Question 1 of 10

    Diabetes Mellitus (DM)

    Blue circle for diabetes[1]

    Diabetes mellitus is a common metabolic disorder of multiple etiology, characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism due to defects in insulin secretion, insulin action, or both. There are four main types of diabetes mellitus: type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes and other specific types (genetic syndromes, pancreatitis, cystic fibrosis, exposure to certain drugs, etc.).

    The disease is caused by this process: metabolic.

    Presentation

    Patients with type 1 diabetes mellitus usually present with classic acute symptoms of hyperglycemia. These include:

    • Polyuria (due to osmotic diuresis when blood glucose level exceeds renal threshold)
    • Thirst (as a consequence of loss of fluids and electrolytes by osmotic diuresis)
    • Postural hypotension (due to reduction of plasma volume by osmotic diuresis)
    • Loss of weight (due to depletion of glycogen stores by glycogenolysis and triglyceride stores by lipolysis; and the reduction of muscle mass as a consequence of the diversion of amino acids for gluconeogenesis)
    • Blurring of vision (because of the exposure of the lens and retina to hyperosmolar fluids)

    Around 25% of the cases of diabetes mellitus present with the acute complication of ketoacidosis.

    In contrast, most of the patients of type 2 diabetes mellitus do not have acute symptoms. The disease may be present for an average of 4 to 7 years before it is detected. The patients have a history of increased urination and thirst but most are asymptomatic initially. The presenting complaints of the patients include lack of energy, delayed wound healing, visual blurring and fungal infections such as pruritis vulvae or balanitis [5].

    In addition, the following complications may be the initial presenting feature in chronically undetected cases.

    Skin
    Flushing
    • The body tries to rid the blood of excess glucose by flushing it out of the system with increased urination.[labtestsonline.org]
    • Abdominal pains or cramps, sometimes acute Nausea and vomiting Nausea and vomiting Central nervous system Headache Confusion, delirium, or seizures Double or blurred vision Irritability Cardiovascular Tachycardia Variable Orthostatic hypotension Skin Flushed[medical-dictionary.thefreedictionary.com]
    Furunculosis
    • […] gland. 1555-65; New Latin, Latin Greek, equivalent to diabē- (variant stem of diabaínein to go through, pass over, equivalent to dia- dia- baínein to pass) -tēs agent suffix Examples from the Web for diabetes mellitus Historical Examples Persistent furunculosis[dictionary.com]
    Pruritus
    • This risk is likely outweighed by the benefits of reducing cardiovascular risk. [ 7 ] Presentation Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections[patient.info]
    Delayed Wound Healing
  • more...
  • urogenital
    Polyuria
    • This is because both disorders cause polyuria , or excessive urine output.[courses.washington.edu]
    • Therefore, patients with moderate or severe hyperglycemia typically have polyuria and polydipsia (excessive thirst).[britannica.com]
    • Generally, Type 1 diabetes presents with increased thirst (polydipsia), frequent urination (polyuria), and increased hunger (polyphagia).[aapos.org]
    • Symptoms of diabetes The main symptoms of diabetes are three – polydipsia, polyphagia and polyuria.[news-medical.net]
    • Diagnosing canine diabetes Diabetes mellitus is not the only cause of polyuria/polydipsia and weight loss.[vetsulin.com]
    Pruritus Vulvae
    • This risk is likely outweighed by the benefits of reducing cardiovascular risk. [ 7 ] Presentation Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections[patient.info]
  • more...
  • Eyes
    Background Retinopathy
    • Follow-up eye examinations should be performed annually in patients with no or minimal background retinopathy.[clevelandclinicmeded.com]
  • more...
  • cardiovascular
  • more...
  • musculoskeletal
    Prayer Sign
    • Consider screening with “prayer sign” (unable to approximate fingers and palms while pressing hands together).[openanesthesia.org]
  • more...
  • gastrointestinal
    Increased Appetite
    • This breakdown results in weight loss, despite increased appetite.[vet.cornell.edu]
    • Amidst the increased appetite and craving for food, persons with DM (usually Type 1) may still experience weight loss because of the improper fat metabolism and breakdown of fat stores.[physio-pedia.com]
    • The four main symptoms of diabetes mellitus are increased thirst, increased urination, weight loss, and increased appetite.[vcahospitals.com]
    • What to Watch For Increased water consumption Increased urination, possibly urinating outside the litterbox Increased appetite (early stages) or loss of appetite (late stages) Weight loss Lethargy Vomiting Sometimes the cat will develop a plantigrade[petmd.com]
    Abdominal Pain
    • Patients diagnosed with DKA develop very high blood sugar levels, abdominal pain, fruity-smelling breath, dehydration, severe weakness, lethargy, and coma.[innerbody.com]
    • Presents as dehydration, hypotension, n/v, abdominal pain, altered mental status.[openanesthesia.org]
    • pain, rapid deep breathing, loss of appetite, reddened and warm skin, headache, drowsiness, fruity-smelling breath, restlessness and ketones in our urine.[nhforsythendocrineconsultants.org]
    • During Diabetic Ketoacidocis (DKA) the patient might experience abdominal pain, anorexia, nausea, vomitting or diarrhea.[physio-pedia.com]
    • Symptoms include abdominal pain , vomiting, rapid breathing, extreme lethargy, and drowsiness.[medical-dictionary.thefreedictionary.com]
    Diarrhea
    • Additional signs of illness (vomiting, diarrhea, or decreased appetite) may be seen in diabetic animals that are left untreated or in those that develop concurrent illness that complicates the control of their disease.[vetspecialists.com]
    • Contact your doctor immediately if you develop vomiting or diarrhea and are not able to drink enough fluids.[drugs.com]
    • During Diabetic Ketoacidocis (DKA) the patient might experience abdominal pain, anorexia, nausea, vomitting or diarrhea.[physio-pedia.com]
    • Galen named the disease "diarrhea of the urine" (diarrhea urinosa). [99] The earliest surviving work with a detailed reference to diabetes is that of Aretaeus of Cappadocia (2nd or early 3rd century CE).[en.wikipedia.org]
    • Diabetic neuropathy can also affect nerves to the stomach and intestines , causing nausea, weight loss, diarrhea , and other symptoms of gastroparesis (delayed emptying of food contents from the stomach into the intestines, due to ineffective contraction[medicinenet.com]
    Constipation
    • Clinical features of type I diabetes Some of the symptoms include weight loss, polyurea, polydipsia, polyphagia, constipation fatigue, cramps, blurred vision, and candidiasis [ 21 ].[omicsonline.org]
    • These include impotence, orthostatic hypotension, delayed gastric emptying, diarrhea or constipation, and asymptomatic retention of urine in the bladder.[medical-dictionary.thefreedictionary.com]
    Delayed Gastric Emptying
    • When given parenterally, it appears to decrease the glucagon level and delay gastric emptying, thereby facilitating insulin action ( 119 , 120 ).[academic.oup.com]
    • These include impotence, orthostatic hypotension, delayed gastric emptying, diarrhea or constipation, and asymptomatic retention of urine in the bladder.[medical-dictionary.thefreedictionary.com]
  • more...
  • respiratoric
  • more...
  • neurologic
    Stroke
    • Even more serious is the increased risk of heart disease and stroke .[webmd.com]
    • Heart attack, stroke and kidney disease can result in premature death.[drugs.com]
    • It is also associated with increased risk of strokes, heart attacks and poor blood circulation to the legs.[yourhormones.info]
    • […] levels are not controlled, the risk of stroke increases significantly Erectile dysfunction - male impotence.[medicalnewstoday.com]
    • Prediabetes also increases the risk of heart disease and stroke.[stanfordchildrens.org]
    Peripheral Neuropathy
    • Figure 11 Bilateral painless ulcers in a patient with diabetic peripheral neuropathy.[bjsm.bmj.com]
    • The most common type is peripheral neuropathy.[drugs.com]
    • Authors reported: "This small, short-term, placebo-controlled trial of inhaled cannabis demonstrated a dose-dependent reduction in diabetic peripheral neuropathy pain in patients with treatment-refractory pain. ...[norml.org]
    • In sub-Saharan Africa, peripheral neuropathy is the principal underlying risk factor in the pathogenesis of foot ulcers in people with diabetes [ 49 ].[intechopen.com]
  • more...
  • Entire body system
    Weight Loss
    • This breakdown results in weight loss, despite increased appetite.[vet.cornell.edu]
    • With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes.[stanfordchildrens.org]
    • Remember, 'little and often' is generally more beneficial for weight loss.  [icatcare.org]
    • This causes weight loss.[nationwidechildrens.org]
    • This causes glucose levels in the blood to rise, leading to symptoms such as increased urination, extreme thirst, and unexplained weight loss.[kidshealth.org]
    Fatigue
    • The signs and symptoms of both types of diabetes include increased urine output and decreased appetite as well as fatigue .[medicinenet.com]
    • Symptoms and Complications People with type 1 DM usually experience a sudden onset of symptoms including: Frequent urination Extreme thirst Weight loss Abnormal hunger Fatigue Blurred vision.[innerbody.com]
    • Some untreated diabetes patients also complain of fatigue.[medicinenet.com]
    • Fatigue with weakness, irritability, blurred vision, numbness or tingling sensations in the hands and feet are also present.[physio-pedia.com]
    • The most common diabetes symptoms include frequent urination , intense thirst and hunger, weight gain, unusual weight loss, fatigue , cuts and bruises that do not heal, male sexual dysfunction , numbness and tingling in hands and feet.[medicalnewstoday.com]
    Coronary Artery Disease
    • artery disease and peripheral vascular disease. diabetes mellitus in Culture diabetes mellitus [(deye-uh- bee -teez, deye-uh- bee -tuhs mel -uh-tuhs)] A chronic disease in which carbohydrates cannot be metabolized properly ( see metabolism ) because[dictionary.com]
    • Screening for coronary artery disease in patients with diabetes.[clevelandclinicmeded.com]
    • Silent myocardial ischemia in diabetic and nondiabetic patients with coronary artery disease.[emedicine.medscape.com]
    • Ann Intern Med 2010 153 194 9 Hong J Zhang Y Lai S Lv A Su Q Dong Y et al SPREAD-DIMCAD Investigators Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease.[annals.org]
    • Diabetes Care . 20 : 614 – 620 . 9 Eisenberg DA. 1998 Cholesterol lowering in the management of coronary artery disease: the clinical implications of recent trials.[academic.oup.com]
    Abdominal Obesity
    • Your doctor will examine you to look for: Obesity, especially abdominal obesity—a condition that greatly raises a person's risk for type 2 diabetes.[drugs.com]
    • People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk.[medicalnewstoday.com]
    • The increase in diabetes mellitus in Africa has been attributable in part to urbanization, urban residence, acculturation, abdominal obesity, globalization, westernization, sedentary lifestyle, behavioural habits, systemic arterial hypertension, physical[intechopen.com]
    • Med Clin North Am . 73 : 111 – 138 . 46 Bjorntop P. 1988 Abdominal obesity and the development of non-insulin dependent diabetes mellitus.[academic.oup.com]
    Family History of Diabetes Mellitus
    Enuresis
    • Early Signs of Type 1 DM Are (Picture 2): Weight loss or poor weight gain, even if eating large amounts of food More thirst than usual Enuresis (bedwetting) Frequent urination More urine than usual Feeling tired all the time Later Signs of Diabetes Are[nationwidechildrens.org]
  • more...
  • Liver, Gall & Pancreas
    Hepatomegaly
    • Some additional signs may also be seen including: Enlargement of the liver (hepatomegaly) - which may be evident on examination by your vet Poor coat Weakness, especially of the back legs caused by diabetes damaging the nerves (diabetic neuropathy) -[icatcare.org]
  • more...
  • Jaw & Teeth
  • more...
  • Workup

    The following investigations are helpful in establishing the diagnosis of diabetes mellitus.

    • Random blood sugar: Diabetes is labelled if the random blood sugar is found to be greater than 200 mg/dL. It is not sufficient for diagnosing diabetes and fasting blood sugar should always be checked subsequently.
    • Fasting blood sugar: Diabetes is confirmed if the fasting blood sugar is more than 126 mg/dL on more than one occasion.
    • Glucose tolerance test: Glucose tolerance test is required for the confirmation of diabetes when the fasting blood sugar is more than normal but less than the diabetic range.
    • Glycosylated hemoglobin: Level of glycosylated hemoglobin reflects the state of glycemia over the preceding 8 to 12 weeks.
    • Serum fructosamine: Serum fructosamine reflects the state of glycemic control for the preceding 2 weeks.

    Laboratory

    Cerebrospinal Fluid
  • more...
  • Urine
    Glycosuria
    • When it is not possible to perform a complete glucose curve, punctual blood samples combined with clinical signs, general observations, and evaluating glycosuria can provide an overview of the diabetic animal.[vetsulin.com]
    • Subsequently, hyperglycemia and glycosuria, but not ketonuria, occured.[pediatrics.aappublications.org]
    • As a rule, however, persistent glycosuria is diagnostic of diabetes mellitus , of which disease it is the essential symptom.[dictionary.com]
    • Characteristically the course is progressive and includes polyuria, polydipsia, weight loss, polyphagia, hyperglycemia, and glycosuria.[medical-dictionary.thefreedictionary.com]
    • Although the presence of hyperglycaemia (a high blood glucose) and glycosuria (glucose in the urine) are typical findings for diabetes, these changes can also occur in some cats simply as a result of stress.[icatcare.org]
    Ketonuria
    • Subsequently, hyperglycemia and glycosuria, but not ketonuria, occured.[pediatrics.aappublications.org]
    • Dogs that, after initial presentation with DKA and its successful treatment, are generally stable and without ketonuria.[vetsulin.com]
    • Patients with type 1 diabetes may also present with weight loss, dehydration, ketonuria and hyperventilation.[patient.info]
    • Characterized by hyperglycemia, glycosuria, polyuria, hyperlipemia (caused by imperfect catabolism of fats), acidosis, ketonuria, and a lowered resistance to infection.[medical-dictionary.thefreedictionary.com]
  • more...
  • Serum
    Ketonuria
    • Subsequently, hyperglycemia and glycosuria, but not ketonuria, occured.[pediatrics.aappublications.org]
    • Dogs that, after initial presentation with DKA and its successful treatment, are generally stable and without ketonuria.[vetsulin.com]
    • Patients with type 1 diabetes may also present with weight loss, dehydration, ketonuria and hyperventilation.[patient.info]
    • Characterized by hyperglycemia, glycosuria, polyuria, hyperlipemia (caused by imperfect catabolism of fats), acidosis, ketonuria, and a lowered resistance to infection.[medical-dictionary.thefreedictionary.com]
    Glucose Increased
    • The result of both of these types are the same; the blood glucose increases to a dangerous level.[wagwalking.com]
    • Regular exercise lowers blood glucose, increases the body's sensitivity to insulin, and increases circulation.[labtestsonline.org]
    Hypertriglyceridemia
    • Hemolytic anemias Patients receiving antiretroviral treatment for human immunodeficiency virus Pregnancy Vitamins E and C Lower or elevate A1C Hemoglobinopathies or hemoglobin variants Malnutrition Falsely elevate A1C Aplastic anemias Hyperbilirubinemia Hypertriglyceridemia[aafp.org]
    Nodular Glomerulosclerosis
    Insulin Increased
    • Compared to those without diabetes, those with the disease have a 1.2 to 1.5-fold greater rate of decline in cognitive function. [29] Being diabetic, especially when on insulin, increases the risk of falls in older people. [30] Causes Comparison of type[en.wikipedia.org]
  • more...
  • HLA Type
    HLA-DR3
    • Associated with HLA DR3 and DR4 and islet cell antibodies around the time of diagnosis.[patient.info]
    • Approximately 95% of patients with type 1 DM have either HLA-DR3 or HLA-DR4.[emedicine.medscape.com]
    HLA-DR4
  • more...
  • Imaging

    X-ray
  • more...
  • Treatment

    The treatment methods available for diabetes mellitus include:

    • Diet alone
    • Diet and insulin
    • Diet and oral hypoglycemic drugs

    Diet

    Around 60% of the patients can be treated adequately with diet alone. A proper diet regimen should be prepared based upon the age, sex, weight and caloric requirements of the patient. Readily absorbable carbohydrates such as sugars should be avoided. Non-nutritive sweeteners such as asparmate, saccharine or sucramate should be used if needed.

    Oral hypoglycemic drugs

    Oral hypoglycemic agents are useful for the treatment of type 2 diabetes mellitus. A wide number of oral hypoglycemic agents are available. They are prescribed individually or in combinations according to the patient. Common oral hypoglycemic agents include sulphonylureas (e.g. glimepride and glipizide), biguanides (e.g. metformin), alpha glucosidase inhibitors (e.g. acarbose and migitol), thiazolidinedions (e.g. pioglitazone and rosiglitazone), D-phenylalanine derivatives (e.g. nateglinide) and insulin stimulators (e.g. repaglinide) [7][8].

    Insulin

    Insulin is used in the treatment of all patients of type 1 diabetes mellitus and in those patients of type 2 diabetes whose hyperglycemia is not controlled by diet and oral hypoglycemic agents. Various preparations of insulin are available and are selected according to each patient.

    Prognosis

    Diabetes mellitus is a chronic disease that disturbs the quality of life of all the patients [4]. The patients are forced to take daily insulin injections and/or oral hypoglycemic drugs. Lifestyle and diet modifications also become essential. However, with early diagnosis and proper control of the disease, the risk of development of associated diseases and complications can be reduced and the patients enjoy a life expectancy that approaches those without the disease. Untreated diabetes mellitus is associated with a high mortality and morbidity rate.

    Complications

    Constipation
    • Clinical features of type I diabetes Some of the symptoms include weight loss, polyurea, polydipsia, polyphagia, constipation fatigue, cramps, blurred vision, and candidiasis [ 21 ].[omicsonline.org]
    • These include impotence, orthostatic hypotension, delayed gastric emptying, diarrhea or constipation, and asymptomatic retention of urine in the bladder.[medical-dictionary.thefreedictionary.com]
    Stroke
    • Even more serious is the increased risk of heart disease and stroke .[webmd.com]
    • Heart attack, stroke and kidney disease can result in premature death.[drugs.com]
    • It is also associated with increased risk of strokes, heart attacks and poor blood circulation to the legs.[yourhormones.info]
    • […] levels are not controlled, the risk of stroke increases significantly Erectile dysfunction - male impotence.[medicalnewstoday.com]
    • Prediabetes also increases the risk of heart disease and stroke.[stanfordchildrens.org]
    Proteinuria
    • GI : gastroparesis in 25% of diabetics Renal : microalbuminuria- proteinuria- renal failure (delayed with ACE inhibitors or ARBs as well as BP control).[openanesthesia.org]
    • Diabetic nephropathy is defined as persistent proteinuria.[clevelandclinicmeded.com]
    • The risk of cardiovascular disease mortality associated with microalbuminuria and gross proteinuria in persons with older-onset diabetes mellitus .[nature.com]
    • […] may predict all causes of mortality but not development of microvascular complications. [14] Nephropathy In the kidneys, the characteristic wall thickening of small arterioles and capillaries leads to diabetic nephropathy, which is characterized by proteinuria[emedicine.medscape.com]
    • Chronic complications of hyperglycemia include retinopathy and blindness, peripheral and autonomic neuropathies, glomerulosclerosis of the kidneys (with proteinuria, nephrotic syndrome, or end-stage renal failure), coronary and peripheral vascular disease[medical-dictionary.thefreedictionary.com]
    Coma
    • Hyperglycemic hyperosmolar nonketotic syndrome is characterized by extremely high blood sugar levels, dehydration, fever, confusion, and coma.[innerbody.com]
    • This condition can worsen and lead to coma (hyperosmolar coma).[medicinenet.com]
    • Other nontoxic goiter E05 Thyrotoxicosis [hyperthyroidism] E06 Thyroiditis E07 Other disorders of thyroid ICD10Data.com E15-E16 ICD-10-CM Range E15-E16 Other disorders of glucose regulation and pancreatic internal secretion E15 Nondiabetic hypoglycemic coma[icd10data.com]
    • Patients with hyperglycemic coma should be treated aggressively with intravenous fluids and insulin.[britannica.com]
    • Patient will have confusion and dull mental state which can lead to coma.[physio-pedia.com]
    Impetigo
    • Several skin disorders are more common in diabetic patients, particularly those due to infection such as candida and impetigo.[dermnetnz.org]
    Dehydration
    • Caused by severe osmotic diuresis and subsequent dehydration/prerenal failure.[openanesthesia.org]
    • As glucose is lost in the urine it draws fluid and other small molecules with it, causing excessive urination, which in turn causes dehydration and thirst.[diapedia.org]
    • Hyperglycemic hyperosmolar nonketotic syndrome is characterized by extremely high blood sugar levels, dehydration, fever, confusion, and coma.[innerbody.com]
    • It usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance, and insulin deficiency.[ssa.gov]
    • The dehydration also causes increased thirst and water consumption.[medicinenet.com]
    Skin Infection
    • Foot complications - neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated Skin complications - people with diabetes are more susceptible to skin infections and skin disorders Heart problems - such as ischemic heart disease[medicalnewstoday.com]
    • Untreated diabetic pets are more likely to develop infections and commonly get bladder, kidney, or skin infections.[vetmed.wsu.edu]
    Loss of Vision
    • Diabetes mellitus is associated with damage to the small blood vessels in the retina, resulting in loss of vision.[who.int]
    • Early retinopathy may have no symptoms, but early treatment is essential to prevent any loss of vision.[aapos.org]
    • Chronic high blood glucose can cause long-term damage to blood vessels, nerves, and organs throughout the body and can lead to other conditions such as kidney disease , loss of vision, strokes , cardiovascular disease , and circulatory problems in the[labtestsonline.org]
    Hyperglycemia
    • Other patients present with symptoms of hyperglycemia that have been present for months or with the sudden onset of symptoms of very severe hyperglycemia and vascular collapse.[britannica.com]
    • High Blood Sugar see Hyperglycemia How to Prevent Diabetes Hyperglycemia Hypoglycemic Medicines see Diabetes Medicines Insulin see Diabetes Medicines Insulin Resistance see Metabolic Syndrome ; Prediabetes Insulin-Dependent Diabetes Mellitus see Diabetes[medlineplus.gov]
    • Diabetics are more prone to hypoglycemia than hyperglycemia during exercise.[physio-pedia.com]
    Erectile Dysfunction
    • dysfunction - male impotence.[medicalnewstoday.com]
    • Erectile dysfunction can also be caused by poor blood flow to the penis from diabetic blood vessel disease.[medicinenet.com]
    • They may also have autonomic neuropathy, which may result in postural hypotension (fainting upon sitting up or standing), gastric retention, erectile dysfunction , or urinary bladder dysfunction.[britannica.com]
    • dysfunction in men Absence of menstruation in women Rapid breathing (acute) Decreased consciousness, coma (acute) Symptoms of impending hypoglycemia: Temporary hypoglycemia in the diabetic may be caused by the accidental injection of too much insulin[labtestsonline.org]
    • Miocrovascular complications are diabetic eye diseases (retinopathy and cataracts), renal disease, erectile dysfunction, and peripheral neuropathy [ 68 ].[intechopen.com]
    Hyperkalemia
    Furunculosis
    • […] gland. 1555-65; New Latin, Latin Greek, equivalent to diabē- (variant stem of diabaínein to go through, pass over, equivalent to dia- dia- baínein to pass) -tēs agent suffix Examples from the Web for diabetes mellitus Historical Examples Persistent furunculosis[dictionary.com]
    Peripheral Neuropathy
    • Figure 11 Bilateral painless ulcers in a patient with diabetic peripheral neuropathy.[bjsm.bmj.com]
    • The most common type is peripheral neuropathy.[drugs.com]
    • Authors reported: "This small, short-term, placebo-controlled trial of inhaled cannabis demonstrated a dose-dependent reduction in diabetic peripheral neuropathy pain in patients with treatment-refractory pain. ...[norml.org]
    • In sub-Saharan Africa, peripheral neuropathy is the principal underlying risk factor in the pathogenesis of foot ulcers in people with diabetes [ 49 ].[intechopen.com]
    Carpal Tunnel Syndrome
    • Carpal tunnel syndrome in Rochester, Minnesota, 1961 to 1980.[bjsm.bmj.com]
    Osteoarthritis
    • Obesity increases the risk of developing not only type 2 diabetes, cardiovascular disease, stroke, osteoarthritis and some forms of cancer [ 27 ].[intechopen.com]
    Hypertriglyceridemia
    • Hemolytic anemias Patients receiving antiretroviral treatment for human immunodeficiency virus Pregnancy Vitamins E and C Lower or elevate A1C Hemoglobinopathies or hemoglobin variants Malnutrition Falsely elevate A1C Aplastic anemias Hyperbilirubinemia Hypertriglyceridemia[aafp.org]
    Cardiomyopathy
    • Cannabidiol attenuates cardiac dysfunction, oxidative stress, fibrosis, and inflammatory and cell death signaling pathways in diabetic cardiomyopathy .[norml.org]
    • […] diabetes mellitus risk factors cardiovascular diseases Abundant evidence shows that patients with type 1 diabetes or type 2 diabetes are at high risk for several cardiovascular disorders: coronary heart disease, stroke, peripheral arterial disease, cardiomyopathy[circ.ahajournals.org]
    • Diabetic cardiomyopathy: pathophysiology and clinical features .[nature.com]
    Acute Pyelonephritis
    Obesity
    • Obesity 23: 290-295. [17] Beulaygue and French. 2016.[norml.org]
    • Diabetes and obesity in pregnancy.[journals.plos.org]
    • Third, type 2 diabetes occurs at an earlier age in obese and overweight persons, and the prevalence of obesity is rising in the United States.[circ.ahajournals.org]
    • Endocr Rev . 13 : 415 – 431 . 44 , Lithell H. 1991 Different etiologies of type 2 (non-insulin dependent) diabetes mellitus in obese and non obese subjects.[academic.oup.com]
    • Obese people have insulin resistance .[webmd.com]
    Cataract
    • Cataract is a common cause of visual impairment in patients with diabetes.[aao.org]
    • Cataracts are more common in diabetics.[library.med.utah.edu]
    • However, most dogs with diabetes will develop cataracts within a year of diagnosis that progress to blindness; this condition will develop even with appropriate treatment.[vetspecialists.com]
    • Annual dilated eye examinations are recommended. 3.Cataract - Occurs at a younger age in diabetic patients 4.Glaucoma- More likely to develop in diabetics than in the general population.[aapos.org]
    • These cases are not emergencies, although dogs without cataracts should be treated diligently to try to avoid this complication.[vetsulin.com]
    Pneumococcal Pneumonia
    Glaucoma
    • Glaucoma with excavation of the optic cup, microscopic.[library.med.utah.edu]
    • Annual dilated eye examinations are recommended. 3.Cataract - Occurs at a younger age in diabetic patients 4.Glaucoma- More likely to develop in diabetics than in the general population.[aapos.org]
    • Loss of vision due to certain types of glaucoma and cataract may also be more common in people with diabetes than in those without the disease.[who.int]
    • Other common problems in people with diabetes include blurred vision, cataracts and glaucoma.[nhforsythendocrineconsultants.org]
    • Complications linked to badly controlled diabetes: Below is a list of possible complications that can be caused by badly controlled diabetes: Eye complications - glaucoma , cataracts, diabetic retinopathy, and some others.[medicalnewstoday.com]
    Retinopathy
    • Retinopathy is divided into two main categories: Nonproliferative retinopathy and proliferative retinopathy.[clevelandclinicmeded.com]
    • Diabetic retinopathy on funduscopic examination.[library.med.utah.edu]
    • All patients with diabetes are at risk for developing retinopathy.[aapos.org]
    • […] factor for sight-threatening diabetic retinopathy (DR); antihypertensive treatment is linked with proliferative DR and statins with maculopathy.[medscape.org]
    • Good metabolic control can delay the onset and progression of diabetic retinopathy.[who.int]
    Arteriosclerosis
    • Hyaline arteriosclerosis, a characteristic pattern of wall thickening of small arterioles and capillaries, is widespread and is responsible for ischemic changes in the kidney, retina, brain, and peripheral nerves.[emedicine.medscape.com]
    Acute Myocardial Infarction
    • myocardial infarction (OR 0.62, 95% CI 0.49 to 0.79, p 0.01).[acc.org]
    • Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study.[emedicine.medscape.com]
    Hyperlipidemia
    • Consequently, the treatment of confounding risk factors of obesity, hypertension, and hyperlipidemia assumes major importance and must be coordinated with good glycemic control for reduction in total mortality in type 2 diabetes mellitus ( 6 – 11 ).[academic.oup.com]
    • Vascular complications are aggravated by hypertension and hyperlipidemia (high serum levels of lipids ), both of which are common in patients with diabetes.[britannica.com]
    • In addition, hypertension and dyslipidemia (high triglyceride and low HDL-cholesterol levels; postprandial hyperlipidemia) often are present in these individuals.[omicsonline.org]
    • […] ideal [50th percentile] for height) and who have any two of the following risk factors: history of type 2 diabetes in a first- or second-degree relative, belonging to a high-risk ethnic group ( Table 1 8 , 16 – 20 ) , acanthosis nigricans, hypertension, hyperlipidemia[aafp.org]
    • Risk Factor Goal of Therapy Hyperlipidemia LDL cholesterol, pts with CVD DM LDL LDL cholesterol level elevated LDL Triglyceride level 200-499 mg/dL Non-HDL cholesterol level HDL cholesterol level Raise HDL (no specific goal) Hypertension BP Prothrombotic[clevelandclinicmeded.com]
    Fatty Liver
    • Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: A cross-sectional study .[norml.org]
    • […] for hypertension) Impaired glucose tolerance, impaired fasting glucose, and/or metabolic syndrome Member of an at-risk racial or ethnic group: Asian, black, Hispanic, Native American (Alaska Native or American Indian), or Pacific Islander Nonalcoholic fatty[aafp.org]
    • liver disease 3.6 Infections seen in patients with diabetes 3.7 Limited joint mobility 3.8 Edema Diagnosis of diabetes mellitus The identification of patients with diabetes or pre-diabetes by screening allows for earlier intervention, with potential[omicsonline.org]
    Tuberculosis
    • Burden of diabetes mellitus in developing countries Sub-Saharan Africa will face a double disease burden represented by increased rates of non-communicable diseases added to endemic, pandemic, and emergent infections such as malaria, tuberculosis, and[intechopen.com]
    • Diabetes, Glycemic Control, and Risk of Tuberculosis: A population-based case-control study.[emedicine.medscape.com]
    Dupuytren Contracture
    • Dupuytren’s contracture Dupuytren’s contracture is the palmar or digital thickening, tethering, or contracture of the hands (fig 3).[bjsm.bmj.com]
    • These patients may also suffer from Dupuytren's contracture (tendon tightening, which bends the fingers).[dermnetnz.org]
    Coronary Artery Disease
    • artery disease and peripheral vascular disease. diabetes mellitus in Culture diabetes mellitus [(deye-uh- bee -teez, deye-uh- bee -tuhs mel -uh-tuhs)] A chronic disease in which carbohydrates cannot be metabolized properly ( see metabolism ) because[dictionary.com]
    • Screening for coronary artery disease in patients with diabetes.[clevelandclinicmeded.com]
    • Silent myocardial ischemia in diabetic and nondiabetic patients with coronary artery disease.[emedicine.medscape.com]
    • Ann Intern Med 2010 153 194 9 Hong J Zhang Y Lai S Lv A Su Q Dong Y et al SPREAD-DIMCAD Investigators Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease.[annals.org]
    • Diabetes Care . 20 : 614 – 620 . 9 Eisenberg DA. 1998 Cholesterol lowering in the management of coronary artery disease: the clinical implications of recent trials.[academic.oup.com]
    Graves Disease
    • The prevalence of type 1 DM is increased in patients with other autoimmune diseases, such as Graves disease, Hashimoto thyroiditis, and Addison disease.[emedicine.medscape.com]
    Unstable Angina
    • Patients with diabetes-associated CVD can present with stable or unstable angina pectoris, MI, or dysrhythmias; however, many patients have unrecognizable symptoms.[clevelandclinicmeded.com]
    Autonomic Neuropathy
    • See Diabetic Neuropathy , Autonomic Neuropathy and Neuropathic Pain and its Management .[patient.info]
    • They may also have autonomic neuropathy, which may result in postural hypotension (fainting upon sitting up or standing), gastric retention, erectile dysfunction , or urinary bladder dysfunction.[britannica.com]
    • Diabetic cardiovascular autonomic neuropathy.[emedicine.medscape.com]
    • Autonomic neuropathy is diagnosed in patients with gastroparesis or orthostatic hypotension.[clevelandclinicmeded.com]
    Mononeuritis Multiplex
    • Findings can be asymmetric (mononeuritis multiplex) or symmetric conforming to a distal-to-proximal gradient of involvement (most common).[clevelandclinicmeded.com]
    Transient Ischemic Attack
    • In fact, Diabetes irreversibly damages the large blood vessels, doubling the risk of cardiovascular disease in the form of ischemic heart disease (angina and myocardial infarctions), cerebrovascular disease (stroke and transient ischemic attacks) and[harringtonhospital.org]
    Polyhydramnios
    • Type 2 Diabetes Mellitus Fetal risks Macrosomia Hyperbilirubinemia Hypoglycemia Shoulder dystocia Brachial plexus injury Respiratory Distress Syndrome Congenital abnormalities Intrauterine growth retardation Spontaneous abortion and intrauterine death Polyhydramnios[clinicaladvisor.com]
    Pruritus Vulvae
    • This risk is likely outweighed by the benefits of reducing cardiovascular risk. [ 7 ] Presentation Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections[patient.info]
    Peripheral Vascular Disease
    • Peripheral vascular disease is a particular problem with diabetes mellitus and is made worse through the development of diabetic neuropathy, leading to propensity for injury.[library.med.utah.edu]
    • vascular disease (atherosclerosis of the blood vessels of the extremities).[harringtonhospital.org]
    • Diabetes increases the risk of cardiovascular disease, stroke, and peripheral vascular disease.[aapos.org]
    • vascular disease. diabetes mellitus in Culture diabetes mellitus [(deye-uh- bee -teez, deye-uh- bee -tuhs mel -uh-tuhs)] A chronic disease in which carbohydrates cannot be metabolized properly ( see metabolism ) because the pancreas fails to secrete[dictionary.com]
    • Macrovascular complications such as stroke, heart disease, peripheral vascular disease and foot problems.[intechopen.com]
    Osteomyelitis
    • The joints most commonly affected are weight-bearing joints such as the foot, ankles, and knees; joints such as the hand and wrist are rarely affected. 35 Initial warmth and erythema mimic osteomyelitis or septic arthritis, but the absence of fever, elevated[bjsm.bmj.com]
    • Patients with DM often also sustain infected ulcerations of the feet, which may result in osteomyelitis and the need for amputation.[medical-dictionary.thefreedictionary.com]
    Celiac Disease
    • All children with T1DM should be monitored for symptoms and/or screened for commonly associated conditions such as thyroid and celiac disease.[pedsinreview.aappublications.org]
    • "The Role of Gluten in Celiac Disease and Type 1 Diabetes" .[en.wikipedia.org]
    • 2.1.2 Diabetic nephropathy 2.1.3 Diabetic neuropathy 2.2 Macrovascular disease 3- Other complications and associated conditions 3.1 Impaired growth and development 3.2 Associated autoimmune conditions 3.2.1 Hypothyroidism 3.2.2 Hyperthyroidism 3.2.3 Celiac[omicsonline.org]
    Diabetic Amyotrophy
    • Diabetic amyotrophy: current concepts.[bjsm.bmj.com]
    • A rare but severe form of diabetic neuropathy is diabetic amyotrophy, which begins with pain followed by severe weakness and spreads from unilateral to bilateral.[clevelandclinicmeded.com]
    Proliferative Retinopathy
    • Proliferative retinopathy is more ominous and is more likely to occur when diabetes mellitus is poorly controlled.[library.med.utah.edu]
    • Proliferative retinopathy can include new vessels in the eyes or vitreous hemorrhage.[clevelandclinicmeded.com]
    • The risk of ESRD and proliferative retinopathy is twice as high in men as in women when the onset of diabetes occurred before age 15 years. [43] Patients with type 1 DM who survive the period 10-20 years after disease onset without fulminant complications[emedicine.medscape.com]
    Diabetic Nephropathy
    • […] for Quality and Efficiency in Health Care (IQWiG) to assess urinary proteome analysis for detection of diabetic nephropathy (DN) in patients with diabetes mellitus and arterial hypertension.[ncbi.nlm.nih.gov]
    • Nephropathy see Diabetic Kidney Problems Diabetic Nerve Problems Diabetic Retinopathy see Diabetic Eye Problems Gestational Diabetes see Diabetes and Pregnancy Glucose see Blood Sugar Hemoglobin A1c see A1C High Blood Glucose see Hyperglycemia High Blood[medlineplus.gov]
    • Diabetic nephropathy is defined as persistent proteinuria.[clevelandclinicmeded.com]
    • Schwartz, M.D. 33 Diabetic Nephropathy and Treatment of Hypertension Allen I.[endotext.org]
    • Many of them stem from damage to the tiny blood vessels in your eyes (called diabetic retinopathy ), nerves ( diabetic neuropathy ), and kidneys (diabetic nephropathy).[webmd.com]
    Nodular Glomerulosclerosis
    Preeclampsia
    • *When excluding second pregnancies with gestational age below 37 weeks, multiple pregnancies, and pregnancies with hypertensive disorders in second pregnancy (hypertension during pregnancy, preeclampsia, eclampsia, and HELLP).[journals.plos.org]
    • Low-dose aspirin to prevent preeclampsia in women at high risk.[bmcmedicine.biomedcentral.com]
    • Women with gestational diabetes mellitus (GDM) who have fasting hyperglycemia have a three- to fourfold increased risk of infant malformations. 26 , 27 The goal of screening is to reduce maternal and fetal complications such as preeclampsia, cesarean[aafp.org]
    • One meta-analysis found a weak but significant linear increase in the risk of childhood type 1 DM with increasing maternal age. [35] However, little evidence supports any substantial increase in childhood type 1 DM risk after pregnancy complicated by preeclampsia[emedicine.medscape.com]
    Eclampsia
    • Soy protein-enriched versus no soy protein diet (one trial ): no clear differences seen for: pre-eclampsia ( RR 2.00, 95% CI 0.19 to 21.03; 68 women); or caesarean section ( RR 1.00, 95% CI 0.57 to 1.77; 68 women).[cochrane.org]
    • Researching new methods of screening for adverse pregnancy outcome: lessons from pre-eclampsia.[bmcmedicine.biomedcentral.com]
    • *When excluding second pregnancies with gestational age below 37 weeks, multiple pregnancies, and pregnancies with hypertensive disorders in second pregnancy (hypertension during pregnancy, preeclampsia, eclampsia, and HELLP).[journals.plos.org]
    • It can also cause complications such as high blood pressure and pre-eclampsia in the pregnant woman.[labtestsonline.org]
    • A meta-analysis of the association between pre-eclampsia and childhood-onset Type 1 diabetes mellitus.[emedicine.medscape.com]
    Delayed Gastric Emptying
    • When given parenterally, it appears to decrease the glucagon level and delay gastric emptying, thereby facilitating insulin action ( 119 , 120 ).[academic.oup.com]
    • These include impotence, orthostatic hypotension, delayed gastric emptying, diarrhea or constipation, and asymptomatic retention of urine in the bladder.[medical-dictionary.thefreedictionary.com]
    Spontaneous Abortion
    • abortion and intrauterine death Polyhydramnios Polycythemia Hypocalcemia Post-natal complications Childhood obesity Metabolic syndrome Diabetes mellitus type 2 Pathophysiology The fetus is dependent on maternal glucose for energy Glucose is transported[clinicaladvisor.com]
    Leg Ulcer

    Etiology

    Diabetes mellitus may be primary or secondary.
    Primary diabetes mellitus has two types [2].

    • Insulin dependent diabetes mellitus (Type 1)
    • Non-insulin dependent diabetes mellitus (Type 2)

    Type 1 diabetes mellitus usually results from an autoimmune disease process. It is associated with a positive family history. The child of a patient having type 1 diabetes has a greater risk of developing the disease. The risk is greater with diabetic father as compared to the diabetic mother. There is around 30 to 35% concordance in monozygotic twins. 95% of the patients carry HLA-DR3, HLD-DR4 or both genes. Infection with coxsackievirus B4

    Type 2 diabetes mellitus has a 100% concordance in identical twins, implying a much stronger genetic association. Around 25% of the patients have a first degree relative suffering from this disease. Overeating combined with obesity acts as a diabetogenic factor.

    Causes

    Constipation
    • Clinical features of type I diabetes Some of the symptoms include weight loss, polyurea, polydipsia, polyphagia, constipation fatigue, cramps, blurred vision, and candidiasis [ 21 ].[omicsonline.org]
    • These include impotence, orthostatic hypotension, delayed gastric emptying, diarrhea or constipation, and asymptomatic retention of urine in the bladder.[medical-dictionary.thefreedictionary.com]
    Dehydration
    • Caused by severe osmotic diuresis and subsequent dehydration/prerenal failure.[openanesthesia.org]
    • As glucose is lost in the urine it draws fluid and other small molecules with it, causing excessive urination, which in turn causes dehydration and thirst.[diapedia.org]
    • Hyperglycemic hyperosmolar nonketotic syndrome is characterized by extremely high blood sugar levels, dehydration, fever, confusion, and coma.[innerbody.com]
    • It usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance, and insulin deficiency.[ssa.gov]
    • The dehydration also causes increased thirst and water consumption.[medicinenet.com]
    Celiac Disease
    • All children with T1DM should be monitored for symptoms and/or screened for commonly associated conditions such as thyroid and celiac disease.[pedsinreview.aappublications.org]
    • "The Role of Gluten in Celiac Disease and Type 1 Diabetes" .[en.wikipedia.org]
    • 2.1.2 Diabetic nephropathy 2.1.3 Diabetic neuropathy 2.2 Macrovascular disease 3- Other complications and associated conditions 3.1 Impaired growth and development 3.2 Associated autoimmune conditions 3.2.1 Hypothyroidism 3.2.2 Hyperthyroidism 3.2.3 Celiac[omicsonline.org]

    Epidemiology

    Type 1 diabetes mellitus is the most common metabolic disease in childhood. It is present in around 1 in every 500 child or adolescent.

    Type 2 diabetes mellitus is very common worldwide, particularly the US because of the high caloric diet. Its incidence is on the rise and it is said that type 2 diabetes is rapidly becoming a global “epidemic”. It is estimated that around 552 million people worldwide will be suffering from it by the year 2030.

    Sex distribution
    Age distribution

    Pathophysiology

    Type 1 diabetes mellitus is caused by an autoimmune process in which there is lymphocytic infiltration and subsequent destruction of the beta cells in the pancreas. These cells are responsible for the production of insulin and their destruction causes the level of insulin to fall leading to hyperglycemia.

    In type 2 diabetes mellitus, there is both reduced secretion of insulin as well as insulin resistance in the peripheral tissues [3]. As a result, hyperglycemia develops.

    Prevention

    There is no effective preventive measure against type 1 diabetes mellitus as it is an autoimmune disease that occurs early in childhood.

    Type 2 diabetes mellitus can be prevented by adopting a healthy lifestyle. Eating a healthy diet, avoiding overeating, controlling obesity and performing daily exercise greatly reduce the risk of development of type 2 diabetes mellitus [9] [10].

    Summary

    Diabetes mellitus is a clinical syndrome that is characterized by chronic hyperglycemia along with disturbances in the metabolism of carbohydrates, lipids and proteins [1]. It is of two main types, type 1 and type 2 diabetes mellitus. The former is also referred to as insulin dependent diabetes mellitus while the latter is also known as non-insulin dependent diabetes mellitus.

    Patient Information

    Diabetes mellitus is a disease in which the level of sugar in the blood is raised. It is of two types, one usually affecting people since childhood and the other appearing late in adulthood. Diabetes is associated with many diseases and complications and should be diagnosed and treated early to ensure better expectancy and quality of life.

    Other symptoms


    Self-assessment

    Related Questions


    Ask Question


    5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.

    References

    1. Hoogwerf BJ, Sferra J, Donley BG. Diabetes mellitus--overview. Foot and ankle clinics. Dec 2006;11(4):703-715.
    2. Avery L. Diabetes mellitus types 1 and 2: an overview. Nursing standard. Nov 11-17 1998;13(8):35-38.
    3. Ostenson CG. The pathophysiology of type 2 diabetes mellitus: an overview. Acta physiologica Scandinavica. Mar 2001;171(3):241-247.
    4. Ionova TI, Odin VI, Nikitina TP, Kurbatova KA, Shablovskaia NE. [Quality of life and problems posed by hypoglycemia in type 2 diabetes mellitus during oral hypoglycemic therapy]. Klinicheskaia meditsina. 2013;91(9):34-40.
    5. Ratner RE. Type 2 diabetes mellitus: the grand overview. Diabetic medicine : a journal of the British Diabetic Association. 1998;15 Suppl 4:S4-7.
    6. Bustos-Saldana R, Prieto-Miranda S, Grupo de Estudio de Factores de Riesgo de Ulceraciones en los Pies de los Pacientes Diabeticos T. [Foot ulceration risk factors in type 2 diabetes mellitus]. Revista medica del Instituto Mexicano del Seguro Social. Sep-Oct 2009;47(5):467-476.
    7. McAvoy KH. Oral hypoglycemic agents in the management of non-insulin-dependent diabetes mellitus among the elderly. The Diabetes educator. Sep-Oct 1991;17(5):411-413.
    8. Lubbos H, Miller JL, Rose LI. Oral hypoglycemic agents in type II diabetes mellitus. American family physician. Nov 15 1995;52(7):2075-2078.
    9. Olmsted WH. Obesity: key to the prevention of diabetes. Journal - Michigan State Medical Society. Oct 1953;52(10):1057-1061.
    10. Boulin R, Rambert P. [Prevention of diabetes mellitus]. La Semana medica. Oct 22 1952;28(38):429-430.

    • Carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesThe Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the - M Tendera, V Aboyans, ML Bartelink - European Heart , 2011 - Eur Soc Cardiology
    • Beneficial health effects of modest weight loss. - DJ Goldstein - International journal of obesity and related metabolic , 1992 - ukpmc.ac.uk
    • An autopsy study of cerebrovascular accident in diabetes mellitus - M ALEX, EK BARON, S GOLDENBERG - Circulation, 1962 - Am Heart Assoc
    • A Case of Esophageal Actinomycosis in a Patient with Diabetes Mellitus - DY Gu, JH Roh, DG Lim, YH Jo, JH Yu - Korean Journal of , 2012 - synapse.koreamed.org
    • Of celiac disease identified by the presence of serum endomysial antibodies in children with chronic diarrhea, short stature, or insulin-dependent diabetes mellitus - TM Rossi, CH Albini, V Kumar - The Journal of pediatrics, 1993 - Elsevier
    • 9Carbohydrate metabolism in trauma - DW Wilmore - Clinics in endocrinology and metabolism, 1976 - Elsevier
    • Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus - AD Morris, DIR Boyle, AD McMahon, SA Greene - The Lancet, 1997 - Elsevier
    • الموضوع: Guidelines for the diagnosis of diabetes mellitus and the clinical periodontology - DAS Gomes, JR Pires, DMP Spolidorio, EP Zuza - egydental.com
    • A 10-Year Experience With Bacteriology of Acute Thoracic EmpyemaEmphasis on Klebsiella pneumoniae in Patients With Diabetes Mellitus - KY Chen, PR Hsueh, YS Liaw - CHEST , 2000 - journal.publications.chestnet.org
    • A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? - CP Fung, FY Chang, SC Lee, BS Hu, BIT Kuo, CY Liu - Gut, 2002 - gut.bmj.com
    • Acute cholecystitis in the diabetic: a case-control study of outcome - MS Hickman, WH Schwesinger, CP Page - Archives of Surgery, 1988 - Am Med Assoc
    • Hepatic function in diabetes mellitus, portal cirrhosis and other liver diseases: A correlation of clinical, biochemical and liver needle biopsy findings I. Diabetes mellitus - A Bogoch, WGB Casselman, A Kaplan - The American journal of , 1955 - Elsevier
    • A new classification and diagnostic criteria for invasive fungal sinusitis - RD deShazo, M O'Brien, K Chapin - —Head & Neck , 1997 - Am Med Assoc
    • Cure after cefazolin treatment failure of Methicillin-sensitive Staphylococcus aureus(MSSA) tricuspid valve acute bacterial endocarditis from a peripherally - BA Cunha, N Hamid, H Kessler, S Parchuri - Heart & Lung: The Journal of , 2005 - Elsevier
    • Of Aspergillus galactomannan antigen testing with a new cut‐off index and Aspergillus precipitating antibody testing for the diagnosis of chronic pulmonary - Y Kitasato, Y Tao, T Hoshino, K Tachibana - , 2009 - Wiley Online Library
    • Bullous pemphigoid: therapy in patients with and without diabetes mellitus - TF Downham, TA Chapel - Archives of dermatology, 1978 - Am Med Assoc
    • A Double Blind Study of the Effect of Acipimox on Serum Lipids, Blood Glucose Control and Insulin Action in Non‐obese Patients with Type 2 Diabetes Mellitus - GR Fulcher, C Catalano, M Walker, M Farrer - Diabetic , 2009 - Wiley Online Library
    • Cutaneous manifestations of diabetes mellitus - MI Perez, SR Kohn - Journal of the American Academy of Dermatology, 1994 - Elsevier
    • Of renal involvement in newly-diagnosed middle-aged and elderly diabetic patients. Cross-sectional data from the population-based study “Diabetes Care in General - NF Olivarius, AH Andreasen, N Keiding, CE Mogensen - Diabetologia, 1993 - Springer
    • Radical production and autoxidative glycosylation. Glucose autoxidation as the cause of protein damage in the experimental glycation model of diabetes mellitus and - JV Hunt, RT Dean, SP Wolff - Biochemical journal, 1988 - ncbi.nlm.nih.gov
    • Assessment and management of foot disease in patients with diabetes - GM Caputo, PR Cavanagh, JS Ulbrecht - England Journal of , 1994 - Mass Medical Soc
    • A new clinical scale for the staging of dementia. - CP Hughes, L Berg, WL Danziger, LA Coben - The British Journal of , 1982 - RCP
    • Increased prevalence of renal biopsy findings other than diabetic glomerulopathy in type II diabetes mellitus - NT Richards, I Greaves, SJ Lee, AJ Howie - Nephrology Dialysis , 1992 - ERA-EDTA
    • β-cells in type II diabetes mellitus - D Porte - Diabetes, 1991 - Am Diabetes Assoc
    • Albuminuria response to very high-dose valsartan in type 2 diabetes mellitus - NK Hollenberg, HH Parving, G Viberti - Journal of , 2007 - journals.lww.com
    • Endothelial and erectile dysfunction, diabetes mellitus, and the metabolic syndrome: common pathways and treatments? - V Fonseca, A Jawa - The American journal of cardiology, 2005 - Elsevier
    • Of Candida glabrata and its response to boric acid vaginal suppositories in comparison with oral fluconazole in patients with diabetes and vulvovaginal candidiasis - D Ray, R Goswami, U Banerjee, V Dadhwal - Diabetes , 2007 - Am Diabetes Assoc
    • A study of Candida esophagitis in elderly patients attending a district general hospital in the UK - N Weerasuriya, J Snape - Diseases of the Esophagus, 2006 - Wiley Online Library
    • A new paradigm for type 2 diabetes mellitus: could it be a disease of the foregut? - MS Hickey, WJ Pories, KG MacDonald Jr - Annals of , 1998 - ncbi.nlm.nih.gov
    • With diabetes mellitus: recommendations to the scientific advisory board of the nationals Kidney Foundation from an Ad Hoc Committee of the council on diabetes mel - PH Bennett, S Haffner, BL Kasiske, WF Keane - American journal of , 1995 - Elsevier
    • Nasal carriage of mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) in a pet dog associated with MRSA infection in household contacts - FA Manian - Clinical Infectious Diseases, 2003 - cid.oxfordjournals.org
    • DIABETES MELLITUS PREDISPOSE THE PATIENT TO THE PYOGENIC SKIN INFECTIONS? A STUDY OF THE ETIOLOGIC RELATIONSHIP OF FURUNCULOSIS - JR WILLIAMS - Journal of the American Medical Association, 1942 - Am Med Assoc
    • An X-linked syndrome of diarrhea, polyendocrinopathy, and fatal infection in infancy - BR Powell, NRM Buist, P Stenzel - The Journal of pediatrics, 1982 - Elsevier
    • Common fungal infections of the feet in patients with diabetes mellitus - JS Tan, WS Joseph - Drugs & aging, 2004 - ingentaconnect.com
    • Effects of Epalrestat, an Aldose Reductase Inhibitor, on Diabetic Peripheral Neuropathy The 3-year, multicenter, comparative Aldose Reductase Inhibitor-Diabetes - N Hotta, Y Akanuma, R Kawamori, K Matsuoka - Diabetes , 2006 - Am Diabetes Assoc
    • Acute Charcot arthropathy in patients with diabetes mellitus: healing times by foot location. - DR Sinacore - Journal of Diabetes and its Complications, 1998 - ncbi.nlm.nih.gov
    • An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome - J Becker, DB Nora, I Gomes, FF Stringari - Clinical , 2002 - Elsevier
    • A case of chronic calcium pyrophosphate dihydrate crystal disease (tophaceous pseudogout) in the temporomandibular joint - B Meul, K Ernestus, J Neugebauer, AC Kuebler - Oral diseases, 2008 - Wiley Online Library
    • OBESITY AND TO SOME OF THE COMPLICATING DEGENERATIVE DISEASES:(DIABETES MELLITUS, ESSENTIAL HYPERTENSION, OSTEO-ARTHRITIS - M Bruger, CA Poindexter - Archives of Internal Medicine, 1934 - Am Med Assoc
    • Abnormal lipoprotein-lipase-mediated plasma triglyceride removal in untreated diabetes mellitus associated with hypertriglyceridemia - JD Brunzell, D Porte, EL Bierman - Metabolism, 1979 - Elsevier
    • A subtype of diabetes mellitus associated with a mutation of mitochondrial DNA - T Kadowaki, H Kadowaki, Y Mori, K Tobe - England Journal of , 1994 - Mass Medical Soc
    • Candida vertebral osteomyelitis: Report of three cases and a review of the literature - BC Friedman, GL Simon - Diagnostic microbiology and infectious disease, 1987 - Elsevier
    • Eggerthella hongkongensis sp. nov. and eggerthella sinensis sp. nov., two novel Eggerthella species, account for half of the cases of - SKP Lau, PCY Woo, GKS Woo, AMY Fung - and infectious disease, 2004 - Elsevier
    • Actinomycete infections in humans—a review - KP Schaal, HJ Lee - Gene, 1992 - Elsevier
    • Epidural abscess complicating insertion of epidural catheters - JMG Phillips, JC Stedeford - British journal of , 2002 - British Jrnl Anaesthesia
    • Bacterial urinary tract infections in diabetes. - JE Patterson, VT Andriole - Infectious disease clinics of North , 1997 - ukpmc.ac.uk
    • Big renin and biosynthetic defect of aldosterone in diabetes mellitus - A deLeiva, AR Christlieb, JC Melby - England Journal of , 1976 - Mass Medical Soc
    • Caused by Staphylococcus aureus: a study of one hundred and twenty-two cases and a review of the literature concerned with experimental infection in animals - D Skinner, CS Keefer - Archives of Internal Medicine, 1941 - Am Med Assoc
    • 316 MEDIcAL NEWS IN BRu Canad. MA 3. - BC DIXON-WARREN - ncbi.nlm.nih.gov
    • Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies - CY Jeon, MB Murray - PLoS medicine, 2008 - dx.plos.org
    • Brainstem perfusion is impaired in chronic fatigue syndrome - DC Costa, C Tannock, J Brostoff - QJM, 1995 - Oxford Univ Press
    • Hormonal (C-peptide and glucagon) profile and liability to ketoacidosis during nutritional rehabilitation in Ethiopian patients with malnutrition-related diabetes mellitus - J Abdulkadir, B Mengesha, ZW Gabriel, H Keen - Diabetologia, 1990 - Springer
    • Between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent - Y Gillet, B Issartel, P Vanhems - Lancet (London, , 2002 - jvsmedicscorner.com
    • Asymptomatic bacteriuria in patients with diabetes mellitus - GG Zhanel, GKM Harding - Review of Infectious , 1990 - cid.oxfordjournals.org
    • Cancer incidence in a population-based cohort of patients hospitalized with diabetes mellitus in Denmark - L Wideroff, G Gridley, WH Chow - the National Cancer , 1997 - jnci.oxfordjournals.org
    • Birth weight and adult hypertension, diabetes mellitus, and obesity in US men - GC Curhan, WC Willett, EB Rimm, D Spiegelman - Circulation, 1996 - Am Heart Assoc
    • Diabetes mellitus and free radicals Free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications - SP Wolff - British Medical Bulletin, 1993 - British Council
    • A 2-year follow-up study on bone mineral density and markers of bone turnover in patients with long-standing insulin-dependent diabetes mellitus - T Miazgowski, S Czekalski - Osteoporosis international, 1998 - Springer
    • A cost-benefit analysis of immunization for pneumococcal pneumonia - KM Patrick, FR Woolley - JAMA: the journal of the American Medical , 1981 - Am Med Assoc
    • Between nocturnal blood pressure reduction and progression of visual field defect in patients with primary open-angle glaucoma or normal-tension glaucoma - T Tokunaga, K Kashiwagi, T Tsumura - Japanese journal of , 2004 - Springer
    • Of retinopathy in normotensive people with type 1 diabetes. The EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin-Dependent Diabetes Mellitus - N Chaturvedi, AK Sjolie, JM Stephenson - Lancet, 1998 - ukpmc.ac.uk
    • Aspiration pneumonia: dental and oral risk factors in an older veteran population - MS Terpenning, GW Taylor, DE Lopatin - Journal of the , 2001 - Wiley Online Library
    • Retinal vein occlusion in juvenile diabetes: Case report with consideration of the pathogenic relationship between diabetic retinopathy and retinal vein occlusion - J Ditzel, P White - Journal of chronic diseases, 1956 - Elsevier
    • Arteriosclerotic heart disease in diabetes mellitus: a clinical study of 383 patients - IM Liebow, HK Hellerstein, M Miller - The American Journal of Medicine, 1955 - Elsevier
    • Cryptococcosis in human immunodeficiency virus-negative patients - S Kiertiburanakul, S Wirojtananugoon - International journal of , 2006 - ukpmc.ac.uk
    • Diabetes mellitus in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel–Thrombolysis in Myocardial Infarction - SD Wiviott, E Braunwald, DJ Angiolillo, S Meisel - Circulation, 2008 - Am Heart Assoc
    • Hypouricemia and hyperuricemia in type 2 diabetes: two different phenotypes - S Bo, P Cavallo‐Perin, L Gentile - European journal of , 2001 - Wiley Online Library
    • 1 Treatment of diabetic ketoacidosis and non-ketotic hyperosmolar diabetic coma - W Berger, U Keller - Baillière's clinical endocrinology and metabolism, 1992 - Elsevier
    • Copper, zinc, manganese, and magnesium status and complications of diabetes mellitus - RM Walter, JY Uriu-Hare, KL Olin, MH Oster - Diabetes , 1991 - Am Diabetes Assoc
    • Between the effects of gemfibrozil and simvastatin on insulin sensitivity in patients with non—Insulin-dependent diabetes mellitus and hyperlipoproteinemia - M Öhrvall, H Lithell, J Johansson, B Vessby - Metabolism, 1995 - Elsevier
    • Between plasma endothelin-1 levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy in patients with Type 2 diabetes mellitus. - G Ak, S Buyukberber, A Sevinc, HM Turk - Journal of Diabetes , 2001 - ukpmc.ac.uk
    • A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease - E Bugianesi, E Gentilcore, R Manini, S Natale - The American journal of , 2005 - nature.com
    • A simple method to detect linkage for rare recessive diseases: an application to juvenile diabetes - BK Suarez, SE Hodoe - Clinical genetics, 1979 - Wiley Online Library
    • Current medical diagnosis & treatment 2010 - SJ McPhee, MA Papadakis, MW Rabow - 2010 - media.matthewsbooks.com.s3.
    • Of fluvastatin+ fenofibrate combination therapy and fluvastatin monotherapy in the treatment of combined hyperlipidemia, type 2 diabetes mellitus, and coronary heart - G Derosa, AEG Cicero, G Bertone, MN Piccinni - Clinical , 2004 - ukpmc.ac.uk
    • Acute bacterial meningitis in adults: a hospital-based epidemiological study - LM Tang, ST Chen, WC Hsu, RK Lyu - Qjm, 1999 - Oxford Univ Press
    • Between the content of lysyl oxidase-dependent cross-links in skin collagen, nonenzymatic glycosylation, and long-term complications in type I diabetes mellitus. - B Buckingham, KM Reiser - Journal of Clinical Investigation, 1990 - ncbi.nlm.nih.gov
    • Candida prosthetic arthritis: report of a case treated with fluconazole and review of the literature - AR Tunkel, CY Thomas, B Wispelwey - The American journal of medicine, 1993 - Elsevier
    • 'Toxic strep syndrome'associated with group C streptococcus - P Keiser, W Campbell - Archives of internal medicine, 1992 - Am Med Assoc
    • Cardiovascular Münster (PROCAM) study: prevalence of hyperlipidemia in persons with hypertension and/or diabetes mellitus and the relationship to coronary heart - G Assmann, H Schulte - American heart journal, 1988 - Elsevier
    • AG polymorphism (IDDM12 locus) with acute-onset and insulin-depleted IDDM as well as autoimmune thyroid disease (Graves' disease and Hashimoto's thyroiditis) - T Awata, S Kurihara, M Iitaka, S Takei, I Inoue, C Ishii - Diabetes, 1998 - ncbi.nlm.nih.gov
    • -peptide levels and insulin independence following autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus - CEB Couri, MCB Oliveira, ABPL Stracieri - JAMA: the journal of , 2009 - Am Med Assoc
    • (DIPOM) trial: rationale and design of a multicenter, randomized, placebo-controlled, clinical trial of metoprolol for patients with diabetes mellitus who are undergoing - AB Juul, J Wetterslev, A Kofoed-Enevoldsen - American heart , 2004 - ukpmc.ac.uk
    • β-myosin heavy chain defects in two families with non-compaction cardiomyopathy: linking non-compaction to hypertrophic, restrictive, and dilated cardiomyopathies - YM Hoedemaekers, K Caliskan - European heart , 2007 - Eur Soc Cardiology
    • Abnormal glucose counterregulation in insulin-dependent diabetes mellitus: interaction of anti-insulin antibodies and impaired glucagon and epinephrine secretion - G Bolli, P De Feo, P Compagnucci, MG Cartechini - Diabetes, 1983 - Am Diabetes Assoc
    • Case‐of‐the‐month: Perineuritis presenting as mononeuritis multiplex - Z Simmons, JW Albers, AAF Sima - Muscle & nerve, 1992 - Wiley Online Library
    • Transpormation (nodular regenerative hyperplasia) of the liver: A report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules - IR Wanless - Hepatology, 1990 - Wiley Online Library
    • A case of nontraumatic clostridial gas gangrene occurring in a patient with colon adenocarcinoma, liver cirrhosis, and diabetes mellitus - M Takeyama, H Mori, T Nagareda - Pathology , 2008 - Wiley Online Library
    • Acquired reactive perforating collagenosis: report of six cases and review of the literature - IR Faver, MS Daoud, WP Daniel Su - Journal of the American Academy of , 1994 - Elsevier
    • Chronic necrotizing pulmonary aspergillosis: a discrete clinical entity - RE Binder, LJ Faling, RD Pugatch, C Mahasaen - Medicine, 1982 - aspergillus.org.uk
    • Stroke using the Congestive heart failure, Hypertension, Age> 75, Diabetes mellitus, and prior Stroke or transient ischemic attack (CHADS2) risk stratification - S Rietbrock, E Heeley, J Plumb - American heart , 2008 - mp.medscape.com
    • An autopsy study of cerebrovascular accident in diabetes mellitus - M ALEX, EK BARON, S GOLDENBERG - Circulation, 1962 - Am Heart Assoc
    • Diabetes on perinatal morbidity reassessed: report of the International Workshop on Adverse Perinatal Outcomes of Gestational Diabetes Mellitus, - A Blank, GD Grave, BE Metzger - Diabetes Care, 1995 - Am Diabetes Assoc
    • Associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery. - MD Kertai, E Boersma, CM Westerhout - European journal of , 2004 - ukpmc.ac.uk
    • 8 Arterial disease as a cause of impotence - V Michal - Clinics in endocrinology and metabolism, 1982 - Elsevier
    • Cholesterol atheromatous embolism: an increasingly recognized cause of acute renal failure - F Scolari, M Bracchi, B Valzorio, E Movilli - Nephrology Dialysis , 1996 - ERA-EDTA
    • 'Spectacular shrinking deficit'Rapid recovery from a major hemispheric syndrome by migration of an embolus - K Minematsu, T Yamaguchi, T Omae - Neurology, 1992 - AAN Enterprises
    • Cryptococcal disease presenting as cellulitis - DJ Anderson, C Schmidt, J Goodman - Clinical infectious , 1992 - cid.oxfordjournals.org
    • Diabetes mellitus from the inside out: Ecological perspectives on a chronic disease. - SS Galazka, JK Eckert - Family Systems Medicine, 1984 - psycnet.apa.org
    • . Dermatological Complications of Diabetes Mellitus; Allergy to Insulin and Oral Agents - ES Marmur, FR Pasternack - of Diabetes Mellitus, 2002 - books.google.com
    • Four-year follow-up of Palmaz-Schatz stent revascularization as treatment for atherosclerotic renal artery stenosis - G Dorros, M Jaff, L Mathiak, II Dorros, A Lowe - Circulation, 1998 - Am Heart Assoc
    • Association of diabetes mellitus and disorders of the anterior pituitary, thyroid and adrenal cortex - WM Balfour, RG Sprague - The American journal of medicine, 1949 - Elsevier
    • Diabetes as a risk factor for herpes zoster infection: results of a population-based study in Israel - AD Heymann, G Chodick, T Karpati, L Kamer, E Kremer - Infection, 2008 - Springer
    • Are hypertension or cardiac embolism likely causes of lacunar infarction? - J Lodder, JM Bamford, PA Sandercock, LN Jones - Stroke, 1990 - Am Heart Assoc
    • Hypertension but not vascular disease per se are associated with persistent platelet activation in vivo: evidence derived from the study of peripheral arterial disease - G Davì, P Gresele, F Violi, S Basili, M Catalano - Circulation, 1997 - Am Heart Assoc
    • And arterial calcification in insulin-dependent diabetes mellitus: interrelations and risk factor profiles. Pittsburgh Epidemiology of Diabetes Complications Study-V - RE Maser, SK Wolfson Jr, D Ellis, EA Stein - Arteriosclerosis, , 1991 - Am Heart Assoc
    • Abnormalities of the foot in patients with diabetes mellitus: findings on MR imaging. - TE Moore, WT Yuh, MH Kathol - American Journal of , 1991 - Am Roentgen Ray Soc
    • Cranial nerve palsy in spontaneous dissection of the extracranial internal carotid artery - B Mokri, PL Silbert, WI Schievink, DG Piepgras - Neurology, 1996 - AAN Enterprises
    • Big renin and biosynthetic defect of aldosterone in diabetes mellitus - A deLeiva, AR Christlieb, JC Melby - England Journal of , 1976 - Mass Medical Soc
    • Adjunctive hyperbaric oxygen for treatment of rhinocerebral mucormycosis - BJ Ferguson, TG Mitchell, R Moon - Review of Infectious , 1988 - cid.oxfordjournals.org
    • Of celiac disease identified by the presence of serum endomysial antibodies in children with chronic diarrhea, short stature, or insulin-dependent diabetes mellitus - TM Rossi, CH Albini, V Kumar - The Journal of pediatrics, 1993 - Elsevier
    • A new agent of onychomycosis in the elderly: Onychocola canadensis - N Contet-Audonneau, JL Schmutz, AM Basile - European Journal of , 1997 - jle.com
    • Reaction with Purpura of Schönlein-Henoch Type, Acute Nephritis, and Angioneurotic Œdema.(2) Obesity and Diabetes Mellitus (Precipitated by Infection) - L Mirabel - Proceedings of the Royal Society of Medicine, 1951 - ncbi.nlm.nih.gov
    • 9 Liver abscesses and hydatid disease - JEJ Krige, IJ Beckingham - ABC - siteem.com
    • Acquired zinc deficiency in association with anorexia nervosa: case report and review of the literature - AS Voorhees, M Riba - Pediatric dermatology, 1992 - Wiley Online Library
    • Acute severe irreversible visual loss with sphenoethmoiditis-'posterior'orbital cellulitis - ML Slavin, JS Glaser - Archives of ophthalmology, 1987 - Am Med Assoc
    • Auditory disturbance as a prodrome of anterior inferior cerebellar artery infarction - H Lee, YW Cho - Journal of Neurology, Neurosurgery & Psychiatry, 2003 - jnnp.bmj.com
    • A survey of reports of quetiapine-associated hyperglycemia and diabetes mellitus. - EA Koller, J Weber, PM Doraiswamy - The Journal of clinical , 2004 - ukpmc.ac.uk
    • 1MEDICAL AND SURGICAL PRACTICE INTHE HOSPITALS AND ASYLUMS OF THE - R a Baer-Osesarean - bmj.com
    • Cancer incidence in a population-based cohort of patients hospitalized with diabetes mellitus in Denmark - L Wideroff, G Gridley, WH Chow - Journal of the , 1997 - jnci.oxfordjournals.org
    • Adult listeriosis--a review of 18 cases. - Y Samra, M Hertz, G Altmann - Postgraduate Medical Journal, 1984 - pmj.bmj.com
    • A comparison of risk factors for preterm labor and term small-for-gestational-age birth - JM Lang, E Lieberman, A Cohen - Epidemiology, 1996 - JSTOR
    • Case‐of‐the‐month: Painful thigh mass in a young woman: Diabetic muscle infarction - RJ Barohn, JT Kissel - Muscle & nerve, 1992 - Wiley Online Library
    • Can Legionnaires disease be diagnosed by clinical criteria? a critical review - L Mulazimoglu, LY Victor - CHEST Journal, 2001 - journal.publications.chestnet.org
    • Active tuberculosis undiagnosed until autopsy - ID Bobrowitz - The American journal of medicine, 1982 - Elsevier
    • Acute respiratory failure associated with pulmonary cryptococcosis in non-AIDS patients - RA Vilchez, P Linden, J Lacomis - CHEST , 2001 - journal.publications.chestnet.org
    • Delayed puberty - C Traggiai, R Stanhope - Best Practice & Research Clinical Endocrinology , 2002 - Elsevier
    • CNS manifestations of diabetes mellitus. - RN DeJong - Postgraduate medicine, 1977 - ukpmc.ac.uk
    • Between an insertion/deletion polymorphism in the angiotensin I–converting enzyme gene and diabetic nephropathy and proliferative retinopathy in IDDM patients - L Tarnow, F Cambien, P Rossing, FS Nielsen - Diabetes, 1995 - Am Diabetes Assoc
    • Chronic open-angle glaucoma and ocular hypertension. An epidemiological study. - RW Morgan, SM Drance - British Journal of Ophthalmology, 1975 - bjo.bmj.com
    • Prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6- - Y Ohkubo, H Kishikawa, E Araki, T Miyata - Diabetes research and , 1995 - Elsevier
    • A light microscopic study of glomerulosclerosis in Japanese patients with noninsulin-dependent diabetes mellitus: the relationship between clinical and histological - Y Suzuki, M Ueno, H Hayashi, S Nishi, H Satou - Clinical , 1994 - ukpmc.ac.uk
    • Cutaneous manifestation of diabetes melitus - S Mahajan, RV Koranne, SK Sharma - Indian Journal of Dermatology, , 2003 - Medknow
    • A Rare Type of Femoral‐Sciatic Neuropathy in Diabetes Mellitus - B SKANSE, K GYDELL - Acta medica Scandinavica, 1956 - Wiley Online Library
    • Diabetes prevention - YY Bo-abbas, VJ Brousseau, DB Louria - New England journal , 2002 - Mass Medical Soc
    • Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5,480 cases - S Aktogu, A Yorgancioglu, K Cirak, T Kose - European Respiratory , 1996 - ersj.org.uk
    • -01) carbohydrate-adjusted fluid diet in improving the metabolism of carbohydrates and lipids in patients with esophageal cancer complicated by diabetes mellitus - T Fujiwara, Y Naomoto, T Motoki, K Shigemitsu - Journal of Surgical , 2007 - Elsevier
    • Atypical radiological images of pulmonary tuberculosis in 192 diabetic patients: a comparative study - C Perez-Guzman, A Torres-Cruz - of Tuberculosis and , 2001 - ingentaconnect.com
    • A clinical evaluation of the C-reactive protein test - RS YOCUM, AA DOERNER - Archives of Internal Medicine, 1957 - Am Med Assoc
    • A study of HLA antigen association in localized and generalized granuloma annulare - R FRIEDMAN‐BIRNBAUM, O Gideoni - British Journal of , 1986 - Wiley Online Library
    • Chronic Care Clinics for Diabetes in Primary Care A system-wide randomized trial - EH Wagner, LC Grothaus, N Sandhu, MS Galvin - Diabetes , 2001 - Am Diabetes Assoc
    • Glucokinase gene: isolation, characterization, and identification of two missense mutations linked to early-onset non-insulin-dependent (type 2) diabetes mellitus - M Stoffel, PH Froguel, J Takeda - Proceedings of the , 1992 - National Acad Sciences
    • Compliance of the proximal stomach and dyspeptic symptoms in patients with type I diabetes mellitus - M Samsom, GAM Salet, JMM Roelofs - Digestive diseases and , 1995 - Springer
    • An algorithm for the evaluation of peripheral neuropathy - DSS Polyneuropathies - Am Fam Physician, 1998 - aafp.org
    • Below-the-knee amputation for arteriosclerosis obliterans: With and without diabetes mellitus - JJ Cranley, RJ Krause, ES Strasser - Archives of , 1969 - Am Med Assoc
    • Insulin treatment retards the microvascular complications of insulin‐dependent diabetes mellitus (IDDM): the Stockholm Diabetes Intervention Study (SDIS) after 5 - P Reichard, B Berglund, A Britz, I Cars - Journal of internal , 2009 - Wiley Online Library
    • Of celiac disease identified by the presence of serum endomysial antibodies in children with chronic diarrhea, short stature, or insulin-dependent diabetes mellitus - TM Rossi, CH Albini, V Kumar - The Journal of pediatrics, 1993 - Elsevier
    • Current medical diagnosis & treatment 2010 - SJ McPhee, MA Papadakis, MW Rabow - 2010 - media.matthewsbooks.com.s3.
    • Of Oral and Intravenous Dextrose Tolerance Tests in Endocrine Disorders with Decreased Dextrose Tolerance: Diabetes Mellitus, Thyrotoxicosis, Cushing's Syndrome - L GOLDBERG, R LUFT - Acta Medica Scandinavica, 1949 - Wiley Online Library
    • Autoimmune chronic pancreatitis simulating pancreatic lymphoma. - A Horiuchi, T Kaneko, N Yamamura - The American journal , 1996 - ukpmc.ac.uk
    • Conn's Current Therapy 2008: Text with Online Reference - RE Rakel, ET Bope - 2007 - lavoisier.fr
    • Abnormal antioxidant status in impaired glucose tolerance and non-insulin-dependent diabetes mellitus. - S Vijayalingam, A Parthiban - Diabetic medicine: a , 1996 - mdrf-eprints.in
    • Nervous System Function in Type 1 Diabetes Mellitus The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study - R Pop-Busui, PA Low, BH Waberski, CL Martin - Circulation, 2009 - Am Heart Assoc
    • Abnormal intestinal motility in diabetics with the gastroparesis syndrome - M CAMILLERI - European journal of clinical , 2008 - Wiley Online Library
    • And polydipsia in wild caught bank voles ( Clethrionomys glareolus) and their laboratory-bred offspring.: Is polydipsia a symptom of diabetes mellitus? - B Schoenecker, KE Heller, T Freimanis - Applied animal behaviour science, 2000 - Elsevier
    • ': relationship between weight, height, body mass index and age at diagnosis in a large cohort of 9,248 German and Austrian children with type 1 diabetes mellitus - I Knerr, J Wolf, T Reinehr, R Stachow, M Grabert - Diabetologia, 2005 - Springer
    • Complications, co-morbidity, and blood glucose control in type 2 diabetes mellitus patients in Germany-results from the CODE-2™ study - A Liebl, A Neiss, A Spannheimer - & diabetes, 2002 - thieme-connect.com
    • And development in German children and adolescents with type 1 diabetes: cross-sectional analysis of recent data from the DPV diabetes documentation and quality - T Rohrer, E Stierkorb, S Heger, B Karges, K Raile - European Journal of , 2007 - EFES
    • A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women. - S Liu, JE Manson, MJ Stampfer, FB Hu - American journal of , 2000 - ncbi.nlm.nih.gov
    • 3H-thymidine uptake by the rat urinary bladder after induction of diabetes mellitus. - B Eika, RM Levin, FC Monson, M Murphy - The Journal of , 1993 - ukpmc.ac.uk
    • Assessment of pulse wave reflection: blunted response to endothelium-dependent beta2-adrenergic vasodilation in type II diabetes mellitus - EE Änggård, JM Ritter, RG Gosling - Journal of the , 1999 - Am Coll Cardio Found
    • αvβ6 integrin regulates renal fibrosis and inflammation in Alport mouse - K Hahm, ME Lukashev, Y Luo, WJ Yang - The American journal of , 2007 - Elsevier
    • An overview of diabetes mellitus in older persons. - JE Morley - Clinics in geriatric medicine, 1999 - ukpmc.ac.uk
    • A prospective study of postmenopausal estrogen therapy and subsequent incidence of non-insulin-dependent diabetes mellitus - JAE Manson, EB Rimm, GA Colditz, WC Willett - Annals of , 1992 - Elsevier
    • Asmymptomatic parotid gland enlargement in diabetes mellitus. - D Davidson, BS Leibel, B Berris - Annals of internal medicine, 1969 - ncbi.nlm.nih.gov
    • Clinical assessment of hyperlipidemic pancreatitis. - MR Fortson, SN Freedman - The American journal of , 1995 - ukpmc.ac.uk
    • A case of diabetes mellitus quickly following mumps - HF Harris - The Boston Medical and Surgical Journal, 1899 - Mass Medical Soc
    • Chronic inflammatory demyelinating polyneuropathy (CIDP) in diabetics - JD Stewart, R McKelvey, L Durcan, S Carpenter - Journal of the , 1996 - Elsevier
    • IGF) gene expression is reduced in neural tissues and liver from rats with non-insulin-dependent diabetes mellitus, and IGF treatment ameliorates diabetic neuropathy - HX Zhuang, L Wuarin, ZJ Fei, DN Ishii - Journal of Pharmacology and , 1997 - ASPET
    • " Portal" adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. - P Björntorp - Arteriosclerosis, Thrombosis, and Vascular Biology, 1990 - Am Heart Assoc
    • Clinical studies with an aldose reductase inhibitor in the autonomic and somatic neuropathies of diabetes - JB Jaspan, VL Towle, R Maselli, K Herold - Metabolism, 1986 - Elsevier
    • A concomitant review of the effects of diabetes mellitus and hypothyroidism in wound healing - ITOW HEALING - World Journal of, 2006 - wjgnet.com
    • A pseudoepidemic of Mycobacterium chelonae infection caused by contamination of a fibreoptic bronchoscope suction channel - HC Wang, YS Liaw, PC Yang, SH Kuo - European Respiratory , 1995 - Eur Respiratory Soc
    • 61. Ischemic Colon - J Thomas, NM Khardori - Emergencies in Infectious Diseases, 2010 - books.google.com
    • Anamnese und Befund - J Dahmer - 2006 - books.google.com
    • Investigation of fluoroquinolone resistance in infections due to extended-spectrum β-lactamase—producing Escherichia coli and Klebsiella pneumoniae - E Lautenbach, BL Strom, WB Bilker - Clinical infectious , 2001 - cid.oxfordjournals.org
    • Antibody negative NIDDM in adult black subjects with diabetic ketoacidosis and increased frequency of human leukocyte antigen DR3 and DR4: Flatbush diabetes - MA Banerji, RL Chaiken, H Huey, T Tuomi, AJ Norin - Diabetes, 1994 - Am Diabetes Assoc
    • A systematic study of HLA class II-beta DNA restriction fragments in insulin-dependent diabetes mellitus - O Cohen-Haguenauer, E Robbins - Proceedings of the , 1985 - National Acad Sciences
    • Analysis of families at risk for insulin-dependent diabetes mellitus reveals that HLA antigens influence progression to clinical disease. - MC Honeyman, LC Harrison, B Drummond - Molecular , 1995 - ncbi.nlm.nih.gov
    • A clinical investigation of nocturnal polyuria in patients with nocturia: a diurnal variation in arginine vasopressin secretion and its relevance to mean blood pressure - O Natsume - The Journal of urology, 2006 - Elsevier
    • 1 Clinical evaluation of liver disease - KJ Simpson, NDC Finlayson - Baillière's clinical gastroenterology, 1995 - Elsevier
    • Acalculous cholecystitis - AM Munster, JR Brown - The American Journal of Surgery, 1967 - Elsevier
    • Abnormalities of the foot in patients with diabetes mellitus: findings on MR imaging. - TE Moore, WT Yuh, MH Kathol - American Journal of , 1991 - Am Roentgen Ray Soc
    • Between early metabolic control and the development of microalbuminuria—a longitudinal study in children with type 1 (insulin-dependent) diabetes mellitus - S Rudberg, E Ullman, G Dahlquist - Diabetologia, 1993 - Springer
    • Bardet-Biedl syndrome: a molecular and phenotypic study of 18 families. - PL Beales, AM Warner, GA Hitman - Journal of medical , 1997 - jmg.bmj.com
    • Brittle nail syndrome: Treatment options and the role of the nurse - RK Scher, P Fleckman, B Tulumbas, L McCollam - Dermatology , 2003 - livar.net
    • Analog treatment of girls with precocious puberty: long term follow-up comparing girls with hypothalamic hamartoma to those with idiopathic precocious puberty - PP Feuillan, JV Jones, K Barnes - Journal of Clinical , 1999 - Endocrine Soc
    • Anorectal sensorimotor dysfunction in fecal incontinence and diabetes mellitus - A Wald, AK Tunuguntla - New England Journal of Medicine, 1984 - Mass Medical Soc
    • Extramural and intramural coronary arteries in juvenile diabetes mellitus: analysis of nine necropsy patients aged 19 to 38 years with onset of diabetes before age 15 - FV Crall, WC Roberts - The American journal of medicine, 1978 - Elsevier
    • Aortic Msx2-Wnt Calcification Cascade Is Regulated by TNF-α–Dependent Signals in Diabetic Ldlr−/− Mice - Z Al-Aly, JS Shao, CF Lai, E Huang, J Cai - , and vascular biology, 2007 - Am Heart Assoc
    • Body build and behavior in young children: I. Body build and nursery school teachers' ratings - RN Walker - Monographs of the Society for Research in Child , 1962 - JSTOR
    • Of adult staphylococcal meningitis in southern Taiwan: a clinical comparison of Staphylococcus aureus infection and coagulase-negative staphylococcal - W Chang, C Lu, C Huang, Y Chuang, N Tsai - Japanese journal of , 2007 - nih.go.jp
    • Chronic Fatigue Syndrome: A Working Case Definition Ann Intern Med. 1988; 108: 387-389 - GP Holmes, JE Kaplan, NM Gantz, AL Komaroff - Ann Intern , 1988 - cfsuntied.com
    • Association of HLA—B8, DRw3, and Anti‐Acetylcholine Receptor Antibodies in Myasthenia Gravis - F Naeim, JC Keesey, C Herrmann, J Lindstrom - Antigens, 2008 - Wiley Online Library
    • A family study of the association between insulin dependent diabetes mellitus, autoantibodies and the HLA system - BC Winearls, JG Bodmer, WF Bodmer - Tissue , 2008 - Wiley Online Library
    • Pattern in connective autoimmune diseases. A comparison with microvascular changes in diseases of social importance: arterial hypertension and diabetes mellitus - SN Lambova, U Müller-Ladner - Modern rheumatology, 2009 - Springer
    • Activation of glycogen synthase in skeletal muscles in young nonobese Caucasian first-degree relatives of patients with non-insulin-dependent diabetes mellitus. - A Vaag, JE Henriksen - Journal of Clinical , 1992 - ncbi.nlm.nih.gov

    Media References

    1. Blue circle for diabetes, Public Domain

    Languages

    Self-assessment