Construção de barreiras para diminuir as falhas nas mensurações glicêmicas realizadas pela enfermagem em pacientes críticos com insulina intravenosa

Esta pesquisa tem como objeto os fatores que influenciam a mensuração glicêmica realizada pela enfermagem em pacientes que recebem insulina contínua intravenosa utilizando glicosímetros portáteis à beira leito. Vários fatores podem influenciar a mensuração glicêmica, tais como a amostra sanguínea, a calibração do aparelho, a estocagem das fitas-teste, o hematócrito dos pacientes, o uso de vasoaminas e falhas do operador. A partir da Tese de que: A identificação dos fatores que influenciam a mensuração glicêmica realizada pela enfermagem através de glicosímetros é determinante para a eficiência das barreiras de salvaguarda voltadas para a minimização de falhas na sua execução, a fim de garantir resultados glicêmicos confiáveis e, consequentemente, realizar a titulação da insulina com segurança, teve-se como objetivo geral propor ações de enfermagem que funcionem como barreiras para diminuir as falhas nas mensurações glicêmicas realizadas pela enfermagem em pacientes que recebem infusão contínua de insulina. Espera-se contribuir com ações para garantir a adequação e o controle rigoroso da insulina administrada. Estudo observacional, transversal, prospectivo com abordagem quantitativa na análise dos dados, em uma unidade intensiva cirúrgica cardiológica de um hospital público do Rio de Janeiro. As variáveis do estudo foram submetidas a tratamentos estatísticos não paramétricos e às medidas de associação. Foram investigados 42 pacientes com observação de 417 glicemias. Predominaram pacientes do sexo feminino (57,14%), média de idade de 48 (15,85) anos, sem insuficiência renal e sem tratamento dialítico (90,48%). Observou-se PAM com média de 77(10,29) mmHg, uso de vasoaminas (80,95%), PaO2 ≥ 90mmHg em 85,71% e hematócrito <35% em 71,42%. Encontrou-se uma incidência de hipoglicemia de 35,7%, sendo a população dividida em dois grupos, o primeiro (G1) com pacientes que apresentaram hipoglicemia ≤ 60mg/dl (n=15), e o segundo (G2), com pacientes sem hipoglicemia (n=27). O hematócrito baixo foi a característica clínica que apresentou maior associação com a hipoglicemia. Pacientes com esta condição apresentaram 5,60 vezes mais risco de apresentarem hipoglicemia. O uso de vasoaminas elevou 3,3 vezes o risco de hipoglicemia em pacientes com estas medicações. A realização de cirurgias de emergência, a presença de insuficiência renal com tratamento dialítico, e a elevação da PaO2 acima de 90mmHg também apresentaram associação positiva com a hipoglicemia. Das 417 mensurações observadas, predominou o uso de amostra sanguínea de origem arterial. Observou-se que em todas as etapas da técnica de mensuração houve desvio de execução, com exceção de compressão da polpa digital. Os desvios observados que mostraram associação positiva (RR>1) para pacientes com hipoglicemia foram: a falta de calibração do glicosímetro, a falta de verificação da validade/integridade da fita teste, a falta da higienização das mãos e a falta da coleta de até 1 ml de sangue. Construiu-se uma revisão da técnica de mensuração glicêmica com enfoque nos fatores que podem comprometer o resultado glicêmico levando em conta o risco de hipoglicemia. Tornou-se evidente que a compreensão apropriada dos fatores que influenciam a glicemia e a mensuração glicêmica é indispensável para o enfermeiro na obtenção de resultados glicêmicos confiáveis, e assim, evitar erros na titulação das doses de insulina administrada.

Efeito do treinamento físico intenso e da dose única de polifenóis sobre indicadores cardiometabólicos em militares fisicamente condicionados

O exercício físico pode promover o desequilíbrio oxidativo e na secreção e ação das adipocinas, leptina e adiponectina, que desempenham papel fundamental no desenvolvimento de doenças cardiometabólicas, incluindo a síndrome metabólica, disfunção endotelial, desordens inflamatórias e vasculares. Militares são submetidos a exercícios físicos intensos e podem apresentar maior risco de doenças cardiovasculares. A identificação de parâmetros capazes de detectar o risco cardiovascular precoce em grupos muito ativos fisicamente é complexa. A razão leptina/adiponectina (L/A) e a concentração de LDL eletronegativa (LDL (-)) vem sendo considerados bons indicadores de risco cardiovascular precoce porém não há estudos que investiguem a utilidade destes marcadores em militares. Os polifenóis, presentes na uva (Vitis vinífera), apresentam efeitos cardioprotetores como inibição da oxidação das lipoproteínas e controle glicêmico. Na presente tese objetivou-se identificar o risco cardiovascular em jovens militares altamente treinados, utilizando diferentes parâmetros, incluindo a razão L/A e investigar a influência do exercício militar e do uso de dose única de Vitis vinifera sobre parâmetros cardiometabólicos de militares fisicamente treinados. O primeiro estudo contou com a participação de 54 militares d gênero masculino, condicionados fisicamente, após descanso de 24h. No segundo estudo, participaram 54 militares do gênero masculino distribuídos aleatoriamente, de forma duplo-cego, para receber única dose contendo 200 mg de extrato seco de Vitis vinifera (GS, n = 27) ou 200 mg de placebo (amido) (GP, n = 27). Considerados em conjunto, os resultados sugerem que militares treinados poderiam ser classificados como limítrofes quanto ao risco cardiovascular, quando somente o perfil lipídico é empregado como marcador. As medidas de CC e CC/E são parâmetros de fácil obtenção e podem ser empregados na identificação do potencial risco cardiovascular, enquanto outros estudos não confirmam a eficácia da razão L/A para este fim. A comparação das concentrações plasmáticas de adiponectina e leptina apresentou diferença significativa apenas intragrupo para ambos os grupos. As concentrações plasmáticas das adipocinas foram influenciadas pelo treinamento. Os indicadores de homeostase glicêmica, glicemia de jejum e insulina plasmática, foram semelhantes entre os grupos, não sendo sendo influenciada pelo treinamento ou suplementação. A suplementação de polifenóis reduziu as concentrações de LDL(-) do GS em relação ao GP em T24h e T48h (p<0,05). Estes achados sugerem que o treinamento físico afeta a secreção das adipocinas independentemente do uso da Vitis vinífera. Entretanto, a dose única de polifenóis pode reduzir o risco cardiometabólico proveniente da oxidação da LDL (-)

Estudo da sinalização da insulina nos tecidos muscular e adiposo de ratos submetidos à desnutrição materna no início da lactação

Vários estudos sugerem que a desnutrição materna no período pós-natal poderia causar alterações na homeostase glicêmica da prole na vida adulta. Neste trabalho objetivamos investigar a interferência da programação metabólica induzida pela desnutrição protéica materna durante o início da lactação sobre a homeostase glicêmica e a sinalização da insulina nos tecidos muscular e adiposo. Animais desnutridos (D-dieta da mãe contendo 0% de proteína nos primeiros 10 dias de lactação) ou controle (C-dieta da mãe contendo 22% de proteína) foram estudados do nascimento até a vida adulta. Em resumo, observamos uma diminuição na insulina plasmática acompanhada de normoglicemia nos animais adultos desnutridos. A ativação do receptor de insulina (IR), após a estimulação com o hormônio apresentou-se diminuída durante o período de restrição protéica em músculo isolado destes animais experimentais. Durante o período da lactação, observamos uma diminuição na captação de glicose, na fosforilação do substrato para o receptor de insulina (IRS 1) e na translocação do GLUT 4 no tecido muscular. Na idade adulta, entretanto, houve aumento significativo na captação de glicose e translocação do GLUT 4 no músculo, associado com o aumento na expressão da PI3 quinase associada ao IRS 1. No tecido adiposo de ratos desnutridos adultos observamos menor fosforilação em tirosina tanto do IR quanto do IRS 1, que foi compensada pela maior ativação do IRS 2 e da PI3 quinase. Os níveis basais de pAkt e de GLUT 4 na membrana estavam aumentados, culminando em um aumento na captação de glicose. Observamos também uma redistribuição do citoesqueleto de actina e maior resistência aos efeitos da Ltrunculina B nos adipócitos dos ratos desnutridos. Em conclusão, este estudo demonstrou que a desnutrição materna no início da lactação é capaz de causar alterações na prole na vida adulta, o que parece estar relacionado com a expressão e ativação de proteínas chave na cascata da sinalização da insulina nos tecidos periféricos, importantes na regulação do metabolismo da glicose.

Haematological and biochemical alterations of Catla catla fingerlings following sublethal exposure to Nuvan

The sublethal exposure (0.24 ppm) of Nuvan on some biochemical compositions such as serum protein, blood glucose, glutamate oxaloacetate transaminase (AST) and glutamate pyruvate transaminase (ALT) and on some hematological parameters such as red blood corpuscles (RBC), white blood corpuscles (WBC), hemoglobin content (Hb), mean corpuscular concentration (MCV), mean corpuscular hemoglobin concentration (MCHC) of Catla catla fingerlings were studied. The hematological and biochemical parameters evoked a significant reduction (excepting MCV, ALT and AST which is significantly increased) with increasing days of Nuvan exposure.

重组人胰岛素样生长因子1对db/db小鼠血糖的影响

下载PDF阅读器目的:研究重组人胰岛素样生长因子1(rhIGF-1)对近似于人类2型糖尿病的db/db小鼠的降血糖作用.方法:正常饲养db/db及同品系的正常小鼠,定期监测血糖和血胰岛素水平.待db/db小鼠表现出明显的高血糖及高胰岛素血症后随机分为4组,每日皮下注射溶媒、胰岛素或不同剂量的rhlGF-1,共2周.首次给药后每30min测定血糖1次,观测不同干预方式的即时降糖效果.再于每次给药前测定血糖,观察2周内的变化趋势.结果:db/db小鼠饲养至8周龄时表现出明显的血糖升高及高胰岛素血症.所用剂量的胰岛素对db/db小鼠未表现出明显的降血糖作用;rhIGF-1特别是高剂量rhIGF-1即时及短期降糖效果均较明显,可有效保护db/db小鼠.结论:rhIGF-1对db/db小鼠有较好的降血糖作用,对伴有明显胰岛素抵抗的糖尿病患者具有临床应用前景.

三种藏药材的化学成分研究

本学位论文报道了西藏产三种藏族传统植物药材的化学成分研究。论文由四章组成，前三章是实验部分，分别报道了尼泊尔黄堇(Corydalis hendersonii Hemsl.)、藏波罗花(Incarvillea younghusbandii Sprague)和全缘叶绿绒蒿(Meconopsis interifolia Franch.)的化学成分研究结果。从这三种青藏高原药用植物中共分离鉴定出33 个化合物，其中1 个是新化合物。第四章概述了罂粟科紫堇属植物的化学和药理研究进展。 第一章为尼泊尔黄堇的化学成分研究。通过正、反相硅胶柱色谱等分离方法从药用植物尼泊尔黄堇的地上部分共分离纯化得到12 个化合物。运用MS、1H-NMR、13C-NMR、DEPT、HMBC、NOESY 等现代波谱学方法将它们的结构鉴定为：刺罂粟碱(1) ， 普托品(2) ， 新那亭(3) ， 斯可任(4) ， tetrahydrothalifendine (5) ，9-methyl-decumbenine C (6)，tetrahydroberberrubine (7)，隐品碱(8)，α-别隐品碱(9)，6,7-methylenedioxy-1(2H)-oxoisoquinolinone (10)，6-丙酮基-5,6 -二氢血根碱(11)和β-谷甾醇(12)。其中化合物6 为新化合物，为首次发现的分子骨架上C-9 位连有甲基的苯肽异喹啉类型生物碱。另外，除化合物1 和2 外，其它9 个生物碱（3～11）均为首次从该种植物中分离得到。同时，我们还对对尼泊尔黄堇中的总生物碱进行了串联质谱分析。 第二章为藏波罗花的化学成分研究。从该药用植物的地上部分共分离得到16个化合物，通过理化常数和波谱数据鉴定为：异佛手柑内酯(1)，6-甲氧基当归素(2)，欧前胡素(3)，花椒毒内酯(4)，珊瑚菜素(5)，水合氧化前胡素(6)，rivulobirin A (7)，齐墩果酸甲酯(8)，咖啡酸甲酯(9)，银桦酸(10)，(D)-boschniakinic acid (11)，对羟基苯甲酸(12) ， tert-O-β-D-glucopyranosyl-(R)-heraclenol (13) ， 5-methoxy-8-O-β-D-glucopyranosyloxypsoralen (14)，前胡苷V(15)和苯乙醇-O-β-D-吡喃葡萄糖-(1→2)-O-β-D-吡喃葡萄糖苷(16)。所有以上化合物均为首次从该种植物中分离得到。另外我们还首次对藏波罗花挥发油的化学成分进行了气相色谱-质谱(GC-MS)联用分析，共鉴定出39 个挥发性成分。 第三章为全缘叶绿绒蒿化学成分的分离鉴定。从传统藏药材全缘叶绿绒蒿地上部分共分离纯化出8 个化合物。通过理化常数和波谱数据将他们的结构分别鉴定为：去甲血根碱(1)，β-谷甾醇(2)，3-羟基-齐墩果烷-12(13)-烯-30-酸(3)，6-丙酮基-5,6-二氢血根碱(4)，木犀草素(5)，胡萝卜苷(6)，quercetin 3-O-β-D-glucopyranosyl-(1→6)-β-D-glucopyranoside (7)和普托品(8)。其中化合物1，4 和7 为首次从该种药用植物中分离得到。 第四章为综述，总结和归纳了近年来罂粟科紫堇属植物的化学和药理研究进展。 This dissertation consists of four parts. The first, second and third parts report the studies on the chemical constituents from the medicinal plants of Corydalis hendersonii, Incarvillea younghusbandii and Meconopsis interifolia. The forth part reviews the progress of the studies on Corydalis species. The first chapter is about the isolations and identifications of alkalids from the aerial parts of C. hendersonii which is a traditional Tibetan medicine to treat febrifuge, high blood pressure and hepatitis. A new isoquinoline alkaloid, 9-methyl-decumbenine C (6), together with ten known alkaloids, stylopine (1), protopine (2), canadine (3), scoulerine (4), tetrahydrothalifendine (5), tetrahydroberberrubine (7), cryptopine (8), α-allocryptopine (9), 6,7-methylenedioxy-1(2H)-isoquinolinone (10) and 6-acetonyl-5,6-dihydrosanguinarine (11), and β-sitosterol (12) were isolated. Their structures were elucidated by spectroscopic methods. Furthermore, the total alkaloids were analyzed by ESI-MSn. The second chapter is about the isolations and identifications of chemical constituents from the aerial parts of I. younghusbandii. Sixteen compounds were isolated and purified by normal and reversed phase silica gel column chromatography. By spectral analysis, there structures were identified as isobergapten (1), sphondin (2), imperatorin (3), xanthotoxin (4), phellopterin (5), heraclenol (6), rivulobirin A (7), methyl oleanolate (8), methyl caffeate (9), grevillic acid (10), (D)-boschniakinic acid (11), 4-hydroxybenzoic acid (12), tert-O-β-D-glucopyranosyl-(R)-heraclenol (13), 5-methoxy-8-O-β-D-glucopyranosyloxypsoralen (14), decuroside Ⅴ(15), and phenylethyl-O-β-Dglucopyranosyl-(1→2)-β-D-glucopyranoside (16). All of these compounds were isolated from this plant for the first time．By the way, the chemical components of the essential oil from I. younghusbandii were analyzed by GC-MS for the first time. The third chapter is about the the isolations and identifications of the chemical constituents of M. interifolia. Eight compounds were isolated and identified as norsanguinarine (1), β-sitosterol (2), 3-hydroxyolean-12(13)-en-30-oic acid (3), 6-acetonyl-5,6-dihydrosanguinarine (4), luteolin (5), daucosterol (6), quercetin 3-O-β-D-glucopyranosyl-(1→6)-β-D-glucopyranoside (7) and protopine (8). The compounds 1, 4 and 7 were isolated from this herb for the first time. The last chapter is a review of the research progress of the studies on Corydalis species, which includes the chemical constituents in this genus and their pharmacology.

Sedentariness and physical inactivity in diabetes: a case for home-based exercise prescription

Increasing proportions of the global population are being diagnosed with diabetes. It is anticipated that by 2030, 10% of the adult population worldwide will be living with this condition. Lifestyle factors can impact on the development, management and progression of diabetes. Obesity and sedentary living are contributory factors to the increased volume of diabetes. Physical activity offers those living with diabetes the opportunities to keep well and attain potentially more stable blood glucose control reducing the level of medical intervention required and delaying or preventing some of the life-changing complications that can derive from a diabetes diagnosis. Exercise interventions are effective in preventing and treating type-II diabetes. However, maintaining regular exercise routines, especially home-based exercises may provide a key for sustaining the health benefits.

Inibidores da renina

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Inibidores do co-transportador renal de sódio-glicose 2

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Renal failure and the neural control of the kidney

Renal failure (RF) is associated with an over activation of the sympathetic nervous system. The aim of this thesis was to investigate the hypothesis that as the kidney progresses into RF there is an inappropriate and sustained activation of renal afferent nerves which results in a dysregulation of basal RSNA and reflexly controlled RSNA by the high and low pressure baroreceptors. Baroreflex gain curves for both RSNA and HR were generated in control and RF rats. This study clearly showed a blunted high-pressure baroreflex in RF rats, an impairment which was almost completely corrected by bilateral renal denervation. The integrity of the low-pressure cardiopulmonary receptors to inhibit RSNA was investigated using acute saline volume. Again, a blunted reflex sympatho-inhibition of RSNA was observed, which was corrected by renal denervation. Finally a functional study to examine how the renal excretory response to volume expansion differed in RF was carried out. This study revealed an impairment of the low-pressure baroreflex control of the sympathetic outflow. The result of these studies suggest that cisplatin induced RF initiates a neural signal from within the kidney, which over rides the normal reflex regulation of RSNA by the high and low – pressure baroreceptors and that this impairment in function can be normalised by renal denervation. This raises further questions as to the mechanisms involved in the afferent over activation arising from the diseased kidneys.

Safety profile of L-arginine infusion in moderately severe falciparum malaria.

BACKGROUND: L-arginine infusion improves endothelial function in malaria but its safety profile has not been described in detail. We assessed clinical symptoms, hemodynamic status and biochemical parameters before and after a single L-arginine infusion in adults with moderately severe malaria. METHODOLOGY AND FINDINGS: In an ascending dose study, adjunctive intravenous L-arginine hydrochloride was infused over 30 minutes in doses of 3 g, 6 g and 12 g to three separate groups of 10 adults hospitalized with moderately severe Plasmodium falciparum malaria in addition to standard quinine therapy. Symptoms, vital signs and selected biochemical measurements were assessed before, during, and for 24 hours after infusion. No new or worsening symptoms developed apart from mild discomfort at the intravenous cannula site in two patients. There was a dose-response relationship between increasing mg/kg dose and the maximum decrease in systolic (rho = 0.463; Spearman's, p = 0.02) and diastolic blood pressure (r = 0.42; Pearson's, p = 0.02), and with the maximum increment in blood potassium (r = 0.70, p<0.001) and maximum decrement in bicarbonate concentrations (r = 0.53, p = 0.003) and pH (r = 0.48, p = 0.007). At the highest dose (12 g), changes in blood pressure and electrolytes were not clinically significant, with a mean maximum decrease in mean arterial blood pressure of 6 mmHg (range: 0-11; p<0.001), mean maximal increase in potassium of 0.5 mmol/L (range 0.2-0.7 mmol/L; p<0.001), and mean maximal decrease in bicarbonate of 3 mEq/L (range 1-7; p<0.01) without a significant change in pH. There was no significant dose-response relationship with blood phosphate, lactate, anion gap and glucose concentrations. All patients had an uncomplicated clinical recovery. CONCLUSIONS/SIGNIFICANCE: Infusion of up to 12 g of intravenous L-arginine hydrochloride over 30 minutes is well tolerated in adults with moderately severe malaria, with no clinically important changes in hemodynamic or biochemical status. Trials of adjunctive L-arginine can be extended to phase 2 studies in severe malaria. TRIAL REGISTRATION: ClinicalTrials.gov NCT00147368.

Intake, digestibility, and passage of a commercially designed diet by two Propithecus species.

The digestibility and passage of an experimental diet was used to compare the digestive physiology of two Propithecus species: P. verreauxi and P. tattersalli. Though both animals have a similar feeding ecology, the captive status of P. verreauxi is considered more stable than that of P. tattersalli. The test diet included a local tree species, Rhus copallina, at 15% of dry matter intake (DMI) and Mazuri Leafeater Primate Diet at 85% of DMI. The chemical composition of the diet (dry matter basis) was 25% crude protein, 34% neutral detergent fiber (NDF), and 22% acid detergent fiber (ADF) with a gross energy of 4.52 kcal/g. After a 6 week acclimation to the experimental diet, animals were placed in research caging. After a 7 day adjustment period, animals were dosed with chromium mordant and Co-EDTA as markers for digesta passage and all feed refusals and feces were collected at timed intervals for 7 days. Digestibility values, similar for both species, were approximately 65% for dry matter, crude protein, and energy, and 40% and 35% respectively, for NDF and ADF. Transit times (17-18.5 hr) and mean retention times (31-34 hr) were not significantly different between species, and there was no difference between the chromium mordant and Co-EDTA. Serum values for glucose, urea, and non-esterified fatty acids (NEFA) were obtained during four different time periods to monitor nutritional status. While there was no change in serum glucose, serum urea increased over time. The NEFAs increased across all four time periods for P. verreauxi and increased for the first three periods then decreased in the last period for P. tattersalli. Results obtained indicate no difference in digestibility nor digesta passage between species, and that both Propithecus species were similar to other post-gastric folivores.

Magnetic Resonance Imaging Biomarkers of Renal Structure and Function

The kidney's major role in filtration depends on its high blood flow, concentrating mechanisms, and biochemical activation. The kidney's greatest strengths also lead to vulnerability for drug-induced nephrotoxicity and other renal injuries. The current standard to diagnose renal injuries is with a percutaneous renal biopsy, which can be biased and insufficient. In one particular case, biopsy of a kidney with renal cell carcinoma can actually initiate metastasis. Tools that are sensitive and specific to detect renal disease early are essential, especially noninvasive diagnostic imaging. While other imaging modalities (ultrasound and x-ray/CT) have their unique advantages and disadvantages, MRI has superb soft tissue contrast without ionizing radiation. More importantly, there is a richness of contrast mechanisms in MRI that has yet to be explored and applied to study renal disease.

The focus of this work is to advance preclinical imaging tools to study the structure and function of the renal system. Studies were conducted in normal and disease models to understand general renal physiology as well as pathophysiology. This dissertation is separated into two parts--the first is the identification of renal architecture with ex vivo MRI; the second is the characterization of renal dynamics and function with in vivo MRI. High resolution ex vivo imaging provided several opportunities including: 1) identification of fine renal structures, 2) implementation of different contrast mechanisms with several pulse sequences and reconstruction methods, 3) development of image-processing tools to extract regions and structures, and 4) understanding of the nephron structures that create MR contrast and that are important for renal physiology. The ex vivo studies allowed for understanding and translation to in vivo studies. While the structure of this dissertation is organized by individual projects, the goal is singular: to develop magnetic resonance imaging biomarkers for renal system.

The work presented here includes three ex vivo studies and two in vivo studies:

1) Magnetic resonance histology of age-related nephropathy in sprague dawley.

2) Quantitative susceptibility mapping of kidney inflammation and fibrosis in type 1 angiotensin receptor-deficient mice.

3) Susceptibility tensor imaging of the kidney and its microstructural underpinnings.

4) 4D MRI of renal function in the developing mouse.

5) 4D MRI of polycystic kidneys in rapamycin treated Glis3-deficient mice.

Implant healing in experimental animal models of diabetes.

Diabetes mellitus is becoming increasingly prevalent worldwide. Additionally, there is an increasing number of patients receiving implantable devices such as glucose sensors and orthopedic implants. Thus, it is likely that the number of diabetic patients receiving these devices will also increase. Even though implantable medical devices are considered biocompatible by the Food and Drug Administration, the adverse tissue healing that occurs adjacent to these foreign objects is a leading cause of their failure. This foreign body response leads to fibrosis, encapsulation of the device, and a reduction or cessation of device performance. A second adverse event is microbial infection of implanted devices, which can lead to persistent local and systemic infections and also exacerbates the fibrotic response. Nearly half of all nosocomial infections are associated with the presence of an indwelling medical device. Events associated with both the foreign body response and implant infection can necessitate device removal and may lead to amputation, which is associated with significant morbidity and cost. Diabetes mellitus is generally indicated as a risk factor for the infection of a variety of implants such as prosthetic joints, pacemakers, implantable cardioverter defibrillators, penile implants, and urinary catheters. Implant infection rates in diabetic patients vary depending upon the implant and the microorganism, however, for example, diabetes was found to be a significant variable associated with a nearly 7.2% infection rate for implantable cardioverter defibrillators by the microorganism Candida albicans. While research has elucidated many of the altered mechanisms of diabetic cutaneous wound healing, the internal healing adjacent to indwelling medical devices in a diabetic model has rarely been studied. Understanding this healing process is crucial to facilitating improved device design. The purpose of this article is to summarize the physiologic factors that influence wound healing and infection in diabetic patients, to review research concerning diabetes and biomedical implants and device infection, and to critically analyze which diabetic animal model might be advantageous for assessing internal healing adjacent to implanted devices.