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1.
Pediatr Diabetes ; 17(7): 531-534, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26530055

RESUMO

Exercise in diabetes patients has many benefits but also several risks, of which hypoglycemia is most often discussed. We present a case with recurrent keto-acidosis post-exercise, in which we hypothesize that glycogen replacement strategies were insufficient. Our experience in this case and review of the literature emphasize the importance of discussing glycogen replacement strategies with your diabetic athletes.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Cetoacidose Diabética/etiologia , Exercício Físico/fisiologia , Glicogênio/uso terapêutico , Adolescente , Atletas , Humanos , Masculino , Esforço Físico/fisiologia , Recidiva
2.
Clin Endocrinol (Oxf) ; 82(6): 854-61, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25409576

RESUMO

BACKGROUND: Growth hormone (GH) treatment is effective in improving adult height (AH) in short children born SGA. However, there is a wide variation in height gain, even after adjustment for predictive variables. It is therefore important to investigate new factors which can influence the response to GH. OBJECTIVE: To investigate the efficacy of GH treatment (1 mg/m(2/) day) in short SGA children on AH. To assess the relation between spontaneous catch-up growth after birth and growth during puberty on the total height gain SDS to AH. PATIENTS: Longitudinal GH trial in 170 children. RESULTS: Median age at start of GH was 7·1 years and height -3·0 SDS. AH was -1·8 SDS (TH-corrected AH -1·1 SDS) in boys and -1·9 SDS (TH-corrected AH -1·3 SDS) in girls. Spontaneous catch-up growth after birth was ≥0·5 SDS in 42% of children. In contrast to expectation, spontaneous catch-up growth was negatively correlated with total height gain SDS during GH (P = 0·009). During puberty, height SDS declined (-0·4 SDS in boys and -0·5 SDS in girls) resulting in a lower total height gain SDS than expected. Pubertal height gain was 25·5 cm in boys and 15·3 cm in girls, significantly lower compared to AGA children (P < 0·001). At onset of puberty, BA for boys and girls was moderately advanced (P = 0·02 and P < 0·001, respectively). Growth velocity was comparable to AGA children during the first two years of puberty, but thereafter significantly lower until reaching AH (P < 0·001). CONCLUSION: In contrast to our hypothesis, children with greater spontaneous catch-up growth after birth show a lower total height gain SDS during GH. Height SDS declines from mid-puberty, due to a marked early deceleration of growth velocity.


Assuntos
Estatura/efeitos dos fármacos , Desenvolvimento Humano , Hormônio do Crescimento Humano , Recém-Nascido Pequeno para a Idade Gestacional/crescimento & desenvolvimento , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Substâncias de Crescimento/administração & dosagem , Substâncias de Crescimento/efeitos adversos , Desenvolvimento Humano/efeitos dos fármacos , Desenvolvimento Humano/fisiologia , Hormônio do Crescimento Humano/administração & dosagem , Hormônio do Crescimento Humano/efeitos adversos , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Países Baixos
4.
Diabetologia ; 47(1): 104-12, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14618236

RESUMO

AIM/HYPOTHESIS: Type I diabetes is associated with altered hepatic bile formation and increased intestinal cholesterol absorption. The aim of this study was to evaluate whether altered expression of the ATP-Binding Cassette half-transporters Abcg5 and Abcg8, recently implicated in control of both hepatobiliary cholesterol secretion and intestinal cholesterol absorption, contributes to changed cholesterol metabolism in experimental diabetes. METHODS: mRNA and protein expression of Abcg5 and Abcg8 were determined in the liver and intestine of rats with streptozotozin-induced diabetes and related to relevant metabolic parameters in plasma, liver and bile. RESULTS: Hepatic mRNA expression of both Abcg5 (-76%) and Abcg8 (-71%) was reduced in diabetic rats when compared to control rats. In spite of increased HDL cholesterol, considered a major source of biliary cholesterol, secretion of the sterol into bile relative to that of bile salts was reduced by 65% in diabetic animals. Intestinal mRNA expression of Abcg5 (-47%) and Abcg8 (-43%) as well as Abcg5 protein contents were also reduced in insulin-deficient animals. This was accompanied by a three- to four-fold increase in plasma beta-sitosterol and campesterol concentrations and by a doubling of the calculated apparent cholesterol absorption. These effects partially normalized upon insulin supplementation. CONCLUSION/INTERPRETATION: Our data indicate that effects of insulin-deficiency on bile composition and cholesterol absorption in rats are, at least partly, attributable to changes in hepatic and intestinal Abcg5 and Abcg8 expression.


Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Colesterol/análogos & derivados , Colesterol/sangue , Diabetes Mellitus Experimental/metabolismo , Regulação da Expressão Gênica , Lipoproteínas/genética , Fitosteróis , Transcrição Gênica/genética , Membro 5 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Membro 8 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Animais , Apolipoproteína A-I/metabolismo , Bile/metabolismo , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/genética , Mucosa Intestinal/metabolismo , Fígado/metabolismo , Masculino , RNA Mensageiro/genética , Ratos , Ratos Wistar , Sitosteroides/sangue , Triglicerídeos/metabolismo
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