Navegando por Assunto "Hemoglobina glicada"

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Acesso aberto (Open Access)
Avaliação do crescimento linear em crianças com o diagnóstico de Diabetes Mellitus Tipo 1
(Universidade Federal do Pará, 2024-02-21) BARBOSA, Bruna Lopes; FELÍCIO, Karem Miléo; http://lattes.cnpq.br/5289063715182942
The Type 1 Diabetes Mellitus (T1DM) is characterized by the destruction of the ß-cells resulting in loss of endogenous insulin production. It is one of the most common presentations of youth-onset diabetes. The treatment needs multi-disciplinary approach and is based on intensive insulin therapy. The chronic hyperglycemia and severe insulin deficiency are known to be associated with impaired linear growth. The dysregulation of the GH-IGF-1 axis in T1DM is characterized by decreases in circulating IGF-1, GHR and GHBP, along with increases in GH and IGFBP-1. This study evaluated the influence of glycemic control in the linear growth of T1DM patients treated at Universitary Hospital João de Barros Barreto and compared the growth of these patients with the WHO`s reference. For that, a retrospective cohort study was made using data from medical records at the period between 5 and 19years old from 78 patients (40 females/ 38 males) following the criteria of age at the diagnosis £ 15 years old (females) and £ 17 years old (males). They were at diagnosis 8,6 years old, the duration of the disease was de15,4 years, glycated hemoglobin (HbA1C) 10,5 %. Among them, 58 patients (28 females/ 28 males) were achieved the final height (FH). The female’s FH was 156,2cm (Z score -1,11SDS) and the male’s FH was 166cm (Z score -1,45SDS). Only 19% were above the OMS`s media. But 26% had short stature. 9% were at Z≤ -3SDS. HbA1C ≥ 9,5% was related with worse FH. Each 1% of elevation in HbA1C was associated with a reduction of 2,23cm on FH, and 26% of FH variability were influenced by HbA1C level. The ones with HbA1C ³ 9% had significant stature loss compared to TH. In conclusion, the T1DM patients evaluated were shorter than the media of WHO`s charts, however the majority did not have short stature. HbA1C levels were negatively associated with stature loss compared to TH and final heigh. There was no correlation between FH and weight, insulin total dose, gender and diabetes duration.
Acesso aberto (Open Access)
Influência da suplementação de altas doses de vitamina D no controle glicêmico em pacientes com diabetes mellitus tipo 1
(Universidade Federal do Pará, 2018-12-10) MELO, Franciane Trindade Cunha de; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306
Although the intensive glycemic control of Diabetes Mellitus (DM) with insulin has reduced the incidence of microvascular and macrovascular complications, most patients still develop these injuries with high morbidity and mortality. It has been suggested that low levels of vitamin D (VD) may be associated with the development of Type 1 diabetes mellitus (DM1) and poor glycemic control. As a therapeutic potential, the use of VD in patients with DM1 has presented controversial results regarding the reduction of glucose levels. The objective of this study is to analyze the effects of high-dose vitamin D supplementation on glycemic control of patients with DM1, assessed through glycated hemoglobin levels (HbA1c). A prospective, 12week clinical trial including 52 patients with DM1, which were supplemented with high doses of cholecalciferol, was performed. The dose used for this vitamin was according to the participant's VD value. Patients with VD levels below 30 ng / mL received 10,000 IU / day, and when 30-60 ng / mL, they used 4,000 IU / day. The levels of VD and HbA1c were evaluated before and after 3 months of vitamin supplementation. When we analyzed the total number of patients (N = 52), there was no improvement in the glycemic control evaluated by HbA1c ((9.3 ± 2.3 vs 9.5 ± 2.4, p=NS). To better study the effects of VD on HbA1c, patients were divided into 3 groups according to HbA1c variation: those whose HbA1c reduced ≥ 0.5% (group 1, N = 14); those with no variation in HbA1c (group 2, N = 19) and those with ≥ 0.5% increase in HbA1c (group 3, N = 24). There was a decrease in HbA1c in only one specific group (N = 14). In addition, there was no reduction in prandial basal insulin needs or full dose after three months of VD supplementation. Thus, our data suggest that there is no additional benefit of VD supplementation in the optimization of glycemic control evaluated by HbA1C in patients with DM1.