Influência do antioxidante quercetina sobre a remodelação cardíaca e a atividade oxidativa de ratos com Diabetes mellitus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da relação entre diabetes mellitus e doença periodontal: um estudo em pacientes pertencentes à Casa do Diabético no município de Belém-PA

O diabetes mellitus é uma doença caracterizada por anormalidades endócrinas e matabólicas, que resulta em alterações em muitos setores do organismo. Ao passo que a doença periodontal é uma lesão infecto-inflamatória que envolve os tecidos de sustentação dos dentes. Convém, esclarecer a relação entre o diabetes mellitus e a doença periodontal por uma associação biológica, na qual diabéticos apresentam deficiência na resposta orgânica e aumento da suscetibilidade para muitos tipos de infecção, incluindo a infecção perioodntal. Este trabalho tem como objetivo comparar indivíduos com adequado controle metabólico do diabetes mellitus e indivíduos com pobre controle glicêmico da doença, em diferentes tempos de duração do diabetes. Foram avaliados periodontalmente 31 indivíduos com controle glicêmico adequado e 29 sujeitos com pobre controle metabólico. Os resultados revelaram que a condições de higiene bucal e de inflamação gengival são similares entre os indivíduos com diferentes anos de diabetes, independente da qualidade do controle metabólico do diabetes mellitus. A profundidade de sondagem revelou maior severidade em indivíduos com mais de cinco anos de doença, principalmente no grupo com pobre controle glicêmico. Em conclusão, indivíduos diabéticos com mais de cinco anos de duração da doença e com pobre controle metabólico do nível de glicemia apresentam maiores perdas de estrutura periodontal.

Avaliação da qualidade de vida de pacientes com Diabetes Mellitus tipo 1: dados do primeiro estudo multicêntrico no Brasil

O Diabetes Mellitus tipo 1 (DM1) é a endocrinopatia mais comum da infância e adolescência e impacta negativamente na qualidade de vida (QV). O EuroQol é um instrumento que afere o estado de saúde e vem sendo utilizado na grande maioria dos estudos multicêntricos mundiais em diabetes e tem se mostrado uma ferramenta extremamente útil e confiável. O objetivo desse estudo é avaliar a QV de pacientes com DM1 do Brasil, país de proporções continentais, por meio da análise do EuroQol. Para isso, realizou-se estudo retrospectivo e transversal, no qual foram analisados questionários de pacientes com DM1, respondidos no período de dezembro de 2008 a dezembro de 2010, em 28 centros de pesquisa de 20 cidades das quatro regiões do país (sudeste, norte/nordeste, sul e centro-oeste). Foram também coletados dados sobre complicações crônicas micro e macrovasculares e perfil lipídico. A avaliação da qualidade de vida pelo EuroQol mostra que a nota média atribuída ao estado geral de saúde é nitidamente menor que a encontrada em dois outros estudos populacionais com DM1 realizados na Europa (EQ-VAS da Alemanha, Holanda e Brasil foram de 82,1 ± 14; 81 ± 15 e 72 ± 22, respectivamente). O EuroQol demonstra que a região Norte-Nordeste apresenta melhor índice na avaliação do estado geral de saúde quando comparada a região Sudeste e menor frequência de ansiedade-depressão autorreferidas, quando comparada às demais regiões do país (Norte-Nordeste = 1,53 ± 0,6, Sudeste = 1,65 ± 0,7, Sul = 1,72 ± 0,7 e Centro-Oeste = 1,67 ± 0,7; p <0,05). Adicionalmente, diversas variáveis conhecidas (idade, duração do DM, prática de atividade física, HbA1c, glicemia de jejum e presença de complicações crônicas se correlacionaram com a QV (r = -0,1, p <0,05; r = -0,1, p <0,05; r = -0,1, p <0,05; r = -0,2, p <0,05; r = -0,1, p <0,05 e r= -0,1, p <0,05, respectivamente). Esse é o primeiro estudo a avaliar a qualidade de vida de pacientes com DM1 a nível populacional no hemisfério sul. Nossos dados indicam uma pior qualidade de vida dos pacientes com DM 1 no Brasil quando comparado a dados de países europeus. Apesar de ter sido encontrado uma inferior duração do DM e menor presença de complicações microvasculares na região Norte/ Nordeste, quando comparada à outras regiões, nossos dados sugerem a existência de elementos adicionais responsáveis pela melhor QV e menor presença de ansiedade/depressão encontradas nesta região. Novos estudos são necessários para identificar esses possíveis fatores.

Efeito do Diabetes mellitus e da insulinoterapia na osseointegração estabelecida ao redor de implantes instalados em tíbia de ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estomatite protética em pacientes com Diabetes mellitus: prevalência de Candida spp. e eficiência dos tratamentos com nistatina e desinfecção de próteses por micro-ondas

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

Síntese e caracterização de novos complexos de vanádio: estudo da utilização dos complexos no tratamento do Diabetes Mellitus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Heart rate variability in children with type 1 diabetes mellitus

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

Elevated micronucleus frequency in patients with type 2 diabetes, dyslipidemia and periodontitis

The over-production of reactive oxygen species (ROS) can cause oxidative damage to a large number of molecules, including DNA, and has been associated with the pathogenesis of several disorders, such as diabetes mellitus (DM), dyslipidemia and periodontitis (PD). We hypothesise that the presence of these diseases could proportionally increase the DNA damage. The aim of this study was to assess the micronucleus frequency (MNF), as a biomarker for DNA damage, in individuals with type 2 DM, dyslipidemia and PD. One hundred and fifty patients were divided into five groups based upon diabetic, dyslipidemic and periodontal status (Group 1 - poor controlled DM with dyslipidemia and PD; Group 2 - well-controlled DM with dyslipidemia and PD; Group 3 - without DM with dyslipidemia and PD; Group 4 - without DM, without dyslipidemia and with PD; and Group 5 - without DM, dyslipidemia and PD). Blood analyses were carried out for fasting plasma glucose, HbA1c and lipid profile. Periodontal examinations were performed, and venous blood was collected and processed for micronucleus (MN) assay. The frequency of micronuclei was evaluated by cell culture cytokinesis-block MN assay. The general characteristics of each group were described by the mean and standard deviation and the data were submitted to the Mann-Whitney, Kruskal-Wallis, Multiple Logistic Regression and Spearman tests. The Groups 1, 2 and 3 were similarly dyslipidemic presenting increased levels of total cholesterol, low density lipoprotein cholesterol and triglycerides. Periodontal tissue destruction and local inflammation were significantly more severe in diabetics, particularly in Group 1. Frequency of bi-nucleated cells with MN and MNF, as well as nucleoplasmic bridges, were significantly higher for poor controlled diabetics with dyslipidemia and PD in comparison with those systemically healthy, even after adjusting for age, and considering Bonferroni's correction. Elevated frequency of micronuclei was found in patients affected by type 2 diabetes, dyslipidemia and PD. This result suggests that these three pathologies occurring simultaneously promote an additional role to produce DNA impairment. In addition, the micronuclei assay was useful as a biomarker for DNA damage in individuals with chronic degenerative diseases.

Dinâmica linear e não linear da variabilidade da frequência cardíaca: sensibilidade, especificidade, valor preditivo e correlação de características físicas e clínicas no Diabetes Mellitus tipo 1

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

Parâmetros Neuropáticos no Diabetes Mellitus

Pós-graduação em Fisioterapia - FCT

Periodontal disease-associated compensatory expression of osteoprotegerin is lost in type 1 diabetes mellitus and correlates with alveolar bone destruction by regulating osteoclastogenesis

Alveolar bone resorption results from the inflammatory response to periodontal pathogens. Systemic diseases that affect the host response, such as type 1 diabetes mellitus (DM1), can potentiate the severity of periodontal disease (PD) and accelerate bone resorption. However, the biological mechanisms by which DM1 modulates PD are not fully understood. The aim of this study was to determine the influence of DM1 on alveolar bone resorption and to evaluate the role of receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoprotegerin (OPG) in osteoclastogenesis in rats. PD was induced by means of ligature in nondiabetic and in streptozotocyn-induced DM1 rats. Morphological and morphometric analyses, stereology and osteoclast counting were performed. RANKL and OPG mRNA levels, protein content, and location were determined. PD caused alveolar bone resorption, increased the number of osteoclasts in the alveolar bone crest and also promoted changes in RANKL/OPG mRNA expression. DM1 alone showed alveolar bone destruction and an increased number of osteoclasts at the periapical and furcal regions. DM1 exacerbated these characteristics, with a greater impact on bone structure, resulting in a low OPG content and a higher RANKL/OPG ratio, which correlated with prominent osteoclastogenesis. This work demonstrates that the effects of PD and DM1 enhance bone destruction, confirms the importance of the RANKL signaling pathway in bone destruction in DM1 in animal models and suggests the existence of alternative mechanisms potentiating bone degradation in PD.

Assessment of structural cardiac abnormalities and diastolic function in women with gestational diabetes mellitus

Background: The main manifestation of hyperglycaemia during pregnancy is gestational diabetes mellitus. It can herald diabetes mellitus type 2 and its deleterious long-term effects, such as hypertension and cardiovascular disease. The aim of this study was to assess diastolic function in women with gestational diabetes mellitus, one of the first signs of future cardiovascular disease.Methods: A total of 21 women with gestational diabetes mellitus and 23 healthy pregnant women (control group) between 34 and 37weeks of gestation underwent echocardiographic assessment. The diagnosis of gestational diabetes mellitus was made in agreement with the American Diabetes Association criteria. Echocardiographic images obtained were analysed according to the criteria of the American Society of Echocardiography. Data were analysed using Pearson correlation coefficient, analysis of variance and Student's t-test.Results: Women with gestational diabetes mellitus had higher posterior wall and interventricular septum thickness, increased left ventricular mass and left ventricular mass index, lower early diastolic annular velocity and early diastolic annular velocity/late diastolic annular velocity ratio. There was a positive correlation between left ventricular mass index and fasting glucose and pregnancy body mass index.Conclusion: Patients with gestational diabetes mellitus seem to have a different diastolic profile as well as a mildly dysfunctional pattern on echocardiogram, which may show a need for greater glycaemic control.

Efeito Diabetes mellitus gestacional na modulação de genes relacionados ao metabolismo mitocondrial e a implicação na predisposiçao do recém-nascido à obesidade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Diabetes mellitus: avaliação do conhecimento de cirurgiões-dentistas em municípios de três estados brasileiros

Introduction: Pathological changes in the bucal cavity associated with Diabetes mellitus (DM) may include gingivitis, periodontal disease, salivary gland dysfunction and xerostomia (dry mouth), susceptibility to bucal infections, burning mouth syndrome, and altered taste. Objective: This study assessed the technical and scientific knowledge of dentists working in primary care in the National Health System (SUS) on the DM. Material and method: The study was conducted in the municipalities of Birigui-SP, Maringá-PR and TrêsLagoas-MS, with the participation of 76 dentists working in the SUS primary care system.These professionals agreed to answer to a questionnaire developed for this study and the results of the questions were submitted to a quantitative analysis. Result: Showed that 94.7% were in contact with diabetic patients; 97.4% know what is DM; about other types of DM, 77.6% said they know, the most mentioned (by 55.9%) was the gestational DM. The DM2 was indicated as the most prevalent by 59.2%; the normal range of fasting blood glucose level was quoted correctly by 2.6% of the participants; obesity was reported by 98.7% of participants as a risk factor for DM; 96.0% stated correctly what are the main signs and symptoms related to Diabetes; periodontal disease was reported by 92.1% as an bucal manifestation in diabetic patients. Conclusion: The dentist needs to develop specific knowledge about DM, being able to identify normal levels of blood glucose and ready to identify and meet the bearer of DM.

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.