Diabetic disease

Kiel PJ, McCord AD. 2005. Pharmacist impact on clinical outcomes in a diabetes disease management program via collaborative practice. Ann Pharmacotber 39 1828—3A... 

Type 1 diabetes Disease effect in WS UF None Forty-five new PRP (38)... 

Yoshikawa (6) prepared xanthine derivatives, (V), which were effective as DPP-IV inhibitors and useful for treating, preventing, or improving diabetic diseases. 

Concentrations of various carboxylic acids in human body fluids reflect some of the major metabolic processes of the body. These metabolites apparently originate from lipid and amino acid metabolism the major metabolic defects are frequently associated with unbalanced concentrations of these acidic substances. One of the most widely occurring conditions of this kind is ketoacidosis in diabetic disease high concentrations of the so-called ketone bodies (3-hydroxybutyric acids, acetoacetic acid and others) are the traditional hallmarks of ketoacidosis. Many additional acidurias were discovered (particularly during the last 15 years) in major part due to the availability of GC and GC/MS techniques. Acidurias are among the serious medical conditions that are usually a result of genetic aberration (enzyme deficiencies), but environmental factors or nutritional deficiency could occasionally be involved. These conditions are characterized by either (a) drastically enhanced excretion of normal metabolic intermediates, or (b) excretion of unusual metabolites that are produced from the accumulated intermediates via alternate biochemical pathways. Many acidemic conditions have now been documented in the literature, and the role of GC in such medical discoveries has been adequately stressed in the recent reviews of Jellum [15] and Tanaka and Hine [373]. 

A protective role for OL extracted from olive leaves against diabetic disease was first postulated by Gonzalez et al. in the early 1990s [152]. In that study, the hypoglycemic effect of OL in animals with alloxan-induced diabetes was attributed to a potentiation of glucose-induced insulin release and parallel increased peripheral uptake of glucose [152]. Subsequent studies evidenced a stronger link of the antidiabetic action with the antioxidant effects of OL. The role played by OS for diabetes complications such as retinopathy, nephropathy, and coronary heart... 

Because of its high concentration of several key nutrients, many physicians and nutritionists regard pork as a desirable part of many special diets, such as those for peptic ulcer, diabetes, diseases of the liver, and in geriatric and pediatric conditions where it is important to maintain a good supply of high-quality protein and other body-building and restorative nutrients which patients need. The lean cuts of fresh and cured pork are excellent foods, which afford appetizing variety for the patient. 

Edema is a condition of abnormally large fluid volume in the circulatory system or in tissues between the body s cells. For a healthy human body, the venous and lymphatic systems collaborate to maintain the micro- and macro-circulatory homeostasis of the tissues. Ulceration of the skin develops when the normal functions of these two systems are disturbed either as a result of diabetic diseases or by the application of excessive pressure on the tissue. This leads to large amounts of edema and wound exudate, with peri-wound skin having dermatitis, hyperemia or maceration, dark pigmentation, atrophy blanche, and fibrosis. Figure 8.1 shows an example of a patient with venous leg ulcers. 

Keywords— Diabetic disease, bone marrow failure, bone broken. 

Prior to this work, dietary fiber, of which ceUulose is oae of the more important constituents, was considered important primarily as a means of preventing or overcoming constipation. Otherwise, dietary fiber was considered to be a metaboHcally iaert substance. A large variety of diseases such as appendicitis, hiatus hernia, gallstones, ischemic heart disease, diabetes, obesity, dental caries, and duodenal ulcers are now suspected to be associated with the consumption of a highly refined diet (42). 

NIDDM is a much more common disease than IDDM, accounting for about 85—90% of all cases of diabetes meUitus. Whereas NIDDM may be present at any age, the incidence increases dramatically with advanced age over 10% of the population reaching 70 years of age has NIDDM. Patients with NIDDM do not require insulin treatment to maintain life or prevent the spontaneous occurrence of diabetic ketoacidosis. Therefore, NIDDM is frequendy asymptomatic and unrecognized, and diagnosis requires screening for elevations in blood or urinary sugar. Most forms of NIDDM are associated with a family history of the disease, and NIDDM is commonly associated with and exacerbated by obesity. The causes of NIDDM are not well understood and there may be many molecular defects which lead to NIDDM. 

Stmctural defects at the receptor level are determinant for a number of receptor diseases. In nephrogenic diabetes insipidus, where patients void large volumes of dilute urine even in the presence of vasopressin (antidiuretic hormone) (105), the disease is linked to mutations in three discrete regions of the G-protein-linked vasopressin (V2) receptor (106,107). 

In 1986, the FDA s Sugars Task Force assessed the impact of sugar consumption on human health and nutrition and concluded that sucrose is not an independent risk factor for heart disease, nor does it cause or contribute to the development of diabetes (62). Although diet is important after the onset of diabetes, sucrose can be well tolerated by insulin-dependent diabetics (63—65). 

Sugar is one of the purest foods made, from natural sources, and has never been known to contain any toxic or harmful components. Intensive investigations by the U.S. Food and Dmg Administration resulted in a book in 1986 on the health and safety factors of sugar (cane and beet) in the diet (18). The conclusion was that sugar has no deleterious effect on health in regard to heart disease, diabetes, or other metaboHc disorder. 

Ascorbic acid also forms soluble chelate complexes with iron (142—145). It seems ascorbic acid has no effect on high iron levels found in people with iron overload (146). It is well known, in fact, that ascorbic acid in the presence of iron can exhibit either prooxidant or antioxidant effects, depending on the concentration used (147). The combination of citric acid and ascorbic acid may enhance the iron load in aging populations. Iron overload may be the most important common etiologic factor in the development of heart disease, cancer, diabetes, osteoporosis, arthritis, and possibly other disorders. The synergistic combination of citric acid and ascorbic acid needs further study, particularly because the iron overload produced may be correctable (147). 

Vitamin D metaboUtes may therefore play an active role ia diseases related to these functions, ie, leukemia, cancer (breast, colon, prostate), and autoimmune diseases (AIDS, immune encephaUtis, and diabetes) (51, 141,193—197, 202, 203). 

Patients having high plasma renin activity (PRA) (>8 ng/(mLh)) respond best to an ACE inhibitor or a -adrenoceptor blocker those having low PRA (<1 ng/(mLh)) usually elderly and black, respond best to a calcium channel blocker or a diuretic (184). -Adrenoceptor blockers should not be used in patients who have diabetes, asthma, bradycardia, or peripheral vascular diseases. The thiazide-type diuretics (qv) should be used with caution in patients having diabetes. Likewise, -adrenoceptor blockers should not be combined with verapamil or diltiazem because these dmgs slow the atrioventricular nodal conduction in the heart. Calcium channel blockers are preferred in patients having coronary insufficiency diseases because of the cardioprotective effects of these dmgs. 

Nifedipine (Table 3) is a potent vasodilator that selectively dilates resistance vessels and has fewer effects on venous vessels. It does not cause reflex tachycardia during chronic therapy. Nifedipine is one of the first-line choices for black or elderly patients and patients having concomitant angina pectoris, diabetes, or peripheral vascular diseases. Nifedipine, sublingually, is also suitable for the treatment of hypertensive emergencies. Nifedipine does not impair sexual function or worsen blood Hpid profile. The side effects are flushing, headache, and dizziness. 

When adrninistered long-term for the treatment of hypertension, diuretics fulfill the goals of preventing cardiovascular disease and increasing longevity. However, diuretic therapy may produce both side and toxic effects that are significant in certain patient subgroups, eg, diabetics and cardiac patients. 

Infusion devices have been used for diabetes, cancer chemotherapy, pain control (patient-controUed analgesia, ie, PGA), infection, Alzheimer s disease, Parkinson s, nausea, thalassemia, thromboembolism, and to treat severe spasms resulting from spiaal cord iajury (140—143). 

The separation of proteins and peptides mixtures is the objective of protein biochemisdy. Albumin (Mr 66 000) concentration in a biological fluid (seaim, urine or cerebrbrospinal fluid) is assayed as markers for a series disease, such as nephritic syndrome or chronic glomuleronephritis. In diabetic patients the progression of microalbuminuria is accompanied by an increase in urinary concentrations of human semm albumen. In normal the excretion of albumin is 20 (tg/ml, in pathology - 20-200 p.g/ml. 

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