[Multiple medication use in diabetic patients aged]

Multiple medication use is especially common in those with diabetes aged due to multiple illnesses, certain chronic diseases and disabling of the growing demand for care, treatment advances, but also some over-prescription. To assess the achievement of treatment goals in a population of older diabetics, to analyze drug consumption and to derive a practical driving prevention. This descriptive retrospective study was interested in 600 cases of diabetic patients older than 60 years, recruited from the diabetes followed at the National Institute of Nutrition and Health Unit in Tunis Sidi Hassine involving three local clinics to during the years 2009-2010. The average age of the study population was 70 +/- 0.5 years with extremes from 65 to 92 years. In our study, 91% of patients between 2 and 5 chronic diseases and the majority of subjects suffering from disabilities. The number of drugs prescribed in our subjects [all dosage forms combined] varies between 1 and 4,with a peak of interest to patients treated with 2-4 drugs, encountered in 91% of cases. The similarity of shapes and colors of certain drugs often confusing. Multiple medication use is common in older diabetic subjects. Hence the need for good coordination between prescribers to prevent abuse and ensure the correct therapeutic education of patients and their families

[Effect of protein restriction on renal function and nutritional status of type 1 diabetes at the stage of renal impairment]

In an effort to slow the deterioration of renal function, several authors have recommended in the diabetic stage renal disease with moderate renal impairment decreased protein intake to 0.7 or 0.3 g / kg / day associated with energy intake of at least 30 to 35 kcal / kg / day. However, in clinical practice this proved difficult to achieve without exposing patients to the risk of under nutrition. To evaluate the effects of a protein restricted diet on the development of diabetic nephropathy and the nutritional status of diabetic patients with renal impairment at the stage of moderate renal impairment compared with those of a group of diabetics with the same characteristics put under basal diabetic diet. Prospective study of 57 diabetic patients in moderate stage renal disease of middle age [32 +/- 0.6 years] followed at the National Institute of Nutrition of Tunis in 2010. Our patients were separated into two groups [group A comprising 30 patients, put on diabetic diet basal and group B comprising 27 patients used in protein-deficient diet: 0.6 to 0.7 g / kg /d]. We followed the evolution of certain parameters: glomerular filtration rate [GFR], serum albumin, albuminuria, nutritional risk index [NRI] and we analyzed dietary intake at D0, D90 and D180. Renal function in patients in group B improved as demonstrated by the trend towards higher GFR. It increased from day 0 to day 90 and at day 180. In parallel, there was a beneficial effect on albuminuria which was reduced from 380 +/- 56 mg/24h on day 0, to 322 +/- 50mg/24h at day J90 and 302 +/- 16 mg/24h at day 180. In group A, the opposite phenomena occurred. The patients in Group B have also reduced their overall caloric intake to less than 1800 kcal / day making sure that the balance of their diet quality could no longer be assured the result has a tendency to under nutrition noted more frequently in the latter group [NRI0 = 97.90%, NRI 90= 90.10%, NRI180=90,0%]. In the literature these results were found by several studies. The protein-deficient diet [0.6 to 0.7 g/ kg /d] must be integrated into the overall care of diabetic renal insufficiency with moderate renal impairment but requires rigorous repeated dietary interviews and customized to avoid malnutrition can result

[What is the place of artificial sweeteners in the food of our diabetics?]

Artificial Sweeteners are food additives increasingly developed by the food industry. Study of the consumption of sweeteners in diabetic patients. This prospective cross study performed using a questionnaire to 100 patients recruited at random outpatients of the National Institute of Nutrition. Data on the BMI,the blood sugar were found in clinical records. 94% of diabetics have at least heard of sweeteners and 50% use it regularly. Sweetener table are the most consumed sweeteners, in order of frequency Saccharin, Sucralose and Aspartame, used to sweeten coffee and tea. The trade products "light" are consumed by 29% of patients. Yet consumers have no real information on these products. There was no statistically significant correlation between the consumption of sweeteners and BMI, balance and diabetes evolution. A statistically significant correlation was found between consumption and socio-economic and cultural development of patients. The education of diabetic patients should include information of patients on these sweeteners, their interest, their against-indications and adverse reactions

[Association of type 1 diabetes and celiac disease: the lived for this double pathology]

the association of diabetes type 1 and celiac disease seems to pose many problems diagnostic, therapeutic and psychological. Aim of our work is to study in eight patients with type 1 diabetes associated with celiac disease their daily experience and the constraints that this pathological association imposes. This cross-sectional study involved eight patients with type 1 diabetes and celiac disease known for at least 1 year. All patients were given a thorough interrogation specifying the regular monitoring of the two diseases and the quality of the observance of the diabetic dietary and gluten-free diet, as well as an assessment of impact of diabetes. the caloric intake in relation to the recommendations is very insufficient. Taking snack is not respected. There is also the consumption of certain foods containing gluten masked and regular consumption of sucrose by our patients despite a long-term evolution of diabetes [19 +/- 6 years] and celiac disease [11 +/- 7.8 years]. Half of patients have degenerative complications of diabetes. In light of these results, a frequent evaluation of nutrition education in these patients and a psychological care seems necessary

[Malitus diabetes of elderly patients: therapeutic recommendations]

In the elderly diabetic patient, therapeutic decision is very delicate because of the psycho-social pathological ground at this age. The emergence of new concepts of ageing and frailty made it possible to re-examine the plasma glucose goals and to build strategies of prevention and treatment adapted to the clinical and biological profiles of elderly subjects

[Blood pressure and type 2 diabetes mellitus: impact of the insulin therapy]

The incidence of arterial hypertension is by 2-3 times with diabetics than with non-diabetics. Ethiopathogenesis of arterial hypertension in type 2 diabetes is multifactorial insulin-resistance, obesity, hyperlipoproteinemia, age, smoking and probably method of treatment [insulin therapy]. The aim of this retrospective study is to evaluate, over 5 years period, the level of blood pressure and the frequency's progression of arterial hypertension in 35 type 2 diabetes patients treated with insulin. Comparison of 35 type 2 diabetes patients treated with insulin to 35 controls treated with oral hypoglycemic agents. No significant differences were found over 5 years period in mean systolic blood pressure, mean diastolic blood pressure and frequency of arterial hypertension. However, frequency of arterial hypertension was correlated with mean dose of insulin. Our study confirms the long-term results found in the literature reading effects of insulin therapy on blood pressure in diabetic patients

Protective role of polyunsaturated fatty acids epsilon-3 in age related macular

Many studies showed a protective role of omega -3 polyunsaturated fatty acids [AGPI epsilon S] against diseases related to aging, including cardiovascular diseases and diseases of the retina. Docosahexaenoic acid [DHA], the AGPI epsilon 3 having the most significant biological effect, has anti-inflammatory and anti-apoptotic properties on the photoreceptors and could have beneficial effects on the occurrence of age-related macular degeneration. An increase in the consumption of AGPI epsilon 3-rich food [fish, nuts..] could be of interest in decreasing the incidence of this very frequent retinal disease