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1.
Rev. Asoc. Odontol. Argent ; 109(1): 64-72, ene.-abr. 2021. tab
Article in Spanish | LILACS | ID: biblio-1281783

ABSTRACT

La diabetes mellitus es una enfermedad metabólica caracterizada por altos niveles de glucosa en sangre y defectos en la producción y/o la acción de la insulina. La hiperglucemia crónica puede derivar en complicaciones metabólicas y vasculares como micro- y macroangiopatías y alteraciones en el metabolismo de lípidos y proteínas. Los pacientes diabéticos mal controlados o no controlados presentan signos y síntomas evidenciables a nivel bucal. En el mundo, alrededor del 8,8% de los adultos de entre 20 y 79 años padecen este trastorno endócrino, y se estima que para el año 2045 unos 629 millones de personas de este rango etario tendrán diabetes. Por ello, es fundamental que el odontólogo se encuentre familiarizado con el manejo médico de estos pacientes, a fin de estar preparado para brindarles un tratamiento adecuado y responder a las emergencias médicas que se presenten durante su atención. En esta revisión se emplearon resultados extraídos manualmente de artículos indexados en las bases de datos MEDLINE y EBSCO que responden a la búsqueda de los términos diabetes mellitus, dental management, oral surgery y HbA1c, con el objetivo de describir el manejo médico-odontológico del paciente diabético hasta la fecha (AU)


Diabetes Mellitus is a metabolic disease characterized by high blood glucose levels and defects in the production and/or the use of insulin. Chronic hyperglycemia can lead to metabolic and vascular complications. Vascular complications include micro and macroangiopathies. The metabolic disorders are: alterations of lipid and protein metabolism. Patients with poorly controlled or uncontrolled diabetes present symptoms that are evident in the oral cavity. Around 8.8% of adults between 20-79 years old, worldwide, have this endocrine disorder and it is estimated that by 2045, 629 million people in this age group, will have diabetes. Therefore, it is essential for dentists to be familiar with the medical management of these patients, in order to provide adequate treatment and eventual management of medical emergencies that may occur during dental treatment. The present review used data extracted manually from articles indexed in the MEDLINE and EBSCO databases, using the terms: Diabetes mellitus, Dental Management, Oral Surgery and HbA1c. The following article aims to describe the medical/dental management of the diabetic patient updated to date (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Dental Care for Chronically Ill/methods , Diabetes Complications , Diabetes Mellitus/pathology , Surgery, Oral/methods , Glycated Hemoglobin A , Databases, Bibliographic , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Hyperglycemia/complications
2.
Rev. medica electron ; 42(4): 2130-2139, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139303

ABSTRACT

RESUMEN La pielonefritis enfisematosa se considerada una entidad clínica inusual. Constituye una infección necrotizante aguda, con formación de gas en el parénquima renal, sistema colector y/o espacio perirrenal. La población diabética es más propensa a este tipo de pielonefritis, pero se han descrito casos de pielonefritis enfisematosa recurrente en pacientes con obstrucción de la vía urinaria en ausencia de diabetes mellitus. Del 69 al 97 % de los casos, el germen implicado en la génesis de la enfermedad es la Escherichia coli, seguido por la klebsiella pneumoniae; responsable de una enfermedad con alto impacto en la morbimortalidad de los pacientes diabéticos. El conocer esta entidad clínica, permite realizar un diagnóstico precoz con el fin de establecer el tratamiento más adecuado que contribuya a una mejor sobrevida en el paciente. Los estudios tomográficos orientan en el diagnóstico, facilitan tener la opción de un tratamiento conservador y cuando lo requiera un correcto tratamiento invasivo, que debe ser individualizado según la posible causa que lo genera (AU).


ABSTRACT Emphysematous pyelonephritis is considered an unusual clinical entity. It is an acute necrotizing infection, with gas formation in the renal parenchyma, the collector system and/or perinephric space. Diabetic population is more prone to this kind of pyelonephritis, but cases of emphysematous pyelonephritis have been described in patients with urinary tract obstruction in absence of Diabetes mellitus. On 69 to 97 % of the cases, the germ implied in the disease genesis is Escherichia coli, followed by Klebsiella pneumonia, that are responsible for a disease having a high impact on the diabetic patients´ morbidity and mortality. Knowing this clinical entity allows arriving to a precocious diagnosis with the aim of establishing the most suitable treatment contributing to a better patients´ survival. Tomographic studies guide in the diagnosis, facilitate the option of a conserving treatment, and when it is required a correct invasive treatment individualized according to the possible cause generating it (AU).


Subject(s)
Humans , Male , Female , Pyelonephritis/diagnosis , Infections/diagnosis , Pyelonephritis/complications , Pyelonephritis/epidemiology , Signs and Symptoms , Therapeutics , Sepsis/diagnosis , Diabetes Mellitus/pathology
3.
Braz. J. Pharm. Sci. (Online) ; 56: e18401, 2020. tab, graf
Article in English | LILACS | ID: biblio-1364409

ABSTRACT

Diabetes was investigated as a risk factor for nephrotoxicity induced by vancomycin. In the present study, the drug's nephrotoxic effect was indirectly evaluated by Glomerular Filtration Rate, albuminuria and serum levels of creatinine and urea on the 1st, 7th and 14th days of vancomicyn therapy in a group of diabetic and non-diabetic patients, with and without previous nephropathy. The correlations between investigated variables (including the population's epidemiological profile and hospital care) were measured by the Spearman test. The sample consisted of 132 patients, predominantly male diabetic patients with previous nephropathy, over 40 years, receiving ≥ 10 grams of vancomycin for the treatment of infectious diseases and showing satisfactory clinical outcomes. A risk of vancomycin drug interaction with potential nephrotoxic outcome was observed in 36.4% of patients who used multiple drugs. Furthermore, 80% of patients had an increase of at least 0.5 mg.dL-1 in baseline serum levels of creatinine and urea at the end of the study. This was more common among the diabetic patients with previous nephropathy, showing higher albuminuria and a reduction in the Glomerular Filtration Rate. Therefore, it has been recommended that the use of vancomycin in diabetic patients should be in careful dosages and that kidney functioning be monitored.


Subject(s)
Humans , Male , Adult , Patients , Vancomycin/adverse effects , Risk Factors , Diabetes Mellitus/pathology , Pharmaceutical Preparations/analysis , Chronic Disease/classification , Drug Interactions/physiology , Drug Synergism , Hospital Care/organization & administration
4.
Revista Digital de Postgrado ; 9(1): e202, 2020.
Article in Spanish | LILACS, LIVECS | ID: biblio-1095048

ABSTRACT

La diabetes mellitus (DM) se considera como un conjunto de trastornos metabólicos relacionados con la hiperglucemia, que requiere cambios en estilos de vida, en virtud de que no solo se afecta el estado físico, sino que requiere cambios que pueden influir en el estado emocional y psicosocial. Las personas con diabetes requieren de cuidados continuos orientados al control metabólico centrados en el empoderamiento, autocuidado y en la educación terapéutica para alcanzar metas y resultados orientados a minimizar la aparición de las complicaciones crónicas. Objetivo: analizar la importancia de la educación terapéutica en los pacientes con trastornos afectivos como depresión y ansiedad, asociados a la diabetes. Conclusión: la educación terapéutica como parte integral del tratamiento de la DM ha demostrado mejorar los síntomas asociados a depresión y ansiedad, lo cual podría adquirir un valor importante en el manejo de este grupo de pacientes(AU)


Diabetes mellitus (DM) is considered as a set of metabolic disorders related to hyperglycemia, which requires changes in lifestyle, because not only physical condition is affected, but it also requires changes that can influence emotional state and psychosocial. People with diabetes require continuous care oriented to metabolic control focused on empowerment, self-care and therapeutic education to achieve goals and results aimed at minimizing the occurrence of chronic complications. Objective: to analyze the importance of therapeutic education in patients with affective disorders such as depression and anxiety, associated with diabetes. Conclusion: therapeutic education as an integral part of the treatment of DM has been shown to improve symptoms associated with depression and anxiety, which could acquire an important value in the management of this group of patients(AU)


Subject(s)
Humans , Diabetes Mellitus/pathology , Diabetes Mellitus/prevention & control , Diabetes Mellitus/drug therapy , Diabulimia/pathology , Hypoglycemia/etiology , Anxiety , Therapeutics , Affective Symptoms , Depression
5.
Acta méd. costarric ; 61(3): 111-118, jul.-sep. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1019302

ABSTRACT

Resumen Objetivo : El objetivo del estudio fue analizar el consumo de azúcares añadidos por la población urbana costarricense y los factores asociados a este. Método: Estudio transversal donde se analizan los datos de 798 participantes del Estudio ELANS-Costa Rica, que constituyen una muestra representativa de la población urbana costarricense, (con edades entre 15 y 65 años). Para conocer el consumo de azúcares añadidos, se realizan dos recordatorios de 24 horas, en días no consecutivos. Se recolectan variables sociodemográficas, cantidad, lugar y momento del consumo. Resultados: El consumo de azúcares añadidos representa el 14,7% de la energía consumida por la población urbana costarricense, siendo este porcentaje mayor en las mujeres y en las personas más jóvenes. La mayor cantidad de azúcares añadidos se consume en el hogar y durante las meriendas. Las bebidas azucaradas constituyen la principal fuente de azúcares añadidos en la dieta costarricense, y las bebidas gaseosas son la fuente más importante en el quintil de mayor consumo. Conclusión: La ingesta de energía obtenida de los azúcares añadidos supera la recomendación máxima establecida por la Organización Mundial de la Salud, por lo tanto, es necesario establecer políticas públicas dirigidas a reducir su consumo y a la modificación de conductas asociadas a la preparación e ingesta de alimentos fuente de azúcares añadidos.


Abstract Aim: High consumption of added sugars has been associated with a greater risk of chronic diseases, appearance of caries and weight gain, which implies a lower quality of life for the population and an increase in costs for the health system. The aim of this study was to evaluate the intake of added sugar and its related factors in urban Costa Rican population. Methods : This was a cross-sectional study conducted in a representative sample of the Costa Rican urban population (798 participants aged between 15 and 65 years). To determine the consumption of added sugars, two 24 hours recalls were conducted, in non-consecutive days. Sociodemographic variables, quantity of food consumed, place and time of consumption were collected. Results: The consumption of added sugars represents 14.7% of total energy intake for the Costa Rican urban population. This consumption is higher among women and younger people. The greater amount of added sugars was consumed in the home and during snacks. Sugar-sweetened beverages were the main source of this added sugar in the Costa Rican diet and soft drinks were the most important source in the highest consumption quintile. Conclusions: The intake of energy obtained from the added sugars exceeds the máximum recommendation established by the World Health Organization, therefore it is necessary to establish public policies aimed at reducing consumption and modifying behaviors associated with the preparation and intake of food source of added sugars.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Carbonated Beverages/adverse effects , Diabetes Mellitus/pathology , Sugars/analysis , Dietary Sugars/administration & dosage , Obesity/diagnosis , Costa Rica
6.
Rev. Ateneo Argent. Odontol ; 60(1): 33-40, jul. 2019.
Article in Spanish | LILACS | ID: biblio-1119529

ABSTRACT

La enfermedad periodontal es una infección mixta, causada por bacterias periodonto-patógenas que conforman la placa subgingival, se caracteriza por inflamación crónica y destrucción progresiva del aparato de soporte dentario. La lesión característica es la bolsa periodontal, cuyo epitelio ulcerado permitiría el pasaje de bacterias y sus factores de virulencia, toxinas, enzimas y mediadores inflamatorios hacia la circulación general. Este proceso inflamatorio crónico localizado en la cavidad oral puede activar también, la respuesta inflamatoria a nivel sistémico. La periodontitis es un factor de riesgo en el origen y evolución de numerosas enfermedades crónicas sistémicas, como la diabetes mellitus; trastorno endocrino caracterizado por hiperglucemia, hiperinsulinemia, y resistencia a la insulina. Los efectos perjudiciales de las infecciones periodontales sobre la diabetes se explican por el aumento de mediadores proinflamatorios sistémicos, lo que agravaría el estado de resistencia a la insulina, considerando estos pacientes con afectación periodontal como pacientes sistémicamente comprometidos. La diabetes mellitus y la periodontitis comparten una evolución compleja y, entre ellas, se constituye una relación bidireccional. El objetivo de esta revisión es proporcionar una visión actual sobre procesos moleculares y celulares que vinculan a la enfermedad periodontal e inflamación crónica con la diabetes mellitus (AU)


Periodontal Disease is a mixed infection, caused by periodontopathogenic bacteria that make up the subgingival plaque, characterized by chronic inflammation and progressive destruction of the dental support apparatus. The characteristic lesion is the periodontal pocket whose ulcerated epithelium would allow the passage of bacteria and their virulence factors, toxins, enzymes and inflammatory mediators into the general circulation. This chronic inflammatory process located in the oral cavity can also activate the inflammatory response at the systemic level. Periodontitis is a risk factor in the origin and evolution of numerous chronic systemic diseases, such as Diabetes mellitus; endocrine disorder characterized by hyperglycemia, hyperinsulinemia, and insulin resistance. The detrimental effects of periodontal infections on Diabetes are explained by the increase of systemic proinflammatory mediators, which would aggravate the state of insulin resistance, considering these patients with periodontal involvement as systemically compromised patients. Diabetes mellitus and Periodontitis share a complex evolution and between them a bidirectional relationship is established. The aim of this review is to provide a current view on molecular and cellular processes that link periodontal disease and chronic inflammation with diabetes mellitus (AU)


Subject(s)
Humans , Periodontal Diseases , Periodontitis/etiology , Risk Factors , Diabetes Mellitus/pathology , Insulin Resistance , Chronic Disease , Virulence Factors , Hyperglycemia , Inflammation
7.
Article in English | LILACS, BBO | ID: biblio-1056865

ABSTRACT

Abstract Objective: To examine the relationship between the level of glycemic control and coated tongue in type 2 diabetes mellitus patients with xerostomia. Material and Methods: This study was an analytical survey and involved 64 type 2 diabetes mellitus patients, aged between 17 to 65 years old with 34 males and 30 females. Diagnosis of diabetes mellitus was determined from the patient's medical records. The level of glycemic control was obtained from the patient's last blood sugar examination. Xerostomia was diagnosed with a questionnaire, while coated tongue diagnosis based on clinical features and the severity of coated tongue was assessed using the Kojima index Results: There was a significant relationship between the level of glycemic control and coated tongue (p=0.0026) in type 2 diabetes mellitus patients with xerostomia. Moreover, there was a significant relationship between the level of glycemic control and the severity of the coated tongue (p=0.001). Specifically, poor glycemic control was associated with a higher occurrence of the coated tongue as well as more severe tongue coating Conclusion: There was a significant relationship between the level of glycemic control in and coated tongue in type 2 diabetes mellitus patients with xerostomia. Therefore, diabetes mellitus patients should control their level of glycemic control to prevent the oral complication of the disease.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tongue Diseases/pathology , Xerostomia/diagnosis , Diabetes Mellitus/pathology , Diabetes Mellitus, Type 2/pathology , Glycemic Control , Medical Records , Surveys and Questionnaires , Data Interpretation, Statistical , Glycemic Index , Observational Studies as Topic/methods , Indonesia/epidemiology
8.
Rev. bras. anal. clin ; 50(1): 27-32, jun. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-911966

ABSTRACT

Objetivo: Este trabalho tem como objetivo analisar a prevalência de pacientes diabéticos atendimentos no Laboratório de Análises Clínicas da FURB (LAC-FURB), no ano 2015. Métodos: Análise estatística dos dados dos pacientes que realizaram glicemia de jejum e hemoglobina glicada. Foram analisados também os parciais de urina realizados no mesmo dia dos exames plasmáticos, citados anteriormente. Os pacientes apresentavam idade do 0 aos 93 anos com idade média de 46 anos. A coleta dos dados foi realizada no banco de dados do LAC-FURB. Foram excluídos das análises os dados das gestantes pelo diagnóstico diferenciado e os exames de teste de tolerância oral a glicose devido ao pequeno tamanho amostral. Resultados: Foram atendidos no ano de 2015 no LAC-FURB 929 pacientes dos quais 689 realizaram os exames de glicemia de jejum e/ou hemoglobina glicada. De acordo com a análise estatística concluiu-se que 13% dos pacientes tiveram resultados compatíveis com Diabetes mellitus (DM) e 23% foram considerados intolerantes à glicose. Além disso, observou-se que existe uma forte correlação entre os resultados de glicose plasmática de jejum elevada e de hemoglobina glicada, também elevada, assim como os pacientes que apresentaram níveis sanguíneos de glicose acima de 180 mg/dL apresentaram glicosúria. Conclusão: A DM é uma doença complexa que requer inúmeros cuidados e acompanhamento. A análise dos dados evidenciou que 13% dos pacientes tiveram resultados compatíveis com DM e 23% foram considerados intolerantes à glicose, sendo que a maioria dos pacientes diagnosticados foram mulheres. Fatores como o climatério associados com a cultura de maior preocupação e procura por serviços de saúde deste público explicam estes resultados.


Subject(s)
Glycated Hemoglobin A , Diabetes Mellitus/pathology , Glucose , Glycosuria , Glycemic Index
9.
Braz. dent. j ; 29(3): 309-315, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-951550

ABSTRACT

Abstract The aim of this study was to investigate salivary levels of TGFβ1 and proliferation/ maturation of epithelial mucosa cells in diabetic and hypertensive patients. Design: in this cross-sectional study, whole stimulated saliva and oral mucosa exfoliative cytology specimens were collected from 39 patients that were healthy (control, n=10) or presented history of arterial hypertension (HAS, n=9), diabetes mellitus (DM, n=10) or both (DM+HAS, n=10). Salivary flow rate (SFR), TGFβ1 level in saliva, AgNORs and the epithelial maturation were evaluated. Non-parametric Kruskal-Wallis test, followed by Dunn's multiple comparison post-test and the Spearman test correlation analysis were used. SFR showed a significant decreased in DM and DM+HAS (0.47±0.11 and 0.64±0.43 mL/min) when compared to control (1.4±0.38 mL/min). DM+HAS presented the highest value of TGFβ1 concentration (24.72±5.89 pg/mL). It was observed a positive correlation between TGFβ1 and glycaemia (R=0.6371; p<0.001) and a negative correlation between TGFβ1 and saliva (R=-0.6162; p<0.001) and glycaemia and SFR (R=-0.5654; P=0.001). AgNORs number and status of maturation of mucosa cells were similar for all conditions. DM and DM+HAS presented the lowest SFR, which correlated with increased TGFβ1 levels. Despite the higher TGFβ1 secretion it was not observed changes in the morphology or proliferation of epithelial cells when diabetes or hypertension was present.


Resumo O objetivo deste estudo foi investigar os níveis de TGFβ1 na saliva e a proliferação/maturação das células epiteliais da mucosa em paciente diabéticos e hipertensos. Neste estudo transversal, saliva estimulada e amostras de citologia exfoliativa de mucosa oral foram coletadas de um total de 39 pacientes que se apresentavam saudáveis (controle, n=10) ou com história de hipertensão arterial (HAS, n=9), diabetes mellitus (DM, n=10) ou ambos (DM+HAS, n=10). Taxa de fluxo salivar (SFR), níveis de TGFβ1 na saliva, AgNORs e maturação epitelial foram avaliados. Teste não-paramétrico de Kruskal-Wallis, seguido de comparação múltipla de Dunn e correlação de Spearman foram utilizados para as análises. SFR diminuiu significantemente em DM e DM+HAS (0,47±0,11 e 0,64±0,43 mL/min) quando comparado ao controle (1,4±0,38 mL/min). DM+HAS apresentou os maiores valores de concentração de TGFβ1 (24,72±5,89 pg/mL). Foi observada uma correlação positiva entre TGFβ1 e glicemia (R=0,6371; p<0,001) e uma correlação negativa entre TGFβ1 e saliva (R=-0,6162; p<0,001) e glicemia e SFR (R=-0,5654; p=0,001). Número de AgNORs e o padrão da maturação das células epiteliais foram similares entre os todos grupos. DM e DM+HAS apresentaram os menores valores de SFR, os quais foram correlacionados com o aumento nos níveis de TGFβ1. Apesar da maior secreção de TGFβ1, não foram observadas mudanças na morfologia ou proliferação das células epiteliais quando o paciente apresentava diabetes ou hipertensão.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Saliva/metabolism , Diabetes Mellitus/metabolism , Transforming Growth Factor beta1/metabolism , Hypertension/metabolism , Mouth Mucosa/metabolism , Mouth Mucosa/pathology , Salivation , Secretory Rate , Blood Glucose/metabolism , Case-Control Studies , Cross-Sectional Studies , Antigens, Nuclear , Diabetes Mellitus/pathology , Diabetes Mellitus/blood , Hypertension/pathology
10.
Article in English, Portuguese | LILACS | ID: biblio-909191

ABSTRACT

A doença cardiovascular (DCV) de origem aterosclerótica é a principal causa da morbidade e mortalidade em pacientes com diabetes mellitus (DM). Tanto os fatores de risco cardiovascular associados à resistência à insulina (RI) no contexto da síndrome da adiposidade visceral (SAV) quanto a hiperglicemia crônica contribuem para o risco da DCV na DM. A hiperinsulinemia compensatória que se estabelece na RI estimula os fatores de transcrição SREBP1c e SREBP1 em que se ativam os genes lipogênicos, levando à grande produção hepática de triglicérides. A hipertrigliceridemia é o gatilho para as demais alterações lipídicas que contribuem para o perfil pró-aterogênico na RI, caracterizando-se pelo predomínio de LDL pequenas e densas e redução do colesterol HDL. A hiperinsulinemia, também, está intimamente ligada à hipertensão arterial, pois aumenta o tônus simpático e a reabsorção renal de sódio. A RI é considerada o melhor fator preditivo para a ocorrência de DM tipo 2 (DM2), sendo necessário um defeito concomitante na secreção de insulina para que a hiperglicemia se estabeleça. Os efeitos deletérios da hiperglicemia devem-se à ativação de vias bioquímicas que resultam em inflamação e estresse oxidativo celular. A dislipidemia e a hipertensão arterial secundárias à RI, assim como a hiperglicemia, são importantes moduladores do risco cardiovascular na SAV e na DM2 e devem ser intensiva e conjuntamente abordados no tratamento e prevenção da DCV.


Cardiovascular disease (CVD) of atherosclerotic origin is the main cause of morbidity and mortality in patients with diabetes mellitus (DM). Both the cardiovascular risk factors associated with insulin resistance (IR) in the context of visceral adiposity syndrome (VAS) and chronic hyperglycemia contribute to the risk of CVD in DM. Compensatory hyperinsulinemia established in IR stimulates the transcription factors SREBP1c and SREBP1a, which activate lipogenic genes, leading to high hepatic production of triglycerides. Hypertriglyceridemia triggers other lipid changes that contribute to the pro-atherogenic profile in IR, which is characterized by the predominance of small and dense LDL and reduction of HDL-cholesterol. Hyperinsulinemia is also closely linked to arterial hypertension, as it increases sympathetic tone and renal sodium reabsorption. IR is considered the best predictive factor for the occurrence of type 2 DM (DM2), and a concomitant defect in insulin secretion is required for hyperglycemia to be established. The harmful effects of hyperglycemia are due to activation of biochemical pathways that result in inflammation and cellular oxidative stress. Dyslipidemia and hypertension secondary to IR, as well as hyperglycemia, are important modulators of cardiovascular risk in VAS and DM2 and should be intensively and jointly addressed in the management and prevention of CVD.


Subject(s)
Humans , Cardiovascular Diseases/pathology , Metabolic Syndrome/complications , Diabetes Mellitus/diagnosis , Diabetes Mellitus/pathology , Atherosclerosis/complications , Insulin Resistance , Risk Factors , Inflammation/diet therapy
11.
HU rev ; 44(1): 7-13, 2018.
Article in Portuguese | LILACS | ID: biblio-981853

ABSTRACT

Introdução: Diabetes mellitus é uma doença metabólica que afeta vários órgãos-alvo, incluindo os ossos. Objetivo: Avaliar pelo método de esqueletonização o efeito do Diabetes mellitus tipo I (DM1) na microarquitetura de osso esponjoso. Material e métodos: Quatorze ratos Wistar foram divididos em: Saudável (S, n=7) e Diabético (D, n=7). O DM1 foi induzido por meio de injeção endovenosa de estreptozotocina no grupo D, sendo a confirmação da condição realizada por checagem do nível glicêmico. Os animais foram sacrificados após 35 dias da indução no grupo D, juntamente com os do grupo S. As epífises femorais foram seccionadas, removidas, desmineralizadas e incluídas em parafina. Dois cortes (5 µm) foram obtidos, corados em Hematoxilina e Eosina, e analisados ao Microscópio de Luz. Foi realizada a delimitação interativa das trabéculas ósseas, seguido pelo processo de binarização utilizando threshold global, feita por dois operadores distintos. Depois, foi realizado o processo de esqueletonização para acesso às características das trabéculas e da rede de interconexão entre elas. Os parâmetros avaliados foram: Área óssea em micrômetros quadrados (B.Ar, seguido pela proporção em porcentagem BV/TV), Índice de Modelo estrutural (SMI), Dimensão Fractal (FD), Número de trabéculas (Tb.N), Número de ramos (B.N), Número total de junções (Junc.N), Média de pontos terminais (End.p), Média de extensão de cada ramo (R.Le) e Número de junções triplas (Triple.points.N). Resultados: Houve diferença significante apenas no parâmetro SMI para os diferentes operadores (p<0,0001), sendo o mesmo retirado da análise entre diabetes vs saudável. Houve diferença significante na quantidade óssea, sendo maior no grupo S (0,46±0,09) comparado ao grupo D (0,41±0,07) (p=0,0082). Os demais parâmetros não mostraram diferença significante. Conclusão: Conclui-se que a área óssea no grupo saudável é maior em comparação ao DM1. Dentro das limitações deste estudo, parece que a distribuição espacial das trabéculas e suas características de interconexão não são alteradas no diabetes.


Introduction: Diabetes is a metabolic disease that affects several target-organs, including bone. Objective: Analyze the effects of Diabetes Mellitus Type 1 (DM1) on the trabecular bone microarchitecture by using the skeletonization process. Material and methods: Fourteen Wistar rats were divided in two groups: Health (S, n=7) and Diabetic (D, n=7). DM1 was induced with streptozotocin in D group, and glycemic levels were tested on peripheral blood samples. After 35 days, the animals were euthanized and had their femurs removed. The epiphysis were decalcified and embedded in paraffin. Five microns sections were stained in Hematoxylin and Eosin, and analyzed at the light microscope. Bone trabeculae were manually delimited, and then the binarization process with a global threshold was performed for each image. The whole process were conducted by two operators separately. Skeletonization was applied to binary images in order to evaluate the trabeculae characteristics and their network. Bone area (B.Ar), Bone proportion (BV/TV) Strucutre Model Index (SMI), Fractal Dimension (FD), Trabeculae number (Tb.N), Mean branches (B.N), Mean junction points (Junc.N), Mean End-points (End.p), Mean branches length (B.Le), and Mean triple points (Triple.points.N) were evaluated. Results: There was a significant difference only for SMI between different operators (p<0.0001), being this parameter excluded for the evaluation between health and diabetic groups. There was a significant difference between S and D for bone area, with S (0.46±0.09) higher than D (0.41±0.07) (p=0.0082). The other parameters analyzed were not significantly different. Conclusion: Bone trabecular area was higher in health compared with diabetes. Within the limitations of this study, one could suggest that there are no alterations of the spatial distribution of the trabeculae with their network and their inner structural characteristics.


Subject(s)
Animals , Male , Rats , Image Processing, Computer-Assisted/methods , Diabetes Mellitus/pathology , Diabetes Mellitus, Experimental/pathology , Cancellous Bone/ultrastructure , Rats, Wistar
12.
Rev. salud pública ; 19(5): 609-616, sep.-oct. 2017. tab
Article in Spanish | LILACS | ID: biblio-962046

ABSTRACT

RESUMEN Objetivo Determinar la frecuencia y factores de riesgo para Síndrome Metabólico (SM) en adultos con Diabetes mellitus, hipertensión arterial y sin diabetes-hipertensión. Material y Métodos Se realizó un estudio transversal analítico en derechohabientes de ambos sexos y mayores de 20 años de los servicios de consulta externa del HGZ No. 1 IMSS Colima, México. Las variables estudiadas fueron edad, IMC, diámetro de la cintura, grado de escolaridad, estado socioeconómico, grado de actividad física, tabaquismo, antecedentes familiares para diabetes e hipertensión arterial (HTA) y parámetros bioquímicos como glucosa, colesterol HDL, triglicéridos. Resultados Se estudiaron 417 pacientes (170 hombres y 247 mujeres), con un promedio de edad 53,2 ± 13,4 años (intervalo 20 a 86 años). La frecuencia global del SM fue del 52,3 % (56 % mujeres y 46,4 % hombres). Mientras que la frecuencia del SM fue de 50 % en DM2, 42% en HTA, 80 % DM2 + HTA y 28,2 % sin DM o HTA. La frecuencia del tabaquismo fue del 27,8 % y fue un factor de riesgo importante para la totalidad de pacientes con SM, en DM2 y en DM2+HAT. Conclusiones La frecuencia del SM en adultos fue del 52,3 %, las mujeres fueron más afectadas y el tabaquismo fue el factor de riesgo más importante.(AU)


ABSTRACT Objective Determinate the frequency and the risk factors for Metabolic Syndrome in adults with diabetes mellitus, Hypertension and without Diabetes- Hypertension. Materials and Methods We realized a cross-sectional study in patients of both sexes and older than 20 years of the "Hospital General de Zona 1 IMSS" in Colima, Mexico. The variables studied were: age, BMI, waist circumference, cigarette smoking, and family history of diabetes and hypertension, and biochemical parameters, such as glucose, HDL cholesterol and triglycerides. Results A total of 417 persons were enrolled (170 men and 247 women), with an age average of 53.2 ± 13.4 years (age range, 20 to 86 years). The global frequency of the metabolic syndrome was 52.3 % (56 % in women and 46.4 % in men). While the MS frequency was 50 % in DM2, 42 % in hypertension, 80 % in DM2+hypertension and 28.2 % without DM2 and hypertension. The cigarette smoking frequency was 27.8 %, and it was an important risk factor for the totally of patients with MS, in DM2 and in DM2+hypertension. Conclusions The frequency of MS in adults was 52.3 %, women were the most affected, and cigarette smoking was the most important risk factor.(AU)


Subject(s)
Humans , Metabolic Syndrome/epidemiology , Diabetes Mellitus/pathology , Hypertension/pathology , Epidemiology, Descriptive , Prevalence , Cross-Sectional Studies/instrumentation
13.
Rev. medica electron ; 39(4): 916-932, jul.-ago. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-902216

ABSTRACT

La insuficiencia cardíaca afecta aproximadamente a 5.1 millones de adultos en los Estados Unidos de América, con expectativas de alcanzar a casi 8 millones de adultos para 2030. Los pacientes portadores de insuficiencia cardiaca están en mayor riesgo de sufrir una mayor morbilidad y mortalidad que la población en general; además, existen co-morbilidades que pueden complicar el cuidado de estos pacientes. La diabetes mellitus, el dolor crónico y la depresión son diagnósticos que muy a menudo coexisten con la insuficiencia cardiaca. Los medicamentos con que normalmente se tratan estas co-morbilidades pueden inducir o empeorar los síntomas de la insuficiencia cardiaca, así que determinar la terapia apropiada es de vital importancia. Los médicos deben entender la relación que existe entre estas medicaciones y la insuficiencia cardiaca para mejorar la asistencia, aumentar la seguridad del paciente y reducir la morbilidad y mortalidad. Este trabajo analiza la asociación entre ciertos medicamentos usados para el tratamiento de estas co-morbilidades y su relación con la insuficiencia cardiaca. El propósito de este artículo es proporcionar una orientación farmacológica donde las opciones de tratamiento tengan especial consideración con un aumento de la supervisión médica, para evitar la descompensación o aparición de la insuficiencia cardiaca en los pacientes portadores de diabetes mellitus, dolor crónico y depresión (AU).


Heart failure affects approximately 5.1 million adults in the USA, with expectations of a rise to nearly 8 million adults by 2030. Patients with heart failure are at increased risk for morbidity/mortality, and co-morbidities can further complicate care for these patients. Diabetes mellitus, chronic pain, and depression are diagnoses that often coexist with heart failure. Medications commonly used to treat these co-morbidities may induce or worsen heart failure symptoms, so determining appropriate drug therapy is important. Healthcare providers must understand the relationship between these medications and heart failure in order to improve prescribing practices to increase patient safety and reduce morbidity and mortality. This manuscript discusses the association between certain medications used to treat the aforementioned diagnoses and their relationship to heart failure. The purpose of this article is to provide guidance on which pharmacologic options require special consideration, increased monitoring, or complete avoidance in heart failure patients with diabetes mellitus, chronic pain, and/or depression (AU).


Subject(s)
Humans , Male , Female , Diabetes Mellitus/pathology , Chronic Pain/pathology , Heart Failure/complications , Depression/pathology , Depression/prevention & control , Depression/therapy , Diabetes Mellitus/prevention & control , Chronic Pain/prevention & control , Heart Failure/diagnosis , Heart Failure/mortality , Heart Failure/pathology , Heart Failure/prevention & control , Heart Failure/epidemiology
14.
Rev. medica electron ; 39(3): 602-606, may.-jun. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-902196

ABSTRACT

La diabetes mellitus es una enfermedad crónica no trasmisible muy frecuente en la ciudad de Matanzas, se presenta en cualquier grupo etáreo, siendo tipo I o tipo II. En la diabetes tipo I, el cuerpo no produce insulina. En la diabetes tipo II, la más común, el cuerpo no produce o no usa la insulina adecuadamente. Sin suficiente insulina, la glucosa permanece en la sangre, provocando múltiples complicaciones tanto agudas como crónicas. La diabetes insípida es un trastorno poco común del metabolismo del agua. Esto quiere decir que el balance entre la cantidad de agua o líquido que usted toma no corresponde con el volumen de excreción urinaria. Es causada por una falta de respuesta o una respuesta deficiente a la hormona antidiurética vasopresina. Esta hormona controla el balance hídrico mediante la concentración de orina. Los pacientes con diabetes insípida orinan mucho, por lo cual necesitan beber bastantes líquidos para reemplazar los que pierden. Se presenta un paciente de 45 años con antecedentes de salud que debutó con una diabetes insípida y un año más tarde con una diabetes mellitus tipo II concomitando ambas, corroborándose por los complementarios correspondientes y mejorando con tratamiento (AU).


Diabetes mellitus is a non-transmissible chronic disease, very frequent in the city of Matanzas, which is present in any age group, and is classified as type I and type II. In the type I diabetes, the body does not produce insulin. In the type II diabetes, the most common one, the body does not produce or does not use it effectively. Without enough insulin, glucose remains in the blood, causing several complications, both acute and chronic. The diabetes insipidus is a few common disorder of the water metabolism. That means that the balance between the quantity of water or any other fluid someone drinks does not coincide with the volume of the urinary excretion. It is due to a lack of answer or a deficient answer to the anti-diuretic hormone vasopressin. This hormone controls the water balance through the urine concentration. The patients with diabetes insipidus urinate a lot, so they need to drink many liquids to replace those they lose. It is presented the case of a patient aged 45 years, with health antecedents, that debuted with diabetes insipidus and a year later with a concomitant type II diabetes mellitus. The complementary tests confirmed that and the patient got better with the treatment (AU).


Subject(s)
Humans , Male , Female , Adult , Diabetes Insipidus/epidemiology , Diabetes Mellitus/epidemiology , Diabetes Complications , Diabetes Insipidus/complications , Diabetes Insipidus/congenital , Diabetes Insipidus/diagnosis , Diabetes Insipidus/pathology , Diabetes Mellitus/congenital , Diabetes Mellitus/diagnosis , Diabetes Mellitus/pathology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology
15.
Ann. hepatol ; 16(2): 215-220, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-887225

ABSTRACT

ABSTRACT Introduction and aim. The effect of the new direct acting antiviral drugs (DAAs) for chronic hepatitis C (HCV) on glycemic control is unknown. Materials and methods. We conducted a retrospective cohort study of patients who were treated for chronic HCV with direct-acting antiviral medications at a single academic institution between May 2013 and April 2016. Univariate analysis was performed comparing subjects pre- and post-treatment. Results. One hundred seventy-five consecutive adult patients were treated for chronic HCV and met enrollment criteria. The majority (80.8%) were genotype 1 and overall cohort sustained virologic response at week 12 (SVR12) was 97.8%. Thirty-one (18.5%) had diabetes mellitus (DM); twenty-six had pre- and post-treatment HbA1c values. Of these, 76.9% were male and 61.5% had cirrhosis. Ninety-six percent were prescribed sofosbuvir-based therapy and all but one (96.8%) achieved SVR12. Three patients were started on treatment despite meeting the definition for poorly controlled DM (HbA1c > 9 mg/dL). There was no significant difference when comparing pre-treatment (7.36 mg/dL, 95% CI 6.55-8.16) to post-treatment HbA1c (7.11 mg/dL, 95% CI 6.34-7.88, p = 0.268). Thirty-one percent of subjects required dose escalation or the initiation of insulin based therapy during treatment. Discussion. Although chronic HCV is associated with exacerbation of insulin resistance, our results showed HbA1c to be unaffected by eradication of chronic HCV with DAA in diabetic patients with and without cirrhosis. Paradoxically, almost 1/3 of patients required escalation of anti-diabetic therapy during treatment. Long-term studies are warranted to understand the relationship between HCV viral eradication and insulin metabolism.(AU)


Subject(s)
Humans , Antiviral Agents/pharmacology , Hepatitis C, Chronic/drug therapy , Glycemic Index , Retrospective Studies , Cohort Studies , Diabetes Mellitus/pathology , Insulin/metabolism
16.
Rev. cuba. oftalmol ; 30(1): 0-0, ene.-mar. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-901343

ABSTRACT

Objetivo: describir el comportamiento de manifestaciones oftalmológicas de anexos y segmento anterior en pacientes diabéticos de un área de salud. Métodos: se realizó un estudio descriptivo transversal. La muestra fue conformada por 134 pacientes diabéticos. Se aplicaron métodos de estadística descriptiva para variables cualitativas. Para el procesamiento y análisis de la información se confeccionó una base de datos en programa estadístico Microsoft Excel 2003. Resultados: el 88,8 por ciento de los pacientes tenían más de 50 años. Predominaron el grupo de 60-69 años, con edad media de 62,5 años; el sexo femenino a razón de 97:37 y la diabetes mellitus tipo 2 (97,8 por ciento), con menos de 5 años de evolución (57,4 por ciento). Las enfermedades oculares que se presentaron con mayor frecuencia fueron ojo seco (76,1 por ciento), blefaritis (41,7 por ciento), pterigion (20,1 por ciento), tortuosidad vascular conjuntival (15,6 por ciento), engrosamiento conjuntival (11,1 por ciento), queratitis punctata y neurotrófica (4,5 por ciento) seguida de herpes zoster oftálmico (2,2 por ciento), rubeosis del iris (1,5 por ciento) y úlcera corneal y catarata (0,8 por ciento). Conclusiones: la diabetes mellitus es un problema de salud real. Las personas diabéticas presentan con frecuencia daño ocular como ojo seco, blefaritis, queratitis, entre otros, por lo que deben consultar al oftalmólogo periódicamente(AU)


Objective : to describe the behavior of the ophthalmologic manifestations of annexes and previous segment in diabetic patients in an area of health. Method: a carried out a traverse descriptive study. The sample was constituted by134 diabetic patients. Methods of descriptive statistic were applied for qualitative variables. For the prosecution and analysis of the information a database was made in statistical program Microsoft Excel 2003. Results: 88,8 percent of the patients had more than 50 years prevailing the 60-69 year-old group, with half age 62,5 years old. The feminine sex prevailed to reason of 97:37. Diabetes mellitus type 2 prevailed (97,8 percent), with less than 5 years of evolution (57,4 percent). The ocular pathologies that were presented with more frequency were dry eye (76,1 percent), blepharitis (41,7 percent), pterigion (20,1 percent), tortuosity vascular conjunctival (15,6 percent), and conjunctival engrosamiento (11,1 percent). Punctata keratopathy and neurotropic keratopathy (4,5 percent) followed by herpes zoster ophthalmicus (2,2 percent), rubeosis of the iris (1,5 percent) and corneal ulcer, waterfall (0,8 percent). Conclusions: the diabetic mellitus is a problem of real health. Diabetic people frequently present ocular damage as dry eye, blepharitis, keratopathy among other, for what they should attend the oculist periodically(AU)


Subject(s)
Humans , Female , Middle Aged , Aged , Diabetes Mellitus/pathology , Diagnostic Techniques, Ophthalmological/adverse effects , Eye Manifestations , Statistical Databases , Cross-Sectional Studies , Epidemiology, Descriptive
18.
Braz. J. Pharm. Sci. (Online) ; 53(4): e17144, 2017. tab
Article in English | LILACS | ID: biblio-889420

ABSTRACT

ABSTRACT Diabetic complications, comorbidities, and cost of treatment affect the quality of life (QoL) of an individual. The QoL assessment is considered an important measure of outcome in chronic disease management. The objective of our study was to assess the quality of life in Type II diabetes mellitus patients with and without complications using the modified diabetes quality of life (MDQoL)-17. A prospective descriptive study was conducted over 6 months, after taking ethical committee approval. As per the inclusion criteria from medicine wards of tertiary care hospital, 250 patients were selected. Demographic characteristics were documented in the data collection form and the patients were administered with the MDQoL questionnaire in different languages. The data was analyzed using IBM SPSS version 20. Majority of the patients were male (64.4%). The average age of the study population was 60.34±12.04 years. Most of the patients had a diabetes history of more than 10 years and HbA1c > 8%. The average QoL score was 65.47±15.07. Majority of the diabetic patients had the QoL score between 70 and 50. Patients without complication had a better QoL. As the number of complications increased, there was a decrease in the QoL. The presence of comorbidity also decreased the QoL. There was a statistically significant correlation with various parameters such as age, duration of diabetes history, HbA1c, number of complications and type of complication verses QoL of diabetic patients (p<0.05). The overall QoL in diabetic patients is reduced. Thus, proper management and strict glycemic control is necessary to prevent progression and occurrence of complications to maintain a better QoL in diabetes patients.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Surveys and Questionnaires/statistics & numerical data , Diabetes Complications/prevention & control , Diabetes Mellitus/pathology
19.
Rev. Círc. Argent. Odontol ; 73(223): 4-9, oct. 2016. tab, ilus, graf
Article in Spanish | LILACS | ID: biblio-908062

ABSTRACT

El propósito de esta presentación es marcar el concepto de que la asociación entre enfermedad periodontal y diabetes es una vía bidireccional; la primera puede determinar el inicio o agravamiento de la diabetes, en tanto que ésta es uno de los factores de riesgo más estudiados que puede aumentar la gravedad de las enfermedades periodontales que son siempre iniciadas por los microorganismos patógenos.


Subject(s)
Male , Female , Humans , Diabetes Mellitus/pathology , Periodontal Diseases/etiology , Risk Factors , Anti-Bacterial Agents/therapeutic use , Dental Care for Chronically Ill/methods , Dental Plaque/prevention & control , Dental Plaque/therapy , Dental Scaling/methods , Diabetes Mellitus/drug therapy , Diabetes Mellitus/genetics , Periodontal Diseases/therapy , Photochemotherapy/methods
20.
An. bras. dermatol ; 91(5,supl.1): 148-150, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837944

ABSTRACT

Abstract Early malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by lesions, which can suppurate and be accompanied by systemic symptoms such as high fever, asthenia, myalgia, and torpor state. We report a diabetic patient with characteristic features of the disease showing favorable evolution of the lesions after appropriate treatment.


Subject(s)
Humans , Female , Middle Aged , Skin/pathology , Syphilis, Cutaneous/pathology , Syphilis/pathology , Diabetes Mellitus/pathology , Skin Ulcer/pathology , Erythema/pathology , Immunocompetence
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