Diabetes Mellitus

Source: www.ncbi.nlm.nih.gov --- 1 day ago
Related Articles Epidemiology of Diabetes Mellitus in German general practitioners' consultation--results of the SESAM 2-study. Exp Clin Endocrinol Diabetes. 2008 Jun;116(6):326-8 Authors: Frese T, Sandholzer H, Voigt S, Voigt R The treatment of chronic diseases is of eminent importance in primary care, and type 2-Diabetes Mellitus is one of the most common dysfunctions. Its world-wide prevalence has been increasing from year to year. Thus, to estimate the prevalence and incidence of Diabetes Mellitus, we performed the SESAM (Sächsiche epidemiologische Studie in der Allgemeinmedizin) 2-study in cooperation with general practitioners (GPs) from the German state of Saxony; 270 of the 2510 (10.8%) solicited physicians participated. Cross-sectional data were collected from 1 October 1999 until 30 September 2000, from randomly selected patients previously known to the practitioner. From a total of 8877 consultations with 270 GPs, Diabetes was prevalent in 14% (n = 1241) of the patients and the incidence was 0.3% (27 of 8877 cases). The consultation prevalence was estimated at 14.3% (n = 1268; CI 13.6-15%). Of the diabetic patients, 3.5% (n = 44) suffered from type 1-Diabetes, while type 2-Diabetes was found in 66.9% (n = 848) of the cases. "Other Diabetes" was determined in 19.2% (n = 244), and "not further specified Diabetes", in 10.4% (n = 132) of the cases. Related to the German population in general, the prevalence ranged from 7.9 to 9.2 ...

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The Foundation for Revitalization of Local Health Traditions (FRLHT), an NGO recognized by the Scientific and Industrial Research Organization (SIRO) of the Department of Scientific and Industrial Research (DSIR) has developed a herbal drug using 42 ...

Source: www.ncbi.nlm.nih.gov --- 5 days ago
Related Articles Can newer therapies delay the progression of type 2 Diabetes Mellitus? Endocr Pract. 2008 Jul-Aug;14(5):625-38 Authors: Horton ES OBJECTIVE: To review the multifactorial and progressive nature of type 2 Diabetes Mellitus (T2DM), the consequences of its progression, and the potential of traditional and newer therapies to delay the progression of this disease. METHODS: The relevant literature is reviewed, and the mechanisms of action of novel agents for treatment of T2DM are discussed. RESULTS: The global prevalence of Diabetes has been increasing in recent decades, reaching near-epidemic proportions, and is projected to more than double by 2030. More than 90% of cases of Diabetes in most countries consist of T2DM, but many individuals remain undiagnosed or are diagnosed only after their disease has progressed considerably. Inadequate glycemic control in a majority of patients with T2DM is due to the progressive nature of the disease, delay in initiating pharmacotherapy, and failure to intensify treatment more quickly in patients who do not achieve glycemic targets. Traditional oral therapies are usually effective at lowering hyperglycemia initially but do not prevent disease progression; thus, many patients ultimately require insulin. Furthermore, because most antidiabetic therapies are associated with weight gain or risk of hypoglycemia (or both), patients may not adhere to treatment recommendations. CONCLUSION: A new ...

Source: www.ncbi.nlm.nih.gov --- 3 days ago
Related Articles Greater Clinical Benefit of More Intensive Oral Antiplatelet Therapy With Prasugrel in Patients With Diabetes Mellitus in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction 38. Circulation. 2008 Aug 31; Authors: Wiviott SD, Braunwald E, Angiolillo DJ, Meisel S, Dalby AJ, Verheugt FW, Goodman SG, Corbalan R, Purdy DA, Murphy SA, McCabe CH, Antman EM, BACKGROUND: -Patients with Diabetes Mellitus (DM) are at high risk for recurrent cardiovascular events after acute coronary syndromes, in part because of increased platelet reactivity. The Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38) showed an overall reduction in ischemic events with more intensive antiplatelet therapy with prasugrel than with clopidogrel but with more bleeding. We compared prasugrel with clopidogrel among subjects with DM in TRITON-TIMI 38. Methods and Results-We classified 13 608 subjects on the basis of preexisting history of DM and further according to insulin use. Prespecified analyses of the primary (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) and key secondary end points, including net clinical benefit (death, nonfatal myocardial infarction, nonfatal stroke, and nonfatal TIMI major bleeding) were compared by use of the ...

Source: www.ncbi.nlm.nih.gov --- 35 days ago
Related Articles [Metformin and type-2 Diabetes Mellitus] Aten Primaria. 2008 Mar;40(3):147-53 Authors: Mata Cases M PMID: 18373928 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 5 days ago
Related Articles [Dementia and Diabetes Mellitus] Srp Arh Celok Lek. 2008 Mar-Apr;136(3-4):170-5 Authors: Dementia and Diabetes Mellitus (DM) are major health problems nowadays. DM leads to a significant cognitive decline and increases the risk of dementia, mostly Alzheimer's Disease (AD) and vascular dementia (VaD) by 50-100% and 100-150%, respectively. Amyloid beta (Abeta), the main pathogenic factor in AD development, is eliminated by advanced glycation end products (AGEs) and degraded by insulin degrading enzyme (IDE) for which it competes with insulin. Insulin stimulates secretion of Abeta and promotes brain inflammation. DM I and II cause slowing down of mental speed, lowering of mental flexibility and DM II learning and memory disturbances. DM acts both directly by hyperglycaemia and hyperinsulinaemia and by the blood vessel changes. Hyperglycaemia changes synapse plasticity and leads to cognitive decline. AGEs disrupt the neuron function and bonding to Abeta increases its aggregability. Glycation of tau protein promotes production of neurofibrillary tangles (NFT), the main intracellular pathogenic factor in AD. AGE 2 in DM causes pathological angiogenesis and apoptosis of neurons. AGE receptor (RAGE) is also the specific Abeta receptor with which it produces reactive oxygen species that has, as a result, disruption of mitochondrial function and reduction of neuronal energy resources. Insulinoresistance is linked with the dysex ...

Source: www.moreover.com --- 23 days ago
Diabetes is a major health problem being faced by modern society of today all over the world and India is predicted to have the most number of people with Diabetes Mellitus by the year 2025. ...

Source: www.ncbi.nlm.nih.gov --- 28 days ago
Related Articles Diabetes Mellitus: an opportunity for therapy with stem cells? Regen Med. 2008 May;3(3):377-97 Authors: Sordi V, Bertuzzi F, Piemonti L In both Type 1 and 2 Diabetes, insufficient numbers of insulin-producing beta-cells are a major cause of defective control of blood glucose and its complications. Restoration of damaged beta-cells by endocrine pancreas regeneration would be an ideal therapeutic option. The possibility of generating insulin-secreting cells with adult pancreatic stem or progenitor cells has been investigated extensively. The conversion of differentiated cells such as hepatocytes into beta-cells is being attempted using molecular insights into the transcriptional make-up of beta-cells. Additionally, the enhanced proliferation of beta-cells in vivo or in vitro is being pursued as a strategy for regenerative medicine for Diabetes. Advances have also been made in directing the differentiation of embryonic stem cells into beta-cells. Although progress is encouraging, major gaps in our understanding of developmental biology of the pancreas and adult beta-cell dynamics remain to be bridged before a therapeutic application is made possible. PMID: 18462060 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 27 days ago
Related Articles Serum selenium and glutathione peroxidase concentrations in type 2 Diabetes Mellitus patients. Prim Care Diabetes. 2008 Jun;2(2):81-5 Authors: Kornhauser C, Garcia-Ramirez JR, Wrobel K, Pérez-Luque EL, Garay-Sevilla ME, Wrobel K AIMS: Antioxidant selenium (Se) properties and, its protective role against oxidative damage play an important role in diabetic complications. Our objective was to gain further insight on a link between selenium status and diabetic nephropathy. METHODS: We assessed glutathione peroxidase (GPx) and Se in type 2 Diabetes Mellitus patients with microalbuminuria (MA) (group 1), without microalbuminuria (group 2), and in control subjects (group 3). Glucose, urea, creatinine and glycated hemoglobin tests were tested in sera. A complete clinical record was elaborated. RESULTS: For diabetic patients both, the time from diagnosis and plasma glucose concentration were higher in group 1 as compared to group 2. Control group showed higher serum Se concentrations as compared to the diabetic groups. The two groups of diabetic patients showed similar serum Se levels. Serum concentration of GPx was significantly lower in group 1 as compared to groups 2 and 3. Microalbuminuria (MA) test showed a positive correlation with glucose, and a negative relationship with serum Se and GPx. Multiple regression revealed an inverse relationship between selenium or GPx in serum and the results of the MA test. CONCLUSIONS: Ou ...

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Source: www.ncbi.nlm.nih.gov --- 16 days ago
Related Articles Therapeutic approach of type 2 Diabetes Mellitus with GLP-1 based therapies. Diabetes Metab. 2008 Feb;34 Suppl 2:S78-90 Authors: Penfornis A, Borot S, Raccah D The goal of this review is to think about how to incorporate the GLP-1 based agents, represented by the dipeptidyl peptidase-4 (DPP-4) inhibitors or the glucagon-like peptide-1 (GLP-1) analogs, in the guidelines for the management of type 2 Diabetes (T2DM). Orally administered DPP-4 inhibitors, such as sitagliptin and vildagliptin, reduce HbA(1c) (absolute values) by 0.5-1.1% (5 to 12%, relative values), with few adverse events and no weight gain. The sub-cutaneous injected GLP-1 analogs show larger reductions in HbA(1c) (0.8-1.7%, absolute values; 9.4-20.0%, relative values), associated with weight loss (1.75-3.8 kg); their most common adverse events are gastrointestinal symptoms which contribute to a substantial treatment interruption. If they do not challenge the use of metformin as the initial therapy of T2DM, several studies argue in favour of the use of DPP-4 inhibitors, either in combination with metformin as the initial treatment or, in add-on therapy to metformin. The advantages of this combination over others currently used are reviewed. In patients not tolerating metformin, DPP-4 inhibitors seem to be an excellent alternative as a monotherapy. As long as oral triple therapy is concerned, the choice for the association metformin + thiazolidinedione + ...

Source: www.ncbi.nlm.nih.gov --- 20 days ago
Effects of pioglitazone on serum fetuin-A levels in patients with type 2 Diabetes Mellitus. Metabolism. 2008 Sep;57(9):1248-52 Authors: Mori K, Emoto M, Araki T, Yokoyama H, Lee E, Teramura M, Koyama H, Shoji T, Inaba M, Nishizawa Y Fetuin-A (alpha2-Heremans-Schmid glycoprotein), a circulating glycoprotein, can inhibit insulin signaling both in vivo and in vitro. Recently, we and another independent group have shown that fetuin-A is positively associated with insulin resistance in humans. Furthermore, it has been reported that higher fetuin-A levels are associated with metabolic syndrome and atherogenic lipid profiles. These data suggest that fetuin-A might be a regulator of insulin resistance and/or metabolic syndrome. However, it is not clear how fetuin-A levels are regulated. To address this, we investigated the effects of representative insulin-sensitizing therapies such as pioglitazone, metformin, and aerobic exercise on fetuin-A levels. Twenty-seven patients with type 2 Diabetes Mellitus were divided into pioglitazone-treated (Pio), metformin-treated (Met), and exercise-treated (Ex) groups. Ten patients in the Pio group and 9 patients in the Met group took 15 or 30 mg/d pioglitazone or 500 or 750 mg/d metformin, respectively, for 6 months. Eight patients in the Ex group underwent a 3-month aerobic exercise program. Serum fetuin-A levels were measured before and after each intervention. Intervention significantly decreased hemogl ...

Source: www.ncbi.nlm.nih.gov --- 34 days ago
Related Articles [Adrenergic reactivity and course of the wound process in Diabetes Mellitus condition: diagnostic significance and pathogenetic interpretation] Klin Khir. 2008 Jan;(1):40-2 Authors: Barinova ME In order to establish interrelationship between the organism adrenoreactivity and the wound process course in presence of Diabetes Mellitus the dynamics of effective concentration of alpha2-adrenoreceptors agonist (alpha2-AR), causing aggregation of 50% of thrombocytes (EC50) in patients, suffering Diabetes Mellitus, complicated by purulent-necrotic affection of lower extremities in admission to the hospital and during the period of treatment, was studied. The cutaneous wounds healing was accompanied by the organism adrenoreactivity normalization, in condition of durable unhealing of the wound the alpha2-AR sensitivity tolerance to the therapy performed was noted. It permits to consider the EC50 index as a criterion of severity of dysregulation changes and the therapy efficacy. PMID: 18610855 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 23 days ago
Related Articles The WNT signalling pathway and Diabetes Mellitus. Diabetologia. 2008 Aug 12; Authors: Jin T The WNT signalling pathway is involved in many physiological and pathophysiological activities. WNT ligands bind to Frizzled receptors and co-receptors (LDL receptor-related protein 5/6), triggering a cascade of signalling events. The major effector of the canonical WNT signalling pathway is the bipartite transcription factor beta-catenin/T cell transcription factor (beta-cat/TCF), formed by free beta-cat and one of the four TCFs. The WNT pathway is involved in lipid metabolism and glucose homeostasis, and mutations in LRP5 may lead to the development of Diabetes and obesity. beta-Cat/TCF is also involved in the production of the incretin hormone glucagon-like peptide-1 in the intestinal endocrine L cells. More recently, genome-wide association studies have identified TCF7L2 as a Diabetes susceptibility gene, and individuals carrying certain TCF7L2 single nucleotide polymorphisms could be more susceptible to the development of type 2 Diabetes. Furthermore, beta-cat is able to interact with forkhead box transcription factor subgroup O (FOXO) proteins. Since FOXO and TCF proteins compete for a limited pool of beta-cat, enhanced FOXO activity during ageing and oxidative stress may attenuate WNT-mediated activities. These observations shed new light on the pathogenesis of type 2 Diabetes as an age-dependent disease. PMID: 18696049 ...

Source: www.ncbi.nlm.nih.gov --- 16 days ago
Related Articles Beneficial effects of exercise on muscle mitochondrial function in Diabetes Mellitus. Sports Med. 2008;38(9):735-50 Authors: Lumini JA, Magalhães J, Oliveira PJ, Ascensão A The physiopathology of Diabetes Mellitus has been closely associated with a variety of alterations in mitochondrial histology, biochemistry and function. Generally, the alterations comprise increased mitochondrial reactive oxygen and nitrogen species (RONS) generation, resulting in oxidative stress and damage; decreased capacity to metabolize lipids, leading to intramyocyte lipid accumulation; and diminished mitochondrial density and reduced levels of uncoupling proteins (UCPs), with consequent impairment in mitochondrial function. Chronic physical exercise is a physiological stimulus able to induce mitochondrial adaptations that can counteract the adverse effects of Diabetes on muscle mitochondria. However, the mechanisms responsible for mitochondrial adaptations in the muscles of diabetic patients are still unclear. The main mechanisms by which exercise may be considered an important non-pharmacological strategy for preventing and/or attenuating Diabetes-induced mitochondrial impairments may involve (i) increased mitochondrial biogenesis, which is dependent on the increased expression of some important proteins, such as the 'master switch' peroxisome proliferator-activated receptor (PPAR)-gamma-coactivator-1alpha (PGC-1alpha) and heat shock prote ...

Source: www.ncbi.nlm.nih.gov --- 15 days ago
Related Articles Implementing intensified treatment strategies for patients with type 2 Diabetes Mellitus. J Fam Pract. 2007 Nov;56(11 Suppl Implementing):S9-16 Authors: Brunton SA, Rolla AR Primary care physicians play central roles in the management of patients with Diabetes, providing care for approximately 90% to 95% of adult patients with type 2 Diabetes Mellitus (DM). Treatment goals are well established, although treatment guidelines continue to evolve in response to new evidence and advances in therapy. Clinicians face significant challenges in managing this multifaceted and complex disease. Less than 12% of diagnosed patients reach treatment goals for blood glucose, cholesterol, and blood pressure. Treatment typically begins with the use of single-agent pharmacotherapy in conjunction with lifestyle modifications. As the disease progresses, other pharmacologic agents are added as treatment is intensified to achieve target goals. This CME activity examines the clinical uncertainties resulting from disease progression and provides recommendations for the long-term management of patients with type 2 DM. PMID: 18684359 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 21 days ago
Related Articles Antioxidant status in coronary heart disease (CHD) patients with type 2 Diabetes Mellitus. J Ayub Med Coll Abbottabad. 2007 Oct-Dec;19(4):98-101 Authors: Bansilal , Ali N, Afzal N, Khan TS, Shahjahan S BACKGROUND: The present study was carried out to see the levels of vitamin C, vitamin E and total antioxidant (AO) in Coronary Heart Disease (CHD) patients with and without Type-2 Diabetes Mellitus (T2DM). In various previous studies it has been reported that, Diabetes, hypertension and smoking are risk factors for CHD and all risk factors were common in these patients. METHODS: Serum was tested from 80 CHD patients and 21 healthy controls, matched for age, height, and weight. RESULTS: No significant difference was seen between the age, height and weight of the subjects and controls. CHD patients were mostly male, smokers, over 40 year of age and belonging upper class families. The mean plasma glucose was significantly higher (p < 0.05) in CHD patients having T2DM as compare to CHD patient with out T2DM. Risk factors for CHD, like Diabetes, hypertension and smoking were common in these patients. No significant difference was seen in vitamin C level of patients of CHD. Vitamin E level was significantly (p < 0.05) low among the CHD patients as compared to controls and a significant (p < 0.05) decrease in mean vitamin E level was observed among smoker CHD patients as compared to non-smoker CHD patients. But no significant d ...

Source: www.ncbi.nlm.nih.gov --- 31 days ago
Related Articles Immunologic and biochemical factors of coincident celiac disease and type 1 Diabetes Mellitus in children. Pediatr Res. 2008 Jul 23; Authors: Myśliwiec M, Balcerska A, Zorena K, Myśliwska J, Wiśniewski P The objective of the study was to investigate whether immunologic and biochemical events occurring in the course of type 1 Diabetes Mellitus might play a role in the development of the celiac disease. The study was carried out on 223 children with long-standing Diabetes Mellitus type 1. All the patients had TSH, fT4, fT3, urinary albumin secretion rate, IgA, level of antigliadin antibodies (AGA) IgA and IgG, anti-tissue transglutaminase (tTG) IgA antibodies, anti-endomysium (EmA) IgA and IgG antibodies and anti-tyreoglobulin antibodies (TG), anti-thyroid peroxidase (TPO) antibodies evaluated. Serum TNF-alpha, IL-6, IL-10 levels were also measured. The group of children with coincident DM1 and celiac disease and without autoimmune thyroiditis was characterized by significantly higher HbA1c, higher serum TNF-alpha, IL-6 but lower serum IL-10 in relation to the remaining diabetic patients. A statistically significant positive correlation was observed between IgA-anti-tTG and serum TNF-alpha (R=0.28, p=0.026); between IgG AGA and serum IL-6 (R=0.31, p=0.023); and between HbA1c and IgA-anti-tTG (R=0.21, p=0.001) and IgA EmA (R=0.22, p=0.001). Poor metabolic control, persistent elevated levels of pro-inflammatory cytokines a ...

Source: www.ncbi.nlm.nih.gov --- 7 days ago
Related Articles [The use of cavinton in patients with lacunar stroke developed against the background of Diabetes Mellitus and arterial hypertension] Zh Nevrol Psikhiatr Im S S Korsakova. 2007;107(4):64-6 Authors: Spirin NN, Pizova NV, Shadrichev VA, Filatov VF, Bakucheva MV PMID: 18688926 [PubMed - indexed for MEDLINE] ...