760 resultados para Typ 2-diabetes


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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CONTEXTO E OBJETIVO:Gestações complicadas pelo diabetes estão associadas com aumento das complicações neonatais e maternas. A complicação mais grave materna é o risco de desenvolver diabetes tipo 2 após 10-12 anos do parto. Para o controle rigoroso da glicose no sangue, as mulheres grávidas são tratadas de forma ambulatorial ou com internações hospitalares. O objetivo deste estudo é avaliar a efetividade do tratamento ambulatorial versus hospitalização em gestações complicadas por diabetes ou hiperglicemia.TIPO DE ESTUDO E LOCAL:Revisão sistemática conduzida em hospital universitário público.MÉTODOS:Uma revisão sistemática da literatura foi realizada e as principais bases de dados eletrônicas foram pesquisadas. A data da pesquisa mais recente foi 4 de setembro de 2011. Dois autores selecionaram independentemente os ensaios clínicos relevantes, avaliaram a qualidade metodológica e extraíram os dados.RESULTADOS:Apenas três estudos foram selecionados, com tamanho de amostra pequeno. Não houve diferença estatisticamente significativa entre o tratamento ambulatorial versus hospitalização em relação à mortalidade em nenhuma das subcategorias analisadas: mortes perinatais e neonatais, (risco relativo [RR] 0,65; 95% de intervalo de confiança [IC] 0,11-3,84, P = 0,63); morte neonatal (RR 0,29, IC 95% 0,01-6,07, P = 0,43), e óbitos infantis (RR 0,29, IC 95% 0,01-6,07, P = 0,43).CONCLUSÕES:Com base em estudos com risco de viés alto ou moderado, esta revisão demonstrou que não há diferença estatisticamente significante entre o tratamento ambulatorial comparado com o hospitalar na redução das taxas de mortalidade em gestações complicadas por diabetes ou hiperglicemia. Esta revisão sistemática também sugere a necessidade de mais ensaios clínicos randomizados sobre o assunto.

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

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The main function of the immune system is the defense against infection, being composed by the leukocytes that modulate the immune response, which can be innate or adaptive. The physical exercise can causes positive or negative alterations in the total or relative number of leukocytes. When the exercise has a low or moderate intensity it`s considered beneficial for improving the function of the cells responsible for the defense and to reduce the risk of infectious illnesses. The type 2 diabetes is related to an incapacity of the body in rightly respond to insulin, associated to an resistance to its actions. The purpose of this research was to make a study of the immune system characteristics, as well as the type 2 diabetes and the relation among both and the physical exercise. So, it was analyzed a group of type 2 diabetics coming from Diabetics House of Franca -SP, treated through a program of mix physical training. Two collections of blood were pre and post training program for the pair comparable of the participants. It was found positive alterations of the subpopulations of leukocytes that show a probable improvement of the immunological state what allows us to suggest about a possible improvement of the immunological activity, what would be measured by the activation of these cells forward to an inflammatory/infectious condition. So, we suggest that future studies involving diabetes, immune system and physical exercise be encouraged.

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Alterations in maternal metabolism are important in order to supply the demands of the fetus. However, pregnant women with some degree of insulin resistance, such as in cases of overweight/obesity, central obesity and polycystic ovaries syndrome, associated to the action of anti-insulin placental hormones, contribute to a case of hyperglycemia of varied intensity, characterizing gestational diabetes mellitus (GDM) and leading to adverse effects both maternal and fetal. At the absence of a universal consensus to the tracking and diagnosis of GDM, this review had the purpose of listing the various protocols that have been proposed, as well as highlighting the risk factors associated with GDM and its complications. The most recent protocol is the one from the American Diabetes Association, with changes that would be justified by the alarming raise in worldwide obesity and, consequently, the potential increase to the occurrence of type 2 diabetes mellitus, not always diagnosed before the gestational period. The intention of this protocol is to identify the gestating women that could benefit from hyperglycemia control, improving the prognostic of these pregnancies and preventing future complications for mothers and their children.

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The objective of this update was to perform an evaluation of articles published in recent years about the Arg972 polymorphism of IRS-1 gene and its role in diabetes. It was used the database site of National Center of Biotechnology Information (NCBI - PUB- -MED). For search of articles the terms “polymorphisms on IRS-1 and diabetes” were used. Approximately 54% of the articles found were related to the polymorphism of interest and of these, approximately 68% the polymorphism was linked to various forms of diabetes. The Arg972 polymorphism is associated with decreased insulin synthesis and secretion with reduced stimulation of the activity of insulin pathway PI3K, MAPK and thymidine incorporation. It more frequently in patients with type 2 diabetes and gestational diabetes, showing a direct connection with the status of obesity and insulin resistance.

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Lifestyle is directly related to the incidence of type 2 diabetes mellitus (DM-2), a risk dramatically elevated by obesity and inactivity. Several studies have verified that educational interventions can delay the onset of DM-2. Some of the interventions strategies utilized medication and diet, diet and/or physical exercise or the combination of diet and exercise, generally referred to a change in lifestyle. Despite the evidence that DM-2 can be preventive, there is still limited availability of effective prevention programs. DM-2 is considered an emerging public health problem as it is estimated that by the year of 2030 there will be about 366 million people with diabetes worldwide. DM2 remains a leading cause of cardiovascular disorders and many other complications. Our intent with this paper is to present researches and strategies (diet and physical activity interventions) that successfully improved plasma glucose control as a result of an effective lifestyle intervention program.

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Objective: To analyze drug prescriptions for insulin and oral antidiabetic drugs in type 1 and type 2 diabetes mellitus patients seen in the Brazilian Public Healthcare System (Unified Health System - SUS) in Ribeirao Preto, SP, Brazil. Subjects and methods: All the patients with diabetes seen in the SUS in the western district of Ribeirao Preto, SP, Brazil between March/2006 and February/2007 were included in the study. Results: A total of 3,982 patients were identified. Mean age of the patients was 60.6 years, and 61.0% were females. Sixty percent of the patients were treated with monotherapy. Doses of oral antidiabetic drugs were lower in monotherapy than in polytherapy. Ten patients received doses of glibenclamide or metformin above the recommended maximum doses, and in elderly patients there was no reduction in drug doses. Conclusion: Monotherapy with oral antidiabetic drugs was the predominant procedure, and the doses were not individualized according to age. Arq Bras Endocrinol Metab. 2012;56(2):120-7