Science.gov

Sample records for insulinkraevende diabetes mellitus epidemiologi

  1. Epidemiology of diabetes mellitus in old age in Japan.

    PubMed

    Nakano, Tadasumi; Ito, Hideki

    2007-09-01

    Epidemiological studies on diabetes mellitus revealed that the number of patients with diabetes mellitus is gradually increasing in Japan along with development of car society and westernization of food intake. Since prevalence of diabetes mellitus increases with aging, proportion of individuals with diabetes mellitus aged over 60 has exceeded two-third of estimated total number of patients (7.40 million in 2002) in Japan where aging of society is rapidly progressing. Type 2 diabetes mellitus is common in diabetes mellitus in old age, and there are rarely elderly patients with type 1 diabetes mellitus. Prevalence of both diabetic microangiopathy and atherosclerotic vascular diseases is higher in the elderly with diabetes mellitus than in the middle-aged with diabetes mellitus. Furthermore, atherosclerotic vascular diseases (ischemic heart disease, cerebro-vascular disease and peripheral vascular disease) are more prevalent in the elderly with diabetes mellitus than in those without diabetes mellitus. Many studies demonstrated that functional declines, i.e. decreases in activities of daily living, physical activity and cognitive function, deteriorated quality of life in the elderly, and functional declines are more prominent in the elderly with diabetes mellitus than in those without diabetes mellitus. In order to clarify how the elderly patients with diabetes mellitus should be treated to maintain their quality of life, a nationwide randomized controlled intervention study using 1173 Japanese elderly patients with diabetes mellitus is now performing. In summary, number of elderly patients with diabetes mellitus is overwhelmingly increasing in Japan as well as in westernized countries. It is necessary for us to treat the elderly with diabetes mellitus to maintain their function and quality of life. PMID:17644210

  2. Gestational diabetes mellitus in South Asia: Epidemiology.

    PubMed

    Jawad, Fatema; Ejaz, Kiran

    2016-09-01

    Gestational diabetes mellitus, is defined by the American Diabetes Association as "diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes". WHO has further classified the period of diagnosis as Hyperglycaemia in Pregnancy and Gestational Diabetes Mellitus. The former term is applicable in the early period of gestation and GDM is detected after 24 weeks. Irrespective of the guidelines followed, the presence of Diabetes Mellitus during pregnancy, has to be taken seriously as it is an important metabolic derangement and can prove to be harmful for the mother and dangerous for the foetus. The rising incidence of Type 2 Diabetes Mellitus in the world along with obesity, is a major contributing factor for GDM. The trend of this rise is more steep in the low and middle income countries thus proportionately increasing the risk for GDM. South Asia falls in this bracket and the responsible factors have to be identified and corrected. Management should begin from primordial prevention for which education is a key factor. Every woman should be taught the way to follow a healthy life style. Identification of the contributing factors and universal screening facilities for all pregnant women living in both rural and urban areas, should be given prime importance. On detecting Hyperglycaemia in Pregnancy or GDM, monitoring and health care facilities should be provided. This review provides some available figures of GDM in South Asia, the risk factors in this population and the steps for prevention.

  3. Gestational diabetes mellitus in South Asia: Epidemiology.

    PubMed

    Jawad, Fatema; Ejaz, Kiran

    2016-09-01

    Gestational diabetes mellitus, is defined by the American Diabetes Association as "diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes". WHO has further classified the period of diagnosis as Hyperglycaemia in Pregnancy and Gestational Diabetes Mellitus. The former term is applicable in the early period of gestation and GDM is detected after 24 weeks. Irrespective of the guidelines followed, the presence of Diabetes Mellitus during pregnancy, has to be taken seriously as it is an important metabolic derangement and can prove to be harmful for the mother and dangerous for the foetus. The rising incidence of Type 2 Diabetes Mellitus in the world along with obesity, is a major contributing factor for GDM. The trend of this rise is more steep in the low and middle income countries thus proportionately increasing the risk for GDM. South Asia falls in this bracket and the responsible factors have to be identified and corrected. Management should begin from primordial prevention for which education is a key factor. Every woman should be taught the way to follow a healthy life style. Identification of the contributing factors and universal screening facilities for all pregnant women living in both rural and urban areas, should be given prime importance. On detecting Hyperglycaemia in Pregnancy or GDM, monitoring and health care facilities should be provided. This review provides some available figures of GDM in South Asia, the risk factors in this population and the steps for prevention. PMID:27582153

  4. 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.

  5. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review.

    PubMed

    de Macedo, Geisa Maria Campos; Nunes, Samanta; Barreto, Tania

    2016-01-01

    Skin disorders, usually neglected and frequently underdiagnosed among diabetic patients, are common complications and encounter a broad spectrum of disorders in both type 1 and type 2 diabetes mellitus (DM)-e.g. cutaneous infection, dry skin, pruritus. Skin disorders are highly associated with increased risk of important outcomes, such as skin lesions, ulcerations and diabetic foot, which can lead to major complications and revolve around multifactorial factors besides hyperglycemia and advanced glycation end products. Although diabetic's skin disorders are consistent in the literature, there is limited data regarding early-stage skin disorders in DM patients. Disease control, early-stage treatment (e.g. skin hydration, orthotic devices) and awareness can reduce morbidity of DM patients. Thus, better understanding of the burden of skin disorders in DM patients may raise awareness on prevention and management. Therefore, the aim of this study is to perform a literature review to evaluate the main clinical characteristics and complications of skin disorders in diabetic's patients. Additionally, physiopathology early-stage skin disorders and dermocosmetic management were also reviewed. PMID:27583022

  6. Betatrophin in Diabetes Mellitus: the Epidemiological Evidence in Humans.

    PubMed

    Espes, Daniel; Martinell, Mats; Liljebäck, Hanna; Carlsson, Per-Ola

    2015-12-01

    The prevalence of type 2 diabetes is increasing worldwide, and while numerous treatments exist, none of the current pharmacologic therapies is curative. Pharmacologic approaches that increase beta cell mass may present an avenue for actual cure. There have been numerous reports on factors that can induce beta cell proliferation in rodents, whereas there are still very limited data on the occurrence of beta cell proliferation in humans. The recent discovery of the hormone betatrophin, which in mice counteracted glucose intolerance induced by insulin resistance by potently stimulating beta cell proliferation, has boosted the hope for a new target for drug development for the treatment of diabetes mellitus in humans. With the encouraging preclinical findings as a background, this review presents the available clinical data on betatrophin and discusses its possible role in humans.

  7. The association between type 2 diabetes mellitus and women cancer: the epidemiological evidences and putative mechanisms.

    PubMed

    Joung, Kyong Hye; Jeong, Jae-Wook; Ku, Bon Jeong

    2015-01-01

    Type 2 diabetes mellitus (T2DM), a chronic disease increasing rapidly worldwide, is well established as an important risk factor for various types of cancer. Although many factors impact the development of T2DM and cancer including sex, age, ethnicity, obesity, diet, physical activity levels, and environmental exposure, many epidemiological and experimental studies are gradually contributing to knowledge regarding the interrelationship between DM and cancer. The insulin resistance, hyperinsulinemia, and chronic inflammation associated with diabetes mellitus are all associated strongly with cancer. The changes in bioavailable ovarian steroid hormone that occur in diabetes mellitus (the increasing levels of estrogen and androgen and the decreasing level of progesterone) are also considered potentially carcinogenic conditions for the breast, endometrium, and ovaries in women. In addition, the interaction among insulin, insulin-like growth factors (IGFs), and ovarian steroid hormones, such as estrogen and progesterone, could act synergistically during cancer development. Here, we review the cancer-related mechanisms in T2DM, the epidemiological evidence linking T2DM and cancers in women, and the role of antidiabetic medication in these cancers.

  8. Molecular pathological epidemiology in diabetes mellitus and risk of hepatocellular carcinoma

    PubMed Central

    Gao, Chun

    2016-01-01

    Molecular pathological epidemiology (MPE) is a multidisciplinary and transdisciplinary study field, which has emerged as an integrated approach of molecular pathology and epidemiology, and investigates the relationship between exogenous and endogenous exposure factors, tumor molecular signatures, and tumor initiation, progression, and response to treatment. Molecular epidemiology broadly encompasses MPE and conventional-type molecular epidemiology. Hepatocellular carcinoma (HCC) is the third most common cause of cancer-associated death worldwide and remains as a major public health challenge. Over the past few decades, a number of epidemiological studies have demonstrated that diabetes mellitus (DM) is an established independent risk factor for HCC. However, how DM affects the occurrence and development of HCC remains as yet unclearly understood. MPE may be a promising approach to investigate the molecular mechanisms of carcinogenesis of DM in HCC, and provide some useful insights for this pathological process, although a few challenges must be overcome. This review highlights the recent advances in this field, including: (1) introduction of MPE; (2) HCC, risk factors, and DM as an established independent risk factor for HCC; (3) molecular pathology, molecular epidemiology, and MPE in DM and HCC; and (4) MPE studies in DM and risk of HCC. More MPE studies are expected to be performed in future and I believe that this field can provide some very important insights on the molecular mechanisms, diagnosis, personalized prevention and treatment for DM and risk of HCC. PMID:27721917

  9. Candidemia in patients with diabetes mellitus: epidemiology and predictors of mortality.

    PubMed

    Bader, Mazen S; Lai, Sue Min; Kumar, Vinutha; Hinthorn, Daniel

    2004-01-01

    Candidemia is the fourth most frequent nosocomial bloodstream infection in the US. The clinical characteristics and outcome of candidemia in adult patients with diabetes mellitus (DM) have not been reported in the literature. The objective of the study was to determine the epidemiology and determinants of mortality in diabetic patients with candidemia. A retrospective cohort study among diabetic patients with candidemia was carried out at 2 medical centers. The primary outcome was death from any cause after the onset of candidemia until discharge from the hospital. A stepwise logistic regression analysis was performed to determine the predictors of mortality. From June 1995 to June 2003, 87 patients with both DM and candidemia were studied. Candida albicans was the most common (48/87, 55%) and Candida glabrata the second most common isolate of candidemia (18/87, 21%). Overall hospital mortality was 39% (34/87). Logistic regression analysis identified 3 independent determinants of death; Apache II score > or =23 (OR 8.3, 95% CI{2.7, 25.4}, p =0.0002), nosocomial candidemia (OR 10.2, 95% CI{1.1, 97.9}, p = 0.04), and mechanical ventilation (OR 3.6, 95% CI{1.1, 11.2}, p = 0.03). The study demonstrates the emergence of non-albicans species of Candida as major causes of candidemia among diabetic patients. The severity of illness reflected by Apache II was the most significant predictor of mortality among diabetic patients with candidemia.

  10. Epidemiology and interaction of diabetes mellitus and tuberculosis and challenges for care: a review.

    PubMed

    Harries, A D; Satyanarayana, S; Kumar, A M V; Nagaraja, S B; Isaakidis, P; Malhotra, S; Achanta, S; Naik, B; Wilson, N; Zachariah, R; Lönnroth, K; Kapur, A

    2013-11-01

    The global burden of diabetes mellitus (DM) is immense, with numbers expected to rise to over 550 million by 2030. Countries in Asia, such as India and China, will bear the brunt of this unfolding epidemic. Persons with DM have a significantly increased risk of developing active tuberculosis (TB) that is two to three times higher than in persons without DM. This article reviews the epidemiology and interactions of these two diseases, discusses how the World Health Organization and International Union Against Tuberculosis and Lung Disease developed and launched the Collaborative Framework for the care and control of TB and DM, and examines three important challenges for care. These relate to 1) bi-directional screening of the two diseases, 2) treatment of patients with dual disease, and 3) prevention of TB in persons with DM. For each area, the gaps in knowledge and the priority research areas are highlighted. Undiagnosed, inadequately treated and poorly controlled DM appears to be a much greater threat to TB prevention and control than previously realised, and the problem needs to be addressed. Prevention of DM through attention to unhealthy diets, sedentary lifestyles and childhood and adult obesity must be included in broad non-communicable disease prevention strategies. This collaborative framework provides a template for action, and the recommendations now need to be implemented and evaluated in the field to lay down a firm foundation for the scaling up of interventions that work and are effective in tackling this dual burden of disease.

  11. [Diabetes mellitus].

    PubMed

    Pérez-Díaz, Iván

    2016-09-01

    Worldwide, the cases of type 2 Diabetes Mellitus (DM2) has doubled in the last two decades. In the same period, obesity rates have triplicated, mainly because of the increase in the caloric intake and physical inactivity. According to the World Health Organization (WHO), more than 6 billion people consume cow´s milk and dairy products. By far, this amount exceeds the number o patients suffering from DM2. The increased consumption of highly caloric beverages including whole cow´s milk has incited several countries to publish recommendations on and encourage the intake of low fat milk and non-fat or reduced fat dairy products intake. Because of the multifactorial basis of DM2 and the controversial evidence regarding the relationship between cow's milk consumption and DM2 development, it is difficult to establish an optimal amount of milk per day for a good health, with no side effects. It is necessary to inform the general population on the nutritional value and health benefits of cow's milk. PMID:27603888

  12. Epidemiology: work-related stress and the risk of type 2 diabetes mellitus.

    PubMed

    Brunner, Eric J; Kivimäki, Mika

    2013-08-01

    A new cohort study links work-related stress to an increased risk of developing type 2 diabetes mellitus (T2DM) in women, but the findings are less clear in men. Randomized controlled studies are now needed to determine whether management of stress could be used to reduce the risk of developing T2DM.

  13. [Diabetes mellitus and cognitive decline].

    PubMed

    Iglseder, Bernhard

    2011-11-01

    From large epidemiological studies, it has been demonstrated that diabetes mellitus is a risk factor for cognitive decline: Compared to healthy controls, patients with diabetes perform worse on cognitive tests, they experience a pronounced cognitive decline over time and have a higher incidence of dementia. Mechanisms contributing to cognitive decline include vascular damage, negative consequences of hypo- and hyperglycemia, and various dysfunctions in insulin action, summarized as insulin resistance. Possible targets for prevention and treatment of cognitive decline have attracted scientific attention.

  14. [Diabetes mellitus and exercise].

    PubMed

    Yoh, Kousei

    2006-08-01

    Diabetes mellitus is one of the most important life-style related diseases. As for the type 2 diabetes mellitus in particular, lack of exercise has a large influence on the onset and disease progress. We can improve glucose tolerance by exercising. Exercise is the most important fundamental treatment in diabetes mellitus. Continuation and safety become important to let exercise therapy succeed. It is important with a diabetic that a lot of patients without exercise habit should start to gain exercise habit. When we expect an exercise effect, we should take consideration of intensity and volume in exercise for performing. We should consider each contraindication matter even if we put it to have many complications with a diabetic when we perform exercise therapy. A case-by-case exercise treatment in diabetic patient is required.

  15. 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.

  16. 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

  17. Entrapment neuropathies in diabetes mellitus.

    PubMed

    Rota, Eugenia; Morelli, Nicola

    2016-09-15

    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.

  18. Entrapment neuropathies in diabetes mellitus.

    PubMed

    Rota, Eugenia; Morelli, Nicola

    2016-09-15

    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

  19. 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.

  20. Epidemiology of diabetes mellitus in Singapore: comparison with other ASEAN countries.

    PubMed

    Cheah, J S; Yeo, P P; Thai, A C; Lui, K F; Wang, K W; Tan, Y T; Ng, Y K; Tan, B Y

    1985-04-01

    Singapore is a tropical island city-state with a population of 2.4178 million consisting of Chinese (76.7%), Malays (14.7%), Indians (6.4%) and other races (2.2%). A diabetic survey of the adult population, aged 15 years and above, carried out in 1975, shows that the prevalence of diabetes is 1.99%; it is higher in males (2.36%) than in females (1.64%). It occurs mainly in the age group 40 years and above (5.08%) and is uncommon in the age group 15-39 years (0.40%). In males, the highest prevalence of diabetes (7.0%) is in the age group 45-49 years while in females the highest prevalence (7.2%) is in the age group 55-59 years. 43.3% of the diabetics are of normal weight while 44.3% are overweight and 12.4% are underweight. 59.6% of the diabetics are newly diagnosed while 40.4% are known diabetics; 64.3% of the newly diagnosed diabetics have no symptoms. The prevalence of diabetes among the Indians (6.07%) is significantly higher than that in Malays (2.43%) and Chinese (1.55%). Indian diabetics have a slightly higher positive family history of diabetes (12.7%) than Malays (10.9%) and Chinese (6.5%). Obesity is commoner in Malay diabetics (64.7%) than in Chinese (41.6%) and Indians (35.7%). The possible factors leading to the significantly higher prevalence of diabetes among the Indians compared to the other ethnic groups in Singapore are discussed. It is suggested that the Indian gene is susceptible to diabetes (diabetic genotype) and increased food consumption, altered lifestyle and greater obesity leads to the expression of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4037681

  1. Diabetes Mellitus Review.

    PubMed

    Blair, Meg

    2016-01-01

    Diabetes mellitus is a group of physiological dysfunctions characterized by hyperglycemia resulting directly from insulin resistance, inadequate insulin secretion, or excessive glucagon secretion. Type 1 diabetes (T1D) is an autoimmune disorder leading to the destruction of pancreatic beta-cells. Type 2 diabetes (T2D), which is much more common, is primarily a problem of progressively impaired glucose regulation due to a combination of dysfunctional pancreatic beta cells and insulin resistance. The purpose of this article is to review the basic science of type 2 diabetes and its complications, and to discuss the most recent treatment guidelines.

  2. [Diabetes mellitus and aging as a risk factor for cerebral vascular disease: epidemiology, pathophysiology and prevention].

    PubMed

    Cantú-Brito, Carlos; Mimenza-Alvarado, Alberto; Sánchez-Hernández, Juan José

    2010-01-01

    Older patients with diabetes have a high risk of vascular complications. They have an increase of approximately 3 times for developing stroke compared with subjects without diabetes. In addition, up to 75-80% of deaths in diabetic patients are associated with major cardiovascular events including stroke. The risk of stroke is high within 5 years of diagnosis for type 2 diabetes is 9% (mortality 21%), that is more than doubles the rate for the general population. From observational registries in a collaborative stroke study in Mexico, we analyzed clinical data, risk factors, and outcome of 1182 diabetic patients with cerebral ischemia, with focus in elderly subjects. There was a high frequency of hyperglycemia during the acute phase of stroke: the median value was 140 mg/dL and 40% had values higher than 180 mg/dL. Clinical outcome was usually unfavorable in elderly stroke patients with diabetes: case fatality rate was 30% at 30 days and survivors had moderate to severe disability, usually as consequence of the propensity to develop more systemic medical complications during hospital stay. Primary stroke prevention studies in patients with diabetes reveal that tight control of glucose is not associated with reduction in stroke risk. Therefore, proper control of other vascular risk factors is mandatory in patients with diabetes, in particular of arterial hypertension.

  3. [Diabetes mellitus and aging as a risk factor for cerebral vascular disease: epidemiology, pathophysiology and prevention].

    PubMed

    Cantú-Brito, Carlos; Mimenza-Alvarado, Alberto; Sánchez-Hernández, Juan José

    2010-01-01

    Older patients with diabetes have a high risk of vascular complications. They have an increase of approximately 3 times for developing stroke compared with subjects without diabetes. In addition, up to 75-80% of deaths in diabetic patients are associated with major cardiovascular events including stroke. The risk of stroke is high within 5 years of diagnosis for type 2 diabetes is 9% (mortality 21%), that is more than doubles the rate for the general population. From observational registries in a collaborative stroke study in Mexico, we analyzed clinical data, risk factors, and outcome of 1182 diabetic patients with cerebral ischemia, with focus in elderly subjects. There was a high frequency of hyperglycemia during the acute phase of stroke: the median value was 140 mg/dL and 40% had values higher than 180 mg/dL. Clinical outcome was usually unfavorable in elderly stroke patients with diabetes: case fatality rate was 30% at 30 days and survivors had moderate to severe disability, usually as consequence of the propensity to develop more systemic medical complications during hospital stay. Primary stroke prevention studies in patients with diabetes reveal that tight control of glucose is not associated with reduction in stroke risk. Therefore, proper control of other vascular risk factors is mandatory in patients with diabetes, in particular of arterial hypertension. PMID:21222313

  4. Acatalasemia and diabetes mellitus.

    PubMed

    Góth, László; Nagy, Teréz

    2012-09-15

    The enzyme catalase catalyzes the breakdown of hydrogen peroxide into oxygen and water. It is the main regulator of hydrogen peroxide metabolism. Hydrogen peroxide is a highly reactive small molecule formed as a natural byproducts of energy metabolism. Excessive concentrations may cause significant damages to protein, DNA, RNA and lipids. Low levels in muscle cells, facilitate insulin signaling. Acatalasemia is a result of the homozygous mutations in the catalase gene, has a worldwide distribution with 12 known mutations. Increased hydrogen peroxide, due to catalase deficiency, plays a role in the pathogenesis of several diseases such as diabetes mellitus. Diabetes mellitus is a disorder caused by multiple genetic and environmental factors. Examination of Hungarian diabetic and acatalasemic patients showed that an increased frequency of catalase gene mutations exists among diabetes patients. Inherited catalase deficiency may increase the risk of type 2 diabetes mellitus, especially for females. Early onset of type 2 diabetes occurs with inherited catalase deficiency. Low levels of SOD and glutathione peroxidase could contribute to complications caused by increased oxidative stress. PMID:22365890

  5. Introduction to diabetes mellitus.

    PubMed

    Kaul, Kirti; Tarr, Joanna M; Ahmad, Shamim I; Kohner, Eva M; Chibber, Rakesh

    2012-01-01

    The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Furthermore it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This chapter introduces the types of diabetes and diabetic complications such as impairment of immune system, periodontal disease, retinopathy, nephropathy, somatic and autonomic neuropathy, cardiovascular diseases and diabetic foot. Also included are the current management and treatments, and emerging therapies.

  6. Introduction to diabetes mellitus.

    PubMed

    Kaul, Kirti; Tarr, Joanna M; Ahmad, Shamim I; Kohner, Eva M; Chibber, Rakesh

    2012-01-01

    The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Furthermore it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This chapter introduces the types of diabetes and diabetic complications such as impairment of immune system, periodontal disease, retinopathy, nephropathy, somatic and autonomic neuropathy, cardiovascular diseases and diabetic foot. Also included are the current management and treatments, and emerging therapies. PMID:23393665

  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. 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.

  9. Management of diabetes mellitus in clinical practice.

    PubMed

    Lawal, Muili

    Diabetes is a global health problem, with a challenging epidemiology. It is one of the major health problems affecting countries around the world, particularly the UK (World Health Organization [WHO], 2006; Department of Health [DH], 2006b). It is also a growing public health threat in the US (Mokdad et al, 2001). As a result, diabetes has become an important public health issue, prompting the WHO and International Diabetes Federation (IDF) to adopt the theme 'Diabetes for Everyone' for World Diabetes Day 2006. In 2007, on World Diabetes Day, the United Nations also launched its 'Living with Diabetes at School' campaign, in response to the growing diabetes 'epidemics' (Diabetes UK, 2007). This article provides an overview of diabetes mellitus and its acute- and long-term management, including definition, aetiology, pathophysiology, classification, signs, symptoms and complications. The role of the nurse in providing patient-centred care for people with diabetes is emphasized.

  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. [Hypertension and diabetes mellitus].

    PubMed

    Araki, Shin-ichi; Maegawa, Hiroshi

    2015-11-01

    The goal of diabetes treatment is to maintain a quality of life. Hypertension is a common diabetes comorbidity and is a risk factor for mortality. Epidemiological studies show that blood pressure (BP) lowering is associated with improving prognosis in this population. However, recent clinical trials and meta-analyses report no benefit of an intensive BP lowering of < 130/80 mmHg on mortality and cardiovascular complications, except stroke. Furthermore, the excess BP lowering should be avoided not to increase the risk of adverse effects such as hypotension, especially in elderly patients or those with adverse vascular complications. In Japanese diabetes guidelines, a BP target of < 130/80 mmHg is still recommended in diabetic patients with hypertension because of the high incidence of stroke in Japanese.

  12. Neurodegeneration in diabetes mellitus.

    PubMed

    Umegaki, Hiroyuki

    2012-01-01

    Diabetes mellitus is recognized as a group of heterogeneous disorders with the common elements of hyperglycaemia and glucose intolerance due to insulin deficiency, impaired effectiveness of insulin action, or both. The prevalence of Type 2 diabetes mellitus (T2DM) increases with age and dementia also increases its incidence in later life. Recent studies have revealed that T2DM is a risk factor for cognitive dysfunction or dementia, especially those related to Alzheimer's disease (AD). Insulin resistance, which is often associated with T2DM, may induce a deficiency of insulin effects in the central nervous system (CNS). Insulin may have a neuroprotective role and may have some impact on acetylcholine (ACh) synthesis. Hyperinsulinemia, induced by insulin resistance occurring in T2DM, may be associated with insulin deficiency caused by reduced insulin transport via the blood brain barrier (BBB). Insulin has multiple important functions in the brain. Some basic research, however, suggests that insulin accelerates Alzheimer-related pathology through its effects on the amyloid beta (Aβ) metabolism and tau phosphorylation.Asymptomatic ischemic lesions in T2DM subjects may lower the threshold for the development of dementia and this may explain the inconsistency between the basic research and clinicopathological studies.More research to elucidate the mechanism of neurodegeneration associated with T2DM is warranted.

  13. Diabetes mellitus in elderly.

    PubMed

    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

  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. 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

  16. [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. PMID:27052238

  17. Diabetic retinopathy - ocular complications of diabetes mellitus

    PubMed Central

    Nentwich, Martin M; Ulbig, Michael W

    2015-01-01

    In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the working-age population. In the next 15 years, the number of patients suffering from diabetes mellitus is expected to increase significantly. By the year 2030, about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide (prevalence 7.7%), while in 2010 there were 285 million people with diabetes mellitus (prevalence 6.4%). This accounts for an increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e., exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema. PMID:25897358

  18. Diabetes mellitus and cognitive impairments.

    PubMed

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

    2016-09-15

    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.

  19. 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

  20. 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.

  1. Diabetes mellitus and cognitive impairments.

    PubMed

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

    2016-09-15

    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

  2. [Diabetes mellitus and Alzheimer's disease].

    PubMed

    Salacz, Pál; Csibri, Eva

    2011-03-27

    The incidence of Alzheimer's disease and diabetes is increasing with age. Thus, in light of demographic change and aging societies, they are becoming a growing issue for public health. Further, there are linkages between the two diseases. In particular, risk assessment studies suggest that type 2 diabetes mellitus is a risk factor of Alzheimer's disease. Hence, even though Alzheimer's disease can only be influenced to a limited extent, optimal treatment of diabetes mellitus may have also a positive effect on Alzheimer's disease. While the relationship between the two diseases is not yet completely clear, in addition to the known vascular effects of diabetes mellitus recent results shed light on central nervous system effects directly influencing the neurodegenerative process. Treatment of central insulin resistance, a phenomenon explored in recent years, may be a promising avenue, not only in addressing metabolic disorder, but also Alzheimer's disease.

  3. 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.

  4. 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

  5. Insulin dependent diabetes mellitus epidemiology: HLA genotype study in 12 north eastern Italian families with two siblings affected by type I diabetes.

    PubMed

    Pinelli, L; Drei, F; Gonfiantini, E; Visentin, A; Roata, C; Ciaffoni, S; Maffeis, C

    1989-12-01

    The purpose of our study was to evaluate the relationship between the histocompatibility antigens and type I diabetes mellitus in families living in the north-eastern part of Italy. In each family two siblings were affected by diabetes. HLA-antigens were determined with the lymphocytotoxicity test, utilizing antisera of the series A-B-C-DR. The phenotypic frequencies were compared with those observed in controls. We showed that diabetes has a strong association with HLA DR 3 and/or DR 4 antigens. In particular we registered high frequency of compound heterozygous DR 3 - DR 4 subjects, and this fact supports the hypothesis of the existence of two different genes for diabetes associated with these HLA antigens. Moreover we observed a particular haplotype segregation with a very high percentage of HLA identity between patients belonging to the same family, confirming the association between HLA and genetic susceptibility to insulin dependent diabetes. These results confirm data in the literature and, completed by other data from other patients' families living in our area, will be useful in providing reliable genetic counselling. PMID:2606174

  6. Diabetes mellitus and oral health.

    PubMed

    Kudiyirickal, Marina George; Pappachan, Joseph M

    2015-05-01

    The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen oral infections and vice versa. In the literature, periodontitis and diabetes in the young to middle-aged adults have been the most widely researched area. Understanding the patho-physiology, clinical manifestations and management of different types of orofacial diseases in diabetic patients are important to the diabetologist and the dentist for the optimal care of patients with these diseases. This review explores the inter-link between diabetes and oral health. PMID:25487035

  7. [Diabetes mellitus and vascular calcification].

    PubMed

    Okuno, Yasuhisa; Sato, Kyoko

    2002-08-01

    Two types of arterial calcification are well recognized:intimal (atherosclerotic) and medial (Monckeberg type). These two calcifications are considered different in pathogenesis. Arterial calcification has recently been reported to be an organized, regulated process similar to bone formation. The relation of calcification to diabetes mellitus remains still unclear. EBCT can noninvasively and accurately detect coronary artery calcification. Diabetic patients seem to have increased prevalence of coronary calcification when compared with non-diabetic patients. Medial artery calcification is an independent predictor of cardiovascular mortality in diabetic patients. PMID:15775402

  8. [Cerebral complications of diabetes mellitus].

    PubMed

    Aszalós, Zsuzsa

    2007-12-16

    According to WHO data more than 180 million people suffer from diabetes mellitus worldwide and this number could double within 15 years. Normal function of the brain is dependent on continuous supply of glucose. In hypoglycemia, production of counterregulatory hormones (glucagon, epinephrine, growth hormone, and cortisol) increases, the sympathetic system becomes stimulated, and features of neuroglycopenia appear in order to save the homeostasis. Hypoglycemia is an alarming, actually life threatening condition, but the exposure to chronic hyperglycemia has a more detrimental effect on the brain than recurrent exposure to severe hypoglycemia. The active neural response to hyperglycemia induces changes in gene expression and function. The first steps against hyperosmolality are initially adaptive, but later hyperactivation of the hypothalamic magnocellular neurosecretory cells leads to their structural damage. Changes in hippocampal gene transcription are partially implicated in the deterioration of declarative memory. Neurologically passive shunting of excess glucose through alternative cellular metabolic pathways induces atherogenic, vascular lesions, free radicals, leukoencephalopathy and atrophy of the brain and thus leading to cognitive deficits. In physiological conditions insulin has neuroprotective effect. However, insulin resistance in the central nervous system correlates with insulin resistance in the periphery. Loss of responsiveness to insulin could render neurons more susceptible to neurotoxic insults, the protective effect of insulin diminishes, and apoptosis, neurodegeneration and the resultant cognitive decline are all increased in insulin-resistant patients. Some unclear relations appear between diabetes mellitus and Alzheimer's disease. Diabetic patients with APOE-4 gene have an increased risk for Alzheimer's disease. Prevalence of depression is higher in patients with diabetes mellitus and in turn, depression is a risk factor for diabetes mellitus

  9. Vitamin D and diabetes mellitus: an update 2013.

    PubMed

    Griz, Luiz Henrique Maciel; Bandeira, Francisco; Gabbay, Mônica Andrade Lima; Dib, Sergio Atala; Carvalho, Eduardo Freese de

    2014-02-01

    Vitamin D deficiency and diabetes mellitus are two common conditions and they are widely prevalent across all ages, races, geographical regions, and socioeconomic conditions. Epidemiologic studies have shown association of vitamin D deficiency and increased risk of chronic diseases, such as cancer, cardiovascular disease, type 2 diabetes, and autoimmune diseases, such as multiple sclerosis and type 1 diabetes mellitus. The identification of 1,25(OH)2D receptors and 1-α-hydroxilase expression in pancreatic beta cells, in cells of the immune system, and in various others tissues, besides the bone system support the role of vitamin D in the pathogenesis of type 2 diabetes. Observational studies have revealed an association between 25(OH) D deficiency and the prevalence of type 1 diabetes in children and adolescents. This review will focus on the concept of vitamin D deficiency, its prevalence, and its role in the pathogenesis and risk of diabetes mellitus and cardiovascular diseases.

  10. Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-Onset Diabetes of the Young

    MedlinePlus

    ... Neonatal Diabetes Mellitus and MODY Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and MODY The most common forms of ... is inherited from each parent. Monogenic Forms of Diabetes Some rare forms of diabetes result from mutations ...

  11. Monocyte functions in diabetes mellitus.

    PubMed

    Geisler, C; Almdal, T; Bennedsen, J; Rhodes, J M; Kølendorf, K

    1982-02-01

    The aim of this study was to investigate the functions of monocytes obtained from 14 patients with diabetes mellitus (DM) compared with those of monocytes from healthy individuals. It was found that the total number of circulating monocytes in the 14 diabetic patients was lower than that from the healthy individuals. Phagocytosis of Candida albicans was decreased in the monocytes from the patients, whereas pinocytosis of acridine and phagocytosis of latex and sheep red blood cells were normal. The chemotactic response towards casein was enhanced. The possible consequences of these findings for the elucidation of concomitant infections in diabetic patients are discussed.

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

    PubMed

    Hashimoto, Kunihiko; Koga, Masafumi

    2015-07-25

    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.

  13. Microalbuminuria and diabetes mellitus.

    PubMed

    Konen, J C; Shihabi, Z K

    1993-12-01

    Small concentrations of albumin detected in the urine predict renal dysfunction and reflect vascular abnormalities such as atherosclerosis, retinopathy and, probably, neuropathy. Although microalbuminuria is not specific for diabetic complications, it has been most extensively studied in diabetics. The rate of urinary albumin excretion can also be used to determine therapeutic response to pharmacologic and lifestyle interventions such as diet, smoking cessation and physical activity. The pathophysiology of microalbuminuria and its clinical significance in diabetes is presented, along with a discussion of measurement issues and implications for clinical management. An algorithm for the evaluation of diabetic patients is included. PMID:8249773

  14. Type 2 diabetes mellitus and Alzheimer's disease.

    PubMed

    Barbagallo, Mario; Dominguez, Ligia J

    2014-12-15

    Epidemiological and biological evidences support a link between type 2 diabetes mellitus (DM2) and Alzheimer's disease (AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Future trials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes.

  15. 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

  16. RECENT ADVANCES IN CHILDHOOD DIABETES MELLITUS

    PubMed Central

    Ayoola, O.O.

    2008-01-01

    Diabetes mellitus (DM) is a syndrome characterized by disturbed metabolism of carbohydrate, protein, and fat. It is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin. It presents with very different medical and psychosocial issues in children. Epidemiological studies indicate that there is gradual but steady increase in the incidence of both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in both developed and developing countries. The manifestations, therapy goals, clinical course, susceptibility to complications of diabetes differ among childhood cases. T1DM accounts for the majority of cases of diabetes in children. Diabetic ketoacidosis may be the initial presentation of T1DM in many children particularly in Africa probably due to low level of awareness. The focus of this review on T1DM is to provide an overview of the major advances in the aetiology, pathogenesis, and clinical management of newly diagnosed children and their subsequent management with the aim of ensuring optimal growth and development as well as preventing acute and chronic complications. The advances in insulin therapy and regimens and the presentation and management of diabetic ketoacidosis are discussed. The prospects for the cure of the disease are also highlighted in this review. PMID:25161448

  17. [Therapy of diabetes mellitus today].

    PubMed

    Seige, K; Ulrich, E

    1975-05-01

    The therapy of diabetes mellitus is always connected with the observation of an adapted diet, the aim of which is the obtaining of the optimal weight. Still more intensive concentric educational measures for patients and persons endangered by diabetes are necessary, in which cases muscular action is of increasing importance. Sulfonylureas furthering the secretion of insulin are to be used only as far as necessary. Peripherally acting anti-diabetics, such as biguanides have an indication in diabetes mellitus which is exactly defined and to be observed. Also with regard to the combat against adiposity their influence on the lipometabolism needs further clarification. Metabolic and immunologic insulin resistance are complications of the insulin therapy. The extensive technical preparation of the human synthetic insulin may contribute to the improvement of the prognosis of diabetes. At present the introduction of artifical beta-cell-systems is a problem of the diminishing of the apparatuses. The genetic consultation for diabetics is important and in many cases possible.

  18. [Hypertension and diabetes mellitus].

    PubMed

    Janka, H U

    1993-03-01

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

  19. Genetics of gestational diabetes mellitus.

    PubMed

    Radha, Venkatesan; Kanthimathi, Sekar; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2016-09-01

    Gestational diabetes mellitus (GDM) has now become a major public health problem because of its prevalence and its associated complications during pregnancy. Earlier studies have suggested that type 2 diabetes mellitus (T2DM) and GDM might have similar pathophysiology, such as increased insulin resistance, decreased insulin secretion resulting in hyperglycaemia. Evidence for a genetic basis of GDM has been poorly understood. To some extent, the current advancement in genomic techniques has thrown better light on the genetics of GDM. Based on the candidate gene approach and genome wide association studies, genetic loci in several genes that are responsible for insulin secretion, insulin resistance, lipid and glucose metabolism and other pathways have shown association with the GDM susceptibility. Understanding the possible underlying genetic factors of GDM would help us in gaining knowledge on the pathophysiologic mechanism of the disease. PMID:27582142

  20. 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.

  1. [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. PMID:26666157

  2. 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

  3. 76 FR 55460 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA). ACTION: Notice of applications 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...

  4. 78 FR 63294 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...). Diabetes Mellitus and Driving Experience of the Applicants The Agency established the current requirement... clinical diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR...

  5. 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

  6. Type 2 diabetes mellitus in youth.

    PubMed

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

    2003-08-01

    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) recommended screening guidelines to identify youth at high risk for type 2 DM and in implementing student health programs that focus positively on the importance of physical activity and healthy eating habits. The purpose of this article is to present an overview of the epidemiology, pathophysiology, complications, diagnosis, and treatment, as well as the recommended screening guidelines for type 2 DM in the pediatric age group. The information provided will enhance awareness, promote screening, and empower the school nurse to more effectively promote healthy lifestyle education.

  7. Primary prevention of diabetes mellitus.

    PubMed

    Zimmet, P Z

    1988-03-01

    Two-thirds of all deaths in developed countries are caused by the major noncommunicable diseases, e.g., cardiovascular disease, cancer, and non-insulin-dependent diabetes mellitus (NIDDM). There is increasing evidence that these diseases are a consequence of life-style change, and they have a number of risk factors in common. Primary prevention of both insulin-dependent diabetes mellitus (IDDM) and NIDDM has become increasingly important because of their significant morbidity and mortality and the human and economic costs associated with diabetes and its complications. Prevention of the two major forms of diabetes, IDDM and NIDDM, are quite separate issues. The former appears to be an autoimmune disorder, whereas the latter should be considered along with other life-style-related noncommunicable diseases. The primary prevention of NIDDM appears to offer the greatest promise of success. The uncertainty that still exists as to the role of obesity and other risk factors in the development of NIDDM gives support to a multiple-risk-factor intervention approach (through a healthy life-style strategy) for NIDDM prevention.

  8. 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

    ... Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Workshop The Diabetes Mellitus... opportunities for type 1 diabetes research supported by the Special Statutory Funding Program for Type 1... Dr. Sanford Garfield, Executive Secretary of the Diabetes Mellitus Interagency Coordinating...

  9. [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.

  10. Immunology of diabetes mellitus.

    PubMed

    Maclaren, N

    1992-01-01

    Insulin-dependent diabetes is an autoimmune disease that may be becoming more prevalent. It has a polygenic mode of inheritance with a major gene being present in the HLA DQ locus on chromosome 6. Inferential data suggest that environmental factors may be important to genetic penetrance albeit we still lack proof for involvement of often maligned viruses. Patients with IDD and their families are predisposed to organ-specific autoimmunities which should be routinely screened for. Autoantibodies to insulin, to a beta cell cytoplasmic lipid containing moiety and to a beta cell protein of 64KDa, which is believed to be the GABA forming enzyme GAD, can be used to predict IDD among relatives and probably the general population as well. Immunosuppressive therapy can modify the course of IDD after diagnosis and should be able to delay the clinical onset if given before diagnosis. Rigorous insulin therapy should also be given as needed to control hyperglycemia and avoid glucose toxicity to the islets. Such trials are now underway.

  11. [Nutritional therapy in diabetes mellitus].

    PubMed

    Toeller, M

    1993-03-01

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

  12. [Driving license and mellitus diabetes].

    PubMed

    Cimino, Luc; Deneufgermain, Alain; Lalau, Jean-Daniel

    2015-10-01

    For the "light group" as for the "heavy group" driving license cannot be issued or renewed to the applicant or drivers suffering from a condition that may constitute or lead to functional disability jeopardize road safety when driving a motor vehicle. The decision to issue or renew the license by the prefectural authority is taken on the advice of the departmental medical commission or a licensed physician. The decree of August 31, 2010 establishes the list of medical conditions incompatible with obtaining or maintaining the driving license or which may give rise to the issue of driving license limited validity. "Diabetes mellitus treated with medications that can cause hypoglycemia" belongs to this list. If the medical control of driving ability comes at the initiative of the user, the treating physician should firstly ensure the understanding of prescribed treatments that can cause hypoglycaemic episodes and other by informing diabetic person she must pass a medical examination of fitness to drive in a licensed physician.

  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. Vitamin D and diabetes mellitus.

    PubMed

    Harinarayan, Chittari Venkata

    2014-01-01

    The vitamin D endocrine system in now recognized as subserving a wide range of fundamental biological functions in cell differentiation, inhibition of cell growth as well as immunomodulation. Both forms of immunity, namely adaptive and innate, are regulated by 1,25(OH)2D3. The immune-modulatory properties of vitamin D suggest that it could play a potential therapeutic role in prevention of type 1 diabetes mellitus (T1DM). It is postulated that large doses of vitamin D supplementation may influence the pattern of immune regulation and subsequent progression to T1DM in a genetically susceptible individual. More studies are required to substantiate the relation between T1DM and vitamin D/vitamin D analogues in the pattern of immune regulations in susceptible individuals. In type 2 diabetes mellitus (T2DM), vitamin D may influence both insulin secretion and sensitivity. An inverse relationship between T2DM and vitamin D is postulated from cross-sectional and prospective studies, though conclusive proof is as yet lacking. Available studies differ in their design and in the recommended daily allowances (RDA) of vitamin D in non-skeletal diseases and β-cell function. Large, well designed, controlled, randomized interventional studies on the potential role of vitamin D and calcium in prevention and management of T2DM are required to clarify the relationship between vitamin D and glucose homeostasis in T2DM.

  15. 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.

  16. 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

  17. Are We in the Same Risk of Diabetes Mellitus? Gender- and Age-Specific Epidemiology of Diabetes in 2001 to 2014 in the Korean Population

    PubMed Central

    Koo, Bo Kyung

    2016-01-01

    In the early 2000s, the prevalence of diabetes in adults aged ≥30 years in Korea was about 9% to 10%, and it remained stable. However, a nationwide survey showed that this prevalence increased over the past few years. After age-standardization using the Korean population of the year 2010, the prevalence of diabetes in adults aged ≥30 years was 10.0% to 10.8% between 2001 and 2012, which increased to 12.5% in 2013 and 11.6% in 2014. During that period, there have been changes in the gender- and age-specific prevalence of diabetes in Korean adults. The prevalence of diabetes in the elderly population increased significantly, while this prevalence in young adults, especially in young women, did not change significantly. The contribution of each diabetic risk factor, such as obesity, β-cell dysfunction, sarcopenia, and socioeconomic status, in developing diabetes has also changed during that period in each gender and age group. For young women, obesity was the most important risk factor; by contrast, for elderly diabetic patients, sarcopenia was more important than obesity as a risk factor. Considering the economic burden of diabetes and its associated comorbidities, a public health policy targeting the major risk factors in each population might be more effective in preventing diabetes. PMID:27273907

  18. Prevention of Gestational Diabetes Mellitus (GDM).

    PubMed

    Kalra, Sanjay; Gupta, Yashdeep; Kumar, Arun

    2016-09-01

    Prevention of Gestational diabetes mellitus holds the key to prevention of the diabetes and metabolic syndrome epidemic sweeping the world. This review discusses prevention of gestational diabetes and provides a scientific framework for the study of this topic. It classifies prevention in various ways, and suggests strategies which fit the different levels of prevention of gestational diabetes. The review also cites recent evidence and best practices to support the feasibility of prevention of gestational diabetes. PMID:27582141

  19. 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. PMID:25410222

  20. 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.

  1. STRESS AND ADJUSTMENT IN DIABETES MELLITUS

    PubMed Central

    Parveen, Sabiha; 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. PMID:21455356

  2. Coronary Artery Revascularization in Patients with Diabetes Mellitus

    MedlinePlus

    ... Patient Page Coronary Artery Revascularization in Patients With Diabetes Mellitus David H. Fitchett , Milan Gupta , Michael E. ... with exertion), heart attack, and possibly sudden death. Diabetes and Coronary Artery Disease Patients with diabetes mellitus ...

  3. 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

  4. Insulin degludec for diabetes mellitus.

    PubMed

    2013-07-01

    Over the last few years there has been a steady increase in the number of prescriptions dispensed in primary care for intermediate and long-acting insulin analogues and a reduction in prescriptions for biphasic isophane insulin. For example, in England, the volume of intermediate and long-acting insulin analogues in general practice has risen from approximately 650,000 prescriptions per quarter in 2007 to over 850,000 per quarter in 2012.(1) ▾Insulin degludec (Tresiba, Novo Nordisk) is a new long acting basal insulin analogue for the management of diabetes mellitus in adults.(2) Two strengths of insulin degludec (100 units/mL and 200 units/mL) were launched in the UK in February 2013. Here we discuss evidence for the effectiveness and safety of insulin degludec. PMID:23842634

  5. [Cognitive functions impairment in diabetes mellitus patient].

    PubMed

    Prikryl, R

    2007-01-01

    An increased research interest in the relation between diabetes mellitus and dementia or deterioration of cognitive functions has been recently noticed. The relatively rich scientific literature in this topic shows that diabetes mellitus itself can cause an impairment of cognitive functions regardless patient's age or the fact whether he has type 1 or type 2 diabetes mellitus. Type 1 diabetes mellitus leads to a psychomotor retardation while type 2 diabetes mellitus tends to be associated with impaired storage of new information. The exact mechanism through which diabetes impairs cognition has not been explained sufficiently yet, but several hypothetical mechanisms which might explain the relation between diabetes and impaired cognition have been proposed. To explain the etiopathogenetic mechanisms underlying the relation between diabetes and dementia, further research, especially research focused on process clinical-imaging studies or clinical-pathological studies is necessary. As far as clinical practice is concerned, it is important to bear in mind that prevention, timely diagnosis and optimum treatment of diabetes may help to reduce incidence of dementia or cognitive functions' impairment.

  6. 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. PMID:20960555

  7. 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.

  8. Comparing knowledge of diabetes mellitus among rural and urban diabetics.

    PubMed

    Sabri, Ahmad Ayaz; Qayyum, Muhammad Ahad; Saigol, Naif Usman; Zafar, Khurram; Aslam, Fawad

    2007-07-01

    A questionnaire-based cross-sectional study was carried out to assess the awareness of diabetes mellitus among rural and urban diabetics. After analyzing the awareness level of both populations, the urban diabetics were found to be more educated about diabetes. A 25-question survey was used to judge the awareness level of diabetes mellitus. A total of 240 diabetics were surveyed, 120 each from rural and urban areas. The mean awareness among the rural population was 13 (SD+/-2) correct answers out of a possible 25. Similarly, in the case of the urban diabetics the mean awareness was 18 (SD+/-2) correct answers. The survey was conducted on randomly chosen diabetics belonging to Lahore and Faisalabad, (urban areas), as well as Habibabad, Haveli Koranga and Baba Kanwal (rural areas). The results emphasize the interrelation between demography and awareness of diabetes mellitus. The rural diabetics are far less knowledgeable about diabetes mellitus, its management and its complications. Thus, there is an urgent need to improve the awareness level of diabetes mellitus in rural areas. Doing so will give rise to a healthier workforce and a lessened economic burden on Pakistan.

  9. [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.

  10. Real life with type 1 diabetes mellitus.

    PubMed

    Yagnik, Deepak

    2015-04-01

    Type 1 diabetes mellitus (T1DM) is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. Those affected by this disorder have a challenging life, both in terms of health and social adjustments. Various "alternative medicines" are offered to them in an effort to cure. Research has shown that good control over diabetes can be maintained through regular self-monitoring of blood glucose and frequent checking of diabetic complications. Here, I describe a female with T1DM and her journey with the disorder.

  11. Real life with type 1 diabetes mellitus

    PubMed Central

    Yagnik, Deepak

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. Those affected by this disorder have a challenging life, both in terms of health and social adjustments. Various “alternative medicines” are offered to them in an effort to cure. Research has shown that good control over diabetes can be maintained through regular self-monitoring of blood glucose and frequent checking of diabetic complications. Here, I describe a female with T1DM and her journey with the disorder. PMID:25941661

  12. Movement disorders in patients with diabetes mellitus.

    PubMed

    Jagota, Priya; Bhidayasiri, Roongroj; Lang, Anthony E

    2012-03-15

    Movement disorders are not infrequent in patients with diabetes mellitus. These may occur on the basis of both central and peripheral nervous system dysfunction and can be secondary to severe hyperglycemia, complications of diabetes or its treatment and less often to diseases in which both diabetes and a movement disorder are primary manifestations of the same underlying disease. We present a typical case of a severe movement disorder complicating diabetes as a springboard to review the spectrum of disorders associated with this condition.

  13. Autonomic Neuropathy in Diabetes Mellitus

    PubMed Central

    Verrotti, Alberto; Prezioso, Giovanni; Scattoni, Raffaella; Chiarelli, Francesco

    2014-01-01

    Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, often overlooked and misdiagnosed. It is a systemic-wide disorder that may be asymptomatic in the early stages. The most studied and clinically important form of DAN is cardiovascular autonomic neuropathy defined as the impairment of autonomic control of the cardiovascular system in patients with diabetes after exclusion of other causes. The reported prevalence of DAN varies widely depending on inconsistent definition, different diagnostic method, different patient cohorts studied. The pathogenesis is still unclear and probably multifactorial. Once DAN becomes clinically evident, no form of therapy has been identified, which can effectively stop or reverse it. Prevention strategies are based on strict glycemic control with intensive insulin treatment, multifactorial intervention, and lifestyle modification including control of hypertension, dyslipidemia, stop smoking, weight loss, and adequate physical exercise. The present review summarizes the latest knowledge regarding clinical presentation, epidemiology, pathogenesis, and management of DAN, with some mention to childhood and adolescent population. PMID:25520703

  14. [Is diabetes mellitus worth treating?].

    PubMed

    Towpik, Iwona; Wender-Ozegowska, Ewa

    2014-03-01

    The aim of the paper was to present data that enable us to determine whether treatment of hyperglycemia diagnosed during pregnancy in the era of a steadily growing number of women with gestational diabetes mellitus (GDM) and an ongoing debate about new criteria and diagnostic strategies, is a valid option. GDM is the main metabolic disorder developing during pregnancy complicating around 6% of all pregnancies. Mistreatment of hyperglycemia during pregnancy may cause several fetal complications, especially neonatal overgrowth (macrosomia or LGA). The risk of macrosomia is directly related to maternal hyperglycemia (twice as high as in the control group with glucose levels exceeding 130 mg/dl). Apart from maternal hyperglycemia and fetal hyperinsulinemia, insulin-like growth factors and selected adipocytokines produced by adipose tissue and placenta are among the factors contributing to the development of diabetic fetopathy, whose risk increases by 2-fold with glucose levels exceeding 130 mg/dl. The role of hyperglycemia as a factor inducing several perinatal complications was confirmed by the HAPO study but it is not the sole reason of adverse effects. Also, maternal obesity weight gain during pregnancy and maternal hyperlipidemia seem to be involved in the pathogenesis of feto-maternal complications. Changes in fetal growth, disturbances in the perinatal period, there just some of the negative consequences of maternal GDM. Disturbance of carbohydrate metabolism during pregnancy causes long-lasting consequences for both, the mother and the child, including increased risk of overt diabetes, metabolic syndrome and cardiovascular complications. Children born to GDM mothers are at a significant risk of psycho-motoric disability and a higher risk of schizophrenia. ACHOIS and MFMU studies have confirmed that even mild hyperglycemia, detected and treated in a timely manner significantly improves maternal and fetal outcome. Various meta-analyses have revealed a positive

  15. [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

  16. [Pathological interaction between diabetes mellitus and Alzheimer's disease].

    PubMed

    Takeda, Shuko

    2012-11-01

    The incidence of dementia and diabetes mellitus is increasing at an alarming rate, and has become a major public health concern all over the world. Recent epidemiological studies suggest that the risk of Alzheimer's disease is increased in individuals with diabetes mellitus, although the underlying mechanisms remain largely unknown. To analyze underlying mechanisms linking Alzheimer's disease and diabetes mellitus, we established unique animal models that show pathological manifestations of both diseases. Our findings suggest that impaired brain insulin signaling and cerebrovascular changes could be potential underlying mechanisms for this relationship. On the other hand, interestingly, Alzheimer's amyloid pathology aggravated diabetes mellitus in these mouse models, suggesting the presence of mutual interaction between these diseases. In addition, we also found that plasma Abeta levels rapidly and strikingly increased after glucose loading in Alzheimer's disease mouse models, which could be a novel diagnostic marker of Alzheimer's disease. The current review summarizes the results of our recent studies on the pathological relationship between these diseases, which could provide novel insights into this intensely debated association.

  17. 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

  18. Diabetes mellitus: The epidemic of the century.

    PubMed

    Kharroubi, Akram T; Darwish, Hisham M

    2015-06-25

    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

  19. 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)…

  20. Biological effects of omega-3 fatty acids in diabetes mellitus.

    PubMed

    Malasanos, T H; Stacpoole, P W

    1991-12-01

    Fish oils exert important biological effects on several pathways predisposing to atherosclerosis. Epidemiological studies provided the initial evidence that omega-3 fatty acids may be the principal factor in fish oils responsible for these effects and have led to several short-term clinical trials in which fish-oil concentrates have been administered to various populations at risk for coronary heart disease, including patients with diabetes mellitus. omega-3 Fatty acids reduce serum lipids and lipoproteins, impair platelet aggregation, increase cell membrane fluidity, and lower blood pressure in humans. In this review, we highlight these and other potentially antiatherogenic properties of marine lipids in diabetic subjects.

  1. 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

  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.

  3. Central nervous system involvement in diabetes mellitus.

    PubMed

    Selvarajah, Dinesh; Tesfaye, Solomon

    2006-12-01

    Diabetic complications result in much morbidity and mortality and considerable consumption of scarce medical resources. Thus, elucidation of the risk factors and pathophysiologic mechanisms underlying diabetic complications is important. The effects of diabetes on the central nervous system (CNS) result in cognitive dysfunction and cerebrovascular disease. Treatment-related hypoglycemia also has CNS consequences. Advances in neuroimaging now provide greater insights into the structural and functional impact of diabetes on the CNS. Greater understanding of CNS involvement could lead to new strategies to prevent or reverse the damage caused by diabetes mellitus.

  4. Statins and Risk of New-Onset Diabetes Mellitus

    MedlinePlus

    ... Association Cardiology Patient Page Statins and Risk of New-Onset Diabetes Mellitus Ravi V. Shah and Allison ... most common adverse effects, and recent concerns about new-onset diabetes mellitus to help patients and providers ...

  5. 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... individual assessment of drivers with diabetes mellitus, and be consistent with the criteria described in... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications;...

  6. 78 FR 63280 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... exemptions from the prohibition against persons with insulin- treated diabetes mellitus (ITDM) operating... drivers with diabetes mellitus, and be consistent with the criteria described in section 4018 of the... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications;...

  7. 78 FR 63298 - 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... must provide for individual assessment of drivers with diabetes mellitus, and be consistent with the... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications;...

  8. Pancreas transplant for diabetes mellitus.

    PubMed

    Kerr, Hannah R; Hatipoglu, Betul; Krishnamurthi, Venkatesh

    2015-11-01

    Pancreas transplant is an option for patients with type 1 diabetes and for some patients with type 2 diabetes and advanced diabetic kidney disease. The procedure has a high success rate, and performing it earlier in the course of diabetes could help prevent or reverse the long-term complications of diabetes.

  9. 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

  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. Chapter 1: Epidemiology of Type 1 Diabetes

    PubMed Central

    Maahs, David M; West, Nancy A; Lawrence, Jean M.; Mayer-Davis, Elizabeth J

    2010-01-01

    Synopsis This chapter describes the epidemiology of type 1 diabetes mellitus (T1D) around the world and across the lifespan. Epidemiologic patterns of T1D by demographic, geographic, biologic, cultural and other factors in populations are presented to gain insight about the etiology, natural history, risks, and complications of T1D. Data from large epidemiologic studies worldwide indicate that the incidence of T1D has been increasing by 2–5% worldwide and that the prevalence of T1D is approximately 1 in 300 in the US by 18 years of age. Research on risk factors for T1D is an active area of research to identify genetic and environmental triggers that could potentially be targeted for intervention. While significant advances have been made in the clinical care of T1D with resultant improvements in quality of life and clinical outcomes, much more needs to be done to improve care of, and ultimately find a cure for T1D. Epidemiologic studies have an important on-going role to investigate the complex causes, clinical care, prevention, and cure of T1D. PMID:20723815

  12. [Diabetes mellitus, coronary artery disease and heart disease].

    PubMed

    Clodi, Martin; Säly, Christoph; Hoppichler, Friedrich; Resl, Michael; Steinwender, Clemens; Eber, Bernd

    2016-04-01

    Diabetes mellitus, cardiovascular disease and heart failure are interacting dynamically. Patients being diagnosed with cardiovascular disease should be screened for diabetes mellitus. Enhanced cardiovascular risk stratification based on biomarkers, symptoms and classical risk factors should be performed in patients with pre-existing diabetes mellitus. PMID:27052249

  13. 76 FR 71111 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...). Diabetes Mellitus and Driving Experience of the Applicants The Agency established the current requirement... clinical diagnosis of diabetes mellitus currently requiring insulin for control.'' (49 CFR...

  14. 77 FR 7232 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... persons with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in...). Diabetes Mellitus and Driving Experience of the Applicants The Agency established the current requirement... clinical diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR...

  15. 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...). Diabetes Mellitus and Driving Experience of the Applicants The Agency established the current requirement... clinical diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR...

  16. 77 FR 61655 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ...; 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... diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3))....

  17. 75 FR 52813 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... 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, the... drivers with diabetes mellitus, and be consistent with the criteria described in section 4018 of...

  18. 76 FR 78725 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... 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 commerce...).\\1\\ The revision must provide for individual assessment of drivers with diabetes mellitus, and...

  19. 75 FR 52809 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... 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, the... must provide for individual assessment of drivers with diabetes mellitus, and be consistent with...

  20. 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... 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...

  1. 76 FR 78720 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... 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...

  2. 78 FR 67459 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... with insulin-treated diabetes mellitus (ITDM) from operating commercial motor vehicles (CMVs) in... CFR 391.41(b)(3). Diabetes Mellitus and Driving Experience of the Applicants The Agency established... established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for...

  3. 78 FR 32704 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... 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...) \\1\\. The revision must provide for individual assessment of drivers with diabetes mellitus, and...

  4. 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... would be achieved by complying with the current regulation 49 CFR 391.41(b)(3). Diabetes Mellitus and... of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3))....

  5. 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... 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...

  6. 76 FR 78722 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... 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...

  7. 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... achieved by complying with the current regulation 49 CFR 391.41(b)(3). Diabetes Mellitus and Driving... of a Program to Qualify Individuals with Insulin-Treated Diabetes Mellitus to Operate in...

  8. 75 FR 59788 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... 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, the... revision must provide for individual assessment of drivers with diabetes mellitus, and be consistent...

  9. 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...). Diabetes Mellitus and Driving Experience of the Applicants The Agency established the current standard for... diagnosis of diabetes mellitus currently requiring insulin for control'' (49 CFR 391.41(b)(3))....

  10. Endothelial Dysfunction in Type 2 Diabetes Mellitus.

    PubMed

    Dhananjayan, R; Koundinya, K S Srivani; Malati, T; Kutala, Vijay Kumar

    2016-10-01

    Endothelial dysfunction is an imbalance in the production of vasodilator factors and when this balance is disrupted, it predisposes the vasculature towards pro-thrombotic and pro-atherogenic effects. This results in vasoconstriction, leukocyte adherence, platelet activation, mitogenesis, pro-oxidation, impaired coagulation and nitric oxide production, vascular inflammation, atherosclerosis and thrombosis. Endothelial dysfunction is focussed as it is a potential contributor to the pathogenesis of vascular disease in diabetes mellitus. Under physiological conditions, there is a balanced release of endothelial-derived relaxing and contracting factors, but this delicate balance is altered in diabetes mellitus and atherosclerosis, thereby contributing to further progression of vascular and end-organ damage. This review focuses on endothelial dysfunction in atherosclerosis, insulin resistance, metabolic syndrome, oxidative stress associated with diabetes mellitus, markers and genetics that are implicated in endothelial dysfunction.

  11. Endothelial Dysfunction in Type 2 Diabetes Mellitus.

    PubMed

    Dhananjayan, R; Koundinya, K S Srivani; Malati, T; Kutala, Vijay Kumar

    2016-10-01

    Endothelial dysfunction is an imbalance in the production of vasodilator factors and when this balance is disrupted, it predisposes the vasculature towards pro-thrombotic and pro-atherogenic effects. This results in vasoconstriction, leukocyte adherence, platelet activation, mitogenesis, pro-oxidation, impaired coagulation and nitric oxide production, vascular inflammation, atherosclerosis and thrombosis. Endothelial dysfunction is focussed as it is a potential contributor to the pathogenesis of vascular disease in diabetes mellitus. Under physiological conditions, there is a balanced release of endothelial-derived relaxing and contracting factors, but this delicate balance is altered in diabetes mellitus and atherosclerosis, thereby contributing to further progression of vascular and end-organ damage. This review focuses on endothelial dysfunction in atherosclerosis, insulin resistance, metabolic syndrome, oxidative stress associated with diabetes mellitus, markers and genetics that are implicated in endothelial dysfunction. PMID:27605734

  12. Failure to initiate early insulin therapy – A risk factor for diabetic retinopathy in insulin users with Type 2 diabetes mellitus: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS, Report number 35)

    PubMed Central

    Gupta, Aditi; Delhiwala, Kushal S; Raman, Rajiv P G; Sharma, Tarun; Srinivasan, Sangeetha; Kulothungan, Vaitheeswaran

    2016-01-01

    Context: Insulin users have been reported to have a higher incidence of diabetic retinopathy (DR). Aim: The aim was to elucidate the factors associated with DR among insulin users, especially association between duration, prior to initiating insulin for Type 2 diabetes mellitus (DM) and developing DR. Materials and Methods: Retrospective cross-sectional observational study included 1414 subjects having Type 2 DM. Insulin users were defined as subjects using insulin for glycemic control, and insulin nonusers as those either not using any antidiabetic treatment or using diet control or oral medications. The duration before initiating insulin after diagnosis was calculated by subtracting the duration of insulin usage from the duration of DM. DR was clinically graded using Klein's classification. SPSS (version 9.0) was used for statistical analysis. Results: Insulin users had more incidence of DR (52.9% vs. 16.3%, P < 0.0001) and sight threatening DR (19.1% vs. 2.4%, P < 0.0001) in comparison to insulin nonusers. Among insulin users, longer duration of DM (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.00–1.25, P = 0.044) and abdominal obesity (OR 1.15, 95% CI 1.02–1.29, P = 0.021) was associated with DR. The presence of DR was significantly associated with longer duration (≥5 years) prior to initiating insulin therapy, overall (38.0% vs. 62.0%, P = 0.013), and in subjects with suboptimal glycemic control (32.5% vs. 67.5%, P = 0.022). Conclusions: The presence of DR is significantly associated with longer duration of diabetes (>5 years) and sub-optimal glycemic control (glycosylated hemoglobin <7.0%). Among insulin users, abdominal obesity was found to be a significant predictor of DR; DR is associated with longer duration prior to initiating insulin therapy in Type 2 DM subjects with suboptimal glycemic control. PMID:27488152

  13. [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.

  14. Therapeutic management of posttransplant diabetes mellitus.

    PubMed

    Mannon, Roslyn B

    2008-04-01

    Diabetes mellitus continues to be a common metabolic complication after solid organ transplantation. The etiology is multifactorial and includes both modifiable and nonmodifiable factors. Immunosuppression may play a critical role in its development. Targets of treatment include oral hypoglycemics as well as insulin. More recently, several novel agents have been approved by the Food and Drug Administration for treatment of type 2 diabetes. There is limited experience with these agents in transplant recipients. Use of oral and subcutaneous therapies as well as insulin will be reviewed. As diabetes has a negative impact on patient and graft outcome, the transplant practitioner must be vigilant in screening and managing diabetes after transplantation.

  15. 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

  16. 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

  17. [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. PMID:27459757

  18. Diabetes mellitus and tuberculosis facts and controversies

    PubMed Central

    2013-01-01

    Tuberculosis (TB) and diabetes mellitus (DM) are both important health issues. A bidirectional association between them has been demonstrated by many researchers. The link of DM and TB is more prominent in developing countries where TB is endemic and the burden of diabetes mellitus is increasing. The association between diabetes and tuberculosis may be the next challenge for global tuberculosis control worldwide. Proper planning and collaboration are necessary to reduce the dual burden of diabetes and TB. One model similar to the TB-HIV program for prevention, screening and treatment of both diseases can be the best approach. In this paper, we review existing data and discuss the matters of controversy that would be helpful for determining research priorities in different countries. PMID:24360398

  19. [Acatalasemia and type 2 diabetes mellitus].

    PubMed

    Góth, László; Nagy, Teréz; Káplár, Miklós

    2015-03-01

    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. PMID:25726767

  20. [Diabetes mellitus and its animal models].

    PubMed

    Duhault, J; Koenig-Berard, E

    1997-01-01

    This review presents the major animal models usually used for the study of the pathological processes related to insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM) and to the main diabetic complications. These models can be observed spontaneously or can be obtained by selective cross-breeding or toxic exposure (chemical or viral), as well as genetically induced. They reproduce some aspects of the human pathology without combining them all in a single model. Consequently, a pertinent pharmacological approach may compare the results obtained with several models. The examination of the recent results obtained with transgenesis does not allow these animal models to replace more classical ones but they may constitute a future challenge for gene therapy despite the multifactorial aspect of diabetic disease. PMID:9501560

  1. [Acatalasemia and type 2 diabetes mellitus].

    PubMed

    Góth, László; Nagy, Teréz; Káplár, Miklós

    2015-03-01

    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.

  2. Reduced risk of prostate cancer among patients with diabetes mellitus.

    PubMed

    Weiderpass, Elisabete; Ye, Weimin; Vainio, Harri; Kaaks, Rudolf; Adami, Hans-Olov

    2002-11-20

    Although diabetes mellitus is associated with an increased risk of several malignancies, a negative association with prostate cancer is biologically most plausible. The epidemiologic evidence is, however, inconsistent, limited and based mostly on small studies. We present results from a large, population-based cohort study in Sweden, where we assessed prostate cancer risk among patients hospitalized for diabetes mellitus. The cohort was composed of patients identified in the Swedish In-Patient Register as having a hospital discharge diagnosis of diabetes mellitus in 1965-1994. The follow-up was done by linkages with the national cancer register and other population-based registers. Standardized incidence ratios (SIRs), with 95% confidence interval (CI), were used as a measure of relative risk. After complete exclusion of the first year of follow-up (to avoid selection bias), 135,950 men remained in the cohort, contributing 827,099 years of follow-up to the study. A total of 2,455 incident cases of primary prostate cancer were identified during 1-31 years of follow-up, yielding an overall SIR of 0.91 (95% CI 0.87-0.94); this risk reduction was more pronounced among patients who have been hospitalized for diabetic complications (SIR = 0.82; 95% CI 0.74-0.91). We found no consistent trends in risk related to age at first hospitalization or to duration of follow-up. We did find a small, but significantly decreased risk of prostate cancer among men who had been hospitalized for diabetes mellitus.

  3. [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. PMID:1307994

  4. 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.

  5. 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.

  6. Diabetes mellitus: Possible risk and promoting factors of cholangiocarcinoma: Association of diabetes mellitus and cholangiocarcinoma.

    PubMed

    Saengboonmee, Charupong; Seubwai, Wunchana; Wongkham, Chaisiri; Wongkham, Sopit

    2015-06-01

    The highest incidence of Cholangiocarcinoma (CCA), a malignancy of bile duct epithelia, is in the Northeast of Thailand. The liver fluke, Opisthorchis viverrini, is the known risk factor for CCA development in this region. Approximately 1% of O. viverrini infected individuals develop CCA. There could be other factors that influence the cholangiocarcinogenesis particularly in the O. viverrini infected individuals. The global epidemiological studies of risk factors for CCA in non-O. viverrini related patients indicated diabetes mellitus (DM) as a risk factor of CCA. The molecular studies in many cancers indicated that high levels of glucose, insulin and an obese condition directly and indirectly enhanced growth of cancers. For O. viverrini associated CCA, there is limited information related to DM and CCA development. High mortality rates of CCA and DM, however, were reported in the same geographical areas of northeastern Thailand. Whether DM is a factor that enhances CCA development in O. viverrini infected individuals or promotes CCA progression are discussed in a perspective of epidemiological and molecular studies. PMID:25910864

  7. Thyroid Disorders and Diabetes Mellitus

    PubMed Central

    Hage, Mirella; Zantout, Mira S.; Azar, Sami T.

    2011-01-01

    Studies have found that diabetes and thyroid disorders tend to coexist in patients. Both conditions involve a dysfunction of the endocrine system. Thyroid disorders can have a major impact on glucose control, and untreated thyroid disorders affect the management of diabetes in patients. Consequently, a systematic approach to thyroid testing in patients with diabetes is recommended. PMID:21785689

  8. The cardiorenal syndrome in diabetes mellitus.

    PubMed

    Karnib, Hussein H; Ziyadeh, Fuad N

    2010-09-01

    The cardiorenal syndrome in patients with diabetes mellitus represents a systemic condition that affects both the cardiovascular and renal systems. Diabetes is a well established risk factor for cardiovascular disease (CVD), and a significant proportion of diabetic patients go on to develop clinically significant nephropathy. In the diabetic state the kidney is involved by progressive sclerosis/fibrosis and proteinuria, due most likely to overactivity of the transforming growth factor-beta system and, to some extent, the vascular endothelial growth factor system, respectively. The pathogenesis of CVD in diabetes is multifactorial, involving hemodynamic forces, humoral/metabolic factors, and oxidative stress. Additionally, it has been suggested that endothelial dysfunction may lead to simultaneous development and progression of renal and cardiac pathology in diabetes. The risk of microvascular complications can be reduced by intensive glycemic control in patients with type 1 and type 2 diabetes mellitus whereas benefit to the cardiovascular system is less clear. However, intensified intervention involving other CVD risk factors like hypertension and dyslepidemia and interception of the rennin-angiotensin-aldosterone system in patients with type 2 diabetes have been shown to be associated with significant reduction in the risk for renal disease progression that was paralleled by a significant reduction in cardiovascular disease burden. PMID:20599286

  9. 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.

  10. [Cardiovascular outcome clinical trials in type 2 diabetes mellitus: what are the epidemiological and methodological evidence and the first evaluations to date?].

    PubMed

    Fiorentino, Teresa Vanessa; Sesti, Giorgio

    2016-03-01

    Clinical trials of glucose-lowering strategies in patients with type 2 diabetes mellitus (T2DM) have shown a favorable effect of intensive glycemic control on microvascular complications but failed to show a clear benefit on cardiovascular events. In 2008, the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) have required stringent criteria to approve new glucose-lowering drugs, demanding proof of cardiovascular safety. As a result of these regulatory requirements, a number of cardiovascular outcome trials in T2DM have been conducted examining the cardiovascular safety of novel glucose-lowering drugs. Dipeptidyl peptidase 4 (DPP4) inhibitors, analogs of glucagon-like peptide 1 (GLP-1), and inhibitors of the renal sodium-glucose linked transporter-2 (SGLT2) are new classes of glucose-lowering drugs for subjects with T2DM. The results of the cardiovascular outcome trials comparing the DPP4 inhibitors saxagliptin, alogliptin, and sitagliptin or the GLP-1 analog lixisenatide to placebo have demonstrated that these drugs are safe. The results of a cardiovascular outcome trial comparing the SGLT2 inhibitor empagliflozin to placebo have been published. Notably, empagliflozin treatment has been associated with a significant reduction in the primary composite cardiovascular outcome. Although the question regarding the positive effect of glycemic control on cardiovascular risk is still unanswered, current evidence suggests that a multifactorial approach aimed at treating not only hyperglycemia but also classical cardiovascular risk factors is necessary in order to reduce the risk of cardiovascular events in patients with T2DM. PMID:27030121

  11. Type 2 diabetes in Brazil: epidemiology and management

    PubMed Central

    de Almeida-Pititto, Bianca; Dias, Monike Lourenço; de Moraes, Ana Carolina Franco; Ferreira, Sandra RG; Franco, Denise Reis; Eliaschewitz, Freddy Goldberg

    2015-01-01

    Type 2 diabetes mellitus (T2DM) is one of the most important epidemic diseases in the world this century, and accounts for 90% of cases of diabetes globally. Brazil is one of the most important examples of the alarming picture of T2DM in emergent societies, being the country with the fourth largest number of people with diabetes. The aim of this paper is to review the literature on diabetes in Brazil, specifically looking at the epidemiology and management of T2DM. A literature search was conducted using PubMed and LILACS to identify articles containing information on diabetes in Brazil. Official documents from the Brazilian government, World Health Organization, and International Diabetes Federation were also reviewed. PMID:25609989

  12. Placental vanadium in gestational diabetes mellitus.

    PubMed

    Manci, E A; Coffin, C M; Smith, S M; Ganong, C A

    1989-01-01

    Although many studies in animal models and in cell cultures have shown that vanadate has insulin-like effects, it has not been studied in human diabetes mellitus. In this study the levels of vanadium in human placentae from 23 pregnancies complicated by gestational diabetes mellitus were compared with 18 uncomplicated non-diabetic pregnancies closely matched for maternal age, gravidity, and gestational age. Using the unpaired Student's t-test, the mid-disc placental levels in gestational diabetes (7.62 +/- 1.29 micrograms/g dry weight) were significantly lower (p less than 0.05) than controls (8.73 +/- 1.85 micrograms/g dry weight). These findings appear to be independent of placental size and birthweight. When these data were analyzed according to treatment, the vanadium levels in insulin-treated cases (8.07 +/- 1.32 micrograms/g dry weight) were not significantly different from the matched controls (8.84 +/- 1.69 micrograms/dry weight); the levels in noninsulin treated cases (7.08 +/- 1.25 micrograms/g dry weight), however, were significantly (p less than 0.005) lower than controls (8.99 +/- 1.96 micrograms/g dry weight). It is interesting to speculate that there may be increased binding of vanadium to maternal tissues in human diabetes mellitus when insulin is deficient.

  13. 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.

  14. 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.

  15. Platelet adhesiveness in diabetes mellitus

    PubMed Central

    Shaw, S.; Pegrum, G. D.; Wolff, Sylvia; Ashton, W. L.

    1967-01-01

    Platelet adhesiveness has been assessed on whole blood from a series of 34 diabetics and 50 control subjects using adenosine diphosphate (A.D.P.) and by adherence to glass microspherules (ballotini). Using both techniques it was possible to demonstrate a significant increase in platelet adhesiveness in the diabetic patients. PMID:5614070

  16. 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.

  17. 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.

  18. 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

  19. [The relationship of periodontitis and diabetes mellitus].

    PubMed

    Kasaj, Adrian; Gortan-Kasaj, Aristea; Willerhausen, Brita; Hoffmann, Oliver; Angelov, Nikola; Zafiropoulos, Gregory-George

    2007-09-01

    Periodontitis is a chronic, dental-plaque induced inflammatory disease of the tooth-supporting tissues, resulting in a gradual loss of connective tissue attachment and alveolar bone. The interrelationship between diabetes mellitus and periodontitis has been studied for many years. At,present, there is strong evidence to suggest that the incidence and severity of periodontitis is influenced by the presence or absence of diabetes mellitus as well as by the degree of diabetes control by patients. Elevated blood glucose levels in poorly controlled diabetics result in an increase of protein glycosylation leading to amplified formation of so-called Advanced Glycation End products (AGE). AGEs are glucose products that have the ability to attract and stimulate inflammatory cells to produce inflammatory cytokines, elevating the risk of periodontal attachment and/or alveolar bone loss. Gram-negative periodontal infection significantly decreases glucose tolerance and can lead, like other types of inflammation, to an increase in the severity of diabetes. Thus, diabetes and periodontal disease form a system in which periodontitis is aggravated and metabolic control of blood glucose levels becomes more difficult. This in turn leads to mutual aggravation that results in a self-enforcing catabolic process, a vicious circle of inflammation, tissue destruction and insulin resistance. PMID:18044471

  20. 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... diabetes exemption applications from 23 individuals and requested comments from the public (77 FR 33551... complying with the current regulation 49 CFR 391.41(b)(3). Diabetes Mellitus and Driving Experience of...

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

    PubMed Central

    Duhamelle, Alexis; Langlois, Isabelle; Desmarchelier, Marion

    2015-01-01

    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. PMID:26130836

  2. [Diabetes mellitus in the elderly].

    PubMed

    Górska, Maria

    2002-01-01

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

  3. 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...

  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. 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. PMID:27664636

  6. [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.

  7. [Diabetic encephalopathy: an underexposed complication of diabetes mellitus].

    PubMed

    Brands, A M A; Henselmans, J M L; de Haan, E H F; Biessels, G J

    2003-01-01

    Diabetes mellitus seems to be associated with gradually developing end-organ damage to the central nervous system. This relatively unknown complication of both diabetes type 1 and type 2 can be referred to as 'diabetic encephalopathy'. Measurable manifestations are electrophysiological and structural changes and limitations in the cognitive functioning. The mechanisms responsible for this diabetic encephalopathy are only partially known. Chronic metabolic and vascular changes seem to play an important role. The effects of diabetes on the brain are most distinct in the elderly. This may be the consequence of interactions between the mechanisms that underlie the ageing of the brain, dementia and the origin of diabetic complications. At present there are few leads for the targeted diagnostics and treatment of individual patients.

  8. 78 FR 14561 - Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... meeting on March 28, 2013, focusing on ``Federal Initiatives to Address Gestational Diabetes Mellitus... 28, 2013 DMICC meeting will focus on ``Federal Initiatives to Address Gestational Diabetes Mellitus... HUMAN SERVICES National Institutes of Health Notice of Diabetes Mellitus Interagency...

  9. 77 FR 64347 - Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... meeting will focus on ``Federal Initiatives To Address Gestational Diabetes Mellitus.'' Any member of the... HUMAN SERVICES National Institutes of Health Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting SUMMARY: The Diabetes Mellitus Interagency Coordinating Committee (DMICC) will hold...

  10. 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

  11. 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. PMID:27595114

  12. Experimental Diabetes Mellitus in Different Animal Models

    PubMed Central

    Al-awar, Amin; 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.

  13. Experimental Diabetes Mellitus in Different Animal Models

    PubMed Central

    Al-awar, Amin; 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. PMID:27595114

  14. 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...

  15. Aldose Reductase, Oxidative Stress, and Diabetic Mellitus

    PubMed Central

    Tang, Wai Ho; Martin, Kathleen A.; Hwa, John

    2012-01-01

    Diabetes mellitus (DM) is a complex metabolic disorder arising from lack of insulin production or insulin resistance (Diagnosis and classification of diabetes mellitus, 2007). DM is a leading cause of morbidity and mortality in the developed world, particularly from vascular complications such as atherothrombosis in the coronary vessels. Aldose reductase (AR; ALR2; EC 1.1.1.21), a key enzyme in the polyol pathway, catalyzes nicotinamide adenosine dinucleotide phosphate-dependent reduction of glucose to sorbitol, leading to excessive accumulation of intracellular reactive oxygen species (ROS) in various tissues of DM including the heart, vasculature, neurons, eyes, and kidneys. As an example, hyperglycemia through such polyol pathway induced oxidative stress, may have dual heart actions, on coronary blood vessel (atherothrombosis) and myocardium (heart failure) leading to severe morbidity and mortality (reviewed in Heather and Clarke, 2011). In cells cultured under high glucose conditions, many studies have demonstrated similar AR-dependent increases in ROS production, confirming AR as an important factor for the pathogenesis of many diabetic complications. Moreover, recent studies have shown that AR inhibitors may be able to prevent or delay the onset of cardiovascular complications such as ischemia/reperfusion injury, atherosclerosis, and atherothrombosis. In this review, we will focus on describing pivotal roles of AR in the pathogenesis of cardiovascular diseases as well as other diabetic complications, and the potential use of AR inhibitors as an emerging therapeutic strategy in preventing DM complications. PMID:22582044

  16. Diabetes Mellitus in the Transplanted Kidney

    PubMed Central

    Peev, Vasil; Reiser, Jochen; Alachkar, Nada

    2014-01-01

    Diabetes mellitus (DM) is the most common cause of chronic kidney disease and end stage renal disease. New onset diabetes mellitus after transplant (NODAT) has been described in approximately 30% of non-diabetic kidney-transplant recipients many years post transplantation. DM in patients with kidney transplantation constitutes a major comorbidity, and has significant impact on the patients and allografts’ outcome. In addition to the major comorbidity and mortality that result from cardiovascular and other DM complications, long standing DM after kidney-transplant has significant pathological injury to the allograft, which results in lowering the allografts and the patients’ survivals. In spite of the cumulative body of data on diabetic nephropathy (DN) in the native kidney, there has been very limited data on the DN in the transplanted kidney. In this review, we will shed the light on the risk factors that lead to the development of NODAT. We will also describe the impact of DM on the transplanted kidney, and the outcome of kidney-transplant recipients with NODAT. Additionally, we will present the most acceptable data on management of NODAT. PMID:25221544

  17. Aldose reductase, oxidative stress, and diabetic mellitus.

    PubMed

    Tang, Wai Ho; Martin, Kathleen A; Hwa, John

    2012-01-01

    Diabetes mellitus (DM) is a complex metabolic disorder arising from lack of insulin production or insulin resistance (Diagnosis and classification of diabetes mellitus, 2007). DM is a leading cause of morbidity and mortality in the developed world, particularly from vascular complications such as atherothrombosis in the coronary vessels. Aldose reductase (AR; ALR2; EC 1.1.1.21), a key enzyme in the polyol pathway, catalyzes nicotinamide adenosine dinucleotide phosphate-dependent reduction of glucose to sorbitol, leading to excessive accumulation of intracellular reactive oxygen species (ROS) in various tissues of DM including the heart, vasculature, neurons, eyes, and kidneys. As an example, hyperglycemia through such polyol pathway induced oxidative stress, may have dual heart actions, on coronary blood vessel (atherothrombosis) and myocardium (heart failure) leading to severe morbidity and mortality (reviewed in Heather and Clarke, 2011). In cells cultured under high glucose conditions, many studies have demonstrated similar AR-dependent increases in ROS production, confirming AR as an important factor for the pathogenesis of many diabetic complications. Moreover, recent studies have shown that AR inhibitors may be able to prevent or delay the onset of cardiovascular complications such as ischemia/reperfusion injury, atherosclerosis, and atherothrombosis. In this review, we will focus on describing pivotal roles of AR in the pathogenesis of cardiovascular diseases as well as other diabetic complications, and the potential use of AR inhibitors as an emerging therapeutic strategy in preventing DM complications. PMID:22582044

  18. 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

  19. Epidemiology of Type 1 Diabetes Mellitus in Korea through an Investigation of the National Registration Project of Type 1 Diabetes for the Reimbursement of Glucometer Strips with Additional Analyses Using Claims Data

    PubMed Central

    Song, Sun Ok; Nam, Joo Young; Park, Kyeong Hye; Yoon, Ji-Hae; Son, Kyung-Mi; Ko, Young; Lim, Dong-Ha

    2016-01-01

    Background The aim of this study was to estimate the prevalence and incidence of type 1 diabetes mellitus (T1DM) in Korea. In addition, we planned to do a performance analysis of the Registration Project of Type 1 diabetes for the reimbursement of consumable materials. Methods To obtain nationwide data on the incidence and prevalence of T1DM, we extracted claims data from July 2011 to August 2013 from the Registration Project of Type 1 diabetes on the reimbursement of consumable materials in the National Health Insurance (NHI) Database. For a more detailed analysis of the T1DM population in Korea, stratification by gender, age, and area was performed, and prevalence and incidence were calculated. Results Of the 8,256 subjects enrolled over the 26 months, the male to female ratio was 1 to 1.12, the median age was 37.1 years, and an average of 136 new T1DM patients were registered to the T1DM registry each month, resulting in 1,632 newly diagnosed T1DM patients each year. We found that the incidence rate of new T1DM cases was 3.28 per 100,000 people. The average proportion of T1DM patients compared with each region's population was 0.0125%. The total number of insurance subscribers under the universal compulsory NHI in Korea was 49,662,097, and the total number of diabetes patients, excluding duplication, was 3,762,332. Conclusion The prevalence of T1DM over the course of the study was approximately 0.017% to 0.021% of the entire population of Korea, and the annual incidence of T1DM was 3.28:100,000 overall and 3.25:100,000 for Koreans under 20 years old. PMID:26912154

  20. 78 FR 79062 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... January 17, 2008 (73 FR 3316). FOR FURTHER INFORMATION CONTACT: Elaine M. Papp, Chief, Medical Programs... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt...

  1. 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.

  2. 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.

  3. Prevalence and risk factors of gestational diabetes mellitus in Yemen

    PubMed Central

    Ali, Abdullatif D; Mehrass, Amat Al-Khaleq O; Al-Adhroey, Abdulelah H; Al-Shammakh, Abdulqawi A; Amran, Adel A

    2016-01-01

    Purpose Gestational diabetes mellitus (GDM) continues to be a significant health disorder triggering harmful complications in pregnant women and fetuses. Our knowledge of GDM epidemiology in Yemen is largely based on very limited data. The aim of this study was, therefore, to determine the prevalence and risk factors of GDM among pregnant women in Dhamar governorate, Yemen. Patients and methods A total of 311 subjects were randomly selected for this cross sectional survey. Health history data and blood samples were collected using a pretested questionnaire. To determine the prevalence of GDM, the fasting and random blood glucose techniques were applied according to the recommendations of the American Diabetes Association, using alternative methods that are more convenient to the targeted population. Poisson’s regression model incorporating robust sandwich variance was utilized to assess the association of potential risk factors in developing GDM. Results The prevalence of GDM was found to be 5.1% among the study population. Multivariate analysis confirmed age ≥30 years, previous GDM, family history of diabetes, and history of polycystic ovary syndrome as independent risk factors for GDM prevalence. However, body mass index ≥30 kg/m2 and previous macrosomic baby were found to be dependent risk factors. Conclusion This study reports new epidemiological information about the prevalence and risk factors of GDM in Yemen. Introduction of proper maternal and neonatal medical care and health education are important in order to save the mother and the baby. PMID:26869814

  4. Management of feline diabetes mellitus.

    PubMed

    Rand, J S; Martin, G J

    2001-09-01

    Up to one quarter of diabetic cats can be well controlled with oral hypoglycemic drugs, although at least 75% require insulin therapy. Most available insulins provide good clinical control but only moderate glycemic control. Because mild to moderate hyperglycemia is well tolerated by cats receiving insulin but hypoglycemia can be life threatening, conservative insulin dosing is recommended. Clinical signs and water intake indicate whether a dose adjustment is required, but serial blood glucose measurements are usually needed to determine the direction of the adjustment. Starting doses of 0.3 to 0.5 IU/kg administered twice daily (rounded down to the nearest whole unit) are usually safe. Dose adjustments should not exceed 1 IU per cat every 2 to 4 weeks unless clinical hypoglycemia has occurred. Cats with clinical hypoglycemia need to be reassessed to see if they are in remission. If not, a 50% to 75% reduction in dose is advised. Approximately 30% of cats go into diabetic remission 1 to 4 months after an adequate treatment protocol is instituted. PMID:11570131

  5. 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. PMID:25093391

  6. Type 2 diabetes mellitus and Invokana: an FDA approved drug.

    PubMed

    Akhtar, Nida

    2013-11-01

    Diabetes Mellitus is a chronic metabolic disease affecting wide range of people across the globe. In India the rate of subjects being suffered from diabetes is continuously increasing. So, the development of drugs for its effective treatment is essential. Thereby, various attempts have been made to discover newer drugs, to reduce the rate of anti diabetic occurrence. Anti-diabetic drugs were found to treat diabetes mellitus by lowering glucose levels in the blood. Both the use antidiabetic drugs as well as the changes in lifestyle and proper diet can significantly affect the severity of diabetes mellitus and also reduces the symptoms and occurrence of the disease. Researches in the past few years on diabetes mellitus showed that this disease is spreading at a very faster rate, thereby; various attempts have been made to treat it efficaciously. Development and approval of antidiabetic drugs is quite necessary. There are different classes of anti-diabetic drugs reported to treat diabetes. The objective of the present review is to explore Invokana as a newly approved antidiabetic drug for the effective treatment of type 2 diabetes. This review focuses mainly on the various aspects of diabetes mellitus and its treatment perspectives. From the various clinical studies done on Invokana, it was concluded that and Invokana was found to be very effective for the efficacious therapy of diabetes mellitus.

  7. 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.

  8. Gestational diabetes mellitus: Where are we now?

    PubMed

    Ashwal, Eran; Hod, Moshe

    2015-12-01

    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.

  9. [Carbostimulin-correcting effect on metabolic aspects of diabetes mellitus].

    PubMed

    Efimov, A S; Gulyĭ, M F; Dzvonkevich, N D; Shevtsova, N F; Whcherbak, A V

    1980-01-01

    Application of carbostimulin, the preparation stimulating CO2 fixation in tissues, in a complex therapy of diabetes mellitus patients rises the CO2 level, restores the total content of alpha-ketoacids and free amino acids in blood, increases (within the physiological normal limits) the urea content in blood and urine of diabetes mellitus patients. PMID:6789526

  10. 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.

  11. 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.

  12. Genetic Links between Diabetes Mellitus and Coronary Atherosclerosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Diabetes mellitus is one of the most common endocrine disorders affecting almost 6% of the world's population and with clear indication that its prevalence continues to increase. The causes of diabetes mellitus are multifactorial and in the general population, both genetic and environmental factors ...

  13. 75 FR 34206 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... 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, the... (68 FR 52441).\\1\\ The revision must provide for individual assessment of drivers with...

  14. 76 FR 37171 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... diabetes exemption applications from twenty-four individuals and requested comments from the public (76 FR... general population. The diabetes rule provides that ``A person is physically qualified to drive a... and manage his/her diabetes mellitus, received education related to diabetes management, and is on...

  15. 77 FR 38383 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... diabetes exemption applications from 23 individuals and requested comments from the public (77 FR 27842... indicated that drivers with diabetes had a higher rate of crash involvement than the general population. The... diabetes mellitus, received education related to diabetes management, and is on a stable insulin...

  16. Coronary artery disease and diabetes mellitus.

    PubMed

    Aronson, Doron; Edelman, Elazer R

    2014-08-01

    Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM. PMID:25091969

  17. Coronary Artery Disease and Diabetes Mellitus.

    PubMed

    Aronson, Doron; Edelman, Elazer R

    2016-01-01

    Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM. PMID:26567979

  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. Screening and diagnosis of gestational diabetes mellitus.

    PubMed

    Gupta, Yashdeep; Kalra, Bharti

    2016-09-01

    American Diabetes Association defines gestational diabetes mellitus (GDM) as diabetes which is diagnosed in the 2nd or 3rd trimester of pregnancy and is not clearly overt diabetes. GDM, if missed or not treated properly can result in maternal and foetal complications, short as well as long term. Screening for overt diabetes, especially for high risk women should be done at the earliest in pregnancy and for GDM, universally at 24-28 weeks of gestation. One step screening by IADPSG (75 gram OGTT), has been recently adopted by most of professional bodies to achieve uniformity. IADPSG criteria have resulted in increase in prevalence of GDM, and consequently increase pressure on health care services as well as on patients. This has resulted in discordance of view on universal adoption of the criteria. Many feel this criteria results in over diagnosis without clear benefits. This brief review will provide the answers to some of the important questions pertaining to screening for GDM. PMID:27582144

  20. Neuronal Ca2+ disregulation in diabetes mellitus.

    PubMed

    Biessels, Geert Jan; ter Laak, Mariël P; Hamers, Frank P T; Gispen, Willem Hendrik

    2002-07-01

    The Ca(2+) hypothesis of brain ageing and dementia may account for part of the available data on the pathogenesis of dementia and certain neurodegenerative disorders. The hypothesis proposes that disturbances in the homeostasis of neuronal cytosolic free Ca(2+) are part of a final common pathway, ultimately leading to neuronal dysfunction and cell death. The hypothesis also proposes that a small change in cytosolic free Ca(2+) sustained over a long period of time will result in similar damage as a large change over a short period. Diabetes mellitus is associated with neurological complications in the peripheral and central nervous system, as reflected in peripheral neuropathy, modest cognitive impairments and an increased risk of dementia. In animal models of diabetes, learning impairments are associated with alterations in Ca(2+) -dependent forms of hippocampal synaptic plasticity. Disturbances in the homeostasis of cytosolic free Ca(2+) may present a final common pathway in the multifactorial pathogenesis of neurological complications of diabetes, which involves vascular changes, oxidative stress, and non-enzymatic protein glycation. In line with the Ca(2+) hypothesis of neurodegenerative disorders, a prolonged, small increase in basal cytosolic Ca(2+) levels indeed exists in sensory neurones of diabetic animals. In addition, Ca(2+) dynamics are affected. Ca(2+) channel blockers, such as nimodipine, have been shown to improve experimental peripheral neuropathy, through a vascular mechanism, possibly in combination with direct neuronal effects. Preliminary studies indicate that nimodipine may also improve Ca(2+)-dependent forms of synaptic plasticity in the hippocampus of diabetic rats.

  1. [Diabetes mellitus and osteoporosis. Mutual interaction between bone and blood vessel in diabetes mellitus].

    PubMed

    Mori, Hiroko; Okada, Yosuke; Tanaka, Yoshiya

    2012-09-01

    The patients with "Diabetes Mellitus", "Hypertension" and "Hyperlipidemia" are accompanied with an osteoporosis. It is well known that increased fracture risk is observed in diabetes mellitus. Some reports indicate increased fracture risk in hypertension, arterial calcification and ischemic heart disease. Vascular calcification is an active process similar to physiological mineralization of skeletal tissues. A number of factors were reported to regulate differentiation of multiple cell types among bone and blood vessels. Thus, bone metabolism-related factors activities participate in vascular calcification. However, the effective treatment for suppressing the progression of vascular calcification has not been established. Here we will review recent advances in the researches of mutual connection between bone and blood vessel and present our findings that the SERM or bisphosphonate are useful in prevention of vascular calcification in diabetes.

  2. The interface between thyroid and diabetes mellitus.

    PubMed

    Duntas, Leonidas H; Orgiazzi, Jacques; Brabant, Georg

    2011-07-01

    Thyroid disease and type 1 but also type 2 diabetes mellitus (DM) are strongly associated, and this has important clinical implications for insulin sensitivity and treatment requirements. The pathophysiological basis of this association has only recently been better elucidated. It rests on a complex interaction of common signalling pathways and, in the case of type 1 diabetes and autoimmune thyroid disease, on a linked genetic susceptibility. The pathophysiological mechanisms underlying this linked regulation are increasingly being unravelled. They are exemplified in the regulation of 5' adenosine monophosphate-activated protein kinase (AMPK), a central target not only for the modulation of insulin sensitivity but also for the feedback of thyroid hormones on appetite and energy expenditure. The present review will discuss these concepts and their consequences for the clinical care of patients with DM and thyroid disorders. Moreover, it makes reference to the added effect of metformin in suppressing TSH.

  3. Elevated galanin may predict the risk of type 2 diabetes mellitus for development of Alzheimer's disease.

    PubMed

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

    2015-09-01

    Alzheimer's disease is the most common form of dementia among the elderly and is characterized by progressive loss of memory and cognition. Epidemiological and clinical studies demonstrated that type 2 diabetes mellitus is an important risk factor for the development of Alzheimer's disease, i.e., the patients with type 2 diabetes mellitus are frequently companied with Alzheimer's disease symptoms. Despite many studies recently probed into the comorbid state of both diseases, so far the precise mechanism for this association is poorly understood. Emerging evidences suggest that defects in galanin play a central role on type 2 diabetes mellitus and is considered to be a risk factor for Alzheimer's disease development. This review provides a new insight into the multivariate relationship among galanin, type 2 diabetes mellitus and Alzheimer's disease, highlighting the effect of galanin system on the cross-talk between both diseases in human and rodent models. The current data support that activating central GalR2 attenuates insulin resistance and Alzheimer's disease feature in animal models. These may help us better understanding the pathogenesis of both diseases and provide useful hints for the development of novel therapeutic approaches to treat type 2 diabetes mellitus and Alzheimer's disease.

  4. 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

  5. Physical activity and gestational diabetes mellitus.

    PubMed

    van Poppel, Mireille N M; Ruchat, Stephanie-May; Mottola, Michelle F

    2014-01-01

    Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy'. GDM is associated with several detrimental health consequences during pregnancy and delivery for both mother and baby. The largest public health impact of GDM is through its role on future diabetes in the mother and obesity and diabetes in the offspring. Physical activity (PA) is likely an effective intervention for prevention and treatment of GDM, given its known effectiveness in prevention and treatment of type 2 diabetes. Based on observational studies, PA initiated before and/or during pregnancy has a positive influence on maternal glucose and insulin metabolism and reduces the risk of GDM. However, although PA interventions have been reported to be effective at improving glycemic control in women who already developed GDM, prenatal PA interventions aimed at preventing GDM have shown modest effectiveness in increasing PA levels and thus were not effective in improving glucose/insulin metabolism or reducing GDM incidence. There is therefore a strong need to develop effective strategies for increasing PA levels, especially in women at high risk for GDM who are often obese and inactive. The optimal intervention for preventing or managing GDM is still unknown, and further studies are needed to determine the type, intensity, frequency and duration for the most successful PA intervention. Furthermore, the effects of PA on neonatal outcomes are not clear, and it is highly recommended that future studies examine more specific neonatal outcomes such as body composition. PMID:25226805

  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. 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

  8. 76 FR 43694 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Meeting The Diabetes Mellitus Interagency Coordinating Committee (DMICC)...

  9. Gestational diabetes mellitus: Non-insulin management.

    PubMed

    Magon, Navneet; Seshiah, V

    2011-10-01

    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".

  10. Digging the genome for diabetes mellitus: the 2nd ADA Research Symposium on the Genetics of Diabetes, San Jose, CA, USA, 17-19 October 1999.

    PubMed

    Pani, M A; Badenhoop, K

    2000-01-01

    The diabetes genetics community recently met in California to discuss the impact that the latest findings in susceptibility mapping might have on our understanding of the pathophysiology of diabetes mellitus and its long-term complications. Organized by Ralph DeFronzo (San Antonio, TX) and Alan Permutt (St Louis, MO) the symposium covered the genetics of type 1 and type 2 diabetes, obesity, approaches to population selection and stratification, quantitative trait analysis, epidemiological tools and technological advances in genotyping.

  11. Managing dyslipidaemia in type 2 diabetes mellitus.

    PubMed

    Szalat, Auryan; Durst, Ronen; Leitersdorf, Eran

    2016-06-01

    Glucose-control has a modest beneficial effect on cardiovascular outcomes in patients with type 2 diabetes mellitus. Thus, managing other atherogenic risk factors including hypertriglyceridemia, low HDL-cholesterol and moderately elevated LDL-cholesterol levels with increased small dense LDL-cholesterol fraction, is crucial. Insulin resistance is a key pathophysiologic factor in this population. Treatment starts with lifestyle modifications, but current best programmes have not translated into positive cardiovascular outcomes. Lowering LDL-cholesterol with statins is currently the main treatment strategy, but significant residual risk remains. Attempts to elevate HDL-cholesterol and to reduce triglycerides levels, with niacin or fibrates have not improved cardiovascular prognosis, but addition of ezetimibe, or fibrates in specific patients subgroups, have shown modest benefit. Some glucose-lowering medications and bariatric surgery may also improve diabetic dyslipidemia. Results of three major cardiovascular outcome trials evaluating the effect of lowering LDL-cholesterol with PCSK9 inhibitors in large cohorts that include thousands of diabetic patients are pending. PMID:27432076

  12. 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.

  13. [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. PMID:26433309

  14. [Cognitive deficit: another complication of diabetes mellitus?].

    PubMed

    Almeida-Pititto, Bianca de; Almada Filho, Clineu de M; Cendoroglo, Maysa S

    2008-10-01

    As the population getting older, the chronic diseases will be more prevalent as diabetes mellitus (DM) and diseases characterized by cognitive deficits, as dementia. Studies have already shown an association between DM and cardiovascular risk factors associated with cognitive impairment. Besides the vascular complications of DM, studies have proposed the role of hyperglycemia and advanced glycosilation end products (AGEP) causing oxidative stress and beta-amyloid protein brain deposition. Other factors have also been investigated, such as the role of insulinemia, genetic and IGF-1 (insulin-like growth factor-1). Some studies showed that good glucose control and intake of polyunsaturated fat, Omega-3 or anti-oxidative food can play a protector role against cognitive deficits. Improving knowledge about the association between DM and cognition and its physiopathology, can be essential for the prevention and treatment of cognitive impairment, leading to a beneficial impact on the quality of life of elderly patients with DM. PMID:19082295

  15. [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.

  16. Acromegaly and diabetes mellitus associated with hyperthyroidism.

    PubMed

    Deng, Datong; Luo, Li; Chen, Mingwei; Xu, Min; Wang, Youmin

    2014-01-01

    A 66-year-old woman with acromegaly and diabetes mellitus as well as primary hyperthyroidism is described. Serum GH Levels were inappprpriately high.MRI revealed an enlarged sella turcica with intrasellar mass. Her HbAlc was 12.2% and fasting blood glucose 8.89 mmol/l. Thyroid hormone levels in serum and thyroidal radioiodine uptake values were elevated, while TSH measurements in serum were low. Anti TPO antibodies were negative, TSH receptor antibodies were normal. Thyrotoxicosis as the first presenting illness in acromegaly was particulary uncommon. An ultrasound thyroid scan showed a multinodular goiter. Histology of the pituitary lesion showed a typical eosinophilic adenoma which only secreted GH when tested with specific immunostain. Post-operatively, the patient's clinical conditions improved, however, secondary hypoadrenalism appeared. PMID:24977962

  17. 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

  18. Traumatic injuries in patients with diabetes mellitus.

    PubMed

    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

  19. Vitamin D and Gestational Diabetes Mellitus

    PubMed Central

    Burris, Heather H.; Camargo, Carlos A.

    2014-01-01

    Gestational diabetes mellitus (GDM) complicates 7–14% of pregnancies in the United States. Vitamin D deficiency also is common in pregnancy. Emerging evidence suggests that Vitamin D administration can improve insulin sensitivity and glucose tolerance, but whether vitamin D supplementation can prevent GDM is unknown. Observational studies provide conflicting evidence as to whether low serum 25-hydroxyvitmain D (25(OH)D) levels are associated with GDM. Two recent systematic reviews concluded that vitamin D deficiency is associated with a higher risk of GDM. However, these reviews are limited by the observational and diverse nature of the included studies. Of greatest concern is the inability to understand how important confounding variables such as race/ethnicity and adiposity might affect the association. Randomized controlled trial data remain limited but are critical to understanding whether supplementation with vitamin D beyond what is contained in routine prenatal vitamins will prevent GDM or improve glucose tolerance for women with GDM. PMID:24277676

  20. Diabetic myopathy: impact of diabetes mellitus on skeletal muscle progenitor cells.

    PubMed

    D'Souza, Donna M; Al-Sajee, Dhuha; Hawke, Thomas J

    2013-01-01

    Diabetes mellitus is defined as a group of metabolic diseases that are associated with the presence of a hyperglycemic state due to impairments in insulin release and/or function. While the development of each form of diabetes (Type 1 or Type 2) drastically differs, resultant pathologies often overlap. In each diabetic condition, a failure to maintain healthy muscle is often observed, and is termed diabetic myopathy. This significant, but often overlooked, complication is believed to contribute to the progression of additional diabetic complications due to the vital importance of skeletal muscle for our physical and metabolic well-being. While studies have investigated the link between changes to skeletal muscle metabolic health following diabetes mellitus onset (particularly Type 2 diabetes mellitus), few have examined the negative impact of diabetes mellitus on the growth and reparative capacities of skeletal muscle that often coincides with disease development. Importantly, evidence is accumulating that the muscle progenitor cell population (particularly the muscle satellite cell population) is also negatively affected by the diabetic environment, and as such, likely contributes to the declining skeletal muscle health observed in diabetes mellitus. In this review, we summarize the current knowledge surrounding the influence of diabetes mellitus on skeletal muscle growth and repair, with a particular emphasis on the impact of diabetes mellitus on skeletal muscle progenitor cell populations.

  1. The potential biological mechanisms of arsenic-induced diabetes mellitus.

    PubMed

    Tseng, Chin-Hsiao

    2004-06-01

    Although epidemiologic studies carried out in Taiwan, Bangladesh, and Sweden have demonstrated a diabetogenic effect of arsenic, the mechanisms remain unclear and require further investigation. This paper reviewed the potential biological mechanisms of arsenic-induced diabetes mellitus based on the current knowledge of the biochemical properties of arsenic. Arsenate can substitute phosphate in the formation of adenosine triphosphate (ATP) and other phosphate intermediates involved in glucose metabolism, which could theoretically slow down the normal metabolism of glucose, interrupt the production of energy, and interfere with the ATP-dependent insulin secretion. However, the concentration of arsenate required for such reaction is high and not physiologically relevant, and these effects may only happen in acute intoxication and may not be effective in subjects chronically exposed to low-dose arsenic. On the other hand, arsenite has high affinity for sulfhydryl groups and thus can form covalent bonds with the disulfide bridges in the molecules of insulin, insulin receptors, glucose transporters (GLUTs), and enzymes involved in glucose metabolism (e.g., pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase). As a result, the normal functions of these molecules can be hampered. However, a direct effect on these molecules caused by arsenite at physiologically relevant concentrations seems unlikely. Recent evidence has shown that treatment of arsenite at lower and physiologically relevant concentrations can stimulate glucose transport, in contrary to an inhibitory effect exerted by phenylarsine oxide (PAO) or by higher doses of arsenite. Induction of oxidative stress and interferences in signal transduction or gene expression by arsenic or by its methylated metabolites are the most possible causes to arsenic-induced diabetes mellitus through mechanisms of induction of insulin resistance and beta cell dysfunction. Recent studies have shown that, in subjects with

  2. Swedish recommendations on recreational diving and diabetes mellitus.

    PubMed

    Jendle, Johan; Adolfsson, Peter; Ornhagen, Hans

    2012-12-01

    Divers from many countries travel to explore various diving sites worldwide. In 2005, the Divers Alert Network (DAN) wrote guidelines for recreational diving and diabetes mellitus, but there is no up-to-date consensus or adoption of international guidelines on diabetes and diving. There are also large differences between the regulations in different countries. This is potentially both a medical and an insurance problem for a diver with diabetes. We present the current Swedish recommendations for recreational divers with Type 1 diabetes mellitus.

  3. Diabetes mellitus and tuberculosis: programmatic management issues.

    PubMed

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

    2015-08-01

    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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Childhood precursors of adolescent outcomes in type 1 diabetes mellitus.

    PubMed

    Cameron, F J; Northam, E A

    2005-03-01

    Contemporary outcome measures of chronic illnesses such as type 1 diabetes mellitus are broader than those clinical outcomes traditionally assessed in therapeutic encounters. A holistic approach emphasises quality of life and emotional well-being as well as the achievement of optimal disease management. This paper reviews current knowledge about growth, metabolic control, diabetes complications, neurocognitive and psychological outcomes as well as health-related quality of life in childhood diabetes mellitus. It is suggested that the antecedents of adverse diabetes and psychological outcomes in adolescence lie in the years prior to adolescence. The model of care in childhood diabetes mellitus must be focussed on earlier screening and intervention if adverse outcomes are to be reduced. PMID:15813600

  11. Diabetes mellitus and Alzheimer's disease: shared pathology and treatment?

    PubMed

    Akter, Kawser; Lanza, Emily A; Martin, Stephen A; Myronyuk, Natalie; Rua, Melanie; Raffa, Robert B

    2011-03-01

    Epidemiological and basic science evidence suggest a possible shared pathophysiology between type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD). It has even been hypothesized that AD might be 'type 3 diabetes'. The present review summarizes some of the evidence for the possible link, putative biochemical pathways and ongoing clinical trials of antidiabetic drugs in AD patients. The primary and review literature were searched for articles published in peer-reviewed sources that were related to a putative connection between T2DM and AD. In addition, public sources of clinical trials were searched for the relevant information regarding the testing of antidiabetic drugs in AD patients. The evidence for a connection between T2DM and AD is based upon a variety of diverse studies, but definitive biochemical mechanisms remain unknown. Additional study is needed to prove the existence or the extent of a link between T2DM and AD, but sufficient evidence exists to warrant further study. Presently, AD patients might benefit from treatment with pharmacotherapy currently used to treat T2DM and clinical trials of such therapy are currently underway.

  12. 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.

  13. Corneal biomechanical properties in children with diabetes mellitus.

    PubMed

    Kara, Necip; Yildirim, Yusuf; Univar, Tolga; Kontbay, Tugba

    2012-08-01

    Purpose. To compare the biomechanical properties of corneas in eyes of children with diabetes mellitus and in eyes of children without diabetes mellitus.
Methods. In this prospective, comparative, and cross-sectional study, 46 patients with diabetes mellitus (study group) and 50 healthy individuals (control group) were enrolled. The corneal hysteresis (CH) and corneal resistance factor (CRF) were measured in children with and without diabetes using the Ocular Response Analyzer. Differences in the corneal biomechanical properties were determined using an independent-samples t test. Correlations between ocular and diabetic parameters were also evaluated.
Results. Mean CH was 12.3±1.3 (SD) mmHg and 12.5±1.5 mmHg and the mean CRF was 12.4±1.7 mmHg and 11.9±1.5 mmHg in the diabetic and control groups, respectively (p>0.05). Corneal hysteresis and CRF were not correlated with fasting glucose level, HbA1c, age, or duration of diabetes.
Conclusions. The findings indicate that diabetes mellitus does not affect corneal biomechanical parameters such as CH and CRF in children. In addition, CH and CRF are not affected by fasting glucose level, HbA1c, age, or duration of diabetes. PMID:22890598

  14. The role of blood groups in the development of diabetes mellitus after gestational diabetes mellitus

    PubMed Central

    Karagoz, Hatice; Erden, Abdulsamet; Ozer, Ozerhan; Esmeray, Kubra; Cetinkaya, Ali; Avci, Deniz; Karahan, Samet; Basak, Mustafa; Bulut, Kadir; Mutlu, Hasan; Simsek, Yasin

    2015-01-01

    Introduction Gestational diabetes mellitus (GDM) is a common condition that is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy and it affects approximately 5% of all pregnancies all over the world. GDM is not only associated with adverse pregnancy outcomes such as macrosomia, dystocia, birth trauma, and metabolic complications in newborns, but it is also a strong predictor of transitioning to overt DM postpartum. The association of ABO blood groups with DM has been observed before in several epidemiological and genetic studies and resulted with inconsistent findings, but still there are not enough studies in the literature about the association of ABO blood groups with GDM. In this study, we aimed at investigating any possible relationship between the ABO blood group system and GDM and also the transitioning of GDM to overt DM postpartum, in Turkey. Patients and methods A total of 233 patients with GDM from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. The cases that have serologically determined blood groups and Rh factor in the hospital records were included in the study, and the patients with unknown blood groups were excluded. Patients were classified according to blood groups (A, B, AB, and O) and Rh status (+/−). GDM was diagnosed based on the glucose cut-points of the International Association of the Diabetes and Pregnancy Society Groups. The distributions of blood groups of the patients with GDM were compared with the distribution of blood groups of 17,314 healthy donors who were admitted to the Turkish Red Crescent Blood Service in our city in 2012. Results There was a significant difference between the patients with GDM and control group in terms of distribution of ABO blood groups. Blood group AB was found to be higher in the patients with GDM compared to the control group (P=0.029). When the patients were compared according to the development of DM, the ratio

  15. Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care

    PubMed Central

    2011-01-01

    Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index), were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (κ = 0.990), with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (κ = 0.778), the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who also had diabetes and in

  16. [Prediction and prevention of type 1 diabetes mellitus: initial results and recent prospects].

    PubMed

    Madácsy, László

    2011-11-27

    Epidemiological studies indicate that the incidence and prevalence of type 1 diabetes mellitus is rising worldwide. The increase in incidence has been most prominent in the youngest age group of childhood. Prediction of type 1a autoimmune diabetes can be established by a positive family history or by genetic, immunological or metabolic markers. Prevention of type 1 diabetes can be implemented at three different levels of pathogenesis: primary prevention in individuals without any sign of beta-cell damage, secondary prevention in individuals with signs of beta-cell destruction and tertiary prevention in patients with newly diagnosed type 1 diabetes. In recent years our knowledge of the disease pathogenesis has grown quickly, and several new prevention trials have been initiated worldwide. Immunologic intervention for type 1 diabetes will prove to be probably the most effective.

  17. Comment on: Statin use and risk of diabetes mellitus.

    PubMed

    Eren, Mehmet Ali; Sabuncu, Tevfik; Karaaslan, Hüseyin

    2016-04-25

    In manuscript named "Statin use and risk of diabetes mellitus" by Chogtu et al, authors defined that pravastatin 40 mg/dL reduced the risk of diabetes by 30% in West of Scotland Coronary Prevention study. In fact, pravastatin 40 mg/dL reduced coronary heart disease risk approximately 30% in mentioned study. PMID:27114756

  18. 77 FR 27842 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... exemption from the prohibition against persons with insulin-treated diabetes mellitus (ITDM) operating..., 2003 (68 FR 52441).\\1\\ The revision must provide for individual assessment of drivers with diabetes... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications;...

  19. 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)

  20. 77 FR 64585 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... Management System (FDMS) published in the Federal Register on January 17, 2008 (73 FR 3316), or you may visit... crash involvement than the general population. The diabetes rule provides that ``A person is physically...; Diabetes Mellitus AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of...

  1. [Bile acids in the bile in diabetes mellitus].

    PubMed

    Slivka, O Ia; Zelinskiĭ, B A; Zelinskiĭ, S Ts

    1979-01-01

    Hepatic and gall bladder bile of healthy persons (8) and of patients with severe form of diabetes mellitus (17) was studied. Paer chromatography was applied for determination of cholic, chenodeoxycholic, deoxycholic bile acids and their conjugates with glycin and taurine. An absolute content and percentage of glycodeoxycholic and glycochenodeoxycholic bile acids were increased, and glycochenodeoxycholic acid content and taurates proportion were decreased in the gall bladder and hepatic bile of diabetic patients. The data obtained pointed to disturbed hepatic function in severe diabetes mellitus; it was expressed in suppression of bile acids synthesis and conjugation, and also in depression of transformation of deoxycholic into cholic acid.

  2. Chronic Invasive Pulmonary Aspergillosis in Two Cats with Diabetes Mellitus.

    PubMed

    Leite-Filho, R V; Fredo, G; Lupion, C G; Spanamberg, A; Carvalho, G; Ferreiro, L; Driemeier, D; Pavarini, S P; Sonne, L

    2016-01-01

    Human patients with diabetes mellitus are at increased risk of fungal infections. Diabetes mellitus has also been implicated as a predisposing factor in the establishment of fungal lung infections in cats. Two diabetic cats of different origins presented with severe acute respiratory conditions that resulted in their death. At necropsy examination there was friable, black material in the main bronchi that obstructed the bronchial lumina. Microscopical examination of the lungs revealed the presence of pneumonia, calcium oxalate crystals and a large quantity of fungal hyphae and conidial heads. Fungal infection was confirmed with Grocott's methenamine silver stain. The results of the mycology analysis were compatible with Aspergillus section Nigri. PMID:27466162

  3. Preconceptional Iron Intake and Gestational Diabetes Mellitus.

    PubMed

    Darling, Anne Marie; Mitchell, Allen A; Werler, Martha M

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  4. Preconceptional Iron Intake and Gestational Diabetes Mellitus

    PubMed Central

    Darling, Anne Marie; Mitchell, Allen A.; Werler, Martha M.

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  5. 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.

  6. Clinical applications of advanced lipoprotein testing in diabetes mellitus

    PubMed Central

    Moin, Danyaal S; Rohatgi, Anand

    2011-01-01

    Traditional lipid profiles often fail to fully explain the elevated cardiovascular risk of individuals with diabetes mellitus. Advanced lipoprotein testing offers a novel means to evaluate dyslipidemia and refine risk estimation. Numerous observational studies have demonstrated a characteristic pattern of elevated levels of small, dense LDL particles, out of proportion to traditional lipid levels, in patients with both diabetes mellitus and the metabolic syndrome. Commonly used glucose and lipid-lowering agents have varied effects in patients with diabetes on both LDL and HDL subfractions. The exact role of advanced lipoprotein testing in patients with diabetes mellitus and the metabolic syndrome remains unclear but may offer improved assessment of cardiovascular risk compared with traditional lipid measurements. PMID:22162979

  7. 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.

  8. Insulin-dependent (type I) diabetes mellitus.

    PubMed Central

    Rodger, W

    1991-01-01

    Insulin-dependent (type I) diabetes mellitus is a chronic disease characterized by hyperglycemia, impaired metabolism and storage of important nutrients, evidence of autoimmunity, and long-term vascular and neurologic complications. Insulin secretory function is limited. Cell membrane binding is not primarily involved. The goal of treatment is to relieve symptoms and to achieve blood glucose levels as close to normal as possible without severe hypoglycemia. However, even with education and self-monitoring of the blood glucose level, attaining recommended target values (plasma glucose level less than 8.0 mmol/L before main meals for adults) remains difficult. Human insulin offers no advantage in glycemic control but is important in the management and prevention of immune-related clinical problems (e.g., injection-site lipoatrophy, insulin resistance and allergy) associated with the use of beef or pork insulin. Therapy with one or two injections per day of mixed short-acting or intermediate-acting insulin preparations is a compromise between convenience and the potential for achieving target plasma glucose levels. Intensive insulin therapy with multiple daily injections or continuous infusion with an insulin pump improves mean glycated hemoglobin levels; however, it increases rates of severe hypoglycemia and has not been shown to decrease the incidence of clinically significant renal, retinal or neurologic dysfunction. Future prospects include automated techniques of insulin delivery, immunosuppression to preserve endogenous insulin secretion and islet transplantation. PMID:1933705

  9. 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

  10. Pulmonary function in patients with diabetes mellitus.

    PubMed

    Sreeja, C K; Samuel, Elizabeth; Kesavachandran, C; Shashidhar, Shankar

    2003-01-01

    The present study was carried out to assess the lung functions in oral medicated and insulin administered patients with normal controls. 20 subjects were selected as the study group for oral medication (Group I), 20 subjects were selected as the study group for insulin treatment (Group II) and 40 subjects were selected as normal controls. Age group of Group I and Group II were 51.25 +/- 6.28 and 50.8 +/- 6.56 respectively and controls were age and height matched. Seventeen patients of Group I were undergoing treatment for the last 10-20 years and 20 patients in Group II were undergoing treatment for the last 30 years. Only male subjects were selected for the study. Lung function test were carried out with Spirometer (Vitallograph Compact II). A significant reduction in forced expiratory volume/forced vital capacity (FEV1/FVC%) was observed in oral pills used subjects and insulin administered subjects as compared to controls. Significant decrease in forced expiratory flow rate (FEF25-75%) in group I subjects was also observed as compared to controls. Forced mid flow time (FMFT) showed a significant increase in group II in comparison to controls. These changes clearly show the expiratory flow rates are reduced both in orally medicated and insulin administered patients. Increase in FMFT in group I may be due to the reduced respiratory ability to carry out the FVC test along with the side effects of oral medication for diabetes mellitus. PMID:12708129

  11. [Latest overview of type 1 diabetes mellitus].

    PubMed

    Miura, Junnosuke; Uchigata, Yasuko

    2008-07-01

    Type 1 diabetes mellitus (T1DM) was defined as a heterogeneous disorder characterized by severe beta-cell loss. The subtype 1A is characterized by abnormal autoimmue-mediated response and 1B is idiopathic etiology, and most of patients with T1DM are classified in 1A. There are three subtypes characterized by onset, fulminant, acute onset and slowly progressive in T1DM. Among these three subtypes, there are differences in genetic etiology, pathogenesis and prevalence of autoantibodies. Glutamic acid decarboxylase-65 (GAD65), insulinoma-associated antigen-2 (IA-2) and insulin are major autoantigens in T1DM and autoantibodies for former two are frequently used for clinical diagnosis. Also novel autoantibodies for T1DM have been found and clinical characteristics of the patients with each antibody will be made clearer. There have been eager efforts to develop immunotherapies to prevent islet destruction and to cure the disorder with islet transplantation, and new treatment with inhaled insulin regimen. Continuous glucose monitoring system(CGMS) has been established to make clearer the daily profile of blood glucose of the patients and to improve the metabolic control. Most efficient treatment for T1DM is a still insulin injection. However, the development of new medical devices and novel treatment rather than insulin injection has been done and the progression will promise improved prognosis of vascular complications.

  12. Muscular response and adaptation to diabetes mellitus.

    PubMed

    Sun, Zilin; Liu, Lili; Liu, Naifeng; Liu, Yuefei

    2008-05-01

    Diabetes mellitus (DM) is an epidemic medical challenge that threatens the health and life quality of people worldwide. DM impairs metabolic, neural and vascular function and thus has profound impacts on different systems and organs in the body. Though continuous endeavour has been made to study its etiology and mechanisms, no cure for DM has yet been found. DM development may be multi-factorial. The skeletal muscle is one of the most important systems, involved in the development of DM, and affected by insulin. DM induces diverse functional, metabolic, and structural changes in the skeletal muscle. DM reduces the functional capacity of skeletal muscle leading to muscle weakness, causes metabolic disturbance characterized by reduced cellular glucose uptake and fatty acid oxidation, and structural changes with muscle atrophy, augmented lipid deposition, decreased mitochondria as well as muscle fiber transformation. DM-induced changes in the skeletal muscle seem to be dependent on types and severity of DM as well as on muscle fibers. The central mechanism underlying these changes is impaired insulin action in the skeletal muscle.

  13. Combination immunotherapies for type 1 diabetes mellitus.

    PubMed

    Pozzilli, Paolo; Maddaloni, Ernesto; Buzzetti, Raffaella

    2015-05-01

    Immunotherapies for type 1 diabetes mellitus (T1DM) have been the focus of intense basic and clinical research over the past few decades. Restoring β-cell function is the ultimate goal of intervention trials that target the immune system in T1DM. In an attempt to achieve this aim, different combination therapies have been proposed over the past few years that are based on treatments tackling the various mechanisms involved in the destruction of β cells. The results of clinical trials have not matched expectations based on the positive results from preclinical studies. The heterogeneity of T1DM might explain the negative results obtained, but previous trials have not addressed this issue. However, novel promising combination therapies are being developed, including those that couple immunomodulators with drugs that stimulate β-cell regeneration in order to restore normoglycaemia. This strategy is an encouraging one to pursue the goal of finding a cure for T1DM. This Review summarizes the available data about combination immunotherapies in T1DM, particularly addressing their clinical importance. The available data supporting the use of registered drugs, such as proton pump inhibitors and incretin-based agents, that have been shown to induce β-cell regeneration will also be discussed.

  14. 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

  15. Genetics of canine diabetes mellitus: are the diabetes susceptibility genes identified in humans involved in breed susceptibility to diabetes mellitus in dogs?

    PubMed

    Catchpole, Brian; Adams, Jamie P; Holder, Angela L; Short, Andrea D; Ollier, William E R; Kennedy, Lorna J

    2013-02-01

    Diabetes mellitus is a common endocrinopathy in companion animals, characterised by hyperglycaemia, glycosuria and weight loss, resulting from an absolute or relative deficiency in the pancreatic hormone insulin. There are breed differences in susceptibility to diabetes mellitus in dogs, with the Samoyed breed being overrepresented, while Boxers are relatively absent in the UK population of diabetic dogs, suggesting that genetic factors play an important role in determining susceptibility to the disease. A number of genes, linked with susceptibility to diabetes mellitus in humans, are associated with an increased risk of diabetes mellitus in dogs, some of which appear to be relatively breed-specific. Diabetes mellitus in dogs has been associated with major histocompatibility complex (MHC) class II genes (dog leucocyte antigen; DLA), with similar haplotypes and genotypes being identified in the most susceptible breeds. A region containing a variable number of tandem repeats (VNTR) and several polymorphisms have been identified in the canine insulin gene, with some alleles associated with susceptibility or resistance to diabetes mellitus in a breed-specific manner. Polymorphisms in the canine CTLA4 promoter and in other immune response genes are associated with susceptibility to diabetes mellitus in a number of pedigree breeds. Genome wide association studies are currently underway that should shed further light on the genetic factors responsible for the breed profile seen in the diabetic dog population.

  16. Progression of Coronary Artery Calcium in Type 1 Diabetes Mellitus

    PubMed Central

    Costacou, Tina; Edmundowicz, Daniel; Prince, Catherine; Conway, Baqiyyah; Orchard, Trevor J.

    2008-01-01

    Coronary artery calcium (CAC) has been previously associated with atherosclerotic plaque disease and coronary events. Thus, identifying predictors of CAC progression may provide new insights on early risk factor intervention and subsequent reduction of more severe atherosclerotic disease. We aimed to identify risk factors of CAC progression and evaluate whether risk factor change relates to CAC progression in a cohort of type 1 diabetes mellitus (DM). Participants of the Pittsburgh Epidemiology of Diabetes Complications study, a prospective investigation of childhood-onset type 1 DM, who received 2 electron beam computed tomography screenings 4 years apart were selected for study (n=222). CAC was calculated by the Agatston method of scoring and progression was defined as an increase >2.5 in the square root-transformed CAC score. Adjusting for diabetes duration and initial CAC score, body mass index (BMI, OR=1.13 95% CI=1.01-1.26), non-high density lipoprotein cholesterol (OR=1.01, 95% CI=1.003-1.03), and albumin excretion rate (OR=1.30, 95% CI=1.03-1.63) were associated with CAC progression. When considering change in risk factors, an increase in BMI (OR=1.38, 95% CI=1.10-1.72) was also associated with CAC progression after adjustment. In conclusion, in this cohort of type 1 DM, in addition to baseline BMI, non-high density lipoprotein cholesterol and albumin excretion rate, all known coronary artery disease risk factors, weight gain further added to the prediction of CAC progression. Thus, weight control, in addition to lipid and renal management may help retard atherosclerosis progression in type 1 DM. PMID:17996516

  17. 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.

  18. A Review of Insulin for the Treatment of Diabetes Mellitus.

    PubMed

    Freeland, Barbara; Farber, Margo S

    2016-09-01

    Insulin is commonly used in the treatment of diabetes in the home care setting. Understanding the wide variety of insulin preparations available will assist the clinician in guiding people with diabetes and their caregivers through the complexities of self-care and promote safe and optimal glucose control. The purpose of this article is to review the various available insulin preparations and discuss their use in the treatment of diabetes mellitus. PMID:27580280

  19. Survey on testing for gestational diabetes mellitus in Australia.

    PubMed

    Flack, Jeff R; Ross, Glynis P

    2016-08-01

    We surveyed members of National Association of Diabetes Centres (NADC) assessing use of new Australasian Diabetes In Pregnancy Society (ADIPS) and Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Gestational Diabetes Mellitus (GDM) diagnostic guidelines in Australia. We found piecemeal adoption of recommended changes, with cessation of the 50 g glucose challenge test (GCT) universal, early screening implementation common, but by varied methodologies, and new diagnostic criteria acceptance far from complete with significant workload increases almost universal.

  20. Monograph series on aging-related diseases: VIII. Non-insulin-dependent diabetes mellitus (NIDDM)

    PubMed

    Barceló, A

    1996-01-01

    Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia and by disturbances of carbohydrate, fat and protein metabolism. Diabetes mellitus is associated with absolute or relative deficiency in the secretion and/or action of the hormone insulin.

  1. 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.

  2. 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.

  3. Prevalence and awareness regarding diabetes mellitus in rural Tamaka, Kolar

    PubMed Central

    Muninarayana, C.; Balachandra, G.; Hiremath, S. G.; Iyengar, Krishna; Anil, N. S.

    2010-01-01

    Background: The worldwide prevalence of diabetes mellitus has risen dramatically in the developing countries over the past two decades. Regular screening of adults is essential for early detection and care. There are limited studies on diabetes awareness and prevalence in rural communities. Hence this prevalence and knowledge assessment study was undertaken. Such data are extremely important to plan the public health policies with specific reference to implementation of National Diabetic Control Program. Aims: To study the prevalence and awareness of diabetes mellitus in rural areas. Settings and Design: Cross-sectional, household study. Materials and Methods: A study on adults and elderly age group in Tamaka village was undertaken. Structured questionnaire was used to assess the knowledge of diabetes and capillary blood screening tests done to detect diabetes. Statistical Analysis Used: SPSS - 11 software. Results and Conclusions: Ten per cent of the 311 adults screened had hyperglycemia. Half of the interviewed population had some awareness about diabetes and its symptoms. But more than half (75%) of them were not aware of the long term effects of diabetes and diabetic care. The common perception about diet in diabetes was to avoid sweets, rice and fruits and to consume more ragi, millet and wheat chapattis. Diabetes in young adults is common. Relevant knowledge about diabetes is poor in rural population. Hence community level awareness programs have to be organized. Healthcare providers must be aware of community perceptions and practices. PMID:20431801

  4. [Change in the incidence of diabetes mellitus in oral cancer patients based on a long-term comparative study].

    PubMed

    Végh, Dániel; Bányai, Dorottya; Ujpál, Márta

    2015-03-01

    Our research is focused on the incidence of diabetes mellitus and glucose metabolic disorders among oral cancer patients and the frequency of different oral localizations of cancer. Diabetes mellitus affects 7% of the Hungarian population. This study uses data spanning 14 years, with 2 datasets of 1998-1999 and 2012-2013, collected first hand by the authors. These datasets have led us to examine the blood glucose level in 267 patients with histologically confirmed malignant tumours in the oral cavity. Diabetes mellitus was found in 59 of them (22.1%), The blood glucose was elevated in 32 cases (12%). The most frequent tumor locations among the diabetic patients: labial, lingual and gingival tumors gingivae. Comparative epidemiological study demonstrates that in 2012-2013 dataset there was an increased observed percentage of people with diabetes mellitus [17.6% to 22.1%]. The percentage of patients with IFG (impaired fasting glucose) also increased from 9.8% to 12%. Overall the number of patients with glucose metabolic disorders climbed from 27.4% to 34.1%, (p > 0.05). Our intention of this introductory analysis is to emphasize the close connection of these two very important disease groups, and the wider spread of diabetes mellitus.

  5. 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.

  6. Diabetes Mellitus, Cognitive Impairment, and Traditional Chinese Medicine

    PubMed Central

    Seto, S. W.; Yang, G. Y.; Kiat, H.; Bensoussan, A.; Kwan, Y. W.; Chang, D.

    2015-01-01

    Diabetes mellitus (DM) is a metabolic disorder affecting a large number of people worldwide. Numerous studies have demonstrated that DM can cause damage to multiple systems, leading to complications such as heart disease, cancer, and cerebrovascular disorders. Numerous epidemiological studies have shown that DM is closely associated with dementia and cognition dysfunction, with recent research focusing on the role of DM-mediated cerebrovascular damage in dementia. Despite the therapeutic benefits of antidiabetic agents for the treatment of DM-mediated cognitive dysfunction, most of these pharmaceutical agents are associated with various undesirable side-effects and their long-term benefits are therefore in doubt. Early evidence exists to support the use of traditional Chinese medicine (TCM) interventions, which tend to have minimal toxicity and side-effects. More importantly, these TCM interventions appear to offer significant effects in reducing DM-related complications beyond blood glucose control. However, more research is needed to further validate these claims and to explore their relevant mechanisms of action. The aims of this paper are (1) to provide an updated overview on the association between DM and cognitive dysfunction and (2) to review the scientific evidence underpinning the use of TCM interventions for the treatment and prevention of DM-induced cognitive dysfunction and dementia. PMID:26060494

  7. Epidemiology of diabetic kidney disease.

    PubMed

    Reutens, Anne T

    2013-01-01

    The increasing prevalence of diabetes has led to DKD becoming the leading cause of ESRD in many regions. The economic cost of DKD will grow to prohibitive amounts unless strategies to prevent its onset or progression are urgently implemented. In type 1 and type 2 diabetes, the presence of microalbuminuria and macroalbuminuria confers increased risk of developing ESRD and of death. Comparison of recent studies with earlier historical studies shows that the incidence of ESRD and death has decreased in DKD. Increased risk of albuminuria has been identified in certain non-European ethnic groups. However, the initial concept of progression of DKD as an albuminuric phenotype involving development of microalbuminuria, macroalbuminuria, and then ESRD has had to be modified. Albumin excretion frequently regresses, and GFR can decline without abnormality in albumin excretion. There is emerging evidence that changes in renal function occurring early in the course of diabetes predict future outcomes. The major challenges are to prevent DKD onset, to detect it early, and to improve DKD outcomes globally. PMID:23290726

  8. [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.

  9. 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.

  10. 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.

  11. 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)

  12. Gender discrimination for women with diabetes mellitus in Algeria

    PubMed Central

    Chentli, Farida; Azzoug, Said; Meskine, Djamila; El Gradechi, Aldjia

    2014-01-01

    Background: Nowadays diabetes mellitus (DM) is one of the greatest global challenges. Its expansion varies from an area to another according to genetic, traditions, socio-economic conditions, and stress. In Algeria, as in other emerging countries undergoing an epidemiological transition, noncommunicable diseases are sharply increasing. After high blood pressure, DM is now the second metabolic disease. But are women more concerned by DM since obesity frequency is higher in females? Can we assert that there is a sort of sex discrimination for DM complications? Materials and Methods: To answer these questions we took into account published documents carried in Algerian population. But, as those were very scarce, we also considered newspapers articles, some documents published by health minister department, posters and oral communications of the Algerian Society of Endocrinology and Diabetology, and our clinical experience. We also have done a small survey to get our patients’ opinions. Results and Conclusion: At the first sight, it seems gender discrimination between men and women cannot exist since most epidemiological studies showed that both sexes are broadly and equally affected by DM, except for old aged females who are the most affected. When we reconsidered the problem, and when we compared past results to those obtained after the terrorism period, many studies showed a sort of gender difference. Apart from gestational DM, which is increasing sharply, some complications and death related to DM are prevailing in women. Coronary diseases and cerebral vascular accidents are more frequent in women too, especially the young ones and those suffering from DM. These complications are probably due to the recent and rapid modification in women's lifestyle with a strong reduction in physical activity, eating disorders, hormonal contraception, and high sensitivity to perceived stress secondary to the near past stressing life and/or to numerous responsibilities taken by

  13. Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Tsilidis, Konstantinos K; Allen, Naomi E; Appleby, Paul N; Rohrmann, Sabine; Nöthlings, Ute; Arriola, Larraitz; Gunter, Marc J; Chajes, Veronique; Rinaldi, Sabina; Romieu, Isabelle; Murphy, Neil; Riboli, Elio; Tzoulaki, Ioanna; Kaaks, Rudolf; Lukanova, Annekatrin; Boeing, Heiner; Pischon, Tobias; Dahm, Christina C; Overvad, Kim; Quirós, J Ramón; Fonseca-Nunes, Ana; Molina-Montes, Esther; Gavrila Chervase, Diana; Ardanaz, Eva; Khaw, Kay T; Wareham, Nick J; Roswall, Nina; Tjønneland, Anne; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Bueno-de-Mesquita, H Bas; Malm, Johan; Orho-Melander, Marju; Johansson, Mattias; Stattin, Pär; Travis, Ruth C; Key, Timothy J

    2015-01-15

    The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer.

  14. 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

  15. Prevalence of diabetes mellitus in patients with acromegaly.

    PubMed

    Dreval, A V; Trigolosova, I V; Misnikova, I V; Kovalyova, Y A; Tishenina, R S; Barsukov, I A; Vinogradova, A V; Wolffenbuttel, B H R

    2014-01-01

    Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (P<0.001). The prevalence of ECMDs was also higher in patients with acromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3-1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.

  16. 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

  17. 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. PMID:27022444

  18. [Polish Multicenter Study on Diabetes Epidemiology (PMSDE)--1998-2000].

    PubMed

    Szybiński, Z

    2001-09-01

    Diabetes mellitus is a growing health problem at all ages in all countries. The Saint Vincent Declaration signed by the representatives of all European countries--among them by Poland--indicated the main goals to reduce this burden. This may be achieved by elaboration and initiation of the nation-wide programme for early detection and control of diabetes on the population level. The Polish Task Force for Diabetes Management worked out and put into operation in 1998 the project commissioned by the Ministry of Health funded by the Polish State Committee for Research (PBZ-018-11). The urgent need for the implementation of this programme was a result of the increasing number of diabetic patients on the primary health care level, diabetic complications and hospitalisations. The programme was based on the assumption that primary and secondary prevention of NIDDM may eliminate or reduce its risk factors and therefore decrease its prevalence and morbidity and should integrate epidemiology, identification of risk factors, education, intervention models and economics of diabetes. This issue of the Polish Archives of Internal Medicine contains the main results of the programme and reflects an actual situation of diabetes in Poland creating a rational basis for intervention on the population level. Evaluation of the incidence rate of the diabetes type 1 in 10 selected areas (population basis 30% of age group 0-29) revealed values from 8.4 to 14.7/100,000 in the age group 1-14 and from 4.4 to 11.2/100,000 in the age group 15-29. It accounts for the 2-3 fold increase in comparison with the results achieved in 1986 (Z. Szybinski). However an ascertainment of the register in the age group 15-29 dropped down during the last 10 years and additional sources of data must be involved in the survey. Prevalence of diabetes type 2 in 3 selected areas Krakow 10.77% (M. Szurkowska), Lublin 15.6% (J. Łopatynski) and Łódź 15.7% (J. Drzewoski) based on the population random sample over 35

  19. 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

  20. [Endothelial function and the microcirculation in diabetes mellitus].

    PubMed

    Arosio, E; Minuz, P; Prior, M

    1999-01-01

    The role of endothelial dysfunction in the pathogenesis of diabetic microangiopathy is reviewed. Reversible alterations in microcirculation, consisting of increased capillary pressure, blood flow and endothelial permeability, can be detected at an early stage in diabetes mellitus. Irreversible structural modifications of the vascular wall, such as thickening of the basal membrane due to the extracellular accumulation of proteins, take place at later stages. Atherosclerosis further affects microcirculation in diabetes mellitus by decreasing autoregulatory capacity and blood flow reserve. Endothelial dysfunction has been observed to precede the onset of microvascular lesions, as demonstrated by reduction in the vasodilatory response to vasoactive agents and by alterations in the antithrombotic properties of the endothelium. Experimental data available so far suggest that endothelial dysfunction may be directly related to hyperglycemia. Abnormalities in lipoprotein metabolism, generation of glycation end products, and increased oxidative stress may also be responsible for the endothelial dysfunction in diabetes mellitus. Insulin resistance appears to be related to endothelial dysfunction in non-insulin-dependent diabetes mellitus through a reduction in the biological activity of endothelial-derived nitric oxide.

  1. 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.

  2. Epidemiology of air pollution and diabetes.

    PubMed

    Thiering, Elisabeth; Heinrich, Joachim

    2015-07-01

    Air pollution affects a large proportion of the global population. Air pollutants are hypothesized to exert their effects via impaired endothelial function, elevated systemic inflammation, mitochondrial dysfunction, and oxidative stress, all of which are hallmarks of type 2 diabetes (T2D). Here we review epidemiological studies aimed at answering whether diabetes patients are more vulnerable to ambient (outdoor) air pollution exposure and whether air pollution is associated with diabetes development or other predisposing conditions for T2D. Current evidence suggests an association between air pollution exposure and T2D, but more critical analysis is warranted. Understanding the associations between air pollution exposure and the development of T2D is critical in our efforts to control sources of air pollution and their impact on the disease.

  3. Glycosylated hemoglobin determination from capillary blood samples. Utility in an epidemiologic survey of diabetes.

    PubMed

    Ferrell, R E; Hanis, C L; Aguilar, L; Tulloch, B; Garcia, C; Schull, W J

    1984-02-01

    Total glycosylated hemoglobin was measured from capillary blood specimens obtained from a sample of 1880 individuals of Mexican-American ancestry residing in Starr County, Texas, between January 1981 and February 1982, as part of an epidemiologic survey to assess the prevalence of noninsulin-dependent diabetes mellitus (Type II). No significant difference was found between males and females. Diabetics were found to have significantly higher levels of glycosylated hemoglobin than nondiabetics. However, among diabetics, there was no significant difference between newly diagnosed and known diabetics, and known diabetics taking medication did not differ significantly from those not taking medication. An analysis of the specificity and sensitivity of glycosylated hemoglobin, fasting blood glucose, and casual blood glucose determinations as screening devices in a survey of diabetes prevalence reveals that glycosylated hemoglobin is superior to casual blood glucose determination. The conditions under which various screening devices might be more effective are discussed. PMID:6695895

  4. [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. PMID:27052250

  5. [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.

  6. 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.

  7. [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. PMID:27598916

  8. 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.

  9. 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. PMID:25185980

  10. 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.

  11. Association of mitochondrial DNA haplogroups and vascular complications of diabetes mellitus: A population-based study.

    PubMed

    Martikainen, Mika H; Rönnemaa, Tapani; Majamaa, Kari

    2015-07-01

    We investigated whether mitochondrial (mtDNA) haplogroups and maternal family history of diabetes mellitus were associated with vascular diabetes mellitus complications in a population-based cohort of 299 Finnish diabetes mellitus patients with disease onset in young adult age. We found that haplogroup U was more prevalent among patients with no vascular diabetes mellitus complications than among those with at least one complication (p = 0.038). Haplogroup U was also more prevalent among the patients who reported maternal family history of diabetes mellitus than among those who did not (p = 0.0013). Furthermore, haplogroup U was more prevalent among patients with maternal family history of diabetes mellitus but no vascular diabetes mellitus complications than among those with at least one vascular diabetes mellitus complication but no maternal family history of diabetes mellitus (p = 0.0003 for difference). These findings suggest that different mtDNA-related factors may influence the risk of diabetes mellitus per se and the risk of vascular diabetes mellitus complications. Further studies are, however, warranted to replicate and elaborate on these results.

  12. Mortality from diabetes mellitus, 2004 to 2008: A multiple-cause-of-death analysis.

    PubMed

    Park, Jungwee; Peters, Paul A

    2014-03-01

    Using multiple-cause-of-death data, this study examines diabetes mellitus as a cause of mortality. During the 2004-to-2008 period, diabetes mellitus was listed as either the underlying cause or a contributing cause of 119,617 deaths. It was more than twice as likely to be a contributing than the underlying cause of death. When it was identified as the underlying cause of death, diabetes mellitus was rarely the only cause. The diabetes mellitus mortality rate was relatively high among males, older individuals, and people living in lower-income neighbourhoods. Provincial/Territorial differences in rates of death from diabetes mellitus were considerable. When diabetes mellitus was the underlying cause of death, cardiovascular diseases were listed as a contributing cause most often, and when diabetes mellitus was a contributing cause, cardiovascular diseases were most likely to be the underlying cause.

  13. A revitalized battle against diabetes mellitus for the new millennium.

    PubMed

    Capriotti, T; McLaughlin, S

    1998-12-01

    Despite great advances in control and treatment, diabetes mellitus (DM) remains a formidable opponent for the health care team. A major cause of morbidity and mortality throughout the world, DM continues to increase in prevalence. Nurses are in a strategic position to employ new research findings and aggressive strategies to fight this killer disease.

  14. 77 FR 532 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... date (76 FR 78718) and they are now included in this notice. Diabetes Mellitus and Driving Experience... Management System (FDMS) published in the Federal Register on January 17, 2008 (73 FR 3316), or you may visit... comments from the public (76 FR 71112). The public comment period closed on December 16, 2011, and...

  15. Jordanian School Counselors' Knowledge about and Attitudes toward Diabetes Mellitus

    ERIC Educational Resources Information Center

    Tannous, Adel G.; Khateeb, Jamal M.; Khamra, Hatem A.; Hadidi, Muna S.; Natour, Mayada M.

    2012-01-01

    This study investigated the knowledge and attitudes of Jordanian school counselors toward diabetes mellitus. A sample of 295 counselors completed a questionnaire consisting of two parts concerning knowledge and attitudes. The face validity of the questionnaire was assessed using an informed panel of judges, and its reliability was established…

  16. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies.

    PubMed

    Zimmet, Paul; Alberti, K George; Magliano, Dianna J; Bennett, Peter H

    2016-10-01

    Diabetes mellitus is one of the most important public health challenges of the twenty-first century. Until the past decade, it has been seriously underrated as a global health threat. Major gaps exist in efforts to comprehend the burden nationally and globally, especially in developing nations, due to a lack of accurate data for monitoring and surveillance. Early attempts to obtain accurate data, discussed in this article, seem to have been cast aside so, at present, these needs remain unmet. Existing international efforts to assemble information fall far short of requirements. Current estimates are imprecise, only providing a rough picture, and probably underestimate the disease burden. The methodologies that are currently used, and that are discussed in this Perspectives article, are inadequate for providing a complete and accurate assessment of the prevalence of diabetes mellitus. International consensus on uniform standards and criteria for reporting national data on diabetes mellitus prevalence as well as for common complications of diabetes mellitus and mortality need to be developed.

  17. Method for identifying type I diabetes mellitus in humans

    DOEpatents

    Metz, Thomas O [Kennewick, WA; Qian, Weijun [Richland, WA; Jacobs, Jon M [Pasco, WA

    2011-04-12

    A method and system for classifying subject populations utilizing predictive and diagnostic biomarkers for type I diabetes mellitus. The method including determining the levels of a variety of markers within the serum or plasma of a target organism and correlating this level to general populations as a screen for predisposition or progressive monitoring of disease presence or predisposition.

  18. Metabolomics: Insulin Resistance and Type 2 Diabetes Mellitus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Type 2 diabetes mellitus (T2DM) develops over many years, providing an opportunity to consider early prognostic tools that guide interventions to thwart disease. Advancements in analytical chemistry enable quantitation of hundreds of metabolites in biofluids and tissues (metabolomics), providing in...

  19. Coping Styles in Youths with Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Hanson, Cindy L.; And Others

    1989-01-01

    Evaluated relationships between two coping styles and two health outcomes in 135 youth with insulin-dependent diabetes mellitus (IDDM). Found that poor adherence to treatment, older adolescent age, and long duration of IDDM correlated with ventilation and avoidance coping. High ventilation and avoidance coping was predicted by high stress, low…

  20. Treatment options for post-transplantation diabetes mellitus.

    PubMed

    Sharif, Adnan

    2015-01-01

    Treatment options for management of post-transplantation diabetes mellitus (PTDM) are limited with regards to the availability of strong clinical evidence base. This is a concern as PTDM is common after solid organ transplantation and associated with poor clinical outcomes. PTDM and type 2 diabetes mellitus are distinct pathophysiological entities that have important differences with regards to aetiology, clinical course and management. Therefore, any clinical evidence of treatment benefit from the general population with type 2 diabetes mellitus may not be directly translated to the solid organ transplant recipient. In addition, the potential risk and benefit of using many of these therapeutic agents must take account of the complicated post-transplantation milieu of immunosuppression. While there is reasonable evidence base for treatment of diabetes mellitus in the general population, the same is not true in a post-transplantation setting. In this article the treatment options available for PTDM will be discussed, with a transplant-specific focus on the pros and cons of each particular component of the glucose lowering therapy armoury.

  1. Maximum Oxygen Uptake Determination in Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Fremion, Amy S.; And Others

    1987-01-01

    A study of 10 children with insulin-dependent diabetes mellitus performing a maximum-effort cycling test indicated blood glucose levels did not change appreciably during test, while maximal oxygen uptake was substandard for their age groups. Findings suggest patients in fair to poor metabolic control can tolerate stress testing without…

  2. Diabetes mellitus with pulmonary tuberculosis--a double trouble.

    PubMed

    Kant, Surya; Lata, Hem; Natu, S M; Mishra, Arvind Kumar; Verma, N S

    2013-03-01

    Diabetic patients are often at a higher risk for developing several types of infections and infection does alter the handling of glucose by tissues. Pulmonary infections in diabetics are characterised by alteration in host defence, in entire body and in the lung locally as well as in the function of respiratory epithelium and ciliary motility. Association between diabetes mellitus and pulmonary tuberculosis is well established, while the prevalence of tuberculosis is increased 4-5 times more among diabetics. Impairment of host defence plays an important role for changing the clinical, radiological and bacteriological presentation in diabetic patients. It is also reported by the various studies that hyperglycaemia favours the growth of tuberculosis bacilli. So the severity of tuberculosis appears more cirtical with the degree of hyperglycaemia and host defence activity. This overlap between the diabetic and tuberculosis epidemics could adversely affect global tuberculosis control efforts. PMID:24592761

  3. The HLA system and diabetes mellitus.

    PubMed

    Cudworth, A G; Woodrow, J C

    1977-06-01

    There is a significant positive association between insulin dependent diabetes, irrespective of age of onset, and the HLA system, whereas there is no association of HLA antigens with non-insulin dependent diabetes. There is a significant concordance value for HLA antigen frequencies in insulin dependent diabetics from three different centres, indicating that the genes (s) conferring susceptibility to this type of diabetes is possibly present in all "juvenile-onset" diabetics and is in linkage disequilibrium with all the B locus alleles. PMID:892129

  4. Benefits of caloric restriction for cardiometabolic health, including type 2 diabetes mellitus risk.

    PubMed

    Soare, Andreea; Weiss, Edward P; Pozzilli, Paolo

    2014-03-01

    In the United States, life expectancy has markedly increased during the past century, and population ageing is expected to double within the next 25 years. The process of ageing in a population is associated with the development of chronic diseases, such as type 2 diabetes mellitus, that can be prevented, and even reversed, with the implementation of healthy lifestyle interventions. The evidence to date, consolidated by the numerous epidemiological studies and clinical trials conducted, suggests that caloric restriction is an effective nutritional intervention for preventing most of these age-related conditions. At a metabolic level, caloric restriction with adequate nutrition has been shown to improve insulin sensitivity, reduce fasting glucose and insulin concentration and prevent obesity, type 2 diabetes, hypertension and chronic inflammation. The purpose of this article is to review current knowledge of the metabolic and clinical implications of caloric restriction with adequate nutrition for the prevention of type 2 diabetes and cardiovascular disease. PMID:24532291

  5. Shared links between type 2 diabetes mellitus and Alzheimer's disease: A review.

    PubMed

    Mittal, Khyati; Katare, Deepshikha Pande

    2016-01-01

    Epidemiological studies have proved that, there are pathophysiological connections between Type 2 Diabetes Mellitus (T2DM) and Alzheimer's disease (AD). Diabetic patients have higher incidences of cognitive impairment and hence they are more at the risk of developing AD. Some of the recent evidences have majorly stated the effects of insulin resistance in the disturbance of various biological processes and signaling pathways. Both hyperglycemia and hypoglycemic conditions contributes in dysfunctioning of cognitive abilities and functions. The present review summarizes the evidences which establish the possible links between the two pathologies on the account of molecular, biochemical and at histopathological level. The information regarding their interactions was collected from different databases and journals. The gathered information will clearly establish the link among the two pathologies and will be helpful in future for the development of drugs for Type 3 Diabetes.

  6. Arterial hypertension in diabetes mellitus: from theory to clinical practice.

    PubMed

    Sampanis, C; Zamboulis, C

    2008-04-01

    Diabetes mellitus and arterial hypertension are two common diseases that often coexist. Patients with diabetes have much higher rate of hypertension than that in general population. The co-existence of these disorders appears to accelerate microvascular and macrovascular complications and greatly increases the cardiovascular risk, risk of stroke and end stage renal disease. Arterial hypertension is clearly related to nephropathy in subjects with type 1 diabetes. In patients with type 2 diabetes insulin resistance seems to play a pivotal role in the pathogenesis of hypertension. Several well designed randomized controlled trials have provided evidence that patients with diabetes will benefit from a more aggressive treatment of hypertension. This benefit is seen at blood pressure level<130/80 mmHg. Moreover, most diabetic patients with hypertension require combination therapy to achieve optimal blood pressure goals. Angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, diuretics, beta-adrenoreceptor blockers and calcium- channel blockers are all effective antihypertensive agents in type 2 diabetes mellitus and no comparative trial showed the superiority of any particular class in either lowering blood pressure or reducing cardiovascular morbidity and mortality. On the basis of experimental arguments and clinical observations that have shown their apparent superiority in slowing diabetic nephropathy, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers are preferred as the first choice alone or in combination with diuretics. Second choice should be long-acting calcium-channel blockers or cardioselective beta blockers. Clinicians should be aware of the need for aggressive treatment of hypertension and spend more time in order to provide maximal benefit to the treatment of diabetes mellitus and hypertension. PMID:18923653

  7. Arterial hypertension in diabetes mellitus: from theory to clinical practice

    PubMed Central

    Sampanis, C; Zamboulis, C

    2008-01-01

    Diabetes mellitus and arterial hypertension are two common diseases that often coexist. Patients with diabetes have much higher rate of hypertension than that in general population. The co-existence of these disorders appears to accelerate microvascular and macrovascular complications and greatly increases the cardiovascular risk, risk of stroke and end stage renal disease. Arterial hypertension is clearly related to nephropathy in subjects with type 1 diabetes. In patients with type 2 diabetes insulin resistance seems to play a pivotal role in the pathogenesis of hypertension. Several well designed randomized controlled trials have provided evidence that patients with diabetes will benefit from a more aggressive treatment of hypertension. This benefit is seen at blood pressure level < 130/80 mmHg. Mopreover, most diabetic patients with hypertension require combination therapy to achieve optimal blood pressure goals. Angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, diuretics, β-adrenoreceptor blockers and calcium- channel blockers are all effective antihypertensive agents in type 2 diabetes mellitus and no comparative trial showed the superiority of any particular class in either lowering blood pressure or reducing cardiovascular morbidity and mortality. On the basis of experimental arguments and clinical observations that have shown their apparent superiority in slowing diabetic nephropathy, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers are preferred as the first choice alone or in combination with diuretics. Second choice should be long-acting calcium-channel blockers or cardioselective β blockers. Clinicians should be aware of the need for aggressive treatment of hypertension and spend more time in order to provide maximal benefit to the treatment of diabetes mellitus and hypertension. PMID:18923653

  8. Association of GSTs polymorphisms with risk of gestational diabetes mellitus.

    PubMed

    Li, Yan; Li, Shaoru; Zhai, Qianqian; Hai, Jie; Wang, Di; Cao, Meng; Zhang, Qinggui

    2015-01-01

    We conducted a case-control study to investigate the association between GSTM1, GSTT1 and GSTP1 IIe105Val polymorphisms and development of gestational diabetes mellitus in a Chinese population. A total of 320 patients with gestational diabetes mellitus and 358 pregnancy subjects were consecutively collected between January 2013 and December 2014. Genotyping for detection of GSTM1, GSTT1 and GSTP1 IIe105Val was conducted by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) method. By Fisher's exact test, we found that the genotype distributions of GSTP1 IIe105Val were in line with the Hardy-Weinberg equilibrium in control subjects (P=0.57). By Chi-square test, we found significant differences in the genotype distributions of GSTM1 (χ(2)=11.49, P=0.001) and GSTT1 (χ(2)=18.50, P<0.001). Using unconditional logistic analysis, individuals carrying the null genotypes of GSTM1 and GSTT1 were associated with an increased risk of gestational diabetes mellitus when compared with the present genotype, and the adjusted Ors (95% CI) were 1.71 (1.24-2.36) and 2.00 (1.44-2.79), respectively. However, the GSTP1 IIe105Val polymorphism was not associated with an elevated risk of gestational diabetes mellitus. In conclusion, we suggest that the GSTM1 null genotype and GSTT1 null genotype are correlated with an increased risk of gestational diabetes mellitus in a Chinese population.

  9. Association of GSTs polymorphisms with risk of gestational diabetes mellitus

    PubMed Central

    Li, Yan; Li, Shaoru; Zhai, Qianqian; Hai, Jie; Wang, Di; Cao, Meng; Zhang, Qinggui

    2015-01-01

    We conducted a case-control study to investigate the association between GSTM1, GSTT1 and GSTP1 IIe105Val polymorphisms and development of gestational diabetes mellitus in a Chinese population. A total of 320 patients with gestational diabetes mellitus and 358 pregnancy subjects were consecutively collected between January 2013 and December 2014. Genotyping for detection of GSTM1, GSTT1 and GSTP1 IIe105Val was conducted by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) method. By Fisher’s exact test, we found that the genotype distributions of GSTP1 IIe105Val were in line with the Hardy-Weinberg equilibrium in control subjects (P=0.57). By Chi-square test, we found significant differences in the genotype distributions of GSTM1 (χ2=11.49, P=0.001) and GSTT1 (χ2=18.50, P<0.001). Using unconditional logistic analysis, individuals carrying the null genotypes of GSTM1 and GSTT1 were associated with an increased risk of gestational diabetes mellitus when compared with the present genotype, and the adjusted Ors (95% CI) were 1.71 (1.24-2.36) and 2.00 (1.44-2.79), respectively. However, the GSTP1 IIe105Val polymorphism was not associated with an elevated risk of gestational diabetes mellitus. In conclusion, we suggest that the GSTM1 null genotype and GSTT1 null genotype are correlated with an increased risk of gestational diabetes mellitus in a Chinese population. PMID:26823865

  10. [Cardiovascular disease prevention in adults with type 2 diabetes mellitus according to the recent statement from the American Heart Association/American Diabetes Association].

    PubMed

    Avogaro, Angelo

    2016-03-01

    There is a clear epidemiologic association between glycemic control and cardiovascular disease. There is strong evidence of a microvascular benefit by lowering glycated hemoglobin <7% while acknowledging lack of proven macrovascular benefits. It is therefore relevant, in all diabetic patients, to control all major cardiovascular risk factors such as obesity, hypertension, and dyslipidemia. These risk factors, easily measurable, account for 90% of acute myocardial infarction. In this review, the update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus from the American Heart Association and the American Diabetes Association is discussed and commented.

  11. Acute large-dose exposure to organophosphates in patients with and without diabetes mellitus: analysis of mortality rate and new-onset diabetes mellitus

    PubMed Central

    2014-01-01

    Background We investigated the mortality rates of patients with and without diabetes mellitus after acute large-dose exposure to organophosphate insecticides. All patients without diabetes mellitus were traced to examine the long-term risk of new-onset diabetes mellitus. Previous reports indicated that organophosphate exposure might increase the risk of new-onset diabetes mellitus. Methods We analyzed the records of 118 patients referred to Chang Gung Memorial Hospital for management of intentional organophosphate poisoning between 2000 and 2011. Patients were stratified by diabetes mellitus status. Demographic, clinical, laboratory and mortality data were analyzed. Results Most patients were middle aged (53.45 ± 16.20 years) and male (65.3%) and were referred to our hospital after a relatively short amount of time had elapsed since poisoning (median 3.0 hours). 18 (15.2%) of 118 patients died, including 15 (13.8%) of 109 patients without diabetes mellitus and 3 (33.3%) of 9 with diabetes mellitus. There was no significant difference in mortality between these groups (P = 0.117). In a multivariate Cox regression model, hypotension (P = 0.000), respiratory failure (P = 0.042), coma (P = 0.023), and corrected QT interval prolongation (P = 0.002) were significant risk factors for mortality. Conversely, diabetes mellitus status was not a significant variable in this model. At routine outpatient follow up a median of 1.25 months post exposure, random blood glucose measurements gave no evidence of new-onset diabetes in patients without pre-existing diabetes. Conclusions Diabetes mellitus status might not increase mortality risk following acute large-dose exposure to organophosphates, and the risk of new-onset diabetes mellitus also might be minimal in the short term. Larger prospective studies with formal testing for diabetes at later times post-exposure are required. PMID:24597539

  12. Current status of managing diabetes mellitus in Korea.

    PubMed

    Ha, Kyoung Hwa; Kim, Dae Jung

    2016-09-01

    Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes. PMID:27604796

  13. [Changes in cognitive function in patients with diabetes mellitus].

    PubMed

    Szémán, Barbara; Nagy, Géza; Varga, Tímea; Veres-Székely, Anna; Sasvári, Mária; Fitala, Dávid; Szollosi, Adrienn; Katonai, Rózsa; Kotyuk, Eszter; Somogyi, Anikó

    2012-03-01

    Patients with diabetes are approximately 1.5 times more likely to experience cognitive decline than individuals without diabetes mellitus. Most of the data suggest that patients with diabetes have reduced performance in numerous domains of cognitive function. In patients with type 1 diabetes, specific and global deficits involving speed of psychomotor efficiency, information processing, mental flexibility, attention, and visual perception seem to be present, while in patients with type 2 diabetes an increase in memory deficits, a reduction in psychomotor speed, and reduced frontal lobe (executive) functions have been found. The complex pathophysiology of changes in the central nervous system in diabetes has not yet been fully elucidated. It is important to consider the patient's age at the onset of diabetes, the glycemic control status, and the presence of diabetic complications. Neurological consequences of diabetes appear parallel to those observed in the aging brain. Neuroimaging studies highlight several structural cerebral changes, cortical and subcortical atrophy, beside increased leukoaraiosis that occurs in association with diabetes. There is supporting evidence from many hypotheses to explain the pathophysiology of cognitive decline associated with diabetes. The main hypotheses pointing to the potential, implied mechanisms involve hyperglycemia, hypoglycemia, microvascular disease, insulin resistance, hyperinsulinism, hyperphosphorylation of tau protein, and amyloid-β deposition.

  14. Current status of managing diabetes mellitus in Korea

    PubMed Central

    Ha, Kyoung Hwa; Kim, Dae Jung

    2016-01-01

    Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes. PMID:27604796

  15. Current status of managing diabetes mellitus in Korea.

    PubMed

    Ha, Kyoung Hwa; Kim, Dae Jung

    2016-09-01

    Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes.

  16. Diabetes mellitus in a black-footed ferret

    USGS Publications Warehouse

    Carpenter, J.W.; Novilla, M.N.

    1977-01-01

    Diabetes mellitus was tentatively diagnosed in a black-footed ferret with polyuria, polydipsia, polyphagia, dehydration, and weight loss. Laboratory findings (marked hyperglycemia (724 mg/100 ml), glycosuria, and ketonuria) and the subsequent favorable response to insulin therapy confirmed the diagnosis. Although lesions were not observed in the pancreas, gross and histologic findings concomitant with diabetes mellitus included arteriosclerosis, with calcification of the aorta and other major vessels; mild necrotizing hepatitis; and mild proliferative glomerulonephritis. A perineal adenocarcinoma, with metastasis to an internal iliac lymph node, was an incidental finding. Special stains demonstrated adequate numbers of beta cell granules in the islets of Langerhans. Thus, the diabetes was apparently due to a lack of release of the synthesized insulin or to diminished effectiveness of the secreted insulin.

  17. Vitamin D replacement and type 2 diabetes mellitus.

    PubMed

    Issa, Claire M; Zantout, Mira S; Azar, Sami T

    2015-01-01

    The objective of this paper is to review the evidence testing the possible benefit of vitamin D replacement on diabetes control and complications. Type 2 diabetes mellitus (DM 2) has become a significant global health care problem and its reported incidence is increasing at an alarming rate. Despite the improvement in therapy and development of new drugs, treatment is still not optimal especially with the associated adverse effects of most of the available drugs. New efforts are shifted toward disease prevention and a search for safer drugs. New mounting evidence is associating low vitamin D to diabetes mellitus and as such many studies were conducted to test the effect of vitamin D replacement on incidence of diabetes, diabetes control as well as diabetes complications. Although these studies present several limitations, vitamin D replacement seems to have beneficial effect on all aspects of diabetes: incidence, control and complications. Further longer term and more powered controlled trials are necessary to draw firmer conclusions on this beneficial role of vitamin D treatment on DM.

  18. Vitamin D replacement and type 2 diabetes mellitus.

    PubMed

    Issa, Claire M; Zantout, Mira S; Azar, Sami T

    2015-01-01

    The objective of this paper is to review the evidence testing the possible benefit of vitamin D replacement on diabetes control and complications. Type 2 diabetes mellitus (DM 2) has become a significant global health care problem and its reported incidence is increasing at an alarming rate. Despite the improvement in therapy and development of new drugs, treatment is still not optimal especially with the associated adverse effects of most of the available drugs. New efforts are shifted toward disease prevention and a search for safer drugs. New mounting evidence is associating low vitamin D to diabetes mellitus and as such many studies were conducted to test the effect of vitamin D replacement on incidence of diabetes, diabetes control as well as diabetes complications. Although these studies present several limitations, vitamin D replacement seems to have beneficial effect on all aspects of diabetes: incidence, control and complications. Further longer term and more powered controlled trials are necessary to draw firmer conclusions on this beneficial role of vitamin D treatment on DM. PMID:25495839

  19. Nonpharmacological interventions for the prevention of type 2 diabetes mellitus.

    PubMed

    Schwarz, Peter E; Greaves, Colin J; Lindström, Jaana; Yates, Thomas; Davies, Melanie J

    2012-01-17

    During the past decade, improved understanding of the pathophysiological mechanisms of diabetes development has resulted in advances in therapeutic concepts, but has also supported the potential for diabetes prevention through nonpharmacological means. At the beginning of the century, we experienced a shift in paradigm, as landmark studies have shown that diabetes mellitus is preventable with lifestyle intervention; moderate changes in diet and physical activity produce a substantial and sustained reduction in the incidence of type 2 diabetes mellitus (T2DM) for individuals with impaired glucose tolerance. This evidence must now be translated into clinical and public-health practice, but translational studies have varied in their ability to replicate the results of clinical trials. This variation reflects a number of challenging barriers for diabetes prevention in real-world clinical practice, which makes it necessary to focus on identifying efficient intervention methods and delivery mechanisms. Research is now focusing on these mechanisms, as well as on developing efficient screening and risk-identification strategies and realistic scenarios for public-health policy to implement diabetes prevention programs. In this Review, we will discuss these mechanisms and will consider the implications of diabetes prevention for public-health strategy and policy.

  20. Prevalence of diabetes mellitus in a Saudi community

    PubMed Central

    Alqurashi, Khalid A.; Aljabri, Khalid S.; Bokhari, Samia A.

    2011-01-01

    BACKGROUND AND OBJECTIVES: Quantifying the prevalence of diabetes mellitus is important to allow for rational planning and allocation of resources. Therefore, we designed this study to determine the prevalence of diabetes among Saudi nationals. DESIGN AND SETTING: A cross-sectional study among patients attending a primary care clinic in June 2009. PATIENTS AND METHODS: Patients were interviewed with structured questionnaires to determine the presence of diabetes by questioning for history of the disease, and charts were reviewed to document any diabetic therapies that the patients may have undergone in the past or were undergoing at that time. RESULTS: Of 6024 subjects, diabetes mellitus was present in 1792 (30%) patients. The mean (SD) age of the patients was 55.3 (13.2) years. The prevalence of diabetes was 34.1% in males and 27.6% in females (P<.0001). The mean (SD) age for onset of diabetes in males and females was 57.5 (13.1) and 53.4 (13.1) years, respectively (P<.0001). Females <50 years old had a higher prevalence than males in the corresponding age range—34.1% and 25.1%, respectively (P<.0001). The prevalence of diabetes decreased in patients older than 70 years. The prevalence of body mass index of ≥25 was 72.5%. Among patients with diabetes, the prevalence of body mass index of ≥25 was 85.7% (P<.0001). There was a higher prevalence of obesity (body mass index, ≥25) in females (87.7%) as compared to males (83.1%) (P=.008). CONCLUSION: The prevalence of diabetes is high among the Saudi population and represents a major clinical and public health problem. A national prevention program to prevent diabetes and address the modifiable risk factors at the community level, targeting high-risk groups, should be implemented soon. PMID:21245594

  1. Epidemiology, mechanisms, and management of diabetic gastroparesis.

    PubMed

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

    2011-01-01

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

  2. Effects of acute dietary iron overload in pigs (Sus scrofa) with induced type 2 diabetes mellitus.

    PubMed

    Espinoza, A; Morales, S; Arredondo, M

    2014-06-01

    Epidemiological studies have reported an association between high iron (Fe) levels and elevated risk of developing type 2 diabetes mellitus (T2D). It is believed that the formation of Fe-catalyzed hydroxyl radicals may contribute to the development of diabetes. Our goal was to determine the effect of a diet with a high Fe content on type 2 diabetic pigs. Four groups of piglets were studied: (1) control group, basal diet; (2) Fe group, basal diet with 3,000 ppm ferrous sulfate; (3) diabetic group (streptozotocin-induced type 2 diabetes) with basal diet; (4) diabetic/Fe group, diabetic animals/3,000 ppm ferrous sulfate. For 2 months, biochemical and hematological parameters were evaluated. Tissue samples of liver and duodenum were obtained to determine mRNA relative abundance of DMT1, ferroportin (Fpn), ferritin (Fn), hepcidin (Hpc), and transferrin receptor by qRT-PCR. Fe group presented increased levels of hematological (erythrocytes, hematocrit, and hemoglobin) and iron parameters. Diabetic/Fe group showed similar behavior as Fe group but in lesser extent. The relative abundance of different genes in the four study groups yielded a different expression pattern. DMT1 showed a lower expression in the two iron groups compared with control and diabetic animals, and Hpc showed an increased on its expression in Fe and diabetic/Fe groups. Diabetic/Fe group presents greater expression of Fn and Fpn. These results suggest that there is an interaction between Fe nutrition, inflammation, and oxidative stress in the diabetes development.

  3. Functional herbal food ingredients used in type 2 diabetes mellitus

    PubMed Central

    Perera, Pathirage Kamal; Li, Yunman

    2012-01-01

    From many reports it is clear that diabetes will be one of the major diseases in the coming years. As a result there is a rapidly increasing interest in searching new medicines, or even better searching prophylactic methods. Based on a large number of chemical and pharmacological research work, numerous bioactive compounds have been found in functional herbal food ingredients for diabetes. The present paper reviews functional herbal food ingredients with regards to their anti-diabetic active principles and pharmacological test results, which are commonly used in Asian culinary system and medical system and have demonstrated clinical or/and experimental anti-diabetic effectiveness. Our idea of reviewing this article is to give more attention to these functional food ingredients as targets medicinal foods in order to prevent or slow down the development of type 2 diabetes mellitus. PMID:22654403

  4. Current and Emerging Aspects of Diabetes Mellitus in Acromegaly.

    PubMed

    Frara, Stefano; Maffezzoni, Filippo; Mazziotti, Gherardo; Giustina, Andrea

    2016-07-01

    Diabetes mellitus is a frequent complication of acromegaly, a disease characterized by chronic hypersecretion of growth hormone (GH) by a pituitary adenoma. Diabetes occurs commonly but not only as a consequence of an insulin-resistant state induced by GH excess. The development of diabetes in patients with acromegaly is clinically relevant, since such a complication is thought to increase the already elevated cardiovascular morbidity and mortality risk of the disease. Emerging data suggest that a specific cardiomyopathy can be identified in acromegaly patients with diabetes. Moreover, the presence of diabetes may also influence therapeutic decision making in acromegaly, since traditional and newly developed drugs used in this clinical setting may impact glucose metabolism regardless of control of GH hypersecretion. PMID:27229934

  5. Functional herbal food ingredients used in type 2 diabetes mellitus.

    PubMed

    Perera, Pathirage Kamal; Li, Yunman

    2012-01-01

    From many reports it is clear that diabetes will be one of the major diseases in the coming years. As a result there is a rapidly increasing interest in searching new medicines, or even better searching prophylactic methods. Based on a large number of chemical and pharmacological research work, numerous bioactive compounds have been found in functional herbal food ingredients for diabetes. The present paper reviews functional herbal food ingredients with regards to their anti-diabetic active principles and pharmacological test results, which are commonly used in Asian culinary system and medical system and have demonstrated clinical or/and experimental anti-diabetic effectiveness. Our idea of reviewing this article is to give more attention to these functional food ingredients as targets medicinal foods in order to prevent or slow down the development of type 2 diabetes mellitus.

  6. Personalized medicine in diabetes mellitus: current opportunities and future prospects.

    PubMed

    Kleinberger, Jeffrey W; Pollin, Toni I

    2015-06-01

    Diabetes mellitus affects approximately 382 million individuals worldwide and is a leading cause of morbidity and mortality. Over 40 and nearly 80 genetic loci influencing susceptibility to type 1 and type 2 diabetes, respectively, have been identified. In addition, there is emerging evidence that some genetic variants help to predict response to treatment. Other variants confer apparent protection from diabetes or its complications and may lead to development of novel treatment approaches. Currently, there is clear clinical utility to genetic testing to find the at least 1% of diabetic individuals who have monogenic diabetes (e.g., maturity-onset diabetes of the young and KATP channel neonatal diabetes). Diagnosing many of these currently underdiagnosed types of diabetes enables personalized treatment, resulting in improved and less invasive glucose control, better prediction of prognosis, and enhanced familial risk assessment. Efforts to enhance the rate of detection, diagnosis, and personalized treatment of individuals with monogenic diabetes should set the stage for effective clinical translation of current genetic, pharmacogenetic, and pharmacogenomic research of more complex forms of diabetes. PMID:25907167

  7. Personalized medicine in diabetes mellitus: current opportunities and future prospects.

    PubMed

    Kleinberger, Jeffrey W; Pollin, Toni I

    2015-06-01

    Diabetes mellitus affects approximately 382 million individuals worldwide and is a leading cause of morbidity and mortality. Over 40 and nearly 80 genetic loci influencing susceptibility to type 1 and type 2 diabetes, respectively, have been identified. In addition, there is emerging evidence that some genetic variants help to predict response to treatment. Other variants confer apparent protection from diabetes or its complications and may lead to development of novel treatment approaches. Currently, there is clear clinical utility to genetic testing to find the at least 1% of diabetic individuals who have monogenic diabetes (e.g., maturity-onset diabetes of the young and KATP channel neonatal diabetes). Diagnosing many of these currently underdiagnosed types of diabetes enables personalized treatment, resulting in improved and less invasive glucose control, better prediction of prognosis, and enhanced familial risk assessment. Efforts to enhance the rate of detection, diagnosis, and personalized treatment of individuals with monogenic diabetes should set the stage for effective clinical translation of current genetic, pharmacogenetic, and pharmacogenomic research of more complex forms of diabetes.

  8. Insulin-Dependent Diabetes Mellitus: Educational Implications.

    ERIC Educational Resources Information Center

    Yousef, Jamal M. S.

    1995-01-01

    This article provides an overview of the educational implications of diabetes in children through discussion of the nature of diabetes, factors associated with educational performance, and the teacher's role in meeting the child's needs. It argues that teachers should treat these students as normal learners, without ignoring their unique needs or…

  9. Serum glycosidase activity in diabetes mellitus.

    PubMed

    Merimee, T J; Kennedy, A L; Mehl, T D; Rosenbloom, A

    1981-02-01

    The activity of three glycosidic enzymes, B-glucuronidase, N-acetylglucosaminidase, and B-galactosidase were measured in plasma samples from 163 diabetic subjects and 72 normal controls. No age- or sex-based variation in concentration was noted in controls. Plasma activity of B-glucuronidase and N-acetylglucosaminidase in diabetics correlated directly with the overall level of glycemia as measured by HbA1c levels. B-galactosidase activity was consistently normal in diabetics. A significant age-based variation was noted in the diabetic group for B-glucuronidase and N-acetylglucosaminidase. Prior to age 12 B-glucuronidase and N-acetylglucosaminidase were normal in diabetics, but activity increased significantly after the age of 12, a change that appeared to coincide with the development of puberty. PMID:6781956

  10. Lean diabetes mellitus: An emerging entity in the era of obesity.

    PubMed

    George, Amrutha Mary; Jacob, Amith George; Fogelfeld, Leon

    2015-05-15

    Much has been published on the characteristics of type 2 diabetes mellitus and its association with the epidemic of obesity. But relatively little is known about the incidence of lean diabetes, progression of disease and fate of the patients with low-normal body mass index (< 25). Studies in developing countries have shown that the clinical characteristics of these patients include history of childhood malnutrition, poor socioeconomic status, relatively early age of onset and absence of ketosis on withdrawal of insulin. In the United States, recent studies showed that the lean, normal weight diabetes is not rare especially among minority populations. They showed that these patients are mainly males, have higher prevalence of insulin use indicating rapid beta cell failure. They might have increased total, cardiovascular and non cardiovascular mortality when compared to obese diabetic patients. In this review, the epidemiologic and clinical features of lean diabetes are presented. The potential causal mechanisms of this emerging diabetes type that may include genetic, autoimmune, acquired and behavioral factors are discussed. The need for studies to further elucidate the causation as well as specific prevention and treatment of lean diabetes is emphasized. PMID:25987958

  11. Ayurvedic concept of obesity, metabolic syndrome, and diabetes mellitus.

    PubMed

    Sharma, Hari; Chandola, H M

    2011-06-01

    Obesity, metabolic syndrome, and diabetes mellitus are increasing to epidemic proportions globally. There are 400 million clinically obese adults worldwide and there are more than 220 million people who have diabetes. The global impact of these disorders is immense in terms of human suffering and economic burden. There is an urgent need for a more effective understanding of these disease processes and their management, including the use of natural strategies that are affordable and efficacious. The health care system known as Ayurveda has much to offer in this regard. Ayurveda describes a set of complex clinical disorders, collectively called Prameha, that are characterized by frequent abnormal micturition. The clinical conditions associated with Prameha correlate in many ways with obesity, metabolic syndrome, and diabetes mellitus. The etiology, classification, pathogenesis, and management of Prameha are discussed at length and in detail in the Ayurvedic texts. The theoretical background and comprehensive set of strategies Ayurveda utilizes to treat Prameha may be valuable in managing obesity, metabolic syndrome, and diabetes mellitus in an efficacious and cost-effective manner. PMID:21649521

  12. [Diabetes mellitus and early failures in oral implantology].

    PubMed

    Niang, P; Ba, A; Dia, Tine S; Tamba, B; Gassama, Barry B C; Diallo, B

    2011-09-01

    It has become increasingly common for diabetic patients to be considered as candidates for dental implants. However even though success rates of implant therapy in diabetic are high, this does not preclude failures. Failure to osseointegrate in the initial healing phase results in a fibrous tissue encapsulation of the implant and clinical mobility, leading ultimately to the failure of the implant. This review presents the current knowledge regarding the effect of diabetes mellitus on the osseointegration of implants including pathophysiologic aspects as well as their potential implications on bone metabolism and osseointegration, implant success rate at the second-phase surgery and guidelines for pre and post-operative management. In experimental models of diabetes mellitus, a reduced level of bone-implant contact has been shown, and this can be reversed by means of treatment with insulin. Compared with the general population, a higher failure rate is seen in diabetic patients. Most of these occur at the second-phase surgery, seemingly pointing to the microvascular complications of this condition as a possible causal factor. It is necessary to take certain special considerations into account for the placement of implants in diabetic patient. A good control of plasma glycemia, together with other measures, has been shown to improve the percentages of implant survival in these patients.

  13. Diabetes mellitus and its effects on menarche.

    PubMed

    Schriock, E A; Winter, R J; Traisman, H S

    1984-04-01

    In a combined mail and medical record survey of 121 non-diabetic and 90 diabetic girls greater than or equal to 9 years of age, the mean age of menarche in the control non-diabetic population was 13.0 +/- 1.2 years and 13.4 +/- 1.2 years in the diabetics. The diabetic group was divided into those whose onset was before or after age 11 years (DM less than 11, DM greater than or equal to 11). The DM greater than or equal to 11 group had a mean menarchal age of 14.0 +/- 1.2 years and the DM less than 11 group, 13.1 +/- 1.2 (p less than 0.005). The DM greater than or equal to 11 group also differed significantly from the control group. The difference between the two groups suggests that the onset of diabetes near the onset of puberty may have a more disruptive effect on hypothalamic-pituitary-gonadal axis maturation that does the prepubertal onset of diabetes.

  14. Gestational diabetes mellitus among African-American women.

    PubMed

    Roseman, J M; Go, R C; Perkins, L L; Barger, B D; Bell, D H; Goldenberg, R L; DuBard, M B; Huddleston, J F; Sedlacek, C M; Acton, R T

    1991-06-01

    Gestational diabetes mellitus (GDM) is associated with increased risk of poor outcomes for the pregnancy. It is a strong risk factor for subsequent diabetes. The epidemiology of GDM in African-American women is not well known. It has not been demonstrated that their risk factors are similar in character and weight to those among White women. There is considerable multicollinearity among GDM risk factors such as age, parity, obesity, hypertension, and family history of diabetes, and this needs to be sorted out. This review is based on the results of a nested case-control study to evaluate the frequency of, and the relationships of the known risk factors with, the onset of GDM among African-American women. All cases of GDM within a cohort of women seen at any of the county health department clinics in Jefferson County, Alabama from 1981 to 1987 were identified. The cohort represents approximately 63% of all African-American pregnancies in the county during the period. With few exceptions (5.1% based on fasting plasma glucose greater than or equal to 120 mg/dl), potential GDM cases (7.1%) were selected on the basis of a 2 h post 100 g carbohydrate meal screening plasma glucose measure at their second prenatal visit and again at 28-32 weeks greater than or equal to 115 mg/dl and diagnosed on the basis of the results of an oral glucose tolerance test (OGTT) using the criteria of O'Sullivan and Mahan. Women with any prior history of diabetes (even in pregnancy), 1.6%, were excluded. The frequency of the new diagnosis of GDM among African-American women in this pregnancy in the cohort was 2.5% of pregnancies and 3.4% of women, which is similar to the values reported in the other studies. Controls were selected from women with negative screening tests who delivered after a GDM subject. The results reported in this paper reflect 358 cases (86% of all eligible GDM cases identified) and 273 controls. Cases were significantly older (28.3 vs. 21.7 years), of higher gravidity (2

  15. Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations.

    PubMed

    Low Wang, Cecilia C; Hess, Connie N; Hiatt, William R; Goldfine, Allison B

    2016-06-14

    Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting. PMID:27297342

  16. Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations.

    PubMed

    Low Wang, Cecilia C; Hess, Connie N; Hiatt, William R; Goldfine, Allison B

    2016-06-14

    Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting.

  17. Measurement of β-hydroxybutyrate in cats with nonketotic diabetes mellitus, diabetic ketosis, and diabetic ketoacidosis.

    PubMed

    Weingart, Christiane; Lotz, Fabian; Kohn, Barbara

    2012-03-01

    Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM). The standard method of detection of ketone bodies is the dipstick method, which detects semiquantitatively acetoacetate, but not β-hydroxybutyrate (β-HB). The objectives of the current study were to assess the diagnostic utility of β-HB to diagnose diabetic ketosis (DK) and DKA in cats and to establish a cut-off value for the diagnosis of DKA. Sixty-two cats were included in the study. Eleven cats were healthy (group 1); in the remainder of cats (51), a diagnosis of DM was based on hyperglycemia, glucosuria, and increased fructosamine concentrations. Nineteen of 51 cats suffered from nonketotic diabetes mellitus (group 2). In 11 cats, plasma ketone bodies were detected with the dipstick method (diabetic ketosis, group 3). In 21 cats, plasma ketone bodies and metabolic acidosis were present (DKA, group 4). Plasma β-HB was measured in all cats by an enzymatic method (spectrophotometry). A cut-off value for the diagnosis of DKA was calculated based on the receiver operating characteristic curve. In healthy cats, the β-HB concentration ranged from 0 to 0.1 mmol/l; in cats of group 2, from 0 to 0.9 mmol/l (median: 0.1 mmol/l); in cats of group 3, from 0.6 to 6.8 mmol/l (median: 1.7 mmol/l); and in cats of group 4, from 3.8 to 12.2 mmol/l (median: 7.9 mmol/l). A cut-off value of 2.4 mmol/l revealed 100% sensitivity and 87% specificity to diagnose DKA. Beta-hydroxybutyrate is a useful parameter for the diagnosis of diabetic ketosis and DKA in cats.

  18. Effect of diet on type 2 diabetes mellitus: a review.

    PubMed

    Khazrai, Y M; Defeudis, G; Pozzilli, P

    2014-03-01

    Type 2 diabetes mellitus is one of the fastest growing diseases; the number of people affected by diabetes will soon reach 552 million worldwide, with associated increases in complications and healthcare expenditure. Lifestyle and medical nutrition therapy are considered the keystones of type 2 diabetes prevention and treatment, but there is no definite consensus on how to treat this disease with these therapies. The American Diabetes Association has made several recommendations regarding the medical nutrition therapy of diabetes; these emphasize the importance of minimizing macrovascular and microvascular complications in people with diabetes. Four types of diets were reviewed for their effects on diabetes: the Mediterranean diet, a low-carbohydrate/high-protein diet, a vegan diet and a vegetarian diet. Each of the four types of diet has been shown to improve metabolic conditions, but the degree of improvement varies from patient to patient. Therefore, it is necessary to evaluate a patient's pathophysiological characteristics in order to determine the diet that will achieve metabolic improvement in each individual. Many dietary regimens are available for patients with type 2 diabetes to choose from, according to personal taste and cultural tradition. It is important to provide a tailor-made diet wherever possible in order to maximize the efficacy of the diet on reducing diabetes symptoms and to encourage patient adherence. Additional randomized studies, both short term (to analyse physiological responses) and long term, could help reduce the multitude of diets currently recommended and focus on a shorter list of useful regimens.

  19. Shoulder limited joint mobility in people with diabetes mellitus

    PubMed Central

    Shah, Kshamata M.; Clark, B. Ruth; McGill, Janet B.; Lang, Catherine E.; Mueller, Michael J.

    2015-01-01

    Background Limited joint mobility at the shoulder is an understudied problem in people with diabetes mellitus. The purpose of this study was to determine the differences in shoulder kinematics between a group with diabetes and those without diabetes. Methods Fifty-two participants were recruited, 26 with diabetes and 26 non-diabetes controls (matched for age, BMI and sex). Three-dimensional position of the trunk, scapula and humerus were collected using electromagnetic tracking sensors during scapular plane elevation and rotation movements. Findings Glenohumeral external rotation was reduced by 11.1° – 16.3° (P<0.05) throughout the humerothoracic elevation range of motion, from neutral to peak elevation, in individuals with diabetes as compared to controls. Peak humerothoracic elevation was decreased by 10–14°, and peak external rotation with the arm abducted was decreased 22° in the diabetes group compared to controls (P<0.05). Scapulothoracic and glenohumeral internal rotation motions were not different between the two groups. Interpretation Shoulder limited joint mobility, in particular decreased external rotation, was seen in individuals with diabetes as compared to control participants. Future research should investigate causes of diabetic limited joint mobility and strategies to improve shoulder mobility and prevent additional detrimental changes in movement and function. PMID:25595462

  20. Type 2 diabetes mellitus in children and adolescents: a review from a European perspective.

    PubMed

    Kiess, W; Böttner, A; Raile, K; Kapellen, T; Müller, G; Galler, A; Paschke, R; Wabitsch, M

    2003-01-01

    Changes in food consumption and exercise are fueling a worldwide increase in obesity in children and adolescents. As a consequence of this dramatic development, an increasing rate of type 2 diabetes mellitus has been recorded in children and adolescents in the USA and, more recently, in many countries around the world. Both genetic and environmental factors contribute to the pathogenesis of type 2 diabetes. Lower susceptibility in white Caucasians and higher susceptibility in Asians, Hispanics and blacks have been noted. There is a high hidden prevalence and a lack of exact data on the epidemiology of the disease in Europe: in Germany only 70 patients below the age of 15 years were identified in the systematic, nationwide DPV (Diabetessoftware für prospektive Verlaufsdokumentation) diabetes survey, but our calculations suggest that more than 5000 young people in Germany at present would meet the diagnostic criteria of type 2 diabetes. In Australasia, the prevalence of type 2 diabetes is reportedly high in some ethnic groups and again is linked very closely to the obesity epidemic. No uniform and evidence-based treatment strategy is available: many groups use metformin, exercise programmes and nutritional education as a comprehensive approach to treat type 2 diabetes in childhood and adolescence. The lack of clear epidemiological data and a strong need for accepted treatment strategies point to the key role of preventive programmes. Prevention of obesity will help to counteract the emerging worldwide epidemic of type 2 diabetes in youth. Preventive programmes should focus on exercise training and reducing sedentary behaviour such as television viewing, encouraging healthy nutrition and supporting general education programmes since shorter school education is clearly associated with higher rates of obesity and hence the susceptibility of an individual to acquire type 2 diabetes.

  1. Zinc and type 2 diabetes mellitus with periodontitis – a systematic review.

    PubMed

    Pushparani, D S

    2014-01-01

    Diabetes mellitus has been increasing rapidly worldwide, making it a huge health pressure on society in both the developed and developing countries. During the last thirty years, diabetes mellitus, a chronic metabolic disease characterized by hyperglycemia is proving itself to be fatal. Periodontitis was considered as one of the main, oral health problems encountered in patients with diabetes mellitus. There exists a direct relation between the risk of complications of diabetes and periodontitis over time. The present review gives an outline of the features that govern the interrelationship between zinc and diabetes mellitus with periodontal disease, including the physiologic mechanisms and clinical studies, and presents scientific evidences. The disturbance in the zinc micronutrient and increased oxidative stress in type 2 diabetes may bring about insulin resistance and the creation of diabetic complications. The progression of diabetes mellitus may bring about perturbation in micronutrient metabolism and status.

  2. Variation of plantar pressure in Chinese diabetes mellitus.

    PubMed

    Yang, Chuan; Xiao, Huisheng; Wang, Chuan; Mai, LiFang; Liu, Dan; Qi, Yiqing; Ren, Meng; Yan, Li

    2015-01-01

    To investigate dynamic changes in plantar pressure in Chinese diabetes mellitus patients and to provide a basis for further preventing diabetic foot. This is a cross-sectional investigation including 649 Chinese diabetes mellitus patients (diabetes group) and 808 "normal" Chinese persons (nondiabetes group) with normal blood glucose levels. All the subjects provided a complete medical history and underwent a physical examination and a 75-g oral glucose tolerance test. All subjects walked barefoot with their usual gait, and their dynamic plantar forces were measured using the one-step method with a plantar pressure measurement instrument; 5 measurements were performed for each foot. No significant differences were found in age, height, body weight, or body mass index between the two groups. The fasting blood glucose levels, plantar contact time, maximum force, pressure-time integrals and force-time integrals in the diabetes group were significantly higher than those in the nondiabetes group (p < 0.05). However, the maximum pressure was significantly higher in the nondiabetes group than in the diabetes group (p < 0.05). No difference was found in the contact areas between the two groups (p > 0.05). The maximum plantar force distributions were essentially the same, with the highest force found for the medial heel, followed by the medial forefoot and the first toe. The peak plantar pressure was located at the medial forefoot for the nondiabetes group and at the hallucis for the diabetes group. In the diabetes group, the momentum in each plantar region was higher than that in the nondiabetes group; this difference was especially apparent in the heel, the lateral forefoot and the hallucis. The dynamic plantar pressures in diabetic patients differ from those in nondiabetic people with increased maximum force and pressure, a different distribution pattern and significantly increased momentum, which may lead to the formation of foot ulcers.

  3. Evaluation of thyroid function in diabetes mellitus in Calabar, Nigeria.

    PubMed

    Udiong, C E J; Udoh, A E; Etukudoh, M E

    2007-09-01

    The prevalence of abnormal thyroid hormone levels in diabetes mellitus in Nigeria is not well described. To determine the incidence of abnormal thyroid hormone levels in diabetics in Calabar, Nigeria, fasting blood samples from 161 diabetic subjects and 105 non-diabetic controls were analysed. Free thyroxine (FT), thyroid stimulating hormone (TSH), total triiodothyronine (T(3)) and total thyroxine (T(4)) kits obtained from Biomerica Inc. of USA were used for the analysis. TSH levels (1.80±1.62) in diabetics were significantly lower (p=0.016) than the level in non-diabetic controls (2.34±1.24). Male diabetics had lower (p<0.05) levels of TSH (1.192±0.68 miu/ml) than diabetic females (1.90±1.70 mlu/mt). The level of T(3) in diabetic males (125±97ng/ml) was higher than the level in females (98±75ng/dl). TSH (F=2.74, p=0.049), T(4)(F=56.87, p=0.001), T(3)(F=56.44, P=0.001) in diabetics and FT(4) (F=5.74, p=0.002) in controls showed significant variation with the ages of the subjects. Out of 161 diabetics subjects studies 26.6% had low plasma thyroid hormone levels (FT(4)>2.01 ng/dl). This study has shown a high incidence (46.5%) of abnormal thyroid hormone levels among the diabetics in Nigeria (hypothyroidism 26.6%, hyperthyroidism, 19.9%). The prevalence of hypothyroidism was higher in women (16.8%) than in men (9.9%), while hyperthyroidism was higher in males (11%) than in females (8%). This study has defined thyroid function status of diabetics in Calabar, Nigeria probably the first of such work in Africa. PMID:23105687

  4. Differential impact of non-insulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus on breast reconstruction outcomes.

    PubMed

    Qin, Charles; Vaca, Elbert; Lovecchio, Francis; Ver Halen, Jon P; Hansen, Nora M; Kim, John Y S

    2014-07-01

    While the comparative safety of breast reconstruction in diabetic patients has been previously studied, we examine the differential effects of insulin and non-insulin-dependence on surgical/medical outcomes. Patients undergoing implant/expander or autologous breast reconstruction were extracted from the National Surgical Quality Improvement Program 2005-2012 database. Preoperative and postoperative variables were analyzed using chi-square and Student's t test as appropriate. Multivariate regression modeling was used to evaluate whether non-insulin-dependent diabetes mellitus (NIDDM) or insulin-dependent diabetes mellitus (IDDM) is independently associated with adverse 30-day events following breast reconstruction. Of 29,736 patients meeting inclusion criteria, 23,042 (77.5 %) underwent implant/expander reconstructions, of which 815 had NIDDM and 283 had IDDM. Of the 6,694 (22.5 %) patients who underwent autologous reconstructions, 286 had NIDDM and 94 had IDDM. Rates of overall and surgical complications significantly differed among non-diabetic, NIDDM and IDDM patients in both the implant/expander and autologous cohorts on univariate analysis. After multivariate analysis, NIDDM was significantly associated with surgical complications (OR 1.511); IDDM was significantly associated with medical (OR 1.815) and overall complications (OR 1.852); and any type of diabetes was significantly associated with surgical (OR 1.58) and overall (OR 1.361) complications after autologous reconstruction. Diabetes of any type was not associated with any type of complication after implant/expander reconstruction. In this large, multi-institutional study, diabetes mellitus was significantly associated with adverse outcomes after autologous, but not implant-based breast reconstruction. The multivariate analysis in this study adds granularity to the differential effects of NIDDM and IDDM on complication risk.

  5. Fungal Esophagitis in a Child with Insulin Dependent Diabetes Mellitus.

    PubMed

    Saeed, Anjum; Assiri, Asaad; Zaidi, Zafar; Alsheikh, Abdulmalik

    2016-08-01

    Esophagitis in children is not uncommon, mostly due to gastro-esophageal reflux. Other conditions like eosinophilic and infective esophagitis need to be elucidated in differential diagnoses. Fungal orCandida esophagitisusually occurs in high risk children who are immune-compromised, malnourished, on steroid therapy or have uncontrolled diabetes mellitus. An eleven-year girl presented with uncontrolled type I diabetes mellitus and recurrent epigastric pain with vomiting. Her oral intake was satisfactory. There was no dysphagia and odynophagia. Physical examination was normal with good oral hygiene. Failure in responding to conventional medications led to endoscopic evaluation, which revealed white patches and esophageal inflammation and diagnosed as fungal esophagitis on histopathology. Although infective esophagitis is encountered sporadically in pediatric age group, but it should always be considered in high risk individuals and when conventional medication fails to resolve the symptoms. PMID:27539771

  6. Review of gestational diabetes mellitus effects on vascular structure and function.

    PubMed

    Jensen, Louise A; Chik, Constance L; Ryan, Edmond A

    2016-05-01

    Vascular dysfunction has been described in women with a history of gestational diabetes mellitus. Furthermore, previous gestational diabetes mellitus increases the risk of developing Type 2 diabetes mellitus, a risk factor for cardiovascular disease. Factors contributing to vascular changes remain uncertain. The aim of this review was to summarize vascular structure and function changes found to occur in women with previous gestational diabetes mellitus and to identify factors that contribute to vascular dysfunction. A systematic search of electronic databases yielded 15 publications from 1998 to March 2014 that met the inclusion criteria. Our review confirmed that previous gestational diabetes mellitus contributes to vascular dysfunction, and the most consistent risk factor associated with previous gestational diabetes mellitus and vascular dysfunction was elevated body mass index. Heterogeneity existed across studies in determining the relationship of glycaemic levels and insulin resistance to vascular dysfunction.

  7. The Therapeutic Effect of Zuogui Wan in Gestational Diabetes Mellitus Rats

    PubMed Central

    Feng, Qianjin; Niu, Xin; Liu, Xinshe; Xu, Kaixia; Yang, Xiangzhu; Wang, Huifeng

    2014-01-01

    In this experiment, we established an animal model of gestational diabetes mellitus rats using streptozotocin. Using the rat model of GDM, the pregnant rats in 1-19d were divided into three groups: (1) Zuogui Wan gestational diabetes mellitus group (group I, n = 12), (2) gestational diabetes mellitus rats as the control group (group II, n = 11), and (3) rats of normal pregnancy group (group III, n = 11). Compared with gestational diabetes mellitus rats as the control group, Zuogui Wan can change the indexes of fasting blood glucose, body weight, total cholesterol, insulin, and metabolism cage index significantly in Zuogui Wan gestational diabetes mellitus group. We can conclude that Zuogui Wan has the therapeutic effect on gestational diabetes mellitus. PMID:25136475

  8. Seasonal variations of severe hypoglycemia in patients with type 1 diabetes mellitus, type 2 diabetes mellitus, and non-diabetes mellitus: clinical analysis of 578 hypoglycemia cases.

    PubMed

    Tsujimoto, Tetsuro; Yamamoto-Honda, Ritsuko; Kajio, Hiroshi; Kishimoto, Miyako; Noto, Hiroshi; Hachiya, Remi; Kimura, Akio; Kakei, Masafumi; Noda, Mitsuhiko

    2014-11-01

    Blood glucose control in patients with diabetes mellitus (DM) is reportedly influenced by the seasons, with hemoglobin A1c (HbA1c) levels decreasing in the summer or warm season and increasing in the winter or cold season. In addition, several studies have shown that sepsis is also associated with the seasons. Although both blood glucose control and sepsis can strongly affect the occurrence of severe hypoglycemia, few studies have examined the seasonal variation of severe hypoglycemia. The aim of the present study is to examine the association between severe hypoglycemia and the seasons in patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and non-diabetes mellitus (non-DM). We retrospectively reviewed all the patients with severe hypoglycemia at a national center in Japan between April 1, 2006 and March 31, 2012. A total of 57,132 consecutive cases that had visited the emergency room by ambulance were screened, and 578 eligible cases of severe hypoglycemia were enrolled in this study. The primary outcome was to assess the seasonality of severe hypoglycemia. In the T1DM group (n  =  88), severe hypoglycemia occurred significantly more often in the summer than in the winter (35.2% in summer vs 18.2% in winter, P  =  0.01), and the HbA1c levels were highest in the winter and lowest in the summer (9.1% [7.6%-10.1%] in winter vs 7.7% [7.1%-8.3%] in summer, P  =  0.13). In the non-DM group (n  =  173), severe hypoglycemia occurred significantly more often in the winter than in the summer (30.6% in winter vs 19.6% in summer, P  =  0.01), and sepsis as a complication occurred significantly more often in winter than in summer (24.5% in winter vs 5.9% in summer, P  =  0.02). In the T2DM group (n  =  317), the occurrence of severe hypoglycemia and the HbA1c levels did not differ significantly among the seasons. The occurrence of severe hypoglycemia might be seasonal and might fluctuate with temperature changes

  9. Update on blood pressure goals in diabetes mellitus.

    PubMed

    Laffin, Luke J; Bakris, George L

    2015-06-01

    The most recent guideline statements by the 2014 Expert Panel of the National Institutes of Health as well as the American and International Societies of Hypertension recommend a blood pressure goal of <140/90 mmHg in patients with diabetes mellitus. This follows prior guidelines that recommended lower BP treatment goals of <130/80 mmHg in patients with diabetes. Reducing cardiovascular morbidity and mortality by trying to achieve recommended goals of risk factors like blood pressure, glucose, and cholesterol in patients with diabetes is paramount. Data from multiple trials demonstrates that early treatment of hypertension in people with diabetes clearly prevents both macrovascular and microvascular complications, but the goal blood pressure that should be achieved is now modified to a higher level. We address the evidence and evolution of how and why this blood pressure goal has changed in recent years.

  10. [Comprehensive geriatric assessment in older patients with diabetes mellitus].

    PubMed

    Araki, Atsushi

    2013-11-01

    Because the prevalence of older old patients with diabetes is increasing in Japan, diabetic patients with physical or cognitive impairment are also becoming to be more prevalent in clinical practice. The comprehensive geriatric assessment (CGA) consists of 5 important domains: physical function (basic ADL, instrumental ADL, vision, etc.), psychological function, mental function, socio-economic conditions, and patient's preference. The functions in CGA can be used as predictors for prognosis, a tool for early diagnosis of dementia, assessment tool of patient's capacity for insulin self-injection, and outcomes of diabetes treatment. The CGA is also useful in performing a patient-centered approach to improve the physical, psychological, and mental functions as well as to individualize a treatment goal of HbA1c in elderly patients with diabetes mellitus.

  11. Ayurveda for diabetes mellitus: a review of the biomedical literature.

    PubMed

    Elder, Charles

    2004-01-01

    Diabetes mellitus is a condition that is extremely serious from both clinical and public health standpoints. The traditional healthcare system of India, Ayurveda, offers a balanced and holistic multi-modality approach to treating this disorder. Many Ayurvedic modalities have been subjected to empirical scientific evaluation, but most such research has been done in India, receiving little attention in North America. This paper offers a review of the English language literature related to Ayurveda and diabetes care, encompassing herbs, diet, yoga, and meditation as modalities that are accessible and acceptable to Western clinicians and patients. There is a considerable amount of data from both animal and human trials suggesting efficacy of Ayurvedic interventions in managing diabetes. However, the reported human trials generally fall short of contemporary methodological standards. More research is needed in the area of Ayurvedic treatment of diabetes, assessing both whole practice and individual modalities.

  12. [Diabetes mellitus: from clinical knowledge to public health concern].

    PubMed

    Scheen, André J

    2007-01-01

    Diabetes mellitus is a chronic disease whose prevalence is increasing worldwide. It remains associated with a high risk of severe complications, essentially micro- and macro-vascular complications. Type 1 diabetes is an auto-immune disease that leads to the destruction of insulin-secreting B cells and therefore requires an intensive optimised exogenous insulin therapy. Type 2 diabetes is a polygenic disease whose expression is favoured by inadequate lifestyle, leading to obesity. It combines a relative insulin secretory defect and insulin resistance, the latter being associated with various other cardiovascular risk factors. Treatment consists of lifestyle modifications first, then the prescription of various glucose-lowering oral drugs and finally, when requested, insulin therapy. A multi-risk intervention is mandatory to improve the cardiovascular prognosis. The prevention of diabetes and its complications is a major public health objective.

  13. [Insulinization in type 2 diabetes mellitus. Intensification options].

    PubMed

    Fuente, Graciela V; Sinay, Isaac; Costa Gil, José E; Puchulu, Félix; Dieuzeide, Guillermo; Rodríguez, Martín; Faingold, María C; Litwak, León E

    2016-01-01

    Diabetes mellitus is associated with vascular complications and high rates of morbidity and mortality. Timely insulin therapy, intensified when necessary, represent appropriate measures to prevent or delay the onset of complications. However, the incidence of hypoglycemia and difficulties in treatment adherence represent barriers to achieve therapeutic success. Premixes analogs and, specially, combinations of insulin analogues are associated with pharmacokinetic and pharmacodynamic advantages, that translate into clinical benefits such as improved metabolic control, decreased hypoglycemic events and, for their simplicity, potentially greater adherence.

  14. Diabetes mellitus may induce cardiovascular disease by decreasing neuroplasticity

    PubMed Central

    Zheng, Zhihua; Wu, Junyan; Wang, Ruolun; Zeng, Yingtong

    2014-01-01

    Summary Neuroplasticity has been defined “the ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its structure, function and connections”. The nervous system monitors and coordinates internal organ function. Thus neuroplasticity may be associated with the pathogenesis of other diseases besides neuropsychiatric diseases. Decreased neuroplasticity is associated with cardiovascular disease (CVD) and a disease related to decreased neuroplasticity may confer a greater CVD risk. Diabetes mellitus (DM) is related to CVD and DM induces decreased neuroplasticity, which is manifested as depression, Alzheimer’s disease and diabetic neuropathy. Therefore we conclude that DM may induce CVD by decreasing neuroplasticity. PMID:25014044

  15. [Autoimmune diseases in type 1A diabetes mellitus].

    PubMed

    Ferreira-Hermosillo, Aldo; Molina-Ayala, Mario Antonio

    2015-08-01

    Type 1A diabetes (DM1A) is an autoimmune disease that comprises 10% of patients with diabetes mellitus. Its frequency is gradually increasing in countries like Mexico. Patients with DM1A commonly have hypothyroidism, Addison disease, celiac disease and less common diseases such as polyglandular syndrome. These diseases are related to susceptibility genes such as HLA, CTLA-4 and PTPN22, which induce central and peripheral immunologic tolerance. This review article emphasizes the importance of searching other autoimmune diseases in patients with DM1A, to improve their prognosis and quality of life.

  16. Involvement of central nervous system in diabetes mellitus.

    PubMed Central

    Verma, A; Bisht, M S; Ahuja, G K

    1984-01-01

    Brainstem auditory evoked responses were recorded in 22 diabetic patients with a variable duration of illness (mean 5.8 years) and 14 normal healthy controls of comparable age. The initial 10 millisecond components, found to be most consistent and reproducible, were analysed. Variations in the form of individual wave latency, interpeak latencies and V wave amplitude were compared in both the groups. No difference was found in any of the parameters. It was concluded that central neural pathways are not involved at least initially in diabetes mellitus. PMID:6726270

  17. Myo-Inositol Supplementation to Prevent Gestational Diabetes Mellitus.

    PubMed

    Celentano, Claudio; Matarrelli, Barbara; Mattei, Peter A; Pavone, Giulia; Vitacolonna, Ester; Liberati, Marco

    2016-03-01

    Gestational diabetes mellitus (GDM) is a common complication characterized by increased insulin resistance, and by increased risk for adverse pregnancy outcomes affecting both the mother and the fetus. International guidelines describe optimal ways to recognize it, and the recommended treatment of patients affected to reduce adverse outcomes. Improving insulin resistance could reduce incidence of GDM and its complications. Recently, a few trials have been published on the possible prevention of GDM. Inositol has been proposed as a food supplement that might reduce gestational diabetes incidence in high-risk pregnant women. PMID:26898405

  18. Myo-Inositol Supplementation to Prevent Gestational Diabetes Mellitus.

    PubMed

    Celentano, Claudio; Matarrelli, Barbara; Mattei, Peter A; Pavone, Giulia; Vitacolonna, Ester; Liberati, Marco

    2016-03-01

    Gestational diabetes mellitus (GDM) is a common complication characterized by increased insulin resistance, and by increased risk for adverse pregnancy outcomes affecting both the mother and the fetus. International guidelines describe optimal ways to recognize it, and the recommended treatment of patients affected to reduce adverse outcomes. Improving insulin resistance could reduce incidence of GDM and its complications. Recently, a few trials have been published on the possible prevention of GDM. Inositol has been proposed as a food supplement that might reduce gestational diabetes incidence in high-risk pregnant women.

  19. Telecare for diabetes mellitus: case managers' experiences.

    PubMed

    Chang, Chi-Ping; Lee, Ting-Ting; Chou, Chun-Chen; Mills, Mary Etta

    2013-10-01

    Diabetes is a metabolic disorder that, if not treated promptly and appropriately, can cause complex health complications and mortality. Changes in societal structure have fostered an increase in the incidence of diabetes and made the traditional hospital visit model less efficient for meeting the care needs of these patients. The care models that apply technology, such as telecare or so-called telehealth, may be useful in working with diabetes patients. The current study applied qualitative research methodology through interviews with nine diabetes case managers involved in telecare services. To identify the participants' acceptance and perceived effectiveness of telecare services, content analysis of the interview data was used. The following four major themes were identified in the study results: (1) improved case management, (2) setting appropriate expectations for care outcome, (3) acknowledging patients' sense of losing privacy, and (4) disease prevention and interdisciplinary cooperation. The study findings may serve as an indicator of the need for further promotion, appraisal, and validation of the telecare services model, to enhance the comprehensiveness of diabetes care.

  20. Diabetes mellitus in patients with cystic fibrosis.

    PubMed

    Alves, Crésio de Aragão Dantas; Aguiar, Renata Arruti; Alves, Ana Cláudia S; Santana, Maria Angélica

    2007-01-01

    Cystic fibrosis-related diabetes (CFRD) is the principal extra-pulmonary complication of cystic fibrosis, occurring in 15-30% of adult cystic fibrosis patients. The number of cystic fibrosis patients who develop diabetes is increasing in parallel with increases in life expectancy. The aim of this study was to review the physiopathology, clinical presentation, diagnosis and treatment of CFRD. A bibliographic search of the Medline and Latin American and Caribbean Health Sciences Literature databases was made. Articles were selected from among those published in the last twenty years. Insulin deficiency, caused by reduced beta-cell mass, is the main etiologic mechanism, although insulin resistance also plays a role. Presenting features of type 1 and type 2 diabetes, CFRD typically affects individuals of approximately 20 years of age. It can also be accompanied by fasting, non-fasting or intermittent hyperglycemia. Glucose intolerance is associated with worsening of nutritional status, increased morbidity, decreased survival and reduced pulmonary function. Microvascular complications are always present, although macrovascular complications are rarely seen. An oral glucose tolerance test is recommended annually for patients > or = 10 years of age and for any patients presenting unexplained weight loss or symptoms of diabetes. Patients hospitalized with severe diseases should also be screened. If fasting hyperglycemia persists for more than 48 h, insulin therapy is recommended. Insulin administration remains the treatment of choice for diabetes and fasting hyperglycemia. Calories should not be restricted, and patients with CFRD should be managed by a multidisciplinary team. PMID:17724542

  1. [Simvastatin's effect on insulin resistance in rats with diabetes mellitus].

    PubMed

    Iskakova, S; Zharmakhanova, G; Bekmukhambetov, Y; Dworacka, M; Dworacki, G

    2015-05-01

    The aim of this experimental study was to estimate the effect of Simvastatin on glycemic variability-related insulin resistance in the course of diabetes mellitus (DM) in rats. Fifty seven male Wistar rats were divided into four groups: I - rats with diabetes mellitus and glycemic variability treated with Simvastatin (20 mg/kg body weight, intragastral during 8 weeks); II - placebo-treated rats with DM and glycemic variability; III - placebo treated rats with DM and IV - nondiabetic control rats. DM was induced by feeding rats with high-fat diet (61%) during five weeks and low-dose of Streptozotocin (30 mg/kg, intraperitoneally). Daily glucose excursions were stimulated by feeding animals twice a day. We measured fasting blood glucose, glycated hemoglobin (HbA1c), insulin and HOMAIR was calculated. Higher insulin resistance in diabetic rats is related to greater daily glycemic variability. In our study was installed significant increasing HOMAIR in diabetics rats with glycemic excursions comparison with the control. Our results showed that the simvastatin-treatment decreases the indices glycemic variability and HOMA in diabetic rats with glycemic excursions.

  2. Focus on migrants with type 2 diabetes mellitus in European Countries.

    PubMed

    Testa, Roberto; Bonfigli, Anna Rita; Genovese, Stefano; Ceriello, Antonio

    2016-04-01

    The prevalence of type 2 diabetes mellitus, one of the major causes of morbility and mortality in Europe, is increasing in all European countries. Diabetes is not distributed equally among all population groups, as higher incidence, appearance of complications, and different mortality rates have been observed among migrants and the native population. These differences may be due to genetic profiles, lifestyle, and utilization of the health care system in different ways. Taking into account that the quantity of migrants is nowadays increasing, mainly in the southern part of Europe, the knowledge of diabetes in migrants through a better collection of data is necessary, considering that few limited epidemiological studies have evaluated the importance of this problem in EU countries. A special effort in developing a comprehensive management for native and immigrant populations in order to prevent and cure diabetes should be mandatory. This activity could be helpful to limit the incidence of future diabetes complications and to avoid the consequent burden of the health care system along with a control on its costs. It is clear that diabetes complication prevention is essential for long-term sustainability of the health care system.

  3. Vaccination of patients with diabetes mellitus--a retrospective study.

    PubMed

    Mad'ar, Rastislav; Benesová, Dagmar; Brandejská, Dana; Cermáková, Miriam; Dvorková, Alena; Gazárková, Olga; Jakubalová, Silvana; Kochová, Ilona; Lastovicková, Jana; Nebáznivá, Dagmar; Orolinová, Marta; Polomis, Karel; Rehka, Václav; Sattranová, Ludmila; Schejbalová, Miriam; Slámová, Alena; Skalleová, Deanna; Sevcíková, Hana; Tkadlecová, Hana; Tmejová, Marta; Trmal, Josef; Turková, Dagmar

    2011-06-01

    402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated'against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%)--- 5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient. Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any ri-k- provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent. There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.

  4. Metabolic neuroimaging of the brain in diabetes mellitus and hypoglycaemia.

    PubMed

    Cheah, Yee-Seun; Amiel, Stephanie A

    2012-10-01

    Functional neuroimaging techniques can be used to study changes in regional brain activation, using changes in surrogate markers such as regional cerebral perfusion and rates of glucose uptake or metabolism. These approaches are shedding new light on two major health problems: the increasing burden of type 2 diabetes mellitus (T2DM), which is driven by the rising prevalence of insulin resistance and obesity; and recurrent intractable problematic hypoglycaemia, which is driven by the cognitive impairment that can occur in association with iatrogenic hypoglycaemic episodes. Some patients with diabetes mellitus lose awareness of being hypoglycaemic, which puts them at risk of severe hypoglycaemia as they are unlikely to take action to prevent the condition worsening. Involvement of corticolimbic brain and centres serving higher executive functions as well as the hypothalamus has been demonstrated in both situations and has implications for therapy. This Review describes the relevant principles of functional neuroimaging techniques and presents data supporting the notion that the dysregulation of central pathways involved in metabolic regulation, reward and appetite could contribute to problematic hypoglycaemia during therapy for diabetes mellitus and to insulin-resistant obesity and T2DM. Understanding these dysregulations could enable the development of novel clinical interventions.

  5. Influence of Bisphenol A on Type 2 Diabetes Mellitus

    PubMed Central

    Provvisiero, Donatella Paola; Pivonello, Claudia; Muscogiuri, Giovanna; Negri, Mariarosaria; de Angelis, Cristina; Simeoli, Chiara; Pivonello, Rosario; Colao, Annamaria

    2016-01-01

    Bisphenol A (BPA) is an organic synthetic compound employed to produce plastics and epoxy resins. It is used as a structural component in polycarbonate beverage bottles and as coating for metal surface in food containers and packaging. The adverse effects of BPA on human health are widely disputed. BPA has been recently associated with a wide variety of medical disorders and, in particular, it was identified as potential endocrine-disrupting compound with diabetogenic action. Most of the clinical observational studies in humans reveal a positive link between BPA exposure, evaluated by the measurement of urinary BPA levels, and the risk of developing type 2 diabetes mellitus. Clinical studies on humans and preclinical studies on in vivo, ex vivo, and in vitro models indicate that BPA, mostly at low doses, may have a role in increasing type 2 diabetes mellitus developmental risk, directly acting on pancreatic cells, in which BPA induces the impairment of insulin and glucagon secretion, triggers inhibition of cell growth and apoptosis, and acts on muscle, hepatic, and adipose cell function, triggering an insulin-resistant state. The current review summarizes the available evidences regarding the association between BPA and type 2 diabetes mellitus, focusing on both clinical and preclinical studies. PMID:27782064

  6. Evidence for current diagnostic criteria of diabetes mellitus

    PubMed Central

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications. PMID:27660696

  7. Evidence for current diagnostic criteria of diabetes mellitus.

    PubMed

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-09-15

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications. PMID:27660696

  8. Evidence for current diagnostic criteria of diabetes mellitus

    PubMed Central

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

  9. [Progress in treating diabetes mellitus with adult stem cells].

    PubMed

    Zhang, Lixin; Teng, Chunbo; An, Tiezhu

    2008-02-01

    Diabetes mellitus is a metabolic diseases, mainly including type 1 and type 2 diabetes. Treatment for type 1 and part of type 2 often involves regular insulin injection. However, this treatment neither precisely controls the blood sugar levels, nor prevents the diabetes complications. Transplantation of islets of Langerhans offers an attractive strategy for diabetes therapies, but its wide application has been limited by donor shortage and immunological rejection after transplantation. Stem cells with strong proliferation capacity and multipotential may be potential cell sources in diabetes therapies. For this, adult stem cells are interesting because of absence of teratoma formation and ethnical problems. Adult pancreatic stem cells (PSCs) really exist and could produce insulin-secreting cells both under the condition of pancreatic injury and in vitro culture, but lack of effective markers to enrich PSCs hampers the studies of exploring the expanding and differentiating conditions in vitro. Some other adult stem cells, such as hepatic stem cells, marrow stem cells or intestine stem cells, were also suggested to transdifferentiate into insulin-producing cells under special culture conditions in vitro or by genetic modifications. Moreover, transplanting these adult stem cells-derived insulin-secreting cells into the diabetic mouse could cure diabetes. Thus, adult stem cells would supply the abundant beta-cell sources for cell replacement therapy of diabetes. PMID:18464596

  10. [Progress in treating diabetes mellitus with adult stem cells].

    PubMed

    Zhang, Lixin; Teng, Chunbo; An, Tiezhu

    2008-02-01

    Diabetes mellitus is a metabolic diseases, mainly including type 1 and type 2 diabetes. Treatment for type 1 and part of type 2 often involves regular insulin injection. However, this treatment neither precisely controls the blood sugar levels, nor prevents the diabetes complications. Transplantation of islets of Langerhans offers an attractive strategy for diabetes therapies, but its wide application has been limited by donor shortage and immunological rejection after transplantation. Stem cells with strong proliferation capacity and multipotential may be potential cell sources in diabetes therapies. For this, adult stem cells are interesting because of absence of teratoma formation and ethnical problems. Adult pancreatic stem cells (PSCs) really exist and could produce insulin-secreting cells both under the condition of pancreatic injury and in vitro culture, but lack of effective markers to enrich PSCs hampers the studies of exploring the expanding and differentiating conditions in vitro. Some other adult stem cells, such as hepatic stem cells, marrow stem cells or intestine stem cells, were also suggested to transdifferentiate into insulin-producing cells under special culture conditions in vitro or by genetic modifications. Moreover, transplanting these adult stem cells-derived insulin-secreting cells into the diabetic mouse could cure diabetes. Thus, adult stem cells would supply the abundant beta-cell sources for cell replacement therapy of diabetes.

  11. Articular and abarticular manifestations in type 2 diabetes mellitus

    PubMed Central

    Abourazzak, Fatima Ezzahra; Akasbi, Nessrine; Houssaini, Ghita Sqalli; Bazouti, Sabah; Bensbaa, Salma; Hachimi, Hicham; Ajdi, Farida; Harzy, Taoufik

    2014-01-01

    Objective Diabetes mellitus (DM), a worldwide high-prevalence disease, is associated with a large variety of rheumatic manifestations. It affects the connective tissues in many ways and causes alterations in the periarticular and the musculoskeletal systems. In most cases, these manifestations are associated with functional disability and pain, affecting the quality of life of the diabetic patient. The aim of our study is to review the different articular and abarticular manifestations in diabetic patients and the associated factors of these rheumatic manifestations. Material and Methods A cross-sectional study that includes all patients suffering from type 2 DM who present with articular or abarticular manifestations. Results We included 116 diabetic patients presenting with articular or abarticular manifestations. Our study showed four important findings. First, a large variety of articular and abarticular manifestations were present in patients with type 2 DM. Second, osteoarthritis (OA) of the knee was the most frequent articular manifestations. It was seen in 49% of our patients. Third, the most common manifestations in diabetic Moroccan patients were carpal tunnel syndrome (CTS), adhesive capsulitis of the shoulder, and diabetic cheiroarthropathy (29%, 23%, and 16%, respectively). Fourth, there was a significant association between vascular complications and the development of articular and abarticular manifestations. Conclusion This study shows that the articular and abarticular manifestations in diabetic Moroccan patients are dominated by CTS, adhesive capsulitis of the shoulder, and diabetic cheiroarthropathy, with a significant association between vascular complications and the development of some of these manifestations. PMID:27708897

  12. Evidence for current diagnostic criteria of diabetes mellitus.

    PubMed

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-09-15

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

  13. Hyperglycemia and Diabetes Mellitus Following Organ Transplantation.

    PubMed

    Galindo, Rodolfo J; Wallia, Amisha

    2016-02-01

    Hyperglycemia is common following organ transplantation, regardless of the pre-transplant diabetes status. Transient post-transplant hyperglycemia and/or new-onset diabetes after transplantation (NODAT) are common and are associated with increased morbidity and mortality. NODAT and type 2 diabetes share similar characteristics, but the pathophysiology may differ. Immunosuppressive agents and steroids play a key role in the development of NODAT. Glycemic control is challenging in this population due to fluctuating renal/end-organ function, immunosuppressive dosing, nutritional status, and drug-drug interactions. A proactive and multidisciplinary approach is essential, along with flexible protocols to adjust to patient status, type of organ transplanted, and corticosteroid regimens. Insulin is the preferred agent for hospitalized patients and during the early post-transplant period; optimal glycemic control (BG < 180 mg/dl with minimal hypoglycemia [<70 mg/dl]) is desired.

  14. Streptococcus agalactiae pyomyositis in diabetes mellitus.

    PubMed

    Panikkath, Deepa; Tantrachoti, Pakpoom; Panikkath, Ragesh; Nugent, Kenneth

    2016-07-01

    Pyomyositis is an acute infectious disorder affecting the skeletal muscle. Although seen more commonly in the tropics, cases are being reported in temperate countries, including the United States. We report a case of nontropical pyomyositis in a 58-year-old diabetic man who presented with a vague chest wall swelling. His initial clinical presentation and imaging findings suggested an intramuscular hematoma. He later developed fever with increased swelling, and pyomyositis was diagnosed after an aspiration of the swelling yielded Streptococcus agalactiae. Aspiration of the abscess and the use of appropriate antibiotics led to complete resolution of the disease. We discuss possible factors in diabetics that might predispose them to pyomyositis. PMID:27365874

  15. Molecular links between Alzheimer's disease and diabetes mellitus.

    PubMed

    Yang, Y; Song, W

    2013-10-10

    Substantial epidemiological evidence shows an increased risk for developing Alzheimer's disease (AD) in people with diabetes. Yet the underlying molecular mechanisms still remain to be elucidated. This article reviews the current studies on common pathological processes of Alzheimer's disease and diabetes with particular focus on potential mechanisms through which diabetes affects the initiation and progression of Alzheimer's disease. Impairment of insulin signaling, inflammation, oxidative stress, mitochondrial dysfunction, advanced glycation end products, APOEε4 and cholesterol appear to be important mediators and are likely to act synergistically in promoting AD pathology.

  16. Insulin release in type 2 diabetes mellitus.

    PubMed

    Efendic, S; Khan, A; Ostenson, C G

    1994-01-01

    Impaired insulin response is a characteristic feature of Type 2 diabetes. Overt diabetes develops when beta-cells fail to release enough insulin to compensate for decreased insulin sensitivity. However, a subgroup of normal weight patients demonstrates a pronounced beta-cell secretory defect and a normal insulin sensitivity. The molecular basis behind the impaired insulin response in Type 2 diabetes is not clear. Our studies in two animal models of this disease (GK rat and ob/ob mouse) suggest that an impaired glucose metabolism may be a primary defect in the stimulus-secretion coupling in the beta-cells in Type 2 diabetes. In the GK rat, three major alterations in the islet metabolism of glucose have been demonstrated: 1) increased glucose utilization but unchanged glucose oxidation; 2) increased glucose cycling and 3) decreased activity of the glycerol phosphate shuttle. In ob/ob animals we have found an increased rate of glucose cycling. These derangements might result in an incomplete closure of ATP-sensitive K(+)-channels with a decreased insulin response as a consequence.

  17. Diabetes mellitus: an important risk factor for reactivation of tuberculosis

    PubMed Central

    Rivera, Carmen; Mangual, Michelle; Martinez, José; Rivera, Kelvin; Fernandez, Ricardo

    2016-01-01

    Summary Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. Learning points Diabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis. High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes. Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. PMID:27482384

  18. Telemedicine and ocular health in diabetes mellitus.

    PubMed

    Bursell, Sven-Erik; Brazionis, Laima; Jenkins, Alicia

    2012-05-01

    Teleretinal/teleophthalmological programs that use existing health information technology infrastructure solutions for people with diabetes increase access to and adherence to appropriate eye care. Teleophthalmological studies indicate that the single act of patients viewing their own retinal images improves self-management behaviour and clinical outcomes. In some settings this can be done at lower cost and with improved visual outcomes compared with standard eye care. Cost-effective and sustainable teleretinal surveillance for detection of diabetic retinopathy requires a combination of an inexpensive portable device for taking low light-level retinal images without the use of pharmacological dilation of the pupil and a computer-assisted methodology for rapidly detecting and diagnosing diabetic retinopathy. A more holistic telehealth-care paradigm augmented with the use of health information technology, medical devices, mobile phone and mobile health applications and software applications to improve health-care co-ordination, self-care management and education can significantly impact a broad range of health outcomes, including prevention of diabetes-associated visual loss. This approach will require a collaborative, transformational, patient-centred health-care program that integrates data from medical record systems with remote monitoring of data and a longitudinal health record. This includes data associated with social media applications and personal mobile health technology and should support continuous interactions between the patient, health-care team and the patient's social environment. Taken together, this system will deliver contextually and temporally relevant decision support to patients to facilitate their well-being and to reduce the risk of diabetic complications. PMID:22594547

  19. Mediterranean diet rich in olive oil and obesity, metabolic syndrome and diabetes mellitus.

    PubMed

    Pérez-Martínez, Pablo; García-Ríos, Antonio; Delgado-Lista, Javier; Pérez-Jiménez, Francisco; López-Miranda, José

    2011-01-01

    After decades of epidemiological, clinical and experimental research, it has become clear that consumption of Mediterranean dietary patterns rich in olive oil has a profound influence on health outcomes, including obesity, metabolic syndrome (MetS) and diabetes mellitus. Traditionally, many beneficial properties associated with this oil have been ascribed to its high oleic acid content. Olive oil, however, is a functional food that, besides having high-monounsaturated (MUFA) content, contains other minor components with biological properties. In this line, phenolic compounds have shown antioxidant and antiinflammatory properties, prevent lipoperoxidation, induce favorable changes of lipid profile, improve endothelial function, and disclose antithrombotic properties. Research into the pharmacological properties of the minor components of olive oil is very active and could lead to the formulation of functional food and nutraceuticals. Although more data are mandatory the Mediterranean diet rich in olive oil does not contribute to obesity and appears to be a useful tool in the lifestyle management of the MetS. Moreover there is good scientific support for MUFA diets, especially those based on olive oil, as an alternative approach to low-fat diets for the medical nutritional therapy in diabetes. The objective of this review is to present evidence illustrating the relationship between Mediterranean diet, olive oil and metabolic diseases, including obesity, MetS and diabetes mellitus and to discuss potential mechanisms by which this food can help in disease prevention and treatment.

  20. Ensete superbum ameliorates renal dysfunction in experimental diabetes mellitus

    PubMed Central

    Sreekutty, MS; Mini, S

    2016-01-01

    Objective(s): Hyperglycemia mediated oxidative stress plays a key role in the pathogenesis of diabetic complications like nephropathy. In the present study, we evaluated the effect of ethanolic extract of Ensete superbum seeds (ESSE) on renal dysfunction and oxidative stress in streptozotocin-induced diabetic rats. Materials and Methods: Glucose, HbA1c, total protein, albumin, renal function markers (urea, uric acid and creatinine), and lipid peroxidation levels were evaluated. Renal enzymatic and non-enzymatic antioxidants were examined along with renal histopathological study. Results: ESSE (400 mg/kg BW t) administration reduced glucose and HbA1c, and improved serum total protein and albumin in diabetic rats. ESSE in diabetic rats recorded decrement in renal function markers and renal lipid peroxidation products along with significant increment in enzymatic and non-enzymatic antioxidants. Renal morphological abnormalities of diabetic rats were markedly ameliorated by E. superbum. Conclusion: These results suggest that the antioxidant effect of E. superbum could ameliorate oxidative stress and delay/prevent the progress of diabetic nephropathy in diabetes mellitus. PMID:27096072

  1. Immune dysfunction in patients with diabetes mellitus (DM).

    PubMed

    Geerlings, S E; Hoepelman, A I

    1999-12-01

    Patients with diabetes mellitus (DM) have infections more often than those without DM. The course of the infections is also more complicated in this patient group. One of the possible causes of this increased prevalence of infections is defects in immunity. Besides some decreased cellular responses in vitro, no disturbances in adaptive immunity in diabetic patients have been described. Different disturbances (low complement factor 4, decreased cytokine response after stimulation) in humoral innate immunity have been described in diabetic patients. However, the clinical relevance of these findings is not clear. Concerning cellular innate immunity most studies show decreased functions (chemotaxis, phagocytosis, killing) of diabetic polymorphonuclear cells and diabetic monocytes/macrophages compared to cells of controls. In general, a better regulation of the DM leads to an improvement of these cellular functions. Furthermore, some microorganisms become more virulent in a high glucose environment. Another mechanism which can lead to the increased prevalence of infections in diabetic patients is an increased adherence of microorganisms to diabetic compared to nondiabetic cells. This has been described for Candida albicans. Possibly the carbohydrate composition of the receptor plays a role in this phenomenon.

  2. [Guidelines for the management of diabetes mellitus type 2].

    PubMed

    Mediavilla Bravo, José Javier

    2014-09-01

    In the last few years, the publication of new studies in diabetes, together with the development of new classes of blood glucose-lowering medications, have led to updates of the most prestigious clinical practice guidelines for the treatment of diabetes. Thus, a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes was published in April 2012. An update of one of the evidence-based guidelines issued by the Canadian Diabetes Association appeared in 2013 and this year, 2014, saw the publication of the consensus document of the redGDPS, whose guidelines are those most closely followed by primary care physicians in Spain. The three guidelines highlight the need for an individualized approach to type 2 diabetes mellitus, outlining both target glycemic goals and distinct treatment regimens based on patient characteristics, disease stage and the presence of comorbidities or complications. In the treatment of the disease, the three guidelines also stress the importance of considering patients' opinions and of recommending lifestyle modifications to achieve good disease control. Metformin is identified as the first-line drug, with the addition of other glucose-lowering agents if necessary. PMID:25595348

  3. [Guidelines for the management of diabetes mellitus type 2].

    PubMed

    Mediavilla Bravo, José Javier

    2014-09-01

    In the last few years, the publication of new studies in diabetes, together with the development of new classes of blood glucose-lowering medications, have led to updates of the most prestigious clinical practice guidelines for the treatment of diabetes. Thus, a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes was published in April 2012. An update of one of the evidence-based guidelines issued by the Canadian Diabetes Association appeared in 2013 and this year, 2014, saw the publication of the consensus document of the redGDPS, whose guidelines are those most closely followed by primary care physicians in Spain. The three guidelines highlight the need for an individualized approach to type 2 diabetes mellitus, outlining both target glycemic goals and distinct treatment regimens based on patient characteristics, disease stage and the presence of comorbidities or complications. In the treatment of the disease, the three guidelines also stress the importance of considering patients' opinions and of recommending lifestyle modifications to achieve good disease control. Metformin is identified as the first-line drug, with the addition of other glucose-lowering agents if necessary.

  4. [Type 2 diabetes mellitus and obesity: should we treat the obesity or the diabetes?].

    PubMed

    García, Santiago Durán; Sanz, Santiago Durán; Sanz, Alejandro Durán

    2013-09-01

    In this article, we review the results that can be expected after significant weight loss in patients with type 2 diabetes mellitus. We provide consensus-based documentation supported by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation on the importance of physical exercise, metabolic-bariatric surgery, and drug therapy. Lastly, we report the results of studies published in the last few years on glucagon-like peptide-1 analogs and the new family of oral drugs known as gliflozins, specifically studies published on dapagliflozin. PMID:24444519

  5. [Type 2 diabetes mellitus and obesity: should we treat the obesity or the diabetes?].

    PubMed

    García, Santiago Durán; Sanz, Santiago Durán; Sanz, Alejandro Durán

    2013-09-01

    In this article, we review the results that can be expected after significant weight loss in patients with type 2 diabetes mellitus. We provide consensus-based documentation supported by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation on the importance of physical exercise, metabolic-bariatric surgery, and drug therapy. Lastly, we report the results of studies published in the last few years on glucagon-like peptide-1 analogs and the new family of oral drugs known as gliflozins, specifically studies published on dapagliflozin.

  6. Sedentary behavior, gestational diabetes mellitus, and type 2 diabetes risk: where do we stand?

    PubMed

    Johnson, Steven T; Lynch, Brigid; Vallance, Jeff; Davenport, Margie H; Gardiner, Paul A; Butalia, Sonia

    2016-04-01

    A substantial number of pregnancies are complicated by gestational diabetes mellitus (GDM) and up to 70 % of women with GDM go on to develop type 2 diabetes. Given the extensive body of research suggesting physical activity reduces the risk of type 2 diabetes, facilitating physical activity, and reducing sedentary time may be effective approaches to promote the health of women with a previous GDM diagnosis. Here, we discuss physical activity, exercise, and sedentary behavior, in the context of GDM and the potential for type 2 diabetes risk reduction. PMID:26823010

  7. Laser therapy in wound healing associated with diabetes mellitus - Review*

    PubMed Central

    de Sousa, Raquel Gomes; Batista, Keila de Nazaré Madureira

    2016-01-01

    The article discusses the results of a literature review on the application of low intensity laser therapy on the healing of wounds associated diabetes mellitus in the last 10 years. Objective To determine the most effective parameter in healing wounds related to diabetes mellitus, as well as the most widely used type of laser. Methodology consisted of bibliographic searching the databases Bireme, SciELO, PubMed/Medline and Lilacs by using the keywords related to the topic. Were selected from these keywords, papers discussing the use of laser on wounds associated with diabetes, published in the period 2005-2014, in Portuguese or English. Results After analyzing the research, 12 studies consistent with the theme were selected. Conclusion Based on this review, the studies that showed more satisfactory results in healing diabetic wounds were those who applied energy densities in the range of 3-5 J/cm2, power densities equal to or below 0.2 W/cm2 and continuous emission. The He-Ne laser with a wavelength of 632.8 nm was used more often. PMID:27579745

  8. [Knowledge and attitude towards diabetes mellitus in Argentina].

    PubMed

    Rodríguez, Martín; Puchulu, Félix

    2015-01-01

    A population survey was conducted in 9 provinces of Argentina in 2012 aimed at determining the level of knowledge of diabetes mellitus and the risk of developing the disease. This was a cross-sectional study based on the general population and including men and women aged 18-70 years from all socioeconomic backgrounds. Results showed that 30.5% of participants without diabetes mellitus were at risk of developing the disease. Fifty-nine percent of participants had a body mass index = 25 kg/m2. Forty-nine percent did less than 30 minutes of daily physical activity. Only 34% of the population ate fruits and vegetables every day. Ninety-eight percent of participants had once heard of diabetes, and 67% defined it as a severe or very severe disease. In view of the findings resulting from this survey, healthcare services are expected to improve prevention and effective control of cardiovascular risk factors as well as to enhance preventive actions in order to encourage the adoption of healthier lifestyles from an earlier age and to achieve greater knowledge not only among patients living with diabetes, but also within the general population. PMID:26707657

  9. The role of immunotherapy in type I diabetes mellitus.

    PubMed

    Geffner, M E; Lippe, B M

    1987-03-01

    Type I diabetes mellitus appears to result from an insidious immunologic destruction of pancreatic beta-cells in genetically susceptible persons exposed to one or a series of environmental insults. This genetic susceptibility is related to alleles located on the sixth chromosome in the HLA-DR or an adjacent region. With superimposition of a viral or other environmental triggering event, cell-and antibody-mediated events are activated that lead to the specific autorejection of beta-cells and consequent insulin deficiency. Immunosuppressive strategies to impede or halt complete destruction of beta-cells, using cyclosporine, have already been initiated in both animals and humans with diabetes mellitus. Because of the potential toxicity of all current immunosuppressive regimens, such therapies cannot, at this time, be considered for wide-scale use in persons with type I diabetes. Reported inductions, however, of insulin independence in patients with newly diagnosed type I diabetes using cyclosporine or other agents underscore the role of the immune system in the pathogenesis of the disease and highlight the need to develop safer, more specific immunomodulation designed to avoid complete beta-cell destruction.

  10. [Knowledge and attitude towards diabetes mellitus in Argentina].

    PubMed

    Rodríguez, Martín; Puchulu, Félix

    2015-01-01

    A population survey was conducted in 9 provinces of Argentina in 2012 aimed at determining the level of knowledge of diabetes mellitus and the risk of developing the disease. This was a cross-sectional study based on the general population and including men and women aged 18-70 years from all socioeconomic backgrounds. Results showed that 30.5% of participants without diabetes mellitus were at risk of developing the disease. Fifty-nine percent of participants had a body mass index = 25 kg/m2. Forty-nine percent did less than 30 minutes of daily physical activity. Only 34% of the population ate fruits and vegetables every day. Ninety-eight percent of participants had once heard of diabetes, and 67% defined it as a severe or very severe disease. In view of the findings resulting from this survey, healthcare services are expected to improve prevention and effective control of cardiovascular risk factors as well as to enhance preventive actions in order to encourage the adoption of healthier lifestyles from an earlier age and to achieve greater knowledge not only among patients living with diabetes, but also within the general population.

  11. [New therapeutic strategies for type 1 diabetes mellitus].

    PubMed

    Barajas, M; Príncipe, R M; Escalada, J; Prósper, F; Salvador, J

    2008-01-01

    The main determinant of the risk of complications from type 1 diabetes mellitus is the total lifetime blood glucose levels. To impact on the health and quality of life of individuals with diabetes, safe and effective methods of achieving and maintaining normoglycemia are needed. Unfortunately, intensive insulin therapy does not achieve normal levels of blood glucose, is difficult to implement for many patients, and limited by the accompanying increased frequency of severe hypoglycemia. Hence, the only way at present to restore permanently normoglycemia without hypoglycemia is to provide the patient with additional beta-cells. This can be achieved by transplanting an intact pancreas, or by transplanting islets. The shortage of functional beta-cells from available donors is one of the major limiting factors for the treatment of diabetes by islet transplantation. Therefore, methods to preserve or even promote regeneration of the beta-cell mass are dearly needed. Significant progress has been made over the last decade in stem cell biology. However, the quest for identification of stem cells has been hampered by the lack of appropriate research tools including assays that allow assess their differentiation potential in vitro and in vivo. Therefore, new techniques are necessary in order to develop new therapeutic strategies based on stem cells for the treatment of diabetes mellitus type 1.

  12. Kelly West Lecture. Primary prevention of type II diabetes mellitus.

    PubMed

    Stern, M P

    1991-05-01

    A useful paradigm for developing a public health strategy for combating chronic diseases consists of three phases: observational epidemiological studies, first cross-sectional and then prospective; intervention trials; and, finally, public health action. Although the field of cardiovascular epidemiology is well advanced into the third phase, i.e., public health action, the field of diabetes epidemiology is at least a generation behind and has only recently entered the phase of prospective observational studies. Part of the reason for this lag may be that, unlike cardiovascular disease, non-insulin-dependent (type II) diabetes has not been traditionally viewed as an epidemic, thereby detracting from a sense of urgency about the disease. Although this perspective may be appropriate for white populations, data from around the world make it increasingly apparent that type II diabetes has indeed reached epidemic proportions in non-white populations. Prospective studies are needed to firmly establish risk factors on which public health actions can be confidently based. Although anthropometric and metabolic risk factors such as obesity, body fat distribution, and circulating glucose and insulin concentrations are becoming well established as risk factors for type II diabetes, much less is known about behavioral risk factors. These latter risk factors are especially important because they are often amenable to public health action. There are preliminary data suggesting that decreased physical activity and increased fat consumption may be behavioral risk factors for diabetes. Decreased total energy intake, reflecting either low levels of physical activity or an intrinsically low metabolic rate, perhaps genetic in origin, may also be a diabetes risk factor. Unlike the field of cardiovascular epidemiology, in which there is already a critical mass of intervention trials on primary prevention, such trials are essentially nonexistent in the field of diabetes epidemiology; they

  13. [Type 2 diabetes mellitus: new treatments].

    PubMed

    Ascaso, Juan F

    2014-08-01

    The benefits and problems associated with traditional hypoglycemic drugs, such as failure of beta cells, hypoglycemia and weight gain, that lead to a worsening of diabetes, are reviewed. New hypoglycemic drugs with incretin effect (glucagon-like peptide-1 agonists and dipeptidyl peptidase 4 inhibitors), achieve, in a glucose dependent manner, an glycosylated hemoglobin reduction without hypoglycemia or increase in body weight. Recently, another group of oral hypoglycemic drugs, sodium-glucose cotransporter type 2 inhibitors, have demonstrated efficacy in diabetes control by inhibiting renal glucose reabsorption. However, long-term effects and cardiovascular prevention remain to be demonstrated. We have more and better drugs nowadays. Hypoglycemic treatment should be customized (glycosylated hemoglobin levels, risk-benefit, risk of hypoglycemia, weight changes, cardiovascular risk), with a combination of drugs being necessary in most cases. However, we do not have yet an ideal hypoglycemic drug. Moreover we must remember that an early and intensive treatment of dyslipidemia and hypertension is essential for the prevention of cardiovascular disease in patients with type 2 diabetes.

  14. [Type 2 diabetes mellitus: new treatments].

    PubMed

    Ascaso, Juan F

    2014-08-01

    The benefits and problems associated with traditional hypoglycemic drugs, such as failure of beta cells, hypoglycemia and weight gain, that lead to a worsening of diabetes, are reviewed. New hypoglycemic drugs with incretin effect (glucagon-like peptide-1 agonists and dipeptidyl peptidase 4 inhibitors), achieve, in a glucose dependent manner, an glycosylated hemoglobin reduction without hypoglycemia or increase in body weight. Recently, another group of oral hypoglycemic drugs, sodium-glucose cotransporter type 2 inhibitors, have demonstrated efficacy in diabetes control by inhibiting renal glucose reabsorption. However, long-term effects and cardiovascular prevention remain to be demonstrated. We have more and better drugs nowadays. Hypoglycemic treatment should be customized (glycosylated hemoglobin levels, risk-benefit, risk of hypoglycemia, weight changes, cardiovascular risk), with a combination of drugs being necessary in most cases. However, we do not have yet an ideal hypoglycemic drug. Moreover we must remember that an early and intensive treatment of dyslipidemia and hypertension is essential for the prevention of cardiovascular disease in patients with type 2 diabetes. PMID:23937815

  15. Epidemiology, Mechanisms and Management of Diabetic Gastroparesis

    PubMed Central

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

    2010-01-01

    Background Recent evidence of the significant impact of gastroparesis on morbidity and mortality mandates optimized management of this condition. Gastroparesis affects nutritional state and, in diabetics, it also has deleterious effects on glycemic control and secondary effects on organs that lead to increased mortality. First-line treatment includes restoration of nutrition and medications (prokinetic and antiemetic). Aim To review the epidemiology, pathophysiology, impact, natural history, time trends and treatment of gastroparesis with particular focus on diabetic gastroparesis. Methods The pros and cons of current treatment options including metoclopramide are discussed. Second-line approaches include surgery, venting gastrostomy or jejunostomy, and gastric electrical stimulation; most of these treatments are based on open-label treatment trials. Results/Conclusions In the future, drugs that target the underlying defects and new prokinetics such as newer 5-HT4 agonists (which appear to be devoid of cardiac or vascular effects), ghrelin agonists, new approaches to pacing the stomach, and stem cell therapies may bring more effective treatments to ameliorate the management of patients with gastroparesis. PMID:20951838

  16. Deoxysphingoid bases as plasma markers in Diabetes mellitus

    PubMed Central

    2010-01-01

    Background Sphingoid bases are formed from the precursors L-serine and palmitoyl-CoA-a reaction which is catalyzed by the serine-palmitoyltransferase (SPT). SPT metabolizes, besides palmitoyl-CoA also other acyl-CoAs but shows also variability towards the use of other amino acid substrates. The enzyme is also able to metabolize alanine, which results in the formation of an atypical deoxy-sphingoid base (DSB). This promiscuous activity is greatly increased in the case of the sensory neuropathy HSAN1, and pathologically elevated DSB levels have been identified as the cause of this disease. Clinically, HSAN1 shows a pronounced similarity to the diabetic sensory neuropathy (DSN), which is the most common chronic complication of diabetes mellitus. Since serine and alanine metabolism is functionally linked to carbohydrate metabolism by their precursors 3-phosphoglycerate and pyruvate, we were interested to see whether the levels of certain sphingoid base metabolites are altered in patients with diabetes. Results In a case-control study we compared plasma sphingoid base levels between healthy and diabetic individuals. DSB levels were higher in the diabetic group whereas C16 and C18 sphingoid bases were not significantly different. Plasma serine, but not alanine levels were lower in the diabetic group. A subsequent lipoprotein fractionation showed that the DSBs are primarily present in the LDL and VLDL fraction. Conclusion Our results suggest that DSBs are a novel category of plasma biomarkers in diabetes which reflect functional impairments of carbohydrate metabolism. Furthermore, elevated DSB levels as we see them in diabetic patients might also contribute to the progression of the diabetic sensory neuropathy, the most frequent complication of diabetes. PMID:20712864

  17. Outcome of renal replacement treatment in patients with diabetes mellitus.

    PubMed Central

    McMillan, M A; Briggs, J D; Junor, B J

    1990-01-01

    OBJECTIVE--To compare the outcome of renal replacement treatment in patients with diabetes mellitus and in non-diabetic patients with end stage renal failure. DESIGN--Retrospective comparison of cases and matched controls. SETTING--Renal unit, Western Infirmary, Glasgow, providing both dialysis and renal transplantation. PATIENTS--82 Diabetic patients starting renal replacement treatment between 1979 and 1988, compared with 82 matched non-diabetic controls with renal failure and 39 different matched controls undergoing renal transplantation. MAIN OUTCOME MEASURES--Patient characteristics, history of smoking, prevalence of left ventricular hypertrophy and myocardial ischaemia at start of renal replacement treatment; survival of patients with renal replacement treatment and of patients and allografts with renal transplantation. RESULTS--The overall survival of the diabetic patients during the treatment was 83%, 59%, and 50% at one, three, and five years. Survival was significantly poorer in the diabetic patients than the controls (p less than 0.001). Particularly adverse features for outcome at the start of treatment were increasing age (p less than 0.01) and current cigarette smoking (relative risk (95% confidence interval) 2.28 (0.93 to 4.84), p less than 0.05). Deaths were mainly from cardiac and vascular causes. The incidence of peritonitis in patients on continuous ambulatory peritoneal dialysis was the same in diabetic patients and controls (49% in each group remained free of peritonitis after one year), and the survival of renal allografts was not significantly worse in diabetic patients (p less than 0.5). CONCLUSIONS--Renal replacement treatment may give good results in diabetic patients, although the outlook remains less favourable than for non-diabetic patients because of coexistent, progressive vascular disease, which is more severe in older patients. PMID:2207427

  18. Identification and treatment of eating disorders in women with type 1 diabetes mellitus.

    PubMed

    Goebel-Fabbri, Ann E; Fikkan, Janna; Connell, Alexa; Vangsness, Laura; Anderson, Barbara J

    2002-01-01

    A series of case reports in the early 1980s and prevalence studies in the 1990s highlighted the serious medical consequences of coexisting eating disorders and diabetes mellitus. Diabetes-specific treatment issues, such as the need to carefully monitor diet, exercise, and blood glucose, may contribute to the development of eating disorder symptoms among women with diabetes mellitus. The attention to food portions and bodyweight that is part of routine diabetes mellitus management parallels the rigid thinking about food and body image found in women with eating disorders who do not have diabetes mellitus. Additionally, intensive insulin management of diabetes mellitus, the current standard of care, has been shown to be associated with bodyweight gain. Following from this, it may be that the very goals of state-of-the-art diabetes mellitus care increase the risk for developing an eating disorder. Once an eating disorder and recurrent insulin omission becomes entrenched, a pattern develops which is hard to break - one of chronic hyperglycemia, depressed mood, fear of bodyweight gain, and frustration with diabetes management. Eating disorders predispose women with diabetes mellitus to many complex medical risks. For example, insulin omission and reduction, eating disorder symptoms unique to diabetes mellitus, are strongly associated with an increased risk of diabetic ketoacidosis and with microvascular complications of diabetes mellitus such as retinopathy. For this reason, it is critical that diabetes mellitus clinicians understand more about eating disorders so as to improve the likelihood of early detection, appropriate treatment, and prevention of acute and long-term medical complications within this high-risk group of women.

  19. Limited joint mobility syndrome in diabetes mellitus: A minireview

    PubMed Central

    Gerrits, Esther G; Landman, Gijs W; Nijenhuis-Rosien, Leonie; Bilo, Henk J

    2015-01-01

    Limited joint mobility syndrome (LJMS) or diabetic cheiroarthropathy is a long term complication of diabetes mellitus. The diagnosis of LJMS is based on clinical features: progression of painless stiffness of hands and fingers, fixed flexion contractures of the small hand and foot joints, impairment of fine motion and impaired grip strength in the hands. As the syndrome progresses, it can also affect other joints. It is important to properly diagnose such a complication as LJMS. Moreover, it is important to diagnose LJMS because it is known that the presence of LJMS is associated with micro- and macrovascular complications of diabetes. Due to the lack of curative treatment options, the suggested method to prevent or decelerate the development of LJMS is improving or maintaining good glycemic control. Daily stretching excercises of joints aim to prevent or delay progression of joint stiffness, may reduce the risk of inadvertent falls and will add to maintain quality of life. PMID:26265997

  20. [Periodontal disease in children with diabetes mellitus type 1].

    PubMed

    Tuleutaeva, S; Ashirbekova, Z; Manapova, D; Almurat, S; Kharchenko, V

    2014-10-01

    The aim of the article was to study the occurrence of periodontal diseases in children with type I diabetes mellitus. The examination of 78 children revealed periodontal diseases in 40 children with type I diabetes. OHI-S, CPITN, PMA indices were determined. Pathological changes in periodontal tissues were revealed in 100% of cases. The following were identified: gingival hemorrhage (100%), over - and under-gingival dental tartar (100%), inflammation of gingival papilla (87,5%) marginal (80%) and alveolar gingiva (55%). Spread of periodontal disease among children with I type diabetes is characterized as high and is equal to 100%. Degree of periodontal sickness is evaluated as average and is M=2,28; SD=0,47 according to CPITN index. Treatment and preventive measures should be carried out taking into account major somatic disease.

  1. Fournier's gangrene: non-clostridial gas gangrene of the perineum and diabetes mellitus.

    PubMed Central

    Lamerton, A J

    1986-01-01

    Three successfully managed cases of Fournier's gangrene, all with diabetes, are reported. A simple bacteriological classification is offered and the importance of diabetes mellitus as a predisposing factor is stressed. Images Figure 1. Figure 2. Figure 3. PMID:3701767

  2. Hemoglobin concentration in men with type 2 diabetes mellitus.

    PubMed

    Harusato, Ichiko; Fukui, Michiaki; Tanaka, Muhei; Shiraishi, Emi; Senmaru, Takafumi; Sakabe, Kazumi; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2010-06-01

    Anemia is a common but often overlooked complication of diabetes. We investigated the relationship between hemoglobin concentration and various factors as well as markers of subclinical atherosclerosis in men with type 2 diabetes mellitus. Hemoglobin concentration was measured in 319 men with type 2 diabetes mellitus. We evaluated the relationship between hemoglobin concentration and various factors including age, body mass index, and glycemic control, as well as between hemoglobin concentration and pulse wave velocity or ankle-brachial index (n = 209) and between hemoglobin concentration and carotid intima-media thickness or plaque score (n = 125). Mean hemoglobin concentration was 14.2 +/- 0.80 g/dL. Body mass index (r = 0.340, P < .0001) and estimated glomerular filtration rate (r = 0.219, P = .0011) were positively associated with hemoglobin concentration, whereas age (r = -0.388, P < .0001), glycated albumin (r = -0.148, P = .0121), serum creatinine concentration (r = -0.206, P = .0019), and log (urinary albumin excretion) (r = -0.188, P = .0010) were negatively associated with hemoglobin concentration. Multiple regression analysis identified age (beta = -0.222, P = .0019), body mass index (beta = 0.145, P = .0432), systolic blood pressure (beta = 0.214, P = .0015), total cholesterol concentration (beta = 0.170, P = .0077), and serum creatinine concentration (beta = -0.181, P = .0045) as independent determinants of hemoglobin concentration. No significant association was observed between hemoglobin concentration and serum erythropoietin concentration (r = -0.079, P = .2980). Negative correlations were found between hemoglobin concentration and pulse wave velocity (r = -0.289, P < .0001) and between hemoglobin concentration and plaque score (r = -0.275, P = .0024). In conclusion, hemoglobin concentration was associated with various factors; and decreased hemoglobin concentration was associated with subclinical markers of atherosclerosis in men with type 2

  3. [Visual impairment in juvenile diabetes mellitus due to optic atrophy: Wolfram's syndrome].

    PubMed

    Immink, Annelies; Reeser, H Maarten; Brus, Frank

    2010-01-01

    Wolfram's syndrome is a rare neurodegenerative disorder, which usually first manifests itself around the age of 6 years. The diagnosis can be made based on the characteristics incorporated in the 'DIDMOAD' acronym: diabetes insipidus, diabetes mellitus, optic atrophy and deafness. We present 2 boys, diagnosed with diabetes mellitus at the age of 5 and 4 years respectively. Both children developed optic atrophy over the years. These 2 cases illustrate that alongside diabetic retinopathy, possible syndromes, such as Wolfram's syndrome, should also be considered in children with diabetes mellitus and visual impairment.

  4. Atorvastatin prevents type 2 diabetes mellitus--an experimental study.

    PubMed

    Madhu, Sri Venkata; Aslam, Mohammad; Galav, Vikas; Bhattacharya, Swapan Kumar; Jafri, Aiman Abbas

    2014-04-01

    Recent reports of increased diabetes risk have raised concerns regarding the use of statins. The present study was therefore planned to clarify whether atorvastatin can prevent diabetes development in a rat model of type 2 diabetes mellitus. Eight week old male Wistar rats were randomized into three groups (n = 12 each group). Group A was given standard chow diet, while group B and group C were offered high sucrose diet. In addition to high sucrose diet, group C was given atorvastatin (20mg/kg/day) from beginning of study till 26th week. After 26 weeks, a low dose of streptozotocin (15 mg/kg, i.p.) was given to all 3 groups and further followed for 4 weeks. Oral glucose tolerance tests were done at week 4, 26 and week 30. Development of impaired glucose tolerance at week 26 (16.66% vs 100%, P = <0.001) and diabetes at week 30 (16.66% vs 81.81%, P = 0.002) was significantly lower in rats pretreated with atorvastatin along with high sucrose diet viz group C compared to group B rats who received high sucrose diet only respectively. Also, metabolic indices like body weight, hypertriglyceridemia, glucose area under the curve (Gl-AUC) were significantly lower in group C compared to group B (P = <0.05) while insulin resistance (HOMA-IR) was also lower in group C (P = 0.05). This study clearly demonstrates for the first time in a rat model of type 2 diabetes mellitus that atorvastatin prevents development of type 2 diabetes.

  5. The changing demography of diabetes mellitus in Singapore.

    PubMed

    Lee, W R

    2000-10-01

    Diabetes mellitus has been on the rise in Singapore, while Singaporeans are becoming more affluent, our lifestyles are more sedentary and our population is ageing rapidly. The prevalence of diabetes mellitus rose from 2% in 1975 to 4.7% in 1984, 8.6% in 1992 and 9.0% of adults 18-69 years old in 1998. Malay and Indian women and Indian men were at higher risk, with 14.3, 14.9 and 16.7% prevalence rates, respectively. A further 15% of the adult population have impaired glucose tolerance (IGT). Diabetes was a factor in 39.7% of strokes and in 9.3% of all deaths in Singapore, and is the sixth most common cause of death. In the Diabcare Singapore 1998 Study, 91% of participants were diagnosed with Type 2 diabetes, with mean BMI of 25.1+/-4.4 kg/m(2). The incidence of Type 1 diabetes in childhood is 2.46 per 100000 children 0-12 years of age, while Type 2 diabetes in childhood is an emerging problem. The prevalence of obesity (BMI >30 kg/m(2)) among persons aged 18-69 years rose to 6% in 1998, up from 5.1% in 1992. The prevalence of obesity was highest among the Malays (16.2%) followed by the Indians (12.2%) and the Chinese (3.8%). About 12% of schoolchildren are obese. Increased efforts must be made to change lifestyle and eating patterns in our society, reduce childhood obesity and encourage adults to make lifelong sports and exercise part of the Singaporean way of life. Singapore has one of the world's fastest ageing populations, and even now, 32.4% of Singaporeans 60-69 years of age have diabetes. We should consider screening for diabetes in obese schoolchildren and seek to improve quality of care for people with diabetes, including enlisting the aid of community organisations to improve access to diabetes education, monitoring, support and complications screening services. PMID:11024582

  6. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus: longitudinal study.

    PubMed

    Qiu, Miaoyan; Shen, Weili; Song, Xiaomin; Ju, Liping; Tong, Wenxin; Wang, Haiyan; Zheng, Sheng; Jin, Yan; Wu, Yixin; Wang, Weiqing; Tian, Jingyan

    2015-03-01

    Whether prediabetes mellitus alone or combined with other disorders means a higher risk for cardiovascular disease (CVD) is still controversial. This study aimed to investigate the association between prediabetes mellitus and CVD and diabetes mellitus and to explore whether prediabetes mellitus alone or combined with other syndromes, such as hypertension, could promote CVD risks significantly. This longitudinal population-based study of 1609 residents from Shanghai in Southern China was conducted between 2002 and 2014. Participants with a history of CVD at baseline were excluded from analysis. Multivariate log-binomial regression models were used to adjust possible coexisting factors. Incidence of CVD during follow-up was 10.1%. After adjusting for age, sex, and other factors, the association between prediabetes mellitus and CVD was not observed. When hypertension was incorporated in stratifying factors, adjusted CVD risk was elevated significantly (odds ratio, 2.41; 95% confidence interval, 1.25-4.64) in prediabetes mellitus and hypertension combined group, and coexistence of diabetes mellitus and hypertension made CVD risk highly significantly increased, reaching 3.43-fold higher than the reference group. Blood glucose level within prediabetic range is significantly associated with elevated risks for diabetes mellitus after multivariable adjustment, but only when it is concurrent with other disorders, such as hypertension, it will significantly increase CVD risk.

  7. Brain changes in diabetes mellitus patients with gastrointestinal symptoms.

    PubMed

    Drewes, Anne M; Søfteland, Eirik; Dimcevski, Georg; Farmer, Adam D; Brock, Christina; Frøkjær, Jens B; Krogh, Klaus; Drewes, Asbjørn M

    2016-01-25

    Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal (GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testing mainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes, especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation.

  8. Patient Selection in Vitamin E Treatment in Diabetes Mellitus

    PubMed Central

    Goldenstein, Hagit; Levy, Nina S.; Lipener, Yisrael T.; Levy, Andrew P.

    2013-01-01

    In diabetes there is an increase in oxidative stress due to elevated glucose levels in the plasma. High glucose promotes glycosylation of both plasma and cellular proteins which particularly affects the endothelial cell lining of the blood vessel wall and interferes with its normal function. Thus diabetes mellitus patients suffer from a higher incidence of cardiovascular complications such as atherosclerosis as compared to the non-diabetic population. Haptoglobin (Hp) is a plasma protein which binds free hemoglobin and prevents heme-iron mediated oxidation. There are three different types of Hp which differ in their antioxidant ability. Several clinical studies have shown that the Hp 2-2 genotype is associated with higher incidence of cardiovascular diseases among diabetics. Vitamin E, a low cost, easy to use antioxidant, was found to decrease the risk of developing cardiovascular diseases in Hp 2-2 diabetic patients. This review summarizes several studies which show the importance of vitamin E supplementation in a specific sub-group of patients consisting of diabetic individuals carrying the Hp 2-2 genotype. PMID:23469912

  9. Animal Models of Diabetes Mellitus for Islet Transplantation

    PubMed Central

    Sakata, Naoaki; Yoshimatsu, Gumpei; Tsuchiya, Haruyuki; Egawa, Shinichi; Unno, Michiaki

    2012-01-01

    Due to current improvements in techniques for islet isolation and transplantation and protocols for immunosuppressants, islet transplantation has become an effective treatment for severe diabetes patients. Many diabetic animal models have contributed to such improvements. In this paper, we focus on 3 types of models with different mechanisms for inducing diabetes mellitus (DM): models induced by drugs including streptozotocin (STZ), pancreatomized models, and spontaneous models due to autoimmunity. STZ-induced diabetes is one of the most commonly used experimental diabetic models and is employed using many specimens including rodents, pigs or monkeys. The management of STZ models is well established for islet studies. Pancreatomized models reveal different aspects compared to STZ-induced models in terms of loss of function in the increase and decrease of blood glucose and therefore are useful for evaluating the condition in total pancreatomized patients. Spontaneous models are useful for preclinical studies including the assessment of immunosuppressants because such models involve the same mechanisms as type 1 DM in the clinical setting. In conclusion, islet researchers should select suitable diabetic animal models according to the aim of the study. PMID:23346100

  10. Animal models of diabetes mellitus for islet transplantation.

    PubMed

    Sakata, Naoaki; Yoshimatsu, Gumpei; Tsuchiya, Haruyuki; Egawa, Shinichi; Unno, Michiaki

    2012-01-01

    Due to current improvements in techniques for islet isolation and transplantation and protocols for immunosuppressants, islet transplantation has become an effective treatment for severe diabetes patients. Many diabetic animal models have contributed to such improvements. In this paper, we focus on 3 types of models with different mechanisms for inducing diabetes mellitus (DM): models induced by drugs including streptozotocin (STZ), pancreatomized models, and spontaneous models due to autoimmunity. STZ-induced diabetes is one of the most commonly used experimental diabetic models and is employed using many specimens including rodents, pigs or monkeys. The management of STZ models is well established for islet studies. Pancreatomized models reveal different aspects compared to STZ-induced models in terms of loss of function in the increase and decrease of blood glucose and therefore are useful for evaluating the condition in total pancreatomized patients. Spontaneous models are useful for preclinical studies including the assessment of immunosuppressants because such models involve the same mechanisms as type 1 DM in the clinical setting. In conclusion, islet researchers should select suitable diabetic animal models according to the aim of the study. PMID:23346100

  11. Inorganic arsenic exposure and type 2 diabetes mellitus in Mexico.

    PubMed

    Coronado-González, José Antonio; Del Razo, Luz María; García-Vargas, Gonzalo; Sanmiguel-Salazar, Francisca; Escobedo-de la Peña, Jorge

    2007-07-01

    Inorganic arsenic exposure in drinking water has been recently related to diabetes mellitus. To evaluate this relationship the authors conducted in 2003, a case-control study in an arseniasis-endemic region from Coahuila, a northern state of Mexico with a high incidence of diabetes. The present analysis includes 200 cases and 200 controls. Cases were obtained from a previous cross-sectional study conducted in that region. Diagnosis of diabetes was established following the American Diabetes Association criteria, with two fasting glucose values > or = 126 mg/100 ml (> or = 7.0 mmol/l) or a history of diabetes treated with insulin or oral hypoglycemic agents. The next subject studied, subsequent to the identification of a case in the cross-sectional study was taken as control. Inorganic arsenic exposure was measured through total arsenic concentrations in urine, measured by hydride-generation atomic absorption spectrophotometry. Subjects with intermediate total arsenic concentration in urine (63.5-104 microg/g creatinine) had two-fold higher risk of having diabetes (odds ratio=2.16; 95% confidence interval: 1.23, 3.79), but the risk was almost three times greater in subjects with higher concentrations of total arsenic in urine (odds ratio=2.84; 95% confidence interval: 1.64, 4.92). This data provides additional evidence that inorganic arsenic exposure may be diabetogenic.

  12. Brain changes in diabetes mellitus patients with gastrointestinal symptoms

    PubMed Central

    Drewes, Anne M; Søfteland, Eirik; Dimcevski, Georg; Farmer, Adam D; Brock, Christina; Frøkjær, Jens B; Krogh, Klaus; Drewes, Asbjørn M

    2016-01-01

    Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal (GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testing mainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes, especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation. PMID:26839652

  13. Rehabilitation of Tendon Problems in Patients with Diabetes Mellitus.

    PubMed

    Rees, Jonathan; Gaida, Jamie E; Silbernagel, Karin Grävare; Zwerver, Johannes; Anthony, Joseph S; Scott, Alex

    2016-01-01

    Exercise is crucial in the management of diabetes mellitus and its associated complications. However, individuals with diabetes have a heightened risk of musculoskeletal problems, including tendon pathologies. Diabetes has a significant impact on the function of tendons due to the accumulation of advanced glycation end-products in the load-bearing collagen. In addition, tendon vascularity and healing may be reduced due to diabetes-induced changes in the peripheral vascular system, and impaired synthesis of collagen and glycosaminoglycan. The current chapter presents an evidence-based discussion of considerations for the rehabilitation of tendon problems in people with diabetes. The following conditions are discussed in detail - calcific tendinopathy, tenosynovitis, tendon rupture, and non-calcifying tendinopathy. Common diabetes-related findings are presented, along with their potential impact on tendinopathy management and suggested modifications to standard tendinopathy treatment protocols. A holistic approach should be used to optimize musculotendinous function, including a comprehensive exercise prescription addressing strength, flexibility, and aerobic fitness. PMID:27535262

  14. Inorganic arsenic exposure and type 2 diabetes mellitus in Mexico

    SciTech Connect

    Coronado-Gonzalez, Jose Antonio; Razo, Luz Maria del; Garcia-Vargas, Gonzalo; Sanmiguel-Salazar, Francisca; Escobedo-de la Pena, Jorge . E-mail: jorgeep@servidor.unam.mx

    2007-07-15

    Inorganic arsenic exposure in drinking water has been recently related to diabetes mellitus. To evaluate this relationship the authors conducted in 2003, a case-control study in an arseniasis-endemic region from Coahuila, a northern state of Mexico with a high incidence of diabetes. The present analysis includes 200 cases and 200 controls. Cases were obtained from a previous cross-sectional study conducted in that region. Diagnosis of diabetes was established following the American Diabetes Association criteria, with two fasting glucose values {>=}126 mg/100 ml ({>=}7.0 mmol/l) or a history of diabetes treated with insulin or oral hypoglycemic agents. The next subject studied, subsequent to the identification of a case in the cross-sectional study was taken as control. Inorganic arsenic exposure was measured through total arsenic concentrations in urine, measured by hydride-generation atomic absorption spectrophotometry. Subjects with intermediate total arsenic concentration in urine (63.5-104 {mu}g/g creatinine) had two-fold higher risk of having diabetes (odds ratio=2.16; 95% confidence interval: 1.23, 3.79), but the risk was almost three times greater in subjects with higher concentrations of total arsenic in urine (odds ratio=2.84; 95% confidence interval: 1.64, 4.92). This data provides additional evidence that inorganic arsenic exposure may be diabetogenic.

  15. Obesity and metabolic surgery in type 1 diabetes mellitus.

    PubMed

    Raab, Heike; Weiner, R A; Frenken, M; Rett, K; Weiner, S

    2013-03-01

    Introducción: La cirugía de la obesidad es un método eficaz para el tratamiento de la obesidad y la diabetes mellitus tipo 2. Este tipo de diabetes puede se resuelve por completo en el 78,1% de los pacientes diabéticos y mejora en el 86,6% de los pacientes diabéticos. Sin embargo, poco se sabe acerca de la cirugía bariátrica en la diabetes mellitus tipo 1. Métodos: Presentamos 6 pacientes mujeres obesas con diabetes mellitus tipo 1 que se sometieron a cirugía bariátrica. Dos de ellas fueron sometidas a un bypass gástrico en-Y-Roux (BPGYR), una se le realizó una gastrectomía en manga y a las tres restantes una derivación biliopancreática con-switch duodenal (DBP-SD). Resultados: Nuestros resultados mostraron una reducción de peso notable, así como una mejora en el control de la glucosa en sangre y el requerimiento de insulina en los años de seguimiento después de la cirugía. El IMC prequirúrgico de las 6 pacientes osciló entre 37,3-46,0 kg/m2 y mejoró a 25,8-29,0 kg/m2 un año después de la cirugía. La HbA1c disminuyó de 6,7-9,8% antes de la cirugía a 5,7-8,5% un año después de la cirugía. El requerimiento diario de insulina se redujo de 62-150 UI/día antes de la cirugía a 15-54 UI /día al cabo de un año. Conclusión: Los resultados son impresionantes y muestran una mejora en la sensibilidad a la insulina tras una cirugía de la obesidad. No obstante, un control óptimo de la glucosa de sangre sigue siendo muy importante en la terapia de la diabetes mellitus tipo 1 para evitarcomplicaciones a largo plazo.

  16. The cost of diabetes chronic complications among Iranian people with type 2 diabetes mellitus

    PubMed Central

    2014-01-01

    Background To evaluate the cost of diabetes related micro- and macrovascular complications in Iranian people with type 2 diabetes mellitus. Methods In routine clinical practice, people with type 2 diabetes mellitus were assessed for 10 years at a diabetes care center. The type of medications and clinical data were extracted from patients’ documents. Mortality rate and the incidence of micro- and macrovascular complications recorded in patients’ documents were analyzed. Cost analysis was comprised of 1) para clinic costs as well as laboratory, medications, clinical visits and nonmedical costs 2) inpatient costs as well as hospital admission costs, disability, and mortality costs. Results From 1562 people with type 2 diabetes mellitus, a total of 1000 patients with mean duration disease of 11.2 years, who had completed information in their documents, were studied. All people were free from complications at baseline. Mean cumulative incidence of diabetes-related complications over 10 years were 10.9 ± 3.5%, 8.0 ± 3.1%, 4.6 ± 1.7%, 9.1 ± 3.6% and 2.3 ± 0.9% for peripheral neuropathy and diabetic foot ulcer, nephropathy, ophthalmic complications, cardiovascular disease and death, respectively. People with better glycemic control had less complication and also related expenditures. Average para clinic cost per patient was 393.6 ± 47.8 and average inpatient cost per patient was 1520.7 ± 104.5 USD. Conclusions Our findings demonstrate considerable incidence of diabetes chronic complications and also high health care expenditure for related complications among our patients. As the number of people with diabetes continues to rise, early detection of the disease and implementation of timely and appropriate therapeutic strategies could decrease the burden of diabetes chronic complications and also huge related expenditures. PMID:24593991

  17. Pediatrics Residents' Attitudes about Insulin-Dependent Diabetes Mellitus and Children with Diabetes.

    ERIC Educational Resources Information Center

    Ingersoll, Gary M.; And Others

    1990-01-01

    Comparison of the beliefs and attitudes of a sample of pediatric residents (n=56) and practicing physicians (n=1,500) concerning children with insulin-dependent Diabetes Mellitus and the disease itself found residents in their second and third years of training considerably more negative about both than physicians or first-year residents.…

  18. Processing Diabetes Mellitus Composite Events in MAGPIE.

    PubMed

    Brugués, Albert; Bromuri, Stefano; Barry, Michael; Del Toro, Óscar Jiménez; Mazurkiewicz, Maciej R; Kardas, Przemyslaw; Pegueroles, Josep; Schumacher, Michael

    2016-02-01

    The focus of this research is in the definition of programmable expert Personal Health Systems (PHS) to monitor patients affected by chronic diseases using agent oriented programming and mobile computing to represent the interactions happening amongst the components of the system. The paper also discusses issues of knowledge representation within the medical domain when dealing with temporal patterns concerning the physiological values of the patient. In the presented agent based PHS the doctors can personalize for each patient monitoring rules that can be defined in a graphical way. Furthermore, to achieve better scalability, the computations for monitoring the patients are distributed among their devices rather than being performed in a centralized server. The system is evaluated using data of 21 diabetic patients to detect temporal patterns according to a set of monitoring rules defined. The system's scalability is evaluated by comparing it with a centralized approach. The evaluation concerning the detection of temporal patterns highlights the system's ability to monitor chronic patients affected by diabetes. Regarding the scalability, the results show the fact that an approach exploiting the use of mobile computing is more scalable than a centralized approach. Therefore, more likely to satisfy the needs of next generation PHSs. PHSs are becoming an adopted technology to deal with the surge of patients affected by chronic illnesses. This paper discusses architectural choices to make an agent based PHS more scalable by using a distributed mobile computing approach. It also discusses how to model the medical knowledge in the PHS in such a way that it is modifiable at run time. The evaluation highlights the necessity of distributing the reasoning to the mobile part of the system and that modifiable rules are able to deal with the change in lifestyle of the patients affected by chronic illnesses.

  19. [Etiopathogenesis of type 2 diabetes mellitus].

    PubMed

    Kubát, K; Zboril, M

    1999-12-01

    In the genesis and development of type 2 diabetes in the great majority of subjects the contemporary lifestyle characterized by inadequate physical activity and an excessive energy intake is of basic importance. The majority of abnormalities and defects revealed by laboratory tests is probably secondary and caused by the above mentioned factors. Contemporary views of the etiopathogenesis of the disease are demotivating for patients: if the cause of their disease were an inborn disorder at the level of transmission of a signal on membranes then probably nothing else can be done than to take prescribed drugs. If the mistake involves the lifestyle, the latter can be changed and the disease avoided. Any medicamentous treatment is associated with the risk of undesirable effects--the complication of hyperinsulinism in treatment with sulphonyl urea derivatives and insulin or lactate acidosis after treatment with biguanides. This risk is not influenced by early prevention: dietary restraint and adequate physical exercise. Diabetes type 2 and 1--despite the common sign of hyperglycaemia--are characterized by a fundamental difference: (not influenced by treatment) DM type 1 is characterized by enhanced catabolic processes, starvation at the cellular level. Type 2 is characterized by enhanced anabolic processes, excessive amounts of nutrients in cells. The authors submit recommendations which respect the secondary character of deviations for the development of DM 2 which can be detected by laboratory methods: The following are the basic etiopathogenetic mechanism for the development of DM 2: 1. Chronic excessive intake and inadequate output of energy a) increased nutrient supply to the liver with secondary increase of gluconeogenesis in the liver, b) chronic increased supply of glucose to peripheral tissues, in particular muscles and adipose tissue, inadequate physical exercise, with secondary restriction of nutrient supplies to these tissues. 2. Secondary affection of

  20. Processing Diabetes Mellitus Composite Events in MAGPIE.

    PubMed

    Brugués, Albert; Bromuri, Stefano; Barry, Michael; Del Toro, Óscar Jiménez; Mazurkiewicz, Maciej R; Kardas, Przemyslaw; Pegueroles, Josep; Schumacher, Michael

    2016-02-01

    The focus of this research is in the definition of programmable expert Personal Health Systems (PHS) to monitor patients affected by chronic diseases using agent oriented programming and mobile computing to represent the interactions happening amongst the components of the system. The paper also discusses issues of knowledge representation within the medical domain when dealing with temporal patterns concerning the physiological values of the patient. In the presented agent based PHS the doctors can personalize for each patient monitoring rules that can be defined in a graphical way. Furthermore, to achieve better scalability, the computations for monitoring the patients are distributed among their devices rather than being performed in a centralized server. The system is evaluated using data of 21 diabetic patients to detect temporal patterns according to a set of monitoring rules defined. The system's scalability is evaluated by comparing it with a centralized approach. The evaluation concerning the detection of temporal patterns highlights the system's ability to monitor chronic patients affected by diabetes. Regarding the scalability, the results show the fact that an approach exploiting the use of mobile computing is more scalable than a centralized approach. Therefore, more likely to satisfy the needs of next generation PHSs. PHSs are becoming an adopted technology to deal with the surge of patients affected by chronic illnesses. This paper discusses architectural choices to make an agent based PHS more scalable by using a distributed mobile computing approach. It also discusses how to model the medical knowledge in the PHS in such a way that it is modifiable at run time. The evaluation highlights the necessity of distributing the reasoning to the mobile part of the system and that modifiable rules are able to deal with the change in lifestyle of the patients affected by chronic illnesses. PMID:26590982

  1. Endoplasmic reticulum stress, diabetes mellitus, and tissue injury.

    PubMed

    Huang, Liu; Xie, Hong; Liu, Hao

    2014-01-01

    Endoplasmic reticulum (ER) stress is characterized by the accumulation of unfolded and misfolded proteins in the ER lumen. Unfolded and misfolded protein accumulation interferes with the ER function and triggers ER stress response. Thus, ER stress response, also called unfolded protein response (UPR), is an adaptive process that controls the protein amount in the ER lumen and the downstream protein demand. In normal conditions, the role of ER stress is to maintain ER homeostasis, restore ER function, and protect stressed cells from apoptosis, by coordinating gene expression, protein synthesis, and accelerating protein degradation through several molecular pathways. However, prolonged ER stress response plays a paradoxical role, which leads to cell damage, apoptosis, and concomitant tissue injuries. A number of tissue alterations are involved with diabetes mellitus progress and its comorbidities via ER stress. However, certain pharmacological agents affecting ER stress have been identified. In this review, we summarized the relationship between ER stress and insulin resistance development. Moreover, we aim to explain how ER stress influences type 2 diabetes mellitus (T2DM) development. In addition, we reviewed the literature on ER stress and UPR in three kinds of tissue injuries induced by T2DM. Finally, a retrospective analysis of the effects of anti-diabetes medications on ER stress is presented.

  2. Diabetes mellitus, periapical inflammation and endodontic treatment outcome

    PubMed Central

    Castellanos-Cosano, Lizett; Machuca, Guillermo; López-López, Jose; Martín-González, Jenifer; Velasco-Ortega, Eugenio; Sánchez-Domínguez, Benito; López-Frías, Francisco J.

    2012-01-01

    The possible connection between chronic oral inflammatory processes, such as apical periodontitis and periodontal disease (PD), and systemic health is one of the most interesting aspects faced by the medical and dental scientific community. Chronic apical periodontitis shares important characteristics with PD: 1) both are chronic infections of the oral cavity, 2) the Gram-negative anaerobic microbiota found in both diseases is comparable, and 3) in both infectious processes increased local levels of inflammatory mediators may have an impact on systemic levels. One of the systemic disorders linked to PD is diabetes mellitus (DM); is therefore plausible to assume that chronic apical periodontitis and endodontic treatment are also associated with DM. The status of knowledge regarding the relationship between DM and endodontics is reviewed. Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth. The results of some studies suggest that periapical disease may contribute to diabetic metabolic dyscontrol. Key words: Apical periodontitis, diabetes mellitus, endodontics, root canal treatment. PMID:22143698

  3. Salivary gland dysfunction markers in type 2 diabetes mellitus patients

    PubMed Central

    Aitken-Saavedra, Juan; Rojas-Alcayaga, Gonzalo; Maturana-Ramírez, Andrea; Escobar-Álvarez, Alejandro; Cortes-Coloma, Andrea; Reyes-Rojas, Montserrat; Viera -Sapiain, Valentina; Villablanca-Martínez, Claudia

    2015-01-01

    Background Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. Material and Methods A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. Results There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). Conclusions The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients. Key words:Saliva, type 2 diabetes mellitus, pH, protein concentration, xerostomia. PMID:26535097

  4. Advances in management of type 1 diabetes mellitus

    PubMed Central

    Aathira, Ravindranath; Jain, Vandana

    2014-01-01

    Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. The quest for newer therapies is continuing and this review attempts to outline the recent developments. The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure well controlled delivery, stable half-lives and lesser side effects. Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery. Continuous glucose monitoring systems are also becoming more accurate and user friendly. Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required. Artificial pancreas has enabled to a certain extent to close the loop between blood glucose level and insulin delivery with devices armed with meal and exercise announcements, dual hormone delivery and pramlintide infusion. Islet, pancreas-kidney and stem cells transplants are also being attempted though complete success is still a far way off. Incorporating insulin gene and secretary apparatus is another ambitious leap to achieve insulin independence though the search for the ideal vector and target cell is still continuing. Finally to stand up to the statement, prevention is better than cure, immunological methods are being investigated to be used as vaccine to prevent the onset of diabetes mellitus. PMID:25317246

  5. Advances in management of type 1 diabetes mellitus.

    PubMed

    Aathira, Ravindranath; Jain, Vandana

    2014-10-15

    Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. The quest for newer therapies is continuing and this review attempts to outline the recent developments. The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure well controlled delivery, stable half-lives and lesser side effects. Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery. Continuous glucose monitoring systems are also becoming more accurate and user friendly. Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required. Artificial pancreas has enabled to a certain extent to close the loop between blood glucose level and insulin delivery with devices armed with meal and exercise announcements, dual hormone delivery and pramlintide infusion. Islet, pancreas-kidney and stem cells transplants are also being attempted though complete success is still a far way off. Incorporating insulin gene and secretary apparatus is another ambitious leap to achieve insulin independence though the search for the ideal vector and target cell is still continuing. Finally to stand up to the statement, prevention is better than cure, immunological methods are being investigated to be used as vaccine to prevent the onset of diabetes mellitus.

  6. Type 2 diabetes mellitus in children and adolescents.

    PubMed

    Tieh, Peter; Dreimane, Daina

    2014-02-01

    Type 2 diabetes mellitus (T2DM) is a chronic progressive disease with high morbidity and mortality rates. Previously an adult onset disease, it is now being diagnosed more and more in childhood and adolescence. Lately, Asia has become the epicenter of this epidemic. Childhood T2DM is a new challenge for the pediatrician. Due to similarities in presentation, children may initially be misdiagnosed with Type 1 diabetes mellitus (T1DM). Most oral anti-diabetic agents have not been approved for use in adolescents, and there is a concern for safety of their use. Lifestyle intervention is difficult to conduct, and adherence to recommendations is lower in adolescents than in adults with T2DM. Higher incidence and early onset of co-morbidities, with lack of long term outcomes data make the management problematic. In many communities, due to a shortage of specialists, general practitioners will treat children with T2DM. Guidelines cited in this review are designed to help with the diagnostic process and management.

  7. The diagnosis of posttransplantation diabetes mellitus: meeting the challenges.

    PubMed

    Werzowa, J; Hecking, M; Haidinger, M; Döller, D; Sharif, A; Tura, A; Säemann, M D

    2015-05-01

    Posttransplantation diabetes mellitus (PTDM) is a major complication after renal transplantation due to its negative impact on patient and graft survival, and affects up to 40% of renal transplant recipients. The generation of evidence regarding its optimal treatment is now progressing with some emphasis on early postoperative insulin treatment that targets β-cell failure. This therapy seems to benefit renal transplant patients but contrasts with previous PTDM guidelines that were following treatment of type 2 diabetes mellitus (DM): oral antidiabetics first, insulin last. Similarly, in the current PTDM consensus recommendations, diagnostic procedures are in accordance with the American Diabetes Association (ADA) recommendations for diagnosis of DM. PTDM and type 2 DM, however, are distinct disease entities with different pathophysiological backgrounds. This review will discuss the significance of the standard diagnostic criteria for DM in patients after renal transplantation without prior DM. In particular, the role of glycated hemoglobin (HbA1c) and oral glucose tolerance testing (OGTT) will be reviewed. In addition, the potential role of other glycated proteins and continuous glucose monitoring will be covered, although these parameters are not yet part of the consensus recommendations.

  8. The Vogt-Koyanagi-Harada syndrome: association with hypothyroidism and diabetes mellitus.

    PubMed Central

    Jaggarao, N.; Voth, D.; Jacobsen, J.

    1989-01-01

    A 45 year old Saudi male with poliosis, alopecia areata, vitiligo, anterior uveitis, inflammatory changes in the posterior pole of the retina and paraparesis presented with features of the Vogt-Koyanagi-Harada syndrome, uncontrolled diabetes mellitus and hypothyroidism. To the best of our knowledge the association of diabetes mellitus and hypothyroidism in this syndrome has not been reported previously. PMID:2602259

  9. Endocrine stress responses and risk of type 2 diabetes mellitus.

    PubMed

    Siddiqui, Azaz; Madhu, S V; Sharma, S B; Desai, N G

    2015-01-01

    This study was carried to ascertain whether stress responses are associated with abnormalities in glucose tolerance, insulin sensitivity and pancreatic beta cell function and risk of type 2 Diabetes Mellitus. Salivary cortisol, a marker of hypothalamic-pituitary-adrenal (HPA) axis and salivary α-amylase, a marker of sympathetic nervous system (SNS) were compared in 125 subjects of newly detected diabetes mellitus (NDDM) and normal glucose tolerance (NGT) subjects who were diagnosed on the basis of oral glucose tolerance test (OGTT). Assessment of stress in them was done through stress scales - presumptive stressful life events scale (PSLES), perceived stress scale (PSS) and sense of coherence (SOC) and correlated with these and other stress response markers. Significantly higher 10 pm salivary cortisol and post dexamethasone salivary cortisol were found in NDDM subjects as compared to NGT. 10 pm salivary cortisol correlated significantly with fasting plasma glucose (FPG), 2 h plasma glucose (2h PG) and glycated hemoglobin (HbA1c) while post dex salivary cortisol correlated with 2h PG, HbA1c and salivary α-amylase with 2h PG. Stepwise logistic regression analysis showed that body mass index (OR: 1.840), SOC (OR: 0.688) and 10 pm salivary cortisol (OR: 1.427) were the strongest predictors of NDDM. The results of the present study indicate that NDDM subjects display significantly higher chronic stress and stress responses when compared to subjects with NGT. Chronic stress and endocrine stress responses are significantly associated with glucose intolerance, insulin resistance and diabetes mellitus. PMID:26303379

  10. Endocrine stress responses and risk of type 2 diabetes mellitus.

    PubMed

    Siddiqui, Azaz; Madhu, S V; Sharma, S B; Desai, N G

    2015-01-01

    This study was carried to ascertain whether stress responses are associated with abnormalities in glucose tolerance, insulin sensitivity and pancreatic beta cell function and risk of type 2 Diabetes Mellitus. Salivary cortisol, a marker of hypothalamic-pituitary-adrenal (HPA) axis and salivary α-amylase, a marker of sympathetic nervous system (SNS) were compared in 125 subjects of newly detected diabetes mellitus (NDDM) and normal glucose tolerance (NGT) subjects who were diagnosed on the basis of oral glucose tolerance test (OGTT). Assessment of stress in them was done through stress scales - presumptive stressful life events scale (PSLES), perceived stress scale (PSS) and sense of coherence (SOC) and correlated with these and other stress response markers. Significantly higher 10 pm salivary cortisol and post dexamethasone salivary cortisol were found in NDDM subjects as compared to NGT. 10 pm salivary cortisol correlated significantly with fasting plasma glucose (FPG), 2 h plasma glucose (2h PG) and glycated hemoglobin (HbA1c) while post dex salivary cortisol correlated with 2h PG, HbA1c and salivary α-amylase with 2h PG. Stepwise logistic regression analysis showed that body mass index (OR: 1.840), SOC (OR: 0.688) and 10 pm salivary cortisol (OR: 1.427) were the strongest predictors of NDDM. The results of the present study indicate that NDDM subjects display significantly higher chronic stress and stress responses when compared to subjects with NGT. Chronic stress and endocrine stress responses are significantly associated with glucose intolerance, insulin resistance and diabetes mellitus.

  11. Diabetes mellitus: Exploring the challenges in the drug development process.

    PubMed

    Vaz, Julius A; Patnaik, Ashis

    2012-07-01

    Diabetes mellitus has reached epidemic proportions and continues to be a major burden on society globally. The International Diabetes Federation (IDF) estimated the global burden of diabetes to be 366 million in 2011 and predicted that by 2030 this will have risen to 552 million. In spite of newer and effective treatment options, newer delivery and diagnostic devices, stricter glycaemic targets, better treatment guidelines and increased awareness of the disease, baseline glycosylated hemoglobin remains relatively high in subjects diagnosed and treated with type 2 diabetes. The search continues for an ideal anti diabetic drug that will not only normalize blood glucose but also provide beta cell rest and possibly restoration of beta cell function. The development of anti diabetic drugs is riddled with fundamental challenges. The concept of beta cell rest and restoration is yet to be completely understood and proven on a long term. The ideal therapeutic approach to treating type 2 diabetes is not yet determined. Our understanding of drug safety in early clinical development is primarily limited to "Type A" reactions. Until marketing authorization most drugs are approved based on the principle of confirming non-inferiority with an existing gold standard or determining superiority to a placebo. The need to obtain robust pharmaco-economic data prior to marketing authorization in order to determine appropriate pricing of a new drug remains a major challenge. The present review outlines some of the challenges in drug development of anti-diabetic drugs citing examples of pulmonary insulin, insulin analogues, thiazolidinediones and the GLP1 analogues. PMID:23125962

  12. Glucocorticoid dynamics and impaired wound healing in diabetes mellitus.

    PubMed

    Bitar, M S

    1998-02-01

    The aim of the present study was to examine corticosterone dynamics and its role in the pathogenesis of impaired wound healing in diabetes mellitus (DM). The streptozotocin-treated rat was used as an animal model for type I DM. A linear skin incision and subcutaneously implanted polyvinyl alcohol sponge disks were considered as wound-healing models. The data regarding corticosterone dynamics revealed diabetes-related increments in plasma corticosterone concentrations at various time intervals during the diurnal cycle (9:00 a.m., 12:00 noon, and 3:00 p.m.) Moreover, a reduction in the levels of hippocampal glucocorticoid receptors was also evident in this disease state. Immobilization-induced stress elevated plasma corticosterone levels in both control and 30-day diabetic rats. Although the diabetic rat seems capable of appropriately initiating a corticosterone stress response, it is dramatically impaired in its capacity to terminate it. A progressive decrease in collagen deposition on polyvinyl alcohol sponge and wounded skin tensile strength was seen as a function of the duration of diabetes. Similarly, polyvinyl alcohol sponges retrieved from 30-day diabetic rats also showed a marked reduction in the expression of mRNA transcripts for type I and type III collagen. A simulation of the impairment in wound-healing potential in DM was achieved by treating control animals with a supraphysiological dose of hydrocortisone. It is worthy of note that an endocrinological paradigm involving adrenalectomy and replacement therapy with hydrocortisone significantly improved the wound-related parameters, including collagen metabolism and wounded skin tensile strength in the streptozotocin diabetic rats. Overall, our data provide evidence that the diabetic state is associated with hypercortisolemia and that this phenomenon may contribute to impaired wound healing in DM.

  13. Glucocorticoid dynamics and impaired wound healing in diabetes mellitus.

    PubMed Central

    Bitar, M. S.

    1998-01-01

    The aim of the present study was to examine corticosterone dynamics and its role in the pathogenesis of impaired wound healing in diabetes mellitus (DM). The streptozotocin-treated rat was used as an animal model for type I DM. A linear skin incision and subcutaneously implanted polyvinyl alcohol sponge disks were considered as wound-healing models. The data regarding corticosterone dynamics revealed diabetes-related increments in plasma corticosterone concentrations at various time intervals during the diurnal cycle (9:00 a.m., 12:00 noon, and 3:00 p.m.) Moreover, a reduction in the levels of hippocampal glucocorticoid receptors was also evident in this disease state. Immobilization-induced stress elevated plasma corticosterone levels in both control and 30-day diabetic rats. Although the diabetic rat seems capable of appropriately initiating a corticosterone stress response, it is dramatically impaired in its capacity to terminate it. A progressive decrease in collagen deposition on polyvinyl alcohol sponge and wounded skin tensile strength was seen as a function of the duration of diabetes. Similarly, polyvinyl alcohol sponges retrieved from 30-day diabetic rats also showed a marked reduction in the expression of mRNA transcripts for type I and type III collagen. A simulation of the impairment in wound-healing potential in DM was achieved by treating control animals with a supraphysiological dose of hydrocortisone. It is worthy of note that an endocrinological paradigm involving adrenalectomy and replacement therapy with hydrocortisone significantly improved the wound-related parameters, including collagen metabolism and wounded skin tensile strength in the streptozotocin diabetic rats. Overall, our data provide evidence that the diabetic state is associated with hypercortisolemia and that this phenomenon may contribute to impaired wound healing in DM. PMID:9466581

  14. Family caregiving for adults with schizophrenia and diabetes mellitus.

    PubMed

    El-Mallakh, Peggy; Yates, Brittany Evans; Adkins, Sarah

    2013-08-01

    Diabetes mellitus (DM) is common among those with schizophrenia, but little is known about family members' roles in the care of relatives who have both schizophrenia and DM. The purpose of this descriptive correlational study was to examine DM knowledge and caregiver burden among 27 family caregivers of people with schizophrenia and DM. Findings indicate that DM knowledge was low. Objective caregiver burden was highest for providing assistance with daily living activities. Subjective burden was highest for preventing the care recipient from keeping people awake at night and dealing with the care recipient's non-adherence to DM care. Family caregivers are in need of education and support in the caregiving role.

  15. [Insulinization in type 2 diabetes mellitus. Intensification options].

    PubMed

    Fuente, Graciela V; Sinay, Isaac; Costa Gil, José E; Puchulu, Félix; Dieuzeide, Guillermo; Rodríguez, Martín; Faingold, María C; Litwak, León E

    2016-01-01

    Diabetes mellitus is associated with vascular complications and high rates of morbidity and mortality. Timely insulin therapy, intensified when necessary, represent appropriate measures to prevent or delay the onset of complications. However, the incidence of hypoglycemia and difficulties in treatment adherence represent barriers to achieve therapeutic success. Premixes analogs and, specially, combinations of insulin analogues are associated with pharmacokinetic and pharmacodynamic advantages, that translate into clinical benefits such as improved metabolic control, decreased hypoglycemic events and, for their simplicity, potentially greater adherence. PMID:27295707

  16. [Effectiveness of physical exercise programs in patients with diabetes mellitus].

    PubMed

    Cano-De La Cuerda, Roberto; Aguila-Maturana, Ana María; Miangolarra-Page, Juan Carlos

    2009-02-14

    Clinical studies with methodological rigor have shown that the strategies for lifestyle modification and drug therapies can prevent or at least delay the development of type 2 diabetes mellitus (DM) in individuals at high risk. Combination of regular physical exercise and diet is more effective than each one separately to achieve modest weight loss and improve metabolic control in patients with DM. Our objective is to describe the role of exercise in patients with DM and the exercise programs in relation to the previous considerations, taking into account the intensity of the exercise, components of the program, duration, frequency and precautions. PMID:19211086

  17. [Primary combined oral antidiabetic therapy in type-2 diabetes mellitus].

    PubMed

    Winkler, Gábor; Baranyi, Eva

    2002-10-27

    New target values of the metabolic control and recent directions in the therapeutic strategies of type 2 diabetes mellitus are overviewed. Attention is called to the atherogenic effect of blood glucose elevations exceeding physiological level, even when only post-prandial and with short duration. The significance of early phase prandial insulin secretion in the metabolic state is underlined, and the related new therapeutic possibilities are discussed. Practical guidelines are given to the introduction of oral antidiabetic therapy, and the importance of the early, aggressive, combined treatment with a complex mechanism of action is emphasized.

  18. The anaesthetic practitioner and type 1 diabetes mellitus.

    PubMed

    Wade, Tina

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is a serious lifelong condition affecting many people in the UK. With the increasing prevalence of T1DM, it is inevitable that more patients will present for anaesthesia and surgery. This article will inform anaesthetic practitioners about the condition, the challenges involved with glycaemic control, complications such as hyperglycaemia and hypoglycaemia, and the importance of maintaining good glycaemic control. It will offer advice about what anaesthetic practitioners can do to help manage and care for their patients.

  19. Stem cell therapies for type 1 diabetes mellitus.

    PubMed

    Voltarelli, Júilio C; Couri, Carlos E B; Rodrigues, Maria C; Moraes, Daniela A; Stracieri, Ana-Beatriz P L; Pieroni, Fabiano; Navarro, George; Leal, Angela M O; Simões, Belinda P

    2011-06-01

    The present review discusses the use of autologous hematopoietic stem cell transplantation (HSCT) for the treatment of diabetes mellitus type 1 (DM 1). It has been observed that high dose immunosuppression followed by HSCT shows better results among other immunotherapeutic treatments for the disease as the patients with adequate beta cell reserve achieve insulin independence. However, this response is not maintained and reoccurrence of the disease is major a major challenge to use HSCT in future to prevent or control relapse of DM 1.

  20. [Effectiveness of physical exercise programs in patients with diabetes mellitus].

    PubMed

    Cano-De La Cuerda, Roberto; Aguila-Maturana, Ana María; Miangolarra-Page, Juan Carlos

    2009-02-14

    Clinical studies with methodological rigor have shown that the strategies for lifestyle modification and drug therapies can prevent or at least delay the development of type 2 diabetes mellitus (DM) in individuals at high risk. Combination of regular physical exercise and diet is more effective than each one separately to achieve modest weight loss and improve metabolic control in patients with DM. Our objective is to describe the role of exercise in patients with DM and the exercise programs in relation to the previous considerations, taking into account the intensity of the exercise, components of the program, duration, frequency and precautions.

  1. Incus and stapes necrosis associated with diabetes mellitus.

    PubMed

    Tüz, M; Doğru, H; Yasan, H; Döner, F; Yariktaş, M

    2006-07-01

    Chronic otitis media is often associated with ossicular defects, the most frequent being necrosis of the long process of incus. Except for infection and cholesteatoma; trauma and local pressure by chorda tympani are uncommon causes leading to incus erosion. In the literature, no case of incus necrosis has been reported associated with type II diabetes mellitus (DM). A patient is presented in this report with incus and stapes suprastructure necrosis and associated type II DM who was admitted to the out-patient clinic with complaints of conductive hearing loss. PMID:16834796

  2. Celiac disease in type 1 diabetes mellitus

    PubMed Central

    2012-01-01

    Celiac Disease (CD) occurs in patients with Type 1 Diabetes (T1D) ranging the prevalence of 4.4-11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background: HLA genotype DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, DR3-DQ2 with CD. The classical severe presentation of CD rarely occurs in T1D patients, but more often patients have few/mild symptoms of CD or are completely asymptomatic (silent CD). In fact diagnosis of CD is regularly performed by means of the screening in T1D patients. The effects of gluten-free diet (GFD) on the growth and T1D metabolic control in CD/T1D patient are controversial. Regarding of the GFD composition, there is a debate on the higher glycaemic index of gluten-free foods respect to gluten-containing foods; furthermore GFD could be poorer of fibers and richer of fat. The adherence to GFD by children with CD-T1D has been reported generally below 50%, lower respect to the 73% of CD patients, a lower compliance being more frequent among asymptomatic patients. The more severe problems of GFD adherence usually occur during adolescence when in GFD non compliant subjects the lowest quality of life is reported. A psychological and educational support should be provided for these patients. PMID:22449104

  3. Type 2 diabetes mellitus and skeletal muscle metabolic function.

    PubMed

    Phielix, Esther; Mensink, Marco

    2008-05-23

    Type 2 diabetic patients are characterized by a decreased fat oxidative capacity and high levels of circulating free fatty acids (FFAs). The latter is known to cause insulin resistance, in particularly in skeletal muscle, by reducing insulin stimulated glucose uptake, most likely via accumulation of lipid inside the muscle cell. A reduced skeletal muscle oxidative capacity can exaggerate this. Furthermore, type 2 diabetes is associated with impaired metabolic flexibility, i.e. an impaired switching from fatty acid to glucose oxidation in response to insulin. Thus, a reduced fat oxidative capacity and metabolic inflexibility are important components of skeletal muscle insulin resistance. The cause of these derangements in skeletal muscle of type 2 diabetic patients remains to be elucidated. An impaired mitochondrial function is a likely candidate. Evidence from both in vivo and ex vivo studies supports the idea that an impaired skeletal muscle mitochondrial function is related to the development of insulin resistance and type 2 diabetes mellitus. A decreased mitochondrial oxidative capacity in skeletal muscle was revealed in diabetic patients, using in vivo 31-Phosphorus Magnetic Resonance Spectroscopy (31P-MRS). However, quantification of mitochondrial function using ex vivo high-resolution respirometry revealed opposite results. Future (human) studies should challenge this concept of impaired mitochondrial function underlying metabolic defects and prove if mitochondria are truly functional impaired in insulin resistance, or low in number, and whether it represents the primary starting point of pathogenesis of insulin resistance, or is just an other feature of the insulin resistant state. PMID:18342897

  4. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum?

    PubMed Central

    Chawla, Aastha; Chawla, Rajeev; Jaggi, Shalini

    2016-01-01

    Diabetes and related complications are associated with long-term damage and failure of various organ systems. The line of demarcation between the pathogenic mechanisms of microvascular and macrovascular complications of diabetes and differing responses to therapeutic interventions is blurred. Diabetes induces changes in the microvasculature, causing extracellular matrix protein synthesis, and capillary basement membrane thickening which are the pathognomic features of diabetic microangiopathy. These changes in conjunction with advanced glycation end products, oxidative stress, low grade inflammation, and neovascularization of vasa vasorum can lead to macrovascular complications. Hyperglycemia is the principal cause of microvasculopathy but also appears to play an important role in causation of macrovasculopathy. There is thought to be an intersection between micro and macro vascular complications, but the two disorders seem to be strongly interconnected, with micro vascular diseases promoting atherosclerosis through processes such as hypoxia and changes in vasa vasorum. It is thus imperative to understand whether microvascular complications distinctly precede macrovascular complications or do both of them progress simultaneously as a continuum. This will allow re-focusing on the clinical issues with a unifying perspective which can improve type 2 diabetes mellitus outcomes. PMID:27366724

  5. Prevalence rates for diabetes mellitus in Puerto Rico.

    PubMed

    Haddock, L; de Conty, I T

    1991-07-01

    The aim of this study was to analyze prevalence data for diabetes mellitus obtained from a household interview of a random sample of the general population by the Department of Health of the Commonwealth of Puerto Rico for the years 1975-1986. Details of the prevalence rate by sex and age were analyzed for the years 1981, 1984, 1985, and 1986 and for the urban and rural population in 1985. The mean prevalence rate of known cases of diabetes showed a tendency to increase from 3.1% in 1975 to 5.1% in 1986. Prevalence rates adjusted for age and sex showed an increase in the mean prevalence for 1986 compared with that of 1981. The prevalence rate was significantly higher for the rural population for the age-group 45-64 yr old and for the urban population for the age-group greater than or equal to 65 yr. The prevalence rate compares with that of Mexican Americans and Puerto Ricans in the New York City area. On the basis of the prevalence data, approximately 90% of the diabetic population is non-insulin dependent and 10% are insulin dependent. Major risk factors thought to explain the increased prevalence of non-insulin-dependent diabetes are increasing longevity of the Puerto Rican population, genetic predisposition, obesity, and changes in life-styles. In conclusion, Puerto Ricans, as other Hispanic Americans, have a higher prevalence of diabetes than the white American population.

  6. Patient selection and vitamin E treatment in diabetes mellitus.

    PubMed

    Goldenstein, Hagit; Levy, Nina S; Lipener, Yisrael T; Levy, Andrew P

    2013-03-01

    In diabetes, there is an increase in oxidative stress due to elevated glucose levels in the plasma. High glucose promotes glycosylation, of both plasma and cellular proteins, which particularly affects the endothelial-cell lining of the blood vessel wall and interferes with its normal function. Thus, diabetes mellitus patients suffer from a higher incidence of cardiovascular complications such as atherosclerosis as compared with the nondiabetic population. Haptoglobin (Hp) is a plasma protein that binds free hemoglobin and prevents heme-iron mediated oxidation. There are three different types of Hp, which differ in their antioxidant ability. Several clinical studies have shown that the Hp 2-2 genotype is associated with higher incidence of cardiovascular diseases among diabetics. Vitamin E, a low-cost, easy-to-use antioxidant, was found to decrease the risk of developing cardiovascular diseases in Hp 2-2 diabetic patients. This review summarizes several studies that show the importance of vitamin E supplementation in a specific subgroup of patients, diabetic individuals carrying the Hp 2-2 genotype. PMID:23469912

  7. Type 1 diabetes mellitus presenting with diabetic ketoacidosis (DKA) in a neonate.

    PubMed

    Ahmed, Fareed; Kazi, Ghazala; Khan, Waqas

    2016-08-01

    Neonatal diabetes mellitus (NDM) is a rare manifestation with an incidence of one affected individual among 400000 live births. NDM can be divided into Transient (TNDM) and Permanent (PNDM) types. A significant overlap occurs between both groups, to an extent that TNDM cannot be distinguished from PNDM based solely on clinical features. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (TIDM). DKA at diagnosis is more common in young children near the age of five years. Neonatal DKA is a rare occurrence causing it to be missed in the differential diagnosis of neonatal illness and results delay in appropriate management and increase in morbidity and mortality rate. PMID:27524542

  8. [Antihypertensive therapy in diabetes mellitus: Guidelines of the Austrian Diabetes Association 2016].

    PubMed

    Schernthaner, Guntram; Drexel, Heinz; Rosenkranz, Alexander; Schernthaner, Gerit-Holger; Watschinger, Bruno

    2016-04-01

    Blood pressure lowering is one of the most important interventions for reducing the vascular complications and mortality in patients with diabetes mellitus. Recent studies indicate that the optimal blood pressure level might be in the range between 130-140 mmHg systolic and 80‒90 mmHg diastolic. Lower blood pressure levels (e.g. 120/80 mmHg) can further reduce the risk for stroke and diabetic nephropathy, but are associated with increased cardiovascular mortality. In particular, very low blood pressure levels (< 120 mmHg) should be avoided in patients with coronary heart disease or peripheral arterial disease. Most patients with diabetes mellitus need antihypertensive combination therapies, whereby ACE-inhibitors or Angiotensin-II receptor antagonists should be first line drugs. PMID:27052224

  9. [Antihypertensive therapy in diabetes mellitus: Guidelines of the Austrian Diabetes Association 2016].

    PubMed

    Schernthaner, Guntram; Drexel, Heinz; Rosenkranz, Alexander; Schernthaner, Gerit-Holger; Watschinger, Bruno

    2016-04-01

    Blood pressure lowering is one of the most important interventions for reducing the vascular complications and mortality in patients with diabetes mellitus. Recent studies indicate that the optimal blood pressure level might be in the range between 130-140 mmHg systolic and 80‒90 mmHg diastolic. Lower blood pressure levels (e.g. 120/80 mmHg) can further reduce the risk for stroke and diabetic nephropathy, but are associated with increased cardiovascular mortality. In particular, very low blood pressure levels (< 120 mmHg) should be avoided in patients with coronary heart disease or peripheral arterial disease. Most patients with diabetes mellitus need antihypertensive combination therapies, whereby ACE-inhibitors or Angiotensin-II receptor antagonists should be first line drugs.

  10. Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management.

    PubMed

    Sousa, André Gustavo P; Cabral, João Victor de Sousa; El-Feghaly, William Batah; de Sousa, Luísa Silva; Nunes, Adriana Bezerra

    2016-03-10

    Patients with diabetes mellitus (DM) frequently develop electrolyte disorders, including hyperkalemia. The most important causal factor of chronic hyperkalemia in patients with diabetes is the syndrome of hyporeninemic hypoaldosteronism (HH), but other conditions may also contribute. Moreover, as hyperkalemia is related to the blockage of the renin-angiotensin-aldosterone system (RAAS) and HH is most common among patients with mild to moderate renal insufficiency due to diabetic nephropathy (DN), the proper evaluation and management of these patients is quite complex. Despite its obvious relationship with diabetic nephropathy, HH is also related to other microvascular complications, such as DN, particularly the autonomic type. To confirm the diagnosis, plasma aldosterone concentration and the levels of renin and cortisol are measured when the RAAS is activated. In addition, synthetic mineralocorticoid and/or diuretics are used for the treatment of this syndrome. However, few studies on the implications of HH in the treatment of patients with DM have been conducted in recent years, and therefore little, if any, progress has been made. This comprehensive review highlights the findings regarding the epidemiology, diagnosis, and management recommendations for HH in patients with DM to clarify the diagnosis of this clinical condition, which is often neglected, and to assist in the improvement of patient care.

  11. Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management

    PubMed Central

    Sousa, André Gustavo P; Cabral, João Victor de Sousa; El-Feghaly, William Batah; de Sousa, Luísa Silva; Nunes, Adriana Bezerra

    2016-01-01

    Patients with diabetes mellitus (DM) frequently develop electrolyte disorders, including hyperkalemia. The most important causal factor of chronic hyperkalemia in patients with diabetes is the syndrome of hyporeninemic hypoaldosteronism (HH), but other conditions may also contribute. Moreover, as hyperkalemia is related to the blockage of the renin-angiotensin-aldosterone system (RAAS) and HH is most common among patients with mild to moderate renal insufficiency due to diabetic nephropathy (DN), the proper evaluation and management of these patients is quite complex. Despite its obvious relationship with diabetic nephropathy, HH is also related to other microvascular complications, such as DN, particularly the autonomic type. To confirm the diagnosis, plasma aldosterone concentration and the levels of renin and cortisol are measured when the RAAS is activated. In addition, synthetic mineralocorticoid and/or diuretics are used for the treatment of this syndrome. However, few studies on the implications of HH in the treatment of patients with DM have been conducted in recent years, and therefore little, if any, progress has been made. This comprehensive review highlights the findings regarding the epidemiology, diagnosis, and management recommendations for HH in patients with DM to clarify the diagnosis of this clinical condition, which is often neglected, and to assist in the improvement of patient care. PMID:26981183

  12. Sweating in Systemic Abnormalities: Uremia and Diabetes Mellitus.

    PubMed

    Murota, Hiroyuki

    2016-01-01

    Sweating disorders are sometimes observed in various systemic diseases that include genetic disorders, organ damage, metabolic impairment, autoimmune diseases, and neuropathic disorders. In these diseases, various symptoms such as autonomic failures, psychopathic disorders, abnormal skin innervation, and sweat gland dysfunction can interact with one another in diverse ways, resulting in impaired sweating. This review focuses on the influence of uremia (with or without hemodialysis) and diabetes mellitus on impaired sweating. Dialysis patients perspire less, but their sweat contains higher levels of uremic toxins than do healthy subjects. Neuropathic disorders in diabetes patients develop in relation to disease severity and can impair sweating. Physicians should consider the development of various problems, such as increased body temperature, dry skin, and increased susceptibility to infection, due to decreased sweating, as they are often found in these systemic abnormalities. PMID:27584963

  13. [Gestational diabetes mellitus: importance of blood glucose monitoring].

    PubMed

    Flores Le-Roux, Juana A; Benaiges Boix, David; Pedro-Botet, Juan

    2013-01-01

    Gestational diabetes mellitus (GDM) is common during pregnancy, and is frequently associated with maternal and perinatal complications. Intensive treatment of hyperglycaemia during pregnancy has been shown to reduce perinatal morbidity. In women with pregestational type 1 or 2 diabetes, hyperglycaemia during labour and delivery is an important factor in the development of neonatal hypoglycaemia. There are no generally accepted recommendations for women with GDM. Recent studies evaluating patients with GDM show that peripartum glucose control can be achieved in these women without the need for insulin use in the majority of cases. Hyperglycaemia during labour is not related with treatment established during pregnancy but rather with non-compliance of endocrinological follow-up. Factors such as ethnic origin, neonatal hypoxaemia, and large for gestational age seem to play an important role in the development of neonatal hypoglycaemia.

  14. Diabetes mellitus and disturbances in brain connectivity: a bidirectional relationship?

    PubMed

    Mansur, Rodrigo B; Cha, Danielle S; Woldeyohannes, Hanna O; Soczynska, Joanna K; Zugman, Andre; Brietzke, Elisa; McIntyre, Roger S

    2014-12-01

    Diabetes mellitus (DM) is associated with deficits across multiple cognitive domains. The observed impairments in cognitive function are hypothesized to be subserved by alterations in brain structure and function. Several lines of evidence indicate that alterations in glial integrity and function, as well as abnormal synchrony within brain circuits and associated networks, are observed in adults with DM. Microangiopathy and alterations in insulin homeostasis appear to be principal effector systems, although a unitary explanation subsuming the complex etiopathology of white matter in DM is unavailable. A contemporary model of disease pathophysiology for several mental disorders, including but not limited to mood disorders, posits abnormalities in the synchronization of cellular systems in circuits. The observation that similar abnormalities occur in diabetic populations provides the basis for hypothesizing the convergence of pathoetiological factors. Herein, we propose that abnormal structure, function and chemical composition as well as synchrony within and between circuits is an accompaniment of DM and is shared in common with several mental disorders.

  15. Current view from Alzheimer disease to type 2 diabetes mellitus.

    PubMed

    Rasool, Mahmood; Malik, Arif; Qazi, Aamer M; Sheikh, Ishfaq A; Manan, Abdul; Shaheen, Sumaira; Qazi, Mahmood H; Chaudhary, Adeel G; Abuzenadah, Adel M; Asif, Muhammad; Alqahtani, Mohammed H; Iqbal, Zafar; Shaik, Munvar M; Gan, Siew H; Kamal, Mohammad A

    2014-04-01

    Alzheimer's disease (AD) is a neurodegenerative disorder that leads to memory problems. It has been associated with type 2 diabetes mellitus at both the molecular and biochemical level. Pancreatic cells have molecular similarities to the brain at the transcriptomic and proteomic levels. Several genes have been reported to be responsible for both AD and diabetes. Currently, no proper treatment is available but various therapeutic approaches are utilized worldwide for the management of these disorders and may be nanoparticles and herbal treatment of Bacopa monnieri will make promise for the treatment of AD in future. The formation of amyloids in neurons and the formation of amylin in pancreatic cells are potential links between these two disorders, which can be silent killers.

  16. Canagliflozin Treatment in Patients with Type 2 Diabetes Mellitus.

    PubMed

    Triplitt, Curtis; Cornell, Susan

    2015-01-01

    Current guidelines for treatment of type 2 diabetes mellitus (T2DM) indicate a patient-centered approach that should go beyond glycemic control. Of the many antihyperglycemic agents available for treatment of T2DM, sodium-glucose cotransporter 2 (SGLT2) inhibitors offer the advantages of reduced glycated hemoglobin (A1C), body weight (BW), and systolic blood pressure (SBP) and are associated with a low risk of hypoglycemia when used either as monotherapy or with other agents not typically associated with increased risk of hypoglycemia. Collaborative, multidisciplinary teams are best suited to provide care to patients with diabetes, and clinical pharmacists can enhance the care provided by these teams. This review aims to provide insight into the mode of action, pharmacology, potential drug-drug interactions, clinical benefits, and safety considerations associated with use of the SGLT2 inhibitor canagliflozin in patients with T2DM and to provide information to enhance clinical pharmacists' understanding of canagliflozin.

  17. Child abuse suspicion masquerading new onset insulin dependent diabetes mellitus.

    PubMed

    Shles, Ayelet; Fainmesser, Pinchas; Eliakim, Alon; Nemet, Dan

    2011-01-01

    The identification and diagnosis of child abuse is a challenging task to the pediatrician. The increased awareness among both the public and medical personnel, while improving attentiveness to this important subject, can sometimes result in misdiagnosing medical conditions, thus causing distress and delay in required treatment. Numerous reports have described conditions mimicking non-accidental injuries; most of these include dermatological findings related to skin diseases, medical conditions causing pathological fractures, and rare diseases with unusual physical findings. We present a case of a 9.5-year-old child in which the workup for a suspected abusive event led to a delay in the diagnosis of insulin dependent diabetes mellitus later presented as diabetic ketoacidosis. PMID:22145485

  18. Risk assessment and management of post-transplant diabetes mellitus.

    PubMed

    Han, Eugene; Kim, Myoung Soo; Kim, Yu Seun; Kang, Eun Seok

    2016-10-01

    The success rate of organ transplantation has been increasing with advances in surgical and pharmacological techniques. However, the number of solid organ transplant recipients who require metabolic disease management is also growing. Post-transplant diabetes mellitus (PTDM) is a common complication after solid organ transplantation and is associated with risks of graft loss, cardiovascular morbidity, and mortality. Other risk factors for PTDM include older age, genetic background, obesity, hepatitis C virus infection, hypomagnesemia, and use of immunosuppressant agents (corticosteroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitor). Management of PTDM should be started before the transplantation plan to properly screen high-risk patients. Even though PTDM management is similar to that of general type 2 diabetes, therapeutic approaches must be made with consideration of drug interactions between immunosuppressive agents, glucose-lowering medications, and graft rejection and function.

  19. Type 2 diabetes mellitus in children and youth.

    PubMed

    Ramkumar, S; Tandon, Nikhil

    2013-03-01

    Type 2 diabetes mellitus (T2DM) which used to be a disease of adults is now seen commonly at an early age in children and adolescents. T2DM is now an important diagnostic consideration in children who present with signs and symptoms of diabetes. The emerging epidemic of obesity in children throughout the world and the resultant insulin resistance contributes to the increasing prevalence of T2DM in this population. The recommended treatment options include metformin and insulin. Optimal glycemic control is essential considering the lifelong nature of the disease and therefore, the increased risk of long term complications - both microvascular and macrovascular. This review article summarizes the classification, diagnosis, pathogenesis, management, complications and screening of T2DM in children, incorporating and contextualizing guidelines from various professional associations.

  20. Canagliflozin Treatment in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Triplitt, Curtis; Cornell, Susan

    2015-01-01

    Current guidelines for treatment of type 2 diabetes mellitus (T2DM) indicate a patient-centered approach that should go beyond glycemic control. Of the many antihyperglycemic agents available for treatment of T2DM, sodium-glucose cotransporter 2 (SGLT2) inhibitors offer the advantages of reduced glycated hemoglobin (A1C), body weight (BW), and systolic blood pressure (SBP) and are associated with a low risk of hypoglycemia when used either as monotherapy or with other agents not typically associated with increased risk of hypoglycemia. Collaborative, multidisciplinary teams are best suited to provide care to patients with diabetes, and clinical pharmacists can enhance the care provided by these teams. This review aims to provide insight into the mode of action, pharmacology, potential drug–drug interactions, clinical benefits, and safety considerations associated with use of the SGLT2 inhibitor canagliflozin in patients with T2DM and to provide information to enhance clinical pharmacists’ understanding of canagliflozin. PMID:26523120

  1. Transplantation of mesenchymal stem cells improves type 1 diabetes mellitus.

    PubMed

    Li, Lisha; Li, Furong; Gao, Feng; Yang, Yali; Liu, Yuanyuan; Guo, Pingping; Li, Yulin

    2016-05-01

    Bone-marrow-derived stem cells can regenerate pancreatic tissue in a model of type 1 diabetes mellitus. Mesenchymal stem cells (MSCs) form the main part of bone marrow. We show that the intrapancreatic transplantation of MSCs elevates serum insulin and C-peptide, while decreasing blood glucose. MSCs engrafted into the damaged rat pancreas become distributed into the blood vessels, acini, ducts, and islets. Renascent islets, islet-like clusters, and a small number of MSCs expressing insulin protein have been observed in the pancreas of diabetic rats. Intrapancreatic transplantation of MSCs triggers a series of molecular and cellular events, including differentiation towards the pancreas directly and the provision of a niche to start endogenous pancreatic regeneration, which ameliorates hypoinsulinemia and hyperglycemia caused by streptozotocin. These data establish the many roles of MSCs in the restoration of the function of an injured organ. PMID:26650464

  2. Juvenile rheumatoid arthritis in children with diabetes mellitus.

    PubMed

    Rudolf, M C; Genel, M; Tamborlane, W V; Dwyer, J M

    1981-10-01

    Seven children with insulin-dependent diabetes mellitus were found to have juvenile rheumatoid arthritis; six of these children had the polyarticular form of the disease. All six had positive serology (rheumatoid factor and/or antinuclear antibody) and clinical or serologic evidence of autoimmune diseases usually ascribed to the thyrogastric cluster. Five expressed HLA antigens associated with increased risk for both diabetes and rheumatoid arthritis in adults. Evidence of B cell hyperactivity and impaired T cell response was found in some, but immunoregulatory function was normal in all. The association of these two diseases may be the result of factors other than chance alone, and may be more common than previously suspected. PMID:6974234

  3. [Cytological changes in patients with diabetes mellitus and corneal ulcer].

    PubMed

    Raica, D; Turlea, M; Ciocmăreanu, M; Haidar, A; Demian, C; Jinga, F

    1999-01-01

    There were studied 11 diabetic patients, insulin dependents, from 4 were with juvenile diabetes mellitus. These were hospitalized in the Dept. Ophthalm. of the City Hospital of Arad, during 1996-1998, admitted with the diagnosis of corneal ulcer. There were made samples of the gathered secretion from the level of conjunctiva and of the grataj material, gathered at the level of the edges of the corneal ulcer. All samples were stained with the BPT-Drăgan method. There are described cytologic alterations, insisting on details that indicate the severity of the corneal disease. There are taken into consideration cytologic aspects in relationship with the clinical outcome of the disease, pointing out the cellular alterations which announce a nonfavourable prognosis. Cytologic results can improve the diagnosis and they are involved in therapeutic schedule. PMID:10641114

  4. Risk assessment and management of post-transplant diabetes mellitus.

    PubMed

    Han, Eugene; Kim, Myoung Soo; Kim, Yu Seun; Kang, Eun Seok

    2016-10-01

    The success rate of organ transplantation has been increasing with advances in surgical and pharmacological techniques. However, the number of solid organ transplant recipients who require metabolic disease management is also growing. Post-transplant diabetes mellitus (PTDM) is a common complication after solid organ transplantation and is associated with risks of graft loss, cardiovascular morbidity, and mortality. Other risk factors for PTDM include older age, genetic background, obesity, hepatitis C virus infection, hypomagnesemia, and use of immunosuppressant agents (corticosteroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitor). Management of PTDM should be started before the transplantation plan to properly screen high-risk patients. Even though PTDM management is similar to that of general type 2 diabetes, therapeutic approaches must be made with consideration of drug interactions between immunosuppressive agents, glucose-lowering medications, and graft rejection and function. PMID:27621191

  5. Diabetes mellitus: current concepts in diagnosis, classification and coding.

    PubMed

    Allende-Vigo, M

    2001-06-01

    Diabetes mellitus (DM) is a chronic disorder of metabolism, which is commonly found in the Puerto Rican population. In this article the current concepts in diagnosis, classification and correct coding of DM are discussed. Since the cutoff point for diagnosing DM was lowered to 126 mg/dl in a fasting plasma glucose levels, many persons may be undiagnosed unless physicians are aware of this fact. Once diagnosed, strict control of the disease is mandatory to prevent the chronic diabetic complications. It is very important to classify and code the persons with DM accurately. This practice will help researchers, physicians, health insurance managers and other persons to assess the prevalence of DM and its complications. This will eventually lead to better management of this important disease.

  6. Management of type 2 diabetes mellitus associated with pituitary gigantism.

    PubMed

    Ali, Omar; Banerjee, Swati; Kelly, Daniel F; Lee, Phillip D K

    2007-01-01

    Pituitary gigantism, a condition of endogenous growth hormone (GH) hypersecretion prior to epiphyseal closure, is a rare condition. In the adult condition of GH excess, acromegaly, the occurrence of type 2 diabetes mellitus (T2DM) and diabetic ketoacidosis (DKA) have been reported, with resolution following normalization of GH levels. We report the case of a 16-year-old male with pituitary gigantism due to a large invasive suprasellar adenoma who presented with T2DM and DKA. Despite surgical de-bulking, radiotherapy and medical treatment with cabergoline and pegvisomant, GH and insulin-like growth factor-I (IGF-I) levels remained elevated. However, the T2DM and recurrent DKA were successfully managed with metformin and low-dose glargine insulin, respectively. We review the pathophysiology of T2DM and DKA in growth hormone excess and available treatment options. PMID:17629784

  7. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus

    PubMed Central

    Tangvarasittichai, Surapon

    2015-01-01

    Oxidative stress is increased in metabolic syndrome and type 2 diabetes mellitus (T2DM) and this appears to underlie the development of cardiovascular disease, T2DM and diabetic complications. Increased oxidative stress appears to be a deleterious factor leading to insulin resistance, dyslipidemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to T2DM. Chronic oxidative stress, hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant, have high oxidative energy requirements, decrease the gene expression of key β-cell genes and induce cell death. If β-cell functioning is impaired, it results in an under production of insulin, impairs glucose stimulated insulin secretion, fasting hyperglycemia and eventually the development of T2DM. PMID:25897356

  8. Attenuating type 2 diabetes with postpartum interventions following gestational diabetes mellitus

    PubMed Central

    Wasalathanthri, Sudharshani

    2015-01-01

    Women with a history of gestational diabetes should be screened during and after the postpartum period because of a high risk for developing type 2 diabetes mellitus. Although differences exist between guidelines practiced throughout various parts of the world, all recommend the use of cutoffs for fasting and/or post-load plasma glucose to diagnose diabetes or pre-diabetes. The use of these glycemic parameters could be optimized when a trend is observed, rather than considering them as isolated values at various time points. As the presence of insulin resistance and beta-cell dysfunction start before glycemic changes are evident, the estimation of insulin sensitivity and beta-cell function by Homeostatic Model Assessment is suggested for women who have additional risk factors for diabetes, such as obesity. Disease-modifying lifestyle intervention should be the first-line strategy to prevent or delay the onset of diabetes in women with a history of gestational diabetes mellitus. Intensive lifestyle interventions are designed to decrease caloric intake and increase physical activity in order to reduce body weight and fat, which will in turn reduce insulin resistance. This article also reviews unique problems of postpartum women, which should be considered when designing and implementing an intervention. Innovative “out of the box” thinking is appreciated, as continued adherence to a program is a challenge to both the women and the health care personnel who deal with them. PMID:25987963

  9. Attenuating type 2 diabetes with postpartum interventions following gestational diabetes mellitus.

    PubMed

    Wasalathanthri, Sudharshani

    2015-05-15

    Women with a history of gestational diabetes should be screened during and after the postpartum period because of a high risk for developing type 2 diabetes mellitus. Although differences exist between guidelines practiced throughout various parts of the world, all recommend the use of cutoffs for fasting and/or post-load plasma glucose to diagnose diabetes or pre-diabetes. The use of these glycemic parameters could be optimized when a trend is observed, rather than considering them as isolated values at various time points. As the presence of insulin resistance and beta-cell dysfunction start before glycemic changes are evident, the estimation of insulin sensitivity and beta-cell function by Homeostatic Model Assessment is suggested for women who have additional risk factors for diabetes, such as obesity. Disease-modifying lifestyle intervention should be the first-line strategy to prevent or delay the onset of diabetes in women with a history of gestational diabetes mellitus. Intensive lifestyle interventions are designed to decrease caloric intake and increase physical activity in order to reduce body weight and fat, which will in turn reduce insulin resistance. This article also reviews unique problems of postpartum women, which should be considered when designing and implementing an intervention. Innovative "out of the box" thinking is appreciated, as continued adherence to a program is a challenge to both the women and the health care personnel who deal with them. PMID:25987963

  10. Attenuating type 2 diabetes with postpartum interventions following gestational diabetes mellitus.

    PubMed

    Wasalathanthri, Sudharshani

    2015-05-15

    Women with a history of gestational diabetes should be screened during and after the postpartum period because of a high risk for developing type 2 diabetes mellitus. Although differences exist between guidelines practiced throughout various parts of the world, all recommend the use of cutoffs for fasting and/or post-load plasma glucose to diagnose diabetes or pre-diabetes. The use of these glycemic parameters could be optimized when a trend is observed, rather than considering them as isolated values at various time points. As the presence of insulin resistance and beta-cell dysfunction start before glycemic changes are evident, the estimation of insulin sensitivity and beta-cell function by Homeostatic Model Assessment is suggested for women who have additional risk factors for diabetes, such as obesity. Disease-modifying lifestyle intervention should be the first-line strategy to prevent or delay the onset of diabetes in women with a history of gestational diabetes mellitus. Intensive lifestyle interventions are designed to decrease caloric intake and increase physical activity in order to reduce body weight and fat, which will in turn reduce insulin resistance. This article also reviews unique problems of postpartum women, which should be considered when designing and implementing an intervention. Innovative "out of the box" thinking is appreciated, as continued adherence to a program is a challenge to both the women and the health care personnel who deal with them.

  11. [Renal histological lesions in patients with type II diabetes mellitus].

    PubMed

    Castellano, I; Covarsí, A; Novillo, R; Gómez-Martino, J R; Ferrando, L

    2002-01-01

    Diabetic glomerulosclerosis is the most frequent cause of renal disease in patients with type II diabetes mellitus (DM), sometimes accompanied by vascular lesions. However, other glomerular pathologies are important in these patients. The aim of this study was to evaluate the prevalence of non-diabetic nephropathy (NDN) in selected patients with type II DM, and to identify clinical markers that may predict its presence in this population. We reviewed 20 renal biopsies performed on twenty patients with type II DM. Nine of them showed diabetic nephropathy (DN) (45%), whereas eleven showed NDN (55%): 1 IgA nephropathy, 3 vasculitis and 7 membranous nephropathy. We found no differences between the two groups with regard to sex, duration of DM, insulin therapy, glycosylated haemoglobin, proteinuria, presence of nephrotic syndrome, hypertension, serum IgA level or renal size. The NDN group had haematuria in 63.6%, whereas the patients with NDN had it in 44.4% (NS). Body mass index was higher in NDN patients (30 +/- 6.7 vs 22 +/- 2.9; p < 0.01), The same was true for creatinine clearance (82.2 +/- 51.4 ml/m vs 40.4 +/- 19.6 ml/m; p < 0.05). The age at the moment of diagnosis was higher in ND patients (67 +/- 11.2 vs 54.3 +/- 4.6; p < 0.05). The 3 patients who had diabetic retinopathy were found to have DN on renal biopsy (diagnostic specificity = 100%), although 66.7% of the patients with diabetic glomerulopathy had no retinopathy. We conclude that patients with type II DM with renal findings suggesting non-diabetic renal disease frequently it have NDN, and a renal biopsy must be performed. The presence of retinopathy has a predictive value of 100% in predicting DN, therefore its existence may make this diagnostic procedure unneccesary.

  12. Understanding the type 2 diabetes mellitus and cardiovascular disease risk paradox.

    PubMed

    Green, Jennifer B

    2014-05-01

    Patients with diabetes have approximately a 2-fold increase in the risk for coronary heart disease, stroke, and death from vascular causes compared with patients who do not have diabetes. Interventions targeted at modifiable risk factors, such as smoking cessation and management of hypertension and dyslipidemia, reduce the risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). Paradoxically, large randomized studies have failed to conclusively show that intensively lowering glucose reduces CVD event rates in patients with T2DM, despite pathophysiologic and epidemiologic evidence suggesting that hyperglycemia contributes to CVD. Although initiation of intensive glycemic control early in the disease course may be associated with a reduction in the long-term risk of cardiovascular (CV) events, this approach in those with long-standing or complicated T2DM is not of clear benefit and may even be harmful in some. Failure to mitigate risk with antihyperglycemic therapy and the potential for some treatments to increase CVD risk underlies a treatment paradox. New glucose-lowering therapies are now subject to close scrutiny for CV safety before and after drug approval. Results from the first trials designed to meet the recent CV regulatory requirements have shown no increased risk of major adverse CV events but also no CV benefit from dipeptidyl peptidase-4 inhibitor therapy, as well as a potentially increased risk of hospitalization for heart failure. Conclusive evidence of CV risk reduction with glucose-lowering therapy is still lacking and scrutiny of additional agents is necessary. Type 2 diabetes mellitus is a heterogeneous disease, for which patient-centered, individualized care, and goal-setting is appropriate. Interventions that focus on the management of CV risk factors and glucose lowering with medications that are not cardiotoxic represent an optimal and attainable treatment approach.

  13. Macroscopic placental changes associated with fetal and maternal events in diabetes mellitus

    PubMed Central

    Salge, Ana Karina Marques; Rocha, Karlla Morgana Nunes; Xavier, Raphaela Maioni; Ramalho, Wilzianne Silva; Rocha, Érika Lopes; Guimarães, Janaína Valadares; Silva, Renata Calciolari Rossi e; Siqueira, Karina Machado; Abdalla, Douglas Reis; Michelin, Márcia Antoniazzi; Murta, Eddie Fernando Candido

    2012-01-01

    OBJECTIVES: The current study sought to identify macroscopic placental changes associated with clinical conditions in women with or without diabetes and their newborns. METHODS: The study population consisted of 62 pregnant women clinically diagnosed with diabetes and 62 healthy women (control group). RESULTS: Among the subjects with diabetes, 43 women (69.3%) were diagnosed with gestational diabetes mellitus, 15 had diabetes mellitus I (24.2%), and four had diabetes mellitus II (6.5%). The mean age of the women studied was 28.5±5.71 years, and the mean gestational age of the diabetic women was 38.51 weeks. Of the 62 placentas from diabetic pregnancies, 49 (79%) maternal surfaces and 59 (95.2%) fetal surfaces showed abnormalities, including calcium and fibrin deposits, placental infarction, hematoma, and fibrosis. A statistical association was found between newborn gender and fetal and maternal placental changes (p = 0.002). The mean weight of the newborns studied was 3,287±563 g for women with diabetes mellitus, 3,205±544 g for those with gestational diabetes mellitus, 3,563±696 g for those with diabetes mellitus II, and 3,095±451 g for those with diabetes mellitus I. CONCLUSIONS: Infarction, hematoma, calcification, and fibrin were found on the maternal and fetal placental surfaces in women with diabetes. Women with gestational diabetes and post-term infants had more calcium deposits on the maternal placental surface as compared to those with type I and type II diabetes. PMID:23070348

  14. Serum Glycated Albumin to Guide the Diagnosis of Diabetes Mellitus.

    PubMed

    Wu, Wan-Chen; Ma, Wen-Ya; Wei, Jung-Nan; Yu, Tse-Ya; Lin, Mao-Shin; Shih, Shyang-Rong; Hua, Cyue-Huei; Liao, Ying-Jhu; Chuang, Lee-Ming; Li, Hung-Yuan

    2016-01-01

    In the diagnosis of diabetes mellitus, hemoglobin A1c (HbA1c) is sometimes measured to determine the need of an oral glucose tolerance test (OGTT). However, HbA1c does not accurately reflect glycemic status in certain conditions. This study was performed to test the possibility that measurement of serum glycated albumin (GA) better assesses the need for OGTT. From 2006 to 2012, 1559 subjects not known to have diabetes or to use anti-diabetic medications were enrolled. Serum GA was measured, and a 75-g OGTT was then performed to diagnose diabetes. Serum GA correlated significantly to age (r = 0.27, p<0.001), serum albumin (r = -0.1179, age-adjusted p = 0.001), body mass index (r = -0.24, age-adjusted p<0.001), waist circumference (r = -0.16, age-adjusted p<0.001), and plasma GA (r = 0.999, p<0.001), but was unaffected by diet (p = 0.8). Using serum GA at 15% for diagnosis of diabetes, the sensitivity, specificity, and area under the receiver-operating characteristic curve were 74%, 85%, and 0.86, respectively. Applying a fasting plasma glucose (FPG) value of < 100 mg/dL to exclude diabetes and of ≥ 126 mg/dL to diagnose diabetes, 14.4% of the study population require an OGTT (OGTT%) with a sensitivity of 78.8% and a specificity of 100%. When serum GA value of 14% and 17% were used to exclude and diagnose diabetes, respectively, the sensitivity improved to 83.3%, with a slightly decrease in specificity (98.2%), but a significant increase in OGTT% (35%). Using combined FPG and serum GA cutoff values (FPG < 100 mg/dL plus serum GA < 15% to exclude diabetes and FPG ≥ 126 mg/dL or serum GA ≥ 17% to diagnose diabetes), the OGTT% was reduced to 22.5% and the sensitivity increased to 85.6% with no change in specificity (98.2%). In the diagnosis of diabetes, serum GA measurements can be used to determine the need of an OGTT.

  15. Aspirin sensitivity of platelet aggregation in diabetes mellitus.

    PubMed

    Albert, Stewart G; Hasnain, Bibi I; Ritter, Detlef G; Joist, J Heinrich; Mooradian, Arshag D

    2005-11-01

    Although aspirin is cardioprotective in high-risk populations, many with diabetes mellitus (DM) are unresponsive to these benefits. We questioned whether cardiovascular unresponsiveness might be demonstrated by lack of aspirin sensitivity to in vitro platelet functions especially in subjects with poorly controlled diabetes. Six women and 4 men (48+/-8 years [mean+/-S.D.]), selected for poor control (glycohemoglobin 11.9+/-2.2%) and 10 sex-age (+/-5 years) matched controls received 81 mg aspirin daily. There was a 2-week washout from aspirin and related drugs. After the aspirin dose on day-7, blood for platelet aggregation assays, and 24-h urine for 2,3 dinor thromboxane B2 (TxB2) and 2,3 dinor 6-keto (PGF1alpha) were obtained. Aspirin sensitivity was defined as inhibition (i.e., lower than expected) platelet aggregation after exposure to an agonist. Those with diabetes and controls were sensitive to aspirin inhibition of platelet aggregation induced by 1.6 mM arachidonic acid (9.5+/-3.9% versus 9.1+/-3.1%, normal range 40-100%) and by 0.83 microg/mL collagen (17.4+/-13.9% versus 13.2+/-9.3%, normal range 60-93%), respectively. Aspirin sensitivity to 2 microM ADP was present in five with diabetes and five controls. Urinary prostaglandin metabolites were suppressed below reference ranges, without differences between those with DM or controls for TxB2 (350+/-149 pg/mg versus 348+/-93 pg/mg creatinine) and PGF1alpha (255+/-104 pg/mg versus 222+/-88 pg/mg creatinine). In conclusion, in poorly controlled diabetes, there was no differential lack of aspirin sensitivity to platelet aggregation, or lack of aspirin suppression of urinary TxB2 or PGF1alpha, compared with controls on aspirin. Despite suppression of urinary prostaglandin metabolites, aspirin resistance was most apparent to ADP-mediated platelet aggregation. It is not known what level of inhibition of in vitro tests is necessary for the cardioprotective benefits of aspirin in diabetes mellitus. Thus, the lack of

  16. The epidemiology of type 1 diabetes in children.

    PubMed

    Stanescu, Diana E; Lord, Katherine; Lipman, Terri H

    2012-12-01

    Type 1 diabetes is one of the most common chronic diseases of childhood and adolescence. Multiple registries have assessed its epidemiology and have noted a steady increase in incidence of the disease. This article addresses the epidemiology of type 1 diabetes in children aged 0 to 19 years, by reviewing the available, current data from both US and international registries. The prevalence and incidence data by race, ethnicity, age of onset, sex, season of onset, and temporal trends of the disease are presented. Multiple risk factors have been implicated for the increasing incidence in type 1 diabetes, and these genetic and environmental risk factors are discussed.

  17. Statin-Associated Diabetes Mellitus: Review and Clinical Guide.

    PubMed

    Backes, James M; Kostoff, Matthew D; Gibson, Cheryl A; Ruisinger, Janelle F

    2016-03-01

    A small but significant link between new-onset diabetes mellitus (NOD) and statin therapy was noted with rosuvastatin users in the Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin study. Since then multiple analyses have further confirmed this association, with most studies demonstrating a modest increase in NOD with statin therapy, especially among individuals with risk factors for developing diabetes mellitus. More recent observational analyses suggest a stronger correlation between statin use and NOD, however. A definitive mechanism confirming causation between statins and glucose impairment remains elusive, but many have been proposed. Although considered a class effect by the US Food and Drug Administration, most data indicate NOD is dependent upon the dose and potency of the statin, with certain agents appearing to be less diabetogenic. The consensus is that the benefits of statin therapy far outweigh the risk of NOD, especially among patients with high cardiovascular risk. Nonetheless, more studies are needed to better understand this association and long-term clinical implications. In the meantime, we provide clinicians with a practical guide to assist with clinical decision making when prescribing statin therapy. Overall, this article serves to provide the primary care physician with a timely review of the most clinically relevant data regarding statins and NOD, with hopes to ultimately optimize statin prescribing and limit any potential drug-induced glucose impairment.

  18. SGLT2 inhibition in diabetes mellitus: rationale and clinical prospects.

    PubMed

    Ferrannini, Ele; Solini, Anna

    2012-02-07

    This Review covers the rationale, physiological consequences and clinical application of pharmacological sodium-glucose cotransporter 2 (SGLT2) inhibition. In patients with type 2 diabetes mellitus, in whom renal glucose reabsorption might be upregulated, orally active, selective SGLT2 inhibitors improve glycaemic control to a therapeutically useful extent. Chronic administration of several SGLT2 inhibitors dose-dependently lowers HbA(1c) levels by 0.5-1.5% without causing hypoglycaemia. The unique mechanism of action of SGLT2 inhibitors-which does not hinge upon β-cell function or tissue insulin sensitivity-means that they can exert their antihyperglycaemic effects in combination with any other oral antidiabetic drug as well as insulin. Available phase III studies confirm a good tolerability profile. Weight loss owing to urinary calorie leakage may be less than expected, but the negative energy balance offers a valuable clinical benefit. Offloading of sodium can assist blood pressure control. The progressive loss of efficacy in patients with reduced glomerular function will have to be balanced against the possibility of renal protection. The safety issues of genitourinary infections and cancer risk requires careful, proactive monitoring and analysis of robust exposure data, particularly in elderly, frail patients and in patients with impaired kidney function and/or high cardiovascular/cancer risk, who represent an increasing fraction of the population with diabetes mellitus.

  19. The metallome of the human placenta in gestational diabetes mellitus.

    PubMed

    Roverso, Marco; Berté, Chiara; Di Marco, Valerio; Lapolla, Annunziata; Badocco, Denis; Pastore, Paolo; Visentin, Silvia; Cosmi, Erich

    2015-07-01

    Obtaining the knowledge of the "omics" and therefore of the metallomics of gestational diabetes mellitus (GDM) appears to be a necessary task to obtain information about the molecular causes of this disease. In this study, the metallome of GDM and of other types of diabetes mellitus was first reviewed. The comparative analysis of the published data revealed that no GDM elemental markers could be identified with sufficient reliability in blood or in the other considered samples, with the partial exception of selenium. The placenta was chosen as an alternative target organ for the analysis of the GDM metallome. The full elemental average composition of 19 healthy placentas was obtained by ICP-MS. Analyses were then performed on 28 placentas from women affected by GDM. The statistical tests and the principal component analysis evidenced that cadmium was found in lower concentrations and selenium was found in higher concentrations in GDM placentas than in those of the control group. These results were interpreted in light of literature data, and they attract attention on two key elements for understanding the molecular pathways of GDM.

  20. Exercise thallium imaging in patients with diabetes mellitus. Prognostic implications

    SciTech Connect

    Felsher, J.; Meissner, M.D.; Hakki, A.H.; Heo, J.; Kane-Marsch, S.; Iskandrian, A.S.

    1987-02-01

    We used exercise thallium 201 imaging in 123 patients with diabetes mellitus (77 men and 46 women, aged 56 +/- 8 years), 75% of whom had angina pectoris (typical or atypical). During exercise testing, 18 patients (15%) had angina pectoris, 28 (23%) had ischemic ST changes, and 69 (56%) had abnormal thallium images. During follow-up (up to 36 months), there were 12 cardiac events; four patients died of cardiac causes and eight had nonfatal acute myocardial infarction. Univariate and multivariate survival analysis identified two independent predictors of cardiac events: the event rate was significantly less in patients with normal images and exercise heart rate over 120 beats per minute than in patients with abnormal images and exercise heart rate of 120 beats per minute or less (0% vs 22%). The patients with abnormal images or exercise heart rate of 120 beats per minute or less had an intermediate event rate (11.5%). Furthermore, two of the 54 patients with normal images and ten of 69 patients with abnormal images had subsequent cardiac events. Thus, exercise thallium imaging is useful in risk stratification in patients with diabetes mellitus.

  1. A Combined Metabolomic and Proteomic Analysis of Gestational Diabetes Mellitus.

    PubMed

    Hajduk, Joanna; Klupczynska, Agnieszka; Dereziński, Paweł; Matysiak, Jan; Kokot, Piotr; Nowak, Dorota M; Gajęcka, Marzena; Nowak-Markwitz, Ewa; Kokot, Zenon J

    2015-12-16

    The aim of this pilot study was to apply a novel combined metabolomic and proteomic approach in analysis of gestational diabetes mellitus. The investigation was performed with plasma samples derived from pregnant women with diagnosed gestational diabetes mellitus (n = 18) and a matched control group (n = 13). The mass spectrometry-based analyses allowed to determine 42 free amino acids and low molecular-weight peptide profiles. Different expressions of several peptides and altered amino acid profiles were observed in the analyzed groups. The combination of proteomic and metabolomic data allowed obtaining the model with a high discriminatory power, where amino acids ethanolamine, L-citrulline, L-asparagine, and peptide ions with m/z 1488.59; 4111.89 and 2913.15 had the highest contribution to the model. The sensitivity (94.44%) and specificity (84.62%), as well as the total group membership classification value (90.32%) calculated from the post hoc classification matrix of a joint model were the highest when compared with a single analysis of either amino acid levels or peptide ion intensities. The obtained results indicated a high potential of integration of proteomic and metabolomics analysis regardless the sample size. This promising approach together with clinical evaluation of the subjects can also be used in the study of other diseases.

  2. Diabetes Mellitus Induces Alzheimer’s Disease Pathology: Histopathological Evidence from Animal Models

    PubMed Central

    Kimura, Nobuyuki

    2016-01-01

    Alzheimer’s disease (AD) is the major causative disease of dementia and is characterized pathologically by the accumulation of senile plaques (SPs) and neurofibrillary tangles (NFTs) in the brain. Although genetic studies show that β-amyloid protein (Aβ), the major component of SPs, is the key factor underlying AD pathogenesis, it remains unclear why advanced age often leads to AD. Interestingly, several epidemiological and clinical studies show that type II diabetes mellitus (DM) patients are more likely to exhibit increased susceptibility to AD. Moreover, growing evidence suggests that there are several connections between the neuropathology that underlies AD and DM, and there is evidence that the experimental induction of DM can cause cognitive dysfunction, even in rodent animal models. This mini-review summarizes histopathological evidence that DM induces AD pathology in animal models and discusses the possibility that aberrant insulin signaling is a key factor in the induction of AD pathology. PMID:27058526

  3. Obstructive sleep apnea as a risk factor for type 2 diabetes mellitus

    PubMed Central

    Rajan, Preethi; Greenberg, Harly

    2015-01-01

    Obstructive sleep apnea (OSA) is independently associated with cardiovascular and cardiometabolic risk in several large epidemiologic studies. OSA leads to several physiologic disturbances such as intermittent hypoxia, sleep fragmentation, and increase in autonomic tone. These disturbances have been associated with insulin resistance and type 2 diabetes mellitus (T2DM) in animal and human studies. Studies also suggest a bidirectional relationship between OSA and T2DM whereby T2DM itself might contribute to the features of OSA. Moreover, successful treatment of OSA may reduce these risks, although this is controversial. The purpose of this article is to review 1) the links and bidirectional associations between OSA and T2DM; 2) the pathogenic mechanisms that might link these two disease states; 3) the role of continuous positive airway pressure therapy in improving glucose tolerance, sensitivity, and resistance; and 4) the implications for clinical practice. PMID:26491377

  4. [The Polypill: between myths and reality in the treatment of type 2 diabetes mellitus].

    PubMed

    Ruiz, J; Egli, M

    2006-05-31

    The Polypill: between myths and reality in the treatment of type 2 diabetes mellitus The concept of "Polypill" was developed from modeling analyses and the data were extracted from randomized-control trials and epidemiological studies. This "Polypill" should be a combination of three antihypertensive drugs associated to aspirin, a statin and folic acid. This "Polypill" would allow to reduce of more than 80% the cardiovascular events. The original publication suggests that all subjects of more than 55 years could benefit from this magic pill. Numerous positive and negative reactions showed themselves further to this publication. Other approaches based on the change of lifestyle seem so effective. Nevertheless, to have a really effective approach the therapeutic educational dimension should be also included in the basic strategy. PMID:16783994

  5. Application of berberine on treating type 2 diabetes mellitus.

    PubMed

    Pang, Bing; Zhao, Lin-Hua; Zhou, Qiang; Zhao, Tian-Yu; Wang, Han; Gu, Cheng-Juan; Tong, Xiao-Lin

    2015-01-01

    Traditional Chinese medicine (TCM) performs a good clinical practice and is showing a bright future in the treatment of diabetes mellitus (DM). TCM treatment has certain advantages of less toxicity and/or side effects, and herbs could provide multiple therapeutic effects. Berberine (BBR) is a classical natural medicine. In this review, we summarize the application of BBR in the treatment of DM from two aspects. First, modern pharmacological effects of BBR on glucose metabolism are summarized, such as improving insulin resistance, promoting insulin secretion, inhibiting gluconeogenesis in liver, stimulating glycolysis in peripheral tissue cells, modulating gut microbiota, reducing intestinal absorption of glucose, and regulating lipid metabolism. BBR is used to treat diabetic nephropathy (DPN), diabetic neuropathy (DN), and diabetic cardiomyopathy due to its antioxidant and anti-inflammatory activities. Second, the clinical application of BBR is reviewed, such as listing some clinical trials on the effectiveness and safety of BBR, explaining applicable stage and syndrome, the reasonable dose and dose formulation, and the toxicity and/or side effects. This review provides scientific evidence about BBR, as well as introducing some traditional Chinese medical theory and clinical experience, in order to guide clinician to use BBR more suitably and reasonably.

  6. Plasma YKL-40 during pregnancy and gestational diabetes mellitus.

    PubMed

    Rinnov, Anders R; Rathcke, Camilla N; Bonde, Lisbeth; Vilsbøll, Tina; Knop, Filip K

    2015-11-01

    Gestational diabetes mellitus (GDM) is characterised by hyperglycaemia during pregnancy. The clinical circumstances involved in the development of GDM leaves the patient at a high risk of the subsequent development of type 2 diabetes. Plasma levels of the inflammation marker YKL-40 are elevated in type 2 diabetes and correlate with fasting plasma glucose levels and insulin resistance in patients with type 2 diabetes. With the present study we aimed to determine if pregnancy (and associated insulin resistance) with or without GDM affects plasma YKL-40 levels. Plasma from women diagnosed with GDM and healthy normal glucose-tolerant pregnant women (non-GDM) was obtained at the third trimester of pregnancy and again 3-4 months following delivery, and levels of YKL-40 and interleukin 6 (IL-6; known to regulate YKL-40) were measured. Plasma YKL-40 levels were similarly low during pregnancy in both groups and increased significantly after delivery, but remained lower in the GDM group compared with the non-GDM group postpartum. In contrast, plasma IL-6 levels were not affected by pregnancy or diagnosis of GDM, Nevertheless, YKL-40 levels were associated with IL-6 levels in the non-GDM group (but not in the GDM group). Pregnancy seems to be associated with a temporary reduction in circulating YKL-40, which increases after delivery, but to a much lesser extent in women with GDM than in non-GDM women.

  7. Update on the treatment of type 2 diabetes mellitus

    PubMed Central

    Marín-Peñalver, Juan José; Martín-Timón, Iciar; Sevillano-Collantes, Cristina; del Cañizo-Gómez, Francisco Javier

    2016-01-01

    To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade. PMID:27660695

  8. Diabetes mellitus in the pre-school child.

    PubMed

    Santilli, F; Greene, S; Chiarelli, F

    2000-12-01

    Diabetes mellitus presents rarely in the pre-school child and presents specific problems because of the peculiarity of the young child physiology. Pathogenesis involves the classic immunological mechanisms, with a higher incidence of other autoimmunity and family history of diabetes. Because of the rarity of the condition in this age group, the delay of the recognition of the signs and symptoms, which are often subtle at onset, determines the increased incidence of ketoacidosis. The reasons for the lower glycaemic control in this age group include the persistence of endogenous insulin, but also a more detailed involvement by the parents in organising diabetes. For the same reason ketoacidosis is an unusual occurrence after diagnosis. As to insulin therapy, three or more injections a day should be recommended, as in the older child, while the modern devices for blood glucose monitoring have proved useful to improve glycaemic control and to decrease the frequency of nocturnal hypoglycaemia, which gives particular concern given the vulnerability of the nervous system in this age group. Management of diabetes in the pre-school child may result very difficult for both parents and health carers because of the erratic daily pattern of activity, sleep and feeding; however, with a cautious strategy which involves insulin therapy, diet and monitoring it is possible to achieve satisfactorily the following aims: physical well-being of the young child, normal growth, lack of hyperglycaemia or hypoglycaemia, acceptable value of glycosilated haemoglobin.

  9. Update on the treatment of type 2 diabetes mellitus.

    PubMed

    Marín-Peñalver, Juan José; Martín-Timón, Iciar; Sevillano-Collantes, Cristina; Del Cañizo-Gómez, Francisco Javier

    2016-09-15

    To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade. PMID:27660695

  10. Involvement of liver in diabetes mellitus: herbal remedies.

    PubMed

    Thent, Z C; Das, S

    2014-01-01

    Liver disease is considered as one of the major complications in oxidative stress disorders like diabetes mellitus (DM). DM presents with deterioration in carbohydrate metabolism which is characterized with chronic hyperglycemia. The organ which involves in glucose or carbohydrate metabolism and is most likely to be affected is the liver. Deterioration in liver architecture and metabolism in DM, are considered as common findings. In the present review both biochemical and histological changes occurring in diabetic liver are conferred in detail. To counteract the oxidative stress disorders and its untoward complications, antioxidant or herbs have emerged as alternative medicine. The present review focuses on several herbs with antioxidant properties towards diabetic liver disease such as Liquorice, Pelargonium gravenolens, Momordica charantia, Propolis from bee hives, Dihar, Curcuma Longa, Tinospora cordifolia, Kangen-karyu, Parsley, Chard, Green tea Catechins and Piper sarmentosum (P.s). The herbs or the compounds present in herbs have potential to improve the liver metabolism and maintain the integrity of liver tissue in DM. The review also opens the door for effective use of herbal products for complications involved in the diabetic liver disease. PMID:25203338

  11. Update on the treatment of type 2 diabetes mellitus

    PubMed Central

    Marín-Peñalver, Juan José; Martín-Timón, Iciar; Sevillano-Collantes, Cristina; del Cañizo-Gómez, Francisco Javier

    2016-01-01

    To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade.

  12. ASSESSMENT OF RISK FACTORS FOR DIABETES MELLITUS TYPE 2

    PubMed Central

    Begic, Edin; Arnautovic, Amira; Masic, Izet

    2016-01-01

    Introduction: Diabetes is a group of metabolic diseases characterized by hyperglycemia, and represents a disease of the modern age, disease of the 21st century. Prevention of this disease is listed as imperative. Aim of this article was to evaluate questionnaires on the assessment of risk factors for Diabetes Mellitus type 2. Material and Methods: A total of 540 questionnaires handed out randomly to citizens of Canton Sarajevo of all ages, sexes and educational levels (in January 2016) were analyzed. Results: Analyzed questionnaires showed relatively low risk of getting diabetes in the next ten years in the majority of the population. These results are rather encouraging but may in some way be in confrontation with the statistics which show a rapid outburst of diabetes. Conclusion: The life-style is the main reason for such a thing to happen, and looking at these questionnaires, we might get the feeling that we really do live in a, conditionally speaking, physically active society. That, from our everyday experience is not entirely true. It would be wise to continue doing research on this topic on the territory of Bosnia and Herzegovina. PMID:27482159

  13. [Diabetes mellitus in childhood and adolescence. Clinical types].

    PubMed

    Sires, J M

    1979-01-01

    It is today's general medical opinion that children's diabetes mellitus was uncommon in the past. It was generally admitted at that time the initail stages were so sudden as to make difficut its early diagnosis. It's increased incidence is at present an alarming truth; however, a parallel increase of diabetic coma or of mulminant types has rather dropped. Diabetes may be diagnosed by just considering the main symptoms at the onset which are polydipsia, polyuria and weight loss. If an early diagnosis is not made, acidosis (abdominal pain, nausea, vomiting) may appear within a few days or weeks followed by coma (Kussamul's acidotic respiration and dehydration). Coma may be avoided by an early diagnosis and a life may be saved. It must be stressed that an important percentage of children and adolescents show a slow and gradual evolution (week or months) of their diabetes: gradual weight loss, sometimes with noticeable polyphagia, occasional enuresis, but without other associated symptoms. Asymptomatic, intermittent glucosurias are also frequent; they vary in magnitude an almost always they appear without ketonuria and with fasting normal glycemia. According to our experience they may precede in weeks or months the clinical manifestations of the disease. Postprandial glycemia is a sure diagnostic resource; it is of greater trustworthines than fasting glycemia; therefore we advise it as a routine diagnostic procedure which we recommend widely. In uncertain situations, the oral glucose tolerance test is advisable. PMID:486258

  14. Update on the treatment of type 2 diabetes mellitus.

    PubMed

    Marín-Peñalver, Juan José; Martín-Timón, Iciar; Sevillano-Collantes, Cristina; Del Cañizo-Gómez, Francisco Javier

    2016-09-15

    To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade.

  15. Development of automated analytical capability for the early detection of diabetes mellitus

    NASA Technical Reports Server (NTRS)

    Zlatkis, A.

    1976-01-01

    The total profile of volatile metabolites in urine of patients with diabetes mellitus was studied. Because of the drastic abnormalities in the metabolism of carbohydrates, lipids, and proteins connected with diabetes it was expected that apart from acetone further characteristic abnormalities occur in the profiles if volatile urinary metabolites in cases of diabetes mellitus. Quantitative and qualitative changes were found in these urines as compared to the urines of normal subjects.

  16. Autophagy dysfunction and its link to Alzheimer's disease and type II diabetes mellitus.

    PubMed

    Wilson, Cornelia M; Magnaudeix, Amandine; Yardin, Catherine; Terro, Faraj

    2014-03-01

    Epidemiological data testifies the increasing incidence of Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM). Some associations were made between occidental lifestyle and development of these pathologies, moreover AD and T2DM are linked since each pathology is a causative risk factor for the other. Interestingly, autophagy, a catabolic pathway whose efficiency declines with age is importantly impaired in the affected tissues. Autophagy regulation is dependent of cell metabolic status and consequently on the 5'AMP-activated protein kinase (AMPK) and mammalian target of rapamycin signaling pathways. These pathways are altered with aging and molecular, pharmacological and physiological interventions increase lifespan in various organismal models and favours healthy aging diminishing the occurrence of age-related diseases such as diabetes, cancer, cardiovascular and neurodegenerative pathologies. Decreasing calorie intake has been known for a long time to have a beneficial effect on longevity and health. Some drug agonists of AMPK are known to mimic these effects such as metformin or resveratrol, a polyphenol extracted from plants and present in red wine, a component of the French paradox related diet. In this review, we present the epidemiological and pathogenesis links existing between AD and T2DM with an insight into the perturbations of the autophagic process highlighting the crucial role of the AMPK in development of age and metabolic related diseases. Hence, in a last part we will discuss the possible interventions susceptible to combat both T2DM and AD.

  17. Prevalence of metabolic syndrome in type 2 diabetes mellitus patients

    PubMed Central

    Nsiah, Kwabena; Shang, V Owusua; Boateng, K Agyenim; Mensah, FO

    2015-01-01

    Background: The diabetic condition is influenced by several factors, some of which can accelerate the disease's progression to various complications that aggravate the morbidity. Aims: This study aimed at determining the prevalence of metabolic syndrome (MetS) and its individual components and the most critical predictive risk factors of MetS in type 2 diabetic patients. Materials and Methods: This cross-sectional study involved 150 type 2 diabetes mellitus patients and was conducted at the Diabetes Centre of the Komfo Anokye Teaching Hospital in Kumasi, the Ashanti Region of Ghana, from February, 2013 to April, 2013. The study involved the use of a questionnaire to obtain some information on the diabetics, undertaking anthropometric measurements, as well as collecting blood samples for the measurement of some biochemical parameters; fasting blood glucose and lipid profile. MetS was defined according to the National Cholesterol Education Program/Adult Treatment Panel III criteria. Results: The prevalence of MetS was 58% in the studied Ghanaian population. Hypertension was the commonest risk factor (60%), followed by central obesity (48.67%) and dyslipidemia (37%). Female type 2 diabetics had a higher prevalence of MetS, and carried more components than their male counterparts. Regression analysis showed three factors; femininity, high body mass index and low educational status were the most critical predictive risk factors of MetS, according to this study. Conclusion: With hypertension being the commonest component, future cardiovascular disease prevention strategies should focus attention on its management and prevention, through education. PMID:26097823

  18. Analysis of intracranial pressure pulse waveform and brain capillary morphology in type 2 diabetes mellitus rats.

    PubMed

    Onodera, Hidetaka; Oshio, Kotaro; Uchida, Masashi; Tanaka, Yuichiro; Hashimoto, Takuo

    2012-06-15

    Diabetes mellitus in neurosurgical patients is known to be a disease with high risks and severe outcomes. However, the mechanism by which diabetes mellitus induces dysfunction of brain tissue is not well known. The hypothesis of this study was that the damage to brain microvasculature in diabetes mellitus results in impaired compliance of the brain. Pathological changes associated with type II diabetes were investigated using a rat model. Pathophysiological changes in diabetic brain tissue were also investigated to confirm cerebral compliance by analyzing intracranial pressure waveforms. Pathologic findings revealed thickening of the basement membrane and fibrous collagen infiltration into the inner basement membrane of the brain microvasculature in diabetes mellitus. Analysis of intracranial pressure waveforms revealed that the P2 portion increased in diabetic rats compared to the control and was increased further with the increase in intracranial pressure. Analysis of the differential pressure curve, with respect to time, demonstrated that intracranial elasticity showed a concomitant increase. Pathologic findings and intracranial pressure waveforms were consistent with changes in brain microvasculature in diabetes mellitus. The increase of elasticity of brain tissue in diabetes mellitus may exacerbate the damage of intracranial disease.

  19. The epidemiology and molecular mechanisms linking obesity, diabetes, and cancer.

    PubMed

    Ferguson, Rosalyn D; Gallagher, Emily J; Scheinman, Eyal J; Damouni, Rawan; LeRoith, Derek

    2013-01-01

    The worldwide epidemic of obesity is associated with increasing rates of the metabolic syndrome and type 2 diabetes. Epidemiological studies have reported that these conditions are linked to increased rates of cancer incidence and mortality. Obesity, particularly abdominal obesity, is associated with insulin resistance and the development of dyslipidemia, hyperglycemia, and ultimately type 2 diabetes. Although many metabolic abnormalities occur with obesity and type 2 diabetes, insulin resistance and hyperinsulinemia appear to be central to these conditions and may contribute to dyslipidemia and altered levels of circulating estrogens and androgens. In this review, we will discuss the epidemiological and molecular links between obesity, type 2 diabetes, and cancer, and how hyperinsulinemia and dyslipidemia may contribute to cancer development. We will discuss how these metabolic abnormalities may interact with estrogen signaling in breast cancer growth. Finally, we will discuss the effects of type 2 diabetes medications on cancer risk. PMID:23810003

  20. [Outcomes in women with history of gestational diabetes mellitus. Screening and prevention of type 2 diabetes mellitus. Literature review].

    PubMed

    Vérier-Mine, O

    2010-12-01

    Women with a history of gestational diabetes mellitus (GDM) are characterized by a high risk of type 2 diabetes mellitus (T2DM) (X 7), metabolic syndrome (X 2 to 5) and cardiovascular diseases (X 1,7). Women with lesser degrees of glucose intolerance share the same risks. T2DM may occur from postpartum (5 to 14%) to several years later, up to 25 years. Some factors associated with T2DM are identified: obesity, early diagnostic before 24 weeks, high pregnancy OGTT blood glucose or insulinotherapy. Screening for T2DM only with fasting glucose provides less sensibility than with OGTT; HbA1c may supplant these dosages. The recurrence rate of GDM is between 30 and 84%, non-white ethnicity and insulinotherapy during GDM being the best proven predictors. High risk women need repeated life-long screenings for glycemic abnomalies, or when another pregnancy is planned. Among overweight or obese women with history of GDM who show minor glycoregulation disturbances, it is proved that modifications of lifestyle in intensive programs or metformin halve the risk of DT2. However, studies analysing practices show low adhesion to screening; without an intensive program, few women implement lifestyle modifications. These intensive programs should be implemented and proposed to high-risk women. Their therapeutic education should also include prevention of cardiovascular risk factors.