Trabajo de Investigación Requisito para optar al Título de Cirujano Dentista / Autor no autoriza el acceso a texto completo de su documento / INTRODUCCIÓN: La diabetes mellitus tipo 2 (DM2) es un trastorno metabólico debido a una deficiencia progresiva en la secreción de insulina. El control glicémico en pacientes con DM2 se debe mantener en niveles adecuados; si estos no se mantienen, pueden presentarse consecuencias negativas locales y sistémicas importantes. El examen de Hemoglobina Glicosilada (HbA1C) se utiliza para definir el verdadero control glicémico de la enfermedad, por lo que debe mantenerse en niveles adecuados. Las levaduras del género Candida son microorganismos comensales, que cambian a una forma patógena al existir alteración en los mecanismos de defensa del hospedero. La DM2, especialmente en estado descompensado, se ha asociado al desarrollo de patologías provocadas por infección con microorganismos oportunistas, en especial por levaduras del género Candida. MATERIAL Y MÉTODOS: Se obtuvieron muestras de saliva de 52 sujetos voluntarios mayores de 30 años con diagnóstico de DM2, previo consentimiento informado firmado. El grupo se dividió según su condición metabólica en diabéticos compensados (HbA1C < 7%) y no compensados (HbA1C > 7%). Un volumen de 100 μl de saliva se sembró en placas de Agar Sabouraud Tetraciclina y CHROMagar Candida ®, las que se incubaron durante 48 horas a 30 ºC, hasta el desarrollo de colonias. En estas placas se estimó el número de células viables y se identificaron presuntivamente las especies de Candida presente según su coloración. La identidad de las colonias observadas se confirmó molecularmente mediante Reacción en Cadena de la Polimerasa (PCR) y bioquímicamente mediante el Sistema de Identificación API ID32C ®. RESULTADOS: El promedio de HbA1C de la muestra total correspondió a 8,16 %, donde 40 correspondieron a mujeres y 12 a hombres, entre 33 y 82 años de edad. La portación de levaduras no tuvo diferencias significativas en relación al género y al estado metabólico (p > 0,05) pero fue mayor al aumentar la edad (p = 0,024). La cantidad de UFC, medida en rangos mayor o menor a 400 UFC/ml fue mayor en el 6 grupo descompensado (p = 0,025) y al aumentar la edad (p = 0,017). Se identificaron 6 especies, donde la más aislada en la muestra fue C. albicans con un 66,1 % y en 38 (97,4 %) del total de sujetos portadores, seguido por C. glabrata. La diversidad de especies no se relacionó a género ni al estado metabólico (p > 0,05) pero sí a la edad (p = 0,049). CONCLUSIONES: La descompensación metabólica en pacientes con DM2 se asoció a una mayor cantidad de UFC/ml no así con una mayor diversidad de especies.

Diabetes ist assoziiert mit einer endothelialen Dysfunktion sowie einer vermehrten Aktivierung von Thrombozyten. Beides erhöht wahrscheinlich das Risiko eines kardiovaskulären Ereignisses. In der vorliegenden experimentellen Arbeit wurde untersucht, ob der Hydroxy-3-Methyl-Glutaryl (HMG)-CoA-Reduktase-Inhibitor Rosuvastatin zu einer Verbesserung der Endotheldysfunktion und einer Reduktion der Thrombozyten-Aktivierung im diabetischen Tiermodell beiträgt. Zu diesem Zweck wurde männlichen Wistar Ratten einmalig Beta-Zell-toxisches Streptozotocin injiziert und dadurch künstlich ein Diabetes mit persistierender Hyperglykämie erzeugt. Die Behandlung mit Rosuvastatin (20 mg/kg Körpergewicht täglich) beziehungsweise Placebo wurde zwei Wochen nach Induktion der Hyperglykämie begonnen und über zwei weitere Wochen fortgeführt. Die Gefäßfunktion wurde anschließend an isolierten Aortensegmenten im Organbad gemessen, die Bestimmung der Thrombozyten-Aktivierung erfolgte in frischem Vollblut. Die endothelabhängige Relaxation der Gefäße, induziert durch den rezeptorabhängigen Agonisten Acetylcholin, war in diabetischen Ratten signifikant vermindert und konnte durch die Rosuvastatin-Therapie verbessert werden. Dies ließ sich hauptsächlich auf eine deutlich reduzierte Sensitivität der Gefäßmuskulatur für Stickstoffmonoxid (NO) zurück führen, welche bei den diabetischen Tieren durch eine gesteigerte Superoxidbildung bedingt war. Rosuvastatin reduzierte signifikant die Bildung der Sauerstoffradikalen und verbesserte darüber hinaus die NO-Sensitivität. Weiterhin konnte durch die HMG-CoA-Reduktase-Inhibition die Bindung von Fibrinogen an aktiviertes GPIIb/IIIa, sowie die P-Selektin-Expression auf der Thrombozytenoberfläche als Marker der Thrombozyten-Degranulation reduziert werden, während diese beiden Marker der Thrombozyten-Aktivierung in der Placebo-behandelten diabetischen Versuchsgruppe erhöht waren. Aus diesen Ergebnissen lässt sich schlussfolgern, dass eine Behandlung mit dem HMG-CoA-Reduktase-Inhibitor Rosuvastatin bei diabetischen Ratten die Endotheldysfunktion der Gefäße verbessert und die Aktivierung von Thrombozyten durch eine verbesserte Verfügbarkeit des endogenen Thrombozyten-Inhibitors NO vermindert. Übertragen auf das menschliche Gefäßsystem könnte dieser Effekt zu einer Verminderung kardiovaskulärer Ereignisse durch eine Statin-Therapie bei Patienten mit Diabetes beitragen. / Hypothesis: Diabetes is associated with vascular dysfunction and platelet activation, both of which may contribute to increased cardiovascular risk. We investigated whether the hydroxy-methyl-glutaryl CoA reductase inhibitor rosuvastatin improves vascular dysfunction and reduces platelet activation in diabetic rats. Methods: Male Wistar-rats were injected with streptozotocin (STZ, 50 mg/kg i.v.) to induce insulin-deficient diabetes. Treatment with rosuvastatin (20 mg/kg/day) or vehicle was initiated 2 weeks after injection of STZ and continued for 2 weeks. At week 4, platelet activation was assessed in fresh whole blood and vascular function was characterized in isolated aortic segments in organ bath chambers. Results: Diabetic rats displayed severe impairment of phenylephrine-induced contraction, which was significantly improved by rosuvastatin. Endothelium-dependent relaxation induced by acetylcholine was significantly attenuated in diabetic rats and improved by treatment with rosuvastatin (maximum relaxation, % of precontraction: control: 99.8±0.2, STZ-vehicle: 80.7±2.9, STZ-rosuvastatin: 98.9±0.7; p<0.01). Treatment with rosuvastatin significantly reduced fibrinogen-binding to activated GPIIb/IIIa (mean fluorescence: control: 161.0±6.9, STZ- vehicle: 207.8±15.9, rosuvastatin: 173.6±5.3; p<0.05) and P-Selectin surface expression on platelets (mean fluorescence: control: 76.5±7.3, STZ- vehicle: 92.1±5.5, rosuvastatin: 75.2±6.5; p<0.05). Conclusions: We demonstrate that rosuvastatin treatment normalizes vascular dysfunction and reduces platelet activation in diabetic rats. These effects may contribute to the reduction of cardiovascular events by statins in diabetic patients.

Eine Schädigung des Endothels ist früh nachweisbar in der Pathogenese kardiovaskulärer Erkrankungen. Beim Diabetes mellitus führt die Entkopplung der endothelialen Stickstoffmonoxid-Synthase (eNOS) durch Bildung von Superoxidanionen (O2-) anstatt von Stickstoffmonoxid (NO) zu einer gesteigerten Produktion an reaktiven Sauerstoffradikalen (ROS) und zu einer Schädigung des Endothels. Bei der Endothelregeneration spielen die kürzlich entdeckten endothelialen Progenitorzellen (EPCs) eine entscheidende Rolle. Für deren Mobilisierung und volle Funktionalität ist die eNOS von essentieller Bedeutung. In der vorliegenden Arbeit wurde die Hypothese untersucht, daß die beim Diabetes mellitus bekannte Entkopplung der eNOS auch eine wichtige Rolle bei der verminderten Mobilisierung und Dysfunktion von EPCs spielen könnte. Bei Patienten mit Typ-II Diabetes waren die EPC-Spiegel im Blut deutlich vermindert, die EPCs von diabetischen Patienten produzierten mehr O2- und ihre Funktion war im Vergleich zu den EPCs von Kontrollen eingeschränkt. Die gestörte Funktion der EPCs ließ sich durch eine Blockade der NOS mit NG-nitro-L-Arginin (L-NNA) zu einem großen Teil wiederherstellen. Gleichzeitig war dies auch mit einer verminderten O2--Produktion verbunden. In kultivierten EPCs führte die Inkubation mit Glukose zu einer vermehrten O2-- Produktion und einer verminderten Migrationsfähigkeit. Die Proteinkinase C scheint hierbei mechanistisch über eine Aktivierung der NADPH-Oxidase (NOX) von Bedeutung zu sein. Die durch Glukose hervorgerufene gesteigerte O2--Generierung resultiert in verminderten intrazellulären Tetrahydrobiopterin (BH4) -Spiegeln, dem wahrscheinlich entscheidenden pathophysiologischen Mechanismus bei der eNOS-Entkopplung. Nach exogener Zufuhr von BH4 kam es zu einer signifikanten Funktionsverbesserung der EPCs und einer deutlich verminderten O2--Produktion. Im Tiermodell des Diabetes wurden EPC-mobilisierende Mechanismen untersucht. Bei Ratten wurde durch Streptozotozininjektion ein Typ-I-Diabetes hervorgerufen. Bei diesen Tieren konnten ebenso wie bei den diabetischen Patienten verminderte EPC-Spiegel nachgewiesen werden. Ursache hierfür könnte eine Entkopplung der eNOS im Knochenmark sein. Hier zeigte sich eine gesteigerte O2--Produktion, welche durch eine NOS-Blockade mittels L-NNA teilweise reversibel war. Wahrscheinlich sind die auf die Entkopplung der eNOS zurückzuführende verminderte EPC-Mobilisierung und -Funktion mitbestimmende Faktoren in der Pathogenese von vaskulären Komplikationen beim Diabetes mellitus. / Early in the pathogenesis of cardiovascular diseases the endothelium gets impaired. In diabetes mellitus the uncoupling of the endothelial nitric oxide synthase (eNOS) causes endothelial dysfunction by the formation of superoxide anions (O2-) instead of nitric oxide (NO). For the proper regeneration of the endothelial monolayer endothelial progenitor cells (EPC) are essential. The eNOS plays a crucial role in the mobilisation and functionality of the EPCs. In this work we investigated, if the in diabetes mellitus appearing uncoupling of the eNOS plays a major role in the dysfunction and lesser mobilisation of EPCs. EPC levels in diabetic patients were significantly reduced and produced more O2-. The impaired function of EPCs could be nearly be reversed by adding NG-nitro-L-arginine (L-NNA) and also the O2-- production was reduced. Cultivated EPCs, who were incubated with glucose, produced more O2- and their migratory capacity was reduced. The protein-kinase C seems to activate the NADPH-oxidase. This seems to be an important mechanism in the eNOS-uncoupling. The intracellular tetrahydrobiopterin-concentration (BH4) was reduced. The exogenous application of BH4 resulted in a better EPC-function and lesser O2--production. In an animal-model the mechanisms for the EPC-mobilisation were investigated. We used type-1 diabetic rats, induced by the injection of streptocotocine. The EPC-levels in these animals were reduced. A reason for that could be the uncoupling of the eNOS in the bone marrow. The O2--formation was initially elevated and could be reduced by the addition of L-NNA. It is possible, that the by the eNOS-uncoupling induced bad function and lesser mobilisation of EPCs in diabetes mellitus can lead to vascular complications.

Objectives. The Pregnancy, Nutrition & Diabetes (PND) study aimed to evaluate the dietary status of urban Black pregnant women attending the Antenatal Clinic at the Charlotte Maxeke (Johannesburg General) Hospital. In addition, the study investigated the effects of maternal dietary intake and hormonal levels during pregnancy on fetal growth, birth size and the early postnatal development of risk factors for future Type 2 diabetes. The study analysis precedes a detailed description of the study population, including its comparison with other populations. Methods. 126 women were enrolled in the study before 24 weeks of gestation. Twice during pregnancy (weeks 20-24 and 30-36, visits V1 and V2) and approximately six months after the delivery (visit V3), volunteers participated in a standard 75 g oral glucose tolerance test (OGTT). Blood pressure, anthropometric and socio-demographic data were taken and a food frequency questionnaire was administered at each visit. The daily maternal intakes of total energy and macronutrients expressed as a % of total energy intake (%E) were calculated and further evaluated. A comparison with the crude nutrients intakes was also performed. During both pregnancy visits, an ultrasound examination was carried out to obtain estimates of fetal biometry and fetal well-being and the postnatal anthropometric parameters were also measured. Blood samples were collected at fasting, 30min, 60min and 120min of the OGTT for the measurements of maternal glucose (GLC), insulin (INS), C-peptide (C-PEP) and proinsulin (PI) and fasting samples for the determination of placental lactogen (HPL), insulinlike growth factor 1 (IGF-1), insulin-like growth factor binding protein 1 (IGF-BP1), free thyroxin (FT4), cortisol (CORT) and leptin (LEPT). Infant fasting blood samples were used for the analysis of the GLC, INS, PI, IGF-BP3 and LEPT. The plasma glucose samples were analysed on the Beckman Glucose Analyser 2, whilst all the other analytes were measured by an immunoassay method on 96-well plates. Results – DESCRIPTIVE DATA. Study participants. The majority of the study participants had completed high school education, however were unemployed and of low and very poor socio-economic levels. In comparison with another study from the developing world, the Pune study in India, the women from the current study were older, heavier with greater body mass index (BMI) and they were also taller. They had higher head and arm circumference. Birth outcomes. The birth size of African babies in the current study, although smaller in all parameters, was still relatively closer to the size of the Caucasian babies seen within the Southampton (Godfrey et al. 1996) or Helsinki (Forsén et al. 1997) studies than to the birth size of the babies from Trivandrum (Jaya et al. 1995) or Pune (Rao et al. 2001) in India. These relatively smaller African babies have comparable (or even larger) maternal placental sizes in relation to the mothers of both European studies. However, in comparison with the small Indian babies, the major difference noted was a substantially smaller placental size of the Pune mothers. Compared to z-scores from the World Health Organization (WHO) child growth standards (WHO Anthropo 2010), the PND study babies were born lighter and shorter with a larger head circumference (HC). A growth delay observed near the neonatal visit was followed by catch up growth in weight for age, however no catch-up growth was observed for length for age by the second postnatal visit. Dietary intakes. The PND study women had pregnancy energy intakes slightly below the national level intakes (Steyn et al. 2006), except for the energy intake at V3, which exceeded the national level. The lower energy intake during pregnancy is attributable to a lower intake of dietary protein and total carbohydrate. The fat intake was substantially higher in the PND study, with levels almost double at the second postnatal visit. This discrepancy may be due to differences between investigated populations or due to increased requirements of energy during lactation. In comparison with the Recommended Dietary Allowances (RDA), during the pregnancy period women in the current study had lesser crude protein and higher carbohydrate intake. Intake of the crude protein after delivery was low in comparison to the RDA for lactating women. Total carbohydrate intake exceeded the RDA. The relation between the intake of macronutrients expressed as a percentage of total energy (%E) and RDA was similar. The current study participants had a lower intake of energy, especially during the pregnancy period, when compared to populations in the developed world. They had a lower intake of protein at all visits in comparison with the national average for women or with that found in the Southampton study or when compared to the usual American diet. The energyadjusted intake of fat and carbohydrate were comparable with the Southampton and American data. This population in our study was therefore more comparable to that of Pune than to American or Southampton populations. However, despite similar total energy intakes as the Pune Study, total protein and fat intakes were higher in the African mothers, which may explain their higher weights and birthweights of their babies. Results – ANALYTICAL DATA Dietary intakes. Maternal dietary intakes showed significant effects on the fetal biometrical measurements, mainly involving the fetal head, femur length and the size of abdomen. The outcomes also show a significant relationship between maternal protein intake and baby’s birth weight. Associations were also found for maternal dietary intakes and the neonatal length and BMI and the markers of the infant β-cell function. Intakes of the plant protein and polyunsaturated fat supported the linear growth. There was no correlation between maternal dietary intake and the fetal growth rate. Effects of the total energy intake and carbohydrate seemed to be direct, while the effect of protein and fat may be delayed, possibly involving metabolic adaptation of the mother and the partitioning of nutrients between the mother, placenta and fetus. (See Table: Associations between the maternal dietary intake and the neonatal INSF1 levels, Pg. xiv). Maternal hormones. The data of the current study show significant relationships between maternal pregnancy hormones and fetal growth rate and the postnatal growth rate, although maternal anthropometry and fetal gender and BMI are also significantly involved. The maternal thyroid hormones seem to play an important role in fetal and postnatal growth and insulin metabolism (N=76, p=0.002, ß=-0.343; AR2=0.106) in the association with the neonatal fasting insulin. Discussion. The outcomes of the current study show that the African pregnant women in the study had lower energy intakes attributable to a lower intake of dietary protein and total carbohydrate. Maternal dietary intakes showed significant effects on the fetal biometrical parameters. Protein dietary intake was positively associated with baby’s birth weight and was shown to be statistically significant. Associations were also found for maternal dietary intakes and the infant postnatal BMI and the markers of the infant β-cell function. Quality of the protein and fat has different effects on fetal/infant growth. Maternal hormones showed correlations with fetal growth rate and the outcomes of the current study also show that maternal hormones can affect neonatal and early postnatal infant glucose levels and β-cell function. They are also linked to the programming of early obesity. The maternal thyroid hormones seem to play an important role. The maternal low energy, protein (especially plant protein) and PUFA intakes during gestation may be the reasons for the lower z-score birth parameters of the infants in comparison with the World Health Organization (WHO) child growth standards (WHO Anthro 2010). The disproportionally larger head of the newborn may be an outcome of the brain sparing effect. A suggestion for an increased maternal dietary intake of energy, protein and PUFA has been made.

Orientador: Ana Angélica Henrique Fernandes / Resumo: Diabetes mellitus (DM) é uma desordem metabólica caracterizada pela hiperglicemia persistente, com distúrbios no metabolismo de carboidratos, lipídios e proteínas, resultante de defeitos na secreção de insulina, ação da insulina ou ambos. A utilização de antioxidantes tem contribuído para melhorar a hiperglicemia e também minimizar as complicações diabéticas. Geraniol, um monoterpeno, presente na composição de óleos essenciais de várias plantas medicinais, apresenta ação antioxidante e antihiperglicemiante, sendo capaz de contribuir na terapêutica desta patologia. Este estudo tem como objetivo avaliar o metabolismo energético e estresse oxidativo no miocárdio de ratos com DM tipo 1, tratados com geraniol. Foram utilizados 32 ratos machos, Wistar (± 250g de peso corporal), distribuídos em 4 grupos experimentais (n=8): C (normais, controle); GE (normais, tratados com geraniol); DM (diabéticos, não-tratados); DM-GE (diabéticos, tratados com geraniol). A DM tipo 1 experimental foi induzido através da administração de estreptozotocina (STZ – 60 mg/Kg de peso corporal, i.p., dose única). Os animais dos grupos GE e DM-GE receberam geraniol (200 mg/Kg/dia) via gavagem durante 30 dias e os animais dos grupos C e DM receberam água pelo mesmo procedimento. Durante o período experimental, foram avaliados consumo de água e ração. Após este período, os animais em jejum de 12 horas, foram anestesiados (xilazina e cetamina) e eutanasiados. Foram coletadas amostras séricas para análise da con... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Diabetes mellitus (DM) is a metabolic disease characterized by persistent hyperglycemia, with disorders in the metabolism of carbohydrates, lipids and proteins, resulting from defects in insulin secretion, insulin action, or both. The use of antioxidants has contributed to improve hyperglycemia and also minimize diabetic complications. Geraniol, a monoterpene, present in the composition of essential oil of various medicinal plants, has oxidant and antihyperglycemic action, being able to contribute in the therapy of this pathology. This study aimed to evaluate the energetic metabolism and oxidative stress in the myocardium of rats with type 1 DM treated with geraniol. 32 male Wistar rats (±250g body weigth), distributed in four experimental groups (n=8): C (normal, control); GE (normal, treated with geraniol); DM (diabetic, untreated); DM-GE (diabetic, treated with geraniol). Experimental type 1 DM was induced by streptozotocin (STZ - 60mg/Kg body weight, i.p., single dose). Animals of the group GE and DM-GE received geraniol (200mg/K/day) by gavage for 30 days and animals of the group C and DM received water by the same procedure. Animals of the group GE and DM-GE received geraniol (200mg/K/day) by gavage for 30 days and animals of the group C and DM received water by the same procedure. During the experimental period, food and water intake were evaluated. After this period the animals, in a 12h fast, were anesthetized and euthanized. Serum samples were collected for glycemia... (Complete abstract click electronic access below) / Doutor

Made available in DSpace on 2019-03-30T00:23:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-06-25 / Nowadays, more devices are already connected to the Internet than humans. "Smart"devices can talk to others and measure, monitor, and control the physical world. The list of sensors and devices, connected on the web, is growing exponentially. Thus, wearable devices have made it possible for healthcare professionals to remotely monitor patient health using sensors, actuators, and other mobile communication devices. The Internet of Things (IoT) for medical devices (IoHT) is revolutionizing the healthcare industry by providing an environment in which patient data can be transmitted through a gateway to a secure, cloud-based platform for storage, aggregation and analysis. This work proposes a portable device, based on the IoT architecture, called LibreMonitor, in order to monitor continuously and remotely the condition of diabetic patients. This device consists of an NFC module, together with an IoT card, which captures the data of the glucose measurement of the Freestyle Libre sensor and transmits it via Bluetooth LE communication to a mobile application. The application allows the patient to see the screen, the bloodglucoserateinrealtimeandtheirhistories(15minutesandeighthours). Thedatacollected and displayed in the application is then transmitted via WiFi/3G/4G communication to a secure, cloud-based platform called Nightscout, where it will be stored and analyzed by healthcare professionals. As a result, this work concludes that, for the samples studied, it is possible to transform a low-cost, ef¿cient and reliable CGM (Flash Glucose Monitoring) device into CGM (Continuous Glucose Monitoring), which can provide quite satisfactory clinical results, aiming to provide a better quality of life for diabetic patients. Keywords: Diabetes Mellitus, IoT, IoHT, Internet of Things, Internet of Health Things, DM1, DM2, Gestational Diabetes, LibreMonitor. / Nos dias atuais,mais dispositivos já estãoconectadosàInternet doqueoshumanos. Dispositivos ¿Inteligentes¿ podem conversar com outros e mensurar, monitorar e controlar o mundo físico. A lista de sensores e dispositivos, conectados na web, está crescendo exponencialmente. Desse modo, os dispositivos vestíveis tornaram possível que pro¿ssionais da saúde possam monitorar remotamente a saúde do paciente usando sensores, atuadores e outros dispositivos de comunicação móvel. A Internet das Coisas (IoT) para dispositivos médicos (IoHT), está revolucionando o funcionamento do setor de saúde, fornecendo um ambiente em que os dados do paciente possam ser transmitidos através de um gateway, para uma plataforma segura, baseada em nuvem para armazenamento,agregaçãoeanálise. Estetrabalhopropõeumdispositivoportátil,baseadonaarquitetura IoT, chamado LibreMonitor, com o intuito de monitorar continuamente e remotamente a condição dos pacientes diabéticos. Esse dispositivo consiste em um módulo NFC, em conjunto com uma placa IoT, que captura os dados das medições da taxa de glicose do sensor Freestyle Libre, e as transmite, via comunicação Bluetooth LE, para um aplicativo móvel. O aplicativo permite que o paciente veja na tela, a taxa de glicose no sangue em tempo real e seus históricos (de 15 minutos e oito horas). Os dados coletados e exibidos no aplicativo são, posteriormente, transmitidos via comunicação WiFi/3G/4G, para uma plataforma segura, baseada em nuvem, chamada Nightscout, onde serão armazenados e analisados pelos pro¿ssionais de saúde. Como resultado, este trabalho conclui que, para as amostras estudadas, é possível transformar um dispositivo FGM (Flash Glucose Monitoring) em CGM (Continuous Glucose Monitoring), de baixo custo, e¿ciente e con¿ável, podendo propiciar resultados clínicos bastante satisfatórios, visando proporcionar uma melhor qualidade de vida ao paciente diabético. Palavras-chave: DiabetesMellitus,IoT,IoHT,InternetdasCoisas,InternetdasCoisasdeSaúde, DM1, DM2, Diabetes Gestacional, LibreMonitor.

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Made available in DSpace on 2019-04-05T23:11:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-11-23 / Objective: To evaluate the profile of the performance of Physical Education Professionals when dealing with persons with Diabetes Mellitus in the gyms in the city of Fortaleza, Brazil. Methods: This is a quantitative, descriptive and transversal study conducted in gyms registered with the Regional Physical Education Council - CREF-5. 400 Physical Education graduates, registered with the CREF, who were working at 84 gyms in the Municipality of Fortaleza-CE were studied. Through a structured questionnaire with objective and subjective questions, all the professionals were questioned about their general characteristics and their professional qualifications (sex, age, time since qualifying, place of graduation, whether they have any specialization courses), knowledge regarding diabetes mellitus and the characteristics of the diabetic clientele (diagnostic criteria and the classification of diabetes and the minimum care required to work with a diabetic clientele) and the characteristics of the professionals performance regarding the diabetic clientele. Results: Of the 400 physical education professionals, 265 (66.3%) worked with diabetic students; this group was made up mainly by professionals who were only graduates. The most common type of diabetes found in the workplace was type 2 diabetes. Most of the participants were unable to state the glycemic values to consider whether a student is diabetic. Around 151 (57%) professionals affirmed that they requested or carried out an initial physical evaluation of students with diabetes and only 120 (45.3%) of physical educators working with diabetics asked for medical consent. Practically none of the participants knew of situations that counter-indicated physical exercise for diabetic students or the habitual care that these students should have. Regarding monitoring, most of the professionals did not use the capillary glycemia test before and after physical exercise. Conclusion: It was concluded that the attributes of Physical Education Professionals include the prescription and guidance of specific activities and the monitoring of persons with special care needs, such as invalids and persons living with chronic conditions such as diabetes mellitus. Thus, obviously these professionals need to be qualified to deal with this. / Objetivo: Avaliar o perfil da atuação do Profissional de Educação Física junto aos portadores de Diabetes Mellitus nas academias de Fortaleza. Métodos: Trata-se de um estudo de abordagem quantitativa, descritivo e transversal, tendo sido conduzido nas academias de ginástica cadastradas no Conselho Regional de Educação Física CREF-5. Foram estudados 400 profissionais de Educação Física graduados e cadastrados no CREF que atuavam nas 84 academias de ginástica do Município de Fortaleza-CE. Através de questionário estruturado com perguntas objetivas e subjetivas, todos os participantes foram questionados quanto as caracterísiticas gerais e formação profissional (sexo, idade, tempo de formação profissional, local de graduação, se possui especialização e qual área), conhecimento sobre diabetes mellitus e característica da clientela diabética (critérios de diagnósticos e de classificação do diabetes e cuidados mínimos necessários para atuação com a clientela diabética), características da atuação dos profissionais frente à clientela diabética. Resultados: Dos 400 educadores físicos, 265 (66,3%) trabalhavam com alunos diabéticos, sendo esse grupo constituído pela maioria de profissionais que eram somente graduados. O tipo de diabetes mais encontrado no local de trabalho foi o diabetes tipo 2. A maioria dos participantes não sabiam informar os valores glicêmicos para considerar um aluno diabético. Cerca de 151 (57%) profissionais afirmaram que solicitavam ou faziam alguma avaliação física prévia nos alunos com diabetes e apenas 120 (45,3%) dos educadores físicos que atuavam com diabéticos solicitavam liberação médica. A quase totalidade dos participantes não sabiam informar as situações que contra-indicavam o exercício físico para alunos diabéticos e nem as recomendações e os cuidados habituais que esses alunos deveriam ter. Em relação ao monitoramento, a maioria dos profissionais não utilizam o teste de glicemia capilar antes e após o exercício físico. Conclusão: Conclui-se que faz parte das atribuições do Profissional de Educação Física a prescrição e orientação de atividades específicas e seu acompanhamento para com pessoas que tenham necessidades especiais de atendimento, como os enfermos ou pessoas que convivem com perturbações de saúde de ordem crônica, como o diabetes mellitus. Para tanto, faz-se necessária, a qualificação desses profissionais.

Giessen, Universität, Thesis (doctoral), 2002.

Thesis (doctoral)--Universität, Hannover, 2000.