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6. Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Author

Rheinheimer, J., Bauer, A., Silveiro, S., Estivalet, A., Bouças, A., Rosa, A., de Souza, B., de Oliveira, F., Cruz, L., Brondani, L., Azevedo, M., Lemos, N., Carlessi, Rodrigo, Assmann, T., Gross, J., Leitão, C., Crispim, D., Rheinheimer, J., Bauer, A., Silveiro, S., Estivalet, A., Bouças, A., Rosa, A., de Souza, B., de Oliveira, F., Cruz, L., Brondani, L., Azevedo, M., Lemos, N., Carlessi, Rodrigo, Assmann, T., Gross, J., Leitão, C., and Crispim, D.

Abstract

Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM", who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre - Rio Grande do Sul, Brazil.

Published
2015

7. Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil

Author

Fernando Gerchman, Zanatta, C. M., Burttet, L. M., Picon, P. X., Lisboa, H. R. K., Silveiro, S. P., Gross, J. L., and Canani, L. H.

Subjects
lcsh:R5-920, Chronic complications, Diabetes mellitus, lcsh:Biology (General), Ethnicity, lcsh:Medicine (General), lcsh:QH301-705.5
Abstract

Ethnicity has been shown to be associated with micro- and macrovascular complications of diabetes in European and North American populations. We analyzed the contribution of ethnicity to the prevalence of micro- and macrovascular complications in Brazilian subjects with type 2 diabetes attending the national public health system. Data from 1810 subjects with type 2 diabetes (1512 whites and 298 blacks) were analyzed cross-sectionally. The rates of ischemic heart disease, peripheral vascular disease, stroke, distal sensory neuropathy, and diabetic retinopathy were assessed according to self-reported ethnicity using multiple logistic regression models. Compared to whites, black subjects [odds ratio = 1.72 (95%CI = 1.14-2.6)] were more likely to have ischemic heart disease when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, smoking habit, and serum creatinine. Blacks were also more likely to have end-stage renal disease [3.2 (1.7-6.0)] and proliferative diabetic retinopathy [1.9 (1.1-3.2)] compared to whites when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, and smoking habit. The rates of peripheral vascular disease, stroke and distal sensory neuropathy did not differ between groups. The higher rates of ischemic heart disease, end-stage renal disease and proliferative diabetic retinopathy in black rather than in white Brazilians were not explained by differences in conventional risk factors. Identifying which aspects of ethnicity confer a higher risk for these complications in black patients is crucial in order to understand why such differences exist and to develop more effective strategies to reduce the onset and progression of these complications.

Published
2008

17. Alogliptin after acute coronary syndrome in patients with type 2 diabetes

Author

White, W. B., Cannon, C. P., Heller, S. R., Nissen, S. E., Bergenstal, R. M., Bakris, G. L., Perez, A. T., Fleck, P. R., Mehta, C. R., Kupfer, S., Wilson, C., Cushman, W. C., Zannad, F., Aiub, J., Albisu, J., Alvarez, C., Astesiano, A., Barcudi, R., Bendersky, M., Bono, J., Bustos, B., Cartasegna, L., Caruso, O., Casabe, H., Castro, R., Colombo, H., Cuneo, C., Cura, F., Loredo, L., Dran, R., Fernandez, H., Garcia Pinna, J., Hrabar, A., Klyver Saleme, M., Luquez, H., Mackinnon, I., Maffei, L., Majul, C., Mallagray, M., Marino, J., Martinez, D., Martingano, R., Nul, D., Parody, M. L., Petrucci, J., Pieroni, M., Daniel Piskorz, Prado, A., Ramos, H., Resk, J., Rodriguez, M., Rojas, C., Sarjanovich, R., Sarries, A., Sessa, H., Silveiro, S., Sosa Liprandi, M. I., Tartaglione, J., Tonin, H., Vallejos, J., Vigo, S., Visco, V., Vita, N., Vogel, D., Vogelmann, O., Zaidman, C., Zangroniz, P., Colquhoun, D., Coverdale, S., Flecknoe-Brown, S., Hii, C. S., Roberts-Thomson, P., Drexel, H., Luger, A., Pieber, T., Cools, F., Ruige, J., Schoors, D., Vercammen, C., Wollaert, B., Alves Da Costa, F., Amodeo, C., Baggenstoss, R., Barbosa, E., Barroso Souza, W. K., Bassan, R., Borges, J. L., Botelho, R., Braile, M. C., Castello, H., Chrisman, C., Dos Santos, F., Faria Neto, J., Farsky, P., Fernandes Da Costa, A., Fraige Filho, F., Garbelini, B., Garcia, M. F., Garzon, P., Guimaraes, A. E., Herdy, A., Hernandes, M., Hilgemberg, S., Hissa, M., Jatene, J. A., Kormann, A., Leaes, P., Lima, F., Lisboa, H. R., Maia, L., Maia Da Silva, F., Maldonado Franco, D., Martin, J. F., Medeiros, A., Michalaros, Y., Miguel Leitao, A., Montenegro, S., Moraes Junior, J., Mota Gomes, M., Paiva, M. S., Precoma, D., Rabelo, A., Reis, G., Reis, H., Rossi, P., Saporito, W., Sarmento Leite, R., Silva, R. P., Silva Junior, D., Sousa, L., Sousa, A. C., Ueda, R., Vilas-Boas, F., Wainstein, M., Zago, A., Angelova, M., Apostolova, E., Daskalova, I., Delchev, A., Hristozov, K., Ilieva, M., Kovacheva, S., Lucheva, M., Temelkova, M., Toneva, A., Videva, V., Vuchkova, E., Bakbak, A., Carpentier, A., Chan, Y. K., Cheema, A., Chouinard, G., Conway, J., Dery, J. P., Dowell, A., Frechette, A., Jakubowski, M., Kelly, A., Ma, P., Maung, T. Z., Mehta, S., Parker, D., Pesant, Y., Polasek, P., Ransom, T., Syan, G., Vizel, S., Albornoz, F., Castro Galvez, P., Cobos, J. L., Conejeros, C., D Acuña Apablaza, M., Fajardo, G., Illanes Brochet, G., Lazcano, M. O., Pincetti, C., Potthoff, S., Raffo, C., Saavedra, V., Schnettler, M., Sepulveda, P., Stockins, B., Vejar, M., Accini, J. L., Cotes Aroca, C. H., Fernandez Ruiz, R. L., Orozco Linares, L. A., Vesga Angarita, B. E., Aganovic, I., Bagatin, J., Canecki-Varzic, S., Erzen, D. J., Knezevic, A., Maric, A., Milicevic, G., Popovic, Z., Rubes, J., Weiss, S. S., Dresslerova, I., Havelkova, J., Kucera, D., Machacek, J., Pumprla, J., May, O., Perrild, H., Aziz, M. A., El Badry, M., Hasanein, M., Airaksinen, J., Laine, M., Nyman, K., Vikman, S., Bonnet, J., Elbaz, M., Henry, P., Paillard, F., Petit, C., Tropeano, A. I., Behnke, T., Bornstein, S., Busch, K., Ebelt, H., Faghih, M., Fischer, H., Heuer, H., Paschke, R., Porner, T. C., Tangerding, G., Vöhringer, H. F., Adamson, K., Beatt, K., Bellary, S., Chapman, J., Cooke, A., Fisher, M., Gnudi, L., Jones, H., Kumar, S., Nagi, D., Oldroyd, K., Richardson, T., Robertson, D., Robinson, A., Saravanan, P., Viljoen, A., Wilding, J., Wilkinson, P., Wong, Y. K., Zoupas, C., Arango, J., Castellanos, J., Ceren Flores, C., Corona, V., Granados-Fuentes, A., Haase, F., Montenegro, P., Prado, J. H., Villalobos, R., Chow, F., Li, S. K., Li, J., Yan, P. Y., Yeung, V., Abel, T., Benedek, A., Dezso, E., Dudas, M., Édes, I., Fulop, G., Kovács, A., Lupkovics, G., Merkely, B., Nagy, A., Oroszlan, T., Palinkas, A., Papp, A., Patkay, J., Simon, E., Sitkei, E., Tabak, A., Tomcsányi, J., Abdullakutty, J., Abhyankar, A., Akalkotkar, U., Alexander, T., Arneja, J., Aslam, N., Babu, P. R., Babu, B. R., Banker, D., Bantwal, G., Bhimashankar, P. R., Calton, R. K., Chopda, M., Dande, A., Dani, S., Deshpande, N., Dhanwal, D., Dharmadhikari, A., Gadkari, M., Garg, N., Ghaisas, N., Goyal, N. K., Gupta, J. B., Jawahirani, A., Joseph, S., Kumar, R., Kumble, M., Mathavan, A., Mathur, A., Mohanan, P. P., Nair, A., Nair, T., Namjoshi, D., Pinto, R., Prakash, G., Purushotham, R., Raju, S., Ramachandran, P., Ramesh, S. S., Rao, B., Ravikishore, A., Reddy, G. R., Roy, S., Sadhu, N., Sastry, B. K., Singh, P., Srinivas, A., Thacker, H., Thanvi, S., Thomas, J., Adawi, F., Bashkin, A., Cohen, J., Harman-Boehm, I., Hasin, Y., Hayek, T., Iakobishvili, Z., Katz, A., Kracoff, O., Minuchin, O., Moriel, M., Mosseri, M., Omary, M., Wainstein, J., Weiss, A., Zeltser, D., Calabro, P., Derosa, G., Genovese, S., Novo, S., Olivieri, C., Piatti, P., Violini, R., Volpe, M., Ajioka, M., Amano, T., Arasaki, O., Daida, H., Fujimoto, K., Fujinaga, H., Higashiue, S., Hirohata, A., Hosokawa, S., Ikefuji, H., Inagaki, M., Iseki, H., Iwabuchi, M., Iwasaki, T., Kakishita, M., Katsuda, Y., Kawada, K., Kawajiri, K., Kawamitsu, K., Kobayashi, K., Komada, F., Komura, Y., Machida, M., Maemura, K., Matsubara, T., Matsubayashi, S., Matsumoto, T., Matsumoto, N., Mima, T., Miyamoto, N., Momiyama, Y., Morimoto, T., Murakami, M., Nakashima, E., Niijima, Y., Noda, T., Node, K., Nozaki, A., Nunohiro, T., Ogawa, T., Ono, Y., Saeki, T., Sakota, S., Sakuragi, S., Sasaki, T., Sato, Y., Sueyoshi, A., Suzuki, M., Takagi, G., Tanabe, J., Tanaka, S., Tei, I., Yamamoto, M., Yanagihara, K., Hong, T. J., Jeon, H. K., Kang, D. H., Kim, C. H., Kim, D. S., Kim, H. S., Kim, J. H., Kim, S. K., Kim, W. S., Kim, Y. K., Lee, S. R., Lee, K. W., Park, H. S., Pyun, W. B., Rha, S. W., Yoon, J., Yoon, K. H., Bennakhi, A., Geldnere, K., Sokolova, J., Teterovska, D., Dautaraite, V., Kakariekiene, V., Kavaliauskiene, R., Kucinskiene, A., Lasiene, J., Mickuviene, N., Palinauskas, A., Urboniene, A., Zilaitiene, B., Abdul Manap, H., Abidin, I. Z., Isa, S. H., Khir, A. M., Ng, K. H., Tan, F., Yusof, Z., Yusoff, K., Zambahari, R., Aguila-Marin, J., Aguilera Real, M., Alvarado-Ruiz, R., Alvarez Lopez, H., Arenas Leon, J., Bayram Llamas, E. A., Calvo Vargas, C., Carrillo Calvillo, J., Los Rios Ibarra, M., Dominguez-Reyes, C. A., Duarte, M., Elizondo, E., Fajardo Campos, P., Fanghanel-Salmon, G., Figueroa Sauceda, S., Gallegos Martinez, J., Garcia-Cantu, E., Garza Ruiz, J. A., Gonzalez Gonzalez, J. G., Guerrero Garza, M., Hernandez Herrera, C., Hernandez Munuzuri, J., Hernandez-Garcia, H., Jimenez Ramos, S., Laviada Molina, H., Lopez Villezca, D., Montano-Gonzalez, E., Nevarez Ruiz, L., Ramos Lopez, G., Reyes Araiza, R., Salazar-Gaytan, A., Salcido Vazquez, E., Sanchez Mijangos, H., Solis Morales, L., Benatar, J., Dixon, P., Nirmalaraj, K., Rosen, I., Scott, R., Young, S., Araoz Tarco, O., Barreda Cáceres, L., Benites Lopez, C., Camacho Cosavalente, L., Chavez Huapalla, E., Chois Malaga, A., Copaja Flores, A., Farfan Aspilcueta, J., Gallardo Rojas, W., Gallegos Cazorla, A., Galvez Caballero, D., Garcia Matheus, J., Garrido Carrasco, E., Gomez Sanchez, J., Hernandez Zuniga, J., Lu Galarreta, L., Luna, A., Manrique Hurtado, H., Orihuela Pastor, B., Pando Alvarez, R. M., Sanchez Povis, J., Torres Eguiluz, P., Valdivia Portugal, A., Vargas Gonzales, R., Zapata Rincon, L., Aquitania, G., Fortinez, J. T., Go, A., Gomez, M. H., Habaluyas, R., Jasul, G., Magno, M., Manalo, C. J., Mirasol, R., Morales-Palomares, E., Salvador, D. R., Sy, R. A., Tirador, L., Yao, C., Arciszewska, M., Bartkowiak, R., Czajkowska-Kaczmarek, E., Gil, R., Gniot, J., Janik, K., Janion, M., Jaworska, K., Jozwa, R., Kawecka-Jaszcz, K., Kawka-Urbanek, T., Kondys, M., Korecki, J., Korzeniak, R., Kowalisko, A., Krzeminska-Pakula, M., Kwiecien, J., Nessler, J., Odrowaz-Pieniazek, P., Piepiorka, M., Rajzer, M., Skokowska, E., Spyra, J., Sroka, M., Stasinska, T., Szymczyk, I., Trznadel-Morawska, I., Wysokinski, A., Mateus, P., Matos, P., Mimoso, J., Monteiro, P., Caballero, B., Garcia-Rinaldi, R., Gonzalez, E., Ortiz-Carrasquillo, R., Roman, A., Sierra, Y., Unger, N., Vazquez-Tanus, J., Alexandru, T., Busegeanu, M., Cozman, D. C., Fica, S., Minescu, B., Morosanu, M., Negrisanu, G. D., Pintilei, E., Pop, L., Szilagyi, I., Teodorescu, I., Tomescu, M., Barbarash, O., Chumakova, G., Churina, S., Dogadin, S., Dvoryashina, I., Esip, V., Glezer, M., Gordeev, I., Gordienko, A., Gratsiansky, N., Grineva, E., Khasanov, N., Kostenko, V., Meleshkevich, T., Mikhin, V., Morugova, T., Motylev, I., Nikolaev, K., Ponomareva, A., Repin, M., Reshetko, O., Shustov, S., Shutemova, E., Shvarts, Y., Simanenkov, V., Sobolev, K., Sukmanova, I., Timofeev, A., Tsyba, L., Varvarina, G., Vertkin, A., Vishnevsky, A., Volkov, D., Vorobiev, S., Vorokhobina, N., Yakhontov, D., Zonova, E., Zrazhevskiy, K., Damjanovic, S., Djordjevic, D., Pavlovic, M., Perunicic, J., Ristic, A., Stojkovic, S., Tasic, N., Bolvanska, N., Buganova, I., Dulkova, K., Dzupina, A., Fulop, P., Gergel, V., Kokles, M., Micko, K., Svoren, P., Urban, M., Vadinova, S., Vargova, A., Burgess, L., Coetzee, K., Du Toit, J., Gani, M., Joshi, P., Naiker, P., Nortje, H., Sarvan, M., Seeber, M., Siebert, M., Zyl, L., Wellmann, H., Calvo, C., La Hera, J., Teresa, L., Melero-Pita, A., Mesa, J., Parra Barona, J., Serrano, P., Soto, A., Tofe, S., Hornestam, B., Kempe, A., Rosenqvist, U., Rydberg, E., Tengmark, B. O., Torstensson, I., Chang, C. T., Hsia, T. L., Hsieh, I. C., Lai, W. T., Wu, C. J., Hutayanon, P., Kosachunhanun, N., Marapracertsak, M., Piamsomboon, C., Seekaew, S., Srimahachota, S., Sukhum, P., Suraamornkul, S., Tantiwong, P., Wongvipaporn, C., Amosova, K., Barna, O., Bazylevych, A., Berenfus, V., Dyadyk, A., Fushtey, I., Gyrina, O., Iabluchanskyi, M., Karpenko, O., Kaydashev, I., Korzh, O., Kulynych, R., Legkonogov, O., Mankovsky, B., Mostovoy, Y., Parkhomenko, O., Popik, G., Rudenko, L., Rudyk, I., Shevchuk, S., Sirenko, Y., Suprun, Y., Tryshchuk, N., Tseluyko, V., Vakaliuk, I., Al Mahmeed, W., Acheatel, R., Ahmad, A., Akbar, S., Akhter, F., Albirini, A., Alexander, A., Al-Joundi, B., Al-Joundi, T., Allen, G., Aloi, J., Alvarado, O., Alzohaili, O., Anderson, C., Arastu, A., Arena, C., Argoud, G., Ariani, M., Arora, C., Awasty, V., Barker, B., Barnum, O., Bartkowiak, A. J., Barzilay, J., Behrens, P., Belledonne, M., Bergman, B., Bilnoski, W., Bisognano, J., Bissette, S., Blumberg, E., Bonabi, N., Bradley, A., Breton, C., Britos, M., Broadstone, V., Budoff, M., Burge, M., Butman, S., Carroll, M., Challappa, K., Chepuri, V., Cherlin, R., Cheung, D., Coats, P., Collins, J., Cruz, H., Daboul, N., Damberg, G., David, W., Dean, J., Dedeke, E., Deeb, W., Dehaven, J., Dobs, A., Donelan, T., Dy, J., Dykstra, G., Eisen, H., Farris, N., Fattal, P., Fishman, N., Foster, M., Fredrickson, S., Gabra, N., Gabriel, J., Gatien, L., Giddings, S., Ginsberg, B., Gips, S., Glandt, M., Goldfein, A., Gordon, M., Gould, R., Graf, R., Graham, B., Graves, M., Grena, P., Hahn, R., Hamilton, D., Hamroff, G., Hanke, F., Haque, I., Harper, J., Harris, A., Harris, S., Henson, B., Hermanns, D., Herndon, W., Hershberger, V., Hyman, D., Isserman, S., Iteld, B., Jacob, M., Jaffrani, N., Jamal, A., Johnson, D., Johnson, G., Kaluski, E., Keller, R., Kereiakes, D., Khan, M., Khan, S., Klein, M., Knutson, T., Korban, E., Kozinn, M., Kraft, P., Kroeze, J., Kukuy, E., Lader, E., Laliotis, A., Lambert, C., Landau, C., Latif, K., Lee, K., Lester, F., Levenson, D., Levinson, D., Lewis, D., Litt, M., Littlefield, R., Lo, E., Lovell, C., Mahal, S., Makam, S., Mandviwala, M., Marar, I., Masri, B., Mattson, S., Mays, M., Mcgrew, F., Meengs, M., Mikell, F., Miller, M., Miranda, F., Moll, D., Multani, P., Munuswamy, K., Nallasivan, M., Nayles, L., Ong, S., Pacheco, T., Paez, H., Patel, S., Phillips, R., Pierpont, B., Prasad, J., Quinlan, E., Quion, J., Qureshi, M., Rahman, A., Raikhel, M., Ramanathan, K., Randhawa, P., Ravi, R., Reddy, R., Rendell, M., Rickner, K., Rictor, K., Rivas, J., Rosenblit, P., Rosenstock, J., Ross, S., Salacata, A., Saririan, M., Schima, S., Schlau, A., Schmedtje, J., Scott, C., Scott, D., Serru-Paez, A., Shah, R., Shah, A., Shaoulian, E., Shomali, M., Shubrook, J., Silver, K., Singh, S., Speer, J., Stevens, J., Stringam, S., Taussig, A., Taylor, A., Tee, H., Teixeira, G., Tilley, A., Toggart, E., Twahirwa, M., Unks, D., Vakili, B., Vora, K., Wang, X., Warner, A., Wefald, F., Weinberg, B., Weinstein, D., White, L., Wu, P., Yasuda, T., Yazdani, S., Yetman, C., Zarich, S., Zebrack, J., Fonseca, V. A., Mccullough, P. A., Desouza, C., Goff, D. C., Harrell, F. E., Menon, V., Sila, C., Kalahasti, V., Ahmed, S., Al Solaiman, F., Bennett, M., Cavender, M., Heil, B., Katzan, I., Monteleone, P., O Brien, B., Oommen, S., Senn, T., Sharma, J., Stegman, B., Uchino, K., Zishiri, E., Pasca, N., Brown, K., Scebbi, T., Atanasovski, I., Mccue, M., Streit, J., Oh, R., Bueno, O., Lee, D., Camisasca, R., Miyata, Y., Rubin, A., Williamson, N., Vara, S., Keeter, K., Ross, B., Los Reyes, A., Donnelly, J., Koshy-Hunt, S., Beers, B., Black, S., Buckley, M., Ephrem, M., Riley, B., West, N., Harre, M., Hsieh, R., Oshinyemi, K., Oka, Y., Matsui, N., Hoang, M., Doyle, C., Koziol, M., Lam, H., Edmonds, A., Azooz, W., Cao, C., Kim, D., Boeshaar, A., Dewindt, A., Nicholson, K., Smith, N., Hisada, M., Harding, S., Yoshioka, N., Gujral-Sandhu, K., Gans, J., Gresk, C., Kujawski, M. R., Villinski, A., Cosner, S., Johannsen, C., Barchha, N., and Knapp, B.

19. Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta-analysis.

Author

Viecceli C, Remonti LR, Hirakata VN, Mastella LS, Gnielka V, Oppermann ML, Silveiro SP, and Reichelt AJ

Subjects
Birth Weight, Female, Humans, Infant, Small for Gestational Age, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Pregnancy, Randomized Controlled Trials as Topic, United States, Diabetes, Gestational prevention & control, Pregnancy Complications epidemiology, Pregnancy Outcome, Weight Gain
Abstract

The Institute of Medicine updated guidelines for gestational weight gain in 2009, with no special recommendations for gestational diabetes. Our objectives were to describe the prevalence of weight gain adequacy and their association with adverse pregnancy outcomes in gestational diabetes. We searched MEDLINE, EMBASE, COCHRANE and SCOPUS. We calculated the pooled prevalence of gain adequacy and relative risks for pregnancy outcomes within Institute of Medicine categories. Thirty-three studies/abstracts (88,599 women) were included. Thirty-one studies provided data on the prevalence of weight gain adequacy; it was adequate in 34% (95% CI: 29-39%) of women, insufficient in 30% (95% CI: 27-34%) and excessive in 37% (95% CI: 33-41%). Excessive gain was associated with increased risks of pharmacological treatment, hypertensive disorders of pregnancy, caesarean section, large for gestational age and macrosomic babies, compared to adequate or non-excessive gain. Weight gain below the guidance had a protective effect on large babies (RR: 0.71; 95% CI: 0.56-0.90) and macrosomia (RR 0.57; 95% CI 0.40-0.83), and did not increase the risk of small babies (RR 1.40; 95% CI 0.86-2.27). Less than recommended weight gain would be beneficial, while effective prevention of excessive gain is of utmost importance, in gestational diabetes pregnancies. Nevertheless, no ideal range for weight gain could be established., (© 2017 World Obesity Federation.)

Published
2017
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20. Effect of metabolic syndrome and of its individual components on renal function of patients with type 2 diabetes mellitus.

Author

Moehlecke M, Leitão CB, Kramer CK, Rodrigues TC, Nickel C, Silveiro SP, Gross JL, and Canani LH

Subjects
Adult, Cross-Sectional Studies, Diabetic Nephropathies diagnosis, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Renal Insufficiency, Chronic diagnosis, Severity of Illness Index, Diabetes Mellitus, Type 2 complications, Diabetic Nephropathies etiology, Metabolic Syndrome complications, Renal Insufficiency, Chronic etiology
Abstract

The objective of this study was to evaluate the effect of metabolic syndrome (MetS) and its individual components on the renal function of patients with type 2 diabetes mellitus (DM). A cross-sectional study was performed in 842 type 2 DM patients. A clinical and laboratory evaluation, including estimated glomerular filtration rate (eGFR) calculated by the modification of diet in renal disease formula, was performed. MetS was defined according to National Cholesterol Education Program - Adult Treatment Panel III criteria. Mean patient age was 57.9 +/- 10.1 years and 313 (37.2%) patients were males. MetS was detected in 662 (78.6%) patients. A progressive reduction in eGFR was observed as the number of individual MetS components increased (one: 98.2 +/- 30.8; two: 92.9 +/- 28.1; three: 84.0 +/- 25.1; four: 83.8 +/- 28.5, and five: 79.0 +/- 23.0; P < 0.001). MetS increased the risk for low eGFR (<60 mL x min(-1) x 1.73 (m2)(-1)) 2.82-fold (95%CI = 1.55-5.12, P < 0.001). Hypertension (OR = 2.2, 95%CI = 1.39-3.49, P = 0.001) and hypertriglyceridemia (OR = 1.62, 95%CI = 1.19-2.20, P = 0.002) were the individual components with the strongest associations with low eGFR. In conclusion, there is an association between MetS and the reduction of eGFR in patients with type 2 DM, with hypertension and hypertriglyceridemia being the most important contributors in this sample. Interventional studies should be conducted to determine if treatment of MetS can prevent renal failure in type 2 DM patients.

Published
2010
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21. Performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study equations in healthy South Brazilians.

Author

Soares AA, Eyff TF, Campani RB, Ritter L, Weinert LS, Camargo JL, and Silveiro SP

Subjects
Adult, Aged, Aged, 80 and over, Brazil epidemiology, Chromium Radioisotopes, Chronic Disease, Cross-Sectional Studies, Edetic Acid, Female, Humans, Kidney Diseases epidemiology, Male, Mass Spectrometry, Middle Aged, Young Adult, Glomerular Filtration Rate physiology, Kidney Diseases physiopathology, Models, Biological
Published
2010
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22. Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil.

Author

Gerchman F, Zanatta CM, Burttet LM, Picon PX, Lisboa HR, Silveiro SP, Gross JL, and Canani LH

Subjects
Aged, Brazil epidemiology, Brazil ethnology, Chronic Disease, Cross-Sectional Studies, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 ethnology, Diabetic Angiopathies ethnology, Female, Humans, Male, Middle Aged, Prevalence, Black People statistics & numerical data, Diabetes Mellitus, Type 2 epidemiology, Diabetic Angiopathies epidemiology
Abstract

Ethnicity has been shown to be associated with micro- and macrovascular complications of diabetes in European and North American populations. We analyzed the contribution of ethnicity to the prevalence of micro- and macrovascular complications in Brazilian subjects with type 2 diabetes attending the national public health system. Data from 1810 subjects with type 2 diabetes (1512 whites and 298 blacks) were analyzed cross-sectionally. The rates of ischemic heart disease, peripheral vascular disease, stroke, distal sensory neuropathy, and diabetic retinopathy were assessed according to self-reported ethnicity using multiple logistic regression models. Compared to whites, black subjects [odds ratio = 1.72 (95%CI = 1.14-2.6)] were more likely to have ischemic heart disease when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, smoking habit, and serum creatinine. Blacks were also more likely to have end-stage renal disease [3.2 (1.7-6.0)] and proliferative diabetic retinopathy [1.9 (1.1-3.2)] compared to whites when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, and smoking habit. The rates of peripheral vascular disease, stroke and distal sensory neuropathy did not differ between groups. The higher rates of ischemic heart disease, end-stage renal disease and proliferative diabetic retinopathy in black rather than in white Brazilians were not explained by differences in conventional risk factors. Identifying which aspects of ethnicity confer a higher risk for these complications in black patients is crucial in order to understand why such differences exist and to develop more effective strategies to reduce the onset and progression of these complications.

Published
2008
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23. Hypothyroidism in a Brazilian kindred due to iodide trapping defect caused by a homozygous mutation in the sodium/iodide symporter gene.

Author

Pohlenz J, Medeiros-Neto G, Gross JL, Silveiro SP, Knobel M, and Refetoff S

Subjects
Adult, Animals, Base Sequence, Biological Transport, Brazil, COS Cells, Codon, Female, Genotype, Homozygote, Humans, Hypothyroidism metabolism, Male, Pedigree, Recombinant Proteins metabolism, Transfection, Carrier Proteins genetics, Carrier Proteins metabolism, Hypothyroidism genetics, Iodides metabolism, Membrane Proteins genetics, Membrane Proteins metabolism, Point Mutation, Symporters
Abstract

A 36 year old man with a large goiter was suspected of having iodide (I-) transport defect based on low thyroidal and salivary gland radioiodide uptake. Thyroid surgery was performed, because thyroid cytology could not exclude a malignancy. Sequencing of the entire Na+/I- symporter (NIS) cDNA derived from thyroidal mRNA revealed a homozygous substitution of the normal cytosine in nucleotide (nt) 1163 with an adenine, resulting in a stop (TGA) at codon 272. This nonsense mutation produces a truncated NIS with undetectable I- transport activity when expressed into COS-7 cells. Genotyping confirmed that the propositus was homozygous for the mutation whereas his unaffected mother, son, and paternal aunt were heterozygous. This nt substitution was not detected in any of 50 normal individuals, ruling out a polymorphism. While the homozygous mutant NIS-272X causes congenital hypothyroidism, expression of one normal allele in the heterozygote (C272X) is sufficient to maintain active thyroidal I- uptake and function.

Published
1997
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24. Five-year prospective study of glomerular filtration rate and albumin excretion rate in normofiltering and hyperfiltering normoalbuminuric NIDDM patients.

Author

Silveiro SP, Friedman R, de Azevedo MJ, Canani LH, and Gross JL

Subjects
Adult, Aged, Biomarkers urine, Case-Control Studies, Diabetes Mellitus, Type 2 urine, Diabetic Angiopathies physiopathology, Diabetic Nephropathies urine, Diabetic Neuropathies physiopathology, Diabetic Retinopathy physiopathology, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Reference Values, Time Factors, Albuminuria, Diabetes Mellitus, Type 2 physiopathology, Diabetic Nephropathies physiopathology, Glomerular Filtration Rate
Abstract

Objective: To evaluate the evolution of glomerular filtration rate (GFR) and albumin excretion rate (AER) of normofiltering (NF) and hyperfiltering (HF) normoalbuminuric NIDDM patients., Research Design and Methods: A longitudinal study of 32 normoalbuminuric (AER < 20 micrograms/min) NIDDM patients and 20 age-, sex-, and BMI-matched normal individuals was done. Subjects had their GFR (51Cr-labeled EDTA single-injection method) measured at entry and after 40 and 60 months. At entry, 13 NIDDM patients had GFR values above the upper limit of the normal range in our laboratory (> 137 ml.min-1 x 1.73 m-2) and were considered as HF. In NIDDM patients, the 24-h AER (radioimmunoassay), HbA1c, urinary urea, and mean arterial blood pressure (MBP) were analyzed at entry and after 40 and 60 months., Results: There was a significant decline of GFR in NIDDM patients and normal subjects at 60 months. The decline was significantly greater in HF patients (-0.61 ml.min-1.month-1; P = 0.001) than in NF (-0, 18) and control subjects (-0, 14); the rate of change in NF and control subjects was the same (P > 0.05). In stepwise multiple regression analysis, with GFR decline as the dependent variable and GFR and AER at baseline, age and change in MBP, change in urinary urea, change in HbA1c, and change in therapy as independent variables, only baseline GFR (R2 = 0.19, P = 0.002) and age (R2 = 0.31, P = 0.048) were significantly related to the outcome. At 60 months, AER raised > 20 micrograms/min in three HF and in four NF patients. In logistic regression analysis, only higher initial AER (although still in the normal range; P = 0.037) and an increase in urinary urea (P = 0.021) were significantly related to the later development of microalbuminuria., Conclusions: The GFR of normoalbuminuric NIDDM patients declines significantly over 60 months. This decline is associated to baseline GFR and age. HF NIDDM patients show a faster decline in GFR than NF patients, whose GFR falls at a rate that is compatible with the age-related change observed in normal control subjects. The development of microalbuminuria is related to higher baseline AER and to increases in urinary urea and is similar in NF (4 of 19) and HF (3 of 13) NIDDM patients (P > 0.05).

Published
1996
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25. Risk factors for development of proteinuria by type II (non-insulin dependent) diabetic patients.

Author

Gross JL, Stein AC, Beck MO, Fuchs SC, Silveiro SP, de-Azevedo MJ, and Friedman R

Subjects
Adult, Aged, Blood Glucose metabolism, Cholesterol blood, Cross-Sectional Studies, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 urine, Female, Humans, Male, Middle Aged, Odds Ratio, Risk Factors, Triglycerides blood, Diabetes Mellitus, Type 2 physiopathology, Proteinuria blood, Proteinuria etiology
Abstract

1. Renal involvement in non-insulin dependent diabetes mellitus patients is the single most important cause of renal failure. The aim of this study was to evaluate the clinical features and to assess the risk factors for the development of proteinuria by non-insulin dependent diabetic patients. 2. Risk factors (expressed as an odds ratio) were calculated by multiple logistic regression analysis taking into account age, sex, body mass index, known duration of diabetes, presence of arterial hypertension, fasting plasma glucose, cholesterol and triglycerides as independent variables and proteinuria as the dependent variable. Sixty-four normoalbuminuric (24-h albumin excretion rate < 30 micrograms/min, 27 females, mean age 53.7 years) and 53 proteinuric (24-h proteinuria > 0.5 g, 31 females, mean age 59.3 years) were studied. 3. Proteinuric patients were older, with a longer mean known duration of diabetes (12.4 vs 5.6 years), higher mean fasting plasma glucose (214 vs 168 mg/dl) and plasma creatinine (1.5 vs 1.1 mg/dl) and more frequently presented diabetic retinopathy (94% vs 23%), peripheral neuropathy (94% vs 23%) and arterial hypertension (73% vs 16%) than normoalbuminuric patients. Age > 50 years, body mass index > 28.6 kg/m2, known duration of diabetes > 10 years, presence of arterial hypertension, and fasting plasma glucose > 160 mg/dl were significantly and independently associated with development of proteinuria.

Published
1993

26. Effect of age and sex on glomerular filtration rate measured by 51Cr-EDTA.

Author

Gross JL, Friedman R, Azevedo MJ, Silveiro SP, and Pecis M

Subjects
Adult, Chromium Radioisotopes, Female, Humans, Male, Middle Aged, Reference Values, Aging physiology, Edetic Acid, Glomerular Filtration Rate, Sex Characteristics
Abstract

1. The effect of age and sex on glomerular filtration rate (GFR) was measured by the 51Cr-EDTA radioisotopic method in 76 normal individuals (43 women and 33 men). 2. Age has a significant effect on GFR. Subjects aged 41 to 60 years have GFR values [104.5 +/- 16.5 ml min-1 (1.73 m2)-1, N = 43] lower than younger individuals aged 20 to 40 years [116.6 +/- 11.2 ml min-1 (1.73 m2)-1, N = 33]. GFR decreases after 40 years of age by approximately 6.0 ml min-1 (1.73 m2)-1 per decade. 3. GFR values in women [105.9 +/- 16.0 ml min-1 (1.73 m2)-1, N = 43] were lower when compared to men [114.8 +/- 14.3 ml min-1 (1.73 m2)-1, N = 33]. 4. We conclude that the effect of sex and age must be taken into account when establishing reference values for GFR.

Published
1992

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