Aspectos dos efeitos do sono no aparelho digestório

Dantas, Roberto Oliveira; Aben-Athar, C G

doi:10.1590/s0004-28032002000100010

Cited by 16 publications

(5 citation statements)

References 30 publications

(34 reference statements)

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“…Gastric emptying is slow during sleep, but rapid eye movement (REM) sleep is associated with faster gastric emptying. 24 Children who take "afternoon naps" reach REM sleep faster after sleep onset than preadolescents who have discontinued their afternoon naps. In preadolescents and adolescents, the REM sleep is dominantly in the last two-thirds of the night.…”

Section: Discussionmentioning

confidence: 99%

Insulin Doses before and One Year after Pump Start: Children Have a Reversed Dawn Phenomenon

Nicolajsen

Samuelsson

Hanås

2012

J Diabetes Sci Technol

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Abbreviations: (HbA1c) hemoglobin A1c, (MDI) multiple daily injections, (PG) plasma glucose, (REM) rapid eye movement, (TDD) total daily dose Keywords: basal rate, bolus doses, children, dawn phenomenon, diabetes, insulin pump Abstract Objective:We aimed to investigate the basal rate and bolus doses in children and adolescents at the start of insulin pump therapy and after 1 year of use. Patients and Methods:Case records from 29 children and adolescents were examined. All pumps were started with rapid-acting insulin (Humalog). Patients were aged 13.1 ± 3.9 years, with a diabetes duration of 5.4 ± 4.1 years at pump start. Sixteen pumps were started for high hemoglobin A1c (HbA1c; >8.8%, 73 mmol/mol) and 13 for other reasons. Results:Basal rates declined in both groups by 20% at 3 days after pump start. The bolus doses were reduced by 25-30% when the indication was high HbA1c and by 15% in the others. After 1 year, there was a significant difference in the basal rate between age groups. The 3-9-year-old age group had higher basal rates during the late evening (10:00 PM-12:00 AM), while the 15-21-year-old age group had higher basal rates in the early morning (3:00 AM-7:00 AM). Conclusions:Insulin doses are reduced considerably when starting with a pump in pediatric practice. Younger children needed higher basal rates late in the evening (reversed dawn phenomenon), while older teenagers seem to need an increase in the morning, which may correspond to a true dawn phenomenon.

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Section: Discussionmentioning

confidence: 99%

Insulin Doses before and One Year after Pump Start: Children Have a Reversed Dawn Phenomenon

Nicolajsen

Samuelsson

Hanås

2012

J Diabetes Sci Technol

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“…32 Another factor that could have influenced our findings is that increased gastric volume leads to greater physical discomfort and thus impairs the consolidation of sleep onset. It has been demonstrated that sleep decreases the activity of the digestive tract, 33 which may have an overloaded activity during the night if food intake is excessive.…”

Section: Anthropometric Evaluationmentioning

confidence: 99%

Relationship between Food Intake and Sleep Pattern in Healthy Individuals

Crispim

Zimberg²,

Reis³

et al. 2011

Journal of Clinical Sleep Medicine

144

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Study Objectives: The purpose of this study was to analyze the relationship between food intake and sleep patterns in healthy individuals. Methods: Fifty-two healthy volunteers (27 women and 25 men) were recruited to participate in the study. Volunteers underwent sleep evaluation through nocturnal polysomnography and completed a 3-day food diary to evaluate food intake. Results S C I E N T I F I C I N V E S T I G A T I O N SO besity is becoming a worldwide epidemic. 1 The etiology of this disease is multifactorial; among the causes are changes in food intake, 2 life style, environment, 2,3 and genetics, 4,5 in addition to physiological 6 and psychological 7 infl uences and, more recently, alterations in sleep patterns. [8][9][10][11] Sleep curtailment has become common due to the demands and opportunities of modern society.12 Recent studies show that alterations in sleep time can infl uence various aspects associated with the nutritional and metabolic balance of the body, such as the control of body mass, 9,11 food intake, 10,13 glycemic levels, 14,15 and the levels of cholesterol and triacylglycerol. 16 Although some studies show that short duration sleep changes the food intake pattern and may cause obesity, 9-11 few studies have analyzed whether the opposite casual sequence also occurs; that is, if food intake promotes alterations in the sleep pattern. Indeed, studies that have examined this matter are controversial and use different methodologies. Some studies indicate an impairment of sleep quality when there is an excessive carbohydrate intake. 17,18 Driver et al.,19 however, comparing the effect of an evening meal on nocturnal sleep in seven healthy men, did not fi nd any effect. Therefore, this study proposes to analyze the correlation between habitual food intake and sleep patterns in healthy individuals. METHODS SampleFifty-two healthy volunteers (27 women and 25 men) between 19 and 45 years old took part in this study. The participants were young adults and were non-obese. They were sedentary and not taking medication. They were all nonsmokers and spent regular times in bed at night (7.5-8.5 h). The subjects did not suffer from sleep disturbances (apnea and hypopnea index [AHI] < 5, and periodic leg movements [PLM] during sleep were < 5, as assessed bRIEF SUMMARY Current Knowledge/Study Rationale: Few studies have analyzed if food intake promotes alterations in the sleep pattern. Therefore, the objective of this study was to analyze the correlation between habitual food intake and sleep patterns in healthy individuals. Study Impact: This study demonstrated that a higher food intake close to the sleeping period is associated with negative aspects of sleep patterns in healthy individuals, especially in women. However, this is an area poorly explored in the literature, and more studies are necessary to elucidate the real infl uence of food intake upon sleep.

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“…Total metformin exposure was lower with once-daily am dosing than with once-daily pm or twice-daily dosing. Slowed gastrointestinal transit during sleep [ 36 ] following pm dosing may allow prolonged metformin contact with gut transporters which modestly increases absorption relative to morning dosing. Indeed, the right-shifted PK profile with Metformin DR pm dosing compared with am dosing (together with previous findings that Metformin DR pm dosing results in peak concentrations approximately 10 h post-dose [ 5 ]) is probably responsible for the elevated am concentrations observed with Metformin DR vs Metformin IR observed in study 1.…”

Section: Discussionmentioning

confidence: 99%

Once-daily delayed-release metformin lowers plasma glucose and enhances fasting and postprandial GLP-1 and PYY: results from two randomised trials

DeFronzo

Buse

Kim³

et al. 2016

Diabetologia

101

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Aims/hypothesisDelayed-release metformin (Metformin DR) was developed to maximise gut-based mechanisms of metformin action by targeting the drug to the ileum. Metformin DR was evaluated in two studies. Study 1 compared the bioavailability and effects on circulating glucose and gut hormones (glucagon-like peptide-1, peptide YY) of Metformin DR dosed twice-daily to twice-daily immediate-release metformin (Metformin IR). Study 2 compared the bioavailability and glycaemic effects of Metformin DR dosages of 1,000 mg once-daily in the morning, 1,000 mg once-daily in the evening, and 500 mg twice-daily.MethodsStudy 1 was a blinded, randomised, crossover study (three × 5 day treatment periods) of twice-daily 500 mg or 1,000 mg Metformin DR vs twice-daily 1,000 mg Metformin IR in 24 participants with type 2 diabetes conducted at two study sites (Celerion Inc.; Tempe, AZ, and Lincoln, NE, USA). Plasma glucose and gut hormones were assessed over 10.25 h at the start and end of each treatment period; plasma metformin was measured over 11 h at the end of each treatment period. Study 2 was a non-blinded, randomised, crossover study (three × 7 day treatment periods) of 1,000 mg Metformin DR once-daily in the morning, 1,000 mg Metformin DR once-daily in the evening, or 500 mg Metformin DR twice-daily in 26 participants with type 2 diabetes performed at a single study site (Celerion, Tempe, AZ). Plasma glucose was assessed over 24 h at the start and end of each treatment period, and plasma metformin was measured over 30 h at the end of each treatment period. Both studies implemented centrally generated computer-based randomisation using a 1:1:1 allocation ratio.ResultsA total of 24 randomised participants were included in study 1; of these, 19 completed the study and were included in the evaluable population. In the evaluable population, all treatments produced similar significant reductions in fasting glucose (median reduction range, −0.67 to −0.81 mmol/l across treatments) and postprandial glucose (Day 5 to baseline AUC0–t ratio = 0.9 for all three treatments) and increases in gut hormones (Day 5 to baseline AUC0–t ratio range: 1.6–1.9 for GLP-1 and 1.4–1.5 for PYY) despite an almost 60% reduction in systemic metformin exposure for 500 mg Metformin DR compared with Metformin IR. A total of 26 randomised participants were included in study 2: 24 had at least one dose of study medication and at least one post-dose pharmacokinetic/pharmacodynamic assessment and were included in the pharmacokinetic/pharmacodynamic intent-to-treat analysis; and 12 completed all treatment periods and were included in the evaluable population. In the evaluable population, Metformin DR administered once-daily in the morning had 28% (90% CI −16%, −39%) lower bioavailability (least squares mean ratio of metformin AUC0–24) compared with either once-daily in the evening or twice-daily, although the glucose-lowering effects were maintained. In both studies, adverse events were primarily gastrointestinal in nature, and indicated similar or improved tolerabil...

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Aspectos dos efeitos do sono no aparelho digestório

Cited by 16 publications

References 30 publications

Insulin Doses before and One Year after Pump Start: Children Have a Reversed Dawn Phenomenon

Insulin Doses before and One Year after Pump Start: Children Have a Reversed Dawn Phenomenon

Relationship between Food Intake and Sleep Pattern in Healthy Individuals

Once-daily delayed-release metformin lowers plasma glucose and enhances fasting and postprandial GLP-1 and PYY: results from two randomised trials

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