Diabetes and Endocrinology Center

Calgary, Canada

Diabetes and Endocrinology Center

Calgary, Canada
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Pella D.,Safaric University | Singh R.B.,Halberg Hospital and Research Institute | Dimitrov B.D.,University of Southampton | Chaves H.,Federal University of Pernambuco | And 17 more authors.
World Heart Journal | Year: 2014

Background: There has been persistent emphasis from various health agencies including United Nations on the prevention of cardiovascular diseases (CVDs) and other chronic diseases. This review focusses on the emergence of CVDs and other chronic diseases as well as on modern strategies for their prevention. Methods: A systematic and narrative review was conducted using such reference databases as MEDLINE (PubMed), Web of Science and EBSCO, with additional secondary sources and grey literature searching. Opinions of experts were also sought and discussions followed. Results: The prevalence of primary risk factors for most chronic diseases is rapidly increasing in low and middle income populations due to the on-going economic development and progress. There is a decrease in such risk factors in the developed countries as due to education and adoption of preventive strategies result in a reduction in CVD mortality. Hypertension (5-10%), type 2 diabetes (3- 5%) and CAD (3-4%) are very low in the adult rural populations of India, China, and in the African subcontinent which has less economic development. It seems that it is not poverty, but the lack of health education, possibly due to ineffective policies of national and local governments. In urban and immigrant populations of India and China, which are economically better off, NCDs are significantly higher than they are in some of the highincome populations. Health education and promotion of healthier lifestyle and behaviour appear to be important for prevention in such countries. Conclusion: These findings may require modification of the existing American and European guidelines, proposed for the prevention of CVDs and other chronic diseases, in highincome populations. © 2014 Nova Science Publishers, Inc.

Zhang R.,Strathclyde Institute of Pharmacy and Biomedical science | Zhang R.,Guangzhou University of Chinese Medicine | Zhang T.,Strathclyde Institute of Pharmacy and Biomedical science | Ali A.M.,Strathclyde Institute of Pharmacy and Biomedical science | And 4 more authors.
Computational and Structural Biotechnology Journal | Year: 2016

Metabolomic profiling was carried out on 53 post-mortem brain samples from subjects diagnosed with schizophrenia, depression, bipolar disorder (SDB), diabetes, and controls. Chromatography on a ZICpHILIC column was used with detection by Orbitrap mass spectrometry. Data extraction was carried out with m/z Mine 2.14 with metabolite searching against an in-house database. There was no clear discrimination between the controls and the SDB samples on the basis of a principal components analysis (PCA) model of 755 identified or putatively identified metabolites. Orthogonal partial least square discriminant analysis (OPLSDA) produced clear separation between 17 of the controls and 19 of the SDB samples (R2CUM 0.976, Q2 0.671, p-value of the cross-validated ANOVA score 0.0024). The most important metabolites producing discrimination were the lipophilic amino acids leucine/isoleucine, proline, methionine, phenylalanine, and tyrosine; the neurotransmitters GABA and NAAG and sugar metabolites sorbitol, gluconic acid, xylitol, ribitol, arabinotol, and erythritol. Eight samples from diabetic brains were analysed, six of which grouped with the SDB samples without compromising the model (R2 CUM 0.850, Q2 CUM 0.534, p-value for cross-validated ANOVA score 0.00087). There appears on the basis of this small sample set to be some commonality between metabolic perturbations resulting from diabetes and from SDB. © 2016 The Authors.

Geiker N.R.W.,Copenhagen University | Ritz C.,Copenhagen University | Pedersen S.D.,Copenhagen University | Pedersen S.D.,Diabetes and Endocrinology Center | And 3 more authors.
American Journal of Clinical Nutrition | Year: 2016

Background: Hormonal fluctuations during the menstrual cycle influence energy intake and expenditure as well as eating preferences and behavior. Objective: We examined the effect in healthy, overweight, premenopausal women of a diet and exercise weight-loss program that was designed to target and moderate the effects of the menstrual cycle compared with the effect of simple energy restriction. Design: A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). Results: Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m2): 32.0 ± 5.2]. Both groups lost weight during the study. In an intention-to-treat analysis, the Menstralean group did not achieve a clinically significant weight loss compared with that of the control group (P = 0.61). In per-protocol analyses, a more-pronounced weight loss of 4.3 ± 1.4 kg (P = 0.002) was shown in adherent Menstralean subjects than in the control group. Conclusion: A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial was registered at clinicaltrials.gov as NCT01622114. © 2016 American Society for Nutrition.

Savage M.,Diabetes and Endocrinology Center | Hilton L.,Bolton Diabetes Center
Journal of Diabetes Nursing | Year: 2010

Diabetic ketoacidosis (DKA) is a life-threatening metabolic abnormality associated with type 1 diabetes. It results from absolute or relative insulin deficiency, with an associated increase in counter-regulatory hormones which increase hepatic glucose production, inducing severe hyperglycaemia. Despite improvements in diabetes care, it remains a significant clinical problem. As a result, the Joint British Diabetes Societies (JBDS) has produced updated guidance for the management of DKA to reflect developments in technology and new practice in the UK. A number of new recommendations have been introduced, including prompt referral to the diabetes specialist team and the use of ketone meters. This article summarises the JBDS guideline and discusses the implications of standardised treatment in departments admitting people with DKA.

Savage M.W.,Diabetes and Endocrinology Center
Clinical Medicine, Journal of the Royal College of Physicians of London | Year: 2011

DKA is a medical emergency with a significant morbidity and mortality. It is now recommended that FRIVII be used with bedside measurement of metabolic parameters. The DST should always be involved as soon as possible and ideally within 24 hours because this has been demonstrated to be associated with a better patient experience and reduced length of stay. In the management of diabetic ketoacidosis the following guidance should therefore be followed: • measure blood ketones, venous (not arterial) pH and bicarbonate and use results as treatment markers • monitor ketones and glucose using bedside meters, when available and operating within their quality assurance range • monitor electrolytes on blood gas analysers with intermittent laboratory confirmation • replace 'sliding scale' insulin with weight-based FRIVII • involve the DST as soon as possible • continue long-acting insulin analogues as normal. 1 © Royal College of Physicians, 2011. All rights reserved.

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