ABSTRACT
Diabetes is the commonest endocrine metabolic disorder in Nigeria. Aim: The aim was to assess the level of glycaemic control in type 2 diabetics in Oredo and Egor local government areas in Benin metropolis, with a view of planning improved diabetes care. Study and Design: This is a cross sectional study. Place and Duration of the Study: The study was carried out in the department of medicine Central Hospital Benin (Secondary Health center), department of Medicine University of Benin teaching Hospital (Tertiary Health center) and department of chemical pathology, University of Benin teaching hospital Benin City Nigeria between October 2012 and June 2013. Methodology: Fasting Blood sample of 126 type 2 diabetics (38.1% males and 61.9% females from the secondary health centre and 781 type 2 diabetics (47.1% male and 58.3% females ) from the tertiary health centre was assayed for plasma glucose and Glycated haemoglobin. Body mass index was calculated from measured height and weight and blood pressure measurements taken with mercury sphygmomanometer. Results: Mean fasting plasma glucose and mean glycated haemoglobin was 142.2±7.2mg/dl, 8.3±2.1% and 145.8±5.4mg/dL,8.3±2.6% for patients in the secondary and tertiary health centres respectively. 20.6% of the patients in the secondary health centre and 40.5% of those in the tertiary health centre had glycated haemoglobin values < 7% as recommended by the American Diabetes Association (ADA). 25.3% and 20.6% of the patients in the secondary and tertiary health centres respectively, met the blood pressure target recommended by ADA. Conclusion: Most diabetics in Egor and Oredo Local Government Areas, Benin City, south-south Nigeria still have suboptimal glycaemic control, are hypertensive and have chronic complications of the disease. Improved Health care delivery, and subsidization of health care is recommended.
ABSTRACT
Para trabajar en el área de la nutrición, es muy importante entender y aplicar estrategias basadas en evidencia, en particular para evaluar el estado nutricional tanto a nivel individual como poblacional y decidir la estrategia de intervención más adecuada y documentarla. Países como Venezuela se encuentran en el proceso de transición nutricional, con la subsiguiente coexistencia característica de casos de sub-nutrición y de sobre-nutrición incluso dentro de una misma familia. Es importante contar con modelos estandarizados que permitan la evaluación de la situación nutricional para obtener cambios que resulten exitosos al implementar intervenciones tanto a nivel individual como a nivel poblacional. En el presente trabajo se describe el Proceso de Cuidado y Manejo Nutricional (NCP) de American Dietetic Association (ADA) y comprender la factibilidad de su aplicación como herramienta eficiente y basada en evidencia y la utilidad que pudiese tener en países en vías de desarrollo entendiendo la importancia de sus cuatro fases: Primera fase: Diagnóstico Nutricional se exhorta al análisis con estándares basados en evidencia y se documentan los casos. En la segunda fase: Diagnóstico Nutricional: se identifica y etiqueta el problema, se determinan las posibles causas y factores de riesgo contribuyentes. En la tercera fase: Intervención Nutricional se realiza el plan de intervención nutricional, donde se ejecutarían las acciones con la respectiva documentación del proceso y en la cuarta fase: Monitoreo y Evaluación, se monitorea el éxito de la implementación del NCP, se procede a medir los indicadores establecidos, se evalúan los resultados y se documenta debidamente(AU)
For health care practitioners working in nutrition is most important to understand evidence based tools in particular to evaluate nutritional status individually and within populations thus they can select the optimal intervention and document it. Countries such as Venezuela are immerse in a process called nutrition Transition where the characteristic coexistence of under and over nutrition are frequent even within the same family. It is important to count on standardized models that allow and guide the nutritional evaluation, intervention and monitoring to obtain successful changes in correcting the inadequate nutritional situation at individual level and as population. We aim to introduce and encourage the use of ADA Nutrition Care Process (NCP) by health care practitioners related to nutrition field as well as understand the feasibility of its application as an efficient and based evidence tool in developing countries, and fully describe its four phases: First Phase Nutrition Assessment: it is encouraged the use of appropriate methods and tools. Second Phase, Nutrition Diagnosis identifies and labels the problem, determining possible causes and contributing risk factors. Third Phase: Nutrition Intervention, consist of a purposefully planned actions designed with the intent of changing a nutrition related behavior, risk factor, environmental condition, or aspect of health status. Fourth Phase: Nutrition Monitoring and Evaluation: refers to the review and measurement of the success of the intervention. Documenting this information is encouraged because it promotes a way to monitor the outcomes effectively, that can be replicated due to the standardized patterns it follows(AU)
Subject(s)
Humans , Male , Female , Nutrition Surveys , Food Guide , Nutritional Transition , Evidence-Based Practice , Nutrition Programs , Food Security , Nutritional EpidemiologyABSTRACT
The daily use of aspirin in patients with type 2 diabetes mellitus (DM2) reduces significantly cardiovascular events (CVE). In the absence of contraindications, American Diabetes Association (ADA) recommends the use of aspirin to all DM2 patients older than 40 years of age. To evaluate aspirin use among 636 out patients with DM2 who participate in a regional multicenter study in Southern Brazil, a standard questionnaire was used. Patients also underwent a physical examination and laboratorial tests. All patients were older than 40 years (mean 58 ± 11 years old; 42 percent male) and by ADA guidelines most of them should be using aspirin. However, only 177 (27.5 percent) were on this medication. The use of aspirin was higher when any CVE were present. However, the percentage of users was still below the expected, not even reaching 50 percent. In conclusion, even though the use of aspirin is greater in patients with CVE, and its benefits are well documented, it is still underutilized. Strategies to enhance the use of aspirin should be developed to reduce the morbidity and mortality from cardiovascular diseases in patients with DM2.
O uso diário de aspirina em pacientes com diabetes mellitus do tipo 2 (DM2) reduz significantemente os eventos cardiovasculares (ECV). Na ausência de contraindicações, a ADA (American Diabetes Association) recomenda o uso de aspirina para todos os pacientes com DM2 maiores de 40 anos de idade. Para avaliar o uso de aspirina em 636 pacientes ambulatoriais com DM2 que participaram de um estudo multicêntrico na região Sul do Brasil, utilizamos um questionário padrão. Os pacientes foram também examinados e submetidos a testes laboratoriais. Todos eram maiores de 40 anos (média 58 ± 11 anos; 42 por cento homens) e a maioria deles deveria estar usando aspirina, de acordo com as orientações da ADA. Entretanto, somente 177 (27,5 por cento) estavam com esta medicação. O uso de aspirina era maior em presença de qualquer ECV. Contudo, a porcentagem dos que a usavam estava ainda abaixo do esperado, não atingindo 50 por cento. Em conclusão, mesmo sendo o uso da aspirina maior em pacientes com ECV, e seus benefícios bem documentados, ela ainda é subutilizada. Assim, estratégias para aumentar o uso de aspirina devem ser desenvolvidas para reduzir a morbi-mortalidade decorrente da doença cardiovascular em pacientes com DM2.