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At least 1,423 records · Page 79Linked to original sources
PubMed1985

Treatment strategies for patients with non-insulin-dependent diabetes mellitus.

Strategies for the treatment of patients with non-insulin-dependent diabetes mellitus are discussed. In order to achieve treatment goals, diet and exercise remain important components of an overall treatment program that may include sulfonylurea drugs, especially in cases where patients are of normal weight or only slightly obese, have had the disease less than five years, and are taking little or no insulin. Failure to control blood sugar levels with sulfonylurea drugs may lead to combining this therapy with insulin or administering insulin alone, regardless of patients' weights.

Arginine↗
PubMed1985

Effects of oral sulfonylureas on the spectrum of defects in non-insulin-dependent diabetes mellitus.

Blood glucose and plasma insulin responses to hypoglycemic agents in normal subjects and patients with non-insulin-dependent diabetes mellitus are presented. The responses of the normal subjects and the diabetic patients show differences in response to different hypoglycemic agents. Interim data from the United Kingdom's prospective study of non-insulin-dependent diabetes mellitus are presented. About half of the anticipated subjects (approximately 2,000) have been enrolled in that clinical trial as of December 1984. It is concluded that sulfonylurea drugs have a role in the treatment of non-insulin-dependent diabetes mellitus, but that each patient must be treated individually since the disease is heterogeneous. Furthermore, more studies than are now customary should be performed on each patient to determine which of several available agents is most appropriate.

Adult↗
PubMed1986

Selective osmoreceptor dysfunction presenting as intermittent hypernatremia following surgery for a pituitary chromophobe adenoma.

Intermittent hypernatremia following hypothalamic surgery or trauma is usually attributed to the triphasic dysfunction of vasopressin release (diabetes insipidus, inappropriate vasopressin release, and diabetes insipidus). A 39-year-old patient had hypodipsia and intermittent hypernatremia following hypothalamic surgery for a chromophobe adenoma. Mean arterial pressure fell by 25 percent during orthostasis testing and was associated with an increase in vasopressin levels from 1.3 microU/ml to 12 microU/ml. Plasma renin activity and aldosterone increased from 1.1 to 16 ng/ml per hour and from 6.7 to 39 ng/dl, respectively, and remained elevated for three and a half hours after tilt testing. Hypertonic saline infusion, on the other hand, increased serum osmolality from 290 to 304 mOsm/kg but did not result in a significant rise in vasopressin levels (all were less than 1 microU/ml). These results are consistent with a selective dysfunction of the osmoreceptor pathways of vasopressin release and intact volume receptor-mediated pathways. Patients with intermittent hypernatremia following hypothalamic surgery or trauma should be questioned specifically regarding thirst. If it is impaired or absent, these patients should be watched carefully, not only for the development of triphasic dysfunction of vasopressin release, but also for a selective osmoreceptor dysfunction associated with thirst deficits as found in patients with "essential hypernatremia."

Adult↗
PubMed1986

Diabetes insipidus in a quadriplegic patient.

An incomplete quadriplegic patient underwent investigation for production of copious amounts of dilute urine. Serum osmolality, electrolytes, BUN, glucose, and serum antidiuretic hormone (ADH) were recorded, as well as urinary osmolality, electrolytes, glucose, and pH. In response to subcutaneous vasopressin during the dehydration test, the patient's urinary osmolality increased by 12%, from 620 mOsm/l to 695 mOsm/l. A definitive diagnosis of partial central diabetes insipidus was made. Physicians involved in the care of patients with spinal cord injuries should be aware of the method of evaluating polyuric conditions, particularly while the patient is undergoing catheterization.

Adult↗