Diabetes autoimune em adultos: características clínicas e autoanticorpos

Abstract

Avaliamos a prevalência dos anticorpos anti-insulina (IAA), anti-decarboxilase do ácido glutâmico (anti-GAD), anti-ilhota de Langerhans (ICA) e as características clínicas e metabólicas de 66 pacientes com diabetes mellitus (DM) de início na idade adulta (47,2±11,6 anos) e duração do DM de 14,3±8,4 anos. RESULTADOS: ICA foi positivo em 10 casos (10 a 640U JDF), três deles também positivos para anti-GAD (15,6 a 113,5U/ml) e um deles para IAA (naqueles sem terapia insulínica). 15,2% dos pacientes tinham um ou mais autoanticorpos, com maior prevalência para ICA. Os pacientes com e sem autoanticorpos não diferiram quanto à apresentação clínica do DM ou à prevalência de complicações. Apenas os níveis de colesterol foram menores no grupo anticorpo positivo (205,2±49,6 vs. 247,1±61,3mg/dl; p<0,05). CONCLUSÃO: 15,2% dos pacientes com DM de início na idade adulta tinham um ou mais autoanticorpos, com maior prevalência para ICA. A determinação de autoanticorpos é necessária para o diagnóstico do DM autoimune.

Influence of the Use of Laser Phototherapy (λ660 or 790 nm) on the Survival of Cutaneous Flaps on Diabetic Rats

“…Long-term assessment of these complications has been extensively studied. 3,17 This study assessed the use of laser light of two wavelengths on the survival rate of musculocutaneous flaps on diabetic Wistar rats. Flap failure owing to deficient vascularization is a major cause of failure of this procedure.…”

Frequency of the anti-glutamic acid decarboxylase immunological marker in patients with diabetes duration longer than three years in southern Brazil

“… 3 Fifty percent of adult patients who are anti-GAD-positive at diagnosis exhibit a clear insulin deficiency within 10 years, compared with just 3% of anti-GAD-negative patients. 6 Anti-GAD tends to be the first marker to appear, years before disease onset, with a diagnostic sensitivity of 75-85% and specificity of 98-99%. 7 These antibodies can be assayed in clinical practice in situations in which diabetes cases cannot be classified on clinical presentation alone.…”

Polarized Light (λ400–2000 nm) on Third-Degree Burns in Diabetic Rats: Immunohistochemical Study

“…6 Diabetes causes delayed healing through several pathways: reduced chemotaxis of leukocytes; changes in oxygen diffusion, reduced nutrient transport, decreased number and activity of fibroblasts, impaired capacity of collagen synthesis and delayed maturation and instability of the collagen, and increased number of plasmocytes. 5,[7][8][9][10] Additionally, patients with uncontrolled diabetes may show impaired vision, 11 diabetic angiopathy, arteriosclerosis, impaired leukocyte activity ROS activity, as well as decreased production of IL-2. 12 Impaired wound healing in patients with diabetes is well documented in the literature as are the therapeutic approaches used to quicken the repair process in these patients.…”