oxidative stress, coagulopathy and inflammation and between these factors and the vascular damage. Various studies have showed the potential role of adhesion molecules in the pathogenesis of diabetic vasculopathy. They promote leukocyte recruitment, which is one of the initial steps in the genesis of atherosclerotic plaque. Adhesion molecules are also involved in the pathogenesis of diabetes mellitus type 1; sICAM-1 would have a particular immunomodulatory role in the process of destroying beta-cells and could be used as a subclinical marker of insulitis. Plasma levels of soluble adhesion molecules correlate with hyperglycemia, insulin resistance, dyslipidemia and obesity; they are associated with the development of nephropathy, retinopathy, myocardial infarction, stroke and obliterant peripheral arterial disease in diabetic type 1 and 2. Given the role of these molecules in endothelial dysfunction genesis and tissue damage associated with diabetes, they could constitute a therapeutic target for the prevention of genesis and progression of chronic complications of diabetic disease.

  7. [Lifestyle of elderly patients with diabetes mellitus].

    PubMed

    Fukuoka, Yuki; Yamada, Yuichiro

    2013-11-01

    In elderly people, glucose tolerance is deteriorated and the incidence of diabetes mellitus is increased, due to decreased muscle mass and physical activity, declining pancreatic beta cell function, and other factors. Diabetes mellitus is an important risk factor for arteriosclerosis development in the elderly. Precise diagnosis and adequate treatment are necessary to prevent cerebrovascular and ischemic heart diseases. Elderly patients with diabetes mellitus are characteristically afflicted with more complications, impaired activities of daily living, cognitive function decline, and family environment problems, as compared with young and middle-aged diabetics. Therefore, tailor-made rather than uniform therapy becomes important. Lifestyle modification is the basis of diabetes treatment. Herein, we describe "prevention and management" of diabetes mellitus, focusing on the lifestyles of elderly diabetics.

  8. 18-FDG in diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Fares, Y.; Itoh, M.; Watabe, H.; Ghista, D. N.

    1993-06-01

    The intravenous glucose tolerance test, IVGTT, has been used to evaluate patients in whom abnormalities in carbohydrate metabolism and diabetes mellitus are suspected. IVGTT, if analyzed using "minimal models", or discrete-time methods, provides information on the sensitivity of glucose disappearance to insulin and on pancreatic sensitivity to glucose, information that cannot be obtained from direct analysis of the dynamic response alone. In a preliminary study, data obtained by intravenously injecting 18-FDG in four subjects was analyzed using a discrete-time model. The experimental details, the results and their implications will be discussed.

  9. PATTERN OF CUTANEOUS MANIFESTATIONS IN DIABETES MELLITUS

    PubMed Central

    Goyal, Abhishek; Raina, Sujeet; Kaushal, Satinder S; Mahajan, Vikram; Sharma, Nand Lal

    2010-01-01

    Background: Diabetes mellitus affects individuals of all ages and socioeconomic status. Skin is affected by the acute metabolic derangements as well as by chronic degenerative complications of diabetes. Aims: To evaluate the prevalence of skin manifestations in patients with diabetes mellitus. To analyze the prevalence and pattern of skin disorders among diabetic patients from this region of Western Himalayas. Materials and Methods: One hundred consecutive patients with the diagnosis of diabetes mellitus and having skin lesions, either attending the diabetic clinic or admitted in medical wards were included in this study. Results: The common skin disorders were: Xerosis (44%), diabetic dermopathy (36%), skin tags (32%), cutaneous infections (31%), and seborrheic keratosis (30%). Conclusion: Skin is involved in diabetes quite often and the manifestations are numerous. High prevalence of xerosis in our diabetic population is perhaps due to cold and dry climatic conditions in the region for most of the time in the year. PMID:20418975

  10. Gestational diabetes mellitus screening and outcomes.

    PubMed

    Aktün, Hale Lebriz; Uyan, Derya; Yorgunlar, Betül; Acet, Mustafa

    2015-01-01

    To verify the usefulness of the World Health Organization criteria for the diagnosis of gestational diabetes mellitus in pregnant women and its effectiveness in the prevention of maternal and neonatal adverse results in women younger than 35 years without apparent risk factors for gestational diabetes mellitus. This is a retrospective study based on population involving 1360 pregnant women who delivered and who were followed-up in a university hospital in Istanbul. All women underwent the 75-g oral glucose tolerance test screening, usually in between the 24(th)-28(th) weeks of pregnancy. In all cases, the identification of gestational diabetes mellitus was determined in accordance with the World Health Organization criteria. Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn't showed any significant deviation between the groups. There was a moderate association between gestational diabetes mellitus and metabolic complications. Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organization criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatal weight.

  11. Diabetes mellitus and heart disease.

    PubMed

    Ambhore, Anand; Teo, Swee Guan; Poh, Kian Keong

    2013-07-01

    Diabetes mellitus is responsible for diverse cardiovascular complications such as accelerated atherosclerosis, increased plaque burden and diffuse coronary lesions. It is also a major risk factor for myocardial infarction, stroke and peripheral vascular disease. Here, we present two cases. The first patient had subtle changes in the ECGs, with severe coronary artery disease requiring coronary artery bypass grafting, while the second had deep T wave inversion in the ECG and was found to have normal coronary arteries and nonischaemic cardiomyopathy. Although ECG failed to show the severity of the disease, it is invaluable as a simple, noninvasive test to aid in diagnosis. Our two cases stress the importance of a high index of suspicion and the low threshold for investigations in the diabetic population.

  12. [Dyslipidemia in diabetes mellitus: diagnosis and treatment].

    PubMed

    Oikawa, Shinichi

    2015-12-01

    Dyslipidemia in diabetes mellitus is a secondary change in hyperglycemia. Even if hyperlipidemia was not present, dyslipidemia will be present, especially as the increase of remnant. Usually this dyslipidemia is improved by a good control of hyperglycemia. In the pathogenesis the various factors relate to the lipid/lipoprotein metabolism, by insulin action (hyperinsulinemia or insulinopenia), adipokines, or hyperglycemia itself. The every changes of lipoprotein metabolism could be occurred in diabetes mellitus, and those are related to the increase of atherogenic lipoproteins. We should recognize the mechanism of lipids/lipoprotein metabolism in diabetes mellitus and approach to prevent the atherosclerotic diseases in diabetes.

  13. Periodontal disease and diabetes mellitus

    PubMed Central

    NEGRATO, Carlos Antonio; TARZIA, Olinda; JOVANOVIČ, Lois; CHINELLATO, Luiz Eduardo Montenegro

    2013-01-01

    Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. Objective: The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the english and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. Methods: This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in english and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. Results: This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. Conclusions: The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes

  14. Periodontal disease and diabetes mellitus.

    PubMed

    Negrato, Carlos Antonio; Tarzia, Olinda; Jovanovič, Lois; Chinellato, Luiz Eduardo Montenegro

    2013-01-01

    Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the English and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in English and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes-related complications.

  15. [Diabetes mellitus: Definition, classification and diagnosis].

    PubMed

    Roden, Michael

    2012-12-01

    Diabetes mellitus comprises of a group of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classifications for diabetes mellitus type 1-4 are described and the main features of type 1 and type 2 diabetes are compared to allow for better discrimination between these diabetes types. Furthermore, the criteria for the correct biochemical diagnosis during fasting and oral glucose tolerance tests as well as the use of hemoglobin A1c (HbA1c) are summarized. These data form the basis of the recommendations of the Austrian Diabetes Association for the clinical praxis of diabetes treatment.

  16. [Diabetes mellitus: definition, classification and diagnosis].

    PubMed

    Roden, Michael

    2016-04-01

    Diabetes mellitus comprises of a group of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classifications for diabetes mellitus type 1-4 are described and the main features of type 1 and type 2 diabetes are compared to allow for better discrimination between these diabetes types. Furthermore, the criteria for the correct biochemical diagnosis during fasting and oral glucose tolerance tests as well as the use of hemoglobin A1c (HbA1c) are summarized. These data form the basis of the recommendations of the Austrian Diabetes Association for the clinical praxis of diabetes treatment.

  17. Methylglyoxal, diabetes mellitus and diabetic complications.

    PubMed

    Vander Jagt, David L

    2008-01-01

    A large literature has developed around methylglyoxal (MG) concerning its role in diabetes mellitus (DM) and in the development of diabetic complications. This is related to the observation that levels of reactive aldehydes, especially 2-oxoaldehydes such as MG, are elevated in DM. There are numerous metabolic origins of MG that are accentuated in DM. MG has effects on insulin secretion from pancreatic beta-cells and is a major precursor of advanced glycation endproducts (AGE). Consequently, MG has a role in primary DM as well in the etiology of long-term complications. There is an extensive literature concerning the enzymes involved in the metabolism of MG, especially the glyoxalase system and aldose reductase. In addition, there is a rapidly developing literature on the direct and indirect effects of MG on signaling pathways that impact DM. This review attempts to integrate this DM-associated literature related to MG.

  18. Noninvasive detection of diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Eppstein, Jonathan A.; Bursell, Sven-Erik

    1992-05-01

    Recent advances in fluorescence spectroscopy of the lens reveal the potential of a non-invasive device and methodology to sensitively measure changes in the lens of the eye associated with diabetes mellitus. The system relies on the detection of the spectrum of fluorescence emitted from a selected volume (approximately 1/10 mm3) of the lens of living human subjects using low power excitation illumination from monochromatic light sources. The sensitivity of this technique is based on the measurement of the fluorescence intensity in a selected region of the fluorescence spectrum and normalization of this fluorescence with respect to attenuation (scattering and absorption) of the incident excitation light. The amplitude of the unshifted Rayleigh line, measured as part of the fluorescence spectrum, is used as a measure of the attenuation of the excitation light in the lens. Using this methodology we have demonstrated that the normalized lens fluorescence provides a more sensitive discrimination between diabetic and non-diabetic lenses than more conventional measurements of fluorescence intensity from the lens. The existing instrumentation will be described as well as the proposed design for a commercial version of the instrument expected to be ready for FDA trials by late 1992. The results from clinical measurements are used to describe a relationship between normalized lens fluorescence and hemoglobin A1c levels in diabetic patients.

  19. Ayurvedic treatments for diabetes mellitus

    PubMed Central

    Sridharan, Kalpana; Mohan, Roshni; Ramaratnam, Sridharan; Panneerselvam, Deepak

    2013-01-01

    Background Patients with diabetes frequently use complimentary and alternative medications including Ayurvedic medications and hence it is important to determine their efficacy and safety. Objectives To assess the effects of Ayurvedic treatments for diabetes mellitus. Search methods We searched The Cochrane Library (issue 10, 2011), MEDLINE (until 31 August 2011), EMBASE (until 31 August 2011), AMED (until 14 October 2011), the database of randomised trials from South Asia (until 14 October 2011), the database of the grey literature (OpenSigle, until 14 October 2011) and databases of ongoing trials (until 14 October 2011). In addition we performed hand searches of several journals and reference lists of potentially relevant trials. Selection criteria We included randomized trials of at least two months duration of Ayurvedic interventions for diabetes mellitus. Participants of both genders, all ages and any type of diabetes were included irrespective of duration of diabetes, antidiabetic treatment, comorbidity or diabetes related complications. Data collection and analysis Two authors independently extracted data. Risk of bias of trials was evaluated as indicated in the Cochrane Handbook for Systematic Reviews of Intervention. Main results Results of only a limited number of studies could be combined, in view of different types of interventions and variable quality of data. We found six trials of proprietary herbal mixtures and one of whole system Ayurvedic treatment. These studies enrolled 354 participants ( 172 on treatment, 158 on controls, 24 allocation unknown). The treatment duration ranged from 3 to 6 months. All these studies included adults with type 2 diabetes mellitus. With regard to our primary outcomes, significant reductions in glycosylated haemoglobin A1c (HbA1c), fasting blood sugar (FBS) or both were observed with Diabecon, Inolter and Cogent DB compared to placebo or no additional treatment, while no significant hypoglycaemic response was found

  20. Ayurvedic treatments for diabetes mellitus.

    PubMed

    Sridharan, Kalpana; Mohan, Roshni; Ramaratnam, Sridharan; Panneerselvam, Deepak

    2011-12-07

    Patients with diabetes frequently use complimentary and alternative medications including Ayurvedic medications and hence it is important to determine their efficacy and safety. To assess the effects of Ayurvedic treatments for diabetes mellitus. We searched The Cochrane Library (issue 10, 2011), MEDLINE (until 31 August 2011), EMBASE (until 31 August 2011), AMED (until 14 October 2011), the database of randomised trials from South Asia (until 14 October 2011), the database of the grey literature (OpenSigle, until 14 October 2011) and databases of ongoing trials (until 14 October 2011). In addition we performed hand searches of several journals and reference lists of potentially relevant trials. We included randomized trials of at least two months duration of Ayurvedic interventions for diabetes mellitus. Participants of both genders, all ages and any type of diabetes were included irrespective of duration of diabetes, antidiabetic treatment, comorbidity or diabetes related complications. Two authors independently extracted data. Risk of bias of trials was evaluated as indicated in the Cochrane Handbook for Systematic Reviews of Intervention. Results of only a limited number of studies could be combined, in view of different types of interventions and variable quality of data. We found six trials of proprietary herbal mixtures and one of whole system Ayurvedic treatment. These studies enrolled 354 participants ( 172 on treatment, 158 on controls, 24 allocation unknown). The treatment duration ranged from 3 to 6 months. All these studies included adults with type 2 diabetes mellitus.With regard to our primary outcomes, significant reductions in glycosylated haemoglobin A1c (HbA1c), fasting blood sugar (FBS) or both were observed with Diabecon, Inolter and Cogent DB compared to placebo or no additional treatment, while no significant hypoglycaemic response was found with Pancreas tonic and Hyponidd treatment. The study of whole system Ayurvedic treatment did not

  1. Osteoporosis in patients with diabetes mellitus.

    PubMed

    Hofbauer, Lorenz C; Brueck, Carolin C; Singh, Shiv K; Dobnig, Harald

    2007-09-01

    Demographic trends with longer life expectancy and a lifestyle characterized by low physical activity and high-energy food intake contribute to an increasing incidence of diabetes mellitus and osteoporosis. Diabetes mellitus is a risk factor for osteoporotic fractures. Patients with recent onset of type 1 diabetes mellitus may have impaired bone formation because of the absence of the anabolic effects of insulin and amylin, whereas in long-standing type 1 diabetes mellitus, vascular complications may account for low bone mass and increased fracture risk. Patients with type 2 diabetes mellitus display an increased fracture risk despite a higher BMD, which is mainly attributable to the increased risk of falling. Strategies to improve BMD and to prevent osteoporotic fractures in patients with type 1 diabetes mellitus may include optimal glycemic control and aggressive prevention and treatment of vascular complications. Patients with type 2 diabetes mellitus may additionally benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls.

  2. Neurologic infections in diabetes mellitus.

    PubMed

    Jay, Cheryl A; Solbrig, Marylou V

    2014-01-01

    Even at a time when HIV/AIDS and immunosuppressive therapy have increased the number of individuals living with significant immunocompromise, diabetes mellitus (DM) remains a major comorbid disorder for several rare but potentially lethal infections, including rhino-orbital-cerebral mucormycosis and malignant external otitis. DM is also a commonly associated condition in patients with nontropical pyomyositis, pyogenic spinal infections, Listeria meningitis, and blastomycosis. As West Nile virus spread to and across North America over a decade ago, DM appeared in many series as a risk factor for death or neuroinvasive disease. More recently, in several large international population-based studies, DM was identified as a risk factor for herpes zoster. The relationships among infection, DM, and the nervous system are multidirectional. Viral infections have been implicated in the pathogenesis of type 1 and type 2 DM, while parasitic infections have been hypothesized to protect against autoimmune disorders, including type 1 DM. DM-related neurologic disease can predispose to systemic infection - polyneuropathy is the predominant risk factor for diabetic foot infection. Because prognosis for many neurologic infections depends on timely institution of antimicrobial and sometimes surgical therapy, neurologists caring for diabetic patients should be familiar with the clinical features of the neuroinfectious syndromes associated with DM.

  3. Stress and adjustment in diabetes mellitus.

    PubMed

    Parveen, S; Singh, S B

    1999-01-01

    Stress and adjustment in diabetics is studied in order to know the influence of maladjustment and stress in the causation of the disease. The sample of study consists of 100 diabetics patients, 100 nonpsychosomatic and 100 normal person. Results obtained are discussed in detail. It is concluded that maladjustment and stress are important contributing factors in' diabetes mellitus.

  4. Antioxidant plants and diabetes mellitus

    PubMed Central

    Nasri, Hamid; Shirzad, Hedayatollah; Baradaran, Azar; Rafieian-kopaei, Mahmoud

    2015-01-01

    The incidence of diabetes mellitus (DM) is increasing rapidly and it is expected to increase by 2030. Other than currently available therapeutic options, there are a lot of herbal medicines, which have been recommended for its treatment. Herbal medicines have long been used for the treatment of DM because of the advantage usually having no or less side-effects. Most of these plants have antioxidant activities and hence, prevent or treat hard curable diseases, other than having the property of combating the toxicity of toxic or other drugs. In this review other than presenting new findings of DM, the plants, which are used and have been evaluated scientifically for the treatment of DM are introduced. PMID:26487879

  5. Carnitine metabolism in diabetes mellitus.

    PubMed

    Coker, Mahmut; Coker, Canan; Darcan, Sükran; Can, Sule; Orbak, Zerrin; Gökşen, Damla

    2002-06-01

    In diabetes mellitus (DM), increased fatty acids have negative effects on pancreatic beta-cell functions, in addition to enhanced mitochondrial transportation of fatty acids related to decreased insulin levels. The aim of this study was to evaluate lipid metabolism in children with DM by measuring plasma fatty acids and carnitine fractions to reveal relationships between carnitine status and increased fatty acid oxidation. Increased plasma fatty acids (except for arachidonic acid, there were no significant differences in the ratio of each specific fatty acid to total fatty acids), lipoprotein (a), acyl carnitine levels and urinary total and free acyl carnitine excretion, and decreased plasma free carnitine levels, were found in children with DM. There were no correlations between the duration of DM or HbA1c and study parameters. It is recommended that plasma free carnitine determinations should be made even if the patient has good metabolic control.

  6. 78 FR 20381 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  7. 76 FR 25769 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-05

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  8. 76 FR 9854 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  9. 78 FR 14406 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  10. 78 FR 16758 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  11. 76 FR 1496 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  12. 77 FR 40941 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  13. 78 FR 38439 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  14. 77 FR 52384 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes...: Notice of applications for exemption from the diabetes mellitus requirement; request for comments... against persons with insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles...

  15. 76 FR 17478 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  16. 78 FR 79062 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  17. 76 FR 61140 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  18. 76 FR 9862 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  19. 75 FR 28677 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemptions from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  20. 78 FR 1927 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-09

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  1. 76 FR 79756 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  2. 78 FR 26419 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  3. 78 FR 22599 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-16

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  4. 78 FR 38435 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  5. 78 FR 50482 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  6. 76 FR 66120 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  7. 78 FR 16032 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  8. 76 FR 17475 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  9. 77 FR 18302 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  10. 76 FR 32012 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  11. 78 FR 68139 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  12. 75 FR 63536 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  13. 78 FR 50486 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  14. 77 FR 48587 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-14

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  15. 76 FR 21792 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-18

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  16. 77 FR 36333 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-18

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  17. 78 FR 1923 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-09

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  18. 76 FR 47291 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... for exemption from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate...

  19. 77 FR 65931 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... applications for exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA... with insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in...

  20. 77 FR 533 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  1. 77 FR 5870 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted,...

  2. Weight management in type 2 diabetes mellitus.

    PubMed

    Siram, Amulya T; Yanagisawa, Robert; Skamagas, Maria

    2010-01-01

    Obesity is a well known risk factor for type 2 diabetes mellitus. Individuals with type 2 diabetes mellitus are at risk for weight gain as a result of multiple influences, including sedentary lifestyle, high-calorie diet, diabetes medications, sociocultural factors, chronic medical and psychiatric illnesses, and a dysregulated enteroendocrine axis. Because both diabetes mellitus and obesity predispose patients to abnormal cardiometabolic profiles and increased cardiovascular disease, management of diabetes mellitus should focus on weight management and optimizing cardiometabolic parameters, concomitant with glycemic control. Lifestyle modification incorporating healthy, calorie-appropriate diets and increased physical activity, in addition to metformin, are central components to diabetes management and weight management. These interventions have been shown to improve body weight, glycemic control, and overall cardiometabolic profile. The weight-neutral and weight-losing diabetes medications include metformin, alpha-glucosidase inhibitors, glucagon-like peptide-1 analogs, dipeptidyl peptidase-4 inhibitors, and amylin analogs. It is essential that providers understand the metabolic and weight effects of diabetes medications in order to develop strategies for managing diabetes mellitus while helping patients maintain or lose weight in order to improve their overall health outcomes.

  3. Management of diabetes mellitus in infants.

    PubMed

    Karges, Beate; Meissner, Thomas; Icks, Andrea; Kapellen, Thomas; Holl, Reinhard W

    2011-11-29

    Diabetes mellitus diagnosed during the first 2 years of life differs from the disease in older children regarding its causes, clinical characteristics, treatment options and needs in terms of education and psychosocial support. Over the past decade, new genetic causes of neonatal diabetes mellitus have been elucidated, including monogenic β-cell defects and chromosome 6q24 abnormalities. In patients with KCNJ11 or ABCC8 mutations and diabetes mellitus, oral sulfonylurea offers an easy and effective treatment option. Type 1 diabetes mellitus in infants is characterized by a more rapid disease onset, poorer residual β-cell function and lower rate of partial remission than in older children. Insulin therapy in infants with type 1 diabetes mellitus or other monogenic causes of diabetes mellitus is a challenge, and novel data highlight the value of continuous subcutaneous insulin infusion in this very young patient population. Infants are entirely dependent on caregivers for insulin therapy, nutrition and glucose monitoring, which emphasizes the need for appropriate education and psychosocial support of parents. To achieve optimal long-term metabolic control with low rates of acute and chronic complications, continuous and structured diabetes care should be provided by a multidisciplinary health-care team.

  4. Management and treatment of diabetes mellitus.

    PubMed

    Imam, Khalid

    2012-01-01

    Management of patients with Type 2 diabetes mellitus (T2DM) demands a comprehensive approach which includes diabetes education, an emphasis on life style modification, achievement of good glycemic control, minimization of cardiovascular risk, and avoidance of drugs that can aggravate glucose or lipid metabolism, and screening for diabetes complications. Comprehensive diabetes management can delay the progression of complication and maximize the quality of life. Acquiring knowledge about diabetes is an essential part of diabetes management, and even more important is to make the patient aware of this chronic disease. "For a diabetic patient, knowledge and understanding are not a part of treatment--they are the treatment".

  5. Gestational diabetes mellitus and subsequent development of overt diabetes mellitus.

    PubMed

    Damm, P

    1998-11-01

    GDM develops in 1-3% of all pregnancies. Women with GDM are characterized by a relatively diminished insulin secretion coupled with a pregnancy-induced insulin resistance primary located in skeletal muscle tissue. The cellular background for this insulin resistance is not known. The binding of insulin to its receptor and the subsequent activation of the insulin receptor tyrosine kinase have significant importance for the cellular effect of insulin. Thus, the pathogenesis to the insulin resistance was studied by investigating insulin receptor binding and tyrosine kinase activity in skeletal muscle biopsies from women with GDM and pregnant controls. No major abnormalities were found in GDM wherefore it is likely that the insulin resistance is caused by intracellular defects distal to the activation of the tyrosine kinase. Glucose tolerance returns to normal postpartum in the majority of women with GDM. However, previous studies, in populations quite different from a Danish population, have shown that women with previous GDM have a high risk of developing overt diabetes mellitus later in life. Hence, we aimed to investigate the prognosis of women with previous GDM with respect to subsequent development of diabetes and also to identify predictive factors for the development of overt diabets in these women. A follow-up study of diet treated GDM women diagnosed during 1978 to 1985 at the Rigshospital, Copenhagen was performed. Glucose tolerance was evaluated in 241 women (81% of the GDM population) 2-11 years after pregnancy. Abnormal glucose tolerance was found in 34.4% of the women (3.7% IDDM, 13.7% NIDDM, 17% IGT) in contrast to a control group where none had diabetes and 5.3% had IGT. Logistic regression analysis identified the following independent risk factors for later development of diabetes: a high fasting glucose level at diagnosis of GDM, a delivery more than 3 weeks before term, and an abnormal OGTT 2 months postpartum. Low insulin secretion at diagnosis of

  6. [GASTROENTEROLOGICAL SYMPTOM IN DIABETES MELLITUS TYPE 2].

    PubMed

    Osipenko, M F; Vorontsova, E S; Zhuk, E A

    2015-01-01

    The data of the literature and own data on the frequency and mechanisms of gastrointestinal symptoms in patients with diabetes mellitus type 2 are discussed. Changes in the gastrointestinal tract with diabetes mellitus type 2 are detected over its entire length and occur more frequently than in the general population. Among the reasons of it the presence of autonomic neuropathy, factor of hyperglycemia, increased anxiety and depression in patients are discussed.

  7. Telomere attrition and diabetes mellitus.

    PubMed

    Tamura, Yoshiaki; Takubo, Kaiyo; Aida, Junko; Araki, Atsushi; Ito, Hideki

    2016-03-01

    Type 2 diabetes mellitus (DM) is a disease characterized by dysfunction of various organs. Recent studies have shown a close relationship between DM and telomere attrition in leukocytes. In patients with DM or impaired glucose tolerance, excessive oxidative stress induces damage to telomeres and shortens their length. Furthermore, it is suggested that telomere length is a good surrogate marker for mortality and diabetic complications in DM patients. We recently found that telomere length in pancreatic β-cells is also shortened in DM patients, potentially leading to an impaired capacity for proliferation and insulin secretion, and accelerated cell death. In contrast, leukocyte telomere length has also been reported in patients with obesity or insulin resistance, both of which are frequently associated with type 2 DM. In an animal model, it has been shown that telomere attrition in adipose tissue induces insulin resistance. Taken together, the available data suggest that hyperglycemia, oxidative stress, and telomere attrition in pancreatic β-cells and adipocytes create a vicious cycle that underlies the pathophysiology of type 2 DM. Inhibition of telomere attrition in various organs, including pancreatic β-cells, could be a new approach for preventing the progression of DM and its complications. © 2016 Japan Geriatrics Society.

  8. Arterial stiffness in diabetes mellitus.

    PubMed

    Prenner, Stuart B; Chirinos, Julio A

    2015-02-01

    Arterial stiffness is an age-related process that is a shared consequence of numerous diseases including diabetes mellitus (DM), and is an independent predictor of mortality both in this population and in the general population. While much has been published about arterial stiffness in patients with DM, a thorough review of the current literature is lacking. Using a systematic literature search strategy, we aimed to summarize our current understanding related to arterial stiffness in DM. We review key studies demonstrating that, among patients with established DM, arterial stiffness is closely related to the progression of complications of DM, including nephropathy, retinopathy, and neuropathy. It is also becoming clear that arterial stiffness can be increased even in pre-diabetic populations with impaired glucose tolerance, and in those with the metabolic syndrome (METS), well before the onset of overt DM. Some data suggests that arterial stiffness can predict the onset of DM. However, future work is needed to further clarify whether large artery stiffness and the pulsatile hemodynamic changes that accompany it are involved in the pathogenesis of DM, and whether interventions targeting arterial stiffness are associated with improved clinical outcomes in DM. We also review of the potential mechanisms of arterial stiffness in DM, with particular emphasis on the role of advanced glycation endproducts (AGEs) and nitric oxide dysregulation, and address potential future directions for research.

  9. Periodontal pathogens and gestational diabetes mellitus.

    PubMed

    Dasanayake, A P; Chhun, N; Tanner, A C R; Craig, R G; Lee, M J; Moore, A F; Norman, R G

    2008-04-01

    In previous cross-sectional or case-control studies, clinical periodontal disease has been associated with gestational diabetes mellitus. To test the hypothesis that, in comparison with women who do not develop gestational diabetes mellitus, those who do develop it will have had a greater exposure to clinical and other periodontal parameters, we measured clinical, bacteriological (in plaque and cervico-vaginal samples), immunological, and inflammatory mediator parameters 7 weeks before the diagnosis of gestational diabetes mellitus in 265 predominantly Hispanic (83%) women in New York. Twenty-two cases of gestational diabetes mellitus emerged from the cohort (8.3%). When the cases were compared with healthy control individuals, higher pre-pregnancy body mass index (p=0.004), vaginal levels of Tannerella forsythia (p=0.01), serum C-reactive protein (p=0.01), and prior gestational diabetes mellitus (p=0.006) emerged as risk factors, even though the clinical periodontal disease failed to reach statistical significance (50% in those with gestational diabetes mellitus vs. 37.3% in the healthy group; p=0.38).

  10. Diabetes mellitus: The epidemic of the century

    PubMed Central

    Kharroubi, Akram T; Darwish, Hisham M

    2015-01-01

    The epidemic nature of diabetes mellitus in different regions is reviewed. The Middle East and North Africa region has the highest prevalence of diabetes in adults (10.9%) whereas, the Western Pacific region has the highest number of adults diagnosed with diabetes and has countries with the highest prevalence of diabetes (37.5%). Different classes of diabetes mellitus, type 1, type 2, gestational diabetes and other types of diabetes mellitus are compared in terms of diagnostic criteria, etiology and genetics. The molecular genetics of diabetes received extensive attention in recent years by many prominent investigators and research groups in the biomedical field. A large array of mutations and single nucleotide polymorphisms in genes that play a role in the various steps and pathways involved in glucose metabolism and the development, control and function of pancreatic cells at various levels are reviewed. The major advances in the molecular understanding of diabetes in relation to the different types of diabetes in comparison to the previous understanding in this field are briefly reviewed here. Despite the accumulation of extensive data at the molecular and cellular levels, the mechanism of diabetes development and complications are still not fully understood. Definitely, more extensive research is needed in this field that will eventually reflect on the ultimate objective to improve diagnoses, therapy and minimize the chance of chronic complications development. PMID:26131326

  11. 77 FR 37060 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Meeting The Diabetes Mellitus Interagency Coordinating Committee (DMICC) will hold a... facilitates cooperation, communication, and collaboration on diabetes among government entities....

  12. Type 2 Diabetes Mellitus in Youth

    ERIC Educational Resources Information Center

    Quarry-Horn, Jill L.; Evans, Barbara J.; Kerrigan, James R.

    2003-01-01

    In the United States, the incidence of type 2 diabetes mellitus (DM) in children and adolescents has been increasing at an alarming rate. Early recognition and intervention can delay the onset of type 2 DM and prevent the long-term complications. School nurses have an essential role in implementing the American Diabetes Association (ADA)…

  13. Gastroparesis in diabetes mellitus: an ultrasonographic study.

    PubMed

    Moldovan, Corina; Dumitrascu, Dan L; Demian, Luiza; Brisc, Ciprian; Vatca, Liliana; Magheru, Sorina

    2005-03-01

    To investigate diabetic gastro-paresis, a complication of diabetes mellitus and its determinants. A group of 36 patients with diabetes and 20 healthy controls, with comparable age and sex ratio were investigated with an established ultrasonographic method. A mixed test meal of 400 kcal was given. Antral fasting and postprandial area, postprandial distension and emptying time were assessed. Glucose control was estimated by the measurement of fasting and postprandial glucose as well as by assessing HbA1c. Antral area was nonsignificantly larger in diabetes mellitus. Postprandial antral area and postprandial antral distension were higher in diabetes than in the controls. The prevalence of gastroparesis was 52.7%, without differences between the two types of diabetes: 53.8% in type I and 52.2% in type II diabetes mellitus. Gastroparesis was associated with poor short and long time control of blood glucose and with positive parasympathetic tests. Gastroparesis did not correlate with symptoms. Gastroparesis is a real complication in diabetes mellitus and can be documented using an ultrasonographic method. Poor glucose control and autonomic neuropathy are associated with gastroparesis.

  14. Type 2 Diabetes Mellitus in Youth

    ERIC Educational Resources Information Center

    Quarry-Horn, Jill L.; Evans, Barbara J.; Kerrigan, James R.

    2003-01-01

    In the United States, the incidence of type 2 diabetes mellitus (DM) in children and adolescents has been increasing at an alarming rate. Early recognition and intervention can delay the onset of type 2 DM and prevent the long-term complications. School nurses have an essential role in implementing the American Diabetes Association (ADA)…

  15. Feline diabetes mellitus: diagnosis, treatment, and monitoring.

    PubMed

    Rios, Lori; Ward, Cynthis

    2008-12-01

    Advances in the treatment and monitoring of diabetes mellitus in humans are being applied to feline patients. The authors present the current approaches to the treatment of diabetic cats as well as their experience with the use of new monitoring technology.

  16. Markers of Oxidative Stress during Diabetes Mellitus

    PubMed Central

    Tiwari, Brahm Kumar; Pandey, Kanti Bhooshan; Abidi, A. B.; Rizvi, Syed Ibrahim

    2013-01-01

    The prevalence of diabetes mellitus is rising all over the world. Uncontrolled state of hyperglycemia due to defects in insulin secretion/action leads to a variety of complications including peripheral vascular diseases, nephropathy, neuropathy, retinopathy, morbidity, and/or mortality. Large body of evidence suggests major role of reactive oxygen species/oxidative stress in development and progression of diabetic complications. In the present paper, we have discussed the recent researches on the biomarkers of oxidative stress during type 2 diabetes mellitus. PMID:26317014

  17. Oral Manifestations and Complications of Diabetes Mellitus

    PubMed Central

    Al-Maskari, Awatif Y.; Al-Maskari, Masoud Y.; Al-Sudairy, Salem

    2011-01-01

    Diabetes mellitus is a chronic disease affecting all age groups. It is one of the leading causes of mortality and morbidity worldwide. Many chronic macrovascular and microvascular complications of diabetes have been reported in the literature with few reports about oral complications. This article aims to review and increase the awareness of oral manifestations and complications of diabetes mellitus and to stimulate research on the subject. It treats in depth some of the complications such as periodontal disease, fungal infection and salivary dysfunction while other complications are mentioned briefly. PMID:21969888

  18. Nailfold capillaroscopy in diabetes mellitus.

    PubMed

    Maldonado, G; Guerrero, R; Paredes, C; Ríos, C

    2017-07-01

    Diabetes mellitus (DM) is characterized by chronic hyperglycemia states and the development of specific microvascular disorders such as retinopathy and nephropathy. Conventional methods are used to study the vascular compromise of this entity, however, the use of capillaroscopy for the evaluation of capillary microarchitecture is not frequently used. Observational and descriptive study of 65 patients with an established diagnosis of DM and a control group that underwent an initial capillaroscopy examination. The parameters considered were: Capillary diameter (ectasia and giant capillaries), cross-linked, tortuous, arborified capillaries, avascular zones, haemorrhages, dominant morphology, visibility of the subpapillary venous plexus (SPVP), cuticulitis and SD pattern. Capillaroscopy was performed in 65 patients, the findings were: tortous capillaries (63%), crosslinked capillaries (59%), avascular areas (48%), ectasias (39%), giant capillaries (11%). The capillaroscopic findings were evident in the majority of the studied population, 83%, compared to 17% who did not have capillaroscopic alterations. Significant capillaroscopic changes were demonstrated in patients with DM, in turn, we described a specific pattern consisting of: capillary dilatation, avascular zones and tortuous capillaries. Patients with more comorbidities and evolution of the disease showed greater microvascular damage. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Pharmacogenetics of posttransplant diabetes mellitus.

    PubMed

    Lancia, P; Adam de Beaumais, T; Jacqz-Aigrain, E

    2017-03-28

    Many factors (physiological, pathological, environmental or genetic) are associated with variability in drug effect. Most patients respond to a standard treatment but the drug may be ineffective or toxic. In this review, we focused on genetic markers of posttransplant diabetes mellitus (PTDM) after renal transplantation, a frequent complication of immunosuppressive therapy and important risk factor of graft loss and mortality. An initial literature search identified 100 publications and among them 32 association studies were retrieved under 'Pharmacogenetics and PTDM'. Thirty-five variants in 25 genes with an impact on insulin secretion, disposition or effect were significantly associated with PTDM. The population studied, immunosuppressive regimen, follow-up, PTDM diagnostic and genetic variations tested were highly variable between studies. Although pharmacogenetic biomarkers are key tools of great promise for preventing toxicities and improving event-free survival rates, replication studies are required to select validated biomarkers linked to the occurrence of PTDM and select appropriate immusuppressive treatment to improve renal graft and patient outcome.The Pharmacogenomics Journal advance online publication, 28 March 2017; doi:10.1038/tpj.2017.1.

  20. KNOWLEDGE OF DIABETIC COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS.

    PubMed

    Ullah, Fahim; Afridi, Ayesha Khan; Rahim, Fawad; Ashfaq, Muhammad; Khan, Sheema; Shabbier, Ghulam; Rahman, Sadiq Ur

    2015-01-01

    The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 +/- 10.821 years while the mean duration of diabetes mellitus was 9.75 +/- 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus.

  1. Outcomes of polytrauma patients with diabetes mellitus

    PubMed Central

    2014-01-01

    Background The impact of diabetes mellitus in patients with multiple system injuries remains obscure. This study was designed to increase knowledge of outcomes of polytrauma in patients who have diabetes mellitus. Methods Data from the Trauma Audit and Research Network was used to identify patients who had suffered polytrauma during 2003 to 2011. These patients were filtered to those with known outcomes, then separated into those with diabetes, those known to have other co-morbidities but not diabetes and those known not to have any co-morbidities or diabetes. The data were analyzed to establish if patients with diabetes had differing outcomes associated with their diabetes versus the other groups. Results In total, 222 patients had diabetes, 2,558 had no past medical co-morbidities (PMC), 2,709 had PMC but no diabetes. The diabetic group of patients was found to be older than the other groups (P <0.05). A higher mortality rate was found in the diabetic group compared to the non-PMC group (32.4% versus 12.9%), P <0.05). Rates of many complications including renal failure, myocardial infarction, acute respiratory distress syndrome, pulmonary embolism and deep vein thrombosis were all found to be higher in the diabetic group. Conclusions Close monitoring of diabetic patients may result in improved outcomes. Tighter glycemic control and earlier intervention for complications may reduce mortality and morbidity. PMID:25026864

  2. Managing hypertension in type 2 diabetes mellitus.

    PubMed

    Horr, Samuel; Nissen, Steven

    2016-06-01

    Hypertension is a common problem in the diabetic population with estimates suggesting a prevalence exceeding 60%. Comorbid hypertension and diabetes mellitus are associated with high rates of macrovascular and microvascular complications. These two pathologies share overlapping risk factors, importantly central obesity. Treatment of hypertension is unequivocally beneficial and improves all-cause mortality, cardiovascular mortality, major cardiovascular events, and microvascular outcomes including nephropathy and retinopathy. Although controversial, current guidelines recommend a target blood pressure in the diabetic population of <140/90 mmHg, which is a similar target to that proposed for individuals without diabetes. Management of blood pressure in patients with diabetes includes both lifestyle modifications and pharmacological therapies. This article reviews the evidence for management of hypertension in patients with type 2 diabetes mellitus, and provides a recommended treatment strategy based on the available data. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. [Costs of known diabetes mellitus in Spain].

    PubMed

    Hart, W M; Espinosa, C; Rovira, J

    1997-09-13

    Diabetes mellitus is an important cause of mortality and morbidity in western nations with high costs for both patients and health care systems. Based on the latest epidemiological studies and in combination with Spanish demographic data the direct health care costs of known diabetes mellitus were estimated for the following areas: hospitalisation directly due to the disease, hospitalisation due to certain chronic complications such as acute myocardial infarction, amputations and renal disease (dialysis and transplant), outpatient visits, consumption of anti-diabetic medication, self-control, analyses, additional explorations and camps for diabetic children. In 1994, the total direct costs of diabetes mellitus in Spain were estimated to be more than 90,000 millions pesetas in a population of more than 1,400,000 known diabetic persons. This implies an average annual costs of approximately 63,000 pesetas per patient. If this cost is divided into categories, hospitalisation represents approximately 58% of the global cost, outpatient visits 14%, antidiabetic drugs 13%, self-control 4.7%, analyses 10% and camps a mere 0.04%. The most important component of the costs of diabetes mellitus in Spain in 1994 was hospitalisation due to the disease itself and its chronic complications which would seem to logically imply that resources ought to be targeted at reducing or postponing the development of such complications.

  4. 77 FR 46149 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-02

    ... [Docket No. FMCSA-2012-0164] Qualification of Drivers; Exemption Applications; Diabetes Mellitus AGENCY... diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of applications from 19 individuals for exemption from the prohibition against persons with insulin-treated...

  5. Statins and Risk of New-Onset Diabetes Mellitus

    MedlinePlus

    ... Patient Page Statins and Risk of New-Onset Diabetes Mellitus Ravi V. Shah , Allison B. Goldfine Download ... initiation in at-risk patients. Can Statins Cause Diabetes Mellitus? Careful review of findings from many trials ...

  6. Diabetes mellitus-associated periodontitis: differences between type 1 and type 2 diabetes mellitus.

    PubMed

    Aspriello, S D; Zizzi, A; Tirabassi, G; Buldreghini, E; Biscotti, T; Faloia, E; Stramazzotti, D; Boscaro, M; Piemontese, M

    2011-04-01

    Although many studies have appeared about diabetes mellitus-associated periodontitis, few have compared periodontitis inflammatory markers between type 1 (T1DM) and type 2 diabetes mellitus (T2DM), and information regarding this issue is scarce and contradictory. We evaluated the levels of plasma C-reactive protein and of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in gingival crevicular fluid in two groups of subjects affected by T1DM and T2DM, in order to identify possible differences between the two classes in the inflammatory mechanisms of diabetes mellitus-associated periodontitis. Plasma C-reactive protein and gingival crevicular fluid IL-1β, IL-6 and TNF-α were measured in periodontitis patients affected by type 1 (P-T1DM, n = 24) and type 2 diabetes mellitus (P-T2DM, n = 24). Gingival crevicular fluid levels of IL-1β and TNF-α in P-T1DM subjects were significantly higher than in P-T2DM subjects. In P-T1DM subjects, we found significant negative correlations between the duration of diabetes mellitus and IL-1β and between the duration of diabetes mellitus and TNF-α. This study shows that IL-1β and TNF-α levels in periodontitis patients with T1DM are affected by the duration of diabetes mellitus. © 2010 John Wiley & Sons A/S.

  7. Endothelial dysfunction in diabetes mellitus: Molecular mechanisms and clinical implications

    PubMed Central

    Tabit, Corey E.; Chung, William B.; Hamburg, Naomi M.

    2010-01-01

    Cardiovascular disease is a major complication of diabetes mellitus, and improved strategies for prevention and treatment are needed. Endothelial dysfunction contributes to the pathogenesis and clinical expression of atherosclerosis in diabetes mellitus. This article reviews the evidence linking endothelial dysfunction to human diabetes mellitus and experimental studies that investigated the responsible mechanisms. We then discuss the implications of these studies for current management and for new approaches for the prevention and treatment of cardiovascular disease in patients with diabetes mellitus. PMID:20186491

  8. Diabetes Mellitus and Colorectal Neoplasia

    PubMed Central

    Acevedo, Alejandro; Diaz, Yaritza; Perez, Cynthia M.; Garau, Maria; Baron, John

    2012-01-01

    Background Many studies have provided evidence for an association between obesity, physical inactivity, and western diet as risk factors for colorectal cancer (CRC). Few studies directly address the association between type 2 Diabetes Mellitus (DM) and the risk of colorectal lesions at specific anatomic locations. Methods 2,663 subjects with a previous history of adenoma(s) and removal of all current adenomas at study entry were followed for a mean time of three years across three different chemoprevention clinical trials. The primary endpoint was colorectal adenoma recurrence and number of lesions during the treatment phase; the secondary endpoints were presence of advanced colorectal neoplasia (CRN) and location of CRN. Using log linear regression, the effect of DM status on the relative risk (RR) of CRN recurrence, advanced CRN, and location of CRN was assessed. Results DM status was not significantly associated with incidence of colorectal adenomas, incidence of advanced colorectal lesions, or left-sided colorectal neoplastic lesions. Subjects with DM had a marginally increased risk of right-sided (p= 0.06) colorectal adenomas and a significant increased risk of multiple right-sided adenomas (p=0.03) in the unadjusted model; this association was not significant after adjusting for age and other potential confounders (RR=1.22, 95% CI: 0.85–1.76). Conclusion We did not observe a statistically significant increased risk in CRN recurrence for overall neoplasia, advanced neoplasia or location of neoplasia in individuals with DM compared to non-DM individuals. However, given the patterns observed in this investigation, future studies with longer follow-up time and longer DM exposure, incorporating objective measurements of type 2 DM might help elucidate the risk of CRN among individuals with DM. PMID:23560242

  9. The association between Diabetes mellitus and Depression.

    PubMed

    Bădescu, S V; Tătaru, C; Kobylinska, L; Georgescu, E L; Zahiu, D M; Zăgrean, A M; Zăgrean, L

    2016-01-01

    Depression occurrence is two to three times higher in people with diabetes mellitus, the majority of the cases remaining under-diagnosed. The purpose of this review was to show the links between depression and diabetes, point out the importance of identifying depression in diabetic patients and identify the possible ways to address both diseases. Possible common pathophysiological mechanisms as stress and inflammation were explained, while emphasis was made on screening for depression in diabetic patients. An important aspect for the diabetic specialist would be the understanding of the common origins of diabetes and depression and the awareness of this quite common comorbidity, in order to improve the outcomes of both diseases. DALYS = disability adjusted life years, DSM-5 = American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, DM1 = Type 1 diabetes mellitus, DM2 = Type 2 diabetes mellitus, HPA-axis = hypothalamus - pituitary - adrenal axis, SNS = sympathetic nervous system, BDI = Beck Depression Inventory, CES-D = Centre for Epidemiologic Studies Depression Scale, HADS = Hospital Anxiety and Depression Scale, PHQ = Patient Health Questionnaire.

  10. Diabetes mellitus and metformin in hepatocellular carcinoma

    PubMed Central

    Fujita, Koji; Iwama, Hisakazu; Miyoshi, Hisaaki; Tani, Joji; Oura, Kyoko; Tadokoro, Tomoko; Sakamoto, Teppei; Nomura, Takako; Morishita, Asahiro; Yoneyama, Hirohito; Masaki, Tsutomu

    2016-01-01

    Hepatocellular carcinoma (HCC) is the leading cause of cancer-related death worldwide. Diabetes mellitus, a risk factor for cancer, is also globally endemic. The clinical link between these two diseases has been the subject of investigation for a century, and diabetes mellitus has been established as a risk factor for HCC. Accordingly, metformin, a first-line oral anti-diabetic, was first proposed as a candidate anti-cancer agent in 2005 in a cohort study in Scotland. Several subsequent large cohort studies and randomized controlled trials have not demonstrated significant efficacy for metformin in suppressing HCC incidence and mortality in diabetic patients; however, two recent randomized controlled trials have reported positive data for the tumor-preventive potential of metformin in non-diabetic subjects. The search for biological links between cancer and diabetes has revealed intracellular pathways that are shared by cancer and diabetes. The signal transduction mechanisms by which metformin suppresses carcinogenesis in cell lines or xenograft tissues and improves chemoresistance in cancer stem cells have also been elucidated. This review addresses the clinical and biological links between HCC and diabetes mellitus and the anti-cancer activity of metformin in clinical studies and basic experiments. PMID:27468203

  11. The association between Diabetes mellitus and Depression

    PubMed Central

    Bădescu, SV; Tătaru, C; Kobylinska, L; Georgescu, EL; Zahiu, DM; Zăgrean, AM; Zăgrean, L

    2016-01-01

    Depression occurrence is two to three times higher in people with diabetes mellitus, the majority of the cases remaining under-diagnosed. The purpose of this review was to show the links between depression and diabetes, point out the importance of identifying depression in diabetic patients and identify the possible ways to address both diseases. Possible common pathophysiological mechanisms as stress and inflammation were explained, while emphasis was made on screening for depression in diabetic patients. An important aspect for the diabetic specialist would be the understanding of the common origins of diabetes and depression and the awareness of this quite common comorbidity, in order to improve the outcomes of both diseases. Abbreviations: DALYS = disability adjusted life years, DSM-5 = American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, DM1 = Type 1 diabetes mellitus, DM2 = Type 2 diabetes mellitus, HPA-axis = hypothalamus – pituitary – adrenal axis, SNS = sympathetic nervous system, BDI = Beck Depression Inventory, CES-D = Centre for Epidemiologic Studies Depression Scale, HADS = Hospital Anxiety and Depression Scale, PHQ = Patient Health Questionnaire. PMID:27453739

  12. 77 FR 43901 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... complying with the current regulation 49 CFR 391.41(b)(3). Diabetes Mellitus and Driving Experience of the... person has no established medical history or clinical diagnosis of diabetes mellitus currently...

  13. 77 FR 63411 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-16

    ... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt of... diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce. If granted, the... individual assessment of drivers with diabetes mellitus, and be consistent with the criteria described...

  14. 76 FR 5243 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3)). FMCSA... Congress on the Feasibility of a Program to Qualify Individuals with Insulin-Treated Diabetes Mellitus...

  15. 78 FR 19798 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3)). FMCSA established its diabetes... of a Program to Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in...

  16. 78 FR 26107 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3)). FMCSA... Congress on the Feasibility of a Program to Qualify Individuals with Insulin-Treated Diabetes Mellitus...

  17. [Surgical treatment of type 2 diabetes mellitus].

    PubMed

    Carrillo-Esper, Raúl; Muciño-Bermejo, María Jimena

    2014-01-01

    Sustained remission of type 2 diabetes mellitus and significantly improved hyperlipidemia and arterial hypertension, control has been achieves in both lean and obese patient after bariatric surgery procedures or other gastrointestinal surgical procedures. It has been demonstrated that the metabolic effects of bariatric surgery in these patients derives not only in reducing weight and caloric intake, but also endocrine changes resulting from surgical manifestation gastrointestinal tract. In this article we review the clinical outcomes of such interventions (collectively called "metabolic surgery") and the perspectives on the role that these surgeries play in the treatment of patients with type 2 diabetes mellitus.

  18. The syndrome of diabetes insipidus, diabetes mellitus and optic atrophy (DIDMOA) with diabetic cheiroarthropathy

    PubMed Central

    FitzGerald, G. A.; Greally, J. F.; Drury, M. I.

    1978-01-01

    Two sisters with diabetes mellitus and optic atrophy are described. One of them also has vasopressin responsive diabetes insipidus. Both have diabetic cheiroarthropathy, an unusual deformity of the hands. ImagesFig. 1

  19. Neuropsychiatric screening in type 2 diabetes mellitus.

    PubMed

    Kota, Sunil K; Meher, Lalit K; Jammula, Sruti; Krishna, S V S; Kota, Siva K; Modi, Kirtikumar D

    2012-03-01

    Diabetes mellitus is considered to be one of the most psychologically demanding of the chronic medical illnesses and is often associated with several psychiatric disorders. Psychiatric disorders can be a risk factor for, as well as a complication of, diabetes leading to bidirectional association between the two morbidities. Physicians caring for people with diabetes must be trained to recognize and manage comorbid psychiatric conditions that commonly occur. Our current article reviews the various screening procedures for effective evaluation of the neuropsychiatric illnesses coexisting with diabetes and other pertinent issues.

  20. Hypoglycemia, chronic kidney disease, and diabetes mellitus.

    PubMed

    Alsahli, Mazen; Gerich, John E

    2014-11-01

    Hypoglycemia is a major problem associated with substantial morbidity and mortality in patients with diabetes and is often a major barrier to achieving optimal glycemic control. Chronic kidney disease not only is an independent risk factor for hypoglycemia but also augments the risk of hypoglycemia that is already present in people with diabetes. This article summarizes our current knowledge of the epidemiology, pathogenesis, and morbidity of hypoglycemia in patients with diabetes and chronic kidney disease and reviews therapeutic considerations in this situation. PubMed and MEDLINE were searched for literature published in English from January 1989 to May 2014 for diabetes mellitus, hypoglycemia, chronic kidney disease, and chronic renal insufficiency.

  1. Erythropoietic stress and anemia in diabetes mellitus.

    PubMed

    Singh, Dhruv K; Winocour, Peter; Farrington, Ken

    2009-04-01

    Anemia is one of the world's most common preventable conditions, yet it is often overlooked, especially in people with diabetes mellitus. Diabetes-related chronic hyperglycemia can lead to a hypoxic environment in the renal interstitium, which results in impaired production of erythropoietin by the peritubular fibroblasts and subsequent anemia. Anemia in patients with diabetes mellitus might contribute to the pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. Anemia occurs earlier in patients with diabetic renal disease than in nondiabetic individuals with chronic kidney disease. Although erythropoietin has been used to treat renal anemia for nearly two decades, debate persists over the optimal target hemoglobin level. Most guidelines recommend that hemoglobin levels be maintained between 105g/l and 125g/l. The suggested role of anemia correction--to prevent the progression of left ventricular hypertrophy in patients with diabetes mellitus--is yet to be established. However, an emphasis on regular screening for anemia, alongside that for other diabetes-related complications, might help to delay the progression of vascular complications in these patients.

  2. Genetic Counseling for Diabetes Mellitus

    PubMed Central

    Stein, Stephanie A.; Maloney, Kristin L.; Pollin, Toni I.

    2014-01-01

    Most diabetes is polygenic in etiology, with (type 1 diabetes, T1DM) or without (type 2 diabetes, T2DM) an autoimmune basis. Genetic counseling for diabetes generally focuses on providing empiric risk information based on family history and/or the effects of maternal hyperglycemia on pregnancy outcome. An estimated one to five percent of diabetes is monogenic in nature, e.g., maturity onset diabetes of the young (MODY), with molecular testing and etiology-based treatment available. However, recent studies show that most monogenic diabetes is misdiagnosed as T1DM or T2DM. While efforts are underway to increase the rate of diagnosis in the diabetes clinic, genetic counselors and clinical geneticists are in a prime position to identify monogenic cases through targeted questions during a family history combined with working in conjunction with diabetes professionals to diagnose and assure proper treatment and familial risk assessment for individuals with monogenic diabetes. PMID:25045596

  3. [TYPE 2 DIABETES MELLITUS AND DEPRESSION].

    PubMed

    Kravchenko, A Ya; Esaulenko, I E; Sahnenko, V V; Budnevskyj, A V; Podvygyn, S N

    2016-01-01

    The clinical significance of type 2 diabetes mellitus is not confined to metabolic disorders. A serious problem is also affective pathology that occurs in the majority (30-70%) of patients. However, diagnostics and correction of anxiety and depressive disorders associated with diabetes are often given insufficient attention. Many studies showed relationship between affective disorders and low adherence to the prescribed treatment resulting in general deterioration of clinical prognosis of diabetes. This review article describes the basic mechanisms behind the interrelation of affective disorders and diabetes. The role of persistent subclinical inflammation in diabetes and depression is discussed. The influence of emotional stress on the activation of the hypothalamic-pituitary-adrenal axis on the overproduction of cortisol is emphasized. The similarity of some structural changes in the brain tissue in diabetes and depression is discussed. Effect of endocrine disruption in the emotional sphere is demonstrated. Mechanisms responsible for the development of diabetes and its complications provoked by depression are considered.

  4. [Acatalasemia and type 2 diabetes mellitus].

    PubMed

    Góth, László; Nagy, Teréz; Káplár, Miklós

    2015-03-08

    The catalase enzyme decomposes the toxic concentrations of hydrogen peroxide into oxygen and water. Hydrogen peroxide is a highly reactive small molecule and its excessive concentration may cause significant damages to proteins, deoxyribonucleic acid, ribonucleic acid and lipids. Acatalasemia refers to inherited deficiency of the catalase enzyme. In this review the authors discuss the possible role of the human catalase enzyme, the metabolism of hydrogen peroxide, and the phenomenon of hydrogen peroxide paradox. In addition, they review data obtained from Hungarian acatalasemic patients indicating an increased frequency of type 2 diabetes mellitus, especially in female patients, and an early onset of type 2 diabetes in these patients. There are 10 catalase gene variants which appear to be responsible for decreased blood catalase activity in acatalasemic patients with type 2 diabetes. It is assumed that low levels of blood catalase may cause an increased concentration of hydrogen peroxide which may contribute to the pathogenesis of type 2 diabetes mellitus.

  5. Cutaneous Manifestations of Diabetes Mellitus: A Review.

    PubMed

    Lima, Ana Luiza; Illing, Tanja; Schliemann, Sibylle; Elsner, Peter

    2017-04-03

    Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus. Moreover, diabetic neuropathy and angiopathy may also affect the skin. Pruritus, necrobiosis lipoidica, scleredema adultorum of Buschke, and granuloma annulare are examples of frequent noninfectious skin diseases. Bacterial and fungal skin infections are more frequent in people with diabetes. Diabetic neuropathy and angiopathy are responsible for diabetic foot syndrome and diabetic dermopathy. Furthermore, antidiabetic therapies may provoke dermatologic adverse events. Treatment with insulin may evoke local reactions like lipohypertrophy, lipoatrophy and both instant and delayed type allergy. Erythema multiforme, leukocytoclastic vasculitis, drug eruptions, and photosensitivity have been described as adverse reactions to oral antidiabetics. The identification of lesions may be crucial for the first diagnosis and for proper therapy of diabetes.

  6. [Evaluation of nopal capsules in diabetes mellitus].

    PubMed

    Frati Munari, A C; Vera Lastra, O; Ariza Andraca, C R

    1992-01-01

    To find out if commercial capsules with dried nopal (prickle-pear cactus, Opuntia ficus indica may have a role in the management of diabetes mellitus, three experiments were performed: 30 capsules where given in fasting condition to 10 diabetic subjects and serum glucose was measured through out 3 hours; a control test was performed with 30 placebo capsules. OGTT with previous intake of 30 nopal or placebo capsules was performed in ten healthy individuals. In a crossover and single blinded study 14 diabetic patients withdrew the oral hypoglycemic treatment and received 10 nopal or placebo capsules t.i.d. during one week; serum glucose, cholesterol and tryglycerides levels were measured before and after each one-week period. Five healthy subjects were also studied in the same fashion. Opuntia capsules did not show acute hypoglycemic effect and did not influence OGTT. In diabetic patients serum glucose, cholesterol and tryglycerides levels did not change with Opuntia, but they increased with placebo (P < 0.01 glucose and cholesterol, P = NS triglycerides). In healthy individuals glycemia did not change with nopal, while cholesterol and triglycerides decreased (P < 0.01 vs. placebo). The intake of 30 Opuntia capsules daily in patients with diabetes mellitus had a discrete beneficial effect on glucose and cholesterol. However this dose is unpractical and at present it is not recommended in the management of diabetes mellitus.

  7. Diabetes mellitus and severe mental illness: mechanisms and clinical implications.

    PubMed

    Holt, Richard I G; Mitchell, Alex J

    2015-02-01

    The prevalence of diabetes mellitus is twofold to threefold higher in people with severe mental illness (SMI) than in the general population, with diabetes mellitus affecting ∼12% of people receiving antipsychotics. The consequences of diabetes mellitus are more severe and frequent in people with SMI than in those without these conditions, with increased rates of microvascular and macrovascular complications, acute metabolic dysregulation and deaths related to diabetes mellitus. Multiple complex mechanisms underlie the association between diabetes mellitus and SMI; these mechanisms include genetic, environmental and disease-specific factors, and treatment-specific factors. Although antipsychotics are the mainstay of treatment in SMI, a causative link, albeit of uncertain magnitude, seems to exist between antipsychotics and diabetes mellitus. The principles of managing diabetes mellitus in people with SMI are similar to those for the general population and should follow currently established treatment algorithms. Lifestyle interventions are needed to reduce incident diabetes mellitus. In addition, improved uptake of opportunities to screen for this disease will reduce the high prevalence of undiagnosed diabetes mellitus. Currently, people with SMI receive poorer treatment for diabetes mellitus than the general population. Thus, health-care professionals in primary care, diabetes mellitus services and mental health teams have a responsibility to ensure that patients with SMI are not disadvantaged.

  8. Type 2 diabetes mellitus as a disorder of galanin resistance.

    PubMed

    Fang, Penghua; Shi, Mingyi; Zhu, Yan; Bo, Ping; Zhang, Zhenwen

    2016-01-01

    The increasing prevalence of type 2 diabetes mellitus with its high morbidity and mortality becomes an important health problem. The multifactorial etiology of type 2 diabetes mellitus is relative to many gene and molecule alterations, and increased insulin resistance. Besides these, however, there are still other predisposing and risk factors accounting for type 2 diabetes mellitus not to be identified and recognized. Emerging evidence indicated that defects in galanin function played a crucial role in development of type 2 diabetes mellitus. Galanin homeostasis is tightly relative to insulin resistance and is regulated by blood glucose. Hyperglycemia, hyperinsulinism, enhanced plasma galanin levels and decreased galanin receptor activities are some of the characters of type 2 diabetes mellitus. The discrepancy between high insulin level and low glucose handling is named as insulin resistance. Similarly, the discrepancy between high galanin level and low glucose handling may be denominated as galanin resistance too. In this review, the characteristic milestones of type 2 diabetes mellitus were condensed as two analogical conceptual models, obesity-hyper-insulin-insulin resistance-type 2 diabetes mellitus and obesity-hyper-galanin-galanin resistance-type 2 diabetes mellitus. Both galanin resistance and insulin resistance are correlative with each other. Conceptualizing the etiology of type 2 diabetes mellitus as a disorder of galanin resistance may inspire a new concept to deepen our knowledge about pathogenesis of type 2 diabetes mellitus, eventually leading to novel preventive and therapeutic interventions for type 2 diabetes mellitus.

  9. Serum markers for type II diabetes mellitus

    DOEpatents

    Metz, Thomas O; Qian, Wei-Jun; Jacobs, Jon M; Polpitiya, Ashoka D; Camp, II, David G; Smith, Richard D

    2014-03-18

    A method for identifying persons with increased risk of developing type 2 diabetes mellitus utilizing selected biomarkers described hereafter either alone or in combination. The present invention allows for broad based, reliable, screening of large population bases and provides other advantages, including the formulation of effective strategies for characterizing, archiving, and contrasting data from multiple sample types under varying conditions.

  10. [Letter: Ovulation inhibitors and diabetes mellitus].

    PubMed

    Mehnert, H

    1975-11-14

    Juvenile diabetes mellitus is discussed as a contraindication for treatment with ovulation inhibitors. It is held that the risks of oral contraception must be balanced with the risks of pregnancy in each individual case. The advantages and disadvantages of sterilization and of other methods of birth control must also be weighed. No general rule can be given; each case must be considered individually.

  11. Aircrew and type 1 diabetes mellitus.

    PubMed

    Heller, Simon R; Nicholson, Anthony N

    2006-04-01

    The most stringent clinical criteria cannot guarantee that individuals with Type 1 diabetes mellitus (DM) will preserve awareness of an impending hypoglycemic episode or that a hypoglycemic episode can be prevented. Further, cognition may be impaired for a considerable period of time beyond the correction of any episode. These observations and their implications to operational aircrew with Type 1 DM are discussed.

  12. Diabetes mellitus in the context of blood transfusion.

    PubMed

    Chowdhury, Nilotpal

    2017-03-01

    Diabetes mellitus is one of the commonest medical conditions affecting humans. However, knowledge of diabetes mellitus in the context of blood transfusion is lacking. In this article, the eligibility of people with diabetes as donors, issues faced during blood component transfusion to diabetics and impaired glucose tolerance among chronic blood recipients will be discussed, along with discussion of the present state of evidence.

  13. Diabetes mellitus: influences on cancer risk.

    PubMed

    Szablewski, Leszek

    2014-10-01

    Diabetes mellitus and cancer are common conditions, and their co-diagnosis in the same individual is not infrequent. The relative risks associated with type 2 diabetes are greater than twofold for hepatic, pancreatic, and endometrial cancers. The relative risk is somewhat lower, at 1.2-1.5-fold for colorectal, breast, and bladder cancers. In comparison, the relative risk of lung cancer is less than 1. The evidence for other malignancies (e.g. kidney, non-Hodgkin lymphoma) is inconclusive, whereas prostatic cancer occurs less frequently in male patients with diabetes. The potential biologic links between the two diseases are incompletely understood. Evidence from observational studies suggests that some medications used to treat hyperglycemia are associated with either increased or reduced risk of cancer. Whereas anti-diabetic drugs have a minor influence on cancer risk, drugs used to treat cancer may either cause diabetes or worsen pre-existing diabetes. If hyperinsulinemia acts as a critical link between the observed increased cancer risk and type 2 diabetes, one would predict that patients with type 1 diabetes would have a different cancer risk pattern than patients with type 2 diabetes because the former patients are exposed to lower levels of exogenous administered insulin. Obtained results showed that patients with type 1 diabetes had elevated risks of cancers of the stomach, cervix, and endometrium. Type 1 diabetes is associated with a modest excess cancer risk overall and risks of specific cancers that differ from those associated with type 2 diabetes.

  14. Diabetes Mellitus Standards of Care.

    PubMed

    Mays, Lucy

    2015-12-01

    Diabetes is a worldwide epidemic with a high cost regarding consumption of health care resources and is associated with high levels of morbidity and mortality. The complex nature of diabetes requires the use of evidence-based guidelines regarding diabetes management. These evidence-based guidelines are lengthy and do not readily translate into nursing care. As an integral component of the interprofessional team, the nurse must provide a thorough assessment of patients with diabetes and work to achieve individual patient treatment goals. Evaluation of patient progress toward treatment goals with regular/frequent follow-up is necessary to promote effective self-management of diabetes.

  15. The Comorbidity of Diabetes Mellitus and Depression

    PubMed Central

    Katon, Wayne J.

    2009-01-01

    Several factors, including sedentary lifestyle, obesity, and an aging population, contribute to epidemic rates of type 2 diabetes mellitus. Depression frequently occurs comorbidly with diabetes although it is unrecognized and untreated in approximately two thirds of patients with both conditions. The course of depression in patients with both diabetes and depression is chronic and severe. Up to 80% of patients with diabetes and depression will experience a relapse of depressive symptoms over a 5-year period. Depression is associated with nonadherence to diabetes self-care—including following dietary restrictions, medication compliance, and blood glucose monitoring—resulting in worse overall clinical outcomes. Due to potential negative health consequences associated with comorbid diabetes and depression, both conditions should be optimally treated to maximize patient outcomes. PMID:18954592

  16. Effect of diabetes mellitus on sleep quality

    PubMed Central

    Surani, Salim; Brito, Veronica; Surani, Asif; Ghamande, Shekhar

    2015-01-01

    Diabetes mellitus (DM) is a highly prevalent condition affecting about 347 million people worldwide. In addition to its numerous clinical implications, DM also exerts a negative effect on patient’s sleep quality. Impaired sleep quality disrupts the adequate glycemic control regarded as corner stone in DM management and also lead to many deleterious effects causing a profound impact on health related quality of life. This article outlines various factors leading to impaired sleep quality among diabetics and delineates how individual factor influences sleep. The article also discusses potential interventions and lifestyle changes to promote healthy sleep among diabetics. PMID:26131327

  17. Calcium homeostasis in diabetes mellitus.

    PubMed

    Heath, H; Lambert, P W; Service, F J; Arnaud, S B

    1979-09-01

    Experimentally diabetic rats have low serum 1,25-dihydroxyvitamin D, intestinal malabsorption of calcium, secondary hyperparathyroidism, and bone loss. To examine the hypothesis that abnormalities similar to those in the diabetic rat might explain human diabetic osteopenia, we studied calcium metabolism in 40 healthy control and 82 diabetic patients aged 18--75 yr [47 untreated: fasting plasma glucose (mean +/- SE), 267 +/- 8 mg/dl; 19 treated but hyperglycemic: glucose 305 +/- 24 mg/dl; 16 treated and in better control: glucose, 146 +/- 8 mg/dl]. Serum total calcium, ionic calcium, immunoreactive parathyroid hormone (Arnaud method, GP-1M and CH-12M antisera), 25-hydroxyvitamin D (Haddad method), and 1,25-dihydroxyvitamin D (Lambert method) concentrations were normal in all 3 groups of diabetics and were not significantly different from values in the control group. We determined absorption of calcium from the intestine by a double isotope method (100 mg Ca carrier; normal range, 40--80%) in 11 control and 13 untreated, uncontrolled diabetics (mean plasma glucose, 285 +/- 17 mg/dl). Absorption of calcium in controls was 60 +/- 3% and in diabetics was 56 +/- 3% (not significantly different). We have found no derangement of calcium metabolism in adults with insulin-requiring juvenile- and adult-onset diabetes regardless of treatment status. The experimental diabetic rat model does not appear to be useful for determining the pathogenesis of adult human diabetic osteopenia.

  18. Antioxidant role of zinc in diabetes mellitus.

    PubMed

    Cruz, Kyria Jayanne Clímaco; de Oliveira, Ana Raquel Soares; Marreiro, Dilina do Nascimento

    2015-03-15

    Chronic hyperglycemia statue noticed in diabetes mellitus favors the manifestation of oxidative stress by increasing the production of reactive oxygen species and/or by reducing the antioxidant defense system activity. Zinc plays an important role in antioxidant defense in type 2 diabetic patients by notably acting as a cofactor of the superoxide dismutase enzyme, by modulating the glutathione metabolism and metallothionein expression, by competing with iron and copper in the cell membrane and by inhibiting nicotinamide adenine dinucleotide phosphate-oxidase enzyme. Zinc also improves the oxidative stress in these patients by reducing chronic hyperglycemia. It indeed promotes phosphorylation of insulin receptors by enhancing transport of glucose into cells. However, several studies reveal changes in zinc metabolism in individuals with type 2 diabetes mellitus and controversies remain regarding the effect of zinc supplementation in the improvement of oxidative stress in these patients. Faced with the serious challenge of the metabolic disorders related to oxidative stress in diabetes along with the importance of antioxidant nutrients in the control of this disease, new studies may contribute to improve our understanding of the role played by zinc against oxidative stress and its connection with type 2 diabetes mellitus prognosis. This could serve as a prelude to the development of prevention strategies and treatment of disorders associated with this chronic disease.

  19. Bartter's syndrome with type 2 diabetes mellitus.

    PubMed

    See, Ting-Ting; Lee, Siu-Pak

    2009-02-01

    We report a rare case of Bartter's syndrome in a 35-year-old woman with type 2 diabetes mellitus. The patient presented with leg weakness, fatigue, polyuria and polydipsia. Hypokalemia, metabolic alkalosis, and high renin and aldosterone concentrations were present, but the patient was normotensive. Gitelman's syndrome was excluded because of the presence of hypercalciuria, secondary hyperparathyroidism and bilateral nephrocalcinosis. The patients condition improved upon administration of a prostaglandin synthetase inhibitor (acemetacin), oral potassium chloride and potassium-sparing diuretics. Five months later, the patient discontinued acemetacin because of epigastric discomfort; at the same time, severe hypokalemia and hyperglycemia developed. Glucagon stimulation and water deprivation tests were performed. Type 2 diabetes mellitus with nephrogenic diabetes insipidus was diagnosed. To avoid further gastrointestinal complications, the patient was treated with celecoxib, a selective cyclooxygenase 2 inhibitor. This case serves as a reminder that Bartter's syndrome is associated with various metabolic derangements including nephrogenic diabetes insipidus, nephrocalcinosis and diabetes mellitus. When treating Bartter's syndrome, it is also prudent to remember that the long-term use of nonsteroidal anti-inflammatory drugs and potassium-sparing diuretics may result in serious adverse reactions.

  20. Tuberculosis and diabetes mellitus: merging epidemics.

    PubMed

    Sen, Tiyas; Joshi, Shashank R; Udwadia, Zarir F

    2009-05-01

    The link between tuberculosis (TB) and diabetes mellitus (DM) has occupied the center stage of discussion. Experts have raised concern about the merging epidemics of tuberculosis and diabetes particularly in the low to medium income countries like India and China that have the highest burden of TB in the world, and are experiencing the fastest increase in the prevalence of DM. There is good evidence that DM makes a substantial contribution to TB incidence. The huge prevalence of DM in India, may be contributing to the increasing prevalence of TB. This review looks at the link between these two merging epidemics. We discuss the epidemiology, clinical features, microbiology and radiology, and management and treatment outcomes of patients with tuberculosis and diabetes mellitus.

  1. [Nasal mucosa in patients with diabetes mellitus].

    PubMed

    Müller, Maciej; Betlejewski, Stanisław

    2003-01-01

    Diabetes mellitus is the most common endocrinologic disease all over the world. 150 million people suffer from this disease, in Poland about 2 million. The disease on the basis of the onset and pathophysiology may be divided into type I and type II. Pathophysiologic changes include diabetic microangiopathy, macroangiopathy and neuropathy. The most common presentations in head and neck are otitis externa, hypoacusis, vertigo, disequilibrium, xerostomia, dysphagia, fungal and recurrent infections. The changes in nasal mucosa are not very well known. Only few papers concerned the problem. The main complaints of patients regarding the nose are xeromycteria, hyposmia and various degree of decreased patency of the nose. Chronic atrophic rhinitis, septal perforation, ulceration of nasal mucosa, alar necrosis, symptoms of staphylococcal or fungal infection can be found during otolaryngologic examination. The treatment in this group of patients should consist of systemic therapy of diabetes mellitus and on the other hand focal therapy with the use of a solution to moisten the nasal mucosa.

  2. Fasting growth hormone levels in diabetes mellitus.

    PubMed

    Nazaimoon, W M; Ng, M L; Khalid, B A

    1993-11-01

    Fasting serum growth hormone (GH) levels of different groups of diabetic patients were measured and compared to age-matched normal subjects. Insulin-dependent diabetes mellitus (IDDM) children (aged 12-17 years) were found to have significantly lower fasting GH levels than age-matched normal children (p < 0.001). In the adult age groups of 18-44 and 45-76 years, the IDDM patients showed increased fasting GH levels compared to age-matched normal subjects (p < 0.06 and p < 0.001 respectively) and non-insulin-dependent diabetes mellitus (NIDDM) patients (p < 0.05 and p < 0.001 respectively). The fasting GH levels of IDDM patients of the age group 18-44 years also showed significant correlations with glycated haemoglobin (r = 0.510, p = 0.002) and fasting blood sugar levels (r = 0.571, p = 0.01).

  3. 77 FR 43417 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Applicants The Agency established the current requirement for diabetes in 1970 because several risk studies... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...

  4. 76 FR 32015 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles... notice of receipt of Federal diabetes exemption applications from twenty-three individuals and...

  5. 75 FR 57329 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from twenty-one individuals and...

  6. 77 FR 25227 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from seventeen individuals and requested comments from the public (77...

  7. 76 FR 26792 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-09

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from eighteen individuals and requested comments from the public (76...

  8. 76 FR 47290 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles... notice of receipt of Federal diabetes exemption applications from twenty-three individuals and...

  9. 78 FR 76397 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... October 23, 2013, FMCSA published a notice of receipt of Federal diabetes exemption applications from...

  10. 75 FR 50797 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-17

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... receipt of Federal diabetes exemption applications from twenty individuals and requested comments from...

  11. 78 FR 65031 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... August 19, 2013, FMCSA published a notice of receipt of Federal diabetes exemption applications from...

  12. 77 FR 532 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from twenty individuals and...

  13. 75 FR 28684 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles... . Background On March 26, 2010, FMCSA published a Notice of receipt of Federal diabetes exemption...

  14. 75 FR 64394 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from thirty-five individuals and...

  15. 78 FR 5559 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in..., FMCSA published a notice of receipt of Federal diabetes exemption applications from 26 individuals...

  16. 76 FR 44650 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from nineteeen individuals and requested comments from the public (76...

  17. 77 FR 5873 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from fifteen individuals and...

  18. 75 FR 65056 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-21

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from thirty-nine individuals and...

  19. 77 FR 75493 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 14 individuals and requested...

  20. 76 FR 1495 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from twenty-one individuals and...

  1. 78 FR 1926 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-09

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 12 individuals and requested...

  2. 78 FR 35088 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 20 individuals and requested...

  3. 78 FR 39825 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... a notice of receipt of Federal diabetes exemption applications from 16 individuals and...

  4. 78 FR 76400 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... October 23, 2013, FMCSA published a notice of receipt of Federal diabetes exemption applications from...

  5. 77 FR 46791 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 17 individuals and requested...

  6. 76 FR 79759 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from eighteen individuals and...

  7. 75 FR 38598 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles... . Background On May 21, 2010, FMCSA published a Notice of receipt of Federal diabetes exemption...

  8. 78 FR 77784 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-24

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... October 28, 2013, FMCSA published a notice of receipt of Federal diabetes exemption applications from...

  9. 78 FR 76399 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... October 23, 2013, FMCSA published a notice of receipt of Federal diabetes exemption applications from ]...

  10. 78 FR 76398 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... October 23, 2013, FMCSA published a notice of receipt of Federal diabetes exemption applications from...

  11. 77 FR 51845 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 23 individuals and requested...

  12. 77 FR 536 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from eighteen individuals and...

  13. 77 FR 65929 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 14 individuals and requested...

  14. 76 FR 9867 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from fifteen individuals and...

  15. 78 FR 78479 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibition against persons with insulin- treated diabetes mellitus (ITDM) operating commercial motor vehicles... individuals listed in this notice have recently requested such an exemption from the diabetes prohibition...

  16. 76 FR 27376 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from seventeen individuals and requested comments from the public (76...

  17. 77 FR 75492 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 16 individuals and requested...

  18. 77 FR 38383 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from 23 individuals and requested comments from the public (77 FR...

  19. 78 FR 26422 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 20 individuals and requested...

  20. 76 FR 47288 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from fifteen individuals and requested comments from the public (76...

  1. 76 FR 61139 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles... notice of receipt of Federal diabetes exemption applications from thirty-three individuals and...

  2. Affordable Care Act and Diabetes Mellitus.

    PubMed

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.

  3. [Control of atherosclerosis in diabetes mellitus].

    PubMed

    Quiroz Martínez, Alejandro

    2003-01-01

    Diabetic patients develop atherosclerosis in an accelerated way as compared to non-diabetic patients. This is due to a generalized metabolic disorder that includes hyperglycemia, insulin resistance, dyslipidosis, loss of the endothelial regulatory function, a tendency for vasoconstriction, and a prothrombotic state. The main complications are coronary artery disease, peripheral vascular disease, and cerebrovascular disease. In all these manifestations and at all severity levels, diabetic patients, in particular post-menopausal women, have the worst prognosis with any type of treatment as compared to non-diabetic patients. These findings lead to consider the sole presentation of diabetes mellitus to be equivalent to cardiovascular risk. The largest reduction in risk is achieved by controlling hypertension, followed by a control of glycemia, reduction of glycosylated hemoglobulin and control of dyslipidosis. Benefits in the cardiovascular realm have not extended to other vascular territories, such as the lower extremities or the brain.

  4. Oral epithelial hyperplasia in diabetes mellitus.

    PubMed

    Girtan, Mihaela; Zurac, Sabina; Stăniceanu, Florica; Bastian, Alexandra; Popp, Cristiana; Nichita, Luciana; Laba, Elisabeta; Forna, Norina

    2009-01-01

    Diabetes mellitus is one of the chronic systemic disorders with major influences of the oral cavity microenvironment. Oral manifestations of diabetes are diverse; they are represented by candidose, lichen plan, recurrent aphthous stomatitis, gingivitis, salivary disorders, oral mucosa atrophy and rarely hypertrophy; a possible link between oral cancer and diabetes is suspected, both in animal models and humans. We report a case of a young woman with type 1 diabetes with class I Kennedy edentation with mobile denture prosthesis; latter in the clinical follow-up, a hyperplasic lesion of the oral mucosa with p53 expression within the epithelial nuclei was identified, p53 being the more likely pathogenic pathway involved in diabetes-related oral cancer. The approach of this patient required multidisciplinary investigations and careful follow-up.

  5. Metabolic programming, epigenetics, and gestational diabetes mellitus.

    PubMed

    Pinney, Sara E; Simmons, Rebecca A

    2012-02-01

    The link between an adverse intrauterine environment and the development of disease later in life has been observed in offspring of pregnancies complicated by obesity and diabetes, but the molecular mechanisms underlying this phenomenon are unknown. In this review, we highlight recent publications exploring the role of gestational diabetes mellitus in the programming of disease in the offspring. We also review recent publications aiming to identify mechanisms responsible for the "programming effect" that results from exposure to diabetes in utero. Finally, we highlight research on the role of epigenetic regulation of gene expression in an animal model of uteroplacental insufficiency where the offspring develop diabetes as a model by which an exposure to the mother can alter epigenetic modifications that affect expression of key genes and ultimately lead to the development of diabetes in the offspring.

  6. The endocrine system in diabetes mellitus.

    PubMed

    Alrefai, Hisham; Allababidi, Hisham; Levy, Shiri; Levy, Joseph

    2002-07-01

    The pathophysiology of diabetes mellitus is complex and not fully understood. However, it emerges as an abnormal metabolic condition associated with a systemic damage to the vascular bed. Cumulative evidence also reveals that the endocrine system is not intact in patients with diabetes mellitus. It is not clear whether the changes observed in the endocrine system represent a primary defect or reflect the effects of the impaired insulin action and abnormal carbohydrate and lipid metabolism on the hormonal milieu. Review of the literature reveals that the function of the entire endocrine system including the functions of hormones from the hypothalamus, pituitary, adrenal, thyroid, parathyroid, the vitamin D system, the gonads, and the endocrine function of the adipose tissue, is impaired. Good metabolic control and insulin treatment may reverse some of these abnormalities. It remains unanswered as to what extent these changes in the endocrine system contribute to the vascular pathologies observed in individuals affected by diabetes mellitus and whether part of the abnormalities observed in the endocrine system reflect a basic cellular defect in the diabetic syndrome.

  7. Increased admissions for diabetes mellitus after burn.

    PubMed

    Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; O'Halloran, Emily; Rea, Suzanne; Wood, Fiona M

    2016-12-01

    Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n=30,997) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12-4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (<18 years, IRR, 95% CI: 2.65, 1.41-4.97) and adulthood (≥18 years, IRR, 95% CI: 2.12, 1.76-2.55). Incident admissions were significantly elevated in the burn cohort during the first 5 years post-burn when compared with the uninjured (HR, 95% CI: 1.96, 1.46-2.64); no significant difference was found beyond 5 years post-burn (HR, 95% CI: 1.08, 0.82-1.41). Findings of increased hospital admission rates and prolonged length of hospital stay for diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident

  8. Vitamins and Type 2 Diabetes Mellitus

    PubMed Central

    Valdés-Ramos, Roxana; Ana Laura, Guadarrama-López; Elina, Martínez-Carrillo Beatriz; Donají, Benítez-Arciniega Alejandra

    2015-01-01

    The present review evaluates the relationship between type 2 diabetes mellitus and individual or combined vitamins. Antioxidant vitamins A, C and E are found decreased in diabetic subjects, possibly due to an increased need to control the excessive oxidative stress produced by abnormalities in glucose metabolism. On the other hand, retinol binding protein exerts a modulating effect, as it has adipokine functions. With respect to the B group vitamins, thiamin, pyridoxine and biotin have been found decreased but the mechanisms are not clear, however supplementation has shown some improvement of the metabolic control in diabetic patients. The absorption of folic acid and vitamin B12 is importantly decreased by the prolongued use of metformin, which is the first choice drug in uncomplicated diabetes, thus these two nutrients have been found deficient in the disease and most probably need to be supplemented regularly. On the other hand, vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones. Although some studies have found an association of vitamin K intake with glucose metabolism further research is needed. Studies on the use of multivitamin supplements have shown unconclusive results. After reviewing the evidence, no real recommendation on the use of vitamin supplements in type 2 diabetes mellitus can be issued, however patients using metformin during prolongued periods may need folic acid and vitamin B12. PMID:25388747

  9. Vitamins and type 2 diabetes mellitus.

    PubMed

    Valdés-Ramos, Roxana; Guadarrama-López, Ana Laura; Martínez-Carrillo, Beatriz Elina; Benítez-Arciniega, Alejandra Donají

    2015-01-01

    The present review evaluates the relationship between type 2 diabetes mellitus and individual or combined vitamins. Antioxidant vitamins A, C and E are found decreased in diabetic subjects, possibly due to an increased need to control the excessive oxidative stress produced by abnormalities in glucose metabolism. On the other hand, retinol binding protein exerts a modulating effect, as it has adipokine functions. With respect to the B group vitamins, thiamin, pyridoxine and biotin have been found decreased but the mechanisms are not clear, however supplementation has shown some improvement of the metabolic control in diabetic patients. The absorption of folic acid and vitamin B12 is importantly decreased by the prolongued use of metformin, which is the first choice drug in uncomplicated diabetes, thus these two nutrients have been found deficient in the disease and most probably need to be supplemented regularly. On the other hand, vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones. Although some studies have found an association of vitamin K intake with glucose metabolism further research is needed. Studies on the use of multivitamin supplements have shown unconclusive results. After reviewing the evidence, no real recommendation on the use of vitamin supplements in type 2 diabetes mellitus can be issued, however patients using metformin during prolongued periods may need folic acid and vitamin B12.

  10. Diabetes mellitus in children and adolescents.

    PubMed

    Botero, Diego; Wolfsdorf, Joseph I

    2005-01-01

    Until recently, diabetes in children was virtually synonymous with type 1 diabetes mellitus, whereas type 2 diabetes was a disease of middle age and the elderly. Over the past 10-20 years, an alarming increase in the prevalence of type 2 diabetes has been reported from pediatric diabetes centers in North America and elsewhere in the world. Lifestyle factors responsible for the worldwide epidemic of overweight and obesity are responsible for the increase in the prevalence of type 2 diabetes in adults and children. This article briefly discusses the diagnosis and major types of diabetes in children but focuses on aspects of type 2 diabetes in children and adolescents, including demographics, pathophysiology, clinical presentation, screening, prevention and treatment. The identification of children at risk for type 2 diabetes and the implementation of community-wide preventive programs will be essential to reverse the tide. The availability of calorie dense "fast foods," candy, and sugared soft drinks must be restricted in schools and other venues frequented by children. Parents must limit the amount of time their children spend watching television and playing computer games. After-school programs that promote physical activity should be a priority of local and central governmental agencies. Prevention will only succeed if governments and local communities recognize that childhood obesity is an important public health problem and provide an environment that promotes changes in lifestyle that prevent and reverse obesity.

  11. [Breast cancer and diabetes mellitus: Complex interactions].

    PubMed

    Bernard, L; Reix, N; Benabu, J-C; Gabriele, V; Mathelin, C

    2016-12-01

    The aim of this literature review was to quantify the incidence and mortality of breast cancer for women treated for a diabetes mellitus and to analyze the complex relationship between these two common diseases. The articles analyzed were extracted from the PubMed database from 2000 to 2015. A total of 22 case/control studies or cohorts were retained, allowing the realization of a meta-analysis. The incidence of breast cancer for women with diabetes is significantly increased for cohorts (RR=1.32; 95% CI: 1.06 to 1.65) and not significantly for case/control studies (RR=1.46; 95% CI: 0.99 to 2.26). Overall, mortality of women with breast cancer is significantly increased for diabetic patients compared with non-diabetic patients (RR=1.53; 95% CI: 1.23 to 1.90). The links between diabetes and breast cancer are explained by common risk factors (overweight/obesity, qualitative and quantitative dietary errors, physical inactivity), biological changes and the impact of some anti-diabetic treatments or hormonotherapy. Physicians facing a diabetic patient treated for breast cancer have a role in choosing the best anti-diabetic treatment and implementing lifestyle modifications. Diabetic women without breast cancer should participate in organized breast screening programs and have an annual breast clinical examination. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. 78 FR 24303 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... several risk studies indicated that drivers with diabetes had a higher rate of crash involvement than the...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of final... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...

  13. 77 FR 59450 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-27

    ... [FMCSA Docket No. FMCSA-2012-0164] Qualification of Drivers; Exemption Applications; Diabetes Mellitus... insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in interstate... diabetes exemption applications from 19 individuals and requested comments from the public (77 FR...

  14. 75 FR 38597 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT ACTION: Notice of final... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles... . Background On May 10, 2010, FMCSA published a Notice of receipt of Federal diabetes exemption...

  15. 76 FR 69795 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of final... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from twenty-two individuals and...

  16. 77 FR 64585 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of final... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... notice of receipt of Federal diabetes exemption applications from 28 individuals and requested...

  17. Transient diabetes mellitus in a domestic ferret (Mustela putorius furo).

    PubMed

    Duhamelle, Alexis; Langlois, Isabelle; Desmarchelier, Marion

    2015-07-01

    A 3.5-year-old spayed female ferret, fed a diet high in refined sugar, was referred for lethargy, polyuria, polydipsia, and polyphagia. Diabetic ketoacidosis was diagnosed. Treatment included insulin therapy and a low carbohydrate diet. Diabetes mellitus resolved 54 d later, and insulin therapy was discontinued. There has been no recurrence of the diabetes mellitus.

  18. 77 FR 33264 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... insulin for control'' (49 CFR 391.41(b)(3)). FMCSA established its diabetes exemption program, based on... Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in Interstate Commerce as...

  19. 77 FR 27841 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... insulin for control'' (49 CFR 391.41(b)(3)). FMCSA established its diabetes exemption program, based on... Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in Interstate Commerce as...

  20. 77 FR 17116 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... insulin for control'' (49 CFR 391.41(b)(3)). FMCSA established its diabetes exemption program, based on... Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in Interstate Commerce as...

  1. 77 FR 29446 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... insulin for control'' (49 CFR 391.41(b)(3)). FMCSA established its diabetes exemption program, based on... Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in Interstate Commerce as...

  2. 77 FR 13685 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... insulin for control'' (49 CFR 391.41(b)(3)). FMCSA established its diabetes exemption program, based on... Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in Interstate Commerce as...

  3. Animal models of diabetes mellitus.

    PubMed

    Rees, D A; Alcolado, J C

    2005-04-01

    Animal models have been used extensively in diabetes research. Early studies used pancreatectomised dogs to confirm the central role of the pancreas in glucose homeostasis, culminating in the discovery and purification of insulin. Today, animal experimentation is contentious and subject to legal and ethical restrictions that vary throughout the world. Most experiments are carried out on rodents, although some studies are still performed on larger animals. Several toxins, including streptozotocin and alloxan, induce hyperglycaemia in rats and mice. Selective inbreeding has produced several strains of animal that are considered reasonable models of Type 1 diabetes, Type 2 diabetes and related phenotypes such as obesity and insulin resistance. Apart from their use in studying the pathogenesis of the disease and its complications, all new treatments for diabetes, including islet cell transplantation and preventative strategies, are initially investigated in animals. In recent years, molecular biological techniques have produced a large number of new animal models for the study of diabetes, including knock-in, generalized knock-out and tissue-specific knockout mice.

  4. Spices in the management of diabetes mellitus.

    PubMed

    Bi, Xinyan; Lim, Joseph; Henry, Christiani Jeyakumar

    2017-02-15

    Diabetes mellitus (DM) remains a major health care problem worldwide both in developing and developed countries. Many factors, including age, obesity, sex, and diet, are involved in the etiology of DM. Nowadays, drug and dietetic therapies are the two major approaches used for prevention and control of DM. Compared to drug therapy, a resurgence of interest in using diet to manage and treat DM has emerged in recent years. Conventional dietary methods to treat DM include the use of culinary herbs and/or spices. Spices have long been known for their antioxidant, anti-inflammatory, and anti-diabetic properties. This review explores the anti-diabetic properties of commonly used spices, such as cinnamon, ginger, turmeric, and cumin, and the use of these spices for prevention and management of diabetes and associated complications.

  5. Visual complications in diabetes mellitus: beyond retinopathy.

    PubMed

    Khan, A; Petropoulos, I N; Ponirakis, G; Malik, R A

    2017-04-01

    Diabetic retinopathy is the most common cause of vision loss in people with diabetes mellitus; however, other causes of visual impairment/loss include other retinal and non-retinal visual problems, including glaucoma, age-related macular degeneration, non-arteritic anterior ischaemic optic neuropathy and cataracts. Additionally, when a person with diabetes complains of visual disturbance despite a visual acuity of 6/6, abnormalities in refraction, contrast sensitivity, straylight and amplitude of accommodation should be considered. We review and highlight these visual problems for physicians who manage people with diabetes to ensure timely referral and treatment to limit visual disability, which can have a significant impact on daily living, especially for those participating in sports and driving.

  6. Fetal programming and gestational diabetes mellitus.

    PubMed

    Monteiro, Lara J; Norman, Jane E; Rice, Gregory E; Illanes, Sebastián E

    2016-12-01

    Gestational diabetes mellitus is defined by new-onset glucose intolerance during pregnancy. About 2-5% of all pregnant women develop gestational diabetes during their pregnancies and the prevalence has increased considerably during the last decade. This metabolic condition is manifested when pancreatic β-cells lose their ability to compensate for increased insulin resistance during pregnancy, however, the pathogenesis of the disease remains largely unknown. Gestational diabetes is strongly associated with adverse pregnancy outcome as well as with long-term adverse effects on the offspring which likely occurs due to epigenetic modifications of the fetal genome. In the current review we address gestational diabetes and the short and long term complications for both mothers and offspring focusing on the importance of fetal programming in conferring risk of developing diseases in adulthood. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Diabetes mellitus and stroke: A clinical update

    PubMed Central

    Tun, Nyo Nyo; Arunagirinathan, Ganesan; Munshi, Sunil K; Pappachan, Joseph M

    2017-01-01

    Cardiovascular disease including stroke is a major complication that tremendously increases the morbidity and mortality in patients with diabetes mellitus (DM). DM poses about four times higher risk for stroke. Cardiometabolic risk factors including obesity, hypertension, and dyslipidaemia often co-exist in patients with DM that add on to stroke risk. Because of the strong association between DM and other stroke risk factors, physicians and diabetologists managing patients should have thorough understanding of these risk factors and management. This review is an evidence-based approach to the epidemiological aspects, pathophysiology, diagnostic work up and management algorithms for patients with diabetes and stroke. PMID:28694925

  8. [Hyperglycemic crisis in patients with diabetes mellitus].

    PubMed

    Schneider, S

    2012-09-01

    Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most acute life-threatening complications of diabetes mellitus and in most cases treatment should be administered in an intensive care unit. Clinically, DKA and HHS differ according to the presence of metabolic acidosis; however, the treatment of DKA and HHS is similar. The main principles are intravenous administration of insulin and correction of fluid and electrolyte abnormalities which are typically present. By the application of a standardized treatment algorithm a low mortality rate can be achieved.

  9. Gestational diabetes mellitus: an updated overview.

    PubMed

    Chiefari, E; Arcidiacono, B; Foti, D; Brunetti, A

    2017-03-10

    The clinical and public health relevance of gestational diabetes mellitus (GDM) is widely debated due to its increasing incidence, the resulting negative economic impact, and the potential for severe GDM-related pregnancy complications. Also, effective prevention strategies in this area are still lacking, and controversies exist regarding diagnosis and management of this form of diabetes. Different diagnostic criteria are currently adopted worldwide, while recommendations for diet, physical activity, healthy weight, and use of oral hypoglycemic drugs are not always uniform. In the present review, we provide an update of current insights on clinical aspects of GDM, by discussing the more controversial issues.

  10. Permanent neonatal diabetes mellitus in Jordan.

    PubMed

    Abujbara, Mousa A; Liswi, Mohammed I; El-Khateeb, Mohammed S; Flanagan, Sarah E; Ellard, Sian; Ajlouni, Kamel M

    2014-09-01

    Permanent neonatal diabetes mellitus (PNDM) is a rare heterogeneous form of diabetes that develops within the first 6 months of life. The objective of this study is to define the genetic etiology and incidence of permanent neonatal diabetes mellitus in Jordan. This study was conducted in Jordan at the National Center of Diabetes, Endocrinology and Genetics, Amman, between 2006 and 2012. The study included 22 cases diagnosed with diabetes within the first year of life. The incidence of PNDM in Jordan was calculated as one case for every 203,221 live births. Mutations were found in six out of ten cases diagnosed before 6 months and included one homozygous ABCC8 p.R826W mutation, three cases with a heterozygous KCNJ11 p.R201C mutation, and two cases with a homozygous EIF2AK3 splicing mutation. The genetic etiology of PNDM in Jordan is different from that seen in European countries and more similar to other Arab countries.

  11. Diabetes mellitus and inflammatory periodontal diseases.

    PubMed

    Mealey, Brian L; Rose, Louis F

    2008-09-01

    THE PURPOSE OF REVIEW: Periodontal diseases are inflammatory conditions that were once thought to have manifestations localized to the oral cavity alone, and were therefore considered the concern of only dentists and other oral health professionals. Emerging evidence has changed this view and now suggests that periodontal diseases may play a role in numerous conditions that impact systemic well-being, including diabetes mellitus. This review examines the relationships that exist between periodontal diseases and diabetes mellitus, with a focus on potential common pathophysiologic pathways including those associated with inflammation, altered host responses, and insulin resistance. Periodontal inflammation is associated with an elevated systemic inflammatory state and an increased risk of major cardiovascular events such as myocardial infarction and stroke, adverse pregnancy outcomes such as preeclampsia, low birth weight, and preterm birth, and altered glycemic control in people with diabetes. Intervention trials suggest that periodontal therapy, which decreases the intraoral bacterial bioburden and reduces periodontal inflammation, can have a significant impact on systemic inflammatory status. Evidence suggests that periodontal therapy is associated with improved glycemic control in many patients with both diabetes and periodontal diseases. Recognition of the bilateral relationships between oral and systemic health will challenge physicians and dentists to work together closely in the future when managing patients with diabetes and periodontal disease.

  12. [Association between periodontitis and diabetes mellitus].

    PubMed

    Meng, Huan-xin

    2007-02-18

    This paper focused on the relationship between periodontitis and Type 2 diabetes mellitus (T2DM). There is an abundance of evidence that diabetes mellitus play important etiological roles in periodontal diseases. In addition, periodontal diseases have powerful and multiple influences on the occurrence and severity of systemic conditions and diseases, such as diabetes mellitus, cardiovascular disease, respiratory disease and pregnancy complications. The relationship of periodontitis and diabetes has been supported by sufficient evidences in the past twenty years: (1) diabetes is an independent risk factor of chronic periodontitis; (2) metabolic control will improve the prognosis of chronic periodontitis; (3) the treatment of chronic periodontitis will improve the metabolic level. Our recent investigation on periodontal status in the families of type 2 diabetes mellitus further confirmed the relationship. It was showed that the periodontal index such as probing depth (PD), attachment loss (AL) and numbers of tooth loss in diabetes family members were significantly higher than non-diabetes family members, while no difference of periodontal parameters was found between well control family members and non diabetes family members. In the development of type 2 diabetes (T2DM) and its complications, the advanced glycation end products (AGEs) and its receptors were to be recognized as important factors. The distributions of AGEs and the receptor for AGEs (RAGE) are highly consistent in various tissues. One study in our laboratory demonstrated that RAGE was strongly expressed in gingival tissues gathered from T2DM patients with periodontitis compared with systemically healthy chronic periodontitis patients, the expression of RAGE was positively correlated with the expression of TNF-alpha, indicating that AGE-RAGE pathway was involved in the development of periodontitis in T2DM patients. It is known that inflammation could induce the prediabetic status characterized by

  13. Novel Directions for Diabetes Mellitus Drug Discovery

    PubMed Central

    Maiese, Kenneth; Chong, Zhao Zhong; Shang, Yan Chen; Wang, Shaohui

    2012-01-01

    Introduction Diabetes mellitus impacts almost 200 million individuals worldwide and leads to debilitating complications. New avenues of drug discovery must target the underlying cellular processes of oxidative stress, apoptosis, autophagy, and inflammation that can mediate multi-system pathology during diabetes mellitus. Areas Covered We examine novel directions for drug discovery that involve the β-nicotinamide adenine dinucleotide (NAD+) precursor nicotinamide, the cytokine erythropoietin, the NAD+-dependent protein histone deacetylase SIRT1, the serine/threonine-protein kinase mammalian target of rapamycin (mTOR), and the wingless pathway. Implications for the targeting of these pathways that oversee gluconeogenic genes, insulin signaling and resistance, fatty acid beta-oxidation, inflammation, and cellular survival are presented. Expert Opinion Nicotinamide, erythropoietin, and the downstram pathways of SIRT1, mTOR, forkhead transcription factors, and wingless signaling offer exciting prospects for novel directions of drug discovery for the treatment of metabolic disorders. Future investigations must dissect the complex relationship and fine modulation of these pathways for the successful translation of robust reparative and regenerative strategies against diabetes mellitus and the complications of this disorder. PMID:23092114

  14. [Schizophrenia, diabetes mellitus and antipsychotics].

    PubMed

    Gury, C

    2004-01-01

    During the last years, a contribution of antipsychotic drugs in the increase of diabetes prevalence in schizophrenic population has been repetitively suggested. The debate focused mainly on the second-generation antipsychotics. The analysis of the scientific literature indicates however that this discussion is not recent and an increase of diabetes prevalence in schizophrenic populations was already described before the introduction of neuroleptics. Then, after the introduction of the first neuroleptics in the 1950s, an increase of diabetes prevalence was reported among treated patients and the same alarms occurred in the 1990s after the introduction of second-generation antipsychotics. These treatments were related to an increase of glucose tolerance impairment, type II diabetes and diabetic acidoketosis. Recent epidemiological studies have confirmed the increase prevalence of diabetes in schizophrenic patients, particularly in schizophrenic patients before any antipsychotic treatment. Among the suggested mechanisms, there are sedentary life (due to hospitalisation and sedative effects of neuroleptics), food imbalance, shared genetic factors for diabetes and schizophrenia. Moreover, the frequency of the metabolic syndrome is increased in schizophrenic populations. This syndrome associates blood glucose increase, lipid metabolism disorders and android obesity. This could explain--via an increase of the cortisol production--the increase of mortality due to cardiovascular diseases observed in schizoprhenic patients. Thus, it seems well established that schizophrenia is associated with an increased risk for diabetes. It is however more difficult to evaluate the role of antipsychotic treatment as a causative factor of diabetes. Indeed, there are many published case reports or diabetes or diabetic acidoketosis after an antipsychotic treatment, but the level of evidence in controlled trials is low. Many studies were performed on large databases, but were retrospective

  15. The Case for Control in Diabetes Mellitus

    PubMed Central

    Davidson, Mayer B.

    1978-01-01

    In all diabetic animal models studied to date, microangiopathic complications develop which can be prevented by tight control and reversed by either islet cell transplantation or transplanting the diabetic kidney into a nondiabetic environment. In humans the prevalence of these complications in secondary diabetes mellitus is similar to the prevalence in genetic diabetes. Furthermore, mesangial basement membrane thickness is normal at the onset of the disease and increases shortly thereafter. These two facts strongly suggest that the microangiopathic complications are not an independent genetic component but rather are secondary to the metabolic derangements of uncontrolled diabetes. Normal kidneys transplanted into diabetic recipients developed the vascular lesions of diabetes. Conversely, two diabetic kidneys inadvertently transplanted into nondiabetic recipients showed clearing of the vascular lesions. Most retrospective studies support the conclusion that control is associated with lessened complications. The three prospective studies published to date also support this hypothesis. Because glucose concentrations cannot be brought to normal levels by present methods, the critical question is whether a major emphasis on restoring metabolism to as nearly normal as possible will help ameliorate the microangiopathic complications in our patients. The accumulated evidence would strongly favor an affirmative answer. Two daily injections of intermediate-acting insulin supplemented with small amounts of short-acting insulin as needed is one method to approach this goal. PMID:360622

  16. Experimental Diabetes Mellitus in Different Animal Models.

    PubMed

    Al-Awar, Amin; Kupai, Krisztina; Veszelka, Médea; Szűcs, Gergő; Attieh, Zouhair; Murlasits, Zsolt; Török, Szilvia; Pósa, Anikó; Varga, Csaba

    2016-01-01

    Animal models have historically played a critical role in the exploration and characterization of disease pathophysiology and target identification and in the evaluation of novel therapeutic agents and treatments in vivo. Diabetes mellitus disease, commonly known as diabetes, is a group of metabolic disorders characterized by high blood glucose levels for a prolonged time. To avoid late complications of diabetes and related costs, primary prevention and early treatment are therefore necessary. Due to its chronic symptoms, new treatment strategies need to be developed, because of the limited effectiveness of the current therapies. We overviewed the pathophysiological features of diabetes in relation to its complications in type 1 and type 2 mice along with rat models, including Zucker Diabetic Fatty (ZDF) rats, BB rats, LEW 1AR1/-iddm rats, Goto-Kakizaki rats, chemically induced diabetic models, and Nonobese Diabetic mouse, and Akita mice model. The advantages and disadvantages that these models comprise were also addressed in this review. This paper briefly reviews the wide pathophysiological and molecular mechanisms associated with type 1 and type 2 diabetes, particularly focusing on the challenges associated with the evaluation and predictive validation of these models as ideal animal models for preclinical assessments and discovering new drugs and therapeutic agents for translational application in humans.

  17. Type 2 diabetes mellitus and exercise impairment.

    PubMed

    Reusch, Jane E B; Bridenstine, Mark; Regensteiner, Judith G

    2013-03-01

    Limitations in physical fitness, a consistent finding in individuals with both type I and type 2 diabetes mellitus, correlate strongly with cardiovascular and all-cause mortality. These limitations may significantly contribute to the persistent excess cardiovascular mortality affecting this group. Exercise impairments in VO2 peak and VO2 kinetics manifest early on in diabetes, even with good glycemic control and in the absence of clinically apparent complications. Subclinical cardiac dysfunction is often present but does not fully explain the observed defect in exercise capacity in persons with diabetes. In part, the cardiac limitations are secondary to decreased perfusion with exercise challenge. This is a reversible defect. Similarly, in the skeletal muscle, impairments in nutritive blood flow correlate with slowed (or inefficient) exercise kinetics and decreased exercise capacity. Several correlations highlight the likelihood of endothelial-specific impairments as mediators of exercise dysfunction in diabetes, including insulin resistance, endothelial dysfunction, decreased myocardial perfusion, slowed tissue hemoglobin oxygen saturation, and impairment in mitochondrial function. Both exercise training and therapies targeted at improving insulin sensitivity and endothelial function improve physical fitness in subjects with type 2 diabetes. Optimization of exercise functions in people with diabetes has implications for diabetes prevention and reductions in mortality risk. Understanding the molecular details of endothelial dysfunction in diabetes may provide specific therapeutic targets for the remediation of this defect. Rat models to test this hypothesis are under study.

  18. 78 FR 14561 - Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... HUMAN SERVICES National Institutes of Health Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting SUMMARY: The Diabetes Mellitus Interagency Coordinating Committee (DMICC) will hold a meeting on March 28, 2013, focusing on ``Federal Initiatives to Address Gestational Diabetes Mellitus...

  19. 78 FR 26641 - National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... Diseases, Diabetes Mellitus Interagency Coordinating Committee Notice of Workshop SUMMARY: The Diabetes Mellitus Interagency Coordinating Committee (DMICC) will hold a 2-day workshop on June 6-7, 2013. The... Mellitus Interagency Coordinating Committee, National Institute of Diabetes and Digestive and...

  20. Masked Hypertension in Diabetes Mellitus

    PubMed Central

    Franklin, Stanley S.; Thijs, Lutgarde; Li, Yan; Hansen, Tine W.; Boggia, José; Liu, Yanping; Asayama, Kei; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Torp-Pedersen, Christian; Dolan, Eamon; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Filipovský, Jan; Imai, Yutaka; Wang, Jiguang; Ibsen, Hans; O’Brien, Eoin; Staessen, Jan A.

    2013-01-01

    Although distinguishing features of masked hypertension in diabetics are well known, the significance of antihypertensive treatment on clinical practice decisions has not been fully explored. We analyzed 9691 subjects from the population-based 11-country International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes. Prevalence of masked hypertension in untreated normotensive participants was higher (P<0.0001) among 229 diabetics (29.3%, n=67) than among 5486 nondiabetics (18.8%, n=1031). Over a median of 11.0 years of follow-up, the adjusted risk for a composite cardiovascular end point in untreated diabetic-masked hypertensives tended to be higher than in normotensives (hazard rate [HR], 1.96; 95% confidence interval [CI], 0.97–3.97; P=0.059), similar to untreated stage 1 hypertensives (HR, 1.07; CI, 0.58–1.98; P=0.82), but less than stage 2 hypertensives (HR, 0.53; CI, 0.29–0.99; P=0.048). In contrast, cardiovascular risk was not significantly different in antihypertensive-treated diabetic-masked hypertensives, as compared with the normotensive comparator group (HR, 1.13; CI, 0.54–2.35; P=0.75), stage 1 hypertensives (HR, 0.91; CI, 0.49–1.69; P=0.76), and stage 2 hypertensives (HR, 0.65; CI, 0.35–1.20; P=0.17). In the untreated diabetic-masked hypertensive population, mean conventional systolic/diastolic blood pressure was 129.2±8.0/76.0±7.3 mm Hg, and mean daytime systolic/diastolic blood pressure 141.5±9.1/83.7±6.5 mm Hg. In conclusion, masked hypertension occurred in 29% of untreated diabetics, had comparable cardiovascular risk as stage 1 hypertension, and would require considerable reduction in conventional blood pressure to reach daytime ambulatory treatment goal. Importantly, many hypertensive diabetics when receiving antihypertensive therapy can present with normalized conventional and elevated ambulatory blood pressure that mimics masked hypertension. PMID:23478096

  1. Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients.

    PubMed

    Poulimeneas, Dimitrios; Grammatikopoulou, Maria G; Bougioukli, Vasiliki; Iosifidou, Parthena; Vasiloglou, Maria F; Gerama, Maria-Assimina; Mitsos, Dimitrios; Chrysanthakopoulou, Ioanna; Tsigga, Maria; Kazakos, Kyriakos

    2016-01-01

    Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients' medical files. Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Remission of diabetes mellitus in cats with diabetic ketoacidosis.

    PubMed

    Sieber-Ruckstuhl, N S; Kley, S; Tschuor, F; Zini, E; Ohlerth, S; Boretti, F S; Reusch, C E

    2008-01-01

    Diabetic ketoacidosis (DKA) has long been considered a key clinical feature of type-1 diabetes mellitus (DM) in humans although. An increasing number of cases of ketoacidosis have been reported in people with type-2 DM. Cats initially diagnosed with DKA can achieve remission from diabetes. Cats with DKA and diabetic remission are more likely to have been administered glucocorticoids before diagnosis. Twelve cats with DKA and 7 cats with uncomplicated DM. Retrospective case review. Medical records of cats presenting with DKA or DM were evaluated. Diabetic remission was defined as being clinically unremarkable for at least 1 month after insulin withdrawal. The cats were assigned to 1 of 3 groups: (1) cats with DKA and diabetic remission; (2) cats with DKA without diabetic remission; and (3) cats with DM and diabetic remission. Seven cats with DKA had remission from diabetes. These cats had significantly higher concentrations of leukocytes and segmented neutrophils, and significantly lower concentrations of eosinophils in blood and had pancreatic disease more often than did cats with uncomplicated DM and diabetic remission. With regard to pretreatment, 3/7 cats in group 1, 1/5 cats in group 2, and 1/7 cats in group 3 had been treated with glucocorticoids. Remission of DM in cats presenting with DKA is possible. Cats with DKA and remission have more components of a stress leucogram, pancreatic disease, and seemed to be treated more often with glucocorticoids than cats with uncomplicated DM and diabetic remission.

  3. Regeneration therapy for diabetes mellitus.

    PubMed

    Yamaoka, Takashi

    2003-06-01

    Regeneration therapy can be classified into three categories. The first category, in vitro regeneration therapy, makes use of transplanted cultured cells, including embryonic stem (ES) cells, pancreatic precursor cells and beta-cell lines, in conjunction with immunosuppressive therapy or immunoisolation for the treatment of patients with Type 1 diabetes. In the second type of regeneration therapy, ex vivo regeneration therapy, a patient's own cells, such as bone marrow stem cells, are transiently removed and induced to differentiate into beta-cells in vitro. However, at the present time, insulin-producing cells cannot be generated from bone marrow stem cells. In vivo regeneration therapy, the third type of regeneration therapy, enables impaired tissue to regenerate from a patient's own cells in vivo. beta-Cell neogenesis from non-beta-cells, and beta-cell proliferation in vivo have been considered in particular as regeneration therapies for patients with Type 2 diabetes. Regeneration therapy for pancreatic beta-cells can be combined with various other therapeutic strategies, including islet transplantation, cell-based therapy, gene therapy and drug therapy, to promote beta-cell proliferation and neogenesis; it is hoped that these strategies will, in the future, provide a cure for diabetes.

  4. Acute Kidney Injury in Diabetes Mellitus

    PubMed Central

    Müller, G. A.

    2016-01-01

    Diabetes mellitus (DM) significantly increases the overall morbidity and mortality, particularly by elevating the cardiovascular risk. The kidneys are severely affected as well, partly as a result of intrarenal athero- and arteriosclerosis but also due to noninflammatory glomerular damage (diabetic nephropathy). DM is the most frequent cause of end-stage renal disease in our society. Acute kidney injury (AKI) remains a clinical and prognostic problem of fundamental importance since incidences have been increased in recent years while mortality has not substantially been improved. As a matter of fact, not many studies particularly addressed the topic “AKI in diabetes mellitus.” Aim of this article is to summarize AKI epidemiology and outcomes in DM and current recommendations on blood glucose control in the intensive care unit with regard to the risk for acquiring AKI, and finally several aspects related to postischemic microvasculopathy in AKI of diabetic patients shall be discussed. We intend to deal with this relevant topic, last but not least with regard to increasing incidences and prevalences of both disorders, AKI and DM. PMID:27974972

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

    PubMed Central

    Fraser, F C; Gunn, T

    1977-01-01

    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 increased probability of developing juvenile diabetes mellitus. PMID:881709

  6. Punica granatum: heuristic treatment for diabetes mellitus.

    PubMed

    Katz, Sarah Rachel; Newman, Robert A; Lansky, Ephraim Philip

    2007-06-01

    The current diabetes epidemic is a global concern with readily available effective therapies or preventative measures in demand. One natural product with such potential is the pomegranate (Punica granatum), with hypoglycemic activity noted from its flowers, seeds, and juice in canons of the traditional folk medicines of India. The mechanisms for such effects are largely unknown, though recent research suggests pomegranate flowers and juice may prevent diabetic sequelae via peroxisome proliferator-activated receptor-gamma binding and nitric oxide production. Pomegranate compounds associated with antidiabetic effects include oleanolic, ursolic, and gallic acids. Pomegranate fractions and their active compounds hold potential and are worthy of further investigations as safe and effective medical treatments for diabetes mellitus and its pathological consequences.

  7. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis.

    PubMed

    Ewald, Nils; Hardt, Philip D

    2013-11-14

    Diabetes secondary to pancreatic diseases is commonly referred to as pancreatogenic diabetes or type 3c diabetes mellitus. It is a clinically relevant condition with a prevalence of 5%-10% among all diabetic subjects in Western populations. In nearly 80% of all type 3c diabetes mellitus cases, chronic pancreatitis seems to be the underlying disease. The prevalence and clinical importance of diabetes secondary to chronic pancreatitis has certainly been underestimated and underappreciated so far. In contrast to the management of type 1 or type 2 diabetes mellitus, the endocrinopathy in type 3c is very complex. The course of the disease is complicated by additional present comorbidities such as maldigestion and concomitant qualitative malnutrition. General awareness that patients with known and/or clinically overt chronic pancreatitis will develop type 3c diabetes mellitus (up to 90% of all cases) is rather good. However, in a patient first presenting with diabetes mellitus, chronic pancreatitis as a potential causative condition is seldom considered. Thus many patients are misdiagnosed. The failure to correctly diagnose type 3 diabetes mellitus leads to a failure to implement an appropriate medical therapy. In patients with type 3c diabetes mellitus treating exocrine pancreatic insufficiency, preventing or treating a lack of fat-soluble vitamins (especially vitamin D) and restoring impaired fat hydrolysis and incretin secretion are key-features of medical therapy.

  8. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis

    PubMed Central

    Ewald, Nils; Hardt, Philip D

    2013-01-01

    Diabetes secondary to pancreatic diseases is commonly referred to as pancreatogenic diabetes or type 3c diabetes mellitus. It is a clinically relevant condition with a prevalence of 5%-10% among all diabetic subjects in Western populations. In nearly 80% of all type 3c diabetes mellitus cases, chronic pancreatitis seems to be the underlying disease. The prevalence and clinical importance of diabetes secondary to chronic pancreatitis has certainly been underestimated and underappreciated so far. In contrast to the management of type 1 or type 2 diabetes mellitus, the endocrinopathy in type 3c is very complex. The course of the disease is complicated by additional present comorbidities such as maldigestion and concomitant qualitative malnutrition. General awareness that patients with known and/or clinically overt chronic pancreatitis will develop type 3c diabetes mellitus (up to 90% of all cases) is rather good. However, in a patient first presenting with diabetes mellitus, chronic pancreatitis as a potential causative condition is seldom considered. Thus many patients are misdiagnosed. The failure to correctly diagnose type 3 diabetes mellitus leads to a failure to implement an appropriate medical therapy. In patients with type 3c diabetes mellitus treating exocrine pancreatic insufficiency, preventing or treating a lack of fat-soluble vitamins (especially vitamin D) and restoring impaired fat hydrolysis and incretin secretion are key-features of medical therapy. PMID:24259958

  9. 75 FR 25919 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemptions from the diabetes mellitus standard; request for comments. SUMMARY: FMCSA announces receipt of applications from 33 individuals for exemptions from the prohibition for persons with insulin-treated...

  10. Coronary Artery Revascularization in Patients with Diabetes Mellitus

    MedlinePlus

    ... References Figures & Tables Info & Metrics eLetters What Is Coronary Artery Disease? Atherosclerosis is the disease process that narrows large ... heart attack, and possibly sudden death. Diabetes and Coronary Artery Disease Patients with diabetes mellitus have more extensive atherosclerosis ...

  11. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    PubMed Central

    Burlina, S.; Dalfrà, M. G.

    2016-01-01

    The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected. PMID:27956897

  12. Diabetes mellitus and pancreatitis--cause or effect?

    PubMed

    Davison, L J

    2015-01-01

    Diabetes mellitus and pancreatitis are two distinct diseases encountered commonly in small animal practice. Whilst the clinical signs of diabetes mellitus are usually unmistakeable, a firm diagnosis of pancreatitis can prove more elusive, as clinical signs are often variable. Over the past 10 to 15 years, despite the fact that the clinical signs of diabetes mellitus are remarkably consistent, it has become more apparent that the underlying pathology of diabetes mellitus in dogs and cats is heterogeneous, with exocrine pancreatic inflammation accompanying diabetes mellitus in a number of cases. However, the question remains as to whether the diabetes mellitus causes the pancreatitis or whether, conversely, the pancreatitis leads to diabetes mellitus--as there is evidence to support both scenarios. The concurrence of diabetes mellitus and pancreatitis has clinical implications for case management as such cases may follow a more difficult clinical course, with their glycaemic control being "brittle" as a result of variation in the degree of pancreatic inflammation. Problems may also arise if abdominal pain or vomiting lead to anorexia. In addition, diabetic cases with pancreatitis are at risk of developing exocrine pancreatic insufficiency in the following months to years, which can complicate their management further.

  13. Apoptosis of beta cells in diabetes mellitus.

    PubMed

    Anuradha, Rachakatla; Saraswati, Mudigonda; Kumar, Kishore G; Rani, Surekha H

    2014-11-01

    Diabetes mellitus is a multifactorial metabolic disorder characterized by hyperglycemia. Apoptosis in beta cells has been observed in response to diverse stimuli, such as glucose, cytokines, free fatty acids, leptin, and sulfonylureas, leading to the activation of polyol, hexosamine, and diacylglycerol/protein kinase-C (DAG/PKC) pathways that mediate oxidative and nitrosative stress causing the release of different cytokines. Cytokines induce the expression of Fas and tumor necrosis factor-alpha (TNF-α) by activating the transcription factor, nuclear factor-κb, and signal transducer and activator of transcription 1 (STAT-1) in the β cells in the extrinsic pathway of apoptosis. Cytokines produced in beta cells also induce proapoptotic members of the intrinsic pathway of apoptosis. The genetic alterations in apoptosis signaling machinery and the pathogenesis of diabetes include Fas, FasL, Akt, caspases, calpain-10, and phosphatase and tensin homolog (Pten). The other gene products that are involved in diabetes are nitric oxide synthase-2 (NOS2), small ubiquitin-like modifier (SUMO), apolipoprotein CIII (ApoCIII), forkhead box protein O1 (FOXO1), and Kruppel-like zinc finger protein Gli-similar 3 (GLIS3). The gene products having antiapoptotic nature are Bcl-2 and Bcl-XL. Epigenetic mechanisms play an important role in type I and type II diabetes. Further studies on the apoptotic genes and gene products in diabetics may be helpful in pharmacogenomics and individualized treatment along with antioxidants targeting apoptosis in diabetes.

  14. Homocysteine, Cortisol, Diabetes Mellitus, and Psychopathology

    PubMed Central

    Kontoangelos, K.; Papageorgiou, C. C.; Raptis, A. E.; Tsiotra, P.; Lambadiari, V.; Papadimitriou, G. N.; Rabavilas, A. D.; Dimitriadis, G.; Raptis, S. A.

    2015-01-01

    Objective. This study investigates the association of homocysteine and cortisol with psychological factors in type 2 diabetic patients. Method. Homocysteine, cortisol, and psychological variables were analyzed from 131 diabetic patients. Psychological factors were assessed with the Eysenck Personality Questionnaire (EPQ), Hostility and Direction of Hostility Questionnaire (HDHQ), the Symptom Checklist 90-R (SCL 90-R), the Zung Self-Rating Depression Scale (ZDRS), and the Maudsley O-C Inventory Questionnaire (MOCI). Blood samples were taken by measuring homocysteine and cortisol in both subgroups during the initial phase of the study (T0). One year later (T1), the uncontrolled diabetic patients were reevaluated with the use of the same psychometric instruments and with an identical blood analysis. Results. The relation of psychoticism and homocysteine is positive among controlled diabetic patients (P value = 0.006 < 0.05) and negative among uncontrolled ones (P value = 0.137). Higher values of cortisol correspond to lower scores on extraversion subscale (r p = −0.223, P value = 0.010). Controlled diabetic patients showed a statistically significant negative relationship between homocysteine and the act-out hostility subscale (r sp = −0.247, P = 0.023). There is a statistically significant relationship between homocysteine and somatization (r sp = −0.220, P = 0.043). Conclusions. These findings support the notion that homocysteine and cortisol are related to trait and state psychological factors in patients with diabetes mellitus type 2. PMID:25722989

  15. Influenza immunization in adults with diabetes mellitus.

    PubMed

    Feery, B J; Hartman, L J; Hampson, A W; Proietto, J

    1983-01-01

    The antibody responses to influenza vaccination of a group of adult diabetic patients were compared with responses in a healthy group of regular volunteer vaccinees. The initial and final geometric mean hemagglutination-inhibiting antibody titers were lower in the patient group, but the relative increase in titers was greater for each of the vaccine components. The percentage of fourfold rises in individual titers was greater in the diabetic group than in the control group. It was concluded that patients with diabetes mellitus responded normally to influenza vaccination. This was confirmed in an additional study. There was no significant difference in the antibody responses of patients treated with insulin or oral antidiabetic agents. There was no impairment of diabetic control as a result of influenza vaccination when this was evaluated by measuring the concentration of glycosylated hemoglobin, or by random blood glucose estimations. There was no significant change in the serum insulin level after immunization in patients on oral diabetic agents. It was concluded that influenza vaccination was safe and effective in adult diabetic patients.

  16. Pulmonary lesions in cats with diabetes mellitus.

    PubMed

    Mexas, Angela M; Hess, Rebecka S; Hawkins, Eleanor C; Martin, Linda D

    2006-01-01

    Diabetes mellitus (DM) is a common endocrinopathy of cats and humans. Although few studies have examined the effects of DM on the pulmonary system, changes in pulmonary function and immunology in humans with type I and II diabetes, and pulmonary lesions in a murine diabetic model have been documented. Our objective was to determine whether pulmonary lesions occurred in cats with DM. Medical records and necropsy evaluations of 42 cats with DM were compared with those of 45 age-matched, nondiabetic cats for the presence of clinical evidence of respiratory disease and pulmonary histopathological findings at the time of necropsy. No statistical difference was noted in the presence of clinical evidence of respiratory disease between cats with diabetes and control cats. Nevertheless, there was a significant association between the presence of abnormal pulmonary histopathology and DM (P = .018, odds ratio = 3 inclusive of all cats; P = .005, odds ratio = 5 when non-DM cats with overt clinical evidence of respiratory disease were excluded). Pulmonary abnormalities detected by histopathological examination in cats with diabetes included congestion and edema, histiocytosis, pneumonia, smooth muscle hypertrophy, fibrosis, mineralization, neoplasia, and type II pneumocyte hyperplasia. The observed association between DM and pulmonary lesions in cats, independent of clinical evidence of respiratory disease, emphasizes the need for careful assessment of the respiratory tract in sick cats with diabetes.

  17. Optimizing cardiovascular outcomes in diabetes mellitus.

    PubMed

    Sobel, Burton E

    2007-09-01

    This article presents a series of take-home statements, compiled by a multidisciplinary steering committee, concerning significant aspects of macrovascular disease in patients with diabetes mellitus, including the extent of risk, pathogenetic mechanisms, and optimal management for risk reduction. The discussion focuses in particular on the impact of diabetes medications beyond blood glucose control. In summary, these statements are as follows: (1) Patients with diabetes have an increased risk for cardiovascular disease that contributes to decreased life expectancy; (2) prognosis after a cardiovascular event is poorer in patients with diabetes; (3) pathogenetic mechanisms include insulin resistance, endothelial dysfunction, dyslipidemia, chronic inflammation, procoagulability, and impaired fibrinolysis; (4) management of established cardiovascular risk factors, for example with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and antihypertensive therapy, reduces cardiovascular event rates in diabetes; (5) correction of hyperglycemia can reduce macrovascular event rates, but the coupling to hyperglycemia is less tight for macrovascular events than it is for reduction of microvascular complications; (6) patients with diabetes should be screened for additional cardiovascular risk factors and appropriate interventions should be initiated; (7) results of observational and interventional studies have indicated that some insulin sensitizers appear to reduce the incidence of cardiovascular events and improve survival; (8) thiazolidinediones have beneficial effects on metabolism that may improve cardiovascular risk, and a randomized clinical trial in patients with advanced atherosclerosis indicates that addition of pioglitazone to therapy for hyperglycemia may reduce the incidence of cardiovascular events such as myocardial infarction and stroke.

  18. Renal morphology in cats with diabetes mellitus.

    PubMed

    Zini, E; Benali, S; Coppola, L; Guscetti, F; Ackermann, M; Lutz, T A; Reusch, C E; Aresu, L

    2014-11-01

    In humans, diabetes mellitus (DM) is an important cause of renal damage, with glomerular lesions being predominant. In cats, although diabetes is a common endocrinopathy, it is yet unknown whether it leads to renal damage. The aim of the study was to compare renal histologic features and parameters of renal function in diabetic cats against a control population matched for age, gender, breed, and body weight. Thirty-two diabetic and 20 control cats were included. Kidney sections from paraffin-embedded kidney samples were stained and examined with optical microscopy to identify glomerular, tubulointerstitial, and vascular lesions and to assess their frequency and severity. Serum creatinine and urea concentrations were also compared. Glomerular lesions were observed in 29 cats overall, with mesangial matrix increase being more common (19 cats). Tubulointerstitial lesions were observed in 42 cats, including lymphocytic infiltration (29), fibrosis (22), or tubular necrosis (21). Vascular lesions were observed in 5 cases. The frequency and severity of histologic lesions did not differ between diabetic and control cats; however, among diabetics, those that survived longer after diagnosis had more glomerular and vascular lesions. Serum creatinine and urea concentrations were similar between groups; in diabetic cats median creatinine was 109 μmol/l (range, 51-1200) and urea was 12 mmol/l (range, 4-63), and in controls creatinine was 126 μmol/l (range, 50-875) and urea 11 mmol/l (range, 3-80). The results suggest that DM in cats does not lead to microscopically detectable kidney lesions or clinically relevant renal dysfunction. The authors hypothesize that the short life expectancy of diabetic cats may be the main reason for the difference from human diabetics. © The Author(s) 2014.

  19. Ocular complications in children with diabetes mellitus

    PubMed Central

    Geloneck, Megan M.; Forbes, Brian J.; Shaffer, James; Ying, Gui-shuang; Binenbaum, Gil

    2016-01-01

    Objective The effectiveness of annual diabetic eye exams in children is unclear. We sought to determine the prevalence and onset of ocular pathology in children with diabetes mellitus (DM), identify risk factors for ocular disease, and recommend a screening regimen for asymptomatic children. Design Retrospective consecutive cohort study. Subjects Children less than age 18 years with type 1 or 2 DM examined over a 4 year period. Methods All children underwent a complete eye exam, including dilated fundoscopy and cycloplegic refraction. A literature review was performed, identifying the youngest reported age and shortest reported duration of DM prior to the diagnosis of diabetic retinopathy. Main outcome measures Prevalence of diabetic retinopathy, cataract, high refractive error, and strabismus. Results 370 children (mean age 11.2 years, range 1–17.5) had 693 examinations, with mean DM duration 5.2 years (range 0.1–16.2), mean HbA1c 8.6 (range 5 to ≥14). No children had diabetic retinopathy. 12 had cataract; 5 required extraction but were identified by decreased vision, not diabetic screening. 19 had strabismus; only one was microvascular paralytic strabismus. 41 had high refractive error. There were no associations between these conditions and duration or control of DM. In the literature, the youngest age at diagnosis of severe diabetic retinopathy was 15 years and the shortest duration of disease was 5 years. Conclusion Diabetic retinopathy is rare in children regardless of duration and control of DM. Based upon our study and literature review, screening examinations for type 1 diabetics could begin at age 15 years or at 5 years after the diagnosis of DM, whichever occurs later, unless the child is judged by the endocrinologist as being at unusally high risk. Other ocular complications are identifiable through existing amblyopia screening methods. PMID:26341461

  20. [Obesity disease with diabetes mellitus].

    PubMed

    Nagamine, Kazuhiro; Ueno, Hiroaki; Nakazato, Masamitsu

    2015-12-01

    Obesity has been increasing not only in Japan but also in both developed and developing countries. Mean body mass index of Japanese patients with type 2 diabetes has been increasing, and it reached 25.0 in 2013. If body weight decreases more than 3% of initial body weight in patients with metabolic syndrome, not only glucose metabolism but also dyslipidemia and hypertension improve. To reduce the excess body weight, behavior therapy, calorie restriction, and exercise are necessary. The next strategies are drugs including mazindol, glucose-like peptide-1 receptor agonist and sodium-dependent glucose cotransporter 2 inhibitor, and bariatric surgery. Because it is often difficult to reduce body weight using only present non-invasive therapies, clarification of appetite mechanisms and development of novel anti-obesity drugs with few side effects are needed.

  1. Rheumatic manifestations of diabetes mellitus.

    PubMed

    Lebiedz-Odrobina, Dorota; Kay, Jonathan

    2010-11-01

    DM is associated with various musculoskeletal manifestations. The strength of this relationship varies among the various musculoskeletal disorders; the associations are based mostly on epidemiologic data. For most of these conditions, definitive pathophysiologic correlates are lacking.Hand and shoulder disorders occur more frequently than other musculoskeletal manifestations of DM. Recognition of the association between DM and shoulder adhesive capsulitis, DD, and stenosing flexor tenosynovitis facilitates their correct diagnosis in the setting of DM and prompt initiation of appropriate treatment, which may include optimizing glycemic control. Conversely, awareness and identification of the characteristic musculoskeletal manifestations of DM may facilitate earlier diagnosis of DM and initiation of glucose-lowering therapy to retard the development of diabetic complications.Much less has been published about the musculoskeletal complications of DM than about its micro- and macrovascular complications. Prospective case-control cohort studies are needed to establish the true prevalence of musculoskeletal complications of DM and the metabolic syndrome, especially in this era of tighter glycemic control.The potential relationship between DM and the development of OA needs to be clarified in large, prospective, case-control cohort studies. The effect on musculoskeletal manifestations of various therapeutic regimens to manage DM should be studied prospectively. Treatment regimens for some musculoskeletal conditions associated with DM, such as DISH, should be studied in larger prospective, randomized,controlled clinical trials.At the molecular level, further studies are warranted to clarify the potential contribution of AGEs and adipokines to the development of OA and diabetic musculoskeletal syndromes, such as shoulder adhesive capsulitis, DD, stenosing flexor tenosynovitis, and LJM. Identification of such molecular targets for therapy would promote the development of

  2. Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus

    PubMed Central

    Hashimoto, Kunihiko; Koga, Masafumi

    2015-01-01

    Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternal-infant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus (GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c (HbA1c); however, we have demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, large-population epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol. PMID:26240701

  3. Hypersomatotropism, acromegaly, and hyperadrenocorticism and feline diabetes mellitus.

    PubMed

    Niessen, Stijn J M; Church, David B; Forcada, Yaiza

    2013-03-01

    When confronted with a diabetic cat in clinical practice, it is tempting to assume it has a form of diabetes mellitus akin to human type 2 diabetes mellitus (diabetes). For most diabetic cats examined, this will indeed be justified. Nevertheless, a significant proportion have other specific types of diabetes with distinctly different etiologies. This article discusses the concept of other specific types of feline diabetes caused by endocrinopathies, and more specifically feline hypersomatotropism, acromegaly, and hyperadrenocorticism, including relevance, presentation, diagnosis, and therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Diabetes Mellitus in Outpatients in Debre Berhan Referral Hospital, Ethiopia

    PubMed Central

    Habtewold, Tesfa Dejenie; Tsega, Wendwesen Dibekulu; Wale, Bayu Yihun

    2016-01-01

    Introduction. Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. Objective. To assess the prevalence and associated factors of diabetes mellitus among outpatients of Debre Berhan Referral Hospital. Methods and Materials. A cross-sectional study was conducted from April to June 2015 among 385 patients. Random quota sampling technique was used to get individual patients and risk factors assessment. Patients diabetes status was ascertained by World Health Organization Diabetes Mellitus Diagnostic Criteria. The collected data were entered, cleaned, and analyzed and Chi-square test was applied to test any association between dependent and independent variable. Result. Out of the total 385 study patients, 368 have participated in the study yielding a response rate of 95.3%. Concerning clinical presentation of diabetes mellitus, 13.3% of patients reported thirst, 14.4% of patients declared polyurea, and 14.9% of patients ascertained unexplained weight loss. The statistically significant associated factors of diabetes mellitus were hypertensive history, obesity, the number of parities, and smoking history. Conclusion. The prevalence of diabetes mellitus among outpatients in Debre Berhan Referral Hospital was 0.34% and several clinical and behavioral factors contribute to the occurrence of diabetes mellitus which impose initiation of preventive, promotive, and curative strategies. PMID:26881245

  5. Diabetes Mellitus in Outpatients in Debre Berhan Referral Hospital, Ethiopia.

    PubMed

    Habtewold, Tesfa Dejenie; Tsega, Wendwesen Dibekulu; Wale, Bayu Yihun

    2016-01-01

    Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. To assess the prevalence and associated factors of diabetes mellitus among outpatients of Debre Berhan Referral Hospital. A cross-sectional study was conducted from April to June 2015 among 385 patients. Random quota sampling technique was used to get individual patients and risk factors assessment. Patients diabetes status was ascertained by World Health Organization Diabetes Mellitus Diagnostic Criteria. The collected data were entered, cleaned, and analyzed and Chi-square test was applied to test any association between dependent and independent variable. Result. Out of the total 385 study patients, 368 have participated in the study yielding a response rate of 95.3%. Concerning clinical presentation of diabetes mellitus, 13.3% of patients reported thirst, 14.4% of patients declared polyurea, and 14.9% of patients ascertained unexplained weight loss. The statistically significant associated factors of diabetes mellitus were hypertensive history, obesity, the number of parities, and smoking history. The prevalence of diabetes mellitus among outpatients in Debre Berhan Referral Hospital was 0.34% and several clinical and behavioral factors contribute to the occurrence of diabetes mellitus which impose initiation of preventive, promotive, and curative strategies.

  6. Visual Perception Associated With Diabetes Mellitus

    NASA Astrophysics Data System (ADS)

    Suaste, Ernesto

    2004-09-01

    We designs and implement an instrumental methodology of analysis of the pupillary response to chromatic stimuli in order to observe the changes of pupillary area in the process of contraction and dilation in diabetic patients. Visual stimuli were used in the visible spectrum (400nm-650nm). Three different programs were used to determinate the best stimulation in order to obtain the better and contrasted pupillary response for diagnosis of the visual perception of colors. The stimulators PG0, PG12 and PG20 were designed in our laboratory. The test was carried out with 44 people, 33 men, 10 women and a boy (22-52 and 6 years), 12 with the stimulator PG0, 21 with PG12 and 17 with PG20, 7 subjects participated in more than a test. According to the plates of Ishihara, 40 of those subjects have normal vision to the colors, one subject suffers dicromasy (inability to differ or to perceive red and green) and while three of them present deficiencies to observe the blue and red spectrum (they suffer type II diabetes mellitus). With this instrumental methodology, we pretend to obtain an indication in the pupillary variability for the early diagnose of the diabetes mellitus, as well as a monitoring instrument for it.

  7. Gestational diabetes mellitus: Where are we now?

    PubMed

    Ashwal, Eran; Hod, Moshe

    2015-12-07

    Gestational diabetes mellitus (GDM) is defined as any carbohydrate intolerance first diagnosed during pregnancy. The prevalence of GDM is about 2-5% of normal pregnancies and depends of the prevalence of same population to type 2 diabetes mellitus. It is associated with adverse outcome for the mother, the fetus, neonate, child and adult offspring of the diabetic mother. Detection of GDM lies on screening, followed as necessary by diagnostic measures. Screening can either be selective, based upon risk stratification or universal. Timely testing enables the obstetrician to assess glucose tolerance in the presence of the insulin-resistant state of pregnancy and permits treatment to begin before excessive fetal growth has occurred. Once a diagnosis of GDM was made close perinatal surveillance is warranted. The goal of treatment is reducing fetal-maternal morbidity and mortality related with GDM. The exact glucose values needed are still not absolutely proved. The decision whether and when to induce delivery depends on gestational age, estimated fetal weight, maternal glycemic control and bishop score. Future research is needed regarding prevention of GDM, treatment goals and effectiveness of interventions, guidelines for pregnancy care and prevention of long term metabolic sequel for both the infant and the mother.

  8. Feline models of type 2 diabetes mellitus.

    PubMed

    Henson, Michael S; O'Brien, Timothy D

    2006-01-01

    Feline diabetes mellitus (FDM) closely resembles human type 2 diabetes mellitus (T2DM) in many respects including clinical, physiological, and pathological features of the disease. These features include age of onset of FDM in middle age, association with obesity, residual but declining insulin secretion, development of islet amyloid deposits, loss of approximately 50% of beta-cell mass, and development of complications in several organ systems including peripheral polyneuropathy and retinopathy. Many of the pathological aspects of the disease are also experimentally inducible, facilitating study of the pathogenesis of these lesions. Physiological aspects of FDM and obesity are also well studied in the cat and provide an excellent basis for comparative studies of human T2DM. The relatively short generation time of cats along with breed predispositions to development of FDM may allow for more rapid screening and identification of genetic markers for diabetes susceptibility. FDM, in both spontaneous and inducible forms, therefore provides a good animal model of human T2DM and may provide additional insights into the pathogenesis of this important condition.

  9. Type 2 diabetes mellitus in children and adolescents

    PubMed Central

    Reinehr, Thomas

    2013-01-01

    Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians should be aware of the frequent mild or asymptomatic manifestation of type 2 diabetes mellitus in childhood. Therefore, a screening seems meaningful especially in high risk groups such as children and adolescents with obesity, relatives with type 2 diabetes mellitus, and clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, or acanthosis nigricans). Treatment of choice is lifestyle intervention followed by pharmacological treatment (e.g., metformin). New drugs such as dipeptidyl peptidase inhibitors or glucagon like peptide 1 mimetics are in the pipeline for treatment of youth with type 2 diabetes mellitus. However, recent reports indicate a high dropout of the medical care system of adolescents with type 2 diabetes mellitus suggesting that management of children and adolescents with type 2 diabetes mellitus requires some remodeling of current healthcare practices. PMID:24379917

  10. Peptide and protein biomarkers for type 1 diabetes mellitus

    DOEpatents

    Zhang, Qibin; Metz, Thomas O.

    2016-08-30

    A method for identifying persons with increased risk of developing type 1 diabetes mellitus, or having type I diabetes mellitus, utilizing selected biomarkers described herein either alone or in combination. The present disclosure allows for broad based, reliable, screening of large population bases. Also provided are arrays and kits that can be used to perform such methods.

  11. Peptide and protein biomarkers for type 1 diabetes mellitus

    DOEpatents

    Zhang, Qibin; Metz, Thomas O.

    2014-06-10

    A method for identifying persons with increased risk of developing type 1 diabetes mellitus, or having type I diabetes mellitus, utilizing selected biomarkers described herein either alone or in combination. The present disclosure allows for broad based, reliable, screening of large population bases. Also provided are arrays and kits that can be used to perform such methods.

  12. Expected role of medical technologists in diabetes mellitus education teams.

    PubMed

    Kotani, Kazuhiko; Imazato, Takahiro; Anzai, Keizo

    2015-06-01

    The expected role of medical technologists within diabetes mellitus education teams was surveyed. In addition to items regarding laboratory examinations and results themselves, good communication with patients and education team members was highly required. When medical technologists sufficiently follow this role, it would aid patients to cope with life with diabetes mellitus.

  13. 76 FR 78718 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... clinical diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3... Report to Congress on the Feasibility of a Program to Qualify Individuals with Insulin-Treated...

  14. 78 FR 7855 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... clinical diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3... Report to Congress on the Feasibility of a Program to Qualify Individuals with Insulin-Treated...

  15. Surgery in the treatment of type 2 diabetes mellitus.

    PubMed

    Maleckas, A; Venclauskas, L; Wallenius, V; Lönroth, H; Fändriks, L

    2015-03-01

    The prevalence of diabetes is increasing worldwide, and most of the cases are type 2 diabetes mellitus. The relationship between type 2 diabetes mellitus and obesity is well established, and surgical treatment is widely used for obese patients with type 2 diabetes mellitus. The aim was to present current knowledge about the possible mechanisms responsible for glucose control after surgical procedures and to review the surgical treatment results. Medical literature was searched for the articles presenting the impact of surgical treatment on glycemic control, long-term results, and possible mechanisms of action among obese individuals with type 2 diabetes mellitus. Remission of type 2 diabetes mellitus after bariatric surgery depends on the definition of the remission used. Complete remission rate after surgery with the new criteria is lower than was considered before. Randomized controlled studies demonstrate that surgery is superior to best medical treatment for the patients with type 2 diabetes mellitus. The recurrence of type 2 diabetes mellitus after bariatric surgery is observed in up to 40% of cases with ≥ 5 years of follow-up. Despite the recurrence of type 2 diabetes mellitus in this group, better glycemic control and lower risk of macrovascular complications are present. Incretin effects on glycemic control after bariatric surgery are well described, but the role of other possible mechanisms (bile acids, microbiota, intestinal gluconeogenesis) in humans is unclear. Surgery is an effective treatment of type 2 diabetes mellitus in obese patients. The most optimal surgical procedure for the treatment of obese patients with type 2 diabetes mellitus is still to be established. More research is needed to explore the mechanisms of glycemic control after bariatric surgery. © The Finnish Surgical Society 2015.

  16. Exocrine Pancreas in Cats With Diabetes Mellitus.

    PubMed

    Zini, E; Ferro, S; Lunardi, F; Zanetti, R; Heller, R S; Coppola, L M; Guscetti, F; Osto, M; Lutz, T A; Cavicchioli, L; Reusch, C E

    2016-01-01

    Pancreatitis has been described in cats with diabetes mellitus, although the number of studies currently available is very limited. In addition, ketoacidosis has been hypothesized to be associated with pancreatitis in diabetic cats. The aims of the present study were to investigate whether diabetic cats have pancreatitis and to determine if pancreatitis is more frequent with ketoacidosis. Samples of pancreas were collected postmortem from 37 diabetic cats, including 15 with ketoacidosis, and 20 control cats matched for age, sex, breed, and body weight. Sections were stained with hematoxylin and eosin, double-labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/PCNA, and glucagon/Ki67, and single-labeled for Iba1. A previously proposed semiquantitative score was used to characterize pancreatitis, along with counts of inflammatory cells. Scores of pancreatitis and the number of neutrophils, macrophages, and lymphocytes in the exocrine pancreas did not differ between diabetic and control cats or between diabetic cats with and without ketoacidosis. Of note, PCNA-positive acinar cells were increased (P = .002) in diabetic cats, particularly near islets (P < .001). Ki67-positive acinar cells were increased only near islets (P = .038). Ketoacidosis was not linked to proliferation. The results suggest that histopathologic evidence of pancreatitis may not be more frequent in diabetic cats and that ketoacidosis may not be associated with it at the time of death. Augmented PCNA-positive acinar cells might indicate increased proliferation due to chronic pancreatitis. The reason behind the prevalent proliferation of acinar cells surrounding pancreatic islets deserves further investigation. © The Author(s) 2015.

  17. Endocrine Pancreas in Cats With Diabetes Mellitus.

    PubMed

    Zini, E; Lunardi, F; Zanetti, R; Heller, R S; Coppola, L M; Ferro, S; Guscetti, F; Osto, M; Lutz, T A; Reusch, C E; Cavicchioli, L

    2016-01-01

    Pancreatic amyloidosis and loss of α and β cells have been shown to occur in cats with diabetes mellitus, although the number of studies currently available is very limited. Furthermore, it is not known whether pancreatic islet inflammation is a common feature. The aims of the present study were to characterize islet lesions and to investigate whether diabetic cats have inflammation of the pancreatic islets. Samples of pancreas were collected postmortem from 37 diabetic and 20 control cats matched for age, sex, breed, and body weight. Histologic sections were stained with hematoxylin and eosin and Congo red; double labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/proliferating cell nuclear antigen, and glucagon/Ki67; and single labeled for amylin and Iba1. Mean insulin-positive cross-sectional area was approximately 65% lower in diabetic than control cats (P = .009), while that of amylin and glucagon was similar. Surprisingly, amyloid deposition was similar between groups (P = .408). Proliferation of insulin- and glucagon-positive cells and the number of neutrophils, macrophages, and T (CD3) and B (CD20) lymphocytes in the islets did not differ. The presence of T and B lymphocytes combined tended to be more frequent in diabetic cats (n = 8 of 37; 21.6%) than control cats (n = 1 of 20; 5.0%). The results confirm previous observations that loss of β cells but not α cells occurs in diabetic cats. Islet amyloidosis was present in diabetic cats but was not greater than in controls. A subset of diabetic cats had lymphocytic infiltration of the islets, which might be associated with β-cell loss. © The Author(s) 2015.

  18. Buccal alterations in diabetes mellitus

    PubMed Central

    2010-01-01

    Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a) increased concentration of mucin and glucose; b) impaired production and/or action of many antimicrobial factors; c) absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d) bad taste; e) oral candidiasis f) increased cells exfoliation after contact, because of poor lubrication; g) increased proliferation of pathogenic microorganisms; h) coated tongue; i) halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a) tongue alterations, generally a burning mouth; b) periodontal disease; c) white spots due to demineralization in the teeth; d) caries; e) delayed healing of wounds; f) greater tendency to infections; g) lichen planus; h) mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present. PMID:20180965

  19. Momordica charantia for type 2 diabetes mellitus.

    PubMed

    Ooi, Cheow Peng; Yassin, Zaitun; Hamid, Tengku-Aizan

    2012-08-15

    Momordica charantia (bitter gourd) is not only a nutritious vegetable but it is also used in traditional medical practices to treat type 2 diabetes mellitus. Experimental studies with animals and humans suggested that the vegetable has a possible role in glycaemic control. To assess the effects of mormodica charantia for type 2 diabetes mellitus. Several electronic databases were searched, among these were The Cochrane Library (Issue 1, 2012), MEDLINE, EMBASE, CINAHL, SIGLE and LILACS (all up to February 2012), combined with handsearches. No language restriction was used. We included randomised controlled trials (RCTs) that compared momordica charantia with placebo or a control intervention, with or without pharmacological or non-pharmacological interventions. Two authors independently extracted data. Risk of bias of the trials was evaluated using the parameters of randomisation, allocation concealment, blinding, completeness of outcome data, selective reporting and other potential sources of bias. A meta-analysis was not performed given the quality of data and the variability of preparations of momordica charantia used in the interventions (no similar preparation was tested twice). Four randomised controlled trials with up to three months duration and investigating 479 participants met the inclusion criteria. Risk of bias of these trials (only two studies were published as a full peer-reviewed publication) was generally high. Two RCTs compared the effects of preparations from different parts of the momordica charantia plant with placebo on glycaemic control in type 2 diabetes mellitus. There was no statistically significant difference in the glycaemic control with momordica charantia preparations compared to placebo. When momordica charantia was compared to metformin or glibenclamide, there was also no significant change in reliable parameters of glycaemic control. No serious adverse effects were reported in any trial. No trial investigated death from any cause

  20. Momordica charantia for type 2 diabetes mellitus.

    PubMed

    Ooi, Cheow Peng; Yassin, Zaitun; Hamid, Tengku-Aizan

    2010-02-17

    Momordica charantia is not only a nutritious vegetable, but is also used in traditional medical practices to treat type 2 diabetes mellitus. Experimental studies with animals and humans suggested that the vegetable has a possible role in glycaemic control. To assess the effects of mormodica charantia for type 2 diabetes mellitus. Several electronic databases were searched, among these The Cochrane Library (issue 4, 2009), MEDLINE, EMBASE, CINAHL, SIGLE and LILACS (all up to November 2009), combined with handsearches. No language restriction was used. Randomized controlled trials that compared momordica charantia with a placebo or a control intervention with or without pharmacological or non-pharmacological interventions were included. Two authors independently extracted the data. Risk of bias of trials was evaluated using the parameters of randomization, allocation concealment, blinding, completeness of outcome data, selective reporting and other potential sources of bias. A meta-analysis was not performed given the quality of data and the variability of preparations of momordica charantia used in interventions (no similar preparation was tested twice). Three randomised controlled trials with up to three months duration and investigating 350 participants met the inclusion criteria. Risk of bias of these trials (only one study was published as a full peer-reviewed publication) was generally high. Two RCTs compared the effect of preparations from different parts of the momordica charantia plants and placebo on the glycemic control in type 2 diabetes mellitus. There was no statistically significant difference compared to placebo. The effects of preparation from the leaves of the plant and glibenclamide were comparable in the third trial. No serious adverse effects were reported in all the trials. There were no documentations of death from any cause, morbidity, (health-related) quality of life and costs. There is insufficient evidence to recommend momordica charantia

  1. [Bone architecture and strength in diabetes mellitus].

    PubMed

    Okazaki, Ryo

    2013-07-01

    Increased fracture risks in diabetes mellitus (DM) have been attributed to deteriorated bone quality both in type 1 and 2 DM because increased risks are disproportionate to their bone mineral densities (BMD) . Although still very little is known about bone architecture in type 1 DM, recent advancement in the techniques, such as high-resolution peripheral quantitative CT (HR-pQCT) and trabecular bone score (TBS) , have revealed that, in type 2 DM, bone microstructure is compromised despite preserved BMD, which may account for high fracture risk in DM.

  2. Recessive inheritance of diabetes: the syndrome of diabetes insipidus, diabetes mellitus, optic atrophy and deafness.

    PubMed

    Page, M M; Asmal, A C; Edwards, C R

    1976-07-01

    A few rare syndromes have been delineated in which diabetes mellitus is inherited in association with other conditions. This paper describes five patients, including four siblings in one family, who have diabetes insipidus, diabetes mellitus, optic atrophy and deafness (the DIDMOAD syndrome). The parents of both families are normal but are first cousins. All the patients have insulin-dependent diabetes mellitus with a typical juvenile-onset. The onset of diabetes insipidus was insidious and the symptoms could easily have been ascribed to poor control of diabetes mellitus. The importance of diagnosing diabetes insipidus is that all these patients had dilatation of the urinary tract varying from mild hydroureter to severe hydronephrosis and this improved with treatment of the diabetes insipidus. It is suggested that patients with diabetes mellitus and optic atrophy should have regular screening tests for diabetes insipidus since it is likely that they represent cases of the full syndrome with incomplete clinical expression. The occurrence of this rare syndrome in four siblings of unaffected parents indicates that the syndrome is due to a recessive gene, but the pathogenesis is unknown.

  3. Dissecting copper homeostasis in diabetes mellitus.

    PubMed

    Lowe, Jennifer; Taveira-da-Silva, Rosilane; Hilário-Souza, Elaine

    2017-04-01

    Diabetes Mellitus (DM) is characterized by elevated blood glucose levels (hyperglycemia). It can occur due to impaired secretion or action of the hormone insulin, which is produced by pancreatic beta-cells to promote the entry of glucose into the cells. It is known that hyperglycemia has an important role in the production of reactive oxygen species in all types of DM and that an imbalance of transition metal as Cu and Fe plays a pivotal role in stimulating the oxidative stress. Different levels of some transition metals, as Cu, Fe, Mn, and Zn has been reported comparing diabetic animal models with the control group. An increased Cu status is also described in diabetic patients. Homeostasis of Cu depends on distinct proteins, where Cu(I)-ATPases are important transmembrane proteins for acquisition, active transport, distribution and elimination of Cu ions. In this review we first provide an overview of the literature about the relationship between diabetes and copper, the modulation of Cu(I)-ATPases activity and protein expression in DM, to next discuss the alternative treatments for diabetes using Cu chelation. © 2016 IUBMB Life, 69(4):255-262, 2017.

  4. Diabetes mellitus, part 1: physiology and complications.

    PubMed

    Nair, Muralitharan

    In part 1 of this 2-part article the author discusses the physiology and complications of diabetes mellitus (DM), a chronic and progressive disorder which affects all ages of the population. The number of people diagnosed with diabetes is approximately 1.8 million and an estimated further 1 million are undiagnosed (Department of Health, 2005). In the UK, 1-2% of the population have diabetes and among school children this is approximately 2 in 1000 (Watkins, 1996). There are two main types of diabetes--type 1 and type 2 (Porth, 2005). The aetiology of DM is unknown; however, genetic and environmental factors have been linked to its development. Type 1 results from the loss of insulin production in the beta cells of the pancreas, and type 2 from a lack of serum insulin or poor uptake of glucose into the cells. Diabetes causes disease in many organs in the body, which may be life-threatening if untreated. Complications such as heart disease, vascular disease, renal failure and blindness (Roberts, 2005) have all been reported. The increased prevalence may be caused by factors such as environmental aspects, diet, an ageing population and low levels of physical exercise.

  5. Diabetes Mellitus: Management of Gastrointestinal Complications.

    PubMed

    Careyva, Beth; Stello, Brian

    2016-12-15

    Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of undigested food, bloating, and abdominal pain. Gastroparesis is diagnosed based on clinical symptoms and a delay in gastric emptying in the absence of mechanical obstruction. Gastric emptying scintigraphy is the preferred diagnostic test. Treatment involves glucose control, dietary changes, and prokinetic medications when needed. Nonalcoholic fatty liver disease and its more severe variant, nonalcoholic steatohepatitis, are becoming increasingly prevalent in persons with diabetes. Screening for nonalcoholic fatty liver disease is not recommended, and most cases are diagnosed when steatosis is found incidentally on imaging or from liver function testing followed by diagnostic ultrasonography. Liver biopsy is the preferred diagnostic test for nonalcoholic steatohepatitis. Clinical scoring systems are being developed that, when used in conjunction with less invasive imaging, can more accurately predict which patients have severe fibrosis requiring biopsy. Treatment of nonalcoholic fatty liver disease involves weight loss and improved glycemic control; no medications have been approved for treatment of this condition. Diabetes is also a risk factor for gastroesophageal reflux disease. Patients may be asymptomatic or present with atypical symptoms, including globus sensation and dysphagia. Diabetes also may exacerbate hepatitis C and pancreatitis, resulting in more severe complications. Glycemic control improves or reverses most gastrointestinal complications of diabetes.

  6. Statin use and risk of diabetes mellitus

    PubMed Central

    Chogtu, Bharti; Magazine, Rahul; Bairy, KL

    2015-01-01

    The 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, statins, are widely used in the primary and secondary prevention of cardiovascular diseases to lower serum cholesterol levels. As type 2 diabetes mellitus is accompanied by dyslipidemia, statins have a major role in preventing the long term complications in diabetes and are recommended for diabetics with normal low density lipoprotein levels as well. In 2012, United States Food and Drug Administration released changes to statin safety label to include that statins have been found to increase glycosylated haemoglobin and fasting serum glucose levels. Many studies done on patients with cardiovascular risk factors have shown that statins have diabetogenic potential and the effect varies as per the dosage and type used. The various mechanisms for this effect have been proposed and one of them is downregulation of glucose transporters by the statins. The recommendations by the investigators are that though statins can have diabetogenic risk, they have more long term benefits which can outweigh the risk. In elderly patients and those with metabolic syndrome, as the risk of diabetes increase, the statins should be used cautiously. Other than a subset of population with risk for diabetes; statins still have long term survival benefits in most of the patients. PMID:25789118

  7. 78 FR 12821 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... for diabetes in 1970 because several risk studies indicated that drivers with diabetes had a higher... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...

  8. 77 FR 7232 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... for diabetes in 1970 because several risk studies indicated that drivers with diabetes had a higher... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...

  9. 76 FR 71111 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... for diabetes in 1970 because several risk studies indicated that drivers with diabetes had a higher... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...

  10. 75 FR 77952 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ... diabetes in 1970 because several risk studies indicated that drivers with diabetes had a higher rate of... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... prohibiting persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles...

  11. 76 FR 78725 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate commerce... monitoring, has stable control of his diabetes using insulin, and is able to drive a Commercial Motor Vehicle... understands diabetes management and monitoring, has stable control of his diabetes using insulin, and is...

  12. Burden of type 2 diabetes mellitus in Brazil.

    PubMed

    Costa, Amine Farias; Flor, Luísa Sorio; Campos, Mônica Rodrigues; Oliveira, Andreia Ferreira de; Costa, Maria de Fátima Dos Santos; Silva, Raulino Sabino da; Lobato, Luiz Cláudio da Paixão; Schramm, Joyce Mendes de Andrade

    2017-03-30

    Type 2 diabetes mellitus currently ranks high among indicators used in Global Burden of Disease Studies. The current study estimated the burden of disease attributable to type 2 diabetes mellitus and its chronic complications in Brazil, 2008. We calculated disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) stratified by gender, age bracket, and major geographic region. Type 2 diabetes mellitus accounted for 5% of the burden of disease in Brazil, ranking 3rd in women and 6th in men in the composition of DALYs. The largest share of DALYs was concentrated in the 30-59-year age bracket and consisted mainly of YLDs. The highest YLL and YLD rates were in the Northeast and South of Brazil, respectively. Chronic complications represented 80% of YLDs from type 2 diabetes mellitus. Type 2 diabetes mellitus ranked as a leading health problem in Brazil in 2008, accounting for relevant shares of mortality and morbidity.

  13. [Advances in arterial hypertension and diabetes mellitus].

    PubMed

    Cordero, Alberto; Lekuona, Iñaki; Galve, Enrique; Mazón, Pilar

    2012-01-01

    In 2011, the importance of hypertension and diabetes mellitus as the two main risk factors responsible for the development of cardiovascular disease became clear, as did their significance as major public health issues. Compared with previous years, in which publication of the results of large clinical trials dominated scientific progress, in the last year, the focus has shifted to evidence that novel mechanisms associated with blood pressure, glucose metabolism and diabetes can influence cardiovascular disease. Of particular importance were clinical trials in the area of renal dysfunction, such as the SHARP and ROADMAP trials. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  14. Chromium picolinate supplementation for diabetes mellitus.

    PubMed

    Fox, G N; Sabovic, Z

    1998-01-01

    Chromium picolinate is a widely available nutritional supplement marketed for a plethora of afflictions. There is some evidence, including results from human studies, that it has a role in glucose homeostasis. We report the case of a 28-year-old woman with an 18-year history of type 1 diabetes mellitus whose glycosylated hemoglobin (Hb A1c) declined from 11.3% to 7.9% 3 months after initiation of chromium picolinate, 200 micrograms 3 times daily. Chromium picolinate continues to fall squarely within the scope of "alternative medicine," with both unproven benefits and unknown risks. It deserves closer scrutiny with additional prospective, randomized, double-blind, placebo-controlled trials to evaluate its efficacy in improving outcomes in patients with diabetes. A brief review of the literature was done to assist physicians who are being called upon to counsel and treat patients who are engaging in alternative therapies.

  15. [McCune-Albright syndrome associated with diabetes mellitus].

    PubMed

    Chihaoui, M; Hamza, N; Lamine, F; Jabeur, S; Yazidi, M; Ftouhi, B; Slimane, H

    2012-03-01

    McCune-Albright syndrome (MAS) consists of the triad of polyostotic fibrous dysplasia, cutaneous pigmentation, and multiple endocrine abnormalities. Type 1 diabetes mellitus is not included in MAS. We report the case of an 18-year-old girl who presented with McCune-Albright syndrome. The diagnosis was made by the presence of precocious puberty at the age of 6 years, cutaneous pigmentation, polyostotic fibrous dysplasia, and phosphate diabetes. Type 1 diabetes mellitus developed at the age of 16 years. We discuss this case, the relationship between type 1 diabetes mellitus and MAS, with a literature review.

  16. Teenage pregnancy in type 1 diabetes mellitus.

    PubMed

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

    2010-03-01

    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.

  17. Diabetes Mellitus Associated with Epidemic of Infectious Hepatitis in Nigeria

    PubMed Central

    Adi, F. C.

    1974-01-01

    This report concerns nine cases of diabetes mellitus associated with infectious hepatitis, an epidemic of which swept through eastern Nigeria between 1970 and 1972. All the patients showed the classical symptoms and signs of diabetes. They quickly responded to treatment, and after a few months the diabetes completely disappeared. Corticosteroid-glucose tolerance tests in four patients 12 to 30 months after the remission of their diabetes were normal. Contact with the remaining five patients had been lost a few months after clinical remission of their diabetes. The infectious hepatitis virus may have damaged pancreatic islet cells to cause an acute remittant form of diabetes mellitus. PMID:4811847

  18. Mitochondrial Plasticity in Obesity and Diabetes Mellitus

    PubMed Central

    Jelenik, Tomas

    2013-01-01

    Abstract Significance: Insulin resistance and its related diseases, obesity and type 2 diabetes mellitus (T2DM), have been linked to changes in aerobic metabolism, pointing to a possible role of mitochondria in the development of insulin resistance. Recent Advances: Refined methodology of ex vivo high-resolution respirometry and in vivo magnetic resonance spectroscopy now allows describing several features of mitochondria in humans. In addition to measuring mitochondrial function at baseline and after exercise-induced submaximal energy depletion, the response of mitochondria to endocrine and metabolic challenges, termed mitochondrial plasticity, can be assessed using hyperinsulinemic clamp tests. While insulin resistant states do not uniformly relate to baseline and post-exercise mitochondrial function, mitochondrial plasticity is typically impaired in insulin resistant relatives of T2DM, in overt T2DM and even in type 1 diabetes mellitus (T1DM). Critical Issues: The variability of baseline mitochondrial function in the main target tissue of insulin action, skeletal muscle and liver, may be attributed to inherited and acquired changes in either mitochondrial quantity or quality. In addition to certain gene polymorphisms and aging, circulating glucose and lipid concentrations correlate with both mitochondrial function and plasticity. Future Directions: Despite the associations between features of mitochondrial function and insulin sensitivity, the question of a causal relationship between compromised mitochondrial plasticity and insulin resistance in the development of obesity and T2DM remains to be resolved. Antioxid. Redox Signal. 19, 258–268. PMID:22938510

  19. [Hypoglycemia in the elderly with diabetes mellitus].

    PubMed

    Avila-Fematt, Flor M G; Montaña-Alvarez, Mariano

    2010-01-01

    Aging is associated with an increasing prevalence of chronic diseases, including type 2 diabetes mellitus and its chronic and acute complications. With changes observed in diabetes mellitus treatment goals and the lower levels of glycosylated hemoglobin recommended, the prevalence of hypoglycemia especially in patients treated with insulin has increased. Aging and changes in the physiologic reserves generate a decreased perception of symptoms associated with hypoglycemia, increasing the risk of unawareness or severe episodes. Traditionally, age was a risk factor for hypoglycemia, but in the population over 60 years, multiple comorbidities like chronic heart failure, malnutrition and renal failure are associated with increased risk of developing this acute complication. It is necessary to train doctors and nurses from all levels of care to recognize the specific clinical manifestation of low blood glucose that allow early detection and treatment, because this complication is associated with an increased hospital and 1-year after discharge mortality, with falls and cognitive impairment that directly affect the independence and functionality of older persons.

  20. Carnitine deficiency in diabetes mellitus complications.

    PubMed

    Tamamoğullari, N; Siliğ, Y; Içağasioğlu, S; Atalay, A

    1999-01-01

    In this study, the serum total, free and ester carnitine levels in 24 type II diabetes mellitus (DM) patients with complications and 15 type II DM patients with no complications were investigated. The patients were investigated in four groups; the control group included the patients with no complications (group 1), the groups including the patients with retinopathy (group 2), hyperlipidemia (group 3), and neuropathy (group 4). In addition, patients were grouped into two. The first group included 10 patients who took insulin by injection (group 5), and the second group included 29 patients using antidiabetic drugs orally (OAD) (group 6). Free and ester carnitine levels were determined by using Boehringer Manheim UV-enzymatic L-carnitine kit. Statistical analysis results showed that both the plasma total and free carnitine levels of groups 2, 3, and 4 were found to be low when compared to the levels of group 1 (p < 0.05). It was observed that the plasma total and free carnitine levels of group 5 were lower when compared to group 6. No significant difference was observed between the plasma ester carnitine levels of all the groups investigated. As a result of this study, it has been thought that carnitine plays an important role in diabetes mellitus complications.

  1. Peptide Vaccines for Hypertension and Diabetes Mellitus.

    PubMed

    Nakagami, Hironori; Koriyama, Hiroshi; Morishita, Ryuichi

    2014-11-26

    Vaccines are commonly used as a preventive medicine for infectious diseases worldwide; however, the trial for an amyloid beta vaccine against Alzheimer's disease will open a new concept in vaccination. In case of therapeutic vaccines for cancer, their targets are usually specific antigens in cancer cells, allowing activated cytotoxic T cells (CTLs) to attach and remove the antigen-presenting cancer cells. In our therapeutic vaccines against hypertension, the target is angiotensin II (Ang II) and induced anti-Ang II antibodies could efficiently ameliorate high blood pressure. Similarly, we developed the therapeutic vaccine against DPP4 for diabetes mellitus. However, because Ang II or DPP4 is an endogenous hormone, we must avoid autoimmune disease induced by these vaccines. Therefore, our system was used to design a therapeutic vaccine that elicits anti-Ang II or DPP4 antibodies without CTL activation against Ang II or DPP4. In this review, we will describe our concept of therapeutic vaccines for hypertension and diabetes mellitus.

  2. Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile

    PubMed Central

    Guerrero-Núñez, Sara; Valenzuela-Suazo, Sandra; Cid-Henríquez, Patricia

    2017-01-01

    ABSTRACT Objective: determine the prevalence of Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile and its relation with the variables: Health Care Coverage of Diabetes Mellitus Type 2; Average of diabetics with metabolic control in 2011-2013; Mortality Rate for Diabetes Mellitus; and Percentage of nurses participating in the Cardiovascular Health Program. Method: cross-sectional descriptive study with ecological components that uses documentary sources of the Ministry of Health. It was established that there is correlation between the Universal Effective Coverage of Diabetes Mellitus Type 2 and the independent variables; it was applied the Pearson Coefficient, being significant at the 0.05 level. Results: in Chile Universal Health Care Coverage of Diabetes Mellitus Type 2 (HbA1c<7% estimated population) is less than 20%; this is related with Mortality Rate for Diabetes Mellitus and Percentage of nurses participating in the Cardiovascular Health Program, being significant at the 0.01 level. Conclusion: effective prevalence of Universal Health Coverage of Diabetes Mellitus Type 2 is low, even though some regions stand out in this research and in the metabolic control of patients who participate in health control program; its relation with percentage of nurses participating in the Cardiovascular Health Program represents a challenge and an opportunity for the health system. PMID:28403339

  3. Influence of diabetes mellitus on mortality in breast cancer patients.

    PubMed

    Zhou, Yunhai; Zhang, Xiang; Gu, Chen; Xia, Jiazeng

    2015-12-01

    Breast cancer is one of the most common malignant tumours among women worldwide. Besides, diabetes mellitus is also a major health problem in developed countries. This study explores the association between diabetes mellitus and breast cancer patients' survival outcomes. A systematic literature search in Embase (http://www.embase.com) and MEDLINE (http://www.ncbi.nlm.nih.gov/pubmed) was conducted from January 1960 to April 2014 and systematically identified clinical studies that evaluated the association between breast cancer mortality and diabetes mellitus. Clinical studies investigating the association between diabetes mellitus and breast cancer patients' survival outcomes were included. Twenty publications were chosen for the meta-analysis, of which 16 studies had all-cause mortality data and 12 studies had breast cancer mortality data. Published from 2001 to 2013, all 20 studies followed a total of 2,645,249 patients including more than 207,832 diabetic patients. Pre-existing diabetes mellitus was associated with a 37% increased risk for all-cause mortality in women with breast cancer (hazard ratio (HR) = 1.37; 95% confidence interval (CI): 1.34-1.41; P = 0.02). Diabetes mellitus was associated with a 17% increased risk for breast cancer mortality in women with breast cancer (HR = 1.17; 95% CI: 1.11-1.22; P < 0.01). Women with diabetes mellitus are at higher risk of breast cancer-specific and all-cause mortality after initial breast cancer diagnosis. © 2014 Royal Australasian College of Surgeons.

  4. Plasma vasopressin in uncontrolled diabetes mellitus.

    PubMed

    Zerbe, R L; Vinicor, F; Robertson, G L

    1979-05-01

    Concentrations of the antidiuretic hormone, arginine vasopressin, were measured in 28 patients with severe hyperglycemia to determine if abnormalities in hormonal regulation of water excretion could contribute to the extreme dehydration of uncontrolled diabetes mellitus. Vasopressin levels were markedly elevated in both nonketotic and ketotic patients, indicating that vasopressin deficiency plays no role in the polyuria that accompanies hyperglycemia. Instead, the observed increases in vasopressin represent an ineffective effort to conserve water in the face of an overwhelming solute diuresis caused by the glucosuria. The reasons for such marked elevations in plasma vasopressin in these diabetic patients are multifactorial. Both groups of diabetic patients had evidence of hypovolemia, which was sufficient in magnitude to stimulate vasopressin release. Furthermore, nausea provided an independent stimulus to vasopressin secretion in many patients. Osmotic stimulation might have resulted from the large fraction of unidentified plasma solutes, but this factor alone was not sufficient to explain the markedly increased concentrations of vasopressin. Whether such elevations in vasopressin could have metabolic and/or hemodynamic effects in uncrontrolled diabetes remains to be established.

  5. Insulin management of type 2 diabetes mellitus.

    PubMed

    Petznick, Allison

    2011-07-15

    Insulin therapy is recommended for patients with type 2 diabetes mellitus and an initial A1C level greater than 9 percent, or if diabetes is uncontrolled despite optimal oral glycemic therapy. Insulin therapy may be initiated as augmentation, starting at 0.3 unit per kg, or as replacement, starting at 0.6 to 1.0 unit per kg. When using replacement therapy, 50 percent of the total daily insulin dose is given as basal, and 50 percent as bolus, divided up before breakfast, lunch, and dinner. Augmentation therapy can include basal or bolus insulin. Replacement therapy includes basal-bolus insulin and correction or premixed insulin. Glucose control, adverse effects, cost, adherence, and quality of life need to be considered when choosing therapy. Metformin should be continued if possible because it is proven to reduce all-cause mortality and cardiovascular events in overweight patients with diabetes. In a study comparing premixed, bolus, and basal insulin, hypoglycemia was more common with premixed and bolus insulin, and weight gain was more common with bolus insulin. Titration of insulin over time is critical to improving glycemic control and preventing diabetes-related complications.

  6. AGE restriction in diabetes mellitus: a paradigm shift.

    PubMed

    Vlassara, Helen; Striker, Gary E

    2011-05-24

    Persistently elevated oxidative stress and inflammation precede or occur during the development of type 1 or type 2 diabetes mellitus and precipitate devastating complications. Given the rapidly increasing incidence of diabetes mellitus and obesity in the space of a few decades, new genetic mutations are unlikely to be the cause, instead pointing to environmental initiators. A hallmark of contemporary culture is a preference for thermally processed foods, replete with pro-oxidant advanced glycation endproducts (AGEs). These molecules are appetite-increasing and, thus, efficient enhancers of overnutrition (which promotes obesity) and oxidant overload (which promotes inflammation). Studies of genetic and nongenetic animal models of diabetes mellitus suggest that suppression of host defenses, under sustained pressure from food-derived AGEs, may potentially shift homeostasis towards a higher basal level of oxidative stress, inflammation and injury of both insulin-producing and insulin-responsive cells. This sequence promotes both types of diabetes mellitus. Reducing basal oxidative stress by AGE restriction in mice, without energy or nutrient change, reinstates host defenses, alleviates inflammation, prevents diabetes mellitus, vascular and renal complications and extends normal lifespan. Studies in healthy humans and in those with diabetes mellitus show that consumption of high amounts of food-related AGEs is a determinant of insulin resistance and inflammation and that AGE restriction improves both. This Review focuses on AGEs as novel initiators of oxidative stress that precedes, rather than results from, diabetes mellitus. Therapeutic gains from AGE restriction constitute a paradigm shift.

  7. AGE restriction in diabetes mellitus: a paradigm shift

    PubMed Central

    Vlassara, Helen; Striker, Gary E.

    2013-01-01

    Persistently elevated oxidative stress and inflammation precede or occur during the development of type 1 or type 2 diabetes mellitus and precipitate devastating complications. Given the rapidly increasing incidence of diabetes mellitus and obesity in the space of a few decades, new genetic mutations are unlikely to be the cause, instead pointing to environmental initiators. A hallmark of contemporary culture is a preference for thermally processed foods, replete with pro-oxidant advanced glycation endproducts (AGEs). These molecules are appetite-increasing and, thus, efficient enhancers of overnutrition (which promotes obesity) and oxidant overload (which promotes inflammation). Studies of genetic and nongenetic animal models of diabetes mellitus suggest that suppression of host defenses, under sustained pressure from food-derived AGEs, may potentially shift homeostasis towards a higher basal level of oxidative stress, inflammation and injury of both insulin-producing and insulin-responsive cells. This sequence promotes both types of diabetes mellitus. Reducing basal oxidative stress by AGE restriction in mice, without energy or nutrient change, reinstates host defenses, alleviates inflammation, prevents diabetes mellitus, vascular and renal complications and extends normal lifespan. Studies in healthy humans and in those with diabetes mellitus show that consumption of high amounts of food-related AGEs is a determinant of insulin resistance and inflammation and that AGE restriction improves both. This Review focuses on AGEs as novel initiators of oxidative stress that precedes, rather than results from, diabetes mellitus. Therapeutic gains from AGE restriction constitute a paradigm shift. PMID:21610689

  8. Risk Related to Pre–Diabetes Mellitus and Diabetes Mellitus in Heart Failure With Reduced Ejection Fraction

    PubMed Central

    Kristensen, Søren L.; Preiss, David; Jhund, Pardeep S.; Squire, Iain; Cardoso, José Silva; Merkely, Bela; Martinez, Felipe; Starling, Randall C.; Desai, Akshay S.; Lefkowitz, Martin P.; Rizkala, Adel R.; Rouleau, Jean L.; Shi, Victor C.; Solomon, Scott D.; Swedberg, Karl; Zile, Michael R.; Packer, Milton

    2016-01-01

    Background— The prevalence of pre–diabetes mellitus and its consequences in patients with heart failure and reduced ejection fraction are not known. We investigated these in the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial. Methods and Results— We examined clinical outcomes in 8399 patients with heart failure and reduced ejection fraction according to history of diabetes mellitus and glycemic status (baseline hemoglobin A1c [HbA1c]: <6.0% [<42 mmol/mol], 6.0%–6.4% [42–47 mmol/mol; pre–diabetes mellitus], and ≥6.5% [≥48 mmol/mol; diabetes mellitus]), in Cox regression models adjusted for known predictors of poor outcome. Patients with a history of diabetes mellitus (n=2907 [35%]) had a higher risk of the primary composite outcome of heart failure hospitalization or cardiovascular mortality compared with those without a history of diabetes mellitus: adjusted hazard ratio, 1.38; 95% confidence interval, 1.25 to 1.52; P<0.001. HbA1c measurement showed that an additional 1106 (13% of total) patients had undiagnosed diabetes mellitus and 2103 (25%) had pre–diabetes mellitus. The hazard ratio for patients with undiagnosed diabetes mellitus (HbA1c, >6.5%) and known diabetes mellitus compared with those with HbA1c<6.0% was 1.39 (1.17–1.64); P<0.001 and 1.64 (1.43–1.87); P<0.001, respectively. Patients with pre–diabetes mellitus were also at higher risk (hazard ratio, 1.27 [1.10–1.47]; P<0.001) compared with those with HbA1c<6.0%. The benefit of LCZ696 (sacubitril/valsartan) compared with enalapril was consistent across the range of HbA1c in the trial. Conclusions— In patients with heart failure and reduced ejection fraction, dysglycemia is common and pre–diabetes mellitus is associated with a higher risk of adverse cardiovascular outcomes (compared with patients with no diabetes mellitus and HbA1c <6.0%). LCZ696 was beneficial compared with enalapril

  9. ATP-dependent potassium channels and type 2 diabetes mellitus.

    PubMed

    Bonfanti, Dianne Heloisa; Alcazar, Larissa Pontes; Arakaki, Priscila Akemi; Martins, Laysa Toschi; Agustini, Bruna Carla; de Moraes Rego, Fabiane Gomes; Frigeri, Henrique Ravanhol

    2015-05-01

    Diabetes mellitus is a public health problem, which affects a millions worldwide. Most diabetes cases are classified as type 2 diabetes mellitus, which is highly associated with obesity. Type 2 diabetes is considered a multifactorial disorder, with both environmental and genetic factors contributing to its development. An important issue linked with diabetes development is the failure of the insulin releasing mechanism involving abnormal activity of the ATP-dependent potassium channel, KATP. This channel is a transmembrane protein encoded by the KCNJ11 and ABCC8 genes. Furthermore, polymorphisms in these genes have been linked to type 2 diabetes because of the role of KATP in insulin release. While several genetic variations have been reported to be associated with this disease, the E23K polymorphism is most commonly associated with this pathology, as well as to obesity. Here, we review the molecular genetics of the potassium channel and discusses its most described polymorphisms and their associations with type 2 diabetes mellitus.

  10. Gestational diabetes mellitus: Non-insulin management

    PubMed Central

    Magon, Navneet; Seshiah, V.

    2011-01-01

    Gestational diabetes mellitus (GDM) complicates a substantial number of pregnancies. There is consensus that in patients of GDM, excellent blood glucose control, with diet and, when necessary, oral hypoglycemics and insulin results in improved perinatal outcomes, and appreciably reduces the probability of serious neonatal morbidity compared with routine prenatal care. Goals of metabolic management of a pregnancy complicated with GDM have to balance the needs of a healthy pregnancy with the requirements to control glucose level. Medical nutrition therapy is the cornerstone of therapy for women with GDM. Surveillance with daily self-monitoring of blood glucose has been found to help guide management in a much better way than blood glucose checking in labs and clinics, which tends to be less frequent. Historically, insulin has been the therapeutic agent of choice for controlling hyperglycemia in pregnant women. However, difficulty in medication administration with multiple daily injections, potential for hypoglycemia, and increase in appetite and weight make this therapeutic option cumbersome for many pregnant patients. Use of oral hypogycemic agents (OHAs) in pregnancy has opened new vistas for GDM management. At present, there is a growing acceptance of glyburide (glibenclamide) use as the primary therapy for GDM. Glyburide and metformin have been found to be safe, effective and economical for the treatment of gestational diabetes. Insulin, however, still has an important role to play in GDM. GDM is a window of opportunity, which needs to be seized, for prevention of diabetes in future life. Goal of our educational programs should be not only to improve pregnancy outcomes but also to promote healthy lifestyle changes for the mother that will last long after delivery. Team effort on part of obstetricians and endocrinologists is required to make “the diabetes capital of the world” into “the diabetes care capital of the world”. PMID:22028999

  11. Diabetes mellitus related bone metabolism and periodontal disease

    PubMed Central

    Wu, Ying-Ying; Xiao, E; Graves, Dana T

    2015-01-01

    Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts. PMID:25857702

  12. Diabetes mellitus related bone metabolism and periodontal disease.

    PubMed

    Wu, Ying-Ying; Xiao, E; Graves, Dana T

    2015-06-26

    Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts.

  13. [Diabetes and rheumatism: is diabetes mellitus also an inflammatory disease?].

    PubMed

    Graf, S; Schumm-Draeger, P-M

    2011-11-01

    New studies have demonstrated similarities in the complex pathomechanisms of diabetes mellitus type 1 (T₁D) and rheumatic diseases and in particular rheumatoid arthritis (RA). Common HLA gene complex characteristics and polymorphisms of inflammatory cytokines, such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) play a special role in both disorders. The metabolic syndrome, associated with insulin resistance and diabetes mellitus type 2 (T₂D), often shows criteria of a subclinical chronic inflammation. New forms of therapy with monoclonal antibodies against TNF-α, IL-1 and IL-6 have improved the management of patients with RA. Cytokine-induced inflammation also seems to be important in the pathogenesis and progression of T₁D and T₂D. Whether a therapy with the same monoclonal antibodies established in RA could also be successful in diabetes still has to be investigated in further studies. Both RA and T₁D are autoimmune disorders and show a cumulative incidence with further autoimmune diseases.

  14. Preventive pharmacotherapy in type 2 diabetes mellitus

    PubMed Central

    Choudhary, Neeraj; Kalra, Sanjay; Unnikrishnan, Ambika Gopalkrishnan; Ajish, T. P.

    2012-01-01

    Over the last few decades certain demographic changes have been observed worldwide, which have led to an increase in the prevalence of chronic non-communicable diseases. Type 2 diabetes mellitus and associated cardiovascular disease are major contributors to this disease burden leading to rising morbidity and mortality. It is worrisome to see that type 2 diabetes with its micro- and macrovascular complications is occurring in younger populations where it was hitherto unseen. Prevention appears to be an important strategy to reduce the burden of disease. Along with inculcating healthy lifestyle habits across populations, it may be suitable to use preventive pharmacotherapy in those with pre-diabetes and / or other risk factors like obesity, hypertension, and on the like. Metformin, alpha glucosidase inhibitors like acarbose, miglitol, and voglibose, and pioglitazone have all been used with success. The issues of compliance and adverse effects during long-term use have tempered the use of these drugs. The best approach would be to motivate the patient for effective lifestyle changes, and pharmacological management if the lifestyle changes are not successful in achieving their goals. PMID:22276251

  15. Diabetes mellitus and white matter hyperintensity.

    PubMed

    Tamura, Yoshiaki; Araki, Atsushi

    2015-12-01

    White matter hyperintensity (WMH) is a brain lesion detected as a high-intensity area in magnetic resonance imaging T2 and fluid-attenuated inversion recovery images, and it has been suggested that WMH reflects damage to small vessels in periventricular and subcortical areas. Although WMH has been linked to the incidence of stroke, more recently it has been clarified that WMH is also associated with progression of cognitive decline and functional disability, which are components of so-called geriatric syndrome. In addition to hypertension, which is the classical risk factor for WMH, evidence has been accumulating to suggest that diabetes mellitus could also be associated with WMH progression, and some studies have shown that WMH severity is correlated with cognitive decline in patients with diabetes. The factors that accelerate WMH formation in elderly patients with diabetes remain poorly defined. It is considered that insulin resistance is an exacerbating factor, but the effects of hypertension, dyslipidemia or other vascular risk factors have yet be clarified, and further studies are required.

  16. Preventive pharmacotherapy in type 2 diabetes mellitus.

    PubMed

    Choudhary, Neeraj; Kalra, Sanjay; Unnikrishnan, Ambika Gopalkrishnan; Ajish, T P

    2012-01-01

    Over the last few decades certain demographic changes have been observed worldwide, which have led to an increase in the prevalence of chronic non-communicable diseases. Type 2 diabetes mellitus and associated cardiovascular disease are major contributors to this disease burden leading to rising morbidity and mortality. It is worrisome to see that type 2 diabetes with its micro- and macrovascular complications is occurring in younger populations where it was hitherto unseen. Prevention appears to be an important strategy to reduce the burden of disease. Along with inculcating healthy lifestyle habits across populations, it may be suitable to use preventive pharmacotherapy in those with pre-diabetes and / or other risk factors like obesity, hypertension, and on the like. Metformin, alpha glucosidase inhibitors like acarbose, miglitol, and voglibose, and pioglitazone have all been used with success. The issues of compliance and adverse effects during long-term use have tempered the use of these drugs. The best approach would be to motivate the patient for effective lifestyle changes, and pharmacological management if the lifestyle changes are not successful in achieving their goals.

  17. Prevention of type 2 diabetes mellitus in women with previous gestational diabetes mellitus.

    PubMed

    Moon, Joon Ho; Kwak, Soo Heon; Jang, Hak C

    2017-01-01

    Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.

  18. Prevention of type 2 diabetes mellitus in women with previous gestational diabetes mellitus

    PubMed Central

    Moon, Joon Ho; Kwak, Soo Heon; Jang, Hak C.

    2017-01-01

    Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes. PMID:28049284

  19. 78 FR 65754 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... the current requirement for diabetes in 1970 because several risk studies indicated that drivers with... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...

  20. 76 FR 37171 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from twenty-four individuals and requested comments from the public (76...

  1. 78 FR 56988 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-16

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the prohibition against persons with insulin-treated diabetes mellitus (ITDM) operating... such an exemption from the diabetes prohibition in 49 CFR 391.41(b)(3), which applies to drivers...

  2. 75 FR 27616 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from fifty-three individuals and requested comments from the public (75...

  3. 76 FR 72031 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... with insulin-treated diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in interstate... from the diabetes prohibition in 49 CFR 391.41(b) (3), which applies to drivers of CMVs in...

  4. 76 FR 37882 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes exemption applications from twenty-one individuals and requested comments from the public (76...

  5. 78 FR 64267 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... individuals for exemptions from the prohibition against persons with insulin- treated diabetes mellitus (ITDM... recently requested such an exemption from the diabetes prohibition in 49 CFR 391.41(b)(3), which applies...

  6. 78 FR 65034 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemptions from the prohibition against persons with insulin- treated diabetes mellitus (ITDM) operating... such an exemption from the diabetes prohibition in 49 CFR 391.41(b)(3), which applies to drivers...

  7. 76 FR 53707 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-29

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... diabetes ] exemption applications from twenty-two individuals and requested comments from the public (76...

  8. Type 2 diabetes mellitus: An unusual association with Down's syndrome

    PubMed Central

    Kota, Sunil Kumar; Tripathy, Prabhas Ranjan; Kota, Siva Krishna; Jammula, Sruti

    2013-01-01

    Down's syndrome (DS) is known to be associated with autoimmune disease including type 1 diabetes. To the best of our knowledge, there are no reports of DS with type 2 diabetes mellitus in the literature. We hereby report two cases of DS with type 2 diabetes. PMID:24339554

  9. Type 2 diabetes mellitus: An unusual association with Down's syndrome.

    PubMed

    Kota, Sunil Kumar; Tripathy, Prabhas Ranjan; Kota, Siva Krishna; Jammula, Sruti

    2013-07-01

    Down's syndrome (DS) is known to be associated with autoimmune disease including type 1 diabetes. To the best of our knowledge, there are no reports of DS with type 2 diabetes mellitus in the literature. We hereby report two cases of DS with type 2 diabetes.

  10. Iliopsoas abscess in adolescents with type 1 diabetes mellitus

    PubMed Central

    Maines, Evelina; Franceschi, Roberto; Cauvin, Vittoria; d’Annunzio, Giuseppe; Pini Prato, Alessio; Castagnola, Elio; Di Palma, Annunziata

    2015-01-01

    Key Clinical Message Iliopsoas abscesses have been reported in adult diabetic patients, but only one case has been so far reported in the pediatric diabetic literature. We report three cases of iliopsoas abscesses in three adolescents with type 1 diabetes mellitus, suggesting that an increased awareness of this condition is required for its early recognition and prompt treatment. PMID:26273460

  11. 78 FR 37272 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-20

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF... because several risk studies indicated that drivers with diabetes had a higher rate of crash involvement... willingness to properly monitor and manage his/her diabetes mellitus, received education related to diabetes...

  12. 77 FR 10607 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION... that drivers with diabetes had a higher rate of crash involvement than the general population. The... manage his/her diabetes mellitus, received education related to diabetes management, and is on a stable...

  13. 77 FR 70529 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION... crash involvement than the general population. The diabetes rule provides that ``A person is physically... willingness to properly monitor and manage his/her diabetes mellitus, received education related to diabetes...

  14. 76 FR 22940 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION... risk studies indicated that drivers with diabetes had a higher rate of crash involvement than the... properly monitor and manage his/her diabetes mellitus, received education related to diabetes management...

  15. 78 FR 60014 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION... ] rate of crash involvement than the general population. The diabetes rule provides that ``A person is... willingness to properly monitor and manage his/her diabetes mellitus, received education related to diabetes...

  16. 78 FR 63295 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... individuals for exemptions from the prohibition against persons with insulin- treated diabetes mellitus (ITDM... management and monitoring, has stable control of his diabetes using insulin, and is able to drive a CMV... monitoring, has stable control of his diabetes using insulin, and is able to drive a CMV safely. Mr....

  17. Clinical peripheral neuropathy associated with diabetes mellitus in 3 dogs.

    PubMed

    Morgan, Megan J; Vite, Charles H; Radhakrishnan, Anant; Hess, Rebecka S

    2008-06-01

    Clinical and electrodiagnostic findings in 3 spontaneously diabetic dogs with clinical peripheral neuropathy (PN) are reported. Clinical signs of a PN may develop in diabetic dogs with adequate glycemic control. In addition, laryngeal paralysis may develop in association with diabetes mellitus in dogs with clinical PN.

  18. Diabetes mellitus, diabetes insipidus, optic atrophy, and deafness: A case of Wolfram (DIDMOAD) syndrome.

    PubMed

    Maleki, Nasrollah; Bashardoust, Bahman; Zakeri, Anahita; Salehifar, Azita; Tavosi, Zahra

    2015-01-01

    To report a case of Wolfram syndrome (WS) characterized by diabetes mellitus, diabetes insipidus, progressive optic atrophy, and deafness. A 19-year-old female patient, a known case of diabetes mellitus type I from six years before, presented with progressive vision loss since four years earlier. On fundoscopic examination, she had bilateral optic atrophy without diabetic retinopathy. The patient also had diabetes insipidus, neurosensory deafness, and neurogenic bladder. WS should be considered a differential diagnosis in patients with diabetes mellitus who present with optic atrophy, and it is necessary to perform a hearing test as well as collecting 24-h urine output.

  19. [Testosterone deficiency, metabolic syndrome and diabetes mellitus].

    PubMed

    Fernández-Miró, Mercè; Chillarón, Juan J; Pedro-Botet, Juan

    2016-01-15

    Testosterone deficiency in adult age is associated with a decrease in libido, energy, hematocrit, muscle mass and bone mineral density, as well as with depression. More recently, testosterone deficiency has also been associated with various components of the metabolic syndrome, which in turn is associated with a five-fold increase in the risk of cardiovascular disease. Low testosterone levels are associated with increased insulin resistance, increase in fat mass, low HDL cholesterol, higher triglyceride levels and hypertension. Testosterone replacement therapy in patients with testosterone deficiency and type 2 diabetes mellitus and/or metabolic syndrome has shown reductions in insulin resistance, total cholesterol, LDL cholesterol and triglycerides and improvement in glycemic control and anthropometric parameters.

  20. Traumatic injuries in patients with diabetes mellitus

    PubMed Central

    El-Menyar, Ayman; Mekkodathil, Ahammed; Al-Thani, Hassan

    2016-01-01

    Diabetes mellitus (DM) is associated with increased in-hospital morbidity and mortality in patients sustained traumatic injuries. Identification of risk factors of traumatic injuries that lead to hospital admissions and death in DM patients is crucial to set effective preventive strategies. We aimed to conduct a traditional narrative literature review to describe the role of hypoglycemia as a risk factor of driving and fall-related traumatic injuries. DM poses significant burden as a risk factor and predictor of worse outcomes in traumatic injuries. Although there is no consensus on the impact and clear hazards of hyperglycemia in comparison to the hypoglycemia, both extremes of DM need to be carefully addressed and taken into consideration for proper management. Moreover, physicians, patients, and concerned authorities should be aware of all these potential hazards to share and establish the right management plans. PMID:27162438

  1. Stem cell therapy for diabetes mellitus

    PubMed Central

    Voltarelli, Júlio C; Couri, Carlos E B; Oliveira, Maria C; Moraes, Daniela A; Stracieri, Ana B P L; Pieroni, Fabiano; Barros, George M N; Malmegrim, Kelen C R; Simões, Belinda P; Leal, Angela M O; Foss, Milton C

    2011-01-01

    In this review, we present (1) a brief discussion of hematopoietic stem cell transplantation (HSCT) for severe and refractory autoimmune diseases (AIDs) from its beginning in 1996 through recently initiated prospective randomized clinical trials; (2) an update (up to July 2009) of clinical and laboratory outcomes of 23 patients with newly diagnosed type 1 diabetes mellitus (T1DM), who underwent autologous HSCT at the Bone Marrow Transplantation Unit of the Ribeirão Preto Medical School, University of São Paulo, Brazil; (3) a discussion of possible mechanisms of action of HSCT in AIDs, including preliminary laboratory data obtained from our patients; and (4) a discussion of future perspectives of stem cell therapy for T1DM and type 2 DM, including the use of stem cell sources other than adult bone marrow and the combination of cell therapy with regenerative compounds. PMID:25018908

  2. Biofluid proteases profiling in diabetes mellitus.

    PubMed

    Trindade, Fábio; Ferreira, Rita; Amado, Francisco; Vitorino, Rui

    2015-01-01

    The investigation of protease relevance in biologic systems beyond catabolism of proteins and peptides to amino acids has stimulated interest as to their role in the pathogenesis of several disorders including diabetes mellitus (DM). Evaluation of proteases and the assessment of their activity in biofluids are fundamental to elucidate these proteolytic systems in DM and its related complications. In contrast to traditional immunoassay or substrate based approaches that targeted specific proteases and their inhibitors, the field of degradomics has provided a comprehensive approach to study these enzymes. Although the degradome contains over 500 proteases, very few have been associated with DM and its micro- and macrovascular complications. In this paper, we review these proteases and their respective inhibitors with emphasis on DM. It is likely that future research will expand these initial studies and look to develop high throughput automated technologies to identify and characterize biofluid proteases of diagnostic and prognostic value in other pathologies.

  3. Bone damage in type 2 diabetes mellitus.

    PubMed

    Carnevale, V; Romagnoli, E; D'Erasmo, L; D'Erasmo, E

    2014-11-01

    This review focuses on the mechanisms determining bone fragility in patients with type 2 diabetes mellitus (T2DM). Despite bone mineral density (BMD) is usually normal or more often increased in these patients, fracture incidence is high, probably because of altered bone "quality". The latter seems to depend on several, only partly elucidated, mechanisms, such as the increased skeletal content of advanced glycation end-products causing collagen deterioration, the altered differentiation of bone osteogenic cells, the altered bone turnover and micro-architecture. Disease duration, its severity and metabolic control, the type of therapy, the presence or absence of complications, as like as the other known predictors for falls, are all relevant contributing factors affecting fracture risk in T2DM. In these patients the estimate of fracture risk in the everyday clinical practice may be challenging, due to the lower predictive capacity of both BMD and risk factors-based algorithms (e.g. FRAX).

  4. [New therapies for type 2 diabetes mellitus].

    PubMed

    Puig-Domingo, Manuel; Pellitero, Silvia

    2015-06-22

    The increasing prevalence of obesity and type 2 diabetes mellitus (T2DM) has led to a growing interest in the investigation of new therapies. Treatment of T2DM has focused on the insulinopenia and insulin resistance. However, in the last 10 years, new lines of research have emerged for the treatment of T2DM and preclinical studies appear promising. The possibility of using these drugs in combination with other currently available drugs will enhance the antidiabetic effect and promote weight loss with fewer side effects. The data provided by post-marketing monitoring will help us to better understand their safety profile and potential long-term effects on target organs, especially the cardiovascular risk. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  5. Tuberculosis and diabetes mellitus: convergence of two epidemics.

    PubMed

    Dooley, Kelly E; Chaisson, Richard E

    2009-12-01

    The link between diabetes mellitus and tuberculosis has been recognised for centuries. In recent decades, tuberculosis incidence has declined in high-income countries, but incidence remains high in countries that have high rates of infection with HIV, high prevalence of malnutrition and crowded living conditions, or poor tuberculosis control infrastructure. At the same time, diabetes mellitus prevalence is soaring globally, fuelled by obesity. There is growing evidence that diabetes mellitus is an important risk factor for tuberculosis and might affect disease presentation and treatment response. Furthermore, tuberculosis might induce glucose intolerance and worsen glycaemic control in people with diabetes. We review the epidemiology of the tuberculosis and diabetes epidemics, and provide a synopsis of the evidence for the role of diabetes mellitus in susceptibility to, clinical presentation of, and response to treatment for tuberculosis. In addition, we review potential mechanisms by which diabetes mellitus can cause tuberculosis, the effects of tuberculosis on diabetic control, and pharmacokinetic issues related to the co-management of diabetes and tuberculosis.

  6. Diabetes Mellitus Coding Training for Family Practice Residents.

    PubMed

    Urse, Geraldine N

    2015-07-01

    Although physicians regularly use numeric coding systems such as the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to describe patient encounters, coding errors are common. One of the most complicated diagnoses to code is diabetes mellitus. The ICD-9-CM currently has 39 separate codes for diabetes mellitus; this number will be expanded to more than 50 with the introduction of ICD-10-CM in October 2015. To assess the effect of a 1-hour focused presentation on ICD-9-CM codes on diabetes mellitus coding. A 1-hour focused lecture on the correct use of diabetes mellitus codes for patient visits was presented to family practice residents at Doctors Hospital Family Practice in Columbus, Ohio. To assess resident knowledge of the topic, a pretest and posttest were given to residents before and after the lecture, respectively. Medical records of all patients with diabetes mellitus who were cared for at the hospital 6 weeks before and 6 weeks after the lecture were reviewed and compared for the use of diabetes mellitus ICD-9 codes. Eighteen residents attended the lecture and completed the pretest and posttest. The mean (SD) percentage of correct answers was 72.8% (17.1%) for the pretest and 84.4% (14.6%) for the posttest, for an improvement of 11.6 percentage points (P≤.035). The percentage of total available codes used did not substantially change from before to after the lecture, but the use of the generic ICD-9-CM code for diabetes mellitus type II controlled (250.00) declined (58 of 176 [33%] to 102 of 393 [26%]) and the use of other codes increased, indicating a greater variety in codes used after the focused lecture. After a focused lecture on diabetes mellitus coding, resident coding knowledge improved. Review of medical record data did not reveal an overall change in the number of diabetic codes used after the lecture but did reveal a greater variety in the codes used.

  7. Optimizing postpartum care for the patient with gestational diabetes mellitus.

    PubMed

    Martinez, Noelle G; Niznik, Charlotte M; Yee, Lynn M

    2017-09-01

    Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be <50%, with particularly low rates in Latina patients, as well as patients with public insurance, low education levels, and low health literacy. Data suggest our current health services infrastructure loses patients in the postpartum gap between pregnancy-focused care and primary care. Previous studies have suggested strategies to promote oral glucose tolerance testing completion to identify type 2 diabetes mellitus. Based on existing evidence, we propose best practices for the postpartum care of women with gestational diabetes mellitus: (1) enhanced patient support for identifying long-term health care providers, (2) patient-centered medical home utilization when possible, (3) patient and provider test reminders, and (4) formalized obstetrician-primary care provider hand offs using the Situation Background Assessment Recommendation (SBAR) mnemonic. These strategies deserve future investigation to solidify a multilevel approach for identifying and preventing the continuum of diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Metabolic syndrome and diabetes mellitus in childhood cancer survivors.

    PubMed

    Bizzarri, C; Bottaro, G; Pinto, R M; Cappa, M

    2014-06-01

    The survival of children with cancer has grown considerably in recent years resulting in a marked increase of endocrine complications. increasingly recognized problems are metabolic syndrome and diabetes mellitus. We critically analysed the most recent literature about the prevalence and molecular mechanisms of metabolic dysregulation and long-term cardio-metabolic risk in this population. Hypothalamic irradiation determines growth hormone deficiency and hypogonadism; moreover it is able to disrupt the appetite regulating centre leading to hyperphagia and progressive obesity. These conditions determine an insulin resistant state, contributing to the development of metabolic syndrome and diabetes mellitus. Irradiation and/or chemotherapy may lead to an insulin secretory defect through a direct damage of pancreatic beta cells. Metabolic syndrome and diabetes mellitus represent increasingly recognized long-term complications of childhood cancer treatment. The different impact of insulin resistance and secretory defects on the onset and progression of metabolic syndrome and diabetes mellitus remains unclear.

  9. Influence of diabetes mellitus on heart failure risk and outcome

    PubMed Central

    Bauters, Christophe; Lamblin, Nicolas; Mc Fadden, Eugène P; Van Belle, Eric; Millaire, Alain; de Groote, Pascal

    2003-01-01

    Our aim is to summarize and discuss the recent literature linking diabetes mellitus with heart failure, and to address the issue of the optimal treatment for diabetic patients with heart failure. The studies linking diabetes mellitus (DM) with heart failure (HF) The prevalence of diabetes mellitus in heart failure populations is close to 20% compared with 4 to 6% in control populations. Epidemiological studies have demonstrated an increased risk of heart failure in diabetics; moreover, in diabetic populations, poor glycemic control has been associated with an increased risk of heart failure. Various mechanisms may link diabetes mellitus to heart failure: firstly, associated comorbidities such as hypertension may play a role; secondly, diabetes accelerates the development of coronary atherosclerosis; thirdly, experimental and clinical studies support the existence of a specific diabetic cardiomyopathy related to microangiopathy, metabolic factors or myocardial fibrosis. Subgroup analyses of randomized trials demonstrate that diabetes is also an important prognostic factor in heart failure. In addition, it has been suggested that the deleterious impact of diabetes may be especially marked in patients with ischemic cardiomyopathy. Treatment of heart failure in diabetic patients The knowledge of the diabetic status may help to define the optimal therapeutic strategy for heart failure patients. Cornerstone treatments such as ACE inhibitors or beta-blockers appear to be uniformly beneficial in diabetic and non diabetic populations. However, in ischemic cardiomyopathy, the choice of the revascularization technique may differ according to diabetic status. Finally, clinical studies are needed to determine whether improved metabolic control might favorably influence the outcome of diabetic heart failure patients. PMID:12556246

  10. Mechanisms of current therapies for diabetes mellitus type 2

    PubMed Central

    2012-01-01

    The array of medications available for the treatment of hyperglycemia has increased rapidly in the previous decade, and recent investigations have clarified novel mechanisms underlying the antihyperglycemic efficacy of these drugs. This article reviews the mechanisms of action for medications currently approved to treat diabetes mellitus in the United States, with the exception of insulin and its analogs. Finally, it attempts to integrate these mechanisms into the schema of pathophysiological factors that combine to produce hyperglycemia in patients with diabetes mellitus. PMID:23209008

  11. Prevalence and determinants of diabetes mellitus in Puducherry, South India.

    PubMed

    Bharati, Dharamvir Ranjan; Pal, Ranabir; Kar, Sumit; Rekha, R; Yamuna, T V; Basu, Mausumi

    2011-10-01

    Diabetes mellitus is an emerging global health problem. It is a chronic, noncommunicable, and expensive public health disease. To determine the prevalence and the risk factors of type 2 diabetes mellitus among the adult population of Puducherry, South India. This was a population-based cross-sectional study carried out during 1(st) May 2007-30(th) November 2007 in the rural and urban field practice area of Mahatma Gandhi Medical College and Research Institute, Puducherry. Simple random sampling technique was used for the selection of 1370 adult 20 years of age and above. Main outcome measures were the assessment of the prevalence of prevalence and correlates of diabetes among the adult population. Predesigned and pretested questionnaire was used to elicit the information on family and individual sociodemographic variables. Height, weight, waist, and hip circumference, blood pressure was measured and venous blood was also collected to measure fasting blood glucose, blood cholesterol. Overall, 8.47% study subjects were diagnosed as diabetic. The univariate analysis and multivariate logistic regression analysis showed that the important correlates of diabetes mellitus were age, blood cholesterol, and family history of diabetes. The findings were found to be statistically significant. In our study we observed that adults having increased age, hypercholesterolemia, and family history of diabetes mellitus are more likely to develop diabetes mellitus.

  12. Diabetes mellitus and tuberculosis: programmatic management issues

    PubMed Central

    Kumar, A. M. V.; Satyanarayana, S.; Lin, Y.; Zachariah, R.; Lönnroth, K.; Kapur, A.

    2015-01-01

    SUMMARY In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation. Key programmatic challenges include the following: whether screening should be directed at all patients or targeted at those with high-risk characteristics; the most suitable technologies for diagnosing TB and diabetes in routine settings; the best time to screen TB patients for DM; how to provide an integrated, coordinated approach to case management; and finally, how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation. The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB. PMID:26162352

  13. Coronary artery disease and diabetes mellitus

    PubMed Central

    Aronson, Doron; Edelman, Elazer R.

    2015-01-01

    SUMMARY Coronary artery disease (CAD) is a major determinant of the long-term prognosis among patients with diabetes mellitus (DM). DM is associated with a 2 to 4-fold increased mortality risk from heart disease. Furthermore, in patients with DM there is an increased mortality after MI, and worse overall prognosis with CAD. Near-normal glycemic control for a median of 3.5 to 5 years does not reduce cardiovascular events. Thus, the general goal of HbA1c <7% appears reasonable for the majority of patients. Iatrogenic hypoglycemia is the limiting factor in the glycemic management of diabetes, and is an independent cause of excess morbidity and mortality. Statins are effective in reducing major coronary events, stroke, and the need for coronary revascularization. Selection of the optimal myocardial revascularization strategy for patients with DM and multivessel coronary artery disease is crucial and requires a multidisciplinary team approach (‘heart team’). Large scale clinical trials have shown that for many patients with 1- or 2-vessel coronary artery disease, there is little prognostic benefit from any intervention over optimal medical therapy (OMT). PCI with drug-eluting or bare metal stents is appropriate for patients who remain symptomatic with OMT. Randomized trials comparing multivessel PCI to coronary artery bypass grafting (CABG) have consistently demonstrated the superiority of CABG in reducing mortality, myocardial infarctions and need for repeat revascularizations. PMID:25091969

  14. Occupational chemical exposure and diabetes mellitus risk.

    PubMed

    Leso, Veruscka; Capitanelli, Ilaria; Lops, Erika Alessandra; Ricciardi, Walter; Iavicoli, Ivo

    2017-03-01

    Diabetes mellitus (DM) is a group of metabolic diseases that may originate from an interaction between genetic and lifestyle risk factors. However, the possible role of occupational chemical exposures in the disease development and progression remains unclear. Therefore, this review aimed to provide a comprehensive evaluation of the relationship between occupational exposure to specific chemical substances or industrial activities and DM morbidity and mortality outcomes. Although some positive findings may support the diabetogenic role of certain pesticides and dioxins in different workplaces, the variable conditions of exposure, the lack of quantitative environmental or biological monitoring data and the different outcomes evaluated do not allow defining a specific exposure-disease causality. Therefore, further epidemiological studies will be necessary to adequately assess modes of action for different substances, dose-response relationships as well as individual susceptibility factors potentially affecting the exposure-disease continuum. Overall, this appears important to adequately assess, communicate and manage risks in occupational chemical exposure settings with the aim to protect workers and build healthier job conditions for diabetic employees.

  15. Diabetes mellitus and Ramadan in Algeria.

    PubMed

    Chentli, Farida; Azzoug, Said; Amani, Mohammed El Amine; Elgradechi, Aldjia

    2013-10-01

    Ramadan, one of the five pillars of Islam, is a holy month in Algeria where diabetes mellitus (DM) is more frequent in urban areas with a frequency which varies from 8 to 16%. DM complications are broadly as frequent as in developed countries, except for neuropathy which seems more frequent. Despite contraindications which are regularly explained to our patients and despite the flexible side of Islam toward chronic diseases, most Algerian people with DM insist on fasting. Not fasting is considered a sin and shameful. There are also other reasons put forward by diabetic persons, such as very strong religious faith, habit of fasting together with the whole family since an early age, solidarity with the family, friends, and neighbors, and finally and probably because of the desire to appear "normal" and share a festive and a spiritual atmosphere of Ramadan. As in other Muslim countries, severe hypoglycemia the main motive of hospitalizations during the holy month, ketoacidosis, dehydration, orthostatic hypotension and thrombosis are some of the complications which Algerian people with DM are exposed to when fasting.

  16. Diabetes mellitus and Ramadan in Algeria

    PubMed Central

    Chentli, Farida; Azzoug, Said; Amani, Mohammed El Amine; Elgradechi, Aldjia

    2013-01-01

    Ramadan, one of the five pillars of Islam, is a holy month in Algeria where diabetes mellitus (DM) is more frequent in urban areas with a frequency which varies from 8 to 16%. DM complications are broadly as frequent as in developed countries, except for neuropathy which seems more frequent. Despite contraindications which are regularly explained to our patients and despite the flexible side of Islam toward chronic diseases, most Algerian people with DM insist on fasting. Not fasting is considered a sin and shameful. There are also other reasons put forward by diabetic persons, such as very strong religious faith, habit of fasting together with the whole family since an early age, solidarity with the family, friends, and neighbors, and finally and probably because of the desire to appear “normal” and share a festive and a spiritual atmosphere of Ramadan. As in other Muslim countries, severe hypoglycemia the main motive of hospitalizations during the holy month, ketoacidosis, dehydration, orthostatic hypotension and thrombosis are some of the complications which Algerian people with DM are exposed to when fasting. PMID:24251192

  17. Obesity and type 1 diabetes mellitus management.

    PubMed

    Chillarón, J J; Benaiges, D; Mañé, L; Pedro-Botet, J; Flores Le-Roux, J A

    2015-03-01

    Patients with type 1 diabetes mellitus (T1DM) traditionally had a low body mass index and microangiopathic complications were common. The Diabetes Control and Complications Trial, published in 1993, demonstrated that therapy aimed at maintaining HbA1c levels as close to normal as feasible reduced the incidence of microangiopathy. Since then, the use of intensive insulin therapy to optimise metabolic control became generalised, with two main side effects: a higher rate of severe hypoglycaemia and increased weight gain. Approximately 50% of patients with T1DM are currently obese or overweight, which reduces or nullifies the benefits of good metabolic control, and which has other negative consequences; therefore, strategies to achieve weight control in patients with T1DM are necessary. At present, treatment with GLP-1 and SGLT-2 inhibitors has yielded promising short-term results that need to be confirmed in studies with larger numbers of patients and long-term follow-up. It is possible that, in coming years, the applicability of bariatric surgery in obese patients with T1DM will be similar to that of the general population or T2DM.

  18. Depression in type 2 diabetes mellitus--a brief review.

    PubMed

    Siddiqui, Samreen

    2014-01-01

    Diabetes mellitus is a chronic disease which has been associated with depression. Depression is more common in adults with type 2 diabetes mellitus (T2DM) as compared to those without. Both micro- and macro vascular diabetic complications are associated with depression and have shown to increase the risk of mood disorder. Further, poor glycemic control in T2DM patients could lead to more complications of diabetes and such patients are more likely to develop depression. More research is needed in this area to determine the exact relationship between depression and T2DM and to unfold the mystery of mechanism behind this.

  19. Arterial Calcification in Diabetes Mellitus: Preclinical Models and Translational Implications.

    PubMed

    Stabley, John N; Towler, Dwight A

    2017-02-01

    Diabetes mellitus increasingly afflicts our aging and dysmetabolic population. Type 2 diabetes mellitus and the antecedent metabolic syndrome represent the vast majority of the disease burden-increasingly prevalent in children and older adults. However, type 1 diabetes mellitus is also advancing in preadolescent children. As such, a crushing wave of cardiometabolic disease burden now faces our society. Arteriosclerotic calcification is increased in metabolic syndrome, type 2 diabetes mellitus, and type 1 diabetes mellitus-impairing conduit vessel compliance and function, thereby increasing the risk for dementia, stroke, heart attack, limb ischemia, renal insufficiency, and lower extremity amputation. Preclinical models of these dysmetabolic settings have provided insights into the pathobiology of arterial calcification. Osteochondrogenic morphogens in the BMP-Wnt signaling relay and transcriptional regulatory programs driven by Msx and Runx gene families are entrained to innate immune responses-responses activated by the dysmetabolic state-to direct arterial matrix deposition and mineralization. Recent studies implicate the endothelial-mesenchymal transition in contributing to the phenotypic drift of mineralizing vascular progenitors. In this brief overview, we discuss preclinical disease models that provide mechanistic insights-and point to challenges and opportunities to translate these insights into new therapeutic strategies for our patients afflicted with diabetes mellitus and its arteriosclerotic complications.

  20. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications.

    PubMed

    Frier, Brian M

    2014-12-01

    Hypoglycaemia is a frequent adverse effect of treatment of diabetes mellitus with insulin and sulphonylureas. Fear of hypoglycaemia alters self-management of diabetes mellitus and prevents optimal glycaemic control. Mild (self-treated) and severe (requiring help) hypoglycaemia episodes are more common in type 1 diabetes mellitus but people with insulin-treated type 2 diabetes mellitus are also exposed to frequent hypoglycaemic events, many of which occur during sleep. Hypoglycaemia can disrupt many everyday activities such as driving, work performance and leisure pursuits. In addition to accidents and physical injury, the morbidity of hypoglycaemia involves the cardiovascular and central nervous systems. Whereas coma and seizures are well-recognized neurological sequelae of hypoglycaemia, much interest is currently focused on the potential for hypoglycaemia to cause dangerous and life-threatening cardiac complications, such as arrhythmias and myocardial ischaemia, and whether recurrent severe hypoglycaemia can cause permanent cognitive impairment or promote cognitive decline and accelerate the onset of dementia in middle-aged and elderly people with diabetes mellitus. Prevention of hypoglycaemia is an important part of diabetes mellitus management and strategies include patient education, glucose monitoring, appropriate adjustment of diet and medications in relation to everyday circumstances including physical exercise, and the application of new technologies such as real-time continuous glucose monitoring, modified insulin pumps and the artificial pancreas.

  1. Heart rate variability in children with type 1 diabetes mellitus

    PubMed Central

    Gardim, Camila Balsamo; de Oliveira, Bruno Affonso P.; Bernardo, Aline Fernanda B.; Gomes, Rayana Loch; Pacagnelli, Francis Lopes; Lorençoni, Roselene Modolo R.; Vanderlei, Luiz Carlos M.

    2014-01-01

    OBJECTIVE: To gather current information about the effects of type 1 diabetes mellitus on children's cardiac autonomic behavior. DATA SOURCES: The search of articles was conducted on PubMed, Ibecs, Medline, Cochrane, Lilacs, SciELO and PEDro databases using the MeSH terms: "autonomic nervous system", "diabetes mellitus", "child", "type 1 diabetes mellitus", "sympathetic nervous system" and "parasympathetic nervous system", and their respective versions in Portuguese (DeCS). Articles published from January 2003 to February 2013 that enrolled children with 9-12 years old with type 1 diabetes mellitus were included in the review. DATA SYNTHESIS: The electronic search resulted in four articles that approached the heart rate variability in children with type 1 diabetes mellitus, showing that, in general, these children present decreased global heart rate variability and vagal activity. The practice of physical activity promoted benefits for these individuals. CONCLUSIONS: Children with type 1 diabetes mellitus present changes on autonomic modulation, indicating the need for early attention to avoid future complications in this group. PMID:25119762

  2. Faecal Microbiota of Cats with Insulin-Treated Diabetes Mellitus

    PubMed Central

    Bell, Erin T.; Suchodolski, Jan S.; Isaiah, Anitha; Fleeman, Linda M.; Cook, Audrey K.; Steiner, Jörg M.; Mansfield, Caroline S.

    2014-01-01

    Microorganisms within the gastrointestinal tract significantly influence metabolic processes within their mammalian host, and recently several groups have sought to characterise the gastrointestinal microbiota of individuals affected by metabolic disease. Differences in the composition of the gastrointestinal microbiota have been reported in mouse models of type 2 diabetes mellitus, as well as in human patients. Diabetes mellitus in cats has many similarities to type 2 diabetes in humans. No studies of the gastrointestinal microbiota of diabetic cats have been previously published. The objectives of this study were to compare the composition of the faecal microbiota of diabetic and non-diabetic cats, and secondarily to determine if host signalment and dietary factors influence the composition of the faecal microbiota in cats. Faecal samples were collected from insulin-treated diabetic and non-diabetic cats, and Illumina sequencing of the 16S rRNA gene and quantitative PCR were performed on each sample. ANOSIM based on the unweighted UniFrac distance metric identified no difference in the composition of the faecal microbiota between diabetic and non-diabetic cats, and no significant differences in the proportions of dominant bacteria by phylum, class, order, family or genus as determined by 16S rRNA gene sequencing were identified between diabetic and non-diabetic cats. qPCR identified a decrease in Faecalibacterium spp. in cats aged over ten years. Cat breed or gender, dietary carbohydrate, protein or fat content, and dietary formulation (wet versus dry food) did not affect the composition of the faecal microbiota. In conclusion, the composition of the faecal microbiota was not altered by the presence of diabetes mellitus in cats. Additional studies that compare the functional products of the microbiota in diabetic and non-diabetic cats are warranted to further investigate the potential impact of the gastrointestinal microbiota on metabolic diseases such as

  3. Faecal microbiota of cats with insulin-treated diabetes mellitus.

    PubMed

    Bell, Erin T; Suchodolski, Jan S; Isaiah, Anitha; Fleeman, Linda M; Cook, Audrey K; Steiner, Jörg M; Mansfield, Caroline S

    2014-01-01

    Microorganisms within the gastrointestinal tract significantly influence metabolic processes within their mammalian host, and recently several groups have sought to characterise the gastrointestinal microbiota of individuals affected by metabolic disease. Differences in the composition of the gastrointestinal microbiota have been reported in mouse models of type 2 diabetes mellitus, as well as in human patients. Diabetes mellitus in cats has many similarities to type 2 diabetes in humans. No studies of the gastrointestinal microbiota of diabetic cats have been previously published. The objectives of this study were to compare the composition of the faecal microbiota of diabetic and non-diabetic cats, and secondarily to determine if host signalment and dietary factors influence the composition of the faecal microbiota in cats. Faecal samples were collected from insulin-treated diabetic and non-diabetic cats, and Illumina sequencing of the 16S rRNA gene and quantitative PCR were performed on each sample. ANOSIM based on the unweighted UniFrac distance metric identified no difference in the composition of the faecal microbiota between diabetic and non-diabetic cats, and no significant differences in the proportions of dominant bacteria by phylum, class, order, family or genus as determined by 16S rRNA gene sequencing were identified between diabetic and non-diabetic cats. qPCR identified a decrease in Faecalibacterium spp. in cats aged over ten years. Cat breed or gender, dietary carbohydrate, protein or fat content, and dietary formulation (wet versus dry food) did not affect the composition of the faecal microbiota. In conclusion, the composition of the faecal microbiota was not altered by the presence of diabetes mellitus in cats. Additional studies that compare the functional products of the microbiota in diabetic and non-diabetic cats are warranted to further investigate the potential impact of the gastrointestinal microbiota on metabolic diseases such as

  4. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

    PubMed

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

    2017-05-01

    The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Immunogenetics of Type 1 Diabetes Mellitus

    PubMed Central

    Morran, Michael P.; Vonberg, Andrew; Khadra, Anmar; Pietropaolo, Massimo

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune disease arising through a complex interaction of both genetic and immunologic factors. Similar to the majority of autoimmune diseases, T1DM usually has a relapsing remitting disease course with autoantibody and T cellular responses to islet autoantigens, which precede the clinical onset of the disease process. The immunological diagnosis of autoimmune diseases relies primarily on the detection of autoantibodies in the serum of T1DM patients. Although their pathogenic significance remains uncertain, they have the practical advantage of serving as surrogate biomarkers for predicting the clinical onset of T1DM. Type 1 diabetes is a polygenic disease with a small number of genes having large effects, (i.e. HLA) and a large number of genes having small effects. Risk of T1DM progression is conferred by specific HLA DR/DQ alleles [e.g., DRB1*03-DQB1*0201 (DR3) or DRB1*04-DQB1*0302 (DR4)]. In addition, HLA alleles such as DQB1*0602 are associated with dominant protection from T1DM in multiple populations. A discordance rate of greater than 50% between monozygotic twins indicates a potential involvement of environmental factors on disease development. Viral infections may play a role in the chain of events leading to disease, albeit conclusive evidence linking infections with T1DM remains to be firmly established. Two syndromes have been described in which an immune-mediated form of diabetes occurs as the result of a single gene defect. These syndromes are termed autoimmune polyglandular syndrome type I (APS-I) or autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), and X-linked poyendocrinopathy, immune dysfunction and diarrhea (XPID). These two syndromes are unique models to understand the mechanisms involved in the loss of tolerance to self-antigens in autoimmune diabetes and its associated organ-specific autoimmune disorders. A growing number of animal models of these diseases have greatly helped

  6. Immunogenetics of type 1 diabetes mellitus.

    PubMed

    Morran, Michael P; Vonberg, Andrew; Khadra, Anmar; Pietropaolo, Massimo

    2015-04-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune disease arising through a complex interaction of both genetic and immunologic factors. Similar to the majority of autoimmune diseases, T1DM usually has a relapsing remitting disease course with autoantibody and T cellular responses to islet autoantigens, which precede the clinical onset of the disease process. The immunological diagnosis of autoimmune diseases relies primarily on the detection of autoantibodies in the serum of T1DM patients. Although their pathogenic significance remains uncertain, they have the practical advantage of serving as surrogate biomarkers for predicting the clinical onset of T1DM. Type 1 diabetes is a polygenic disease with a small number of genes having large effects (i.e. HLA), and a large number of genes having small effects. Risk of T1DM progression is conferred by specific HLA DR/DQ alleles [e.g., DRB1*03-DQB1*0201 (DR3) or DRB1*04-DQB1*0302 (DR4)]. In addition, HLA alleles such as DQB1*0602 are associated with dominant protection from T1DM in multiple populations. A discordance rate of greater than 50% between monozygotic twins indicates a potential involvement of environmental factors on disease development. Viral infections may play a role in the chain of events leading to disease, albeit conclusive evidence linking infections with T1DM remains to be firmly established. Two syndromes have been described in which an immune-mediated form of diabetes occurs as the result of a single gene defect. These syndromes are termed autoimmune polyglandular syndrome type I (APS-I) or autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), and X-linked poyendocrinopathy, immune dysfunction and diarrhea (XPID). These two syndromes are unique models to understand the mechanisms involved in the loss of tolerance to self-antigens in autoimmune diabetes and its associated organ-specific autoimmune disorders. A growing number of animal models of these diseases have greatly helped

  7. Postmortem diagnosis of diabetes mellitus and its complications

    PubMed Central

    Palmiere, Cristian

    2015-01-01

    Diabetes mellitus has become a major cause of death worldwide and diabetic ketoacidosis is the most common cause of death in children and adolescents with type 1 diabetes. Acute complications of diabetes mellitus as causes of death may be difficult to diagnose due to missing characteristic macroscopic and microscopic findings. Biochemical analyses, including vitreous glucose, blood (or alternative specimen) beta-hydroxybutyrate, and blood glycated hemoglobin determination, may complement postmortem investigations and provide useful information for determining the cause of death even in corpses with advanced decompositional changes. In this article, we performed a review of the literature pertaining to the diagnostic performance of classical and novel biochemical parameters that may be used in the forensic casework to identify disorders in glucose metabolism. We also present a review focusing on the usefulness of traditional and alternative specimens that can be sampled and subsequently analyzed to diagnose acute complications of diabetes mellitus as causes of death. PMID:26088843

  8. Postmortem diagnosis of diabetes mellitus and its complications.

    PubMed

    Palmiere, Cristian

    2015-06-01

    Diabetes mellitus has become a major cause of death worldwide and diabetic ketoacidosis is the most common cause of death in children and adolescents with type 1 diabetes. Acute complications of diabetes mellitus as causes of death may be difficult to diagnose due to missing characteristic macroscopic and microscopic findings. Biochemical analyses, including vitreous glucose, blood (or alternative specimen) beta-hydroxybutyrate, and blood glycated hemoglobin determination, may complement postmortem investigations and provide useful information for determining the cause of death even in corpses with advanced decompositional changes. In this article, we performed a review of the literature pertaining to the diagnostic performance of classical and novel biochemical parameters that may be used in the forensic casework to identify disorders in glucose metabolism. We also present a review focusing on the usefulness of traditional and alternative specimens that can be sampled and subsequently analyzed to diagnose acute complications of diabetes mellitus as causes of death.

  9. Wolfram Syndrome presenting with optic atrophy and diabetes mellitus: two case reports.

    PubMed

    Manaviat, Masoud Reza; Rashidi, Maryam; Mohammadi, Seyed Mohammad

    2009-12-19

    Wolfram syndrome is the constellation of juvenile onset diabetes mellitus and optic atrophy, known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness).Patients demonstrate diabetes mellitus followed by optic atrophy in the first decade, diabetes insipidus and sensorineural deafness in the second decade, dilated renal outflow tracts early in the third decade, and multiple neurological abnormalities early in the fourth decade.This study reports two siblings with late diagnosed wolfram syndrome with diabetes insipidus, diabetes mellitus, optic atrophy, deafness and severe urological abnormalities.In conclusion, cases having early onset insulin-dependent diabetes mellitus and optic atrophy together need to be evaluated with respect to Wolfram.

  10. Wolfram Syndrome presenting with optic atrophy and diabetes mellitus: two case reports

    PubMed Central

    2009-01-01

    Wolfram syndrome is the constellation of juvenile onset diabetes mellitus and optic atrophy, known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness). Patients demonstrate diabetes mellitus followed by optic atrophy in the first decade, diabetes insipidus and sensorineural deafness in the second decade, dilated renal outflow tracts early in the third decade, and multiple neurological abnormalities early in the fourth decade. This study reports two siblings with late diagnosed wolfram syndrome with diabetes insipidus, diabetes mellitus, optic atrophy, deafness and severe urological abnormalities. In conclusion, cases having early onset insulin-dependent diabetes mellitus and optic atrophy together need to be evaluated with respect to Wolfram. PMID:20062605

  11. Gestational diabetes mellitus: risks and management during and after pregnancy.

    PubMed

    Buchanan, Thomas A; Xiang, Anny H; Page, Kathleen A

    2012-11-01

    Gestational diabetes mellitus (GDM) carries a small but potentially important risk of adverse perinatal outcomes and a long-term risk of obesity and glucose intolerance in offspring. Mothers with GDM have an excess of hypertensive disorders during pregnancy and a high risk of developing diabetes mellitus thereafter. Diagnosing and treating GDM can reduce perinatal complications, but only a small fraction of pregnancies benefit. Nutritional management is the cornerstone of treatment; insulin, glyburide and metformin can be used to intensify treatment. Fetal measurements complement maternal glucose monitoring in the identification of pregnancies that require such intensification. Glucose testing shortly after delivery can stratify the short-term diabetes risk in mothers. Thereafter, annual glucose and HbA(1c) testing can detect deteriorating glycaemic control, a harbinger of future diabetes mellitus, usually type 2 diabetes mellitus. Interventions that mitigate obesity or its metabolic effects are most potent in preventing or delaying diabetes mellitus. Lifestyle modification is the primary approach; use of medications for diabetes prevention after GDM remains controversial. Family planning enables optimization of health in subsequent pregnancies. Breastfeeding may reduce obesity in children and is recommended. Families should be encouraged to help children adopt lifestyles that reduce the risk of obesity.

  12. Urinary tract infection in patients with diabetes mellitus.

    PubMed

    Fünfstück, Reinhard; Nicolle, Lindsay E; Hanefeld, Markolf; Naber, Kurt G

    2012-01-01

    Urinary tract infection occurs with increased frequency and severity in patients with diabetes mellitus. General host factors enhancing risk for urinary tract infection in diabetics include age, metabolic control, and long term complications, primarily diabetic nephropathy and cystopathy. Alterations in the innate immune system have been described and may also contribute. Treatment of asymptomatic bacteriuria in diabetic patients is not indicated. Early diagnosis and prompt intervention is recommended to limit morbidity of symptomatic infection. Clinical studies comparing management of urinary tract infection in persons with diabetes compared to those without as well as diabetic patients with good or poor glucose control will be necessary to improve care of urinary infection in persons with diabetes mellitus.

  13. Childhood diabetes mellitus: recent advances & future prospects.

    PubMed

    Dejkhamron, Prapai; Menon, Ram K; Sperling, Mark A

    2007-03-01

    Diabetes mellitus (DM) is a metabolic disease characterized by absolute or relative insulin deficiency. Absolute deficiency of insulin most commonly results from an autoimmune destruction of insulin producing cells in the pancreas and in general, the term Type 1 DM (T1DM) is used to denote childhood diabetes associated with autoimmunity and absolute insulin deficiency. The term Type 2 DM (T2DM) is used to denote diabetes resulting from a relative deficiency of insulin when insulin secretion is inadequate to overcome co-existent resistance to insulin action on carbohydrate, protein or fat metabolism; T2DM is most commonly associated with the prototypic insulin resistant state of obesity. In the western hemisphere DM is one of the most prevalent chronic diseases in childhood, whereas the incidence of T1DM in developing countries is significantly less than that in the western hemisphere. Epidemiological studies indicate that there is gradual but steady increase in the incidence of both T1DM and T2DM in both developed and developing countries. This review provides an overview of the major advances in our understanding of the aetiology, pathogenesis, and clinical management of DM in children with the focus being on T1DM. Genetic predisposition, environmental causes, and emerging concepts of the pathogenesis of T1DM such as the accelerator hypothesis are discussed. The goals of treating a child with DM are to achieve normal growth and development with prevention of acute and chronic complications of DM. These goals are achieved by co-ordinated care delivered by a multidisciplinary team focusing on insulin administrations, glucose monitoring, meal planning, and screening for complications. Newer insulin analogues ("designer" insulin) and automated methods of delivery via programmable pumps have revolutionized the care of the child with diabetes. Though T1DM cannot yet be prevented, ongoing trials and strategies aimed at modulating the autoimmune response and the

  14. 77 FR 43096 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Diabetes Mellitus...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ... meeting will focus on ``Diabetes, Dementia, and Alzheimer's Disease.'' Any member of the public interested... Diseases; Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting SUMMARY: The Diabetes... Coordinating Committee, National Institute of Diabetes and Digestive and Kidney Diseases, 31 Center Drive...

  15. 76 FR 20358 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... opportunities for type 1 diabetes research supported by the Special Statutory Funding Program for Type 1... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Workshop The Diabetes...

  16. Diabetes mellitus in North West Ethiopia: a community based study

    PubMed Central

    2014-01-01

    Background Diabetes mellitus is recognized as one of the emerging public health problems in developing countries. However, its magnitude has not been studied at community levels, making the provision of appropriate services difficult in such countries. Hence, this study aimed to compare the magnitude and associated risks of diabetes mellitus among urban and rural adults in northwest Ethiopia. Methods A cross-sectional population based survey was performed using the WHO STEPwise method on adults aged 35 years and above. A multistage cluster random sampling strategy was used to select study participants from urban and rural locations. Fasting blood glucose levels were determined using peripheral blood samples by finger puncture. Prevalence was computed with a 95% confidence interval for each residential area. Selected risk factors were assessed using logistic regression. Results The prevalence of diabetes mellitus among adults aged 35 years and above was 5.1% [95% CI: 3.8, 6.4] for urban and 2.1% [95% CI: 1.2, 2.9] for rural dwellers. The majority (69%) of the identified diabetic cases were not diagnosed prior to the survey. The highest proportion (82.6%) of the undiagnosed cases was noted among the rural population and 63% among the urban population. Family history of diabetes (AOR = 5.05; 2.43, 10.51), older age (AOR = 4.86; 1.99, 11.9) and physical inactivity (AOR = 1.92; 1.06, 3.45) were significantly associated with diabetes mellitus among the urban population. Alcohol consumption (AOR = 0 .24, 0 .06, 0.99) was inversely associated with diabetes mellitus in rural areas. Conclusion The prevalence of diabetes mellitus is considerably high among the urban compared to the rural population. Diabetes is largely undiagnosed and untreated, especially in rural settings. Appropriate actions need to be taken to provide access to early diagnosis and treatment in order to reduce associated complications. PMID:24479725

  17. Diabetes mellitus in North West Ethiopia: a community based study.

    PubMed

    Abebe, Solomon Mekonnen; Berhane, Yemane; Worku, Alemayehu; Assefa, Abebayehu

    2014-01-30

    Diabetes mellitus is recognized as one of the emerging public health problems in developing countries. However, its magnitude has not been studied at community levels, making the provision of appropriate services difficult in such countries. Hence, this study aimed to compare the magnitude and associated risks of diabetes mellitus among urban and rural adults in northwest Ethiopia. A cross-sectional population based survey was performed using the WHO STEPwise method on adults aged 35 years and above. A multistage cluster random sampling strategy was used to select study participants from urban and rural locations. Fasting blood glucose levels were determined using peripheral blood samples by finger puncture. Prevalence was computed with a 95% confidence interval for each residential area. Selected risk factors were assessed using logistic regression. The prevalence of diabetes mellitus among adults aged 35 years and above was 5.1% [95% CI: 3.8, 6.4] for urban and 2.1% [95% CI: 1.2, 2.9] for rural dwellers. The majority (69%) of the identified diabetic cases were not diagnosed prior to the survey. The highest proportion (82.6%) of the undiagnosed cases was noted among the rural population and 63% among the urban population. Family history of diabetes (AOR = 5.05; 2.43, 10.51), older age (AOR = 4.86; 1.99, 11.9) and physical inactivity (AOR = 1.92; 1.06, 3.45) were significantly associated with diabetes mellitus among the urban population. Alcohol consumption (AOR = 0 .24, 0 .06, 0.99) was inversely associated with diabetes mellitus in rural areas. The prevalence of diabetes mellitus is considerably high among the urban compared to the rural population. Diabetes is largely undiagnosed and untreated, especially in rural settings. Appropriate actions need to be taken to provide access to early diagnosis and treatment in order to reduce associated complications.

  18. 75 FR 44049 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-27

    ... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in.../E8-785.pdf . Background On June 16, 2010, FMCSA published a Notice of receipt of Federal...

  19. Disseminated mucormycosis in an adolescent with newly diagnosed diabetes mellitus.

    PubMed

    McCrory, Michael C; Moore, Blake A; Nakagawa, Thomas A; Givner, Laurence B; Jason, Donald R; Palavecino, Elizabeth L; Ajizian, Samuel J

    2014-10-01

    We report a 16-year-old, previously healthy female who presented with disseminated mucormycosis leading to multiorgan failure and death with newly diagnosed type 1 diabetes mellitus and ketoacidosis. We review previous reported cases of mucormycosis in children with diabetes to demonstrate that this uncommon invasive infection may cause significant morbidity and mortality in this population.

  20. Counseling Families of Children with Diabetes Mellitus: An Overview.

    ERIC Educational Resources Information Center

    Yousef, Jamal M. S.

    1995-01-01

    The impact that counseling can have on a family with a child with diabetes mellitus is discussed. The benefits for the child's psychosocial adjustment and development are highlighted. An overview of the challenges a family with a diabetic child faces is provided and the counselor's role in assisting such families is emphasized. (CR)

  1. Gestational Diabetes Mellitus: Post-partum Risk and Follow up.

    PubMed

    Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

    2017-09-11

    Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and post-partum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Counseling Families of Children with Diabetes Mellitus: An Overview.

    ERIC Educational Resources Information Center

    Yousef, Jamal M. S.

    1995-01-01

    The impact that counseling can have on a family with a child with diabetes mellitus is discussed. The benefits for the child's psychosocial adjustment and development are highlighted. An overview of the challenges a family with a diabetic child faces is provided and the counselor's role in assisting such families is emphasized. (CR)

  3. Atypical diabetes mellitus associated with bone marrow transplantation.

    PubMed

    Tor, Ozlem; Garg, Rajesh K

    2010-01-01

    To describe 3 cases of atypical diabetes mellitus following bone marrow transplantation. We describe the clinical presentation and relevant laboratory findings of 3 patients who presented with new-onset diabetes mellitus after bone marrow transplantation and discuss the possible mechanisms. A 52-year-old white man with chronic myelogenous leukemia, a 51-year-old white woman with acute myelogenous leukemia, and a 38-year-old Hispanic woman with acute myelogenous leukemia presented with acute onset of diabetes mellitus after bone marrow transplantation. Although blood glucose levels were initially very high, the patients required only small insulin dosages for glycemic control. Both the acute onset and requirement of relatively small insulin dosages were characteristic of type 1 diabetes mellitus. Onset of diabetes appeared to be unrelated to immunosuppressive drug therapy because it happened several months after starting these drugs. C-peptide was detectable, and glutamic acid decarboxylase antibodies were absent. Diabetes mellitus remitted spontaneously after a few months while the immunosuppressive drugs were continued. Although the underlying mechanisms are unknown, cytokine changes after bone marrow transplantation may have led to temporary beta-cell dysfunction in these patients.

  4. Diabetes mellitus as a novel risk factor for gastrointestinal malignancies.

    PubMed

    Herrigel, Dana J; Moss, Rebecca A

    2014-10-01

    Evidence of an emerging etiologic link between diabetes mellitus and several gastrointestinal malignancies is presented. Although a correlation between pancreatic cancer and diabetes mellitus has long been suspected, the potential role diabetes mellitus plays in the pathogenicity of both hepatocellular carcinoma and colon cancer is becoming increasingly well defined. Further supporting the prospect of etiologic linkage, the association of diabetes mellitus with colon cancer is consistently demonstrated to be independent of obesity. An increasing incidence of diabetes and obesity in the United States has led to a recent surge in incidence of hepatocellular cancer on the background of nonalcoholic fatty liver disease, and this disease is expected to commensurately grow in incidence. Widespread recognition of this emerging risk factor may lead to a change in screening practices. Although the mechanisms underlying the correlation are still under investigation, the role of insulin, the insulin-like growth factor-I, and related binding and signaling pathways as regulators of cell growth and cell proliferation are implicated in carcinogenesis and tumor growth. The potential role of metformin and other medications for diabetes mellitus in the chemoprevention, carcinogenesis, and treatment of gastrointestinal malignancies is also presented.

  5. Gastric stimulation in treatment in type 2 diabetes mellitus.

    PubMed

    Zonca, P; Hoppe, C; Cambal, M; Jacobi, C A

    2014-01-01

    Metabolic surgery is a dynamic field providing a wide range of new techniques. The aim of our paper is to inform about gastric electrostimulation in the treatment of type 2 diabetes mellitus. Gastric electrostimulation in type 2 diabetes mellitus treatment is performed by means of implanting Tantalus system (Metacure). When triggered by food intake, the Tantalus system generates signals for the stomach to contract. Early after the food intake, thus before the stomach distends completely, the system increases spontaneous stomach contractions. Via afferent vagal signals, these increased contractions are evaluated by the central nervous system as a sign that satiety has been reached. Three pairs of electrodes connected with a stimulator are implanted laparoscopically. The system comes equipped with a battery as well. Laparoscopically implanted system of stomach electrostimulation presents a simple and easily regulated system without disturbing the integrity of gastrointestinal tract. It is a reversible system. In accord with preliminary results, Tantalus offers a safe and effective treatment of type 2 diabetes mellitus by reducing other cardiometabolical risky factors. The operation safety is comparable with that of similar minimally invasive surgical techniques. In order to improve our understanding of diabetes mellitus pathophysiology as well as of effects of gastric electrostimulation, more trials need to be performed. The surgical diabetes treatment represents an interesting chance for patients and it might become a common technique in the future (Fig. 1, Ref. 29). diabetes mellitus, obesity, gastric stimulation, pacemaker.

  6. Permanent neonatal diabetes mellitus - a case report of a rare cause of diabetes mellitus in East Africa.

    PubMed

    Nyangabyaki-Twesigye, Catherine; Muhame, Michael Rugambwa; Bahendeka, Silver

    2015-12-01

    Diabetes mellitus is a metabolic disease characterised by chronically high glucose levels. Genetic factors have been implicated in the aetiology following mutations in a single gene. An extremely rare form of diabetes mellitus is monogenic diabetes, a subset of which is permanent neonatal diabetes, and is usually suspected if a child is diagnosed with diabetes at less than 6 months of age. We present the first case reported from East Africa of a child diagnosed with permanent neonatal diabetes resulting from a mutation in the KCNJ11 gene encoding the Kir6.2 subunit. Despite the rarity of permanent neonatal diabetes, this diagnosis should be considered in infants with persistent hyperglycaemia requiring insulin therapy. Children with an ATP-sensitive potassium channel defect in the pancreatic beta cell have an overall good prognosis when treated with oral sulphonylurea therapy.

  7. Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile.

    PubMed

    Guerrero-Núñez, Sara; Valenzuela-Suazo, Sandra; Cid-Henríquez, Patricia

    2017-04-06

    determine the prevalence of Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile and its relation with the variables: Health Care Coverage of Diabetes Mellitus Type 2; Average of diabetics with metabolic control in 2011-2013; Mortality Rate for Diabetes Mellitus; and Percentage of nurses participating in the Cardiovascular Health Program. cross-sectional descriptive study with ecological components that uses documentary sources of the Ministry of Health. It was established that there is correlation between the Universal Effective Coverage of Diabetes Mellitus Type 2 and the independent variables; it was applied the Pearson Coefficient, being significant at the 0.05 level. in Chile Universal Health Care Coverage of Diabetes Mellitus Type 2 (HbA1c<7% estimated population) is less than 20%; this is related with Mortality Rate for Diabetes Mellitus and Percentage of nurses participating in the Cardiovascular Health Program, being significant at the 0.01 level. effective prevalence of Universal Health Coverage of Diabetes Mellitus Type 2 is low, even though some regions stand out in this research and in the metabolic control of patients who participate in health control program; its relation with percentage of nurses participating in the Cardiovascular Health Program represents a challenge and an opportunity for the health system. determinar a prevalência de Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 em Chile e sua relação com as variáveis; Cobertura da Diabetes Mellitus tipo 2, Média de diabéticos com controle metabólico em 2011-2013, Taxa de Mortalidade por Diabetes Mellitus e Percentagem de participação de enfermeiras no Programa de Saúde Cardiovascular. estudo descritivo transversal com componentes ecológicos, utilizando fontes documentais do Ministério da Saúde. Foi estabelecida correlação entre Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 e as variáveis independentes, aplicando o Coeficiente de Pearson, sendo

  8. Sporadic hypokalemic paralysis caused by osmotic diuresis in diabetes mellitus.

    PubMed

    Vishnu, Venugopalan Y; Kattadimmal, Anoop; Rao, Suparna A; Kadhiravan, Tamilarasu

    2014-07-01

    A wide variety of neurological manifestations are known in patients with diabetes mellitus. We describe a 40-year-old man who presented with hypokalemic paralysis. On evaluation, we found that the cause of the hypokalemia was osmotic diuresis induced by marked hyperglycemia due to undiagnosed diabetes mellitus. The patient had an uneventful recovery with potassium replacement, followed by glycemic control with insulin. Barring a few instances of symptomatic hypokalemia in the setting of diabetic emergencies, to our knowledge uncomplicated hyperglycemia has not been reported to result in hypokalemic paralysis.

  9. [Bariatric surgery for the treatment of type 2 diabetes mellitus].

    PubMed

    Benaiges Boix, David; Goday Arno, Albert; Pedro-Botet, Juan

    2012-04-14

    Weight loss can improve metabolic control in patients with type 2 diabetes mellitus but the results of conventional therapy in this respect have been discouraging. Besides achieving significant and sustained weight loss, bariatric surgery can improve or resolve type 2 diabetes mellitus in the majority of patients. Anatomical modifications and changes in the secretion of intestinal hormones can explain the superiority of malabsorptive techniques. Currently, bariatric surgery offers a therapeutic alternative for type 2 diabetes patients with severe obesity and poor metabolic control under conventional therapy. Ongoing research will provide insights regarding the effect of intestinal hormones, new surgery techniques and the possible benefits of bariatric surgery in non-obese patients.

  10. Gestational diabetes mellitus: metabolic control during labour.

    PubMed

    Balsells, M; Corcoy, R; Adelantado, J M; García-Patterson, A; Altirriba, O; de Leiva, A

    2000-10-01

    The purpose of this study was to assess, in women with gestational diabetes mellitus (GDM): 1) metabolic control during labour using a standardised protocol; 2) the influence of therapy during pregnancy in intrapartum metabolic control and insulin requirements; and 3) the impact of maternal glycaemia during labour on neonatal hypoglycaemia. An observational study of 85 women with GDM (54 insulin-treated) was performed. Intrapartum metabolic management included i.v. glucose and insulin infusions, urinary ketone measurement and hourly capillary blood glucose (CBG) monitoring. Mean CBG from arrival to delivery was 4.7 +/- 1.1 mmol/l with 83% of mean CBG values within the target range (2.8-6.9 mmol/l). Mean CBG and insulin requirements were unrelated to therapy during pregnancy, but hypoglycaemia (CBG<2.8 mmol/l) was more frequent in women receiving insulin during pregnancy (40.7 vs 19.4 %, p<0.01). In several logistic regression models, CBG during labour was predictive of neonatal hypoglycaemia. We conclude that in women with GDM, the use of a standardised intrapartum management protocol is associated to fair metabolic control, that insulin requirements during labour are unrelated to therapy during pregnancy and that high CBG during labour increases the risk of neonatal hypoglycaemia.

  11. Diabetes Mellitus: Channeling Care through Cellular Discovery

    PubMed Central

    Maiese, Kenneth; Shang, Yan Chen; Chong, Zhao Zhong; Hou, Jinling

    2010-01-01

    Diabetes mellitus (DM) impacts a significant portion of the world’s population and care for this disorder places an economic burden on the gross domestic product for any particular country. Furthermore, both Type 1 and Type 2 DM are becoming increasingly prevalent and there is increased incidence of impaired glucose tolerance in the young. The complications of DM are protean and can involve multiple systems throughout the body that are susceptible to the detrimental effects of oxidative stress and apoptotic cell injury. For these reasons, innovative strategies are necessary for the implementation of new treatments for DM that are generated through the further understanding of cellular pathways that govern the pathological consequences of DM. In particular, both the precursor for the coenzyme β-nicotinamide adenine dinucleotide (NAD+), nicotinamide, and the growth factor erythropoietin offer novel platforms for drug discovery that involve cellular metabolic homeostasis and inflammatory cell control. Interestingly, these agents and their tightly associated pathways that consist of cell cycle regulation, protein kinase B, forkhead transcription factors, and Wnt signaling also function in a broader sense as biomarkers for disease onset and progression. PMID:20158461

  12. Gestational diabetes mellitus, programing and epigenetics.

    PubMed

    Yan, Jie; Yang, Huixia

    2014-08-01

    Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Offspring exposed to maternal hyperglycemia have a higher birth weight and are prone to develop metabolic disease in adult life. The intrauterine environmental or nutritional status seems to be involved in the fetal programing. The concept of "Developmental Origins of Health and Disease" (DOHaD) has been widely accepted and it brings new insights into the molecular pathogenesis of human diseases. The underlying mechanism is still under discussion and epigenetic mechanisms may provide an explanation for the phenomenon. The aim of this review is to illustrate the role of epigenetic modifications in the development of insulin resistance in metabolic diseases induced by adverse intrauterine exposures. Changes in epigenetic mechanism may be an early event in pathogenesis and progression of the metabolic disease in humans. Studies on epigenetic modifications contribute to our understanding of long-term effects of in utero exposure and shed light on the disease prevention and treatment by modulating epigenetic changes.

  13. Exercise guidelines for gestational diabetes mellitus

    PubMed Central

    Padayachee, Cliantha; Coombes, Jeff S

    2015-01-01

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. This disease has many detrimental consequences for the woman, the unborn foetus and child. The management of GDM aims to mediate the effects of hyperglycaemia by controlling blood glucose levels. Along with pharmacology and dietary interventions, exercise has a powerful potential to assist with blood glucose control. Due to the uncertainty of risks and benefits of exercise during pregnancy, women tend to avoid exercise. However, under adequate supervision exercise is both safe and beneficial in the treatment of GDM. Therefore it is vital that exercise is incorporated into the continuum of care for women with GDM. Medical doctors should be able to refer to competently informed exercise professionals to aid in GDM treatment. It is important that exercise treatment is informed by research. Hence, the development of evidence-based guidelines is important to inform practice. Currently there are no guidelines for exercise in GDM. This review aims to assess the efficacy of exercise for the management of GDM in order to establish an exercise prescription guideline specific to the condition. It is recommended that women with GDM should do both aerobic and resistance exercise at a moderate intensity, a minimum of three times a week for 30-60 min each time. PMID:26240700

  14. Concurrent hyperadrenocorticism and diabetes mellitus in dogs.

    PubMed

    Miceli, D D; Pignataro, O P; Castillo, V A

    2017-07-25

    Hyperadrenocorticism (HAC) and diabetes mellitus (DM) are two diseases that can occur concurrently in dogs. The objective of this study was to evaluate the coexistence of HAC and DM, and the risk factors involved that could contribute to the development of DM in dogs with HAC. A total of 235 dogs with HAC were studied and, according to their fasting glycemia, they were divided into three groups: <5.6mmol/L, between 5.6 and 10.08mmol/L and >10.08mmol/L. The following parameters were evaluated: age, gender, cause of HAC, body condition, glycemia, total cholesterol, triglycerides, urinary cortisol:creatinin ratio (UCCR) and survival time. A 13.61% concurrence of HAC and DM was observed. Dogs with a fasting glycemia >5.6mmol/L, with dislipemia, with Pituitary-Dependent Hyperadrenocorticism, UCCR >100×10(-6) and non-castrated females showed a higher risk of developing DM. The development of DM in dogs with HAC reduces the survival time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. [Eating behavior in patients with diabetes mellitus].

    PubMed

    Sapozhnikova, I E; Tarlovskaia, E I; Vedenskaia, T P

    2012-01-01

    To study the specific features of eating behavior (EB) in patients with diabetes mellitus (DM). One hundred and seventy-eight patients, including 128 with type 2 DM and 50 with type 1 DM, were examined. Questionnaire survey, general clinical, and laboratory studies were conducted. The patient groups did not differ in educational level and gender. In the patients with type 1 DM, the duration of the disease was longer and the incidence of complications was higher than in those with type 2 DM. Carbohydrate metabolism was decompensated in the majority of the patients with types 1 and 2 DM. A higher normative score if only by one of the disordered EB (DEB) scales (according to the DEBQ), was found in 68 and 78.9% with type 1 and type 2 DM, respectively. The patients with type 2 DM were more frequently ascertained to have restrictive EB. The patients with type 2 DM and restrictive EB were more aware of the disease, more often checked blood glucose levels themselves, and were better compensated. The proportion of patients with external and emotiogenic EB did not differ between the groups, the latter type was registered less frequently. Disordered EBs were detected in many patients with DM. The found features of EB may be taken into account while teaching the patients.

  16. Diabetes mellitus: channeling care through cellular discovery.

    PubMed

    Maiese, Kenneth; Shang, Yan Chen; Chong, Zhao Zhong; Hou, Jinling

    2010-02-01

    Diabetes mellitus (DM) impacts a significant portion of the world's population and care for this disorder places an economic burden on the gross domestic product for any particular country. Furthermore, both Type 1 and Type 2 DM are becoming increasingly prevalent and there is increased incidence of impaired glucose tolerance in the young. The complications of DM are protean and can involve multiple systems throughout the body that are susceptible to the detrimental effects of oxidative stress and apoptotic cell injury. For these reasons, innovative strategies are necessary for the implementation of new treatments for DM that are generated through the further understanding of cellular pathways that govern the pathological consequences of DM. In particular, both the precursor for the coenzyme beta-nicotinamide adenine dinucleotide (NAD(+)), nicotinamide, and the growth factor erythropoietin offer novel platforms for drug discovery that involve cellular metabolic homeostasis and inflammatory cell control. Interestingly, these agents and their tightly associated pathways that consist of cell cycle regulation, protein kinase B, forkhead transcription factors, and Wnt signaling also function in a broader sense as biomarkers for disease onset and progression.

  17. Adjunct therapy for type 1 diabetes mellitus.

    PubMed

    Lebovitz, Harold E

    2010-06-01

    Insulin replacement therapy in type 1 diabetes mellitus (T1DM) is nonphysiologic. Hyperinsulinemia is generated in the periphery to achieve normal insulin concentrations in the liver. This mismatch results in increased hypoglycemia, increased food intake with weight gain, and insufficient regulation of postprandial glucose excursions. Islet amyloid polypeptide is a hormone synthesized in pancreatic beta cells and cosecreted with insulin. Circulating islet amyloid polypeptide binds to receptors located in the hindbrain and increases satiety, delays gastric emptying and suppresses glucagon secretion. Thus, islet amyloid polypeptide complements the effects of insulin. T1DM is a state of both islet amyloid polypeptide and insulin deficiency. Pramlintide, a synthetic analog of islet amyloid polypeptide, can replace this hormone in patients with T1DM. When administered as adjunctive therapy to such patients treated with insulin, pramlintide decreases food intake and causes weight loss. Pramlintide therapy is also associated with suppression of glucagon secretion and delayed gastric emptying, both of which decrease postprandial plasma glucose excursions. Pramlintide therapy improves glycemic control and lessens weight gain. Agents that decrease intestinal carbohydrate digestion (alpha-glucosidase inhibitors) or decrease insulin resistance (metformin) might be alternative adjunctive therapies in T1DM, though its benefits are marginally supported by clinical data.

  18. Pharmacological Management of Gestational Diabetes Mellitus.

    PubMed

    Bergel, Riki; Hadar, Eran; Toledano, Yoel; Hod, Moshe

    2016-11-01

    Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy. We performed an extensive literature review of different available studies, published during the last 50 years, concerning pharmacological therapy for GDM, dealing with safety and efficacy, for both fetal and maternal morbidity consequences; as well as failure and success in establishing appropriate metabolic and glucose control. Oral medication therapy is a safe and effective treatment modality for GDM and in some circumstances may serve as first-line therapy when nutritional modifications fail. When oral agents fail to establish glucose control then insulin injections should be added. Determining the best oral therapy in inconclusive, although it seems that metformin is slightly superior to glyburide, in some aspects. As for parenteral therapy, all insulins listed in this article are considered both safe and effective for treatment of hyperglycemia during pregnancy. Importantly, a better safety profile, with similar efficacy is documented for most analogues. As GDM prevalence rises, there is a need for successful monitoring and treatment for patients. Caregivers should know the possible and available therapeutic options.

  19. Does bilirubin protect against developing diabetes mellitus?

    PubMed

    Breimer, Lars H; Mikhailidis, Dimitri P

    2016-01-01

    After 25 years of evaluating bilirubin as a possible protective agent in neonatal and cardiovascular disease, interest has moved on to a exploring a possible protective role in diabetes mellitus (DM). This review finds conflicting prospective data for a protective relationship though there are retrospective, case-controlled data, that can only show association, which is not causality. Only prospective studies can show causality. Also, it would appear that the underlying biochemical assumptions do not readily translate from the animal to the human setting. Given that many factors impact on circulating bilirubin levels, it is not surprising that a clear-cut answer is not available; the jury is still out. Any relationship between DM and bilirubin might relate to intermediates in bilirubin metabolism, including relationships involving the genes for the enzymes participating in those steps. Nevertheless, the pursuit of bilirubin in disease causation is opening new avenues for research and if it is established that serum bilirubin can predict risks, much will have been achieved. The answer may have to come from molecular genetic analyses.

  20. [A disseminated form of Langerhans histiocytosis associated with diabetes insipidus and diabetes mellitus].

    PubMed

    Ben Ghorbel, I; Houman, M H; B'chir, S; Chamakhi, S; Miled, M

    2001-05-01

    Langerhans' cell histiocytosis is a rare disorder of unknown etiology characterized by a wide clinical spectrum and varied behavior. Diabetes insipidus is a relatively common feature in Langerhans' cell histiocytosis. The presence of both diabetes insipidus and mellitus associated with histiocytosis in an adult is rare. To our knowledge, only three previous cases have been reported. We report the clinical presentation, pathologic findings and clinical progress in an adult female who had disseminated Langerhans' cell histiocytosis (hypothalamic infiltration, multifocal bone involvement) associated with both diabetes insipidus and mellitus. The pathogenesis of diabetes mellitus in such an association will be discussed.

  1. Trabecular bone histomorphometry in humans with Type 1 Diabetes Mellitus.

    PubMed

    Armas, Laura A G; Akhter, Mohammed P; Drincic, Andjela; Recker, Robert R

    2012-01-01

    Patients with Type 1 Diabetes Mellitus (DM) have markedly increased risk of fracture, but little is known about abnormalities in bone microarchitecture or remodeling properties that might give insight into the pathogenesis of skeletal fragility in these patients. We report here a case-control study comparing bone histomorphometric and micro-CT results from iliac biopsies in 18 otherwise healthy subjects with Type 1 Diabetes Mellitus with those from healthy age- and sex-matched non-diabetic control subjects. Five of the diabetics had histories of low-trauma fracture. Transilial bone biopsies were obtained after tetracycline labeling. The biopsy specimens were fixed, embedded, and scanned using a desktop μCT at 16 μm resolution. They were then sectioned and quantitative histomorphometry was performed as previously described by Recker et al. [1]. Two sections, >250 μm apart, were read from the central part of each biopsy. Overall there were no significant differences between diabetics and controls in histomorphometric or micro-CT measurements. However, fracturing diabetics had structural and dynamic trends different from nonfracturing diabetics by both methods of analysis. In conclusion, Type 1 Diabetes Mellitus does not result in abnormalities in bone histomorphometric or micro-CT variables in the absence of manifest complications from the diabetes. However, diabetics suffering fractures may have defects in their skeletal microarchitecture that may underlie the presence of excess skeletal fragility.

  2. Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus

    PubMed Central

    Gunderson, Erica P.; Hurston, Shanta R.; Ning, Xian; Lo, Joan C.; Crites, Yvonne; Walton, David; Dewey, Kathryn G.; Azevedo, Robert A.; Young, Stephen; Fox, Gary; Elmasian, Cathie C.; Salvador, Nora; Lum, Michael; Sternfeld, Barbara; Quesenberry, Charles P.

    2016-01-01

    Background Lactation improves glucose metabolism, but its role in preventing type 2 diabetes mellitus (DM) after gestational diabetes mellitus (GDM) remains uncertain. Objective To evaluate lactation and the 2-year incidence of DM after GDM pregnancy. Design Prospective, observational cohort of women with recent GDM. (ClinicalTrials.gov: NCT01967030) Setting Integrated health care system. Participants 1035 women diagnosed with GDM who delivered singletons at 35 weeks' gestation or later and enrolled in the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy from 2008 to 2011. Measurements Three in-person research examinations from 6 to 9 weeks after delivery (baseline) and annual follow-up for 2 years that included 2-hour, 75-g oral glucose tolerance testing; anthropometry; and interviews. Multivariable Weibull regression models evaluated independent associations of lactation measures with incident DM adjusted for potential confounders. Results Of 1010 women without diabetes at baseline, 959 (95%) were evaluated up to 2 years later; 113 (11.8%) developed incident DM. There were graded inverse associations for lactation intensity at baseline with incident DM and adjusted hazard ratios of 0.64, 0.54, and 0.46 for mostly formula or mixed/inconsistent, mostly lactation, and exclusive lactation versus exclusive formula feeding, respectively (P trend = 0.016). Time-dependent lactation duration showed graded inverse associations with incident DM and adjusted hazard ratios of 0.55, 0.50, and 0.43 for greater than 2 to 5 months, greater than 5 to 10 months, and greater than 10 months, respectively, versus 0 to 2 months (P trend = 0.007). Weight change slightly attenuated hazard ratios. Limitation Randomized design is not feasible or desirable for clinical studies of lactation. Conclusion Higher lactation intensity and longer duration were independently associated with lower 2-year incidences of DM after GDM pregnancy. Lactation may prevent DM after GDM

  3. Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus: A Prospective Cohort Study.

    PubMed

    Gunderson, Erica P; Hurston, Shanta R; Ning, Xian; Lo, Joan C; Crites, Yvonne; Walton, David; Dewey, Kathryn G; Azevedo, Robert A; Young, Stephen; Fox, Gary; Elmasian, Cathie C; Salvador, Nora; Lum, Michael; Sternfeld, Barbara; Quesenberry, Charles P

    2015-12-15

    Lactation improves glucose metabolism, but its role in preventing type 2 diabetes mellitus (DM) after gestational diabetes mellitus (GDM) remains uncertain. To evaluate lactation and the 2-year incidence of DM after GDM pregnancy. Prospective, observational cohort of women with recent GDM. (ClinicalTrials.gov: NCT01967030). Integrated health care system. 1035 women diagnosed with GDM who delivered singletons at 35 weeks' gestation or later and enrolled in the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy from 2008 to 2011. Three in-person research examinations from 6 to 9 weeks after delivery (baseline) and annual follow-up for 2 years that included 2-hour, 75-g oral glucose tolerance testing; anthropometry; and interviews. Multivariable Weibull regression models evaluated independent associations of lactation measures with incident DM adjusted for potential confounders. Of 1010 women without diabetes at baseline, 959 (95%) were evaluated up to 2 years later; 113 (11.8%) developed incident DM. There were graded inverse associations for lactation intensity at baseline with incident DM and adjusted hazard ratios of 0.64, 0.54, and 0.46 for mostly formula or mixed/inconsistent, mostly lactation, and exclusive lactation versus exclusive formula feeding, respectively (P trend = 0.016). Time-dependent lactation duration showed graded inverse associations with incident DM and adjusted hazard ratios of 0.55, 0.50, and 0.43 for greater than 2 to 5 months, greater than 5 to 10 months, and greater than 10 months, respectively, versus 0 to 2 months (P trend = 0.007). Weight change slightly attenuated hazard ratios. Randomized design is not feasible or desirable for clinical studies of lactation. Higher lactation intensity and longer duration were independently associated with lower 2-year incidences of DM after GDM pregnancy. Lactation may prevent DM after GDM delivery. National Institute of Child Health and Human Development.

  4. Insulin oedema in a child with newly diagnosed diabetes mellitus.

    PubMed

    Aravamudhan, Avinash; Gardner, Chris; Smith, Claire; Senniappan, Senthil

    2014-05-01

    Insulin oedema is a rare complication of insulin therapy for diabetes mellitus. It has been reported in type 1 diabetes mellitus, in poorly controlled type 2 diabetes mellitus following either the initiation or intensification of insulin therapy and in underweight patients on large doses of insulin. There are only a few case reports since it was first described in 1928, showing that it is an uncommon and probably an under-reported complication. The majority of those reports have been in the adult population. The generalised oedema tends to develop shortly after initiation or intensification of insulin therapy and resolves spontaneously within few weeks. We present one of the youngest patients reported in the literature, a 9-year-old boy who developed insulin oedema within few days of presenting with diabetic ketoacidosis. The case highlights the importance of recognising this generally transient and self-resolving complication and differentiating it from other serious causes of oedema.

  5. Ischemia reperfusion injury, ischemic conditioning and diabetes mellitus.

    PubMed

    Lejay, Anne; Fang, Fei; John, Rohan; Van, Julie A D; Barr, Meredith; Thaveau, Fabien; Chakfe, Nabil; Geny, Bernard; Scholey, James W

    2016-02-01

    Ischemia/reperfusion, which is characterized by deficient oxygen supply and subsequent restoration of blood flow, can cause irreversible damages to tissue. Mechanisms contributing to the pathogenesis of ischemia reperfusion injury are complex, multifactorial and highly integrated. Extensive research has focused on increasing organ tolerance to ischemia reperfusion injury, especially through the use of ischemic conditioning strategies. Of morbidities that potentially compromise the protective mechanisms of the heart, diabetes mellitus appears primarily important to study. Diabetes mellitus increases myocardial susceptibility to ischemia reperfusion injury and also modifies myocardial responses to ischemic conditioning strategies by disruption of intracellular signaling responsible for enhancement of resistance to cell death. The purpose of this review is twofold: first, to summarize mechanisms underlying ischemia reperfusion injury and the signal transduction pathways underlying ischemic conditioning cardioprotection; and second, to focus on diabetes mellitus and mechanisms that may be responsible for the lack of effect of ischemic conditioning strategies in diabetes.

  6. Diabetes mellitus as a contributory factor in oral candidosis.

    PubMed

    Soysa, N S; Samaranayake, L P; Ellepola, A N B

    2006-05-01

    It has been reported that poor glycaemic control predisposes to oral candidal infection in diabetic patients. For instance, the carriage of Candida species and the density of candidal growth in the oral cavity is frequently claimed to be increased in patients with diabetes mellitus. However, the validity of these observations remains controversial. Hence, we review and discuss here the clinical data in the literature on the relationship between diabetes and oral candidal carriage and infection, and possible mechanisms associated with its pathogenicity.

  7. Cognitive and motor perturbations in elderly with longstanding diabetes mellitus.

    PubMed

    Díaz-Gerevini, G T; Repossi, G; Dain, A; Tarres, M C; Das, U N; Eynard, A R

    2014-06-01

    Type 2 diabetes mellitus is a chronic disease characterized by insulin resistance; inflammation; oxidative stress; vascular damage; and dysfunction of glucose, protein, and lipid metabolisms. However, comparatively less attention has been paid to neurologic alterations seen in elderly individuals with type 2 diabetes. We review clinical, metabolic, and biochemical aspects of diabetic encephalopathy (DE) and propose that quality of dietary lipids is closely linked to DE. This implies that preventive nutritional interventions may be designed to improve DE.

  8. Monitoring methods for dogs and cats with diabetes mellitus.

    PubMed

    Cook, Audrey K

    2012-05-01

    Effective monitoring is essential for the management of dogs and cats with diabetes mellitus. However, methods for evaluating glycemic control must be tailored to meet both the needs of the patient and the expectations of the owner. This article discusses the philosophies that drive blood glucose monitoring in veterinary diabetics and review common practices. The advantages and limitations of the various options are presented. © 2012 Diabetes Technology Society.

  9. Global burden of disease attributable to diabetes mellitus in Brazil.

    PubMed

    Oliveira, Andreia Ferreira de; Valente, Joaquim Gonçalves; Leite, Iuri da Costa; Schramm, Joyce Mendes de Andrade; Azevedo, Anne S Renteria de; Gadelha, Angela Maria Jourdan

    2009-06-01

    Type II diabetes mellitus accounts for 90% of all cases of diabetes, and its inclusion in health evaluation has shown that its complications have a considerable impact on the population's quality of life. The current article presents the results of the Global Burden of Disease Study in Brazil for the year 1998, with an emphasis on diabetes mellitus and its complications. The indicator used was disability-adjusted life years (DALY), using a discount rate of 3%. In Brazil, ischemic heart disease, stroke, and diabetes accounted for 14.7% of total lost DALYs. Brazil showed a higher proportion of years lived with disability (YLDs) among total DALYs for diabetes as compared to other countries. Retinopathy and neuropathy were the complications that contributed most to YLDs. According to forecasts, diabetes mellitus will have an increasing impact on years of life lost due to premature death and disability in the world, shifting from the 11th to 7th cause of death by 2030. It is thus urgent to implement effective measures for prevention, early diagnosis, counseling, and adequate follow-up of patients with diabetes mellitus.

  10. Polymorphism of the renalase gene in gestational diabetes mellitus.

    PubMed

    Fatima, Syeda Sadia; Jamil, Zehra; Alam, Faiza; Malik, Hajira Zafar; Madhani, Sarosh Irfan; Ahmad, Muhammad Saad; Shabbir, Tayyab; Rehmani, Muhammed Noman; Rabbani, Amna

    2017-01-01

    Renalase is considered as a novel candidate gene for type 2 diabetes. In this study, we aimed to investigate the relationship of serum renalase and two single nucleotide polymorphisms with gestational diabetes mellitus. One hundred and ninety-eight normotensive pregnant females (n = 99 gestational diabetes mellitus; n = 99 euglycemic pregnant controls) were classified according to the International Association of the Diabetes and Pregnancy Study criteria. Fasting and 2-h post glucose load blood levels and anthropometric assessment was performed. Serum renalase was measured using enzyme-linked immunosorbent assay, whereas DNA samples were genotyped for renalase single nucleotide polymorphisms rs2576178 and rs10887800 using Polymerase chain reaction-Restriction fragment length polymorphism method. In an age-matched case control study, no difference was observed in the serum levels of renalase (p > 0.05). The variant rs10887800 showed an association with gestational diabetes mellitus and remained significant after multiple adjustments (p < 0.05), whereas rs2576178 showed weak association (p = 0.030) that was lost after multiple adjustments (p = 0.09). We inferred a modest association of the rs10887800 polymorphism with gestational diabetes. Although gestational diabetes mellitus is self-reversible, yet presence of this minor G allele might predispose to metabolic syndrome phenotypes in near the future.

  11. Tendinopathy in diabetes mellitus patients-Epidemiology, pathogenesis, and management.

    PubMed

    Lui, Pauline Po Yee

    2017-01-20

    Chronic tendinopathy is a frequent and disabling musculo-skeletal problem affecting the athletic and general populations. The affected tendon is presented with local tenderness, swelling, and pain which restrict the activity of the individual. Tendon degeneration reduces the mechanical strength and predisposes it to rupture. The pathogenic mechanisms of chronic tendinopathy are not fully understood and several major non-mutually exclusive hypotheses including activation of the hypoxia-apoptosis-pro-inflammatory cytokines cascade, neurovascular ingrowth, increased production of neuromediators, and erroneous stem cell differentiation have been proposed. Many intrinsic and extrinsic risk/causative factors can predispose to the development of tendinopathy. Among them, diabetes mellitus is an important risk/causative factor. This review aims to appraise the current literature on the epidemiology and pathology of tendinopathy in diabetic patients. Systematic reviews were done to summarize the literature on (a) the association between diabetes mellitus and tendinopathy/tendon tears, (b) the pathological changes in tendon under diabetic or hyperglycemic conditions, and (c) the effects of diabetes mellitus or hyperglycemia on the outcomes of tendon healing. The potential mechanisms of diabetes mellitus in causing and exacerbating tendinopathy with reference to the major non-mutually exclusive hypotheses of the pathogenic mechanisms of chronic tendinopathy as reported in the literature are also discussed. Potential strategies for the management of tendinopathy in diabetic patients are presented.

  12. Oral manifestations of Diabetes Mellitus. A systematic review.

    PubMed

    Mauri-Obradors, E; Estrugo-Devesa, A; Jané-Salas, E; Viñas, M; López-López, J

    2017-09-01

    Diabetes Mellitus has become a global epidemic and presents many complications, usually proportional to the degree and duration of hyperglycemia. The aim of this systematic review was to investigate the different oral manifestations associated with Diabetes Mellitus. A MEDLINE search for "Diabetes Mellitus and oral manifestations" was performed. A further search was conducted for "diabetes" and its individual oral manifestation. Inclusion criteria were as follows: human clinical studies with a minimum of 30 patients; studies published in relevant scientific journals between January 1998 and January 2016. Nineteen studies fulfilled the inclusion criteria and were analyzed, assessing the strength of scientific evidence according to recommendations made by the Centre for Evidence-Based Medicine, Oxford (OCEBM), which permits adequate assessment of prevalence studies. A total 3,712 patients (2,084 diabetics) were included in the studies reviewed. Of the 19 studies analyzed, 4 were longitudinal studies and 15 cross-sectional studies. Periodontal disease, periapical lesions, xerostomia and taste disturbance were more prevalent among diabetic patients. An association between diabetes and caries and mucosal lesions proved positive in 5 out of 10 studies. Despite multiple oral manifestations associated with DM, awareness of the associations between diabetes, oral health, and general health is inadequate. It is necessary for doctors and dentists to be aware of the various oral manifestations of diabetes in order to make an early diagnosis.

  13. Insulin gene therapy for type 1 diabetes mellitus.

    PubMed

    Handorf, Andrew M; Sollinger, Hans W; Alam, Tausif

    2015-04-01

    Type 1 diabetes mellitus is an autoimmune disease resulting from the destruction of pancreatic β cells. Current treatments for patients with type 1 diabetes mellitus include daily insulin injections or whole pancreas transplant, each of which are associated with profound drawbacks. Insulin gene therapy, which has shown great efficacy in correcting hyperglycemia in animal models, holds great promise as an alternative strategy to treat type 1 diabetes mellitus in humans. Insulin gene therapy refers to the targeted expression of insulin in non-β cells, with hepatocytes emerging as the primary therapeutic target. In this review, we present an overview of the current state of insulin gene therapy to treat type 1 diabetes mellitus, including the need for an alternative therapy, important features dictating the success of the therapy, and current obstacles preventing the translation of this treatment option to a clinical setting. In so doing, we hope to shed light on insulin gene therapy as a viable option to treat type 1 diabetes mellitus.

  14. The effects of polycystic ovary syndrome on gestational diabetes mellitus.

    PubMed

    Aktun, Hale Lebriz; Yorgunlar, Betul; Acet, Mustafa; Aygun, Banu Kumbak; Karaca, Nilay

    2016-01-01

    The aim of this study was to explore the inter-relationship between polycystic ovary syndrome and gestational diabetes mellitus, and demonstrate maternal and fetal outcomes. This was a case-control study in 1360 pregnant women who received a diagnosis of gestational diabetes mellitus between 24 and 28 weeks of gestational age. Among all diagnosed with gestational diabetes mellitus, 150 pregnant women had received a polycystic ovary syndrome, and 160 women who did not have polycystic ovary syndrome were designated as controls. The incidence of pregnancy-induced hypertension was 26.3% and 12% in the case and control groups, respectively. Preeclampsia was seen at an incidence of 12% and 6% in case and in control groups, respectively. The difference in neonatal hypoglycemia between the two groups was statistically significant, with an incidence of 17% and 5% in the case and in control groups, respectively. This study demonstrated that the presence of polycystic ovary syndrome along with gestational diabetes mellitus increases the risk of pregnancy induced hypertension by 2.4 fold, preeclampsia by 2 fold and neonatal hypoglycemia by 3.2 fold, compared to gestational diabetes mellitus alone.

  15. The effects of diabetes mellitus and hypertension on work productivity.

    PubMed

    Krstović-Spremo, Vesna; Račić, Maja; Joksimović, Bojan N; Joksimović, Vedrana R

    2014-01-01

    The primary objective of this paper is to examine the impact of diabetes mellitus on the ability to work in patients with diabetes mellitus. The second objective of this paper is to examine the differences in the ability to work between patients with diabetes mellitus and patients with other chronic diseases, such as hypertension. A study was conducted in 10 family medicine practices from two primary health care centers, Pale and East Sarajevo, in the period between July 2009 and May 2010, utilising a retrospective medical records review and a cross sectional survey. The outcomes used to portray respondent's health status included functional measures and ability to work. Functional measures were analyzed using SF-36 and a general questionnaire. Absenteeism and productivity loss were retrospectively analyzed for the past ten years from a regional sick-leave database and the administrative records of the Commission for the assessment of work capacity for the Pension and Disability Insurance Fund of the Republika Srpska respectively. Out of the total number of patients with diabetes, 24.6% had some form of disability. A statistically significant difference was found between the two groups; patients with diabetes mellitus were much more likely to have problems meeting the required standards at the workplace due to emotional and physical health issues compared to hypertensive patients. Diabetes mellitus appears to reduce an individual's ability to work in comparison to patients with hypertension. There is a need to set up a diabetes mellitus prevention program and to develop and implement effective targeted intervention to help workers to manage their disease better. Copyright © 2014 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  16. Maternal Lipids May Predict Fetal Growth in Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus Pregnancies.

    PubMed

    Krstevska, Brankica; Jovanovska, Sasha Misevska; Krstevska, Slagjana Simeonova; Nakova, Valentina Velkoska; Serafimoski, Vladimir

    2016-11-01

    During diabetic pregnancy, complex metabolic changes occur in the lipid profile. The aim of the study was to determine the predictive values of maternal serum lipid levels on large-for-gestational age newborns during the third trimester in pregnancies of women with type 2 diabetes mellitus (DM2) and gestational diabetes mellitus (GDM). Data of forty three pregnancies of women with DM2 and two hundred women with GDM were analyzed. The analysis encompassed the following parameters: age, body mass index (BMI), lipid parameters, HbA1c in first, second and third trimester of pregnancy, preeclampsia and baby birth weight. DM2 and GDM groups showed statistically significant differences in the following variables: total lipids, triglycerides, total cholesterol, BMI, age, baby birth weight, incidence of SGA and preterm delivery (9.4 ± 2.3 vs. 11.0 ± 2.3 mmol/L, 2.4 ± 1.4 vs. 3.4 ± 1.6 mmol/L, 5.5 ± 1.2 vs. 6.4 ± 1.4 mmol/L, 30.6 ± 5.4 vs. 26.9 ± 5.2 kg/m2, 34 ± 7.8 vs. 31.5 ± 5.6 years, 3183 ± 972 vs. 3533 ± 699 g., 20% vs. 7.5%, 27.9 vs. 14%, respectively, p < 0.05). Linear multiple regression analysis demonstrated that triglycerides, LDL-C and total cholesterol were independent predictors of LGA (p < 0.05). Triglycerides and LDL-C in the third trimester of pregnancy are independent predictors for fetal macrosomia in DM2 and GDM pregnancies. Thus, the maternal serum triglycerides and LDL-C levels determined in the maternal blood taken in the third trimester of pregnancy may indentify women who will give birth to LGA newborns.

  17. [Effects of diabetes mellitus on the occurrence of age-related macular degeneration].

    PubMed

    Li, Xia; Wang, Yu-sheng

    2011-03-01

    Diabetes mellitus causing long term disturbed glucose metabolism could result in tissue injury and multiple complications. According to recent studies, diabetes mellitus might be regarded as one of the risk factors of age related macular degeneration (AMD). Diabetes mellitus affects the incidence and progression of AMD through altering hemodynamics, increasing oxidative stress, accumulating advanced glycation end products, etc. By studying epidemiological investigation and basic research on this subject comprehensively, it is required to review the correlation between diabetes mellitus and AMD.

  18. Study characteristics of juvenile diabetes mellitus cases in bangladesh.

    PubMed

    Karim, Rezaul; Mona, Nusrat Jahan

    2014-06-01

    To identify the proportion and some selected characteristics of juvenile diabetics attending BIRDEM hospital. This was a cross sectional study. The study was conducted in the BIRDEM hospital. All Diabetic young aged up to 18 years who visit BIRDEM hospital were included in study population. The sample size was 240. It was observed that among the respondents 43.3% were protein deficient pancreatic diabetes (PDPD), 30.8% were Type-1 diabetes, 20% were fibro-calculus pancreatic diabetes (FCPD) and remaining 5.8% were Type-2 diabetes. Family history of diabetes was found among one-fifth of the respondents. It was found that majority 86.4% of Type-1 diabetes were presented in early age < 10 years in contrast to Type-2 diabetes 4.5%, PDPD 9.1% and FCPD 0.0%. It was found that 50% of type-1 diabetes patient and 17.6% of Type-2 diabetes patient were from urban area and 24.5% of FCDP patient and 52.8% of PDPD patient were from rural areas. It was observed that Type-1 and Type-2 diabetes were associated with the family history of diabetes mellitus than FCPD and PDPD. Severe underweight and sever stunted was significantly higher among the protein deficient diabetes mellitus compare to Type-2 diabetes. Juvenile diabetes is emerging health problem in modern era. Like old population the incidence of juvenile diabetes is increasing day by day. It is time for the health planner to prevent and control the disease; otherwise it will be major problem after a decade.

  19. Targeting blood pressure in people with diabetes mellitus.

    PubMed

    Brimble, K Scott

    2016-06-29

    Hypertension is a strong risk factor for cardiovascular (CV)-related morbidity and mortality, and its treatment has been shown to be beneficial. Hypertension is common in people with diabetes mellitus, and the combination of these conditions markedly increases CV risk in comparison with individuals with neither condition. Although there is increasing clarity as to blood pressure (BP) targets in numerous conditions, the target in people with diabetes remains unclear, and, as a result, many clinical practice guidelines differ on the optimal BP goal. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial did not demonstrate benefit when systolic BP (SBP) was lowered to less than 120 mmHg compared with a target of less than 140 mmHg. This was in contrast to the recent SPRINT trial (Systolic Blood Pressure Intervention Trial), which demonstrated the superiority of a target SBP of less than 120 mmHg in reducing CV events. However, people with diabetes mellitus were excluded. Recent meta-analyses have suggested that lowering BP in patients with diabetes mellitus should be reserved for a baseline SBP greater than 140 mmHg, targeting an SBP of between 130 and 140 mmHg. Lower targets may reduce the risk of stroke but may also be harmful with respect to other important CV outcomes. The methodological limitations of these meta-analyses highlight the need for a large randomized controlled trial comparing lower and standard BP targets in people with diabetes mellitus.

  20. Diabetes mellitus and bone disease in cystic fibrosis.

    PubMed

    Curran, David R; McArdle, John R; Talwalkar, Jaideep S

    2009-10-01

    Patients with cystic fibrosis are frequently affected with pancreatic insufficiency and are predisposed to the development of diabetes mellitus (DM) and bone demineralization. Cystic fibrosis-related diabetes mellitus is a clinical entity distinct from type 1 and type 2 diabetes, with important implications for the nutritional and pulmonary health of cystic fibrosis patients. This form of diabetes owes largely to insulin deficiency, but alterations in insulin sensitivity and hepatic glucose production have also been described. Therapy for cystic fibrosis-related diabetes differs substantially from type 2 DM, with careful attention to prandial glycemic excursions crucial to controlling its metabolic effects. Bone disease, including osteopenia and osteoporosis, also occurs with increased frequency in cystic fibrosis, owing to defects in intestinal absorption, chronic inflammation, lung disease, low body weight, and gonadal dysfunction. The pathogenesis, implications, diagnosis, and therapy of cystic fibrosis-related bone demineralization are discussed, with attention to recommended approaches to prevention of and treatment of established bone disease.

  1. MicroRNAs and Cardiovascular Disease in Diabetes Mellitus

    PubMed Central

    Ding, Yue

    2017-01-01

    Cardiovascular disease (CVD) is the major macrovascular complication of diabetes mellitus. Recently, although CVD morbidity and mortality have decreased as a result of comprehensive control of CVD risk factors, CVD remains the leading cause of death of patients with diabetes in many countries, indicating the potential underlying pathophysiological mechanisms. MicroRNAs are a class of noncoding, single-stranded RNA molecules that are involved in β-cell function, insulin secretion, insulin resistance, skeletal muscle, and adipose tissue and which play an important role in glucose homeostasis and the pathogenesis of diabetic complications. Here, we review recent progress in research on microRNAs in endothelial cell and vascular smooth muscle cell dysfunction, macrophage and platelet activation, lipid metabolism abnormality, and cardiomyocyte repolarization in diabetes mellitus. We also review the progress of microRNAs as potential biomarkers and therapeutic targets of CVD in patients with diabetes. PMID:28299324

  2. Infections in patients with diabetes mellitus: A review of pathogenesis

    PubMed Central

    Casqueiro, Juliana; Casqueiro, Janine; Alves, Cresio

    2012-01-01

    In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, which potentially increases their morbimortality. The greater frequency of infections in diabetic patients is caused by the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro- and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and greater number of medical interventions in these patients. The infections affect all organs and systems. Some of these problems are seen mostly in diabetic people, such as foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis. In addition to the increased morbidity, infectious processes may be the first manifestation of diabetes mellitus or the precipitating factors for complications inherent to the disease, such as diabetic ketoacidosis and hypoglycemia. Immunization with anti-pneumococcal and influenza vaccines is recommended to reduce hospitalizations, deaths, and medical expenses. PMID:22701840

  3. Diabetes mellitus effect on rat corneal dielectric properties.

    PubMed

    Olszewski, J; Marzec, E; Florek, E; Kulza, M

    2012-03-01

    In the course of the study, we carried out a dielectric examination to determine the effect of diabetes mellitus on the rat corneal function. Measurements were performed over the frequency range of 500 Hz-100 kHz in air and at the temperatures from 25 to 150°C. The frequency dependencies of the loss tangent for the healthy and the diabetic cornea exhibit two peaks at 2 kHz and 16 kHz in the α-dispersion region. The amplitude of these both peaks is smaller for the diabetic cornea than that for the healthy one. The temperature dependencies of the loss tangent for the healthy and the diabetic cornea reveal β-relaxation in the range of 30-70°C and 50-90°C, respectively. The present study exhibits that the dielectric spectroscopy is useful in detection of the effect of diabetes mellitus on the corneal molecular behavior.

  4. Risk factors for retinopathy in diabetes mellitus in Kelantan, Malaysia.

    PubMed

    Shriwas, S R; Rahman Isa, A B; Reddy, S C; Mohammad, M; Mohammad, W B; Mazlan, M

    1996-12-01

    Few attempts have been made to determine the risk factors for diabetic retinopathy which is a major cause of visual impairment and blindness. One hundred and forty patients of diabetes mellitus were studied to determine the prevalence and types of retinopathy, and its relation to various risk factors. Nearly half (48.6%) of the patients suffered from retinopathy. The significant associated risk factors were long duration of diabetes, proteinuria and elevated serum creatinine level. However, there was no significant association between the prevalence of retinopathy and high levels of serum cholesterol, C-peptide levels, associated hypertension, and glycaemic control of diabetes mellitus. An effective screening programme for detection of retinopathy in the patients of diabetes as a regular practice is encouraged.

  5. Treating lipid abnormalities in patients with type 2 diabetes mellitus.

    PubMed

    Steiner, G

    2001-12-20

    The typical lipid levels in type 2 diabetes mellitus are low high-density lipoprotein cholesterol, normal low-density lipoprotein cholesterol, and high triglycerides. Atherosclerotic cardiovascular disease is the most common problem confronting those with type 2 diabetes mellitus. Some previous large lipid-lowering clinical trials conducted subanalyses of individuals with type 2 diabetes. Although these trials suggested a coronary benefit, questions remained because of (1) the limitations of such subanalyses, (2) the atypical characteristics of the populations, and (3) some inconsistencies in their findings. The Diabetes Atherosclerosis Intervention Study (DAIS), a randomized, double-blind, placebo-controlled study in men and women with type 2 diabetes, has demonstrated by quantitative angiography that treatment with micronized fenofibrate corrected their lipid abnormalities and reduced the progression of coronary disease. Furthermore, this occurred in individuals with lipid levels that many physicians would consider to be normal.

  6. Ministry of Health Clinical Practice Guidelines: Diabetes Mellitus

    PubMed Central

    Goh, Su Yen; Ang, Seng Bin; Bee, Yong Mong; Chen, Richard YT; Gardner, Daphne; Ho, Emily; Adaikan, Kala; Lee, Alvin; Lee, Chung Horn; Lim, Fong Seng; Lim, Hwee Boon; Lim, Su Chi; Seow, Julie; Soh, Abel Wah Ek; Sum, Chee Fang; Tai, E Shyong; Thai, Ah Chuan; Wong, Tien Yin; Yap, Fabian

    2014-01-01

    The Ministry of Health (MOH) have updated the clinical practice guidelines on Diabetes Mellitus to provide doctors and patients in Singapore with evidence-based treatment for diabetes mellitus. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Diabetes Mellitus, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. PMID:25017409

  7. Supporting adolescents with type 1 diabetes mellitus: a qualitative study.

    PubMed

    Rostami, Shahnaz; Parsa-Yekta, Zohreh; Najafi Ghezeljeh, Tahereh; Vanaki, Zohreh

    2014-03-01

    Without sufficient support, type 1 diabetes mellitus often disturbs patients' normal lives. This study describes and explores the support that Iranian adolescents with type 1 diabetes mellitus experienced. Semistructured interviews were conducted with ten adolescents, seven family members, one dietitian, one nurse, and one school nurse. Participants were chosen using purposive sampling from two teaching hospitals and one high school in two urban areas of Iran. Using standard procedures for content analysis, three main themes were identified: maintaining a normal life; receiving tangible, informational, and emotional support from the family and society; and advancement of life toward normalization. The cornerstone of maintaining a normal life for adolescents with type 1 diabetes mellitus is to adopt an active role in taking care of themselves within their systems of support.

  8. Ministry of Health Clinical Practice Guidelines: Diabetes Mellitus.

    PubMed

    Goh, S Y; Ang, S B; Bee, Y M; Chen, Y T; Gardner, D S; Ho, E T; Adaikan, K; Lee, Y C; Lee, C H; Lim, F S; Lim, H B; Lim, S C; Seow, J; Soh, A W; Sum, C F; Tai, E S; Thai, A C; Wong, T Y; Yap, F

    2014-06-01

    The Ministry of Health (MOH) have updated the clinical practice guidelines on Diabetes Mellitus to provide doctors and patients in Singapore with evidence-based treatment for diabetes mellitus. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Diabetes Mellitus, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  9. New therapeutic agents for diabetes mellitus: implications for anesthetic management.

    PubMed

    Chen, Daniel; Lee, Stephanie L; Peterfreund, Robert A

    2009-06-01

    Multiple hormones and transmitter systems contribute to glucose homeostasis and the control of metabolism. Recently, the gastrointestinal peptide hormones glucagon-like peptide 1 and amylin have been shown to significantly contribute to this complex physiology. These advances provide the foundation for new treatments for diabetes mellitus. Therapies based on glucagon-like peptide 1 and amylin have now been introduced into clinical practice. Rimonabant, the selective endocannabinoid receptor antagonist, had been used in European countries for the treatment of obesity; it has recently been withdrawn for this indication. This drug exhibited therapeutic benefits for metabolic variables and for type 2 diabetes mellitus. Anesthesia providers caring for patients with diabetes mellitus will need to understand the implications of these new therapies in perioperative settings, particularly with respect to side effects and interactions.

  10. [Prevalence of diabetes mellitus in rural areas in Chad].

    PubMed

    Dionadji, M; Boy, B; Mouanodji, M; Batakao, G

    2010-08-01

    The purpose of this study conducted from January 10 to 28, 2004, was to determine the prevalence of diabetes mellitus in a sedentary rural population over the age of 18 years old in Chad. The study population included a total of 412 persons, i.e., 222 men (54%) and 190 women (46%), with a mean age of 35 years (range, 18 to 90 years). Hypertension and obesity were observed in 16.4% and 8.7% of subjects respectively. The prevalence of diabetes mellitus was 7.39%. The prevalence of impaired fasting glucose (IFG) was 5.44% overall, 9% in women and 2.77% in men (p < 0.0001). This study indicated a high prevelence of diabetes mellitus and female IGF in rural areas of Chad. Further study is needed to evaluate risk factors.

  11. Cardiovascular autonomic neuropathy in patients with diabetes mellitus.

    PubMed

    Lozano, T; Ena, J

    Cardiovascular autonomic neuropathy associated with diabetes mellitus is caused by an impairment of the autonomic system. The prevalence of this condition ranges from 20% to 65%, depending on the duration of the diabetes mellitus. Clinically, the autonomic function disorder is associated with resting tachycardia, exercise intolerance, orthostatic hypotension, intraoperative cardiovascular instability, silent myocardial ischemia and increased mortality. For the diagnosis, the integrity of the parasympathetic and sympathetic nervous system is assessed. Parasympathetic activity is examined by measuring heart rate variability in response to deep breathing, standing and the Valsalva manoeuvre. Sympathetic integrity is examined by measuring blood pressure in response to standing and isometric exercise. The treatment includes the metabolic control of diabetes mellitus and of the cardiovascular risk factors. Treating symptoms such as orthostatic hypotension requires special attention.

  12. [Pernicious anemia in an adolescent with type 1 diabetes mellitus].

    PubMed

    Carneiro, M; Dumont, C

    2009-04-01

    The most frequent organ-specific autoimmune diseases associated with type 1 diabetes mellitus in children are hypothyroidism and celiac disease. Among adults, other associations exist, notably with pernicious anemia, which is extremely rare in children. We relate the observation of an adolescent with type 1 diabetes mellitus and hypothyroidism, admitted for severe anemia in addition to chronic anemia caused by autoimmune gastritis. Blood cell count showed severe aregenerative anemia with pancytopenia, with signs of non-autoimmune hemolysis. Vitamin B12 levels were low, bone marrow aspiration revealed erythroid hyperplasia, and anti-intrinsic factor antibodies were positive, providing the diagnosis of pernicious anemia. Treatment with intramuscular vitamin B12 produced brisk reticulosis after 6 days, with a subsequent rapid resolution of the anemia. Follow-up of type 1 diabetes mellitus in children requires screening for organ-specific autoimmune diseases; in case of unexplained anemia, autoimmune gastritis must be suggested. It can evolve into pernicious anemia.

  13. Bariatric Surgery in Type 1 Diabetes Mellitus: A Systematic Review.

    PubMed

    Mahawar, Kamal K; De Alwis, Nimantha; Carr, William R J; Jennings, Neil; Schroeder, Norbert; Small, Peter K

    2016-01-01

    Bariatric surgery is recognised as an effective treatment strategy for obese patients with type 2 diabetes mellitus. An increasing number of patients with type 1 diabetes mellitus also suffer with obesity and obesity-associated comorbidities but the role of bariatric and metabolic surgery in this group of patients is unclear. This systematic review investigates published English language scientific literature to understand the results of bariatric surgery in obese patients with type 1 diabetes mellitus. We found that these patients can experience significant weight loss and comorbidity resolution with bariatric surgery. Though most patients also see a decline in total insulin requirement, glycaemic control remains difficult. Most of the patients reported in literature have undergone gastric bypass but data is insufficient to recommend any particular procedure.

  14. Menu variations for diabetes mellitus patients using Goal Programming model

    NASA Astrophysics Data System (ADS)

    Dhoruri, Atmini; Lestari, Dwi; Ratnasari, Eminugroho

    2017-08-01

    Diabetes mellitus (DM) was a chronic metabolic disease characterized by higher than normal blood glucose level (normal blood glucose level = = 80 -120 mg/dl). In this study, type 2 DM which mostly caused by unhealthy eating habits would be investigated. Related to eating habit, DM patients needed dietary menu planning with an extracare regarding their nutrients intake (energy, protein, fat and carbohydrate). Therefore, the measures taken were by organizing nutritious dietary menu for diabetes mellitus patients. Dietary menu with appropriate amount of nutrients was organized by considering the amount of calories, proteins, fats and carbohydrates. In this study, Goal Programming model was employed to determine optimal dietary menu variations for diabetes mellitus patients by paying attention to optimal expenses. According to the data obtained from hospitals in Yogyakarta, optimal menu variations would be analyzed by using Goal Programming model and would be completed by using LINGO computer program.

  15. U. S. Army Aviation Epidemiology Data Registry: Army Aviators with Diabetes Mellitus and Impaired Glucose Tolerance

    DTIC Science & Technology

    1994-03-01

    glucose tolerance (IGT), diabetes mellitus (DM), use of oral hypoglycemic agents, or use of insulin for the period 1988 to 1992. The paper reviewed the...incidence and prevalence of diabetes mellitus in Army aviators. The study tabulated the incidence and age-specific annual rates of diabetes mellitus and

  16. Association of diabetes insipidus, diabetes mellitus, optic atrophy, and deafness. The Wolfram or DIDMOAD syndrome.

    PubMed Central

    Najjar, S S; Saikaly, M G; Zaytoun, G M; Abdelnoor, A

    1985-01-01

    Seven patients with a rare syndrome of diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), neurosensory deafness (D), atony of the urinary tract, and other abnormalities (Wolfram or DIDMOAD syndrome) are reported. Of the seven patients, three siblings were followed up for 10-17 years. All seven patients had diabetes mellitus and optic atrophy; six had diabetes insipidus; and in the four patients investigated there was dilatation of the urinary tract. The severity of diabetes varied, and all required insulin for control of the hyperglycaemia. In one patient the course of the disease simulated maturity onset diabetes of the young; another presented with ketoacidosis; but none had haplotypes usually associated with insulin dependent diabetes mellitus. The diabetes insipidus responded to chlorpropamide, suggesting partial antidiuretic hormone deficiency. Onset of optic atrophy and loss of vision occurred relatively late and progressed slowly, although in one patient there was a rapid deterioration in visual acuity. Deafness was mild, of late onset, and of sensorineural origin. A degenerative process affecting the central and peripheral nervous system can explain all the manifestations of the syndrome except diabetes mellitus. The pathogenesis of the diabetes mellitus remains obscure. PMID:4051539

  17. Diabetes mellitus in children suffering from beta-thalassaemia.

    PubMed

    el-Hazmi, M A; al-Swailem, A; al-Fawaz, I; Warsey, A S; al-Swailem, A

    1994-10-01

    Insulin-dependent diabetes mellitus (IDDM) is a frequent complication in patients with beta-thalassaemia major. It is believed to be a consequence of the damage inflicted by iron overload to the pancreatic beta-cell. Liver disorders and genetic influences seem to be additional predisposing factors to diabetes mellitus in patients with beta-thalassaemia. Ethnic variations are frequently reported on prevalence and complications of diabetes mellitus in the beta-thalassaemia patients. We investigated 50 Saudi children (< 15 years) with beta-thalassaemia major and 50 beta-thalassaemia minor, and age- and sex-matched controls for the prevalence of diabetes mellitus, and its relation to hitherto claimed predisposing factors. Fasting blood glucose, plasma insulin level, liver function tests, plasma ferritin, iron, and transferrin were assessed in each patient and glucose tolerance was evaluated. Results in patients with beta-thalassaemia major were compared with those obtained for beta-thalassaemia minor and the controls. The results showed moderate elevation of ferritin level in the majority of the beta-thalassaemia major despite desferroxamine therapy. Either hyperinsulinaemia or hypoinsulinaemia was encountered in the majority of these patients. The prevalence of diabetes mellitus was 6 per cent compared to 2 per cent in the beta-thalassaemia minor and normal children. Impaired glucose tolerance (IGT) occurred at a significantly higher (24 per cent) frequency in the beta-thalassaemia major compared to 2 and 0 per cent in the beta-thalassaemia minor patients and normal controls, respectively. The prevalence of diabetes mellitus was significantly lower in the Saudi thalassaemic patients compared to the results obtained from patients of other ethnic groups reported in literature.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Oral health status of diabetes mellitus patients in Southwest Cameroon.

    PubMed

    Bissong, Mea; Azodo, C C; Agbor, M A; Nkuo-Akenji, T; Fon, P Nde

    2015-06-01

    Diabetes mellitus affects virtually all tissues and organs the body including the hard and soft issues of the oral cavity, manifesting with several complications. To assess the prevalence of oral diseases in diabetics and non-diabetics and to correlate oral diseases with glycaemic control. This was an observational study involving 149 diabetic patients recruited from hospitals in Southwest Region of Cameroon and 102 non-diabetic controls drawn from the general population. The study participants were aged 18 years and above. Data were collected using questionnaires, oral examination and laboratory tests. Oral examination was conducted to assess dental plaque, calculus, dental caries, periodontitis, gingivitis and candidiasis. Glycemic status was assessed by measuring glycated hemoglobin (HbA1c) levels using standardized methods. Thirty five out of 149 (23.5%) diabetic patients had gingivitis; 37 (24.8%) had periodontitis; 29 (19.5%) had dental caries and 32 (21.5%) had oral candidiasis. Gingivitis, periodontitis and oral candidiasis was significantly higher in diabetics than non-diabetics (P < 0.001). Also, more diabetic patients presented with poor oral hygiene than non-diabetics. Poorly controlled diabetics presented more with gingivitis and candidiasis than well-controlled diabetics and this relationship was statistically significant. The prevalence of oral disease was significantly higher in diabetics than in non-diabetic controls and hyperglycaemia seemed to be a major contributor to oral health in diabetic patients in the study area. Proper management of blood sugar levels might improve on the oral health of diabetes mellitus patients.

  19. Gestational diabetes mellitus: challenges in diagnosis and management.

    PubMed

    Mpondo, Bonaventura C T; Ernest, Alex; Dee, Hannah E

    2015-01-01

    Gestational diabetes mellitus (GDM) is a well-characterized disease affecting a significant population of pregnant women worldwide. It has been widely linked to undue weight gain associated with factors such as diet, obesity, family history, and ethnicity. Poorly controlled GDM results in maternal and fetal morbidity and mortality. Improved outcomes therefore rely on early diagnosis and tight glycaemic control. While straightforward protocols exist for screening and management of diabetes mellitus in the general population, management of GDM remains controversial with conflicting guidelines and treatment protocols. This review highlights the diagnostic and management options for GDM in light of recent advances in care.

  20. [Coma in type 2 diabete mellitus on metformin treatment].

    PubMed

    Renard, C; Tellal, S; Fevre, G; Ragot, C; Vest, P; Foissaud, V; Renaudeau, C

    2003-01-01

    Non traumatic coma in diabete mellitus has two origins : hypo- or hyperglycemia. Coma with hyperglycemia can be due to ketoacidosis, hyperosmolar state or lactic acidosis. The present observation reports on a type 2 diabete mellitus patient presenting with a coma while the patient was on metformin and glibenclamide treatment. On admission, biologicals tests showed major acidosis, hyperglycemia and hyperosmolarity. No metformine accumulation was demonstrated by analytical measure. In this case, the association of hyperosmolar state and metabolic acidosis prove the difficulty of the differential diagnosis.

  1. [Analgesia of labor in women with diabetes mellitus].

    PubMed

    Neymark, M I; Kovalev, A I

    2015-01-01

    The article deals with a study of duration of physiological labors in women with diabetes mellitus. 120 women were devided into three groups according to method of analgesia. We assessed data of central haemodynamics, efficacy of analgesia, glucose level in blood, conditions of fetus and newborn. We found that epidural analgesia with bupivacaine hydrochloride was an optimal method of labor analgesia in women with diabetes mellitus. This method provided a stabilization of glucose level in blood, normalization of data of central haemodynamics and allowed to avoid anomalies of labor Analgesia with promedol and paracetamol is a preferable method in case of presence of epidural analgesia contraindications.

  2. Diabetes mellitus and renal involvement in chronic viral liver disease.

    PubMed

    Iovanescu, V F; Streba, C T; Ionescu, M; Constantinescu, A F; Vere, C C; Rogoveanu, I; Moța, E

    2015-01-01

    Chronic viral liver disease is often associated with other conditions. Diabetes mellitus (DM) is frequently reported in this context and may play a role in the progression of the liver disease to hepatocellular carcinoma (HCC). Renal disease is also an important extrahepatic manifestation of hepatitis viral infection and its presence is associated with poor prognosis and management issues. Our study had multiple purposes: to determine the frequency of the association between chronic viral liver disease and diabetes mellitus, evaluate the potential of diabetes mellitus as a risk factor for HCC and assess an eventual renal involvement. We included in our study a number of 246 patients with chronic liver disease, from whom 136 were diagnosed with chronic viral hepatitis and 110 with viral liver cirrhosis. These patients were assessed by using a clinical examination and a series of tests, including serum transaminase levels, serum bilirubin, serum albumin, markers of cholestasis, fasting plasma glucose levels, serum creatinine, urea, albuminuria, Addis-Hamburger test, electrophoresis of urinary proteins, abdominal ultrasound and, in some cases, CT examination. We obtained the following results: diabetes mellitus is often associated with chronic liver disease of viral etiology, having been identified in 18.29% of the patients in our study. Age above 60 in patients with chronic hepatitis (p=0.013<0.05) and presence of hepatitis C virus were particularly correlated with the presence of diabetes mellitus. Renal disease was present in 13.4% of the patients with chronic liver disease and it was especially associated with liver cirrhosis and hepatitis C virus. The most common form of renal injury was glomerulonephritis. Acute kidney injury was diagnosed only in cirrhotic patients as hepatorenal syndrome, occurring in 7.27% of the subjects, while chronic kidney disease was identified only in two cases of chronic viral hepatitis. Four patients in our study were diagnosed with

  3. Sirtuins as novel players in the pathogenesis of diabetes mellitus

    PubMed Central

    Turkmen, Kultigin; Karagoz, Ali; Kucuk, Adem

    2014-01-01

    Diabetes mellitus (DM) is a systemic and complex disease with micro and macrovascular complications that result from impaired metabolic pathways and genetic susceptibilities. DM has been accepted as an epidemic worldwide during the last two decades. A substantial gap in our knowledge exists regarding the pathophysiology of this metabolic disorder despite the improved diagnostic tools and therapeutic approaches. Sirtuins are a group of NAD+ dependent enzymes that are involved in cellular homeostasis due to their deacetylating activity. In the present review, we aimed to discuss the role of associated sirtuins in the pathogenesis and treatment of diabetes mellitus. PMID:25512793

  4. [Insulin producing cells as therapy in diabetes mellitus].

    PubMed

    Schnedl, W J; Hohmeier, H E; Newgard, C B

    1996-01-01

    Even with intensive insulin therapy it is impossible to reach physiological blood glucose levels in insulin-dependent diabetes mellitus. Because of the high costs and technical problems involved in islet cell transplantation broad applicability of this therapy seems uncertain. An alternative approach is the development of molecular-engineered insulin-producing clonal cell lines. The main interest is in rodent insulinoma cell lines and neuroendocrine AtT-20ins cells. This paper reviews the current knowledge about glucose-stimulated insulin secretion and the problems that have to be solved before these cells can be used for therapy in diabetes mellitus.

  5. [Review on periodontal disease and metabolic control of diabetes mellitus].

    PubMed

    Steffens, João Paulo; Glaci Reinke, Stella Maria; Angel Muñoz, Miguel; Santos, Fábio André dos; Luiz Pilatti, Gibson

    2010-09-01

    There may be an interaction between periodontal disease and some systemic diseases such as diabetes mellitus. The objective of this review was to verify, by means of a review of clinical trials, if there is a positive association between periodontal disease and the glycemic control of type 2 diabetes mellitus (DM-2) patients. Eleven articles that fi t the study criteria were revised. It was concluded that periodontal disease may influence the metabolic control of DM-2. Additional studies with larger sample sizes and longer follow up are necessary for a better clarification of this issue.

  6. Infantile onset diabetes mellitus in developing countries - India.

    PubMed

    Varadarajan, Poovazhagi

    2016-03-25

    Infantile onset diabetes mellitus (IODM) is an uncommon metabolic disorder in children. Infants with onset of diabetes mellitus (DM) at age less than one year are likely to have transient or permanent neonatal DM or rarely type 1 diabetes. Diabetes with onset below 6 mo is a heterogeneous disease caused by single gene mutations. Literature on IODM is scanty in India. Nearly 83% of IODM cases present with diabetic keto acidosis at the onset. Missed diagnosis was common in infants with diabetes (67%). Potassium channel mutation with sulphonylurea responsiveness is the common type in the non-syndromic IODM and Wolcott Rallison syndrome is the common type in syndromic diabetes. Developmental delay and seizures were the associated co-morbid states. Genetic diagnosis has made a phenomenal change in the management of IODM. Switching from subcutaneous insulin to oral hypoglycemic drugs is a major clinical breakthrough in the management of certain types of monogenic diabetes. Mortality in neonatal diabetes is 32.5% during follow-up from Indian studies. This article is a review of neonatal diabetes and available literature on IODM from India.

  7. Diabetes mellitus and male aging: Pharmacotherapeutics and clinical implications.

    PubMed

    Putta, Swathi; Peluso, Ilaria; Yarla, Nagendra Sastry; Kilari, Eswar Kumar; Bishayee, Anupam; Lu, Da-Yong; Barreto, George E; Ashraf, Ghulam Md; Scotti, Luciana; Scotti, Marcus T; Singla, Rajeev K; Alexiou, Thonos; Atanasov, Atanas G; Tarasov, Vadim V; Bramhachari, P Veera; Imandi, Sarat Babu; Chintala, Madhuri; Sharma, Bechan; Reale, Marcella; Filosa, Rosanna; Aliev, Gjumrakch; Kamal, Mohammad Amjad

    2017-08-22

    Andropause or male menopause is defined as androgen decline and onset of hypogonadism in the aging male. Testosterone deficiency in adult male is associated with diabetes mellitus, coronary artery disease, and heart failure. Type 2 diabetic male patients aged above 30 years showed low testosterone levels which is common in diabetic men and had symptoms of hypogonadism. Male sexual dysfunction among diabetic patients can include disorders of libido, ejaculatory problems, and erectile dysfunctions are common among people with diabetes, particularly in older men who had diabetes for years. Older diabetics tend to have both impaired insulin release as well as insulin resistance. There is growing evidence indicating the pathophysiological connections among the mechanisms of oxidative damage by disruption of the oxidative balance, increased levels of enzymatic glycation products in testicular region and glucose transporters, obesity and proinflammatory cytokines in male infertile patients with diabetes. Epidemiological studies suggest that many clinical findings in diabetics are linked to low testosterone levels. This article reviews pathophysiological mechanisms, observational studies, and clinical implications of testosterone therapy in type 2 diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  8. Infantile onset diabetes mellitus in developing countries - India

    PubMed Central

    Varadarajan, Poovazhagi

    2016-01-01

    Infantile onset diabetes mellitus (IODM) is an uncommon metabolic disorder in children. Infants with onset of diabetes mellitus (DM) at age less than one year are likely to have transient or permanent neonatal DM or rarely type 1 diabetes. Diabetes with onset below 6 mo is a heterogeneous disease caused by single gene mutations. Literature on IODM is scanty in India. Nearly 83% of IODM cases present with diabetic keto acidosis at the onset. Missed diagnosis was common in infants with diabetes (67%). Potassium channel mutation with sulphonylurea responsiveness is the common type in the non-syndromic IODM and Wolcott Rallison syndrome is the common type in syndromic diabetes. Developmental delay and seizures were the associated co-morbid states. Genetic diagnosis has made a phenomenal change in the management of IODM. Switching from subcutaneous insulin to oral hypoglycemic drugs is a major clinical breakthrough in the management of certain types of monogenic diabetes. Mortality in neonatal diabetes is 32.5% during follow-up from Indian studies. This article is a review of neonatal diabetes and available literature on IODM from India. PMID:27022444

  9. [Cardiovascular prevention in diabetes mellitus: A multifactorial challenge].

    PubMed

    Pedro-Botet, Juan; Chillarón, Juan J; Benaiges, David; Flores-Le Roux, Juana A

    2016-01-01

    Patients with type2 diabetes mellitus have a high to very high cardiovascular risk, and often have other associated risk factors, such as hypertension, obesity and dyslipidaemia. Cardiovascular disease is the leading cause of morbidity and mortality in this population. An integrated control of all risk factors in patients with diabetes is essential for minimising the risk of macrovascular complications. Given the benefits of the multifactorial intervention strategies for cardiovascular prevention in diabetic patients, a review is presented on the therapeutic goals established for each risk factor in diabetes and the benefits of their control.

  10. Mutual Impact of Diabetes Mellitus and Tuberculosis in China.

    PubMed

    Cheng, Jun; Zhang, Hui; Zhao, Yan Lin; Wang, Li Xia; Chen, Ming Ting

    2017-05-01

    China has a double burden of diabetes mellitus and tuberculosis, and many studies have been carried out on the mutual impact of these two diseases. This paper systematically reviewed studies conducted in China covering the mutual impact of epidemics of diabetes and tuberculosis, the impact of diabetes on multi-drug resistant tuberculosis and on the tuberculosis clinical manifestation and treatment outcome, the yields of bi-directional screening, and economic evaluation for tuberculosis screening among diabetes patients. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  11. [Thyroid autoimmunity in type I (insulin dependent) diabetes mellitus].

    PubMed

    Pavía Sesma, C; Valls Tolosa, C; Eighian Baho, B; Gallart Marsillas, M; Albarrán Deogracias, J M

    1989-12-01

    225 diabetic children aged 4-18 years, were screened for antithyroid antibodies. 120 of them were determined at onset of diabetes mellitus. In the remaining patients, duration of diabetes ranged from 6 months to 8 years. The overall prevalence of thyroid antibodies was 14.19% (21/148), while positive titres were found in 10.39% (8/77), at onset. Chronic lymphocytic thyroiditis was diagnosed in 16 patients. No growth retardation was observed. Thyroxine therapy was started in all hypothyroid cases. We conclude that antithyroid antibodies screening in well indicated in diabetic children in view of their high prevalence and strong association with chronic thyroiditis.

  12. Feline diabetes mellitus: low carbohydrates versus high fiber?

    PubMed

    Kirk, Claudia A

    2006-11-01

    Treatment of diabetes mellitus (DM) in the cat relies primarily on the adequate insulin therapy and controlled dietary intake. The goals of managing DM in the cat have changed from attaining glycemic control to achieving diabetic remission (transient diabetes) in a large proportion of cases. Remission rates of up to 68% have been published. The used of low-carbohydrate foods for cats improves the odds of achieving diabetic remission by fourfold. Nonetheless, some cats show an improved response to high-fiber food. Clinical judgement, trial, and personal preference to currently dictate which diet to offer an individual animal.

  13. Milestones in the history of diabetes mellitus: The main contributors

    PubMed Central

    Karamanou, Marianna; Protogerou, Athanase; Tsoucalas, Gregory; Androutsos, George; Poulakou-Rebelakou, Effie

    2016-01-01

    Diabetes mellitus is a group of metabolic diseases involving carbohydrate, lipid, and protein metabolism. It is characterized by persistent hyperglycemia which results from defects in insulin secretion, or action or both. Diabetes mellitus has been known since antiquity. Descriptions have been found in the Egyptian papyri, in ancient Indian and Chinese medical literature, as well as, in the work of ancient Greek and Arab physicians. In the 2nd century AD Aretaeus of Cappadocia provided the first accurate description of diabetes, coining the term diabetes, while in 17th century Thomas Willis added the term mellitus to the disease, in an attempt to describe the extremely sweet taste of the urine. The important work of the 19th century French physiologist Claude Bernard, on the glycogenic action of the liver, paved the way for further progress in the study of the disease. In 1889, Oskar Minkowski and Joseph von Mering performed their famous experiment of removing the pancreas from a dog and producing severe and fatal diabetes. In 1921, Frederick Banting and Charles Best extended Minkowski’s and Mering’s experiment. They isolated insulin from pancreatic islets and administrated to patients suffering from type 1 diabetes, saving thus the lives of millions and inaugurating a new era in diabetes treatment. PMID:26788261

  14. Systolic blood pressure in cats with diabetes mellitus.

    PubMed

    Sennello, Kathleen A; Schulman, Rhonda L; Prosek, Robert; Siegel, Arthur M

    2003-07-15

    To determine the prevalence of systemic hypertension in cats with diabetes mellitus and establish ranges for echocardiographic variables in diabetic cats. Prospective study. 14 cats with diabetes mellitus and 19 healthy control cats. Systolic blood pressure was measured indirectly with a noninvasive Doppler technique. Ophthalmic and echocardiographic examinations were performed, and urine protein concentration was measured. Cats were considered to have hypertension if they had systolic blood pressure > 180 mm Hg and at least 1 other clinical abnormality typically associated with hypertension (eg, hypertensive retinopathy, left ventricular hypertrophy, or proteinuria). None of the diabetic or control cats had systolic blood pressure > 180 mm Hg. One diabetic cat had left ventricular hypertrophy, but systolic blood pressure was 174 mm Hg. None of the cats had evidence of hypertensive retinopathy or proteinuria. Mean values for echocardiographic variables for the diabetic cats were not significantly different from published values for healthy cats. Results suggest that hypertension does not occur or occurs in only a small percentage of cats with diabetes mellitus.

  15. Oxidative Stress: A Link between Diabetes Mellitus and Periodontal Disease.

    PubMed

    Monea, Adriana; Mezei, Tibor; Popsor, Sorin; Monea, Monica

    2014-01-01

    Objective. To investigate oxidative stress (OS) and histological changes that occur in the periodontium of subjects with type 2 diabetes mellitus without signs of periodontal disease and to establish if oxidative stress is a possible link between diabetes mellitus and periodontal changes. Materials and Methods. Tissue samples from ten adult patients with type 2 diabetes mellitus (T2D) and eight healthy adults were harvested. The specimens were examined by microscope using standard hematoxylin-eosin stain, at various magnifications, and investigated for tissue levels of malondialdehyde (MDA) and glutathione (GSH). Results. Our results showed that periodontal tissues in patients with T2D present significant inflammation, affecting both epithelial and connective tissues. Mean MDA tissue levels were 3.578 ± 0.60 SD in diabetics versus 0.406 ± 0.27 SD in controls (P < 0.0001), while mean GSH tissue levels were 2.48 ± 1.02 SD in diabetics versus 9.7875 ± 2.42 SD in controls (P < 0.0001). Conclusion. Diabetic subjects had higher MDA levels in their periodontal tissues, suggesting an increased lipid peroxidation in T2D, and decreased GSH tissue levels, suggesting an alteration of the local antioxidant defense mechanism. These results are in concordance with the histological changes that we found in periodontal tissues of diabetic subjects, confirming the hypothesis of OS implication, as a correlation between periodontal disease incidence and T2D.

  16. Novel avenues of drug discovery and biomarkers for diabetes mellitus.

    PubMed

    Maiese, Kenneth; Chong, Zhao Zhong; Shang, Yan Chen; Hou, Jinling

    2011-02-01

    Globally, developed nations spend a significant amount of their resources on health care initiatives that poorly translate into increased population life expectancy. As an example, the United States devotes 16% of its gross domestic product to health care, the highest level in the world, but falls behind other nations that enjoy greater individual life expectancy. These observations point to the need for pioneering avenues of drug discovery to increase life span with controlled costs. In particular, innovative drug development for metabolic disorders such as diabetes mellitus becomes increasingly critical given that the number of diabetic people will increase exponentially over the next 20 years. This article discusses the elucidation and targeting of novel cellular pathways that are intimately tied to oxidative stress in diabetes mellitus for new treatment strategies. Pathways that involve wingless, β-nicotinamide adenine dinucleotide (NAD(+)) precursors, and cytokines govern complex biological pathways that determine both cell survival and longevity during diabetes mellitus and its complications. Furthermore, the role of these entities as biomarkers for disease can further enhance their utility irrespective of their treatment potential. Greater understanding of the intricacies of these unique cellular mechanisms will shape future drug discovery for diabetes mellitus to provide focused clinical care with limited or absent long-term complications.

  17. Preoperative Evaluation of Patients with Diabetes Mellitus.

    PubMed

    Miller, Joshua D; Richman, Deborah C

    2016-03-01

    There are more than 29 million people in the United States with diabetes; it is estimated that by 2050, one in 3 individuals will have the disease. At least 50% of patients with diabetes are expected to undergo surgery in their lifetime. Complications from uncontrolled diabetes can impact multiple organ systems and affect perioperative risk. In this review, the authors discuss principles in diabetes management that will assist the perioperative clinician in caring for patients with diabetes.

  18. Nodular glomerulosclerosis in patients’ without history of diabetes mellitus: a case report

    PubMed Central

    Goucha, Rym; Karoui, Cyrine; Abderrahim, Ezzedine; Hamida, Fethi Ben; Elyounsi, Fethi; Maiz, Hedi Ben; Abdallah, Taieb Ben; Kheder, Adel

    2009-01-01

    Introduction Diabetic nephropathy can occur during the course of both type1 and type 2 diabetes mellitus. The characteristic lesions are diffuse or nodular (Kimmelsteil-Wilson) diabetic glomerulosclerosis. The reported cases represent unusual presentations of diabetes mellitus. Case presentation We report the case of a 49-year-old man without prior history of diabetes mellitus who presented with rapidly progressive renal failure and whose renal biopsy revealed nodular (Kimmelsteil-Wilson) glomerulosclerosis lesions characteristic of diabetes. Conclusion Renal manifestations of diabetes mellitus may antedate other more common presenting symptoms of this disease and we critically review the literature on this subject. PMID:19918545

  19. Role of the calpain on the development of diabetes mellitus and its chronic complications.

    PubMed

    Wan, Ting-Ting; Li, Xiu-Fen; Sun, Yan-Ming; Li, Yan-Bo; Su, Ying

    2015-08-01

    Diabetes mellitus (DM) is associated with acute and chronic complications that cause major morbidity and significant mortality. Calpains, a family of Ca(2+)-dependent cytosolic cysteine proteases, can modulate their substrates' structure and function through limited proteolytic activity. Calpain is a ubiquitous calcium-sensitive protease that is essential for normal physiologic function. However, alterations in calcium homeostasis lead to pathologic activation of calpain in diabetes mellitus. Since not much is known on the relationship between calpain and diabetes mellitus, this review outlines the contribution of calpain to chronic complications of diabetes mellitus, such as diabetic cardiomyopathy, diabetic nephropathy and diabetic retinopathy.

  20. Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus.

    PubMed

    Furukawa, Shinya; Yamamoto, Shin; Todo, Yasuhiko; Maruyama, Kotatsu; Miyake, Teruki; Ueda, Teruhisa; Niiya, Tetsuji; Senba, Takatoshi; Torisu, Masamoto; Kumagi, Teru; Miyauchi, Syozo; Sakai, Takenori; Minami, Hisaka; Miyaoka, Hiroaki; Matsuura, Bunzo; Hiasa, Yoichi; Onji, Morikazu; Tanigawa, Takeshi

    2014-01-01

    Subclinical hypothyroidism (SCH) has been associated with type 2 diabetes mellitus. However, it is unknown whether common complications of type 2 diabetes, such as diabetic nephropathy, are also present with SCH. Here, we investigated the association between SCH and diabetic nephropathy among Japanese patients with type 2 diabetes mellitus. In this multicenter cross-sectional study, we recruited 414 such patients who had no previous history of thyroid disease. Serum thyroid hormone levels and the urinary albumin:creatinine ratio were measured. SCH was defined as an elevated thyroid-stimulating hormone (TSH) level (>4.0 mIU/L), and diabetic nephropathy was defined as urinary albumin/creatinine ratio ≥300 mg/g. The prevalence of SCH was 8.7% (n = 36) among patients with type 2 diabetes mellitus. The SCH group had a higher prevalence of dyslipidemia (p = 0.008) and diabetic nephropathy (p = 0.014) than the euthyroid group. Multivariate analysis identified significant positive associations between diabetic nephropathy and SCH (odds ratio [OR], 3.51; 95% confidence interval [CI], 1.10-10.0; p = 0.034), hypertension (OR, 4.56; 95% CI, 1.69-14.7; p = 0.001), and smoking (OR, 3.02; 95% CI, 1.14-7.91; p = 0.026). SCH may be independently associated with diabetic nephropathy in Japanese patients with type 2 diabetes mellitus.

  1. Diabetes mellitus induced impairment of male reproductive functions: a review.

    PubMed

    Jangir, Ram Niwas; Jain, Gyan Chand

    2014-05-01

    Diabetes mellitus (DM) represents one of the greatest threats to human health all over the world. The incidence of DM is rising rapidly also including children and young persons of reproductive age. Diabetes has been associated with reproductive impairment in both men and women. Diabetes may affect male reproductive functions at multiple levels as a result of its effects on the endocrine control of spermatogenesis, steroidogenesis, sperm maturation, impairment of penile erection and ejaculation. A large number of studies both on diabetic men and experimental diabetic animals have been published on the impact of DM on male reproductive functions during the past few years but many of them have conflicting results. The present review summarizes the research finding of a large number of research papers on the reproductive functions especially on hypothalmo-pituitary-gonadal axis, spermatogenesis, histopathology of testis, synthesis and secretion of testosterone, sperm quality, ejaculatory function and fertility both in diabetic men and experimental diabetic animals.

  2. Nutrition and diabetes mellitus: an overview of the current evidence.

    PubMed

    Dämon, Sabine; Schätzer, Manuel; Höfler, Jürgen; Tomasec, Goran; Hoppichler, Friedrich

    2011-06-01

    Overwhelming evidence exists supporting the benefit of lifestyle and nutritional interventions to prevent or delay type 2 and gestational diabetes and improve glycemic control and co-morbidities in patients of all sub-types of diabetes mellitus. Therefore, nutritional therapy is an indispensable and fundamental treatment component, which has to be based on evidence-based recommendations, adapted for dietary intake and medication, and periodically adapted according to diagnosis and individual course of illness. This overview is based on the currently valid evidence-based nutritional recommendations of the European and American Diabetes Associations for the management of diabetes mellitus. It describes the quality and quantity of beneficial macronutrient (carbohydrates, fat, and protein) and micronutrient intake, alcohol consumption, and food groups. Moreover, the evidence for supplements and functional foods is summarized and the role of body weight and different weight loss diets are discussed.

  3. Resistin role in development of gestational diabetes mellitus.

    PubMed

    Siddiqui, Khalid; George, Teena P

    2017-07-01

    Diabetes is estimated to be one of the major causes of deaths in most countries due to its high prevalence rate, which was 8.8% in 2015. Hyperglycemia detected during pregnancy is known as gestational diabetes mellitus and it increases the potential risk of development of Type 2 diabetes in mothers with its varying prevalence rate of 1-14% in different populations. It also leads to the higher risk of developing abnormal glucose tolerance and obesity in their child at an early age. Recent studies show that potential mediators of insulin resistance such as adipokines - adiponectin, leptin and resistin are important for glucose and lipid metabolism. Adipokines are directly involved in the regulation of insulin secretion and insulin sensitivity in the liver, muscle and adipose tissue. It is also involved in inflammation, adipose tissue accumulation, adverse fat distribution and subsequently affects glucose metabolism. This review highlights the role of resistin (an adipokine) in the development of gestational diabetes mellitus.

  4. [Measurement of glucose and diagnosis of diabetes mellitus].

    PubMed

    Odum, L

    1999-02-15

    In order to reduce the number of complications associated with type 2 diabetes mellitus, clinicians have begun to screen for asymptomatic diabetes more intensely. The American Diabetes Association has proposed new guidelines for the diagnosis of diabetes mellitus to obtain a more simple diagnostic procedure. This is now mainly based on measurements of at least two fasting venous plasma glucose concentrations. The risk of wrong conclusions are larger using the glucose tolerance test due to the large intra-individual biological variation. It would be desirable if a national consensus of using either whole blood glucose values or plasma values could be reached, in order to obtain a more simple system. As the influence of haematocrit are omitted by using plasma, it is suggested that diagnostic glucose concentrations are measured in venous plasma/serum. Capillary blood values measured in connection with treatment could be converted to plasma values.

  5. Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds.

    PubMed

    Carolan, Mary

    2014-05-01

    To explore diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds and to gather information which would assist with the development of an educational programme that would support both women and diabetes educators. Rates of gestational diabetes mellitus have increased dramatically in recent years. This is concerning as gestational diabetes mellitus is linked to poorer pregnancy outcomes including hypertension, stillbirth, and nursery admission. Poorest outcomes occur among disadvantaged women. gestational diabetes mellitus is also associated with maternal type 2 diabetes and with child obesity and type 2 diabetes among offspring. Effective self-management of gestational diabetes mellitus reduces these risks. Diabetes nurse educators provide most education and support for gestational diabetes mellitus self-management. An interpretative phenomenological analysis approach, as espoused by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51), provided the framework for this study. The views of six diabetes educators were explored through in-depth interviewing. Interviews were transcribed verbatim and analysed according to steps outlined by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51). Three themes emerged from the data: (1) working in a suboptimal environment, (2) working to address the difficulties and (3) looking to the future. Throughout, the diabetes nurse educators sought opportunities to connect with women in their care and to make the educational content understandable and meaningful. Low literacy among disadvantaged women has a significant impact on their understanding of gestational diabetes mellitus information. In turn, catering for women with low literacy contributes to increased workloads for diabetes nurse educators, making them vulnerable to burnout. There is a need

  6. 76 FR 9587 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... this meeting contact Dr. Sanford Garfield, Executive Secretary of the Diabetes Mellitus Interagency...: dmicc@mail.nih.gov . Dated: February 14, 2011. Sanford Garfield, Executive Secretary, DMICC, Division of...

  7. Common and rare forms of diabetes mellitus: towards a continuum of diabetes subtypes.

    PubMed

    Flannick, Jason; Johansson, Stefan; Njølstad, Pål R

    2016-07-01

    Insights into the genetic basis of type 2 diabetes mellitus (T2DM) have been difficult to discern, despite substantial research. More is known about rare forms of diabetes mellitus, several of which share clinical and genetic features with the common form of T2DM. In this Review, we discuss the extent to which the study of rare and low-frequency mutations in large populations has begun to bridge the gap between rare and common forms of diabetes mellitus. We hypothesize that the perceived division between these diseases might be due, in part, to the historical ascertainment bias of genetic studies, rather than a clear distinction between disease pathophysiologies. We also discuss possible implications of a new model for the genetic basis of diabetes mellitus subtypes, where the boundary between subtypes becomes blurred.

  8. Thyroid gland diseases in adult patients with diabetes mellitus.

    PubMed

    Vondra, K; Vrbikova, J; Dvorakova, K

    2005-12-01

    This review concerns the relation between most frequent thyroid gland diseases and diabetes mellitus in adult patients. Special attention is paid to autoimmune thyroiditis, Graves' disease, thyroid autoimmunity in pregnant diabetic women, and iodine metabolism. We focused on mechanisms leading to coexistence of both endocrine disorders, and on distinctions in the prevalence, diagnosis, clinical course and treatment of thyroid diseases in diabetic patients. The prevalence of thyroid diseases in diabetic patients is 2-3 times higher than in nondiabetic subjects; it raises with age, and is strongly influenced by female gender and autoimmune diabetes. Clinical relevance of thyroid diseases, especially in diabetic patients, significantly increases if it is associated with deteriorated function, which always cause a number problems with metabolic compensation of diabetes. Most serious consequences are increased frequency of hypoglycaemia in hypothyroidism and development of potentially life-threatening ketoacidosis in thyrotoxicosis. In spite of that, little attention is paid to the diagnosis of thyroid diseases in diabetics, as they are diagnosed in only about half of the patients. At the end, we provide recommendations for the thyroid disease screening and diagnosis in patients with diabetes mellitus based on our experience.

  9. Vitamin D and diabetes mellitus: Causal or casual association?

    PubMed

    Grammatiki, M; Rapti, E; Karras, S; Ajjan, R A; Kotsa, Kalliopi

    2017-01-07

    The incidence of both type 2 and type 1 diabetes mellitus has been increasing worldwide. Vitamin D deficiency, or the awareness of its prevalence, has also been increasing. Vitamin D may have a role in the pathogenic mechanisms predisposing to type 2 diabetes by modulating insulin resistance and/or pancreatic β-cell function. Vitamin D status or elements involved in its activation or transport may also be involved in the development of type 1 diabetes mellitus through immunomodulatory role . Based on these observations a potential association between vitamin D and diabetes has been hypothesized. In this review we discuss up to date evidence linking vitamin D with the development of diabetes. Moreover, the role of vitamin D supplementation in the prevention of both types of diabetes is analysed together with its role in improving glycemic control in diabetic patients. We also address the potential role of vitamin D deficiency in the development of macro- and microvascular complications in diabetes. Finally, we provide recommendation for Vitamin D therapy in diabetes in view of current evidence and highlight areas for potential future research in this area.

  10. Diabetes mellitus and spinal epidural abscess: clinical or surgical treatment?

    PubMed

    Felício, João S; Martins, Carlliane Lins P; Liberman, Bernardo

    2011-12-01

    Spinal epidural abscess (SEA) is an uncommon condition and its most important predisposing factor is diabetes mellitus. Although the treatment of choice is prompt surgical abscess evacuation, followed by antibiotic therapy, successful conservative treatment of SEA has been reported in some cases. We describe a SEA case in a 23-year old white woman with diabetes for 14 years, who was successfully treated only with antibiotics, and achieved full recovery at the fourth month of follow-up.

  11. [Antihyperglycemic treatment guidelines for diabetes mellitus type 2].

    PubMed

    Clodi, Martin; Abrahamian, Heidemarie; Drexel, Heinz; Fasching, Peter; Föger, Bernhard; Francesconi, Claudia; Hoppichler, Friedrich; Kaser, Susanne; Kautzky-Willer, Alexandra; Lechleitner, Monika; Ludvik, Bernhard; Prager, Rudolf; Fröhlich-Reiterer, Elke; Roden, Michael; Säly, Christoph; Schernthaner, Guntram; Sourij, Harald; Toplak, Hermann; Wascher, Thomas C; Weitgasser, Raimund

    2016-04-01

    Hyperglycemia significantly contributes to micro- and macrovascular complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.

  12. Monitoring Methods for Dogs and Cats with Diabetes Mellitus

    PubMed Central

    Cook, Audrey K

    2012-01-01

    Effective monitoring is essential for the management of dogs and cats with diabetes mellitus. However, methods for evaluating glycemic control must be tailored to meet both the needs of the patient and the expectations of the owner. This article discusses the philosophies that drive blood glucose monitoring in veterinary diabetics and review common practices. The advantages and limitations of the various options are presented. PMID:22768878

  13. Epidemiology of Diabetes Mellitus in the United Arab Emirates.

    PubMed

    Razzak, Hira Abdul; Harbi, Alya; Shelpai, Wael; Qawas, Ahmad

    2017-09-20

    Background/ Objective: Diabetes mellitus is a non-communicable disease which has become a major global public health issue. This systematic review summarized epidemiological studies related to the prevalence, risk factors, complications, incidence, knowledge, attitude and practices of Diabetes Mellitus (DM) among Arab population in the United Arab Emirates (UAE). PubMed, Scopus databases, Science direct, Wiley online library, and other local journals were searched to identify relevant literature using appropriate keywords to retrieve studies conducted in the UAE. Search limits were restricted to studies in English language, between 2007 and 2016, and on UAE population (both citizens and expatriates). Electronic database search yielded 24 studies about the prevalence, incidence, complications, risk factors, knowledge, attitudes and practices of diabetes, including cross sectional studies (n =18), population-based survey (n = 1), retrospective cohort studies (n = 3), qualitative (n=1), and randomized controlled trial (n = 1). Countrywide prevalence estimates of Diabetes Mellitus were reported to be high. The major determinants of Diabetes Mellitus involved hypertension, physical inactivity, sedentary lifestyle, and unhealthy diet. Even though past evidences have promulgated the role of numerous causative factors, the epidemiological implications of some of the risk factors including family history, educational level, and the use of alcohol remains elusive. This systematic review signifies epidemiology of Diabetes Mellitus in the United Arab Emirates and suggests that extra efforts are needed for preventive and curative strategies in order to decrease the burden of this non-communicable disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Serum cotinine levels and diabetes mellitus in never smokers.

    PubMed

    Alshaarawy, Omayma; Elbaz, Hosam A

    2015-01-01

    The aim of the current study is to examine the association of environmental tobacco smoke (ETS) exposure evident by serum cotinine level, and diabetes mellitus in never smokers. Previous studies suggest that active tobacco cigarette smoking is associated with diabetes mellitus risk. However it is not clear if the low-level "background" ETS exposure is associated with diabetes among never smokers. We present evidence from five independent replications based on the US nationally representative National Health and Nutrition Examination Surveys (NHANES) conducted 2003-12. Our exposure of interest is ETS exposure among never smokers, measured by serum cotinine levels (ng/mL), and our main outcome is diabetes mellitus assessed via self-reported physician-diagnosis, current use of insulin and/or oral hypoglycemic medications, plasma fasting glucose levels ≥126mg/dL or glycohemoglobin levels ≥6.5%. The conceptual model encompassed age, sex, ethnic self-identification, education, poverty-income ratio, alcohol drinking, total cholesterol and body mass index. In never smokers, higher serum cotinine levels were positively associated with diabetes mellitus (the meta-analytic summary estimate is 1.2, 95% CI=1.1, 1.2). This association was not evident among never smokers with cotinine levels below 3ng/mL. These replications help sustain evidence of ETS-diabetes mellitus association, which might be explained by shared psychosocial characteristics. Prospective studies with appropriate biomarkers are needed to further investigate this association. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. [Diabetes in Pregnancy - Type 1/Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus].

    PubMed

    Kleinwechter, Helmut; Demandt, Norbert

    2016-09-01

    In Germany in 5.5% of all births diabetes is registered. In patients with type 1 and type 2 diabetes planning pregnancy, preconception counseling, diabetologic care with optimized periconceptional metabolic control and folic acid supplementation are essential for good pregnancy outcome. Gestational diabetes (GDM) should be diagnosed timely and managed according to existing guidelines. GDM is treated with insulin in approximately 20%. In 1-2% of GDM cases a glucokinase gene mutation is present (MODY 2). Pregnancies after bariatric-metabolic surgery are increasing and show high risks. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Different role of zinc transporter 8 between type 1 diabetes mellitus and type 2 diabetes mellitus.

    PubMed

    Yi, Bo; Huang, Gan; Zhou, Zhiguang

    2016-07-01

    Diabetes can be simply classified into type 1 diabetes mellitus and type 2 diabetes mellitus. Zinc transporter 8 (ZnT8), a novel islet autoantigen, is specifically expressed in insulin-containing secretory granules of β-cells. Genetic studies show that the genotypes of SLC30A8 can determine either protective or diabetogenic response depending on environmental and lifestyle factors. The ZnT8 protein expression, as well as zinc content in β-cells, was decreased in diabetic mice. Thus, ZnT8 might participate in insulin biosynthesis and release, and subsequently involved deteriorated β-cell function through direct or indirect mechanisms in type 1 diabetes mellitus and type 2 diabetes mellitus. From a clinical feature standpoint, the prevalence of ZnT8A is gradiently increased in type 2 diabetes mellitus, latent autoimmune diabetes in adults and type 1 diabetes mellitus. The frequency and epitopes of ZnT8-specific T cells and cytokine release by ZnT8-specific T cells are also different in diabetic patients and healthy controls. Additionally, the response to ZnT8 administration is also different in type 1 diabetes mellitus and type 2 diabetes mellitus. In the present review, we summarize the literature about clinical aspects of ZnT8 in the pathogenesis of diabetes, and suggest that ZnT8 might play a different role between type 1 diabetes mellitus and type 2 diabetes mellitus.

  17. Increased risk of diabetes mellitus and likelihood of receiving diabetes mellitus treatment in patients with psoriasis.

    PubMed

    Azfar, Rahat S; Seminara, Nicole M; Shin, Daniel B; Troxel, Andrea B; Margolis, David J; Gelfand, Joel M

    2012-09-01

    To assess the risk of incident diabetes mellitus (DM) in patients with psoriasis and to evaluate DM treatment patterns among patients with psoriasis and incident DM. Population-based cohort study. United Kingdom-based electronic medical records. We matched 108 132 patients with psoriasis aged 18 to 90 years with 430 716 unexposed patients based on practice and time of visit. For our nested study, only patients who developed incident DM during our study time were included. Incident DM and adjusted risk of pharmacotherapy among those with incident DM. The fully adjusted hazard ratios (95% CIs) for incident DM were 1.14 (95% CI, 1.10-1.18), 1.11 (95% CI, 1.07-1.15), and 1.46 (95% CI, 1.30-1.65) in the overall, mild, and severe psoriasis groups, respectively. Among those with incident DM and severe psoriasis, the adjusted risk for receiving DM pharmacotherapy was 1.55 (95% CI, 1.15-2.10). Our results suggest that psoriasis is an independent risk factor for the development of type 2 DM in a dose-dependent manner, and that patients with severe psoriasis who develop DM are more likely to receive systemic diabetic therapies in comparison with patients with DM but without psoriasis.

  18. Diabetes mellitus type 2 and functional foods of plant origin.

    PubMed

    Pathak, Manju

    2014-01-01

    Diabetes is the common, exponentially growing, serious human health problem existing globally. Risk factors like genetic predisposition, lack of balanced diet, inappropriate and lethargic lifestyle, overweight, obesity, stress including emotional and oxidative and lack of probiotics in gut are found to be the causing factors either in isolation or in synergy predisposing Diabetes. High blood sugar is a common symptom in all types of diabetes mellitus and the physiological cause of diabetes is lack of hormone Insulin or resistance in function faced by insulin. Low levels of Insulin causes decreased utilization of glucose by body cells, increased mobilization of fats from fat storage cells and depletion of proteins in the tissues of the body, keeping the body in crisis. The functional foods help achieving optimal physiological metabolism and cellular functions helping the body to come out of these crises. The mechanism of the functional foods is envisaged to act via optimizing vitamins, minerals, essential amino acids, prebiotics and probiotics. This paper reviews role of functional foods of plant origin in the regulation of blood sugar in type 2 diabetes mellitus and also discusses some vital patents in this area. The article aims at creating awareness about key food ingredients in order to prevent most acute effects of diabetes mellitus and to greatly delay the chronic effects as well.

  19. Point-of-care testing in diabetes mellitus.

    PubMed

    Price, Christopher P

    2003-09-01

    Diabetes mellitus is an excellent case study of the evolution, and successful application, of point-of-care testing. It offers a valuable history of the way in which technology has evolved, and continues to evolve, to meet the needs of patients whilst also providing for a more optimal delivery of care. Diabetes mellitus is also a good exemplar of where test and treatment regimes must operate in complete harmony in order to achieve the greatest benefit. Thus whilst the measurement of blood glucose is central to the screening, diagnosis and management of diabetes, it is in the latter use, largely related to supporting compliance with therapy, that point-of-care testing is of greatest relevance. In addition, there are other tests, more associated with the management of diabetes and early detection of the complications associated with diabetes, that are appropriate to the point-of-care testing modality. This Review will focus on the developments in technology and the harnessing of this innovation to support the delivery of clinical, organisational and economic benefits in the care of patients with diabetes mellitus.

  20. Multifocal diabetic muscle infarction: a rare complication of poorly controlled diabetes mellitus.

    PubMed

    Chebbi, Wafa; Jerbi, Saida; Klii, Rym; Alaya, Wafa; Mestiri, Sarra; Zantour, Baha; Sfar, Mohamed Habib

    2014-01-01

    Diabetic muscle infarction (DMI) is a rare complication of long-standing poorly controlled diabetes mellitus. We herein describe the case of a 56-year-old man with a 10-year history of poorly controlled type 2 diabetes mellitus with multiple microvascular and macrovascular complications who presented with the sudden onset of left thigh pain and swelling. MRI suggested muscle infarction. A muscle biopsy demonstrated coagulation necrosis in the skeletal muscle with inflammation and infarction in the walls of small blood vessels. Physicians should consider DMI in the differential diagnosis of patients with diabetes who present with painful, swollen muscles without systemic signs of infection.