Diabetes mellitus glucose intolerance

Familial hypertriacylglycerolemia (type IV) Overproduction of VLDL often associated with glucose intolerance and hyperinsulinemia. Cholesterol levels rise with the VLDL concentration. LDL and HDL tend to be subnormal. This type of pattern is commonly associated with coronary heart disease, type II diabetes mellitus, obesity, alcoholism, and administration of progestational hormones. 

Glucose levels should be monitored closely when CHCs are started or stopped in patients with a history of glucose intolerance or diabetes mellitus. 

Diabetes Mellitus A heterogeneous group of disorders that share glucose intolerance in common. [NIH]... 

Abdominal obesity is associated with a threatening combination of metabolic abnormalities that includes glucose intolerance, insulin resistance, hyperinsulinemia, dyslipidemia (low HDL and elevated VLDL), and hypertension. This clustering of metabolic abnormalities has been referred to as syndrome X, the insulin resistance syndrome, or the metabolic syndrome. Individuals with this syndrome liave a significantly increased risk for developing diabetes mellitus and cardiovascular disorders. For example, men with the syndrome are three to four times more likely to die of cardiovascular disease. 

Diabetes was also more common in 63 patients taking clozapine than in 67 receiving typical depot neuroleptic drugs (299). The percentages of type 2 diabetes mellitus were 12% and 6% respectively. Nevertheless, the mechanism is not known. In six patients with schizophrenia, clozapine increased mean concentrations of blood glucose, insulin, and C peptide (300). The authors concluded that the glucose intolerance was due to increased insulin resistance. 

Since changes in glucose balance after diuretics tend to be reversible on withdrawal, measures of carbohydrate homeostasis should be assessed after several months of thiazide treatment to detect those few patients who experience significant glucose intolerance (353). With this approach, the small risk of diabetes mellitus secondary to diuretic therapy can be minimized. 

When lithium toxicity has been reported in patients with diabetes mellitus, it has been attributed to impaired glucose intolerance (681). 

A 32-year-old African-American man with no prior history of diabetes mellitus or glucose intolerance had a raised blood glucose concentration after 6 weeks of olanzapine therapy, and required insulin (864). Olanzapine was withdrawn and blood glucose concentrations returned to normal about 2 weeks later. At rechallenge hyperglycemia occurred again. 

Spigset O, Mjorndal T. Increased glucose intolerance related to digoxin treatment in patients with type 2 diabetes mellitus. J Intern Med 1999 246(4) 419-22. 

Adverse Effects. Common side effects of tacrolimus include gastrointestinal disturbances (cramps, nausea, diarrhea, constipation), weakness, fever, and skin rashes and itching. More serious problems include renal and central nervous system (CNS) toxicity (headache, anxiety, nervousness, seizures).41 Tacrolimus is also associated with problems with glucose metabolism (hyperglycemia, glucose intolerance), and can cause diabetes mellitus in certain individuals.73... 

Breum L, Bjerre U, Bak JF, Jacobsen S, Astrup A (1995) Long-term effects of fluoxetine on glycemic control in obese patients with non-insulin-dependent diabetes mellitus or glucose intolerance influence on muscle glycogen synthase and insulin receptor kinase activity. Metabolism 44 1570-1576... 

Non-insulin-dependent diabetes mellitus (NIDDM), also known as late-onset or type II diabetes, affects over 12 million Americans, only about half of whom are aware of their disease (H6). Importantly, most diabetics have the disease for 4-7 years before it is diagnosed. About 50% of men and women aged 65-74 years demonstrate glucose intolerance (i.e., increased glucose levels but below that required for a definitive diagnosis) about 20% of these have NIDDM (C3, B16). NIDDM is a major cause of cardiovascular disease, stroke, renal failure, and blindness it is also associated with accelerated aging. 

The diabetogenic actions of cortisol may lead to glucose intolerance or overt diabetes mellitus. A peculiar tendency for the disposition of fat in the face (moon facies), posterior neck (buffalo hump), thorax, and abdomen, while sparing the distal extremities, causes a distinct central obesity. ... 

BOX 25-2 Classification of Diabetes Mellitus and Other Categories of Glucose intolerance... 

NDDG. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes 1979 28 1039-57. 

Since hypercholesterolemia (in particular, LDL cholesterol) increases the risk of CHD, it seems reasonable to lower cholesterol levels in patients whose levels put them at risk. Before treatment, other risk factors such as hypertension, cigarette smoking, obesity, and glucose intolerance need to be evaluated and corrected. Disorders that exacerbate hyperlipoproteinemia (e.g., chronic ethanol abuse, hypothyroidism, diabetes mellitus) need to be treated before lipid-lowering measures are taken (discussed earlier. Table 20-7). 

Gestational Diabetes Mellitus (GDM) Glucose intolerance that is first recognized during pregnancy is classified as GDM. The prevalence of GDM varies among... 

Gestational diabetes mellitus (GDM) complicates roughly 7% of all pregnancies in the United States. Most women will return to normoglycemia postpartum, but 30% to 50% will develop type 2 DM or glucose intolerance later in life. 

Gestational diabetes mellitus (GDM) is defined as glucose intolerance which is first recognized during pregnancy. Gestational diabetes complicates about 7% of all pregnancies. Clinical detection is important, as therapy will reduce perinatal morbidity and mortality. 

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