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Myers, Valerie Harwell Herbert James D. "Mood and anxiety symptomatology in adults with insulin-dependent Diabetes Mellitus using intensive management regimens /." Philadelphia, Pa. : Drexel University, 2003. http://dspace.library.drexel.edu/handle/1860/233.
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Bastos, Jaqueline Silva [UNESP]. "Construção de uma plataforma de força para avaliação da pressão plantar em indivíduos com diabetes mellitus." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/97033.
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O presente estudo é uma interação interdisciplinar entre os conceitos da engenharia mecânica e a ciência da saúde, usada para rastrear alterações nos pés de portadores de Diabetes Mellitus, possibilitando, através de uma plataforma de força, a identificação do risco de formação de úlceras plantares secundárias à sobrecarga mecânica em áreas de sensibilidade diminuída. Para tal foi projetada e construída uma plataforma de força de fácil operação. O estudo em análise foi realizado com um grupo de 30 voluntários, de ambos os sexos, com idade entre 30 e 69 anos (com idade média de 50 anos) distribuídos entre portadores de Diabetes mellitus e não diabéticos. A amostra foi dividida em três grupos: diabéticos com e sem neuropatia diabética e não diabéticos. Todos participantes, possuem características antropométricas compatíveis e não apresentam deformidades articulares significativas nos pés e nem dificuldades de marcha. Cada participante foi avaliado três vezes, permanecendo em posição ereta e estática sobre a plataforma, num tempo de 20 segundos em cada coleta. Através da análise da distribuição da pressão plantar foi observado que os voluntários diabéticos com neuropatia diabética apresentaram desigualdade pressórica nas áreas de menor sensibilidade protetora dos pés o que indica risco de formação de úlceras plantares
The following study is an interdisciplinary interaction between concepts of mechanic engineering and the health science, it is used to find disturbs in patients with Mellitus diabetic feet. It is possible through a force platform that recognizes the risk of appearing planter ulcers that are secondary from the mechanic overcharge in areas where the sensibility was decreased. So, it was projected and built a force platform which is cheap and easy to operate. The study of analyses has been realized with 30 volunteers, both gender, from 30 to 69 years old (average 50 years old) they were divided between Mellitus Diabetics and no diabetics. The sample divided was into three groups: Diabetic with neuropathy and without neuropathy and no diabetics. All of them have anthropometrics compatible characteristics and they do not present significant joint deformities in foot neither walk difficulties. Every patient was availed three times they were stand up and static on the platform during 20 seconds. Throughout the plant pressure analysis distribution it was noted the diabetic volunteers with diabetic neuropathy have presented unequal pressure value in the regions where the feet protection sensibility was decreased and it denotes risk of plants ulcer development
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Simpson, Sandra Marcia. "Walking the line managing type 2 diabetes : a grounded theory study of part-Europeans from Fiji : a thesis submitted in partial fulfilment of the requirement for the degree of Master in Health Science, Department of Nursing Studies, Auckland University of Technology, November 2004." Full thesis. Abstract, 2004.
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Pang, Pik-ming. "Social support, stress and life contentment in relation to diabetes mellitus control /." [Hong Kong : University of Hong Kong], 1990. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1292524X.
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Beales, Philip Edward. "Diabetes prevention in the non-obese diabetic mouse." Thesis, University of East London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265059.
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Bastos, Jaqueline Silva. "Construção de uma plataforma de força para avaliação da pressão plantar em indivíduos com diabetes mellitus /." Guaratinguetá : [s.n.], 2011. http://hdl.handle.net/11449/97033.
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Orientador: José Elias TomaziniBanca: Mauro Pedro Peres
Banca: Magda Francisca Gonçalves Rocha
Resumo: O presente estudo é uma interação interdisciplinar entre os conceitos da engenharia mecânica e a ciência da saúde, usada para rastrear alterações nos pés de portadores de Diabetes Mellitus, possibilitando, através de uma plataforma de força, a identificação do risco de formação de úlceras plantares secundárias à sobrecarga mecânica em áreas de sensibilidade diminuída. Para tal foi projetada e construída uma plataforma de força de fácil operação. O estudo em análise foi realizado com um grupo de 30 voluntários, de ambos os sexos, com idade entre 30 e 69 anos (com idade média de 50 anos) distribuídos entre portadores de Diabetes mellitus e não diabéticos. A amostra foi dividida em três grupos: diabéticos com e sem neuropatia diabética e não diabéticos. Todos participantes, possuem características antropométricas compatíveis e não apresentam deformidades articulares significativas nos pés e nem dificuldades de marcha. Cada participante foi avaliado três vezes, permanecendo em posição ereta e estática sobre a plataforma, num tempo de 20 segundos em cada coleta. Através da análise da distribuição da pressão plantar foi observado que os voluntários diabéticos com neuropatia diabética apresentaram desigualdade pressórica nas áreas de menor sensibilidade protetora dos pés o que indica risco de formação de úlceras plantares
Abstract: The following study is an interdisciplinary interaction between concepts of mechanic engineering and the health science, it is used to find disturbs in patients with Mellitus diabetic feet. It is possible through a force platform that recognizes the risk of appearing planter ulcers that are secondary from the mechanic overcharge in areas where the sensibility was decreased. So, it was projected and built a force platform which is cheap and easy to operate. The study of analyses has been realized with 30 volunteers, both gender, from 30 to 69 years old (average 50 years old) they were divided between Mellitus Diabetics and no diabetics. The sample divided was into three groups: Diabetic with neuropathy and without neuropathy and no diabetics. All of them have anthropometrics compatible characteristics and they do not present significant joint deformities in foot neither walk difficulties. Every patient was availed three times they were stand up and static on the platform during 20 seconds. Throughout the plant pressure analysis distribution it was noted the diabetic volunteers with diabetic neuropathy have presented unequal pressure value in the regions where the feet protection sensibility was decreased and it denotes risk of plants ulcer development
Mestre
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Nordwall, Maria. "Long term complications in juvenile diabetes mellitus." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-6377.
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Beemer, Abigail M. "Diet compliance of home care clients with diabetes mellitus." Thesis, This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-10312009-020249/.
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Radzevičienė, Lina. "Sergančiųjų cukriniu diabetu mokymo organizavimo ir kokybės vertinimas poliklinikoje." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20060612_144532-92108.
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Aim of the study. To assess the organization possibilities and evaluate the quality of diabetes education in outpatient clinic.
Methods. The anonymous questionnaire survey was performed among adult diabetic patients in Kaunas Dainava outpatient clinic in october-December, 2005. 500 questionnaire were given to the patients, the responce rate was 354 patients (70.8 %). The data was analysed by application of statistical package SPSS 12.0 for Windows. The associations between the variables were measured using the Chi-squared (χ²) test.
Results. The positive evaluation of diabetes education in Kaunas Dainava outpatient clinic was given by 73.7 % of patients. 98.3 % believed that diabetes education is necessary. 77.9 % knew about diabetes, 80.8 % - were aware of fasting glycaemia criteria, 95.3 % - glycaemia in untreated patients. 82.2 % understood the importance of diet and it‘s ingredients (90.6 %). Less than a half (40.4 %) were aware of glycated hemoglobin and importance of postprandial glycaemia. Only 33.2 % of those taught in „Diabetes school“ had adequate diabetes control. The target glycated hemoglobin was reached in 42.1 % of thosewho attended the inpatient „Diabetes school“ and only in 22.5 % of those who didn‘t. Diabetes complications have been diagnosed in 43.7 % of those whose glycated hemoglobin ≤ 7 % and in 76.2 % of those whose glycated hemoglobin > 7 %.
Conclusions. Diabetes education in Kaunas Dainava outpatient clinic is not sistematic organized, the time of... [to full text]
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Lerco, Mauro Masson. "Nefropatia diabética experimental : estudo de parâmetros clínicos, laboratoriais e análise ultra-estrutural e morfométrica da membrana basal e podócitos glomerulares de ratos diabéticos induzidos pela aloxana /." Botucatu : [s.n.], 2004. http://hdl.handle.net/11449/100385.
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Orientador: Cesár Tadeu SpadellaResumo: Sessenta animais da espécie "Rattus wistar" de ambos os sexos, pesando de 200 a 300 gramas, foram divididos em dois grupos experimentais: G1 ou grupo normal, constituído por dez animais e G2 ou grupo diabético, constituído inicialmente por 50 animais, que foram inoculados com aloxana à 2% por via endovenosa, na dose de 42mg/kg de peso corporal. Desses, dez animais com diabetes experimental grave (glicemia maior que 200mg/dl), sobreviveram durante o seguimento de 12 meses e constituíram o grupo diabético ou G2. Os seguintes parâmetros clínicos e laboratoriais foram estudados em cada grupo experimental: aspecto geral dos animais, peso, ingestão hídrica, ingestão alimentar, diurese e dosagens da glicemia, glicose urinária e proteinúria. As observações, com exceção da proteinúria de 24 horas, foram observadas em três momentos experimentais: inicial ou 14 dias após a indução do diabetes no grupo diabético e 14 dias de observação no grupo normal, 6º e 12º mês de seguimento. A dosagem da proteinúria de 24 horas foi efetuada no 12º mês de seguimento nos dois grupos experimentais. Após o 12º mês de seguimento, os animais foram sacrificados, após anestesia, e o rim direito de quatro animais diabéticos e quatro animais normais, escolhidos ao acaso, foi preparado para o estudo à microscopia eletrônica. As elétron-micrografias obtidas com aumento de 42.000 vezes foram analisadas por morfometria pela utilização de sistema computadorizado "Quin Lite 2,5 LEICA", interessando a espessura da MBG, o número de podócitos, o número de "slit diaphragm"e a extensão dos "slit diaphragm". Os resultados dos parâmetros clínicos e bioquímicos foram analisados pelo teste de comparações múltiplas de Tukey e pela análise não paramétrica de Mann-Whitney e Kruskal-Wallis, adotando-se o nível de significância de p< 0,05... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Sixty "Rattus wistar" of both sexes with 200-300 g of body weight, were divided in two experimental groups: normal group (G1 - 10 animals) and diabetic group (G2- 50 animals at the beginning), which were inoculated with a endovenous injection of 2% alloxan in a dose of 42 mg /kg/body weight. From these ten animals with severe experimental diabetics (glicemia > 200 mg%) will survive during 12 months of follow-up, being considered the experimental group (G2). The following clinic and laboratory parameters were studied: clinical aspect, body weight, water and food intake, diuresis, as well fasting glycemia, urinary glucose and proteinuria. The observations, excepting proteinuria (24 hours) were made at three experimental moments as it follows: initial or 14 days after diabetes induction or follow-up (normal controls) and at 6 and 12 months. Proteinuria was measured at the 12th month in boths groups. After 12 months of diabetes induction or follow-up (G1), the animals were sacrificed being the right kidney from four animals of each group processed for Electron Mycroscopy. The electron micrographys were taken with magnification of 42,000 and were analysed according to morphometric techniques by using computer System "Quin Lite 2.5 LEICA", being studied the following aspects: glomerular basement membrane thickening, podocytes and slit diaphragm number, and the slit diaphragm extension. The results of the clinical and laboratory parameters were statistically analysed according to Tukey's multiple comparison being used the level of 5% significance. The results of morphometric study were analysed according to Mann-Whitney and Kruskal-Wallis test, using a software "Sigma Stat 2,0", being used level of 5% significance. G2 group presented lower body weight, higher water intake and diuresis than G1 group; the general aspect... (Complete abstract click electronic address below)
Doutor
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Hall-Johnson, Richard Earl. "Effects of Acute and Chronic Glycemic Control on Memory Performance in Persons with Type II Diabetes Mellitus." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279158/.
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Memory performance was measured in 48 persons between the ages of 40 - 65 with Type II diabetes. Correlations between performance on the California Verbal Learning Test, tests of Working Memory, Priming Memory, and Prospective Memory and several predictor variables were examined. These variables included the Slosson Intelligence Test Scores, demographic variables, presence of diabetic complications, finger-stick and HbA1c measures. Subjects performed worse than the normative sample on the California Verbal Learning Test. Higher chronic and acute blood glucose tended to be associated with worse performance on the CVLT, Priming, and Working Memory. However, after the effects of intelligence, education, and sex were statistically controlled, glycemic status predicted performance on just a few memory measures. These were short-delay recall compared with recall on List A trial 5, and List B on the CVLT, and recall accuracy on digit forward of the Working Memory Test. Glucose status was unrelated to performance on a prospective memory test. Several other demographic and diabetic complication factors predicted performance beyond the contribution of intelligence. These results contrast with previous studies which found strong effects of glycemic control, but did not statistically control for the contribution of intelligence. Differential effects of diabetic status on different aspects of memory were discussed.
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Cheng, Yuk-ling Tavia. "Coping, social support, and depressive symptoms of older adults with diabetes mellitus /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20897261.
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Yue, Pui-hang. "Social support and self-rated health among older adults with diabetes mellitus /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22330872.
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Tahiliani, Arunkumar Govindram. "Studies on diabetes-induced myocardial alterations in streptozotocin diabetic rats." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/25979.
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Diabetes is known to result in a large number of alterations which affect various systems and organs. One of the more prominent disorders associated with diabetes is that of cardiac disease. Clinically, diabetics
suffer from morbidity and mortality of cardiac origin to a greater extent than the nondiabetic population. Various functional studies have also revealed that the efficiency of diabetic hearts to function as pumps is lower than that of normal hearts. Experimentally, myocardial function of either rats or dogs made diabetic with either streptozotocin (STZ) or alloxan has been studied and a depression clearly demonstrated in both the species. The abnormalities of cardiac function in experimental diabetes are accompanied by depression of various enzyme systems in the heart. These include the ability of the sarcoplasmic reticulum (SR) to take up calcium; the myosin and actomyosin ATPase activities; and the Na⁺, K⁺ ATPase activity. All these changes can be prevented and reversed by insulin treatment suggesting that the myocardial problems seen in STZ or alloxan diabetic animals are due to diabetes and not direct toxicities of the drugs.
It is not known whether the beneficial effects of in vivo insulin treatment are due to its direct myocardial effects or whether they are secondary to its effects mediated via normalisation of metabolism in diabetic animals. Thus, in the first part of the present investigation, we examined the direct effects of insulin on hearts from either control or diabetic rats using the isolated working heart preparation. Rats made diabetic with STZ (55 mg/kg) were sacrificed either 3 days or 6 weeks after induction of the disease and their hearts isolated and perfused in the working heart mode. Glucose concentrations varying from 5mM to 20mM were used in the perfusion medium, either in the presence or absence of insulin (5mU/mL). Left ventricular function was expressed as left ventricular developed pressure (LVDP) and the rates of contraction and relaxation (positive and negative dP/dt respectively) at various left atrial filling pressures. Three days after injecting STZ into rats, the animals exhibited hypoinsulinemia, hyperglycemia and their body weights although not significantly different from those of control animals, tended to be lower than the body weights of controls. Animals treated in this manner did not exhibit depression of cardiac function when compared with the myocardial function of control rats. Hearts from control rats exposed to regular insulin in the presence of 5mM glucose exhibited values of contractility which were significantly greater as compared with those obtained from control rat hearts not exposed to the hormone. When insulin was perfused along with a higher concentration of glucose (10mM), function of control rat hearts was affected to a significant extent. As opposed to the effects on control rat hearts, insulin failed to increase contractility in hearts from 3 day diabetic rats when either 5 or 10mM glucose was used in the perfusion medium.
The study was then repeated using animals which had been diabetic for six weeks. At the time of sacrifice, these animals were hypoinsulinemic, hyperglycemic and weighed significantly less than their age-matched controls. Analysis of cardiac function revealed a significant depression in diabetic rats as compared with controls. Increasing glucose concentrations from 5 to 20mM in the perfusion medium did not affect the function of either control or diabetic rat hearts. Perfusion with regular insulin increased contractility in control rat hearts; the increase in contractility was not affected by increasing the glucose concentration from 5 to 10mM. However, contractility of diabetic rat hearts was not affected by insulin perfusion when either 5 or 10mM glucose was used in the perfusion medium. In order to eliminate the possibility of involvement of glucagon (which may contaminate commercial insulin preparations) in the effects of insulin on control rat hearts, part of the study was repeated using glucagon - free insulin. While the glucagon - free insulin increased contractility in control rat hearts, diabetic rat hearts were not affected. These results are identical to those obtained with regular insulin, suggesting that the effects of insulin observed were due to insulin itself.
Although insulin treatment prevents and reverses diabetes - induced myocardial alterations in the rats, due to its widespread metabolic effects, it is not a good tool for investigating the specific factors which cause the cardiac abnormalities. In addition, a major problem with insulin treatment clinically is the fact that hypoglycemia can be associated with it, inadequate control occurs in some diabetics and secondary complications, such as myocardial problems, occur despite insulin treatment. It is thus desirable to have treatments which selectively affect certain aspects of diabetes so that the suspected underlying causes can be corrected specifically and their significance in causing the myocardial problems assessed. It would also be useful to have drug treatments which could either substitute for insulin or could be used in addition to the peptide. We have thus studied the effectiveness of certain treatments in preventing diabetes - induced myocardial alterations. The first one used was methyl palmoxirate, a fatty acid analog which is reported to reduce blood glucose levels in diabetic rats and dogs. The glucose - lowering effect is mediated via inhibition of fatty acid metabolism due to inhibition of carnitine acyl transferase resulting in inhibition of acyl carnitine formation and eventually inhibition of fatty acid transport across the mitochondrial membrane. Rats were treated with the drug (25mg/kg/day p.o.) three days after they were injected with either STZ or buffer. The treatment was carried out for 6 weeks and cardiac performance was then assesed. Untreated and treated diabetic rats were hypoinsulinemic, hyperglycemic and hyperlipedemic at the time of sacrifice. Cardiac function, which was depressed in diabetic animals, was still depressed despite the methyl palmoxirate treatment. However, the ability of the myocardial sarcoplasmic reticulum (SR) to take up calcium, which was depressed in diabetic rats, was normal in treated diabetic rats. Also, the levels of long chain acyl carnitines (LCAC) in the myocardial SR were normalised by methyl palmoxirate treatment in diabetic rats.
In an effort to normalise diabetes - induced myocardial alterations in rats, we then attempted a combination of either methyl palmoxirate or carnitine (as both can prevent the depression of SR calcium uptake) with thyroid hormone treatment (as it can normalise myosin ATPase depression in diabetic rat hearts). The treatment protocol was identical to that described above (30µg/kg/day s.c. T₃ was used). Although the general features of both control and diabetic animals were not affected by either of the combination treatments, cardiac dysfunction in diabetic rats was prevented by methyl palmoxirate and T₃ treatment. Carnitine and T₃ treatment, on the other hand, affected the function of diabetic rat hearts only at the lower left atrial filling pressures. These results suggest that the combination treatment of methyl palmoxirate and T₃ affect parameters besides SR calcium uptake and myosin ATPase. This is because the combination of carnitine and T₃, which also supposedly affects same parameters as the other combination, could not prevent the myocardial alterations. One of the possible reasons for the effectiveness of the combination of methyl palmoxirate and T₃ could be that animals treated with methyl palmoxirate derived at least part of their metabolic energy (especially at higher left atrial filling pressures) from glucose and thus reduced the oxygen demand at higher filling pressures as opposed to the untreated diabetic rat hearts which depended completely on fatty acids for their metabolic energy demands.Pharmaceutical Sciences, Faculty of
Graduate
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Maharaj, Sherry I. "The interpersonal context of Diabetes Mellitus examining the links between eating disturbances, metabolic control, and the quality of family functioning among girls with Type 1 diabetes /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0025/NQ39286.pdf.
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Lam, Chun-yin Julia. "Psychosocial correlates of illness control and adjustment in patients with diabetes mellitus /." Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19882257.
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van, Netten Jaap J., Peter A. Lazzarini, David G. Armstrong, Sicco A. Bus, Robert Fitridge, Keith Harding, Ewan Kinnear, et al. "Diabetic Foot Australia guideline on footwear for people with diabetes." BIOMED CENTRAL LTD, 2018. http://hdl.handle.net/10150/626601.
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Background: The aim of this paper was to create an updated Australian guideline on footwear for people with diabetes. Methods: We reviewed new footwear publications, (international guidelines, and consensus expert opinion alongside the 2013 Australian footwear guideline to formulate updated recommendations. Result: We recommend health professionals managing people with diabetes should: (1) Advise people with diabetes to wear footwear that fits, protects and accommodates the shape of their feet. (2) Advise people with diabetes to always wear socks within their footwear, in order to reduce shear and friction. (3) Educate people with diabetes, their relatives and caregivers on the importance of wearing appropriate footwear to prevent foot ulceration. (4) Instruct people with diabetes at intermediate-or high-risk of foot ulceration to obtain footwear from an appropriately trained professional to ensure it fits, protects and accommodates the shape of their feet. (5) Motivate people with diabetes at intermediate-or high-risk of foot ulceration to wear their footwear at all times, both indoors and outdoors. (6) Motivate people with diabetes at intermediate-or high-risk of foot ulceration (or their relatives and caregivers) to check their footwear, each time before wearing, to ensure that there are no foreign objects in, or penetrating, the footwear; and check their feet, each time their footwear is removed, to ensure there are no signs of abnormal pressure, trauma or ulceration. (7) For people with a foot deformity or pre-ulcerative lesion, consider prescribing medical grade footwear, which may include custom-made in-shoe orthoses or insoles. (8) For people with a healed plantar foot ulcer, prescribe medical grade footwear with custom-made in-shoe orthoses or insoles with a demonstrated plantar pressure relieving effect at high-risk areas. (9) Review prescribed footwear every three months to ensure it still fits adequately, protects, and supports the foot. (10) For people with a plantar diabetic foot ulcer, footwear is not specifically recommended for treatment; prescribe appropriate offloading devices to heal these ulcers. Conclusions: This guideline contains 10 key recommendations to guide health professionals in selecting the most appropriate footwear to meet the specific foot risk needs of an individual with diabetes.
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Pohlová, Simona. "Fenomén non-compliance pacienta s diagnózou diabetes mellitus." Master's thesis, Vysoká škola ekonomická v Praze, 2009. http://www.nusl.cz/ntk/nusl-15427.
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This diploma thesis is focused on the study of the phenomenon of the non-compliance, or more specifically on the study of the phenomenon of the non-compliance of patients with diagnosis of diabetes mellitus. The theoretical part contains a discussion of the phenomenon of the non-compliance, of a problematics of the diabetes mellitus and associated complications and comorbidities. The practical part is based on the statistical evaluation of the specifically prepared survey of patients of the private ambulance of diabetology and endocrinology in Trutnov. The results of survey were processed to obtain contingency tables, and then the correlations between individual aspects of compliance or non-compliance were studied using statistical correlation analysis.
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Grou, Isabel Maria Lampreia. "Diabetes mellitus em canídeos." Bachelor's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2008. http://hdl.handle.net/10400.5/900.
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Dissertação de Mestrado Integrado em Medicina VeterináriaA diabetes mellitus é uma insuficiência absoluta ou relativa de insulina que resulta da deficiente secreção desta por parte das células pancreáticas ou da oposição à acção da insulina. A diabetes é uma das endocrinopatias mais frequentes no cão. Quando é diagnosticado com diabetes mellitus, o animal pode encontrar-se num estado dependente de administração exógena de insulina de insulina, em que as células já não produzem insulina, ou num estado de não dependente de insulina, em que as células ainda possuem alguma função residual. No cão, a diabetes mellitus dependente de insulina é uma patologia multifactorial. Alguns dos factores implicados na etiologia da doença são: predisposição genética, infecção, patologia que provoque antagonismo à insulina, fármacos, obesidade, insulite imunomediada e pancreatite. Todos os factores referidos desempenham um papel que culmina na perda de função das células , hipoinsulinemia, deficiência no transporte da glucose para o interior das células e aceleração do processo de gluconeogénese hepática e glicogenólise. A insuficiência em insulina provoca a diminuição da utilização da glucose, levando a hiperglicemia. A glucose, como é uma molécula pequena, é filtrada pelo glomérulo renal; quando a capacidade de reabsorção de glucose das células dos túbulos renais a partir do filtrado glomerular é excedida, ocorre glicosúria. A glicosúria provoca diurese osmótica, que leva a polidipsia. Como a entrada da glucose nas células do centro da saciedade é mediada pela insulina, o centro da saciedade não inibe o centro da alimentação. Os quatro sinais clássicos de diabetes são então poliúria, polidipsia, polifagia e perda de peso. O principal objectivo da terapêutica instituída é eliminar os sinais clínicos observados pelo dono, o que pode ser conseguido com uma administração ponderada de insulina, dieta, exercício e com a prevenção ou controlo de doenças inflamatórias, infecciosas, neoplásicas e endócrinas. As complicações mais frequentes são cegueira devido à formação de cataratas, pancreatite crónica e infecções recorrentes do tracto urinário, das vias respiratórias e da pele. Os animais diabéticos têm ainda o risco de desenvolver hipoglicemia e cetoacidose. A cetoacidose diabética é consequência da diabetes que resulta em formação de corpos cetónicos no fígado, em acidose metabólica, desidratação severa, choque e possivelmente morte. A maior parte dos cães diabéticos vive menos de 5 anos após o diagnóstico, sendo que os primeiros seis meses são decisivos para o controlo da doença. Com cuidados apropriados por parte dos donos, avaliações regulares por parte do veterinário e uma boa comunicação entre o cliente e o médico veterinário, muitos animais diabéticos podem levar vidas relativamente normais durante vários anos.
ABSTRACT - Diabetes mellitus, which is a very common endocrinopathy in the dog, is an absolute or relative insufficiency in the production of insulin by the pancreatic cells or an impaired sensitivity to the hormone or both. When diagnosed with diabetes mellitus some animal may need insulin therapy immediately, for their cells produce no insulin - insulin dependent diabetes mellitus, and some others may have a slower loss of function of cells - non-insulin dependent diabetes mellitus. The etiology of insulin dependent diabetes mellitus in the dog is multifactorial, being related to genetic susceptibility, infections, insulin resistance inducing disease, drugs, obesity, immune mediated insulitis and pancreatitis. All these factors lead to the functional loss of pancreatic cells, impaired transport of glucose into cells and enhancing the hepatic gluconeogenesis and glycogenolisis. The classic clinical signs of diabetes mellitus are polyuria, polydipsia, polyphagia and weight loss. The insulin deficiency leads to a decrease in glucose use and sequent hyperglycemia. Being a small molecule, glucose is filtrated in the renal glomérulos; when the ability of reabsorbing glucose of the tubular cells is overwhelmed, glycosuria occurs. Glycosuria leads to osmotic diuresis, which in turn leads to polydipsia. To enter the satiety center cells, glucose needs insulin. Without it, the satiety center never inhibits the hunger center. The treatment of diabetes aims to control the clinical signs described, and that con be achieved with insulin therapy, diet, exercise and prophylaxis and control of infectious, inflammatory, neoplastic or endocrine diseases. The most frequent consequences of diabetes mellitus in dogs are blindness as a consequence of diabetic cataracts, chronic pancreatitis and urinary tract, skin and upper respiratory tract infections. Diabetic dogs have an increased risk of developing hypoglycemia and ketoacidosis. Ketoacidosis leads to hepatic production of ketone bodies, metabolic acidosis, severe dehydration and even death. Most diabetic dogs live up to 5 years after they are diagnosed, the six first months being the most important ones. With proper care from the owner, regular reevaluations with the veterinarian and good communication between veterinarian and owner, the diabetic dog can have an ordinary life for several years.
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Balbinot, Luciane Fachin. "Diagnóstico de neuropatia no diabetes mellitus tipo 2 e no pré-diabetes." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/79515.
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Segundo dados de 2012 da Sociedade Brasileira de Diabetes, se estima que cerca de 6% da população brasileira tenha diabetes e cerca de 7 a 8% tenha pré-diabetes. A neuropatia diabética é a complicação mais frequente dessa doença podendo já ocorrer no pré-diabetes. O início da neuropatia diabética é precoce e exibe grande variabilidade de manifestações clínicas, incluindo o comprometimento de diversas fibras nervosas somáticas e autonômicas. O diagnóstico tardio da neuropatia em diabéticos está associado à maior incidência de complicações como, por exemplo, ulcerações e amputações típicas do “pé diabético” e risco cardiovascular aumentado, incluindo a morte súbita. Dados como os citados acima motivaram a presente pesquisa, que se propõe a associar métodos diagnósticos não invasivos, disponíveis em nosso meio, a protocolos de investigação já recomendados pela comunidade científica internacional para neuropatia diabética. Aplicou-se um extenso protocolo de testes com finalidade de rastreamento da neuropatia somática e autonômica em três grupos de indivíduos: grupo DM (com diabetes melitus tipo 2), grupo Pré-DM, pré diabético e grupo C, de controles saudáveis. O teste em estudo foi a Termografia Computadorizada por Infravermelho, método sem contato que capta a emissão da radiação infravermelha pelo corpo humano e que, com auxílio de softwares, possibilita medições de temperatura em graus Celsius. A termografia foi testada na região plantar, utilizando-se de duas variáveis: Índice de Recuperação Térmica e presença ou não de Anisotermia Interdigital. O padrão de referência para a Termografia plantar foram os testes cardíacos de Variabilidade da Frequência Cardíaca. Pesquisas prévias demonstraram uma relação estreita entre a Neuropatia Autonômica Cardíaca (NAC) e neuropatia autonômica sistêmica. Quanto à reprodutibilidade das medidas termográficas, encontrou-se que as medidas relativas de diferenças de temperatura (Δt) são reprodutíveis nos diferentes grupos estudados e são preferíveis às medições de temperatura absoluta, confirmando a literatura. A presença de Anisotermia Interdigital parece ser o teste mais apropriado para identificar neuropatia em suas formas iniciais no grupo com diabetes e pré- diabetes, pela simplicidade de sua aplicação e pela sua boa sensibilidade e especificidade. Com a inclusão da termografia plantar em programas de rastreamento de neuropatia diabética pode-se prever um diagnóstico mais precoce e, assim, um controle mais efetivo de fatores de risco para esta patologia bem como tratamento mais precoce.According to 2012 data from the Brazilian Society of Diabetes it is estimated that about 6% of the population have diabetes and about 7 to 8% have pre-diabetes. Diabetic neuropathy is the most common complication of this disease and may already occur in the pre-diabetes. The onset of diabetic neuropathy is early and shows great variability of clinical manifestations, including the commitment of various somatic and autonomic nerve fibers. Delayed diagnosis of diabetic neuropathy is associated with higher incidence of complications such as ulcerations and amputations, typical "diabetic foot" and increased of cardiovascular risk, including sudden death. Data such as those mentioned above have motivated this research, which aims to involve non-invasive diagnostic methods available in our area, the research protocols as recommended by the international scientific community for diabetic neuropathy. We applied an extensive testing protocol with the purpose of tracking somatic and autonomic neuropathy in three different groups: DM group, with type 2 diabetes, Pre-DM group, pre diabetic, and C, healthy controls. The test under study was Computerized Infrared Thermography, a no contact method that captures the emission of infrared radiation by the human body and, with the help of software, can make measurements of temperature in degrees Celsius. Thermography was tested in the plantar region, using two variables: Thermal Recovery Index and presence or absence of Interdigital Anisothermal. The reference standard for the plantar thermography tests were cardiac Heart Rate Variability. Previous studies have demonstrated a close relationship between Cardiac Autonomic Neuropathy (CAN) and systemic autonomic neuropathy. The reproducibility of the thermographic measurements was found that the relative measures of temperature differences (Δt) are reproducible in different groups, and are preferable to absolute temperature measurements, confirming the literature. The presence of Interdigital Anisothermal seems to be the most appropriate test to identify neuropathy in their initial forms in the group with diabetes and pre diabetes, because the simplicity of its application and its good sensitivity and specificity. With the addition of plantar thermography in the screening of diabetic neuropathy we may predict an earlier diagnosis and thus a more effective control of risk factors for this disease and earlier treatment.
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Lam, Chun-yin Julia, and 林駿瑛. "Psychosocial correlates of illness control and adjustment in patients with diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B29873034.
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Påhlsson, Hans-Ivar. "Methodological aspects of toe blood pressure measurements for evaluation of arterial insuffiency in patients with diabetes /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-181-4/.
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Hjelm, Katarina. "Migration, health and diabetes mellitus studies comparing foreign- and Swedish-born diabetic subjects living in Sweden /." Lund, Sweden : Dept. of Community Health Sciences, Lund University, 1998. http://books.google.com/books?id=BPFrAAAAMAAJ.
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Pilkauskienė, Ramutė. "Pediatrų endokrinologų, slaugytojų ir tėvų požiūris į šeimos problemas, vaikui susirgus cukriniu diabetu." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2005. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2005~D_20050614_123532-83061.
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Summary
The diabetes is а chronic non-infectious disease that touches people from the birth to the old age. Children and young people mostly suffer from diabetes type 1. Тhe morbidity in this disease is increasing not only in Lithuania but also in the whole world. In 1980, 30 million people in the world suffered from the diabetes, while in 2000 there were already 100 million such people. As the number of children suffering from the diabetes is increasing, it is very important to understand what influence to their psycho-social development is caused bу this disease, how the relationship between the child and his or her family changes, and how the relationship between the diabetics, their family and the environment develops.
When а child falls ill with the diabetes, the family faces many questions, and the life splits into two parts: before the disease and after its diagnosing. А child who suffers from diabetes of type 1 has to make insulin injections during аll his or her life, to check the quantity of glucose in the blood, to observe nutrition recommendations. The family whose child falls ill with an incurable disease experiences the process of loss. The duration of its stages and its succession depends of the psychosocial state of the family.
The treatment of children's diabetes is also complicated due to psychological peculiarities of the age of children. Children of different ages can perform different tasks and to undertake different duties. Eventually, а child will bе... [to full text]
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Silva, Bruno Alves. "Atenuação do descenso noturno na predição do início da albuminúria em diabéticos tipo 1." Universidade Estadual Paulista (UNESP), 2018. http://hdl.handle.net/11449/152963.
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A presença de albuminúria constitui fator prognóstico desfavorável nos pacientes diabéticos do tipo 1 e precede a elevação da PA de consultório em três anos. A monitorização ambulatorial de pressão arterial (MAPA) pode identificar a atenuação ou desaparecimento do descenso noturno, o que prediz o risco cardiovascular, independentemente da pressão arterial de 24 h. Entretanto, apenas um estudo avaliou o papel preditivo da atenuação do descenso noturno para o desenvolvimento da albuminúria no diabetes do tipo 1. Assim, o objetivo do corrente trabalho é de avaliar, em coorte brasileira, se o descenso noturno atenuado pode predizer o desenvolvimento de albuminúria no diabetes do tipo 1. Foi realizado estudo observacional prospectivo que visou avaliar o poder preditivo da ausência ou atenuação do descenso noturno em relação ao surgimento de albuminúria em pacientes diabéticos tipo 1 normoalbuminúricos. Os pacientes foram submetidos à MAPA e dosada a albuminúria por mais de 2 vezes. Ao cabo de um ano a albuminúria foi reavaliada. A frequência de evolução para albuminúria ente os pacientes com descenso noturno ausente/atenuado ou presente foi comparada pelo teste de Fisher. As médias de pressão arterial (PA) foram comparadas por teste "t" para amostras independentes. Foi realizada regressão linear para avaliar a associação entre descenso noturno e elevação da albuminúria no seguimento. O nível de significância foi estabelecido em 5 %. Foram avaliados 24 pacientes com idade de 24 ±8,2 anos, seis pacientes do sexo masculino. Seis pacientes tinham descenso noturno presente para PA sistólica (PAS) (média de PAS em 24 h: 119±7,5mmHg) destes, apenas um evoluiu para albuminúria. Dos 18 que tinham descenso noturno atenuado para PAS (média de PAS em 24 h: 122±8,4mmHg; p=0,36 em relação aos pacientes descenso noturno presente), 14 evoluíram para albuminúria (p=0,01). Em relação à PA diastólica (PAD), 12 pacientes tinham descenso noturno presente (média de PAD em 24 h: 72±5,2mmHg), destes, 6 evoluíram para albuminúria. Dos outros 12 que tinham descenso noturno ausente (média de PAD em 24 h: 74±5,6mmHg; p=0,31 em relação aos pacientes com descenso noturno presente), 9 evoluíram com microalbuminúria (p=0,40). A porcentagem de descenso noturno da PAS apresentou coeficiente de correlação com a variação da albuminúria de 0,40; p= 0,061. A porcentagem de descenso noturno da PAD apresentou coeficiente de correlação com a variação da albuminúria de 0,46; p=0,027. Em conclusão, a evolução para albuminúria associou-se à classificação descenso noturno atenuado para PAS, mesmo com PAS em 24 horas normal. Ou seja, a atenuação do descenso noturno para PAS precedeu o início da nefropatia diabética incipiente no diabetes do tipo 1. Estes resultados ressaltam a importância da realização da MAPA no momento do diagnóstico, e no seguimento, dos pacientes diabéticos tipo 1.
The presence of albuminuria constitutes an unfavorable prognosis in type 1 diabetic patients and precedes an increase in office BP in three years. Ambulatory blood pressure monitoring (ABPM) can identify an attenuation or disappearance of noc-turnal descent, which predicts cardiovascular risk, regardless of blood pressure of 24 h. There is no type 1 diabetes. Thus, the objective of the current evaluation work, in a Brazilian cohort, whether the attenuated nocturnal decline may predict the devel-opment of albuminuria in type 1 diabetes. A prospective observational study was carried out to evaluate the predictive power of the absence or attenuation of the noc-turnal descent in relation to the appearance of albuminuria in type 1 diabetic normoalbuminuric patients. The patients were submitted to ABPM and dosed albu-minuria by more than 2 times. After one year and albuminuria for reassessment. The frequency of progression to albuminuria in patients with absent / attenuated or pre-sent nocturnal descent was compared by Fisher's test. Blood pressure (BP) averag-es were compared by "t" test for independent samples. Linear regression was per-formed to evaluate an association between nocturnal descent and elevated albumi-nuria at follow-up. The level of significance was set at 5%. Twenty-four patients, aged 24 ± 8.2 years, six male patients were evaluated. Six pa-tients had a nocturnal decrease in systolic BP (SBP) (mean SBP in 24 h: 119 ± 7.5 mmHg), only one had progressed to albuminuria. Of the 18 patients who had an at-tenuated nocturnal decrease in SBP (mean SBP at 24 h: 122 ± 8.4 mmHg, p = 0.36 in relation to the patients present at night), 14 developed albuminuria (p = 0.01). In relation to the diastolic BP (DBP), 12 patients had nocturnal decrease present (mean DBP in 24 h: 72 ± 5.2 mmHg), of these, 6 evolved into albuminuria. Of the 12 others who had a nocturnal descent absent (mean PAD at 24 h: 74 ± 5.6 mmHg, p = .31 compared to patients with nocturnal decrease), 9 developed microalbuminuria (p = 0.40). The percentage of nocturnal SBP decrease had a correlation coefficient with albuminuria variation of 0.40; p = 0.061. The percentage of nocturnal decrease in DBP presented a correlation coefficient with albuminuria variation of 0.46; p = 0.027. In conclusion, the progression to albuminuria was associated with an attenuated nocturnal descent for SBP, even with SBP at normal 24 hours. That is, attenuation of nocturnal descent into SBP preceded the onset of incipient diabetic nephropathy in type 1 diabetes. These results suggest that ABPM should be performed at the time of diagnosis and follow-up of type 1 diabetic patients.
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Roberts, Clare Louise. "Associations between satisfaction with diabetes care, diabetic control and psychological variables in adolescents with type I insulin dependent diabetes mellitus." Thesis, University of Edinburgh, 2000. http://hdl.handle.net/1842/26887.
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Insulin Dependent Diabetes Mellitus (IDDM) is a life-long condition, which is the third most common chronic illness in young people (Metcalfe & Baum, 1991). Management of the illness includes a daily regimen of blood testing, insulin injections and careful balancing of diet and exercise (Shillitoe, 1995). In adolescence, diabetes control often deteriorates (Brink, 1997; Jacobson, Hauser, Wolsdorf, Houlihan, Herskowitz, Wertlieb & Watt, 1987). This consequently can have a detrimental effect on future physical health (Diabetes Control and Complications Trial, 1994). A large amount of research has sought to identify the relevant variables that are indicative of good and poor adjustment to chronic illness (for example, Eiser, 1990a). Several models have been developed, including the Risk and Resilience Model (Wallander & Varni, 1998), which was used to guide this study. It is hypothesised that patient satisfaction with diabetes care will act as a resilience factor and therefore be associated with better psychological well-being. Eighty-three young people between the ages of 14 and 18 attending diabetes outpatient clinics in the Lothian area were assessed, using standardised measures of patient satisfaction, quality of life, psychological well-being and adaptation to diabetes. The relationships between these variables, diabetic control and the effects of age, gender and time since diagnosis were calculated. Results are discussed in relation to the planning and evaluation of medical and psychological services for adolescents with diabetes. Finally, methodological weaknesses are highlighted and implications for future research discussed.
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Walker, Kelly N. "Family functioning and diabetic ketoacidosis in pediatric patients with type i diabetes." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0004901.
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Thesis (M.S.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 42 pages. Includes Vita. Includes bibliographical references.
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Espelt, Hernández Albert 1981. "Socioeconomic inequalities in type 2 diabetes mellitus in Europe." Doctoral thesis, Universitat Pompeu Fabra, 2011. http://hdl.handle.net/10803/85055.
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Type 2 diabetes mellitus (T2DM) has become a major health problem worldwide. The St. Vincent declaration emphasized the urgent need to improve the epidemiological knowledge of this disease in Europe. Within Europe, research on the link between socioeconomic position (SEP) and type 2 diabetes is scarce.
The objective of this thesis was to conduct an extensive review of the current literature on socioeconomic inequalities in type 2 diabetes within European countries, while analyzing the relationship between, incidence, prevalence and mortality due to T2DM and SEP. In addition, we also analyzed trends on SEP inequalities in the prevalence of T2DM in Spain (1983-2006). Finally, we also assessed the appropriate use of health surveys with self-reported diagnosis in order to further analyze the relation between SEP and T2DM.
Different sources of information were used throughout the study. The systematic review was completed using the PUBMED database while the empirical studies used data of two European projects, the EUROTHINE, SHARE and the Spanish National Health Survey (study of trends in SEP inequalities in T2DM) along with the Catalonia health surveys (study of validation). The thesis consists of 5 papers that attempt to respond to the different objectives.
The studies included in this thesis suggest that socio-economic position (SEP) inequalities affect the incidence, prevalence and mortality by T2DM in Europe. These SEP inequalities are partly explained for body mass index, diet and physical activity. Moreover, these inequalities seemed to have remained constant or increased over time. Finally, health interview surveys with self-reported T2DM seems to be a good instrument to evaluate SEP inequalities in T2DM.La Diabetis Mellitus Tipus 2 (DM2) ha esdevingut un dels principals problemes de salut a nivell mundial. La declaració de ST VINCENT emfatitzava la necessitat i la urgència de millorar-ne el coneixement epidemiològic a nivell Europeu. Els estudis a nivell europeu sobre les desigualtats per Posició Socioeconòmica (PSE) en la DM2 eren força escassos. L’objectiu d’aquesta tesi era fer una revisió extensa dels estudis publicats sobre desigualtats per PSE en la DM2 a Europa, així com analitzar la relació entre la incidència, la prevalença i la mortalitat per DM2 i la PSE. Un altre objectiu també era analitzar la tendència de les desigualtats per PSE en la prevalença de DM2 a Espanya (1983-2006). Finalment, com a objectiu també hi figurava el valorar l’ús adequat de les enquestes de salut amb auto - declaració de DM2 per tal d’avaluar les desigualtats per PSE en la DM2. Per tal de dur a terme els objectius es van emprar diferents fonts d’informació. Per tal de dur a terme la revisió sistemàtica es va emprar la base de dades de PUBMED mentre que pels estudis empírics es van utilitzar les dades de dos projectes europeus com són el projecte EUROTHINE i el SHARE i les enquestes nacionals de salut d’Espanya (per la tendència de diabetis) i de Catalunya (per la validació). La tesi consta de 5 articles que intenten donar resposta als diferents objectius. Els estudis inclosos en aquesta tesi suggereixen que existeixen desigualtats per posició socioeconòmica (SEP) en la DM2, tant en la incidència, en la prevalença com en la mortalitat a Europa. Aquestes desigualtats per PSE s’expliquen en part per l’índex de massa corporal, la dieta o l’activitat física. A més a més, aquestes desigualtats sembla que s’han mantingut constants o han crescut al llarg del temps. Finalment, s’ha vist que les enquestes de salut amb la pregunta d’auto-declaració de la diabetis són un bon instrument per avaluar les desigualtats per PSE en la DM2.
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Tala, Hazel Marie Bituin Linan. "The oral health status and dental awareness of young Hong Kong Chinese with insulin dependent diabetes mellitus (IDDM)." Click to view the E-thesis via HKUTO, 2000. http://sunzi.lib.hku.hk/hkuto/record/B31954145.
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Pessôa, Bruno Sevá. "O bloqueio do receptor mineralocorticóide melhora a nefropatia pelo aumento da atividade da glicose-6-fosfato desidrogenase e redução do estresse oxidativo em ratos diabéticos hipertensos." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308459.
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Orientador: José Butori Lopes de FariaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Foi demonstrado, em modelos de diabetes tipo 1 e tipo 2, que o uso de espironolactona (SPR), um antagonista do receptor mineralocorticóide, possui efeitos benéficos na lesão renal através de mecanismos anti-inflamatórios e antioxidantes. Os efeitos de um antagonista do receptor mineralocorticóide na nefropatia diabética (ND) parecem ser independentes da redução da pressão arterial (PA) e do bloqueio do sistema renina-angiotensina-aldosterona (SRAA). Em modelos in vitro e in vivo a aldosterona promoveu aumento do estresse oxidativo através da enzima glicose-6-fosfato desidrogenase (G6PD). A atividade da G6PD foi reduzida pelo aumento da aldosterona e da glicose, reduzindo a capacidade antioxidante e aumentando o estresse oxidativo. Neste trabalho investigamos se o uso da SPR melhora a ND em animais diabéticos e hipertensos pela melhora na atividade da G6PD, reduzindo o estresse oxidativo independentemente dos efeitos na PA e na glicemia. Ratos espontaneamente hipertensos (SHR) foram tornados diabéticos pela injeção de estreptozotocina (STZ) e os animais controles receberam apenas o veículo. Os animais diabéticos foram randomizados para receber ou não SPR na água de beber. Após 8 semanas de tratamento os animais foram eutanaziados e os rins coletados para as análises. A glicemia foi maior nos animais diabéticos e não foi modificada pelo tratamento. Não houve alteração na PA nos grupos diabéticos e diabéticos tratados. A albuminúria e a expressão renal de fibronectina foi maior no grupo diabético em relação ao controle e esses parâmetros foram reduzidos com o tratamento. A atividade da G6PD e a relação glutationa reduzida (GSH) / glutationa oxidada (GSSG) foram reduzidas no grupo diabético e o tratamento restaurou ao nível dos controles. Os níveis urinários de 8-OHdG e TBARS foram maiores nos animais diabéticos e o tratamento reduziu ao nível dos controles. A produção de superóxido via NADPH oxidase e a expressão da subunidade p47phox da NADPH oxidase foram maiores no grupo diabético em relação ao controle e o tratamento reduziu esses parâmetros significativamente. Os resultados sugerem que a SPR melhora a nefropatia em ratos diabéticos e hipertensos por restaurar a atividade da G6PD, diminuindo o estresse oxidativo sem afetar a PA e a glicemia.
Abstract: Strict glycemic management, control of blood pressure, and use of drugs that interfere with the renin angiotensin system are the most effective interventions for prevention and treatment of diabetic nephropathy. In addition, recent studies have suggested that beneficial effects of aldosterone blockade on diabetic nephropathy seem to be independent of blood pressure reduction and renin-angiotensin blockade on diabetic nephropathy. It has been demonstrated thah type 1 and type 2 diabetic animal models treated with aldosterone blocker had a beneficial effects in renal tissue through antioxidants and anti-inflammatory mechanisms. In vitro and in vivo studies showed a decreased in G6PD activity in high glucose and aldosterone levels leading to an increased in oxidative stress. In the present study we investigated whether spironolactone improves nephropathy by increasing G6PD activity and reducing oxidative stress in hypertensive diabetic rats. Spontaneously hypertensive rats were rendered diabetic by intravenous injection of streptozotocin. The diabetic animals were randomized to receive or not receive spironolactone for 8 weeks. Plasma glucose levels were higher in diabetic rats and it was not modified by spironolactone. Likewise, systolic blood pressure was unaltered by diabetes or by treatment. Albuminuria and renal expression of fibronectin were higher in the diabetic group compared to control, and these parameters were reduced with aldosterone blockade. G6PD activity and the GSH / GSSG ratio were reduced in diabetic rats and the treatment restored to control levels. Urinary levels of 8-OHdG and TBARS renal cortex levels, a marker of oxidative stress, were higher in diabetic rats when compared to controls, and the treatment reduced to control levels. The production of superoxide induced by NADPH oxidase and p47phox, an isoform of NADPH oxidase, was higher in diabetic rats when compared to controls and was signficantly reduced in treated rats. These results suggest that spironolactone ameliorates nephropathy in the diabetic hypertensive rats by restoring G6PD activity and diminishes oxidative stress without affecting blood pressure
Mestrado
Ciencias Basicas
Mestre em Clinica Medica
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Pollock, Stacey M. "Type 1 diabetes mellitus a study of exercise, personality, and disordered eating in young women /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ56198.pdf.
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Clifford, Rhonda Marise. "Pharmaceutical care in diabetes mellitus." Curtin University of Technology, School of Pharmacy, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=14951.
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People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention programs to decrease this risk. In addition to tertiary care for patients with diabetes, there is a need for simple programs to be implemented in the community that allow the benefits of improved metabolic and blood pressure control to be realised more widely. Pharmaceutical care comprises the detection, prevention and solution of drug-related problems in a quantifiable form, so that outcomes of care can be easily reviewed and monitored. Previous studies of pharmaceutical care programs in patients with diabetes do not provide conclusive evidence of the benefit of pharmaceutical care. The aim of this research was to evaluate the impact of the provision of pharmaceutical care to patients with diabetes mellitus in an Australian context. In order to develop a pharmaceutical care program, the characteristics of an Australian cohort of patients with diabetes were reviewed. The Fremantle Diabetes Study (FDS), was a community-based prospective observational study of diabetes care, control and complications in a postcode-defined region of 120 097 people surrounding the port city of Fremantle in Western Australia. It was intended that the FDS annual reviews would provide important local information in order to design and implement a prospective pharmaceutical care program. A pilot pharmaceutical care program was subsequently developed for use in a diabetes outpatient clinic. This program was then modified for use in a community-based sample of type 2 diabetes mellitus patients, drawn from the FDS cohort.Demographic parameters, including ethnicity and treatment details, were reviewed at study entry for the full FDS cohort and then over time for a subset of patients that returned for four subsequent annual assessments. Insulin use was more common in patients of Southern European origin compared with the Anglo-Celt group irrespective of the level of glycaemia, at baseline. This difference persisted during subsequent follow-up but was not associated with improved glycaemic control. These findings demonstrated that there are important ethnic differences in the management of patients with type 2 diabetes mellitus. The pilot pharmaceutical care program was carried out in high-risk diabetes mellitus patients attending a hospital outpatient clinic. The patients had poor glycaemic control, dyslipidaemia, hypertension and/or were on three or more prescription medications. In the pharmaceutical care arm, a clinical pharmacist reviewed and monitored all aspects of the patients' drug therapy in collaboration with other health care professionals at six weekly intervals for six months. The control patients received usual outpatient care. Seventy-three patients were recruited into the study, of whom 48 (66%) were randomised to receive pharmaceutical care. One in six patients was taking complementary medicines. The pharmaceutical care program provided patients with important medication information that resulted in changes to drug therapy. However, the six-month program did not lead to an improvement in glycaemic control. The next phase of the study adapted the pilot hospital-based pharmaceutical care program to a community-based setting.
Two hundred and two type 2 diabetes mellitus FDS patients were recruited, of whom 101 (50%) were randomised to the pharmaceutical care program, and all were followed for 12-months. There were significant reductions in risk factors associated with coronary heart disease in the case but not the control group over time, specifically glycaemic control, lipid levels, and blood pressure. Glycosylated haemoglobin fell from 7.5% to 7.0% (P<0.0001), total cholesterol fell from 5 mmol/L to 4.6 mmol/L (P<0.0001), systolic blood pressure fell from 158 mmHg to 143 mmHg (P<0.0001) and diastolic blood pressure fell from 77mmHg to 71mmHg (P<0.0001). Multiple linear regression analysis confirmed that pharmaceutical care program involvement was an independent predictor of benefit after adjustment for key variables. The 10-year coronary heart disease risk for patients without a previous coronary event was reduced by 4.6% over the 12-month study period in the pharmaceutical care group (P<0.0001), while there was no change in the controls (P=0.23). This phase of the study showed that medium-term individualised pharmaceutical care reduced vascular risk factors in a community-based cohort of patients with diabetes and that provision of a multifactorial intervention can improve health outcomes in type 2 diabetes mellitus. As part of the pharmaceutical care program, a high level of complementary medicine use was found. As a result, a study of complementary medicine use was undertaken in 351 patients from the FDS. A convenience sample of FDS patients was interviewed regarding their use of complementary medicines. A literature search was conducted to assess the potential impact of these medicines on diabetes, concomitant medications or diabetes-related co-morbidities.
Eighty-three of 351 (23.6%) patients with diabetes had consumed at least one complementary medicine in the previous year and 42% (77/183) of the products potentially necessitated additional patient monitoring or could be considered potentially inappropriate for a diabetic patient. The data indicated the need for patient disclosure of complementary medicine use and adequate monitoring for complementary medicine-related adverse events, as part of the pharmaceutical care process. The pharmaceutical care model was established to provide a framework by which drug use could be improved to enhance patients' clinical and health-related quality of life outcomes. For the present study, a straightforward pharmaceutical care program was adapted from a hospital setting to a community setting, where the principal requirement was a clinical pharmacist who had completed a self-directed diabetes-training program. In this context, clinically relevant parameters improved over the course of the study period. Pharmaceutical care programs such as this can begin the process of translating the findings of large and expensive clinical trials into standard clinical practice.
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Sels, Jean-Pierre Joseph Emile. "Dietary fibre and diabetes mellitus." Maastricht : Maastricht : Datawyse ; University Library, Maastricht University [Host], 1991. http://arno.unimaas.nl/show.cgi?fid=5618.
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Chan, Juliana Chung Ngor. "Diabetes mellitus in Hong Kong." Thesis, University of Liverpool, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246160.
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Talwar, D. "Glucosylated haemoglobin and diabetes mellitus." Thesis, University of Strathclyde, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.371982.
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Lutgers, Helen Lucia. "Skin autofluorescence in diabetes mellitus." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2008. http://irs.ub.rug.nl/ppn/.
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Pinto, Mariana de Carvalho [UNESP]. "Parâmetros Neuropáticos no Diabetes Mellitus." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/123212.
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000823511.pdf: 283504 bytes, checksum: 38d7295662309f22f82f5bf9f3013361 (MD5)A neuropatia diabética é caracterizada por uma síndrome clínica ou sub -clínica que afeta o sistema nervoso central e periférico, incluindo o autonômico. Frente ao crescente número de novos casos de diabetes mellitus e a elevada incidência de manifestações crônico - degenerativas, como a neuropatia periférica e a neuropatia autonômica cardiovascular, este estudo objetivou: a) fazer uma comparação da variabilidade cardíaca (VC), em indivíduos com diabetes mellitus tipo 2 com confirmação de neuropatia diabética periférica, e indivíduos saudáveis.; b) identificar o risco de queda através de um teste de mobilidade fun cional em não diabéticos, diabéticos neuropatas e diabéticos neuropata -vasculopatas. Para tanto, no primeiro estudo participaram 108 indivíduos divididos em grupo controle (GC) (n=34) e grupo diabético neuropata (GDN) (n=74). Inicialmente, foram reali zados testes para confirmação da neuropatia. Em seguida, a avaliação da atividade do sistema nervoso autônomo (SNA) foi realizada por meio da VC com o auxílio do software Nerve -Express® (Heart Rhythm Instruments, Metuchen, NJ, EUA). Já o segundo estudo, foi composto por 61 sujeitos de ambos os gêneros divididos em GC (n=32), GDN (n=18) e grupo diabético neuropata vasculopata (GDNV) (12)...
Diabetic neuropathy is characterized by clinical or sub -clinical syndrome that affects the central and peripheral nervous system including the autonomic. Tackle the growing number of 17 new cases of diabetes mellitus and the high incidence of chronic degenerative disorders, such as peripheral neuropathy and cardiovascular autonomic neuropathy, this study aimed to: a) make a comparison of heart rate variability (CV), in individuals with diabetes mellitus type 2 with confirmation of diabetic peripheral neuropathy, and healthy individuals .; b) identify the risk of falling through a functional mobility test in non -diabetic, diabetic neuropathy and diabetic neuropathy-vasculopathies. Therefore, in the first s tudy participated 108 individuals divided into a control group (CG) (n = 34) and diabetic neuropathy group (GDN) (n = 74). Initially, to confirm the neuropathy tests were performed. Then, the evaluation of the activity of the autonomic nervous system (ANS) was performed by the VC with the help of Nerve - Express® software (Heart Rhythm Instruments, Metuchen, NJ, USA). The second study consisted of 61 subjects of both genders divided into GC (n = 32), GDN (n = 18) and diabetic neuropathy vasculopata group (GDNV) (12)...
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Pinto, Mariana de Carvalho. "Parâmetros Neuropáticos no Diabetes Mellitus /." Presidente Prudente, 2014. http://hdl.handle.net/11449/123212.
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Orientador: Cristina Elena Prado Teles FregonesiBanca: Roselene Modolo Regueiro Lorençoni
Banca: Marli Aparecida Defani
Resumo: A neuropatia diabética é caracterizada por uma síndrome clínica ou sub -clínica que afeta o sistema nervoso central e periférico, incluindo o autonômico. Frente ao crescente número de novos casos de diabetes mellitus e a elevada incidência de manifestações crônico - degenerativas, como a neuropatia periférica e a neuropatia autonômica cardiovascular, este estudo objetivou: a) fazer uma comparação da variabilidade cardíaca (VC), em indivíduos com diabetes mellitus tipo 2 com confirmação de neuropatia diabética periférica, e indivíduos saudáveis.; b) identificar o risco de queda através de um teste de mobilidade fun cional em não diabéticos, diabéticos neuropatas e diabéticos neuropata -vasculopatas. Para tanto, no primeiro estudo participaram 108 indivíduos divididos em grupo controle (GC) (n=34) e grupo diabético neuropata (GDN) (n=74). Inicialmente, foram reali zados testes para confirmação da neuropatia. Em seguida, a avaliação da atividade do sistema nervoso autônomo (SNA) foi realizada por meio da VC com o auxílio do software Nerve -Express® (Heart Rhythm Instruments, Metuchen, NJ, EUA). Já o segundo estudo, foi composto por 61 sujeitos de ambos os gêneros divididos em GC (n=32), GDN (n=18) e grupo diabético neuropata vasculopata (GDNV) (12)...
Abstract: Diabetic neuropathy is characterized by clinical or sub -clinical syndrome that affects the central and peripheral nervous system including the autonomic. Tackle the growing number of 17 new cases of diabetes mellitus and the high incidence of chronic degenerative disorders, such as peripheral neuropathy and cardiovascular autonomic neuropathy, this study aimed to: a) make a comparison of heart rate variability (CV), in individuals with diabetes mellitus type 2 with confirmation of diabetic peripheral neuropathy, and healthy individuals .; b) identify the risk of falling through a functional mobility test in non -diabetic, diabetic neuropathy and diabetic neuropathy-vasculopathies. Therefore, in the first s tudy participated 108 individuals divided into a control group (CG) (n = 34) and diabetic neuropathy group (GDN) (n = 74). Initially, to confirm the neuropathy tests were performed. Then, the evaluation of the activity of the autonomic nervous system (ANS) was performed by the VC with the help of Nerve - Express® software (Heart Rhythm Instruments, Metuchen, NJ, USA). The second study consisted of 61 subjects of both genders divided into GC (n = 32), GDN (n = 18) and diabetic neuropathy vasculopata group (GDNV) (12)...
Mestre
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Coimbra, Eva Cristina Alves de Sá. "Doença periodontal e Diabetes Mellitus." Bachelor's thesis, [s.n.], 2009. http://hdl.handle.net/10284/1210.
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Monografia apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Medicina DentáriaO objectivo deste trabalho foi avaliar, através da literatura, as possíveis associações entre diabetes e doença periodontal. A expressão “doença periodontal” é usada para designar, um conjunto de manifestações patológicas que afectam as estruturas de suporte dos dentes e caracteriza-se clinicamente por sintomas e sinais como inflamação, bolsas de profundidade variável à sondagem, perda de inserção, recessão gengival e mobilidade dentária. Estudos epidemiológicos permitiram identificar múltiplos factores de risco para a doença periodontal, entre os quais se incluem bactérias, nível baixo de higiene oral, envelhecimento, tabagismo, factores genéticos e certas doenças ou afecções sistémicas, designadamente a diabetes. A associação de diabetes mellitus com a doença periodontal foi amplamente investigada nos últimos anos. As evidências sugerem que a diabetes e a doença periodontal se relacionam por duas vias: a infecção periodontal crónica aumenta a gravidade da diabetes e complica o controlo metabólico e a diabetes diminui a resposta do hospedeiro à infecção periodontal. Considerando esta relação entre as duas patologias, os diabéticos devem ser objecto de cuidados especiais no âmbito da Medicina Oral e, particularmente quanto aos cuidados preventivos de saúde periodontal. The objective of the present work is to do a literature review these problable interrelationships between diabetes and periodontal disease. Periodontal disease is a generic expression used to name a variety of periodontium pathological manifestations that affect the tooth functional support structures and is characterized by inflammatory signs, periodontal pockets, epithelical adherence loss, gingival recession, and tooth mobility. Epidemiological studies identified multiple risk factors for the periodontal illness, including bacteria, low level of oral hygiene, genetic factors, aging, tobacco use, gender, socio-economic status and certain systemic conditions like diabetes mellitus. The association between diabetes mellitus and periodontal disease has been widely investigated in the last two decades. Scientific evidence suggests that there´s a two-way relationship between diabetes mellitus and periodontitis, in one way diabetes increase infection susceptibility and in reverse way periodontal chronic infection severity and makes metabolic control more difficult. Considering the relationship between these two pathologies, diabetic patients should be object of special oral care and keep a good periodontal health.
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Nilsson, Patrik. "Pancreastransplantation, öcellstransplantation och diabetes mellitus." Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-95950.
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Sammanfattning Diabetes mellitus karakteriseras av högt blodsocker och är ett samlingsnamn för olika diabetessjukdomar där typ 1-diabetes och typ 2-diabetes är de vanligaste sjukdomarna. Kroppens blodglukoshalter regleras av hormonet insulin som är ett nödvändigt hormon för att kroppens celler ska kunna ta upp kolhydrater, aminosyror och fett. Vid typ 1-diabetes förstörs bukspottkörtelns insulinproducerande betaceller av kroppens eget immunförsvar. Viktiga transplantationsmetoder för att återställa bukspottkörtelns endokrina funktion är pancreas- och öcellstransplantation som båda resulterat i främst minskade akuta hypoglykemier men även förbättrade blodsockervärden och insulinfrihet. Pancreastransplantation är en mer riskfylld operation jämfört med öcellstransplantation och studier har visat på mer postoperativa komplikationer men längre och högre insulinfrihet hos patienter som genomgått pancreastransplantation. Tanken utvecklades till att jämföra litteratur som behandlar studier som jämför pancreas- och öcellstransplantation hos diabetiker avseende komplikationer, glukoskontroll och insulinfrihet. Syftet med arbetet var att göra en jämförelse mellan litteratur som behandlar pancreastransplantation respektive öcellstransplantation hos patienter med diabetes mellitus för att utröna vilken behandling som ger minst komplikationer och behov av insulinbehandling efter transplantation och en uppföljningstid på minst 1 år. Litteraturstudien baseras på 6 kohortstudier som alla erhölls via databasen PubMed. Studierna är utförda i Schweiz, USA, Tjeckien, Kanada och utgår från i grunden samma frågeställning men har delvis olika patienturval och metoder. Studie 2 och studie 5 har betydligt högre studiepopulation än övriga studier vilket ger högre bevisvärde för resultatet i dessa studier. Resultatsammanställningen visar att på både kort och lång sikt är komplikationsrisken betydligt större hos patienter efter pancreastransplantation jämfört med öcellstransplantation. Allvarliga, omedvetna hypoglykemier, som är livshotande tillstånd, är ovanliga hos patienter efter båda typerna av transplantation. På både kort och lång sikt visar pancreastransplanterade patienter betydligt lägre HbA1c-värden och betydligt högre C-peptidvärden jämfört med öcellstransplanterade patienter. Resultatet visar, i linje med tidigare resultat, att insulinfriheten består hos fler pacreastransplanterade patienter och under längre tid jämfört med öcellstransplanterade patienter. Efter 5 år är >50% av pancreastransplanterade patienter insulinfria medan motsvarande siffra hos öcellstransplanterade patienter är <10%.För att besvara syftet har litteraturstudien visat att vid jämförelse mellan litteratur som behandlar pancreastransplantation respektive öcellstransplantation hos patienter med diabetes mellitus ger öcellstransplantation minst akuta komplikationer men pancreastransplantation högst insulinfrihet, minst behov av insulinbehandling, efter transplantation och en uppföljningstid på minst ett år.Abstract Diabetes mellitus is characterized by hyperglycemia and is a collective name for different diabetic diseases. Type 1 diabetes and type 2 diabetes are the most common diseases. Insulin, which is the regulatory hormone for the body`s blood glucose levels, is necessary for the body`s cells to be able to absorb nutrition like carbohydrates, amino acids and fat. In type 1 diabetes the pancreas insulin-producing beta cells are destroyed by the body`s own immune system. Important transplantation methods to restore pancreatic endocrine function are whole pancreas transplantation and islet transplantation. Both methods of transplantation mainly decreased acute hypoglycaemia and improved blood sugar levels and insulin therapy. Pancreas transplantation is a more risky operation compared to islet transplantation. Patients who have gone through pancreatic transplantation in general have shown more postoperative complications but at the same time also longer periods without insulin therapy compared to patients who have gone through islet transplantation. The aim of this study was to make a comparison between literature dealing with pancreatic transplantation and islet transplantation regarding complications, glucose control and insulin requirements with a follow-up time of at least 1 year. The literature study is based on 6 cohort studies, all obtained through the PubMed database. The studies were conducted in Switzerland, USA, Czech Republic, Canada and are basically based on the same question but have partly different patient selection and methods. Study 2 and study 5 have a significantly higher study population than other studies, which gives higher evidence of the results of these studies. The results compilation shows that in both the short and the long term, the risk of complications is significantly greater in patients after pancreatic transplantation compared to islet transplantation. In both the short and long term, pancreatic transplant patients show significantly lower HbA1c values and significantly higher C-peptide values compared to islet transplant patients. Severe unconscious hypoglycaemia is a life-threatening condition. However, severe unconscious hypoglycaemia is uncommon in patients after both types of transplantation. The result shows, in line with previous results, that insulin freedom persists in higher number of pancreatic transplant patients and for longer period of time compared to islet transplant patients. After 5 years >50% of pancreatic transplant patients are insulin free while the corresponding number in islet transplant patients is <10%. In summary, data presented in this literature study show that islet transplantation give less acute complications, but that whole pancreas transplantation results in better glucose control for a longer time period.
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Khin, May Oo. "Metformin in gestational diabetes mellitus." Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/77511/.
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Gestational diabetes mellitus (GDM) can affect up to 1 in 5 of pregnancies and is associated with adverse pregnancy outcomes including pre-eclampsia, neonatal hypoglycaemia, large for gestational age, increased adiposity and birth trauma. Good glycaemic control is the key to reduce these outcomes. Diet and lifestyle modification followed by insulin as necessary is the conventional type of management. Metformin is increasingly used in pregancy but with limited evidence, its role in GDM has not been well-established. A systematic review including both randomized and non-randomized controlled studies have been conducted to evaluate the contemporary evidence of metformin in GDM. It is suggested that metformin in GDM could be a useful alternative to insulin and is regarded as the best oral anti-hyperglycaemic agent in GDM management currently. However, almost half of metformin-treated GDM patients required supplementary insulin to achieve target glucose levels (metformin failure). Women with higher metabolic risk factors are likely to develop metformin failure. A clinical cohort of metformin-treated GDM is used to develop the predictive model to identify GDM women who are at risk of metformin failure. It has been found that women identified by new IADPSG and NICE 2015 fasting criteria are highly likely to develop metformin failure. It has also been established a number of algorithm based on various baseline characters of GDM women which will help primary healthcare physicians choose the best medication for GDM management. One of the possible side-effects of metformin includes lowering of serum vitamin B12 levels whereas serum vitamin B12 deficiency during pregnancy which is associated with increased insulin resistance. It is reported that in low vitamin B12 state, offspring’s insulin resistance is found to be higher among women with high folate low B12 state. Hence, in order to fully appreciate the role of vitamin B12 deficiency in metformin failure, it is first necessary to understand the effects of folate in low vitamin B12 condition on pregnancy outcomes in GDM. It has also been found that in normal vitamin B12 GDM women, serum folate levels are negatively associated with plasma glucose levels but not low B12 state. This underlines the fact that in order for folate to have its role, it is important to have normal vitamin B12 levels. Despite increasing use of metformin, it is not yet routine to check vitamin B12 levels before it is given. It is important to understand whether vitamin B12 has a role in metformin action. Thus, the mechanism by which vitamin B12 deficiency might interfere with metformin action was studied. In vitamin B12 deficient hepatocytes, metformin stimulation of AMPK was reduced which was followed by reduced downstream signalling in lipid metabolism. This effects were reversed by vitamin B12 supplementation. Thus, it is concluded that vitamin B12 deficiency could interfere with metformin action and before metformin is given, every GDM woman should be checked for serum vitamin B12 levels and should be supplemented if deficient. Overall, vitamin B12 could play a critical role in GDM management and it is important for every GDM woman to have normal vitamin B12 levels.
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Chan, A. W. "Neuropathic pain in diabetes mellitus." Thesis, Cardiff University, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.496046.
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Paradis, Hilje K. "Osmoregulation in uncontrolled diabetes mellitus." Thesis, University of Ottawa (Canada), 1991. http://hdl.handle.net/10393/7568.
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In this thesis we studied the influence of osmotic loading on vasopressin secretion and water intake in experimentally-induced diabetes mellitus, in the insulin deprived state as well as when treated with insulin, in order to investigate whether the osmotic drive for vasopressin release and thirst is altered in the diabetic state. Four dogs were used for the experiments to be reported. They were infused with hypertonic sodium sulfate to investigate the influence of osmotic loading on water intake and vasopressin secretion in the control, insulin-treated diabetic and diabetic conditions. Forty-eight hours of insulin depletion did not produce a change in the basal plasma vasopressin levels, even though there was a significant increase in plasma osmolality. In addition, forty-eight hours of insulin depletion did not alter the sensitivity of the osmoreceptors controlling vasopressin release and thirst. The effect of the diabetic condition on the osmotic threshold is subject to interpretation of the data. If glucose is considered an osmotically effective solute in the diabetic state, there is an upward resetting of the osmostat for vasopressin release and thirst, and a downward or leftward shift of the osmostat when glucose is not considered to be effective osmotically. The results of the present study provide evidence that the osmotic sensitivity of vasopressin release and thirst is not affected by the presence or absence of insulin. However, whether there is a true resetting of the osmostat for vasopressin release and thirst in the diabetic state depends on the assumption mode concerning glucose permeability.
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Kizmaz, Sara, and Elsa Khoury. "Diabetes mellitus och parodontal sjukdom." Thesis, Karlstads universitet, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-41732.
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Ferreira, Filipa Cristina Costa. "A Diabetes - Principais Parâmetros para o Controlo da Diabetes." Master's thesis, Faculdade de Ciências Médicas. UNL, 2013. http://hdl.handle.net/10362/10001.
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RESUMO: A Diabetes Mellitus é uma doença metabólica crónica, com deficiência a nível do metabolismo dos hidratos de carbono, lípidos e proteínas, resultante de deficiências na secreção ou ação da insulina, ou de ambas, que quando não tratada antecipadamente e de modo conveniente, pode ter consequências muito graves. Dado a incidência a nível mundial da Diabetes Mellitus, torna-se de elevada importância avaliar toda a sua envolvência e estudar bem quais os critérios a ter em consideração. Este trabalho propõe-se estudar para além dos parâmetros bioquímicos relacionados com a doença - Glicose e Hemoglobina Glicada A1c (HbA1c), analisar os resultados dos últimos cinco anos (2008-2012) dos ensaios interlaboratoriais do PNAEQ, do Departamento de Epidemiologia, do Instituto Nacional de Saúde Dr. Ricardo Jorge. Foram também analisadas as metodologias utilizadas e as variações interlaboratoriais, de forma a entender qual ou quais são os parâmetros mais adequados para o seu diagnóstico e controlo.
Este estudo utilizou a população de laboratórios portugueses, públicos e privados, de Portugal Continental e Ilhas, um laboratório de Angola e outro de Macau que se inscreveram no PNAEQ nestes cinco anos, sendo a amostra composta pelo n.º de participações. No programa de Química Clinica foram distribuídas 38 amostras e no programa de HbA1c foram distribuídas 22 amostras.
Para a glicose, o nível de desempenho nos ensaios é na globalidade das amostras de Excelente, no entanto verifica-se que sempre que a concentração da amostra é de nível patológico, que a maioria dos ensaios o desempenho foi inferior – Bom. O método de eleição e com CV% mais baixos foi o método da hexoquinase. Para a HbA1c, o nível de desempenho nos ensaios é na globalidade das amostras de Excelente. O método de eleição e com CV% mais baixos foi o método de HPLC. O CV% para a glicose ronda desde 2010 a 2012, os 3% e para a HbA1c foi de aproximadamente 4,0% em 2012.
A HbA1c tem mostrado ser uma ferramenta muito útil, importante e robusta na monitorização da Diabetes, sendo hoje em dia quase sempre requisitada em análises de rotina a diabéticos de modo a prevenir complicações que possam vir a acorrer. No futuro poderá ser um importante, senão o parâmetro de futuro, para o diagnóstico da Diabetes, no entanto, mesmo já tendo sido muito trabalhada a sua padronização, ainda existem questões por responder como quais são na realidade todos os seus interferentes, qual a verdadeira relação da HbA1c com a glicose média estimada, em todas as populações e com estudos epidemiológicos. Também a própria educação do diabético e clínico deve ser aprimorada, pelo que neste momento as PTGO e os doseamentos de glicose em jejum devem ser utilizados e encontrando-se a Norma da DGS N.º 033/2011 de acordo com as necessidades e com o estado da arte deste parâmetro. A implementação da glicose média estimada será uma mais-valia na monitorização dos diabéticos pelo que deverá ser uma das prioridades a ter em conta no futuro desta padronização, uniformizando a decisão clinica baseada nela e minimizando a dificuldade de interpretação de resultados de laboratório para laboratório. --------------ABSTRACT: Diabetes Mellitus is a chronic metabolic disease, with a deficit in the metabolism of carbohydrates, lipids and proteins, resulting from deficiencies in insulin secretion or action, or both, which if, when not early treated in a proper way, may result in very serious consequences. Given the worldwide incidence of diabetes mellitus, it is highly important to evaluate all its background and study specifically all the criteria to take into consideration. The aim of this thesis is to study and evaluate beyond the biochemical parameters related to the disease - Glucose and Glycated Haemoglobin A1c (HbA1c), analyze the results of the last five years (2008-2012) of the PNAEQ interlaboratorial tests, in the Department of Epidemiology of National Institute of Health Dr. Ricardo Jorge. It is also intended to analyze the methodologies used and the interlaboratorial variations, in order to understand the most suitable parameters for the diagnosis and control.
This study was based in a population of Portuguese laboratories, public and private, of Portugal mainland and islands, a laboratory of Angola and other from Macau, who enrolled in PNAEQ in these five years, and the sample was composed by the n. º of holdings. In the Clinical Chemistry Program there were distributed 38 samples and in the program HbA1c were distributed 22 samples.
For glucose, the level of performance in the total nº of the samples was Excellent; however, it was found that when the concentration level of the sample was pathological, in most of the tests the performance was Good. The most preferred method with the lowest CV% is the hexokinase method. For the HbA1c, as a whole, the samples’ tests were Excellent, at the level of performance. The method of election with the lower CV% was the HPLC. The CV% for glucose was around 3%, from 2010 to 2012 and the HbA1c was approximately 4.0% in 2012.
The HbA1c method has demonstrated to be a very useful tool, important and robust for monitoring diabetes, being nowadays, almost always required in routine analysis to prevent future complications. In the future it may be an important parameter, if not the most important, for the diagnosis of diabetes. However, despite it has already been standardized, there are still some questions that need to be answered, such as, which are in fact all their interferences, which is the true connection of HbA1c, when compared with the estimated average glucose, in all populations and epidemiological studies. Moreover, the education of the patient and the doctor concerning diabetes should be improved. Nowadays, the Oral Glucose Tolerance Test (OGTT) and fasting glucose determinations should be used and, the needs and the state of the art of this parameter, should be in accordance with the Standard DGS N. º 033/2011.
The Implementation of the estimated average glucose will be an added value in monitoring diabetics and, therefore, should be a priority to consider in its future standardization and clinical decision based on it, will be uniform and the difficulty of interpreting results from laboratory to laboratory will be minimal.
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Rua, Inês dos Santos. "Diabetes mellitus tipo 1 e gravidez." Master's thesis, 2017. http://hdl.handle.net/10316/82754.
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Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaA diabetes mellitus tipo 1 (DM tipo 1) é uma doença metabólica crónica que apresenta uma incidência crescente e que pode estar presente em mulheres em idade fértil que pretendam engravidar. Assim, com este artigo pretendeu-se abordar a classificação, diagnóstico e fisiopatologia da DM tipo 1, quais as alterações e complicações associadas a esta patologia na gravidez e quais as estratégias utilizadas para o controlo e seguimento da gravidez na mulher com DM tipo 1. . Para isso fez-se pesquisa de artigos na PubMed e outro tipo de documentos, publicados entre 2006 e 2016, escritos em inglês ou português, e que abordassem o tema. .As adaptações do organismo materno à gravidez provocam alterações no equilíbrio metabólico da diabética, provocando um maior risco de hipoglicemia no primeiro trimestre e de hiperglicemia especialmente no terceiro trimestre. A gravidez na doente com diabetes implica maior risco de cetoacidose diabética, assim como possível agravamento das complicações da diabetes, retinopatia e nefropatia, e aumento do risco de complicações obstétricas, como abortamento espontâneo, pré-eclâmpsia, parto pré-termo e parto distócico. A presença da diabetes materna implica também um aumento do risco de complicações fetais, como malformações, distócia de ombros, ser grande para a idade gestacional, Apgar inferior a 7 aos 5 minutos, hipoglicemia neonatal e morte perinatal. . O seguimento da doente com DM tipo 1 deve ocorrer desde o período pré-concecional até ao período pós-parto em centro diferenciado. Durante todo este período pretende-se planear a gravidez, manter um bom controlo metabólico, tentando especialmente manter a normoglicemia de forma segura e diagnosticar e tratar atempadamente possíveis alterações ou complicações que surjam. .Com este artigo, concluiu-se que as mulheres com DM tipo 1, que não apresentem complicações graves da diabetes, podem engravidar se forem adequadamente acompanhadas e participarem ativamente no seu controlo metabólico.
Type 1 diabetes mellitus is a chronic and metabolic disease whose incidence is rising. Fertile women can have this disease and may want to become pregnant. So, with this article, we wanted to discuss diabetes’s classification, diagnosis and physiopathology, complications during pregnancy associated with this disease and what are the strategies used in management of the pregnancy in women with type 1 diabetes. . In order to do that, we have made a search for articles in Pubmed and also looked for other documents, all written between 2006 and 2016 in English or Portuguese and related with the topic. . The maternal body adaptations to pregnancy make changes on metabolic balance, improving the hypoglycaemia risk during the first trimester and the hyperglycaemia risk, in particular, during the third trimester. The pregnancy in these women increases the risk of diabetic ketoacidosis and progression of diabetic complication, such as retinopathy and nephropathy, and also raise the risk of obstetric complications, like miscarriage, pre-eclampsia, pre-term birth and obstructed labour. The presence of maternal diabetes also increases the risk of foetal complications, such as malformations, shoulder dystocia, being large for gestational age, Apgar less than 7 at 5 minutes, neonatal hypoglycaemia and perinatal death. . The management of the women with type 1 diabetes should be from preconception until postpartum and occur in a differentiated centre. During this all-time, the pregnancy should be planned, keeping a good glycaemic control, especially trying to maintain safely the glycaemia in the normal range, and diagnose and treat possible changes and complications. . We have concluded, with this article, that women with type 1 diabetes mellitus can get pregnant, if they haven’t serious complications of diabetes, if they are well followed and participate in their metabolic control actively.