RESUMO
PI3K-δ mediates key immune cell signaling pathways and is a target of interest for treatment of oncological and immunological disorders. Here we describe the discovery and optimization of a novel series of PI3K-δ selective inhibitors. We first identified hits containing an isoindolinone scaffold using a combined ligand- and receptor-based virtual screening workflow, and then improved potency and selectivity guided by structural data and modeling. Careful optimization of molecular properties led to compounds with improved permeability and pharmacokinetic profile, and high potency in a whole blood assay.
Assuntos
Classe I de Fosfatidilinositol 3-Quinases/antagonistas & inibidores , Descoberta de Drogas , Inibidores de Fosfoinositídeo-3 Quinase/farmacologia , Ftalimidas/farmacologia , Classe I de Fosfatidilinositol 3-Quinases/metabolismo , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos , Humanos , Estrutura Molecular , Inibidores de Fosfoinositídeo-3 Quinase/síntese química , Inibidores de Fosfoinositídeo-3 Quinase/química , Ftalimidas/síntese química , Ftalimidas/química , Relação Estrutura-AtividadeRESUMO
PI3Kδ mediates key immune cell signaling pathways and is a target of interest for multiple indications in immunology and oncology. Here we report a structure-based scaffold-hopping strategy for the design of chemically diverse PI3Kδ inhibitors. Using this strategy, we identified several scaffolds that can be combined to generate new PI3Kδ inhibitors with high potency and isoform selectivity. In particular, an oxindole-based scaffold was found to impart exquisite selectivity when combined with several hinge binding motifs.
Assuntos
Desenho de Fármacos , Oxindóis/farmacologia , Fosfatidilinositol 3-Quinases/metabolismo , Inibidores de Fosfoinositídeo-3 Quinase/farmacologia , Sítios de Ligação/efeitos dos fármacos , Relação Dose-Resposta a Droga , Humanos , Estrutura Molecular , Oxindóis/síntese química , Oxindóis/química , Inibidores de Fosfoinositídeo-3 Quinase/síntese química , Inibidores de Fosfoinositídeo-3 Quinase/química , Relação Estrutura-AtividadeRESUMO
The mammalian Janus Kinases (JAK1, JAK2, JAK3 and TYK2) are intracellular, non-receptor tyrosine kinases whose activities have been associated in the literature and the clinic with a variety of hyperproliferative diseases and immunological disorders. At the onset of the program, it was hypothesized that a JAK1 selective compound over JAK2 could lead to an improved therapeutic index relative to marketed non-selective JAK inhibitors by avoiding the clinical AEs, such as anemia, presumably associated with JAK2 inhibition. During the course of the JAK1 program, a number of diverse chemical scaffolds were identified from both uHTS campaigns and de novo scaffold design. As part of this effort, a (benz)imidazole scaffold evolved via a scaffold-hopping exercise from a mature chemical series. Concurrent crystallography-driven exploration of the ribose pocket and the solvent front led to analogs with optimized kinome and JAK1 selectivities over the JAK2 isoform by targeting several residues unique to JAK1, such as Arg-879 and Glu-966.
Assuntos
Benzimidazóis/química , Benzimidazóis/farmacologia , Janus Quinase 1/antagonistas & inibidores , Inibidores de Proteínas Quinases/química , Inibidores de Proteínas Quinases/farmacologia , Piridonas/química , Piridonas/farmacologia , Benzimidazóis/síntese química , Cristalografia por Raios X , Desenho de Fármacos , Humanos , Janus Quinase 1/metabolismo , Modelos Moleculares , Inibidores de Proteínas Quinases/síntese química , Piridonas/síntese química , Relação Estrutura-AtividadeRESUMO
Modulating GPR88 activity is suggested to have therapeutic utility in the treatment of CNS disorders, such as schizophrenia. This Letter will describe the discovery and SAR development of a class of potent GPR88 agonists.
Assuntos
Amidas/farmacologia , Aminas/farmacologia , Doenças do Sistema Nervoso Central/tratamento farmacológico , Descoberta de Drogas , Receptores Acoplados a Proteínas G/agonistas , Amidas/síntese química , Amidas/química , Aminas/síntese química , Aminas/química , Relação Dose-Resposta a Droga , Humanos , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
Small molecule modulators of GPR88 activity (agonists, antagonists, or modulators) are of interest as potential agents for the treatment of a variety of psychiatric disorders including schizophrenia. A series of phenylglycinol and phenylamine analogs have been prepared and evaluated for their GPR88 agonist activity and pharmacokinetic (PK) properties.
Assuntos
Aminas/farmacologia , Desenho de Fármacos , Etanolaminas/farmacologia , Receptores Acoplados a Proteínas G/agonistas , Aminas/síntese química , Aminas/química , Relação Dose-Resposta a Droga , Etanolaminas/síntese química , Etanolaminas/química , Células HEK293 , Humanos , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
We conducted a phase I-IIa, randomized, monocentric, double-blind, placebo-controlled clinical trial to evaluate the safety and impact of the combination treatment of Itolizumab and insulin on preserving beta cell function in adults with recent-onset type 1 diabetes. Twelve patients were randomly assigned to three treatment groups, each receiving a different Itolizumab dose (0.4/0.8/1.6 mg/kg body weight, respectively) and a placebo group. All patients received concomitant intensive multiple-dose insulin therapy. Endogenous insulin secretion was assessed by the measurement of C-peptide during the mixed-meal tolerance test. No serious adverse events were reported. No changes in the total daily insulin doses, glycated hemoglobin levels, and stimulated C-peptide were observed between the Itolizumab and placebo groups at 52 weeks. A significant decrease in stimulated C-peptide was observed during the follow-up period (p = 0.012). One subject treated with 1.6 mg of Itolizumab showed a marked increase in the levels of stimulated C-peptide three years after completion of the trial. Taken together, this is the first study to demonstrate that combination treatment with Itolizumab and insulin is safe in humans and does not affect the residual function of beta cells up to 52 weeks. The findings from our study show preliminary evidence that high doses of Itolizumab could potentially arrest the loss of beta cell function in the long term. Further studies with a longer follow-up and larger numbers of patients are envisaged to assess the effect with high dose Itolizumab.
RESUMO
The approvals of idelalisib and duvelisib have validated PI3Kδ inhibitors for the treatment for hematological malignancies driven by the PI3K/AKT pathway. Our program led to the identification of structurally distinct heterocycloalkyl purine inhibitors with excellent isoform and kinome selectivity; however, they had high projected human doses. Improved ligand contacts gave potency enhancements, while replacement of metabolic liabilities led to extended half-lives in preclinical species, affording PI3Kδ inhibitors with low once-daily predicted human doses. Treatment of C57BL/6-Foxp3-GDL reporter mice with 30 and 100 mg/kg/day of 3c (MSD-496486311) led to a 70% reduction in Foxp3-expressing regulatory T cells as observed through bioluminescence imaging with luciferin, consistent with the role of PI3K/AKT signaling in Treg cell proliferation. As a model for allergic rhinitis and asthma, treatment of ovalbumin-challenged Brown Norway rats with 0.3 to 30 mg/kg/day of 3c gave a dose-dependent reduction in pulmonary bronchoalveolar lavage inflammation eosinophil cell count.
Assuntos
Classe I de Fosfatidilinositol 3-Quinases/química , Fatores Imunológicos/química , Pirrolidinas/química , Animais , Antígenos CD/metabolismo , Antígenos de Diferenciação de Linfócitos T/metabolismo , Linfócitos B/citologia , Linfócitos B/efeitos dos fármacos , Linfócitos B/metabolismo , Sítios de Ligação , Classe I de Fosfatidilinositol 3-Quinases/metabolismo , Modelos Animais de Doenças , Cães , Meia-Vida , Humanos , Fatores Imunológicos/metabolismo , Fatores Imunológicos/farmacologia , Fatores Imunológicos/uso terapêutico , Lectinas Tipo C/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Simulação de Dinâmica Molecular , Proteínas Proto-Oncogênicas c-akt/metabolismo , Pirrolidinas/metabolismo , Pirrolidinas/farmacologia , Pirrolidinas/uso terapêutico , Ratos , Ratos Wistar , Rinite Alérgica/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos , Relação Estrutura-AtividadeRESUMO
The development of a novel series of purines as gamma-secretase modulators for potential use in the treatment of Alzheimer's disease is disclosed herein. Optimization of a previously disclosed pyrimidine series afforded a series of potent purine-based gamma-secretase modulators with 300- to 2000-fold in vitro selectivity over inhibition of Notch cleavage and that selectively reduces Alphabeta42 in an APP-YAC transgenic mouse model.
Assuntos
Doença de Alzheimer/tratamento farmacológico , Secretases da Proteína Precursora do Amiloide/metabolismo , Peptídeos beta-Amiloides/antagonistas & inibidores , Fragmentos de Peptídeos/antagonistas & inibidores , Purinas/química , Purinas/uso terapêutico , Secretases da Proteína Precursora do Amiloide/genética , Peptídeos beta-Amiloides/metabolismo , Animais , Humanos , Camundongos , Camundongos Transgênicos , Fragmentos de Peptídeos/metabolismo , Purinas/farmacologia , Receptores Notch/metabolismo , Relação Estrutura-AtividadeRESUMO
PI3Kδ catalytic activity is required for immune cell activation, and has been implicated in inflammatory diseases as well as hematological malignancies in which the AKT pathway is overactive. A purine PI3Kδ inhibitor bearing a benzimidazolone-piperidine motif was found to be poorly tolerated in dog, which was attributed to diffuse vascular injury. Several strategies were implemented to mitigate this finding, including reconstruction of the benzimidazolone-piperidine selectivity motif. Structure-based design led to the identification of O- and N-linked heterocycloalkyls, with pyrrolidines being particularly ligand efficient and kinome selective, and having an improved safety pharmacology profile. A representative was advanced into a dog tolerability study where it was found to be well tolerated, with no histopathological evidence of vascular injury.
Assuntos
Classe Ia de Fosfatidilinositol 3-Quinase/metabolismo , Inibidores de Proteínas Quinases/farmacologia , Purinas/farmacologia , Pirrolidinas/farmacologia , Animais , Cães , Desenho de Fármacos , Células HeLa , Humanos , Masculino , Inibidores de Proteínas Quinases/síntese química , Inibidores de Proteínas Quinases/toxicidade , Purinas/síntese química , Purinas/toxicidade , Pirrolidinas/síntese química , Pirrolidinas/toxicidade , Ratos WistarRESUMO
RESUMEN Fundamento: el giro hacia una educación por habilidades supone una nueva cultura de aprendizaje. Comprender que cada estudiante progresa a diferentes ritmos en el dominio de una habilidad implica saber atender oportunamente sus necesidades y la personalización de sus trayectorias. Objetivo: describir la percepción que tienen los estudiantes del tercer año de la carrera de Estomatología sobre sus habilidades específicas. Métodos: estudio descriptivo de corte transversal realizado en la Clínica Estomatológica de Especialidades de Cienfuegos. Se trabajó con la totalidad de los estudiantes que cursan el tercer año de la carrera de estomatología, asignatura Operatoria Clínica en el quinto semestre. Resultados: los estudiantes perciben que deben seguir perfeccionando la mayoría de las habilidades, fundamentalmente en la confección de la historia clínica individual en los incisos: examen bucal y diagnóstico. El 50 % de los estudiantes tiene la percepción de que realizan el interrogatorio, identifican hábitos y plan de tratamiento muy bien. En los procedimientos clínicos solo la técnica de anestesia infiltrativa alcanza mayor porcentaje en el nivel superior de la escala de precepción representado por un 83,3%. Conclusiones: la percepción de los estudiantes respecto a las habilidades específicas está en correspondencia con el año académico que cursan. Perciben que deben seguir perfeccionando la mayoría de ellas. Los resultados expuestos permiten al claustro de profesores desarrollar estrategias docentes que contribuyan al desarrollo de dichas habilidades.
ABSTRACT Background: the change towards skills-based education means a new learning culture. Understanding that each student progresses at different rates in the mastery of a skill implies knowing how to deal with their needs timely and personalize their trajectories. Objective: to describe the third year students Stomatology career perception about their specific abilities. Methods: descriptive, observational, cross-sectional study carried out at the Cienfuegos Specialties Stomatological Clinic. All the third year stomatology students who are in the fifth semester of a Clinical Operative subject participated in the research. Results: the students perceive that they must improve the skills, mainly in the preparation of the individual medical history in sections: oral exam and diagnosis. The 50% of the students make the questioning, identify habits and treatment plan very well. In clinical procedures, only the infiltrative anesthesia technique achieves a higher percentage at the upper level of the perception scale, represented by 83.3%. Conclusions: the students' perception regarding the specific skills is in correspondence with the academic year they study. They think that they must improve most of them. The results presented allow the faculty to develop teaching strategies that contribute to the development of these skills.
RESUMO
RESUMEN Introducción: La prueba de tolerancia de comida mixta es considerada la prueba de oro para la medición de la producción de insulina endógena en pacientes con diabetes tipo 1. Objetivo: Determinar la utilidad de la prueba de tolerancia de comida mixta con Nutrial I para evaluar la función de las células ß en diabéticos tipo 1 de diagnóstico reciente y la relación de esa función con algunas características clínicas y bioquímicas. Métodos: Se estudiaron variables bioquímicas como la glucemia, hemoglobina glucosilada (HbA1c), péptido C y fracciones lipídicas. La prueba de tolerancia de comida mixta con Nutrial I se aplicó a 18 sujetos con diabetes tipo 1 de diagnóstico reciente y a 8 voluntarios con edades comprendidas entre 19 y 35 años. El consumo del suplemento Nutrial I se calculó según el peso del paciente. Se obtuvieron muestras para glucemia y péptido C a los -10, 0, 30, 60, 90 y 120 minutos. Resultados: Se observaron concentraciones elevadas de glucemia y disminuidas de péptido C durante la prueba de tolerancia de comida mixta en los diabéticos tipo 1 de diagnóstico reciente, en comparación con los voluntarios, así como, diferencias en las áreas bajo la curva de péptido C (AUC-pc) (p= 0,001). En los diabéticos tipo 1 de diagnóstico reciente se evidenció una correlación negativa entre el AUC-pc con los niveles de glucemia en ayunas (r= -0,747; p ( 0,0001) y la HbA1c (r= -0,535; p= 0,022). Por el contrario, se encontró una correlación positiva entre el AUC-pc y el péptido C en ayunas (r= 0,722; p= 0,001). El AUC-pc después de la prueba de tolerancia de comida mixta es mayor en los sujetos con glucemia en ayunas si GA < 7 mmol/L con respecto a los sujetos con glucemia en ayunas ( 7 mmol/L (p= 0,012). Conclusiones: El empleo del Nutrial I en la prueba de tolerancia de comida mixta fue útil en la evaluación de la función de las células β en diabéticos tipo 1 de diagnóstico reciente. Los valores bajos de glucemia en ayunas durante esta prueba son marcadores indirectos de una función residual de células ( más conservada en los diabéticos tipo 1 de diagnóstico reciente(AU)
ABSTRACT Introduction: The tolerance test of mixed food is considered the gold standard for the measurement of endogenous insulin production in patients with diabetes type 1. Objective: To determine the usefulness of the tolerance test of mixed food with Nutrial I to assess the ß-cells function in patients with diabetes type 1 of recent diagnosis and the relation of this function with some clinical and biochemical characteristics. Methods: There were studied biochemical variables as the blood glucose, glycosylated haemoglobin (HbA1c), C-peptide and lipid fractions. The tolerance test of mixed food with Nutrial I was applied to 18 individuals with diabetes type 1 of recent diagnosis and in 8 volunteers aged between 19 and 35 years old. The consumption of Nutrial I supplement was calculated according to the weight of the patient. Samples were obtained for blood glucose and C-peptide at -10, 0, 30, 60, 90 and 120 minutes. Results: There were observed high concentrations of glycemia and decreased amounts of C-peptide during the tolerance test of mixed food in recently diagnosed type 1 diabetics in comparison with the volunteers, as well as differences in areas under the curve of C-peptide (AUC-pc) (p= 0.001). In the recently diagnosed type 1 diabetics was evident a negative correlation between the AUC-pc with fasting plasma glucose levels (r= -0,747; p(0.0001) and HbA1c (r= -0,535; p= 0.022). On the contrary, it was found a positive correlation between the AUC-pc and fasting C-peptide (r = 0.722; p = 0.001). The AUC-pc after the tolerance test of mixed food was greater in subjects with fasting blood glucose < 7 mmol/L with respect to the subjects with fasting blood glucose ( 7 mmol/L (p= 0.012). Conclusions: The use of Nutrial I in the tolerance test of mixed food was useful in the assessment of the role of the β-cells in patients with recently diagnosed diabetes type 1. Low values of fasting blood glucose during this test are indirect markers of a residual function of (cells more preserved in type 1 diabetics of recent diagnosis(AU)
Assuntos
Humanos , Glicemia/fisiologia , Diabetes Mellitus Tipo 1/diagnóstico , Secreção de Insulina/fisiologia , Epidemiologia Descritiva , Estudos TransversaisRESUMO
La macroprolactinemia se define como la presencia de cantidades elevadas de esta isoforma de la prolactina en suero, en conjunto con concentraciones normales de prolactina monomérica. Se trata de una entidad bastante común, considerada entre las tres primeras causas de hiperprolactinemia. Su origen parece responder a mecanismos autoinmunes y el seguimiento de los pacientes afectos durante periodos de 10 años ha demostrado que es una condición crónica. La prueba de elección para el diagnóstico es la cromatografía líquida en columna de gel, pero este es un método costoso que generalmente es suplido por la prueba de precipitación con polietinglicol. Por mucho tiempo ha prevalecido el concepto de que estos pacientes son esencialmente asintomáticos, pero reportes recientes señalan la presencia de síntomas de hiperprolactinemia como parte significativa del cuadro, aunque la literatura actual muestra criterios divergentes. En estos pacientes la realización de resonancia magnética nuclear hipofisaria parece ser un procedimiento innecesario, basado en la escasa frecuencia de resultados positivos. El tratamiento farmacológico con agonistas dopaminérgicos muestran respuestas contradictorias en cuanto a la desaparición de los síntomas y la normalización de los niveles de prolactina. Por tanto, la inexistencia de un consenso en la literatura científica en lo referente a las manifestaciones clínicas y el manejo, obliga a una conveniente valoración individual de cada caso(AU)
Macroprolactinemia is defined as the presence of high quantities of this prolactin isoform in serum, together with normal concentrations of monomeric prolactin. It is a common entity, considered among the three first causes of hyperprolactinaemia. The origin seems to respond to autoimmune mechanisms and the affected patients follow-up during ten years periods has shown that it is a chronic condition. The standard gold test to the diagnostic is gel-filtration chromatography, but it is an expensive method that is generally supplied by the polyethylene glycol precipitation test. During a long time, the concept that these patients are essentially asymptomatic has prevailed, but recent reports stamps the presence of hyperprolactinemia symptoms as a significant part of the entity, although current literature shows divergent criteria. In these patients, performing pituitary magnetic resonance seems to be an unnecessary procedure, based on the rare frequency of positive results. Pharmacological treatment with dopamine agonists shows contradictory responses with regard to symptoms disappearance and prolactin levels normalization. Therefore, the lack of consensus in the scientific literature with regard to the clinical manifestations and the management, requires a convenient individual assessment of each case(AU)
Assuntos
Humanos , Masculino , Feminino , Prolactina/análise , Cromatografia Líquida/métodosRESUMO
Introducción: la deficiencia o insuficiencia de vitamina D es una pandemia mundial que afecta aproximadamente 1 000 millones de personas. Investigaciones indican, que entre las funciones no clásicas de la vitamina D, se incluye su rol en enfermedades cardiovasculares y el síndrome metabólico. Objetivos: determinar si existe deficiencia de vitamina D en la población de edad mediana, y su posible asociación con algunos elementos del síndrome metabólico. Métodos: estudio descriptivo transversal que incluyó 17 hombres y 42 mujeres, de agosto de 2014 a abril de 2016. Se determinaron los niveles de 25hidroxi vitamina D (normal ≥ 30, deficiencia < 30 ng/mL), y se vincularon con elementos clínicos y bioquímicos del síndrome metabólico. Resultados: el 47,46 por ciento presentó deficiencia de vitamina D. La media estuvo disminuida (29,36 ng/mL) en personas obesas. Se encontró correlación inversa significativa (p= 0,039), entre la circunferencia de cintura aumentada en mujeres y los niveles de vitamina D. También hubo correlación positiva significativa (p= 0,015), cuando se asociaron niveles de tensión arterial diastólica en personas con HTA sistodiastólica y niveles de vitamina D. El 62,5 por ciento de personas obesas presentó deficiencia de vitamina D. La comparación de medias entre niveles deficientes de vitamina D y niveles más elevados de glucemias, resultó estadísticamente significativa (p= 0,013). Conclusiones: resultó frecuente la deficiencia de vitamina D en las personas estudiadas. Una mayor circunferencia de cintura en mujeres, se asocia con niveles más bajos de vitamina D. Niveles más altos de vitamina D, se asocian con cifras más elevadas de tensión arterial diastólica. La deficiencia de vitamina D se asocia con niveles más elevados de glucemia(AU)
Introduction: Vitamin D deficiency or insufficiency is a world pandemic affecting roughly 1 billion people. Several research studies reveal that Vitamin D has as a non-classical function its role in cardiovascular diseases and in the metabolic syndrome. Objectives: to determine whether there is Vitamin D deficiency in the middle-aged population and its possible association with some elements of the metabolic syndrome. Methods: descriptive and cross-sectional study of 17 men and 42 women conducted from August 2014 to April 2016. The levels of 25-hydroxyl Vitamin D (normal ≥ 30, deficiency < 30 ng/mL), were also determined and linked to clinical and biochemical elements of the metabolic syndrome. Results: in the group, 47.46 percent presented with Vitamin D deficiency. The mean was reduced in obese people (29.36 ng/mL). Significant inverse correlation was found (p= 0.039) between the increased waist circumference in women and the Vitamin D levels. Significant positive correlation (p= 0.015) was also observed when levels of diastolic blood pressure were associated in persons with systolic-diastolic blood hypertension with levels of Vitamin D. In the group, 62.5 percent of obese persons had Vitamin D deficiency. The mean comparison between levels of Vitamin D and higher levels of glycemia was statistically significant (p= 0.013). Conclusions: Vitamin D deficiency was common in the studied persons. Increased waist circumference in women is associated with lowest levels of Vitamin D whereas higher levels of Vitamin D are associated with higher diastolic blood pressure values. Vitamin D deficiency is related to higher levels of glycemia(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Deficiência de Vitamina D/etiologia , Síndrome Metabólica , Circunferência da Cintura , Epidemiologia Descritiva , Estudos Transversais , Índice GlicêmicoRESUMO
Las determinantes del estado de salud oral deben estar en estrecha relación con los cambios dinámicos de una sociedad. Este trabajo pretende reflexionar sobre cómo las trasformaciones en la sociedad cubana actual pudieran condicionar la aparición de cambios conceptuales en el análisis de la situación de salud. Se aborda la necesidad de crear modelos y metodologías más novedosas aplicadas al contexto cubano. Las tendencias referidas a determinantes sociales permitirán trazar correctas estrategias de intervención en salud bucodental en nuestro contexto. Los futuros estudios epidemiológicos deberán dedicar especial atención a aspectos sociales como el ingreso percápita en la familia, la dinámica familiar, la igualdad de género, el respeto a la diversidad, el empleo, las condiciones de trabajo, las redes de apoyo social y la seguridad alimentaria o dieta adecuada.
The determinants of oral health must be closely related to the dynamic changes in society. This paper aims at reflecting on how the transformations in Cuban society might lead to conceptual changes in the analysis of the health situation. The need for more innovative models and methodologies applied to the Cuban context are discussed. The trends regarding social determinants will allow developing proper oral health intervention strategies in our context. Future epidemiological studies should pay special attention to social issues such as household income, family dynamics, gender equality, respect for diversity, employment, working conditions, social support networks and food security or proper diet.
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Desde la creación en 1976 por Steel y colaboradores (1) de una clínica para el control preconcepcional de la mujer diabética en el Royal Informary de Edimburgo hasta la actualidad existe consensos sobre la importancia de que la mujer con diabetes mellitus conciba el embarazo en un momento deseado y metabólicamente ideal por las graves complicaciones materno-fetales si éste se produjera con descontrol concomitando con factores de riesgo y/o complicaciones crónicas avanzadas por lo que la planificación familiar constituye el pilar esencial para lograrlo (2). Es obvio que no existen diferencias apreciables entre la mujer diabética y no diabética en cuanto a los métodos anticonceptivos disponibles pero debe tenerse en consideración las alteraciones propias del síndrome diabético en el momento de seleccionar cual método usar e individualizar cada caso según al paridad, los factores de riesgo biosociales y las complicaciones entre otros aspectos (3). Es por ello que realizamos este trabajo para conocer las características generales de la contracepción en mujeres diabéticas en edad fértil así como su valoración sobre los distintos métodos y el control metabólico en aquella sin contracepción...