We are in the so-called nutritional transition, in which obesity and its comorbidities have emerged as an important research topic, and the information on food composition is fundamental to promote nutritional safety. Fructose is the sweetest carbohydrate, and this sweetness, along with its low cost, is the key factor for its use in commercial drinks and sweets. The global average consumption of fructose per capita has increased from 56 g/day in 1986 to 65 g/day in 2007. Experimental models associate high fructose intake with the development of obesity and induced insulin resistance. In recent studies, diabetic patients have been reported to use fructose more frequently than glucose. Fructose acts differently in the hypothalamus and generates less satiety than glucose; thus, fructose has a high lipogenic potential. Replacing fructose with another isocaloric carbohydrate is associated with better glycemic control.
The obesity epidemic gathers growing media attention recently, as overweight and obesity's prevalence keeps rising. This comes along with an increase in the intake of artificial sweeteners in food products. A causal relationship between the consumption of sweeteners and obesity is so far not clear in the medical literature. This paper describes the development of artificial sweeteners in a historical context. It collects epidemiological and experimental evidence that possibly relates the use of artificial sweeteners with weight gain. Finally, these effects are explained based on the neuroscience of food reward, the possible effects of glucose on the metabolism and the association between sweeteners and gut microbiota.
Abstract:: Diabetes Mellitus is characterized by numerous metabolic disorders, which have in common the serum elevation of glucose, caused for a pancreatic malfunction in insulin secretion and / or its action. It is a non-communicable disease, considered major public health problems and generalized growth worldwide, being a chronic disease, which can generate a high treatment cost. Metabolic surgery is a safe treatment, regulated by the Federal Council of Medicine and useful in treating people with BMI over 30 years of age, who are unable to control pathologies associated with obesity, especially type 2 diabetes. The general objective of this study is to understand through a literature review the main impacts of metabolic surgery about the remission of DM 2. This present study it is an exploratory and descriptive study carried out through a literature review. Data were collected through research in virtual health databases, at the Virtual Health Library - VHL, Latin American and Caribbean Health Sciences Information System, LILACS, National Library of Medicine - MEDLINE, Scielo, USP database, PUBMED theses and books. Metabolic surgery proof be a good and effective treatment for having and maintaining good weight loss, as well as a significant clinical and metabolic improvement that extends beyond weight loss. Metabolic surgery is a satisfactory way of achieving long-term weight reduction in obese individuals, increasing survival for these patients. Obese patients with DM2 have a long-term remission of DM2 after bariatric / metabolic surgery. Therefore, it concludes that such procedure is effective in the treatment of the disease and other diseases associated with obesity. 1
Obesity is a public health problem and its prevalence increases every year, resulting from a complex interaction between genetic, metabolic and environmental factors, as well as cultural influences. The Intestinal Microbiota is composed of trillions of microorganisms by forming a symbiotic relationship with the host and helping the absorption of various nutrients, increasing the extraction of components of the diet, the lipogenesis and intestinal permeability. Studies show that there is difference between the composition of the intestinal microbiota of an obese person and a healthy one. The purpose of this article is to review the literature on the relationship between the Intestinal Microbiota, Obesity and Insulin Resistance and also illustrate some studies on the subject.
Time in Range is a new concept in Diabetology, defining the percentage of the length of time in which the patient stays within a predetermined range of blood glucose. Electronic devices, from which the concept of Time in Range derived, help promote a better comprehension of these procedures, and may lead to a decrease in glycemic variability and to a lower risk of complications. It may also ease the control and adjustments in the treatment of diabetes. Therefore, the application of the Time in Range concept could generate a better diabetes control. Diabetes Mellitus is a chronic metabolic disease caused by hyperglycemia due to changes related to insulin production and action. It has high morbidity and mortality and high prevalence and may affect several age groups. Currently, its classification is based on its etiology, with the most common diagnoses being pre-diabetes, type 1, type 2 and gestational diabetes. It should be investigated early in patients who have risk factors such as obesity and physical inactivity. It is diagnosed by alterations in fasting or random glucose measurement, oral glucose tolerance test and glycated hemoglobin. Its control and monitoring should be based on glycemic stability. Even more mechanisms are being developed to help the patient in the control of blood glucose, avoiding risks of acute and chronic complications, which can be severe and limiting.
Background: Hantavirus pulmonary syndrome (HPS) is an emerging rodent-borne disease in the American continent, characterized by acute respiratory distress and a high case-fatality ratio. The present work describes a case of HPS, with favorable outcome, whose initial features were mistaken for leptospirosis or other less severe acute infections. Methodology: The case of a 32-year-old male with an uneventful course of HPS is reported. He was inadvertently infected at work by exposure to a rodent-contaminated environment in Brasília, Federal District vicinity, during May 2008. Results and Conclusions: Fever, headache and myalgia after exposure to a rodent-contaminated environment raised clinical suspicion. Noncardiac pulmonary edema, hydrothorax, neutrophilia with band forms 26%, high hematocrit, thrombocytopenia, and elevated liver enzymes were observed. Leptospirosis and dengue were the main differential diagnoses because both pathogens are endemic in the area. Hantavirus IgM antibody-capture ELISA was positive, while tests for dengue, leptospirosis and yellow fever were negative. The prognosis for HPS is ominous and misdiagnoses may increase mortality. Better chances of survival depend on prompt intensive care support. Reports of moderate or less typical cases can raise the suspicion index among primary care and hospital-based physicians about this uncommon but severe condition that often affects previously healthy young individuals from developing countries, and subjects who interact with rodent-infested environments in North America. High awareness of HPS allowed successful management of the patient, even before establishing the diagnosis, by serological tests at the reference laboratory of the Ministry of Health. Clinical suspicion favored warning local health authorities about a new case of HPS.
A cirurgia metabólica é um conjunto de intervenções realizadas no trato digestório de indivíduos com obesidade grau I (índice de massa corporal - IMC entre 30 e 34,9kg/m2) e diabetes mellitus tipo 2 (DM2) que não respondem ao tratamento convencional (dietoterapia, farmacoterapia, psicoterapia e atividade física) a, pelo menos, dois anos de seguimento clínico e nutricional regular. O propósito da cirurgia metabólica é alcançar a melhora e/ou a remissão do DM2 e, em consequência, de outras comorbidades associadas à obesidade. A inclusão da cirurgia metabólica como opção terapêutica para indivíduos com DM2, no Sistema Único de Saúde (SUS), foi aprovada em 2019 na Câmara Legislativa do Distrito Federal (CLDF) por meio da Lei n° 6.343/2019. A lei garante a continuidade do trabalho e o tratamento cirúrgico aos pacientes, sendo uma opção segura e efetiva ao diabético não obeso grave, antes que venha a óbito por complicações e/ou apresente sequelas devido à falta de efetividade terapêutica. O objetivo deste capítulo é descrever os efeitos da cirurgia metabólica para indivíduos com DM2 no SUS.
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