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At least 37 records · Page 2Linked to original sources

PubMed1979

Bone mineral loss in insulin-treated diabetes mellitus: studies on pathogenesis.

To elucidate pathogenetic factors of bone mineral loss in diabetes mellitus, bone mineral content (BMC), glucose and calcium homeostasis were evaluated in a cross-sectionsl study of 215 insulin-treated diabetics. BMC declined 10% during the first 5 years of diabetes. This coincided with cessation of insulin secretion, deterioration of metabolic control and raising urinary calcium excretion rates of calcium and phosphorus. BMC was inversely correlated to fasting blood glucose (P less than 0.02), to glycosuria (P less than 0.02) and to insulin requirement (P less than 0.002), and positively to the glucagon-stimulated serum C-peptide levels (P less than 0.005). Urinary excretion rates of calcium and phosphorus correlated positively with the degree of hyperglycaemia (P less than 0.001) and glycosuria (P less than 0.001). The skeletal calcium loss corresponded to the excess of urinary excretion during the phase of BMC reduction. There was no evidence of secondary hyperparathyroidism. The relationship between bone loss and disturbed glucose homeostasis indicates that diabetic bone loss is secondary to the metabolic abnormalities, possibly acting directly on bone.

Adolescent↗

PubMedDate not supplied

Some social factors related to control of diabetes mellitus in adult Jamaican patients.

A population of 103 adult diabetic patients was interviewed at the Outpatient Clinic for diabetic patients of the University Hospital of the West Indies to examine the effects of severity of the illness and social variables, such as facilities at home, education attained, employment status, informal medication, and understanding of the illness in relation to its control. Patients were classified as severe if there were clinical evidence of vascular or neurologic complications of diabetes and as mild if there were no complications. Control of diabetes was regarded as good if the patients were free from or had less than 2+ glycosuria and as poor if they had had 2+ or more glycosuria during the six months before the study. We found that the quality of control was mainly determined by the severity of the disease. In the mild diabetic, proper diabetic control was not influenced by any social variable examined. In the severe diabetic the quality of control was associated with social amenities, educational status, employment status, and understanding of the disease.

Adult↗

PubMed1979

Induction of diabetes in animals by parenteral administration of ferric nitrilotriacetate. A model of experimental hemochromatosis.

Rats and rabbits parenterally treated with a large daily dose of ferric nitrilotriacetate manifested diabetic symptoms such as hypergycemia, glycosuria, ketonemia, and ketonuria after approximately 60 days fo treatment. The blood insulin response to oral glucose loading was poor. Heavy iron deposits were found in liver parenchymal cells and in pancreatic exocrine cells, although some iron was deposited in the macrophages and reticuloendothelial cells of the organs. Faint iron staining was found in some pancreatic islet cells, with a reduction in beta granules and weak zinc staining. Cirrhotic liver changes and skin pigment deposition were not observed. Repeated blood withdrawals from ferric-nitrilotriacetate-treated animals resulted in disappearance of hypergycmia, glycosuria, ketonemia, and ketonuria; disappearance of iron from the liver and pancreas; and restoration of islet beta granules to the control level.

Acetates↗

PubMed1979

Screening for diabetes mellitus in leprosy patients with complicated ulcers.

All patients admitted to an ulcer ward in a leprosy hospital over the period of one year were screened for glycosuria. Out of 154 patients screened 4 showed glycosuria. These 4 patients had more severely complicated ulcers evidenced by their longer duration of admission. Early diagnosis and treatment of diabetes in leprosy patients with complicated ulcers is important.

Adult↗

PubMed1979

Hyperosmolar diabetes presenting as acute urinary retention: report of three cases.

Three elderly patients presented at one hospital in a 2-week period with acute urinary retention precipitated by the hyperosmolar non-ketotic diabetic state. In each case routine urine testing was reported as showing 1 per cent glycosuria. The first two patients were admitted at night and blood glucose estimations were not done. This led to a delay of 16 and 12 h respectively before the appropriate therapy was instituted. It is suggested that this clinical presentation, previously unreported, may not be a rarity and represents an avoidable cause of death in patients with acute urinary retention.

Acute Disease↗

PubMed1978

Chronic hypertension induced by streptozotocin in rats.

An intravenous injection of 40 or 65 mg/kg streptozotocin induced not only diabetes but also severe hypertension in rats. Whereas the hyperglycemia developed fully within a few days after the injection of streptozotocin, the hypertension progessively advanced and reached maximum level several weeks after the treatment and lasted more than 20 weeks. Twenty mg/kg streptozotocin did not induce hyperglycemia but significantly increased blood pressure several weeks after the treatment. Arrest of growth, polyuria, glycosuria, hyperlipemia and lenticular cataracts developed in the animals treated with 40 or 65 mg/kg streptozotocin, but in none of the animals treated with 20 mg/kg. In histological examinations in the 24th week after the treatment, degranulation and necrosis in the pancreatic beta-cells, and vacuolization and deposition of PAS-positive materials in the renal proximal tubules were found in the animals treated with 40 or 65 mg/kg streptozotocin.

Animals↗

PubMed1979

Hypomagnesaemia in diabetes.

The plasma magnesium (Mg) concentrations of 582 unselected diabetic outpatients and 140 control subjects were measured by atomic absorption spectrophotometry. Mean plasma Mg (+/-S.D.) was significantly lower in the diabetic patients (0.737 +/- 0.071 mmol/l) than in the control subjects (0.810 +/- 0.057 mmol/l), and 146 (25%) diabetics had values below those of all control subjects except one. Plasma Mg correlated best with clinic blood glucose concentration (r = -0.32, p less than 0.001) and other significant associations were observed with glycosuria, age, sex, insulin therapy and biguanide therapy. Although its significance is unclear, hypomagnesaemia could conceivably predispose to ischaemic heart disease in diabetes.

Adolescent↗

PubMed1979

Syngeneic transplantation of the fetal rat pancreas IV. Dissociated versus whole organ implantation.

Reversal of insulinopenia, hyperglycemia, glycosuria, and polyuria associated with severe alloxan diabetes in the rat was accomplished by syngeneic transplantation of whole late-gestation fetal rat pancreata. Intravenous glucose tolerance test (GTT) revealed an improved yet still abnormal glucose and insulin response in reversed recipients reconstituted with as few as two pancreata from fetal donors. Eight fetal donors were sufficient to return glucose and insulin response following GTT to normal. Seventy to eighty percent fewer donors were required when the pancreata were transplanted in their entirely as opposed to transplantation of pancreata subjected to prior enzymatic and mechanical dissociation. The facility and simplicity of the whole fetal pancreas implantation technique makes it an appealing model for further study of islet growth and differentiation at the transplant site and of its effect on the metabolic state of the recipient.

Animals↗

PubMed1977

Glycosylated haemoglobin concentrations and clinitest results in insulin-dependent diabetes.

In 11 insulin-dependent diabetic outpatients, haemoglobin AIc (HbAIc) was measured by an electrofocusing method. Diabetic control was evaluated by the semiquantitative urine test for sugar, 'Clinitest', three times a day every day in the 8 weeks before the HbAIc determination. 24-hour glycosuria and fasting and postprandial blood-glucose levels were measured one to five times during this period. The HbAIc concentration correlated highly with the semi-quantitative urinary-sugar-concentration index but not with the other parameters.

Blood Glucose↗

PubMed1976

Renal hypertrophy in streptozotocin-diabetic rats.

1. Kidney weight and content of protein, RNA and DNA were measured in rats with streptozotocin diabetes of varying duration. 2. Diabetic rats had larger kidneys than control rats: after 3 days of diabetes the weight increase was 15 per cent and after 42 days of diabetes it was 90 per cent. The protein content rose in parallel to the weight. 3 RNA content was already increased after 36 h of glycosuria, whereas DNA content was unchanged for the first 3 days of diabetes, and increased thereafter. The protein/DNA ratio increased rapidly during the first 3 days but remained constant thereafter. 4. Insulin treatment decreased the renal weight gain by about 67 per cent during the first 8 days of diabetes, but did not prevent the increase in DNA. When insulin was started after 25 days of diabetes there was only a slight regression of kidney growth.

Animals↗

PubMed1978

An interpretation of the intravenous glucose tolerance test in the light of recent findings on the kinetics of glucose and insulin in man.

1. A theoretical investigation of the intravenous glucose tolerance test has been carried out based on recent findings on the kinetics in man of insulin production, distribution, disposal and action, and of glucose turnover and distribution. 2. A good fit to published data on four groups of subjects required a scheme that includes two extravascular glucose spaces and separate venous, arterial and capillary volumes. The fit to the data was little affected by variations within the physiological range of venous and arterial volumes, cardiac output, glycosuria and the properties of the less-accessible glucose pool. 3. The only variables needed to account for the differences between the groups were kinsulin (a measure of the mean sensitivity of insulin-dependent tissues to insulin action) and the readily accessible glucose space. 4. Three published schemes for insulin kinetics were used. They were all consistent with the data and gave very similar relative values for kinsulin in the four groups. 5. It is shown that a rigorous interpretation of the test requires a knowledge of the hepatic response to the glucose load during the test. These effects are not well characterized in pathological states, e.g. diabetes and injury. Consequently conclusions about insulin resistance in these states drawn only from the test are doubtful.

Blood Glucose↗

PubMed1979

Obesity, lipids, and glucose intolerance. The Framingham Study.

Some lipid and lipoprotein accompaniments of obesity and its association with glucose intolerance are examined in the Framingham cohort of 5209 men and women ages 30 to 59 examined biennially over 18 years. While beta and pre-beta lipoproteins were positively correlated with relative weight, high density lipoprotein cholesterol was inversely correlated. The association was strongest for high density lipoprotein cholesterol, varying little by age and sex. Triglyceride was a close second, but unlike high density lipoproteins, it and other lipids were more closely associated with obesity in men than women and in younger than older persons. Obese persons tended to have a greater likelihood of glycosuria and an increasing prevalence of diabetes. Relative weight in the Framingham cohort rose in both sexes to age 54, remained essentially unchanged until age 62 and then began to decline. Despite such changes body weights even 18 years apart had a correlation of 0.8. Men from each succeeding birth cohort were heavier, women were lighter, but even women from the most recent birth cohort were much more frequently above "desirable" weight than below it.

Adult↗

PubMed1979

Hemoglobin A1c (HbA1c) in children with long standing and newly diagnosed diabetes mellitus.

In 35 children with long-standing diabetes mellitus, a significant correlation was found between the hemoglobin A1c (HbA1c)--and the 24-hour urinary glucose excretion. By contrast, 11 newly diagnosed diabetic children had grossly elevated HbA1c-concentrations, but no correlations could be established between the levels of HbA1c and the duration of symptoms, blood glucose, glycosuria, ketonuria and the acid--base status. However, HbA1c and C-peptide were significantly correlated. The elevated HbA1c-concentrations decreased towards normal in all of these 11 children after 2--3 months following adequate therapy. The results suggest that the determination of HbA1c may serve as a valuable metabolic control index in children with long-standing diabetes mellitus, but adds little information in newly diagnosed patients. For the individual diabetic child during the early treatment period, HbA1c may be the index of choice for adequacy of metabolic control.

Acid-Base Equilibrium↗

PubMed1979

Cadmium nephropathy.

Cadmium is an inessential trace metal which accumulates in human tissues from contamination of food, water or air. The kidney is the critical organ following long-term, low-level absorption either by inhalation or ingestion; accumulation occurring in tubular epithelium in the form of a cadmium-metallothionein complex, giving rise to tubular dysfunction. In a group of 12 cadmium workers some of whom were followed for up to 16 years, tubular proteinuria, renal glycosuria, aminoaciduria, hypercalciuria and defects of concentration and acidification have been observed. Two men became recurrent renal stone formers and 1 man, who had nephrocalcinosis when first seen, later developed vitamin D-resistant osteomalacia. Renal tubular dysfunction following cadmium exposure may continue symptom-free for long intervals, but in a proportion of cases serious clinical effects may eventually develop.

Aged↗

PubMed1978

The course of development of glucose intolerance in the monkey (Macaca mulatta).

Longitudinal studies of the rhesus monkey reveal a syndrome of diabetes mellitus in those that become middle-aged and obese. The sequence of events in the development of the disease progresses from normoinsulinemia with normoglycemia through stages of hyperinsulinemia followed by below normal insulin levels with hyperglycemia and glycosuria. We believe the rhesus to be an excellent nonhuman primate model for maturity-onset diabetes in humans.

Age Factors↗

PubMed1978

Glipizide in the treatment of maturity-onset diabetes: a multi-centre, out-patient study.

A multi-centre clinical assessment was carried out in 592 diabetic patients to study the efficacy and tolerance of glipizide under normal out-patient conditions. Of the total group, 347 patients were maturity-onset diabetics who had received no previous treatment or only dietary control. The other 245 patients had previously received treatment with other hypoglycaemic agents, including insulin in 23 cases. Mean initial dosage was 7.5 mg glipizide per day and this increased over the 3-month period of the study to 10.1 mg in the total group (9.3 mg in new patients). Mean post-prandial blood glucose levels and glycosuria fell rapidly during the first week and then continued to decrease slowly. Changes in mean body weight were somewhat erratic during the trial and at 12 weeks there was an apparent mean increase of 1 kg. After allowing for dropouts, analysis of the results showed that 96.7% of the new patient group and 90.5% of the total group were satisfactorily controlled and maintained on glipizide. Patient tolerance was good, and only 28 (4.7%) patients complained of side-effects, almost half of which related to mild, transient hypoglycaemia.

Adult↗

PubMedDate not supplied

Plasma lipid levels in insulin-dependent diabetes mellitus.

Because several recent reports have indicated a high incidence of hyperlipidemia in insulin-dependent juvenile diabetes, the plasma lipid levels were measured in a population of insulin-dependent diabetic patients to determine if hyperlipidemia is necessarily associated with diabetes. Only one patient had an elevated cholesterol concentration (greater than 220 mg. per deciliter) and two patients had an elevated triglyceride concentration (greater than 140 mg. per deciliter), giving an incidence of 6.4 per cent. A normal control group had an incidence of hyperlipidemia of 5.7 per cent. The mean cholesterol level (164 "/- 38 mg. per deciliter) of the diabetic population was significantly less than that of the normal control group (183 +/- 38 mg. per deciliter). The diabetic patients were divided into groups on the basis of 24-hour urinary glucose excretion and records of glycosuria. The serum triglyceride of the patients in group 4 (highest urinary glucose content and spills) was significantly elevated above three other groups with less glucosuria. Dietary history revealed that group 4 patients consumed a significantly higher percentage of fat. Cholesterol levels did not correlate with parameters of regulation of the diabetes.

Adolescent↗

PubMed1979

[Treatment of diabetes without biguanides. Observation on the course after changing treatment (author's transl)].

In 56 patients with maturity onset diabetes receiving combined therapy with different oral hypoglycemic drugs, biguanide treatment was stopped while sulphonylurea compounds were continued without major changes. In four patients insulin therapy had to be initiated rapidly. In 14 other patients follow-up observations could not be performed for various reasons. The reamining 38 patients were divided into four groups according to their treatment. On the average, chemical control could not be maintained in any group after discontinuation of biguanide therapy. Blood glucose concentrations and glycosuria increased. Later, in 6 of 38 patients secondary failure of sulphonylurea treatment became apparent.

Adult↗