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Early Renal Dysfunction in Obese Patients with Insulin Resistance

Abstract

Background and aims. Obese individuals have insulin resistance status assessed in the present study by the HOMA index (“Homeostasis model assessment”). This prospective study assessed renal disorders in the insulin resistance in obese patients.

Material and Methods. The study included 73 young obese patients. The assessment included the HOMA index before meal and parameters of renal function (glomerular filtration rate, albuminuria, β2-microglobulinuria).

Results. In young obese, insulin-resistance patients, glomerular hyperfiltration and β2-microglobulinuria are found in 77.0 and 93.4% of cases respectively. The albuminuria is noted in some cases, which reduces diagnostic value.

Conclusions. In young obese patients with insulin resistance, glomerular hyperfiltration and β2-microglobulinuria are main diagnostic markers of renal dysfunction.

Open access
The Effect of Thymoquinone Toward Tooth Disorder Prevention in Postnatal Rat offspring Born from Hyperglycemia Pregnant Rats

Abstract

Background and aims. Hyperglycemia in pregnancy was caused by reduced insulin production that led to tooth germ growth disorder. Thymoquinone could increase insulin production through pancreatic β-cells regeneration. The purpose of this study was to determine the effect of thymoquinone to prevent tooth disorder in rat offspring born from hyperglycemia pregnant rat.

Material and method. Wistar rat offspring used in this research taken from pregnant rat induced hyperglycemia with streptozotocin 40 mg/kgBW divided into four groups. Rat offspring observation had been done on 3rd, 5th, and 7th day postnatal. The histological image of first maxillary molar tooth germ stained with Haematoxilin Eosin and Mallory’s Trichrome. The parameters of rat offspring were body weight, blood glucose levels, tooth growth stages, tooth dimension width, and tooth germ enamel matrix.

Results. Thymoquinone group had the widest tooth germ dimension compare to other groups. All rat offspring tooth germs were at the appositioncalcification stage in matrix enamel (pre-enamel). The analysis showed that no statistical differences between thymoquinone group and metformin group (p>0.05).

Conclusions. Thymoquinone has same function with metformin to prevent tooth disorder in rat offspring born from pregnant rat induced hyperglycemia.

Open access
Euglycemic Ketoacidosis Diagnosis and Treatment Protocol in Type 1 Diabetes Patient

Abstract

Introduction. The introduction of sodium glucose cotransporter 2 inhibitors in the management of diabetes was an innovation in the treatment of this disease, considering the protective cardiovascular effect not only the ability of decreasing the plasma glucose. In Europe, this class of medication is approved for the treatment of type 2 diabetes and some of them (dapagliflozin and sotagliflozin) are also approved for use in certain patients with type 1 diabetes mellitus. These patients must have inadequate control of their blood glucose levels despite optimal insulin therapy. One of the adverse effects is diabetic ketoacidosis.

Case report. This case report presents a diabetic patient whose treatment was changed from insulin therapy to oral therapy. Within 10 days after the initiation of the new treatment her condition gradually worsened and she arrived at the emergency room with nausea, vomiting and altered general condition. She was admitted for euglycemic ketoacidosis and treated according to the protocol.

Conclusions. This case reveals the importance of continuing the insulin therapy when adding a sodium glucose cotransporter 2 inhibitor in type 1 diabetes patients.

Open access
Highlighted of Ramadan Fasting on Diabetes-Study of Complications, Biochemical Aspects and Anthropometry

Abstract

Background and aims: The diabetic exempted from fasting by religion, wishing or not to observe the fast, is exposed like any other during Ramadan to a change in lifestyle. The objective of this study was to highlight the effects of Ramadan fasting on diabetes.

Material and methods: Multicentre study on 899 diabetics was carried to collect data on the behaviour of diabetics with regard to the fast of Ramadan, biochemicals and anthropometry parameters.

Results. The sample consists of 541 diabetic fasters (DTMF) and 358 no fasters. The causes of interruption of fasting were: hypoglycemia (82.4%), dehydration (44.5%), hyperglycemia (12.6%), high blood pressure (13.7%), loss of consciousness (8.3%). The risk factors related to fasting for DTMF were the type of diabetes and gender. Discussion and modifications about dietary, blood glucose monitoring and nutritional education sessions showed a protective effect against the occurrence of hypo and hyperglycemia and loss of consciousness. Decreasing differences were noted for Hb1Ac, LDL and Total-Cholesterol between before and after Ramadan. The weight of DTMF decreased in post-Ramadan (p=0.0000).

Conclusion. There is a need to consider regular preventive measures based on public information on the effects of diabetes related complications and the benefits of a balanced diet combined with regular physical activity in nutrition education sessions.

Open access
Lifestyle Medicine – New Concept, Innovative Discipline

Abstract

A large percentage 63% of premature deaths and chronic diseases could be prevented by adhering to healthy dietary patterns, being physically active and avoid smoking. The concept of lifestyle medicine introduced 20 years ago by Rippe is defined as the integration of modern lifestyle practices into evidence-based medicine, in order to lower risk factors or to be support for chronic therapies. A new taxonomy is proposed in lifestyle medicine, with determinants, as drivers for chronic diseases, anthropogens and metaflammation, the metabolic inflammatory state. Other possible determinants are proposed for lack os scope in life, estrangement and lost identity. Despite all health messages, healthy behaviors are exceptions, not the rule. It will be important in the future to change how practitioners will support individuals in their efforts to live healthier. More psychological and social factors should be analyzed. Many doctors are not self-confident with prescribing healthy lifestyle or nutritional recommendations. Creating a new discipline should foster development of preventive recommendations. General practitioners will need specific academic trainings to learn how to promote recommendations for lifestyle changes for health, for prevention and for diseases management, starting by adopting themselves healthy lifestyles.

Open access
Micronutrients and Oral Health an Opportunity to Prevent Oral Diseases

Abstract

Nutrition plays an important role in oral health as it affects the growth of craniofacial, dental and periodontal structures. When adequate food is not unavailable, oral health may be impaired, and even overexposure to the diet may also inversely affect. Therefore, there is interdependency between nutrition and oral health. The importance of Micronutrients in normal function is becoming increasingly apparent and insufficient micronutrient intake has both short term and long-term consequences. Micronutrient assessment of suspected individual and appropriate supplement therapy may assist in dental disease prevention.

Open access
Modern Ways of Treatment of Metabolic Disorders in Women with Polycystic Ovarian Syndrome

Abstract

Article represents complex approach to PCOS problem from the position of prophylaxis and therapy of metabolic disorders, which include overweight and obesity, insulin resistance, carbohydrate and lipid metabolism deviations. Lifestyle modification specifically including healthy diet was provided as an example. Also, were described medications, which increase insulin sensitivity and method of treatment in case of 3rd class obesity.

Open access
The Qualitative and Quantitative Structure of Oral Microbiocenosis in Rats with Periodontitis in a Setting of Hyper- and Hypothyroidism

Abstract

Background and aims. Oral microbial flora is a highly sensitive indicator system producing qualitative and quantitative responses to changes in various individual organs and systems. The aim of study was to perform a comparative analysis of qualitative and quantitative structure of oral microbiocenosis in rats with comorbidity-free periodontitis and in animals with periodontitis in a setting of hyper- and hypothyroidism.

Material and methods. Experimental studies were conducted on 48 mature male white rats. Samples for microbiological tests were taken from dental surfaces (on the border between hard tissue and gums in the interdental spaces). The isolated pure cultures were identified by their morphological, tinctorial, cultural and biochemical properties and the signs of pathogenecity.

Results. We found that the oral dysbiosis occurring in a setting of periodontitis in rats is chiefly characterized by increased quantity of coccal forms and by increased candidal inoculation; these organisms cumulatively inhibit the growth of normal microbial flora, such as Lactobacilli, bacteroids and Bifidobacteria. Thyroid dysfunction exacerbates changes in the qualitative and quantitative structure of oral microbiocenosis.

Conclusions. The periodontitis in a setting of thyroid dysfunction increases both the species variety and the quantitative counts of oral microbial flora, with predominance of such microbial organisms as Staph. aureus, E. coli, E. faecalis, Candida albicans and P. aeruginosa.

Open access
The Relationship Between Lipid Metabolism and The Level of Albuminuria with Single Nucleotide Polymorphism -204A>C [rs 3808607] CYP7A1 Gene in Patients with Type 2 Diabetes Mellitus and Diabetic Nephropathy

Abstract

Background and aims. The purpose of our study was to determine the features of diabetic nephropathy, to identify the relationship between the level of albumin excretion, urine and lipid profile, genotype variants of the CYP7A1 gene in people with type 2 diabetes and diabetic nephropathy.

Material and methods. Patients were divided into three groups. Normoalbinuria was detected in group I, and II - microalbuminuria, and III -macroalbuminuria. Determination of albumin to creatinine ratio was more accurate, although more expensive method. We examined single nucleotide polymorphism -204A> C [rs 3808607] of the promoter region of the CYP7A1 gene.

Results. It was established that homozygotes by the major allele with genotype AA had lower values of albuminuria, atherogenic lipoproteins, total cholesterol, triglycerides and higher levels of anti-atherogenic lipoproteins than patients with AС and СС genotypes.

Conclusion. The СС genotype was most unfavorable in the prognostic plan, since homozygotes for this minor allele were characterized by higher values of albuminuria, total cholesterol, triglycerides, and lower values of high-density lipoprotein

Open access
Uncommon Manifestation of Hypoglycemia in a Patient with Insulinoma – A Case Report

Abstract

Insulinoma are insulin-secreting tumors of pancreatic origin that generates hypoglycemia by excessive secretion of insulin. Insulinoma is a rare disease ant the most tumors are benign, solitary and occur at intrapancreatic sites.

Case report. A 42-year old Caucasian women was hospitalized at the “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases Bucharest in April 2019 after an episode of hypoglycaemia remitted after intravenous glucose administration. Patient accused for about two weeks anxiety phenomena. At the time of admission in the hospital the patient was conscious in a good general condition. Paraclinical investigations revealed basal blood glucose 29 mg/dl, fasting insulin serum 87.7 µU/ml and pancreatic C-peptide-7.90 ng/ml. During hospitalization under strict glycaemic monitoring, the patient presented frequent asymptomatic hypoglycemic episodes that was remitted after intravenous glucose administration. Nuclear magnetic resonance highlighted a nodular lesion of the pancreas and in May 2019 the tumor resection was practiced. After surgery the blood glucose ranged between 86 mg/dl and 116 mg/dl. To mention that patient has a family history of diabetes and she’s obese.

Conclusion. This case suggests that lack symptoms of hypoglycaemia may be present in patients with insulinoma. Diagnostic of insulinoma requires high clinical suspicions, accurate biochemical investigations and imaging techniques for the localization of the tumor and may represent a challenge in certain situations.

Open access