Diabeteksen aiheuttamat kustannukset kansantaloudelle

Tiivistelmä. Tämä pro gradu -tutkielma on kirjallisuuskatsaus diabeteksen kustannuksista Suomessa. Kirjallisuuskatsauksessa keskitytään terveydenhuollon kustannuksiin ja talouden muihin suoriin sekä epäsuoriin kustannuksiin. Kirjallisuuskatsauksessa keskitytään tutkimusalalla tehtyjen empiiristen tutkimusten, raporttien ja artikkelien esittelyyn. Terveyteen kannattaa investoida. Pitämällä huolen omista elintavoista, on mahdollista vähentää terveysriskejä. Mikäli jokainen suomalainen ylläpitäisi terveellisiä elintapoja, saataisiin lääkekustannukset ja terveydenhuollon kysyntä laskemaan. Voimavarojen jakautumista olisi helpompaa arvioida perusteellisemmin. Diabetes on yksi maailman yleisimmistä taudeista. Suomessa ja maailmalla se luokitellaan kansantaudiksi. Diabetesta diagnosoidaan vuodessa miljoonia ja sairaudella on korkea kuolleisuus. Diabetes aiheuttaa kuluja niin mikro kuin makrotaloudenkin tasolla. Kuluja syntyy muun muassa lääkehoidosta, sairaalahoidosta, työttömyyseläkkeistä, lisäsairauksista sekä ennaltaehkäisystä. Viimeisten tutkimusten mukaan diabeteksen terveydenhuollon kulut olivat noin 1,5 miljardia euroa. Pro gradu -tutkielma on katsaus diabeteksen yleisimpiin kustannuksiin. Mistä kulut aiheutuvat ja miten kulut ovat kehittyneet vuosien saatossa. Tavoitteena on myös avata diabeteksen ennaltaehkäisysuunnitelmaa sekä tulevaisuutta diabeteksen kanssa

Lactic acid production from lime-treated wheat straw by Bacillus coagulans: neutralization of acid by fed-batch addition of alkaline substrate

Conventional processes for lignocellulose-to-organic acid conversion requires pretreatment, enzymatic hydrolysis, and microbial fermentation. In this study, lime-treated wheat straw was hydrolyzed and fermented simultaneously to lactic acid by an enzyme preparation and Bacillus coagulans DSM 2314. Decrease in pH because of lactic acid formation was partially adjusted by automatic addition of the alkaline substrate. After 55 h of incubation, the polymeric glucan, xylan, and arabinan present in the lime-treated straw were hydrolyzed for 55%, 75%, and 80%, respectively. Lactic acid (40.7 g/l) indicated a fermentation efficiency of 81% and a chiral l(+)-lactic acid purity of 97.2%. In total, 711 g lactic acid was produced out of 2,706 g lime-treated straw, representing 43% of the overall theoretical maximum yield. Approximately half of the lactic acid produced was neutralized by fed-batch feeding of lime-treated straw, whereas the remaining half was neutralized during the batch phase with a Ca(OH)2 suspension. Of the lime added during the pretreatment of straw, 61% was used for the neutralization of lactic acid. This is the first demonstration of a process having a combined alkaline pretreatment of lignocellulosic biomass and pH control in fermentation resulting in a significant saving of lime consumption and avoiding the necessity to recycle lime

Effects of cereal breakfasts on postprandial glucose, appetite regulation and voluntary energy intake at a subsequent standardized lunch; focusing on rye products

<p>Abstract</p> <p>Background</p> <p>Rye products have been demonstrated to lower the acute insulin demand, induce a low and prolonged blood glucose response (high Glycemic Profile, GP) and reduce subclinical inflammation. These products may therefore contribute to a lowered risk of obesity, type 2 diabetes and cardio vascular disease. The objective of the present paper was to evaluate the mechanism for a reduced postprandial insulin demand with rye products, and to explore possible appetite regulating properties.</p> <p>Methods</p> <p>10 healthy subjects were served breakfast meals (50 g of available starch) with endosperm- or whole grain rye breads, with and without lactic acid, boiled whole grain rye- (RK) or wheat (WK) kernels, or white wheat bread reference (WWB) in random order in a cross-over design. Plasma concentrations of glucose, ghrelin, serum insulin, free fatty acids, adiponectin, breath hydrogen excretion (H₂), and subjective satiety was evaluated during the postprandial phase. 270 min after the breakfast, an ad lib lunch buffet was served and the voluntary energy intake (EI) was registered.</p> <p>Results</p> <p>All rye products and WK induced lower insulinemic indices (II) than WWB. A lower incremental insulin peak following breakfast correlated with a lower EI at lunch (r = 0.38). A low II was related to improved satiety in the early postprandial phase (fullness AUC 0-60 min, r = -0.36). RK induced a higher GP compared to WWB and WK. A higher GP was related to a lowered <it>desire to eat </it>before lunch (AUC 210-270) and to a lower concentration of ghrelin in the late postprandial phase after breakfast (270 min), r = -0.29 and -0.29), which in turn was related to a lower voluntary EI (r = 0.43 and 0.33). The RK breakfast improved satiety in the early postprandial phase (0-60 min) compared to WWB, and induced a lower EI at lunch (-16%). A high content of indigestible carbohydrates in the breakfast products was related to improved satiety (0-60 min, r = 0.68 for fullness), and a higher breath H₂in the late postprandial phase (120-270 and 270-390 min, r = 0.46 and 0.70). High H₂(AUC 120-270 min) also correlated with lower EI (r = -0.34).</p> <p>Conclusions</p> <p>Rye products, rich in indigestible carbohydrates, induce colonic fermentation already post the breakfast meal, and lowers acute insulin responses. A high excretion of breath H2 also correlated with a higher GP. Especially, rye kernels induced a high GP which was associated with a 16% lowering of energy intake at a subsequent lunch meal. The bulking effect of rye fiber, colonically derived fermentation metabolites, a high GP and a low insulin response possibly all contributes to the benefits on glucose- and appetite regulation seen in an acute and semi-acute perspective.</p

Impact of network structure and cellular response on spike time correlations

Novel experimental techniques reveal the simultaneous activity of larger and larger numbers of neurons. As a result there is increasing interest in the structure of cooperative -- or correlated -- activity in neural populations, and in the possible impact of such correlations on the neural code. A fundamental theoretical challenge is to understand how the architecture of network connectivity along with the dynamical properties of single cells shape the magnitude and timescale of correlations. We provide a general approach to this problem by extending prior techniques based on linear response theory. We consider networks of general integrate-and-fire cells with arbitrary architecture, and provide explicit expressions for the approximate cross-correlation between constituent cells. These correlations depend strongly on the operating point (input mean and variance) of the neurons, even when connectivity is fixed. Moreover, the approximations admit an expansion in powers of the matrices that describe the network architecture. This expansion can be readily interpreted in terms of paths between different cells. We apply our results to large excitatory-inhibitory networks, and demonstrate first how precise balance --- or lack thereof --- between the strengths and timescales of excitatory and inhibitory synapses is reflected in the overall correlation structure of the network. We then derive explicit expressions for the average correlation structure in randomly connected networks. These expressions help to identify the important factors that shape coordinated neural activity in such networks

Unexpected High Digestion Rate of Cooked Starch by the Ct-Maltase-Glucoamylase Small Intestine Mucosal α-Glucosidase Subunit

For starch digestion to glucose, two luminal α-amylases and four gut mucosal α-glucosidase subunits are employed. The aim of this research was to investigate, for the first time, direct digestion capability of individual mucosal α-glucosidases on cooked (gelatinized) starch. Gelatinized normal maize starch was digested with N- and C-terminal subunits of recombinant mammalian maltase-glucoamylase (MGAM) and sucrase-isomaltase (SI) of varying amounts and digestion periods. Without the aid of α-amylase, Ct-MGAM demonstrated an unexpected rapid and high digestion degree near 80%, while other subunits showed 20 to 30% digestion. These findings suggest that Ct-MGAM assists α-amylase in digesting starch molecules and potentially may compensate for developmental or pathological amylase deficiencies

Technologies for physical activity self-monitoring: a study of differences between users and non-users

Anna &Aring;kerberg,1,2 Anne S&ouml;derlund,2 Maria Lind&eacute;n1 1School of Innovation, Design and Engineering, 2School of Health, Care and Social Welfare, M&auml;lardalen University, V&auml;ster&aring;s, Sweden Background: Different kinds of physical activity (PA) self-monitoring technologies are used today to monitor and motivate PA behavior change. The user focus is essential in the development process of this technology, including potential future users such as representatives from the group of non-users. There is also a need to study whether there are differences between the groups of users and non-users. The aims of this study were to investigate possible differences between users and non-users regarding their opinions about PA self-monitoring technologies and to investigate differences in demographic variables between the groups. Materials and methods: Participants were randomly selected from seven municipalities in central Sweden. In total, 107 adults responded to the Physical Activity Products Questionnaire, which consisted of 22 questions. Results: Significant differences between the users and non-users were shown for six of the 20 measurement-related items: measures accurately (p=0.007), measures with high precision (p=0.024), measures distance (p=0.020), measures speed (p=0.003), shows minutes of activity (p=0.004), and shows geographical position (p=0.000). Significant differences between the users and non-users were also found for two of the 29 encouragement items: measures accurately (p=0.001) and has long-term memory (p=0.019). Significant differences between the groups were also shown for level of education (p=0.030) and level of physical exercise (p=0.037). Conclusion: With a few exceptions, the users and the non-users in this study had similar opinions about PA self-monitoring technologies. Because this study showed significant differences regarding level of education and level of physical exercise, these demographic variables seemed more relevant to investigate than differences in opinions about the PA self-monitoring technologies. Keywords: physical activity, technology, opinion, user, non-user&nbsp