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‣ Estado nutricional e metabólico de pacientes gastrectomizados e colectomizados por câncer clinicamente curados com e sem diabetes mellitus: impacto da homeostase glicídica sobre variáveis clínicas e bioquímicas; Nutritional and metabolic status of clinically cured patients submitted to gastrectomy and to colorectal surgery for cancer with or without diabetes mellitus: impact of glucose homeostasis on clinical and biochemical variables

Hayashi, Silvia Yoko
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/01/2014 Português
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O rearranjo da anatomia gastrointestinal é atualmente o foco de estudos para a remissão e cura do diabetes mellitus tipo 2. Há evidências a favor da melhora desta comorbidade após a gastrectomia em pacientes não obesos, entretanto sem análise de longo prazo. O intestino grosso, como integrante do aparelho digestório e potencialmente produtor de incretinas, ainda não foi estudado em relação à influência de sua retirada (colectomia) no desfecho do diabetes. Nestas circunstâncias, faz-se necessário um estudo em longo prazo destas duas cirurgias na homeostase glicídica. Objetivos: Analisar a resposta em longo prazo do diabetes e pré-diabetes pré-existentes após gastrectomia, bem como, colectomia por câncer. Métodos: Foram analisados pacientes adultos submetidos à gastrectomia subtotal e total (Y de Roux) por câncer gástrico e colectomia (direita ou retossigmoidectomia) por câncer de colo e reto há mais de 3 anos e sem sinais de doença em atividade. Incluíram-se controles nas duas situações de pós-operatório tardio com homeostase glicídica normal, a fim de averiguar também sua evolução em longo prazo. Agregou-se ainda um grupo controle pré-operatório atual constituído de doentes diabéticos com câncer gástrico...

‣ A saúde e os estilos de vida dos jovens com diabetes tipo I

Andrade, Maria de Lurdes Monteiro Serrabulho
Fonte: Universidade Técnica de Lisboa Publicador: Universidade Técnica de Lisboa
Tipo: Tese de Doutorado
Publicado em //2014 Português
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Doutoramento em Ciências da Educação, especialidade Educação para a Saúde; As constantes mudanças sociais, ocupacionais, familiares e emocionais na vida dos jovens adultos com diabetes tipo 1 podem afetar a adesão ao tratamento da diabetes e a qualidade de vida dos jovens. Pretende-se com este estudo conhecer os comportamentos de saúde, estilos de vida, competências pessoais e sociais, suporte social, satisfação com a vida, adesão ao tratamento, representações sobre a doença e adaptação psicológica à diabetes dos jovens adultos com diabetes tipo 1, assim como as suas representações, perceções e opiniões em relação à vida e à diabetes. Foi realizado um estudo quantitativo, com aplicação de questionários a 278 jovens adultos com diabetes tipo 1 (18 - 35 anos), tendo sido organizados 7 estudos com base nesses resultados, e um estudo qualitativo, com utilização de grupos focais, em que participaram 30 jovens (18 - 34 anos). Verificou-se que, apesar das dificuldades inerentes a esta fase da vida, a maior parte dos jovens adultos com diabetes tipo 1 apresenta boas competências pessoais e sociais, bom suporte social e satisfação com a vida, representações positivas sobre a diabetes e boa adaptação psicológica à diabetes. A maior parte dos jovens não revela sintomas de ansiedade...

‣ Immunomodulation by Mesenchymal Stem Cells : A Potential Therapeutic Strategy for Type 1 Diabetes

Abdi, Reza; Fiorina, Paolo; Adra, Chaker N.; Atkinson, Mark; Sayegh, Mohamed H.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em /07/2008 Português
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Mesenchymal stem cells (MSCs) are pluripotent stromal cells that have the potential to give rise to cells of diverse lineages. Interestingly, MSCs can be found in virtually all postnatal tissues. The main criteria currently used to characterize and identify these cells are the capacity for self-renewal and differentiation into tissues of mesodermal origin, combined with a lack in expression of certain hematopoietic molecules. Because of their developmental plasticity, the notion of MSC-based therapeutic intervention has become an emerging strategy for the replacement of injured tissues. MSCs have also been noted to possess the ability to impart profound immunomodulatory effects in vivo. Indeed, some of the initial observations regarding MSC protection from tissue injury once thought mediated by tissue regeneration may, in reality, result from immunomodulation. Whereas the exact mechanisms underlying the immunomodulatory functions of MSC remain largely unknown, these cells have been exploited in a variety of clinical trials aimed at reducing the burden of immune-mediated disease. This article focuses on recent advances that have broadened our understanding of the immunomodulatory properties of MSC and provides insight as to their potential for clinical use as a cell-based therapy for immune-mediated disorders and...

‣ Anatomical Locations of Human Brown Adipose Tissue: Functional Relevance and Implications in Obesity and Type 2 Diabetes

Sacks, Harold; Symonds, Michael E.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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We will review information about and present hypotheses as to the anatomy of brown adipose tissue (BAT). Why is it located where it is in humans? Its anatomical distribution is likely to confer survival value by protecting critical organs from hypothermia by adaptive thermogenesis. Ultimately, the location and function will be important when considering therapeutic strategies for preventing and treating obesity and type 2 diabetes, in which case successful interventions will need to have a significant effect on BAT function in subjects living in a thermoneutral environment. In view of the diverse locations and potential differences in responsiveness between BAT depots, it is likely that BAT will be shown to have much more subtle and thus previously overlooked functions and regulatory control mechanisms.

‣ AMPK: A Target for Drugs and Natural Products With Effects on Both Diabetes and Cancer

Hardie, D. Grahame
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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The AMP-activated protein kinase (AMPK) is a highly conserved sensor of cellular energy that appears to have arisen at an early stage during eukaryotic evolution. In 2001 it was shown to be activated by metformin, currently the major drug for treatment for type 2 diabetes. Although the known metabolic effects of AMPK activation are consistent with the idea that it mediates some of the therapeutic benefits of metformin, as discussed below it now appears unlikely that AMPK is the sole target of the drug. AMPK is also activated by several natural plant products derived from traditional medicines, and the mechanisms by which they activate AMPK are discussed. One of these is salicylate, probably the oldest medicinal agent known to humankind. The salicylate prodrug salsalate has been shown to improve metabolic parameters in subjects with insulin resistance and prediabetes, and whether this might be mediated in part by AMPK is discussed. Interestingly, there is evidence that both metformin and aspirin provide some protection against development of cancer in humans, and whether AMPK might be involved in these effects is also discussed.

‣ Population comparison of two clinical approaches to the metabolic syndrome : Implications of the new International Diabetes Federation consensus definition

Adams, R.; Appleton, S.; Wilson, D.; Taylor, A.; DalGrande, E.; Chittleborough, C.; Gill, T.; Ruffin, R.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
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Robert J. Adams, Sarah Appleton, David H. Wilson, Anne W. Taylor, Eleonora Dal Grande, Catherine Chittleborough, Tiffany Gill, and Richard Ruffin; © 2005 by the American Diabetes Association

‣ Effect of treatment of gestational diabetes mellitus on obesity in the next generation

Gillman, M.; Oakey, H.; Baghurst, P.; Volkmer, R.; Robinson, J.; Crowther, C.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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OBJECTIVE--Gestational diabetes mellitus (GDM) may cause obesity in the offspring. The objective was to assess the effect of treatment for mild GDM on the BMI of 4- to 5-year-old children. RESEARCH DESIGN AND METHODS--Participants were 199 mothers who participated in a randomized controlled trial of the treatment of mild GDM during pregnancy and their children. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance program in the state of South Australia. The main outcome measure was age- and sex-specific BMI Z score based on standards of the International Obesity Task Force. RESULTS--At birth, prevalence of macrosomia (birth weight [greater than or equal to] 4,000 g) was 5.3% among the 94 children whose mothers were in the intervention group, and 21.9% among the 105 children in the routine care control group. At 4- to 5-years-old, mean (SD) BMI Z score was 0.49 (1.20) in intervention children and 0.41 (1.40) among controls. The difference between treatment groups was 0.08 (95% CI -0.29 to 0.44), an estimate minimally changed by adjustment for maternal race, parity, age, and socio-economic index (0.08 [-0.29 to 0.45]). Evaluating BMI [greater than or equal to] 85th percentile rather than continuous BMI Z score gave similarly null results. CONCLUSIONS--Although treatment of GDM substantially reduced macrosomia at birth...

‣ A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with Type 2 diabetes

Wycherley, T.; Noakes, M.; Clifton, P.; Cleanthous, X.; Keogh, J.; Brinkworth, G.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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OBJECTIVE: To evaluate the effects of two low-fat hypocaloric diets differing in the carbohydrate-to-protein ratio, with and without resistance exercise training (RT), on weight loss, body composition, and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 83 men and women with type 2 diabetes (aged 56.1 ± 7.5 years, BMI 35.4 ± 4.6 kg/m2) were randomly assigned to an isocaloric, energy-restricted diet (female subjects 6 MJ/day, male subjects 7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3 days/week) for 16 weeks. Body weight and composition, waist circumference (WC), and cardiometabolic risk markers were assessed. RESULTS: Fifty-nine participants completed the study. There was a significant group effect (P ≤ 0.04) for body weight, fat mass, and WC with the greatest reductions occuring in HP+RT (weight [CON: −8.6 ± 4.6 kg, HP: −9.0 ± 4.8 kg, CON+RT: −10.5 ± 5.1 kg, HP+RT: −13.8 ± 6.0 kg], fat mass [CON: −6.4 ± 3.4 kg, HP: −6.7 ± 4.0 kg, CON+RT: −7.9 ± 3.7 kg, HP+RT: −11.1 ± 3.7 kg], and WC [CON: −8.2 ± 4.6 cm, HP: −8.9 ± 3.9 cm...

‣ Effects of a D-xylose preload with or without sitagliptin on gastric emptying, glucagon-like peptide-1, and postprandial glycemia in type 2 diabetes

Wu, T.; Bound, M.; Zhao, R.; Standfield, S.; Bellon, M.; Jones, K.; Horowitz, M.; Rayner, C.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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OBJECTIVE Macronutrient “preloads” can reduce postprandial glycemia by slowing gastric emptying and stimulating glucagon-like peptide-1 (GLP-1) secretion. An ideal preload would entail minimal additional energy intake and might be optimized by concurrent inhibition of dipeptidyl peptidase-4 (DPP-4). We evaluated the effects of a low-energy d-xylose preload, with or without sitagliptin, on gastric emptying, plasma intact GLP-1 concentrations, and postprandial glycemia in type 2 diabetes. RESEARCH DESIGN AND METHODS Twelve type 2 diabetic patients were studied on four occasions each. After 100 mg sitagliptin (S) or placebo (P) and an overnight fast, patients consumed a preload drink containing either 50 g d-xylose (X) or 80 mg sucralose (control [C]), followed after 40 min by a mashed potato meal labeled with 13C-octanoate. Blood was sampled at intervals. Gastric emptying was determined. RESULTS Both peak blood glucose and the amplitude of glycemic excursion were lower after PX and SC than PC (P < 0.01 for each) and were lowest after SX (P < 0.05 for each), while overall blood glucose was lower after SX than PC (P < 0.05). The postprandial insulin-to-glucose ratio was attenuated (P < 0.05) and gastric emptying was slower (P < 0.01) after d-xylose...

‣ Effects of intraduodenal glutamine on incretin hormone and insulin release, the glycemic response to an intraduodenal glucose infusion, and antropyloroduodenal motility in health and type 2 diabetes

Chang, J.; Wu, T.; Greenfield, J.; Samocha-Bonet, D.; Horowitz, M.; Rayner, C.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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OBJECTIVE Glutamine reduces postprandial glycemia when given before oral glucose. We evaluated whether this is mediated by stimulation of insulin and/or slowing of gastric emptying. RESEARCH DESIGN AND METHODS Ten healthy subjects were studied during intraduodenal (ID) infusion of glutamine (7.5 or 15 g) or saline over 30 min, followed by glucose (75 g over 100 min), while recording antropyloroduodenal pressures. Ten patients with type 2 diabetes mellitus (T2DM) were also studied with 15 g glutamine or saline. RESULTS ID glutamine stimulated glucagon-like peptide 1 (GLP-1; healthy: P < 0.05; T2DM: P < 0.05), glucose-dependent insulinotropic polypeptide (GIP; P = 0.098; P < 0.05), glucagon (P < 0.01; P < 0.001), insulin (P = 0.05; P < 0.01), and phasic pyloric pressures (P < 0.05; P < 0.05), but did not lower blood glucose (P = 0.077; P = 0.5). CONCLUSIONS Glutamine does not lower glycemia after ID glucose, despite stimulating GLP-1, GIP, and insulin, probably due to increased glucagon. Its capacity for pyloric stimulation suggests that delayed gastric emptying is a major mechanism for lowering glycemia when glutamine is given before oral glucose.; Jessica Chang, Tongzhi Wu, Jerry R. Greenfield, Dorit Samocha-Bonet, Michael Horowitz...

‣ Effects of sitagliptin on glycemia, incretin hormones, and antropyloroduodenal motility in response to intraduodenal glucose infusion in healthy lean and obese humans and patients with type 2 diabetes treated with or without metformin

Wu, T.; Ma, J.; Bound, M.J.; Checklin, H.; Deacon, C.F.; Jones, K.L.; Horowitz, M.; Rayner, C.K.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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The impact of variations in gastric emptying, which influence the magnitude of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) secretion, on glucose lowering by dipeptidyl peptidase-4 (DPP-4) inhibitors is unclear. We evaluated responses to intraduodenal glucose infusion (60 g over 120 min [i.e., 2 kcal/min], a rate that predominantly stimulates GIP but not GLP-1) after sitagliptin versus control in 12 healthy lean, 12 obese, and 12 type 2 diabetic subjects taking metformin 850 mg b.i.d. versus placebo. As expected, sitagliptin augmented plasma-intact GIP substantially and intact GLP-1 modestly. Sitagliptin attenuated glycemic excursions in healthy lean and obese but not type 2 diabetic subjects, without affecting glucagon or energy intake. In contrast, metformin reduced fasting and glucose-stimulated glycemia, suppressed energy intake, and augmented total and intact GLP-1, total GIP, and glucagon in type 2 diabetic subjects, with no additional glucose lowering when combined with sitagliptin. These observations indicate that in type 2 diabetes, 1) the capacity of endogenous GIP to lower blood glucose is impaired; 2) the effect of DPP-4 inhibition on glycemia is likely to depend on adequate endogenous GLP-1 release...

‣ Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes

Strawbridge, R.; Dupuis, J.; Prokopenko, I.; Barker, A.; Ahlqvist, E.; Rybin, D.; Petrie, J.; Travers, M.; Bouatia-Naji, N.; Dimas, A.; Nica, A.; Wheeler, E.; Chen, H.; Voight, B.; Taneera, J.; Kanoni, S.; Peden, J.; Turrini, F.; Gustafsson, S.; Zabena, C
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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OBJECTIVE Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10−8). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10−4), improved β-cell function (P = 1.1 × 10−5), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10−6). Notably...

‣ A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial

Tay, J.; Luscombe-Marsh, N.D.; Thompson, C.H.; Noakes, M.; Buckley, J.D.; Wittert, G.A.; Yancy, W.S.; Brinkworth, G.D.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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OBJECTIVE: To comprehensively compare the effects of a very low-carbohydrate, high-unsaturated/low-saturated fat diet (LC) with those of a high-unrefined carbohydrate, low-fat diet (HC) on glycemic control and cardiovascular disease (CVD) risk factors in type 2 diabetes (T₂DM). RESEARCH DESIGN AND METHODS: Obese adults (n = 115, BMI 34.4 ± 4.2 kg/m², age 58 ± 7 years) with T₂DM were randomized to a hypocaloric LC diet (14% carbohydrate [<50 g/day], 28% protein, and 58% fat [<10% saturated fat]) or an energy-matched HC diet (53% carbohydrate, 17% protein, and 30% fat [<10% saturated fat]) combined with structured exercise for 24 weeks. The outcomes measured were as follows: glycosylated hemoglobin (HbA₁ₑ), glycemic variability (GV; assessed by 48-h continuous glucose monitoring), antiglycemic medication changes (antiglycemic medication effects score [MES]), and blood lipids and pressure. RESULTS: A total of 93 participants completed 24 weeks. Both groups achieved similar completion rates (LC 79%, HC 82%) and weight loss (LC -12.0 ± 6.3 kg, HC -11.5 ± 5.5 kg); P ≥ 0.50. Blood pressure (-9.8/-7.3 ± 11.6/6.8 mmHg), fasting blood glucose (-1.4 ± 2.3 mmol/L), and LDL cholesterol (-0.3 ± 0.6 mmol/L) decreased, with no diet effect (P ≥ 0.10). LC achieved greater reductions in triglycerides (-0.5 ± 0.5 vs. -0.1 ± 0.5 mmol/L)...

‣ Small intestinal glucose exposure determines the magnitude of the incretin effect in health and type 2 diabetes

Marathe, C.S.; Rayner, C.K.; Bound, M.; Checklin, H.; Standfield, S.; Wishart, J.; Lange, K.; Jones, K.L.; Horowitz, M.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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The potential influence of gastric emptying on the "incretin effect," mediated by glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), is unknown. The objectives of this study were to determine the effects of intraduodenal (ID) glucose infusions at 2 (ID2) and 4 (ID4) kcal/min (equating to two rates of gastric emptying within the physiological range) on the size of the incretin effect, gastrointestinal glucose disposal (GIGD), plasma GIP, GLP-1, and glucagon secretion in health and type 2 diabetes. We studied 10 male BMI-matched controls and 11 male type 2 patients managed by diet or metformin only. In both groups, GIP, GLP-1, and the magnitude of incretin effect were greater with ID4 than ID2, as was GIGD; plasma glucagon was suppressed by ID2, but not ID4. There was no difference in the incretin effect between the two groups. Based on these data, we conclude that the rate of small intestinal glucose exposure (i.e., glucose load) is a major determinant of the comparative secretion of GIP and GLP-1, as well as the magnitude of the incretin effect and GIGD in health and type 2 diabetes.; Chinmay S. Marathe, Christopher K. Rayner, Michelle Bound, Helen Checklin, Scott Standfield, Judith Wishart, Kylie Lange...

‣ Relationship between urinary sodium excretion over time and mortality in type 2 diabetes

Ekinci, E.I.; Moran, J.L.; Thomas, M.C.; Cheong, K.; Clarke, S.; Chen, A.; Dobson, M.; Leong, A.; MacIsaac, R.J.; Jerums, G.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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Elif I. Ekinci, John L. Moran, Merlin C. Thomas, Karey Cheong, Sophie Clarke, Angela Chen, Matt Dobson, Amanda Leong, Richard J. MacIsaac, and George Jerums; Prior Presentation. This study was presented in abstract form at the 73rd Scientific Sessions of the American Diabetes Association, Chicago, IL, 21–25 June 2013.

‣ Typ-2-Diabetes: Assoziationsstudie zur Identifizierung erblicher Risikofaktoren und Ermittlung mit Typ-2-Diabetes in Zusammenhang stehender parentaler Krebs-Risiken; Type 2 diabetes: association study for identification of hereditary risk factors and determination of type 2 diabetes associated parental cancer risks

Zürn, Christine Stefanie
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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Der Typ-2-Diabetes wird als multifaktorielles Krankheitsbild durch die Interaktion von erblichen Merkmalen mit diversen Risikofaktoren hervorgerufen. Während Risikofaktoren wie beispielsweise Adipositas, Bewegungsmangel und Nikotinabusus weitgehend aufgeklärt sind, liegt die komplexe Genetik dieser Erkrankung noch weitgehend im Dunkeln, da bisher nur wenige und dann überwiegend bevölkerungsspezifische Suszeptibilitätsgene identifiziert werden konnten. Ziel der vorliegenden Untersuchung war die Identifikation bisher unbekannter mit Typ-2-Diabetes vergesellschafteter molekulargenetischer Marker und die Überprüfung der Relevanz von Polymorphismen in bereits bekannten Typ-2-Diabetes-Kandidatengenen in unserer Population. Im Rahmen einer Fall-Kontroll-Studie wurde eine Typ-2-Diabetesgruppe und eine Kontrollgruppe aus Blutspendern zusammengestellt. Zur Untersuchung erblicher Faktoren für den Typ-2-Diabetes wurden ca. 1.560 genomisch-weit verteilte Polymorphismen herangezogen. Außerdem wurden fünf Polymorphismen in Typ-2-Diabetes-spezifischen Kandidatengenregionen individuell genotypisiert. Die Genotypisierung erfolgte mittels MALDI-TOF-Massenspektrometrie, wobei zum einen vier DNA-Pools gebildet und zum anderen individuelle DNA-Proben der Studienteilnehmer verwendet wurden. Bei der Untersuchung der erblichen Faktoren für den Typ-2-Diabetes konnten aus den genomisch-weit verteilten ca. 1.560 SNPs bei den Frauen 20 und bei den Männern 5 Polymorphismen signifikant mit Typ-2-Diabetes assoziiert werden. Diese SNPs liegen in den bisher noch nicht mit Typ-2-Diabetes in Zusammenhang gesehenen Genen HLA-B...

‣ Determinants of maternal triglycerides in women with gestational diabetes mellitus in the Metformin in Gestational Diabetes (MiG) study

Barrett, H.; Nitert, M.; Jones, L.; O'Rourke, P.; Lust, K.; Gatford, K.; De Blasio, M.; Coat, S.; Owens, J.; Hague, W.; McIntyre, H.; Callaway, L.; Rowan, J.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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OBJECTIVE Factors associated with increasing maternal triglyceride concentrations in late pregnancy include gestational age, obesity, preeclampsia, and altered glucose metabolism. In a subgroup of women in the Metformin in Gestational Diabetes (MiG) trial, maternal plasma triglycerides increased more between enrollment (30 weeks) and 36 weeks in those treated with metformin compared with insulin. The aim of this study was to explain this finding by examining factors potentially related to triglycerides in these women. RESEARCH DESIGN AND METHODS Of the 733 women randomized to metformin or insulin in the MiG trial, 432 (219 metformin and 213 insulin) had fasting plasma triglycerides measured at enrollment and at 36 weeks. Factors associated with maternal triglycerides were assessed using general linear modeling. RESULTS Mean plasma triglyceride concentrations were 2.43 (95% CI 2.35–2.51) mmol/L at enrollment. Triglycerides were higher at 36 weeks in women randomized to metformin (2.94 [2.80–3.08] mmol/L; +23.13% [18.72–27.53%]) than insulin (2.65 [2.54–2.77] mmol/L, P = 0.002; +14.36% [10.91–17.82%], P = 0.002). At 36 weeks, triglycerides were associated with HbA1c (P = 0.03), ethnicity (P = 0.001), and treatment allocation (P = 0.005). In insulin-treated women...

‣ Changes in insulin resistance and Hba(1C) are related to exercise-mediated changes in body composition in older adults with type 2 diabetes

Mavros, Y.; Kay, S.; Anderberg, K.; Baker, M.; Wang, Y.; Zhao, R.; Meiklejohn, J.; Climstein, M.; O'Sullivan, A.; de Vos, N.; Baune, B.; Blair, S.; Simar, D.; Rooney, K.; Singh, N.; Fiatarone-Singh, M.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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OBJECTIVE To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes. RESEARCH DESIGN AND METHODS One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography. RESULTS Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r = −0.38; P = 0.04) and fat mass (r = 0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0.05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group. CONCLUSIONS Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.; Yorgi Mavros...

‣ Diabetes: An Investor's Perspective

Harris, Bernard
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em /03/2008 Português
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Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise. Moreover, the baby boomer demographic is anticipated to place an enormous burden on the health care system and employer-based health insurance premiums were increased at rates as high as 10% per year in 2006.

‣ ANALYSIS: Mobile Phones Integrated into Diabetes Management: A Logical Progression

Malasanos, Toree
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em /01/2008 Português
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In this issue of Journal of Diabetes Science and Technology, the intervention described by D. Katz, “Novel Interactive Cell-Phone Technology for Health Enhancement,” uses cell phones to provide the rapid communication necessary for the support of intensive management of diabetes. Mobile technology is widely accepted in today's society and can be an effective tool for this cause. There have been numerous interventions using various communication tools, including cell phones, to manage chronic disease, which all propose that improved communication and feedback to patients would improve health status. Dr. Katz has taken the next step by giving semiautomated, real-time, immediate feedback on each data point all transmitted by cell phone.