Semaglutide Attenuates Anxious and Depressive-Like Behaviors and Reverses the Cognitive Impairment in a Type 2 Diabetes Mellitus Mouse Model Via the Microbiota-Gut-Brain Axis.

Newly conducted research suggests that metabolic disorders, like diabetes and obesity, play a significant role as risk factors for psychiatric disorders. This connection presents a potential avenue for creating novel antidepressant medications by repurposing drugs originally developed to address antidiabetic conditions. Earlier investigations have shown that GLP-1 (Glucagon-like Peptide-1) analogs exhibit neuroprotective qualities in various models of neurological diseases, encompassing conditions such as Alzheimer's disease, Parkinson's disease, and stroke. Moreover, GLP-1 analogs have demonstrated the capability to enhance neurogenesis, a process recognized for its significance in memory formation and the cognitive and emotional aspects of information processing. Nonetheless, whether semaglutide holds efficacy as both an antidepressant and anxiolytic agent remains uncertain. To address this, our study focused on a mouse model of depression linked to type 2 diabetes induced by a High Fat Diet (HFD). In this model, we administered semaglutide (0.05 mg/Kg intraperitoneally) on a weekly basis to evaluate its potential as a therapeutic option for depression and anxiety. Diabetic mice had higher blood glucose, lipidic profile, and insulin resistance. Moreover, mice fed HFD showed higher serum interleukin (IL)-1ß and lipopolysaccharide (LPS) associated with impaired humor and cognition. The analysis of behavioral responses revealed that the administration of semaglutide effectively mitigated depressive- and anxiety-like behaviors, concurrently demonstrating an enhancement in cognitive function. Additionally, semaglutide treatment protected synaptic plasticity and reversed the hippocampal neuroinflammation induced by HFD fed, improving activation of the insulin pathway, demonstrating the protective effects of semaglutide. We also found that semaglutide treatment decreased astrogliosis and microgliosis in the dentate gyrus region of the hippocampus. In addition, semaglutide prevented the DM2-induced impairments of pro-opiomelanocortin (POMC), and G-protein-coupled receptor 43 (GPR43) and simultaneously increased the NeuN + and Glucagon-like Peptide-1 receptor (GLP-1R+) neurons in the hippocampus. Our data also showed that semaglutide increased the serotonin (5-HT) and serotonin transporter (5-HTT) and glutamatergic receptors in the hippocampus. At last, semaglutide changed the gut microbiota profile (increasing Bacterioidetes, Bacteroides acidifaciens, and Blautia coccoides) and decreased leaky gut, improving the gut-brain axis. Taken together, semaglutide has the potential to act as a therapeutic tool for depression and anxiety.

Mulheres com síndrome do ovário policísticos que desenvolveram diabetes melitus 2 antes dos 35 anos: ansiedade, má qualidade do sono e não controle glicêmico / Women with polycystic ovarian syndrome who developed diabetes mellitus 2 before the age of 35: anxiety, poor sleep quality and lack of glycemic control / Mujeres con síndrome de ovario poliquístico que desarrollaron diabetes melitus 2 antes de los 35 años: ansiedad, mala calidad del sueño y sin control glucémico

Introdução: A síndrome dos ovários policísticos (SOP) consiste em uma desordem de origem endocrinológica de grande prevalência nas mulheres em idade fértil, sendo acometidas por ela aproximadamente de 6 a 16% da população feminina - em consonância com diversos critérios diagnósticos 1-4. Essa síndrome é associada ao hiperandrogenismo e à resistência insulínica (RI), com manifestações clínicas relacionadas a alterações reprodutivas 4, desenvolvimento de diabetes mellitus (DM2) e obesidade. Esta pesquisa objetiva compreender o perfil das mulheres com DM 2 antes dos 35 anos e os fatores que podem levar a esta condição. Metodologia: Este estudo se deu por meio de inquérito on-line feito a mulheres diagnosticadas com SOP, e com menos de 35 anos de idade. Foi desenvolvido de maneira virtualizada via plataforma GoogleForms® em função da pandemia do COVID-19. Tratou-se de um levantamento sobre presença de fatores de risco para DM 2, como sobrepeso e alimentação, sedentarismo e qualidade do sono; em grupos de mulheres com SOP diabéticas e não diabéticas, para efeito de comparação. Resultados e discussão: Um total de 198 mulheres responderam ao questionário, sendo divididas em Diabéticas (DM) e não diabéticas (NDM). O grupo DM foi o que mais apresentou IMC elevado (acima de 30), e o que mais se declarou seguir orientações nutricionais. Atividade física não diferenciou entre os grupos. O grupo DM foi o que declarou dormir mais tarde (pós 23:00) quando comparado com o grupo NDM. O sobrepeso indica ser um fator importante para o advento da DM 2 neste grupo, sendo as orientações nutricionais não tão efetivas, devido muito a dificuldade de aderir às orientações. O hábito de dormir tarde implica em alterações que levam a aumento da RI via estresse oxidativo, contribuindo para obesidade e DM 2. Conclusões: A obesidade é um fator decisivo para a precocidade da DM 2 em mulheres com SOP, e sua condição é multifatorial, associada a seguimento de orientações nutricionais, atividade física e qualidade do sono. O evitar da precocidade da DM 2 neste grupo passa por esta compreensão.

Introduction: Polycystic ovary syndrome (PCOS) is an endocrinological disorder with high prevalence in women of childbearing age, affected by approximately 6 to 16% of the female population - in line with several diagnostic criteria 1-4. This syndrome is associated with hyperandrogenism and insulin resistance (IR), with clinical manifestations related to reproductive changes 4, development of diabetes mellitus (DM2) and obesity. This research aims to understand the profile of women with DM 2 before the age of 35 and the factors that can lead to this condition. Methodology: This study was carried out through an online survey made to women diagnosed with PCOS, and under 35 years of age. It was developed in a virtualized way via the GoogleForms® platform due to the COVID-19 pandemic. This was a survey on the presence of risk factors for DM 2, such as overweight and diet, sedentary lifestyle and sleep quality; in groups of women with diabetic and non-diabetic PCOS for comparison purposes. Results and discussion: A total of 198 women answered the questionnaire, divided into Diabetic (DM) and non-diabetic (NDM). The DM group was the one with the highest BMI (above 30), and the one that most declared to follow nutritional guidelines. Physical activity did not differ between groups. The DM group was the one who reported sleeping later (after 11 pm) when compared to the NDM group. Overweight is an important factor for the advent of DM 2 in this group, and nutritional guidelines are not so effective, due to the difficulty in adhering to the guidelines. The habit of sleeping late implies changes that lead to increased IR via oxidative stress, contributing to obesity and DM 2. Conclusions: Obesity is a decisive factor for the precocity of DM 2 in women with PCOS, and its condition is multifactorial, associated with following nutritional guidelines, physical activity and sleep quality. Avoiding the precocity of DM 2 in this group involves this understanding.

Introducción: El síndrome de ovario poliquístico (SOP) es un trastorno de origen endocrinológico de alta prevalencia en mujeres en edad fértil, afectando aproximadamente entre el 6 y el 16% de la población femenina, de acuerdo con diversos criterios diagnósticos 1- 4 . Este síndrome se asocia con hiperandrogenismo y resistencia a la insulina (RI), con manifestaciones clínicas relacionadas con cambios reproductivos 4, desarrollo de diabetes mellitus (DM2) y obesidad. Esta investigación tiene como objetivo conocer el perfil de las mujeres con DM 2 antes de los 35 años y los factores que pueden conducir a esta condición. Metodología: Este estudio se realizó a través de una encuesta online realizada entre mujeres diagnosticadas con SOP y menores de 35 años. Fue desarrollado de manera virtualizada a través de la plataforma GoogleForms® debido a la pandemia de COVID-19. Se realizó una encuesta sobre la presencia de factores de riesgo para DM 2, como sobrepeso y alimentación, sedentarismo y calidad del sueño; en grupos de mujeres diabéticas y no diabéticas con síndrome de ovario poliquístico, con fines de comparación. Resultados y discusión: Respondieron al cuestionario un total de 198 mujeres, divididas en diabéticas (DM) y no diabéticas (NDM). El grupo DM fue el que presentó un IMC más elevado (superior a 30), y el que más declaró seguir las pautas nutricionales. La actividad física no difirió entre los grupos. El grupo DM fue el que reportó dormir más tarde (después de las 11:00 pm) en comparación con el grupo NDM. El sobrepeso indica que es un factor importante en la aparición de DM 2 en este grupo, siendo las pautas nutricionales no tan efectivas, en gran parte por la dificultad para cumplirlas. El hábito de dormir tarde implica cambios que conducen a un aumento de la RI vía estrés oxidativo, contribuyendo a la obesidad y la DM 2. Conclusiones: La obesidad es un factor decisivo en la aparición temprana de la DM 2 en mujeres con SOP, y su condición es multifactorial, asociado con el seguimiento de pautas nutricionales, actividad física y calidad del sueño. Evitar la precocidad de la DM 2 en este grupo requiere esta comprensión.

Efeito do uso de probióticos e simbióticos no controle metabólico em pacientes com diabetes Mellitus tipo 2 e pré-diabetes: uma revisão sistemática de literatura / Effect of probiotics and symbotics on metabolic control in patients with type 2 diabetes Mellitus and pre-diabetes: a systematic literature review / Efecto del uso de probióticos y simbióticos sobre el control metabólico en pacientes con diabetes Mellitus tipo 2 y prediabetes: una revisión sistemática de la literatura

O diabetes mellitus constitui um distúrbio clínico heterogêneo, apresentando comumente hiperglicemia e estado inflamatório crônico. Tais condições se relacionam com a microbiota intestinal, compreendida como um conjunto de microrganismos que interagem com o hospedeiro de maneira benéfica ou maléfica. Nos pacientes diabéticos, a modulação microbiológica do intestino é bastante intrigante, pois o uso de probióticos tem auxiliado na redução da endotoxemia metabólica e de mediadores inflamatórios. Dessa forma, o objetivo deste trabalho é realizar uma revisão sistemática de literatura, buscando verificar a relação entre o uso de probióticos e simbióticos e a melhora metabólica em indivíduos diabéticos ou em risco de desenvolver tal patologia. Para tanto, foi realizada uma revisão sistemática, com coleta de dados realizada nas bases de dados PubMed, LILACS e ScienceDirect, com o objetivo de localizar ensaios clínicos que contemplassem a relação entre o uso de probióticos e simbióticos e a melhora metabólica (glicêmica e no tocante aos marcadores inflamatórios) na população-alvo. Os artigos coletados foram publicados entre janeiro de 2017 e fevereiro de 2022, e os estudos incluídos na revisão se restringiram ao idioma inglês. Foram avaliados quatro estudos, a maioria demonstrando uma redução significativa na glicemia em jejum e melhora metabólica geral, com redução dos níveis de marcadores inflamatórios após introdução de probióticos e simbióticos. Dessa forma, foi possível concluir que, apesar de muitos estudos serem inconclusivos em relação ao efeito dos probióticos sobre o controle glicêmico, pode haver espaço para tais suplementos no tratamento do diabetes mellitus tipo 2 e pré-diabetes. Entretanto, mais estudos são necessários para confirmar esses resultados.

Diabetes mellitus is a heterogeneous clinical disorder, commonly presenting hyperglycemia and chronic inflammatory state. These conditions are related to the intestinal microbiota, understood as a set of microorganisms that interact with the host in a beneficial or harmful way. Microbiological modulation of the intestine in diabetic patients is quite interesting, as probiotics have helped reduce metabolic endotoxemia and inflammatory mediators. Thus, this systematic literature review sought to verify the relationship between use of probiotics and symbiotics and glycemic/metabolic control in patients with type 2 Diabetes Mellitus and pre-diabetes. Bibliographic search was conducted in the PubMed, LILACS and ScienceDirect databases to identify clinical trials on the effect of probiotics and symbiotics on glycemic/metabolic improvement/control in the targeted patients. Retrieved articles were published between January 2017 and February 2022, but only papers in English were included in the review, resulting in four articles evaluated. Most studies showed a significant reduction in fasting blood glucose and general metabolic improvement, with reduced levels of inflammatory markers, after introduction of probiotics and symbiotics. Although many studies are inconclusive regarding the effect of probiotics and symbiotics on glycemic control, such supplements may have space in DM2 and pre-DM treatment. Further studies are needed to confirm these results.

La diabetes mellitus es un trastorno clínico heterogéneo, caracterizada comúnmente por la hiperglucemia y un estado inflamatorio crónico. Esta condición está relacionada con la microbiota intestinal, que abarca un conjunto de microorganismos que viven con el huésped benéfica o maléficamente. En pacientes diabéticos, la modulación microbiológica del intestino es muy intrigante, puesto que el uso de probióticos ha ayudado a reducir la endotoxemia metabólica y los mediadores inflamatorios. Así, el objetivo de este trabajo es realizar una revisión sistemática de la literatura para verificar la relación entre el uso de probióticos y simbióticos y la mejoría metabólica en diabéticos y prediabéticos. Por lo tanto, se realizó una revisión sistemática, con recolección de datos en las bases de datos PubMed, LILACS y ScienceDirect, con el objetivo de localizar ensayos clínicos que contemplaran la relación entre el uso de probióticos y simbióticos y la mejora metabólica (glucémica y en cuanto a marcadores inflamatorios) en el público objetivo. Los artículos habían sido publicados entre enero de 2017 y febrero de 2022 y  se restringieron al idioma inglés. Se evaluaron cuatro estudios, la mayoría demostró una reducción significativa en la glucosa en sangre en ayunas y una mejora metabólica general, con niveles reducidos de marcadores inflamatorios, después de la introducción de probióticos y simbióticos. Así, fue posible concluir que, aunque muchos estudios no son concluyentes en cuanto al efecto de los probióticos en el control glucémico, hay espacio para tales suplementos en el tratamiento de la diabetes mellitus y la prediabetes. Sin embargo, se necesitan más estudios para confirmar estos resultados.

Uso de empagliflozina en pacientes diabéticos tipo 2 con insuficiencia cardíaca

Resumen: Introducción: La insuficiencia cardíaca es una patología con alta prevalencia y morbimortalidad. Entre las estrategias terapéuticas se debe considerar el abordaje de las comorbilidades, entre ellas la diabetes mellitus tipo 2. Los pacientes con insuficiencia cardíaca que la asocian, tienen 75% más riesgo de hospitalización y mortalidad. La Food and Drug Administration ha enfatizado desde 2008 que todo nuevo hipoglucemiante debe tener un efecto beneficioso o al menos neutro a nivel cardiovascular. Varios estudios han demostrado que los inhibidores del cotransportador sodio glucosa tipo 2 (empagliflozina, canagliflozina y dapagliflozina) cumplen con estos requerimientos. El objetivo de este trabajo es describir la experiencia en "vida real" de la empagliflozina en pacientes con diabetes mellitus 2 e insuficiencia cardíaca con fracción de eyección reducida. Metodología: Se realizó un estudio prospectivo, longitudinal, entre julio 2019 - abril 2021 en una Unidad Multidisciplinaria de Insuficiencia Cardíaca. Resultados: Se incluyeron 25 pacientes Se incluyeron 25 pacientes (13 hombres) con edad media 61 años. La dosis objetivo de empagliflozina se alcanzó en el 95% de los pacientes. Se observó un descenso de peso, hemoglobina glicosilada y glicemia de ayunas. Conclusiones: La empagliflozina presentó buena tolerabilidad, con efectos beneficiosos a nivel cardiovascular y mínimos efectos adversos.

Abstract: Introduction: Heart failure is a pathology with high prevalence and morbidity and mortality. Among the therapeutic strategies, addressing comorbidities should be considered, including type 2 diabetes mellitus. Patients with associated heart failure have a 75% higher risk of hospitalization and mortality. The Food and Drug Administration has emphasized since 2008 that all new hypoglycemic agents must have a beneficial or at least neutral effect at the cardiovascular level. Several studies have shown that sodium-glucose cotransporter 2 inhibitors (empagliflozin, canagliflozin, and dapagliflozin) meet these requirements. The objective of this work is to describe the "real life" experience of empagliflozin in patients with type 2 diabetes mellitus and heart failure with reduced ejection fraction. Methodology: A prospective, longitudinal study was carried out between July 2019 and April 2021 in a Multidisciplinary Heart Failure Unit. Results: Twenty-five patients (13 men) with a mean age of 61 years were included. The target dose of empagliflozin was achieved in 95% of patients. A decrease in weight, glycosylated hemoglobin and fasting blood glucose was observed. Conclusions: Empagliflozin presented good tolerability, with beneficial effects at the cardiovascular level and minimal adverse effects.

Resumo: Introdução: A insuficiência cardíaca é uma patologia com alta prevalência e morbidade e mortalidade. Dentre as estratégias terapêuticas, deve-se considerar a abordagem de comorbidades, incluindo diabetes mellitus tipo 2. Pacientes com insuficiência cardíaca associada apresentam risco 75% maior de hospitalização e mortalidade. A Food and Drug Administration tem enfatizado desde 2008 que todos os novos agentes hipoglicemiantes devem ter um efeito benéfico ou pelo menos neutro no nível cardiovascular. Vários estudos mostraram que os inibidores do cotransportador 2 de sódio-glicose (empagliflozina, canagliflozina e dapagliflozina) atendem a esses requisitos. O objetivo deste trabalho é descrever a experiência da "vida real" da empagliflozina em pacientes com diabetes mellitus tipo 2 e insuficiência cardíaca com fração de ejeção reduzida. Metodologia: Foi realizado um estudo prospectivo, longitudinal, entre julho de 2019 e abril de 2021 em uma Unidade Multidisciplinar de Insuficiência Cardíaca. Resultados: Vinte e cinco pacientes (13 homens) com idade média de 61 anos foram incluídos. A dose alvo de empagliflozina foi alcançada em 95% dos pacientes. Observou-se diminuição do peso, da hemoglobina glicosilada e da glicemia de jejum. Conclusões: A empagliflozina apresentou boa tolerabilidade, com efeitos benéficos a nível cardiovascular e efeitos adversos mínimos.

Factores de riesgo para desarrollar diabetes mellitus II / Risk factors for developing diabetes mellitus II / Factores de risco para o desenvolvimento da diabetes mellitus II

La diabetes mellitus constituye uno de los problemas de salud más importantes en el mundo por la alta carga de enfermedad en términos de discapacidad y mortalidad prematura que ocasiona, debido a su alta prevalencia e incidencia a nivel mundial se configura como una epidemia. OBJETIVO: determinar el riesgo para desarrollar diabetes mellitus tipo II en las personas de la Cuidad de Cuenca. MATERIALES Y METODOS: se realizó un estudio, descriptivo, correlacional, prospectivo, cuantitativo y de corte transversal, mediante la aplicación del test de FINDRISC, La muestra estuvo compuesta por 379 personas no diabéticas con edades comprendidas entre 18 y 65 años de edad. RESULTADOS: se determinó que las variables sexo, edad, el peso, la talla, el perímetro de cintura, el tiempo diario de actividad física y antecedentes familiares de DM1- 2 presentan una correlación significativa en el nivel 0,01 (bilateral) con el riesgo de desarrollar DM2 según la puntuación del test de FINDRISC. CONCLUSIÓN: los datos obtenidos sugieren la necesidad de programas de intervención multidisciplinar en las unidades de salud asociados a programas educativos, ingesta dietética adecuada y actividad física regular.

Diabetes mellitus is one of the most important health problems in the world due to the high burden of disease in terms of disability and premature mortality it causes, due to its high prevalence and incidence worldwide is configured as an epidemic. OBJECTIVE: to determine the risk of developing type II diabetes mellitus in people from the city of Cuenca. MATERIAL AND METHODS: descriptive, correlational, prospective, quantitative and cross-sectional study was carried out through the application of the FINDRISC test. The sample was composed of 379 non-diabetic persons between 18 and 65 years of age. RESULTS: it was determined that the variables sex, age, weight, height, waist circumference, daily physical activity time and family history of DM1- 2 presented a significant correlation at the 0.01 level (bilateral) with the risk of developing DM2 according to the FINDRISC test score. CONCLUSION: the data obtained suggest the need for multidisciplinary intervention programs in health units associated with educational programs, adequate dietary intake and regular physical activity.

A diabetes mellitus é um dos problemas de saúde mais importantes do mundo devido ao elevado peso da doença em termos de incapacidade e mortalidade prematura que provoca, devido à sua elevada prevalência e incidência a nível mundial é configurada como uma epidemia. OBJECTIVO: determinar o risco de desenvolvimento da diabetes mellitus tipo II nas pessoas da cidade de Cuenca. MATERIAIS E METODOS: Foi realizado um estudo descritivo, correlativo, prospectivo, quantitativo e transversal utilizando o teste FINDRISC. A amostra consistiu em 379 pessoas não diabéticas entre os 18 e os 65 anos de idade. RESULTADOS: Foi determinado que as variáveis sexo, idade, peso, altura, circunferência da cintura, tempo de atividade física diária e história familiar de DM1- 2 apresentaram uma correlação significativa ao nível 0,01 (bilateral) com o risco de desenvolvimento de DM2 de acordo com a pontuação do teste FINDRISC. CONCLUSÃO: os dados obtidos sugerem a necessidade de programas de intervenção multidisciplinar em unidades de saúde associados a programas educativos, ingestão alimentar adequada e actividade física regular.

The Beige Adipocyte as a Therapy for Metabolic Diseases.

Adipose tissue is traditionally categorized into white and brown relating to their function and morphology. The classical white adipose tissue builds up energy in the form of triglycerides and is useful for preventing fatigue during periods of low caloric intake and the brown adipose tissue more energetically active, with a greater number of mitochondria and energy production in the form of heat. Since adult humans possess significant amounts of active brown fat depots and its mass inversely correlates with adiposity, brown fat might play an important role in human obesity and energy homeostasis. New evidence suggests two types of thermogenic adipocytes with distinct developmental and anatomical features: classical brown adipocytes and beige adipocytes. Beige adipocyte has recently attracted special interest because of its ability to dissipate energy and the possible ability to differentiate themselves from white adipocytes. The presence of brown and beige adipocyte in human adults has acquired attention as a possible therapeutic intervention for metabolic diseases. Importantly, adult human brown appears to be mainly composed of beige-like adipocytes, making this cell type an attractive therapeutic target for obesity and obesity-related diseases, such as atherosclerosis, arterial hypertension and diabetes mellitus type 2. Because many epigenetics changes can affect beige adipocyte differentiation from adipose progenitor cells, the knowledge of the circumstances that affect the development of beige adipocyte cells may be important to new pathways in the treatment of metabolic diseases. New molecules have emerged as possible therapeutic targets, which through the impulse to develop beige adipocytes can be useful for clinical studies. In this review will discuss some recent observations arising from the unique physiological capacity of these cells and their possible role as ways to treat obesity and diabetes mellitus type 2.

Association between vitamin D status and glycemic profile in postmenopausal women with type 2 diabetes.

The aim of this study is to evaluate the association between vitamin D status and glycemic profile in postmenopausal women with type 2 diabetes. A cross-sectional study was carried out with 70 (59.47 ±â€¯6.47 years; 1.56 ±â€¯0.05 m; 73.56 ±â€¯13.01 kg; 30.30 ±â€¯5.00 BMI kg/m2) postmenopausal women with type 2 diabetes (T2D). The blood samples were collected after fasting for 12 h and the main outcome parameters were serum follicle-stimulating hormone (FSH), estradiol; 25-OH vitamin D; insulin; C-Reactive Protein; cholesterol total (CT), triglycerides (TG), high density lipoprotein (HDL-cholesterol), glucose; calcium, HDL-cholesterol. The average serum 25(OH)D level in this study was 28.45 ±â€¯8.26 ng/mL. The prevalence of hypovitaminosis D was 60%. Table 1 displays mean and standard deviation values for participants' characteristics. The postmenopause status of the women studied was confirmed by FSH and estradiol measurement. All the clinical and anthropometric characteristics did not show difference (p > 0.05) between the groups (Table 2). Triglycerides level was highest (p < 0.0391) in the hypovitaminosis D group. The other serum markers did not show statistical differences (p > 0.05) between the groups. In conclusion, our results suggest that only TG level shows a negative correlation with vitamin D status in postmenopausal women with type 2 diabetes.

Experiencia de pacientes con diabetes e hipertensión que participan en un programa de telemonitoreo / Experience of patients with diabetes and high blood pressure that participates in a Telemonitoring Program

Resumen Objetivo: conocer la experiencia de personas con diabetes mellitus o hipertensión, pertenecientes a un programa de telemonitoreo. Método: diseño cualitativo a través de grupos focales a usuarios del Servicio de Salud Pública en Santiago de Chile. Participaron 46 personas distribuidas en 10 grupos. Resultados: estos se orientan a los beneficios percibidos de participar en el programa: promoción de rutinas de cuidado de la salud, aprendizaje sobre el manejo de su enfermedad, empoderamiento frente a los servicios de urgencia, apoyo percibido por parte del equipo de salud del servicio de telemonitoreo, integración de la familia a los cuidados de la salud, comodidad y accesibilidad; y posibles barreras percibidas para ingresar o permanecer en el programa. Conclusión: este es el primer estudio en Chile sobre la experiencia de pacientes con enfermedades crónicas pertenecientes a un programa de telemonitoreo. Los resultados dan cuenta de la aceptación y utilidad del programa en el seguimiento de sus enfermedades y son un aporte fundamental para el perfeccionamiento y desarrollo de estos programas.

Abstract Aim: To assess the experience of people with diabetes mellitus and/or hypertension belonging to a telemonitoring program. Method: Qualitative design through focus groups with users of the Public Health Service in Santiago de Chile. A total of 46 adults distributed in 10 groups are included in the present study. Results: The results include the perception of benefits of participating in a monitoring program -promotion of health care routines, pathology management, empowerment when referred to Emergency Services, support of the Telemonitoring Health Team, integration of the family into health care, comfort and accessibility-; and perceived barriers to access or stay in the program -worries about the use of technology and the time used for everyday control. Conclusions: this is the first study conducted in Chile that asses the experience of patients with chronic diseases that are enrolled in a telemonitoring program. The results show the acceptation and utility of the telemonitoring program and are a contribution to the improvement and development of these kind of programs.

Nivel de conocimientos y aptitudes sobre complicaciones crónicas de la diabetes mellitus 2, hospital nacional PNP. Luis N. Saenz, 2016 / Level of knowledge and skills on chronic complications of diabetes mellitus 2, hospital national PNP Luis N. Saenz, 2016

Objetivo: Determinar la relación entre conocimientos y aptitudes en pacientes diabéticos sobre las complicaciones crónicas de la diabetes mellitus 2 en el servicio de endocrinología del Hospital Nacional PNP Luis N. Suárez el 2016. Métodos: Estudio cuantitativo, descriptivo, transversal y correlacional. Se encuestaron a 110 pacientes diabéticos con un cuestionario para valorar los conocimientos (10 ítems con respuesta de selección múltiple) y otro para las aptitudes (tipo Lickert modificado). Los conocimientos se clasificaron como nivel alto, medio y bajo y las aptitudes como favorables, desfavorables e indiferentes según la Escala de Estanones. Se determinó la normalidad de las puntuaciones con la Prueba de Kolmogorov-Smirnov y las asociaciones con chi cuadrado, p<0.05 y prueba de correlación de Pearson. Resultados: La edad media fue 49.85±6.97 años, 74.5% sexo femenino, 75.5% con tiempo de enfermedad entre 1-5 años, 67.3% con buena adherencia al tratamiento farmacológico. El nivel de conocimientos fue: alto 28.2%, medio 49.1% y bajo 22.7%; y las aptitudes fueron: favorables 23.6%, desfavorables 58.2% e indiferentes 18.2%. No existe relación entre conocimientos y aptitudes (p=0.247). Sólo se encontró asociación estadística entre conocimiento y tratamiento farmacológico (p<0.05). Conclusión: Los pacientes diabéticos tienen un nivel de conocimiento medio sobre sus complicaciones crónicas y sus aptitudes fueron predominantemente desfavorables. Es necesario realizar estrategias educativas para mejorar los conocimiento y las aptitudes de los diabéticos.

Objective: To determine the relationship between knowledge and aptitude in diabetic patients regarding the chronic complications of diabetic mellitus 2 in the endocrinology service of National Hospital PNP Luis N. Saenz. Methods: Quantitative, descriptive, transverse and correlational study. 110 diabetic patients were surveyed with a questionnaire to assess the knowledge (10 items with a multiple choice response) and another one for the skills (modified Lickert type). The knowledge was classified as high, medium and low level and the skills as favorable, unfavorable and indifferent according to the Estanones Scale. The normality of the scores with the Kolmogorov-Smirnov test and associations with chi-square, p <0.05 and Pearson's correlation test were determined. Results: The mean age was 49.85 ± 6.97 years, 74.5% female, 75.5% with disease time between 1-5 years, 67.3% with good adherence to pharmacological treatment. The level of knowledge was: high 28.2%, medium 49.1% and low 22.7%; And the skills were: favorable 23.6%, unfavorable 58.2% and indifferent 18.2%. There is no relation between knowledge and skills (p = 0.247). Only statistical association was found between knowledge and pharmacological treatment (p <0.05). Conclusion: Diabetic patients have an average level of knowledge about their chronic complications and their abilities were predominantly unfavorable. It is necessary to carry out educational strategies to improve the knowledge and skills of diabetics.

Efecto cardiometabólico de los inhibidores del cotransportador sodio glucosa tipo 2 (SGLT2) / Cardiometabolic effect of inhibitors of sodium glucose cotransporter type 2 (SGLT2)

Resumen: El advenimiento de nuevos fármacos para el tratamiento de los distintos componentes del síndrome metabólico, que por su farmacocinética y farmacodinamia tengan un efecto pleiotrópico, ha tomado auge. Hace poco los inhibidores del cotransportador sodio glucosa tipo 2 (SGLT2) prescritos para el tratamiento de la diabetes mellitus 2 han demostrado tener un efecto protector cardiorrenal. Éstos actúan en el segmento S1 del túbulo proximal disminuyendo la filtración de glucosa e incrementando su excreción urinaria; con efecto glucosúrico y natriurético. Este último es el principal mecanismo de protección cardiovascular. Modelos experimentales y estudios, entre los que destacan el estudio EMPAREG y el programa CANVAS, han demostrado que los inhibidores de SGLT2 permiten disminuir la progresión de la miocardiopatía hipertrófica, fibrosis, remodelamiento, disfunción sistólica e insuficiencia cardiaca, por su efecto en la precarga y poscarga. Los resultados de estos estudios reconocen a este grupo de fármacos (específicamente a la empagliflozina y canagliflozina) como tratamiento de protección cardiovascular en pacientes con diabetes mellitus 2, recomendados actualmente por la FDA, ACC/AHA, la Sociedad Europea de Cardiología y recientemente por la Asociación Americana de Diabetes (ADA) en su reciente publicación de 2018.

Abstract: There is an increase in the use of new drugs for the treatment of the different elements that integrate the metabolic syndrome; that, by their pharmacokinetics and pharmacodynamics have a pleiotropic effect. Recently, the inhibitors of sodium glucose cotransporter type 2 (SGLT2) used for the treatment of diabetes mellitus type 2 have demonstrated a cardio-renal protector effect. They function at the S1 segment of the proximal tube, lowering the filtration of glucose and enhancing its excretion; resulting in a glycosuric and natriuretic effect. This is the main mechanism of cardiovascular protection. Experimental essays and different studies, such as the EMAREG study and the CANVAS program, have established that the inhibitors of SGLT2 reduce the progression of hypertrophic cardiomyopathy, fibrosis, cardiac remodeling, systolic dysfunction and heart failure. The results of these studies recognize this group of drugs (empaglifozine and canaglifozine) as a valid treatment for cardiovascular protection in patients with diabetes mellitus type 2, and which is recommended by the FDA, the ACC/AHA, the European Society of Cardiology and the American Diabetes Association (ADA) in its last publication in 2018.

Metabolomics applied to the discovery of tuberculosis and diabetes mellitus biomarkers.

Tuberculosis (TB) and diabetes mellitus Type 2 (DM2) are two diseases as ancient as they are harmful to human health. The outcome for both diseases in part depends on immune and metabolic individual responses. DM2 is increasing yearly, mainly due to environmental, genetic and lifestyle habits. There are multiple evidence that DM2 is one of the most important risk factor of becoming infected with TB or reactivating latent TB. Mass spectrometry-based metabolomics is an important tool for elucidating the metabolites and metabolic pathways that influence the immune responses to M. tuberculosis infection during diabetes. We provide an up-to-date review highlighting the importance and benefit of metabolomics for identifying biomarkers as candidate molecules for diagnosis, disease activity or prognosis.

Hipoglucemia grave en pacientes con diabetes mellitus 2 y azoados normales / Severe hypoglycemia in patients with diabetes mellitus type 2 and normal creatinine serum values

Resumen: ANTECEDENTES: la hipoglucemia grave es causa frecuente de hospitalización en México. OBJETIVO: identificar las características clínicas y de laboratorio asociadas con hipoglucemia grave en pacientes consecutivos con hipoglucemia grave y azoados normales. PACIENTES Y MÉTODO: estudio prospectivo en el que del 11 agosto de 2011 al 31 mayo de 2013 se incluyeron pacientes con hipoglucemia grave y creatinina normal. Se registró edad, sexo, tiempo de evolución de la diabetes mellitus, tratamiento antidiabético, comorbilidades y depuración de creatinina en orina de 24 horas. RESULTADOS: ingresaron 234 pacientes con hipoglucemia grave, 21 9% tenían creatinina normal: 13 mujeres 62% y 8 38% hombres, con edad promedio de 64.76 años límites: 42-84; 13 62% eran mayores de 60 años; 15 71% tenían más de 5 años con diabetes mellitus 2 promedio de evolución de 9.2 años; 15 recibían glibenclamida 71%, 4 en combinación con insulina 19% y 8 con metformina 38%; 2 recibían rosiglitazona más insulina. Cuatro no tenían comorbilidades 19%; 14 tenían hipertensión arterial 71% y 3 neoplasia adenocarcinoma, carcinoma gástrico y carcinoma esofágico; 11 52% ingresaron con pérdida del estado de alerta; 5 con desorientación 24%, 4 con trastornos de conducta 19%, uno con dislalia 5%; 15 de 21 71% tenían grado avanzado de deterioro renal, a pesar de tener azoados normales. CONCLUSIONES: es importante determinar la depuración de creatinina en todos los niveles de atención, única guía para prescribir tratamientos seguros de acuerdo con la función renal. La glibenclamida debe prescribirse con cautela en adultos mayores, con más de 10 años de evolución de la diabetes mellitus 2 y evitarse en los sujetos con insuficiencia renal crónica documentada.

Abstract: BACKGROUND: Severe hypoglycemia is a frequent cause of hospitalization in Mexico. OBJECTIVE: To identify the clinical and laboratory characteristics associated to severe hypoglycemia in consecutive patients with severe hypoglycemia and normal creatinine serum values. PATIENTS AND METHOD: A prospective study was done from August 11, 2011 to May 31, 2013, including patients with severe hypoglycemia and normal creatinine serum values. Age, sex, time of evolution of diabetes mellitus 2, antidiabetic treatment, comorbidities and 24-hour urine creatinine clearance were recorded. RESULTS: From 234 patients with severe hypoglycemia admitted, 21 9% had normal creatinine: 13 women 62% and 8 38% men, with a mean age of 64.76 years range: 42-84; 13 62% were older than 60 years; 15 71% had more than 5 years with DM2 mean evolution of 9.2 years; 15 received glibenclamide 71%, 4 in combination with insulin 19% and 8 with metformin 38%. Two received rosiglitazone plus insulin. Four patients had not comorbidities 19%; 16 had arterial hypertension 71% and 3, neoplasms adenocarcinoma, gastric carcinoma and esophageal carcinoma. Eleven patients 52% were admitted with syncope, 5 with disorientation 24%, 4 with conduct disorders 19% and one with dyslalia 5%; 15 of 21 patients 71% had advanced degrees of renal impairment, despite normal creatinine serum values. CONCLUSIONS: It is important to perform creatinine clearance at all levels of care, the only guide for safe treatments according to kidney function. Glibenclamide should be cautiously prescribed in older adults with a history of more than 10 years of diabetes mellitus 2 and should be avoided in those with documented chronic renal failure.

Acupuntura y masaje: auxiliar en el tratamiento de pacientes con hipertension y diabetes en el Ejido Cuitláhuac de Tacotalpa / Acupuncture and massage: aid in the treatment of patients with hypertension and diabetes in Ejido Cuitláhuac Tacotalpa / Acupuntura e massagem: ajuda no tratamento de pacientes com hipertensão e diabetes em Ejido Cuitláhuac Tacotalpa

ResumenIntroducción.En enfermería ha destacado la inclusión de medicina tradicional y alternativa como disciplina para prevenir, diagnosticar, tratar y rehabilitar al paciente con técnicas de masaje y acupuntura. En la revista Salud Mundial la OMS enlista enfermedades que pueden ser tratadas con dicha medicina, disminuyendo las repercusiones de patologías que ocupan los primeros lugares de morbimortalidad en México. Objetivo.Conocer si la acupuntura y el masaje son tratamientos alternativos auxiliares en la HTA y DM2 en usuarios del centro de salud de Cuitláhuac, Tacotalpa, Tab.Método. Estudio cuantitativo, transversal, cuasiexperimental, en 28 pacientes con DM2 y HTA, conmediciones antes y después del tratamiento alternativo.Resultado.Con el tratamiento alternativo, la glicemia bajó de 131 a 124 mg y la presión arterial de 140/79 a 123/83 mmHg (p ≤ 0.05).Conclusión.La acupuntura y masajemuestran ser auxiliares altratar enfermedades crónicas, no se cuenta con resultados más específicos en población indígena mexicana y es necesario realizar estudios con diseños más robustos para determinar su eficacia.

AbstractIntroduction.Nursing has highlighted the inclusion of traditional and alternative medicine as a discipline to prevent, diagnose, treat and rehabilitate the patient with acupuncture and massage techniques. In the WHO Global Health magazine lists diseases that can be treated with this medicine, reducing the impact of diseases that are at the top of morbidity and mortality in Mexico. Objective. Know if acupuncture and massage are alternative treatments aids in hypertension and DM2 users Cuitláhuac health center, Tacotalpa, Tab.Method.Quantitative, transversal, quasi-experimental, in 28 patients with type 2 diabetes and hypertension, with measurements before and after alternative treatment study.Result. With alternative treatment, blood glucose levels dropped from 131 to 124 mg and blood pressure of 140/79 to 123/83 mmHg (p ≤ 0.05).Conclusion. Acupuncture and massage shown to be ancillary to treat chronic diseases, do not have more specific results in Mexico's indigenous population and studies are needed with more robust designs for their effectiveness.

ResumoIntrodução.Enfermagemdestacou a inclusão da medicinatradicional e alternativacomoumadisciplinaparaprevenir, diagnosticar, tratar e reabilitar o paciente com técnicas de acupuntura e massagem. Na revista WHO Global Health lista de doençasquepodemsertratadascomestemedicamento, reduzindo o impacto de doençasqueestão no topo de morbidade e mortalidade no México. Objectivo. Saber se aacupuntura e massagemsãoajudartratamentosalternativosnahipertensão e usuários de DM2 centro de saúdeCuitláhuac, Tacotalpa, Tabasco.Método. Quantitativa, transversal, quasi-experimental, em 28 pacientes com diabetes tipo 2 e hipertensão, com medições antes e depois de estudo de tratamentoalternativo.Resultado. Com tratamentoalternativo, osníveis de glicose no sanguecaiu de 131 para 124 mg e pressão arterial de 140/79 a 123/83 mmHg (p ≤ 0,05).Conclusão.Acupuntura e massagemdemonstrouserauxiliar no tratamento de doençascrônicas, nãotêmresultadosmaisespecíficosemestudospopulacionais e indígenas do México sãonecessárioscomdesenhosmaisrobustospara a suaeficácia.

Avaliação do desempenho de enfermagem em um programa de previdência social / Evaluation of nursing performance in a social security program

Resumo Objetivo Avaliar o desempenho da enfermagem no controle do diabetes de pacientes ambulatoriais do IMSS (Instituto Mexicano de Seguro Social) - hospital Prospera número 44 em Tamazunchale, San Luis Potosi, México. Métodos Estudo quantitativo, transversal e descritivo, com amostra de 30 enfermeiros recrutados de agosto de 2014 a abril de 2015. Foi utilizado um guia de observação de desempenho que avaliou as funções administrativas, assistenciais, de ensino e de comunicação. O desempenho foi classificado como bom, razoável e ruim por meio de estatísticas descritivas. Resultados Um total de 93.3% da amostra consistiu de mulheres, auxiliares de enfermagem certificadas; 70% com estudo de nível técnico. As medidas globais das funções administração, assistencial, de ensino e de comunicação indicaram que 6,7% apresentaram desempenho bom, 40% desempenho razoável e 53,3% desempenho ruim. Conclusão As funções de cuidar e ensinar mostraram oportunidades significativas para melhorar o autocuidado ao paciente. A avaliação do desempenho de enfermagem forneceu evidências para a gestão dos serviços no programa de diabetes.

Abstract Objective To evaluate nursing performance in the control of diabetic outpatients of the IMSS (Instituto Mexicano del Seguro Social [Mexican Social Security Institute])-Prospera hospital number 44 in Tamazunchale, San Luis Potosi, Mexico. Methods This quantitative, descriptive, cross-sectional study consisted of a sample of 30 nurses recruited from August 2014 to April 2015. A performance observation guide that evaluated administrative, care, teaching, and communication functions was used. Performance was classified as good, fair, and poor by means of descriptive statistics. Results A total of 93.3% of the sample consisted of female certified nurse assistants, 70% with studies at the technician level. The overall measurements of the administrative, care, teaching, and communication functions indicated that 6.7% presented good performance, 40% fair performance, and 53.3% poor performance. Conclusion Care and teaching functions show significant opportunities for improving patient self-care. Nursing performance evaluation provides evidence for the management of services in the diabetes program.

Niveles de testosterona libre en pacientes del sexo masculino con diabetes mellitus tipo 2

Los niveles disminuidos de testosterona están asociados con esterilidad e impotencia sexual. El objetivo del presente estudio fue investigar la relación entre diabetes mellitus (DM) tipo 2 con los niveles de testosterona libre y si ésta se correlaciona con la HbA1c y IMC. Se analizó las concentraciones séricas de testosterona libre en 10 varones con un índice de masa corporal (IMC) medio de 27,4 kg/m², edad media 46,4 años, provenientes de zonas urbanas, que asisten a la Tercera Cátedra de Clínica Médica y el Programa Nacional de Diabetes. Las concentraciones promedio de testosterona libre fueron menores a los rangos considerados normales: 10,29 mg/dL vs 13-35 mg/dL. El valor promedio de HbA1c fue 6,43%. No se encontró correlación entre el IMC y la testosterona libre. Se deduce en esta serie de casos que los pacientes diabéticos tienen niveles reducidos testosterona libre y que la misma no se correlaciona con la HbA1c ni el IMC.

Decreased testosterone levels are associated with sterility and sexual impotence. The objective of this study was to study the relation between type 2 diabetes mellitus (DM) and levels of free testosterone and also whether this relation is correlated to HbA1c and body mass index (BMI). The free testosterone serum concentrations of 10 men with a medium BMI of 27.4 kg/m², mean age of 46.4 years from urban zones that attended the Third Chair of Medical Clinic and the National Program of Diabetes were analyzed. The mean concentrations of free testosterone were lower than the range considered normal: 10.29 mg/dL vs 13-35 mg/dL. The mean value of HbA1c was 6.43%. A correlation between BMI and free testosterone was not found. It is concluded that these diabetic patients have reduced free testosterone levels and these are not correlated to either HbA1c or BMI.

Prevalencia de síndrome metabólico en pacientes psoriáticos chilenos / Prevalence of metabolic syndrome in Chilean patients with psoriasis

Introducción: Existe poca información de la asociación entre Psoriasis y síndrome metabólico (SM) en Chile. Objetivos: Determinar la prevalencia de SM en psoriáticos chilenos. Material y métodos: Se realizó un estudio caso-control, con 487 pacientes (238 psoriáticos y 239 controles). En ambos grupos se analizó la prevalencia de SM además del exceso de peso, hipertensión arterial, diabetes mellitus 2, hipertrigliceridemia y niveles de HDL bajo. Resultados: Los psoriáticos presentaron mayor probabilidad de padecer SM versus los controles (35,29% vs 23,29%) OR 1,8 (1,20-2,66) p<0,05. Se asoció también con circunferencia abdominal aumentada (57,14% vs 36,94) OR 2,6 (1,79 - 3,78), exceso de peso (85,99% vs 63,45%) OR 2,46 (1,62 ­ 3,73) p<0,05 y diabetes mellitus 2 (13,45% vs 4,42%) OR 3,85 (1,79 - 8,26) p<0,05. Conclusiones: Se encontró una mayor prevalencia de SM, exceso de peso, circunferencia abdominal aumentada y diabetes mellitus 2 en el grupo psoriático en comparación al grupo control.

Background: There is a paucity of information about Psoriasis and metabolic syndrome (MS) association in Chile. Aim: To determine the MS prevalence in Chilean psoriatic patients. Material and Methods: A case-control study was conducted which included 487 patients (238 psoriatic patients and 239 controls). In both groups, MS prevalence, overweight, hypertension, diabetes mellitus type 2, hypertriglyceridemia and low HDL were analyzed. Results: Psoriatic patients were more likely to present MS than controls (35.29% vs 23.29%) OR 1.8 (1.20 to 2.66) p <0.05. In addition, it was associated with increased abdominal circumference (57.14% vs 36.94) OR 2.6 (1.79 to 3.78), overweight (85.99% vs 63.45%) OR 2.46 (1.62 to 3.73) p <0.05 and diabetes mellitus type 2 (13.45% vs. 4.42%) OR 3.85 (1.79 to 8.26) p <0.05. Conclusions: There is a higher prevalence of MS, overweight, increased abdominal circumference and type 2 diabetes mellitus in the psoriatic group compared with the control group.

Calidad de hidratos de carbono de la dieta y su efecto sobre el control metabólico de la Diabetes Tipo 2 / Quality of carbohydrates in the diet and their effect on metabolic control of type 2 diabetes

El objetivo de este estudio fue determinar la relación entre los parámetros de control metabólico y la calidad de los hidratos de carbono (H de C) de la dieta, en sujetos diabéticos tipo 2 (DM 2), controlados con dieta y/o metformina. A 108 hombres y mujeres con edades comprendidas entre 18 y 60 años, hemoglobinas glicosiladas (HbA1c) entre 6% y 10%, sin sulfonilureas ni insulinoterapia; se les aplicó dos encuestas de recordatorio de 24 horas. Se determinó la ingesta de H de C, el índice glicémico (IG) y la carga glicémica (CG) de la dieta. Desde las fichas clínicas se obtuvieron valores recientes de HbA1c. Los datos fueron tabulados en el programa SPSS versión 17. Se utilizó el test de correlación de Pearson para analizar el grado de asociación entre las variables, considerándose significativo un p < 0,05. El promedio de HbA1c fue de 7,3 ± 1,3 %, el consumo de H de C fue de 219,8 ± 27,0 g/día; el IG fue de 74,9 ± 11,3 % y la CG fue de 164,0 ± 22,04 g. Se encontró correlación positiva y significativa entre el consumo de H de C (r=0,290; p<0,05), IG (r=0,70; p<0,001) y CG (r=0,225; p<0,05) de la dieta con los niveles de HbA1c de los sujetos estudiados. En conclusión la calidad de los H de C, especialmente el IG, de la dieta de los sujetos estudiados se asocia fuertemente al control metabólico de la DM 2.

The Objective of this study was to determine the relationship between the parameters of metabolic control and quality of carbohydrates (CHO) of the diet in individuals with type 2 diabetes, controlled with diet and / or Metformin. In 108 men and women aged between 18 and 60 years, glycosylated hemoglobin A (HbA1c) between 6 % and 10 %, without sulfonylureas or insulintheraphy; were examined through two separate surveys of 24-hour recall. The CHO intake, GI, GL of diet was analyzed. Values of HbA1c were collected from medical records. Data was tabulated in SPSS version 17 software. The Pearson correlation test was used to analyze the degree of association between variables, considering significant at p < 0.05. The mean HbA1c was 7.3 ± 1.3%, CHO consumption was 219.8 ± 27.0 g / day; GI was 74.9 ± 11.3% and GL was 164.0 ± 22.04 g. A significant positive correlation was found out between the CHO intake (r = 0.290, P < 0.05), GI (r = 0.70, p < 0.001), GL (r = 0.225, p < 0.05) of diet and HbA1c levels in the individuals. In conclusion the study showed that the quality of CHO, mainly GI, are strongly associated with metabolic control of DM 2.

Biofilm formation by oral clinical isolates of Candida species.

We have conducted a longitudinal study to quantify biofilms in oral clinical isolates of Candida species (spp.) from adults with local and systemic predisposing factors for candidiasis. A total of 69 yeast isolates from 63 Mexican patients were evaluated. These isolates (39 C. albicans, 15 C. tropicalis, 7 C. glabrata, 4 C. krusei, 1 C. lusitaniae, 1 C. kefyr, 1 C. guilliermondii and 1 C. pulcherrima) were obtained from two clinical sites: 62.3% (n=43) from the oral mucosa of totally and partially edentulous patients, and 37.7% (n=26) from the oral mucosa of diabetics. In addition, Candida ATCC strains were used as controls for each experiment. The kinetics of biofilm formation were measured by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide [XTT] reduction; each isolate was tested at 6, 12 and 24h. Biofilm formation is dependent on the Candida spp. and its clinical origin. On average, the oral isolates of C. glabrata are strong biofilm producers, whereas C. albicans and C. tropicalis are moderate producers. The most common species in our population was C. albicans. While the kinetics of C. albicans biofilm formation varies between oral isolates, it generally maintains steady growth from 2 to 48h, when it reaches its maximum growth.