Giuseppe Seghieri - Academia.edu (original) (raw)

Papers by Giuseppe Seghieri

Research paper thumbnail of The Assessment of Ankle Range-of-Motion and Its Relationship with Overall Muscle Strength in a Cross-Section of Soccer Players

Sports

Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possi... more Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possible risk factor for injury and other negative consequences over time. The main objective of this research was to investigate the effects of soccer practice on ankle ROM throughout the entire period of a sports career of soccer players (SP). Furthermore, the relationship between ankle ROM and muscle strength in SP of different ages was studied. A total of 204 SP (range 6.7–45.1 years) and 87 controls (range: 7.5–45.2 years) matched for age, body mass index (BMI), and gender, were assessed. Ankle ROM in both plantar flexion (APF) and dorsiflexion (ADF) in addition to handgrip strength (HGS) were evaluated using an inclinometer and the Jamar hydraulic hand dynamometer, respectively. The comparison between SP and control groups showed a significant reduction in ankle ROM of both APF (26.3 ± 7.2° vs. 32.6 ± 7.4°; d = −0.90; p < 0.001) and ADF (95.5 ± 15.6° vs. 105.5 ± 15.8°; d = −0.66; p &...

Research paper thumbnail of Validation and reliability of a new PC-controlled device for the evaluation of key pinch strength in healthy adults

Italian journal of anatomy and embryology, 2017

Objective: Hand muscle strength assessment is widespread and can be a useful marker in the evalua... more Objective: Hand muscle strength assessment is widespread and can be a useful marker in the evaluation and monitoring of subjects at different ages and health conditions. This study aimed at validating and determining the reliability of a new digital device for evaluation of hand pinch strength by comparing it with a well-validated hand strength assessment device, the Jamar hydraulic hand dynamometer. Methods: In 65 healthy subjects, (males / females: 29 / 36), mean age 40.3±18.0 (range: 19.3 - 76.5) years, hand pinch strength and hydraulic hand dynamometer were used to assess hand strength following a testing protocol. Only the dominant hand was tested. Evaluations were performed considering gender, hand dominance, body mass index and age, according to the standardized testing protocol. The mean of three consecutive grip tests and lateral pinch tests was recorded. Results: There was a strong correlation (p<0.0001) between the hydraulic hand dynamometer and hand pinch strength tes...

Research paper thumbnail of Evaluating ankle joint mobility for ulcerative risk: a different method

Research paper thumbnail of The Possible Role of Trekking Poles to Improve Posture, Balance, and Plantar Pressures Distribution in Diabetic Patient

Research paper thumbnail of The impact of diabetes mellitus and sport practice on joint mobility, muscle strength and posture of young subjects

Italian journal of anatomy and embryology, 2016

It is known that diabetic disease may modify patients’ joint mobility, muscle strength and postur... more It is known that diabetic disease may modify patients’ joint mobility, muscle strength and posture. The aim of this study was to evaluate the presence of differences between young patients with T1DM and young sports subjects. In 23 patients with diabetes (13/11:m/f), mean age 10.7±1.2 yrs, duration of diabetes 6.1±3.0 yrs, mean HbA1c 7.6±0.9 %, (group D), and in 52 healthy control subjects (39/14:m/f), mean age 11,1±1,5 yrs (group C) were evaluated muscle strength (standing long jump, hand grip, key pinch test), ankle joint mobility (AJM) (inclinometer), flexibility (sit and reach test), foot plantar pressure distribution in quiet standing and posture (baropodometric analysis, images). Group C was composed by 2 teams of soccer players: 23 soccer players (23/0:m:f), mean age 12,0±0,3 yrs (group SP1); 15 young soccer players (15:0/m:f), mean age 9,0±1,3 yrs (group SP2); and a team of 14 volleyball players (0:14/:m:f), mean age 11,8±0,3 yrs (group VP). The group D showed a significant ...

Research paper thumbnail of Glycated haemoglobin in nondiabetic pregnancy: Relation to neonatal weight and pregnancy outcome

Diabetes Nutrition & Metabolism, 1996

Research paper thumbnail of Gender Effect on the Relation between Diabetes and Hospitalization for Heart Failure

Experimental and Clinical Endocrinology & Diabetes, 2011

Cardiovascular risk among diabetic patients is at least twice as much the one for non-diabetic in... more Cardiovascular risk among diabetic patients is at least twice as much the one for non-diabetic individuals and even greater when diabetic women are considered. Heart failure (HF) is a common unfavorable outcome of cardiovascular disease in diabetes. However, since the comparison among sexes of heart failure prevalence in diabetic patients remains limited, this study is aimed at expanding the information about this point.We have evaluated the association between diabetes and HF by reviewing the medical records of all subjects discharged from the Internal Medicine and Cardiology Units of all hospitals in the Tuscany region, Italy, during the period January 2002 through December 2008. In particular we sought concomitance of ICD-9-CM codes for diabetes and HF.Patients discharged by Internal Medicine were on average older, more represented by women, and had a lesser number of individuals coded as diabetic (p<0.05 for all). Relative risk for HF (95% CI) was significantly higher in pati...

Research paper thumbnail of Pregestational exposure to hormonal combined contraceptives and risk of gestational diabetes: an observational retrospective population study

Research paper thumbnail of Indications of reduced pulmonary function in type 1 (insulin-dependent) diabetes mellitus

Diabetes Research and Clinical Practice, 1994

Abnormalities of pulmonary function tests have been described in type 1 (insulin-dependent) diabe... more Abnormalities of pulmonary function tests have been described in type 1 (insulin-dependent) diabetes mellitus (IDDM). To better characterise such abnormalities and to verify whether these latter are associated with the presence of diabetic microvascular disease we compared 23 non-smoking patients who had IDDM with 24 non-smoking healthy control subjects strictly matched for sex, age, and body mass index. Compared with controls, diabetic patients had a reduced forced vital capacity (FVC) (87.5 +/- 13.1% vs. 96.4 +/- 13.6% of the predicted; P = 0.03) and forced expiratory volume in 1 s (FEV1) (90.5 +/- 17.7% vs. 101.2 +/- 13.2% of the predicted; P = 0.02). While within the group of patients the presence of retinopathy and autonomic neuropathy were not associated with modifications of pulmonary function tests, those with altered urinary albumin excretion rate (AER &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 20 micrograms/min; range 21-589) (n = 7) had a significantly lower pulmonary diffusion capacity (DLCO) than the 16 normoalbuminuric subjects (62.6 +/- 7.2% vs. 88.7 +/- 20.1% of the predicted; P = 0.01). Moreover, in the group of patients, DLCO was inversely related with AER (r = -0.43; P = 0.04). In conclusion, IDDM is characterised by reduced FVC and FEV1, while a significant decrease in DLCO may be considered as selectively associated with renal disease.

Research paper thumbnail of ROS and kidney disease in the evolution from acute phase to chronic end stage disease: A commentary on “Oxidative signaling in renal epithelium: Critical role of cPLA2 and p38SAPK”

Free Radical Biology and Medicine, 2006

Abbreviations: AA, arachidonic acid; ERK-1/2, extracellular signalregulated kinases 1 and 2; ESRD... more Abbreviations: AA, arachidonic acid; ERK-1/2, extracellular signalregulated kinases 1 and 2; ESRD, end-stage renal disease; MAPK, mitogenactivated protein kinase; ROS, reactive oxygen species.

Research paper thumbnail of Long Term Predictors of Post-Partum Glucose Metabolism in Women with Gestational Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes, 2010

The question asked by this study was whether β-cell function expressed by insulin secretion/sensi... more The question asked by this study was whether β-cell function expressed by insulin secretion/sensitivity measured during pregnancy in women with gestational diabetes (GDM) predicts post-partum long-term derangement in glucose metabolism. Seventy-four Caucasian women with previous GDM were retested through a 75 g-2-h-OGTT after 8 [6] years (median[interquartile range]) from index pregnancy, measuring at pregnancy and follow-up insulin sensitivity, insulin secretion (1-h-incremental-insulin-area/incremental-glucose-area: ΔAUC60 (I)/ΔAUC60 (G)) as well as the product of Stumvoll-first-phase - secretion x insulin sensitivity (insulin-secretion-sensitivity index (ISSI). At follow-up 47 women were normotelerant to glucose and 27 had altered glucose metabolism (AGM:10 with type 2 diabetes and 17 with IGT). Women progressed to AGM had at their index pregnancy higher mean 2-h-OGTT-glucose area (1.15±0.09 VS. 1.09±0.09 mol l 2-h (-1);p=0.014), and lower ΔAUC60 (I)/ΔAUC60 (median [interquantile range]) (54.4 [51.7] vs. 73.4 [60] pmol mmol (-1)) and ISSI (2 977 [766] vs. 3 708 [1 141]; p&amp;amp;amp;amp;lt;0.05 for both), but similar insulin sensitivity index 2.9 [2.5] VS. 3.2 [2.2] ml min (-1) m (-2);p=NS). Two-h-OGTT-glucose area, or decrease in ΔAUC60 (I)/ΔAUC60 (G) and ISSI were significantly associated with glucose tolerance impairment and with raised adjusted risk for AGM while insulin sensitivity at pregnancy did no predict AGM development. In this group of women increased post-load plasma glucose and impaired β-cell function assessed during GDM pregnancy predict long-term post-partum AGM, while insulin sensitivity measured at the same time does not.

Research paper thumbnail of Plasma and platelet ascorbate pools and lipid peroxidation in insulin-dependent diabetes mellitus

European Journal of Clinical Investigation, 1998

As diabetes mellitus represents a situation in which production of peroxides is increased, the ai... more As diabetes mellitus represents a situation in which production of peroxides is increased, the aim of this study was to investigate the relationship between plasma and platelet levels of ascorbic acid (AA)/dehydroascorbic acid (DHA) and those of malonyldialdehyde (MDA), an indirect marker of lipoperoxides, both assayed using high-performance liquid chromatography (HPLC), in 59 patients with insulin-dependent diabetes mellitus (IDDM) compared with 51 healthy control subjects matched for sex, age, smoking habits, as well as for dietary intake of energy, alcohol and vitamin C. Mean plasma and platelet MDA were significantly higher in the patients affected with IDDM than in control subjects. Moreover, the diabetic group was characterized by a huge decrease in plasma AA [8.45 +/- 5.5 mumol L-1 (SD) vs. 33.4 +/- 7.6 mumol L-1, P = 0.0001], mirrored by a significant increase in plasma DHA (11.9 +/- 3.9 mumol L-1 vs. 3.9 +/- 2.5 mumol L-1, P = 0.0001). No detectable DHA was observed in the platelets from both diabetic and control subjects, whereas AA was significantly increased in platelets from diabetic patients compared with control subjects (42.6 +/- 7.4 vs. 34.8 +/- 5.1 nmol 10(-9) platelets, P = 0.0001). Platelet AA in the diabetic group was significantly inversely correlated with glycated haemoglobin (r = -0.34; P = 0.04) and directly with plasma AA (r = 0.39; P = 0.02), the sum of plasma AA + DHA (r = 0.44; P = 0.009) and with platelet MDA (r = 0.38; P = 0.02). (a) The ratio plasma AA/DHA is significantly lowered in IDDM in association with an increase in MDA levels; (b) only AA is detected in platelets, being augmented in the diabetic group; (c) plasma ascorbate depletion does not reflect platelet levels of AA; and, finally, (d) metabolic control, as well as intracellular lipoperoxides, modulates platelet AA in IDDM.

Research paper thumbnail of Influence of gestational diabetes on the long-term control of glucose tolerance

Diabetologia, 2007

Aims/hypothesis Gestational diabetes (GDM) carries a high risk of subsequent diabetes. We asked w... more Aims/hypothesis Gestational diabetes (GDM) carries a high risk of subsequent diabetes. We asked what impact prior GDM has on beta cell function and insulin action in women who maintain normal glucose tolerance (NGT) for a long time. Methods Ninety-one women with NGT (aged 41±8 years, mean±SD) were studied (by mathematical modelling of the C-peptide response to an OGTT) 7 [6] years (median [interquartile range]) after the index pregnancy, during which 52 had GDM (pGDM) and 39 had NGT (pNGT). In all women an OGTT had also been performed at 29± 3 weeks of the index pregnancy. Results Women with pGDM were matched with women with pNGT for age, familial diabetes, time and weight gain since index pregnancy, parity, BMI (25.4±3.9 vs 26.8± 6.4 kg/m 2 ), and fasting (4.64±0.56 vs 4.97±0.46 mmol/l) and 2 h plasma glucose levels (5.91±1.14 vs 5.91± 1.21 mmol/l). Nonetheless, fasting (49 [29] vs 70 [45] pmol min −1 m −2 , p<0.001) and total insulin secretion (32 [17] vs 48 [21] nmol m −2 , p<0.0001) and beta cell glucose sensitivity (slope of the insulin secretion/plasma glucose concentration-response function) (95 [71] vs 115 [79] pmol min −1 m −2 (mmol/l) −1 , p=0.025) were reduced in the pGDM group compared with the pNGT group, while insulin sensitivity was preserved (424 [98] vs 398 [77] ml min −1 m −2 ). At index pregnancy, women with pGDM and those with pNGT had similar age and BMI. However, both insulin sensitivity (359 [93] vs 417 [92] ml min −1 m −2 , p=0.0012) and the insulin/glucose incremental area ratio (an empirical index of beta cell function; 98 [74] vs 138 [122] pmol/mmol, p=0.028) were reduced in women with pGDM.

Research paper thumbnail of Does parity increase insulin resistance during pregnancy?

Diabetic Medicine, 2005

To study the effect of parity on impairment of insulin sensitivity during pregnancy and on the ri... more To study the effect of parity on impairment of insulin sensitivity during pregnancy and on the risk of gestational diabetes (GDM). We studied the relationship between parity and peripheral insulin sensitivity index (ISI(OGTT)) or GDM in 1880 caucasian women, who underwent a 100-g, 3-h oral glucose tolerance test (OGTT) between the 24th and 28th gestational week and in 75 women who underwent an OGTT in two consecutive pregnancies. A proxy for beta-cell function (basal plasma C peptide/fasting plasma glucose; CP/FPG) was also measured. By univariate analysis parity was related to decreased ISI(OGTT) and to increased CP/FPG in those with parity &amp;amp;gt; 3 and likewise GDM, diagnosed in 124 women (6.58%), was linearly related to parity (P = 0.0034) and strongly age dependent. The relationships between parity and ISI(OGTT), CP/FPG and GDM were no longer significant after adjustment for age, pregestational body mass index (BMI), and weight gain. GDM was significantly related to age and pregestational weight, while ISI(OGTT) and CP/FPG were inversely related to prepregnancy BMI or weight gain. In comparison with the index pregnancy, the subsequent pregnancy was characterized by an increase in actual and prepregnancy BMI, in 2 h area under curve (AUC) glucose and by a decrease in ISI(OGTT) (P = 0.0001). The longer the time interval between pregnancies and the higher the increment in pregestational BMI or in weight gain during the pregnancy, the greater were the ISI(OGTT) decrease and 2-h AUC glucose increase. Parity is not directly linked to insulin sensitivity deterioration, to CP/FPG increase during pregnancy, or to GDM appearance, although it is linked through the mediation of progressive ageing and weight gain either before or during pregnancy, when there is a sufficiently long time interval between pregnancies.

Research paper thumbnail of Prognostic impact of electrocardiographic signs in patients with Type 2 diabetes and cardiovascular disease: results from the PROactive study

Diabetic Medicine, 2011

Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating... more Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating patients with Type 2 diabetes and cardiovascular disease, the independent prognostic relevance of electrocardiographic signs has not thoroughly been examined.

Research paper thumbnail of Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2013

Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID... more Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID) in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. Patients and methods: We considered a cohort of 315 (154 male/161 female) patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas), who were given exenatide (10 µg/BID) and who fully completed 4 months, 8 months, and 12 months of follow-ups. Results: Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A 1c (HbA 1c ), it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037), and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018). Target glycemic response (1-year HbA 1c # 7%) was achieved in a significantly higher proportion of males than females (38% versus 27%; χ 2 = 4.66; P = 0.03). Target weight loss expressed as 1-year weight percent fall from baseline $ 75th percentile (8.5%) was significantly higher in females at 8 and 12 months (P , 0.05; for both). One-year glycemic target response was inversely related to baseline HbA 1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy) was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic response only in women (P = 0.009). Target 1-year weight loss was predicted by longer diabetes duration among males and by lower baseline HbA 1c among females. Finally, no significant difference between genders was noted as to gastrointestinal side effects after exenatide therapy. Conclusion: According to this "real world" experience, predictors of glycemic control and body weight loss after 12 months of exenatide BID therapy are different between genders in type 2 diabetes.

Research paper thumbnail of Gender modulates the relationship between body weight and plasma glucose in overweight or obese subjects

Diabetes Research and Clinical Practice, 2008

Research paper thumbnail of Improvement of diabetic foot care after the Implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study

Diabetes Research and Clinical Practice, 2007

The aim of this prospective study was to evaluate the efficacy of the implementation of the Inter... more The aim of this prospective study was to evaluate the efficacy of the implementation of the International Consensus on the Diabetic Foot (ICDF) in the area of Pistoia (Tuscany, Italy), in terms of percentage of population screened, reduction of hospitalization, and reduction of lower extremity amputations.

Research paper thumbnail of Increase in Serum Uric Acid Is Selectively Associated With Stroke in Type 2 Diabetes

Research paper thumbnail of Relationship Between Gestational Diabetes Mellitus and Low Maternal Birth Weight

Diabetes Care, 2002

To study the relationship between low birth weight and the presence of gestational diabetes melli... more To study the relationship between low birth weight and the presence of gestational diabetes mellitus (GDM) or peripheral insulin resistance during pregnancy. We studied the relationship between peripheral insulin sensitivity (calculated by Matsuda and DeFronzo&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s oral glucose tolerance test (OGTT)-derived insulin sensitivity index [ISI(OGTT)]) or GDM prevalence and birth weight in 604 pregnant women, classified as normally glucose tolerant (n = 462) or affected with GDM (n = 142) after a 100-g 3-h oral glucose tolerance test. We then categorized these subjects into two groups: individuals with birth weight in the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10th percentile (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2,600 g; n = 68) and individuals with birth weight in the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10th percentile (n = 536). GDM prevalence was higher in the group in the lowest birth weight decile (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2,600 g; 24/68; 35%) than in the group with normal/high birth weight (118/536; 22%; chi(2) = 5.917; P = 0.01). Relative risk for GDM adjusted for age, parity, family history of diabetes, and prepregnancy body weight was about twofold in the group with low birth weight (odds ratio = 1.89 [95% CI 1.088-3.285; P = 0.023]), and the prevalence of low birth weight was about threefold higher in the first ISI(OGTT) decile. In 450 women whose newborn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight was known, the delivery of macrosomic babies was associated with a twofold higher relative risk for GDM in women who themselves had low birth weight. In the latter, the relationships between their newborn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight and either maternal glucose tolerance (positive) or ISI(OGTT) (negative) were amplified. Low maternal birth weight was associated with a twofold higher risk for GDM, independent of major confounders. Such a risk was highest in women with low birth weight who delivered macrosomic babies, and in the group with low birth weight, the relationship between maternal glucose tolerance or insulin resistance and offspring&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s neonatal weight was much more evident.

Research paper thumbnail of The Assessment of Ankle Range-of-Motion and Its Relationship with Overall Muscle Strength in a Cross-Section of Soccer Players

Sports

Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possi... more Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possible risk factor for injury and other negative consequences over time. The main objective of this research was to investigate the effects of soccer practice on ankle ROM throughout the entire period of a sports career of soccer players (SP). Furthermore, the relationship between ankle ROM and muscle strength in SP of different ages was studied. A total of 204 SP (range 6.7–45.1 years) and 87 controls (range: 7.5–45.2 years) matched for age, body mass index (BMI), and gender, were assessed. Ankle ROM in both plantar flexion (APF) and dorsiflexion (ADF) in addition to handgrip strength (HGS) were evaluated using an inclinometer and the Jamar hydraulic hand dynamometer, respectively. The comparison between SP and control groups showed a significant reduction in ankle ROM of both APF (26.3 ± 7.2° vs. 32.6 ± 7.4°; d = −0.90; p < 0.001) and ADF (95.5 ± 15.6° vs. 105.5 ± 15.8°; d = −0.66; p &...

Research paper thumbnail of Validation and reliability of a new PC-controlled device for the evaluation of key pinch strength in healthy adults

Italian journal of anatomy and embryology, 2017

Objective: Hand muscle strength assessment is widespread and can be a useful marker in the evalua... more Objective: Hand muscle strength assessment is widespread and can be a useful marker in the evaluation and monitoring of subjects at different ages and health conditions. This study aimed at validating and determining the reliability of a new digital device for evaluation of hand pinch strength by comparing it with a well-validated hand strength assessment device, the Jamar hydraulic hand dynamometer. Methods: In 65 healthy subjects, (males / females: 29 / 36), mean age 40.3±18.0 (range: 19.3 - 76.5) years, hand pinch strength and hydraulic hand dynamometer were used to assess hand strength following a testing protocol. Only the dominant hand was tested. Evaluations were performed considering gender, hand dominance, body mass index and age, according to the standardized testing protocol. The mean of three consecutive grip tests and lateral pinch tests was recorded. Results: There was a strong correlation (p<0.0001) between the hydraulic hand dynamometer and hand pinch strength tes...

Research paper thumbnail of Evaluating ankle joint mobility for ulcerative risk: a different method

Research paper thumbnail of The Possible Role of Trekking Poles to Improve Posture, Balance, and Plantar Pressures Distribution in Diabetic Patient

Research paper thumbnail of The impact of diabetes mellitus and sport practice on joint mobility, muscle strength and posture of young subjects

Italian journal of anatomy and embryology, 2016

It is known that diabetic disease may modify patients’ joint mobility, muscle strength and postur... more It is known that diabetic disease may modify patients’ joint mobility, muscle strength and posture. The aim of this study was to evaluate the presence of differences between young patients with T1DM and young sports subjects. In 23 patients with diabetes (13/11:m/f), mean age 10.7±1.2 yrs, duration of diabetes 6.1±3.0 yrs, mean HbA1c 7.6±0.9 %, (group D), and in 52 healthy control subjects (39/14:m/f), mean age 11,1±1,5 yrs (group C) were evaluated muscle strength (standing long jump, hand grip, key pinch test), ankle joint mobility (AJM) (inclinometer), flexibility (sit and reach test), foot plantar pressure distribution in quiet standing and posture (baropodometric analysis, images). Group C was composed by 2 teams of soccer players: 23 soccer players (23/0:m:f), mean age 12,0±0,3 yrs (group SP1); 15 young soccer players (15:0/m:f), mean age 9,0±1,3 yrs (group SP2); and a team of 14 volleyball players (0:14/:m:f), mean age 11,8±0,3 yrs (group VP). The group D showed a significant ...

Research paper thumbnail of Glycated haemoglobin in nondiabetic pregnancy: Relation to neonatal weight and pregnancy outcome

Diabetes Nutrition & Metabolism, 1996

Research paper thumbnail of Gender Effect on the Relation between Diabetes and Hospitalization for Heart Failure

Experimental and Clinical Endocrinology & Diabetes, 2011

Cardiovascular risk among diabetic patients is at least twice as much the one for non-diabetic in... more Cardiovascular risk among diabetic patients is at least twice as much the one for non-diabetic individuals and even greater when diabetic women are considered. Heart failure (HF) is a common unfavorable outcome of cardiovascular disease in diabetes. However, since the comparison among sexes of heart failure prevalence in diabetic patients remains limited, this study is aimed at expanding the information about this point.We have evaluated the association between diabetes and HF by reviewing the medical records of all subjects discharged from the Internal Medicine and Cardiology Units of all hospitals in the Tuscany region, Italy, during the period January 2002 through December 2008. In particular we sought concomitance of ICD-9-CM codes for diabetes and HF.Patients discharged by Internal Medicine were on average older, more represented by women, and had a lesser number of individuals coded as diabetic (p<0.05 for all). Relative risk for HF (95% CI) was significantly higher in pati...

Research paper thumbnail of Pregestational exposure to hormonal combined contraceptives and risk of gestational diabetes: an observational retrospective population study

Research paper thumbnail of Indications of reduced pulmonary function in type 1 (insulin-dependent) diabetes mellitus

Diabetes Research and Clinical Practice, 1994

Abnormalities of pulmonary function tests have been described in type 1 (insulin-dependent) diabe... more Abnormalities of pulmonary function tests have been described in type 1 (insulin-dependent) diabetes mellitus (IDDM). To better characterise such abnormalities and to verify whether these latter are associated with the presence of diabetic microvascular disease we compared 23 non-smoking patients who had IDDM with 24 non-smoking healthy control subjects strictly matched for sex, age, and body mass index. Compared with controls, diabetic patients had a reduced forced vital capacity (FVC) (87.5 +/- 13.1% vs. 96.4 +/- 13.6% of the predicted; P = 0.03) and forced expiratory volume in 1 s (FEV1) (90.5 +/- 17.7% vs. 101.2 +/- 13.2% of the predicted; P = 0.02). While within the group of patients the presence of retinopathy and autonomic neuropathy were not associated with modifications of pulmonary function tests, those with altered urinary albumin excretion rate (AER &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 20 micrograms/min; range 21-589) (n = 7) had a significantly lower pulmonary diffusion capacity (DLCO) than the 16 normoalbuminuric subjects (62.6 +/- 7.2% vs. 88.7 +/- 20.1% of the predicted; P = 0.01). Moreover, in the group of patients, DLCO was inversely related with AER (r = -0.43; P = 0.04). In conclusion, IDDM is characterised by reduced FVC and FEV1, while a significant decrease in DLCO may be considered as selectively associated with renal disease.

Research paper thumbnail of ROS and kidney disease in the evolution from acute phase to chronic end stage disease: A commentary on “Oxidative signaling in renal epithelium: Critical role of cPLA2 and p38SAPK”

Free Radical Biology and Medicine, 2006

Abbreviations: AA, arachidonic acid; ERK-1/2, extracellular signalregulated kinases 1 and 2; ESRD... more Abbreviations: AA, arachidonic acid; ERK-1/2, extracellular signalregulated kinases 1 and 2; ESRD, end-stage renal disease; MAPK, mitogenactivated protein kinase; ROS, reactive oxygen species.

Research paper thumbnail of Long Term Predictors of Post-Partum Glucose Metabolism in Women with Gestational Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes, 2010

The question asked by this study was whether β-cell function expressed by insulin secretion/sensi... more The question asked by this study was whether β-cell function expressed by insulin secretion/sensitivity measured during pregnancy in women with gestational diabetes (GDM) predicts post-partum long-term derangement in glucose metabolism. Seventy-four Caucasian women with previous GDM were retested through a 75 g-2-h-OGTT after 8 [6] years (median[interquartile range]) from index pregnancy, measuring at pregnancy and follow-up insulin sensitivity, insulin secretion (1-h-incremental-insulin-area/incremental-glucose-area: ΔAUC60 (I)/ΔAUC60 (G)) as well as the product of Stumvoll-first-phase - secretion x insulin sensitivity (insulin-secretion-sensitivity index (ISSI). At follow-up 47 women were normotelerant to glucose and 27 had altered glucose metabolism (AGM:10 with type 2 diabetes and 17 with IGT). Women progressed to AGM had at their index pregnancy higher mean 2-h-OGTT-glucose area (1.15±0.09 VS. 1.09±0.09 mol l 2-h (-1);p=0.014), and lower ΔAUC60 (I)/ΔAUC60 (median [interquantile range]) (54.4 [51.7] vs. 73.4 [60] pmol mmol (-1)) and ISSI (2 977 [766] vs. 3 708 [1 141]; p&amp;amp;amp;amp;lt;0.05 for both), but similar insulin sensitivity index 2.9 [2.5] VS. 3.2 [2.2] ml min (-1) m (-2);p=NS). Two-h-OGTT-glucose area, or decrease in ΔAUC60 (I)/ΔAUC60 (G) and ISSI were significantly associated with glucose tolerance impairment and with raised adjusted risk for AGM while insulin sensitivity at pregnancy did no predict AGM development. In this group of women increased post-load plasma glucose and impaired β-cell function assessed during GDM pregnancy predict long-term post-partum AGM, while insulin sensitivity measured at the same time does not.

Research paper thumbnail of Plasma and platelet ascorbate pools and lipid peroxidation in insulin-dependent diabetes mellitus

European Journal of Clinical Investigation, 1998

As diabetes mellitus represents a situation in which production of peroxides is increased, the ai... more As diabetes mellitus represents a situation in which production of peroxides is increased, the aim of this study was to investigate the relationship between plasma and platelet levels of ascorbic acid (AA)/dehydroascorbic acid (DHA) and those of malonyldialdehyde (MDA), an indirect marker of lipoperoxides, both assayed using high-performance liquid chromatography (HPLC), in 59 patients with insulin-dependent diabetes mellitus (IDDM) compared with 51 healthy control subjects matched for sex, age, smoking habits, as well as for dietary intake of energy, alcohol and vitamin C. Mean plasma and platelet MDA were significantly higher in the patients affected with IDDM than in control subjects. Moreover, the diabetic group was characterized by a huge decrease in plasma AA [8.45 +/- 5.5 mumol L-1 (SD) vs. 33.4 +/- 7.6 mumol L-1, P = 0.0001], mirrored by a significant increase in plasma DHA (11.9 +/- 3.9 mumol L-1 vs. 3.9 +/- 2.5 mumol L-1, P = 0.0001). No detectable DHA was observed in the platelets from both diabetic and control subjects, whereas AA was significantly increased in platelets from diabetic patients compared with control subjects (42.6 +/- 7.4 vs. 34.8 +/- 5.1 nmol 10(-9) platelets, P = 0.0001). Platelet AA in the diabetic group was significantly inversely correlated with glycated haemoglobin (r = -0.34; P = 0.04) and directly with plasma AA (r = 0.39; P = 0.02), the sum of plasma AA + DHA (r = 0.44; P = 0.009) and with platelet MDA (r = 0.38; P = 0.02). (a) The ratio plasma AA/DHA is significantly lowered in IDDM in association with an increase in MDA levels; (b) only AA is detected in platelets, being augmented in the diabetic group; (c) plasma ascorbate depletion does not reflect platelet levels of AA; and, finally, (d) metabolic control, as well as intracellular lipoperoxides, modulates platelet AA in IDDM.

Research paper thumbnail of Influence of gestational diabetes on the long-term control of glucose tolerance

Diabetologia, 2007

Aims/hypothesis Gestational diabetes (GDM) carries a high risk of subsequent diabetes. We asked w... more Aims/hypothesis Gestational diabetes (GDM) carries a high risk of subsequent diabetes. We asked what impact prior GDM has on beta cell function and insulin action in women who maintain normal glucose tolerance (NGT) for a long time. Methods Ninety-one women with NGT (aged 41±8 years, mean±SD) were studied (by mathematical modelling of the C-peptide response to an OGTT) 7 [6] years (median [interquartile range]) after the index pregnancy, during which 52 had GDM (pGDM) and 39 had NGT (pNGT). In all women an OGTT had also been performed at 29± 3 weeks of the index pregnancy. Results Women with pGDM were matched with women with pNGT for age, familial diabetes, time and weight gain since index pregnancy, parity, BMI (25.4±3.9 vs 26.8± 6.4 kg/m 2 ), and fasting (4.64±0.56 vs 4.97±0.46 mmol/l) and 2 h plasma glucose levels (5.91±1.14 vs 5.91± 1.21 mmol/l). Nonetheless, fasting (49 [29] vs 70 [45] pmol min −1 m −2 , p<0.001) and total insulin secretion (32 [17] vs 48 [21] nmol m −2 , p<0.0001) and beta cell glucose sensitivity (slope of the insulin secretion/plasma glucose concentration-response function) (95 [71] vs 115 [79] pmol min −1 m −2 (mmol/l) −1 , p=0.025) were reduced in the pGDM group compared with the pNGT group, while insulin sensitivity was preserved (424 [98] vs 398 [77] ml min −1 m −2 ). At index pregnancy, women with pGDM and those with pNGT had similar age and BMI. However, both insulin sensitivity (359 [93] vs 417 [92] ml min −1 m −2 , p=0.0012) and the insulin/glucose incremental area ratio (an empirical index of beta cell function; 98 [74] vs 138 [122] pmol/mmol, p=0.028) were reduced in women with pGDM.

Research paper thumbnail of Does parity increase insulin resistance during pregnancy?

Diabetic Medicine, 2005

To study the effect of parity on impairment of insulin sensitivity during pregnancy and on the ri... more To study the effect of parity on impairment of insulin sensitivity during pregnancy and on the risk of gestational diabetes (GDM). We studied the relationship between parity and peripheral insulin sensitivity index (ISI(OGTT)) or GDM in 1880 caucasian women, who underwent a 100-g, 3-h oral glucose tolerance test (OGTT) between the 24th and 28th gestational week and in 75 women who underwent an OGTT in two consecutive pregnancies. A proxy for beta-cell function (basal plasma C peptide/fasting plasma glucose; CP/FPG) was also measured. By univariate analysis parity was related to decreased ISI(OGTT) and to increased CP/FPG in those with parity &amp;amp;gt; 3 and likewise GDM, diagnosed in 124 women (6.58%), was linearly related to parity (P = 0.0034) and strongly age dependent. The relationships between parity and ISI(OGTT), CP/FPG and GDM were no longer significant after adjustment for age, pregestational body mass index (BMI), and weight gain. GDM was significantly related to age and pregestational weight, while ISI(OGTT) and CP/FPG were inversely related to prepregnancy BMI or weight gain. In comparison with the index pregnancy, the subsequent pregnancy was characterized by an increase in actual and prepregnancy BMI, in 2 h area under curve (AUC) glucose and by a decrease in ISI(OGTT) (P = 0.0001). The longer the time interval between pregnancies and the higher the increment in pregestational BMI or in weight gain during the pregnancy, the greater were the ISI(OGTT) decrease and 2-h AUC glucose increase. Parity is not directly linked to insulin sensitivity deterioration, to CP/FPG increase during pregnancy, or to GDM appearance, although it is linked through the mediation of progressive ageing and weight gain either before or during pregnancy, when there is a sufficiently long time interval between pregnancies.

Research paper thumbnail of Prognostic impact of electrocardiographic signs in patients with Type 2 diabetes and cardiovascular disease: results from the PROactive study

Diabetic Medicine, 2011

Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating... more Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating patients with Type 2 diabetes and cardiovascular disease, the independent prognostic relevance of electrocardiographic signs has not thoroughly been examined.

Research paper thumbnail of Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2013

Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID... more Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID) in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. Patients and methods: We considered a cohort of 315 (154 male/161 female) patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas), who were given exenatide (10 µg/BID) and who fully completed 4 months, 8 months, and 12 months of follow-ups. Results: Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A 1c (HbA 1c ), it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037), and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018). Target glycemic response (1-year HbA 1c # 7%) was achieved in a significantly higher proportion of males than females (38% versus 27%; χ 2 = 4.66; P = 0.03). Target weight loss expressed as 1-year weight percent fall from baseline $ 75th percentile (8.5%) was significantly higher in females at 8 and 12 months (P , 0.05; for both). One-year glycemic target response was inversely related to baseline HbA 1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy) was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic response only in women (P = 0.009). Target 1-year weight loss was predicted by longer diabetes duration among males and by lower baseline HbA 1c among females. Finally, no significant difference between genders was noted as to gastrointestinal side effects after exenatide therapy. Conclusion: According to this "real world" experience, predictors of glycemic control and body weight loss after 12 months of exenatide BID therapy are different between genders in type 2 diabetes.

Research paper thumbnail of Gender modulates the relationship between body weight and plasma glucose in overweight or obese subjects

Diabetes Research and Clinical Practice, 2008

Research paper thumbnail of Improvement of diabetic foot care after the Implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study

Diabetes Research and Clinical Practice, 2007

The aim of this prospective study was to evaluate the efficacy of the implementation of the Inter... more The aim of this prospective study was to evaluate the efficacy of the implementation of the International Consensus on the Diabetic Foot (ICDF) in the area of Pistoia (Tuscany, Italy), in terms of percentage of population screened, reduction of hospitalization, and reduction of lower extremity amputations.

Research paper thumbnail of Increase in Serum Uric Acid Is Selectively Associated With Stroke in Type 2 Diabetes

Research paper thumbnail of Relationship Between Gestational Diabetes Mellitus and Low Maternal Birth Weight

Diabetes Care, 2002

To study the relationship between low birth weight and the presence of gestational diabetes melli... more To study the relationship between low birth weight and the presence of gestational diabetes mellitus (GDM) or peripheral insulin resistance during pregnancy. We studied the relationship between peripheral insulin sensitivity (calculated by Matsuda and DeFronzo&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s oral glucose tolerance test (OGTT)-derived insulin sensitivity index [ISI(OGTT)]) or GDM prevalence and birth weight in 604 pregnant women, classified as normally glucose tolerant (n = 462) or affected with GDM (n = 142) after a 100-g 3-h oral glucose tolerance test. We then categorized these subjects into two groups: individuals with birth weight in the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10th percentile (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2,600 g; n = 68) and individuals with birth weight in the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10th percentile (n = 536). GDM prevalence was higher in the group in the lowest birth weight decile (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2,600 g; 24/68; 35%) than in the group with normal/high birth weight (118/536; 22%; chi(2) = 5.917; P = 0.01). Relative risk for GDM adjusted for age, parity, family history of diabetes, and prepregnancy body weight was about twofold in the group with low birth weight (odds ratio = 1.89 [95% CI 1.088-3.285; P = 0.023]), and the prevalence of low birth weight was about threefold higher in the first ISI(OGTT) decile. In 450 women whose newborn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight was known, the delivery of macrosomic babies was associated with a twofold higher relative risk for GDM in women who themselves had low birth weight. In the latter, the relationships between their newborn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s weight and either maternal glucose tolerance (positive) or ISI(OGTT) (negative) were amplified. Low maternal birth weight was associated with a twofold higher risk for GDM, independent of major confounders. Such a risk was highest in women with low birth weight who delivered macrosomic babies, and in the group with low birth weight, the relationship between maternal glucose tolerance or insulin resistance and offspring&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s neonatal weight was much more evident.