Made available in DSpace on 2014-06-12T18:28:11Z (GMT). No. of bitstreams: 2 arquivo7935_1.pdf: 1418172 bytes, checksum: 171bd509bf001fe699106a240a8ede6b (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2002 / 88 GRÁVIDAS COM DIABETES GESTACIONAL E SEUS RECÉM-NASCIDOS FORAM ESTUDADOS NA MATERNIDADE DO HOSPITAL BARÃO DE LUCENA, QUE É CENTRO DE REFERÊNCIA EM GRAVIDEZ DE ALTO RISCO NO PERÍODO COMPREENDIDO ENTRE JANEIRO DE 1996 A DEZEMBRO DE 1999. O OBJETIVO DO ESTUDADO FOI IDENTIFOCAR QUAIS OS FATORES DE RISCO MATERNOS QUE PODERIAM PREDISPOR AO APARECIMENTO DE MORBIDADES NEONATAIS MAIS COMUNS. AS MORBIDADES NEONATAIS CONSIDERADAS FORAM PREMATURIDADE, MACROSSOMIA, HIPOGLICEMIA, HIPOCALCEMIA, POLICITEMIA, HIPÓXIA E DOENÇAS RESPIRATÓRIAS. ALGUMAS CARACTERÍSTICAS CLÍNICAS FORAM ENCONTRADAS NAS GESTANTES DIABÉTICAS QUE CONTRIBUÍRAM PARA O DESGASTE NEONATAL. AS MAIS IMPORTANTES FORAM A IDADE MAIS VELHA (25 A 33 ANOS), AS QUE TINHAM MAIOR PARIDADE (1 A 5), AS QUE INICIARAM O PRÉ-NATAL TARDIAMENTE, AS QUE TIVERAM HIPERTENSÃO E/OU PRÉ-ECLÂMPSIA, ANEMIA, DOENÇAS INFECCIOSAS E POLIDRÂMNIO. O CONTROLE DOS DIABETES E O USO DE TERAPIA INSULINICA PARECEU CONTRIBUIR PARA DIMINUIÇÃO DAS MORBILADES NEONATAIS. HIPOCALCEMIA NÃO ESTEVE PRESENTE PORQUE OS RECÉM-NASCIDOS DAS DIABÉTICAS USAVAM GLUCONATO DE CÁLCIO POR ROTINA DO SERVIÇO. AS DOENÇAS RESPIRATÓRIAS ESTIVERAM PRESENTES MAIS NÃO FORAM SIGNIFICATIVAS. CIRCULAR DE CORDÃO ESTEVE PRESENTE. MUITOS ESTUDOS EM HUMANOS SERÃO NECESSÁRIOS PARA IDENTIFICAR OS RISCOS E EVOLUIR AS VÁRIAS MODALIDADES DE INTERVENÇÃO

Made available in DSpace on 2014-06-12T23:00:05Z (GMT). No. of bitstreams: 2 arquivo6772_1.pdf: 1985201 bytes, checksum: 525278287870647dfc12c0e8323e0d0d (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2011 / Faculdade Maurício de Nassau / O processo de envelhecimento humano acontece durante toda a vida, sendo caracterizado principalmente pela diminuição da capacidade funcional e biopsicossocial dos indivíduos. Estudos comprovam que com o aumento da idade e das doenças crônicas, cresce também o número de doenças psiquiátricas, e entre elas a depressão. A presente pesquisa objetivou averiguar a existência de sintomas depressivos em pacientes idosos com Diabetes Mellitus (DM), nas Unidades Básicas de Saúde da Família (UBSF) no município de Cabedelo PB, e correlacionar os possíveis sintomas encontrados com o estilo de vida da amostra em questão. Trata-se de um estudo descritivo, de caráter quali-quantitativo, com delineamento transversal, no qual após observado os critérios de inclusão e exclusão, foi selecionada a amostra em três UBSF deste município, vinculadas ao Programa de Saúde na Família (PSF). A coleta dos dados ocorreu nos meses de Janeiro e Fevereiro de 2011, onde a amostra constou de 30 idosos do sexo masculino e feminino, com faixa etária variando entre 60 e 85 anos, e diagnóstico clínico de DM, sendo estes cadastrados e assistidos nas respectivas UBSF. Foram administrados com os mesmos: uma entrevista semiestruturada para traçar o perfil do idoso voluntário; o Mini Exame do Estado Mental (MEEM), com o objetivo de detectar sinais sugestivos de demência, e a Escala de Depressão Geriátrica Abreviada (GDS-15), com a finalidade de verificar a existência de sintomas sugestivos de depressão. Os resultados obtidos com esta amostra, apontam que quando ocorre o DM nos idosos, pode existir a presença de sintomas depressivos nestes, quando associado ao tempo de recebimento, estilo de vida e a não adesão ao tratamento. Com os resultados encontrados na presente pesquisa, observa-se a necessidade de implementação de políticas públicas de atenção à pessoa idosa no município de Cabedelo, no sentido de organizar ações de saúde que possibilitem realizar um diagnóstico precoce da presença de sintomas depressivos em idosos, considerando como os fatores de risco e prognóstico para instalação, o DM como um possível agente precursor destes sintomas

Orientador: Miguel Arcanjo Areas / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-25T02:49:11Z (GMT). No. of bitstreams: 1 Magri_LucianaDiPietro_M.pdf: 5695174 bytes, checksum: ff8a109406a55c411987c8bd46d57e88 (MD5) Previous issue date: 1999 / Resumo: A mistura polpa de laranja/goma guar (PLG) foi caracterizada física e físico-quimicamente, apresentando as seguintes características: fibra total (76,12%) com predominância da fração solúvel (43,54%) sobre a insolúvel (32,58%); predominância de partículas de tamanho pequeno (89,7%) em relação às de tamanho médio (10,3%); capacidade de hidratação (16,30 gramas de água/gramas de amostra); densidade aparente de 0,17 gramas/ml; viscosidade de 4,25 cP. Por se tratar de uma fonte de fibra semipurificada, apresentou, também, proteínas (6,70%), açúcares solúveis totais (2,60%), lipídios (7,90%), umidade (5%) e cinza (1,7%). No primeiro ensaio biológico, utilizaram-se ratos wistar machos, adultos, normais (N) e diabéticos (D), tendo a mistura PLG (10mg/ ml) provocado redução (p<0,05) da glicemia durante o teste de tolerância à glicose nos animais normais (30 e 60 minutos) e diabéticos (30,60 e 90 minutos) que receberam por sonda orogástrica, solução de glicose (0,15 g/ Kg de peso corpóreo). No segundo ensaio, ratos wistar machos adultos, normais (N) e diabéticos (D) foram alimentados, durante 32 dias, com dietas contendo 0% (N e D) e 20% da PLG (NF e DF). Observou-se no grupo NF em relação ao grupo N, redução da ingestão alimentar, embora não significativa, devido, provavelmente, à diminuição da taxa de esvaziamento gástrico provocado pela fração solúvel da PLG, com conseqüente aumento da saciedade. Além disso, o grupo NF, apresentou redução do ganho de peso corpóreo (p<0,05) como resultado não somente da menor ingestão alimentar como também pela redução da digestibilidade aparente da proteína da dieta (Da), o que refletiu no quociente de eficiência protéica operacional (PER.op). A ingestão da PLG, ainda, causou nos animais normais e diabéticos (p<0,05) redução do tempo de trânsito intestinal inicial, aumento da freqüência de defecação, aumento do peso e volume fecal. Além disso, o grupo DF também apresentou menor perda de peso corpóreo, o que refletiu no aumento dos índices de Valor Biológico aparente operacional (Vba.op), Utilização Líquida da Proteína (NPU.op) e do teor de nitrogênio muscular; foram também verificados redução nos níveis plasmáticos de glicose (p<0,05 ), o que contribuiu para atenuar os aspectos fisiopatológicos característicos do diabetes, tais como hiperfagia, polidipsia e poliúria. Por outro lado, o grupo DF também apresentou aumento do teor de gordura fecal e diminuição dos teores de colesterol e triglicerídeos plasmáticos devidos, provavelmente, à menor biodisponibilidade de nutrientes da dieta em função dos efeitos da PLG sobre a motilidade intestinal. A menor mobilização das reservas endógenas do grupo DF permitiu que se observasse maior peso absoluto e relativo do músculo gastrocnêmico e teor de gordura epididimária. Verificou-se também que a PLG não provocou alterações morfológicas significativas no estômago, intestino delgado e grosso, tanto nos animais normais quanto nos diabéticos. Assim, os resultados obtidos indicam que a PLG poderá ser utilizada como componente alimentar na terapia do diabetes / Abstract: The physical and physicochemical characteristics of the orange pulp/guar gum mixture (PLG) were determined, presenting the following results: total fibers (76.12%) with soluble fraction predominance (43.54%) in relation to the insoluble fraction (32.58%); small size parti eles predominanee (89.7%) in relation to the medium size parti eles (10.3%); hydration capaeity (16.30 9 water/g sample); apparent density 0.17 g/ml; viseosity 4.25 eP. Being a source of semi-purified fiber, the mixture also presented proteins (6.70%), total sugars (2.60%), lipids (7.90%), moisture (5%) and ashes (1.7%). In the first biologieal essay, normal (N) and diabetics (D) male adult Wistar rats were used, observing reduction (p<0.05) of the glucemia during the glueose tolerance test in the normal (30 and 60 minutes) and diabetics animais (30, 60 and 90 minutes) that received by orogastric catheter a glucose solution (1,5 gl Kg body weight) with 10 mgl mL of PLG. In the second essay normal (N) and diabeties (D) mal e adult Wistar rats were fed, during 32 days, with diets containing 0% (N and D) and 20% of PLG (NF and DF). It was observed in the group NF in relation to the group N; a reduction of the food ingestion, but not significant, probably due to the decrease of the gastrie emptying rate provoked by the soluble fraction of PLG, with consequent increase of the satiety. Besides that the group NF presented reduction of the body weight gain (p<0.05) as result not only of the smallest food ingestion but also of the reduetion of the apparent protein digestibility (Da) of the diet, that reflected in the operational Protein Efficieney Ratio (PERop). The ingestion of PLG also caused in the normal and diabetic animals (p<O.O5) a reduction of the initial intestinal transit time, an increase of the defecation frequency, fecal weight and fecal bulk. Besides that the group DF also presented smaller loss of corporal weight, which reflected in the increase of the indexes of operational Apparent Biological Value (Vba.op), Protein Liquid Use (NPU.op) and of the muscular nitrogen content; it was also verified the reduction in the plasmatic glucose levels (p<0,05), that contributed to attenuate the physiopathological aspects, characteristic of the diabetes, such as hiperphagia, polydipsia and polyuria. On the other hand, the group DF also presented an increase of the fecal fat content and a decrease of the cholesterol and plasmatic triglyceride contents, probably due to the smallest nutrient bioavailability of the diet in function of the effects of PLG on the intestinal motility. The smallest mobilization of the endogenous reserves of the group DF allowed that a larger absolute and relative weight of the gastronomies muscle and epipidimarial fat content were observed. It was also verified that the PLG did not provoke significant morphologic alterations in the stomach, large and small intestines, both in normal and diabetics animais. Thus, the obtained results indicate that PLG may be used as food component in the diabetes therapy / Mestrado / Fisiologia e Biologia / Mestre em Biologia Funcional e Molecular

Orientador: Antonio Ari Gonçalves / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-07-26T01:08:16Z (GMT). No. of bitstreams: 1 Brito_IsauraJaquelinedeLima_M.pdf: 989146 bytes, checksum: 48b07c7eba19250d2d3629159416bbd5 (MD5) Previous issue date: 2000 / Resumo: A participação do sistema nervoso parassimpático na modulação da secreção de insulina manifesta-se claramente durante a fase cefálica a qual se segue ao estímulo iniciado pelo estímulo sensorial provocado pelo alimento na boca. O objetivo deste trabalho foi estudar os efeitos, a curto e médio prazo, que a vagotomia subdiafragmática seletiva do ramo pancreático poderia provocar na permeabilidade da membrana plasmática ao Ca2+. Para avaliar os efeitos da vagotomia usamos os secretagogos: glicose e arginina e a potencialização pela carbamilcolina sobre os efeitos de glicose. Adicionalmente estudamos os efeitos sistêmicos que esta desnervação poderia provocar sobre a tolerância à glicose e à insulina. Antes de avaliar os efeitos da vagotomia (após 8 e 30 dias) verificamos que a resposta característica da fase cefálica, estava ausente, resultando em aumento da glicemia ¿Observação: O resumo, na íntegra poderá ser visualizado no texto completo da tese digital / Abstract: purpose of this work was to study the effects of pancreatic vagotomy on the systemic responses to glucose (GTT) , insulin (ITI), and on the B cell membrane permeability to Ca2+. The experiments were performed on vagotomized rats (pancreatic branch) after being checked for the absence of the cephalic phase of secretion, 8 or 30 days after surgery. In the absence of the parasympathetic control, the glycemia was not altered after 12 h fasting levels of (P>0,05). However, the handling of an overload of glucose (1g/kg of body weight) was affected by vagotomy ...Note: The complete abstract is available with the full electronic digital thesis or dissertations / Mestrado / Fisiologia / Mestre em Biologia Funcional e Molecular

Orientador: Jose Ranali / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-14T02:02:26Z (GMT). No. of bitstreams: 1 Esmerino_LuisAntonio_M.pdf: 2326820 bytes, checksum: 246c2fd96f506d736a06e0daaba6cbf8 (MD5) Previous issue date: 1991 / Resumo: A adrenalina ou outra substância do tipo catecolamina associada as soluções anestésicas locais aumentam a eficiência e a duração da anestesia local. Por outro lado as catecolaminas induzem a uma série de efeitos metabólicos, entre eles a hiperglicemia. No presentre trabalho, administrou-se cloridrato de Bupivacaína a 0,5% com adrenalina 1:200.000 e cloridrato de Lidocaína a 2% com noradrenalina 1:50.000 na região posterior da maxila de ratos machos normais e diabéticos aloxânicos em doses equivalentes a 10 tubetes (adrenalina 90 'mu' e noradrenalina 360'mu'). Taxas glicêmicas foram determinadas pelo sistema Haemo-Glukotest 'MARCA REGISTRADA' 20-800 R, com leitura em Reflolux 'MARCA REGISTRADA' II, antes da administração (tempo 0) e 30, 60, 120 e 180 minutos após administração da soluções anestésicas locais. Os resultados obtidos foram submetidos a análise de variância e teste de TUCKEY a nível de 5%. Para os ratos normais, a análise estatística mostrou diferença significante no tempo de 60 minutos para Bupi/Adr., quando comparada com Lido/NAdr. e soro fisiológico (controle). Nos ratos diabéticos aloxânicos não houve diferença estatlstica significante entre as soluções anestésicas locais. Podemos concluir que os vasoconstritores associados aos anestésicos locais nas doses administradas não provocam uma hiperglicemia estatisticamente significante. Visto que a glicogeneólise aos 60 minutos foi transitória e a gliconeogênese que contribui para uma hiperglicemia mais duradoura não ocorreu em nenhum dos grupos experimentais / Abstract: In ord er to evaluate the role of vasoconstrictors (contained in local anesthesics) in the glycemia, solutions of bupivacaine hydrochroride 0,5% with epinephrine 5 'mu'/ml and lignocaine 2% with norepninephrine 20 'mu'/ml were administred (submucosal injection in the posterior region of maxilla) into normal aloxanic diabetic rats in equivalent doses of 10 cartridges. Glycemia rates were determined by Haemo-glukotest 'MARCA REGISTRADA' System 20-800 R on the Reflolux 'MARCA REGISTRADA' II, before administration (time 0) and 30, 60, 120 and 180 minutes after administration of local anesthetics and saline (control). The statistical analysis were performed with an analyses of variance (ANOVA) and TUKEY test (p<0,05). In a 60 minutes time, in normal rats, the adminstration of bupi/epinephrine led to an increase in glycemia statisticaly significant (p<0,05) when compared to the adminstration of lido/norepinephrine and saline. In the aloxanic diabetic rats, there were no significant statistical differences among the solutions administered. It is concluded thet vasoconstrictors (epinephrine and norepinephrine) contained in local anesthetics in the administered doses did not alter glycemia significantly (p<0,05). The transitory glycemia occurred in 60 minutes in normal rats, could be due to activation of glycogenolysis, since in this time gluconeogenesis could not have occured. / Mestrado / Farmacologia, Anestesiologia e Terapeutica / Mestre em Odontologia

Orientador: Eduardo Dias de Andrade / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-14T04:11:00Z (GMT). No. of bitstreams: 1 Souza_PatriciaMedeirosde_M.pdf: 1293424 bytes, checksum: d64ef9d754021c735cf05b8091359f8d (MD5) Previous issue date: 1992 / Resumo: Este trabalho teve por objetivo avaliar a influência da betametasona, um corticosteroide bastante empregado como antiinflamatorio em Odontologia, sobre os valores de glicemia em jejum, em ratos normais e diabéticos-aloxãnicos. Para tal, foram utilizados 40 ratos (Rattus novergicus albino, raça Wistar heterogenética), machos, adultos (90 dias) e com um peso em média de 300 g, que foram divididos em 2 grupos (normais e diabéticos) e estes em 2 sub-grupos (tratados com solução salina ou betametasona, em dose única). A glicemia foi medida nos tempos 0 (zero) e 30, 60, 120 e 240 minutos após o tratamento de auto-monitoramento de glicose sanguínea. Os resultados mostraram não ocorrer uma diferença estatisticamente significante (p < 0,05) nos níveis glicêmicos de ratos normais ou diabéticos, quando tratados com solução salina ou betametasona, estudo, na dose de 0,1. mg/kg, nos diferentes tempos de estudo / Abstract: The aim of this paper was study the influence of betamethasone, a corticosteroid very used like anti-inflammatory in Dentistry, over the values of fasted glycemia, in normal and alloxan-diabetics rats. For this purpose, there were been used 40 rats (Rattus novergicus albino, race Wistar heterogenetic), male, grow-up (90days) and with the weight of 300 g in average, wich were divided in 2 groups (normal and diabetic) and these ones in 2 subgroups (the subgroup that received the treatment of saline or the other, betamethasone, in single dosage). The glycemia was measured using the method of self glucose monitoring. The beginning time was 0 (zero) and the others were 30, 60, 120 and 240 minutes after treatment. The results showed that did'nt appear a significant statistic difference (p < 0,05) in the glycemic level of normal and diabetics rats, when they received saline or betamethasone in a single dosage of 0,1 mg/kg, in differents times of study / Mestrado / Farmacologia / Mestre em Odontologia

HLA genotypes were determined and prospective investigations performed on members of 166 families, each including a Type 1 diabetic proband. A computer-based system (Genobase) was created for data storage and analysis. Newly-diagnosed cases ascertained in East Berkshire (incidence rate: 17.8 x 10^-5/year) and additional data from two other studies contribute to some analyses. Major findings include non-random assortment of HLA-B8 within families and a tendency for HLA-identical siblings of diabetic probands to be younger than expected. Discrete multivariate analysis and other methods show no major genetic heterogeneity within Type 1 diabetes. However, there is minor heterogeneity affecting the interaction of age and seasonal variation in incidence of the diabetes. Furthermore, the HLA genotype B8,15 is here shown to be significantly more frequent in Type 1 diabetic probands than expected assuming Hardy-Weinberg equilibrium. With support from other internal and published data, it is concluded that susceptibility to Type 1 diabetes is genetically multifactorial. Increased prevalence of organ-specific autoimmunity is confirmed in the families, and differences in distribution of islet-cell antibodies (ICA) and thyroid/gastric antibodies demonstrated. Five subjects, ICA-positive from the first test, developed diabetes after up to 30 months, demonstrating prolonged latency. Quantitative risk of diabetes is estimated (separately) in terms of ICA results and of HLA genotypes. Non-diabetic siblings of affected probands are investigated for evidence that an HLA-linked immune response gene might contribute to susceptibility. Response patterns to previous polio vaccination give some support, but the excess of thyroid/gastric antibodies in the siblings is not due to such a gene. The dissertation concludes with discussion of aetiological hypotheses and indications for further work.

Abstract Diabetes mellitus has been linked with an increased risk for oral diseases, especially periodontal diseases (Oliver &amp; Tervonen 1994, Yalda et al. 1994). Further investigations have, however, shown that this risk is not equal in all patients with diabetes. These studies explored the relationship between the diabetic status and periodontal diseases, dental caries and salivary factors. In a group of the diabetic adolescents aged 12 to 18 years, dental caries and gingivitis were shown to associate with poor metabolic control of diabetes. An increase of caries prevalence and the severity of gingivitis was evident in alarmingly poorly controlled patients with glycosylated haemoglobin (HbA1) values of 13% or higher. The hyperglycaemia-associated increase of gingivitis was confirmed in a group of newly diagnosed diabetic children and adolescents, whose gingival inflammation decreased during a follow-up after the correction of hyperglycaemia by initiation of insulin treatment. Decreased salivary flow rates and elevated salivary glucose levels were observed during the hyperglycaemic state of children and adolescents with newly diagnosed diabetes. Higher salivary microbial counts, especially yeast counts, were related to the lower salivary flow rates and higher salivary glucose levels. In adult patients with type 1 diabetes, the complex diabetic status was assessed by means of the level of metabolic control and/or the presence and severity of diabetic complications. Adult diabetic patients with poor metabolic control and/or complications exhibited more deepened pockets and clinical attachment loss, and after periodontal treatment, the recurrence of deepened pockets was faster in these patients compared to the other diabetic patients or the controls. The high-risk subjects among adults with type 1 diabetes were categorised as follows: subjects with long-term HbA1 values over 10%, independently of whether the patient has diabetic complications or not; subjects with advanced diabetic complications, such as preproliferative or proliferative retinopathy, nephropathy, limb amputations or recurrent infections; and subjects with multiple diabetic complications, irrespective of the level of metabolic control. In conclusion, dental professionals should be aware of the level of glycaemic control in their patients with type 1 diabetes, and the prevention and intensified treatment should be focused on those with a poor metabolic control (HbA1c values around or over 10%). In the case of adult patients, more comprehensive knowledge about the diabetic status of the patients is needed in order to be able to identify the subjects at high risk for periodontitis and in need of regular maintenance care at least twice a year. The medical and nursing personnel should also be aware of periodontitis as a complication of diabetes, and especially in the case of adult diabetic patients, they should refer their patients to dental treatment when necessary.

Magister Pharmaceuticae - MPharm / Increasing diabetes prevalence rates, poor involvement of and limited knowledge among health care professionals in disease management, and poor implementation of guidelines are barriers to quality diabetes care. This thesis aimed to develop, implement and evaluate an on-site diabetes pharmacotherapy program for public sector pharmacists. Qualitative and quantitative research methods were used inthe pre- and post-intervention study. / South Africa

The purpose of this study was to answer the question, 'Will diabetic patients taught by means of a "Diabetic Teaching Tool" demonstrate a higher level of learning about self-care, than patients taught in the institution's usual manner?' The answer to the question was sought by comparing the self-care knowledge and skills of two groups of diabetic patients admitted to a suburban general hospital which, prior to the study, offered no planned programme of diabetic patient education. All diabetic patients admitted to this hospital over a six month period were screened for eligibility to participate in the study according to criteria stated by the researcher. Eligible patients admitted in the first three months were designated as control subjects; those in the last three months as experimental subjects. The twenty subjects in the control group were taught in an unplanned manner, based upon whether and/or what instructions were deemed pertinent by their nurses. A "Diabetic Teaching Tool"-- designed by the researcher and administered by each patient's own nurse(s)-- was used to instruct the twenty experimental subjects. After discharge, each of the forty subjects was visited by the researcher, at which time a profile sheet was completed and a test of diabetic learning administered. Demographic and diabetic characteristics of the subjects-obtained from the patient profile sheets-- were analyzed and described in terms of distributions, medians and/or means. The test results were subjected to t-test analyses on several dimensions. And a number of demographic and diabetic traits were compared with their respective test scores by means of the Pearson Product Moment Correlation Coefficient. The data supported the following conclusions: 1. Diabetic patients taught by means of the "Diabetic Teaching Tool" demonstrated a significantly higher level of learning about self-care than did patients taught in the unplanned manner. 2. Statistically significant differences were found between test scores of patients taught with the "Diabetic Teaching Tool" and those receiving unplanned instruction regardless of the duration of their diabetes. Thus 'old' diabetics were able to derive as much benefit from the teaching tool as were 'new' diabetics. 3. The level of learning demonstrated by patients taught with the "Diabetic Teaching Tool" appeared to be independent of the following factors: age at time of teaching and testing, previous education, and age at onset of diabetes; each of these factors was significantly related to the level of learning of patients receiving unplanned instruction. 4. Diabetic patients taught by means of the "Diabetic Teaching Tool" cited the nurse as a valuable source of information regarding diabetic management more than five times as frequently as did patients receiving unplanned instruction. Based upon these findings, several implications for nursing practice and recommendations for further research were suggested. / Applied Science, Faculty of / Nursing, School of / Graduate