Disfunção autonômica cardiovascular no diabetes mellitus experimental

Cardiorespiratory parameters and glycated hemoglobin of patients with type 2 diabetes after a rehabilitation program

INTRODUCTION

Cardiovascular autonomic dysfunction reflex of the pathophysiology of diabetes mellitus (DM) favors an increase in morbidity and mortality related to cardiovascular events, and for this reason has been one of the most studied clinical entities.

METHOD

An experimental study of a randomized clinical trial type was therefore proposed to analyze the hemodynamic and glycemic response after the practice of a rehabilitation program in patients with type 2 diabetes mellitus (T2DM). In this clinical trial the patients will initially be submitted to an evaluation protocol that consists of assessing blood pressure, heart rate, Borg scale, respiratory rate, oxygen saturation, distance traveled through the 6-minute walk test, quality of life questionnaire, Pittsburgh sleep quality questionnaire, and still glycated hemoglobin and heart rate variability through the cardiofrequency meter. After careful evaluation of the patients, they will be submitted to a metabolic rehabilitation program composed of aerobic and resisted exercises, performed for 12 weeks, in 3 weekly meetings of 60 minutes each. With such evaluations, it will be possible to construct with evidence that it is possible to work safer metabolic rehabilitation programs in patients with T2DM or other diseases that generate cardiovascular risks, guaranteeing them an improvement in cardiorespiratory fitness, hemodynamic and glycemic variables, allowing improvement of the quality of life.

ETHICS AND DISSEMINATION

The protocol is approved by the host institution's ethics committee under the number 1.616.721. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT3094767.

Role of autologous mesenchymal stem cells associated with platelet-rich plasma on healing of cutaneous wounds in diabetic mice

BACKGROUND

Chronic cutaneous lesions affect 15% of human patients with diabetes, and the associated risk of limb amputations is 15-46 times greater than that of people with normal glycaemia. It is estimated that half of these limb amputations could be avoided by opportune treatment with somatic stem cells or platelet-rich plasma (PRP).

METHODS

We evaluated the effects of autologous transplant of mesenchymal stem cells (MSCs) with or without combination with autologous PRP in the re-epithelialization of cutaneous lesions induced in diabetic mice.

RESULTS

Animals treated with MSCs alone showed a similar level of re-epithelialization of cutaneous lesions to those treated with MSC plus PRP, and no significant difference was found between the two treatments.

CONCLUSION

Both treatments gave better results than daily cleaning of the cutaneous lesions with saline or covering of the lesions with semipermeable adherent bandage.