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‣ Gut Microbiota and Type 1 Diabetes

Vaarala, Outi
Fonte: SBDR - Society for Biomedical Diabetes Research Publicador: SBDR - Society for Biomedical Diabetes Research
Tipo: Artigo de Revista Científica
Português
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The gut immune system has a key role in the development of autoimmune diabetes, and factors that control the gut immune system are also regulators of beta-cell autoimmunity. Gut microbiota modulate the function of the gut immune system by their effect on the innate immune system, such as the intestinal epithelial cells and dendritic cells, and on the adaptive immune system, in particular intestinal T cells. Due to the immunological link between gut and pancreas, e.g. the shared lymphocyte homing receptors, the immunological changes in the gut are reflected in the pancreas. According to animal studies, changes in gut microbiota alter the development of autoimmune diabetes. This has been demonstrated by antibiotics that induce changes in the gut microbiota. Furthermore, gut-colonizing microbes may modify the incidence of autoimmune diabetes in animal models. Deficient toll-like receptor (TLR) signaling, mediating microbial stimulus in immune cells, prevents autoimmune diabetes, which appears to be dependent on alterations in the intestinal microbiota. Although few studies have been conducted in humans, recent studies suggest that the abundance of Bacteroides and lack of butyrate-producing bacteria in fecal microbiota are associated with beta-cell autoimmunity and type 1 diabetes. It is possible that altered gut microbiota are associated with immunological aberrancies in type 1 diabetes. The changes in gut microbiota could lead to alterations in the gut immune system...

‣ Event Rates, Hospital Utilization, and Costs Associated with Major Complications of Diabetes: A Multicountry Comparative Analysis

Clarke, Philip M.; Glasziou, Paul; Patel, Anushka; Chalmers, John; Harrap, Stephen B.; Woodward, Mark Phillip; Salomon, Joshua A.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
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Philip Clarke and colleagues examined patient-level data for over 11,000 participants with type 2 diabetes from 20 countries and find that major complications of diabetes significantly increased hospital use and costs across settings. Background: Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries. Methods and Findings: Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE) study (mean age at entry 66 y). The probability of hospital utilization and number of days in hospital for major events associated with coronary disease, cerebrovascular disease, congestive heart failure, peripheral vascular disease, and nephropathy were estimated for three regions (Asia, Eastern Europe, and Established Market Economies) using multiple regression analysis. The resulting estimates of days spent in hospital were multiplied by regional estimates of the costs per hospital bed-day from the World Health Organization to compute annual acute and long-term costs associated with the different types of complications. To assist...

‣ Common Variants in CDKAL1, CDKN2A/B, IGF2BP2, SLC30A8, and HHEX/IDE Genes Are Associated With Type 2 Diabetes and Impaired Fasting Glucose in a Chinese Han Population

Li, Huaixing; Loos, Ruth J.F.; Yu, Zhijie; Ye, Xingwang; Chen, Lihua; Pan, An; Lin, Xu; Wu, Ying; Hu, Frank B.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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OBJECTIVE— Genome-wide association studies have identified common variants in CDKAL1, CDKN2A/B, IGF2BP2, SLC30A8, HHEX/IDE, EXT2, and LOC387761 loci that significantly increase the risk of type 2 diabetes. We aimed to replicate these observations in a population-based cohort of Chinese Hans and examine the associations of these variants with type 2 diabetes and diabetes-related phenotypes. RESEARCH DESIGN AND METHODS— We genotyped 17 single nucleotide polymorhisms (SNPs) in 3,210 unrelated Chinese Hans, including 424 participants with type 2 diabetes, 878 with impaired fasting glucose (IFG), and 1,908 with normal fasting glucose. RESULTS— We confirmed the associations between type 2 diabetes and variants near CDKAL1 (odds ratio 1.49 [95% CI 1.27–1.75]; P = 8.91 × 10−7) and CDKN2A/B (1.31 [1.12–1.54]; P = 1.0 × 10−3). We observed significant association of SNPs in IGF2BP2 (1.17 [1.03–1.32]; P = 0.014) and SLC30A8 (1.12 [1.01–1.25]; P = 0.033) with combined IFG/type 2 diabetes. The SNPs in CDKAL1, IGF2BP2, and SLC30A8 were also associated with impaired β-cell function estimated by homeostasis model assessment of β-cell function. When combined, each additional risk allele from CDKAL1-rs9465871, CDKN2A/B-rs10811661...

‣ Common Variants in 40 Genes Assessed for Diabetes Incidence and Response to Metformin and Lifestyle Intervention in the Diabetes Prevention Program

Jablonski, Kathleen A.; McAteer, Jarred B.; Franks, Paul W.; Pollin, Toni I.; Hanson, Robert L.; Fowler, Sarah; Shuldiner, Alan R.; Knowler, William C.; de Bakker, Paul I Wen; Saxena, Richa; Altshuler, David Matthew; Florez, Jose Carlos
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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OBJECTIVE: Genome-wide association studies have begun to elucidate the genetic architecture of type 2 diabetes. We examined whether single nucleotide polymorphisms (SNPs) identified through targeted complementary approaches affect diabetes incidence in the at-risk population of the Diabetes Prevention Program (DPP) and whether they influence a response to preventive interventions. RESEARCH DESIGN AND METHODS: We selected SNPs identified by prior genome-wide association studies for type 2 diabetes and related traits, or capturing common variation in 40 candidate genes previously associated with type 2 diabetes, implicated in monogenic diabetes, encoding type 2 diabetes drug targets or drug-metabolizing/transporting enzymes, or involved in relevant physiological processes. We analyzed 1,590 SNPs for association with incident diabetes and their interaction with response to metformin or lifestyle interventions in 2,994 DPP participants. We controlled for multiple hypothesis testing by assessing false discovery rates. RESULTS: We replicated the association of variants in the metformin transporter gene (SLC47A1) with metformin response and detected nominal interactions in the AMP kinase (AMPK) gene (STK11), the AMPK subunit genes (PRKAA1) and (PRKAA2)...

‣ Personalized Genetic Risk Counseling to Motivate Diabetes Prevention: A randomized trial

Grant, Richard W.; O’Brien, Kelsey E.; Waxler, Jessica L.; Vassy, Jason L.; Delahanty, Linda M.; Bissett, Laurie G.; Green, Robert C.; Stember, Katherine G.; Guiducci, Candace; Park, Elyse R.; Florez, Jose C.; Meigs, James B.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top and bottom score quartiles received individual genetic counseling before being enrolled with untested control participants in a 12-week, validated, diabetes prevention program. Middle-risk quartile participants were not studied further. We examined the effect of this genetic counseling intervention on patient self-reported attitudes, program attendance, and weight loss, separately comparing higher-risk and lower-risk result recipients with control participants. RESULTS The 108 participants enrolled in the diabetes prevention program included 42 participants at higher diabetes genetic risk, 32 at lower diabetes genetic risk, and 34 untested control subjects. Mean age was 57.9 ± 10.6 years, 61% were men, and average BMI was 34.8 kg/m2, with no differences among randomization groups. Participants attended 6.8 ± 4.3 group sessions and lost 8.5 ± 10.1 pounds...

‣ White Blood Cells Count and Incidence of Type 2 Diabetes in Young Men

Twig, Gilad; Afek, Arnon; Shamiss, Ari; Derazne, Estela; Tzur, Dorit; Gordon, Barak; Tirosh, Amir
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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OBJECTIVE Association between white blood cell (WBC) count and diabetes risk has been recently suggested. We assessed whether WBC count is an independent risk factor for diabetes incidence among young healthy adults. RESEARCH DESIGN AND METHODS WBC count was measured in 24,897 young (mean age 30.8 ± 5.36 years), normoglycemic men with WBC range of 3,000 to 12,000 cells/mm3. Participants were periodically screened for diabetes during a mean follow-up of 7.5 years. RESULTS During 185,354 person-years of follow-up, diabetes was diagnosed in 447 subjects. A multivariate model adjusted for age, BMI, family history of diabetes, physical activity, and fasting glucose and triglyceride levels revealed a 7.6% increase in incident diabetes for every increment of 1,000 cells/mm3 (P = 0.046). When grouped in quintiles, a baseline WBC count above 6,900 cells/mm3 had an independent 52% increase in diabetes risk (hazard ratio 1.52 [95% CI 1.06–2.18]) compared with the lowest quintile (WBC <5,400 cells/mm3). Men at the lowest WBC quintile were protected from diabetes incidence even in the presence of overweight, family history of diabetes, or elevated triglyceride levels. After simultaneous control for risk factors, BMI was the primary contributor of the variation in multivariate models (P < 0.001)...

‣ Diabetes: eventos agudos na atenção básica

Paese, Fernanda; Vidor, Ana Cristina; Botelho, Lúcio José
Fonte: Universidade Aberta do SUS Publicador: Universidade Aberta do SUS
Publicado em // Português
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Este objeto começa explicando que o diabetes é uma das doenças mais frequentes em pessoas que buscam os serviços de saúde, principalmente na Atenção Básica. Destaca que a grande prevalência de diabetes na população faz com que suas complicações sejam também frequentes, gerando grande demanda aos serviços de saúde. Conceitua os diferentes tipos de diabetes, dentre os quais o diabetes mellitus tipo 1, diabetes mellitus tipo 2, diabetes mellitus gestacional e outros tipos específicos de diabetes. Indica os principais fatores de risco para o desenvolvimento de diabetes tipo 2, pois, além de ser a forma predominante, é também a que apresenta a grande maioria das complicações. Orienta que as principais complicações agudas do diabetes são as hipoglicemias e as hiperglicemias, explicando características da cetoacidose diabética (CAD) e do estado hiperosmolar hiperglicêmico (EHH), mostrando como diagnosticar tais complicações. Detalha que a doença periodontal também é uma complicação aguda muito comum em diabéticos. Afirma que o acesso dos usuários aos recursos médicos adequados deve ser assegurado e explana orientações dietéticas para pessoas com diabetes, além de repassar orientações para a verificação da glicemia capilar e para o monitoramento da terapêutica farmacológica...

‣ Manejo do diabetes: eventos agudos na atenção básica

Paese, Fernanda; Vidor, Ana Cristina; Botelho, Lúcio José
Fonte: Universidade Aberta do SUS Publicador: Universidade Aberta do SUS
Publicado em // Português
Relevância na Pesquisa
36.37005%
Este objeto começa explicando que o diabetes é uma das doenças mais frequentes em pessoas que buscam os serviços de saúde, principalmente na Atenção Básica. Destaca que a grande prevalência de diabetes na população faz com que suas complicações sejam também frequentes, gerando grande demanda aos serviços de saúde. Conceitua os diferentes tipos de diabetes, dentre os quais o diabetes mellitus tipo 1, diabetes mellitus tipo 2, diabetes mellitus gestacional e outros tipos específicos de diabetes. Indica os principais fatores de risco para o desenvolvimento de diabetes tipo 2, pois, além de ser a forma predominante, é também a que apresenta a grande maioria das complicações. Orienta que as principais complicações agudas do diabetes são as hipoglicemias e as hiperglicemias, explicando características da cetoacidose diabética (CAD) e do estado hiperosmolar hiperglicêmico (EHH), mostrando como diagnosticar tais complicações. Detalha que a doença periodontal também é uma complicação aguda muito comum em diabéticos. Afirma que o acesso dos usuários aos recursos médicos adequados deve ser assegurado e explana orientações dietéticas para pessoas com diabetes, além de repassar orientações para a verificação da glicemia capilar e para o monitoramento da terapêutica farmacológica...

‣ Influência do diabetes e da corticoterapia no desenvolvimento da osteonecrose maxilar associada ao uso de alendronato de sódio; Influence of diabetes and corticotherapy in the development of osteonecrosis of the jaws associated with sodium alendronate

Couto, Soraya de Azambuja Berti
Fonte: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre Publicador: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
Tipo: Tese de Doutorado
Português
Relevância na Pesquisa
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A presente pesquisa teve por objetivo verificar a influência da corticoterapia e do diabetes mellitus no desenvolvimento da osteonecrose maxilar associada ao uso de alendronato de sódio em animais de experimentação. A amostra compreendeu 44 ratos fêmeos, da linhagem Wistar, distribuídos aleatoriamente em 4 grupos: (1) 11 ratos tratados com alendronato de sódio (grupo alendronato); (2) 11 ratos tratados com alendronato de sódio e corticoterapia sistêmica (grupo corticosteroide); (3) 11 ratos tratados com alendronato de sódio e submetidos à indução de diabetes mellitus (grupo diabetes); (4) 11 ratos aos quais foi administrada solução salina (grupo-controle). Todos os animais foram submetidos a exodontias dos molares superiores do lado direito uma vez decorridos 90 dias do início do experimento. A eutanásia foi realizada 21 dias após os procedimentos cirúrgicos. Os cortes histológicos foram corados pela técnica de hematoxilina e eosina (H&E) e, subsequentemente, submetidos a processamento imunoistoquímico empregando-se os anticorpos anti-BMP-4 e anti-MMP-13. A avaliação histológica consistiu na análise quantitativa das variáveis: epitélio, tecido conjuntivo, infiltrado inflamatório, restos radiculares, colônias microbianas...

‣ Avaliação do status antioxidante, expressão gênica e polimorfismos dos genes SOD1, SOD2 e GPx1 em crianças, adolescentes e adultos jovens com diabetes tipo 1

Oliveira, Yonara Monique da Costa
Fonte: Universidade Federal do Rio Grande do Norte; BR; UFRN; Programa de Pós-Graduação em Ciências Farmacêuticas; Bioanálises e Medicamentos Publicador: Universidade Federal do Rio Grande do Norte; BR; UFRN; Programa de Pós-Graduação em Ciências Farmacêuticas; Bioanálises e Medicamentos
Tipo: Dissertação Formato: application/pdf
Português
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Studies report that the pathophysiological mechanism of diabetes complications is associated with increased production of Reactive Oxygen Species (ROS)-induced by hyperglycemia and changes in the capacity the antioxidant defense system. In this sense, the aim of this study was to evaluate changes in the capacity of antioxidant defense system, by evaluating antioxidant status, gene expression and polymorphisms in the genes of GPx1, SOD1 and SOD2 in children, adolescents and young adults with type 1 diabetes. We studied 101 individuals with type 1 diabetes (T1D) and 106 normoglycemic individuals (NG) aged between 6 and 20 years. Individuals with type 1 diabetes were evaluated as a whole group and subdivided according to glycemic control in DM1G good glycemic control and DM1P poor glycemic control. Glycemic and metabolic control was evaluate by serum glucose, glycated hemoglobin, triglycerides, total cholesterol and fractions (HDL and LDL). Renal function was assessed by measurement of serum urea and creatinine and albumin-to-creatinine ratio (ACR) in spot urine. Antioxidant status was evaluate by content of reduced glutathione (GSH) in whole blood and the activity of erythrocyte enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD). We also analyzed gene expression and gene polymorphisms of GPx1 (rs1050450)...

‣ Interferência do diabetes mellitus tipo I nos níveis de lactose na transição entre as fases I e II da lactogênese em mulheres puérperas

Oliveira, Angela Maria de Morais
Fonte: Universidade Federal de Uberlândia Publicador: Universidade Federal de Uberlândia
Tipo: Dissertação
Português
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A lactogênese é constituída por duas fases, designadas como I e II. Uma das características da transição entre estas fases é o aumento da concentração de lactose no colostro. Este estudo teve como objetivo avaliar a interferência do diabetes mellitus na transição da lactogênese I para a lactogênese II. Foram avaliadas 11 mulheres puérperas portadoras de diabetes mellitus tipo 1 pré-gestacional e 19 puérperas sem diabetes. Nos cinco primeiros dias após o parto, a cada intervalo de 24 horas, foram coletadas amostras do colostro das mães para análise de seu teor em lactose, por reação com ácido pícrico. Em ambos os grupos houve um aumento progressivo na concentração de lactose com o tempo. A dependência da concentração de lactose com o tempo, após o parto, foi ajustada a uma curva de crescimento sigmoidal que mostrou a transição da lactogênese I para a lactogênese II. A análise desta transição revelou um atraso de 18 horas para início da lactogênese II nas puérperas portadoras de diabetes mellitus com controle metabólico inadequado em relação às puérperas sem diabetes. ______________________________________________________________________________ ABSTRACT; Lactogenesis is constituted by two phases...

‣ Avalia??o da rela??o entre diabetes mellitus e doen?a periodontal: um estudo em pacientes pertencentes ? Casa do Diab?tico no munic?pio de Bel?m-PA

SAITO, Kunihiro
Fonte: Universidade Federal do Pará Publicador: Universidade Federal do Pará
Tipo: Dissertação de Mestrado
Português
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O diabetes mellitus ? uma doen?a caracterizada por anormalidades end?crinas e matab?licas, que resulta em altera??es em muitos setores do organismo. Ao passo que a doen?a periodontal ? uma les?o infecto-inflamat?ria que envolve os tecidos de sustenta??o dos dentes. Conv?m, esclarecer a rela??o entre o diabetes mellitus e a doen?a periodontal por uma associa??o biol?gica, na qual diab?ticos apresentam defici?ncia na resposta org?nica e aumento da suscetibilidade para muitos tipos de infec??o, incluindo a infec??o perioodntal. Este trabalho tem como objetivo comparar indiv?duos com adequado controle metab?lico do diabetes mellitus e indiv?duos com pobre controle glic?mico da doen?a, em diferentes tempos de dura??o do diabetes. Foram avaliados periodontalmente 31 indiv?duos com controle glic?mico adequado e 29 sujeitos com pobre controle metab?lico. Os resultados revelaram que a condi??es de higiene bucal e de inflama??o gengival s?o similares entre os indiv?duos com diferentes anos de diabetes, independente da qualidade do controle metab?lico do diabetes mellitus. A profundidade de sondagem revelou maior severidade em indiv?duos com mais de cinco anos de doen?a, principalmente no grupo com pobre controle glic?mico. Em conclus?o, indiv?duos diab?ticos com mais de cinco anos de dura??o da doen?a e com pobre controle metab?lico do n?vel de glicemia apresentam maiores perdas de estrutura periodontal.; ABSTRACT: Diabetes mellitus is a disease that is characterized by endocrinological and metabolic abnormalities...

‣ Effect of type 2 diabetes on mortality risk associated with end-stage kidney disease

Villar, E.; Polkinghorne, K.; Chang, S.; Chadban, S.; McDonald, S.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
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AIMS/HYPOTHESIS: Patients with end-stage kidney disease (ESKD) and patients with diabetes mellitus experience higher mortality rates than the general population. Whether ESKD imparts the same excess in mortality risk for those with diabetes as it does for those without diabetes is unknown. METHODS: Included in the study were all white patients aged > or =25 years with incident ESKD and type 2 diabetes (n = 4,141) or with incident ESKD but without diabetes (n = 13,289) in Australia from 1991 to 2005, and all the individuals aged > or =25 years without ESKD and with type 2 diabetes (n = 909) or without ESKD without diabetes (n = 10,302) enrolled in the AusDiab Study--a nationwide Australian representative cohort--from 1999 to 2005. Excess mortality was analysed in patients with ESKD by diabetes status, using age-, sex- and diabetes-status-specific standardised mortality ratios (SMRs) in the first 8 years after first renal replacement therapy among ANZDATA patients relative to AusDiab participants. RESULTS: The SMRs in patients with ESKD were, in non-diabetic patients and in those with type 2 diabetes, respectively: 14.2 (95% CI 13.9-14.6) and 10.8 (95% CI 10.4-11.2) (p < 0.01); in people aged <60 years, 28.7 (95% CI 27.2-30.4) and 18.6 (95% CI 17.1-20.4) (p < 0.01); in people aged > or =60 years...

‣ The status and perspective of diabetes health education in China : inspiration from Australia

Wilson, A.; Gyi, A.
Fonte: Blackwell Science Asia Pty Ltd Publicador: Blackwell Science Asia Pty Ltd
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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This paper discusses possible approaches to improving diabetes care and developing effective education models in China based on the experience of diabetes education in Australia. The prevalence of diabetes mellitus in China is increasing rapidly. China is currently second on the list of the top 10 countries with the highest diabetes burden. Enormous impact of diabetes on China health system is daunting and the urgent action is needed. Diabetes education is the keystone of diabetes care and structured self-management education is considered to be the key to successful outcomes. Although many diabetes education programmes have been initiated in China, barriers have been identified for implementation of the programmes. These include: lack of public awareness of diabetes; lack of standards of practice for diabetes educators; and lack of evaluation programmes to assess their performance. We suggest four possible approaches to addressing the current problems of diabetes education in China.; Anne Wilson, Aye Aye Gyi

‣ U-shape association between white blood cell count and the risk of diabetes in young Chinese adults

Du, X.; Zhu, B.; Hu, G.; Mao, W.; Wang, S.; Zhang, H.; Wang, F.; Shi, Z.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
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Background: Chronic low-grade inflammation is related to diabetes risk in population studies. Elevated levels of white blood cells (WBC) were related to the risk of diabetes in cross-sectional studies in the Chinese population. The objective of the study is to assess the prospective association between WBC and the risk of diabetes in the Chinese population. Methods: We examined 7445 manual workers aged 18–59 years free from diabetes at baseline. Fasting glucose concentrations and white cell count were measured at annual health examinations from 1997 to 2007. Anthropometric measurements were taken by health workers. In the present study, each participant had at least two measurements of fasting blood glucose. Results: During a mean of 4.94 years follow-up, 178 participants developed diabetes. After controlling for known risk factors for diabetes (age, gender, smoking, drinking, parental history of diabetes, body mass index, systolic blood pressure, hepatitis B surface antigen and liver function), a U-shaped association between WBC count and diabetes was found. The hazard ratios (HR) of diabetes across quartiles of WBC count were 1.87 (95% CI 1.15–3.05), 1.00, 1.46 (0.88–2.42) and 2.04 (1.28–3.25). The association was stronger among non-smokers: compared with the second quartile...

‣ The DIAMIND study: postpartum SMS reminders to women who have had gestational diabetes mellitus to test for type 2 diabetes: a randomised controlled trial - study protocol

Heatley, E.; Middleton, P.; Hague, W.; Crowther, C.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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BACKGROUND Postpartum follow up of women who have been found to have gestational diabetes during pregnancy is essential because of the strong association of gestational diabetes with subsequent type 2 diabetes. Postal reminders have been shown to increase significantly attendance for oral glucose tolerance testing postpartum. It is possible that a short message service (text) reminder system may also be effective. This trial aims to assess whether a text message reminder system for women who have experienced gestational diabetes in their index pregnancy will increase attendance for oral glucose tolerance testing within six months after birth. METHODS/DESIGN Design: Single centre (Women’s and Children’s Hospital, South Australia), parallel group randomised controlled trial. Inclusion criteria: Women diagnosed with gestational diabetes in their index pregnancy (oral glucose tolerance test with fasting glucose ≥ 5.5 mmol/L and/or two hour glucose ≥ 7.8 mmol/L), with access to a mobile phone, whose capillary blood glucose profile measurements prior to postnatal discharge are all normal (fasting glucose < 6.0 mmol/L, postprandial glucoses < 8.0 mmol/L). Exclusion criteria: Pregestational diabetes mellitus, triplet/higher order multiple birth or stillbirth in the index pregnancy...

‣ Señales neurohormonales tras gastrectomía tubular y by-pass gástrico: implicación en la pérdida de peso y resolución de la diabetes mellitus tipo 2

Navarro García, María Inmaculada
Fonte: Universidade de Múrcia Publicador: Universidade de Múrcia
Tipo: Tese de Doutorado Formato: application/pdf
Português
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36.37005%
PALABRAS CLAVE: Cirugía bariatrica.Gastrectomía tubular laparoscópica.Bypass gástrico laparoscópico. Pérdida de exceso de peso.Diabetes Mellitus. Hormonas gastrointestinales.Ghrelina.GLP-1.PYY. SEÑALES NEUROHORMONALES TRAS GASTRECTOMÍA TUBULAR Y BY-PASS GÁSTRICO.IMPLICACIÓN EN LA PÉRDIDA DE PESO Y RESOLUCIÓN DE LA DIABETES MELLITUS TIPO 2. OBJETIVO Nuestro objetivo fue comparar la técnica gastrectomía tubular (GT) con el by-pass gástrico (BP),en cuanto a la pérdida ponderal y resolución de comorbilidades. Analizando los marcadores del síndrome metabólico y las modificaciones hormonales en ayunas con ambos procedimientos. MATERIAL Y MÉTODO El estudio se realizó en el Servicio de Cirugía General del Complejo Hospitalario de Cartagena,entre 2011-2013 y un seguimiento de 24 meses.Estudio observacional de cohortes analíticas prospectivo consecutivo,donde se diseñaron dos grupos de estudio distribuidos de forma no aleatoria: grupo A (100 pacientes BP),y grupo B (100 pacientes GT).Los criterios de inclusión fueron los utilizados por la Sociedad Española de Cirugía de la Obesidad (SECO).La asignación de los pacientes a un determinado grupo se realizó siempre en el mismo orden y según fecha de inclusión en lista de espera quirúrgica. En el protocolo de estudio de incluyeron:datos demográficos (edad y sexo); variables clínicas preoperatorias (peso...

‣ The impact of new echocardiographic techniques to detect myocardial dysfunction in asymptomatic type 1 diabetes mellitus : insight myocardial deformation and three dimensional echocardiography; Impacto de nuevas técnicas ecocardiográficas para la detección de disfunción miocárdica en la diabetes mellitus tipo 1 asintomática : papel de la deformación miocárdica y la ecocardiografía tridimensional

Ruisanchez Villar, Cristina
Fonte: Universidade de Cantabria Publicador: Universidade de Cantabria
Tipo: Tese de Doutorado
Português
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RESUMEN: Introducción y objetivos. El posible efecto deletéreo del control metabólico crónico y la microalbuminuria sobre el miocardio en la diabetes mellitus tipo 1 (DM1) es controvertido. El presente estudio evalúa la presencia de disfunción miocárdica subclínica en el diabético joven utilizando speckle tracking bidimensional (2D-ST) y ecocardiografía tridimensional, así como la influencia de la duración de la enfermedad, la hemoglobina glicosilada (HbA1C) media de 1 año y la microalbuminuria sobre parámetros sensibles de función cardíaca. Métodos y resultados. Comparamos 70 adultos jóvenes con diabetes tipo 1 con 81 voluntarios sanos. Utilizamos 2D-ST para medir la deformación o strain longitudinal global (SL) como marcador de función sistólica y el pico E de la tasa de deformación longitudinal o strain rate (E SR) para evaluar la función diastólica del VI. Tanto el SL (p<0,001) como la onda E SR (p<0,001) fueron significativamente inferiores en los diabéticos respecto al grupo de controles sanos. Encontramos una asociación estadísticamente significativa entre la HbA1c y el SL (p=0.01), y E SR longitudinal (p=0.001), siendo en el análisis de regresión multivariante el factor más fuertemente relacionado con ambos parámetros de función miocárdica sistólica (p=0.01) y diastólica (p=0.001). La duración de la diabetes así como la presencia de microalbuminuria no mostraron ser factores independientes asociados con el SL. Conclusión. Pacientes jóvenes con DM tipo 1 y FE normal presentan signos precoces de disfunción miocárdica utilizando 2D-ST. Un control metabólico pobre (HbA1c anual) parece influir negativamente sobre estos parámetros sensibles de función cardíaca.; ABSTRACT: Background: Echocardiography has contributed to reveal a distinct diabetic cardiomyopathy in type 1 Diabetes Mellitus; however detection of early stages is still an unmet clinical need. Our aim was to study the utility of novel sensitive echocardiographic techniques to detect subclinical myocardial dysfunction in asymptomatic type 1 diabetes mellitus and whether the metabolic status is of influence. Methods and results: 70 asymptomatic type 1 diabetes mellitus patients were compared with 81 healthy volunteers. All participants underwent a full conventional echocardiographic study. Left ventricular ejection fraction (LVEF) was evaluated on two-dimensional (2D) and 3-dimensional (3D) echocardiogram. We used 2D-speckle tracking to analyse LV global longitudinal myocardial strain (GLS) as a surrogate of LV systolic function...

‣ Mature onset diabetes of the young (MODY).; Mature onset diabetes of the young (MODY).

Nobre, E Lacerda; Serviços de Endocrinologia Diabetes e Metabolismo, Serviço de Patologia Clínica, Hospital Militar Principal, Lisboa, Portugal.; Lopes, L Oliveira; Miranda, A; Pragosa, M; de Castro, J Jácome
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 31/12/2002 Português
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Maturity-onset diabetes of the young (MODY) is a rare form of juvenile diabetes mellitus, defined by early onset, absence of ketosis, non-insulin-dependent diabetes and autosomal dominant inheritance. Advances in molecular genetic analysis have identified mutations accounting for different MODY subtypes, all of them associated with defects of insulin secretion. We present a case of a nine year-old boy, admitted to our outpatient clinic because of mild and intermittent osmotic symptoms (polyuria, polyphagia and polydipsia) and persistently high values of fasting blood glucose in the last year. He had a family history of diabetes in three consecutive generations compatible with autossomal dominant inheritance. His height was 138.5 cm (90th centile) and his weight was 33.5 Kg (90th centile). General examination was unremarkable, in a prepubertal boy. A standard oral glucose tolerance test was performed. The fasting blood glucose was 118 mg/dl with a two hour value of 160 mg/dl. ICA, IAA and GAD autoantibodies were undetectable. He started on diet therapy, keeping his fasting blood glucose measurements on the upper limits of normal and HbA1c in the normal range. He was diagnosed as having MODY 2 on a clinical basis, as it is not possible to perform molecular analysis of this pathology in Portugal. As MODY is recently thought to account for 2-5% of all cases of type 2 Diabetes Mellitus it is important to consider it as a possible diagnosis in children who present with incidental hyperglycaemia. Molecular genetic testing is very important as it enables us to make a firm diagnosis of MODY...

‣ Friedreich ataxia and diabetes mellitus--family study.; Ataxia de friedreich e diabetes mellitus. Estudo de uma Família.

Melo, Miguel; Serviço de Endocrinologia, Diabetes e Metabolismo, Hospitais da Universidade de Coimbra, Coimbra.; Fagulha, Ana; Barros, Luisa; Guimarães, Joana; Carrilho, Francisco; Carvalheiro, Manuela
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 31/12/2005 Português
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Friedreich's ataxia (FA) is one of the genetic syndromes sometimes associated with diabetes and the most common hereditary ataxia. It is a autosomal recessive neurodegenerative disease, caused by a mutation in the FRDA gene, which originates decreased expression of frataxin, a mitochondrial protein involved in iron metabolism. The disorder is usually manifest in childhood and is characterised by ataxia, dysarthria, scoliosis and feet deformity. About two thirds of patients have hypertrophic cardiomyopathy, 10% have diabetes and 20% have another glucose homeostasis disorder. Both insulin resistance and beta-cell dysfunction are implicated in this patients' diabetes pathophysiology. The mean half-life is 35 years. Cause of death is usually related to cardiomyopathy or diabetes' complications. We report the case study of two twin sisters with 28 years old, in whom FA was diagnosed in the first decade, both of them with diabetes since their early twenties. A third sister with FA is reported, with no glucose homeostasis disorder. They also have two healthy male brothers. Based in this cases, the FA associated diabetes pathophysiology is discussed, concerning the therapeutic approach to these patients and to their diabetic relatives without neurologic symptoms. The role of molecular genetic testing and genetic counselling are also debated.; Friedreich's ataxia (FA) is one of the genetic syndromes sometimes associated with diabetes and the most common hereditary ataxia. It is a autosomal recessive neurodegenerative disease...