Navegando por Assunto "Mellitus"

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Acesso aberto (Open Access)
Influência da suplementação de vitamina D na variabilidade glicêmica em pacientes com diabetes Mellitus tipo 1
(Universidade Federal do Pará, 2016-01-27) FELÍCIO, Karem Mileo; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Recent studies suggest that glycemic variability (GV) could influence the risk of complications in diabetes, independently from glycemic control (GC). GV is the evaluation of the daily fluctuations of glycemia through specific calculations. The few studies that have assessed the effects of supplementation with vitamin D (VD) in patients with diabetes type 1(DM1) on GC are controversial and there is no data about a possible action of VD on GV in these patients. Our study aims to evaluate the effects of VD supplementation on GV in patients with DM1. We executed a prospective, controlled study with 22 patients with DM1. Doses of either 4.000 or 10.000 IU/day of cholecalciferol were administered for 12 weeks according to the patient’s previous vitamin D serum levels. All patients were submitted to continuous glucose monitoring system (CGMS) with the analysis of 41.000 glycemias, dosage of vitamin D and HbA1c before and after the treatment. When the pre and post treatment variables were compared, no differences were observed, except for the expected improvement of the levels and status of VD (26,1 ± 9,0 vs 44,4 ± 24,7 ng/mL ; p<0,01 e 1,00 ± 0,76 vs 0,36 ± 0,66 ; p<0,01), respectively. Correlations were found between the percentage variation (Δ) of the glycemia standard deviation (ΔGSD), calculated using the CGMS, with Δ of the basal (r= 0,6; p<0,01) and total insulin (r= 0,6; p<0,01). Our study also found a correlation between the VD status after supplementation and Δ of the prandial (r= 0,5; p<0,05) and total insulin (r= 0,4; p<0,05), indicating that the better the vitamin D status, lower the doses of insulin needed by the patients. To efficiently study the GV, patients were divided in two groups: Patients in which the ΔGSD improved (group 1; N= 12 (55%)) and those in which the ΔGSD worsened (group 2; N= 10 (45%)). Group 1 when compared to group 2 showed lower needs of insulin (Δbasal insulin = -8,0 vs 6,3%; (p<0,05)) and lower frequency of hypoglycemia (12/44 (27%) vs 21/33 (64%), hypoglycemias / days evaluated ; p<0,01). Our data suggests that supplementation of VD on patients with DM1 could improve the GV associated to a lower need of insulin in more than 50% of these patients. The improvement of GV was strongly associated with reduction in frequency of hypoglycaemia. However, it was not possible to demonstrate benefits of vitamin D on glycaemic control measured by the HbA1c.
Acesso aberto (Open Access)
Vitamina D e nefropatia em pacientes com diabetes Mellitus tipo 1
(Universidade Federal do Pará, 2015-10-06) LUZ, Rafael Mendonça; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
Diabetes Mellitus type 1 (DM1) results from destruction of the pancreatic beta cells by an immunological process, which may progress to kidney complications. Both genetic and environmental factors are involved in the pathogenesis of type 1 diabetes, and vitamin D deficiency appears as a candidate among the risk factors for developing both diabetes and diabetic nephropathy. The objective of this study was to evaluate the existence of an association between low levels of vitamin D with the presence and degree of diabetic nephropathy in patients with type 1 diabetes. Additionally, our study aimed to establish the prevalence of vitamin D deficiency in normal individuals of our region and determine if it differs from DM1 patients. A cross-sectional study, between November 2013 and December 2014, in which levels of 25 (OH) D and albuminuria were analyzed in 37 patients with DM1, normal creatinine levels and 36 control subjects. The patients with DM1 and hypovitaminosis D had higher levels of albuminuria compared with those with normal vitamin D levels (albuminuria = log10 1.92 vs. 1.44; p <0.05). When the group of patients was separeted according to the stage of diabetic nephropathy in those with normoalbuminuria, microalbuminuria, and macroalbuminuria, we found lower levels of 25(OH)D in the latter when compared to the first two groups (26.7 ± 6.2, 24.8 and 15.9 ± 7 ± 7.6 ng / mL; p <0.05, respectively). In DM1 group, we found correlations between vitamin D levels with the levels of albuminuria and diabetic nephropathy stages (r= -0.5, p<0.01 r= -0.4; p <0.05, respectively). Additionally, the prevalence of vitamin D deficiency among control subjects was quite high (78%), and there was no difference compared to patients with DM1, whose prevalence was 73%. Patients with type 1 diabetes when compared to control group also showed no difference regarding the average levels of 25(OH)D (24.2 ± 7.4 versus 25.8 ± 11.2 ng / mL, NS). Our data suggest an association between reduced levels of vitamin D and the presence and severity of diabetic nephropathy. In addition, patients with type 1 diabetes mellitus, when compared to normal control subjects in our region did not differ in average and status of 25(OH)D levels.