Preval��ncia de resist��ncia �� insulina, intoler��ncia �� glicose e diabetes mellitus tipo 2 em pacientes com s��ndrome doa ov��rios polic��sticos(SOP)

P��s-gradua����o em Ginecologia, Obstetr��cia e Mastologia - FMB

Secre����o de insulina e sensibilidade �� insulina em indiv��duos de risco para o Diabetes mellitus Tipo 2

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior (CAPES)

Avalia����o da correla����o entre peroxida����o lip��dica e o perfil de marcadores inflamat��rios em pacientes com Diabetes mellitus tipo 2, dislipidemia e periodontite cr��nica

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico (CNPq)

Efeito do tratamento periodontal n��o-cir��rgico em pacientes portadores de Diabetes mellitus tipo 2 com doen��a periodontal: an��lises cl��nica, enzim��tica e microbiol��gica

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior (CAPES)

Avalia����o da express��o g��nica e de les��es no DNA de ��ndividuos portadores de diabetes mellitus tipo 2, dislipidemia e periodontite cr��nica

P��s-gradua����o em Odontologia - FOAR

Investiga����o da express��o de genes do metabolismo lip��dico em pacientes com Diabetes Mellitus tipo 2, Dislipidemia e Doen��a Periodontal Cr��nica

P��s-gradua����o em Odontologia - FOAR

Investiga����o da express��o de genes do metabolismo lip��dico em pacientes com Diabetes Mellitus tipo 2, Dislipidemia e Doen��a Periodontal Cr��nica

P��s-gradua����o em Odontologia - FOAR

Color vision impairment in type 2 diabetes assessed by the D-15d test and the Cambridge Colour Test

Color vision impairment emerges at early stages of diabetes mellitus type 2 (DM2) and may precede diabetic retinopathy or the appearance of vascular alterations in the retina. The aim of the present study was to compare the evaluation of the color vision with two different tests - the Lanthony desaturated D-15d test (a traditional color arrangement test), and the Cambridge Colour Test (CCT) (a computerized color discrimination test) - in patients diagnosed with DM2 without clinical signs of diabetic retinopathy (DR), and in sex- and age-matched control groups. Both color tests revealed statistically significant differences between the controls and the worst eyes of the DM2 patients. In addition, the degree of color vision impairment diagnosed by both tests correlated with the disease duration. The D-15d outcomes indicated solely tritan losses. In comparison, CCT outcomes revealed diffuse losses in color discrimination: 13.3% for best eyes and 29% for worst eyes. In addition, elevation of tritan thresholds in the DM2 patients, as detected by the Trivector subtest of the CCT, was found to correlate with the level of glycated hemoglobin. Outcomes of both tests confirm that subclinical losses of color vision are present in DM2 patients at an early stage of the disease, prior to signs of retinopathy. Considering the advantages of the CCT test compared to the D-15d test, further studies should attempt to verify and/or improve the efficiency of the CCT test.

Comparison of venous plasma glycemia and capillary glycemia for the screening of type 2 diabetes mellitus in the Japanese-Brazilian community of Mombuca (Guatapar��-SP)

Abstract Background To identify the most appropriate cut-off points of fasting glycemia for the screening of diabetes mellitus type 2 (DM2) with the comparison of the properties of capillary glycemia (CG) and venous blood plasma glycemia (PG) in a population of Japanese origin from the community of Mombuca, Guatapar�� - SP, Brazil. Methods This was a population-based descriptive cross-sectional study conducted on a sample of 131 individuals of both genders aged 20 years or more (66.8% of the target population). CG was measured with a glucometer in a blood sample obtained from the fingertip and PG was determined by an enzymatic method (hexokinase) in venous blood plasma, after a 10-14 hour fast in both cases. Data were analyzed by the receiver operating characteristic (ROC) curve in order to identify the best cut-off point for fasting glycemia (CG and PG) for the diagnosis of DM, using the 2-hour plasma glycemia > 200 mg/dl as gold - standard. Results The ROC curve revealed that the best cut-off point for the screening of DM was 110 mg/dl for CG and 105 mg/dl for PG, values that would optimize the relation between individuals with positive and false-positive results. The area under the ROC curve was 0.814 for CG (p < 0.01) and 0.836 for PG (p < 0.01). Conclusions The cut-off points of 105 mg/dl(5.8 mmol/l) for PG and of 110 mg/dl(6.1 mmol/l) for CG appear to be the most appropriate for the screening of DM2 in the population under study, with emphasis on the fact that the value recommended for CG is 5 mg/dl higher than that for PG, in contrast to WHO recommendations.

Rela����o entre conhecimento, atitude, escolaridade e tempo de doen��a em indiv��duos com diabetes mellitus

OBJETIVOS: Relacionar o conhecimento e a atitude de usu��rios com Diabetes mellitus tipo 2 (DM2), conforme a escolaridade e o tempo da doen��a. M��TODOS: Estudo de abordagem quantitativa, descritivo transversal realizado em uma Unidade B��sica Distrital de Sa��de do munic��pio de Ribeir��o Preto, SP, em 2010. Foram entrevistados 123 usu��rios com DM2, que atenderam aos crit��rios de inclus��o. Para coleta de dados, foram utilizados: Question��rio de Conhecimento (DKN-A) e Question��rio de Atitudes Psicol��gicas do Diabetes (ATT-19). Os dados foram obtidos por meio de entrevista dirigida. Para a an��lise, utilizou-se o teste Exato de Fisher. RESULTADOS: a m��dia de idade foi de 63,87��9,09 anos, 4,54��3,66 anos de estudo, tempo m��dio de doen��a 11,18��8,64 anos. A escolaridade e o tempo de doen��a mostraram-se estatisticamente significantes (p<0,01 e 0,02, respectivamente) para a aquisi����o do conhecimento e prontid��o para o autocuidado em Diabetes. CONCLUS��ES: escolaridade e tempo de doen��a s��o vari��veis que influenciam o conhecimento e atitude do paciente com DM2.

DIN��MICA PS��QUICA E EFIC��CIA ADAPTATIVA DE PACIENTES COM DIABETES MELLITUS TIPO 2

O diabetes �� uma doen��a cr��nica conhecida h�� aproximadamente 3.500 anos e que atinge, atualmente, cerca de 18,8 milh��es de pessoas no mundo, sendo, portanto, de grande interesse a diversos pesquisadores das mais variadas ��reas. Esta doen��a �� resultante de uma insufici��ncia de insulina, que desempenha papel fundamental nos processos metab��licos do organismo. A incid��ncia do Diabetes Mellitus tipo 2 tem apresentado um consider��vel crescimento nas ��ltimas d��cadas, principalmente decorrente da elevada expectativa de vida e, tamb��m, pelo resultado de comportamentos destrutivos a sa��de, como o abuso de subst��ncias, dieta inadequada e um estilo de vida sedent��rio. O presente estudo teve por objetivos avaliar a Qualidade de Vida, a din��mica ps��quica, a efic��cia adaptativa e verificar os n��veis glic��micos de pessoas com Diabetes Mellitus tipo 2 participantes de um grupo psicoeducativo. Participaram deste estudo 14 pessoas com Diabetes Mellitus tipo 2. Os instrumentos utilizados foram: 1. Escala da Associa����o Brasileira de Institutos de Pesquisa de Mercado (ABIPEME); 2. Escala Diagn��stica Adaptativa Operacionalizada (EDAO); 3. Teste das Rela����es Objetais de Phillipson (TRO); e, 4. WHOQOL-bref. Os resultados mostraram que alguns pacientes apresentaram uma melhora significativa em seus n��veis glic��micos ap��s a realiza����o do grupo psicoeducativo, mesmo verificando que alguns n��o atingiram ainda bom controle de sua glicemia. A qualidade de vida destes participantes apresentou-se com n��veis muito bons. Ao avaliar a efic��cia adaptativa e a din��mica ps��quica destes participantes, verificou-se o quanto �� dif��cil aceitar que se tem uma doen��a cr��nica e ter atitudes para realizar o tratamento adequado. Conclu��mos que para estas pessoas com diabetes poderem aderir ao tratamento �� necess��rio que ele apresente uma boa capacidade de solucionar conflitos, e, apresente seu mundo interno ligado �� posi����o depressiva. Se estes fatores estiverem equilibrados o estilo de vida e o bem-estar desses pacientes ser��o positivos, de modo que eles possam apresentar consequentemente um bom progn��stico com menos complica����es da doen��a durante mais tempo de vida.

Short-term stability in refractive status despite large fluctuations in glucose levels in diabetes mellitus type 1 and 2

Purpose: This work investigates how short-term changes in blood glucose concentration affect the refractive components of the diabetic eye in patients with long-term Type 1 and Type 2 diabetes. Methods: Blood glucose concentration, refractive error components (mean spherical equivalent MSE, J0, J45), central corneal thickness (CCT), anterior chamber depth (ACD), crystalline lens thickness (LT), axial length (AL) and ocular aberrations were monitored at two-hourly intervals over a 12-hour period in: 20 T1DM patients (mean age �� SD) 38��14 years, baseline HbA1c 8.6��1.9%; 21 T2DM patients (mean age �� SD) 56��11 years, HbA1c 7.5��1.8%; and in 20 control subjects (mean age �� SD) 49��23 years, HbA1c 5.5��0.5%. The refractive and biometric results were compared with the corresponding changes in blood glucose concentration. Results: Blood glucose concentration at different times was found to vary significantly within (p<0.0005) and between groups (p<0.0005). However, the refractive error components and ocular aberrations were not found to alter significantly over the day in either the diabetic patients or the control subjects (p>0.05). Minor changes of marginal statistical or optical significance were observed in some biometric parameters. Similarly there were some marginally significant differences between the baseline biometric parameters of well-controlled and poorly-controlled diabetic subjects. Conclusion: This work suggests that normal, short-term fluctuations (of up to about 6 mM/l on a timescale of a few hours) in the blood glucose levels of diabetics are not usually associated with acute changes in refractive error or ocular wavefront aberrations. It is therefore possible that factors other than refractive error fluctuations are sometimes responsible for the transient visual problems often reported by diabetic patients. �� 2012 Huntjens et al.

HDL-C and HDL-C/ApoA-I predict long-term progression of glycemia in established type 2 diabetes

<p>OBJECTIVE: Low HDL cholesterol (HDL-C) and small HDL particle size may directly promote hyperglycemia. We evaluated associations of HDL-C, apolipoprotein A-I (apoA-I), and HDL-C/apoA-I with insulin secretion, insulin resistance, HbA1c, and long-term glycemic deterioration, reflected by initiation of pharmacologic glucose control.</p><p>RESEARCH DESIGN AND METHODS: The 5-year Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study followed 9,795 type 2 diabetic subjects. We calculated baseline associations of fasting HDL-C, apoA-I, and HDL-C/apoA-I with HbA1c and, in those not taking exogenous insulin (n = 8,271), with estimated ��-cell function (homeostasis model assessment of ��-cell function [HOMA-B]) and insulin resistance (HOMA-IR). Among the 2,608 subjects prescribed lifestyle only, Cox proportional hazards analysis evaluated associations of HDL-C, apoA-I, and HDL-C/apoA-I with subsequent initiation of oral hypoglycemic agents (OHAs) or insulin.</p><p>RESULTS: Adjusted for age and sex, baseline HDL-C, apoA-I, and HDL-C/apoA-I were inversely associated with HOMA-IR (r = -0.233, -0.134, and -0.230; all P &lt; 0.001; n = 8,271) but not related to HbA1c (all P &gt; 0.05; n = 9,795). ApoA-I was also inversely associated with HOMA-B (r = -0.063; P = 0.002; n = 8,271) adjusted for age, sex, and HOMA-IR. Prospectively, lower baseline HDL-C and HDL-C/apoA-I levels predicted greater uptake (per 1-SD lower: hazard ratio [HR] 1.13 [CI 1.07-1.19], P &lt; 0.001; and HR 1.16 [CI 1.10-1.23], P &lt; 0.001, respectively) and earlier uptake (median 12.9 and 24.0 months, respectively, for quartile 1 vs. quartile 4; both P &lt; 0.01) of OHAs and insulin, with no difference in HbA1c thresholds for initiation (P = 0.87 and P = 0.81). Controlling for HOMA-IR and triglycerides lessened both associations, but HDL-C/apoA-I remained significant.</p><p>CONCLUSIONS: HDL-C, apoA-I, and HDL-C/apoA-I were associated with concurrent insulin resistance but not HbA1c. However, lower HDL-C and HDL-C/apoA-I predicted greater and earlier need for pharmacologic glucose control.</p>

Sjuksk��terskans omv��rdnads��tg��rder och r��d till egenv��rd f��r att f��rebygga fotkomplikationer hos personer med diabetes mellitus typ II : En litteraturstudie

Bakgrund: Diabetes mellitus typ 2 (DMT2) ��kar i v��rlden och kan leda till allvarliga fotkomplikationer. Det har p��visats brister i den f��rbyggande v��rden f��r att undvika fotkomplikationer. Sjuksk��terskan ansvarar f��r att st��tta personer med DMT2 och m��let ��r att f�� dem att k��nna sig sj��lvst��ndiga och delaktiga i sin egenv��rd. Syfte: Syftet med studien var att belysa omv��rdnads��tg��rder och egenv��rd som f��rebygger fotkomplikationer f��r personer med DMT2 Metod: En litteraturstudie som utg��r ifr��n 20 vetenskapliga artiklar med kvantitativ uppbyggnad. S��kningarna av Artiklarna ��r s��kta i databaserna Cinahl och Pubmed. Samtliga artiklar ��r kvalitetsgranskade. Resultat: Identifiering av risker ��r en viktig faktor i f��rebyggandet av fotkomplikationer. Dagliga inspektioner och unders��kningar av f��tterna ��r viktiga egenv��rdsr��d som sjuksk��terskan b��r tilldela genom individuell undervisning. Sjuksk��terskan skall efter b��sta f��rm��ga st��tta och motivera personer med DMT2 till god egenv��rd. Slutsats: Sjuksk��terskan b��r undervisa och ge personer med DMT2 tillr��cklig kunskap, f��r att sj��lvst��ndigt kunna utf��ra f��rebyggande egenv��rd.

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes

Objectives: Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic + resistance + agility/balance + flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. Methods: This was a non-experimental pre-post evaluation study. Participants (N = 43; 62.92 �� 5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70 min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Results: Significant improvements in the performance of the 6-Minute Walk Test (&#916; = 8.20%, p < 0.001), 30-Second Chair Stand Test (&#916; = 28.84%, p < 0.001), Timed Up and Go Test (&#916; = 14.31%, p < 0.001), and Chair Sit and Reach Test (&#916; = 102.90%, p < 0.001) were identified between baseline and end-exercise intervention time points. Conclusions: A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.