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Resumen Objetivos: Describir los patrones de prescripción de los medicamentos para la diabetes mellitus tipo 2 (DM2) y comorbilidades de pacientes atendidos en cinco instituciones prestadoras de servicios de salud de Colombia. Metodología: Estudio descriptivo transversal, en el cual se revisaron las historias clínicas de 5098 pacientes con DM2, atendidos en centros de atención ambulatoria ubicados en cinco ciudades colombianas entre el 1.º de enero y el 31 de diciembre de 2014. Cada uno de los pacientes con DM2 tenía al menos dos consultas ambulatorias registradas durante el periodo de estudio. La recolección de la información se hizo mediante una encuesta electrónica. Para la categorización de los medicamentos se usaron las guías nacionales e internacionales para el tratamiento de la diabetes. El análisis de los datos fue realizado utilizando el programa IBM SPSS® Statistics versión 21. Resultados: El medicamento de más frecuente prescripción fueron las biguanidas (59 %) y las sulfonilureas (28 %). La prescripción de inhibidores de la dipeptidil peptidasa-4 fue 7 % y la frecuencia de prescripción de agonista del receptor del péptido similar al glucagón tipo 1 (AR GLP-1) fue de 2 %. El medicamento con mayor frecuencia de prescripción como monoterapia fueron las biguanidas (22 %). La combinación más frecuente fue biguanida y las sulfonilureas (21 %), seguida de biguanida e insulina (10 %), y otras combinaciones. El 27 % pacientes con DM2 no recibió ningún tratamiento farmacológico para la diabetes. Con respecto a los medicamentos para comorbilidades, el 52 % de los pacientes utiliza al menos un tipo de antihipertensivo, el 39 % usa al menos un tipo de hipolipemiante y el 35 % utiliza ácido acetilsalicílico. Conclusiones: Las biguanidas fueron el medicamento con mayor frecuencia de prescripción, seguido de las sulfonilureas. Uno de cada cuatro pacientes no tenía registro de prescripción de medicamentos. El uso de ácido acetilsalicílico como prevención del riesgo cardiovascular fue menor al esperado.
Abstract Objetive: to describe the patterns of medicine prescriptions for diabetes mellitus type 2 (dm2) and the comorbidity of patients in five health care institutions in Colombia. Methodology: descriptive cross-sectional study carried out checking the medical records of 5098 patients with dm2 treated at the outpatient service centers in five Colombian cities between January 1 and December 31 of 2014. Each patient with dm2 had a record of at least two outpatient appointments registered during the time of this study. The information was collected through electronic surveys. National and international guides on diabetes treatment were used to categorize the medications. The spss® 21 software was used to analyze the data. Results: the most frequently prescribed medications were biguanides (59%) and sulfonylureas (28%). The prescription of inhibitors for Dipeptidyl peptidase-4 was 7% and the frequency of prescription of glucagon-like peptide-1 receptor agonists (ar glp-1) was 2%. The medication with the highest frequency of prescription as monotherapy were biguanides (22%). The most frequent combination was biguanide and sulfonylureas (21%). The second most frequent combination was biguanide with insulin (10%), and other combinations. 27% of patients with dm2 did not receive any pharmacological treatment for diabetes. Regarding the medicines for comorbidity, 52% of patients use at least one type of antihypertensive drug, 39% use at least one type of hypolipidemic drug and 35% uses acetylsalicylic acid. Conclusions: biguanides were the most frequently prescribed medication, sulfonylureas came after. One in four patients did not have a record of medicine prescription. The prescription of acetylsalicylic acid to prevent cardiovascular risk was lower than expected.
Resumo Objetivo: descrever os padrões de prescrição dos medicamen tos para a Diabetes Mellitus tipo 2 (dm2) e de comorbilidades de pacientes atendidos em cinco instituições de serviço de saú de da Colômbia. Metodologia: estudo descritivo transversal, no qual revisaram-se as histórias clínicas de 5098 pacientes com dm2, atendidos em centros de atendimento ambulatorial localizados em cinco cidades colombianas, entre 1 de janeiro e 31 de dezembro de 2014. Cada paciente com dm2 tinha pelo menos duas consultas ambulatoriais registradas durante o pe ríodo do estudo. A informação coletou-se através de inquérito eletrônico. Para a categorização dos medicamentos, utiliza ram-se os guias nacionais e internacionais para o tratamento da diabete. A análise dos dados realizou-se utilizando o progra ma spss® 21. Resultados: os medicamentos de prescrição mais frequente foram biguanidas (59%) e as sulfoniluréias (28%). A prescrição de inibidores da dipeptidil peptidase IV foi 7% e a frequência de prescrição de agonista do receptor do péptido si milar ao glucagão tipo 1 (ar glp-1) foi de 2%. O medicamento com mais frequência de prescrição como monoterapia foi as biguanidas (22%). A combinação mais frequente foi biguanida e sulfoniluréias (21%). A segunda combinação mais frequente foi biguanida com insulina (10%), e outras combinações. 27% dos pacientes com dm2 não recebeu tratamento farmacológi co nenhum para a diabetes. Respeito dos medicamentos para comorbilidades, 52% dos pacientes utiliza pelo menos um tipo de anti-hipertensivo, 39% utiliza pelo menos um tipo de hi polipemiante e 35% utiliza ácido acetilsalicílico. Conclusões: as biguanidas foram o medicamento com mais frequência de prescrição, e depois as sulfoniluréias. Um de quatro pacientes não rinha registro de prescrição de medicamentos. O uso de ácido acetilsalicílico como prevenção do risco cardiovascular foi menor do que se esperava.
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Aim To investigate the effect of polydatin on cardiomyocyte hypertrophy induced by high glucose (25.5 mmol·L -1 )and insulin (0.1 μmol ·L -1 ) (HGI)and its possible influence on peroxisome prolif-erator-activated receptor-β (PPARβ)/nuclear tran-scription factor-κB (NF-κB)/nitric oxide (NO)signa-ling pathway.Methods The cardiomyocyte hypertro-phy was characterized in rat primary cardiomyocytes by measuring the cell surface area,protein content,and atrial natriuretic factor (ANF)mRNA expression.The mRNA and protein expressions were measured by qRT-PCR and Western blotting,respectively.The activity of NO synthase (NOS)and NO content were measured by reagent kit through ultraviolet spectroscopy.Results HGI significantly induced cardiomyocyte hypertrophy which increased the cell surface area,protein content and ANF mRNA expression (P <0.01 ).Meanwhile, the expressions of PPARβmRNA and protein reduced while the NF-κB p65 and iNOS expressions increased significantly which occurred in parallel with rising NOS activity and NO concentration (P <0.01 ).Polydatin (0.1,1,10 μmol·L -1 )inhibited the cardiomyocyte hypertrophy induced by HGI (P <0.01 ),and re-versed the mRNA and protein expressions of PPARβ, NF-κB p65 and iNOS,and NOS activity,as well as NO content.These effects of polydatin were abolished by GSK0660 (1 μmol·L -1 ),a selective PPARβan-tagonist (P <0.05 ).Conclusion Polydatin resists HGI-induced cardiomyocyte hypertrophy,which may be mediated by PPARβup-regulation,and then NF-κB-iNOS-NO pathway inactivation.
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Aim To investigate the effect of flavonoids from Prinsepia utilis Royle( FPR) on the histomorphol-ogy of kidney in diabetic mice, and to investigate its protective mechanism. Methods Diabetic mice in-duced by alloxan were given FPR orally each day for four weeks. After the administration for two and four weeks, ten mice in each group were randomly sacri-ficed. The kidneys were removed and weighed. The extracted renal tissue was embedded with paraffin and sectioned, the sections were stained with Hematoxylin and Eosin(HE)、Periodic acid Schiff(PAS) and Go-mori, and then observed under the microscopy. 1mm3 of renal cortex fixed with glutaral in four centi-degree , and then the ultrastructure of each group was observed under the electron microscope respectively after four weeks′ treatment. Results Compared with the model control group, in the treatment group, observation un-der the microscopy showed that glomerular volume and mesangial cells reduced, FPR could relieve thickening of the glomerular basement membrane ( GBM ) , little inflammatory cells infiltrated in the interstitium,tubular epithelial cells almost became normal, renal tubule had little glucogen, fiber decreased in the interstitium of renal tubule. Observation under the electron micro-scope indicated that foot process in podocytes lined up in order, mitochondria of the renal tubule’ s epithelial cell almost recovered. Conclusion FPR can relieve the changes of renal pathology,improve renal function, and delay the progression of pathologic changes of kid-ney in diabetic mice partly through reducing the blood glucose and the blood lipid.
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Objective To construct several human proinsulin mutants plasmid related to diabetes and to express in INS-1 (Insulin secreting beta cell derived line) cell. Methods Human mild proinsulin gene was used as template , and site-directed mutagenesis PCR was employed to generate four human proinsulin plasmid mutants. Each mutant plasmid was sequenced then transfected with empty plasmid and mild plasmid into INS-1 cell by liposome 2000. Insulin value in each cell solution was determined by radioimmunoassay. Results Proinsulin mutants plasmid were confirmed by sequencing. In-sulin values in culture solution of H-C(B19)G、H-L(B11)P、H-R(S6)C mutants are less than those in wild type and H-F (B25)L(P＜0.05). Comparison of insulin values between H-C(B19)G、H-L(B11)P、H-R(S6)C groups were not statistically significant(P>0.05), and all these three groups showed no significant differences with empty plasmid group statistically (P>0.05).Insulin value of H-F(B25)L was of no significant differences statistically with empty plasmid(P>0.05). Conclu-sion Four human proinsulin mutants plasmid were constructed and expressed successfully in INS-1 cell, and different mu-tants plasmid result in diabetes through different mechanism.
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BACKGROUND: Cell adhesion molecules (CAMs) have been shown to be highly expressed in atherosclerotic lesions. Membrane-bound CAMs allow the tethering and rolling of monocytes and lymphocytes as well as the firm attachment and transendothelial migration of leukocytes. Soluble forms of CAMs may serve as monitors for increased expression of membrane-bound CAMs and thus may reflect progressive formation of atherosclerotic lesions. We assessed the role of the solu-ble CAMs in patients with type 2 Diabetes. METHODS: Serum levels of soluble E-selectin (sE-selectin), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured by enzyme immunoassay (R and D Systems, Minneapolis, USA) in patients with type 2 Diabetes (n=69) and normal control subjects (n=38). RESULTS: Fasting blood sugar, serum cholesterol, and blood pressure were significantly (P < 0.001) higher in diabetic patients than in control subjects. Serum sE-selectin, sICAM-1, and sVCAM-1 concentrations in diabetic patients were significantly (P < 0.001) higher than in the control subjects (69.7 +/- 32.0, 257.1 +/- 73.0 and 813.8 +/- 322.6 ng/mL versus 43.3 +/- 19.5, 173.1 +/- 66.8, and 400.4 +/- 77.4 ng/mL, respectively). The serum sICAM-1 concentrations in diabetic patients with microalbu-minuria were significantly (P=0.004) higher than in those patients without microalbuminuria (311.3 +/- 79.0 ng/mL versus 245.2 +/- 60.2 ng/mL). However, the sE-selectin and sVCAM-1 concentrations in diabetic patients with microalbuminuria were only slightly (P < 0.10) higher than in the patients without microalbuminuria. CONCLUSIONS: These results suggest that three kinds of circulating CAMs measured in this study increased significantly in patients with type 2 Diabetes. It is considered that circulating CAMs may be markers for atherosclerotic lesions in patients with type 2 Diabetes with symptomatic and asymptomatic atherosclerosis.
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Humanos , Aterosclerosis , Glucemia , Presión Sanguínea , Moléculas de Adhesión Celular , Adhesión Celular , Colesterol , Diabetes Mellitus Tipo 2 , Selectina E , Ayuno , Técnicas para Inmunoenzimas , Molécula 1 de Adhesión Intercelular , Leucocitos , Linfocitos , Monocitos , Migración Transendotelial y Transepitelial , Molécula 1 de Adhesión Celular VascularRESUMEN
In type 2 diabetic patients the f re quencies of point mutations 3316G→A and 3394T→C in mitochondrial DNA (mt DNA) were 3.9% (6/152) and 5.3% (8/152) respectively, which were significantly higher than those in normal controls and patients with coronary heart disease. This fi nding suggests that mtDNA 3316G→A and 3394T→G mutations are related to type 2 diabetes.