Need for a revision of the Dutch perspective? November 27, Start: Academy building RUG, open to the public Faculty: Untreated gestational diabetes mellitus GDM is associated with an increased risk of complications for both mother and child.
Many of these complications can be reduced by early diagnosis and treatment of GDM. However, worldwide there is a lack of agreement on the best way to diagnose and treat GDM. The diagnostic thresholds are based on the old WHO consensus originating from and have until now not been updated to the newest more stringent criteria, implemented in These new criteria have been adopted by many expert committees.
However, evidence that applying the stricter criteria for GDM improves pregnancy outcomes is more info. The research described in this thesis aimed to evaluate the current Dutch national guideline of GDM i. And what are consequences when the current diagnostic criteria of GDM are to be revised?
In this thesis we have shown that the currently Thesis On Type 2 Diabetes Mellitus national guideline for screening and treatment of GDM is successful in reducing the risk of short-term adverse outcomes, but not in reducing the likelihood of having a large-for-gestational-age neonate. We have also shown that the long-term care for GDM is far from optimal and requires further improvement. In order to further optimize GDM care and pregnancy outcomes we advise the use of more stringent blood glucose criteria for GDM diagnosis.
Early diagnosis and treatment of high blood pressure BP and cholesterol is important to reduce cardiovascular risk. In all age groups, except Thesis On Type 2 Diabetes Mellitus aged years, women had a significantly lower Thesis On Type 2 Diabetes Mellitus than men.
Use of BP-lowering medication did not result in BP levels comparable with non-users, except in those aged years. BP was significantly higher in obese vs.
Mean LDL-C varied between 2. Esl Presentation Proofreading Site Uk higher statin use, obese participants had a higher LDL-C than those with a normal weight. Statins abolished the age-dependent LDL-C increase. Obese individuals, especially men younger than 50, have a higher BP and LDL-C compared with those with overweight and a normal weight.
These data suggest that more attention is needed for active screening and treatment of cardiovascular risk factors.
Read the full article at: Abstract Introduction and aim: Insight into the total economic burden of diabetes mellitus DM is essential for decision makers and payers. Currently available estimates for the Netherlands only include part of the total burden or are no longer up-to-date. Therefore, this study aimed to determine the current total economic burden of DM and its complications in the Netherlands, by including all the relevant cost components.
The study combined a systematic literature review to identify all relevant published information and a targeted review to identify relevant information in the grey literature. The identified evidence was then combined to estimate the current total economic burden. Inthere were an estimated 1. DM and its complications pose a substantial economic burden to the Netherlands, which is expected to rise due to changing demographics and lifestyle. Indirect costs, such as welfare payments, accounted for a large portion of the current total economic burden of DM, while these cost components are often not included in cost estimations.
Publicly available data for key cost drivers such as complications were scarce. Epidemiology of metabolic health Lifestyle determinants and health-related quality of life PhD ceremony: January 11, Start: Academy building RUG, open to the public. This combination of metabolic complications is called the metabolic syndrome.
It is associated with an increased risk of type 2 diabetes and cardiovascular diseases. Approximately one Thesis On Type 2 Diabetes Mellitus four Europeans have the metabolic syndrome. Even though it is usually caused by obesity, a sub-group of obese people seem to be less susceptible to the metabolic health risks. They have an equally healthy metabolism as lean people. In the literature, this is referred to as metabolically healthy obese.
In ten large population studies from seven different European countries the occurrence of the metabolic syndrome and metabolically healthy obesity has been estimated. The metabolic syndrome is common in Europe and the Netherlands. However, in the Dutch LifeLines study still nearly 1 out of 4 obese women and 1 out of 10 obese men are metabolically healthy depending on their age.
From studies with LifeLines data only, it seems that smoking- drinking- eating- and continue reading behaviours of these people is important. The level of tobacco use and drinking more than one alcoholic beverage per day was already related to the development of the metabolic syndrome. Actively changing lifestyle factors will reduce the number of people developing the metabolic syndrome, and consequently will reduce the incidence of type 2 diabetes and cardiovascular diseases.
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However, even before these more serious chronic conditions occur, obese subjects without metabolic complications http://cocktail24.info/blog/best-university-essay-editor-sites-for-mba.php an impaired quality of life.
Therefore, in the treatment of obesity it is advisable to take into account aspects relating to the quality of life. Erfelijke stofwisselingsziekten is een groep aangeboren aandoeningen waarbij er sprake is van een defect in een enzym, cofactor of transporter. Hierdoor ontstaat een stoornis in het koolhydraat- vet- of eiwitmetabolisme, of in de synthese of afbraak van complexe moleculen.
Er zijn momenteel ruim erfelijke metabole ziekten beschreven, waarvan de meeste zeldzaam tot uiterst zeldzaam zijn.
Thesis On Type 2 Diabetes Mellitus wordt echter geschat dat ten minste 1 op de levendgeborenen een stofwisselingsziekte heeft.
Voorheen waren erfelijke stofwisselingsziekten bij uitstek het terrein van de kinderarts en dit specialisme erkent dan ook het aandachtsgebied metabole ziekten. Het zeldzame voorkomen en de specifieke problemen die zich op volwassen leeftijd voordoen maakt dat gespecialiseerde zorg voor hen belangrijk is. Langdurig vasten, bijvoorbeeld rond een chirurgische ingreep, kan leiden tot levensbedreigende metabole ontregeling, vooral wanneer de nodige voorzorgsmaatregelen niet zijn genomen.
U vindt hierover informatie op de website www. Nog meer informatieover stofwisselingsziekten vindt u in dit artikel in het Nederlands Tijdschrift voor Geneeskunde: En natuurlijk op goede en informatieve websites als: Lipids and apolipoproteins in cardiovascular disease PhD ceremony: December 14, Start: Academy building RUG Faculty: The first part of this thesis describes the role of cholesterol more info and associated proteins, and their role in the development of cardiovascular disease.
There seems to be an advantage in determining the balance between good and bad cholesterol, as compared to the separate measures when attempting to predict link development of cardiovascular disease.
Certain genes that have an influence on proteins transporting cholesterol from one particle to the other, do not seem to have an effect on the predictive value of these measures. The inhibition of this protein does increase the level of the good cholesterol, but this does not seem to result in any survival benefit. The second part of this thesis describes the effect of cholesterol lowering agents on different cholesterol particles and associated proteins.
Cholesterol lowering agents seem to affect the number of particles less than their cholesterol content. This could lead to a lack of intensive cholesterol treatment when only the cholesterol concentration is considered. Thyroid cancer treatment Long-term effects and new developments PhD Thesis On Type 2 Diabetes Mellitus Esther Klein Hesselink When: October 12, Start: Thyroid cancer is increasingly common.
This is especially the case for differentiated thyroid cancer DTCwhich has a favorable prognosis. Treatment consists of surgical removal of the thyroid gland, radioiodine treatment, and life-long administration of relatively high doses of thyroid hormone. This treatment is effective, but also rather aggressive since it can result in the occurrence of both short- and long-term adverse effects. There used to be little attention for this issue, as cancer-related outcome was less favorable.
Nowadays, we see a lot of DTC patients with small tumors who have a near-normal life expectancy. For these patients long-term adverse effects of treatment are very important since they can negatively impact quality of life. In this thesis we therefore studied the occurrence of long-term effects of DTC treatment.
We found that atrial fibrillation a cardiac rhythm disturbance and mortality read article to cardiovascular diseases are more common in DTC patients as compared to the general population.
Living with type 2 diabetes in rural Uganda - PhD presentation
Furthermore, we found that a part of patients have salivary glands dysfunction following radioiodine treatment. Fortunately, the adverse effects of treatment on bone marrow function were limited. Furthermore, there is a small group of thyroid cancer patients with more aggressive disease.
For these patients, cure is often not achievable. Therefore, we studied the efficacy and toxicity of tyrosine kinase inhibitors a new class of drugs that have been studied in these patients. In addition, we studied the hereditary material of several thyroid cancers in an attempt to understand more of thyroid cancer pathogenesis. In de afgelopen jaren bleek regelmatig dat mensen met een bijnierziekte verschillende instructies ontvingen van hun behandelaars hoe om te gaan met stress.
Ook vanuit het UMCG is hieraan intensief meegewerkt. De nieuwe stressinstructie is verkrijgbaar via uw behandelend internist-endocrinoloog, maar kan ook gedownload worden via de website van Bijniernet. Effects of radioiodine treatment on salivary gland function in patients with differentiated thyroid carcinoma: Klein Hesselink1, Adrienne H. Jager2, Arjan Vissink1 and Thera P. Complaints of a dry mouth xerostomia and sialoadenitis are frequent side effects of radioiodine treatment in differentiated thyroid cancer DTC patients.
However, detailed prospective data on alterations in salivary gland functioning after radioiodine treatment I are scarce. Therefore, the primary aim of this study was to prospectively assess the effect of high-activity radioiodine treatment on stimulated whole saliva flow rate. Secondary aims were to study unstimulated whole and stimulated glandular i.