bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Related to the High Prevalence of Diabetic Kidney Disease in Ecuador-Update for Health Policy Makers
Authors: GUADALUPE MARIANA E. , ALVAREZ CONDO GRACIELA B. , VERA LORENTI FANNY E. , PAZMIÑO GOMEZ BETTY J. , RODAS NEIRA EDGAR I. , VERON DOLORES , CERCADO ALICIA G. , VILLEGAS GUILLERMO A. , TUFRO ALDA , VERON DELMA 
Published: June 2018

Type 2 diabetes mellitus (T2DM) and diabetic kidney disease (DKD) are prevalent diseases in South America. Identification of factors associated to DKD is key to design appropriate regional health policies. We characterized DKD in 1663 adults (99% Confidence level, 1.4% margin of error) recruited from the general population of the Ecuadorian coast between 2014 and 2017 (46±14 years of age, 64% of them were women). Framed in our prospective, observational and cross-sectional study (NCT02237352) we evaluated demographic data, personal and family history, BMI, blood pressure (BP), plasma glucose (PG), HbA1c, creatinine (cr) and microalbuminuria (μAlb). T2DM was defined as peoples with clinical diagnosis of T2DM, being on insulin or oral hypoglycemic treatment, fasting PG ≥126 mg/dl, random glucose ≥200 mg/dl and HbA1c ≥6.5%. Subjects were deemed to have DKD when they presented μAlb ≥30 mg/gr-cr and/or estimated glomerular filtration rate ˂60 ml/min/1.73m2.
Results: Our study shows that the prevalence of DKD in the Ecuadorian coast was 9.3% (95% CI, 8%-11%) with 19.5% of the persons not knowing their T2DM status. The factors significantly different comparing DKD vs. non-DKD subjects (P&lt;0.05) were: Female 71.4% (CI 95%, 64% -78%) vs. 57.4% (95% CI, 61%-66%); age 58±9 vs. 45±14 years; BMI 29.5±4.9 vs. 27.7±5.3 Kg/m2; systolic BP 133.5±20.9 vs. 119.4±16.8 mmHg; diastolic BP 82.9±13.4 vs. 75.4±12 mmHg; PG 197.3±103.6 vs. 98.4±41.5 mg/dl; HbA1c 8.8±2.6 vs. 5.7±1.3%; personal history of gestational diabetes (GD) 7.3% (95% CI, 3%-14%) vs. 2.4% (95% CI, 2%-4%) and overweight newborn children (ONBC) 30.9% (95% CI, 23%-41%) vs. 14.7% (95% CI, 13%- 17%).
Conclusion: Female gender, age, BMI, BP, PG, HbA1c, history of ONBC and GD all are factors linked to DKD in the Ecuadorian coast that should be considered to design meaningful health policies, to address the currently high prevalence of DKD. The amount of people unknowing their diagnosis of T2DM among folks with DKD suggests emphasizing the screening of T2DM.

Disclosure
M.E. Guadalupe: None. G.B. Alvarez Condo: None. F.E. Vera Lorenti: None. B.J. Pazmiño Gomez: None. E.I. Rodas Neira: None. D. Veron: None. A.G. Cercado: None. G.A. Villegas: None. A. Tufro: None. D. Veron: None.
Levels of Connective Tissue Growth Factor (CTGF) Predict Development of Kidney Dysfunction in Type 2 Diabetes-The VADT Study
Authors: HUNT KELLY J. , JAFFA MIRAN A. , GARRETT SARA M. , LUTTRELL DEIRDRE K. , LIPSON KENNETH E. , LOPES-VIRELLA MARIA F. , LUTTRELL LOUIS M. , JAFFA AYAD A. ,   VADT INVESTIGATORS
Published: June 2018

Connective tissue growth factor (CTGF) is a member of the CCN family of matricellular proteins that has been implicated in the inflammatory process, response to injury and wound healing. An emerging role of CTGF is that of a profibrotic factor implicated in the development of kidney disease. Our objective was to determine the role of CTGF as a predictor of macroalbuminuria (ACR ≥300µg/mg twice) and chronic kidney disease (CKD) stage 3 (GFR &lt;60ml/min twice) and stage 4 (GFR &lt;30ml/min once or twice) in the VADT cohort. Levels of CTGF were measured in 952 VADT patients, a median of 1.9 years after entry into the study. Participants were followed for a median of 3.8 years for renal outcomes. CTGF categories were defined as below the detectable limit (i.e., referent, 54.5%), lower half of detectable values (i.e., 22.8%) and upper half of detectable values (22.7%). Odds ratios (ORs) for kidney endpoints in relation to CTGF categories were calculated by logistic regression. Even with adjustment for baseline ACR levels, individuals in the highest compared to lowest CTGF category were at higher risk of macroalbuminuria [OR=3.21 (95% CI: 1.37, 7.53)]. In contrast, CTGF was predictive of incident stage 3 and stage 4 CKD only when baseline GFR levels were not adjusted for. Our study indicates that high levels of CTGF are associated with and predict future kidney dysfunction in patients with type 2 diabetes.

Disclosure
K.J. Hunt: None. M.A. Jaffa: None. S.M. Garrett: None. D.K. Luttrell: None. K.E. Lipson: Employee; Self; FibroGen, Inc.. Stock/Shareholder; Self; AbbVie Inc., Abbott, Becton, Dickinson and Company, Bristol-Myers Squibb Company, General Electric, Gilead Sciences, Inc., Medtronic, Nestlé, Novartis AG, Oracle, Pfizer Inc., Quest Diagnostics. Consultant; Spouse/Partner; Diabesen. M.F. Lopes-Virella: None. L.M. Luttrell: None. A.A. Jaffa: None.
The Risk Factors for Rapid Decline of Renal Function in Japanese Patients with Diabetes Mellitus
Authors: MATSUHISA MUNEHIDE , MORI HIROYASU , OHISHI MAMI , ISHIZU MASASHI , SUZUKI REIKO , TAKIKAWA INEKO , TANIGUCHI SATOSHI , TAMAKI MOTOYUKI , AKEHI YUKO , KURAHASHI KIYOE , YOSHIDA SUMIKO , ENDO ITSURO , AIHARA KEN-ICHI , FUNAKI MAKOTO , KURODA AKIO 
Published: June 2018

Background: To prevent the end-stage renal failure, it is important to identify the high-risk patients with rapid decline of renal function (RDRF).
Aim: We intended to clarify the risk factors for RDRF in Japanese patients with diabetes.
Methods: One hundred sixteen out-patients with diabetes (type 1/2, 38/78; M/F, 60/56; age 60.1±12.3 years; BMI, 25.3±4.8; HbA1c, 7.3±1.0%; eGFR, 68±22mL/min/1.73m2) were enrolled in this study, and were followed for one year. We defined RDRF as more than 20% of annual decline of eGFR. The sodium intake was estimated from the urine sodium excretion from early morning urine specimen according to previous report (J Hum Hypertens. 2002). The visceral fat area (VFA) was determined by the impedance method (HDS-2000, Omron Healthcare, Japan)
Results: 8.6% of participants were matched to the criteria of RDRF. In subjects with RDRF, the energy intake (45.6±10.6 kcal/kg BW/day), sodium intake (12.5±1.8 g/day), VFA (157±51 cm2) and prevalence of hypertension (100%) were higher than those without RDRF. Annual decline of eGFR was significantly correlated with the stage of diabetic nephropathy, VFA, systolic and diastolic blood pressure, urinary albumin excretion rate, triglyceride, and daily intake of energy, sodium and protein (p&lt;0.05). The logistic regression analysis revealed that the independent determinants of RDRF were energy intake, sodium intake, and visceral fat area. In addition, the Receiver Operating Characteristic (ROC) analysis revealed that the cut-off values of these parameters were 46.8kcal/ kg BW/ day of energy intake (AUC 0.84, p&lt;0.01), 11.8g/day of sodium intake (AUC 0.90, p&lt;0.01), and 117cm2 of visceral fat area (AUC 0.88, p&lt;0.01).
Conclusion: Visceral obesity, and high intake of energy and sodium contributed to rapid decline of renal function in Japanese patients with diabetes. Body weight management with adequate energy and sodium intake, therefore, may contribute to prevent progression of diabetic kidney disease.

Disclosure
M. Matsuhisa: None. H. Mori: None. M. Ohishi: None. M. Ishizu: None. R. Suzuki: None. I. Takikawa: None. S. Taniguchi: None. M. Tamaki: None. Y. Akehi: None. K. Kurahashi: None. S. Yoshida: None. I. Endo: None. K. Aihara: None. M. Funaki: Research Support; Self; Otsuka Holdings Co., Ltd., The Knowledge Cluster from the Ministry of Education, Science, and Culture of Japan. Board Member; Self; Mechanogenic C.C.. A. Kuroda: None.
Structure Equation Modeling Analysis of Risk Factors and the Pathway Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes
Authors: LEE TAO-CHUN , CHUNG FU-MEI 
Published: June 2018

Background: Diabetes mellitus is the most common cause of chronic kidney disease (CKD), however, the inter-relationships and pathogenetic mechanisms among risk factors are still largely unknown.Structural equation models (SEMs)was applied to test a hypothesis model of causal pathways related to CKD in patients with type 2 diabetes mellitus (T2DM).
Methods: A total of 3,395 subjects with T2DM were enrolled in this study. A hypothesized SEM was applied to assess associations between demographic data, diabetic self-management behaviors, diabetes control,life style, psycho-social, chronic inflammation factors, anthropometric, and metabolic variables simultaneously and the risk of CKD.
Results: Seven baseline factors including demographic data (-0.075), white blood cell count (0.084), high blood pressure (0.144), WHO 5 well-being index (-0.082), diabetes control (0.099), triglyceride(0.091) and uric acid (0.282) levels had direct effects on the risk of CKD. The final model could explain 26%of the variability in baseline CKD status. The pathway associated with CKD was further confirmed by SEM analysis showing that the same direct and specific indirect factors as in baseline CKD status analysis contributed to the risk of CKD at 12 months of follow-up. The final model could explain 31%of the variability in the risk of CKD at 12 months of follow-up.
Conclusions: This study is the first to investigate associations between factors obtained from real world daily practice and CKD status simultaneously, and delineate the pathway and inter-relationships of the risk factors contributing to the pathogenesis of CKD in patients with T2DM.

Disclosure
T. Lee: None. F. Chung: None.
Clinical Characteristics and Outcomes in Patients Admitted with Diabetic Ketoacidosis (DKA) and End-Stage Renal Disease (ESRD)
Authors: GALINDO RODOLFO J. , PASQUEL FRANCISCO J. , TSEGKA KATERINA G. , CARDONA SAUMETH , DHRUV NEIL , VELLANKI PRIYATHAMA , FAYFMAN MAYA , HAW J. SONYA , MIGDAL ALEXANDRA , NAIR SHAILESH , WANG HEQIONG , UMPIERREZ GUILLERMO E. 
Published: June 2018

Management of patients with diabetic ketoacidosis (DKA) and end stage renal disease (ESRD) is challenging. We used data (ICD-9/10 codes and clinical) from the Emory Clinical Data Warehouse from 1/1/2006-12/31/2016 to determine the clinical presentation and outcomes of patients with DKA. DKA was confirmed with admission bicarbonate &lt;18 mEq/L, beta-hydroxybutyrate &gt;3 mmol/L, and pH &lt; 7.3, during the first encounter. ESRD was defined as glomerular filtration rate &lt;15 mL/min/1.73 m2. Among 681 patients admitted with DKA (45±18 years, 51% female); there were 65 (9.5%) and 616 (90.5%) patients with and without ESRD, respectively. On admission, patients with ESRD were older, more likely to be female, and had admission blood glucose, potassium and osmolality higher than patients without ESRD, Table. Patients with ESRD had longer length-of-stay (LOS); however, there were no differences in admission anion gap, pH, time-to-correction of hyperglycemia, hypoglycemia and hypokalemia rates, or hospital mortality between groups. About one in every ten patients admitted with DKA has ESRD. Patients with DKA and ESRD were older, presented with more severe hyperglycemia and had longer LOS; however, response to therapy and mortality was similar to patients without ESRD.DKA with ESRD n: 65 (9.5%)DKA without ESRD n: 616 (90.5%)p-valueAge, years57.4 ± 15.243.7 ± 17.40.001Female, n (%)41 (63)3(50)0.04BMI, mean (kg/m2)29.6± 9.227.2 ± 7.50.033HbA1c, %9.9 ± 2.611.7 ± 2.80.003BG, mg/dl753.6 ± 441585 ± 2500.003Anion Gap, mEq/L22.9 ± 722.8 ± 60.95Bicarbonate, mmol/L12.0 ± 411.5 ± 3.90.26Effective Osm, mOsm/kg303.9 ± 23296.7 ± 170.02Sodium, mmol/L131.0 ± 7132.1 ± 60.12Beta-hydroxybutyrate, mmol/L5.0 ± 3.16.3 ± 2.50.02Admission potassium, mEq/L5.7 ± 1.45.1 ± 1.1&lt;0.001Time to BG &lt; 250 mg/dl, minutes372.1 ± 279415 ± 2260.79Hospital mortality, n (%)2 (3)11 (2)0.36LOS, median days (Q1, Q3)8 (5, 16)3 (2, 5)&lt;0.001Hypoglycemia &lt;70 mg/dl, n (%)10 (15)77 (13)0.56Hypokalemia &lt; 3.0 mEq/L, n (%)16 (25)126 (20)0.43

Disclosure
R.J. Galindo: None. F.J. Pasquel: Consultant; Self; Merck Sharp & Dohme Corp., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc.. K.G. Tsegka: None. S. Cardona: None. N. Dhruv: None. P. Vellanki: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca. M. Fayfman: None. J. Haw: None. A. Migdal: None. S. Nair: None. H. Wang: None. G.E. Umpierrez: Research Support; Self; Sanofi US, Merck & Co., Inc., Novo Nordisk Inc., AstraZeneca. Advisory Panel; Self; Sanofi, Intarcia Therapeutics, Inc..
A Magnetic Resonance Imaging Volumetry Study of Regional Brain Atrophy in Diabetic Peripheral Neuropathy
Authors: SELVARAJAH DINESH , HEIBERG-GIBBONS FRANCESCA , WILKINSON IAIN D. , GANDHI RAJIV , TESFAYE SOLOMON 
Published: June 2018

Aims: Diabetic neuropathy (DN) is a serious complication which was hitherto considered a disease of the peripheral nervous system. In this study we sought to investigate in detail changes in brain morphometry in DN. The aim of this study was to identify regional brain volume changes that were specific to DN (painful and painless DN)
Methods: 102 patients with diabetes (34 No-DN, 34 Painless DN and 34 Painful DN) and 34 healthy volunteers underwent detailed clinical and neurophysiological assessments. All subjects underwent 3-dimensional T1-weighted brain MRI (3.0T, Philips). Brain volume analysis was performed using SIENAX (www.fmrib.ox.ac.uk/fsl) and Freesurfer (http://surfer.nmr.mgh.harvard.edu/).
Results: Groups were matched for age and gender. Total brain volume was significantly lower painful DN [1401.7 (10.7)ml] and painless DN [1393.5 (69.6)ml]) compared to HV [1457.2(79.2)ml] and No DN [1437.2(60.9)ml]; ANOVA p=&lt;0.01). Total grey matter volume was significantly lower in painful DN [713.9(67.1)ml] and painless DN [717.2(42.4)ml] compared to controls (HV [758.4(46.5)]; p=&lt;0.01; No DN [747.3(41.1)]; p=0.015). There were no significant differences in white matter (ANOVA p=0.18) and CSF (ANOVA p=0.23) volumes. Painful DN subjects had significantly lower cortical thickness in the right postcentral gyrus [1.83(0.14)mm vs. HV 1.91(0.13)mm]; (p=0.02); left precentral gyrus [2.31(0.16)mm vs. HV [2.39(0.12)mm]; (p=0.02) and no DN [2.38(0.14)mm]; (p=0.04); and left insula [2.81(0.15)mm] vs. HV [2.97(0.14)mm] p=&lt;0.01).
Conclusion: This is the largest cohort study of brain volume changes in subjects with DN examined to date. We have demonstrated significant reduction in grey matter volume in painful and painless DN subjects. In painful DN this is localised within the somatomotor cortex and insula. These findings highlight significant CNS involvement in DN that provides clues to the pathogenesis of this condition.

Disclosure
D. Selvarajah: None. F. Heiberg-Gibbons: None. I.D. Wilkinson: None. R. Gandhi: None. S. Tesfaye: Speaker's Bureau; Self; Pfizer Inc.. Other Relationship; Self; Janssen Pharmaceuticals, Inc., Takeda Development Centre Europe Ltd.. Advisory Panel; Self; Wörwag Pharma GmbH & Co. KG.
Impaired Hemodynamic Response to Thermal Pain in Painful Diabetic Neuropathy
Authors: GREIG MARNI , WILKINSON IAIN D. , SELVARAJAH DINESH , SHILLO PALLAI RAPPAI , GANDHI RAJIV , TESFAYE SOLOMON 
Published: June 2018

Objective: Painful diabetic peripheral neuropathy (painful-DPN) causes distressing neuropathic pain that is only partially responsive to treatment. A better understanding of CNS correlates of painful-DPN is vital to develop more effective therapeutics. The aim of this study was to measure cerebral perfusion of the pain processing areas of the brain using MR-Dynamic Susceptibility Contrast (MR-DSC) imaging at rest and under experimental pain condition.
Methods: 55 T1DM subjects (20 painful-DPN, 23 painless-DPN, 13 no-DPN) and 19 Healthy Volunteers (HV); underwent detailed clinical and neurophysiological assessment (NISLL+7 tests of nerve function; DN4 questionnaire). MR images were obtained at 3T using a MR-DSC, T2*-weighted technique (TR/TE=1250/35ms; 72 dynamics) to assess the passage of a bolus of intravenous gadolinium-chelate through cerebral vascular bed. Subjects were scanned at baseline and during 90s of heat-pain applied to the right lateral thigh (non-neuropathic area). The time-to-peak (TTP) concentration of gadolinium in regions of interest (ROI): right and left thalamus, right and left sensory cortices (RSC and LSC), was measured.
Results: At baseline, although the mean TTP (s) in the ROIs was shorter in the painful-DPN group [e.g., RT: M (SD): 9.22 (1.13) vs. HV 9.83 (0.99), no-DPN 9.59 (0.90), painless-DPN 9.94 (0.97)] this was not statistically significant (p=0.058). However the ΔTTP in response to thermal pain was significantly different between the groups LT (p=0.021), RT (p=0.003), LSC (p=0.009), RSC (p=0.008). Whilst HV respond to thermal pain by shortening the TTP in ROI the painful-DPN group do the reverse (p&lt;0.05).
Conclusion: Subjects with painful-DPN have a paradoxical increase in TTP, indicating that chronic neuropathic pain state may result in a failure to mount a hemodynamic response to external pain and descending inhibition. This novel finding may serve as an objective marker of painful-DPN, and in the future may facilitate the development of novel treatments.

Disclosure
M. Greig: None. I.D. Wilkinson: None. D. Selvarajah: None. P. Shillo: None. R. Gandhi: None. S. Tesfaye: Speaker's Bureau; Self; Pfizer Inc.. Other Relationship; Self; Janssen Pharmaceuticals, Inc., Takeda Development Centre Europe Ltd.. Advisory Panel; Self; Wörwag Pharma GmbH & Co. KG.
Suppression of Neuropathy Development in Diabetic Rage-Deficient Mice Is Associated with Absence of M1/M2 Macrophage Skewing in the Sciatic Nerve
Authors: OSONOI SHO , MIZUKAMI HIROKI , OGASAWARA SAORI , TAKAHASHI KAZUHISA , SANGO KAZUNORI , YAGIHASHI SOROKU 
Published: June 2018

Infiltrating macrophage (Mφ) into sciatic nerve (SN) is assumed one of the pathogenesis of diabetic polyneuropathy (DPN). In particular, skewing infiltrating Mφ toward pro-inflammatory (M1) Mφ, but not anti-inflammatory (M2) Mφ, possibly contributes to dysfunction of SN in diabetic state. However, the impacts of Mφ into dorsal root ganglia (DRG) in DPN are not yet well explored. For this purpose, male C57BL/6 mice (W) and receptor for AGEs (RAGE) null mice (R) were recruited and rendered diabetic (D) with STZ injection. After 8 weeks, nerve conduction velocity (NCV) and tail flick test were performed. Subsequently, mice were sacrificed to dissect SN and DRG, which were evaluated in the pathology and mRNA expression by qPCR. WD showed significant delay of NCV and increase in threshold for thermal sensation (p&lt;0.01), while those were maintained in RD. Pathological analysis elucidated decrease in the average size of cell bodies in the DRG neuron of WD compared to W (p&lt;0.01), as well as the expression of CGRP in DRG neurons (p&lt;0.01). RD maintained neuronal cell size and CGRP expression. Significant increase in infiltration of Iba-I positive Mφ emerged in SN of WD compared to W (p&lt;0.05). The increase was more robust, composed mostly of M2 in RD than WD (p&lt;0.01). No increase of Mφ infiltration was identified in DRG of diabetic groups. The expression of iNOS (a marker for M1) was increased in SN of WD compared to W (p &lt; 0.01), but not in that of RD. The expression of Arg1 (a marker for M2) was significantly increased in SN of RD compared to WD (p &lt; 0.01). However, no changes of iNOS and Arg1 expression were detected in DRG. Our results suggest that proinflammatory changes in distal nerve elicits systematic sensory neuropathy in diabetes and correction of M1φ/M2φ imbalance may be beneficial for its prevention.

Disclosure
S. Osonoi: None. H. Mizukami: Research Support; Self; Sanwa Kagaku Kenkyusho Co., Ltd., Mitsubishi Tanabe Pharma Corporation. S. Ogasawara: None. K. Takahashi: None. K. Sango: None. S. Yagihashi: None.
Clinical Application of Photoacoustic Imaging to the Evaluation of Diabetic Polyneuropathy
Authors: YAGIHASHI SOROKU 
Published: June 2018

Objective evaluation of peripheral nerve function and pathology is essential for the early diagnosis and determination of clinical staging of diabetic polyneuropathy (DPN). To this end, we attempted to apply the photoacoustic imaging (PAI) to clinical diagnosis of DPN and characterization of background pathology. PAI is the imaging system for the dual ultrasound detection of the specific tissues or organs and released signals from the same tissues irradiated with laser light with specific wave length. For the application of PAI to DPN, we selected the median (MN) and sural nerves (SN) for the evaluation and applied laser light to these nerves for the detection of signals from hemoglobin. With this method, PAI enables depiction of nerve bundle cross sectional area (NA), and hemoglobin distribution, thereby blood volume (BV), vascular area (VA) or caliber at the arteriolar/venular levels. In this study, 12 healthy control subjects (C) and 54 diabetic patients (DM) with (n=30) or without DPN (n=24) were subjected to PAI examination. DPN was confirmed by Japanese study group criteria. Correlation analysis was also conducted between PAI data and clinical staging of DPN. We found significant increases of NA 14% in MN and 18% in SN in DM compared to C, and trends of increases in NA toward advanced DPN. There was also a trend of increase in VA in DM with advanced DPN although there was no significant difference between C and DM. Compared to C, BV in SN was increased 12% in DM, but it was decreased in DM with DPN compared to those without DPN. These findings indicated that expanded nerve bundle area with decreased BV was characteristic in DPN. Our results suggest that endoneurial edema of nerve bundles, epi- and perineurial fibrosis and congestion with endoneurial ischemia may contribute to the development of DPN. We consider that PAI is a new and valuable method for the clinical application to DPN.

Disclosure
S. Yagihashi: None.
hBMSC-TERT in Cutaneous Diabetic Wound—Histological Analysis and Metalloproteinases
Authors: LEAL ÂNGELA M. 
Published: June 2018

Diabetes (DM) is associated with micro- and macrovascular complications and impaired wound healing which leads to the formation of chronic lesions. Mesenchymal stem cells exert anti-inflammatory and secretory actions and their use in chronic lesions has obtained a high success rate, improving the healing process. In the present study, we have evaluated the effects of the use of a lineage of human mesenchymal cells obtained from bone marrow cells and immortalized by the enzyme telomerase (hBMSC-TERT), in wound healing in diabetics and their possible mechanism as regulators of MMPs. Male Wistar rats were divided into 6 groups (n = 8): Control without injury, Control with injury, Control with injury + hBMSC-TERT, Diabetics without injury, Diabetics with injury, Diabetics with injury + hBMSC-TERT. DM was induced by intraperitoneal injection of streptozotocin (60 mg/kg) and cutaneous lesions were performed in the dorsal region with the use of a punch (6 mm). Three weekly subcutaneous injections of hBMSC-TERT (1x106) into the lesion were performed. Thirteen days after the last injection, euthanasia and the collection of cutaneous tissue were performed for histological analysis (hematoxylin-eosin) and MMP-2 activity determination by gelatin zymography. The presence of fibroblasts and inflammatory infiltrate was significantly lower (p &lt;0.05) in infused diabetic animals when compared to those non-infused, indicating an improvement of the healing process in the diabetic group treated with hBMSC-TERT. The diabetic animals infused with hBMSC-TERT showed improvement in the healing process with respect to the amount and organization of collagen when compared to diabetic animals that did not receive an infusion of hBMSC-TERT. The levels of pro MMP-2 were significantly higher in Control with injury group than in Control group treated with hBMSC-TERT and in diabetic animals.
In conclusion, the data indicate that hBMSC-TERT may become an important therapeutic tool.

Disclosure
Â.M. Leal: None.