Diabetic Center

Treviso, Italy

Diabetic Center

Treviso, Italy
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Candido R.,Diabetic Center | Toffoli B.,University of Ferrara | Bernardi S.,University of Trieste | Zella D.,University of Maryland, Baltimore | And 2 more authors.
Journal of Vascular Research | Year: 2010

Background/Aims: Since elevated plasma levels of osteoprotegerin (OPG) represent a risk factor for death and heart failure in patients affected by diabetes mellitus and coronary artery disease, this study aimed to elucidate potential roles of OPG in the pathogenesis of atherosclerosis. Methods and Results: Recombinant human full-length OPG, used at concentrations comparable to the elevated levels found in the serum of diabetic patients, significantly increased the proliferation rate of rodent vascular smooth muscle cells (VSMC). To mimic the moderate chronic elevation of OPG observed in diabetic patients, low doses (1 μg\mouse) of full-length human OPG were injected intraperitoneally every 3 weeks in diabetic apolipoprotein E (apoE)-null mice. The group of animals treated for 12 weeks with recombinant OPG showed a small increase in the total aortic plaque area at necropsy in comparison to vehicle-treated animals. Importantly, while no differences in the amount of interstitial collagen or the degree of macrophage infiltration were observed between OPG-treated and vehicle-treated apoE-null diabetic animals, a significant increase in the number of α-actin-positive smooth muscle cells was observed in the plaques of OPG-treated mice. Conclusions: Our data suggest that OPG promotes VSMC proliferation and might be directly involved in pathogenetic aspects of atherosclerosis. Copyright © 2009 S. Karger AG, Basel.

Toffoli B.,University of Ferrara | Toffoli B.,Institute for Maternal and Child Health | Bernardi S.,University of Trieste | Candido R.,Diabetic Center | And 6 more authors.
Molecular and Cellular Endocrinology | Year: 2011

Although serum osteoprotegerin (OPG) is significantly increased in diabetic subjects, its potential role in beta cell dysfunction has not been investigated. This study aimed to assess the effect of full-length OPG administered in vivo in mice on pancreatic islet structure and function and its interaction with the renin-angiotensin system (RAS).OPG-treated mice showed increased islet monocyte/macrophage infiltration, fibrosis and apoptosis with reduction of islet function. The remodeling of islet architecture was associated with increased pancreatic expression of components of the RAS, growth factor genes (transforming growth factor β and connective tissue growth factor) and inflammatory molecules (monocyte chemotactic protein-1 and vascular adhesion molecule type 1). Prevention of these changes with improvement of insulin secretion was observed in ramipril treated animals. Our data suggest that OPG might play an important role in promoting beta cell dysfunction and that the upregulation of the local RAS represents one possible mechanism responsible for the OPG-induced beta cell dysfunction. © 2010 Elsevier Ireland Ltd.

Tessari P.,University of Padua | Kiwanuka E.,University of Padua | Kiwanuka E.,Diabetic Center | Barazzoni R.,University of Padua | And 10 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2015

Context: Subjects with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) often exhibit hypertriglyceridemia. The mechanism(s) of such an increase are poorly known. Objective: We investigated very low-density lipoprotein (VLDL)-Apo B 100 kinetics in T2DM subjects with and without DN, and in healthy controls. Design: Stable isotope 13C-leucine infusion and modeling analysis of tracer-to-tracee ratio dynamics in the protein product pool in the 6-8-h period following tracer infusion were employed. Setting: Male subjects affected by T2DM, either with (n = 9) or without (n = 5) DN, and healthy male controls (n=6), were studied under spontaneous glycemic levels in the post-absorptive state. Results: In the T2DM patients with DN, plasma triglyceride (TG) (mean±SD; 2.2±0.8 mmol/L) and VLDL-Apo B 100 (17.4±10.4 mg/dL) concentrations, and VLDL-Apo B 100 pool (0.56±0.29 g), were ∼60-80% greater (P < .05 or less) than those of the T2DM subjects without DN (TG, 1.4 ± 0.5 mmol/L; VLDL-Apo B 100, 9.9 ± 2.5 mg/dL; VLDL-Apo B 100 pool, 0.36 ± 0.09 g), and ∼80-110% greater (P<.04 or less) than those of nondiabetic controls (TG, 1.2±0.4 mmol/L; VLDL-Apo B 100, 8.2 ± 1.7 mg/dL; VLDL-Apo B 100, 0.32 ± 0.09 g). In sharp contrast however, in the subjects with T2DM and DN, VLDL-Apo B 100 fractional synthesis rate was ≥50% lower (4.8 ± 2.2 pools/d) than that of either the T2DM subjects without DN (9.9 ± 4.3 pools/d; P < .025) or the control subjects (12.5 ± 9.1 pools/d; P < .04). Conclusions: The hypertriglyceridemia of T2DM patients with DN is not due to hepatic VLDL-Apo B 100 overproduction, which is decreased, but it should be attributed to decreased apolipoprotein removal. Copyright © 2015 by the Endocrine Society.

Ahmed A.A.,Diabetic Center
Avances en Diabetologia | Year: 2010

Diabetes is one of the growing health problems in the Middle East region in general and Saudi Arabia in particular. The increasing number of the population and changes in the pattern of life in the region expose a large number of the population to diabetes and its complications. The following review discusses the magnitude of the diabetes problem in Saudi Arabia, diabetic peripheral neuropathy, diabetic arterial disease, diabetic foot and the impact of education to prevent diabetic foot diseases on the outcome of diabetic foot problems. According to my knowledge, this is the first review which shows the magnitude of diabetic foot problems and its risk factors in Saudi Arabia.

Alfadhli E.M.,Taibha University | Osman E.N.,Taibha University | Basri T.H.,Madinah Maternity and Children Hospital | Mansuri N.S.,Taibha University | And 3 more authors.
Annals of Saudi Medicine | Year: 2015

BACKGROUND AND OBJECTIVES: The prevalence of gestational diabetes (GDM) has increased recently worldwide, mainly due to adoption of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. The objectives of this study were to determine the prevalence of GDM in Saudi women and to assess risk factors and pregnancy outcomes using the IADPSG criteria. DESIGN AND SETTING: A prospective descriptive study of pregnant Saudi women presenting at the Maternity and Children Hospital, Medina, Saudi Arabia, between October 2011 and June 2014. METHODS: Fasting plasma glucose, glycated hemoglobin, and random plasma glucose concentrations were obtained for all participants at the first antenatal visit. In women with normal results, screening for GDM was performed at 24 to 28 weeks of gestation, with a 75-g oral glucose tolerance test (OGTT). Women who had GDM were treated with diet, exercise, and insulin as needed. Pregnancy outcomes were recorded after delivery. Multiple logistic regression was used to assess possible risk factors for GDM. RESULTS: Early screenings showed abnormal glucose in 211 of 954 women (22.1%). In 445 women, the OGTT showed GDM in 183 women (39.4%). GDM cases identified by OGTT and by early screening increased the rate of GDM to 51% (292 women). Older maternal age, higher body mass index, higher blood pressure, past GDM, history of delivering a malformed child, and family history of diabetes were the main risk factors for GDM. GDM increased the risk of neonatal hypoglycemia (OR 9.353), low Apgar score (OR 5.546), and induction of labor (OR 2.33). The newborns of GDM mothers had a higher birth weight: 3043 g vs. 2890 g in the non-GDM group (P=.004). Other maternal and neonatal outcomes were not significantly different between the two groups. CONCLUSION: The prevalence of GDM is high among Saudi women. Timely and effective treatment reduces perinatal morbidity and improves outcomes. © Annals of Saudi Medicine.

Toffoli B.,Institute for Maternal and Child Health | Bernardi S.,Baker IDI Heart and Diabetes Institute | Candido R.,Diabetic Center | Zacchigna S.,International Center for Genetic Engineering and Biotechnology | And 2 more authors.
Investigational New Drugs | Year: 2012

Recent clinical trials carried out in patients with advanced cancer have shown that recombinant TRAIL administration is usually safe and well tolerated when used either alone or in association with chemotherapeutic drugs. Notably, anticancer chemotherapy can be associated to cardiomiopathy. We have here demonstrated that TRAIL (administrated as either recombinant soluble TRAIL or as AAV-TRAIL expression viral vector) reduced the development of cardiomyopathy in the ApoE-/- diabetic mouse model. These data suggest, for the first time, that therapeutically administration of TRAIL might have a cardioprotective effect. © 2012 Springer Science+Business Media, LLC.

Nanda Kumar L.G.,MNR Medical College | Kaveri N.K.,MNR Medical College | Anmol M.N.Y.,Diabetic Center
Diabetes and Metabolic Syndrome: Clinical Research and Reviews | Year: 2011

Background: Reports of urban based studies suggest an increase in the prevalence of MS worldwide along with diabetes, hypertension and atherogenic dyslipidemia. The supporting rural based studies on MS are few and prevalence of MS among women is underestimated. In this prospective study we have evaluated the clinic prevalence of metabolic syndrome among rural Indian population with special emphasis on prevalence in women. Research design and method: 2329 patients attending to diabetic centre were evaluated for the markers of MS. Anthropometric measurements, clinical assessment, capillary blood glucose and lipid profile (TC, HDL-C, TG, LDL-C, VLDL-C) were done and classified as per NCEP ATP III and NCEP ATP III modified for Asian guidelines. We compared the prevalence of MS between males and females for statistical significance by SPSS 16.0 statistical software. The level of significance was kept at <0.05. Results: The Clinic prevalence of metabolic syndrome was 61.74% with 57.59% males and 69.66% females as per NCEP ATP III guidelines. 73.85% of the study population had MS, with 68.85% males and 83.39% females had MS as per modified Asian criteria. We could get a statistically significant variation between males and females in FBS, PPBS, SBP, DBP, TC, HDL-C, TG, LDL-C, VLDL-C, TC/HDL, LDL/HDL, BMI, W/H ratio and W/S ratio. Conclusion: Prevalence MS is increasing at an epidemic proportion bringing with it micro and macro vascular complications. Women are more prone to develop MS in rural population than the men and there is a statistically significant variation in the biochemical and anthropometric parameters. This is an era of 'gender equality'; here we see women over taking men in metabolic syndrome and its complications. © 2012 Diabetes India. Published by Elsevier Ltd. All rights reserved.

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