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  • 1
    In: Biomedicines, MDPI AG, Vol. 11, No. 1 ( 2022-12-27), p. 72-
    Abstract: Diabetes mellitus is a disease with multiple gastrointestinal symptoms (diarrhea or constipation, abdominal pain, bloating) whose pathogenesis is multifactorial. The most important of these factors is the enteric nervous system, also known as the “second brain”; a part of the peripheral nervous system capable of functioning independently of the central nervous system. Modulation of the enteric nervous system can be done by short-chain fatty acids, which are bacterial metabolites of the intestinal microbiota. In addition, these acids provide multiple benefits in diabetes, particularly by stimulating glucagon-like peptide 1 and insulin secretion. However, it is not clear what type of nutraceuticals (probiotics, prebiotics, and alimentary supplements) can be used to increase the amount of short-chain fatty acids and achieve the beneficial effects in diabetes. Thus, even if several studies demonstrate that the gut microbiota modulates the activity of the ENS, and thus, may have a positive effect in diabetes, further studies are needed to underline this effect. This review outlines the most recent data regarding the involvement of SCFAs as a disease modifying agent in diabetes mellitus type 2. For an in-depth understanding of the modulation of gut dysbiosis with SCFAs in diabetes, we provide an overview of the interplay between gut microbiota and ENS.
    Type of Medium: Online Resource
    ISSN: 2227-9059
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2720867-9
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  • 2
    In: Revista Romana de Medicina de Laborator, Walter de Gruyter GmbH, Vol. 26, No. 3 ( 2018-07-01), p. 345-352
    Abstract: Chronic hyperglycemia is an important cause for the development of chronic complications of diabetes, but glycemic variability has emerged in recent years as an independent contributor to diabetes-related complications. Our objective was to evaluate glycemic variability in patients with T2DM treated with insulin compared with other antidiabetic drugs. In this retrospective study, we collected 24-hour continuous glucose monitoring (CGM) recording data from 95 patients with T2DM, of which 27 treated with insulin and 68 with non-insulin treatment. We calculated and compared 16 glucose variability parameters in the insulin-treated and non-insulin treated groups. Insulin treated patients had significantly higher values of parameters describing the amplitude of glucose value fluctuations (standard deviation of glucose values, percentage coefficient of variation [%CV], and mean amplitude of glycemic excursion [MAGE] , p 〈 0.05) and time-dependent glucose variability (percentage of time with glycemic values below 70 mg/dl and continuous overall net glycemic action [CONGA] at 2, 4 and 6 hours, p 〈 0.05). In conclusion, insulin therapy in T2DM is correlated with significantly higher glycemic variability.
    Type of Medium: Online Resource
    ISSN: 2284-5623
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2018
    detail.hit.zdb_id: 2864269-7
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  • 3
    In: Biomedicines, MDPI AG, Vol. 10, No. 2 ( 2022-01-28), p. 308-
    Abstract: Diabetes mellitus is considered to be a global epidemic. The combination of genetic susceptibility and an unhealthy lifestyle is considered to be the main trigger of this metabolic disorder. Recently, there has been increased interest in the roles of gut microbiota as a new potential contributor to this epidemic. Research, in recent years, has contributed to an in-depth characterization of the human microbiome and its associations with various diseases, including metabolic diseases and diabetes mellitus. It is known that diet can change the composition of gut microbiota, but it is unclear how this, in turn, may influence metabolism. The main objective of this review is to evaluate the pathogenetic association between microbiota and diabetes and to explore any new therapeutic agents, including nutraceuticals that may modulate the microbiota. We also look at several mechanisms involved in this process. There is a clear, bidirectional relationship between microbiota and diabetes. Current treatments for diabetes influence microbiota in various ways, some beneficial, but others with still unclear effects. Microbiota-aimed treatments have seen no real-world significant effects on the progression of diabetes and its complications, with more studies needed in order to find a really beneficial agent.
    Type of Medium: Online Resource
    ISSN: 2227-9059
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2720867-9
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  • 4
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2016
    In:  Revista Romana de Medicina de Laborator Vol. 24, No. 1 ( 2016-3-1), p. 55-64
    In: Revista Romana de Medicina de Laborator, Walter de Gruyter GmbH, Vol. 24, No. 1 ( 2016-3-1), p. 55-64
    Abstract: Introduction. Dawn phenomenon could have deleterious effect on overall glycemic control. Glycemic variability may be an independent risk factor for the development of diabetes chronic complications. The study aimed to evaluate any correlations between the dawn phenomenon and parameters of glycemic variability in a cohort of type 2 diabetes patients (T2DM). Material and methods. This retrospective observational study included 131 T2DM patients. Continuous glucose monitoring (CGM) has been performed. Data from the first 24h of full recording were used for analysis of glycemic variability indices: mean level of 24h interstitial glucose value and standard deviation; % coefficient of variation; J index; mean amplitude of glycemic excursion - MAGE; continuous overall net glycemic action (CONGA) at 1, 2, 4 and 6 hours; mean of daily differences (MODD) index. Results. Mean age was 56.04 ± 9.91 years, 35.9% women, 17.6% on diet, 53.4% on oral therapy and 29% on insulin. Dawn phenomenon was more frequent in patients below 60 years (70%) and in oral therapy group (72.85%). Significant correlations between the dawn phenomenon and j-index, MAGE, CONGA-4 and CONGA-6 have been found in T2DM patients on diet therapy alone. The amplitude of dawn phenomenon was 46.10 ± 24.40 mg/dl and significantly correlated (p 〈 0.05) after adjustment for age, gender and treatment with % CV, MAGE, CONGA-1, CONGA-2, CONGA-4, CONGA-6 and MODD. Conclusions. The dawn phenomenon significantly increases the glycemic variability parameters in drug-naive T2DM patients, with no impact in T2DM on oral or insulin therapy.
    Type of Medium: Online Resource
    ISSN: 2284-5623
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2016
    detail.hit.zdb_id: 2864269-7
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  • 5
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2019
    In:  Romanian Journal of Diabetes Nutrition and Metabolic Diseases Vol. 26, No. 2 ( 2019-06-01), p. 177-183
    In: Romanian Journal of Diabetes Nutrition and Metabolic Diseases, Walter de Gruyter GmbH, Vol. 26, No. 2 ( 2019-06-01), p. 177-183
    Abstract: Background and aims: The present study aimed to assess the relative validity of the Romanian version of a food frequency questionnaire (FFQ) in evaluating habitual dietary intake. Material and methods: We used an FFQ that comprised questions on 90 beverage and food items from Nurses Health Questionnaire. The linguistic interchangeability between translation and original questions of the FFQ was assessed in 50 bilingual adults. Also, the FFQ was validated against the 24-h recall diary in 85 participants from ORO study enrolled in Cluj County. Results: The Spearman correlation coefficients between the Romanian and English versions of the FFQ ranged between 0.614 and 1.000, with the majority having values 〉 0.900 (p 〈 0.05 for all). Caloric and nutrient intake estimated from FFQ was significantly correlated with that derived from 24-h dietary recall (correlation coefficients 0.243 to 0.339; p-values 〈 0.05). 〉 70% of the participants were classified in the same or adjacent quartiles of energy and nutrient consumption showing a good agreement between FFQ and 24-h dietary recall. Tested FFQ questionnaire had a good internal consistency with Cronbach’s alpha coefficients of 0.931 and 0.949, respectively. Conclusion: Tested FFQ had an acceptable relative validity and can be used to estimate caloric and macronutrient intake.
    Type of Medium: Online Resource
    ISSN: 2284-6417
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2019
    detail.hit.zdb_id: 2860636-X
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  • 6
    In: Romanian Journal of Diabetes Nutrition and Metabolic Diseases, Walter de Gruyter GmbH, Vol. 21, No. 4 ( 2014-12-1), p. 291-299
    Abstract: Background and aims. The aim of our research was to evaluate the impact of short-time continuous glucose monitoring (CGM) on glycemic control evaluated by HbA1c and within-day glucose variability. We also assessed if the initiation of insulin therapy in conjunction with lifestyle recommendations may prevent the weight gain. Materials and method. We included 28 patients with type 2 diabetes with 2 consecutive CGMS recordings available (baseline and follow-up) and for which were collected data on weight, body mass index (BMI), percentage (%) of body fat, visceral fat area, HbA1c and glycemic variability. Results. The HbA1c decreased significantly from 8.8% at baseline to 7.3% at follow-up (p 〈 0.0001) in the whole group, and from 10.5% to 7.5% in the subgroup for which the insulin therapy was initiated at baseline (p=0.011). The BMI, % body fat and visceral fat area decreased significantly from 29.2 kg/m 2 to 28.4 kg/m 2 ; from 32.3% to 30.4%; and from 141.6 to 129.3 (cm 2 ), respectively. No increase of these parameters was observed in the subgroup for which the insulin therapy was initiated at baseline. Conclusion. The use of CGMS in combination with individualized lifestyle and therapeutic recommendations may have a beneficial effect on glycemic control and may prevent the weight gain associated with insulin initiation.
    Type of Medium: Online Resource
    ISSN: 2284-6417
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2014
    detail.hit.zdb_id: 2860636-X
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  • 7
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2012
    In:  Romanian Journal of Diabetes Nutrition and Metabolic Diseases Vol. 19, No. 1 ( 2012-01-1), p. 33-40
    In: Romanian Journal of Diabetes Nutrition and Metabolic Diseases, Walter de Gruyter GmbH, Vol. 19, No. 1 ( 2012-01-1), p. 33-40
    Abstract: Introduction: The skin, the largest human organ, is often affected by diabetes mellitus (DM). We know that DM affects the hydration of stratum corneum (SC), the sebum content of the skin and to some extent, the barrier function of the epidermis and elasticity, but we do not know the factors leading to these changes. Objectives: The objectives of this study were to determine the factors associated with changes in physical properties of the skin (skin hydration degree, sebumetry, transepidermal water loss and skin elasticity) in patients with diabetes. Materials and methods: The physical properties of the skin were assessed using the Multi Probe Adapter Systems MPA ® (Courage-Khazaka, Germany) in 57 patients with diabetes and 46 non-diabetic. Results: Statistical analysis of the entire group of 103 subjects showed a significant association between female gender and decreased SC hydration (p 〈 0.05 in all cases), decreased values of transepidermal water loss (TEWL) (β=-0.282, p=0.006) and decreased elasticity of the skin in forearm (β=-0.216, p=0.043). Also, the presence of DM was negatively associated with levels of SC hydration measured on the forearm (β=-0.281, p=0.005). Furthermore, in patients with diabetes, the presence of diabetic neuropathy (DNP) was negatively associated with the hydration of SC measured at all levels (forearm: β=-0.465, p 〈 0.001; leg: β=-0.590, p 〈 0.001; tight: β=-0.198, p 〈 0.001). The observed relationship was independent of age and sex of the participants (p 〈 0.05 after adjustment for age and sex). Regarding skin elasticity, increasing age was associated with lower levels of skin elasticity both in entire group and in patients with DM, at all sites of measurements (p 〈 0.05 in all cases). Additionally, in patients with diabetes, elasticity of the skin measured at forearm and tight was negativelly associated with type of DM (forearm: β=-0.335, p=0.023; tight: β=-0.522, p 〈 0.001). In our study, nor diabetes neither DNP were not associated with TEWL values. Conclusions: The presence of DNP seems to be the main predictor of decreased SC hydration in all measuring points and skin elasticity is significantly associated with age. There are some gender-related modification in physical properties of the skin. Surprisingly, type 2 DM was associated with reduced elasticity in the thigh, and this association was independent of age and sex.
    Type of Medium: Online Resource
    ISSN: 2068-7532
    Language: Unknown
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2012
    detail.hit.zdb_id: 2640392-4
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  • 8
    In: Medicine and Pharmacy Reports, Clujul Medical, Vol. 89, No. 1 ( 2016-02-02), p. 82-88
    Abstract: Background and aims. We aimed to study prevalence  and the predictive factors of non-alcoholic fatty liver disease (NAFLD) defined by the fatty liver index (FLI) in type 2 diabetic patients (T2DM).Methods. Three hundred and eighty-one T2DM outpatients who regularly attended a Consulting Clinic in Cluj were retrospectivelly included. FLI, a surrogate steatosis biomarker based on body mass index (BMI), waist circumference (WC), triglycerides (TGL) and gammaglutamyl-transferase (GGT) was used to assess NAFLD in all patients. Anthropometric and biochemical parameters were measured. Hepatic steatosis (HS) was evaluated by ultrasonography.Results. NAFLD-FLI (defined as FLI 〉 60) was correlated with HS evaluated by ultrasound (r=0.28; p 〈 0.001). NAFLD-FLI was detected in 79% of T2DM. The prevalence of obesity in NAFLD-FLI patients was 80%. Of the patients with normal alanine aminotransferase (ALAT), 73.8 % had NAFLD. At univariate analysis, NAFLD-FLI was correlated with age (r= -0.14; p=0.007), sex (r=0.20; p 〈 0.001), LDL cholesterol (r=0.12; p=0.032), HDL cholesterol (r = -0.13; p=0.015), ALAT (r=0.20; p 〈 0.001) and ASAT (r=0.19; p 〈 0.001). At multiple regression analysis, sex, ALAT and LDL-cholesterol were independent predictors of NAFLD-FLI. After logistic regression model, ALAT, LDL-cholesterol, HOMA-IR were good independent predictors of NAFLD-FLI.Conclusions. NAFLD-FLI could be useful to identify NAFLD in T2DM patients. Subjects with T2DM had a high prevalence of NADLD-FLI even with normal ALAT levels . Our findings showed that sex, ALAT, LDL cholesterol and IR were significant and independent factors associated with the presence of NAFLD in T2DM subjects.
    Type of Medium: Online Resource
    ISSN: 2668-0572 , 2602-0807
    Language: Unknown
    Publisher: Clujul Medical
    Publication Date: 2016
    detail.hit.zdb_id: 2974430-1
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  • 9
    Online Resource
    Online Resource
    MDPI AG ; 2023
    In:  International Journal of Molecular Sciences Vol. 24, No. 4 ( 2023-02-08), p. 3385-
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 24, No. 4 ( 2023-02-08), p. 3385-
    Abstract: Atherosclerotic cardiovascular disease is the most common cause of morbidity and mortality worldwide. Diabetes mellitus increases cardiovascular risk. Heart failure and atrial fibrillation are associated comorbidities that share the main cardiovascular risk factors. The use of incretin-based therapies promoted the idea that activation of alternative signaling pathways is effective in reducing the risk of atherosclerosis and heart failure. Gut-derived molecules, gut hormones, and gut microbiota metabolites showed both positive and detrimental effects in cardiometabolic disorders. Although inflammation plays a key role in cardiometabolic disorders, additional intracellular signaling pathways are involved and could explain the observed effects. Revealing the involved molecular mechanisms could provide novel therapeutic strategies and a better understanding of the relationship between the gut, metabolic syndrome, and cardiovascular diseases.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 10
    In: Medical Ultrasonography, SRUMB - Romanian Society for Ultrasonography in Medicine and Biology, Vol. 17, No. 3 ( 2015-09-01), p. 300-
    Abstract: Aim: The aim of this study was to evaluate the impact of clinical parameters and indices of body composition on the rela- tion between non-alcoholic fatty liver disease (NAFLD) and carotid intima-media thickness (cIMT), in a type 2 diabetes mel- litus population (T2DM). Material and methods: We retrospectively enrolled 336 T2DM outpatients who regularly attended Regina Maria Clinic in Cluj. Clinical, anthropometric and biochemical parameters were measured. Ultrasonography (US) was used to assess hepatic steatosis (HS) in all patients and cIMT in 146 subjects. Body composition was assessed by bioelectric impedance (BIA, InBody 720) in all patients. Results: cIMT was correlated with age (r=0.25; p=0.004), systolic blood pressure (r=0.18; p=0.041), glycated haemoglobin A1C (HbA1C, r=0.20; p=0.04), and with coronary artery disease (r=0.20; p=0.007). HS did not correlate with cIMT (r=0.04; p=0.64). cIMT was correlated with visceral fatty area (VFA, r=0.18; p=0.014) but not with other indices of body composition. Homeostasis model assessment for insulin resistance (HOMA-IR) was not correlated with cIMT (r=0.17; p=0.086). After multivariate analysis, age, HbA1c, and VFA were good independent predictors of cIMT (r=0.45; p˂0.001). Conclusions: These results are suggestive that in T2DM patients, fatty liver is not a direct mediator of early carotid atherosclerosis. Our data indicate that visceral fat accumulation and HbA1C are determinant factors of cIMT sugesting that controlling abdominal obesity and hyperglicemia might reduce atherosclerotic disease risk in NAFLD-T2DM subjects.
    Type of Medium: Online Resource
    ISSN: 2066-8643 , 1844-4172
    Language: Unknown
    Publisher: SRUMB - Romanian Society for Ultrasonography in Medicine and Biology
    Publication Date: 2015
    detail.hit.zdb_id: 2529623-1
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