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1.
Biomed Environ Sci ; 34(1): 9-18, 2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33531103

RESUMEN

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion: An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.


Asunto(s)
Índice Glucémico , Ácido Úrico/sangre , Anciano , Grupo de Ascendencia Continental Asiática , Glucemia/análisis , China/epidemiología , Estudios de Cohortes , Diabetes Mellitus/sangre , Femenino , Prueba de Tolerancia a la Glucosa , Hemoglobina A Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad
2.
Medicine (Baltimore) ; 100(4): e24200, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530212

RESUMEN

BACKGROUND: Diabetic peripheral neuropathy (DPN) is 1 of the most common clinical complications of diabetes, which seriously affects the quality of life of patients and causes a substantial economic burden on diabetes care. The pathogenesis of DPN is complex. There is no targeted treatment method, and mainstream treatment methods have low efficacy and large side effects. Traditional Chinese medicine has rich clinical experience in the prevention and treatment of diabetic peripheral neuropathy, which has dramatically improved the quality of life of patients. It is clinically proven that traditional Chinese medicine fumigants (TCMF) have apparent effects in treating diabetic peripheral neuropathy. Therefore, we aim to systematically review the effectiveness and safety of TCMF for DPN. METHODS: We will search the following databases: PubMed, Embase, Cochrane Library, MEDLINE, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, Cqvip Database, and Wanfang Data. Besides, we will also search for clinical trial registrations, potential grey literature, relevant conference abstracts, and reference lists of established studies. The studies published from the inception of the database to November 2020 will be retrieved. The randomized controlled trials on TCMF for DPN will be included. Also, we will search for clinical trial registrations, potential grey literature, relevant conference abstracts, and reference lists of established studies. The main result is clinical efficacy and nerve conduction velocity. Fasting blood glucose, 2 hours postprandial blood glucose, blood lipid, glycosylated hemoglobin, and adverse events are secondary results. We will perform the analyses using RevMan V.5.3 software. RESULTS: This study will provide a high-quality comprehensive evaluation of the efficacy and safety of TCMF in the treatment of DPN. CONCLUSIONS: This systematic review will evaluate the effectiveness and safety of TCMF in the treatment of DPN, and provide the latest evidence for clinical application. INPLASY REGISTRATION NUMBER: INPLASY2020110137.


Asunto(s)
Neuropatías Diabéticas/terapia , Fumigación/métodos , Medicina China Tradicional/métodos , Enfermedades del Sistema Nervioso Periférico/terapia , Glucemia/análisis , Diabetes Mellitus/sangre , Diabetes Mellitus/fisiopatología , Neuropatías Diabéticas/sangre , Neuropatías Diabéticas/etiología , Hemoglobina A Glucada/análisis , Humanos , Metaanálisis como Asunto , Conducción Nerviosa , Enfermedades del Sistema Nervioso Periférico/sangre , Enfermedades del Sistema Nervioso Periférico/etiología , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
3.
Medicine (Baltimore) ; 100(4): e23532, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530160

RESUMEN

BACKGROUND: Baduanjin is an ancient technique of physical and breathing exercises (Dao Yin). This technique is divided into eight sections and each section is a motion, so it is called "Baduanjin". It is practice without equipment, simple and easy to learn, whose effect is significant leading to good fitness effect. Diabetes mellitus is a chronic metabolic disease. Clinical studies have reported that Baduanjin can affect the metabolism of blood glucose and blood lipid in diabetic patients, but the reported efficacy is different among different studies. Therefore, the study is aimed to systematically evaluate the size and differences of the impact of Baduanjin on the metabolism of glucose and lipid in diabetic patients. METHODS: Retrieved randomized controlled trials(RCTs) on effects of Baduanjin on glucose and lipid metabolism in diabetic patients from PubMed, Web of Science, the Cochrane Library, Embase, CNKI with computer while mutually retrieved the same things from Chinese Clinical Trial Registry(ChiCTR), Google Academic and Baidu Academic. The retrieval time was from their establishment to October 2020. Then 2 researchers independently extracted relevant data and evaluated the quality of the included literatures, and meta-analysis was conducted on the included literatures using RevMan5.3. RESULTS: This research used outcome indicators like fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, total cholesterol content and triglyceride content to explore the effect of Baduanjin on glucose and lipid metabolism in diabetic patients specifically. CONCLUSION: The research will provide reliable evidence-based proof for Baduanjin improving glucose and lipid metabolism of diabetic patients. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/ OSF.IO/AGJHQ.


Asunto(s)
Glucemia/metabolismo , Ejercicios Respiratorios/métodos , Diabetes Mellitus/terapia , Metabolismo de los Lípidos/fisiología , Medicina China Tradicional/métodos , Diabetes Mellitus/sangre , Humanos , Metaanálisis como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
4.
Medicine (Baltimore) ; 100(4): e24433, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530244

RESUMEN

BACKGROUND: The improvement effect of exercise on diabetes mellitus has been widely recognized. Taijiquan, as a popular exercise mode for middle-aged and elderly people, is not clear about its effect on glucose and lipid metabolism in elderly diabetic patients. In this paper, the influence of Taijiquan on glucose and lipid metabolism in middle-aged and elderly diabetic patients was studied by using a meta-analysis method, to provide evidence for the clinical promotion of Taijiquan to improve glucose and lipid metabolism in diabetic patients. METHODS: Computer system search and manual search were conducted respectively in web of science, PubMed, Cochrane Library, EMBASE, Google Scholar, China National Knowledge Infrastructure, Wanfang Database, VIP from the inception to August 1, 2020. Randomized controlled trials of the application of Taijiquan in middle-aged and elderly diabetic patients were collected. RESULTS: The current study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program. CONCLUSION: This review aims to study the effect of Taijiquan on the glucose and lipid metabolism of middle-aged and elderly diabetic patients, objectively evaluate the effect of Taijiquan on the glucose and lipid metabolism of middle-aged and elderly diabetic patients, and provide scientific basis for clinical exercise intervention in middle-aged and elderly diabetic patients. PROTOCOL REGISTRATION NUMBER: INPLASY2020120107.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus/terapia , Lípidos/sangre , Tai Ji/métodos , Anciano , Anciano de 80 o más Años , Diabetes Mellitus/sangre , Femenino , Humanos , Metabolismo de los Lípidos , Masculino , Metaanálisis como Asunto , Persona de Mediana Edad , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
5.
Mol Cell ; 81(3): 629-637.e5, 2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33400924

RESUMEN

As a master regulator of metabolism, AMP-activated protein kinase (AMPK) is activated upon energy and glucose shortage but suppressed upon overnutrition. Exaggerated negative regulation of AMPK signaling by nutrient overload plays a crucial role in metabolic diseases. However, the mechanism underlying the negative regulation is poorly understood. Here, we demonstrate that high glucose represses AMPK signaling via MG53 (also called TRIM72) E3-ubiquitin-ligase-mediated AMPKα degradation and deactivation. Specifically, high-glucose-stimulated reactive oxygen species (ROS) signals AKT to phosphorylate AMPKα at S485/491, which facilitates the recruitment of MG53 and the subsequent ubiquitination and degradation of AMPKα. In addition, high glucose deactivates AMPK by ROS-dependent suppression of phosphorylation of AMPKα at T172. These findings not only delineate the mechanism underlying the impairment of AMPK signaling in overnutrition-related diseases but also highlight the significance of keeping the yin-yang balance of AMPK signaling in the maintenance of metabolic homeostasis.


Asunto(s)
Proteínas Quinasas Activadas por AMP/metabolismo , Diabetes Mellitus/enzimología , Glucosa/farmacología , Proteínas de la Membrana/metabolismo , Músculo Esquelético/efectos de los fármacos , Obesidad/enzimología , Proteínas Quinasas Activadas por AMP/genética , Animales , Glucemia/metabolismo , Diabetes Mellitus/sangre , Diabetes Mellitus/genética , Modelos Animales de Enfermedad , Células HEK293 , Humanos , Macaca mulatta , Masculino , Proteínas de la Membrana/genética , Ratones Endogámicos C57BL , Músculo Esquelético/enzimología , Obesidad/sangre , Obesidad/genética , Fosforilación , Proteínas Serina-Treonina Quinasas/metabolismo , Proteolisis , Especies Reactivas de Oxígeno/metabolismo , Transducción de Señal , Ubiquitinación
6.
Medicina (Kaunas) ; 57(1)2021 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-33466617

RESUMEN

Background and objectives: Critically and non-critically ill patients with SARS-CoV-2 infection (Covid-19) may present with higher-than-expected glycemia, even in the absence of diabetes. With this study we aimed to assess glucose, glycemic gap (GlyG) and insulin secretion/sensitivity measures in patients with Covid-19. Materials and Methods: We studied, upon admission, 157 patients with Covid-19 (84: in wards and 73: in intensive care units; ICU); 135 had no history of diabetes. We measured blood glucose upon admission as well as glycated hemoglobin (A1c), plasma insulin and C-peptide. We calculated the GlyG and the Homeostasis Model Assessment 2 (HOMA2) estimates of steady state beta cell function (HOMA2%B) and insulin sensitivity (HOMA2%S). Statistical assessment was done with analysis or the Kruskal-Wallis test. Results: Compared to patients in the wards without diabetes, patients with diabetes in the wards, as well as patients in the ICU (without or with diabetes) had higher admission glycemia. The GlyG was significantly higher in patients without diabetes in the ICU compared to patients without diabetes in the wards, while HOMA2%B based on glucose and insulin was significantly higher in the ICU patients compared to patients in the wards. Of all the parameters, HOMA2%S based on C-peptide/glucose was higher in survivors (n = 133). Conclusions: In our series of patients with Covid-19, a substantial number of patients with and without diabetes had admission hyperglycemia and those who were critically ill may have had compromised insulin secretion and lowered sensitivity to insulin. These findings lend credence to reports of association between Covid-19 and hyperglycemia/secondary diabetes.


Asunto(s)
Glucemia/análisis , Péptido C/sangre , Resistencia a la Insulina , Insulina/sangre , Anciano , Enfermedad Crítica , Diabetes Mellitus/sangre , Diabetes Mellitus/epidemiología , Femenino , Hemoglobina A Glucada/análisis , Grecia/epidemiología , Hospitalización , Humanos , Hiperglucemia , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad
7.
Biomed Pharmacother ; 134: 111151, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33370629

RESUMEN

Different portions (stem GIS and leaf GIL) of Garcinia linii were extracted by ethanol/water and crude extracts were employed to investigate the contents of total phenol and flavonoids, antioxidation activities, and inhibitory activities of α-amylase and α-glucosidase via enzymatic assay and OGTT and OSTT for lowering glucose levels. The data revealed that GlS and GlL contained different levels of flavonoids and total phenol. Furthermore, the results showed the extracts exhibited remarkable antioxidation activities and inhibitory activities of α-amylase and α-glucosidase. In silico docking studies were done using Gold software and the probable molecules retrieved from PubChem were docked with several anti-diabetic relate targets, the results showed several components of G. linii could potentially inhibit diabetic molecules when compared with clinic drugs. The cell glucose uptake data also confirmed that GlL and GlS could retain the active component in the regulation of insulin, AMPK, PPARγ, and DPP4. In vivo, the evidence showed G. linii extracts including syringaldehyde suppressed effect of hyperglycemia on OSTT and OGTT assays. These results suggest that G. linii extract has a potential therapeutic value for the treatment of diabetes in humans.


Asunto(s)
Antioxidantes/farmacología , Glucemia/efectos de los fármacos , Diabetes Mellitus/tratamiento farmacológico , Garcinia , Inhibidores de Glicósido Hidrolasas/farmacología , Extractos Vegetales/farmacología , alfa-Amilasas/antagonistas & inhibidores , Células 3T3 , Adipocitos/efectos de los fármacos , Adipocitos/enzimología , Animales , Antioxidantes/aislamiento & purificación , Biomarcadores/sangre , Glucemia/metabolismo , Diabetes Mellitus/sangre , Diabetes Mellitus/enzimología , Diabetes Mellitus/etiología , Dieta Alta en Grasa , Modelos Animales de Enfermedad , Garcinia/química , Inhibidores de Glicósido Hidrolasas/aislamiento & purificación , Hepatocitos/efectos de los fármacos , Hepatocitos/enzimología , Masculino , Ratones , Ratones Endogámicos ICR , Simulación del Acoplamiento Molecular , Obesidad/etiología , Extractos Vegetales/aislamiento & purificación , Hojas de la Planta , Tallos de la Planta , alfa-Amilasas/metabolismo , alfa-Glucosidasas/metabolismo
8.
PLoS One ; 15(12): e0243602, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33382747

RESUMEN

Diabetes is one of the most common comorbidities in adult patients with coronavirus disease 2019 (COVID-19). This study aimed to analyze the mortality risk factors of diabetic patients with COVID-19. A total of 167 patients with severe COVID-19, including 55 diabetic patients and 112 nondiabetic patients at Tongji Hospital, Wuhan, China from January 28, 2020, to March 10, 2020, were collected. The laboratory, radiological, management information, and medical history was retrospectively reviewed. Potential mortality risk factors in diabetic patients with COVID-19 were evaluated by the proportional hazard Cox model. The clinical information of 167 patients with severe COVID-19 was analyzed. The median age was 65.0 years. Approximately 32.9% of patients had diabetes. In total patients, older age, diabetes, and lymphocyte count were associated with increased risk of death. In diabetic patients, increased mortality was associated with decreased lymphocyte count (≤0.45×109/L, HR 0.196, 95% CI 0.049-0.781, P = 0.021), lactate dehydrogenase >600 U/L (HR 8.010, 95% CI 1.540-41.670, P = 0.013), hsCRP >90 mg/L (HR 4.551, 95% CI 1.472-14.070, P = 0.009) and interleukin-10 >10 U/mL (HR 5.362, 95% CI 1.239-23.199, P = 0.025). COVID-19 patients with diabetes had a poor prognosis, especially when they had two or more of the following abnormalities (χ2 = 58.62, P<0.001): lymphocyte count was ≤0.45×109/L, lactate dehydrogenase was >600 U/L, hsCRP was >90 mg/L and IL-10 was >10 U/mL. For diabetic patients with COVID-19, more attention should be paid to the dynamic monitoring of cytokine levels, and the control of hyperglycemia.


Asunto(s)
Diabetes Mellitus , /metabolismo , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , /mortalidad , China/epidemiología , Diabetes Mellitus/sangre , Diabetes Mellitus/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Interleucina-10/sangre , L-Lactato Deshidrogenasa/sangre , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
9.
PLoS One ; 15(12): e0243465, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33332410

RESUMEN

Continuous glucose monitoring (CGM) improves treatment with lower blood glucose levels and less patient effort. In combination with continuous insulin application, glycemic control improves and hypoglycemic episodes should decrease. Direct feedback of CGM to continuous subcutaneous insulin application, using an algorithm is called a closed-loop (CL) artificial pancreas system. Commercial devices stop insulin application by predicting hypoglycemic blood glucose levels through direct interaction between the sensor and pump. The prediction is usually made for about 30 minutes and insulin delivery is restarted at the previous level if a rise in blood glucose is predicted within the next 30 minutes (hybrid closed loop system, HCL this is known as a predictive low glucose suspend system (PLGS)). In a fully CL system, sensor and pump communicate permanently with each other. Hybrid closed-loop (HCL) systems, which require the user to estimate the meal size and provide a meal insulin basis, are commercially available in Germany at the moment. These systems result in fewer hyperglycemic and hypoglycemic episodes with improved glucose control. Open source initiatives have provided support by building do-it-yourself CL (DIYCL) devices for automated insulin application since 2014, and are used by a tech-savvy subgroup of patients. The first commercial hybrid CL system has been available in Germany since September 2019. We surveyed 1054 patients to determine which devices are currently used, which features would be in demand by potential users, and the benefits of DIYCL systems. 9.7% of these used a DIYCL system, while 50% would most likely trust these systems but more than 85% of the patients would use a commercial closed loop system, if available. The DIYCL users had a better glucose control regarding their time in range (TIR) and glycated hemoglobin (HbA1c).


Asunto(s)
Automonitorización de la Glucosa Sanguínea/instrumentación , Diabetes Mellitus/psicología , Adolescente , Adulto , Anciano , Glucemia/análisis , Automonitorización de la Glucosa Sanguínea/métodos , Niño , Preescolar , Diabetes Mellitus/sangre , Diabetes Mellitus/tratamiento farmacológico , Femenino , Alemania , Hemoglobina A Glucada/análisis , Humanos , Hipoglucemiantes/uso terapéutico , Lactante , Recién Nacido , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
10.
Pan Afr Med J ; 35(Suppl 2): 139, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193954

RESUMEN

Thiamine-responsive megaloblastic anaemia (TRMA) is a syndrome associated with megaloblastic anaemia, diabetes mellitus and sensorineural deafness, due to mutations in the SLC19A2gene, which codes for a thiamine carrier protein. Oral thiamine supplementation is the main treatment. We report the case of a 19-year-old man known for TRMA, who presented in the emergency department with bicytopenia (haemoglobin 5,4 g/dL, thrombocytes 38×109/L) revealed by dyspnea and chest pain. Investigations excluded bleeding, hemolysis, coagulopathy and iron deficiencies. A recent infection and an acute coronary syndrome have also been eliminated. We later found out that thiamine treatment had been discontinued three months before, due to general confinement in Tunisia during the COVID-19 pandemic. Parenteral administration of 100 mg of thiamine daily resulted in the recovery of haematopoiesis within three weeks.


Asunto(s)
Anemia Megaloblástica/sangre , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/sangre , Pérdida Auditiva Sensorineural/sangre , Pandemias , Neumonía Viral/epidemiología , Deficiencia de Tiamina/congénito , Trombocitopenia/etiología , Síndrome Coronario Agudo/diagnóstico , Anemia Megaloblástica/tratamiento farmacológico , Anemia Megaloblástica/fisiopatología , Dolor en el Pecho/etiología , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/fisiopatología , Diagnóstico Diferencial , Hemoglobina A Glucada/análisis , Accesibilidad a los Servicios de Salud , Pérdida Auditiva Sensorineural/tratamiento farmacológico , Pérdida Auditiva Sensorineural/fisiopatología , Hemoglobinas/análisis , Humanos , Masculino , Derrame Pericárdico/diagnóstico por imagen , Derrame Pericárdico/etiología , Recurrencia , Tiamina/provisión & distribución , Tiamina/uso terapéutico , Deficiencia de Tiamina/sangre , Deficiencia de Tiamina/tratamiento farmacológico , Deficiencia de Tiamina/fisiopatología , Túnez , Adulto Joven
11.
Pan Afr Med J ; 37: 32, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33209159

RESUMEN

Diabetes is considered a risk factor for complications due to COVID-19. In order to clarify this association, we are exploring the characteristics, the clinical signs, the outcomes and death in diabetic patients with COVID-19. In this retrospective observational study we are evaluating the demographic characteristics, the comorbidities of the patients, the clinical signs of the infection, the signs of clinical severity, the biological assessment at admission, the treatment, the outcomes and the deaths of 133 patients with COVID-19, of which 25 (19,4%) had diabetes. In the compared COVID-19 patients, with and without diabetes, the patients with diabetes were older, had higher blood pressure and more cardio-vascular diseases. Severe forms were more present in diabetic patients (56% versus 27.1%). Weight loss was higher in diabetic patients (6kg versus 3kg). Biologically, diabetic patients had higher levels of C-reactive protein (28 versus 5.8mg/l), procalcitonin (0.28 versus 0,13ng/l), ferritin (501 versus 140ng/ml), lactic dehydrogenase (268 versus 226IU/l) and of D. dimer (665 versus 444µg/l). Diabetic patients required more oxygen therapy (60% versus 26.9%), more mechanical ventilation (20% versus 8.3%) and more frequent admission to the intensive care unit (60% versus 27.8%). They presented more thromboembolic complications (12% versus 9%) but there were not significant differences in the other outcomes and in death rates. The excess of morbidity and mortality due to diabetes was still not fully clarified; the role of demographic factors, the interaction of mediations with ACE-2 receptors and the role of co-morbidities will all need to be studied in order to identify the patient at risk profile, i.e. who can develop severe forms of the diseases and more outcomes. The early identification of a possible hyper inflammation could be very valuable. More attention should be paid to patients with COVID-19 with diabetes because they are at a high risk of complications.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/epidemiología , Neumonía Viral/epidemiología , Factores de Edad , Proteína C-Reactiva/análisis , Enfermedades Cardiovasculares/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/mortalidad , Cuidados Críticos/estadística & datos numéricos , Complicaciones de la Diabetes/sangre , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/mortalidad , Diabetes Mellitus/sangre , Diabetes Mellitus/mortalidad , Ferritinas/sangre , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Hipertensión/epidemiología , L-Lactato Deshidrogenasa/sangre , Persona de Mediana Edad , Marruecos/epidemiología , Oxígeno/uso terapéutico , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Polipéptido alfa Relacionado con Calcitonina/sangre , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos , Tromboembolia/epidemiología
12.
J Med Life ; 13(3): 404-409, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33072216

RESUMEN

In acute peritonitis, any surgical intervention leads to impaired immune protection with the development of postoperative purulent-septic complications, which increases several times the likelihood of death, especially in people with secondary immunodeficiency as a consequence diabetes mellitus. We aimed to study the dynamics of pro- and anti-inflammatory cytokine content in rat serum under experimental acute generalized peritonitis on the background of diabetes mellitus. Fifty-six white rats were used for the study. The determination of the serum cytokine profile was performed by enzyme-linked immunosorbent assay. When comparing the levels of interleukins between the study groups, a statistically significant increase in the level of proinflammatory cytokines was found in the group of diabetic animals during all experimental periods. In particular, the concentration of interleukin - 1ß increased significantly by 94% on day 1 of observation, by 115% on day 3, and by 121% on day 7 compared to the control group. Similarly, a significant increase in TNF-α levels was observed in animals with diabetes. In this group, the most significant increase in the level of TNF-α was recorded on the seventh day of the experiment, and it increased by 3.4 times. Animals with acute peritonitis on the background of diabetes had a significantly increased concentration of anti-inflammatory cytokines in the serum of all study groups, which confirms their involvement in the pathogenesis of the disease under study.


Asunto(s)
Citocinas/sangre , Diabetes Mellitus/sangre , Peritonitis/sangre , Peritonitis/complicaciones , Animales , Ensayo de Inmunoadsorción Enzimática , Mediadores de Inflamación/sangre , Masculino , Ratas , Factor de Necrosis Tumoral alfa/sangre
13.
Cochrane Database Syst Rev ; 10: CD004730, 2020 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-33075159

RESUMEN

BACKGROUND: The Cystic Fibrosis Foundation recommends both short-term and long-acting insulin therapy when cystic fibrosis-related diabetes (CFRD) has been diagnosed. Diagnosis is based on: an elevated fasting blood glucose level greater than 6.94 mmol/L (125 mg/dL); or oral glucose tolerance tests greater than 11.11 mmol/L (200 mg/dL) at two hours; or symptomatic diabetes for random glucose levels greater than 11.11 mmol/L (200 mg/dL); or glycated hemoglobin levels of at least 6.5%. This is an update of a previously published review. OBJECTIVES: To establish the effectiveness of insulin and oral agents for managing diabetes in people with cystic fibrosis in relation to blood sugar levels, lung function and weight management. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also handsearched abstracts from pulmonary symposia and the North American Cystic Fibrosis Conferences. Date of most recent register search: 10 September 2020. We searched online trials registries; date of most recent searches: 21 March 2020. SELECTION CRITERIA: Randomized controlled trials comparing all methods of pharmacological diabetes therapy in people with diagnosed CFRD. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed the risk of bias in the included studies. Authors also used GRADE to assess the quality of the evidence. MAIN RESULTS: The searches identified 29 trials (45 references). Four included trials provide results: one short-term single-center cross-over trial (seven adults) comparing insulin with oral repaglinide and no medication in adults with CFRD and normal fasting glucose; one long-term multicenter trial (61 adults with CFRD) comparing insulin with oral repaglinide and placebo; one long-term multicenter trial (67 adults) comparing insulin with oral repaglinide; and one 12-week single-center cross-over trial (20 adults) comparing the long-acting insulin glargine to short-term neutral protamine Hagedorn insulin. Two ongoing trials of newly approved incretin mimics have been noted for possible future inclusion. Downgrading of the quality of the evidence was mainly due to risks of bias across all domains, but particularly due to concerns surrounding allocation concealment and selective reporting. There were also some concerns due to imprecision from small sample sizes and low event rates. Finally, there may be some bias due to the amounts of insulin and repaglinide given not being comparable. Data from one trial comparing insulin to placebo (39 participants) did not show any difference between groups for the primary outcomes of blood glucose levels (very low-quality evidence), lung function (low-quality evidence) or nutritional status (low-quality evidence). Similarly, no differences between groups were seen for the secondary outcomes of number of hypoglycemic episodes (low-quality evidence), secondary infection complications or quality of life (QoL). These results were mirrored in the narrative reports for the second trial in this comparison (seven participants). Data from the one-year trial comparing repaglinide to placebo (38 participants), showed no differences between groups for the primary outcomes of blood glucose levels (very low-quality evidence), lung function (low-quality evidence) and nutritional status (low-quality evidence). Also, no differences were seen between groups for the secondary outcomes of number of hypoglycemic episodes (low-quality evidence), secondary infection complications or QoL. These findings were mirrored in the narrative reports for the second trial (n = 7) in this comparison. Three trials compared insulin to repaglinide (119 participants). Data from one trial (n = 67) showed no difference in blood glucose levels at either 12 months (high-quality evidence) or 24 months; narrative reports from one trial (45 participants) reported no difference between groups, but the second trial (7 participants) reported a beneficial effect of insulin over repaglinide. Two trials (112 participants) found no difference between insulin and repaglinide in lung function or nutritional status (moderate-quality evidence). Two trials (56 participants) reported no difference in the number of hypoglycemic episodes (low-quality evidence). One trial (45 participants) reported no difference between groups in secondary infections and cystic fibrosis QoL. The single trial comparing glargine to neutral protamine Hagedorn insulin did not report directly on the review's primary outcomes, but did report no differences between groups in post-prandial glucose values and weight; neither group reported infectious complications. There was no difference in episodes of hypoglycemia (very low-quality evidence) and while there was no difference reported in QoL, all participants opted to continue treatment with glargine after the trial was completed. Mortality was not reported by any trial in any comparison, but death was not given as a reason for withdrawal in any trial. AUTHORS' CONCLUSIONS: This review has not found any conclusive evidence that any agent has a distinct advantage over another in controlling hyperglycemia or the clinical outcomes associated with CFRD. Given the treatment burden already experienced by people with cystic fibrosis, oral therapy may be a viable treatment option. While some cystic fibrosis centers use oral medications to help control diabetes, the Cystic Fibrosis Foundation (USA) clinical practice guidelines support the use of insulin therapy and this remains the most widely-used treatment method. Randomized controlled trials specifically related to controlling diabetes and its impact on the course of pulmonary disease process in cystic fibrosis continue to be a high priority. Specifically, investigators should evaluate adherence to different therapies and also whether there is benefit in using additional hypoglycemic agents as well as the newly approved incretin mimics. Agents that potentiate insulin action, especially agents with additional anti-inflammatory potential should also be further investigated as adjuvant therapy to insulin.


Asunto(s)
Fibrosis Quística/complicaciones , Diabetes Mellitus/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Administración Oral , Sesgo , Glucemia/análisis , Carbamatos/administración & dosificación , Fibrosis Quística/sangre , Diabetes Mellitus/sangre , Diabetes Mellitus/etiología , Ayuno/sangre , Humanos , Hiperglucemia/tratamiento farmacológico , Insulina Glargina/administración & dosificación , Insulina Isófana/administración & dosificación , Piperidinas/administración & dosificación , Ensayos Clínicos Controlados Aleatorios como Asunto
14.
Front Cell Infect Microbiol ; 10: 560899, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33117727

RESUMEN

Background: Coronavirus disease (COVID-19) is a current global public health emergency. However, current research on the blood test results of pregnant women with COVID-19 is insufficient. Methods: A case-control study was carried out based on clinical blood test results. Pregnant COVID-19 patients, pregnant COVID-19 patients with diabetes, and pregnant COVID-19 patients with hypertension, were assessed in this study. Also, 120 controls were matched by age, parity, fetus number, and presence of chronic disease. T-tests, Chi-square tests, Wilcoxon signed-rank tests, and Kruskal-Wallis tests were used to compare data from the blood tests and liver function indices among the selected groups. Results: Between January 24 and March 14, 2020, 60 pregnant COVID-19 patients delivered at the Maternal and Child Health Hospital of Hubei Province. The average maternal age of pregnant COVID-19 patients was 30.97 years and the mean gestational period was 37.87 weeks. 71.67% (43/60) of pregnant COVID-19 patients gave birth by cesarean delivery. In total, 21.67% (13/60) were diagnosed with diabetes and 18.33% (11/60) were diagnosed with hypertension during pregnancy. Compared to controls, pregnant COVID-19 patients showed significantly lower numbers of blood lymphocytes and higher numbers of neutrophils, as well as higher levels of C-reactive protein and total bilirubin. Among the three groups, pregnant COVID-19 patients with diabetes had significantly higher levels of neutrophils and lower levels of total protein. Aspartate transaminase levels were higher in pregnant COVID-19 patients with hypertension than in pregnant COVID-19 patients with no comorbidities and controls with hypertension. Interpretations: Blood and liver function indices indicate that chronic complications, including hypertension and diabetes, could increase the risk of inflammation and liver injury in pregnant COVID-19 patients.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Diabetes Mellitus/diagnóstico , Hipertensión/diagnóstico , Neumonía Viral/fisiopatología , Complicaciones Infecciosas del Embarazo/virología , Adulto , Aspartato Aminotransferasas/sangre , Betacoronavirus , Bilirrubina/sangre , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Cesárea/estadística & datos numéricos , Diabetes Mellitus/sangre , Femenino , Humanos , Hipertensión/sangre , Hígado/fisiología , Pruebas de Función Hepática , Recuento de Linfocitos , Linfocitos/citología , Neutrófilos/citología , Pandemias , Embarazo
15.
J Diabetes Sci Technol ; 14(6): 1065-1073, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33063556

RESUMEN

BACKGROUND: Amidst the coronavirus disease 2019 (COVID-19) pandemic, continuous glucose monitoring (CGM) has emerged as an alternative for inpatient point-of-care blood glucose (POC-BG) monitoring. We performed a feasibility pilot study using CGM in critically ill patients with COVID-19 in the intensive care unit (ICU). METHODS: Single-center, retrospective study of glucose monitoring in critically ill patients with COVID-19 on insulin therapy using Medtronic Guardian Connect and Dexcom G6 CGM systems. Primary outcomes were feasibility and accuracy for trending POC-BG. Secondary outcomes included reliability and nurse acceptance. Sensor glucose (SG) was used for trends between POC-BG with nursing guidance to reduce POC-BG frequency from one to two hours to four hours when the SG was in the target range. Mean absolute relative difference (MARD), Clarke error grids analysis (EGA), and Bland-Altman (B&A) plots were calculated for accuracy of paired SG and POC-BG measurements. RESULTS: CGM devices were placed on 11 patients: Medtronic (n = 6) and Dexcom G6 (n = 5). Both systems were feasible and reliable with good nurse acceptance. To determine accuracy, 437 paired SG and POC-BG readings were analyzed. For Medtronic, the MARD was 13.1% with 100% of readings in zones A and B on Clarke EGA. For Dexcom, MARD was 11.1% with 98% of readings in zones A and B. B&A plots had a mean bias of -17.76 mg/dL (Medtronic) and -1.94 mg/dL (Dexcom), with wide 95% limits of agreement. CONCLUSIONS: During the COVID-19 pandemic, CGM is feasible in critically ill patients and has acceptable accuracy to identify trends and guide intermittent blood glucose monitoring with insulin therapy.


Asunto(s)
Glucemia/análisis , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/terapia , Enfermedad Crítica/terapia , Monitoreo Fisiológico/instrumentación , Neumonía Viral/sangre , Neumonía Viral/terapia , Adulto , Anciano , Betacoronavirus/fisiología , Glucemia/metabolismo , Automonitorización de la Glucosa Sanguínea/instrumentación , Automonitorización de la Glucosa Sanguínea/métodos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Enfermedad Crítica/epidemiología , Enfermedad Crítica/mortalidad , Diabetes Mellitus/sangre , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidad , Diabetes Mellitus/terapia , Estudios de Factibilidad , Femenino , Humanos , Hiperglucemia/sangre , Hiperglucemia/diagnóstico , Hiperglucemia/mortalidad , Hiperglucemia/terapia , Insulina/administración & dosificación , Sistemas de Infusión de Insulina , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , Pandemias , Proyectos Piloto , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Sistemas de Atención de Punto , Pronóstico , Reproducibilidad de los Resultados , Estudios Retrospectivos
16.
Niger J Clin Pract ; 23(10): 1431-1436, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33047702

RESUMEN

Background: Diabetes mellitus (DM) and depression are common chronic disease states of public health importance with huge burden and the potential to impact many aspects of life. They are said to be related though this relationship is not fully understood. The presence of depression among patients with DM is associated with poor glycemic control, complications, and poor self-care. Method: This was a descriptive cross-sectional study conducted at the Diabetes Clinic of the Jos University Teaching Hospital. Three hundred and ten (310) patients with diabetes mellitus were recruited consecutively. The depression module of the Mini International Neuropsychiatric Interview (M.I.N.I.) version 5.0 was used to ascertain depression among these patients. Other demographic data were obtained using a questionnaire. Blood pressure, weight, and height were also measured and the body mass index (BMI) calculated. Results: One hundred and eighty four (59.35%) of the study population were females and the mean age (SD) of the study population was 54 ± 12 years. The mean age (SD) of the females was 53 ± 11 years and that of the males was 54 ± 12 years with no significant statistical difference (P = 0.35). Two hundred and forty nine (80.32%) of the study population were urban dwellers with 140 (45.16%) earning less than N500, 000 (794 USD) yearly. Current major depression was found in 35 (11.3%) patients, among whom 7 (2.3%) had recurrent depression. The presence of DM complications (OR: 3.50, 95% CI 1.16-10.61) and a positive family history of depression (OR: 4.03, 95% CI 1.32-12.29) were found to be correlates of current major depression. Conclusion: The prevalence of current major depression among patients with diabetes mellitus in this study is high. We recommend that all patients with DM should be screened for depression and treated appropriately to reduce its consequences.


Asunto(s)
Depresión/epidemiología , Trastorno Depresivo Mayor/epidemiología , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/epidemiología , Adulto , Anciano , Índice de Masa Corporal , Peso Corporal , Estudios Transversales , Trastorno Depresivo Mayor/psicología , Diabetes Mellitus/sangre , Diabetes Mellitus/psicología , Femenino , Hemoglobina A Glucada/análisis , Hospitales de Enseñanza , Humanos , Hiperglucemia/epidemiología , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Prevalencia , Escalas de Valoración Psiquiátrica , Autocuidado , Encuestas y Cuestionarios
18.
J Diabetes Sci Technol ; 14(6): 1035-1064, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32985262

RESUMEN

This article is the work product of the Continuous Glucose Monitor and Automated Insulin Dosing Systems in the Hospital Consensus Guideline Panel, which was organized by Diabetes Technology Society and met virtually on April 23, 2020. The guideline panel consisted of 24 international experts in the use of continuous glucose monitors (CGMs) and automated insulin dosing (AID) systems representing adult endocrinology, pediatric endocrinology, obstetrics and gynecology, advanced practice nursing, diabetes care and education, clinical chemistry, bioengineering, and product liability law. The panelists reviewed the medical literature pertaining to five topics: (1) continuation of home CGMs after hospitalization, (2) initiation of CGMs in the hospital, (3) continuation of AID systems in the hospital, (4) logistics and hands-on care of hospitalized patients using CGMs and AID systems, and (5) data management of CGMs and AID systems in the hospital. The panelists then developed three types of recommendations for each topic, including clinical practice (to use the technology optimally), research (to improve the safety and effectiveness of the technology), and hospital policies (to build an environment for facilitating use of these devices) for each of the five topics. The panelists voted on 78 proposed recommendations. Based on the panel vote, 77 recommendations were classified as either strong or mild. One recommendation failed to reach consensus. Additional research is needed on CGMs and AID systems in the hospital setting regarding device accuracy, practices for deployment, data management, and achievable outcomes. This guideline is intended to support these technologies for the management of hospitalized patients with diabetes.


Asunto(s)
Glucemia/análisis , Equipos y Suministros , Hospitalización , Sistemas de Infusión de Insulina , Insulina/administración & dosificación , Monitoreo Fisiológico/instrumentación , Adulto , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Automonitorización de la Glucosa Sanguínea/instrumentación , Automonitorización de la Glucosa Sanguínea/métodos , Automonitorización de la Glucosa Sanguínea/normas , Niño , Consenso , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Complicaciones de la Diabetes/sangre , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/terapia , Diabetes Mellitus/sangre , Diabetes Mellitus/epidemiología , Diabetes Mellitus/terapia , Cálculo de Dosificación de Drogas , Equipos y Suministros/normas , Femenino , Hospitales/normas , Humanos , Sistemas de Infusión de Insulina/normas , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/normas , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Embarazo
19.
PLoS One ; 15(9): e0238763, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32941454

RESUMEN

BACKGROUND: Recent studies have found hypomagnesemia is linked to a heightened risk of cardiovascular events and mortality in hemodialysis (HD) patients; however, the level of serum magnesium (s-Mg) necessary for promoting overall health in these patients and the effects of s-Mg in diabetes HD patients remains to be clarified. METHODS: HD outpatients (n = 148 under, age ≤ 70 y) were followed over a 6-y period. They were divided into four groups according to their average s-Mg during the first year (L; low level, H; high level) and if they had DM or not (non-DM). The endpoint was mortality and hospitalization for decline of Activities of Daily Living (death/hospitalization). A receiver operating characteristics curve was used in diagnostic tests to identify s-Mg associated with this endpoint. Kaplan-Meier, log-rank test, and a Cox proportional hazards model were used to evaluate prognoses. Fisher's exact test and multiple regressions examined the causes of the endpoints between the four groups and the factors predictive of s-Mg. RESULTS: s-Mg at 2.7 mg/dL was associated with death/hospitalization. The 5-y survival rate was 38.1%, 86.7%, 73.2% and 87.5%, in the DM/Mg(L), DM/Mg(H), non-DM/Mg(L) and non-DM/Mg(H) groups, respectively (P < 0.001). The Cox proportional hazards model showed significantly lower risk in other groups compared with that in the DM/Mg(L) group [DM/Mg(H); hazard ratio (HR): 0.22, 95% confidence interval (CI): 0.05-0.97, P = 0.046, non-DM/Mg(L); HR: 0.32, 95% CI: 0.15-0.68, P = 0.003, non-DM/Mg(H); HR: 0.17, 95% CI: 0.06-0.44, P < 0.001]. The frequency of the different causes of the endpoints for each group was not significant; s-Mg only associated with age in the DM group. CONCLUSIONS: s-Mg greater than 2.7 mg/dL associated with a favorable prognosis in HD patients with DM, suggesting that s-Mg is a factor independent of diabetes.


Asunto(s)
Diabetes Mellitus/sangre , Diabetes Mellitus/diagnóstico , Magnesio/sangre , Diálisis Renal , Actividades Cotidianas , Diabetes Mellitus/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Curva ROC , Estudios Retrospectivos , Análisis de Supervivencia
20.
Geriatr Gerontol Int ; 20(10): 980-987, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32886834

RESUMEN

AIMS: Sarcopenia is a serious problem because of its poor prognosis. Growth differentiation factor 15 (GDF15) is associated with mitochondrial dysfunction, inflammation, insulin resistance and oxidative stress, which may play crucial roles for the development of sarcopenia. We aimed to examine whether serum GDF15 level is associated with muscle mass, strength and lower extremity function in older patients with cardiometabolic disease. METHODS: Serum GDF15 levels were measured in 257 patients with cardiometabolic diseases (including 133 patients with diabetes) who had visited the frailty clinic, using a latex turbidimetric immunoassay. Appendicular skeletal muscle index, handgrip strength, timed-up-and-go test and gait speed were evaluated. Power, speed, balance and total scores based on the sit-to-stand test were calculated to assess lower extremity function. RESULTS: The highest tertile of serum GDF15 was independently associated with low handgrip strength, low gait speed, long timed-up-and-go time and scores of lower extremity function but not an appendicular skeletal muscle index in multiple logistic regression analyses after adjustment for covariates. Patients in the highest tertile of GDF15 were at the risk of having three to nine times lower grip strength, three times lower gait speed, five to six times lower mobility and five to 11 times reduction in lower extremity function as compared with those in the lowest GDF15 tertile dependent on the models. CONCLUSIONS: Elevated serum GDF15 level was independently associated with low muscle strength and lower extremity function in older patients with cardiometabolic disease. Serum GDF15 could be one of the biomarkers for muscle weakness and low physical performance. Geriatr Gerontol Int 2020; 20: 980-987.


Asunto(s)
Enfermedades Cardiovasculares/sangre , Diabetes Mellitus/sangre , Factor 15 de Diferenciación de Crecimiento/sangre , Extremidad Inferior/fisiopatología , Fuerza Muscular/fisiología , Sarcopenia/sangre , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Enfermedades Cardiovasculares/fisiopatología , Diabetes Mellitus/fisiopatología , Femenino , Fragilidad , Fuerza de la Mano , Humanos , Masculino , Músculo Esquelético/fisiopatología , Sarcopenia/fisiopatología , Estudios de Tiempo y Movimiento , Velocidad al Caminar/fisiología
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