Blood glucose related adverse drug reaction of antitumor monoclonal antibodies: a retrospective analysis using Vigibase

Abstract On the increasing prevalence of using mAbs (monoclonal antibodies) in cancer therapy and the severe risk of hyperglycemia, we aimed to analyze the main clinical ADRs of mAbs, with a focus on adverse hyperglycemic events associated with currently clinically used mAbs. mAbs as well as target information were selected from Martinadale book and published articles. Drug approving information was collected from each government website, and ADR statistic data were collected from VigibaseR, comparing with Adverse Event Reporting System of US FDA. Top 10 mAbs were classified within listing in total ADR records, ADRs per year, hyperglycemic ADR records. Vigibase data were updated onto 15 Feb 2019. 20 mAbs were analyzed with 263217 ADR reports, wherein 16751 records on Metabolism and nutrition disorders and 1444 records on Glucose metabolism disorders. The geographic, age, gender distributions and annual ADR report numbers were listed respectively. Of the top 10, Rituximab, Bevacizumab and Nivolumab were on the top 3 in total ADR record and hyperglycemic record. Top 3 record results were similar in Vigibase and FDA database. It is of increasing importance for clinicians to be aware of early detection, patient management, or drug selection strategies when using mAbs, particularly within the high glycemic risk-reported mAbs, to improve the efficacy and tolerability of mAbs regiment and optimize patient outcomes.

Acetate wheat starch improving blood glucose response and bilan lipid on obesity dyslipidemia mice

Abstract Resistant starch is particularly concerned with beneficial effects in regulating blood glucose concentration and lipid metabolism, reducing the risk of diabetes and cardiovascular diseases. This study aimed to validate the effects of wheat starch acetate containing 32.1% resistant starch on postprandial blood glucose response and lipid profile on obesity, dyslipidemia Swiss mice induced by a high-fat diet. The result showed that there was a restriction on postprandial hyperglycemia and remained stable for 2 hours after meal efficiently comparing with the control group fed natural wheat starch. Simultaneously, when maintaining the dose of 5g/kg once or twice a day for 8 weeks, wheat starch acetate to be able to reduce body weight and blood glucose, triglyceride, cholesterol levels compared to the control group (p<0.05)

Efectos metabólicos del consumo excesivo de fructosa añadida / Metabolic effects of excessive fructose consumption added

El consumo de fructosa ha aumentado en los últimos 50 años por la incorporación a la dieta de jarabe de maíz alto en fructosa (JMAF), presente en productos industrializados, como las bebidas azucaradas. Se puede asociar la ingesta de fructosa en altas concentraciones con el aumento de la obesidad y trastornos metabólicos. La fructosa, un azúcar natural que se encuentra en muchas frutas, se consume en cantidades significativas en las dietas occidentales. En cantidades iguales, es más dulce que la glucosa o la sacarosa y, por lo tanto, se usa comúnmente como edulcorante. Debido al incremento de obesidad entre la población joven y general y a los efectos negativos que puede tener a corto y largo plazo es importante considerar de donde provienen las calorías que se ingieren diariamente. Esta revisión describirá la relación entre el consumo de fructosa en altas concentraciones y el riesgo de desarrollar obesidad, resistencia a la insulina, lipogenesis de novo e inflamación.

The consumption of fructose has increased in the last 50 years due to the incorporation into the diet of high fructose corn syrup (HFCS), present in industrialized products, such as sugary drinks. The intake of fructose in high concentrations can be associated with the increase of obesity and metabolic disorders. Fructose, a natural sugar found in many fruits, is consumed in significant quantities in Western diets. In equal amounts, it is sweeter than glucose or sucrose and, therefore, is commonly used as a sweetener. Due to the increase of obesity among the young and general population and the negative effects that can have in the short and long term it is important to consider where the calories that are ingested daily come from. This review will describe the relationship between fructose consumption in high concentrations and the risk of developing obesity, insulin resistance, de novo lipogenesis, nonalcoholic fatty liver, inflammation and metabolic syndrome.

Metabolic dysregulation in early onset psychiatric disorder before and after exposure to antipsychotic drugs

Antipsychotic Drugs (APDs) are being widely prescribed to treat various disorders, including schizophrenia and bipolar disorder; however, abnormal glucose metabolism and weight gain have been reported with Atypical Anti-Psychotic drugs (AAPDs) that can lead to insulin-resistance and type 2 diabetes mellitus. The study was designed to assess various biochemical parameters including insulin and blood sugar before and after exposure to APDs in order to exclude the involvement of psychiatric disorders and certain other factors in metabolic dysregulations. Fifty seven APDs-naïve patients with first episode psychosis were divided into six groups who received olanzapine, quetiapine, risperidone, aripiprazole, haloperidol or combination of olanzapine with escitalopram and haloperidol. The serum samples were taken before the intake of the first dose and then on follow-up. Decrease in the level of elevated insulin and glucose was observed post-treatment in some patients, while others were observed whose insulin and glucose levels increased post-treatment, yet some patients did not show any disturbance in the insulin and glucose levels. It is concluded that psychiatric disorders by itself, narcotics, cigarette smoking and use of oral snuff may be also be implicated in metabolic dysregulations. The effects of APDs on insulin and glucose in healthy volunteers might be different than in patients with psychiatric disorders.

Pros and cons of insulin administration on liver glucose metabolism in strength-trained healthy mice

Non-diabetic individuals use hormones like insulin to improve muscle strength and performance. However, as insulin also leads the liver and the adipose tissue to an anabolic state, the purpose of this study was to investigate the effects of insulin on liver metabolism in trained non-diabetic Swiss mice. The mice were divided into four groups: sedentary treated with saline (SS) or insulin (SI) and trained treated with saline (TS) or insulin (TI). Training was made in a vertical stair, at 90% of the maximum load, three times per week. Insulin (0.3 U/kg body weight) or saline were given intraperitoneally five times per week. After eight weeks, tissue and blood were collected and in situ liver perfusion with glycerol+lactate or alanine+glutamine (4 mM each) was carried out. The trained animals increased their muscle strength (+100%) and decreased body weight gain (-11%), subcutaneous fat (-42%), mesenteric fat (-45%), and peritoneal adipocyte size (-33%) compared with the sedentary groups. Insulin prevented the adipose effects of training (TI). The gastrocnemius muscle had greater density of muscle fibers (+60%) and less connective tissue in the trained groups. Liver glycogen was increased by insulin (SI +40% and TI +117%), as well as liver basal glucose release (TI +40%). Lactate and pyruvate release were reduced to a half by training. The greater gluconeogenesis from alanine+glutamine induced by training (TS +50%) was reversed by insulin (TI). Insulin administration had no additional effect on muscle strength and reversed some of the lipolytic and gluconeogenic effects of the resistance training. Therefore, insulin administration does not complement training in improving liver glucose metabolism.

Glycemic effects of simvastatin: Where do we stand?

ABSTRACT In clinical practice, simvastatin is usually used in the treatment of dyslipidemia patients and those at risk of or with established cardiovascular disease. However, previous studies have shown that simvastatin has the potential to affect glycemic parameters as it reportedly reduced insulin secretion and sensitivity. The exact mechanism by which simvastatin affects glycemia is still unknown, but previous studies have postulated the involvement of the glucose-insulin secretion mechanism. This review focuses on the effects of simvastatin, either alone or in combination with other lipid lowering agents, antidiabetics and antihypertensives, on glucose homeostasis. Some studies have reported that simvastatin might impair the levels of glucose metabolism markers in the blood while others have reported no effect or improvement in glycemia.

Expresión del síndrome metabólico frente a factores ambientales / Expression of metabolic syndrome against environmental factors / Expressão da síndrome metabólica frente a fatores ambientais

El Síndrome Metabólico (SM) se define como la asociación de alteraciones metabólicas e inflamatorias a nivel molecular, celular o hemodinámico, que pueden presentarse en forma simultánea o secuencial en un mismo individuo. Esto imprime un mayor riesgo de desarrollar diabetes y enfermedades cardiovasculares, teniendo como base la resistencia insulínica. Su diagnóstico se presenta cuando existe obesidad abdominal y dos o más componentes adicionales: triglicéridos elevados, lipoproteína de alta densidad (HDL) baja, alteración en la regulación de la glucemia y presión arterial alta. En este contexto, y dada su relación con los factores ambientales, el objetivo del presente trabajo fue evaluar la relación del SM en poblaciones expuestas a diferentes niveles de contaminación atmosférica, determinando dicha asociación mediante las respuestas obtenidas de una encuesta socioeconómica, de antecedentes de salud, y contrastándolas con análisis sanguíneos. Finalmente, los resultados obtenidos evidencian intercurrencias entre el grado de contaminación atmosférica y el SM.

The metabolic syndrome (MS) is defined as the association of metabolic disorders and inflammatory diseases at molecular, cellular or hemodynamic levels, which may occur simultaneously or sequentially in the same individual. This adds an increased risk of developing diabetes and cardiovascular disease, based on insulin resistance. MS diagnosis is made when there are two or more additional components and abdominal obesity: elevated triglycerides, high density lipoprotein (HDL) low, altered regulation of blood glucose and high blood pressure. In this context, and given its relationship with environmental factors, the objective of this study was to evaluate the relationship of MS in populations exposed to different levels of air pollution,determining the association with the responses obtained from a socio-economic survey and health history, and contrasting them with a blood test. Finally, the results show intercurrences between the degree of air pollution and SM.

A síndrome metabólica (SM) é definida como a associação de alterações metabólicas e inflamatórias em nível molecular, celular ou hemodinâmico, que podem ocorrer em forma simultânea ou sequencial num mesmo indivíduo. Isto adiciona um maior risco de desenvolver diabetes e doenças cardiovasculares, tendo como base a resistência à insulina. Seu diagnóstico ocorre quando há obesidade abdominal e dois ou mais componentes adicionais: aumento dos triglicerídeos, lipoproteína de alta densidade (HDL) baixa, alteração na regulação da glicemia e pressão arterial elevada. Neste contexto, e devido a sua relação com os fatores ambientais, o objetivo desse estudo foi avaliar a relação da SM em populações expostas a diferentes níveis de poluição do ar, determinando tal associação através das respostas obtidasa em um levantamento socioeconômico, histórico de saúde e em contraste com análises de sangue. Por fim, os resultados mostram intercorrências entre o grau de poluição do ar e a SM.

The influence of simvastatin in induced peritoneal fibrosis in rats by peritoneal dialysis solution with glucosis 4.25% / Influência da sinvastatina na fibrose peritoneal induzida em ratos pelo uso de solução de diálise peritoneal com glicose a 4,25%

PURPOSE: To investigate the influence of using simvastatin on the peritoneal fibrosis induced in rats using peritoneal dialysis solution with glucoses 4.25%. METHODS: Prospective controlled study in 20 non-uremic Wistar rats. The animals received a peritoneal infusion of 10 ml/100 g of peritoneal dialysis solution glucose 4.25% on a daily basis. The animals were divided in two groups: experimental and control. The experimental group received simvastatin 4 mg/kg/d, by a gastric tube. The control group did not receive any drug. The follow-up was 21 and 49 days. At the end, one surgical procedure was performed to get histological samples of visceral and parietal peritoneum. The samples were analyzed using Hematoxylin Eosin and Sirius Red, to evaluate the severity of the fibrosis. RESULTS: The analysis showed that the intensity of the fibrosis, the peritoneal thickness and the cell number in experimental and control groups were not statistically significant different in experimental and control groups. CONCLUSION: The simvastatin do not decrease the intensity of fibrosis on the peritoneal membrane that happens on rats on peritoneal dialysis.

OBJETIVO: Investigar a influência do uso da sinvastatina na fibrose peritoneal induzida em ratos pelo uso de solução de diálise peritoneal rica em glicose. MÉTODOS: Estudo prospectivo controlado, em ratos Wistar não urêmicos. Foram estudados 20 animais. Os animais foram submetidos diariamente à punção abdominal, sendo infundida solução de diálise peritoneal com glicose a 4,25% na dose de 10 ml/100 g de peso. Os animais foram divididos em dois grupos: experimental e controle. O grupo experimental recebeu sinvastatina na dose de 4 mg/kg/dia por gavagem. O grupo controle não recebeu nenhuma droga. Foram acompanhados por 21 e 49 dias. Ao final do período foram submetidos à procedimento cirúrgico para retirada de peritônio parietal e visceral. As amostras obtidas foram analisadas histologicamente, usando-se coloração Hematoxilina - Eosina e Sirius Red, para avaliação do grau de fibrose. RESULTADOS: A análise mostrou que a intensidade da fibrose, a espessura do peritônio e o número de células não atingiram diferença estatisticamente significante entre os grupos experimental e controle. CONCLUSÃO: A sinvastatina não foi capaz de alterar a intensidade da fibrose peritoneal induzida pelo uso de solução de diálise em ratos.

Resposta plasmática de glicose e insulina em eqüinos alimentados com diferentes fontes de amido / Plasmatic response of glucose and insulin in horses fed diets containing different starch sources

O objetivo deste trabalho foi medir a resposta plasmática de glicose e insulina em cavalos alimentados com dietas contendo concentrados energéticos formulados com diferentes fontes de amido, tais como milho, aveia, sorgo e uma mistura de milho e aveia em partes iguais por peso. Foram utilizados quatro eqüinos com 36 meses de idade em media, mestiços, machos, castrados, com peso aproximado de 350 kg. O delineamento experimental utilizado foi um quadrado latino 4X4 (quatro animais, quatro tratamentos, quatro períodos). Os resultados foram processados através de programa computacional,a normalidade dos resíduos verificada pelo Teste de Shapiro - Wilk, eas variâncias comparadas pelo teste F. Não foram observadas diferenças nos níveis de glicose plasmática entre tratamentos. No caso da glicose, todos os tratamentos atingiram seu máximo nível duas horas e meia pós-ingestão O nível de insulina plasmática foi significativamente inferior antes da refeição em aqueles cavalos tratados com a mistura de milho e aveia, e significativamente superior nos cavalos alimentados com milho como fonte de energia três horas e meia pós ingesta. Os valores de glicose e insulina plasmática observados neste estudo podem ter sido influenciados pelo processamento das dietas na forma peletizada, promovendo uma maior absorção de glicose no intestino delgado. As dietas contendo diferentes fontes de amido não influenciaram nem o tempo nem a quantidade de glicose absorvida no intestino delgado. As variações observadas nos níveis de insulina indicam que um manejo alimentar apropriado pode influenciar os níveis deste hormônio, moderando os seus efeitos indesejáveis.

This study was aimed to measure the plasmatic response of glucose and insulin of horses fed diets containing different starch sources,like corn, oat, sorghum and a mix of corn and oat in equal parts. Four standarbred gelding 36 month old an weighing average of 350 kg were used in a Latin Square 4 x 4 (four animals, four treatments and four period) trial design. No statistical differences were observed in plasmatic glucose levels either before or after ingestion between treatments. Maximum plasmatic level of glucose was observed in all diets two and a half hours post ingestion. Insulin plasmatic level was significantly lower before ingestion in horses treated with the mixed corn and oat diet, when compared with the other treatments. In the other hand, the insulin plasmatic level in horses fed corn-formulated diet was statistically higher than the others treatments at three hours and a half after ingestion. Diets containing different sources of starch had no effect in time neither quantity of glucose absorbed in small intestine. Variation observed in insulin plasmatic levels indicate that a proper feeding can have a regulatory effect of this hormone, avoiding undesirable’s behaviors.

Influência da sacarose, lactose e glicose + frutose no potencial cariogênico de S. mutans: estudo in situ e in vitro / Influence of sucrose, lactose and glucose + fructose on the cariogenic potential of S. mutans: an in situ and in vitro study

Objetivo: Este estudo determinou o efeito in situ de sacarose, lactose e glicose+frutose na colonização do esmalte por S. mutans e seu potencial cariogênico in vitro. Metodologia: Doze voluntários participaram da etapa in situ, tipo duplo-cego, cruzada, em quatro etapas de 48 horas. Dispositivos palatinos contendo três blocos de esmalte bovino receberam uma gota de substrato 4 vezes/dia. O biofilme formado foi inoculado em meio de cultura Mitis-Salivarius-Bacitracina (MSB) para determinação do número de colônias (UFC). No experimento in vitro, os açúcares e S. mutans foram adicionados ao meio Brain-Heart-Infusion; o pH foi aferido após 6, 12, 24, 48 horas; o peso úmido do biofilme foi determinado e inoculado em MSB. Resultados: Não houve diferença estatisticamente significante na colonização pelos microorganismos no modelo in situ. No estudo in vitro, os meios contendo sacarose e lactose apresentaram maior número de colônias e de peso úmido de biofilme que glicose+frutose (P<0,05). O pH reduzido do meio foi mantido por maior período de tempo na presença de sacarose (48h/pH=4,4). Conclusão: Embora não tenha havido diferença de colonização por S. mutans frente à sacarose e lactose neste delineamento in situ, o estudo in vitro mostrou potencial cariogênico distinto das soluções testadas.

Purpose: This study evaluated the in situ effect of sucrose, lactose, and glucose+fructose on dental enamel colonization by S. mutans and its in vitro cariogenic potential. Methods: Twelve volunteers participated in a crossover double-blind in situ study, comprising four 48-hour stages. Acrylic resin appliances with three bovine enamel blocks received a drop of experimental solution 4 times/day. The biofilm formed was inoculated in Mitis-Salivarius-Bacitracin (MSB) culture to determine the number of colonies (CFU). In the in vitro experiment, the solutions and S. mutans were added to the Brain-Heart-Infusion medium; the pH was measured after 6, 12, 24, and 48 hours; the biofilm-wet weight was determined and inoculated in MSB. Results: There was no in situ effect of any solution on S. mutans colonization. The in vitro results showed that sucrose and lactose yielded larger number of colonies and biofilm wet-weight than glucose+fructose solution (P<0.05); sucrose samples sustained reduced pH values for a longer period of time (48 hours/pH=4.4). Conclusion: Although there was no difference of S. mutans colonization under sucrose and lactose challenge in situ, the study vitro showed different cariogenic potential of the tested solutions.

Efeito da glicose na histomorfologia do peritônio durante a diálise peritoneal / Glucose effects on the histomorfology of the peritoneum during peritonealdialysis

As alterações peritoneais em pacientes submetidos à diálise peritoneal por longos períodos começam com as modificações mesoteliais e, mais tarde, envolvem alterações submesoteliais, fibrose e vasculopatias. Entre outros fatores, essas alterações podem ser decorrentes da alta concentração de glicose da solução de diálise. Desta forma, o objetivo do presente estudo foi estudar as alterações histomorfológicas na membrana peritoneal de ratos submetidos à diálise peritoneal, com solução de glicose a temperatura ambiente. Foram utilizados 20 ratos Wistar divididos em dois grupos: grupo controle (GC) com oito animais que não receberam nenhuma injeção intraperitoneal, e grupo solução concentrada (GSC) com 12 animais que receberam 10ml de fluido de diálise com 4,25% de glicose uma vez por dia durante 30 dias. Nos animais do GSC, o peritônio visceral do baço e o parietal da parede abdominal apresentaram alterações epiteliais com transformação cúbica das células mesoteliais e espessamento na camada submesotelial, respectivamente. Esses resultados sugerem que a solução de diálise com 4,25% de glicose em temperatura ambiente realizada uma vez por dia durante 30 dias pode alterar a histomorfologia do peritônio.

Alterations in the peritoneum of patients submitted to peritoneal dialysis during long periods begins with modifications of the mesothelium, and latter unfolds to alterations of the submesothelium, of the vascular system and fibrosis. One of the possible explications to these alterations is the high concentration of glucose in the dialysis solution. Therefore, the aim of this study was to study the histomorphological alterations of the peritoneal membrane in rats submitted to peritoneal dialysis, with the glucose solution at the local temperature. 20 Wistar rats were used, divided into two groups: control group (CG) with eight animals that didn't receive intraperitoneal injection and the concentrated solution group (CSG) with12 animals that received 10ml of the dialysis fluid with 4.25% of glucose, once a day, for 30 days. The visceral peritoneum of the spleen and the parietal peritoneum of the abdominal wall of the animals of CSG showed alterations of the epithelial layer with cubic transformation of the mesothelium cells and the thickness of the submesothelium layer, respectively. The dialysis solution of glucose at the concentration of 4.25%, at local temperature, applied once a day, during 30 days, altered the histomorphology of the peritoneum.

Control estricto de la glicemia en pacientes en cuidado crítico: mecanismo de acción: [revisión] / Strict control of blood glucose in patients in critical care: mechanism of action: [review]

Recientemente, fue demostrada la importancia de mantener mediante el uso de una infusión contínua de insulina, un control estricto de la glicemia en los pacientes en cuidados intensivos. El mecanismo mediante el cual esta medida terapéutica, disminuye significativamente la mortalidad y la morbilidad de este grupo de pacientes, involucra una gama importante de factores, que a grandes rasgos se pueden dividir en dos: prevención de los efectos deletéreos de la hiperglicemia y acciones benéficas propias de la insulina. La investigación en este campo, ha abierto la puesta al descubrimiento de interacciones entre la glucosa y la insulina que van mucho mas allá del metabolismo energético. De esta forma, ahora se reconoce que ambas juegan un papel importante en la regulación de los procesos de inflamación y coagulación, que ocurren en pacientes que se encuentran en unidades de cuidado crítico.

Opposite lipemic response of Wistar rats and C57BL/6 mice to dietary glucose or fructose supplementation

The metabolic effects of carbohydrate supplementation in mice have not been extensively studied. In rats, glucose- and fructose-rich diets induce hypertriacylglycerolemia. In the present study, we compared the metabolic responses to two monosaccharide supplementations in two murine models. Adult male Wistar rats (N = 80) and C57BL/6 mice (N = 60), after 3 weeks on a standardized diet, were submitted to dietary supplementation by gavage with glucose (G) or fructose (F) solutions (500 g/L), 8 g/kg body weight for 21 days. Glycemia was significantly higher in rats after fructose treatment (F: 7.9 vs 9.3 mM) and in mice (G: 6.5 vs 10 and F: 6.6 vs 8.9 mM) after both carbohydrate treatments. Triacylglycerolemia increased significantly 1.5 times in rats after G or F supplementation. Total cholesterol did not change with G treatment in rats, but did decrease after F supplementation (1.5 vs 1.4 mM, P < 0.05). Both supplementations in rats induced insulin resistance, as suggested by the higher Homeostasis Model Assessment Index. In contrast, mice showed significant decreases in triacylglycerol (G: 1.8 vs 1.4 and F: 1.9 vs 1.4 mM, P < 0.01) and total cholesterol levels (G and F: 2.7 vs 2.5 mM, P < 0.05) after both monosaccharide supplementations. Wistar rats and C57BL/6 mice, although belonging to the same family (Muridae), presented opposite responses to glucose and fructose supplementation regarding serum triacylglycerol, free fatty acids, and insulin levels after monosaccharide treatment. Thus, while Wistar rats developed features of plurimetabolic syndrome, C57BL/6 mice presented changes in serum biochemical profile considered to be healthier for the cardiovascular system.

Efeitos da ingestão de glicose sobre a circulação materno-fetal / Materno-fetal hemodynamic repercussion of glucose ingestion

OBJETIVOS: analisar o efeito da glicose na hemodinâmica materno-fetal pela avaliação doplervelocimétrica da circulação materno-fetal e fetoplacentária. MÉTODOS: trata-se de estudo realizado por único observador, no qual foram incluídas 31 gestantes clinicamente sadias entre a 28ª e a 36ª semana. Os parâmetros foram avaliados imediatamente antes e 60 minutos após a ingestão de 50 g de glicose. Foram utilizados como critérios de inclusão a avaliação clínica e laboratorial normal, a presença de feto único, a idade gestacional entre a 28ª e a 36ª semana de gestação confirmada por exame de ultra-sonografia e/ou a data da última menstruação, a glicemia de jejum menor ou igual a 110 mg/dL e o teste de sobrecarga após 50 g de glicose menor de 140 mg/dL. Como critérios de exclusão, adotaram-se a presença de malformação ou alterações de desenvolvimento fetal, o trabalho de parto, os antecedentes familiares de diabetes, as patologias próprias ou intercorrentes à gestação e o uso de fumo, álcool ou outras drogas. Foram avaliados os vasos maternos da artéria carótida comum e artérias uterinas, os vasos placentários da artéria umbilical e os vasos fetais da artéria cerebral média e aorta abdominal. Foram analisados os seguintes parâmetros em cada vaso: índice de resistência, índice de pulsatilidade, velocidade sistólica máxima, velocidade diastólica final e tempo de aceleração. A freqüência cardíaca fetal foi avaliada pelo modo M da ultra-sonografia. Para análise estatística foi utilizado o teste t de Student quando a variável diferença de antes e depois da ingestão de glicose apresentou distribuição normal no teste de Kolmogorov-Smirnov. Quando a normalidade foi rejeitada, utilizamos o teste não-paramétrico de Wilcoxon, com o nível de significância sempre estabelecido de p<0,05. RESULTADOS: Observou-se a elevação da glicemia materna após a ingestão de 50 g de glicose (pré: 68,0±10,1 mg/dL e pós: 104,6±28,2 mg/dL; p<0,001). A freqüência...

PURPOSE: to analyze the effect of glucose in the materno-fetal hemodynamics through dopplervelocimetric assessment of the materno-fetal and fetoplacentary circulation. METHODS: the study was carried out by a single observer on 31 clinically healthy pregnant women from the 28th to the 36th gestational week. Parameters were assessed immediately before or 60 minutes after the ingestion of 50 g of glucose. The including criteria comprised normal clinical and laboratorial evaluation, the presence of only one fetus, gestational age between 28 and 36 weeks confirmed by ultrasonography and/or the date of the last menstruation, fasting glycemia less or equal to 110 mg/dL and less than 140 mg/dL after 50 g of glucose overload. The excluding criteria consisted of the presence of fetal malformation or development alterations, labor, diabetes as a family predisposition, pathologies due to or underlying gestation and use of tobacco, alcohol and/or other substances. The mother´s common carotid artery and uterine arteries, the umbilical artery and the fetal medial cerebral artery and abdominal aorta were evaluated. In each blood vessel, the following parameters were analyzed: resistance index, pulsatility index, maximum systolic speed, final diastolic speed and acceleration time. The fetal heart rate was evaluated by M Mode ultrasonography. For the statistical analysis, the Student's t test was used when the variable presented normal distribution in Kolmogorov-Smirnov's test. When normality was rejected, the Wilcoxon's non-parametric test was used, with the significance level always established at p<0.05. RESULTS: the maternal glycemia increased after the ingestion of 50 g of glucose (before: 68.0±10.1 mg/dL and after: 104.6±28.2 mg/dL; p<0.001), and fetal heart rate decreased after the glucose ingestion (before: 137.9±6.1 bpm and after: 134.5±6.9 bpm; p<0.001). The umbilical artery presented an increase in the pulsatility...

role of pyridoxal-5'-phosphate with simple sugars on cardiovascular diseases prediction in rats

The objective of the present study is to assess the effect of different dietary simple sugars [sucrose, glucose and fructose] on the prediction of cardiovascular disease [CVD] risk factors, with regard to supplementation with high dose of vitamin B6 [500 mg/100 g diet] in the form of pyridoxal-5'-phosphate [PLP]. It was concluded that, long term consumption of high carbohydrate diets increase the prediction of CVD by increasing plasma TG, total cholesterol and LDL-C levels. Dietary glucose was the best sugar used for substitution of starch, while fructose is considered as a risk factor for CVD. Plasma albumin showed little association with CVD. Pyridoxal-5'-phosphate and glucose in combination act in a synergistic manner through highly significant reduction in plasma LDL-C and significantly increase HDL-C levels throughout the first and second periods of the experiment. Supplementation with pyridoxal-5'-phosphate did not affect the plasma glucose levels on 21 days, but improves and normalizes the platelets count, and reduces the elevated TG levels via several mechanisms, and hence, reduces the risk factors leading to CVD

Effects of L-arginine on development of mouse pre-implantation embryos in culture media with high level of glucose

It is accepted that maternal hyperglycemia causes delay in early embryonic development, spontaneous miscarriage and malformations. According to various studies, some of these problems occur in earlier stages of embryonic developmen especially pre-implantation stage. It seems that elevated glucose level of blood can have important role in this regard as potential teratogen factor. One of cases, which can be related to racousnesses resulting from glucose effects is Nitric Oxide [NO] system disorder in hyperglycemic condition. Some evidences show at first in hyperglycemic condition, L-arginine uptake of media by embryo increases and therefore leads to decrease amount of available L-arginine and since L-arginine is essential substrate for NO production, so it's decrease inhibits NO production. To examine this hypothesis, 2-cell embryos of mice were cultured in media of high concentration of glucose [30mM] and different concentrations of L-arginine [5, 10, 20 mM] and their growth and development were assessed and at the end, embryos were stained by Hoechst 33254 color and the number of their blactocysts were counted by use a Fluorescence microscope. Comparison of embryos culture in HTF culture media with different concentration of glucose and L-arginin showed in high glucose media up to 30 mM affects growth and development of embryos totally and decrease their blactocysts numbers, but addition of 5-10 mM L-arginine to this media significantly improves this condition. On the contrary addition of L-NAME [an antagonist of L-arginine] significantly inhibits the development of pre-implantation embryos. It seems that reduction in NO production in diabetes is due to decreases in amount of available L-arginine, because increase in L-arginine concentration in high glucose media up to 10 mM partially improves high glucose embryo toxicity. Base on acquired result, it seems use of L-arginine or material which cause NO release in media, can have important role in prevention of high glucosis embryo toxicity

Malformaciones congénitas en los hijos de madres diabéticas / Congenital malformations in the offspring of diabetic mothers

The offspring of diabetic mothers have a 10 times higher frequency of congenital malformations and 5 times higher frequency of spontaneous abortions. Since the discovery of insulin, the prognosis of pregnancies has improved, both for the mother and the offspring. However, the prevalence of congenital malformations at birth has not decreased significantly. The embriological process that leads to anomalies in the offspring of diabetic mothers probably occurs between 6 and 8 weeks of gestation. According to animal experiments, hyperglycemia, ketones and free radicals may be involved in the genesis of malfomations, but different strains of rats respond differently to these potential teratogenic agents. Possibly, a higher genetic susceptibility towards congenital malformations also plays a role in diabetic women. Therefore, although the intimate mechanism producing malformations in the offspring of diabetic women is not known, several strategies to decrease the prevalence of malformations in these women, such as the use of antioxidants, are being tested

Selección de alimentos con poder de retención de glucosa para la dieta del diabético / Selection of food by retention power of glucose retention of the diet for the diabetic

La diabetes es una patología de alta prevalencia a nivel mundial, se han ensayado diversas alternativas en el manejo de la dieta de estospacientes a fin de conseguir un régimen alimenticio que no tenga caracteres híperglicemiantes y que supriman la glicosuria. Joslin, preconizó regímenes con un mínimo de 150 gramos de hidratos de carbono, cifra de seguridad que permite un buen estado de nutrición, aconsejándose un"régimen normal". Partiendo de las leyesde alimentación de Escudero y de las recomendaciones de la Asociación Americana de Diabetes, los hidratos de carbono deben suministrarse en cantidad adecuada para que el hígado aumente sus reservas de glucógeno, si estas reservas se agotan hay mayor consumo de proteínas y lípidos, provocando así un balance negativo. Por lo tanto, el régimen debe ser satisfactorio desde el punto de vista nutricional durante las 24 horas, favoreciendo así el estado ponderal óptimo. Los alimentos ricos en fibras no digeribles, como los cereales, el salvado, disminuyen la absorción de glucosa. Los polisacáridos son menos hiperglicemiantes que los monosacáridos, es el caso del almidón de arroz que lleva la glucosa en el 50 por ciento menos que los otros polisacáridos, esto induce a pensar que los almidones son aprovechados de distinta manera en la digestión y absorción. Precisamente el objetivo del presente trabajo es fortalecer todos los conocimientos inherentes a la acción de los polisacáridos, mediante el estudio de seleccionar alimentos que tengan la propiedad de retener glucosa in vitrio, para posteriormente ser sometido a prueba en pacientes diabéticos

Validez del diascan en la determinación de niveles de glucemia en pacientes diabeticos y no diabéticos / Validity of diascan in the determination of levels of glucemia in diabetics and no diabetic patients

Se practicaron determinaciones de glucemia, por el método enzimático diascan, con sangre capilar de 92 pacientes que acudieron al Laboratorio del Centro Ambulatorio "Dr. Rafael Vicente andrade", del IVSS de Barquisimeto, estado Lara, tomándose simultáneamente muestra de sangre venosa para determinación de glucemia en suero por método enzimático hexoquinasa. Los resultados de validez obtenidos en base a la más medidas de sensibilidad y especificidad fueron bajos, mientras que el coeficiente de correlación se asemeja al obtenido en los anteriores. Se sugiere no sólo medir la validez del diascan en base a su sensibilidad y especificidad, sino también evaluar su rendimiento, reproductibilidad y fidelidad utilizando una muestra que sea representativa de la población