Athletes with Chronic Conditions
Flavia Meyer, Zbigniew Szygula, Boguslaw Wilk in Fluid Balance, Hydration, and Athletic Performance, 2016
As it was briefly mentioned above, individuals with type 1 diabetes often need to decrease their insulin intake and/or increase their carbohydrate intake prior to exercise in order to prevent deleterious declines in blood glucose, and consequently hypo-glycemia, during and after exercise (Perkins and Riddell 2006; Riddell and Perkins 2006; Yardley et al. 2013). How much the individual decreases their insulin dosage or increases their carbohydrate intake is often largely based on personal experience. It will also depend on the time of day exercise is being performed, the anticipated duration and intensity of the exercise, blood glucose trends throughout the day (i.e., antecedent hypoglycemia can increase the risk of another hypoglycemic event [Cryer 2013]), as well as the timing of previous snacks/meals and related insulin intake prior to exercise. Fear of hypoglycemia is a very common barrier to exercise in individuals with type 1 diabetes (Brazeau et al. 2008) and often leads to excessive caution with respect to exercise-related adjustments. As such, it is not unusual for individuals with type 1 diabetes to start exercise with their blood glucose levels in the hyperglycemic range (Yardley et al. 2013, 2015), in order to prevent encountering hypoglycemic levels before the end of the exercise session (Figure 12.2). This can lead to varying degrees of glucosuria and dehydration depending on the severity and duration of hyperglycemia.
Treatment and Pharmacological Interventions in Streptozotocin Diabetes
John H. McNeill in Experimental Models of Diabetes, 2018
Molybdate has been demonstrated to have effects similar to vanadium and selenium in partially correcting the symptoms of diabetes in STZ diabetic rats.66 Thus, sodium molyb-date when administered in drinking water (0.4 to 0.5 g/l) and in food (0.75 to 1.25 g/kg) normalized plasma glucose levels by the end of the 8-week treatment period. Food and fluid intake, and glucosuria were significantly improved by this treatment, as was glucose tolerance in response to an oral or intravenous glucose load. These improvements in glucose metabolism occurred in the absence of any changes in plasma insulin or improved insulin output during the oral or intravenous glucose challenge tests. Plasma urea (an indicator of kidney function) and plasma AST and ALT (indicators of liver function) were elevated in the diabetic rats. These parameters were partially normalized by the treatment. Permolybdate and pertungstate have also shown to lower blood glucose in STZ diabetic rats when administered as a single i.p. dose of 0.1 mol/kg with the maximum effect seen at 6 to 8 h.67
Diagnosis and Screening of Diabetes Mellitus in the Elderly
Medha N. Munshi, Lewis A. Lipsitz in Geriatric Diabetes, 2007
Measurement of glycosuria based on a urine dipstick is frequently used both in primary and in secondary care. Urine can be tested fasting, random or postprandial. However in all cases sensitivity is low (16–64%) and the predictive value of a positive test ranges from 11% to 37% (based on a prevalence of diabetes ranging 6–12%). Glycosuria should not be used as a screening instrument for diabetes, as over 65% of individuals with diabetes may be misclassified as non-diabetic. Blood glucose levels could be high enough to represent diabetes but glycosuria may not be present due to the high renal threshold in the elderly. Additionally glycosuria in the absence of hyperglycemia is not diagnostic of diabetes. Glycosuria may also be present in the absence of diabetes in disorders such as renal tubular function.
Non-diabetic glycosuria as a diagnostic clue for acute tubulointerstitial nephritis in patients with azotemia
Published in Renal Failure, 2020
To assess the utility of urine glucose test in identifying ATIN as a cause of elevated creatinine, we performed a retrospective analysis of adult patients who underwent a native kidney biopsy at Asan Medical Center (Seoul, Korea) as a diagnostic evaluation for serum creatinine higher than 1.4 mg/dL. Patients aged <18 years, having diabetes mellitus or transplanted kidney were excluded. The presence of diabetes mellitus was determined by the positive history of diabetes mellitus, a fasting plasma glucose ≥ 126 mg/dL or HbA1c ≥ 6.5% [13]. Glycosuria may also occur in a person who doesn't have diabetes if blood glucose level rises higher than 170–200 mg/dL and the filtered glucose load exceeds the capacity for tubular glucose reabsorption [14]. So, the patients with blood glucose higher than 170 mg/dL on the day when urine glucose was positive were also excluded. Patients with proteinuria in the nephrotic range (24-h urine protein > 3.5 g, urine protein/creatinine >3.5 g/g or urine albumin/creatinine >2.5 g/g [15]) were excluded because ATIN-induced proteinuria is mild and only rarely is in the nephrotic range [1,2]. In some patients with nephrotic syndrome, ATIN was combined to minimal change or focal segmental glomerulosclerosis, and those patients were also excluded because nephrotic syndrome itself was an indication of a kidney biopsy to determine the pathologic type, regardless of the presence of ATIN.
High glucose-mediated overexpression of ICAM-1 in human vaginal epithelial cells increases adhesion of Candida albicans
Published in Journal of Obstetrics and Gynaecology, 2018
Hiroshige Mikamo, Yuka Yamagishi, Hiroyuki Sugiyama, Hisato Sadakata, Shun Miyazaki, Takako Sano, Tsutomu Tomita
Vulvovaginal candidiasis (VVC) is an infection related to diabetes (Grigoriou et al. 2006; Hirji et al. 2012; Geerlings et al. 2014; Njomanang Soh et al. 2016). The risk of VVC is especially high in uncontrolled diabetes (Goswami et al. 2000; de Leon et al. 2002). This is caused by glycosuria, host immune dysfunction and enhanced virulence of infecting microorganisms that occur in diabetes (Raith et al. 1983; Sobel 1989; Geerlings et al. 2014). There is a high incidence of genital infections in patients treated with sodium glucose co-transporter type 2 (SGLT2) inhibitors (Geerlings et al. 2014; Nauck 2014; Scheen 2015). These inhibitors block the reabsorption of glucose in the kidney, which decreases the blood glucose levels by excretion into the urine. This urinary glucose generates an advantageous environment for infecting pathogenic microorganisms, thus increasing the incidence of VVC.
Lowe syndrome with extremely short stature: growth hormone deficiency may be the pathogeny
Published in Growth Factors, 2019
Chengjun Dai, Liying Wang, Youli Li, Zhichao Zheng, Jieqi Qian, Chaoban Wang, Zishuo Liu, Xiaoou Shan
Short stature and scoliosis were revealed by physical examination, and visual impairment was discovered in SL-01. Growth hormone provocation test indicated that the peak secretion of growth hormone was less than 5 ng/ml (>10 ng/ml in normal people). Table 1 showed the results obtained from growth hormone provocation test, and the results of other hormone tests were presented in Table 2. These tests of hormones were conducted when the boy was 9 years 5 months old. Blood biochemistry analysis was performed at the age of 14 years, showed that lactate dehydrogenase was 980 U/l (120 ∼ 246U/l), blood urea nitrogen was 5.9 mmol/l (2.9 ∼ 8.2 mmol/l), serum creatinine was 70.5 μmol/l (30 ∼ 50 μmol/l), blood potassium was 3.19 mmol/l (3.5 ∼ 5.3 mmol/l), and glomerular filtration rate(GFR) was 42.5 ml/min according to the Schwartz-equation recalibrated by Böckenhauer et al., indicating the renal insufficiency. Routine urine test was found indicative of slight glycosuria and proteinuria. The urine microprotein analysis revealed severe proteinuria (Table 3). According to the ultrasound examination, the size of kidney was normal. Radiological examination of hand demonstrated that the bone age was less than 8 when he was 14-year-old actually. In addition, he showed a slight scoliosis (Figure 1). Brain MRI of the patient was suggestive of a small pituitary (Figure 2). The bone mineral density Z score was -3.9, indicating low bone mineral density. The clinical manifestation and test results of patient SL-01 suggested the diagnosis of Lowe syndrome.
Related Knowledge Centers
- Diabetes
- Fanconi Syndrome
- Glucose
- Reabsorption
- Tubular Fluid
- Ultrafiltration
- Urine
- Circulatory System
- Kidney
- Blood Sugar Level