Science.gov

Sample records for pacientes con diabetes

  1. [Treatment of type 2 diabetes mellitus in patients with chronic kidney disease. Grupo de Trabajo para el Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal crónica].

    PubMed

    Gómez-Huelgas, Ricardo; Martínez-Castelao, Alberto; Artola, Sara; Górriz, José Luis; Menéndez, Edelmiro

    2014-01-21

    Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases, which represent an important public health problem and require a multidisciplinary management. T2DM is the main cause of CKD and it also causes a significant comorbidity with regard to non-diabetic nephropathy. Patients with diabetes and kidney disease represent a special risk group as they have higher morbi-mortality as well as higher risk of hypoglycemia than diabetic individuals with a normal kidney function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of available evidence. The current consensus report aims to ease the appropriate selection and dosage of antidiabetic treatments as well as the establishment of safety objectives of glycemic control in patients with CKD.

  2. Encefalitis por anticuerpos contra el receptor de NMDA: experiencia con seis pacientes pediátricos. Potencial eficacia del metotrexato

    PubMed Central

    Bravo-Oro, Antonio; Abud-Mendoza, Carlos; Quezada-Corona, Arturo; Dalmau, Josep; Campos-Guevara, Verónica

    2016-01-01

    Introducción La encefalitis por anticuerpos contra el receptor de N-metil-D-aspartato (NMDA) es una entidad cada vez más diagnosticada en edad pediátrica. A diferencia de los adultos, en muchos casos no se asocia a tumores y las manifestaciones iniciales en niños más frecuentes son crisis convulsivas y trastornos del movimiento, mientras que en los adultos predominan las alteraciones psiquiátricas. Casos clínicos Presentamos seis casos pediátricos confirmados con anticuerpos contra la subunidad NR1 del receptor de NMDA en suero y líquido cefalorraquídeo. Cinco de los casos comenzaron con crisis convulsivas como manifestación clínica inicial antes de desarrollar el cuadro clásico de esta entidad. En todos los casos se utilizaron esteroides como primera línea de tratamiento, con los que sólo se observó control de las manifestaciones en uno, por lo que el resto de los pacientes requirió inmunomoduladores de segunda línea. Todos los pacientes recibieron metotrexato como tratamiento inmunomodulador para evitar recaídas y la evolución fue a la mejoría en todos ellos. Conclusiones En nuestra serie de pacientes con encefalitis por anticuerpos contra el receptor de NMDA, ninguno se asoció a tumores. Todos los casos recibieron metotrexato por lo menos durante un año, no observamos eventos adversos clínicos ni por laboratorio, ni hubo secuelas neurológicas ni recaídas durante el tratamiento. Aunque es una serie pequeña y es deseable incrementar el número y tiempo de evolución, consideramos el metotrexato una excelente alternativa como tratamiento inmunomodulador para esta patología. PMID:24150952

  3. Meal Planning for People with Diabetes, 2nd Edition = Planificacion de Comidas para Personas con Diabetes, 2 Edicion.

    ERIC Educational Resources Information Center

    National Migrant Resource Program, Inc., Austin, TX.

    This booklet provides information about diabetes and meal planning particularly designed for migrant individuals. The first section defines diabetes, explains different types of diabetes, lists results of uncontrolled diabetes, and describes the goals and components of a diabetic meal plan. The second section explains the exchange system of…

  4. Trombosis primaria de la descendente anterior en un paciente con síndrome de anticuerpos antifosfolípidos.

    PubMed

    Acuña-Valerio, Jorge; Peña-Duque, Marco Antonio; Contreras-Villaseñor, Álvaro

    2017-01-01

    El síndrome de anticuerpos antifosfolípidos es una situación clínica y bioquímica heterogénea. Presentamos el caso de un varón joven con antecedente de tromboembolia venosa que se presentó en esta ocasión por dolor precordial, con elevación del ST en el electrocardiograma. Fue llevado a sala de angiografía para realizar angioplastia primaria y se observó una oclusión total ostial de la descendente anterior. Se realizó aspiración manual del trombo. No se realizó angioplastia con balón ni stent. En la angiografía de control a las 48 horas se observó ausencia de trombo y de placas aterosclerosas, lo cual se corroboró mediante ultrasonido intracoronario. Antiphospholipid antibody syndrome is a heterogeneous clinical and biochemical entity. We present the case of a young male with history of venous thromboembolism. This time he presents because of chest ischemic pain associated with ST segment elevation. He was taken to the cath lab to perform a primary percutaneous coronary intervention and a total occlusion of the left anterior descending artery was noted. Successful thrombus aspiration was performed. No stent was deployed. He was taken to the cath lab for a second look angiography and no atherosclerotic lesions were observed, which was confirmed by intravascular ultrasound.

  5. Diabetes

    MedlinePlus

    ... version of this page please turn Javascript on. Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means ... high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type ...

  6. Sulfonylurea treatment before genetic testing in neonatal diabetes: pros and cons.

    PubMed

    Carmody, David; Bell, Charles D; Hwang, Jessica L; Dickens, Jazzmyne T; Sima, Daniela I; Felipe, Dania L; Zimmer, Carrie A; Davis, Ajuah O; Kotlyarevska, Kateryna; Naylor, Rochelle N; Philipson, Louis H; Greeley, Siri Atma W

    2014-12-01

    Diabetes in neonates nearly always has a monogenic etiology. Earlier sulfonylurea therapy can improve glycemic control and potential neurodevelopmental outcomes in children with KCNJ11 or ABCC8 mutations, the most common gene causes. Assess the risks and benefits of initiating sulfonylurea therapy before genetic testing results become available. Observational retrospective study of subjects with neonatal diabetes within the University of Chicago Monogenic Diabetes Registry. Response to sulfonylurea (determined by whether insulin could be discontinued) and treatment side effects in those treated empirically. A total of 154 subjects were diagnosed with diabetes before 6 months of age. A genetic diagnosis had been determined in 118 (77%), with 73 (47%) having a mutation in KCNJ11 or ABCC8. The median time from clinical diagnosis to genetic diagnosis was 10.4 weeks (range, 1.6 to 58.2 wk). In nine probands, an empiric sulfonylurea trial was initiated within 28 days of diabetes diagnosis. A genetic cause was subsequently found in eight cases, and insulin was discontinued within 14 days of sulfonylurea initiation in all of these cases. Sulfonylurea therapy appears to be safe and often successful in neonatal diabetes patients before genetic testing results are available; however, larger numbers of cases must be studied. Given the potential beneficial effect on neurodevelopmental outcome, glycemic control, and the current barriers to expeditious acquisition of genetic testing, an empiric inpatient trial of sulfonylurea can be considered. However, obtaining a genetic diagnosis remains imperative to inform long-term management and prognosis.

  7. Development of type 2 diabetes mellitus thirty-one years after Billroth II in a patient asking for diabetes surgery.

    PubMed

    Garciacaballero, M; Reyes-Ortiz, A; Toval, J A; Martínez-Moreno, J M; Miralles, F

    2014-07-01

    INTRODUCCIÓN: La cirugía de la diabetes en pacientes obesos y delgados parece ser una alternativa superior al tratamiento médico actual. El bypass gástrico es un tratamiento alternativo al tratamiento médico actual. Sin embargo, todavía hay dudas sobre si la diabetes puede reaparecer si hay aumento de peso o si se mantienen los efectos en el tiempo. Otras preguntas se refieren al tipo de cirugía para hacer la longitud del remanente gástrico o el tamaño del reservorio para la resolución de la Diabetes Mellitus. Presentación del caso: Paciente masculino de 69 años de edad, vino a nosotros con el fin de realizar el bypass gástrico de una anastomosis a medida (BAGUA) para tratar su diabetes mellitus tipo 2 y el síndrome metabólico. Tiene antecedentes de úlcera péptica tratado con gastrectomía subtotal y reconstrucción tipo Billroth II hace 49 años. Actualmente él no es obeso y desarrolló diabetes 31 años después de la cirugía. DISCUSIÓN: A nivel mundial no hay reportes de pacientes con IMC normal que después de realizar un bypass gástrico desarrollaron diabetes mellitus. Hay casos en que los pacientes diabéticos obesos después del bypass gástrico mejoran o remite la DMT2, pero reaparece debido a la pérdida de peso insuficiente o reganancia de él. El paciente con un bypass gástrico tipo Billroth II, no debió desarrollar diabetes. Él tiene peso normal y no ha aumentado de peso que podría estar relacionado con el desarrollo de diabetes. CONCLUSIÓN: Los resultados generados por la cirugía bariátrica son alentadores, pero aún no aclaran la forma precisa cómo la cirugía produce una rápida mejoría del metabolismo sistémico como la diabetes, pero en nuestro paciente, el efecto fue muy diferente debido a que el bypass gástrico no tuvo un efecto protector contra la diabetes.

  8. Sulfonylurea Treatment Before Genetic Testing in Neonatal Diabetes: Pros and Cons

    PubMed Central

    Carmody, David; Bell, Charles D.; Hwang, Jessica L.; Dickens, Jazzmyne T.; Sima, Daniela I.; Felipe, Dania L.; Zimmer, Carrie A.; Davis, Ajuah O.; Kotlyarevska, Kateryna; Naylor, Rochelle N.; Philipson, Louis H.

    2014-01-01

    Context: Diabetes in neonates nearly always has a monogenic etiology. Earlier sulfonylurea therapy can improve glycemic control and potential neurodevelopmental outcomes in children with KCNJ11 or ABCC8 mutations, the most common gene causes. Objective: Assess the risks and benefits of initiating sulfonylurea therapy before genetic testing results become available. Design, Setting, and Patients: Observational retrospective study of subjects with neonatal diabetes within the University of Chicago Monogenic Diabetes Registry. Main Outcome Measures: Response to sulfonylurea (determined by whether insulin could be discontinued) and treatment side effects in those treated empirically. Results: A total of 154 subjects were diagnosed with diabetes before 6 months of age. A genetic diagnosis had been determined in 118 (77%), with 73 (47%) having a mutation in KCNJ11 or ABCC8. The median time from clinical diagnosis to genetic diagnosis was 10.4 weeks (range, 1.6 to 58.2 wk). In nine probands, an empiric sulfonylurea trial was initiated within 28 days of diabetes diagnosis. A genetic cause was subsequently found in eight cases, and insulin was discontinued within 14 days of sulfonylurea initiation in all of these cases. Conclusions: Sulfonylurea therapy appears to be safe and often successful in neonatal diabetes patients before genetic testing results are available; however, larger numbers of cases must be studied. Given the potential beneficial effect on neurodevelopmental outcome, glycemic control, and the current barriers to expeditious acquisition of genetic testing, an empiric inpatient trial of sulfonylurea can be considered. However, obtaining a genetic diagnosis remains imperative to inform long-term management and prognosis. PMID:25238204

  9. Heat shock proteins and heat therapy for type 2 diabetes: pros and cons.

    PubMed

    Krause, Mauricio; Ludwig, Mirna Stela; Heck, Thiago Gomes; Takahashi, Hilton Kenji

    2015-07-01

    Heat therapy, such as sauna and hot tub, has become an increasingly regular therapeutical practice around the world since several studies have shown benefits of heat therapy in metabolic and cardiovascular diseases. The use of heat therapy in people with type 2 diabetes mellitus revealed a striking reduction of 1% unit in the glycated hemoglobin, suggesting this therapy for the treatment of diabetes. Herein, we shall discuss the use of heat therapy and the mechanisms involved, and suggest a provisional guide for the use of heat therapy in obesity and diabetes. Human studies indicate that heat therapy reduces fasting glycemia, glycated hemoglobin, body weight, and adiposity. Animal studies have indicated that nitric oxide and the increase in heat shock protein 70 expression is involved in the improvements induced by heat therapy on insulin sensitivity, adiposity, inflammation, and vasomotricity. Heat therapy is a promising and inexpensive tool for the treatment of obesity and diabetes. We proposed that transient increments in nitric oxide and heat shock protein 70 levels may explain the benefits of heat therapy. We suggest that heat therapy (sauna: 80-100°C; hot tub: at 40°C) for 15 min, three times a week, for 3 months, is a safe method to test its efficiency.

  10. [Efficacy and safety of initial treatment with glimpeiride versus sitagliptin in type 2 diabetes].

    PubMed

    Tamez-Pérez, Héctor Eloy

    2015-01-01

    Introducción: La diabetes mellitus tipo 2 (DM2) es una enfermedad multifactorial que puede ser abordada tanto con antidiabéticos orales como con insulina. Los antidiabéticos orales glimepirida y sitagliptina poseen mecanismos de acción diferentes que no se han comparado directamente en pacientes con DM2 de reciente diagnóstico en Latinoamérica. El objetivo primario de este estudio multicéntrico de 24 semanas, de dos brazos, randomizado (1:1) y abierto, en pacientes adultos con DM2 y niveles de hemoglobina glucosilada (HbA1c) > 8.5 % < 11 %, fue comparar la eficacia de glimepirida con sitagliptina en pacientes adultos vírgenes de tratamiento. Como objetivos secundarios se compararon los efectos sobre la glucosa plasmática de ayuno y postprandial, hipoglucemia, cambio de peso, porcentaje de pacientes que se retiraron del protocolo, la seguridad de ambos tratamientos, signos vitales y resultados de laboratorio. Resultados: No se encontraron diferencias significativas en la eficacia de ambos medicamentos en el control de glucosa, ni en ningún otro parámetro, con la excepción de la incidencia de hipoglucemia, que se reportó con una frecuencia significativamente mayor en los pacientes del grupo de glimepirida. No existieron fatalidades en ningún grupo. Conclusiones: Se concluye que la monoterapia de glimepirida y sitagliptina reducen niveles de HbA1c con eficacia similar.

  11. Treatment of type 2 diabetes with combined therapy: what are the pros and cons?

    PubMed

    Massi-Benedetti, Massimo; Orsini-Federici, Marco

    2008-02-01

    Type 2 diabetes is a progressive syndrome that evolves toward complete insulin deficiency during the patient's life. A stepwise approach for its treatment should be tailored according to the natural course of the disease, including adding insulin when hypoglycemic oral agent failure occurs. Treatment with insulin alone should eventually be considered in a relevant number of cases. Experience has shown the protective effects of insulin on beta-cell survival and function, resulting in more stable metabolic control. On the contrary, treatment with most insulin secretagogues has been associated with increased beta-cell apoptosis, reduced responsiveness to high glucose, and impairment of myocardial function during ischemic conditions. In addition, macrovascular complications are associated with postprandial hyperglycemia, indicating the need for tight glycemic control. Insulin treatment, especially with rapid-acting analogs, has been demonstrated to successfully control postprandial glucose excursions. Finally, a reason for concern with regard to combined therapy is represented by the evidence that polipharmacy reduces compliance to the treatment regimen. This can be particularly relevant in patients with type 2 diabetes usually taking drugs for complications and for concomitant diseases with consequent deterioration not only of metabolic control but also of other conditions. In conclusion, therapy with insulin alone immediately after hypoglycemic oral agent failure may be a useful and safe therapeutic approach in type 2 diabetes.

  12. Diabetes

    MedlinePlus

    ... obese and are less physically active.What is pre-diabetes?Pre-diabetes occurs when blood sugar levels are higher ... that your doctor can say you have diabetes. Pre-diabetes is becoming more common in the United ...

  13. Metabolic disorders of liver and iron in diabetic and non-diabetic patients BMI < 35 or > 35 before gastric bypass.

    PubMed

    Garcíacaballero, Manuel; Reyes-Ortiz, Alexander; Martínez-Moreno, José Manuel; Toval-Mata, José Antonio

    2014-05-01

    Introducción: La presencia de anormalidades en las vías metabólicas del hierro y el funcionamiento del hígado pueden producir resistencia a la insulina o síndrome metabólico. Por lo tanto, es importante examinar esas alteraciones que pueden conducir al desarrollo de enfermedades. El estado nutricional es otro factor importante que está íntimamente ligada a la diabetes y la obesidad. Pacientes y métodos: Se estudiaron 131 pacientes (78 pacientes no diabéticos y 53 diabéticos), 37 pacientes IMC ≤35 (3 IMC < 25, 18 IMC 25-29,9, 16 IMC 30-34,9) y 94 pacientes IMC ≥35 (81 IMC 35-49,9 y 13 de IMC ≥50). Los sujetos fueron sometidos a estudios de laboratorio relacionadas con el funcionamiento del hígado y el metabolismo del hierro. Se determinó también el estado nutricional en nuestros pacientes. Resultados: El hierro estuvo alterado en 14% de los pacientes IMC >35 y los diabéticos alcanzaron 3% a 25%. La vitamina B12 fue baja en 4% de los no diabéticos IMC > 35, y alta en el 6% de los diabéticos IMC < 35. El 6% de los diabéticos IMC < 35 tenía hiperbilirrubinemia. Las transaminasas estuvieron elevadas en pacientes IMC > 35, pero exacerbados en los diabéticos. GGT se eleva del 41% al 47% en BMI > 35. ALP estuvo elevada en el 25% de los diabéticos. Las proteínas séricas totales y la albúmina estuvieron alterados en los diabéticos causando desnutrición leve. 90% de los pacientes tenían una nutrición normal y 10% desnutrición leve. Conclusiones: El metabolismo hepático y del hierro están estrechamente relacionadas con el inicio de la obesidad y la diabetes. Si hay un aumento de peso, los riesgos metabólicos acumulados se elevan. La presencia de la diabesidad y el aumento de la duración de la diabetes empeoran el metabolismo. El estado nutricional se altera en la obesidad, pero es peor con la adición de la diabetes.

  14. [Lower extremity amputation rates in diabetic patients].

    PubMed

    Cisneros-González, Nelly; Ascencio-Montiel, Iván Jesús; Libreros-Bango, Vita Norma; Rodríguez-Vázquez, Héctor; Campos-Hernández, Ángel; Dávila-Torres, Javier; Kumate-Rodríguez, Jesús; Borja-Aburto, Víctor Hugo

    2016-01-01

    Introducción: las amputaciones de extremidades inferiores disminuyen la calidad de vida de los pacientes con diabetes mellitus (DM). El objetivo de este estudio fue describir el índice de amputaciones de extremidades inferiores (mayores y menores) en sujetos con DM adscritos al Instituto Mexicano del Seguro Social (IMSS), comparando los años 2004 y 2013. Métodos: estudio observacional transversal comparativo. Se evaluaron los registros hospitalarios de amputaciones obtenidos del Sistema de Estadísticas Médicas (DataMart) y del Censo de pacientes con DM obtenido del Sistema de Atención Integral a la Salud. Se calcularon los índices de amputaciones mayores y menores x 100,000 sujetos con DM adscritos a Medicina Familiar. Resultados: durante 2004 y 2013 se observaron 2 334 340 y 3 416 643 pacientes con DM adscritos a Medicina Familiar respectivamente. Los promedios de edad al momento de la amputación fueron similares en el año 2004 y 2013 (61.7 años para las amputaciones menores y 65.6 años para las amputaciones mayores). Los índices de amputaciones mayores fueron de 100.9 y de 111.1 x 100 000 sujetos con DM en 2004 y 2013; mientras que el índice de amputaciones menores de extremidades inferiores fue de 168.8 y de 162.5 x 100 000 sujetos con DM en el durante 2004 y 2013 respectivamente. Conclusiones: el índice de amputaciones de extremidades inferiores en el IMSS es muy alto comparado con lo reportado en países desarrollados. El índice de amputaciones mayores se incrementó para el año 2013, comparado con 2004.

  15. High prevalence of inactivity among young patients with type 1 diabetes in south Spain.

    PubMed

    Gutiérrez Manzanedo, José Vicente; Carral San Laureano, Florentino; García Domínguez, Gloria; Ayala Ortega, Carmen; Jiménez Carmona, Soledad; Aguilar Diosdado, Manuel

    2014-04-01

    Objetivos: Describir el nivel de actividad física habitual y analizar su asociación con el control metabólico y la presencia de complicaciones microvasculares en una cohorte de pacientes con diabetes tipo 1 (DM-1) del sur de España. Métodos: Estudio transversal observacional que incluyó ciento treinta pacientes de 33,9 ± 11,5 años de edad y una duración de la enfermedad de 16,5 ± 9,5 años que fueron reclutados consecutivamente en el Servicio de Endocrinología del Hospital Universitario Puerta del Mar (Cádiz, España). El nivel de actividad física habitual fue evaluado utilizando el “General Practice Physical Activity Questionnaire” (GPPAQ) conjuntamente con diversos parámetros clínicos, antropométricos, metabólicos y de complicaciones microvasculares. Resultados: Los pacientes con DM-1 fueron agrupados en cuatro categorías de nivel de actividad física: inactivo (n = 33; 25,3%), moderadamente inactivo (n = 31; 23,8%), moderadamente activo (n = 26; 20,0%) y activo (n = 40; 30,9%). No observamos diferencias significativas en el nivel de hemoglobina glucosilada (HbA1c) entre los diferentes grupos de actividad física analizados. Los pacientes clasificados como moderadamente activos y activos fueron con mayor probabilidad hombres, más jóvenes y con menores niveles plasmáticos de triglicéridos que los pacientes clasificados como inactivos o moderadamente inactivos, sin encontrarse diferencias en otras variables clínicas o antropométricas. Adicionalmente, los pacientes activos y moderadamente activos tenían una menor prevalencia de retinopatía diabética y de complicaciones microvasculares en general comparados con los pacientes inactivos o moderadamente inactivos. Conclusiones: La mitad de los pacientes con DM-1 evaluados fueron clasificados como inactivos y estos pacientes tenían mayor prevalencia de retinopatía diabética que los pacientes activos. No fueron documentadas diferencias en los niveles de HbA1c entre los diferentes grupos

  16. [Oral magnesium supplementation: an adjuvant alternative to facing the worldwide challenge of type 2 diabetes?].

    PubMed

    Guerrero-Romero, Fernando; Rodríguez-Morán, Martha

    2014-01-01

    Antecedentes: ante la repercusión de la diabetes tipo 2 en la calidad de vida y los altos costos de su tratamiento, es urgente la búsqueda de alternativas para el control metabólico y la prevención primaria de esta enfermedad. Objetivo: revisar la evidencia derivada de estudios de cohortes acerca de la relación entre las concentraciones séricas y la ingesta de magnesio con el riesgo de diabetes tipo 2, y de ensayos clínicos de la eficacia de las sales orales de magnesio en la reducción de la glucemia. Material y métodos: estudio retrospectivo, efectuado con base en la búsqueda de estudios de cohorte mayores de 10 años en MEDLINE, EMBASE, y Cochrane Controlled Trials Register, actualizada al 30 de septiembre del 2013. Resultados: se encontraron siete estudios de cohorte (24,388 personas/ año) que muestran que la ingesta de magnesio disminuye el riesgo de diabetes tipo 2; dos estudios (13,076 personas/año) indican que la baja ingesta de magnesio en la dieta no parece asociarse con el riesgo de diabetes; 1 estudio (8,735 personas/año) demuestra que la hipomagnesemia se asocia con alteraciones del metabolismo de la glucosa. De 11 ensayos clínicos con asignación al azar, 5 estudios en sujetos de riesgo muestran que las sales orales de magnesio reducen la glucemia, y 6 estudios en pacientes con diabetes tipo 2 muestran resultados inconsistentes. Conclusiones: la ingesta de magnesio en la dieta habitual o de sales orales de magnesio es recomendable en la prevención de diabetes. La eficacia de las sales de magnesio en la reducción de la glucemia de pacientes con diabetes tipo 2, es inconsistente.

  17. [NORMATIVE VALUES OF SF-6D QUESTIONNAIRE FOR CHILEAN DIABETES PATIENTS].

    PubMed

    Garcia-Gordillo, Miguel A; Collado-Mateo, Daniel; Olivares, Pedro R; Adsuar, José C

    2015-12-01

    Introducción: la diabetes mellitus es una de las enfermedades crónicas de mayor prevalencia e impacto económico a nivel mundial. La diabetes produce un impacto sobre la calidad de vida relacionada con la salud de las personas que la padecen. El cuestionario SF-6D permite evaluar la calidad de vida relacionada con la salud. Es uno de los cuestionarios más usados a nivel mundial, ya que permite conocer las preferencias sociales de los distintos estados de salud. Sin embargo, según nuestro conocimiento no se dispone de los valores normativos de este cuestionario en la población diabética chilena. Objetivo: reportar los datos normativos del cuestionario SF-6D en la población diabética chilena. Métodos: los datos fueron extraídos de la Encuesta Nacional de Salud (ENS 2009-2010) de Chile. En este estudio se incluyen 424 personas que presentan diabetes (143 hombres y 281 mujeres). Los datos se han presentado segregados por sexo y grupo de edad, así como por región, estado civil, hábito tabáquico, nivel de ingresos y estudios. Resultados: el índice de utilidad del SF-6D en mujeres chilenas con diabetes fue de 0,65 (± 0,15), mientras que en hombres fue 0,70 (± 0,15). Menos del 5% de la población declara una utilidad con valor 1. El índice de utilidad del SF-6D en pacientes con diabetes disminuye con la edad, en las situaciones de bajos ingresos y con niveles de educación bajos. Conclusiones: este estudio presenta los valores normativos chilenos del SF-6D derivado del SF-12 en pacientes con diabetes.

  18. URINARY LOSS OF MICRONUTRIENTS IN DIABETIC PATIENTS ATTENDING A TERTIARY HOSPITAL SERVICE.

    PubMed

    da Silva Santos, Andressa Feijó; Souza Santos, Roberta Deh; Foss-Freitas, Maria Cristina; Carvalho da Cunha, Selma Freire; Marchini, Júlio Sérgio; Marques Miguel Suen, Vivian

    2015-08-01

    Introducción/objetivos: la deficiencia de micronutrientes puede contribuir a un menor control de la diabetes. El objetivo de este estudio fue evaluar la excreción urinaria de micronutrientes en pacientes con diabetes mellitus tipo 2. Métodos: los pacientes con diabetes y los controles fueron evaluados por la ingesta de alimentos, la antropometría, la pérdida urinaria de micronutrientes y comparados por Mann Whitney no paramétrico (p < 0,05). Resultados: fueron evaluados nueve sujetos diabéticos (52 ± 14 años con un IMC de 30 ± 11 kg/m² y la circunferencia de la cintura (CC) de 99 ± 25 cm) y nueve sujetos control (51 ± 16 años, IMC 26 ± 5 kg/m² y CA total de 90 ± 13 cm). La excreción de hierro más alta se observó en el grupo diabético y la mayor excreción de magnesio en el grupo de control. Conclusiones: el tipo 2 de pacientes diabéticos estudiados aquí no mostraron un aumento en la excreción de micronutrientes en la orina en comparación con los controles.

  19. Diabetes.

    PubMed

    2014-09-23

    Essential facts Type 1 and type 2 diabetes affect 3.2 million people in the UK. Diabetes is associated with serious complications, including heart disease and stroke, which can lead to disability and premature death. It is the leading cause of preventable sight loss in people of working age in the UK. A quarter of people with diabetes will have kidney disease at some point in their lives, and the condition increases the risk of amputation. Good diabetes management has been shown to reduce the incidence of these serious complications.

  20. [Neurological effects of hypoglycemia in diabetic patients].

    PubMed

    Caballero-Corchuelo, J

    2016-09-16

    Introduccion. El tratamiento farmacologico de la diabetes se asocia a un aumento en el riesgo de hipoglucemia. Los episodios de hipoglucemia afectan a la calidad de vida del paciente y a actividades diarias comunes, ademas de la morbimortalidad que pueden producir en casos con sintomatologia neurologica. Objetivo. Revisar las principales complicaciones neurologicas de la hipoglucemia en pacientes diabeticos, con especial interes en las consecuencias a largo plazo. Desarrollo. Tras revisar la fisiopatologia de la hipoglucemia en el paciente diabetico, se describe el papel de la hipoglucemia en tres situaciones: las alteraciones en los mecanismos neuroendocrinos de regulacion de la glucemia, los efectos de la hipoglucemia en los niños y la relacion con el deterioro cognitivo en los adultos. Conclusiones. Aparte de los daños neurologicos agudos que pueden suceder en casos de hipoglucemia grave, los episodios de hipoglucemia repetidos se asocian a otros efectos neurologicos a largo plazo: afectan a los mecanismos de contrarregulacion ante episodios de hipoglucemia subsiguientes, aumentando el riesgo de hipoglucemias graves, y pueden producir alteraciones cognitivas en poblaciones vulnerables, como los niños pequeños o ancianos.

  1. [Comparison of glycemic control in diabetic patients with and without metabolic syndrome].

    PubMed

    Cruz del Castillo, A H; Córdova Fernández, J A; Ramos Lagunes, I; Camara, Jorge; Ortiz Solana, X E; Vigil Pérez, C A; García Ramos, G

    2013-01-01

    Objetivo: Comparar el nivel glucémico en pacientes con diabetes tipo 2 (DM2) con y sin síndrome metabólico (SM). Metodología: Estudio transversal analítico. Se incluyeron aleatoriamente pacientes con DM2 corroborado en su expediente clínico. El SM se identificó en pacientes con al menos 3 de 5 criterios del ATP III (AdultTreatment Panel III). Se aplicó un cuestionario estructurado. Se determinó hemoglobina glucosilada (HbA1c), colesterol-HDL, triglicéridos, hipertensión arterial sistémica (HAS), índice de masa corporal (IMC), circunferencia de cintura (CCi) y cadera (CCa). Plan de análisis: prevalencia, prueba t de Student, correlación de Pearson y regresión logística. Resultados: Se incluyeron 283 pacientes. Edad promedio: 59.8±10.6 años. Predominó el sexo femenino (73.6%)Criterios cubiertos para SM: hipocolesterolemia-HDL: 62.9%; hipertrigliceridemia: 56.3%; obesidad abdominal (OA) 90.1%; hipertensión arterial sistémica (HAS): 62.5%. La prevalencia de SM fue 86.6% (IC95% 83% a 89%). No hubo diferencia significativa en el promedio de HbA1c en pacientes con y sin SM, HAS, OA, e hipocolesterolemia-HDL. En cambio, sujetos con hipertrigliceridemia tuvieron un promedio significativamente mayor de HbA1c que aquellos sin hipertrigliceridemia (8.9±2.3 vs 8.5±2.1, respectivamente; p=0.01). HbA1c correlacionó positivamente con trigliceridemia (r=0.24, p=0.001), y negativamente con el peso (r= -0.19, p=0.001), IMC (r= -0.172, p=0.004), CCi (r= -0.12, p=0.004) y CCa (r=-0.14, p=0.02). En el análisis multivariado ajustado, solamente la duración de la diabetes se asoció con el nivel glucémico (OR= 1.014, IC95% 1.010 a 1.016). Conclusiones: No encontramos diferencias significativas en el nivel glucémico en pacientes con y sin SM.

  2. Stay at a Healthy Weight. Tips for Kids with Type 2 Diabetes = Mantente en un Peso Saludable. Consejos Para Muchachos con Diabetes Tipo 2

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2005

    2005-01-01

    A healthy weight means you are not too fat or too thin. Your doctor may have said that you should not gain more weight or that you need to lose a few pounds. If you have diabetes and are overweight, you are not alone. The steps you take to manage your weight will help you feel better and may improve your blood sugar or glucose (GLOO-kos) levels.…

  3. Diabetes.

    PubMed

    Lomberk, Gwen

    2009-01-01

    Pancreatologists have often divided research of the pancreas based upon the origin of the function or disease, namely the endocrine or exocrine pancreas. In fact, as a result, many of our meetings and conferences have followed separate paths. Interestingly, among patients with chronic pancreatitis and pancreatic cancer, both disorders of the exocrine pancreas, diabetes is common. However, the clinical features of the diabetes associated with these two differ. Peripheral insulin resistance and hyperinsulinemia are the predominant diabetic traits in pancreatic cancer, while reduced islet cell mass and impaired insulin secretion are observed more often in chronic pancreatitis. The causal relationship between diabetes and pancreatic cancer remains an intriguing but unanswered question. Since diabetes often precedes pancreatic cancer, it is regarded as a potential risk factor for malignancy. On the other hand, there remains the possibility that pancreatic cancer secretes diabetogenic factors. Regardless of how the science ultimately illuminates this issue, there is increasing interest in utilizing screening for diabetes to aid early detection of pancreatic tumor lesions. Therefore, in this issue of Pancreatology and the Web, we explore the topic of diabetes to keep us alert to this very important association, even if we study diseases of the exocrine pancreas.

  4. Hypoglycemic treatment of diabetic patients in the Emergency Department.

    PubMed

    Caballero Requejo, Carmen; Urbieta Sanz, Elena; Trujillano Ruiz, Abel; García-Molina Sáez, Celia; Onteniente Candela, María; Piñera Salmerón, Pascual

    2016-05-01

    Objetivo: Analizar la adecuacion del tratamiento hipoglucemiante prescrito en el Servicio de Urgencias a las recomendaciones de consenso disponibles, asi como evaluar su repercusion clinica. Método: Estudio observacional descriptivo. Se incluyeron pacientes que se encontraban en la sala de observacion del Servicio de Urgencias pendientes de ingreso hospitalario, con diagnostico previo de diabetes mellitus y en tratamiento domiciliario con farmacos hipoglucemiantes. Se evaluo el manejo del tratamiento antidiabetico y su repercusion clinica. Resultados: Se incluyeron 78 pacientes. Al ingreso en el Servicio de Urgencias se modifico el tratamiento en el 91% de los pacientes, y se omitio en el 9%, siendo el tratamiento mas pautado los rescates con insulina rapida (68%). Los tratamientos prescritos se ajustaron en un 16,7% a las recomendaciones de la Sociedad Espanola de Medicina de Urgencias y Emergencias. Tras la intervencion del farmaceutico, la omision descendio al 1,3% y la adecuacion a las recomendaciones aumento al 20,5%. Comparando los pacientes cuyo tratamiento se ajusto a las recomendaciones y los que no, la repercusion clinica fue, respectivamente: media de glucemia a las 24 horas 138,3 } 49,5 mg/dL versus 182,7 } 97,1 mg/dL (p = 0,688); media de rescates con insulina lispro 1 } 1,6 versus 1,5 } 1,8 (p = 0,293); media de unidades de insulina lispro administradas 4,6 } 12,7 UI frente a 6,6 } 11,3 UI (p = 0,155). Conclusiones: Encontramos una baja adecuacion de las prescripciones de antidiabeticos a las recomendaciones de consenso. Estos resultados van en linea con otros estudios, objetivandose un abuso de las pautas de rescate con insulina rapida como unico tratamiento hipoglucemiante.

  5. Total and subtypes of dietary fat intake and risk of type 2 diabetes mellitus in the Prevención con Dieta Mediterránea (PREDIMED) study.

    PubMed

    Guasch-Ferré, Marta; Becerra-Tomás, Nerea; Ruiz-Canela, Miguel; Corella, Dolores; Schröder, Helmut; Estruch, Ramon; Ros, Emilio; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Serra-Majem, Lluís; Lapetra, José; Basora, Josep; Martín-Calvo, Nerea; Portoles, Olga; Fitó, Montserrat; Hu, Frank B; Forga, Lluís; Salas-Salvadó, Jordi

    2017-03-01

    Background: The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes.Objective: We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the incidence of type 2 diabetes (T2D).Design: A prospective cohort analysis of 3349 individuals who were free of diabetes at baseline but were at high cardiovascular risk from the PREvención con DIeta MEDiterránea (PREDIMED) study was conducted. Detailed dietary information was assessed at baseline and yearly during the follow-up using a food frequency questionnaire. Multivariable Cox proportional hazards models were used to estimate T2D HRs and 95% CIs according to baseline and yearly updated fat intake.Results: We documented 266 incident cases during 4.3 y of follow-up. Baseline saturated and animal fat intake was not associated with the risk of T2D. After multivariable adjustment, participants in the highest quartile of updated intake of saturated and animal fat had a higher risk of diabetes than the lowest quartile (HR: 2.19; 95% CI: 1.28, 3.73; and P-trend = 0.01 compared with HR: 2.00; 95% CI: 1.29, 3.09; and P-trend < 0.01, respectively). In both the Mediterranean diet and control groups, participants in the highest quartile of updated animal fat intake had an ∼2-fold higher risk of T2D than their counterparts in the lowest quartile. The consumption of 1 serving of butter and cheese was associated with a higher risk of diabetes, whereas whole-fat yogurt intake was associated with a lower risk.Conclusions: In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake

  6. [Characteristics of diabetes mellitus patients under a chronic disease program].

    PubMed

    López, Ana Cristina; Aguirre, Ana Noemi; Roitter, Claudia Valentina; Aguirre, Jorge Alberto; Cecchetto, Eugenio; Bernet, Jorgelina; García, Adelaida Judith; Mantaras, José

    2015-01-01

    La Diabetes Mellitus (DM) es una enfermedad crónica no transmisible con una prevalencia en Argentina del 9,8%. El seguimiento de pacientes con DM se realiza en un Programa de Enfermedades Crónicas desarrollado en la obra social universitaria DASPU, de la Universidad Nacional de Córdoba Argentina. Objetivo: describir características clínicas de personas con DM de un programa de seguimiento. Identificar variables de control metabólico asociadas a la presencia de complicaciones. Material y método. Estudio observacional, transversal, descriptivo. Se incluyeron datos de pacientes con DM bajo programa del año 2010. Las variables categóricas se describen como proporciones y las numéricas como media ±DE. La comparación de medias se realizó mediante test de Student. Resultados: total 1017 casos, edad media 61 ±14 años, 54,6% masculinos, DM tipo 1: 8,5%, DM tipo 2: 90,9%, DM gestacional: 0,7%. Factores de riesgo cardiovascular: hipertensión arterial en 78%, dislipemia en 35%. Complicaciones microvasculares: 25,5%, macrovasculares: 18,6%. La enfermedad coronaria fue la complicación más frecuente: 14,5%. El 69% presentó valores de hemoglobina glicosilada (HbA1C) ≤7,4%; el promedio de colesterol total fue 185 mg/dl y de colesterol LDL 111 mg/dl. El promedio de HbA1C fue más elevado en pacientes con complicaciones microvasculares que sin complicaciones: 7,47% vs 7,18% (p=0,009). En pacientes con complicaciones macrovasculares hubo una tendencia inversa, no significativa (7,21% vs 7,26%; p=0,65). El promedio de colesterol total fue menor en el grupo con complicaciones macrovasculares (173 mg/dl vs 189 mg/dl; p=0,001). Igual comportamiento se observó en relación al C-LDL (101 vs 113 mg/dl; p=0,001). Conclusión: Las características clínicas evaluadas coinciden en su distribución y complicaciones con estudios epidemiológicos reportados en la bibliografía, los valores de HbA1C y colesterol total alcanzan valores óptimos en un gran porcentaje de nuestra

  7. Glycemic and lipid metabolic disorders in diabetic and non-diabetic patients bmi < 35 or > 35 before gastric bypass.

    PubMed

    Garcia-Caballero, Manuel; Reyes-Ortiz, Alexander; Martínez-Moreno, José Manuel; Toval-Mata, José Antonio

    2014-05-01

    Introducción: La obesidad y la diabetes son enfermedades de alta prevalencia a nivel mundial. Actualmente no existe un tratamiento médico eficaz para combatir el aumento de peso. La obesidad es precursora de enfermedades tales como la diabetes o el síndrome metabólico. Es necesario saber si el aumento de peso tiene efectos acumulativos sobre el metabolismo de la glucemia y los lípidos como precursores de complicaciones o comorbilidades. Pacientes y métodos: Se estudiaron 131 pacientes (78 no diabéticos y 53 diabéticos), 37 IMC ≤35 (3 IMC < 25, 18 IMC 25-29,9, 16 IMC 30-34,9) y 94 IMC ≥35 (81 IMC 35- 49,9 y 13 de IMC ≥50). Se analizó el IMC, el género, la diabetes y su tiempo de evolución. El perfil lipídico, glucosa, HbA1c y el péptido C fueron evaluados después de un ayuno de 12 horas. Resultados: Los pacientes diabéticos y diabesos mostraron niveles altos de triglicéridos. Los pacientes no diabéticos tienen alteración de la glucosa (58% IMC 35). El 20% de los no diabéticos IMC 35 tenían niveles altos. El 5% de los diabéticos IMC < 35 tenía bajos niveles de péptido C y 36% de IMC > 35 tenían niveles altos. HbA1c fue mayor en 40% de pacientes no diabéticos IMC < 35 frente al 13% de IMC > 35. Conclusiones: La glucosa y los triglicéridos aumentan con la edad y los años de evolución de la DMT2. La edad de ≥51 años y los hombres son los más afectados. El aumento de peso tiene efecto acumulativo alterando el metabolismo favoreciendo la aparición de la diabetes y sus comorbilidades. A pesar de tener un tratamiento de control intensivo de la diabetes, esta continúa con sus efectos nocivos sobre los pacientes a través de los años.

  8. Malnutrition prevalence in hospitalized elderly diabetic patients.

    PubMed

    Sanz París, Alejandro; García, José M; Gómez-Candela, Carmen; Burgos, Rosa; Martín, Ángela; Matía, Pilar

    2013-01-01

    Introducción: La prevalencia de desnutrición es desconocida entre los ancianos con diabetes mellitus. Objetivos: Determinar la prevalencia de desnutrición en ancianos hospitalizados con diabetes mellitus, y describir su impacto en el pronóstico clínico. Material y métodos: Se llevó a cabo un estudio multicéntrico en 35 hospitales españoles. La desnutrición fue valorada mediante la herramienta Mini Nutritional Assessment (MNA). Los pacientes fueron seguidos hasta el alta. Resultados: Fueron incluidos 1.090 sujetos (78 ± 7,1 años; 50% hombres). 39,1% mostraron riesgo de desnutrición y 21,2% desnutrición establecida. El 15,5% de los sujetos desnutridos y 31,9 % de aquellos en riesgo tenían un IMC ≥30 kg/m(2). En el análisis multivariante, el sexo femenino (OR = 1,38; IC 95%: 1,19-1,11), la edad (OR = 1,04; IC 95%: 1,02-1,06) y la presencia de complicaciones por diabetes (OR = 1,97; IC 95%: 1,52-2,56) se asociaron al diagnóstico de desnutrición. La estancia media fue mayor en sujetos en riesgo y con desnutrición que en los pacientes bien nutridos (12,7 ± 9,9 y 15,7 ± 12.8 días vs 10,7 ± 9,9 días; p < 0,0001). Tras ajustar por edad y sexo, la puntuación del MNA (OR = 0,895; IC 95% 0,814-0,985) y el valor de albúmina (OR = 0,441; IC 95% 0,212-0,915) se asociaron de forma independiente con la mortalidad. La puntuación del MNA se asoció con la probabilidad de alta a domicilio (OR = 1,150; IC 95% 1,084-1,219). Conclusiones: Se observó una elevada prevalencia de desnutrición entre los ancianos hospitalizados con diabetes, independientemente del IMC. El diagnóstico de desnutrición, el valor de albúmina y la puntuación del MNA se asociaron con la estancia media, mortalidad y destino al alta.

  9. DIABETES

    PubMed Central

    Natarajan, Loki

    2015-01-01

    A new study shows that statin therapy before diagnosis of diabetes mellitus is not associated with an increased risk of microvascular disease and might even be beneficial for retinopathy and neuropathy. These data suggest a potential protective effect of statins in specific complications, which should be further investigated in randomized controlled trials. PMID:25366041

  10. [Proliferative diabetic retinopathy -- therapeutic approach (clinical case)].

    PubMed

    Burcea, M; Muşat, Ovidiu; Mahdi, Labib; Gheorghe, Andreea; Spulbar, F; Gobej, I

    2014-01-01

    We present the case of a 54 year old pacient diagnosed with neglected insulin dependent diabetes and proliferative diabetic retinopathy. Surgery was recommended and we practiced posterior vitrectomy, endolaser and heavy silicone oil endotamponade. Post-operative evolution was favorable.

  11. 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.

  12. [Effect of the DiabetIMSS program on cardiovascular risk, blood pressure and HDL cholesterol in patients with metabolic syndrome].

    PubMed

    Mendoza-Romo, Miguel Angel; Montes-Acuña, Juan Felipe; Zavala-Cruz, Gad Gamed; Nieva-de Jesús, Rafael Natividad; Ramírez-Arreola, María Cleofas; Andrade-Rodríguez, Héctor Jesús

    2017-01-01

    Objetivo: evaluar el efecto del programa DiabetIMSS sobre el riesgo cardiovascular, la tensión arterial y colesterol-HDL en pacientes con síndrome metabólico. Métodos: estudio de intervención cuasiexperimental. Muestreo no probabilístico por conveniencia. Se incluyeron 35 sujetos que participaron en la estrategia educativa de un año de duración. Se recolectaron las siguientes variables: edad, género, tabaquismo, colesterol total, HDL, TA sistólica y diastólica; se calculó el riesgo cardiovascular con calculadora basada en Framingham. Se utilizó estadística descriptiva con porcentajes e inferencial con t de Student. Resultados: hubo una elevación de la proporción de sujetos que incrementaron sus cifras del colesterol-HDL posterior a la intervención, generando, por ende, un incremento del factor protector (p < 0.05). En razón de las cifras tensionales, se presentó una mejoría notable en todos los rangos de presión arterial (p < 0.05). Conclusiones: la estrategia educativa para el control del paciente diabético presentó un comportamiento favorable en el colesterol-HDL y tensión arterial, disminuyendo el riesgo cardiovascular de los pacientes.

  13. [Association of inflammatory cytokines with bone turnover markers in type 1 diabetes].

    PubMed

    Molina-Ayala, Mario; Cruz-Soto, Ruth Carmina; Vargas-Ortega, Guadalupe; González-Virla, Baldomero; Ferreira-Hermosillo, Aldo; Mac Gregor-Gooch, Julián; Mendoza-Zubieta, Victoria

    2016-01-01

    Introducción: la diabetes mellitus afecta de una manera adversa al esqueleto y esos mecanismos fisiopatológicos continúan sin entenderse completamente. Por lo tanto, el objetivo de este estudio es identificar citocinas inflamatorias (IL-1, IL-6 y TNFα) en pacientes con DM1 y su asociación con marcadores de formación (sPINP) y resorción (sCTX) óseas. Métodos: Se estudiaron 62 pacientes con DM1, mayores de 18 años. Se determinaron los valores de la HbA1c, la vitamina D, las citocinas inflamatorias, así como los de los marcadores de formación y resorción óseas. Resultados: 49 pacientes fueron del sexo femenino con una edad media de 33.5 años, HbA1c > 7.5 en 83%, vitamina D 16 ng/mL. En los pacientes con HbA1c > 7.5 hubo correlación positiva entre el TNFa y sCTX (r = 0.43, p = 0.05), IL-6 y sCTX (r = 0.48, p = 0.037). Posterior a un modelo de regresión lineal simple entre el sCTX y la IL-6 se encontró un coeficiente beta de 23.8, p = 0.030 (IC 2-45.6), es decir, por cada unidad de elevación de IL-6 hay un incremento de sCTX de 23.8 pg/mL. Conclusiones: encontramos una asociación positiva entre TNF-alfa e IL-6 con el marcador de resorción ósea (sCTX) en pacientes con HbA1c > 7.5 %. El descontrol metabólico se asoció con la elevación de citocinas inflamatorias TNF-alfa e IL-6.

  14. NORMATIVE VALUES OF EQ-5D-5L FOR DIABETES PATIENTS FROM SPAIN.

    PubMed

    Collado Mateo, Daniel; García Gordillo, Miguel A; Olivares, Pedro R; Adsuar, José C

    2015-10-01

    Introducción: la diabetes es una enfermedad metabólica que puede conllevar una reducción de la calidad de vida relacionada con la salud. El EQ-5D es un cuestionario genérico de calidad de vida relacionada con la salud basado en preferencias sociales. Este cuestionario ha sido muy utilizado en pacientes con diabetes. Objetivo: el objetivo del presente artículo es informar sobre los valores normativos del cuestionario EQ-5D-5L en personas españolas con diabetes. Métodos: se utilizaron datos de la Encuesta Española de Salud (2011/2012). Un total de 1.857 personas con diabetes participaron en la encuesta. La puntuación del EQ-5D-5L se ha reflejado en función del sexo, región (incluyendo las 17 comunidades autónomas y las 2 ciudades autónomas de España), y 8 grupos de edad. Resultados: la media del índice de utilidad para toda la muestra fue de 0,742. Esta fue mejor para hombres (0,826) que para mujeres (0,673). Resultados similares se observaron en la Escala Visual Analógica. El efecto techo fue mucho mayor en hombres (44,83%) que en mujeres (24,41%). Conclusiones: el presente estudio recoge datos normativos representativos del EQ-5D-5L en España de personas con diabetes.

  15. [Association between diabetes mellitus and cognitive decline in older adults. A population based study].

    PubMed

    Arjona-Villicaña, Ruy David; Esperón-Hernández, Ramón Ignacio; Herrera-Correa, Gloria María; Albertos-Alpuche, Nelly Eugenia

    2014-01-01

    Introducción: la asociación entre diabetes y deterioro cognitivo es conocida; sin embargo, existen pocos datos respecto a si esta asociación es diferente a partir del sexo. Este estudio pretende determinar esta asociación y establecer si existe diferencia de acuerdo al sexo, en adultos mayores de Mérida, Yucatán, México. Métodos: participaron 1293 personas mayores de 60 años sin depresión grave, historia de enfermedad psiquiátrica, o evento vascular cerebral, a quienes se les aplicó una encuesta estructurada que incluyó el mini examen del estado mental, antropometría y medición capilar de glucosa y lípidos. Se compararon estos parámetros entre pacientes diabéticos y no diabéticos. Se determinó la asociación de diabetes con deterioro cognitivo mediante regresión logística para la población en general y para cada uno de los sexos. Resultados: la prevalencia de diabetes fue del 27.38 %. Los pacientes diabéticos fueron más jóvenes (p = 0.049), con menor escolaridad (p = 0.014) y con mayor circunferencia abdominal (p = 0.004) que los no diabéticos. La diabetes estuvo asociada a una mayor frecuencia de deterioro cognitivo únicamente en las mujeres (ß = 2.897, IC 95 % 1.428-5.877, p = 0.003). Conclusión: existe asociación entre diabetes y deterioro cognitivo en mujeres mayores de 60 años. Hacen falta estudios longitudinales que confirmen estos hallazgos.

  16. Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA).

    PubMed

    Garciacaballero, M; Martínez-Moreno, J M; Toval, J A; Miralles, F; Mínguez, A; Osorio, D; Mata, J M; Reyes-Ortiz, A

    2013-03-01

    Introducción: Aunque la cirugía bariátrica ha demostrado ser un método muy eficaz en el tratamiento de pacientes diabéticos cuyo páncreas aún es capaz de producir insulina (diabetes tipo 2), así como del síndrome metabólico y las complicaciones relacionadas con la diabetes, no hay información sobre el efecto de este tipo de cirugía en pacientes IMC 24-34 cuando el páncreas no produce insulina en absoluto (tipo 1, tipo LADA y diabetes tipo 2 de larga evolución, entre otros). Métodos: Presentamos datos preliminares de una serie de 11 pacientes todos con valores de Péptido C < 0,0 ng/ml. El seguimiento postoperatorio varia de 6 y 60 meses (media 19 meses). Estudiamos los cambios en el control de la glucemia, evolución del síndrome metabólico y complicaciones relacionadas con la diabetes tras bypass de una anastomosis (BAGUA). Resultados: Mejoraron todos los valores relativos al control glucémico HbA1c (de 8,9 ± 0,6 a 6,7 ± 0,2%), FPG (Glucosa Plasmática Ayunas) (de 222,36 ± 16,87 a 94 ± 5 (mg/dl)) así como el requerimiento diario de insulina, tanto de insulina rápida (de 40,6 ± 12,8 a 0 U/día) como de insulina retardada (41,27 ± 7,3 U/día a 15,2 ± 3,3 U/día). Se resolvieron el 100% de las comorbilidades estudiadas y se mejoraron algunas complicaciones graves derivadas de la diabetes como retinopatía o nefropatía. Conclusiones: El bypass gástrico de una anastomosis adaptado a pacientes diabéticos IMC24-34 con péptido C cero elimina el uso de insulina de acción rápida, reduce a una sola inyección diaria la insulina retardada y mejora el control glucémico. Tras la cirugía desaparecen el síndrome metabólico y los episodios severos de hipoglucemia, y mejora significativamente la retinopatía, neuropatía, nefropatía, vasculopatía periférica y cardiopatía.

  17. [Hepatic steatosis as diabetes type 2 predictor].

    PubMed

    Loureiro, Carolina; Martínez-Aguayo, Alejandro; Campino, Carmen; Carvajal, Cristián; Fardella, Carlos; García, Hernán

    2014-02-01

    El hígado graso no alcohólico (HGNA) es una complicación frecuente en pacientes obesos y se correlaciona con insulino resistencia (IR) y diabetes mellitus tipo 2 (DM2). Alanino aminotransferasa (ALT) se ha reconocido como un marcador bioquímico de HGNA y es utilizada para tamizaje de esta enfermedad. Objetivos: Evaluar la asociación entre niveles plasmáticos de aminotransaminasas, con variables antropométricas, marcadores de insulino resistencia e inflamación en población pediátrica. Sujetos y Métodos: Se estudiaron 348 sujetos (52,7% mujeres), con edades entre los 4,9 y 15,6 años. Se realizó antropometría y determinación sérica de: Aspartato aminotransferasa (AST), ALT, glicemia, insulina, perfil lipídico, PCR us, TNF-, IL-6 y adiponectina. Se calculó el HOMA-IR, QUICKI y el HOMA-. Los resultados se expresaron como mediana y rango intercuartil. Las variables fueron transformadas Log10 previo estudio con correlación de Pearson. Resultados: ALT se correlacionó positivamente con: IMCpuntaje z (r = 0,335), razón cintura / talla (r = 0,358), insulina (r = 0,33), HOMA-IR (r = 0,33), HOMA-(r = 0,26), TG /HDLCol (r = 0,2), PCR us (r = 0,3) y negativamente con QUICKI (r= -0,25) y adiponectina (r = -0,113). No fueron significativas las correlaciones de ALT con glicemia, TNF-e IL-6. Conclusión: En este estudio demostramos que ALT, se correlacionó significativamente con insulino resistencia y marcadores de inflamación, todos ellos son reconocidos como factores de riesgo para pre-diabetes. ALT debe ser parte de la evaluación de todo niño obeso, especialmente en aquellos con otros riesgos cardiometabólicos, dado que podría predecir desarrollo posterior de DM2. Estudio de imágenes son necesarios para confirmar presencia de HGNA en esta población.

  18. Resolution of type 2 diabetes and prediabetes following laparoscopic sleeve gastrectomy: medium term results.

    PubMed

    Romero Lluch, Ana R; Martínez-Ortega, Antonio J; Socas-Macías, María; Jiménez-Varo, Ignacio; Pereira-Cunill, José L; Serrano-Aguayo, Pilar; Morales-Conde, Salvador; García-Luna, Pedro P

    2014-11-15

    Objetivos: Evaluar la efectividad de la gastroplastia tubular laparoscópica (GTL) en la resolución de la diabetes tipo 2 (DM2), de la prediabetes (PDM) y de otras comorbilidades en pacientes obesos. Material y métodos: Estudio observacional retrospectivo. Se incluyeron a los pacientes con DM2 (n= 36) o PDM (n= 44) que fueron sometidos a GTL en nuestro hospital entre 2009 y 2012. Se consideró criterio de PDM presentar HbA1c entre 5.7-6.4% en al menos dos ocasiones. Periodo de seguimiento entre 1-4 años (media 17.5 meses). Como criterio de resolución de la DM2 se consideró presentar HbA1c.

  19. Criptococosis cutánea primaria en paciente inmunocompetente.

    PubMed

    Vázquez-Osorio, Igor; García-Rodiño, Sara; Rodríguez-Rodríguez, Marta; Labandeira, Javier; Suárez-Peñaranda, José Manuel; Sánchez-Aguilar, MDolores; Vázquez-Veiga, Hugo

    2016-05-15

    La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol.

  20. [Stages of grief in diabetes and metabolic control].

    PubMed

    Rodríguez-Moctezuma, José Raymundo; López-Delgado, María Elisa; Ortiz-Aguirre, Alma Rosa; Jiménez-Luna, Jorge; López-Ocaña, Luis Rafael; Chacón-Sánchez, Jesús

    2015-01-01

    Introducción: el objetivo de este artículo es identificar las etapas del duelo y su asociación con el control metabólico en pacientes diabéticos tipo 2. Métodos: se incluyeron 186 sujetos diabéticos, de ambos sexos, sin pérdida reciente de un ser querido ni enfermedades terminales. Se les aplicó un instrumento validado que exploró las etapas del duelo (negación, ira/incredulidad, negociación, depresión, y aceptación). Se midió: IMC, perímetro de cintura, niveles promedio de glucosa, colesterol y triglicéridos en los últimos 6 meses. Resultados: las asociaciones entre las etapas del duelo y las variables clínicas mostraron que en la negación, el IMC es mayor 33.1 ± 6.2 contra 28.9 ± 4.6 con p = 0.001; en etapa de incredulidad, la glucemia es mayor 190 ± 67 frente a 16 ± 51 con p < 0.05; la etapa de negociación se asocia a mayor edad 65.6 ± 10 contra 59.1 ± 11 años con p = 0.001 y con nivel de colesterol mayor de 229.4 ± 39.1 frente a 206.6 ± 40 con p < 0.05; la etapa de depresión se asoció con mayor tiempo de diagnóstico 13.3 ± 8.9 frente a 9.4 ± 7.1 años, con p < 0.05 y con el nivel de glucemia de 198.9 ± 60 frente a 164 ± 51 mg/dL con p = 0.001. Conclusiones: existen asociaciones lógicas entre variables clínicas y etapas del duelo. Se debe identificar el duelo como un elemento adicional en la evaluación de pacientes con diabetes y establecer estrategias que mejoren la adherencia al tratamiento y el control metabólico.

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

    PubMed

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

    2017-04-06

    significante ao 0,05. no Chile a Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 (HbA1c<7% em população estimada) é menor que 20%. Esta se relaciona com uma Taxa de Mortalidade por Diabetes Mellitus e Percentagem de participação de enfermeiras no Programa de Saúde Cardiovascular, que ademais é significativa ao 0,01. a prevalência de Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 é baixa, mesmo quando algumas regiões se destacam nas pesquisas e no controle metabólico de pacientes assistentes ao controle. Sua relação com a Percentagem de participação de enfermeiras no Programa de Saúde Cardiovascular se constitui em um desafio e oportunidade em saúde. determinar la prevalencia de la Cobertura Universal Efectiva de la diabetes mellitus tipo 2 en Chile y su relación con las variables: Cobertura de Diabetes Mellitus tipo 2, Promedio de diabéticos con control metabólico en 2011-2013, Tasa de Mortalidad por Diabetes Mellitus y Porcentaje de participación de enfermeros en el Programa de Salud Cardiovascular. estudio descriptivo transversal con componentes ecológicos, utilizando fuentes documentales del Ministerio de Salud. Se estableció que existe correlación entre la Cobertura Universal Efectiva de la Diabetes Mellitus tipo 2 y las variables independientes, aplicando el Coeficiente de Pearson, siendo significativa al nivel 0,05. en Chile la Cobertura Universal Efectiva de Diabetes Mellitus tipo 2 (HbA1c<7% en población estimada) es menor que 20%; esta se relaciona con la Tasa de Mortalidad por Diabetes Mellitus y con el Porcentaje de participación de enfermeras en el Programa de Salud Cardiovascular, que es significativa al nivel 0,01. la prevalencia de Cobertura Universal Efectiva de la Diabetes Mellitus tipo 2 es baja; sin embargo algunas regiones se destacan en la cobertura y en el control metabólico de pacientes que participan del control de salud. La relación de la cobertura con el porcentaje de participación de enfermeras en el

  2. Quality of life of diabetic patients with medical or surgical treatment.

    PubMed

    Weiner, S; Neugehauer, E A M

    2013-03-01

    Introducción: En general, la mayoría de los estudios coinciden en que la calidad de vida de las personas con diabetes es peor que la calidad de vida de la población general (QoL). Además, estos mismos estudios también han descrito efectos muy positivos sobre la calidad de vida tras cirugía bariátrica. El objetivo de este estudio fue analizar si el impacto sobre la calidad de vida de los pacientes diabéticos después de ser sometidos a cirugía bariátrica según el test (QoL) es el que se supone debería ser. Métodos: Analizamos nuestra colección de datos prospectivos de 524 pacientes diabéticos que se sometieron a cirugía bariátrica entre 2001 y 2005. Todos los pacientes realizaron 3 cuestionarios de calidad de vida antes de la cirugía y después de 1, 3, 6 y 12 meses. Las respuestas se recogieron en una base de datos anual. Todos los pacientes se sometieron a una intervención de banda gástrica ajustable, Bypass Gástrico en-Y-Roux o BPD-Scopinaro. Resultados: En total se obtuvieron los datos completos de 89 pacientes que fueron incluidos en el estudio. 1 año después de la cirugía, la calidad de vida mejoró de manera significativa e independientemente de la remisión de la enfermedad y de la pérdida de peso. La diabetes mejoró en todos los casos. La mejora en la calidad de vida fue superior en los pacientes con remisión de la enfermedad que en los que únicamente mejoraron su estado, pero inferior que en los pacientes que no tenían diabetes antes de la operación. Conclusiones: Tras el análisis de la literatura y de nuestros propios datos prospectivos, podemos concluir que los beneficios que obtienen los pacientes diabéticos tras la cirugía bariátrica son debidos principalmente a la mejora de su diabetes, independientemente del IMC inicial y de la disminución del IMC tras la intervención. Se necesitan más estudios para investigar los resultados del test QoL en diabéticos con bajo índice de masa corporal tras la cirugía bari

  3. Effect of L-arginine supplementation on insulin resistance and adipocitokines levels in head and neck cancer non diabetic patients after surgery.

    PubMed

    de Luis, Daniel; Izaola, Olatz; de la Fuente, Beatriz; Aller, R

    2014-10-10

    Introducción: Alguntos trabajos han encontrado que la L-arginina induce efectos beneficiosos sobre la resistencia a la insulina, tanto en pacientes con diabetes tipo 2 como en individuos sanos. El objetivo de nuestro estudio fue investigar si la suplementación enteral de L-arginina (20 g por día) en pacientes con cáncer de cabeza y cuello puede modificar la resistencia a la insulina, los niveles de leptina y adiponectina después de la cirugía. Material y métodos: Tras la cirugía 82 pacientes fueron asignados aleatoriamente a dos grupos: grupo I recibió un enterales suplementos de dieta con una dosis alta de arginina (20 g por día) y el grupo II recibió una fórmula enteral sin arginina. En el momento basal y el día 10 tras la cirugia, se registraron los siguientes parámetros: glucosa, proteína C reactiva, insulina, HOMA (Homeostasis Model Assessment), leptina y adiponectina. Resultados: Los valores de peso, índice de masa corporal, la masa grasa y la masa libre de grasa se mantuvieron sin cambios durante la intervención nutricional aguda en ambos grupos. Los niveles de insulina UI/L (-0,21 + / -0,18) y HOMA (-0,07 + / -0,13) disminuyeron en el grupo de arginina. Los niveles de adiponectina (1,8 + / -2.3ng/ml) aumentaron en el grupo de arginina. Conclusión: La nutrición enteral con L-arginina a corto plazo en los pacientes afectados por cáncer de cabeza y cuello y tras cirugía es capaz de mejorar la resistencia a la insulina y los niveles de adiponectina.

  4. [Indications for the use of continuous subcutaneous insulin infusion in pediatric patients with type 1 diabetes mellitus].

    PubMed

    Espejel-Huerta, Diana; Antillón-Ferreira, Carlos Alberto; Iglesias-Leboreiro, José; Bernárdez-Zapata, Isabel; Martínez-Ramos Méndez, Angélica; Rendón-Macías, Mario Enrique

    2016-01-01

    Introducción: la diabetes es un problema serio de salud para la pediatría. En pacientes de ese grupo etario, el control depende de la adecuada administración de la insulina.Se buscó analizar las indicaciones para el uso de terapia de infusión continua subcutánea de insulina (ICSI) en niños y adolescentes con diabetes mellitus 1 (DM1). Métodos: estudio descriptivo en pacientes de 1 a 16 años con DM1, en quienes se propuso el inicio de la terapia con ICSI. Se analizó el motivo principal para justificar su inicio y si este fue diferente según edad, sexo y tiempo de evolución. Resultados: en 61 pacientes se aceptó el inicio de ICSI. La mediana de edad fue de 9 años al momento de la colocación y 43 pacientes (71.6 %) tuvieron más de un año de diagnóstico. Los motivos principales para su inicio fueron: 42.6 % (26 de 61) ante un deseo de mejorar su calidad de vida; 34.4 % (21 de 61) para reducir una variabilidad glucémica importante; 13.1 % (8 de 61) para controlar hipoglucemias recurrentes, y 9.8 % (6 de 61) para lograr metas de control en su valor de HbA1c. En los menores de 6 años (n = 14) se indicó más por hipoglucemias recurrentes y para mejorar su calidad de vida; para los de 6 a 12 años (n = 27) para mejorar su calidad de vida; y en los mayores de 12 años (n = 20) por variabilidad glucémica importante e hipoglucemias recurrentes. No hubo diferencias por sexos. Conclusión: los principales motivos que influyeron en la indicación de la ICSI en nuestros pacientes pediátricos fueron mejorar su calidad de vida y lograr un mejor control glucémico.

  5. Safety in the hypertriglyceridemia treatment with N-3 polyunsaturated fatty acids on glucose metabolism in subjects with type 2 diabetes mellitus.

    PubMed

    Reis, Caio Eduardo Gonçalves; Landim, Karla Câmara; Nunes, Aline Costa Santos; Dullius, Jane

    2014-10-06

    Introducción: Diabetes mellitus tipo 2 aumenta el riesgo de hipertrigliceridemia y es un factor de riesgo independiente para las enfermedades cardiovasculares. La literatura actual revela efectos beneficiosos de n-3 ácidos grasos poliinsaturados (n-3 AGPI) en el tratamiento de la hipertrigliceridemia, sin embargo, la seguridad de este tratamento en los sujetos diabéticos tipo 2 es discutible. Esta revisión de la literatura discute la seguridad del n-3 PUFA la suplementación sobre el metabolismo de la glucosa en el tratamiento de la hipertrigliceridemia en pacientes con diabetes mellitus tipo 2. Métodos: Se ha realizado una revisión de la literatura en la base de datos MEDLINE y EMBASE del los ensayos clínicos publicados con fecha posterior al 1990 hasta Junio de 2014 sobre los efectos de la ingesta / suplementos del n-3 AGPI en el tratamiento de la hipertrigliceridemia en pacientes con diabetes mellitus tipo 2. Resultados y Discusión: Catorce estudios clínicos (n = 2105) se incluyeron en esta revisión. Del estudios informaron una reducción en los niveles de triglicéridos entre 12 a 34% en interior del grupo comparación y de 15 a 36% en entre grupos análisis. Cuatro estudios mostraron un aumento significativo en el LDL-c (6-18%) y otros cuatro en los niveles de HDL-c (4 - 15%). No se encontraron cambios significativos en el colesterol total, VLDL-c, la glucosa, HbA1c y el índice de sensibilidad a la insulina. Conclusión: El n-3 AGPI suplementación lleva una mejora en los niveles de triglicéridos y no arrojaron deterioro en el metabolismo de la glucosa en pacientes con hipertrigliceridemia con diabetes mellitus tipo 2 siendo una opción segura para el tratamiento de la población diabética.

  6. Association of β1 and β3 adrenergic receptors gene polymorphisms with insulin resistance and high lipid profiles related to type 2 diabetes and metabolic syndrome.

    PubMed

    Burguete-Garcia, Ana I; Martinez-Nava, Gabriela A; Valladares-Salgado, Adan; Bermudez Morales, V H; Estrada-Velasco, Barbara; Wacher, Niels; Peralta-Romero, Jesus; Garcia-Mena, Jaime; Parra, Esteban; Cruz, Miguel

    2014-06-01

    Antecedentes: Entre los diversos genes asociados a la diabetes tipo 2 (DT2), los receptores –adrenérgicos– son excelentes candidatos para estudiar en la población mexicana dada la alta prevalencia de estas patologías. El objetivo de este trabajo fue analizar la asociación de polimorfismos en los genes ADRB1 (rs1801253) (Arg389Gly) y ADRB3 (Trp64Arg) con DT2 y SM. Métodos: Se estudiaron 445 pacientes con Síndrome Metabólico, 502 con diabetes tipo 2 y 552 controles sanos. Se evaluaron las características antropométricas, perfil bioquímico completo y los polimorfismos Arg389Gly y Trp64Arg SNPs se determinaron mediante ensayos TaqMan. El análisis de datos fue ajustado por porcentaje de ancestralidad. Resultados: Para la variante ADRB1 Arg389Gly se observó una asociación estadísticamente significativa con un aumento de los niveles de LDL (P < 0,008 ), y la variante ADRB3 Trp64Arg se asoció a mayor HOMA- IR (p < 0,018) y con un aumento de los niveles de insulina (P < 0,001). Mediante modelos de regresión logística múltiple en los tres modelos de heredabilidad se evaluó la asociación de ambos polimorfismos y DT2 y SM, observando un asociación significativa en los 3 modelos solo con DT2, ADRB3 en el modelo codominante Trp/Arg un OR de 1.53 (1.9 a 2.13 , P < 0.003) que se incrementó hasta OR 2,99 (1,44 a 6,22 , P < 0,003) para el genotipo Arg/Arg . Se encontró bajo el modelo dominante genotipo Trp/Arg- Arg/Arg con OR 1.67 (1.21 a 2.30, p < 0.002). En el modelo recesivo (Arg/Arg), también un OR 2.56 (1.24 a 5.26 , P < 0.01). Conclusiones: La variante ADRB3 Trp64Arg se asoció significativamente con DT2 y ADRB1 Gly389Arg en alteraciones en el metabolismo de lípidos. Nuestros resultados demuestran que estas variantes son posibles biomarcadores para predecir las alteraciones metabólicas y la evolución en pacientes con síndrome Metabólico y diabetes tipo 2.

  7. [Effects of exenatide lar in type 2 diabetes mellitus and obesity].

    PubMed

    Sierra Poyatos, Roberto; Riobó Serván, Pilar; Vázquez Martínez, Clotilde

    2014-10-24

    Introducción: Los análogos GLP-1 han demostrado ser un tratamiento eficaz en el tratamiento de la diabetes mellitus tipo 2 (DM-2) y la obesidad. Objetivo: Evaluar la eficacia de exenatide LAR sobre la pérdida de peso, control glucémico, tensión arterial (TA) y perfil lipídico, en DM-2 y obesidad. Material y métodos: Estudio retrospectivo de pacientes en tratamiento con exenatide LAR durante 6 meses. Se recogieron datos demográficos (edad, sexo), antropométricos, glucemia basal, hemoglobina glicada (HbA1c), tensión arterial y perfil lipídico al inicio y a los 6 meses de tratamiento. Se ha realizado un análisis de regresión logística para evaluar posibles factores predictores de eficacia. Resultados: 30 pacientes (17 varones, edad media: 61,7±9,5 años) con DM-2 de 9,7±6,2 años de evolución. La HbA1c se redujo en 1,3% (IC95% 1,04-1,57, p.

  8. Planificación Neuroquirúrgica con Software Osirix

    PubMed Central

    Jaimovich, Sebastián Gastón; Guevara, Martin; Pampin, Sergio; Jaimovich, Roberto; Gardella, Javier Luis

    2014-01-01

    Introducción: La individualidad anatómica es clave para reducir el trauma quirúrgico y obtener un mejor resultado. Actualmente, el avance en las neuroimágenes ha permitido objetivar esa individualidad anatómica, permitiendo planificar la intervención quirúrgica. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. Caso 1: Paciente con meningioma de la convexidad parasagital izquierda en área premotora; Caso 2: Paciente con macroadenoma hipofisario, operada previamente por vía transeptoesfenoidal en otra institución con una resección parcial; Caso 3: Paciente con lesiones en pedúnculo cerebeloso medio bilateral. Se realizó la planificación prequirúrgica con el software OsiriX, fusionando y reconstruyendo en 3D las imágenes de TC e IRM, para analizar relaciones anatómicas, medir distancias, coordenadas y trayectorias, entre otras funciones. Discusión: El software OsiriX de acceso libre y gratuito permite al cirujano, mediante la fusión y reconstrucción en 3D de imágenes, analizar la anatomía individual del paciente y planificar de forma rápida, simple, segura y económica cirugías de alta complejidad. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente, para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. En el Caso 3 permitió obtener las coordenadas estereotáxicas y trayectoria de una lesión sin representación tomográfica. Conclusión: En casos de no contar con costosos sistemas de neuronavegación o estereotáxia el software OsiriX es una alternativa a la hora de planificar la cirugía, con el objetivo de disminuir el trauma y la morbilidad operatoria. PMID:25165617

  9. Diabetes Insipidus

    MedlinePlus

    ... Kidneys & How They Work Kidney Disease A-Z Diabetes Insipidus What is diabetes insipidus? Diabetes insipidus is a rare disorder that ... produce more urine. What are the types of diabetes insipidus? The types of diabetes insipidus include central ...

  10. Diabetes - resources

    MedlinePlus

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

  11. DIABETES MELLITUS COMO FACTOR DE RIESGO DE DEMENCIA EN LA POBLACIÓN ADULTA MAYOR MEXICANA

    PubMed Central

    Silvia, Mejía-Arango; Clemente, y Zúñiga-Gil

    2012-01-01

    Introduccion La diabetes mellitus y las demencias constituyen dos problemas crecientes de salud entre la población adulta mayor del mundo y en particular de los paises en desarrollo. Hacen falta estudios longitudinales sobre el papel de la diabetes como factor de riesgo para demencia. Objetivo Determinar el riesgo de demencia en sujetos Mexicanos con diabetes mellitus tipo 2. Materiales y Metodos Los sujetos diabéticos libres de demencia pertenecientes al Estudio Nacional de Salud y Envejecimiento en México fueron evaluados a los dos años de la línea de base. Se estudió el papel de los factores sociodemográficos, de otras comorbilidades y del tipo de tratamiento en la conversión a demencia. Resultados Durante la línea de base 749 sujetos (13.8%) tuvieron diabetes. El riesgo de desarrollar demencia en estos individuos fue el doble (RR, 2.08 IC 95%, 1.59–2.73). Se encontró un riesgo mayor en individuos de 80 años y más (RR 2.44 IC 95%, 1.46–4.08), en los hombres (RR, 2.25 IC 95%, 1.46–3.49) y en sujetos con nivel educativo menor de 7 años. El estar bajo tratamiento con insulina incrementó el riesgo de demencia (RR, 2.83, IC 95%, 1.58–5.06). Las otras comorbilidades que aumentaron el riesgo de demencia en los pacientes diabéticos fueron la hipertensión (RR, 2.75, IC 95%, 1.86–4.06) y la depresión (RR, 3.78, 95% IC 2.37–6.04). Conclusión Los sujetos con diabetes mellitus tienen un riesgo mayor de desarrollar demencia, La baja escolaridad y otras comorbilidades altamente prevalentes en la población Mexicana contribuyen a la asociación diabetes-demencia. PMID:21948010

  12. [Clinical improvement of diabetic neuropathy with carbamazepine or diclofenac treatment].

    PubMed

    Tinoco-Samos, Andrea; Córdova-Pérez, Nydia; Arenas-Téllez, Juan Manuel; Vargas-Girón, Antonio; Zárate, Arturo; Hernández-Valencia, Marcelino

    2013-01-01

    Introducción: la neuropatía diabética afecta diversos aspectos de la vida del paciente, pero aún no hay un tratamiento específico. Se hizo un análisis comparativo de la mejoría clínica con manejo de carbamazepina y diclofenaco. Métodos: estudio prospectivo, longitudinal, de dos grupos de pacientes diabéticos con signos y síntomas de neuropatía diabética: 30 usaron 200 mg de carbamazepina cada 24 horas por una semana, con incremento gradual hasta 200 mg cada seis horas por 10 meses; 29 utilizaron 100 mg de diclofenaco sódico cada 12 horas. Se hicieron evaluaciones bimestrales para graduar el dolor según la percepción del paciente. Los estudios de laboratorio incluyeron glucosa y perfil de lípidos. Se empleó Anova para mediciones repetidas. Resultados: los pacientes tratados con carbamazepina no tuvieron dolor después de 10 meses de tratamiento, a diferencia del grupo con diclofenaco (p < 0.01). Con la carbamazepina disminuyeron los calambres y mejoró la fuerza muscular, la presencia de pulsos y la percepción de temperatura y presión (p < 0.05). Los tres últimos se deterioraron con el diclofenaco. Conclusiones: hay que reconocer la sintomatología en pacientes diabéticos para dar el tratamiento adecuado.

  13. [Physical exploration and morbidity of pelvic members in the diabetic patient type 2].

    PubMed

    Vargas-Daza, Emma Rosa; Rivera-Pérez, María del Pilar; Villarreal-Ríos, Enrique; Galicia-Rodríguez, Liliana; Martínez-González, Lidia

    2013-01-01

    Objetivo: determinar la prevalencia de exploración física y morbilidad de miembros pélvicos en el paciente diabético tipo 2. Métodos: estudio transversal descriptivo. Se analizaron 189 expedientes de pacientes diabéticos de medicina familiar. La muestra se estimó con la fórmula de proporciones para población finita. Las unidades muestrales se eligieron por conveniencia y se retomaron de cada uno de los consultorios de medicina familiar. Se estudiaron variables sociodemográficas y de salud (patologías agregadas, tiempo de evolución de la diabetes, control glucémico y consultas al año). Del servicio se estudiaron exploraciones físicas realizadas y signos explorados por el médico en un año. Se utilizó estadística descriptiva para el análisis de datos. Resultados: edad promedio de 58.89 años (IC 95 %, 57.1-60.7), predominó el sexo femenino con 61.9 % (IC 95 %, 55.0-68.8), el promedio de tiempo de evolución fue de 10.60 ± 7.29 años. La mayoría tenía descontrol glucémico. En el 74.1 % se exploró algún signo en miembros pélvicos, al 14.3 % se le detectó algún problema agregado; de estos, 9.0 % padecía onicomicosis. Conclusión: la exploración física de los miembros pélvicos no se realiza en la totalidad de los pacientes diabéticos tipo 2.

  14. [Prevalence of urinary tract symptoms in women with diabetes mellitus].

    PubMed

    Jiménez-Rodríguez, Javier; Carbajal-Ramírez, Angélica; Meza-Vázquez, Héctor; Moreno-Palacios, Jorge; Serrano-Brambila, Eduardo

    2016-01-01

    Introducción: la diabetes mellitus (DM) conlleva un aumento de la ingesta de líquidos y del gasto urinario por el estado hiperosmolar al que induce a los que la padecen. El objetivo fue evaluar la prevalencia de síntomas urinarios en mujeres con DM, su impacto en la calidad de vida y su asociación con el tiempo de diagnóstico de DM, neuropatía y control glucémico. Métodos: en una cohorte de mujeres del programa DiabetIMSS evaluamos, de enero de 2011 a enero de 2013, sus antecedentes, neuropatía y síntomas urinarios, control glucémico e impacto en la calidad de vida mediante entrevista, medición de peso, exámenes paraclínicos y cuestionarios (ICIQ-SF, IPSS y QoL). Resultados: entrevistamos 169 mujeres con mediana de edad de 58 años (29-85) y mediana al diagnóstico de DM de 9 años (0.5-31). Presentaron síntomas urinarios 128 (75.7 %), principalmente incontinencia urinaria de esfuerzo y urgencia (45.3 y 40.6 %), síntomas obstructivos (25 %) e irritativos (10.1 %). Su impacto en la calidad de vida fue de leve a moderado (91.1 %). Presentaron neuropatía 154 (91.1 %), con un tiempo mayor de evolución en las pacientes sintomáticas (12 frente a 4.8 meses), igualmente prevalecieron los síntomas urinarios en aquellas con neuropatía de más de un año de evolución, p < 0.05. Conclusión: la prevalencia de síntomas urinarios en mujeres diabéticas es elevada, con el tiempo de evolución de neuropatía como único factor asociado. El tiempo de evolución de DM y una determinación de HbA1c no evidenciaron asociación significativa.

  15. Diabetic Retinopathy

    MedlinePlus

    ... version of this page please turn Javascript on. Diabetic Retinopathy What Is Diabetic Retinopathy? Click for more information Can Cause Vision ... vision loss and even blindness can result. Other Diabetic Eye Diseases In addition to diabetic retinopathy, other ...

  16. La salud en personas con discapacidad intelectual en España: estudio europeo POMONA-II

    PubMed Central

    Martínez-Leal, Rafael; Salvador-Carulla, Luis; Gutiérrez-Colosía, Mencía Ruiz; Nadal, Margarida; Novell-Alsina, Ramón; Martorell, Almudena; González-Gordón, Rodrigo G.; Mérida-Gutiérrez, M. Reyes; Ángel, Silvia; Milagrosa-Tejonero, Luisa; Rodríguez, Alicia; García-Gutiérrez, Juan C.; Pérez-Vicente, Amado; García-Ibáñez, José; Aguilera-Inés, Francisco

    2011-01-01

    Introducción Estudios internacionales demuestran que existe un patrón diferenciado de salud y una disparidad en la atención sanitaria entre personas con discapacidad intelectual (DI) y población general. Objetivo Obtener datos sobre el estado de salud de las personas con DI y compararlos con datos de población general. Pacientes y métodos Se utilizó el conjunto de indicadores de salud P15 en una muestra de 111 sujetos con DI. Los datos de salud encontrados se compararon según el tipo de residencia de los sujetos y se utilizó la Encuesta Nacional de Salud 2006 para comparar estos datos con los de la población general. Resultados La muestra con DI presentó 25 veces más casos de epilepsia y el doble de obesidad. Un 20% presentó dolor bucal, y existió una alta presencia de problemas sensoriales, de movilidad y psicosis. Sin embargo, encontramos una baja presencia de patologías como la diabetes, la hipertensión, la osteoartritis y la osteoporosis. También presentaron una menor participación en programas de prevención y promoción de la salud, un mayor número de ingresos hospitalarios y un uso menor de los servicios de urgencia. Conclusiones El patrón de salud de las personas con DI difiere del de la población general, y éstas realizan un uso distinto de los servicios sanitarios. Es importante el desarrollo de programas de promoción de salud y de formación profesional específicamente diseñados para la atención de personas con DI, así como la implementación de encuestas de salud que incluyan datos sobre esta población. PMID:21948011

  17. [Relationship between body fat and creatinine clearence in adults with and without diabetes mellitus].

    PubMed

    Romero-Campos, Sandra; Viveros-Cortés, Ángel; Medina-Escobedo, Martha; Sansores-España, Delia; Villanueva-Jorge, Salha

    2015-01-01

    Introducción: la obesidad es un factor de riesgo para daño renal. El objetivo del estudio fue conocer la relación entre el porcentaje de grasa corporal (PG) y la depuración de creatinina en pacientes adultos con y sin diabetes mellitus 2 (DM2). Métodos: estudio observacional, prospectivo, transversal de correlación. Se evaluaron adultos entre 18 y 60 años, con y sin DM2. Se determinó el tiempo de evolución con DM2, el PG, el índice de masa corporal (IMC), la depuración de creatinina (Cockroft-Gault [DCrCG]), la glicemia y la micro/macroalbuminuria. Mediante la prueba de Spearman se determinó la correlación entre DCrCG y PG. Resultados: se incluyeron 174 sujetos. La frecuencia de obesidad por IMC y PG en sujetos con y sin DM2 fue similar. El 12.6 % no tuvo daño renal y el 50.7 % tuvo riesgo aumentado de enfermedad renal. Las frecuencias para los estadios 1 a 4 fueron 12.0, 20.1, 4.0 y 0.6 %, de forma respectiva. La prueba de Spearman mostró relación directa entre PG y DCrCG, mayor en diabéticos (r = 0.418 frente a r = 0.327, p < 0.0001). Conclusiones: el PG corporal se correlacionó en forma directa con la DCrCG en sujetos con y sin DM2; se infiere que a mayor daño renal, menor grasa tiene la población evaluada.

  18. Innovative models for the empowerment of patients with type 2 diabetes: the CAIPaDi program.

    PubMed

    Hernandez-Jimenez, Sergio; Garcia-Ulloa, Cristina; Mehta, Roopa; Aguilar-Salinas, Carlos A; Kershenobich-Stalnikowitz, David

    2014-01-01

    Empowerment interventions for chronic diseases are an evolving process. No agreement exists regarding the necessary components and methodologies to be applied. Systematic reviews have assessed the effect of self-management interventions. Improvements in illness beliefs, adherence to drug therapy and glucose monitoring have been reported. In the long term, no major changes have been achieved in weight, physical activity, smoking status, and depression scores. There is a need for additional studies. The CAIPaDi (Centro de Atención Integral del Paciente con Diabetes) program is an intervention designed to provide education and empowerment techniques (using simple low-cost interactive tools) over a short period of time followed by at-distance support using internet or cell phone technology. The target population consists of patients with type 2 diabetes, free of chronic complications who are non-smokers. The intervention is composed of four monthly visits followed by a continuous at-distance support system. At each visit, patients stay for six hours in the center. Information is presented in group sessions. Empowerment techniques are applied during individual exchanges with the team or during facilitated group sessions. In summary, empowerment programs are an unmet need in many healthcare services. This review also discusses relevant studies and patents in the management of type 2 diabetes.

  19. Women and Diabetes -- Diabetes Medicines

    MedlinePlus

    ... Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing options ... 800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are listed ...

  20. Diabetes - tests and checkups

    MedlinePlus

    ... High blood pressure Microalbuminuria test Type 1 diabetes Type 2 diabetes Patient Instructions ACE inhibitors Diabetes and exercise Diabetes - eye care Diabetes - foot ulcers Diabetes - keeping ...

  1. Tratamiento Quirúrgico de los Meningiomas del Foramen Óptico, Técnicay Resultados de una Serie de 18 Pacientes

    PubMed Central

    Goldschmidt, Ezequiel; Ajler, Pablo; Campero, Álvaro; Landriel, Federico; Sposito, Maximiliano; Carrizo, Antonio

    2014-01-01

    Introducción: los meningiomas del foramen óptico producen un rápido deterioro de la función visual aún cuando su tamaño es pequeño, por eso su diagnóstico y manejo difiere del resto de los meningiomas clinoideos. El propósito de este estudio es presentar la técnica y los resultados de nuestro manejo quirúrgico de meningiomas foraminales (MF). Pacientes y Métodos: se llevó a cabo una revisión de las historias clínicas de 47 pacientes con meningiomas primarios intraorbitarios. Se realizaron 52 cirugías en los pacientes con MF. Se empleó una craneotomía fronto-orbitaria, seguida de una descompresión extradural del canal óptico, resección del componente intraorbitario y exploración intradural del nervio óptico. Resultados: de los 12 pacientes con MF que presentaban la visión conservada, la agudeza visual fue preservada en 7 casos, mejoró en 2, y empeoró en 3. En 18 pacientes, el principal síntoma fue exoftalmos y en 35 pacientes ceguera unilateral. Ocurrieron 6 recurrencias, 2 a 10 años después de la resección quirúrgica. Cinco de ellos fueron reoperados. Se indicó radioterapia después de la recurrencia en 3 pacientes. Conclusión: el manejo de los MF continúa siendo controvertido y frecuentemente se propone un tratamiento conservador. Basados en nuestros hallazgos de frecuente extensión intracraneal, proponemos realizar una resección total o subtotal del tumor, preservando el nervio óptico en pacientes con visión prequirúrgica conservada. PMID:25165616

  2. Diabetes mellitus y atrofia óptica: estudio del síndrome de Wolfram.

    PubMed

    Rivas-Gómez, Bernardette; Reza-Albarrán, Alfredo Adolfo

    2017-01-01

    El síndrome de Wolfram (SW), también conocido por el acrónimo DIDMOAD, es una enfermedad hereditaria rara y progresiva, de transmisión autosómica recesiva, cuyos criterios diagnósticos mínimos son diabetes mellitus y atrofia óptica antes de los 15 años de edad. Describir la presentación clínica, bioquímica y molecular del SW en un hospital de tercer nivel en México. Se revisaron los expedientes de pacientes que cumplían con criterios diagnósticos clínicos mínimos de SW atendidos entre enero de 1987 y mayo de 2015 en un hospital de tercer nivel en -México. Cinco pacientes cumplieron con los criterios de inclusión (tres hombres y dos mujeres). La diabetes mellitus fue la primera manifestación del síndrome en todos ellos, con una media de edad al diagnóstico de 5.8 ± 2.71 años, mientras que el diagnóstico del SW se estableció en promedio a los 15.8 ± 8.37 años. Todos los pacientes tenían atrofia óptica y dos presentaron el espectro DIDMOAD completo. Se describen nuevas asociaciones con hepatitis autoinmunitaria y cáncer de testículo. El presente estudio muestra la variabilidad de presentación clínica del SW y dos asociaciones no descritas previamente. Wolfram syndrome (WS), also known by the acronym DIDMOAD, is a rare and progresive hereditary disease of autosomal recessive inheritance which minimum ascertainment diagnostic criteria are the occurrence together of diabetes mellitus and optic atrophy before 15 years of age. To describe the clinical, biochemical and molecular profile of WS in a tertiary care hospital in Mexico. We reviewed patients records who fulfill the minimum ascertainment diagnostic criteria of WS presenting between January 1987 and May 2015 in a tertiary care hospital in Mexico. Five patients fulfill the inclusion criteria (three male and two female). Diabetes mellitus was the first manifestation of the syndrome in all of them, with a mean age at diagnosis of 5.8 ± 2.71 years, while the WS diagnosis was

  3. Diabetic Nephropathy without Diabetes

    PubMed Central

    López-Revuelta, Katia; Méndez Abreu, Angel A.; Gerrero-Márquez, Carmen; Stanescu, Ramona-Ionela; Martínez Marín, Maria Isabel; Pérez Fernández, Elia

    2015-01-01

    Diabetic nephropathy without diabetes (DNND), previously known as idiopathic nodular glomerulosclerosis, is an uncommon entity and thus rarely suspected; diagnosis is histological once diabetes is discarded. In this study we describe two new cases of DNND and review the literature. We analyzed all the individualized data of previous publications except one series of attached data. DNND appears to be favored by recognized cardiovascular risk factors. However, in contrast with diabetes, apparently no factor alone has been demonstrated to be sufficient to develop DNND. Other factors not considered as genetic and environmental factors could play a role or interact. The most plausible hypothesis for the occurrence of DNND would be a special form of atherosclerotic or metabolic glomerulopathy than can occur with or without diabetes. The clinical spectrum of cardiovascular risk factors and histological findings support this theory, with hypertension as one of the characteristic clinical features. PMID:26239683

  4. Serum and liver lipids distributions in streptozotocin induced diabetic rat treated with diet containing yam (Dioscorea bulbifera) flour.

    PubMed

    Rozeno Pessoa, Letícia; Rêgo, Thaís de Salgado; Asht, Louise da Silva; Monteiro, Igor Cabral Coutinho do Rêgo; Fortunato, Rodrigo Soares; Feijó, Márcia Barreto da Silva; Correia-Santos, André Manoel; da Costa, Carlos Alberto Soares; Boaventura, Gilson Teles

    2015-04-01

    Introducción: La enfermedad hepática como una de las principales causas de mortalidad en los pacientes con diabetes mellitus. Hay un interés para investigar las propiedades hipolipemiantes de ñame. El objetivo era evaluar el papel de ñame brasileña (Dioscorea bulbifera) en suero y los niveles hepáticos de triglicéridos y colesterol, en las ratas diabéticas . Métodos: Las ratas se dividieron en tres grupos: control (C), diabéticos (DM); Diabetic ñame (DMA), se trata con dieta que contenía 25 g / 100 g de harina de ñame. Después de 5 semanas de experimento, la glucosa, la insulina, la grasa gonadal y la masa del hígado fueron evaluados. Se cuantificaron las concentraciones de suero e hígado de los triglicéridos y las concentraciones de colesterol. Se determinaron los tioles totales de hígado. Resultados: Después de las 5 semanas, experimental ducha grupos (p.

  5. [Figures performance of glycemia in type 2 diabetic patients with intake of two breakfast with the same amount of carbohydrates].

    PubMed

    Rueda Páez, Elsy Victoria; Maldonado Obando, Yohanna del Carmen; Caballero Pérez, Luz Alba

    2015-04-01

    Los carbohidratos (CHO) simples en el riesgo cardiometabólico, conllevan al incremento de la glucemia y los niveles de insulina y, a largo plazo a Diabetes Mellitus tipo 2 (DM2). OBJETIVO: determinar el comportamiento de cifras de glucemia en pacientes DM2 con la ingesta de dos desayunos. METODOLOGÍA: Se valoraron por antropometría, bioquímica y clínica 14 pacientes con DM2 a quienes se les administró 2 desayunos en tiempos diferentes con 50 g de CHO representados en galleta tipo dulce y pan blanco. RESULTADOS: se evidenció alteración en el 92,8% de colesterol de baja Densidad (Ldlc), Colesterol Total (CT) y Colesterol de alta densidad (Hdlc) en el 50% y triacilglicerol (TG) en un 35,7%. El comportamiento de la glucemia para el desayuno con galleta no presentó diferencia significativa en la cifra preprandial y postprandial a las 2 y 3 horas (p= 0,051 y 0,054 respectivamente) la glucemia de las 2 horas con las 3 horas mostraron significancia (p=0,012). En el desayuno con pan blanco la glucemia preprandial y postprandial a las 2 horas aumentó (p= 0,006), en tanto, que a las 3 horas, la cifra reportada entre las 2 y 3 horas no presentaron diferencias significativas ( p= 0,114 y 0,051 respectivamente). Al comparar cada una de las glucemias de los desayunos en los periodos preprandial a las 2 y 3 horas no se encontraron diferencias estadísticamente significativas (p>0,05). CONCLUSIÓN: cantidades isocalóricas de carbohidratos de 2 desayunos ingeridos en días diferentes se comportaron de igual manera en las cifras de glucemia. El desayuno con galleta favorecería a la población diabética por los ingredientes utilizados en su elaboración dada su dislipidemia.

  6. [Blood glucose and insulin responses to two hypocaloric enteral formulas in patients with diabetes mellitus type 2].

    PubMed

    de Luis, D A; Izaola, O; de la Fuente, B; Araújo, K

    2013-01-01

    Objetivos: El objetivo del presente estudio es comparar la respuesta glucémica e insulinémica de pacientes diabéticos tipo 2 tras la administración oral de 250 ml de dos formulas enterales: una formula especifica (Novasource® Diabet Smartflex®) frente a una fórmula isocalórica estándar. Material y métodos: El diseño fue cruzado, recibiendo los pacientes diabéticos (n = 15) de manera aleatoria las dos fórmulas. Se realizó una curva de glucemia e insulinemia en los tiempos 0, 10,20, 30,60, 90, 120,150 y 180 minutos. Las variables analizadas fueron, el área bajo la curva (AUC0-t), la concentración máxima (Cmax), el tiempo en que se alcanza la concentración máxima (Tmax) y las concentraciones de los parámetros bioquímicos en cada período del estudio. Resultados: Se estudiaron 11 varones (73.3%) y 4 mujeres (26.7%), la edad media fue de 56,9 ± 10,9 años. Los pacientes que recibieron Novasource® Diabet presentan una media menor de AUC0-t, diferencia entre medias de glucemia -4.753,26 mg/min/dl (IC 95%: -7.256,7 a -2.249,82), también presentaron una media de insulinemia significativamente menor de AUC0-t, diferencia de medias: -930,27 uU/min/ml (IC 95%: -1.696,34 a -164,2). La Cmax mostró unas medias de glucemia significativamente menores con la fórmula específica, diferencia de medias -26,89 mg/dl (IC 95% 42,11 a -11,67) e insulinemia, diferencia de medias: -5,39 uU/ml (IC 95%: -10,37 a -1,43). El análisis de Tmax muestra que las medias de glucemia con la fórmula específica son significativamente menores, diferencia de medias -19,82 min (IC 95%: -32,11 a -7,33), sin diferencia significativa en la Tmax de insulinemia. Finalmente el análisis de las concentraciones de glucosa en el total del estudio muestra que el grupo con la formula específica tiene una media menor de glucosa 25,77 mg/dl (IC 95%: 18,29 a 33,25), sucediendo lo mismo con la insulinemia 4,39 U/ml (IC 95%: 0,927 a 7,87). Conclusiones: Los pacientes diabéticos tipo 2 que

  7. Diabetic nephropathy: changes after diabetes surgery?

    PubMed

    Ros Ruiz, S

    2013-03-01

    Introducción: La obesidad, como pieza clave dentro del síndrome metabólico, está asociada con el enfermedad renal crónica (ERC) temprana. Además, varios estudios observacionales, de corte transversal y longitudinal han demostrado que la obesidad es un factor de riesgo independiente para la aparición, progresión y empobrecimiento del pronóstico de la ERC incluida la nefropatía diabética. Esto implica que cuando se revierte la obesidad, mejora mucho de los factores de riesgo de ERC y la propia ERC. Por lo tanto, todas las medidas encaminadas a la pérdida de peso permitiría minimizar los riesgos asociados a la obesidad y mejorar el perfil metabólico. La evidencia actual ha demostrado que la cirugía bariátrica (CB) puede revertir o mejorar la proteinuria y la ERC en pacientes con obesidad mórbida. Objetivos y métodos: Esta revisión tiene como objetivo proporcionar evidencia sobre los efectos beneficiosos de la pérdida de peso tras la CB en los diferentes estadios de la ERC incluido los receptores de trasplante renal, especialmente los efectos beneficiosos en la reducción o mejora de la proteinuria y de la insuficiencia renal. Además, esta revisión sistemática actualizada de la literatura analiza los efectos adversos potenciales que podría producir la CB no solo sobre la función renal, sino también sobre la morbimortalidad en el período peri y postoperatorio. Conclusiones: Los resultados de los diferentes casos clínicos, metaanálisis, así como, revisiones sistemáticas de los ensayos clínicos demuestran que el tratamiento de la obesidad mediantes cambios en el estilo de vida, tratamiento farmacológico y CB pueden reducir la proteinuria y prevenir la pérdida de la función renal. Asimismo, la CB minimiza las complicaciones, y permite a los pacientes obesos con ERC avanzada recibir un trasplante renal con buenos resultados.

  8. Ependimoma myxopapilar sacro gigante con osteolisis

    PubMed Central

    Ajler, Pablo; Landriel, Federico; Goldschmidt, Ezequiel; Campero, Álvaro; Yampolsky, Claudio

    2014-01-01

    Objetivo: la presentación de un caso de una paciente con un ependimoma sacro con extensa infiltración y destrucción ósea local. Descripción del caso: una mujer de 53 años acudió a la consulta por dolor lumbosacro y alteraciones sensitivas perineales y esfinterianas. La imágenes por Resonancia Magnética (IRM) y la Tomografía Axial Computada (TAC) mostraron una lesión expansiva gigante a nivel S2-S4 con extensa osteólisis e invasión de tejidos adyacentes. Se realizó una exéresis tumoral completa con mejoría del estatus funcional. La anatomía patológica informó ependimoma mixopapilar. Discusión: la extensión de la resección quirúrgica es el mejor predictor de buen pronóstico. El tratamiento radiante se reserva como opción adyuvante para las resecciones incompletas y recidiva tumoral. La quimioterapia sólo debería utilizarse en casos en que la cirugía y la radioterapia estén contraindicadas. Conclusión: Los ependimomas mixopapilares sacros con destrucción ósea y presentación intra y extradural son muy infrecuentes y deben ser tenidos en cuenta entre los diagnósticos diferenciales preoperatorios. Su resección total, siempre que sea posible, es la mejor alternativa terapéutica. PMID:25165615

  9. C-peptide levels predict type 2 diabetes remission after bariatric surgery.

    PubMed

    Ramos-Leví, Ana M; Matía, Pilar; Cabrerizo, Lucio; Barabash, Ana; Torrejón, María José; Sánchez-Pernaute, Andrés; Torres, Antonio J; Rubio, Miguel A

    2013-01-01

    Introducción: La determinación del péptido C (pC) suele emplearse como un indicador de la reserva betapancreática. El objetivo de este estudio es evaluar si el pC basal, es un parámetro predictor de remisión de diabetes mellitus tipo 2 (DM2) tras cirugía bariátrica (CB). Material y métodos: Estudio retrospectivo de 22 pacientes con DM2 e IMC > 35 kg/m2, intervenidos mediante CB. Recogida de datos clínicos, antropométricos y analíticos relativos al metabolismo de la glucosa, antes de la CB y al año. Análisis de pacientes en remisión completa de DM2 al año de la CB (glucosa basal [GB] < 100 mg/dl, HbA1c < 6%, sin tratamiento farmacológico) y las variables preoperatorias asociadas a remisión (regresión logística binaria). Estimación del mejor valor umbral de pC para predecir la remisión de DM2 con curva ROC. Resultados: Características pre-CB (media ± DE): edad 53,3 ± 9,4 años, IMC 42,9 ± 6,8 kg/m2, duración DM2 6,9 ± 5,2 años, GB 159,6 ± 56,6 mg/dl, HbA1c 7,5 ± 1,1%, pC 4,0 ± 2,0 (mediana 3,8, rango 0,1-8,9) ng/ml. 12 pacientes (54,5%) presentaron remisión de DM2. El pC preoperatorio se correlacionó con la HbA1c a los 12 meses (r = - 0,519, p = 0,013). Los valores de pC pre-CB fueron más elevados en los pacientes que alcanzaron remisión de DM2 (5,0 ± 1,7 vs 3,0 ± 1,7 ng/ml, p = 0,013). Un valor de pC > 3,75 ng/ml supuso una sensibilidad y especificidad para remisión de DM2 de 75% y 80%, respectivamente. La tasa de remisión de DM2 fue de 27,3% si el pC basal pre-CB < 3,8 ng/ml, y 81,7% si > 3,8 ng/ml (p = 0,010). Conclusiones: Los pacientes con pC basal preoperatorio elevado son los que mayores tasas de remisión alcanzan al año de la CB. Una concentración de pC basal > 3,75 ng/dL parece un buen predictor de remisión completa de DM2 al año de la CB.

  10. Asian Americans and Diabetes

    MedlinePlus

    ... the Corporation Board of Trustees Leadership Council History Managing Diabetes Childhood Diabetes Nutrition Exercise Online Diabetes Classes ... Support Planned Giving Philanthropy Team Diabetes Information & Resources » Managing Diabetes » Asian Americans & Diabetes Newly Diagnosed Managing Diabetes ...

  11. Incidence and risk factors for diabetes, hypertension and obesity after liver transplantation.

    PubMed

    Anastácio, Lucilene Rezende; Ribeiro, Hélem de Sena; Ferreira, Livia García; Lima, Agnaldo Soares; Vilela, Eduardo García; Toulson Davisson Correia, María Isabel

    2013-01-01

    Objetivo: Los trastornos metabólicos han sido ampliamente descritos en los pacientes sometidos al transplante hepático (TH). Material y métodos: La incidencia de hipertensión arterial, diabetes mellitus y obesidad además de los factores de riesgo se evaluaron en 144 pacientes post-TH al menos un año después del trasplante (59% hombres, edad promedio 54 años, mediana del tiempo desde el trasplante 4 años). Los factores de riesgo se evaluaron mediante análisis de regresión logística de acuerdo con variables demográficas, socioeconómicas, estilo de vida, así como variables clínicas, antropométricas y dietéticas. Resultados: La incidencia de hipertensión fue del 18,9%, la diabetes, el 14,0% y la obesidad, el 15,9%. Los factores de riesgo para la incidencia de la hipertensión fueron la obesidad abdominal (OR: 2,36, IC: 1,02-5,43, p < 0,05), los antecedentes familiares de hipertensión arterial (OR: 2,75, IC: 1,06-7,19, p < 0,05) y el uso de la ciclosporina (OR: 3,92, IC: 1,05-14,70, p < 0,05). Los factores de riesgo para la incidencia de diabetes fueron niveles más altos de glucosa en ayuno (mg/dL) pre-TH (OR: 1,04, IC: 1,01-1,06, p < 0,05) y el diagnóstico de cirrosis alcohólica como indicación de TH (OR: 2,54, IC: 0,84-7,72, p < 0,05). La incidencia de obesidad después del TH se relacionó con el bajo consumo de la leche (mL) (OR: 1,01, IC: 1,001-10,01, p < 0,05), donante con IMC más grande (kg/m(2)) (OR: 1,34, IC: 1,04-1,74; p < 0,05), mayor índice de masa corporal antes de la enfermedad hepática (kg/m(2)) (OR: 1,79, IC: 1,36-2,36, p < 0,01) y ingreso per cápita dos veces el sueldo mínimo (OR: 5,71, IC: 4,51- 6,86, p < 0,05). Conclusión: El TH se asoció con tasas significativamente más altas de hipertensión, diabetes y obesidad. La incidencia de estos trastornos se relacionó con la terapia inmunosupresora y otros factores de riesgo que comunes en la población general.

  12. [Diabetic neuropathy].

    PubMed

    Lechleitner, Monika; Abrahamian, Heidemarie; Francesconi, Claudia; Kofler, Markus

    2016-04-01

    These are the guidelines for diagnosis and treatment of diabetic neuropathy. This diabetic late complication comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy. The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided.

  13. Diabetic neuropathy.

    PubMed

    Vinik, Aaron I; Nevoret, Marie-Laure; Casellini, Carolina; Parson, Henri

    2013-12-01

    Diabetic neuropathy (DN) is the most common and troublesome complication of diabetes mellitus, leading to the greatest morbidity and mortality and resulting in a huge economic burden for diabetes care. The clinical assessment of diabetic peripheral neuropathy and its treatment options are multifactorial. Patients with DN should be screened for autonomic neuropathy, as there is a high degree of coexistence of the two complications. A review of the clinical assessment and treatment algorithms for diabetic neuropathy, painful neuropathy, and autonomic dysfunction is provided.

  14. Diabetes Insipidus

    MedlinePlus

    ... Center Pacientes y Cuidadores Hormones and Health The Endocrine System Hormones Endocrine Disrupting Chemicals (EDCs) Steroid and Hormone ... Learn About Clinical Trials Hormones and Health The Endocrine System Hormones Endocrine Disrupting Chemicals (EDCs) Steroid and Hormone ...

  15. RELACIÓN MÉDICO PACIENTE: DERECHOS DEL ADULTO MAYOR

    PubMed Central

    Barrantes-Monge, Melba; Rodríguez, Eduardo; Lama, Alexis

    2009-01-01

    Existen prejuicios en relación con la vejez, incluso entre los profesionales que se dedican a la gerontología. Uno común y peligroso es considerar que los viejos son todos enfermos o discapacitados. La relación médico-paciente es la piedra angular de la práctica y ética médicas. Para alcanzar el respeto por los adultos mayores es necesaria una medicina prudente, basada en una práctica en la cual la reflexión ética y clínica pueda contribuir. Esto último es posible si se hacen valer los derechos del adulto mayor, en particular como paciente para la toma de decisiones. PMID:20379380

  16. Ferritin in hypertensive and diabetic women before and after bariatric surgery.

    PubMed

    Marin, Flávia Andréia; Rasera Junior, Irineu; Leite, Celso Vieira De Souza; Oliveira, Maria Rita Marques de

    2014-10-16

    Además de importante marcador de las reservas de hierro, la ferritina sérica es un marcador de la inflamación sistémica, mientras que la obesidad se ha asociado con la inflamación crónica. Objetivo: Identificar, después de 6 meses, el efecto de la cirugía bariátrica sobre los niveles de ferritina sérica en hipertensos, diabéticos o sin estas comorbilidades preoperatorias mujeres. Pacientes y métodos: Los autores realizaron un estudio retrospectivo de 200 mujeres sometidas a bypass gástrico en Y de Roux (BGYR), con edades comprendidas entre 20 y 45 años, con un índice de masa corporal (IMC) superior a 35 kg/m2, con hipertensión arterial (HA, n = 70), la diabetes mellitus tipo 2 (DM2, n = 40) y sin comorbilidades (SC, n = 90) fueron evaluados antes y 6 meses después de BGYR. Antropométricas, de laboratorio (ferritina sérica y hemoglobina) y la información de comorbilidad se recogió de la historia clínica electrónica. Resultados: Antes de la cirugía, las mujeres con comorbilidades eran mayores, tenían mayores hipertensos IMC, niveles más altos de ferritina diabéticos en relación con el grupo SC. La resolución de las comorbilidades después de 6 meses de DGYR ocurrió en el 68 % de las mujeres con hipertensión y el 86 % de los diabéticos. 6 meses después de la cirugía, se observó una disminución de la ferritina sérica en mujeres con comorbilidades de 110,1 ± 86,3 a 88,7 ± 80,5 ng/dl en el grupo con hipertensión y 164,8 ± 133,4 a 101 2 ± 97,7 ng/dl en DM2 (p < 0,05) y la hemoglobina, excepto en los pacientes diabéticos (p > 0,05). Conclusión: El aumento de la ferritina en mujeres obesas en el periodo de premenopausia se relacionan con las principales comorbilidades de la obesidad, y la presencia de estas comorbilidades fue fundamental en la reducción de la ferritina sérica después de la cirugía bariátrica.

  17. Diabetes and Foot Problems

    MedlinePlus

    ... Infographic (English) Low Blood Glucose (Hypoglycemia) Nerve Damage (Diabetic Neuropathies) Diabetic Kidney Disease Diabetes and Foot Problems Diabetic ... time, diabetes may cause nerve damage, also called diabetic neuropathy , that can cause tingling and pain, and can ...

  18. Diabetes Medicines

    MedlinePlus

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Insulin, Medicines, & Other Diabetes Treatments Taking insulin or other ... medication plan. What are the different types of insulin? Several types of insulin are available. Each type ...

  19. Diabetes Complications

    MedlinePlus

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

  20. Diabetes Insipidus

    MedlinePlus

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

  1. [Diabetes mellitus].

    PubMed

    Bosi, E

    2003-01-01

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

  2. Diabetes insipidus - nephrogenic

    MedlinePlus

    Nephrogenic diabetes insipidus; Acquired nephrogenic diabetes insipidus; Congenital diabetes insipidus; NDI ... of very dilute urine. NDI is rare. Congenital diabetes insipidus is present at birth. It is a ...

  3. Diabetic Neuropathies.

    PubMed

    Izenberg, Aaron; Perkins, Bruce A; Bril, Vera

    2015-08-01

    Diabetes mellitus is a common condition and diabetics are prone to develop a spectrum of neuropathic complications ranging from symmetric and diffuse to asymmetric and focal neuropathies that may be associated with significant morbidity. Diabetic sensorimotor polyneuropathy is the most common of these complications, occurring in patients with type 1 and 2 diabetes mellitus, as well as in those with prediabetes and glucose intolerance. In this review, the authors discuss the wide variety of neuropathies that can present in the context of diabetes, including the clinical manifestations, diagnostic features, and approach to management. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. ConSCRIPT

    PubMed Central

    Mottarella, Scott E.; Rosa, Mario; Bangura, Abdul; Bernstein, Herbert J.; Craig, Paul A.

    2011-01-01

    The aim of the Structural Biology Extensible Visualization Scripting Language (SBEVSL) project is to allow users who are experts in one scripting language to use that language in a second molecular visualization environment without requiring the user to learn a new scripting language. ConSCRIPT, the first SBEVSL release, is a plug-in for PyMOL that accepts RasMol scripting commands either as premade scripts or as line-by-line entries from PyMOL's own command line. The plug-in is available for download at http://sourceforge.net/projects/sbevsl/files in the ConSCRIPT folder. PMID:21567873

  5. Genetics of Diabetes

    MedlinePlus

    ... A A A Listen En Español Genetics of Diabetes You've probably wondered how you developed diabetes. ... to develop diabetes than others. What Leads to Diabetes? Type 1 and type 2 diabetes have different ...

  6. Types of Diabetes

    MedlinePlus

    ... Dental Problems Diabetes & Sexual & Urologic Problems What is Diabetes? Diabetes is a disease that occurs when your ... is serious. What are the different types of diabetes? The most common types of diabetes are type ...

  7. Diabetes and Pregnancy

    MedlinePlus

    ... Statistics Diabetes A-Z Pregnancy if You Have Diabetes If you have diabetes and plan to have ... are pregnant, you have gestational diabetes . How can diabetes affect my baby? A baby’s organs, such as ...

  8. Diabetes eye exams

    MedlinePlus

    Diabetic retinopathy - eye exams; Diabetes - eye exams; Glaucoma - diabetic eye exam; Macular edema - diabetic eye exam ... if the doctor who takes care of your diabetes checks your eyes, you need an eye exam ...

  9. Diabetes and Kidney Disease

    MedlinePlus

    ... disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose , also called ... I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes- ...

  10. Types of Diabetes

    MedlinePlus

    ... this page please turn Javascript on. Type 1 Diabetes Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, ... in children, teenagers or young adults. Treatment for type 1 diabetes includes taking insulin shots or using an insulin ...

  11. The intake of yam (Dioscorea bulbifera Linn) attenuated the hyperglycemia and the bone fragility in female diabetic rats.

    PubMed

    Rêgo, Thaís de Salgado; Ash, Louise da Silva; Pessoa, Letícia; Feijó, Márcia Barreto da Silva; Leite, Juliana; dos Santos, Aline de Sousa; da Costa, Carlos Alberto Soares; Boaventura, Gilson Teles

    2014-02-01

    Introducción: Los pacientes diabéticos tienen un mayor riesgo de fracturas osteoporóticas. Los alimentos, como el ñame, para oponerse a la hiperglucemia, se ha utilizado para el tratamiento de la diabetes. Objetivos: El objetivo era evaluar el papel de ñame brasileño (Dioscorea bulbifera) sobre la glucemia y el hueso parámetros de ratas diabéticas hembra. Métodos: Ratas Wistar hembra con 3 meses de edad fueron asignados en tres grupos. El grupo de control (C, n = 6), tratados con dieta normal de la grasa. Las ratas diabéticas tratadas con dieta alta en grasas y sin (DM, n = 8) y con (DMY, n = 8) harina de ñame liofilizado. Después se cuantificaron 5 semanas del experimento, la glucosa y la insulina en suero, la masa páncreas, el número y el área de islotes del páncreas. Y los parámetros de fémur fueron analizados por absorciometría de rayos X de energía dual (DXA) y la tomografía computarizada (CT). Resultados: Las diferencias se consideraron significativas si P < 0,05. Grupos diabéticos mostraron menor (P < 0,05): el fémur y la masa páncreas, el área de los islotes pancreáticos y la insulina. Sin embargo, DMY mostró inferior (-10%, P < 0,05) concentraciones de glucosa al grupo DM. Fémur, por DXA, mostró menor densidad mineral ósea, el contenido y el área en el grupo de DM. Mientras que el grupo DMY mostró mayor (27%, P < 0,05) radiodensidad de la cabeza femoral en comparación con el grupo de DM. Discusión: Suplemento de harina de ñame brasileña no fijó un defecto, pero alivia las consecuencias de la enfermedad diabética experimental. Se mostró resultados para controlar el aumento de los niveles de glucosa en sangre en ratas diabéticas, lo que sugiere la protección en agentes oxidantes y posponer daño en el hueso. Conclusión: Teniendo en cuenta todos los resultados de este estudio, nuestros resultados sugieren que la harina de ñame actúa de producir beneficios en la diabetes experimental.

  12. The Con Test

    ERIC Educational Resources Information Center

    Fletcher, Michael

    2009-01-01

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

  13. Monogenic Diabetes

    MedlinePlus

    ... gene. In contrast, the most common types of diabetes—type 1 and type 2—are caused by multiple genes ( ... some children with monogenic diabetes are misdiagnosed with type 1 diabetes and are given insulin. When correctly diagnosed, some ...

  14. Diabetic neuropathy.

    PubMed

    Said, Gérard

    2013-01-01

    Diabetes is the most common cause of peripheral neuropathy in the world. Both type 1 (insulin-dependent) and type 2 diabetes are commonly complicated by peripheral nerve disorders. Two main types of neuropathy are observed: the most common is a nerve fiber length-dependent, distal symmetrical sensory polyneuropathy with little motor involvement but frequent, and potentially life threatening, autonomic dysfunction. Alteration of temperature and pain sensations in the feet is an early manifestation of diabetic polyneuropathy. The second pattern is a focal neuropathy, which more commonly complicates or reveals type 2 diabetes. Poor diabetic control increases the risk of neuropathy with subsequent neuropathic pains and trophic changes in the feet, which can be prevented by education of patients.

  15. [Diabetic miocardiopathy].

    PubMed

    Gil-Ortega, Ignacio; Carlos Kaski, Juan

    2006-10-21

    The world-wide estimated prevalence of diabetes mellitus for 2025 is of about 300 million, resulting from a higher prevalence of obesity and sedentary lifestyles in the developed world. The group of cardiovascular diseases is responsible for 80% of deaths among diabetic patients. Several authors have suggested that patients with diabetes mellitus have a predisposition to develop a form of cardiomyopathy, known as <diabetic cardiomyopathy>, which is not related to ischemic heart disease or hypertension, and may progress to cardiac failure. Such condition is known to be associated with a poor prognosis in patients with diabetes mellitus. The prevalence appears to be high. Thus, tissue Doppler techniques added to conventional echocardiography assessment have estimated it to be as high as 75%. However, the use of echocardiography as a screening tool in the asymptomatic diabetic population is problematic. Biomarkers of cardiac dysfunction have been proposed for diagnosis. In this article, we have assessed the role of biomarkers in the diagnosis of this condition and proposed a diagnostic algorithm that may be useful for the assessment of asymptomatic patients with diabetes.

  16. Nam Con Son Basin

    SciTech Connect

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

    1994-07-01

    The Nam Con Son basin is the largest oil and gas bearing basin in Vietnam, and has a number of producing fields. The history of studies in the basin can be divided into four periods: Pre-1975, 1976-1980, 1981-1989, and 1990-present. A number of oil companies have carried out geological and geophysical studies and conducted drilling activities in the basin. These include ONGC, Enterprise Oil, BP, Shell, Petro-Canada, IPL, Lasmo, etc. Pre-Tertiary formations comprise quartz diorites, granodiorites, and metamorphic rocks of Mesozoic age. Cenozoic rocks include those of the Cau Formation (Oligocene and older), Dua Formation (lower Miocene), Thong-Mang Cau Formation (middle Miocene), Nam Con Son Formation (upper Miocene) and Bien Dong Formation (Pliocene-Quaternary). The basement is composed of pre-Cenozoic formations. Three fault systems are evident in the basin: north-south fault system, northeast-southwest fault system, and east-west fault system. Four tectonic zones can also be distinguished: western differentiated zone, northern differentiated zone, Dua-Natuna high zone, and eastern trough zone.

  17. Diabetic Pets

    MedlinePlus

    ... only be made by a veterinarian. Because older dogs and cats are more likely to develop age- ... such as cataracts, which commonly develop in diabetic dogs and cats. Other problems that can occur include ...

  18. Diabetic neuropathy

    PubMed Central

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

    2006-01-01

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

  19. Diabetes Medicines

    MedlinePlus

    ... type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. If ...

  20. [Diabetes insipidus].

    PubMed

    Krysiak, Robert; Handzlik-Orlik, Gabriela; Okopień, Bogusław

    2014-01-01

    Diabetes insipidus is an uncommon disorder of water-electrolyte balance characterized by the excretion of abnormally large volumes of diluted urine (polyuria) and increased fluid intake (polydipsia). The disease may result from the insufficient production of vasopressin, its increased degradation, an impaired response of kidneys to vasopressin, or may be secondary to excessive water intake. Patients with severe and uncompensated symptoms may develop marked dehydration, neurologic symptoms and encephalopathy, and therefore diabetes insipidus can be a life-threatening condition if not properly diagnosed and managed. Patients with diabetes insipidus require treatment with desmopressin or drugs increasing sensitivity of the distal nephron to vasopressin, but this treatment may be confusing because of the disorder's variable pathophysiology and side-effects of pharmacotherapy. This review summarizes the current knowledge on different aspects of the pathophysiology, classification, clinical presentation, diagnosis, and management of diabetes insipidus. The reader is also provided with some practical recommendations on dealing with patients suffering from this disease.

  1. Diabetes Myths

    MedlinePlus

    ... Fundraising & Local Events Matching Gift Fundraising Events Donate Stocks Give by Phone 1-800-DIABETES (800-342- ... Promotions that Give Back Donate Your Collectibles Donate Stocks About Us Who We Are Careers Contact Us ...

  2. Preventing Diabetes

    MedlinePlus

    ... a reasonable body weight —Losing even a few pounds can help reduce your risk of developing type ... 2 diabetes. For example, if you weigh 200 pounds, losing only 10 pounds could make a difference. ...

  3. Diabetic Emergencies

    MedlinePlus

    ... Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It ... seek immediate medical assistance. READ IN EMERGENCIES A-Z Mental Health Emergencies - Waits for Care Grow Dramatically ...

  4. Travelling diabetics.

    PubMed

    Chełmińska, Katarzyna; Jaremin, Bogdan

    2002-01-01

    During the past several decades, the number of both business and tourist travels has greatly increased. Among them are persons suffering from chronic diseases, including diabetics for whom travels pose the additional health-hazard. Irrespective of better education, self-control and constantly improving quality of specialistic equipment available, diabetics still are the group of patients requiring particular attention. In the case of travelling diabetics, problems may occur concerning the transport and storage of insulin, as well as control of glycaemia, all caused by irregularity of meals, variable diet, physical activity, stress, kinetosis (sea voyages), and the change of time zones. The travel may as well evoke ailments caused by the change of climate and concomitant diseases such as traveller's diarrhoea, malaria, etc. Apart from avoiding glycaemia fluctuations, important for retaining health of diabetics is the prevention of other diseases and carrying the necessary drugs.

  5. Immunizations - diabetes

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000331.htm Immunizations - diabetes To use the sharing features on this page, please enable JavaScript. Immunizations (vaccines or vaccinations) help protect you from some ...

  6. Construction and validation of the Self-care Assessment Instrument for patients with type 2 diabetes mellitus.

    PubMed

    Mendonça, Simonize Cunha Barreto de; Zanetti, Maria Lúcia; Sawada, Namie Okino; Barreto, Ikaro Daniel de Carvalho; Andrade, Joseilze Santos de; Otero, Liudmila Miyar

    2017-06-05

    to construct and validate the contents of the Self-care Assessment instrument for patients with type 2 diabetes mellitus. methodological study, based on Orem's General Theory of Nursing. The empirical categories and the items of the instrument were elucidated through a focus group. The content validation process was performed by seven specialists and the semantic analysis by 14 patients. The Content Validity Indices of the items, ≥0.78, and of the scale, ≥0.90, were considered excellent. the instrument contains 131 items in six dimensions corresponding to the health deviation self-care requisites. Regarding the maintenance, a Content Validity Index of 0.98 was obtained for the full set of items, and, regarding the relevance, Content Validity Indices ≥0.80 were obtained for the majority of the assessed psychometric criteria. the instrument showed evidence of content validity. construir e validar o conteúdo do instrumento Avaliação do Autocuidado para pacientes com diabetes mellitus tipo 2. estudo metodológico, fundamentado na Teoria Geral de Enfermagem de Orem. As categorias empíricas e os itens do instrumento foram elucidados por meio de grupo focal. O processo de validação de conteúdo foi realizado por sete especialistas e a análise semântica por 14 pacientes. Foram considerados como excelente Índice de Validade de Conteúdo dos itens ≥ 0,78 e da escala ≥ 0,90. o instrumento contém seis dimensões correspondentes aos requisitos de autocuidado para o desvio da saúde, desmembradas em 131 itens. Quanto à permanência, obteve-se para o conjunto total de itens Índice de Validade de Conteúdo de 0,98, e quanto à adequação Índice de Validade de Conteúdo ≥ 0,80 para maioria dos critérios psicométricos avaliados. o instrumento mostrou evidências de validade de conteúdo. construir y validar el contenido del instrumento Evaluación del Autocuidado para pacientes con diabetes mellitus tipo 2. estudio metodológico, fundamentado en la Teor

  7. Diabetes and nerve damage

    MedlinePlus

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  8. Diabetes and Pregnancy

    MedlinePlus

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

  9. Women and Diabetes

    MedlinePlus

    ... Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More sharing options ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take ...

  10. Diabetes Prevention Program (DPP)

    MedlinePlus

    ... Recruiting Patients & Families Consortia, Networks & Centers Reports & Planning Diabetes Prevention Program (DPP) Page Content On this page: ... increased risk of developing diabetes. [ Top ] Type 2 Diabetes and Prediabetes Type 2 diabetes is a disorder ...

  11. Dealing with Diabetes Distress

    MedlinePlus

    ... section to its Standards of Medical Care in Diabetes - 2017 guidelines on screening and treating people with diabetes ... Institute, San Diego; Standards of Medical Care in Diabetes - 2017 ; January 2017, Diabetes Care HealthDay Copyright (c) 2017 ...

  12. What Is Diabetes?

    MedlinePlus

    ... Diabetes and Digestive and Kidney Diseases (NIDDK) NIDDK Research of Type 1 Diabetes TEDDY TEDDY (short for The Environmental ... 1 Diabetes Beyond Type 1 JDRF (Curing Diabetes Type 1 through research) FDA Approval of First Automated Insulin Device for ...

  13. Diabetic Heart Disease

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Diabetic Heart Disease? The term "diabetic heart disease" (DHD) refers to ... Kidney Diseases' Introduction to Diabetes Web page. What Heart Diseases Are Involved in Diabetic Heart Disease? DHD may ...

  14. Diabetes and kidney disease

    MedlinePlus

    Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease ... 26696680 . Tong LL, Adler S. Prevention and treatment of diabetic nephropathy. In: Johnson RJ, Feehally J, Floege J, eds. ...

  15. Diabetes, Pancreatogenic Diabetes, and Pancreatic Cancer.

    PubMed

    Andersen, Dana K; Korc, Murray; Petersen, Gloria M; Eibl, Guido; Li, Donghui; Rickels, Michael R; Chari, Suresh T; Abbruzzese, James L

    2017-05-01

    The relationships between diabetes and pancreatic ductal adenocarcinoma (PDAC) are complex. Longstanding type 2 diabetes (T2DM) is a risk factor for pancreatic cancer, but increasing epidemiological data point to PDAC as also a cause of diabetes due to unknown mechanisms. New-onset diabetes is of particular interest to the oncology community as the differentiation of new-onset diabetes caused by PDAC as distinct from T2DM may allow for earlier diagnosis of PDAC. To address these relationships and raise awareness of the relationships between PDAC and diabetes, a symposium entitled Diabetes, Pancreatogenic Diabetes, and Pancreatic Cancer was held at the American Diabetes Association's 76th Scientific Sessions in June 2016. This article summarizes the data presented at that symposium, describing the current understanding of the interrelationships between diabetes, diabetes management, and pancreatic cancer, and identifies areas where additional research is needed. © 2017 by the American Diabetes Association.

  16. Diabetic dyslipidemia.

    PubMed

    Wu, Liya; Parhofer, Klaus G

    2014-12-01

    Diabetic dyslipidemia is characterized by elevated fasting and postprandial triglycerides, low HDL-cholesterol, elevated LDL-cholesterol and the predominance of small dense LDL particles. These lipid changes represent the major link between diabetes and the increased cardiovascular risk of diabetic patients. The underlying pathophysiology is only partially understood. Alterations of insulin sensitive pathways, increased concentrations of free fatty acids and low grade inflammation all play a role and result in an overproduction and decreased catabolism of triglyceride rich lipoproteins of intestinal and hepatic origin. The observed changes in HDL and LDL are mostly sequence to this. Lifestyle modification and glucose control may improve the lipid profile but statin therapy mediates the biggest benefit with respect to cardiovascular risk reduction. Therefore most diabetic patients should receive statin therapy. The role of other lipid lowering drugs, such as ezetimibe, fibrates, omega-3 fatty acids, niacin and bile acid sequestrants is less well defined as they are characterized by largely negative outcome trials. This review examines the pathophysiology of diabetic dyslipidemia and its relationship to cardiovascular diseases. Management approaches will also be discussed.

  17. Diabetes Insipidus.

    PubMed

    Lu, H A Jenny

    2017-01-01

    Disruption of water and electrolyte balance is frequently encountered in clinical medicine. Regulating water metabolism is critically important. Diabetes insipidus (DI) presented with excessive water loss from the kidney is a major disorder of water metabolism. To understand the molecular and cellular mechanisms and pathophysiology of DI and rationales of clinical management of DI is important for both research and clinical practice. This chapter will first review various forms of DI focusing on central diabetes insipidus (CDI) and nephrogenic diabetes insipidus (NDI ) . This is followed by a discussion of regulatory mechanisms underlying CDI and NDI , with a focus on the regulatory axis of vasopressin, vasopressin receptor 2 (V2R ) and the water channel molecule, aquaporin 2 (AQP2 ). The clinical manifestation, diagnosis and management of various forms of DI will also be discussed with highlights of some of the latest therapeutic strategies that are developed from in vitro experiments and animal studies.

  18. Diabetes Technology.

    PubMed

    Pfützner, Andreas

    2016-01-01

    Diabetes technology is an evolving field. The research started with the development of blood glucose meters for patient self-testing and the introduction of insulin pen injection devices. Modern devices employ new technological features, such as the use of computer simulations and mathematical algorithms, connectivity and signal transfer, and the use of modern (space research-derived) materials. With these innovations, the goal to develop an artificial pancreas by closing the loop between a continuous glucose sensor and a continuous insulin-delivering device via insulin delivery algorithms is coming closer to reality. As a consequence, interim achievements on this way result in the commercialization of innovative new diabetes technology devices, which help to facilitate the daily life of the affected people with diabetes. © 2016 S. Karger AG, Basel.

  19. Diabetic retinopathy.

    PubMed

    Moreno, A; Lozano, M; Salinas, P

    2013-03-01

    This paper describes the importance of diabetic retinopathy in the loss of visual function. We exposed the most important risk factors, such as diabetes duration, poor metabolic control, pregnancy, puberty, hypertension, poor control of blood lipids, renal disease, and sleep apnea syndrome. We describe the pathogenesis of the disease, small retinal vessel microangiopathies which produce extravasation, edema and ischemia phenomena. We put special emphasis on the vascular endothelial growth factor (VEGF) and its pathogenic importance. They are also described the main clinical symptoms as microaneurysms, intraretinal hemorrhages, hard and soft exudates, intraretinal microvascular abnormalities (IRMA), venous disorders, formation of new vessels and diabetic macular edema (the latter being the most common cause of vision loss). Finally we describe the latest diagnostic techniques and eye treatment, with special emphasis on obesity surgery importance as more important preventive factor to eliminate the predisposing and precipitating disease symptoms.

  20. Diabetes education via mobile text messaging.

    PubMed

    Wangberg, Silje C; Arsand, Eirik; Andersson, Niklas

    2006-01-01

    Living with diabetes makes great educational demands on a family. We have tested the feasibility of using the mobile phone short message service (SMS) for reaching people with diabetes information. We also assessed user satisfaction and perceived pros and cons of the medium through interviews. Eleven parents of children with type 1 diabetes received messages for 11 weeks. The parents were positive about the system and said that they would like to continue to use it. The pop-up reminding effect of SMS messages in busy everyday life was noted as positive. Some parents experienced the messages as somewhat intrusive, arriving too often and at inconvenient times. The parents also noted the potential of the messages to facilitate communication with their adolescent children. The inability to store all of the messages or to print them out were seen as major disadvantages. Overall, the SMS seems to hold promise as means of delivering diabetes information.

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

    MedlinePlus

    ... Diabetes Monogenic Forms of Diabetes Monogenic Forms of Diabetes The most common forms of diabetes, type 1 ... is inherited from each parent. Monogenic Forms of Diabetes Some rare forms of diabetes result from mutations ...

  2. [Diabetic emergencies].

    PubMed

    Berger, W

    1997-02-18

    Based on case reports pathogenesis and treatment of the following diabetic emergencies were discussed: 1. The hyperosmolar non-ketotic coma without or with only modest ketosis occurring mainly in type II diabetics and the severe ketoacidosis with or without disturbed consciousness occurring mainly in type I diabetics are the two forms of severe metabolic decompensation of diabetes mellitus. 2. Severe hypoglycaemia may be caused by treatment with sulfonylureas and insulin. 3. The most dangerous life threatening adverse effect of biguanides is lactic acidosis. The incidence of ketoacidosis is about 1-5% in type I diabetics with a mortality of 3-9%. Mortality rates of hyperosmolar non-ketotic comas are much higher, approaching 20-40%, and are explained by severe concomitant complications and older age. The most important triggering factors of diabetic coma are infections, insulin dispensing errors and non-compliance. Carefully instructing patients about the risks of loosing appetite and vomiting as early signs of ketoacidosis is essential. Adequate replacement of fluid, electrolyte and water are the most important therapeutical aspects of ketoacidosis and hyperosmolar non-ketotic coma. Early diagnosis and appropriate treatment of infection by antibiotics are important. Complication of therapy (hypokalemia, hypovolemia and rapid full of oncotic pressure) should be avoided by clinical and laboratory monitoring. Treatment of acidosis with bicarbonate has been found more dangerous than useful. Severe hypoglycaemia is the most important and most dangerous side effect of sulfonylurea and insulin. The incidence of severe hypoglycaemia under glibenclamide ist 3-5 fold higher than under treatment with tolbutamide or glibornurid. Glibenclamide should not be recommended anymore. Longterm experience of the therapeutic security of new sulfonylurea derivates like glimepirid is lacking. Blood-glucose-measurements in the afternoon are important for recognizing disposition to

  3. High protein diets and diabetes.

    PubMed

    Carapetis, Melissa; Phillips, Patrick J

    2006-06-01

    Higher protein diets are currently 'hot'. The CSIRO total wellbeing diet book has been on the bestseller list in Australia and internationally. Various other high protein diets have also had, or are getting, media attention. However, high protein diets, particularly for people with diabetes, are controversial. There are questions about effectiveness and safety, especially in the long term. As a general practitioner people will look to you for advice about what to eat. This article summarises the pros and cons of two of the popular higher protein diets--the Atkins diet and the CSIRO total wellbeing.

  4. Erectile Dysfunction and Diabetes

    MedlinePlus

    ... 22202 1-800-DIABETES (800-342-2383) Copyright 1995-2017. American Diabetes Association. All rights reserved. Use of this website constitutes acceptance of our Terms of Use and Privacy Policy « American Diabetes Association Diabetes Forecast Stop Diabetes Step ...

  5. Seguridad del paciente en Radioterapia Intraoperatoria: Impacto de los elementos controlados por el Radiofisico

    NASA Astrophysics Data System (ADS)

    Tarjuelo, Juan Lopez

    tambien se uso para estudiar la estabilidad de las camaras de ionizacion mencionadas. Se realizo la dosimetria in vivo en 45 pacientes con MOSFET reforzados mobile TN-502RDM-H, pelicula radiocromica Gafchromic MD-55-2, y se elaboro un modelo teorico para explicar los datos. Por ultimo, al precisarse el uso en RIO de la simulacion virtual y del calculo de la dosis absorbida en el paciente virtual, se ha ilustrado este apartado con la aceptacion y el estado de referencia inicial del planificador de tratamientos modulados con calculo de Monte Carlo Elekta Monaco. Para ello se utilizaron la camara de ionizacion TW31016-0104 y la matriz seven29 de PTW-Freiburg, pelicula radiocromica Gafchromic EBT-2, y diferentes maniquies. Resultados: El FMEA identifico 57 modos de fallo y efectos potenciales. No se experimentaron sucesos relativos a una administracion inadecuada de la dosis absorbida. Se identificaron las revisiones dobles y por un par como claves para reducir los riesgos asociados al equipo de profesionales involucrado en la RIO. Se identificaron tambien oportunidades de mejora con el uso de la automatizacion y el enclavamiento. En cuanto al SPC, los indices de capacidad del proceso abarcaron de 1,6 a 9,3 para un nivel de especificaciones del +/-2%. Las intervenciones simuladas alcanzaron del 2% al 34% de las sesiones de medida. Las camaras de ionizacion Farmer derivaron en direcciones opuestas en un periodo de 6 anos; aunque ello no se aprecio en los informes de calibracion del laboratorio acreditado. No derivo la camara PPC-40. En la dosimetria in vivo, las medidas de los MOSFET no se desviaron significativamente de las medidas con pelicula. Los valores centrales de las dosis absorbidas quedaron entre la dosis absorbida prescrita y la maxima, con lo que indicaron un tratamiento correcto del lecho tumoral. Las anchuras de los intervalos de confianza de las dosis absorbidas esperadas segun el modelo teorico al nivel del 95% abarcaron del 8,6% al 14,7%. Las verificaciones de

  6. Bronze diabetes.

    PubMed

    L N, Akshatha; Shenoy, Mamatha T; Yadav, Charu; M S, Rukmini; Kamath, Nutan

    2015-04-01

    Thalassemia is a group of disorders characterized by deficient production of the β-globin sub unit of hemoglobin. The mandatory blood transfusions in patients with thalassemia to maintain adequate erythrocyte levels, leads to iron overload. The prevalence of diabetes in patients with thalassemia varies from 6 to 14%. We here by present a known case of thalassemia major in an 18 year old boy. He was diagnosed with thalassemia before the age of one year and is on regular blood transfusion every two weeks since then. The repeated blood transfusion is one of the common causes for haemochromatosis. Iron overload initially leads to glucose abnormalities such as insulin resistance and hyperinsulinemia, which is followed by impaired secretion of insulin. Diagnosed as a case of bronze diabetes, this patient is on insulin therapy for the last two years. Currently the patient is on iron chelation therapy at Kasturba Medical College Hospital, Mangalore, Karnataka, India.

  7. Diabetic Neuropathy

    PubMed Central

    Gibbons, Christopher H.; Freeman, Roy; Veves, Aristidis

    2010-01-01

    OBJECTIVE To determine the relationships among large, small, and autonomic fiber neurophysiological measures in a cross-sectional study of patients with diabetes. RESEARCH DESIGN AND METHODS We assessed 130 individuals: 25 healthy subjects and 105 subjects with diabetes. Subjects were classified by the presence or absence of neuropathy by physical examination. All subjects underwent autonomic testing, nerve conduction studies, quantitative sensory testing, and nerve-axon reflex vasodilation in addition to quantifiable neurological examination and symptom scores. Correlation and cluster analysis were used to determine relationships between and among different neurophysiological testing parameters. RESULTS Results of neurophysiological tests were abnormal in patients with clinical evidence of diabetic neuropathy compared with results in healthy control subjects and in those without neuropathy (P < 0.01, all tests). The correlations among individual tests varied widely, both within (r range <0.5–>0.9, NS to <0.001) and between test groups (r range <0.2–>0.5, NS to <0.01). A two-step hierarchical cluster analysis revealed that neurophysiological tests do not aggregate by typical “small,” “large,” or “autonomic” nerve fiber subtypes. CONCLUSIONS The modest correlation coefficients seen between the different testing modalities suggest that these techniques measure different neurophysiological parameters and are therefore not interchangeable. However, the data suggest that only a small number of neurophysiological tests are actually required to clinically differentiate individuals with neuropathy from those without. The natural clustering of both patients and healthy control subjects suggests that variations in the population will need to be considered in future studies of diabetic neuropathy. PMID:20805259

  8. Diabetic Nerve Problems

    MedlinePlus

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

  9. Diabetes and exercise

    MedlinePlus

    ... tablets One half can (177 mL) of regular, non-diet soda One half cup (4 ounces or ... Health Topics Diabetes Diabetes in Children and Teens Diabetes Type 1 Browse the Encyclopedia A.D.A.M., Inc. ...

  10. Carbohydrates and Diabetes

    MedlinePlus

    ... Right Sport for You Healthy School Lunch Planner Carbohydrates and Diabetes KidsHealth > For Teens > Carbohydrates and Diabetes ... Los carbohidratos y la diabetes Carbs and Blood Sugar Keeping your blood sugar levels on track means ...

  11. Preventing Diabetes Problems

    MedlinePlus

    ... Other Dental Problems Diabetes & Sexual & Urologic Problems Preventing Diabetes Problems View or Print All Sections Heart Disease & ... prevent or delay sexual and urologic problems. Depression & Diabetes Depression is common among people with a chronic, ...

  12. American Diabetes Association

    MedlinePlus

    ... 800-342-2383) Give by Mail Close Fight Diabetes Complications 40% of people with diabetes eventually develop ... Next » « Previous Our Mission: To prevent and cure diabetes and to improve the lives of all people ...

  13. Native Americans with Diabetes

    MedlinePlus

    ... Read the MMWR Science Clips Native Americans with Diabetes Better diabetes care can decrease kidney failure Language: ... between 1996 and 2013. Problem Kidney failure from diabetes was highest among Native Americans. Native Americans are ...

  14. "Stop Diabetes Now!"

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Diabetes "Stop Diabetes Now!" Past Issues / Fall 2009 Table of Contents ... Tips for Seniors at Risk for Type 2 Diabetes Lifestyle changes that lead to weight loss—such ...

  15. Gestational Diabetes and Pregnancy

    MedlinePlus

    ... Arrives Trouble Getting Pregnant Avoiding Pregnancy Articles Gestational Diabetes and Pregnancy Language: English Español (Spanish) Recommend ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  16. Diabetic Eye Disease

    MedlinePlus

    ... eye diseases that can threaten your sight are Diabetic retinopathy The retina is the inner lining at the ... as viewed by a person with diabetic retinopathy. Diabetic macular edema The part of your retina that you need ...

  17. Psychoeducative groups help control type 2 diabetes in a primary care setting.

    PubMed

    Cervantes Cuesta, Miguel Ángel; García-Talavera Espín, Noelia Victoria; Brotons Román, Josefa; Núñez Sánchez, M Ángeles; Brocal Ibáñez, Pedro; Villalba Martín, Pilar; Saura García, Carmen; Sánchez Esteban, Tomasa; Romero López-Reinoso, Helena; Delgado Aroca, Ma José; Sánchez Gil, Dolores; Meoro Avilés, Amparo; Soriano Palao, José

    2013-01-01

    Introducción: Los cambios en el estilo de vida mejoran el control de los diabéticos tipo 2, pero no sabemos cuales son las estrategias más eficientes para conseguir estos cambios. Hemos medido el impacto de una intervención psicoeducativa grupal en diabetes mediante hemoglobina glicosilada (HbA1c), índice de masa corporal (IMC) y factores de riesgo cardiovascular (FRCV). Métodos: Se trata de un ensayo clínico controlado, randomizado y multicéntrico, de 72 pacientes diabéticos tipo 2, edad media 63,08 AÑOs, 50% mujeres, HbA1c media 6.98% e IMC medio 30,48 kg/m2. Se comparó el efecto terapéutico de una intervención psicoeducativa grupal(GSE) con una educación diabetológica convencional (GC). Resultados: El GSE presentó una mayor reducción media de HbA1c, -0,51 ± 1,07 vs -0,06 ± 0,53% (p 0,003), un mayor grado de cumplimiento de los objetivos de control óptimo de HbA1c, 80% vs 48% (p 0,005) y una mayor reducción media de peso, -1,93 ± 3,57 vs 0,52 ± 1,73 kg (p 0,002), que el GC. También se objetivó una mejoría significativa de colesterol total, colesterol LDL, triglicéridos, tensión arterial sistólica y diastólica en GSE (todas las p < 0,05). Conclusiones: Los GSE de diabéticos tipo 2 consiguieron una mejoría significativa de HbA1c, IMC y FRCV, y superaron a la educación diabetológica convencional en el grado de cumplimiento de los objetivos de control óptimo de la diabetes. Debemos plantearnos cambios estructurales en nuestros programas asistenciales para introducir estos avances más eficientes en educación terapeútica de diabetes en atención primaria.

  18. Diabetic emergencies in adults.

    PubMed

    Moore, Tina

    In this article the author discusses three diabetic emergencies: diabetic ketoacidosis, hyperosmolar non-ketotic syndrome and hypoglycaemia, which all require prompt recognition and appropriate intervention.

  19. Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina.

    PubMed

    Vielmuth, Franziska; Schumann, Ricarda G; Spindler, Volker; Wolf, Armin; Scheler, Renate; Mayer, Wolfgang J; Henrich, Paul B; Haritoglou, Christos

    2017-01-01

    Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómica con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómica no reveló diferencias significativas en cuanto a elasticidad de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel.

  20. Precision diabetes: learning from monogenic diabetes.

    PubMed

    Hattersley, Andrew T; Patel, Kashyap A

    2017-05-01

    The precision medicine approach of tailoring treatment to the individual characteristics of each patient or subgroup has been a great success in monogenic diabetes subtypes, MODY and neonatal diabetes. This review examines what has led to the success of a precision medicine approach in monogenic diabetes (precision diabetes) and outlines possible implications for type 2 diabetes. For monogenic diabetes, the molecular genetics can define discrete aetiological subtypes that have profound implications on diabetes treatment and can predict future development of associated clinical features, allowing early preventative or supportive treatment. In contrast, type 2 diabetes has overlapping polygenic susceptibility and underlying aetiologies, making it difficult to define discrete clinical subtypes with a dramatic implication for treatment. The implementation of precision medicine in neonatal diabetes was simple and rapid as it was based on single clinical criteria (diagnosed <6 months of age). In contrast, in MODY it was more complex and slow because of the lack of single criteria to identify patients, but it was greatly assisted by the development of a diagnostic probability calculator and associated smartphone app. Experience in monogenic diabetes suggests that successful adoption of a precision diabetes approach in type 2 diabetes will require simple, quick, easily accessible stratification that is based on a combination of routine clinical data, rather than relying on newer technologies. Analysing existing clinical data from routine clinical practice and trials may provide early success for precision medicine in type 2 diabetes.

  1. Teenage pregnancy in type 1 diabetes mellitus.

    PubMed

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

    2010-03-01

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

  2. Tips for Teens with Diabetes: About Diabetes

    ERIC Educational Resources Information Center

    National Diabetes Education Program (NDEP), 2010

    2010-01-01

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

  3. Technologies for Metabolic Monitoring Military Section Editorials in Diabetes Technologies and Therapeutics

    DTIC Science & Technology

    2004-12-01

    monitoring, diabetes, IGF-I, patient decision assist, hyperspectral imaging, actigraphy , accelerometry, foot contact time, Con A-glucose sensing, lactate...physical activity using hip- and wrist-worn accelerometers. Diabetes Technology and Therapeutics 5(6): 1023- 1034. Friedl KE. Actigraphy as metabolic...of Type I and care system: elegant simplicity, patient em- Type it diabetes in the military population are powerment, open software architecture

  4. Diabetes insipidus.

    PubMed

    Maghnie, Mohamad

    2003-01-01

    Diabetes insipidus is a heterogeneous condition characterized by polyuria and polydipsia caused by a lack of secretion of vasopressin, its physiological suppression following excessive water intake, or kidney resistance to its action. In many patients, it is caused by the destruction or degeneration of the neurons that originate in the supraoptic and paraventricular nuclei of the hypothalamus. Known causes of these lesions include: germinoma or craniopharyngioma; Langerhans cell histiocytosis and sarcoidosis of the central nervous system; local inflammatory, autoimmune or vascular diseases; trauma following surgery or accident; and, rarely, genetic defects in vasopressin biosynthesis inherited as autosomal dominant or X-linked recessive traits. Thirty to fifty percent of cases are considered idiopathic. Magnetic resonance imaging (MRI) allows identification of the posterior pituitary hyperintensity and of hypothalamic-pituitary abnormalities. Thickening of the pituitary stalk is the second most common finding on MRI scans in several local inflammatory pathologies and autoimmune diseases or germinoma, but it is not specific to any single subtype. A progressive increase in the size of the anterior pituitary gland should alert physicians to the possibility that a germinoma is present, whereas a decrease can suggest the presence of an inflammatory or autoimmune process. Most children with acquired central diabetes insipidus and a thickened pituitary stalk have anterior pituitary hormone deficiencies during follow-up. Biopsy of enlarged pituitary stalk should be reserved for patients with a hypothalamic-pituitary mass and progressive thickening of the pituitary stalk, since spontaneous recovery may occur.

  5. Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus.

    PubMed

    Zanchetta, Flávia Cristina; Trevisan, Danilo Donizetti; Apolinario, Priscila Peruzzo; Silva, Juliana Bastoni da; Lima, Maria Helena de Melo

    2016-01-01

    To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients. A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS). About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The "emotional burden", "regimen-related distress", and "interpersonal distress" domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175). These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study. Avaliar a relação entre o estresse relacionado ao diabetes e as características clínicas e sociodemográficas de pacientes com diabetes mellitus do tipo 2. Estudo transversal com base na análise secundária de dados coletados em um ambulatório de atendimento terciário no Brasil. Os participantes preencheram um questionário sobre as características sociodemográficas e clínicas, e a versão brasileira da Diabetes Distress Scale (B-DDS). Aproximadamente 31% dos 130 pacientes elegíveis relataram estresse relacionado ao diabetes, e a média do escore da B-DDS foi de 2,6. O modelo de regressão múltipla mostrou que a pontuação B-DDS foi positivamente correlacionada com o estado civil (p=0

  6. Diabetes Mellitus has no Significant Influence on the Prevalence of Antenatal Asymptomatic Bacteriuria

    PubMed Central

    Gundela, Swarnalatha; Avula, Renuka Devi

    2016-01-01

    Introduction Diabetes is a known risk factor for asymptomatic bacteriuria (ASB). However, the influence of diabetes on antenatal ASB was previously not addressed. Aim The prevalence of ASB, effect of risk factors and type of isolates and susceptibility patterns were studied in diabetic pregnancy. Materials and Methods A total of 311 pregnant women were recruited for this study of which 103 were diabetic and 208 non-diabetic. A clean catch midstream urine samples were collected and cultured. The isolates were identified and antibiotic sensitivity was studied. The data was analysed by Chi-square test. Results The prevalence of ASB in diabetic pregnancy was 38.83% (40/103; 95% CI: 23.73 - 53.94) and in non-diabetic pregnancy was 37.98% (79/208; CI: 27.28- 48.68). The odds ratio was not significant 1.0225 (95% CU: 0.65 – 1.599; p=0.922) and associated factors such as age and gestational period had no effect. The major isolates were Escherichia coli (25.0%), Staphylococcus aureus (22.5%), Coagulase negative staphylococci (CONS) (20.00%), and Klebsiella pneumonia (20.00%) in diabetic pregnancy and CONS (31.7%), E.coli (24.0%) and K.pneumonia (16.5%) in non-diabetic pregnancy. The isolates of diabetic pregnancy showed highest susceptibility to nitrofurantoin (56.4%), gentamicin (38.5%) and cotrimoxazole (38.5%) whereas that of non-diabetic pregnancy to gentamicin (43.0%), azithromycin (32.9%) and norfloxacin (30.4). There was no significant (p<0.05) difference in the type and susceptibly of the isolates between diabetic and non-diabetic pregnancy. Conclusion Diabetes has no significant influence on the prevalence of ASB in diabetic pregnancy both in terms of isolates and antibiotic susceptibility pattern. PMID:27190802

  7. Gestational diabetes - self-care

    MedlinePlus

    Pregnancy - gestational diabetes; Prenatal care - gestational diabetes ... Gestational diabetes is high blood sugar (glucose) that happens during pregnancy. There are no symptoms in most cases. But ...

  8. Pros and cons of screening for occult Cushing syndrome.

    PubMed

    Tabarin, Antoine; Perez, Paul

    2011-03-22

    Systematic screening studies performed mainly in patients with diabetes mellitus have revealed an unexpectedly high prevalence of occult Cushing syndrome. Such studies may provide a rationale for systematically screening obese patients with type 2 diabetes mellitus. However, a screening strategy is only justified if it is supported by enough evidence of its efficacy and if the benefits will outweigh drawbacks. To date, the natural history of occult Cushing syndrome and its possible effect on long-term morbidity are unknown. The clinical spectrum of occult Cushing syndrome and its relatively low prevalence may potentially negatively affect the performance of endocrine tests used to diagnose overt Cushing syndrome and generate false positives. Whether the cure of occult Cushing syndrome favorably influences clinical outcomes and is more beneficial than treatment of diabetes mellitus and cardiovascular risk factors with currently available pharmacological tools remains to be demonstrated. Last, the acceptability of a screening program by professionals and the health-care system in terms of workload and costs is highly questionable. Thus, an assessment of the indications for and against screening for occult Cushing syndrome on the basis of currently available data suggests that, to date, the cons surpass the pros.

  9. Strong diabetes

    PubMed Central

    Young, James; Anwar, Aresh

    2007-01-01

    The case of a 36‐year‐old male professional bodybuilder is reported. He presented to the accident and emergency department with right upper quadrant pain. This was on the background of a 15‐year history of anabolic steroid and growth hormone misuse. Examination revealed mild hepatomegaly and a random blood sugar of 30.2 mmol/l. There was no evidence of ketonuria or acidosis. Biochemical evidence of hepatitis was found, and the patient was in acute renal failure. He was given a sliding scale of insulin and an intravenous infusion of crystalloid. The hepatitis and hyperglycaemia settled with conservative treatment. It is believed that this is the first reported case of frank diabetes precipitated by supraphysiological recreational growth hormone misuse. PMID:17324962

  10. Strong diabetes

    PubMed Central

    Young, James; Anwar, Aresh

    2009-01-01

    The case of a 36-year-old male professional bodybuilder is reported. He presented to the accident and emergency department with right upper quadrant pain. This was on the background of a 15-year history of anabolic steroid and growth hormone misuse. Examination revealed mild hepatomegaly and a random blood sugar of 30.2 mmol/l. There was no evidence of ketonuria or acidosis. Biochemical evidence of hepatitis was found, and the patient was in acute renal failure. He was given a sliding scale of insulin and an intravenous infusion of crystalloid. The hepatitis and hyperglycaemia settled with conservative treatment. It is believed that this is the first reported case of frank diabetes precipitated by supraphysiological recreational growth hormone misuse. PMID:21686671

  11. Hepatitis B vaccination coverage in patients with diabetes mellitus.

    PubMed

    Arrelias, Clarissa Cordeiro Alves; Bellissimo-Rodrigues, Fernando; Lima, Letícia Cristina Lourenço de; Silva, Anderson Soares da; Lima, Nereida Kilza da Costa; Zanetti, Maria Lucia

    2016-04-01

    Analyze the factors associated with full hepatitis B vaccination (three doses) in patients with diabetes mellitus. Cross-sectional study, conducted in a health unit in a city in the state of São Paulo, with 255 patients on outpatient follow-up, in 2014. Data were obtained from the computerized system of the Municipal Health Department and via a structured questionnaire. A logistic regression model was used for analysis. Full hepatitis B vaccination was noted in 13.7% of the patients and shown to be directly associated with their educational level (OR=1.30; CI: 1.07-1.57) and current or previous work as a health professional (OR=3.21; CI: 1.16-8.89). Hepatitis B vaccination coverage was found to be low in patients with diabetes mellitus, indicating their vulnerability to this serious and potentially fatal disease. Higher educational level and working in the field of health were associated with better vaccination coverage. Analisar os fatores associados à vacinação completa contra hepatite B (3 doses) em pacientes com diabetes mellitus. Estudo transversal, realizado em uma Unidade de Saúde, de uma cidade do interior paulista, com 255 pacientes em seguimento ambulatorial, em 2014. Os dados foram obtidos no sistema informatizado da Secretaria Municipal de Saúde e por meio de um questionário estruturado e, para análise, modelo de regressão logística. Vacinação completa contra hepatite B foi observada em 13,7% dos pacientes e mostrou-se diretamente associada ao nível de escolaridade (OR=1,30; IC: 1,07-1,57) e ao trabalho atual ou pregresso como profissional da saúde (OR=3,21; IC: 1,16-8,89). A cobertura vacinal contra hepatite B mostrou-se baixa em pacientes com diabetes mellitus, evidenciando a vulnerabilidade a essa doença grave e potencialmente fatal. Maior escolaridade e o trabalho na área da saúde foram associados a melhor cobertura vacinal.

  12. Diabetes and pancreatic cancer.

    PubMed

    Muniraj, T; Chari, S T

    2012-12-01

    The relationship between diabetes and pancreatic cancer is complex. Diabetes or impaired glucose tolerance is present in more than 2/3rd of pancreatic cancer patients. Epidemiological studies have consistently shown a modest increase in the risk of pancreatic cancer in type 2 diabetes, with an inverse relationship to duration of disease. Additionally, recent studies suggest that anti-diabetic medications may modulate the risk of pancreatic cancer in type 2 diabetes. Subjects >50 years of age with new onset diabetes are at higher risk of having pancreatic cancer. However, to screen new-onset diabetes for pancreatic cancer, additional markers are needed that can distinguish pancreatic cancer-associated diabetes from type 2 diabetes.

  13. [Diabetic eye disease].

    PubMed

    Henriques, José; Vaz-Pereira, Sara; Nascimento, João; Rosa, Paulo Caldeira

    2015-01-01

    Diabetes mellitus is a chronic metabolic disease characterized by sustained hyperglycemia leading to macro and microvascular complications. The eye is one of the main organs affected by this disease, being diabetic retinopathy the most well-known microvascular complication and the leading cause of blindness in the working age population. However, diabetic ocular disease is not only characterized by diabetic retinopathy. Other important ocular manifestations of diabetes mellitus include cataract, glaucoma, ischemic optic neuropathy, cranial nerve palsies and recurrent corneal erosion syndrome. Here, we emphasize diabetic retinopathy as the most important and characteristic complication of diabetes mellitus, but also review less well-known complications with the aim to alert and sensitize non-ophthalmologist clinicians that treat diabetic individuals, in order to promote an early diagnosis and treatment of the sight-threatening complications of diabetes.

  14. Flaxseed and Diabetes.

    PubMed

    Prasad, Kailash; Dhar, Arti

    2016-01-01

    Flaxseed contains 32% to 45% of its mass as oil of which 51% to 55% is α-linolenic acid. Flax lignan complex and secoisolariciresinol diglucoside (SDG) have been isolated from flaxseed. Flaxseed and its components have antioxidant, hypolipidemic and hypoglycemic effects. These are mostly due to the SDG content. Oxidative stress has been implicated in both type 1 and type 2 diabetes. Flaxseed, flaxseed oil and flax lignan complex have not been investigated as to whether they reduce the incidence of diabetes and/or delay the development of diabetes. However, their effects on serum glucose have been studied. Flaxseed and flax lignan complex improve glycemic control. Animal models of type I diabetes involving streptozotocin administration or utilizing Bio-Breed diabetic (BBdp) prone rats are associated with oxidative stress. SDG treatment reduced the incidence of diabetes using serum glucose levels by 75% in the streptozotocin model of diabetes and by 72% in the BBdp rat model of diabetes. These reductions in development of diabetes were associated with decreases in oxidative stress measured by serum and pancreatic malondialdehyde (MDA). SDG delays the development of diabetes in Zucker diabetic fatty (ZDF) rat model of type 2 diabetes and this effect was associated with a reduction in serum MDA and glycated haemoglobin A1C. The data suggest that SDG may have a great potential for reducing the incidence of type 1 diabetes and delaying the development of type 2 diabetes in humans.

  15. "Control Your Diabetes. For Life."

    MedlinePlus

    ... this page please turn Javascript on. Feature: Diabetes "Control Your Diabetes. For Life." Past Issues / Fall 2009 Table of Contents For information about "Control Your Diabetes. For Life" campaign, visit www.YourDiabetesInfo. ...

  16. Diabetes Diet, Eating, & Physical Activity

    MedlinePlus

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes Diet, Eating, & Physical Activity Nutrition and physical activity ... What foods can I eat if I have diabetes? You may worry that having diabetes means going ...

  17. Diabetes, Heart Disease, and Stroke

    MedlinePlus

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes, Heart Disease, and Stroke Having diabetes means that ... help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood ...

  18. How to Treat Gestational Diabetes

    MedlinePlus

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  19. Diabetes in Children and Teens

    MedlinePlus

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

  20. Step 3: Manage Your Diabetes

    MedlinePlus

    ... of this page please turn JavaScript on. Feature: Type 2 Diabetes Step 3: Manage Your Diabetes Past Issues / Fall ... you visit your health care team. Read More "Type 2 Diabetes" Articles Diabetes Is Serious But Manageable / Step 1: ...

  1. Diabetes Type 2 - Multiple Languages

    MedlinePlus

    ... Section Diabetes Type 2: MedlinePlus Health Topic - English Diabetes tipo 2: Tema de salud de MedlinePlus - español (Spanish) National Library of Medicine Diabetes: Are You at Risk? - English Diabetes: Are You ...

  2. INTRODUCTION OF PASTEURIZED/RAW COW'S MILK DURING THE SECOND SEMESTER OF LIFE AS A RISK FACTOR OF TYPE 1 DIABETES MELLITUS IN SCHOOL CHILDREN AND ADOLESCENTS.

    PubMed

    Villagrán-García, Edna F; Hurtado-López, Erika F; Vasquez-Garibay, Edgar M; Troyo-Sanromán, Rogelio; Aguirre-Salas, Liuba M; Larrosa-Haro, Alfredo; León-Robles, Ruth V

    2015-08-01

    Objetivo: demostrar que la diabetes mellitus tipo 1 (DMT1) en escolares y adolescentes se asocia a una temprana introducción de leche entera pasteurizada/no pasteurizada en el segundo semestre de vida. Material y métodos: en este estudio no probabilístico de casos y controles se incluyeron 150 participantes (75 pacientes y 75 controles), divididos de acuerdo a la edad y el sexo de 6 a 16 años de edad. Se consideró DMT1 como una variable independiente. El análisis estadístico incluyó la prueba de Ji cuadrada y razón de momios con su intervalo de confianza del 95% Resultados: los participantes fueron 51% varones, con edades de 11 ± 3.2 años y el 80% alimentados al pecho materno, 18% en forma exclusiva, y el 13% recibieron leche entera pasteurizada/no pasteurizada. Los niños que recibieron leche entera pasteurizada/no pasteurizada tuvieron un riesgo mayor de DMT1 [OR, 3,9 (1,2-12,8)]. La presencia de DMT1 fue tres veces más elevada en quienes consumieron leche entera pasteurizada/no pasteurizada que en aquellos que recibieron fórmula de seguimiento [RM, 3,2 (1,03-10,07)]. Conclusión: la introducción de leche entera pasteurizada/ no pasteurizada en el segundo semestre de vida incrementó cuatro veces la probabilidad de desarrollo de DMT1 en escolares y adolescentes.

  3. Diabetes, Dementia and Hypoglycemia.

    PubMed

    Meneilly, Graydon S; Tessier, Daniel M

    2016-02-01

    We are experiencing an epidemic of both diabetes and dementia among older adults in this country. The risk for dementia appears to be increased in patients with diabetes, and patients with dementia and diabetes appear to be at greater risk for severe hypoglycemia. In addition, there may be an increased risk for developing dementia by older patients with diabetes who have had episodes of severe hypoglycemia, although this issue is controversial. In this article, we review the factors that contribute to the increased risk for dementia in older adults with diabetes and outline the complex relationships between hypoglycemia and dementia. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  4. Diabetic autonomic neuropathy.

    PubMed

    Freeman, Roy

    2014-01-01

    Diabetes mellitus is the commonest cause of an autonomic neuropathy in the developed world. Diabetic autonomic neuropathy causes a constellation of symptoms and signs affecting cardiovascular, urogenital, gastrointestinal, pupillomotor, thermoregulatory, and sudomotor systems. Several discrete syndromes associated with diabetes cause autonomic dysfunction. The most prevalent of these are: generalized diabetic autonomic neuropathy, autonomic neuropathy associated with the prediabetic state, treatment-induced painful and autonomic neuropathy, and transient hypoglycemia-associated autonomic neuropathy. These autonomic manifestations of diabetes are responsible for the most troublesome and disabling features of diabetic peripheral neuropathy and result in a significant proportion of the mortality and morbidity associated with the disease.

  5. Recurrence of gestational diabetes.

    PubMed

    Coelingh Bennink, H J

    1977-01-01

    The recurrence rate of gestational diabetes in 58 patients who had had the foregoing pregnancy complicated by diabetes was estimated to be 30% if our former criteria for abnormal glucose tolerance were strictly applied and 25% if our new, more stringent criteria were used. The recurrence rate is not influenced by prophylactic administration of pyridoxine. The perinatal morbidity complicating the 'second' pregnancy of former gestational diabetics was not increased in those patients who were not treated again, as compared with those who were. Recurrent gestational diabetes is associated with a degree of overdiagnosis in an attempt to detect all gestational diabetics. It is suggested that recurrent gestational diabetes occurs mainly in prediabetic patients.

  6. Type 2 Diabetes: What You Need to Know

    MedlinePlus

    ... Us Home Health Information Diabetes English English Español Diabetes Diabetes is a disease that occurs when your ... Diabetes Preventing Diabetes after Pregnancy More Diabetes Topics Diabetes Basics What is Diabetes? Symptoms & Causes of Diabetes ...

  7. Diabetes in Navajo Youth

    PubMed Central

    Dabelea, Dana; DeGroat, Joquetta; Sorrelman, Carmelita; Glass, Martia; Percy, Christopher A.; Avery, Charlene; Hu, Diana; D'Agostino, Ralph B.; Beyer, Jennifer; Imperatore, Giuseppina; Testaverde, Lisa; Klingensmith, Georgeanna; Hamman, Richard F.

    2009-01-01

    OBJECTIVE—To estimate the prevalence and incidence of diabetes, clinical characteristics, and risk factors for chronic complications among Navajo youth, using data collected by the SEARCH for Diabetes in Youth Study (SEARCH study). RESEARCH DESIGN AND METHODS—The SEARCH study identified all prevalent cases of diabetes in 2001 and all incident cases in 2002–2005 among Navajo youth. We estimated denominators with the user population for eligible health care facilities. Youth with diabetes also attended a research visit that included questionnaires, physical examination, blood and urine collection, and extended medical record abstraction. RESULTS—Diabetes is infrequent among Navajo youth aged <10 years. However, both prevalence and incidence of diabetes are high in older youth. Among adolescents aged 15–19 years, 1 in 359 Navajo youth had diabetes in 2001 and 1 in 2,542 developed diabetes annually. The vast majority of diabetes among Navajo youth with diabetes is type 2, although type 1 diabetes is also present, especially among younger children. Navajo youth with either diabetes type were likely to have poor glycemic control, high prevalence of unhealthy behaviors, and evidence of severely depressed mood. Youth with type 2 diabetes had more metabolic factors associated with obesity and insulin resistance (abdominal fat deposition, dyslipidemia, and higher albumin-to-creatinine ratio) than youth with type 1 diabetes. CONCLUSIONS—Our data provide evidence that diabetes is an important health problem for Navajo youth. Targeted efforts aimed at primary prevention of diabetes in Navajo youth and efforts to prevent or delay the development of chronic complications among those with diabetes are warranted. PMID:19246579

  8. Course of acute pancreatitis in diabetic patients.

    PubMed

    Koziel, Dorota; Gluszek, Stanislaw; Osuch, Martyna Gluszek

    2016-01-01

    Negli anni recenti in molti paesi europei si è dimostrata una crescente incidenza della pancreatite acuta (AP), ed alcuni studi indicano un aumento di rischio di AP nei pazienti diabetici. Questo studio è pertanto finalizzato a valutare il decorso clinico della AP nei pazienti diabetici. Sono stati studiati tutti i pazienti curati in reparto chirurgico per una diagnosi di AP identificando come pazienti diabetici quelli che all’anamnesi hanno confermato essere affetti da diabete di tipo 1 o di tipo 2 prima di essere ricoverati per AP. I pazienti ricoverati per AP, ed arruolati nello studio sono stati 963, e tra essi vi erano 87 (9%) diabetici. Tra questi ultimi erano più numerosi quelli portatori di calcolosi biliare quale causa della pancreatite (46% vs 32%). Nella maggioranza dei casi il decorso della AP è stato di gravità moderata, ma comunque nel 10,3% dei pazienti con diabete il decorso della malattia è stato moderatamente grave, e nel 12,7% decisamente grave. Non sono state osservate differenze nella mortalità da AP in entrambi i gruppi. Insufficienza sistemica è stata osservata più frequentemente nel gruppo dei diabetici di tipo 2 (5,4%) e 23,1% in quelli di tipo 2, a fronte del 5,1% dei pazienti non diabetici, con differenze statisticamente non significative. In conclusione l’incidenza della AP nei pazienti diabetici aumenta con l’età, ed è più spesso correlata con la calcolosi biliare. In questo gruppo di pazienti in decorso clinico è èiù frequentemente grave, con insufficienza sistemica nei diabetici di tipo 1.

  9. Diabetes risk factors (image)

    MedlinePlus

    ... and type 2 diabetes typically begins in adulthood. Type 2 diabetes is becoming more common due to the growing number of older Americans and an increasing trend toward obesity and a sedentary lifestyle. Without proper ...

  10. Diabetic Kidney Problems

    MedlinePlus

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

  11. Tuberculosis and Diabetes

    MedlinePlus

    ... TB AND DIABETES IN THE ERA OF THE SUSTAINABLE DEVELOPMENT GOALS The Collaborative Framework for care and control ... to reduce the impact of diabetes. The new Sustainable Development Goals also place the spotlight on ending TB ...

  12. Adrenomedullin and diabetes

    PubMed Central

    Wong, Hoi Kin; Tang, Fai; Cheung, Tsang Tommy; Cheung, Bernard Man Yung

    2014-01-01

    Adrenomedullin (ADM) is a peptide hormone widely expressed in different tissues, especially in the vasculature. Apart from its vasodilatatory and hypotensive effect, it plays multiple roles in the regulation of hormonal secretion, glucose metabolism and inflammatory response. ADM regulates insulin balance and may participate in the development of diabetes. The plasma level of ADM is increased in people with diabetes, while in healthy individuals the plasma ADM concentration remains low. Plasma ADM levels are further increased in patients with diabetic complications. In type 1 diabetes, plasma ADM level is correlated with renal failure and retinopathy, while in type 2 diabetes its level is linked with a wider range of complications. The elevation of ADM level in diabetes may be due to hyperinsulinemia, oxidative stress and endothelial injury. At the same time, a rise in plasma ADM level can trigger the onset of diabetes. Strategies to reduce ADM level should be explored so as to reduce diabetic complications. PMID:24936257

  13. Weight in Diabetes

    PubMed Central

    Kenshole, Anne B.

    1972-01-01

    Diabetes is being increasingly detected among the overweight. The author discusses the links between diabetes and obesity, and outlines methods by which satisfactory weight reduction may be achieved. PMID:20468726

  14. Diabetes and bone health.

    PubMed

    Antonopoulou, Marianna; Bahtiyar, Gül; Banerji, Mary Ann; Sacerdote, Alan S

    2013-11-01

    The increasing prevalence of diabetes especially type 2 diabetes worldwide is indisputable. Diabetics suffer increased morbidity and mortality, compared to their non-diabetic counterparts, not only because of vascular complications, but also because of an increased fracture incidence. Both types 1 and 2 diabetes and some medications used to treat it are associated with osteoporotic fractures. The responsible mechanisms remain incompletely elucidated. In this review, we evaluate the role of glycemic control in bone health, and the effect of anti-diabetic medications such as thiazolidinediones, sulfonylureas, DPP-4 inhibitors, and GLP-1 agonists. In addition, we examine the possible role of insulin and metformin as anabolic agents for bone. Lastly, we identify the current and future screening tools that help evaluate bone health in diabetics and their limitations. In this way we can offer individualized treatment, to the at-risk diabetic population.

  15. Diabetes Research Institute Foundation

    MedlinePlus

    ... issue Enjoying the Holidays Gifts and Resolutions Diabetes Divorce August 2010 issue Eating Disorders Video: Eating Disorders ... diabetes. Latest News Halting T1D Progression Possible beneficial effects of high-dose vitamin D and Omega-3 ...

  16. Carbohydrate Counting and Diabetes

    MedlinePlus

    ... targets, you will need to balance your carbohydrate intake with physical activity and diabetes medicines or insulin shots. How much carbohydrate do I need each day? The daily amount of carbohydrate, protein, and fat for people with diabetes has not ...

  17. Diabetic Heart Disease

    MedlinePlus

    ... be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy. Diabetes by itself puts you at risk for heart disease. Other risk factors include Family history of heart disease Carrying extra ...

  18. Genetics of Diabetes Insipidus.

    PubMed

    Schernthaner-Reiter, Marie Helene; Stratakis, Constantine A; Luger, Anton

    2017-06-01

    Diabetes insipidus is a disease characterized by polyuria and polydipsia due to inadequate release of arginine vasopressin from the posterior pituitary gland (neurohypophyseal diabetes insipidus) or due to arginine vasopressin insensitivity by the renal distal tubule, leading to a deficiency in tubular water reabsorption (nephrogenic diabetes insipidus). This article reviews the genetics of diabetes insipidus in the context of its diagnosis, clinical presentation, and therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Diabetes Type 2

    MedlinePlus

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

  20. Hyperglycemia and Diabetic Ketoacidosis

    MedlinePlus

    ... urine test is positive, contact your child's diabetes health care team. Tests done by a lab or hospital can confirm whether a child has diabetic ketoacidosis , if necessary. Some ... blood for ketones. Ask the diabetes health care team if such a meter is a good ...

  1. Teen Diabetes Quiz

    MedlinePlus

    ... Teens with diabetes should not eat at fast food restaurants. True False Teens get type 2 diabetes because: They have certain genes They are overweight They have a family member who has diabetes They are American Indian, Alaska Native, African American, Hispanic/Latino, Asian American, ...

  2. Herpes zoster and diabetes.

    PubMed

    Kalra, Sanjay; Chawla, Aastha

    2016-08-01

    This review is a succinct description of the relationship between herpes zoster and diabetes. It makes a strong case for screening for diabetes in all patients of herpes zoster, and for using insulin to achieve optimal glycaemic control in persons with concomitant diabetes and herpes zoster. It highlights potential impact of dipeptidyl peptidase 4 inhibitor therapy and statin usage on herpes zoster incidence.

  3. Diabetes in HFE Hemochromatosis

    PubMed Central

    Acton, Ronald T.

    2017-01-01

    Diabetes in whites of European descent with hemochromatosis was first attributed to pancreatic siderosis. Later observations revealed that the pathogenesis of diabetes in HFE hemochromatosis is multifactorial and its clinical manifestations are heterogeneous. Increased type 2 diabetes risk in HFE hemochromatosis is associated with one or more factors, including abnormal iron homeostasis and iron overload, decreased insulin secretion, cirrhosis, diabetes in first-degree relatives, increased body mass index, insulin resistance, and metabolic syndrome. In p.C282Y homozygotes, serum ferritin, usually elevated at hemochromatosis diagnosis, largely reflects body iron stores but not diabetes risk. In persons with diabetes type 2 without hemochromatosis diagnoses, serum ferritin levels are higher than those of persons without diabetes, but most values are within the reference range. Phlebotomy therapy to achieve iron depletion does not improve diabetes control in all persons with HFE hemochromatosis. The prevalence of type 2 diabetes diagnosed today in whites of European descent with and without HFE hemochromatosis is similar. Routine iron phenotyping or HFE genotyping of patients with type 2 diabetes is not recommended. Herein, we review diabetes in HFE hemochromatosis and the role of iron in diabetes pathogenesis in whites of European descent with and without HFE hemochromatosis. PMID:28331855

  4. Diabetic neuropathy in children.

    PubMed

    Mah, Jean K; Pacaud, Danièle

    2014-01-01

    The worldwide burden of diabetes and its complications in children continues to increase due to the rise in type 1 and type 2 diabetes. Although overt diabetic neuropathy is rarely present in children and adolescents with diabetes, subclinical diabetic neuropathy has been estimated to occur in approximately half of all children with type 1 diabetes with a duration of 5 years or longer and up to 25% of pediatric patients with newly diagnosed diabetes have abnormal findings on nerve conduction studies. The present review on the state of pediatric diabetic neuropathy covers the definition, prevalence, pathogenesis, diagnosis, risk factors, and possible treatment approaches specific to children and adolescents with diabetes. It also highlights the many unknowns in this field. Nonetheless, new emerging interventions that can either prevent or delay the progression of diabetic microvascular and macrovascular complications may become available in the near future. Until specific interventions for diabetic neuropathy are available for use in children, it will be hard to justify screening for neuropathy other than through clinical assessment. Meanwhile, the search for quicker, easily administered, and quantifiable tests for diabetic neuropathy and efforts to establish valid pediatric norms for well-established measures used in adults will need to continue.

  5. The Student with Diabetes.

    ERIC Educational Resources Information Center

    Wentworth, Samuel M.; Hoover, Joan

    1981-01-01

    Since nearly one million students suffer from diabetes, most teachers are likely to have a diabetic child in class at some time. Though most diabetic children are not likely to require an insulin injection during the day, it is necessary that every teacher be aware of the occasional problems which might arise. (JN)

  6. Diabetes insipidus: The other diabetes

    PubMed Central

    Kalra, Sanjay; Zargar, Abdul Hamid; Jain, Sunil M.; Sethi, Bipin; Chowdhury, Subhankar; Singh, Awadhesh Kumar; Thomas, Nihal; Unnikrishnan, A. G.; Thakkar, Piya Ballani; Malve, Harshad

    2016-01-01

    Diabetes insipidus (DI) is a hereditary or acquired condition which disrupts normal life of persons with the condition; disruption is due to increased thirst and passing of large volumes of urine, even at night. A systematic search of literature for DI was carried out using the PubMed database for the purpose of this review. Central DI due to impaired secretion of arginine vasopressin (AVP) could result from traumatic brain injury, surgery, or tumors whereas nephrogenic DI due to failure of the kidney to respond to AVP is usually inherited. The earliest treatment was posterior pituitary extracts containing vasopressin and oxytocin. The synthetic analog of vasopressin, desmopressin has several benefits over vasopressin. Desmopressin was initially available as intranasal preparation, but now the oral tablet and melt formulations have gained significance, with benefits such as ease of administration and stability at room temperature. Other molecules used for treatment include chlorpropamide, carbamazepine, thiazide diuretics, indapamide, clofibrate, indomethacin, and amiloride. However, desmopressin remains the most widely used drug for the treatment of DI. This review covers the physiology of water balance, causes of DI and various treatment modalities available, with a special focus on desmopressin. PMID:26904464

  7. Biomarkers in Diabetic Retinopathy

    PubMed Central

    Jenkins, Alicia J.; Joglekar, Mugdha V.; Hardikar, Anandwardhan A.; Keech, Anthony C.; O'Neal, David N.; Januszewski, Andrzej S.

    2015-01-01

    There is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat

  8. Biomarkers in Diabetic Retinopathy.

    PubMed

    Jenkins, Alicia J; Joglekar, Mugdha V; Hardikar, Anandwardhan A; Keech, Anthony C; O'Neal, David N; Januszewski, Andrzej S

    2015-01-01

    There is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat

  9. Egg consumption and risk of type 2 diabetes in a Mediterranean cohort; the sun project.

    PubMed

    Zazpe, Itziar; Beunza, Juan José; Bes-Rastrollo, Maira; Basterra-Gortari, Francisco Javier; Mari-Sanchis, Amelia; Martínez-González, Miguel Ángel

    2013-01-01

    Introducción y Objetivo: La prevalencia de la diabetes está aumentando a un ritmo alarmante en casi todos los países. Algunos estudios en poblaciones no mediterráneas sugieren que un mayor consumo de huevo se asocia con un mayor riesgo de diabetes. El objetivo de nuestro estudio fue evaluar prospectivamente la asociación entre el consumo de huevo y la incidencia de diabetes tipo 2 en una gran cohorte de graduados universitarios esp2013les. Métodos: Un total de 15.956 participantes (edad media: 38,5 2013s) seguidos durante 6,6 2013s (mediana), y libres de la diabetes mellitus al inicio del estudio fueron incluidos en este estudio. El consumo de huevos se evaluó al inicio del estudio a través de un cuestionario semicuantitativo de frecuencia de alimentos repetidamente validado en España. Los casos de diabetes mellitas incidente fueron diagnosticados por un médico a través de cuestionarios de seguimiento bianuales y posteriormente confirmados por los informes médicos o registros, de acuerdo con los criterios de la American Diabetes Association. Los análisis se realizaron a través de modelos de regresión logística no condicional multivariable. Resultados: Después de ajustar por los factores de confusión, el consumo de huevo no se asoció con el desarrollo de diabetes mellitus. Odds Ratio de aquellos participantes con mayores consumos frente a los del cuartel más bajo de consumo de huevos (< 4 huevos/semana frente a >1 huevo/semana) fue 0,7, IC del 95% CI 0.3-1.7. Conclusión: El consumo de huevos no se asoció con el desarrollo de diabetes mellitus en esta cohorte mediterránea.

  10. Animal Models of Diabetic Retinopathy.

    PubMed

    Jiang, Xiaoyan; Yang, Lizhu; Luo, Yan

    2015-01-01

    Diabetic retinopathy (DR) is one of today's main causes of blindness in numerous developed countries worldwide. The underlying pathogenesis of DR is complex and not well understood, thus impeding development of specific, effective treatment modalities. Consequently, the use of animal models of DR is of critical importance for investigating the pathogenesis of and treatment for DR. While rats and mice are the most commonly used animal models of DR, the zebrafish now appears to be a promising model. Nonhuman primates and humans have similar eye structures, and both can develop spontaneous diabetes mellitus (DM). Although various traditionally used animal models of DR undergo a number of pathological changes similar to those of human DR, several human variations, e.g. retinal neovascularization, cannot yet be fully mimicked in any existing animal model of DM. Since both the animal models and the methods chosen for inducing DR have great influence on experimental results, a clear understanding of available animal models is vital for planning an experimental design. In this review, we summarize the mechanisms, methodologies and pros and cons of the most commonly used animal models of DR.

  11. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    PubMed Central

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  12. [Glomerulonephritis in diabetics].

    PubMed

    Mágori, A; Sonkodi, S; Lászik, Z; Mohácsi, G

    1989-10-01

    Diagnosis of glomerulonephritis (GN) is rare among diabetics and few data relevant to this issue can be found in literature. In Institute of Pathology of "Szent-Györgyi Albert" University of Medicine the presence of GN was found in cases during the examination of renal biopsy material of 36 diabetics. All patients have suffered from diabetes mellitus of 2nd type and of less than 10 year existence, requiring no insulin treatment. In 2 cases diffuse diabetic glomerulosclerosis associated with GN. It is emphasized that kidney biopsy and its complex--light and electronmicroscopic and immunhistological--examination are essential to the diagnosis of GN of diabetics.

  13. Diabetes care during Hajj.

    PubMed

    Alsafadi, Hala; Goodwin, Wendy; Syed, Ateeq

    2011-06-01

    Keeping well during Hajj is a challenge for people with diabetes. However, with proactive planning and education, it may prove to be an excellent opportunity for reviewing management and enhancing diabetes education to reduce diabetes-related short- and long-term problems. People with diabetes should have enough time to consider a management plan. It is important that healthcare professionals are well informed regarding the effects of Hajj on diabetes and are able to offer advice, guidance and change of medications as required during pre-Hajj counselling to enable patients to stay healthy.

  14. Diabetes mellitus in cats.

    PubMed

    Rand, Jacquie S; Marshall, Rhett D

    2005-01-01

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

  15. Diabetes insipidus.

    PubMed

    Leroy, Clara; Karrouz, Wassila; Douillard, Claire; Do Cao, Christine; Cortet, Christine; Wémeau, Jean-Louis; Vantyghem, Marie-Christine

    2013-12-01

    Diabetes insipidus (DI) is characterized by hypotonic polyuria greater than 3 liters/24 hours in adults and persisting even during water deprivation. It is mostly due to a defect in arginin-vasopressin (AVP) synthesis (central DI); other causes are: AVP resistance (nephrogenic DI), abnormal thirst regulation (primary polydipsia) or early destruction of AVP by placental enzymes (gestational DI). A thorough medical history is warranted to investigate nocturnal persistence of polyuria (night waking being a good sign of its organic nature) to specify the onset and duration of the trouble, the medication use and the potential hereditary nature of the disorder. The next step is based on weight and blood pressure measurements and especially the quantification of beverages and diuresis over a 24-hour cycle. Assessment of signs of dehydration, bladder distention, pituitary hormone hyper- or hyposecretion, tumor chiasmatic syndrome, granulomatosis and cancer is required. The diagnosis is based on biological assessment, pituitary magnetic resonance imaging (MRI) and results of a desmopressin test. In severe forms of DI, urine osmolality remains below 250 mOsmol/kg and serum sodium greater than 145 mmol/L. In partial forms of DI (urine osmolality between 250 and 750), the water deprivation test demonstrating the incapacity to obtain a maximal urine concentration is valuable, together with vasopressin or copeptin measurement. The pituitary MRI is done to investigate the lack of spontaneous hyperintensity signal in the posterior pituitary, which marks the absence of AVP and supports the diagnosis of central DI rather than primary polydipsia (although not absolute); it can also recognize lesions of the pituitary gland or pituitary stalk. Acquired central DI of sudden onset should suggest a craniopharyngioma or germinoma if it occurs before the age of 30 years, and metastasis after the age of 50 years. Fifteen to 20% of head trauma lead to hypopituitarism, including DI in 2% of

  16. The Diabetic Foot

    PubMed Central

    Hunt, J.A.

    1990-01-01

    The diabetic foot presents a complex interplay of neuropathic, macrovascular, and microvascular disease on an abnormal metabolic background, complicated by an increased susceptibility to mechanical, thermal, and chemical injury and decreased healing ability. The abnormalities of diabetes, once present, are not curable. But most severe foot abnormalities in the diabetic are due to neglect of injury and are mostly preventable. The physician must ensure that the diabetic patient learns the principles of good foot care. If time for teaching is limited, this task must be delegated to a podiatrist or a diabetes nurse educator in a diabetes day centre. It is the physician's responsibility to confirm foot care by personal inspection of the feet of all diabetic patients at every visit. PMID:21234002

  17. Fenofibrate and Diabetic Retinopathy.

    PubMed

    Knickelbein, Jared E; Abbott, Akshar B; Chew, Emily Y

    2016-10-01

    Diabetic retinopathy, a common and sight-threatening microvascular complication of diabetes mellitus, is a leading cause of blindness among working-aged adults. Medical therapies including intensive control of hyperglycemia and hypertension have been shown to reduce the incidence and progression of diabetic retinopathy. The association of dyslipidemia and treatment with statins with diabetic retinopathy is inconsistent in epidemiologic studies. However, two recent randomized clinical trials have demonstrated beneficial effects of systemic fenofibrate therapy in reducing the progression of diabetic retinopathy independently of serum lipid levels. These findings suggest that fenofibrate may be an effective strategy for reducing the progression of diabetic retinopathy, thus reducing the large and growing public health burden of treating the sight-threatening complications of diabetic retinopathy.

  18. El efecto de la panfotocoagulación con láser en edema macular diabético con el fotocoagulador Pascal® versus el láser de argón convencional.

    PubMed

    Mahgoub, Mohamed M; Macky, Tamer A

    2017-07-11

    Objetivo: El objetivo de este estudio fue comparar el efecto de la panfotocoagulación (PFC) en el edema macular diabético (EMD) en pacientes con retinopatía diabética proliferativa (RDP) con el fotocoagulador Pascal® (FP) vs. un fotocoagulador con láser de argón convencional (FLAC). Métodos: Se aleatorizó el uso de FP o FLAC en ochenta ojos con RDP y EMD con afectación central de la mácula. Ambos grupos tuvieron una evaluación de base de mejor agudeza visual corregida y fueron examinados con tomografía de coherencia óptica y angiografía con fluoresceína. Resultados: El número medio de disparos de láser en los grupos de FP y FLAC fue 1.726,10 y 752,00 en la sesión 1 y 1.589,00 y 830,00 (p < 0,001) en la sesión 2, respectivamente. El grosor foveal central (GFC) medio antes de comenzar el estudio fue 306 ± 100 y 314 ± 98 en los grupos de FP y FLAC, respectivamente. A las 8 semanas, el GFC medio fue 332 ± 116 y 347 ± 111 en los grupos de FP y FLAC, respectivamente (p > 0,05). La MAVC media fue similar durante el periodo de estudio y no hubo ninguna diferencia significativa entre los grupos (p > 0,05). Conclusiones: El FP y el FLAC mostraron efectos similares en el EMD en ojos con RDP y fueron igualmente seguros sin un aumento significativo del GFC. © 2017 S. Karger AG, Basel.

  19. [Diabetes education in adult diabetic patients].

    PubMed

    Weitgasser, Raimund; Clodi, Martin; Cvach, Sarah; Grafinger, Peter; Lechleitner, Monika; Howorka, Kinga; Ludvik, Bernhard

    2016-04-01

    Diabetes education and self management has gained a critical role in diabetes care. Patient empowerment aims to actively influence the course of the disease by self-monitoring and treatment modification, as well as integration of diabetes in patients' daily life to achieve changes in lifestyle accordingly.Diabetes education has to be made accessible for all patients with the disease. To be able to provide a structured and validated education program adequate personal as well as space, organizational and financial background are required. Besides an increase in knowledge about the disease it has been shown that structured diabetes education is able to improve diabetes outcome measured by parameters like blood glucose, HbA1c, blood pressure and body weight in follow-up evaluations. Modern education programs emphasize the ability of patients to integrate diabetes in everyday life and stress physical activity besides healthy eating as a main component of lifestyle therapy and use interactive methods in order to increase the acceptance of personal responsibility.

  20. Type 2 Diabetes Mellitus remission eighteen months after Roux-en-Y gastric bypass.

    PubMed

    Girundi, Marcelo Gomes

    2016-01-01

    to evaluate the effectiveness of Roux-en-Y gastric bypass in improving the glycemic profile of obese patients with type 2 Diabetes Mellitus (DM2) after 18 months of follow-up. four hundred sixty-eight pacients with DM2 and BMI ≥35 were submitted to Roux-en-Y gastric bypass, from 1998 to 2010. All patients were submitted to glycemic control analysis in the 3rd, 6th, 9th, 12th and 18th postoperative months. We considered: type 2 diabetic patients, the ones with fasting glucose ≥126mg/dl and HbA1C ≥6.5 in two dosages; high risk patients for diabetes, those who presented fasting glucose ≥ 100 to 125 mg/dl and HbA1C between 5.7%-6.4%; and normal patients, those presenting glucose <100mg/dl and HbA1C <5.7%. Such diagnostic criteria were based on the official position of Sociedade Brasileira de Diabetes, published in July, 2011. The remission of DM2 was seen in 410 (87.6%) out of 468 patients 18 months after the surgery, that being a meaningful difference, with p<0.001. Fourty-eight (10.3%) patients sustained criteria for the disease and ten (2.1%) continued at high risk for DM2. Roux-en-Y gastric bypass was effective in the promotion and maintaince of long-term glycemic control. There are evidences showing that the remission of DM2 is not only related to weight loss and that other enteroinsular axis mechanisms must be involved. avaliar a eficácia da gastroplastia com derivação em Y-de-Roux, em pacientes obesos e portadores de Diabetes Mellitus tipo 2 (DM2), na melhoria do perfil glicêmico após 18 meses de seguimento. foram submetidos à derivação gástrica em Y-de-Roux 468 pacientes com IMC ≥35 e portadores de DM2, no período de 1998 a 2010. Todos os pacientes tiveram a análise do controle glicêmico realizadas no terceiro, sexto, nono, 12o e 18o meses de pós-operatório. Os critérios diagnósticos de diabetes foram baseados no Posicionamento Oficial da Sociedade Brasileira de Diabetes, publicado em julho de 2011. observou-se a remissão do DM2 em

  1. Diabetic Retinopathy and Diabetic Macular Edema.

    PubMed

    Cohen, Steven R; Gardner, Thomas W

    2016-01-01

    Diabetic retinopathy and diabetic macular edema result from chronic damage to the neurovascular structures of the retina. The pathophysiology of retinal damage remains uncertain but includes metabolic and neuroinflammatory insults. These mechanisms are addressed by intensive metabolic control of the systemic disease and by the use of ocular anti-inflammatory agents, including vascular endothelial growth factor inhibitors and corticosteroids. Improved understanding of the ocular and systemic mechanisms that underlie diabetic retinopathy will lead to improved means to diagnose and treat retinopathy and better maintain vision.

  2. [Skin symptoms in diabetic metabolism].

    PubMed

    Feldmann, R; Prins, C

    1995-04-01

    Diabetes mellitus is a common disease, and the cutaneous manifestations of it are frequently encountered. Some skin diseases have a strong association with diabetes, as necrobiosis lipoidica and diabetic bullae. They can be regarded as a cutaneous marker for diabetes. Other disorders--for example shin spots--also occur in the nondiabetic population. Cutaneous infections may be a sign of poorly controlled diabetes.

  3. Neuropathy and Diabetic Foot Syndrome

    PubMed Central

    Volmer-Thole, Maren; Lobmann, Ralf

    2016-01-01

    Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature; in the pathophysiology of diabetic foot ulceration polyneuropathy is important. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the still high rates of major amputations. PMID:27294922

  4. Neuropathy and Diabetic Foot Syndrome.

    PubMed

    Volmer-Thole, Maren; Lobmann, Ralf

    2016-06-10

    Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature; in the pathophysiology of diabetic foot ulceration polyneuropathy is important. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the still high rates of major amputations.

  5. Diabetes knowledge among older adults with diabetes in Beijing, China.

    PubMed

    Hu, Jie; Gruber, Kenneth J; Liu, Huaping; Zhao, Hong; Garcia, Alexandra A

    2013-01-01

    To explore the relationships of demographic and clinical variables and attendance at diabetes educational programmes with diabetes knowledge among a community sample of older Chinese adults with type 2 diabetes residing in Beijing. Knowledge of diabetes is an important component of diabetes self-management. Level of education, duration of diabetes, visits to a dietician and diabetes self-management are associated with diabetes knowledge. A few studies have examined these relationships in older Chinese with diabetes. A descriptive correlational study. The study was conducted in face-to-face interviews with 108 older adults with type 2 diabetes and an average age of 68 (SD = 8·41) years residing in six residential apartment complexes in Beijing. Along with the assessment of diabetes knowledge and diabetes self-management, assessments of glucose, blood pressure, body mass index (BMI) and waist circumference were obtained. Age and systolic blood pressure were negatively associated with diabetes knowledge. Diabetes knowledge was not related to diabetes self-care activities or glucose level. A regression model with age, education and clinical variables significantly predicted diabetes knowledge, explaining 29% of the variance in knowledge. Participants who had a family history of diabetes, visited traditional Chinese medicine (TCM) doctors and ophthalmologists and attended diabetes educational programmes were more likely to have high scores on diabetes knowledge. Age, education, a family history of diabetes, visits to TCM providers and ophthalmologists and attending diabetes class are factors associated with increased levels of diabetes knowledge. Healthcare providers need to provide age-specific, low literacy and family-focused diabetes education programmes and consider integrating principles and holistic perspectives of TCM in diabetes educational programmes for older Chinese with diabetes. © 2012 Blackwell Publishing Ltd.

  6. [A comparison of two systems for hydration of children with diabetic ketoacidosis. a randomized controlled trial].

    PubMed

    Ferreira, Juan Pablo; Penazzi, Matias; Taborda, Macarena; Funes, Santiago; Villareal, Mauricio

    2015-01-01

    Introducción: El tratamiento de la cetoacidosis diabética (CAD) requiere controles horarios de glucemia que definen modificaciones en la administración de insulina y glucosa endovenosa. En cada cambio se prepara una nueva solución endovenosa, generando retrasos y, eventualmente, errores. El sistema de dos soluciones hidroelectrolíticas (idéntica composición electrolítica, una con glucosa y otra sin) en paralelo unidas en una vía común al paciente, permite cambios inmediatos en el flujo de glucosa, con la sola modificación de los goteos. Objetivo: Comparar el tiempo requerido para la estabilización de pacientes con CAD, utilizando dos sistemas de hidratación: tradicional (1 solución hidroelectrolítica) vs. alternativo (2 soluciones hidroelectrolíticas –“two bags”-). Métodos: Ensayo clínico controlado y aleatorizado que incluyó niños de 1 a 18 años, hospitalizados por CAD (glucemia >200 mg/dl, pH <7,3, bicarbonato <15 mmol/L, glucosuria y cetonuria). Luego de la hidratación inicial, los pacientes fueron aleatorizados a uno de 2 sistemas de hidratación (tradicional o alternativo), manteniéndolo hasta la estabilización del paciente (glucemia ≤250 mg/dl, pH ≥7,3, bicarbonato ≥15 mmol/L); el tiempo requerido en alcanzar la estabilización fue la variable de resultado. Resultados: Al incorporar 12 de los 32 sujetos previstos (6 en cada grupo¬) el Comité de Monitoreo de Seguridad efectuó análisis interino preestablecido, encontrando que el tiempo en alcanzar la estabilización fue significativamente menor con el sistema alternativo (9,8±1,16 horas vs. 13,3±2,8 horas; p=0,018). Debido a la magnitud del hallazgo, se consultó al Comité de Ética, decidiendo suspender el estudio. Conclusión: El sistema alternativo (“two-bags”) permitió alcanzar la estabilización del paciente con CAD en un tiempo significativamente menor.

  7. Diabetes and Pancreatic Cancer

    PubMed Central

    Li, Donghui

    2011-01-01

    Type 2 diabetes mellitus is likely the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Epidemiological investigations have found that long-term type 2 diabetes mellitus is associated with a 1.5- to 2.0-fold increase in the risk of pancreatic cancer. A causal relationship between diabetes and pancreatic cancer is also supported by findings from prediagnostic evaluations of glucose and insulin levels in prospective studies. Insulin resistance and associated hyperglycemia, hyperinsulinemia, and inflammation have been suggested to be the underlying mechanisms contributing to development of diabetes-associated pancreatic cancer. Signaling pathways that regulate the metabolic process also play important roles in cell proliferation and tumor growth. Use of the antidiabetic drug metformin has been associated with reduced risk of pancreatic cancer in diabetics and recognized as an antitumor agent with the potential to prevent and treat this cancer. On the other hand, new-onset diabetes may indicate subclinical pancreatic cancer, and patients with new-onset diabetes may constitute a population in whom pancreatic cancer can be detected early. Biomarkers that help define high-risk individuals for clinical screening for pancreatic cancer are urgently needed. Why pancreatic cancer causes diabetes and how diabetes affects the clinical outcome of pancreatic cancer have yet to be fully determined. Improved understanding of the pathological mechanisms shared by diabetes and pancreatic cancer would be the key to the development of novel preventive and therapeutic strategies for this cancer. PMID:22162232

  8. Diabetes in the Aged

    PubMed Central

    Grobin, Wulf

    1970-01-01

    In keeping with the already known high prevalence of diabetes among residents of the Jewish Home for the Aged, Toronto, annual screening disclosed an average incidence of 25.5% of abnormal glucose tolerance (two-hour post-glucose blood sugars above 140 mg./100 ml.) in residents not known to be diabetic. Forty-five (47%) of the 94 residents with abnormal screening values were considered subsequently to be diabetic according to our criteria. Long-term follow-up, particularly of 81 residents initially normoglycemic in 1964-5, confirmed that the natural course of glucose tolerance in this population was one of progressive deterioration. By contrast, improvement amounting to remission has been demonstrated in nine out of 20 residents several years after they had been declared diabetic, and is thought to have been induced by dietotherapy. Moderate hyperglycemia per se did not cause symptoms in these almost always keto-resistant and usually aglycosuric aged diabetics, who often claimed they felt better when hyperglycemic. Hypoglycemia was an ever present danger when anti-diabetic medication was used; it was the main reason for undertreatment. So far, data from our long-term study have not shown morbidity to be markedly increased in the diabetics, and mortality was found to be evenly distributed among diabetic and non-diabetic male residents. However, in the females there was a clear correlation between mortality rate and the diminished glucose tolerance. What may appear as overdiagnosis of diabetes in the aged is recommended in the hope that early institution of dietary treatment will delay the development of clinical diabetes and the need for anti-diabetic agents. This, in turn, would prevent iatrogenic hypoglycemia. It would also reduce the severity and frequency of spontaneous hypoglycemia which, we believe, occurs more commonly in the early phase of diabetes in the aged than is generally realized. PMID:5476778

  9. Preeclampsia and Diabetes

    PubMed Central

    Weissgerber, Tracey L.; Mudd, Lanay M.

    2015-01-01

    Preeclampsia is diagnosed in women presenting with new onset hypertension accompanied by proteinuria or other signs of severe organ dysfunction in the second half of pregnancy. Preeclampsia risk is increased two to four-fold among women with type 1 or type 2 diabetes. The limited number of pregnant women with preexisting diabetes and difficulties associated with diagnosing preeclampsia in women with proteinuria prior to pregnancy are significant barriers to research in this high-risk population. GDM also increases preeclampsia risk, although it is unclear whether these two conditions share a common pathophysiological pathway. Non-diabetic women who have had preeclampsia are more likely to develop type 2 diabetes later in life. Among women with type 1 diabetes, a history of preeclampsia is associated with an increased risk of retinopathy and nephropathy. More research examining pathophysiology, treatment and the long-term health implications of preeclampsia among women with preexisting and gestational diabetes is needed. PMID:25644816

  10. Update on diabetes classification.

    PubMed

    Thomas, Celeste C; Philipson, Louis H

    2015-01-01

    This article highlights the difficulties in creating a definitive classification of diabetes mellitus in the absence of a complete understanding of the pathogenesis of the major forms. This brief review shows the evolving nature of the classification of diabetes mellitus. No classification scheme is ideal, and all have some overlap and inconsistencies. The only diabetes in which it is possible to accurately diagnose by DNA sequencing, monogenic diabetes, remains undiagnosed in more than 90% of the individuals who have diabetes caused by one of the known gene mutations. The point of classification, or taxonomy, of disease, should be to give insight into both pathogenesis and treatment. It remains a source of frustration that all schemes of diabetes mellitus continue to fall short of this goal. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Amputation in Diabetic Patients.

    PubMed

    Singh, Gurjit; Chawla, S

    2006-01-01

    Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. The present study examines the amputation risk criterion and the long term outcome in terms of amputations and mortality in patients with diabetic foot. 27 patients with diabetic foot lesions were studied. There were 15 patients with early lesions and 10 with advanced lesions. 15 patients were managed conservatively including local amputations and 12 with lower extremity amputations. 80% patients were males in 45-59 years of age group and all patients had more than 6 years of poorly controlled diabetes. Precipitating factors included walking barefoot, history of minor trauma, infection, callosities or burns in 86% of patients. Major lower limb amputations were common in irregularly treated, poorly controlled diabetics due to infection in a limb devitalized by angiopathy and desensitised by neuropathy. Diabetic foot ulcers are associated with high morbidity and mortality. Mortality was higher in ischaemic ulcers than neuropathic ulcers.

  12. Genitourinary infection in diabetes

    PubMed Central

    Julka, Sandeep

    2013-01-01

    Diabetes is known to increase the risk of infection and the commonest amongst them are the ones involving the genitourinary tract. The infections in a diabetic patient are unique in that they are recurrent, more severe, requiring hospitalization, and also have higher mortality than nondiabetics. Some infections are exclusively found in diabetics like the emphysematous pyelonephritis while others have their natural history complicated due to hyperglycemia. Asymptomatic bacteriuria may lead to albuminuria and urinary tract infection and may need to be treated in diabetics. Not just this certain organisms have a predilection for the genitourinary tract of the diabetic patient. All of the above makes the diabetic patient vulnerable to infections and therefore early diagnosis and appropriate treatment is mandatory. PMID:24251228

  13. Carbohydrates and Diabetes (For Parents)

    MedlinePlus

    ... Habits for TV, Video Games, and the Internet Carbohydrates and Diabetes KidsHealth > For Parents > Carbohydrates and Diabetes ... many kids with diabetes take to stay healthy. Carbohydrates and Blood Sugar The two main forms of ...

  14. Snacking when you have diabetes

    MedlinePlus

    Healthy snacking - diabetes; Low blood sugar - snacking; Hypoglycemia - snacking ... When you have diabetes , you need to control your blood sugar. Insulin or diabetes medicines, as well as exercise in general, helps lower ...

  15. Managing Diabetes: Looking Beyond Carbs

    MedlinePlus

    ... overview/diet-eating-physical-activity. Accessed Jan. 30, 2017. Diabetes meal plans and a healthy diet. American Diabetes ... ... 2017. Cook with heart-healthy foods. American Diabetes Association. ...

  16. Cranial mononeuropathy III - diabetic type

    MedlinePlus

    ... diabetic type of cranial mononeuropathy III is a complication of diabetes . It causes double vision and eyelid drooping . ... Cooper ME, Vinik AI, Plutzky J, Boulton AJM. Complications of diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg ...

  17. National Diabetes Statistics Report, 2014

    MedlinePlus

    ... age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. ... Americans, Hispanics/Latinos, Asians, and Pacific Islanders. 9 Gestational diabetes is a form of glucose intolerance diagnosed during ...

  18. History of Diabetes Insipidus.

    PubMed

    Valenti, Giovanna; Tamma, Grazia

    2016-02-01

    Under physiological conditions, fluid and electrolyte homoeostasis is maintained by the kidney adjusting urine volume and composition according to body needs. Diabetes Insipidus is a complex and heterogeneous clinical syndrome affecting water balance and characterized by constant diuresis, resulting in large volumes of dilute urine. With respect to the similarly named Diabetes Mellitus, a disease already known in ancient Egypt, Greece and Asia, Diabetes Insipidus has been described several thousand years later. In 1670s Thomas Willis, noted the difference in taste of urine from polyuric subjects compared with healthy individuals and started the differentiation of Diabetes Mellitus from the more rare entity of Diabetes Insipidus. In 1794, Johann Peter Frank described polyuric patients excreting nonsaccharine urine and introduced the term of Diabetes Insipidus. An hystorical milestone was the in 1913, when Farini successfully used posterior pituitary extracts to treat Diabetes Insipidus. Until 1920s the available evidence indicated Diabetes Insipidus as a disorder of the pituitary gland. In the early 1928, De Lange first observed that some patients with Diabetes Insipidus did not respond to posterior pituitary extracts and subsequently Forssman and Waring in 1945 established that the kidney had a critical role for these forms of Diabetes Insipidus resistant to this treatment. In 1947 Williams and Henry introduced the term Nephrogenic Diabetes Insipidus for the congenital syndrome characterized by polyuria and renal concentrating defect resistant to vasopressin. In 1955, du Vigneaud received the 1955 Nobel Prize in chemistry for the first synthesis of the hormone vasopressin representing a milestone for the treatment of Central Diabetes Insipidus.

  19. Diabetes and Eating Disorders

    PubMed Central

    Goebel-Fabbri, Ann E.

    2008-01-01

    The problem of insulin restriction is an important women's health issue in type 1 diabetes. This behavior is associated with increased rates of diabetes complications and decreased quality of life. Clinical and technological research is greatly needed to improve treatment tools and strategies for this problem. In this commentary, the author describes the scope of the problem of eating disorders and diabetes, as well as offers ideas about ways technology may be applied to help solve this complex problem. PMID:19885221

  20. Diabetes Care in India.

    PubMed

    Joshi, Shashank R

    2015-01-01

    Diabetes has become a major health care problem in India with an estimated 66.8 million people suffering from the condition, representing the largest number of any country in the world. The rising burden of diabetes has greatly affected the health care sector and economy in India. The goal of health care experts in India is to transform India into a diabetes care capital in the world. An expert detailed review of the medical literature with an Asian Indian context was performed. Recent epidemiologic studies from India point to a great burden from diabetes. Diabetes control in India is far from ideal with a mean hemoglobin A1c of 9.0%-at least 2.0% higher than suggested by international bodies. Nearly half of people with diabetes remain undetected, accounting for complications at the time of diagnosis. Screening can differentiate an asymptomatic individual at high risk from one at low risk for diabetes. Despite the large number of people with diabetes in India, awareness is low and needs to be addressed. Other challenges include balancing the need for glycemic control with risk reduction due to overly tight control, especially in high-risk groups and taking into account health care professional expertise, attitudes, and perceptions. Pharmacologic care should be individualized with early consideration of combination therapy. Regular exercise, yoga, mindful eating, and stress management form a cornerstone in the management of diabetes. Considering the high cost incurred at various steps of screening, diagnosis, monitoring, and management, it is important to realize the cost-effective measures of diabetes care that are necessary to implement. Result-oriented organized programs involving patient education, as well as updating the medical fraternity on various developments in the management of diabetes, are required to combat the current diabetes epidemic in India. Copyright © 2015. Published by Elsevier Inc.

  1. Diabetes - preventing heart attack and stroke

    MedlinePlus

    Diabetes complications - heart; Coronary artery disease - diabetes; CAD - diabetes; Cerebrovascular disease - diabetes ... People with diabetes have a higher chance of having heart attacks and strokes. Smoking and having high blood pressure and high ...

  2. Take Steps to Prevent Type 2 Diabetes

    MedlinePlus

    ... En español Take Steps to Prevent Type 2 Diabetes Browse Sections The Basics Overview Types of Diabetes ... 1 of 9 sections The Basics: Types of Diabetes What is diabetes? Diabetes is a disease. People ...

  3. Nutrition in Diabetes.

    PubMed

    Hamdy, Osama; Barakatun-Nisak, Mohd-Yusof

    2016-12-01

    Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed.

  4. The diabetic foot.

    PubMed

    Ahmad, Jamal

    2016-01-01

    Diabetic foot problems are responsible for nearly 50% of all diabetes-related hospital bed days. Approximately 10-15% of diabetic patients developed foot ulcers at some state in their life and 15% of all load in amputations are performed in patients with diabetes. There is a need to provide extensive education to both primary care physicians and the patients regarding the relationship between glucose control and complications encountered in the foot and ankle. The management of diabetic foot disease is focussed primarily on avoiding amputation of lower extremities and should be carried out through three main strategies; identification of the "at risk" foot, treatment of acutely diseased foot, and prevention of further problems. These are several obstacles in the management of DFI that include poor knowledge and awareness of diabetes and its complications, lack of appropriate podiatry services. These goals are possible only by the establishment of a dedicated team of podiatrist, endocrinologist, vascular surgeon and a pedorthist. The plastic surgeons, orthopaedic surgeons & diabetes teaching nurses/educator dedicated to foot care could be a part of the team. Identifying the patients with diabetes at risk for ulceration requires feet examination, including the vascular & neurological systems, skin conditions, and foot structure. Conservative management of foot problems has dramatically reduced the risk of amputation by simple procedures, such as appropriate foot wear, cleanliness, aggressive surgical debridement, regular wound dressing by simple wet-to-dry saline guage, and ulcer management. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  5. Diabetic Hyperosmolar Syndrome

    MedlinePlus

    ... treatment can correct diabetic hyperosmolar syndrome within hours. Treatment typically includes: Intravenous fluids to counter dehydration Intravenous insulin to lower your blood sugar levels Intravenous potassium, ...

  6. Diabetes, Nutrition, and Exercise.

    PubMed

    Abdelhafiz, Ahmed H; Sinclair, Alan J

    2015-08-01

    Aging is associated with body composition changes that lead to glucose intolerance and increased risk of diabetes. The incidence of diabetes increases with aging, and the prevalence has increased because of the increased life expectancy of the population. Lifestyle modifications through nutrition and exercise in combination with medications are the main components of diabetes management. The potential benefits of nutrition and exercise intervention in older people with diabetes are enormous. Nutrition and exercise training are feasible even in frail older people living in care homes and should take into consideration individual circumstances, cultural factors, and ethnic preferences.

  7. Globalization of Diabetes

    PubMed Central

    2011-01-01

    Type 2 diabetes is a global public health crisis that threatens the economies of all nations, particularly developing countries. Fueled by rapid urbanization, nutrition transition, and increasingly sedentary lifestyles, the epidemic has grown in parallel with the worldwide rise in obesity. Asia's large population and rapid economic development have made it an epicenter of the epidemic. Asian populations tend to develop diabetes at younger ages and lower BMI levels than Caucasians. Several factors contribute to accelerated diabetes epidemic in Asians, including the “normal-weight metabolically obese” phenotype; high prevalence of smoking and heavy alcohol use; high intake of refined carbohydrates (e.g., white rice); and dramatically decreased physical activity levels. Poor nutrition in utero and in early life combined with overnutrition in later life may also play a role in Asia's diabetes epidemic. Recent advances in genome-wide association studies have contributed substantially to our understanding of diabetes pathophysiology, but currently identified genetic loci are insufficient to explain ethnic differences in diabetes risk. Nonetheless, interactions between Westernized diet and lifestyle and genetic background may accelerate the growth of diabetes in the context of rapid nutrition transition. Epidemiologic studies and randomized clinical trials show that type 2 diabetes is largely preventable through diet and lifestyle modifications. Translating these findings into practice, however, requires fundamental changes in public policies, the food and built environments, and health systems. To curb the escalating diabetes epidemic, primary prevention through promotion of a healthy diet and lifestyle should be a global public policy priority. PMID:21617109

  8. Vitamin D and Diabetes

    PubMed Central

    PITTAS, ANASTASSIOS G.; DAWSON-HUGHES, BESS

    2010-01-01

    On the basis of evidence from animal and human studies, vitamin D has emerged as a potential risk modifier for type 1 and type 2 diabetes (type 1 diabetes and type 2 diabetes). Vitamin D is thought to have both direct (through activation of the vitamin D receptor) and indirect (via regulation of calcium homeostasis) effects on various mechanisms related to the pathophysiology of both types of diabetes, including pancreatic beta cell dysfunction, impaired insulin action and systemic inflammation. Observational case-control studies have shown that vitamin D supplementation in pregnancy or early childhood is associated with reduced risk of incident type 1 diabetes. There are no trials on the effect of vitamin D (ergocalciferol or cholecalciferol) on type 1 diabetes. An association between vitamin D insufficiency and incident type 2 diabetes has been reported in longitudinal observational studies, but the association is not consistent. Results from small underpowered trials and post-hoc analyses of data from larger trials designed for bone-specific outcomes show no effect of vitamin D supplementation on glycemia in healthy adults but vitamin D may retard the progression to diabetes in adults with glucose intolerance. Because vitamin D is an excellent marker of general health status, the positive results reported in some observational studies might reflect unmeasured and unaccounted confounding. Therefore, the hypothesis that vitamin D may modify diabetes risk needs to be confirmed in trials specifically designed for that purpose. PMID:20304061

  9. Bioreactors addressing diabetes mellitus.

    PubMed

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

    2014-11-01

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

  10. Painful diabetic neuropathy.

    PubMed

    Peltier, Amanda; Goutman, Stephen A; Callaghan, Brian C

    2014-05-06

    Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease [corrected]. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined.

  11. Diabetic Retinopathy: Nature and Extent.

    ERIC Educational Resources Information Center

    Coughlin, W. Ronald; Patz, Arnall

    1978-01-01

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

  12. Diabetic Retinopathy: Nature and Extent.

    ERIC Educational Resources Information Center

    Coughlin, W. Ronald; Patz, Arnall

    1978-01-01

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

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

    PubMed Central

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

    1978-01-01

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

  14. "Governare il diabete" ("to steer diabetes"): a new proposal for diabetic camps.

    PubMed

    Salvatoni, Alessandro; Pompili, Valeria; Biasoli, Roberta; Cardani, Roberta; Arioli, Gianluigi; Nespoli, Luigi

    2003-01-01

    "Governare il diabete" (the Italian translation of "to steer diabetes") is a project which gives young diabetics the opportunity of sailing with non-diabetic companions in a protected and educational environment. The education technique, based on the parallelism between sailing and diabetes, encourage correct self-management of both diabetes related and unrelated problems. The impact of the experience on self-esteem, quality of life and metabolic control is currently under investigation.

  15. [Bariatric surgery in adults: variables that facilitate and hinder weight loss from pacients perspective].

    PubMed

    Lecaros-Bravo, Javiera; Cruzat-Mandich, Claudia; Díaz-Castrillón, Fernanda; Moore-Infante, Catalina

    2015-04-01

    Introducción: La obesidad se ha convertido en un problema de salud pública a nivel mundial. Asociado a esto, las cirugías bariátricas han ido en progresivo aumento, dada su efectividad en la baja de peso a corto plazo. Sin embargo, se ha visto que existe un alto porcentaje de reganancia de peso a partir del tercer año post cirugía y existen pocos estudios de seguimiento de estos pacientes. Objetivos: Describir los facilitadores y obstaculizadores de la pérdida de peso, desde la perspectiva de adultos que han sido sometidos a cirugía bariátrica. Métodos: Se utilizó un enfoque cualitativo, descriptivo, basado en la Teoría Fundamentada. Se realizaron entrevistas en profundidad y los datos se analizaron a través de codificación abierta. La muestra estuvo compuesta por 8 mujeres y 3 hombres adultos, intervenidos en clínicas privadas. Resultados: Se generaron cinco categorías de análisis: (1) variables que favorecen la pérdida de peso post cirugía bariátrica, (2) variables que dificultan la pérdida y mantención de peso post cirugía, (3) evaluación de los resultados de la cirugía bariátrica, (4) problematización de la obesidad, y (5) relación con la comida. Discusión: Los principales hallazgos indican que el fracaso y el éxito en la pérdida de peso post cirugía se encuentra asociado a la posibilidad de tener una red de apoyo emocional y social, así como a la posibilidad de comprender y modificar el rol de la comida como mecanismo de regulación emocional.

  16. [Diabetic nephropathy/diabetic kidney disease].

    PubMed

    Boucek, P

    2013-03-01

    Diabetic kidney disease (DKD), which belongs to the triad of diabetic microvascular complications, is currently the main cause of end-stage renal disease in developed countries. DKD usually simultaneously leads to a deteriorated long-term control of glucose metabolism and blood pressure, and to the development of diabetic retinopathy, neuropathy and atherosclerotic complications, which are the main causes of patients' mortality. Screening of the initial stages of DKD is to be based on the detection of increased albumin leak into the urine, microalbuminuria, and the reduction of renal function by means of estimates of glomerular filtration rate based on the serum creatinine level. The main objective of the prophylactic and treatment measures is to prevent the onset of DKD, or at least to stop its transition into an irreversible, progressive stage characterised by a permanent, often nephrotic proteinuria. The basic procedures in the prevention and treatment of DKD are maintaining the optimal metabolic control of diabetes and intensive hypertension treatment based on the inhibition of the renin-angiotensin system. Reaching the stage of progressive renal insufficiency (serum creatinine level approximately > or = 200 micromol/l) is an indication for further follow-up in the nephrology department, which will then take the necessary preparatory measures for dialysis treatment. The optimal method of kidney function replacement for patients with DKD is kidney transplantation, or combined kidney-pancreas transplantation in patients with type 1 diabetes.

  17. Diabetic kidney disease.

    PubMed

    Thomas, Merlin C; Brownlee, Michael; Susztak, Katalin; Sharma, Kumar; Jandeleit-Dahm, Karin A M; Zoungas, Sophia; Rossing, Peter; Groop, Per-Henrik; Cooper, Mark E

    2015-07-30

    The kidney is arguably the most important target of microvascular damage in diabetes. A substantial proportion of individuals with diabetes will develop kidney disease owing to their disease and/or other co-morbidity, including hypertension and ageing-related nephron loss. The presence and severity of chronic kidney disease (CKD) identify individuals who are at increased risk of adverse health outcomes and premature mortality. Consequently, preventing and managing CKD in patients with diabetes is now a key aim of their overall management. Intensive management of patients with diabetes includes controlling blood glucose levels and blood pressure as well as blockade of the renin-angiotensin-aldosterone system; these approaches will reduce the incidence of diabetic kidney disease and slow its progression. Indeed, the major decline in the incidence of diabetic kidney disease (DKD) over the past 30 years and improved patient prognosis are largely attributable to improved diabetes care. However, there remains an unmet need for innovative treatment strategies to prevent, arrest, treat and reverse DKD. In this Primer, we summarize what is now known about the molecular pathogenesis of CKD in patients with diabetes and the key pathways and targets implicated in its progression. In addition, we discuss the current evidence for the prevention and management of DKD as well as the many controversies. Finally, we explore the opportunities to develop new interventions through urgently needed investment in dedicated and focused research. For an illustrated summary of this Primer, visit: http://go.nature.com/NKHDzg.

  18. 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.

  19. [Exercise and diabetes].

    PubMed

    Murillo García, Serafín; Novials Sardà, Anna

    2011-05-01

    The recommendations about physical exercise in people with diabetes have changed in parallel with the development of knowledge and treatments of the disease. Before the discovery of insulin, exercise was considered a dangerous activity, usually discouraged by the increased risk of ketosis that resulted. In contrast, today, exercise is a basic activity included within the recommended healthy lifestyle for patients with diabetes.

  20. Idiopathic central diabetes Insipidus.

    PubMed

    Grace, Mary; Balachandran, Venu; Menon, Sooraj

    2011-10-01

    Idiopathic central diabetes insipidus (CDI) is a rare disorder characterized clinically by polyuria and polydipsia, and an abnormal urinary concentration without any identified etiology. We report a case of central diabetes insipidus in a 60-year-old lady in the absence of secondary causes like trauma, infection, and infiltrative disorders of brain.

  1. Diabetes Treatment Breakthrough.

    ERIC Educational Resources Information Center

    Baker, Shelly; And Others

    1993-01-01

    Eight experts in visual impairment respond briefly to reports that intensive monitoring of blood glucose levels by persons with diabetes can lead to a 70% reduction in the progression of detectable diabetic retinopathy. Comments are generally optimistic, though some cautions are raised. (DB)

  2. Medicines for Diabetes

    MedlinePlus

    ... body's cells where it can be used for energy. Without insulin around, glucose stays in the blood and blood sugar levels get too high. The types of insulin you use and how much you need to take each day will depend on your diabetes management plan. Some kids with diabetes need to take ...

  3. Therapies for diabetic dyslipidaemia.

    PubMed

    Bell, D S H; Al Badarin, F; O'Keefe, J H

    2011-04-01

    Correction of diabetic dyslipidaemia in diabetic patients is the most important factor in reducing cardiac risk. Diabetic dyslipidaemia is characterized by elevated triglycerides, low total high-density lipoprotein (HDL) and small dense low-density lipoprotein (LDL) particles. The most important therapeutic goal in diabetic dyslipidaemia is correction of the non-HDL-cholesterol (HDL-C) level. Glycaemic control with particular attention to postprandial glucose control plays a role not only in improving dyslipidaemia but also in lowering cardiac events. Pioglitazone is particularly effective for improving the manifestations of diabetic dyslipidaemia, in addition to its favorable effects on systemic inflammation and hyperglycaemia. Use of statins in addition to lifestyle change is recommended in most if not all type 2 diabetic patients and the goal should be to lower the LDL to a level recommended for the patient with existing cardiovascular disease (CVD) (non-HDL-C level <100 mg/dl). In addition, therapies for normalization of HDL and triglyceride levels should be deployed. Most patients with type 2 diabetes (T2D) will require combining a lipid-lowering therapy with therapeutic lifestyle changes to achieve optimal lipid levels. Combinations usually include two or more of the following: a statin, nicotinic acid, omega-3 fats and bile acid sequestrants (BASs). Fibrates may also be of use in diabetic patients with persistently elevated triglycerides and depressed HDL-C levels, although their role in lowering adverse CV events is questionable. © 2011 Blackwell Publishing Ltd.

  4. Vulvovaginitis and diabetes.

    PubMed

    Kalra, Bharti; Kalra, Sanjay

    2017-01-01

    Vulvovaginitis is a commonly encountered comorbid condition of diabetes, and is linked to poor glycaemic control. Proper, timely diagnosis and management is necessary to ensure optimal perineal/genital and metabolic health. Knowledge of current guidelines and recommendations helps in achieving this goal. This review describes the etiology, pathogenesis, clinical features, differential diagnosis, management and prevention of VV in diabetes.

  5. Diabetic neuralgic amyotrophy

    PubMed Central

    Williams, Alan J.

    1981-01-01

    A rare neurological condition, neuralgic amyotrophy, in a diabetic is reported. Strong evidence for a causal relationship is suggested. Comment is made on striking similarities between the clinical presentation and course of both diabetic and neuralgic amyotrophy, inferring a similar end pathological process. ImagesFig. 1 PMID:7312743

  6. Diabetes Treatment Breakthrough.

    ERIC Educational Resources Information Center

    Baker, Shelly; And Others

    1993-01-01

    Eight experts in visual impairment respond briefly to reports that intensive monitoring of blood glucose levels by persons with diabetes can lead to a 70% reduction in the progression of detectable diabetic retinopathy. Comments are generally optimistic, though some cautions are raised. (DB)

  7. Help Teens Manage Diabetes

    MedlinePlus

    ... Grey, dean of the Yale University School of Nursing, developed and tested a program called Coping Skills Training (CST) as a part of routine diabetes ... is to improve diabetic teens' coping and communication skills, healthy ... sugar levels. "Nursing research is about helping people deal with the ...

  8. Eyebrow colour in diabetics.

    PubMed

    Wollina, U

    2005-12-01

    Hair colour may be affected by a metabolic disease. Systematic investigations in diabetics are missing. A clinical study was performed to evaluate whether dark colour of eyebrows in greying males is associated with diabetes or not. Academic teaching hospital, inpatient and outpatient department. In an uncontrolled analysis two groups of male patients between 50 to 70 years of age were investigated for evidence of diabetes mellitus. Inclusion criteria were original scalp hair colour brown to black with more than 50% greying hair, no chemotherapy, hormone (except insulin) or interferon treatment, current or previous, no artificial colouring of hair, and absence of total alopecia. Group A consisted of 50 males with dark eyebrow colour, group B of 50 males with greying of eyebrows. A careful medical history and clinical examination was performed. In patients without known diabetes, blood sugar levels (profile during the day) and HbA1c were evaluated. In group A 38 of 50 patients (76%) were diabetics type II. The mean duration of diabetes was 3.4 years (SD 6.8 years; range 1 year to 31 years). Six patients were diagnosed as having diabetes for the first time. In group B 9 of 50 patients (18%) were diabetics, two of type I and 7 of type II. One patient with a newly detected diabetes type II was seen. The mean duration of diabetes was 4.1 years (SD 7.6 years; range: 1 year to 39 years). The difference in diabetes frequency is statistically highly significant (two-sided t-test: p<0.0001). Odds ratios (OR) for diabetes are higher in greying males with dark eyebrows (OR 3.17) vs. those with greying eyebrows and scalp hair (OR 0.19) in this age group. In male diabetics at the age of 50 years or more greying of the eyebrows seems to be inhibited or delayed. The presence of dark eyebrows with greying scalp hair in males might be a clinical sign for patients at risk of diabetes type II.

  9. 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.

  10. Diabetes Research and Training Centers: Diabetes Education. Fact Sheet.

    ERIC Educational Resources Information Center

    National Diabetes Information Clearinghouse, Bethesda, MD.

    Established in 1977 by the Diabetes Research and Education Act, the six Diabetes Research and Training Centers (DRTCs) located throughout the country offer resources for diabetes educators and other health professionals involved in treating or counseling people with diabetes. DRTCs provide continuing education, seminars, and workshops in…

  11. Diabetes Technologies and Their Role in Diabetes Management

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  12. Type 1 diabetes

    PubMed Central

    Atkinson, Mark A; Eisenbarth, George S; Michels, Aaron W

    2015-01-01

    Over the past decade, knowledge of the pathogenesis and natural history of type 1 diabetes has grown substantially, particularly with regard to disease prediction and heterogeneity, pancreatic pathology, and epidemiology. Technological improvements in insulin pumps and continuous glucose monitors help patients with type 1 diabetes manage the challenge of lifelong insulin administration. Agents that show promise for averting debilitating disease-associated complications have also been identified. However, despite broad organisational, intellectual, and fiscal investments, no means for preventing or curing type 1 diabetes exists, and, globally, the quality of diabetes management remains uneven. This Seminar discusses current progress in epidemiology, pathology, diagnosis, and treatment of type 1 diabetes, and prospects for an improved future for individuals with this disease. PMID:23890997

  13. [Diabetes and travel].

    PubMed

    Bauduceau, B; Mayaudon, H; Ducorps, M; Belmejdoub, G; Thiolet, C; Pellan, M; Cosson, E

    1997-01-01

    With the continuing expansion in international air travel, increasing numbers of diabetic patients consult physicians for advice before going abroad. Careful planning is required taking into account climatic and medical conditions at the destination. Diabetic travelers should pack an appropriate treatment kit and contract special insurance coverage for medical evacuation. Precautions are necessary to limit the effects of motion sickness and time differences on diabetes control and especially the risk of hypoglycemia. Special attention is needed to avoid digestive problems and prevent foot injuries which can lead to serious complications in diabetic patients. Diabetic patients cannot forget their health problem during vacation and must be especially cautious when traveling. However with proper training, the risks of foreign travel can be reduced to acceptable levels.

  14. Diabetes mellitus and dementia.

    PubMed

    Ninomiya, Toshiharu

    2014-01-01

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

  15. Diabetes and Schizophrenia.

    PubMed

    Suvisaari, Jaana; Keinänen, Jaakko; Eskelinen, Saana; Mantere, Outi

    2016-02-01

    People with schizophrenia have 2- to 5-fold higher risk of type 2 diabetes than the general population. The traditional risk factors for type 2 diabetes, especially obesity, poor diet, and sedentary lifestyle, are common in people with schizophrenia already early in the course of illness. People with schizophrenia also often have low socioeconomic status and income, which affects their possibilities to make healthy lifestyle choices. Antipsychotic medications increase the risk of type 2 diabetes both directly by affecting insulin sensitivity and indirectly by causing weight gain. Lifestyle modification interventions for prevention of diabetes should be an integral part of treatment of patients with schizophrenia. In the treatment of type 2 diabetes in patients with schizophrenia, communication and collaboration between medical care and psychiatric treatment providers are essential.

  16. Catalpol ameliorates diabetic atherosclerosis in diabetic rabbits

    PubMed Central

    Liu, Jiang-Yue; Zheng, Chen-Zhao; Hao, Xin-Ping; Zhang, Dai-Juan; Mao, An-Wei; Yuan, Ping

    2016-01-01

    Catalpol, isolated from the roots of Rehmanniaglutinosa, Chinese foxglove, is an iridoid glycoside with antioxidant, anti-inflammatory and anti-hyperglycemic agent. The present study was to investigate the effects of catalpol on diabetic atherosclerosis in alloxan-induced diabetic rabbits. Diabetes was induced in rabbits by a hyperlipidemic diet and intravenous injection of alloxan (100 mg/kg). Rabbits were treated for 12 weeks. The fasting blood glucose, insulin, homeostasis model of insulin resistance, total cholesterol and triglyceride were measured. The thoracic aorta was excised for histology. The plasma and vascular changes including some markers of oxidative stress, inflammatory cytokines and fibrosis factors were examined. Plasma levels of fasting blood glucose, insulin and homeostasis model of insulin resistance were significantly decreased in catalpol group. Catalpol treatment ameliorated diabetic atherosclerosis in diabetic rabbits as demonstrated by significantly inhibited neointimal hyperplasia and macrophages recruitment. Catalpol treatment also enhanced the activities of superoxide dismutase, glutathione peroxidase, and increased the plasma levels of total antioxidant status, meanwhile reduced the levels of malondialdehyde, protein carbonyl groups and advanced glycation end product. Furthermore, catalpol also reduced circulating levels of tumor necrosis factor-α, monocyte chemotactic protein-1 and vascular cell adhesion molecule-1. Catalpol also decreased transforming growth factor-β1 and collagen IV mRNA and protein expressions in the vessels. Catalpol exerts an ameliorative effect on atherosclerotic lesion in alloxan-induced diabetic rabbits. The possible mechanisms may be related to inhibition of oxidative stress inflammatory response and anti-fibrosis and reduced aggregation of extracellular matrix. PMID:27830011

  17. Race/Ethnic Difference in Diabetes and Diabetic Complications

    PubMed Central

    Spanakis, Elias K.; Golden, Sherita Hill

    2013-01-01

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

  18. [Diabetes and pregnancy].

    PubMed

    Zúñiga-González, S A

    1998-06-01

    Diabetes mellitus during pregnancy could result in severe or fatal complications to mother or the unborn product, like polyhydramnios, preeclampsia, abortion, neonatal asphyxia, macrosomia, stillbirth, and others, therefore is very important the early detection and treatment of diabetes. Gestacional Diabetes Mellitus (GDM) is the carbohydrate intolerance of variable severity first recognized during pregnancy. The screening test consist of 50 g of oral glucose and a plasma glucose measurement at one hour, regardless of the time of the last meal, and this may do in all pregnancies between 24 and 28 weeks of gestation. If plasma glucose level above 140 mg/dl results, a oral glucose tolerance test with 100 g must be done. This is the GDM diagnostic test. The risk factors for gestacional diabetes (older than 30 years of age, obesity, arterial hypertension, glucosury, previous GDM, family history of diabetes, family history of macrosomia) identify only 50% of pregnancies with gestacional diabetes, therefore, is necessary to screen all pregnancies who become pregnant, a strict control before pregnant is indispensable, with aim to slow congenital malformations probability and another complications. Gestacional diabetes prevalence in hispanic women in the U.S.A. is 12.3 percent. Diabetes mellitus prevalence in Mexico is about 2-6 percent. The goal of management of diabetes during pregnancy is the maintainance of fasting plasma glucose 105 mg/dl and 120 mg/dl two hours after meals. Treatment consist in diabetes education, diet with caloric needs calculation, exercise, and occasionally insulin. Is necessary the prenatal monitoring, the supervision of delivery or cesarean metabolic changes, and the postnatal monitoring of the mother and product.

  19. MicroRNA-26a Promotes Regulatory T cells and Suppresses Autoimmune Diabetes in Mice.

    PubMed

    Ma, Hui; Zhang, Shoutao; Shi, Doufei; Mao, Yanhua; Cui, Jianguo

    2016-02-01

    Type-1 diabetes (TID) is an autoimmune disease in which the body's own immune cells attack islet β cells, the cells in the pancreas that produce and release the hormone insulin. Mir-26a has been reported to play functions in cellular differentiation, cell growth, cell apoptosis, and metastasis. However, the role of microRNA-26a (Mir-26a) in autoimmune TID has never been investigated. In our current study, we found that pre-Mir-26a (LV-26a)-treated mice had significantly longer normoglycemic time and lower frequency of autoreactive IFN-γ-producing CD4(+) cells compared with an empty lentiviral vector (LV-Con)-treated non-obese diabetic (NOD) mice. Mir-26a suppresses autoreactive T cells and expands Tregs in vivo and in vitro. Furthermore, in our adoptive transfer study, the groups receiving whole splenocytes and CD25-depleted splenocytes from LV-Con-treated diabetic NOD mice develop diabetes at 3 to 4 weeks of age. In comparison, mice injected with undepleted splenocytes obtained from LV-26a-treated reversal NOD mice develop diabetes after 6-8 weeks. And depletion of CD25(+) cells in the splenocytes of reversed mice abrogates the delay in diabetes onset. In conclusion, Mir-26a suppresses autoimmune diabetes in NOD mice in part through promoted regulatory T cells (Tregs) expression.

  20. Undiagnosed Diabetes and Pre-Diabetes in Health Disparities

    PubMed Central

    Fisher-Hoch, Susan P.

    2015-01-01

    Globally half of all diabetes mellitus is undiagnosed. We sought to determine the extent and characteristics of undiagnosed type 2 diabetes mellitus and pre-diabetes in Mexican Americans residing in the United States. This disadvantaged population with 50% lifetime risk of diabetes is a microcosm of the current pandemic. We accessed baseline data between 2004 and 2014 from 2,838 adults recruited to our Cameron County Hispanic Cohort (CCHC); a two-stage randomly selected ‘Framingham-like’ cohort of Mexican Americans on the US Mexico border with severe health disparities. We examined prevalence, risk factors and metabolic health in diagnosed and undiagnosed diabetes and pre-diabetes. Two thirds of this Mexican American population has diabetes or pre-diabetes. Diabetes prevalence was 28.0%, nearly half undiagnosed, and pre-diabetes 31.6%. Mean BMI among those with diabetes was 33.5 kg/m2 compared with 29.0 kg/m2 for those without diabetes. Significant risk factors were low income and educational levels. Most with diabetes had increased waist/hip ratio. Lack of insurance and access to health services played a decisive role in failure to have diabetes diagnosed. Participants with undiagnosed diabetes and pre-diabetes had similar measures of poor metabolic health similar but generally not as severe as those with diagnosed diabetes. More than 50% of a minority Mexican American population in South Texas has diabetes or pre-diabetes and is metabolically unhealthy. Only a third of diabetes cases were diagnosed. Sustained efforts are imperative to identify, diagnose and treat individuals in underserved communities. PMID:26186342

  1. Type 2 Diabetes Risk Test

    MedlinePlus

    ... for signing up! engagement en -- Have Type 2 Diabetes? - 2017-03-lwt2d-en.html Have Type 2 Diabetes? ... 1-800-DIABETES (800-342-2383) Copyright 1995-2017. American Diabetes Association. All rights reserved. Use of this website ...

  2. Living With Diabetes: Foot Care

    MedlinePlus

    ... Online Chat Closed engagement en -- Have Type 2 Diabetes? - 2017-03-lwt2d-en.html Have Type 2 Diabetes? ... 1-800-DIABETES (800-342-2383) Copyright 1995-2017. American Diabetes Association. All rights reserved. Use of this website ...

  3. Living with Type 1 Diabetes

    MedlinePlus

    ... Online Chat Closed engagement en -- Have Type 2 Diabetes? - 2017-03-lwt2d-en.html Have Type 2 Diabetes? ... 1-800-DIABETES (800-342-2383) Copyright 1995-2017. American Diabetes Association. All rights reserved. Use of this website ...

  4. Contraception and the Adolescent Diabetic.

    ERIC Educational Resources Information Center

    Fennoy, Ilene

    1989-01-01

    Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

  5. Contraception and the Adolescent Diabetic.

    ERIC Educational Resources Information Center

    Fennoy, Ilene

    1989-01-01

    Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

  6. Animal models for diabetes: Understanding the pathogenesis and finding new treatments.

    PubMed

    King, Aileen; Bowe, James

    2016-01-01

    Diabetes mellitus is a lifelong, metabolic disease that is characterised by an inability to maintain normal glucose homeostasis. There are several different forms of diabetes, however the two most common are Type 1 and Type 2 diabetes. Type 1 diabetes is caused by the autoimmune destruction of pancreatic beta cells and a subsequent lack of insulin production, whilst Type 2 diabetes is due to a combination of both insulin resistance and an inability of the beta cells to compensate adequately with increased insulin release. Animal models are increasingly being used to elucidate the mechanisms underlying both Type 1 and Type 2 diabetes as well as to identify and refine novel treatments. However, a wide range of different animal models are currently in use. The majority of these models are suited to addressing certain specific aspects of diabetes research, but may be of little use in other studies. All have pros and cons, and selecting an appropriate model for addressing a specific question is not always a trivial task and will influence the study results and their interpretation. Thus, as the number of available animal models increases it is important to consider the potential roles of these models in the many different aspects of diabetes research. This review gathers information on the currently used experimental animal models of both Type 1 and Type 2 diabetes and evaluates their advantages and disadvantages for research purposes and details the factors that should be taken into account in their use. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Bacterial pneumonia: comparison between diabetics and non-diabetics.

    PubMed

    Akbar, D H

    2001-01-01

    To determine the causative organisms, antimicrobial susceptibility, and outcome of community- and hospital-acquired pneumonia in diabetics and to compare this with non-diabetics, sputum cultures done at King Abdulaziz University Hospital in the period between January 1998 and December 1999 were reviewed. A total of 354 cases were studied, of which 125 (35%) were diabetics. Diabetic patients were older with a male predominance compared to non-diabetics. H. influenza was the commonest pathogen in community-acquired pneumonia (CAP) in both diabetics and non-diabetics, but there was a predominance of Staphylococcus aureus in diabetics compared to non-diabetics. Gram-negative bacilli were the commonest pathogens in hospital-acquired pneumonia (HAP) in both diabetics and non-diabetics. Ampicillin, co-amoxyclav, flouroquinolones, second-generation cephalosporins and erythromycin were used empirically in CAP while aminoglycosides, fluoroquinolones and imipenem were used in HAP in both diabetics and non-diabetics. No significant difference in mortality was found between diabetics and non-diabetics, for either CAP or HAP.

  8. Pediatric obesity & type 2 diabetes.

    PubMed

    Dea, Tara L

    2011-01-01

    This article focuses on (a) identifying obesity and other risk factors for developing type 2 diabetes, (b) differentiating between pediatric type 1 diabetes and type 2 diabetes, and (c) treating pediatric type 2 diabetes. Obesity has significant implications on a child's health, including an increased risk for insulin resistance and progression to type 2 diabetes. Type 2 diabetes in children, characterized by insulin resistance and relative pancreatic b-cell failure due to the increased demand for insulin production, has now reached epidemic proportions. Longitudinal research on pediatric type 2 diabetes, however, is lacking because this epidemic is relatively new. Treatment of type 2 diabetes in children is focused on lifestyle modification with weight management/increased physical activity, and pharmacological management through oral medication or insulin therapy. Because children with type 2 diabetes are at risk for developing diabetes-related complications earlier in life, they need to be closely monitored for comorbidities.

  9. Genetic Counseling for Diabetes Mellitus

    PubMed Central

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

    2014-01-01

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

  10. Persistent arterial stiffness and endothelial dysfunction following successful pancreas-kidney transplantation in Type 1 diabetes.

    PubMed

    Stadler, M; Theuer, E; Anderwald, C; Hanusch-Enserer, U; Auinger, M; Bieglmayer, C; Quehenberger, P; Bischof, M; Kästenbauer, T; Wolzt, M; Wagner, O; Prager, R

    2009-10-01

    Successful simultaneous pancreas-kidney transplantation (SPK) in Type 1 diabetic (T1DM) patients results in improved cardiovascular outcome and survival. However, it is doubtful whether the impairment of cardiovascular and endothelial function in T1DM can be completely reversed. Pulse-wave velocity, stroke volume, heart rate, serological markers of endothelial dysfunction (soluble intercellular, vascular cell-adhesion molecules, E-selectin, and plasminogen-activator-inhibitor-1) were measured in 10 T1DM patients after SPK with non-diabetic glucose levels, 10 T1DM patients with poor [T1DM>8; glycated haemoglobin (HbA1c)>8%], and 10 with good glucose control (T1DM<7, HbA1c<7%), in 6 non-diabetic patients after kidney transplantation (KT) and 9 non-diabetic control subjects (CON), matching for major anthropometric characteristics. Pulse-wave velocity was increased in SPK (P < 0.02 vs. CON, KT, T1DM<7) and in T1DM>8 (P < 0.02 vs. T1DM<7). Systolic blood pressure was increased in SPK (P < 0.05 vs. CON). Stroke volume was reduced in SPK, T1DM>8 and T1DM<7 and KT (P < 0.01 vs. CON). Heart rate was elevated in SPK and in T1DM>8 (P < 0.0003 vs. CON and T1DM<7). In SPK, soluble intercellular and vascular cell-adhesion molecules were 100% and 44% higher (P < 0.03 vs. CON), respectively, while plasminogen-activator-inhibitor-1 was decreased in SPK (P < 0.02 vs. CON). T1DM patients after SPK experience arterial stiffness, a higher heart-rate and blood pressure, reduced stroke volume and serological signs of endothelial dysfunction. Thus, functional and structural cardiovascular alterations as a result of glucotoxicity, uraemia and hypertension in T1DM might not be completely resolved by SPK.

  11. Diabetes insipidus: historical aspects.

    PubMed

    Lindholm, Jörgen

    2004-01-01

    The contributions to our present knowledge and understanding of diabetes insipidus are briefly surveyed. Though a disease presenting with polyuria and thirst had been recognized since Antiquity, it was not until the 17. Century the distinction was made between diabetes insipidus and diabetes mellitus. At the beginning of the 20. Century almost nothing was known about the function of the pituitary. It was generally believed that diabetes insipidus was a renal disease. Two clinical observations in 1912 suggested an association between the hypophysis and diabetes insipidus. This view was supported by the recognition in 1913 that extract of the posterior lobe of the pituitary was effective in diabetes insipidus. Despite much evidence to the contrary, it was assumed that the antidiuretic hormone was produced in the intermediate lobe of the pituitary. Around 1950 it was finally established that 'the posterior lobe hormones' are in fact secreted in the hypothalamus. At the same time the antidiuretic hormone was isolated and synthesized. More recently, progress within genetics has made it possible to characterize in details other rare types of diabetes insipidus.

  12. [Diabetes and pregnancy].

    PubMed

    Schäfer-Graf, U M; Vetter, K

    1999-10-01

    Preexisting type-I-diabetes (incidence 0.8%) and gestational diabetes (3-5%) are the two manifestations of disturbed carbohydrate metabolism in pregnancy. Maternal hyperglycemia and the resulting excessive glucose supply for the fetus leads to fetal hyperinsulinism which is responsible for the complications in the offspring. The most important clinical manifestations are the excessive growth of the fetus (macrosomia), the risk of intrauterine death and the neonatal morbidity caused by hypoglycemia and the delay of maturation of lungs and liver. Women with type-I-diabetes require preconception counseling and optimizing of glucose control to reduce the rate of abortion and of congenital anomalies of the offspring. Furthermore kidney function and retinopathia should be evaluated preconceptionally. The management of diabetic pregnancies requires a tight cooperation of obstetricians and diabetologists. Blood glucose levels have to be lower than outside pregnancy. Gestational diabetes is diagnosed by a screening test with 50 g glucose for all women followed by a regular 75 g oGTT when the glucose value is > or = 140 mg%. In most of the women euglycemia can be achieved by diet and exercise. Women after pregnancies with gestational diabetes should be retested postnatally and counseled about their increased risk to develop diabetes in later life.

  13. Diabetes Health Disparities

    PubMed Central

    Peek, Monica E.; Cargill, Algernon; Huang, Elbert S.

    2008-01-01

    Racial and ethnic minorities bear a disproportionate burden of the diabetes epidemic; they have higher prevalence rates, worse diabetes control, and higher rates of complications. This article reviews the effectiveness of health care interventions at improving health outcomes and/or reducing diabetes health disparities among racial/ethnic minorities with diabetes. Forty-two studies met inclusion criteria. On average, these health care interventions improved the quality of care for racial/ethnic minorities, improved health outcomes (such as diabetes control and reduced diabetes complications), and possibly reduced health disparities in quality of care. There is evidence supporting the use of interventions that target patients (primarily through culturally tailored programs), providers (especially through one-on-one feedback and education), and health systems (particularly with nurse case managers and nurse clinicians). More research is needed in the areas of racial/ethnic minorities other than African Americans and Latinos, health disparity reductions, long-term diabetes-related outcomes, and the sustainability of health care interventions over time. PMID:17881626

  14. Vitamin D and diabetes

    PubMed Central

    MITRI, JOANNA; PITTAS, ANASTASSIOS G.

    2014-01-01

    Synopsis There has been increasing evidence suggesting that vitamin D may play an important role in modifying risk of diabetes. In this regard, Vitamin D has both direct and indirect effects, the latter via regulation of calcium effects on various mechanisms related to the pathophysiology of type 2 diabetes, including pancreatic beta cell dysfunction, impaired insulin action and systemic inflammation. The human evidence comes primarily from many cross-sectional and prospective observational studies, most of which showed an inverse association between vitamin D status and prevalence or incidence of type 2 diabetes. The effect of vitamin D supplementation on glycemia or incident type 2 diabetes has been reported in several trials with mixed results. The present article describes the biological plausibility behind the potential association between vitamin D and type 2 diabetes and summarizes the current evidence supporting a relation between vitamin D and type 2 diabetes and briefly reports on the potential association between vitamin D and type 1 diabetes. PMID:24582099

  15. Purinergic signalling and diabetes.

    PubMed

    Burnstock, Geoffrey; Novak, Ivana

    2013-09-01

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

  16. Diabetes in Cushing Disease.

    PubMed

    Mazziotti, G; Formenti, A M; Frara, S; Maffezzoni, F; Doga, M; Giustina, A

    2017-05-01

    This review focuses on the pathophysiological and clinical aspects of diabetes mellitus occurring in patients with Cushing disease (CD). Insulin resistance and impairment in insulin secretion are both involved in the pathogenesis of glucocorticoid-induced diabetes. Correction of glucocorticoid excess does not always resolve abnormalities of glucose homeostasis, and correction of hyperglycaemia is specifically required. In fact, insulin resistance may persist even after correction of glucocorticoid excess and diabetes needs to be treated for long term. On the other hand, emerging drugs used in the treatment of CD, such as the novel somatostatin analog pasireotide, may have direct effects on glucose homeostasis regardless of control of cortisol excess. Diabetes mellitus is a frequent and early complication of CD with important diagnostic, prognostic and therapeutic implications. Specifically, diagnosis of CD in patients with diabetes may be difficult due to potential misinterpretation of markers of cortisol hypersecretion. Moreover, diabetes mellitus is often difficult to be controlled in CD requiring a careful and dedicated therapeutic approach. Finally, the coexistence of diabetes may influence the therapeutic decision making in CD, since drugs used in this setting may variably influence glucose homeostasis regardless of control of hypercortisolism.

  17. Diabetes mellitus and suicide

    PubMed Central

    Sarkar, Siddharth; Balhara, Yatan Pal Singh

    2014-01-01

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

  18. Diabetes in Asians

    PubMed Central

    2015-01-01

    The prevalence of diabetes is increasing globally, particularly in Asia. According to the 2013 Diabetes Atlas, an estimated 366 million people are affected by diabetes worldwide; 36% of those affected live in the Western Pacific region, with a significant proportion in East Asia. The reasons for this marked increase in the prevalence of diabetes can be extrapolated from several distinct features of the Asian region. First, the two most populated countries, China and India, are located in Asia. Second, Asians have experienced extremely rapid economic growth, including rapid changes in dietary patterns, during the past decades. As a result, Asians tend to have more visceral fat within the same body mass index range compared with Westerners. In addition, increased insulin resistance relative to reduced insulin secretory function is another important feature of Asian individuals with diabetes. Young age of disease onset is also a distinctive characteristic of these patients. Moreover, changing dietary patterns, such as increased consumption of white rice and processed red meat, contributes to the deteriorated lifestyle of this region. Recent studies suggest a distinctive responsiveness to novel anti-diabetic agents in Asia; however, further research and efforts to reverse the increasing prevalence of diabetes are needed worldwide. PMID:26435131

  19. [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.

  20. [Type 2 diabetes complications].

    PubMed

    Schlienger, Jean-Louis

    2013-05-01

    People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies.

  1. Milk and diabetes.

    PubMed

    Schrezenmeir, J; Jagla, A

    2000-04-01

    Type 1 diabetes is based on autoimmunity, and its development is in part determined by environmental factors. Among those, milk intake is discussed as playing a pathogenic role. Geographical and temporal relations between type 1 diabetes prevalence and cow's milk consumption have been found in ecological studies. Several case-control studies found a negative correlation between frequency and/or duration of breast-feeding and diabetes, but this was not confirmed by all authors. T-cell and humoral responses related to cow's milk proteins were suggested to trigger diabetes. The different findings of studies in animals and humans as well as the potential underlying mechanisms with regard to single milk proteins (bovine serum albumin, beta-lactoglobulin, casein) are discussed in this review. In contrast to type 1 diabetes, the etiology of type 2 diabetes, characterized by insulin resistance is still unclear. In a population with a high prevalence of type 2 diabetes, the Pima Indians, people who were exclusively breastfed had significantly lower rates of type 2 diabetes than those who were exclusively bottlefed. Studies in lactovegetarians imply that consumption of low fat dairy products is associated with lower incidence and mortality of diabetes and lower blood pressures. In contrast, preference for a diet high in animal fat could be a pathogenic factor, and milk and high fat dairy products contribute considerably to dietary fat intake. Concerning milk fat composition, the opposite effects of various fatty acids (saturated fatty acids, trans-fatty acids, conjugated linoleic acid) in vitro, in animals and in humans have to be considered.

  2. Osteopenia in juvenile diabetes.

    PubMed

    Shore, R M; Chesney, R W; Mazess, R B; Rose, P G; Bargman, G J

    1981-01-01

    The bone mineral status of fifty-one children with diabetes mellitus was studied by single photon absorptiometry. The mean bone mineral content was 13% below values predicted by age, sex, height, and weight. Those children whose diabetes was one year or less in duration were as osteopenic as those whose diabetes was of longer duration. The demineralized children received a higher daily insulin dose than others. No association was noted between the degree of skeletal demineralization and sex, statural growth, renal function, and serum calcium and phosphorus. No significant changes in bone mineral content were noted longitudinally.

  3. Multiple Myeloma and Diabetes

    PubMed Central

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

    2011-01-01

    Multiple myeloma is a malignant plasma cell disorder that accounts for approximately 10% of all hematologic cancers. It is characterized by accumulation of clonal plasma cells, predominantly in the bone marrow. The prevalence of type 2 diabetes is increasing; therefore, it is expected that there will be an increase in the diagnosis of multiple myeloma with concomitant diabetes mellitus. The treatment of multiple myeloma and diabetes mellitus is multifaceted. The coexistence of the two conditions in a patient forms a major challenge for physicians. PMID:22363889

  4. 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

  5. Obesity and diabetes.

    PubMed

    Riobó Serván, Pilar

    2013-09-01

    Type 2 diabetes mellitus is characterized by hyperglycemia, insulin resistance, and relative impairment in insulin secretion and its possible long term complications. Its pathogenesis is poorly understood, but both genetic and environmental factors, such as obesity and aging, play a key role. "Diabesity" is a new term which refers to diabetes occurring in the context of obesity. In this article, we will discuss the epidemiology and impact of diabetes and obesity and will also outline the components of the metabolic syndrome and the studies that demonstrate that screening and prevention are possible in an attempt to control this epidemic.

  6. Diabetic radiculoplexus neuropathies.

    PubMed

    Laughlin, Ruple S; Dyck, P James B

    2014-01-01

    Diabetic radiculoplexus neuropathies (DRPN) are neuropathies clinically and pathologically distinct from the neuropathy typically associated with diabetes (DPN). DRPN are usually subacute in onset, painful, and often demonstrate a monophasic course with incomplete recovery. Pathologically, these neuropathies are due to ischemic injury from altered immunity and often have features suggestive or diagnostic of microvasculitis. Unlike DPN, immune therapy may be helpful in treatment of these conditions given their pathological substrate and therefore are important to identify early and distinguish from other neuropathies that occur in patient with diabetes.

  7. Diabetes prevention programs.

    PubMed

    Ramachandran, A; Snehalatha, C

    2011-03-01

    Primary prevention of type 2 diabetes is effective for curbing its epidemic. Lifestyle intervention has been found to be a highly effective, safe, and cost-effective method for the prevention of diabetes in high-risk persons, the benefit of which can extend for many years. Among the pharmacologic agents studied for prevention of diabetes, metformin has been found to be the safest. Interventions using drugs are less preferred because the drugs' effects tend to dissipate after their use is stopped and adverse effects may also result. The major challenge is to translate current knowledge into prevention programs at the national level. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. [Diabetes and social deprivation].

    PubMed

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

    2012-01-01

    Diabetes prevalence is frequently associated with low socioeconomic status (SES), but little is known about the relationship between SES and diabetes control, follow-up and quality of life. We evaluated SES by using the EPICES score, an individual index of deprivation (Evaluation de la Précarité et des Inégalités de Santé dans les Centres d'Examen de Santé; Evaluation of Precariousness and Inequalities in Health Examination Centers). A total of 1686 subjects aged from 25 to 85 years were selected at random in Montpellier and 154 in Narbonne, of whom 126 were managed by a care network including diabetologists, general practitioners and nurses. Capillary glycemia, the body mass index (BMI), waist circumference (WC), and blood pressure were measured in all the subjects. HbA1c was measured in subjects with above-normal glycemia. Five hundred sixty-four subjects from the study population (190 diabetic patients, 292 subjects with non diabetic hyperglycemia, and 86 euglycemic subjects) were clinically evaluated and asked to complete a questionnaire covering socioeconomic status and diet. The data were then compared between deprived and non deprived subjects. One hundred sixty-one diabetic patients had a clinical examination and completed a detailed questionnaire including their history, therapy, control and follow-up of diabetes, perception of diabetes, quality of life, socioeconomic status and diet. The data were then compared between deprived and non deprived patients. One hundred twenty-six diabetic subjects managed by the AUDIAB care network were compared with 163 diabetics recruited in Montpellier, based on the same investigations and the same questionnaires. The data were compared between the overall patients and between deprived and non deprived patients. In the overall population, deprived subjects were younger and more frequently smokers, and had higher BMI than non deprived subjects. The overall prevalence of type 2 diabetes was 8.1%. Among patients

  9. Prevalence of diabetes and pre-diabetes in Kansas.

    PubMed

    Ablah, Elizabeth; Dong, Frank; Cupertino, Ana Paula; Konda, Kurt; Johnston, Judy A; Collins, Tracie

    2013-01-01

    The study objective was to determine the prevalence of diabetes and prediabetes among rural and urban populations in Kansas. This study utilized 2009 BRFSS data and included 18,912 respondents. Participants were identified through a stratified random sample of adult Kansans, living in a non-institutionalized setting, and with access to a land-based telephone line. Analyses were conducted using SAS to provide descriptive statistics for groups based on diabetes status. A logistic regression was conducted to explore significant variables associated with the likelihood of diabetes. Diabetes prevalence was lower among urban (11.8%) populations than rural (12.7%) areas of Kansas, but the inverse was true for pre-diabetes (3.7% urban, 3.1% in rural). Lower income and lower levels of educational attainment were associated with increased rates of diabetes and pre-diabetes, with the highest prevalence levels overall found among rural Latinos (19.3%) and urban African Americans (22.9%). Multivariate regression suggests that age, income, ethnicity, education, sex, rural vs urban status, and race all served as significant predicators of diabetes, net of other factors. Rural residents were more likely than urban residents to report having diabetes, whereas urban residents were more likely than rural residents to report having pre-diabetes. Although rural vs urban status played a significant role in the model's predicative ability for diabetes and pre-diabetes diagnosis, increased age was by far the most significant factor in diabetes and pre-diabetes diagnosis.

  10. Mincle Signaling Promotes Con A Hepatitis.

    PubMed

    Greco, Stephanie H; Torres-Hernandez, Alejandro; Kalabin, Aleksandr; Whiteman, Clint; Rokosh, Rae; Ravirala, Sushma; Ochi, Atsuo; Gutierrez, Johana; Salyana, Muhammad Atif; Mani, Vishnu R; Nagaraj, Savitha V; Deutsch, Michael; Seifert, Lena; Daley, Donnele; Barilla, Rocky; Hundeyin, Mautin; Nikifrov, Yuriy; Tejada, Karla; Gelb, Bruce E; Katz, Steven C; Miller, George

    2016-10-01

    Con A hepatitis is regarded as a T cell-mediated model of acute liver injury. Mincle is a C-type lectin receptor that is critical in the immune response to mycobacteria and fungi but does not have a well-defined role in preclinical models of non-pathogen-mediated inflammation. Because Mincle can ligate the cell death ligand SAP130, we postulated that Mincle signaling drives intrahepatic inflammation and liver injury in Con A hepatitis. Acute liver injury was assessed in the murine Con A hepatitis model using C57BL/6, Mincle(-/-), and Dectin-1(-/-) mice. The role of C/EBPβ and hypoxia-inducible factor-1α (HIF-1α) signaling was assessed using selective inhibitors. We found that Mincle was highly expressed in hepatic innate inflammatory cells and endothelial cells in both mice and humans. Furthermore, sterile Mincle ligands and Mincle signaling intermediates were increased in the murine liver in Con A hepatitis. Most significantly, Mincle deletion or blockade protected against Con A hepatitis, whereas Mincle ligation exacerbated disease. Bone marrow chimeric and adoptive transfer experiments suggested that Mincle signaling in infiltrating myeloid cells dictates disease phenotype. Conversely, signaling via other C-type lectin receptors did not alter disease course. Mechanistically, we found that Mincle blockade decreased the NF-κβ-related signaling intermediates C/EBPβ and HIF-1α, both of which are necessary in macrophage-mediated inflammatory responses. Accordingly, Mincle deletion lowered production of nitrites in Con A hepatitis and inhibition of both C/EBPβ and HIF-1α reduced the severity of liver disease. Our work implicates a novel innate immune driver of Con A hepatitis and, more broadly, suggests a potential role for Mincle in diseases governed by sterile inflammation.

  11. Mincle Signaling Promotes Con-A Hepatitis

    PubMed Central

    Greco, Stephanie H.; Torres-Hernandez, Alejandro; Kalabin, Aleksandr; Whiteman, Clint; Rokosh, Rae; Ravirala, Sushma; Ochi, Atsuo; Gutierrez, Johana; Salyana, Muhammad Atif; Mani, Vishnu R.; Nagaraj, Savitha V.; Deutsch, Michael; Seifert, Lena; Daley, Donnele; Barilla, Rocky; Hundeyin, Mautin; Nikifrov, Yuriy; Tejada, Karla; Gelb, Bruce E.; Katz, Steven C.; Miller, George

    2016-01-01

    Concanavalin-A (Con-A) hepatitis is regarded as a T cell-mediated model of acute liver injury. Mincle is a C-type lectin receptor (CLR) that is critical in the immune response to mycobacteria and fungi, but does not have a well-defined role in pre-clinical models of non-pathogen mediated inflammation. Since Mincle can ligate the cell death ligand SAP130, we postulated that Mincle signaling drives intrahepatic inflammation and liver injury in Con-A hepatitis. Acute liver injury was assessed in the murine Con-A hepatitis model using C57BL/6, Mincle−/−, and Dectin-1−/− mice. The role of C/EBPβ and HIF-1α signaling was assessed using selective inhibitors. We found that Mincle was highly expressed in hepatic innate inflammatory cells and endothelial cells in both mice and humans. Furthermore, sterile Mincle ligands and Mincle signaling intermediates were increased in the murine liver in Con-A hepatitis. Most significantly, Mincle deletion or blockade protected against Con-A hepatitis whereas Mincle ligation exacerbated disease. Bone marrow chimeric and adoptive transfer experiments suggested that Mincle signaling in infiltrating myeloid cells dictates disease phenotype. Conversely, signaling via other CLRs did not alter disease course. Mechanistically, we found that Mincle blockade decreased the NF-κβ related signaling intermediates, C/EBPβ and HIF-1α, both of which are necessary in macrophage-mediated inflammatory responses. Accordingly, Mincle deletion lowered production of nitrites in Con-A hepatitis and inhibition of both C/EBPβ and HIF1-α reduced the severity of liver disease. Our work implicates a novel innate immune driver of Con-A hepatitis and, more broadly, suggests a potential role for Mincle in diseases governed by sterile inflammation. PMID:27559045

  12. Infant of diabetic mother

    MedlinePlus

    ... ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 39. Moore TR, Hauguel-De Mouzon S, Catalano P. Diabetes in ... Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene MF, eds. Creasy and Resnik's Maternal- ...

  13. Cardiovascular Disease and Diabetes

    MedlinePlus

    ... loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least ... has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and ...

  14. Type 1 diabetes

    MedlinePlus

    ... sure your kidneys are working well ( microalbuminuria and serum creatinine ). Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease . See the dentist every 6 months for a ...

  15. Diabetic Eye Problems

    MedlinePlus

    ... too high. Over time, this can damage your eyes. The most common problem is diabetic retinopathy. It ... light-sensitive tissue at the back of your eye. You need a healthy retina to see clearly. ...

  16. Diabetes - eye care

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000078.htm Diabetes - eye care To use the sharing features on this ... prevent them from getting worse. You Need Regular eye Exams Every year, you should have an eye ...

  17. Causes of Diabetes

    MedlinePlus

    ... check out these Body Mass Index (BMI) charts . Insulin resistance Type 2 diabetes usually begins with insulin ... of pregnancy along with genetic and lifestyle factors. Insulin resistance Hormones produced by the placenta contribute to ...

  18. Diabetes Type 1

    MedlinePlus

    ... type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over ...

  19. Medicines for Diabetes

    MedlinePlus

    ... kid stay healthy and feel good. All About Insulin The most common diabetes medicine is insulin, which ... lower blood sugar how long they last continue Insulin Table The table below shows the types of ...

  20. Diabetes and Wound Angiogenesis

    PubMed Central

    Okonkwo, Uzoagu A.; DiPietro, Luisa A.

    2017-01-01

    Diabetes Mellitus Type II (DM2) is a growing international health concern with no end in sight. Complications of DM2 involve a myriad of comorbidities including the serious complications of poor wound healing, chronic ulceration, and resultant limb amputation. In skin wound healing, which has definite, orderly phases, diabetes leads to improper function at all stages. While the etiology of chronic, non-healing diabetic wounds is multi-faceted, the progression to a non-healing phenotype is closely linked to poor vascular networks. This review focuses on diabetic wound healing, paying special attention to the aberrations that have been described in the proliferative, remodeling, and maturation phases of wound angiogenesis. Additionally, this review considers therapeutics that may offer promise to better wound healing outcomes. PMID:28671607

  1. Diabetes Interactive Atlas

    PubMed Central

    Burrows, Nilka R.; Geiss, Linda S.

    2014-01-01

    The Diabetes Interactive Atlas is a recently released Web-based collection of maps that allows users to view geographic patterns and examine trends in diabetes and its risk factors over time across the United States and within states. The atlas provides maps, tables, graphs, and motion charts that depict national, state, and county data. Large amounts of data can be viewed in various ways simultaneously. In this article, we describe the design and technical issues for developing the atlas and provide an overview of the atlas’ maps and graphs. The Diabetes Interactive Atlas improves visualization of geographic patterns, highlights observation of trends, and demonstrates the concomitant geographic and temporal growth of diabetes and obesity. PMID:24503340

  2. "Diabetes has instant consequences…"

    MedlinePlus

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

  3. Type I diabetes (image)

    MedlinePlus

    ... high levels of glucose in the blood, the insulin-producing cells in the pancreas secrete the hormone insulin. Type I diabetes occurs when these cells are destroyed by the body's own immune system.

  4. Dietary survey of diabetics.

    PubMed Central

    Hackett, A F; Court, S; McCowen, C; Parkin, J M

    1986-01-01

    This study of 168 diabetic children from Tyneside and Teeside aimed to record what the children actually ate and to compare this with both their prescribed diet and current recommendations. The amounts of energy consumed were similar to those expected of non-diabetic children, but the components of the diabetic children's diets were different, consisting of more fat and fibre, but less sugars and carbohydrates. They ate more carbohydrate than prescribed but less than current recommendations as there was a shortfall between the amount prescribed and that suggested in the recommendations. Diabetic control was related to the amount of fibre consumed and to compliance with the prescribed diet, but not to the proportion of energy taken as carbohydrate. The insulin dose was slightly lower in those children eating more fibre. PMID:3006604

  5. Diabetic Retinopathy Analysis.

    PubMed

    Sivakumar, R; Ravindran, G; Muthayya, M; Lakshminarayanan, S; Velmurughendran, C U

    2005-01-01

    Diabetic retinopathy is one of the common complications of diabetes. Unfortunately, in many cases the patient is not aware of any symptoms until it is too late for effective treatment. Through analysis of evoked potential response of the retina, the optical nerve, and the optical brain center, a way will be paved for early diagnosis of diabetic retinopathy and prognosis during the treatment process. In this paper, we present an artificial-neural-network-based method to classify diabetic retinopathy subjects according to changes in visual evoked potential spectral components and an anatomically realistic computer model of the human eye under normal and retinopathy conditions in a virtual environment using 3D Max Studio and Windows Movie Maker.

  6. Hyperglycemia and Diabetic Ketoacidosis

    MedlinePlus

    ... Because the body can't use glucose for energy properly, kids with hyperglycemia may be unusually tired. continue Checking for High Blood Sugar Levels As part of the diabetes management plan, you'll need to check your child's ...

  7. Diabetic nephropathy and pregnancy.

    PubMed

    Landon, Mark B

    2007-12-01

    Diabetic nephropathy, the most common etiology for end-stage renal disease, complicates approximately 5% of insulin-dependent diabetic pregnancies. Assessment for vasculopathy is important before pregnancy because nephropathy can increase perinatal risks including potential for preeclampsia and preterm birth. Counseling women receiving renoprotective medications including angiotensin converting enzyme inhibitors has recently become complicated in light of new information suggesting a teratogenic risk for these agents. Most reproductive age women with overt diabetic nephropathy have preserved renal function and do not seem to have the progression of their disease affected by pregnancy. Perinatal outcomes are excellent for these women who have received care in tertiary institutions. However, there are relatively few women with significant renal impairment included in case series of pregnancies complicated by diabetic nephropathy. For these women, adverse perinatal outcomes are more common, and the effect of pregnancy on the course of their disease is less certain.

  8. EASD Diabetes Technology Meeting

    PubMed Central

    2014-01-01

    The first diabetes technology meeting organized by the European Diabetes Association covers the range from regulatory aspects, patient safety, about registries to clinical studies. After an intensive discussion about the evidence required for registration and reimbursement on new medical devices and in vitro diagnostics it becomes clear that more and better clinical trials will be required in the future. This was also highlighted by representatives of the American Diabetes Association. The 2 associations will be active in this field of research by a joint committee. This meeting is intended not to become a large-scale meeting focused on education but to provide a platform for an open discussion of experts involved in all areas that are relevant to achieve a meaningful usage of diabetes technology. PMID:24876444

  9. Diabetes and Alzheimer's Linked

    MedlinePlus

    ... cause pain in your feet or hands (diabetic neuropathy) Digestive problems (gastroparesis) Steps to prevent or manage ... home. Accessed Feb. 3, 2016. March 23, 2016 Original article: http://www.mayoclinic.org/diseases-conditions/alzheimers- ...

  10. Diabetes and eye disease

    MedlinePlus

    ... have damage to the blood vessels in your eye, some types of exercise can make the problem worse. Check with your health care provider before starting an exercise program. Other eye problems that can occur in people with diabetes ...

  11. Diabetic hyperglycemic hyperosmolar syndrome

    MedlinePlus

    ... 2 diabetes . It involves extremely high blood sugar (glucose) level without the presence of ketones. ... is a condition of: Extremely high blood sugar (glucose) level Extreme lack of water ( dehydration ) Decreased alertness ...

  12. Teen Diabetes Quiz Answers

    MedlinePlus

    ... Javascript on. Answer: B Diabetes causes your blood glucose to be too high. Glucose comes from the food you eat and is needed to fuel our bodies. Glucose is also stored in our liver and muscles. ...

  13. Type 2 diabetes

    MedlinePlus

    ... which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the ... stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored ...

  14. Cannabis masks diabetic ketoacidosis.

    PubMed

    Hennessy, Annemarie

    2011-10-04

    This is the first series to identify that diabetic ketosis presenting in cannabis users has a different and conflicting acid base profile compared to non-cannabis users and can confuse the need for intensive or critical care in these at-risk patients. This association of drugtaking history and clinical presentation has implications for how the authors treat the drug using sector of the population with diabetes.

  15. Peripheral neuropathy in diabetes.

    PubMed

    Majumder, A; Chatterjee, S; Maji, D

    2013-06-01

    Peripheral neuropathy is common complication of diabetes. The prevalence of peripheral neuropathy among diabetic patients on the basis of loss of vibration sensation had been studied. Detailed clinical history of each patient including age, gender, duration of diabetes, foot ulcer and biothesiometry was recorded in 211 diabetic patients between 20 and 80 years of age. It was observed that all patients under 30 years age (n = 8) felt vibration below 15 volts (no risk zone); 77% (24 out of 31) of the patients in the age group of 30-39 years were in the no risk zone, and 23% (n = 7) had mild peripheral neuropathy. Sixty per cent of the patients between 40 and 50 years (n = 44) were in the no risk zone, while 32% (n = 24) had mild peripheral neuropathy, 5% (n = 4) had moderate neuropathy and 3% (n = 2) had severe peripheral neuropathy. Amongst patients above 50 years of age, 31% (n = 31) were in no risk zone, 34% (n = 34) had mild peripheral neuropathy, 22% (n = 20) had moderate peripheral neuropathy and 13% (n = 13) had severe peripheral neuropathy. Of the patients with diabetes for less than 5 years, 58% had no neuropathy, and only 3% had severe neuropathy. Of the patients with diabetes for 5 to 15 years, 50% had no neuropathy, 30% had mild, and 10% had severe peripheral neuropathy. When patients with diabetes for over 15 years were studied, only 6% had no neuropathy and 19% had severe peripheral neuropathy. The study re-establishes that the severity of peripheral neuropathy increases with age and vibration perception decreses progressively with increased duration of diabetes. Vibration perception threshold testing helps to identify the high risk subjects who require special counselling and education to protect their feet.

  16. Diabetes insipidus in pregnancy

    PubMed Central

    Hague, William M

    2009-01-01

    Diabetes insipidus is an uncommon condition with various aetiologies. Recent research has uncovered new mechanisms underlying the syndrome. Careful attention to management is essential in pregnant women to avoid serious complications. Diabetes insipidus in pregnancy may be due to relative reduction in secretion of AVP from the posterior pituitary (cranial DI), increase in breakdown of AVP by placental cystine aminopeptidase with vasopressinase activity, or resistance of the rental tubules to AVP (nephrogenic DI). PMID:27579058

  17. [Nephrogenic diabetes insipidus].

    PubMed

    Bichet, Daniel Georges

    2006-11-01

    Nephrogenic diabetes insipidus which can be inherited or acquired, is characterized by an inability to concentrate urine despite normal or elevated plasma concentrations of the antidiuretic hormone, arginine-vasopressine (AVP). Polyuria, with hyposthenuria and polydipsia are the cardinal clinical manifestations of the disease. Hypercalcemia, hypokaliemia, lithium administration and chronic renal failure are the principal causes of acquired nephrogenic diabetes insipidus. About 90 percent of patients with congenital nephrogenic diabetes insipidus are males with X-linked recessive nephrogenic diabetes insipidus who have mutations in the arginine-vasopressin receptor 2 (AVPR2) gene that codes for the vasopressin V2 receptor. The gene is located in chromosome region Xq28. In about 10 percent of the families studied, congenital nephrogenic diabetes insipidus has an autosomal recessive or autosomal dominant mode of inheritance. In these cases, mutations have been identified in the aquaporin-2 gene (AQP2), which is located in chromosome region 12q13 and codes for the vasopressin-sensitive water channel. Other inherited disorders with mild, moderate or severe inability to concentrate urine include Bartter's syndrome and Cystinosis. Identification of the molecular defect underlying congenital nephrogenic diabetes insipidus is of immediate clinical significance because early diagnosis and treatment of affected infants can avert the physical and mental retardation associated with episodes of dehydration.

  18. Hyperprolactinaemia in male diabetics.

    PubMed Central

    Mooradian, A. D.; Morley, J. E.; Billington, C. J.; Slag, M. F.; Elson, M. K.; Shafer, R. B.

    1985-01-01

    We recently investigated two patients with diabetes and elevated serum prolactin levels in whom no cause of hyperprolactinaemia could be found. For this reason we measured fasting serum prolactin levels in 72 diabetic males and compared the results with those of 63 healthy males and 90 nondiabetic males attending an Impotence Clinic. The diabetic group had significantly higher serum prolactin levels (13.1 +/- 0.9 ng/ml) than the two control groups (9.9 +/- 0.6 ng/ml for normal males and 7.7 +/- 0.3 ng/ml for the non-diabetic impotent group). Eighteen percent of the diabetics studied had serum prolactin levels above the normal range for males (greater than 20 ng/ml). There was no correlation between serum prolactin levels and duration of diabetes, glycosylated haemoglobin level or presence of clinically apparent retinopathy. The correlation between serum prolactin level and fasting plasma glucose was weak though statistically significant (r = 0.26, P less than 0.05). PMID:3991396

  19. Digital Diabetes Congress 2017.

    PubMed

    Klonoff, David C; Kerr, David; Wong, Jenise C; Pavlovic, Yarmela; Koliwad, Suneil; Hu, Julia; Salber, Patricia; Aguilera, Adrian; Long, William; Hamilton, Giles; Chen, Kong Y; Adi, Saleh

    2017-09-01

    The purpose of developing mobile applications for diabetes is generally to: (1) provide enhanced access to timely information for patients, health care professionals, and researchers; (2) facilitate remote monitoring and diagnosis of patients, often based on information delivered by wearable devices; (3) provide decision support to assist patients in selecting treatment; or (4) deliver timely recommendations for treatment to increase adherence to prescribed therapy. There is a perception that mobile applications can provide meaningful clinical benefits, however, there is only sparse convincing evidence to support this belief at the present time. Compounding this problem is the short life span of digital software, such that if a traditional type of randomized controlled trial is conducted on a product, by the time the study has been designed, approved by an IRB, conducted, and analyzed, the product might have significantly changed to a next generation system. Because of great interest in establishing what are the potential benefits, metrics of success, and appropriate components of mobile applications for diabetes, Diabetes Technology Society and William Sansum Diabetes Center launched the Digital Diabetes Congress, March 7-8, 2017, in San Francisco. This report contains summaries of the meeting's 12 sessions. Each summary was written by the session's moderator who helped develop the session prior to the event and keep it on track during the event. This meeting report presents a summary of how 57 panelists, speakers, and moderators, who are leaders in digital health, see the current and future landscape of digital health tools applied to diabetes.

  20. Where frailty meets diabetes.

    PubMed

    Perkisas, Stany; Vandewoude, Maurits

    2016-01-01

    Diabetes is a chronic illness that has an effect on multiple organ systems. Frailty is a state of increased vulnerability to stressors and a limited capacity to maintain homeostasis. It is a multidimensional concept and a dynamic condition that can improve or worsen over time. Frailty is either physical or psychological or a combination of these two components. Sarcopenia, which is the age-related loss of skeletal muscle mass and strength, is the main attributor to the physical form of frailty. Although the pathophysiology of diabetes is commonly focused on impaired insulin secretion, overload of gluconeogenesis and insulin resistance, newer insights broaden this etiologic horizon. Immunologic factors that create a chronic state of low-grade inflammation--'inflammaging'--have an influence on both the ageing process and diabetes. Persons with diabetes mellitus already tend to have an accelerated ageing process that places them at greater risk for developing frailty at an earlier age. The development of frailty--and sarcopenia--is multifactorial and includes nutritional, physical and hormonal elements; these elements are interlinked with those of diabetes. A lower muscle mass will lead to poorer glycaemic control through lower muscle glucose uptake. This leads to higher insulin secretion and insulin resistance, which is the stepping stone for diabetes itself.

  1. Diabetic patients: Psychological aspects.

    PubMed

    Adili, Fatemeh; Larijani, Bagher; Haghighatpanah, Mohammadreza

    2006-11-01

    This study was undertaken to consider the psychological aspect of diabetes with regard to improving clinical outcomes. The review was limited to literature reports on the causes, solutions, and treatments of some common psychological problems known to complicate diabetes management. A literature search was undertaken using Pub-Med, CINAHL, Proquest, Elsevier, Blackwell Synergy, Ovid, Ebsco, Rose net, and Google websites, including studies published in English journals between 1995 and 2006. Therefore about 88 articles were selected based on the inclusion criteria. In earlier studies, relatively little empirical research was found to substantiate the effect of psychological counseling in complicated diabetes. The greatest deficits were seen in areas of mental health, self-esteem parent impact, and family cohesion. There were some different factors, which influence the psychological aspect of diabetic patients, such as age, gender, place of living, familial and social support, motivation, energy, life satisfaction, and lifestyle. There are various types of solutions for coping with the psychological problems in diabetic clients. The most essential solution lies in educating the patients and healthcare providers on the subject. Before initiating each educational intervention, a thorough assessment would be crucial. Treatment plans may benefit from cognitive behavior therapy (CBT), behavior family therapy, improving family communication, problem-solving skills, and providing motivation for diabetic patients. Moreover, it seems that the close collaboration between diabetologists and psychologists would be fruitful.

  2. Osteoporosis, Fractures, and Diabetes

    PubMed Central

    2014-01-01

    It is well established that osteoporosis and diabetes are prevalent diseases with significant associated morbidity and mortality. Patients with diabetes mellitus have an increased risk of bone fractures. In type 1 diabetes, the risk is increased by ∼6 times and is due to low bone mass. Despite increased bone mineral density (BMD), in patients with type 2 diabetes the risk is increased (which is about twice the risk in the general population) due to the inferior quality of bone. Bone fragility in type 2 diabetes, which is not reflected by bone mineral density, depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers and examination methods are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. One of these methods can be trabecular bone score. The aim of the paper is to present the present state of scientific knowledge about the osteoporosis risk in diabetic patient. The review also discusses the possibility of problematic using the study conclusions in real clinical practice. PMID:25050121

  3. Diabetic corneal neuropathy.

    PubMed Central

    Schultz, R O; Peters, M A; Sobocinski, K; Nassif, K; Schultz, K J

    1983-01-01

    Corneal epithelial lesions can be found in approximately one-half of asymptomatic patients with diabetes mellitus. These lesions are transient and clinically resemble the keratopathy seen in staphylococcal keratoconjunctivitis. Staphylococcal organisms, however, can be isolated in equal percentages from diabetic patients without keratopathy. Diabetic peripheral neuropathy was found to be related to the presence of diabetic keratopathy after adjusting for age with analysis of covariance. The strongest predictor of both keratopathy and corneal fluorescein staining was vibration perception threshold in the toes (P less than 0.01); and the severity of keratopathy was directly related to the degree of diminution of peripheral sensation. Other predictors of keratopathy were: reduced tear breakup time (P less than 0.03), type of diabetes (P less than 0.01), and metabolic status as indicated by c-peptide fasting (P less than 0.01). No significant relationships were found between the presence of keratopathy and tear glucose levels, endothelial cell densities, corneal thickness measurements, the presence of S epidermidis, or with duration of disease. It is our conclusion that asymptomatic epithelial lesions in the nontraumatized diabetic cornea can occur as a manifestation of generalized polyneuropathy and probably represent a specific form of corneal neuropathy. Images FIGURE 1 FIGURE 2 FIGURE 3 PMID:6676964

  4. Diabetes and pancreatic cancer.

    PubMed

    Burney, Saira; Irfan, Khadija; Saif, Muhammad Wasif; Masud, Faisal

    2014-07-28

    Research suggests a possible link between type 2 diabetes and several malignancies. Animal models have shown that hyperinsulinemic state underlying diabetes promotes tumor formation through stimulation of insulin-IGF-1 pathway; a possible role of inflammation is also proposed. One such link which has been under considerable study for years is that between diabetes and pancreatic cancer. Although epidemiological evidence points towards a reciprocal link between the two, the cause-effect relationship still remains unclear. This link was the subject of a large German epidemiological study presented at the American Society of Clinical Oncology Annual Meeting 2014 (Abstract #1604), which underscored the link between diabetes and some cancers. Schmidt et al. performed a retrospective database analysis over a 12 year period and reported an increased risk of certain types of cancer in diabetic patients. The most significant association (HR 2.17) was found for pancreatic cancer. Given the high mortality of pancreatic cancer, prevention through timely screening could play an important role in improving prognosis. Older subjects with recent-onset diabetes represent a high-risk group and hence are potential targets for pancreatic cancer screening thereby enabling its early diagnosis at a curable stage.

  5. Zinc and Diabetic Retinopathy

    PubMed Central

    Miao, Xiao; Sun, Weixia; Miao, Lining; Fu, Yaowen; Wang, Yonggang; Su, Guanfang; Liu, Quan

    2013-01-01

    Zinc (Zn) is an important nutrient that is involved in various physiological metabolisms. Zn dyshomeostasis is often associated with various pathogeneses of chronic diseases, such as metabolic syndrome, diabetes, and related complications. Zn is present in ocular tissue in high concentrations, particularly in the retina and choroid. Zn deficiencies have been shown to affect ocular development, cataracts, age-related macular degeneration, and even diabetic retinopathy. However, the mechanism by which Zn deficiency increases the prevalence of diabetic retinopathy remains unclear. In addition, due to the negative effect of Zn deficiency on the eye, Zn supplementation should prevent diabetic retinopathy; however, limited available data do not always support this notion. Therefore, the goal of this paper was to summarize these pieces of available information regarding Zn prevention of diabetic retinopathy. Current theories and possible mechanisms underlying the role of Zn in the eye-related diseases are discussed. The possible factors that affect the preventive effect of Zn supplementation on diabetic retinopathy were also discussed. PMID:23671870

  6. Delaying or Preventing Type 2 Diabetes

    MedlinePlus

    ... Problems Diabetes & Sexual & Urologic Problems Preventing Type 2 Diabetes Perhaps you have learned that you have a ... I lower my chances of developing type 2 diabetes? Research such as the Diabetes Prevention Program shows ...

  7. Facing Diabetes: What You Need to Know

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Diabetes Facing Diabetes: What You Need to Know Past Issues / Fall ... your loved ones. Photos: AP The Faces of Diabetes Diabetes strikes millions of Americans, young and old, ...

  8. Diabetes - taking care of your feet

    MedlinePlus

    Diabetes - foot care - self-care; Diabetic foot ulcer - foot care; Diabetic neuropathy - foot care ... Diabetes can damage the nerves and blood vessels in your feet. This damage can cause numbness and ...

  9. Type 1 Diabetes: What Is It?

    MedlinePlus

    ... with diabetes may feel frustrated if the natural body changes of puberty make their diabetes somewhat harder to control. Having a child with diabetes can seem overwhelming at times, but you're not alone. Your child's diabetes ...

  10. Type 2 Diabetes Widespread in Adults

    MedlinePlus

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

  11. Impaired Distal Thermoregulation in Diabetes and Diabetic Polyneuropathy

    PubMed Central

    Rutkove, Seward B.; Veves, Aristidis; Mitsa, Theophano; Nie, Rui; Fogerson, Patricia M.; Garmirian, Lindsay P.; Nardin, Rachel A.

    2009-01-01

    OBJECTIVE To determine how thermoregulation of the feet is affected by diabetes and diabetic polyneuropathy in both wakefulness and sleep. RESEARCH DESIGN AND METHODS Normal subjects, diabetic subjects without neuropathy, diabetic subjects with small-fiber diabetic polyneuropathy, and those with advanced diabetic polyneuropathy were categorized based on neurological examination, nerve conduction studies, and quantitative sensory testing. Subjects underwent foot temperature monitoring using an iButton device attached to the foot and a second iButton for recording of ambient temperature. Socks and footwear were standardized, and subjects maintained an activity diary. Data were collected over a 32-h period and analyzed. RESULTS A total of 39 normal subjects, 28 patients with diabetes but without diabetic polyneuropathy, 14 patients with isolated small-fiber diabetic polyneuropathy, and 27 patients with more advanced diabetic polyneuropathy participated. No consistent differences in foot temperature regulation between the four groups were identified during wakefulness. During sleep, however, multiple metrics revealed significant abnormalities in the diabetic patients. These included reduced mean foot temperature (P < 0.001), reduced maximal temperature (P < 0.001), increased rate of cooling (P < 0.001), as well as increased frequency of variation (P = 0.005), supporting that patients with diabetic polyneuropathy and even those with only diabetes but no diabetic polyneuropathy have impaired nocturnal thermoregulation. CONCLUSIONS Nocturnal foot thermoregulation is impaired in patients with diabetes and diabetic polyneuropathy. Because neurons are highly temperature sensitive and because foot warming is part of the normal biology of sleep onset and maintenance, these findings suggest new potentially treatable mechanisms of diabetes-associated nocturnal pain and sleep disturbance. PMID:19196899

  12. Treating young adults with type 2 diabetes or monogenic diabetes.

    PubMed

    Owen, Katharine R

    2016-06-01

    It is increasingly recognised that diabetes in young adults has a wide differential diagnosis. There are many monogenic causes, including monogenic beta-cell dysfunction, mitochondrial diabetes and severe insulin resistance. Type 2 diabetes in the young is becoming more prevalent, particularly after adolescence. It's important to understand the clinical features and diagnostic tools available to classify the different forms of young adult diabetes. Classic type 1 diabetes is characterised by positive β-cell antibodies and absence of endogenous insulin secretion. Young type 2 diabetes is accompanied by metabolic syndrome with obesity, hypertension and dyslipidaemia. Monogenic β-cell dysfunction is characterised by non-autoimmune, C-peptide positive diabetes with a strong family history, while mitochondrial diabetes features deafness and other neurological involvement. Severe insulin resistance involves a young-onset metabolic syndrome often with a disproportionately low BMI. A suspected diagnosis of monogenic diabetes is confirmed with genetic testing, which is widely available in specialist centres across the world. Treatment of young adult diabetes is similarly diverse. Mutations in the transcription factors HNF1A and HNF4A and in the β-cell potassium ATP channel components cause diabetes which responds to low dose and high dose sulfonylurea agents, respectively, while glucokinase mutations require no treatment. Monogenic insulin resistance and young-onset type 2 diabetes are both challenging to treat, but first line management involves insulin sensitisers and aggressive management of cardiovascular risk. Outcomes are poor in young-onset type 2 diabetes compared to both older onset type 2 and type 1 diabetes diagnosed at a similar age. The evidence base for treatments in monogenic and young-onset type 2 diabetes relies on studies of moderate quality at best and largely on extrapolation from work conducted in older type 2 diabetes subjects. Better quality

  13. Diabetes and employment productivity: does diabetes management matter?

    PubMed

    Brown I I I, H Shelton; Perez, Adriana; Yarnell, Lisa Marie; Pagan, Jose A; Hanis, Craig L; Fischer-Hoch, Susan P; McCormick, Joseph B

    2011-01-01

    To determine whether labor market effects were the result of diabetes per se or rather depended on the degree to which diabetes was controlled through management of blood sugar levels. This study utilized data from a recently completed survey of households in Brownsville, Texas, a largely Mexican American community with a high prevalence of diabetes that is located on the Texas-Mexico border. Diabetes management, or control, was measured by blood sugar levels, glycosylated hemoglobin (A1C) levels, and interaction terms. Methods used were probit and Heckman regression. Management of diabetes did not appear to have a discernible impact on labor market outcomes in the short run. However, diabetes was negatively associated with male productivity, particularly in males' propensity to work. The new American Diabetes Association (ADA) definition of diabetes is based on having an A1C level of <6.5%. Using the new ADA definition, diabetes was negatively associated with female productivity. Female productivity was also negatively associated with the new ADA definition of prediabetes (A1C levels between 5.7% and 6.4%). However, very few people with diabetes actually controlled their blood sugar or A1C levels. These results imply that in order to avoid productivity losses associated with diabetes, more scarce prevention resources should be spent on prevention of the onset of diabetes than on the management of A1C for those already diagnosed with diabetes. For women, the prevention of prediabetes is key.

  14. Methylglyoxal, diabetes mellitus and diabetic complications.

    PubMed

    Vander Jagt, David L

    2008-01-01

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

  15. Patient decision making: strategies for diabetes diet adherence intervention.

    PubMed

    Kavookjian, Jan; Berger, Bruce A; Grimley, Diane M; Villaume, William A; Anderson, Heidi M; Barker, Kenneth N

    2005-09-01

    Patient self-care is critical in controlling diabetes and its complications. Lack of diet adherence is a particular challenge to effective diabetes intervention. The Transtheoretical Model (TTM) of Change, decision-making theory, and self-efficacy have contributed to successful tailoring of interventions in many target behaviors. The purpose of this study was to develop a diagnostic tool, including TTM measures for the stages of change, decisional balance, and self-efficacy, that pharmacists involved in diabetes intervention can use for patients resistant to a diet regimen. A questionnaire was developed through a literature review, interviews with diabetic patients, an expert panel input, and pretesting. Cross-sectional implementation of the questionnaire among a convenience sample of 193 type 1 and type 2 diabetic patients took place at 4 patient care sites throughout the southeastern United States. Validated measures were used to collect respondent self-report for the TTM variables and for demographic and diabetes history variables. Social desirability was also assessed. Relationships among TTM measures for diet adherence generally replicated those established for other target behaviors. Salient items were identified as potential facilitators (decisional balance pros) or barriers (decisional balance cons and self-efficacy tempting situations) to change. Social desirability exhibited a statistically significant relationship with patient report of diet adherence, with statistically significant differences in mean social desirability across race categories. The TTM measures for the stages of change, decisional balance, and self-efficacy are useful for making decisions on individually tailored interventions for diet adherence, with caution asserted about the potential of diabetes patients to self-report the target behavior in a socially desirable manner. Future research directions, implications, and limitations of the findings are also presented.

  16. 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

  17. [Pregestional diabetes mellitus and pregnancy].

    PubMed

    Bělobrádková, Jana

    2016-01-01

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

  18. Molecular Mechanisms of Curcumin on Diabetes-Induced Endothelial Dysfunctions: Txnip, ICAM-1, and NOX2 Expressions

    PubMed Central

    Wongeakin, Natchaya; Bhattarakosol, Parvapan; Patumraj, Suthiluk

    2014-01-01

    We aim to investigate the effects of curcumin on preventing diabetes-induced vascular inflammation in association with its actions on Txnip, ICAM-1, and NOX2 enzyme expressions. Male Wistar rats were divided into four groups: control (CON), diabetic (DM; streptozotocin (STZ), i.v. 55 mg/kg BW), control-treated with curcumin (CONCUR; 300 mg/kg BW), and diabetes treated with curcumin (DMCUR; 300 mg/kg BW). 12th week after STZ injection, iris blood perfusion, leukocyte adhesion, Txnip, p47phox, and malondialdehyde (MDA) levels were determined by using laser Doppler, intravital fluorescent confocal microscopy, Western Blot analysis, and TBAR assay, respectively. The iris blood perfusion of DM and DMCUR was decreased significantly compared to CON and CONCUR (P < 0.001). Plasma glucose and HbA1c of DM and DMCUR were increased significantly compared to CON and CONCUR (P < 0.001). Leukocyte adhesion, ICAM-1, p47phox expression, and MDA levels in DM were increased significantly compared to CON, CONCUR, and DMCUR (P < 0.05). Txnip expression in DM and DMCUR was significantly higher than CON and CONCUR (P < 0.05). From Pearson's analysis, the correlation between the plasma MDA level and the endothelial functions was significant. It suggested that curcumin could ameliorate diabetic vascular inflammation by decreasing ROS overproduction, reducing leukocyte-endothelium interaction, and inhibiting ICAM-1 and NOX2 expression. PMID:25054130

  19. Heat stress attenuates skeletal muscle atrophy of extensor digitorum longus in streptozotocin-induced diabetic rats.

    PubMed

    Nonaka, K; Une, S; Akiyama, J

    2015-09-01

    To investigate whether heat stress attenuates skeletal muscle atrophy of the extensor digitorum longus (EDL) muscle in streptozotocin-induced diabetic rats, 12-week-old male Wistar rats were randomly assigned to four groups (n = 6 per group): control (Con), heat stress (HS), diabetes mellitus (DM), and diabetes mellitus/heat stress (DM + HS). Diabetes was induced by intraperitoneal injection of streptozotocin (50 mg/kg). Heat stress was induced in the HS and DM + HS groups by immersion of the lower half of the body in hot water at 42 °C for 30 min; it was initiated 7 days after injection of streptozotocin, and was performed once a day, five times a week for 3 weeks. The muscle fiber cross-sectional area of EDL muscles from diabetic and non-diabetic rats was determined; heat stress protein (HSP) 72 and HSP25 expression levels were also analyzed by western blotting. Diabetes-induced muscle fiber atrophy was attenuated upon heat stress treatment in diabetic rats. HSP72 and HSP25 expression was upregulated in the DM + HS group compared with the DM group. Our findings suggest that heat stress attenuates atrophy of the EDL muscle by upregulating HSP72 and HSP25 expression.

  20. Diabetes Care: 10 Ways to Avoid Diabetes Complications

    MedlinePlus

    ... Following your diabetes treatment plan takes round-the-clock commitment. But your efforts are worthwhile. Careful diabetes ... foot problems: Wash your feet daily in lukewarm water. Avoid soaking your feet, as this can lead ...

  1. Galaxias australes con núcleo doble

    NASA Astrophysics Data System (ADS)

    Gimeno, G.; Díaz, R.; Carranza, G.

    Se estudia una muestra de galaxias australes con núcleo doble a partir de una búsqueda extensiva en la literatura. Se analizan las características morfológicas, fotométricas y espectroscópicas de la muestra. Para algunas galaxias se han realizado observaciones con el espectrógrafo multifunción (EMF) de la Estación Astrofísica de Bosque Alegre a partir de las cuales se determinaron parámetros cinemáticos.

  2. GeConT: gene context analysis.

    PubMed

    Ciria, R; Abreu-Goodger, C; Morett, E; Merino, E

    2004-09-22

    The fact that adjacent genes in bacteria are often functionally related is widely known. GeConT (Gene Context Tool) is a web interface designed to visualize genome context of a gene or a group of genes and their orthologs in all the completely sequenced genomes. The graphical information of GeConT can be used to analyze genome annotation, functional ortholog identification or to verify the genomic context congruence of any set of genes that share a common property. http://www.ibt.unam.mx/biocomputo/gecont.html

  3. Sexual dysfunction in diabetes.

    PubMed

    Tamás, Várkonyi; Kempler, Peter

    2014-01-01

    We aimed to summarize the etiology, clinical characteristics, diagnosis, and possible treatment options of sexual dysfunction in diabetic patients of both sexes. Details of dysfunction in diabetic women are less conclusive than in men due to the lack of standardized evaluation of sexual function in women. Male sexual dysfunction is a common complication of diabetes, including abnormalities of orgasmic/ejaculatory function and desire/libido in addition to penile erection. The prevalence of erectile dysfunction (ED) among diabetic men varies from 35% to 75%. Diabetes-induced ED has a multifactorial etiology including metabolic, neurologic, vascular, hormonal, and psychological components. ED should be regarded as the first sign of cardiovascular disease because it can be present before development of symptomatic coronary artery disease, as larger coronary vessels better tolerate the same amount of plaque compared to smaller penile arteries. The diagnosis of ED is based on validated questionnaires and determination of functional and organic abnormalities. First-, second- and third-line therapy may be applied. Phosphodiesterase-5 (PDE-5) inhibitor treatment from the first-line options leads to smooth muscle relaxation in the corpus cavernosum and enhancement in blood flow, resulting in erection during sexual stimulus. The use of PDE-5 inhibitors in the presence of oral nitrates is strictly contraindicated in diabetic men, as in nondiabetic subjects. All PDE-5 inhibitors have been evaluated for ED in diabetic patients with convincing efficacy data. Second-line therapy includes intracavernosal, trans- or intraurethral administration of vasoactive drugs or application of a vacuum device. Third-line therapies are the implantation of penile prosthesis and penile revascularization.

  4. Diabetes Complications in Youth

    PubMed Central

    Buckloh, Lisa M.; Lochrie, Amanda S.; Antal, Holly; Milkes, Amy; Canas, J. Atilio; Hutchinson, Sally; Wysocki, Tim

    2008-01-01

    OBJECTIVE—Youth with type 1 diabetes face long-term risks of health complications of the disease. Little is known about patients’ and parents’ knowledge, acquisition of information, and family communication regarding these complications. This paper reports qualitative analyses of parental focus-group discussions of this topic. RESEARCH DESIGN AND METHODS—A total of 47 participants (30 mothers, 14 fathers, and 3 others) representing 33 children between the ages of 8 and 18 years with type 1 diabetes participated in 1 of 13 focus groups. Open-ended questions focused on the type and amount of information about long-term complications presented to parents by health care professionals at different time points, as well as the way that information was presented. Questions also elicited details about parent-child communication and exposure to misconceptions about diabetes complications. RESULTS—Qualitative analysis of the transcribed focus groups revealed that participants experienced significant anxiety about diabetes complications, with a shift from concern about daily management tasks to concern about long-term complications over time. Participants desired a flexible, collaborative educational approach, especially regarding the timing and type of information, relative to the child's age and duration of diabetes. Many parents wanted more sensitive communication and emotional support from health care providers. Motivating children appeared to be a particular challenge; family burnout with regard to diabetes care over time was reported. Knowledge was gained in many ways, yet misinformation was uncommon. CONCLUSIONS—Obtaining information about long-term complications is an important process that changes over the course of the disease and with the child's developmental level. More research is needed, especially regarding youth knowledge, learning, and beliefs about diabetes complications. PMID:18509210

  5. Diabetes Care in Nigeria.

    PubMed

    Fasanmade, Olufemi A; Dagogo-Jack, Samuel

    2015-01-01

    Diabetes is a noncommunicable disease that has attained great significance in the sub-Saharan region, with Nigeria being the most affected. Many persons with the condition suffer a reduced life expectancy and quality of life. Diabetes places an extra burden on the individuals and families affected, especially for the majority of patients unable to access quality health care. To describe the elements of diabetes management in Nigeria, areas for improvement, and proposed strategies to optimize care. A systematic literature search was performed on diabetes in Nigeria. Local and nonindexed literature, PubMed, and Google Scholar were used to source information on the subject. Diabetes-related morbidity and mortality continue to increase due to population expansion, urban migration, declining physical activity, and dietary factors. The organization of diabetes care is poorly coordinated, especially at the primary and secondary tiers of the public health care system, with consequent poor outcomes. Thus life expectancy (just about 50 years), which is low in the region, is further reduced by the double jeopardy of communicable (eg, tuberculosis, HIV/AIDS, and malaria) and noncommunicable diseases, such as diabetes and its closely related comorbidity, hypertension. The way forward is to improve maternal and child care, promote screening of at-risk populations, and develop strategies for primary prevention and early intervention to optimize glycemic control. Greater commitment to health care by the government and nongovernmental organizations and greater awareness by Nigerians should facilitate the desired improvements in disease prevention and glycemic control in those who are already affected. Copyright © 2015. Published by Elsevier Inc.

  6. Lipid disorders in diabetes.

    PubMed

    Goldberg, R B

    1981-01-01

    Hyperlipidemia is common in diabetic patients. While our understanding of lipid and lipoprotein metabolism in diabetes is incomplete, a pathophysiologic approach to this problem is presented. It is based on the recognition that diabetes is metabolically heterogeneous. Thus the roles of insulin deficiency, insulin resistance, obesity, and genetic factors are discussed in relation to their effects on lipoprotein production and catabolism. The most important defect in insulin-deficient subjects appears to be a deficiency of lipoprotein lipase, which is responsible for the removal of the triglyceride-rich lipoproteins. In non-insulin-dependent subjects there is evidence for a removal defect as well as, in some patients, for overproduction of VLDL-triglyceride. Cholesterol levels may be elevated and it is important to distinguish between VLDL, LDL, and HDL as the causes for these increases. HDL-cholesterol levels may be increased in insulin-dependent subjects, whereas they may be decreased in obese non-insulin-dependent patients. Mild elevations of LDL-cholesterol may occur in inadequately controlled type I and II diabetic patients, while elevated VLDL may raise the serum cholesterol in addition to the triglyceride levels. The rationale for therapy is based on the complications of severe hypertriglyceridemia and the risk of occlusive atherosclerosis. Management is directed at improving glycemic control, altering dietary composition, and reducing calories in obese patients. Improved glycemic control is effective in reducing triglyceride and cholesterol levels in insulin-deficient subjects. The response of the non-insulin-dependent diabetic patient to improved control may be complicated by associated obesity or familial hyperlipidemia. The advantages and disadvantages of fat versus carbohydrate restriction in the diet are discussed. Finally, resistant hyperlipidemia may require drug therapy. Diabetic hyperlipidemia should be viewed as resulting from an interaction between

  7. Rheumatological manifestations in diabetes mellitus.

    PubMed

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

    2006-11-01

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

  8. Adrenergic desensitization in left ventricle from streptozotocin diabetic swine.

    PubMed

    Roth, D A; White, C D; Hamilton, C D; Hall, J L; Stanley, W C

    1995-10-01

    Patients with diabetes mellitus that exhibit cardiac pump failure display compromised stroke volume, ejection fraction, and slower rates of rise and fall of left ventricular (LV) dP/dt in the absence of ischemic injury. We hypothesized that diabetic cardiomyopathy may involve decrements in adrenergic sensitivity, with specific molecular alterations in the beta-adrenergic receptor (beta AR)- G protein- adenylyl cyclase (AC) signal transduction system. We assessed the effects of 3 months of streptozotocin-induced diabetes (125 mg/kg i.v.; DIAB, n = 10) on myocardial signal transduction in mini-pigs. DIAB were hyperglycemic compared to controls (CON, n = 10; 20.92 +/- 2.64 v 5.24 +/- 0.35 mM glucose), and had lower fasting insulin levels (6.46 +/- 0.97 v 13.68 +/- 3.91 microU/ml). Transmural LV free wall homogenates from DIAB exhibited similar beta AR density as CON, but decreased cAMP production (pmol cAMP/mg prot.min) using these pharmacological stimulators: 10 microM Isoproterenol plus 100 microM GTP (74 +/- 5 v 97 +/- 11); 100 microM Gpp(NH)p (116 +/- 7 v 161 +/- 17); 10 mM fluoride ion (266 +/- 16 v 324 +/- 25). No differences between DIAB and CON were observed when stimulated by 100 microM forskolin (440 +/- 20 v 429 +/- 33), suggesting no alterations in the catalytic subunit of AC. In DIAB, quantitative immunoblotting indicated slightly depressed levels of Gs (552 +/- 44 v 630 +/- 59 pmol/g ww; NS), but a significant redistribution of alpha s from the sarcolemma to the cytosol (32.7 +/- 0.82% v 25.9 +/- 1.7%). Significantly elevated levels of cardiac Gi were seen in DIAB homogenates compared to CON ventricles (2326 +/- 145 v 1522 +/- 181 pmol/g ww), with no alpha i subunit redistribution. We conclude that despite maintained beta AR density, receptor-dependent and G protein-dependent stimulation of AC is depressed so that streptozotocin-induced diabetic LV is affected by increased cardiac Gi, redistribution of Gs alpha to the cytosol, and an increase in the Gi

  9. Diabetes and osteoporotic fractures: the role of the diabetes educator.

    PubMed

    Kemmis, Karen; Stuber, Diana

    2005-01-01

    The purpose of this article is to present information that will assist the diabetes educator in screening patients with diabetes for risk of osteoporosis and fracture, to offer appropriate treatment options for patients, and to identify potential referrals to other providers for patients with diabetes and increased risk of fracture.

  10. Diabetes Nutrition: Eating Out When You Have Diabetes

    MedlinePlus

    ... unsweetened iced tea, sparkling water, mineral water or diet soda. Alcohol and diabetes If your diabetes is under control and your ... Delahanty LM, et al. Patient information: Type 2 diabetes mellitus and diet (beyond the basics). http://www.uptodate.com/home. ...

  11. Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero

    PubMed Central

    Sosa, Fidel; Bustamante, Jorge; Rodríguez, Facundo; Argañaraz, Romina; Rubino, Pablo; Lambre, Jorge

    2017-01-01

    Resumen Introducción: Los aneurismas asociados a malformaciones arteriovenosas (MAV) son lesiones vasculares que suelen encontrarse hasta en el 15% de los casos, incrementando el riesgo global de hemorragia. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. El síndrome del acento extranjero es un raro trastorno neurológico en el que el paciente habla su lengua materna como lo haría una persona extranjera y suena con “acento” extranjero a oídos de los oyentes nativos. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Presentación de caso: Paciente pediátrico que luego de la exéresis de una MAV fronto-opercular posterior izquierda remite por completo un aneurisma de hiperflujo asociado, presentando en el postquirúrgico el síndrome del acento extranjero. Conclusión: Queda reportado el caso de este raro síndrome y la resolución espontánea de un aneurisma proximal luego de la exéresis de una MAV. PMID:28480115

  12. Shoes and Orthotics for Diabetics

    MedlinePlus

    ... All Site Content AOFAS / FootCareMD / Conditions / Diabetic Foot Shoes and Orthotics for Diabetics Page Content Proper footwear ... result in a more stable and functional foot. Shoes If you are in the early stages of ...

  13. Recent Advances (in Diabetes Research)

    MedlinePlus

    ... 29, 2015 Pathway to Stop Diabetes Scientist Generates Smart Insulin Patch American Diabetes Association Pathway to Stop ... a paper describing the development of an innovative "smart insulin" patch that imitates the body's beta cells ...

  14. Diabetes: Unique to Older Adults

    MedlinePlus

    ... Stroke Urinary Incontinence Related Documents PDF Choosing Wisely: Diabetes Tests and Treatments Download Related Video Join our e-newsletter! Aging & Health A to Z Diabetes Unique to Older Adults This section provides information ...

  15. Living with Diabetic Heart Disease

    MedlinePlus

    ... from the NHLBI on Twitter. Living With Diabetic Heart Disease Diabetic heart disease (DHD) increases the likelihood of earlier and more ... also tend to have less success from certain heart disease treatments, such as coronary artery bypass grafting and ...

  16. Diabetes Continues Its Relentless Rise

    MedlinePlus

    ... medlineplus.gov/news/fullstory_164596.html Diabetes Continues Its Relentless Rise But doctors making headway with heart ... main risk factor for type 2 diabetes, though it's not the only factor involved in the disease. ...

  17. Diabetes Resources for Older Adults

    MedlinePlus

    ... can occur when you have the disease. Common diabetes problems include Heart Disease and Stroke Nerve Damage (Diabetic Neuropathy) Foot Problems Gum Disease and Other Dental Problems Low Blood Glucose (Hypoglycemia) ...

  18. Metabolomics in diabetes.

    PubMed

    Zhang, Ai-hua; Qiu, Shi; Xu, Hong-ying; Sun, Hui; Wang, Xi-jun

    2014-02-15

    Characterization of metabolic changes is key to early detection, treatment, and understanding molecular mechanisms of diabetes. Diabetes represents one of the most important global health problems. Approximately 90% of diabetics have type 2 diabetes. Identification of effective screening markers is critical for early treatment and intervention that can delay and/or prevent complications associated with this chronic disease. Fortunately, metabolomics has introduced new insights into the pathology of diabetes as well as to predict disease onset and revealed new biomarkers to improve diagnostics in a range of diseases. Small-molecule metabolites have an important role in biological systems and represent attractive candidates to understand T2D phenotypes. Characteristic patterns of metabolites can be revealed that broaden our understanding of T2D disorder. This technique-driven review aims to demystify the mechanisms of T2D, to provide updates on the applications of metabolomics in addressing T2D with a focus on metabolites based biomarker discovery. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Diabetic nephropathy: preventing progression

    PubMed Central

    2010-01-01

    Introduction Up to one third of people with type 1 or 2 diabetes will develop microalbuminuria or macroalbuminuria after 20 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with type 1 diabetes and early nephropathy? What are the effects of treatments in people with type 1 diabetes and late nephropathy? What are the effects of treatments in people with type 2 diabetes and early nephropathy? What are the effects of treatments in people with type 2 diabetes and late nephropathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, glycaemic control, protein restriction, and tight control of blood pressure. PMID:21418671

  20. Diabetes and dyslipidaemia.

    PubMed

    Schwartz, Sherwyn L

    2006-07-01

    The risk of developing cardiovascular disease (CVD) is higher and the prognosis poorer for diabetic than for non-diabetic individuals. Diabetic dyslipidaemia is characterized by hypertriglyceridaemia, low levels of high-density lipoprotein cholesterol (HDL-C) and the presence of small, dense low-density lipoprotein (LDL) particles. Increased physical activity and weight loss are the first steps in managing diabetic dyslipidaemia. A secondary goal is to achieve non-HDL-C targets with cholesterol-lowering therapy. Improved glycaemic control, the first priority in managing hypertriglyceridaemia, can also aid in lowering levels of LDL-C. Lipid-lowering therapy should be initiated if lifestyle changes and glycaemic control fail to reduce LDL-C levels to <100 mg/dl (5.5 mmol/l), regardless of the status of CVD, coronary heart disease or peripheral vascular disease, and to reduce triglyceride levels of > or =150 mg/dl (8.3 mmol/l). Many diabetic patients may need oral hypoglycaemic agents or insulin to achieve adequate glycaemic control. Intensive insulin therapy can provide tight glycaemic control and reduce elevated triglyceride levels.

  1. Diabetic foot disease.

    PubMed

    Younes, Nidal A; Ahmad, Azmi T

    2006-01-01

    To review the spectrum of foot problems in patients with diabetes and the underlying etiologic factors. In this review, the term "diabetic foot disease" (DFD) will be used (previously referred to as simply "diabetic foot"). The relevant anatomy of the foot is discussed, the clinical evaluation and severity of DFD are outlined, and the role of both systemic control and local measures in the management of DFD is addressed. DFD is linked with a wide variety of etiologic associations, pathologic forms, and clinical severity. The causes of DFD include such factors as diabetic neuropathy, vascular insufficiency, and the presence of underlying bone deformity. The pathologic forms range from superficial skin lesions, soft tissue infections, joint swellings, and deformities to frank necrosis and gangrene. The clinical severity ranges from mild, self-resolving disease to fulminant, rapidly progressive disease that usually eventuates in amputation. The heterogeneity of patients whose illness is grouped collectively under the diagnosis of DFD has contributed to the persisting confusion and controversy regarding the optimal classification system for diabetes-related foot problems and their appropriate management. Optimal management of DFD involves a multimodality approach directed at regular foot care, blood glucose control, and early recognition of foot problems. Appropriate surgical management, administration of systemic antibiotics, and off-loading techniques are necessary to prevent the progression of DFD.

  2. Foot screening for diabetics.

    PubMed

    Nather, Aziz; Chionh, Siok Bee; Tay, Patricia L M; Aziz, Zameer; Teng, Janelle W H; Rajeswari, K; Erasmus, Adriaan; Nambiar, Ajay

    2010-06-01

    This study aims to evaluate the results of foot screening performed in a study population of 2137 diabetics (3926 feet) screened from 2006 to 2008 by the National University Hospital (NUH) multi-disciplinary team for diabetic foot problems. A standardised protocol was designed. Foot screening consisted of detailed history taking and clinical examination including assessment for sensory neuropathy by Semmes Weinstein monofilament (SWMF) and neurothesiometer and assessment of vasculopathy by ankle-brachial index (ABI) and total body irradiation (TBI). The foot screening was performed by a trained staff nurse. All patients were classified according to King's College Classification. Majority of the patients were in the fifth (27.9%) and sixth (30.0%) decades of life. Two thousand sixty-four had type II diabetes, and only 73 had type I diabetes. Neuropathy was found in 1307 (33.3%) feet based on 5.07 SWMF. Vasculopathy was recorded in 510 (13.0%) and 546 (13.9%) feet based on ABI <0.8 and TBI <0.7. According to King's Classification, 1069 (50.0%) were Stage 1: Normal and 615 (28.8%) were Stage 2: At-Risk. Foot screening should be performed as early as possible to detect "At-Risk" feet and prevent the development of diabetic foot complications, thereby further reducing the risk of major amputations.

  3. Diabetes and exercise

    PubMed Central

    Peirce, N. S.

    1999-01-01

    Exercise is frequently recommended in the management of type 1 and 2 diabetes mellitus and can improve glucose uptake by increasing insulin sensitivity and lowering body adiposity. Both alone and when combined with diet and drug therapy, physical activity can result in improvements in glycaemic control in type 2 diabetes. In addition, exercise can also help to prevent the onset of type 2 diabetes, in particular in those at higher risk, and has an important role in reducing the significant worldwide burden of this type of diabetes. Recent studies have improved our understanding of the acute and long term physiological benefits of physical activity, although the precise duration, intensity, and type of exercise have yet to be fully elucidated. However, in type 1 diabetes, the expected improvements in glycaemic control with exercise have not been clearly established. Instead significant physical and psychological benefits of exercise can be achieved while careful education, screening, and planning allow the metabolic, microvascular, and macrovascular risks to be predicted and diminished. 


 PMID:10378067

  4. InterCon Travel Health: Case B

    ERIC Educational Resources Information Center

    Truman, Gregory E.; Pachamanova, Dessislava A.; Goldstein, Michael A.

    2010-01-01

    InterCon provides services to health insurers of foreign tourists who travel to the United States and Canada. Management wants to implement a new information system that will deal with several operational problems, but it is having difficulty securing the capital resources to fund the system's development. After an initial failure, the chief…

  5. InterCon Travel Health: Case B

    ERIC Educational Resources Information Center

    Truman, Gregory E.; Pachamanova, Dessislava A.; Goldstein, Michael A.

    2010-01-01

    InterCon provides services to health insurers of foreign tourists who travel to the United States and Canada. Management wants to implement a new information system that will deal with several operational problems, but it is having difficulty securing the capital resources to fund the system's development. After an initial failure, the chief…

  6. Acromegaly presenting with diabetic ketoacidosis.

    PubMed Central

    Katz, J. R.; Edwards, R.; Khan, M.; Conway, G. S.

    1996-01-01

    Diabetes in acromegaly is usually non-insulin dependent and is secondary to insulin resistance caused by growth hormone excess. Diabetic ketoacidosis is a result of relative insulin deficiency and is a rare feature of acromegaly. We describe a case of acromegaly presenting with diabetic ketoacidosis. We demonstrate that growth hormone excess can cause diabetic ketoacidosis in the presence of relative, but not absolute insulin deficiency. PMID:8944212

  7. Periodontal health and diabetes awareness among Saudi diabetes patients

    PubMed Central

    Bahammam, Maha A

    2015-01-01

    Purpose This study aimed to examine diabetic patients in Jeddah, Saudi Arabia, regarding their general diabetic and oral health-related awareness and practices, their awareness of the association of diabetes with periodontal disease, and their sources of diabetes-related information. Methods Diabetic patients (n=454) who were receiving care at the diabetes clinic in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2013 to May 2014, completed a six-part questionnaire assessing their sociodemographic characteristics, general and oral health awareness and practices, and sources of diabetes-related information. Descriptive statistics were used to report the results. Results The responses indicated inadequate health-related practices in the surveyed group: 22.2% brushed their teeth twice daily, 73.6% never flossed their teeth, and while 80.2% visited a physician in the past year, only 12.6% visited a dentist during the same year. Of the respondents, 94.8% reported that they had never received advice on oral hygiene tasks in relation to diabetes from a health professional. Awareness about the diabetes and periodontal disease association was limited: 46.7% knew that diabetics have gum problems more often if their blood sugar stays very high, and only 21.8% knew that gum disease makes it harder to control blood sugar in diabetic patients. A significant association (P<0.05) was found between a higher level of education and greater general and oral awareness, as well as a significant association (P<0.05) between longer duration of disease, regular exercise, and regular visits to the physician and awareness about diabetes mellitus. Additionally, a significant association (P<0.05) was found between regular dental visits and both periodontal disease and diabetes awareness. Family and friends were the main source of diabetes-related information, and the Internet was the least likely source. Conclusion Customized educational programs should be planned for

  8. Health and diabetes self-efficacy: a study of diabetic and non-diabetic free clinic patients and family members.

    PubMed

    Kamimura, Akiko; Christensen, Nancy; Myers, Kyl; Nourian, Maziar M; Ashby, Jeanie; Greenwood, Jessica L J; Reel, Justine J

    2014-08-01

    Free clinics across the country provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. This study examined perceived health status among diabetic and non-diabetic free clinic patients and family members of the patients. Diabetes self-efficacy among diabetic free clinic patients was also investigated with the goal of developing appropriate diabetes health education programs to promote diabetes self-management. English or Spanish speaking patients and family members (N = 365) aged 18 years or older completed a self-administered survey. Physical and mental health and diabetes self-efficacy were measured using standardized instruments. Diabetic free clinic patients reported poorer physical and mental health and higher levels of dysfunction compared to non-diabetic free clinic patients and family members. Having a family history of diabetes and using emergency room or urgent care services were significant factors that affected health and dysfunction among diabetic and non-diabetes free clinic patients and family members. Diabetic free clinic patients need to receive services not only for diabetes, but also for overall health and dysfunction issues. Diabetes educational programs for free clinic patients should include a component to increase diabetes empowerment as well as the knowledge of treatment and management of diabetes. Non-diabetic patients and family members who have a family history of diabetes should also participate in diabetes education. Family members of free clinic patients need help to support a diabetic family member or with diabetes prevention.

  9. Diabetes Education in Tribal Schools

    ERIC Educational Resources Information Center

    Helgeson, Lars; Francis, Carolee Dodge

    2006-01-01

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

  10. Diabetes Education in Tribal Schools

    ERIC Educational Resources Information Center

    Helgeson, Lars; Francis, Carolee Dodge

    2006-01-01

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

  11. Type 1 Diabetes and Sleep.

    PubMed

    Farabi, Sarah S

    2016-02-01

    IN BRIEF In people with type 1 diabetes, sleep may be disrupted as a result of both behavioral and physiological aspects of diabetes and its management. This sleep disruption may negatively affect disease progression and development of complications. This review highlights key research findings regarding sleep in people with type 1 diabetes.

  12. Diagnosing Diabetes and Preventing Rehospitalizations

    PubMed Central

    Robbins, Jessica M.; Webb, David A.

    2006-01-01

    Background Patients with diabetes frequently are hospitalized, and quality of inpatient care for diabetes is of great concern. Rehospitalization after hospital discharge is a frequent adverse outcome experienced by patients with diabetes. Objectives We assessed the frequency of and risk factors for rehospitalization among all Philadelphia residents with diabetes. Methods Individual histories of hospitalization were ascertained from hospital discharge summaries for Philadelphia residents ages 25–84 who had at least 1 diabetes hospitalization from 1994 through 2001. Logistic regression was used to assess predictors of nonelective rehospitalization within 30 days of discharge, including recording of diabetes diagnosis. Results Nonelective rehospitalizations within 30 days of hospital discharge were ascertained for 58,308 (20.0%) of 291,752 discharges. The proportion rehospitalized was 9.4% after a patient’s first diabetes diagnosis hospitalization; after later discharges for which a diabetes diagnosis was not recorded, rehospitalizations occurred in 30.6% of all cases. The absence of a diabetes diagnosis was a highly significant predictor of rehospitalization after adjustment for age, year, gender, race/ethnicity, insurance status, admission type, severity code, length of stay, discharge status, and number of previous hospitalizations. Conclusion Failure to record a diabetes diagnoses in administrative hospital discharge data may reflect lack of attention to the critical needs of patients with diabetes who are being treated for other conditions, whereas the attention to patient education and follow-up planning for patients with incident diabetes diagnoses may reduce the risk of rehospitalization. PMID:16501402

  13. Diabetic Youths and Their Families

    ERIC Educational Resources Information Center

    Smith, Melva

    1974-01-01

    In response to a need for a comprehensive program to fill the gap in services for children with diabetes and their families, the Diabetic Youth and Family Program of Wichita, Kansas is directing efforts to deal effectively and creatively with children's diabetic problems. (CS)

  14. [Coffee and diabetes].

    PubMed

    Kempf, Kerstin; Martin, Stephan

    2010-12-01

    Lack of physical activity and high caloric diet are main causes for increasing diabetes prevalence. Thus, it is possible to influence blood glucose levels by lifestyle modifications. Coffee is an important lifestyle factor in Germany with a mean consumption of about 150 litres per inhabitant. It is important to know that coffee cannot be equated with caffeine. Scientific investigations have shown that caffeine can temporarily have a negative impact on cardiovascular risk factors but does not promote development of cardiovascular events. On the other hand, several international prospective studies demonstrate a protective effect of coffee on the development of type 2 diabetes as coffee consumption can reduce glucose uptake. Coffee components, e.g. chlorogenic acid, play a central role, as they can inhibit oxidative stress and inflammation in addition. In the context of lifestyle tasks coffee consumption therefore is an additional option for modifying diabetes risk.

  15. Diabetic nephropathy and antioxidants.

    PubMed

    Tavafi, Majid

    2013-01-01

    Oxidative stress has crucial role in pathogenesis of diabetic nephropathy (DN). Despite satisfactory results from antioxidant therapy in rodent, antioxidant therapy showed conflicting results in combat with DN in diabetic patients. Directory of Open Access Journals (DOAJ), Google Scholar,Pubmed (NLM), LISTA (EBSCO) and Web of Science have been searched. Treatment of DN in human are insufficient with rennin angiotensin system (RAS) blockers, so additional agent ought to combine with this management. Meanwhile based on DN pathogenesis and evidences in experimental and human researches, the antioxidants are the best candidate. New multi-property antioxidants may be improved human DN that show high power antioxidant capacity, long half-life time, high permeability to mitochondrion, improve body antioxidants enzymes activity and anti-inflammatory effects. Based on this review and our studies on diabetic rats, rosmarinic acid a multi-property antioxidant may be useful in DN patients, but of course, needs to be proven in clinical trials studies.

  16. [Diabetes in liver cirrhosis].

    PubMed

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

    2013-01-01

    The prevalence of overt diabetes mellitus (DM) in liver cirrhosis is about 30%. However, DM or impaired glucose tolerance can be observed in 90% after an oral glucose tolerance test in patients with normal fasting plasma glucose. Type 2 DM may produce cirrhosis, whereas DM may be a complication of cirrhosis. The latter is known as «hepatogenous diabetes». Overt and subclinical DM is associated with liver complications and death in cirrhotic patients. Treating diabetes is difficult in cirrhotic patients because of the metabolic impairments due to liver disease and because the most appropriate pharmacologic treatment has not been defined. It is also unknown if glycemic control with hypoglycemic agents has any impact on the course of the liver disease. Copyright © 2013 Elsevier España, S.L. y AEEH y AEG. All rights reserved.

  17. [Gestational diabetes mellitus].

    PubMed

    Senat, M-V; Deruelle, P

    2016-04-01

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

  18. [Infection and diabetic foot].

    PubMed

    Senneville, E

    2008-09-01

    The large number of factors that influence the outcome of patients with diabetic foot infections calls for a multidisciplinary management of such patients. Infection is always the consequence of a preexisting foot wound whose chronicity is facilitated by the diabetic peripheral neuropathy, whereas peripheral vascular disease is a factor of poor outcome, especially regarding the risk for leg amputation. Primary and secondary prevention of IPD depends both on the efficacy of wound off-loading. Antibiotic treatment should only be considered for clinically infected foot wounds for which diagnostic criteria have recently been proposed by international consensus. The choice of the antibiotic regimen should take into account the risk for selecting bacterial resistance, and as a consequence, agents with a narrow spectrum of activity should be preferred. Respect of the measures for preventing the spread of bacterial resistance in diabetic foot centers is particularly important.

  19. Gut feelings about diabetes

    PubMed Central

    Laferrère, Blandine

    2013-01-01

    Studies of patients going into diabetes remission after gastric bypass surgery have demonstrated the important role of the gut in glucose control. The improvement of type 2 diabetes after gastric bypass surgery occurs via weight dependent and weight independent mechanisms. The rapid improvement of glucose levels within days after the surgery, in relation to change of meal pattern, rapid nutrient transit, enhanced incretin release and improved incretin effect on insulin secretion, suggest mechanisms independent of weight loss. Alternatively, insulin sensitivity improves over time as a function of weight loss. The role of bile acids and microbiome in the metabolic improvement after bariatric surgery remains to be determined. While most patients after bariatric surgery experienced sustained weight loss and improved metabolism, small scale studies have shown weight regain and diabetes relapse, the mechanisms of which remain unknown. PMID:22386248

  20. Mitochondrial Dynamics in Diabetes

    PubMed Central

    Galloway, Chad A.; Jhun, Bong Sook; Yu, Tianzheng

    2011-01-01

    Abstract Mitochondria are at the center of cellular energy metabolism and regulate cell life and death. The cell biological aspect of mitochondria, especially mitochondrial dynamics, has drawn much attention through implications in human pathology, including neurological disorders and metabolic diseases. Mitochondrial fission and fusion are the main processes governing the morphological plasticity and are controlled by multiple factors, including mechanochemical enzymes and accessory proteins. Emerging evidence suggests that mitochondrial dynamics plays an important role in metabolism–secretion coupling in pancreatic β-cells as well as complications of diabetes. This review describes an overview of mechanistic and functional aspects of mitochondrial fission and fusion, and comments on the recent advances connecting mitochondrial dynamics with diabetes and diabetic complications. Antioxid. Redox Signal. 14, 439–457. PMID:20518704

  1. Inflammation in Diabetic Retinopathy

    PubMed Central

    Tang, Johnny; Kern, Timothy S.

    2012-01-01

    Diabetes causes a number of metabolic and physiologic abnormalities in the retina, but which of these abnormalities contribute to recognized features of diabetic retinopathy (DR) is less clear. Many of the molecular and physiologic abnormalities that have been found to develop in the retina in diabetes are consistent with inflammation. Moreover, a number of anti-inflammatory therapies have been found to significantly inhibit development of different aspects of DR in animal models. Herein, we review the inflammatory mediators and their relationship to early and late DR, and discuss the potential of anti-inflammatory approaches to inhibit development of different stages of the retinopathy. We focus primarily on information derived from in vivo studies, supplementing with information from in vitro studies were important. PMID:21635964

  2. Tropical Diabetic Hand Syndrome

    PubMed Central

    Okpara, TC; Ezeala-Adikaibe, BA; Omire, O; Nwonye, E; Maluze, J

    2015-01-01

    Any adult with diabetes in the tropics with hand cellulitis, infection and gangrene qualifies for tropical diabetic hand syndrome (TDHS). We reviewed a 39-year-old woman with a 3-week history of swelling of the left index finger following an insect bite. The swelling progressively increased in size, was very painful, and extended to the palm. There was no history or symptoms suggestive of chronic complications of diabetes. Random blood sugar on presentation was above 600 mg/dl using a glucometer. Examination revealed an edematous left palm draining pus from multiple sinuses, necrotic and gangrenous left index finger extending down to just above the thenar eminence. A diagnosis of TDHS in a patient with hyperosmolar state was made. She was managed accordingly and subsequently underwent aggressive debridement and desloughing. Two fingers were amputated and the wound was allowed to heal by secondary intention. PMID:27057390

  3. [Diabetic nephropathy: emerging treatments].

    PubMed

    Gueutin, Victor; Gauthier, Marion; Cazenave, Maud; Izzedine, Hassane

    2014-07-01

    Diabetic nephropathy is a leading cause of end-stage renal disease worldwide. The mainstay of treatment has been management of hyperglycaemia, blood pressure and proteinuria using hypoglycemic agents, ACE inhibitors, and angiotensin receptor blockers. Since 2000, new therapeutic strategies began to emerge targeting the biochemical activity of glucose molecules on the renal tissue. Various substances have been studied with varying degrees of success, ranging from vitamin B to camel's milk. Silymarin reduces urinary excretion of albumin, tumor necrosis factor (TNF)-α, and malondialdehyde in patients with diabetic nephropathy and may be considered as a novel addition to the anti-diabetic nephropathy armamentarium. Although some results are promising, studies on a larger scale are needed to validate the utility of these molecules in the treatment of the DN. Copyright © 2014 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  4. Metabolomics of Diabetic Retinopathy.

    PubMed

    Liew, Gerald; Lei, Zhou; Tan, Gavin; Joachim, Nichole; Ho, I-Van; Wong, Tien Y; Mitchell, Paul; Gopinath, Bamini; Crossett, Ben

    2017-09-23

    Metabolomics is the study of dysregulated metabolites in biological materials. We reviewed the use of the technique to elucidate the genetic and environmental factors that contribute to the development of diabetic retinopathy. With regard to metabolomic studies of diabetic retinopathy, the field remains in its infancy with few studies published to date and little replication of results. Vitreous and serum samples are the main tissues examined, and dysregulation in pathways such as the pentose phosphate pathway, arginine to proline pathway, polyol pathway, and ascorbic acidic pathways have been reported. Few studies have examined the metabolomic underpinnings of diabetic retinopathy. Further research is required to replicate findings to date and determine longitudinal associations with disease.

  5. Diabetes and exercise.

    PubMed

    Lumb, Alistair

    2014-12-01

    Exercise has a beneficial effect on metabolic parameters affecting cardiovascular risk, such as lipids and blood glucose, and is a key component in both the prevention and the management of type 2 diabetes. Glycaemic control improves with both aerobic and resistance exercise in type 2 diabetes, but no glycaemic benefit is seen in type 1 diabetes. This probably results from glucose fluctuations commonly seen with exercise. Low and moderate intensity exercise are generally associated with a fall in blood glucose, and high intensity exercise can be associated with a rise in blood glucose. Trial evidence is suggestive of a reduction in cardiovascular risk with exercise, although evidence from prospective, randomised controlled trials is certainly not conclusive.

  6. Doxorubicin Induces Inflammatory Modulation and Metabolic Dysregulation in Diabetic Skeletal Muscle

    PubMed Central

    Supriya, Rashmi; Tam, Bjorn T.; Pei, Xiao M.; Lai, Christopher W.; Chan, Lawrence W.; Yung, Benjamin Y.; Siu, Parco M.

    2016-01-01

    Anti-cancer agent doxorubicin (DOX) has been demonstrated to worsen insulin signaling, engender muscle atrophy, trigger pro-inflammation, and induce a shift to anaerobic glycolytic metabolism in skeletal muscle. The myotoxicity of DOX in diabetic skeletal muscle remains largely unclear. This study examined the effects of DOX on insulin signaling, muscle atrophy, pro-/anti-inflammatory microenvironment, and glycolysis metabolic regulation in skeletal muscle of db/db diabetic and db/+ non-diabetic mice. Non-diabetic db/+ mice and diabetic db/db mice were randomly assigned to the following groups: db/+CON, db/+DOX, db/dbCON, and db/dbDOX. Mice in db/+DOX and db/dbDOX groups were intraperitoneally injected with DOX at a dose of 15 mg per kg body weight whereas mice in db/+CON and db/dbCON groups were injected with the same volume of saline instead of DOX. Gastrocnemius was immediately harvested, weighed, washed with cold phosphate buffered saline, frozen in liquid nitrogen, and stored at −80°C for later analysis. The effects of DOX on diabetic muscle were neither seen in insulin signaling markers (Glut4, pIRS1Ser636∕639, and pAktSer473) nor muscle atrophy markers (muscle mass, MuRF1 and MAFbx). However, DOX exposure resulted in enhancement of pro-inflammatory favoring microenvironment (as indicated by TNF-α, HIFα and pNFκBp65) accompanied by diminution of anti-inflammatory favoring microenvironment (as indicated by IL15, PGC1α and pAMPKβ1Ser108). Metabolism of diabetic muscle was shifted to anaerobic glycolysis after DOX exposure as demonstrated by our analyses of PDK4, LDH and pACCSer79. Our results demonstrated that there might be a link between inflammatory modulation and the dysregulation of aerobic glycolytic metabolism in DOX-injured diabetic skeletal muscle. These findings help to understand the pathogenesis of DOX-induced myotoxicity in diabetic muscle. PMID:27512375

  7. [Diabetic gangrene and amputation].

    PubMed

    Bríza, J; Krska, Z

    1996-01-01

    The authors describe group of 60 patients with diabetic gangrena of lower extremity. In 24 cases was performed primary amputation (14 acral and 10 in thigh for sepsis). In 14 patients was carried out balloon angioplasty, in 6 bypass and in 16 a lumbal sympathectomy. The big amputation was necessary after the revascularization in 9 cases. A treatment of the diabetic foot have to be complex. Before amputation is the angiography necessary. It is enabled also by the balloon angioplasty. Microangiopathy with the good arteriography finding in main limb arteries make acral amputation possible.

  8. Pathogenesis of feline diabetes.

    PubMed

    Rand, Jacquie S

    2013-03-01

    Diabetes mellitus is the result of inadequate insulin secretion. In cats this is often associated with conditions that reduce insulin sensitivity and increase the requirement for insulin secretion. Obesity, and acromegaly, and pancreatitis are common predisposing causes of diabetes in cats. The mechanisms that prevent the pancreatic β cells from secreting adequate amounts of insulin are not well understood, but may include inflammatory mediators, reactive oxygen species, toxic intracellular protein oligomers, and toxicity from increased blood glucose concentrations. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  9. [The diabetic foot].

    PubMed

    Hartemann-Heurtier, Agnès; Ha Van, Georges

    2003-05-15

    Diabetic patients are concerned with foot complications when a peripheral neuropathy is present. Screening of predisposed patients may be annually assessed using monofilament testing. Peripheral arterial disease, when associated, increases amputation risk. Ideal treatment requires a multidisciplinary approach with a first-line medical treatment including an optimal off-loading of the diabetic ulcer, ulcer dertersion, glycemic control, and if necessary antibiotic therapy. In case of associated osteomyelitis, a limited surgical resection of the infected bone may be performed. In case of associated arterial disease, a revascularization procedure precede bone resection.

  10. Imaging in Diabetic Retinopathy

    PubMed Central

    Salz, David A.; Witkin, Andre J.

    2015-01-01

    While the primary method for evaluating diabetic retinopathy involves direct and indirect ophthalmoscopy, various imaging modalities are of significant utility in the screening, evaluation, diagnosis, and treatment of different presentations and manifestations of this disease. This manuscript is a review of the important imaging modalities that are used in diabetic retinopathy, including color fundus photography, fluorescein angiography, B-scan ultrasonography, and optical coherence tomography. The article will provide an overview of these different imaging techniques and how they can be most effectively used in current practice. PMID:25949070

  11. Diabetic and endocrine emergencies

    PubMed Central

    Kearney, T; Dang, C

    2007-01-01

    Endocrine emergencies constitute only a small percentage of the emergency workload of general doctors, comprising about 1.5% of all hospital admission in England in 2004–5. Most of these are diabetes related with the remaining conditions totalling a few hundred cases at most. Hence any individual doctor might not have sufficient exposure to be confident in their management. This review discusses the management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, hypercalcaemia, thyroid storm, myxoedema coma, acute adrenal insufficiency, phaeochromocytoma hypertensive crisis and pituitary apoplexy in the adult population. PMID:17308209

  12. Methylglyoxal, obesity, and diabetes.

    PubMed

    Matafome, Paulo; Sena, Cristina; Seiça, Raquel

    2013-06-01

    Methylglyoxal (MG) is a highly reactive compound derived mainly from glucose and fructose metabolism. This metabolite has been implicated in diabetic complications as it is a strong AGE precursor. Furthermore, recent studies suggested a role for MG in insulin resistance and beta-cell dysfunction. Although several drugs have been developed in the recent years to scavenge MG and inhibit AGE formation, we are still far from having an effective strategy to prevent MG-induced mechanisms. This review summarizes the mechanisms of MG formation, detoxification, and action. Furthermore, we review the current knowledge about its implication on the pathophysiology and complications of obesity and diabetes.

  13. Metabolomics in childhood diabetes

    PubMed Central

    Frohnert, Brigitte I; Rewers, Marian J

    2015-01-01

    Recent increases in the incidence of both type 1 (T1D) and type 2 diabetes (T2D) in children and adolescents point to the importance of environmental factors in the development of these diseases. Metabolomic analysis explores the integrated response of the organism to environmental changes. Metabolic profiling can identify biomarkers that are predictive of disease incidence and development, potentially providing insight into disease pathogenesis. This review provides an overview of the role of metabolomic analysis in diabetes research and summarizes recent research relating to the development of T1D and T2D in children. PMID:26420304

  14. [Gestational diabetes mellitus].

    PubMed

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

    2012-12-01

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

  15. Risk of Vaginal Infections at Early Gestation in Patients with Diabetic Conditions during Pregnancy: A Retrospective Cohort Study

    PubMed Central

    Marschalek, Julian; Farr, Alex; Kiss, Herbert; Hagmann, Michael; Göbl, Christian S; Trofaier, Marie-Louise; Kueronya, Verena; Petricevic, Ljubomir

    2016-01-01

    Pregnant women with gestational diabetes mellitus (GDM) are reported to be at increased risk for infections of the genital tract. This study aimed to compare the prevalence of asymptomatic bacterial vaginosis (BV) and Candida colonization at early gestation between pregnant women with and without diabetic conditions during pregnancy. We included data from 8, 486 singleton pregnancies that underwent an antenatal infection screen-and-treat programme at our department. All women with GDM or pre-existing diabetes were retrospectively assigned to the diabetic group (DIAB), whereas non-diabetic women served as controls (CON). Prevalence for BV and Candida colonization was 9% and 14% in the DIAB group, and 9% and 13% in the CON group, respectively (n.s.). No significant difference regarding stillbirth and preterm delivery (PTD), defined as a delivery earlier than 37 + 0 (37 weeks plus 0 days) weeks of gestation was found. We could not find an increased risk of colonization with vaginal pathogens at early gestation in pregnant women with diabetes, compared to non-diabetic women. Large prospective studies are needed to evaluate the long-term risk of colonization with vaginal pathogens during the course of pregnancy in these women. PMID:27167850

  16. Diabetes foot disease: the Cinderella of Australian diabetes management?

    PubMed Central

    2012-01-01

    Diabetes is one of the greatest public health challenges to face Australia. It is already Australia’s leading cause of kidney failure, blindness (in those under 60 years) and lower limb amputation, and causes significant cardiovascular disease. Australia’s diabetes amputation rate is one of the worst in the developed world, and appears to have significantly increased in the last decade, whereas some other diabetes complication rates appear to have decreased. This paper aims to compare the national burden of disease for the four major diabetes-related complications and the availability of government funding to combat these complications, in order to determine where diabetes foot disease ranks in Australia. Our review of relevant national literature indicates foot disease ranks second overall in burden of disease and last in evidenced-based government funding to combat these diabetes complications. This suggests public funding to address foot disease in Australia is disproportionately low when compared to funding dedicated to other diabetes complications. There is ample evidence that appropriate government funding of evidence-based care improves all diabetes complication outcomes and reduces overall costs. Numerous diverse Australian peak bodies have now recommended similar diabetes foot evidence-based strategies that have reduced diabetes amputation rates and associated costs in other developed nations. It would seem intuitive that “it’s time” to fund these evidence-based strategies for diabetes foot disease in Australia as well. PMID:23021818

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2008-01-01

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

  19. Diabetes mellitus and periodontal disease.

    PubMed

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

    1978-02-01

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

  20. Diabetes mellitus and periodontal disease.

    PubMed

    Zachariasen, R D

    1991-05-01

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

  1. Osteomyelitis in the diabetic foot

    PubMed Central

    Malhotra, Rishi; Chan, Claire Shu-Yi; Nather, Aziz

    2014-01-01

    Osteomyelitis (OM) is a common complication of diabetic foot ulcers and/or diabetic foot infections. This review article discusses the clinical presentation, diagnosis, and treatment of OM in the diabetic foot. Clinical features that point to the possibility of OM include the presence of exposed bone in the depth of a diabetic foot ulcer. Medical imaging studies include plain radiographs, magnetic resonance imaging, and bone scintigraphy. A high index of suspicion is also required to make the diagnosis of OM in the diabetic foot combined with clinical and radiological studies. PMID:25147627

  2. 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.

  3. Gestational diabetes affects fetal autophagy.

    PubMed

    Avagliano, Laura; Massa, Valentina; Terraneo, Laura; Samaja, Michele; Doi, Patrizia; Bulfamante, Gaetano Pietro; Marconi, Anna Maria

    2017-07-01

    Autophagy is a catabolic process involved in the preservation of energy homeostasis and its dysregulation has been implicated in the development of metabolic disorders, including diabetes mellitus. Gestational diabetes mellitus represents a risk for fetal morbidity and mortality. The present study focuses on the autophagy process in human diabetic placenta and fetal pancreas, compared with controls. Analysis of the autophagy markers LC3, Beclin-1 and p62 suggests an impairment of the autophagy process in diabetic placentas. Results indicate an association between gestational diabetes and autophagy, emphasizing the importance of unravelling the mechanisms regulating this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Therapeutic strategies for diabetic neuropathy.

    PubMed

    Habib, Ali A; Brannagan, Thomas H

    2010-03-01

    Diabetes is the leading cause of peripheral neuropathy globally. Duration of diabetes, glycemic control, and preexisting cardiovascular risk factors independently correlate with the development and progression of diabetic peripheral neuropathy as well as cardiovascular autonomic neuropathy. The pathogenesis of diabetic neuropathy remains unclear, although insulin resistance, oxidative stress, mitochondrial dysfunction, abnormal glucose metabolism, advanced glycation end products, neurotrophic factors, and protein kinase C activation all may play a role. Strict glycemic control remains the only available treatment option, although other treatments are in development. Multiple options are available for symptom management. In this article, we review factors associated with development and progression of diabetic neuropathy and discuss available treatment options.

  5. Rheumatologic manifestations of diabetes mellitus.

    PubMed

    Crispin, José C; Alcocer-Varela, Jorge

    2003-06-15

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

  6. Pancreatitis and diabetes in cats.

    PubMed

    Caney, Sarah M A

    2013-03-01

    Pancreatitis is an important potential cause and complicating factor in cases of diabetes mellitus. Pancreatitis can lead to development of diabetes mellitus, which may be transient (diabetic remission) or permanent through destruction and loss of β cells. Pancreatitis can also be a complicating factor in management of diabetic cats by exacerbating or inducing peripheral insulin resistance, particularly at times of intensified pancreatitic inflammation. Pancreatitis is commonly associated with other inflammatory conditions-especially inflammatory bowel disease and cholangiohepatitis-and its presence makes management of diabetes mellitus more challenging. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Short term supplementation of dietary antioxidants selectively regulates the inflammatory responses during early cutaneous wound healing in diabetic mice

    PubMed Central

    2011-01-01

    Background Diabetic foot ulcers are serious complications for diabetic patients, yet the precise mechanism that underlines the treatment of these diabetic complications remains unclear. We hypothesized that dietary antioxidant supplementation with vitamin C, combined either with vitamin E or with vitamin E and NAC, improves delayed wound healing through modulation of blood glucose levels, oxidative stress, and inflammatory response. Methods Diabetes was induced by administration of alloxan monohydrate. Mice were divided into 4 groups; CON (non-diabetic control mice fed AIN 93 G purified rodent diet), DM (diabetic mice fed AIN 93 G purified rodent diet), VCE (diabetic mice fed 0.5% vitamin C and 0.5% vitamin E supplemented diet), and Comb (diabetic mice fed 0.5% vitamin C, 0.5% vitamin E, and 2.5% NAC supplemented diet). After 10 days of dietary antioxidant supplementation, cutaneous full-thickness excisional wounds were performed, and the rate of wound closure was examined. TBARS as lipid peroxidation products and vitamin E levels were measured in the liver. Expression levels of oxidative stress and inflammatory response related proteins were measured in the cutaneous wound site. Results Dietary antioxidant supplementation improved blood glucose levels and wound closure rate and increased liver vitamin E, but not liver TBARS levels in the diabetic mice as compared to those of the CON. In addition, dietary antioxidant supplementation modulated the expression levels of pIκBα, HO-1, CuZnSOD, iNOS and COX-2 proteins in the diabetic mice. Conclusions These findings demonstrated that delayed wound healing is associated with an inflammatory response induced by hyperglycaemia, and suggests that dietary antioxidant supplementation may have beneficial effects on wound healing through selective modulation of blood glucose levels, oxidative stress, and inflammatory response. PMID:22088091

  8. Many faces of monogenic diabetes.

    PubMed

    Schwitzgebel, Valerie M

    2014-03-23

    Monogenic diabetes represents a heterogeneous group of disorders resulting from defects in single genes. Defects are categorized primarily into two groups: disruption of β-cell function or a reduction in the number of β-cells. A complex network of transcription factors control pancreas formation, and a dysfunction of regulators high in the hierarchy leads to pancreatic agenesis. Dysfunction among factors further downstream might cause organ hypoplasia, absence of islets of Langerhans or a reduction in the number of β-cells. Many transcription factors have pleiotropic effects, explaining the association of diabetes with other congenital malformations, including cerebellar agenesis and pituitary agenesis. Monogenic diabetes variants are classified conventionally according to age of onset, with neonatal diabetes occurring before the age of 6 months and maturity onset diabetes of the young (MODY) manifesting before the age of 25 years. Recently, certain familial genetic defects were shown to manifest as neonatal diabetes, MODY or even adult onset diabetes. Patients with neonatal diabetes require a thorough genetic work-up in any case, and because extensive phenotypic overlap exists between monogenic, type 2, and type 1 diabetes, genetic analysis will also help improve diagnosis in these cases. Next generation sequencing will facilitate rapid screening, leading to the discovery of digenic and oligogenic diabetes variants, and helping to improve our understanding of the genetics underlying other types of diabetes. An accurate diagnosis remains important, because it might lead to a change in the treatment of affected subjects and influence long-term complications.

  9. Updates in diabetic peripheral neuropathy

    PubMed Central

    Juster-Switlyk, Kelsey; Smith, A. Gordon

    2016-01-01

    Diabetes has become one of the largest global health-care problems of the 21 st century. According to the Centers for Disease Control and Prevention, the population prevalence of diabetes in the US is approaching 10% and is increasing by 5% each year. Diabetic neuropathy is the most common complication associated with diabetes mellitus. Diabetes causes a broad spectrum of neuropathic complications, including acute and chronic forms affecting each level of the peripheral nerve, from the root to the distal axon. This review will focus on the most common form, distal symmetric diabetic polyneuropathy. There has been an evolution in our understanding of the pathophysiology and the management of diabetic polyneuropathy over the past decade. We highlight these new perspectives and provide updates from the past decade of research. PMID:27158461

  10. Diabetic Neuropathy: Mechanisms to Management

    PubMed Central

    Edwards, James L.; Vincent, Andrea; Cheng, Thomas; Feldman, Eva L.

    2014-01-01

    Neuropathy is the most common and debilitating complication of diabetes and results in pain, decreased motility, and amputation. Diabetic neuropathy encompasses a variety of forms whose impact ranges from discomfort to death. Hyperglycemia induces oxidative stress in diabetic neurons and results in activation of multiple biochemical pathways. These activated pathways are a major source of damage and are potential therapeutic targets in diabetic neuropathy. Though therapies are available to alleviate the symptoms of diabetic neuropathy, few options are available to eliminate the root causes. The immense physical, psychological, and economic cost of diabetic neuropathy underscores the need for causally targeted therapies. This review covers the pathology, epidemiology, biochemical pathways, and prevention of diabetic neuropathy, as well as discusses current symptomatic and causal therapies and novel approaches to identify therapeutic targets. PMID:18616962

  11. Updates in diabetic peripheral neuropathy.

    PubMed

    Juster-Switlyk, Kelsey; Smith, A Gordon

    2016-01-01

    Diabetes has become one of the largest global health-care problems of the 21 (st) century. According to the Centers for Disease Control and Prevention, the population prevalence of diabetes in the US is approaching 10% and is increasing by 5% each year. Diabetic neuropathy is the most common complication associated with diabetes mellitus. Diabetes causes a broad spectrum of neuropathic complications, including acute and chronic forms affecting each level of the peripheral nerve, from the root to the distal axon. This review will focus on the most common form, distal symmetric diabetic polyneuropathy. There has been an evolution in our understanding of the pathophysiology and the management of diabetic polyneuropathy over the past decade. We highlight these new perspectives and provide updates from the past decade of research.

  12. The Spectrum of Diabetic Neuropathies

    PubMed Central

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

    2009-01-01

    Diabetes mellitus is associated with many different neuropathic syndromes, ranging from a mild sensory disturbance as can be seen in a diabetic sensorimotor polyneuropathy, to the debilitating pain and weakness of a diabetic lumbosacral radiculoplexus neuropathy. The etiology of these syndromes has been extensively studied, and may vary among metabolic, compressive, and immunological bases for the different disorders, as well as mechanisms yet to be discovered. Many of these disorders of nerve appear to be separate conditions with different underlying mechanisms, and some are directly caused by diabetes mellitus, whereas others are associated with it but not caused by hyperglycemia. We discuss a number of the more common disorders of nerve found with diabetes mellitus. We discuss the symmetrical neuropathies, particularly generalized diabetic polyneuropathy, and then the focal or asymmetrical types of diabetes-associated neuropathy. PMID:18194747

  13. Heat Shock Proteins and Diabetes.

    PubMed

    Zilaee, Marzie; Shirali, Saeed

    2016-12-01

    Diabetes is a chronic disease, and its prevalence continues to rise and can increase the risk for the progression of microvascular (such as nephropathy, retinopathy and neuropathy) and also macrovascular complications. Diabetes is a condition in which the oxidative stress and inflammation rise. Heat shock proteins (HSPs) are a highly conserved family of proteins that are expressed by all cells exposed to environmental stress, and they have diverse functions. In patients with diabetes, the expression and levels of HSPs decrease, but these chaperones can aid in improving some complications of diabetes, such as oxidative stress and inflammation. (The suppression of some HSPs is associated with a generalized increase in tissue inflammation.) In this review, we summarize the current understanding of HSPs in diabetes as well as their complications, and we also highlight their potential role as therapeutic targets in diabetes. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  14. Relationship between diabetic retinopathy, diabetic macular oedema and erectile dysfunction in type 2 diabetics.

    PubMed

    Chew, Sky K H; Taouk, Yamna; Xie, Jing; Nicolaou, Theona E; Wang, Jie Jin; Wong, Tien Y; Lamoureux, Ecosse L

    2013-01-01

    To investigate the relationship of diabetic retinopathy and diabetic macular oedema with erectile dysfunction in patients with type 2 diabetes. Hospital-based, cross-sectional study. Three hundred twenty-four men with diabetes from the Diabetic Management Project were recruited. Participants underwent a comprehensive interview, a complete eye examination, fasting blood tests, and had retinal and macula assessments using fundus images and optical coherence tomography, respectively. Diabetic retinopathy was categorized as none, mild, moderate, severe non-proliferative and proliferative, and diabetic macular oedema as none, mild, moderate and severe. Erectile dysfunction was defined as problems achieving or maintaining an erection and was assessed using a self-reported questionnaire. Erectile dysfunction. The mean ± standard deviation age of 324 men with type 2 diabetes was 65.2 ± 11.1 years. Compared with patients without diabetic retinopathy, those with any retinopathy (odds ratio 2.06, 95% confidence interval 1.22-3.48, P = 0.007) had a twofold increased odds of having erectile dysfunction. Patients with severe non-proliferative diabetic retinopathy (odds ratio 4.39, 95% confidence interval 1.48-13.0, P = 0.008) and proliferative diabetic retinopathy (odds ratio 2.74, 95% confidence interval 1.44-5.19, P = 0.002) had fourfold and threefold increased odds of having erectile dysfunction, respectively, compared with those without diabetic retinopathy. Diabetic macular oedema, irrespective of presence or severity, was not independently associated with erectile dysfunction. The presence and severity of diabetic retinopathy but not diabetic macular oedema are independently associated with self-reported erectile dysfunction. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  15. Impulse Control, Diabetes-Specific Self-Efficacy, and Diabetes Management Among Emerging Adults With Type 1 Diabetes

    PubMed Central

    Hanna, Kathleen M.; Slaven, James E.; Weaver, Michael T.; Fortenberry, J. Dennis

    2013-01-01

    Objective To explore the relationships among impulse control, diabetes-specific self-efficacy, and diabetes management behaviors among emerging adults with type 1 diabetes. Methods A total of 204 high school seniors (M = 18.25 years, SD = .45, 55.9% females) with type 1 diabetes self-reported on impulse control, diabetes-specific self-efficacy, and diabetes management behaviors during the past 3 months. Mediation and path analyses were used to address aims. Results Greater impulse control was associated with better diabetes management among these emerging adults. In addition, diabetes-specific self-efficacy partially mediated the relationship between impulse control and diabetes management. Conclusions Impulse control and diabetes-specific self-efficacy may be important in the management of type 1 diabetes among emerging adults. Diabetes-specific self-efficacy may play an important role in successful diabetes management among youth with lower impulse control. PMID:23115219

  16. Games and Diabetes

    PubMed Central

    Lazem, Shaimaa; Webster, Mary; Holmes, Wayne; Wolf, Motje

    2015-01-01

    Here we review 18 articles that describe the design and evaluation of 1 or more games for diabetes from technical, methodological, and theoretical perspectives. We undertook searches covering the period 2010 to May 2015 in the ACM, IEEE, Journal of Medical Internet Research, Studies in Health Technology and Informatics, and Google Scholar online databases using the keywords “children,” “computer games,” “diabetes,” “games,” “type 1,” and “type 2” in various Boolean combinations. The review sets out to establish, for future research, an understanding of the current landscape of digital games designed for children with diabetes. We briefly explored the use and impact of well-established learning theories in such games. The most frequently mentioned theoretical frameworks were social cognitive theory and social constructivism. Due to the limitations of the reported evaluation methodologies, little evidence was found to support the strong promise of games for diabetes. Furthermore, we could not establish a relation between design features and the game outcomes. We argue that an in-depth discussion about the extent to which learning theories could and should be manifested in the design decisions is required. PMID:26337753

  17. Diabetes and Behavior.

    ERIC Educational Resources Information Center

    Surwit, Richard S.; And Others

    1983-01-01

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

  18. Diabetes and Behavior.

    ERIC Educational Resources Information Center

    Surwit, Richard S.; And Others

    1983-01-01

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

  19. Tea, obesity, and diabetes.

    PubMed

    Kao, Yung-Hsi; Chang, Hsin-Huei; Lee, Meng-Jung; Chen, Chia-Lin

    2006-02-01

    Tea has been found to possess widespread biological functions based on a variety of laboratory data. The effects of tea on obesity and diabetes have received increasing attention. This paper reviews the evidence for the connections among tea catechins, and obesity and diabetes. Tea catechins, especially (-)-epigallocatechin gallate (EGCG), appear to have antiobesity and antidiabetic effects. While few epidemiological and clinical studies show the health benefits of EGCG on obesity and diabetes, the mechanisms of its actions are emerging based on the various laboratory data. These mechanisms may be related to certain pathways, such as through the modulations of energy balance, endocrine systems, food intake, lipid and carbohydrate metabolism, the redox status, and activities of different types of cells (i. e., fat, liver, muscle, and beta-pancreatic cells). Because the EGCG receptor, the so-called 67-kDa laminin receptor (LR), has been discovered with colocalization of other types of LR and cytoskeleton in both cancer cells and normal cells, this may explain that EGCG possesses numerous actions. The mechanistic results of this review may possibly be utilized in the treatment of obesity, diabetes, and other related diseases using tea- and EGCG-based folk medicines.

  20. Cystic fibrosis related diabetes.

    PubMed

    O'Shea, Donal; O'Connell, Jean

    2014-08-01

    Improved life expectancy in cystic fibrosis (CF) has led to an expanding population of adults with CF, now representing almost 50 % of the total CF population. This creates new challenges from long-term complications such as diabetes mellitus (DM), a condition that is present in 40 %-50 % of adults with CF. Cystic fibrosis-related diabetes (CFRD) results from a primary defect of insulin deficiency and although sharing features with type 1 (DM1) and type 2 diabetes (DM2), it is a clinically distinct condition. Progression to diabetes is associated with poorer CF clinical outcomes and increased mortality. CFRD is not associated with an increased risk of cardiovascular disease and the prevalence of microvascular complications is lower than DM1 or DM2. Rather, the primary goal of insulin therapy is the preservation of lung function and optimization of nutritional status. There is increasing evidence that appropriate screening and early intervention with insulin can reverse weight loss and improve pulmonary function. This approach may include targeting postprandial hyperglycemia not detected by standard diagnostic tests such as the oral glucose tolerance test. Further clinical research is required to guide when and how much to intervene in patients who are already dealing with the burden of one chronic illness.

  1. Metabolomics in diabetic complications.

    PubMed

    Filla, Laura A; Edwards, James L

    2016-04-01

    With a global prevalence of 9%, diabetes is the direct cause of millions of deaths each year and is quickly becoming a health crisis. Major long-term complications of diabetes arise from persistent oxidative stress and dysfunction in multiple metabolic pathways. The most serious complications involve vascular damage and include cardiovascular disease as well as microvascular disorders such as nephropathy, neuropathy, and retinopathy. Current clinical analyses like glycated hemoglobin and plasma glucose measurements hold some value as prognostic indicators of the severity of complications, but investigations into the underlying pathophysiology are still lacking. Advancements in biotechnology hold the key to uncovering new pathways and establishing therapeutic targets. Metabolomics, the study of small endogenous molecules, is a powerful toolset for studying pathophysiological processes and has been used to elucidate metabolic signatures of diabetes in various biological systems. Current challenges in the field involve correlating these biomarkers to specific complications to provide a better prediction of future risk and disease progression. This review will highlight the progress that has been made in the field of metabolomics including technological advancements, the identification of potential biomarkers, and metabolic pathways relevant to macro- and microvascular diabetic complications.

  2. [Diabetes and Ramadan].

    PubMed

    Zantar, Amina; Azzoug, Said; Belhimer, Faiza; Chentli, Farida

    2012-11-01

    Ramadan, one of the five pillars of Islam, is a holy month for Muslims. During this month, they have a duty to fast every day from sunrise to sunset. This religion spares diabetics and persons with chronic illnesses from this duty, because lack of eating and drinking all the day has many bad consequences on their health. But, because of a very strong habit, by solidarity with the family, or by fear of exclusion from the society, many diabetics insist on fasting as demonstrated by numerous studies. The problem is, when they fast, diabetics are at risk from complications such as severe hypoglycemia, hyperglycemia, ketoacidosis, dehydration and thrombosis. To avoid this, consensus and recommendations have emerged in order to develop new approaches that would minimize the various complications. It appears from different recommendations that only diabetics whose equilibrium is stable, free of degenerative complications, and able to manage properly their diseases will be allowed to fast. The physician's role is to assist the faithful person to Ramadan by raising awareness of lifestyle and dietary rules, daily self-monitoring, and a new adjustment of treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  3. Adjusting to Childhood Diabetes.

    ERIC Educational Resources Information Center

    Johnson, Suzanne Bennett

    Insulin dependent diabetes is an incurable disease requiring complex management by the patient and/or his family. Previous research has found that there is no specific personality type associated with this or other diseases, nor do chronically ill persons exhibit characteristic behavioral or emotional problems. An attempt to identify the…

  4. 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

  5. Diabetes mellitus and inflammation.

    PubMed

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

    2013-06-01

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

  6. Adjusting to Childhood Diabetes.

    ERIC Educational Resources Information Center

    Johnson, Suzanne Bennett

    Insulin dependent diabetes is an incurable disease requiring complex management by the patient and/or his family. Previous research has found that there is no specific personality type associated with this or other diseases, nor do chronically ill persons exhibit characteristic behavioral or emotional problems. An attempt to identify the…

  7. [Obesity and diabetes mellitus].

    PubMed

    Tron'ko, N D; Zak, K P

    2013-12-01

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

  8. Periodontal disease and diabetes.

    PubMed

    Bascones-Martínez, Antonio; Arias-Herrera, Santiago; Criado-Cámara, Elena; Bascones-Ilundáin, Jaime; Bascones-Ilundáin, Cristina

    2012-01-01

    Diabetes is considered to be a genetically and environmentally based chronic metabolic and vascular syndrome caused by a partial or total insulin deficiency with alteration in the metabolism of lipids, carbohydrates and proteins culminating with different manifestations in different organisms. In humans hyperglycemia is the main consequence of defects in the secretion and/or action of insulin, and its deregulation can produce secondary lesions in various organs, especially kidneys, eyes, nerves, blood vessels and immune systems. Periodontal disease is an entity of localized infection that involves tooth-supporting tissues. The first clinical manifestation of periodontal disease is the appearance of periodontal pockets, which offer a favorable niche for bacterial colonization. The etiology of periodontal disease is multifactorial, being caused by interactions between multiple micro-organisms (necessary but not sufficient primary etiologic factors), a host with some degree of susceptibility and environmental factors. According to current scientific evidence, there is a symbiotic relationship between diabetes and periodontitis, such that diabetes is associated with an increased incidence and progression of periodontitis, and periodontal infection is associated with poor glycaemic control in diabetes due to poor immune systems. Hence, for a good periodontal control it is necessary to treat both periodontal disease and glycaemic control.

  9. Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study.

    PubMed

    Díez-Espino, J; Basterra-Gortari, F J; Salas-Salvadó, J; Buil-Cosiales, P; Corella, D; Schröder, H; Estruch, R; Ros, E; Gómez-Gracia, E; Arós, F; Fiol, M; Lapetra, J; Serra-Majem, L; Pintó, X; Babio, N; Quiles, L; Fito, M; Marti, A; Toledo, E

    2017-08-01

    Eggs are a major source of dietary cholesterol and their consumption has been sometimes discouraged. A relationship between egg consumption and the incidence of cardiovascular disease (CVD) has been suggested to be present exclusively among patients with type2 diabetes. To assess the association between egg consumption and CVD in a large Mediterranean cohort where approximately 50% of participants had type 2 diabetes. We prospectively followed 7216 participants (55-80 years old) at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) study for a mean of 5.8 years. All participants were initially free of CVD. Yearly repeated measurements of dietary information with a validated 137-item food-frequency questionnaire were used to assess egg consumption and other dietary exposures. The endpoint was the rate of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes). A major cardiovascular event occurred in 342 participants. Baseline egg consumption was not significantly associated with cardiovascular events in the total population. Non-diabetic participants who ate on average >4 eggs/week had a hazard ratio (HR) of 0.96 (95% confidence interval, 0.33-2.76) in the fully adjusted multivariable model when compared with non-diabetic participants who reported the lowest egg consumption (<2 eggs/week). Among diabetic participants, the HR was 1.33 (0.72-2.46). There was no evidence of interaction by diabetic status. HRs per 500 eggs of cumulative consumption during follow-up were 0.94 (0.66-1.33) in non-diabetics and 1.18 (0.90-1.55) in diabetics. Low to moderated egg consumption was not associated with an increased CVD risk in diabetic or non-diabetic individuals at high cardiovascular risk. This trial was registered at controlled-trials.com as ISRCTN35739639. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. 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.

  11. Reaching closure with skin stretching. Applications in the diabetic foot.

    PubMed

    Armstrong, D G; Wunderlich, R P; Lavery, L A

    1998-01-01

    At the present time, there are no evidence-based protocols outlining the use of the Sure-Closure Skin Stretching System on diabetic, neuropathic wounds. Ideally, surgical correction of the precipitating deformity and appropriate shoe gear accommodation should be performed con-comitantly with skin stretching (as indicated) to achieve an optimal long-term result. For several years, we have used the Sure-Closure device as an adjunctive treatment for diabetic-foot wound closure, and believe that, ultimately, this device more likely will be used in a clinical setting. In this manner, a patient with an open wound may, under aseptic conditions, be sequestered for a period of 1 to 2 hours during a clinical visit to allow for skin stretching. This procedure may be carried out two or three times weekly until closure is achieved. Mechanically assisted delayed primary closure is a relatively new category of wound closure; however, this device is by no means a panacea. Appropriate patient selection and intraoperative judgment are of critical preoperative and perioperative importance when employing this technique. Currently, we are completing a clinical trial comparing mechanically assisted delayed primary-wound closure to traditional treatment and off-loading in a population of high-risk diabetic patients. We believe that this project will better elucidate the relative indications and contraindications with what may be a very effective tool for the diabetic foot specialist.

  12. EXPERIMENTAL STUDIES ON DIABETES

    PubMed Central

    Allen, Frederick M.

    1920-01-01

    1. The injurious effects of excessive carbohydrate diet are demonstrable in partially depancreatized dogs, in the same manner as in human patients. With severe diabetes there is rapid progress of emaciation and weakness and early death. 2. With milder diabetes, there is frequently a transitional state following operation, when the fate depends on the diet. If the tolerance is spared for a time, recovery sometimes occurs to such extent that diabetes cannot be produced by any kind or quantity of feeding, but only by removal of a small additional fragment of pancreatic tissue. The proper degree of carbohydrate overfeeding is important in this early period for producing the most useful type of diabetic animals; namely, those having good digestion and general health combined with a permanent lowering of assimilative power, like the condition of human patients. 3. In the early stage, glucose is more powerful than starch in producing diabetes, and animals which are progressing toward complete recovery on starch diet can be sent into hopeless diabetes by admixture of glucose. The difference seems to be merely of the rate of absorption, and indicates that a rapid flood of carbohydrate is more injurious to the pancreatic function than a slow absorption. Whenever permanent diabetes is present, so that complete recovery is impossible, starch brings on glycosuria more slowly than sugar, but just as surely. The difference in time in different cases amounts to days, weeks, or months. The clinical lesson from such experiments is that even if a patient becomes free from glycosuria on withdrawal of sugar only, nevertheless other foods should also be limited. 4. No significant differences were observed between the assimilation of different starches, or any extreme lowering of the carbohydrate tolerance by proteins, such as alleged by certain writers in connection with the "oatmeal cure". 5. Repair of traumatic inflammation and hypertrophy of the pancreas remnant have been mentioned

  13. Conserva a Puerto Rico con bosques maderables

    Treesearch

    Frank H. Wadsworth

    2009-01-01

    [article in Spanish] Puerto Rico consume muchos productos forestales costosos de importar. También tiene bosques extensos con maderas explotables. Además, existen condiciones físicas favorables para la producción de madera útil. No obstante, hoy día no se utiliza la madera de los bosques actuales ocurre la deforestación para cualquier fin. Los Bosques productivos de...

  14. Somatic cell nuclear transfer: pros and cons.

    PubMed

    Sumer, Huseyin; Liu, Jun; Tat, Pollyanna; Heffernan, Corey; Jones, Karen L; Verma, Paul J

    2009-01-01

    Even though the technique of mammalian SCNT is just over a decade old it has already resulted in numerous significant advances. Despite the recent advances in the reprogramming field, SCNT remains the bench-mark for the generation of both genetically unmodified autologous pluripotent stem cells for transplantation and for the production of cloned animals. In this review we will discuss the pros and cons of SCNT, drawing comparisons with other reprogramming methods.

  15. [Gestational Diabetes Mellitus].

    PubMed

    Krejčí, Hana

    2016-01-01

    The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations. Gestational diabetes is therefore an important link fitting into the accumulation curve of the incidence of overweight, obesity, metabolic syndrome and consequently also T2DM among the whole population. Genetic as well as epigenetic factors play a great role in the GDM pathogenesis, which is shown by the fact that this complication also affects women with normal BMI. When it comes to diagnosing GDM, we will need to manage also in future with establishing fasting glycemia and glycemia following glucose challenge (OGTT) that may include a considerable degree of measurement inaccuracy. It is therefore necessary to observe pre-analytical and analytical conditions of measurements in order to obtain a reliable result. It is a positive sign that the Czech professional associations have adopted new international criteria for diagnosing GDM which, as opposed to those valid earlier, better reflect the risk of pregnancy-related and perinatal complications.The care for gestational patients with diabetes at a low risk (due to satisfactory glycemic control through a diet or small pharmacotherapeutic doses, with an eutrophic fetus and without associated complications) is provided by an outpatient gynecologist and a diabetes specialist, they can give birth in standard maternity hospitals. The care for gestational patients with diabetes at a higher risk

  16. 77 FR 37060 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

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

  17. The outpatient cost of diabetes care in Italian diabetes centers.

    PubMed

    Garattini, L; Tediosi, F; Chiaffarino, F; Roggeri, D; Parazzini, F; Coscelli, C

    2001-01-01

    To provide resource utilization patterns and cost estimates of outpatient care for types I and II diabetes mellitus in Italy, based on retrospectively collected data. Multicenter, retrospective observational study analyzing individual costs in a sample of patients with diabetes mellitus. A total of 2260 patients were stratified into eight groups by type of diabetes, glycemic control, and age. Thirty-five centers for diabetes care in Italy. The per-patient cost of treatment was [symbol: see text] 136.8 in two months for type I diabetes (N = 592) and [symbol: see text] 123.3 for type II diabetes (N = 1668). Pharmaceutical therapy consisting of antidiabetic drugs only accounted for only 32% to 36% of treatments cost in type I patients and between 13% and 24% in type II. Diagnostic tests accounted for 27% to 42% of treatment costs in patients with both type I and type II diabetes, day-hospital days accounted for 15% to 22% in type I, 25% to 27% in type II, and consultations accounted for 16% to 20% in type I patients and between 17% and 21% in type II diabetes. Despite limitations caused by the short period considered, and considering that in Italy the cost of diabetes has received limited attention, we believe this study presents some interesting information on the burden of diabetes in this country.

  18. Digital therapy in diabetes.

    PubMed

    Cahn, Avivit; Akirov, Amit; Raz, Itamar

    2017-09-05

    Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions of what to eat, when to exercise, and determine their insulin dose and timing if required. Additionally, patients and providers are generating vast amounts of data from many sources including electronic medical records, insulin pumps, sensors, glucometers, other wearables, as well as evolving genomic, proteomic, metabolomic and microbiomic data. Multiple digital tools and apps have been developed to assist patients to choose wisely, as well as enhance their compliance by employing motivational tools and incorporating incentives from social media and gaming techniques. The health care teams and health administrators benefit from digital developments which sift through the enormous amounts of patient generated data. Data is acquired, integrated, analyzed, and presented in a self-explanatory manner, highlighting important trends and items which require attention. Employment of decision support systems may propose data-driven actions which, for the most, require final approval by the patient or physician before execution, and once implemented may improve patient outcomes. The digital diabetes clinic aims to incorporate all digital patient data and provide individually tailored virtual or face-to-face visits to those persons who need them most. Digital diabetes care has demonstrated only modest HbA1c reduction in multiple studies, and borderline cost-effectiveness, although patient satisfaction appears to be increased. Better understanding of the barriers to digital diabetes care and identification of unmet needs may yield improved utilization of this evolving technology in a safe, effective and cost-saving manner. This article is protected by copyright. All rights reserved.

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

    PubMed

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

    2015-01-01

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

  20. Not all neuropathy in diabetes is of diabetic etiology: differential diagnosis of diabetic neuropathy.

    PubMed

    Freeman, Roy

    2009-12-01

    Diabetic peripheral neuropathy is the most common peripheral neuropathy in the developed world; however, not all patients with diabetes and peripheral nerve disease have a peripheral neuropathy caused by diabetes. Several (although not all) studies have drawn attention to the presence of other potential causes of a neuropathy in individuals with diabetes; 10% to 50% of individuals with diabetes may have an additional potential cause of a peripheral neuropathy and some may have more than one cause. Neurotoxic medications, alcohol abuse, vitamin B(12) deficiency, renal disease, chronic inflammatory demyelinating neuropathy, inherited neuropathy, and vasculitis are the most common additional potential causes of a peripheral neuropathy in these series. The most common disorders in the differential diagnosis of a generalized diabetic peripheral neuropathy are discussed in this article. Prospective studies to investigate the prevalence of other disorders that might be responsible for a peripheral neuropathy in individuals with diabetes are warranted.

  1. [ANTIOXIDANT DYSFUNCTIONALITY OF HIGH-DENSITY LIPOPROTEINS (HDL) IN DECOMPENSATED DIABETIC PATIENTS].

    PubMed

    Awad, Fernanda; Contreras-Duarte, Susana; Molina, Patricia; Quiñones, Verónica; Serrano, Valentina; Abbott, Eduardo; Maiz, Alberto; Busso, Dolores; Rigotti, Attilio

    2015-09-01

    Introducción: las lipoproteínas de alta densidad (HDL) tienen un importante efecto protector cardiovascular mediado por su función durante el transporte reverso del colesterol, así como por otras actividades, incluyendo una significativa acción antiinflamatoria y antioxidante. La funcionalidad antiinflamatoria y antioxidante de las HDL está alterada en los pacientes diabéticos crónicos estables, aunque no existe mayor información en caso de una crisis hiperglicémica. Objetivo: determinar si durante un estado de descompensación diabética aguda las partículas de HDL exhiben un deterioro de su función antioxidante y si esta logra recuperarse una vez resuelto el cuadro agudo. Métodos: la actividad antioxidante de las HDL se midió mediante un ensayo de fluorescencia in vitro en muestras plasmáticas de pacientes diabéticos con descompensación aguda obtenidas tanto al ingreso, alcanzada la resolución intrahospitalaria del evento agudo, así como en un control ambulatorio post-hospitalización. Como comparación, se analizaron partículas de HDL de algunos sujetos sanos como condición control. Resultados: la actividad antioxidante de las HDL en pacientes con descompensación diabética aguda fue significativamente menor a la observada en el grupo control sano, y esta se fue recuperando progresivamente hasta normalizarse en el momento del control ambulatorio. La crisis hiperglicémica también demostró una baja actividad plasmática de la enzima antioxidante paraoxonasa- 1, la cual aumentó significativamente en el control ambulatorio. Conclusión: las partículas de HDL presentes en pacientes con una descompensación diabética aguda presentan una reducción significativa y reversible de su capacidad antioxidante, probablemente como consecuencia de una alteración en la actividad de la paraoxonasa-1.

  2. [Breviary of diabetes education for internist].

    PubMed

    Uličiansky, Vladimír

    Diabetes education is an important cornerstone for diabetes care. Patients with diabetes should participate in education to facilitate the knowledge, skill sand ability necessary for diabetes both at diagnosis and there after. Effective self-management can improve clinical outcomes, health status, and quality of life. diabetes mellitus - education - self-management.

  3. Epidemiological Issues in Diabetic Retinopathy

    PubMed Central

    Scanlon, Peter H; Aldington, Stephen J; Stratton, Irene M

    2013-01-01

    There is currently an epidemic of diabetes in the world, principally type 2 diabetes that is linked to changing lifestyle, obesity, and increasing age of the population. Latest estimates from the International Diabetes Federation (IDF) forecasts a rise from 366 million people worldwide to 552 million by 2030. Type 1 diabetes is more common in the Northern hemisphere with the highest rates in Finland and there is evidence of a rise in some central European countries, particularly in the younger children under 5 years of age. Modifiable risk factors for progression of diabetic retinopathy (DR) are blood glucose, blood pressure, serum lipids, and smoking. Nonmodifiable risk factors are duration, age, genetic predisposition, and ethnicity. Other risk factors are pregnancy, microaneurysm count in an eye, microaneurysm formation rate, and the presence of any DR in the second eye. DR, macular edema (ME), and proliferative DR (PDR) develop with increased duration of diabetes and the rates are dependent on the above risk factors. In one study of type 1 diabetes, the median individual risk for the development of early retinal changes was 9.1 years of diabetes duration. Another study reported the 25 year incidence of proliferative retinopathy among population-based cohort of type 1 patients with diabetes was 42.9%. In recent years, people with diabetes have lower rates of progression than historically to PDR and severe visual loss, which may reflect better control of glucose, blood pressure, and serum lipids, and earlier diagnosis. PMID:24339678

  4. Calcium homeostasis in diabetes mellitus.

    PubMed

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

    1979-09-01

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

  5. Renal function in diabetic nephropathy

    PubMed Central

    Dabla, Pradeep Kumar

    2010-01-01

    Diabetic nephropathy is the kidney disease that occurs as a result of diabetes. Cardiovascular and renal complications share common risk factors such as blood pressure, blood lipids, and glycemic control. Thus, chronic kidney disease may predict cardiovascular disease in the general population. The impact of diabetes on renal impairment changes with increasing age. Serum markers of glomerular filtration rate and microalbuminuria identify renal impairment in different segments of the diabetic population, indicating that serum markers as well as microalbuminuria tests should be used in screening for nephropathy in diabetic older people. The American Diabetes Association and the National Institutes of Health recommend Estimated glomerular filtration rate (eGFR) calculated from serum creatinine at least once a year in all people with diabetes for detection of kidney dysfunction. eGFR remains an independent and significant predictor after adjustment for conventional risk factors including age, sex, duration of diabetes, smoking, obesity, blood pressure, and glycemic and lipid control, as well as presence of diabetic retinopathy. Cystatin-C (Cys C) may in future be the preferred marker of diabetic nephropathy due differences in measurements of serum creatinine by various methods. The appropriate reference limit for Cys C in geriatric clinical practice must be defined by further research. Various studies have shown the importance of measurement of albuminuria, eGFR, serum creatinine and hemoglobin level to further enhance the prediction of end stage renal disease. PMID:21537427

  6. MicroRNAs in diabetes and diabetes-associated complications.

    PubMed

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

    2012-06-01

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

  7. Assessment of diabetes acceptance can help identify patients with ineffective diabetes self-care and poor diabetes control.

    PubMed

    Schmitt, A; Reimer, A; Kulzer, B; Haak, T; Gahr, A; Hermanns, N

    2014-11-01

    To estimate the associations between insufficient diabetes acceptance and relevant diabetes outcomes. A total of 320 patients completed questionnaires on diabetes non-acceptance (the Acceptance and Action Diabetes Questionnaire), diabetes distress (the Problem Areas in Diabetes Scale), depressive mood (the Center for Epidemiologic Studies Depression Scale), coping with illness (the Freiburg Questionnaire of Coping with Illness), self-care activities (the Summary of Diabetes Self-Care Activities Measure) and quality of life (the Short Form-36 Health Questionnaire). A six-item version of the Acceptance and Action Diabetes Questionnaire showing good reliability and validity was established, and the associations between insufficient acceptance and clinical outcomes were estimated. Higher diabetes non-acceptance correlated significantly with less active coping (-0.37), reduced self-care (-0.43) and higher HbA1c levels (0.31), higher diabetes distress (0.53) and more depressive symptoms (0.36). Correlations of diabetes non-acceptance with diabetes self-care/glycaemic control were significantly higher than were those of depressive mood or diabetes distress with these criteria. Low diabetes acceptance is associated with impaired self-care and glycaemic control. Assessment of diabetes acceptance may facilitate the detection of patients at high risk and may present an essential target for treatments to improve diabetes control that is more relevant than elevated depressive mood or diabetes distress. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  8. Menopause and risk of diabetes in the Diabetes Prevention Program

    PubMed Central

    Kim, Catherine; Edelstein, Sharon L.; Crandall, Jill P.; Dabelea, Dana; Kitabchi, Abbas E.; Hamman, Richard F.; Montez, Maria G.; Perreault, Leigh; Foulkes, Mary A.; Barrett-Connor, Elizabeth

    2012-01-01

    Objective The study objective was to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopausal status modifies response to diabetes prevention interventions. Methods The study population included women in premenopause (n=708), natural postmenopause (n=328), and bilateral oophorectomy (n=201) in the Diabetes Prevention Program (DPP), a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy (HT) use. Results After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (HR 0.19, 95% CI 0.04, 0.94), although observations were too few to determine if this was independent of HT use. No significant differences were seen in the metformin (HR 1.29, 95% CI 0.63, 2.64) or placebo arms (HR 1.37, 95% CI 0.74, 2.55). Conclusions Among women at high-risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with decreased diabetes risk. PMID:21709591

  9. Menopause and risk of diabetes in the Diabetes Prevention Program.

    PubMed

    Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

    2011-08-01

    The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

  10. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  11. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  12. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  13. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  14. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of meat...

  15. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall...

  16. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  17. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  18. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  19. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  20. Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

    PubMed

    Arnold, Pamela; Scheurer, Danielle; Dake, Andrew W; Hedgpeth, Angela; Hutto, Amy; Colquitt, Caroline; Hermayer, Kathie L

    2016-04-01

    The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Published by Elsevier Inc.

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

    PubMed

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

    1976-07-01

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

  2. Diabetes autoantibodies do not predict progression to diabetes in adults: the Diabetes Prevention Program.

    PubMed

    Dabelea, D; Ma, Y; Knowler, W C; Marcovina, S; Saudek, C D; Arakaki, R; White, N H; Kahn, S E; Orchard, T J; Goldberg, R; Palmer, J; Hamman, R F

    2014-09-01

    To determine if the presence of diabetes autoantibodies predicts the development of diabetes among participants in the Diabetes Prevention Program. A total of 3050 participants were randomized into three treatment groups: intensive lifestyle intervention, metformin and placebo. Glutamic acid decarboxylase (GAD) 65 autoantibodies and insulinoma-associated-2 autoantibodies were measured at baseline and participants were followed for 3.2 years for the development of diabetes. The overall prevalence of GAD autoantibodies was 4.0%, and it varied across racial/ethnic groups from 2.4% among Asian-Pacific Islanders to 7.0% among non-Hispanic black people. There were no significant differences in BMI or metabolic variables (glucose, insulin, HbA(1c), estimated insulin resistance, corrected insulin response) stratified by baseline GAD antibody status. GAD autoantibody positivity did not predict diabetes overall (adjusted hazard ratio 0.98; 95% CI 0.56-1.73) or in any of the three treatment groups. Insulinoma-associated-2 autoantibodies were positive in only one participant (0.033%). These data suggest that 'diabetes autoimmunity', as reflected by GAD antibodies and insulinoma-associated-2 autoantibodies, in middle-aged individuals at risk for diabetes is not a clinically relevant risk factor for progression to diabetes. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  3. [Depressive disorders in diabetic patients].

    PubMed

    Manoudi, F; Chagh, R; Benhima, I; Asri, F; Diouri, A; Tazi, I

    2012-10-01

    Diabetes is a public health problem. Its global prevalence was 2.8% in 2000 and it will reach 4.4% in 2030 to be 366 million diabetics. In Morocco, this true "epidemic" affects 6.6% of the population. Many epidemiologic studies have shown that patients with diabetes are more susceptible to depression. Diabetes and depression align in a non-accidental way and complicate one another. We report a cross-sectional study conducted in association with the endocrinology department of the Mohammed VI university hospital during the period spread between April and September 2006. The aim was to evaluate the prevalence of depressive disorders in patients with diabetes and to describe their sociodemographic and clinical profile. The study included 187 patients. The scales used were the Mini International Neuropsychiatric Interview (MINI) and Hamilton's depression. Sociodemographics and diabetic characteristics were evaluated by self-questionnaire. The average age of our patients was 53±14 years and the percentage of females was high: 71.2%. Diabetes type 2 was the most representative (85.6%), diabetes type 1 (11.8%) and gestational diabetes (2.7%). Half of diabetics were treated with an association of healthy dietary measures (MHD) and oral anti-diabetics; 31.6% were under MHD and insulin therapy; 33.2% of patients had acute complications and 43.5% had degenerative complications. Only 11 patients (5.9%) had antecedents of depression. The prevalence of major depressive episode was 41.2%; 27.8% of patients suffered from dysthymia and 21.9% from double depression. Hamilton's depression scale indicates that all depressed patients had mild depression (total of 17 items from 8 to 17). Major depressive episode and dysthymia were frequent in out patients. Dysthymia was predominant in diabetic patients in the 46 to 55 years age group, never been schooled and without any comorbidity. The vast majority of patients with EDM had type 2 diabetes with 89.6%, 7.8% type 1 diabetes and 2

  4. Cybersecurity for Connected Diabetes Devices.

    PubMed

    Klonoff, David C

    2015-04-16

    Diabetes devices are increasingly connected wirelessly to each other and to data-displaying reader devices. Threats to the accurate flow of information and commands may compromise the function of these devices and put their users at risk of health complications. Sound cybersecurity of connected diabetes devices is necessary to maintain confidentiality, integrity, and availability of the data and commands. Diabetes devices can be hacked by unauthorized agents and also by patients themselves to extract data that are not automatically provided by product software. Unauthorized access to connected diabetes devices has been simulated and could happen in reality. A cybersecurity standard designed specifically for connected diabetes devices will improve the safety of these products and increase confidence of users that the products will be secure. © 2015 Diabetes Technology Society.

  5. Diabetes Mellitus and Heart Failure.

    PubMed

    Lehrke, Michael; Marx, Nikolaus

    2017-06-01

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

  6. Diabetes Mellitus and Heart Failure.

    PubMed

    Lehrke, Michael; Marx, Nikolaus

    2017-07-01

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

  7. [Diabetes mellitus in acute pancreatitis].

    PubMed

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

    2002-01-01

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

  8. Diabetes from humans to cats.

    PubMed

    Osto, M; Zini, E; Reusch, C E; Lutz, T A

    2013-02-01

    Diabetes mellitus is a common endocrinopathy in humans and in cats. The general prevalence of diabetes mellitus, and in particular of type 2 diabetes, has risen dramatically in recent years. This increase has often been linked to the rise in the obesity pandemic because obesity and the ensuing metabolic consequences constitute major risk factors for human type 2 and for feline diabetes. Feline diabetes shares many features of human type 2 diabetes in respect to its pathophysiology, underlying risk factors and treatment strategies. This review will briefly summarize major characteristics in the human and the feline disease and where available, point out the current knowledge on similarities and differences. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Diabetes: An Investor's Perspective

    PubMed Central

    Harris, Bernard

    2008-01-01

    Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise. Moreover, the baby boomer demographic is anticipated to place an enormous burden on the health care system and employer-based health insurance premiums were increased at rates as high as 10% per year in 2006. The quest to address these challenges has also created opportunities for investment, particularly in the fields of telemedicine, health care information technology, and medical technology. The author shares his business perspective, informed by years of experience as a physician and astronaut at NASA, and describes new applications of exciting technologies that deliver effective and efficient health care to diabetes patients, no matter where they may be. PMID:19885357

  10. Drug therapy for diabetes.

    PubMed

    Haas, L B

    1991-09-01

    Drug therapy with oral hypoglycemic agents and insulin are components of diabetes management regimens that also include diet, exercise/activity, monitoring, and education. Major concerns for practitioners using drug therapy are selection of the appropriate therapy for a particular patient, and drug interactions and side effects. Drug therapy is based on knowledge of the medications' pharmacokinetics; glucose goals, as determined by practitioners and patients; common sense; and strong participatory relationships between practitioners and patients and, if indicated, families. When using insulin, practitioners need to consider the differences between insulin therapy for insulin-dependent and non-insulin-dependent diabetes; how to initiate, adjust, and supplement insulin; situations that require variations in insulin therapy; and injection mechanics.

  11. Neonatal Diabetes Mellitus

    PubMed Central

    Aguilar-Bryan, Lydia; Bryan, Joseph

    2008-01-01

    An explosion of work over the last decade has produced insight into the multiple hereditary causes of a nonimmunological form of diabetes diagnosed most frequently within the first 6 months of life. These studies are providing increased understanding of genes involved in the entire chain of steps that control glucose homeostasis. Neonatal diabetes is now understood to arise from mutations in genes that play critical roles in the development of the pancreas, of β-cell apoptosis and insulin processing, as well as the regulation of insulin release. For the basic researcher, this work is providing novel tools to explore fundamental molecular and cellular processes. For the clinician, these studies underscore the need to identify the genetic cause underlying each case. It is increasingly clear that the prognosis, therapeutic approach, and genetic counseling a physician provides must be tailored to a specific gene in order to provide the best medical care. PMID:18436707

  12. [Gestational diabetes mellitus].

    PubMed

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

    2016-04-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birth weight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e. g. glucosuria)). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140 mg/dl) insulin

  13. Subacute diabetic proximal neuropathy

    NASA Technical Reports Server (NTRS)

    Pascoe, M. K.; Low, P. A.; Windebank, A. J.; Litchy, W. J.

    1997-01-01

    OBJECTIVE: To evaluate the clinical, electrophysiologic, autonomic, and neuropathologic characteristics and the natural history of subacute diabetic proximal neuropathy and its response to immunotherapy. MATERIAL AND METHODS: For the 12-year period from 1983 to 1995, we conducted a retrospective review of medical records of Mayo Clinic patients with diabetes who had subacute onset and progression of proximal weakness. The responses of treated versus untreated patients were compared statistically. RESULTS: During the designated study period, 44 patients with subacute diabetic proximal neuropathy were encountered. Most patients were middle-aged or elderly, and no sex preponderance was noted. The proximal muscle weakness often was associated with reduced or absent lower extremity reflexes. Associated weight loss was a common finding. Frequently, patients had some evidence of demyelination on nerve conduction studies, but it invariably was accompanied by concomitant axonal degeneration. The cerebrospinal fluid protein concentration was usually increased. Diffuse and substantial autonomic failure was generally present. In most cases, a sural nerve biopsy specimen suggested demyelination, although evidence of an inflammatory infiltrate was less common. Of 12 patients who received treatment (with prednisone, intravenous immune globulin, or plasma exchange), 9 had improvement of their conditions, but 17 of 29 untreated patients (59%) with follow-up also eventually had improvement, albeit at a much slower rate. Improvement was usually incomplete. CONCLUSION: We suggest that the entity of subacute diabetic proximal neuropathy is an extensive and severe variant of bilateral lumbosacral radiculoplexopathy, with some features suggestive of an immune-mediated cause. It differs from chronic inflammatory demyelinating polyradiculoneuropathy in that most cases have a more restricted distribution and seem to be monophasic and self-limiting. The efficacy of immunotherapy is unproved

  14. [Gestational diabetes mellitus].

    PubMed

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

    2004-01-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations in the diabetic range. In case of a high risk for GDM/type 2 diabetes (history of GDM or prediabetes [impaired fasting glucose or impaired glucose tolerance]; malformation, stillbirth, successive abortions or birth-weight > 4500 g in previous pregnancies) performance of the OGTT (120 min; 75 g glucose) is recommended already in the first trimester and--if normal--the OGTT should be repeated in the second/third trimester. In case of clinical symptoms of diabetes (glucosuria, macrosomia) the test has to be performed immediately. All other women should undergo a diagnostic test between 24 and 28 gestational weeks. If fasting plasma glucose exceeds 95 mg/dl, 1 h 180 mg/dl and 2 hrs 155 mg/dl after glucose loading (OGTT) the woman is classified as GDM (one pathological value is sufficient). In this case a strict metabolic control is mandatory. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 130 mg/dl) insulin therapy should be initiated. Maternal and fetal monitoring is required in order to minimize maternal and fetal/neonatal morbidity and perinatal mortality. After delivery all women with GDM have to be reevaluated as to their glucose tolerance by a 75 g OGTT (WHO criteria).

  15. Diabetes in cystic fibrosis.

    PubMed

    Bridges, Nicola

    2013-05-01

    Cystic fibrosis related diabetes (CFRD) is a common complication of cystic fibrosis, caused by a fall in insulin secretion with age in individuals with pancreatic insufficiency. CFRD is associated with worse clinical status and increased mortality. Treatment of CFRD with insulin results in sustained improvements in lung function and nutrition. While clinical experience with insulin treatment in CF has increased, the selection of who to treat and glycaemic targets remain unclear. Copyright © 2013. Published by Elsevier Ltd.

  16. Subacute diabetic proximal neuropathy

    NASA Technical Reports Server (NTRS)

    Pascoe, M. K.; Low, P. A.; Windebank, A. J.; Litchy, W. J.

    1997-01-01

    OBJECTIVE: To evaluate the clinical, electrophysiologic, autonomic, and neuropathologic characteristics and the natural history of subacute diabetic proximal neuropathy and its response to immunotherapy. MATERIAL AND METHODS: For the 12-year period from 1983 to 1995, we conducted a retrospective review of medical records of Mayo Clinic patients with diabetes who had subacute onset and progression of proximal weakness. The responses of treated versus untreated patients were compared statistically. RESULTS: During the designated study period, 44 patients with subacute diabetic proximal neuropathy were encountered. Most patients were middle-aged or elderly, and no sex preponderance was noted. The proximal muscle weakness often was associated with reduced or absent lower extremity reflexes. Associated weight loss was a common finding. Frequently, patients had some evidence of demyelination on nerve conduction studies, but it invariably was accompanied by concomitant axonal degeneration. The cerebrospinal fluid protein concentration was usually increased. Diffuse and substantial autonomic failure was generally present. In most cases, a sural nerve biopsy specimen suggested demyelination, although evidence of an inflammatory infiltrate was less common. Of 12 patients who received treatment (with prednisone, intravenous immune globulin, or plasma exchange), 9 had improvement of their conditions, but 17 of 29 untreated patients (59%) with follow-up also eventually had improvement, albeit at a much slower rate. Improvement was usually incomplete. CONCLUSION: We suggest that the entity of subacute diabetic proximal neuropathy is an extensive and severe variant of bilateral lumbosacral radiculoplexopathy, with some features suggestive of an immune-mediated cause. It differs from chronic inflammatory demyelinating polyradiculoneuropathy in that most cases have a more restricted distribution and seem to be monophasic and self-limiting. The efficacy of immunotherapy is unproved

  17. [The diabetic foot].

    PubMed

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

    1998-10-01

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

  18. Diabetes insipidus in children.

    PubMed

    Jain, Vandana; Ravindranath, Aathira

    2016-01-01

    Diabetes insipidus (DI) is one of the common disorders affecting sodium and water homeostasis, and results when ADH is either inadequately produced, or unable to negotiate its actions on the renal collecting tubules through aquaporins. The diagnostic algorithm starts with exclusion of other causes of polyuria and establishing low urine osmolality in the presence of high serum osmolality. In this paper, we have reviewed the diagnosis, etiology and management of DI in children, with special emphasis on recent advances in the field.

  19. Pirfenidone for Diabetic Nephropathy

    PubMed Central

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

    2011-01-01

    Pirfenidone is an oral antifibrotic agent that benefits diabetic nephropathy in animal models, but whether it is effective for human diabetic nephropathy is unknown. We conducted a randomized, double-blind, placebo-controlled study in 77 subjects with diabetic nephropathy who had elevated albuminuria and reduced estimated GFR (eGFR) (20 to 75 ml/min per 1.73 m2). The prespecified primary outcome was a change in eGFR after 1 year of therapy. We randomly assigned 26 subjects to placebo, 26 to pirfenidone at 1200 mg/d, and 25 to pirfenidone at 2400 mg/d. Among the 52 subjects who completed the study, the mean eGFR increased in the pirfenidone 1200-mg/d group (+3.3 ± 8.5 ml/min per 1.73 m2) whereas the mean eGFR decreased in the placebo group (−2.2 ± 4.8 ml/min per 1.73 m2; P = 0.026 versus pirfenidone at 1200 mg/d). The dropout rate was high (11 of 25) in the pirfenidone 2400-mg/d group, and the change in eGFR was not significantly different from placebo (−1.9 ± 6.7 ml/min per 1.73 m2). Of the 77 subjects, 4 initiated hemodialysis in the placebo group, 1 in the pirfenidone 2400-mg/d group, and none in the pirfenidone 1200-mg/d group during the study (P = 0.25). Baseline levels of plasma biomarkers of inflammation and fibrosis significantly correlated with baseline eGFR but did not predict response to therapy. In conclusion, these results suggest that pirfenidone is a promising agent for individuals with overt diabetic nephropathy. PMID:21511828

  20. Diagnosing gestational diabetes

    PubMed Central

    2011-01-01

    The newly proposed criteria for diagnosing gestational diabetes will result in a gestational diabetes prevalence of 17.8%, doubling the numbers of pregnant women currently diagnosed. These new diagnostic criteria are based primarily on the levels of glucose associated with a 1.75-fold increased risk of giving birth to large-for-gestational age infants (LGA) in the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study; they use a single OGTT. Thus, of 23,316 pregnancies, gestational diabetes would be diagnosed in 4,150 women rather than in 2,448 women if a twofold increased risk of LGA were used. It should be recognised that the majority of women with LGA have normal glucose levels during pregnancy by these proposed criteria and that maternal obesity is a stronger predictor of LGA. The expected benefit of a diagnosis of gestational diabetes in these 1,702 additional women would be the prevention of 140 cases of LGA, 21 cases of shoulder dystocia and 16 cases of birth injury. The reproducibility of an OGTT for diagnosing mild hyperglycaemia is poor. Given that (1) glucose is a weak predictor of LGA, (2) treating these extra numbers has a modest outcome benefit and (3) the diagnosis may be based on a single raised OGTT value, further debate should occur before resources are allocated to implementing this change. Electronic supplementary material The online version of this article (doi:10.1007/s00125-010-2005-4) contains supplementary material, which is available to authorised users. PMID:21203743

  1. Type 2 Diabetes and Spina Bifida

    MedlinePlus

    ... blood sugars can Also called adult onset or non-insulin dependent diabet , es damage the kidneys, heart, and eyes; and predispose type 2 diabetes is a chronic condition that affects how diabetics ...

  2. Diabetes - low blood sugar - self-care

    MedlinePlus

    ... or 118 ml) of fruit juice or regular, non-diet soda, 5 or 6 hard candies, one ... team. Related MedlinePlus Health Topics Diabetes Diabetes Medicines Diabetes Type 1 Hypoglycemia Browse the Encyclopedia A.D.A.M., ...

  3. Discussing Diabetes with Your Healthcare Provider

    MedlinePlus

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

  4. Diabetes and Sexual and Urologic Problems

    MedlinePlus

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes & Sexual & Urologic Problems Troublesome bladder symptoms and changes ... early onset of these sexual and urologic problems. Diabetes and Sexual Problems Both men and women with ...

  5. A Relentless Illness—Fighting Diabetes

    MedlinePlus

    ... Current Issue Past Issues A Relentless Illness— Fighting Diabetes Past Issues / Fall 2006 Table of Contents For ... the fight to control and cure type 1 diabetes. As international chairman of the Juvenile Diabetes Research ...

  6. How Is Diabetes Treated in Children?

    MedlinePlus

    ... Consumers Home For Consumers Consumer Updates How Is Diabetes Treated in Children? Share Tweet Linkedin Pin it ... worse over time. back to top Type 2 Diabetes Type 2 diabetes is most often diagnosed in ...

  7. Diabetes and Menopause: A Twin Challenge

    MedlinePlus

    ... overview/managing-diabetes/4-steps. Accessed Jan. 11, 2017. Diabetes, heart disease, and stroke. National Institute of Diabetes ... Diseases. ... 11, 2017. Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. ...

  8. Diabetes Control: Why It's Important (For Kids)

    MedlinePlus

    ... Room? What Happens in the Operating Room? Diabetes Control: Why It's Important KidsHealth > For Kids > Diabetes Control: ... Causes Blood Sugar Levels to Be Out of Control? Managing diabetes is like a three-way balancing ...

  9. Spectrum of renal disease in diabetes.

    PubMed

    Teng, Jessie; Dwyer, Karen M; Hill, Prue; See, Emily; Ekinci, Elif I; Jerums, George; MacIsaac, Richard J

    2014-09-01

    The spectrum of renal disease in patients with diabetes encompasses both diabetic kidney disease (including albuminuric and non-albuminuric phenotypes) and non-diabetic kidney disease. Diabetic kidney disease can manifest as varying degrees of renal insufficiency and albuminuria, with heterogeneity in histology reported on renal biopsy. For patients with diabetes and proteinuria, the finding of non-diabetic kidney disease alone or superimposed on the changes of diabetic nephropathy is increasingly reported. It is important to identify non-diabetic kidney disease as some forms are treatable, sometimes leading to remission. Clinical indications for a heightened suspicion of non-diabetic kidney disease and hence consideration for renal biopsy in patients with diabetes and nephropathy include absence of diabetic retinopathy, short duration of diabetes, atypical chronology, presence of haematuria or other systemic disease, and the nephrotic syndrome.

  10. "Don't take diabetes for granted."

    MedlinePlus

    ... please turn Javascript on. Feature: Diabetes Stories "Don't take diabetes for granted." Past Issues / Fall 2009 ... regularly, and take your medicines on time. Don't take diabetes for granted! Fall 2009 Issue: Volume ...

  11. For Men, Ignoring Diabetes Can Be Deadly

    MedlinePlus

    ... Well with Diabetes. Simpler Diabetes Care: Estimated Average Glucose (eAG) The American Diabetes Association has a new way to understand blood glucose (sugar) levels over time. It is called "eAG," ...

  12. The Emerging Diabetes Online Community

    PubMed Central

    Hilliard, Marisa E.; Sparling, Kerri M.; Hitchcock, Jeff; Oser, Tamara K.; Hood, Korey K.

    2015-01-01

    Background Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Methods Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Results Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals’ privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. Conclusion The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact. PMID:25901500

  13. The status of diabetic embryopathy

    PubMed Central

    Eriksson, Ulf J.; Wentzel, Parri

    2016-01-01

    Diabetic embryopathy is a theoretical enigma and a clinical challenge. Both type 1 and type 2 diabetic pregnancy carry a significant risk for fetal maldevelopment, and the precise reasons for the diabetes-induced teratogenicity are not clearly identified. The experimental work in this field has revealed a partial, however complex, answer to the teratological question, and we will review some of the latest suggestions. PMID:27117607

  14. Hemorheological Disorders in Diabetes Mellitus

    PubMed Central

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

    2008-01-01

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

  15. MRI in diabetes: first results.

    PubMed

    Medarova, Zdravka; Moore, Anna

    2009-08-01

    This article will highlight the latest accomplishments in the area of MRI of diabetes including imaging of beta cell mass, imaging of autoimmune attack in type 1 diabetes, imaging of islet vasculature, and imaging of islet transplantation. Diabetes is a devastating disease in which the body does not produce or properly use insulin. Noninvasive imaging could greatly aid in the diagnosis, staging, and treatment efficiency of this disease.

  16. The emerging diabetes online community.

    PubMed

    Hilliard, Marisa E; Sparling, Kerri M; Hitchcock, Jeff; Oser, Tamara K; Hood, Korey K

    2015-01-01

    Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals' privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact.

  17. Diabetes mellitus and the skin*

    PubMed Central

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

    2017-01-01

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

  18. Inflammation in diabetic kidney disease

    PubMed Central

    García-García, Patricia M; Getino-Melián, María A; Domínguez-Pimentel, Virginia; Navarro-González, Juan F

    2014-01-01

    Diabetes mellitus entails significant health problems worldwide. The pathogenesis of diabetes is multifactorial, resulting from interactions of both genetic and environmental factors that trigger a complex network of pathophysiological events, with metabolic and hemodynamic alterations. In this context, inflammation has emerged as a key pathophysiology mechanism. New pathogenic pathways will provide targets for prevention or future treatments. This review will focus on the implications of inflammation in diabetes mellitus, with special attention to inflammatory cytokines. PMID:25126391

  19. Diabetes mellitus and periodontal diseases.

    PubMed

    Mealey, Brian L; Oates, Thomas W

    2006-08-01

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

  20. [Early onset diabetes mellitus].

    PubMed

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

    2013-12-01

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