Ozonoterapia sistémica en pacientes diabéticos insulinodependientes con dolor neuropático / Systemic ozone therapy in insulin-dependent diabetic patients with neuropathic pain

Introducción: Con frecuencia, los pacientes diabéticos presentan dolor neuropático como complicación de su enfermedad. Objetivo: Identificar las ventajas de la ozonoterapia sistémica en pacientes diabéticos insulinodependientes con dolor neuropático. Métodos: Se realizó un estudio descriptivo en diabéticos insulinodependientes con dolor neuropático que acudieron a la Clínica del Dolor del Hospital Clínico Quirúrgico Hermanos Ameijeiras entre febrero de 2014 hasta enero de 2019. A todos se les cuantificó el dolor, la presencia de parestesias, la fuerza muscular, el reflejo aquiliano y la hemoglobina glicosilada. Se administraron 15 sesiones de ozono vía rectal y 6 de autohemoterapia mayor. Se compararon los resultados de la primera sesión y en la última (8 semanas de tratamiento). Resultados: El 45,3 por ciento tenían 60 años o más, 59 por ciento eran del sexo femenino y 89,3 por ciento tenían 15 o más años de evolución de la diabetes. En la primera consulta la intensidad del dolor en 100 por ciento osciló entre 7 y 10 de la escala numérica verbal y todos presentaron parestesias. En 59,3 por ciento existió disminución de la fuerza muscular, 62 por ciento presentó reflejo aquiliano disminuido y 88 por ciento hemoglobina glicosilada mayor o igual a 12 por ciento. Estos síntomas mejoraron a las ocho semanas. Conclusiones: Las probadas propiedades analgésicas y antiinflamatorias del ozono lo convierten en la actualidad en una herramienta terapéuticas de las más eficientes para el control del dolor crónico en pacientes diabéticos insulinodependientes(AU)

Introduction: Frequently, diabetic patients present neuropathic pain as a complication of their disease. Objective: To identify the advantages of systemic ozone therapy for insulin-dependent diabetic patients with neuropathic pain. Methods: A descriptive study was carried out with insulin-dependent diabetic patients with neuropathic pain who attended the Pain Clinic of Hermanos Ameijeiras Clinical-Surgical Hospital between February 2014 until January 2019. All of them were quantified pain, the presence of paresthesias, muscle strength, ankle jerk reflex, and glycosylated hemoglobin. The patients received fifteen sessions of rectal ozone and six sessions of major self-hemotherapy. We compared the outcomes after the first session and after the last one (eight weeks). Results: 45.3 percent were 60 years or older, 59 percent were female, and 89.3 percent had a natural history of diabetes of 15 years or more. In the first hospital visit, the intensity of 100 percent pain ranged between 7 and 10 according to the verbal numeric scale, and all presented paresthesias. In 59.3 percent, there was a decrease in muscle strength, 62 percent had decreased ankle jerk reflex, and 88 percent had glycosylated hemoglobin higher than or equal to 12 percent. These symptoms improved at week eight. Conclusions: The proven analgesic and anti-inflammatory properties of ozone make it currently a therapeutic tool among the most efficient for controlling chronic pain in insulin-dependent diabetic patients(AU)

Five-year girl with advanced lupus nephritis and insulin dependent diabetes mellitus

Systemic Lupus Erythematosus (SLE) and Insulin Dependent Diabetes Mellitus (IDDM) are two common auto immune disorder occurring in children which can involve the renal system. The condition when occurs simultaneously in a child and its effects and follow up on the kidneys and its management have been mentioned here. A five-year-old girl was presented with low grade fever, dryness of mouth and bilateral pain over knee joints over four months. She had facial puffiness, mild bilateral pedal edema, and ascites on admission. She was treated immunosuppressive medications following a renal biopsy and insulin for IDDM

Neurophysiological Changes In Person With Insulin Dependent And Non Insulin Dependent Diabetes Mellitus

Background: Diabetes mellitus is a disease caused by an inability of the body to metabolize glucose properly. The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. As Insulin and non-insulin dependent diabetes shows their effect on various physiological systems includes central, peripheral and autonomic nervous systems, musculoskeletal, cardiovascular and other vital systems. A common complications due to the IDDM and NIDDM includes peripheral neuropathy, retinopathy, nephropathy and vascular complication. Insulin and non-insulin dependent diabetes mellitus, both affect the peripheral nervous system significantly. Therefore we would like to find out neurophysiological changes on peripheral nervous systems between insulin and non-insulin dependent diabetes mellitus. Aim: To find out the Neuro-physiological changes between IDDM and NIDDM. Materials and Method: 120 individuals screened with SF36 (general health good and above) were included with age limit between 25 to 60 years. Those individuals having a history of hospitalization in last 1 year, acute fever, present history of radiculopathy and open wound were excluded. They were divided into 2 groups IDDM and NIDDM. For nerve conduction study–distal latency, amplitude and NCV of sensory and motor nerves were performed. Nerve conduction studies of common peroneal, tibial and sural nerves were examined in both groups. Latency, NCV and CMAP/SNAP were taken as outcome measures. Result and Discussion: Bio-statistical analysis has been done using Mann-Whitney test. Result suggest that there is a significant difference in Neurophysiological changes (p<0.05) between IDDM and NIDDM groups. Conclusion: In context to our study and neurophysiological findings, individuals with IDDM must be taken into consideration for promotion, prevention, and care as compared to NIDDM for secondary complications.

Prevalence, progression, and outcomes of diabetic retinopathy during pregnancy in Indian scenario

Purpose: The objective of this study is to evaluate pattern of diabetic retinopathy (DR) during pregnancy in females with pregestational diabetes mellitus (DM). Methods: This is an ambispective observational cohort study conducted at an Indian tertiary care centre. A total of 50 pregnant females with pregestational DM were included while those with gestational DM were excluded from the study. Ocular examination (inclusive of fundus photography) was conducted and systemic parameters (inclusive of Glycated hemoglobin) were assessed during each of the 3 trimesters and 3 months postpartum. The prevalence and progression of DR during pregnancy in the study cohort were the main outcome measures. Results: Three of the 50 patients had type 1 DM while 47 had type II DM. All the patients with type I DM were insulin dependent while 19 patients with type II DM were insulin dependent. Overall prevalence of DR was 8% (4/50); 2 cases had nonproliferative DR (NPDR), and 2 had proliferative DR (PDR). During the study period, worsening was seen in both the patients with PDR and one required vitrectomy. Mean visual acuity in patients with PDR decreased from 0.77 logMAR units at presentation to 1.23 logMAR at final follow-up. There was no change in the mean visual acuity of patients with NPDR. None of the patients with NPDR converted to PDR. There was no new onset DR in the patients without DR at presentation. Assessment of risk factors for DR revealed significantly higher duration of DM (14 ± 6.32 years vs. 3.43 ± 1.43 years, P = 0.0008). The median age was also higher in the DR patients (31 years vs. 29 years, P = 0.32). Conclusion: No new onset cases were seen during the course of pregnancy and no conversion from NPDR to PDR was seen; however, a worsening of the two PDR cases was observed. No cases of DR were seen in noninsulin-dependent DM. None of the four participants with DR showed a spontaneous resolution of DR postpartum. Patients with PDR and long-standing DM require careful observation during pregnancy. A registry of diabetic mothers should be set up for development of guidelines for managing such cases.

The health related quality of life of non-insulin dependent diabetes mellitus patients admitted at Brokenshire Integrated Health Ministries, Incorporated

OBJECTIVE: The purpose of this study was to determine the quality of life of type 2 diabetic patients admitted at a private tertiary hospital in Davao City using the Ferrans and Powers Quality of Life IndexDESIGN: This study is a descriptive, cross-sectional examination to determine self-rated quality of life among diabetic patients admitted at a private tertiary hospital in Davao City using the Ferrans and Powers Quality of Life Index.RESULTS: The cross sectional study involved 37 respondents of a private tertiary hospital in Davao City. Most belong to ages 50 years and above (91.9%), are females (59.5%) and married (89.2%). All have some form of formal schooling and 51.4% are employed. Most do not adhere to recommended diet (59.5%), exercise (64.9%), have no history of smoking (56.8%) and have higher BMI however 54% had controlled glucose (54%). Majority have been diagnosed with diabetes for 5-10 years (43.2%), have complications (59%) and are under combination therapy. The mean overall quality of life and QOL subscales of patients were good. Most sociodemographic, lifestyle and medical factors did not show any statistical significance (p value >0.05). Age had positive association with overall quality of life, health and function and socioeconomic subscales. Maintenance medication and civil status had positive association with the socioeconomic and family subscales respectively.CONCLUSION: The mean overall quality of life and QOL subscales of patients were good. Older age, marriage and combination therapy were associated with high quality of life and specific subscales. Other factors showed no significant association thus further studies are recommended. Assessment of Quality of life and management of modifiable risk factors of diabetes are also recommended.

Emblica officinalis improves glycemic status and oxidative stress in STZ induced type 2 diabetic model rats

OBJECTIVE@#To evaluate the antidiabetic and antioxidant potential of Emblica officinalis (E. officinalis) fruit on normal and type 2 diabetic rats.@*METHODS@#Type 2 diabetes was induced into the male Long-Evans rats. The rats were divided into nine groups including control groups receiving water, type 2 diabetic controls, type 2 diabetic rats treated with glibenclamide (T2GT) and type 2 diabetic rats treated with aqueous extract of fruit pulp of E. officinalis. They were fed orally for 8 weeks with a single feeding. Blood was collected by cutting the tail tip on 0 and 28 days and by decapitation on 56 day. Packed red blood cells and serum were used for evaluating different biochemical parameters.@*RESULTS@#Four weeks administration of aqueous extract of E. officinalis improved oral glucose tolerance in type 2 rats and after 8 weeks it caused significant (P<0.007) reduction in fasting serum glucose level compared to 0 day. Triglycerides decreased by 14% but there was no significant change in serum ALT, creatinine, cholesterol and insulin level in any group. Furthermore, reduced erythrocyte malondialdehyde level showed no significant change (P<0.07) but reduced glutathione content was found to be increased significantly (P<0.05).@*CONCLUSIONS@#The aqueous extract of E. officinalis has a promising antidiabetic and antioxidant properties and may be considered for further clinical studies in drug development.

Effect of norvasc and benazepril for treatment elderly hypertensive patients with NIDDM * / 重庆医学

Objective To investigate the effect of Norvasc combined with Benazepril for treatment elderly hypertensive patients with Non-insulin-dependent diabetes mellitus .Methods 52 cases of elderly hypertensive patients with Non-insulin-dependent diabe-tes mellitus were selected as the study object and were randomly divided into the observation group and the control group ,each with 26 cases of patients .The observation group was given Norvasc combined with Benazepril while the control group was given Nor-vasc .Results After 8 weeks ,the SBP and DBP of the observation group were significantly lower than that of the control group (P<0 .05) .The FBG and 2h PBG were significantly lower than that of the control group as well as the ISI significantly higher (P<0 .05) .Conclusion Norvasc combined with Benazepril can effectively control the blood pressure and plasma glucose of elderly hy-pertensive with Non-insulin-dependent diabetes mellitus ,also improve the ISI of patients .It is deserved to be promoted widely in the clinical work .

Double-blind, placebo-controlled clinical evaluation of an Ayurvedic formulation (GlucoCare capsules) in non-insulin dependent diabetes mellitus.

Diabetes mellitus describes a metabolic disorder of multiple etiologies characterized by insulin resistance, relative insulin deficiency and hyperglycemia with disturbances of carbohydrate, fat and protein metabolism. The goal for treatment of diabetes is to prevent its acute manifestations and long-term microvascular and macrovascular complications. The present study was conducted to evaluate the efficacy and safety of an Ayurvedic formulation (GlucoCare Capsules) in non-insulin dependent diabetes mellitus. Fifty NIDDM patients of pitta-kapha prakriti attending the outpatient department of the Government Ayurvedic Medical College, Guwahati, Assam, India were included in the study, and randomly divided into 2 groups, GlucoCare and placebo. All received either GlucoCare or placebo in a dose of 2 capsules twice daily, before meals for 3 months. All 50 patients completed the study - no drop outs, withdrawals or patients lost to follow up. The GlucoCare group showed significant improvement in symptoms from the 2nd month till the end of the study. GlucoCare was well tolerated by all patients throughout the treatment period with no evidence of adverse effects. The study indicates clinical efficacy of GlucoCare Capsules in the management of NIDDM in those belonging to pitta-kapha prakriti. The formulation is well tolerated and appears safe in the dosage used.

Pathology of diabetic myocardiac microangiopathy / 老年心脏病学杂志（英文版）

Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity from those in controls. Nor was there difference in number of myofibers or diameters of myocardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group(P<0.0 l),and the capillary basement membrane in the former was significantly thicker than in the latter(P<0.01).Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.

Corrlation of dorsal artery of foot with type 2 diabetes mellitus on ultrasonography / 中华医学超声杂志（电子版）

Objective To evaluate the correlation between lesions of dorsal artery of foot and type 2 diabetes on CDFI. Methods Dorsal artery of foot was examinated in 97 cases with type 2 diabetes and 46 cases without diabetes mellitus. Results There were variable changes in intima-media of dorsal artery of foot in type 2 diabetes patients.And the patients with hyperlipidemia and hypertension showed serious lesions in the dorsal artery of foot and bifurcation of the blood vessel .Simple arteriosclerosis showed not only lesions in intima-media of dorsal artery of foot but also relative mild lesions in bifurcation of the blood vessel. Blood vessel lesion incidence in type 2 diabetes was significantly higher than that of the control group (P<0.01). Conclusions There was a significant correlation between lesions of dorsal artery of foot and type 2 diabetes patient's condition. CDFI is an effective method in evaluating patient's condition, degree and prognosis of type 2 diabetes, and has an important clinical value in early diagnosis, prognosis and treatment.Simple arteriosclerosis showed focal lesions in bifurcation of the blood vessel while dorsal artery of foot showed relatively mild lesions .

Plasma total homocysteine and macrovascular complications are associated with food and nutrient intake in patients with Type II diabetes mellitus

The present study was conducted to document the association between plasma homocysteine levels and the presence of macrovascular angiopathy with food and nutrient intake patterns among patients with Type II diabetes mellitus in Korea. Plasma total homocysteine concentration was analyzed by HPLC-fluorescence detector method in 127 patients with non-insulin dependent diabetes mellitus. Logistic regression analyses were performed respectively to study the association of plasma homocysteine levels with clinical and dietary characteristics and macroangiopathy (MA). The average plasma homocysteine level of patients with MA was 14.2 micromol/l, which was significantly higher than that of patients without MA (11.4 micromol/l). The proportions of patients with MA showed a significant difference, being 32.3% in hyperhomocysteinemic (>14.0 micromol/l) patients and 13.5% in others with homocysteine levels lower than 14.0 micromol/l. Odds ratios for macroangiopathy by tertile increase of plasma homocysteine concentration were 1.633 (Q2) and 4.831 (Q3), when adjusted for age, sex, and cigarette smoking. Patients with MA consumed reduced amounts of vitamin B1, B2, and folate. The results indicate that the plasma homocysteine levels are significantly increased in NIDDM patients who have macroangiopathy. Dietary management such as increased fruits and vegetables and decreased potatoes and starches might be beneficial for the prevention of macroangiopathy in diabetic patients.

Effect of Displaying P277 Peptide on Surface of L-asparaginase on Its Antigenicity and Efficacy of Autoimmune Diabetes Prevention in NOD Mice / 中国生物化学与分子生物学报

The recombinant chimeric enzyme of AnsB-TTP-P277 comprising L-asparaginase, a tetanus toxin peptide spacer and P277 was expressed as a soluble protein in Escherichia coli. The purified chimeric enzyme exhibited primary activity of the native asparaginase. Prediabetic NOD mice immunized with the chimeric enzyme could induce specific antibodies against P277 and the specificity of anti-P277 antibodies was verified by Western blot assay. The study showed that displaying the P277 epitope on the surface of asparaginase could effectively overcome the weak antigenicity of the P277 epitope and evoke a strong P277-specific immune response in mice. Moreover, the concentration of blood glucose was measured by an automated analyzer.Histochemical analysis of mice pancreas tissues showed that the administration of the chimeric enzyme to NOD mice could prevent the development of diabetes more efficiently than the peptide P277 itself.

Intranasal vaccination with p277 tandem repeat sequences carried by Hsp65 prevented type 1 diabetes in NOD mice / 中国临床药理学与治疗学

AIM: To improve the prevent efficacy of peptide p277 in autoimmune diabetes. METHODS: The recombinant expression plasmid pET28-Hsp65-6×p277 was constructed by inserting 6×p277 which were amplified by PCR into the vector pET28-Hsp65. The plasmid pET28-Hsp65-6×p277 was transformed into E.coli BL21 (DE3) and the fusion protein (Hsp65-6×p277) was expressed effectively as soluble protein after inducing by lactose. The fusion protein was purified and then used to immunize 4-week old female NOD mice with three times of i.n. inoculations in the absence of adjuvants. Serum samples from the immunized mice were collected at monthly interval. The concentrations of blood glucose and antibodies were measured by automatic analyzer. RESULTS: Administration with the Hsp65-6×p277 to NOD mice could prevent the development of diabetes. CONCLUSION: The fusion protein Hsp65-6×p277 might be further developed to a vaccine against insulin-dependent diabetes mellitus.

Mhc: polimorfimoos genéticos en autoinmunidad

Las enfermedades autoinmunes se caracterizan por inflamación, así como por el desarrollo y mantenimiento de anticuerpos y linfocitos T dirigidos contra antígenos propios (autoantígenos). Aunque la etiología de estas enfermedades es desconocida, poseen mecanismos en común. Existe una fuerte asociación genética entre ciertas enfermedades autoinmunes como la artritis reumatoide, esclerosis múltiple y diabetes mellitus insulino-dependiente y algunos alelos y/o haplotipos del complejo principal de histocompatibilidad. La explicación actual para este tipo de asociaciones propone que las moléculas del complejo principal de histocompatibilidad que se han encontrado asociadas, unen de manera eficiente autoantígenos envueltos en la patofisiología de la enfermedad, lo cual resulta en una respuesta inmune periférica mediada por células T contra autoantígenos y las secuelas autoinmunes. La susceptibilidad individual en autoinmunidad puede estar determinada por una combinación de polimorfismos específicos de genes que codifican para múltiples citocinas, antígenos del complejo principal de histocompatibilidad, moléculas de adhesión y proteínas celulares. Esta condición puede conducir a la expresión anormal de moléculas inmunorreguladoras y finalmente resultar en el desarrollo o exacerbación de la enfermedad. Recientemente también se ha estudiado el papel de las secuencias virales en la patogénesis de autoinmunidad, principalmente involucradas en mimetismo molecular.

Autoimmune diseases are characterized by inflammation and by the development and maintenance of antibodies and T lymphocytes against "self" antigens. Although the etiology of these diseases is unknown, they have a number of cellular and molecular mechanisms in common. A strong genetic association exists between a number of autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, and insulin-dependent diabetes mellitus (IDDM) and the expression of certain alleles or haplotypes of the major histocompatibility complex (MHC). The current explanation for this association proposes that disease-associated MHC molecules efficiently bind autoantigens involved in the pathophysiology of the disease. This results in a peripheral T cell-mediated immune response to the autoantigens and autoimmune sequelae. Individual susceptibility to autoimmune diseases may be determined by a combination of specific polymorphisms of genes encoding multiple cytokines, MHC antigens, adhesion molecules, and cellular proteins. This condition may lead to abnormal expression of immunoregulatory molecules and finally result in the development or exacerbation of the disease. Recently, the role of viral sequences in the pathogenesis of autoimmunity has been discussed, mainly involved in molecular mimicry.

Adaptação transcultural e validação do "Diabetes Quality of Life for Youts" de Ingersoll e Marrero / Cross-cultural adaptation and validation of the "Diabetes Quality of Life for Youths" of Ingersoll and Marrero

A avaliação da qualidade de vida tem sido considerada, na atualidade, como um parâmetro fundamental na compreensão do impacto causado pelo diabetes mellitus do tipo 1, no cotidiano dos adolescentes. Na realidade brasileira não existem instrumentos específicos validados que possibilitem essa avaliação. Assim sendo, este estudo teve como objetivos fazer a adaptação transcultural e validação "Diabetes Quality of Life for Youths"(DQOLY) de Ingersoll e Marrero e, analisar as relações entre a variáveis sócio demográficas, clínicas e a questão da autopercepção do estado de saúde e os escores obtidos pela aplicação do instrumento. O DQOLY é composto por 53 itens agrupados nos domínios: satisfação, impacto e preocupação. O processo de adaptação transcultural incluiu as etapas: tradução para o português, back translation, revisão pelos juízes e pré-teste. O instrumento adaptado, foi aplicado a 124 adolescentes com diabetes mellitus tipo 1, para a análise de suas propriedades psicométricas(confiabilidade e validade). A adaptação transcultural gerou uma versão brasileira do instrumento que na análise da consistência interna, apresentou valores de Alpha de Cronbach de 0, 8695 para o domínio Satisfação, 0, 8658 para o Impacto, 0, 8387 para o Preocupação e 0, 9333 para o total, com a exclusão de três itens inconsistentes no domínio Impacto e portanto, o instrumento gerado ficou constituído por 48 itens. No teste-reteste não houve diferenças significativas(p>0, 05) --------------------------------------|a entre duas aplicações do instrumento aos mesmos sujeitos, o que demonstrou a estabilidade temporal do mesmo. Na análise de validade de conteúdo, a concordância entre os juízes não foi unânime somente quando envolveu a avaliação de um deles. A validade convergente foi configurada pelas correlações positivas e significativas entre os escores total e por domínios do instrumento em estudo e da escala de Autoestima(p<0,001). (continuação) A validade fatorial não confirmou os três domínios. Nas comparações dos escores do instrumento entre adolescentes com controle metabólico adequado e não adequado, houve diferença significativa para os domínios impacto, preocupação e total(p<0, 05), o que determinou a validade discriminante. Os escores do instrumento foram relacionados às variáveis sócio demográficas, clinicas e a autopercepção do estado de saúde e os resultados demonstraram correlação positiva e significativa(p<0,05) entre o maior número de episódios de hiperglicemia relatadas e todos os escores do instrumento, indicando que quanto maior o número de hiperglicemias relatadas, pior a qualidade de vida. O domínio satisfação se correlacionou negativamente com a maior frequência das monitorizações domiciliares da glicemia, mostrando que o maior número de testes correlaciona-se com melhor qualidade de vida neste domínio. Todos os domínios do instrumento e o total tiveram correlação positiva e estatisticamente significativa com o relato de melhor percepção do estado de saúde(p<0, 001). Este estudo indica que o DQOLY adaptado para a cultura brasileira é um instrumento confiável e válido para utilização em nosso meio.

The quality of life evaluation has been considered, nowadays, as a fundamental parameter on comprehension of diabetes type 1's impact on adolescent's lifestyle. In the Brazilian reality, there are no validated specific instruments that permit this evaluation. Hence, the goals of this study were to cross-culturally adapt and validate the Ingersoll and Marrero's "Diabetes Quality of Life for Youths" (DQOLY) instrument and to analyze the relations among social demographics, clinical variables, self perceived health status and the scores obtained through the adapted instrument application. The DQOLY is composed of 53 items arranged by domains: satisfaction, impact, worries. The cross-cultural adaptation process included the stages: translation into portuguese, back translation, committee review and pre- testing. The adapted instrument was applied to 124 type 1 diabetes adolescents in order to assess the psychometric properties(reliability and validity). The cross-cultural adaptation originated the Brazilian version, in which, internal consistency evaluated by Conbach's Apha scored 0.8695 for satisfaction domain, 0.8658 for impact, 0.8387 for worries and 0.9333 for total, the exclusion of three inconsistent items on Impact domain generated a 48- item instrument. Regarding the test-retest, there were no significant differences(p>0.05) between two instrument appliances on the same subjects, which demonstrated its temporal stability. In the case of content validity, the agreement between the judges was the rule, except when it just involved the evaluation of one of them. The convergent validity was demonstrated by positive and significant correlation among the instrument's total and domains scores and the self esteem scale(p<0.001). The factorial validity did not confirm the three domains. In the regard to instrument scores comparisons among adolescents with and without adequate metabolic control, (continue) (continuation)there were significant differences on impact, worries domains and total(p<0.05), which demonstrated the discriminant validity. The instrument scores were related to socio- demographics and clinical variables. The self- perceived health status and the results indicated significant positive correlation(p<0.05) among the larger number of hyperglycemic episodes referred and all instrument's scores, indicating that the higher is the number of related hyperglycemia's episodes, the worse is the quality of life. The satisfaction domain was negatively correlated to the higher frequency of home monitoring blood glucose, demonstrating that the higher are the frequencies of the tests , the better is the quality of life in this domain. All instrument's domains and total had positive and significant correlation with self- perceived health status(p<0.001). This study indicates that adaptacion of the DQOLY into Brazilian culture is a reliable and valid instrument for utilization in our reality.

Association of the Tumor Necrosis Factor-alpha Gene Polymorphism with End-Stage Kidney Failure / 대한신장학회잡지

BACKGROUND: It is evident that cytokines play a role in the pathogenesis as well as the progression of renal diseases. The purpose of this study was to determine whether cytokine gene polymorphism is a marker of susceptibility to end-stage kidney failure (ESKF) in Korean populations. METHODS: -308 G/A polymorphism of tumor necrosis factor-alpha (TNF-alpha) gene was genotyped in 257 dialysis patients and 277 age-matched healthy controls, 86 NIDDM patients with kidney failure and 102 NIDDM controls without nephropathy. RESULTS: We found a decreased frequency of TNF-alpha allele 2 (TNF2, 2.9%) in ESKF patients compared to healthy controls (7.5%, p<0.05). We also found a decreased frequency of TNF-alpha allele 2 (TNF2, 2.3%) in NIDDM patients with kidney failure compared to NIDDM controls without nephropathy (7.6%, p<0.05). The carriage rate of TNF2 was significantly lower in NIDDM patients with kidney failure than in NIDDM controls without nephropathy (4.4% vs. 13.2%, p<0.05). In addition, allele frequency of TNF2 were remarkably different from those previously reported, indicating a significant ethnic difference. CONCLUSION: There is a significant ethnic difference in the polymorphism of TNF-alpha gene. The non-carriage TNF2 was more prevalent in the kidney failur group. But, we could not determine any association between the TNF-alpha gene polymorphism and the development of kidney failure.

Relations of Glycosylated Hemoglobin and Parameters of Nerve Conduction Study in Diabetic Peripheral Polyneuropathy

OBJECTIVE: This study was performed to determine the relations of glycosylated hemoglobin (HbA1c) and parameters of nerve conduction study (NCS) in diabetic peripheral polyneuropathy patients. METHOD: Prospectively, total 40 patients with non-insulin dependent diabetes mellitus were included in the study. NCS was performed on median, ulnar, posterior tibial, deep peroneal, superficial peroneal, and sural nerves. Distal latency and conduction velocity (CV) of compound muscle action potential (CMAP), distal latency and amplitude of sensory nerve action potential (SNAP) were used as parameters of NCS. Multiple linear regression analysis were used to analyze the relations of HbA1c and parameters of NCS, after adjustment for age, height, weight, and disease duration of diabetes mellitus. RESULTS: HbA1c level had an inverse relation to CV of median motor nerve (beta= 1.272, p<0.01), ulnar motor nerve (beta= 1.287, p<0.01), posterior tibial nerve (beta= 0.982, p<0.05), and deep peroneal nerve (beta= 1.449, p<0.05). CONCLUSION: This study indicates that HbA1c level was inversely related to motor nerve CV, and that sustained hyperglycemia may be involved in demyelination of motor nerves. Analysis of motor nerve CV related to HbA1c is expected to be useful in the follow-up or efficacy study of diabetes mellitus neuropathy as baseline data.

Gene expression differential study in peripheral blood mononuclear cell(PBMC) of patients with SLE and IDDM / 中国免疫学杂志

6).The genes were genes that associated with the regulation of cell differentiation and proliferation,adhesion and signal tranduction,apoptosis,transcription and modulation,and DNA damage and repair that.Conclusion:The differential hybridzation analysis of Atlas cDNA expression arrays can be a useful method for analysing the expression profiles of PBMC genes and studing genes differential expression in SLE and IDDM patients.

Clinical Evaluation of Hypoglycemic Symptoms Reported by Children with Insulin-dependent Diabetes Mellitus and by Their Parents

PURPOSE: The following study has been carried out to find the symptoms of hypoglycemia and the symptoms of transient focal neurologic deficit, which were complained by insulin dependent diabetes mellitus patients and their parents. METHODS: The subjects of this study were 16 insulin dependent diabetic patients who were admitted to the pediatric department of Samsung Medical Center. From the 28 possible symptoms of hypoglycemia, the patients and their parents were asked to choose the symptoms they were experiencing through questionnaires, and the mean score was obtained by dividing the frequency of each symptom manifestation by 4 levels. RESULTS: Of the 16 patients, there were 6 males and 10 females and their average age was 13 years. The complaints raised by insulin dependent diabetic patients and their parents regarding the symptoms of hypoglycemia were relatively similar. However the frequency of observed symptoms such as pounding heart, dizziness and trembling was higher in the complaints of patients, and the mean score of objective symptoms such as slurred speech, odd behaviors, aggressiveness was much higher in the complaints of parents. During symptoms of hypoglycemia, three cases were seen throwing fits of convulsions due to neurologic deficit. CONCLUSION: It is thought that parents can offer a reasonably accurate information on the symptoms of hypoglycemia in insulin dependent diabetic patients, and particularly, behavioral changes in young children with diabetes mellitus is considered as an important characteristic for testing hypoglycemia.

The expression of receptor for advanced glycation end product in gingival tissues of type 2 diabetic patients with periodontitis / 实用口腔医学杂志

Objective:To detect the distribution of the receptor for advanced glycation end products(RAGE) in gingival tissues of patients with non-insulin dependent diabetes mellitus(NIDDM) accompanying periodontitis.Methods:5 patients with chronic periodontitits(CP) and 4 patients with NIDDM accompanying periodontitis were included. Immunohistochemical staining was performed to detect RAGE and tumor necrosis factor ?(TNF-?) expression in gingival tissues.Interleukin 6(IL-6) and TNF-? levels in gingival crevicular fluid and serum of these patients were examined by ELISA.Results:More RAGE cells were observed in the gingival tissus in the patients of NIDDM with CP than in those of CP(P0.05).Conclusion:RAGE may play a role in the destruction of periodontal tissues in NIDDM patients with CP.