Is the lung a 'target organ' in diabetes mellitus?

Article Abstract:

Long-term complications of diabetes mellitus are thought to involve disorders of the microvasculature (very small blood vessels) and an interaction of glucose molecules with tissue proteins. Because the lung consists of an extensive microvascular circulation system and abundant connective tissue, it may be a "target organ" for adverse effects of the hyperglycemia (increased blood glucose) of diabetes mellitus. Since normal lung mechanics and gas exchange depend on the microvasculature and connective tissue of the lung, disorders of these two lung systems may lead to impaired lung function. Structural changes of lung tissue in patients with diabetes mellitus include thickening of the epithelial cells of the alveoli (the gas-exchanging units of the lung) and thickening of the basal cells of the lung capillaries (very small blood vessels). Abnormalities in lung function associated with diabetes mellitus include decreased lung volumes in young insulin-dependent diabetics; decreased elasticity of lung tissue in all diabetics; and impaired diffusion of oxygen from the lungs into the blood due to a reduced blood volume in the capillaries. The impaired mechanical function of the lung may result from alterations in lung connective tissue due to glucose binding. Impaired oxygen diffusion most likely results from the disease of the lung microvasculature. Thus the lung should be considered a target organ in diabetes mellitus, although the relationship of this impaired lung function to respiratory disease is not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Evaluation, Lungs, Lung, Pulmonary circulation, Pulmonary manifestations of general diseases, Respiratory symptoms

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Hyperkalemia in diabetes mellitus: effect of a triamterene-hydrochlorothiazide combination

Article Abstract:

Hyperkalemia (high potassium levels in the blood) occurs in patients with diabetes and advanced age when medications that interfere with the kidney's excretion of potassium are taken. Data about the frequency of hyperkalemia are reviewed in patients who were given triamterene-hydrochlorthiazide (Maxzide, usually prescribed for high blood pressure). In patients who had normal potassium levels before taking Maxzide, hyperkalemia developed at a rate of 0.59 percent in nondiabetics and 1.08 percent in diabetics. Hyperkalemia was three to five times more likely to occur in patients over 60 years of age; all of the diabetic patients with hyperkalemia were elderly. Severity of hyperkalemia was not influenced by diabetes. Hypokalemia (low potassium levels in the blood) occurred in five percent of the patients given Maxzide, but it was not influenced by age or diabetes. It is concluded that the frequency of hyperkalemia is not so great that such medications which interfere with excretion of potassium should routinely be avoided when their use might be beneficial. Kidney function and blood potassium levels should be assessed prior to treatment and repeated at regular intervals thereafter, especially in the elderly.

Diagnosis, Dosage and administration, Hydrochlorothiazide, Hyperkalemia, Triamterene

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The influence of age, sex, smoking, and diabetes on lower limb transcutaneous oxygen tension in patients with arterial occlusive disease

Article Abstract:

In some diseases and conditions, the blood circulation through the legs is diminished by blocked arteries, a condition known as arterial occlusive disease. A decreased blood supply to the legs can cause pain while walking or at rest. Blood circulation in the legs can be assessed by using the noninvasive technique of measuring the transcutaneous oxygen tension (TcPO2). TcPO2 is useful in determining a prognosis after diseased blood vessels in the legs have been surgically replaced or reopened. The influence of age, sex, smoking and diabetes on the TcPO2 was assessed in the legs in 129 patients. Blood pressure in the legs and clinical signs and symptoms of occlusive disease such as painful walking were also used to assess blood flow in the legs. Age, sex and smoking did not effect TcPO2 or the severity of the disease. Patients with diabetes had lower TcPO2, even when patients with similarly severe occlusive disease were compared. TcPO2 is a useful tool for assessing blood vessel blockage in diabetics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Prognosis, Blood vessels, Leg, Tobacco, Arterial occlusions, Arterial occlusive diseases, Extremities, Lower, Blood circulation disorders, Vascular diseases, Intermittent claudication

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