Early commitment of cardiovascular autonomic modulation in Brazilian patients with congenital generalized lipodystrophy.

Background: Metabolic abnormalities in congenital generalized lipodystrophy (CGL) are associated with microvascular complications. However, the evaluation of different types of neuropathy in these patients, including the commitment of cardiovascular autonomic modulation, is scarce. The objective of the present study was to determine the prevalence of cardiovascular autonomic neuropathy (CAN) in patients with CGL compared with individuals with type 1 diabetes and healthy subjects.

Effects of non-supervised low intensity aerobic excise training on the microvascular endothelial function of patients with type 1 diabetes: a non-pharmacological interventional study.

Background: The aim of the present study was to evaluate changes in microvascular density and reactivity in patients with type 1 diabetes (T1D) resulting from low intensity chronic exercise training.

Methods: This study included 22 (34 ± 7 ears) consecutive outpatients with T1D and disease duration > 6 years. We used intravital video-microscopy to measure basal skin capillary density and capillary recruitment using post-occlusive reactive hyperemia (PORH) in the dorsum of the fingers.

Intravoxel Incoherent Motion Diffusion Weighted MR Imaging at 3.0 T: Assessment of Steatohepatitis and Fibrosis Compared with Liver Biopsy in Type 2 Diabetic Patients.

Objective: To evaluate the capability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) to assess steatohepatitis and fibrosis determined by histopathology in type 2 diabetic patients.

Methods: Fifty-nine type 2 diabetic patients (49 women, 10 men; mean age, 54 ± 9 years) were submitted to liver biopsy for the evaluation of non-alcoholic fatty liver disease (NAFLD) and underwent DWI on a 3.0T MR system using 10 b values.

Influence of a family history of type 2 diabetes, demographic and clinical data on carotid intima-media thickness in patients with type 1 diabetes: a cross-sectional study.

Background: Intima-media thickness (IMT) of the common carotid artery is a surrogate end point of cardiovascular disease (CVD). Identifying the factors associated with a higher IMT may contribute to the identification of subjects with higher CVD risk. Our objective was to compare the common carotid IMT of type 1 diabetes patients to healthy control subjects.

Reproducibility of methods used for the assessment of autonomous nervous system's function.

Objective: The objective of this study is to investigate the influence of the day-to-day variability of the measures of heart rate variability (HRV) on the sample size calculation for the study of cardiac autonomic neuropathy.

Material And Methods: We analyzed HRV in the frequency domain [very low (VLF), low (LF), and high frequency (HF) bands] and in the time domain [the root mean squared of successive RR intervals differences (RMSSD); the mean RR intervals (RRNN); the standard deviation of RR intervals (SDNN) and the coefficient of variation (CV)] during a 5-min electrocardiogram record. We also analyzed the heart rate response to deep breathing [expiration:inspiration ratio], to the Valsalva maneuver and to standing [maximum:minimum ratio] and the blood pressure response to standing.

Impact of diabetes on cardiovascular disease: an update.

Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction.

[Influence of dietary glycemic index on anthropometric and biochemical parameters in patients with type 1 diabetes].

Objective: To assess the influence of a non-pharmacological intervention, consisting of a diet low glycemic index (GI) for a period of six months on metabolic control and anthropometric parameters in patients with type 1 diabetes mellitus.

Subjects And Methods: Ninety-six type 1 diabetic patients underwent an anthropometric, biochemical and dietary assessment before and six months after the prescription of diet based on the glycemic index.

Results: After six months we observed a decrease in A1C levels (9,8 ± 2,26% vs.

Effect of the carbohydrate counting method on glycemic control in patients with type 1 diabetes.

Background: The importance of achieving and maintaining an appropriate metabolic control in patients with type 1 diabetes mellitus (DM1) has been established in many studies aiming to prevent the development of chronic complications. The carbohydrate counting method can be recommended as an additional tool in the nutritional treatment of diabetes, allowing patients with DM1 to have more flexible food choices. This study aimed to evaluate the influence of nutrition intervention and the use of multiple short-acting insulin according to the carbohydrate counting method on clinical and metabolic control in patients with DM1.

Insulin signaling pathways in a patient with insulin resistance of difficult management - a case report.

Insulin signalling pathways were investigated in a 33 year-old woman with immunologic insulin resistance. Her past medical history was remarkable for intermittent use of insulin and allergic reactions to several drugs, and measure of plasma anti-insulin antibodies level corroborated the clinical suspicion of immune mediated insulin resistance (8074 nU/ml - RIA - Ref value: <60). Treatment with several immunosuppressive regimens was tried, however the results were disappointing.

'Diabetology & Metabolic Syndrome: providing an open access future for diabetes research'.

Diabetology & Metabolic Syndrome (D&MS), the official journal of the Brazilian Diabetes Society (SBD), is a new open access, peer reviewed journal publishing research on all aspects of the pathophysiology of diabetes and metabolic syndrome. With the many ongoing and upcoming challenges for diabetes diagnosis, treatment and care, a dedicated journal providing unrestricted access for researchers and health care professionals working in the field of diabetes is needed. Diabetology & Metabolic Syndrome aims to fulfil this need.

[Reliability of the classification of nutritional status obtained through the BMI and three different methods of body fat percentage in patients with type 1 diabetes mellitus].

Objective: To assess the reliability of classification of nutritional status (NS) obtained through the body mass index (BMI) and three different methods of body composition (BC) in individuals type 1 diabetics (T1D) and non-diabetic subjects.

Methods: 84 patients with T1D and 37 controls were evaluated. Anthropometric data was collected to calculate BMI and assessment of BC was performed through the methods of skinfold thickness (SF), bipolar (BI) and tetrapolar (TT) bioelectrical impedance.

Serum platelet-activating factor acetylhydrolase activity: a novel potential inflammatory marker in type 1 diabetes.

Plasma activity of the platelet-activating factor acetylhydrolase (PAF-AH) plays an important role in inflammation and atherosclerotic process in chronic diseases. We aimed to evaluate the levels of PAF-AH activity and their association with the metabolic profile and chronic complications in patients with type 1 diabetes. The study included 118 outpatients (54 males) aged 27.

[Insulin resistance and secretion assessment across a range of glucose tolerance from normal individuals through diabetes].

Aim And Methods: Our main aim was to determine the association between clinical, demographical parameters and different insulin resistance and secretion indices in apparently healthy subjects, without previous knowledge of their own level of glucose tolerance. For that purpose, we evaluated 105 individuals from February to August 2003 by means of OGTT, aged 33.4+/-1.

[QTc interval and traditional risk factors to atherosclerotic disease in patients with type 1 diabetes].

To evaluate the QTc interval and its relation with clinical, laboratorial variables and LDL susceptibility to in vitro oxidation in patients with type 1 DM, we studied 40 diabetics and 33 non diabetics with 24.83 +/- 10.21 and 23.

Prevalence of Type 2 diabetic patients within the targets of care guidelines in daily clinical practice: a multi-center study in Brazil.

Major clinical studies have shown that the targets for blood glucose, lipid profile and blood pressure in type 2 diabetic patients are difficult to maintain in clinical practice. However, there are few data concerning South American populations. Using guidelines represented by the Brazilian Diabetes Society, we evaluated cardiovascular (CV) risk factors, glycemic control and the availability of screening for diabetes complications in 2233 (60% females) outpatients with type 2 diabetes aged 59.

Platelet-activating factor acetylhydrolase (PAF-AH) activity in patients with type 1 diabetes mellitus.

Objective: To evaluate platelet-activating factor acetylhydrolase (PAF-AH) activity and its relationship with clinical and demographic variables, metabolic control, apolipoprotein A and B levels and the susceptibility of low-density lipoprotein (LDL) to in vitro oxidation in patients with type 1 diabetes mellitus (DM 1).

Methods: Forty two patients with DM 1 (27 females) and 48 control subjects (16 females) matched for gender, age and body mass index (BMI) were evaluated. The following tests were performed: fast plasma glucose (FG) and postprandial plasma glucose (PPG), lipid profile, uric acid (UA), glycosylated hemoglobin (HbA1c), and low-density lipoprotein (LDL) oxidation rate using colorimetric assay.

[Evaluation of microalbuminuria in non-diabetic individuals].

Aim: To evaluate the presence of microalbuminuria in non-diabetic subjects, associating it to the presence of cardiovascular risk factors like hypertension, smoking, dislipidemia and obesity. The urinary albumin excretion rate (UAE) was also evaluated regarding to insulin secretion and resistance indices.

Design And Methods: 105 subjects aged 33.

[Anthropometric parameters and metabolic syndrome in type 2 diabetes].

To evaluate the value of body mass index (BMI) as predictor of waist circumference of cardiovascular risk (CRWC) and diagnostic of metabolic syndrome (MSWC) in patients with type 2 diabetes mellitus (DM 2), we assessed BMI and WC in 753 patients with DM 2 (472 women) with 23 +/- 8 years. The participants had been divided in groups in accordance with the presence or absence of ACCR or ACMS. The best BMI cut-off to predict such disturbances was evaluated in women and men.

[Glitazones and the metabolic syndrome: mechanism of action, pathophysiology and therapeutic indications].

Diabetes mellitus (DM) is considered a major public health problem in both developed and developing countries due to its chronic complications, at the macro or microcirculation, with great impact on mortality and morbidity in all patients. The disease is considered the end of a pathophysiologic process involving peripheral and hepatic insulin resistance and reduced insulin secretion that have been started years before the clinical diagnosis. Metabolic syndrome (MS) is a disorder that results from the increasing prevalence of obesity worldwide.

[Nationwide multicenter study on the prevalence of overweight and obesity in type 2 diabetes mellitus in the Brazilian population].

Aim: To evaluate the prevalence of overweight and obesity in type 2 diabetic (DM2) outpatients from different regions of Brazil.

Patients And Methods: We studied 2,519 randomly selected patients, from 11 hospitals, 2 endocrine and one general public care clinics from 10 cities. Overweight was defined as body-mass index (BMI) > 25 and obesity as BMI > 30 kg/m2.

[Lipid profile and anthropometrical evaluation in type 1 diabetes].

Intensive insulin therapy in patients with type 1 diabetes is resulting in a better clinic and metabolic control. On the other hand, an increase in overweight and obesity prevalence, which could contribute to a higher risk of cardiovascular disease, has been observed. The aim of our study is to analyze the demographics, clinical and laboratorial factors associated to the presence of dyslipidemia in a group of patients with type 1 diabetes compared to a non-diabetic population.

[Effects of metformin on endothelial dysfunction of the renal circulation resulting from acute hyperglycemia in non-diabetic rabbits].

Objective: To assess the effects of metformin (Met) on the endothelial dysfunction of the renal circulation of non-diabetic rabbits acutely induced by levels of glucose usually observed in diabetic patients in daily clinical practice.

Methods: Isolated perfused kidneys from non-diabetic rabbits were exposed for 3 h to normal (100 mg/dl--control group) or high (270 mg/dl) D-glucose with or without Met (100 microM). The glucose levels used correspond to 2 h post-breakfast median values (272 mg/dl) obtained from a cohort of 780 type 2 diabetic (DM2) outpatients seen in our service.

[Body adiposity and its influence on clinical and metabolic parameters of patients with type 1 diabetes].

We evaluated the influence of body adiposity (BA), which was measured by bioelectrical impedance, body mass index (BMI) and waist circumference (WC), in clinical and laboratorial parameters of 64 patients with type 1 diabetes (DM1), 33 females, matched for diabetes duration. Women had greater BA than men. Fourteen patients were overweight.