Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients

The aim of this study was to investigate oral yeast colonization, antifungal susceptibility and strain diversity in insulin-dependent diabetes mellitus patients (175), as well as to evaluate the influence of dental prostheses. Oral rinse samples were cultured on selective media, in order to isolate, count and identify the yeasts recovered. More than half of the diabetic subjects (53%) carried significant amounts of Candida cells in the buccal cavity and these organisms were recovered at higher densities in diabetics wearing dentures. A total of 93 yeast strains were isolated from these patients, including: Candida spp. (n = 89); Pichia (n = 02); Trichosporon (n = 1), and Geotrichum (n = 1). C. albicans represented 56% of these strains, non-albicans Candida 39.8%, and other genera of yeast 4.3%. C. albicans was prevalent, followed by C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. rugosa and C. guilliermondii. Agar disk-diffusion tests of the susceptibility of non-albicans Candida and other genera of yeast to fluconazole showed resistance in 21.9%, mainly in C. rugosa (100%), C. glabrata (57%) and C. krusei (50%). Local oral factors, such as the presence of dentures, in association with diabetes, seemed to have the effect of increasing the amount and variety of Candida species in the oral cavities, mainly those with lower drug susceptibilities.

Efeitos do treinamento aeróbio sobre sinais precoces do remodelamento do ventrículo esquerdo induzido pelo diabetes Mellitus experimental

Our aim was to investigate the effects of an aerobic training program on adverse and early left ventricle (LV) remodeling, using an experimental model of short-term type 1 diabetes (T1D). Wistar rats were divided in 4 groups: sedentary control (SC), trained control (TC), sedentary diabetic (SD) and trained diabetic (TD). T1D was induced by streptozotocin (45 mg/kg). The training program consisted of 4 weeks running on a treadmill (13 m/min, 60 min/day, 5 days/week). At the end of the experiments, hearts were collected for analysis of morphology and transcriptional profile of LV, by focusing on its remodeling. Deaths were recorded during the 4-week period. We verified high mortality among animals of DS group, whereas it was significantly reduced in DT group. DS group also showed an increase in cross-sectional area of cardiomyocytes and fibrosis. TD group exhibited reduction in measures of cardiac trophism, but with respect to collagen content, it was similar to CS group. Analysis of gene expression related to cardiac remodeling revealed decreased expression of collagen I and III, as well as low expression of MMP-2 in DS group. TD group showed decreased levels of mRNA for MMP-9, and unchanged gene expression of MMP-2 when compared with the CS group. The expression of MMP-2 and TGF-1 were increased in CT group. The ratio between gene expression of collagen I and III was increased in the CT group and decreased in diabetic groups. These results establish early changes of the structure and transcriptional profile of LV myocardium. Moreover, they indicate that aerobic exercise training plays specific protection against mechanisms responsible for cardiac damage observed in T1D

A experiência de adolescentes portadores de diabetes Mellitus Tipo 1: seus significados e sentido

Worldwide, the diabetes mellitus is considered a serious problem of public health; it also involves high costs for its treatment and its complications. Even though the onset of diabetes mellitus type 1 is on 5% to 10% of the diabetic population, it is the most aggressive type of anifestation; furthermore, it is the commonest chronic disease in childhood and adolescence. Such data show the importance of understanding the development of this disease from the moment the individual perceives it, according to their experience, observing the complexity of the phenomenon thoroughly. This study aimed to comprehend the experience of the adolescent with onset of diabetes mellitus type 1 in order to learn how these young individuals perceive and reason their place in the world when they experience this illness. The methodological strategy was based on qualitative research of phenomenological inspiration. We applied the main ideas of heideggerian ontology and some concepts of existential phenomenological psychology to guide our reflexive path. The participants were 10 young individuals (06 female and 04 male), ages between 15 and 18, under treatment in the city of Recife, Pernambuco. The methodological resource was the narrative, which allowed us access to the adolescents experience. The comprehension of the reports was based on the heideggerian hermeneutics, whose priority is the interpretation of the meaning expressed by the participants speech. The results showed that factors such as social, family, economic and cultural context greatly influence the perception and the way the individuals deal with, perceive and reason their experience. We noticed that the diabetes type 1 may often represent a limitation, but it does not make it impossible to be part of the world with others. The data show a significant affective ambivalence regarding the content more directly related to the disease. This demonstrates the unique way which each one gives meaning and reasons their condition of existence. This research points out the need to understand the complexity of this phenomenon in a more complete manner, considering the adolescent in their timely and historical context. We believe we can encourage thinking that may become actions which are more fit to the reality researched regarding all the parties involved with the subject, such as health professionals, adolescents, family, support programs and public health policies

Ações educativas com portadores de diabetes Mellitus através da educação popular em saúde

Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

Hearing loss in patients with diabetes mellitus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Caracterização de um modelo experimental de Diabetes Mellitus, induzido pela aloxana em ratos: estudo clínico e laboratorial

OBJETIVO: O presente estudo teve por objetivo caracterizar as alterações clínicas e laboratoriais do rato portador de Diabetes Mellitus induzido pela administração endovenosa de aloxana. MÉTODOS: Os animais foram distribuídos, por sorteio, em dois grupos experimentais: Grupo Controle Normal (G1), constituído de 25 animais sadios, e Grupo Diabético (G2), formado por 25 animais diabéticos graves, que foram avaliados em cinco momentos (1, 3, 6, 9 e 12 meses) de seguimento, tendo sido estudados os seguintes parâmetros: evolução clínica (peso, ingestão hídrica, ingestão alimentar e diurese) e exames bioquímicos (glicemia de jejum, glicose urinária, glicosúria, cetonúria, colesterol total, colesterol HDL, triglicérides e lipídios). RESULTADOS: A injeção de aloxana 2% na via endovenosa do rato acompanhou-se de um índice de mortalidade de 39%, tendo produzido diabetes grave também em 39% dos animais. O diabetes foi caracterizado por queda progressiva do peso corporal, elevação substancial da ingestão hídrica, ingestão alimentar e da diurese, com valores glicêmicos acima de 300 mg/dl, glicosúria 3+ e, eventualmente, cetonúria. O diabetes não altera o perfil de colesterol e lípides de ratos a longo prazo. CONCLUSÃO: Nossos estudos revelam que a aloxana produz, no rato, alterações clínicas e laboratoriais características de diabetes grave, as quais possibilitam estudos a longo prazo do diabetes.

Diabetes mellitus juvenil: a experiência de familiares de adolescentes e pré-adolescentes

Este estudo foi desenvolvido com o objetivo de investigar a experiência de cuidar de adolescentes e pré-adolescentes portadores de diabetes tipo I, na perspectiva dos seus familiares. Foi utilizada a abordagem fenomenológica, modalidade de pesquisa qualitativa que se propõe a compreender os significados das experiências vividas. Foram entrevistados dez pais (9 mães e 1 pai) em hospital de ensino do interior paulista. A experiência de cuidar do filho com diabetes emerge das convergências das descrições dos participantes, sendo descrita em três temas principais: o universo da doença; relação com as pessoas; reflexão sobre a experiência vivida. Os participantes descrevem suas dificuldades e estratégias para manterem a família unida e ainda oferecer suporte aos filhos. Eles acreditam que têm que aceitar e enfrentar os desafios, além de estimularem os filhos para sua segurança e qualidade de vida. Os dados mostraram a necessidade de um suporte profissional, além de um espaço para a discussão de temas tanto para as crianças com diabetes como para seus familiares.

Compreendendo o significado de qualidade de vida segundo idosos portadores de diabetes mellitus tipo II

Trata-se de uma pesquisa qualitativa com abordagem fenomenológica, objetivando descrever o significado de qualidade de vida, segundo relatos de idosos portadores de diabetes mellitus tipo II, e avaliar as repercussões da doença sobre sua vida. Entrevistamos 12 idosos diabéticos, no período de setembro a outubro de 2008, entre um e quarenta anos de evolução da doença. Foi feita a seguinte questão norteadora: Para o Sr. (a), o que significa qualidade de vida? A análise dos discursos mostrou facetas relevantes ligadas ao cotidiano do idoso com diabetes mellitus. Para eles, a qualidade de vida está intimamente relacionada à saúde física, independência na vida diária e econômica, integração social, suporte familiar e saúde mental-espiritual. A restrição alimentar foi o ponto de maior repercussão do diabetes sobre seu modo de viver. Verificou-se que cabe aos profissionais de saúde ampliar o diálogo profissional-paciente, promovendo autonomia e independência no cuidado e corresponsabilização.

Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Comprovação do efeito antioxidante de plantas medicinais utilizadas no tratamento do Diabetes mellitus em animais: artigo de atualização

Diabetes mellitus (DM) é uma síndrome de etiologia múltipla caracterizada por hiperglicemia crônica. Esta hiperglicemia induz o aumento na produção de espécies reativas de oxigênio (ERO) e diminuição das defesas antioxidantes. Devido às complicações causadas pelo diabete, muitos indivíduos optam por terapias alternativas à base de plantas medicinais para amenizar seus efeitos. Sendo assim, nesta revisão de literatura, foram analisados e descritos diversos trabalhos experimentais com a utilização de animais diabéticos para comprovar os efeitos antioxidantes de algumas dessas plantas e verificar se os títulos e resumos disponibilizados nos artigos são compatíveis aos objetivos de nossa busca.

Capacitação de profissionais da atenção primária à saúde para educação em Diabetes Mellitus

Objective: To present the proposal of educational workshops on diabetes and a strategy of evaluation aimed at upgrading the professionals' performance in primary care. Methods: The workshops were implemented using participatory methodology, play techniques, experiences, and group dynamics, involving the participation of 85 health professionals from Units of Primary Care, in the city of Belo Horizonte, MG. The knowledge about the disease and the skills required for self-care were measured by applying specific instruments. The workshops were evaluated based on the instrument: developed for that purpose. Results: There were limitations in the knowledge of professionals about pathophysiology and the disease's complementary tests. The workshops helped to awaken the potential of professionals (reflection, criticism and creativity) necessary to change the educational process. It was considered a pedagogical strategy, easy to understand, interactive and playful. Conclusions: The workshops contributed to the planning of the educational process and the structuring of an evaluation model of practices of health and education promotion in diabetes.

The influence of short-term diabetes mellitus and insulin therapy on alveolar bone loss in rats

Background: It is well known that the multiple direct and indirect consequences of hyperglycemia in diabetic individuals have been linked to a number of abnormal host effector mechanisms that could lead to an increased risk of developing periodontal disease.Objective: the aim of this study was to investigate the effect of short-term experimental diabetes and insulin therapy on the severity of alveolar bone loss in rats, and the effect of experimental periodontitis on glycemic control.Methods: Seventy-two male Wistar rats were divided into four groups: group I animals were submitted to dental ligature around lower right first molars (ligated); group II consisted of streptozotocin (STZ)-diabetic, ligated rats; group III represented STZ-diabetic, unligated rats; and group IV consisted of insulin-treated (6 U/day), STZ-diabetic, ligated rats. Blood glucose of all diabetic rats was monitored at regular intervals. Standardized digital radiographs were taken after killing at 7, 15 and 30 days to measure the amount of bone loss about the mesial root surface of the first molar tooth in each rat.Results: No significant (p < 0.05) changes in plasma glucose levels of insulin-treated diabetic rats were found among the different examinations after the beginning of insulin therapy. Rats from group II showed significantly greater increases in mean plasma glucose levels at 15 and 30 days after ligature placement compared with rats from group III (p < 0.05). Furthermore, in spite of the significant alveolar bone loss progression that was observed in groups I, II and IV (p < 0.00001; two-way ANOVA), no significant differences among these groups regarding the severity of bone loss (p = 0.77) and no significant interaction between treatment group and time (p = 0.81) were found.Conclusions: Within the limits of this study, it can be suggested that the severity of periodontal disease was not affected by short-term diabetes, and that experimental periodontitis increased blood glucose levels in uncontrolled diabetic rats.

Effect of diabetes mellitus and insulin therapy on bone density around osseointegrated dental implants: a digital subtraction radiography study in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)