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2.
Georgian Med News ; (294): 72-76, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687953

RESUMO

Dysbacteriosis of the oral cavity is known to complicate the course of chronic catarrhal gingivitis resulting from functional disorders of the macroorganism ecosystem, decreased amount of probiotic and increased amount of opportunistic and pathogenic microflora. And natural immune response is activated first in this case. It differentiates pathogens by TLR. The aim - to enhance the efficacy of treatment of chronic catarrhal gingivitis in children suffering from type 1 diabetes mellitus by means of improving the methods of pharmacological correction on the basis of investigation of the indices of local natural immune response and microbiological properties of the disease. We formed 2 group of the study. Children received basic insulin therapy. The treatment of chronic catarrhal gingivitis in children from the main group were suggested the antiseptic solution "Decasan"; pill of a probiotic action "BioGaia ProDentis" and the immune modulator "Imupret". Children from the comparative group were treated according to the common scheme. Oral microflora of children after treatment was decreased by 69,42% of general microbial number in children from the main group. Natural immunity state was also indicative of the improved protective mechanisms of the oral cavity in children from the main subgroup in the dynamics of treatment: twice as less level of mRNA TLR-2 expression was found in the main subgroup and mRNA TLR-4 - 45,44%. Therefore, the initiated course of treatment concerning chronic catarrhal gingivitis promoted a considerable improvement of the periodontal tissue state in children.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Gengivite/imunologia , Gengivite/microbiologia , Doenças Periodontais/patologia , Anti-Infecciosos Locais/uso terapêutico , Criança , Comorbidade , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Ecossistema , Gengivite/tratamento farmacológico , Gengivite/epidemiologia , Humanos , Insulina/administração & dosagem , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Probióticos/administração & dosagem
3.
Pan Afr Med J ; 33: 322, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692874

RESUMO

Introduction: Diabetic ketoacidosis (DKA) is a severe metabolic complication of diabetes. Recent years have seen a marked increase in prevalence of diabetic ketoacidosis, but mortality is low. This study aimed to describe the epidemiological, clinical, therapeutic and prognostic features of patients with severe or moderate DKA admitted to the Emergency Department. Methods: He conducted a prospective, descriptive study including patients with moderate or severe DKA. Standardized care protocol. We studied the epidemiological, clinical, therapeutic and prognostic features of these patients. Results: The study involved 185 patients with moderate or severe DKA. The average age of patients was 38+/-18 years, with a sex ratio of 0.94. Known diabetes was reported in 159 patients (85%) of whom 116 had type 1 diabetes. The most common factors of decompensation were treatment discontinuation in 42% and infection in 32%. Average blood glucose was 32.7+/-12 mmol/L, pH =7.14+/-0.13, HCO3- =7.2+/-3.56 mmol/L. The mean duration of intravenous insulin was 17.3 +/- 16 hours. Hypoglycaemia was reported in 26 patients (14%), hypokalemia in 80 (43%) patients and hyperchloraemic mineral acidosis in 43 patients (23%). Intrahospital mortality was 2.1%. Conclusion: Diabetic ketoacidosis occurs in young subjects treated with insulin therapy. Treatment is based on intravenous insulin associated with correction of fluid deficit. Complications mainly include hypokalemia and hypoglycemia and mortality is low.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Cetoacidose Diabética/epidemiologia , Insulina/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Cetoacidose Diabética/tratamento farmacológico , Serviço Hospitalar de Emergência , Feminino , Humanos , Hipoglicemia/epidemiologia , Hipoglicemia/etiologia , Hipoglicemiantes/administração & dosagem , Hipopotassemia/epidemiologia , Hipopotassemia/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
4.
Nurs Res ; 68(6): 445-452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693550

RESUMO

BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/psicologia , Estresse Psicológico/epidemiologia , Adulto , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Autorrelato
5.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(9): 540-549, nov. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184376

RESUMO

Introduction: Few studies assessing the relationship between oxidative stress and glycemic variability in children with type 1 diabetes mellitus (T1DM) are available, and most of them reported no significant results. Objective: To assess the relationship between glucose control, glycemic variability, and oxidative stress as measured by urinary excretion of 8-iso-prostanglandin F2-alpha (8-iso-PGF2alfa) in children with T1DM. Materials and methods: A cross-sectional study including 25 children with T1DM. Participants were evaluated during five days in two different situations: 1st phase during a summer camp, and 2nd phase in their everyday life at home. The following data were collected in each study phase:. Six capillary blood glucose measurements per day. Mean blood glucose (MBG) levels and glucose variability parameters, including standard deviation, coefficient of variation, and mean amplitude of glycemic excursions (MAGE), were calculated. - Capillary HbA1c level. - 24-h urine sample to measure 8-iso-PGF2alfa. Results: There were no statistically significant differences in urinary 8-iso-PGF2alfa levels (142 ± 37 vs. 172 ± 61 pg/mg creatinine) and glucose control and glycemic variability parameters between both phases. In the 2nd phase, statistically significant correlations were found between urinary 8-iso-PGF2alfa and HbA1c levels (r = 0.53), MBG (r = 0.72), standard deviation (r = 0.49), and MAGE (r = 0.42). No significant correlations between glucose control, glycemic variability and urinary 8-iso-PGF2alfa excretion were found in the 1st phase. Conclusions: A significant correlation was found between glycemic variability and HbA1c level and urinary 8-iso-PGF2α excretion in a group of children with T1DM during their daily lives. Additional studies are needed to confirm this finding and to explore its long-term impact on health


Introducción: En niños con diabetes tipo 1 (DM1) hay pocos estudios que evalúen la relación entre estrés oxidativo y variabilidad glucémica, y la mayoría de ellos no encuentran resultados significativos. Objetivo: Evaluar la relación entre control metabólico, variabilidad glucémica y estrés oxidativo medido por la excreción urinaria de 8-iso-prostaglandina F2 alfa (8-iso-PGF2alfa) en niños con DM1. Material y método: Estudio transversal que incluyó 25 niños con DM1. Los participantes fueron evaluados durante 5 días en 2 situaciones diferentes: 1.a fase durante un campamento de verano y 2.a fase durante su actividad habitual en domicilio. En cada fase se recogieron:- Seis determinaciones de glucemia capilar diarias. Se calcularon glucemia media y parámetros de variabilidad glucémica: desviación estándar, coeficiente de variación y «mean amplitude of glycemic excursions» (MAGE). - HbA1c capilar. - Muestra de orina de 24h para la determinación de 8-iso-PGF2alfa. Resultados: No se encontraron diferencias estadísticamente significativas en excreción urinaria de 8-iso-PGF2alfa (142 ± 37 vs. 172 ± 61 pg/mg creatinina) y parámetros de control y variabilidad glucémicos entre las fases. En la 2.a fase se observaron correlaciones estadísticamente significativas entre 8-iso-PGF2alfa urinario con HbA1c (r = 0,53), glucemia media (r = 0,72), desviación estándar (r = 0,49) y MAGE (r = 0,42). En la 1.a fase del estudio no se han detectado correlaciones significativas. Conclusiones: Se ha encontrado una correlación significativa entre parámetros de variabilidad glucémica y HbA1c con la excreción urinaria de 8-iso-PGF2alfa en un grupo de niños con DM1 evaluados durante su vida diaria. Son necesarios más estudios para confirmar estos resultados y evaluar el impacto a largo plazo sobre la salud


Assuntos
Humanos , Criança , Diabetes Mellitus Tipo 1/complicações , Estresse Oxidativo , Índice Glicêmico , Metabolismo Basal , Dinoprosta/análogos & derivados , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/diagnóstico , Estudos Transversais , Diabetes Mellitus Tipo 1/urina , Dinoprosta/sangue
7.
Invest Ophthalmol Vis Sci ; 60(13): 4310-4318, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31622467

RESUMO

Purpose: To evaluate whether retinal capillary nonperfusion is found predominantly adjacent to arteries or veins in eyes with diabetic retinopathy (DR). Methods: Sixty-three eyes from 44 patients with proliferative DR (PDR) or non-PDR (NPDR) were included. Images (12 × 12-mm) foveal-centered optical coherence tomography (OCT) angiography (OCTA) images were taken using the Zeiss Plex Elite 9000. In 37 eyes, widefield montages with five fixation points were also obtained. A semiautomatic algorithm that detects nonperfusion in full-retina OCT slabs was developed, and the percentages of capillary nonperfusion within the total image area were calculated. Retinal arteries and veins were manually traced. Based on the shortest distance, nonperfusion pixels were labeled as either arterial-side or venous-side. Arterial-adjacent and venous-adjacent nonperfusion and the A/V ratio (arterial-adjacent nonperfusion divided by venous-adjacent nonperfusion) were quantified. Results: Twenty-two eyes with moderate NPDR, 16 eyes with severe NPDR, and 25 eyes with PDR were scanned. Total nonperfusion area in PDR (median: 8.93%) was greater than in moderate NPDR (3.49%, P < 0.01). Arterial-adjacent nonperfusion was greater than venous-adjacent nonperfusion for all stages of DR (P < 0.001). The median A/V ratios were 1.93 in moderate NPDR, 1.84 in severe NPDR, and 1.78 in PDR. The A/V ratio was negatively correlated with the total nonperfusion area (r = -0.600, P < 0.0001). The results from the widefield montages showed similar patterns. Conclusions: OCTA images with arteries and veins traced allowed us to estimate the nonperfusion distribution. In DR, smaller nonperfusion tends to be arterial-adjacent, while larger nonperfusion tends toward veins.


Assuntos
Retinopatia Diabética/fisiopatologia , Isquemia/fisiopatologia , Artéria Retiniana/fisiopatologia , Veia Retiniana/fisiopatologia , Idoso , Capilares/fisiopatologia , Estudos Transversais , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/diagnóstico por imagem , Feminino , Angiofluoresceinografia , Humanos , Isquemia/diagnóstico por imagem , Edema Macular/diagnóstico por imagem , Edema Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Artéria Retiniana/diagnóstico por imagem , Veia Retiniana/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
8.
Life Sci ; 237: 116950, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31605709

RESUMO

C-peptide is a small peptide connecting two chains of proinsulin molecule and is dissociated before the release of insulin. It is secreted in an equimolar amount to insulin from the pancreatic beta-cells into the circulation. Recent evidence demonstrates that it has other physiologic activities beyond its structural function. C-peptide modulates intracellular signaling pathways in various pathophysiologic states and, could potentially be a new therapeutic target for different disorders including diabetic complications. There is growing evidence that c-peptide has modulatory effects on the molecular mechanisms involved in the development of diabetic nephropathy. Although we have little direct evidence, pharmacological properties of c-peptide suggest that it can provide potent renoprotective effects especially, in a c-peptide deficient milieu as in type 1 diabetes mellitus. In this review, we describe possible molecular mechanisms by which c-peptide may improve renal efficiency in a diabetic milieu.


Assuntos
Peptídeo C/uso terapêutico , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus Tipo 1/complicações , Nefropatias Diabéticas/prevenção & controle , Animais , Complicações do Diabetes/etiologia , Nefropatias Diabéticas/etiologia , Humanos
9.
Zhonghua Yi Xue Za Zhi ; 99(34): 2654-2659, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31505714

RESUMO

Objective: To investigate the awareness of preconception care among women of child-bearing age with type 1 diabetes (T1DM) and their self-management status, in order to provide evidence for establishment of management pathway for women with T1DM in pregnancy in China. Methods: This cross-sectional survey recruited female participants of child-bearing age from the cohort of Guangdong Type 1 Diabetes Translational Medicine Study conducted between June 2011 and December 2017. The participants were asked to fill out a questionnaire on the awareness of preconception care, their frequency of self-monitoring of blood glucose (SMBG) and other related variables. Chi-squared test or chi-squared test for trend was used in comparisons of categorical variables, and logistic regression analysis was performed to assess associated factors. Results: Totally, 441 women of child-bearing age with T1DM were investigated. The results show that their awareness of preconception care was poor (15.42%, 68/441). Higher educational level (χ(2trend)=3.990, P=0.046), experience of post-diabetes education evaluation (P<0.001), and better coverage of different modules in diabetes education (survival skills: χ(2)=7.525, P=0.004; basic knowledge: χ(2)=8.598, P=0.002; advanced knowledge: P<0.001) were associated with better awareness of preconception care. The average frequency of SMBG in these participants was 0.29 (0.14, 2.00) times per day, and only 8.5% (37/435) of them reached the frequency (≥4 times per day) recommended by guidelines. Moreover, 21.1% (92/435) of them hardly ever performed SMBG. Conclusion: Child-bearing age women with T1DM in Gunangdong had poor awareness of preconception care, with a much lower SMBG frequency than recommendation.


Assuntos
Diabetes Mellitus Tipo 1 , Conscientização , Automonitorização da Glicemia , China , Estudos Transversais , Diabetes Mellitus Tipo 1/complicações , Feminino , Humanos , Gravidez , Complicações na Gravidez
10.
Ann Agric Environ Med ; 26(3): 429-438, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559799

RESUMO

INTRODUCTION: Quality of Life (QoL) of Polish women and men with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) was analyzed, taking into consideration acceptance of the illness, the occurrence of depression, complications of diabetes, concentration of glycated haemoglobin, and demographic factors. MATERIAL AND METHODS: The study was conducted among 115 patients with T1DM and 215 patients with T2DM aged 18-60. The patients were divided into women and men. The tool applied for studying QoL was the Polish language version of the Audit of diabetes-dependent QoL questionnaire(ADDQoL) comprising 2 questions related to the general QoL and 19 domains related to aspects of life. Each domain included 2 components: Impact and Importance, and their product determined the value of the weighted impact score. The Acceptance of Illness Scale, Beck Depression Inventory and studied demographic and clinical parameters were also applied. RESULTS: Patients with both types of diabetes demonstrated a negative influence of the disease in all domains of ADDQoL. Values of the average weighted impact of ADDQoL showed significant associations with diabetic complications in T1DM and gender and depressive symptoms in T2DM. Diabetes negatively affects the QoL of diabetic patients in Poland, especially regarding freedom to eat and to drink and sex life in both genders in T1DM, and freedom to eat and drink, and feelings about the future in both genders, and working life and sex life in T2DM men. CONCLUSIONS: Risk factors for worse QoL are: the occurrence of diabetes complications in T1DM patients and male gender and depression in T2DM patients.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida , Adolescente , Adulto , Depressão , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Humanos , Pessoa de Meia-Idade , Polônia , Inquéritos e Questionários , Adulto Jovem
11.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31515299

RESUMO

BACKGROUND: Diagnostic delays in the pediatric emergency department (ED) can lead to unnecessary interventions and prolonged ED length of stay (LOS), especially in patients with diabetes mellitus evaluated for diabetic ketoacidosis (DKA). At our institution, baseline DKA determination time (arrival to diagnosis) was 86 minutes, and 61% of patients did not meet DKA criteria. Subsequently, intravenous (IV) placement occurred in 85% of patients without DKA. We aimed to use point-of-care (POC) testing to reduce DKA determination time from 86 to 30 minutes and to reduce IV placements in patients without DKA from 85% to 20% over 18 months. METHODS: Four key interventions (POC tests, order panels, provider guidelines, and nursing guidelines) were tested by using plan-do-study-act cycles. DKA determination time was our primary outcome, and secondary outcomes included the percentage of patients receiving IV placement and ED LOS. Process measures included the rate of use of POC testing and order panels. All measures were analyzed on statistical process control charts. RESULTS: Between January 2015 and July 2018, 783 patients with diabetes mellitus were evaluated for DKA. After all 4 interventions, DKA determination time decreased from 86 to 26 minutes (P < .001). In patients without DKA, IV placement decreased from 85% to 36% (P < .001). ED LOS decreased from 206 to 186 minutes (P = .009) in patients discharged from the hospital after DKA evaluation. POC testing and order panel use increased from 0% to 98% and 90%, respectively. CONCLUSIONS: Using quality-improvement methodology, we achieved a meaningful reduction in DKA determination time, the percentage of IV placements, and ED LOS.


Assuntos
Cetoacidose Diabética/diagnóstico , Cetoacidose Diabética/terapia , Serviço Hospitalar de Emergência/organização & administração , Testes Imediatos , Melhoria de Qualidade , Tempo para o Tratamento , Adolescente , Glicemia/análise , Criança , Pré-Escolar , Diagnóstico Tardio/prevenção & controle , Diabetes Mellitus Tipo 1/complicações , Feminino , Hidratação , Guias como Assunto , Hospitais Pediátricos , Humanos , Hipoglicemiantes/uso terapêutico , Lactente , Insulina/uso terapêutico , Tempo de Internação , Masculino , Equipe de Assistência ao Paciente , Wisconsin , Adulto Jovem
12.
Invest Ophthalmol Vis Sci ; 60(12): 3937-3942, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31546259

RESUMO

Purpose: Few studies have explored the association of genetic variants in microRNA genes and binding sites with diabetic retinopathy (DR) in type 1 diabetes. We conducted a genome-wide scan for single nucleotide polymorphisms (SNPs) in these genes by using data from a genome-wide association study (GWAS). Methods: All known SNPs were imputed from our GWAS data (n = 325) of DR cases and diabetic controls (no DR). Relevant SNPS were extracted using miRNASNP and PolymiRTS (version 2) databases. χ2 tests and logistic regression (adjusting for age, sex, duration of diabetes, HbA1c, and hypertension) were used to test the association between the imputed SNPs and DR phenotypes (any DR, nonproliferative DR [NPDR], proliferative DR [PDR], diabetic macular edema [DME], and sight-threatening DR defined as PDR, severe NPDR, or clinically significant macula edema [CSME]) compared with diabetic controls. Top-ranking SNPs were genotyped in a larger cohort (N = 560) to confirm their association with DR. Results: Three SNPs (rs10061133, rs1049835, rs9501255) were selected and genotyped in the final cohort. Rs10061133 in MIR449b was protective of sight-threatening DR (odds ratio [OR] = 0.32, P = 3.68 × 10-4) and PDR (OR = 0.30, P = 8.12 × 10-4), and the associations became more significant as the cohort increased in size. Conclusions: Rs10061133 in MIR449b is significantly associated with a decreased risk of PDR and sight-threatening DR in Caucasian patients with type 1 diabetes. This can guide future studies on genetic risk profiling and on developing microRNA-related therapies for sight-threatening DR.


Assuntos
Retinopatia Diabética/genética , MicroRNAs/genética , Polimorfismo de Nucleotídeo Único/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Estudos de Coortes , Diabetes Mellitus Tipo 1/complicações , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Estudo de Associação Genômica Ampla , Técnicas de Genotipagem , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances
13.
Pan Afr Med J ; 33: 103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489081

RESUMO

Introduction: Foot deformities and amputations are parameters that have been studied as risk factors for diabetic foot ulceration (DFU). However, inclusion of "foot deformities" and "amputations" in a single, broad variable and with reference to the severity of these deformities, may better characterize subjects who are prone to develop DFU. Methods: The objective of the study was the examination of amputative and non-amputative foot deformities severity as risk factor for DFU in relation with the other established risk factors. A cross-sectional and case-control study was conducted from October 2005 to November 2016. One hundred and thirty-four subjects with type 1 and 2 diabetes, with and without active foot ulcers, participated. A structured quantitative interview guide was used. Univariate logistic regression analysis for the literature's established risk factors was performed, as well as for two versions of the "amputative and non-amputative foot deformities severity" variable. Subsequently, multivariate logistic regression analysis (MLRA) for three models and receiver operating characteristic (ROC) curve analysis were carried out. Results: From the MLRA, only PAD (peripheral arterial disease) was significant (OR 3.56, 95% CI 1.17-10.82, P=0.025 and OR 3.33, 95% CI 1.02-10.08, P=0.033). Concerning the ROC curve analysis of the models, the one with the three categories amputative and non-amputative foot deformities severity variable, had the greatest area under the ROC curve (0.763, P<0.001). Conclusion: A united variable for lower extremity amputations and other foot deformities with reference to their severity, could be more helpful to the clinicians in identifying patients with diabetes at risk for foot ulceration.


Assuntos
Amputação/estatística & dados numéricos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/epidemiologia , Deformidades do Pé/epidemiologia , Idoso , Estudos de Casos e Controles , Estudos Transversais , Pé Diabético/etiologia , Feminino , Humanos , Modelos Logísticos , Extremidade Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Projetos Piloto , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença
14.
Acta Diabetol ; 56(12): 1315-1321, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493030

RESUMO

AIM: To assess the association between alcohol consumption and/or cigarette smoking with other unhealthy behaviors and clinical cardiovascular risk factors in youth with type 1 diabetes. METHODS: Two hundred and twenty-eight youth with type 1 diabetes (age 13-19 years) were consecutively enrolled in three Regional Pediatric Diabetes Centers in Italy. Demographic, anthropometric, lifestyle (adherence to the Mediterranean diet pattern and sports participation) and laboratory parameters were compared among youth reporting isolated or combined alcohol consumption and/or cigarette smoking. RESULTS: Ten percent of the youth reported alcohol consumption, 10% cigarette smoking and 6% both alcohol and cigarette use; 74% did not report alcohol or cigarette use. Compared to non-drinker non-smoker youth, smokers showed significantly higher percentages of each of the behavioral and clinical cardiovascular risk factors. Drinkers showed a significantly higher proportion of abdominal adiposity, dyslipidemia and poor adherence to the Mediterranean diet. Alcohol consumption was independently associated with both dyslipidemia and high glycosylated hemoglobin. CONCLUSIONS: Our findings emphasize the need to increase the awareness of youth with T1D about the negative impact of alcohol drinking on cardiovascular risk, since the effects of alcohol might be underestimated with respect to the well-known detrimental effects of smoking. Clustering of unhealthy lifestyle should be discouraged in type 1 diabetes youth in order to promote cardiovascular protection.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Doenças Cardiovasculares/epidemiologia , Fumar Cigarros/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Angiopatias Diabéticas/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Doenças Cardiovasculares/etiologia , Fumar Cigarros/efeitos adversos , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/complicações , Angiopatias Diabéticas/etiologia , Feminino , Hemoglobina A Glicada/análise , Hemoglobina A Glicada/metabolismo , Humanos , Itália/epidemiologia , Estilo de Vida , Masculino , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
15.
Transplant Proc ; 51(8): 2775-2780, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31493915

RESUMO

INTRODUCTION: Most life-threatening diabetes-related complications involve the kidneys, eyes, cardiovascular system, and autonomic nervous system. Clinical islet transplantation (CITx) may be a therapeutic option for some patients. In this study, we analyzed the progression of diabetic complications after CITx and in patients waiting for islet transplantation. METHODS: From 2008 to 2015, 67 patients were listed for pancreatic or islet transplantation. We compared beta scores, islet scores, and secondary complications between patients who underwent islet allotransplantation (CITx group, n = 6) and the patients awaiting islet transplantation (wait group, n = 19) at baseline and during the 1-year follow-up. RESULTS: In the CITx group, good islet function was observed in 80% of patients 1 month post-transplantation and 40% of patients 1 year post-transplantation; however, no patient achieved insulin independence. One patient who underwent simultaneous islet-kidney transplantation died on day 8 because of severe bleeding in the retroperitoneal space. In 1 case, islet primary nonfunction was observed. Mean islet score in the CITx group 1 year post-transplantation was significantly higher than the pretransplant score and wait group scores at enrollment and 1 year later (P < .01). Increased albuminuria was observed in 3 of 11 (27%) patients in the wait group and 0 patients in the CITx group (P = .08). One patient (9%) in the wait group developed chronic renal failure requiring hemodialysis. Ophthalmologic procedures were required by 47% of patients in the wait group and 0 patients in the CITx group in the first year after transplantation (P < .01). CONCLUSION: Successful islet transplantation slows the progression of diabetic complications.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/cirurgia , Insulina , Transplante das Ilhotas Pancreáticas , Adulto , Glicemia/análise , Diabetes Mellitus Tipo 1/sangue , Feminino , Humanos , Insulina/sangue , Insulina/uso terapêutico , Masculino , Pessoa de Meia-Idade
16.
Med Arch ; 73(3): 144-148, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31402800

RESUMO

Introduction: Previous research found that diabetes mellitus capable to aggravate osteoarthritis disease. In brief, the hyperglycemia condition in diabetes mellitus has an impact on protein glycation of all joint components, including molecule, such as perlecan. The protein expression of perlecan reflects the presence amount of perlecan in the matrix of articular cartilage. However, the impact of hyperglycemia on articular perlecan has not been explained. Moreover, the role of perlecan as a mechanotransducer for chondrocytes in type 1 Diabetes mellitus remains unclear. Aim: This research aims to analyze the effect of hyperglycemia in type 1 Diabetes mellitus to the mRNA level and protein expression of perlecan. Methods: Thirty-five adult male rats were divided into seven groups, such as three groups of rat model with anterior cruciate ligament transection (ACLT) at right knee (ACLT1, ACLT2, ACLT3); three groups of rats with ACLT at right knee which followed by Streptozotocin injection for diabetic mice model (DM1, DM2, DM3); and control group (N). Rat sacrificed at the third week, fourth week, and sixth week after two months of maintenance. The mRNA level and protein expression were analyzed by using PCR and Western blot. All of data was analyzed by ANOVA. Results: Protein expression of perlecan in ACLT mice with diabetes mellitus (DM1, DM2, DM3 group) was gradually decreased according to the increased hyperglycemia duration. Whilst, protein expression of perlecan within ACLT mice without diabetes mellitus (ACLT1, ACLT2, ACLT3 group) was increased. The similar result also demonstrated by the mRNA level of perlecan. Group of DM1, DM2, DM3 exhibited decreased mRNA level of perlecan over the hyperglycemia duration. While, ACLT1, ACLT2, and ACLT3 group had a gradually increased of perlecan mRNA level. Conclusion: Hyperglycemia on osteoarthritic condition decreased mRNA level and protein expression of perlecan which increased the severity of osteoarthritis disease.


Assuntos
Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Tipo 1/sangue , Proteoglicanas de Heparan Sulfato/genética , Proteoglicanas de Heparan Sulfato/metabolismo , Hiperglicemia/sangue , Osteoartrite/metabolismo , Animais , Glicemia , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 1/complicações , Modelos Animais de Doenças , Hiperglicemia/etiologia , Masculino , Osteoartrite/complicações , Osteoartrite/genética , RNA Mensageiro/metabolismo , Ratos
17.
Life Sci ; 234: 116738, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31398418

RESUMO

AIMS: Oxidative stress has been linked to the development and progression of diabetic nephropathy (DN). The present study evaluated whether the dipeptidyl peptidase-4 inhibitor sitagliptin attenuates glomerular lesions and oxidative stress evoked by chronic hyperglycemia, by a mechanism independent of insulin secretion and glycemia normalization. MAIN METHODS: A rat model of DN caused by streptozotocin injection was established and the effects of sitagliptin (5 mg/kg/day) were evaluated after two weeks of treatment. KEY FINDINGS: Sitagliptin treatment did not change body weight, glycemic and lipid profiles. However, histopathological observation revealed that sitagliptin attenuates diabetes-induced glomerular lesions on diabetic rats. Sitagliptin also ameliorated the increase in DPP-4 content and promoted the stabilization of GLP-1 in the diabetic kidney. Furthermore, sitagliptin treatment significantly attenuated the increase of free-radical formation and the decrease of antioxidant defenses, attenuating therefore the oxidative stress in the kidneys of diabetic animals. SIGNIFICANCE: The results suggest that sitagliptin treatment alleviates kidney oxidative stress in type 1 diabetic rats, which could play a key role in reducing the progression of DN.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Nefropatias Diabéticas/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Glomérulos Renais/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Fosfato de Sitagliptina/uso terapêutico , Animais , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/patologia , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/patologia , Inibidores da Dipeptidil Peptidase IV/farmacologia , Glomérulos Renais/metabolismo , Glomérulos Renais/patologia , Masculino , Ratos , Ratos Wistar , Fosfato de Sitagliptina/farmacologia
19.
Diabetes Metab Syndr ; 13(4): 2431-2435, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405655

RESUMO

BACKGROUND: Diabetes in Sudan is real health challenge for health authorities especially optimum glycemic control and complications in particular diabetic septic foot. This is study aimed to assess knowledge of individuals with diabetes about self-foot care. METHODS: This is descriptive cross sectional, health facility-based study conducted in diabetes center in Khartoum, Sudan. The study recruited 150 individuals with diabetes. Data was collected using a standardized pretested questionnaire. RESULTS: Among the participants 64.7% were females and 35.3% were males, 36% of the participants were between the age of 51-60 years old. Good glycemic control (HbA1c) were achieved by 41.3% only. The participants who had good knowledge about diabetic foot self-care were 46.7%, poor knowledge 29.3% and moderate knowledge 24%. Good self-practice toward diabetic foot self-care was reported by 42.6%, moderate by 36.7% and poor practice by 20.7%. The awareness and practices significantly correlated with an increase in ages (≥51 years), higher level of education, medium income, unemployment, longer duration of diabetes > 10years, family history, controlled diabetes mellitus and education about diabetes complications and diabetic foot care (P value < 0.05). CONCLUSIONS: Only (46.7%) of participants address good awareness and practices about self-foot care. Accordingly, there is a great need to provide continuous health education to the patients about diabetic foot self-care and this knowledge-application gap must be narrowed down.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/terapia , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Autocuidado/estatística & dados numéricos , Autocuidado/normas , Adulto , Estudos Transversais , Pé Diabético/etiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Sudão/epidemiologia , Inquéritos e Questionários
20.
Diabetes Metab Syndr ; 13(4): 2441-2444, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405657

RESUMO

BACKGROUND: Diabetes mellitus is a metabolic disease known as one of the most common illness in the world. It is believed that diabetic patients are at high risk of varied infections than non-diabetics. The aim of this study was to determine the frequency and pattern of infections in diabetic patients admitted to the internal wards of educational hospitals of Ahvaz Jundishapur University of Medical Sciences. METHODS: This descriptive cross-sectional study was performed on 700 diabetic patients from January 2014 to December 2015 in internal wards (general, endocrine, gastroenterology, lung, nephrology, cardiology, neurology and infectious diseases) of educational hospitals affiliated to Ahvaz JundishapurUniversity of Medical Sciences. Data includeddemographic information, type of diabetes treatment, duration of diabetes mellitus, final diagnosis, and blood sugar on admission that were analyzed statistically. RESULTS: Out of 700 patients, 374 (53.4%) women and 326 (46.6%) men were entered into this study. The number of non-infectious and infectious patients were 506 (72.3%) and 194 (27.7%). The mean of age,duration of diabetes, and glucose were 62.34 ±â€¯14.38 years, 11.11 ±â€¯7.18 years, and 271.98 ±â€¯90 (mg/dl) in patients with infectious diseases respectively. The most common infectious illnesses were diabetic foot infections (32.5%), pneumonia (18%), soft tissue abscess(13.9%), and urinary tract infections (11.3%). CONCLUSION: Infectious diseases are one of the most common factorsto hospitalize diabetic patients (27.7%), most of whom had diabetic foot infections, pneumonia, and soft tissue abscess.


Assuntos
Doenças Transmissíveis/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Hospitais de Ensino/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Transmissíveis/etiologia , Estudos Transversais , Complicações do Diabetes/etiologia , Feminino , Seguimentos , Hospitalização , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
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