Coronary heart disease risk factor profiles in black patients with non-insulin-dependent diabetes mellitus: paradoxic patterns

Article Abstract:

There are two forms of noninsulin-dependent diabetes mellitus (NIDDM) in American blacks. One form is characterized by insulin resistance, or the inability of the tissues to respond to insulin, a hormone that controls glucose metabolism. The other form of NIDDM in American blacks is characterized by normal sensitivity of tissues to insulin. The factors that increase the risk of cardiovascular disease were assessed in patients with insulin-sensitive and insulin-resistant NIDDM. The study included 22 black patients with NIDDM who had almost normal blood glucose levels and were not receiving drug therapy for NIDDM. The patients were tested for insulin sensitivity, blood levels of insulin, obesity, glucose metabolism, and levels of lipids (fats) in the blood, including high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol, and triglycerides. Insulin sensitivity was normal in 59 percent of patients. Obesity and blood levels of insulin, total cholesterol, LDL cholesterol, and triglycerides were lower in insulin-sensitive patients, compared with insulin-resistant patients. The blood levels of HDL cholesterol were similar in both groups and fell within the high limits of the normal range of values. The blood levels of cholesterol, LDL cholesterol and triglycerides were correlated with blood levels of insulin and ability of tissues to use glucose in response to insulin; this relation was not influenced by obesity. The results show that the insulin-sensitive form of NIDDM is more prevalent than the insulin-resistant form among American blacks and is also associated with a low risk of cardiovascular disease. Black patients with NIDDM tend to have a lower incidence (number of new cases) of angina and heart attack, compared with white patients with NIDDM. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Demographic aspects, African Americans, Coronary heart disease

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Workshop VII - retinopathy, nephropathy, neuropathy, and tight control

Article Abstract:

Insulin-dependent diabetes mellitus (IDDM) is a condition in which the insulin-secreting pancreatic beta cell ceases to function properly, resulting in excessively low levels of insulin in the blood. Because the primary role of insulin is to promote the metabolism of sugars such as glucose, diabetic patients have uncontrolled, high levels of blood glucose that must be kept in check by life-long daily injections of insulin. In recent years, researchers have suggested that there may be a relation between elevated endogenous insulin doses and the development of several diseases: high blood pressure (hypertension) and atherosclerosis (the accumulation of occlusive fatty deposits on the inner walls of blood vessels), hyperlipidemia (elevated blood levels of fats), neuropathy (impaired functioning of nerves), and nephropathy (impaired kidney function). Given this relationship, the question arises as to whether the daily injections of insulin that NIDDM patients take might contribute to the development of any of these conditions. Several studies currently underway in the United States and Great Britain seek to address this and related questions. At this time, the data are inconclusive. It is possible that elevated endogenous insulin levels occur in a metabolic milieu that is completely different from that found during the brief periods of hyperinsulinemia seen in patients with IDDM, and the same relationships will not obtain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Complications and side effects, Retinal diseases, Kidney diseases, Hyperglycemia, Insulin, Peripheral nerve diseases, Peripheral nervous system diseases, Sulfonylurea compounds, Sulfonylureas

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Platelet activity and phosphoinositide turnover increase with advancing age

Article Abstract:

The activity of platelets, blood cells involved in clotting, increases with age. Platelet function depends on the turnover, or metabolism, of phosphoinositides, which are naturally occurring phosphate-containing fatty acids located in the cell membrane. The role of phosphoinositide turnover in the increase of platelet activity with advanced age was examined in 40 healthy subjects, aged 22 to 62 years. Platelet activity was assessed by measuring platelet aggregation, or accumulation, and blood levels of beta-thromboglobulin (beta-TBG), which is a marker of platelet secretion. Phosphoinositide turnover was assessed by measuring the rate of incorporation or addition of a radioactive phosphate group, 32Pi, to specific phosphoinositide compounds; the breakdown of radioactive phosphoinositide compounds; and the production of phosphatidic acid. The results showed that advanced age was associated with increased platelet aggregation and increased blood levels of beta-TBG. Phosphoinositide turnover was also increased with age and correlated with changes in platelet aggregation and beta-TBG levels. Thus, aging is associated with increases in platelet aggregation, beta-TBG levels, and phosphoinositide turnover. These results suggest that enhanced phosphoinositide turnover may play a role in increasing platelet activity with advanced age. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aging, Measurement, Physiological aspects, Blood platelets, Phosphoinositides, Phosphatidylinositols

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