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1.
Physiol Rev ; 103(1): 7-30, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-35635320

RESUMO

In this paper, we provide an overview of the evolution of the definition of hyperglycemia during the past century and the alterations in glucose dynamics that cause fasting and postprandial hyperglycemia. We discuss how extensive mechanistic, physiological research into the factors and pathways that regulate the appearance of glucose in the circulation and its uptake and metabolism by tissues and organs has contributed knowledge that has advanced our understanding of different types of hyperglycemia, namely prediabetes and diabetes and their subtypes (impaired fasting plasma glucose, impaired glucose tolerance, combined impaired fasting plasma glucose, impaired glucose tolerance, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus), their relationships with medical complications, and how to prevent and treat hyperglycemia.


Assuntos
Diabetes Mellitus Tipo 2 , Intolerância à Glucose , Hiperglicemia , Estado Pré-Diabético , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Glucose , Intolerância à Glucose/metabolismo , Humanos , Hiperglicemia/metabolismo , Estado Pré-Diabético/diagnóstico , Gravidez , Açúcares
2.
Ann Pharmacother ; 57(1): 51-54, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35652701

RESUMO

BACKGROUND: There are more than 350 reports of hyperglycemia post-influenza vaccine according to the Vaccine Adverse Effect Reporting System. Only one case report has been published detailing unusual post-vaccination hyperglycemia. The mechanism as to why hyperglycemia may occur post-vaccination has not been fully elucidated. OBJECTIVE: Primary: To identify hyperglycemia within the first 24 hours of influenza vaccine. Secondary: To identify transient property of hyperglycemia within 4 days after vaccine. METHODS: Multicenter prospective cohort study. Recruitment conducted throughout San Antonio, Texas, during 2018-2020 influenza seasons. Patients were included if 18 years or older, had diabetes mellitus, and currently checking their blood glucose daily. Patients excluded if they had a recent medication change that would effect their blood glucose readings. Patients had hemoglobin A1c and blood glucose measured prior to vaccination with a single dose (0.5 mL) of the tri-valent influenza vaccine intramuscularly. Glucose readings were collected within 24 hours post-vaccination and subsequent mornings for 4 days. RESULTS: A total of 34 patients were included. Average patient age was 75 years with 60% white, 30% black, and 10% Hispanic. Median fasting glucose pre-vaccination was significantly lower than the median value 0 to 24 hours post-vaccination (140 vs 203 mg/dL, P < 0.0001). CONCLUSION AND RELEVANCE: Hyperglycemia was noted 0 to 24 hours post-vaccination and was transient in nature with a return to baseline by post-vaccination day 2. This trial was conducted to close a potential gap in counseling regarding the flu vaccine and decrease any potential concern surrounding the vaccine in patients with diabetes that could lead to reduced vaccination rates.


Assuntos
Diabetes Mellitus , Hiperglicemia , Vacinas contra Influenza , Idoso , Humanos , Glicemia , Diabetes Mellitus/epidemiologia , Hemoglobina A Glicada , Hiperglicemia/diagnóstico , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , Estudos Prospectivos , Vacinação/efeitos adversos
3.
Spectrochim Acta A Mol Biomol Spectrosc ; 285: 121797, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36115306

RESUMO

Inhibiting the activity of α-amylase has been considered an effective strategy to manage hyperglycemia. Hyperoside and quercetin are the main natural flavonoids in various plants, and the inhibition mechanism on α-amylase remains unclear. In this study, the structure-activity relationships between hyperoside/quercetin and α-amylase were evaluated by enzyme kinetic analysis, multi-spectroscopic techniques, and molecular docking analysis. Results showed that hyperoside and quercetin exhibited significant α-amylase inhibitory activities with IC50 values of 0.491 and 0.325 mg/mL, respectively. The α-amylase activity decreased in the presence of hyperoside and quercetin in a competitive and noncompetitive manner, respectively. UV-vis spectra suggested that the aromatic amino acid residues (Trp and Tyr) microenvironment of α-amylase changed in the presence of these two flavonoids. FTIR and CD spectra showed the vibrations of the amide bands and the secondary structure content changes. The fluorescence quenching mechanism of α-amylase by hyperoside and quercetin belonged to the static quenching type. Finally, molecular docking intuitively showed that hyperoside/quercetin formed hydrogen bonds with the key active site residues (Asp197, Glu233, and Asp300) in α-amylase. MD simulation indicated hyperoside/quercetin-α-amylase docked complexes had good stability. Taken together, this research provides new sights to developing potent drugs or functional foods with hyperoside and quercetin, offering new avenues for hyperglycemia treatment.


Assuntos
Hiperglicemia , alfa-Amilases , Humanos , alfa-Amilases/metabolismo , Simulação de Acoplamento Molecular , Quercetina/química , Cinética , Flavonoides/química , Relação Estrutura-Atividade , Análise Espectral
4.
Food Chem ; 404(Pt A): 134598, 2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-36444040

RESUMO

Crude polysaccharides extracted from red kidney bean (RK) display significant antidiabetic activity in type 2 diabetic mice, but the underlying mechanism and the core functional component has not been elucidated. In this study, the antidiabetic effect and mechanism of RK are investigated by serum metabolomics and high-throughput sequencing. In addition, the key component was identified by evaluating the improvement on glucose and lipid homeostasis in type 2 diabetic rats. Our data indicated that RK relieved the symptoms of hyperglycemia, hyperlipidemia in STZ-induced diabetic rats. RK not only improved the metabolic disturbance by regulating the biosynthesis of unsaturated fatty acids, but also modified gut microbiota composition by selectively enriching in key genera of Bacteroides, Phascolarctobacterium, Succinivibrio, Blautia. We further found the purified polysaccharides (RKP) were identified as the core biofunctional component in RK. Our present studies provide evidence that RKP are potential effective dietary supplement for type 2 diabetic individuals.


Assuntos
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Microbioma Gastrointestinal , Hiperglicemia , Hiperlipidemias , Phaseolus , Ratos , Camundongos , Animais , Hiperlipidemias/tratamento farmacológico , Hiperlipidemias/genética , Diabetes Mellitus Experimental/tratamento farmacológico , Hiperglicemia/tratamento farmacológico , Hiperglicemia/genética , Polissacarídeos , Hipoglicemiantes , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/genética , Lipídeos
5.
J Hazard Mater ; 444(Pt A): 130368, 2023 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-36423455

RESUMO

Pesticide thiram is widely used in agriculture and has been demonstrated to cause tibial dyschondroplasia (TD) in birds. However, the underlying mechanism remains unclear. This work used multi-omics analysis to evaluate the molecular pathways of TD in broilers that were exposed to low level of thiram. Integrative analysis of transcriptomic, proteomic, and metabolomic revealed thiram activity in enhancing pathological ECM remodeling via attenuating the glycolysis pathway and activating the hexosamine and glucuronic acid pathways. Intriguingly, we found hyperglycemia as a crucial factor for ECM overproduction, which resulted in the development of TD. We further demonstrated that high glucose levels are caused by islet secretion dysfunction in thiram-treated broilers. A combination of factors, including lipid disorder, low-grade inflammation, and gut flora disturbance, might contribute to the dysregulation of insulin secretion. The current work revealed the underlying toxicological mechanisms of thiram-induced tibial dyschondroplasia through blood glucose disorder via the gut-pancreas axis in chickens for the first time, which makes it easier to figure out the health risks of pesticides for worldwide policy decisions.


Assuntos
Hiperglicemia , Osteocondrodisplasias , Animais , Tiram/toxicidade , Osteocondrodisplasias/induzido quimicamente , Osteocondrodisplasias/genética , Galinhas , Proteômica , Pâncreas
6.
Front Endocrinol (Lausanne) ; 13: 1011411, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36465630

RESUMO

Aim and scope: Glycemic variability (GV) denotes the fluctuations in the glucose values around the baseline. High glycemic variability is associated with a higher risk of diabetes-associated complications. In this study, we sought to determine the impact of therapeutic interventions based on flash glucose monitoring on rapid, short-term glycemic variability. We also studied the prevalent albuminuria in diabetic kidney disease and its effect on glycemic variability. Methods: In a 14-day, single-center, prospective intervention study, we measured the GV indices at baseline (days 1-4) and ten days after ambulatory glucose profile-based intervention using flash glucose monitoring (Abbott Libre Pro, Abbott Diabetes Care, Alameda, California, USA) in patients with type 2 diabetes. An EasyGV calculator was used to estimate the flash glucose monitoring (FGM)-derived measures of GV. The primary outcome was to assess the impact of FGMS-based therapeutic interventions on glycemic variability markers: SD, mean amplitude of glycemic excursion [MAGE], continuous overall net glycemic action [CONGA], absolute means of daily differences [MODD], M value, and coefficient of variance [%CV], AUC below 70 mg/dl, low blood glucose index, AUC above 180 mg/dl [AUC >180], high blood glucose index [HBGI], and J index. Time-related matrices (time in range (%), time above range (%), and time below range (%) were also calculated from the ambulatory glucose profile. Renal function parameters (serum creatinine, estimated glomerular filtration rate, urine albumin excretion) were calculated. The GV with regard to albumin excretion rate was compared. Results: Fifty-eight T2DM patients (63.8%, males) with a mean age of 51.5 ± 11.9 years were studied. When compared with baseline (days 1-4), on day 14, there was a significant improvement in mean sensor glucose (mg/dl) median (IQR) [155 (116-247) vs 131 (103-163) (p ≤0.001)], JINDEX [15,878 (7,706-28,298) vs 8,812 (5,545-14,130) (p ≤0.001)], HBGI [361 (304-492) vs 334 (280-379) (p ≤0.001)], MAGE (mg/dl) [112 (8-146) vs 82 (59-109) (p ≤0.001)], M-value [2,477 (1,883-3,848) vs 2,156 (1,667-2,656) (p ≤ 0.001)], MAG (mg/dl) [111 (88-132) vs 88 (69-102) (p ≤ 0.001)]. Patients with albuminuria at baseline had high mean sensor glucose (mg/dl) median (IQR) [190 (131-200) vs 131 (112-156) (p = 0.001)], CONGA (mg/dl) median (IQR) [155 (101-165) vs 108 (83-120) (p = 0.001)], JINDEX, HBGI, MAGE (mg/dl), and M-value are, median (IQR) [20,715 (10,970-26,217 vs 91,118 (6,504-15,445)) (p ≤ 0.01)], [415 (338-423) vs 328 (292-354) (p = 0.001)], [125 (102-196) vs 103 (74-143) (p ≤ 0.01)], [3,014 (2,233-3,080) vs 2,132 (1,788-2,402) (p ≤0.01)], respectively. Conclusion: In type 2 diabetes, flash glucose monitoring-guided therapeutic interventions can reduce glycemic variability in a brief span (10 days) of time. Also, albuminuria in type 2 diabetes is associated with high glycemic variability. Reduced diabetes complications may ultimately result from this reduced glycemic variability.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Masculino , Humanos , Gravidez , Adulto , Pessoa de Meia-Idade , Feminino , Albuminúria/etiologia , Glicemia , Diabetes Mellitus Tipo 2/complicações , Estudos Prospectivos , Automonitorização da Glicemia , Glucose , Tomada de Decisões , Albuminas
7.
Eur Rev Med Pharmacol Sci ; 26(22): 8351-8357, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36459018

RESUMO

OBJECTIVE: The current study aims to reconnoiter the outcome of diabetes mellitus type 2 (DMT2) on levels of advanced glycation end products (AGEs) and pro-inflammatory chemokine in gingival crevicular fluid (GCF) of individuals undergoing fixed orthodontic treatment. PATIENTS AND METHODS: Participants were divided into a diabetic and no-diabetic group according to inclusion and exclusion criteria. Power analysis was adopted from a previous study that reported GCF chemokines in obese individuals. All teeth were measured for clinical periodontal parameters (CPP). GCF and saliva were collected 3 months after placing stainless steel archwire. GCF was investigated for pro-inflammatory cytokines all expressed in pg/mL. Quantification of chemokines was performed using a Magnetic bead-based multiplex assay for the Luminex® platform. Non-normality of data was assessed by Mann-Whitney U-test. Normality was estimated using an Independent t-test. Descriptive data were computed in the form of standard deviations and means. RESULTS: Unstimulated whole saliva flow rate (UWSFR) was significantly lower in diabetic patients compared to non-diabetics (p=.021). Amongst different clinical periodontal parameters (CPP) no difference in plaque scores (PS) and probing depth (PD) was found between diabetic and non-diabetic participants. Two GCF chemokines i.e., Resistin (p=.031) and AGEs (p=.017) were observed to be significantly higher in DMT2 participants compared to the non-diabetes group. CPP and GCF biomarkers in diabetic and non-diabetic individuals demonstrated a positive correlation between AGEs and GCF resistin levels concerning bleeding on probing (BoP) in diabetic patients. CONCLUSIONS: Participants with DMT2 after alignment with an orthodontic device exhibited significantly high levels of resistin and AGEs. The proinflammatory response was noted in patients with hyperglycemia undergoing orthodontic treatment.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Adulto , Humanos , Líquido do Sulco Gengival , Resistina , Assistência Odontológica
8.
Sci Rep ; 12(1): 20910, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463296

RESUMO

Type-2 diabetes mellitus (T2DM) is a medical condition in which oral medications avail to patients to curb their hyperglycaemia after failed dietary therapy. However, individual responses to the prescribed pharmacotherapy may differ due to their clinical profiles, comorbidities, lifestyles and medical adherence. One approach is to identify similar patients within the same community to predict their likely response to the prescribed diabetes medications. This study aims to present an evidence-based diabetes medication recommendation system (DMRS) underpinned by patient similarity analytics. The DMRS was developed using 10-year electronic health records of 54,933 adult patients with T2DM from six primary care clinics in Singapore. Multiple clinical variables including patient demographics, comorbidities, laboratory test results, existing medications, and trajectory patterns of haemoglobin A1c (HbA1c) were used to identify similar patients. The DMRS was evaluated on four groups of patients with comorbidities such as hyperlipidaemia (HLD) and hypertension (HTN). Recommendations were assessed using hit ratio which represents the percentage of patients with at least one recommended sets of medication matches exactly the diabetes prescriptions in both the type and dosage. Recall, precision, and mean reciprocal ranking of the recommendation against the diabetes prescriptions in the EHR records were also computed. Evaluation against the EHR prescriptions revealed that the DMRS recommendations can achieve hit ratio of 81% for diabetes patients with no comorbidity, 84% for those with HLD, 78% for those with HTN, and 75% for those with both HLD and HTN. By considering patients' clinical profiles and their trajectory patterns of HbA1c, the DMRS can provide an individualized recommendation that resembles the actual prescribed medication and dosage. Such a system is useful as a shared decision-making tool to assist clinicians in selecting the appropriate medications for patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Hipertensão , Adulto , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobina A Glicada , Prescrições
9.
Sci Rep ; 12(1): 20912, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463298

RESUMO

Hyperglycemia is a major risk factor in the development of diabetic complications and promotes vascular complications through dysregulation of endothelial cell function. Various mechanisms have been proposed for endothelial cell dysregulation but the early transcriptomic alterations of endothelial cells under hyperglycemic conditions are not well documented. Here we use deep time-series RNA-seq profiling of human aortic endothelial cells (HAECs) following exposure to normal (NG) and high glucose (HG) conditions over a time course from baseline to 24 h to identify the early and transient transcriptomic changes, alteration of molecular networks, and their temporal dynamics. The analysis revealed that the most significant pathway activation/inhibition events take place in the 1- to 4-h transition and identified distinct clusters of genes that underlie a cascade of coordinated transcriptional events unique to HG conditions. Temporal co-expression and causal network analysis implicate the activation of type 2 diabetes (T2D) and growth factor signalling pathways including STAT3 and NF-κB. These results document HAEC transcriptional changes induced by hyperglycemic conditions and provide basic insight into the rapid molecular alterations that promote endothelial cell dysfunction.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Doenças Vasculares , Humanos , Células Endoteliais , Aorta , Hiperglicemia/genética , NF-kappa B
15.
Turk J Med Sci ; 52(4): 1093-1102, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36326390

RESUMO

BACKGROUND: There are not many studies conducted to detect and recognize the symptoms during the prediabetes period. In our study, we aimed to determine the symptoms that can be seen in prediabetes and diabetes and their prevalence and to determine the similarities and differences between the two groups. METHODS: Individuals who were diagnosed with prediabetes or diabetes, over the age of 18, literate, and accepted to collaborate were included in our study. The "Diabetes Symptoms Checklist Scale" was used by interviewing 321 participants, 161 prediabetic and 160 diabetic, face-to-face. RESULTS: It has been found that the most common symptom in both the prediabetes and the diabetes group is "fatigue" (88.2% prediabetes, 89.4% diabetes). The symptoms seen in the dimensions of neurology and hyperglycemia are more common in individuals with diabetes than in individuals with prediabetes [neurology score: 1.85 ± 0.84 vs. 1.66 ± 0.64 (p = 0.02), respectively; hyperglycemia score: 2.39 ± 0.94 vs. 2.08 ± 0.83 (p = 0.002), respectively]. It was observed that the symptom burden increased in all subdimensions with the long duration of illness, being a female, not working, having a family history, and not doing exercise, and high fasting blood glucose and high HbA1c values. The level of education, family history, accompanying hyperlipidemia, neurology, and hyperglycemia symptoms are associated with diabetes; and it has been determined that cardiology symptoms are associated with prediabetes. DISCUSSION: Especially; during the follow-up of patients with prediabetes who have a low education level and diabetic family history and concomitant hyperlipidemia, there may be an increase in neurological and hyperglycemic symptoms at the point of development of type 2 diabetes. In this respect, we recommend that these factors, which we found to be predictive of diabetes compared to prediabetes, should be questioned more carefully during patient visits.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperglicemia , Estado Pré-Diabético , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada/análise , Glicemia
16.
Diabetes Care ; 45(11): 2787-2795, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36318674

RESUMO

BACKGROUND: Lifestyle interventions improve the metabolic control of individuals with hyperglycemia. PURPOSE: We aimed to determine the effect of lifestyle interventions on cardiovascular and all-cause mortality in this population. DATA SOURCES: Searches were made through MEDLINE, Cochrane CENTRAL, Embase, and Web of Science (no date/language restriction, until 15 May 2022). STUDY SELECTION: We included randomized clinical trials (RCTs) of subjects with prediabetes and type 2 diabetes, comparing intensive lifestyle interventions with usual care, with a minimum of 2 years of active intervention. DATA EXTRACTION: Data from the 11 RCTs selected were extracted in duplicate. A frequentist and arm-based meta-analysis was performed with random-effects models to estimate relative risk (RR) for mortality, and heterogeneity was assessed through I2 metrics. A generalized linear mixed model (GLMM) was used to confirm the findings. DATA SYNTHESIS: Lifestyle interventions were not superior to usual care in reducing cardiovascular (RR 0.99; 95% CI 0.79-1.23) or all-cause (RR 0.93; 95% CI 0.85-1.03) mortality. Subgroup, sensitivity, and meta-regression analyses showed no influence of type of intervention, mean follow-up, age, glycemic status, geographical location, risk of bias, or weight change. All of these results were confirmed with the GLMM. Most studies had a low risk of bias according to the RoB 2.0 tool and the certainty of evidence was moderate for both outcomes. LIMITATIONS: Most studies had a low risk of bias according to the RoB 2.0 tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach resulted in moderate certainty of evidence for both outcomes. Differences in lifestyle programs and in usual care between the studies should be considered in the interpretation of our results. CONCLUSIONS: Intensive lifestyle interventions implemented so far did not show superiority to usual care in reducing cardiovascular or all-cause mortality for subjects with prediabetes and type 2 diabetes.


Assuntos
Sistema Cardiovascular , Diabetes Mellitus Tipo 2 , Hiperglicemia , Estado Pré-Diabético , Humanos , Estilo de Vida
17.
Georgian Med News ; (328-329): 47-52, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36318841

RESUMO

Gestational diabetes mellitus (GDM) is chronic hyperglycemia during gestation in women without previously diagnosed diabetes. This hyperglycemia is caused by impaired glucose tolerance due to pancreatic ß-cell dysfunction in the setting of chronic insulin resistance. GDM has been found to affect approximately 4-16.5% of pregnant women worldwide. The large range of prevalence is associated with different approaches to the diagnosis of gestational diabetes, which are addressed in recent organizational documents but have not yet been introduced into wide clinical practice, and therefore prevalence figures vary between countries, as well as between regions of one country. Studies have shown that overweight and obese patients or people with a family history of any form of diabetes are more likely to have GDM and the incidence of GDM increases with the age of the pregnant woman. It has been proven that half of the cases of GDM occur as a relapse in a subsequent pregnancy. Consequences of GDM include an increased risk of maternal cardiovascular disease and type 2 diabetes, as well as macrosomia and birth complications in the infant. There is also a long-term risk of obesity, type 2 diabetes, and cardiovascular disease in the child. Despite the fact that management strategies, insulin therapy, and behavioral therapy have been discussed for a long time, the effectiveness of these methods is insufficient. This review discusses what is currently known about the epidemiology, pathophysiology of GDM, and maternal and child outcomes.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Hiperglicemia , Feminino , Humanos , Gravidez , Diabetes Gestacional/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Prevalência , Mães , Obesidade/epidemiologia
18.
J Med Case Rep ; 16(1): 398, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316784

RESUMO

BACKGROUND: We report two similar cases of patients diagnosed with hemiballismus-hemichorea syndrome secondary to uncontrolled hyperglycemia. Both patients were treated at an inpatient rehabilitation center and made a significant recovery in both function and activities of daily living. Although hemiballismus-hemichorea syndrome has known pharmacological treatments, little has been reported on the effectiveness of acute rehabilitation on managing and treating this syndrome. CASE PRESENTATION: The first case involves a 44-year-old Hispanic male with past medical history of type 2 diabetes mellitus, hypertension, anxiety, and depression who presented with continuous, uncontrollable, unilateral movements 1 month following a hospital admission for hyperglycemia. Magnetic resonance imaging findings showed lesions in the basal ganglia, confirming the diagnosis of hemiballismus-hemichorea syndrome. The patient was started on antipsychotic medications and antihyperglycemic medications controlling glucose levels, but continued to have hemiballismus symptoms. The second case involves a 78-year-old Haitian female with past medical history of type 2 diabetes mellitus and hypertension who presented with weakness and continuous, involuntary movements in her upper and lower extremities 1 month following a hospital admission for hyperglycemia and encephalopathy. Magnetic resonance imaging findings were positive for bilateral lesions in the basal ganglia, establishing a diagnosis of hemiballismus-hemichorea syndrome. After a 2-week stay at an acute rehabilitation center, both patients made a significant recovery in function and activities of daily living. CONCLUSION: The aim in presenting these cases is to elucidate the etiology and progression of a rare disease process known as hemiballismus-hemichorea syndrome and to provide evidence for the potential positive impact of acute rehabilitation on patients with unresolved hemiballismus-hemichorea following an episode of hyperglycemia.


Assuntos
Diabetes Mellitus Tipo 2 , Discinesias , Hiperglicemia , Hipertensão , Humanos , Masculino , Feminino , Adulto , Idoso , Diabetes Mellitus Tipo 2/complicações , Atividades Cotidianas , Haiti , Discinesias/diagnóstico , Hiperglicemia/complicações , Hiperglicemia/tratamento farmacológico , Hipertensão/complicações
19.
Medicine (Baltimore) ; 101(43): e31405, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316900

RESUMO

BACKGROUND: The aim of this meta-analysis is to systematically evaluate and summarize the risk factors of intensive care unit acquired weakness (ICU-AW), to provide evidence-based evidence for the formulation of prevention strategies for ICU-AW. METHODS: PubMed, EMBASE, Web of Science, CBM (China Biology Medicine, China), Chinese National Knowledge Infrastructure, Chinese WANFANG, and VIP will be searched to define relevant risk factors for ICU-AW. The databases search period is from January 1, 2005 to August 13, 2021. The Newcastle Ottawa Scale (NOS) is used to evaluate the quality of the included studies. RevMan 5.3 analysis software will be used for meta-analysis. RESULTS: This systematic review and meta-analysis included a total of 12 cohort studies, including 9 international journals and 3 Chinese journals, with a total of 1950 patients, of which 856 had ICU-AW. The results showed that the significant risk factors for ICU-AW included female (odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.06-1.71; P = .02), mechanical ventilation days (OR = 3.04, 95% CI: 1.82-4.26; P < .00001), age (OR = 6.33, 95% CI: 5.05-7.61; P < .00001), length of intensive care unit (ICU) stay (OR = 3.78, 95% CI: 2.06-5.51; P < .0001), infectious disease (OR = 1.67, 95% CI: 1.20-2.33; P = .002), renal replacement therapy (OR = 1.59, 95% CI: 1.11-2.28; P = .01), use of aminoglucoside drugs (OR = 2.51, 95% CI: 1.54-4.08; P = .0002), sepsis related organ failure assessment (SOFA) score (OR = 1.07, 95% CI: 0.24-1.90; P = .01), hyperglycemia (OR = 2.95, 95% CI: 1.70-5.11; P = .0001). CONCLUSION: This meta-analysis provides comprehensive evidence-based on the assessment of the risk factors for ICU-AW, their multifactorial etiology was confirmed. This study indicated that female, mechanical ventilation days, age, length of ICU stay, infectious disease, renal replacement therapy, use of aminoglucoside drugs, SOFA score, and hyperglycemia are independent risk factors for ICU-AW. We have not found consistent evidence that corticosteroids, neuromuscular blockers, sepsis have any effect on ICU-AW risk.


Assuntos
Hiperglicemia , Sepse , Humanos , Feminino , Debilidade Muscular/etiologia , Unidades de Terapia Intensiva , Fatores de Risco , Sepse/complicações , Hiperglicemia/complicações
20.
Medicine (Baltimore) ; 101(43): e31320, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316919

RESUMO

To estimate the prevalence of metabolic syndrome (MS) and metabolic components and their associated factors and component combinations according to hypertension status in Tibetans living at high altitude. Multistage sampling of 1473 participants (799 hypertensive patients and 674 normotensive subjects). MS prevalence and the number of metabolic components ≥ 3 were significantly higher in the hypertensive than normotensives. In hypertensive patients, the most common component was central obesity and it combined with: high blood pressure, in those with 2 risk factors, plus fasting hyperglycemia, in those with 3 risk factors, and high triglyceride, in those with 4 risk factors. In normotensive subjects, the most common single component was low high-density-lipoprotein cholesterol, and most component combination included central obesity and hyperglycemia in those with 2 risk factors, plus high blood pressure in those with 3 risk factors, and high triglycerides in those with 4 risk factors. Body mass index and female both were associated with increased possibilities of MS in hypertensive and normotensive participants. Low incoming, and high educational levels were associated with an elevated probability of MS in normotensive Tibetans also. The priority of prevention from cardiovascular diseases by targeting metabolic components in the hypertensive was different from normotensives. Different MS components had various lifestyle and socioeconomic factors.


Assuntos
Hiperglicemia , Hipertensão , Síndrome Metabólica , Humanos , Feminino , Estudos Transversais , Obesidade Abdominal/complicações , Tibet/epidemiologia , Hipertensão/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/complicações , Fatores de Risco , Índice de Massa Corporal , Hiperglicemia/complicações , Obesidade/epidemiologia , Obesidade/complicações , Prevalência
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