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1.
Braz. j. biol ; 84: e252952, 2024. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1355913

ABSTRACT

Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-"B" & "O", blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetic's patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.


Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados ​​para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados ​​pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos "B" e "O", sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.


Subject(s)
Humans , Rh-Hr Blood-Group System , Diabetes Mellitus/epidemiology , Pakistan/epidemiology , ABO Blood-Group System , Cities
2.
Arq. bras. oftalmol ; 86(1): 27-32, Jan.-Feb. 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1403483

ABSTRACT

ABSTRACT Purpose: To evaluate the relationship between subfoveal choroidal thickness and plasma asymmetrical dimethylarginine level and the severity of diabetic retinopathy in patients with type 2 diabetes mellitus. Methods: A total of 68 cases, including 15 patients without diabetic retinopathy, 17 patients with nonproliferative diabetic retinopathy, 16 patients with type 2 diabetes mellitus and proliferative diabetic retinopathy, and 20 healthy patients (control group), were enrolled in this study. Subfoveal choroidal thickness was measured manually using the enhanced depth imaging optical coherence tomography scanning program, and plasma asymmetrical dimethylarginine level was measured using a commercial micro enzyme-linked immunosorbent assay kit. Results: The subfoveal choroidal thickness values and plasma asymmetrical dimethylarginine levels were significantly different between the four groups (p<0.001 and p<0.001). The subfoveal choroidal thickness values were significantly lower in the proliferative diabetic retinopathy group than in the other three groups (no diabetic retinopathy, nonproliferative diabetic retinopathy, and control groups; p<0.001, p=0.045, and p<0.001, respectively). The plasma asymmetrical dimethylarginine levels were significantly higher in the proliferative diabetic retinopathy group than in the other three groups (p<0.001, p<0.04, and p<0.001, respectively). In addition, a significant negative correlation was also found between plasma asymmetrical dimethylarginine level and subfoveal choroidal thickness (p<0.001, r=-0.479). Conclusion: Asymmetrical dimethylarginine is an important marker of endothelial dysfunction and endogenous endothelial nitric oxide synthase inhibitor. The severity of diabetic retinopathy was related to increased plasma asymmetrical dimethylarginine level and reduced subfoveal choroidal thickness in type 2 diabetic patients with diabetic retinopathy.


RESUMO Objetivo: Avaliar a relação da espessura subfoveal da coroide e dos níveis plasmáticos de dimetil-arginina assimétrica com a gravidade da retinopatia diabética em pacientes com diabetes mellitus tipo 2. Métodos: Foram incluídos 68 casos, compreendendo 15 pacientes sem retinopatia diabética, 17 pacientes com retinopatia diabética não proliferativa, 16 pacientes com retinopatia diabética proliferativa, e 20 casos saudáveis (grupo de controle). A espessura subfoveal da coroide foi medida manualmente, usando o programa de varredura com tomografia computadorizada óptica com imagem profunda aprimorada, e os níveis plasmáticos de dimetil-arginina assimétrica foram medidos usando um kit microELISA comercial. Resultados: Os valores da espessura subfoveal da coroide e os níveis plasmáticos de dimetil-arginina assimétrica foram significativamente diferentes nos quatro grupos (p<0,001 para ambos os parâmetros). Os valores da espessura subfoveal da coroide foram significativamente menores no grupo com retinopatia diabética proliferativa do que nos outros três grupos (sem retinopatia diabética, retinopatia diabética não proliferativa e grupo de controle, com p<0,001, p=0,045 e p<0,001, respectivamente). Já os níveis plasmáticos de dimetil-arginina assimétrica foram significativamente maiores no grupo com retinopatia diabética proliferativa do que nos outros três grupos (p<0,001, p=0,04 e p<0,001, respectivamente). Além disso, também foi encontrada uma correlação negativa significativa entre os níveis plasmáticos de dimetil-arginina assimétrica e a espessura subfoveal da coroide (p<0,001, r=-0,479). Conclusão: A dimetil-arginina assimétrica é um importante marcador de disfunção endotelial e um inibidor endógeno da óxido nítrico sintase. Foi encontrada uma relação da gravidade da retinopatia diabética e de níveis elevados de dimetil-arginina assimétrica no plasma com a redução da espessura subfoveal da coroide em pacientes diabéticos tipo 2 com retinopatia diabética.

3.
Braz. j. biol ; 83: e250179, 2023. graf
Article in English | LILACS, VETINDEX | ID: biblio-1339372

ABSTRACT

Abstract Diabetes mellitus (DM) is a non-communicable disease throughout the world in which there is persistently high blood glucose level from the normal range. The diabetes and insulin resistance are mainly responsible for the morbidities and mortalities of humans in the world. This disease is mainly regulated by various enzymes and hormones among which Glycogen synthase kinase-3 (GSK-3) is a principle enzyme and insulin is the key hormone regulating it. The GSK-3, that is the key enzyme is normally showing its actions by various mechanisms that include its phosphorylation, formation of protein complexes, and other cellular distribution and thus it control and directly affects cellular morphology, its growth, mobility and apoptosis of the cell. Disturbances in the action of GSK-3 enzyme may leads to various disease conditions that include insulin resistance leading to diabetes, neurological disease like Alzheimer's disease and cancer. Fluoroquinolones are the most common class of drugs that shows dysglycemic effects via interacting with GSK-3 enzyme. Therefore, it is the need of the day to properly understand functions and mechanisms of GSK-3, especially its role in glucose homeostasis via effects on glycogen synthase.


Resumo O diabetes mellitus (DM) é uma doença não transmissível em todo o mundo, na qual existe nível glicêmico persistentemente alto em relação à normalidade. O diabetes e a resistência à insulina são os principais responsáveis ​​pelas morbidades e mortalidades de humanos no mundo. Essa doença é regulada principalmente por várias enzimas e hormônios, entre os quais a glicogênio sintase quinase-3 (GSK-3) é uma enzima principal e a insulina é o principal hormônio que a regula. A GSK-3, que é a enzima-chave, normalmente mostra suas ações por vários mecanismos que incluem sua fosforilação, formação de complexos de proteínas e outras distribuições celulares e, portanto, controla e afeta diretamente a morfologia celular, seu crescimento, mobilidade e apoptose do célula. Perturbações na ação da enzima GSK-3 podem levar a várias condições de doença que incluem resistência à insulina que leva ao diabetes, doenças neurológicas como a doença de Alzheimer e câncer. As fluoroquinolonas são a classe mais comum de drogas que apresentam efeitos disglicêmicos por meio da interação com a enzima GSK-3. Portanto, é necessário hoje em dia compreender adequadamente as funções e mecanismos da GSK-3, principalmente seu papel na homeostase da glicose via efeitos na glicogênio sintase.


Subject(s)
Humans , Insulin Resistance , Diabetes Mellitus , Glycogen Synthase Kinase 3 , Glucose , Homeostasis
4.
Rev. enferm. UERJ ; 30: e64079, jan. -dez. 2022.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1371649

ABSTRACT

Objetivo: comparar o comportamento glicêmico dos pacientes em pós-operatório de cirurgia cardíaca valvar e de revascularização do miocárdio, submetidos ao mesmo protocolo de controle glicêmico, e avaliar a incidência de hipoglicemia e mortalidade intra-hospitalar dessa população. Método: estudo de coorte, retrospectivo, quantitativo, que avaliou 354 prontuários de cirurgias realizadas em 2016. Resultados: pacientes revascularizados apresentaram maiores médias glicêmicas (149,14±36,03), maior uso de insulina e coeficiente de variação (23,30%). Entretanto, a incidência de hipoglicemia foi maior entre valvares (35,32%), mais acometidos por lesão renal aguda (6,58%), terapia de substituição renal (11,97%) e mortalidade hospitalar (6,58%). Conclusão: evidenciou-se uma população heterogênea com desfechos clínicos que caracterizaram os valvares como mais criticos, devido a maior número de portadores de fibrilaçao atrial, maior tempo de CEC, e maior uso de vasoaminas e corticosteroides. Logo, é necessário conhecer as particularidades de cada população, para gerenciar protocolos específicos de controle glicêmico para diferentes perfis epidemiológicos.


Objective: to compare the glycemic behavior of patients in the postoperative period of valve heart surgery and myocardial revascularization, submitted to the same glycemic control protocol and to assess the incidence of hypoglycemia and mortality and in-hospital mortality in this population. Method: cohort, retrospective, quantitative study that evaluated 354 medical records of surgeries performed in 2016. Results: revascularized patients had higher blood glucose means (149,14±36.03), greater use of insulin and higher coefficient of variation (23.30%). However, the incidence of hypoglycemia was higher (35.32%) valve patients, more affected by acute kidney injury (6.58%), renal replacement therapy (11.97%) and hospital mortality (6.58%). Conclusion: a heterogeneous population with clinical outcomes that characterized the valves as more critical, due to a greater number of patients with atrial fibrillation, longer CEC time, and greater use of vasoamines and corticosteroids. It is necessary to know the particularities of each population, in order to manage specific glycemic control protocols for different epidemiological profiles.


Objetivo: comparar el comportamiento glucémico de pacientes en postoperatorio de cirugía valvular y revascularización miocárdica, sometidos al mismo protocolo de control glicémico y evaluar la incidencia de hipoglucemia y mortalidad hospitalaria en esta población. Método: estudio de cohorte, retrospectivo, cuantitativo que evaluó 354 historias clínicas, entre agosto y octubre de 2020, de cirugías realizadas en 2016. Resultados: pacientes revascularizados presentaron mayores medias de glucemia (149,14±36,03), mayor uso de insulina y mayor coeficiente de variación (23,30%). Aunque, la incidencia de hipoglucemia fue mayor (35,32%) entre las válvulas, que se vieron más afectadas por daño renal agudo (6,58%), terapia de reemplazo renal (11,97%) y mortalidad hospitalaria (6,58%). Conclusión: el estudio mostró una población heterogénea con resultados clínicos que caracterizaron a las válvulas como más críticas, debido a un mayor número de pacientes con fibrilación auricular, mayor tiempo de CEC y mayor uso de vasoaminas y corticoides. Por tanto, es necesario conocer las particularidades de cada población, para gestionar el control glucémico con protocolos específicos para diferentes perfiles epidemiológicos.

5.
Braz. j. oral sci ; 21: e225337, jan.-dez. 2022. ilus
Article in English | LILACS, BBO | ID: biblio-1366230

ABSTRACT

Aim: To elaborate and validate an instrument for Brazilian Portuguese speakers, to assess dentists' knowledge about care of patients with diabetes mellitus (Dental-Diabetes). Methods: Methodological study comprising four stages: a) Elaboration of instrument; b) Content validation (computing Content Validity Index - CVI) based on Expert Committee assessment; c) Pre-test with 30 dentists, followed by assessment of suggestions by Expert Committee; d) Psychometric validation through instrument application in a sample of 127 dentists by means of the web tool e-Surv. Cronbach's alpha and intraclass correlation coefficients were used to evaluate, respectively, internal consistency and reproducibility. Results: The final version of the instrument consists of 22 questions (7 on sociodemographic data and 15 querying dentists' knowledge) and those submitted for validation attained a CVI of 0.95 [95% CI 0.916-0,981], showing satisfactory internal consistency, with 0.794 Cronbach's alpha [95% CI 0.741-0.842] and an intraclass correlation coefficient of 0.799 [95% CI: 0.746-0.846] between the test and retest scores. Conclusions: Dental-Diabetes is a comprehensive instrument, culturally adequate and validated to assess dentists' knowledge about care of patients with diabetes


Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Dentists , Diabetes Mellitus , Psychometrics , Reproducibility of Results
6.
Rev. Univ. Ind. Santander, Salud ; 54: e321, Dec. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1407020

ABSTRACT

Abstract Introduction and objective: In Colombia, Dipeptidyl-Peptidase IV (DPP4) inhibitors are recommended as second-best choice for type 2 diabetes mellitus treatment. However, no evaluation of the accomplishment or impact of this recommendation was performed. The objective was to determine the prescription of the DPP4 inhibitor according to the Colombian Clinicial Practice Guide regarding type 2 diabetes mellitus treatment, and its effects on glycosylated hemoglobin (HbAlc). Materials and methods: A descriptive study that included patients with type 2 diabetes mellitus who attended a first level between 2016 and 2018, had a prescription for DPP4 inhibitor and at least two control appointments. Variables included were sociodemographic, clinics, treatment and comorbidities. The unadjusted prescription was defined as the lack of accomplishment of Colombian guidelines. Descriptive statistics and X2 test were used for the comparison of categorical variables. A binary logistic regression model was applied. Results: 112 out of 207 patients accomplished inclusion criteria, of which 77 were women (68.8%). Also, 68.8% of the patients had an unadjusted prescription of the iDPP4. There was a 0.21% total reduction in HbA1c levels, with a mean of 198.2 ± 124 days between the first and second control measurement (reduction of 0.55% when the prescription was adjusted to the guidelines and 0.05% if it was unadjusted). Conclusion: There is a limited impact of DPP4 inhibitors regarding the reduction of HbA1c and metabolic control, and there is a slight follow-up to the Colombian guidelines in patients who attend a first level.


Resumen Introducción y Objetivo: En Colombia se recomiendan los inhibidores de la Dipeptidil Peptidasa-IV (iDPP4) como segunda opción para el manejo de la diabetes mellitus tipo 2. No se ha evaluado el cumplimiento e impacto de esta recomendación. Como objetivo se buscó determinar la prescripción de los iDPP4 según las recomendaciones de la Guía de Práctica Clínica colombiana, y su efecto sobre la hemoglobina glicosilada (HbA1c). Materiales y métodos: Estudio descriptivo que incluyó pacientes con diabetes mellitus tipo 2 que consultaron a un primer nivel entre 2016 y 2018, y tenían formulado un iDPP4, con al menos dos consultas de seguimiento. Se incluyeron variables sociodemográficas, clínicas, tratamiento y comorbilidades. La prescripción no ajustada se definió como la falta de cumplimento de la recomendación de la guía colombiana. Se empleó estadística descriptiva y pruebas X2 para la comparación de variables categóricas. Se aplicó un modelo de regresión logística binaria. Resultados: Hubo 207 pacientes de los cuales 112 cumplieron criterios de inclusión, 77 eran mujeres (68,8%). El 68,8% de los pacientes presentaron una prescripción no ajustada del iDPP4. Hubo una reducción total de 0,21%, con una media de 198,2±124 días entre la primera y segunda medición de HbA1c de control (reducción de 0,55% cuando la prescripción se ajustaba a la guía colombiana y 0,05% cuando no). Conclusión: Hay un limitado impacto de los iDPP4 frente a la reducción de HbA1c y poco seguimiento de la guía colombiana en pacientes de primer nivel de atención.

7.
Säo Paulo med. j ; 140(6): 818-828, Nov.-Dec. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1410223

ABSTRACT

Abstract BACKGROUND: Chronically elevated alpha-2-macroglobulin (A2MG) in the blood has been correlated with diabetes and the HbA1c profile; however, no systematic review has been conducted to evaluate the association of A2MG salivary levels and glycemia or HbA1c levels in diabetes mellitus type 2 (DM2) patients. OBJECTIVE: To evaluate whether A2MG salivary levels are related to the glycemia or HbA1c levels in DM2 patients. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia (UFU), Brazil. METHODS: Eight databases were used as research sources. The eligibility criteria included studies that reported data regarding mean salivary A2MG and the correlation between glycemia and/or HbA1c levels of DM2 subjects (uncontrolled and well-controlled) and non-diabetic subjects. The risk of bias of the studies selected was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for use in JBI systematic reviews. Pooled correlation coefficients were estimated using the Hunter-Schmidt method. Study estimates were weighted according to their sample size, and heterogeneity was calculated using the chi-square statistic. RESULTS: Four studies on DM2 patients were included in this systematic review after careful analysis of 1482 studies. Three studies compared A2MG with HbA1c and glycemia. Overall, the correlation between A2MG and HbA1c was strong (r = 0.838). In contrast, the correlation between A2MG and glycemia was low (r = 0.354). CONCLUSION: The strong association between HbA1C and salivary A2MG suggests that this salivary protein has the potential to be a surrogate for HbA1C, if corroboratory further evidence is obtained through large-scale studies.

8.
Säo Paulo med. j ; 140(6): 767-774, Nov.-Dec. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1410227

ABSTRACT

ABSTRACT BACKGROUND: Albuminuria is a risk factor for microvascular and macrovascular complications in the diabetic population. However, few studies have correlated poor glycemic control and albuminuria prevalence in Hispanic populations. OBJECTIVE: To evaluate the association between glycemic control and albuminuria among Peruvian adults with type 2 diabetes mellitus (T2DM). DESIGN AND SETTING: Cross-sectional analytical study among adults with T2DM in Lima, Peru. METHODS: We included adults over 18 years old who were in a clinical follow-up program at a private clinic in Lima in 2018. Poor glycemic control was defined as a serum value of glycosylated hemoglobin A1C (HbA1C) ≥ 7%. Albuminuria was defined as albumin values > 30 mg/dl in the first morning urine. We generated generalized linear regression models from the Poisson family with robust variance. We calculated the crude and adjusted prevalence ratios (PRs) with their 95% confidence interval (CI). RESULTS: We analyzed 907 participants of median age 58 years (interquartile range, IQR 49 to 66), and 62.8% were males. The prevalence of poor glycemic control was 39.8%, and the prevalence of albuminuria was 22.7%. The prevalences of albuminuria in groups with poor glycemic control and adequate glycemic control were 32.7% and 16.1%, respectively. In the adjusted regression analysis, we found a statistically significant association between poor glycemic control and albuminuria (annual percentage rate, aPR = 1.70; 95% CI: 1.28-2.27). CONCLUSIONS: The prevalence of poor glycemic control and albuminuria was high in our study population. Moreover, Peruvian T2DM adults with poor glycemic control were more likely to have albuminuria.

9.
J. Health Biol. Sci. (Online) ; 10(1): 1-5, 01/jan./2022.
Article in English | LILACS | ID: biblio-1411471

ABSTRACT

Objectives: the aim of this study was to evaluate the effects of the association of dry extracts of Astragalus membranaceus, Peumus boldus and Curcuma longa in rats with induced diabetes. Methods: After the induction of type 2 diabetes by intraperitoneal streptozotocin, male Wistar rats were randomly assigned to groups (n=6) and treated for 20 days. The extracts were suspended in water and administered through orogastric gavage once daily as described: Group I: healthy control (saline); group II: received Astragalus membranaceus, Peumus boldus and Curcuma longa (400 mg/kg/day of each dry extract); group III: received Astragalus membranaceus, Peumus boldus, Curcuma longa (400 mg/kg/day of each dry extract) and glibenclamide (15 mg/kg/day). Fasting glucose, glucose tolerance, alanine aminotransferase, aspartate aminotransferase and fructosamine were evaluated. Results: Fasting blood glucose and glucose tolerance for groups II and III were influenced by treatments (p<0.05). The extracts did not significantly influence the efficacy of glibenclamide. Conclusion: The results found in this study allow us to consider that it is not possible to conclude that the compounds evaluated are not effective in DM in rats, due to variables such as total treatment period, doses, size of pancreatic injury caused by streptozotocin, and diet profile may have influenced the results. The studied compounds have potential for application in diabetes and further studies should be carried out to adjust the treatment.


Objetivos: avaliar os efeitos da associação de extratos secos de Astragalus membranaceus, Peumus boldus e Curcuma longa em ratos com diabetes induzida. Métodos: Após a indução de diabetes tipo 2 (DM) por estreptozotocina intraperitoneal, ratos Wistar machos foram distribuídos aleatoriamente em grupos (n=6) e tratados por 20 dias. Os extratos foram suspensos em água e administrados por gavagem orogástrica uma vez ao dia conforme descrito: Grupo I: controle saudável (solução salina); grupo II: recebeu Astragalus membranaceus, Peumus boldus e Curcuma longa (400 mg/kg/dia de cada extrato seco); grupo III: receberam Astragalus membranaceus, Peumus boldus, Curcuma longa (400 mg/kg/dia de cada extrato seco) e glibenclamida (15 mg/kg/dia). A glicemia de jejum, tolerância à glicose, alanina aminotransferase, aspartato aminotransferase e frutosamina foram avaliados. Resultados: A glicemia de jejum e a tolerância à glicose para os grupos II e III foram influenciadas pelos tratamentos (p<0,05). Os extratos não influenciaram significativamente na eficácia da glibenclamida. Conclusão: Os resultados encontrados neste estudo permitem considerar que não é possível concluir que os compostos avaliados não são eficazes no DM em ratos, devido às variáveis como tempo total de tratamento, doses e tamanho da lesão pancreática causada por estreptozotocina, além do perfil da dieta, que podem ter influenciado os resultados. Os compostos estudados têm potencial para aplicação em diabetes e mais estudos devem ser realizados para adequar o tratamento.


Subject(s)
Astragalus propinquus , Blood Glucose , Streptozocin , Fructosamine , Curcuma , Peumus , Diabetes Mellitus , Alanine Transaminase
10.
Arch. endocrinol. metab. (Online) ; 66(6): 883-894, Nov.-Dec. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403256

ABSTRACT

ABSTRACT The management of diabetes mellitus (DM) requires maintaining glycemic control, and patients must keep their blood glucose levels close to the normal range to reduce the risk of microvascular complications and cardiovascular events. While glycated hemoglobin (A1C) is currently the primary measure for glucose management and a key marker for long-term complications, it does not provide information on acute glycemic excursions and overall glycemic variability. These limitations may even be higher in some special situations, thereby compromising A1C accuracy, especially when wider glycemic variability is expected and/or when the glycemic goal is more stringent. To attain adequate glycemic control, continuous glucose monitoring (CGM) is more useful than self-monitoring of blood glucose (SMBG), as it is more convenient and provides a greater amount of data. Flash Glucose Monitoring (isCGM /FGM) is a widely accepted option of CGM for measuring interstitial glucose levels in individuals with DM. However, its application under special conditions, such as pregnancy, patients on hemodialysis, patients with cirrhosis, during hospitalization in the intensive care unit and during physical exercise has not yet been fully validated. This review addresses some of these specific situations in which hypoglycemia should be avoided, or in pregnancy, where strict glycemic control is essential, and the application of isCGM/FGM could alleviate the shortcomings associated with poor glucose control or high glycemic variability, thereby contributing to high-quality care.

11.
Arq. bras. oftalmol ; 85(6): 572-577, Nov.-Dec. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1403456

ABSTRACT

ABSTRACT Purpose: The aim of this study was to investigate the association of anatomical outcomes and medications of patients with systemic diseases who underwent Descemet membrane endothelial keratoplasty with donor factors. Methods: Sixty nondiabetic donors of endothelial grafts and 60 patients who underwent operation by a single surgeon were included in this retrospective study. The patients' data, including the presence of diabetes mellitus and hypertension, antidiabetic-antihypertensive medications, and intracameral tamponades and anatomical outcomes, were recorded. The donor data were obtained from eye bank records. Results: Eighteen patients had type 2 diabetes mellitus (30%) and 34 had hypertension (56.6%). Among the patients with diabetes mellitus, 13 were receiving a single-agent antidiabetic drug, 4 were receiving dual oral antidiabetic therapy, and 1 was receiving insulin therapy. Among the hypertensive patients, 11 had monotherapy and 23 had dual antihypertensive therapy. Postoperatively, 35 patients (58.3%) had an endothelial attachment, 8 (13.3%) received reinjection, 7 (11.7%) required re-Descemet membrane endothelial keratoplasty, and 10 (16.7%) underwent penetrating keratoplasty. The mean donor age was 51.2 ± 14.1 years. The most common cause of donor death was cardiopulmonary arrest (36/60 cases; 60.0%). Regression analysis revealed that the presence of diabetes mellitus significantly disrupted graft attachment (p=0.034), while the presence of hypertension, antidiabetic and antihypertensive medication use, and the type of tamponade used in the patients, and the age, sex, cause of death, and specular endothelial cell count of donors were not statistically significantly associated with graft attachment (p>0.05). Conclusion: In this study, the anatomical outcomes of Descemet membrane endothelial keratoplasty surgery were affected by recipient and donor factors. The presence of diabetes mellitus in the recipient significantly negatively affected graft attachment.


RESUMO Objetivo: Investigar a associação de desfechos ana tômicos com doenças sistêmicas e medicamentos em casos submetidos à ceratoplastia endotelial da membrana de Descemet e fatores relativos aos doadores. Métodos: Foram incluídos neste estudo retrospectivo enxertos obtidos de doadores não diabéticos e 60 casos operados por um único cirurgião. Foram registrados os dados dos casos, incluindo a presença de diabetes mellitus e hipertensão, medicamentos antidiabéticos e anti-hipertensivos, tamponamentos intracamerais e desfechos anatômicos. Os dados dos doadores foram obtidos dos prontuários do banco de olhos. Resultados: Dezoito casos tinham diabetes mellitus tipo 2 (30%) e 34 tinham hipertensão (56,6%). Entre os casos de diabetes mellitus, 13 estavam em uso de uma medicação antidiabética de agente único, 4 estavam em terapia antidiabética oral dupla e 1 estava em insulinoterapia. Entre os hipertensos, 11 estavam em monoterapia e 23 em terapia anti-hipertensiva dupla. No pós-operatório, 35 pacientes (58,3%) submeteram-se a uma fixação endotelial, enquanto 8 casos (13,3%) receberam reinjeção, 7 casos (11,7%) necessitaram de ceratoplastia endotelial da membrana de Descemet e 10 casos (16,7%) foram submetidos a uma ceratoplastia penetrante. A média de idade dos doadores foi de 51,2 ± 14,1 anos. A causa mais comum de morte do doador foi parada cardiorrespiratória (36/60 casos; 60,0%). A análise de regressão revelou que a presença de diabetes mellitus causa distúrbios significativos na fixação do enxerto (p=0,034), enquanto a presença de hipertensão, o uso de medicamentos antidiabéticos e anti-hipertensivos, o tipo de tamponamento usado, a idade, o sexo, a causa da morte e a contagem de células endoteliais especulares dos doadores não demonstraram associações estatisticamente significativas com a fixação do enxerto (p>0,05). Conclusões: Os resultados anatômicos da cirurgia de ceratoplastia endotelial da membrana de Descemet são afetados por fatores do receptor e do doador. A presença de diabetes mellitus no receptor teve um significativo impacto negativo na fixação do enxerto.

12.
Rev. enferm. UERJ ; 30: e66069, jan. -dez. 2022.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1392822

ABSTRACT

Objetivo: avaliar o Grau de Implantação das ações desenvolvidas pela Atenção Básica para a assistência às pessoas com Diabetes Mellitus. Método: estudo avaliativo, tipo análise de implantação, realizada em Estratégia de Saúde da Família e Farmácia Municipal, por meio de análise documental, entrevista, observação participante e diário de campo, a partir de Modelo Avaliativo, aprovado pelo Comitê de Ética em Pesquisa. Resultados: o Grau de Implantação das ações realizadas foi considerado insatisfatório (54,34%), sendo a dimensão Político-Organizacional com Grau de Implantação crítico (45,23%) e a Técnico- Assistencial com Grau de Implantação insatisfatório (60,41%), o que conduziu a proposição de recomendações com vistas a subsidiar a tomada de decisão, para a melhoria da assistência. Conclusão: os resultados mostram uma realidade ainda distante do que é proposto nas políticas públicas e podem contribuir para o estabelecimento de novas e resolutivas formas de organizar os serviços e produzir saúde na gestão participativa.


Objective: to evaluate the Deployment Level of the measures developed by Primary Care to provide care to people with Diabetes Mellitus. Method: this is an evaluative study, using a deployment analysis, carried out within the Family Health Strategy and the Municipal Pharmacy, through document analysis, interview, participant observation, and field diary, based on an Evaluation Model, approved by the Research Ethics Committee. Results: the Deployment Level of the measures performed was considered unsatisfactory (54.34%), with the Political-Organizational dimension reaching a critical Deployment Level (45.23%) and the Technical-Assistance dimension reaching an unsatisfactory Deployment Level (60.41%), which led to the proposition of recommendations aiming to subsidize decision making, aiming to improve assistance. Conclusion: the results reveal a reality that is still distant from what is proposed in public policies and can to contribute to the establishment of novel and resolute forms of organizing services and producing health in participatory management.


Objetivo: evaluar el grado de implantación de las acciones desarrolladas por la Atención Básica para la atención a las personas con Diabetes Mellitus. Método: estudio evaluativo, de tipo análisis de implantación, realizado dentro del programa Estrategia de Salud de la Familia y Farmacia Municipal, a través de análisis documental, entrevista, observación participante y diario de campo, a partir del modelo evaluativo, aprobado por el Comité de Ética en Investigación. Resultados: el grado de implantación de las acciones realizadas se consideró insatisfactorio (54,34%), siendo que la dimensión Político-organizacional obtuvo un grado de implantación crítico (45,23%) y la dimensión Técnico-asistencial un grado de implementación insatisfactorio (60,41%), lo que llevó a la propuesta de recomendaciones que objetivan subsidiar la toma de decisiones para la mejoría de la asistencia. Conclusión: los resultados muestran una realidad aún distante de lo propuesto por las políticas públicas y pueden contribuir en el establecimiento de nuevas y resolutivas formas de organizar el servicio y fomentar la salud en la gestión participativa.

13.
Medicina (B.Aires) ; 82(5): 746-751, Oct. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1405731

ABSTRACT

Resumen Introducción: Se ha informado que los veteranos de guerra están más expuestos a factores de riesgo cardiovascular. El objetivo del presente trabajo fue establecer los factores de riesgo, el perfil cardiometabólico y la prevalencia de enfermedad cardiovascular de un grupo de excombatientes de la Guerra de Malvinas (HdeM). Métodos: En un diseño caso-control se analizaron los datos de 799 HdeM y se compararon 799 controles de misma edad. La muestra se seleccionó de los participantes del Programa de Prevención de Salud Cardiovascular de la Fundación Favaloro, entre enero de 2017 y diciembre de 2019. Resultados: La edad promedio fue 56.9 ± 3.9 años. Se observó un aumento del peso entre los HdeM (91.3 ± 16.6 kg vs. 88.2 ± 14.7 kg; p = 0.0001). Se observó mayor frecuencia de hipertensión arterial en HdeM (42% vs. 34%; p < 0.001) y diabetes mellitus (15.1% vs. 10.4%; p < 0.005). El síndrome metabólico fue más prevalente en HdeM (49.2% vs. 39.7%; p = 0.0001). Se observó que el antecedente de infarto agudo de miocardio fue más frecuente entre los HdeM (3.6% vs. 2%; p < 0.05), con similar prevalencia de ACV (1.2% vs. 1%; p = ns), angioplastia corona ria (3.2% vs. 2.1%; p = ns) o cirugía de revascularización miocárdica (0.8% vs. 0.4%; p = ns). Discusión: Los HdeM mostraron mayor prevalencia de factores de riesgo, síndrome metabólico e infarto agudo de miocardio. Es importante tener en cuenta este aumento de riesgo para maximizar las estrategias de prevención cardiovascular en los excombatientes.


Abstract Introduction: It has been reported in different parts of the world that war veterans are more exposed to cardio vascular risk factors. The objective of this study was to establish the risk factors, the cardiometabolic profile and the prevalence of cardiovascular disease in a group of ex-combatants of the Malvinas War (HdeM). Methods: In a case-control design, data from 799 HdeM were analyzed and compared with 799 controls matched by age. The sample was selected from the participants of the Cardiovascular Health Prevention Program of the Favaloro Foundation, between January 2017 and December 2019. Results: The average age was 56.9 ± 3.9 years. An increase in weight was observed among the HdeM (91.3 ± 16.6 kg vs. 88.2 ± 14.7 kg; p = 0.0001). A higher frequency of arterial hypertension (42% vs. 34%; p < 0.001) and diabetes mellitus (15.1% vs. 10.4%; p < 0.005) was observed in HdeM. Metabolic syndrome was also more prevalent in HdeM (49.2% vs. 39.7%; p = 0.0001). It was observed that the history of acute myocardial infarction was more frequent among the HdeM (3.6% vs. 2%; p < 0.05), with a similar prevalence of stroke (1.2% vs. 1%; p = ns), coronary angioplasty (3.2% vs. 2.1%; p = ns) or myocardial revascularization surgery (0.8% vs. 0.4%; p = ns). Discussion: The HdeM showed an increase in the frequency of risk factors, metabolic syndrome and acute myocardial infarction. It is important to take this increased risk into account in order to maximize cardiovascular prevention strategies in ex-combatants.

14.
Rev. bras. cir. cardiovasc ; 37(5): 744-753, Sept.-Oct. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1407302

ABSTRACT

Abstract There remains a significant paucity of information evaluating the effect of glycated HbA1c levels and its theorized effect on mortality and morbidity rates following cardiac surgery. Diabetes is a very common comorbidity in patients undergoing open heart surgery, as there is a shift in patient characteristics and greater risk. Currently, there is no clear consensus that an increase in HbA1c level is associated with increased perioperative mortality rate. However, the reported literature is more commonly able to demonstrate that elevated HbA1c levels is associated with increased rates of wound infection, cardiovascular events and renal failure, and thus, higher post-operative morbidities. This review aims to examine and synthesis the evidence behind each of the morbidities and mortalities associated with open heart surgery and the impact of high HbA1c on the reported outcomes.

15.
Rev. medica electron ; 44(5): 799-810, sept.-oct. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409768

ABSTRACT

RESUMEN Introducción: la diabetes mellitus, considerada uno de los principales problemas de salud a nivel mundial, es de las enfermedades que más caras resultan a la sociedad, debido a su alta y temprana mortalidad. Objetivos: caracterizar el comportamiento de la mortalidad causada por la diabetes mellitus en el municipio de Colón, en los últimos once años. Materiales y métodos: estudio descriptivo retrospectivo de la base de datos de fallecidos de la Dirección Municipal de Salud del municipio de Colón, desde el 1 de enero de 2011 hasta el 31 de diciembre de 2021. Fueron seleccionados 221 sujetos con diabetes mellitus como causa básica de muerte. Las variables independientes fueron: año de fallecimiento, sexo, edad y causa directa de muerte. Los resultados se analizaron con estadística descriptiva, a través del paquete SPSS. Resultados: tendencia creciente de la mortalidad, más acentuada en el año 2021, en el que fallecieron 38 diabéticos. Predominio en mujeres (134) con respecto a hombres (87), y en el grupo etario de 65 años y más (67,4 %). Se identificaron como más frecuentes causas de muerte las enfermedades del corazón (24 %), la bronconeumonía (20,4 %) y la insuficiencia renal crónica (14,9 %). Conclusiones: en el municipio de Colón, la mortalidad por diabetes mellitus ha mostrado una tendencia al alza durante los últimos once años; el predominio en mujeres, personas mayores de 65 años, y las enfermedades del corazón como causas directas de muerte, caracterizaron su comportamiento.


ABSTRACT Introduction: diabetes mellitus, considered one of the main health problems worldwide, is among the diseases resulting more expensive to society, because of its high and early mortality. Objective: to characterize the behavior of mortality caused by diabetes mellitus in the municipality of Colon, in the last eleven years. Materials and methods: descriptive, retrospective study of the database of deaths from the Municipal Health Department of the municipality of Colon, from January 1st 2011 to December 31st, 2021. 221 subjects with diabetes mellitus with diabetes mellitus main cause of death were chosen. The independent variables were: year of death, gender, age and direct cause of death. The results were analyzed using descriptive statistics, through SPSS package. Results: increasing tendency of mortality, more accentuated in 2021, when 38 diabetic patients died. Women (134) predominated over men (87) and predominated also the age group of 65 years and over (67.4 %). Hearth diseases (24 %), bronchopneumonia (20.4 %), and chronic renal failure (14.9 %) were identified as more frequent causes of death. Conclusions: mortality due to diabetes mellitus has showed an increasing tendency during the last eleven years; the predominance in women, people over 65 years, and hearth diseases as direct causes of death characterized its behavior.

16.
Medisan ; 26(5)sept.-oct. 2022. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1405846

ABSTRACT

Introducción: La diabetes mellitus se encuentra entre las enfermedades crónicas no transmisibles más comunes en el mundo, y se estima que para el 2030 será diagnosticada en 7,7 % de la población mayor de 18 años, es decir, en 430 millones de individuos. Objetivo: Caracterizar a pacientes diabéticos que presentaron infarto agudo de miocardio con elevación del segmento ST, según variables clinicoepidemiológicas, electrocardiográficas, ecocardiográficas y terapéuticas. Métodos: Se realizó un estudio descriptivo, desde enero hasta diciembre de 2019, de 137 pacientes con antecedente de diabetes mellitus que presentaron infarto agudo de miocardio con elevación del segmento ST, atendidos en el Servicio de Cardiología del Hospital Provincial Clínico-Quirúrgico Docente Saturnino Lora de Santiago de Cuba. Entre las variables analizadas figuraron la edad, el sexo, la clase funcional, las complicaciones, la función sistólica y la diastólica del ventrículo izquierdo, la terapia de reperfusión empleada y el estado del paciente al egreso. Resultados: En la serie predominaron el sexo masculino y el grupo etario mayor de 60 y más años. Se observó que el infarto agudo de miocardio en la topografía anterior presentara más complicaciones, así como mayor número de pacientes con tratamiento trombolítico y combinado. Asimismo, la mayoría de los pacientes egresaron vivos, lo cual se correspondió, además, con que recibieran terapia trombolítica. Al analizar a los pacientes con alteraciones segmentarias en el estudio ecocardiográfico, se obtuvo una primacía de los fallecidos en ese grupo en cuestión. Conclusiones: Los pacientes diabéticos que presentan infarto agudo de miocardio con elevación del segmento ST constituyen un grupo independiente con especificidades clínicas y ecocardiográficas y mayor riesgo de complicaciones mortales.


Introduction: Diabetes mellitus is not among the most common chronic non communicable diseases in the world, and is considered that by 2030 it will be diagnosed in the 7.7 % of the population over 18 years, that is to say, in 430 million individuals. Objective: To characterize diabetic patients that presented acute heart attack with elevation of the ST segment, according to clinical epidemiological, electrocardiographic, echocardiographic and therapeutic variables. Methods: A descriptive study was carried out from January to December, 2019 of 137 patients with history of diabetes mellitus that presented acute heart attack with elevation of the ST segment, assisted in the Cardiology Service of Saturnino Lora Teaching Clinical-Surgical Provincial Hospital in Santiago de Cuba. Among the analyzed variables figured the age, sex, functional class, complications, systolic and dyastolic function of the left ventricle, the therapy of reperfusion used and the state of the patient when discharged from the hospital. Results: In the series there was a prevalence of the male sex and the 60 and over age group. It was observed that the acute heart attack in the previous topography presented more complications, as well as higher number of patients with thrombolitic and combined treatment. Also, most of the patients were alive when discharged from the hospital, which also corresponded with the thrombolitic therapy received. When analyzing the patients with segmental alterations in the echocardiographic study, a primacy of the deceaseds was obtained in that group. Conclusions: The diabetic patients that present acute heart attack with elevation of the ST segment constitute an independent group with clinical and echocardiographic specificities, and more risk of mortal complications.


Subject(s)
Diabetes Mellitus , Myocardial Infarction , Echocardiography , ST Elevation Myocardial Infarction
17.
Rev. enferm. neurol ; 21(1): 15-20, ene.-abr. 2022. graf, tab
Article in Spanish | LILACS, BDENF | ID: biblio-1397925

ABSTRACT

Introducción: el dormir mal podría ser la causa de diabetes mellitus tipo II y otras enfermedades crónicas no transmisibles. Objetivo: conocer la calidad de sueño de las personas con diabetes mellitus tipo II. Material y métodos: se realizó un estudio descriptivo, la muestra 44 adultos con diabetes mellitus. Se aplicó el cuestionario de Índice de Calidad de Sueño de Pittsburgh, 19 reactivos que contiene siete componentes con una escala de 0 a 3. La suma de estos da el índice. Resultados: se evaluó la calidad de sueño en 44 personas con diabetes mellitus tipo II, de abril a agosto 2021. El promedio de edad 67 años, 73 % del sexo femenino. El 39 % tiene una mala calidad de sueño, 27 % tarda en dormir entre 30 y 60 minutos, 18 % duerme <5 horas, 79.5 % no tiene una eficiencia de sueño normal, 48% reporto tener alteraciones del sueño una o dos veces a la semana, 11 % usa medicamentos para dormir menos de una vez a la semana y 11 % tiene una disfunción diurna. En cuanto al índice de calidad de sueño 85 % tiene un índice > 5. Conclusión: las personas diabéticas tienen una mala calidad de sueño lo cual puede afectar su metabolismo, en consecuencia es necesario realizar una intervención para mejorar su calidad de sueño.


Introduction: poor sleep could be the cause of type II diabetes mellitus and other chronic non-communicable diseases. Objective: to know the quality of sleep of people with type II diabetes mellitus. Material and methods: a descriptive study was carried out, the sample consisted of 44 adults with diabetes mellitus. The 19-item Pittsburgh Sleep Quality Index questionnaire was applied, containing seven components with a scale from 0 to 3. The sum of these gives the index. Results: the quality of sleep was evaluated in 44 people with type II diabetes mellitus, from April to August 2021. The average age was 67 years old, 73% are female. 39% have a poor quality of sleep, 27% take between 30 to 60 minutes to sleep, 18% sleep <5 hours, 79.5% do not have a normal sleep efficiency, 48% reported having sleep disturbances one or twice a week, 11% use sleep medications less than once a week and 11% have a daytime dysfunction. Regarding the sleep quality index, 85% have an index> 5 Conclusion: diabetic people have a poor quality of sleep which can affect their metabolism, so it is necessary to carry out an intervention to improve their quality of sleep.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Health Risk , Sleep , Diabetes Mellitus
18.
Arq. ciências saúde UNIPAR ; 26(3): 643-656, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1399314

ABSTRACT

O Diabetes Mellitus (DM) é uma doença crônica, que tem elevada prevalência na sociedade e representa um problema de saúde pública devido à natureza de suas complicações, acredita-se que a dificuldade na manutenção do tratamento, pode estar relacionada a deficiência ou falta de adesão. O estudo teve como objetivo relatar à adesão ao tratamento do Diabetes Mellitus na Atenção Primária a Saúde. Trata-se de um estudo descritivo, com abordagem qualitativa, realizado com 30 pacientes diabéticos de uma Unidade de Atenção Primária à Saúde de Guaiúba-CE, no período de agosto a outubro de 2021. A coleta de dados deu-se por entrevista semiestruturada utilizando questões norteadoras sobre adesão ao tratamento, adoção de práticas promotoras de saúde e posteriormente sujeita a análise de conteúdo. Observou-se que a adesão ao tratamento do diabetes envolve inúmeros desafios, relacionados principalmente ao usuário e sistemas de saúde/profissionais. Os maiores desafios encontrados foram em relação a supervalorização do tratamento medicamentoso frente a adoção de hábitos saudáveis e de ações promotoras de autocuidado. Nesse cenário, nota-se a importância de conhecer os fatores que influenciam na adesão ao tratamento com o intuito de se lançar estratégias para aperfeiçoar o planejamento de ações e intervenções a esses pacientes.


Diabetes Mellitus (DM) is a chronic disease that is highly prevalent in society and represents a public health problem due to the nature of its complications. The study aimed to report on the adherence to treatment of Diabetes Mellitus in Primary Health Care. This is a descriptive study, with a qualitative approach, conducted with 30 diabetic patients from a Primary Health Care Unit in Guaiúba-CE, in the period from August to October 2021. Data were collected through semi-structured interviews using guiding questions about adherence to treatment, adoption of health-promoting practices and later subjected to content analysis. It was observed that diabetes treatment adherence involves numerous challenges, mainly related to the user and health systems/professionals. The biggest challenges found were related to the overvaluation of drug treatment against the adoption of healthy habits and self-care promoting actions. In this scenario, it is important to know the factors that influence treatment adherence in order to develop strategies to improve the planning of actions and interventions for these patients.


La diabetes mellitus (DM) es una enfermedad crónica, que tiene una alta prevalencia en la sociedad y representa un problema de salud pública debido a la naturaleza de sus complicaciones, se cree que la dificultad para mantener el tratamiento puede estar relacionada con la deficiencia o falta de adherencia. El estudio tenía como objetivo informar sobre la adherencia al tratamiento de la Diabetes Mellitus en Atención Primaria. Se trata de un estudio descriptivo con enfoque cualitativo, realizado con 30 pacientes diabéticos de una Unidad de Atención Primaria de Salud de Guaiúba-CE, en el período de agosto a octubre de 2021. La recogida de datos se llevó a cabo mediante entrevistas semiestructuradas en las que se utilizaron preguntas orientativas sobre la adherencia al tratamiento y la adopción de prácticas de promoción de la salud, y posteriormente se sometieron a un análisis de contenido. Se ha observado que el acceso al tratamiento de la diabetes conlleva numerosos desafíos, relacionados principalmente con el usuario y los sistemas de salud/profesionales. Los mayores retos encontrados estaban relacionados con la sobrevaloración del tratamiento farmacológico frente a la adopción de hábitos saludables y acciones de promoción del autocuidado. En este escenario, se constata la importancia de conocer los factores que influyen en la adherencia al tratamiento para poner en marcha estrategias que mejoren la planificación de las acciones e intervenciones para estos pacientes.


Subject(s)
Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Patients , Primary Health Care/organization & administration , Diabetes Mellitus/drug therapy , Treatment Adherence and Compliance , Self Care/instrumentation , Unified Health System , Pharmaceutical Preparations/analysis , Exercise/physiology , Public Health , Chronic Disease/drug therapy , Diabetes Mellitus/diagnosis , Drug Therapy , Diet, Healthy , Health Promotion , Health Services Accessibility , Nursing Care/methods
20.
Arch. argent. pediatr ; 120(5): e223-e225, oct. 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1395831

ABSTRACT

La ataxia de Friedreich, de herencia autosómica recesiva causada por una expansión repetida de trinucleótidos se asocia, entre otras complicaciones sistémicas, con diabetes mellitus. La aparición de torpeza motriz, con dificultad en la carrera y el salto en un varón de 6 años motivaron el estudio genético para ataxia de Friedrich y permitieron confirmar el diagnóstico. Tres años más tarde, se diagnosticó diabetes mellitus y se inició el tratamiento con insulina. Durante el seguimiento, presentó un importante deterioro neurológico, con necesidad de usar silla de ruedas, lo que dificultó un adecuado control metabólico. Se presenta el manejo y la evolución de un paciente con ataxia de Friedreich y diabetes mellitus


Friedreich's ataxia is an autosomal recessive disease caused by trinucleotide repeat expansion, presenting among other systemic complications, diabetes mellitus. The appearance of motor clumsiness, with running and jumping difficulties in a 6-year-old boy prompted the genetic study of Friedreich's ataxia, confirming his diagnosis. After diagnosis,it was evaluated by Pediatric Cardiology, detecting the presence of non-obstructive hypertrophic cardiomyopathy, and by Pediatric Endocrinology, due to overweight. At 9 years of age, he was diagnosed with diabetes mellitus, a regimen of insulin treatment was initiated. During follow-up, he presented significant neurological deterioration, reaching the use of a wheelchair,which hinders adequate metabolic control. This is a report of a pediatric patient with Friedrich ataxia and diabetes mellitus.


Subject(s)
Humans , Male , Child , Friedreich Ataxia/complications , Friedreich Ataxia/diagnosis , Friedreich Ataxia/genetics , Diabetes Mellitus , Insulins , Family
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