Obesity, diabetes, and related manifestations are associated with an enhanced, but poorly understood, risk for mucosal infection and systemic inflammation. Here, we show in mouse models of obesity and diabetes that hyperglycemia drives intestinal barrier permeability, through GLUT2-dependent transcriptional reprogramming of intestinal epithelial cells and alteration of tight and adherence junction integrity. Consequently, hyperglycemia-mediated barrier disruption leads to systemic influx of microbial products and enhanced dissemination of enteric infection. Treatment of hyperglycemia, intestinal epithelial-specific GLUT2 deletion, or inhibition of glucose metabolism restores barrier function and bacterial containment. In humans, systemic influx of intestinal microbiome products correlates with individualized glycemic control, indicated by glycated hemoglobin levels. Together, our results mechanistically link hyperglycemia and intestinal barrier function with systemic infectious and inflammatory consequences of obesity and diabetes.

Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection.

(2012). The 2012 SEMDSA Guideline for the Management of Type 2 Diabetes. Journal of Endocrinology, Metabolism and Diabetes of South Africa: Vol. 17, No. 1, pp. 61-62.

https://www.tandfonline.com/doi/pdf/10.1080/22201009.2012.10872276

The 2012 SEMDSA Guideline for the Management of Type 2 Diabetes

Hospital admissions, emergency department utilisation and patient activation for self-management among people with diabetes

Objetivos Determinar a prevalencia de sintomas de ansiedade e depressao em estudantes de Medicina e avaliar fatores associados. Metodos Estudo de corte transversal com 234 estudantes que responderam a um questionario eletronico com variaveis sociodemograficas e a Escala Hospitalar de Ansiedade e Depressao (Ehad). Resultados Em relacao a ansiedade, o escore medio da Ehad foi de 6,7 (DP: +/- 3,4), com 34,3% (80) apresentando sintomas falso-positivos de ansiedade e 19,7% (46) manifestando sintomas sugestivos do transtorno. Quanto a depressao, o escore medio da Ehad foi de 4,4 (DP: +/- 3,1), com 19,3% (45) apresentando sintomas falso-positivos para depressao e 5,6% (13) manifestando sintomas sugestivos do transtorno. Na analise univariada, o uso de drogas psicoativas associou-se a presenca de sintomas de ansiedade; para sintomas de depressao, o estudante ser procedente da RMR foi fator protetor, ao passo que o uso de drogas ilicitas foi associado a risco. Conclusao A prevalencia de sintomas de ansiedade e depressao associada ao uso de drogas psicoativas e ilicitas, respectivamente, indica a necessidade de medidas de prevencao e diagnostico precoces.

Prevalência de Sintomas de Ansiedade e Depressão em Estudantes de Medicina

This study aimed to investigate relationships between dysglycaemia and length of hospital stay, short-term mortality and readmission in an unselected population in an acute medical unit (AMU). The rate of follow up in non-diabetic individuals with hyperglycaemia was also measured. We analysed data from all 1,502 patients admitted through our AMU in February 2010 to assess blood glucose levels on admission, length of stay, 28-day readmissions and mortality, and to determine whether blood glucose > or = 11.1 mmol/l on admission in non-diabetic individuals was followed up. In total, blood glucose was measured on admission for 893 patients. Mean length of stay was 8.8 (standard deviation 11.9) days, for patients with blood glucose 20.1 mmol/l. Length of stay for patients with blood glucose > 6.5 mmol/l on admission was significantly longer (p = 0.002). The 28-day readmission rates were 6.4%, 6%, 9.7%, 12.5%, 10% and 15%, respectively, and 28-day death rates were 4.8%, 6%, 5.8%, 17.2%, 17.1% and 6.1%, respectively. Overall, 51.4% of non-diabetic individuals with blood glucose > 11.1 mmol/l on admission were followed up. The study showed that blood glucose > 6.5 mmol/l on admission is associated with significantly longer length of stay. Hyperglycaemia was associated with increased 28-day mortality and readmissions, and is frequently underinvestigated.

https://www.rcpjournals.org/content/clinmedicine/12/2/137.full.pdf

Assessing the relationship between admission glucose levels, subsequent length of hospital stay, readmission and mortality

O uso de drogas entre estudantes universitarios esta cada dia mais difundido. Os indices de uso de alcool e drogas ilicitas podem ser maiores na populacao universitaria do que na populacao em geral. OBJETIVO: Este trabalho procurou detectar quais sao as drogas de abuso usadas pelos estudantes de medicina de universidade privada de Curitiba para posterior implementacao de programa de prevencao secundaria nesta populacao. METODOS: Durante 106 dias, em 2006, foi aplicada adaptacao virtual do questionario Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) aos 209 estudantes de medicina participantes do presente trabalho. RESULTADOS: Oitenta e oito (42%) estudantes participaram. A maioria era solteira (88%) e tinham entre 17 e 25 anos (85%). Setenta e oito por cento usou alcool pelo menos uma vez na vida. O uso na vida de tabaco foi de 39%; cannabis sativa 26%, inalantes 22% e estimulantes 11%. DISCUSSAO: Os resultados encontrados sao semelhantes aos de outras pesquisas em universidades e mostram alto numero de usuarios de drogas, especialmente o alcool. Essa e uma situacao preocupante e aponta a importância da instituicao educacional na prevencao da dependencia quimica. CONCLUSAO: O ambiente universitario influencia o uso de drogas e novas estrategias de prevencao sao necessarias.

https://www.scielo.br/pdf/jbpsiq/v57n3/05.pdf

Detecção do uso de drogas de abuso por estudantes de medicina de uma universidade privada

Background
Hyperglycemia in hospitalized patients is known to be related to a higher incidence of clinical and surgical complications and poorer outcomes. Adequate glycemic control and earlier diagnosis of type 2 diabetes during hospitalization are cost-effective measures.

/pdf/impact-of-hyperglycemia-on-morbidity-and-mortality-length-of-1svw8igj42.pdf

Deborah Tockus

Papers

Detecção do uso de drogas de abuso por estudantes de medicina de uma universidade privada

Impact of hyperglycemia on morbidity and mortality, length of hospitalization and rates of re-hospitalization in a general hospital setting in Brazil.