Made available in DSpace on 2014-06-11T19:31:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-07-22Bitstream added on 2014-06-13T20:41:16Z : No. of bitstreams: 1 cavalheiro_sfl_dr_arafcf.pdf: 9453648 bytes, checksum: c79876e33e0a6edbfac171334d0ca967 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / No Brasil estima-se a existência de aproximadamente 12 milhões de adultos com Diabetes Mellitus (DM) e destes entre 54 a 76% apresentam taxas de mau controle. Esta situação torna o DM um sério problema de saúde pública, devido tanto ao número de pessoas afetadas como aos custos envolvidos no seu controle e no tratamento de suas complicações. A previsão é que em 2030 haverá um crescimento de 67,11% nesta população. Tal situação demonstra a necessidade de melhora urgente no atendimento ou a inserção de novas abordagens de cuidado com evidências científicas (estudos translacionais). Neste sentido, este estudo translacional fase 1 pretende desenvolver e avaliar um protocolo de Atenção Farmacêutica intensivo com metodologia educacional de empoderamento (ATENFAR-EPW), visando contribuir na melhoria do controle glicêmico e qualidade de vida de adultos com Diabetes Mellitus tipo 2 (DM2). MÉTODOS. Estudo conduzido em 3 etapas por farmacêutico-educador em diabetes: (1) desenvolvimento e elaboração do protocolo de ATENFAR-EPW e de instrumentos para acompanhamento e avaliação de indicadores; (2) estudo clínico controlado e randomizado em dois grupos – grupo de intervenção com n=12 (GAF) e grupo de atendimento usual com n=8 (GAU); (3) avaliação de aceitação do protocolo. RESULTADOS. (1) características do protocolo desenvolvido: (a) atendimento domiciliar e ou... / In Brazil it is estimated there are approximately 12 million adults with Diabetes Mellitus (DM), and, from this population, the rate for poor glycemic control varies from 54 to 76%. This makes DM a serious public health problem due to both, the number of people affected, and the cost of controlling and treating DM related complications. This situation demonstrates the urgent need for improvement in service or the insertion of new approaches to care based on scientific evidence (translational research). Thus, this study aims to develop a translational research and evaluate a protocol for intensive Pharmaceutical Care with educational methodology of empowerment (ATENFAR-EPW), aiming to improve glycemic control and quality of life of adults with diabetes mellitus type 2 (DM2). METHODS. The study was conducted in steps by the pharmacist-educator in diabetes: (1) development and drafting of the protocol ATENFAR-EPW and tools for monitoring and evaluation of the indicators, (2) controlled and randomized clinical study into two groups - the intervention group with n = 12 (GAF) and usual care group with n = 8 (GAU), conducted from October 2010 to July 2011. RESULTS. (1) characteristics of the developed protocol: (a) home care or by phone or outpatient, (b). number of visits / duration = 6 ± 2 visits / 12 weeks, (c) length of service / adult = 56 ± 28 min, (d) no. of interventions / adult = 48 ± 14. (2) Evaluation of the impact of the study: (a) significant reduction in HbA1c (- 1.3 ± 1.1, p = 0.005), (b) significant improvement of... (Complete abstract click electronic access below)

In dogs, nutrition has been implicated in the development of numerous chronic diseases, including obesity, diabetes and cardiovascular disease. Health claims for dog food are not regulated in Canada, thus many claims do not have a scientific basis. The development of a pet food with proven health benefits is important to pet owners as well as the pet food industry. The purpose of this study was to develop a low glycemic canine diet that will provide health benefits for dogs, namely decreased serum insulin and glucose concentrations, reduced food intake and weight gain, and improved cardiovascular health. To achieve this objective, four studies were performed. These studies examined the acute and longer term health effects of feeding unprocessed as well as extruded carbohydrate sources as both single ingredients and in complete dog diets. In addition, metabolic and cardiovascular health parameters were measured in dogs when they were lean, obese and after weight loss. Post-prandial serum glucose and insulin responses were used to determine glycemic index of the carbohydrate sources and to evaluate glucose tolerance. Flow-mediated dilation, echocardiography and blood pressure were used to assess cardiovascular health. Computed tomography was performed to measure body fat amount and distribution. Leptin, adiponectin and C-reactive protein were also analyzed. The results of these studies found that peas had a lower glycemic index compared to barley and rice, but that after extrusion, the glycemic index of the pea diet was not different than the rice diet. Post-prandial hyperglycemia in dogs was associated with acute changes in endothelial function which may be related to increased methylglyoxal concentrations. However, several negative health effects were observed in dogs after only 12 weeks of obesity and weight loss reversed some, but not all, of these changes. The pea-based diet reduced post-prandial insulin response in obese dogs after 12 weeks on the diet even though no changes were observed in body fat amount or distribution. In conclusion, this research supports the usefulness of peas as an ingredient in canine diets and provides valuable data for the pet food and pulse industries, as well as for veterinarians and pet owners.

As part of a project to see whether potatoes with a low glycemic-index (GI) could be developed through plant breeding, the GI values of 4 new potato varieties differing in starch structure was determined in 3 studies over 2 years in human subjects. Since cooking and cooling affects starch structure the potatoes were studied both freshly cooked (boiled) and cooled. The first study showed that cooling reduced the GI of two varieties by 40-50% but had no effect in the others (treatment × variety interaction, p=0.024), an effect which was confirmed in study 2. Differences in GI were readily explained by differences in starch structure or in-vitro digestion rate. Carbohydrate malabsorption increased from 3 to 5% upon cooling, not enough to account for the reduced GI. It is concluded that the effect on GI of cooling cooked potatoes varies in different varieties. Further research is needed to understand the mechanism.

Barley has been receiving increased attention as a human food due to the health benefits associated with β-glucan fiber and its potential as a low glycemic index (GI) functional food. Research has shown a relationship between the physico-chemical properties of β-glucan and the physiological effects, which may be altered by processing. However, it is not known if the physiological effects of consuming barley are affected by variations in chemical composition among cultivars or by common processing methods such as pearling or milling. The primary objective of this thesis was to characterize the effects of differences in cultivar starch and fibre content, level of pearling and milling on the GI, satiety and the physico-chemical properties of β-glucan. Nine barley cultivars varying in starch-type and β-glucan content were studied in three experiments in separate groups of ten healthy participants. Blood glucose and satiety ratings were measured and the GI was calculated. Total starch, total fibre, β-glucan, molecular weight (MW), solubility and β-glucan viscosity were determined in vitro. Results showed that GI varied by cultivar (CDC-Fibar, 26 ± 3 vs. AC-Parkhill, 35 ± 4, P < 0.05) and pearling (WG, 26 ± 4 vs. WP 35 ± 3, P < 0.05). When two cultivars were milled and processed to wet pasta the GI increased by 184% (P < 0.05). The pearled wet pasta had a significantly lower GI compared to the whole grain (P < 0.05). Boiled barley kernels tended to elicit greater satiety than white bread, but the difference was not significant. In both the boiled barley kernels and the wet pasta, pearling did not affect the MW, viscosity and solubility. MW did not significantly differ between cultivars but solubility and viscosity did (P < 0.05). The wet pasta had significantly lower MW, solubility, viscosity but not β-glucan content than the boiled barley kernels (P < 0.05). In conclusion, pearling did not have an effect but milling and extruding resulted in significant reduction in MW, solubility and viscosity. The GI of barley is influenced significantly by cultivar, pearling and milling. Further studies are required to determine the effect on satiety.

Barley has been receiving increased attention as a human food due to the health benefits associated with β-glucan fiber and its potential as a low glycemic index (GI) functional food. Research has shown a relationship between the physico-chemical properties of β-glucan and the physiological effects, which may be altered by processing. However, it is not known if the physiological effects of consuming barley are affected by variations in chemical composition among cultivars or by common processing methods such as pearling or milling. The primary objective of this thesis was to characterize the effects of differences in cultivar starch and fibre content, level of pearling and milling on the GI, satiety and the physico-chemical properties of β-glucan. Nine barley cultivars varying in starch-type and β-glucan content were studied in three experiments in separate groups of ten healthy participants. Blood glucose and satiety ratings were measured and the GI was calculated. Total starch, total fibre, β-glucan, molecular weight (MW), solubility and β-glucan viscosity were determined in vitro. Results showed that GI varied by cultivar (CDC-Fibar, 26 ± 3 vs. AC-Parkhill, 35 ± 4, P < 0.05) and pearling (WG, 26 ± 4 vs. WP 35 ± 3, P < 0.05). When two cultivars were milled and processed to wet pasta the GI increased by 184% (P < 0.05). The pearled wet pasta had a significantly lower GI compared to the whole grain (P < 0.05). Boiled barley kernels tended to elicit greater satiety than white bread, but the difference was not significant. In both the boiled barley kernels and the wet pasta, pearling did not affect the MW, viscosity and solubility. MW did not significantly differ between cultivars but solubility and viscosity did (P < 0.05). The wet pasta had significantly lower MW, solubility, viscosity but not β-glucan content than the boiled barley kernels (P < 0.05). In conclusion, pearling did not have an effect but milling and extruding resulted in significant reduction in MW, solubility and viscosity. The GI of barley is influenced significantly by cultivar, pearling and milling. Further studies are required to determine the effect on satiety.

As part of a project to see whether potatoes with a low glycemic-index (GI) could be developed through plant breeding, the GI values of 4 new potato varieties differing in starch structure was determined in 3 studies over 2 years in human subjects. Since cooking and cooling affects starch structure the potatoes were studied both freshly cooked (boiled) and cooled. The first study showed that cooling reduced the GI of two varieties by 40-50% but had no effect in the others (treatment × variety interaction, p=0.024), an effect which was confirmed in study 2. Differences in GI were readily explained by differences in starch structure or in-vitro digestion rate. Carbohydrate malabsorption increased from 3 to 5% upon cooling, not enough to account for the reduced GI. It is concluded that the effect on GI of cooling cooked potatoes varies in different varieties. Further research is needed to understand the mechanism.

Thesis (M.S.)--Auburn University, 2007. / Abstract. Vita. Includes bibliographic references (ℓ. 90-99)

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 132-151).

Diabetes mellitus and periodontitis are diseases of high prevalence. These two diseases are also related with each other. Periodontal therapies have already become a part of the treatment for glycemic control; however the benefits of different periodontal therapies are unclear. In the first phase of this study, we performed a systematic review of the current randomized controlled trials for the benefits of periodontal therapies. In the second phase, we analyzed the evidence for the benefits of periodontal therapies (serum HbA1c, fructosamine, periodontal pocket depth, clinical attachment level, bleeding on probing, plaque index, gingival index, C-reaction protein, and gingival crevicular fluid volume). In the third phase, we reported safety issues (total withdrawals, withdrawal due to serious adverse effects, serious adverse events and common adverse effects). In general, most included studies were poorly reported. Additional high-quality research studies into benefits of periodontal therapies are needed.

Please read the abstract in the dissertation / Dissertation (M (Dietetics))--University of Pretoria, 2008. / Human Nutrition / M (Dietetics) / unrestricted