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1
Grou, Isabel Maria Lampreia. „Diabetes mellitus em canídeos“. Bachelor's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2008. http://hdl.handle.net/10400.5/900.
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Dissertação de Mestrado Integrado em Medicina VeterináriaA diabetes mellitus é uma insuficiência absoluta ou relativa de insulina que resulta da deficiente secreção desta por parte das células pancreáticas ou da oposição à acção da insulina. A diabetes é uma das endocrinopatias mais frequentes no cão. Quando é diagnosticado com diabetes mellitus, o animal pode encontrar-se num estado dependente de administração exógena de insulina de insulina, em que as células já não produzem insulina, ou num estado de não dependente de insulina, em que as células ainda possuem alguma função residual. No cão, a diabetes mellitus dependente de insulina é uma patologia multifactorial. Alguns dos factores implicados na etiologia da doença são: predisposição genética, infecção, patologia que provoque antagonismo à insulina, fármacos, obesidade, insulite imunomediada e pancreatite. Todos os factores referidos desempenham um papel que culmina na perda de função das células , hipoinsulinemia, deficiência no transporte da glucose para o interior das células e aceleração do processo de gluconeogénese hepática e glicogenólise. A insuficiência em insulina provoca a diminuição da utilização da glucose, levando a hiperglicemia. A glucose, como é uma molécula pequena, é filtrada pelo glomérulo renal; quando a capacidade de reabsorção de glucose das células dos túbulos renais a partir do filtrado glomerular é excedida, ocorre glicosúria. A glicosúria provoca diurese osmótica, que leva a polidipsia. Como a entrada da glucose nas células do centro da saciedade é mediada pela insulina, o centro da saciedade não inibe o centro da alimentação. Os quatro sinais clássicos de diabetes são então poliúria, polidipsia, polifagia e perda de peso. O principal objectivo da terapêutica instituída é eliminar os sinais clínicos observados pelo dono, o que pode ser conseguido com uma administração ponderada de insulina, dieta, exercício e com a prevenção ou controlo de doenças inflamatórias, infecciosas, neoplásicas e endócrinas. As complicações mais frequentes são cegueira devido à formação de cataratas, pancreatite crónica e infecções recorrentes do tracto urinário, das vias respiratórias e da pele. Os animais diabéticos têm ainda o risco de desenvolver hipoglicemia e cetoacidose. A cetoacidose diabética é consequência da diabetes que resulta em formação de corpos cetónicos no fígado, em acidose metabólica, desidratação severa, choque e possivelmente morte. A maior parte dos cães diabéticos vive menos de 5 anos após o diagnóstico, sendo que os primeiros seis meses são decisivos para o controlo da doença. Com cuidados apropriados por parte dos donos, avaliações regulares por parte do veterinário e uma boa comunicação entre o cliente e o médico veterinário, muitos animais diabéticos podem levar vidas relativamente normais durante vários anos.
ABSTRACT - Diabetes mellitus, which is a very common endocrinopathy in the dog, is an absolute or relative insufficiency in the production of insulin by the pancreatic cells or an impaired sensitivity to the hormone or both. When diagnosed with diabetes mellitus some animal may need insulin therapy immediately, for their cells produce no insulin - insulin dependent diabetes mellitus, and some others may have a slower loss of function of cells - non-insulin dependent diabetes mellitus. The etiology of insulin dependent diabetes mellitus in the dog is multifactorial, being related to genetic susceptibility, infections, insulin resistance inducing disease, drugs, obesity, immune mediated insulitis and pancreatitis. All these factors lead to the functional loss of pancreatic cells, impaired transport of glucose into cells and enhancing the hepatic gluconeogenesis and glycogenolisis. The classic clinical signs of diabetes mellitus are polyuria, polydipsia, polyphagia and weight loss. The insulin deficiency leads to a decrease in glucose use and sequent hyperglycemia. Being a small molecule, glucose is filtrated in the renal glomérulos; when the ability of reabsorbing glucose of the tubular cells is overwhelmed, glycosuria occurs. Glycosuria leads to osmotic diuresis, which in turn leads to polydipsia. To enter the satiety center cells, glucose needs insulin. Without it, the satiety center never inhibits the hunger center. The treatment of diabetes aims to control the clinical signs described, and that con be achieved with insulin therapy, diet, exercise and prophylaxis and control of infectious, inflammatory, neoplastic or endocrine diseases. The most frequent consequences of diabetes mellitus in dogs are blindness as a consequence of diabetic cataracts, chronic pancreatitis and urinary tract, skin and upper respiratory tract infections. Diabetic dogs have an increased risk of developing hypoglycemia and ketoacidosis. Ketoacidosis leads to hepatic production of ketone bodies, metabolic acidosis, severe dehydration and even death. Most diabetic dogs live up to 5 years after they are diagnosed, the six first months being the most important ones. With proper care from the owner, regular reevaluations with the veterinarian and good communication between veterinarian and owner, the diabetic dog can have an ordinary life for several years.
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Nordwall, Maria. „Long term complications in juvenile diabetes mellitus“. Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-6377.
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Beales, Philip Edward. „Diabetes prevention in the non-obese diabetic mouse“. Thesis, University of East London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265059.
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Clifford, Rhonda Marise. „Pharmaceutical care in diabetes mellitus“. Curtin University of Technology, School of Pharmacy, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=14951.
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People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention programs to decrease this risk. In addition to tertiary care for patients with diabetes, there is a need for simple programs to be implemented in the community that allow the benefits of improved metabolic and blood pressure control to be realised more widely. Pharmaceutical care comprises the detection, prevention and solution of drug-related problems in a quantifiable form, so that outcomes of care can be easily reviewed and monitored. Previous studies of pharmaceutical care programs in patients with diabetes do not provide conclusive evidence of the benefit of pharmaceutical care. The aim of this research was to evaluate the impact of the provision of pharmaceutical care to patients with diabetes mellitus in an Australian context. In order to develop a pharmaceutical care program, the characteristics of an Australian cohort of patients with diabetes were reviewed. The Fremantle Diabetes Study (FDS), was a community-based prospective observational study of diabetes care, control and complications in a postcode-defined region of 120 097 people surrounding the port city of Fremantle in Western Australia. It was intended that the FDS annual reviews would provide important local information in order to design and implement a prospective pharmaceutical care program. A pilot pharmaceutical care program was subsequently developed for use in a diabetes outpatient clinic. This program was then modified for use in a community-based sample of type 2 diabetes mellitus patients, drawn from the FDS cohort.Demographic parameters, including ethnicity and treatment details, were reviewed at study entry for the full FDS cohort and then over time for a subset of patients that returned for four subsequent annual assessments. Insulin use was more common in patients of Southern European origin compared with the Anglo-Celt group irrespective of the level of glycaemia, at baseline. This difference persisted during subsequent follow-up but was not associated with improved glycaemic control. These findings demonstrated that there are important ethnic differences in the management of patients with type 2 diabetes mellitus. The pilot pharmaceutical care program was carried out in high-risk diabetes mellitus patients attending a hospital outpatient clinic. The patients had poor glycaemic control, dyslipidaemia, hypertension and/or were on three or more prescription medications. In the pharmaceutical care arm, a clinical pharmacist reviewed and monitored all aspects of the patients' drug therapy in collaboration with other health care professionals at six weekly intervals for six months. The control patients received usual outpatient care. Seventy-three patients were recruited into the study, of whom 48 (66%) were randomised to receive pharmaceutical care. One in six patients was taking complementary medicines. The pharmaceutical care program provided patients with important medication information that resulted in changes to drug therapy. However, the six-month program did not lead to an improvement in glycaemic control. The next phase of the study adapted the pilot hospital-based pharmaceutical care program to a community-based setting.
Two hundred and two type 2 diabetes mellitus FDS patients were recruited, of whom 101 (50%) were randomised to the pharmaceutical care program, and all were followed for 12-months. There were significant reductions in risk factors associated with coronary heart disease in the case but not the control group over time, specifically glycaemic control, lipid levels, and blood pressure. Glycosylated haemoglobin fell from 7.5% to 7.0% (P<0.0001), total cholesterol fell from 5 mmol/L to 4.6 mmol/L (P<0.0001), systolic blood pressure fell from 158 mmHg to 143 mmHg (P<0.0001) and diastolic blood pressure fell from 77mmHg to 71mmHg (P<0.0001). Multiple linear regression analysis confirmed that pharmaceutical care program involvement was an independent predictor of benefit after adjustment for key variables. The 10-year coronary heart disease risk for patients without a previous coronary event was reduced by 4.6% over the 12-month study period in the pharmaceutical care group (P<0.0001), while there was no change in the controls (P=0.23). This phase of the study showed that medium-term individualised pharmaceutical care reduced vascular risk factors in a community-based cohort of patients with diabetes and that provision of a multifactorial intervention can improve health outcomes in type 2 diabetes mellitus. As part of the pharmaceutical care program, a high level of complementary medicine use was found. As a result, a study of complementary medicine use was undertaken in 351 patients from the FDS. A convenience sample of FDS patients was interviewed regarding their use of complementary medicines. A literature search was conducted to assess the potential impact of these medicines on diabetes, concomitant medications or diabetes-related co-morbidities.
Eighty-three of 351 (23.6%) patients with diabetes had consumed at least one complementary medicine in the previous year and 42% (77/183) of the products potentially necessitated additional patient monitoring or could be considered potentially inappropriate for a diabetic patient. The data indicated the need for patient disclosure of complementary medicine use and adequate monitoring for complementary medicine-related adverse events, as part of the pharmaceutical care process. The pharmaceutical care model was established to provide a framework by which drug use could be improved to enhance patients' clinical and health-related quality of life outcomes. For the present study, a straightforward pharmaceutical care program was adapted from a hospital setting to a community setting, where the principal requirement was a clinical pharmacist who had completed a self-directed diabetes-training program. In this context, clinically relevant parameters improved over the course of the study period. Pharmaceutical care programs such as this can begin the process of translating the findings of large and expensive clinical trials into standard clinical practice.
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Sels, Jean-Pierre Joseph Emile. „Dietary fibre and diabetes mellitus“. Maastricht : Maastricht : Datawyse ; University Library, Maastricht University [Host], 1991. http://arno.unimaas.nl/show.cgi?fid=5618.
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Chan, Juliana Chung Ngor. „Diabetes mellitus in Hong Kong“. Thesis, University of Liverpool, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246160.
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Talwar, D. „Glucosylated haemoglobin and diabetes mellitus“. Thesis, University of Strathclyde, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.371982.
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Lutgers, Helen Lucia. „Skin autofluorescence in diabetes mellitus“. [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2008. http://irs.ub.rug.nl/ppn/.
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Pinto, Mariana de Carvalho [UNESP]. „Parâmetros Neuropáticos no Diabetes Mellitus“. Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/123212.
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000823511.pdf: 283504 bytes, checksum: 38d7295662309f22f82f5bf9f3013361 (MD5)A neuropatia diabética é caracterizada por uma síndrome clínica ou sub -clínica que afeta o sistema nervoso central e periférico, incluindo o autonômico. Frente ao crescente número de novos casos de diabetes mellitus e a elevada incidência de manifestações crônico - degenerativas, como a neuropatia periférica e a neuropatia autonômica cardiovascular, este estudo objetivou: a) fazer uma comparação da variabilidade cardíaca (VC), em indivíduos com diabetes mellitus tipo 2 com confirmação de neuropatia diabética periférica, e indivíduos saudáveis.; b) identificar o risco de queda através de um teste de mobilidade fun cional em não diabéticos, diabéticos neuropatas e diabéticos neuropata -vasculopatas. Para tanto, no primeiro estudo participaram 108 indivíduos divididos em grupo controle (GC) (n=34) e grupo diabético neuropata (GDN) (n=74). Inicialmente, foram reali zados testes para confirmação da neuropatia. Em seguida, a avaliação da atividade do sistema nervoso autônomo (SNA) foi realizada por meio da VC com o auxílio do software Nerve -Express® (Heart Rhythm Instruments, Metuchen, NJ, EUA). Já o segundo estudo, foi composto por 61 sujeitos de ambos os gêneros divididos em GC (n=32), GDN (n=18) e grupo diabético neuropata vasculopata (GDNV) (12)...
Diabetic neuropathy is characterized by clinical or sub -clinical syndrome that affects the central and peripheral nervous system including the autonomic. Tackle the growing number of 17 new cases of diabetes mellitus and the high incidence of chronic degenerative disorders, such as peripheral neuropathy and cardiovascular autonomic neuropathy, this study aimed to: a) make a comparison of heart rate variability (CV), in individuals with diabetes mellitus type 2 with confirmation of diabetic peripheral neuropathy, and healthy individuals .; b) identify the risk of falling through a functional mobility test in non -diabetic, diabetic neuropathy and diabetic neuropathy-vasculopathies. Therefore, in the first s tudy participated 108 individuals divided into a control group (CG) (n = 34) and diabetic neuropathy group (GDN) (n = 74). Initially, to confirm the neuropathy tests were performed. Then, the evaluation of the activity of the autonomic nervous system (ANS) was performed by the VC with the help of Nerve - Express® software (Heart Rhythm Instruments, Metuchen, NJ, USA). The second study consisted of 61 subjects of both genders divided into GC (n = 32), GDN (n = 18) and diabetic neuropathy vasculopata group (GDNV) (12)...
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Pinto, Mariana de Carvalho. „Parâmetros Neuropáticos no Diabetes Mellitus /“. Presidente Prudente, 2014. http://hdl.handle.net/11449/123212.
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Orientador: Cristina Elena Prado Teles FregonesiBanca: Roselene Modolo Regueiro Lorençoni
Banca: Marli Aparecida Defani
Resumo: A neuropatia diabética é caracterizada por uma síndrome clínica ou sub -clínica que afeta o sistema nervoso central e periférico, incluindo o autonômico. Frente ao crescente número de novos casos de diabetes mellitus e a elevada incidência de manifestações crônico - degenerativas, como a neuropatia periférica e a neuropatia autonômica cardiovascular, este estudo objetivou: a) fazer uma comparação da variabilidade cardíaca (VC), em indivíduos com diabetes mellitus tipo 2 com confirmação de neuropatia diabética periférica, e indivíduos saudáveis.; b) identificar o risco de queda através de um teste de mobilidade fun cional em não diabéticos, diabéticos neuropatas e diabéticos neuropata -vasculopatas. Para tanto, no primeiro estudo participaram 108 indivíduos divididos em grupo controle (GC) (n=34) e grupo diabético neuropata (GDN) (n=74). Inicialmente, foram reali zados testes para confirmação da neuropatia. Em seguida, a avaliação da atividade do sistema nervoso autônomo (SNA) foi realizada por meio da VC com o auxílio do software Nerve -Express® (Heart Rhythm Instruments, Metuchen, NJ, EUA). Já o segundo estudo, foi composto por 61 sujeitos de ambos os gêneros divididos em GC (n=32), GDN (n=18) e grupo diabético neuropata vasculopata (GDNV) (12)...
Abstract: Diabetic neuropathy is characterized by clinical or sub -clinical syndrome that affects the central and peripheral nervous system including the autonomic. Tackle the growing number of 17 new cases of diabetes mellitus and the high incidence of chronic degenerative disorders, such as peripheral neuropathy and cardiovascular autonomic neuropathy, this study aimed to: a) make a comparison of heart rate variability (CV), in individuals with diabetes mellitus type 2 with confirmation of diabetic peripheral neuropathy, and healthy individuals .; b) identify the risk of falling through a functional mobility test in non -diabetic, diabetic neuropathy and diabetic neuropathy-vasculopathies. Therefore, in the first s tudy participated 108 individuals divided into a control group (CG) (n = 34) and diabetic neuropathy group (GDN) (n = 74). Initially, to confirm the neuropathy tests were performed. Then, the evaluation of the activity of the autonomic nervous system (ANS) was performed by the VC with the help of Nerve - Express® software (Heart Rhythm Instruments, Metuchen, NJ, USA). The second study consisted of 61 subjects of both genders divided into GC (n = 32), GDN (n = 18) and diabetic neuropathy vasculopata group (GDNV) (12)...
Mestre
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Coimbra, Eva Cristina Alves de Sá. „Doença periodontal e Diabetes Mellitus“. Bachelor's thesis, [s.n.], 2009. http://hdl.handle.net/10284/1210.
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Monografia apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Medicina DentáriaO objectivo deste trabalho foi avaliar, através da literatura, as possíveis associações entre diabetes e doença periodontal. A expressão “doença periodontal” é usada para designar, um conjunto de manifestações patológicas que afectam as estruturas de suporte dos dentes e caracteriza-se clinicamente por sintomas e sinais como inflamação, bolsas de profundidade variável à sondagem, perda de inserção, recessão gengival e mobilidade dentária. Estudos epidemiológicos permitiram identificar múltiplos factores de risco para a doença periodontal, entre os quais se incluem bactérias, nível baixo de higiene oral, envelhecimento, tabagismo, factores genéticos e certas doenças ou afecções sistémicas, designadamente a diabetes. A associação de diabetes mellitus com a doença periodontal foi amplamente investigada nos últimos anos. As evidências sugerem que a diabetes e a doença periodontal se relacionam por duas vias: a infecção periodontal crónica aumenta a gravidade da diabetes e complica o controlo metabólico e a diabetes diminui a resposta do hospedeiro à infecção periodontal. Considerando esta relação entre as duas patologias, os diabéticos devem ser objecto de cuidados especiais no âmbito da Medicina Oral e, particularmente quanto aos cuidados preventivos de saúde periodontal. The objective of the present work is to do a literature review these problable interrelationships between diabetes and periodontal disease. Periodontal disease is a generic expression used to name a variety of periodontium pathological manifestations that affect the tooth functional support structures and is characterized by inflammatory signs, periodontal pockets, epithelical adherence loss, gingival recession, and tooth mobility. Epidemiological studies identified multiple risk factors for the periodontal illness, including bacteria, low level of oral hygiene, genetic factors, aging, tobacco use, gender, socio-economic status and certain systemic conditions like diabetes mellitus. The association between diabetes mellitus and periodontal disease has been widely investigated in the last two decades. Scientific evidence suggests that there´s a two-way relationship between diabetes mellitus and periodontitis, in one way diabetes increase infection susceptibility and in reverse way periodontal chronic infection severity and makes metabolic control more difficult. Considering the relationship between these two pathologies, diabetic patients should be object of special oral care and keep a good periodontal health.
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Nilsson, Patrik. „Pancreastransplantation, öcellstransplantation och diabetes mellitus“. Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-95950.
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Sammanfattning Diabetes mellitus karakteriseras av högt blodsocker och är ett samlingsnamn för olika diabetessjukdomar där typ 1-diabetes och typ 2-diabetes är de vanligaste sjukdomarna. Kroppens blodglukoshalter regleras av hormonet insulin som är ett nödvändigt hormon för att kroppens celler ska kunna ta upp kolhydrater, aminosyror och fett. Vid typ 1-diabetes förstörs bukspottkörtelns insulinproducerande betaceller av kroppens eget immunförsvar. Viktiga transplantationsmetoder för att återställa bukspottkörtelns endokrina funktion är pancreas- och öcellstransplantation som båda resulterat i främst minskade akuta hypoglykemier men även förbättrade blodsockervärden och insulinfrihet. Pancreastransplantation är en mer riskfylld operation jämfört med öcellstransplantation och studier har visat på mer postoperativa komplikationer men längre och högre insulinfrihet hos patienter som genomgått pancreastransplantation. Tanken utvecklades till att jämföra litteratur som behandlar studier som jämför pancreas- och öcellstransplantation hos diabetiker avseende komplikationer, glukoskontroll och insulinfrihet. Syftet med arbetet var att göra en jämförelse mellan litteratur som behandlar pancreastransplantation respektive öcellstransplantation hos patienter med diabetes mellitus för att utröna vilken behandling som ger minst komplikationer och behov av insulinbehandling efter transplantation och en uppföljningstid på minst 1 år. Litteraturstudien baseras på 6 kohortstudier som alla erhölls via databasen PubMed. Studierna är utförda i Schweiz, USA, Tjeckien, Kanada och utgår från i grunden samma frågeställning men har delvis olika patienturval och metoder. Studie 2 och studie 5 har betydligt högre studiepopulation än övriga studier vilket ger högre bevisvärde för resultatet i dessa studier. Resultatsammanställningen visar att på både kort och lång sikt är komplikationsrisken betydligt större hos patienter efter pancreastransplantation jämfört med öcellstransplantation. Allvarliga, omedvetna hypoglykemier, som är livshotande tillstånd, är ovanliga hos patienter efter båda typerna av transplantation. På både kort och lång sikt visar pancreastransplanterade patienter betydligt lägre HbA1c-värden och betydligt högre C-peptidvärden jämfört med öcellstransplanterade patienter. Resultatet visar, i linje med tidigare resultat, att insulinfriheten består hos fler pacreastransplanterade patienter och under längre tid jämfört med öcellstransplanterade patienter. Efter 5 år är >50% av pancreastransplanterade patienter insulinfria medan motsvarande siffra hos öcellstransplanterade patienter är <10%.För att besvara syftet har litteraturstudien visat att vid jämförelse mellan litteratur som behandlar pancreastransplantation respektive öcellstransplantation hos patienter med diabetes mellitus ger öcellstransplantation minst akuta komplikationer men pancreastransplantation högst insulinfrihet, minst behov av insulinbehandling, efter transplantation och en uppföljningstid på minst ett år.Abstract Diabetes mellitus is characterized by hyperglycemia and is a collective name for different diabetic diseases. Type 1 diabetes and type 2 diabetes are the most common diseases. Insulin, which is the regulatory hormone for the body`s blood glucose levels, is necessary for the body`s cells to be able to absorb nutrition like carbohydrates, amino acids and fat. In type 1 diabetes the pancreas insulin-producing beta cells are destroyed by the body`s own immune system. Important transplantation methods to restore pancreatic endocrine function are whole pancreas transplantation and islet transplantation. Both methods of transplantation mainly decreased acute hypoglycaemia and improved blood sugar levels and insulin therapy. Pancreas transplantation is a more risky operation compared to islet transplantation. Patients who have gone through pancreatic transplantation in general have shown more postoperative complications but at the same time also longer periods without insulin therapy compared to patients who have gone through islet transplantation. The aim of this study was to make a comparison between literature dealing with pancreatic transplantation and islet transplantation regarding complications, glucose control and insulin requirements with a follow-up time of at least 1 year. The literature study is based on 6 cohort studies, all obtained through the PubMed database. The studies were conducted in Switzerland, USA, Czech Republic, Canada and are basically based on the same question but have partly different patient selection and methods. Study 2 and study 5 have a significantly higher study population than other studies, which gives higher evidence of the results of these studies. The results compilation shows that in both the short and the long term, the risk of complications is significantly greater in patients after pancreatic transplantation compared to islet transplantation. In both the short and long term, pancreatic transplant patients show significantly lower HbA1c values and significantly higher C-peptide values compared to islet transplant patients. Severe unconscious hypoglycaemia is a life-threatening condition. However, severe unconscious hypoglycaemia is uncommon in patients after both types of transplantation. The result shows, in line with previous results, that insulin freedom persists in higher number of pancreatic transplant patients and for longer period of time compared to islet transplant patients. After 5 years >50% of pancreatic transplant patients are insulin free while the corresponding number in islet transplant patients is <10%. In summary, data presented in this literature study show that islet transplantation give less acute complications, but that whole pancreas transplantation results in better glucose control for a longer time period.
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Khin, May Oo. „Metformin in gestational diabetes mellitus“. Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/77511/.
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Gestational diabetes mellitus (GDM) can affect up to 1 in 5 of pregnancies and is associated with adverse pregnancy outcomes including pre-eclampsia, neonatal hypoglycaemia, large for gestational age, increased adiposity and birth trauma. Good glycaemic control is the key to reduce these outcomes. Diet and lifestyle modification followed by insulin as necessary is the conventional type of management. Metformin is increasingly used in pregancy but with limited evidence, its role in GDM has not been well-established. A systematic review including both randomized and non-randomized controlled studies have been conducted to evaluate the contemporary evidence of metformin in GDM. It is suggested that metformin in GDM could be a useful alternative to insulin and is regarded as the best oral anti-hyperglycaemic agent in GDM management currently. However, almost half of metformin-treated GDM patients required supplementary insulin to achieve target glucose levels (metformin failure). Women with higher metabolic risk factors are likely to develop metformin failure. A clinical cohort of metformin-treated GDM is used to develop the predictive model to identify GDM women who are at risk of metformin failure. It has been found that women identified by new IADPSG and NICE 2015 fasting criteria are highly likely to develop metformin failure. It has also been established a number of algorithm based on various baseline characters of GDM women which will help primary healthcare physicians choose the best medication for GDM management. One of the possible side-effects of metformin includes lowering of serum vitamin B12 levels whereas serum vitamin B12 deficiency during pregnancy which is associated with increased insulin resistance. It is reported that in low vitamin B12 state, offspring’s insulin resistance is found to be higher among women with high folate low B12 state. Hence, in order to fully appreciate the role of vitamin B12 deficiency in metformin failure, it is first necessary to understand the effects of folate in low vitamin B12 condition on pregnancy outcomes in GDM. It has also been found that in normal vitamin B12 GDM women, serum folate levels are negatively associated with plasma glucose levels but not low B12 state. This underlines the fact that in order for folate to have its role, it is important to have normal vitamin B12 levels. Despite increasing use of metformin, it is not yet routine to check vitamin B12 levels before it is given. It is important to understand whether vitamin B12 has a role in metformin action. Thus, the mechanism by which vitamin B12 deficiency might interfere with metformin action was studied. In vitamin B12 deficient hepatocytes, metformin stimulation of AMPK was reduced which was followed by reduced downstream signalling in lipid metabolism. This effects were reversed by vitamin B12 supplementation. Thus, it is concluded that vitamin B12 deficiency could interfere with metformin action and before metformin is given, every GDM woman should be checked for serum vitamin B12 levels and should be supplemented if deficient. Overall, vitamin B12 could play a critical role in GDM management and it is important for every GDM woman to have normal vitamin B12 levels.
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Chan, A. W. „Neuropathic pain in diabetes mellitus“. Thesis, Cardiff University, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.496046.
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Paradis, Hilje K. „Osmoregulation in uncontrolled diabetes mellitus“. Thesis, University of Ottawa (Canada), 1991. http://hdl.handle.net/10393/7568.
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In this thesis we studied the influence of osmotic loading on vasopressin secretion and water intake in experimentally-induced diabetes mellitus, in the insulin deprived state as well as when treated with insulin, in order to investigate whether the osmotic drive for vasopressin release and thirst is altered in the diabetic state. Four dogs were used for the experiments to be reported. They were infused with hypertonic sodium sulfate to investigate the influence of osmotic loading on water intake and vasopressin secretion in the control, insulin-treated diabetic and diabetic conditions. Forty-eight hours of insulin depletion did not produce a change in the basal plasma vasopressin levels, even though there was a significant increase in plasma osmolality. In addition, forty-eight hours of insulin depletion did not alter the sensitivity of the osmoreceptors controlling vasopressin release and thirst. The effect of the diabetic condition on the osmotic threshold is subject to interpretation of the data. If glucose is considered an osmotically effective solute in the diabetic state, there is an upward resetting of the osmostat for vasopressin release and thirst, and a downward or leftward shift of the osmostat when glucose is not considered to be effective osmotically. The results of the present study provide evidence that the osmotic sensitivity of vasopressin release and thirst is not affected by the presence or absence of insulin. However, whether there is a true resetting of the osmostat for vasopressin release and thirst in the diabetic state depends on the assumption mode concerning glucose permeability.
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Kizmaz, Sara, und Elsa Khoury. „Diabetes mellitus och parodontal sjukdom“. Thesis, Karlstads universitet, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-41732.
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Wawarta, Rainer. „Mechanismen der Magenentleerung bei Diabetes mellitus“. Diss., lmu, 2005. http://nbn-resolving.de/urn:nbn:de:bvb:19-30505.
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Bohlin, Christina, und Anneli Nyvoll. „Egenvård vid Diabetes Mellitus typ 2“. Thesis, Mid Sweden University, Mid Sweden University, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-222.
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Diabetes typ 2 är en kronisk sjukdom som är en av Sveriges största folksjukdomar med cirka 300 000 drabbade personer, ett stort mörkertal bär utan vetskap på sjukdomen. Diabetes typ 2 ökar kraftigt bland befolkningen i såväl Sverige som i övriga länder. Syftet med denna systematiska litteraturstudie var att belysa faktorer som är av betydelse för följsamhet vid egenvård hos personer med diabetes typ 2. Denna litteraturstudie baseras på 14 vetenskapliga artiklar varav nio är kvantitativ och fem är kvalitativa publicerades mellan år 2003-2008. Artiklarna analyserades och resulterade i fyra kategorier:Relationer där stöd var den största faktorn, Livsperspektiv vilket innefattar kulturell bakgrund och förnekelse, Lidande med ilska och frustration över att drabbats av sjukdom och Kunskap som innefattade brist på förståelse och kunskap om sjukdomen och dess behandling. Genom kontinuerlig egenvårdsorienterad utbildning med individen i fokus och med stöd och förståelse från omgivningen gynnades patientens egenvård. Ökade kunskaper hos vårdpersonalen om hur människor med diabetes upplever sin livssituation kan bidra till utveckling och förbättring av
omvårdnaden. Vårdgivarens uppgift blir att motivera och uppmuntra patientens till livsstilsförändring.
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Mukbel, Sami [Verfasser]. „Nierenzellkarzinom bei Diabetes mellitus / Sami Mukbel“. Greifswald : Universitätsbibliothek Greifswald, 2013. http://d-nb.info/1031883584/34.
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Naundorf, Katrin [Verfasser]. „Alexithymie und Diabetes mellitus / Katrin Naundorf“. Gießen : Universitätsbibliothek, 2015. http://d-nb.info/1076760449/34.
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Scott, Adrian Roy. „Peripheral blood flow and diabetes mellitus“. Thesis, University of Nottingham, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.303002.
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Townsend, J. „Cholinergic neuropathy in experimental diabetes mellitus“. Thesis, University of Nottingham, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.379284.
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Robinson, J. P. „Axonal transport in experimental diabetes mellitus“. Thesis, University of Nottingham, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.379276.
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Ciantar, Marilou. „Cynoytophaga SPP and diabetes mellitus-periodontitis“. Thesis, University College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399751.
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Perrin, Rachel Morvah. „Factors affecting permeability in diabetes mellitus“. Thesis, University of Bristol, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442198.
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Fall, Tove. „Characterisation of diabetes mellitus in dogs“. Uppsala : Dept. of Clinical Sciences, Swedish University of Agricultural Sciences, 2009. http://epsilon.slu.se/200945.pdf.
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Dick, Gregory M. „Coronary artery reactivity in diabetes mellitus“. free to MU campus, to others for purchase, 1996. http://wwwlib.umi.com/cr/mo/fullcit?p9809664.
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Silva, Denise Maria Guerreiro Vieira da. „Narrativas do viver com diabetes mellitus :“. Florianópolis, SC, 2000. http://repositorio.ufsc.br/xmlui/handle/123456789/78129.
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Tese (Doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde.Made available in DSpace on 2012-10-17T10:40:32Z (GMT). No. of bitstreams: 0Bitstream added on 2014-09-25T17:05:55Z : No. of bitstreams: 1 153093.pdf: 4571723 bytes, checksum: 0e49feb74382fdcb9af7f4dbf42fef16 (MD5)
Estudo qualitativo que teve como objetivo compreender como as pessoas constroem a experiência de viver com diabetes mellitus, inspirado no pensamento interpretativista de Clifford Geertz e Arthur Kleinman, utilizando a análise de narrativas. Para chegar a compreensão da experiência, foram realizadas entrevistas, cuja análise revelou que ao reconstituírem suas vivências, as pessoas apresentam o diabetes como doença complexa, difícil de conviver, que infiltra-se em suas vidas, trazendo conseqüências ruins e ameaçando o futuro. A análise das representações narrativas, mostraram cinco diferentes modos pelos quais as pessoas controem a experiência de viver com o diabetes: viver sem prazeres, viver mantendo o diabetes sob controle, viver na esperança de uma vida melhor, viver em conflito e viver como se não tivesse diabetes. As histórias que as pessoas contam sobre suas vidas e sobre como é viver com diabetes, representam a expressão de uma experiência que foi sendo construída nas interações sociais, nas análises compartilhadas sobre os acontecimentos vividos e nas versões reelaboradas desses acontecimentos. Estes resultados confirmaram a tese que O diabetes mellitus e seus significados são elaborados pelas pessoas no percurso do seu processo de viver e podem diversificar de acordo com suas experiências pessoais e culturais.
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Tunieva, Svetlana, und Alma Zverotic. „Diabetes mellitus typ 2 och livskvalitet“. Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25250.
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Diabetes mellitus typ 2 är en kronisk sjukdom som ökar allt mer i Sverige och i övriga världen. Att få diagnosen diabetes innebär för patienten en svår upplevelse och förknippas ofta med komplikationer, vilket leder till upplevelsen av försämrad livskvalitet. Syftet med denna litteraturstudie var att beskriva hur diabetes typ 2 patienter upplever sin livskvalitet. Frågeställningen var vilka faktorer som påverkar livskvaliteten såväl positivt som negativt. Artikelsökningen i databaserna PubMed, Cinahl och Medline resulterade i totalt 12 vetenskapliga artiklar som behandlade ämnet och svarade på studiens syfte och frågeställning. I resultaten framgick att socialt stöd, egenvård, diabeteskomplikationer, psykologiska faktorer samt socioekonomiska faktorer påverkade patienternas livskvalitet på olika sätt. Sjuksköterskor behöver öka sina kunskaper om faktorer som påverkar livskvaliteten och att öka förståelsen för patienterna. Genom patientundervisning och information, stöd, patientengagemang i egenvården samt uppmuntran till uppföljning av den kommer sjuksköterskan att bidra till en lyckad sjukdomsbehandling och att patienten bibehåller eller stärker sin livskvalitet.Diabetes mellitus type 2 is a chronic disease increasing in Sweden as well as worldwide. To be diagnosed with type 2 diabetes means a difficult experience and it is often associated with complications, leading to the perception of decreased quality of life. The purpose of this literature review was to describe how type 2 diabetes patients experience their quality of life. The question was which factors that affect the healthrelated quality of life in both positive and negative ways. Search for scientific articles in the databases PubMed, Cinahl and Medline resulted in a total of twelve scientific articles on the subject that answered the study's purpose and question. The results showed that social support, self care, diabetes complications, psychological factors and socio-economic factors affected patients' quality of life in different ways. Nurses need to increase their knowledge about factors that affect quality of life and increase understanding of patients. Through patient education and information, support, patient involvement in self care and encouragement to follow-up self care behaviours can the nurse contribute to a successful disease treatment and the patient maintain or increase their quality of life.
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Lijlebladh, Emma, und Camilla Tirone. „Diabetes mellitus typ 1 i allmänvården“. Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26744.
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The aim of this literature study has been to investigate the general nurse's knowledge of diabetes type 1 and its complications. The questions were: What does the general nurse need to know about diabetes type 1? What does the general nurse know about diabetes type 1? To answer these questions, a literature study has been done of 8 scientific articles. The theoretical reference study on which the study has been based is Gustafsson's SAUK Model for affirmative nursing care. The result shows that the nurse lacks knowledge in the nursing care of diabetes patients and this reflects the fact that little research has been done on diabetes mellitus type 1 in recent years. The result also shows that guidelines for diabetes serve as a useful implement for keeping knowledge alive and for performing good nursing care.Syftet med denna litteraturstudie är att ta reda på allmänsjuksköterskans kunskaper om diabetes mellitus typ 1 och dess komplikationer. Frågeställningarna är: Vad behöver allmänsjuksköterskan veta om diabetes typ 1? Vad vet allmänsjuksköterskan om diabetes typ 1? För att besvara dessa frågeställningar görs en litteraturstudie med hjälp av 8 vetenskapliga artiklar. Den teoretiska referensram som ligger till grund för studien är Gustafssons SAUK- modell för bekräftande omvårdnad. Resultatet visar på att det finns brist på kunskap hos sjuksköterskan inom omvårdnad av patienter med diabetes. I resultatet speglas att det finns lite forskning gjord på diabetes mellitus typ 1 de senaste åren. Den visar även på att riktlinjer för diabetes är ett bra redskap för att hålla kunskaper vid liv och bedriva en god omvårdnad.
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Barazandegan, Melissa. „Assessment of type II diabetes mellitus“. Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59826.
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Several methods have been proposed to evaluate a person's insulin sensitivity (ISI). However, all are neither easy nor inexpensive to implement. Therefore, the purpose of this research is to develop a new ISI that can be easily and accurately obtained by patients themselves without costly, time consuming and inconvenient testing methods. In this thesis, the proposed testing method has been simulated on the computerized model of the type II diabetic-patients to estimate the ISI. The proposed new ISI correlates well with the ISI called M-value obtained from the gold standard but elaborate euglycemic hyperinsulinemic clamp (r = 0.927, p = 0.0045).
In this research, using a stochastic nonlinear state-space model, the insulin-glucose dynamics in type II diabetes mellitus is modeled. If only a few blood glucose and insulin measurements per day are available in a non-clinical setting, estimating the parameters of such a model is difficult. Therefore, when the glucose and insulin concentrations are only available at irregular intervals, developing a predictive model of the blood glucose of a person with type II diabetes mellitus is important. To overcome these difficulties, under various levels of randomly missing clinical data, we resort to online Sequential Monte Carlo estimation of states and parameters of the state-space model for type II diabetic patients. This method is efficient in monitoring and estimating the dynamics of the peripheral glucose, insulin and incretins concentration when 10%, 25% and 50% of the simulated clinical data were randomly removed. Variabilities such as insulin sensitivity, carbohydrates intake, exercise, and more make controlling blood glucose level a complex problem. In patients with advanced TIIDM, the control of blood glucose level may fail even under insulin pump therapy. Therefore, building a reliable model-based fault detection (FD) system to detect failures in controlling blood glucose level is critical. In this thesis, we propose utilizing a validated robust model-based FD technique for detecting faults in the insulin infusion system and detecting patients organ dysfunction. Our results show that the proposed technique is capable of detecting disconnection in insulin infusion systems and detecting peripheral and hepatic insulin resistance.Applied Science, Faculty of
Graduate
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Hallstedt, Maria, und Schött Eva Tjärdahl. „Diabetes mellitus typ 1 och livskvalitet - faktorer som påverkar livskvaliteten hos vuxna med diabetes mellitus typ 1“. Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25353.
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Under utövandet av sitt yrke möter allmänsjuksköterskan många patienter med DMT1 (diabetes mellitus typ 1). Enligt Carnevali (1999) leder kunskap om individens resurser och krav i det dagliga livet till en mer individuellt anpassad vård. En ökad förståelse för livskvaliteten vid DMT1 och vilka faktorer som påverkar den kan leda till ett bättre bemötande i vården. Syftet med denna litteraturstudie var att beskriva faktorer som kan påverka livs¬kvaliteten inom olika områden hos individer med diabetes mellitus typ 1. Metoden som användes var en modell för litteraturbaserade examensarbeten av Friberg et al (2006). Vid litteratursökningen användes databaserna PubMed och Cinahl. Artiklarna granskades efter Polit et al (2006) och Willman et al (2006) samt kvalitetsbedömdes efter kriterier från SBU (1999). Totalt användes nio kvantitativa artiklar som underlag till resultatet. I resultatet framgick att sen¬komplikationer är en faktor med starkt negativ inverkan på livskvaliteten hos individer med DMT1. Andra faktorer som vid DMT1 kan påverka livskvaliteten negativt är injicerande av insulin och förekomst av GI-symtom. Gruppundervisning, en bra relation till partnern och behandling med insulinpump har däremot en positiv inverkan på livskvaliteten hos individer med DMT1.During the exercise of his/her profession the general nurse encounters many patients with DMT1 (diabetes mellitus type 1). According to Carnevali (1999), knowledge of the individual´s resources and requirements of daily life leads to a more individualized care. A better understanding of the quality of life at DMT1 and the factors which affect it can lead to an improved encounter in the health care system. The aim of this literature review was to describe the factors that can affect quality of life in different areas in individuals with diabetes mellitus type 1. The method used was a model for literature based theses by Friberg et al (2006). In the search of literature the databases PubMed and Cinahl where used. Articles were examined after models by Polit et al (2006) and Willman et al (2006) and quality was assessed according to criteria from SBU (1999). A total of nine quantitative articles were used as a basis for the results. The results showed that long-term complications were a factor with a strong negative impact on the quality of life of individuals with DMT1. Other factors that may affect the quality of life at DMT1 adversely were injecting insulin and the occurrence of GI symptoms. Group-education, a good relationship and treatment with insulin pump had a positive impact on the quality of life of individuals with DMT1.
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Turatti, Luiz Alberto Andreotti. „Papel dos componentes do sistema GH-IGF-IGFBP nos mecanismos envolvidos na resposta imunológica do Diabetes Melito tipo 1“. Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/5/5135/tde-10102014-114845/.
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Com o objetivo de verificar se as proteínas do sistema GH-IGF-IGFBP e o receptor do fator de crescimento insulina símile tipo I (IGF-IR) estão envolvidos na etiopatogenia do Diabetes Melito tipo 1 (DM1) , foram estudados 23 pacientes prépúberes portadores de DM1 em diferentes fases do diagnóstico (Grupo A: tempo de diagnóstico <= 6 meses; Grupo B: tempo de diagnóstico > 6 meses) e 10 indivíduos pré-púberes sadios como grupo controle (Grupo C). A expressão do mRNA do IGFIR realizada através do ensaio molecular de RT-PCR nos linfócitos periféricos T e B não demonstrou diferenças estatisticamente significantes nos linfócitos T quando comparados indivíduos diabéticos e controles, sugerindo que a ativação imunológica destas células seja independente da ação do IGF-IR. Observou-se uma maior expressão do mRNA do IGF-IR dos linfócitos B de pacientes diabéticos em relação ao grupo controle (p < 0,05). A avaliação das proteínas do sistema GH-IGF-IGFBP não demonstrou diferença estatística significante entre os grupos. Estes achados, associados à presença de auto-anticorpos para o DM1 (ICA, anti-GAD e anti-IA2) sugerem fortemente o papel do IGF-IR na ativação dos linfócitos B envolvidos na etiopatogenia do DM1Aiming to verify if GH-IGF-IGFBP proteins system and insulin-like growth factor type I receptor (IGF-IR) are implicated on pathofisiology of type 1 Diabetes Mellitus (DM1), we studied 23 prepubertal patients with DM1 on different stages of diagnosis (Group A: time of diagnosis <= 6 months; Group B: time of diagnosis > 6 months) and 10 prepubertal healthy subjects as control group (Group C). The RT-PCR molecular assay for IGF-IR mRNA on peripheral T and B lymphocytes didn\'t show statistical differences between the groups when T cells were analyzed. We found an increase of IGF-IR mRNA expression on B cells from diabetic patients when compared to healthy subjects (p< 0,05). There were no differences in the GH-IGF-IGFBP proteins system levels between the groups. Our study suggest that IGF-IR in association with diabetes-related autoantibodies (ICA, anti-GAD and anti-IA2) presence could activate B cells involved on pathofisiology of DM1
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Radzevičienė, Lina. „Sergančiųjų cukriniu diabetu mokymo organizavimo ir kokybės vertinimas poliklinikoje“. Master's thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20060612_144532-92108.
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Aim of the study. To assess the organization possibilities and evaluate the quality of diabetes education in outpatient clinic.
Methods. The anonymous questionnaire survey was performed among adult diabetic patients in Kaunas Dainava outpatient clinic in october-December, 2005. 500 questionnaire were given to the patients, the responce rate was 354 patients (70.8 %). The data was analysed by application of statistical package SPSS 12.0 for Windows. The associations between the variables were measured using the Chi-squared (χ²) test.
Results. The positive evaluation of diabetes education in Kaunas Dainava outpatient clinic was given by 73.7 % of patients. 98.3 % believed that diabetes education is necessary. 77.9 % knew about diabetes, 80.8 % - were aware of fasting glycaemia criteria, 95.3 % - glycaemia in untreated patients. 82.2 % understood the importance of diet and it‘s ingredients (90.6 %). Less than a half (40.4 %) were aware of glycated hemoglobin and importance of postprandial glycaemia. Only 33.2 % of those taught in „Diabetes school“ had adequate diabetes control. The target glycated hemoglobin was reached in 42.1 % of thosewho attended the inpatient „Diabetes school“ and only in 22.5 % of those who didn‘t. Diabetes complications have been diagnosed in 43.7 % of those whose glycated hemoglobin ≤ 7 % and in 76.2 % of those whose glycated hemoglobin > 7 %.
Conclusions. Diabetes education in Kaunas Dainava outpatient clinic is not sistematic organized, the time of... [to full text]
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Pincho, Isa Sofia dos Santos. „Viver melhor com diabetes: promoção do autocuidado das pessoas idosas com diabetes“. Master's thesis, Universidade de Évora, 2018. http://hdl.handle.net/10174/23503.
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A diabetes mellitus é uma doença crónica com elevada prevalência e complicações associadas que conduzem a incapacidades. Um dos concelhos do Barlavento Algarvio com maior prevalência de pessoas idosas com diabetes é Vila do Bispo.
Este relatório apresenta o projeto de intervenção, desenvolvido no Estágio do Mestrado em Enfermagem, realizado na UCSP de Vila do Bispo dirigido às pessoas idosas com diabetes.
O objetivo geral foi promover a sua adesão ao autocuidado. Foi utilizada a metodologia de planeamento em saúde. Foi aplicado o questionário sobre as atividades de autocuidado com a diabetes, traduzida e validada para português por Bastos & Lopes (2004).
Os resultados sugerem que os determinantes sociodemográficos têm influência no autocuidado na diabetes, e que a dimensão da atividade física continua a ser das que menos adesão apresenta. Foram desenvolvidas atividades de educação para a saúde no sentido de aumentar o conhecimento para o autocuidado; ABSTRAT:
Living better with diabetes: Promoting self-care for the elderly with diabetes
Diabetes mellitus is a chronic disease with a high prevalence and associated complications that lead to disability. One of the counties of the Eastern Algarve with the highest prevalence of elderly people with diabetes is Vila do Bispo.
This report presents the intervention project, developed in the Master's Degree in Nursing, held at the Vila do Bispo UCSP for the elderly with diabetes.
The general objective was to promote adherence to self-care. The methodology of health planning was used. The questionnaire on self-care activities with diabetes was translated and validated into Portuguese by Bastos & Lopes (2004).
The results suggest that sociodemographic determinants have an influence on self-care in diabetes, and that the dimension of physical activity continues to be the one with the least adherence. Health education activities were developed to increase knowledge for self-care.
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Elrayah-Eliadarous, Hind. „Economic burden of diabetes on patients and their families in Sudan /“. Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-450-1/.
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Espelt, Hernández Albert 1981. „Socioeconomic inequalities in type 2 diabetes mellitus in Europe“. Doctoral thesis, Universitat Pompeu Fabra, 2011. http://hdl.handle.net/10803/85055.
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Type 2 diabetes mellitus (T2DM) has become a major health problem worldwide. The St. Vincent declaration emphasized the urgent need to improve the epidemiological knowledge of this disease in Europe. Within Europe, research on the link between socioeconomic position (SEP) and type 2 diabetes is scarce.
The objective of this thesis was to conduct an extensive review of the current literature on socioeconomic inequalities in type 2 diabetes within European countries, while analyzing the relationship between, incidence, prevalence and mortality due to T2DM and SEP. In addition, we also analyzed trends on SEP inequalities in the prevalence of T2DM in Spain (1983-2006). Finally, we also assessed the appropriate use of health surveys with self-reported diagnosis in order to further analyze the relation between SEP and T2DM.
Different sources of information were used throughout the study. The systematic review was completed using the PUBMED database while the empirical studies used data of two European projects, the EUROTHINE, SHARE and the Spanish National Health Survey (study of trends in SEP inequalities in T2DM) along with the Catalonia health surveys (study of validation). The thesis consists of 5 papers that attempt to respond to the different objectives.
The studies included in this thesis suggest that socio-economic position (SEP) inequalities affect the incidence, prevalence and mortality by T2DM in Europe. These SEP inequalities are partly explained for body mass index, diet and physical activity. Moreover, these inequalities seemed to have remained constant or increased over time. Finally, health interview surveys with self-reported T2DM seems to be a good instrument to evaluate SEP inequalities in T2DM.La Diabetis Mellitus Tipus 2 (DM2) ha esdevingut un dels principals problemes de salut a nivell mundial. La declaració de ST VINCENT emfatitzava la necessitat i la urgència de millorar-ne el coneixement epidemiològic a nivell Europeu. Els estudis a nivell europeu sobre les desigualtats per Posició Socioeconòmica (PSE) en la DM2 eren força escassos. L’objectiu d’aquesta tesi era fer una revisió extensa dels estudis publicats sobre desigualtats per PSE en la DM2 a Europa, així com analitzar la relació entre la incidència, la prevalença i la mortalitat per DM2 i la PSE. Un altre objectiu també era analitzar la tendència de les desigualtats per PSE en la prevalença de DM2 a Espanya (1983-2006). Finalment, com a objectiu també hi figurava el valorar l’ús adequat de les enquestes de salut amb auto - declaració de DM2 per tal d’avaluar les desigualtats per PSE en la DM2. Per tal de dur a terme els objectius es van emprar diferents fonts d’informació. Per tal de dur a terme la revisió sistemàtica es va emprar la base de dades de PUBMED mentre que pels estudis empírics es van utilitzar les dades de dos projectes europeus com són el projecte EUROTHINE i el SHARE i les enquestes nacionals de salut d’Espanya (per la tendència de diabetis) i de Catalunya (per la validació). La tesi consta de 5 articles que intenten donar resposta als diferents objectius. Els estudis inclosos en aquesta tesi suggereixen que existeixen desigualtats per posició socioeconòmica (SEP) en la DM2, tant en la incidència, en la prevalença com en la mortalitat a Europa. Aquestes desigualtats per PSE s’expliquen en part per l’índex de massa corporal, la dieta o l’activitat física. A més a més, aquestes desigualtats sembla que s’han mantingut constants o han crescut al llarg del temps. Finalment, s’ha vist que les enquestes de salut amb la pregunta d’auto-declaració de la diabetis són un bon instrument per avaluar les desigualtats per PSE en la DM2.
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Jamali, Reza. „Peripheral Hypoglycaemic Neuropathy in Type 1 Diabetic Rats : Morphologic and Metabolic Studies“. Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7978.
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Eleftheriadis, Dimitrios Verfasser], und Michael [Gutachter] [Roden. „Häufigkeit eines Diabetes mellitus und eines Risikobereichs für Diabetes mellitus bei chronischen Lebererkrankungen / Dimitrios Eleftheriadis ; Gutachter: Michael Roden“. Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2016. http://d-nb.info/1115856081/34.
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Eleftheriadis, Dimitrios [Verfasser], und Michael [Gutachter] Roden. „Häufigkeit eines Diabetes mellitus und eines Risikobereichs für Diabetes mellitus bei chronischen Lebererkrankungen / Dimitrios Eleftheriadis ; Gutachter: Michael Roden“. Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2016. http://d-nb.info/1115856081/34.
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Myers, Valerie Harwell Herbert James D. „Mood and anxiety symptomatology in adults with insulin-dependent Diabetes Mellitus using intensive management regimens /“. Philadelphia, Pa. : Drexel University, 2003. http://dspace.library.drexel.edu/handle/1860/233.
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Skiadopoulos, Dionysios. „Diabetes mellitus“. Master's thesis, 2013. http://www.nusl.cz/ntk/nusl-322114.
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This theses on Diabetes Mellitus aims at giving an insight at various aspects of this chronic disease and the risk factors that lead to it; the varius ways it develops in the human body; the old and new approaches to treatment, both from a pharmacological and a non- pharmacologiacal point of view; ways to prevent and to manage the diabetes complications; how to improve the live of the diabetic patients who are faced with not only physical but also psychological problems; statistical data from around the world wkich focuses on epidemiology and outlines the issue of the cost of diabetes. Finally, this paper links diabetes mellitus with the Alzheimer's disease as a different expression of diabetes, since it is closely associated with several key neuronal factors implicated in dementia. In many respects, Alzheimer's is a brain form of diabetes. Even in the earliest stages of the disease, the brain's ability to metabolize sugar is reduced. Normally, insulin plays a big role in helping the brain take up sugar from the blood. But, in Alzheimer's, insulin is not very effective in the brain. Consequently, the brain cells practically starve to death.
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Hrouzková, Šárka. „Léčba diabetes mellitus“. Master's thesis, 2008. http://www.nusl.cz/ntk/nusl-292553.
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DM is metabolic disorder characterized with hyperglycaemia at absolute shortage of endogenous insulin (DM1T), or at its relative shortage (DM2T). DM1T is a symptom of B-cell destruction in islets of pancreas Langerhans that occurs mostly on autoimmune basis. Lack of insulin results in disorder of glucose use and in increased catabolism of fat and proteins. The result of this disorder is hyperglycaemia, glycosuria, polyuria, thirst, eventually ketoacidotic coma. DM2T which prevalence is continuously increasing represents significant medical, social and economic problem. DM2T develops due to insulin resistance and later due to insufficient insulin secretion after each meal. Insulin resistance mostly develops in connection with obesity. In the course of disorder the defect of insulin secretion gradually worsens and micro and macro vascular complications develops that are the most frequent cause of death of patient suffering from the disorder. Diabetes treatment is of complicated and complex nature that has to be based on simultaneous intensive therapy, prevention, collaboration with patient, education, individual adjustment of treatment and therapeutic goals. The Czech Republic belongs to a few countries where diabetology as an independent branch of medicine exists. The goal of treatment is to ensure...
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Kwiczalová, Krystyna. „Diabetes mellitus I - Vybrané aspekty aterogeneze u pacientů s diabetes mellitus“. Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-297238.
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OBJECTIVE: The objective of this dissertation was to compare the efficiency of an insulin pump and an intensified insulin regime on atherosclerosis markers - especially the lipid spectrum in patients with diabetes mellitus. INTRODUCTION: Diabetes mellitus is an illness developing in an increasing number of persons. The aim of diabetes mellitus type 1 treatment is to compensate the symptoms of this pathology in an effort to postpone or reduce the complications of the illness. In diabetes patients, complications connected with atherosclerosis are very common. These consequences of diabetes become the most common cause of death of patients. The insulin pump and the intensified insulin regime are strategies with the help of which doctors attempt to influence the development of complications associated with diabetes. The choice between these two procedures is still under heated discussion. METHODS: At work we compared 50 patients treated with the insulin pump and 50 who had an intensified insulin regime. We compared the lipid spectrum, glycosylated hemoglobin, BMI, number of insulin units per day, and complications in both groups. We also studied the connection between this illness and diseases of the thyroid gland, or smoking. We compared the possible differences based on gender. MAIN FINDINGS: We did...
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Mendes, Dunia Margarida Abdulrahman. „Diabetes Mellitus em Odontopediatria“. Master's thesis, 2018. http://hdl.handle.net/10284/7470.
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A Diabetes Mellitus é uma doença crónica encontra-se em larga expansão em todo mundo.
Pode surgir em qualquer idade, afetando todo organismo, inclusive a cavidade oral. Apresentando manifestações orais como: xerostomia, hiposalivação, cárie dentária e doença periodontal.
Estas manifestações orais apresentam maior incidência em pacientes com mau controlo glicémico, por esse motivo a melhor forma de prevenir as complicações orais associadas a diabetes é o controlo glicémico rigoroso seguindo as instruções do endocrinologista. O médico dentista deve fazer parte da equipa multidisciplinar para o acompanhamento do paciente diabético, dessa forma, oferecer acompanhamento médico completo reduzindo as complicações gerais e orais associadas à doença em questão.
Na revisão bibliográfica presente destacamos as crianças diabéticas e abordamos a saúde oral da criança diabética e a importância do médico dentista para garantir um tratamento completo ao paciente diabético.
Para a elaboração deste trabalho foi realizada uma pesquisa bibliográfica de artigos científicos no período de março a setembro de 2018, nos motores de pesquisa: B-ON, Pubmed, Science Direct, Google académico, Scielo, Lenus, Wiley online library e UNICID.Diabetes Mellitus is a chronic disease that is expanding all over the world. It can appear at any age, affecting every organism, including the oral cavity. Presenting oral manifestations as: xerostomia, hyposalivation, dental caries and periodontal disease. These oral manifestations have a higher incidence in patients with poor glycemic control, so the best way to prevent diabetes-related oral complications is through strict glycemic control following the instructions of the endocrinologist. It is advisable for the dentist to be part of the multidisciplinary team for the follow-up of the diabetic patient and thus to offer complete medical control reducing the general and oral complications associated with diabetes. In the present bibliographic review we highlight the diabetic children and we discuss oral health in diabetics children and the importance of the dentist to guarantee a complete treatment to the diabetic patient. For the elaboration of this work a bibliographical research of scientific articles was carried out from March to September of 2018, in the search engines: B-ON, PubMed, Science Direct, Academic Google, Scielo, Lenus, Wiley online library and UNICID.
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Carreira, Sara Alexandra dos Santos. „Periodontite e diabetes mellitus“. Master's thesis, 2018. http://hdl.handle.net/10400.26/25127.
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Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizA presente dissertação aborda a relação bidireccional entre a Diabetes Mellitus e a Peridontite. Para a realização do trabalho foi efectuada uma pesquisa electrónica na base de dados Google Académico, Pubmed, ScienceDirect e Cochrane. A periodontite é uma doença inflamatória crónica caracterizada pela destruição do periodonto. É altamente prevalente e pode ter um impacto significativamente negativo na qualidade de vida. A Diabetes Mellitus, principalmente se não controlada, encontra-se associada a um aumento da prevalência e severidade de periodontite. Da mesma forma, a inflamação periodontal compromete o controlo glicémico e encontra-se relacionada com um aumento da incidência de complicações diabéticas. Apesar da relação bidireccional entre a Diabetes Mellitus e a Periodontite se encontrar bem definida, os mecanismos que relacionam as duas doenças ainda não estão completamente compreendidos. Os principais mecanismos que se acredita estarem envolvidos no aumento do risco e gravidade de periodontite, em pacientes diabéticos, são mediados pelo estado hiperglicémico e pela acumulação de produtos finais de glicação avançada (AGEs), nos tecidos periodontais. O tratamento periodontal não-cirúrgico tem sido associado a melhorias no controlo glicémico, com reduções de HbA1c de, aproximadamente, 0.4%. A redução dos níveis de HbA1c encontra-se relacionada com a diminuição de complicações diabéticas. Por estas razões, a saúde oral deve ser promovida como um componente integrante do controlo da Diabetes Mellitus.
The present dissertation approaches the bidirectional relationship between Diabetes Mellitus and Peridontitis. An electronic search, using Google Scholar, Pubmed, ScienceDirect and Cochrane, was made to accomplish this work. Periodontitis is a chronic inflammatory disease characterized by the destruction of the periodontium. It is highly prevalent and can have a significantly negative impact on quality of life. Diabetes mellitus, especially if uncontrolled, is associated with an increase in the prevalence and severity of periodontitis. Similarly, periodontal inflammation compromises glycemic control and is related to an increased incidence of diabetic complications. Although the bidirectional relationship between Diabetes Mellitus and Periodontitis is well defined, the mechanisms that relate the two diseases are not still completely understood. The main mechanisms believed to be involved in the increased risk and severity of periodontitis in diabetic patients are mediated by the hyperglycemic state and the accumulation of advanced glycation end products (AGEs) in the periodontal tissues. Non-surgical periodontal treatment has been associated with improvements in glycemic control, with reductions in HbA1c of approximately 0.4%. The reduction of HbA1c levels is related to the reduction of diabetic complications. For these reasons, oral health should be promoted as an integral component of Diabetes Mellitus management.
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Oliveira, Ana Maria Pinheiro. „Diabetes mellitus e hipoglicemia“. Master's thesis, 2014. http://hdl.handle.net/10316/26280.
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A hipoglicemia é uma das mais frequentes complicações do tratamento da diabetes mellitus (DM), constituindo o principal obstáculo à otimização do controlo glicémico.
Efetuou-se uma revisão da evidência mais atual do conceito de hipoglicemia, da sua etiopatogenia, da forma de apresentação clínica, das complicações que lhe podem estar associadas, do tratamento e da prevenção.
A hipoglicemia pode ser definida como qualquer episódio em que se regista uma glicemia anormalmente baixa, que expõe o doente a um risco potencial. Atualmente, sugere-se um limiar glicémico de 70mg/dL para a definição de hipoglicemia em doentes diabéticos.
Previamente a este valor ser atingido, as respostas da contra-regulação são ativadas, ocorrendo, sequencialmente, diminuição da secreção de insulina, aumento da secreção de glucagon, secreção de epinefrina, norepinefrina e acetilcolina, e, finalmente, de somatotrofina e de cortisol. Na DM, sobretudo tipo 1, estes mecanismos estão alterados: há uma hiperinsulinémia iatrogénica, um défice na secreção do glucagon e, na presença de episódios de hipoglicemia recorrentes, uma secreção deficiente de epinefrina, originando a síndrome clínica de hipoglicemia sem pródromos. A combinação destes três defeitos está na origem da Insuficiência Autonómica Associada à Hipoglicemia (IAAH), e torna o risco de hipoglicemia severa pelo menos 25 vezes superior.
A ativação do Sistema Nervoso Autónomo (SNA) e o défice cerebral de glicose irão originar sintomas neurogénicos e neuroglicopénicos. O reconhecimento destes sintomas pode ser particularmente problemático em crianças, durante a noite e nos doentes com hipoglicemia sem pródromos, situações que favorecem o desenvolvimento de eventos severos.
Morbilidade significativa está associada à hipoglicemia. A ativação do sistema simpato-adrenal induz alterações da irrigação coronária, que podem levar à isquémia miocárdica, e poderá provocar alterações da repolarização cardíaca, que podem estar na origem de arritmias fatais. Indução de stresse oxidativo, disfunção endotelial, inflamação e aumento da viscosidade sanguínea e da coagulabilidade ocorrem também em consequência da hipoglicemia, fatores que poderão desempenhar um papel importante nas complicações cardiovasculares da DM. Uma relação direta entre hipoglicemia e mortalidade permanece por estabelecer, embora estudos em doentes idosos e com comorbilidades indiquem que a hipoglicemia poderá aumentar o risco de morte. O mesmo parece não se verificar em doentes jovens, para os quais um controlo glicémico apertado parece estar associado a efeitos benéficos no que se refere às complicações macrovasculares da DM, apesar do risco aumentado de hipoglicemia. A longo-prazo e em consequência de eventos hipoglicémicos recorrentes, sobretudo em idade pré-escolar e em idosos, poderá haver dano cerebral, com alterações da função cognitiva.
O tratamento tem como objetivos restaurar os níveis de glicemia e prevenir a hipoglicemia recorrente. Deve ser o mais precoce possível e pode passar por ingestão de hidratos de carbono (HC) em casos leves a moderados, ou por glucagon ou soros glicosados em casos severos.
A individualização da terapêutica torna-se, atualmente, essencial no tratamento dos doentes com DM para a prevenção da hipoglicemia, quer no que se refere aos fármacos usados, quer relativamente aos alvos glicémicos estabelecidos. Outros fatores importantes incluem a monitorização da glicemia e a educação do doente no que se refere à alimentação e ao exercício.
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Machado, Pedro Emanuel Silva. „Diabetes mellitus no cão“. Master's thesis, 2010. http://hdl.handle.net/10348/682.
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Dissertação de Mestrado em Medicina VeterináriaA diabetes mellitus é uma doença metabólica de etiologia heterogénea, caracterizada por um aumento crónico da concentração de glicose no sangue devido a um defeito na produção de insulina ou falha na sua utilização a nível celular. A insulina é a base fundamental do tratamento da diabetes mellitus no cão, sendo factores coadjuvantes a dieta e o exercício. Os animais não tratados ou mal controlados podem sofrer complicações como a cetoacidose diabética. Este trabalho foi efectuado durante o estágio curricular no Centro Veterinário Valdelasfuentes e encontra-se estruturado em duas partes principais: revisão bibliográfica sobre o tema e apresentação de 4 casos clínicos, acompanhados durante o mesmo período. Tendo em conta o conhecimento teórico e prático adquiridos durante a realização deste trabalho, é possível concluir que o sucesso do tratamento depende essencialmente, do compromisso do proprietário em tratar a doença, da facilidade de regulação da glicemia, da presença de doenças concorrentes, assim como da prevenção de complicações crónicas relacionadas com a diabetes mellitus.
Diabetes mellitus consists of a group of metabolic diseases, with heterogenic etiology, that are characterized by a chronic excess of blood glucose concentration, resulting from defects in insulin secretion, insulin action, or both. Insulin is the cornerstone of therapy for Diabetes mellitus in dogs. Diet and exercise plays an integral role in the successful management of diabetic dog. Untreated animals or bad controlled ones can suffer complications as diabetic ketoacidosis. This work was performed during the curricular period in the Veterinary Center Valdelasfuentes and is structured in two main parts: bibliographical report and presentation of 4 case studies, accompanied during the same period. Based on practical and theoretical knowledge acquired during the achievement of this work, is possible to conclude that the success on handling this disease, depends essentially, on the owner commitment to treat the disease, on the facility of glucose regulation, on the presence of concurrent diseases, as well as the prevention of chronic complications related with the Diabetes mellitus.
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Rizeq, Andreas-Ashraf. „Diabetes mellitus in Cyprus“. Master's thesis, 2008. http://www.nusl.cz/ntk/nusl-292491.
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My topic was about diabetes mellitus in Cyprus in relation with the world. For my diploma work I used literature searches in electronic form from different databases and also books, journals, and published articles. My diploma thesis was divided into two main parts, the theoretical part and the results. In the theoretical part diabetes mellitus was described according its definition, classification, clinical manifestations, complications, diagnosis, non- pharmacological and pharmacological treatment. In the results first were described evidence-based guidelines and recommendations from NICE for the management, non-pharmacological and pharmacological treatment for type 1 and type 2 diabetes mellitus in children and adults. Then the general situation of diabetes was described for Cyprus, EU, Czech Republic and the world, according the incidence/prevalence of diabetes, cost of diabetes care, government priorities, policy framework, guidelines and reimbursement. From the results it's obvious that the burden of diabetes is constantly increasing and immediate measures must be taken to prevent further increase. Also it exists the problem with reimbursement for the therapy of diabetes in many countries, including Cyprus. Cyprus Diabetic Association (CDA) provides great help for the patients with diabetes,...
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Doležálková, Radana. „Alexithymie a diabetes mellitus“. Master's thesis, 1994. http://www.nusl.cz/ntk/nusl-366253.
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