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1.
Food Chem ; 368: 130883, 2022 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-34438179

RESUMO

The effects of acetylation, hydroxypropylation, cellulase hydrolysis and crosslinking on adsorption capacities and in vitro hypoglycemic activities of millet bran dietary fibre (MBDF) were studied. The results demonstrated that both acetylation and hydroxypropylation improved water swelling ability of MBDF, and adsorption capacities of cholesterol, cholate and copper ion on MBDF. Acetylation and hydroxypropylation also enhanced α-glucosidase and α-amylase inhibition activities, glucose-binding ability and glucose diffusion retardation index (GDRI) of MBDF. Acetylated MBDF showed the highest cholate (77.31 mg/g) and cholesterol (13.97 mg/g) adsorption capacities. The crosslinking improved adsorption of cholate, cholesterol, copper ion (25.64 mg/g) and nitrite ion (181.59 µg/g) on MBDF; but reduced α-amylase inhibition activity (p < 0.05). Moreover, cellulase hydrolyzed MBDF exhibited the highest GDRI (39.60%) and α-amylase inhibition activity (34.53%), but the lowest oil and cholate adsorption capacities. The results suggest that the modified MBDFs can be used as an ingredient of hypoglycemic foods.


Assuntos
Celulase , Milhetes , Acetilação , Adsorção , Celulase/metabolismo , Fibras na Dieta , Hidrólise , Hipoglicemiantes , Milhetes/metabolismo
2.
Food Chem ; 370: 131010, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34530347

RESUMO

Laminaria japonica is a familiar marine plant and is often used as food due to its abundant carbohydrates, vitamins and minerals. As one of the main types of active substances in L. japonica, polysaccharides are widely used in the food and chemical industries and in medicine and healthcare due to their health benefits, such as immunoregulatory, antioxidant, and antidiabetic effects. However, there has been no systematic summary of the isolation, structural characterization and bioactivities of L. japonica polysaccharides (LJPs). Therefore, the present review includes a survey of extraction and purification methods for these bioactive molecules, along with a dissertation on the structural characterization of the carbohydrate components. Moreover, an overview of the most recent results related to LJP biological activities is provided. This review provides a useful reference for further research, production, and application of LJPs in functional foods and therapeutic agents.


Assuntos
Laminaria , Antioxidantes , Hipoglicemiantes , Extratos Vegetais , Polissacarídeos
3.
Food Chem ; 372: 131335, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-34818743

RESUMO

Mulberry leaves (MLs) have been used traditionally to raise silkworms and as herbs and herbal drinks. In vitro and in vivo studies as well as some clinical trials provide some evidence of health benefits, mostly for ML extracts. ML extracts showed antioxidant, hypoglycemic, anticholesterol (affecting lipid metabolism), antiobesity, anti-inflammatory, anticancer activities, and so on. These might be linked to strong antioxidant activities, inhibition of α-glucosidase and α-amylase, reduction of foam cell formation, inhibition of fat formation, decrease of NF-κB activity, and the promotion or induction of apoptosis. Phenolic constituents, especially flavonoids, phenolic acids and alkaloids, are likely to contribute to the reported effects. The phytochemistry and pharmacology of MLs confer the traditional and current uses as medicine, food, fodder, and cosmetics. This paper reviews the economic value, chemical composition and pharmacology of MLs to provide a reference for the development and utilization of MLs.


Assuntos
Morus , Frutas , Hipoglicemiantes/farmacologia , Compostos Fitoquímicos , Extratos Vegetais/farmacologia , Folhas de Planta
4.
Food Chem ; 371: 131128, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34563970

RESUMO

Lithocarpus polystachyus Rehd. known as Sweet Tea in China has attracted lots of interest for its good hypoglycemic effect and the potential as a hypoglycemic agent. Based on affinity separation-UPLC-Q-TOF-MS/MS, 54 potential α-glucosidase inhibitiors were identified and 44 were structurally determined. Out of them, 41 were identified for the first time from this plant including flavonoids, fatty acids, triterpenes, alkaloids, and coumarins. Enzyme assays revealed that flavonoids exhibited higher inhibitory activity against α-glucosidase than others with astilbin (IC50 = 6.14 µg·mL-1), morin (IC50 = 8.46 µg·mL-1), and naringenin (IC50 = 10.03 µg·mL-1) showing 2- to 4-fold higher potency than the positive control acarbose. They were proved as reversible inhibitors with mixed inhibition mechanism. Ki (Ki') values and molecular dockings strongly supported the potency order of astilbin, morin and naringenin that showed in the enzyme assays.


Assuntos
Fagaceae , Inibidores de Glicosídeo Hidrolases , Hipoglicemiantes , Extratos Vegetais , Folhas de Planta , Espectrometria de Massas em Tandem , alfa-Glucosidases
6.
Rev Esp Salud Publica ; 952021 Nov 12.
Artigo em Espanhol | MEDLINE | ID: mdl-34728595

RESUMO

OBJECTIVE: The therapeutic arsenal of hypoglycaemic drugs has been increased by the commercialization of new molecules in recent years. The main objective of this study was to know the trend of use of this group of drugs in a healthcare area. METHODS: The data was obtained through an electronic medical prescription billing computer application that contains all the information on the consumption of prescription drugs. The last seven years were analyzed in a healthcare area that covers a population of 85 thousand inhabitants and the defined daily dose (DDD) per inhabitant per day was used as a measurement variable. RESULTS: In our health area, an increasing and constant use of antidiabetic drugs was observed from a value of 55.62 DHD per inhabitant per day in 2014 to a value of 65.04 in 2020. Throughout the period studied, oral hypoglycemic drug combinations and sodium-glucose cotransporter-2 inhibitors were the therapeutic subgroups that experienced growth greater than 50%. CONCLUSIONS: The consumption of hypoglycemic agents experienced a notable growth in the period analyzed, mainly at the expense of new therapeutic groups and new commercialized molecules.


Assuntos
Diabetes Mellitus Tipo 2 , Preparações Farmacêuticas , Inibidores do Transportador 2 de Sódio-Glicose , Atenção à Saúde , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucose , Humanos , Hipoglicemiantes , Espanha
7.
Sensors (Basel) ; 21(21)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34770425

RESUMO

The use of automated insulin delivery systems has become a reality for people with type 1 diabetes (T1D), with several hybrid systems already on the market. One of the particularities of this technology is that the patient is in the loop. People with T1D are the plant to control and also a plant operator, because they may have to provide information to the control loop. The most immediate information provided by patients that affects performance and safety are the announcement of meals and exercise. Therefore, to ensure safety and performance, the human factor impact needs to be addressed by designing fault monitoring strategies. In this paper, a monitoring system is developed to diagnose potential patient modes and faults. The monitoring system is based on the residual generation of a bank of observers. To that aim, a linear parameter varying (LPV) polytopic representation of the system is adopted and a bank of Kalman filters is designed using linear matrix inequalities (LMI). The system uncertainty is propagated using a zonotopic-set representation, which allows determining confidence bounds for each of the observer outputs and residuals. For the detection of modes, a hybrid automaton model is generated and diagnosis is performed by interpreting the events and transitions within the automaton. The developed system is tested in simulation, showing the potential benefits of using the proposed approach for artificial pancreas systems.


Assuntos
Diabetes Mellitus Tipo 1 , Pâncreas Artificial , Glicemia , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Hipoglicemiantes , Insulina , Sistemas de Infusão de Insulina
8.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34770502

RESUMO

(1) Background: Intensive insulin therapy using continuous subcutaneous insulin infusion (CSII) with continuous real-time glucose monitoring (rt CGM) is the best option for patients with T1D. The recent introduction of a technology called Advanced Hybrid Closed Loop (AHCL) represents a new era in the treatment of type 1 diabetes, the next step towards better care, as well as improving the effectiveness and safety of therapy. The aim is to present the case of a T1D patient with a borderline total daily dose of insulin being treated with the Medtronic AHCL system in automatic mode. (2) Materials and Methods: A 9-year-old boy, from October 2020, with type 1 diabetes in remission was connected to the Minimed™ 780G (AHCL) system in accordance with the manufacturer's recommendations (daily insulin dose > 8 units, age > 7). Records of the patient's history were collected from visits to The Department of Children's Diabetology, as well as from the Medtronic CareLink™ software and the DPV SWEET program from October 2020 to April 2021. (3) Results: The patient's total daily insulin requirement decreased in the first 6 weeks after the AHCL was connected, which may reflect the remission phase (tight glycemic control with a healthy lifestyle). The lowest daily insulin requirement of 5.7 units was also recorded. In a three-month follow-up of the patient treated with AHCL, it was found that for almost 38% of the days the insulin dose was less than 8 IU. (4) Conclusions: The AHCL system allows safe and effective insulin therapy in automatic mode, as well as in patients with a lower daily insulin requirement. The AHCL system should be considered a good therapeutic option for patients from the onset of T1D, as well in the remission phase.


Assuntos
Diabetes Mellitus Tipo 1 , Glicemia , Automonitorização da Glicemia , Criança , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Hipoglicemiantes , Insulina , Sistemas de Infusão de Insulina , Masculino
9.
Br J Community Nurs ; 26(11): 544-552, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34731035

RESUMO

Type 1 diabetes is a lifelong condition which affects all age ranges, for reasons unknown, and the UK has one of the highest incidences of this complex condition in the world. Type 1 diabetes is caused by autoimmune damage to the insulin-producing ß-cells found in the pancreatic islet cells, leading to severe insulin deficiency. People with diabetes need to achieve a target glyosylated haemoglobin level to avoid macro- and microvascular complications, but there is the associated risk of hypoglycaemic events. These can vary in severity and consequences but will likely always cause worry for the person living with diabetes. There are many risk factors and reasons to be explored when looking at hypoglycaemia. This case study explores the nursing interventions that can be safely worked through and prioritised, within the community setting, to allow people with diabetes to be safe from severe hypoglycaemia, thus improving their quality of life and safety, as well as reducing costs for the NHS.


Assuntos
Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 1/enfermagem , Hemoglobina A Glicada/análise , Hipoglicemia/prevenção & controle , Hipoglicemiantes/administração & dosagem , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Hipoglicemia/etiologia , Hipoglicemia/enfermagem , Hipoglicemiantes/uso terapêutico , Qualidade de Vida
10.
Lancet ; 398(10313): 1837-1850, 2021 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-34774146

RESUMO

Type 1 diabetes is on the rise globally; however, the burden of mortality remains disproportionate in low-income and middle-income countries (LMICs). As 2021 marks 100 years since the discovery of insulin, we revisit progress, global burden of type 1 diabetes trends, and understanding of the pathogenesis and management practices related to the disease. Despite much progress, inequities in access and availability of insulin formulations persist and are reflected in differences in survival and morbidity patterns related to the disease. Some of these inequities have also been exacerbated by health-system challenges during the COVID-19 pandemic. There is a clear opportunity to improve access to insulin and related essential technologies for improved management of type 1 diabetes in LMICs, especially as a part of universal health coverage. These improvements will require concerted action and investments in human resources, community engagement, and education for the timely diagnosis and management of type 1 diabetes, as well as adequate health-care financing. Further research in LMICs, especially those in Africa, is needed to improve our understanding of the burden, risk factors, and implementation strategies for managing type 1 diabetes.


Assuntos
Países em Desenvolvimento , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 1/terapia , Carga Global da Doença/tendências , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Adolescente , Criança , Pré-Escolar , Gerenciamento Clínico , História do Século XX , História do Século XXI , Humanos , Hipoglicemiantes/economia , Hipoglicemiantes/história , Insulina/economia , Insulina/história , Expectativa de Vida , Cobertura Universal do Seguro de Saúde
11.
J Pak Med Assoc ; 71(11): 2637-2640, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783749

RESUMO

Patients with type 2 diabetes (T2D) are at high risk of cardiovascular complications. Novel anti-diabetic medications such as sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and Glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to possess cardiac and renal protective effects beyond their ability to lower plasma glucose. Use of SGLT-2i and GLP-1RA in patients with T2D and heart failure reduce cardiovascular risk and heart failure-related hospitalisations. SGLT-2i treatment has been shown to improve the long-term prognosis of patients with heart failure. Both drugs also have the potential to normalise ventricular-arterial coupling (VAC). VAC is the crosstalk between the left ventricular function and arterial system, and is an indicator of the global cardiovascular performance. In this overview, we will describe the concept of VAC and the features of diabetic cardiomyopathy, as well as VAC as a potential therapeutic target in diabetes by the use of novel anti-diabetic drugs, primarily SGLT-2i and GLP-1RA.


Assuntos
Diabetes Mellitus Tipo 2 , Inibidores do Transportador 2 de Sódio-Glicose , Artérias , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Receptor do Peptídeo Semelhante ao Glucagon 1 , Humanos , Hipoglicemiantes/uso terapêutico , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico
12.
Cien Saude Colet ; 26(suppl 3): 5081-5088, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34787200

RESUMO

The objective of this study was to analyze the use and access to medications for type 2 diabetes among older people registered in the family health strategy in Ribeirão Preto, São Paulo. A population-based household survey was undertaken with 338 older adults selected using two-stage cluster sampling. Pharmacotherapy of diabetes and access to medications was investigated using a structured questionnaire administered by means of face-to-face interviews. The number of medicines used to treat diabetes ranged between 1 and 4. Respondents predominantly used only oral antidiabetic agents. The use of metformin and sulfonylureas on their own was reported by 37.9% and 9.8% of respondents, respectively. Frequency of insulin use was greatest in the 80 years and overage group (38.9%). The large majority of respondents (96.4%) had full access to medicines. Means of payment was "free of charge" in 78.1% of the respondents and public pharmacies were the main source of medication (74.8%). The most commonly used oral antidiabetic was metformin, which is consistent with current treatment guidelines. However, the findings show inappropriate medication use among older people, more specifically the use of sulfonylureas on their own. The findings of this study highlight the important role played by the public health service in providing medications for type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Farmácias , Idoso , Brasil , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Hipoglicemiantes
14.
Home Healthc Now ; 39(6): 354-355, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34738973
15.
Nurs Clin North Am ; 56(4): 527-541, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34749892

RESUMO

Obesity is the most significant risk factor for the development of diabetes. Both obesity and diabetes rates have continued to increase in tandem and pose increased mortality for patients and increased health care costs for the community. Weight loss of 5% or more of total body weight renders improvements in glycemic control, decreases in the need for diabetes medications, and improved quality of life. Cotreatment of obesity and diabetes requires a comprehensive medical approach that encompasses intensive lifestyle modification including behavioral changes, nutrition, and physical activity, as well as pharmacotherapy and possible surgical management.


Assuntos
Terapia Comportamental , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/fisiopatologia , Exercício Físico , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Obesidade/tratamento farmacológico , Obesidade/fisiopatologia , Perda de Peso , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/epidemiologia , Derivação Gástrica , Humanos , Estilo de Vida , Obesidade/epidemiologia , Fatores de Risco
16.
Molecules ; 26(21)2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34771066

RESUMO

Panax ginseng was employed in the treatment of "Xiao-Ke" symptom, which nowadays known as diabetes mellitus, in traditional Chinese medicine for more than a thousand years. Ginsenoside Re was the major pharmacologic ingredient found abundantly in ginseng. However, the anti-diabetic of Ginsenoside Re and its underlying mechanism in metabolic level are still unclear. Serum and urine metabolomic method was carried out to investigate the anti-diabetic pharmacological effects and the potential mechanism of Ginsenoside Re on high-fat diet combined streptozotocin-induced type 2 diabetes mellitus (T2DM) rats based on ultra-high-performance liquid chromatography coupled with quadrupole exactive orbitrap mass spectrometry (UHPLC-Q-Exactive Orbitrap/MS). Serum and urine samples were collected from the control group (CON), T2DM group, metformin (MET) treatment group, and ginsenoside Re treatment group after intervention. The biochemical parameters of serum were firstly analyzed. The endogenous metabolites in serum and urine were detected by UHPLC-MS. The potential metabolites were screened by multivariate statistical analysis and identified by accurate mass measurement, MS/MS, and metabolite databases. The anti-diabetic-related metabolites were analyzed by KEGG metabolic pathway, and its potential mechanism was discussed. The treatment of ginsenoside Re significantly reduced the blood glucose and serum lipid level improved the oxidative stress caused by T2DM. Biochemical parameters (urea nitrogen, uric acid) showed that ginsenoside Re could improve renal function in T2DM rats. Respective 2 and 6 differential metabolites were found and identified in serum and urine of ginsenoside Re compared with T2DM group and enriched in KEGG pathway. Metabolic pathways analysis indicated that the differential metabolites related to T2DM were mainly involved in arachidonic acid metabolism, Vitamin B6, steroid hormone biosynthesis, and bile secretion metabolic pathways. This study verified the anti-diabetic and anti-oxidation effects of ginsenoside Re, elaborated that ginsenoside Re has a good regulation of the metabolic disorder in T2DM rats, which could promote insulin secretion, stimulated cannabinoid type 1 receptor (CB1), and CaMKK ß to activate AMPK signaling pathway, inhibited insulin resistance, and improved blood glucose uptake and diabetic nephropathy, so as to play the role of anti-diabetic.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Ginsenosídeos/uso terapêutico , Hipoglicemiantes/uso terapêutico , Metabolômica , Animais , Cromatografia Líquida de Alta Pressão , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/induzido quimicamente , Diabetes Mellitus Tipo 2/metabolismo , Ginsenosídeos/análise , Ginsenosídeos/metabolismo , Hipoglicemiantes/análise , Hipoglicemiantes/metabolismo , Masculino , Espectrometria de Massas , Panax/química , Ratos , Ratos Wistar , Estreptozocina
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