Blood-Sugar and Arterial Disease

Keen, H.; Rose, Geoffrey; Pyke, David A.; Boyns, D. R.; Chlouverakis, C.; Mistry, Sandeep

doi:10.1016/s0140-6736(65)91470-4

Cited by 172 publications

(52 citation statements)

References 10 publications

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“…The large proportion of patients who died from myocardial or cerebral vascular disease is in keeping with the figures of other studies in diabetic patients [24,25]. It is now accepted that diabetes predisposes to atheromatous disease.…”

Section: Discussionsupporting

confidence: 85%

Long-term follow-up of patients who underwent yttrium-90 pituitary implantation for treatment of proliferative diabetic retinopathy

et al. 1987

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Summary. Between 1960 and 117 patients underwent pituitary implantation with yttrium-90 (90y) for treatment of proliferative retinopathy at the Hammersmith Hospital, London. Mean age at operation was 35 ___ 11 years (mean__ SD), and mean duration of diabetes 18.6_ 10.0 years. Mean insulin dosage prior to implant was 67.2+24 units, falling to 30.4 + 14.9 units post-implant. Thirty-two per cent of patients are still living, 60% are deceased and 8% are lost to followup. The 5-year survival rate was 82%. Of the causes of death, 21% died of infection, adrenal insufficiency or hypoglycaemia, 12% of renal failure, and 47% of myocardial or cerebral vascular disease. Ophthalmological follow-up was carded out on the 100 patients operated on between 1965 and 1976. The mean age of this group at implant was 35 ___ 10.5 years, and mean duration of diabetes 17.2 + 8.7 years. Visual acuity in the better eye at operation was 6/12 or better in 84% of patients, and this percentage remained similar at the time of the 5 and 10 year follow-up. Blindness (6/60 or worse) in both eyes was present in 12% of patients at the time of 5 and 10 year assessments. By 5 years new vessels on the disc had improved from a mean grading of 2.7 + 1.6 to 0.8 __-1.2 (p < 0.001), and by 10 years there was no disc neovascularisation in any eye. There was a similar improvement in the grading of hard exudates, microaneurysms and haemorrhages, but there was an increase in fibrous retinitis proliferans. It is concluded that pituitary ablation was an effective method of treating proliferative retinopathy, and may have had a beneficial effect on other microvascular complications.

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Section: Discussionsupporting

confidence: 85%

Long-term follow-up of patients who underwent yttrium-90 pituitary implantation for treatment of proliferative diabetic retinopathy

et al. 1987

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“…Caspary and Peberdy (1965) showed an increase in platelet stickiness in women on the pill, but this was significant only in the presence of an encephalitogenic agent-an artificial situation, unless one postulates the necessity of two or more unknown factors working on the particular patients in whom arterial lesions develop. Wynn and Doar (1966) have shown changes in carbohydrate metabolism in 20% of patients similar to those seen in steroid diabetes; and Keen et al (1965) have shown an increased incidence of vascular accidents in asymptomatic diabetes. Wynn et al (1966) have shown changes in serum triglycerides to figures resembling those seen in men, and raised the possibility of some relation to the development of atheroma.…”

Section: Discussionmentioning

confidence: 87%

Cerebral arterial insufficiency and oral contraceptives.

Bickerstaff¹,

Holmes²

1967

BMJ

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The question of whether there is an association between the use of oral contraceptives and cerebrovascular accidents has been bedevilled by the lack of accurate knowledge of the frequency (or rarity) of Because of the fallacy of trying to make a diagnosis of a cerebral thrombosis from the clinical picture alone, the criteria must be stated on which it was assumed that the patient had had an episode of cerebral arterial insufficiency. These criteria have been applied to all cases in the present study.

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“…Comparisons of people with impaired glucose tolerance and age-matched control subjects have shown higher average blood pressures in the former [24] and in some studies higher average cholesterol levels as well [13,25]. A higher frequency of electrocardiographic abnormalities has also been observed in persons with impaired glucose tolerance [12,13,26,27]. As mentioned above, some prospective studies have found impaired glucose tolerance to be associated with increased morbidity and/or mortality rates.…”

Section: Pre-diagnosismentioning

confidence: 98%

Type 2 (non-insulin-dependent) diabetes mellitus and coronary heart disease ? chicken, egg or neither?

1984

Diabetologia

167

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Summary. Review of the literature yields much evidence against a correlation between duration of non-insulin-dependent diabetes mellitus (Type 2 diabetes) and the degree of coronary atherosclerosis or the risk of clinically evident coronary heart disease (CHD). Furthermore, an increased risk of CHD, similar to that in previously diagnosed diabetic subjects, has been demonstrated in persons with impaired glucose tolerance. These observations suggest that an increased risk of CHD is not a consequence of the development of diabetes (i. e. persistent hyperglycaemia). It is more likely that diabetes develops in individuals who already possess characteristics which increase the risk of CHD in addition to the risk of developing diabetes.

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Blood-Sugar and Arterial Disease

Cited by 172 publications

References 10 publications

Long-term follow-up of patients who underwent yttrium-90 pituitary implantation for treatment of proliferative diabetic retinopathy

Long-term follow-up of patients who underwent yttrium-90 pituitary implantation for treatment of proliferative diabetic retinopathy

Cerebral arterial insufficiency and oral contraceptives.

Type 2 (non-insulin-dependent) diabetes mellitus and coronary heart disease ? chicken, egg or neither?

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