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1.
Medicine (Baltimore) ; 98(39): e17273, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574841

RESUMO

BACKGROUND: Previous study has reported that Fuyuan Xingnao Decoction (FYXND) can be utilized for the treatment of patients with diabetes mellitus (DM) combined cerebral infarction (CI) effectively. METHODS: We will search from the following databases of MEDLINE, EMBASE, Cochrane Library, PsycINFO, Global Health, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All databases will be searched from the inception to the present without language limitation. Two independent authors will perform literature selection, information collection, and methodological quality assessment. Statistical analysis will be carried out using RevMan 5.3 software. RESULTS: This study will provide accurate results on the effectiveness and safety of FYXND on DM and CI through primary and secondary outcomes. The primary outcome is neurological deficit. The secondary outcomes consist of fasting blood glucose, hemoglobin Alc, fasting insulin, quality of life, and adverse effects. CONCLUSIONS: This well-designed study will establish high quality evidence of the effectiveness and safety of FYXND for DM and CI to facilitate the clinical practice and guideline development.


Assuntos
Infarto Cerebral/tratamento farmacológico , Complicações do Diabetes/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Infarto Cerebral/etiologia , Complicações do Diabetes/sangue , Complicações do Diabetes/complicações , Diabetes Mellitus/sangue , Humanos , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
2.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190014.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596385

RESUMO

OBJECTIVES: To analyze the socioeconomic and demographic differences in medication use to control hypertension and diabetes mellitus in Brazil. METHOD: Data from the National Health Survey (Pesquisa Nacional de Saúde - PNS) performed in Brazil in 2013 with a representative sample of the population aged 18years old or older were analyzed. The use of medications for hypertension and diabetes according to income, education, race, possession of a private health insurance plan and region of household were estimated. Theprevalence ratios adjusted for sex and age were also estimated using Poisson regression. RESULTS: 81.4% of the hypertensive population used medication to control the disease. The use was higher among females, white/Caucasian individuals and those with a private health plan. In the case of diabetes mellitus, 80.2% of the population used medication to control the disease and the use was higher in elderly patients, patients with a higher level of education, patients with a private health plan, and patients in the Southeast region. Inequalities according to income and health plan were small even in the strata of sex, age and geographic region analyzed. CONCLUSION: We found a high use of medication to control hypertension and diabetes. Socioeconomic inequalities in use were not expressive, probably due to medication policies that promote greater and equitable access to medicines in Brazil.


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Inquéritos Epidemiológicos/métodos , Hipertensão/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Disparidades em Assistência à Saúde , Humanos , Hipertensão/epidemiologia , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Classe Social , Fatores Socioeconômicos , Adulto Jovem
3.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 282-288, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496160

RESUMO

OBJECTIVE: To determine the effect of trimetazidine on cardiac function and exercise tolerance in primary hypertension patients with type 2 diabetic. METHODS: In this randomized, double-blind, placebo-controlled prospective study, 60 primary hypertensive patients with diabetic were equally assigned into two groups, patients received trimetazidine (20 mg, 3 times a day) or placebo for 1 year. Echocardiography, cardiopulmonary exercise testing were performed; and the plasma N terminal pro B type natriuretic peptide (NT-ProBNP), hr-CRP, TNF-α, angiotensin Ⅱ and endothelin concentration were determined before and after treatment. RESULTS: In trimetazidine group, the left ventricular mass index, the mitral flow velocity E wave to A wave ratio (E/A), the peak early diastolic velocity (VE) to late diastolic velocity (VA) ratio (VE/VA) and the peak systolic velocity (Vs) were significantly improved, the plasma NT-ProBNP level was significantly decreased, and the exercise time, metabolic equivalent, maximal oxygen uptake and anaerobic threshold were significantly increased (all P<0.05); plasma concentration of hr-CRP, TNF-α, angiotensin Ⅱ and endothelin were significantly reduced after trimetazidine treatment, compared with baseline (all P<0.05) and with placebo (all P<0.05). There were no significant differences in any of above parameters after treatment in placebo group (all P>0.05). No severe adverse reaction was observed in both groups. CONCLUSIONS: For patients with both hypertension and diabetes, trimetazidine can improve cardiac function and increase exercise tolerance.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Tolerância ao Exercício , Coração , Hipertensão , Trimetazidina , Complicações do Diabetes/complicações , Diabetes Mellitus/tratamento farmacológico , Método Duplo-Cego , Tolerância ao Exercício/efeitos dos fármacos , Coração/efeitos dos fármacos , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Peptídeo Natriurético Encefálico/sangue , Estudos Prospectivos , Resultado do Tratamento , Trimetazidina/farmacologia , Trimetazidina/uso terapêutico , Vasodilatadores/farmacologia , Vasodilatadores/uso terapêutico
4.
Pan Afr Med J ; 33: 100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489078

RESUMO

Introduction: Hypertension, among diabetic patients, is a worldwide public-health challenge and a leading modifiable risk factor for other cardiovascular diseases. The main purpose of this study was to identify determinants of hypertension among diabetic patients. Methods: Data were collected from January to March 2018 using an interviewer-administered structured questionnaire. Data collectors and supervisors were trained before the period of data collection. The questionnaire was pretested on 5% of the sample at Suhul hospital. Bivariable logistic regression was employed to examine the crude associations between the outcome variable and determinant variables. This was followed by multivariable analysis to examine the determinants of hypertension among diabetic patients by selecting variables which had p value ≤0.2 in the bivariable analysis. Results: The age range of the respondents was 18-80 years, with the median age of 51.56±14.92 years. Not attending diabetes mellitus education sessions (AOR=2.61, 95% CI (1.12,6.1), duration since diagnosis with diabetes (AOR=8.52; 95% CI (1.97, 36.84), poor glycemic control (AOR=22.99, 95CI (5.92,89.28), overweight (AOR=4.84, 95%CI (1.42,16.51), and non-adherence to diabetes medication (AOR=4.66, 95% CI (2.22,9.79), diet (AOR=9.70,95% CI (3.34,28.22), exercise (AOR= 5.47, 95% CI (2.35,12.75), and self-monitoring blood glucose (AOR=6.62, 95% CI (3.16, 13.86) were found to be the determinants of hypertension among diabetic patients. Conclusion: This research concludes that longer duration with diabetes, nonattendance of diabetes education sessions, poor glycemic control, and not-adherence to antidiabetic medications, diet, exercise and self-monitoring blood glucose were found to be the determinants of hypertension among diabetic patients.


Assuntos
Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Hipoglicemiantes/administração & dosagem , Adesão à Medicação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Estudos de Casos e Controles , Diabetes Mellitus/tratamento farmacológico , Etiópia/epidemiologia , Feminino , Hospitais Públicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
5.
Life Sci ; 234: 116776, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31425698

RESUMO

Glucagon-like peptide-1 is a peptide of incretin family which is used in the management of diabetes as glucagon-like peptide-1 receptor agonist (GLP-1RA). Dipeptidyl peptidase-4 enzyme metabolizes glucagon-like peptide-1 and various dipeptidyl peptidase-4 enzyme inhibitors (DPP-4i) are also used in the management of diabetes. These antidiabetic agents provide anti-hyperglycemic effects via several molecular mechanisms including promoting insulin secretion, suppression of glucagon secretion and slowing the gastric emptying. There is some research suggesting that they can induce insulin sensitivity in peripheral tissues. In this study, we review the possible molecular mechanisms by which GLP-1RA and DPP-4i can improve insulin resistance and increase insulin sensitivity in insulin-dependent peripheral tissues.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Hipoglicemiantes/uso terapêutico , Resistência à Insulina , Animais , Diabetes Mellitus/metabolismo , Inibidores da Dipeptidil Peptidase IV/farmacologia , Peptídeo 1 Semelhante ao Glucagon/metabolismo , Receptor do Peptídeo Semelhante ao Glucagon 1/metabolismo , Glucose/metabolismo , Humanos , Hipoglicemiantes/farmacologia , Insulina/metabolismo , Estresse Oxidativo/efeitos dos fármacos
6.
J Agric Food Chem ; 67(38): 10604-10613, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31466448

RESUMO

The aim of this study was to investigate the dipeptidyl peptidase-IV (DPP-IV) inhibition and metabolic stability of a casein-derived peptide Val-Pro-Tyr-Pro-Gln (VPYPQ) and its fragments as well as their release from casein following hydrolysis. Results showed that VPYPQ was the most potent DPP-IV inhibitory peptide among them with an IC50 value of 41.45 µM. This might be due to its two internal Pro residues at positions 2 and 4. Moreover, VPYPQ was resistant to hydrolysis by gastrointestinal enzymes and was relatively more stable to hydrolysis by DPP-IV and peptidases in plasma compared with its fragments. Additionally, oral administration of VPYPQ at a dose of 90 µmol/kg body weight could reduce the postprandial blood glucose levels in mice. More importantly, VPYPQ could be released efficiently from casein following hydrolysis by a combination of papain and in vitro digestion, reaching up to 3211.15 µg/g. Therefore, VPYPQ was a promising casein-derived DPP-IV inhibitor.


Assuntos
Caseínas/química , Preparações de Ação Retardada/química , Inibidores da Dipeptidil Peptidase IV/química , Peptídeos/química , Animais , Biocatálise , Glicemia/metabolismo , Preparações de Ação Retardada/administração & dosagem , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/metabolismo , Dipeptidil Peptidase 4/química , Dipeptidil Peptidase 4/metabolismo , Inibidores da Dipeptidil Peptidase IV/administração & dosagem , Teste de Tolerância a Glucose , Humanos , Hidrólise , Camundongos , Peptídeo Hidrolases/química , Peptídeo Hidrolases/metabolismo , Peptídeos/administração & dosagem , Ratos , Ratos Sprague-Dawley
7.
Bol. latinoam. Caribe plantas med. aromát ; 18(4): 392-410, jul. 2019. mapas, tab, graf
Artigo em Inglês | LILACS | ID: biblio-1008179

RESUMO

An ethnobotanical study was conducted with the aim to identify the medicinal plants used for the treatment of Diabetes mellitus (DM) in Sidi Bel Abbes region (Northwest Algeria). Sidi Bel Abbes, known for its diverse ecological habitats, such as mountains, steppe, lake, and fertile plains with diverse medicinal plants. The data was collected through questionnaire and interviews with inhabitants and traditional healers. The results obtained revealed that 33 plant species distributed in 20 genera belonging to 21 families for the treatment of DM were used. The most represented families were Lamiaceae, Asteraceae, Myrtaceae, Fabaceae and Lauraceae. Medicinal plants commonly used were Trigonella foenum-graecum, Olea europaea, Cinamomum cassia, Artemisia herba-alba, Lupinus albus, Juniperus communis, Rosmarinus officinalis, Prunus dulcis and Berberis vulgaris. The study revealed that, leaves, followed by seeds and stem bark were mostly used parts. Also, decoction and infusion were the most frequently used method of preparation. This study confirms that most people with Diabetes mellitus in the study areas rely on traditional medicine for their primary health care needs.


Se realizó un estudio etnobotánico con el objetivo de identificar las plantas medicinales utilizadas para el tratamiento de la Diabetes mellitus (DM) en la región de Sidi Bel Abbes (noroeste de Algeria). Sidi Bel Abbes, conocida por sus diversos hábitats ecológicos, como montañas, estepas, lagos y fértiles llanuras con plantas medicinales. Los datos se recopilaron mediante cuestionarios y entrevistas con habitantes y curanderos tradicionales. Los resultados obtenidos revelaron que 33 especies vegetales distribuidas en 20 géneros pertenecientes à 21 familias fueron utilizadas para el tratamiento de DM. Las familias más representadas fueron Lamiaceae, Asteraceae, Myrtaceae, Fabaceae y Lauraceae. Las plantas medicinales comúnmente utilizadas fueron Trigonella foenum-graecum, Olea europaea, Cinamomum cassia, Artemisia herba-alba, Lupinus albus, Juniperus communis, Rosmarinus officinalis, Prunus amygdalus y Berberis vulgaris. El estudio reveló que las hojas, seguidas de las semillas y la corteza de tallo, eran en su mayoría partes usadas. Sin embargo, la infusión y la decocción son el método de preparación más utilizado. El estudio reveló que las hojas, seguidas de las semillas y las partes del área, eran en su mayoría partes utilizadas. Tambien, la decocción y la infusión fueron los métodos de preparación más utilizado. Este estudio confirma que la mayoría de las personas con Diabetes mellitus en las áreas d'estudio dependen de la medicina tradicional para sus necesidades d'atenciónn primaria de la salud.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Plantas Medicinais , Folhas de Planta , Etnobotânica , Preparações de Plantas/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Sementes , Extratos Vegetais/uso terapêutico , Inquéritos e Questionários , Argélia , Medicina Tradicional
8.
BMC Health Serv Res ; 19(1): 422, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238950

RESUMO

BACKGROUND: Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of mail order pharmacy delivery and better medication adherence, but little is known about the barriers and facilitators to mail order pharmacy use in diabetes patients. This qualitative study examined factors related to mail order pharmacy use versus traditional "brick and mortar" pharmacies to refill prescriptions. METHODS: We conducted four 90-min focus groups in 2016 among 28 diabetes patients in the Hawaii and Northern California regions of Kaiser Permanente, a large integrated health care delivery system. We queried participants on their preferred mode for refilling prescriptions and perceived barriers and facilitators of mail order pharmacy use. One researcher independently coded each focus group transcript, with two of these transcripts double-coded by a second researcher to promote reliability. We employed thematic analysis guided by the Capability, Opportunity, Motivation, and Behavior (COM-B) framework using NVivo 11 software. RESULTS: A total of 28 diabetes patients participated. Participants' average age was 64.1 years; 57% were female; and racial/ethnic backgrounds included Asian/Native Hawaiian/Pacific Islander (36%), Black/African-American (21%) Hispanic/Latino (7%), and non-Hispanic White (36%). Analysis uncovered 26 themes related to the decision to use mail order pharmacy, with each theme representing a barrier or facilitator mapped to the COM-B framework. Most themes (20/26) fell into the COM-B category of 'Opportunity.' Opportunity barriers to mail order pharmacy use included unpredictability of medication delivery date, concerns about mail security, and difficulty coordinating refill orders for multiple prescriptions. In contrast, facilitators included greater access and convenience (e.g., no need to wait in line or arrange transportation) compared to traditional pharmacies. Motivational facilitators to mail order pharmacy use included receiving a pharmacy benefit plan incentive of a free one-month supply of prescriptions. CONCLUSIONS: This study found that while patients with diabetes may benefit from mail order pharmacy use, they perceive numerous barriers to using the service. These findings will inform the design of interventions and quality improvement initiatives to increase mail order pharmacy use, which in turn may improve medication adherence and outcomes in diabetes patients, across health care systems.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Assistência Farmacêutica/estatística & dados numéricos , Serviços Postais/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , California , Feminino , Grupos Focais , Hawaii , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Pesquisa Qualitativa
9.
Top Curr Chem (Cham) ; 377(4): 19, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31165274

RESUMO

This review is an effort to summarize recent developments in synthesis of O-glycosides and N-, C-glycosyl molecules with promising antidiabetic potential. Articles published after 2000 are included. First, the O-glycosides used in the treatment of diabetes are presented, followed by the N-glycosides and finally the C-glycosides constituting the largest group of antidiabetic drugs are described. Within each group of glycosides, we presented how the structure of compounds representing potential drugs changes and when discussing chemical compounds of a similar structure, achievements are presented in the chronological order. C-Glycosyl compounds mimicking O-glycosides structure, exhibit the best features in terms of pharmacodynamics and pharmacokinetics. Therefore, the largest part of the article is concerned with the description of the synthesis and biological studies of various C-glycosides. Also N-glycosides such as N-(ß-D-glucopyranosyl)-amides, N-(ß-D-glucopyranosyl)-ureas, and 1,2,3-triazolyl derivatives belong to the most potent classes of antidiabetic agents. In order to indicate which of the compounds presented in the given sections have the best inhibitory properties, a list of the best inhibitors is presented at the end of each section. In summary, the best inhibitors were selected from each of the summarizing figures and the results of the ranking were placed. In this way, the reader can learn about the structure of the compounds having the best antidiabetic activity. The compounds, whose synthesis was described in the article but did not appear on the figures presenting the structures of the most active inhibitors, did not show proper activity as inhibitors. Thus, the article also presents studies that have not yielded the desired results and show directions of research that should not be followed. In order to show the directions of the latest research, articles from 2018 to 2019 are described in a separate Sect. 5. In Sect. 6, biological mechanisms of action of the glycosides and patents of marketed drugs are described.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Descoberta de Drogas/métodos , Glicosídeos/química , Glicosídeos/farmacologia , Hipoglicemiantes/química , Hipoglicemiantes/farmacologia , Animais , Diabetes Mellitus/enzimologia , Diabetes Mellitus/metabolismo , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacocinética , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Glicogênio Fosforilase/antagonistas & inibidores , Glicogênio Fosforilase/metabolismo , Glicosídeos/farmacocinética , Glicosídeos/uso terapêutico , Humanos , Hipoglicemiantes/farmacocinética , Hipoglicemiantes/uso terapêutico , Proteína Tirosina Fosfatase não Receptora Tipo 1/antagonistas & inibidores , Proteína Tirosina Fosfatase não Receptora Tipo 1/metabolismo , Inibidores do Transportador 2 de Sódio-Glicose/química , Inibidores do Transportador 2 de Sódio-Glicose/farmacocinética , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Relação Estrutura-Atividade
10.
Food Chem Toxicol ; 131: 110562, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31181236

RESUMO

Brown seaweed Sargassum confusum (C. Agardh) has been used in traditional Chinese medicine to treat a variety of diseases. The aim of the present study was to evaluate the anti-diabetic effect of oligosaccharides from brown seaweed S. confusum (SCO). The anti-diabetic effect of SCO was evaluated in vivo using high-fat/high-sucrose fed hamsters. Molecular mechanisms of modulating gene expression of specific members of insulin signaling pathways were determined. The components of the intestinal microflora in diabetic animals were also analyzed by high-throughput 16S rRNA gene sequencing. And it was found that SCO had a sequence of sulfated anhydrogalactose and methyl sulfated galactoside units. Fasting blood glucose levels were significantly decreased after SCO administration. Histology showed that SCO could protect the cellular architecture of the liver. SCO could also significantly increase the relative abundance of Lactobacillus and Clostridium XIVa and decrease that of Allobaculum, Bacteroides and Clostridium IV. The active role of SCO in anti-diabetic effect was revealed by its regulation of insulin receptor substrate 1/phosphatidylinositol 3-kinase and c-Jun N-terminal kinase pathways. These results suggested that SCO might be used as a functional material to regulate gut microbiota in obese and diabetic individuals.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Hipoglicemiantes/uso terapêutico , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Oligossacarídeos/uso terapêutico , Sargassum/química , Animais , Bactérias/genética , Sequência de Bases , Glicemia/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Dieta da Carga de Carboidratos , Dieta Hiperlipídica , Hipoglicemiantes/isolamento & purificação , Fígado/efeitos dos fármacos , Fígado/patologia , Masculino , Mesocricetus , Oligossacarídeos/isolamento & purificação , Substâncias Protetoras/isolamento & purificação , Substâncias Protetoras/uso terapêutico , RNA Ribossômico 16S/genética , Alga Marinha/química
11.
BMC Complement Altern Med ; 19(1): 137, 2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215420

RESUMO

BACKGROUND: The Cree of Eeyou Istchee (James Bay area of northern Quebec) suffer from a high rate of diabetes and its complications partly due to the introduction of the western lifestyle within their culture. As part of a search for alternative medicine based on traditional practice, this project evaluates the biological activity of Picea mariana (Mill.) Britton, Sterns & Poggenb. needle, bark, and cone, in preventing glucose toxicity to PC12-AC cells in vitro (a diabetic neurophathy model) and whether habitat and growth environment influence this activity. METHODS: Three different organs (needle, bark, and cone) of P. mariana were collected at different geographical locations and ecological conditions and their 80% ethanolic extracts were prepared. Extracts were then tested for their ability to protect PC12-AC cells from hyperglycaemic challenge at physiologically relevant concentrations of 0.25, 0.5, 1.0 and 2.0 µg/mL. Folin-Ciocalteu method was used to determine the total phenolic content of P. mariana extracts. RESULTS: All extracts were well-tolerated in vitro exhibiting LD50 of 25 µg/mL or higher. Extracts from all tested organs showed a cytoprotective concentration-dependent response. Furthermore, the cytoprotective activity was habitat- and growth environment-dependent with plants grown in bog or forest habitats in coastal or inland environments exhibiting different cytoprotective efficacies. These differences in activity correlated with total phenolic content but not with antioxidant activity. In addition, this paper provides the first complete Ultra-Performance Liquid Chromatography-quadrupole time-of-flight (UPLC-QTOF) mass spectrometry analysis of Picea mariana's bark, needles and cones. CONCLUSIONS: Together, these results provide further understanding of the cytoprotective activity of Canadian boreal forest plants identified by the Cree healers of Eeyou Istchee in a cell model of diabetic neuropathy. Their activity is relevant to diabetic peripheral neuropathic complications and shows that their properties can be optimized by harvesting in optimal growth environments.


Assuntos
Diabetes Mellitus/fisiopatologia , Glucose/toxicidade , Hipoglicemiantes/farmacologia , Picea/química , Extratos Vegetais/farmacologia , Substâncias Protetoras/farmacologia , Animais , Sobrevivência Celular/efeitos dos fármacos , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/metabolismo , Glucose/metabolismo , Hipoglicemiantes/análise , Células PC12 , Extratos Vegetais/análise , Substâncias Protetoras/análise , Quebeque , Ratos
12.
Rev Med Suisse ; 15(653): 1132-1139, 2019 May 29.
Artigo em Francês | MEDLINE | ID: mdl-31148425

RESUMO

Hemodialysis (HD) centers are facing an increasing number of patients with diabetes. These cases require an intensive multidisciplinary approach of the consequences of renal failure, glycemic control and nutrition and the management of frequent co-morbidities, in particular the diabetic foot. A major challenge is to decrease glycemic variability and the risk of hypoglycemia. Because of increased risk of hypoglycemia-associated mortality, the HbA1C target is loosened in the majority of HD patients. Continuous glucose monitoring technology has identified important glycemic fluctuations during and after dialysis. However, their reliability in HD needs to be improved. New therapeutic pathways that decrease glucose excursions and hypoglycemia, such as GLP1 receptor agonists and sensor-coupled insulin pumps, have yet to be validated in HD.


Assuntos
Complicações do Diabetes , Falência Renal Crônica , Diálise Renal , Glicemia , Automonitorização da Glicemia , Complicações do Diabetes/terapia , Diabetes Mellitus/tratamento farmacológico , Hemoglobina A Glicada , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Reprodutibilidade dos Testes
13.
Protein Pept Lett ; 26(9): 664-675, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31215368

RESUMO

Bioactive peptides are short chain of amino acids (usually 2-20) that are linked by amide bond in a specific sequence which have some biological effects in animals or humans. These can be of diverse origin like plant, animal, fish, microbe, marine organism or even synthetic. They are successfully used in the management of many diseases. In recent years increased attention has been raised for its effects and mechanism of action in various disease conditions like cancer, immunity, cardiovascular disease, hypertension, inflammation, diabetes, microbial infections etc. Bioactive peptides are more bioavailable and less allergenic when compared to total proteins. Food derived bioactive peptides have health benefits and its demand has increased tremendously over the past decade. This review gives a view on last two years research on potential bioactive peptides derived from food which have significant therapeutic effects.


Assuntos
Produtos Biológicos/uso terapêutico , Alimentos , Peptídeos/uso terapêutico , Animais , Produtos Biológicos/química , Produtos Biológicos/metabolismo , Doenças Cardiovasculares/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Doenças do Sistema Imunitário/tratamento farmacológico , Infecção/tratamento farmacológico , Inflamação/tratamento farmacológico , Neoplasias/tratamento farmacológico , Peptídeos/química , Peptídeos/metabolismo
14.
Life Sci ; 231: 116483, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31102743

RESUMO

Alzheimer's disease (AD) remains one of the greatest global concerns. Current treatment of AD - the acetylcholinesterase inhibitors - provides temporary improvement of cognitive functions, but does not affect the core of the underlying pathological process. There is still the need for alternative approaches, preferably ones based on the upstream events in the AD pathogenesis. The nature of AD pathogenesis remains complicated and not entirely explained. It is assumed to comprise of many interrelated events which can sequentially lead to further pathologies - as a kind of vicious cycle. The solution in this case could be to interact with these processes on multiple levels at the same time. The proposed approach hopes to achieve the state of equilibrium between two pathological pathways via reducing their dynamics on appropriate levels. The first step is to inhibit Tumor Necrosis Factor signaling related to inflammatory response. The second is to take advantage of the influence of insulin signaling on amyloid-ß processing to restore its proper clearance. Employing two only partially-beneficial approaches into a novel approach aims at breaking the "vicious cycle" and eliciting synergistic effect via working on different levels simultaneously. The effect of such therapy could allow physicians to completely inhibit neural damage. The proposed strategy may prove easily introducible as an efficacious clinical approach employing novel anti-TNF agents in combination with anti-diabetic agents. Data is needed on its influence on cognitive functions, any occurrence of adverse effects, and the development of models of optimal doses and their temporal location.


Assuntos
Doença de Alzheimer/fisiopatologia , Doença de Alzheimer/terapia , Diabetes Mellitus/terapia , Inflamação/terapia , Anti-Inflamatórios/uso terapêutico , Cognição , Demência/tratamento farmacológico , Demência/fisiopatologia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/imunologia , Diabetes Mellitus/metabolismo , Sinergismo Farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Inflamação/metabolismo , Insulina/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
15.
Planta Med ; 85(11-12): 825-839, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31064029

RESUMO

Incretins are metabolic hormones released after a meal that increase insulin secretion from pancreatic ß-cells. The two main incretins are the intestinal peptides glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide. Both induce a decrease in glycemia, slow down the absorption of nutrients, and are inactivated by the enzyme dipeptidyl peptidase-4. Recently, incretin-based therapies have become a useful tool to treat diabetic patients, and different studies have focused on the identification of glucagon-like peptide-1 receptor agonists, including those of natural origin. This review focuses on the new findings of medicinal plants and natural products as possible active agents on the potentiation of incretin receptor signaling. Among these, soluble fiber from species of Plantago and guar gum show promising effects, iridoid derivatives are relevant activators of incretin receptors, and derivatives of cyanidin, especially diglycosylated ones, are an interesting source of dipeptidyl peptidase-4 inhibitors.


Assuntos
Produtos Biológicos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Incretinas/agonistas , Fitoterapia/métodos , Plantas Medicinais , Animais , Humanos , Incretinas/fisiologia
16.
Chem Biol Interact ; 310: 108665, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31125535

RESUMO

Diabetes mellitus (DM) is metabolism related problems that share the phenotype of hyperglycemia, which is triggered by a complicated interaction of hereditary and environmental elements. It is the main reason for end-stage renal disease (ESRD), amputations of the traumatic lower extremity, and grown-up visual impairment. It additionally inclines to neurodegenerative and cardiovascular sicknesses. With an expanding rate around the world, DM may be the main motive of morbidity and mortality within the foreseeable future. The objective of treatment for DM is to inhibit mortality and difficulties through normalizing blood glucose stage. Genistein, a naturally available soy isoflavone, is accounted for to have various medical advantages credited to numerous natural capacities. In the course of recent years, various examinations have shown that genistein has hostile to diabetic impacts, specifically, direct consequences for ß-cell expansion, glucose-triggered insulin discharge, and safety towards apoptosis, unbiased of its functions as an estrogen receptor agonist, cancer prevention agent, or tyrosine kinase inhibitor. The present evaluation emphases on the promising molecular and biochemical paths associated with DM complications and, specifically, the multi-target method of genistein in diminishing diabetic neuropathy, nephropathy, and retinopathy.


Assuntos
Complicações do Diabetes/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Genisteína/uso terapêutico , Estresse Oxidativo/efeitos dos fármacos , Animais , Complicações do Diabetes/metabolismo , Diabetes Mellitus/metabolismo , Nefropatias Diabéticas/tratamento farmacológico , Neuropatias Diabéticas/tratamento farmacológico , Retinopatia Diabética/tratamento farmacológico , Genisteína/farmacologia , Humanos
18.
Nat Commun ; 10(1): 2172, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-31092829

RESUMO

Inducing mitochondrial uncoupling (mUncoupling) is an attractive therapeutic strategy for treating metabolic diseases because it leads to calorie-wasting by reducing the efficiency of oxidative phosphorylation (OXPHOS) in mitochondria. Here we report a safe mUncoupler, OPC-163493, which has unique pharmacokinetic characteristics. OPC-163493 shows a good bioavailability upon oral administration and primarily distributed to specific organs: the liver and kidneys, avoiding systemic toxicities. It exhibits insulin-independent antidiabetic effects in multiple animal models of type I and type II diabetes and antisteatotic effects in fatty liver models. These beneficial effects can be explained by the improvement of glucose metabolism and enhancement of energy expenditure by OPC-163493 in the liver. Moreover, OPC-163493 treatment lowered blood pressure, extended survival, and improved renal function in the rat model of stroke/hypertension, possibly by enhancing NO bioavailability in blood vessels and reducing mitochondrial ROS production. OPC-163493 is a liver-localized/targeted mUncoupler that ameliorates various complications of diabetes.


Assuntos
Hipoglicemiantes/farmacologia , Fígado/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Desacopladores/farmacologia , Administração Oral , Animais , Pressão Sanguínea/efeitos dos fármacos , Células CHO , Cricetulus , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Modelos Animais de Doenças , Fígado Gorduroso/tratamento farmacológico , Fígado Gorduroso/etiologia , Fígado Gorduroso/patologia , Feminino , Células Hep G2 , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etiologia , Hipertensão/mortalidade , Hipoglicemiantes/farmacocinética , Hipoglicemiantes/uso terapêutico , Rim/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos , Mitocôndrias/metabolismo , Fosforilação Oxidativa/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/mortalidade , Análise de Sobrevida , Desacopladores/farmacocinética , Desacopladores/uso terapêutico
19.
Oxid Med Cell Longev ; 2019: 2867516, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31049131

RESUMO

Reactive Oxygen Species (ROS) play an essential dual role in living systems. Healthy levels of ROS modulate several signaling pathways, but at the same time, when they exceed normal physiological amounts, they work in the opposite direction, playing pivotal functions in the pathophysiology of multiple severe medical conditions (i.e., cancer, diabetes, neurodegenerative and cardiovascular diseases, and aging). Therefore, the research for methods to detect their levels via light-sensitive fluorescent probes has been extensively studied over the years. However, this is not the only link between light and ROS. In fact, the modulation of ROS mediated by light has been exploited already for a long time. In this review, we report the state of the art, as well as recent developments, in the field of photostimulation of oxidative stress, from photobiomodulation (PBM) mediated by naturally expressed light-sensitive proteins to the most recent optogenetic approaches, and finally, we describe the main methods of exogenous stimulation, in particular highlighting the new insights based on optically driven ROS modulation mediated by polymeric materials.


Assuntos
Antioxidantes/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Doenças Neurodegenerativas/tratamento farmacológico , Espécies Reativas de Oxigênio/antagonistas & inibidores , Envelhecimento/efeitos dos fármacos , Envelhecimento/metabolismo , Envelhecimento/patologia , Animais , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Humanos , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/patologia , Estresse Oxidativo/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos
20.
Rev Med Chil ; 147(2): 173-180, 2019 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-31095165

RESUMO

BACKGROUND: To reduce the progression of chronic kidney disease (CKD) and cardiovascular risk, the guidelines recommend the blockade of the renin-angiotensin-aldosterone system (RAAS) in patients with proteinuria. AIM: To assess the frequency of enalapril or losartan use in diabetics or hypertensive patients with stage 3 CKD. MATERIAL AND METHODS: Review of clinical records of patients with CKD in an urban primary care clinic. RESULTS: We identified 408 subjects aged 40 to 98 years (66% women) with stage 3 CKD. Sixty six percent had only hypertension and 34% were diabetic with or without hypertension. Seventy four percent received RAAS blockers (52% used enalapril, 45% losartan and 2% both medications). RAAS blockers were used in 70% of hypertensive and 78% of diabetic patients. The prescription in hypertensive diabetics with microalbuminuria was lower than in those without microalbuminuria (72% vs 87%, p < 0.05), but the opposite occurred in pure hypertensive patients with and without microalbuminuria (88% vs 69%, p < 0.05). There were no significant differences in blood pressure levels, microalbuminuria or serum potassium levels between RAAS blocker users and non-users. No differences were observed either between enalapril and losartan users. CONCLUSIONS: The adherence to clinical guidelines is insufficient and users of the recommended drugs did not achieve the expected goals.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Enalapril/uso terapêutico , Losartan/uso terapêutico , Insuficiência Renal Crônica/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Albuminúria/urina , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Inibidores da Enzima Conversora de Angiotensina/normas , Creatinina/sangue , Diabetes Mellitus/tratamento farmacológico , Progressão da Doença , Quimioterapia Combinada , Enalapril/administração & dosagem , Enalapril/normas , Feminino , Humanos , Hipertensão/tratamento farmacológico , Losartan/administração & dosagem , Losartan/normas , Masculino , Pessoa de Meia-Idade , Proteinúria/urina , Sistema Renina-Angiotensina , Cooperação e Adesão ao Tratamento/psicologia
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