Aging diabetes mellitus

Systemic diseases Normal aging, diabetes mellitus, chronic renal failure, coronary heart disease Multifactorial neuronal and vascular dysfunction... 

Those with type 1 diabetes mellitus produce insulin in insufficient amounts and tiierefore must have insulin supplementation to survive Type 1 diabetes usually has a rapid onset, occurs before die age of 20 years, produces more severe symptoms tiian type 2 diabetes, and is more difficult to control. Major symptoms of type 1 diabetes include hyperglycemia, polydipsia (increased thirst), polyphagia (increased appetite), polyuria (increased urination), and weight loss. Treatment of type 1 diabetes is particularly difficult to control because of the lack of insulin production by die pancreas. Treatment requires a strict regimen tiiat typically includes a carefully calculated diet, planned physical activity, home glucose testing several times a day, and multiple daily insulin injections. 

Ms. Baxter, age 37years, has been taking insulin for the past 6 years for type 1 diabetes mellitus. An assessment at the outpatient clinic reveals a blood... 

Hunt, J.V., Dean, R.T. and Wolff, S. (1988). Hydroxyl radical production and autoxidative glycosylation. Glucose oxidation as the cause of protein damage in the experimental glycation model of diabetes mellitus and ageing. Biochem. J. 256, 205-212. 

Sinclair, A.J., Lunec, J., Girling, A.J. and Barnett, A.H. (1992). Modulators of free radical activity in diabetes mellitus role of ascorbic acid. In Free Radicals and Aging (eds. I. Emerit and B. Chance) pp. 342-352. BirkhauserVerlagBasel. 

Risk factors for embolic cerebrovascular accidents include previous ischemic stroke, transient ischemic attacks (TIA), systemic embolism, age >75 yr, moderately or severely impaired left ventricular systolic function, hypertension, diabetes mellitus... 

Creatinine clearance < 60 mL/min/1.73 m2 (stages III-V chronic kidney disease), diabetes mellitus (with renal insufficiency), hypertension, chronic heart failure, cirrhosis, nephrosis, age >75 yr, cholesterol emboli syndrome, multiple myeloma (questionable)... 

Type 2 diabetes mellitus since age 36 it is often not well controlled because of poor patient compliance Hypertension x 3 years, currently controlled History of hepatitis B... 

Father died at age 45 from coronary disease, mother alive at age 62 with type 2 diabetes mellitus, hypertension, hyperlipidemia, and gastroesophageal reflux disease... 

Father with a history of type 2 diabetes mellitus, hypertension, and stage 5 chronic kidney disease he died from a myocardial infarction at age 68 mother with a history of hypertension she died from injuries sustained in a motor vehicle accident at the age of 52... 

Father living, age 58 years hypertension, diabetes mellitus, dyslipidemia... 

Diabetes mellitus since age 55 it was well controlled until last year when it worsened because of increased confusion of when to take her medication... 

Type 1 diabetes mellitus since age 5, currently controlled... 

Insulin-dependent diabetes mellitus since age 7 it is "reasonably well-controlled" per patient Hypertension for 2 years, currently "controlled" per patient... 

Type II diabetes mellitus since age 48. He admits that his diet prevents his diabetes from being well controlled. 

Father had stroke at age 59 mother has history of hypertension and diabetes mellitus... 

The 23-valent pneumococcal polysaccharide vaccine is recommended for use in all adults 65 years of age or older and adults less than 65 years who have medical comorbidities that increase the risk for serious complications from S. pneumoniae infection, such as chronic pulmonary disorders, cardiovascular disease, diabetes mellitus, chronic liver disease, chronic renal failure, functional or anatomic asplenia, and immunosuppressive disorders. Alaskan natives and certain Native American populations are also at increased risk. Children over the age of 2 years may be vaccinated with the 23-valent pneumococcal polysaccharide vaccine if they are at increased risk for invasive S. pneumoniae infections, such as children with sickle cell anemia or those receiving cochlear implants. 

Mutations in GK (Hx IV) causes maturity-onset diabetes of the young (MOD Y), a form of non-insulin-dependent diabetes mellitus (NIDDM) characterized by onset before 25 years of age and an autosomal dominant inheritance (PI 2). This suggests that the mutations in other forms of Hx may also contribute to the development of NIDDM. Among them, Hx II is a particularly attractive candidate, although this isozyme is not expressed in red blood cells. Hx II has been analyzed extensively in the muscle of prediabetic insulin-resistant individuals. But studies have shown that Hx II mutation alone is unlikely to have a significant role in the development of peripheral insulin resistance and NIDDM (L6). 

The formation of atherosclerotic plaques is the underlying cause of coronary artery disease (CAD) and ACS in most patients. Endothelial dysfunction leads to the formation of fatty streaks in the coronary arteries and eventually to atherosclerotic plaques. Factors responsible for development of atherosclerosis include hypertension, age, male gender, tobacco use, diabetes mellitus, obesity, and dyslipidemia. 

Cholecystectomy Enteric gram-negative bacilli, anaerobes Cefazolin 1 g x 1 for high-risk patients Laparoscopic None High-risk patients only (acute cholecystitis, common duct stones, previous biliary surgeiy, jaundice, age >60 years, obesity, diabetes mellitus) IA... 

Risk factors for TD include duration of antipsychotic therapy, higher dose, possibly cumulative dose, increasing age, occurrence of acute extrapyrami-dal symptoms, poor antipsychotic response, diagnosis of organic mental disorder, diabetes mellitus, mood disorders, and possibly female gender. 

Endocrine Thyroid gland atrophies with age Increased incidence of diabetes mellitus, thyroid disease Menopause... 

The origins of diabetes mellitus are still being investigated. There is a familial trait—certain histocompatability phenotypes and perhaps other non-HLA genes are more frequently displayed by juvenile diabetics than others. Viral infections in childhood may precipitate immune responses which damage the P islet cells. Other types of diabetes, such as that shown by middle-aged or older patients, have different causes and can often be controlled by appropriate diet. 

Mr Patel came to the UK from his native India in 1969 when he was 22 years old. For almost 30 years he has run, very successfully with the help of his family, a small business which now employs 30 people in the suburbs of Leicester. At the age of 38 years, Mr Patel was diagnosed with diabetes mellitus (Type 1 diabetes) and now has trouble controlling his weight and is on medication to regulate his plasma triglyceride and cholesterol concentrations. 

Monnier VM, Kohn RR and Cerami A (1984) Accelerated age-related browning of human collagen in diabetes mellitus. Proc Natl Acad Sci USA 81, 583-587. 

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