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Sample records for central diabetes insipidus

  1. Diagnosis and treatment of central diabetes insipidus

    Directory of Open Access Journals (Sweden)

    Ekaterina Aleksandrovna Pigarova

    2014-11-01

    Full Text Available Diabetes insipidus represents a serious disease that dramatically interferes with the everyday life of patients due to the need to constantly replenish of fluid lost in the urine, which comes amid shortage of synthesis, secretion or action of pituitary hormone vasopressin. The main difficulty is the differential diagnosis of types of diabetes insipidus in patients with the syndrome of polydipsia-polyuria as the correct differential diagnosis of these forms predetermine the safety and efficacy of further treatment. This lecture presents the current concepts of etiology, diagnosis and treatment of central diabetes insipidus (CDI. We give the comparative characteristics of various preparations of desmopressin for the treatment of the central form of the disease. We also consider the features of the management of selected patient populations with CDI: during pregnancy and lactation, pathology of the thirst sensation, after traumatic brain injury and neurosurgery.

  2. Metastatic Prostate Adenocarcinoma Presenting Central Diabetes Insipidus

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    Hakkı Yılmaz

    2012-01-01

    Full Text Available The pituitary gland and infundibulum can be involved in a variety of medical conditions, including infiltrative diseases, fungal infections, tuberculosis, and primary and metastatic tumors. Metastases to the pituitary gland are absolutely rare, and they are generally secondary to pulmonary carcinoma in men and breast carcinoma in women. Pituitary metastases more commonly affect the posterior lobe and the infundibulum than the anterior lobe. The posterior lobe involvement may explain why patients with pituitary metastases frequently present with diabetes insipidus. We are presenting a case report of a 78-year-old male patient who had metastatic prostate with sudden onset of polyuria and persistent thirst. He had no electrolyte imbalance except mild hypernatremia. The MRI scan of the brain yielded a suspicious area in pituitary gland. A pituitary stalk metastasis was found on magnetic resonance imaging (MRI of pituitary. Water deprivation test was compatible with DI. A clinical response to nasal vasopressin was achieved and laboratory results revealed central diabetes insipidus. As a result, the intrasellar and suprasellar masses decreased in size, and urinary output accordingly decreased.

  3. Diabetes insipidus - nephrogenic

    Science.gov (United States)

    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 ...

  4. Diabetes insipidus - nephrogenic

    Science.gov (United States)

    Nephrogenic diabetes insipidus; Acquired nephrogenic diabetes insipidus; Congenital diabetes insipidus ... be removed and returned to the blood. Nephrogenic diabetes insipidus (NDI) occurs when the kidney tubules do ...

  5. Central Diabetes Insipidus after Staged Spinal Surgery

    OpenAIRE

    Rosenbaum, Benjamin P.; Steinmetz, Michael P.

    2013-01-01

    Diabetes insipidus (DI) is described following penetrating spinal cord trauma but rarely following instrumented spinal fusion. More commonly, hyponatremia is seen following spine surgery, which may be iatrogenic, attributed to the syndrome of inappropriate antidiuretic hormone release. The authors present a case of a 57-year-old woman who underwent a planned two-stage operation for scoliotic deformity correction. On the third postoperative day, the patient developed hypernatremia (sodium leve...

  6. Central diabetes insipidus following digestion Solanum indicum L. concentrated solution.

    Science.gov (United States)

    Huang, Wen-Hung; Hsu, Ching-Wei; Fang, Ji-Tseng

    2008-04-01

    In Taiwan, Solanum indicum L. has been used in folk medicine for the treatment of inflammation, toothache, ascites, edema, and wound infection. The plant is rich in solanine, an alkaloidal glycoside. We report a 43-year-old man who developed polyuria and polydipsia after taking seven doses of concentrated solution of Solanum indicum L. over two weeks. A water deprivation test and a low serum antidiuretic hormone level helped to confirm a diagnosis of central diabetes insipidus. We suggest that excessive doses of Solanum indicum L. may cause central diabetes insipidus.

  7. Diabetes Insipidus

    Science.gov (United States)

    ... the brain may be neces sary as well. Points to Remember • Diabetes insipidus (DI) is a rare dis ease that ... visit www.ClinicalTrials.gov. For More Information The Diabetes Insipidus and Related Disorders Network 535 Echo Court Saline, MI 48176–1270 Email:gsmayes@aol.com ...

  8. Diabetes Insipidus

    Science.gov (United States)

    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 ...

  9. Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus.

    Science.gov (United States)

    Premji, Resmi; Roopnarinesingh, Nira; Cohen, Joshua; Sen, Sabyasachi

    2016-01-01

    Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated. PMID:27242936

  10. Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus.

    Science.gov (United States)

    Premji, Resmi; Roopnarinesingh, Nira; Cohen, Joshua; Sen, Sabyasachi

    2016-01-01

    Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated.

  11. Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Resmi Premji

    2016-01-01

    Full Text Available Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated.

  12. [Diabetes insipidus].

    Science.gov (United States)

    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.

  13. History of Diabetes Insipidus.

    Science.gov (United States)

    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.

  14. History of Diabetes Insipidus.

    Science.gov (United States)

    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. PMID:26913870

  15. [Etiological diagnosis of central diabetes insipidus: about 41 cases].

    Science.gov (United States)

    Chaker, Fatma; Chihaoui, Melika; Yazidi, Meriem; Slimane, Hedia

    2016-01-01

    The occurrence of polyuria-polydipsia syndrome with hypotonic urine requires careful diagnostic strategy. This study aims to evaluate diagnostic modalities for central diabetes insipidus. We conducted a retrospective study of 41 cases with central diabetes insipidus (CDI). Data were collected at the Department of Endocrinology, University Hospital La Rabta, Tunis, from 1990 to 2013. We identified the circumstances for detecting CDI, the abnormalities in anterior pituitary assessment and pituitary imaging. CDI occurred in the postoperative period in 20 patients. The average urine 24-hour volume was significantly higher in patients with CDI outside a surgical setting. Water deprivation test was successful in all patients who benefited from it. Outside of neurosurgery, infiltration causes were found in 6 patients and tumor causes were found in 6 patients. CDI was associated with empty sella turcica in 1 case and idiopathic sella turcica in 3 patients. Hypothalamic-pituitary magnetic resonance imaging and anterior pituitary balance sheet are systematic outside pituitary surgery setting and obvious primary polydipsia. PMID:27642481

  16. MR imaging of central diabetes insipidus: a pictorial essay

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    Shin, Ji Hoon; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul; Kim, Chang Jin; Hong, Sung Kwan [Ulsan University College of Medicine, Seoul (Korea, Republic of); Na, Dong Gyu [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2001-12-01

    Central diabetes insipidus (DI) can be the outcome of a number of diseases that affect the hypothalamic-neurohypophyseal axis. The causes of the condition can be classified as traumatic, inflammatory, or neoplastic. Traumatic causes include postoperative sella or transection of the pituitary stalk, while infectious or inflammatory causes include meningitis, lymphocytic hypophysitis, and granulomatous inflammations such as sarcoidosis and Wegener's granulomatosis. Various neoplastic conditions such as germinoma, Langerhans cell histiocytosis, metastasis, leukemic infiltration, lymphoma, teratoma, pituitary adenoma, craniopharyngioma, Rathke cleft cyst, hypothalamic glioma, and meningioma are also causes of central DI. In affected patients, careful analysis of these MR imaging features and correlation with the clinical manifestations can allow a more specific diagnosis, which is essential for treatment.

  17. MR imaging of central diabetes insipidus: a pictorial essay

    International Nuclear Information System (INIS)

    Central diabetes insipidus (DI) can be the outcome of a number of diseases that affect the hypothalamic-neurohypophyseal axis. The causes of the condition can be classified as traumatic, inflammatory, or neoplastic. Traumatic causes include postoperative sella or transection of the pituitary stalk, while infectious or inflammatory causes include meningitis, lymphocytic hypophysitis, and granulomatous inflammations such as sarcoidosis and Wegener's granulomatosis. Various neoplastic conditions such as germinoma, Langerhans cell histiocytosis, metastasis, leukemic infiltration, lymphoma, teratoma, pituitary adenoma, craniopharyngioma, Rathke cleft cyst, hypothalamic glioma, and meningioma are also causes of central DI. In affected patients, careful analysis of these MR imaging features and correlation with the clinical manifestations can allow a more specific diagnosis, which is essential for treatment

  18. Quality of life in the patients with central diabetes insipidus assessed by Nagasaki Diabetes Insipidus Questionnaire.

    Science.gov (United States)

    Nozaki, Aya; Ando, Takao; Akazawa, Satoru; Satoh, Tsuyoshi; Sagara, Ikuko; Horie, Ichiro; Imaizumi, Misa; Usa, Toshiro; Yanagisawa, Robert T; Kawakami, Atsushi

    2016-01-01

    Central diabetes insipidus (CDI) is characterized by polyuria and polydipsia due to a deficiency of vasopressin. Currently, the treatment goal for CDI is improvement of quality of life (QOL) by desmopressin (DDAVP) without developing hyponatremia. However, there is no reliable measure for QOL in CDI patients. We evaluate our original questionnaire for QOL, consisting of 12 questions focusing on polyuria, polydipsia, and DDAVP treatment, in CDI patients who underwent a switch from nasal spray to oral disintegrating tablets of DDAVP. Twenty-five CDI patients under nasal DDAVP treatment, six with newly developed CDI, and 18 healthy individuals without known polyuric/polydipsic disorders as control subjects were enrolled. QOL scores were determined by our questionnaire at the enrollment and 3 months after the start of oral DDAVP treatment and were examined by the Wilcoxon signed-rank test. Eleven questions detected improvement in QOL. The sum of the QOL scores of the eleven questions increased from 29.2 ± 5.6 under nasal to 36.8 ± 4.5 under oral DDAVP (p < 0.001). There were no clinically relevant changes in serum levels of Na. After eliminating two questions about DDAVP treatment, the sum of QOL scores was 15.3 ± 6.5 in untreated CDI patients, 24.4 ± 5.2 in those with nasal treatment, 28.9 ± 4.9 in those with oral DDAVP, and 29.5 ± 3.6 in healthy controls. The difference among groups was significant (p < 0.05 in Steel-Dwass test) except between patients treated with oral DDAVP and healthy controls. Our questionnaire can be used to accurately assess QOL in CDI patients.

  19. Caution on diagnosis of idiopathetic central diabetes insipidus

    Institute of Scientific and Technical Information of China (English)

    WANG Xian-ling; WANG Ying-qian; MU Yi-ming

    2012-01-01

    Idiopathetic central diabetes insipidus (CDI) is a heterogeneous hypothalamus-pituitary disease due to the absence or deficiency of arginine vasopressin (AVP).Overexcretion of dilute urine causes body's hydration state and symptoms of extraordinary thirst,even with copious water intake (up to 20 L per day).The diagnosis of CDI is commonly confirmed with water deprivation test and vasopressin analog response.1 This disorder is usually caused by the destruction or degeneration of AVP-secreting magnocellular neurons in hypothalamic supraoptic and paraventricular nuclei.The classical radiological change of CDI is loss of "bright spot" in MRI image,but it is always not special for differential diagnosis of underlying causes.

  20. Anterior Hypopituitarism is Rare and Autoimmune Disease is Common in Adults with Idiopathic Central Diabetes Insipidus.

    LENUS (Irish Health Repository)

    2012-02-01

    Objective: Central diabetes insipidus is a rare clinical condition with a heterogenous aetiology. Up to 40% of cases are classified as idiopathic, though many of these are thought to have an autoimmune basis. Published data has suggested that anterior hypopituitarism is common in childhood onset idiopathic diabetes insipidus. We aimed to assess the incidence of anterior hypopituitarism in a cohort of adult patients with idiopathic diabetes insipidus. Design and Patients: We performed a retrospective review of the databases of two pituitary investigation units. This identified 39 patients with idiopathic diabetes insipidus. All had undergone MRI scanning and dynamic pituitary testing (either insulin tolerance testing or GHRH\\/arginine and short synacthen testing) to assess anterior pituitary function. Results: One patient had partial growth hormone deficiency; no other anterior pituitary hormonal deficits were found. 33% had at least one autoimmune disease in addition to central diabetes insipidus. Conclusions: Our data suggest that anterior hypopituitarism is rare in adult idiopathic diabetes insipidus. Routine screening of these patients for anterior hypopituitarism may not therefore be indicated. The significant prevalence of autoimmune disease in this cohort supports the hypothesis that idiopathic diabetes insipidus may have an autoimmune aetiology.

  1. Generalized status epilepticus associated with massive pulmonary aspiration and transient central diabetes insipidus: case report

    Directory of Open Access Journals (Sweden)

    CARVALHO MAURICIO

    2000-01-01

    Full Text Available Status epilepticus causes significant morbidity and mortality. A case of generalized status epilepticus followed by massive pulmonary aspiration, acute respiratory failure and transient central diabetes insipidus is presented. Seizures were promptly controlled, but the patient required mechanical ventilation and correction of polyuria with desmopressin acetate. During hospitalization mental status improved, diabetes insipidus spontaneously remitted and he was discharged without neurologic sequelae. The clinical and pathophysiological features of this case are discussed.

  2. Combined central diabetes insipidus and cerebral salt wasting syndrome in children.

    Science.gov (United States)

    Lin, Jainn-Jim; Lin, Kuang-Lin; Hsia, Shao-Hsuan; Wu, Chang-Teng; Wang, Huei-Shyong

    2009-02-01

    Central diabetes insipidus, a common consequence of acute central nervous system injury, causes hypernatremia; cerebral salt wasting syndrome can cause hyponatremia. The two conditions occurring simultaneous are rarely described in pediatric patients. Pediatric cases of combined diabetes insipidus and cerebral salt wasting after acute central nervous system injury between January 2000 and December 2007 were retrospectively reviewed, and clinical characteristics were systemically assessed. Sixteen patients, aged 3 months to 18 years, met study criteria: 11 girls and 5 boys. The most common etiologies were severe central nervous system infection (n = 7, 44%) and hypoxic-ischemic event (n = 4, 25%). In 15 patients, diabetes insipidus was diagnosed during the first 3 days after acute central nervous system injury. Onset of cerebral salt wasting syndrome occurred 2-8 days after the onset of diabetes insipidus. In terms of outcome, 13 patients died (81%) and 3 survived under vegetative status (19%). Central diabetes insipidus and cerebral salt wasting syndrome may occur after acute central nervous system injury. A combination of both may impede accurate diagnosis. Proper differential diagnoses are critical, because the treatment strategy for each entity is different.

  3. Central pontine myelinolysis secondary to hypokalaemic nephrogenic diabetes insipidus.

    LENUS (Irish Health Repository)

    Davenport, C

    2010-01-01

    Central pontine myelinolysis (CPM) has been described in alcoholic patients and in the aftermath of rapid correction of chronic hyponatraemia. We describe a case of CPM occurring secondary to nephrogenic diabetes insipidus (DI), which developed as a consequence of severe hypokalaemia. A 63-year-old man with alcohol dependence was admitted to hospital with severe pulmonary sepsis and type 1 respiratory failure. On admission, he had euvolaemic hyponatraemia of 127 mmol\\/L, consistent with a syndrome of inappropriate antidiuretic hormone secondary to his pneumonia. Following admission, his plasma potassium dropped from 3.2 to a nadir of 2.3 mmol\\/L. Mineralocorticoid excess, ectopic adrenocorticotrophic hormone production and other causes of hypokalaemia were excluded. The hypokalaemia provoked significant hypotonic polyuria and a slow rise in plasma sodium to 161 mmol\\/L over several days. Plasma glucose, calcium and creatinine were normal. The polyuria did not respond to desmopressin, and subsequent correction of his polyuria and hypernatraemia after normalization of plasma potassium confirmed the diagnosis of nephrogenic DI due to hypokalaemia. The patient remained obtunded, and the clinical suspicion of osmotic demyelination was confirmed on magnetic resonance imaging. The patient remained comatose and passed away 10 days later. This is the first reported case of nephrogenic DI resulting in the development of CPM, despite a relatively slow rise in plasma sodium of less than 12 mmol\\/L\\/24 h. Coexisting alcohol abuse, hypoxaemia and hypokalaemia may have contributed significantly to the development of CPM in this patient.

  4. Normal MR appearances of the posterior pituitary in central diabetes insipidus associated with septo-optic dysplasia

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    Abernethy, L.J. [Dept. of Radiology, Royal Liverpool Children`s Hospital, Liverpool (United Kingdom); Qunibi, M.A. [Depts. of Radiology and Child Health, Royal Liverpool Children`s Hospital, Liverpool (United Kingdom); Smith, C.S. [Depts. of Radiology and Child Health, Royal Liverpool Children`s Hospital, Liverpool (United Kingdom)

    1997-01-01

    Magnetic resonance (MR) imaging of the pituitary in children with central diabetes insipidus usually shows absence of the normal high signal within the posterior gland. The high signal of the normal posterior pituitary is thought to be due to the presence of intra- cellular storage granules of vasopressin. MR imaging has been advocated as a useful investigation to aid in the distinction between central diabetes insipidus and other causes of thirst and polydipsia. We report the case of an infant with central diabetes insipidus in association with septo-optic dysplasia in whom MR imaging showed normal appearances of the posterior pituitary. The mechanism of central diabetes insipidus in this case may be related to a failure of hypothalamic function affecting osmoreception, rather than to a deficiency of vasopressin. Normal MR appearances of the pituitary do not exclude central diabetes insipidus in infants with midline cerebral malformations. (orig.). With 1 fig.

  5. Normal MR appearances of the posterior pituitary in central diabetes insipidus associated with septo-optic dysplasia

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) imaging of the pituitary in children with central diabetes insipidus usually shows absence of the normal high signal within the posterior gland. The high signal of the normal posterior pituitary is thought to be due to the presence of intra- cellular storage granules of vasopressin. MR imaging has been advocated as a useful investigation to aid in the distinction between central diabetes insipidus and other causes of thirst and polydipsia. We report the case of an infant with central diabetes insipidus in association with septo-optic dysplasia in whom MR imaging showed normal appearances of the posterior pituitary. The mechanism of central diabetes insipidus in this case may be related to a failure of hypothalamic function affecting osmoreception, rather than to a deficiency of vasopressin. Normal MR appearances of the pituitary do not exclude central diabetes insipidus in infants with midline cerebral malformations. (orig.). With 1 fig

  6. Central diabetes insipidus: Is it Langerhans cell histiocytosis of the pituitary stalk? A diagnostic pitfall.

    NARCIS (Netherlands)

    Prosch, H.; Grois, N.; Bökkerink, J.P.M.; Prayer, D.; Leuschner, I.; Minkov, M.; Gadner, H.

    2006-01-01

    Central diabetes insipidus (CDI) is a rare disorder that may be caused by a variety of diseases. In pediatric and adolescent patients the most common causes for CDI are Langerhans cell histiocytosis (LCH) and germinoma. To avoid a potentially hazardous biopsy of the hypothalamic pituitary region it

  7. [Diabetes insipidus and pregnancy].

    Science.gov (United States)

    Gutiérrez Cruz, Oswaldo; Careaga Benítez, Ricardo

    2007-04-01

    Diabetes insipidus is an uncommon pathology; its incidence varies from two to six cases in 100,000 pregnancies. It has multiple etiologies and it is classified in central and neurogenic. Patients with diabetes insipidus generally show intense thirst, polyuria, neurologic symptoms and hypernatremia. It does not seem to alter the patient's fertility. Diabetes insipidus is usually associated with pre-eclampsia, HELLP syndrome, and fatty liver disease of pregnancy. This is a report of a case seen at the Hospital General de Cholula, in Puebla, Mexico. A 19 year-old female, with 37.2 weeks of pregnancy, had a history of Langerhans cell histiocytosis since she was four years. Patient was treated with intranasal desmopressin until 2005. She went to an obstetric evaluation; laboratory and cabinet studies were obtained. A healthy 1900 g female was obtained through vaginal delivery, with a 7/9 Apgar score. We should be familiarized with this uncommon pathology because of its association with several obstetric emergencies.

  8. Diabetes Insipidus

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  9. Diabetes Insipidus

    Science.gov (United States)

    ... and family history physical exam urinalysis blood tests fluid deprivation test magnetic resonance imaging (MRI) Medical and Family History Taking ... history, a physical exam, urinalysis, blood tests, a fluid deprivation test, and magnetic resonance imaging (MRI). The primary treatment for diabetes ...

  10. Diabetes insipidus in infants and children.

    Science.gov (United States)

    Dabrowski, Elizabeth; Kadakia, Rachel; Zimmerman, Donald

    2016-03-01

    Diabetes insipidus, the inability to concentrate urine resulting in polyuria and polydipsia, can have different manifestations and management considerations in infants and children compared to adults. Central diabetes insipidus, secondary to lack of vasopressin production, is more common in children than is nephrogenic diabetes insipidus, the inability to respond appropriately to vasopressin. The goal of treatment in both forms of diabetes insipidus is to decrease urine output and thirst while allowing for appropriate fluid balance, normonatremia and ensuring an acceptable quality of life for each patient. An infant's obligate need to consume calories as liquid and the need for readjustment of medication dosing in growing children both present unique challenges for diabetes insipidus management in the pediatric population. Treatment modalities typically include vasopressin or thiazide diuretics. Special consideration must be given when managing diabetes insipidus in the adipsic patient, post-surgical patient, and in those undergoing chemotherapy or receiving medications that alter free water clearance.

  11. Familial neurohypophyseal diabetes insipidus

    DEFF Research Database (Denmark)

    Kvistgaard, Helene

    2011-01-01

    Familial neurohypophyseal diabetes insipidus (FNDI) is characterized by severe low-solute polyuria and polydipisa. The disease is caused by a deficient neurosecretion of the antidiuretic hormone arginine vasopressin (AVP). The hormone is normally synthesized by the magnocellular neurons in the pa......Familial neurohypophyseal diabetes insipidus (FNDI) is characterized by severe low-solute polyuria and polydipisa. The disease is caused by a deficient neurosecretion of the antidiuretic hormone arginine vasopressin (AVP). The hormone is normally synthesized by the magnocellular neurons...... as one sporadic case of early-onset diabetes insipidus. Genetic testing of the sporadic case of diabetes insipidus revealed a highly unusual mosaicism for a variation in the gene encoding the AVP receptor (AVPR2). This mosaicism had resulted in a partial phenotype and initial diagnostic difficulties...

  12. A Case of Rathke's Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus

    OpenAIRE

    Masahiro Asakawa; Rina Chin; Yoshihiro Niitsu; Tetsuo Sekine; Arisa Niwa; Atsuko Miyake; Naoko Inoshita; Mitsunobu Kawamura; Yoshihiro Ogawa; Yukio Hirata

    2014-01-01

    A 73-year-old woman admitted to our hospital because of headache, poor appetite, malaise, weight loss, and vomiting was found to have central adrenal insufficiency and thyrotoxicosis due to silent thyroiditis. Polyuria developed after replacement with glucocorticoid (masked diabetes insipidus), which was controlled with nasal administration of desmopressin. Magnetic resonance imaging of the brain showed a large cystic pituitary mass (18 × 18 × 12 mm) extending suprasellarly to the optic chias...

  13. Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report

    OpenAIRE

    Choi, Yeun Seoung; Lim, Jung Soo; Kwon, Woocheol; Jung, Soon-Hee; Park, Il Hwan; Lee, Myoung Kyu; Lee, Won Yeon; Yong, Suk Joong; Lee, Seok Jeong; Jung, Ye-Ryung; Choi, Jiwon; Choi, Ji Sun; Jeong, Joon Taek; Yoo, Jin Sae; Kim, Sang-Ha

    2015-01-01

    Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipi...

  14. Diabetes insipidus and pregnancy.

    Science.gov (United States)

    Chanson, Philippe; Salenave, Sylvie

    2016-06-01

    Diabetes insipidus (DI) is a rare complication of pregnancy. It is usually transient, being due to increased placental production of vasopressinase that inactivates circulating vasopressin. Gestational, transient DI occurs late in pregnancy and disappears few days after delivery. Acquired central DI can also occur during pregnancy, for example in a patient with hypophysitis or neuroinfundibulitis during late pregnancy or postpartum. Finally, pre-existing central or nephrogenic DI may occasionally be unmasked by pregnancy. Treatment with dDAVP (desmopressin, Minirin(®)) is very effective on transient DI of pregnancy and also on pre-existing or acquired central DI. Contrary to vasopressin, dDAVP is not degraded by vasopressinase. Nephrogenic DI is insensitive to dDAVP and is therefore more difficult to treat during pregnancy if fluid intake needs to be restricted. PMID:27172867

  15. Diabetes insipidus and pregnancy.

    Science.gov (United States)

    Chanson, Philippe; Salenave, Sylvie

    2016-06-01

    Diabetes insipidus (DI) is a rare complication of pregnancy. It is usually transient, being due to increased placental production of vasopressinase that inactivates circulating vasopressin. Gestational, transient DI occurs late in pregnancy and disappears few days after delivery. Acquired central DI can also occur during pregnancy, for example in a patient with hypophysitis or neuroinfundibulitis during late pregnancy or postpartum. Finally, pre-existing central or nephrogenic DI may occasionally be unmasked by pregnancy. Treatment with dDAVP (desmopressin, Minirin(®)) is very effective on transient DI of pregnancy and also on pre-existing or acquired central DI. Contrary to vasopressin, dDAVP is not degraded by vasopressinase. Nephrogenic DI is insensitive to dDAVP and is therefore more difficult to treat during pregnancy if fluid intake needs to be restricted.

  16. Animal models of Central Diabetes Insipidus: Human relevance of acquired beyond hereditary syndromes and the role of oxytocin.

    Science.gov (United States)

    Bernal, Antonio; Mahía, Javier; Puerto, Amadeo

    2016-07-01

    The aim of this study was to review different animal models of Central Diabetes Insipidus, a neurobiological syndrome characterized by the excretion of copious amounts of diluted urine (polyuria), a consequent water intake (polydipsia), and a rise in the serum sodium concentration (hypernatremia). In rodents, Central Diabetes Insipidus can be caused by genetic disorders (Brattleboro rats) but also by various traumatic/surgical interventions, including neurohypophysectomy, pituitary stalk compression, hypophysectomy, and median eminence lesions. Regardless of its etiology, Central Diabetes Insipidus affects the neuroendocrine system that secretes arginine vasopressin, a neurohormone responsible for antidiuretic functions that acts trough the renal system. However, most Central Diabetes Insipidus models also show disorders in other neurobiological systems, specifically in the secretion of oxytocin, a neurohormone involved in body sodium excretion. Although the hydromineral behaviors shown by the different Central Diabetes Insipidus models have usually been considered as very similar, the present review highlights relevant differences with respect to these behaviors as a function of the individual neurobiological systems affected. Increased understanding of the relationship between the neuroendocrine systems involved and the associated hydromineral behaviors may allow appropriate action to be taken to correct these behavioral neuroendocrine deficits.

  17. Animal models of Central Diabetes Insipidus: Human relevance of acquired beyond hereditary syndromes and the role of oxytocin.

    Science.gov (United States)

    Bernal, Antonio; Mahía, Javier; Puerto, Amadeo

    2016-07-01

    The aim of this study was to review different animal models of Central Diabetes Insipidus, a neurobiological syndrome characterized by the excretion of copious amounts of diluted urine (polyuria), a consequent water intake (polydipsia), and a rise in the serum sodium concentration (hypernatremia). In rodents, Central Diabetes Insipidus can be caused by genetic disorders (Brattleboro rats) but also by various traumatic/surgical interventions, including neurohypophysectomy, pituitary stalk compression, hypophysectomy, and median eminence lesions. Regardless of its etiology, Central Diabetes Insipidus affects the neuroendocrine system that secretes arginine vasopressin, a neurohormone responsible for antidiuretic functions that acts trough the renal system. However, most Central Diabetes Insipidus models also show disorders in other neurobiological systems, specifically in the secretion of oxytocin, a neurohormone involved in body sodium excretion. Although the hydromineral behaviors shown by the different Central Diabetes Insipidus models have usually been considered as very similar, the present review highlights relevant differences with respect to these behaviors as a function of the individual neurobiological systems affected. Increased understanding of the relationship between the neuroendocrine systems involved and the associated hydromineral behaviors may allow appropriate action to be taken to correct these behavioral neuroendocrine deficits. PMID:27118135

  18. Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report

    Science.gov (United States)

    Choi, Yeun Seoung; Lim, Jung Soo; Kwon, Woocheol; Jung, Soon-Hee; Park, Il Hwan; Lee, Myoung Kyu; Lee, Won Yeon; Yong, Suk Joong; Lee, Seok Jeong; Jung, Ye-Ryung; Choi, Jiwon; Choi, Ji Sun; Jeong, Joon Taek; Yoo, Jin Sae

    2015-01-01

    Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus. PMID:26508947

  19. Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report.

    Science.gov (United States)

    Choi, Yeun Seoung; Lim, Jung Soo; Kwon, Woocheol; Jung, Soon-Hee; Park, Il Hwan; Lee, Myoung Kyu; Lee, Won Yeon; Yong, Suk Joong; Lee, Seok Jeong; Jung, Ye-Ryung; Choi, Jiwon; Choi, Ji Sun; Jeong, Joon Taek; Yoo, Jin Sae; Kim, Sang-Ha

    2015-10-01

    Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus. PMID:26508947

  20. Diabete insípido central em um cão Central diabetes insipidus in a dog

    Directory of Open Access Journals (Sweden)

    Claudete Schmidt

    2009-06-01

    Full Text Available Descreve-se um caso de diabete insípido central em um cão, fêmea, nove anos de idade, sem raça definida, com história de poliúria e polidipsia há 18 meses. Com o exame físico, nenhuma alteração sistêmica foi elucidada. Já nos exames laboratoriais complementares, observou-se policitemia e hiperproteinemia, e a densidade específica da urina (1002 encontrava-se abaixo do limiar fisiológico. O animal foi submetido à privação hídrica e se mostrou incapaz de concentrar a urina durante as sete horas observadas, tempo que levou para apresentar 5% de desidratação. Após isso, foi administrado acetato de desmopressina e, 5 horas após, a densidade estava em 1028, confirmando o diabete insípido de origem central. O animal recebeu terapia à base de acetato de desmopressina, apresentando melhora do quadro clínico.A case of central diabetes insipidus in a nine-year-old female dog is described. The dog presented intermitent polyuria and polydipsia in the past 18 months. In the clinical exam, complete blood count, alanine transaminase, alkaline phosphatase, BUN, creatinine, glucose and calcium dosages were normal. However, the specific urine gravity was low and presented the value 1002. The dog was unable to concentrate the urine during the seven hours of water deprivation test and presented 5% of dehydratation. The administration of desmopressin acetate elevated the specific urine gravity to 1028 five hours after the beginning of the treatment, confirming the diagnosis of diabetes insipidus of central origin.

  1. Polyuria with the Concurrent manifestation of Central Diabetes Insipidus (CDI) & Type 2 Diabetes Mellitus (DM).

    Science.gov (United States)

    Shin, Hyun-Jong; Kim, Jae-Ha; Yi, Joo-Hark; Han, Sang-Woong; Kim, Ho-Jung

    2012-12-01

    We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 µg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.

  2. Unusual Presentation of Central Diabetes Insipidus in a Patient With Neurosarcoidosis

    Science.gov (United States)

    Sanghi, Vedha; Kapoor, Aanchal

    2016-01-01

    Hypernatremia is a frequent cause of intensive care unit admission. The patient presented in this article had hypernatremia refractory to D5W (dextrose 5% water) therapy, which led to a complex investigation. Workup revealed central diabetes insipidus most likely secondary to flare up of neurosarcoidosis. The challenge in terms of diagnosis was a presentation with low urine output in the setting of hypernatremia resistant to treatment with desmopressin. This case unfolded the role of hypothyroidism causing secondary renal dysfunction and hence needed continued treatment with thyroxine in addition to treatment for hypernatremia.

  3. Central Diabetes Insipidus and Cisplatin-Induced Renal Salt Wasting Syndrome: A Challenging Combination.

    Science.gov (United States)

    Cortina, Gerard; Hansford, Jordan R; Duke, Trevor

    2016-05-01

    We describe a 2-year-old female with a suprasellar primitive neuroectodermal tumor and central diabetes insipidus (DI) who developed polyuria with natriuresis and subsequent hyponatremia 36 hr after cisplatin administration. The marked urinary losses of sodium in combination with a negative sodium balance led to the diagnosis of cisplatin-induced renal salt wasting syndrome (RSWS). The subsequent clinical management is very challenging. Four weeks later she was discharged from ICU without neurological sequela. The combination of cisplatin-induced RSWS with DI can be confusing and needs careful clinical assessment as inaccurate diagnosis and management can result in increased neurological injury.

  4. Unusual Presentation of Central Diabetes Insipidus in a Patient With Neurosarcoidosis.

    Science.gov (United States)

    Sanghi, Vedha; Kapoor, Aanchal

    2016-01-01

    Hypernatremia is a frequent cause of intensive care unit admission. The patient presented in this article had hypernatremia refractory to D5W (dextrose 5% water) therapy, which led to a complex investigation. Workup revealed central diabetes insipidus most likely secondary to flare up of neurosarcoidosis. The challenge in terms of diagnosis was a presentation with low urine output in the setting of hypernatremia resistant to treatment with desmopressin. This case unfolded the role of hypothyroidism causing secondary renal dysfunction and hence needed continued treatment with thyroxine in addition to treatment for hypernatremia.

  5. Autoimmune central diabetes insipidus in a patient with ureaplasma urealyticum infection and review on new triggers of immune response.

    Science.gov (United States)

    Murdaca, Giuseppe; Russo, Rodolfo; Spanò, Francesca; Ferone, Diego; Albertelli, Manuela; Schenone, Angelo; Contatore, Miriam; Guastalla, Andrea; De Bellis, Annamaria; Garibotto, Giacomo; Puppo, Francesco

    2015-12-01

    Diabetes insipidus is a disease in which large volumes of dilute urine (polyuria) are excreted due to vasopressin (AVP) deficiency [central diabetes insipidus (CDI)] or to AVP resistance (nephrogenic diabetes insipidus). In the majority of patients, the occurrence of CDI is related to the destruction or degeneration of neurons of the hypothalamic supraoptic and paraventricular nuclei. The most common and well recognized causes include local inflammatory or autoimmune diseases, vascular disorders, Langerhans cell histiocytosis (LCH), sarcoidosis, tumors such as germinoma/craniopharyngioma or metastases, traumatic brain injuries, intracranial surgery, and midline cerebral and cranial malformations. Here we have the opportunity to describe an unusual case of female patient who developed autoimmune CDI following ureaplasma urealyticum infection and to review the literature on this uncommon feature. Moreover, we also discussed the potential mechanisms by which ureaplasma urealyticum might favor the development of autoimmune CDI.

  6. Adult Multisystem Langerhans Cell Histiocytosis Presenting with Central Diabetes Insipidus Successfully Treated with Chemotherapy

    Science.gov (United States)

    Choi, Jung-Eun; Lee, Hae Ri; Ohn, Jung Hun; Moon, Min Kyong; Park, Juri; Lee, Seong Jin; Choi, Moon-Gi; Yoo, Hyung Joon; Kim, Jung Han

    2014-01-01

    We report the rare case of an adult who was diagnosed with recurrent multisystem Langerhans cell histiocytosis (LCH) involving the pituitary stalk and lung who present with central diabetes insipidus and was successfully treated with systemic steroids and chemotherapy. A 49-year-old man visited our hospital due to symptoms of polydipsia and polyuria that started 1 month prior. Two years prior to presentation, he underwent excision of right 6th and 7th rib lesions for the osteolytic lesion and chest pain, which were later confirmed to be LCH on pathology. After admission, the water deprivation test was done and the result indicated that he had central diabetes insipidus. Sella magnetic resonance imaging showed a mass on the pituitary stalk with loss of normal bright spot at the posterior lobe of the pituitary. Multiple patchy infiltrations were detected in both lung fields by computed tomography (CT). He was diagnosed with recurrent LCH and was subsequently treated with inhaled desmopressin, systemic steroids, vinblastine, and mercaptopurine. The pituitary mass disappeared after two months and both lungs were clear on chest CT after 11 months. Although clinical remission in multisystem LCH in adults is reportedly rare, our case of adult-onset multisystem LCH was treated successfully with systemic chemotherapy using prednisolone, vinblastine, and 6-mercaptopurine, which was well tolerated. PMID:25309800

  7. Comparison of desmopressin (DDAVP tablet and intranasal spray in the treatment of central diabetes insipidus

    Directory of Open Access Journals (Sweden)

    "Bagher Larijani

    2005-07-01

    Full Text Available Desmoperssin is the drug of choice for treatment of central diabetes insipidus and most commonly it is used as intranasal spray. In this study, efficacy and side effects of oral desmopressin was compared with the intranasal spray. This study was before -after clinical trial on 14 outpatients (9 F, 5 M, age 14 -50 Y with central diabetes insipidus who had been treated with intranasal spray of desmopressin previously. Weight, pulse rate and blood pressure (sitting -standing, biochemical profile, serum electrolytes, 24h urine volume, specific gravity of urine and LFT was measured before and after 1 month study. Starting dose for each patient was one oral tablet of DDAVP (0.1 mg per 8 hours. Paired Samples T-Test was used for data analysis. No clinically significant changes were found as regard to weight, pulse rate, blood pressure, blood chemistry, electrolyte and urinalysis. Single reported adverse effect was headache (43% in tablet group and dyspnea (7% in spray group. Both dosage forms were able to control diurnal polyuria and nocturnal polyuria. The antidiuretic dose - equivalence ratio for intranasal to oral desmopressin was 1: 18. Spray was superior in terms of rapid onset of action and duration of antidiuretic action in 100% and 78% of cases (not significant, respectively. Tablets were more available and much more easily consumed as reported by patients, in 86% (P=0.0006. Treatment with tablets offers a good alternative to the intranasal route, especially in patients with chronic rhinitis or common cold and similar conditions.

  8. Cutting edge: neuronal recognition by CD8 T cells elicits central diabetes insipidus.

    Science.gov (United States)

    Scheikl, Tanja; Pignolet, Béatrice; Dalard, Cécile; Desbois, Sabine; Raison, Danièle; Yamazaki, Masanori; Saoudi, Abdelhadi; Bauer, Jan; Lassmann, Hans; Hardin-Pouzet, Hélène; Liblau, Roland S

    2012-05-15

    An increasing number of neurologic diseases is associated with autoimmunity. The immune effectors contributing to the pathogenesis of such diseases are often unclear. To explore whether self-reactive CD8 T cells could attack CNS neurons in vivo, we generated a mouse model in which the influenza virus hemagglutinin (HA) is expressed specifically in CNS neurons. Transfer of cytotoxic anti-HA CD8 T cells induced an acute but reversible encephalomyelitis in HA-expressing recipient mice. Unexpectedly, diabetes insipidus developed in surviving animals. This robust phenotype was associated with preferential accumulation of cytotoxic CD8 T cells in the hypothalamus, upregulation of MHC class I molecules, and destruction of vasopressin-expressing neurons. IFN-γ production by the pathogenic CD8 T cells was necessary for MHC class I upregulation by hypothalamic neurons and their destruction. This novel mouse model, in combination with related human data, supports the concept that autoreactive CD8 T cells can trigger central diabetes insipidus. PMID:22504649

  9. Diabetes insipidus in children.

    Science.gov (United States)

    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.

  10. Gestational diabetes insipidus. Case Report.

    Science.gov (United States)

    Ejmocka-Ambroziak, Anna; Grzechocińska, Barbara; Jastrzebska, Helena; Kochman, Magdalena; Cyganek, Anna; Wielgoś, Mirosław; Zgliczyński, Wojciech

    2015-01-01

    Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor.

  11. A Case of Turner Syndrome with Concomitant Transient Hypogammaglobulinaemia of Infancy and Central Diabetes Insipidus

    Science.gov (United States)

    Korkmaz, Hüseyin Anıl; Özkan, Behzat; Hazan, Filiz; Büyükinan, Muammer; Çelik, Tanju

    2013-01-01

    Turner syndrome (TS) is a genetic disorder that affects development in females and is characterized by the complete or partial absence of the second sex chromosome, or monosomy X. TS is associated with abnormalities in lymphatic and skeletal development, in growth, and in gonadal function. Cardiac and renal malformations and a number of specific cognitive findings may also be encountered in these patients. An increased risk for hypothyroidism, sensorineural hearing loss, hypertension, and other problems has also been reported. We present the case of a patient with TS accompanied by transient hypogammaglobulinaemia of infancy (THI) and central diabetes insipidus, which we believe is the first reported TS patient with these concomitant disorders. Conflict of interest:None declared. PMID:23419422

  12. A Case of Rathke’s Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Masahiro Asakawa

    2014-01-01

    Full Text Available A 73-year-old woman admitted to our hospital because of headache, poor appetite, malaise, weight loss, and vomiting was found to have central adrenal insufficiency and thyrotoxicosis due to silent thyroiditis. Polyuria developed after replacement with glucocorticoid (masked diabetes insipidus, which was controlled with nasal administration of desmopressin. Magnetic resonance imaging of the brain showed a large cystic pituitary mass (18 × 18 × 12 mm extending suprasellarly to the optic chiasm. Transsphenoidal surgery revealed that the pituitary tumor was Rathke’s cleft cyst. Following surgery, replacement with neither glucocorticoid nor desmopressin was needed any more. Therefore, it is suggested that Rathke’s cleft cyst is responsible for the masked diabetes insipidus and the central insufficiency. Furthermore, it is speculated that thyrotoxicosis with painless thyroiditis might induce changes from subclinical adrenal insufficiency to transiently overt insufficiency.

  13. Diabetes insipidus: the basic and clinical review

    Directory of Open Access Journals (Sweden)

    Muhammad Waseem Abbas

    2016-01-01

    Full Text Available Diabetes insipidus (DI is a complex disease. DI is inability of the body to conserve water. Polydipsia and polyuria are the major manifestations of DI. DI has various variants including central diabetes insipidus (due to defect in ADH secretion, nephrogenic diabetes insipidus (due to defect in ADH receptors or urea receptors, gestational diabetes insipidus (due to catabolism of ADH by placental vasopressinase and primary polydipsia (due to massive fluid intake. The cause of various variants of DI is either acquired or congenital. High plasma osmolality due to hypotonic urine excretion can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. Polyuria and polydipsia help in the diagnosis of DI. Differential diagnosis of various variants of DI can be carried out on the basis of water deprivation test, MRI and other radiological techniques. The proper management of DI is the replenishment of water loss and correction of clinical presentations produced as a result of DI, major is hypernatremia. The best management for primary polydipsia is fluid restriction while fluid intake is used for adipsic diabetes insipidus. ADH replacement therapy is widely used to treat DI. DDAVP or desmopressin is mostly preferred ADH analogue because it has less side effects and resistant to placental vasoprssinase. [Int J Res Med Sci 2016; 4(1.000: 5-11

  14. Apoptosis of supraoptic AVP neurons is involved in the development of central diabetes insipidus after hypophysectomy in rats

    Directory of Open Access Journals (Sweden)

    Huang Lijin

    2008-06-01

    Full Text Available Abstract Background It has been reported that various types of axonal injury of hypothalamo-neurohypophyseal tract can result in degeneration of the magnocellular neurons (MCNs in hypothalamus and development of central diabetes insipidus (CDI. However, the mechanism of the degeneration and death of MCNs after hypophysectomy in vivo is still unclear. This present study was aimed to disclose it and to figure out the dynamic change of central diabetes insipidus after hypophysectomy. Results The analysis on the dynamic change of daily water consumption (DWC, daily urine volume(DUV, specific gravity of urine(USG and plasma vasopressin concentration showed that the change pattern of them was triphasic and neuron counting showed that the degeneration of vasopressin neurons began at 10 d, aggravated at 20 d and then stabilized at 30 d after hypophysectomy. There was marked upregulation of cleaved Caspase-3 expression of vasopressin neurons in hypophysectomy rats. A "ladder" pattern of migration of DNA internucleosomal fragments was detected and apoptotic ultrastructure was found in these neurons. There was time correlation among the occurrence of diabetes insipidus, the changes of plasma vasopressin concentration and the degeneration of vasopressin neurons after hypophysectomy. Conclusion This study firstly demonstrated that apoptosis was involved in degeneration of supraoptic vasopressin neurons after hypophysectomy in vivo and development of CDI. Our study on time course and correlations among water metabolism, degeneration and apoptosis of vasopressin neurons suggested that there should be an efficient therapeutic window in which irreversible CDI might be prevented by anti-apoptosis.

  15. Familial cerebellar ataxia and diabetes insipidus.

    OpenAIRE

    Robinson, I C; O'Malley, B P; Young, I D

    1988-01-01

    Two sisters are reported who both developed partial cranial diabetes insipidus in their 4th decade, followed by progressive cerebellar ataxia. This appears to be the first report of cerebellar ataxia and diabetes insipidus occurring together as a genetic entity.

  16. Pituitary Morphology and Function in 43 Children with Central Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Wendong Liu

    2016-01-01

    Full Text Available Objective. In pediatric central diabetes insipidus (CDI, etiology diagnosis and pituitary function monitoring are usually delayed. This study aimed to illustrate the importance of regular follow-up and pituitary function monitoring in pediatric CDI. Methods. The clinical, hormonal, and neuroradiological characteristics of children with CDI at diagnosis and during 1.5–2-year follow-up were collected and analyzed. Results. The study included 43 CDI patients. The mean interval between initial manifestation and diagnosis was 22.29 ± 3.67 months (range: 2–108 months. The most common complaint was polyuria/polydipsia. Causes included Langerhans cell histiocytosis, germinoma, and craniopharyngioma in 2, 5, and 4 patients; the remaining were idiopathic. No significant changes were found during the 1.5–2 years after CDI diagnosis. Twenty-three of the 43 cases (53.5% had ≥1 anterior pituitary hormone deficiency. Isolated growth hormone deficiency was the most frequent abnormality (37.5% and was not associated with pituitary stalk diameter. Multiple pituitary hormone deficiencies were found in 8 cases with pituitary stalk diameter > 4.5 mm. Conclusion. Diagnosis of CDI is usually delayed. CDI with a pituitary stalk diameter > 4.5 mm carries a higher risk of multiple pituitary hormone deficiencies. Long-term MRI and pituitary function follow-ups are necessary for children with idiopathic CDI.

  17. Pituitary Morphology and Function in 43 Children with Central Diabetes Insipidus

    Science.gov (United States)

    Liu, Wendong; Wang, Limin; Liu, Minghua; Li, Guimei

    2016-01-01

    Objective. In pediatric central diabetes insipidus (CDI), etiology diagnosis and pituitary function monitoring are usually delayed. This study aimed to illustrate the importance of regular follow-up and pituitary function monitoring in pediatric CDI. Methods. The clinical, hormonal, and neuroradiological characteristics of children with CDI at diagnosis and during 1.5–2-year follow-up were collected and analyzed. Results. The study included 43 CDI patients. The mean interval between initial manifestation and diagnosis was 22.29 ± 3.67 months (range: 2–108 months). The most common complaint was polyuria/polydipsia. Causes included Langerhans cell histiocytosis, germinoma, and craniopharyngioma in 2, 5, and 4 patients; the remaining were idiopathic. No significant changes were found during the 1.5–2 years after CDI diagnosis. Twenty-three of the 43 cases (53.5%) had ≥1 anterior pituitary hormone deficiency. Isolated growth hormone deficiency was the most frequent abnormality (37.5%) and was not associated with pituitary stalk diameter. Multiple pituitary hormone deficiencies were found in 8 cases with pituitary stalk diameter > 4.5 mm. Conclusion. Diagnosis of CDI is usually delayed. CDI with a pituitary stalk diameter > 4.5 mm carries a higher risk of multiple pituitary hormone deficiencies. Long-term MRI and pituitary function follow-ups are necessary for children with idiopathic CDI. PMID:27118970

  18. Myelodysplastic syndrome complicated by central diabetes insipidus and cerebral salt wasting syndrome with peculiar change in magnetic resonance images.

    Science.gov (United States)

    Sano, Soichi; Yamagami, Keiko; Morikawa, Takashi; Yoshioka, Katsunobu

    2010-01-01

    Central diabetes insipidus (CDI) could occurs in patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), because of infiltration of leukemic cells into the neurohypophysis or some other reason and it is closely associated with abnormalities of chromosome 7. We report a case of MDS with abnormalities of chromosome 7, presenting as CDI followed by deterioration of polyuria and hyponatremia with a decreased extracellular fluid volume. Magnetic resonance imaging (MRI) revealed symmetrically enhanced lesions in the hypothalamus. Fludrocortisone treatment normalized his serum sodium level and cerebral salt wasting syndrome (CSWS) was suspected.

  19. Diabetes Insipidus after normal vaginal delivery: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2014-07-01

    Treatment was continuing, when the symptoms of central diabetes insipidus resolve and urinary concentrating ability was preferred. Maximum urinary osmolality over the next 11 hours was assessed, 730 mosm/kg was considered normal. Conclusion: Close attention to electrolyte and fluid balance is important in the postpartum period. The symptoms of transient vasopressin-resistant diabetes insipidus resolve in few days to a few weeks after vaginal delivery or when hepatic function returns to normal.

  20. Central diabetes insipidus as a very late relapse limited to the pituitary stalk in Langerhans cell histiocytosis.

    Science.gov (United States)

    Nakagawa, Shunsuke; Shinkoda, Yuichi; Hazeki, Daisuke; Imamura, Mari; Okamoto, Yasuhiro; Kawakami, Kiyoshi; Kawano, Yoshifumi

    2016-07-01

    Central diabetes insipidus (CDI) and relapse are frequently seen in multifocal Langerhans cell histiocytosis (LCH). We present two females with multifocal LCH who developed CDI 9 and 5 years after the initial diagnosis, respectively, as a relapse limited to the pituitary stalk. Combination chemotherapy with cytarabine reduced the mass in the pituitary stalk. Although CDI did not improve, there has been no anterior pituitary hormone deficiency (APHD), neurodegenerative disease in the central nervous system (ND-CNS) or additional relapse for 2 years after therapy. It was difficult to predict the development of CDI in these cases. CDI might develop very late in patients with multifocal LCH, and therefore strict follow-up is necessary, especially with regard to symptoms of CDI such as polydipsia and polyuria. For new-onset CDI with LCH, chemotherapy with cytarabine might be useful for preventing APHD and ND-CNS. PMID:27089406

  1. Two novel mutations in the coding region for neurophysin-II associated with familial central diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Nagasaki, Hiroshi; Ito, Masafumi; Yuasa, Hiromitsu [Nagoya Univ. School of Medicine (Japan)] [and others

    1995-04-01

    Familial central diabetes insipidus is an autosomal dominant disease caused by a deficiency of arginine vasopressin (AVP). We previously reported three distinct mutations in the AVP gene in Japanese familial central diabetes insipidus pedigrees that result in substitution of Ser for Gly{sup 57} in the neurophysin-II (NPII) moiety of the AVP precursor, a substitution of Thr for Ala at the COOH-terminus of the signal peptide, and a deletion of Glu{sup 47} in the NPII moiety. In this study, we analyzed the AVP gene in two pedigrees by direct sequencing of the polymerase chain reaction-amplified DNA and found two novel mutations in exon 2, which encodes the central part of the NPII moiety of the precursor. The mutation in one pedigree was a C to A transition at nucleotide position 1891, which replaces Cys{sup 67} (TGC) with stop codon (TGA). As the premature termination eliminates part of the COOH domain of the NPII moiety and the glycoprotein moiety, the conformation of the truncated protein is likely to be markedly different from that of normal precursor. In another pedigree, a G to T transversion was detected at nucleotide position 1874, which substitutes polar Trp (TGG) for hydrophobic Gly{sup 62}(GGG). It is possible that mutated NPII molecules, as a consequence of a conformational change, cannot bind AVP or self-associate to form higher oligomer complexes. Interestingly, all mutations we have identified to date, with the exception of the signal peptide mutation, are located in exon 2, suggesting the importance of the highly conserved central part of the NPII molecules and/or the NPII moiety in the precursor for AVP synthesis. 21 refs., 5 figs., 2 tabs.

  2. Nephrogenic diabetes insipidus: treat with caution.

    Science.gov (United States)

    Boussemart, Thierry; Nsota, Jacqueline; Martin-Coignard, Dominique; Champion, Gérard

    2009-09-01

    Current therapy for congenital nephrogenic diabetes insipidus consists of appropriate water intake coupled with decreased urine output obtained by means of a low-sodium diet and a combination of thiazide diuretics with renal prostaglandins inhibitors or amiloride. We report a case of congenital nephrogenic diabetes insipidus that was complicated by paradoxical water intoxication secondary to liberal water intake and the initiation of hydrochlorothiazide and indomethacin combination therapy. This report emphasizes the importance of evaluating the water balance and of a quick response with strict protocols following the initiation of indomethacin and thiazide diuretics in nephrogenic diabetes insipidus.

  3. [Gestational diabetes insipidus during a twin pregnancy].

    Science.gov (United States)

    De Mesmay, M; Rigouzzo, A; Bui, T; Louvet, N; Constant, I

    2013-02-01

    Gestational diabetes insipidus is an uncommon clinical disease whose prevalence is approximately two to three pregnancies per 100,000. It may be isolated or associated with preeclampsia. We report a case of gestational diabetes insipidus in a twin pregnancy, originally isolated during two months, and secondarily complicated by HELLP-syndrome. We recall the specific pathophysiology of polyuric-polydipsic syndrome during pregnancy and summarize its various causes. Finally, we discuss the indications, in case of isolated gestational diabetes insipidus, of treatment by dDAVP.

  4. Management of diabetes insipidus in children

    OpenAIRE

    Garima Mishra; Sudha Rao Chandrashekhar

    2011-01-01

    Diabetes Insipidus (DI) is a heterogeneous clinical syndrome of disturbance in water balance, characterized by polyuria (urine output > 4 ml/kg/hr), polydypsia (water intake > 2 L/m 2 /d) and failure to thrive. In children, Nephrogenic DI (NDI) is more common than Central DI (CDI), and is often acquired. The signs and symptoms vary with etiology, age at presentation and mode of onset. Neonates and infants with NDI are severely affected and difficult to treat. Diagnosis is based on the presenc...

  5. Langerhans cell histiocytosis in monozygotic twins with central diabetes insipidus and hypophyseal masses

    Science.gov (United States)

    Wei, Sung-Tai; Chen, Der-Cherng; Cho, Der-Yang; Lin, Hung-Lin

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a systemic disease mainly affecting children and young adults. It can manifest as single system disorder or multi-system involvement. When the central nervous system is involved, the hypothalamic–pituitary axis is the most common location affected. Herein we report a rare case of Langerhans cell histiocytosis in monozygotic twins both with central diabetes and hypophyseal masses. This is the first report about LCH in monozygotic twins with hypophyseal lesions. PMID:25972939

  6. Langerhans cell histiocytosis in monozygotic twins with central diabetes insipidus and hypophyseal masses

    OpenAIRE

    Wei, Sung-Tai; Chen, Der-Cherng; Cho, Der-Yang; Lin, Hung-Lin

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a systemic disease mainly affecting children and young adults. It can manifest as single system disorder or multi-system involvement. When the central nervous system is involved, the hypothalamic–pituitary axis is the most common location affected. Herein we report a rare case of Langerhans cell histiocytosis in monozygotic twins both with central diabetes and hypophyseal masses. This is the first report about LCH in monozygotic twins with hypophyseal le...

  7. Persistent nephrogenic diabetes insipidus following lithium therapy.

    Science.gov (United States)

    Thompson, C J; France, A J; Baylis, P H

    1997-02-01

    We report the case of a patient who developed severe hypernatraemic dehydration following a head injury. Ten years previously he had been diagnosed to have lithium-induced nephrogenic diabetes insipidus, and lithium therapy had been discontinued. He remained thirsty and polyuric despite cessation of lithium and investigations on admission showed him to have normal osmoregulated thirst and vasopressin secretion, with clear evidence of nephrogenic diabetes insipidus. Lithium induced nephrogenic diabetes insipidus is considered to be reversible on cessation of therapy but polyuria persisted in this patient for ten years after lithium was stopped. We discuss the possible renal mechanisms and the implications for management of patients with lithium-induced nephrogenic diabetes insipidus.

  8. [Central diabetes insipidus in adult patients--the first sign of Langerhans cell histiocytosis and Erdheim-Chester disease. Three case studies and literature review].

    Science.gov (United States)

    Adam, Z; Balsíková, K; Krejcí, M; Pour, L; Stĕpánková, S; Svacina, P; Hermanová, M; Vanícek, J; Krupa, P; Stanícek, J; Koukalová, R; Neubauer, J; Krivanová, A; Mayer, J; Hájek, R

    2010-02-01

    Central diabetes insipidus with an onset in adulthood is very rare. Unlike in children, central diabetes insipidus in adults is more frequently caused by inflammatory processes and neoplastic infiltrations that do not originate from the neuronal tissue than primary neuronal tissue tumours. Rare histiocytic neoplasias (Langerhans cell histiocytosis, xanthogranulomatosis and Erdheim-Chester disease) have a specific affinity to hypothalamus and the pituitary stalk not only in paediatric patients but also when occurring in adults. We describe 3 cases of central diabetes insipidus with an onset in adulthood. Diabetes insipidus was the first sign of Langerhans cell histiocytosis in 2 patients, and it was the first sign of Erdheim-Chester disease in one patient. MR imaging showed pathological infiltration and dilated pituitary stalks in all 3 patients. PET-CT proved useful in differential diagnosis, showing further extracranial pathological changes either on the basis of significant glucose accumulation or on the basis of CT imaging. The Langerhans cell histiocytosis in the first patient has also manifested itself as an infiltration of the perianal area with intensive accumulation of fluorodeoxyglucose (FDG) - SUV 8.6 and gingival inflammation indistinguishable from parodontosis. Histology of the perianal infiltrate confirmed Langerhans cell histiocytosis. Infiltration of the pituitary stalk disappeared from the MR image after 4 cycles of 2-chlordeoxyadenosin (5 mg/m2 5 consecutive days). The PET-CT of the 2nd patient showed only borderline accumulation of FDG in the ENT area, while simultaneously performed CT imaging showed cystic restructuring of the pulmonary parenchyma and nodulations consistent with pulmonary Langerhans cell histiocytosis. Bronchoalveolar lavage identified higher number of CD1 and S100 positive elements, consistent, once again, with pulmonary LCH also affecting pituitary stalk and ear canal. The PET-CT of the third patient showed increased activity

  9. Pemetrexed-Induced Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Fung, Enrica; Anand, Shuchi; Bhalla, Vivek

    2016-10-01

    Pemetrexed is an approved antimetabolite agent, now widely used for treating locally advanced or metastatic nonsquamous non-small cell lung cancer. Although no electrolyte abnormalities are described in the prescribing information for this drug, several case reports have noted nephrogenic diabetes insipidus with associated acute kidney injury. We present a case of nephrogenic diabetes insipidus without severely reduced kidney function and propose a mechanism for the isolated finding. Severe hypernatremia can lead to encephalopathy and osmotic demyelination, and our report highlights the importance of careful monitoring of electrolytes and kidney function in patients with lung cancer receiving pemetrexed.

  10. Vasopressin function in familial cranial diabetes insipidus.

    OpenAIRE

    Baylis, P. H.; Robertson, G. L.

    1981-01-01

    A family suffering from cranial diabetes insipidus, that extends over 4 generations, is described. Inheritance of polyuria was autosomal dominant. Vasopressin function was studied in members of the last 2 generations, 4 of whom had polyuria. Osmoregulation of vasopressin secretion was assessed by infusion of hypertonic saline. Plasma vasopressin remained undetectable in one patient, while 2 others had very blunted vasopressin responses to osmotic stimulation. Three non-osmotic stimuli were ap...

  11. Diabetes Insipidus after Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Cristina Capatina

    2015-07-01

    Full Text Available Traumatic brain injury (TBI is a significant cause of morbidity and mortality in many age groups. Neuroendocrine dysfunction has been recognized as a consequence of TBI and consists of both anterior and posterior pituitary insufficiency; water and electrolyte abnormalities (diabetes insipidus (DI and the syndrome of inappropriate antidiuretic hormone secretion (SIADH are amongst the most challenging sequelae. The acute head trauma can lead (directly or indirectly to dysfunction of the hypothalamic neurons secreting antidiuretic hormone (ADH or of the posterior pituitary gland causing post-traumatic DI (PTDI. PTDI is usually diagnosed in the first days after the trauma presenting with hypotonic polyuria. Frequently, the poor general status of most patients prevents adequate fluid intake to compensate the losses and severe dehydration and hypernatremia occur. Management consists of careful monitoring of fluid balance and hormonal replacement. PTDI is associated with high mortality, particularly when presenting very early following the injury. In many surviving patients, the PTDI is transient, lasting a few days to a few weeks and in a minority of cases, it is permanent requiring management similar to that offered to patients with non-traumatic central DI.

  12. Management of diabetes insipidus in children

    Directory of Open Access Journals (Sweden)

    Garima Mishra

    2011-01-01

    Full Text Available Diabetes Insipidus (DI is a heterogeneous clinical syndrome of disturbance in water balance, characterized by polyuria (urine output > 4 ml/kg/hr, polydypsia (water intake > 2 L/m 2 /d and failure to thrive. In children, Nephrogenic DI (NDI is more common than Central DI (CDI, and is often acquired. The signs and symptoms vary with etiology, age at presentation and mode of onset. Neonates and infants with NDI are severely affected and difficult to treat. Diagnosis is based on the presence of high plasma osmolality and low urinary osmolality with significant water diuresis. Water deprivation test with vasopressin challenge, though has limitations, is done to differentiate NDI and CDI and diagnose their partial forms. Measurement of urinary aquaporin 2 and serum copeptin levels are being studied and show promising diagnostic potential. Magnetic Resonance Imaging (MRI pituitary helps in the etiological diagnosis of CDI, absence of posterior pituitary bright signal being the pathognomic sign. If pituitary stalk thickening of < 2 mm is present, these children need to be monitored for evolving lesion. Neonates and young infants are better managed with fluids alone. Older children with CDI are treated with desmopressin. The oral form is safe, highly effective, with more flexibility of dosing and has largely replaced the intranasal form. In NDI besides treatment of the underlying cause, use of high calorie low solute diet and drugs to ameliorate water excretion (thiazide, amelioride, indomethacin are useful. Children with NDI however well treated, remain short and have mental retardation on follow up.

  13. Diabetes insipidus--diagnosis and management.

    Science.gov (United States)

    Di Iorgi, Natascia; Napoli, Flavia; Allegri, Anna Elsa Maria; Olivieri, Irene; Bertelli, Enrica; Gallizia, Annalisa; Rossi, Andrea; Maghnie, Mohamad

    2012-01-01

    Central diabetes insipidus (CDI) is the end result of a number of conditions that affect the hypothalamic-neurohypophyseal system. The known causes include germinoma/craniopharyngioma, Langerhans cell histiocytosis (LCH), local inflammatory, autoimmune or vascular diseases, trauma resulting from surgery or an accident, sarcoidosis, metastases and midline cerebral and cranial malformations. In rare cases, the underlying cause can be genetic defects in vasopressin synthesis that are inherited as autosomal dominant, autosomal recessive or X-linked recessive traits. The diagnosis of the underlying condition is challenging and raises several concerns for patients and parents as it requires long-term follow-up. Proper etiological diagnosis can be achieved via a series of steps that start with clinical observations and then progress to more sophisticated tools. Specifically, MRI identification of pituitary hyperintensity in the posterior part of the sella, now considered a clear marker of neurohypophyseal functional integrity, together with the careful analysis of pituitary stalk shape and size, have provided the most striking findings contributing to the diagnosis and understanding of some forms of 'idiopathic' CDI. MRI STIR (short-inversion-time inversion recovery sequencing) is a promising technology for the early identification of LCH-dependent CDI.

  14. [Diabetes insipidus in a Swiss Braunvieh heifer with internal hydrocephalus].

    Science.gov (United States)

    Braun, U; Feller, B; Gerber, A; Ossent, P

    2008-08-01

    This case report describes the findings in a seven-month-old heifer with diabetes insipidus attributable to internal hydrocephalus. The heifer was referred to the clinic because of reduced appetite, polydipsia, decreased faecal output and weight loss. The heifer was examined daily for 8 days. She was thin and weak and had a dull dry hair coat and decreased appetite. The heifer urinated frequently; the urine was clear and yel low, had a specific gravity of 1.015. A complete blood cell count, biochemical profile and blood gas analysis revealed increased serum urea, increased serum creatinine, hypernatraemia, hyperchloraemia, hypercalcaemia and hypophosphataemia. The heifer received 10 litres of water and 3 litres of ruminal fluid from a healthy cow per os daily for 5 days. The heifer had access to fresh water ad libitum. The general condition of the heifer did not improve after this treatment. Although the concentration of serum urea and creatinine decreased, the concentrations of sodium, chloride and calcium remained higher than normal. Based on the findings, a diagnosis of diabetes insipidus was made and the heifer was euthanatized. Postmortem examination revealed severe internal hydrocephalus, and a definitive diagnosis of central diabetes insipidus attributable to internal hydrocephalus was made.

  15. Genetic forms of neurohypophyseal diabetes insipidus.

    Science.gov (United States)

    Rutishauser, Jonas; Spiess, Martin; Kopp, Peter

    2016-03-01

    Neurohypophyseal diabetes insipidus is characterized by polyuria and polydipsia owing to partial or complete deficiency of the antidiuretic hormone, arginine vasopressin (AVP). Although in most patients non-hereditary causes underlie the disorder, genetic forms have long been recognized and studied both in vivo and in vitro. In most affected families, the disease is transmitted in an autosomal dominant manner, whereas autosomal recessive forms are much less frequent. Both phenotypes can be caused by mutations in the vasopressin-neurophysin II (AVP) gene. In transfected cells expressing dominant mutations, the mutated hormone precursor is retained in the endoplasmic reticulum, where it forms fibrillar aggregates. Autopsy studies in humans and a murine knock-in model suggest that the dominant phenotype results from toxicity to vasopressinergic neurons, but the mechanisms leading to cell death remain unclear. Recessive transmission results from AVP with reduced biologic activity or the deletion of the locus. Genetic neurohypophyseal diabetes insipidus occurring in the context of diabetes mellitus, optic atrophy, and deafness is termed DIDMOAD or Wolfram syndrome, a genetically and phenotypically heterogeneous autosomal recessive disorder caused by mutations in the wolframin (WFS 1) gene.

  16. Genetic forms of neurohypophyseal diabetes insipidus.

    Science.gov (United States)

    Rutishauser, Jonas; Spiess, Martin; Kopp, Peter

    2016-03-01

    Neurohypophyseal diabetes insipidus is characterized by polyuria and polydipsia owing to partial or complete deficiency of the antidiuretic hormone, arginine vasopressin (AVP). Although in most patients non-hereditary causes underlie the disorder, genetic forms have long been recognized and studied both in vivo and in vitro. In most affected families, the disease is transmitted in an autosomal dominant manner, whereas autosomal recessive forms are much less frequent. Both phenotypes can be caused by mutations in the vasopressin-neurophysin II (AVP) gene. In transfected cells expressing dominant mutations, the mutated hormone precursor is retained in the endoplasmic reticulum, where it forms fibrillar aggregates. Autopsy studies in humans and a murine knock-in model suggest that the dominant phenotype results from toxicity to vasopressinergic neurons, but the mechanisms leading to cell death remain unclear. Recessive transmission results from AVP with reduced biologic activity or the deletion of the locus. Genetic neurohypophyseal diabetes insipidus occurring in the context of diabetes mellitus, optic atrophy, and deafness is termed DIDMOAD or Wolfram syndrome, a genetically and phenotypically heterogeneous autosomal recessive disorder caused by mutations in the wolframin (WFS 1) gene. PMID:27156762

  17. Gestational Diabetes Insipidus Associated with HELLP Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Renela Gambito

    2012-01-01

    Full Text Available Gestational diabetes insipidus is a rare, but well recognized, complication of pregnancy. It is related to excess vasopressinase enzyme activity which is metabolized in the liver. A high index of suspicion of gestational diabetes insipidus is required in a correct clinical setting especially in the presence of other risk factors such as preeclampsia, HELLP syndrome, and twin pregnancies. We are presenting a case of gestational diabetes insipidus in a patient with HELLP syndrome. The newborn in this case also had hypernatremia thereby raising possibilities of vasopressinase crossing the placenta.

  18. Gestational diabetes insipidus: a morphological study of the placenta.

    Science.gov (United States)

    Castiglione, F; Buccoliero, A M; Garbini, F; Gheri, C F; Moncini, D; Poggi, G; Saladino, V; Rossi Degl'Innocenti, D; Gheri, R G; Taddei, G L

    2009-12-01

    Gestational diabetes insipidus (GDI) refers to the state of excessive water intake and hypotonic polyuria. Those cases manifesting in pregnancy and referred to as GDI may persist thereafter or may be a transient latent form that resolves after delivery. Microscopic examination of affected subjects has not been previously reported. In the literature, there are various case reports and case series on diabetes insipidus in pregnancy. In this study, we present a case that had transient diabetes insipidus during pregnancy in which the placenta was examined.

  19. Gestational Diabetes Insipidus Associated with HELLP Syndrome: A Case Report.

    Science.gov (United States)

    Gambito, Renela; Chan, Michael; Sheta, Mohamed; Ramirez-Arao, Precious; Gurm, Harmeet; Tunkel, Allan; Nivera, Noel

    2012-01-01

    Gestational diabetes insipidus is a rare, but well recognized, complication of pregnancy. It is related to excess vasopressinase enzyme activity which is metabolized in the liver. A high index of suspicion of gestational diabetes insipidus is required in a correct clinical setting especially in the presence of other risk factors such as preeclampsia, HELLP syndrome, and twin pregnancies. We are presenting a case of gestational diabetes insipidus in a patient with HELLP syndrome. The newborn in this case also had hypernatremia thereby raising possibilities of vasopressinase crossing the placenta.

  20. Rare neonatal diabetes insipidus and associated late risks: Case report

    Directory of Open Access Journals (Sweden)

    Rivas-Crespo Maximiliano

    2012-05-01

    Full Text Available Abstract Background Most cases of neonatal central diabetes insipidus are caused by an injury, which often results in other handicaps in the patient. The infant’s prognosis will be determined by his or her own early age and disability as well as by the physician’s skill. However, the rarity of this condition prevents the acquisition of personal experience dealing with it. Case Presentation A neonatal hemorrhagic stroke, caused by an aortic coarctation, caused right lower limb paresis, swallowing disability, and central diabetes insipidus in a term infant. The scant oral intake, as a consequence of his disability, caused progressive undernutrition which closed a vicious circle, delaying his development and his ability to overcome the swallowing handicap. On the other hand, nasal desmopressin absorption was blocked by several common colds, resulting in brain bleeding because of severe dehydration. This even greater brain damage hampered the improvement of swallowing, closing a second harmful circle. Moreover, a devastating central myelinolysis with quadriplegia, caused by an uncontrolled intravenous infusion, consummated a pernicious sequence, possibly unreported. Conclusions The child’s overall development advanced rapidly when his nutrition was improved by gastrostomy: This was a key effect of nutrition on his highly sensitive neurodevelopment. Besides, this case shows potential risks related to intranasal desmopressin treatment in young children.

  1. Arginine Vasopressin-Independent Mechanism of Impaired Water Excretion in a Patient with Sarcoidosis Complicated by Central Diabetes Insipidus and Glucocorticoid Deficiency

    Directory of Open Access Journals (Sweden)

    Katsunobu Yoshioka

    2011-01-01

    Full Text Available A 28-year-old man was admitted to our hospital because of reduced livido and increased fatigability. Four months before admission, he noticed polyuria, which was gradually relieved by admission. Magnetic resonance imaging revealed enhancing lesion centrally in the pituitary stalk. Biopsy from the skin revealed noncaseating granuloma composed of epithelioid cells, and a diagnosis of sarcoidosis was made. Although plasma arginine vasopressin (AVP was undetectable after administration of hypertonic saline, urinary output was within normal range (1.5 to 2.2 L/day. The urine osmolality became above plasma levels during the hypertonic saline test. Hormonal provocative tests revealed partial glucocorticoid deficiency. Soon after the glucocorticoid therapy was begun, moderate polyuria (from 3.5–4.0 liters daily occurred. At this time, plasma AVP was undetectable, and urine osmolality was consistently below plasma levels during the hypertonic saline test. In conclusion, we showed in human study that masked diabetes insipidus could be mediated by AVP-independent mechanisms.

  2. Glu-47, which forms a salt bridge between neurophysin-II and arginine vasopressin, is deleted in patients with familial central diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Yuasa, Hiromitsu; Ito, Masafumi; Nagasaki, Hiroshi; Oiso, Yutaka; Saito, Hidehiko (Nagoya Univ. School of Medicine, Chiba (Japan)); Miyamoto, S.; Sasaki, N. (Chiba Children' s Hospital, Chiba (Japan))

    1993-09-01

    The arginine vasopressin (AVP) gene was sequenced in a pedigree with familial central diabetes insipidus (DI). When polymerase chain reaction-amplified DNAs from affected subjects were subjected to polyacrylamide gel electrophoresis, fragments including exon 2 displayed two additional, slower migrating bands. These extra bands represented DNA heteroduplexes, indicating that there was a deletion or insertion mutation in exon 2. As the region with such a mutation was identified by direct sequence analysis, polymerase chain reaction-amplified fragments including the region were subcloned and sequenced. A 3-basepair deletion (AGG) out of two consecutive AGG sequences (nucleotides 1824-1829) was identified in one of two alleles. The cosegregation of the mutation with the DI phenotype in the family was confirmed by restriction enzyme analyses. This mutation should yield an abnormal AVP precursor lacking Glu[sup 47] in its neurophysin-II (NP) moiety. Since Glu[sup 47] is essential for NP molecules to form a salt bridge with AVP, it is very likely that the function of NP as a carrier protein for AVP would be impaired. The authors suggest that AVP would undergo accelerated proteolytic degradation, and this mechanism would be involved in the pathogenesis of DI in this pedigree. 34 refs., 4 figs., 2 tabs.

  3. A Rare Case of Congenital Diabetes Insipidus.

    Science.gov (United States)

    Rege, Tanvi; Polsani, Srujana; Jim, Belinda

    2015-01-01

    Congenital nephrogenic diabetes insipidus (NDI) is a conformation disease resulting from protein misfolding. Ninety percent of mutations result from the inactivating mutations of the arginine vasopressin receptor 2 (AVPR2) gene transmitted in an X-linked fashion, blocking the response to vasopressin, resulting in the inability to concentrate urine. Clinical features include polyuria, polydispsia, dehydration, and hypernatremia. They are generally more severely in affected males but present variably in females due to skewed inactivation of the X chromosome. We describe a case of a 40-year-old woman with a history of Type 2 diabetes mellitus, hyperlipidemia, and obesity, who presents with debilitating polyuria since the age of 5 with no clear diagnosis. Interestingly, her son was diagnosed with NDI. Genetic testing revealed that she was heterozygous for the Val88Met mutation in the AVPR2 gene while her son was hemizygous for the same. The patient has since been successfully treated with diuretics and a low solute diet. We highlight that although X-linked NDI patients are mostly males, it should be considered in symptomatic females to prevent delays in the diagnosis. Conformational diseases such as NDI are presently the subject of research using pharmacological chaperones to restore proper receptor membrane localization and function.

  4. Diabetes mellitus, diabetes insipidus, optic atrophy, and deafness: A case of Wolfram (DIDMOAD) syndrome

    OpenAIRE

    Maleki, Nasrollah; Bashardoust, Bahman; Zakeri, Anahita; Salehifar, Azita; Tavosi, Zahra

    2016-01-01

    Purpose To report a case of Wolfram syndrome (WS) characterized by diabetes mellitus, diabetes insipidus, progressive optic atrophy, and deafness. Case report A 19-year-old female patient, a known case of diabetes mellitus type I from six years before, presented with progressive vision loss since four years earlier. On fundoscopic examination, she had bilateral optic atrophy without diabetic retinopathy. The patient also had diabetes insipidus, neurosensory deafness, and neurogenic bladder. C...

  5. Adipsic diabetes insipidus following pituitary surgery for a macroprolactinoma.

    Science.gov (United States)

    Sherlock, M; Agha, A; Crowley, R; Smith, D; Thompson, C J

    2006-01-01

    Adipsic diabetes insipidus (ADI) is a rare condition in which thirst, an essential clinical feature for the prevention of hypernatraemic dehydration, is absent. We report the first case of adipsic diabetes insipidus to occur following surgery for a pituitary macroprolactinoma, with loss of both osmoregulated and baroregulated vasopressin release. Following extensive surgery for a vision threatening macroprolactinoma a 14-year-old boy developed profound hypernatraemia with absent thirst sensation. Detailed investigation, with hypertonic saline infusion and trimetaphan infusion, revealed absence of both osmoregulatory and baroregulatory release of vasopressin. We discuss the investigation and management of such patients and the physiology of hypothalamic-neurohypophyseal dysfunction in such patients.

  6. [An unusual association of transient resolving thyrotoxicosis due to painless thyroiditis, hypopituitarism and central diabetes insipidus associated with spontaneous pituitary apoplexy].

    Science.gov (United States)

    Sasaki, H; Ohnishi, O; Maehara, F; Akiyoshi, K; Kan, K; Katakabe, K; Yamamoto, T; Okumura, M

    1990-01-20

    Pituitary apoplexy is characterized by a wide spectrum of clinical features. A quite rare case of painless thyroiditis, hypopituitarism and central diabetes insipidus (DI) followed by pituitary apoplexy was presented. A 61-year-old woman was admitted to our hospital in May, 1986 because of marked general malaise, polydipsia and weight loss which became progressively worse. Four months earlier she had experienced episodes of abrupt onset of severe headache associated with nausea and blurring vision. Physical examinations revealed a fine tremor, dry skin and nervousness. The thyroid gland was not palpable. Visual fields were intact. Her blood pressure was 105/64 mmHg with variable tachycardia. The routine laboratory studies were normal or negative except for hypoalbuminemia, hypocholesterolemia and hypernatremia. Erythrocyte sedimentation rate was 12 mm/hr. An impairment in corticotropin secretion was suspected from the low plasma cortisol and the low urinary excretion of 17-OHCS and the sufficient response to ACTH. Basal levels of GH and gonadotropin were also low, and responses to the stimulation tests (Insulin-stress, L-DOPA, and LH-RH) were all blunted. Brain computed tomographic scan and magnetic resonance imaging demonstrated a suprasellar mass that, after infusion, developed peripheral ring-like enhancement and large hyperintense pituitary mass, respectively. A diagnosis of pituitary apoplexy with anterior pituitary failure was made. However, the initial levels of thyroid hormones showed elevated as follows: Free T3 7.6 pg/ml, Free T4 3.3 ng/dl and T3-resin uptake 41.1%. TSH responses to TRH were all suppressed. TSH receptor antibody (TBII) was negative. Both antithyroglobulin and antimicrosomal antibodies were repeatedly positive. A thyroid scan with 99mTc revealed no uptake in the thyroid area. These findings led us to the diagnosis of "painless autoimmune thyroiditis". She had become hypothyroid without any medication. At that time radioactive 99mTc and 123

  7. Diabetes insipidus uncovered during conservative management of complicated acute appendicitis

    OpenAIRE

    Mamtani, Anita; Odom, Stephen R.; Butler, Kathryn L.

    2016-01-01

    Key Clinical Message Diabetes insipidus (DI) arises from impaired function of antidiuretic hormone, characterized by hypovolemia, hypernatremia, polyuria, and polydipsia. This case is a reminder of the rare but challenging obstacle that undiagnosed DI poses in fasting surgical patients, requiring prompt recognition and vigilant management of marked homeostatic imbalances.

  8. Diabetes insipidus uncovered during conservative management of complicated acute appendicitis.

    Science.gov (United States)

    Mamtani, Anita; Odom, Stephen R; Butler, Kathryn L

    2016-05-01

    Diabetes insipidus (DI) arises from impaired function of antidiuretic hormone, characterized by hypovolemia, hypernatremia, polyuria, and polydipsia. This case is a reminder of the rare but challenging obstacle that undiagnosed DI poses in fasting surgical patients, requiring prompt recognition and vigilant management of marked homeostatic imbalances. PMID:27190614

  9. Nephrogenic diabetes insipidus in a lethargic lithium-treated patient

    NARCIS (Netherlands)

    Meinardi, [No Value; Donders, SHJ

    1997-01-01

    We report on a patient who developed severe lithium-induced nephrogenic diabetes insipidus (NDI) and neurotoxicity, despite recommended serum lithium levels. Hydrochlorothiazide and indomethacin appeared effective antipolyuric drugs, which led to a normalization of serum osmolality. After re-initiat

  10. Diabetes insipidus: main aspects and comparative analysis with diabetes mellitus Diabetes insipidus: principais aspectos e análise comparativa com diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Flávia Lúcia Abreu Rabelo

    2009-01-01

    Full Text Available Diabetes mellitus is a disease characterized by the excess of sugar in the blood and urine. The two most common types of diabetes are insulin-dependent diabetes mellitus and insulin-resistant diabetes mellitus, both presenting glycemic regulation-damage caused by insulin. Nevertheless, there is another type of diabetes that is less known but not less important, the diabetes insipidus, which is characterized by a problem with the synthesis, secretion or action of the ADH (anti-diuretic hormone that can result in polyuric syndromes with increased excretion of hypotonic urine. Physiologically, variations in the osmotic pressure activate osmoceptors that stimulate the ADH secretion, increasing water reabsorption in the kidney collection tubes. This article intends to revise a wide-ranging study on diabetes insipidus, aiming at a comparative analysis of the incidence, diagnosis, causes, types, treatment and consequences between diabetes insidipus and diabetes mellitus. Diabetes mellitus and insipidus are two different pathologies with a single similarity that is the diabetes itself, that is, the polyuria established. The knowledge of the significant differences between the pathologies studied is important once diabetes insipidus is less known, but can lead to serious complications if not properly treated. O diabetes mellitus é uma doença caracterizada pelo excesso de açúcar no sangue e na urina. Os dois tipos mais comuns de diabetes são diabetes mellitus insulino-dependente e diabetes mellitus insulino – resistente, e que ambos apresentam comprometimento da regulação da glicemia por ação da insulina. No entanto, existe outra forma de diabetes menos conhecida, mas não menos importante, o diabetes insipidus, que é caracterizado por um distúrbio na síntese, secreção ou ação do ADH (hormônio antidiurético, que pode resultar em síndromes poliúricas com excreção aumentada de urina hipotônica. Fisiologicamente, variações na press

  11. Diabetes insipidus as a rare cause of acute cognitive impairment in multiple sclerosis.

    Science.gov (United States)

    Tiedje, V; Schlamann, M; Führer, D; Moeller, L C

    2013-10-01

    Multiple sclerosis (MS) is a complex neurodegenerative disease presenting with a diversity of clinical symptoms including palsy and cognitive impairment. We present a 59-year-old woman with a history of secondary progressive MS since 1987, who was referred to our department because of recent onset of confusion and polydipsia. Initial lab tests showed mildly elevated serum sodium levels and low urine osmolality. Under water deprivation, diuresis and low urine osmolality persisted and serum sodium levels rose above 150 mmol/l. Oral desmopressin resulted in normalisation of serum sodium as well as urine osmolarity, confirming a diagnosis of central diabetes insipidus. As drug-induced diabetes could be excluded, pituitary magnetic resonance imaging (MRI) was performed. A demyelinating lesion was detected in the hypothalamus. The patient was started on oral desmopressin treatment (0.2 mg/day). Fluid intake and serum sodium levels have since remained normal. In summary, we report the rare case of a patient presenting with diabetes insipidus due to progressive MS. Diabetes insipidus should be considered in MS patients who develop new onset of polydipsia.

  12. Diabetes Insipidus in Mice with a Mutation in Aquaporin-2.

    Directory of Open Access Journals (Sweden)

    2005-08-01

    Full Text Available Congenital nephrogenic diabetes insipidus (NDI is a disease characterized by failure of the kidney to concentrate urine in response to vasopressin. Human kindreds with nephrogenic diabetes insipidus have been found to harbor mutations in the vasopressin receptor 2 (Avpr2 gene or the vasopressin-sensitive water channel aquaporin-2 (Aqp2 gene. Development of a treatment is rendered difficult due to the lack of a viable animal model. Through forward genetic screening of ethylnitrosourea-mutagenized mice, we report the identification and characterization of a mouse model of NDI, with an F204V mutation in the Aqp2 gene. Unlike previously attempted murine models of NDI, our mice survive to adulthood and more exactly recapitulate the human disorder. Previous in vitro experiments using renal cell lines suggest recessive Aqp2 mutations result in improper trafficking of the mutant water pore. Using these animals, we have directly proven this hypothesis of improper AQP2 translocation as the molecular defect in nephrogenic diabetes insipidus in the intact organism. Additionally, using a renal cell line we show that the mutated protein, AQP2-F204V, is retained in the endoplasmic reticulum and that this abnormal localization can be rescued by wild-type protein. This novel mouse model allows for further mechanistic studies as well as testing of pharmacological and gene therapies for NDI.

  13. Glucose Galactose Malabsorption complicated with Rickets and Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Al-Lawati, Tawfiq; Vargees, Thomas

    2008-07-01

    Congenital Glucose Galactose malabsorption (CGGM) is a rare disorder with limited data from the Arab world. We report the first case of CGGM in Oman.B.S.A two years old female who presented with chronic osmotic diarrhea since birth with hypernatraemic dehydration. B.S was found to have Glucose Galactose Malabsorption based on clinical trial of ORS and elemental formula. Symptoms resolved on introduction of Carbohydrate free formula. The patient developed many complications while on TPN including rickets and nephrogenic diabetes insipidus. These complications have not been reported earlier in CGGM.

  14. [Congenital nephrogenic diabetes insipidus: about a case report].

    Science.gov (United States)

    Esselmani, Hicham; Yassine, Asmaa; Bouabdellah, Mounya; Benchekroun, Laila; Handor, Najat; Elalami, Sanae; Chabraoui, Layachi

    2013-01-01

    Congenital nephrogenic diabetes insipidus is a rare, hereditary in nature, characterized by an inability of the kidney to concentrate urine, secondary to the manifold resistance to the action of vasopressin. X-linked forms of transmission (90%) are expressed in boys, from the neonatal period in general, by polyuria and polydipsia. Symptomatology in transmissive girls is variable but can sometimes be quite marked. These forms are secondary to mutations in the gene encoding the vasopressin V2 receptor, located at position Xq28, responsible for a loss of function of this receptor. Some of these mutations may cause a partial phenotype, less severe. Forms of autosomal, recessive or dominant are more rare (10%). Treatment is symptomatic, sometimes difficult in infants. It aims to avoid episodes of dehydration. It is based on a conventional diet hypo-osmotic and administration of hydrochlorothiazide and indomethacin. We report here the case of a child with congenital nephrogenic diabetes insipidus hospitalized at Children's Hospital of Rabat and throughout this case we review the pathophysiology and clinical and biological characteristics of the disease and including importance of contribution of clinical biochemistry laboratory in the diagnosis and monitoring of this disease.

  15. Heterogeneous AVPR2 gene mutations in congenital nephrogenic diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Wildin, R.S.; Antush, M.J.; Bennett, R.L.; Schoof, J.M.; Scott, C.R. (Univ. of Washington, Seattle, WA (United States))

    1994-08-01

    Mutations in the AVPR2 gene encoding the receptor for arginine vasopressin in the kidney (V2 ADHR) have been reported in patients with congenital nephrogenic diabetes insipidus, a predominantly X-linked disorder of water homeostasis. The authors have used restriction-enzyme analysis and direct DNA sequencing of genomic PCR product to evaluate the AVPR2 gene in 11 unrelated affected males. Each patient has a different DNA sequence variation, and only one matches a previously reported mutation. Cosegregation of the variations with nephrogenic diabetes insipidus was demonstrated for two families, and a de novo mutation was accomplished in one family. All the variations predict frameshifts, truncations, or nonconservative amino acid substitutions in evolutionarily conserved positions in the V2 ADHR and related receptors. Of interest, a 28-bp deletion is found in one patient, while another, unrelated patient has a tandem duplication of the same 28-bp segment, suggesting that both resulted from the same unusual unequal crossing-over mechanism facilitated by 9-mer direct sequence repeats. Since the V2 ADHR is a member of the seven-transmembrane-domain, G-protein-coupled receptor superfamily, the loss-of-function mutations from this study and others provide important clues to the structure-function relationship of this and related receptors. 55 refs., 4 figs., 2 tabs.

  16. Gestational diabetes insipidus and intrauterine fetal death of monochorionic twins.

    Science.gov (United States)

    Wiser, A; Hershko-Klement, A; Fishman, A; Nachasch, N; Fejgin, M

    2008-10-01

    Gestational diabetes insipidus (GDI) is a rare disorder. The onset is usually in the third trimester of pregnancy. We present a 24-year-old primigravida in her 35th week of a monochorionic-diamniotic twin pregnancy. The patient presented with intrauterine death of both twins accompanied by HELLP syndrome, hypernatremia and hemoconcentration. Urine osmolality below that of the plasma suggested GDI. 1-deamino-8D-arginine vasopressin (dDAVP) treatment was started with a quick response. GDI is probably the result of excessive activity of placental vasopressinase. In cases of liver dysfunction, the clearance rate of vasopressinase decreases, explaining the association of GDI with acute fatty liver and HELLP syndrome. Alert to this diagnosis, its evaluation and treatment is important.

  17. 颅脑创伤后尿崩症合并脑性盐耗综合征%Combined central diabetes insipidus and cerebral salt wasting syndrome after traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    吴雪海; 高亮; 胡锦; 吴惺; 郎黎琴; 金毅; 毛颖; 周良辅

    2011-01-01

    目的 探讨如何正确认识、早期及时诊断和准确治疗尿崩症合并脑性盐耗综合征,以提高救治成功率.方法 回顾性分析6例尿崩症合并脑性盐耗综合征的临床特点:尿量特别异常增多、高脑利钠肽水平和显著尿钠排泄增加是其最显著特征;尿比重、血钠水平和血浆渗透压可以正常;尿量增多单纯加压素疗效不佳,而加用醋酸可的松治疗有效.结果 6例患者及时正确诊断为尿崩症合并脑性盐耗综合征,但其中1例患者因为血钠上升过快出现脑桥脱髓鞘病变,最终植物状态;1例患者因脑疝、多脏衰而死亡;其余4例患者治愈出院.结论 根据尿崩症合并脑性盐耗综合征的临床特点本文提出其参考诊断标准,及时诊断和正确治疗是成功救治的关键.%Objective To discuss the diagnosis coexistence of central diabetes insipidus and cerebral salt wasting syndrome promptly and treat properly.Method Six patients who suffered central diabetes insipidus combined cerebral salt wasting syndrome were analyzed retrospectively.Its characteristics was massive polyuria which can not be controlled by vasopressin alone,but can be controlled by both vasopresin and cortisone acetate.Sodium chloride saline were mainly used to make up for the loss of water and salt.Other charactefistcs were including low CVP,high Pro - BNP,high 24 h urine sodium evacuation with normal serum sodium level,higher osmolarity in urine than in serum which was at normal level,and usually normal urine specific gravity.Results One died and one became vegetative state,other four patients discharged with Glasgow Coma Scale 15.Conclusions Monitoring of water and sodium metabolism systemically were critical to diagnose the concurrent DI and CSW.Slow sodium chloride saline supplement,cortisone acetate and desmopressin were the keys to deal with concurrent DI and CSW.With exact diagnosis and treatment promptly,favourable outcome can be achieved.

  18. Familial neurohypophyseal diabetes insipidus associated with a signal peptide mutation

    Energy Technology Data Exchange (ETDEWEB)

    McLeod, J.F.; Gaskill, M.B.; Bradley, G.S.; Robertson, G.L. (Northwestern Univ. Medical School, Chicago, IL (United States)); Kovacs, L. (Comenius Univ. Medical School, Bratislava (Slovakia)); Rittig, S. (Univ. of Aarhus, Aarhus (Denmark))

    1993-09-01

    The authors studied the pathophysiology, natural history, and genetic basis of familial neurohypophyseal diabetes insipidus (FNDI) in a caucasian kindred. Twelve members had polyuria and a deficiency of plasma vasopressin (AVP), which progressed in severity over time. Another had normal urine volumes and plasma AVP when first tested at age 3 yr, but developed severe FNDI a year later. For unknown reasons, one man had a normal urine volume despite severe AVP deficiency and a history of polyuria in the past. When the AVP-neurophysin-II gene was amplified and sequenced, exon 2/3 was normal, but 7 of 12 clones of exon 1 contained a base substitution (G[yields]A) predicting a substitution of threonine for alanine at the -1 position of the signal peptide. Restriction analysis found the mutation in all 14 affected members, but in none of the 41 controls of 19 adult members with normal urine volumes and plasma or urinary AVP (lod score = 5.7). The mutation was also found in 2 infants in whom AVP was normal when tested at 6 and 9 months of age. We hypothesize that a mutation in exon 1 of the AVP-neurophysin-II gene caused FNDI in this kindred by making an abnormally processed precursor that gradually destroys vasopressinergic neurons. 46 refs., 6 figs.

  19. Diabetes insipidus and adrenal insufficiency in a patient with metastatic breast cancer.

    Science.gov (United States)

    Netelenbos, T; Nooij, M A; Nortier, J W R

    2006-09-01

    A patient previously treated for bilateral breast cancer with mastectomy, radiation therapy and in remission on hormonal therapy for more than five years presented with abdominal symptoms from breast cancer relapse. She developed inappropriate polyuria and hypernatraemia, which responded to desmopressin. In combination with the absence of a high signal from the posterior lobe of the pituitary on MRI , these data indicated the presence of partial central diabetes insipidus. The anterior pituitary showed partial failure (low follicle-stimulating hormone, luteinising hormone and insulin-like growth factor-1 levels). Furthermore, primary adrenal insufficiency had developed, ascribed to bilateral tumour invasion of the adrenals. This rare combination of endocrinological failures in a patient with metastatic breast cancer is discussed.

  20. Transient lymphocytic panhypophysitis associated with SIADH leading to diabetes insipidus after glucocorticoid replacement.

    Science.gov (United States)

    Iida, Mihoko; Takamoto, Satoru; Masuo, Masatoshi; Makita, Kozo; Saito, Toshikazu

    2003-10-01

    A 52-year-old man presented with vomiting, general fatigue and hyponatremia. His symptoms and signs were consistent with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Endocrine studies revealed hypopituitarism and administration of hydrocortisone resulted in a marked polyuria. The patient was diagnosed as masked diabetes insipidus. The lymphocytic hypophysitis was also diagnosed on the basis of MRI findings and anti-pituitary antibody. Six months later, these abnormalities disappeared. Diabetes insipidus may exist in a case of hyponatremia due to contrastive SIADH. Such patients may recover spontaneously and careful follow-up is required, avoiding a long-term treatment by monotonous continuation of hormonal replacement. PMID:14606714

  1. Acetazolamide Attenuates Lithium-Induced Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    de Groot, Theun; Sinke, Anne P; Kortenoeven, Marleen L A; Alsady, Mohammad; Baumgarten, Ruben; Devuyst, Olivier; Loffing, Johannes; Wetzels, Jack F; Deen, Peter M T

    2016-07-01

    To reduce lithium-induced nephrogenic diabetes insipidus (lithium-NDI), patients with bipolar disorder are treated with thiazide and amiloride, which are thought to induce antidiuresis by a compensatory increase in prourine uptake in proximal tubules. However, thiazides induced antidiuresis and alkalinized the urine in lithium-NDI mice lacking the sodium-chloride cotransporter, suggesting that inhibition of carbonic anhydrases (CAs) confers the beneficial thiazide effect. Therefore, we tested the effect of the CA-specific blocker acetazolamide in lithium-NDI. In collecting duct (mpkCCD) cells, acetazolamide reduced the cellular lithium content and attenuated lithium-induced downregulation of aquaporin-2 through a mechanism different from that of amiloride. Treatment of lithium-NDI mice with acetazolamide or thiazide/amiloride induced similar antidiuresis and increased urine osmolality and aquaporin-2 abundance. Thiazide/amiloride-treated mice showed hyponatremia, hyperkalemia, hypercalcemia, metabolic acidosis, and increased serum lithium concentrations, adverse effects previously observed in patients but not in acetazolamide-treated mice in this study. Furthermore, acetazolamide treatment reduced inulin clearance and cortical expression of sodium/hydrogen exchanger 3 and attenuated the increased expression of urinary PGE2 observed in lithium-NDI mice. These results show that the antidiuresis with acetazolamide was partially caused by a tubular-glomerular feedback response and reduced GFR. The tubular-glomerular feedback response and/or direct effect on collecting duct principal or intercalated cells may underlie the reduced urinary PGE2 levels with acetazolamide, thereby contributing to the attenuation of lithium-NDI. In conclusion, CA activity contributes to lithium-NDI development, and acetazolamide attenuates lithium-NDI development in mice similar to thiazide/amiloride but with fewer adverse effects.

  2. Managing adipsic diabetes insipidus following anterior communicating artery aneurysm in a subtropical climate.

    Science.gov (United States)

    Nolan, Brendan; Inder, Warrick J

    2016-07-01

    Diabetes insipidus without perception of thirst, as may follow an anterior communicating artery aneurysm, requires prescription of fluid intake as well as desmopressin. The management goal of maintaining a normal serum sodium is rendered more challenging in a humid subtropical environment, where insensible losses are higher.

  3. Behavioral and endocrine responses of rats with hereditary hypothalamic diabetes insipidus (Brattleboro strain)

    NARCIS (Netherlands)

    Bohus, B.; Wimersma Greidanus, T.B. van; Wied, D. de

    1975-01-01

    Behavioral and endocrine profiles were established of homozygous (HO-DI) and heterozygous (HE-DI) rats with hereditary hypothalamic diabetes insipidus in comparison to Wistar strain rats. HO-DI rats were inferior in acquiring and maintaining active and passive avoidance behavior. Behavioral deficits

  4. Managing adipsic diabetes insipidus following anterior communicating artery aneurysm in a subtropical climate.

    Science.gov (United States)

    Nolan, Brendan; Inder, Warrick J

    2016-07-01

    Diabetes insipidus without perception of thirst, as may follow an anterior communicating artery aneurysm, requires prescription of fluid intake as well as desmopressin. The management goal of maintaining a normal serum sodium is rendered more challenging in a humid subtropical environment, where insensible losses are higher. PMID:27386124

  5. Amiloride blocks lithium entry through the sodium channel thereby attenuating the resultant nephrogenic diabetes insipidus.

    NARCIS (Netherlands)

    Kortenoeven, M.L.A.; Li, Yuedan; Shaw, S.M.; Gaeggeler, H.P.; Rossier, B.C.; Wetzels, J.F.M.; Deen, P.M.T.

    2009-01-01

    Lithium therapy frequently induces nephrogenic diabetes insipidus; amiloride appears to prevent its occurrence in some clinical cases. Amiloride blocks the epithelial sodium channel (ENaC) located in the apical membrane of principal cells; hence one possibility is that ENaC is the main entry site fo

  6. Gestational diabetes insipidus, HELLP syndrome and eclampsia in a twin pregnancy: a case report.

    Science.gov (United States)

    Woelk, J L; Dombroski, R A; Brezina, P R

    2010-02-01

    We report a case of eclampsia in a twin pregnancy complicated by HELLP syndrome and diabetes insipidus. This confluence of disease processes suggests that a modification of common magnesium sulfate treatment protocols may be appropriate in a certain subset of patients.

  7. Metastatic Prostate Adenocarcinoma Presenting Central Diabetes Insipidus

    OpenAIRE

    Hakkı Yılmaz; Mustafa Kaya; Mücteba Can; Mustafa Özbek; Bahir Keyik

    2012-01-01

    The pituitary gland and infundibulum can be involved in a variety of medical conditions, including infiltrative diseases, fungal infections, tuberculosis, and primary and metastatic tumors. Metastases to the pituitary gland are absolutely rare, and they are generally secondary to pulmonary carcinoma in men and breast carcinoma in women. Pituitary metastases more commonly affect the posterior lobe and the infundibulum than the anterior lobe. The posterior lobe involvement may explain why patie...

  8. Partial nephrogenic diabetes insipidus caused by a novel mutation in the AVPR2 gene

    DEFF Research Database (Denmark)

    Færch, Mia; Christensen, Jane H; Corydon, Thomas J;

    2008-01-01

    Objective To identify the molecular basis and clinical characteristics of X-linked congenital nephrogenic diabetes insipidus (CNDI) presenting with an unusual phenotype characterized by partial resistance to AVP. Subjects The proband was admitted at the age of 4 years with a history of polydipsia...... and polyuria since infancy. Initial clinical testing confirmed a diagnosis of diabetes insipidus (DI). Urine osmolarity rose during fluid deprivation and after 20 microg of intranasal desmopressin [1-deamino-8-d-arginine-vasopressin (dDAVP)]. A similar DI phenotype was found in his brother. Methods The coding...... output. Discussion The affected members of this Belgian kindred have CNDI with partial resistance to AVP caused by a mutation in the AVPR2 gene that differs from any of the six mutations reported previously to produce this phenotype. Because the resistance to AVP is partial, this form of CNDI can...

  9. Congenital Nephrogenic Diabetes Insipidus Presented With Bilateral Hydronephrosis and Urinary Infection: A Case Report.

    Science.gov (United States)

    Zheng, Kewen; Xie, Yi; Li, Hanzhong

    2016-05-01

    Nephrogenic diabetes insipidus (NDI) is a condition resulting from the kidney's impaired response to circulating antidiuretic hormone (ADH), leading to polydipsia and polyuria. Urinary tract dilatation caused by NDI is a rare situation. Here, we report a case of congenital NDI presented with bilateral hydronephrosis.A 15-year-old boy complaining a history of intermittent fever was admitted to Peking Union Medical College Hospital. He voided 10 to 15 L of urine daily. Radiographic examination revealed severe dilatation of bilateral renal pelvis, ureter, and bladder. Urinalysis shows hyposthenuria.He was diagnosed NDI since born. Transient insertion of a urethral catheter helped to relieve fever. Medical therapy of hydrochlorothiazide and amiloride was prescribed and effective.Dilatation of urinary tract caused by diabetes insipidus is rare, but may be present in severe condition. Therefore, it is crucial for clinicians to perform early treatment to avoid impairment of renal function. PMID:27258490

  10. Hypopituitarism and diabetes insipidus with localized hypertrophic pachymeningitis (Tolosa-Hunt syndrome) associated with Hashimoto thyroiditis.

    Science.gov (United States)

    Yamakita, Noriyoshi; Hanamoto, Takayuki; Muraoka, Noriaki; Ikeda, Tsuneko; Hirata, Toshifumi; Yasuda, Keigo; Sano, Toshiaki

    2004-01-01

    We report a 69-year-old woman with intracranial pachymeningitis showing hypopituitarism, diabetes insipidus, and Tolosa-Hunt syndrome associated with Hashimoto thyroiditis confirmed by autopsy. A large tumorous lesion of the hypothalamo-pituitary gland was revealed on magnetic resonance imaging, after the patient complained of gait and visual field disturbance. These symptoms subsided after thyroid hormone supplementation. Hypopituitarism and diabetes insipidus were diagnosed after cessation of the treatment by the patient herself. Multiple cranial nerve palsies and orbito-frontalgia appeared. Methylprednisolone pulse therapy improved the symptoms, but they recurred when the dose of glucocorticoid was decreased. The patient died of brain thrombosis. Autopsy revealed typical findings of Hashimoto thyroiditis and intracranial pachymeningitis involving the cranial base and pituitary gland. The high titer of rheumatoid factor and Hashimoto thyroiditis in this patient suggest an immunological role in the pathogenesis of pachymeningitis. PMID:14722395

  11. [Bilateral exophthalmos diabetes insipidus: Erdheim-Chester disease. Clinical and radiological findings].

    Science.gov (United States)

    Le Goff, L; Berros, P; Denis, D; Ridings, B

    2002-01-01

    The authors report a case of a 61-year-old man presenting bilateral exophthalmos and diabetes insipidus. A retro-orbital biopsy revealed nonspecific fibrocollagenic infiltration. The diagnosis of Erdheim-Chester disease was evoked when a multivisceral affection (retroperitoneal and mediastinal periaortic fibrosis) with specific bone localization became evident. The histopatholgical study of a bone biopsy showed xanthogranulomatous infiltration. The patient died a few months later of an intercurrent infection.

  12. Infundibulohypophysitis in a man presenting with diabetes insipidus and cavernous sinus involvement

    OpenAIRE

    Tubridy, N; Saunders, D; Thom, M; Asa, S; Powell, M.; Plant, G; Howard, R

    2001-01-01

    Infundibulohypophysitis is an unusual inflammatory condition that affects the infundibulum, the pituitary stalk, and the neurohypophysis and may be part of a range that includes lymphocytic hypophysitis. Lymphocytic hypophysitis occurs mainly in women and most often presents in the later stages of pregnancy. Infundibulohypophysitis usually presents with diabetes insipidus and the cause remains unclear. The case of a 46 year old man with a 12 week history of polyuria and p...

  13. Membrane protein stability analyses by means of protein energy profiles in case of nephrogenic diabetes insipidus.

    Science.gov (United States)

    Heinke, Florian; Labudde, Dirk

    2012-01-01

    Diabetes insipidus (DI) is a rare endocrine, inheritable disorder with low incidences in an estimated one per 25,000-30,000 live births. This disease is characterized by polyuria and compensatory polydypsia. The diverse underlying causes of DI can be central defects, in which no functional arginine vasopressin (AVP) is released from the pituitary or can be a result of defects in the kidney (nephrogenic DI, NDI). NDI is a disorder in which patients are unable to concentrate their urine despite the presence of AVP. This antidiuretic hormone regulates the process of water reabsorption from the prourine that is formed in the kidney. It binds to its type-2 receptor (V2R) in the kidney induces a cAMP-driven cascade, which leads to the insertion of aquaporin-2 water channels into the apical membrane. Mutations in the genes of V2R and aquaporin-2 often lead to NDI. We investigated a structure model of V2R in its bound and unbound state regarding protein stability using a novel protein energy profile approach. Furthermore, these techniques were applied to the wild-type and selected mutations of aquaporin-2. We show that our results correspond well to experimental water ux analysis, which confirms the applicability of our theoretical approach to equivalent problems.

  14. Membrane Protein Stability Analyses by Means of Protein Energy Profiles in Case of Nephrogenic Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Florian Heinke

    2012-01-01

    Full Text Available Diabetes insipidus (DI is a rare endocrine, inheritable disorder with low incidences in an estimated one per 25,000–30,000 live births. This disease is characterized by polyuria and compensatory polydypsia. The diverse underlying causes of DI can be central defects, in which no functional arginine vasopressin (AVP is released from the pituitary or can be a result of defects in the kidney (nephrogenic DI, NDI. NDI is a disorder in which patients are unable to concentrate their urine despite the presence of AVP. This antidiuretic hormone regulates the process of water reabsorption from the prourine that is formed in the kidney. It binds to its type-2 receptor (V2R in the kidney induces a cAMP-driven cascade, which leads to the insertion of aquaporin-2 water channels into the apical membrane. Mutations in the genes of V2R and aquaporin-2 often lead to NDI. We investigated a structure model of V2R in its bound and unbound state regarding protein stability using a novel protein energy profile approach. Furthermore, these techniques were applied to the wild-type and selected mutations of aquaporin-2. We show that our results correspond well to experimental water ux analysis, which confirms the applicability of our theoretical approach to equivalent problems.

  15. Nephrogenic diabetes insipidus with idiopathic Fanconi′s syndrome in a child who presented as vitamin D resistant rickets

    Directory of Open Access Journals (Sweden)

    Soumya Patra

    2011-01-01

    Full Text Available Fanconi′s syndrome is a complex of multiple tubular dysfunctions of proximal tubular cells occurring alone or in association with a variety of inherited (primary or acquired (secondary disorders. It is characterized by aminoaciduria, normoglycaemic glycosuria, tubular proteinuria without hematuria, metabolic acidosis without anion gap and excessive urinary excretion of phosphorous, calcium, uric acid, bicarbonate, sodium, potassium, and magnesium. Whereas diabetes insipidus is a disease of collecting tubules and child mainly presents with dehydration and hypernatremia. Though all the cases published till date were secondary to drugs, myeloma, hematological disorders, etc., we are reporting the first case of idiopathic Fanconi′s syndrome along with nephrogenic diabetes insipidus in a child who presented to us as resistant rickets. Medline search did not reveal any case of nephrogenic diabetes insipidus associated with idiopathic Fanconi syndrome. We hypothesized that the NDI may be due to of severe hypokalemia induced tubular dysfunction.

  16. Congenital nephrogenic diabetes insipidus: what can we learn from mouse models?

    Science.gov (United States)

    Boone, Michelle; Deen, Peter M T

    2009-02-01

    Aquaporins (AQPs) are central players in mammalian physiology, allowing efficient water transport through cellular membranes. To date, 13 different aquaporins have been identified in mammals (AQP0-AQP12). Knocking out genes in mice and identification of mutations in the human genes provided important information on the role of AQPs in normal physiology. While the physiological role of many AQPs only becomes clear when the putative function is challenged, the lack of AQP2 directly results in a disease phenotype. Aquaporin 2 is highly expressed in the principal cells of the renal collecting duct, where it shuttles between intracellular storage vesicles and the apical membrane. Upon hypernatraemia or hypovolaemia, the antidiuretic hormone vasopressin (AVP) is released from the pituitary into blood and binds to its type 2 receptor on renal principal cells. This initiates a cAMP signalling cascade resulting in the translocation of AQP2-bearing vesicles to the apical membrane. Subsequently, pro-urinary water reabsorption and urine concentration occurs. This process is reversed by a reduction in circulating AVP levels, which is obtained with the establishment of isotonicity. In humans, mutations in the AQP2 gene cause congenital nephrogenic diabetes insipidus (NDI), a disorder characterized by an inability to concentrate urine in response to vasopressin. Until the recent development of several congenital NDI mouse models, our knowledge on AQP2 regulation was primarily based on in vitro studies. This review focuses on the similarities between the in vitro and in vivo studies and discusses new insights into congenital NDI obtained from the mouse models. PMID:18790812

  17. 'Stalkitis' in a pregnant 32-year-old woman: A rare cause of diabetes insipidus

    International Nuclear Information System (INIS)

    A case of lymphocytic infundibulo-neurohypophysitis (LINH) or 'stalkitis' in a 32-year-old woman who presented with diabetes insipidus (DI) during pregnancy is reported here. The diagnosis was made with MR imaging. The clinical and radiological features of this rare disorder and the differential diagnosis of infundibular mass lesions are discussed. The differentiation from lymphocytic adenohypophysitis (LAH) is made. No improvement of the DI accompanying LINH is achieved with trans-sphenoidal surgery. Hence, recognition of typical cases with MR imaging and appropriate medical management avoids unnecessary neurosurgery. This is the second reported case of LINH during pregnancy and may suggest an association. Copyright (1999) Blackwell Science Pty Ltd

  18. Intracranical calcification in siblings with nephrogenic diabetes insipidus: CT and MRI

    International Nuclear Information System (INIS)

    Computed tomography and magnetic resonance imaging (MRI) were used to examine three male siblings with nephrogenic diabetes insipidus (NDI). The two elder brothers had varying degrees of unusual intracranial calcification; the eldest also showed involvement of the cerebral white matter on MRI. The severity of intracranial calcification was related to the time before initiation of treatment and inversely to mental ability. Brain damage and mental retardation in NDI may be caused by a delay in initiating treatment; early detection and treatment are important to prevent brain damage. (orig.)

  19. Mutation Analysis of AVPR2 and AQP2 Gene in Chinese Patients with Congenital Nephrogenic Diabetes Insipidus

    Institute of Scientific and Technical Information of China (English)

    WANG Ying; LI Hong-jun; YU Zhen-xiang; BAO Yong-li; WU Yin; YU Chun-lei; MENG Xiang-ying; LI Yu-xin

    2008-01-01

    To detect mutations of the aquaporin 2 gene(AQP2) and the arginine vasopressin V2 receptor gene(AVPR2)of Chinese congenital nephrogenic diabetes insipidus, and to establish the foundation for further studying the emergence mechanism of the disease and clinical diagnosis, all the exons and part of introns of AQP2 and AVPR2 genes were amplified with intronic primers, using genomic DNA extracted from three patients with congenital nephrogenic diabetes insipidus and two mothers as template, PCR product was ligated into a T-vector and then sequenced. The result was compared with the database sequence to identify the mutable sites via a BLAST search, the incidence of every mutation was analyzed, and the putative transcription factor binding sites that maybe disturbed were analyzed by MAPPER.Mutation g.1394A>G in exon 3 of AVPR2 was detected in all the subjects, g.861C>T(S167L) in exon 2 of AVPR2 and IVS1+3G>A in intron of AQP2 were detected, respectively, in two patients, and c.836A>C in 3' untranslated region of AQP2 was detected in two patients and one mother. Four mutations were identified, g.1394A>G of AVPR2 and c.836A>C of AQP2 have high incidence in patients with nephrogenic diabetes insipidus. Detection on the two sites may become auxiliary diagnosis index of congenital nephrogenic diabetes insipidus.

  20. Diabetes Insipidus and Polydipsia in a Patient with Asperger's Disorder and an Empty Sella: A Case Report.

    Science.gov (United States)

    Raja, Michele; Azzoni, Antonella; Giammarco, Vincenzo

    1998-01-01

    Describes an Italian patient with Asperger disorders, Neurogenic Diabetes Insipidus, and Primary Empty Sella. His response to vasopressin treatment suggested a concomitant presence of primary polydipsia. Implications of the observed concurrence of these rare disorders are discussed in relation to diagnosis and pathogenesis. (Author/CR)

  1. X-Linked Recessive Form of Nephrogenic Diabetes Insipidus in A 7-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Janchevska A.

    2014-12-01

    Full Text Available Nephrogenic diabetes insipidus (NDI is caused by the inability of renal collecting duct cells to respond to arginine vasopressin (AVP/antidiuretic hormone (ADH. We present the case of a 7-year-old boy with a history of excretion of large amounts of dilute urine and polydipsia since infancy. The boy had several vomiting episodes with mild dehydration during the first 3 years of life. There was no evidence of headaches, dizziness or visual problems. He drinks between 2 and 3 L/day and has 24-hour diuresis of 2 liters, now. He has prepubertal appearance with appropriate weight [+0.85 standard deviation score (SDS] and height (+0.15 SDS for his age. His intelligence was also normal. The water deprivation test showed low urine osmolality after 8 hours of dehydration. After desmopressin administration, urine osmolality remained low. Serum osmolality was in the normal range for sex and age before and after desmopressin administration. This indicated a nephrogenic form of diabetes insipidus. Molecular analyses revealed a P286L [p.Pro(CCC286Leu(CTC] mutation in the AVPR2 gene, that was inherited from his mother. This patient is the first case with genetically confirmed X-linked inherited form of NDI in the Republic of Macedonia. Molecular analysis confirmed the clinical diagnosis and enabled genetic advice for this family.

  2. Diabetes Insipidus and Anterior Pituitary Insufficiency Due to Breast Cancer Metastasis

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    Ayşe Arduç

    2016-03-01

    Full Text Available Metastases from breast cancer to the pituitary gland are uncommon. We present a 35-year-old woman with diabetes insipidus and anterior pituitary insufficiency resulting from breast cancer metastases to the pituitary gland. The patient presented with reduced consciousness, fatigue, polyuria, and polydipsia. Hypernatremia (sodium: 154 mmol/L, hypostenuria (urine density: 1001, and hypopituitarism were present on laboratory evaluation. Magnetic resonance imaging (MRI revealed heterogeneous pituitary gland, thickened pituitary stalk (8mm, and loss of normal hyperintense signal of the posterior pituitary. Based on the clinical, laboratory, and MRI findings, the patient was diagnosed with diabetes insipidus and anterior pituitary insufficiency due to pituitary metastases from breast cancer. She received desmopressin, L-thyroxine, and prednisolone, which resulted in improvement of her symptoms and laboratory results. The patient, who also received Gamma Knife radiosurgery and chemotherapy, died six months later due to disseminated metastases. Although pituitary metastasis is rare, it should be kept in mind in patients with breast cancer since early detection and treatment can improve symptoms of patients.

  3. Magnetic resonance imaging of posterior pituitary for evaluation of the neurohypophyseal function in idiopathic and autosomal dominant neurohypophyseal diabetes insipidus

    International Nuclear Information System (INIS)

    We investigated the role of MR imaging for evaluation of the functional status of the neurohypophyseal system in both idiopathic central diabetes insipidus (DI) and familial autosomal dominant neurohypophyseal DI. The patients and family with DI were analyzed retrospectively for the presence or absence of posterior pituitary gland hyperintense signal on MR images. A total of 19 adult patients with idiopathic central DI, 7 members of a family with autosomal dominant DI and 20 control subjects were included in the study. Diagnosis of idiopathic DI was based on the presence of central DI in the absence of any alteration that is known to be responsible for DI. The patients were studied retrospectively and the morphology and intensity of the posterior lobe by MR imaging was assessed by blinded reading. In all patients with idiopathic central DI and the affected members of the family, the posterior bright signal was absent while the stalk was normal on MR images. In contrast, normal posterior pituitary bright signal and stalk were found in unaffected members of the family and all control subjects. We conclude that MR imaging of the posterior pituitary lobe can be used to evaluate the functional status of the neurohypophyseal system in idiopathic central DI and familial autosomal dominant DI. (orig.). With 3 figs., 1 tab

  4. 吕宏生教授治疗尿崩症的经验%Experience of Prof. LV Hong-sheng for treating diabetes insipidus

    Institute of Scientific and Technical Information of China (English)

    陈瑞华

    2014-01-01

    Professor LV considered that diabetes insipidus belong to Xiaoke category. Diabetes insipidus was caused by Bingfu Buzu, Laoyu Guodu and Shenyang Shuaiwei, and diabetes insipidus arosed from Shen. Diabetes insipidus showed more deficiency syndrome and less excess syndrome. Doctors should treat the disease based on Yin and Yang, and the disease was easy to be cured.%吕教授认为尿崩症属“消渴”范畴,多由禀赋不足、劳欲过度、肾阳衰微所致,本病病本在肾,实证鲜见,虚证最多。当根据阴阳的偏盛偏衰程度治疗,从而达到阴阳调和,疾病可望痊愈。

  5. `Stalkitis` in a pregnant 32-year-old woman: A rare cause of diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Leggett, D.A.C.; Anderson, R.J. [Wesley Hospital, Brisbane, QLD (Australia); Hill, P.T. [Ballow Chambers, Brisbane, QLD (Australia)

    1999-02-01

    A case of lymphocytic infundibulo-neurohypophysitis (LINH) or `stalkitis` in a 32-year-old woman who presented with diabetes insipidus (DI) during pregnancy is reported here. The diagnosis was made with MR imaging. The clinical and radiological features of this rare disorder and the differential diagnosis of infundibular mass lesions are discussed. The differentiation from lymphocytic adenohypophysitis (LAH) is made. No improvement of the DI accompanying LINH is achieved with trans-sphenoidal surgery. Hence, recognition of typical cases with MR imaging and appropriate medical management avoids unnecessary neurosurgery. This is the second reported case of LINH during pregnancy and may suggest an association. Copyright (1999) Blackwell Science Pty Ltd 11 refs., 3 figs.

  6. Diabetes insipidus: An unusual presentation of adenocarcinoma of the lung in a patient with no identifiable lung mass

    Directory of Open Access Journals (Sweden)

    Shuchi Gulati

    2015-01-01

    Full Text Available Context: Lung cancers are known to metastasize to unusual sites. Despite this knowledge often times the diagnosis of a primary lung cancer gets delayed especially when the patient presents without respiratory symptoms. Case Report: The patient discussed in our review is a 47-year-old female, smoker who had presented to several hospitals with months of headache, nausea and intermittent episodes of vomiting. She was noted to have hypernatremia due to diabetes insipidus and a pituitary lesion on her magnetic resonance images. The pituitary mass on biopsy was found to represent a metastatic focus from a primary lung adenocarcinoma. Conclusion: Clinicians should be aware of malignancies that are well known to metastasize to the posterior pituitary. Conversely, since not every patient presents with symptoms of metastasis, there is a need to recognize the clinical syndromes (e. g., diabetes insipidus-like symptoms or more subtle symptoms like cranial nerve palsies associated with potential metastasis to the pituitary.

  7. Transient gestational diabetes insipidus diagnosed in successive pregnancies: review of pathophysiology, diagnosis, treatment, and management of delivery.

    Science.gov (United States)

    Kalelioglu, Ibrahim; Kubat Uzum, Ayse; Yildirim, Alkan; Ozkan, Tulay; Gungor, Funda; Has, Recep

    2007-01-01

    Gestational diabetes insipidus (GDI) is a rare disorder characterised by polyuria, polydypsia, and excessive thirst usually manifesting in the third trimester of pregnancy. The etiology is thought to depend on excessive vasopressinase activity, a placental enzyme that degrades arginine-vasopressin (AVP), but not 1-deamino-8-D: -arginine vasopressin (dDAVP), which is a synthetic form. This is a transient syndrome and may be associated with acute fatty liver of pregnancy and preeclampsia. The use of dDAVP in symptomatic cases has been proven as a safe method for both the mother and the fetus during the pregnancy. We report a case of recurrent gestational diabetes insipidus in successive pregnancies, which responded to dDAVP and subsided after delivery.

  8. Abacavir-induced reversible Fanconi syndrome with nephrogenic diabetes insipidus in a patient with acquired immunodeficiency syndrome

    OpenAIRE

    Ahmad M

    2006-01-01

    There are several reports of Fanconi syndrome (FS) with or without nephrogenic diabetes insipidus (NDI) in patients with human immunodeficiency virus (HIV) infection, treated with various antiretroviral medications like cidofovir, adefovir, didenosine and tenofovir. But neither FS nor NDI has been documented with abacavir therapy. We are reporting the first case of abacavir-induced reversible FS with NDI in a patient with acquired immunodeficiency syndrome, who recovered completely with suppo...

  9. Case of retroperitoneal fibrosis following dihydroergotamine therapy. With special reference to partial diabetes insipidus and positive Ga scan

    Energy Technology Data Exchange (ETDEWEB)

    Oguma, Yutaka; Nishimura, Masaharu; Abe, Shosaku; Hasegawa, Hiroshi; Kawakami, Yoshikazu (Hokkaido Univ., Sapporo (Japan). School of Medicine); Ide, Hajime

    1984-06-01

    A 72-year-old male patient who developed retroperitoneal fibrosis during treatment with dihydroergotamine, aspirin, and phenacetin was reported. The disease developed as mediastinal lesions and was accompanied by abnormal deposits of /sup 67/Ga-citrate, idiopathic partial diabetes insipidus, and hypergonadotropinism. One year later, he had fibrotic masses around the great vessels in the abdomen, which caused ureteral obstruction. Fibrous lesions completely disappeared and various laboratory findings improved by steroid therapy following the ablation and fixation of the ureter.

  10. Diabetes Insipidus

    Science.gov (United States)

    ... substance made by the placenta that prevents the mother’s ADH from working. Desmopressin (nasal spray or pill) What is the ... Infographics Myth vs Fact Patient Alerts Scientific Statements Social Media Resources Peer Support Resources International Resource Center Online Store Pacientes y ...

  11. Polyuria and polydipsia in a young child: diagnostic considerations and identification of novel mutation causing familial neurohypophyseal diabetes insipidus.

    Science.gov (United States)

    Stephen, Matthew D; Fenwick, Raymond G; Brosnan, Patrick G

    2012-12-01

    A 3-year 5-month-old boy was seen for second opinion regarding polydipsia and polyuria. Previously, a diagnosis of primary polydipsia was made after normal urine concentration after overnight water deprivation testing. The boy's father, paternal grandfather, and paternal aunt had diabetes insipidus treated with desmopressin acetate. Based on this young boy's symptoms, ability to concentrate urine after informal overnight water deprivation, and family history of diabetes insipidus, we performed AVP gene mutation testing. Analysis of the AVP gene revealed a novel mutation G54E that changes a normal glycine to glutamic acid, caused by a guanine to adenine change at nucleotide g.1537 (exon 2) of the AVP gene. Commonly, patients with familial neurohypophyseal diabetes insipidus (FNHDI) present within the first 6 years of life with progressively worsening polyuria and compensatory polydipsia. Since these patients have progressive loss of arginine vasopressin (AVP), they may initially respond normally to water deprivation testing and have normal pituitary findings on brain MRI. Genetic testing may be helpful in these patients, as well as preemptively diagnosing those with a mutation, thereby avoiding unnecessary surveillance of those unaffected. PMID:20401697

  12. Home blood sodium monitoring, sliding-scale fluid prescription and subcutaneous DDAVP for infantile diabetes insipidus with impaired thirst mechanism

    Directory of Open Access Journals (Sweden)

    Hameed Shihab

    2012-06-01

    Full Text Available Abstract Background/Aims Infants with diabetes insipidus (DI, especially those with impaired thirst mechanism or hypothalamic hyperphagia, are prone to severe sodium fluctuations, often requiring hospitalization. We aimed to avoid dangerous fluctuations in serum sodium and improve parental independence. Methods A 16-month old girl with central DI, absent thirst mechanism and hyperphagia following surgery for hypothalamic astrocytoma had erratic absorption of oral DDAVP during chemotherapy cycles. She required prolonged hospitalizations for hypernatremia and hyponatremic seizure. Intensive monitoring of fluid balance, weight and clinical assessment of hydration were not helpful in predicting serum sodium. Discharge home was deemed unsafe. Oral DDAVP was switched to subcutaneous (twice-daily injections, starting with 0.01mcg/dose, increasing to 0.024mcg/dose. The parents adjusted daily fluid allocation by sliding-scale, according to the blood sodium level (measured by handheld i-STAT analyser, Abbott. We adjusted the DDAVP dose if fluid allocation differed from maintenance requirements for 3 consecutive days. Results After 2.5 months, sodium was better controlled, with 84% of levels within reference range (135-145 mmol/L vs. only 51% on the old regimen (p = 0.0001. The sodium ranged from 132-154 mmol/L, compared to 120–156 on the old regimen. She was discharged home. Conclusion This practical regimen improved sodium control, parental independence, and allowed discharge home.

  13. A case of idiopathic diabetes insipidus presented with bilateral hydroureteronephrosis and neurogenic bladder: A pediatric case report and literature review.

    Science.gov (United States)

    Yuksel, Ozgur Haki; Kivrak, Mithat; Sahin, Aytac; Akan, Serkan; Urkmez, Ahmet; Verit, Ayhan

    2015-01-01

    Diabetes insipidus (DI) is a condition with heterogeneous clinical symptoms characterized by polyuria (urine output >4 mL/kg/hr) and polydipsia (water intake >2 L/m (2)/d). In children, acquired nephrogenic DI (NDI) is more common than central DI (CDI). Diagnosis is based on the presence of high plasma osmolality and low urinary osmolality with significant water diuresis. A water deprivation test with vasopressin challenge, though has limitations, is done to differentiate NDI from CDI and diagnose their incomplete forms. Neonates and young infants are better managed with hydration therapy alone. Older children with CDI are treated with desmopressin (1-deamino-8-D-arginine vasopressin, dDAVP). Its oral form is safe, highly effective and has dosing flexibility. We report a case of an 8-year-old male patient with CDI with severe bilateral non-obstructive hydronephrosis and megaureter. Dramatic clinical and radiological responses to dDAVP treatment were achieved and therapy reduced urine volume and led to marked radiological improvement in hydronephrosis. PMID:26600892

  14. Secondary nephrogenic diabetes insipidus as a complication of inherited renal diseases

    Science.gov (United States)

    Bockenhauer, D; van’t Hoff, W; Dattani, M.; Lehnhardt, A; Subtirelu, M; Hildebrandt, F; Bichet, DG

    2014-01-01

    Background/Aims Nephrogenic diabetes insipidus (NDI) is a serious condition with large water losses in the urine and risk of hypernatremic dehydration. Unrecognised, repeated episodes of hypernatremic dehydration can lead to permanent brain damage. Primary NDI is due to mutations in either AVPR2 or AQP2. NDI can also occur as a secondary complication, most commonly from obstructive uropathy or chronic lithium therapy. We observed NDI in patients with inherited tubulopathies and aimed to define the clinical and molecular phenotype. Methods We reviewed medical notes of four patients with clinical NDI and an underlying molecularly confirmed diagnosis of nephropathic cystinosis, Bartter syndrome, nephronophthisis and apparent mineralocorticoid excess, respectively. Results The patients all failed to concentrate their urine after DDAVP. None had an identifiable mutation in AVPR2 or AQP2, consistent with secondary NDI. Patients experienced repeated episodes of hypernatraemic dehydration and in two cases NDI was initially thought to be the primary diagnosis, delaying recognition of the underlying problem. Conclusion The recognition of this potential complication is important as it has direct implications for the clinical management. The occurrence of NDI in these conditions provides clues for the etiology of aquaporin deficiency. PMID:20733335

  15. Deletion of the V2 vasopressin receptor gene in two Chinese patients with nephrogenic diabetes insipidus

    Directory of Open Access Journals (Sweden)

    Yin Jun

    2006-11-01

    Full Text Available Abstract Background Congenital nephrogenic diabetes insipidus (NDI is a rare X-linked inherited disorder characterized by the excretion of large volumes of diluted urine and caused by mutations in arginine vasopressin receptor 2 (AVPR2 gene. To investigate the mutation of AVPR2 gene in a Chinese family with congenital NDI, we screened AVPR2 gene in two NDI patients and eight family members by PCR amplification and direct sequencing. Results Five specific fragments, covering entire coding sequence and their flanking intronic sequences of AVPR2 gene, were not observed in both patients, while those fragments were all detected in the control subjects. Several different fragments around the AVPR2 locus were amplified step by step. It was revealed that a genomic fragment of 5,995-bp, which contained the entire AVPR2 gene and the last exon (exon 22 of the C1 gene, was deleted and a 3-bp (GAG was inserted. Examination of the other family members showed that the mothers and the grandmother were carriers for this deletion. Conclusion Our findings suggest that the two patients in a Chinese family suffering from congenital NDI had a 5,995-bp deletion and 3-bp (GAG insertion at Xq28. The deletion contained the entire AVPR2 gene and exon 22 of the C1 gene.

  16. Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus

    Science.gov (United States)

    2016-01-01

    Etiologies of a thickened stalk include inflammatory, neoplastic, and idiopathic origins, and the underlying diagnosis may remain occult. We report a patient with a thickened pituitary stalk (TPS) and papillary thyroid carcinoma (PTC) whose diagnosis remained obscure until a skin lesion appeared. The patient presented with PTC, status postthyroidectomy, and I131 therapy. PTC molecular testing revealed BRAF mutant (V600E, GTC>GAG). She had a 5-year history of polyuria/polydipsia. Overnight dehydration study confirmed diabetes insipidus (DI). MRI revealed TPS with loss of the posterior pituitary bright spot. Evaluation showed hypogonadotropic hypogonadism and low IGF-1. Chest X-ray and ACE levels were normal. Radiographs to evaluate for extrapituitary sites of Langerhans Cell Histiocytosis (LCH) were unremarkable. Germinoma studies were negative: normal serum and CSF beta-hCG, alpha-fetoprotein, and CEA. Three years later, the patient developed vulvar labial lesions followed by inguinal region skin lesions, biopsy of which revealed LCH. Reanalysis of thyroid pathology was consistent with concurrent LCH, PTC, and Hashimoto's thyroiditis within the thyroid. This case illustrates that one must be vigilant for extrapituitary manifestations of systemic diseases to diagnose the etiology of TPS. An activating mutation of the protooncogene BRAF is a potential unifying etiology of both PTC and LCH. PMID:27656301

  17. Autophagic degradation of aquaporin-2 is an early event in hypokalemia-induced nephrogenic diabetes insipidus.

    Science.gov (United States)

    Khositseth, Sookkasem; Uawithya, Panapat; Somparn, Poorichaya; Charngkaew, Komgrid; Thippamom, Nattakan; Hoffert, Jason D; Saeed, Fahad; Michael Payne, D; Chen, Shu-Hui; Fenton, Robert A; Pisitkun, Trairak

    2015-12-17

    Hypokalemia (low serum potassium level) is a common electrolyte imbalance that can cause a defect in urinary concentrating ability, i.e., nephrogenic diabetes insipidus (NDI), but the molecular mechanism is unknown. We employed proteomic analysis of inner medullary collecting ducts (IMCD) from rats fed with a potassium-free diet for 1 day. IMCD protein quantification was performed by mass spectrometry using a label-free methodology. A total of 131 proteins, including the water channel AQP2, exhibited significant changes in abundance, most of which were decreased. Bioinformatic analysis revealed that many of the down-regulated proteins were associated with the biological processes of generation of precursor metabolites and energy, actin cytoskeleton organization, and cell-cell adhesion. Targeted LC-MS/MS and immunoblotting studies further confirmed the down regulation of 18 selected proteins. Electron microscopy showed autophagosomes/autophagolysosomes in the IMCD cells of rats deprived of potassium for only 1 day. An increased number of autophagosomes was also confirmed by immunofluorescence, demonstrating co-localization of LC3 and Lamp1 with AQP2 and several other down-regulated proteins in IMCD cells. AQP2 was also detected in autophagosomes in IMCD cells of potassium-deprived rats by immunogold electron microscopy. Thus, enhanced autophagic degradation of proteins, most notably including AQP2, is an early event in hypokalemia-induced NDI.

  18. Signaling Modification by GPCR Heteromer and Its Implication on X-Linked Nephrogenic Diabetes Insipidus

    Science.gov (United States)

    Harikumar, Kaleeckal G.; Miller, Laurence J.; Chow, Billy K. C.

    2016-01-01

    The involvement of secretin (SCT) and secretin receptor (SCTR) in regulating body water homeostasis is well established. Identified as one of the vasopressin (Vp)-independent mechanisms in fluid balance, SCT regulates aquaporin 2 (AQP2) in the kidney distal collecting duct cells through activating intracellular cAMP production. This ability to bypass Vp-mediated water reabsorption in kidney implicates SCT’s potential to treat nephrogenic diabetes insipidus (NDI). Research on NDI in the past has largely been focused on the searching for mutations in vasopressin receptor 2 (AVPR2), while the functional relationship between SCTR, AVPR2 and NDI remains unclear. Here, we demonstrate the interaction between SCTR and AVPR2 to modulate cellular signaling in vitro. Interestingly, we show in this report that upon heteromer formation with SCTR, R137H, a NDI-causing AVPR2 mutant that is defective in trafficking to cell surface, can functionally be rescued. Our data may provide an explanation for this clinically mild case of NDI, and insights into the pathological development of NDI in the future. PMID:27649563

  19. Signaling Modification by GPCR Heteromer and Its Implication on X-Linked Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Ng, Hans K H; Harikumar, Kaleeckal G; Miller, Laurence J; Chow, Billy K C

    2016-01-01

    The involvement of secretin (SCT) and secretin receptor (SCTR) in regulating body water homeostasis is well established. Identified as one of the vasopressin (Vp)-independent mechanisms in fluid balance, SCT regulates aquaporin 2 (AQP2) in the kidney distal collecting duct cells through activating intracellular cAMP production. This ability to bypass Vp-mediated water reabsorption in kidney implicates SCT's potential to treat nephrogenic diabetes insipidus (NDI). Research on NDI in the past has largely been focused on the searching for mutations in vasopressin receptor 2 (AVPR2), while the functional relationship between SCTR, AVPR2 and NDI remains unclear. Here, we demonstrate the interaction between SCTR and AVPR2 to modulate cellular signaling in vitro. Interestingly, we show in this report that upon heteromer formation with SCTR, R137H, a NDI-causing AVPR2 mutant that is defective in trafficking to cell surface, can functionally be rescued. Our data may provide an explanation for this clinically mild case of NDI, and insights into the pathological development of NDI in the future. PMID:27649563

  20. [Vasopressin V2 receptor-related pathologies: congenital nephrogenic diabetes insipidus and nephrogenic syndrome of inappropiate antidiuresis].

    Science.gov (United States)

    Morin, Denis

    2014-12-01

    Congenital nephrogenic diabetes insipidus is a rare hereditary disease with mainly an X-linked inheritance (90% of the cases) but there are also autosomal recessive and dominant forms. Congenital nephrogenic diabetes insipidus is characterized by a resistance of the renal collecting duct to the action of the arginine vasopressin hormone responsible for the inability of the kidney to concentrate urine. The X-linked form is due to inactivating mutations of the vasopressin 2 receptor gene leading to a loss of function of the mutated receptors. Affected males are often symptomatic in the neonatal period with a lack of weight gain, dehydration and hypernatremia but mild phenotypes may also occur. Females carrying the mutation may be asymptomatic but, sometimes, severe polyuria is found due to the random X chromosome inactivation. The autosomal recessive and dominant forms, occurring in both genders, are linked to mutations in the aquaporin-2 gene. The treatment remains difficult, especially in infants, and is based on a low osmotic diet with increased water intake and the use of thiazides and indomethacin. The main goal is to avoid hypernatremic episodes and maintain a good hydration state. Potentially, specific treatment, in some cases of X-linked congenital nephrogenic diabetes insipidus, with pharmacological chaperones such as non-peptide vasopressin-2 receptor antagonists will be available in the future. Conversely, the nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is linked to a constitutive activation of the V(2)-receptor due to activating mutations with clinical and biological features of inappropriate antidiuresis but with low or undetectable plasma arginine vasopressin hormone levels.

  1. Potential role of purinergic signaling in lithium-induced nephrogenic diabetes insipidus.

    Science.gov (United States)

    Zhang, Yue; Nelson, Raoul D; Carlson, Noel G; Kamerath, Craig D; Kohan, Donald E; Kishore, Bellamkonda K

    2009-05-01

    Lithium (Li)-induced nephrogenic diabetes insipidus (NDI) has been attributed to the increased production of renal prostaglandin (PG)E(2). Previously we reported that extracellular nucleotides (ATP/UTP), acting through P(2y2) receptor in rat medullary collecting duct (mCD), produce and release PGE(2). Hence we hypothesized that increased production of PGE(2) in Li-induced NDI may be mediated by enhanced purinergic signaling in the mCD. Sprague-Dawley rats were fed either control or Li-added diet for 14 or 21 days. Li feeding resulted in marked polyuria and polydipsia associated with a decrease in aquaporin (AQP)2 protein abundance in inner medulla ( approximately 20% of controls) and a twofold increase in urinary PGE(2). When acutely challenged ex vivo with adenosine 5'-O-(3-thiotriphosphate) (ATPgammaS), UTP, or ADP, mCD of Li-fed rats showed significantly higher increases (50-130% over control diet-fed rats) in PGE(2) production, indicating that more than one subtype of P(2y) receptor is involved. This was associated with a 3.4-fold increase in P(2y4), but not P(2y2), receptor mRNA expression in the inner medulla of Li-fed rats compared with control diet-fed rats. Confocal laser immunofluorescence microscopy revealed predominant localization of both P(2y2) and P(2y4) receptors in the mCD of control or Li diet-fed rats. Together, these data indicate that in Li-induced NDI 1) purinergic signaling in the mCD is sensitized with increased production of PGE(2) and 2) P(2y2) and/or P(2y4) receptors may be involved in the enhanced purinergic signaling. Our study also reveals the potential beneficial effects of P(2y) receptor antagonists in the treatment and/or prevention of Li-induced NDI.

  2. Defective Store-Operated Calcium Entry Causes Partial Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Mamenko, Mykola; Dhande, Isha; Tomilin, Viktor; Zaika, Oleg; Boukelmoune, Nabila; Zhu, Yaming; Gonzalez-Garay, Manuel L; Pochynyuk, Oleh; Doris, Peter A

    2016-07-01

    Store-operated calcium entry (SOCE) is the mechanism by which extracellular signals elicit prolonged intracellular calcium elevation to drive changes in fundamental cellular processes. Here, we investigated the role of SOCE in the regulation of renal water reabsorption, using the inbred rat strain SHR-A3 as an animal model with disrupted SOCE. We found that SHR-A3, but not SHR-B2, have a novel truncating mutation in the gene encoding stromal interaction molecule 1 (STIM1), the endoplasmic reticulum calcium (Ca(2+)) sensor that triggers SOCE. Balance studies revealed increased urine volume, hypertonic plasma, polydipsia, and impaired urinary concentrating ability accompanied by elevated circulating arginine vasopressin (AVP) levels in SHR-A3 compared with SHR-B2. Isolated, split-open collecting ducts (CD) from SHR-A3 displayed decreased basal intracellular Ca(2+) levels and a major defect in SOCE. Consequently, AVP failed to induce the sustained intracellular Ca(2+) mobilization that requires SOCE in CD cells from SHR-A3. This effect decreased the abundance of aquaporin 2 and enhanced its intracellular retention, suggesting impaired sensitivity of the CD to AVP in SHR-A3. Stim1 knockdown in cultured mpkCCDc14 cells reduced SOCE and basal intracellular Ca(2+) levels and prevented AVP-induced translocation of aquaporin 2, further suggesting the effects in SHR-A3 result from the expression of truncated STIM1. Overall, these results identify a novel mechanism of nephrogenic diabetes insipidus and uncover a role of SOCE in renal water handling. PMID:26574044

  3. Defective Store-Operated Calcium Entry Causes Partial Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Mamenko, Mykola; Dhande, Isha; Tomilin, Viktor; Zaika, Oleg; Boukelmoune, Nabila; Zhu, Yaming; Gonzalez-Garay, Manuel L; Pochynyuk, Oleh; Doris, Peter A

    2016-07-01

    Store-operated calcium entry (SOCE) is the mechanism by which extracellular signals elicit prolonged intracellular calcium elevation to drive changes in fundamental cellular processes. Here, we investigated the role of SOCE in the regulation of renal water reabsorption, using the inbred rat strain SHR-A3 as an animal model with disrupted SOCE. We found that SHR-A3, but not SHR-B2, have a novel truncating mutation in the gene encoding stromal interaction molecule 1 (STIM1), the endoplasmic reticulum calcium (Ca(2+)) sensor that triggers SOCE. Balance studies revealed increased urine volume, hypertonic plasma, polydipsia, and impaired urinary concentrating ability accompanied by elevated circulating arginine vasopressin (AVP) levels in SHR-A3 compared with SHR-B2. Isolated, split-open collecting ducts (CD) from SHR-A3 displayed decreased basal intracellular Ca(2+) levels and a major defect in SOCE. Consequently, AVP failed to induce the sustained intracellular Ca(2+) mobilization that requires SOCE in CD cells from SHR-A3. This effect decreased the abundance of aquaporin 2 and enhanced its intracellular retention, suggesting impaired sensitivity of the CD to AVP in SHR-A3. Stim1 knockdown in cultured mpkCCDc14 cells reduced SOCE and basal intracellular Ca(2+) levels and prevented AVP-induced translocation of aquaporin 2, further suggesting the effects in SHR-A3 result from the expression of truncated STIM1. Overall, these results identify a novel mechanism of nephrogenic diabetes insipidus and uncover a role of SOCE in renal water handling.

  4. X-linked nephrogenic diabetes insipidus: From the ship Hopewell to RFLP studies

    Energy Technology Data Exchange (ETDEWEB)

    Bichet, D.G.; Lonergan, M.; Arthus, M.F.; Ligier, S.; Kluge, R. (Universite de Montreal (Canada)); Hendy, G.N.; Pausova, Z.; Zingg, H.; Morgan, K.; Saenger, P. (McGill Univ., Montreal (Canada)) (and others)

    1992-11-01

    Nephrogenic diabetes insipidus (NDI; designated 304800 in Mendelian Inheritance in Man) is an X-linked disorder with abnormal renal and extrarenal V[sub 2] vasopression receptor responses. The mutant gene has been mapped to Xq28 by analysis of RFLPs, and tight linkage between DXS52 and DNI has been reported. In 1969, Bode and Crawford proposed, under the term, the Hopewell hypothesis' that most cases in North America could be traced to descendants of Ulster Scots who arrived in Nova Scotia in 1761 on the ship Hopewell. They also suggested a link between this family and a large Mormon pedigree. DNA samples obtained from 13 independent affected families, including 42 members of the Hopewell and Mormon pedigrees, were analyzed with probes in the Xq28 region. Genealogical reconstructions were performed. Linkage between NDI and DXS304 (probe U6:2.spl), DXS305 (St35-691), DXS52 (St14-1), DXS15 (DX13), and F8C (F814) showed no recombination in 12 families, with a maximum lod score of 13.5 for DXS52. A recombinant between NDI and DXS304, DXS305, was identified in one family. The haplotype segregating with the disease in the Hopewell pedigree was not shared by other North American families. PCR analysis of the St14 VNTR allowed the distinction of two alleles that were not distinguishable by Southern analysis. Carrier status was predicted in 24 of 26 at-risk females. The Hopewell hypothesis cannot explain the origin of NDI in many of the North American families, since they have no apparent relationship with the Hopewell earlier settlers, either by haplotype or by genealogical analysis. PCR analysis of the DXS52 VNTR in NDI families is very useful for carrier testing and presymptomatic diagnosis, which can prevent the first manifestations of dehydration. 39 refs., 7 figs., 3 tabs.

  5. Nature and recurrence of AVPR2 mutations in X-linked nephrogenic diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Bichet, D.G.; Lonergan, M.; Arthus, M.F. (Universite de Montreal (Canada)); Goodyer, P. (McGill Univ., Montreal (Canada)); Birnbaumer, M.; Rosenthal, W. (Baylor College of Medicine, Houston, TX (United States)); Nivet, H.; Benoit, S.; Giampietro, P.; Simonetti, S. (and others)

    1994-08-01

    X-linked nephrogenic diabetes insipidus (NDI) is a rare disease with defective renal and extrarenal arginine-vasopressin V[sub 2] receptor responses due to mutations in the AVPR2 gene in Xq28. The authors analyzed 31 independent NDI families to determine the nature and recurrence of AVPR2 mutations. Twenty-one new putative disease-causing mutations were identified: 113delCT, 253del35, 255del9, 274insG, V88M, R106C, 402delCT, C112R, Y124X, S126F, W164S, S167L, 684delTA, 804insG, W284X, A285P, W293X, R337X, and three large deletions or gene rearrangements. Five other mutations - R113W, Y128S, R137H, R181C, and R202C - that previously had been reported in other families were detected. There was evidence for recurrent mutation for four mutations (R113W, R137H, S167L, and R337X). Eight de novo mutation events were detected (274insG, R106C, Y128S, 167L [twice], R202C, 684delTA, and R337X). The origins were maternal (one), grandmaternal (one), and grandpaternal (six). In the 31 NDI families and 6 families previously reported, there is evidence both for mutation hot spots for nucleotide substitutions and for small deletions and insertions. More than half (58%) of the nucleotide substitutions in 26 families could be a consequence of 5-methyl-cytosine deamination at a CpG dinucleotide. Most of the small deletions and insertions could be attributed to slipped mispairing during DNA replication. 25 refs., 2 figs., 2 tabs.

  6. Recurring dominant-negative mutations in the AVP-NPII gene cause neurohypophyseal diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Repaske, D.R. [Children`s Hospital Medical Center, Cincinnati, OH (United States); Phillips, J.A.; Krishnamani, M.R.S. [Vanderbilt Univ. School of Medicine, Nashville, TN (United States)] [and others

    1994-09-01

    Autosomal dominant neurohypophyseal diabetes insipidus (ADNDI) is a familial form of arginine vasopressin (or antidiuretic hormone) deficiency that is usually manifest in early childhood with polyuria, polydipsia and an antidiuretic response to exogenous vasopressin or its analogs. The phenotype is postulated to arise from gliosis and depletion of the magnocellular neurons that produce vasopressin in the supraoptic and paraventricular nuclei of the hypothalamus. ADNDI is caused by heterozygosity for a variety of mutations in the AVP-NPII gene which encodes vasopressin, its carrier protein (NPII) and a glycoprotein (copeptin) of unknown function. These mutations include: (1) Ala 19{r_arrow}Thr (G279A) in AVP`s signal peptide, (2) Gly 17{r_arrow}Val (G1740T), (3) Pro 24{r_arrow}Leu (C1761T), (4) Gly 57{r_arrow}Ser (G1859A) and (5) del Glu 47({delta}AGG 1824-26), all of which occur in NPII. In characterizing the AVP-NPII mutations in five non-related ADNDI kindreds, we have detected two kindreds having mutation 1 (G279A), two having mutation 3 (C1761T) and one having mutation 4 (G1859A) without any other allelic changes being detected. Two of these recurring mutations (G279A and G1859A) are transitions that occur at CpG dinucleotides while the third (C1761T) does not. Interestingly, families with the same mutations differed in their ethnicity or in their affected AVP-NPII allele`s associated haplotype of closely linked DNA polymorphisms. Our data indicated that at least three of five known AVP-NPII mutations causing ADNDI tend to recur but the mechanisms by which these dominant-negative mutations cause variable or progressive expression of the ADNDI phenotype remain unclear.

  7. Novel mutation in the AVPR2 gene in a Danish male with nephrogenic diabetes insipidus caused by ER retention and subsequent lysosomal degradation of the mutant receptor

    NARCIS (Netherlands)

    Nejsum, L.N.; Christensen, T.M.; Robben, J.H.; Milligan, G.; Deen, P.M.T.; Bichet, D.G.; Levin, K.

    2011-01-01

    Mutations in the arginine vasopressin receptor 2 (AVPR2) gene can cause X-linked nephrogenic diabetes insipidus (NDI) characterized by the production of large amounts of urine and an inability to concentrate urine in response to the antidiuretic hormone vasopressin. We have identified a novel mutati

  8. Clinical and molecular evidence of abnormal processing and trafficking of the vasopressin preprohormone in a large kindred with familial neurohypophyseal diabetes insipidus due to a signal peptide mutation

    DEFF Research Database (Denmark)

    Siggaard, C; Rittig, S; Corydon, T J;

    1999-01-01

    The autosomal dominant form of familial neurohypophyseal diabetes insipidus (adFNDI) is a rare disease characterized by postnatal onset of polyuria and a deficient neurosecretion of the antidiuretic hormone, arginine vasopressin (AVP). Since 1991, adFNDI has been linked to 31 different mutations ...

  9. Novel mutations in the V2 vasopressin receptor gene in two pedigrees with congenital nephrogenic diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Yuasa, Hiromitsu; Ito, Masafumi; Oiso, Yutaka; Kurokawa, Masaei; Saito, Hidehiko [Nagoya Univ. School of Medicine, Aichi (Japan); Watanabe, Tohru; Oda, Yoshihiko; Ishizuka, Toshie; Tani, Nagayuki; Ito, Seiki; Shibata, Akira [Niigata City General Hospital (Japan)

    1994-08-01

    Novel mutations in the V2 vasopressin receptor gene were identified in two Japanese pedigrees with X-linked congenital nephrogenic diabetes insipidus. The V2 receptor belongs to the family of G-protein-coupled receptors that contain seven distinct transmembrane domains, and the V2 receptor gene is encoded by three exons. The coding regions amplified by polymerase chain reaction were directly sequenced. In a pedigree, one of four consecutive guanine sequences (nucleotides 528-531) in the second exon was deleted (528delG). This deletion mutation results in a frame shift beginning at codon 154 in the second intracellular domain and a premature termination at codon 161. In another pedigree, a missense mutation (A{yields}G) was identified at nucleotide position 310 in the second exon. This point mutation, H80R, changes a histidine at codon 80 in the second transmembrane domain to an arginine that is more positively charged than histidine under the neutral environment. Each mutation cosegregated with the phenotype of diabetes insipidus and supposed to be a cause for resistance to arginine vasopressin. 35 refs., 4 figs., 2 tabs.

  10. Analysis of clinical course and magnetic resonance imaging of posttraumatic diabetes insipidus

    International Nuclear Information System (INIS)

    We analyzed the relationship between posttraumatic diabetes insipidus (DI) onset and magnetic resonance imaging (MRI). In the last 5 years, 13 survivors of head injury were diagnosed with DI. We divided them into 2 groups, early and delayed, by DI onset. The early group consisted of 5 patients diagnosed with DI within 12 hours of injury. The delayed group consisted of 8 diagnosed after 12 hours or more. We analyzed differences between groups for factors such as Glasgow coma scale (GCS) on admission, Glasgow outcome scale (GOS) at discharge, DI duration, intracranial pressure (ICP) when diagnosed with DI, maximum ICP during observation, and MRI findings. In the early group, mean onset of DI was about 40 hours earlier than that in the delayed group, 7±2 vs. 47±19 hours, p<0.05. No significant differences were seen between groups for GCS, ISS, or GOS. Although no significant difference was seen in ICP, barbiturate therapy was needed in 7 cases, craniotomy in 4, and hypothermia therapy in 5 to control ICP in the delayed group. Barbiturate therapy was needed in only 2 cases and no indications were seen for craniotomy or hypothermia therapy in the early group. All cases in the delayed group recovered from DI within 3 weeks, but 3 in the early group were diagnosed with permanent DI and 1 needed antidiuretic hormone (ADH) during 75 days. All of the early group was recognized to have hypothalamic injury and diffuse axonal injury in MRI, but none in the delayed group was recognized for these MRI findings. In the delayed group, the high-intensity signal of the posterior pituitary gland in T1 weighted MRI, thought to represent the granule of ADH, disappeared in the early period and reappeared gradually after recovery from DI, but this signal did not reappear in the early group. We therefore conducted that the crucial cause of posttraumatic DI in the early group is direct hypothalamic injury, perhaps due to diffuse axonal injury, and that in the delayed group, secondary

  11. Analysis of clinical course and magnetic resonance imaging of posttraumatic diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Yoshiaki; Hirota, Tetsuya; Kohno, Masanobu; Iwai, Atsushi; Abe, Yoshio; Ikeuchi, Hisashi; Yoshioka, Toshiharu [Osaka Prefectural General Hospital (Japan)

    2002-06-01

    We analyzed the relationship between posttraumatic diabetes insipidus (DI) onset and magnetic resonance imaging (MRI). In the last 5 years, 13 survivors of head injury were diagnosed with DI. We divided them into 2 groups, early and delayed, by DI onset. The early group consisted of 5 patients diagnosed with DI within 12 hours of injury. The delayed group consisted of 8 diagnosed after 12 hours or more. We analyzed differences between groups for factors such as Glasgow coma scale (GCS) on admission, Glasgow outcome scale (GOS) at discharge, DI duration, intracranial pressure (ICP) when diagnosed with DI, maximum ICP during observation, and MRI findings. In the early group, mean onset of DI was about 40 hours earlier than that in the delayed group, 7{+-}2 vs. 47{+-}19 hours, p<0.05. No significant differences were seen between groups for GCS, ISS, or GOS. Although no significant difference was seen in ICP, barbiturate therapy was needed in 7 cases, craniotomy in 4, and hypothermia therapy in 5 to control ICP in the delayed group. Barbiturate therapy was needed in only 2 cases and no indications were seen for craniotomy or hypothermia therapy in the early group. All cases in the delayed group recovered from DI within 3 weeks, but 3 in the early group were diagnosed with permanent DI and 1 needed antidiuretic hormone (ADH) during 75 days. All of the early group was recognized to have hypothalamic injury and diffuse axonal injury in MRI, but none in the delayed group was recognized for these MRI findings. In the delayed group, the high-intensity signal of the posterior pituitary gland in T1 weighted MRI, thought to represent the granule of ADH, disappeared in the early period and reappeared gradually after recovery from DI, but this signal did not reappear in the early group. We therefore conducted that the crucial cause of posttraumatic DI in the early group is direct hypothalamic injury, perhaps due to diffuse axonal injury, and that in the delayed group, secondary

  12. Competing interests in a lung cancer with metastasis to the pituitary gland: syndrome of inappropriate ADH secretion versus diabetes insipidus.

    Science.gov (United States)

    Gulsin, Gaurav Singh; Jacobs, Madeleine Louisa Bryson; Gohil, Shailesh; Thomas, Adam; Levy, Miles

    2016-01-01

    Metastases to the pituitary gland are rare; cancers that most commonly metastasize to the pituitary are breast and lung cancers. No specific computed tomography or magnetic resonance imaging features reliably distinguish primary pituitary masses from metastases. A combination of a detailed clinical assessment together with specialist endocrine and neuroradiology support is essential to make the rare diagnosis of a pituitary metastasis. We present the case of a man with metastatic lung cancer, initially presenting as hypopituitarism. Subtle features in the history, together with neuroimaging findings atypical for pituitary adenomas, provided clues that the diagnosis was one of the pituitary metastases. Treatment of diabetes insipidus (DI) with replacement antidiuretic hormone (ADH) was complicated by extreme difficulties in achieving a satisfactory sodium and water balance. This was the result of coexistent DI and syndrome of inappropriate ADH secretion perpetuated by the patient's primary lung cancer, a phenomenon not previously described in the literature.

  13. Competing interests in a lung cancer with metastasis to the pituitary gland: syndrome of inappropriate ADH secretion versus diabetes insipidus.

    Science.gov (United States)

    Gulsin, Gaurav Singh; Jacobs, Madeleine Louisa Bryson; Gohil, Shailesh; Thomas, Adam; Levy, Miles

    2016-01-01

    Metastases to the pituitary gland are rare; cancers that most commonly metastasize to the pituitary are breast and lung cancers. No specific computed tomography or magnetic resonance imaging features reliably distinguish primary pituitary masses from metastases. A combination of a detailed clinical assessment together with specialist endocrine and neuroradiology support is essential to make the rare diagnosis of a pituitary metastasis. We present the case of a man with metastatic lung cancer, initially presenting as hypopituitarism. Subtle features in the history, together with neuroimaging findings atypical for pituitary adenomas, provided clues that the diagnosis was one of the pituitary metastases. Treatment of diabetes insipidus (DI) with replacement antidiuretic hormone (ADH) was complicated by extreme difficulties in achieving a satisfactory sodium and water balance. This was the result of coexistent DI and syndrome of inappropriate ADH secretion perpetuated by the patient's primary lung cancer, a phenomenon not previously described in the literature. PMID:27274855

  14. A novel point mutation in the translation initiation codon of the pre-pro-vasopressin-neurophysin II gene: Cosegregation with morphological abnormalities and clinical symptoms in autosomal dominant neurohypophyseal diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Rutishauser, J.; Boeni-Schnetzler, M.; Froesch, E.R.; Wichmann, W.; Huisman, T. [Univ. of Zuerich (Switzerland)] [and others

    1996-01-01

    Autosomal dominant neurohypophyseal diabetes insipidus (ADNDI) is a rare variant of idiopathic central diabetes insipidus. Several different mutations in the human vasopressin-neurophysin II (AVP-NP II) gene have been described. We studied nine family members from three generations of an ADNDI pedigree at the clinical, morphological, and molecular levels. AVP concentrations were measured during diagnostic fluid restriction tests. Coronal and sagittal high resolution T1-weighted images of the pituitary were obtained from affected and healthy family members. PCR was used to amplify the AVP-NP II precursor gene, and PCR products were directly sequenced. Under maximal osmotic stimulation, AVP serum levels were close to or below the detection limit in affected individuals. Magnetic resonance imaging studies revealed the characteristic hyperintense ({open_quotes}bright spot{close_quotes}) appearance of the posterior pituitary in two healthy family members. This signal was absent in all four ADNDI patients examined. The coding sequences of AVP and its carrier protein, neurophysin II, were normal in all family members examined. Affected individuals showed a novel single base deletion (G 227) in the translation initiation codon of the AVP-NP II signal peptide on one allele. The mutation in the AVP-NP II leader sequence appears to be responsible for the disease in this kindred, possibly by interfering with protein translocation. The absence of the hyperintense posterior pituitary signal in affected individuals could reflect deficient posterior pituitary function. 56 refs., 4 figs., 3 tabs.

  15. On the Treatment of 20 Cases of Children With Diabetes Insipidus%浅谈20例小儿尿崩症的治疗

    Institute of Scientific and Technical Information of China (English)

    张玉芹

    2015-01-01

    目的:对小儿尿崩症及其治疗方法进行探讨。方法随机选取我院2014年1月~2014年12月间收治的经临床确诊为患有小儿尿崩症的患儿26例进行探讨分析。结果经过临床治疗,26例患儿均可痊愈。结论小儿尿崩症经过治疗,可以取得明显有效的治疗效果,临床上常采取因病治疗与药物治疗等方法。%Objective Its treatment of diabetes insipidus in children are discussed. Methods Our hospital between January 2014 to December 2014 were treated with clinically diagnosed 26 cases of pediatric diabetes insipidus in children explore analysis. Results After clinical treatment, 26 cases of children can be cured. Conclusion Pediatric diabetes insipidus after treatment, can achieve signiifcant and effective treatment, often take treatment of illness and drug treatment methods in clinical practice.

  16. Genetic forms of nephrogenic diabetes insipidus (NDI): Vasopressin receptor defect (X-linked) and aquaporin defect (autosomal recessive and dominant).

    Science.gov (United States)

    Bichet, Daniel G; Bockenhauer, Detlef

    2016-03-01

    Nephrogenic diabetes insipidus (NDI), 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 vasopressin (AVP). Polyuria with hyposthenuria and polydipsia are the cardinal clinical manifestations of the disease. About 90% of patients with congenital NDI are males with X-linked NDI who have mutations in the vasopressin V2 receptor (AVPR2) gene encoding the vasopressin V2 receptor. In less than 10% of the families studied, congenital NDI has an autosomal recessive or autosomal dominant mode of inheritance with mutations in the aquaporin-2 (AQP2) gene. When studied in vitro, most AVPR2 and AQP2 mutations lead to proteins trapped in the endoplasmic reticulum and are unable to reach the plasma membrane. Prior knowledge of AVPR2 or AQP2 mutations in NDI families and perinatal mutation testing is of direct clinical value and can avert the physical and mental retardation associated with repeated episodes of dehydration.

  17. Identification of Potential Pharmacoperones Capable of Rescuing the Functionality of Misfolded Vasopressin 2 Receptor Involved in Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Smith, Emery; Janovick, Jo Ann; Bannister, Thomas D; Shumate, Justin; Scampavia, Louis; Conn, P Michael; Spicer, Timothy P

    2016-09-01

    Pharmacoperones correct the folding of otherwise misfolded protein mutants, restoring function (i.e., providing "rescue") by correcting their trafficking. Currently, most pharmacoperones possess intrinsic antagonist activity because they were identified using methods initially aimed at discovering such functions. Here, we describe an ultra-high-throughput homogeneous cell-based assay with a cAMP detection system, a method specifically designed to identify pharmacoperones of the vasopressin type 2 receptor (V2R), a GPCR that, when mutated, is associated with nephrogenic diabetes insipidus. Previously developed methods to identify compounds capable of altering cellular trafficking of V2R were modified and used to screen a 645,000 compound collection by measuring the ability of library compounds to rescue a mutant hV2R [L83Q], using a cell-based luminescent detection system. The campaign initially identified 3734 positive modulators of cAMP. The confirmation and counterscreen identified only 147 of the active compounds with an EC50 of ≤5 µM. Of these, 83 were reconfirmed as active through independently obtained pure samples and were also inactive in a relevant counterscreen. Active and tractable compounds within this set can be categorized into three predominant structural clusters, described here, in the first report detailing the results of a large-scale pharmacoperone high-throughput screening campaign. PMID:27280550

  18. X-ray structure of human aquaporin 2 and its implications for nephrogenic diabetes insipidus and trafficking.

    Science.gov (United States)

    Frick, Anna; Eriksson, Urszula Kosinska; de Mattia, Fabrizio; Oberg, Fredrik; Hedfalk, Kristina; Neutze, Richard; de Grip, Willem J; Deen, Peter M T; Törnroth-Horsefield, Susanna

    2014-04-29

    Human aquaporin 2 (AQP2) is a water channel found in the kidney collecting duct, where it plays a key role in concentrating urine. Water reabsorption is regulated by AQP2 trafficking between intracellular storage vesicles and the apical membrane. This process is tightly controlled by the pituitary hormone arginine vasopressin and defective trafficking results in nephrogenic diabetes insipidus (NDI). Here we present the X-ray structure of human AQP2 at 2.75 Å resolution. The C terminus of AQP2 displays multiple conformations with the C-terminal α-helix of one protomer interacting with the cytoplasmic surface of a symmetry-related AQP2 molecule, suggesting potential protein-protein interactions involved in cellular sorting of AQP2. Two Cd(2+)-ion binding sites are observed within the AQP2 tetramer, inducing a rearrangement of loop D, which facilitates this interaction. The locations of several NDI-causing mutations can be observed in the AQP2 structure, primarily situated within transmembrane domains and the majority of which cause misfolding and ER retention. These observations provide a framework for understanding why mutations in AQP2 cause NDI as well as structural insights into AQP2 interactions that may govern its trafficking.

  19. P2Y12 Receptor Localizes in the Renal Collecting Duct and Its Blockade Augments Arginine Vasopressin Action and Alleviates Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Zhang, Yue; Peti-Peterdi, Janos; Müller, Christa E; Carlson, Noel G; Baqi, Younis; Strasburg, David L; Heiney, Kristina M; Villanueva, Karie; Kohan, Donald E; Kishore, Bellamkonda K

    2015-12-01

    P2Y12 receptor (P2Y12-R) signaling is mediated through Gi, ultimately reducing cellular cAMP levels. Because cAMP is a central modulator of arginine vasopressin (AVP)-induced water transport in the renal collecting duct (CD), we hypothesized that if expressed in the CD, P2Y12-R may play a role in renal handling of water in health and in nephrogenic diabetes insipidus. We found P2Y12-R mRNA expression in rat kidney, and immunolocalized its protein and aquaporin-2 (AQP2) in CD principal cells. Administration of clopidogrel bisulfate, an irreversible inhibitor of P2Y12-R, significantly increased urine concentration and AQP2 protein in the kidneys of Sprague-Dawley rats. Notably, clopidogrel did not alter urine concentration in Brattleboro rats that lack AVP. Clopidogrel administration also significantly ameliorated lithium-induced polyuria, improved urine concentrating ability and AQP2 protein abundance, and reversed the lithium-induced increase in free-water excretion, without decreasing blood or kidney tissue lithium levels. Clopidogrel administration also augmented the lithium-induced increase in urinary AVP excretion and suppressed the lithium-induced increase in urinary nitrates/nitrites (nitric oxide production) and 8-isoprostane (oxidative stress). Furthermore, selective blockade of P2Y12-R by the reversible antagonist PSB-0739 in primary cultures of rat inner medullary CD cells potentiated the expression of AQP2 and AQP3 mRNA, and cAMP production induced by dDAVP (desmopressin). In conclusion, pharmacologic blockade of renal P2Y12-R increases urinary concentrating ability by augmenting the effect of AVP on the kidney and ameliorates lithium-induced NDI by potentiating the action of AVP on the CD. This strategy may offer a novel and effective therapy for lithium-induced NDI.

  20. P2Y12 Receptor Localizes in the Renal Collecting Duct and Its Blockade Augments Arginine Vasopressin Action and Alleviates Nephrogenic Diabetes Insipidus.

    Science.gov (United States)

    Zhang, Yue; Peti-Peterdi, Janos; Müller, Christa E; Carlson, Noel G; Baqi, Younis; Strasburg, David L; Heiney, Kristina M; Villanueva, Karie; Kohan, Donald E; Kishore, Bellamkonda K

    2015-12-01

    P2Y12 receptor (P2Y12-R) signaling is mediated through Gi, ultimately reducing cellular cAMP levels. Because cAMP is a central modulator of arginine vasopressin (AVP)-induced water transport in the renal collecting duct (CD), we hypothesized that if expressed in the CD, P2Y12-R may play a role in renal handling of water in health and in nephrogenic diabetes insipidus. We found P2Y12-R mRNA expression in rat kidney, and immunolocalized its protein and aquaporin-2 (AQP2) in CD principal cells. Administration of clopidogrel bisulfate, an irreversible inhibitor of P2Y12-R, significantly increased urine concentration and AQP2 protein in the kidneys of Sprague-Dawley rats. Notably, clopidogrel did not alter urine concentration in Brattleboro rats that lack AVP. Clopidogrel administration also significantly ameliorated lithium-induced polyuria, improved urine concentrating ability and AQP2 protein abundance, and reversed the lithium-induced increase in free-water excretion, without decreasing blood or kidney tissue lithium levels. Clopidogrel administration also augmented the lithium-induced increase in urinary AVP excretion and suppressed the lithium-induced increase in urinary nitrates/nitrites (nitric oxide production) and 8-isoprostane (oxidative stress). Furthermore, selective blockade of P2Y12-R by the reversible antagonist PSB-0739 in primary cultures of rat inner medullary CD cells potentiated the expression of AQP2 and AQP3 mRNA, and cAMP production induced by dDAVP (desmopressin). In conclusion, pharmacologic blockade of renal P2Y12-R increases urinary concentrating ability by augmenting the effect of AVP on the kidney and ameliorates lithium-induced NDI by potentiating the action of AVP on the CD. This strategy may offer a novel and effective therapy for lithium-induced NDI. PMID:25855780

  1. Binding-, intracellular transport-, and biosynthesis-defective mutants of vasopressin type 2 receptor in patients with X-linked nephrogenic diabetes insipidus.

    OpenAIRE

    Tsukaguchi, H; Matsubara, H.; Taketani, S; Mori, Y.; Seido, T; Inada, M

    1995-01-01

    Nephrogenic diabetes insipidus (NDI) is most often an X-linked disorder in which urine is not concentrated due to renal resistance to arginine vasopressin. We recently identified four vasopressin type 2 receptor gene mutations in unrelated X-linked NDI families, including R143P, delta V278, R202C, and 804insG. All these mutations reduced ligand binding activity to < 10% of the normal without affecting mRNA accumulation. To elucidate whether the receptors are expressed on the cell surface, we ...

  2. A novel mutation affecting the arginine-137 residue of AVPR2 in dizygous twins leads to nephrogenic diabetes insipidus and attenuated urine exosome aquaporin-2

    DEFF Research Database (Denmark)

    Hinrichs, Gitte R; Hansen, Louise H; Nielsen, Maria R;

    2016-01-01

    Mutations in the vasopressin V2 receptor gene AVPR2 may cause X-linked nephrogenic diabetes insipidus by defective apical insertion of aquaporin-2 in the renal collecting duct principal cell. Substitution mutations with exchange of arginine at codon 137 can cause nephrogenic syndrome of inappropr...... administration. While a similar urine exosome release rate was shown between probands and controls by western blotting for the marker ALIX, there was a selective decrease in exosome aquaporin-2 versus aquaporin-1 protein in probands compared to controls....

  3. Diabetes insípida adípsica en un operado de craneofaringioma Adipsic diabetes insipidus after surgery for craniopharyngioma

    Directory of Open Access Journals (Sweden)

    A Insúa

    2011-03-01

    Full Text Available La variada clínica de la enfermedad hipotalámica (convulsiones, hidrocefalia, hipopituitarismo, alteraciones del apetito, el sueño y la temperatura corporal incluye también los desórdenes regulatorios de la tonicidad y el volumen del líquido extracelular, debidos a la disrupción de la secreción de ADH (hormona antidiurética, vasopresina y/o del mecanismo de la sed. Se presenta un caso de un paciente operado de un craneofaringioma, que desarrolló diabetes insípida adípsica, que ilustra la alteración conjunta de los mecanismos regulatorios del balance hídrico. Los autores declaran no poseer conflictos de interés.The varied manifestations of hypothalamic disease (seizures, hydrocephalus, hypopytuitarism, altered appetite, sleep and body temperature regulation also include plasma tonicity and extracellular volume regulation disorders, due to the disruption of ADH (antidiuretic hormone, vasopressin secretion and/ or thirst mechanisms. We report the case of a patient operated on craniopharyngioma, who developed adipsic diabetes insipidus which illustrates the combined alterations of the mechanisms regulating water balance. No financial conflicts of interest exist.

  4. Characterization of an aquaporin-2 water channel gene mutation causing partial nephrogenic diabetes insipidus in a Mexican family: evidence of increased frequency of the mutation in the town of origin.

    NARCIS (Netherlands)

    Boccalandro, C.; Mattia, F.P. de; Guo, D.C.; Xue, L.; Orlander, P.; King, T.M.; Gupta, P.; Deen, P.M.T.; Lavis, V.R.; Milewicz, D.M.

    2004-01-01

    A Mexican family with partial congenital nephrogenic diabetes insipidus (NDI) that resulted from a mutation in the aquaporin-2 water channel (AQP2) was characterized, and the source of this rare mutation was traced to the family's town of origin in Mexico. Affected individuals with profound polyuria

  5. Diffuse malignant lymphoma type B with optic chiasm infiltration, visual disturbances, hypopituitarism, hyperprolactinaemia and diabetes insipidus. Case report and literature review

    International Nuclear Information System (INIS)

    The case is reported of a 55-year-old man with diffuse malignant lymphoma type B associated with transient optic chiasm infiltration and visual disturbances but with persistent hypopituitarism, hyperprolactinaemia and diabetes insipidus. The patient was administered chemotherapy and radiotherapy. Repeated MR and CT scans showed optic chiasm infiltration, which disappeared in the course of the chemotherapy but then recurred, changed its appearance and finally disappeared again. In the meantime visual disturbances occurred and disappeared during the therapy. Hypopituitarism, diabetes insipidus and hyperprolactinaemia were diagnosed and replacement therapy was administered. Later on abdominal pain occurred, and a CT scan revealed bilateral kidney masses and enlarged retroperitoneal lymph nodes. These were diffuse malignant lymphoma with regional lymphonodulitis in histology. Finally, hydrothorax and hydroretroperitoneum were diagnosed. The patient died as a result of systemic complications of the disease. The length of survival time documented following the hypothalamochiasmatic infiltration and diagnosis of lymphoma makes the case an unusual one for patients with CNS lymphoma. Hormonal disturbances accompanying the suprasellar region infiltration are very important from the practical point of view. (author)

  6. Three families with autosomal dominant nephrogenic diabetes insipidus caused by aquaporin-2 mutations in the C-terminus.

    Science.gov (United States)

    Kuwahara, M; Iwai, K; Ooeda, T; Igarashi, T; Ogawa, E; Katsushima, Y; Shinbo, I; Uchida, S; Terada, Y; Arthus, M F; Lonergan, M; Fujiwara, T M; Bichet, D G; Marumo, F; Sasaki, S

    2001-10-01

    The vasopressin-regulated water channel aquaporin-2 (AQP2) is known to tetramerize in the apical membrane of the renal tubular cells and contributes to urine concentration. We identified three novel mutations, each in a single allele of exon 4 of the AQP2 gene, in three families showing autosomal dominant nephrogenic diabetes insipidus (NDI). These mutations were found in the C-terminus of AQP2: a deletion of G at nucleotide 721 (721 delG), a deletion of 10 nucleotides starting at nucleotide 763 (763-772del), and a deletion of 7 nucleotides starting at nucleotide 812 (812-818del). The wild-type AQP2 is predicted to be a 271-amino acid protein, whereas these mutant genes are predicted to encode proteins that are 330-333 amino acids in length, because of the frameshift mutations. Interestingly, these three mutant AQP2s shared the same C-terminal tail of 61 amino acids. In Xenopus oocytes injected with mutant AQP2 cRNAs, the osmotic water permeability (Pf) was much smaller than that of oocytes with the AQP2 wild-type (14%-17%). Immunoblot analysis of the lysates of the oocytes expressing the mutant AQP2s detected a band at 34 kD, whereas the immunoblot of the plasma-membrane fractions of the oocytes and immunocytochemistry failed to show a significant surface expression, suggesting a defect in trafficking of these mutant proteins. Furthermore, coinjection of wild-type cRNAs with mutant cRNAs markedly decreased the oocyte Pf in parallel with the surface expression of the wild-type AQP2. Immunoprecipitation with antibodies against wild-type and mutant AQP2 indicated the formation of mixed oligomers composed of wild-type and mutant AQP2 monomers. Our results suggest that the trafficking of mutant AQP2 is impaired because of elongation of the C-terminal tail, and the dominant-negative effect is attributed to oligomerization of the wild-type and mutant AQP2s. Segregation of the mutations in the C-terminus of AQP2 with dominant-type NDI underlies the importance of this

  7. Congenital nephrogenic diabetes insipidus: what can we learn from mouse models?

    NARCIS (Netherlands)

    Boone, M.; Deen, P.M.T.

    2009-01-01

    Aquaporins (AQPs) are central players in mammalian physiology, allowing efficient water transport through cellular membranes. To date, 13 different aquaporins have been identified in mammals (AQP0-AQP12). Knocking out genes in mice and identification of mutations in the human genes provided importan

  8. Acute presentation of gestational diabetes insipidus with pre-eclampsia complicated by cerebral vasoconstriction: a case report and review of the published work.

    Science.gov (United States)

    Mor, Amir; Fuchs, Yael; Zafra, Kathleen; Haberman, Shoshana; Tal, Reshef

    2015-08-01

    Gestational diabetes insipidus (GDI) is a rare, self-limited complication of pregnancy. As it is related to excess placental vasopressinase enzyme activity, which is metabolized in the liver, GDI is more common in pregnancies complicated by conditions associated with liver dysfunction. We present a case of a 41-year-old woman at 38 weeks' gestation who presented with pre-eclampsia with severe features, including impaired liver function and renal insufficiency. Following cesarean section she was diagnosed with GDI, which was further complicated by cerebral vasoconstriction as demonstrated by magnetic resonance angiography. This case raises the possibility that cerebral vasoconstriction may be related to the cause of GDI. A high index of suspicion of GDI should be maintained in patients who present with typical signs and symptoms, especially in the setting of pregnancy complications associated with liver dysfunction.

  9. Case report of severe Cushing’s syndrome in medullary thyroid cancer complicated by functional diabetes insipidus, aortic dissection, jejunal intussusception, and paraneoplastic dysautonomia: remission with sorafenib without reduction in cortisol concentration

    OpenAIRE

    Hammami, Muhammad M.; Duaiji, Najla; Mutairi, Ghazi; Aklabi, Sabah; Qattan, Nasser; Abouzied, Mohei El-Din M.; Sous, Mohamed W.

    2015-01-01

    Background Normalization of cortisol concentration by multikinase inhibitors have been reported in three patients with medullary thyroid cancer-related Cushing’s syndrome. Aortic dissection has been reported in three patients with Cushing’s syndrome. Diabetes insipidus without intrasellar metastasis, intestinal intussusception, and paraneoplastic dysautonomia have not been reported in medullary thyroid cancer. Case presentation An adult male with metastatic medullary thyroid cancer presented ...

  10. Long-term replacement of a mutated nonfunctional CNS gene: reversal of hypothalamic diabetes insipidus using an EIAV-based lentiviral vector expressing arginine vasopressin.

    Science.gov (United States)

    Bienemann, Alison S; Martin-Rendon, Enca; Cosgrave, Anna S; Glover, Colin P J; Wong, Liang-Fong; Kingsman, Susan M; Mitrophanous, Kyriacos A; Mazarakis, Nicholas D; Uney, James B

    2003-05-01

    Due to the complexity of brain function and the difficulty in monitoring alterations in neuronal gene expression, the potential of lentiviral gene therapy vectors to treat disorders of the CNS has been difficult to fully assess. In this study, we have assessed the utility of a third-generation equine infectious anemia virus (EIAV) in the Brattleboro rat model of diabetes insipidus, in which a mutation in the arginine vasopressin (AVP) gene results in the production of nonfunctional mutant AVP precursor protein. Importantly, by using this model it is possible to monitor the success of the gene therapy treatment by noninvasive assays. Injection of an EIAV-CMV-AVP vector into the supraoptic nuclei of the hypothalamus resulted in expression of functional AVP peptide in magnocellular neurons. This was accompanied by a 100% recovery in water homeostasis as assessed by daily water intake, urine production, and urine osmolality lasting for a 1-year measurement period. These data show that a single gene defect leading to a neurological disorder can be corrected with a lentiviral-based strategy. This study highlights the potential of using viral gene therapy for the long-term treatment of disorders of the CNS. PMID:12718901

  11. Identification of 13 new mutations in the vasopressin-neurophysin II gene in 17 kindreds with familial autosomal dominant neurohypophyseal diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Rittig, S.; Siggaard, C.; Pedersen, E.B. [Aahus Univ. Hospital and Faculty of Health Sciences (Denmark)] [and others

    1996-01-01

    Familial neurohypophyseal diabetes insipidus (FNDI) is an autosomal dominant disorder characterized by progressive postnatal deficiency of arginine vasopressin as a result of mutation in the gene that encodes the hormone. To determine the extent of mutations in the coding region that produce the phenotype, we studied members of 17 unrelated kindreds with the disorder. We sequenced all 3 exons of the gene by using a rapid, direct dye-terminator method and found the causative mutation in each kindred. In four kindreds, the mutations were each identical to mutations described in other affected families. In the other 13 kindreds each mutation was unique. There were two missense mutations that altered the cleavage region of the signal peptide, seven missense mutations in exon 2, which codes for the conserved portion of the protein, one nonsense mutation in exon 2, and three nonsense mutations in exon 3. These findings, together with the clinical features of FNDI, suggest that each of the mutations exerts an effect by directing the production of a pre-prohormone that cannot be folded, processed, or degraded properly and eventually destroys vasopressinergic neurons. 63 refs., 5 figs., 6 tabs.

  12. A case of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA)-associated hypertrophic pachymeningitis presenting with multiple cranial nerve palsies and diabetes insipidus.

    Science.gov (United States)

    Yasuda, Ken; Sainouchi, Makoto; Goto, Masahiro; Murase, Nagako; Ohtani, Ryo; Nakamura, Michikazu

    2016-05-31

    A 61-year-old woman developed hearing difficulties and became thirsty after experiencing cold symptoms. A neurological examination revealed a loss of odor sensation, facial palsy, dysphasia, and dysarthria. Vocal cord palsy was observed during pharyngoscopy. Brain magnetic resonance imaging (MRI) showed a thickened pituitary stalk and swelling of the pituitary gland, but no high signal intensity regions were seen in the posterior portion of the pituitary gland. Gadolinium-enhanced MRI demonstrated a thickened dura mater over the anterior cranial fossa. A biopsy specimen of the thickened dura mater showed fibrosis, granulomatous inflammation, and necrotic foci. Blood tests detected myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). The patient's urine osmolarity was low even though she exhibited hypernatremia. We diagnosed her with hypertrophic pachymeningitis associated with MPO-ANCA and diabetes insipidus. The patient received two courses of 5-day high-dose intravenous methylprednisolone (1.0 g/day), and was subsequently administered oral prednisolone, which gradually relieved her symptoms. However, the patient's symptoms recurred despite the high-dose prednisolone treatment. It was difficult to control the patient's symptoms in this case with oral prednisolone monotherapy, but combined treatment with cyclosporine resulted in sustained remission. It is considered that patients with MPO-ANCA-positive hypertrophic pachymeningitis require combination therapy with prednisolone and immunosuppressive agents at an early stage. PMID:27098904

  13. Challenges in management of patients with intracranial germ cell tumor and diabetes insipidus treated with cisplatin and/or ifosfamide based chemotherapy.

    Science.gov (United States)

    Afzal, Samina; Wherrett, Diane; Bartels, Ute; Tabori, Uri; Huang, Annie; Stephens, Derek; Bouffet, Eric

    2010-05-01

    Patients with intracranial germ cell tumor (IGCT) often present with pituitary dysfunction, including diabetes insipidus (DI). Recent protocols have used pre-radiation chemotherapy with combinations of etoposide, carboplatin and/or cisplatin, and ifosfamide. Management of DI in these patients requires monitoring of electrolytes and fluids during chemotherapy and hyperhydration. All consecutive patients treated with chemotherapy for an IGCT during the period 1990-2007 at the Hospital for Sick Children, Toronto were reviewed. Out of 32 patients who received chemotherapy, 21 had DI. Only cycles containing cisplatin and/or ifosfamide and hyperhydration were considered. DI and non-DI patients were compared for each cycle of chemotherapy. Patients were studied for number of days in hospital per chemotherapy course, daily fluid input and output, changes in dose, schedule and route of administration of desmopressin (DDAVP) during chemotherapy, daily variations in sodium level, electrolyte monitoring requirements per day, and complications related to fluid and electrolyte disturbances. Fifty-four cycles of chemotherapy in DI patients were compared to 25 cycles in non DI patients. All 21 patients with DI required daily change in dosage and schedule of DDAVP. Marked variations in daily sodium level were observed in the DI group. Seventeen courses required prolonged admission in the DI group (one in non DI patients) and 6 patients experienced serious complications. In conclusion, DI is a risk factor for complications when cisplatin and/or ifosfamide based protocols are used. The role of these agents in the management of ICGT should be carefully evaluated and guidelines for management of DI established. PMID:19820898

  14. Identification of eight new mutations in familial neurogenic diabetes insipidus supports the concept that defective folding of the mutant provasopressin-neurophysin causes the disease

    Energy Technology Data Exchange (ETDEWEB)

    Rittig, S.; Siggaard, C.; Pedersen, E.B. [University Hospital in Aarhus (Denmark)] [and others

    1994-09-01

    Familial neurogenic diabetes insipidus (FNDI) is an autosomal dominant disorder with a uniform phenotype characterized by polyuria, polydipsia and a severe deficiency of arginine vasopressin (AVP). These abnormalities develop postnatally and appear to be due to progressive degeneration of AVP producing neurons. Previous studies in 8 FNDI kindreds have identified 5 different mutations in the gene that codes for the AVP-neurophysin (NP) precursor, AVP-NP. Four kindreds had the same missense mutation in the part of exon 1 that codes for the C-terminal amino acid of the signal peptide (SP). The other 4 had different missense mutations or a codon deletion in exon 2 which codes for the highly conserved part of NP. In the present study, the AVP-NP genes from 8 other kindreds with FNDI were sequenced bidirectionally using sequence and single-stranded DNA amplified by PCR with biotinylated primers flanking each of the 3 exons. We find that each of the 8 kindreds has a different, previously unreported mutation in either the SP coding part of exon 1, in exon 2 or in the variable, NP-coding part of exon 3. Combining these 8 new mutations with the 5 described previously reveals a distribution pattern that corresponds closely to the domains involved in the mutually interactive processes of AVP binding, folding and dimerization of NP. Based on these findings and the clinical features of FNDI, we postulate that the precursors produced by the mutant alleles are cytotoxic because they do not fold or dimerize properly for subsequent packaging and processing.

  15. A case of a novel mutant vasopressin receptor-dependent nephrogenic diabetes insipidus with bilateral non-obstructive hydronephrosis in a middle aged man: differentiation from aquaporin-dependent nephrogenic diabetes insipidus by response of factor VII and von Willebrand factor to 1-diamino-8-arginine vasopressin administration.

    Science.gov (United States)

    Miyakoshi, Masashi; Kamoi, Kyuzi; Uchida, Shinichi; Sasaki, Sei

    2003-12-01

    We describe a case of a novel mutant vasopressin 2 receptor (V2R)-dependent nephrogenic diabetes insipidus (NDI) with bilateral non-obstructive hydronephrosis in a middle aged man. This could be distinguished from aquaporin 2 (AQP2)-dependent NDI by the response of factor VIII and von Willebrand factor (vWF) to 1-deamino-8-D-arginine vasopressin (DDAVP) administration. A 47-year-old man was admitted to hospital because of polyuria, which had been present from infancy and was suspected of causing non-obstructive hydronephrosis. His mother's father, the older brother of his mother and his second daughter also all had polyuria. Sodium concentration, osmolality and vasopressin in blood were high, while sodium concentration and osmolality in urine were low. There were no changes in urine osmolality, factor VIII and vWF in response to DDAVP infusion. Neither was heart rate, diastolic blood pressure nor facial flushing affected. These findings suggested this case was V2R-dependent NDI rather than AQP2-dependent NDI. Molecular genetic analysis demonstrated that the patient had a V2R missense mutation involving a substitution of cysteine for arginine at position 104 (R104C) located in the first extracellular loop of the V2R. It was also found that the patient's mother and his second daughter were heterozygous for this R104C mutation. PMID:14709855

  16. Diabetes insipidus-rarely symptom of renal failure on multiple organs failure%多器官功能衰竭中肾衰的少见症—尿崩

    Institute of Scientific and Technical Information of China (English)

    宋嘉振; 胡玲

    2001-01-01

    目的 报道因多器官功能衰竭(MOF)产生尿崩症状的病例。方法 MOF14例,在病因治疗和程序化脏器支持的同时,监测其尿量、血、尿晶体渗透量、血电解质、血气分析等指标,观察使用垂体后叶素前、后的变化。结果 2例治愈,12例死亡。病程第2~9d出现尿崩症状,持续时间为43±22h(±s,n=14),高峰尿量9753±2461ml/d(±s,n=14),并有排出等渗尿、血电解质浓度升高、酸血症等变化。垂体后叶素静滴(1U/h)后,3例尿量减少,8例2~4h尿量减少,3例无效。结论 MOF病人产生尿崩是肾浓缩功能衰竭的结果。%Objective To report diabetes insipidus cases caused by multipleorgans failure(MOF).Methods 14 cases suffered from MOF,etiological treatment and programmatic organ supporting were performed.Urine volume,crystal osmotic pressure of blood and urine,free water clean rate,blood electrolyte,blood gas analysis etc.were monitored.Their changes before and after pituitrin infusion were observed.Results 2 cases were cured,12 cases died.Diabetes insipidus was appeared from 2ed to 9th day of course and its time was maintained on 43±22 hours (±s,n=14),peak urine volume was reached 9 753±2 461 ml/d(±s,n=14).At same time,isotonic urine discharged,electrolytic concentration of blood rised and acidemia happened could be seen.When pituitrin was infused by 1U/h dosage,urine volume decreased in 3 cases,8 cases decreased in short time(2~4 h)and 3 cases were no reaction.Conclusions Diabetes insipidus caused by MOF was the result of renal concentrative function failure.

  17. 一中国人家系常染色体显性遗传垂体性尿崩症基因突变研究%Mutation of autosomal dominant neurohypophyseal diabetes insipidus in a Chinese pedigree

    Institute of Scientific and Technical Information of China (English)

    陈育才; 谢文煌; 王柠; 慕容慎行; 黄妙辉; 黄梅芳

    2001-01-01

    Objective To elucidate the molecular mechanism of autosomal dominant neurohypophyseal diabetes insipidus (ADNDI) in Chinese. Methods A Chinese family with ADNDI was studied. Polymerase chain reaction-single strand conformation polymorphisms (PCR-SSCP) of exon 1 and exon 2 of arginine vasopressin neurophysin Ⅱ (AVP-NPII) gene were performed in 4 patients and 4 normal phenotypic members of the pedigree and 1 patient from other family. Direct DNA sequencing of PCR-amplified geomic DNA in exon 2 are carried out. Results In exon 1, the affected patients and unaffected people in same kindred and a nonfamilial insipidus from other family had the same strand in SSCP analysis. But there were differences in SSCP analysis from exon 2 as follows: besides having the same strand as healthy man in same kindred or a nonfamilial affected patient, SSCP analysis showed that affected patients from ADNDI had two new different strands. The results were confirmed by direct DNA sequencing of PCR-amplified geomic DNA. A 3-base pair deletion (GAG) out of two consecutive GAG sequence (nucleotides 1826-1831) was identified in affected individual with ADNDI. This mutation should yield an abnormal AVP precursor lacking Glu47 in its neurophysin-Ⅱ moeity. Since Glu47 is essential for NP molecules to form a salt bridge with AVP, the function of NP as a carrier proetin for AVP would be impaired which leads to acceleration proteolytic degradation. Conclusion The nucleotides deletion in the coding region for neurophysin Ⅱ gene appears to be one of the causes of autosomal dominant neurohypophyseal diabetes insipidus in Chinese.%目的 探讨中国人的常染色体显性遗传垂体性尿崩症(ADNDI)的分子发病机制。方法 对一个家系中4例ADNDI患者、4例未发病者及1例来自其他家庭的患者的精氨酸加压素-运载蛋白Ⅱ(AVP-NPⅡ)基因外显子1和2进行聚合酶链反应-单链构像多态性(PCR-SSCP)分析及基因测序研究。结果 SSCP分

  18. A de Novo mutation in the coding sequence for neurophysin-II (Pro{sup 24} {yields} Leu) is associated with onset and transmission of autosomal dominant neurohypophyseal diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Repaske, D.R.; Browning, J.E. [Children`s Hospital Medical Center, Cincinnati, OH (United States)

    1994-08-01

    The molecular basis of autosomal dominant neurohypophyseal diabetes insipidus, a hereditary deficiency of vasopressin, was determined by nucleotide sequence analysis of the arginine vasopressin-neurophysin-II gene. A C{yields}T mutation at nucleotide 1761 was detected in one allele of this gene in each affected individual in three generations of one family. This mutant gene encodes a normal arginine vasopressin peptide, but predicts a substitution of leucine for proline at amino acid 24 of neurophysin-II, the arginine vasopressin carrier protein. This mutation was not detected in 50 control individuals, thus demonstrating that it is not a common silent genetic polymorphism. The disease arose in the second generation of the studied family, and the chromosome 20 carrying this new mutation was identified by polymorphic CA microsatellite haplotype analysis. The first affected individual inherited this chromosome segment from her mother, who had neither the disease nor this mutation in her somatic cell DNA. Third generation individuals who subsequently inherited this mutation were affected. These data demonstrate that this amino acid substitution in neurophysin-II causes this disease. Two possibilities to explain the mechanism by which clinical deficiency of arginine vasopressin develops even in the presence of one normal arginine vasopressin-neurophysin-II allele are discussed. 40 refs., 4 figs., 2 tabs.

  19. 继发于肾源性尿崩症的巨输尿管-巨膀胱综合征(附一例报告并文献复习)%Megaureter-megacystis syndrome secondary to congenital nephrogenic diabets insipidus (a case report and literature review)

    Institute of Scientific and Technical Information of China (English)

    张小东; 朱积川; 姜辉; 王晓峰; 洪铠; 侯树坤

    2001-01-01

    Objective To study the clinical features and the urologicalcomplications of congenital diabetes insipidus. Methods A case of congenital diabetse insipidus was presented with review of the li-terature.The urodynamics and the isotopic renal dynamic imaging of the patient were studied. Results The patient had megahydronephrosis,megaureter and megacystis with very low specific gravity of the urine (1.000) yet with normal blood chemistry,normal blood electrolytes and with no urinary tract outflow obstruction.The urine volume could be decreased by medication. Conclusions Early diagnosis of congenital diabetes insipidus and the prevention of urological complications are important.Automatic urinary tract rupture secondary to congenital diabetes insipidus is rarely seen.%目的 探讨肾源性尿崩症所致巨输尿管-巨膀胱综合征的临床特点及诊治措施。 方法 分析1999年12月收治的1例病历资料,结合文献复习讨论。 结果 病人为重度尿路积水,血生化、血电解质正常,尿比重1.000。尿动力学检查和肾动态显影未见尿路梗阻表现。利钠利尿剂等药物有助于减少患者尿量。治疗后随访6个月,患者尿量5000~6000ml。B超复查肾盂积水较治疗前有所减轻,膀胱剩余尿量明显减少。 结论 肾源性尿崩症导致巨输尿管-巨膀胱综合征合并尿路破裂者罕见,药物治疗可明显减少尿量,减轻和阻止尿路积水的发生。临床早期诊断采取防治措施十分重要。

  20. [Visual status in diabetic maculopathy after central photocoagulation].

    Science.gov (United States)

    Kieselbach, G; Juen, S

    1989-01-01

    Diabetic macular edema is shown to be treated successfully by central focal argon laser coagulation in most cases. Since February 1986, diabetic patients with macular edema were evaluated prospectively and treated by focal argon laser coagulation and/or grid pattern. A second group of diabetic patients with comparable macular edema and similar retinal changes was explored retrospectively. Visual acuity after treatment in relation to preoperative visual acuity was measured and statistically compared with visual acuity of the second group without laser treatment. The results show that laser treatment is important for stabilization of visual acuity but does not increase visual acuity beneath 0.2. Indications for treatment are discussed. PMID:2587022

  1. 关于股骨头坏死、骨髓炎、脑垂体瘤、尿崩症的患者临床观察与宣教%Patients with Clinical Observation and Education on Avascular Necrosis of the Femoral Head, Osteomyelitis, Pituitary tumor, Diabetes insipidus

    Institute of Scientific and Technical Information of China (English)

    李娟

    2015-01-01

    Through the introduction of avascular necrosis of the femoral head, osteomyelitis, pituitary tumor and diabetes insipidus(DI)in patients with clinical observation process and the nursing operation technique, explains the related health care workers to guide the patients correctly understand the disease, establish the confidence to overcome the disease’s method.%通过介绍股骨头坏死、骨髓炎、脑垂体瘤和尿崩症(DI)患者的临床观察过程和护理操作技术,阐述了相关医护工作者指导患者正确认识疾病、树立战胜疾病信心的方法。

  2. Diabetes Insipidus%尿崩症

    Institute of Scientific and Technical Information of China (English)

    Peter H Baylis; 顾锋

    2002-01-01

    加压素是人体的一种抗利尿激素。它是下丘脑的视上核大细胞神经元合成的九肽激素。其基因定位于第20号染色体,编码一个大的前体蛋白,包括加压素及其神经运载蛋白。当大分子在神经元细胞中转运至垂体后叶的过程中,蛋白质被剪切后抗利尿激素与神经运载蛋白储存在垂体后叶,当血循环中的渗透压改变时,激素释放人血。

  3. Economic evaluation of a diabetes disease management programme with a central role for the diabetes nurse specialist

    NARCIS (Netherlands)

    Steuten, L.M.G.; Bruijsten, M.W.A.M.; Vrijhoef, H.J.M.

    2007-01-01

    Background: In the region of Maastricht, The Netherlands, a disease management programme (DMP) for patients with diabetes mellitus was implemented. The programme aims to improve quality of care within existing budgets. To achieve this, diabetes nurse specialists (DNSs) were given a central role with

  4. Disease: H00253 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00253 Neurohypophyseal diabetes insipidus (NPDI); Central Diabetes Insipidus Centr...D:16713494 Christensen JH, Rittig S Familial neurohypophyseal diabetes insipidus--an update. Semin Nephrol 2...6:209-23 (2006) PMID:12874957 Christensen JH, Siggaard C, Rittig S Autosomal dominant familial neurohypophyseal diabetes insipidus. APMIS Suppl 92-5 (2003) ...

  5. Association of hepatitis C virus infection and diabetes in central Tunisia

    Institute of Scientific and Technical Information of China (English)

    Naoufel Kaabia; Elhem Ben Jazia; Ines Slim; Imen Fodha; Wissem Hachfi; Rafika Gaha; Mabrouk Khalifa; Aoutef Hadj Kilani; Halim Trabelsi; Ahmed Abdelaziz; Fethi Bahri; Amel Letaief

    2009-01-01

    AIM:To investigate hepatitis C virus (HCV) seroprevalence in Tunisian patients with diabetes mellitus and in a control group.METHODS:A crosssectional study was conducted to determine the HCV seroprevalence in 1269 patients with diabetes (452 male,817 female) and 1315 non diabetic patients,attending health centers in Sousse,Tunisia.HCV screening was performed in both groups using a fourthgeneration enzyme immunoassay.RESULTS:In the diabetic group,17 (1.3%) were found to be HCVinfected compared with eight (0.6%) in the control group,although the difference was not significant (P=0.057).Quantitative PCR was performed in 20 patients.Eleven patients were positive and showed HCV genotype 1b in all cases.CONCLUSION:Frequency of HCV antibodies was low in patients with diabetes and in the control group in central Tunisia,with no significant difference between the groups.

  6. Targeting AGEs Signaling Ameliorates Central Nervous System Diabetic Complications in Rats

    Directory of Open Access Journals (Sweden)

    Mohamed Naguib Zakaria

    2015-01-01

    Full Text Available Diabetes is a chronic endocrine disorder associated with several complications as hypertension, advanced brain aging, and cognitive decline. Accumulation of advanced glycation end products (AGEs is an important mechanism that mediates diabetic complications. Upon binding to their receptor (RAGE, AGEs mediate oxidative stress and/or cause cross-linking with proteins in blood vessels and brain tissues. The current investigation was designed to investigate the effect of agents that decrease AGEs signaling, perindopril which increases soluble RAGE (sRAGE and alagebrium which cleaves AGEs cross-links, compared to the standard antidiabetic drug, gliclazide, on the vascular and central nervous system (CNS complications in STZ-induced (50 mg/kg, IP diabetes in rats. Perindopril ameliorated the elevation in blood pressure seen in diabetic animals. In addition, both perindopril and alagebrium significantly inhibited memory decline (performance in the Y-maze, neuronal degeneration (Fluoro-Jade staining, AGEs accumulation in serum and brain, and brain oxidative stress (level of reduced glutathione and activities of catalase and malondialdehyde. These results suggest that blockade of AGEs signaling after diabetes induction in rats is effective in reducing diabetic CNS complications.

  7. Targeting AGEs Signaling Ameliorates Central Nervous System Diabetic Complications in Rats.

    Science.gov (United States)

    Zakaria, Mohamed Naguib; El-Bassossy, Hany M; Barakat, Waleed

    2015-01-01

    Diabetes is a chronic endocrine disorder associated with several complications as hypertension, advanced brain aging, and cognitive decline. Accumulation of advanced glycation end products (AGEs) is an important mechanism that mediates diabetic complications. Upon binding to their receptor (RAGE), AGEs mediate oxidative stress and/or cause cross-linking with proteins in blood vessels and brain tissues. The current investigation was designed to investigate the effect of agents that decrease AGEs signaling, perindopril which increases soluble RAGE (sRAGE) and alagebrium which cleaves AGEs cross-links, compared to the standard antidiabetic drug, gliclazide, on the vascular and central nervous system (CNS) complications in STZ-induced (50 mg/kg, IP) diabetes in rats. Perindopril ameliorated the elevation in blood pressure seen in diabetic animals. In addition, both perindopril and alagebrium significantly inhibited memory decline (performance in the Y-maze), neuronal degeneration (Fluoro-Jade staining), AGEs accumulation in serum and brain, and brain oxidative stress (level of reduced glutathione and activities of catalase and malondialdehyde). These results suggest that blockade of AGEs signaling after diabetes induction in rats is effective in reducing diabetic CNS complications. PMID:26491434

  8. "It is not possible for me to have diabetes"-community perceptions on diabetes and its risk factors in Rural Purworejo District, Central Java, Indonesia.

    Science.gov (United States)

    Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

    2014-06-12

    Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as 'sugar' or 'sweet-pee' disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture's concepts of diseases and risk factors.

  9. The influence of diabetic peripheral neuropathy on local postural muscle and central sensory feedback balance control.

    Directory of Open Access Journals (Sweden)

    Nima Toosizadeh

    Full Text Available Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN. Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control and central-control (postural control using sensory cueing. DPN patients and healthy age-matched adults over 55 years performed two 15-second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2 and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/m2 with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P<0.01, which suggests a compromised local-control balance behavior in DPN patients. Unlike local-control, the rate of sway within central-control was 60% smaller in the DPN group (healthy central-controlslope-Log = 0.39±0.23, P<0.02, which suggests an adaptation mechanism to reduce the overall body sway in DPN patients. Interestingly, significant negative correlations were observed between central-control rate of sway with neuropathy severity (rPearson = 0.65-085, P<0.05 and the history of diabetes (rPearson = 0.58-071, P<0.05. Results suggest that in the lack of sensory feedback cueing, DPN participants were highly unstable compared to controls. However, as soon as they perceived the magnitude of sway using sensory feedback, they chose a high rigid postural control strategy, probably due to high concerns for fall, which may increase the energy cost during extended period of standing; the adaptation

  10. Central adiposity is significantly higher in female compared to male in Pakistani type 2 diabetes mellitus patients

    OpenAIRE

    Omer Akhter; Faraz Fiazuddin; Ayesha Shaheryar; Warda Niaz; Danial Siddiqui; Safia Awan; Nanik Ram; Jaweed Akhter

    2015-01-01

    Background: Type 2 diabetes mellitus (DM) rates are increasing rapidly in South Asians. Cardiovascular complications are more frequent and occur earlier in our patients than patients in many other ethnic groups. Reasons for this are not fully understood. Aims: The aim of this study is to evaluate the body total and central fat percentage in type 2 Diabetes Mellitus patients and to check correlation with BMI, waist circumference and metabolic profile. Settings and Design: A cross-sectional stu...

  11. Orthodontic correction of severely rotated maxillary central incisor in a diabetic adult

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    Rajesh Gyawali

    2015-12-01

    Full Text Available Background: Orthodontics has recently seen an increase in the number of adult population seeking treatment. Financial dependency, increasing awareness and availability of service can be the reasons behind this rise. Though, clinical myths regarding duration, effectiveness of treatment, associated systemic conditions still exist, these should be of no concern and with adequate monitoring and procedural modifications, conventional orthodontic treatment is possible.Case description: A 58 year old Type II diabetic male presented to orthodontic clinic with unesthetic gap between upper front teeth. The history revealed extraction of painful mesiodens. On examination, the patient had Class I molar, canine and incisor relationship. 21 was rotated with 5mm of space between central incisors. Fixed orthodontic treatment was planned after physician consultation regarding his diabetic condition. Bondable buccal tubes instead of bands were used in first molars, 0.022” Roth brackets were bonded on other maxillary teeth. The wire gradually progressed from 0.014”NiTi, 0.016”NiTi to 0.018”SS. Lingual button was attached on the labial and lingual surface of 21 to apply couple. After the correction of rotation of 21, remaining space closure with esthetic contouring of 21 was done. Maintenance of adequate oral hygiene was reinforced throughout the treatment period. Fixed lingual retainer was bonded and pericision performed to retain the achieved result.Conclusion: Orthodontic treatment can be carried out in diabetic adults with good glycemic control to achieve esthetic results; however, measures for maintenance of adequate oral hygiene should be undertaken. Interdisciplinary approach involving restorative procedures can enhance the esthetics achieved.JCMS Nepal. 2015;11(3:30-34

  12. The Influence of Type-1 Diabetes Mellitus on Central Corneal Thickness in Children

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    Pınar Yüksekkaya

    2014-12-01

    Full Text Available Objectives: To evaluate the central corneal thickness (CCT in children with diabetes mellitus (DM, to compare the results with those of age- and sex-matched healthy subjects, and to assess the presence of any relationship between the disease-variable parameters and CCT. Materials and Methods: This prospective, cross-sectional study included 138 eyes of 138 subjects. The CCT was measured by ultrasonic pachymetry in 66 children with type-1 DM and in 72 healthy subjects. The effects of the duration of DM, current hemoglobin A1c levels (HbA1c, and fasting blood glucose (FBG levels on CCT were also evaluated. Results: The demographic characteristics of the study and control groups were similar (p>0.05. The average CCT was greater in the study (555.2±38.6 µm than in the control group (547.7±31.5 µm, but the difference was not statistically significant (independent t-test, p=0.211. CCT was also not significantly different in children with diabetes >5 years’ duration (554.6±39.3 µm compared to diabetes ≤5 years’ duration (555.6±38.6 µm (p>0.05, and there was no significant correlation between the CCT- and the DM-related parameters in the study group (p>0.05. Conclusion: Our findings indicate that DM does not affect the corneal thickness in adolescents. We also did not find any significant correlation between disease-related variables and the CCT. (Turk J Ophthalmol 2014; 44: 445-8

  13. Study on the correlation of serum lipid metabolism and central retinal artery hemodynamics with diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Ran-Yang Guo

    2016-01-01

    Objective:To explore the correlation of serum lipid metabolism and central retinal artery (CRA) hemodynamics with diabetic retinopathy (DR).Methods:A total of 120 patients with type 2 diabetes who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and divided into NDR group (non-diabetic retinopathy), NPR group (non-proliferative retinopathy), and PR group (proliferative retinopathy) with 40 cases in each group according to DR clinical staging. Moreover, 50 healthy individuals who came for physical examinations were served as the control group. The full automatic biochemical analyzer was used to detect the levels of TG, TC, LDL-C, and HDL-C. The color Doppler flow imaging (CDFI) was used to detect EDV, PSV, RI, and PI of CRA and OA.Results:The levels of TG, TC, and LDL-C in NDG, NPR, and PR groups were gradually increased with the aggravation of retinopathy, HDL-C was reduced, the comparison among the three groups was statistically significant, and the comparison with the control group was statistically significant. EDV, PSV, and PI of CRA and OA in NDG, NPR, and PR groups were gradually increased with the aggravation of retinopathy, RI was reduced, the comparison among the three groups was statistically significant, and the comparison with the control group was statistically significant. Conclusions: The lipid metabolism disorder can promote the occurrence and development of DR. The change of CRA and OA hemodynamics is an important pathological basis for developing DR. Clinical detection of serum lipid level and monitoring of the changes of fundus artery hemocynamic parameters are of great significance in early detecting DR.

  14. Diabetes mellitus and its association with central obesity and disability among older adults: a global perspective.

    Science.gov (United States)

    Tyrovolas, Stefanos; Koyanagi, Ai; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Miret, Marta; Chatterji, Somnath; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Leonardi, Matilde; Haro, Josep Maria

    2015-04-01

    The aim of the study was to evaluate the association between various factors and diabetes type II (DM) with a particular emphasis on indicators of central obesity, and to compare the effect of DM on disability among elder populations (≥ 50 years old) in nine countries. Data were available for 52,946 people aged ≥ 18 years who participated in the WHO Study on global AGEing and adult health and the Collaborative Research on Ageing in Europe studies conducted between 2007 and 2012. DM was defined as self-report of physician diagnosis. Height, weight, and waist circumference were measured. Disability status was assessed with the WHODAS II questionnaire. The overall prevalence of DM was 7.9% and ranged from 3.8% (Ghana) to 17.6% (Mexico). A 10 cm increase in waist circumference and waist-to-height ratio of >0.5 were associated with a significant 1.26 (India) to 1.77 (Finland), and 1.68 (China, Spain) to 5.40 (Finland) times higher odds for DM respectively. No significant associations were observed in Mexico and South Africa. DM was associated with significantly higher disability status in all countries except Mexico in the model adjusted for demographics and smoking. The inclusion of chronic conditions associated with diabetes in the model attenuated the coefficients in varying degrees depending on the country. A considerable proportion of the studied older population had DM. Central obesity may be a key factor for the prevention of DM among older populations globally. Prevention of DM especially among the older population globally may contribute to reducing the burden of disability.

  15. Corneal endothelial morphology and central thickness in patients with type II diabetes mellitus

    DEFF Research Database (Denmark)

    Storr-Paulsen, Allan; Singh, Amardeep; Jeppesen, Helene;

    2014-01-01

    PURPOSE: To investigate corneal endothelial cell density and morphology in type II diabetic and non-diabetic patients and to relate potential differences to the glycaemic status. METHODS: A prospective clinical study including 107 patients with type II diabetes and 128 non-diabetic patients. Samp...

  16. Euglycemia restoration by central leptin in type 1 diabetes requires STAT3 signaling but not fast-acting neurotransmitter release

    Science.gov (United States)

    Central leptin action is sufficient to restore euglycemia in insulinopenic type 1 diabetes (T1D); however, the underlying mechanism remains poorly understood. To examine the role of intracellular signal transducer and activator of transcription 3 (STAT3) pathways, we used LepRs/s mice with disrupted...

  17. Central or peripheral delivery of an adenosine A1 receptor agonist improves mechanical allodynia in a mouse model of painful diabetic neuropathy.

    Science.gov (United States)

    Katz, N K; Ryals, J M; Wright, D E

    2015-01-29

    Diabetic peripheral neuropathy is a common complication of diabetes mellitus, and a significant proportion of individuals suffer debilitating pain that significantly affects their quality of life. Unfortunately, symptomatic treatment options have limited efficacy, and often carry significant risk of systemic adverse effects. Activation of the adenosine A1 receptor (A1R) by the analgesic small molecule adenosine has been shown to have antinociceptive benefits in models of inflammatory and neuropathic pain. The current study used a mouse model of painful diabetic neuropathy to determine the effect of diabetes on endogenous adenosine production, and if central or peripheral delivery of adenosine receptor agonists could alleviate signs of mechanical allodynia in diabetic mice. Diabetes was induced using streptozocin in male A/J mice. Mechanical withdrawal thresholds were measured weekly to characterize neuropathy phenotype. Hydrolysis of AMP into adenosine by ectonucleotidases was determined in the dorsal root ganglia (DRG) and spinal cord at 8 weeks post-induction of diabetes. AMP, adenosine and the specific A1R agonist, N(6)-cyclopentyladenosine (CPA), were administered both centrally (intrathecal) and peripherally (intraplantar) to determine the effect of activation of adenosine receptors on mechanical allodynia in diabetic mice. Eight weeks post-induction, diabetic mice displayed significantly decreased hydrolysis of extracellular AMP in the DRG; at this same time, diabetic mice displayed significantly decreased mechanical withdrawal thresholds compared to nondiabetic controls. Central delivery AMP, adenosine and CPA significantly improved mechanical withdrawal thresholds in diabetic mice. Surprisingly, peripheral delivery of CPA also improved mechanical allodynia in diabetic mice. This study provides new evidence that diabetes significantly affects endogenous AMP hydrolysis, suggesting that altered adenosine production could contribute to the development of

  18. Prevalence and related risk factors of peripheral arterial disease in elderly patients with type 2 diabetes in Wuhan, Central China

    Institute of Scientific and Technical Information of China (English)

    WANG Li; DU Fan; MAO Hong; WANG Hong-xiang; ZHAO Shi

    2011-01-01

    Bsckground The investigations of prevalence and risk factors of peripheral arterial disease (PAD) in type 2 diabetic patients have been carried out in many countries and regions,except for Central China.In this study,we determined the prevalence of PAD in type 2 diabetic patients and the related factors that gave rise to increasing of the risk of PAD development in Wuhan,China.Methods The study enrolled 2010 patients aged 60 years and older who were regularly visiting the Central Hospital of Wuhan that is a public hospital from 2005 to 2010,where all residents of the city were offered the medical services.PAD was defined as an ankle-brachial index <0.90 in either leg.To evaluate the role of various risk factors in PAD development,uniformed interviews,clinical examinations and laboratory investigation of all of participants were performed in this study.The correlation between potential risk factors and PAD was analyzed.Results In Wuhan,the prevalence rate of PAD was 24.1% in elderly diabetic patients.Totally,291 patients with PAD had at least one weak but not absent dorsalis pedis pulse in both feet,while 541 patients without PAD showed this way.At least one absent dorsalis pedis pulse was found in 192 patients with PAD as well as 10 patients without PAD.The results of multivariate regression analysis suggested that the age,smoking history,hypertension,diabetic neuropathy and macroangiopathy gave rise to significant increase of PAD development in type 2 diabetic diseases.Conclusions The prevalence of PAD in elderly patients with type 2 diabetes in Wuhan was close to the prevalence that was reported in other regions of China and other Asian countries.Control of the related risk factors and early diagnosis of PAD may play a role in PAD prevention and improving prognosis.

  19. Clinical significance and change curve of ADH in central diabetes insipidus after neurosurgical operation%神经外科术后中枢性尿崩症ADH变化曲线及其临床意义

    Institute of Scientific and Technical Information of China (English)

    张金男; 高宇飞; 赵丛海; 王立坤; 赵勇

    2006-01-01

    目的:探讨神经外科术后并发中枢性尿崩症时血清抗利尿激素(ADH)变化曲线对判断不同类型中枢性尿崩症的临床意义.方法:动态观察神经外科手术后出现中枢性尿崩患者158例,采用放射免疫法测定患者术前及术后2周内不同时间点血清ADH浓度,绘制短暂性、持续性及三相性尿崩症AHD变化曲线.结果:短暂性和三相性尿崩症术后血清ADH立即下降,于术后第2天达最低值,分别为术前血清ADH浓度的41.7%和63.6%,与术前比较差异有显著性(P<0.05).短暂性尿崩症于术后第10天恢复术前水平,而三相性尿崩症在术后第7天血清浓度达高峰,超过术前水平,后逐渐下降.持续性尿崩症患者术后血清ADH于术后1 d后下降,于术后第7天最低值,为术前血清ADH水平的33.3%,后略有波动,但在2周内一直低于术前ADH水平(P<0.05).结论:通过对血清ADH变化曲线的分析,可以区分不同类型的中枢性尿崩症,进行有针对性的治疗,改善患者预后.

  20. Hypoadiponectinemia in obese subjects with type II diabetes: A close association with central obesity indices

    Directory of Open Access Journals (Sweden)

    Ghorban Mohammadzadeh

    2011-01-01

    Full Text Available Background: Adiponectin is an adipocyte secreted protein with important biological functions Hypoadiponectinemia is associated with obesity, insulin resistance, and type II diabetes This study aimed to evaluate serum adiponectin level in obese subjects with type II diabetes and its correlation with metabolic parameters Methods: This cross-sectional study was performed on 40 obese subjects with type II diabetes and 40 non-diabetic obese control subjects Fasting lipid profile was measured by the enzymatic methods The NycoCard HbA1c protocol was used to measure HbAlc The Serum adiponectin, insulin and glucose levels were measured using an enzyme immunoassay and glucose oxidase methods respectively Results: Type II diabetes was associated with hypoadiponectinemia, in both men and women Serum adiponectin level in non-diabetic subjects (6.44 ± 2.47 μg/ml was significantly higher than diabetics (4.55 ± 1.88 μg/ml Furthermore, serum adiponectin concentration in females was significantly higher than males in non-diabetics (7.18 ± 2.68 vs 5.61 ± 0.57 and diabetic groups (5.18 ± 2.08 vs 3.99 ± 1.5 There was a negative and significant correlation between serum adiponectin level with waist (r = -0.451, p = 0.003, waist to hip ratio (r = -0.404, p = 0.01 and BMI (r = - 0.322, p = 0.042 and a positive correlation with HDL (r = 0.337, p = 0.034 in non-diabetic group In diabetic group, there was only found a negative correlation between adiponectin and waist size (r = -0.317, p = 0.046 Conclusions: Obesity and type II diabetes are associated with low serum adiponectin concentration

  1. Osteoprotegerin Serum Level is Associated with Severity of Coronary Artery Calcification in Non Diabetic Centrally Obese Men

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    Trilis Yulianti

    2012-04-01

    Full Text Available BACKGROUND: Osteoprotegerin (OPG is produced by a variety of tissues including those of the cardiovascular system. Recent clinical studies have suggested a significant correlation between elevated OPG serum level and cardiovascular mortality. Since coronary artery calcification (CAC is positively associated with cardiovascular disease (CVD events, we carried out a study to investigate whether OPG serum level is associated with the severity of CAC in non diabetic centrally obese men. METHODS: A cross sectional study was done on seventy non diabetic centrally obese men. CAC score was determined by using dual source computed tomography (DSCT. OPG serum level was measured by enzyme-linked immunosorbent assay (ELISA method. Statistical analysis was done with SPSS for windows ver 16. ANOVA was performed to analyze mean, maximum, minimum value, and standard deviation. Spearman correlation test was performed to determine the correlation between OPG serum level and CAC score. Significance value was defined as alpha level=0.05 based on two-tailed tests. RESULTS: OPG serum level was significantly correlated with CAC score. The severity of CAC increased with the increase of OPG level. Age was significantly correlated with OPG serum level and CAC score. CONCLUSIONS: Our data show that serum OPG level was associated with the severity of CAC, which highlights that OPG could be involved in the progression of CAC in non diabetic obese men. KEYWORDS: obesity, vascular calcification, osteoprotegerin, coronary artery calcification.

  2. Diabetes

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth R

    2015-01-01

    For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestat......For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women...... with gestational diabetes mellitus is highly relevant....

  3. Gestational Diabetes: Long-Term Central Nervous System Developmental and Cognitive Sequelae.

    Science.gov (United States)

    Perna, Robert; Loughan, Ashlee R; Le, Jessica; Tyson, Kelly

    2015-01-01

    Gestational diabetes is a common complication of pregnancy and occurs in approximately 7% of all pregnancies. It has been associated with an increased rate of congenital anomalies including disturbances of intrauterine growth, delayed brain maturity, and neurobehavioral abnormalities in the offspring. The resulting maternal and fetal metabolic dysfunction leads to diminished iron stores (which can affect red blood cell [RBC] production and subsequent organogenesis), a metabolism-placental perfusion mismatch, increased FFA, increased lactic acidosis, and potential hypoxia. Though most newborns born in the context of gestational diabetes are not significantly affected by it, empirical research suggests gestational diabetes has been associated with lower general intelligence, language impairments, attention weaknesses, impulsivity, and behavioral problems. In extreme cases, it may essentially function as a gestational brain insult. Children who are exposed to poorly controlled gestational diabetes may benefit from some form of tracking or follow-up assessments. Additionally, clinicians evaluating children with developmental learning or cognitive dysfunction may want to seek appropriate gestational diabetes-related information from the parents. A greater understanding of this significant gestational risk may help foster improved prenatal diabetes management and may help reduce the neurodevelopmental effects of gestational diabetes. PMID:25265045

  4. Novel role for gabapentin in neuroprotection of central nervous system in streptozotocine-induced diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Giyasettin BAYDAS; Ertugrul SONKAYA; Mehmet TUZCU; Abdullah YASAR; Emir DONDER

    2005-01-01

    Aim: To investigate the effect of gabapentin on neural [neuron-specific enolase (NSE)] and glial markers [glial fibrillary acidic protein (GFAP) and S100B] in different brain regions of diabetic rats. Methods: Diabetes was induced by a single intraperitoneal injection of streptozotocine (50 mg/kg body weight). Rats in one group received vehicle only for 6 weeks. The levels of GFAP, S 100B, and NSE were determined by immunoblotting in the hippocampus, cortex, and cerebellum. Lipid peroxidation (LPO as malondialdehyde+ 4-hydroxyalkenals) and glutathione (GSH) levels were also determined in the same brain parts. Results: Total and degraded GFAP content and S100B protein expression in different areas of brain tissues significantly increased in diabetic rats compared to control rats. Similarly, NSE levels were also significantly elevated in hyperglycemic rats. In addition, there was a significant increase in LPO levels in the diabetic rat brain compared to control rat brains. Pretreatment with gabapentin prevented the upregulation of GFAP, S 100B, and NSE in all brain regions of diabetic rats. The level of LPO was reduced, but not completely halted, by treatment with gabapentin. Conclusion: These results suggest that diabetes causes glial and neuronal injury, possibly as a result of elevated oxidative stress, and that gabapentin protects neurons and glial cells. Thus, we predict that gabapentin treatment will attenuate the hippocampal and cortical neurodegeneration observed during diabetes mellitus in rats.

  5. Hepatitis C as a risk factor for diabetes type 2: lack of evidence in a hospital in central-west Brazil

    Directory of Open Access Journals (Sweden)

    Luce Marina Freires Corrêa da Costa

    2008-02-01

    Full Text Available In order to assess the importance of HCV infection as a possible risk factor for type 2 diabetes mellitus, a case-control study was conducted, comparing the prevalence of HCV infection among diabetic and non-diabetic patients. Diabetic outpatients attending to a University Hospital in Central-West Brazil were evaluated between April and October 2005. A control group composed by patients from the same institution was matched by gender and age. Candidates to control group were included only if fasting glucose measures were under 100 mg/dL. Diabetics and controls had blood samples taken in order to test for antibodies against HCV (anti-HCV by enzyme-immunoassay. Polymerase chain reaction and immunoblot were performed to confirm the anti-HCV status. Each group included 206 participants. Despite of the groups were in general comparable. The diabetics had a greater body mass average and smaller family income. The prevalence of confirmed anti-HCV in the diabetic group was of 1.4%, which was similar to the controls (1%. Finding statistical difference may have been hampered by the low frequency of HCV infection in both groups. It was not possible to demonstrate a role of HCV as an etiologic factor in type 2 diabetes, since HCV infected patients represented a small portion of the overall diabetes cases. This finding does not allow to recommend regular screening for HCV infection in type 2 diabetics in this region.

  6. Diabetic encephalopathy

    OpenAIRE

    I. A. Strokov; V. V. Zakharov; K. I. Strokov

    2012-01-01

    The epidemiology, clinical presentation, morphology, and pathogenesis of central nervous system lesion in types 1 and 2 diabetes mellitus (DM) are considered, by using the results of experimental and clinical studies. The definition of diabetic encephalopathy is given. Whether there is a relationship between diabetic encephalopathy and diabetic polyneuropathy is considered. It is concluded that it is expedient to identify diabetic encephalopathy as a complication of DM. The capacities of path...

  7. The systemic immune network in recent onset type 1 diabetes: central role of interleukin-1 receptor antagonist (DIATOR Trial.

    Directory of Open Access Journals (Sweden)

    Hubert Kolb

    Full Text Available BACKGROUND: The hypothesis was tested that the systemic immune milieu in recent-onset type 1 diabetes is associated with residual beta cell function and other metabolic patient characteristics. METHODS AND FINDINGS: All patients (n = 89, 40% female of the Diabetes and Atorvastatin (DIATOR Trial were analyzed at recruitment, i.e. prior to receiving the study medication. Inclusion criteria were insulin dependent diabetes for 2 weeks to 3 months, age range 18-39 years, and islet cell autoantibodies. Blood samples were analyzed for 14 immune mediators by standard methods. Concentrations of all mediators correlated with at least one other mediator (p<0.05, Spearman correlation giving rise to a network. Interleukin 1 receptor antagonist (IL1-RA held a central position and was associated with both pro- and anti-inflammatory mediators. Further central elements were the pro-inflammatory mediators CRP and IL-6, the soluble adhesion molecules sICAM-1 and E-selectin, and MCP-4 which held a central position in the chemokine network. The two Th1-associated mediators IFNγ and IP-10 remained outside the network but correlated with each other. All correlations were positive (r = 0.25-0.72, i.e., high levels of pro-inflammatory mediators were accompanied by increased levels of anti-inflammatory mediators. IL-1RA was the only mediator associated with fasting and liquid mixed meal stimulated C-peptide concentrations (r = 0.31 and 0.24, p = 0.003 and 0.025, after adjustment for age, sex, BMI. There were associations between the immune mediator network and BMI (IL-1RA, CRP, IL-6, MCP-4, MIP-1ß but few or no associations with HbA1c, insulin dose, lipid parameters, age or sex. CONCLUSIONS: In patients with recent onset type 1 diabetes, systemic acute phase proteins, cytokines, chemokines and soluble adhesion molecules form a network. Among the few central elements IL-1RA has a dominant role. IL-1RA is associated with all other groups of mediators and

  8. DIABETIC AND HYPERTENSIVE EYE DISEASE, AWARENESS AND EVALUATION - A HOSPITAL BASED STUDY IN CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Sarkar

    2014-02-01

    Full Text Available BACKGROUND : Diabetes Mellitus, particularly the Type 2 is a major health problem and of great concern worldwide and so is the Hypertension, the prevalence of which is rising and both combined together may lead to economical blindness if not treated adequately and in time. Hypertension was also identified as the 3 rd ranked factor for disability adjusted life years by the world health report 2002. MATERIAL AND METHODS : A total of 1306 patients attending eye department for either routine checkup or referred by physicians for ophthalmoscopic examinations were studied. Relevant questions were asked regarding the presence of disease and their ocular problems along with the visual status. RESULTS : Mean age of the patients was 55.5 years, males 53.2% and females 46.75%. 118 pa tients were diabetic, 375 patients were hypertensive and 132 patients had combined disease. Awareness of diabetic retinopathy in the disease specific group was 61.01% and hypertensive retinopathy was 19.46%. It was found that awareness of diabetic retinopa thy was more in diabetic population compared to the non - diabetic group, whereas knowledge of hypertension affecting the eye was much poor. Lack of awareness was found directly related to the level of illiteracy and ignorance. Prevalence of retinopathy in t his series was found 24.57% in diabetics & 64.8% in hypertensives. CONCLUSION : People’s education regarding the systemic disease related eye problems and formal education of general public especially of females will be a great step towards reducing the vis ual impairment. Importance of regular follow - up once diagnosed should be emphasized for early detection and management thereby

  9. Optimal central obesity measurement site for assessing cardiometabolic and type 2 diabetes risk in middle-aged adults.

    Directory of Open Access Journals (Sweden)

    Seán R Millar

    Full Text Available Despite recommendations that central obesity assessment should be employed as a marker of cardiometabolic health, no consensus exists regarding measurement protocol. This study examined a range of anthropometric variables and their relationships with cardiometabolic features and type 2 diabetes in order to ascertain whether measurement site influences discriminatory accuracy. In particular, we compared waist circumference (WC measured at two sites: (1 immediately below the lowest rib (WC rib and (2 between the lowest rib and iliac crest (WC midway, which has been recommended by the World Health Organisation and International Diabetes Federation.This was a cross-sectional study involving a random sample of 2,002 men and women aged 46-73 years. Metabolic profiles and WC, hip circumference, pelvic width and body mass index (BMI were determined. Correlation, logistic regression and area under the receiver operating characteristic curve analyses were used to evaluate obesity measurement relationships with metabolic risk phenotypes and type 2 diabetes.WC rib measures displayed the strongest associations with non-optimal lipid and lipoprotein levels, high blood pressure, insulin resistance, impaired fasting glucose, a clustering of metabolic risk features and type 2 diabetes, in both genders. Rib-derived indices improved discrimination of type 2 diabetes by 3-7% compared to BMI and 2-6% compared to WC midway (in men and 5-7% compared to BMI and 4-6% compared to WC midway (in women. A prediction model including BMI and central obesity displayed a significantly higher area under the curve for WC rib (0.78, P=0.003, Rib/height ratio (0.80, P<0.001, Rib/pelvis ratio (0.79, P<0.001, but not for WC midway (0.75, P=0.127, when compared to one with BMI alone (0.74.WC rib is easier to assess and our data suggest that it is a better method for determining obesity-related cardiometabolic risk than WC midway. The clinical utility of rib-derived indices, or

  10. Which Measurement of Blood Pressure Is More Associated With Albuminuria in Patients With Type 2 Diabetes: Central Blood Pressure or Peripheral Blood Pressure?

    Science.gov (United States)

    Kitagawa, Noriyuki; Okada, Hiroshi; Tanaka, Muhei; Hashimoto, Yoshitaka; Kimura, Toshihiro; Nakano, Koji; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto; Fukui, Michiaki

    2016-08-01

    The aim of this study was to investigate whether central systolic blood pressure (SBP) was associated with albuminuria, defined as urinary albumin excretion (UAE) ≥30 mg/g creatinine, and, if so, whether the relationship of central SBP with albuminuria was stronger than that of peripheral SBP in patients with type 2 diabetes. The authors performed a cross-sectional study in 294 outpatients with type 2 diabetes. The relationship between peripheral SBP or central SBP and UAE using regression analysis was evaluated, and the odds ratios of peripheral SBP or central SBP were calculated to identify albuminuria using logistic regression model. Moreover, the area under the receiver operating characteristic curve (AUC) of central SBP was compared with that of peripheral SBP to identify albuminuria. Multiple regression analysis demonstrated that peripheral SBP (β=0.255, Pperipheral SBP (odds ratio, 1.029; 95% confidence interval, 1.016-1.043) or central SBP (odds ratio, 1.022; 95% confidence interval, 1.011-1.034) was associated with an increased odds of albuminuria. In addition, AUC of peripheral SBP was significantly greater than that of central SBP to identify albuminuria (P=0.035). Peripheral SBP is superior to central SBP in identifying albuminuria, although both peripheral and central SBP are associated with UAE in patients with type 2 diabetes.

  11. Chronic central leptin infusion restores cardiac sympathetic-vagal balance and baroreflex sensitivity in diabetic rats

    OpenAIRE

    do Carmo, Jussara M.; Hall, John E.; da Silva, Alexandre A.

    2008-01-01

    This study tested whether leptin restores sympathetic-vagal balance, heart rate (HR) variability, and cardiac baroreflex sensitivity (BRS) in streptozotocin (STZ)-induced diabetes. Sprague-Dawley rats were instrumented with arterial and venous catheters, and a cannula was placed in the lateral ventricle for intracerebroventricular (ICV) leptin infusion. Blood pressure (BP) and HR were monitored by telemetry. BRS and HR variability were estimated by linear regression between HR and BP response...

  12. Correlation Between Adiponectin, Tumor Necrosis Factor-alpha, Insulin Resistance and Atherogenic Dyslipidemia in Non Diabetic Central Obese Males

    Directory of Open Access Journals (Sweden)

    Candra Ninghayu

    2010-04-01

    Full Text Available BACKGROUND: Obesity raises the risk for atherosclerotic cardiovascular disease (ASCVD through many risk factors including atherogenic dyslipidemia. Atherogenic dyslipidemia is characterized by high levels of triglyceride, increased small dense low density lipoprotein particles, and reduced levels of high density lipoprotein cholesterol. The exact mechanisms of central obesity and this atherogenic lipoprotein phenotype (ALP is not clearly understood. Central obesity is characterized by a state of systemic low grade inflammation and insulin resistance. Adipose tissue has recently been shown to secrete a variety of bioactive peptides, called adipocytokines, that can potentially affect glucose and lipid metabolism. The aim of this study was to observe the role of adiponectin, tumor necrosis factor-α (TNF-α and insulin resistance in atherogenic dyslipidemia in nondiabetic central obese males. METHODS: This was a cross-sectional study on 75 non-diabetic central obese male subjects (waist circumferences >90 cm. Adiponectin and TNF-α testing were performed by ELISA; insulin resistance was assessed by the Homeostasis Model Assessment (HOMA index, triglyceride was assessed by GPO-PAP, HDL cholesterol and small dense LDL were measured by homogenous method. Statistical analysis was done by SPSS for Windows v. 11.5 with a significance level at p<0.05. The Pearson and Spearman’s Rho correlation coefficient was used to assess the correlation between various anthropometric and biochemical parameters. RESULTS: There were 75 patients aged 38.0±6.3 years, Adiponectin concentration was 3.55±1.38 μg/ml, HOMA index was 2.28±1.63, TNF-α was 12.42±11.25 pg/ml, triglyceride was 185.17±109.00, HDL-cholesterol was 44.15±9.23 mg/dL, small dense LDL 23.22±12.26 mg/dL. This study revealed that there were correlations between adiponectin and triglyceride (r=-0.236, p=0.042, adiponectin and HDL cholesterol (r=0.300, p=0.009, adiponectin and atherogenic

  13. Diabetic encephalopathy

    Directory of Open Access Journals (Sweden)

    I. A. Strokov

    2012-01-01

    Full Text Available The epidemiology, clinical presentation, morphology, and pathogenesis of central nervous system lesion in types 1 and 2 diabetes mellitus (DM are considered, by using the results of experimental and clinical studies. The definition of diabetic encephalopathy is given. Whether there is a relationship between diabetic encephalopathy and diabetic polyneuropathy is considered. It is concluded that it is expedient to identify diabetic encephalopathy as a complication of DM. The capacities of pathogenetic treatment for diabetic encephalopathy are shown.

  14. Everything in Moderation--Dietary Diversity and Quality, Central Obesity and Risk of Diabetes.

    Directory of Open Access Journals (Sweden)

    Marcia C de Oliveira Otto

    Full Text Available Diet guidelines recommend increasing dietary diversity. Yet, metrics for dietary diversity have neither been well-defined nor evaluated for impact on metabolic health. Also, whether diversity has effects independent of diet quality is unknown. We characterized and evaluated associations of diet diversity and quality with abdominal obesity and type II diabetes (T2D in the Multi-Ethnic Study of Atherosclerosis. At baseline (2000-02, diet was assessed among 5,160 Whites, Hispanic, Blacks, and Chinese age 45-84 y and free of T2D, using a validated questionnaire. Three different aspects of diet diversity were characterized including count (number of different food items eaten more than once/week, a broad measure of diversity, evenness (Berry index, a measure of the spread of the diversity, and dissimilarity (Jaccard distance, a measure of the diversity of the attributes of the foods consumed. Diet quality was characterized using aHEI, DASH, and a priori pattern. Count and evenness were weakly positively correlated with diet quality (r with AHEI: 0.20, 0.04, while dissimilarity was moderately inversely correlated (r = -0.34. In multivariate models, neither count nor evenness was associated with change in waist circumference (WC or incident T2D. Greater food dissimilarity was associated with higher gain in WC (p-trend<0.01, with 120% higher gain in participants in the highest quintile of dissimilarity scores. Diet diversity was not associated with incident T2D. Also, none of the diversity metrics were associated with change in WC or incident T2D when restricted to only healthier or less healthy foods. Higher diet quality was associated with lower risk of T2D. Our findings provide little evidence for benefits of diet diversity for either abdominal obesity or diabetes. Greater dissimilarity among foods was actually associated with gain in WC. These results do not support the notion that "eating everything in moderation" leads to greater diet quality or

  15. Central obesity and risk for type 2 diabetes in Maori, Pacific and European young men in New Zealand

    International Nuclear Information System (INIS)

    Thirty healthy male volunteers between the ages of 18 and 27 and of a wide range of fatness were recruited for this study. Equal numbers (10) self identified as belonging to each of the Maori Pacific and European ethnic groups. Originally it was intended that 90 men(30 in each group) should be measured but the cost and availability of the doubly-labelled water prevented this. Specific measurements undertaken included resting metabolic rate by indirect calorimetry, total energy expenditure over 14 days by the doubly-labelled water technique; total and regional body fat from dual-energy x-ray absorptiometry; anthropometry (body mass index, skinfold thicknesses and girths); fat and carbohydrate utilisation from respiratory quotients and from carbon-13 analysis of expired breath; and dietary intake of macronutrients. Glucose tolerance, insulin, thyroid hormone, leptin and blood lipid determinations were also performed. The groups did not differ significantly in BMI, height body mass or fat mass - but the European group had significantly lower subscapular to triceps skinfolds and fat free mass than the Maori and Pacific group. Resting metabolic rate adjusted for fat mass and fat free mass was not different among the groups. Carbon-13 in expired breath was positively correlated to the subscapular to triceps skinfold ratio and insulin. Reported intake of dietary fibre was negatively related to blood lipids and subscapular to triceps skinfold ratio. Central obesity showed strong associations with biochemical measures of Type 2 diabetes risk These findings emphasise the relationships between body composition and fat distribution with risk of diabetes independent of ethnicity. (author)

  16. Central corneal thickness in children with type 1 diabetes mellitus and the effect of metabolic control on corneal thickness

    Directory of Open Access Journals (Sweden)

    Emine Cinici

    2015-09-01

    Result: CCT is increased in the patients compared to the control group even before diabetes mellitus (DM has developed a retinopathy. A relation of this increase with period of diabetes, HbA1C level and hypoglycemia attack number could not be detected. [Arch Clin Exp Surg 2015; 4(3.000: 148-152

  17. Technologies to better serve the millions of diabetic patients: a holistic, interactive and persuasive ICT model to facilitate self care, in extremely poor rural zones of Central America.

    Science.gov (United States)

    Vargas-Lombardo, Miguel; Jipsion, Armando; Vejarano, Rafael; Camargo, Ismael; Alvarez, Humberto; Mora, Elena Villalba; Ruíz, Ernestina Menasalva

    2012-04-01

    Health indicators express remarkable gaps between health systems at a world-wide level. Countries of the entire world are overflowed by the need of new strategies, methodologies and technologies to better serve the millions of patients, who demand better medical attention. The present archaic and ephemerally systematized systems widen the gap even more than the quality of medical services that should be provided for the millions of diabetic patients. It is therefore necessary to develop highly familiar environments with diabetic patients and their care needs. A Holistic, Interactive and Persuasive ICT model to facilitate self care of patients with diabetes (hIPAPD), is proposed as an innovative technological development in Panama to health optimized treatment for diabetic patients. Three health centers located in the District of Aguadulce, Province of Cocle, located on Panama's Pacific Coast, were selected to validate the model; the area presents extremely poor population, mostly with one daily meal, without any health insurance and with a high illiteracy rate. A series of experiences in the application and validation process are presented and analyzed in order to confirm the application, value and contribution of ICTs in health care in poor regions of Central America. PMID:20703674

  18. The History of Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Manjeet Singh

    2010-12-01

    Full Text Available Diabetes has been recognised since antiquity. The first description that resembles the features of the disease is found in Ebers papyrus (1550 BC. The term ";diabetes"; was first coined by Aretaeus of Cappadocia. Galen described it as a disease specific to the kidneys because of a weakness in their retentive faculties. Word mellitus was added by Thomas Willis in 1675 after rediscovering the sweetness of urine and blood of patients (first noticed by the ancient Indians, Chinese and Japanese. He later noticed that some urine samples were sweet (diabetes mellitus whereas others were tasteless (diabetes insipidus. Later Cullen and John Rollo confirmed these two types. It was only in 1776 that Dobson firstly confirmed the presence of excess sugar in urine and blood as a cause of their sweetness. Claude Bernard discovered in 1857 that liver releases a substance i.e. glycogen which affects blood sugar level. The role of the pancreas in pathogenesis of diabetes was discovered by Mering and Minkowski in 1889. In 1909, Jean De Meyer named glucose lowering hormone as insulin whose existence was hypothetical at that time. Banting and Macleod got Noble prize for isolating insulin in 1923. Discovery of insulin for the treatment of diabetes represents one of the major humanitarian and scientific milestones of the 20th century. Oral hypoglycemic drugs were introduced later. Today researchers are working on insulin patch, implantable pump, insulin-sensitizers, pancreatic or islet cell transplantation and oral insulin solution.

  19. INSULIN IN THE BRAIN: ITS PATHOPHYSIOLOGICAL IMPLICATIONS FOR STATES RELATED WITH CENTRAL INSULIN RESISTANCE, TYPE 2 DIABETES AND ALZHEIMER’S DISEASE

    Directory of Open Access Journals (Sweden)

    ENRIQUE eBLÁZQUEZ

    2014-10-01

    Full Text Available Although the brain has been considered an insulin-insensitive organ, recent reports on the location of insulin and its receptors in the brain have introduced new ways of considering this hormone responsible for several functions. The origin of insulin in the brain has been explained from peripheral or central sources, or both. Regardless of whether insulin is of peripheral origin or produced in the brain, this hormone may act through its own receptors present in the brain. The molecular events through which insulin functions in the brain are the same as those operating in the periphery. However, certain insulin actions are different in the CNS, such as hormone-induced glucose uptake due to a low insulin-sensitive GLUT-4 activity, and because of the predominant presence of GLUT-1 and GLUT-3. In addition, insulin in the brain contributes to the control of nutrient homeostasis, reproduction, cognition and memory, as well as to neurotrophic, neuromodulatory, and neuroprotective effects. Alterations of these functional activities may contribute to the manifestation of several clinical entities, such as central insulin resistance, type 2 diabetes (T2DM and Alzheimer’s disease (AD. A close association between T2DM and AD has been reported, to the extent that AD is twice more frequent in diabetic patients, and some authors have proposed the name type 3 diabetes for this association. There are links between AD and type 2 diabetes mellitus (T2DM through mitochondrial alterations and oxidative stress, altered energy and glucose metabolism, cholesterol modifications, dysfunctional protein OGlcNAcylation, formation of amyloid plaques, altered Aβ metabolism, and tau hyperphosphorylation. Advances in the knowledge of preclinical AD and T2DM may be a major stimulus for the development of treatment for preventing the pathogenic events of

  20. Aquaporin-2: new mutations responsible for autosomal-recessive nephrogenic diabetes insipidus—update and epidemiology

    OpenAIRE

    Bichet, Daniel G.; El Tarazi, Abdulah; Matar, Jessica; Lussier, Yoann; Arthus, Marie-Françoise; Lonergan, Michèle; Bockenhauer, Detlef; Bissonnette, Pierre

    2012-01-01

    It is clinically useful to distinguish between two types of hereditary nephrogenic diabetes insipidus (NDI): a ‘pure’ type characterized by loss of water only and a complex type characterized by loss of water and ions. Patients with congenital NDI bearing mutations in the vasopressin 2 receptor gene, AVPR2, or in the aquaporin-2 gene, AQP2, have a pure NDI phenotype with loss of water but normal conservation of sodium, potassium, chloride and calcium. Patients with hereditary hypokalemic salt...

  1. Data on medicinal plants used in Central America to manage diabetes and its sequelae (skin conditions, cardiovascular disease, kidney disease, urinary problems and vision loss

    Directory of Open Access Journals (Sweden)

    Peter Giovannini

    2016-06-01

    Full Text Available The data described in this article is related to the review article “Medicinal plants used in the traditional management of diabetes and its sequelae in Central America: a review” (Giovannini et al., 2016 [1]. We searched publications on the useful plants of Central America in databases and journals by using selected relevant keywords. We then extracted reported uses of medicinal plants within the disease categories: diabetes mellitus, kidney disease, urinary problems, skin diseases and infections, cardiovascular disease, sexual dysfunction, vision loss, and nerve damage. The following countries were included in our definition of Central America: Belize, Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica and Panama. Data were compiled in a bespoke Access database. Plant names from the published sources were validated against The Plant List (TPL, (The Plant List, 2013 [2] and accepted names and synonyms were extracted. In total, the database includes 607 plant names obtained from the published sources which correspond to 537 plant taxa, 9271 synonyms and 1055 use reports.

  2. Pulmonary Langerhans Cell Histiocytosis and Diabetes Insipidus in a Young Smoker.

    Science.gov (United States)

    Earlam, K; Souza, C A; Glikstein, R; Gomes, M M; Pakhalé, S

    2016-01-01

    Langerhans cell histiocytosis is characterized by the abnormal nodular proliferation of histiocytes in various organ systems. Pulmonary involvement seen in young adults is nearly always seen in the context of past or current cigarette smoking. Although it tends to be a single-system disease, extrapulmonary manifestations involving the skin, bone, and hypothalamic-pituitary-axis are possible. High resolution CT (HRCT) of the thorax findings includes centrilobular nodules and cysts that are bizarre in shape, variable in size, and thin-walled. Often the diagnosis can be made based on the appropriate clinical presentation and typical imaging findings. Treatment includes smoking cessation and the potential use of glucocorticoids or cytotoxic agents depending on the severity of disease and multisystem involvement. PMID:27445532

  3. Pulmonary Langerhans Cell Histiocytosis and Diabetes Insipidus in a Young Smoker

    Directory of Open Access Journals (Sweden)

    K. Earlam

    2016-01-01

    Full Text Available Langerhans cell histiocytosis is characterized by the abnormal nodular proliferation of histiocytes in various organ systems. Pulmonary involvement seen in young adults is nearly always seen in the context of past or current cigarette smoking. Although it tends to be a single-system disease, extrapulmonary manifestations involving the skin, bone, and hypothalamic-pituitary-axis are possible. High resolution CT (HRCT of the thorax findings includes centrilobular nodules and cysts that are bizarre in shape, variable in size, and thin-walled. Often the diagnosis can be made based on the appropriate clinical presentation and typical imaging findings. Treatment includes smoking cessation and the potential use of glucocorticoids or cytotoxic agents depending on the severity of disease and multisystem involvement.

  4. Pulmonary Langerhans Cell Histiocytosis and Diabetes Insipidus in a Young Smoker

    Science.gov (United States)

    Earlam, K.; Souza, C. A.; Glikstein, R.; Gomes, M. M.; Pakhalé, S.

    2016-01-01

    Langerhans cell histiocytosis is characterized by the abnormal nodular proliferation of histiocytes in various organ systems. Pulmonary involvement seen in young adults is nearly always seen in the context of past or current cigarette smoking. Although it tends to be a single-system disease, extrapulmonary manifestations involving the skin, bone, and hypothalamic-pituitary-axis are possible. High resolution CT (HRCT) of the thorax findings includes centrilobular nodules and cysts that are bizarre in shape, variable in size, and thin-walled. Often the diagnosis can be made based on the appropriate clinical presentation and typical imaging findings. Treatment includes smoking cessation and the potential use of glucocorticoids or cytotoxic agents depending on the severity of disease and multisystem involvement. PMID:27445532

  5. Pulmonary Langerhans Cell Histiocytosis and Diabetes Insipidus in a Young Smoker

    Science.gov (United States)

    Earlam, K.; Souza, C. A.; Glikstein, R.; Gomes, M. M.; Pakhalé, S.

    2016-01-01

    Langerhans cell histiocytosis is characterized by the abnormal nodular proliferation of histiocytes in various organ systems. Pulmonary involvement seen in young adults is nearly always seen in the context of past or current cigarette smoking. Although it tends to be a single-system disease, extrapulmonary manifestations involving the skin, bone, and hypothalamic-pituitary-axis are possible. High resolution CT (HRCT) of the thorax findings includes centrilobular nodules and cysts that are bizarre in shape, variable in size, and thin-walled. Often the diagnosis can be made based on the appropriate clinical presentation and typical imaging findings. Treatment includes smoking cessation and the potential use of glucocorticoids or cytotoxic agents depending on the severity of disease and multisystem involvement.

  6. Pulmonary Langerhans Cell Histiocytosis and Diabetes Insipidus in a Young Smoker

    OpenAIRE

    Earlam, K.; Souza, C.A.; Glikstein, R.; Gomes, M. M.; Pakhalé, S.

    2016-01-01

    Langerhans cell histiocytosis is characterized by the abnormal nodular proliferation of histiocytes in various organ systems. Pulmonary involvement seen in young adults is nearly always seen in the context of past or current cigarette smoking. Although it tends to be a single-system disease, extrapulmonary manifestations involving the skin, bone, and hypothalamic-pituitary-axis are possible. High resolution CT (HRCT) of the thorax findings includes centrilobular nodules and cysts that are biz...

  7. Central blood pressure and pulse wave velocity: relationship to target organ damage and cardiovascular morbidity-mortality in diabetic patients or metabolic syndrome. An observational prospective study. LOD-DIABETES study protocol

    Directory of Open Access Journals (Sweden)

    Castaño-Sánchez Carmen

    2010-03-01

    Full Text Available Abstract Background Diabetic patients show an increased prevalence of non-dipping arterial pressure pattern, target organ damage and elevated arterial stiffness. These alterations are associated with increased cardiovascular risk. The objectives of this study are the following: to evaluate the prognostic value of central arterial pressure and pulse wave velocity in relation to the incidence and outcome of target organ damage and the appearance of cardiovascular episodes (cardiovascular mortality, myocardial infarction, chest pain and stroke in patients with type 2 diabetes mellitus or metabolic syndrome. Methods/Design Design: This is an observational prospective study with 5 years duration, of which the first year corresponds to patient inclusion and initial evaluation, and the remaining four years to follow-up. Setting: The study will be carried out in the urban primary care setting. Study population: Consecutive sampling will be used to include patients diagnosed with type 2 diabetes between 20-80 years of age. A total of 110 patients meeting all the inclusion criteria and none of the exclusion criteria will be included. Measurements: Patient age and sex, family and personal history of cardiovascular disease, and cardiovascular risk factors. Height, weight, heart rate and abdominal circumference. Laboratory tests: hemoglobin, lipid profile, creatinine, microalbuminuria, glomerular filtration rate, blood glucose, glycosylated hemoglobin, blood insulin, fibrinogen and high sensitivity C-reactive protein. Clinical and 24-hour ambulatory (home blood pressure monitoring and self-measured blood pressure. Common carotid artery ultrasound for the determination of mean carotid intima-media thickness. Electrocardiogram for assessing left ventricular hypertrophy. Ankle-brachial index. Retinal vascular study based on funduscopy with non-mydriatic retinography and evaluation of pulse wave morphology and pulse wave velocity using the SphygmoCor system. The

  8. Fixed-Combination Olmesartan/Amlodipine Was Superior to Perindopril + Amlodipine in Reducing Central Systolic Blood Pressure in Hypertensive Patients With Diabetes.

    Science.gov (United States)

    Ruilope, Luis M

    2016-06-01

    This post hoc analysis from the Sevikar Compared to the Combination of Perindopril Plus Amlodipine on Central Arterial Blood Pressure in Patients With Moderate-to-Severe Hypertension (SEVITENSION) study assessed the efficacy and tolerability of olmesartan (OLM) and amlodipine (AML) in reducing central systolic blood pressure (CSBP) compared with perindopril (PER) plus AML in hypertensive patients with type 2 diabetes. Patients were randomized to OLM/AML 40/10 mg or PER/AML 8/10 mg for 24 weeks. The primary efficacy endpoint was the absolute change in CSBP from baseline to week 24, which was greater with OLM/AML (-13.72±1.14 mm Hg) compared with PER/AML (-10.21±1.11 mm Hg). The between-group difference was -3.51±1.60 mm Hg (95% confidence interval, -6.66 to -0.36 mm Hg) and was within the noninferiority margin (2 mm Hg) as well as the superiority margin (0 mm Hg). In addition, OLM/AML was associated with a higher proportion of patients achieving blood pressure normalization. In hypertensive patients with diabetes, the fixed-dose combination of OLM/AML was superior to PER/AML in reducing CSBP, as well as other secondary endpoints. PMID:26395174

  9. Endogenous GLP-1 mediates postprandial reductions in activation in central reward and satiety areas in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Ten Kulve, Jennifer S; Veltman, Dick J; van Bloemendaal, Liselotte;

    2015-01-01

    that endogenous GLP-1 has effects on CNS reward and satiety circuits. Methods This was a randomised, crossover, placebo-controlled intervention study, performed in a university medical centre in the Netherlands. We included patients with type 2 diabetes and healthy lean control subjects. Individuals were eligible...... if they were 40–65 years. Inclusion criteria for the healthy lean individuals included a BMI patients with type 2 diabetes included BMI >26 kg/m2, HbA1c levels between 42 and 69 mmol/mol (6.0–8.5%) and treatment for diabetes with only oral glucose......-lowering agents. We assessed CNS activation, defined as blood oxygen level dependent (BOLD) signal, in response to food pictures in obese patients with type 2 diabetes (n = 20) and healthy lean individuals (n = 20) using functional magnetic resonance imaging (fMRI). fMRI was performed in the fasted state...

  10. Regular, high, and moderate intake of vegetables rich in antioxidants may reduce cataract risk in Central African type 2 diabetics

    OpenAIRE

    Mvitu M; Longo-Mbenza B; Tulomba D; Nge A

    2012-01-01

    Moise Mvitu,1 Benjamin Longo-Mbenza,2 Dieudonné Tulomba,3 Augustin Nge31Department of Ophthalmology, University of Kinshasa, Democratic Republic of Congo; 2Faculty of Health Sciences, Walter Sisulu University, South Africa; 3Biostatistics Unit, Lomo Medical Center and Heart of Africa Center of Cardiology, Kinshasa, Democratic Republic of CongoBackground: Antioxidant nutrients found in popularly consumed vegetables, including red beans, are thought to prevent diabetic complications....

  11. Regular, high, and moderate intake of vegetables rich in antioxidants may reduce cataract risk in Central African type 2 diabetics

    Directory of Open Access Journals (Sweden)

    Mvitu M

    2012-06-01

    Full Text Available Moise Mvitu,1 Benjamin Longo-Mbenza,2 Dieudonné Tulomba,3 Augustin Nge31Department of Ophthalmology, University of Kinshasa, Democratic Republic of Congo; 2Faculty of Health Sciences, Walter Sisulu University, South Africa; 3Biostatistics Unit, Lomo Medical Center and Heart of Africa Center of Cardiology, Kinshasa, Democratic Republic of CongoBackground: Antioxidant nutrients found in popularly consumed vegetables, including red beans, are thought to prevent diabetic complications. In this study, we assessed the frequency and contributing factors of intake of fruits and vegetables rich in antioxidants, and we determined their impact on the prevention of diabetes-related cataract extraction.Methods: This was a cross-sectional study, run in Congo among 244 people with type 2 diabetes mellitus. An intake of ≥three servings of vegetables rich in antioxidants/day, intake of red beans, consumption of fruit, and cataract extraction were considered as dependent variables.Results: No patient reported a fruit intake. Intake of red beans was reported by 64 patients (26.2%, while 77 patients (31.6% reported ≥three servings of vegetables rich in antioxidants. High socioeconomic status (OR = 2.3; 95% CI: 1.1–12.5; P = 0.030 and moderate alcohol intake (OR = 4; 95% CI: 1.1–17.4; P = 0.049 were the independent determinants of eating ≥three servings of vegetables rich in antioxidants. Red beans intake (OR = 0.282; 95% CI: 0.115–0.687; P > 0.01 and eating ≥three servings of vegetables rich in antioxidants (OR = 0.256; 95% CI: 0.097–0.671; P = 0.006 were identified as independent and protective factors against the presence of cataracts (9.8% n = 24, whereas type 2 diabetes mellitus duration ≥3 years was the independent risk factor for cataract extraction (OR = 6.3; 95% CI: 2.1–19.2; P > 0.001 in the model with red beans intake and OR = 7.1; 95% CI: 2.3–22.2; P > 0.001 in the model with ≥three servings of vegetables rich in antioxidants

  12. Assessment of cerebral perfusion and cerebrovascular reserve in insulin-dependent diabetic patients without central neurological symptoms by means of 99mTc-HMPAO SPET with acetazolamide

    International Nuclear Information System (INIS)

    The detection of subclinical abnormalities in cerebral blood flow could be of great value in identifying diabetic patients at risk of stroke. The aim of this study was to assess the contribution of semiquantified post-acetazolamide technetium-99m hexamethylpropylene amine oxime single-photon emission tomography (99mTc-HMPAO SPET) in 15 diabetic patients with no clinical history of central neurological disease. After baseline 99mTc-HMPAO SPET, a second SPET scan was acquired after activation of the cerebrovascular reserve (CVR) with an injection of 1 g of acetazolamide (post-ACZ SPET). Semiquantitative analysis was made in 16 regions of interest (ROIs) drawn for each of the three supratentorial slices selected, and in two ROIs in the infratentorial slice. The CVR was calculated in each ROI by subtracting the decay-corrected baseline images from those obtained in the post-ACZ SPET and expressed as the percent increase in the average counts between the two scans. Baseline perfusion and CVR values in the study group were compared with the corresponding values in a control group. Of 750 cortical ROIs studied, 332 showed a decreased CVR (44.3%). The baseline perfusion SPET study showed hypoperfusion in 65 ROIs (8.6%) and hyperperfusion in 56 (7.4%). Of the 65 hypoperfused regions, 66.2% had a normal CVR and 33.8% had a decreased CVR, whereas of the 56 hyperperfused regions, 51.8% had a CVR within normal limits and 48.2% showed a decreased CVR. In conclusion, in comparison with baseline 99mTc-HMPAO SPET, the ACZ activation test provided additional information in the study of cerebrovascular impairment, and allowed characterisation of the subclinical abnormalities in the population studied. The technique may therefore prove useful in evaluating future preventive strategies for stroke in diabetic patients. (orig.)

  13. Irradiation at 660 nm modulates different genes central to wound healing in wounded and diabetic wounded cell models

    Science.gov (United States)

    Houreld, Nicolette N.

    2014-02-01

    Wound healing is a highly orchestrated process and involves a wide variety of cellular components, chemokines and growth factors. Laser irradiation has influenced gene expression and release of various growth factors, cytokines and extracellular matrix proteins involved in wound healing. This study aimed to determine the expression profile of genes involved in wound healing in wounded and diabetic wounded fibroblast cells in response to irradiation at a wavelength of 660 nm. Human skin fibroblast cells (WS1) were irradiated with a diode laser (wavelength 660 nm; fluence 5 J/cm2; power output 100 mW; power density 11 mW/cm2; spot size 9.1 cm2; exposure duration 7 min 35 s). Total RNA was isolated and 1 μg reverse transcribed into cDNA which was used as a template in real-time qualitative polymerase chain reaction (qPCR). Eighty four genes involved in wound healing (extracellular matrix and cell adhesion; inflammatory cytokines and chemokines; growth factors; and signal transduction) were evaluated in wounded and diabetic wounded cell models. Forty eight hours post-irradiation, 6 genes were significantly upregulated and 8 genes were down-regulated in irradiated wounded cells, whereas 1 gene was up-regulated and 33 genes down-regulated in irradiated diabetic wounded cells. Irradiation of stressed fibroblast cells to a wavelength of 660 nm and a fluence of 5 J/cm2 modulated the expression of different genes involved in wound healing in different cell models. Modulation of these genes leads to the effects of laser irradiation seen both in vivo and in vitro, and facilitates the wound healing process.

  14. Diabetic retinopathy.

    Science.gov (United States)

    Wong, Tien Y; Cheung, Chui Ming Gemmy; Larsen, Michael; Sharma, Sanjay; Simó, Rafael

    2016-01-01

    Diabetic retinopathy (DR) is a common complication of diabetes mellitus and is a major cause of vision loss in middle-aged and elderly people. One-third of people with diabetes have DR. Severe stages of DR include proliferative DR, caused by the abnormal growth of new retinal blood vessels, and diabetic macular oedema, in which there is exudation and oedema in the central part of the retina. DR is strongly associated with a prolonged duration of diabetes, hyperglycaemia and hypertension. It is traditionally regarded as a microvascular disease, but retinal neurodegeneration is also involved. Complex interrelated pathophysiological mechanisms triggered by hyperglycaemia underlie the development of DR. These mechanisms include genetic and epigenetic factors, increased production of free radicals, advanced glycosylation end products, inflammatory factors and vascular endothelial growth factor (VEGF). Optimal control of blood glucose and blood pressure in individuals with diabetes remains the cornerstone for preventing the development and arresting the progression of DR. Anti-VEGF therapy is currently indicated for diabetic macular oedema associated with vision loss, whereas laser photocoagulation prevents severe vision loss in eyes with proliferative DR. These measures, together with increasing public awareness and access to regular screening for DR with retinal photography, and the development of new treatments to address early disease stages, will lead to better outcomes and prevent blindness for patients with DR. PMID:27159554

  15. Group B and F Beta Streptococcus Necrotizing Infection-Surgical Challenges with a Deep Central Plantar Space Abscess A Diabetic Limb Salvage Case Report.

    Science.gov (United States)

    Mendivil, Jason M; Jolley, David; Walters, Jodi; Dancho, Jim; Martin, Billy

    2016-05-01

    We present the case of a 66-year-old, type II diabetic male with a deep wound to the plantar-lateral aspect of his right hallux. On examination, the central plantar compartment of his right foot was moderately erythematous and tender on palpation. After obtaining a deep wound culture, treatment was complicated by a progression of a group B and F beta streptococcus, necrotizing infection. The patient underwent a right hallux amputation, followed by a plantar medial incision for drainage of an abscess to the medial and central plantar compartments of the foot. Due to the extent and limb threat of the infection, the patient ultimately underwent a transmetatarsal amputation. Advanced healing modalities were also employed to decrease wound healing times, which allowed the patient to achieve early weightbearing and return to activities of daily living. This study depicts how the astute podiatric surgeon needs to make a decision in a timely manner to surgically debride all nonviable and necrotic tissue in order to minimize further amputation and preserve foot function.

  16. Diabetic Retinopathy

    Science.gov (United States)

    ... Disease > Facts About Diabetic Eye Disease Facts About Diabetic Eye Disease Points to Remember Diabetic eye disease ... existing therapies for different patient groups. What is diabetic eye disease? Diabetic eye disease can affect many ...

  17. Diabetes - resources

    Science.gov (United States)

    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 -- ...

  18. Diabetes - resources

    Science.gov (United States)

    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 -- ...

  19. Near Normalization of Metabolic and Functional Features of the Central Nervous System in Type 1 Diabetic Patients With End-Stage Renal Disease After Kidney-Pancreas Transplantation

    OpenAIRE

    Fiorina, Paolo; Vezzulli, Paolo; Bassi, Roberto; Gremizzi, Chiara; Falautano, Monica; D’Addio, Francesca; Vergani, Andrea; Chabtini, Lola; Altamura, Erica; Mello, Alessandra; Caldara, Rossana; Scavini, Marina; Magnani, Giuseppe; Falini, Andrea; Secchi, Antonio

    2012-01-01

    OBJECTIVE The pathogenesis of brain disorders in type 1 diabetes (T1D) is multifactorial and involves the adverse effects of chronic hyperglycemia and of recurrent hypoglycemia. Kidney-pancreas (KP), but not kidney alone (KD), transplantation is associated with sustained normoglycemia, improvement in quality of life, and reduction of morbidity/mortality in diabetic patients with end-stage renal disease (ESRD). RESEARCH DESIGN AND METHODS The aim of our study was to evaluate with magnetic reso...

  20. Women and Diabetes -- Diabetes Medicines

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  1. X-ray structure of human aquaporin 2 and its implications for nephrogenic diabetes insipidus and trafficking

    NARCIS (Netherlands)

    Frick, A.; Eriksson, U.K.; Mattia, F.P. de; Oberg, F.; Hedfalk, K.; Neutze, R.; Grip, W.J. de; Deen, P.M.T.; Tornroth-Horsefield, S.

    2014-01-01

    Human aquaporin 2 (AQP2) is a water channel found in the kidney collecting duct, where it plays a key role in concentrating urine. Water reabsorption is regulated by AQP2 trafficking between intracellular storage vesicles and the apical membrane. This process is tightly controlled by the pituitary h

  2. Successful treatment with cladribine of Erdheim-Chester disease with orbital and central nervous system involvement developing after treatment of langerhans cell histiocytosis

    Directory of Open Access Journals (Sweden)

    Perić Predrag

    2016-01-01

    Full Text Available Introduction. Erdheim-Chester disease (ECD is a rare, systemic form of non-Langerhans cell histiocytosis of the juvenile xantho-granuloma family with characteristic bilateral symmetrical long bone osteosclerosis, associated with xanthogranulomatous extras-keletal organ involvement. In ECD, central nervous system (CNS and orbital lesions are frequent, and more than half of ECD patients carry the V600E mutation of the proto-oncogene BRAF. The synchronous or metachronous development of ECD and Langerhans cell histiocytosis (LCH in the same patients is rare, and the possible connection between them is still obscure. Cladribine is a purine substrate analogue that is toxic to lymphocytes and monocytes with good hematoencephalic penetration. Case report. We presented a 23-year-old man successfully treated with cladribine due to BRAF V600E-mutation-negative ECD with bilateral orbital and CNS involvement. ECD developed metachronously, 6 years after chemotherapy for multisystem LCH with complete disease remission and remaining central diabetes insipidus. During ECD treatment, the patient received 5 single-agent chemotherapy courses of cladribine (5 mg/m2 for 5 consecutive days every 4 weeks, with a reduction in dose to 4 mg/m2 in a fifth course, delayed due to severe neutropenia and thoracic dermatomal herpes zoster infection following the fourth course. Radiologic signs of systemic and CNS disease started to resolve 3 months after the end of chemotherapy, and CNS lesions completely resolved within 2 years after the treatment. After 12-year follow-up, there was no recurrence or appearance of new systemic or CNS xanthogranu-lomatous lesions or second malignancies. Conclusion. In accordance with our findings and recommendations provided by other authors, cladribine can be considered an effective alternative treatment for ECD, especially with CNS involvement and BRAF V600E-mutation-negative status, when interferon-α as the first-line therapy fails.

  3. Year in diabetes 2012: The diabetes tsunami.

    Science.gov (United States)

    Sherwin, R; Jastreboff, A M

    2012-12-01

    Diabetes affects more than 300 million individuals globally, contributing to significant morbidity and mortality worldwide. As the incidence and prevalence of diabetes continue to escalate with the force of an approaching tsunami, it is imperative that we better define the biological mechanisms causing both obesity and diabetes and identify optimal prevention and treatment strategies that will enable a healthier environment and calmer waters. New guidelines from the American Diabetes Association/European Association of the Study of Diabetes and The Endocrine Society encourage individualized care for each patient with diabetes, both in the outpatient and inpatient setting. Recent data suggest that restoration of normal glucose metabolism in people with prediabetes may delay progression to type 2 diabetes (T2DM). However, several large clinical trials have underscored the limitations of current treatment options once T2DM has developed, particularly in obese children with the disease. Prospects for reversing new-onset type 1 diabetes also appear limited, although recent clinical trials indicate that immunotherapy can delay the loss of β-cell function, suggesting potential benefits if treatment is initiated earlier. Research demonstrating a role for the central nervous system in the development of obesity and T2DM, the identification of a new hormone that simulates some of the benefits of exercise, and the development of new β-cell imaging techniques may provide novel therapeutic targets and biomarkers of early diabetes detection for optimization of interventions. Today's message is that a diabetes tsunami is imminent, and the only way to minimize the damage is to create an early warning system and improve interventions to protect those in its path. PMID:23185035

  4. V ISUAL EVOKED POTENTIALS IN TYPE - 1 DIABETES WITHOUT RETINOPATHY: CO - RELATIONS WITH DURATION OF DIABETES

    OpenAIRE

    Sanjeev Kumar; Virendra; Tonpay; Milind; Nikhil

    2014-01-01

    20 diabetic (Type 1) patients have been studied in order to investigate the possible effects of the type 1 diabetes mellitus on the central nervous system by means of pattern shift visual evoked potentials. Patients with diabetic retinopathy , glaucoma and cataract were excluded from the study. To evaluate central optic pathways involvement in diabetics , visual evoked po tentials (VEP) , in particular the latency of positive peak (P100) , were stu...

  5. Hypothalamic pituitary dysfunction in acute nonmycobacterial infections of central nervous system

    Directory of Open Access Journals (Sweden)

    Dinesh K Dhanwal

    2011-01-01

    central diabetes insipidus. Conclusion: Acute infections of the CNS are associated with abnormalities in the pituitary hormone profile. Further studies are required to evaluate the hypothalamic pituitary axis using dynamic tests and imaging by MRI.

  6. Causes of Diabetes

    Science.gov (United States)

    ... Help for Diabetes Care Diabetes Statistics Causes of Diabetes What is diabetes? Diabetes is a complex group of diseases with ... and type 2 diabetes. What causes type 1 diabetes? Type 1 diabetes is caused by a lack ...

  7. Central nervous system PET-CT imaging reveals regional impairments in pediatric patients with Wolfram syndrome.

    Directory of Open Access Journals (Sweden)

    Agnieszka Zmyslowska

    Full Text Available Wolfram syndrome (WFS is inherited as an autosomal recessive disease with main clinical features of diabetes mellitus, optic atrophy, diabetes insipidus and deafness. However, various neurological defects may also be detected. The aim of this study was to evaluate aspects of brain structure and function using PET-CT (positron emission tomography and computed tomography and MRI (magnetic resonance imaging in pediatric patients with WFS. Regional changes in brain glucose metabolism were measured using standardized uptake values (SUVs based on images of (18F fluorodeoxyglucose (FDG uptake in 7 WFS patients aged 10.1-16.0 years (mean 12.9±2.4 and in 20 healthy children aged 3-17.9 years (mean 12.8±4.1. In all patients the diagnosis of WFS was confirmed by DNA sequencing of the WFS1 gene. Hierarchical clustering showed remarkable similarities of glucose uptake patterns among WFS patients and their differences from the control group. SUV data were subsequently standardized for age groups 13 years old to account for developmental differences. Reduced SUVs in WFS patients as compared to the control group for the bilateral brain regions such as occipital lobe (-1.24±1.20 vs. -0.13±1.05; p = 0.028 and cerebellum (-1.11±0.69 vs. -0.204±1.00; p = 0.036 were observed and the same tendency for cingulate (-1.13±1.05 vs. -0.15±1.12; p = 0.056, temporal lobe (-1.10±0.98 vs. -0.15±1.10; p = 0.057, parietal lobe (-1.06±1.20 vs. -0.08±1.08; p = 0.058, central region (-1.01±1.04 vs. -0.09±1.06; p = 0.060, basal ganglia (-1.05±0.74 vs. -0.20±1.07; p = 0.066 and mesial temporal lobe (-1.06±0.82 vs. -0.26±1.08; p = 0.087 was also noticed. After adjusting for multiple hypothesis testing, the differences in glucose uptake were non-significant. For the first time, regional differences in brain glucose metabolism among patients with WFS were shown using PET-CT imaging.

  8. Diabetic Dermopathy

    Science.gov (United States)

    ... rash and rashes clinical tools newsletter | contact Share | Diabetic Dermopathy Information for adults A A A Brown, ... on the legs are typical in long-standing diabetics. Overview Diabetic dermopathy, also known as shin spots ...

  9. Diabetic Neuropathy

    Science.gov (United States)

    ... Awards Enhancing Diversity Find People About NINDS NINDS Diabetic Neuropathy Information Page Table of Contents (click to ... Trials Organizations Additional resources from MedlinePlus What is Diabetic Neuropathy? Diabetic neuropathy is a peripheral nerve disorder ...

  10. Diabetes Superfoods

    Science.gov (United States)

    ... Home Find Your Local Office Find your local diabetes education program Calendar of Events Wellness Lives Here Drive ... can fund critical diabetes research and support vital diabetes education services that improve the lives of those with ...

  11. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  12. The central role of vascular extracellular matrix and basement membrane remodeling in metabolic syndrome and type 2 diabetes: the matrix preloaded

    Directory of Open Access Journals (Sweden)

    Tyagi Suresh C

    2005-06-01

    Full Text Available Abstract The vascular endothelial basement membrane and extra cellular matrix is a compilation of different macromolecules organized by physical entanglements, opposing ionic charges, chemical covalent bonding, and cross-linking into a biomechanically active polymer. These matrices provide a gel-like form and scaffolding structure with regional tensile strength provided by collagens, elasticity by elastins, adhesiveness by structural glycoproteins, compressibility by proteoglycans – hyaluronans, and communicability by a family of integrins, which exchanges information between cells and between cells and the extracellular matrix of vascular tissues. Each component of the extracellular matrix and specifically the capillary basement membrane possesses unique structural properties and interactions with one another, which determine the separate and combined roles in the multiple diabetic complications or diabetic opathies. Metabolic syndrome, prediabetes, type 2 diabetes mellitus, and their parallel companion (atheroscleropathy are associated with multiple metabolic toxicities and chronic injurious stimuli. The adaptable quality of a matrix or form genetically preloaded with the necessary information to communicate and respond to an ever-changing environment, which supports the interstitium, capillary and arterial vessel wall is individually examined.

  13. Assessment of cerebral perfusion and cerebrovascular reserve in insulin-dependent diabetic patients without central neurological symptoms by means of {sup 99m}Tc-HMPAO SPET with acetazolamide

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez-Bonilla, J.F.; Quirce, R.; Hernandez, A.; Vallina, N.K.; Guede, C.; Banzo, I.; Amado, J.A.; Carril, J.M. [Nuclear Medicine Service, University Hospital Marques de Valdecilla, Santander (Spain)

    2001-11-01

    The detection of subclinical abnormalities in cerebral blood flow could be of great value in identifying diabetic patients at risk of stroke. The aim of this study was to assess the contribution of semiquantified post-acetazolamide technetium-99m hexamethylpropylene amine oxime single-photon emission tomography ({sup 99m}Tc-HMPAO SPET) in 15 diabetic patients with no clinical history of central neurological disease. After baseline {sup 99m}Tc-HMPAO SPET, a second SPET scan was acquired after activation of the cerebrovascular reserve (CVR) with an injection of 1 g of acetazolamide (post-ACZ SPET). Semiquantitative analysis was made in 16 regions of interest (ROIs) drawn for each of the three supratentorial slices selected, and in two ROIs in the infratentorial slice. The CVR was calculated in each ROI by subtracting the decay-corrected baseline images from those obtained in the post-ACZ SPET and expressed as the percent increase in the average counts between the two scans. Baseline perfusion and CVR values in the study group were compared with the corresponding values in a control group. Of 750 cortical ROIs studied, 332 showed a decreased CVR (44.3%). The baseline perfusion SPET study showed hypoperfusion in 65 ROIs (8.6%) and hyperperfusion in 56 (7.4%). Of the 65 hypoperfused regions, 66.2% had a normal CVR and 33.8% had a decreased CVR, whereas of the 56 hyperperfused regions, 51.8% had a CVR within normal limits and 48.2% showed a decreased CVR. In conclusion, in comparison with baseline {sup 99m}Tc-HMPAO SPET, the ACZ activation test provided additional information in the study of cerebrovascular impairment, and allowed characterisation of the subclinical abnormalities in the population studied. The technique may therefore prove useful in evaluating future preventive strategies for stroke in diabetic patients. (orig.)

  14. Types of Diabetes

    Science.gov (United States)

    ... Help for Diabetes Care Diabetes Statistics Types of Diabetes Learn about Diabetes You can learn how to take care of ... to take care of your diabetes. What is diabetes? Diabetes is when your blood glucose, also called ...

  15. GLUTATHIONE PEROXIDASE-1 PRO200LEU POLYMORPHISM (RS1050450) IS ASSOCIATED WITH MORBID OBESITY INDEPENDENTLY OF THE PRESENCE OF PREDIABETES OR DIABETES IN WOMEN FROM CENTRAL MEXICO.

    Science.gov (United States)

    Hernández Guerrero, César; Hernández Chávez, Paulina; Martínez Castro, Noemí; Parra Carriedo, Alicia; García Del Rio, Sandra; Pérez Lizaur, Ana

    2015-10-01

    Introducción: la obesidad afecta a una tercera parte de la población mexicana. El estrés oxidativo (EO) participa activamente en la etiología del fenómeno. La glutatión peroxidasa-1 (GPx-1) juega un papel protector contra el EO. El SNP Pro200Leu (rs10504050) afecta a la actividad de la enzima. Objetivo: determinar la frecuencia del polimorfismo rs10504050 en mujeres con obesidad (OB) y normopeso (CG), determinar la concentración de TBARS en sangre periférica y evaluar el consumo de pro y antioxidantes. Métodos: en el estudio se incluyeron 104 mujeres con obesidad y 70 controles. El polimorfismo rs10504050 se determinó por el método PCR/RFLP. La concentración de TBARS se cuantificó mediante espectrofotometría en plasma sanguíneo. Las participantes se estratificaron y compararon por grados de obesidad y subgrupos de prediabetes y diabetes. Se emplearon las pruebas estadísticas ANOVA de Kruskal Wallis, Xi cuadrada y correlación de Pearson. Resultados: el polimorfismo rs10504050 mostró diferencias estadísticas (Xi2 = 6; p = 0,01) entre la frecuencia del grupo OB (0,61) por arrastre (Pro/Leu+Leu/Leu) y el CG (0,42), así como (Xi2 = 8; p = 0,004) entre personas con obesidad mórbida (0,74) comparadas con el CG. No hubo diferencia significativa entre las frecuencias del rs10504050 en OB con pre o diabetes, comparado con el CG, ni con personas con obesidad sin diabetes. Las concentraciones de TBARS fueron mayores en todos los grados de OB comparados con el CG. Conclusión: el polimorfismo rs10504050 se asoció con obesidad, especialmente mórbida, pero no se asoció con diabetes o prediabetes. El estrés oxidativo está presente de manera significativa en todos los grados de obesidad.

  16. Prevalencia de nefropatía diabética y sus factores de riesgo en un área urbano marginal de la meseta Central de Costa Rica Prevalence and Risk Factors of Diabetic Nephropathy in a Peripheral Urban Area of the Central Plateau of Costa Rica

    Directory of Open Access Journals (Sweden)

    Adriana Laclé-Murray

    2009-03-01

    para estimar en un área de salud la prevalencia y los factores asociados de esta patología. Los métodos diagnósticos para valorar la microalbuminuria deberían estar a la disposición a nivel de atención primaria, para poder afinar este indicador en el contexto de la vigilancia de la DM a nivel nacional.Background and aim: Diabetic nephropathy affects approximately 40% of type 2 diabetic patients and is the leading cause of kidney disease in patients starting renal replacement therapy in developed countries. The same seems to be true in Costa Rica. Knowing its prevalence and associated factors is fundamental to plan and to evaluate health services for the diabetic population. The main objective of this study was to determine the prevalence of diabetic nephropathy and its risk factors in type 2 diabetic patients from a poor marginal urban community of the central plateau of Costa Rica. Methodology: Five hundred and seventy two type 2 diabetics from the Health Area 3 of Desamparados, were identified in 2000, sociodemographic data, metabolic control, comorbidities and microvascular diabetic complications variables were studied. The prevalence of diabetic nephropathy and its associated factors were determined using a multivariate logistic regression analysis for the latter. Results: The cohort had an average age of 58.5 years low education and low income and consisted predominantly of women (63.8%. The group had a high prevalence of hypertension (53.2%, obesity (78.5%, and dyslipidemia (41.5%. Sixty-one percent had the diagnosis of diabetes before age 60 and an average of 8 years with the disease. The prevalence of microvascular complications was high: retinopathy (19.6%, neuropathy (30.6%, nephropathy (33.6%, microproteinuria (24.8%, macroproteinuria (7%, nephrotic syndrome (1.4% and chronic renal insufficiency (7.1% without sex differences. Associated risk factors and odds ratio found for diabetic nephropathy were: diabetic retinopathy (4,6 IC:2.5-8, years of

  17. Purinergic signalling and diabetes

    DEFF Research Database (Denmark)

    Burnstock, Geoffrey; Novak, Ivana

    2013-01-01

    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...

  18. [Diabetic neuropathy].

    Science.gov (United States)

    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.

  19. Central obesity and risk for type 2 diabetes in Maori, Pacific and European young men in New Zealand. Highlights and achievements

    International Nuclear Information System (INIS)

    Weight gain is associated with the incidence of Type 2 diabetes. Maori and Pacific people in New Zealand have a greater prevalence of obesity and Type 2 diabetes compared to NZ European people. We hypothesised that this difference is related to metabolic and fat distribution differences as previously demonstrated in a study of Polynesian and European women. Thirty healthy male volunteers between the ages of 18 and 27 years were selected for a wide range of fatness. Equal numbers, 10 in each group, self-identified as belonging to either the Maori, Pacific or European ethnic groups. Specific measurements undertaken included resting metabolic rate by indirect calorimetry; total energy expenditure over 14 days by the doubly-labelled water technique; total and regional body fat from dual-energy x-ray absorptiometry; anthropornetry (body mass index, skinfold thicknesses and girths); fat and carbohydrate utilisation from respiratory quotients and from carbon-13 analysis of expired breath; and dietary intake of macronutrients. Glucose tolerance, insulin, glycosylated haemoglobin, thyroid hormone, leptin and blood lipid determinations were also performed and HOMA and ISIO-120 indices calculated

  20. Control and chronic complications of diabetes mellitus in an outpatient atention center in Medellín, Colombia, 1998-2001 Control y complicaciones crónicas de la diabetes mellitus en el Centro de Atención Ambulatorio central, Instituto de Seguro Social 1998-2001

    Directory of Open Access Journals (Sweden)

    Catalina Bedoya Gómez

    2004-01-01

    were: cardiovascular 48,4%, eyerelated 57.4%, renal 31,5%, neuropathy 28,6% and diabetic foot 24%. Less than 50% of the patients had reached goals in controlling glycemia, HbA1c, total cholesterol, HDL cholesterol and systolic blood pressure. In the control of triglycerides and diastolic blood pressure, 62% and 76.3%, respectively had reached the goals of control. When association tests among different variables were performed, we only found association between the type of diabetes and the presence of hypertension and cardiovascular disease (p <0.000 for both. Conclusions: in diabetic patients attending the outpatient diabetes control program of the iss sectional Antioquia, diabetes is associated to other metabolic syndrome components in high proportion; these patients have a high incidence of chronic complications which varies from 24 to 58%, thus enhancing their morbility and mortality and they represent an important burden to the health system. We emphasize on the need of early detection in order to do a proper control and to carry out therapeutic and educational strategies to prevent or slow down the appearance of complications. El control de la diabetes mellitus requiere la evaluación continua y estricta de un gran número de factores que lo afectan, no solo desde el punto de vista de la glucemia sino de otros participantes en el trastorno metabólico por ella producida, de otras enfermedades asociadas a ella y de hábitos de salud que influyen en su control y en la aparición de diferentes complicaciones. Para identificar esta situación en el programa de diabetes del Centro de Atención Ambulatoria (CAA central del Instituto del Seguro Social (ISS, seccional Antioquia se evaluaron el control de la diabetes, la presencia de enfermedades asociadas, los hábitos de salud, las complicaciones crónicas presentadas y el grado de control de los diferentes parámetros. Metodología: entre enero de 1998 y diciembre de 2001, mediante un muestreo aleatorio simple con

  1. Malta : Mediterranean Diabetes hub : a journey through the years

    OpenAIRE

    Cuschieri, Sarah; Mamo, Julian

    2014-01-01

    Introduction: Diabetes mellitus in Malta has been an established major health problem for years. It has been linked with cultural, geographical, historical, genetic as well and a change from a Mediterranean diet to a Westernized diet. This diabetes burden has lead to establishment of diabetes clinics both in the central general hospital, as well as in the community. Over the past 50 years, there have been two major epidemiological diabetes studies conducted to evaluate diabetes in the Maltese...

  2. Screening for Gestational Diabetes

    Science.gov (United States)

    ... or obese or having a family history of diabetes. Gestational diabetes usually goes away after the baby is ... Click Here to Learn More About Preventing Gestational Diabetes Gestational Diabetes ( healthfinder. gov) Diabetes and Pregnancy: Gestational Diabetes ( ...

  3. Carbohydrates and Diabetes

    Science.gov (United States)

    ... When You Have Diabetes Meal Plans and Diabetes Smart Supermarket Shopping Diabetes Control: Why It's Important Diabetes: What's True and False? Type 2 Diabetes: What Is It? Food Labels Type 1 Diabetes: What Is It? Contact Us ...

  4. Gestational diabetes

    Science.gov (United States)

    ... special diet. In general, when you have gestational diabetes your diet should: Be moderate in fat and protein Provide ... drinks, fruit juices, and pastries If managing your diet does not ... diabetes medicine by mouth or insulin therapy. Most women ...

  5. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  6. Diabetic Pets

    Science.gov (United States)

    ... health or management, contact your veterinarian. In addition, diabetic pets should be monitored for long-term complications such as cataracts, which commonly develop in diabetic dogs and cats. Other problems that can occur ...

  7. Diabetes Complications

    Science.gov (United States)

    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 ...

  8. Diabetic ketoacidosis

    Science.gov (United States)

    ... to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness.

  9. 中心静脉压与BNP在糖尿病酸中毒合并心衰治疗中的意义%The Significance of Central Venous Pressure and BNP in Diabetic Ketoacidosis with Heart Failure

    Institute of Scientific and Technical Information of China (English)

    陈志

    2012-01-01

      目的:分析中心静脉压(CVP)与B型脑钠肽(BNP)在糖尿病酸中毒中的变化及相关性,为临床合理补液提供依据.方法:回顾分析132例糖尿病酮症酸中毒患者的病历资料,依据是否合并心衰分为:心衰组73例和非心衰组59例;采用酶联免疫吸附法(ELISA)测定患者血浆BNP,有创心电监护测量CVP.结果:心衰组CVP及BNP较非心衰组明显增高,差异有统计学意义(P<0.01),不同心功能分级CVP与BNP呈正相关(r=0.087、0.092、0.97).结论:(1)CVP与BNP在糖尿病酮症酸中毒合并急性心衰中均增高;(2)CVP与BNP在糖尿病酮症酸中毒急性心衰中呈正相关性;(3)CVP与BNP的监测可作为临床补液的参考依据.%  Objective:To analyze the change and correlation of central venous pressure (CVP) and B-type natriuretic peptide (BNP) in diabetic ketoacidosis with heart failure ,to provide a basis for clinical rehydration.Method:A retrospective analysis of 132 cases of diabetic ketoacidosis, who were divided into tow group:heart failure group (73 cases),non-heart failure group (59 cases) that based on the records,by enzyme-linked immunosorbent assay (ELISA) to determine plasma BNP,and measure CVP by invasive ECG. Result:CVP and BNP of heart failure group were obviously higher than non-heart failure group,the difference of tow group were Statistically significant(P<0.01).Statistical significant difference,CVP and cardiac function in different BNP was positively correlated (r=0.087,0.092,0.97).Conclusion:⑴CVP and BNP in acute heart failure in diabetic ketoacidosis were increased.⑵CVP and BNP were positively correlated.⑶Monitoring of CVP and BNP can be used as a reference for clinical infusion.

  10. [Diabetes mellitus].

    Science.gov (United States)

    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. PMID:14523905

  11. Diabetic osteopathy

    OpenAIRE

    Ilić Jana; Kovačev Branka

    2005-01-01

    Introduction. The aim of this study was to point out some dilemmas about the existence and pathogenesis of primary diabetic osteopathy as a separate entity, based on currently available studies. Expert disagreements are present not only about the occurrence of generalized osteopathy with diabetic disease, but also about direct relationship between metabolic diabetes control and bone metabolism and influence of disease duration and sex on bone changes. Pathogenesis of diabetic osteopathy Decre...

  12. Diabetes network.

    Science.gov (United States)

    2016-07-01

    Diabetes UK has launched a network of information and support for commissioning and improvement in diabetes care. The network is free to join and offers monthly updates on good practice from around the UK, a forum for sharing ideas and learning, and access to Diabetes UK resources. PMID:27369708

  13. Diabetic retinopathy

    OpenAIRE

    Mendrinos, Efstratios; Stangos, Alexandros; Pournaras, Constantin

    2007-01-01

    Diabetic retinopathy is the most common cause of blindness in the UK, with older people and those with worse diabetic control, hypertension, and hyperlipidaemia most at risk. Diabetic retinopathy can cause microaneurysms, haemorrhages, exudates, changes to blood vessels, and retinal thickening.

  14. Managing Diabetes: 4 Steps to Manage Your Diabetes for Life

    Science.gov (United States)

    ... Financial Help for Diabetes Care Diabetes Statistics Managing Diabetes 4 Steps to Manage Your Diabetes for Life | NDEP Step 1: Learn about diabetes. ... diabetes care each day. Step 1: Learn about diabetes. What is diabetes? There are three main types ...

  15. V ISUAL EVOKED POTENTIALS IN TYPE - 1 DIABETES WITHOUT RETINOPATHY: CO - RELATIONS WITH DURATION OF DIABETES

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar

    2014-01-01

    Full Text Available 20 diabetic (Type 1 patients have been studied in order to investigate the possible effects of the type 1 diabetes mellitus on the central nervous system by means of pattern shift visual evoked potentials. Patients with diabetic retinopathy , glaucoma and cataract were excluded from the study. To evaluate central optic pathways involvement in diabetics , visual evoked po tentials (VEP , in particular the latency of positive peak (P100 , were studied in 20 patients and 20 normal controls using reversal pattern VEP. P100 latency was significantly increased in diabetics. A positive co - relation was also found between latencies of VEP and duration of disease. Relationship between blood sugar level and P 100 wave latencies and amplitudes in diabetic patients was not significant . VEP measurement seems a simple and sensitive method for detecting early involvement and changes in opti c pathways in diabetics

  16. Diabetic osteopathy

    Directory of Open Access Journals (Sweden)

    Ilić Jana

    2005-01-01

    Full Text Available Introduction. The aim of this study was to point out some dilemmas about the existence and pathogenesis of primary diabetic osteopathy as a separate entity, based on currently available studies. Expert disagreements are present not only about the occurrence of generalized osteopathy with diabetic disease, but also about direct relationship between metabolic diabetes control and bone metabolism and influence of disease duration and sex on bone changes. Pathogenesis of diabetic osteopathy Decreased bone formation is the basic mechanism leading to decreased bone mass. Biochemical markers showed no clear connection with bone density measurement. Insulin and insulin-like growth factor (IGF affect bone metabolism. Osteopathy in patients with diabetic disease-type 1 Some clinical studies have shown that patients with diabetic disease-type 1 have a mild decrease in bone mass, while others have not presented such results. Osteopathy in patients with diabetic disease-type2 In patients with diabetic disease-type 2 the risk for osteopathy is even less defined. Patients treated with oral hypoglycemics present with higher decrease of bone mass has than patients treated with insulin therapy. This could partly be explained by anabolic effects of insulin on bones. Bone fractures in patients with diabetic disease Literature data are contradictory concerning the occurrence of bone fractures in diabetic patients. A survey of bone fracture occurrence in diabetic patients was performed in "Veljko Vlahović Medical Center" in Vrbas and it included a group of 100 patients with diabetic disease. The results show that 12 patients had some fractures: mostly females in postmenopause, aged and with secondary insulin-dependent diabetes and most frequently arm fractures. Considering contradictory literature data, further longitudinal studies are necessary. .

  17. Brain MRI in Type 2 Diabetes

    OpenAIRE

    Tiehuis, A.M.

    2009-01-01

    In recent years is has become clear that type 2 diabetes affects the central nervous system. These long-term complications manifest as structural changes on brain imaging, cognitive decrements and a 1.5-2 fold increased risk for the development of dementia, in particular in the elderly. The pathogenesis of diabetes-induced brain damage is not completely understood. Both vascular and metabolic disturbances may play an important role in the impact of diabetes on the brain. The course of develop...

  18. Diabetic Neuropathies: The Nerve Damage of Diabetes

    Science.gov (United States)

    ... Organizations (PDF, 293 KB). Alternate Language URL Español Diabetic Neuropathies: The Nerve Damage of Diabetes Page Content ... treated? Points to Remember Clinical Trials What are diabetic neuropathies? Diabetic neuropathies are a family of nerve ...

  19. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller;

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  20. Societal costs of diabetes mellitus in Denmark

    DEFF Research Database (Denmark)

    Sortsø, C; Green, A; Jensen, Peter Bjødstrup;

    2016-01-01

    AIM: To provide comprehensive real-world evidence on societal diabetes-attributable costs in Denmark. METHODS: National register data are linked on an individual level through unique central personal registration numbers in Denmark. All patients in the Danish National Diabetes Register in 2011 (N...

  1. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005179 The association of LMNA1908C/T polymorphism with insulin resistance and dyslipidemia in diabetic patients. SU Ben-li (苏本利), et al. Dept Endocrinol, 2nd Affili Hosp, Dalian Med Univ, Dalian 116027. Chin J Diabetes, 2005;13(1) :27-30. Objective: To study the association of LMhlA 1908 C/T polymorphism with insulin resistance and dyslipidemia in type 2 diabetic patients. Methods:

  2. Diabetes Mellitus

    OpenAIRE

    Woodcock, Alison; Bradley, Clare

    2007-01-01

    Diabetes mellitus is a chronic disorder, characterised by raised glucose levels in blood (hyperglycaemia) and urine (glycosuria). The cause may be inherited and/or acquired deficiency of insulin production by the pancreas, or insulin resistance, where the insulin produced is ineffective. Increased blood glucose concentrations can cause structural damage, particularly to blood vessels and nerves. Microvascular complications of diabetes (diabetic retinopathy, nephropathy and neuropathy) bring p...

  3. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930047 Relationship between diabetic cardiacautonomic disturbances and Q-Tc interval pro-longation and its clinical significance.XIANGMingzhu(向明珠),et al.Dept Med,1st PeopleHosp,Shashi,Hubei Prov,Shashi,434000.Chin J Endocrinol & Metabol 1992;8(3):149-151.Autonomic cardiovascular function tests andelectrocardiograms were performed in 61 pa-tients with diabetes mellitus.The result showedthat Q-Tc interval in diabetic patients with ab-

  4. Women and Diabetes

    Medline Plus

    Full Text Available ... diabetes. Food Safety for People with Diabetes Your Glucose Meter - easy-to-read booklet for women Other ... Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need ...

  5. Genetics of Diabetes

    Science.gov (United States)

    ... 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. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes Center Diabetes: DJ's Story (Video) Diabetes: Marco's ... Use Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  7. Women and Diabetes

    Medline Plus

    Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  8. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller;

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  9. Diabetes and Pregnancy: Gestational Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-14

    Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

  10. Disease: H00252 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00252 Congenital nephrogenic diabetes insipidus (NDI) Nephrogenic diabetes insipid...eSH: D018500 OMIM: 304800 125800 PMID:17908859 Linshaw MA Back to basics: congenital nephrogenic diabetes in...sipidus. Pediatr Rev 28:372-80 (2007) PMID:16580609 Bichet DG Nephrogenic diabetes insipidus. Adv Chronic Ki... defects in nephrogenic diabetes insipidus. Pediatr Nephrol 16:1146-52 (2001) ... ...dney Dis 13:96-104 (2006) PMID:11793119 Knoers NV, Deen PM Molecular and cellular

  11. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008395 Evaluating the feature of hypoglycemia detected by continuous glucose monitoring system during temporary continuous subcutaneous insulin infusion in type 2 diabetes patients. LI Ming(李鸣), et al.Shanghai Diabet Clin Center, Dept Endocrinol & Metab, Shanghai Jiaotong Univ, Shanghai 200233. Natl Med J China 2008;88(24):1679-1682.

  12. Diabetes Dyslipidemia

    OpenAIRE

    Schofield, Jonathan D.; Liu, Yifen; Rao-Balakrishna, Prasanna; Malik, Rayaz A.; Soran, Handrean

    2016-01-01

    Diabetes mellitus is associated with a considerably increased risk of premature atherosclerotic cardiovascular disease. Intensive glycemic control has essentially failed to significantly improve cardiovascular outcomes in clinical trials. Dyslipidemia is common in diabetes and there is strong evidence that cholesterol lowering improves cardiovascular outcomes, even in patients with apparently unremarkable lipid profiles. Here, the authors review the pathophysiology and implications of the alt...

  13. Somatotype in Elderly Type 2 Diabetes Patients

    OpenAIRE

    Buffa, Roberto; Floris, Giovanni; F. Putzu, Paolo; Carboni, Luciano; Marini, Elisabetta

    2007-01-01

    Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4±7.0 years; 65 women, mean age 72.9±...

  14. Diabetes and the brain: Cognitive performance in type 1 and type 2 diabetes mellitus

    OpenAIRE

    Brands, A.M.A.

    2007-01-01

    Both type 1 and type 2 diabetes mellitus are associated with altered brain function, a complication referred to as diabetic encephalopathy. The issues surrounding the cognitive and emotional status in chronic, older diabetic patients remain complex. The literature shows contrasting findings and especially the role of recurrent hypoglycemic episodes remains controversial. The research of this thesis was designed to further unravel the clinical and cognitive characteristics of altered central n...

  15. Diabetic encephalopathy: the role of oxidative stress and inflammation in type 2 diabetes

    OpenAIRE

    Reis, Flávio; Soares, MR; Nunes, Sara; Pereira,Frederico

    2012-01-01

    Edna Soares, Sara Nunes, Flávio Reis, Frederico C PereiraLaboratory of Pharmacology and Experimental Therapeutics/IBILI, Coimbra University, Coimbra, PortugalAbstract: Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder associated with an increased risk for central nervous system disorders. Diabetic encephalopathy is a relatively unknown diabetes complication, characterized by electrophysiological, structural, neurochemical, and degenerative neuronal changes that ...

  16. Cranial mononeuropathy III - diabetic type

    Science.gov (United States)

    ... also have eyelid drooping. Prevention Controlling your blood sugar level may reduce the risk of developing this disorder. Alternative Names Diabetic third nerve palsy; Pupil-sparing third cranial nerve palsy Images Central nervous system and peripheral nervous system References Rucker JC. Cranial ...

  17. Quality of Care for First-Degree Relatives of Type 2 Diabetes Patients Diagnosed with Diabetes at a Screening Program One Year After Diagnosis

    OpenAIRE

    Amini, Massoud; Timori, Azam; Aminorroaya, Ashraf

    2008-01-01

    AIMS: Diabetes screening is an effective tool for diagnosing patients who are unaware of their diabetes and for providing them with optimal treatment. The quality of care and treatment of diabetic patients diagnosed at a screening program during one year in Isfahan, a centrally located Iranian city, was assessed. METHODS: In a prospective study, 1640 first-degree relatives of diabetic patients (aged 35-55) were screened for diabetes mellitus at Isfahan Endocrine and Metabolism Research Center...

  18. Diabetes and kidney disease

    Science.gov (United States)

    Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease ... so that you know how meals and activities affect your level OTHER WAYS TO PROTECT YOUR KIDNEYS ...

  19. Diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Zelmanovitz Themis

    2009-09-01

    Full Text Available Abstract Diabetic nephropathy is the leading cause of chronic renal disease and a major cause of cardiovascular mortality. Diabetic nephropathy has been categorized into stages: microalbuminuria and macroalbuminuria. The cut-off values of micro- and macroalbuminuria are arbitrary and their values have been questioned. Subjects in the upper-normal range of albuminuria seem to be at high risk of progression to micro- or macroalbuminuria and they also had a higher blood pressure than normoalbuminuric subjects in the lower normoalbuminuria range. Diabetic nephropathy screening is made by measuring albumin in spot urine. If abnormal, it should be confirmed in two out three samples collected in a three to six-months interval. Additionally, it is recommended that glomerular filtration rate be routinely estimated for appropriate screening of nephropathy, because some patients present a decreased glomerular filtration rate when urine albumin values are in the normal range. The two main risk factors for diabetic nephropathy are hyperglycemia and arterial hypertension, but the genetic susceptibility in both type 1 and type 2 diabetes is of great importance. Other risk factors are smoking, dyslipidemia, proteinuria, glomerular hyperfiltration and dietary factors. Nephropathy is pathologically characterized in individuals with type 1 diabetes by thickening of glomerular and tubular basal membranes, with progressive mesangial expansion (diffuse or nodular leading to progressive reduction of glomerular filtration surface. Concurrent interstitial morphological alterations and hyalinization of afferent and efferent glomerular arterioles also occur. Podocytes abnormalities also appear to be involved in the glomerulosclerosis process. In patients with type 2 diabetes, renal lesions are heterogeneous and more complex than in individuals with type 1 diabetes. Treatment of diabetic nephropathy is based on a multiple risk factor approach, and the goal is retarding the

  20. The Correlation Between Glycosylated Hemoglobin,Central Aortic Pressure and the Formation of the Carotid Artery Plaque with the Patients of Type 2 Diabetes Mellitus%2型糖尿病患者 HbA1 c1 CAP 水平与颈动脉斑块关系的研究

    Institute of Scientific and Technical Information of China (English)

    奥日瀚; 李冬梅

    2015-01-01

    Objective To study the correlation between glycosylated hemoglobin ,central aortic pressure and the formation of the carotid artery plaque with the patients of type 2 diabetes mellitus .Methods Determi-nating the glycosylated hemoglobin ,average fasting blood glucose and peripheral blood pressure ,central aortic pressure( including central systolic pressure ,diastolic pressure ,central pulse pressure) ,of 120 diabetes mellitus patients (diabetes mellitus group) and 100 healthy volunteers (normal control group) .Then according to the re-sult of ultrasound ,the patients were divided into carotid artery plaque group and non -plaque group ,all the data were determined again ,the correlation between glycosylated hemoglobin ,central aortic pressure and the forma-tion of the carotid artery plaque was analyzed by SPSS .Results (1 ) The glycosylated hemoglobin ,average fast-ing blood glucose levels of diabetes group are significantly higher than those of normal control group .(2 )There is no significant difference between systolic central aortic pressure and central pulse pressure of the diabetes mellitus group and those of normal control group .(3 )Glycosylated hemoglobin ,average fasting blood glucose ,central pulse pressure ,systolic central aortic pressure of carotid artery plaque group levels were significantly higher than those of non-plaque group( P<0 .0 1 ) .(4 )Glycosylated hemoglobin levels and the incidence of carotid plaques were positively correlated in diabetes group .(5 )Multiple linear regression analysis showed that for the patients of type 2 diabetes ,glycosylated hemoglobin ,central systolic pressure and central pulse pressure is risk factors of oc-currence and development of carotid plaques .Conclusion Concentrating glycosylated hemoglobin ,central sys-tolic pressure the central pulse pressure helps to monitor the occurrence and development of diabetic carotid plaques .%目的:探讨2型糖尿病患者糖化血红蛋白及中心动脉压与颈动脉

  1. Travelling diabetics.

    Science.gov (United States)

    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.

  2. Diabetes Myths

    Science.gov (United States)

    ... to weight gain. Research has shown that drinking sugary drinks is linked to type 2 diabetes. The American ... drinks energy drinks sports drinks sweet tea other sugary drinks. These will raise blood glucose and can provide ...

  3. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008025 Peroxisome proliferator activated receptor-γ agonists improves arterial stiffness in type 2 diabetic patients with coronary artery disease. YU Jie(于婕), et al. Dept Cardiovasc Med, Peking Univ 3rd Hosp, Beijing 100083. Chin Cir J 2007;22(6):418-422. Objective Arterial stiffness is an independent risk factor for cardiovascular events in diabetic patients, and it may be assessed by measurement of pulse wave velocity(PWV).

  4. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010297 Effect of 4-phenylbutyric acid on diabetic nephropathy rats.LUO Zhifeng(罗志锋),et al.Dept Nephrol,Xinqiao Hosp,3rd Milit Med Univ,Chongqing 400037.Chin J Nephrol 2010;26(5):358-363. Objective To investigate the effect of 4-phenylbutyric acid (4-PBA) on the renal pathogenesis of rats with streptozotocin-induced diabetes and its mechanism.Methods

  5. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008256 Role of heparanase in the pathogenesis of proteinuria in diabetic nephropathy rats.TANG Lin(唐琳),et al.Dept Nephrol,1st Affili Hosp,Zhengzhou Univ,Zhengzhou 450052.Chin J Nephrol 2008;24(4):277-281.Objective To observe the expression of heparanase (HPA)in kidney of diabetic nephropathy(DN)rats and to investigate the role of HPA in the pathogenesis of proteinuria in DN rats.Methods DM rat models induced

  6. Women and Diabetes

    Medline Plus

    Full Text Available ... Beware of Illegally Sold Diabetes Treatments Diabetes and Pregnancy Some women develop diabetes for the first time ... care provider about how to manage diabetes during pregnancy. Medicine and Pregnancy Fact Sheet Pregnancy Registries - Sign- ...

  7. Diabetes and Foot Problems

    Science.gov (United States)

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes and Foot Problems How can diabetes affect my feet? Too much glucose, also called ... you have any of these signs. How can diabetes change the shape of my feet? Nerve damage ...

  8. Cardiovascular Disease and Diabetes

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Cardiovascular Disease & Diabetes Updated:Mar 23,2016 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  9. Diabetes Prevention Program (DPP)

    Science.gov (United States)

    ... 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 ...

  10. Diabetes and Pregnancy

    Science.gov (United States)

    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 ...

  11. Diabetes and nerve damage

    Science.gov (United States)

    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 ...

  12. Gestational Diabetes and Pregnancy

    Science.gov (United States)

    ... have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of ... gestational diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  13. Women and Diabetes

    Medline Plus

    Full Text Available ... 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 ...

  14. Diabetes - eye care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000078.htm Diabetes - eye care To use the sharing features on this ... enable JavaScript. Diabetic retinopathy - care Diabetes and your eyes Diabetes can harm your eyes. It can damage ...

  15. Influência do diabete melito nos resultados imediatos do implante de stent coronário: uma análise dos dados da Central Nacional de Intervenções Cardiovasculares (CENIC

    Directory of Open Access Journals (Sweden)

    Moscoso Isaac

    2006-01-01

    Full Text Available OBJETIVO: Avaliar a influência do diabete melito (DM nos resultados imediatos do implante de stent coronário (SC, de acordo com o quadro clínico de apresentação. MÉTODOS: Entre janeiro/1997 e dezembro/2003, segundo a Central Nacional de Intervenções Cardiovasculares (CENIC, 11.874 pacientes diabéticos foram submetidos a implante de SC: 7.386 (62,3% com insuficiência coronária crônica (ICO, 3.142 (26,4%, em síndrome isquêmica instável sem elevação ST (SIASEST e 1.346 (11,3%, com infarto agudo do miocárdio (IAM com supradesnivelamento de ST. Estes grupos foram comparados com 48.103 não-diabéticos: 30.980 (64,5% com ICO, 10.938 (22,7% em SIASEST e 6.185 (12,8% com IAM. RESULTADOS: Os diabéticos apresentaram características clínicas e angiográficas de maior risco. Os diabéticos com ICO apresentaram taxa de eventos adversos semelhantes aos não-diabéticos (0,98% x 0,91%, p=0,5971, porém, os diabéticos em SIASEST e IAM apresentaram maior incidência de eventos: 2,76% x 1,46% (p<0,0001 e 7,87% x 4,1% (p<0,0001, respectivamente. A análise multivariada mostrou o DM como preditor independente de risco para eventos adversos maiores na SIASEST (OR: 1,92 IC: 1,46-2,52 p<0,0001 e no IAM (OR: 2,0 IC: 1,57-2,54 p<=0,0001 e não na ICO (OR: 1,08 IC: 0,83-1,42 p=0,5470. CONCLUSÃO: Os pacientes diabéticos portadores de ICO apresentaram evolução hospitalar semelhante aos não diabéticos, porém, os com SIASEST e IAM demonstraram maior taxa de eventos cardíacos adversos comparados com a população não-diabética.

  16. From obesity to diabetes.

    Science.gov (United States)

    Keller, U

    2006-07-01

    The prevalence of obesity has been increasing dramatically in the last decades in the whole world, not only in industrialized countries but also in developing areas. A major complication of obesity is insulin resistance and type 2 diabetes. Diabetes is also rapidly increasing world-wide--reaching a prevalence in adults of approx. 5-6% in Central Europe and in the US, and more than 50% in specific, genetically prone populations. This article reviews pathogenetic mechanisms linking obesity and type 2 diabetes. Emphasis is placed on the observation that excessive amounts of adipocytes are associated with an impairment of insulin sensitivity, a key feature of the "metabolic syndrome". This is a cluster of metabolic abnormalities such as type 2 diabetes, hypertension and dyslipidemia; all of them are enhanced by the presence of visceral (abdominal) obesity and all contribute to the increased cardiovascular risk observed in these patients. Besides release of free fatty acids, adipocytes secrete substances that contribute to peripheral insulin resistance, including adiponectin, resistin, TNF-alpha and interleukin 6. Increased turnover of free fatty acids interferes with intracellular metabolism of glucose in the muscle, and they exert lipotoxic effect on pancreatic beta-cells. The pre-receptor metabolism of cortisol is enhanced in visceral adipose tissue by activation of 11 beta-hydroxysteroid dehydrogenase type 1. A new class of anti-diabetic drugs (thiazolidinediones, or glitazones) bind to peroxisome proliferator activated receptor (PPAR-gamma) and lower thereby plasma free fatty acids and cytokine production in adipocytes, in addition to a decrease of resistin and an increase in adiponectin observed in animals, resulting in an overall increase in insulin sensitivity and in an improvement of glucose homeostasis. However, the first step to avoid insulin resistance and prevent the development of diabetes should be a reduction in body weight in overweight subjects, and an

  17. Fahr disease combined with nephrogenic diabetes insipidus: report of one case%Fahr病并肾性尿崩症一例报道

    Institute of Scientific and Technical Information of China (English)

    张桦; 张振; 陈宏; 杨力; 蔡德鸿

    2010-01-01

    @@ Fahr病又称家族性特发性脑血管亚铁钙沉着症,为一种罕见病,主要表现为进行性加重的头晕、头痛、精神障碍等因神经元慢性损害而产生的症候群.实验室检查甲状旁腺激素、血钙、磷正常.主要影像学表现为脑内基本对称分布的钙化灶[1].本文报道Fahr病合并肾性尿崩症一例.

  18. Expression of three different mutations in the arginine vasopressin gene suggests genotype-phenotype correlation in familial neurohypophyseal diabetes insipidus kindreds

    DEFF Research Database (Denmark)

    Siggaard, Charlotte; Christensen, Jane Hvarregaard; Corydon, Thomas Juhl;

    2005-01-01

    reduction of the amount of immunoreactive AVP in the cell culture medium and severe impairment of the intracellular trafficking and processing of the AVP prohormone, supporting the disease causing nature of all three mutations. However, the A19T mutation was associated with some capacity for processing...... and trafficking consistent with the clinical observations. Immunoflourescence studies provided evidence of reticular accumulation of protein within the ER in the A19T and C110X mutants but a unique accumulation of much larger aggregates in the L81P, which were localized both within and immediately outside the ER...

  19. American Association of Diabetes Educators

    Science.gov (United States)

    ... Prevention Program Provider Resources Why Refer for Diabetes Education Benefits of Diabetes Education Working with a Diabetes Educator Jason Baker, ... Prevention Program Provider Resources Why Refer for Diabetes Education Benefits of Diabetes Education Working with a Diabetes Educator Jason Baker, ...

  20. Diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    A. Moreno

    2013-01-01

    Full Text Available 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.

  1. Unexpected Fatal Hypernatremia after Successful Cardiopulmonary Resuscitation with Therapeutic Hypothermia: A Case Report

    OpenAIRE

    Choi, Sang-Sik; Kim, Won Young; Kim, Won; Lim, Kyung-Su

    2012-01-01

    Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine outp...

  2. Endoplasmic reticulum stress and diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Toshiyuki Oshitari

    2008-03-01

    Full Text Available Toshiyuki Oshitari1,2, Natsuyo Hata1, Shuichi Yamamoto11Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan; 2Department of Ophthalmology, Kimitsu Central Hospital, Kisarazu City, Chiba, JapanAbstract: Endoplasmic reticulum (ER stress is involved in the pathogenesis of several diseases including Alzheimer disease and Parkinson disease. Many recent studies have shown that ER stress is related to the pathogenesis of diabetes mellitus, and with the death of pancreatic β-cells, insulin resistance, and the death of the vascular cells in the retina. Diabetic retinopathy is a major complication of diabetes and results in death of both neural and vascular cells. Because the death of the neurons directly affects visual function, the precise mechanism causing the death of neurons in early diabetic retinopathy must be determined. The ideal therapy for preventing the onset and the progression of diabetic retinopathy would be to treat the factors involved with both the vascular and neuronal abnormalities in diabetic retinopathy. In this review, we present evidence that ER stress is involved in the death of both retinal neurons and vascular cells in diabetic eyes, and thus reducing or blocking ER stress may be a potential therapy for preventing the onset and the progression of diabetic retinopathy.Keywords: endoplasmic reticulum stress, diabetic retinopathy, vascular cell death, neuronal cell death

  3. Endoplasmic reticulum stress and diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Toshiyuki Oshitari

    2008-02-01

    Full Text Available Toshiyuki Oshitari1,2, Natsuyo Hata1, Shuichi Yamamoto11Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan; 2Department of Ophthalmology, Kimitsu Central Hospital, Kisarazu City, Chiba, JapanAbstract: Endoplasmic reticulum (ER stress is involved in the pathogenesis of several diseases including Alzheimer disease and Parkinson disease. Many recent studies have shown that ER stress is related to the pathogenesis of diabetes mellitus, and with the death of pancreatic β-cells, insulin resistance, and the death of the vascular cells in the retina. Diabetic retinopathy is a major complication of diabetes and results in death of both neural and vascular cells. Because the death of the neurons directly affects visual function, the precise mechanism causing the death of neurons in early diabetic retinopathy must be determined. The ideal therapy for preventing the onset and the progression of diabetic retinopathy would be to treat the factors involved with both the vascular and neuronal abnormalities in diabetic retinopathy. In this review, we present evidence that ER stress is involved in the death of both retinal neurons and vascular cells in diabetic eyes, and thus reducing or blocking ER stress may be a potential therapy for preventing the onset and the progression of diabetic retinopathy.Keywords: endoplasmic reticulum stress, diabetic retinopathy, vascular cell death, neuronal cell death

  4. Informing the development of a national diabetes register in Ireland: a literature review of the impact of patient registration on diabetes care

    Directory of Open Access Journals (Sweden)

    Monica O'Mullane

    2010-09-01

    Conclusions This review suggested that registers are generally assumed to be an essential element of quality improvement interventions rather than an optional addition. A diabetes register is central to the development of a comprehensive diabetes management system in primary care, which can lead to improvements in the processes and outcomes of diabetes care.

  5. Diabetes research

    International Nuclear Information System (INIS)

    The aim of this study is to determine the long-term effects of alpha-particle pituitary irradiation in patients being treated for diabetic retinopathy. Of particular interest is whether the altered hormonal environment influences vision, renal function, and survival

  6. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970258 Relationship between non-insulin dependent diabetes mellitus and lipoprotein(a)in aged patients.CHI Jiamin(迟家敏), et al. Dept Endocrinol, BeijingHosp, Beijing, 100730. Chin J Geriatr 1997; 16(1): 39-42.

  7. Diabetic Eye Disease

    Science.gov (United States)

    ... Diabetic Eye Disease How can diabetes affect my eyes? Too much glucose, also called sugar, in your blood from diabetes ... diabetes can also affect the nerves to the eye. Having high blood glucose from diabetes causes decreased blood supply to the ...

  8. What Is Diabetic Retinopathy?

    Science.gov (United States)

    ... Ophthalmologist Español Eye Health / Eye Health A-Z Diabetic Retinopathy Sections What Is Diabetic Retinopathy? Diabetic Retinopathy Causes ... Non-Proliferative Diabetic Retinopathy Vision Simulator What Is Diabetic Retinopathy? Written by: Kierstan Boyd Reviewed by: Robert H ...

  9. Fats for diabetics. (Letter).

    NARCIS (Netherlands)

    Katan, M.B.

    1994-01-01

    Opinion. Comments on the treatment of type 2 diabetes from the interaction between nature and nurture. Effective form of treatment for type 2 diabetes; Composition of the diet for diabetics; Identification of unsaturated fats in the diabetic diet; Risks faced by diabetic patients.

  10. Tips for Teens with Diabetes: What Is Diabetes?

    Science.gov (United States)

    ... for Teens with Diabetes What is Diabetes? National Diabetes Education Program Learn about diabetes and how to manage ... normal as possible. Learn more! Check out… National Diabetes Education Program to get free copies of other tip ...

  11. Water and Salt Metabolism Disorders Following Transsphenoidal Pituitary Surgery

    Directory of Open Access Journals (Sweden)

    Mehtap Cakir

    2011-06-01

    Full Text Available Transsphenoidal pituitary surgery is frequently complicated with mild to severe water and electrolyte disturbances in the postoperative period. These disorders are: transient diabetes insipidus, early or delayed hyponatremia, diabetes insipidus followed by hyponatremia (biphasic pattern, diabetes insipidus-hyponatremia-diabetes insipidus (triphasic pattern, permanent diabetes insipidus, and cerebral salt-wasting syndrome. Close monitoring of water intake, urine output, thirst, volume status and serum electrolytes is imperative, and a dynamic treatment plan according to the changing status of the patient is mandatory. This review will focus on the types, course and treatment of water and electrolyte disturbances observed after transsphenoidal pituitary surgery. Turk Jem 2011; 15: 28-32

  12. Economic costs of diabetes in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulkarim K Alhowaish

    2013-01-01

    Full Text Available Background: Diabetes imposes a large economic burden on the individual, national healthcare systems, and countries. Objective: To determine the economic impact of diabetes mellitus on Saudi healthcare system, both now and in the future. Materials and Methods: This research study uses a prevalence-based approach that combines the demographics of the population (classified by nationality, sex and age group with and without diagnosed diabetes in 1992 and 2010. The economic impact of diabetes is estimated in this study, using secondary sources of information provided by Ministry of Health, Ministry of Finance and Central Department of Statistics and Information databases. Results: People diagnosed with diabetes, on average, have medical healthcare expenditures that are ten times higher ($3,686 vs. $380 than what expenditures would be in the absence of diabetes. Over 96% of all medical healthcare expenditures attributed to diabetes are incurred by persons of Saudi nationality, with the remaining 4% incurred by persons of non-Saudi nationality. The population age 45-60 incurs 45% of diabetes-attributed costs, with the remaining population under age 15 incurs 3.8%, age 15-44 incurs 27.5%, and age 60 and above incurs 23.8%. Conclusion: The actual national healthcare burden because of diabetes is likely to exceed the $0.87 billion estimated in this study, because it omits the indirect costs associated with diabetes, such as absenteeism, lost productivity from disease-related absenteeism, unemployment from disease-related disability, lost productivity due to early mortality by disease. The social cost of intangibles such as pain and suffering and care provided by non-paid caregivers as well as healthcare system administrative costs, cost of medications, clinician training programs, and research and infrastructure development is also omitted from this research study. Further studies are needed to confirm the present findings and to improve our

  13. Thalamic amplification of sensory input in experimental diabetes.

    Science.gov (United States)

    Freeman, Oliver J; Evans, Mathew H; Cooper, Garth J S; Petersen, Rasmus S; Gardiner, Natalie J

    2016-07-01

    Diabetic neuropathy is a common, and often debilitating, secondary complication of diabetes mellitus. As pain, hypersensitivity and paraesthesias present in a distal-proximal distribution, symptoms are generally believed to originate from damaged afferents within the peripheral nervous system. Increasing evidence suggests altered processing within the central nervous system in diabetic neuropathy contributes towards somatosensory dysfunction, but whether the accurate coding and relay of peripherally encoded information through the central nervous system is altered in diabetes is not understood. Here, we applied the strengths of the rodent whisker-barrel system to study primary afferent-thalamic processing in diabetic neuropathy. We found that neurons in the thalamic ventral posteromedial nucleus from rats with experimental diabetic neuropathy showed increased firing to precisely graded, multidirectional whisker deflection compared to non-diabetic rats. This thalamic hyperactivity occurred without any overt primary afferent dysfunction, as recordings from the trigeminal ganglion showed these primary afferents to be unaffected by diabetes. These findings suggest that central amplification can substantially transform ascending sensory input in diabetes, even in the absence of a barrage of ectopic primary afferent activity. PMID:27152754

  14. Diabetes - foot ulcers

    Science.gov (United States)

    ... of the ulcer area. This will help speed healing. Be sure to wear shoes that do not ... American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37:S14-S80. PMID: 24357209 www. ...

  15. Pregnancy Complications: Preexisting Diabetes

    Science.gov (United States)

    ... Home > Complications & Loss > Pregnancy complications > Preexisting diabetes Preexisting diabetes E-mail to a friend Please fill in ... and your baby are healthy. What is preexisting diabetes? About 9 out of 100 women (9 percent) ...

  16. Diabetic Nerve Problems

    Science.gov (United States)

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

  17. Hyperglycemia and Diabetic Ketoacidosis

    Science.gov (United States)

    ... Melon Smoothie Pregnant? Your Baby's Growth Hyperglycemia and Diabetic Ketoacidosis KidsHealth > For Parents > Hyperglycemia and Diabetic Ketoacidosis ... sugar levels need to be addressed. previous continue Diabetic Ketoacidosis (DKA) Insulin allows glucose to get into ...

  18. Living With Diabetes

    Science.gov (United States)

    ... Follow Us Health Information > Health Communication Programs > National Diabetes Education Program > Living With Diabetes | Share External Link Disclaimer National Diabetes Education Program NDEP Health Information A-Z Expand By ...

  19. Women and Diabetes

    Medline Plus

    Full Text Available ... these resources to help you talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy- ... these resources to help you talk to your health care provider about how to manage diabetes during pregnancy. ...

  20. Women and Diabetes

    Medline Plus

    Full Text Available ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ... Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  1. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... For Teens For Kids For Parents MORE ON THIS TOPIC Diabetes Center Diabetes: Marco's Story (Video) Diabetes: ... Resources Send to a friend Reprint Guidelines Share this page using: What are these? Note: Clicking these ...

  2. Women and Diabetes

    Medline Plus

    Full Text Available ... Information on WebMD Order Free Women's Health Publications Information from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression in Older Women ...

  3. Women and Diabetes

    Medline Plus

    Full Text Available ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ... Emergency Preparedness International Programs News & Events Training & Continuing ... & Compliance Federal, State & Local Officials Consumers Health ...

  4. Women and Diabetes

    Medline Plus

    Full Text Available ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ... Emergency Preparedness International Programs News & Events Training & Continuing ... Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  5. Women and Diabetes

    Medline Plus

    Full Text Available ... tips to help you manage your diabetes. Food Safety for People with Diabetes Your Glucose Meter - easy- ... to Store your Insulin during Storms and Blackouts Safety Information for Diabetes Medicines and Devices Beware of ...

  6. Diabetes and Kidney Disease

    Science.gov (United States)

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes and Kidney Disease What are my kidneys and ... urine until releasing it through urination. How can diabetes affect my kidneys? Too much glucose , also called ...

  7. Women and Diabetes

    Medline Plus

    Full Text Available ... resources to help you talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy- ... resources to help you talk to your health care provider about how to manage diabetes during pregnancy. ...

  8. "Stop Diabetes Now!"

    Science.gov (United States)

    ... 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 ...

  9. American Diabetes Association

    Science.gov (United States)

    ... 2383) Give by Mail Close November is American Diabetes Month® Share your personal diabetes story and show ... Next » « Previous Our Mission: To prevent and cure diabetes and to improve the lives of all people ...

  10. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes ... Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  11. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... Announcer: People with diabetes should work with their doctors to monitor the ABCs of diabetes. Judith Fradkin, ... want patients who have diabetes to ask their doctors, "What is my A1C, my blood pressure, my ...

  12. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... between diabetes and heart disease. Judith Fradkin, M.D.: What most people don't know is that ... stroke among people with diabetes. Judith Fradkin, M.D.: We call this approach "the ABCs of diabetes." ...

  13. Native Americans and Diabetes

    Medline Plus

    Full Text Available ... high numbers of diabetes cases. Peter Bennett, M.D.: People with diabetes suffer roughly twice the mortality ... diabetes population in the world. Peter Bennett, M.D.: Given the fact that the epidemic has occurred ...

  14. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth Diabetes Movie KidsHealth > For Parents > Diabetes Movie Print A A A Text Size Kids who have diabetes have trouble taking energy from food and delivering ...

  15. "Diabetes Has Instant Consequences..."

    Science.gov (United States)

    ... please turn Javascript on. Feature: Diabetes Stories "Diabetes has instant consequences…" Past Issues / Fall 2009 Table of ... you want to chuck it all. But Diabetes has instant consequences. You learn to be responsible pretty ...

  16. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Story" 5 Things to Know About Zika & Pregnancy Diabetes Movie KidsHealth > For Parents > Diabetes Movie Print A A A Text Size Kids who have diabetes have trouble taking energy from food and delivering ...

  17. Women and Diabetes

    Medline Plus

    Full Text Available ... diabetes for the first time when they become pregnant. This is called gestational (jes-Tay-shun-ul) diabetes. Other women have diabetes before they get pregnant. Use these resources to help you talk to ...

  18. Diabetes care in general practice: from monitoring to insulin therapy

    NARCIS (Netherlands)

    Goudswaard, Alexander Nicolaas

    2004-01-01

    The central aim of this thesis is to investigate the effectiveness of the current management of type 2 diabetes patients with unsatisfactory glycaemic control (HbA1c > 7%) treated in primary care. In chapter 1 we outline the present role of primary care in type 2 diabetes against the background of i

  19. Diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920537 The urinary activity of N-acetyl-D-glucosaminidase and diabetic nephropa-thy. XU Dashun (徐大顺), et al. Shanghai 1stPeople Hosp, 200085. Shanghai Med J 1992;15(8): 439-442. Urinary activity of N-acetyl-β-D-glucosa-minidase (NAG) and NAG: Creatinine(NAGI)in 24-hour urine and NAG-I in a single random

  20. diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950257 Report of a case of glucagonoma misdiag-nosed as“eczema”and“hepatic angioma”for three yearsand review of literature.DAI Weixin(戴为信),et al.PUMC Hosp,Beijing,100730.Chin J Intern Med 1995;34(3):190-192.Glucagonoma is a rare pancreatic tumor,necrolyticmigratory erythema is its distinctive feature and it isoften associated with diabetes mellitus,weight loss.anemia,hypoaminoacidemia,glossitis and stomatitis.

  1. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes, Heart Disease, and Stroke Having diabetes or prediabetes ... can help prevent future health problems. What is diabetes? Diabetes is a disorder of metabolismthe way our ...

  2. Diabetes mellitus

    International Nuclear Information System (INIS)

    It is believed that the pancreas is low sensitive to radiation. In this chapter, the effect of radiation on the pancreas is discussed in the light of the radiosensitivity of the pancreas in animal experiments and the occurrence of diabetes mellitus in A-bomb survivors. In an experiment on the whole-body irradiation with 800 rad using rats, a decrease in insulin secretion itself has not been noted, although a decrease in blood insulin and an increase in glucagon were associated with transiently increased blood glucose. In other studies, there was neither histologically nor endocrinologically abnormal findings due to several hundreds rad of radiation in the acute stage. For A-bomb survivors, blood levels of insulin tended to be slightly increased in the 40-59 age group of A-bomb survivors exposed at ≤1.5 km than those exposed at ≥3.0 km; and in the other age groups, there was no tendency for decreased blood levels of insulin. The ABCC-RERF Adult Health Study data (1958-1960) has revealed that there is no statistically significant correlation between the prevalence of diabetes mellitus and A-bomb radiation; nor has this been noted in any other study. Neither the prevalence of diabetes mellitus nor its complications is found to be independent upon distance from the hypocenter. (N.K.)

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

    Science.gov (United States)

    ... For More Information American Diabetes Association JDRF MedlinePlus Diabetes Disease Organizations Many organizations provide support to patients ... 293 KB). Alternate Language URL Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-onset Diabetes of ...

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

    Science.gov (United States)

    ... Neonatal Diabetes Mellitus and MODY Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and MODY The most common forms of ... is inherited from each parent. Monogenic Forms of Diabetes Some rare forms of diabetes result from mutations ...

  5. Patient education for preventing diabetic foot ulceration (Review)

    OpenAIRE

    Dorresteijn, J.A.; Kriegsman, D M; Assendelft, W. J. J.; Valk, G. D.

    2012-01-01

    BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS: Eligible studies were identified by searching The Cochrane Wounds Group Specialised Register (searched 1 August 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Librar...

  6. Tips for Teens with Diabetes: About Diabetes

    Science.gov (United States)

    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.

  7. The renal concentrating mechanism and the clinical consequences of its loss

    Directory of Open Access Journals (Sweden)

    Emmanuel I Agaba

    2012-01-01

    Full Text Available The integrity of the renal concentrating mechanism is maintained by the anatomical and functional arrangements of the renal transport mechanisms for solute (sodium, potassium, urea, etc and water and by the function of the regulatory hormone for renal concentration, vasopressin. The discovery of aquaporins (water channels in the cell membranes of the renal tubular epithelial cells has elucidated the mechanisms of renal actions of vasopressin. Loss of the concentrating mechanism results in uncontrolled polyuria with low urine osmolality and, if the patient is unable to consume (appropriately large volumes of water, hypernatremia with dire neurological consequences. Loss of concentrating mechanism can be the consequence of defective secretion of vasopressin from the posterior pituitary gland (congenital or acquired central diabetes insipidus or poor response of the target organ to vasopressin (congenital or nephrogenic diabetes insipidus. The differentiation between the three major states producing polyuria with low urine osmolality (central diabetes insipidus, nephrogenic diabetes insipidus and primary polydipsia is done by a standardized water deprivation test. Proper diagnosis is essential for the management, which differs between these three conditions.

  8. Year in Diabetes 2012: The Diabetes Tsunami

    OpenAIRE

    Sherwin, R; Jastreboff, A. M.

    2012-01-01

    Diabetes affects more than 300 million individuals globally, contributing to significant morbidity and mortality worldwide. As the incidence and prevalence of diabetes continue to escalate with the force of an approaching tsunami, it is imperative that we better define the biological mechanisms causing both obesity and diabetes and identify optimal prevention and treatment strategies that will enable a healthier environment and calmer waters. New guidelines from the American Diabetes Associat...

  9. Diabetes mellitus.

    OpenAIRE

    Hurwitz, B; Yudkin, J.

    1992-01-01

    1. Diabetes mellitus is diagnosed by finding a random plasma glucose > 11 mmol/L, or a fasting plasma glucose > 8 mmol/L. The prevalence in the general population is between 1-2% rising to approximately 4-9% in the age group 65+ (Williams, 1985; Croxson et al., 1991). It is more prevalent in people from the Indian subcontinent and in Afro-Caribbeans. 2. Approximately 75% of patients can be treated without recourse to insulin. The development of non-fasting ketonuria and/or significant weight ...

  10. Diabetic Wound Care

    Science.gov (United States)

    ... RSS Home » Learn About Feet » Foot Health Information Diabetic Wound Care What is a Diabetic Foot Ulcer? A diabetic foot ulcer is an open sore or wound ... key factors in the appropriate treatment of a diabetic foot ulcer: Prevention of infection Taking the pressure ...

  11. Women and Diabetes

    Medline Plus

    Full Text Available ... Diabetes Information on WebMD Order Free Women's Health Publications Information from Other Government Agencies and Offices National ... YourDiabetesInfo.org American Diabetes Association Get Other FDA Publications for Women For Women Homepage FDA Diabetes Information ...

  12. Genes and diabetic retinopathy.

    OpenAIRE

    Radha Venkatesan; Rema Mohan; Mohan Viswanathan

    2002-01-01

    Several recent studies have provided evidence that good diabetes control is important to prevent diabetic retinopathy. However, some groups of patients develop diabetic retinopathy despite good control and others escape retinopathy despite poor control. This suggests the role of genetic factors in susceptibility to retinopathy. This article reviews the role of genetic factors in determining diabetic retinopathy.

  13. Women and Diabetes

    Medline Plus

    Full Text Available ... resources to help you talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ... resources to help you talk to your health care provider about how to manage diabetes ... can help doctors learn more about treatments for diabetes. The FDA Office of Women's Health ...

  14. Somatotype in elderly type 2 diabetes patients.

    Science.gov (United States)

    Buffa, Roberto; Floris, Giovanni; Putzu, Paolo F; Carboni, Luciano; Marini, Elisabetta

    2007-09-01

    Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4 +/- 7.0 years; 65 women, mean age 72.9 +/- 7.1 years). The pathological subjects were compared with a control group consisting of 280 healthy individuals (134 men, mean age 74.2 +/- 7.3 years; 146 women, mean age 74.9 +/- 7.4 years). The Heath-Carter somatotype was applied. Diabetic men and women (mean somatotype, respectively: 6.8-5.6-0.6 and 8.6-6.4-0.2) presented significantly higher values of endomorphy than the controls (p = 0.043 in men, p = 0.003 in women); men also had a lower mesomorphic component (p = 0.000). The somatotype method revealed physical peculiarities in type 2 diabetes patients. The marked endomorphy in the pathological individuals can be related to general fatness, which is a well known disease risk factor. The somatotype appears to be a suitable technique for the assessment of physique in type 2 diabetes patients. PMID:18041381

  15. Genomet og diabetes

    DEFF Research Database (Denmark)

    Allin, Kristine Højgaard; Hansen, Torben; Pedersen, Oluf Borbye

    2014-01-01

    In terms of their genetic architecture monogenic diabetes and type 2 diabetes represent two extremes. Whereas each subtype of monogenic diabetes is caused by one penetrant, rare mutation in a single gene, the genetic susceptibility to type 2 diabetes can be attributed to many low-penetrant variants...... across the genome. At present, only 10% of the genetic susceptibility to type 2 diabetes can be explained by the hitherto identified 90 genomic loci. Here we briefly review the genetics of monogenic diabetes and type 2 diabetes and outline future directions of research within this field....

  16. Peripheral blood flow control in diabetes mellitus

    DEFF Research Database (Denmark)

    Hilsted, Jannik

    1991-01-01

    Long term diabetes has a profound effect on the peripheral circulation. This has been demonstrated to be due to the presence of angiopathy and autonomic neuropathy, affecting autoregulation and distensibility of the vessels as well as local and central reflex regulation of the vascular resistance...

  17. Neck circumference as an anthropometric measure of obesity in diabetics

    Directory of Open Access Journals (Sweden)

    Jagadamba Aswathappa

    2013-01-01

    Full Text Available Background: Obesity is a risk factor for type 2 diabetes mellitus. Insulin resistance is associated with visceral subcutaneous fat content. Neck circumference (NC is a marker of upper body subcutaneous adipose tissue distribution. Aim: The aim of this study is to compare NC in diabetics and non-diabetics and to correlate NC with other anthropometric measures. Materials and Methods: A cross-sectional study was conducted in 350 type 2 diabetics and 350 non-diabetics of >30 years of age. Anthropometric parameters like body mass index (BMI, waist circumference (WC, hip circumference, and NC were measured. Independent t-test and Pearson′s correlation were the tests of significance done to analyze quantitative data. Results: There was positive correlation of NC, BMI, and index of central obesity. The NC in diabetics was significantly higher than in non-diabetics (P 36 cm in diabetics and >37 cm in non-diabetics was the best cutoff value to determine subjects with central obesity. Conclusion: The findings indicated that NC may be used both in clinical practice and in epidemiologic studies as a straightforward and reliable index. It is an economical easy to use test with less consumption of time and correlates well with other standard anthropometric parameters.

  18. Diabetes and pancreatic cancer

    OpenAIRE

    MUNIRAJ, T.; Chari, S.T.

    2012-01-01

    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 ...

  19. Diabetes Mellitus and Hypertension

    OpenAIRE

    Tuğrul, Armağan

    2002-01-01

    Hypertension is a major worldwide health problem. Its prevalence is 1.5-2 times higher in diabetic population than that in non-diabetic individuals. Its pathogenesis depends on diabetic nephropathy in type 1, whereas may be multifactorial in type 2 diabetes mellitus. In diabetics, angiotensin converting enzyme inhibitors are most widely preferred in the treatment of hypertension because of their numerous desirable effects. In this article, the most recent data are presented on the relationshi...

  20. Diabetic cardiomyopathy in Zucker diabetic fatty rats: the forgotten right ventricle

    Directory of Open Access Journals (Sweden)

    Lubberink Mark

    2010-06-01

    Full Text Available Abstract Background In patients with myocardial infarction or heart failure, right ventricular (RV dysfunction is associated with death, shock and arrhythmias. In patients with type 2 diabetes mellitus, structural and functional alterations of the left ventricle (LV are highly prevalent, however, little is known about the impact of diabetes on RV characteristics. The purpose of the present study was to investigate whether LV changes are paralleled by RV alterations in a rat model of diabetes. Methods Zucker diabetic fatty (ZDF and control (ZL rats underwent echocardiography and positron emission tomography (PET scanning using [18F]-2-fluoro-2-deoxy-D-glucose under hyperinsulinaemic euglycaemic clamp conditions. Glucose, insulin, triglycerides and fatty acids were assessed from trunk blood. Another group of rats received an insulin or saline injection to study RV insulin signaling. Results ZDF rats developed hyperglycaemia, hyperinsulinaemia and dyslipidaemia (all p M-value (r = 0.91, p M-value (r = 0.77, p Conclusions LV changes were paralleled by RV alterations in insulin-stimulated glucose utilisation and RV systolic function in a rat model of diabetes, which may be attributed to ventricular interdependence as well as to the uniform effect of diabetes. Since diabetic patients are prone to develop diabetic cardiomyopathy and myocardial ischaemia, it might be suggested that RV dysfunction plays a central role in cardiac abnormalities in this population.

  1. Diabetic nephropathy: changes after diabetes surgery?

    Directory of Open Access Journals (Sweden)

    S. Ros Ruiz

    2013-01-01

    Full Text Available Introduction: Obesity, as a central piece inside metabolic syndrome, is associated with early chronic kidney disease (CKD. In addition, several observational, cross sectional, and longitudinal studies have demonstrated that obesity is as an independent risk factor for the onset, aggravated course, and poor outcomes of CKD including diabetic nephropathy. This implies that when obesity is reversed, many CKD risk factors and CKD itself could be favorably influenced. So all measures aimed at weight loss are recommended to minimize risks from obesity-related conditions and generate improvements in the metabolic profile. Recent evidence shows that bariatric surgery (BS can revert or improve proteinuria and CKD in morbidly obese patients. Objectives and methods: The present review is aimed to provide the evidence regarding the beneficial effects of weight loss after BS in different stages of CKD including kidney transplant recipients, with an special focus on the beneficial effect in reducing or improving proteinuria and renal failure. Furthermore, this updated systematic review of the literature analyzes potential adverse effects that BS could induce not only on renal function but also on morbidity and mortality risk in perioperative and postoperative period. Conclusions: Results from the different case reports, meta analysis as well as systematic review of clinical trials show that obesity treatment by way of lifestyle changes, pharmacotherapies and BS can reduce proteinuria and help to prevent loss of renal function. Also BS may reduce complications, and allow obese patients with end-stage renal disease to undergo kidney transplantation with good results.

  2. [Diabetic eye disease].

    Science.gov (United States)

    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. PMID:25817504

  3. Diabetes Resources for Older Adults

    Science.gov (United States)

    ... Follow Us Health Information > Health Communication Programs > National Diabetes Education Program > Living With Diabetes > Diabetes in Older Adults | ... it's more common in older adults. The National Diabetes Education Program offers access to a range of resources ...

  4. "Control Your Diabetes. For Life."

    Science.gov (United States)

    ... 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.org or call toll- ...

  5. How to Treat Gestational Diabetes

    Science.gov (United States)

    ... 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 ...

  6. Diagnosis of Diabetes and Prediabetes

    Science.gov (United States)

    ... Medicines Questions to Ask about Your Diabetes Medicines Diabetes Diet and Eating Carbohydrate Counting and Diabetes Diabetes and ... at NIDDK Meetings & Events Technology Transfer Health Information ... Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información de ...

  7. Diabetes Monitoring System Using Mobile Computing Technologies

    Directory of Open Access Journals (Sweden)

    Mashael Saud Bin-Sabbar

    2013-03-01

    Full Text Available Diabetes is a chronic disease that needs to regularly be monitored to keep the blood sugar levels within normal ranges. This monitoring depends on the diabetic treatment plan that is periodically reviewed by the endocrinologist. The frequent visit to the main hospital seems to be tiring and time consuming for both endocrinologist and diabetes patients. The patient may have to travel to the main city, paying a ticket and reserving a place to stay. Those expenses can be reduced by remotely monitoring the diabetes patients with the help of mobile devices. In this paper, we introduce our implementation of an integrated monitoring tool for the diabetes patients. The designed system provides a daily monitoring and monthly services. The daily monitoring includes recording the result of daily analysis and activates to be transmitted from a patient’s mobile device to a central database. The monthly services require the patient to visit a nearby care center in the patient home town to do the medical examination and checkups. The result of this visit entered into the system and then synchronized with the central database. Finally, the endocrinologist can remotely monitor the patient record and adjust the treatment plan and the insulin doses if need.

  8. Diabetic autonomic neuropathy.

    Science.gov (United States)

    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.

  9. Prevention of type 2 diabetes: a review.

    Science.gov (United States)

    Hussain, A; Claussen, B; Ramachandran, A; Williams, R

    2007-06-01

    One of the major public health challenges of the 21st century is type 2 diabetes. WHO estimates that by 2025 as many as 200-300 million people worldwide will have developed the disease. A distressing increase in children is perhaps the most alarming sign of something going wrong. Roughly half of the risk of type 2 diabetes can be attributed to environmental exposure and the other half to genetics. Central themes for prevention are the risk factors overweight, sedentary lifestyle, certain dietary components and perinatal factors. Overweight is the most critical risk factor, and should be targeted for prevention of type 2 diabetes especially among children and youths. Ethnicity and perinatal factors are also worth considering. Today we know that prevention helps. In the US Diabetes Prevention Programme for high risk individuals, there was a 58% relative reduction in the progression to diabetes in the lifestyle group compared with the controls. Within the lifestyle group, 50% achieved the goal of more than 7% weight reduction, and 74% maintained at least 150 min of moderately intense activity each week. This review discusses different forms of prevention, and proposes first of all to target people with Impaired Glucose Tolerance with increasing activity and altering dietary factors. And secondly, population-based measures to encourage increased physical activity and decreased consumption of energy-dense foods are important, and may target school children and young people, certain ethnic groups and women with gestational diabetes.

  10. Effects of histamine H(1) receptor antagonists on depressive-like behavior in diabetic mice.

    Science.gov (United States)

    Hirano, Shoko; Miyata, Shigeo; Onodera, Kenji; Kamei, Junzo

    2006-02-01

    We previously reported that streptozotocin-induced diabetic mice showed depressive-like behavior in the tail suspension test. It is well known that the central histaminergic system regulates many physiological functions including emotional behaviors. In this study, we examined the role of the central histaminergic system in the diabetes-induced depressive-like behavior in the mouse tail suspension test. The histamine contents in the hypothalamus were significantly higher in diabetic mice than in non-diabetic mice. The histamine H(1) receptor antagonist chlorpheniramine (1-10 mg/kg, s.c.) dose-dependently and significantly reduced the duration of immobility in both non-diabetic and diabetic mice. In contrast, the selective histamine H(1) receptor antagonists epinastine (0.03-0.3 microg/mouse, i.c.v.) and cetirizine (0.01-0.1 microg/mouse, i.c.v.) dose-dependently and significantly suppressed the duration of immobility in diabetic mice, but not in non-diabetic mice. Spontaneous locomotor activity was not affected by histamine H(1) receptor antagonists in either non-diabetic or diabetic mice. In addition, the number and affinity of histamine H(1) receptors in the frontal cortex were not affected by diabetes. In conclusion, we suggest that the altered neuronal system mediated by the activation of histamine H(1) receptors is involved, at least in part, in the depressive-like behavior seen in diabetic mice.

  11. Delaying or Preventing Type 2 Diabetes

    Science.gov (United States)

    ... Care Diabetes Statistics Delaying or Preventing Type 2 Diabetes What is type 2 diabetes? Type 2 diabetes, formerly called adult-onset diabetes, ... for some, taking aspirin daily. Can type 2 diabetes be delayed or prevented? Yes. The results of ...

  12. [Diabetes mellitus].

    Science.gov (United States)

    Pérez-Díaz, Iván

    2016-09-01

    Worldwide, the cases of type 2 Diabetes Mellitus (DM2) has doubled in the last two decades. In the same period, obesity rates have triplicated, mainly because of the increase in the caloric intake and physical inactivity. According to the World Health Organization (WHO), more than 6 billion people consume cow´s milk and dairy products. By far, this amount exceeds the number o patients suffering from DM2. The increased consumption of highly caloric beverages including whole cow´s milk has incited several countries to publish recommendations on and encourage the intake of low fat milk and non-fat or reduced fat dairy products intake. Because of the multifactorial basis of DM2 and the controversial evidence regarding the relationship between cow's milk consumption and DM2 development, it is difficult to establish an optimal amount of milk per day for a good health, with no side effects. It is necessary to inform the general population on the nutritional value and health benefits of cow's milk. PMID:27603888

  13. Diabetic hyperglycemic hyperosmolar syndrome

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000304.htm Diabetic hyperglycemic hyperosmolar syndrome To use the sharing features on this page, please enable JavaScript. Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of ...

  14. MedlinePlus: Diabetes

    Science.gov (United States)

    ... Kidney Problems Diabetic Nerve Problems Hyperglycemia Hypoglycemia Islet Cell Transplantation Pancreas Transplantation Prediabetes National Institutes of Health The primary NIH organization for research on Diabetes is the National Institute ...

  15. Type 1 diabetes

    Science.gov (United States)

    ... your diabetes. But, you are the most important person in managing your diabetes. You should know the basic steps ... to your doctor before starting any exercise program. People with type 1 ... MANAGING YOUR BLOOD SUGAR Checking your blood sugar level ...

  16. Women and Diabetes

    Medline Plus

    Full Text Available ... Consumer Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it ... Depression in Older Women More in Women's Health Topics Mammography Women and Diabetes HPV, HIV, Birth Control ...

  17. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... Boykin has diabetes. She has suffered from heart disease and required bypass surgery because she was unaware of the link between diabetes and heart disease. Judith Fradkin, M.D.: What most people don' ...

  18. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... Sharon Boykin has diabetes. She has suffered from heart disease and required bypass surgery because she was unaware of the link between diabetes and heart disease. Judith Fradkin, M.D.: What most people don' ...

  19. A Better Diabetes Test?

    Science.gov (United States)

    ... have," said Zonszein, director of clinical diabetes at Albert Einstein College of Medicine's University Hospital in New York ... Diabetes Center, University Hospital, and professor, clinical medicine, Albert Einstein College of Medicine, New York City; Oct. 5, ...

  20. Native Americans and Diabetes

    Medline Plus

    Full Text Available ... and grandmother in developing diabetes. Lona Brown: From what I knew when I was younger, you get ... The odds are stacked against them. Much of what the world now knows about Type II diabetes ...

  1. Women and Diabetes

    Science.gov (United States)

    ... Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More ... women during pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help ...

  2. Glycemic Index and Diabetes

    Science.gov (United States)

    ... A A Listen En Español Glycemic Index and Diabetes The glycemic index, or GI, measures how a ... 08-book-sabores-de-cuba.html More from diabetes.org Shopdiabetes.org: Take the Guesswork out of ...

  3. Tight Diabetes Control

    Science.gov (United States)

    ... Size: A A A Listen En Español Tight Diabetes Control Keeping your blood glucose levels as close ... and syringes, than before. What About Type 2 Diabetes? The DCCT studied only people with type 1 ...

  4. Women and Diabetes

    Medline Plus

    Full Text Available ... video en espanol . Get tips on testing your blood sugar. There is good news. Diabetes can be controlled ... diabetes medicines or insulin to help keep their blood sugar at a healthy level. What you need depends ...

  5. Diabetes and Dietary Supplements

    Science.gov (United States)

    ... R S T U V W X Y Z Diabetes and Dietary Supplements: In Depth Share: On This ... health product or practice. Are dietary supplements for diabetes safe? Some dietary supplements may have side effects, ...

  6. Women and Diabetes

    Medline Plus

    Full Text Available ... diabetes medicines or insulin to help keep their blood sugar at a healthy level. What you need depends on your health and the type of diabetes you have. Use these resources to ...

  7. Tuberculosis and Diabetes

    Science.gov (United States)

    ... immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have ... was the direct cause of 1.5 million deaths.  WHO projects that diabetes will be the 7th ...

  8. Adrenomedullin and diabetes.

    Science.gov (United States)

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

    2014-06-15

    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

  9. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... effects of the diabetes I've had five strokes. I've had eight stents put into my ... cholesterol are critical in preventing heart disease and stroke among people with diabetes. Judith Fradkin, M.D.: ...

  10. Native Americans and Diabetes

    Medline Plus

    Full Text Available ... Lona Brown: Do you want another pickle? Child: I got a big pickle! Announcer: The 48-year- ... grandmother in developing diabetes. Lona Brown: From what I knew when I was younger, you get diabetes, ...

  11. Women and Diabetes

    Medline Plus

    Full Text Available ... Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & ... diabetes medicines. Veal el video en espanol . Get tips on testing your blood sugar. There is good news. Diabetes ...

  12. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... among people with diabetes. Judith Fradkin, M.D.: We call this approach "the ABCs of diabetes." A ... the importance of all three of these and we know that controlling the three can dramatically reduce ...

  13. Native Americans and Diabetes

    Medline Plus

    Full Text Available ... mortality rates of people without diabetes. And what we've seen in the Pima population over -- even ... in here, Ramona. Ramona: Okay. Lona Brown: Now we're going to be doing a diabetic foot ...

  14. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available Sharon Boykin: From the side effects of the diabetes I've had five strokes. I've had ... to correct it all. Announcer: Sharon Boykin has diabetes. She has suffered from heart disease and required ...

  15. Diabetic Kidney Problems

    Science.gov (United States)

    ... 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 ...

  16. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... out what I needed to do to correct it all. Announcer: Sharon Boykin has diabetes. She has ... the proportion of people with diabetes and though it seems simple, it's amazing how few people with ...

  17. Diabetes and Insulin

    Science.gov (United States)

    ... or low blood glucose. You can manage your diabetes with diet, exercise, and medicines (if needed). Questions to ask your doctor • What type of diabetes do I have? • What kind of medicine do ...

  18. Burns in diabetic patients

    OpenAIRE

    Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

    2008-01-01

    CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical...

  19. Obesity and Diabetes:

    OpenAIRE

    Diamant, Allison L.; Babey, Susan H.; Wolstein, Joelle; Jones, Malia

    2010-01-01

    The prevalence of both diabetes and obesity has grown significantly in California. Six million adults are obese and an additional 9.3 million are overweight. Obesity is a significant risk factor for diabetes; more than two million adults have been diagnosed with diabetes in California. Obesity and diabetes disproportionately affect people of color, the poor and those with the least education in California. Policy and environmental changes that promote and encourage physical activity and healt...

  20. Themenheft 24 "Diabetes mellitus"

    OpenAIRE

    Icks, Andrea; Rathmann, Wolfgang; Rosenbauer, Joachim; Giani, Guido

    2005-01-01

    Bei etwa 5 % der Bevölkerung in Deutschland ist ein Diabetes mellitus, die sog. Zuckerkrankheit, diagnostiziert worden, rund 90 % davon haben einen Typ 2-Diabetes, der vorwiegend im höheren Lebensalter auftritt. 5 % der Diabeteskranken leiden am insulinpflichtigen Typ 1-Diabetes, der sich vorwiegend im Kindes- und Jugendalter manifestiert. Weitere Diabetesformen sind eher selten. Außerdem gibt es viele Menschen mit einem unentdeckten Diabetes.

  1. Diabetes in Navajo Youth

    OpenAIRE

    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 ...

  2. Diabetes mellitus and pregnancy

    OpenAIRE

    Abourawi, Fathi I

    2006-01-01

    Diabetes mellitus is the most common medical complication of pregnancy and it carries a significant risk to the foetus and the mother. Congenital malformations and perinatal morbidity remain common compared with the offspring of non diabetic pregnancies. Diabetic mothers are at risk of progression of microvascular diabetic complications as well as early pregnancy loss, pre-eclampsia, polyhydramnios and premature labour. Glycaemic control before and during pregnancy is critical and the benefit...

  3. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... cardiovascular disease and other complications of diabetes. Announcer: Diabetes is most common in adults over age 40 but many of them don't realize what they can do to prevent two of the disease's most serious ... of people with diabetes and though it seems simple, it's amazing how ...

  4. Diabetes Type 2

    Science.gov (United States)

    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 ...

  5. Diabetes Type 1

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is ... kidneys, nerves, and gums and teeth. Type 1 diabetes happens most often in children and young adults ...

  6. Diabetic gustatory sweating.

    Science.gov (United States)

    Sheehy, T W

    1991-10-01

    Gustatory sweating is an unusual entity that may occur as an idiosyncratic reaction to certain foods, as a localized reaction to trauma or infection, or as the result of diabetic neuropathy. This report deals with a severe case of diabetic gustatory sweating, discusses the various types of gustatory sweating, and reviews the English literature dealing with the diabetic form. PMID:1928048

  7. Diabetic neuropathy in children.

    Science.gov (United States)

    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.

  8. DIABETES PREVENTION PROGRAM

    Science.gov (United States)

    The Diabetes Prevention Program (DPP) was a major clinical trial, or research study, aimed at discovering whether either diet and exercise or the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in people with impaired glucose toleranc...

  9. Diabetic retinopathy (treatment)

    OpenAIRE

    Mohamed, Quresh Amir; Ross, Adam; Chu, Colin Jonathan

    2011-01-01

    Diabetic retinopathy is the most common cause of blindness in the UK, with older people and those with worse diabetes control, hypertension, and hyperlipidaemia most at risk. Diabetic retinopathy can cause microaneurysms, haemorrhages, exudates, changes to blood vessels, and retinal thickening.

  10. Type 2 diabetes models

    DEFF Research Database (Denmark)

    Gram, Dorte Xenia

    2012-01-01

    This chapter deals with type 2 diabetes in vivo models and techniques suitable for testing new anti-diabetic compounds. In particular, the testing of TRP antagonist for beneficial effects against type 2 diabetes is considered. There are many choices of both in vitro techniques and in vivo models...

  11. N-acetylcysteine and allopurinol synergistically enhance cardiac adiponectin content and reduce myocardial reperfusion injury in diabetic rats

    OpenAIRE

    Tingting Wang; Shigang Qiao; Shaoqing Lei; Yanan Liu; Kwok F J Ng; Aimin Xu; Karen S L Lam; Irwin, Michael G; Zhengyuan Xia

    2011-01-01

    Background: Hyperglycemia-induced oxidative stress plays a central role in the development of diabetic myocardial complications. Adiponectin (APN), an adipokine with anti-diabetic and anti-ischemic effects, is decreased in diabetes. It is unknown whether or not antioxidant treatment with N-acetylcysteine (NAC) and/or allopurinol (ALP) can attenuate APN deficiency and myocardial ischemia reperfusion (MI/R) injury in the early stage of diabetes. Methodology/Principal Findings: Control or strept...

  12. central t

    Directory of Open Access Journals (Sweden)

    Manuel R. Piña Monarrez

    2007-01-01

    Full Text Available Dado que la Regresión Ridge (RR, es una estimación sesgada que parte de la solución de la regresión de Mínimos Cuadrados (MC, es vital establecer las condiciones para las que la distribución central t de Student que se utiliza en la prueba de hipótesis en MC, sea también aplicable a la regresión RR. La prueba de este importante resultado se presenta en este artículo.

  13. Characterization of Retinal Disease Progression in a 1-Year Longitudinal Study of Eyes With Mild Nonproliferative Retinopathy in Diabetes Type 2

    DEFF Research Database (Denmark)

    Ribeiro, Luisa; Bandello, Francesco; Tejerina, Amparo Navea;

    2015-01-01

    PURPOSE: To identify eyes of patients with diabetes type 2 that show progression of retinal disease within a 1-year period using noninvasive techniques. METHODS: Three hundred seventy-four type 2 diabetic patients with mild nonproliferative diabetic retinopathy (Early Treatment Diabetic Retinopathy......DR and in central retinal thickness in eyes with mild nonproliferative diabetic retinopathy and diabetes type 2 are able to identify eyes at risk of progression. These eyes/patients should be selected for inclusion in future clinical trials of drugs targeted to prevent diabetic retinopathy progression to vision...

  14. Cannabinoid-1 receptor antagonists in type-2 diabetes.

    Science.gov (United States)

    Scheen, André J

    2007-12-01

    Type-2 diabetes is closely related to abdominal obesity and is generally associated with other cardiometabolic risk factors, resulting in a risk of major cardiovascular disease. Several animal and human observations suggest that the endocannabinoid system is over-active in the presence of abdominal obesity and/or diabetes. Both central and peripheral endocannabinoid actions, via the activation of CB1 receptors, promote weight gain and associated metabolic changes. Rimonabant, the first selective CB(1) receptor blocker in clinical use, has been shown to reduce body weight, waist circumference, triglycerides, blood pressure, insulin resistance index and C-reactive protein levels, and to increase high-density lipoprotein (HDL) cholesterol and adiponectin concentrations in both non-diabetic and diabetic overweight/obese patients. In addition, a 0.5-0.7% reduction in HbA1c levels was observed in metformin- or sulphonylurea-treated patients with type-2 diabetes and in drug-naïve diabetic patients. Almost half of the metabolic changes, including HbA1c reduction, could not be explained by weight loss, suggesting that there are direct peripheral effects. Rimonabant was generally well-tolerated, and the safety profile was similar in diabetic and non-diabetic patients, with a higher incidence of depressed mood disorders, nausea and dizziness. In conclusion, the potential role of rimonabant in overweight/obese patients with type-2 diabetes and at high risk of cardiovascular disease deserves much consideration.

  15. Epigenetic changes in diabetes.

    Science.gov (United States)

    Al-Haddad, Rami; Karnib, Nabil; Assaad, Rawad Abi; Bilen, Yara; Emmanuel, Nancy; Ghanem, Anthony; Younes, Joe; Zibara, Victor; Stephan, Joseph S; Sleiman, Sama F

    2016-06-20

    The incidence of diabetes is increasing worldwide. Diabetes is quickly becoming one of the leading causes of death. Diabetes is a genetic disease; however, the environment plays critical roles in its development and progression. Epigenetic changes often translate environmental stimuli to changes in gene expression. Changes in epigenetic marks and differential regulation of epigenetic modulators have been observed in different models of diabetes and its associated complications. In this minireview, we will focus DNA methylation, Histone acetylation and methylation and their roles in the pathogenesis of diabetes. PMID:27130819

  16. Update on Diabetes Mellitus

    OpenAIRE

    Murray Korc

    2004-01-01

    Diabetes mellitus is a complex multi-system disorder that may be classified as autoimmune mediated type 1 diabetes, or as insulin resistance associated type 2 diabetes. In type 1 diabetes, there is selective loss of the beta cells within the endocrine islets, as a consequence of T-cell and cytokine mediated destruction of these cells, perhaps in conjunction with destruction of the peri-islet Schwann cells. In type 2 diabetes, the etiology of the resistance ranges from post-receptor defects in...

  17. The epidemiology and molecular mechanisms linking obesity, diabetes, and cancer.

    Science.gov (United States)

    Ferguson, Rosalyn D; Gallagher, Emily J; Scheinman, Eyal J; Damouni, Rawan; LeRoith, Derek

    2013-01-01

    The worldwide epidemic of obesity is associated with increasing rates of the metabolic syndrome and type 2 diabetes. Epidemiological studies have reported that these conditions are linked to increased rates of cancer incidence and mortality. Obesity, particularly abdominal obesity, is associated with insulin resistance and the development of dyslipidemia, hyperglycemia, and ultimately type 2 diabetes. Although many metabolic abnormalities occur with obesity and type 2 diabetes, insulin resistance and hyperinsulinemia appear to be central to these conditions and may contribute to dyslipidemia and altered levels of circulating estrogens and androgens. In this review, we will discuss the epidemiological and molecular links between obesity, type 2 diabetes, and cancer, and how hyperinsulinemia and dyslipidemia may contribute to cancer development. We will discuss how these metabolic abnormalities may interact with estrogen signaling in breast cancer growth. Finally, we will discuss the effects of type 2 diabetes medications on cancer risk. PMID:23810003

  18. Fenofibrate and Diabetic Retinopathy.

    Science.gov (United States)

    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. PMID:27525681

  19. Diabetes and exercise

    DEFF Research Database (Denmark)

    Richter, Erik; Ruderman, N B; Schneider, S H

    1981-01-01

    This review describes (1) the metabolic and hormonal response to exercise in normal and diabetic man, and (2) the potential benefits of physical training in diabetes. Whereas in normal man plasma glucose varies little during exercise, the insulin-dependent diabetic subject may experience...... its site of injection. The response to exercise of noninsulin-dependent diabetic subjects and of diabetic subjects with autonomic neuropathy is also described. Physical training improves glucose tolerance in some noninsulin-dependent diabetic subjects and in insulin-dependent patients, it may diminish...... insulin requirements. It may also have a role in retarding the development of cardiovascular complications. Physical training is not totally innocuous, however, and in many patients with diabetes special precautions are required....

  20. CERN diabetes awareness days

    CERN Multimedia

    2004-01-01

    Do you have diabetes without knowing it? The Medical Service invites everyone working at CERN to participate in the above PREVENTION and DETECTION campaign on the: 8 and 9 November 2004 from 9 am to 4 pm at the infirmary, bldg. 57, ground floor Personal evaluation of diabetes risks, (blood pressure, cholesterol and sugar levels, Body Mass Index measurements and more...) will be offered as well as leaflets, information and advice, (diet, exercise). A dietician specialised in diabetes will be on hand from 2 pm until 4 pm. Diabetes is reaching epidemic proportions in many countries due to an increase in obesity, sedentary lifestyles and poor diet. Diabetes is a major cause of blindness, cardio-vascular and kidney disease. An estimated 30-50% of these cases of diabetes go undetected, despite de fact that easy and efficient prevention exists. Diabetes discovered and treated early is not a severe condition but untreated and ignored it can have dire consequences.

  1. [Effect of prostaglandin synthesis inhibitors of diabetic cystoid macular edema].

    Science.gov (United States)

    Kieselbach, G; Juen, S

    1990-01-01

    In most cases, diabetic macular edema is treated successfully with central laser photocoagulation. However, only few studies report such favorable results in cystoid macular edema, which has a poor visual prognosis. In the present prospective study on diabetics with cystoid macular edema, aged less than 40 years, a better visual outcome was obtained in patients treated with prostaglandin synthesis inhibitors than in an untreated group. PMID:2345629

  2. Psychological aspects of diabetes care: Effecting behavioral change in patients

    OpenAIRE

    Chew, Boon-How; Shariff-Ghazali, Sazlina; Fernandez, Aaron

    2014-01-01

    Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. ...

  3. Brain changes in diabetes mellitus patients with gastrointestinal symptoms

    OpenAIRE

    Drewes, Anne M; Søfteland, Eirik; Dimcevski, Georg; Farmer, Adam D; Brock, Christina; Jens B. Frøkjær; Krogh, Klaus; Drewes, Asbjørn M

    2016-01-01

    Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on t...

  4. Optimization of ingredients for formulating a diabetic dietary supplement

    OpenAIRE

    Pawar, Kanika; Thompkinson, D. K.

    2011-01-01

    A diabetic dietary supplement comprising of multiple ingredients was designed based on recommendation of Indian Council of Medical Research for a diabetic adult. Central composite rotatable design using three variables (ingredient source) and five responses comprising of sensory and physico-chemical attributes were used for computation of an optimized solution. All the responses fitted well into quadratic equation with R2 > 0.80. The optimum levels of ingredient combinations recommended with ...

  5. Usefulness of electronic databases for the detection of unrecognized diabetic patients

    Directory of Open Access Journals (Sweden)

    Elhayany Asher

    2003-11-01

    Full Text Available Abstract Background Even mild hyperglycemia is associated with future acute and chronic complications. Nevertheless, many cases of diabetes in the community go unrecognized. The aim of the study was to determine if national electronic patient records could be used to identify patients with diabetes in a health management organization. Methods The central district databases of Israel's largest health management organization were reviewed for all patients over 20 years old with a documented diagnosis of diabetes mellitus (DM in the chronic disease register or patient file (identified diabetic patients or a fasting serum glucose level of >126 mg/100 ml according to the central laboratory records (suspected diabetic patients. The family physicians of the patients with suspected diabetes were asked for a report on their current diabetic status. Results The searches yielded 1,694 suspected diabetic patients; replies from the family physicians were received for 1,486. Of these, 575 (38.7% were confirmed to have diabetes mellitus. Their addition to the identified patient group raised the relative rate of diabetic patients in the district by 3.2%. Conclusion Cross-referencing existing databases is an efficient, low-cost method for identifying hyperglycemic patients with unrecognized diabetes who require preventive treatment and follow-up. This model can be used to advantage in other clinical sites in Israel and elsewhere with fully computerized databases.

  6. Diabetic Kidney Disease (Diabetic Nephropathy) (Beyond the Basics)

    Science.gov (United States)

    ... SP, et al. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care 2005; 28:164. Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and ... of intensive treatment of type 1 diabetes mellitus on development and ...

  7. What I Need to Know about Gestational Diabetes

    Science.gov (United States)

    ... of Diabetes: Neonatal Diabetes Mellitus and MODY Gestational Diabetes What is gestational diabetes? Gestational diabetes is a type of diabetes that ... 8747 and request a copy. What causes gestational diabetes? Gestational diabetes happens when your body can't ...

  8. Diabetes in the Aged

    Science.gov (United States)

    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. Prevent Diabetes Problems: Keep Your Diabetes under Control

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... Español Prevent diabetes problems: Keep your diabetes under control Page Content On this page: What are diabetes ...

  10. Patients' management of type 2 diabetes in Middle Eastern countries: review of studies

    OpenAIRE

    Alsairafi, Z.; Taylor, K M G; Smith, F J; Alattar, A. T.

    2016-01-01

    The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle...

  11. Diabetic Neuropathies: The Nerve Damage of Diabetes

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  12. Diabetes Device Interoperability for Improved Diabetes Management

    OpenAIRE

    Silk, Alain D.

    2015-01-01

    Scientific and technological advancements have led to the increasing availability and use of sophisticated devices for diabetes management, with corresponding improvements in public health. These devices are often capable of sharing data with a few other specific devices but are generally not broadly interoperable; they cannot work together with a wide variety of other devices. As a result of limited interoperability, benefits of modern diabetes devices and potential for development of innova...

  13. Self-esteem and illness self-concept in emerging adults with Type 1 diabetes: Long-term associations with problem areas in diabetes.

    Science.gov (United States)

    Luyckx, Koen; Rassart, Jessica; Aujoulat, Isabelle; Goubert, Liesbet; Weets, Ilse

    2016-04-01

    This long-term prospective study examined whether illness self-concept (or the degree to which chronic illness becomes integrated in the self) mediated the pathway from self-esteem to problem areas in diabetes in emerging adults with Type 1 diabetes. Having a central illness self-concept (i.e. feeling overwhelmed by diabetes) was found to relate to lower self-esteem, and more treatment, food, emotional, and social support problems. Furthermore, path analyses indicated that self-esteem was negatively related to both levels and relative changes in these problem areas in diabetes over a period of 5 years. Illness self-concept fully mediated these associations.

  14. Gestational diabetes versus pregestational diabetes. Perinatal results.

    Directory of Open Access Journals (Sweden)

    Cristóbal Torres González

    2004-12-01

    Full Text Available Fundament: Diabetes Mellitus is one of the most affecting diseases in the development of pregnancy. This greatly depends on the metabolic control achieved, which has demanded several proyects of treatment, thus decreasing the risks that the gestational process carries out. Objective: to compare the perinatal results between the diabetic gestational women and pregestational ones admitted at Cienfuegos Hospital. Method: Comparative study developed at the Gynecological-Obstetric Universitary Hospital from Cienfuegos province, from January to december 2003, including 167 pregnant women with Diabetes mellitus during pregnancy. The variables under study were: type of Diabetes, Márquez Guillén classification about good or bad fetal-maternal prognosis , treatment used, type of delivery, gestational age at labor, newborn weight, prenatal and maternal complication. Results: There was a predominance of gestational diabetes (73, 6 % over the cases with pregestational diabetes (26,3 %. According to Marquez Guillén classification , the bad fetal-maternal prognosis (X=16.37, p

  15. Angiopoietins and diabetic nephropathy.

    Science.gov (United States)

    Gnudi, Luigi

    2016-08-01

    Diabetic nephropathy is the main cause of end-stage renal failure in the Western world. In diabetes, metabolic and haemodynamic perturbations disrupt the integrity of the glomerular filtration barrier, leading to ultrastructural alterations of the glomeruli, including podocyte foot process fusion and detachment, glomerular basement membrane thickening, reduced endothelial cell glycocalyx, and mesangial extracellular matrix accumulation and glomerulosclerosis, ultimately leading to albuminuria and end-stage renal disease. Many vascular growth factors, such as angiopoietins, are implicated in glomerular biology. In normal physiology angiopoietins regulate the function of the glomerular filtration barrier. When they are dysregulated, however, as they are in diabetes, they drive the cellular mechanisms that mediate diabetic glomerular pathology. Modulation of angiopoietins expression and signalling has been proposed as a tool to correct the cellular mechanisms involved in the pathophysiology of diabetic microvascular disease, such as retinopathy in humans. Future work might evaluate whether this novel therapeutic approach should be extended to diabetic kidney disease. PMID:27207083

  16. Introduction to diabetes mellitus.

    Science.gov (United States)

    Kaul, Kirti; Tarr, Joanna M; Ahmad, Shamim I; Kohner, Eva M; Chibber, Rakesh

    2012-01-01

    The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Furthermore it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This chapter introduces the types of diabetes and diabetic complications such as impairment of immune system, periodontal disease, retinopathy, nephropathy, somatic and autonomic neuropathy, cardiovascular diseases and diabetic foot. Also included are the current management and treatments, and emerging therapies. PMID:23393665

  17. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... of Diabetes Educators JDRF American Heart Association MedlinePlus Diabetes Disease Organizations Many organizations provide support to patients ... Disease Organizations (PDF, 293 KB). Alternate Language URL Diabetes, Heart Disease, and Stroke Page Content On this ...

  18. The Effect of Game-Based Interventions in Rehabilitation of Diabetics

    DEFF Research Database (Denmark)

    Christensen, Jan; Valentiner, Laura Staun; Petersen, Rikke Juelsgaard;

    2016-01-01

    on the effect of game-based interventions on HbA1c, diabetes-related knowledge, and physical outcomes in rehabilitation of diabetes patients. METHODS: We conducted a systematic literature search in MEDLINE, EMBASE, PEDro, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, and Psych INFO in October...

  19. Diabetes Screening Among Immigrants

    OpenAIRE

    Creatore, Maria I.; Gillian L Booth; Manuel, Douglas G.; Moineddin, Rahim; Glazier, Richard H.

    2012-01-01

    OBJECTIVE To examine diabetes screening, predictors of screening, and the burden of undiagnosed diabetes in the immigrant population and whether these estimates differ by ethnicity. RESEARCH DESIGN AND METHODS A population-based retrospective cohort linking administrative health data to immigration files was used to follow the entire diabetes-free population aged 40 years and up in Ontario, Canada (N = 3,484,222) for 3 years (2004–2007) to determine whether individuals were screened for diabe...

  20. Diabetes and exercise

    OpenAIRE

    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 significa...

  1. Multiple Myeloma and Diabetes

    OpenAIRE

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

    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 conditi...

  2. Gestational Diabetes Mellitus

    OpenAIRE

    Mukesh M Agarwal; Dhatt, Gurdeep S.; Syed M Shah

    2010-01-01

    OBJECTIVE To determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM. RESEARCH DESIGN AND METHODS In 10,283 pregnant women undergoing a 75-g oral glucose tolerance test (OGTT) for universal screening of GDM, two FPG thresholds (of the OGTT) were used to rule in and to rule...

  3. Comparative Healthcare: Diabetes Mellitus.

    OpenAIRE

    Dr Mohammed Ali; Dr. Andrew Knight

    2009-01-01

    In the third in this series of ‘comparative healthcare’ medical practitioners explore the approach to diabetes inBangaldesh and Australia respectively. The social and medical consequences of this chronic conditionare highlighted through the approach to patients at various stages of the disease from two nationalperspectives. An astonishing 7% of the 153 million people are reported to have diabetes in Bangladesh. Manyremain undiagnosed. Delays in diagnosis or management of diabetes have life li...

  4. Permanent neonatal diabetes mellitus

    OpenAIRE

    Al-Matary, Abdulrahman; Hussain, Mushtaq; Nahari, Ahmed; Ali, Jaffar

    2012-01-01

    Summary Background: Neonatal diabetes is a rare cause of hyperglycemia, affecting 1: 500,000 births, with persistent hyperglycemia occurring in the first months of life lasting more than 2 weeks and requiring insulin. This condition in infants less than 6 months of age is considered as permanent neonatal diabetes mellitus. Case Report: A rare case of permanent neonatal diabetes mellitus presented with intrauterine growth retardation (IUGR; birth weight: 1460 grams; female), hyperglycemia, gly...

  5. Take Steps to Prevent Type 2 Diabetes

    Science.gov (United States)

    ... 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 ...

  6. Diabetes - preventing heart attack and stroke

    Science.gov (United States)

    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 ...

  7. The Catalase –262C/T Promoter Polymorphism and Diabetic Complications in Caucasians with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Kátia Gonçalves dos Santos

    2006-01-01

    Full Text Available Catalase is a central antioxidant enzyme constituting the primary defense against oxidative stress. In this study, we investigated whether the functional –262C/T polymorphism in the promoter of catalase gene is associated with the presence of diabetic retinopathy (DR, diabetic nephropathy (DN and ischemic heart disease (IHD in 520 Caucasian-Brazilians with type 2 diabetes. The –262C/T polymorphism was also examined in 100 Caucasian blood donors. Patients underwent a clinical and laboratory evaluation consisting of a questionnaire, physical examination, assessment of diabetic complications and laboratory tests. Genotype analysis was performed using the polymerase chain reaction followed by digestion with restriction enzyme. The genotype and allele frequencies of the –262C/T polymorphism in patients with type 2 diabetes were very similar to those of blood donors (T allele frequency = 0.20 and 0.18, respectively. Likewise, there were no differences in either genotype or allele frequencies between type 2 diabetic patients with or without DR, DN or IHD. Thus, our results do not support the hypothesis that the –262C/T polymorphism is related to the development of DR, DN or IHD in patients with type 2 diabetes. Further studies are necessary to elucidate the role of catalase gene polymorphisms in the pathogenesis of diabetic complications.

  8. Diabetes, Nutrition, and Exercise.

    Science.gov (United States)

    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.

  9. PRE-DIABETES

    OpenAIRE

    Akula Annapurna

    2013-01-01

    Pre-diabetes is a condition where the body's cells begin to show resistance to insulin. Glucose circulates in the blood instead of being used by the cells for energy. Blood sugar levels become elevated. Increased weight, unhealthy diet and a sedentary lifestyle can lead to pre-diabetes. WHAT IS PRE-DIABETES A diagnosis of pre-diabetes means that the cells in your body are becoming resistant to insulin and your blood glucose levels are higher than they should be. Since the levels aren't as hig...

  10. Diabetes mellitus type 1

    OpenAIRE

    Tøraasen, Lisa Vangen; Al-Sultan, Zainab

    2014-01-01

    Hvert år blir rundt 600 nordmenn diagnostisert med sykdommen diabetes type 1, og Norge er et av landene i verden med størst andel av barnediabetes. I dag er det 15 000- 20 000 personer i Norge som har diabetes type 1, og antall barn som får diabetes har fordoblet seg de siste 30 årene (Diabetesforbundet, 2014). Problemstillingen vår gikk ut på hvordan sykepleiere kan veilede og undervise ungdom med nyoppdaget diabetes type på sykehus. Ut i fra litteraturstudiet har vi arbeidet oss frem for å ...

  11. Osteoporosis and diabetes

    Directory of Open Access Journals (Sweden)

    M. Barbagallo

    2011-09-01

    Full Text Available Diabetes mellitus and osteoporosis are chronic diseases with an elevated and growing incidence in the elderly. Recent epidemiological studies have demonstrated an elevated risk of hip, humerus and foot fractures in elder diabetic subjects. While type 1 diabetes is generally associated with a mild reduction in bone mineral density (BMD, type 2 diabetes, more prevalent in old subjects, is frequently linked to a normal or high BMD. Studies on experimental models of diabetes have suggested an altered bone structure that may help to explain the elevated risk of fractures observed in these animals and may as well help to explain the paradox of an incremented risk of fractures in type 2 diabetic elderly in the presence of normal or elevated BMD. In addition, diabetic elderly have an increased risk of falls, consequent at least in part to a poor vision, peripheral neuropathy, and weaken muscular performance. Diabetes may affect bone tissue by different mechanisms including obesity, hyperinsulinemia, deposit of advanced glycosilation end products in collagen fibre, reduced circulating levels of IGF-1, hypercalciuria, renal function impairment, microangiopathy and chronic inflammation. A better understanding of these mechanisms may help implement the prevention of fractures in the growing population of mature diabetics.

  12. [Cardiovascular complications of diabetes].

    Science.gov (United States)

    Nishio, Yoshihiko

    2015-12-01

    Several lines of epidemical evidence have shown that type 2 diabetes is the most important risk factor for cardiovascular diseases (CVD). It has been shown that the risk of primary prevention of CVD in patients with diabetes is equal to that of the secondary prevention in general population. In this manuscript, recent reports on the cardiac tests to detect the cardiovascular lesions will be reviewed. The data suggest that MDCT is a promising test even in the patients with diabetes. Furthermore, recent evidence of the treatment of diabetes with insulin or the drugs available recently such as DPP-4 inhibitors and SGLT-2 inhibitors will be reviewed. PMID:26666152

  13. Study of 123I-IMP SPECT on diabetic patients

    International Nuclear Information System (INIS)

    The involvement of peripheral nerves and nerve roots often leads to neurological manifestations which have frequently been described in association with diabetes mellitus. Whether there is any specific involvement of the central nervous system in this process has yet to be determined. Recently, many reports have suggested that significant neurophysiologic abnormalities in the central nervous system can sometimes be found in diabetic patients. In order to accurately examine the existence of central nervous system involvement in patients with diabetes mellitus, comparisons of 123I-IMP (IMP) washout rates were made between normal adults (n=19, average age 43.3 years) and diabetic patients (n=23, average age 43.3 years), and these results were graphically demonstrated by color images. Early images were obtained 30 minutes after intravenous injection, while delayed images were made 4 hours after injection. The IMP washout rate was obtained by subtracting the values of the delayed image with the early image. The standard deviation (SD) of the IMP washout rate for each patient was compared to the averaged SD obtained from healthy adults. After calculating the deviation from SD levels of healthy adults, we made an image of the patient's IMP washout rates. These images were divided into seven degrees (I, II: normal, III, IV: borderline, V∼VII: abnormal) and the ratio of each degree was expressed by a histogram in each cerebral hemisphere as the washout rate index. In 23 diabetic subjects, seven patients were found to be borderline while sixteen patients were abnormal. These impairments were not related either to the presence of diabetic triopathy or the duration of disease. By utilising such a noninvasive method, we were able to accurately evaluate the extent of diabetic central neuropathy. Therefore this subtraction method, which uses the specificity of IMP SPECT, is thus considered to be highly useful for broad clinical application. (author)

  14. The Association between Nonalcoholic Fatty Pancreas Disease and Diabetes

    Science.gov (United States)

    Yang, Yi-Ching; Chen, Ming-Fong; Chang, Chih-Jen

    2013-01-01

    Background Fatty infiltration of the pancreas has been shown to interfere with insulin secretion. Both insulin sensitivity and secretion are important in the pathogenesis of diabetes and prediabetes. However, the relationship between diabetes, prediabetes, and fatty pancreas remains unknown. We aim to investigate the relationships that fatty pancreas and nonalcoholic fatty liver disease (NAFLD) have with prediabetes and diabetes in a Chinese population. Patients and Methods This was a cross-sectional study. A total of 7,464 subjects were recruited. NAFLD and fatty pancreas were assessed by sonography. Clinico-metabolic parameters were compared among subjects with normoglycemia, prediabetes, and diabetes. Multinomial logistic regression was used to evaluate the relationship between fatty pancreas and NAFLD and diabetes or prediabetes with adjustment for cardiometabolic risk factors. Results With an increase in glycemia, a significantly greater proportion of subjects had NAFLD and fatty pancreas (test for trend p<0.05). Similar trends were also found for hypertension, general and central obesity, low-HDL cholesterol, and hypertriglyceridemia. In the logistic regression analysis, age, hypertension, male gender, hypertriglyceridemia, and central obesity were significantly associated with prediabetes and diabetes. Furthermore, the ORs of prediabetes and diabetes for NAFLD were 1.798 (95% CI 1.544–2.094) and 2.578 (95% CI 2.024–3.284), respectively. In addition, fatty pancreas was independently related to diabetes (OR, 1.379; 95% CI, 1.047–1.816) and prediabetes (OR, 1.222; 95% CI, 1.002–1.491) in male subjects. Conclusions Both NAFLD and fatty pancreas were associated with diabetes independent of age, gender, adiposity, and other cardiometabolic risk factors. Fatty pancreas was also related to prediabetes in males. PMID:23671610

  15. The association between nonalcoholic fatty pancreas disease and diabetes.

    Directory of Open Access Journals (Sweden)

    Horng-Yih Ou

    Full Text Available BACKGROUND: Fatty infiltration of the pancreas has been shown to interfere with insulin secretion. Both insulin sensitivity and secretion are important in the pathogenesis of diabetes and prediabetes. However, the relationship between diabetes, prediabetes, and fatty pancreas remains unknown. We aim to investigate the relationships that fatty pancreas and nonalcoholic fatty liver disease (NAFLD have with prediabetes and diabetes in a Chinese population. PATIENTS AND METHODS: This was a cross-sectional study. A total of 7,464 subjects were recruited. NAFLD and fatty pancreas were assessed by sonography. Clinico-metabolic parameters were compared among subjects with normoglycemia, prediabetes, and diabetes. Multinomial logistic regression was used to evaluate the relationship between fatty pancreas and NAFLD and diabetes or prediabetes with adjustment for cardiometabolic risk factors. RESULTS: With an increase in glycemia, a significantly greater proportion of subjects had NAFLD and fatty pancreas (test for trend p<0.05. Similar trends were also found for hypertension, general and central obesity, low-HDL cholesterol, and hypertriglyceridemia. In the logistic regression analysis, age, hypertension, male gender, hypertriglyceridemia, and central obesity were significantly associated with prediabetes and diabetes. Furthermore, the ORs of prediabetes and diabetes for NAFLD were 1.798 (95% CI 1.544-2.094 and 2.578 (95% CI 2.024-3.284, respectively. In addition, fatty pancreas was independently related to diabetes (OR, 1.379; 95% CI, 1.047-1.816 and prediabetes (OR, 1.222; 95% CI, 1.002-1.491 in male subjects. CONCLUSIONS: Both NAFLD and fatty pancreas were associated with diabetes independent of age, gender, adiposity, and other cardiometabolic risk factors. Fatty pancreas was also related to prediabetes in males.

  16. Diabetic Retinopathy: Nature and Extent.

    Science.gov (United States)

    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)

  17. Early detection of diabetes after pregnancy complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Nielsen, Jane Hyldgård; Overgaard, Charlotte; Olesen, Christinna Rebecca;

    2016-01-01

    Abstract Title: Early detection of diabetes after pregnancy complicated by gestational diabetes Background: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. 40% of women with a history gestational diabetes mellitus...... gestational diabetes is low in the North Denmark Region. Follow-up screening ensures early detection of diabetes and initiation of treatment. This emphasizes the importance of development of interventions to improve early detection and prevention of diabetes after gestational diabetes. Further information...... Associations between follow-up screening after gestational diabetes and early detection of diabetes – a register based study Author names: Christinna Rebecca Olesen, Jane Hyldgaard Nielsen, Rikke Nørmark Mortensen, Henrik Bøggild,Christian Torp-Pedersen and Charlotte Overgaard Public Health and Epidemiology...

  18. Advanced glycation end products measured by skin autofluorescence in a population with central obesity

    OpenAIRE

    den Engelsen, Corine; van den Donk, Maureen; Gorter, Kees J; Salomé, Philippe L; Rutten, Guy E

    2012-01-01

    Accumulation of advanced glycation end products (AGEs) is enhanced by chronic hyperglycemia and oxidative stress and this process may contribute to the pathogenesis of vascular disease. Skin autofluorescence (AF), a measure of accumulation of AGEs in skin collagen, is associated with vascular disease in patients with diabetes.   Because central obesity enhances oxidative stress people with central obesity might already have increased accumulation of AGEs before diabetes or cardiovascular dise...

  19. Hypernatremia secondary to post-stroke hypodipsia: just add water!

    OpenAIRE

    Ramthun, Maikel; Mocelin, Altair Jacob; Alvares Delfino, Vinicius Daher

    2011-01-01

    Disorders in water metabolism may occur in stroke patients. When hypernatremia arises in this setting, it is usually secondary to the development of central diabetes insipidus or it is the result of neurologic lesions that prevent patients from having free access to water. Much rarer are the cases of post-stroke hypernatremia caused by hypodipsia secondary to lesions of the thirst center. We report the case of a patient with severe hypernatremia, probably secondary to post-hemorrhagic stroke ...

  20. A pituitary abscess masquerading as recurrent hypernatremia and aseptic meningitis

    OpenAIRE

    Gonzales, Michael; Marik, Paul Ellis; Khardori, Romesh K.; O'Brian, John T

    2012-01-01

    Pituitary abscess is a rare condition. In the setting of multiple surgical interventions, the risk of its development increases. A 49-year-old man presented with episodes of altered mental status. He had two surgeries for a recurrent suprasellar arachnoid cyst. The second surgery was complicated by a persistent cerebrospinal fluid (CSF) leak that required two repairs following which he developed panhypopituitarism and central diabetes insipidus. Twelve months after his last surgery he was dia...

  1. Hypernatremia in patients with severe traumatic brain injury: a systematic review

    OpenAIRE

    Kolmodin, Leif; Sekhon, Mypinder S; Henderson, William R.; Turgeon, Alexis F; Griesdale, Donald EG

    2013-01-01

    Background Hypernatremia is common following traumatic brain injury (TBI) and occurs from a variety of mechanisms, including hyperosmotic fluids, limitation of free water, or diabetes insipidus. The purpose of this systematic review was to assess the relationship between hypernatremia and mortality in patients with TBI. Methods We searched the following databases up to November 2012: MEDLINE, EMBASE, and CENTRAL. Using a combination of MeSH and text terms, we developed search filters for the ...

  2. Hartsfield holoprosencephaly-ectrodactyly syndrome in five male patients: further delineation and review.

    OpenAIRE

    Vilain, Catheline; Mortier, Geert; Van Vliet, Guy; Dubourg, Christèle; Heinrichs, Claudine; De Silva, Deephti; Verloes, Alain; Baumann, Clarisse

    2009-01-01

    International audience We report on five male subjects with a triad of signs compatible with Hartsfield syndrome: ectrodactyly, holoprosencephaly, and mental retardation. Only six patients with this distinctive association have been reported over the past 20 years, all of them being males. Of the patients described here, some have unreported findings such as vermian hypoplasia in one and prolonged survival into adulthood in two. Two patients developed central diabetes insipidus. All were m...

  3. Brainstem auditory evoked potential abnormalities in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sharat Gupta

    2013-01-01

    Full Text Available Background: Diabetes mellitus represents a syndrome complex in which multiple organ systems, including the central nervous system, are affected. Aim: The study was conducted to determine the changes in the brainstem auditory evoked potentials in type 2 diabetes mellitus. Materials and Methods: A cross sectional study was conducted on 126 diabetic males, aged 35-50 years, and 106 age-matched, healthy male volunteers. Brainstem auditory evoked potentials were recorded and the results were analyzed statistically using student′s unpaired t-test. The data consisted of wave latencies I, II, III, IV, V and interpeak latencies I-III, III-V and I-V, separately for both ears. Results: The latency of wave IV was significantly delayed only in the right ear, while the latency of waves III, V and interpeak latencies III-V, I-V showed a significant delay bilaterally in diabetic males. However, no significant difference was found between diabetic and control subjects as regards to the latency of wave IV unilaterally in the left ear and the latencies of waves I, II and interpeak latency I-III bilaterally. Conclusion: Diabetes patients have an early involvement of central auditory pathway, which can be detected with fair accuracy with auditory evoked potential studies.

  4. Characterization of hearing loss in aged type II diabetics.

    Science.gov (United States)

    Frisina, Susan T; Mapes, Frances; Kim, SungHee; Frisina, D Robert; Frisina, Robert D

    2006-01-01

    Presbycusis - age-related hearing loss - is the number one communicative disorder and a significant chronic medical condition of the aged. Little is known about how type II diabetes, another prevalent age-related medical condition, and presbycusis interact. The present investigation aimed to comprehensively characterize the nature of hearing impairment in aged type II diabetics. Hearing tests measuring both peripheral (cochlea) and central (brainstem and cortex) auditory processing were utilized. The majority of differences between the hearing abilities of the aged diabetics and their age-matched controls were found in measures of inner ear function. For example, large differences were found in pure-tone audiograms, wideband noise and speech reception thresholds, and otoacoustic emissions. The greatest deficits tended to be at low frequencies. In addition, there was a strong tendency for diabetes to affect the right ear more than the left. One possible interpretation is that as one develops presbycusis, the right ear advantage is lost, and this decline is accelerated by diabetes. In contrast, auditory processing tests that measure both peripheral and central processing showed fewer declines between the elderly diabetics and the control group. Consequences of elevated blood sugar levels as possible underlying physiological mechanisms for the hearing loss are discussed.

  5. The role of hypertension in the development of nephropathy in type 1 (insulin-dependent) diabetes mellitus

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B; Nørgaard, K; Jensen, T;

    1990-01-01

    Which comes first when developing clinical diabetic nephropathy, the blood pressure rise or the increasing urinary albumin excretion? This issue is discussed based on recent literature of studies in humans with Type 1 (insulin-dependent) diabetes mellitus. We conclude that hypertension has...... a central role in the progression of diabetic nephropathy and has deleterious effects on the life expectancy of patients who already have signs of diabetic renal disease in terms of elevated urinary albumin excretion. However, blood pressure is preceded by small increments of urinary albumin excretion rates......, an indicator of universally increased vascular leakiness, and thus does not seem to be the cause of diabetic nephropathy....

  6. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say ... Pregnant? Your Baby's Growth Diabetes Movie KidsHealth > For Parents > Diabetes Movie Print A A A Text Size ...

  7. Native Americans and Diabetes

    Medline Plus

    Full Text Available ... have inherited genes from the three highest-risk groups for developing diabetes. The odds are stacked against them. Much of what the world now knows about Type II diabetes is a result of work carried on at the National Institutes of Health ...

  8. Diabetic foot infections.

    Science.gov (United States)

    Gemechu, Fassil W; Seemant, Fnu; Curley, Catherine A

    2013-08-01

    Diabetic foot infection, defined as soft tissue or bone infection below the malleoli, is the most common complication of diabetes mellitus leading to hospitalization and the most frequent cause of nontraumatic lower extremity amputation. Diabetic foot infections are diagnosed clinically based on the presence of at least two classic findings of inflammation or purulence. Infections are classified as mild, moderate, or severe. Most diabetic foot infections are polymicrobial. The most common pathogens are aerobic gram-positive cocci, mainly Staphylococcus species. Osteomyelitis is a serious complication of diabetic foot infection that increases the likelihood of surgical intervention. Treatment is based on the extent and severity of the infection and comorbid conditions. Mild infections are treated with oral antibiotics, wound care, and pressure off-loading in the outpatient setting. Selected patients with moderate infections and all patients with severe infections should be hospitalized, given intravenous antibiotics, and evaluated for possible surgical intervention. Peripheral arterial disease is present in up to 40% of patients with diabetic foot infections, making evaluation of the vascular supply critical. All patients with diabetes should undergo a systematic foot examination at least once a year, and more frequently if risk factors for diabetic foot ulcers exist. Preventive measures include patient education on proper foot care, glycemic and blood pressure control, smoking cessation, use of prescription footwear, intensive care from a podiatrist, and evaluation for surgical interventions as indicated.

  9. Know Your Diabetes ABCs

    Medline Plus

    Full Text Available ... somebody who's already had a heart attack. Announcer: Research shows that controlling blood sugar, blood pressure and cholesterol are critical in preventing heart disease and stroke among people with diabetes. Judith Fradkin, M.D.: We call this approach "the ABCs of diabetes." A is the A1C, ...

  10. Women and Diabetes

    Medline Plus

    Full Text Available ... for tips to help you manage your diabetes. Food Safety for People with Diabetes Your Glucose Meter - easy- ... Home Latest Recalls Report an Adverse Event MedWatch Safety Alerts News ... Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & ...

  11. Women and Diabetes

    Medline Plus

    Full Text Available ... you need depends on your health and the type of diabetes you have. Use these resources to help you ... FDA Publications for Women For Women Homepage FDA Diabetes Information for Patients ... 10903 New Hampshire Avenue Silver Spring, MD 20993 1-888-INFO-FDA (1-888-463-6332) Contact ...

  12. Diabetes, Distress, and Depression

    Centers for Disease Control (CDC) Podcasts

    2014-07-10

    This webinar is a discussion on incorporating the emotional side of diabetes into clinical care.  Created: 7/10/2014 by National Center for Chronic Disease Prevention’s Division of Diabetes Translation (NCCDP/DDT).   Date Released: 7/10/2014.

  13. Diabetes mellitus in Germany

    OpenAIRE

    Heidemann, Christin; Du, Yong; Scheidt-Nave, Christa

    2011-01-01

    This issue of GBE kompakt focuses on diabetes mellitus, a metabolic disease. Prevalence of and complications due to diabetes mellitus will be displayed on the basis of data of the telephone survey GEDA 2009 and other data sources. Another focus is on medical care and the use of medical services.

  14. Living With Diabetes

    Science.gov (United States)

    ... twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. ​​ Youth and Teens​ Learn more about lowering the risk for and managing type 2 diabetes in children and teens. W hat is Diabetes? Be Active Stay at a H ealthy Weight Make Healthy Food ...

  15. Peripartum management of diabetes

    Directory of Open Access Journals (Sweden)

    Pramila Kalra

    2013-01-01

    Full Text Available The peripartum control of diabetes is very important for the well-being of the newborn as higher incidence of neonatal hypoglycemia is seen if maternal hyperglycemia happens during this period. Type of diabetes (type 1, type 2 or gestational diabetes also has an effect on the glucose concentration during intrapartum period. During the latent phase of labor, the metabolic demands are stable but during active labor there is increased metabolic demand and decreased insulin requirement. After delivery once the placenta is extracted, insulin resistance rapidly comes down and in patients with pre-gestational diabetes there will be a sudden drop in insulin requirement and the insulin may not be required in women with gestational diabetes, but they just need close monitoring. During breast-feeding blood glucose levels fall because of high metabolic demand and women need to take extra calories to maintain the levels and more vigilance especially in type 1 and type 2 diabetic mothers is required. The protocols used for the management of peripartum management of diabetes mostly rely on glucose and insulin infusion to maintain maternal blood sugars between 70 and 110 mg/dl. The data is mostly from retrospective studies and few randomized control trials done mainly in type 1 diabetes patients. The review summarizes guidelines, which are used for peripartum management of blood glucose.

  16. Teen Diabetes Quiz

    Science.gov (United States)

    ... fruit drinks Sweets and desserts If you have diabetes, you should: Get 60 minutes of physical activity every day Get 20 minutes of physical activity ... Nuts and avocado Butter You can get enough physical activity by just: ... Teens with diabetes should not eat at fast food restaurants. True ...

  17. Detection of a novel arginine vasopression defect by dideoxy fingerprinting

    Energy Technology Data Exchange (ETDEWEB)

    Krishnamani, M.R.S.; Phillips, J.A. III; Copeland, K.C. (Vanderbilt Univ. School of Medicine, Nashville, TN (United States) Univ. of Vermont College of Medicine, Burlington, VT (United States))

    1993-09-01

    Autosomal dominant neurohypophyseal diabetes insipidus is a familial form of diabetes insipidus. This disorder is associated with variable levels of arginine vasopressin (AVP) and diabetes insipidus of varying severity, which responds to exogenous AVP. To determine the molecular basis of autosomal dominant neurohypophyseal diabetes insipidus, the AVP genes of members of a large kindred were analyzed. A new method, called dideoxy fingerprinting, was used to detect an AVP mutation that was characterized by DNA sequencing. The novel defect found changes the last codon of the AVP signal peptide from alanine to threonine, which should perturb cleavage of mature AVP from its precursor protein and inhibit its secretion or action. 18 refs., 3 figs.

  18. Diabetes Technologies and Their Role in Diabetes Management

    Science.gov (United States)

    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…

  19. Impairment of Retrograde Neuronal Transport in Cardiac Vagal Motoneurons in Streptozotocin-Induced Diabetic Rats: A Wheat Ger Agglutinin-Horseradish Peroxidase Neurohistochemical study

    OpenAIRE

    A. Odekunle; Phillips, C M

    2008-01-01

    Central projections of vagal motoneurons to the heart were studied in diabetic rats using Wheat germ Agglutinin-Horseradish peroxidase (WGA-HRP). Experimental rats were rendered diabetic by intraperitoneal injection of streptozotocin in citrate buffer. The diabetic rats were maintained in a stable diabetic state by daily injection of insulin for 24 weeks. Age-matched control rats were injected intraperitoneally with citrate buffer not containing streptozotocin. Control rats were also kept ali...

  20. Diabetes and Schizophrenia.

    Science.gov (United States)

    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. PMID:26803652