Dissertations / Theses: 'Glucose Tolerance Test'

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Bartnik, Małgorzata Zofia. "Glucose regulation and coronary artery disease : studies on prevalence, recognition and prognostic implications /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-401-5/.

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Tenerz, Åke. "Diabetes mellitus and related glucometabolic disturbances in acute myocardial infarction : diagnosis, prevalence and prognostic implications /." Uppsala : Acta Universitatis Upsaliensis Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3423.

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Helm, Jennifer. "Assessing glycaemic control in cystic fibrosis." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/assessing-glycaemic-control-in-cystic-fibrosis(44f8e211-ef09-468d-ad22-f393457eb51b).html.

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Four studies investigating the assessment of glycaemic control in cystic fibrosis are presented within this thesis. The first was a validation study of continual glucose monitoring (CGM) in cystic fibrosis (CF). 50 stable adults with CF underwent home CGM for 3 days, during which time they attended the CF centre for OGTT. Gold standard fasting (0 hour) plasma glucose and 2 hour plasma glucose values during OGTT were compared with concurrent CGM sensor glucose values using a 'limits of agreement' analysis. CGM was found to be valid in adults with CF, with its accuracy being consistent with that published in non-CF populations. The next investigation compared OGTT with CGM with several objectives: to determine whether OGTT is a relevant and adequate measure of glycaemia in CF, find out whether CGM could offer a superior alternative to OGTT and explore whether OGTT and CGM results are associated with prior change in lung function and weight in adults with CF. Data from the first study was used to show that the OGTT can only identify abnormal glycaemic control in CF at a late stage, and that CGM is a more relevant reflection of everyday glycaemia in CF. No correlation was found between prior change in lung function and nutritional status in CF and glycaemia measured by OGTT or CGM. The subsequent study investigated whether CGM could identify early abnormal glycaemic control in CF. This involved ten non-CF healthy controls undergoing the same study protocol as the 50 stable adults with CF, to determine 'normal' glycaemic control parameters. Of 25 CF patients with normal glucose tolerance by OGTT, 19 (76%) had significantly higher mean and/or variability of CGM levels than healthy controls. This lead to changes in their management, including 2 subjects being commenced on insulin therapy. The final investigation was a questionnaire study, asking the 50 CF patients to provide information on their experience of undergoing CGM. 58% of patients responded, with replies indicating that they found CGM broadly acceptable, interfering little in their lives and that their experiences were generally positive. This insight into patients' experiences of CGM can be used to guide future clinical and research roles for this tool. These studies have provided novel data regarding the assessment of glycaemic in CF. Information captured by CGM has greater relevance to CF patients' daily lives than OGTT. CGM can identify early problems with glycaemic control leading to changes in management that may not be detected by conventional measures. CGM offers potential in further clinical application and research to improve the lives and outcomes for adults with CF.

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Zezeski, Abigail Lee. "Utilization of early weaning and intrafollicular insemination as methods to improve the reproductive performance of cattle." Thesis, Virginia Tech, 2015. http://hdl.handle.net/10919/51235.

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Optimization of reproductive efficiency of both beef and dairy herds is critical for sustainability and profitability. Two separate experiments were performed to test the reproductive outcomes following early weaning of beef heifers and intrafollicular insemination in dairy cows. Early weaning is a proven way to induce precocious puberty in heifers. Heifers will experience more estrous cycles before breeding, which is associated with increased fertility. In this experiment, heifers were either subjected to early weaning and a high concentrate diet (EW; 106.5±3.4 days of age) or normal weaning (NW; 231.7±3.33 days of age) treatments. Despite no effect (P>0.15) of weaning treatment on age at puberty, EW heifers tended to have higher pregnancy rates than NW heifers. A progesterone clearance analysis revealed that EW heifers also have greater ability to metabolize progesterone. This altered progesterone metabolism could be a direct result of changes in metabolism caused by feeding a high concentrate diet after early weaning. Pregnancy rates in cattle are often lower than desired. New reproductive advances are constantly developed to improve reproductive function. A recently described possible technique is intrafollicular insemination (IFI). The objective of the second experiment was to investigate whether IFI can cause fertilization. Abattoir ovaries with dominant follicles injected with semen and incubated overnight displayed sperm in close association with granulosa cells. When synchronized cows were subjected to IFI, no pregnancies resulted. While other studies have demonstrated success with IFI, it is still unknown if fertilization is possible within the follicle of the ovary. Master of Science

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Ljunggren, Stefan, and Robert G. Hahn. "Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial." Linköpings universitet, Anestesiologi med intensivvård, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-84540.

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Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery. Funding Agencies|Olle Engkvist Byggmastare Foundation||Stockholm County Council|2009-0433|

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Briceño, Anny Dennis Huillca, and Nathalie Melissa Romani Varillas. "La multiparidad como factor de riesgo para Diabetes Mellitus Gestacional." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2016. http://hdl.handle.net/10757/621829.

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Objetivo: Determinar potenciales factores de riesgo para diabetes mellitus gestacional (DMG). Métodos: Estudio de casos y controles realizado en el Hospital Alberto Sabogal mediante recolección de historias clínicas del 2009 a 2014. Se define como caso las gestantes con diagnóstico de DMG mediante una prueba de tolerancia oral a la glucosa (PTOG), previa glucosa en ayunas anormal y control a la gestante sin valores indicativos de DMG. Las variables de interés fueron paridad, antecedente de cesáreas, abortos y recién nacido con mayor peso. Modelos de regresión logística fueron calculados para estimar odd ratios (OR) e intervalos de confianza al 95% (IC95%). Resultados: Se incluyeron 84 casos y 336 controles. En el modelo multivariado, la multiparidad incrementó el riesgo de DMG (OR= 3,54; IC95% 1,55 – 8,14). También, antecedente de abortos, a partir del segundo aborto (OR= 3,40, IC95% 1,55 – 7,44) y cesáreas previas (1 cesárea OR= 3,5 IC95% 1,89 – 6,47 y 2+ cesáreas OR=8,35 IC95% 3,50 – 19,95). La multiparidad, dos o más abortos y mayor número de cesáreas son factores de riesgo para DMG. Objectives: To identify risk factors for gestational diabetes mellitus (GDM). Methods: A case-control study was performed in Alberto Sabogal Hospital, collecting medical records from 2009 to 2014. A case was defined as a pregnant women diagnosed with GDM by an oral glucose tolerance test (OGTT) after an abnormal fasting glucose and control was defined as a pregnant women without GDM indicative values. The study outcome was GDM. The variables of interest were multiparity, previous cesarean section, abortions, newborn with the greatest weight. Logistic regression were used to calculate the odds ratio (OR) and a confidence interval of 95% (IC95%). Results: 84 cases and 336 controls were included. In the multivariate model, multiparity increased risk of GDM (OR= 3.54, 95% CI 1.55 to 8.14). As well history of abortions, from the second abortion (OR= 3.40, 95% CI 1.55 to 7.44) and previous cesarean section are also related (cesarean section 1 OR= 3.5 95% CI 1.89 to 6.47 and 2+ cesarean OR= 8.35 95% CI 3.50 to 19.95). Multiparity, two or more abortions, a biggest number of cesarean sections are GDM risk factors.

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Chen, Ting. "LKB1 Regulation of High-Fat Diet-induced Adaptation in Mouse Skeletal Muscle." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6682.

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Ad libitum high-fat diet (HFD)-induced obesity leads to insulin resistance in skeletal muscle, altered gene expression, and altered growth signaling, all of which contributes to pathological changes in metabolism. Liver kinase B1 (LKB1) is an important metabolism regulator. The purpose of this dissertation was to understand how knocking out LKB1 influences HFD induced adaptations in mouse skeletal muscle. To do so, control and skeletal muscle LKB1 knock-out (LKB1-KO) mice were put on either standard diet (STD) or HFD for 1 week or 14 weeks, or put on the HFD for 14 weeks and then switched to STD for 1 week (switched diet). The major differences in adaptation in the LKB1-KO mice include: 1) lower fasting blood glucose levels but impaired glucose tolerance compared to WT mice (although conflicting results are generated if the data is not normalized to fasting blood glucose levels), 2) altered expression of 16 HFD-induced genes, and 3) decreased muscle weight. The lower fasting blood glucose in LKB1-KO mice was likely due to elevated serum insulin levels, and the impaired glucose tolerance was associated with decreased phosphorylation of TBC1D1, an important regulator of insulin stimulated glucose uptake. 16 potential important target genes (metabolism, mitochondrial, cytoskeleton, cell cycle, cell-cell interactions, enzyme, ion channel) were identified in the context of HFD feeding and LKB1-KO. These genes were quantified by RT-PCR and grouped according to changes in their patterns of expression among the different groups. Among several other interesting changes in gene expression, the muscle growth-related protein, Ky was not affected by short-term HFD, but increased after long-term HFD, and did not decrease after switched diet, showing that its expression may be an important long-term adaptation to HFD. LKB1-KO promoted anabolic signaling through increasing t-eIF2α and eIF4E expression, and promoted protein degradation through increasing protein ubiquitination. Because the degradation is the main effect and lead to muscle weight decrease. The effect of HFD and/or LKB1-KO on the LKB1-AMPK system was also determined. The results showed that knocking-out LKB1 decreased AMPK activity, decreased nuclear distribution for AMPK α2 and increased AMPK α1 expression. Long-term HFD increased t-AMPK expression in LKB1-KO mice, decreased the cytoplasm p-AMPK and nuclear p/t-AMPK ratio in CON mice. Together the findings of this dissertation demonstrated HFD induced glucose/insulin tolerance, while LKB1-KO had a controversial effect on glucose/insulin sensitivity. Both HFD and LKB1-KO affect AMPK expression and cellular location, while LKB1-KO also affects AMPK activity. LKB1-KO promoted protein degradation through ubiquitination in skeletal muscle.

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Sapienza, Andréia David. "Fatores preditores do uso de insulina em pacientes com diabetes melito gestacional diagnosticado pelo teste de tolerância à glicose oral de 100 gramas." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-29042009-132253/.

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Objetivo: O objetivo desse estudo foi identificar a associação entre fatores clínicos e laboratoriais com o uso de insulina em gestantes com DMG no momento do diagnóstico e analisar os possíveis fatores preditores do uso de insulina. Método: Foram estudadas, de forma retrospectiva, 294 pacientes com diabetes melito gestacional (DMG) diagnosticado por meio do teste de tolerância à glicose oral de 100 gramas (TTGO-100g) entre 24 e 33 semanas completas de gestação, cujo seguimento pré-natal foi realizado ambulatorialmente pelo setor de Endocrinopatias e Gestação da Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de 1 de julho de 2002 a 30 de junho de 2008. Os seguintes fatores clínicos e laboratoriais, que pudessem estar associados ao uso de insulina para controle glicêmico, foram analisados: idade materna, obesidade pré-gestacional - índice de massa corpórea (IMC) > 30 Kg/m2, antecedente familiar de diabetes melito (DM), tabagismo, hipertensão arterial, uso de corticosteróides sistêmicos, antecedente obstétrico de DMG e de macrossomia fetal, nuliparidade, multiparidade, antecedente obstétricos de natimortos e neomortos, idade gestacional no momento do diagnóstico, gemelidade, índice de líquido amniótico (ILA) aumentado ILA > 18 cm, polidrâmnio (ILA > 25 cm), número de valores anormais do TTGO-100g, glicemia de jejum anormal no TTGO- 100g glicemia de jejum > 95 mg/dL; média das quatro glicemias aferidas no TTGO-100g; valor da glicemia de jejum, de 1ª, 2ª e 3ª horas do TTGO-100g e hemoglobina glicada (HbA1c). A associação entre cada fator e a necessidade de insulinoterapia foi analisada individualmente (2 de Pearson / teste exato de Fisher e teste t de Student). O modelo de regressão logística para a análise multivariada foi usado para predizer a probabilidade desses fatores em relação ao uso de insulina. Resultados: Das 294 pacientes avaliadas, 39,8% (117/294) necessitaram de insulinoterapia para controle glicêmico. Observou-se correlação positiva entre o uso de insulina e obesidade pré-gestacional, antecedente familiar de DM, hipertensão arterial, antecedente obstétrico de DMG e de macrossomia fetal, número de valores anormais no TTGO-100g, glicemia de jejum > 95 mg/dL no TTGO-100g; média das quatro glicemias aferidas no TTGO-100g; valor da glicemia de jejum, de 1ª, 2ª e 3ª horas do TTGO-100g e HbA1c pela análise univariada (P<0,05). Na análise do modelo de regressão logística foram desenvolvidos dois modelos que incluíam os seguintes fatores preditores do uso de insulina: obesidade pré-gestacional, antecedente familiar de DM, número de valores anormais no TTGO-100g (só modelo 1) e valor da glicemia de jejum do TTGO-100g (só modelo 2). Os dois primeiros modelos foram novamente analisados, incluindo-se a variável HbA1c para verificação de sua contribuição na predição do uso de insulina. Curvas de probabilidade e escores foram construídos com base nas quatro combinações de fatores preditores. Conclusões: É possível estimar a probabilidade do uso de insulinoterapia para controle glicêmico em gestantes com DMG por meio de IMC pré-gestacional, antecedente familiar de DM, número de valores anormais do TTGO-100g, valor da glicemia de jejum no TTGO-100g e da HbA1c. Objective: To determine the association between clinical and laboratory parameters and insulin requirement in pregnancies complicated by gestational diabetes mellitus (GDM), and to evaluate possible factors predicting the need for insulin therapy. Methods: A total of 294 patients with GDM diagnosed by the 100- g/3-h oral glucose tolerance test (OGTT) between 24 and 33 complete weeks of gestation were retrospectively studied. These patients were under prenatal follow-up at the Obstetric Clinic of the University of Sao Paulo School of Medicine (HCFMUSP) between July 1, 2002 and June 30, 2008. The clinical and laboratory factors which could be associated to the need for insulin therapy were analyzed: maternal age, prepregnancy obesity body mass index (BMI) > 30 Kg/m2, family history of diabetes mellitus (DM), smoking, hypertension, use of systemic corticosteroids, prior GDM, prior fetal macrosomia, nulliparity, multiparity, prior stillbirth, prior neonatal death, gestational age at diagnosis of GDM, multiple pregnancy, elevated amniotic fluid index (AFI) AFI > 18 cm, polyhydramnios (AFI > 25 cm), number of abnormal 100-g/3-h OGTT values, 100-g/3-h OGTT fasting plasma glucose > 95 mg/dL, mean of the four 100-g/3-h OGTT values, 100-g/3-h OGTT fasting/one/two/three plasma glucose values, and glycated hemoglobin (HbA1c). The association between each factor and the need for insulin therapy was then analyzed individually (Pearsons chi-square/Fishers exact or Student t test). The performance of these factors to predict the probability of insulin therapy was estimated using a logistic regression model. Results: Among the 294 patients studied, 39.8% (117/294) required insulin for glycemic control. Univariate analysis showed a positive correlation between insulin therapy and prepregnancy obesity, family history of diabetes, hypertension, prior GDM, prior fetal macrosomia, number of abnormal 100-g/3-h OGTT values, 100-g/3-h OGTT fasting plasma glucose > 95 mg/dL, mean of the four 100-g/3-h OGTT values, 100-g/3-h OGTT fasting/one/two/three plasma glucose values, and HbA1c (P < 0.05). Two logistic regression models were developed and included the following parameters: prepregnancy obesity, family history of diabetes, number of abnormal 100-g/3-h OGTT values (just model 1) and 100-g/3-h OGTT fasting plasma glucose (just model 2). The two first models were analysed another time including the variable HbA1c to verify its contribution on prediction of the need for insulin therapy. Probability curves and scores were constructed based on the four combinations of predictive factors. Conclusions: The probability of insulin therapy can be estimated in pregnant women with GDM based on prepregnancy obesity, family history of diabetes, number of abnormal 100-g/3-h OGTT values, 100-g/3-h OGTT fasting plasma glucose, and HbA1c concentration.

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Heath, Ashleigh E. "Comparison of Screening Methods for Pre-diabetes and Type 2 Diabetes Mellitus by Race/Ethnicity and Gender." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/iph_theses/202.

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INTRODUCTION/OBJECTIVES: Current screening guidelines for pre-diabetes and type 2 diabetes mellitus note that there are discrepancies in diagnosing the disease using the fasting plasma glucose test, oral glucose tolerance test, and HbA1c in high-risk populations. The objective of this study is to compare the effectiveness of screening methods for type 2 diabetes mellitus (T2DM) and pre-diabetes by race/ethnicity and gender. METHODS: Secondary analyses of the National Health and Nutrition Examination Survey (NHANES, 2005-2008) were performed using SPSS 19.0. Screening outcomes were assessed and compared for a sample of n=10,566, NHW, NHB, MA, and Multiracial/other men and women. Analyses included cross tabulations, ANOVA and partial correlations to establish disease prevalence, effectiveness of screenings, and statistical significance. RESULTS: It was found that the HbA1c test is comparable in precision, and is correlated with the FPG for racial and ethnic minorities. The specificities for detecting pre-diabetes using the HbA1c were higher (64-66%) for these groups than by using the standard, FPG screening method (42-49%). There were no strong, significant differences for screening effectiveness for men versus women. DISCUSSION: This study revealed that the HbA1c test might be an effective method for screening for pre-diabetes in racial and ethnic minorities instead of the FPG test alone. Screening in high-risk populations will help delay the onset of T2DM, with increased prevention during the pre-clinical phase.

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Pinto, Denise Entrudo. "Efeito da suplementação isocalórica de sacarina e sacarose no ganho de peso, ingestão calórica, tolerância à glicose e consumo basal de oxigênio em ratos Wistar." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/116773.

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Introdução: O uso de adoçantes não calóricos (ANC) pode interferir na regulação do apetite, promovendo maior ingestão alimentar, maior ganho de peso (GP) e maior adiposidade. Em estudos anteriores, do nosso grupo, os resultados mostraram que os animais que consumiram iogurte com sacarina e aspartame tiveram um maior ganho de peso comparado ao grupo que usou sacarose. Porém, como o consumo calórico total foi semelhante entre os grupos, o aumento de peso não pôde ser explicado pelo aumento de ingestão calórica. Concluímos, então, que o aumento de peso poderia estar associado à redução do gasto energético induzido pelo adoçante artificial. Estudos anteriores já sugeriram que a sacarina poderia induzir um aumento de peso, porém nenhum estudo até o momento avaliou o consumo de oxigênio basal dos animais. Nesse sentido, é possível que a sacarina possa estar determinando a redução do gasto energético e possivelmente contribuindo para um aumento na glicemia. Desse modo, o presente estudo contempla analisar o efeito da sacarina no consumo basal de oxigênio. Materiais e Métodos: Foi realizado um experimento controlado com 37 ratos Wistar machos adultos pesando entre 180 e 220 g, que foram divididos aleatoriamente em três grupos de acordo com o tipo de exposição tanto para adoçante não calórico (sacarina-SAC), adoçante calórico (sacarose-SUC) ou controle (CONT). Os suplementos foram oferecidos diariamente durante um período de 12 semanas. O ganho de peso, ingestão calórica e controle hídrico foram determinados semanalmente, o consumo basal de oxigênio determinado em repouso (VO2) e RER foram medidos no início do estudo, 5 e 12 semanas, e o teste de tolerância à glicose oral foi determinada nas semanas 6 e 12. Resultados: O uso de sacarina promoveu maior ganho de peso que a sacarose (p=0,031). A ingestão calórica total (kcal/g) diferiu entre os grupos (p=0,029). Os animais que consumiram sacarina ingeriram mais ração. Os grupos apresentaram diferenças quanto à ingestão hídrica, sendo o grupo sacarina com o maior consumo (ml/g) (p=0,018). Entretanto, o consumo de oxigênio e o quociente respiratório não foram significativos. Conclusão: O ganho de peso cumulativo nos animais que consumiram sacarina não pode ser atribuído a uma redução no dispêndio de energia, medida pelo consumo de oxigênio, mas sim pelo aumento da ingestão alimentar e hídrica. Introduction: The use of non-caloric sweeteners (ANC) can interfere with the regulation of appetite, promoting greater food intake, greater weight gain (WG) and increased adiposity. In previous data, the results showed that the animals that consumed yogurt saccharin and aspartame had a greater increase in weight compared to the group using sucrose. However, as the total calorie intake was similar between the groups, the weight increase could not be explained by the increase in caloric intake. We concluded that weight gain may be associated with decreased energy expenditure induced by artificial sweetener. Previous studies have suggested that saccharin could induce weight gain, but no study to date has evaluated the consumption of oxygen basal animals. In this sense, it is possible that saccharin may be determining reduction in energy expenditure and possibly contributing to an increase in blood glucose. Thus, this study include saccharin analyze the effect on basal oxygen consumption. Materials and Methods: We conducted a controlled experiment with 37 adult male Wistar rats weighing 180-220 g were randomly divided into three groups according to the type of exposure for both non-caloric sweetener (sugar-SAC), calorie sweetener (sucrose-SUC) or control (CONT). The supplements were given daily over a period of 12 weeks. Weight gain, food intake and water control were determined weekly, basal oxygen consumption determined at rest (VO2) and RER were measured at baseline, 5 and 12 weeks and tolerance test oral glucose was determined at week 6 and 12. Results: The use of saccharin promoted greater weight gain than sucrose (p =0.031). The total caloric intake (kcal/g) differ between the groups (p = 0.029), the animals that consumed saccharin ate more food. The groups differed in water intake, and the sugar group with the highest consumption (ml/g) (p = 0.018). However, the oxygen consumption and the respiratory exchange ratio were not significant. Conclusion: The cumulative weight gain in the animals fed saccharin can not be attributed to a reduction in energy expenditure, measured by oxygen consumption, but can be explained by increased food and water intake.

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Firouzi, Shelby Anne. "Sagittal Abdominal Diameter, Waist Circumference, and BMI as Predictors of Multiple Measures of Glucose Metabolism: An NHANES Investigation of U.S. Adults." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6902.

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OBJECTIVE: The key objective of the present investigation was to compare associations between sagittal abdominal diameter (SAD), waist circumference, and BMI to the oral glucose tolerance test (OGTT), along with fasting glucose, HbA1c, and HOMA-IR, in a nationally representative sample of U.S. adults. The study also analyzed the effect of multiple covariates on the anthropometric and glucose metabolism associations. METHODS: A cross-sectional design, including 3,582 subjects, was used. SAD was assessed using an abdominal caliper. All other data were collected following strict NHANES protocol. The OGTT was the primary variable used to index glucose metabolism. Fasting glucose, HbA1c, and HOMA-IR were also evaluated. RESULTS: Mean ± SE values were as follows: SAD: 22.3 ± 0.1 cm; waist circumference: 98.0 ± 0.4 cm; BMI: 28.6 ± 0.2 kg/m2; OGTT: 113.9 ± 1.0 mg/dL; fasting glucose: 99.6 ± 0.3 mg/dL; HbA1c: 5.4 ± 0.01%; HOMA-IR: 3.2 ± 0.1. SAD consistently emerged as the best predictor of all the indices of glucose metabolism, before and after adjusting for the covariates, and with the sample stratified by gender, race, or age. SAD was not a better predictor of OGTT among normal weight adults and non-Hispanic black adults. CONCLUSION: Obesity, especially abdominal obesity, is strongly related to glucose metabolism and type 2 diabetes. In the present study, SAD was the best anthropometric predictor of glucose metabolism, notwithstanding the high correlations among SAD, waist circumference, and BMI. Due to the ease of taking a SAD measurement, we recommend that healthcare providers consider the use of this simple and inexpensive method to more precisely predict diabetes risk, especially among overweight and obese adults.

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Helminen, O. (Olli). "Glucose metabolism in preclinical type 1 diabetes." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526213255.

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Abstract Type 1 diabetes is considered to be a T cell-mediated autoimmune disease characterized by destruction of the pancreatic beta cells. Its prediction is currently based on diabetes-associated autoantibodies, giving a cumulative risk of 84% during 15 years of follow-up since seroconversion. Prediction of the timing of clinical onset has remained challenging, however. This thesis examines glucose metabolism in autoantibody-positive children with a high risk of developing type 1 diabetes. Out of a total of 14,876 children with an increased genetic risk followed up from birth in the Finnish DIPP study, 567 developed ≥2 autoantibodies during the follow-up and 255 of these (45%) were diagnosed with type 1 diabetes until the end of December 2011. The glucose parameters measured were HbA1c, OGTT and random plasma glucose with 3 to 12 months interval. Seven-day continuous glucose monitoring (CGM) was performed on an age and sex-matched cohort. We showed that rising HbA1c, impaired glucose tolerance in OGTT, random plasma glucose values of ≥7.8mmol/l and potentially CGM can predict type 1 diabetes with a median time to diagnosis of approximately one year. Our results suggest that especially HbA1c and random plasma glucose are cost-effective and improve the prediction of diabetes. These markers may be useful for monitoring the response to treatment in prevention studies Tiivistelmä Tyypin 1 diabetesta pidetään T-soluvälitteisenä autoimmuunitautina, joka johtaa haiman beetasolujen tuhoutumiseen. Tyypin 1 diabeteksen ennustaminen perustuu tällä hetkellä diabetekseen assosioituviin vasta-aineisiin, jotka antavat 84% kumulatiivisen riskin 15 vuoden seurannassa. Taudin puhkeamisen ajankohdan ennustaminen on kuitenkin edelleen vaikeaa. Tämä väitöskirja käsittelee glukoosiaineenvaihduntaa vasta-ainepositiivisilla lapsilla, joilla on suurentunut riski sairastua tyypin 1 diabetekseen. Suomalaisessa DIPP-tutkimuksessa vasta-aineiden kehittymistä on seurattu yhteensä 14876 lapselta. Seurannan aikana 567 lasta kehitti ≥2 autovasta-ainetta ja näistä 255 (45%) sairastui tyypin 1 diabetekseen joulukuun loppuun 2011 mennessä. Glukoosiaineenvaihduntaa seurattiin tutkimalla HbA1c, OGTT ja satunnaisia verensokeriarvoja 3-12 kuukauden välein. Ikä ja sukupuolivakioidussa kohortissa tehtiin jatkuvan sokeripitoisuuden seuranta (CGM). Tutkimuksessamme nouseva HbA1c, heikentynyt sokerin sieto OGTT-kokeessa, satunnainen verensokeri ≥7.8 mmol/l ja mahdollisesti CGM ennustavat tyypin 1 diabeteksen puhkeamista. Tulostemme perusteella erityisesti kustannustehokkaat HbA1c ja satunnainen verensokeri parantavat diabeteksen ennustamista. Nämä parametrit saattavat olla hyödyllisiä myös preventiotutkimuksissa hoitovasteen seurannassa

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Nascimento, Priscilla Marques do. "Impacto da administração das vitaminas D e E na sensibilidade insulínica, metabolismo oxidativo e aspectos da imunidade em ovelhas no período periparto." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/10/10136/tde-31072018-142817/.

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Trinta ovelhas, mestiças (Santa Inês X Dorper), adultas e hígidas foram selecionadas para avaliar o efeito da suplementação intramuscular com as vitaminas D e E no perfil bioquímico, metabolismo energético, metabolismo oxidativo, sensibilidade insulínica e imunidade no periparto. Após confirmação da gestação essas fêmeas foram distribuídas em três grupos de dez animais e no 108° dia de gestação receberam veículo oleoso (grupo controle-GC); ou 70.000 UI/kg de P.V. de vitamina D3 (colecalciferol) (grupo tratado-GD); ou 60UI/kg de P.V. de vitamina E (-tocoferol) (grupo tratado-GE). As amostras de sangue foram coletadas previamente à aplicação da vitamina (-45), quatro (-30); e duas semanas (-15) antes do parto; até duas horas do parto (0), uma (7); duas (15); e quatro semanas após o parto (30). Foram analisadas as concentrações plasmáticas de glicose, beta hidroxibutirato (BHB), ácidos graxos não esterificados (AGNEs) e as concentrações séricas de colesterol, triglicérides, ureia, creatinina, cálcio total, cálcio iônico, proteína total, ácido úrico, aspartato amino transferase (AST), gamaglutamil transferase (GGT), e ainda a creatina quinase (CK). Foram também analisadas as concentrações de insulina e cortisol. Do metabolismo oxidativo foram determinadas as atividades da superóxido dismutase (SOD) e glutationa peroxidase (GSH-Px), a habilidade de redução férrica plasmática (HRFP), substâncias reativas ao ácido tiobarbitúrico (TBARS), bem como o status antioxidante total (TAS). Para avaliar aspectos relacionados à imunidade de monócitos e neutrófilos, por método in vitro, em 24 ovelhas (seis de cada tratamento). As amostras de sangue foram coletadas nos momentos 30; 0; e 30 e avaliadas sem estímulo (burst basal) e com estímulo por DCFH-DA, SaPI e PMA. A imunofenotipagem com anticorpos monoclonais CD8, CD4, CD14, CD16, CD45R, WC1, CD206, foi realizada aos dias -30, -15,0,7 e 30. Foram determinadas as concentrações das vitaminas D e E, nos momentos pré-determinados das coletas e no dia do teste de tolerância à glicose (TTG), realizado para avaliar a sensibilidade insulínica, e foi calculado RQUICKI e RQUICKI BHB. Todas as variáveis estudadas apresentaram efeito de tempo. Houve interação tempo*tratamento em TBARS (P=0,0217) e tendência para vitamina E (0,0811), SOD (0,0886) e GSH-Px (P=0,0643). Houve efeito de tratamento no colesterol (P=0,0088) e vitamina D (P<0,0001) e tendência para TAS (P=0,0830). No TTG, com resultados de AUC de BHB e AGNE apresentaram efeito de número de fetos gestados (P=0,0006 e 0,0005 respectivamente) e o RQUICKIBHB mostrou-se melhor indicador de sensibilidade insulínica do que o RQUICKI em ovelhas. A suplementação com vitamina D influenciou os teores plasmáticos de alfa tocoferol e a resposta imune das ovelhas. A suplementação com vitamina E reduziu a peroxidação lipídica no parto e relacionou-se positivamente com a melhora oxidativa dos monócitos sem estímulo e estimulados por PMA. Thirty healthy adult ewes were selected to evaluate the effect of supplementation with intramuscular vitamins D and E in peripartum period on the biochemical profile, energetic metabolism, oxidative metabolism, insulin sensitivity and immunity. After pregnancy confirmation these females were distributed into three groups of ten animals treated with intramuscular injection containing oily vehicle (control-to-control group) on the 108th day of pregnancy, (CG); or 70,000 IU / kg of body weight of vitamin D3 (cholecalciferol) (treated group-GD); or 60 IU / kg of body weight of vitamin E (-tocopherol) (treated group-GE). Blood samples were collected before the application of the vitamins and vehicle (-45), four (-30); and two weeks (-15) before lambing; until 2 hours of lambing (0); one (7), two (15) and four weeks postpartum (30). Plasma concentrations of glucose, beta hydroxybutyrate (BHB), non-esterified fatty acids (NEFA) and serum concentrations of cholesterol, triglycerides, urea, creatinine, total calcium, ionic calcium, total protein, uric acid, aspartate amino transferase (AST), gammaglutamyl transferase (GGT), and creatine kinase (CK) were measured. The concentrations of insulin and cortisol, the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), plasma ferric reduction ability (FRAP), thiobarbituric acid reactive substances (TBARS), as well as total antioxidant status (TAS) were determinate. Monocytes and neutrophils were assessed by in vitro method to identify aspects related to immunity in 24 ewes (six from each treatment) at -30, 0 and 30. Blood samples were evaluated without stimulus (basal burst), with DCFH-DA, SaPI and PMA stimulus. Immunophenotyping with monoclonal antibodies CD8, CD4, CD14, CD16, CD45R, WC1, CD206 were performed at -30, -15, 0, 7 and 30. The concentrations of vitamins D and E were determinate at the predetermined collection times and on the day of the Intravenous Glucose Tolerance Test (IVGTT), realized to evaluate the insulin sensitivity, as well as RQUICKI and RQUICKI BHB. All variables studied showed time effects. There were interaction time * treatment in TBARS (P = 0.0217) and tendency for vitamin E (0.0811), SOD (0.0886) and GSH-Px 16 (P = 0.0643). Treatment effect on cholesterol (P = 0.0088) and vitamin D (P <0.0001) and tendency for TAS (P = 0.0830) were observed. About of IVGTT, AUC results of BHB and AGNE showed number of fetuses effect (P = 0.0006 and 0.0005 respectively). RQUICKIBHB was a better indicator of insulin sensitivity than RQUICKI in ewes. Vitamin D supplementation influenced the plasma levels of alpha tocopherol and the immune response of ewes. Vitamin E supplementation reduced lipid peroxidation at parturition and was positively related to the oxidative improvement of the monocytes without stimulation and stimulated by PMA. High doses of vitamins D or E administered 45 days before parturition on healthy ewes can be beneficial; however more studies are needed about this topic.

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20

Tenerz, Åke. "Diabetes mellitus and related glucometabolic disturbances in acute myocardial infarction : Diagnosis, prevalence and prognostic implications." Doctoral thesis, Uppsala University, Department of Medical Sciences, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3423.

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In patients with diabetes mellitus (DM), acute myocardial infarction (AMI) is a major cause of death. We have studied two populations with respect to the relationship between DM or related glucometabolic disturbances and AMI.In the first population, the prevalence of DM and the importance of the glycaemic state for the long-term prognosis in non-diabetic patients were investigated in patients with AMI admitted to the Coronary Care Unite at Västerås Central Hospital.In the second population, the prevalence of impaired glucose tolerance (IGT), DM and other metabolic abnormalities was investigated in patients with AMI and without known DM admitted to the Coronary Care Units at Västerås and Karolinska Hospital, Stockholm.21% of the patients with AMI had previously known DM and 4% had newly detected DM if diagnosis is based upon fasting blood glucose (F-BG). The glycemic state, measured as HbA1c, at a 5.5 years follow-up was a risk factor for re-infarction and/or death in non-diabetic patients after AMI.If an oral glucose tolerance test (OGTT) is performed, 40-45% of all patients with AMI have DM and in addition about 30% have IGT. Both an OGTT and a single post-challenge blood glucose value after 60 minutes performed at hospital discharge, were independent predictors of IGT or DM at follow-up. Insulin resistance, measured by homeostatic model assessment (HOMA-IR), decreased during hospital stay, with no further decrease from hospital discharge to follow-up.In summary, the studies in this dissertation have revealed an unexpectedly high prevalence of abnormal glucose tolerance in patients with AMI. The glycaemic state, reflected by HbA1c, in non-diabetic patients after AMI has an impact on the long-term prognosis. Consequently, in all patients with AMI, HbA1c and casual blood glucose should be measured at admission and, at least, F-BG at hospital discharge.

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Mingoti, Rodolfo Daniel. "Qualidade oocitária e embrionária e perfil hormonal e metabólico de vacas repetidoras de serviço submetidas à secagem e indução de lactação." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/10/10131/tde-29112018-114206/.

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A hipótese do presente estudo sugere que a baixa fertilidade de vacas Holandesas (Bos taurus) repetidoras de serviço (RS) está relacionada à baixa qualidade oocitária que, por sua vez, é associada ao quadro de resistência periférica a insulina (RPI). Ainda, a indução de lactação (IL) em vacas Holandesas (Bos taurus) RS pode reverter o quadro de RPI e, consequentemente, melhorar a qualidade oocitária e a produção in vitro de embriões (PIVE). Para testar a hipótese proposta, este estudo objetivou avaliar o efeito da fase da lactação e da gestação [Exp. 1], o efeito da secagem de RS [Exp. 2] e o efeito da IL [Exp. 3] sobre a RPI, a qualidade oocitária e a PIVE em vacas da raça Holandesa (Bos taurus). Nos três estudos foram realizados testes de tolerância à glicose (TTG) para avaliar a RPI através do perfil hormonal sérico de insulina e glicose. Além disso, avaliou-se o perfil bioquímico sérico e folicular e a qualidade oocitária através da PIVE. Verificou-se que, em resposta à infusão de 0,3mg glicose/kg PV, as vacas RS no final da lactação secretaram 53% mais insulina e captaram 40% menos de glicose quando comparadas as vacas no terço inicial de lactação (Exp 1). Esses achados são indicativos do estabelecimento do quadro de RPI nas vacas RS em lactação. Durante o período seco, as vacas RS secretaram 96% mais insulina e captaram 56% menos glicose que as vacas no terço inicial da lactação e as vacas RS em lactação, respectivamente (Exp. 2). Ainda, as vacas com lactação induzida secretaram 11% menos insulina e captaram a mesma quantidade de glicose que vacas paridas em fases semelhantes de lactação (Exp 3), demonstrando que o protocolo de IL foi eficiente em alterar o perfil metabólico, revertendo o quadro de RPI presente nas vacas RS. Nos Exp. 1, 2 e 3 foram verificadas maiores concentrações plasmática de triglicérides (TG; P < 0,05), colesterol total (COL; P < 0,05) e LDL (P < 0,05) no soro sanguíneo em vacas RS quando comparadas com vacas no terço inicial de lactação. Durante o período seco (Exp. 2 e 3), observou-se incremento desses metabólitos, destacando aumento na concentração de TG (P < 0,05), COL (P < 0,05) e LDL (P < 0,05) plasmático em vacas secas quando comparadas as vacas em lactação [início e final (RS) da lactação]. No liquido folicular foram observadas variações no perfil bioquímico para COL e TG. Nos Exp. 1, 2 e 3, verificou-se que vacas RS possuem maior concentração de TG (P < 0,05) e COL (P < 0,05) no fluido folicular do que vacas no terço inicial de lactação. Contrariando a hipótese inicialmente proposta, as vacas RS em lactação e as vacas secas apresentaram maior taxa de blastocisto (P < 0,05) e número de blastocistos por OPU (P < 0,05) que as vacas no terço inicial de lactação (Exp. 1, 2 e 3). Através do perfil de insulina circulante em resposta ao TTG foi possível demonstrar o estabelecimento do quadro de RPI em vacas RS (P < 0,05). Além disso, constatou-se agravamento da RPI em vacas secas (P < 0,05). Esse quadro foi associado ao aumento do escore de condição corporal (P < 0,05) e do peso vivo (kg; P < 0,05) nas vacas RS. Em conclusão, não foi verificada associação negativa entre RPI, qualidade oocitária e PIVE em vacas Holandesas (Bos taurus) RS. Apesar da indução de lactação em vacas Holandesas (Bos taurus) RS alterar o metabolismo e diminuir o quadro de RPI, não foi verificado efetivo positivo na qualidade oocitária e na PIVE. The hypothesis of the present study suggests that low fertility of repeat breeders (RB) Holstein (Bos taurus) cows is related to low oocyte quality, which is associated with peripheral insulin resistance (PIR). Also, induction of lactation (IL) in RB Holstein (Bos taurus) cows can revert PIR and, consequently, improve oocyte quality and in vitro embryo production (IVEP). In order to test the proposed hypothesis, the objective of this study was to evaluate the effect of phase of lactation and gestation [Exp. 1], effect of drying RB [Exp. 2] and effect of IL [Exp. 3] on PIR, oocyte quality and IVEP of Holstein (Bos taurus) cows. In all three studies, glucose tolerance tests (GTT) were performed to evaluate PIR through the serum hormonal insulin and glucose profile. In addition, we evaluated the serum and follicular biochemical profile and oocyte quality through IVEP. It was verified that, in response to a 0.3mg glucose/kg of body weight (BW), RB cows at the end of lactation secreted 53% more insulin and captured 40% less glucose when compared to cows in the initial third of their lactation (Exp. 1). These findings are indicative of the establishment of PIR in RB lactating cows. During the dry period, RB cows secreted 96% more insulin and captured 56% less glucose than cows in the initial third of their lactation and RB lactating cows, respectively (Exp. 2). Also, cows with induced lactation secreted 11% less insulin and captured the same amount of glucose than calved cows in similar lactation phase (Exp. 3), demonstrating that the IL protocol was efficient to alter the metabolic profile, reverting PIR present in RB cows. In Exp. 1, 2 and 3 higher plasmatic concentrations of triglycerides (TG; P<0.05), total cholesterol (COL; P<0.05) and LDL (P<0.05) were verified in the blood serum in RB cows when compared to cows in the initial third of their lactation. During the dry period (Exp. 2 and 3), we observed the increment of these metabolites, and a notable elevation of the plasmatic TG (P < 0.05), COL (P < 0.05) and LDL (P < 0.05) in dry cows when compared to lactating cows [beginning and end (RB) of lactation]. In the follicular fluid, it was possible to observe variations in the biochemical profile for COL and TG. In Exp. 1, 2 and 3, it was verified that RB cows have higher concentration of TG (P < 0.05) and COL (P < 0.05) in the follicular fluid than cows in the initial third of their lactation. Contrary to the initially proposed hypothesis, RB lactating cows and dry cows presented higher blastocyst rate (P<0.05) than cows in the initial third of lactation (Exp. 1, 2 and 3). Through the circulating insulin profile in response to the GTT it was possible to demonstrate the establishment of PIR in RB cows (P<0.05). Also, it was observed worsening of the PIR in dry cows (P<0.05). This condition was associated with an increase in body condition score (P<0.05) and BW (kg; P<0.05) in RB cows. In conclusion, no negative association between PIR, oocyte quality and IVEP was observed in RB Holstein (Bos taurus) cows. Although induction of lactation in RB Holstein (Bos taurus) cows altered the metabolism and reduced PIR, no positive effect was observed in oocyte quality and IVEP.

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Pirkola, J. (Jatta). "Gestational diabetes:long-term, metabolic consequences for the mother and child." Doctoral thesis, University of Oulu, 2010. http://urn.fi/urn:isbn:9789514261701.

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Abstract Gestational diabetes (GDM) indicates increased risk for diabetes and the metabolic syndrome in women. Research on prenatal exposure to GDM as a risk factor for metabolic diseases is conflicting. Overweight (body mass index ≥ 25 kg/m2) is a strong risk factor for GDM and metabolic diseases; however, there are few published previous studies distinguishing the separate effects of overweight and GDM on the later risk for metabolic diseases in women and their children. The present study evaluated pre-pregnancy overweight and GDM as determinants of long-term risk for diabetes and hypertension in women, and the metabolic consequences of prenatal exposures to maternal pre-pregnancy overweight and different types of maternal diabetes in children. The results are based on prospective, clinical data from Oulu University Hospital (n = 63 mothers and their children), and the Northern Finland Birth Cohort 1986 (NFBC 1986, n = 9,362 mothers and their 9,479 children). Compared to normal-weight mothers with normal glucose tolerance in pregnancy, the NFBC 1986 mothers with simultaneous pre-pregnancy overweight and GDM had strikingly high risks for developing diabetes (hazard ratio, HR 47.2; 95% confidence interval 25.5–87.4) and hypertension (HR 9.2 [6.1–13.9]) twenty years after delivery. The risks for these diseases were elevated in mothers with pre-pregnancy overweight even when they had normal glucose tolerance during pregnancy (HR diabetes 12.6 [7.4–21.6], HR hypertension 2.9 [2.1–3.9]). GDM per se indicated increased risk only for diabetes (HR 10.6 [4.2–27.0]). In the cohort from Oulu University Hospital, increased fasting insulin concentration (P = 0.04), first phase insulin response (P = 0.03), and HOMA-B (P = 0.008) were already observed at pre-school age in the offspring of mothers with Type 1 diabetes compared with offspring of mothers with GDM. In the NFBC 1986 offspring, the prevalence of metabolic syndrome was 2.4% at age 16 years, using the International Diabetes Federation pediatric definition. Abdominal obesity, a waist girth over half one’s length, defined approximately 85% of the adolescents with metabolic syndrome. The risks for overweight and abdominal obesity were high in those with prenatal exposure to both maternal pre-pregnancy overweight and GDM (odds ratio for overweight 4.1 [1.9–8.6], for abdominal obesity 3.8 [1.7–8.8]). In children of normal-weight women, prenatal exposure to GDM was not associated with increased risk of these outcomes. Based on this study, preventing and reducing overweight in fertile age seems to be a key target for preventing metabolic diseases in women and their children.

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Oliveira, Louise Helen de. "Associação da insulina circulante com a função ovariana e qualidade oocitária em vacas holandesas." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/11/11139/tde-03022016-153026/.

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O objetivo do primeiro estudo foi avaliar a produção in vitro de embriões (PIVE) em vacas holandesas não lactantes submetidas a aspiração oocitária (OPU) posteriormente ao protocolo de superestimulação folicular similar ao descrito por Nivet et al. (2012) em comparação à realização da OPU em dia aleatório do ciclo estral. Para tal, vacas holandesas não lactantes e não gestantes foram distribuídas aleatoriamente em delineamento tipo crossover em Controle (n = 35), em que as vacas não foram tratadas com FSH, mas submetidas a uma sessão de aspiração em dia aleatório do ciclo estral; ou p-FSH (n = 35), em que, 36 horas após a OPU para sincronização da onda folicular, as vacas foram tratadas com p-FSH por 3 dias e 44 horas após, submetidas a sessões de OPU. O número total de complexos cumulusoócito (CCO) recuperados e o número de oócitos viáveis foram semelhantes entre os grupos controle e p-FSH. Além disso, não houve aumento na proporção de CCO viáveis (CCO viáveis / CCO total recuperado). Da mesma forma, não se detectaram diferenças no número de embriões / sessão de OPU e taxa de blastocistos. O protocolo de superestimulação folicular não melhorou a PIVE em vacas holandesas não lactantes. O experimento 2 testou a hipótese de que vacas leiteiras de alta produção se tornam cada vez mais resistentes à insulina com o avançar da lactação, e consequentemente, a qualidade do oócito é comprometida. Foram utilizadas vacas holandesas em 50 (51,5 ± 3,7; n = 30), 100 (102,3 ± 9,4; n = 30) e 150 (154,5 ± 18,9; n = 30) dias em lactação (DEL). Durante o teste de tolerância à glicose (TTG), não houve diferença entre grupos para qualquer variável relacionada à glicose circulante. No entanto, medidas de insulina circulante foram diferentes em vacas aos 150 DEL em comparação com 50 ou 100 DEL, tais como: maior insulina basal, pico, Δ máx de insulina e AUC 5-60. Porém, não houve diferença entre os grupos para o número ou percentagem de oócitos viáveis. Assim, as vacas desenvolveram resistência à insulina com o aumento do DEL. No entanto, o aumento da resistência à insulina não foi associado com alteração detectável na qualidade dos oócitos aspirados de folículos pequenos e médios. O experimento 3 foi para avaliar se o aumento de insulina circulante durante os períodos de pré e pós desvio folicular aumenta o desenvolvimento inicial e final, do folículo, bem como do corpo lúteo (CL). Além disso, por induzir a ovulação de um folículo maior, o CL resultante de vacas com alta insulina circulante também é maior e mais esteroidogênico, refletindo em maiores concentrações circulantes de progesterona (P4). O delineamento experimental utilizado foi o quadrado latino em arranjo fatorial 2x2, em quatro grupos experimentais: 1) CC = água pré e pós desvio folicular (n = 16); 2) CP = água e propilenoglicol (PPG) pré e pós desvio folicular, respectivamente (n = 16); 3) PC = PPG e água pré e pós desvio folicular, respectivamente (n = 16) e 4) PP = PPG pré e pós desvio folicular (n = 16). O aumento agudo e transitório, durante os períodos de pré e pós desvio não aumentou o desenvolvimento folicular, luteal e concentrações plasmáticas de P4. The aim of the first study was to evaluate the in vitro embryo production (IVEP) in nonlactating Holstein cows subjected to ovum pick-up (OPU) after ovarian superstimulation with a protocol similar to that described by Nivet et al. (2012) in comparison with OPU at a random day of the estrous cycle. Nonlactating Holstein cows were randomly assigned in a crossover design to: Control (n = 35) in which cows were not treated with p-FSH, but subjected to OPU at a random day of the estrous cycle; or p-FSH (n = 35), in which, 36 hours after OPU to synchronize follicle wave, the cows were treated with p-FSH for 3 days and 44 hours later, subjected to OPU sessions. The total number of cumulus-oocyte complex (COC) recovered and the number of viable oocytes were similar between control and p-FSH groups. In addition, there was no increase in the proportion of viable COC (viable COC / overall COC recovered). Likewise, we detected no differences in the number of embryos / OPU session and blastocyst rate. Follicle superstimulation protocol with p-FSH did not improve IVEP in nonlactating Holstein cows. Experiment 2 tested the hypothesis that high-producing dairy cows become increasingly resistant to insulin with advancing lactation, and consequently oocyte quality is compromised. We used Holstein cows at 50 (51.5 ± 3.7; n = 30), 100 (102.3 ± 9.4; n = 30) and 150 (n = 30 154.5 ± 18.9) days in milk (DIM). During the glucose tolerance test (GTT), there was no difference between groups for any variable related to circulating glucose. However, circulating insulin measurements such as basal insulin, peak insulin, Δ max and AUC 5-60 were higher for cows at 150 DIM. Nevertheless, there was no difference between groups for the number or percentage of viable oocytes. Therefore, although cows developed insulin resistance with increasing DIM, this has not been associated with detectable change in the quality of oocytes aspirated from small and medium follicles. The third experiment assessed whether the increase in circulating insulin during periods of pre- and post-follicle deviation increases the initial and final follicle size and corpus luteum (CL) volume. Moreover, by inducing ovulation of greater follicles, resulting in greater CL, cows with high circulating insulin also have higher circulating progesterone (P4). The experimental design was a Latin square in a 2x2 factorial arrangement in four groups: 1) CC = water pre and post follicle deviation (n = 16); 2) CP = water pre and propylene glycol (PPG) post follicle deviation (n = 16); 3) PC = PPG and water pre and post follicle deviation, respectively (n = 16), 4) PP = PPG pre and post follicle deviation (n = 16). Acute and transient circulating insulin increase during periods of pre and post follicle deviation has not affected follicle development, luteal volume or plasma concentrations of P4.

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TAVARES, Maria da Glória Rodrigues. "Alterações nas curvas glicêmicas de pacientes com Diabetes Mellitus gestacional pelo critério IADPSG e a repercussão no peso fetal ao nascimento." Universidade Federal do Maranhão, 2017. http://tedebc.ufma.br:8080/jspui/handle/tede/1901.

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Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-09-04T19:38:44Z No. of bitstreams: 1 MariaGloriaTavares.pdf: 1578457 bytes, checksum: d6ddc32a3c245b3f67f5abd4e4158ad0 (MD5) Made available in DSpace on 2017-09-04T19:38:44Z (GMT). No. of bitstreams: 1 MariaGloriaTavares.pdf: 1578457 bytes, checksum: d6ddc32a3c245b3f67f5abd4e4158ad0 (MD5) Previous issue date: 2017-07-07 Gestational Diabetes Mellitus (GDM) is classified as glucose intolerance, whose onset or detection occurs during pregnancy. One of the ways to identify GDM is 75g oral glucose tolerance test. According to the International Diabetes and Pregnancy Association Study Group(IADPSG), GDM is diagnosed when at least 1 of the three curve points are greater than or equal to 92, 180 and 153 mg / dl at time 0 , 1 and 2 hours respectively. A characteristic of this criterion is the diagnosis based on a single altered value. However, the mechanisms involved in impaired fasting glucose (IFG) are different from those found in impaired glucose tolerance (IGT) after oral glucose tolerance test (OGTT). So, differences in pregnancy outcomes are possible according to OGTT behavior. This work had as general objective to categorize pregnant women diagnosed with GDM, using the IADPSG criteria, according to the type of glycemic alteration found in the OGTT results, and to correlate with fetal weight birth. In order to do so, the cases of DMG treated at the University Hospital of the Federal University of Maranhão, from December 2013 to December 2015, were divided into 3 groups, according to the alterations found in the glycemic curve of the OGTT (Group 1: IFG isolated, Group 2: IGT only, Group 3: IFG and IGT). A total of 89 patients were studied, the majority belonging to groups 3 (54%). This same group had the highest glycemic averages at diagnosis and during follow-up, being the group with the highest occurrence of newborns large for gestational age (LGA), with 39.6%. Then group 1 with an occurrence of 27.3% of newborns LGAs. It was concluded that, as pregnant women with DMG with altered fasting glycemia in the OGTT, especially those with associated glucose intolerance, presented a higher risk for newborns large for gestational age. Diabetes Mellitus Gestacional (DMG) é classicamente definido como intolerância à glicose de gravidade variável, cujo início ou detecção ocorre durante a gravidez. Uma das formas de rastreá-la é através da curva glicêmica após sobrecarga oral de glicose, com 75g de dextrosol. Segundo o critério do International Association of Diabetes and Pregnancy Study Group (IADPSG), considera-se diagnóstico de DMG quando pelo menos um dos três pontos da curva encontra-se maior ou igual a 92, 180 e 153 mg/dl, nos tempos 0, 1, 2 horas respectivamente. Uma característica deste critério, é o diagnóstico baseado em apenas um único valor alterado, seja ele em jejum ou após a sobrecarga. No entanto, os mecanismos que levam à alteração da glicemia jejum (GJA) são diferentes daqueles encontrados na intolerância à glicose (ITG) após sobrecarga de glicose. Sendo assim, acredita-se poder haver diferenças, em relação aos desfechos fetais, a depender do perfil encontrado na curva glicêmica das gestantes com diagnóstico de DMG. Este trabalho teve como objetivo geral categorizar as gestantes diagnosticadas com DMG pelo teste de tolerância oral à glicose (TTOG), utilizando o critério do IADPSG, de acordo com o tipo de alteração glicêmica encontrada na curva de sobrecarga, e correlacionar com o peso fetal ao nascimento. Para isso, foram revisados os casos de DMG atendidos no Hospital Universitário da Universidade Federal do Maranhão (HUUFMA), no período de dezembro de 2013 a dezembro de 2015, estes foram divididos em 3 grupos, de acordo com as alterações encontradas na curva glicêmica do TOTG (Grupo 1: GJA isoladamente; Grupo 2: ITG isoladamente, Grupo 3: GJA e ITG). Foram estudadas 89 pacientes, a maioria pertencente ao grupo 3 (54%). Este mesmo grupo apresentou as médias glicêmicas mais elevadas ao diagnóstico e durante o seguimento, sendo o grupo com maior ocorrência de recém-nascidos grandes para idade gestacional (GIG), com 39,6%. Em seguida o grupo 1 com uma ocorrência de 27,3% de recém nascidos GIGs. Concluiu-se que as gestantes com DMG com alteração na glicemia de jejum no TTOG, principalmente aquelas com intolerância à glicose associada, apresentaram maior risco para recém-nascidos grandes para idade gestacional.

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Osuafor, Godswill Nwabuisi. "Aspects of the interrelation between hypertension and insulin resistance." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6176_1298445712.

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Conclusion of this study: These data suggest that 6 weeks of high-fat feeding induces hypertension but does not produce obesity, dyslipidemia and insulin resistance. However, this model may be useful in studying vascular reactivity in hypertension in the absence of insulin resistance.

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Saramies, J. (Jouko). "Tyypin 2 diabeteksen riskitekijät ja poikkeavan glukoosiaineenvaihdunnan seulonta perusterveydenhuollossa." Doctoral thesis, University of Oulu, 2004. http://urn.fi/urn:isbn:9514276027.

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Abstract Type 2 diabetes can be prevented if the impaired glucose tolerance is found. Oral glucose tolerance test is needed in clinical practise for that but it is expensive and inconvenient. Obesity, hypertension, dyslipidemia and hypertension in pregnancy are factors often found in persons with type 2 diabetes. When there are more than one factor in same person the risk of type 2 diabetes multiplies. The purpose of this study was to investigate the prevalence of abnormal glucose metabolism and risk factors of type 2 diabetes in middle aged Finnish population in Savitaipale municipality and develop a method to screen abnormal glucose metabolism in primary health care. It was also studied the correlation of blood pressure and body mass index during pregnancy and abnormal glucose metabolism in later life. The study population was 1561 people born 1933–1956. 77,5% participated and 1097 people of them not having known abnormal glucose metabolism were taken to the cross-sectional study to develop the screening method. All 325 women who have had childbirth and files of that were taken to the prospective pregnancy cohort study. Information was collected with interview, measurements, laboratory research and from childbirth files. According the World Health Organisation criteria 1999 the prevalence of diabetes was 8,7% in men and 7,4% in women, previously undiagnosed 3,9% and 3,1%. Every fourth had abnormal glucose metabolism (men 23,2%, women 23,5%). The prevalence of obesity, hypertension, use of long-term antihypertensive medication and dyslipidemia (only in women) was higher among those, who had abnormal glucose metabolism. Logistic models were made for the classified risk factors. The model (AUC 0.718 for men, 0.761 for women) containing age, gender, waist circumference, systolic blood pressure and use of long-term antihypertensive medication was as good as model containing in addition family history of diabetes, smoking habits, serum lipids and long-term use of lipid lowering medication. Risk score tables were made from classified risk factors to evaluate the probability of the abnormal glucose metabolism. The blood pressure level and body mass index in pregnancy correlated independently with abnormal glucose metabolism in later life, blood pressure also adjusted with body mass index. Hypertension in pregnancy or after delivery correlated with abnormal glucose metabolism adjusted with body mass index. Hypertension in pregnancy doubled the risk of abnormal glucose metabolism in later life adjusted for body mass index in pregnancy and hypertension in later life. This information is important in prevention of type 2 diabetes Tiivistelmä Tyypin 2 diabetesta voidaan estää, mikäli heikentynyt glukoosinsieto tunnistetaan. Siihen tarvitaan glukoosirasituskoetta, jota on pidetty kalliina ja hankalana toteuttaa. Lihavuus, kohonnut verenpaine, dyslipidemia ja raskausdiabetes ovat tyypin 2 diabeteksen riskitekijöitä ja niiden ryvästyminen samaan henkilöön lisää diabetekseen sairastumisen todennäköisyyttä. Tyypin 2 diabeteksen riskitekijöiden ja poikkeavan glukoosiaineenvaihdunnan määrää ja raskauden aikaisen verenpaineen yhteyttä myöhemmin ilmaantuvaan poikkeavaan glukoosiaineenvaihduntaan tutkittiin 1933–1956 syntyneessä savitaipalelaisessa väestössä. Tavoitteena oli kehittää perusterveydenhuoltoon soveltuva poikkeavan glukoosiaineenvaihdunnan seulontamenetelmä. Kohdejoukosta (n = 1561) osallistui 77,5 %, joista 1097:llä henkilöllä ei tiedetty olevan diabetesta. Heistä kerättiin tietoa haastattelulla, mittauksilla ja laboratoriotutkimuksilla sekä äitiysneuvolakorteista. Raskausaineistoon ja takenevaan kohorttitutkimukseen otettiin kaikki ne 325 naista, myös diabeetikot, joista raskaudesta oli tiedot käytettävissä. Diabetesta sairasti 8,7 % miehistä ja 7,4 % naisista, aiemmin diagnosoimattomia oli 3,9 % ja 3,1 %. Poikkeava glukoosiaineenvaihdunta oli joka neljännellä. Lihavuutta, kohonnutta verenpainetta, verenpainelääkkeen käyttöä ja naisilla dyslipidemiaa oli enemmän niillä, joilla oli poikkeava glukoosiaineenvaihdunta. Tutkimuksessa luotiin luokitelluista muuttujista logistisia malleja. Malli, johon muuttujiksi valittiin ikä, sukupuoli, vyötärön ympärys, systolinen verenpaine ja verenpainelääkkeen käyttö, todettiin yhtä hyväksi (miesten ROC -käyrän AUC 0.718, naisten 0.761) ennustamaan heikentynyt glukoosinsieto ja diabetes kuin malli, johon lisäksi valittiin suvun diabetes, tupakointi, rasva-arvoja ja lipidilääkityksen käyttö. Muuttujista tehtiin taulut, joista voi nähdä poikkeavan glukoosiaineenvaihdunnan todennäköisyyden. Raskauden aikainen verenpaine ja painoindeksi olivat yhteydessä myöhemmin ilmaantuvaan poikkeavaan glukoosiaineenvaihduntaan, samoin loppuraskauden verenpaine painoindeksillä vakioituna. Raskaudessa todettu kohonnut verenpaine oli, mutta raskauden aiheuttama kohonnut verenpaine ei ollut, yhteydessä myöhemmin ilmaantuvaan poikkeavaan glukoosiaineenvaihduntaan painoindeksistä riippumatta, samoin loppuraskauden diastolinen verenpaine seulonnan diastolisesta verenpaineesta riippumatta. Raskaudessa tai sen jälkeen todettu kohonnut verenpaine kaksinkertaisti poikkeavan glukoosiaineenvaihdunnan riskin loppuraskauden painoindeksistä tai seulonnassa todetusta kohonneesta verenpaineesta riippumatta. Kahdella helposti mitattavalla muuttujalla voidaan päätellä glukoosirasituskokeen tarve. Diabetesta ehkäistäessä on tärkeä tietää, että raskauden kohonnut verenpaine ja ylipaino lisäävät myöhempää poikkeavaa glukoosiaineenvaihduntaa

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Chu, Ying-Yueh. "Body fat mass, blood parameters, glucose tolerance test, and fatty acid synthesis and various metabolites in hepatocytes of shhf/mcc-cp obese male and female and homozygous and heterozygous lean male rats /." The Ohio State University, 1992. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487777901659766.

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28

Staaf, Johan. "Childhood Obesity and Islet Function." Doctoral thesis, Uppsala universitet, Institutionen för medicinsk cellbiologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-313310.

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The prevalence of childhood obesity and Type 2 Diabetes Mellitus (T2DM) has increased during recent decades. T2DM is accompanied with functional changes in the islets of Langerhans, which can be identified early in the pathogenesis. The aim of this thesis was to explore how metabolic changes caused by obesity early in life relate to islet function prior to overt T2DM. To address this, Uppsala Longitudinal Study of Childhood Obesity (ULSCO) was established (paper I). Initially, the association between palmitate and insulin secretion was investigated using a translational approach with obese and lean normoglycemic juveniles and isolated human islets (paper II). Secondly, dynamics of islet-hormones insulin and glucagon, and gut-hormones glucagon like-peptide 1 (GLP-1) and glicentin (paper III) and magnetic resonance imaging of pancreatic fat fraction (PFF) (paper IV) were studied in association to glucose tolerance and beta-cell function. Finally, a novel method of analysing shape features of oral glucose tolerance test (OGTT) curves was introduced and evaluated (paper V). Obese subjects had high prevalence of prediabetes and metabolic syndrome (MetS) (paper I). In obese pre-pubertal children with elevated palmitate levels, hyperinsulinemia was observed (paper II). In contrast, obese pubertal adolescents with similar palmitate levels showed moderate insulin levels during OGTT with delayed first phase insulin response. To explore mechanisms for these variations, isolated human islets were exposed to palmitate for different time periods in vitro. After 2 days accentuated insulin response was observed. Impaired beta-cell function and apoptosis were evident after 7 days, however. Hyperglucagonemia and disturbed GLP-1 and glicentin levels were associated with obesity and glycaemic status, with fasting glicentin being predictive of prediabetes (paper III). Furthermore, PFF was increased in obese subjects and associated to MetS and visceral adipose tissue, but not to beta-cell function (paper IV). OGTT curves were converted into geometric centres, centroids, which correlated with differences in glucose tolerance (paper V). In conclusion, the islet function in obese children was associated with elevated levels of palmitate, but not pancreatic fat. Fasting palmitate and glicentin levels, as well as centroid analyses of OGTT curves, could potentially identify obese children at risk of prediabetes and subsequent T2DM.

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Miyake, Cintia Natsumi Higashi. "Avaliação da sensibilidade à insulina em pacientes com lúpus eritematoso sistêmico." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5164/tde-08092016-100644/.

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Introdução: A doença cardiovascular prematura é uma das maiores causas de morbi-mortalidade no lúpus eritematoso sistêmico (LES) e parece estar relacionada à maior prevalência de fatores de risco clássicos e não clássicos. A resistência à insulina (RI) é um importante fator de risco para doenças cardiovasculares (DCV), podendo ter papel no risco cardiovascular aumentado no LES. Objetivo: Avaliar a sensibilidade à insulina de pacientes com LES em resposta ao teste oral de tolerância à refeição (MTT - Meal tolerance test), controlando por potenciais variáveis intervenientes, a saber, nível de atividade física, composição corporal e consumo alimentar. Metodologia: Pacientes com LES (LES; n=33) recrutadas no ambulatório de Reumatologia do HC-FMUSP e voluntárias saudáveis (CTRL; n = 16), pareadas por idade, gênero e índice de massa corporal foram selecionadas. As participantes foram submetidas ao MTT para determinação de estimativas da sensibilidade à insulina e de função das células beta, nível de atividade física (acelerometria), composição corporal (DXA), consumo alimentar (recordatórios alimentares), concentração de adipocinas e citocinas inflamatórias, atividade da doença e uso de medicamentos. Resultados: LES e CTRL apresentaram glicemia de jejum e em resposta ao MTT similares. Em contrapartida, LES apresentou maior insulinemia de jejum, HOMA RI, razão insulina/glicose de jejum e em resposta ao MTT, glucagonemia de jejum e em resposta ao MTT (p < 0,05) e tendência ao menor Índice de sensibilidade à inulina Matsuda (p = 0,06) e à maior insulinemia em resposta ao MTT (p=0,09) quando comparado ao CTRL. Em relação às estimativas da função das células beta, a razão pró-insulina/insulina de jejum e em resposta ao MTT foram similares entre os grupos, embora o grupo LES tenha apresentado maior índice insulinogênico (p=0,02). Conclusão: O grupo LES apresentou maior RI e hiperglucagonemia apesar de tolerância normal à glicose e função preservada das células beta quando comparado ao grupo controle. Esses resultados sugerem que os pacientes LES possuem maior risco de desenvolver DCV quando comparados a sujeitos saudáveis com composição corporal, ingestão alimentar e nível de atividade física similares, o que reforça a necessidade de estratégias para melhorar a sensibilidade à insulina, potencialmente prevenindo ou retardando o surgimento de DCV no LES Background: Premature cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality in systemic lupus erythematosus (SLE) and may be associated with classic and non-classic risk factors. Insulin resistance (IR) is an independent risk factor for CVD and could play a fundamental role in the substantially increased CVD risk in SLE. Objective: To assess insulin sensitivity in a cohort of patients with systemic lupus erythematosus (SLE) fasting and in response to a meal tolerance test (MTT), controlling by potential intervening components, such as physical activity level, body composition and food intake. Methods: SLE patients (LES; n=33) recruited in the HC-FMUSP ambulatory of rheumatology and 16 age- and BMI-matched healthy women (CTRL) were selected. The participants underwent a mixed meal test for assess insulin sensitivity and beta-cell function. Further measurements included physical activity level (assessed by accelerometry), body composition (assessed by DXA), food intake (assessed by a 3-day food record), inflammatory cytokines and adipokines concentrations, disease activity and drug intake. Results: SLE and CTRL showed similar fasting glucose and glucose response to the MTT. In contrast, SLE showed higher fasting insulin levels, HOMA IR, fasting insulin-to-glucose ratio, insulin-to-glucose ratio response to the MTT, fasting glucagon levels, glucagon response to the MTT (p < 0.05), and a tendency towards a lower Matsuda index of whole-body insulin sensitivity (p = 0.06) and a higher insulin response to the MTT (p = 0.09) when compared with CTRL. With respect to the beta-cell function estimates, fasting proinsulin-to-insulin ratio and proinsulin-to-insulin ratio response to the MTT were similar between groups, although SLE showed a higher insulinogenic index (p = 0.02). Conclusion: SLE group showed increased IR and hyperglucagonemia despite normal glucose tolerance and preserved beta-cell function when compared with healthy controls. These results suggest that SLE patients are at higher risk of developing CVD, when compared with healthy subjects with similar body composition, food intake and physical activity level, which reinforces the need of strategies capable of ameliorating insulin sensitivity, thus, potentially preventing or delaying the onset of CVD in SLE

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Sirimarco, Mariana Pinto. "Avaliação dos protocolos de diagnóstico e de controle da hiperglicemia materna impacto na prevalência de Diabetes Melito Gestacional (DMG) e de Hiperglicemia Gestacional Leve (HGL) e nos resultados perinatais /." Botucatu, 2016. http://hdl.handle.net/11449/137866.

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Orientador: Iracema de Mattos Paranhos Calderon Resumo: JUSTIFICATIVA – desde agosto de 2011 o Serviço Especializado de Diabetes e Gravidez da Faculdade de Medicina de Botucatu/Unesp (SEDG-FMB/Unesp) adotou o novo protocolo diagnóstico para o DMG recomendado pela ADA/IADPSG. Entretanto, o Perfil Glicêmico (PG) continuou associado ao TOTG 75g, para diagnosticar a Hiperglicemia Gestacional Leve (HGL), reconhecida e tratada em nosso Serviço como se fosse DMG. A controvérsia sobre o custo-benefício do novo protocolo da ADA/IADPSG e a dúvida sobre a necessidade de manutenção do PG no protocolo do Serviço justificam o presente estudo. OBJETIVOS – avaliar o impacto do novo protocolo da ADA/IADPSG na prevalência de HGL e de DMG, na ocorrência de resultados perinatais adversos (RPNA) e na associação TOTG 75g e PG para diagnóstico de HGL no SEDG-FMB/Unesp. MÉTODO – estudo de corte transversal, incluindo gestantes, e seus recém-nascidos (RN), submetidas aos protocolos diagnósticos e que realizaram pré-natal e parto no Serviço, antes (janeiro de 2008 a 14 de agosto de 2011) e após (15 de agosto de 2011 a dezembro de 2014) à mudança do protocolo, definindo uma amostra por conveniência. Considerando os dois períodos, foram comparadas a prevalência de DMG e de HGL e a ocorrência de RN-GIG, macrossomia, primeira cesárea e tempo de internação dos RN. Na análise estatística foram utilizados análise de Poison e teste t-Student, teste do Qui-quadrado ou Exato de Fischer e cálculo de risco (RR e IC 95%) para os desfechos avaliados. O limite de signifi... (Resumo completo, clicar acesso eletrônico abaixo) Abstract: BACKGROUND - since August 2011 the Specialized Center of Diabetes and Pregnancy of the Botucatu Medical School / Unesp (SEDG-FMB / Unesp) has adopted a new diagnostic protocol for Gestational Diabetes Mellitus (GDM) recommended by the ADA / IADPSG guidelines. However, the glycemic profile (GP) remained associated with the 75g OGTT to diagnose Mild Gestational Hyperglycemia Lite (MGH), recognized and treated in our department as if it were GDM. The controversy over the cost-effectiveness of the new ADA / IADPSG guideline and doubt about the need for GP maintenance in the service protocol justify this study. OBJECTIVES - To assess the impact of the new ADA / IADPSG guideline in the prevalence of MGH and GDM, in the incidence of adverse perinatal outcomes (APNO) and in the association 75g OGTT and PG for diagnosis of MGH at the SEDG-FMB / Unesp. METHOD - cross-sectional study, including pregnant women and their newborns (NB) that underwent diagnostic protocols and had their prenatal care and delivery at the service before (January 2008 to August 14, 2011) and after (15 August 2011 to December 2014) the protocol modification, defining a convenience sample. Considering the two periods, the prevalence of GDM and MGH and the occurrence of LGA-NB, macrosomia, first cesarean delivery and NB hospital stay were compared. For statistical analysis, Poison analysis and Student's t test, chi-square or Fisher's exact test were used and risk estimate (RR and 95% CI) for the assessed outcomes.... (Complete abstract click electronic access below) Mestre

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Holzner, Alexandra. "Der Weißbüschelaffe (Callithrix jacchus) und das Metabolische Syndrom: Einfluss von Geschlecht und pränataler Programmierung." Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-214457.

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Das Metabolische Syndrom (MetSyn) ist gekennzeichnet durch eine Kombination verschiedener kardiovaskulärer Risikofaktoren: Glukoseintoleranz, Adipositas, Dyslipidämie sowie arterielle Hypertonie. Es gilt beim Menschen als eine der Hauptursachen für Herzkreislauferkrankungen und befindet sich weltweit auf enormem Vormarsch. Die Weichen für die Erkrankung werden zum Teil schon vor der Geburt durch eine veränderte Umwelt in utero gestellt. So können Stress oder eine Glukokortikoidbehandlung während der Schwangerschaft zu einem veränderten Phänotyp des Embryos/Fetus führen - mit Konsequenzen für das gesamte spätere Leben. Dieses Phänomen wird als pränatale Programmierung bezeichnet. Neben diesen epigenetischen Effekten spielen u. a. auch geschlechtsabhängige Faktoren eine Rolle für das Risiko, am MetSyn zu erkranken. Die vorliegende Arbeit befasst sich mit den Auswirkungen einer Glukokortikoidbehandlung in der frühen Trächtigkeit sowie dem Einfluss des Geschlechts auf kardiovaskuläre Risikofaktoren im Erwachsenenalter. Als Modelltier für die Studie wurde der Weißbüschelaffe eingesetzt. In einem 2002 stattgefundenen Vorversuch im Deutschen Primatenzentrum in Göttingen wurde tragenden Tieren (F0) eine Woche lang täglich oral Dexamethason verabreicht. Dieses synthetische Glukokortikoid kann die Plazentaschranke passieren. Die drei folgenden in Leipzig gehaltenen Generationen DexF1/2/3W (weibliche Tiere, n = 4/6/2) und DexF2/3M (männliche Tiere, n = 2/4) gingen in die Untersuchung ein. Tiere, die keine Nachkommen der F0-Generation darstellten, bildeten jeweils eine weibliche (ControlW, n = 11) und eine männliche (ControlM, n = 15) Kontrollgruppe und wurden ebenfalls herangezogen, um die Auswirkungen des Geschlechts auf die untersuchten Parameter zu ermitteln. Es wurde ein oraler Glukosetoleranztest (OGTT) durchgeführt (inklusive der Erfassung der Insulinwerte), der Quantitative Insulin Sensitivity Check Index (QUICKI – Maß für die Insulinsensitivität) berechnet sowie Lipidstoffwechselparameter bestimmt. Außerdem fanden wöchentlich Erfassungen des Körpergewichts statt. In mehreren Sitzungen pro Tier wurde der Blutdruck gemessen. Die statistische Auswertung erfolgte mittels Mann-Whitney-U-Test für unabhängige Stichproben. Unterschiede mit einer Irrtumswahrscheinlichkeit p ≤ 0,05 wurden als signifikant angesehen. Im OGTT wies DexF1W im Vergleich zu ControlW 120 Minuten nach oraler Glukoseapplikation eine signifikant niedrigere Insulinkonzentration auf. Da nach 30 und 120 Minuten auch die Glukosekonzentration signifikant erniedrigt war, ist jedoch nicht von einer klinischen Relevanz auszugehen. Weitere Auswirkungen der Dexamethasonapplikation auf die F1- bis F3-Generation konnten nicht beobachtet werden. Beim Vergleich der weiblichen und männlichen Nachkommen unbehandelter Weißbüschelaffen fiel auf, dass weibliche Tiere signifikant höhere Insulinkonzentrationen und damit eine signifikant größere Insulin-AUC (Fläche unter der Kurve) im OGTT zeigten. Ihr QUICKI war signifikant niedriger. Hyperinsulinämie und niedriger QUICKI stellen Symptome einer gestörten Glukoseregulation dar. Die weiblichen Tiere zeigten außerdem eine signifikante Erhöhung hinsichtlich Körpergewicht, VLDL-Triglycerid- und folglich Plasmatriglyceridkonzentrationen. Ihre HDL-Cholesterolwerte waren signifikant niedriger. Diese Kombination einer Hypertriglyceridämie mit niedrigem HDL-Cholesterol wird als atherogene Dyslipidämie bezeichnet. Eine gestörte Glukosehomöostase, eine Adipositas sowie eine atherogene Dyslipidämie stellen kardiovaskuläre Risikofaktoren und wichtige Komponenten des MetSyn dar. Zusammenfassend lässt sich sagen, dass beim Weißbüschelaffen eine Glukokortikoidbehandlung während der frühen Trächtigkeit nicht zum MetSyn der F1- bis F3-Generationen im Erwachsenenalter führte. Hingegen ergab die Untersuchung auf ein geschlechtsabhängiges Erkrankungsrisiko eine eindeutige Prädisposition bei den weiblichen Tieren. Die zu Grunde liegenden Mechanismen dieses Phänomens bleiben Gegenstand weiterer Untersuchungen The metabolic syndrome (MetSyn) consists of a cluster of metabolic disorders, characterized by glucose intolerance, obesity, dyslipidemia and hypertension. In humans, it is a major cause for cardiovascular disease. Its worldwide prevalence is increasing. The way for the disease can be paved even before birth. An adverse intrauterine environment due to prenatal stress or an iatrogenic overexposure of the fetus to glucocorticoids can lead to an altered phenotype with consequences for later life. This phenomenon is called prenatal programming. In addition gender specific factors play a leading role for the risk of developing MetSyn. The aim of the present study was to investigate the influence of a glucocorticoid application in early pregnancy and gender on cardiovascular risk factors in adulthood. The common marmoset was used as model species. In a preliminary experiment (2002) at the german primate centre (Göttingen) animals (F0) were orally treated with dexamethasone for one week during early pregnancy. Dexamethasone is a synthetic glucocorticoid that can pass the placental barrier. The following three generation offspring, reared in Leipzig, DexF1/2/3W (female animal, n = 4/6/2) and DexF2/3M (male animal, n = 2/4) were regarded. Animals that were no descendants of the F0 generation built a female (ControlW, n = 11) and a male (ControlM, n = 15) control group and were also regarded for gender-specific risk for MetSyn. An oral glucose tolerance test (OGTT) was carried out (including measurements of insulin concentration), the Quantitative Insulin Sensitivity Check Index (QUICKI – measure of insulin sensitivity) was calculated and parameters of lipid metabolism were investigated. Furthermore, all animals were weighed weekly and blood pressure was monitored at a series of meetings. Statistical analysis was performed by Mann-Whitney-U-Test for independent samples. The level of significance was defined at p ≤ 0.05. DexF1W in comparison to ControlW had a significantly lower insulin concentration 120 minutes after glucose application in the OGTT and a significantly lower glucose concentration 30 and 120 minutes after reaching the sugar solution. These findings did not seem to be clinically relevant. Apart from that, no consequences could be determined in the F1-3 generation offspring after dexamethasone treatment in pregnancy. Regarding gender comparison of untreated common marmosets, female animals had significantly higher insulin concentrations in OGTT and therefore a significantly greater insulin AUC (area under the curve). QUICKI was significantly lower. Hyperinsulinemia and a low QUICKI are symptoms of an impaired glucose regulation. Furthermore, the female animals showed an increase in body weight, VLDL triglycerides and therefore total triglycerides. HDL cholesterol was significantly lower. Hypertriglyceridemia in combination with low HDL cholesterol is called atherogenic dyslipidemia. A disturbed glucose homeostasis, obesity and an atherogenic dyslipidemia are cardiovascular risk factors and important components of MetSyn. In summary, dexamethasone applied in early pregnancy did not lead to metabolic syndrome in the F1-F3 generation offspring of common marmoset in adulthood. However, the female gender was associated with a higher risk of developing the disease. The underlying mechanisms require further investigation

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Sirimarco, Mariana Pinto [UNESP]. "Avaliação dos protocolos de diagnóstico e de controle da hiperglicemia materna: impacto na prevalência de Diabetes Melito Gestacional (DMG) e de Hiperglicemia Gestacional Leve (HGL) e nos resultados perinatais." Universidade Estadual Paulista (UNESP), 2016. http://hdl.handle.net/11449/137866.

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Submitted by MARIANA PINTO SIRIMARCO null (mpsirimarco@yahoo.com.br) on 2016-04-08T03:04:00Z No. of bitstreams: 1 VERSÃO FINAL 2 08-04.pdf: 1774461 bytes, checksum: 13e24ee503bed7a9ca8d50a2f58cd2aa (MD5) Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-04-08T16:39:33Z (GMT) No. of bitstreams: 1 sirimarco_mp_me_bot.pdf: 1774461 bytes, checksum: 13e24ee503bed7a9ca8d50a2f58cd2aa (MD5) Made available in DSpace on 2016-04-08T16:39:33Z (GMT). No. of bitstreams: 1 sirimarco_mp_me_bot.pdf: 1774461 bytes, checksum: 13e24ee503bed7a9ca8d50a2f58cd2aa (MD5) Previous issue date: 2016-02-29 JUSTIFICATIVA – desde agosto de 2011 o Serviço Especializado de Diabetes e Gravidez da Faculdade de Medicina de Botucatu/Unesp (SEDG-FMB/Unesp) adotou o novo protocolo diagnóstico para o DMG recomendado pela ADA/IADPSG. Entretanto, o Perfil Glicêmico (PG) continuou associado ao TOTG 75g, para diagnosticar a Hiperglicemia Gestacional Leve (HGL), reconhecida e tratada em nosso Serviço como se fosse DMG. A controvérsia sobre o custo-benefício do novo protocolo da ADA/IADPSG e a dúvida sobre a necessidade de manutenção do PG no protocolo do Serviço justificam o presente estudo. OBJETIVOS – avaliar o impacto do novo protocolo da ADA/IADPSG na prevalência de HGL e de DMG, na ocorrência de resultados perinatais adversos (RPNA) e na associação TOTG 75g e PG para diagnóstico de HGL no SEDG-FMB/Unesp. MÉTODO – estudo de corte transversal, incluindo gestantes, e seus recém-nascidos (RN), submetidas aos protocolos diagnósticos e que realizaram pré-natal e parto no Serviço, antes (janeiro de 2008 a 14 de agosto de 2011) e após (15 de agosto de 2011 a dezembro de 2014) à mudança do protocolo, definindo uma amostra por conveniência. Considerando os dois períodos, foram comparadas a prevalência de DMG e de HGL e a ocorrência de RN-GIG, macrossomia, primeira cesárea e tempo de internação dos RN. Na análise estatística foram utilizados análise de Poison e teste t-Student, teste do Qui-quadrado ou Exato de Fischer e cálculo de risco (RR e IC 95%) para os desfechos avaliados. O limite de significância estatística foi de 95% (p < 0,05). RESULTADOS – o NOVO protocolo resultou em aumento no número de mulheres com DMG e deixou de identificar 17,3% do total de gestantes, que mantiveram o diagnóstico de HGL, apesar do TOTG 75g normal. O novo protocolo ADA/IADPSG não influenciou o desfecho perinatal. CONCLUSÕES – esses resultados reforçam a validade da manutenção do PG no protocolo diagnóstico do SEDG-FMB/Unesp. Para concluir sobre o custo-benefício do NOVO protocolo, são necessários grandes estudos, multicêntricos e com tamanho amostral adequado. BACKGROUND - since August 2011 the Specialized Center of Diabetes and Pregnancy of the Botucatu Medical School / Unesp (SEDG-FMB / Unesp) has adopted a new diagnostic protocol for Gestational Diabetes Mellitus (GDM) recommended by the ADA / IADPSG guidelines. However, the glycemic profile (GP) remained associated with the 75g OGTT to diagnose Mild Gestational Hyperglycemia Lite (MGH), recognized and treated in our department as if it were GDM. The controversy over the cost-effectiveness of the new ADA / IADPSG guideline and doubt about the need for GP maintenance in the service protocol justify this study. OBJECTIVES - To assess the impact of the new ADA / IADPSG guideline in the prevalence of MGH and GDM, in the incidence of adverse perinatal outcomes (APNO) and in the association 75g OGTT and PG for diagnosis of MGH at the SEDG-FMB / Unesp. METHOD - cross-sectional study, including pregnant women and their newborns (NB) that underwent diagnostic protocols and had their prenatal care and delivery at the service before (January 2008 to August 14, 2011) and after (15 August 2011 to December 2014) the protocol modification, defining a convenience sample. Considering the two periods, the prevalence of GDM and MGH and the occurrence of LGA-NB, macrosomia, first cesarean delivery and NB hospital stay were compared. For statistical analysis, Poison analysis and Student's t test, chi-square or Fisher's exact test were used and risk estimate (RR and 95% CI) for the assessed outcomes. The statistical significance threshold was 95% (p <0.05). RESULTS - The new protocol resulted in a increase in the number of women with GDM, but failed to identify 17.3% of pregnant women who maintained the diagnosis of MGH, despite normal 75g OGTT. The new ADA / IADPSG guideline did not influence the perinatal outcome. CONCLUSIONS - These results reinforce the validity of maintaining the GP in the diagnosis protocol at the SEDG-FMB / Unesp. To conclude on the cost-effective of the new protocol, large multicenter studies with adequate sample size are required

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Saaristo, T. (Timo). "Assessment of risk and prevention of type 2 diabetes in primary health care." Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514297113.

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Abstract Type 2 diabetes is one of the fastest increasing lifestyle diseases globally. Its cure is not yet possible, but there is firm evidence from scientific studies that it can effectively be prevented by lifestyle changes. There is limited evidence-based information on the prevention of diabetes in practice. This dissertation offers new desirable information on the issue. The aim of this dissertation study was to describe the prevalence of risk factors for type 2 diabetes and hidden glucose disorders predicting the development of diabetes in the Finnish adult population, and to analyse whether the risk for developing diabetes could be reduced by simple lifestyle counselling. Furthermore, the ability of the Finnish Diabetes Risk Score (FINDRISC) to detect glucose disorders leading to diabetes and undiagnosed diabetes was analysed. In the dissertation data from large Finnish population surveys (the FINRISK 2002 glucose tolerance survey and the FIN-D2D 2004−2005 survey) were analysed. In addition, a prospective design and large-scale intervention were included. We found that obesity and glucose disorders are very common in the Finnish middle-aged population. Prevalence of obesity was 24% for men and 28% for women, that of abnormal glucose metabolism 42% for men and 33% for women, and that of undiagnosed diabetes 9% for men and 7% for men. One quarter of individuals aged 45−64 years were at high risk for diabetes. Lifestyle interventions were offered to more than 10,000 high-risk individuals, 3,379 men and 6,770 women. Of the men, 43% were also at high risk for cardiovascular morbidity and 42% at high risk for cardiovascular mortality estimated through the FRAMINGHAM and SCORE risk engines, respectively. The FINDRISC, originally developed for predicting the risk of development of type 2 diabetes, also predicted the prevalence of diabetes in the population. The effect of lifestyle interventions on weight and its association with glucose tolerance was evaluated in individuals at high risk for diabetes in a one-year follow-up. In total 17.5% of them lost ≥ 5% weight. Their relative risk for diabetes decreased 69% compared with the group that maintained their weight. This study shows that FINDRISC predicts prevalent type 2 diabetes. A significant proportion of middle-aged Finnish population has a glucose disorder including undiagnosed type 2 diabetes. Lifestyle interventions in primary health care may promote weight loss, which decreases the risk of diabetes Tiivistelmä Diabetes on yksi nopeimmin lisääntyvistä elintapasairauksista maailmassa. Sitä ei vielä voida parantaa, mutta tieteellisissä tutkimuksissa on kiistattomasti osoitettu, että sitä voidaan tehokkaasti ehkäistä elintapamuutoksilla. Diabeteksen ehkäisystä käytännössä on hyvin niukasti tutkimustietoa. Tämä väitöskirja tuo kaivattua lisätietoa aiheesta. Väitöstutkimuksen päätavoitteena oli selvittää diabeteksen riskitekijöiden ja piilevien diabetesta ennakoivien sokerihäiriöiden yleisyyttä suomalaisessa aikuisväestössä. Tämän ohella tavoitteena oli selvittää voidaanko yksinkertaisella elintapaneuvonnalla vähentää sellaisten henkilöiden sairastumisvaaraa, joilla oli suuri riski sairastua diabetekseen. Lisäksi arvioitiin diabetesriskitestin kykyä tunnistaa ennakoivat sokerihäiriöt ja aiemmin tunnistamaton diabetes. Tutkimuksessa käytettiin laajoja suomalaisia väestötutkimusaineistoja: FINRISKI-2002 -tutkimusta, sen alaotosta ja D2D-väestötutkimusta 2004–2005. Mukana oli myös pitkittäisasetelma ja laajamittainen interventio. Tutkimuksen perusteella huomasimme, että lihavuus ja sokerihäiriöt ovat hyvin yleisiä keski-ikäisillä suomalaisilla. Merkittävästi lihavia (BMI ≥ 30 kg/m2) oli 24 % miehistä ja 28 % naisista ja poikkeava sokeriaineenvaihdunta oli 42 %:lla miehistä ja 33 %:lla naisista. Tunnistamaton diabetes oli 9 %:lla miehistä ja 7 %:lla naisista. Suuressa diabetekseen sairastumisvaarassa oli neljäsosa 45−64-vuotiaista. Interventioon otettiin yli 10 000 suuressa diabeteksen sairastumisriskissä olevaa henkilöä, 3 379 miestä ja 6 770 naista. Miehistä 43 % oli suuressa sairastumisvaarassa myös sydän- ja verisuonisairauteen ja 42 % suuressa kuolemanvaarassa Framingham- ja SCORE-riskilaskureilla arvioituna. Tyypin 2 diabeteksen sairastumisriskin arviointiin kehitetty Riskitesti ennusti hyvin myös diabeteksen esiintymistä väestössä. Elintapainterventioiden vaikutusta painoon ja sokeriaineenvaihduntaan analysoitiin vuoden seurannassa sellaisilla henkilöillä, joilla oli suuri diabetesriski. Paino laski 5 % tai enemmän 17,5 %:lla, jolloin sairastumisriski diabetekseen väheni 69 % verrattuna ryhmään, jonka paino ei muuttunut. Tutkimuksen perusteella lihavuus, sokerihäiriöt ja tunnistamaton diabetes ovat yleisiä keski-ikäisessä väestössä. Riskitesti on hyvä työkalu myös diabeteksen seulonnassa. Perusterveydenhuollossa tarjottavalla elintapaneuvonnalla voidaan saada aikaan laihtuminen, joka vähentää sairastumisvaaraa diabetekseen

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Guillemette, Laetitia. "Implication du TNFα dans la résistance à l’insuline pendant la grossesse". Mémoire, Université de Sherbrooke, 2015. http://hdl.handle.net/11143/6009.

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Résumé : Le diabète gestationnel (DG), qui peut entraîner des conséquences importantes pour la mère et l’enfant, résulte d’un défaut de compensation de la sécrétion d’insuline par rapport à la résistance à l’insuline. Comme la grossesse représente en elle-même un modèle d’augmentation physiologique de la résistance à l’insuline, il est intéressant d’étudier et de caractériser les facteurs qui sont impliqués dans la résistance à l’insuline et, ultimement, dans le DG, chez la femme enceinte. Le Tumor necrosis factor alpha (TNFα) est soupçonné d’être un de ces facteurs, suite aux études effectuées chez les animaux et les populations humaines non enceintes, mais les résultats obtenus en grossesse sont encore controversés. Nous avons émis l’hypothèse que les niveaux circulants de TNFα sont associés au DG et à la résistance à l’insuline dans une large cohorte de femmes enceintes. Nous avons aussi investigué les variations des niveaux de TNFα en réponse à l’hyperglycémie provoquée par voie orale (HGPO) chez des femmes enceintes. Nous avons montré que de hauts niveaux de TNFα étaient liés à une résistance à l’insuline augmentée au 2e trimestre de la grossesse et ce, indépendamment de l’âge, de l’adiposité, de l’âge gestationnel, des triglycérides et des niveaux circulants d’adiponectine dans notre cohorte. De plus, les niveaux de TNFα varient différemment au cours de l’HGPO selon le statut de résistance à l’insuline. En effet, les niveaux de TNFα augmentent à 1h puis diminuent à 2h chez les femmes les plus sensibles à l’insuline, alors qu’ils diminuent tout au long du test chez les femmes les plus résistantes à l’insuline, mais restent en tout temps supérieurs aux niveaux mesurés chez les femmes les plus sensibles à l’insuline. Toutefois, les niveaux de TNFα n’étaient pas différents entre les femmes avec DG et celles normoglycémiques. De façon intéressante, la variation du TNFα pendant l’HGPO chez les femmes DG est similaire à celle chez les femmes avec haute résistance à l’insuline. Ces résultats suggèrent donc que le TNFα est indépendamment associé à la résistance à l’insuline en grossesse et que les voies inflammatoires peuvent contribuer aux dysfonctions glycémiques retrouvées en DG. // Abstract : Gestational diabetes mellitus (GDM), which can exert important impacts on mothers and offspring, results from an imbalance between insulin secretion capacity and insulin resistance. Pregnancy is a state of physiologically increased insulin resistance, providing a unique model to study and characterize biological factors linked to insulin resistance in humans and, ultimately, GDM, in pregnant women. Based on animal studies and analyses in non-pregnant populations, tumor necrosis factor alpha (TNFα) is suspected of being involved in insulin resistance, but results obtained from pregnant populations are still controversial. Our hypothesis was that circulating TNFα would be associated with GDM and insulin resistance in a large cohort of pregnant women. We also investigated dynamic variations of TNFα levels over the course of an oral glucose tolerance test (OGTT) in pregnant women. We showed that higher TNFα levels were associated with higher insulin resistance at 2nd trimester of pregnancy, independent of age, adiposity, gestational age, triglycerides and adiponectin levels in our cohort. Furthermore, TNFα levels varied differently over the course of the OGTT according to insulin resistance status: they rose at 1h and then decreased at 2h in insulin sensitive women, whereas they consistently decreased in insulin resistant women over the course of the test (even though they remained statistically higher than insulin sensitive women’s levels at each time point throughout the OGTT). However, TNFα levels were not different between GDM and non-GDM women. Interestingly, variation of TNFα levels over the course of the OGTT in GDM women followed the same pattern as the variation observed in OGTT in women classified with high insulin resistance. Those results suggest that circulating TNFα is independently associated with insulin resistance in pregnancy and that inflammatory pathways might contribute to glycemic dysregulation observed in GDM.

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Venter, Teneille. "The effects of three carbohydrate supplementation protocols on the blood glucose levels in type I diabetic subjects during a 60 minute bout on the treadmill." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/4157.

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Diabetes associated complications make management during exercise complex (Brugnara, Vinaixa, Murillo, Samino, Rodriguez, Beltran, Lerin, Davison, Correig & Novials, 2012). Research on the prevention of such challenges is of paramount importance. The aim of this study was to determine the effects of three different carbohydrate supplementation protocols on blood glucose levels after every 10 minutes of a 60 minute exercise bout at 65 to 75 % HRR on the treadmill as well as every half hour during a two hour post exercise recovery period. The three protocols implemented after a standardized pre-exercise meal were: control protocol (no carbohydrate supplementation), protocol 1 (one carbohydrate supplementation of 15 grams given at 30 minutes) and protocol 2 (two carbohydrate supplementation of 15 grams given at 30 minutes and 45 minutes). A total of 32 participants took part in the study (Mean age: 32.84 ±12.12). All participants were submitted to all three protocols. Statistical and practical significant differences were found between blood glucose levels of protocol 0 and protocol 1 (MDIF = 2.62 ± 3.99 mmol.L--‐1) at 20 minutes of the exercise duration (p=.024;d=0.42). Statistical and practical significant differences in blood glucose levels with protocol 0 rendering the higher glucose values were also found between protocols 0 and 2 at 10 minutes (MDIF = 3.44 ± 5.54 mmol.L--‐1; p=.001;d=0.62), 20 minutes (MDIF = 3.32 ± 5.23 mmol.L--‐1; p=.001;d=0.63) and 30 minutes of exercise (MDIF = 2.81 ± 5.40 mmol.L--‐1; p=.006;d=0.52) as well as between the mean minimum (M0 = 9.49 ± 4.51 mmol.L--‐1 and M2 = 7.28 ± 4.07 mmol.L--‐1; p=.013;d=0.46), mean maximum (M0 = 12.73 ± 5.51 mmol.L--‐1 and M2 = 10.07 ± 4.63 mmol.L--‐1; p=.015;d=0.46) and overall mean (M0 = 9.07 ± 4.88 mmol.L--‐1 and M2 = 8.53 ± 4.25 mmol.L--‐1; p=.011;d=0.48) with protocol 0 rendering the higher glucose values in all these comparisons. It was concluded that carbohydrate supplementation during exercise affects blood glucose levels positively particularly considering the significant difference found between protocol 0 and 2. Whilst protocol 2 also resulted in less fluctuations in the blood glucose levels during exercise and minimum, overall mean and maximum blood glucose values were closer to “normal/safe” range, there was no conclusive evidence that protocol 2 was better than protocol 1.

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McGarry, Robert Gerard. "Modelling insulin/glucose dynamics and application to the analysis of oral glucose tolerance tests." Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335562.

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Mbu, Desiree Lem. "Expression of circulating Microrna’s (Mirnas) in blood of mixed ancestry subjects with glucose intolerance." Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/2816.

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Thesis (MSc (Biomedical Sciences))--Cape Peninsula University of Technology, 2018. Background: Early detection of individuals who are at risk of developing Glucose Intolerance would decrease the morbidity and mortality associated with this disease. MicroRNA is one of the most widely studied biomolecules involved in epigenetic mechanisms, hence it offers unique opportunities in this regard. Circulating microRNAs are associated with disease pathogenesis during the asymptomatic stage of disease. This has therefore attracted a lot of attention as a potential biomarker for identifying individuals who have an increased risk of developing Glucose Intolerance. The identification of high risk biomarkers for Glucose Intolerance will go a long way to eliminate the possible complications that arise due to late diagnosis and treatment of Glucose Intolerance. This could ultimately lead to better ways to prevent, manage and control the Glucose Intolerance epidemic that is rampant worldwide. The aim of the study is to investigate expression of circulating microRNA’s in blood of mixed ancestry subjects with glucose intolerance. Methods: A quantitative cross-sectional study design involving 36 individuals [who were age, gender and BMI (Body Mass Index) matched] from a total population of 1989 participants of mixed ancestry descent, residing in Bellville South, South Africa was used. Participants were classified as controls (normoglycemic), pre-diabetic (preDM) and diabetic (DM) (screen detected diabetic) according to WHO criteria of 1998. MicroRNAs were extracted from serum using the Qiagen miRNeasy Serum/Plasma Kit (ThermoFisher). The purified micro RNAs were reverse-transcribed to cDNA (complementary deoxyribonucleic acid) using the Qiagen RT2 First Strand Kit. Then, using Qiagen miScript SYBR Green PCR kit and miScript miRNA PCR arrays (ThermoFisher), the real time polymerase chain reaction was done to determine the expression profile the circulating micro RNAs present in the serum of the participants. Results: The 36 participants were evenly divided into 3 groups of 12 participants each as mentioned earlier. There were significant differences between groups in the waist (cm) (p=0.0415) and waist/hip ratio (p=0.0011) with highest values in the DM group and lowest in the normal group. Clinical parameters varied significantly according to glycemic status. As expected, the FBG (mmol/L) (p<0.0001), 2 HRs Post Glucose (mmol/L) (p<0.0001), HbA1c (%) (p=0.0009), Fasting Insulin (mIU/L) (p=0.0039), were all highest in the DM and lowest in the control group. In contrast, the 2 HRs Post Insulin (mIU/L) (p = 0.0027) was highest in the preDM group and lowest in the normal group, while the Glucose/Insulin ratio (p=0.0477) was highest in the normal group and lowest in the preDM group. Triglycerides (mmol/L) (p=0.0043) and Total Chol (mmol/L) (p=0.0429) were significantly increased through the three groups, with highest values in the DM group and lowest in the normal group. Furthermore, 12 of the 84 miRNAs studied were expressed through all the 3 groups and they exhibited both inverse and positive correlations between the clinical parameters, especially the glucose parameters (Fasting blood glucose, 2 hours post glucose, Fasting blood insulin, 2 hours post insulin and Glycated Hemoglobin).

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Glynn, A. Elizabeth. "Glycemic response to a peanut butter and cracker snack in noninsulin dependent diabetics and nondiabetics." Thesis, This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-09292009-020319/.

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Brambrink, Jill K. "Glucose tolerance and insulin sensitivity following exercise : influence of muscle mass and absolute work." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/834516.

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To determine the influence of muscle mass and absolute work on glucose tolerance and insulin sensitivity following exercise, glucose and insulin responses to an oral glucose tolerance test (OGTT) were analyzed in twelve subjects at baseline and 16 to 18 hrs following three different exercise trials performed on a cycle ergometer: 1) two-legged exercise at 60% of two-leg maximal oxygen uptake (VO2max), 2) one-legged exercise at 60% of the oneleg VO2max, and 3) a second one-leg trial at 60% of one-leg VO2max with work matched to the work obtained during the two-leg trial. Each trial was preceeded by two days of inactivity and a three day diet replication. Analysis of serum glucose concentrations during the post-exercise OGTTs demonstrated that glucose tolerance was unaffected by either the amount of active tissue incorporated in the exercise and/or the amount of work completed by the active tissue. On the other hand, serum insulin concentrations following the two-leg trial decreased 23.5% from 347.62 ±37.98 to 266.05 :L41.62 gU/ml in comparison to the one-leg trial (p < 0.05). The incorporation of a smaller muscle mass which completed an equal amount of absolute work as the larger muscle mass (i.e. one-leg work matched trial) resulted in a large (19%), but nonsignificant reduction in the total insulin compared to the one-leg relative work trial. In addition, total insulin following the two-leg and the one-leg work matched trials were reduced by 19% and 14%, respectively, in comparison to baseline. However, they did not reach statistical significance. The results of this study indicate that the incorporation of a larger muscle mass during an acute bout of aerobic exercise results in a reduction in serum insulin in response to a post-exercise oral glucose challenge. In addition, increasing the absolute work of a muscle mass results in similar reductions in serum insulin regardless of the amount of muscle mass involved in the exercise. While glucose tolerance was unaltered by either the amount of active tissue and/or the amount of work completed by the active tissue. School of Physical Education

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Sinsigalli, Nancy A. "Glucose tolerance, plasma insulin, and plasma glucagon in relation to obesity in chickens." Thesis, Virginia Tech, 1985. http://hdl.handle.net/10919/45737.

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Relationships among glucose tolerance, plasma insulin, and plasma glucagon were examined in chicks developed through selection for high (HW) and low (LW) body weight, and in F, crosses (HL) between HW males and LW females. At 21, 42, 63, and 84 days of age, chicks from each population were intubated with glucose (2 g/kg body weight) following a 24-hr fast. Blood was collected at 20-minute intervals up to 100 minutes postadministration. At all ages, the LW chicks were better able to metabolize glucose than their HW counterparts, while the HLs exhibited intermediate responses. Impaired glucose tolerance in the HWs and HLs was not associated with insulin insufficiency; the HWs and HLs, in comparison to the LWs, were hyperinsulinemic at 42 and 63 days of age and plasma insulin levels did not differ among populations at 21 or 84 days of age. Plasma glucagon responses to glucose administration were inconsistent, but plasma glucagon levels were consistently higher in the HWs and HLs than in the LWs. It was concluded that excessive fat deposition in chickens selected for rapid growth is associated with hyperinsulinemia and insulin resistance. Master of Science

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Schell, Timothy Craig. "The influence of anaerobic and aerobic exercise on glucose disposal in young male subjects." Virtual Press, 1994. http://liblink.bsu.edu/uhtbin/catkey/902477.

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Considerable research has been performed on the effects of exercise and glucose tolerance, however, most of this work has examined aerobic exercise designs. This study examines the immediate post-exercise glucose turnover in eight male subjects exposed to a single bout of running and PRE. Both exercise protocols were designed to be of similar duration and at an intensity representing a typical exercise session. This study was conducted in an effort to offer individuals with NIDDM an alternative to the established aerobic forms of exercise for improved glucose control. Each subject completed two preliminary procedures, which consisted of a maximal graded exercise test and a session where a 1 RM was established on six different Cybex variable resistance machines. Subjects then completed a baseline oral glucose tolerance test (OGTT) in which eight blood samples were analyzed for glucose, insulin, hemoglobin, and hematocrit. Two exercise protocols, separated by 3 to 10 days, consisting of a 40 minute treadmill run at 75% VO2max and a 40 minute, 3 set x 10 repetition based on 75% of the1 RM, were performed and followed 45 minutes later by another OGTT. The results demonstrated that there were no apparent differences in blood glucose or insulin levels post-exercise between the exercise modes. However, the form of exercise did seem to have a varied effect on insulin production. The results of the OGTT demonstrated an explicit difference in the insulin response between the lifting and running trials, with the lifting trial being significantly higher than the resting or running trials. The increased insulin levels observed in the lifting trial may be indicative of increased secretion from the pancreas or that the secreted insulin is simply not being used. The insulin resistance observed in the lifting trial may be due to the muscles inability to respond to insulin or some other metabolic factor(s) released during exercise. Additional studies should be performed on different populations to examine the effects of PRE and running in a effort to better understand the mechanisms responsible for glucose uptake. School of Physical Education

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Kaiyala, Karl John. "Effects of high fat feeding on determinants of glucose tolerance and brain insulin delivery in dogs /." Thesis, Connect to this title online; UW restricted, 1997. http://hdl.handle.net/1773/9140.

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Menzel, Stefan [Verfasser]. "Blutzucker-Vergleichsmessung beim oralen Glucose-Toleranz-Test (oGTT) zwischen dem Nova Biomedical StatStrip™ Blutzuckermessgerät und der Standardlabormethode / Stefan Menzel." Greifswald : Universitätsbibliothek Greifswald, 2011. http://d-nb.info/1016608101/34.

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Mazur, Carol Nelson. "Carbohydrate utilization in selected strains of British Columbia chinook salmon." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/29577.

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Digestible carbohydrate is commonly encountered by chinook salmon {Oncorhynchus tshawytscha) in practical culture diets, although little is known regarding its utilization. This study was undertaken to examine (1) the effects of a high carbohydrate diet and (2) glucose tolerance in chinook salmon of selected British Columbia strains. Yearling chinook salmon of three strains were fed to satiation either a high or a low carbohydrate diet for 63 days. The diets were isonitrogenous, and contained respectively 30 % gelatinized wheat starch or an equicaloric amount of herring oil. There was an overall reduction in growth of chinook fed the high-carbohydrate diet over the 63-day feeding period. Although specific growth rates declined initially in the high carbohydrate-fed groups, they were comparable to those of control groups in the final third of the trial, indicating an adaptation response. Chinook fed the high carbohydrate diet had increased carcass protein and ash, and decreased carcass fat levels relative to controls. Feed intake was generally lower in these groups, and differences in feeding response were observed between diets and strains. Although feed and energy efficiencies were reduced in chinook fed the high carbohydrate diet, protein utilization was comparable on the two diets, indicating a protein-sparing effect of the carbohydrate. Consumption of the high carbohydrate diet led to significant elevations in hepatosomatic indices (HSI) and liver glycogen (LG) concentrations. In Quesnel chinook, LG levels exceeding 10 % did not appear to have any detrimental effects on feeding, growth or health. LG concentrations and HSI fell to basal levels in all groups 21 days after feed withdrawal. Some strain differences were evident. For example, Big Qualicum chinook fed the high carbohydrate diet exhibited the lowest liver glycogen accumulation, highest rate of carcass fat deposition, and best energy efficiency ratios relative to control groups, suggesting a difference in carbohydrate metabolism in this strain. On the other hand, Quesnel chinook exhibited the highest relative growth on the high carbohydrate diet. Mortality, although unaffected by diet in the Quesnel and Robertson Creek chinook, appeared to be higher in high carbohydrate-fed Big Qualicum chinook. In the second part of the study, chinook salmon subjected to an oral glucose tolerance test displayed pronounced and persistent hyperglycaemia, indicative of poor glucose tolerance. Strain differences were evident in the magnitude of response. Acclimation to a high carbohydrate diet prior to testing resulted in a significantly reduced elevation of blood glucose, indicating an adaptation response. While plasma glucose concentrations approached 500 mg/dl in some trials, plasma insulin concentrations exhibited a two-fold rise, with indistinct peaks. Plasma glucose and plasma insulin concentrations were poorly correlated, indicating that glucose is a poor insulin secretagogue in chinook salmon. Land and Food Systems, Faculty of Graduate

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Arroyo, Gálvez Leonor, and Goicoechea Segundo Joel Cárdenas. "Test de tolerancia oral a la glucosa modificada en puérperas con recién nacido macrosómico como diagnóstico retrospectivo de diabetes gestacional." Universidad Nacional Mayor de San Marcos. Programa Cybertesis PERÚ, 2004. http://www.cybertesis.edu.pe/sisbib/2004/arroyo_gl/html/index-frames.html.

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Objetivo: El propósito del estudio fue determinar la relación entre el test de Tolerancia oral a la glucosa( TTOG) en las puérperas con macrosomia fetal y plantearlo como un método de diagnostico retrospectivo de diabetes gestacional. Diseño de estudio: Estudio Clínico, Observacional, Prospectivo, Analítico, Comparativo (de casos y controles pareados), con 142 puérperas pareadas por edad, paridad y tipo de parto, 71 con recién nacidos macrosómicos y 71 con recién nacidos con pesos en percentiles de la normalidad. Previo consentimiento informado, se realizó un TTOG modificado de dos horas (basal, 1h y 2 h) con 100 gr de glucosa (positivo si [Glicemia 2h – Basal] + [Glicemia 1h – Basal] > 110 mg/dl) a todas las participantes entre las primeras 8 y 48 horas posparto en el IEMP, entre Abril a Junio del 2003. Se utilizó el paquete SPSS v.10.0 para crear la base de datos y realizar el análisis estadístico que consistió en un análisis univariado, bivariado para evaluar la hipótesis, y finalmente un análisis multivariado. Resultados: El test de tolerancia oral a la glucosa anormal resultó un factor de riesgo para macrosomia fetal, con un odds rate ajustado de 5.93; 95% IC, 2.626-13.393. Se encontró una asociación significativa el antecedente de macrosomia fetal odds rate 15.690; 95% IC, 1.993-123.553 y el control prenatal odds rate 5.696, 95% IC, 1.192-26.828. Conclusión: Existe una relación entre el TTOG en puérperas y macrosomia fetal que puede ser usada como un test de Diagnóstico retrospectivo de Diabetes Gestacional. PALABRAS CLAVES: Test de Tolerancia Oral a la Glucosa, Macrosomia fetal, Diabetes Gestacional.

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Cárdenas, Goicoechea Segundo Joel, and Gálvez Leonor Arroyo. "Test de tolerancia oral a la glucosa modificada en puérperas con recién nacido macrosómico como diagnóstico retrospectivo de diabetes gestacional." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2004. https://hdl.handle.net/20.500.12672/1903.

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Objetivo: El propósito del estudio fue determinar la relación entre el test de Tolerancia oral a la glucosa( TTOG) en las puérperas con macrosomia fetal y plantearlo como un método de diagnostico retrospectivo de diabetes gestacional. Diseño de estudio: Estudio Clínico, Observacional, Prospectivo, Analítico, Comparativo (de casos y controles pareados), con 142 puérperas pareadas por edad, paridad y tipo de parto, 71 con recién nacidos macrosómicos y 71 con recién nacidos con pesos en percentiles de la normalidad. Previo consentimiento informado, se realizó un TTOG modificado de dos horas (basal, 1h y 2 h) con 100 gr de glucosa (positivo si [Glicemia 2h – Basal] + [Glicemia 1h – Basal] > 110 mg/dl) a todas las participantes entre las primeras 8 y 48 horas posparto en el IEMP, entre Abril a Junio del 2003. Se utilizó el paquete SPSS v.10.0 para crear la base de datos y realizar el análisis estadístico que consistió en un análisis univariado, bivariado para evaluar la hipótesis, y finalmente un análisis multivariado. Resultados: El test de tolerancia oral a la glucosa anormal resultó un factor de riesgo para macrosomia fetal, con un odds rate ajustado de 5.93; 95% IC, 2.626-13.393. Se encontró una asociación significativa el antecedente de macrosomia fetal odds rate 15.690; 95% IC, 1.993-123.553 y el control prenatal odds rate 5.696, 95% IC, 1.192-26.828. Conclusión: Existe una relación entre el TTOG en puérperas y macrosomia fetal que puede ser usada como un test de Diagnóstico retrospectivo de Diabetes Gestacional. PALABRAS CLAVES: Test de Tolerancia Oral a la Glucosa, Macrosomia fetal, Diabetes Gestacional. Tesis de segunda especialidad

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Bernabe-Ortiz, Antonio, Andrea Ruiz-Alejos, J. Jaime Miranda, Rohini Mathur, Pablo Perel, and Liam Smeeth. "EZSCAN for undiagnosed type 2 diabetes mellitus: A systematic review and meta-analysis." Public Library of Science (PLoS), 2017. http://hdl.handle.net/10757/622426.

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Objectives: The EZSCAN is a non-invasive device that, by evaluating sweat gland function, may detect subjects with type 2 diabetes mellitus (T2DM). The aim of the study was to conduct a systematic review and meta-analysis including studies assessing the performance of the EZSCAN for detecting cases of undiagnosed T2DM. Methodology/Principal findings: We searched for observational studies including diagnostic accuracy and performance results assessing EZSCAN for detecting cases of undiagnosed T2DM. OVID (Medline, Embase, Global Health), CINAHL and SCOPUS databases, plus secondary resources, were searched until March 29, 2017. The following keywords were utilized for the systematic searching: type 2 diabetes mellitus, hyperglycemia, EZSCAN, SUDOSCAN, and sudomotor function. Two investigators extracted the information for meta-analysis and assessed the quality of the data using the Revised Version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Pooled estimates were obtained by fitting the logistic-normal random-effects model without covariates but random intercepts and using the Freeman-Tukey Arcsine Transformation to stabilize variances. Heterogeneity was also assessed using the I2 measure. Four studies (n = 7,720) were included, three of them used oral glucose tolerance test as the gold standard. Using Hierarchical Summary Receiver Operating Characteristic model, summary sensitivity was 72.0% (95%CI: 60.0%– 83.0%), whereas specificity was 56.0% (95%CI: 38.0%– 74.0%). Studies were very heterogeneous (I2 for sensitivity: 79.2% and for specificity: 99.1%) regarding the inclusion criteria and bias was present mainly due to participants selection. Conclusions: The sensitivity of EZSCAN for detecting cases of undiagnosed T2DM seems to be acceptable, but evidence of high heterogeneity and participant selection bias was detected in most of the studies included. More studies are needed to evaluate the performance of the EZSCAN for undiagnosed T2DM screening, especially at the population level.

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Chang, Wei-Teng, and 張瑋騰. "The Effect of Intravenous Glucose Tolerance Test in Neutralized Female Cats." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/22168095593327187062.

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碩士 國立中興大學 獸醫學系暨研究所 97 In 1991, it was first reported that obesity in feline was associated with neutering. Increased food intake and decreased metabolic rate after neutering might be the reason leading to obesity. Obesity will lead to insulin resistance and impaired glucose tolerance in human and feline. Type 2 diabetes mellitus (non-insulin dependent diabetes mellitus) is preceded by insulin resistance and impaired glucose tolerance. The aim of this study is to investigate the relationship between neutralization and diabetes mellitus in female cats. In our study, four 3-year-old female neutered cats were enrolled into this observation. Body weight of cats was measured every day. Intravenous glucose tolerance test was performed at 1, 2, 3, 4 and 5 months after neutering. Blood samples were collected at 0 and 10, 20, 30, 60 and 120 minutes from intravenous catheter after glucose administration. Plasma insulin and glucose were measured by Mercodia Feline Insluin ELISA and ACCU-CHECK® Active, respectively.In the results, body weight and BMI of cats were significantly higher at 2, 3, 4 and 5 months after neutering in comparison to the time after neutering (p<0.05). The weight gain in 4 cats was 36%, 36%, 59% and 25% respectively. The area under curve of plasma glucose was lower in cat no.4 at 5 and 6 months after neutering in comparison to other cats. The results of fasting insulin and HOMA fluctuated in 6 months observation.In our study, ovariohysterectomy leads to increased body weight and BMI. Overweight in female cats is associated impaired glucose tolerance. Insulin resistance is not found in this study. We suggest that glucose intolerance precedes insulin resistance in the early stage of obesity. Because of the variation of insulin secretion in feline is wide, increase in sample size is necessary in future study.

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Lee, Yu-Kuo, and 李毓國. "The Relationships of Oral Glucose Tolerance Test and BMI In Basketball Players." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/05986845084222327872.

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碩士 臺北巿立體育學院 運動科學研究所 93 The purpose of current study is to investigate the relation of oral glucose tolerance test (OGTT) and BMI. Subjects were recruited voluntarily from Chunghwa Telecom Women Basketball Team to evaluate their glucose metabolism condition by OGTT . After 1 week detraining, we measured relative physiology values in morning. Our result showed that insulin area under curve (IAUC) is significantly associated with BMI value (r = .57, p < .05) and creatine kinase (CK) (177.74 ± 15.64 mg/dl) after orally 75 g glucose given. There was no relations on OGTT and CK. Even though athletes with high BMI exercise regularly, their insulin sensitivity is worse yet. This result implies that other factors which cause the increase of BMI still affect the insulin sensitivity, and then affect the uptake of glucose in spite of regular exercise.

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Gresl, Theresa Ann. "Glucose regulation in adult, male Rhesus monkeys : analysis of intravenous glucose tolerance test data with mathematical modeling /." 2001. http://www.library.wisc.edu/databases/connect/dissertations.html.

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Dissertations / Theses on the topic 'Glucose Tolerance Test'

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