The Journal of diabetic complications最新文献

{"title":"Measuring subclinical neuropathy: Does it relate to clinical neuropathy? Pittsburgh epidemiology of diabetes complications study-V","authors":"Raelene E. Maser ,&nbsp;Viggo K. Nielsen ,&nbsp;Janice S. Dorman ,&nbsp;Allan L. Drash ,&nbsp;Dorothy J. Becker ,&nbsp;Trevor J. Orchard","doi":"10.1016/0891-6632(91)90003-8","DOIUrl":"10.1016/0891-6632(91)90003-8","url":null,"abstract":"<div><p>We report results from 120 (25- to 34-year-old) participants in a neuropathy substudy of subjects with insulin-dependent diabetes mellitus (IDDM) taking part in a cohort follow-up study. Diabetic neuropathy was evaluated by quantitative sensory testing, nerve conduction studies, and clinical examination. Mean quantitative sensory thresholds differed significantly by clinical category of abnormal sensation and ankle reflex activity. Mean sural and peroneal amplitudes and conduction velocities were also significantly lower for subjects classified as having abnormal ankle reflex activity. Modeling potential correlates in logistic analyses showed glycemic control, triglyceride levels, and hypertension status to be independently associated with clinically overt neuropathy. Similar lipid and hemodynamic parameters were associated with abnormality by any single assessment method used to define neuropathy. Although follow-up is needed to resolve the best assessment methods for determining neuropathy, these results suggest that good glycemic control as well as control of blood pressure and lipids is advisable.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 6-12"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90003-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13016977","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":"Prevalence of peripheral and autonomic neuropathy in newly diagnosed type II (noninsulin-dependent) diabetes","authors":"Klaus P. Ratzmann,&nbsp;Martin Raschke,&nbsp;Ingrid Gander,&nbsp;Erika Schimke","doi":"10.1016/0891-6632(91)90002-7","DOIUrl":"10.1016/0891-6632(91)90002-7","url":null,"abstract":"<div><p>Type II (noninsulin-dependent) diabetes (NIDDM) can be preceded by a relatively long period of disturbed glucose metabolism. Therefore, the prevalence of neuropathy and its possible relationship to metabolic abnormalities were investigated in 95 newly diagnosed type II diabetics (upper age limit was set at 55 years) with a mean age of 49.7 years (men/women ratio 1:1). The study program was as follows: Detailed history, clinical investigation of peripheral nerves, sensory assessment to touch and pain (pinprick), vibration sensation using established techniques, and motor nerve conduction velocities (MNCV) of the fibular (peroneal) and ulnar nerves. Three cardiovascular autonomic function tests were performed: the Valsalva maneuver, standing (ratio between RR-interval_max: RR-interval_min), and deep breathing (maximum/minimum heart rate). Vascular diseases were diagnosed using a conventional 12-lead resting electrocardiogram (ECG) and impedance measurement of the lower extremities. The results were as follows: abnormal vibration sensation in 80.0%, abnormalities of MNCV in 15.7%, abnormal sensations to touch or pinprick in 14.7%, and loss of reflexes in 13.6%. If peripheral neuropathy was defined as having at least three of the four abnormalities plus neuropathic symptoms, the prevalence was 6.3% (6 of 95 patients). Abnormalities of the three cardiovascular autonomic function tests were much less prevalent in type II diabetic patients (2.1–7.3%). In conclusion, the study showed that peripheral and autonomic neuropathy is not common at diagnosis in middle-aged type II diabetic patients without signs of microvascular or macrovascular complications.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90002-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12992710","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":"Albuminuria and associated medical risk factors: A cross-sectional study in 451 type II (noninsulin-dependent) diabetic patients. Part 2","authors":"O. Torffvit ,&nbsp;E. Agardh ,&nbsp;C-D. Agardh","doi":"10.1016/0891-6632(91)90007-C","DOIUrl":"10.1016/0891-6632(91)90007-C","url":null,"abstract":"<div><p>The association between urinary albumin concentration (UAC) in a morning urine sample and medical risk factors was evaluated in a cross-sectional study of 451 type II (noninsulin-dependent) diabetic patients. The following four groups of patients were created according to their urinary albumin levels: A) normal (&lt;12.5 mg/L); B) high normal (12.5–30 mg/L); C) microalbuminuria, ie, incipient nephropathy (31–299 mg/L); and D) clinical nephropathy (≥300 mg/L). The patients with high normal levels had higher HbA_1c and systolic blood pressure levels than patients with values within normal limits. The prevalence of incipient and clinical diabetic nephropathy was 20 and 7%, respectively. Incipient nephropathy was associated with higher blood pressures and body weights. Patients with clinical nephropathy had even further increases in these parameters, were older, and had longer duration of diabetes. In both groups of nephropathy, men were preponderant. Thirty six percent of all patients and 73% of patients with clinical nephropathy were treated for hypertension; 55% were treated with insulin. The insulin-treated patients had poorer metabolic control, but there were no differences in blood pressure or serum creatinine levels as compared with those of patients not receiving insulin treatment. The proportion of patients with severe retinopathy increased with the degree of albuminuria, although 22% of the patients with clinical nephropathy continued to be nonretinopathic.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 29-34"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90007-C","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12991916","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":"Lipoproteins and diuretics in type II diabetes","authors":"A. Møller ,&nbsp;A. Schmitz ,&nbsp;M.M. Pedersen ,&nbsp;J.S. Christiansen","doi":"10.1016/0891-6632(91)90004-9","DOIUrl":"10.1016/0891-6632(91)90004-9","url":null,"abstract":"<div><p>This double-blind cross-over study was performed to investigate whether the lipoproteins in plasma were different on furosemide (Lasix Retard) and thiazide (hydrochlorthiazide) treatment in patients suffering from type II diabetes. Twenty-four patients were randomly allocated to either furosemide-hydrochlorthiazide (LR-HCT) or HCT-LR treatment. The treatment period was 12 months: 6 months on each sequence. After inclusion, the patients were seen every second month. Laboratory data were recorded at each visit. The only significant treatment effect was observed for high-density-lipoprotein₃ cholesterol concentration (HDL₃ cholesterol concentration), which was higher when patients were on furosemide therapy (<em>p</em> &lt; 0.05). We conclude from the present study that blood-glucose HbA_1c, and the concentration of lipoproteins connected to development of atherosclerosis is unaffected whether type II diabetes patients are treated with HCT or furosemide.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 13-17"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90004-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12991912","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":"Symptoms of sexual dysfunction and depression in diabetic women","authors":"Liane Leedom ,&nbsp;Mindy Feldman ,&nbsp;Warner Procci ,&nbsp;Adina Zeidler","doi":"10.1016/0891-6632(91)90009-E","DOIUrl":"10.1016/0891-6632(91)90009-E","url":null,"abstract":"<div><p>Studies of sexual dysfunction in diabetic women have been less conclusive than those of sexual dysfunction in diabetic men. We examined the relationship between symptoms of sexual dysfunction, neuropathy, and depression in diabetic women. Diabetic women with neuropathy experienced significantly more symptoms of sexual dysfunction and depression than diabetic women without neuropathy. Furthermore, among women with neuropathy, there was a significant positive correlation between the degree of sexual dysfunction experienced and the degree of depression. These results indicate that depressive symptoms should be examined in studies of sexual dysfunction in diabetic women, and that a biopsychosocial approach is best for assessing sexual dysfunction in diabetic women.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 38-41"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90009-E","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12991919","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":"Polyol pathway activity in nervous tissues of diabetic and galactose-fed rats: Effect of dietary galactose withdrawal or tolrestat intervention therapy","authors":"Janet Sredy,&nbsp;Diane R. Sawicki,&nbsp;Ronald R. Notvest","doi":"10.1016/0891-6632(91)90010-M","DOIUrl":"10.1016/0891-6632(91)90010-M","url":null,"abstract":"<div><p>Enhanced polyol pathway activity resulting in an accumulation of sorbitol and a depletion of myoinositol in nervous tissues has been proposed to be important in development of diabetic neuropathies. This investigation demonstrated that in two models of diabetic complications, streptozocin (STZ)-induced diabetic rats and galactose-fed rats, 5 weeks of disease led to an accumulation of sorbitol or galactitol, respectively, in three cranial nerves (the optic (II), trigeminal (V), and vagus (X) nerves), as well as the sciatic nerve, cerebral cortex, and retina. In both models, the cranial nerves and cerebral cortex contained lower levels of accumulated polyol than the sciatic nerve. In addition, myoinositol depletion was observed in the sciatic nerve only. In a second galactose-fed rat study, returning 5-week galactose-fed rats to a normal diet for 6 weeks led to complete elimination of galactitol from the optic nerve, sciatic nerve, and retina and normalization of the sciatic nerve myoinositol concentration. Similarly, continuing the galactose diet for 6 more weeks (ie, a total of 11 weeks) as well as administration of the aldose reductase inhibitor (ARI) tolrestat (20 and 40 mg/kg/day), caused the sciatic nerve to contain a normal myoinositol concentration and a galactitol concentration that was 95% below the level observed in galactose-fed controls. In the optic nerve and retina, tolrestat was less effective, resulting in 69–78% lower galactitol levels. In conclusion, these findings indicate that sorbitol and galactitol accumulate in cranial nerves, brain, and retina without a concomitant decrease in myoinositol. Either withdrawal of the galactose diet or intervention with tolrestat normalized polyol levels in the sciatic nerve. In the optic nerve and retina, tolrestat, while causing a reduction, was unable to normalize the galactitol levels completely.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 42-47"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90010-M","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12991878","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":"Hyperkalemia in diabetes mellitus","authors":"Antonios H. Tzamaloukas MD","doi":"10.1016/0891-6632(91)90011-D","DOIUrl":"10.1016/0891-6632(91)90011-D","url":null,"abstract":"","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Page 48"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90011-D","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12991880","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":"Residual C-peptide excretion is associated with a better long-term glycemic control and slower progress of retinopathy in type I (insulin-dependent) diabetes mellitus","authors":"S. Sjöberg ,&nbsp;M. Gjötterberg ,&nbsp;L. Berglund ,&nbsp;E. Möller ,&nbsp;J. Östman","doi":"10.1016/0891-6632(91)90005-A","DOIUrl":"10.1016/0891-6632(91)90005-A","url":null,"abstract":"<div><p>We evaluated the progression of microangiopathic lesions in 22 type I diabetic patients with residual C-peptide excretion and in 22 type I diabetic patients matched for age at onset and disease duration without residual C-peptide excretion. We also wished to elucidate whether certain HLA-DR phenotypes were associated with preserved insulin secretory activity and/or microvascular lesions. The two groups of patients were investigated in 1984 and 1985. In the previous report, we observed less frequent signs of early microangiopathic lesions in association with a lower HbA_1c in the group with a detectable urinary C-peptide excretion. The HbA_1c level has been measured regularly (7–12 times) since the initial investigation; the mean value was lower in the patient group with residual C-peptide excretion than in the non-C-peptide group (<em>p</em> = 0.01). Nine of the patients in the group without urinary C-peptide excretion had increased severity of retinopathy, but only two in the group with urinary C-peptide excretion (<em>p</em> = 0.04) had progression of retinopathy. Incipient and/or manifest albuminuria was observed in six of the nonexcretor group and one of the C-peptide excretors. Four of the patients were receiving antihypertensive treatment and three others had a diastolic blood pressure ≥ 90 mmHg in the non-C-peptide excretor group as compared with one with a pressure ≥ 90 mmHg in the C-peptide excretor group. All 16 patients with moderate to advanced nonproliferative background retinopathy and/or incipient albuminuria had HLA-DR <span><math><mtext>3</mtext><mtext>4</mtext></math></span>, <span><math><mtext>3</mtext><mtext>x</mtext></math></span>, or <span><math><mtext>4</mtext><mtext>x</mtext></math></span> antigens, as compared with 20 of 28 patients with few if any signs of microangiopathy. We conclude that urinary C-peptide excretion together with regular measurements of HbA_1c may be used for prognostic evaluation of the increase in severity of retinopathy in groups of patients with type I diabetes.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"5 1","pages":"Pages 18-22"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0891-6632(91)90005-A","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12991913","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":"Urinary excretion of the carboxy terminal domain of type IV collagen is associated with kidney size and function in IDDM","authors":"Ole Torffvit MD ,&nbsp;Jörgen Wieslander PhD ,&nbsp;Lillemor Forsberg MD ,&nbsp;Esbjörn Hederström MD ,&nbsp;Carl-David Agardh MD","doi":"10.1016/0891-6632(90)90016-X","DOIUrl":"10.1016/0891-6632(90)90016-X","url":null,"abstract":"<div><p>We evaluated whether urinary excretion of the carboxy terminal domain (NC1) of Type IV collagen is associated with glomerular filtration rate and kidney size in Type I (insulin-dependent) diabetes mellitus (IDDM). Urinary excretion rate of NC1, glomerular filtration rate (GFR), and kidney size were measured in 16 men with Type I diabetes. Their mean age was 33.3 ± 6.1 years with a duration of diabetes of 14.9 ± 3.7 years (mean ± SD). The urinary excretion rate of NC1 was higher in the diabetic patients than in 18 healthy control subjects. Urinary excretion of NC1 was associated with both kidney size, parenchymal width, and GFR (<em>r</em> = 0.73, <em>p</em> = 0.001; <em>r</em> = 0.63, <em>p</em> = 0.009; <em>r</em> = 0.53, <em>p</em> = 0.04, respectively). The exact relationship between these factors and basement membrane turnover/synthesis remains to be elucidated.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 166-169"},"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)90016-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13304538","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":"Fibrinolysis in patients with diabetic nephropathy determined by plasmin-α2 plasmin inhibitor complexes in plasma","authors":"Mitsunori Yagame,&nbsp;Kazuhiko Eguchi,&nbsp;Daisuke Suzuki,&nbsp;Hideo Machimura,&nbsp;Hiroshi Takeda,&nbsp;Wataru Inoue,&nbsp;Kurumi Tanaka,&nbsp;Hideaki Kaneshige,&nbsp;Yasuo Nomoto,&nbsp;Hideto Sakai","doi":"10.1016/0891-6632(90)90018-Z","DOIUrl":"10.1016/0891-6632(90)90018-Z","url":null,"abstract":"<div><p>Activation of fibrinolysis in patients with diabetic nephropathy was determined by the plasma levels of plasmin-<em>α</em>₂ plasmin inhibitor complexes (<em>α</em>₂PIC) using a one-step sandwich enzyme immunoassay (EIA). Plasma levels of <em>α</em>₂PIC in diabetic patients with persistent proteinuria were significantly higher than those in diabetic patients without proteinuria, patients with chronic glomerulonephritis, and healthy adults. Plasma levels of <em>α</em>₂PIC in diabetic patients with intermittent proteinuria were also significantly higher than those of diabetic patients without proteinuria, patients with chronic glomerulonephritis, and healthy adults. Diabetic patients have been suggested to have a hypercoagulable state. The findings obtained from this study indicated that activation of fibrinolysis might counteract the hypercoagulable state in patients with diabetic nephropathy.</p></div>","PeriodicalId":77636,"journal":{"name":"The Journal of diabetic complications","volume":"4 4","pages":"Pages 175-178"},"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)90018-Z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13304540","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}