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Biomedical subjects

C H Walsh

Publications and source records attributed to C H Walsh.

At least 37 records · Page 2Linked to original sources
PubMed1978

Diabetes mellitus and coeliac disease: a clinical study.

Fourteen adults in whom diabetes mellitus and coeliac disease coexist, are described. In no patient was coeliac disease diagnosed (biopsy proven) before the age of 28 years. Diabetes was recognized before coeliac disease in all except one. Diabetic control was very unstable and hypoglycaemia particularly troublesome before treatment with a gluten free diet. Following gluten restriction, insulin requirement increased in six patients, and diabetic control became more stable. Diarrhoea due to coeliac disease in a patient with coexisting diabetes, may be mistakenly diagnosed as 'diabetic diarrhoea'. However, certain clinical and laboratory features should arouse suspicion that the diarrhoea is not of diabetic origin. These included a history of gastrointestinal symptoms preceding the diagnosis of diabetes, the occurrence of repeated hypoglycaemia, absence of neuropathy, anaemia, low serum folate, low serum albumin and a malabsorption pattern on small bowel radiography. A definitive diagnosis of coeliac disease can be made only jejunal biopsy. The opportunity to diagnose coeliac disease in adult diabetics will usually fall to the diabetologist and wider use of jejunal biopsy in diabetics with chronic or recurrent diarrhoea is suggested.

Adult↗
PubMed1977

Menstruation and control of diabetes.

Seventy per cent of the patients aged 45 years or under and suffering from diabetic ketoacidosis who were seen in one diabetic clinic over five years were women. The association of menstruation with ketoacidosis was assessed over two and a half years, and it was found that menstruation was associated with ketoacidosis more often than would be expected by chance (P less than 0-01). Two hundred women were interviewed and 76 observed that menstruation changed their diabetic control. Fifty-three found that control deteriorated and hyperglycaemia occurred, while 23 found that control improved and hypoglycaemia was a common problem. Menstruation appears to be an important factor in influencing control of diabetes. The mechanism of the changes observed has not yet been determined, but it seems to be a subject worthy of further investigation.

Adolescent↗
PubMed1977

The effect of cigarette smoking on blood sugar, serum insulin and non esterified fatty acids in diabetic and non diabetic subjects.

The effect of cigarette smoking on carbohydrate metabolism has been investigated in 10 diabetic and 18 non-diabetic subjects. All were habitual smokers. Neither the fasting plasma sugar nor the plasma sugar response to an oral glucose load was significantly altered by smoking. Serum insulin, free fatty acids, cholesterol and triglyceride were measured in 10 non-diabetic patients, and were not significantly altered by smoking. It is concluded that in habitual smokers at least, cigarette smoking does not impair carbohydrate metabolism. In addition, it seems that smoking before or during oral glucose tolerance test is unlikely to influence the diagnostic value of the test.

Adult↗
PubMed1976

A study of pituitary function in patients with idiopathic hemochromatosis.

Pituitary function was assessed in twelve male patients with idiopathic hemochromatosis. Though clinical features suggestive of hypogonadism were noted in nine cases, impaired pituitary function was demonstrated in only two instances. Our findings suggest that factors other than pituitary or testicular failure contribute significantly to the occurrence of sexual hypofunction and other features suggestive of hypogonadism seen in many of these patients.

Aged↗
PubMed1976

Congenital malformations in infants of diabetic mothers.

In a series of 701 infants born to diabetic women between 1950 and 1974 ,57(8-1 percent) had congential malformations which is a rate three to four timeshigher than in the normal populations of Birmingham.. In 26 cases(3-8 per cent) the malformations were fatal and accounted for 26 per cent of the perinatal mortality in the series. Central nervous system, cardiovascular and skeletal abnormalities were equally common and there was a high incidence of anencephalus, spina bifida, transposition of the great vessels and sacral dysgenesis...

Abnormalities, Drug-Induced↗
PubMed1976

Studies in whole body potassium and whole body nitrogen in newly diagnosed diabetics.

Serial measurements of whole body potassium and whole body nitrogen were carried out in 18 newly diagnosed diabetcs. Initial measurements were made before treatment of diabetes was commenced, and further measurements were carried out following the start of treatment. Six patients required insulin and the remainder were treated either with diet alone (four cases) or with diet and oral hypoglycaemic agents. Significant increases in whole body potassium and whole body nitrogen were noted following control of diabetes.Thesees. These changes were most marked in the patients treated with insulin. The techniques used for measurement of body potassium and nitrogen offer considerable advantages over conventional metabolic balance studies and the results indicate that the losses of potassium and nitrogen during period of poor diabetic control are much greater than that has been realized.

Adolescent↗
PubMed1976

The management of diabetes in the elderly.

It appears inevitable that with increased longevity, the management of the elderly diabetic will place even greater demands on hospital services. It seems reasonable to adopt a more liberal attitude to the regulation of control of diabetes in the elderly than in younger patients. However, the view that diabetes in the elderly is always mild can be dangerously misleading. A significant number of elderly diabetics develop ketoacidosis or other serious forms of metabolic disturbance, and in these patients the mortality is high. Cardiovascular disease and peripheral vascular disease are major problems in the elderly, the former being the main cause of death. For best results, it is desirable that management of diabetes not be isolated from management of other, coexisting disorders, but rather that it be considered as part of the overall patient problem. As Malins pointed out, we should think in terms of diabetics rather than diabetes.

Aged↗
PubMed1975

Association of foot lesions with retinopathy in patients with newly diagnosed diabetes.

A proportion of newly diagnosed diabetic patients have features so characteristic that they form a distinct syndrome. The patients are predominantly male and present with a foot lesion which is often long established. They are subsequently found to have diabetes mellitus and diabetic retinopathy. In addition, many of them manifest a striking indifference towards their illness. 47 such patients have been seen between the years 1960-1969 at a diabetic clinic in Birmingham which saw a total of 6451 newly diagnosed patients in the same period. 26 of the 45 patients in whom follow-up was complete have died. The present state of health of the 19 surviving patients indicated that the prognosis is poor for patients who have retinopathy and foot lesions when diabetes is diagnosed.

Adult↗
PubMed1975

Hypoglycaemia associated with an intrathoracic fibrosarcoma.

A patient with an intrathoracic fibrosarcoma in whom disabling hypoglycaemic episodes occurred is reported. No further hypoglycaemic episodes occurred following removal of the tumour. The mechanism of the hypoglycaemia associated with non-pancreatic tumours is discussed. It seems that inadequate hepatic glucose output was an important factor in contributing to the hypoglycaemia in this patient.

Aged↗
PubMed1974

Studies on whole-body potassium in non-ketoacidotic diabetics before and after treatment.

Serial measurements of whole-body potassium were carried out in 28 diabetic patients, in 23 of whom diabetes had only recently been diagnosed. Eleven patients were treated with insulin, 12 with oral hypoglycaemic agents, and the rest were already on oral hypoglycaemic agents and had developed poor diabetic control; four of these required insulin. Whole-body potassium was measured before treatment was begun (or altered) and again one and six weeks later. Whole-body potassium (ratio of observed to expected) was initially reduced in most of the patients requiring insulin. After control of diabetes whole-body potassium increased significantly in the three groups. The increase in whole-body potassium in the individual patients varied over a wide range, and in patients who were treated with insulin it was often of a similar magnitude to that observed in patients in diabetic ketoacidosis.

Adolescent↗