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Πέμπτη 26 Μαΐου 2022

Carbohydrate quantity is more closely associated with glycaemic control than weight in pregnant women with type 1 diabetes; insights from the Diabetes and Pre‐eclampsia Intervention Trial (DAPIT)

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Abstract

Aim

To explore the relationships between carbohydrate intake, body mass index and glycaemic control (HbA1c) in pregnant women with type 1 diabetes mellitus (T1DM)

Methods

Secondary analysis of data was undertaken to assess dietary intake in a cohort of women who participated in a randomized controlled trial (RCT) of antioxidant supplementation to prevent pre-eclampsia (DAPIT10). Study specific peripheral venous blood samples were obtained for HbA1c at 26 weeks and 34 weeks. Diet was collected using a validated semi-quantitative food frequency questionnaire at 26-28 weeks gestation which assessed dietary intake over 2 weeks. Mean daily average nutrient intakes were analysed using Q Builder nutritional software (Tinuviel Software, UK) and SPSS Version 25).

Results

Dietary data were available for 547 pregnant women (72% of cohort) aged 29 years (95% CI 28.9-29.9) with average diabetes duration 11.8 years (95% CI 11.1-12.6). Averag e BMI (<16 weeks gestation) was 26.7 kg/m2 (95% CI 26.3 -27 range 18.8-45.6 kg/m2); 43% (n=234) were overweight (BMI 25.0 - 29.9kg/m2) and 20% (n= 112) were obese (BMI>30kg/m2). Differences in HbA1c and carbohydrate quantity and quality were found when adjusted for age and insulin dose. No differences between BMI group were observed in total carbohydrate and glycaemic control, however, differences were noted in fibre and glycaemic index.

Conclusion

Average quantity of dietary carbohydrate influenced HbA1c when adjusted for insulin dose however, BMI had less impact. More research is required on the relationship between carbohydrate consumption and glycaemic control in pregnancy.

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Concomitant and Exceedingly Rare Causes of Oropharyngeal Dysphagia

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This case report describes a man in his 40s who presented with a 5-month history of worsening dysphonia and dysphagia and was subsequently diagnosed with extranodal natural killer/T-cell lymphoma.
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Magnetic resonance guided adaptive stereotactic body radiotherapy for lung tumors in ultracentral location: the MAGELLAN trial (ARO 2021-3)

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Stereotactic Body Radiotherapy (SBRT) is a standard treatment for inoperable primary and secondary lung tumors. In case of ultracentral tumor location, defined as tumor contact with vulnerable mediastinal stru...
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Comparative single-cell RNA-sequencing profiling of BMP4-treated primary glioma cultures reveals therapeutic markers

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Abstract
Background
Glioblastoma (GBM) is the most aggressive primary brain tumor. Its cellular composition is very heterogeneous, with cells exhibiting stem-cell characteristics (GSCs) that co-determine therapy resistance and tumor recurrence. Bone Morphogenetic Protein (BMP)-4 promotes astroglial and suppresses oligodendrocyte differentiation in GSCs, processes associated with superior patient prognosis. We characterized variability in cell viability of patient-derived GBM cultures in response to BMP4 and, based on single-cell transcriptome profiling, propose predictive positive and early-response markers for sensitivity to BMP4.
Methods
Cell viability was assessed in 17 BMP4-treated patient-derived GBM cultures. In two cultures, one highly sensitive to BMP4 (high therapeutic efficacy) and one with low sensitivity, response to treatment with BMP4 was characterized. We applied single-cell RNA-sequencing, analyzed the relative abundance of cell clusters, searched for and identified the aforementioned two marker types, and validated these results in all 17 cultures.
Results
High variation in cell viability was observed after treatment with BMP4. In three cultures with highest sensitivity for BMP4, a substantial new cell subpopulation formed. These cells displayed decreased cell proliferation and increased apoptosis. Neuronal differentiation was reduced most in cultures with little sensitivity for BMP4. OLIG1/2 levels were found predictive for high sensitivity to BMP4. Activation of ribosomal translation (RPL27A, RPS27) was upregulated within one day in cultures that were very sensitive to BMP4.
Conclusion
The changes in composition of patient-derived GBM cultures obtained after treatment with BMP4 correlate with treatment efficacy. OLIG1/2 expression can predict this efficacy, and upregulation of RPL27A and RPS27 are useful early-response markers.
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