Diabetes

2018 ◽  
Author(s):  
Hugh Devlin ◽  
Rebecca Craven
Keyword(s):  
Insulin Resistance ◽  
Blood Glucose ◽  
Periodontal Disease ◽  
Oral Candidiasis ◽  
Medical Complications ◽  
Diabetic Patients ◽  
Long Term Effects ◽  
Defence Mechanisms ◽  
Head And Neck Infections

Diabetes in relation to dentistry is the topic of this chapter. The incidence of diabetes is increasingly rapidly, hand-in-hand with the increase in obesity. Obesity predisposes patients to an increased insulin resistance, i.e. reduces their ability to increase the glucose transport into adipocytes, muscle, and liver cells. The pancreas responds by producing more insulin but when it can no longer produce enough to overcome the insulin resistance, the blood glucose rises. Diabetes is characterized by raised blood glucose. We describe the devastating long-term effects of diabetes, in particular the microvascular and macrovascular medical complications. The dental complications include an increased severity of periodontal disease, oral candidiasis, and dry mouth but in those who are poorly controlled the impaired defence mechanisms can lead to severe head and neck infections and osteomyelitis. A final summary lists the important clinical recommendations for treatment of diabetic patients.

Insulin resistance induced by long-term sleep deprivation in rhesus macaques can be attenuated by Bifidobacterium

2021 ◽  
Author(s):  
Ying Zhao ◽  
Yan Shu ◽  
Ning Zhao ◽  
Zili Zhou ◽  
Xiong Jia ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Circadian Rhythm ◽  
Blood Glucose ◽  
Glucose Metabolism ◽  
Sleep Deprivation ◽  
Rhesus Macaques ◽  
Intravenous Glucose ◽  
Increased Risk ◽  
The Impact

Long-term sleep deprivation (SD) is a bad lifestyle habit, especially among specific occupational practitioners, characterized by circadian rhythm misalignment and abnormal sleep/wake cycles. SD is closely associated with an increased risk of metabolic disturbance, particularly obesity and insulin resistance. The incretin hormone, glucagon-like peptide-1 (GLP-1), is a critical insulin release determinant secreted by the intestinal L-cell upon food intake. Besides, the gut microbiota participates in metabolic homeostasis and regulates GLP-1 release in a circadian rhythm manner. As a commonly recognized intestinal probiotic, Bifidobacterium has various clinical indications regarding its curative effect. However, few studies have investigated the effect of Bifidobacterium supplementation on sleep disorders. In the present study, we explored the impact of long-term SD on the endocrine metabolism of rhesus monkeys and determined the effect of Bifidobacterium supplementation on the SD-induced metabolic status. Lipids concentrations, body weight, fast blood glucose, and insulin levels increased after SD. Furthermore, after two months of long-term SD, the intravenous glucose tolerance test (iVGTT) showed that the glucose metabolism was impaired and the insulin sensitivity decreased. Moreover, one month of Bifidobacterium oral administration significantly reduced blood glucose and attenuated insulin resistance in rhesus macaques. Overall, our results suggested that Bifidobacterium might be used to alleviate SD-induced aberrant glucose metabolism and improve insulin resistance. Also, it might help in better understanding the mechanisms governing the beneficial effects of Bifidobacterium.

Abstract 2605: Hypoglycemia Does Not Increase Long-term Mortality Or Morbidity In Diabetic Patients With Myocardial Infarction. A Report From The Digami 2 Trial.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Linda G Mellbin ◽  
Klas Malmberg ◽  
Anders Waldenstrom ◽  
Hans Wedel ◽  
Lars Ryden
Keyword(s):  
Myocardial Infarction ◽  
Blood Glucose ◽  
Negative Impact ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Hazard Ratios

Aims Tight, insulin-based glucose control is recommended to diabetic patients (DM pat) with acute myocardial infarction (AMI). A potential draw-back would be if insulin induced hypoglycaemia (HG) had a negative impact of future prognosis. Methods 1253 pat (mean age 68 years; 67% males) with type 2 DM and suspect AMI were followed for a median of 2.1 years. 947 were randomised to insulin infusion during at least 24 hours while 306 were treated routinely. HG (blood glucose<3.0 mmol/L with or without symptoms) was recorded during hospitalisation. Unadjusted and adjusted (age, sex, smoking, previous MI and heart failure, renal function, duration of DM, coronary interventions, blood glucose at randomisation) Hazard Ratios (HR) and 95% Confidence Intervals (CI) for cardiovascular events (CVE = death, MI or stroke) during follow up were calculated. Results 153 pat (12.2%) experienced HG. During the first 24 hours 111 (11.7%) insulin-treated pat experienced HG (symptomatic 23.4%) compared with 3 (1.0%) pat on routine treatment (symptomatic 33.3%). As outlined in the figure HG was not an independent predictor of subsequent CVE. Conclusion Insulin induced HG was not a significant risk factor for subsequent CVE in AMI-pat with type 2 DM. Hypoglycaemic seem to identify patients at high risk for other reasons.

Long-term effects of dietary fiber on glucose tolerance and gastric emptying in noninsulin-dependent diabetic patients

1983 ◽  
Vol 37 (3) ◽  
pp. 376-381 ◽  
Author(s):  
T K Ray ◽  
K M Mansell ◽  
L C Knight ◽  
L S Malmud ◽  
O E Owen ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Glucose Tolerance ◽  
Dietary Fiber ◽  
Diabetic Patients ◽  
Long Term Effects

Carbohydrate and Lipid Metabolism during Continuous Ambulatory Peritoneal Dialysis (CAPD): The Effect of a Single Dialysis Cycle

1983 ◽  
Vol 65 (5) ◽  
pp. 539-545 ◽  
Author(s):  
A. Heaton ◽  
D. G. Johnston ◽  
J. M. Burrin ◽  
H. Orskov ◽  
M. K. Ward ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Glucose ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Ketone Bodies ◽  
Serum Insulin ◽  
Dialysis Fluid ◽  
Long Term Effects ◽  
Carbohydrate And Lipid Metabolism ◽  
Normal Controls

1. The effect on hormonal status and intermediary metabolism of a single 6 h dialysis cycle at two different concentrations of dialysate glucose was investigated in six patients on continuous ambulatory peritoneal dialysis. 2. The basal blood glucose level was elevated by 0.5 mmol/l, associated with a threefold increase in basal serum insulin compared with seven normal controls. Blood glucose and serum insulin rose further during dialysis, particularly with hypertonic (215 mmol of glucose/l) dialysis fluid and levels remained high for 6 h after the onset. 3. Plasma glucagon concentrations were 2.7-fold increased and did not decrease to normal during dialysis. 4. Concentrations of the gluconeogenic precursors lactate and alanine were consistently raised, and levels of circulating non-esterified fatty acids and ketone bodies were lowered, particularly with hypertonic dialysis fluid. 5. The long-term effects of sustained hyper-insulinaemia, including suppression of lipolysis and ketogenesis, require further investigation.

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