Diabetes mellitus belongs to diseases frequently occurring in childhood and adulthood. Insufficient knowledge of this disease and an unsatisfactory compensation for diabetes leads to development of late complications that have a negative impact on one's, as well as the family's, life and create an economic problem for society as a whole. The thesis focuses on the main characteristics of the disease, symptoms, diagnosis and treatment. Complications of the disease, including advice for patients themselves and their prevention are described in more detail. Social aspects (work inclusion of a diabetic, invalidity and reduced work capacity, driving of motor vehicles) are also emphasised. The research part containing 18 questions aims to find out to what extent the Czech public is informed about the problematic areas of this disease. It also assesses the feasibility of obtaining information from individuals of different ages and places of residence (city vs. village) regarding diabetes. These hypotheses were stated within the scope of the research: 1. Individuals older than 50 years of age are better informed about diabetes than individuals of a younger age. 1. Individuals living in a city have a better access to information concerning diabetes than individuals living in a village. The data was obtained from questionnaire research, in which respondents older than 18 years of age participated. The data collection took place in Bechyně Spa Ltd. 58 % of the resultant questionnaires were completed by women and 42 % by men.

Este trabalho teve como objetivo conhecer como se dão as interações familiares de adolescentes com diabetes tipo 1 desde o diagnóstico da doença.Utilizou-se como referencial metodológico a História Oral .Os dados coletados mediante entrevistas gravadas com sete adolescentes foram analisados à luz do Modelo Calgary para Avaliação da Família de Wright e Leahey.As narrativas demonstraram que apesar do acréscimo de atividades na rotina diária do adolescente e da família, relacionadas à manutenção e controle do diabetes, as interações familiares sofrem poucas modificações com a chegada da doença e que os conflitos entre os pais e o adolescente com diabetes não diferem tanto daqueles ocorridos entre os pais e adolescentes saudáveis.A superproteção foi um sentimento percebido pelos adolescentes após o surgimento da doença,pois os pais têm preocupações com complicações imediatas e em longo prazo. O principal vínculo demonstrado pelos adolescentes entrevistados com a suas famílias foi o vínculo de confiança. Para eles é muito importante saber que conquistaram a confiança de seus pais de que podem ter certa autonomia em relação ao manejo do diabetes.Com os irmãos compartilham superficialmente o diabetes,mesmo aqueles que mantêm relações mais estreitas.A família extensa também oferece contribuições em diferentes fases da doença. Os adolescentes entrevistados forneceram dados de que sua comunicação verbal com sua família é ampla e direta. Sentem-se livres e confiantes em falar abertamente sobre assuntos diversos com os pais e os outros membros que coabitam, relatando também com quem se relacionam melhor em casa. Percebe-se também que a família tenta de alguma maneira moldar-se de acordo com as necessidades da pessoa que tem diabetes,na organização e funcionamento.Sentimentos de gratidão são demonstrados pela associação especializada em educação em diabetes, citada como a responsável por todo ou grande parte do conhecimento adquirido,principalmente pelas atividades oferecidas no acampamento para jovens, e também como fonte de solução de problemas oriundos do diagnóstico do diabetes para os pais e para os próprios adolescentes. / This study aimed to understand how to give the family interactions of adolescents with type 1 diabetes since diagnosis of illness. The method used was Oral History y. Data collected through recorded interviews with seven adolescents were examined in the light of Wright e Leaheys Calgary Family Evaluation Model .Narratives demonstrated that despite the increased activities in the daily routine of the adolescent and family for care and control of diabetes, family interactions experience little change with the arrival of the illness and that conflicts between parents and adolescents with diabetes do not differ from those that occurred between parents and healthy adolescents. Overprotection was a sentiment felt by the teenagers after the onset of the disease because parents have concerns about immediate complications and long term. The main bond shown by the adolescents interviewed with their families was the bond of trust. Adolescents share the diabetes management with brothers superficially, even those who maintain more closed. Extended family also offers contributions in different stages of the disease. The adolescents interviewed communicate with your family is extensive and direct, feeling confident to talk about various issues with parents and other members, also reporting to whom they relate better at home. Family tries shape up according to the needs of the person who has diabetes, the organization and function.

The aim of the present study was to investigate the influence of insulin-dependent diabetes mellitus (IDDM) on the cognitive functioning, learning difficulties, and behavioral problems in children between the ages of 7 and 12. The sample was composed of elementary school children living in Ankara, Turkey. Data was collected by administering demographic information form, Children&rsquo / s Depression Inventory (CDI), Strength and Difficulties Questionnaire (SDQ), Wechsler Intelligence Scale for Children&ndash / Revised (WISC-R), and Specific Learning Disability Scale. One-way ANOVAs were employed to examine the differences among the levels of parental education, income, school achievement, and child&rsquo / s adherence to IDDM in terms of WISC-R scores, learning difficulty related variables, behavioral problems, and depression. Results revealed that children with low adherence to IDDM were more likely to experience behavioral problems and depression. T-tests were conducted to examine the mean differences between IDDM and control groups in terms of WISC-R scores, and the variables related to learning difficulties, behavioral problems, and depression. As compared to control group, children with IDDM had lower WISC-R information, similarities, arithmetic, and total scores. Also, children with IDDM had lower achievement in several arithmetic, reading, and writing tasks. Furthermore, hierarchical multiple regression analyses were conducted to test the effect of IDDM adherence, age of onset, and illness duration on cognitive functioning, learning, and behaviors. The results did not reveal any significant effect of IDDM related variables on children&rsquo / s cognitive functioning, learning, or behaviors. Findings were discussed with reference to the relevant literature. Implications of the study were discussed and future research topics were suggested.

Este trabalho teve como objetivo conhecer como se dão as interações familiares de adolescentes com diabetes tipo 1 desde o diagnóstico da doença.Utilizou-se como referencial metodológico a História Oral .Os dados coletados mediante entrevistas gravadas com sete adolescentes foram analisados à luz do Modelo Calgary para Avaliação da Família de Wright e Leahey.As narrativas demonstraram que apesar do acréscimo de atividades na rotina diária do adolescente e da família, relacionadas à manutenção e controle do diabetes, as interações familiares sofrem poucas modificações com a chegada da doença e que os conflitos entre os pais e o adolescente com diabetes não diferem tanto daqueles ocorridos entre os pais e adolescentes saudáveis.A superproteção foi um sentimento percebido pelos adolescentes após o surgimento da doença,pois os pais têm preocupações com complicações imediatas e em longo prazo. O principal vínculo demonstrado pelos adolescentes entrevistados com a suas famílias foi o vínculo de confiança. Para eles é muito importante saber que conquistaram a confiança de seus pais de que podem ter certa autonomia em relação ao manejo do diabetes.Com os irmãos compartilham superficialmente o diabetes,mesmo aqueles que mantêm relações mais estreitas.A família extensa também oferece contribuições em diferentes fases da doença. Os adolescentes entrevistados forneceram dados de que sua comunicação verbal com sua família é ampla e direta. Sentem-se livres e confiantes em falar abertamente sobre assuntos diversos com os pais e os outros membros que coabitam, relatando também com quem se relacionam melhor em casa. Percebe-se também que a família tenta de alguma maneira moldar-se de acordo com as necessidades da pessoa que tem diabetes,na organização e funcionamento.Sentimentos de gratidão são demonstrados pela associação especializada em educação em diabetes, citada como a responsável por todo ou grande parte do conhecimento adquirido,principalmente pelas atividades oferecidas no acampamento para jovens, e também como fonte de solução de problemas oriundos do diagnóstico do diabetes para os pais e para os próprios adolescentes. / This study aimed to understand how to give the family interactions of adolescents with type 1 diabetes since diagnosis of illness. The method used was Oral History y. Data collected through recorded interviews with seven adolescents were examined in the light of Wright e Leaheys Calgary Family Evaluation Model .Narratives demonstrated that despite the increased activities in the daily routine of the adolescent and family for care and control of diabetes, family interactions experience little change with the arrival of the illness and that conflicts between parents and adolescents with diabetes do not differ from those that occurred between parents and healthy adolescents. Overprotection was a sentiment felt by the teenagers after the onset of the disease because parents have concerns about immediate complications and long term. The main bond shown by the adolescents interviewed with their families was the bond of trust. Adolescents share the diabetes management with brothers superficially, even those who maintain more closed. Extended family also offers contributions in different stages of the disease. The adolescents interviewed communicate with your family is extensive and direct, feeling confident to talk about various issues with parents and other members, also reporting to whom they relate better at home. Family tries shape up according to the needs of the person who has diabetes, the organization and function.

The pathophysiology of cytokines released by infiltrating white blood cells upon pancreatic beta cells is not fully understood. Early growth response gene-1 (Egr-1) expression is specifically and transiently up regulated in pancreatic beta cells in response to glucose. We hypothesized that interleukin-1 beta (IL-1▀) induction of nitric oxide alters glucose induced Egr-1 transcription levels. Egr-1 levels were assessed via western blot, nitric oxide was measured with a Griess Reagent kit and insulin levels via ELISA. Glucose induced both insulin and Egr-1 production in INS-1 cells. IL-1▀ dose dependently increased nitric oxide production over time and significantly attenuated glucose induced Egr-1 expression. Sodium nitroprusside dose dependently reduced glucose induced Egr-1 production. The data suggest a strong relationship between IL-1▀ induced nitric oxide production and the reduction of glucose stimulated Egr-1 production. The pathways altered by this cytokine could provide a better understanding of the pathophysiology leading to pancreatic beta cell death.

PrediXcan, an imputed gene expression-trait association method, was compared to multiple linear regressions (MLR) of single nucleotide polymorphisms (SNPs) using the quantitative phenotypes serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL) and triglycerides (TG). The gene expression prediction models were trained using transcriptome- and genome-wide data from Depression Genes and Networks (DGN whole blood) and Genotype-Tissue Expression (GTEx) Project (GTEx whole blood, GTEx pancreas and GTEx liver). Linear combinations of the effect sizes derived using elastic net or least absolute shrinkage and selection operator (LASSO) with genotypes from 1304 European patients from the Diabetes Control and Complications Trial (DCCT) were used to estimate the genetically regulated expression (GReX) for genes. Different gene expression predictors were present in each training set. The 10-fold cross-validated predictive performance, estimated GReX, and p values from associations for matched genes were weakly correlated across training sets and strongly correlated for models derived using elastic net and LASSO. MLR models had more significant associations than PrediXcan models and larger inflation factors for p values. A comparison of p values for matched genes between PrediXcan and MLR models showed weak correlations but strong evidence for LDL and HDL associations with genes at locus 1p13.3 and 16q13, respectively. / Thesis / Master of Science (MSc)

Dados prévios ja demostram que o controle intensivo da glicemia diminui o risco de eventos microvasculares em pacientes com diabetes mellitus. No entanto, seu efeito cardiovascular é incerto. Nós sumarizamos os dados de estudos das principais bases de dados. 2 revisores extraíram dados de estudos randomizados de pacientes com diabetes tipo 2, que visavam 2 níveis de intensidade da glicemia. Investigou-se as retinopatia, neuropatias, nefropatias, mortalidade cardiocascular e total, infarto do miocárdio (IAM), acidente vascular cerebral, amputação de membros e episódios de hipoglicemia. Realizamos a meta-análise para obter o risco relativo (RR). Foram incluídos 7 estudos com 27.814 pacientes. O controle intensivo reduziu o RR de IAM e amputação, além progressão da retinopatia, incidência de neuropatia periférica, incidência e progressão de nefropatia e microalbuminúria. Entretanto, dobrou o risco de episódios de hipoglicemia. Não houve diferenças quanto à mortalidade e outros resultados. Conclui-se que controle intensivo reduziu o risco de alguns eventos, sem reduzir a mortalidade, porém as custas do dobro da incidência de de hipoglicemia. / Previous data already show that intensive glucose control reduces the risk of microvascular events in patients with diabetes mellitus. However, its cardiovascular effect is uncertain. We summarize data from studies of the major databases. 2 reviewers extracted data from randomized studies of patients with type 2 diabetes, aimed at two intensity levels of blood glucose. We investigated the retinopathy, neuropathy, nephropathy, and total mortality cardiocascular, myocardial infarction (IAM), stroke, limb amputation and episodes of hypoglycemia. We conducted a meta-analysis to obtain the relative risk (RR). We included seven studies with 27.814 patients. The intensive control reduced the RR of IAM, and amputation, and progression of retinopathy, incidence of peripheral neuropathy, incidence and progression of nephropathy and microalbuminuria. However, it doubled the risk of hypoglycemia. There were no differences in mortality and other outcomes. We conclude that intensive control reduced the risk of some events without reducing mortality, but the expense of twice the incidence of hypoglycemia.

It is currently accepted that the most appropriate diet in the treatment of non-insulin-dependent diabetes mellitus &quoteNIDDM&quote is high in carbohydrates, high in fibre and low in fat. Dietary fibre reduces the rate of carbohydrate absorption, which may have a beneficial effect on insulin action. Furthermore, high fibre diets also increase the amount of carbohydrates which are not absorbed from the small intestine. These malabsorbed carbohydrates are fermented by the bacterial population in the large intestine, producing short chain fatty acids &quoteSCFA&quote, including propionate, which has been shown to alter liver carbohydrate metabolism. This thesis investigated the actions of slowed carbohydrate absorption and carbohydrate malabsorption in streptozotocin-induced &quoteSTZ&quote diabetic rats. High carbohydrate diet supplemented with guar gum, a soluble dietary fibre, fed to STZ diabetic rats improved insulin sensitivity. investigation of the alterations in the stomach and small intestine demonstrated that guar increased the viscosity of the meal in the intestine. The action of increased fermentation, producing more propionate, was investigated by supplementing propionate into the diets of STZ diabetic rats or when perfused into isolated rat livers. No changes in insulin action or liver glucose metabolism were measured. in addition, it was shown that guar gum reduces food intake in STZ diabetic rats. Mild reductions in food intake in STZ diabetic rats were shown to increase insulin action. In summary, STZ diabetic rats fed high carbohydrate, high fibre diets reductions in food consumption and slowed carbohydrate absorption are important factors which may lower blood glucose concentrations and increase insulin action. increased SCFA production is unlikely to contribute significantly to the improvements in insulin action.

Thesis (M.S.)--University of Michigan, 1994.

Thesis (M.S.)--University of Michigan, 1994.