Diabetes mellitus is a chronic disease affecting millions of people worldwide. The degenerative changes caused by diabetes can, however, be controlled through the correct treatment. The outcome of diabetes mellitus depends mainly on the patient's self-management. Health professionals therefore have a major responsibility to assist patients to acquire the essential knowledge, skills and attitudes for self-management. The purpose of this study was to identify diabetic patients and family members' knowledge and views about diabetes mellitus and its treatment regimen. A quantitative descriptive survey design was used. Questionnaires were used to collect data from a convenient sample of diabetic patients and family members. Data was analysed by a computer program called Statistical Package for Social Sciences. Findings revealed that patients and family members lack adequate knowledge on diabetes mellitus and its treatment. Recommendations regarding the required information and assistance to be given to diabetic patients and their family members were formulated. / Health Studies / (MA (Health Studies))

Forage of beta-carotene-fortified orange-fleshed sweet potato is essential for alleviation cattle malnutrition. The study aims were to determine effects of supplementing sweet potato (SP) roots and sun dried forage on degradation of dietary legumes, intake and milk yield in dairy cattle. Mature SP roots were oven dried and forage vines and leaves (V&L) sun dried. Lactating dairy were supplied meals with total mixed ration (TMR) constituting varying levels of sweet potato forage and concentrate. The SP flour was rapidly and completely degraded In Sacco while degradability of V&L was comparable to that of Lucerne hay. Rumen degradation of Lucerne was reduced when the legume was incubated proximal to SP. Substitution of TMR with fresh SP forage and flour meal increased degradability of diets. Glucose post-feeding was increased (P<0.05) by SP roots but no change in milk yield. Orange-fleshed SP forage is recommended for improving energy supply in lactating cow diets / Agriculture and  Animal Health / M. Sc. (Agriculture)

<P align="justify">Dans les conditions physiologiques normales, la glycémie est maintenue dans d'étroites limites. La sécrétion d'insuline par les cellules B pancréatiques joue un rôle majeur dans ce contrôle. En effet, l'insuline est la seule hormone capable d'empêcher une élévation excessive de la glycémie. La cellule B pancréatique constitue un exemple d'oscillateur cellulaire dont la dynamique non linéaire permet l'apparition d'une activité électrique "en salves" ("bursting"). Lors de la sécrétion, les cellules B présentent des oscillations du potentiel membranaire, alternances de phase actives, où la membrane est dépolarisée et durant laquelle des potentiels d'action sont produits, et de phases silencieuses, où le potentiel membranaire est stable et hyperpolarisé. La durée relative de la phase active est directement carrelée au taux de sécrétion d'insuline. Cette activité électrique est produite par une modification des flux ioniques transmembranaires. Il est maintenant établi que l'élévation de la concentration intracellulaire de Ca2+ ([Ca2+]i) qui se produit lors de la phase active est impliquée dans le déclenchement de l'exocytose. Néanmoins, les mécanismes impliqués dans la régulation de l'activité électrique restent mal compris.</P><p><p><P align="justify">Dans ce travail, nous examinons le rôle d'une protéine présente dans la membrane de la cellule B, l'échangeur Na+/Ca2+ ,dans la modulation des oscillations du potentiel membranaire et de la [Ca2+]i .Depuis sa découverte au niveau des cellules cardiaques et de l'axone de calmar, l'échange Na+/Ca2+ a été identifié dans de nombreux autres types cellulaires dont la cellule B pancréatique. Ce transporteur utilise le gradient électrochimique du Na+ comme source d'énergie pour l'expulsion des ions Ca2+ du cytosol. Dans les cellules cardiaques, il représente un mécanisme important d'expulsion du Ca 2+ intracellulaire. De plus, étant donné la stoechiométrie de la réaction de transport, son activité induit un courant (I Na/Ca) qui est impliqué dans la prolongation des potentiels d'action cardiaques. Au niveau de la cellule B pancréatique, le rôle de l'échange Na+/Ca2+ reste mal compris. L'absence d'inhibiteur spécifique de la protéine handicape sérieusement l'approche expérimentale.</P><p><p><P align="justify">Dès lors, nous avons utilisé une approche basée sur la modélisation mathématique afin de clarifier l'impact de l'activité de l'échange Na+/Ca2+ sur l'activité électrique et la régulation de [Ca2+]i de la cellule B pancréatique. La modélisation de l'activité électrique de la cellule B pancréatique repose sur le formalisme développé par Hodgkin et Huxley pour la cellule nerveuse. Dans ce contexte, l'application de la conservation de la charge au circuit équivalent de la membrane cellulaire fournit un système d'équations différentielles ordinaires, non linéaires.</P><p><p><P align="justify">Lors de la première partie de notre travail, nous avons mis au point un dispositif expérimental permettant de mesurer le courant électrique lié aux phénomènes de transport ioniques dans les membranes cellulaires. Nous avons pu détecter I Na/Ca et étudier son activation par la [Ca2+]i et le potentiel membranaire. Ces données expérimentales nous ont permis de proposer un modèle minimal pour I Na/Ca. D'autre part, afin d'évaluer expérimentalement l'effet de l'échange Na+/Ca2+ sur l'activité électrique de la cellule B pancréatique, nous avons étudié l'effet d'une réduction de la concentration extracellulaire de Na+ sur les oscillations du potentiel membranaire.</P><p><p><P align="justify">D'un point de vue théorique, à partir de notre modèle minimal pour I Na/Ca ,nous avons élaboré différents modèles mathématiques de l'activité électrique des cellules B. Ces modèles fournissent une prédiction correcte, qualitativement et quantitativement, de l'effet d'une réduction de la concentration extracellulaire de Na+ sur l'activité électrique périodique de la cellule B pancréatique. D'autre part, nos simulations numériques nous ont permis de démontrer la capacité de l'échange Na+/Ca2+ à moduler la durée relative de la phase active des oscillations du potentiel membranaire. De plus, nous avons pu mettre en évidence un mécanisme physiologique original liant la concentration extracellulaire de glucose et l'activité du transporteur. Enfin, nous nous sommes intéressés aux effets induits par la présence de l'échange Na+/Ca2+ sur l'activité électrique périodique et la régulation de [Ca 2+]i de cellules B couplées électriquement et hétérogènes en leurs paramètres. En effet, dans les conditions physiologiques, les cellules B constituent une population de cellules hétérogènes, électriquement couplées au sein des îlots pancréatiques. Il est établi que ce couplage joue un rôle essentiel dans l'apparition et la régulation de l'activité électrique périodique. Nous avons étudié différents modèles mathématiques correspondant à un réseau de cellules électriquement couplées. Nos simulations numériques nous ont permis de démontrer que l'échange Na+/Ca 2+ joue un rôle clef dans la régulation de la [Ca2+]i au sein d'un réseau de cellules B couplées électriquement. Il prévient, localement, l'apparition de niveaux de [ca2+]i trop élevés, potentiellement dangereux pour le métabolisme cellulaire, causés par l'hétérogénéité des paramètres cellulaires.</P><p><p> / Doctorat en sciences, Spécialisation physique / info:eu-repo/semantics/nonPublished

A obesidade é caracterizada pelo acúmulo excessivo de gordura corporal e quando apresenta índice de massa corporal (IMC) acima de 30 kg/m², complicações metabólicas começam a aparecer. No Brasil, estima-se que 40% da população apresenta IMC acima do normal, o que aumenta a predisposição para o desenvolvimento de doenças cardiovasculares. A obesidade, principalmente na região abdominal, resulta em uma série de reações bioquímicas que podem desenvolver resistência à insulina (RI), diabetes do tipo 2, dislipidemias (alteração nos colesteróis) e aterosclerose. A eletrolipólise é uma técnica destinada à redução do tecido adiposo. Sua aplicação ocorre por pares de agulhas de acupuntura, que são inseridas no tecido subcutâneo e conectadas a um aparelho que gera corrente elétrica de baixa frequência. A estimulação elétrica proporciona alterações fisiológicas nas células de gordura, dentre elas aumento do metabolismo celular e aumento da circulação sanguínea. O objetivo deste estudo foi avaliar quantitativamente os efeitos da eletrolipólise no perfil lipídico, glicêmico e hormonal de mulheres obesas. Participaram da amostra 16 mulheres, com IMC acima de 30kg/m², saudáveis e sedentárias. Elas foram submetidas a 10 sessões de eletrolipólise, cada uma com duração de 40 minutos, 3 vezes por semana, nas frequências de 5 a 50 Hz. Através do teste de Wilcoxon, foi verificado um nível de significância de p<0,05. Os resultados foram obtidos por medidas antropométricas e exames sanguíneos, realizados em um laboratório de análises clínicas. Após as 10 sessões, as voluntárias apresentaram redução significativa de 2% do perímetro abdominal, 3% da circunferência da cintura e de 4% da relação cintura-quadril (RCQ). O colesterol total teve um aumento significativo de 4%. Apesar disso o LDLc, HDL-c, triglicerídeo, insulina, glicemia e proteína C reativa não apresentaram aumento significativo. Desta forma, conclui-se que a eletrolipólise é uma técnica eficaz para o tratamento de gordura, apresentando redução significativa no perímetro abdominal, importante para reduzir o risco de desenvolvimento de doenças crônicas. No entanto, os efeitos metabólicos ainda não estão bem esclarecidos. A população que constituiu a amostra desse estudo, corresponde à realidade de pacientes que buscam tratamento para a redução de gordura em centros médicos e em clínicas de estética. O aumento do colesterol total deve ser melhor investigado, já que o seu aumento é nocivo à saúde e assim é um dado relevante para o serviço de saúde pública. O efeito lipolítico desencadeado pela eletrolipólise, pode ter aumentado as concentrações séricas de ácidos graxos e glicerol, contribuindo para o aumento da síntese hepática do colesterol. Todas as voluntárias eram sedentárias, possivelmente, o tempo de 4 semanas do estudo não foi suficiente para a utilização da gordura como fonte de energia. / Obesity is characterized by the excessive accumulation of body fat. When the Body Mass Index (BMI) is higher than 30 kg/m², metabolic complications begin to appear. In Brazil, it is estimated that 40% of the population is above normal weight level, which increases the possibility of developing cardiovascular diseases. Obesity, especially in the abdominal region, is the result of a series of biochemical reactions that can lead to the development of Insulin Resistance (IR), type 2 diabetes, dyslipidemia (alterations in cholesterol), and atherosclerosis. Electrolipolysis is a technique for reducing adipose tissue. Pairs of acupuncture needles are inserted in the subcutaneous tissue and connected to an apparatus that generates low frequency electric current. The electrical stimulation induces physical alterations in the fat cells, including an increase in cellular metabolism and increased blood circulation. The aim of this study was to evaluate the effects of electrolipolysis on lipidic, glycemic and hormonal profiles of obese women. The sample was composed of 16 women with a BMI of over 30 kg/m² who had a sedentary lifestyle. They were submitted for 10 sessions of electrolipolysis at frequencies of 5-50 Hz during 40 minutes, three times a week. The statistic was verified using the Wilcoxon test, with an accepted significance level of p<0,05. The results were evaluated through anthropometric measurements and blood tests carried out in a clinical analysis laboratory. After the 10 sessions, the volunteers showed a significant reduction of 2% in their abdominal perimeters, 3% in terms of waist circumference and 4% in their waist-hip ratio (WHR). There was a significant increase of 4% in total cholesterol. In spite of this, the LDL-c, HDL-c, triglycerides, insulin, glycemia and C-reactive protein showed no significant increase. Therefore, it can be concluded that electrolipolysis is an effective technique in the treatment of fat, showing a significant reduction in the abdominal perimeter, which is an important factor for reducing the risk of developing chronic diseases. Nevertheless, the metabolic effects have yet to be clarified. The population of the sample in this study corresponds to the reality of patients who seek treatment to reduce fat at medical centers and esthetic clinics. The increase in total cholesterol requires further investigation, as it can be harmful to a patient’s health and this information is relevant in terms of public health services. The lipolytic effect triggered by electrolipolysis may have increased serum concentrations, fatty acids and glycerol, contributing to increased hepatic synthesis of cholesterol. It may be happened that the 4 week study was not sufficient for the use of fat as source of energy by the population.

A obesidade é caracterizada pelo acúmulo excessivo de gordura corporal e quando apresenta índice de massa corporal (IMC) acima de 30 kg/m², complicações metabólicas começam a aparecer. No Brasil, estima-se que 40% da população apresenta IMC acima do normal, o que aumenta a predisposição para o desenvolvimento de doenças cardiovasculares. A obesidade, principalmente na região abdominal, resulta em uma série de reações bioquímicas que podem desenvolver resistência à insulina (RI), diabetes do tipo 2, dislipidemias (alteração nos colesteróis) e aterosclerose. A eletrolipólise é uma técnica destinada à redução do tecido adiposo. Sua aplicação ocorre por pares de agulhas de acupuntura, que são inseridas no tecido subcutâneo e conectadas a um aparelho que gera corrente elétrica de baixa frequência. A estimulação elétrica proporciona alterações fisiológicas nas células de gordura, dentre elas aumento do metabolismo celular e aumento da circulação sanguínea. O objetivo deste estudo foi avaliar quantitativamente os efeitos da eletrolipólise no perfil lipídico, glicêmico e hormonal de mulheres obesas. Participaram da amostra 16 mulheres, com IMC acima de 30kg/m², saudáveis e sedentárias. Elas foram submetidas a 10 sessões de eletrolipólise, cada uma com duração de 40 minutos, 3 vezes por semana, nas frequências de 5 a 50 Hz. Através do teste de Wilcoxon, foi verificado um nível de significância de p<0,05. Os resultados foram obtidos por medidas antropométricas e exames sanguíneos, realizados em um laboratório de análises clínicas. Após as 10 sessões, as voluntárias apresentaram redução significativa de 2% do perímetro abdominal, 3% da circunferência da cintura e de 4% da relação cintura-quadril (RCQ). O colesterol total teve um aumento significativo de 4%. Apesar disso o LDLc, HDL-c, triglicerídeo, insulina, glicemia e proteína C reativa não apresentaram aumento significativo. Desta forma, conclui-se que a eletrolipólise é uma técnica eficaz para o tratamento de gordura, apresentando redução significativa no perímetro abdominal, importante para reduzir o risco de desenvolvimento de doenças crônicas. No entanto, os efeitos metabólicos ainda não estão bem esclarecidos. A população que constituiu a amostra desse estudo, corresponde à realidade de pacientes que buscam tratamento para a redução de gordura em centros médicos e em clínicas de estética. O aumento do colesterol total deve ser melhor investigado, já que o seu aumento é nocivo à saúde e assim é um dado relevante para o serviço de saúde pública. O efeito lipolítico desencadeado pela eletrolipólise, pode ter aumentado as concentrações séricas de ácidos graxos e glicerol, contribuindo para o aumento da síntese hepática do colesterol. Todas as voluntárias eram sedentárias, possivelmente, o tempo de 4 semanas do estudo não foi suficiente para a utilização da gordura como fonte de energia. / Obesity is characterized by the excessive accumulation of body fat. When the Body Mass Index (BMI) is higher than 30 kg/m², metabolic complications begin to appear. In Brazil, it is estimated that 40% of the population is above normal weight level, which increases the possibility of developing cardiovascular diseases. Obesity, especially in the abdominal region, is the result of a series of biochemical reactions that can lead to the development of Insulin Resistance (IR), type 2 diabetes, dyslipidemia (alterations in cholesterol), and atherosclerosis. Electrolipolysis is a technique for reducing adipose tissue. Pairs of acupuncture needles are inserted in the subcutaneous tissue and connected to an apparatus that generates low frequency electric current. The electrical stimulation induces physical alterations in the fat cells, including an increase in cellular metabolism and increased blood circulation. The aim of this study was to evaluate the effects of electrolipolysis on lipidic, glycemic and hormonal profiles of obese women. The sample was composed of 16 women with a BMI of over 30 kg/m² who had a sedentary lifestyle. They were submitted for 10 sessions of electrolipolysis at frequencies of 5-50 Hz during 40 minutes, three times a week. The statistic was verified using the Wilcoxon test, with an accepted significance level of p<0,05. The results were evaluated through anthropometric measurements and blood tests carried out in a clinical analysis laboratory. After the 10 sessions, the volunteers showed a significant reduction of 2% in their abdominal perimeters, 3% in terms of waist circumference and 4% in their waist-hip ratio (WHR). There was a significant increase of 4% in total cholesterol. In spite of this, the LDL-c, HDL-c, triglycerides, insulin, glycemia and C-reactive protein showed no significant increase. Therefore, it can be concluded that electrolipolysis is an effective technique in the treatment of fat, showing a significant reduction in the abdominal perimeter, which is an important factor for reducing the risk of developing chronic diseases. Nevertheless, the metabolic effects have yet to be clarified. The population of the sample in this study corresponds to the reality of patients who seek treatment to reduce fat at medical centers and esthetic clinics. The increase in total cholesterol requires further investigation, as it can be harmful to a patient’s health and this information is relevant in terms of public health services. The lipolytic effect triggered by electrolipolysis may have increased serum concentrations, fatty acids and glycerol, contributing to increased hepatic synthesis of cholesterol. It may be happened that the 4 week study was not sufficient for the use of fat as source of energy by the population.

Indiana University-Purdue University Indianapolis (IUPUI) / Glucagon-like peptide 1 (GLP-1) receptor agonists are a class of incretin based therapeutics which aid in blood glucose management in Type II diabetes mellitus (T2DM). Recent studies have demonstrated direct cardiovascular benefits conferred by these agents including protection in ischemia and heart failure. Despite these observations, human clinical trials fail to support improvements in cardiovascular outcomes independent of glucose lowering effects in the T2DM populations. Prior data from our lab demonstrate that obesity impairs GLP-1 associated increases in myocardial glucose uptake. However, the reasons for this impairment/resistance to cardiac effects of GLP-1 in the setting of obesity remain ill defined. This investigation tested the hypothesis that underlying differences in the cardiac proteome and microRNA (miR) transcriptome could contribute to distinct cardiac responses to ischemia and activation of GLP-1 signaling in the setting of obesity. To identify whether obesity modulated cardiac functional responses to GLP 1 related drugs, we first examined the effects of obesity on cardiac function, miR transcriptome, and proteome in response to short duration ischemia-reperfusion (I/R). We observed divergent physiologic responses (e.g. increased diastolic volume and systolic pressure in lean, decreased diastolic volumes in obese) to regional I/R in obese vs lean hearts that were associated with significant molecular changes as detected by protein mass spectrometry and miR microarray. Molecular changes were related to myocardial calcium handling (SERCA2a, histidine-rich Ca2+ binding protein), myocardial structure and function (titin), and miRs relating to cardiac metabolism, hypertrophy, and cell death, including miR-15, miR-30, miR-199a, miR-214. Importantly, these effects were modified differently by GLP-1 agonism in lean vs obese swine. Additional studies investigated the functional effects of 30 days of treatment with the GLP-1 analogue liraglutide on a model of slowly-developing, unrelieved coronary ischemia. Liraglutide failed to reduce infarct size or collagen deposition. However, analysis of left ventricular pressure-volume relationships support that liraglutide improved diastolic relaxation/filling, load-dependent indices of cardiac function, and cardiac efficiency in response to sympathetic stimulation in obese swine. Taken together, these findings support that miR and proteomic differences underlie distinct changes in functional cardiac responses to I/R and pharmacologic activation of GLP-1 signaling in the setting of obesity.

Abstract Aim: The primary aim of this study was to investigate whether continuous glucose monitoring (CGM) can be used to control glucose levels and whether CGM can improve eating habits and physical activities for people who use this device. Method: The study had 6 participants, aged between 26 to 30 years. The study contained two parts, a digital form, and an interview. All participants completed different questionnaires about their experience with the Lifestyle Libre sensor that they had already used for two weeks or more. Results: CGM is an effective tool for improving people's health. All participants believe that CGM can help them avoid foods that are high in energy and can cause blood sugar to rise a lot. The majority of the participants felt no anxiety about eating patterns. On the other hand, it depended on the individual and their knowledge. The use of the CGM can be painful for some due to the sensor being inserted under the skin, usually on the back of the upper arm. However, this was not an obstacle for the participants in testing the system. One of six participants experienced pain due to the sensor, while all others ranged from slightly painful to no pain at all. Regarding the comfort of wearing the CGM for two weeks, we received different responses from the participants. Regarding activities, four of the six experienced no change in activities because they were already active before the use of the CGM. However, one of the six participants expressed a desire to have the system measure other biomarkers, such as blood oxygen levels, temperatures, etc. Conclusion: In conclusion, the CGM is an effective tool for assisting people in living healthier lives. / En relativt ny teknik är kontinuerligt glukosmättning (continuous glucose monitoring, CGM). Kontinuerlig glukosmättning är en av många självspårningsanordningar som har utvecklats och som är användbar inom bland annat hälsobranschen och för personer med diabetes. CGM är ett öppet system som gör att användaren kan följa upp och förstå hur kroppen reagerar på glukosnivåer. Genom ett öppet system kan blodsockernivån avläsas och därmed ge en varning i realtid. Detta kan exempelvis ge patienter med diabetes en större möjlighet till att ingripa och kontrollera sin diabetes. Det finns alltså många möjligheter med CGM-systemet och det kan uppmuntra många användare att övervaka sin blodsockernivå och göra justeringar mot en mer tillfredsställande. Detta är en intervjustudie och den undersöker hur CGM kan användas för att underlätta individens livsstil eftersom ändringar i människans kost kan ha stora konsekvenser för hälsan. Detta kan i sin tur minska användarnas risk att utveckla diabetes till exempel diabetes typ2. Syftet med studien var att undersöka om CGM kan användas för att kontrollera blodsockernivåerna, och om CGM kan förbättra kostvanor och fysisk aktivitet för personer som använder systemet. Detta kan leda till att utvecklingen av diabetes och andra relaterade sjukdomar kan förhindras. Avgränsningar för studien var att undersöka om CGM kan användas för att förbättra deltagarnas liv. I denna studie analyserade vi inte data från systemet utan vi analyserade den information som deltagarna hade givit till oss. Studien använder sig av sex olika deltagare som alla har använt CGM tidigare. En av dem har diabetes typ 1 och de andra fem deltagarna är helt friska. Studien har delats in i två steg, där det första steget var att skicka en enkät till alla deltagare. Det andra steget var ett digitalt möte för att få mer information samt diskutera svaren som vi redan hade fått från enkäten. Vi spelade in alla digitala intervjuer för att säkerställa att all given information fanns att tillgå senare vid behov. Vi delade sedan in de olika frågeställningarna i olika teman för att få en strukturerad helhetsbild. Utifrån detta kunde vi sedan analysera deltagarnas svar. Resultaten som vi fick från denna studie var positiva. CGM är ett effektivt hjälpmedel som kan användas för att förbättra människors liv genom att hjälpa dem att leva mer hälsosamt. Alla deltagarna anser att CGM kan hjälpa dem att undvika kost som är energirik och som kanorsaka att blodsockernivån stiger mycket och hastigt. Majoriteten av deltagarna kände ingen ängslan kring ätmönster, men det berodde till stor del på individen själv och dennes kunskap. Användningen av CGM kan vara smärtsamt för vissa på grund av att en sensor sättas in under huden, vanligtvis på baksidan av överarmen. Däremot var detta inget hinder för deltagarna att testa systemet. En av sex deltagare upplevde smärta på grund av sensorn medan alla andras upplevelser varierade mellan lite smärtsamt till ingen smärta alls. När det gäller hur bekvämt det är att bära CGM under två veckor, fick vi olika svar från deltagarna. Gällande fysisk aktivitet upplevde fyra av sex ingen ändring eftersom de redan var aktiva innan användningen av CGM. Deltagarna önskade att systemet kunde mäta andra biomarkörer liksom syrenivå i blod, temperatur och liknande. Slutsatsen vi kom fram till med denna studie var att CGM är ett användbart system som kan hjälpa individer att leva mer hälsosamt. För att kunna få en bättre förståelse för hur ämnesomsättningen fungerar i kroppen kan man behöva använda CGM under mer än två veckor.

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Os glicosímetros permitem que a medição da glicemia seja realizada pelo próprio usuário sem alterar a sua rotina de vida. Dois princípios são utilizados para mensurar o nível de glicemia no sangue: o fotométrico e o amperométrico. No princípio fotométrico, após reações bioquímicas com a amostra de sangue venoso capilar, a glicemia é avaliada pela mudança de comprimento de onda de um feixe de luz padrão. No princípio amperométrico, após reações bioquímicas com a amostra de sangue venoso capilar, é avaliada a intensidade de corrente elétrica que circula pela amostra, sendo proporcional a glicemia. Os glicosímetros disponíveis no mercado utilizam um dos dois princípios. O equipamento utilizado pelos laboratórios de análises bioquímicas utiliza o princípio fotométrico com amostras de sangue venoso coletadas do antebraço do paciente. Este trabalho foi aprovado pelo comitê de ética e avalia de forma pareada um conjunto de medidas de glicemia realizadas com vários glicosímetros disponíveis no mercado e um equipamento laboratorial. Os resultados apresentaram forte correlação entre as medições dos glicosímetros e o equipamento laboratorial, mas com erros sistemáticos e aleatórios elevados. Com os resultados obtidos confirma-se que o glicosímetro pode ser utilizado para monitoramento individual de glicemia, mas não pode ser utilizado para fins de diagnóstico / The glucometer allows the measurement of glycemia to be performed by the user without hindering his daily routine. Two principles are used to measure the level of blood glycemia: photometric and amperometric. On the photometric principle, after biochemical reactions with the sample obtained from capillary venous blood, the glycemia is measured by changing the wavelength of a light beam pattern. On the amperometric principle, after the biochemical reactions with the capillary venous blood sample, intensity of eletric current flowing through the sample can be measured and evaluated, where the intensity of the electric current is proportional to the blood glycemia level. The glucometers available on the market use one of the mentioned principles. Equipment used by biochemical analysis laboratories do make use of the photometric principle with venous blood samples collected from the patient's forearm. This work, approved by the ethics committee, evaluates a set of glycemia measures made by multiple glucometers and laboratory measuring equipment used by clinical laboratories. Presented results demonstrated a strong correlation between glycemia measures obtained from glucometer and equipment used on biochemical analysis laboratories, but with a high rate of systematic and random errors. With the results, the usage of glucometers can be assured for personal and individual measurement of glycemia, whereas this kind of device cannot be used for diagnosis.

Indiana University-Purdue University Indianapolis (IUPUI) / The expression of pyruvate dehydrogenase kinase (PDK) 2 and 4 are increased in the fasted state to inactivate the pyruvate dehydrogenase complex (PDC) by phosphorylation to conserve substrates for glucose production. To assess the importance of PDK2 and PDK4 in regulation of the PDC to maintain glucose homeostasis, PDK2 knockout (KO), PDK4 KO, and PDK2/PDK4 double knockout (DKO) mice were generated. PDK2 deficiency caused higher PDC activity and lower blood glucose levels in the fed state while PDK4 deficiency caused similar effects in the fasting state. DKO intensified these effects in both states. PDK2 deficiency had no effect on glucose tolerance, PDK4 deficiency produced a modest effect, but DKO caused a marked improvement, lowered insulin levels, and increased insulin sensitivity. However, the DKO mice were more sensitive than wild-type mice to long term fasting, succumbing to hypoglycemia, ketoacidosis, and hypothermia. Stable isotope flux analysis indicated that hypoglycemia was due to a reduced rate of gluconeogenesis. We hypothesized that hyperglycemia would be prevented in DKO mice fed a high saturated fat diet for 30 weeks. As expected, DKO mice fed a high fat diet had improved glucose tolerance, decreased adiposity, and were euglycemic due to reduction in the rate of gluconeogenesis. Like chow fed DKO mice, high fat fed DKO mice were unusually sensitive to fasting because of ketoacidosis and hypothermia. PDK deficiency resulted in greater PDC activity which limited the availability of pyruvate for oxaloacetate synthesis. Low oxaloacetate resulted in overproduction of ketone bodies by the liver and inhibition of ketone body and fatty acid oxidation by peripheral tissues, culminating in ketoacidosis and hypothermia. Furthermore, when fed a ketogenic diet consisting of low carbohydrate and high fat, DKO mice also exhibited hypothermia, ketoacidosis, and hypoglycemia. The findings establish that PDK2 is more important in the fed state, PDK4 is more important in the fasted state, survival during long term fasting depends upon regulation of the PDC by both PDK2 and PDK4, and that the PDKs are important for the regulation of glucose and ketone body metabolism.