scholarly journals Clinical and laboratory characteristics of the renoretinal syndrome in diabetics

1996 ◽  
Vol 42 (3) ◽  
pp. 3-6
Author(s):  
M. I. Balabolkin ◽  
G. G. Mamayeva ◽  
V. Yu. Evgrafov ◽  
L. I. Lyudina ◽  
N. A. Bishele
Keyword(s):  
Diabetic Nephropathy ◽  
Type I Diabetes ◽  
Type I ◽  
Ophthalmological Examination ◽  
Type Ii ◽  
Pathological Changes ◽  
Clinical Methods ◽  
Microcirculatory Disorders ◽  
Lipid Spectrum ◽  
Fundus Oculi

A total of 107 diabetics were examined using general clinical methods, assessment of microalbuminemia, Rehbergs test for renal function, coagulogram, thromboelastogram, lipid spectrum of the serum, and ophthalmological examination. The stages of diabetic nephropathy and retinopathy and degree of the major pathological changes in the retina were found to be in direct correlation. Initial diabetic retinopathy was found to develop earlier than nephropathy in the majority of patients, and preproliferative and proliferative retinopathy was appreciably more incident in the presence of diabetic nephropathy. Changes in the fundus oculi were more expressed in patients with type I diabetes and nephropathy than in those with type II condition. At the same time, the development of diabetic nephropathy was associated with deterioration of the fundus oculi parameters only in diabetics with type II condition, whereas in those with type I disease it influenced only the number of microaneurysms. The progress of diabetic nephropathy with increase of proteinuria may be caused by such risk factors as microcirculatory disorders and changes in the lipid spectrum of the blood serum.

scholarly journals Conjunctival blood flow after endovascular laser therapy in patients with diabetic nephropathy

1997 ◽  
Vol 43 (6) ◽  
pp. 17-20
Author(s):  
Yu. I. Grinshtein ◽  
S. V. Ivliev ◽  
N. B. Osetrova ◽  
S. S. Ilyenkov
Keyword(s):  
Renal Function ◽  
Diabetic Nephropathy ◽  
Renal Insufficiency ◽  
Laser Therapy ◽  
Chronic Renal Insufficiency ◽  
Vascular Tone ◽  
Type I Diabetes ◽  
Type I ◽  
Microcirculatory Disorders ◽  
Reliable Increase

The conjunctival bloodflow was examined in patients with diabetic nephropathy with different status of renal function and changes in the microcirculatory bed assessed after endovascular laser therapy. Twenty-five donors and twenty-one patients with medium-severe and grave type I diabetes complicated by diabetic nephropathy were followed up. Microcirculatory disorders in the eyeball conjunctiva progressed as renal function deteriorated, which was evident from a reliable increase of the total conjunctival index in parallel with the progress of chronic- renal insufficiency. A course of endovascular laser therapy reliably improved the microcirculation: the arterio-venular coefficient increased and the total conjunctival index decreased in patients with latent and conservatively curable stages of chronic renal insufficiency due to normalization of vascular tone, boosting of the bloodflow, and decrease of red cell sludging.

scholarly journals Diabetic nephropathy: Pathogenesis and treatment

1996 ◽  
Vol 42 (4) ◽  
pp. 37-42
Author(s):  
A. V. Vorontsov ◽  
M. V. Shestakova
Keyword(s):  
Diabetic Nephropathy ◽  
Type I Diabetes ◽  
Clinical Manifestations ◽  
Type I ◽  
Clinical Methods ◽  
Patients With Diabetes ◽  
Long Time ◽  
Modern Classification ◽  
Insulin Dependent ◽  
The Moment

Currently, diabetic nephropathy (DN) is the leading cause of disability and mortality in patients with diabetes mellitus (DM). Developing in 4045% of patients, both insulin-dependent IDDM (type I) and non-insulin-dependent IDDM (type II) diabetes, this formidable complication leads to the development of chronic renal failure, and ultimately to the death of patients from uremia. The first kidney damage in diabetes was described by R. Kimmelstiel and C. Wilson in 1936. It is clinically characterized by the following manifestations: increasing proteinuria (with unchanged urinary sediment), hypertension, the formation of nephrotic syndrome (in about 30% of patients) and a progressive decrease in filtration kidney function. The insidiousness of this complication of diabetes lies in the fact that it develops gradually and remains unnoticed for a long time, since at the initial stages the patient does not cause discomfort. And in the later stages, when the presence of DN is no longer in doubt, preventing its further progression is extremely difficult, and often impossible. For many years in our country, the classification of DNs was used by V. R. Klyachko, according to which prenephrotic, nephrotic, and nephrosclerotic stages were distinguished. According to this classification, DN is diagnosed only from the moment when the patient develops proteinuria, registered by conventional laboratory methods, which indicates the severity and irreversibility of pathological changes in the kidneys. The modern classification, distinguishing stages at which clinical manifestations are still absent, and only functional disorders are detected, was proposed by S. Mogensen in 1983 (see table). In accordance with this classification, the first 3 stages are not detected by conventional clinical methods (preclinical stage of DN). The most informative marker of the early stages of DN is the determination of microalbuminuria (MAU), which means the excretion of albumin with urine in an amount of 30 to 300 mg / day. Identification of UIA in a patient with type I diabetes means that the probability of developing a clinical picture of DN in his next 10 years is 80%.

scholarly journals Glycosaminoglycans in therapy of diabetic nephropathy

1996 ◽  
Vol 42 (5) ◽  
pp. 14-18
Author(s):  
A. V. Vorontsov ◽  
I. I. Dedov ◽  
M. V. Shestakova ◽  
T. M. Milenkaya ◽  
A. P. Knyazeva
Keyword(s):  
Diabetic Nephropathy ◽  
Type I Diabetes ◽  
Combined Therapy ◽  
Basal Membrane ◽  
Type I ◽  
Clotting System ◽  
Antiatherogenic Effect ◽  
The Status ◽  
Glomerular Basal Membrane ◽  
Fundus Oculi

Sulodexide, a drug containing glycosaminoglycans, was used in the treatment of patients with type I diabetes. Along with their effects on the blood clotting system, glycosaminoglycans are capable of preventing the mesangial proliferation and hyperproduction of extracellular matrix, as well as thickening of the glomerular basal membrane and impairment of its permeability and charge selection. A reliable antiproteinuric effect of the drug was noted, persisting for 6 weeks after it was discontinued; the excretion of protein with the urine reliably decreased in patients with both, microalbuminuria and proteinuria. Moreover, an antiatherogenic effect (a reliable decrease of serum atherogenicity coefficient) of sulodexide was observed. Assessment of the status of the fundus oculi of diabetics treated with sulodexide demonstrated a positive dynamics during therapy in some of the patients with nonproliferative and preproliferative retinopathy; no deterioration as regards the fundus oculi were noted. Hence, addition of sulodexide to combined therapy of patients with diabetic nephropathy is effective and pathogenetically justified.

Polymorphism in the 5'-end of the aldose reductase gene is strongly associated with the development of diabetic nephropathy in type I diabetes

Diabetes ◽  
1997 ◽  
Vol 46 (2) ◽  
pp. 287-291 ◽  
Author(s):  
A. E. Heesom ◽  
M. L. Hibberd ◽  
A. Millward ◽  
A. G. Demaine
Keyword(s):  
Diabetic Nephropathy ◽  
Aldose Reductase ◽  
Type I Diabetes ◽  
Type I ◽  
Reductase Gene

scholarly journals Cancer Biology and Prevention in Diabetes

Cells ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 1380 ◽  
Author(s):  
Swayam Prakash Srivastava ◽  
Julie E. Goodwin
Keyword(s):  
Type Ii Diabetes ◽  
Cancer Biology ◽  
Cancer Metastasis ◽  
Type I Diabetes ◽  
Type I ◽  
Type Ii ◽  
Mesenchymal Transition ◽  
Wide Range ◽  
Risk Of Cancer

The available evidence suggests a complex relationship between diabetes and cancer. Epidemiological data suggest a positive correlation, however, in certain types of cancer, a more complex picture emerges, such as in some site-specific cancers being specific to type I diabetes but not to type II diabetes. Reports share common and differential mechanisms which affect the relationship between diabetes and cancer. We discuss the use of antidiabetic drugs in a wide range of cancer therapy and cancer therapeutics in the development of hyperglycemia, especially antineoplastic drugs which often induce hyperglycemia by targeting insulin/IGF-1 signaling. Similarly, dipeptidyl peptidase 4 (DPP-4), a well-known target in type II diabetes mellitus, has differential effects on cancer types. Past studies suggest a protective role of DPP-4 inhibitors, but recent studies show that DPP-4 inhibition induces cancer metastasis. Moreover, molecular pathological mechanisms of cancer in diabetes are currently largely unclear. The cancer-causing mechanisms in diabetes have been shown to be complex, including excessive ROS-formation, destruction of essential biomolecules, chronic inflammation, and impaired healing phenomena, collectively leading to carcinogenesis in diabetic conditions. Diabetes-associated epithelial-to-mesenchymal transition (EMT) and endothelial-to-mesenchymal transition (EndMT) contribute to cancer-associated fibroblast (CAF) formation in tumors, allowing the epithelium and endothelium to enable tumor cell extravasation. In this review, we discuss the risk of cancer associated with anti-diabetic therapies, including DPP-4 inhibitors and SGLT2 inhibitors, and the role of catechol-o-methyltransferase (COMT), AMPK, and cell-specific glucocorticoid receptors in cancer biology. We explore possible mechanistic links between diabetes and cancer biology and discuss new therapeutic approaches.

The natural history of diabetic nephropathy in type I diabetes and the role of metabolic control in its prevention, reversibility and clinical course

1984 ◽  
Vol 21 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Bernardo Léo Wajchenberg ◽  
Emil Sabbaga ◽  
João Américo Fonseca
Keyword(s):  
Diabetic Nephropathy ◽  
Natural History ◽  
Metabolic Control ◽  
Clinical Course ◽  
Type I Diabetes ◽  
Type I ◽  
History Of

Plasma endothelin-1 and total insulin exposure in diabetes mellitus

1999 ◽  
Vol 97 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Flemming WOLLESEN ◽  
Lars BERGLUND ◽  
Christian BERNE
Keyword(s):  
Type Ii Diabetes ◽  
Type I Diabetes ◽  
Insulin Dose ◽  
Albumin Excretion Rate ◽  
Wall Structure ◽  
Type I ◽  
Type Ii ◽  
C Peptide ◽  
Patients With Diabetes

Insulin stimulates endothelin-1 (ET-1) expression in a dose-response relationship, and ET-1 effects on vascular wall structure are similar to the long-term complications of diabetes. We therefore determined whether the plasma ET-1 concentration in patients with diabetes is associated with their total insulin exposure to see if plasma ET-1 might be a link between insulin exposure and long-term complications of diabetes. We studied 69 patients with Type I and 40 patients with Type II diabetes mellitus in equally tight glycaemic control for 2 years in a cross-sectional design. We measured basal and glucagon-stimulated plasma C-peptide, abdominal sagittal diameter, skinfold thickness, glomerular filtration rate, albumin excretion rate and standard clinical characteristics. Mean HbA1c was 6.4% in Type I and 6.3% in Type II diabetes. Patients with an albumin excretion rate > 300 μg/min were excluded. Adjusted mean plasma ET-1 was 4.11 (S.E.M. 0.39) pg/ml in 21 normal subjects, 3.47 (0.19) pg/ml in Type I diabetes and 4.84 (0.26) pg/ml in Type II diabetes (P = 0.0001). In all patients with measurable plasma C-peptide, plasma ET-1 was associated with basal plasma C-peptide (r = 0.5018, P < 0.0001), with stimulated plasma C-peptide (r = 0.5379, P < 0.0001), and with total daily insulin dose (r = 0.2219, P = 0.00851). Abdominal obesity, metabolic abnormalities, blood pressure and glomerular filtration rate were not associated with plasma ET-1, when corrected for C-peptide and daily insulin dose. Our study shows that the plasma concentration of ET-1 is closely associated with insulin secretion and insulin dose in patients with diabetes. Plasma ET-1 is higher in Type II diabetes than in Type I diabetes. Increased insulin exposure in patients with diabetes may have long-term effects on vascular wall structure through its stimulation of ET-1 expression.

Type I Diabetes Masquerading as Type II Diabetes: Possible implications for prevention and treatment

Diabetes Care ◽  
1994 ◽  
Vol 17 (10) ◽  
pp. 1214-1219 ◽  
Author(s):  
R. D. Leslie ◽  
P. Pozzilli
Keyword(s):  
Type Ii Diabetes ◽  
Type I Diabetes ◽  
Type I ◽  
Type Ii ◽  
Prevention And Treatment

A Search for Association between the Polymorphic Markers of PON1 and PON2 Genes and Diabetic Nephropathy in Patients with Type I Diabetes Mellitus

2005 ◽  
Vol 41 (6) ◽  
pp. 688-692
Author(s):  
O. E. Voron’ko ◽  
N. Yu. Yakunina ◽  
M. V. Shestakova ◽  
E. V. Zotova ◽  
L. A. Chugunova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Type I Diabetes ◽  
Type I Diabetes Mellitus ◽  
Type I ◽  
Polymorphic Markers

scholarly journals The C825T polymorphism in the human G-protein β3 subunit gene is not associated with diabetic nephropathy in Type I diabetes mellitus

Diabetologia ◽  
1998 ◽  
Vol 41 (11) ◽  
pp. 1304-1308 ◽  
Author(s):  
D. G. Fogarty ◽  
M. J. Zychma ◽  
L. J. Scott ◽  
J. H. Warram ◽  
A. S. Krolewski
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
G Protein ◽  
Type I Diabetes ◽  
Type I Diabetes Mellitus ◽  
Type I ◽  
Subunit Gene ◽  
C825t Polymorphism
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