Diabetes mellitus is a chronic disease characterized by hyperglycemiaand by complications that include microvascular disease of theeye and kidney and a variety of clinical neuropathies.1 Althoughdiabetes is also associated with premature macrovascular disease,this review is limited to a discussion of retinopathy, nephropathy,and neuropathy. The pathophysiology of these complications ofdiabetes was recently reviewed in the Journal.1
The specific association of microvascular disease and neuropathywith diabetes and the relation of the two complications to theduration of diabetes suggest that they are linked to hyperglycemiaor a concomitant metabolic abnormality. The Diabetes Controland Complications . . . [Full Text of this Article]
General Prevention
Intensive Treatment
Interference with the Basic Pathophysiologic Mechanisms of Complications
Retinopathy
Prevention
Detection
Treatment
Nephropathy
Prevention
Intensive Management
Angiotensin-ConvertingEnzyme Inhibition
Aldose Reductase Inhibition
Detection
Treatment
Antihypertensive Therapy
Protein Restriction
Neuropathy
Prevention
Treatment
Symptomatic Peripheral Neuropathy
Autonomic Neuropathy
Future Perspectives
Source Information
From the Regenstrief Institute for Health Care, Richard Roudebush Veterans Affairs Medical Center (C.M.C.), and the Department of Medicine (C.M.C., D.A.L.), Indiana University School of Medicine, Indianapolis.
Address reprint requests to Dr. Clark at the Regenstrief Institute for Health Care, 1001 W. 10th St., Indianapolis, IN 46202.
Amoako, E., Skelly, A. H., Rossen, E. K.
(2008). Outcomes of an Intervention to Reduce Uncertainty Among African American Women with Diabetes. West J Nurs Res
30: 928-942
[Abstract]
Zagon, I. S., Klocek, M. S., Sassani, J. W., McLaughlin, P. J.
(2007). Use of Topical Insulin to Normalize Corneal Epithelial Healing in Diabetes Mellitus. Arch Ophthalmol
125: 1082-1088
[Abstract][Full Text]
Hiss, R. G., Armbruster, B. A., Gillard, M. L., McClure, L. A.
(2007). Nurse Care Manager Collaboration With Community-Based Physicians Providing Diabetes Care: A Randomized Controlled Trial. The Diabetes Educator
33: 493-502
[Abstract][Full Text]
Ortmann, J., Nett, P. C., Celeiro, J., Hofmann-Lehmann, R., Tornillo, L., Terracciano, L. M., Barton, M.
(2006). Downregulation of renal endothelin-converting enzyme 2 expression in early autoimmune diabetes.. Exp. Biol. Med.
231: 1030-1033
[Abstract][Full Text]
Zagon, I. S., Sassani, J. W., McLaughlin, P. J.
(2006). Insulin treatment ameliorates impaired corneal reepithelialization in diabetic rats.. Diabetes
55: 1141-1147
[Abstract][Full Text]
Congdon, P.
(2006). Estimating diabetes prevalence by small area in England. J Public Health (Oxf)
28: 71-81
[Abstract][Full Text]
Chen, S.-R., Pan, H.-L.
(2003). Up-Regulation of Spinal Muscarinic Receptors and Increased Antinociceptive Effect of Intrathecal Muscarine in Diabetic Rats. J. Pharmacol. Exp. Ther.
307: 676-681
[Abstract][Full Text]
Slack, A, Goldsmith, D J A
(2003). An unusual cause of peripheral neuropathy in a diabetic patient on dialysis: "a sural surprise". Postgrad. Med. J.
79: 477-477
[Full Text]
Yuen, K. C.J., Baker, N. R., Rayman, G.
(2002). Treatment of Chronic Painful Diabetic Neuropathy With Isosorbide Dinitrate Spray: A double-blind placebo-controlled cross-over study. Diabetes Care
25: 1699-1703
[Abstract][Full Text]
Chen, S.-R., Pan, H.-L.
(2002). Hypersensitivity of Spinothalamic Tract Neurons Associated With Diabetic Neuropathic Pain in Rats. J. Neurophysiol.
87: 2726-2733
[Abstract][Full Text]
Ferreira, L. D. M. C.-B., Huey, P. U., Pulford, B. E., Ishii, D. N., Eckel, R. H.
(2002). Sciatic Nerve Lipoprotein Lipase Is Reduced in Streptozotocin-Induced Diabetes and Corrected by Insulin. Endocrinology
143: 1213-1217
[Abstract][Full Text]
Marsh, J. E, Andrews, P. A
(2002). Management of the diabetic patient approaching end-stage renal failure. British Journal of Diabetes & Vascular Disease
2: 121-126
Romeo, J. H.
(2000). Comprehensive versus Holistic Care: Case Studies of Chronic Disease. J Holist Nurs
18: 352-361
[Abstract]
Hoogeveen, E. K., Kostense, P. J., Eysink, P. E. D., Polak, B. C. P., Beks, P. J., Jakobs, C., Dekker, J. M., Nijpels, G., Heine, R. J., Bouter, L. M., Stehouwer, C. D. A.
(2000). Hyperhomocysteinemia Is Associated With the Presence of Retinopathy in Type 2 Diabetes Mellitus: The Hoorn Study. Arch Intern Med
160: 2984-2990
[Abstract][Full Text]
Gilbert, R. E., Rumble, J. R., Cao, Z., Cox, A. J., van Eeden, P., Allen, T. J., Kelly, D. J., Cooper, M. E.
(2000). Endothelin Receptor Antagonism Ameliorates Mast Cell Infiltration, Vascular Hypertrophy, and Epidermal Growth Factor Expression in Experimental Diabetes. Circ. Res.
86: 158-165
[Abstract][Full Text]
Orloff, L. A., Orloff, M. S., Orloff, S. L., Orloff, M. J.
(1999). Lifelong Prevention of Mesangial Enlargement by Whole Pancreas Transplantation in Rats With Diabetes Mellitus. Arch Surg
134: 889-897
[Abstract][Full Text]
Khunti, K., Baker, R., Rumsey, M., Lakhani, M.
(1999). Quality of care of patients with diabetes: collation of data from multi-practice audits of diabetes in primary care. Fam Pract
16: 54-59
[Abstract][Full Text]
Gerbi, A., Maixent, J.-M., Ansaldi, J.-L., Pierlovisi, M., Coste, T., Pelissier, J.-F., Vague, P., Raccah, D.
(1999). Fish Oil Supplementation Prevents Diabetes-Induced Nerve Conduction Velocity and Neuroanatomical Changes in Rats. J. Nutr.
129: 207-213
[Abstract][Full Text]
The CDC Diabetes Cost-Effectiveness Study Group,
(1998). The Cost-effectiveness of Screening for Type 2 Diabetes. JAMA
280: 1757-1763
[Abstract][Full Text]
Ellrodt, G., Cook, D. J., Lee, J., Cho, M., Hunt, D., Weingarten, S.
(1997). Evidence-Based Disease Management. JAMA
278: 1687-1692
[Abstract]
Clark, C. M. Jr., Vinicor, F.
(1996). Introduction. ANN INTERN MED
124: 81-85
[Full Text]
Henry, R. R., Genuth, S.
(1996). Forum One: Current Recommendations about Intensification of Metabolic Control in Non-Insulin-dependent Diabetes Mellitus. ANN INTERN MED
124: 175-177
[Abstract][Full Text]
Puig, J. G., Ruilope, L. M., Ortega, R.
(1995). Antihypertensive Treatment Efficacy in Type II Diabetes Mellitus : Dissociation Between Casual and 24-Hour Ambulatory Blood Pressure. Hypertension
26: 1093-1099
[Abstract][Full Text]
Mahoney, J. E., Gray, S. L., Carnes, M., Klein, M.
(1995). Prevention and Treatment of the Complications of Diabetes Mellitus. NEJM
333: 802-802
[Full Text]