The Journal of diabetic complications最新文献

{"title":"Antisympathetic ganglia antibodies in a patient with gustatory sweating","authors":"Kalon K.L. Ho MD, Steven L. Rabinowe MD","doi":"10.1016/0891-6632(90)90022-W","DOIUrl":"10.1016/0891-6632(90)90022-W","url":null,"abstract":"","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 193-195"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90022-W","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13305753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-normotension and near-normoglycemia in blind Type I diabetic patients with overt diabetic nephropathy","authors":"Peter T. Sawicki,&nbsp;Ulrike Didjurgeit,&nbsp;Ingrid Mühlhauser,&nbsp;Lutz Heinemann,&nbsp;Michael Berger","doi":"10.1016/0891-6632(90)90019-2","DOIUrl":"10.1016/0891-6632(90)90019-2","url":null,"abstract":"<div><p>In patients with diabetic nephropathy, near-normalization of blood pressure (BP) and blood sugar may have a beneficial impact on changes in kidney function, but visually impaired patients may face difficulties when striving for optimal control of hypertension and hyperglycemia. In a prospective feasibility study, we followed a group of nine blind Type I (insulin-dependent) diabetic patients (mean age 30 ± 4 years) with overt diabetic nephropathy and uncontrolled hypertension. All patients received intensified insulin therapy after a structured diabetes treatment and teaching program, and adapted their antihypertensive drug treatment to self-monitored BP values. At recruitment, HbA_1c values were 5.8 ± 0.6%, and remained stable at 6.3 ± 1.7% after a mean observation period of 27 months. BP pressure decreased from <span><math><mtext>150 ± </mtext><mtext>14</mtext><mtext>99</mtext><mtext> ± 14 </mtext><mtext>mmHg to 130 ± </mtext><mtext>17</mtext><mtext>86</mtext><mtext> ± 10 mmHg</mtext></math></span> after 1 year, and to <span><math><mtext>140 ± </mtext><mtext>14</mtext><mtext>99</mtext><mtext> ± 9 </mtext><mtext>mmHg</mtext></math></span> at the last examination, (<em>p</em> &lt; 0.05). Serum creatinine and creatinine clearance remained stable over the observation period at 165 ± 56 μmol/L and 0.8 ± 0.4 ml/s/1.72m² at recruitment, and 152 ± 47 μmol/L and 1.0 ± 0.5 ml/s/1.72m² at the final examination. Proteinuria decreased from 3.2 to 1.4 g/24 h (<em>p</em> &lt; 0.05). No patient needed renal replacement therapy. In a reference group of hypertensive Type I diabetic patients with overt nephropathy who did not have the opportunity to participate in the hypertension treatment and teaching program, BP increased despite antihypertensive therapy from <span><math><mtext>143 ± </mtext><mtext>19</mtext><mtext>87</mtext><mtext> ± 10 </mtext><mtext>mmHg</mtext></math></span> to <span><math><mtext>160 ± </mtext><mtext>28</mtext><mtext>95</mtext><mtext> ± 13 </mtext><mtext>mmHg</mtext></math></span> (NS) while serum creatinine increased from 165 ± 32 to 410 ± 285 μmol/L (<em>p</em> &lt; 0.01). Four patients needed renal replacement therapy. These results indicate that after appropriate training, blind Type I diabetic patients with overt nephropathy may be able to achieve and maintain long-term normotension, and near-normal glycosylated hemoglobin values, which may have beneficial effects on renal function.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 179-183"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90019-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13304542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of diabetic neuropathy with inhibitors of the aldose reductase enzyme","authors":"Andrew J. Green MD,&nbsp;Jonathan B. Jaspan MD, FRCP","doi":"10.1016/0891-6632(90)90011-S","DOIUrl":"10.1016/0891-6632(90)90011-S","url":null,"abstract":"","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 138-144"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90011-S","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13305253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author index, volume 4","authors":"","doi":"10.1016/0891-6632(90)90024-Y","DOIUrl":"https://doi.org/10.1016/0891-6632(90)90024-Y","url":null,"abstract":"","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Page 200"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90024-Y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136848924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When does diabetes mellitus begin?","authors":"Eli A. Friedman","doi":"10.1016/0891-6632(90)90010-3","DOIUrl":"10.1016/0891-6632(90)90010-3","url":null,"abstract":"","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Page 137"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90010-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13305252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal and glycemic determinants of glomerular hyperfiltration in normoalbuminuric diabetics","authors":"C.E. Mogensen ,&nbsp;C.K. Christensen ,&nbsp;M.M. Pedersen ,&nbsp;K.G.M.M. Alberti ,&nbsp;N. Boye ,&nbsp;T. Christensen ,&nbsp;J.Sandahl Christiansen ,&nbsp;A. Flyvbjerg ,&nbsp;J. Ingerslev ,&nbsp;A. Schmitz ,&nbsp;H. Ørskov","doi":"10.1016/0891-6632(90)90015-W","DOIUrl":"10.1016/0891-6632(90)90015-W","url":null,"abstract":"<div><p>Glomerular hyperfiltration is a characteristic feature of insulin-dependent diabetes. We examined the relative roles of renal size, as well as glycemic parameters (HbA_1c, glycosylated albumin, plasma glucose) in addition to growth hormone, somatomedin C, β-hydroxybutyrate, alanine, and glycerol in determining the glomerular filtration rate (GFR). Sixty-two insulin-dependent patients with normal urinary albumin excretion rates (AER &lt;15 μg/min), who were &lt;50 years of age, were included in the study. Data were subjected to multiple regression analysis with GFR as a dependent variable. Renal volume was the primary statistical determinant of hyperfiltration, but HbA_1c also significantly correlated with GFR. No correlation was found with glycosylated albumin or blood glucose, but RPF correlated strongly with GFR, and borderline correlation was found between renal volume and HbA_1c. Renal hyperfiltration, defined as a GFR &gt;150 ml/min, was found in approximately 50% of patients with HbA_1c values &gt;9.5%. Other studies suggest that such patients have a much higher risk of developing clinically evident diabetic nephropathy over the ensuing years. Renal volume appears to be the major determinant of GFR, but long-term metabolic control, as evidenced by the level of HbA_1c, also contributes, partly independent of renal volume. Short-term metabolic control, as evaluated by blood glucose and serum-fructosamine, did not correlate with GFR. We suggest that exact determination of GFR and renal volume should be included in long-term prospective controlled intervention trials in patients with insulin-dependent diabetes mellitus (IDDM).</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 159-165"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90015-W","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13305257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure changes associated with hyperinsulinemia or long-standing diabetes mellitus in spontaneously hypertensive rats","authors":"Masanori Iwase,&nbsp;Kiyohide Nunoi,&nbsp;Masanori Wakisaka,&nbsp;Masanori Kikuchi,&nbsp;Yukihiro Maki,&nbsp;Nobutaka Tsutsu,&nbsp;Seizo Sadoshima,&nbsp;Masatoshi Fujishima","doi":"10.1016/0891-6632(90)90020-6","DOIUrl":"10.1016/0891-6632(90)90020-6","url":null,"abstract":"<div><p>We studied the long-term change in blood pressures of spontaneously hypertensive rats (SHR) treated neonatally with streptozotocin (STZ). Two-day-old male SHR were injected intraperitoneally with 37.5–75.0 mg/kg STZ or with vehicle as control. STZ-treated SHR were divided into mildly or severely diabetic groups according to the nonfasting plasma glucose level at age 12 weeks (the former &lt;300 mg/dl, the latter ≧300 mg/dl). In the mildly diabetic group (MD) (n = 5), body weight increased and nonfasting plasma glucose was normalized. At 52 weeks of age, fasting plasma glucose levels were lower than controls owing to hyperinsulinemia, and insulinomas were found in 60% of rats. The systolic blood pressure (SPB) as measured by a tail-cuff method, decreased after 40 weeks, and the mean BP from 44 to 52 weeks (188 ± 4 mmHg) was significantly lower than that in the control group (209 ± 3 mmHg, <em>p</em> &lt; 0.01). In the severely diabetic group (SD) (n = 6), hyperglycemia persisted until 52 weeks, although its severity became less marked. BP in the SD group increased after 36 weeks, and the mean BP from 44 weeks to 52 weeks (224 ± 5 mmHg) was significantly higher than control (<em>p</em> &lt; 0.05). The present study demonstrated that hypertension was ameliorated in SHR associated with hyperinsulinemia, and deteriorated with long-standing diabetes mellitus.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 184-187"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90020-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13305754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced regional cerebral blood flow in aged noninsulin-dependent diabetic patients with no history of cerebrovascular disease: Evaluation by N-lsopropyl-123I-p-iodoamphetamine with single-photon emission computed tomography","authors":"M. Wakisaka MD ,&nbsp;S. Nagamachi MD ,&nbsp;K. Inoue MD ,&nbsp;Y. Morotomi MD ,&nbsp;K. Nunoi MD ,&nbsp;M. Fujishima MD","doi":"10.1016/0891-6632(90)90017-Y","DOIUrl":"10.1016/0891-6632(90)90017-Y","url":null,"abstract":"<div><p>Regional cerebral blood flow was measured using <em>N</em>-isopropyl-¹²³I-iodoamphetamine with single-photon emission computed tomography (CT) in 16 aged patients with noninsulin-dependent diabetes mellitus (NIDDM, average age 72.8 years, average fasting plasma glucose 7.7 mmol/L), and 12 nondiabetic subjects (71.6 years, 5.3 mmol/L). None had any history of a cerebrovascular accident. Systolic blood pressure (SBP), total cholesterol, and triglyceride levels did not differ between groups. Areas of hypoperfusion were observed in 14 diabetic patients (12 patients had multiple lesions) and in 6 nondiabetic abetic subjects (3 had multiple lesions). Areas where radioactivity was ≥65% of the maximum count of the slice was defined as a region with normal cerebral blood flow (region of interest A, ROI-A), and areas where the count was ≥45% were defined as brain tissue regions other than ventricles (ROI-B). The average <span><math><mtext>ROI-A</mtext><mtext>B</mtext></math></span> ratio of 16 slices was used as a semiquantitative indicator of normal cerebral blood flow throughout the entire brain. Mean <span><math><mtext>ROI-A</mtext><mtext>B</mtext></math></span> ratio was 49.6 ± 1.7% in the diabetic group, significantly lower than the 57.9 ± 1.6% at the nondiabetic group (<em>p</em> &lt; 0.005). The ratio was inversely correlated with SBP (<em>r</em> = −0.61, <em>p</em> &lt; 0.05), total cholesterol (<em>r</em> = −0.51, <em>p</em> &lt; 0.05), and atherogenic index (<em>r</em> = −0.64, <em>p</em> &lt; 0.01), and was positively correlated with high-density lipoprotein (HDL) cholesterol (<em>r</em> = 0.51, <em>p</em> &lt; 0.05) in the diabetic, but not the nondiabetic group. These observations suggest that the age-related reduction in cerebral blood flow may be accelerated by a combination of hyperglycemia plus other risk factors for atherosclerosis.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 170-174"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90017-Y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13304539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between nephropathy, retinopathy, and autonomic neuropathy in patients with Type I diabetes","authors":"Peter Pontuch MD ,&nbsp;Juraj Vozár MD ,&nbsp;Marián Potocký MD ,&nbsp;Boris Krahulec MD","doi":"10.1016/0891-6632(90)90021-V","DOIUrl":"10.1016/0891-6632(90)90021-V","url":null,"abstract":"<div><p>Seventy-two Type I diabetic patients were divided into three groups according to 24 hour urinary albumin excretion (UalbV, mean of three urine collections): normoalbuminuric group 1 (n = 49, <span><math><mtext>UalbV ≤ </mtext><mtext>26 mg</mtext><mtext>24 h</mtext></math></span>), microalbuminuric group 2 (n = 16, <span><math><mtext>26 &lt; UalbV ≤ </mtext><mtext>250 mg</mtext><mtext>24</mtext></math></span> h), proteinuric group 3 (n = 7, <span><math><mtext>UalbV &gt;</mtext><mtext>250 mg</mtext><mtext>24 h</mtext></math></span>). Fluorescein angiography and three cardiovascular autonomic tests were performed. Relative frequencies of ocular findings (no retinopathy/simplex retinopathy/preproliferative and proliferative retinopathy) were determined in each group: group 1 (0.31/0.63/0.06), group 2 (0.56/0.38/0.06), and group 3 (0/0.43/0.57). The most severely affected autonomic function was observed in group 3 (<em>p</em> &lt; 0.01 vs. group 1). Significant partial correlations were found between UalbV and retinopathy (<em>p</em> &lt; 0.01), UalbV, and autonomic neuropathy (<em>p</em> &lt; 0.05), retinopathy and autonomic neuropathy (<em>p</em> &lt; 0.01), and blood pressure and UalbV and/or autonomic neuropathy (<em>p</em> &lt; 0.01). No correlation was found between the variables and the previous 15 months' metabolic control. The results suggest that nephropathy, retinopathy, and autonomic neuropathy are signs of a generalized diabetic microangiopathic process whose progression may be influenced by factors other than diabetes duration and metabolic control.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 188-192"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90021-V","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13304545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term bone loss in insulin-dependent diabetic patients with microvascular complications","authors":"Biørn Mathiassen MD ,&nbsp;Søren Nielsen MD ,&nbsp;Julia S. Johansen MD ,&nbsp;Dorthe Hartwell MD ,&nbsp;Jørn Ditzel MD, PhD ,&nbsp;Paul Rødbro MD, PhD ,&nbsp;Claus Christiansen MD, PhD","doi":"10.1016/0891-6632(90)90012-T","DOIUrl":"10.1016/0891-6632(90)90012-T","url":null,"abstract":"<div><p>Insulin-dependent diabetic patients have an approximately 10% decreased bone mineral content (BMC) when they are studied a few years after clinical onset of diabetes. After that time, patients <em>without</em> diabetic microvascular complications have no, or only very little, further bone loss. The aim of the present study was to investigate if any substantial long-term bone loss occurs in diabetic patients with microvascular complications. We studied 19 insulin-dependent diabetic patients with neither physiologic nor pathologic conditions known to interfere with bone metabolism, other than diabetes. BMC was determined twice, with an interval of 11 years. At initial examination, no patient had diabetic microangiopathy, but at final examination 7 patients had developed diabetic microvascular complications while 12 patients had not. As compared with gender- and age-matched controls, both subgroups had significantly decreased BMC at the initial examination. During the study period, the patients with complications showed further bone loss, whereas the subgroup without complications had unchanged decreased BMC. At final examination, BMC was significantly lower in patients with microvascular complications than in patients without them. The biochemistry of bone metabolism showed a significantly increased fasting urinary excretion of calcium and hydroxyproline in patients with complications, but not in the group without complications, and there was a negative correlation between plasma BGP (osteocalcin) and hemoglobin A_1c for all patients. These findings indicate that, in addition to a decreased BMC (before or shortly after clinical onset of diabetes), patients who develop microvascular complications also develop ongoing bone loss. This loss may be caused by an increased bone resorption, but decreased bone formation during periods of poor diabetic control may be involved as well.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 145-149"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(90)90012-T","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13305254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}