GLYBURIDE VERSUS METFORMIN : NEONATAL COMPLICATIONS IN THE PHARMACOLOGICAL MANAGEMENT OF PATIENTS WITH GESTATIONAL DIABETES. SYSTEMATIC REVIEW OF THE LITERATURE.

2021 ◽  
pp. 77-81
Author(s):  
Alexander Garcia Castañeda ◽  
Maria Camila Ruiz ◽  
Carolina Garcia ◽  
Lida Marcela Vega Mesa ◽  
Gennifer Andrea Gomez Toloza ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Type I Diabetes ◽  
Progressive Increase ◽  
Type I ◽  
Third Trimester ◽  
Pharmacological Management ◽  
High Blood Glucose ◽  
Blood Glucose Concentrations

Diabetes mellitus can be dened as a group of metabolic disorders characterized by high blood glucose concentrations (1) . In general, type I diabetes is frequently associated with a deciency secondary to the destruction of insulin-producing β cells (2) . Meanwhile, type II diabetes is the result of a progressive increase in insulin resistance with a relative decit of it (3) . On the other hand, gestational diabetes is dened by The American Diabetes Association (ADA) as one that is diagnosed in the second or third trimester that is not clearly type 1 or type 2 diabetes (4) .

scholarly journals Platelet Activation and Platelet–Leukocyte Aggregates in Type I Diabetes Mellitus

2018 ◽  
Vol 24 (9_suppl) ◽  
pp. 230S-239S ◽  
Author(s):  
Asmaa M. Zahran ◽  
Omnia El-Badawy ◽  
Ismail L. Mohamad ◽  
Deiaaeldin M. Tamer ◽  
Safwat M. Abdel-Aziz ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Type I Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Control Group ◽  
Type I ◽  
Platelet Activity ◽  
Increased Risk

Hyperglycemia alone may not explain the increased risk of cardiovascular diseases (CVDs) in patients with type 1 diabetes (T1D) compared with type 2. This study emphases on the evaluation of some platelet activity markers in patients with T1D, with relevance to some metabolic disorders as hyperlipidemia and hyperglycemia. This study was performed on 35 patients with T1D and 20 healthy controls. All participants were subjected to full history taking, clinical examination and assay of glycated hemoglobin (HbA1c), and lipid profile. The expression of CD62P and CD36 on platelets and the frequency of platelet–monocyte, and platelet–neutrophil aggregates were assessed by flow cytometry. Patients showed significantly higher expression of CD62P and CD36 than the control group. Platelets aggregates with monocytes were also higher among patients than the control group. Levels of CD36+ platelets, CD62P+ platelets, and platelet–monocyte aggregates revealed significant correlations with the levels of HbA1c, total cholesterol, low-density lipoprotein, and triglycerides. Hyperlipidemia and hyperglycemia accompanying T1D have a stimulatory effect on platelet activation which probably makes those patients vulnerable to CVD than nondiabetics.

Type 1 and 2 Diabetes Mellitus and Oral Health

2019 ◽  
Author(s):  
Goldberg M
Keyword(s):  
Type 2 Diabetes ◽  
Tooth Loss ◽  
Type I Diabetes ◽  
Type I ◽  
Obese Adults ◽  
Irritation Fibroma ◽  
Cardiovascular Illness

Diabetes is characterized by an elevated level of glucose in the blood.Type I diabetes mellitusresults from insulin deficiency. In contrast, type 2 diabetes results of insulin resistance.A third group recently identified confirmed that the secretory defects of gestational insulin are the consequence of abnormal glucose tolerance during pregnancy. Symptoms of diabetes include the classic triad [polyuria, polydipsia, polyphagia]. Long-term complications of diabetes include nephropathy and autoimmune cardiovascular illness dysfunctions. The symptoms of type 2 diabetes develop more slowly than type I diabetes. These patients may be obese. Adults develop micro- and macro- vascular conditions, producing irreversible damages to the eyes (retinopathy, cataracts), kidney (nephropathy), nervous system (neuropathy and parenthesis). Oral complications including candidiasis (fungal infection due to any type of Candida), dental caries, tooth loss, gingivitis, lichen planus, neurosensory disorders (burning mouth syndrome), periodontitis, salivary dysfunction, xerostomia, and taste impairment. Diabetes implicate greater prevalence of fissured tongue, irritation fibroma, traumaticulcers, and recurrent aphthous stomatitis. Hyperglycemia induces non-enzymatic elevated levels of glucose that stimulate interleukin-6 expression. Altogether these factors contribute to cardiovascular disease.

scholarly journals Tackling the silent epidemic of Type-I Diabetes Mellitus (Type-1 DM) through National Health Programmes- A narrative review of available evidence

2021 ◽  
Vol 33 (2) ◽  
pp. 245-249
Author(s):  
Om Prakash Bera ◽  
Vandana Shah ◽  
Sudip Bhattacharya ◽  
Sheikh Mohd Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
Surveillance Systems ◽  
Type I ◽  
Diabetes Research ◽  
Age Group ◽  
Type 2 Dm ◽  
Central Registry

Type 1 diabetes mellitus (T1DM) is an autoimmune ?-cell destruction, usually leading to absolute insulin deficiency, insulin resistance, or by a combination of both. Both the incidence and prevalence of diabetes T1DM is suspected to be high in India, but in the absence of nation-wide registry, the possibility of exact numbers is unsure. Till date, studies done among the population have seen prevalence more than the incidence of the disease, which has led to late screening and diagnosis of the disease within the community settings. India is already suffering from the burden of type 2 DM, in the process of screening those, patients with T1DM are somewhat getting ignored. Furthermore, cost associated with the treatment expenditure and social status of the people suffering from the disease too have a role to consider which has been totally side-lined in national programmes like National Program for Control of Diabetes, Cardiovascular disease, and Stroke (NPCDCS). There is also scarcity of data on the incidence of T1DM which could aid in formulating better policy avenues for the patients suffering from the disease.  Reports on trends in T1DM are more commonly available from countries with better established public health surveillance systems and diabetes research infrastructure. From India, due to scarcity of data on T1DM, we had to rely on published literature of some major centers across the country. Results from the Indian Council of Medical Research (ICMR) first phase, till July 2011 which included 5546 patients found T1DM among 63.9% cases and predominately among children; at registration 11.1% had already developed chronic complication of T1DM. As India is already suffering from the burden of type 2 DM, during current management and treatment, the problem lies at various levels which needs to be addressed. We propose a setting based, life course approach for T1DM where every age group will have access to the health care system either directly or indirectly from intra-natal life till elderly age group through health approach based on scientific methods delivered through health system. In this regard a central registry having enumeration and provisioning of mandatory Insulin to all through a national policy being implemented by NPCDCS is what policy makers must take up at urgent bases if we want to bend the curve of rising T1DM and prevalence of overall diabetes in India.

scholarly journals Inhibition of CeramideDe NovoSynthesis with Myriocin Affects Lipid Metabolism in the Liver of Rats with Streptozotocin-Induced Type 1 Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Krzysztof Kurek ◽  
Patrycja Wiesiołek-Kurek ◽  
Dominika M. Piotrowska ◽  
Bartłomiej Łukaszuk ◽  
Adrian Chabowski ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
Metabolic Diseases ◽  
De Novo ◽  
Type I Diabetes ◽  
Type I ◽  
Positive Effects ◽  
Ceramide Synthesis ◽  
Intracellular Signal

Nowadays diabetes is one of the most common metabolic diseases. Sphingolipids, which are vitally important constituents of intracellular signal transduction pathways, may be among the most pathogenic lipid moieties intermingled in the origin and development of diabetes. It is now well established that inhibition ofde novoceramide synthesis with myriocin exerts positive effects on lipid metabolism and glucose homeostasis in type 2 diabetes mellitus animal models. However, its influence on type I diabetes still remains unknown. Therefore, the scope of this paper is to fulfill that particular gap in our knowledge.

Antidiabetic effect of Psychotria malayana Jack in induced type 1 diabetic rat

MEDISAINS ◽  
2020 ◽  
Vol 18 (1) ◽  
pp. 19
Author(s):  
Fairuz Fairuz ◽  
Hasna Dewi ◽  
Humaryanto Humaryanto
Keyword(s):  
Blood Glucose ◽  
Side Effects ◽  
Type I Diabetes ◽  
Langerhans Cell ◽  
Diabetic Rat ◽  
Type I ◽  
Antidiabetic Effect ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background: Therapies for hyperglycemic treatment, including insulin and oral diabetes medications, have been confirmed to cause several side effects. Thus, finding new drugs with fewer side effects is of high importance. Salung leaf herb (Psychotria malayana Jack) reported used in traditional societies as a treatment for diabetes. However, the scientific proof of this plant for diabetes treatment is still lacking.Objective: To evaluate the antidiabetic effect of the P. malayana jack in induced type 1 diabetic rats by assessing blood glucose level and pancreatic cells in white rats.Methods: Alloxan used to induce type I diabetes. Rats randomly divided into six groups. A Group P1 received 250 mg/kg BW; group P2 received 500 mg/kg BW, group P3 received 1000 mg/kg BW. While group 4 basal received no treatment, group 5 received distilled water as a negative control, and group 6 received glibenclamide as a positive control. Medications are given for six days. Glucose levels were measured, and observation of pancreatic Langerhans cell damages.Results:  A decrease in blood glucose levels observed in all treatment groups. The most significant reduction (49.76%; 1000 mg/kg BW) occurred in the P3 group. Morphological features of pancreatic Langerhans cell damage were slightly high in the P1 group.Conclusion: P. malayana Jack can consider having an antidiabetic effect in a type 1 diabetic rat by reducing blood glucose levels.

scholarly journals Orexin A Enhances Pro-Opiomelanocortin Transcription Regulated by BMP-4 in Mouse Corticotrope AtT20 Cells

2021 ◽  
Vol 22 (9) ◽  
pp. 4553
Author(s):  
Satoshi Fujisawa ◽  
Motoshi Komatsubara ◽  
Naoko Tsukamoto-Yamauchi ◽  
Nahoko Iwata ◽  
Takahiro Nada ◽  
...  
Keyword(s):  
Stress Responses ◽  
Endocrine Function ◽  
Type I ◽  
Orexin A ◽  
Protein Levels ◽  
Bmp Receptors ◽  
Morphogenetic Protein ◽  
Crh Receptor Type 1

Orexin is expressed mainly in the hypothalamus and is known to activate the hypothalamic–pituitary–adrenal (HPA) axis that is involved in various stress responses and its resilience. However, the effects of orexin on the endocrine function of pituitary corticotrope cells remain unclear. In this study, we investigated the roles of orexin A in pro-opiomelanocortin (POMC) transcription using mouse corticotrope AtT20 cells, focusing on the bone morphogenetic protein (BMP) system expressed in the pituitary. Regarding the receptors for orexin, type 2 (OXR2) rather than type 1 (OX1R) receptor mRNA was predominantly expressed in AtT20 cells. It was found that orexin A treatment enhanced POMC expression, induced by corticotropin-releasing hormone (CRH) stimulation through upregulation of CRH receptor type-1 (CRHR1). Orexin A had no direct effect on the POMC transcription suppressed by BMP-4 treatment, whereas it suppressed Smad1/5/9 phosphorylation and Id-1 mRNA expression induced by BMP-4. It was further revealed that orexin A had no significant effect on the expression levels of type I and II BMP receptors but upregulated inhibitory Smad6/7 mRNA and protein levels in AtT20 cells. The results demonstrated that orexin A upregulated CRHR signaling and downregulated BMP-Smad signaling, leading to an enhancement of POMC transcription by corticotrope cells.

scholarly journals Heart involvement in type 1 and type 2 myotonic dystrophy. Insights from a 10-year follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Fioravanti ◽  
P.G Golzio ◽  
M.L Carbone ◽  
A Panarelli ◽  
M Gagliardi ◽  
...  
Keyword(s):  
Myotonic Dystrophy ◽  
Cardiac Involvement ◽  
Type I ◽  
Device Therapy ◽  
Cardiac Symptom ◽  
Conduction Disorders ◽  
Reliable Marker

Abstract Background and aim Myotonic Dystrophy (MD) is the most common inherited muscular dystrophy of the adult. Cardiac manifestation, including arrhythmias and conduction disorders, contributes significantly to the morbidity and mortality of the disease. The transition from a subclinical form of cardiac involvement to potentially life-threating manifestations is highly variable and not yet entirely understood. Aim of this work is to evaluate whether PQ interval (PQi) prolongation could be a reliable marker to predict left and right ventricle impairment and the necessity of a stricter monitoring. Methods In this retrospective cohort study, we selected all consecutive patients with a confirmed diagnosis of MD (type 1 and type 2) referred to our Centre. We performed clinical, laboratoristic and instrumental assessments (every 3, 6 or 12 months), tailored on each patient's features. Every patient was treated according to the latest guidelines for pharmacological and device therapy. ECG (recorded at 25 and 50 mm/sec), 24h ECG Holter and transthoracic echocardiography were performed at least yearly. Cardiac Magnetic Resonance was requested to better stratify intermediate risk patients to implantable device therapy. Results A total of 72 patients (age 48±15 years, 39% female) were included in the analysis. Patients with MD type 1 and type 2 were referred to our Centre after a mean period of 12 years (SD ±8 years) from initial diagnosis. After a mean follow-up of 5 years (±4 years), 8 patients died (mean age at death: 60±12.4 years), all of them for respiratory insufficiency. We evaluated PQ interval (PQi) evolution and type I AVB onset. No statistically significant differences emerged when stratifying for type I AVB. Nevertheless, a PQi increase of more than 20 ms during the follow-up (even if PQ <200 ms) is significantly associated with lower values of TAPSE and greater LVEDD, while no differences emerged for LVEF, dyastolic function and other echocardiographic parameters. Moreover, the evolution of PQ interval is associated with an increasing number of supraventricular arrhythmias and a worse prognosis (shorter interval from first cardiac symptom to death, p 0.025), despite optimal medical therapy. Conclusions Although relatively rare, MD is a challenge for present Cardiologists. How and when to treat those patients is not codified in guidelines or consensus papers. This study suggests PQi variation as a proxy for critical evolution of MD cardiac involvement. ECG and its modification during lifetime seem pivotal for these patients' care, qualifying as a red flag for stringent follow-up. Further evidences, on larger cohorts, are needed to validate these findings. Funding Acknowledgement Type of funding source: None

A School Nurse Application of the ECHO Model

2019 ◽  
pp. 105984051986174
Author(s):  
Suzuho Shimasaki ◽  
Pamela Brunner Nii ◽  
Lisa Davis ◽  
Erin Bishop ◽  
Cari Berget ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Chronic Conditions ◽  
Type I Diabetes ◽  
Models Of Care ◽  
School Nurses ◽  
Type I ◽  
Colorado School ◽  
Childhood Diseases ◽  
Survey Results

Type I diabetes (T1D) is one of the most common childhood diseases and Type 2 diabetes (T2D) is increasing at alarming rates. Given that children spend a great percentage of their time in school, this setting is a critical environment for models of care that lead to better management of this and other health conditions. The School Nurses Managing Diabetes Care ECHO was offered to Colorado school nurses to build their capacity in providing evidence-based management of T1D. The purpose of this effort was to (1) determine whether or not the model could be used as a tool of collaboration and dissemination for school nurses across Colorado and (2) assess the effectiveness of the “School Nurses Managing Diabetes Care” ECHO learning series. Post-series survey results demonstrated a 25% increase in self-efficacy ratings, moving learners from “average among my peers” toward “competent.” Additionally, all respondents planned to make one or more practice changes to improve care for students with T1D. Expanding the use of the ECHO model to implement intensive management of children and youth with T1D is critically important as rates of this and other chronic conditions continue to increase.

scholarly journals Hepatorenal Syndrome

2021 ◽  
Author(s):  
Arshpal Gill ◽  
Ra’ed Nassar ◽  
Ruby Sangha ◽  
Mohammed Abureesh ◽  
Dhineshreddy Gurala ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Blood Flow ◽  
Mortality Rate ◽  
Kidney Injury ◽  
Type I ◽  
Tubular Necrosis ◽  
Cirrhotic Patients

Hepatorenal Syndrome (HRS) is an important condition for clinicians to be aware of in the presence of cirrhosis. In simple terms, HRS is defined as a relative rise in creatinine and relative drop in serum glomerular filtration rate (GFR) alongside renal plasma flow (RPF) in the absence of other competing etiologies of acute kidney injury (AKI) in patients with hepatic cirrhosis. It represents the end stage complication of decompensated cirrhosis in the presence of severe portal hypertension, in the absence of prerenal azotemia, acute tubular necrosis or others. It is a diagnosis of exclusion. The recognition of HRS is of paramount importance for clinicians as it carries a high mortality rate and is an indication for transplantation. Recent advances in understanding the pathophysiology of the disease improved treatment approaches, but the overall prognosis remains poor, with Type I HRS having an average survival under 2 weeks. Generally speaking, AKI and renal failure in cirrhotic patients carry a very high mortality rate, with up to 60% mortality rate for patients with renal failure and cirrhosis and 86.6% of overall mortality rates of patients admitted to the intensive care unit. Of the various etiologies of renal failure in cirrhosis, HRS carries a poor prognosis among cirrhotic patients with acute kidney injury. HRS continues to pose a diagnostic challenge. AKI can be either pre-renal, intrarenal or postrenal. Prerenal causes include hypovolemia, infection, use of vasodilators and functional due to decreased blood flow to the kidney, intra-renal such as glomerulopathy, acute tubular necrosis and post-renal such as obstruction. Patients with cirrhosis are susceptible to developing renal impairment. HRS may be classified as Type 1 or rapidly progressive disease, and Type 2 or slowly progressive disease. There are other types of HRS, but this chapter will focus on Type 1 HRS and Type 2 HRS. HRS is considered a functional etiology of acute kidney injury as there is an apparent lack of nephrological parenchymal damage. It is one several possibilities for acute kidney injury in patients with both acute and chronic liver disease. Acute kidney injury (AKI) is one of the most severe complications that could occur with cirrhosis. Up to 50% of hospitalized patients with cirrhosis can suffer from acute kidney injury, and as mentioned earlier an AKI in the presence of cirrhosis in a hospitalized patient has been associated with nearly a 3.5-fold increase in mortality. The definition of HRS will be discussed in this chapter, but it is characterized specifically as a form of acute kidney injury that occurs in patients with advanced liver cirrhosis which results in a reduction in renal blood flow, unresponsive to fluids this occurs in the setting of portal hypertension and splanchnic vasodilation. This chapter will discuss the incidence of HRS, recognizing HRS, focusing mainly on HRS Type I and Type II, recognizing competing etiologies of renal impairment in cirrhotic patients, and the management HRS.

Diabetes in pregnancy

2020 ◽  
pp. 2627-2637
Author(s):  
Bryony Jones ◽  
Anne Dornhorst
Keyword(s):  
Gestational Diabetes ◽  
Post Partum ◽  
Insulin Dose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Diabetes In Pregnancy ◽  
In Pregnancy

Diabetes in pregnancy is predominantly either pre-existing type 1 or type 2 diabetes mellitus, or gestational diabetes, the latter defined as diabetes or glucose intolerance first diagnosed during the pregnancy. Gestational diabetes usually arises in the late second trimester and is common, affecting from 2–6% to 15–20% of pregnant women depending on diagnostic criteria and country of origin. Gestational diabetes is most commonly diagnosed on the basis of an oral glucose tolerance test performed at 24–28 weeks’ gestation by a plasma glucose at 0 minutes of more than 5.1 (or >5.6, depending on the authority) mmol/L, or at 120 minutes of more than 8.5 (or >7.8) mmol/L. The effect of pregnancy on maternal glycaemic control ceases very quickly post-partum, hence women with pre-existing diabetes taking insulin should immediately revert to their pre-pregnancy regimen after birth, but with a lower insulin dose.

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