Microvascular Permeability in Diabetes

Bottino, Daniel; Tavares, Juliana Carvalho

doi:10.1007/978-2-8178-0761-4_29

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…However, these alterations in perfusion and endothelial structure do not affect insulin delivery to myocytes under normal physiological conditions, because the hyperinsulinemia associated with obesity compensates for this defect [ 159 , 160 , 161 ]. In people with T2D, vascular permeability is increased [ 162 , 163 ] and insulin exchange with the interstitium is enhanced [ 32 ].…”

Section: Effects Of Obesity and Type 2 Diabetes On Insulin Clearancementioning

confidence: 99%

Insulin Clearance in Obesity and Type 2 Diabetes

Koh

Cao

Mittendorfer

2022

IJMS

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Plasma insulin clearance is an important determinant of plasma insulin concentration. In this review, we provide an overview of the factors that regulate insulin removal from plasma and discuss the interrelationships among plasma insulin clearance, excess adiposity, insulin sensitivity, and type 2 diabetes (T2D). We conclude with the perspective that the commonly observed lower insulin clearance rate in people with obesity, compared with lean people, is not a compensatory response to insulin resistance but occurs because insulin sensitivity and insulin clearance are mechanistically, directly linked. Furthermore, insulin clearance decreases postprandially because of the marked increase in insulin delivery to tissues that clear insulin. The commonly observed high postprandial insulin clearance in people with obesity and T2D likely results from the relatively low insulin secretion rate, not an impaired adaptation of tissues that clear insulin.

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Section: Effects Of Obesity and Type 2 Diabetes On Insulin Clearancementioning

confidence: 99%

Insulin Clearance in Obesity and Type 2 Diabetes

Koh

Cao

Mittendorfer

2022

IJMS

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“…13 Polymorphisme pada kluster gen IL-1 (yang mengkodekan IL-1α, IL-1β, dan IL-1 receptor antagonist [IL-1Ra]) menyebabkan lebih banyaknya ekspresi agonis atau berkurangnya respons antagonis yang juga telah dikaitkan dengan onset prematur, meningkatnya keparahan penyakit, atau prognosis lebih buruk dari berbagai kondisi inflamasi, yaitu dari artritis reumatoid, periodontitis, inflammatory bowel disease, Alzheimer disease, dan lain-lainnya. [14][15][16] Rerata kadar CRP sebelum perawatan ialah 61,894±28,075 pg/ml pada kelompok dengan penanganan konservatif dan 30,947±14,037 pg/ml setelah perawatan atau tindakan. Rerata CRP sebelum perawatan pada kelompok agresif ialah 58,105±31,308 pg/ml dan 27,158±15,410 pg/ml setelah perawatan atau tindakan.…”

Section: Bahasanunclassified

Perbandingan Kadar IL-1α antara Tindakan Debridement Tajam Agresif dan Debridement Tajam Konservatif pada Penderita Kaki Diabetik

Tjiptadi¹,

Tangkilisan²

2018

JBM

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Diabetic foot is a chronic complication of diabetes mellitus which is commonly found but very threatening due to its unsatisfied management, usually ended with amputation or death. Sharp debridement is the gold standard of diabetic foot, albeit, it has to be considered wisely due to the metabolic disorder, sepsis, and other comorbid factors of the patients. This study was aimed to compare the dynamics of Il-1α levels in patients with aggresive sharp debridement and with conservative sharp debridement associated with clinical improvement. This was an experimental analytical study. There were 38 patients with diabetic foot admitted at Prof. Dr. R. D. Kandou Hospital Manado with an age range of 30-60 years, obtained by using simple random sampling. The patients were divided inti two groups: aggressive sharp debridement dan conservative sharp debridement, each of 19 patients. Samples for laboratory examination were collected before and after debridement. In consevative sharp debridement group, the mean levels of IL-1α before treatment was 108,158±14,519 pg/ml meanwhile after treatment was 108,526±16,625 pg/ml that showed no significant elevation. In aggressive sharp debridement group, the mean levels of IL-1α before treatment was 93,263±15,172 pg/ml meanwhile after treatment was 104,052±18,807 pg/ml that showed a significant elevation. Conclusion: In patients with diabetic foot, elevation of IL-α levels after aggressive sharp debridement was greater than after conservative sharp debridement.Keywords: diabetic foot, sharp debridement, interleukin 1-αAbstrak: Kaki diabetes merupakan salah satu komplikasi kronik diabetes melitus yang sering dijumpai dan ditakuti oleh karena pengelolaannya sering mengecewakan dan berakhir dengan amputasi, bahkan kematian. Penanganan dengan debridemen tajam pada pasien dengan kaki diabetik merupakan baku emas tetapi masih dipertimbangkan akibat adanya gangguan metabolik, sepsis dan faktor komorbid lainnya. Penelitian ini bertujuan untuk menganalisis tindakan debridement tajam agresif dan konservatif pada pasien kaki diabetik dengan dinamika kadar IL-1α dan hasil perbaikan klinis. Jenis penelitian ialah eksperimental analitik. Populasi penelitian ialah pasien kaki diabetik yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado dengan rentang usia 30-60 tahun. Subjek penelitian diperoleh dengan simple random sampling, terdiri dari 38 pasien, dibagi atas dua kelompok: tindakan debridemen tajam agresif dan debridemen tajam konservatif, masing-masing 19 pasien. Pengumpulan sampel untuk pemeriksaan laboratorik dilakukan sebelum dan setelah masing-masing tindakan. Pada kelompok tindakan konservatif didapatkan rerata nilai IL-1α sebelum tindakan ialah 108,158±14,519 pg/ml sedangkan setelah tindakan ialah 108,526±16,625 pg/ml yang menunjukkan tidak terdapat peningkatan bermakna. Pada kelompok tindakan agresif nilai IL-1α sebelum tindakan ialah 93,263±15,172 pg/ml sedangkan setelah tindakan ialah 104,052±18,807 pg/ml yang menandakan peningkatan bermakna. Simpulan: Peningkatan kadar IL-α setelah tindakan debrideman tajam agresif lebih besar dibandingkan setelah tindakan debrideman tajam konservatif pada penderita kaki diabetik.Kata kunci: kaki diabetik, debridemen tajam, interleukin 1-α

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The Effect of Bitter Melon (Momordica charantia L.) Leaves Extract on TNF-α Serum Levels and Diabetic Foot Ulcers Improvement : Randomized Controlled Trial

Rosyid

Dharmana

Suwondo

et al. 2018

Biomed. Pharmacol. J.

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Diabetic foot ulcer (DFU) is among the many complications of diabetes and it takes a very long period of time to heal. It can lead to the amputation of the lower limb, thereby resulting to death or in most cases, a bad quality of life. The aim and objective of this study is to assess the effect of bitter melon leaves extracts on serum TNF-α levels and improvement of diabetic foot ulcers. The study technique used here is the randomized, double-blinded, placebo-controlled trial. Thirty patients suffering from DFU participated in the trial and according to PEDIS scores were divided into two groups, of which 15 patients were in the treatment group and administered with bitter melon leaves extract at a dose of 6 g/day and the remaining 15 patients were in the control group and were given placebo. This intervention was done for 4 weeks and the examination of serum TNF-α levels was carried out at baseline and at the end of treatment. The readings of the healing process for diabetic foot ulcers with PEDIS scores were also taken at baseline, weeks 2, 3 and 4. Data were analyzed using the paired t-test and the independent t test. After 4 weeks of treatment, there was a decrease in baseline serum TNF-α levels in the treatment and control groups (29.5 ± 8.6 pg/ml, P = 0.0001 and 202.5 ± 610.2 pg/ml, P = 0.001). There was no effect on serum TNF-α levels (P = 0.28). There was a decrease in PEDIS degrees from baseline, week 2, 3 and 4 in the treatment and control groups (2.7±0.5; 2.7±0.5; 2.7±0.6; 1.9±0.6 and 2.6±0.5; 2.6±0.5; 2.5±0.6; 2.2±0.8). However there was no effect on diabetic foot ulcer improvement both groups in week 2 (P = 0.46), week 3 (P = 0.57) and week 4 (P = 0.29). Bitter melon leaves extracts is proven to have no effect on the serum TNF-α levels and improvement of diabetic foot ulcers.

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Microvascular Permeability in Diabetes

Cited by 3 publications

References 37 publications

Insulin Clearance in Obesity and Type 2 Diabetes

Insulin Clearance in Obesity and Type 2 Diabetes

Perbandingan Kadar IL-1α antara Tindakan Debridement Tajam Agresif dan Debridement Tajam Konservatif pada Penderita Kaki Diabetik

The Effect of Bitter Melon (Momordica charantia L.) Leaves Extract on TNF-α Serum Levels and Diabetic Foot Ulcers Improvement : Randomized Controlled Trial

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