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‣ Doença cardiovascular no diabetes melito tipo 1; Cardiovascular disease in type 1 diabetes mellitus

WAJCHENBERG, Bernardo Léo; RASSI, Nelson; FEITOSA, Alina Coutinho R.; LERÁRIO, Antonio Carlos; BETTI, Roberto Tadeu Barcelos
Fonte: Sociedade Brasileira de Endocrinologia e Metabologia Publicador: Sociedade Brasileira de Endocrinologia e Metabologia
Tipo: Artigo de Revista Científica
Português
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O risco de doença arterial coronariana (DAC) nos pacientes com diabetes melito tipo 1 (DM1) é conhecido desde o final dos anos 1970, sendo atualmente a principal causa de mortalidade na população adulta com diabetes tipo 1 de longa duração. A patogênese do processo aterosclerótico nesta doença ainda é obscura, acreditando-se que a hiperglicemia desenvolva aí um papel importante, entretanto vários estudos epidemiológicos mostraram que a associação entre doença coronariana e glicemia, em pacientes com DM1 seja fraca. Dados recentes do estudo DCCT/EDIC mostram que o grupo que recebeu tratamento insulínico intensificado durante o DCCT desenvolveu graus menores de aterosclerose, relacionado aos valores reduzidos de HbA1c durante a fase ativa do estudo, com melhor proteção nos pacientes mais jovens e com menor duração da doença. Há também evidências de que os benefícios são maiores nos pacientes sem nefropatia quando comparados aos com doença renal. Outros fatores de risco importante para o desenvolvimento de DAC em pacientes com DM1 são os mesmos descritos para DM2, incluindo os componentes da síndrome metabólica e marcadores de resistência insulínica. Sugere-se que pacientes com DM1 devam ter o melhor controle glicêmico possível...

‣ Controle Pós-Transcricional em Timócitos e Linfócitos T CD3+ periféricos de camundongos NOD Durante a Emergência do Diabetes Mellitus do Tipo 1; Post-transcriptional control in thymocytes and peripheral CD3+ T Lymphocytes of NOD mice during the emergence of type 1 diabetes

Fornari, Thaís Arouca
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 02/12/2011 Português
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O presente trabalho refere-se ao estudo do papel dos microRNAs no controle pós-transcricional das células T de camundongos Non Obese Diabetic (NOD) modelo que reproduz o diabetes mellitus do tipo 1 (DM-1). Durante o desenvolvimento do trabalho, procurou-se esclarecer a hipótese de que os microRNAs controlam os níveis de determinados RNAs mensageiros (mRNAs) das células T durante a indução ou perda de tolerância imunológica. Portanto, a expressão alterada dos microRNAs estaria contribuindo com o processo da autoimunidade. Sendo assim, o objetivo do estudo foi identificar os perfis de expressão e as redes de interação entre um conjunto de microRNAs e seus respectivos mRNAs alvos nos timócitos e nos linfócitos T CD3+ periféricos durante o desenvolvimento do diabetes mellitus do tipo 1 (DM-1) em camundongos NOD. Para avaliar a expressão de genes codificadores de mRNAs, sendo estes possíveis alvos de microRNAs, utilizou-se a tecnologia de microarrays. O uso de programas de análise e para a construção das redes foi imprescindível. Acreditase que fenômenos complexos como a regulação pós-transcricional de células T e seu envolvimento no processo de tolerância imunológica, bem como o surgimento de doenças autoimunes...

‣ Polimorfismos nos genes que codificam a glutationa peroxidase-4, a tiorredoxina e a proteína de interação com a tiorredoxina modulam a susceptibilidade à doença renal em portadores de diabetes mellitus tipo 1; Polymorphisms in the genes coding for glutathione peroxidase-4, thioredoxin and thioredoxin interaction protein modulate the risk for renal disease in type 1 diabetes patients

Monteiro, Maria Beatriz Camargo de Almeida
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 14/03/2012 Português
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INTRODUÇÃO: evidências sugerem a participação de fatores genéticos na susceptibilidade para o desenvolvimento das complicações renais em pacientes portadores de diabetes mellitus tipo 1 (DM1). Vários genes relacionados às vias bioquímicas induzidas pela hiperglicemia têm sido investigados e o estresse oxidativo foi reconhecido como o principal mecanismo patogênico responsável pelo dano celular causado pela hiperglicemia no DM. Assim, genes que codificam enzimas que participam de vias antioxidantes endógenas são candidatos a conferirem susceptibilidade, ou proteção, contra as complicações renais. Os sistemas da glutationa, glutarredoxina, tiorredoxina e a enzima transcetolase são importantes mecanismos de defesa celular contra o estresse oxidativo. OBJETIVOS: avaliar a associação entre os seguintes polimorfismos de um único nucleotídeo (SNP) e a doença renal em pacientes diabéticos tipo 1: -2030 T/G (rs34071297) e +718C/T (rs713041) no gene que codifica a glutationa peroxidase 4 (GPX4); -3310 G/C (rs10427424) no gene que codifica a glutationa sintetase (GSS); -247 A/G (rs2978668) no gene que codifica a glutationa redutase (GSR); -2763 A/G (rs6556885) no gene que codifica a glutarredoxina (GLRX); -224 T/A (rs2301242) no gene que codifica a tiorredoxina (TXN); +402 T/C (rs7211) no gene que codifica a proteína de interação com a tiorredoxina (TXNIP); -192 G/A (rs3788319) no gene que codifica a tiorredoxina redutase 2 (TXNRD2) e -3787 T/G (rs7637934) e -1410 T/C (rs11130365) no gene que codifica a transcetolase (TKT). CASUÍSTICA E MÉTODOS: 443 pacientes (192 do sexo masculino e 251 do sexo feminino) com DM1 com mais de 10 anos de diagnóstico foram classificados conforme a presença ou ausência das seguintes complicações: (1) nefropatia diabética franca (ND)...

‣ Análise imunoendocrinológica da administração de inibidor de DPP-4 no diabetes mellitus tipo 1 experimental; Immunoendocrinological analyses after administration of dipeptidyl-peptidase-4 inhibitor on experimental type 1 diabetes

Davanso, Mariana Rodrigues
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 18/05/2012 Português
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O diabetes mellitus do tipo 1 (DM1) é uma doença autoimune caracterizada pela destruição seletiva de células pancreáticas produtoras de insulina. Existem diversas formas de tratamento do DM1, tais como administração de insulina, imunossupressores, transplantes de pâncreas ou de ilhotas pancreáticas, porém todos se mostram ineficientes em algum aspecto. Recentemente, uma nova classe de medicamentos, os inibidores da enzima dipeptidil peptidase 4 (iDPP-4), demonstrou eficiência terapêutica e segurança no tratamento de pacientes com diabetes mellitus do tipo 2 devido ao aumento do hormônio peptídeo-1 semelhante ao glucagon (GLP-1, do inglês glucagon-like peptide-1). Além disso, o uso de inibidores de DPP-4 em modelos experimentais de DM1 demonstrou proteção das células pancreáticas contra apoptose, estimulação de neogênese de ilhotas pancreáticas e melhora do controle homeostático da glicose. Esse presente projeto teve como objetivo avaliar o perfil imunológico e endocrinológico da administração do inibidor de DPP-4 (MK0431) em DM1 experimental quimicamente induzido por estreptozotocina em camundongos C57Bl/6. Os animais diabéticos foram tratados com ração controle ou ração contendo inibidor de DPP-4 (4g MK0431/Kg de ração) ad libitum durante 30 e 90 dias. Durante o tratamento os animais tiveram glicemia...

‣ Formas graves de retinopatia predizem aterosclerose subclínica em indivíduos com Diabetes tipo 1=Severe forms of retinopathy predict the presence of subclinical atherosclerosis in type 1 Diabetes subjects; Severe forms of retinopathy predict the presence of subclinical atherosclerosis in type 1 Diabetes subjects

Almeida, Fernando Kude de; Esteves, Jorge Freitas; Gross, Jorge Luiz; Biavatti, Karina; Rodrigues, Ticiana da Costa
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf; application/pdf
Português
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Fundamento: Em pacientes com diabetes tipo 2, a presença de retinopatia está associada a doença cardiovascular aumentada, independentemente dos fatores de risco conhecidos para a doença vascular. Objetivo: Investigar a associação da retinopatia diabética (RD) e seus graus com a presença de aterosclerose coronariana subclínica em pacientes com diabetes tipo 1. Métodos: Um estudo transversal foi conduzido com 150 pacientes com diabetes tipo 1, assintomáticos para doença arterial coronariana. Foram submetidos à avaliação clínica para verificar complicações microvasculares e avaliação para a presença de calcificação arterial coronariana (CAC). Resultados: Formas graves de RD (RD grave não proliferativa – RDNP – e RD proliferativa – RDP) foram associadas à CAC (RC: 3,98; IC de 95%; 1,13-13,9, p = 0,03), de maneira independente dos fatores de risco conhecidos para a doença cardiovascular (idade, A1C, hipertensão, dislipidemia e sexo masculino). Conclusão: Os pacientes com formas graves de RD estão em risco de presença de doença arterial coronariana, de maneira independente dos tradicionais fatores de risco cardiovascular. (Arq Bras Cardiol 2011;97(4):346-349).; Background: In patients with type 2 diabetes...

‣ Frequency of islet cell autoantibodies (IA-2 and GAD) in young Brazilian type 1 diabetes patients

Pardini,V.C.; Mourão,D.M.; Nascimento,P.D.; Vívolo,M.A.; Ferreira,S.R.G.; Pardini,H.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/1999 Português
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97.62844%
Type 1 diabetes, as an autoimmune disease, presents several islet cell-specific autoantibodies such as islet cell antibody (ICA), anti-insulin, anti-glutamic acid decarboxylase (GAD) and the antibody (Ab) against tyrosine phosphatase (PTP)-like protein known as ICA-512 (IA-2). In order to determine the frequency of the anti-GAD and anti-IA-2 autoantibodies in Brazilian type 1 diabetes patients we studied 35 diabetes mellitus (DM) type 1 patients with recent-onset disease (£12 months) and 37 type 1 diabetes patients with long-duration diabetes (>12 months) who were compared to 12 children with normal fasting glucose. Anti-GAD65 and anti-IA-2 autoantibodies were detected with commercial immunoprecipitation assays. The frequency of positive results in recent-onset DM type 1 patients was 80.0% for GADAb, 62.9% for IA-2Ab and 82.9% for GADAb and/or IA-2Ab. The long-duration type 1 diabetes subjects presented frequencies of 54.1% for GADAb and IA-2Ab, and 67.5% for GAD and/or IA-2 antibodies. The control group showed no positive cases. Anti-GAD and IA-2 assays showed a high frequency of positivity in these Brazilian type 1 diabetes patients, who presented the same prevalence as a Caucasian population.

‣ Protection From Retinopathy and Other Complications in Patients With Type 1 Diabetes of Extreme Duration

Asztalos, Bela F.; Schaefer, Ernst J.; Sell, David R.; Strauch, Christopher M.; Monnier, Vincent M.; Sun, Jennifer Katherine; Keenan, Hillary; Cavallerano, Jerry D.; Doria, Alessandro; Aiello, Lloyd Paul; King, George Liang
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Português
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107.36017%
Objective: To assess complication prevalence and identify protective factors in patients with diabetes duration of (geq)50 years. Characterization of a complication-free subgroup in this cohort would suggest that some individuals are protected from diabetes complications and allow identification of endogenous protective factors. Research Design and Methods: Cross-sectional, observational study of 351 U.S. residents who have survived with type 1 diabetes for (geq)50 years (Medalists). Retinopathy, nephropathy, neuropathy, and cardiovascular disease were assessed in relation to HbA(_{1c}), lipids, and advanced glycation end products (AGEs). Retrospective chart review provided longitudinal ophthalmic data for a subgroup. Results: A high proportion of Medalists remain free from proliferative diabetic retinopathy (PDR) (42.6%), nephropathy (86.9%), neuropathy (39.4%), or cardiovascular disease (51.5%). Current and longitudinal (the past 15 years) glycemic control were unrelated to complications. Subjects with high plasma carboxyethyl-lysine and pentosidine were 7.2-fold more likely to have any complication. Of Medalists without PDR, 96% with no retinopathy progression over the first 17 years of follow-up did not experience retinopathy worsening thereafter. Conclusions: The Medalist population is likely enriched for protective factors against complications. These factors might prove useful to the general population with diabetes if they can be used to induce protection against long-term complications. Specific AGE combinations were strongly associated with complications...

‣ Transition experiences and health care utilization among young adults with type 1 diabetes

Garvey, Katharine C; Finkelstein, Jonathan A; Laffel, Lori M; Ochoa, Victoria; Wolfsdorf, Joseph I; Rhodes, Erinn T
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Português
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Background: The purpose of this study was to describe the current status of adult diabetes care in young adults with type 1 diabetes and examine associations between health care transition experiences and care utilization. Methods: We developed a survey to assess transition characteristics and current care in young adults with type 1 diabetes. We mailed the survey to the last known address of young adults who had previously received diabetes care at a tertiary pediatric center. Results: Of 291 surveys sent, 83 (29%) were undeliverable and three (1%) were ineligible. Of 205 surveys delivered, 65 were returned (response rate 32%). Respondents (mean age 26.6 ± 3.0 years, 54% male, 91% Caucasian) transitioned to adult diabetes care at a mean age of 19.2 ± 2.8 years. Although 71% felt mostly/completely prepared for transition, only half received recommendations for a specific adult provider. Twenty-six percent reported gaps exceeding six months between pediatric and adult diabetes care. Respondents who made fewer than three diabetes visits in the year prior to transition (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.2–16.5) or cited moving/relocation as the most important reason for transition (OR 6.3, 95% CI 1.3–31.5) were more likely to report gaps in care exceeding six months. Patients receiving current care from an adult endocrinologist (79%) were more likely to report at least two diabetes visits in the past year (OR 6.0...

‣ Diabetes Mellitus tipo 1: controle glicêmico e fatores de risco cardiovasculares em adultos; Type 1 Diabetes Mellitus: glycemic control and cardiovascular risk factors in adults

GONÇALVES, Alessandra Rocha
Fonte: Universidade Federal de Goiás; BR; UFG; Mestrado em Nutricao e Saude; Ciencias da Saude Publicador: Universidade Federal de Goiás; BR; UFG; Mestrado em Nutricao e Saude; Ciencias da Saude
Tipo: Dissertação Formato: application/pdf
Português
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97.55678%
Objective: To evaluate the nutritional status, the glycemic control and the prevalence of cardiovascular risk factors in patients with type 1 diabetes mellitus (T1DM), attended at the nutrition and endocrinology outpatient clinic of the Goiânia Geral Hospital (GGH). Methodology: a cross-sectional study conducted from March to August/2011, with the following inclusion criteria: consolidated diagnosis of the disease for at least six months, age ranging from 19 to 60 years. Fifty-two patients were selected and interviewed, and 44 came to the clinic for collection of biological material. Personal, socioeconomic and biochemical data were collected. Fasting glucose (FG), glycated hemoglobin (HbA1c), lipid profile and microalbuminuria (MA) were determined. MA and HbA1c were determined by immunoturbidimetry and FG and lipid profile by the enzymatic colorimetric method using a Labmax Plenno apparatus. After collecting the material, physical assessment was performed by three trained interviewers who collected measurements of weight, height, waist circumference and blood pressure measurement, following recommendations from the literature. The following risk factors were evaluated: hypertension, dyslipidemia, general obesity (BMI- body mass index)...

‣ Endothelial dysfunction relates to folate status in children and adolescents with type 1 diabetes

Wiltshire, E.; Gent, R.; Hirte, C.; Pena Vargas, A.; Thomas, D.; Couper, J.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
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Endothelial dysfunction occurs early in the development of vascular disease in diabetes. Total plasma homocyst(e)ine (tHcy) is associated with endothelial dysfunction. We therefore aimed to assess endothelial function in children with type 1 diabetes in relation to tHcy and its determinants. Endothelial function was assessed in 36 children with type 1 diabetes aged 13.7 +/- 2.2 years and 20 age- and sex-matched control subjects using ultrasound assessment of flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)-dependent brachial artery responses. von Willebrand factor (vWF) and thrombomodulin, markers of endothelial activation, were measured in 64 children with type 1 diabetes and 52 control subjects. Fasting glucose, tHcy, serum and red cell folate, vitamin B12, HbA(1c), creatinine, and lipids were also measured. FMD (5.2 +/- 4.7 vs. 9.1 +/- 4.0%, P = 0.002) and the ratio of FMD:GTN-induced dilatation (0.22 +/- 0.39 vs. 0.41 +/- 0.29%, P = 0.008) were significantly lower in diabetic subjects, indicating endothelial dysfunction. In diabetic subjects, red cell folate correlated independently with FMD (beta = 0.42, P = 0.028) and the ratio of FMD:GTN-induced dilatation (beta = 0.59, P < 0.001). Resting vessel diameter correlated independently with tHcy (beta = -0.51...

‣ Designing and implementing sample and data collection for an international genetics study: the Type 1 Diabetes Genetics Consortium

Hilner, Joan E.; Perdue, Letitia H.; Sides, Elizabeth G.; Pierce, June J.; Wagner, Ana M.; Aldrich, Alan; Loth, Amanda; Albret, Lotte; Wagenknecht, Lynne E.; Nierras, Concepcion; Akolkar, Beena; Type 1 Diabetes Genetics Consortium
Fonte: Sage Publications Ltd. Publicador: Sage Publications Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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Background and Purpose The Type 1 Diabetes Genetics Consortium (T1DGC) is an international project whose primary aims are to: (a) discover genes that modify type 1 diabetes risk; and (b) expand upon the existing genetic resources for type 1 diabetes research. The initial goal was to collect 2500 affected sibling pair (ASP) families worldwide. Methods T1DGC was organized into four regional networks (Asia-Pacific, Europe, North America, and the United Kingdom) and a Coordinating Center. A Steering Committee, with representatives from each network, the Coordinating Center, and the funding organizations, was responsible for T1DGC operations. The Coordinating Center, with regional network representatives, developed study documents and data systems. Each network established laboratories for: DNA extraction and cell line production; human leukocyte antigen genotyping; and autoantibody measurement. Samples were tracked from the point of collection, processed at network laboratories and stored for deposit at National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repositories. Phenotypic data were collected and entered into the study database maintained by the Coordinating Center. Results T1DGC achieved its original ASP recruitment goal. In response to research design changes...

‣ Environmental determinants of islet autoimmunity (ENDIA): a pregnancy to early life cohort study in children at-risk of type 1 diabetes

Penno, M.; Couper, J.; Craig, M.; Colman, P.; Rawlinson, W.; Cotterill, A.; Jones, T.; Harrison, L.; Baghurst, P.; Barry, S.; Cameron, F.; Dodd, J.; Duran, C.; Forbes, J.; Makrides, M.; Morahan, G.; Nelson, K.; Nankervis, A.; Sinnott, R.; Wentworth, J.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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BACKGROUND The incidence of type 1 diabetes has increased worldwide, particularly in younger children and those with lower genetic susceptibility. These observations suggest factors in the modern environment promote pancreatic islet autoimmunity and destruction of insulin-producing beta cells. The Environmental Determinants of Islet Autoimmunity (ENDIA) Study is investigating candidate environmental exposures and gene-environment interactions that may contribute to the development of islet autoimmunity and type 1 diabetes. METHODS/DESIGN ENDIA is the only prospective pregnancy/birth cohort study in the Southern Hemisphere investigating the determinants of type 1 diabetes in at-risk children. The study will recruit 1,400 unborn infants or infants less than six months of age with a first-degree relative (i.e. mother, father or sibling) with type 1 diabetes, across five Australian states. Pregnant mothers/infants will be followed prospectively from early pregnancy through childhood to investigate relationships between genotype, the development of islet autoimmunity (and subsequently type 1 diabetes), and prenatal and postnatal environmental factors. ENDIA will evaluate the microbiome, nutrition, bodyweight/composition, metabolome-lipidome...

‣ The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes

Groop, P.H.; Thomas, M.; Moran, J.; Waden, J.; Thorn, L.; Makinen, V.P.; Rosengard-Barlund, M.; Saraheimo, M.; Hietala, K.; Heikkia, O.; Forsblom, C.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
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OBJECTIVES This study aimed to identify clinical features associated with premature mortality in a large contemporary cohort of adults with type 1 diabetes. RESEARCH DESIGN AND METHODS The Finnish Diabetic Nephropathy (FinnDiane) study is a national multicenter prospective follow-up study of 4,201 adults with type 1 diabetes from 21 university and central hospitals, 33 district hospitals, and 26 primary health care centers across Finland. RESULTS During a median 7 years of follow-up, there were 291 deaths (7%), 3.6-fold (95% CI 3.2–4.0) more than that observed in the age- and sex-matched general population. Excess mortality was only observed in individuals with chronic kidney disease. Individuals with normoalbuminuria showed no excess mortality beyond the general population (standardized mortality ratio [SMR] 0.8, 95% CI 0.5–1.1), independent of the duration of diabetes. The presence of microalbuminuria, macroalbuminuria, and end-stage kidney disease was associated with 2.8, 9.2, and 18.3 times higher SMR, respectively. The increase in mortality across each stage of albuminuria was equivalent to the risk conferred by preexisting macrovascular disease. In addition, the glomerular filtration rate was independently associated with mortality...

‣ Cardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT (Adolescent Type 1 Diabetes Cardio-Renal Interventional Trial)

Cho, Y.H.; Craig, M.E.; Davis, E.A.; Cotterill, A.M.; Couper, J.J.; Cameron, F.J.; Benitez-Aguirre, P.Z.; Dalton, R.N.; Dunger, D.B.; Jones, T.W.; Donaghue, K.C.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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OBJECTIVE: This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS: Adolescents recruited as part of a multicenter screening study (n = 445, 49% female, aged 10-17 years, mean duration 6.9 years; mean HbA1c 8.4%, 68 mmol/mol) underwent a 10-min continuous electrocardiogram recording for heart rate variability analysis. Time-domain heart rate variability measures included baseline heart rate, SD of the R-R interval (SDNN), and root mean squared difference of successive R-R intervals (RMSSD). Spectral analysis included sympathetic (low-frequency) and parasympathetic (high-frequency) components. Standardized ACR were calculated from six early morning urine collections using an established algorithm, reflecting age, sex, and duration, and stratified into ACR tertiles, where the upper tertile reflects higher nephropathy risk. RESULTS: The upper-tertile ACR group had a faster heart rate (76 vs. 73 bpm; P < 0.01) and less heart rate variability (SDNN 68 vs. 76 ms, P = 0.02; RMSSD 63 vs. 71 ms, P = 0.04). HbA1c was 8.5% (69 mmol/mmol) in the upper tertile vs. 8.3% (67 mmol/mol) in the lower tertiles (P = 0.07). In multivariable analysis...

‣ Early atherosclerosis relates to urinary albumin excretion and cardiovascular risk factors in adolescents with type 1 diabetes: adolescent type 1 Diabetes cardiorenal Intervention Trial (AdDIT)

Maftei, O.; Pena, A.S.; Sullivan, T.; Jones, T.W.; Donaghue, K.C.; Cameron, F.J.; Davis, E.; Cotterill, A.; Craig, M.E.; Gent, R.; Dalton, N.; Daneman, D.; Dunger, D.; Deanfield, J.; Couper, J.J.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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97.69362%
OBJECTIVE: The origins of cardiovascular and renal disease in type 1 diabetes begin during childhood. We aimed to evaluate carotid (cIMT) and aortic intima-media thickness (aIMT) and their relationship with cardiovascular risk factors and urinary albumin excretion in adolescents with type 1 diabetes in the Adolescent Type 1 Diabetes cardio-renal Intervention Trial (AdDIT). RESEARCH DESIGN AND METHODS: A total of 406 adolescents with type 1 diabetes, who were 14.1 ± 1.9 years old with type 1 diabetes duration of 6.7 ± 3.7 years, and 57 age-matched control subjects provided clinical and biochemical data and ultrasound measurements of vascular structure (cIMT and aIMT). Vascular endothelial and smooth muscle function was also measured in 123 of 406 with type 1 diabetes and all control subjects. RESULTS: In type 1 diabetic subjects, mean/maximal aIMT (P < 0.006; <0.008), but not mean/maximal cIMT, was greater than in control subjects. Mean/maximal aIMT related to urinary albumin-to-creatinine ratio (multiple regression coefficient [SE], 0.013 [0.006], P = 0.03; 0.023 [0.007], P = 0.002), LDL cholesterol (0.019 [0.008], P = 0.02; 0.025 [0.011], P = 0.02), and age (0.010 [0.004], P = 0.004; 0.012 [0.005], P = 0.01), independent of other variables. Mean/maximal cIMT was greater in males (0.023 [0.006]...

‣ Hyperfiltration in type 1 diabetes: does it exist and does it matter for nephropathy?

Thomas, M.C.; Moran, J.L.; Harjutsalo, V.; Thorn, L.; Wadén, J.; Saraheimo, M.; Tolonen, N.; Leiviskä, J.; Jula, A.; Forsblom, C.; Groop, H.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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97.56654%
AIMS/HYPOTHESIS: Hyperfiltration is widely regarded as a contributing factor to the development of microalbuminuria and progressive nephropathy in type 1 diabetes. However, recent studies have questioned this conclusion. METHODS: To address this conflicting evidence, we examined the association between hyperfiltration and progression to microalbuminuria in 2,318 adults with type 1 diabetes. We also compared the estimated GFR in our diabetic patients with rates observed in 6,247 adults from the Finnish general population, using age- and sex-specific z scores. RESULTS: The distribution of estimated GFR in adults with type 1 diabetes and normoalbuminuria was not significantly different from that expected in the general population (p = 0.51, Mann-Whitney test). Type 1 diabetic patients with a higher estimated GFR were also no more likely to develop microalbuminuria over a median of 5.2 years of follow-up than those with normal estimated GFR. This was the case regardless of whether hyperfiltration was defined by an absolute threshold, deciles of estimated GFR or a z score, using creatinine- or cystatin-based clearance formulas in men or in women. CONCLUSIONS/INTERPRETATION: Together with other studies, these data suggest that creatinine- or cystatin-based estimates of GFR do not predict the development of microalbuminuria in patients with type 1 diabetes. Moreover...

‣ 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
Relevância na Pesquisa
97.67002%
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...

‣ Estudo comparativo entre células estromais mesenquimais derivadas de pacientes com diabetes mellitus tipo 1 e de indivíduos saudáveis em relação ao potencial terapêutico no diabetes experimental; Comparative analysis of mesenchymal stromal cells derived from patients with type 1 diabetes mellitus and healthy individuals regarding the therapeutic potential in experimental diabetes

Yaochite, Juliana Navarro Ueda
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 23/05/2014 Português
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97.62319%
O diabetes mellitus do tipo 1 (DM-1) é uma doença autoimune caracterizada pela destruição seletiva de células pancreáticas produtoras de insulina. O tratamento convencional é feito com insulina e existe atualmente a necessidade de desenvolver alternativas terapêuticas para o DM-1, como por exemplo o tratamento com células-tronco. As células estromais mesenquimais multipotentes (multipotent mesenchymal stromal cells-MSCs) representam uma fonte de células ideal para terapias celulares em virtude de seu fácil isolamento, expansão e capacidades imunomoduladora e regenerativa. Ainda não está esclarecido se MSCs isoladas de indivíduos com doenças autoimunes possuem alterações funcionais que poderiam limitar seu uso no contexto do transplante autólogo. Já foi descrito que MSCs de pacientes com esclerose múltipla, artrite reumatoide e lúpus eritematoso sistêmico possuem alterações fenotípicas e/ou funcionais. No entanto, pouco se sabe acerca das características das MSCs de pacientes com DM-1. Desse modo, o objetivo principal deste trabalho foi avaliar a eficácia da infusão de MSCs derivadas de pacientes com DM-1 no tratamento do diabetes experimental e comparar os resultados obtidos com o tratamento feito com MSCs isoladas de indivíduos saudáveis. Além disso...

‣ Quadrivalent HPV vaccine and the risk of type 1 diabetes mellitus in grade 8 girls: A population based cohort study

Walsh, Erica
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
Português
Relevância na Pesquisa
97.58278%
Background: Vaccines have been hypothesized in the etiology of autoimmune diseases including type 1 diabetes. There are cases of diabetes reported in the Vaccine Adverse Event Reporting System (VAERS) following the administration of the human papillomavirus (HPV) vaccine, however this potential association has yet to be investigated. The objective of this thesis was to determine whether there is an association between immunization against HPV and the development of type 1 diabetes mellitus in grade 8 girls eligible for Ontario’s vaccination program. Methods: A retrospective, population-based, cohort study of girls residing within an Ontario health unit and eligible for the province’s publicly funded school-based HPV vaccination program between 2007 and 2010 was executed using provincial administrative health databases and the Immunization Recording Information System (IRIS) database. To control for known, unknown and unmeasured time-independent confounders, a self-controlled case series analysis was conducted. The relative incidence and 95% confidence interval were estimated using conditional Poisson regression. Results: The study cohort was comprised of 3465 girls with a mean age of 13.2 years at cohort entry (range 12.7 to 13.6 years). The mean duration of follow up was 2.7 years and ranged from 1.6 to 3.6 years. The proportion of girls who received at least one dose of the qHPV vaccine during the observation period was 58.3% (n=2020). During the study follow-up 15 cases of new onset type 1 diabetes were observed...

‣ The challenge of caring for children and adolescents with type-1 diabetes at home; El desafío para el control domiciliario en niños y adolescentes diabéticos tipo 1; O desafio para o controle domiciliar em crianças e adolescentes diabéticas tipo1

Zanetti, Maria Lúcia; Mendes, Isabel Amélia Costa; Ribeiro, Kátia Prado
Fonte: Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto Publicador: Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 01/01/2001 Português
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97.56354%
This is a descriptive study concerning mothers of children and adolescents with type-1 diabetes. Its purpose is to identify available resources and analyze the difficulties that these mothers find to control the disease at home. To that end, direct interviews were used and the results enabled us to reach the following conclusions: the resources used for the control of diabetes at home are scarce and, when available, they are not handled adequately; communication between mothers and the health care team was limited. The results also pointed to the need for equity in the assistance to families of children and adolescents with type-1 diabetes by providing support for such families to manage children with chronic diseases.; Estudio descriptivo con madres de niños y adolescentes portadores de Diabetes tipo 1, con el objetivo de identificar los recursos disponibles y analizar las dificultades que esas madres encuentran para el control domiciliario. Para alcanzar los objetivos, realizamos una entrevista dirigida, cuyos resultados nos permitieron concluir: los recursos utilizados en el domicilio para el control de la diabetes son escasos y cuando están disponibles, no son utilizados adecuadamente. La comunicación de las madres con el equipo de salud se mostró limitada. Percibimos también la necesidad de equidad en la atención a las familias de niños y adolescentes diabéticos tipo 1...