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Full-Text Articles in Medicine and Health Sciences
The Natural History Of Diabetes, H. St. George Tucker Jr.
The Natural History Of Diabetes, H. St. George Tucker Jr.
MCV/Q, Medical College of Virginia Quarterly
The familial tendency of diabetes has been recognized for centuries. The genetic studies of Pincus and White (1933), Steinberg and Wilder (1952), Post (1962), and others seem to indicate that diabetes is transmitted as a simple autosomal recessive trait. If this is so, it is obvious that the tendency to diabetes must be established at the moment of conception. What does this tendency to diabetes consist of, and what determines when the disease we have called "diabetes" will appear? What is the status of the predisposed individual prior to the onset of overt diabetes?
The Treatment Of Diabetic Acidosis, Thaddeus S. Danowski
The Treatment Of Diabetic Acidosis, Thaddeus S. Danowski
MCV/Q, Medical College of Virginia Quarterly
The patient with diabetes mellitus who becomes unconscious presents a problem in differential diagnosis. We now recognize six possible causes of coma in the diabetic patient. These include the usual diabetic keto-acidosis, and five possible non-ketotic causes: I. Keto-acidosis II. Non-ketotic causes of coma A. Unconsciousness unrelated to diabetes, e.g. barbiturate intoxication, "stroke," uremia B. Hypoglycemia C. Lactic acidosis D. Hypernatremia E. Hyperglycemia
The State Of Insulin In The Blood, Thaddeus E. Prout
The State Of Insulin In The Blood, Thaddeus E. Prout
MCV/Q, Medical College of Virginia Quarterly
Diabetes mellitus has been reviewed as a group of conditions with impaired function of one or more portions of a feed-back system involving the release and utilization of insulin. It is hoped that this may form a useful scheme by which we can study and understand a number of complex metabolic states which we must still collectively refer to as diabetes mellitus.
Insulin Antigenicity, Thaddeus E. Prout
Insulin Antigenicity, Thaddeus E. Prout
MCV/Q, Medical College of Virginia Quarterly
Thus we have seen that evidence of insulin antigenicity in one or more forms is present in most individuals receiving intermediate insulins for six weeks or longer. A number of clinical manifestations of insulin antigenicity and their treatment have been discussed.
Insulin Antagonists, John A. Owen Jr.
Insulin Antagonists, John A. Owen Jr.
MCV/Q, Medical College of Virginia Quarterly
In conclusion, the synalbumin antagonist exists, and may be important in the pathogenesis of human diabetes, but its role has not been proved. The proof will require elucidation of the problem of species specificity, and ability to measure accurately the levels of synalbumin antagonist.
The Pregnant Diabetic, William R. Jordan
The Pregnant Diabetic, William R. Jordan
MCV/Q, Medical College of Virginia Quarterly
At present, more diabetic females of childbearing age are going through pregnancy, and more diabetic children are living beyond maturity. The outlook for the pregnant diabetic has improved greatly but the infant mortality rate of diabetic children remains relatively high. My remarks are based on observations on 105 pregnant diabetics from my private practice.
Cryosurgery Of The Pituitary Gland, William F. Collins Jr.
Cryosurgery Of The Pituitary Gland, William F. Collins Jr.
MCV/Q, Medical College of Virginia Quarterly
In closing I would like to state that I believe that with stereocryohypophysectomy we have a simple, effective technique which can be utilized to alter pituitary function. It can be performed under local anesthesia and, is a safe and effective method for aid in the control of diabetic retinopathy.
Problems In The Insulin Dependent Diabetic, Clay T. Gardner Jr.
Problems In The Insulin Dependent Diabetic, Clay T. Gardner Jr.
MCV/Q, Medical College of Virginia Quarterly
It is often useful for the physician to classify diabetes as stable or unstable. Maturity-onset diabetes is usually stable, and its management is not difficult, provided the patient is interested and cooperative. Tendency to obesity, relative insensitivity to insulin, and absence of ketosis are characteristic of such patients. Relative insensitivity to insulin does not imply unresponsiveness, but rather that the blood sugar is not overly labile and does not fall sharply in response to exercise or injected insulin. Many patients with such insensitivity to insulin are adequately managed on diet, alone or in combination with the oral hypoglycemic agents. When …
The Natural History Of Diabetic Retinopathy, Guy H. Chan
The Natural History Of Diabetic Retinopathy, Guy H. Chan
MCV/Q, Medical College of Virginia Quarterly
Diabetic retinopathy is a common and increasing cause of blindness. The higher incidence of retinopathy is related to the longer survival of the diabetic patient. The etiology of diabetic retinopathy remains unknown. However, two varieties appear to exist: Type I retinopathy, characterized by a slowly progressive course and ophthalmoscopic findings of microaneurysms, round hemorrhages, and waxy exudates; and Type II retinopathy, associated with a more rapid loss of vision, in which the main findings are venous engorgement, vascular proliferation, connective tissue condensation, and recurrent vitreous hemorrhages. Both types may result in retinitis proliferans and blindness. In the proliferative (Type II) …
Diabetic Neuropathy, Max Ellenberg
Diabetic Neuropathy, Max Ellenberg
MCV/Q, Medical College of Virginia Quarterly
Diabetic neuropathy is becoming increasingly recognized because of its frequency and the severity of its manifestations. There is no domain in the field of medicine or surgery that is not at some time concerned with diabetic neuropathy. Neuropathy in diabetes may be divided into somatic and visceral types. I will discuss chiefly visceral neuropathy, but I should first say a few words about somatic neuropathy, which is the commoner of the two.
Some Surgical Problems In Diabetic Patients, David M. Hume
Some Surgical Problems In Diabetic Patients, David M. Hume
MCV/Q, Medical College of Virginia Quarterly
These patients illustrate some of the more perplexing and challenging surgical problems in diabetic patients. There are many others, but these are particularly gratifying because only a few years back the circulatory problems in the lower extremities were treatable only by high amputation, and in the case of kidney disease with renal failure, there was no other treatment at all.
The Management Of Diabetes In Children, Thaddeus S. Danowski
The Management Of Diabetes In Children, Thaddeus S. Danowski
MCV/Q, Medical College of Virginia Quarterly
I think the time will come when we will all agree that diabetes mellitus is indeed the most common endocrinopathy, and that if we live long enough, at least 25% of the people in this room will develop diabetes. I believe that diabetes has manifestations both as a homozygous and heterozygous state, and that the heterozygous state or so-called carrier state become clinically manifest as we get older. Now I am not sure that such diabetes has the same significance as diabetes coming on earlier in life. It may be a benign type of diabetes, but at any rate, it …
Diabetic Glomerulosclerosis, J. M. B. Bloodworth Jr.
Diabetic Glomerulosclerosis, J. M. B. Bloodworth Jr.
MCV/Q, Medical College of Virginia Quarterly
Why should the mesangial cells be irritated? We recently observed in some diabetics black deposits beneath and on both sides of the basement membrane. These appear quite similar to deposits seen in and around the basement membrane in glomerulonephritis and in lupus nephritis. I do not know for sure what they are, but theory says that in glomerulonephritis they probably represent antigen-antibody complexes. There is some evidence to support this. One would assume that in diabetes they might be the same thing. Or they might be some other atypical plasma protein which results from the abnormal pattern of diabetic metabolism. …
Pituitary Ablation For Diabetic Retinopathy, Olof H. Pearson
Pituitary Ablation For Diabetic Retinopathy, Olof H. Pearson
MCV/Q, Medical College of Virginia Quarterly
Our clinical experience and the experience of others seems to indicate that pituitary ablation can induce a significant beneficial effect on the course of diabetic retinitis, even in advanced stages. We have no strict criteria for the selection of patients. When surgical hypophysectomy is being done, the major restriction is whether the patient has a fair chance of getting through the procedure without great risk of death or serious complication. With yttrium-implant hypophysectomy, the risk of death from the procedure itself has been practically eliminated. The morbidity would be much less if the rhinorrhea and the threat of meningitis could …
Diabetic Microangiopathy, J. M. B. Bloodworth Jr.
Diabetic Microangiopathy, J. M. B. Bloodworth Jr.
MCV/Q, Medical College of Virginia Quarterly
Microangiopathy is the term applied to the abnormal state of the capillaries, arterioles, and venules found in the diabetic patient. It is characterized principally by thickening of the basement membrane of these small vessels. It might be worth mentioning that while we are concerned here with the smaller blood vessels, diabetic patients also show thickening of the basement membrane beneath the endothelium of arteries of all sizes. Also, the basement membrane-like material that surrounds each smooth muscle fiber in the wall of arteries shows similar thickening in diabetic patients. With this thickening, there is an increased glycoprotein content of the …
Treatment Of Diabetes With Oral Hypoglycemic Drugs, James M. Moss
Treatment Of Diabetes With Oral Hypoglycemic Drugs, James M. Moss
MCV/Q, Medical College of Virginia Quarterly
Oral hypoglycemic drugs now available are of two types. The biguanides, of which phenformin (DBI) is the only one available, increase glucose utilization by muscles. The sulfonylureas, tolbutamide (Orinase), acetohexamide (Dymelor), and chlorpropamide (Diabinese), stimulate the pancreas to produce and release more insulin. All three sulfonylureas have the same effect in responsive patients, but they differ in potency and in duration of action.