ABSTRACT
BACKGROUND: The use of glucose lowering agents with favorable weight profile is a growing practice in Diabetology. AIM: To characterize medication combinations in patients with type 2 Diabetes (T2D) and their effect on metabolic control. MATERIAL AND METHODS: Review of medical records of 249 outpatients with T2D with a median age of 66 years, cared for at a medical network. Clinical characteristics, glycated hemoglobin (HbA1c), details of Diabetes treatment (types of drugs or insulin), renal function, lipids and B12 vitamin levels were registered. RESULTS: The median disease duration was 16 years. The most recent HbA1c was 7.4%. No patient was using sulfonylureas, 45 were using Dipeptidyl peptidase 4 inhibitors, 113 were using Sodium-glucose Cotransporter-2 (SGLT2i) Inhibitors, 21 used Glucagon-like Peptide-1 Receptor Agonists (GLP1ra), 158 used basal insulin and 61 on basal plus bolus insulin. The use of SGLT2i or GLP1ra was associated with a metabolic control similar to those patients not using them, while patients on rapid insulin had a significantly worse metabolic control and a tendency to greater body mass index. The use of basal insulin and rapid insulin was significantly associated with more hypoglycemia events. CONCLUSIONS: The use of SGLT2i and GLP1ra in patients with T2D is associated with better metabolic control than rapid insulin with less risk of hypoglycemia. The use of these therapies should be prioritized in the future.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Diabetes Mellitus, Type 2/drug therapy , Ambulatory Care , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Glycated Hemoglobin/metabolism , Drug Combinations , Hypoglycemia/chemically induced , Insulin/adverse effectsABSTRACT
Background: A secondary cause can be found in up to one third of women with osteoporosis, potentially modifying their therapeutic approach. Aim: To determine the prevalence of secondary causes and risk factors for decreased bone mineral density (BMD) and osteoporosis. Material and Methods: We included postmenopausal women with a diagnosis of osteoporosis or low BMD who consulted for the first time in an endocrinology clinic between October 2018 and March 2020. A complete medical history, physical examination and a standardized laboratory assessment to identify secondary causes were performed. Results: During the study period, 114 women were evaluated, 30 of them with low BMD and 84 with osteoporosis. After obtaining a medical history and a structured laboratory screening, at least one secondary cause was found in 50% of patients with osteoporosis and in 67% of those with low BMD. Most patients with no identified secondary cause had at least one risk factor for fragility fractures. Conclusions: A structured evaluation that includes medical history and standardized laboratory study in postmenopausal women with osteoporosis or low BMD, is a valuable tool to identify secondary causes of osteoporosis.
ABSTRACT
El objetivo de este estudio fue describir las consecuencias psicosociales en sujetos privados de la libertad que resultaron inocentes. El marco teórico incluyó los conceptos de psicología jurídica, presunción de inocencia, verdad jurídica, privación de la libertad, efectos de la prisionización y estigmatización social. El instrumento empleado para la recolección de información fue una entrevista semiestructurada, que logró dar cuenta de los efectos psicológicos y sociales de la privación de la libertad en personas que fueron imputadas y que resultaron finalmente inocentes, según la verdad jurídica. Se concluye con la ratificación de las consecuencias psicosociales del hecho de estar privados de la libertad, y con una reflexión acerca de la actuación de los operadores del sistema judicial y la dificultad para detectar los errores.
O objetivo deste estudo é descrever as consequências psicossociais nos sujeitos privados da liberdade que ficaram inocentes. O quadro teórico incluiu os conceitos da psicologia legal, da presunção do inocência, da verdade legal, da privação da liberdade, dos efeitos do encarceramento e da estigmatização social. O instrumento usado para a coleta das informações foi uma entrevista semiestruturada, e evidenciou os efeitos psicológicos e sociais da privação da liberdade nas pessoas que foram imputadas e ficaram inocentes, de acordo com a verdade legal. O artigo conclui com o ratificação das consequências psicossociais do fato de estar privados da liberdade, e com uma reflexão sobre o desempenho dos operadores do sistema judicial e da dificuldade para detectar os erros.
This study was aimed at describing the psychosocial consequences affecting individuals who after having been deprived from their liberty were found innocent. The theoretical frame included concepts such as legal psychology, the presumption of innocence and the in dubio pro-reo, i. e. when in doubt, for the accused principles, judicial truth, deprivation of liberty, and the effects of prisonization and social stigmatization. The instrument used in the gathering of information was a semi-structured interview which succeeded in accounting for the psychological and social consequences of deprivation of liberty for innocent people wrongfully convicted, according to the juridical truth. The study concludes with the ratification of such effects and consequences and the usual difficulty in error detecting and correcting.