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1.
J. bras. nefrol ; 44(1): 26-31, Jan-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365027

ABSTRACT

Abstract Introduction: Tubular damage is common in glomerular diseases (GD). Glycosuria is a marker of tubular dysfunction and may be used to detect tubular lesion and CKD progression. The aim of this study was to evaluate the prevalence and prognostic value of glycosuria at the time of diagnosis in primary glomerulopathies (PG). Methods: We conducted a 24-month retrospective study in patients diagnosed with PG in our center between 2009 and 2020. We excluded diabetic patients, use of SGLT2 inhibitors, transplant patients, and secondary GD. Patients were divided in two groups according to their glycosuria status at diagnosis. Results: We studied 115 patients. Global prevalence of glycosuria was 10% (n=11) and membranous nephropathy (MN) had the highest prevalence (n=5, 17.9%). We found that patients with glycosuria had higher serum creatinine (2.4 vs. 1.2 mg/dL, p=0.030), higher albuminuria (4.8 vs. 1.9 g/g, p=0.004), and lower serum albumin (2.3 vs. 3.2 g/dL, p=0.021). We did not find association with histological prognostic factors. At the end of follow-up, patients with glycosuria had higher prevalence of the composite outcome of stage 5D CKD or 50% increase in basal SCr (45.5% vs. 17.3%, p=0.037). In patients with MN, results were similar but we were able to find an association of glycosuria with more severe interstitial fibrosis and tubular atrophy (25.0 vs. 0.0 %, p=0.032). Conclusion: Ten percent of our patients with PG have glycosuria. Glycosuria at the time of diagnosis was associated with more severe clinical presentation and worst renal outcome. The association with higher albuminuria suggests that tubular function has an impact on the severity and outcomes of PG.


Resumo Introdução: Danos tubulares são comuns em doenças glomerulares (DG). Glicosúria é um marcador de disfunção tubular e pode detectar lesão tubular e progressão da DRC. O objetivo deste estudo foi avaliar a prevalência e o valor prognóstico da glicosúria no diagnóstico em glomerulopatias primárias (GP). Métodos: Realizamos estudo retrospectivo de 24 meses em pacientes diagnosticados com GP em nosso centro entre 2009-2020. Excluímos pacientes diabéticos, uso de inibidores de SGLT2, pacientes transplantados e DG secundárias. Os pacientes dividiram-se em dois grupos de acordo com seu estado de glicosúria no diagnóstico. Resultados: Estudamos 115 pacientes. A prevalência global de glicosúria foi de 10% (n=11) e a nefropatia membranosa (NM) teve maior prevalência (n=5, 17,9%). Constatamos que pacientes com glicosúria apresentavam creatinina sérica mais elevada (2,4 vs. 1,2 mg/dL, p=0,030), albuminúria mais alta (4,8 vs. 1,9 g/g, p=0,004), e albumina sérica mais baixa (2,3 vs. 3,2 g/dL, p=0,021). Não encontramos associação com fatores prognósticos histológicos. Ao final do acompanhamento, pacientes com glicosúria tiveram maior prevalência do desfecho composto de DRC estágio 5D ou aumento de 50% na CrS basal (45,5% vs. 17,3%, p=0,037). Em pacientes com NM, os resultados foram semelhantes, mas encontramos uma associação de glicosúria com fibrose intersticial mais grave e atrofia tubular (25,0 vs. 0,0 %, p=0,032). Conclusão: 10% de nossos pacientes com GP têm glicosúria. A glicosúria no diagnóstico foi associada a uma apresentação clínica mais grave e pior desfecho renal. A associação com albuminúria mais elevada sugere que a função tubular tem um impacto na gravidade e nos desfechos da GP.

2.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 23(1, cont.): e2309, 20200000. tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1129312

ABSTRACT

A diabetes mellitus (DM) é uma doença comum na rotina veterinária, de caráter multifatorial, gerando graves consequências na saúde dos pacientes acometidos. O diagnóstico é possível por meio de manifestações clínicas apresentadas e da realização de exames laboratoriais complementares. Entre esses exames, estão a dosagem da glicose sérica e a urinálise, as quais trazem ao clínico diversas informações, que podem ser correlacionadas aos demais achados, tornando possível o diagnóstico conclusivo de DM. Dessa forma, o presente trabalho teve como objetivo avaliar as alterações urinárias e de glicemia em cães com DM. Para isto, foram analisados laudos de amostras urinárias e de glicose sérica de 15 animais, onde o diagnóstico foi conclusivo para DM. Verificou-se presença de glicosúria em 100% dos casos, sendo observado em 66,67% das amostras glicosúria maior que 1000 mg/dL e, em 33,33% amostras, de 500 mg/dL; a cetonúria esteve presente em 66,67 %; proteinúria em 66,67% e bacteriúria presente em 73,33 dos dados analisados. Já a hiperglicemia foi constatada em 13 pacientes (86,67%). Assim, conclui-se que a urinálise é um exame de suma importância para o estabelecimento do diagnóstico, da melhor terapêutica para cada caso e do prognóstico dos pacientes.(AU)


Diabetes mellitus (DM) is a common disease on the veterinary routine. It has a multifactorial character generating severe consequences on the health of the patient. It can be diagnosed by clinical manifestations and by making additional laboratory tests. These tests include the measurement of serum glucose and urinalysis, which provides the physician with additional information to be correlated with other findings, in order to reach a conclusive diagnosis of DM. Therefore, this study aimed at evaluating urinary and glycemic alterations in dogs with DM. It analyzed reports of urine and serum glucose samples from 15 animals with a conclusive diagnosis for DM. Glycosuria was present in 100% of the cases. In addition, it was also observed that in 66.67% of the samples, glycosuria was higher than 1000 mg/dL, and in 33.33%, it was 500 mg/dL. Ketonuria was present in 66.67% of the samples, while proteinuria was observed in 66.67%. Bacteriuria was present in 73.33% of the samples on the analyzed data. Hyperglycemia was observed in 13 of these patients (86.67%), and thus, it can be concluded that urinalysis is an extremely important test for diagnosis, to choose the best therapy for each case and prognosis of the patients.(AU)


Diabetes mellitus (DM) es una enfermedad común en la rutina veterinaria, con un carácter multifactorial, que genera graves consecuencias en la salud de los pacientes afectados. El diagnóstico es posible a través de las manifestaciones clínicas presentadas y mediante realización de pruebas de laboratorio complementarias. Entre esas pruebas, están la medición de la glucosa en suero y el análisis de orina, que brindan al médico informaciones diversas que pueden ser correlacionadas a otros hallazgos, lo que permite hacer un diagnóstico concluyente de DM. Por lo tanto, el presente estudio tuvo como objetivo evaluar las alteraciones urinarias y glucémicas en perros con DM. Para esto, se analizaron informes de muestras de glucosa en suero y orina de 15 animales, donde el diagnóstico fue concluyente para DM. La glucosuria estuvo presente en el 100% de los casos, observándose en el 66,67% de las muestras glucosuria mayor de 1000 mg / dL y, en el 33,33% de las muestras, de 500 mg / dL; la cetonuria estuvo presente en 66.67%; proteinuria en 66.67% y bacteriuria presente en 73.33 de los datos analizados. Se observó hiperglucemia en 13 de esos pacientes (86,67%). Por lo tanto, se concluye que el análisis de orina es una prueba extremadamente importante para establecer el diagnóstico, el mejor tratamiento para cada caso y el pronóstico de los pacientes.(AU)


Subject(s)
Animals , Dogs , Urine , Urinalysis , Diabetes Mellitus/diagnosis , Dogs/physiology , Ketosis/diagnosis
3.
Article in English | WPRIM | ID: wpr-785701

ABSTRACT

We aimed to identify the clinical variables associated with a better glucose-lowering response to the sodium glucose cotransporter 2 inhibitor ipragliflozin in people with type 2 diabetes mellitus (T2DM). We especially focused on urinary glucose excretion (UGE). This was a single-arm multicenter prospective study. A total of 92 people with T2DM aged 20 to 70 years with glycosylated hemoglobin (HbA1c) levels ≥7.0% and ≤9.5% were enrolled. Ipragliflozin (50 mg) was added to the background therapy for these people for 12 weeks. After 3 months treatment with ipragliflozin, the mean HbA1c levels were decreased from 7.6% to 6.9% and 62.0% of the people reached the HbA1c target of less than 7.0% (P<0.001). In addition, body weight, blood pressure, and lipid parameters were improved after ipragliflozin treatment (all P<0.001). The baseline HbA1c (r=0.66, P<0.001) and morning spot urine glucose to creatinine ratio (r=−0.30, P=0.001) were independently associated with the HbA1c reduction. Ipragliflozin treatment for 12 weeks improves glycemic control and other metabolic parameters. A higher HbA1c and lower UGE at baseline predicts a better glucose-lowering efficacy of ipragliflozin.


Subject(s)
Blood Pressure , Body Weight , Creatinine , Diabetes Mellitus, Type 2 , Glucose , Glycosuria , Glycated Hemoglobin A , Prospective Studies , Sodium , Sodium-Glucose Transporter 2
4.
Indian Heart J ; 2018 Nov; 70(6): 915-921
Article | IMSEAR | ID: sea-191642

ABSTRACT

Patients with type 2 diabetes mellitus (T2DM) exhibit an increased risk for cardiovascular (CV) events. Hyperglycemia itself contributes to the pathogenesis of atherosclerosis and heart failure (HF) in these patients, but glucose-lowering strategies studied to date have had little or no impact on reducing CV risk, especially in patients with a long duration of T2DM and prevalent CV disease (CVD). Sodium-glucose cotransporter-2 (SGLT2) inhibitors are the new class of glucose-lowering medications that increase urinary glucose excretion, thus improving glycemic control, independent of insulin. The recently published CV outcome trial, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients—Removing Excess Glucose (EMPA-REG OUTCOME), demonstrated that the SGLT2 inhibitor empagliflozin significantly reduced the combined CV end point of CV death, nonfatal myocardial infarction, and nonfatal stroke vs. placebo in a population of patients with T2DM and prevalent atherosclerotic CVD. In addition, and quite unexpectedly, empagliflozin significantly and robustly reduced the individual end points of CV death, overall mortality, and hospitalization for HF in this high-risk population. Several beneficial factors beyond glucose control, such as weight loss, lowering blood pressure, sodium depletion, renal hemodynamic effects, effects on myocardial energetics, and/or neurohormonal effects, have been seen with SGLT2 inhibition.

5.
Article in Chinese | WPRIM | ID: wpr-696579

ABSTRACT

Renal glycosuria (RG) is an inherited disorder due to defective reabsorption of glucose by the proximal renal tubular.It is attributed to the mutations in the SCL5A2 gene,encoding the sodium-glucose transporter 2 (SGLT2).A defect of SGLT2 is responsible for impaired reabsorption of the filtered glucose in the proximal renal tubular,termed S1,which leads to glycosuria.RG is characterized by normal fasting serum glucose concentration and persistent isolated glucosuria,identification of glucose as the urinary sugar.The inherited pattern of RG is co-dominant inheritance trait with incomplete penetrance.The diagnostic criteria of glycosurias are as follows:a constant and relatively stable urinary glycosurias (10-100 g/d),identification of glucose as the urinary sugar,normal concentration of fasting plasma glucose and normal oral glucose tolerance test,evidence that individuals have normal carbohydrates intake,storage and metabolism.RG does not require special treatment generally,but the advice concerns diet with increasing the intake of carbohydrates.Physical activity should be moderate and professional,and excesive muscle and exercise should be not advisable.

6.
Rev. Assoc. Med. Bras. (1992) ; 63(7): 636-641, July 2017. tab, graf
Article in English | LILACS | ID: biblio-896368

ABSTRACT

Summary Introduction: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. Objective: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile. Method: A literature search on Pubmed database was performed using the following keywords: "SGLT-2 inhibitors," "dapagliflozin," "empagliflozin," "canagliflozin." Results: SGLT-2 inhibitors are a class of oral antidiabetic drugs directed to the kidney. Their mechanism of action is to reduce blood glucose by inducing glycosuria. Extra-glycemic benefits have been described, such as weight loss, decline in blood pressure and levels of triglycerides and uric acid, and they can slow the progression of kidney disease. Genitourinary infections are the main side effects. There is a low risk of hypotension and hypoglycemia. Diabetic ketoacidosis is a serious adverse effect, although rare. Empagliflozin has already had its cardiovascular benefit demonstrated and studies with other drugs are currently being performed. Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.


Resumo Introdução: O diabetes mellitus é uma das doenças crônicas mais frequentes no mundo, com altas taxas de morbimortalidade, resultando em um grande impacto negativo socioeconômico. Apesar de existirem diversas classes de antidiabéticos orais, a maioria dos pacientes acometidos está fora da meta terapêutica. Objetivo: Revisar o uso dos inibidores da SGLT-2 no tratamento do diabetes mellitus tipo 2, com enfoque nos efeitos favoráveis, desfavoráveis e no perfil cardiovascular. Método: Foi realizada uma pesquisa bibliográfica transversal com artigos científicos obtidos da base de dados Pubmed, utilizando os descritores: "SGLT-2 inhibitors", "dapagliflozin", "empagliflozin", "canagliflozin". Resultados: Os inibidores da SGLT-2 são uma classe de antidiabéticos orais com atuação no rim. O mecanismo de ação é reduzir a glicemia induzindo glicosúria. Benefícios extraglicêmicos já foram descritos, como redução de peso, pressão arterial, triglicerídeos e ácido úrico, além de retardar a progressão da doença renal. O principal efeito colateral é a infecção geniturinária, com baixo risco de hipotensão e hipoglicemia. Cetoacidose diabética é um efeito adverso grave, mas infrequente. A empagliflozina já teve seu benefício cardiovascular demonstrado, e estudos com outras drogas estão em andamento. Conclusão: Os inibidores da SGLT-2 são uma nova opção de tratamento do diabetes mellitus tipo 2, que atua de forma insulino-independente e com potenciais benefícios adicionais, além da redução da glicemia, mas também com risco de efeitos adversos.


Subject(s)
Humans , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2 Inhibitors , Hypoglycemic Agents/therapeutic use , Benzhydryl Compounds/therapeutic use , Blood Glucose/drug effects , Sodium-Glucose Transporter 2 , Canagliflozin/therapeutic use , Glucosides/therapeutic use , Hypoglycemic Agents/adverse effects , Kidney/drug effects
7.
Rev. méd. Chile ; 145(3): 393-396, Mar. 2017.
Article in Spanish | LILACS | ID: biblio-845553

ABSTRACT

Diabetic ketoacidosis with mild hyperglycemia is a major complication of sodium-glucose cotransporter 2 inhibitors. Although its use is not approved for patients with type 1 diabetes mellitus, the drug is often prescribed with the hope of optimizing metabolic control. We report a 20 years old female with hypothyroidism and type 1 diabetes consulting for vomiting and abdominal pain. The patient had used canagliflozin during the two previous months. Laboratory showed a blood glucose of 200 mg/dl, a severe metabolic acidosis (pH 7.1) and ketonemia. The patient was successfully treated in the intensive care unit.


Subject(s)
Humans , Female , Adult , Diabetic Ketoacidosis/chemically induced , Canagliflozin/adverse effects , Hyperglycemia/chemically induced , Hypoglycemic Agents/adverse effects , Diabetic Ketoacidosis/diagnosis , Diabetes Mellitus, Type 1/drug therapy , Canagliflozin/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors , Hyperglycemia/diagnosis , Hypoglycemic Agents/therapeutic use
8.
Article in English | WPRIM | ID: wpr-154207

ABSTRACT

Familial renal glycosuria (FRG) is an inherited disorder characterized by persistent glycosuria in the absence of hyperglycemia. It is caused by mutations in the sodium-glucose co-transporter, leading to increase in the renal excretion of glucose and sodium. However, there have been no studies on the role of fasting and postprandial changes in the urinary sodium excretion in patients with FRG. We report a case of renal glycosuria, which was confirmed by a SLC5A2 mutation via gene sequencing, and compared the postprandial urinary glucose and sodium excretion. A 26-year-old man sometimes experienced glycosuria on routine screening; however, other laboratory findings were normal. His fasting and postprandial urinary glucose excretion levels were 295mg/dL and 2,170mg/dL, respectively. The fasting and postprandial urinary sodium excretion levels were 200mEq/L and 89mEq/L, respectively. In patients with FRG, excessive diuresis might be prevented by a compensatory mechanism that reduces postprandial sodium excretion.


Subject(s)
Adult , Diuresis , Fasting , Glucose , Glycosuria , Glycosuria, Renal , Humans , Hyperglycemia , Mass Screening , Renal Elimination , Sodium , Sodium-Glucose Transport Proteins
9.
Braz. j. med. biol. res ; 47(10): 917-923, 10/2014. tab, graf
Article in English | LILACS | ID: lil-722169

ABSTRACT

Hyperuricemia has been associated with hypertension, diabetes mellitus, and metabolic syndrome. We studied the association between hyperuricemia and glycemic status in a nonrandomized sample of primary care patients. This was a cross-sectional study of adults ≥20 years old who were members of a community-based health care program. Hyperuricemia was defined as a value >7.0 mg/dL for men and >6.0 mg/dL for women. The sample comprised 720 participants including controls (n=257) and patients who were hypertensive and euglycemic (n=118), prediabetic (n=222), or diabetic (n=123). The mean age was 42.4±12.5 years, 45% were male, and 30% were white. The prevalence of hyperuricemia increased from controls (3.9%) to euglycemic hypertension (7.6%) and prediabetic state (14.0%), with values in prediabetic patients being statistically different from controls. Overall, diabetic patients had an 11.4% prevalence of hyperuricemia, which was also statistically different from controls. Of note, diabetic subjects with glycosuria, who represented 24% of the diabetic participants, had a null prevalence of hyperuricemia, and statistically higher values for fractional excretion of uric acid, Na excretion index, and prevalence of microalbuminuria than those without glycosuria. Participants who were prediabetic or diabetic but without glycosuria had a similarly elevated prevalence of hyperuricemia. In contrast, diabetic patients with glycosuria had a null prevalence of hyperuricemia and excreted more uric acid and Na than diabetic subjects without glycosuria. The findings can be explained by enhanced proximal tubule reabsorption early in the course of dysglycemia that decreases with the ensuing glycosuria at the late stage of the disorder.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Glycemic Index , Glycosuria/epidemiology , Hyperuricemia/epidemiology , Uric Acid/blood , Age Factors , Blood Glucose/analysis , Brazil/epidemiology , Comorbidity , Cross-Sectional Studies , Community Health Services/statistics & numerical data , /epidemiology , Glucose Metabolism Disorders/epidemiology , Hypertension/epidemiology , Metabolic Syndrome/epidemiology , Prevalence , Prediabetic State/epidemiology , Sampling Studies
10.
J. bras. nefrol ; 36(1): 80-92, Jan-Mar/2014. tab, graf
Article in English | LILACS | ID: lil-704671

ABSTRACT

The importance of the kidney in glucose homeostasis has been recognized for many years. Recent observations indicating a greater role of renal glucose metabolism in various physiologic and pathologic conditions have rekindled the interest in renal glucose handling as a potential target for the treatment of diabetes. The enormous capacity of the proximal tubular cells to reabsorb the filtered glucose load entirely, utilizing the sodium-glucose co-transporter system (primarily SGLT-2), became the focus of attention. Original studies conducted in experimental animals with the nonspecific SGLT inhibitor phlorizin showed that hyperglycemia after pancreatectomy decreased as a result of forced glycosuria. Subsequently, several compounds with more selective SGLT-2 inhibition properties (“second-generation”) were developed. Some agents made it into pre-clinical and clinical trials and a few have already been approved for commercial use in the treatment of type 2 diabetes. In general, a 6-month period of therapy with SGLT-2 inhibitors is followed by a mean urinary glucose excretion rate of ~80 g/day accompanied by a decline in fasting and postprandial glucose with average decreases in HgA1C ~1.0%. Concomitant body weight loss and a mild but consistent drop in blood pressure also have been reported. In contrast, transient polyuria, thirst with dehydration and occasional hypotension have been described early in the treatment. In addition, a significant increase in the occurrence of uro-genital infections, particularly in women has been documented with the use of SGLT-2 inhibitors. Conclusion: Although long-term cardiovascular, renal and bone/mineral effects are unknown SGLT-2 inhibitors, if used with caution and in the proper patient provide a unique insulin-independent therapeutic option in the management of obese type 2 diabetes patients. .


A importância do rim na homeostase de glicose é reconhecida desde há muitos anos. Observações recentes, indicando um papel maior do metabolismo renal da glicose em várias condições fisiológicas e patológicas, reavivaram o interesse no manuseio renal de glicose como um alvo em potencial para o tratamento do diabetes. A enorme capacidade das células tubulares proximais para reabsorver a carga total de glicose filtrada, utilizando o sistema de co-transporte de sódio e glicose (SGLT), tornou-se o foco de atenção. Estudos originais realizados em animais experimentais com o uso do inibidor não-específico da SGLT florizina, demonstraram que a hiperglicemia após pancreatectomia diminuiu como resultado de glicosúria forçada. Posteriormente, foram desenvolvidas diversas substâncias com propriedades mais seletivas de inibição da SGLT-2 ("segunda geração"). Vários agentes foram usados em ensaios pré-clínicos e clínicos, e alguns já foram aprovados para uso comercial no tratamento da diabetes tipo 2. Em geral, os dados clinicos mostram que um período de 6 meses de tratamento com inibidores da SGLT-2 é seguido por uma taxa de excreção de glicose urinária média de ~ 80 g/dia, acompanhado por uma queda na glicemia de jejum e pós-prandial e com redução média na HbA1C de - 1.0%. Também foram relatados perda concomitante no peso corpóreo e uma leve mas consistente queda da pressão arterial. Em contraste, eventos adversos transitórios como poliúria, sede com desidratação e hipotensão ocasional foram descritos na fase inicial de tratamento. Além disso, um aumento significativo na ocorrência de infecções urogenitais, particularmente em mulheres, foi documentado com o uso de inibidores da SGLT-2. Os efeitos ...


Subject(s)
Humans , /drug therapy , /metabolism , Glucose/metabolism , Renal Reabsorption/drug effects , Sodium-Glucose Transport Proteins/antagonists & inhibitors
11.
J. bras. nefrol ; 34(3): 291-292, jul.-set. 2012.
Article in Portuguese | LILACS | ID: lil-653548

ABSTRACT

A glicosúria como achado acidental implica um estudo etiológico. Apresentam-se os casos de duas adolescentes do sexo feminino, assintomáticas, referenciadas por glicosúria detectada em análise de rotina. Negavam infecções, traumatismos e ingestão de fármacos ou tóxicos. O estudo efetuado confirmou glicosúria na ausência de outras alterações. O estudo genético revelou a presença de mutações do gene SCL5A2, confirmando o diagnóstico de glicosúria renal. A glicosúria renal familiar caracteriza-se por glicosúria isolada persistente na ausência de hiperglicemia e de disfunção tubular renal generalizada. É, geralmente, assintomática e o prognóstico é favorável. Alerta-se para esta rara entidade, pois pode ser motivo de referenciação para consulta de pediatria, salientando-se a importância do diagnóstico diferencial com afecções mais graves que necessitam de tratamento adequado.


Glycosuria as an accidental finding implies a diagnostic workout. We present the cases of two asymptomatic female teenagers referred to a hospital outpatient clinic due to isolated glycosuria detected in a routine analysis. The diagnostic workout revealed isolated glycosuria in the absence of other abnormalities. The genetic study confirmed the diagnosis of renal glycosuria, by revealing SCL5A2 gene mutations. Renal glycosuria is characterized by persistent glycosuria in the absence of hyperglycaemia or generalized renal tubular dysfunction. It's usually asymptomatic and has good prognosis. The authors call the attention to this rare entity, since it can be the reason for reference to a hospital outpatient clinic, underlining the importance of a differential diagnosis with more serious diseases that require proper treatment.


Subject(s)
Adolescent , Female , Humans , Glycosuria, Renal/diagnosis
12.
Sci. med ; 22(2): 97-101, abr-jun. 2012.
Article in Portuguese | LILACS | ID: lil-661322

ABSTRACT

Objetivos: Verificar a influência imediata da drenagem linfática manual em membros inferiores sobre a glicemia capilar e a glicose urinária em pacientes com diabetes mellitus tipo 1.Métodos: Sete sujeitos com diabetes mellitus tipo 1 foram submetidos a nove intervenções de drenagem linfática manual método Vodder. Em todos os atendimentos foram analisadas as variáveis glicemia capilar e glicose urinária pré e pós drenagem linfática manual. Os resultados dos exames foram submetidos ao teste t pareado, sendo considerado significativo um p<0,05.Resultados: Nas dosagens pré drenagem linfática manual, a média da glicemia capilar foi 215,9±129,7 mg/dL e da glicose urinária 1288,2±2221,1 mg/dL, enquanto as dosagens pós drenagem linfática manual mostraram média de glicemia 187,1±109,2 mg/dL e de glicose urinária 1049,6±1866,0 mg/dL. Ambas as variáveis apresentaram diferença significativa entre uma e outra dosagem: para a glicemia capilar, p<0,00001; e para a glicose urinária, p=0,0321.Conclusões: A drenagem linfática manual demonstrou efeito agudo sobre a glicemia capilar e a glicose urinária de sujeitos portadores de diabetes mellitus tipo 1.


AIMS: To assess the immediate influence of manual lymphatic drainage in the lower limbs on capillary glycemia and urinary glucose in patients with type 1 diabetes mellitus. Methods: Seven subjects with type 1 diabetes mellitus underwent nine interventions using the Vodder method of manual lymphatic drainage. We analyzed the blood glucose and glycosuria pre-and post-manual lymph drainage. The results were analyzed using the paired t test, considering p<0.05 significant. Results: The averages pre-manual lymph drainage for blood glucose were 215.9±129.7 mg/dL and for urinary glucose were 1288.2±2221.1 mg/dL, and for the the post-manual lymph drainage were 187.1±109.2 mg/dL for blood glucose and 1049.6±1866.0 mg/dL for urinary glucose. Both variables showed a significant difference: for capillary blood glucose, p<0.00001; and for urinary glucose, p=0.0321.


Subject(s)
Diabetes Mellitus , Drainage , Blood Glucose , Hyperglycemia , Physical Therapy Modalities , Lymphatic System
13.
J. bras. patol. med. lab ; 48(1): 11-14, fev. 2012. tab
Article in Portuguese | LILACS-Express | LILACS | ID: lil-617011

ABSTRACT

INTRODUÇÃO: O ácido ascórbico (vitamina C) é comumente ingerido como suplemento vitamínico. É uma vitamina hidrossolúvel, excretada pela urina e pode interferir nos ensaios laboratoriais, como nas reações de oxirredução para detecção da glicosúria. OBJETIVO: Este trabalho tem como objetivo avaliar a interferência do ácido ascórbico na detecção de glicosúria pelo método de química seca por meio do uso de tiras reagentes. MATERIAIS E MÉTODOS: Amostras de urina foram avaliadas no analisador da marca Clinitek Atlas (Siemens Healthcare Diagnostics Inc., EUA). Foram selecionadas quatro amostras de urina com diferentes concentrações de glicose: 100 mg/dl, 250 mg/dl, 500 mg/dl e 1.000 mg/dl. Para cada concentração de glicose foram criadas cinco alíquotas, adicionando-se uma solução de ácido ascórbico 200 mg/dl, suficiente para obter uma concentração final de ácido ascórbico de 20 mg/dl no primeiro tubo, de 50 mg/dl no segundo tubo, de 270 mg/dl no terceiro tubo, de 1.000 mg/dl no quarto tubo e de 2.000 mg/dl no quinto tubo. Após essa adição, as amostras foram novamente avaliadas no analisador Clinitek Atlas. RESULTADOS: Nas amostras com concentração de 20 mg/dl de ácido, não se evidenciou interferência. Nas concentrações iguais e acima de 50 mg/dl, a interferência do ácido ascórbico se fez presente, sendo que o fato foi caracterizado pelos resultados falso negativos para detecção da glicose urinária. CONCLUSÃO: Os resultados demonstraram a interferência do ácido ascórbico no método da química seca (tiras reagentes), subestimando o nível de glicose urinária.


INTRODUCTION: Ascorbic acid (vitamin C) is commonly used as a vitamin supplement. It is a water soluble vitamin, which is excreted through urine and may interfere in laboratory tests as well as redox reactions for urinary glucose detection. OBJECTIVE: This study aims to assess ascorbic acid interference in glycosuria detection by dry chemistry method (reagent strips). MATERIAL AND METHODS: Urine samples were evaluated by using Clinitek Atlas chemistry analyzer (Siemens Healthcare Diagnostics Inc., USA). Four urine samples with different glucose concentrations were selected: 100 mg/dl, 250 mg/dl, 500 mg/dl and > 1,000 mg/dl. 5 aliquots were created for each glucose concentration and a solution of ascorbic acid 200 mg/dl was added, sufficient to obtain a final ascorbic acid concentration of 20 mg/dl in the first tube, 50 mg/dl in the second tube, 270 mg/dl in the third tube, 1,000 mg/dl the fourth tube, and 2,000 mg/dl in the fifth tube. After the addition of ascorbic acid, the samples were reassessed by using Clinitek Atlas chemistry analyzer. RESULTS: There was no interference at concentrations of 20 mg/dl. However, there was ascorbic acid interference at concentrations higher than or equal to 50 mg/dl, which was characterized by false-negative results for urinary glucose detection. CONCLUSION: The results corroborated the interference of ascorbic acid in dry chemistry method (reagent strips) inasmuch as it underestimates urinary glucose levels.

14.
Chinese Journal of Nephrology ; (12): 606-610, 2011.
Article in Chinese | WPRIM | ID: wpr-419810

ABSTRACT

Objective To establish heterologous expression system of Na+-glucose cotransporter 2 (SGLT2) gene.Methods Human SGLT2 cDNA from normal kidney, generated by RT-PCR,was subclonedintoPEXL-GFP vector andtransfectedinto HEK293cells. After 24hours of incubation, the expression of SGLT2-GFP fusion protein was detected by Western blotting and laser confocal microscopy.Transport activity of SGLT2-GFP fusion proteins in cultured human HEK293 cells was evaluated with the uptake test of glucose analogue.ResultsSGLT2-GFP fusion protein was expressed in cultured human HEK293 cells.Furthermore, confocal microscopy using green fluorescent protein(GFP) revealed a punctate membrane pattern of SGLT2.Glucose analogue uptake increased in HEK293 cells transfected with SGLT2-GFP at least by 3.5 folds compared with HEK293 cells transfected with GFP vector only(P<0.01).Conclusion Heterologous expression of SGLT2 gene in HEK293 cells is successfully established, which provides valuable approach for the functional and pathological study of SGLT2 gene.

15.
Article in Korean | WPRIM | ID: wpr-20898

ABSTRACT

OBJECTIVE: To analyze the incidence of gestational diabetes mellitus (GDM) and its clinical implication of glycosuria identified in 2nd trimester pregnancy. METHODS: This study included pregnant women who had undertaken the 50 g oral glucose tolerance test (50 g OGTT) between 24 and 28 weeks gestation and delivered at term (N=704). Blood and urine sample were collected and analyzed for glucose level, one hour after 50 g OGTT. We applied women to 100 g OGTT if their blood glucose level after 50 g OGTT were more than 140 mg/dL. We compared blood glucose level, rate of GDM, birth weight and number of macrosomia at different urine glucose levels. Urine glucose level were measured by urine dipstick test and grouped to trace, 1+, 2+, 3+, and 4+, which were corresponding to 100, 250, 500, 1,000, 2,000 mg/dL. RESULTS: Women with glycosuria after 50 g OGTT were 258/704 (36.6%). Mean blood glucose levels were 117+/-23 mg/dL, 128+/-20 mg/dL, 135+/-23 mg/dL, 132+/-17 mg/dL, 139+/-25 mg/dL, 153+/-45 mg/dL, mean birth weight 3.29+/-0.40 kg, 3.25+/-0.40 kg, 3.27+/-0.41 kg, 3.34+/-0.35 kg, 3.28+/-0.41 kg, 3.33+/-0.40 kg, and numbers of macrosomia (> or =4.0 kg) 20 (4.5%), 3 (4.8%), 1 (1.8%), 2 (4.2%), 3 (6.7%), 0 (0%) at glycosuria level of negative, trace, 1+, 2+, 3+ and 4+ respectively. Glycosuria level was correlated significantly with blood glucose level (P=0.000), but not with birth weight and macrosomia (P=0.838, 0.881). The rate of GDM was 7/55 (12.7%), 2/48 (4.7%), 7/45 (15.6%), 8/48 (16.7%) in glycosuria level of 1+, 2+, 3+, 4+ and their relationship was statistically significant (P=0.000, AUC=0.734, 95%CI 0.638-0.830). In the cut off value of glycosuria 1+ or greater, sensitivity and positive predictive value were 72.7 and 12.2%. CONCLUSION: Glycosuria correlates well with blood glucose level and GDM prevalence but not with birth weight.


Subject(s)
Birth Weight , Blood Glucose , Diabetes, Gestational , Female , Glucose , Glucose Tolerance Test , Glycosuria , Humans , Incidence , Pregnancy , Pregnant Women , Prevalence
16.
Article in Chinese | WPRIM | ID: wpr-557289

ABSTRACT

Objective:To study the changes of serum advanced oxidation protein products(AOPP) in patients with diabetic nephropathy(DN) and its correlationship with superoxide dismutase(SOD) and glutathione peroxidase(GPx). Methods: Eighty-five diabetes mellitus (DM) patients were divided into 4 groups: non-DN group(DM, n=25), early-stage DN group(DN3, (n=24), )significant DN group(DN4, n=17) and end-stage DN group(DN5, n=17). The concentration of serum AOPP was measured spectrophotometerically, serum SOD was determined by xanthine oxidase test and GPx by DTNB reaction test. (Results:) The concentrations of AOPP in patients of DN5 group (-[117.8?64.8-] ?mol/L) and DN4 group (-[80.0?23.0-] ?mol/L) were significantly higher than that in DM group (-[58.2?17.7-] ?mol/L,P0.05) and negatively correlated with SOD and GPx(r=-0.217, r=-0.374, P

17.
Article in Korean | WPRIM | ID: wpr-130135

ABSTRACT

PURPOSE: This study was performed to assess the diagnostic significance of the urine-stick test in detecting Diabetes Mellitus (DM) and to assess the clinical characteristics of adolescent diabetes. MEHTODS: A total of 926,208 middle and high school children participated. The urine-stick test was performed and those who showed glycosuria and, further studies such as evaluations of plasma glucose, triglyceride, cholesterol and C-peptide level done. We compared the clinical characteristics between the diabetes group and non-diabetes group. RESULTS: Among 926,208 students, 1,020 (0.11%) showed glycosuria. Among the 1,020 glycosuria positive subjects, 339 (33.2%) had further laboratory tests. Two hundred and sixty-eight cases (79.1%) were normal, 52 cases (15.3%) were newly diagnosed as DM, 9 cases (2.7%) were already diagnosed DM, 10 cases (2.9%) had an impaired glucose tolerance. The 52 newly diagnosed DM cases, whose postprandial 2 hour glucose level was more than 200m/dL, showed different fasting glucose levels. Thirty cases (57.7%) had a level of more than 140mg/dL, 11 cases (21.1%) were between 110 and 140mg/dL and 11 cases (21.1%) were at a level of less than 110mg/dL. Polydipsia, polyuria and polyphagia were frequent symptoms exibited by the DM group while weight loss and fatigue showed no significant difference between the DM and non-diabetes groups. Six cases were type 1 DM and 44 cases were type 2 DM. Being female, having a family history of DM and a higher BMI and higher diastolic blood pressure were significant risk factors for DM. CONCLUSION: The positive rate of glycosuria by the urine-stick test was 0.11%. Among glycosuria positive subjects 15.3% were newly diagnosed as DM. For the high risk group, an annual urine-stick test and a postprandial blood glucose test should be performed and a systematic referral system is necessary.


Subject(s)
Adolescent , Blood Glucose , Blood Pressure , C-Peptide , Child , Cholesterol , Diabetes Mellitus , Fasting , Fatigue , Female , Glucose , Glycosuria , Humans , Polydipsia , Polyuria , Referral and Consultation , Risk Factors , Seoul , Triglycerides , Weight Loss
18.
Article in Korean | WPRIM | ID: wpr-130122

ABSTRACT

PURPOSE: This study was performed to assess the diagnostic significance of the urine-stick test in detecting Diabetes Mellitus (DM) and to assess the clinical characteristics of adolescent diabetes. MEHTODS: A total of 926,208 middle and high school children participated. The urine-stick test was performed and those who showed glycosuria and, further studies such as evaluations of plasma glucose, triglyceride, cholesterol and C-peptide level done. We compared the clinical characteristics between the diabetes group and non-diabetes group. RESULTS: Among 926,208 students, 1,020 (0.11%) showed glycosuria. Among the 1,020 glycosuria positive subjects, 339 (33.2%) had further laboratory tests. Two hundred and sixty-eight cases (79.1%) were normal, 52 cases (15.3%) were newly diagnosed as DM, 9 cases (2.7%) were already diagnosed DM, 10 cases (2.9%) had an impaired glucose tolerance. The 52 newly diagnosed DM cases, whose postprandial 2 hour glucose level was more than 200m/dL, showed different fasting glucose levels. Thirty cases (57.7%) had a level of more than 140mg/dL, 11 cases (21.1%) were between 110 and 140mg/dL and 11 cases (21.1%) were at a level of less than 110mg/dL. Polydipsia, polyuria and polyphagia were frequent symptoms exibited by the DM group while weight loss and fatigue showed no significant difference between the DM and non-diabetes groups. Six cases were type 1 DM and 44 cases were type 2 DM. Being female, having a family history of DM and a higher BMI and higher diastolic blood pressure were significant risk factors for DM. CONCLUSION: The positive rate of glycosuria by the urine-stick test was 0.11%. Among glycosuria positive subjects 15.3% were newly diagnosed as DM. For the high risk group, an annual urine-stick test and a postprandial blood glucose test should be performed and a systematic referral system is necessary.


Subject(s)
Adolescent , Blood Glucose , Blood Pressure , C-Peptide , Child , Cholesterol , Diabetes Mellitus , Fasting , Fatigue , Female , Glucose , Glycosuria , Humans , Polydipsia , Polyuria , Referral and Consultation , Risk Factors , Seoul , Triglycerides , Weight Loss
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