Adherencia terapéutica en adultos mayores con hipertensión y diabetes mellitus tipo II: una aproximación cualitativa / Therapeutic adherence in elderly citizens with high blood pressure and type 2 diabetes: A qualitative approach

RESUMEN Objetivo: Explorar y describir dimensiones que afectan la adherencia terapéutica en personas mayores con hipertensión o diabetes tipo 2 en Araucanía, Chile. Metodología: Investigación cualitativa, etnográfica y descriptiva, que se aborda con análisis de contenido según Bardin. Corresponde a una primera fase de un estudio exploratorio, en la que se realizan dos grupos focales, con participación de 12 personas mayores de 70 años con hipertensión, diabetes tipo 2 o ambas. Resultados: Se describen trece categorías emergentes, tres in vivo (ser carga para otras personas, obtención de ayuda a partir del celular y vida empobrecida) y diez teóricas (edadismo, aislamiento y soledad, cultura popular para control de la patología, estructura familiar matriarcal, modelo biomédico arraigado, infravaloración del equipo no médico, paradoja de las expectativas no cumplidas, importancia de la participación social, el autocuidado, adherencia incompleta y fragmentada y riesgo de descompensación). Conclusión: La categoría ageísmo, aislamiento y soledad subyace a un mayor riesgo cardiovascular, por la dificultad que tienen las personas que sufren soledad para adherirse al tratamiento. La relación de ayuda se describe débilmente, prevaleciendo el paternalismo biomédico. Se requiere fortalecer estrategias participativas en el programa cardiovascular y actividades a partir de las necesidades de personas mayores.

ABSTRACT Aim: To explore and describe the dimensions that affect the therapeutic adherence of elderly patients with high blood pressure and/or type 2 diabetes in Araucanía, Chile. Methods: This was a qualitative, ethnographic, and descriptive research that addressed its content analysis following Bardin. It corresponds to the first phase of an exploratory study in which two focus groups are carried out; the participants were 12 people over 70 years of age with hypertension and/or type 2 diabetes. Results: Thirteen emerging categories are described: three are in vivo (being a burden for others, getting help using the cellphone, and impoverished life), and ten are theoretical (ageism, isolation and loneliness, popular culture to control the pathology, matriarchal family structure, deep-rooted biomedical model, underestimation of the non-medical team, unfulfilled expectations paradox, importance of social participation, self-care, incomplete and fragmented adherence, and risk of decompensation). Conclusion: The ageism, isolation and loneliness categories present a greater cardiovascular risk due to the difficulty that people who suffer loneliness have to adhere to the treatment. The aid relationship is weakly described, and the biomedical paternalism prevails. It is necessary to strengthen participatory strategies in the cardiovascular program, and activities based on the needs of the elderly.

RESUMO Objetivo: Explorar e descrever as dimensões que afetam a adesão terapêutica em idosos hipertensos e diabéticos tipo 2, Araucanía, Chile. Metodologia: Pesquisa qualitativa etnográfica, descritiva, abordada com a análise de conteúdo segundo Bardin. Corresponde à primeira fase de um estudo exploratório, no qual são realizados dois grupos focais, com a participação de 12 pessoas com mais de 70 anos com hipertensão, diabetes tipo 2 ou ambos. Resultados: Treze categorias emergentes são descritas, três in vivo; ser um fardo para os outros, obtendo ajuda do celular e da vida empobrecida, e dez teóricos; ageismo, isolamento e solidão, cultura popular para o controle da patologia, estrutura familiar matriarcal, modelo biomédico arraigado, subestimação da equipe não médica, paradoxo das expectativas não atendidas, importância da participação social, autocuidado, adesão incompleta e fragmentada e descompensação de risco. Conclusão: A categoria idade, isolamento e solidão está subjacente a um maior risco cardiovascular, devido à dificuldade que as pessoas que sofrem de solidão têm para aderir ao tratamento. A relação de ajuda é mal descrita, prevalecendo o paternalismo biomédico. É necessário fortalecer estratégias participativas no programa cardiovascular e atividades baseadas nas necessidades dos idosos.

Adherencia terapéutica en adultos mayores con hipertensión y diabetes mellitus tipo II: una aproximación cualitativa

Objetivo: Explorar y describir dimensiones que afectan la adherencia terapéutica en personas mayores con hipertensión o diabetes tipo 2 en Araucanía, Chile. Metodología: Investigación cualitativa, etnográfica y descriptiva, que se aborda con análisis de contenido según Bardin. Corresponde a una primera fase de un estudio exploratorio, en la que se realizan dos grupos focales, con participación de 12 personas mayores de 70 años con hipertensión, diabetes tipo 2 o ambas. Resultados: Se describen trece categorías emergentes, tres in vivo (ser carga para otras personas, obtención de ayuda a partir del celular y vida empobrecida) y diez teóricas (edadismo, aislamiento y soledad, cultura popular para control de la patología, estructura familiar matriarcal, modelo biomédico arraigado, infravaloración del equipo no médico, paradoja de las expectativas no cumplidas, importancia de la participación social, el autocuidado, adherencia incompleta y fragmentada y riesgo de descompensación). Conclusión: La categoría ageísmo, aislamiento y soledad subyace a un mayor riesgo cardiovascular, por la dificultad que tienen las personas que sufren soledad para adherirse al tratamiento. La relación de ayuda se describe débilmente, prevaleciendo el paternalismo biomédico. Se requiere fortalecer estrategias participativas en el programa cardiovascular y actividades a partir de las necesidades de personas mayores.

Aim: To explore and describe the dimensions that affect the therapeutic adherence of elderly patients with high blood pressure and/or type 2 diabetes in Araucanía, Chile. Methods: This was a qualitative, ethnographic, and descriptive research that addressed its content analysis following Bardin. It corresponds to the first phase of an exploratory study in which two focus groups are carried out; the participants were 12 people over 70 years of age with hypertension and/or type 2 diabetes. Results: Thirteen emerging categories are described: three are in vivo (being a burden for others, getting help using the cellphone, and impoverished life), and ten are theoretical (ageism, isolation and loneliness, popular culture to control the pathology, matriarchal family structure, deep-rooted biomedical model, underestimation of the non-medical team, unfulfilled expectations paradox, importance of social participation, self-care, incomplete and fragmented adherence, and risk of decompensation). Conclusion: The ageism, isolation and loneliness categories present a greater cardiovascular risk due to the difficulty that people who suffer loneliness have to adhere to the treatment. The aid relationship is weakly described, and the biomedical paternalism prevails. It is necessary to strengthen participatory strategies in the cardiovascular program, and activities based on the needs of the elderly.

Objetivo: Explorar e descrever as dimensões que afetam a adesão terapêutica em idosos hipertensos e diabéticos tipo 2, Araucanía, Chile. Metodologia: Pesquisa qualitativa etnográfica, descritiva, abordada com a análise de conteúdo segundo Bardin. Corresponde à primeira fase de um estudo exploratório, no qual são realizados dois grupos focais, com a participação de 12 pessoas com mais de 70 anos com hipertensão, diabetes tipo 2 ou ambos. Resultados: Treze categorias emergentes são descritas, três in vivo; ser um fardo para os outros, obtendo ajuda do celular e da vida empobrecida, e dez teóricos; ageismo, isolamento e solidão, cultura popular para o controle da patologia, estrutura familiar matriarcal, modelo biomédico arraigado, subestimação da equipe não médica, paradoxo das expectativas não atendidas, importância da participação social, autocuidado, adesão incompleta e fragmentada e descompensação de risco. Conclusão: A categoria idade, isolamento e solidão está subjacente a um maior risco cardiovascular, devido à dificuldade que as pessoas que sofrem de solidão têm para aderir ao tratamento. A relação de ajuda é mal descrita, prevalecendo o paternalismo biomédico. É necessário fortalecer estratégias participativas no programa cardiovascular e atividades baseadas nas necessidades dos idosos.

Effect of Type-2 Diabetes Mellitus in Retinopathy Patients on MDA, SOD Activity and its Correlation with HbA1c

Abstract Diabetic retinopathy (DR) is a metabolic disorder of the retina and one of the common problems of Type-2 diabetes mellitus (T-2DM) causing visual loss even at teen ages. In this research article, oxidative stress was the main cause due to reactive oxygen species (ROS) generation at hyperglycemic state and become as the focus point of this study to describe (DR) complication onset. The present study was conducted to compare three groups: T-2DM with complication, T-2DM without complication and control group. For this purpose, number of the individuals participating in this study were n=110 as subject along with T-2DM patients with complication n=50, T-2DM patients without complication n=50 and rest n=10 are taken as control/ normoglycemic individuals. T-2DM patients with/without complication have TAG level is lower than normoglycemic/ control. An observed value of (HbA1c%) glycosylated or glycated hemoglobin type A1c concentration of T2DM with complication group was highest (9.63%) amongst the examined groups. T-2DM with complication has lowest SOD activity (660.96 U/gHb) but the malondialdehyde (MDA) level was found to be higher (5.96 µmol/L) amongst studied groups. Lowest plasma TAG, and higher plasma MDA level indicate the presence of oxidative stress in T2D with/without complications. SOD activity was decreased due to the protein glycation and the surplus level of lipid detoxification especially found in T-2DM cases. Good glycemic control counteracts the response of Lipid peroxidation usually occurs in hyperglycemic state.

Abordagens metodológicas utilizadas em intervenções educativas voltadas a indivíduos com diabetes mellitus / Enfoques metodológicos utilizados en intervenciones educativas dirigidas a personas con diabetes mellitus / Methodological approaches used in educational interventions aimed at individuals with diabetes mellitus

Resumo O objetivo da presente pesquisa foi identificar os tipos de abordagens metodológicas utilizadas nas intervenções educativas voltadas para as pessoas que convivem com Diabetes Mellitus. Revisão narrativa da literatura, com busca em quatro bases de dados (Scielo, CINAHL, Scopus e Web of Science), no período de 2014 a 2018. Foram identificados 143 estudos, a partir dos Descritores em Ciências da Saúde (DeCS): "Diabetes mellitus"; "Educação em Saúde" e "Adesão à medicação" para a busca na Biblioteca virtual SciELO. Os descritores MeSH (Medical Subject Headings), "Diabetes mellitus"e "Health education" foram empregados nas bases CINAHL, SCOPUS e Web Of Science. 14 artigos compuseram a amostra final. Foi possível identificar diversas modalidades de intervenções que ao serem selecionadas descrevem exatamente o objetivo que se quer alcançar e nesse contexto a abordagem que apresenta melhores resultados e uma vasta possibilidade de aplicação foi o mapa de conversação em conformação de grupo, apesar de ainda não ser considerada como "padrão-ouro" é uma ferramenta promissora na educação em diabetes.

Abstract The objective of this research was to identify the types of methodological approaches used in educational interventions aimed at people living with diabetes mellitus. Narrative literature review, searching four databases (Scielo, CINAHL, Scopus and Web of Science), from 2014 to 2018. We identified 143 studies from the Descriptors in Health Sciences (DeCS): "Diabetes mellitus "; "Health Education" and "Medication Adherence" to search the SciELO Virtual Library. The descriptors MeSH (Medical Subject Headings), "Diabetes mellitus" and "Health education" were used in CINAHL, SCOPUS and Web Of Science databases. 14 articles made up the final sample. It was possible to identify several modalities of interventions that, when selected, describe exactly the objective to be achieved and in this context the approach with the best results and a wide possibility of application was the group conformation conversation map, although it is not yet considered. as a "gold standard" is a promising tool in diabetes education.

Resumen El objetivo de esta investigación fue identificar los tipos de enfoques metodológicos utilizados en las intervenciones educativas dirigidas a personas con diabetes mellitus. Revisión de la literatura narrativa, buscando en cuatro bases de datos (Scielo, CINAHL, Scopus y Web of Science), de 2014 a 2018. Identificamos 143 estudios de los Descriptores en Ciencias de la Salud (DeCS): "Diabetes mellitus "; "Educación para la salud" y "Adherencia a la medicación" para buscar en la Biblioteca Virtual SciELO. Los descriptores MeSH (Medical Subject Headings), "Diabetes mellitus" y "Health education" se utilizaron en las bases de datos CINAHL, SCOPUS y Web of Science. 14 artículos constituyeron la muestra final. Fue posible identificar varias modalidades de intervenciones que, cuando se seleccionan, describen exactamente el objetivo a alcanzar y, en este contexto, el enfoque que presenta los mejores resultados y una amplia posibilidad de aplicación fue el mapa de conversación de conformación grupal, aunque aún no se considera. como un "estándar de oro" es una herramienta prometedora en la educación para la diabetes.

Risk Factors Of Pulmonary Tuberculosis Among Diabetes Mellitus Patients: A Case-Control Study In Dr. Kariadi General Hospital, Semarang, Indonesia

@#Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). Prevalence of TB among DM patients ranged from 1.7 % to 36 %. Limited information has been reported regarding TB among DM patients in Indonesia. This case-control study aimed to investigate prevalence and related factors of pulmonary TB among DM patients in Dr. Kariadi General Hospital. Cases of pulmonary TB were defined by a positive acid-fast bacilli smear or molecular rapid test and thorax x-ray. Data were presented as frequency and percentage comparing the case and control group. Chi-square continued by Binary logistic regression analyses were done to determine the relationship between the parameters and TB status performed by the SPSS 16. Prevalence of 8.02% or 72 patients were diagnosed as having pulmonary TB from 898 registered patients with DM. Of the 72 TB patients, 30 completed the data as case group, and 45 DM patients without TB determined as a control group. Comparison between the case and control group study found differences in household contact (63.3 % and 4.4 %, respectively), random plasma glucose (76.7 % and 33.3 %), duration of DM (40 % and 71 %), and treatment compliance (30 % and 68.9 %). The final model in Binary logistic regression involved household contact, random plasma glucose level, and treatment compliance. The prevalence of pulmonary TB among DM patients in Dr. Kariadi General Hospital was 8.02%. Risk factors that were associated with this occurrence were: household contact, high random plasma glucose level, and poor treatment compliance.

Assessment of Blood Donation Safety by People Diagnosed with Diabetes, Hypertension, Malaria and Cancer

Thepresentreviewaimstoassesstheblooddonationsafetybypeoplesufferedfromdiabetes,hypertension,malariaandcancer.Diabetes,hypertension,malariaandcancerhavebecomecommonhealthproblemsinhumansociety.Casesofbloodtransfusion-transmittedmalaria,hypertension,cancerandthesafetyofblooddonationbydiabeticpeoplehavebeendescribedaroundtheworldandhighlightedinsomestudies.Diabetesisgenerallyassociatedwithcomplicationsandpeoplewithdiabetesusuallytakedifferentmedicationsandmayalreadyhaveanaemiasecondarytorenalimpairment,B12deficiency.Asfortherecipientsafety,abloodfromapersonwithhyperglycaemiabutotherwisehealthyi.e.satisfyblooddonationsafetystandards(norecordofHIV,HepatitisBorC)wouldbequitesafetoreceiveastheextraglucosewouldsimplyberegulatedandutilisedbytherecipient'sbody.Hypoglycemiaisasbadashyperglycemiaandcouldbefatalandhence,generally,itisnotdesiredthatdiabeticsgiveblooddonations.Diabeticpatientstakingbovineorporcineinsulinmaydevelopantibodiesanditisnotrecommendedthattheantibodycontaminatedbloodtobegiventoanyotherperson.Apersonwithhypertensioncandonateblood,aslongasthebloodpressureisnormalatthetimeofblooddonationandthere’snofluctuation.Malariaisalsoreadilytransmittedbybloodtransfusionthroughdonationscollectedfromasymptomatic,parasitaemicdonors.Theparasiteisreleasedintothebloodstreamduringitslifecycleandwill,therefore,bepresentinblooddonatedbyinfectedindividuals.Thepresenceoftotalanti-Plasmodiumspp.antibodiesinthebloodstreamofindividualsmanyyearsafterexposure,withnohistoryofmalariainthemeantime,isimportanttohighlight.Regardingdonorswithcancerblooddonationsshouldnotbetakenfrompeoplewithrecentlyactivemalignancies,exceptinthecaseofbasalcellcarcinomaorcervicalcarcinomainsitu

Barreras culturales en los adultos mayores con diabetes de comunidades mayas / Cultural barriers in older adults with diabetes from Mayan communities / Barreiras culturais em idosos com diabetes de comunidades maias

Resumen La población adulta mayor maya es considerada vulnerable, debido a barreras que influyen en su calidad de vida, tales como su situación económica y las malas relaciones culturales con el profesional de salud, problemática sobre la que versa este ensayo. La deficiencia de políticas públicas enfocadas a mejorar las condiciones de vida del adulto mayor con diabetes, específicamente en zonas indígenas, es un problema que se debe atender en todo el territorio mexicano, un país con una amplia gama de culturas, por ello se requiere crear y evaluar distintos métodos que ayuden a aumentar la calidad de vida de los adultos mayores, mediante la propuesta de proyectos de salud que consideren los pensamientos y aspectos culturales de cada población y que mejoren las relaciones culturales de la población y los profesionales de la salud, máxime considerando que vivir con una enfermedad crónica puede generar cambios en el ámbito familiar, social e individual, por ende, es fundamental reconocer su forma de vivir y aplicar los cuidados transculturales en la población maya.

Abstract The elderly mayan people are considered one of most vulnerable populations in Mexico, having barriers that affect their quality of life, these include the economic situation and the bad cultural relations with health team, so in this essay is written on the problems found in this specific population. Deficiency of focused public policies to improve the living conditions of the elderly with diabetes, specifically in indigenous areas, is a problem to be addressed in all the Mexican territory, since it is a country with a wide range of cultures, for this reason is required to create and evaluate different methods that will help to increase the quality of life of seniors, the proposal of health projects that consider the thoughts and cultural aspects of each population, It is also urgent that these programs improve the cultural relations of the population and health professionals. Living with a chronic illness can generate changes in family, social and individual spheres, therefore, it is important to recognize its way of life and apply the transcultural care in the mayan population.

Resumo A população adulta maia mais velha é considerada vulnerável, devido a barreiras que influenciam sua qualidade de vida, como a situação econômica e as relações culturais ruins com o profissional de saúde, problema esse que é objeto deste ensaio. A carência de políticas públicas voltadas à melhoria das condições de vida dos idosos com diabetes, especificamente em áreas indígenas, é um problema que deve ser abordado em todo o território mexicano, um país com um amplo espectro de culturas, motivo pelo qual é necessário criar e avaliar diferentes métodos que ajudam a aumentar a qualidade de vida dos idosos, através da proposição de projetos de saúde que considerem os pensamentos e aspectos culturais de cada população e que melhorem as relações culturais da população e dos profissionais de saúde, especialmente considerando que viver com uma doença crônica pode gerar mudanças na família, social e individual, por isso, é essencial reconhecer seu modo de viver e aplicar o cuidado transcultural na população maia.

Prevalence of Microalbuminuria in Newly Diagnosed T2DM Patients attending a Tertiary Care Hospital in North India and its Association with Various Risk Factors

Introduction: The natural history of diabetic nephropathyhas generally been viewed as a descending path fromnormoalbuminuria to end stage renal disease through anintermediate stage marked by microalbuminuria and overtproteinuria. For this reason, measurement of urine albuminis often used as a sensitive marker and predictor of overtnephropathy in patients with diabetes mellitus. Study aimedto determine the prevalence of microalbuminuria in newlydiagnosed type 2 diabetes mellitus patients and to assess theprobable risk factors associated with microalbuminuria.Material and methods: A total of 155 newly diagnosed Type 2Diabetes mellitus patients were includedin our cross-sectionalstudy. After the history, general physical examination andanthropometry, various biochemical investigations includingkidney function test, plasma blood sugars, lipid profile andHbA1c. The detection of microalbuminuria was done byMicral Test (dipstick, Roche Diagnostic) method in a randomspot urine sample. Microalbuminuria was diagnosed if theurinary albumin excretion was ≥20 mg/L of urine.Results: The overall prevalence of nephropathy was 32.9%(51/155).There was significant association of albuminuriawith the increase in age of the patients, increased BMI, highglycated haemoglobin, high fasting plasma glucose, anddyslipidemia.Conclusion: A relatively high prevalence of microalbuminuriaat the time of diagnosis in our study reconfirms that evaluationfor microalbuminuria must be done at the time of diagnosis inall patients of T2DM

Herpes Zoster Ophthalmicus: Clinical Profile And Management, A Prospective Study At A Tertiary Health Care Centre, Western Odisha

Purpose–To study the clinical prole and management of herpes zoster ophthalmicus over a period of two and half years in a tertiary health care centre. Material and methods- it is a prospective study done on 32 patients who were diagnosed with herpes zoster ophthalmicus clinically. Predisposing factors like diabetes mellitus, HIV, hepatitis B, Hepatitis C, anemia, patients having leukaemia and taking chemotherapy were evaluated. Result-Diabetes mellitus was commonest association. Common presentations were periorbital vesicular rash and corneal involvement. Conclusion: commonest presentation was periorbital vesicular rash. Systemic antivirals are efcacious in immunocompromised cases. . Patients were followed up for one year.

Effect of Puerarin Combined with Tanshinone ⅡA on t-PA, PAI-1 and Oxidative Stress in DM Rats with Vascular Lesions / 中国实验方剂学杂志

Objective:To observe the protective effect and mechanism of combination of puerarin combined with tanshinone ⅡA on diabetes mellitus (DM) rats with vascular lesions. Method:The SD rats (fed with high-fat diet) were administrated with streptozotocin(STZ) through intravenous injection to make the model of diabetic vascular lesions. The successfully modeled rats were randomly divided into the model control group, the high-dose group (0.5 g·kg-1+1.0 g·kg-1), the middle-dose group (0.25 g·kg-1+0.5 g·kg-1), the low-dose group (0.05 g·kg-1+0.1 g·kg-1), the puerarin group (0.25 g·kg-1), the tanshinone ⅡA group (0.5 g·kg-1) and the positive control group (Metformin, 0.09 g·kg-1). Each group was administrated with drugs respectively by gavage for 70 days. After intervention in each group, the general conditions and body weight of the rats were observed. The contents of blood grucose and blood lipids were determined by automatic biochemical analyzer. The contents of insulin, advanced glycation end products (AGEs), superoxide dismutase(SOD), glutathione peroxidase (GSH-Px) in serum, the contents of tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and thromboxane B2 (TXB2) in plasma, as well as the contents of AGEs and oxidized low-density lipoprotein(ox-LDL) in aorta homogenate were detected by enzyme-linked immunosorbent assay(ELISA). The content of malondialdehyde(MDA) in serum was determined by chemical colorimetry. Pathological changes of coronary tissue were observed by htoxylin eosin(HE) staining. The expression of PAI-1 protein of aorta was observed by immunohistochemistry. Result:Compared with the normal control group, in the model group, the levels of blood grucose and blood lipids (PPPP2 in plasma (PPPPPPPPP2 in plasma (PPPPPPPConclusion:Puerarin combined with Tanshinone ⅡA could relieve vascular lesions of DM rats. The mechanisms may be related to the reduction of oxidative stress and the regulation of coagulation-fibrinolysis system.

Prevalência e fatores associados à neuropatia periférica em indivíduos com diabetes mellitus / Prevalencia y factores asociados con la neuropatía periférica en individuos con diabetes mellitus / Prevalence and factors associated with peripheral neuropathy in individuals with diabetes mellitus

Objective: To estimate the prevalence of polyneuropathy (PND) in type 2 diabetic individuals assisted at the Center for Health Hiperdia in Viçosa and to identify factors associated with a positive diagnosis of PND through the score of neuropathic symptoms and susceptibility testing. Methods: Cross-sectional quantitative study performed from December 2013 to June 2014, through secondary source. The prevalence of PND and its association with each variable was assessed using the chi-square test and the Fisher exact test. In the logistic regression it was used the method of disposal backward by the Wald test. Results: It was found the prevalence of PND: 36.89%, higher in males, in patients with delayed diagnosis of diabetes mellitus (DM) and with the absence of protective sensation plant (SPP). Conclusion: The study found a high prevalence of PND, reinforcing the need for early diagnosis in order to prevent ulcers and improving the quality of life of diabetic patients.

Objetivo: Estimar a prevalência da polineuropatia (PND) em indivíduos diabéticos tipo 2 assistidos no Centro de Atenção à Saúde Hiperdia, em Viçosa/MG e identificar fatores associados ao diagnóstico positivo da PND através do escore de sintomas neuropáticos e testes de sensibilidade. Métodos: Estudo quantitativo transversal realizado de dezembro de 2013a junho de 2014, através de fonte secundária. A prevalência da PND e sua associação com cada variável foi avaliada pelo teste Qui-quadrado de Pearson e o Teste Exato de Fischer. Na regressão logística utilizou-se o método de eliminação backward pelo teste de Wald. Resultados: Verificou-se a prevalência de PND: 36,89%, sendo maior em indivíduos do sexo masculino, em indivíduos com maior tempo de diagnóstico do Diabetes Mellitus (DM) e ausência de sensibilidade protetora plantar(SPP). Conclusão: O estudo detectou uma alta prevalência de PND, reforçando a necessidade do diagnóstico precoce, a fim de prevenir ulcerações, melhorando a qualidade de vida dos indivíduos diabéticos.

Objetivo: Estimar la prevalencia de polineuropatía (PND) en el tipo 2 individuos diabéticos atendidos en el Centro de Salud Hiperdia en Viçosa e identificar los factores asociados con un diagnóstico positivo del PND a través de la puntuación de los síntomas neuropáticos y las pruebas de sensibilidad. Métodos: Estudio cuantitativo transversal realizado desde diciembre 2013 hasta junio 2014, a través de fuentes secundarias. La prevalencia de PND y su asociación con cada variable se evaluó mediante la prueba de chi-cuadrado y la prueba exacta de Fisher. La regresión logística se utilizó el método de eliminación hacia atrás mediante la prueba de Wald. Resultados: Se encontró que la prevalencia del PND: 36.89%, mayor en los hombres, en los pacientes con diagnóstico tardío de la diabetes mellitus (DM) y la ausencia de plantas sensación protectora (SPP). Conclusión: El estudio encontró una alta prevalencia de PND, lo que refuerza la necesidad de un diagnóstico precoz para prevenir las úlceras, la mejora de la calidad de vida de los pacientes diabéticos.

Relationship between perinatal outcome and weight gain of pregnant women with gestational diabetes mellitus / 中国综合临床

Objective To investigate the relationship between perinatal outcome and weight gain of pregnant women with gestational diabetes mellitus (GDM).Methods Ninety-two cases pregnant women with GDM were collected.The rate of weight increasing was recorded throughout the pregnancy and body mass index (BMI) was calculated.Based on the amplitude of packets of body weight increasing,24 cases was selected during pregnancy as insufficient weight gain group,suitable weight gain group of 42 cases,and excessive weight gain group of 26 cases.Their perinatal outcome were compared.Results In excessive weight gain group,the proportion of the gestational hypertension (19.23％) and postpartum hemorrhage (23.07％) were significantly higher than suitable weight gain group and insufficient weight gain group(7.14％,8.33％ and 4.76％,4.17％),the differences were statistically significant (x2 =8.132,10.453,P ＜ 0.001).Among the three groups,no significant difference was found in terms of the incidence of anemia (3.85％,4.76％,4.17％),preterm labor (7.69％,7.14％,8.33％),premature rupture of membranes (11.54％,11.90％,12.50％) in pregnancy (P2 =0.572,0.492,0.212,P=0.63 1,0.692,0.783).The huge birth weight children rate in excessive weight gain group(15.38％) was significantly higher than suitable weight gain group and insufficient weight gain group (4.76％ and 4.17％).Among three groups,no significant difference was found in terms of the fetal distress (15.38％,16.67％,12.50％) and proportion of low birth weight children (3.85％,4.76％,4.17％) (P2 =1.034,0.572,P =0.310,0.631).Conclusion Excessive weight gain during pregnancy in GDM patients will significantly increase the gestational hypertension,the incidence of huge children and postpartum hemorrhage.Therefore,patients should be closely monitored during pregnancy weight and timely taken intervention.

Acupuntura y masaje: auxiliar en el tratamiento de pacientes con hipertension y diabetes en el Ejido Cuitláhuac de Tacotalpa / Acupuncture and massage: aid in the treatment of patients with hypertension and diabetes in Ejido Cuitláhuac Tacotalpa / Acupuntura e massagem: ajuda no tratamento de pacientes com hipertensão e diabetes em Ejido Cuitláhuac Tacotalpa

ResumenIntroducción.En enfermería ha destacado la inclusión de medicina tradicional y alternativa como disciplina para prevenir, diagnosticar, tratar y rehabilitar al paciente con técnicas de masaje y acupuntura. En la revista Salud Mundial la OMS enlista enfermedades que pueden ser tratadas con dicha medicina, disminuyendo las repercusiones de patologías que ocupan los primeros lugares de morbimortalidad en México. Objetivo.Conocer si la acupuntura y el masaje son tratamientos alternativos auxiliares en la HTA y DM2 en usuarios del centro de salud de Cuitláhuac, Tacotalpa, Tab.Método. Estudio cuantitativo, transversal, cuasiexperimental, en 28 pacientes con DM2 y HTA, conmediciones antes y después del tratamiento alternativo.Resultado.Con el tratamiento alternativo, la glicemia bajó de 131 a 124 mg y la presión arterial de 140/79 a 123/83 mmHg (p ≤ 0.05).Conclusión.La acupuntura y masajemuestran ser auxiliares altratar enfermedades crónicas, no se cuenta con resultados más específicos en población indígena mexicana y es necesario realizar estudios con diseños más robustos para determinar su eficacia.

AbstractIntroduction.Nursing has highlighted the inclusion of traditional and alternative medicine as a discipline to prevent, diagnose, treat and rehabilitate the patient with acupuncture and massage techniques. In the WHO Global Health magazine lists diseases that can be treated with this medicine, reducing the impact of diseases that are at the top of morbidity and mortality in Mexico. Objective. Know if acupuncture and massage are alternative treatments aids in hypertension and DM2 users Cuitláhuac health center, Tacotalpa, Tab.Method.Quantitative, transversal, quasi-experimental, in 28 patients with type 2 diabetes and hypertension, with measurements before and after alternative treatment study.Result. With alternative treatment, blood glucose levels dropped from 131 to 124 mg and blood pressure of 140/79 to 123/83 mmHg (p ≤ 0.05).Conclusion. Acupuncture and massage shown to be ancillary to treat chronic diseases, do not have more specific results in Mexico's indigenous population and studies are needed with more robust designs for their effectiveness.

ResumoIntrodução.Enfermagemdestacou a inclusão da medicinatradicional e alternativacomoumadisciplinaparaprevenir, diagnosticar, tratar e reabilitar o paciente com técnicas de acupuntura e massagem. Na revista WHO Global Health lista de doençasquepodemsertratadascomestemedicamento, reduzindo o impacto de doençasqueestão no topo de morbidade e mortalidade no México. Objectivo. Saber se aacupuntura e massagemsãoajudartratamentosalternativosnahipertensão e usuários de DM2 centro de saúdeCuitláhuac, Tacotalpa, Tabasco.Método. Quantitativa, transversal, quasi-experimental, em 28 pacientes com diabetes tipo 2 e hipertensão, com medições antes e depois de estudo de tratamentoalternativo.Resultado. Com tratamentoalternativo, osníveis de glicose no sanguecaiu de 131 para 124 mg e pressão arterial de 140/79 a 123/83 mmHg (p ≤ 0,05).Conclusão.Acupuntura e massagemdemonstrouserauxiliar no tratamento de doençascrônicas, nãotêmresultadosmaisespecíficosemestudospopulacionais e indígenas do México sãonecessárioscomdesenhosmaisrobustospara a suaeficácia.

Effect of age on prognosis of hepatocellular carcinoma patients with diabetes mellitus: A propensity-score matching analysis / 第二军医大学学报

Objective To explore the effect of age on prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) complicated with diabetes mellitus (DM) after radical resection. Methods The clinical data of 250 patients with HBV-related HCC complicated with DM who received radical resection were collected from the First Affiliated Hospital of Nanchang University and the Eastern Hepatobiliary Surgery Hospital and were retrospectively analyzed. The patients aged 30-80 years old and were divided into the elder group (≥60 years n=58) and the non-elder group (<60 years, n=192). Propensity score matching (PSM) method was used for covariate balance and the overall survival (OS) rates were compared between the two groups. Cox regression was used to analyze the risk factors influencing the prognosis of HCC. Results In the PSM cohort (n=53 in elder group, n=85 in non-elder group), the 1-, 3-, 5-year OS rates were not significantly different between the two groups (P =0. 15). The results of Cox multivariate regression analysis revealed that age was not significantly associated with OS of patients with HBV-related HCC complicated with DM. Conclusion Elder age seems not to decrease the OS of patients with HBV-related HCC complicated with DM after radical resection; elder patients can obtain similar survival as the non-elder ones.

The relationship between estrogen levels and carotid atherosclerosis in postmenopausal women with type 2 diabetes / 中国基层医药

Objective To observe the correlation of estrogen,fasting insulin(FINS),fasting plasma glucose (FPG),glycosylated hemoglobin(HbA1c),blood lipids and carotid arteries -membrane thickening(IMT)in the postmenopausal women with type 2 diabetes.Methods 63 postmenopausal women with type 2 diabetes were divided into normal IMT group(group A),IMT thickening group(group B),plaque group(group C)according to the vascular ultrasound carotid artery intima thickness,at the same time 15 cases of healthy physical examination as control group (group D).All of the groups were detected the plasma total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),fasting plasma glucose(FPG),gly-cosylated hemoglobin(HbA1c),follicle-stimulating hormone(FSH),estradiol(E2).Results Compared with group A,the levels of FINS,IR,HbA1c,TC,LDL-C in group C was higher(t=16.83,14.44,2.50,2.38,2.42,all P<0.01 or P<0.05),however,the results of E2,HDL-C was decreased(t=7.32,5.51,all P<0.01).The levels of FINS,HbA1c,TC,LDL-C,FSH,IR in group D was lower than those of group C(t=19.74,36.44,8.64,7.95, 27.13,6.71,all P<0.01),On the contrast,the levels of HDL-C,E2 were elevated(t=11.34,8.72,all P<0.01). The Pearson's correlation analysis showed that E2 had negative correlation with FINS,IR,TC,LDL-C (P<0.01 or P<0.05).E2 had positive correlation with HDL-C(P<0.05).Logistic regression analysis showed that IMT and FINS,IR,HbA1c,LDL-C were positively correlated(OR=2.94,72.63,27.30,98.18,all P<0.01),while nega-tively correlated with E2 levels(OR=2.94,P<0.01).Conclusion The increased level of estrogen was a protective factor of carotid artery atherosclerosis in postmenopausal women with type 2 diabetes.

Relationship between hOGG1 gene Ser326 Cys polymorphism and severity of coronary artery lesions in patients with diabetes mellitus / 中国病理生理杂志

[ABSTRACT]AIM:Tostudytherelationshipbetweenhuman8-oxoguanineglycosylase1(hOGG1)gene Ser326Cys polymorphism and severity of coronary artery lesions in the patients with diabetes mellitus .METHODS: We retrospectively analyzed 323 patients with diabetic mellitus receiving coronary angiography .These patients underwent the test of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and were divided into Cys/Cys genotype (n=85), Ser/Ser genotype (n=121) and Ser/Cys genotype (n=117) according to the results of PCR-RFLP. All clinical data including history of diseases , complications and biochemical markers , such as blood glucose , blood lipids and so on, were recorded.hOGG1 mRNA and 8-hydroxydeoxyguanosine (8-OHdG) were measured by RT-PCR and ELISA, respectively.The results of coronary angiography such as number and severity of coronary artery with lesions were analyzed by 2 cardiovascular physicians .Gensini score and SYNTAX score were also detected by the unitary criteria .RE-SULTS:(1)8-OHdG in Cys/Cys genotype was higher than that in Ser /Ser genotype and Ser/Cys genotype (P0.05).(2)hOGG1 mRNA ex-pression in Cys/Cys genotype was lower than that in Ser/Ser genotype and Ser/Cys genotype (P0.05) was observed.(3)The probability of triple vessel lesions in Cys/Cys genotype was high and the probability of single vessel lesions in Ser /Cys genotype was low , but the difference among 3 genotypes was not statistically significant (P>0.05).(4)Gensini score and SYNTAX score in Cys/Cys genotype were 48.7 ±15.3 and 39.5 ±17.2, respectively, and the ratio of complex lesions in Cys/Cys genotype was 73.0%.These scores and the ratio of complex lesions were higher than the other 2 genotypes (P0.05).CONCLUSION:hOGG1 gene Ser326Cys polymorphism has relationship with coronary artery lesions in the patients with diabetes mellitus and Cys /Cys genotype might have some impacts on the severity of lesions .The mRNA expression of hOGG1 in the patients with diabetes mellitus carrying Cys/Cys genotype is lower than that in the patients carrying the other 2 genotypes , then decreases the abil-ity of identification and removal of 8-OHdG and the capacity of repairing DNA oxidative damage , and accelerates the devel-opment of atherosclerosis .

Factors affecting mean blood glucose level of newly diagnosed type 2 diabetes pa-tients / 中国病理生理杂志

AIM:TodetecthemoglobinA1c(HbA1c)andparametersofbloodglucosefluctuationinChinesenewlydiag-nosed type 2 diabetes mellitus (T2DM) patients, and further to specify the factors that were related to mean blood glucose (MBG) in this population.METHODS:Newly diagnosed T2DM patients (n=90) from 4 hospitals in Guangdong province were enrolled, and subjected to 3 d continuous glucose monitoring (CGM) after testing for HbA1c and other laboratory tests.Blood glucose data collected during CGM were used to calculate MBG and parameters of blood glucose fluctuation.RESULTS: Correlation analysis revealed that MBG was significantly related to all parameters of blood glucose fluctuation, HbA1c, fast plasma glucose ( FPG) and 2 h postprandial glucose (P<0.01), but not to sex, age or blood lipid profile.Further analysis utilizing step-wise general linear model showed that HbA1c, absolute means of daily difference ( MODD) , difference between maximal and minimal glucose ( DMMG) and FPG had the strongest relation to MBG.CONCLUSION: Factors affecting MBG of the newly diagnosed T2DMpatients in our country include HbA1c, FPG, DMMG and MODD, and thus it may be prone to misleading results that only HbA1c is applied to estimate MBG in this population.

Effects of puerarin combined with saxagliptin on renal fibrosis in type 2 diabetic rats / 中国病理生理杂志

[ABSTRACT]AIM:Toobservetheeffectsofpuerarincombinedwithsaxagliptinonrenalfibrosisintype2dia-betic rats.METHODS:Fifty male Wistar rats were used, of which 8 rats were randomly chosen as normal control group , and the remaining rats were used to establish the type 2 diabetic model.The rats that met the criterion for the diabetic mo-del were randomly divided into model group , puerarin treatment group , saxagliptin treatment group , puerarin combined with saxagliptin treatment group and metformin combined with saxagliptin treatment group .The above-mentioned drugs were ad-ministered for 8 weeks.After that period, all rats were sacrificed.The kidney index (kidney weight/body weight),and blood glucose and HbA1c were examined in all the rats.The morphological changes were observed by HE and Masson stai-ning.The levels of TNF-αand macrophage migration inhibitory factor (MIF) in the serum were measured by ELISA .The mRNA expression of TNF-α, MIF and CD68 was examined by RT-PCR.RESULTS: Compared with normal group , the kidney index, blood glucose and HbA1c, the levels of TNF-αand MIF in the serum and the mRNA expression of TNF-α, MIF and CD68 were increased (P<0.05) in the kidney tissues of model group .Compared with model group , the kidney index, blood glucose and HbA1c, the levels of MIF and TNF-αin the serum and the mRNA expression of TNF-α, MIF and CD68 were decreased ( P<0.05) in puerarin combined with saxagliptin treatment group .CONCLUSION:Puerarin com-bined with saxagliptin reduces blood glucose , decreases MIF and TNF-α, and down-regulates the mRNA expression of TNF-α, MIF and CD68 in the kidney tissues of type 2 diabetic rats, which may contribute to the inhibition of renal fibrosis .

Study on the risk values of glycated hemoglobin in diabetes mellitus and pre-diabetes / 中华检验医学杂志

Objective To study the risk values of glycosylated hemoglobin ( HbA1c) screening patients with diabetes mellitus(DM) and pre-diabetes(PreD) in different age and sex.Methods HbA1c results from10 840 in Taizhou Hospital in 2012 were retrospectively collected , and CHAID analysis of decision tree was used in preliminary hierarchy .Age was further divided into five groups according to the preliminary results , then one-way ANOVA and linear regression were utilized to determine the differences between age groups and the prediction intervals (PI) of HbA1c,respectively.The upper limit value of 95%PI of HbA1c was set as diabetes risk values ( DRVs).By comparison of the sensitivity of DM patients screening by DRVs in 1 889 cases whose HbA1c were between 6.0%to 6.5%and the upper limit value of traditional HbA1c reference intervals to verify the screening value ofDRVs .Then the DRVs of HbA1c were utilized to screen DM in the population whose HbA 1c is were 6.0%-6.5% in 2008,and followed their re-examination records toverify the screening value of the DRVs toin PreD patients. Results (1) On the basis of the initially root of decisiontree by age , the populationwas divided into 9 groups ( P =0.000, F =231.462).By calculatingthe 95% confidence interval(CI) of each group and merging reasonably,it was finally divided into 5 groups:20-30years,31-40years,41-50years,51-60years and >60years (F=434.342, P=0.000).(2)Using the method of linear regression , the 95% PI of HbA1c of the 5 groups showed as following:20-30 years, males 4.6%-5.9%, females 4.6%-5.9%.31-40 years, males 4.8%-6.0%, females 4.7%-6.0%.41-50 years, males 4.9%-6.2%, females 4.8%-6.1%.51-60 years, males 5.0%-6.3%, females 4.9%-6.2%.>60 years, males 5.1%-6.4%, females 5.0%-6.3%.The traditional HbA1c reference interval was4.8%-6.3%.(3) The screening sensitivity of DM by the upper limit value of traditional HbA1c reference interval and DRVs in group which HbA1c was between 6.0%-6.5% were 34.5%and 48.1%,respectively.(4) Reviewing of the group with HbA1c between 6.0%-6.5% and not diagnosed as DM in 2008, 49 hadnegative DM screening results by using the upper limit value of traditional HbA1c reference interval but were positive in our setting DRVs , and 13 have developed to DM now , which accounted for 26.5%.Conclusion HbA1c DRVs need to be set hierarchically between different age and sex groups as a supplement to the traditional reference interval , which has a great significance for the diagnosis and treatment of DM and also forthe screening and intervention of PreD patients.

Changes of urodynamics in female patients with diabetic cystopathy / 中华全科医师杂志

Objective To evaluate the changes of urodynamics in female patients with diabetic cystopathy.Methods Fifty six female patients with diabetic cystopathy were enrolled in the study , including 31 cases with diabetic course <15 years ( groupⅠ) and 25 cases with diabetic course ≥15 years ( group Ⅱ) .Urodynamic examination was performed in all patients and the urodynamic parameters were compared between two groups.Results The average residual urine volume , the volume of first bladder sensation and the max bladder capacity in groups ⅠandⅡwere (35 ±16)ml and (65 ±24) ml,(220 ± 76)ml and (330 ±88) ml, (380 ±92) ml and (580 ±122) ml, respectively; 3 out 31 and 16 out of 25 patients in groups Ⅰ and Ⅱ showed low compliance .The above indexes between two groups were statistically significant ( P<0.01).Conclusion Urodynamics can indicate the severity of functional damage of urinary bladder in patients with diabetic cystopathy .