The object of the present study was to determine simultaneously aspects of hepatic and peripheral glucose metabolism in the intact baboon. Isotopic techniques were used to study glucose turnover rates, glucose recycling, glucose pool and space, and the forearm technique to study peripheral exchange of glucose. The results obtained in the normal animals acted as reference values for each animal. Thereafter diabetes mellitus was produced with streptozotocin, a drug causing destruction of the beta cells of the pancreatic islets. Experiments were then repeated in the acutely diabetic baboon and the nature and extent of the abnormalities in glucose metabolism documented. Lactate metabolism and peripheral lipid metabolism were included in the study in order to establish any interrelationships with glucose metabolism and to determine the abnormalities resulting from the production of diabetes. In the normal animal the turnover rate of lactate was greater than glucose although the lactate pool was much smaller than the glucose pool. After producing diabetes glucose turnover rates increased threefold and correlated with the severity of hyperglycaemia. A significant increase in lactate turnover rates was noted but the increase was less than in the case of glucose turnover rates. The formation of glucose from lactate increased significantly but the fraction of the lactate turnover rate converted to glucose was unchanged. The glucose pool increased nearly threefold and correlated with the increase in glucose turnover rate. There was a significant but smaller increase in lactate pool which correlated with the increase in lactate turnover rate. Both glucose and lactate space decreased after diabetes but the decrease did not correlate with the severity of hyperglycaemia. In the majority of diabetic animals there was no glucose utilization in the forearm, and in fact glucose release was observed. Increased production of lactate occurred in the forearm of the diabetic baboon, despite decreased glucose utilization.Arterial levels of triglyceride and free fatty acid increased threefold after diabetes while the free glycerol level doubled. In the normal animal the general pattern of exchange in the forearm consisted of triglyceride and free fatty acid uptake and free glycerol release. In the diabetic animal triglyceride and free fatty acid release was observed, while the release of free glycerol was decreased. The pattern of forearm metabolism in the diabetic animals was variable and not as consistent as before the production of diabetes. Several interrelationships between glucose, lactate and lipid metabolism were noted. The baboons used in this study showed extreme sensitivity to the metabolic effects of Streptozotocin Diabetes. Hyperglycaemia increased in severity and ketoacidosis invariably developed in the second week. The animals were not treated with insulin and death from severe uncontrolled diabetes occurred in nearly all animals within two weeks. This study has demonstrated the severe abnormalities in hepatic and peripheral glucose metabolism in diabetes. The simultaneous pathogenesis of these abnormalities and their importance in the development of the acute diabetic syndrome have been defined. Associated abnormalities in lactate metabolism and lipid metabolism have also been documented. / Thesis (M.D.)-University of Natal, 1979.

The aim of this thesis was to describe and evaluate visual acuity, macular edema and patientreported outcomes (PRO) following anti-VEGF treatment of diabetic macular edema (DME) patients in a real-world setting. Using a longitudinal study design, a cohort of DME patients was followed from baseline to 1 year after treatment start. Data were collected from two eye clinics at two county hospitals. Social background characteristics, medical data and PRO were measured before treatment initiation, at four month and after 1 year. A total of 57 patients completed the study. Mean age was 69 years and the sample was equally distributed regarding sex. At baseline, the patients described their general health as low. One year after treatment initiation, 30 patients had improved visual acuity and 27 patients had no improvement in visual acuity. The patients whose visual acuity improved reported an improvement in several subscales in patient-reported outcome measures (PROM), which was in contrast to the group that experienced a decline in visual acuity, where there was no improvement in PROM. Outcomes from the study can be useful for developing and providing relevant information and support to patients undergoing this treatment.

<p>2022-03-21</p>

No description available.

<p>2022-03-22</p>

<p>2022-03-23</p>

No description available.

Background and Objective: According to national and regional treatment guidelines, metformin is the first choice and SGLT2-inhibitors may be added in case of insufficient effect of metformin or other comorbidities. SGLT2 inhibitors as add-on to metformin lowers HbA1c further 5-9 mmol/mol. The aim of this study was to map the effect of SGLT2 inhibitors on HbA1c at follow-up and map how many patients that remains on SGLT2 inhibitors with insufficient effect. Study design: A retrospective study in which patients with diabetes type 2 who received a prescription for SGLT2 inhibitors from Visby Norr or Visborg health care center during the period 2018-06-30 to 2020-06-30 was identified. HbA1c, kidney function and weight were registered in an Excel-file at insertion of the SGLT2 inhibitor and at the first follow-up after insertion. Setting: Visby Norr and Visborg health care centers in Gotland. Main outcomes measures: The change in HbA1c after insertion of SGLT2 inhibitors and the proportion of patients who had insufficient effect (HbA1c reduction &lt; 5 mmol/mol) at follow-up. Results: A total of 102 patients was included in the analyze. Following SGLT2 inhibitors was prescribed empagliflozin (91%) and dapagliflozin (9%). Mean follow up visit was within five months after insertion of the SGLT2 inhibitor. The mean decrease in HbA1c was 10 mmol/mol (95% confidence interval 7-13 mmol/mol). There were 21 individuals (21%) who achieved an HbA1c decrease &lt; 5 mmol/mol (mean decrease in this group was 3 mmol/mol), 61 (60%) achieved an HbA1c decrease &gt; 5 mmol/mol (average decrease in this group was 18 mmol/mol) and 20 subjects (19%) had increased HbA1c. Conclusion: In summary, the study shows that five months after insertion of SGLT2 inhibitor resulted in a decrease in HbA1c by 10 mmol/mol. At follow-up 40% of the population had an insufficient effect on HbA1c after insertion of the SGLT2-inhibitors.

ABSTRACT Patients with poorly controlled blood sugar levels and type 2 diabetes have been suggested to be at greater risk of tooth decay; however, the number of studies on this topic is scarce. This study aims to evaluate the association between self-reported diabetes, blood sugar levels, and dental caries in Swedish 40-year-old Swedes. Here we utilized the Gene Lifestyle Interactions in Dental Diseases (GLIDE) database, which provides access to self-reported diabetes, blood sugar levels, and the Decay, Missing, Filled Surfaces (DMFS) status in approximately 90,000 individuals. For this study, we identified 1,617 self-reported diabetes patients, and for each case, two sex- and age-matched controls were randomly selected (n = 3,234). Logistic and linear regression were employed, with appropriate adjustment for age, sex, and years between the dental caries examination and the reported diabetic diagnosis. Patients with self-reported type 2 diabetes displayed a 2.2 DMFS increase (p = 0.019). Additionally, increased blood sugar levels were associated with self-reported type (p &lt; 0.001) and an increased DMFS score (p &lt; 0.001). In conclusion, patients with self-reported type 2 diabetes and poorly controlled blood sugar are associated with an increased DMFS score in Sweden.

Bakgrund: Diabetes mellitus typ – 2 är ett kroniskt tillstånd som ökar världen över. Tillståndet kan drabba personer i olika åldrar. Sjuksköterskan har en betydande roll i personens egenvård i relation till kost- och motionsförändringar vid diabetes mellitus typ – 2. Litteraturöversikten utgår från Orems egenvårdsteori som teoretisk referensram då teorin fokuserar på egenvård.   Syfte: Syftet var att beskriva personers erfarenheter och upplevelser av rekommenderade kost och motionsförändringar vid diabetes mellitus typ – 2.  Metod: En kvalitativ litteraturöversikt med induktiv ansats och analyserades med hjälp av Fribergs sätt att tänka i fem steg.  Resultat: I resultatet identifierades två kategorier och sex subkategorier. Första kategorin var Behov av stöd med subkategorierna Stöd från sjuksköterska, Stöd från närstående och brist på stöd. Andra kategorin var Den nya vardagen med subkategorierna Utmaningar i kostförändringar, Utmaningar i motionsförändringar och Känsla av motivation. Resultatet påvisade att personer med diabetes mellitus typ – 2 upplevde att egenvård och stöd från omgivningen var viktiga delar för att genomgå förändringar i vardagen. Motivation upplevdes även viktig för att optimera en god egenvård.  Slutsats: Litteraturöversikten visade att personer med diabetes mellitus typ – 2 var i behov av stöd från närstående och sjuksköterskan. Information, stöd, utbildning och motivation var till en stor fördel för en god upprätthållen egenvård.