XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Prospective Cohort Study

Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction

Methods available for the measurement of antioxidant capacity are reviewed, presenting the general chemistry underlying the assays, the types of molecules detected, and the most important advantages and shortcomings of each method. This overview provides a basis and rationale for developing standardized antioxidant capacity methods for the food, nutraceutical, and dietary supplement industries. From evaluation of data presented at the First International Congress on Antioxidant Methods in 2004 and in the literature, as well as consideration of potential end uses of antioxidants, it is proposed that procedures and applications for three assays be considered for standardization: the oxygen radical absorbance capacity (ORAC) assay, the Folin-Ciocalteu method, and possibly the Trolox equivalent antioxidant capacity (TEAC) assay. ORAC represent a hydrogen atom transfer (HAT) reaction mechanism, which is most relevant to human biology. The Folin-Ciocalteu method is an electron transfer (ET) based assay and gives reducing capacity, which has normally been expressed as phenolic contents. The TEAC assay represents a second ET-based method. Other assays may need to be considered in the future as more is learned about some of the other radical sources and their importance to human biology.

https://faculty.missouri.edu/~glaserr/3700s14/Antioxidant-Capacity_jf0502698.pdf

Standardized Methods for the Determination of Antioxidant Capacity and Phenolics in Foods and Dietary Supplements

A new automated colorimetric method for measuring total oxidant status.

A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation

A novel automated method to measure total antioxidant response against potent free radical reactions.

A novel and automated assay for thiol/disulphide homeostasis.

OBJECTIVE The aim of this study was to determine the oxidative status and antioxidative status of plasma of patients with complete hydatidiform mole (CHM) and to compare these values with normal pregnancy. METHOD Thirty-eight patients with CHM and 31 healthy pregnant women were enrolled in the study. To determine the antioxidative status of plasma, total antioxidant potential (TAOP) was calculated, and to determine the oxidative status of plasma total peroxide levels were measured. The ratio of TAOP to total peroxide was accepted as an indicator of oxidative stress. RESULTS TAOP of plasma was significantly lower in patients with hydatidiform mole than in healthy pregnant women [mean (SD) values were 511.9 (105.8) and 571.7 (109.4) micromol Trolox equiv./L respectively (p <0.05)]. In contrast, mean (SD) total peroxide level of plasma was significantly higher in the patients [21.8 (6.4) micromol H2O2/L] than in healthy pregnant women [15.6 (6.4) micromol H2O2/L (p <0.001)]. The mean oxidative stress index level was significantly higher in patients with CHM than in healthy pregnant women [4.43 (1.70) versus 2.92 (1.50) respectively (p <0.001)]. CONCLUSION Patients with CHM are exposed to oxidative stress, which may have a role in the pathogenesis of the disease. Supplementation with antioxidative vitamins such as C and E could be considered in treatment.

Ozcan Erel

Papers

A new automated colorimetric method for measuring total oxidant status.

A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation

A novel automated method to measure total antioxidant response against potent free radical reactions.

A novel and automated assay for thiol/disulphide homeostasis.

Increased oxidative stress in patients with hydatidiform mole.