abstract: ABSTRACT This randomized, controlled, double-blind crossover study examined the effects of a preprandial, 20g oral dose of apple cider vinegar (ACV) on colonic fermentation and glycemia in a normal population, with the ultimate intention of identifying the mechanisms by which vinegar has been shown to reduce postprandial glycemia and insulinemia. Fifteen male and female subjects were recruited, ages 20-60y, who had no prior history of gastrointestinal (GI) disease or resections impacting normal GI function, were non-smokers, were non-vegetarian/vegan, were not taking any medications known to alter (glucose) metabolism, and were free of chronic disease including diabetes. Subjects were instructed to avoid exercise, alcohol and smoking the day prior to their trials and to consume a standardized, high-carbohydrate dinner meal the eve prior. There was a one-week washout period per subject between appointments. Breath hydrogen, serum insulin and capillary glucose were assessed over 3 hours after a high-starch breakfast meal to evaluate the impact of preprandial supplementation with ACV or placebo (water). Findings confirmed the antiglycemic effects of ACV as documented in previous studies, with significantly lower mean blood glucose concentrations observed during ACV treatment compared to the placebo at 30 min (p=0.003) and 60 min (p=0.005), and significantly higher mean blood glucose concentrations at 180 min (p=0.045) postprandial. No significant differences in insulin concentrations between treatments. No significant differences were found between treatments (p>0.05) for breath hydrogen; however, a trend was observed between the treatments at 180 min postprandial where breath hydrogen concentration was visually perceived as being higher with ACV treatment compared to the placebo. Therefore, this study failed to support the hypothesis that preprandial ACV ingestion produces a higher rate of colonic fermentation within a 3 hour time period following a high-carbohydrate meal. Due to variations in experiment duration noted in other literature, an additional study of similar nature with an expanded specimen collections period, well beyond 3 hours, is warranted. / Dissertation/Thesis / M.S. Nutrition 2012

Submitted by Rosangela Silva (rosangela.silva3@unioeste.br) on 2018-05-23T13:33:23Z No. of bitstreams: 2 Bruna Juliana Zancanaro Frizon.pdf: 1044725 bytes, checksum: 2ea0da1609bfc95a424d9dc452e0e7da (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-05-23T13:33:23Z (GMT). No. of bitstreams: 2 Bruna Juliana Zancanaro Frizon.pdf: 1044725 bytes, checksum: 2ea0da1609bfc95a424d9dc452e0e7da (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Maternal nutritional, hormonal and metabolic status has direct implications on the development of the intrauterine infant and influence the child's health status throughout childhood and adulthood, an event defined as metabolic programming. Considering that preterm newborns (NBs) are more likely to develop several diseases throughout their life, the following questions arise: Are the maternal metabolic and anthropometric conditions determinant for the blood glucose (Glu) of the preterm newborn at birth and at six months of corrected age (6m CA)? The metabolic condition in mothers with preterm birth (PP) and their respective PTNB differ from mothers with term delivery (TA) and their respective term newborns (TNB)? Therefore, the objectives are: i) To establish whether there is a difference between maternal and infant metabolic status, between TNB and PTNB. ii) Identify whether the maternal metabolic and anthropometric status are correlated to the glycemic, lipidic and insulinemic profile in preterm birth and 6m CA. For that, a quantitative study of observational, longitudinal, prospective type was performed. The sample consisted of mothers and their respective PTNB who remained in the Neonatal Intensive Care Unit (NICU) of the Hospital Universitário do Oeste do Paraná (HUOP), which were compared to the control group, composed of newborns and their respective mothers. Anthropometric parameters (body weight, height and Body Mass Index (BMI) and biochemical plasma levels (Gli, triglycerides (TG), cholesterol (CT) and insulin (INS)) were evaluated. Maternal samples were collected between 24 and 48 hours after delivery and of the babies between 24 and 72 hours after, which was associated with a lower mean age, weight gain and BMI, accompanied by lower plasma levels of CT in relation to TNB mothers (p <0.05). PTNB presented higher Ins and Glu, accompanied by lower CT and TG at birth compared to TNB (p <0.05). At 6 months of CA only the TNB Glu remained higher than in TNB (p <0.05). Linear regression, it was demonstrated that body weight gain and maternal metabolism influenced the blood Glu of the preterm infants at birth and at 6m CA. While the greater maternal weight gain alone is related to lower blood glucose in the PTNB, the association of higher maternal weight gain with higher maternal Glu or TG results in increases in blood Glu in PTNB. At 6 m CA greater Glu or higher maternal TG are related to higher plasma Glu levels in PTNB suggesting that the maternal health condition at the time of delivery has effects on the Glu of premature at birth and early childhood. These findings reinforce the concept of metabolic programming by providing subsidies for new clinical behaviors and appropriate monitoring of pregnant and PTNB in order to avoid the installation of pathological conditions, especially diseases that break glycemic homeostasis, such as diabetes. / O estado nutricional, hormonal e metabólico materno tem implicações diretas sobre o desenvolvimento do bebê intra-utero e influencia o estado de saúde da criança ao longo da infância e na vida adulta, um evento definido como programação metabólica. Considerando que Recém-nascidos Prematuros (RNPT) apresentam maiores chances de desenvolver diversas doenças ao longo da vida, surgem as seguintes questões: São as condições metabólicas e antropométricas maternas determinantes para a glicemia (Gli) do RNPT ao nascimento e aos seis meses de idade corrigida (6m IC)? A condição metabólica em mães com parto prematuro (PP) e seus respectivos RNPT difere de mães com parto a Termo (AT) e seus respectivos Recém-Nascidos a Termo (RNAT). Para tanto, teve-se como objetivos: i) Estabelecer se há diferença entre o estado metabólico materno e do bebê, entre RNAT e RNPT; ii) Identificar se o estado metabólico e antropométrico materno estavam correlacionados ao perfil glicêmico, lipídico e insulinêmico em RNPT ao nascimento e aos 6m IC. Para tal foi realizado estudo quantitativo do tipo observacional, longitudinal, prospectivo. A amostra foi constituída de mães e seus respectivos RNPT que permanecerem na Unidade de Terapia Intensiva Neonatal (UTIN) do Hospital Universitário do Oeste do Paraná (HUOP) os quais foram comparados ao grupo controle, composto por RNAT e suas respectivas mães. Foram avaliados parâmetros antropométricos (peso corporal, estatura e Índice de massa Corporea (IMC) e plasmáticos bioquímicos como: Gli, Triglicerídeos (TG), Colesterol (CT) e Insulina (Ins). Amostras maternas foram coletadas na internação no pré-parto e dos bebês entre as 24-72h após o nascimento e também no retorno aos 6m de IC. Mães de RNPT apresentaram menor média de idade, ganho de peso e de IMC, acompanhado de menor CT em relação a Mães de RNAT (p<0,05). RNPT apresentaram maior Ins e Gli, acompanhado de menor CT e TG ao nascer comparado aos RNAT (p<0,05). Aos 6 m de IC apenas a Gli dos RNPT continuou maior que em RNAT (p<0,05). Usando modelo de regressão linear, foi demonstrado que o ganho de peso corporal e o metabolismo materno influenciaram a Gli dos RNPT ao nascer e aos 6 m de CA. Enquanto o maior ganho de peso materno isoladamente está relacionado à menor Gli do RNPT, a associação de maior ganho de peso materno com maior Gli ou TG materno resultam em aumentos da Gli no RNPT. Aos 6m de IC a maior Gli ou maior TG materno estão relacionados a maiores níveis plasmáticos de gli no RNPT, sugerindo que a condição de saúde materna no momento do parto tem efeitos sobre a Gli do RNPT ao nascer e na infância precoce. Estes achados reforçam o conceito de programação metabólica servindo de subsídios para novas condutas clínicas e o monitoramento apropriado da gestante e do RNPT no intuito de evitar a instalação de quadros patológicos, em especial doenças que rompem a homeostase glicêmica, como é o caso do diabetes.

L’insulinothérapie fonctionnelle (IF) est une méthode de prise en charge du diabète de type 1 (DT1) qui vise à adapter le traitement insulinique des malades à leur mode de vie. Elle repose sur l’autonomisation du patient qui est alors libre de choisir ce qu'il veut manger dans la mesure où il adapte ses doses d’insuline en fonction des aliments consommés. Malgré la formation des patients à cette méthode, l’estimation des glucides contenus dans les repas s’avère parfois difficile et les calculs des doses d’insulines sont régulièrement erronés. Grâce aux capacités technologiques des smartphones, ont vu le jour de nouveaux outils remplaçant les traditionnels carnets et répertoires glucidiques avec pour objectif d’aider les patients dans ces tâches quotidiennes. Peu d’études ont été réalisées pour évaluer l’efficacité réelle de ces dispositifs.Après un exposé des outils couramment utilisés par les patients DT1 sous IF, nous verrons quelles sont les principales applications mobiles qui sont disponibles et qui permettent d’évaluer les glucides des repas et de calculer les doses d’insulines. Nous discuterons ensuite des quelques études cliniques évaluant ces applications.Nous présenterons enfin une application android originale d’aide au comptage de glucides et d’estimation de bolus appelée GLUCAL et développée au sein de l’équipe diabétologie du CHRU Lapeyronie. Cet outil a été testé au cours de deux études cliniques. Un essai préliminaire a été conduit avant une étude randomisée-croisée qui est la seule à avoir été menée à ce jour sur une application de ce type.Ce travail permettra de savoir dans quelle proportion GLUCAL est capable d’améliorer le comptage des glucides et de réduire les erreurs de calculs des bolus, mais également d’évaluer son impact sur le contrôle glycémique des patients. / Carbohydrates (carb) and bolus counting is a therapeutic method used in type 1 diabetes (TD1) which aims to adapt insulin treatment to patient own way of life. It is based on patient’s autonomy since they are allowed to eat any type of food on the condition to adapt insulin doses to the meal ingested. Patients receive a medical education to implement this method, but still carb counting remains a hard task and boluses are frequently erroneous.Thanks to smartphone technical capacities, many applications replacing paper documents and booklets aiming at helping patients in these daily tasks have been developed. But very few studies were conduced to evaluate them clinically.After an overview of the common tools used by TD1 patients to count carbs , we will see the main mobile applications available to help patient in carb counting and bolus estimation. We will then discuss the few clinical studies conduced on those apps.We will finally present an original android application called GLUCAL and developed by the diabetology team of the University Hospital of Montpellier (France). This tool was tested during two clinical studies. A preliminary study has been conduced before a randomized cross-over study which is the first one performed on such an application.This work will help to evaluate the role of GLUCAL in improving carb counting and reducing mistakes of bolus calculation. It will also assess the performance of the application on patient’s glycaemic control.

Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Jakub Draský Supervisor: prof. PharmDr. Petr Pávek, Ph.D. Title of diploma thesis: Pharmacological influence of nuclear receptors in diabetes mellitus therapy Nuclear receptors belong to the superfamily of transcription factors, their main functions include regulating the expression of target genes. In my work I focused mainly on the group of orphan receptors, namely the pregnane X receptor (PXR) and the constitutive androstane receptor (CAR). A common feature of these receptors is their activation by a specific ligand. Both CAR and PXR have an essential function as biological sensors of hydrophobic xenobiotics when they induce enzymes I and II. phase of metabolism. They are also essential in the regulation of gluconeogenesis, insulin response, adipogenesis, cholesterol homeostasis, fatty acids, triglycerides and glycogen. The aim of this experimental work was to introduce a luciferase reporter assay method for two DNA constructs containing the promoter region of the PEPCK and CYP7A1 genes. We used the known agonist rifampicin and the antagonist SPA70 to activate/deactivate PXR. We used CITCO as a CAR receptor agonist. We first verified the functionality of the luciferase reporter gene assay...

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Chest pain is a common presenting complaint to emergency departments (EDs) and is a symptom of serious cardiovascular events such as myocardial infarction (MI) and possibly cardiovascular death. Early decision-making regarding patient disposition is crucial for early intervention and to avoid ED congestion. The Third Universal Definition of MI states that MI diagnosis be made using electrocardiogram (ECG) findings and/or a rise and/or fall in cardiac troponin (cTn) concentrations. However, patients with ECG abnormalities represent less than 1/3 of all ACS patients, leaving the remaining to be diagnosed using multiple measurements of cTn over several hours. I therefore aimed to develop a strategy to identify patients at low-risk for major adverse cardiovascular events (early rule-out), as well as those at greatest short-term cardiac risk (early rule-in). In this thesis I present published work on the clinical utility of glycogen phosphorylase Isoenzyme BB (metabolic marker) in combination with high-sensitivity cTn (hs-cTn) to rule-out adverse cardiac events within 72hrs for patients presenting to the ED within 6hrs of ACS symptom onset. I further assessed the utility of metabolic markers using glucose in this setting. Preliminary results show that using a “healthy” hs-cTn concentration with a normal glucose measurement at presentation can be used to rule-out patients who present to the ED with clinical suspicion of ischemia. Further expansion of this hypothesis demonstrated that an algorithm incorporating both glucose and cTn can effectively rule-in/rule-out MI or MI/cardiovascular death in patients who present to the ED with symptoms of ACS. In addition, presentation hemoglobin A1c identified previously unknown diabetes; which may have overall health implications for these patients. I also demonstrate that using glucose in combination with cTn is a cost-effective decision-making tool in the ED as compared to cTn alone. Application of these rule-in/rule-out algorithms can improve morbidity/mortality rates, and alleviate healthcare burdens. / Thesis / Doctor of Philosophy (Medical Science) / Myocardial ischemia is a reduction in coronary blood flow that is insufficient for heart cell demand, which can lead to myocardial injury and cell death. Acute Coronary Syndrome (ACS) encompasses three clinical presentations of myocardial ischemia: ST-elevation MI (STEMI), non-STEMI (NSTEMI) and unstable angina (UA). Current guidelines recommend using electrocardiogram (ECG) findings and multiple cardiac troponin (cTn) measurements over several hours to diagnose (rule-in) or rule-out ACS in the emergency department (ED). However, given these recommendations patients may spend several hours in the ED, consuming valuable time and resources. This project explores the use of glycemic biomarkers [e.g., glucose and haemoglobin A1c] in combination with cTn to rule-in/rule-out MI and other major cardiovascular events (MACE) to facilitate early decision-making in the ED. This thesis demonstrates that a combination of cTn and glucose at presentation is both an efficient and cost-effective tool for early decision-making in the ED.

O Diabetes mellitus é um distúrbio metabólico de etiologia múltipla que leva a uma hiperglicemia, podendo ocasionar inúmeras disfunções e falências de alguns órgãos e também alterações em cavidade oral. Estudos demonstraram diminuição da glicemia de ratas diabéticas com o uso de laser de baixa potência (LBP) em glândulas salivares. Como o insulin-like growth factor 1 (IGF-1) tem uma estrutura semelhante a da insulina, podendo mimetizar algumas de suas funções, o objetivo do presente trabalho foi analisar o efeito da irradiação com LBP na concentração de IGF-1, nas glândulas parótidas (GP) e submandibulares (GSM), e o efeito na glicemia de ratas diabéticas induzidas por estreptozotocina. Ratas da raça Wistar foram utilizadas e receberam uma injeção intraperitoneal de estreptozotocina ou de tampão conforme o grupo ao qual pertenciam, C (controle) ou D (diabético). Posteriormente, as ratas foram divididas em 4 subgrupos (C0, D0, C5 e D5), de acordo com a dose de irradiação recebida (0 ou 5 J/cm²). O estado diabético dos animais foi confirmado através da glicemia e, após 29 dias, os animais foram submetidos à simulação ou irradiação. O LBP utilizado foi o Photon Lase III (DMC Equipamentos LTDA®). Vinte e quatro horas após o procedimento os animais foram sacrificados para coleta de sangue e das glândulas salivares para as análises da glicemia (método da glicose oxidase e do glicosímetro) e concentração de IGF-1, respectivamente. Os resultados foram analisados pelo teste estatístico de Análise de Variância (ANOVA) e teste de contraste de Tukey, admitindo-se significância de 5%. A glicemia do dia do sacrifício, dos animais diabéticos que receberam irradiação, estava diminuída quando comparada com a glicemia de sacrifício dos animais diabéticos que não receberam o laser (p0,05). Além disso, a glicemia de sacrifício dos animais diabéticos irradiados foi menor que a aferida no dia do diagnóstico, quando foi utilizado o método do glicosímetro (p0,05). A concentração de IGF-1, entretanto, não sofreu influência da doença e nem da irradiação, se mostrando alterada somente quando comparada a GP e GSM. Com base nestes resultados podemos concluir que o LBP pode alterar a glicemia dos animais diabéticos, no entanto, este efeito parece não estar relacionado com a concentração de IGF-1. / Diabetes mellitus is a metabolic disorder of multiple etiologies that leads to hyperglycemia and can cause numerous dysfunctions and failures of some organs and also changes in the oral cavity. Studies have shown a decrease on glucose blood concentration in diabetic rats when low-power laser was used upom salivary glands. As insulin-like growth factor 1 (IGF-1) has a structure similar to insulin, the aim of this study was to analyze the effect of low-power laser irradiation on IGF-1 concentration of the parotid and submandibular glands as well as on glycemia of diabetic rats induced by streptozotocin. Wistar rats were used and received an intraperitoneal injection of streptozotocin or buffer, depending on the group to which they belonged, being C (control) or D (diabetic). Subsequently, the rats were divided into 4 subgroups (C0, D0, C5 and D5) according to the irradiation dose received (0 or 5 J / cm ²). The diabetic state of the animals was confirmed by blood glucose concentration and, after 29 days, the animals were subjected to irradiation or simulation, depending on the group to which they belonged. The laser used was the Photon Lase III (DMC Equipamentos LTDA®). Twenty-four hours after the procedure, the animals were sacrificed and blood and the salivary glands were collected to analyse the glycemia and IGF-1 concentration, respectively. The results were analyzed by Analysis of Variance statistical test (ANOVA) and Tukey\'s contrast test, assuming a significance of 5%. The sacrifice day glycemia of diabetic animals that received irradiation was decreased in comparison with the sacrifice day glycemia of non-irradiated diabetic animals as well as was lower than that measured on the day of diagnosis of irradiated animals (p0,05). The concentration of IGF-1, however, was not affected by diabetes or irradiation. However, IGF-1 concentration was increased on parotid than submandibular glands. Based on these results of the present study, we conclude that LBP can decrease blood glucose concentration of diabetic animals, however, this effect does not appear to be related to the concentration of IGF-1.

O Brasil possui diversas frutas nativas, algumas consideradas potentes fontes de compostos bioativos fenólicos (CBF) como, por exemplo, a cagaita (Eugenia dysenterica DC) que é um fruto nativo do bioma cerrado pertencente à família das Mirtáceas. Alguns CBF presentes nos frutos desta família são capazes de inibir as enzimas envolvidas na digestão dos carboidratos &#945;-amilase e &#945;-glicosidase in vitro. A inibição destas enzimas retarda a absorção de glicose sanguínea reduzindo, assim, a glicemia e insulinemia pós-prandial. O objetivo deste trabalho foi avaliar o efeito de sucos de cagaita, clarificado e não clarificado, ricos em elagitaninos e proantocianidinas, sobre a glicemia e insulinemia pós-prandial de indivíduos pré-diabéticos sem uso de fármacos capazes de influenciar o metabolismo de glicose e insulina, após o consumo de 50 g de pão francês. Três diferentes refeições foram consumidas pelos voluntários (n=14). A primeira foi composta por pão branco (50 g) mais água (300 mL) como controle; a segunda, pão branco (50 g) mais suco cagaita clarificado (300 mL), e a última refeição consistia em pão branco (50 g) mais suco de fruta cagaita não clarificado (300 mL). Os resultados mostraram que ambos os sucos reduziram quantidade total de glicose absorvida (AUC) em 56% (suco clarificado) e 71% (não clarificado) e insulina liberada em 59% (suco clarificado) e 69% (não clarificado), após a ingestão do pão branco. Embora a velocidade de incremento da glicose (VIG) não tenha apresentado diferenças significativas, o incremento absoluto de glucose (IAG), incremento percentual de glicose (IPG) e valores de pico de glicose (VPG) e insulina (VPI) foram significativamente menores do que os de controle (p < 0,05). Além disso, após a ingestão de sucos cagaita observou-se um aumento da capacidade antioxidante do plasma em indivíduos que consumiram as refeições (p < 0,05). / Brazil has several native fruits, some of them are considered potential sources of phenolic compounds. Cagaita (Eugenia dysenterica DC) is a native fruit from Cerrado region belonging to the Myrtaceae family. Some polyphenols presents in fruits of this family may be able to act on inhibition of enzymes related to carbohydrates such as &#945;-amylase and &#945;- glucosidase in vitro. The inhibition of those enzymes activities delays blood glucose absorption, thereby reducing postprandial glycemia and insulinemia. This study aimed to assess the effect of cagaita fruit juices, clarified and non-clarified, rich in phenolic compounds including ellagitannins and proanthocyanidins, on the postprandial blood glucose and insulin responses from a bread meal (50 g), in prediabetic humans who were not taking medications known to influence glucose or insulin metabolism. Three different meals were consumed by volunteers (n=14). The first one consisted of white bread (50 g) plus water (300 mL) as a control; the second one, white bread (50 g) plus clarified cagaita fruit juice (300 mL), and the last one white bread (50 g) plus non-clarified cagaita fruit juice (300 mL). The results showed that both cagaita fruit juices reduced the total amount of glucose absorbed (AUC) by 56% (clarified juice) and 71% (non-clarified) and insulin released by 59% (clarified juice) and 69% (non-clarified), after the ingestion of white bread. Although glucose incremental velocity (GIV) did not show significant differences, absolute increase of glucose (AIg), glucose incremental percentage (GIP) and peak values of glucose (GPV) and insulin (IPV) were significantly lower than those of control (p < 0.05). Also, after ingestion of cagaita juices it was observed an increased antioxidant capacity of plasma in subjects that consumed the meals (p < 0.05).

Orientador: José Roberto Fioretto / Resumo: AUGUSTO, F. M. Insulinoterapia intravenosa contínua para controle de hiperglicemia em crianças criticamente enfermas: estudo clínico, prospectivo, randomizado e controlado [tese]. Botucatu: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp); 2019. Objetivos: Avaliar prospectivamente o comportamento glicêmico de crianças graves, hiperglicêmicas e não diabéticas, os efeitos da insulinoterapia sobre morbimortalidade e segurança de protocolo de controle glicêmico com insulina intravenosa. Métodos: Estudo clínico, prospectivo, randomizado e controlado em UTIP, com crianças entre 28 dias e 16 anos de idade e duas glicemias >180mg/dL, entre 07/2010 e 11/2016. Os pacientes foram alocados por sorteio, em dois grupos: tratado com insulina (GT) e controle (GC). Foram excluídas crianças com duas glicemias >180mg/dL isoladas, diagnosticadas com diabetes mellitus durante a internação e que receberam insulina subcutânea ou em diálise peritoneal. Dados clínicos e glicemias foram coletados da admissão ao encerramento do protocolo. Os grupos foram comparados quanto à idade, peso, gênero, diagnósticos, PRISM, PELOD, uso de catecolaminas, sedação/analgesia e ventilação mecânica (VM), disfunções orgânicas, glicemia, hipoglicemia, Índice de Variação Glicêmica (IVG), Coeficiente de Variabilidade glicêmica (CV), tempo até meta glicêmica (80-180mg/dL), velocidade de oscilação glicêmica e mortalidade. Significância 5%. Resultados: Analisadas 116 crianças clínico-cirúrgicas e pre... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: AUGUSTO, F. M. Continous intravenous insulin therapy for hyperglycemia control in critically ill children: a clinical, prospective, randomized and controlled study. [thesis]. Botucatu: Medical School of Botucatu, São Paulo State University (Unesp); 2019. Objectives: To prospectively assess the glycemic behavior of critically, hyperglycemic and non-diabetic children, the effects of insulin therapy on morbidity and mortality, and the safety of glycemic control protocol with intravenous insulin. Methods: A prospective, randomized, controlled and clinical pilot study in the PICU was designed and enrolled children between 28 days and 16 years of age and two blood glucose levels > 180mg/dL (10mmol/L), from July 2010 to November 2016. Patients were randomly assigned into two groups: treated with insulin (TG) and control (CG). Children with two isolated blood glucose levels >180mg/dL, diagnosed with diabetes mellitus during the study and who received subcutaneous insulin or in peritoneal dialysis were excluded. Clinical data and blood glucose levels were collected from admission to protocol closure. The groups were compared by age, weight, gender, diagnosis, PRISM, PELOD, use of drugs and mechanical ventilation (MV), organic dysfunctions, glycemia, hypoglycemia, Glycemic Variation Index (GVI), Glycemic Variability Coefficient (GVC), time to glycemic target (80-180mg/dL;4,4-10mmol/L), glycemic oscillation rate and mortality. Significance 5%. Results: 166 children with medical and surg... (Complete abstract click electronic access below) / Doutor

O aumento do consumo de alimentos ricos em gorduras e carboidratos associado à reduzida prática de exercícios físicos pode ter como consequência o desenvolvimento da obesidade e de distúrbios metabólicos, tais como intolerância à glicose, resistência à insulina, diabetes tipo 2 e dislipidemias. O músculo esquelético contribui diretamente para o desenvolvimento e progressão dos distúrbios metabólicos, especialmente em decorrência da disfunção mitocondrial. Uma das ferramentas amplamente utilizada para o tratamento de distúrbios metabólicos é o treinamento físico, pois promove adaptações metabólicas no sentido oposto aos prejuízos metabólicos induzidos por dietas hipercalóricas. O presente estudo teve por objetivo avaliar se o treinamento físico aeróbio seria capaz de prevenir o desenvolvimento de distúrbios metabólicos induzidos por dieta hipercalórica composta por ração de cafeteria mais frutose e sacarose diluídas em água de beber em camundongos, e se essa resposta seria mediada por adaptações no músculo esquelético. Os resultados obtidos revelaram que o treinamento físico aeróbio preveniu os distúrbios metabólicos induzidos por dieta hipercalórica, tais como deposição de gordura, hiperfagia, hiperglicemia e aumento de pressão arterial, bem como melhorou a capacidade aeróbia. Essas respostas foram associadas apenas ao aumento na capilarização do músculo esquelético, já que a capacidade oxidativa determinada pela citrato sintase e a expressão da proteína PGC-1? não modificaram / The increased consumption of foods rich in fats and carbohydrates associated with reduced physical exercise may result in the development of obesity and metabolic disorders such as glucose intolerance, insulin resistance, type 2 diabetes and dyslipidemia. Skeletal muscle contributes directly to the development and progression of metabolic disorders, especially as a result of mitochondrial dysfunction. One of the tools widely used for the treatment of metabolic disorders is physical training, which promotes metabolic adaptations in the opposite direction to metabolic damage induced by hypercaloric diets. The present study aimed to evaluate whether physical training could prevent the development of metabolic disorders induced by hypercaloric diet consisting of cafeteria diet plus fructose and sucrose diluted in drinking water in mice, and if this response was mediated by adaptations in skeletal muscle. The results showed that physical training prevented metabolic disorders induced by hypercaloric diet, such as fat deposition, hyperphagia, hyperglycemia, increased blood pressure, and improved aerobic capacity. These responses were associated only with the increase in skeletal muscle capillarity, because oxidative capacity citrate synthase and protein expression of PGC-1? did not change