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VIEIRA, Lindalva Layse de Lima Malagueta. "Estudo dos efeitos da Metformina na eletrogênese cardíaca." Universidade Federal de Pernambuco, 2015. https://repositorio.ufpe.br/handle/123456789/16255.
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CAPEs
A Diabetes Mellitus (DM) é um grave problema de saúde pública, sendo uma das maiores causas de morbimortalidade na grande maioria dos países. Diferentes órgãos são acometidos pela DM; contudo, as doenças cardiovasculares são as maiores responsáveis pela elevada mortalidade vinculada à diabetes. A metformina é atualmente o principal fármaco utilizado para o tratamento da DM do tipo 2 (DM2), embora os riscos-benefícios cardiovasculares dessa droga não estejam totalmente elucidados. O presente estudo teve como objetivo avaliar o potencial arritmogênico da metformina em corações e cardiomiócitos de ratos saudáveis. No tratamento por 10 semanas com metformina os parâmetros biométricos e a glicemia plasmática não foram modificados, mas foi constatado um prolongamento dos intervalos PR, QT e QTc no eletrocardiograma, e uma redução da corrente transitória de saída de K+, Ito.Quando os cardiomiócitos foram incubados por 24 h com metformina, a amplitude da corrente Ito foi reduzida, enquanto aumentou a duração do potencial de ação cardíaco (DPA). A exposição de cardiomiócitos isolados à metformina por um período de 30 min, não reduziu a amplitude da corrente Ito, comprovando que a redução da corrente Ito em cardiomiócitos tratados por 10 semanas e incubados por 24 h com metformina, não ocorreu por uma ligação direta da droga ao canal. A corrente de cálcio tipo L (ICa-L) e a dependência de voltagem da inativação e recuperação da inativação da corrente Ito não foram afetadas em ambas as situações experimentais. Os níveis de RNAm que codifica as subunidades KV4.2, KV4.3 e KChIP2 do canal Ito não foram alterados, sugerindo que a redução da corrente Ito não ocorreria por uma menor síntese proteica das subunidades que compõem o canal Ito. Propõe-se que, esta redução seria resultante de uma acelerada degradação dos canais ou de uma deficiência funcional destes na membrana celular. A partir dos resultados obtidos na presente tese, conclui-se que a metformina apresenta potenciais efeitos arritmogênicos sobre o coração de animais saudáveis, capazes de levar eventualmente à morte súbita.
Diabetes Mellitus (DM) is a major public health problem, and is one of the biggest causes of morbidity and mortality in most countries. Many different human organs are affected by the DM, but cardiovascular diseases are the leading causes of mortality in patients with DM. Even today, the leading drug used to treat type-2 diabetes is metformin. However, its cardiovascular risk-benefits are not entirely clear. This study aimed to determine the potential arrhythmogenic effect of metformin in cardiomyocytes from healthy animals. Therefore, a 10 week treatment with metformin was performed, and it was proved that biometric and metabolic parameters were not affected. However, a lengthening of the PR, QT and QTc interval was found on the electrocardiogram, as well as a reduction in the output of the transitory potassium Ito current. When cardiomyocytes were incubated for 24 h with metformin, the amplitude of the Ito current was reduced and duration of cardiac action potential (APD) increased. Exposure of cardiomyocytes treated with metformin over a period of 30 min did not reduce the amplitude of the current Ito, demonstrating that the reduction in Ito current cardiomyocytes treated for 10 weeks and incubated for 24 h with metformin, does not occur by direct binding of the drug to the canal. The L-type calcium current (ICa-L) and the kinetic properties of voltage-dependent inactivation and recovery from inactivation of Ito current remained unchanged in both experimental conditions. RNAm levels of KV4.2, KChIP2 4.3 and Kv subunits remained unchanged. This suggests that the reduction of the Ito current may not be caused by a decrease in the protein synthesis subunit which is part of the Ito channel.Therefore, this reduction may be caused by a main degradation of the channels or by a worse operating performance in the cell membrane. Experiments accomplished during this thesis try to demonstrate that metformin causes arrhythmogenic effects in the heart of healthy animals.
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Jamali, Reza. "Peripheral Hypoglycaemic Neuropathy in Type 1 Diabetic Rats : Morphologic and Metabolic Studies." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7978.
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Fabris, Chiara. "Glucose variability assessment in diabetes mellitus monitoring and control." Doctoral thesis, Università degli studi di Padova, 2015. http://hdl.handle.net/11577/3424146.
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This dissertation is focused on the assessment of glucose variability (GV) in the treatment of the pathology of diabetes mellitus. GV is a risk factor for the development of diabetes complications, and its assessment combined with the evaluation of glycated hemoglobin levels is believed to be useful to characterize the functioning of glucose metabolism. Given the importance of GV in diabetes, a number of indicators to measure it from the retrospective analysis of sparse self-monitoring of blood glucose (SMBG) or continuous glucose monitoring (CGM) recordings have been proposed in the literature, but several issues are still open. For instance, some GV indicators have been developed specifically from SMBG data, and their use on CGM time-series has not been validated yet. Moreover, the availability of a large number of metrics to quantify GV gives rise to problems in terms of redundant conveyed information, and a compact way to extensively characterize GV would be desirable. Finally, the exploitation of CGM signals and GV to classify the metabolic condition of normal and diabetic subjects is a relatively unexplored problem that could deserve an investigation. These three topics are the object of this dissertation, which is specifically made up of six chapters whose content is briefly outlined below.
Chapter 1 will describe the etiology of the different types of diabetes, discuss the development of diabetes complications, and introduce the technologies used to monitor blood glucose levels and the strategies exploited to manage the treatment of type 1 (T1DM) and type 2 (T2DM) diabetes mellitus.
Chapter 2 will focus specifically on GV and its quantification, and, after highlighting the existing open issues, will precisely state the aims of the thesis.
Chapter 3 will consider the problem of adapting some GV indicators originally developed and validated from SMBG, to the use with CGM signals. In particular, we will specifically look at low blood glucose index (LBGI) and high blood glucose index (HBGI), popular metrics that allow to provide a rapid classification of the quality of glucose control in diabetic subjects, and will provide alternate versions of these indicators adapted to the characteristics of CGMs by modeling the relationship between LBGI/HBGI values obtained from SMBG and CGM recordings. A dataset of 28 T1DM subjects monitored with both SMBG and CGM devices will be used to tune and assess the proposed methodology.
Chapter 4 will address the issue of redundant information conveyed by the available GV indices by using the sparse principal component analysis (SPCA) technique as a tool to provide a parsimonious but still comprehensive characterization of GV in both T1DM and T2DM. Specifically, we will consider 25 GV indicators evaluated on CGM profiles acquired from 33 T1DM and 13 T2DM subjects as initial pool of variables. SPCA will be applied to this set of metrics and will be shown to be able to select a small subset of up to 10 indices that can save more than 60% of the original variance in both applications. The subset of metrics provided by SPCA can be used to parsimoniously describe GV in diabetes.
Chapter 5 will be devoted to the assessment of the possibility of using the outputs from SPCA to build GV-based classifiers of the metabolic condition of normal and diabetic subjects. In particular, by resorting to a dataset of 55 T1DM subjects, 34 normal subjects at high risk of developing T2DM, 39 impaired glucose tolerance subjects, and 29 subjects with T2DM diagnosed, we will show that support vector machines are able to successfully classify the quality of glycemic control and the metabolic condition of disordered subjects, allowing to achieve an accuracy of classification always greater than 70%. The investigation will be performed using both the whole initial pool of 25 indicators and the parsimonious set selected by SPCA as features to design the classifiers; the fact that similar results were obtained in the two scenarios strengthens the speculation that the compact description of GV provided by SPCA is effectively comprehensive for characterizing the subjects' metabolic condition.
Chapter 6 will close this dissertation, with a discussion on possible future developments of the presented investigations.L'obiettivo di questa tesi è l'indagine del ruolo della variabilità glicemica (GV) nella patologia del diabete mellito. La GV è un fattore di rischio per lo sviluppo di complicazioni dal diabete, e la sua valutazione combinata con quella dei livelli di emoglobina glicata è ritenuta essere un elemento utile nel caratterizzare il funzionamento del metabolismo del glucosio. Data l'importanza della GV nel diabete, molteplici indicatori che permettono di ottenerne una quantificazione dall'analisi retrospettiva di segnali di self-monitoring of blood glucose (SMBG) o continuous glucose monitoring (CGM) sono stati proposti in letteratura, ma in merito esistono alcune problematiche ancora aperte. Per esempio, alcuni indici sono stati sviluppati specificamente per essere applicati su serie SMBG, ed il loro utilizzo su segnali CGM non è ancora stato validato. Inoltre, il fatto che esistano numerosi indicatori per quanticare la GV dà origine a problemi di ridondanza nell'informazione trasmessa, ed un approccio che permetta di ottenere una descrizione compatta ma esaustiva della GV sarebbe desiderabile. Infine, l'uso di segnali CGM e dell'informazione sulla GV per classificare lo stato metabolico di soggetti normali e diabetici è un problema relativamente inesplorato che potrebbe meritare di essere trattato. Questi tre argomenti sono l'oggetto di questa tesi, che risulta articolata in sei capitoli il cui contenuto è brevemente delineato di seguito. Il Capitolo 1 descriverà l'eziologia dei differenti tipi di diabete, discuterà lo sviluppo delle complicazioni da diabete, ed introdurrà le tecnologie utilizzate per monitorare la glicemia ed alcune strategie che si possono seguire per trattare il diabete mellito di tipo 1 (T1DM) e 2 (T2DM). Il Capitolo 2 verterà sulla GV e la sua quantificazione, e, dopo aver evidenziato i problemi aperti esistenti, dichiarerà precisamente gli scopi della tesi. Il Capitolo 3 considererà il problema di adattare alcuni indicatori di GV originariamente sviluppati e validati su profili SMBG, all'utilizzo su segnali CGM. In particolare, ci concentreremo su low blood glucose index (LBGI) e high blood glucose index (HBGI), indici popolari che permettono di ottenere una rapida classificazione della qualità del controllo glicemico in soggetti diabetici, e forniremo versioni alternative di questi indicatori adattate alle caratteristiche dei segnali CGM, modellando la relazione tra i valori che LBGI e HBGI assumono quando calcolati da SMBG e CGM. Un dataset di 28 soggetti T1DM monitorati con dispositivi SMBG e CGM sarà utilizzato per mettere a punto la metodologia. Il Capitolo 4 affronterà il problema della ridondanza nell'informazione fornita dagli indicatori di GV esistenti, utilizzando la sparse principal component analysis (SPCA) come approccio per fornire una descrizione parsimoniosa ma allo stesso tempo esaustiva della GV in popolazioni di soggetti con T1DM e T2DM. In particolare, considereremo 25 indicatori di GV valutati su profili CGM acquisiti da 33 soggetti con T1DM e 13 con T2DM come insieme iniziale di variabili. La SPCA sarà applicata a questo pool di indici e permetterà di selezionare un piccolo sottoinsieme di 10 indicatori che consente di preservare più del 60% della varianza originariamente spiegata dall'insieme di partenza in entrambe le applicazioni. Il sottoinsieme di indicatori fornito dalla SPCA può essere utilizzato per descrivere parsimoniosamente la GV nel diabete. Il Capitolo 5 sarà dedicato alla valutazione della possibilità di utilizzare gli output della SPCA per costruire classificatori dello stato metabolico di soggetti normali e diabetici basati sulla GV. In particolare, facendo ricorso ad un dataset di 55 soggetti con T1DM, 34 normali a rischio T2DM, 39 con impaired glucose tolerance, e 29 con T2DM diagnosticato, mostreremo che classificatori progettati su support vector machine sono capaci di discriminare con successo la qualità del controllo glicemico e la condizione metabolica di soggetti con disordini, permettendo di raggiungere un'accuratezza di classicazione sempre maggiore del 70%. Lo studio sarà condotto utilizzando sia il pool iniziale di 25 indicatori che il sottoinsieme parsimonioso fornito dalla SPCA come features per costruire i classificatori; il fatto che risultati simili siano ottenuti nei due casi rafforza la speculazione che la descrizione compatta della GV fornita dalla SPCA sia effettivamente esaustiva nel caratterizzare la condizione metabolica dei soggetti. Il Capitolo 6 chiuderà la tesi, con una discussione su possibili sviluppi futuri degli studi qui presentati.
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GRANCINI, VALERIA. "RUOLO CENTRALE DELLA BETA-CELLULA NEL PROMUOVERE LA REGRESSIONE DEL DIABETE DOPO TRAPIANTO DI FEGATO IN PAZIENTI CON CIRROSI EPATICA." Doctoral thesis, Università degli Studi di Milano, 2019. http://hdl.handle.net/2434/658515.
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BACKGROUND & AIMS:
Diabetes occurring as a direct consequence of loss of liver function is usually characterized by non-diabetic fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) levels and should regress after orthotopic liver transplantation (OLT). This observational, longitudinal study investigated the relationship between the time-courses of changes in all 3 direct determinants of glucose regulation, i.e., β-cell function, insulin clearance and insulin sensitivity, and diabetes regression after OLT.
METHODS:
Eighty cirrhotic patients with non-diabetic FPG and HbA1c levels underwent an extended oral glucose tolerance test (OGTT) before and 3, 6, 12 and 24 months after OLT. The OGTT data were analysed with a mathematical model to estimate derivative control (DC) and proportional control (PC) of β-cell function and insulin clearance (which determine insulin bioavailability), and with the Oral Glucose Insulin Sensitivity (OGIS)-2 h index to estimate insulin sensitivity.
RESULTS:
At baseline, 36 patients were diabetic (45%) and 44 were non-diabetic (55%). Over the 2-year follow-up, 23 diabetic patients (63.9%) regressed to non-diabetic glucose regulation, whereas 13 did not (36.1%); moreover, 4 non-diabetic individuals progressed to diabetes (9.1%), whereas 40 did not (90.9%). Both DC and PC increased in regressors (from month 3 and 24, respectively) and decreased in progressors, whereas they remained stable in non-regressors and only PC decreased in non-progressors. Insulin clearance increased in all groups, apart from progressors. Likewise, OGIS-2 h improved at month 3 in all groups, but thereafter it continued to improve only in regressors, whereas it returned to baseline values in the other groups.
CONCLUSIONS:
Increased insulin bioavailability driven by improved β-cell function plays a central role in favouring diabetes regression after OLT, in the presence of a sustained improvement of insulin sensitivity.
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Rossetti, L. "PLATELET ACTIVATION AND ASSOCIATED TRANSCRIPTIONAL SIGNATURE IN TYPE 2 DIABETIC PATIENTS WITH STABLE CORONARY ARTERY DISEASE: INSIGHTS INTO THEIR THROMBOTIC PROPENSITY." Doctoral thesis, Università degli Studi di Milano, 2014. http://hdl.handle.net/2434/246942.
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Platelet activation and associated transcriptional signature in type 2 diabetic patients with stable coronary artery disease: insights into their thrombotic propensity
Several studies indicate that despite aspirin therapy patients with type-2 diabetes mellitus (T2DM) have both an enhanced platelet reactivity and a hypercoagulable state, supporting the evidence of a greater incidence of coronary artery disease (CAD) compared to patients without T2DM. Tissue Factor (TF) is the principal activator of blood coagulation; it is also expressed by platelets, which, upon activation translocate the protein on the cell surface. We have previously shown that platelet-associated TF (pTF) is increased in CAD patients compared to healthy subjects contributing to an increased thrombin generation capacity. No information is still available on pTF expression in diabetic patients with stable angina (SA).
Our aim is to provide insight into the enhanced risk of thrombotic complications associated with T2DM in order to clarify pathways altered by diabetes and to find new potential targets of pharmacological modulation. In this study we assessed whether T2DM affects pTF expression, the overall prothrombotic potential and platelet transcriptome profile in patients with SA.
We enrolled 85 patients with stable angina (SA), 32 with T2DM and 53 without T2DM; 28 diabetic patients without SA and 37 healthy subjects (HS). Assessment of surface and intracytoplasmic pTF expression was performed by whole blood flow cytometry. The prothrombotic potential was analyzed by thrombin generation assay both in plasma and in isolated platelets using Thrombinoscope. The global haemostatic function was evaluated by thromboelastometry (Rotem). Platelet transcriptome profiles were studied using Illumina BeadChip Human HT-12 v4 microarray.
Haematologic parameters were comparable among the 4 groups except for the percentage of immature platelet fraction, which was higher in SA patients with T2DM (p<0.05). T2DM was associated with an increase in TF expression on platelet surface: it was significantly increased in SA patients with T2DM compared to SA without T2DM and HS (p<0.05). Moreover a significantly higher number of intracytoplasmic TF+-platelets was found in SA patients with T2DM compared to patients without T2DM (27.53±2.8 vs. 14.98±1,34, p<0,001). This finding resulted in an increased thrombin generation, being shorter both the lag time and the time to peak in T2DM patients. TF contribution to thrombin generation was assessed treating samples with an anti-TF antibody which resulted in an increase in the time needed to start thrombin generation in both group of patients, and the delay was significantly greater in diabetic patients. Maximum Clot Firmness, α-Angle and Maximum Velocity of clot formation assessed by ROTEM were all significantly increased in diabetic patients. Microarray analysis showed that 319 unique mRNAs that were differentially expressed between SA patients and HS. When comparison of platelet gene profiling was performed between SA patients with or without T2DM, only 35 genes were found differently expressed. The most upregulated transcript in SA patients with T2DM was CD69, which was reported to be involved in thromboxane production and platelet aggregation.
In conclusion the data here provided indicate that SA patients with T2DM are characterized by a higher number of circulating TF+-platelets compared to patients without T2DM. The platelet-associated TF is functionally active, being able to trigger thrombin generation, which is blocked by a specific anti TF antibody. These findings shed new light on the mechanism involved in the enhanced prothrombotic phenotype associated with T2DM. The differentially expressed transcripts in T2DM platelets provide new insights into the mechanisms underlying the increased platelet reactivity which will be further explored by ad hoc studies.
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GIULIANI, ANGELICA. "Role of microRNAs in inflammaging and age related diseases." Doctoral thesis, Università Politecnica delle Marche, 2018. http://hdl.handle.net/11566/253098.
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L’invecchiamento è un complesso processo derivante da una combinazione di fattori ambientali, genetici e stocastici, caratterizzato da uno stato proinfiammatorio. Questa infiammazione cronica. Di basso grado e sistemica è stata recentemente teorizzata e definita col termine “inflammaging” e rappresenta uno dei principali fattori di rischio di patologie - e.g. patologie cardiovascolari, diabete mellito di tipo 2 e patologie neurodegenerative – comunemente chiamate patologie età-correlate (ARDs).
La senescenza cellulare è storicamente associata all’invecchiamento. La senescenza può essere definita come un arresto stabile del ciclo cellulare accompagnato da una varietà di alterazioni molecolari e biochimiche – e.g. attività metabolica, profilo epigenetico, pathways apoptotici e l’acquisizione di un fenotipo secretorio associato alla senescenza (SASP). Attraverso l’acquisizione del fenotipo SASP, le cellule senescenti sono in grado di modificare il microambiente e alimentare uno stato di infiammazione cronica. I meccanismi che stanno alla base di questi processi infiammatori rappresentano un tema all’avanguardia nel campo della gerontologia molecolare.
I microRNA sono regolatori versatile dell’espressione genica e l’identificazione di un vasto repertorio di queste molecole nel genoma dei mammiferi ha completamente rivoluzionato la nostra comprensione della maggior parte dei processi biologici. Recentemente, il nostro gruppo di ricerca ha contribuito all’identificazione di un piccolo sottogruppo di microRNA (SA-inflamma-miR) modulati e. a loro volta. regolatori della senescenza cellulare, dell’iflammaging e delle ARDs. Abbiamo esplorato tre diversi nuovi aspetti degli SA-inflamma-miR: i) la loro regolazione nelle funzioni mitocondriali nella senescenza replicativa delle cellule endoteliali; ii) la loro modulazione e risposta a seguito del trattamento delle cellule endoteliali con l’adalimumab, un anticorpo monoclonale diretto contro il fattore di necrosi tumorale-α (TNF-α), componente principale della SASP; iii) la loro rilevanza diagnostica in una vasta coorte di soggetti sani di diversa età e pazienti affetti da diabete di tipo 2.Aging is a complex process that results from a combination of environmental, genetic, epigenetic, and stochastic factors. A proinflammatory status is a pervasive feature of aging. This chronic, low-grade, and systemic inflammation has been defined as "inflammaging” and represents one of the major risk factor for pathologies such as cardiovascular diseases, T2DM, and neurodegenerative diseases – commonly referred to as “age-related diseases” (ARDs). Cellular senescence is historically associated with aging. Senescence can be defined as a stable arrest of the cell cycle coupled with a plethora of alterations, e.g. metabolic activity, epigenetic status, apoptosis pathways, and expression of a senescence associated (SA) secretory phenotype (SASP). Through acquisition of the SASP, senescent cells can modify the tissue microenvironment and fuel chronic inflammation, thus promoting the aging process and ARDs development. The mechanisms underlying this inflammatory process represent a cutting-edge topic in the field of molecular gerontology. MiRNAs are versatile regulators of gene expression and the identification of a vast repertoire of miRNA in the mammalian genome has completely revolutionized our understanding of most biological processes. Recently, our group has provided evidence that a relatively small packet of miRNAs, namely SA-inflamma-miRs are regulated by and can in turn affect the senescence process, inflammaging, and ARDs development. Here we explored 3 novel features of SA-inflamma-miRs : i) their regulation of mitochondrial functions during replicative senescence of endothelial cells; ii) their modulation and responsiveness following endothelial cells treatment with adalimumab, a monoclonal antibody directed against tumor necrosis factor-α (TNF-α), a major SASP component; iii) their diagnostic relevance in a large cohort composed of healthy subjects with different age and patients affected by type 2 diabetes, a prototypical ARD.
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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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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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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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COSENTINO, NICOLA. "EFFECTS OF STRESS HYPERGLYCEMIA ACCORDING TO DIABETICSTATUS IN PATIENTS WITH ST-ELEVATION MYOCARDIALINFARCTION AND ITS RELATIONSHIP WITH CARDIAC CELL INJURYAND MITOCHONDRIAL DAMAGE: A TRANSLATIONAL APPROACH." Doctoral thesis, Università degli Studi di Milano, 2023. https://hdl.handle.net/2434/946992.
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Background: Acute hyperglycemia (AH) is common in ST-elevation myocardial
infarction (STEMI) and predicts outcomes. AH is a more powerful prognostic
predictor in patients without diabetes mellitus (DM) than with DM, emphasizing the
role of an acute glucose rise compared to chronic elevations. Moreover, AH may
exacerbate, thorough mitochondrial dysfunction, infarct size (IS). We investigated
the association between AH and chronic glycemia, considered separately or in
combination, with mitochondrial injury and myocardial IS in STEMI patients with or
without DM.
Methods: We measured admission serum glucose (AH), cytochrome c and
mitochondrial DNA levels (mitochondrial biomarkers), and estimated chronic
glucose in all patients. We calculated the acute on chronic (A/C) glycemic ratio. The
primary endpoint was IS at cardiac magnetic resonance. The composite of in hospital mortality, acute-pulmonary-edema, and shock was the secondary endpoint.
Results: 100 STEMI patients with DM and 100 without were included. IS was 25gr
and 19gr and the secondary endpoint occurred in 21% and 8% of patients with and
without DM, respectively (p=0.02 and p=0.01, respectively). The A/C ratio only
significantly correlated with cytochrome c and mitochondrial DNA levels in DM
patients. However, at reclassification analyses, A/C glycemic ratio showed the best
prognostic power in predicting the primary and secondary endpoints as compared
to AH in DM (net-reclassification-index 28% and 31%, respectively) but not in non DM patients (net-reclassification-index 1% and 2%, respectively). In DM patients,
A/C glycemic ratio, but not AH, significantly predicted 1-year mortality, after
adjustment for major confounders.
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Conclusions: In STEMI patients with DM, A/C glycemic ratio seems to be a better
predictor of IS and in-hospital and 1-year outcome than AH. This study highlights
the prognostic role of A/C ratio, its impact on mitochondrial impairment and
outcomes, and may pave the way to interventional trials targeting AH according to
A/C ratio in DM patients with STEMI.
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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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Sousa, Sofia Alexandra. "Diabetes Mellitus felina." Master's thesis, Universidade de Évora, 2022. http://hdl.handle.net/10174/30830.
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O estágio curricular do Mestrado Integrado em Medicina Veterinária da Universidade de Évora realizado durante seis meses no Hospital Veterinário de São Bento, em Lisboa, deu origem ao presente relatório. Este relatório é constituído por duas partes. Na primeira parte fez-se uma breve análise descritiva dos casos clínicos assistidos durante o período de estágio, abordando de forma sumária as patologias mais relevantes para a estagiária. Por sua vez, a segunda parte compreende uma monografia com o tema “Diabetes Mellitus Felina”, onde se realizou uma revisão bibliográfica abordando a fisiologia do pâncreas, a classificação da afeção, a etiologia e patofisiologia, a epidemiologia, a apresentação clínica, o diagnóstico, o tratamento, as complicações associadas, a monitorização e o prognóstico. A Diabetes Mellitus é uma doença endócrina comum no paciente felino que é identificada pela presença de sinais clínicos típicos. Por fim, foi apresentado um caso clínico num gato sendo realizada uma discussão do mesmo; Abstract: Feline Diabetes Mellitus
The internship of the master’s degree in Veterinary medicine from the University of Évora, was held for six months at Hospital Veterinário São Bento, in Lisbon, and resulted in the present report. This report consists of two parts. The first part, was held a brief descriptive analysis of clinical cases assisted during the probationary period, briefly addressing the most relevant pathologies for the intern. In turn, the second part is comprised of the monography with the theme Feline Diabetes Mellitus, where a literature review was carried out addressing physiology of the pancreas, classification of the disease, etiology and pathophysiology, epidemiology, clinical presentation, diagnosis, treatment, associated complications, monitoring and prognosis. Diabetes Mellitus is a common endocrine disease in feline patients that is identified by specific clinical signals. Lastly, a clinical case in a cat was presented and a discussion was carried out.
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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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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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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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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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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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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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Elrayah-Eliadarous, Hind. "Economic burden of diabetes on patients and their families in Sudan /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-450-1/.
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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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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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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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Pacheco, Calderón Javier, Fernández Paloma Salas, and Rigo-Righi Carla Galli. "Vanadium Insulin mimetic activity." Revista de Química, 2012. http://repositorio.pucp.edu.pe/index/handle/123456789/100049.
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La diabetes mellitus es un serio desorden metabólicocrónico que se caracteriza por el incremento anormal de laglucosa en la sangre y por complicaciones vasculares yneurológicas. La diabetes mellitus es causada por una falta oun defecto en la acción de la insulina. Si bien actualmenteexisten varios medicamentos orales además de la insulina oanálogos de la insulina, ninguno de estos es el ideal.El vanadio es capaz de imitar los efectos mostrados por lainsulina tanto in vitro como in vivo y se estudia la posibilidadde usar compuestos de vanadio como agentes antidiabéticos. Eneste artículo se revisará la acción insulino-mimética del vanadioy sus posibles mecanismos en comparación con la insulina.Diabetes mellitus is a serious chronic metabolic disordercharacterized by an increased plasma glucose concentrationand vascular and neurologic complications as well. Diabetesmellitus results from relative or absolute deficiency of insulinsecretion or insulin deficient action. Although there are anumber of oral antidiabetic agents besides insulin or insulinanalogues, none of them is optimal.Vanadium can mimic insulin effects in vitro and in vivoand the possibility of using vanadium compounds asantidiabetic agents is under study. This review will summarizethe insulin mimetic action of vanadium and its possiblemechanisms in comparison with insulin.
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Figueras, Roca Marc. "Caracterització dels Factors Clínics i Biològics Associats a l’Edema Macular Diabètic en la Diabetis Mellitus Tipus II." Doctoral thesis, Universitat de Barcelona, 2018. http://hdl.handle.net/10803/663845.
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INTRODUCCIÓ:
L'edema macular diabètic (EMD) és una complicació clínica associada a la retinopatia diabètica (RD) i és la primera causa de pèrdua visual en diabètics en el món desenvolupat. Implica l'extravasació de fluids i lípids en l'àrea macular, la regió de la retina responsable de la visió central. Alguns dels seus factors de risc, com la hiperglucèmia crònica, són comuns amb la RD. Tanmateix, altres agents claus en la seva etiopatogènia, com els mediadors moleculars de la inflamació i diferents factors de creixement, no han estat estudiats en profunditat, especialment en relació amb la seva presència diferencial lligada a l'existència d'EMD.
OBJECTIU:
Estudiar l'associació entre factors metabòlics i inflamatoris en sang perifèrica i la presència d'EMD així com la seva associació a certes característiques intraoculars.
MATERIALS I MÈTODE:
Es planteja un estudi observacional de tall transversal sobre pacients diabètics amb RD en dos grups, aquells amb EMD associat (n=58) i aquells sense EMD (n=18). Es va realitzar un estudi detallat de la presentació oftalmològica en aquests grups d'acord als criteris d'inclusió i exclusió establerts, incloent diferents paràmetres qualitatius i quantitatius de tomografia de coherència òptica macular (OCT) a tots els pacients i angiografia fluoresceínica retinal de camp ampli (AFCA) en els casos d'EMD. A més a més, es va dur a terme un estudi complet de factors metabòlics (glicèmia, creatinina, colesterol total, LDL colesterol, HDL colesterol, triglicèrids, enzims hepàtics, hemoglobina i hemoglobina glicada) mitjançant anàlisi sanguínia així com de mediadors inflamatoris sèrics (citocines, quimiocines i factors de creixement), també en tots els pacients. El panell de mediadors inflamatoris estudiat, d'acord al coneixement previ disponible tant en mostres sanguínies com intraoculars, inclogué: IL-1β, IL-3, IL-6, IL-8, IL-10, MCP-1, IP-10, IFN-γ, TNF-α i VEGF.
RESULTATS:
Els paràmetres metabòlics i inflamatoris sèrics estudiats no s'han associat directament a la presència d'EMD. Tanmateix, quan aquesta complicació intraocular està present, certes característiques de la mateixa s'associen de forma estadísticament significativa a determinats mediadors sistèmics: la presència d'engruiximent difús de la retina per OCT es relaciona amb majors xifres sèriques d'IL-6; l'existència d'edema macular quístic per OCT s'associa a menors nivells en sang perifèrica d'IL-10; i, finalment, s'han objectivat majors xifres sèriques d'IL-8 i VEGF en aquells casos amb augment de la zona avascular foveal mesurada per AFCA.
CONCLUSIÓ:
El desenvolupament d'EMD no s'associa aparentment a patrons diferenciats de mediadors inflamatoris o metabòlics pel que fa a sang perifèrica. Tanmateix, certes característiques anatòmiques de l'EMD sí que es relacionen amb determinades molècules en l'àmbit sistèmic. Tot i el seu caràcter pilot, aquests resultats aporten valuosa informació sobre les que proposar estratègies futures en el maneig individualitzat del pacient amb EMD.INTRODUCTION: Diabetic macular edema (DME) represents a clinical complication of diabetic retinopathy (DR) and is the major cause of vision loss in diabetic patients in the developed world. It implies fluid and lipid extravasation in the macular area of the retina, which is accountable of main visual acuity. Several DME risk factors, as chronic hyperglycemia, are common to DR. However, other etiopathogenic agents such as inflammatory molecules and growth factors have not been widely studied, specially regarding its differential association to DME. AIMS: To study the association between peripheral blood metabolic and inflammatory factors and presence of diabetic macular edema (DME) and its related anatomic features in type 2 diabetic mellitus (T2DM) patients. MATERIAL AND METHODS: Observational cross-sectional study on a proof of concept basis. Seventy-six T2DM included patients were divided based on the presence (n = 58) or absence of DME (n = 18) according to optical coherence tomography (OCT). Ultra-widefield fluorescein angiography (UWFA) was performed in DME patients. Fasting peripheral blood sample testing included glycemia, glycated hemoglobin, creatinin and lipid levels among others. Serum levels of a broad panel of cytokines and inflammatory mediators were also analyzed. OCT findings included central subfoveal thickness, diffuse retinal thickness (DRT), cystoid macular edema (CME), serous retinal detachment and epirretinal membrane. UWFA items included pattern of DME, presence of peripheral retinal ischemia and enlarged foveal avascular zone (FAZ). RESULTS: Metabolic and inflammatory factors did not statistically differ between groups. However, several inflammatory mediators did associate to certain ocular items of DME cases: IL-6 was significantly higher in patients with DRT (p = 0.044), IL-10 was decreased in patients with CME (p = 0.012), and higher IL-8 (p = 0.031) and VEGF levels (p = 0.031) were observed in patients with enlarged FAZ. CONCLUSION: Inflammatory and metabolic peripheral blood factors in T2DM may not be differentially associated to DME when compared to non-DME cases. However, some OCT and UWFA features of DME such as DRT, CME and enlarged FAZ may be associated to certain systemic inflammatory mediators.
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Silva, Poliana Claus. "Concentração sanguínea de lactato em cães diabéticos." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/10/10136/tde-07072014-141827/.
Full textAbstract:
Em humanos, pacientes com diabetes mellitus (DM) podem apresentar aumento da concentração sérica de lactato quando comparados a indivíduos não-diabéticos. Considerando que existem poucas informações quanto aos valores de lactato em cães diabéticos, o objetivo principal desse trabalho foi determinar a concentração do lactato em cães com DM não tratados (ao diagnóstico), cães com DM em tratamento e cães em cetoacidose diabética (CAD), em comparação com cães hígidos. Foram incluídos 86 cães, sendo 25 do grupo controle e 61 diabéticos (14 ao diagnóstico, 24 em tratamento e 23 em cetoacidose diabética), sendo a maioria proveniente da rotina de atendimento do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia USP, e alguns obtidos em Hospital Veterinário privado. Todos os exames foram processados com os mesmos equipamentos. Os cães diabéticos foram selecionados com base em testes de glicemia, exame de urina e hemogasometria. Somente nos animais do grupo em CAD, foram admitidos pacientes com comorbidades graves, uma vez que estas podem ser responsáveis pela descompensação e que nestes animais indica-se a monitoração da concentração de lactato. Foram excluídos animais em sepse/ choque séptico ou choque cardiogênico, considerando que estas condições causam alteração do lactato. Não houve diferença estatística significativa entre os quatros grupos, quando se excluiu CAD, e nem mesmo quando observados pares de grupos isolados (P> 0,05). A existência de correlação positiva do lactato com a concentração de glicose referida por outros autores aumenta a possibilidade da acidose lática na CAD não ser somente causada pela hipoperfusão como também pela alteração do metabolismo da glicose, merecendo maior investigação a respeito do seu papel na fisiopatologia do DM e nas suas complicações.In humans, diabetes mellitus (DM) patients may present increased lactate levels compared to non-diabetics. Considering that there is little information regarding lactate levels in diabetic dogs, the main goal of this study was the determination of lactate concentration in diabetic dogs at diagnosis, under treatment and in ketoacidosis (DKA), compared to healthy dogs. Eighty six dogs were included: 25 controls and 61 diabetics (14 at diagnosis, 24 under treatment, and 23 in DKA), most patients from the Veterinary Teaching Hospital, School of Veterinary Medicine and Animal Science, University of São Paulo, and a few from a private Veterinary Hospital. All the laboratory analyses were performed with the same equipments. The diabetic dogs were selected based on glycemia levels, urinalysis and blood gas analysis. Only the DKA patients were allowed to have comorbidities, since these may be the cause of decompensation. Patients with sepsis/ septic shock or cardiogenic shock were excluded, as these conditions may lead to lactate changes. There was no difference in lactate levels among groups when compared all together, when excluding DKA group or even when compared as isolated pairs (P>0.05). The existence of a positive correlation between lactate concentration and glycemia referred by other authors, suggests that lactic acidosis seen in DKA may not be only due to poor perfusion, but also due to changes in glucose metabolism, therefore lactate levels deserves further investigation regarding its role in DM pathophysiology and complications.
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Penishkevych, Ya I., O. P. Kuchuk, O. O. Kuzio, and S. V. Tymofiychuk. "Risk factors for progression of diabetic retinopathy in patients with type 2 diabetes mellitus." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/16914.
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Paradis, Hilje K. "Osmoregulation in uncontrolled diabetes mellitus." Thesis, University of Ottawa (Canada), 1991. http://hdl.handle.net/10393/7568.
Full textAbstract:
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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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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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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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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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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Pinto, Mariana de Carvalho. "Parâmetros Neuropáticos no Diabetes Mellitus /." Presidente Prudente, 2014. http://hdl.handle.net/11449/123212.
Full textAbstract:
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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Opoku, Emeline. "Screening for gestational diabetes mellitus." Thesis, Буковинський державний медичний університет, 2012. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/1461.
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Sapunkov, O. D. "Maxillary sinusitis and diabetes mellitus." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19810.
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Грицюк, Мар'яна Іванівна, and Діана Ігорівна Навчук. "Streptozotocin model of diabetes mellitus." Thesis, Хист. Всеукраїнський медичний журнал молодих вчених. - Чернівці: БДМУ, Чернівці 2014, випуск 16., 2014, 2014. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/8659.
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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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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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Rudland, Victoria Louise. "HETEROGENEITY OF GESTATIONAL DIABETES MELLITUS." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15872.
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Gestational diabetes mellitus (GDM) is a complex, heterogeneous disorder. As the prevalence of GDM increases, it is increasingly important to identify subgroups of women within the GDM umbrella whose pathophysiology and associated pregnancy risk necessitates a different management approach in order to optimise maternal and neonatal outcomes. Glucokinase maturity-onset diabetes of the young (GCK-MODY) and islet autoimmunity are two such clinical entities. Recently, new pregnancy-specific screening criteria (NSC) for GCK-MODY were proposed to identify women with GDM who warrant GCK genetic testing. We tested the NSC and HbA1c in a multiethnic GDM cohort. The prevalence of GCK-MODY in women with GDM was ~1%. The NSC performed well for Anglo-Celtic women, but less well for women from other ethnic backgrounds. Antepartum HbA1c was not higher in those with GCK-MODY. We report the first two cases of antepartum fetal GCK genotyping and demonstrate how knowledge of fetal GCK genotype guides the management of maternal hyperglycaemia. We examined the prevalence, clinical significance and antepartum to post-partum trajectory of glutamic acid decarboxylase autoantibodies (GADA), insulinoma-associated antigen-2 autoantibodies (IA-2A), insulin autoantibodies (IAA) and zinc transporter 8 autoantibodies (ZnT8A) in a multiethnic GDM cohort. 9.9% of women were positive for one islet autoantibody antepartum. No participant had multiple islet autoantibodies. ZnT8A were the most common islet autoantibody. For women with positive GADA, IA-2A or IAA antepartum, islet autoantibody positivity typically persisted post-partum and 20% of women had post-partum glucose levels consistent with diabetes. In contrast, women with positive ZnT8A antepartum typically demonstrated normal ZnT8A titres post-partum and normal post-partum glucose tolerance. ZnT8A may be a marker for islet autoimmunity in a proportion of women with GDM, but the clinical relevance of ZnT8A in GDM needs further research.
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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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Clifford, Rhonda. "Pharmaceutical care in diabetes mellitus." Thesis, Curtin University, 2004. http://hdl.handle.net/20.500.11937/1907.
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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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Vujosevic, Stela. "Neuroretinal activation in diabetes mellitus." Doctoral thesis, Università degli studi di Padova, 2013. http://hdl.handle.net/11577/3422610.
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Background: Diabetic retinopathy (DR), one of the leading causes of blindness in developed countries, is the major microvascular complication of diabetes mellitus. Recent studies have demonstrated that the alteration of glial cells and the consequent loss of retinal neuronal cells occur before the vascular lesions are clinically detectable.
Purpose: To find early biomarkers of glial activation in the aqueous humor (AH) of diabetic patients both in presence and in absence of clinically detectable signs ofDR.
Materials and methods:During cataract surgery, 34 patients’ AH samples were collected as follows: 12 healthy subjects, 11 diabetic patients without DR and 11 diabetic patients with nonproliferative diabetic retinopathy (5 without macular edema-ME and 6 with ME). Before surgery, full ophthalmic examination and Spectral-Domain Optical Coherence Tomography (SD-OCT) (Spectralis HRA+OCT, Heildeberg Engineering) were performed in all eyes. The samples were analyzed for the quantification of total proteins by Bradford method, of GFAP, AQP1 and AQP4 by ELISA and of 40 inflammatory cytokines by protein array. Segmentation of retinal layers was also performed.
Results:Mean concentration of GFAP, AQP1 e AQP4 was significantly increased in diabetics versus controls (324.44±262.54pg/µg vs 182.34±114.44pg/µg for GFAP; 105.72±15.69pg/µg vs 50.92±20.36pg/µg for AQP1; and 852.03+103.24pg/µg vs 33.58±21.20pg/µg for AQP4, p<0.05). GFAP showed an approximate 0.8 fold increase, AQP1 1.1 fold increase, whereas AQP4 about 24 folds increase in diabetic patients versus controls. When we separately evaluated DR-no ME eyes vs DR-ME eyes, there was a significant decrease in GFAP, AQP1 e AQPR in DR-ME eyes versus DR-no ME eyes, (Tukey Kramer post hoc p<0.05). GFAP and AQP1 showed even a slight fold decrease versus controls. AQP4/AQP1 concentration showed weak and non significant correlation (Tau=0.21, p=0.3) between these biomarkers, despite the trend in increase.Following cytokines were increased in diabetic patients (with or without DR) compared to healthy subjects: GFAP, AQP1, AQP4, IFNy, IL-1a, IL-1b, IL-3, IL-4, IL-10, IL-11, IL-17, TNF-α, TNF-ß, MCP1, MCP2, Eotaxin,Eotaxin 2, RANTES, sTNFRII, GM-CSF, IP-10, MIP1a, MIP1b. RNFL mean thickness was significantly higher in diabetic patients with DR and ME compared to diabetics without ME (both with and without DR) and healthy subjects (respectively 37.3 μm vs 24.3μm vs 26μm 5μm vs 26.8μm), and the same significance was observed in the inner (33.4μm vs 22.0μm vs 25.0μm 24.3μm) and the external (54.7μm vs 36.7μm 34.6μm 38.1μm) rings and in the superior (40.3μm vs. 26.1μm vs 29.2μm vs 29.5μm), inferior (44.3μm vs 27.2μm vs 29.1μm vs 30.1μm) and temporal (26.3μm vs 16.8μm vs 18.9μm vs 18.0μm) sectors.RNFL mean thickness was significantly reduced in diabetics with DR and without ME compared to healthy subjects.
Conclusions: 23 different biomarkers of glial activation have been recognized in the AH of diabetic patients even with subclinical DR. These proteins could be used in the future as risk markers of occurrence of DR and could provide useful therapeutic targets for its prevention and therapy.Presupposti dello studio: La retinopatia diabetica (RD), una delle principali cause di cecità nei paesi sviluppati, costituisce la più comune complicanza microvascolare del diabete mellito. Recenti studi hanno dimostrato che l’alterazione delle cellule gliali e la conseguente perdita di quelle neuronali si verificano prima che le lesioni vascolari siano clinicamente rilevabili. Scopo dello studio: Lo scopo dello studio è quello di ricercare biomarkers precoci di attivazione gliale nell’umore acqueo di soggetti diabetici non solo in presenza di segni clinicamente rilevabili di RD, ma anche in loro assenza. Materiali e metodi: In corso di intervento di cataratta, sono stati raccolti i campioni di umore acqueo di 34 pazienti così suddivisi: 12 soggetti sani, 11 pazienti diabetici senza retinopatia diabetica e 11 con retinopatia diabetica non proliferante (di cui 5 senza edema maculare e 6 con edema maculare-ME). Prima dell’intervento, tutti i pazienti sono stati sottoposti a visita oftalmologica completa e tomografia a coerenza ottica di tipo spectral domain (SD-OCT) (Spectralis HRA+OCT, Heildeberg Engineering). Nei 34 campioni è stata effettuata la quantificazione delle proteine totali con metodo Bradford, di GFAP, AQP1 ed AQP4 con test ELISA e di 40 citochine infiammatorie con protein array. E’ stata, inoltre, effettuata la segmentazione degli strati retinici sulle scansioni SD-OCT. Risultati: I valori medi delle concentrazioni di GFAP, AQP1 e AQP4nell’umore acqueo sono risultati significativamente più elevati nei soggetti diabetici rispetto ai controlli sani (p<0.05). L’incremento di GFAP e’ stato di circa 0.8 volte, di AQP1 di 1.1 volte e di AQP4 di circa 24 volte nei soggetti diabetici rispetto ai controlli. Le concentrazioni di GFAP, AQP1 e AQP4 sono risultate significativamente ridotte nei soggetti diabetici con ME rispetto ai diabetici senza ME, (Tukey Kramer post hoc, p<0.05). La concentrazione nell’umore acqueo, è risultata significativamente maggiore nei pazienti diabetici (con e senza RD) rispetto ai soggetti sani per le seguenti citochine: GFAP, AQP1, AQP4, IFNy, IL-1a, IL-1b, IL-3, IL-4, IL-10, IL-11, IL-17, TNF- α, TNF-ß, MCP1, MCP2, Eotaxin, Eotaxin 2, RANTES, sTNFRII, GM-CSF, IP-10, MIP1a, MIP1b.Lo spessore maculare medio di RNFL è risultato significativamente maggiore nei pazienti diabetici con RD e ME rispetto ai diabetici senza ME (con e senza RD) ed ai soggetti sani; lo stesso rapporto è stato osservato negli anelli interno ed esterno e nei settori superiore, inferiore e temporale. Lo spessore maculare medio di RNFL è risultato significativamente ridotto nei diabetici con RD e senza ME rispetto ai soggetti sani. Conclusioni: Sono stati riconosciuti nell’umore acqueo di soggetti diabetici 23 diversi biomarkers proteici di attivazione gliale presenti sin dallo stadio subclinico della RD. Questi potranno essere utilizzati in futuro come marcatori di rischio per l’insorgenza di tale complicanza microvascolare e costituire degli utili bersagli terapeutici per la sua prevenzione e cura.
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KNÍŽOVÁ, Kateřina. "Informovanost veřejnosti o diabetu mellitu." Master's thesis, 2009. http://www.nusl.cz/ntk/nusl-51399.
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Diabetes mellitus belongs to diseases frequently occurring in childhood and adulthood. Insufficient knowledge of this disease and an unsatisfactory compensation for diabetes leads to development of late complications that have a negative impact on one's, as well as the family's, life and create an economic problem for society as a whole. The thesis focuses on the main characteristics of the disease, symptoms, diagnosis and treatment. Complications of the disease, including advice for patients themselves and their prevention are described in more detail. Social aspects (work inclusion of a diabetic, invalidity and reduced work capacity, driving of motor vehicles) are also emphasised. The research part containing 18 questions aims to find out to what extent the Czech public is informed about the problematic areas of this disease. It also assesses the feasibility of obtaining information from individuals of different ages and places of residence (city vs. village) regarding diabetes. These hypotheses were stated within the scope of the research: 1. Individuals older than 50 years of age are better informed about diabetes than individuals of a younger age. 1. Individuals living in a city have a better access to information concerning diabetes than individuals living in a village. The data was obtained from questionnaire research, in which respondents older than 18 years of age participated. The data collection took place in Bechyně Spa Ltd. 58 % of the resultant questionnaires were completed by women and 42 % by men.
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Schöppelová, Lucie. "Vliv pravidelné pohybové aktivity na dlouhodobou kompenzaci diabetu mellitu 1. typu." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-382865.
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Introduction: Physical activity should be part of our everyday life. However, for people with Type 1 Diabetes Mellitus it is the most common cause of hypoglycemia. To control diabetes in the right way, it is therefore necessary to follow certain rules and recommendations that help preventing hypoglycemia while the physical activity remains beneficial at the same time. Aim of the work: The main aim of this study is to clarify the influence of physical activity in connection to long-term control of Type 1 Diabetes Mellitus. Methods: 102 respondents with diagnosed Type 1 Diabetes Mellitus in the age of 19-69 years participated in a quantitative analysis. This research was conducted in a form of multicentric examination at two independent medical centers. The data collection was done through questionnaires focused on physical activity and daily regime. The data from questionnaires were then compared to the values of glycated hemoglobin (HbA1C), HDL cholesterol and the total daily dose of insulin of certain patients. For statistical evaluation, analytical tools of Microsoft Office program were used (F-test and t-test). Results: We found correlation between HbA1C values in patients physically active for less than 2 hours/week compared to those who are physically active for more than 2 hours/week (62,72...
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Lochmanová, Aneta. "Vliv diabetické diety při gestačním a pregestačním diabetu mellitu na stravovací návyky." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-387369.
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Introduction: Diploma thesis deals with issues of gestational a pregestational diabetes and the influence od diabetic diet during pregnancy on eating habits. Goals: The theoretical part is focused on general summary of diabetes during pregnancy - its characteristic, epidemiology, risk factors, complications, treatment including glycemic self- monitoring, observation during and after the childbirth. The last part is focused on education, as the important part of the therapy. The emphasis is put on the practical part, which analyse eating habits including measures regime of women dealing with gestational a pregestational diabetes, before and after the pregnancy. Crucial task was the comparison of choice of the food, frequency of monitored food and the regularity of eating. Methods: Research took place through the anomyous questionnaires, obtained on Gynecological-obstetrical clinic of General hospital in Prague. Questionnaires were filled out by woman diagnosed gestational and pregestational diabetes type 1. The discovered data are given into graphs and charts and part of the thesis is dedicated to the analysis of the data. Outcome: According to researched data we can say, that the eating habits before the pregnancy are not sufficient in any of the groups. Due to pregnancy and resulting diatetic...
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Paračková, Zuzana. "Dysregulácia imunitnej odpovede u diabetu mellitu 1. typu." Doctoral thesis, 2021. http://www.nusl.cz/ntk/nusl-438846.
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Type 1 diabetes (T1D) is an autoimmune disease with multifactorial aetiology that involves an attack of self-reactive cytotoxic CD8 lymphocytes on insulin-producing beta cells in the pancreas. In the T1D pathophysiology, both innate and adaptive immunity mechanisms cooperate in the development of inflammation leading to autoimmune destruction. Autoreactive T lymphocytes are the canonical destructors of the beta cells, and B cells produce autoantibodies; the innate immunity cells are considered the initiators of the pathological autoimmune reaction by promoting T and B cell activation. Here, we provide evidence of both innate and adaptive immunity cell types dysregulation in patients with T1D, and that these changes occur before the onset of the disease. The changes in T regulatory lymphocytes (Tregs) and B cell subpopulations occur already in asymptomatic T1D first-degree relatives. During the first year after the onset of the disease, there is a gradual decrease in the neutrophil numbers in the periphery, which probably infiltrate the pancreas. We have focused more closely on the innate immunity dysregulation and its contribution to T1D pathogenesis. Initially, we describe that neutrophil products called neutrophil extracellular traps (NETs) are able to induce IFNγ-producing T cells through...
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Zacharovová, Klára. "Diagnostický příspěvek k hodnocení intervenčních modelů léčby diabetu mellitu 1. typu." Doctoral thesis, 2012. http://www.nusl.cz/ntk/nusl-305984.
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During treatment of diabetes mellitus by immunointervention or transplantation, it is necessary to monitor the markers of immune destruction or rejection of surviving insulin producing cells. An aim of this thesis is to improve the possibilities of following autoimmunity and to detect the survival of transplanted pancreatic islet in vivo. Partial aims included vitality testing of isolated islets for transplantation by measurement of respiration activity, observing the process of in vitro labeling of isolated islets with superparamagnetic iron oxide (SPIO) contrast agent for subsequent magnetic resonance imaging (MRI) of islets and observing SPIO particles transport after transplantation. We also studied a new dual paramagnetic contrast agent combined with fluorescein intended for identification of the MRI contrast agent in samples for histology. Further, we assessed autoimmune reaction by evaluation of cytokine response to specific stimulation with auto-antigens. We tried to affect beta-cells destruction by polyclonal anti- thymocyte antibodies in a mouse experimental model. A new method of the islet respiration measurement correlated with other methods of islet quality testing and it was suggested as a diagnostic test before clinical transplantation. Results obtained studying the intercellular...