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1.
Rio de Janeiro; s.n; s.n; 20240000. 196 p. ilust.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1580453

ABSTRACT

O diagnóstico de enfermagem Risco de padrão glicêmico desequilibrado (DE RPGD) encontrase validado no âmbito teórico-causal, baseada no desenvolvimento de uma Teoria de Médio Alcance. Então, segundo os critérios estabelecidos por NANDA Internacional este diagnóstico encontra-se validado no nível 2.1.2 validade teórico-causal e com isso compreende-se a necessidade de elevá-la ao nível 2.2.2 Validade potencial do conteúdo diagnóstico. Objetivo: Validar o conteúdo do diagnóstico de enfermagem "Risco de padrão glicêmico desequilibrado" e elaborar um infográfico educativo baseado nos componentes do diagnóstico validados em conteúdo. Método: Estudo de validade de conteúdo do diagnóstico de enfermagem RPGD baseado na sabedoria coletiva, de abordagem quantitativa. Todas as etapas do presente estudo foram realizadas no âmbito virtual. A seleção dos experts foi realizada através do Diretório dos grupos de pesquisa no Brasil Lattes pelo portal Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) e pela da técnica snowball sampling ("bola-de-neve"). Para a classificação dos experts, foram utilizados os critérios de classificação de Benner, Tanner e Chesla (2009). Amostra foi composta por 48 experts. O instrumento de coleta elaborado via google form e composto por seis seções. Os dados foram organizados em uma planilha no software Microsoft office Excel 365. Em seguida, os dados foram importados para o software estatístico R versão 4.1.1 para devido tratamento analítico dos testes estatísticos. Para o tratamento dos dados descritivos foi utilizado o software Statistical Package for the Social Sciences (IBM- SPSS) versão 24. A caracterização dos experts foi realizada com base na análise descritiva. Na validade de conteúdo fez-se uso de estatísticas descritivas sendo calculado o Índice de Validade de Conteúdo. Por fim, foi avaliado a concordância dos experts através do Teste de Kappa de Fleiss e Gwet considerando 5% como nível de significância e 95% de confiança. Para o desenvolvimento do infográfico foi utilizado o modelo proposto por Carvalho e Aragão (2012), que consiste em três fases: 1) concepção; 2) execução; e 3) acabamento. Foi obtido a amostra de 51 experts, sendo 45% (nº 23) classificado como iniciante avançado. Todos os componentes diagnósticos foram validados e realizado ajuste na definição diagnóstica para "suscetibilidade a recorrentes flutuações no nível de glicose fora do alvo desejável ao longo do dia e/ou em dias subsequentes", os fatores relacionados com menor índice foram disfunção 6 cognitiva, consumo excessivo de álcool e exercício físico diário excessivo, nas populações em risco foram indivíduos de ascendência africana e indivíduos indígenas e com relação as condições associadas foram preparações farmacêuticas e indivíduos com úlceras em MMII. Foi produzido o infográfico em três categorias, a saber: definição e fatores de risco; condições associadas e populações em risco. O presente estudo atendeu aos objetivos gerais e específicos propostos e realizou a validação de conteúdo do diagnóstico de enfermagem "Risco de Padrão Glicêmico desequilibrado" além da elaboração do protótipo do infográfico referente ao diagnóstico de enfermagem "Risco de Padrão Glicêmico desequilibrado".


The nursing diagnosis Risk of an imbalanced blood glucose pattern (RPGD) is validated in the theoretical-causal sphere, based on the development of a Middle-Range Theory. Therefore, according to the criteria established by NANDA International, this diagnosis is validated at level 2.1.2 theoretical-causal validity, which makes it necessary to raise it to level 2.2.2 potential validity of the diagnostic content. To validate the content of the nursing diagnosis "Risk of imbalanced blood glucose pattern" and to develop an educational infographic based on the components of the diagnosis validated in content. Content validity study of the RPGD nursing diagnosis based on collective wisdom, with a quantitative approach. All the stages of this study were carried out virtually. The experts were selected using the Lattes Directory of Research Groups in Brazil on the National Council for Scientific and Technological Development (CNPq) website and the snowball sampling technique. The classification criteria of Benner, Tanner and Chesla (2009) were used to classify the experts. The sample consisted of 48 experts. The collection instrument was prepared via google form and consisted of six sections. The data was organized in a Microsoft office Excel 365 spreadsheet. The data was then imported into the statistical software R version 4.1.1 for the analytical treatment of the statistical tests. The Statistical Package for the Social Sciences (IBM- SPSS) software version 24 was used to process the descriptive data. The experts were characterized using descriptive analysis. For content validity, descriptive statistics were used and the Content Validity Index was calculated. Finally, the agreement of the experts was assessed using the Fleiss and Gwet Kappa Test, considering 5% as the level of significance and 95% confidence. The model proposed by Carvalho and Aragão (2012) was used to develop the infographic, which consists of three phases: 1) conception; 2) execution; and 3) finishing. A sample of 51 experts was obtained, with 45% (no. 23) classified as advanced beginners. All the diagnostic components were validated and an adjustment was made to the diagnostic definition to "susceptibility to recurrent fluctuations in glucose level outside the desirable target throughout the day and/or on subsequent days", the factors related to the lowest index were cognitive dysfunction, excessive alcohol consumption and excessive daily physical exercise, the populations at risk were individuals of African descent and indigenous individuals and with regard to associated 8 conditions were pharmaceutical preparations and individuals with ulcers in the lower limbs. The infographic was produced in three categories, namely: definition and risk factors; associated conditions and populations at risk. This study met the general and specific objectives proposed and validated the content of the nursing diagnosis "Risk of imbalanced blood glucose pattern", as well as producing an infographic


Subject(s)
Blood Glucose , Nursing Diagnosis , Validation Study , Diabetes Mellitus
2.
Medwave ; 24(3): e2758, 30-04-2024. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1553769

ABSTRACT

INTRODUCCIÓN: La diabetes mellitus tipo 2 es una enfermedad de alta prevalencia y está asociada a mayor morbimortalidad. Debido al bajo porcentaje de compensación, se han buscado nuevas estrategias de tratamiento farmacológico, como los inhibidores del cotransportador sodio-glucosa tipo 2. OBJETIVO: Describir la evolución de pacientes diabéticos tipo 2 insulino-requirentes tratados con empagliflozina en el Hospital Peñaflor, ubicado en el sector poniente de la Región Metropolitana, Chile. El objetivo primario fue evaluar la eficacia del medicamento respecto a hemoglobina glicosilada A1c. Los objetivos secundarios fueron registrar el logro de hemoglobina glicosilada A1c igual o menor a 7,5% según análisis de supervivencia. Luego, consignar el cambio en la velocidad de filtración glomerular y en la excreción urinaria de albúmina post tratamiento. MÉTODOS: Revisión de ficha clínica de todos los pacientes tratados con empagliflozina desde noviembre de 2019 a junio de 2023. Media de seguimiento de 19 (de 16,3 a 40) meses. Para comparación entre valores de hemoglobina glicosilada A1c según rangos de seguimiento, se utilizó prueba T de Student de términos pareados o prueba de Wilcoxon. RESULTADOS: Se estudió a 58 pacientes, 15 hombres y 43 mujeres (74,1%). Edad 58,5 ± 9,2 años, rango de 35 a 75 años. Hemoglobina glicosilada A1c basal de 10,3 ± 1,6% y 8,98% ± 2,2 en un rango de seguimiento de 18 a 24 meses post tratamiento, resultando en un descenso de 1,27% (p = 0,002; intervalo de confianza 95%: 0,5 a 2,03). El efecto adverso más frecuente fue infección del tracto urinario. CONCLUSIONES: Los pacientes diabéticos tipo 2 insulino-requirentes tratados con empagliflozina en el Hospital Peñaflor lograron un mejor control glicémico con pocos efectos adversos.


BACKGROUND: Type 2 diabetes mellitus is a highly prevalent disease and is associated with increased morbidity and mortality. Due to the low percentage of adequate glycemic control, new strategies for the treatment of type 2 diabetes mellitus have been sought, including sodium-glucose cotransporter type 2 inhibitorss. OBJECTIVE: To describe the evolution of patients with type 2 diabetes mellitus with insulin requirements treated with empagliflozin at the Peñaflor Hospital. The primary objective was to evaluate the efficacy of the medication regarding glycosylated hemoglobin A1c (HbA1c). The secondary objectives were: 1) achievement of HbA1c equal to or less than 7.5% according to survival analysis. 2) Change in glomerular filtration rate and urinary albumin excretion post treatment. METHODS: Review of clinical records of all patients treated with empagliflozin from November 2019 to June 2023. Average follow-up of 19 (16.3 to 40) months. To compare HbA1c values according to follow-up ranges, the paired T test or Wilcoxon test was used. RESULTS: We included 58 patients, 15 men and 43 women (74.1%), with an average age of 58.5 ± 9.2 years, ranging from 35 to 75 years. Baseline HbA1c of 10.3 ± 1.6% and 8.98% ± 2.2 in a follow-up of 18 to 24 months post-treatment, resulted in a decrease of 1.27% (p = 0.002; confidence interval 95%: 0.5 to 2.03). The most common adverse effect was urinary tract infection. CONCLUSIONS: Patients with type 2 diabetes mellitus with insulin requirements treated with empagliflozin at the Peñaflor Hospital achieved better glycemic control with few adverse effects.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Diabetes Mellitus, Type 2 , Insulins/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Glucosides , Benzhydryl Compounds/adverse effects , Blood Glucose/metabolism , Glycated Hemoglobin , Treatment Outcome , Hypoglycemic Agents/adverse effects
3.
HSJ ; 14: 1-7, Março 2024.
Article in English | LILACS | ID: biblio-1570876

ABSTRACT

Objective: To determine the epidemiological profile of patients with type 2 diabetes mellitus in a teaching unit. Method: In this observational, cross-sectional, and descriptive study, data from the medical records of consultations conducted between February 2020 and May 2022 at an endocrinology outpatient clinic in a teaching unit in Northeast Brazil were evaluated. A descriptive analysis of the data was performed, with percentage values, medians, and interquartile ranges (IQRs) reported. Result: Data were collected from the medical records of 118 patients, and the medical records of 95 patients were used for statistical analysis after the exclusion of records with insufficient data. Seventy patients (73.6%) were female, with a median age of 57 years (IQR 51.5-65), a median body mass index (BMI) of 28.9 kg/m2 (IQR 25.7-33.1) and a median age at diagnosis of 47.5 years (IQR 38-55). The median glycated hemoglobin (HbA1c) and fasting blood glucose levels during follow-up were 7.6% (IQR 6.6-9.7) and 132.8 mg/dL (IQR 113.5-201.7), respectively, and only 36.8% (n=35) of patients were within their HbA1C therapeutic target range. Approximately 73.6% (n=70) of the patients used statins, but only 18 (18.9%) had LDL-c within their therapeutic target range. Twenty-seven patients (28.4%) had kidney dysfunction, either albuminuria or a glomerular filtration rate (GFR) reduction, and 6 of them (22.2%) did not use any nephroprotective medication. Fewer than half of the patients underwent fundoscopy, and 32.5% of them showed some degree of retinopathy. Neuropathy was present in 33 patients (34.7%), with 3 patients (3.16%) presenting with amputations. Conclusion: Adequate glycemic control was achieved in just under half of the patients, and a relevant proportion of patients experienced microvascular complications. Strategies for the early detection of complications and more aggressive treatment of the disease and its comorbidities are necessary


Objetivo: Traçar o perfil epidemiológico de pacientes com Diabetes Tipo 2 de uma unidade docente-assistencial. Método: Estudo observacional, transversal e descritivo com dados de prontuário de consultas realizadas entre fevereiro de 2020 e maio de 2022 no ambulatório de endocrinologia de uma unidade docente-assistencial no nordeste brasileiro. Procedeu-se à análise descritiva dos dados, sendo informados os valores percentuais, mediana e intervalo interquartil. Resultado: De um total de 118 prontuários, foram analisados 95 pacientes após a exclusão daqueles com dados insuficientes. Destes, 73,6% (n=70) são do sexo feminino, com idade mediana de 57 anos (IIQ 51,5-65), mediana do IMC 28,9kg/m2 (IIQ 25,7-33,1) e idade ao diagnóstico de 47,5 anos (IIQ 38-55). As medianas da última HbA1C e glicemia em jejum foram 7,6% (IIQ 6,6-9,7) e 132,8 mg/dL (IIQ 113,5- 201,7), e apenas 36,8% (n=35) foram classificados como dentro da meta pela HbA1C. Cerca de 73,6% (n=70) dos pacientes utilizavam estatinas, mas somente 18 (18,9%) tinham LDL-c dentro da meta terapêutica. Vinte e sete pacientes (28,4%) apresentavam disfunção renal, seja albuminúria e/ou redução da TFG, e 6 (22,2%) não usavam nenhuma medicação nefroprotetora. Menos da metade dos pacientes realizou fundoscopia, e, destes, 32,5% apresentavam algum grau de retinopatia. Neuropatia está presente em 33 pacientes (34,7%), com 3 pacientes (3,16%) apresentando amputações. Conclusão: O controle glicêmico adequado foi obtido em pouco menos da metade dos pacientes e uma proporção relevante apresenta complicações microvasculares. Estratégias de detecção precoce de complicações e de tratamento mais agressivo da doença e suas comorbidades são necessárias


Subject(s)
Blood Glucose , Quality Indicators, Health Care , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Endocrinology , Glycemic Control , Patients , Teaching , Therapeutics , Health Profile , Glycated Hemoglobin , Pharmaceutical Preparations , Body Mass Index , Records , Medical Records , Disease , Data Interpretation, Statistical , Fasting , Health Strategies , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Diagnosis , Albuminuria , Faculty , Ambulatory Care Facilities , Glomerular Filtration Rate , House Calls , Methods
4.
J. Health Biol. Sci. (Online) ; 12(1): 1-5, jan.-dez. 2024. tab, ilus
Article in English | LILACS | ID: biblio-1573172

ABSTRACT

Aim: this study aimed to evaluate the effects of surgical treatment for endometriosis on the metabolic profile of women diagnosed with deep endometriosis. Methods: we conducted a prospective observational study with a sample of 30 women in the menacme diagnosed with deep endometriosis who underwent videolaparoscopic surgery in a reference center in Brazil between October 2020 and December 2021. A total of 30 women performed clinical and laboratory tests regarding their metabolic profile on two occasions, during preoperative tests and six months after video-laparoscopy. Results: patients had lower average levels of Total Cholesterol (TC), Low-Density Cholesterol (LDL-c), Triglycerides (TGC), and Fasting Glycemia (FG) after the surgical procedure. The average TC level was 8.2% lower after surgery, LDL-c was 12.8% lower, TGC was 10.9% lower, and FG was 7.3% lower. The results showed a statistically significant difference for all these parameters (p < 0.001). Conclusions: video-laparoscopy was associated with a favorable lipid profile compared to the preoperative lipid profile, with a significant improvement in the average levels of LDL-c, HDL-c, TC, TGC, and FG. Long-term follow-up studies are needed to determine whether surgical treatment for endometriosis can improve the metabolic parameters of women with endometriosis and favor a lower predisposition to atherogenesis.


Objetivo: Aeste estudo teve como objetivo avaliar os efeitos do tratamento cirúrgico da endometriose no perfil metabólico de mulheres com diagnóstico de endometriose profunda. Métodos: foi realizado um estudo observacional prospectivo com uma amostra de 30 mulheres na menacme, com diagnóstico de endometriose profunda, que foram submetidas à videolaparoscopia em um centro de referência no Brasil, entre outubro de 2020 e dezembro de 2021. As mulheres realizaram exames clínicos e laboratoriais quanto ao seu perfil metabólico em duas ocasiões, durante exames pré-operatórios e seis meses após a videolaparoscopia. Resultados: as pacientes apresentaram níveis médios mais baixos de Colesterol Total (CT), Colesterol de Baixa Densidade (LDL-c), Triglicerídeos (TGC) e Glicemia de Jejum (GJ) após o procedimento cirúrgico. O nível médio de CT foi 8,2% menor após a cirurgia, o LDL-c foi 12,8% menor, o TGC foi 10,9% menor e a GJ foi 7,3% menor. Os resultados mostraram diferença estatisticamente significativa para todos esses parâmetros (p < 0,001). Conclusões: a videolaparoscopia foi associada a um perfil lipídico favorável em comparação ao perfil lipídico pré-operatório, com melhora significativa nos níveis médios de LDL-c, HDL-c, CT, TGC e GJ. Estudos de acompanhamento a longo prazo são necessários para determinar se o tratamento cirúrgico da endometriose pode melhorar os parâmetros metabólicos de mulheres com endometriose e favorecer uma menor predisposição à aterogênese.


Subject(s)
Humans , Female , Endometriosis , Reference Standards , General Surgery , Surgical Procedures, Operative , Therapeutics , Women , Blood Glucose , Comorbidity , Cholesterol , Laparoscopy , Pelvic Pain , Dyslipidemias , Comprehensive Metabolic Panel , Cholesterol, HDL
5.
Zhongguo dangdai erke zazhi ; Zhongguo dangdai erke zazhi;(12): 62-66, 2024.
Article in Chinese | WPRIM | ID: wpr-1009894

ABSTRACT

OBJECTIVES@#To investigate the risk factors for diabetic ketoacidosis (DKA) in children/adolescents with type 1 diabetes mellitus (T1DM) and to establish a model for predicting the risk of DKA.@*METHODS@#A retrospective analysis was performed on 217 children/adolescents with T1DM who were admitted to General Hospital of Ningxia Medical University from January 2018 to December 2021. Among the 217 children/adolescents,169 cases with DKA were included as the DKA group and 48 cases without DKA were included as the non-DKA group. The risk factors for DKA in the children/adolescents with T1DM were analyzed, and a nomogram model was established for predicting the risk of DKA in children/adolescents with T1DM.@*RESULTS@#For the 217 children/adolescents with T1DM, the incidence rate of DKA was 77.9% (169/217). The multivariate logistic regression analysis showed that high levels of random blood glucose, hemoglobin A1c (HbA1c), blood ketone body, and triglyceride on admission were closely associated with the development of DKA in the children/adolescents with T1DM (OR=1.156, 3.2031015, 20.131, and 9.519 respectively; P<0.05). The nomogram prediction model had a C-statistic of 0.95, with a mean absolute error of 0.004 between the risk of DKA predicted by the nomogram model and the actual risk of DKA, indicating that the model had a good overall prediction ability.@*CONCLUSIONS@#High levels of random blood glucose, HbA1c, blood ketone body, and triglyceride on admission are closely associated with the development of DKA in children/adolescents with T1DM, and targeted intervention measures should be developed to reduce the risk of DKA.


Subject(s)
Child , Adolescent , Humans , Diabetes Mellitus, Type 1/complications , Blood Glucose , Glycated Hemoglobin , Retrospective Studies , Ketosis , Risk Factors , Ketone Bodies , Triglycerides
6.
Rev. chil. endocrinol. diabetes ; 17(1): 16-22, 2024.
Article in Spanish | LILACS | ID: biblio-1525785

ABSTRACT

INTRODUCCIÓN: El aumento global de la prevalencia de la diabetes ha generado un interés creciente en terapias alternativas, incluyendo el uso de edulcorantes no nutritivos (ENN) en reemplazo de la sacarosa. En el mercado chileno la sucralosa y la estevia son los más utilizados. OBJETIVO: Describir los efectos de la ingesta de estevia y sucralosa sobre los resultados metabólicos y apetito-saciedad en sujetos con diabetes DM1 y DM2, considerando la evidencia disponible. MÉTODOS: Revisión descriptiva. Se realizó búsqueda en PubMed, WoS y Scopus utilizando los siguientes términos y palabras clave: "stevia rebaudiana", "blood glucose", "insulin", "metabolic processes", "sucralose", "diabetes type 1 and 2", "appetite" o "satiety". El análisis de los estudios seleccionados fue discrecional. RESULTADOS: La evidencia sobre la respuesta glicémica e insulínica es variable, con algunos estudios sugiriendo beneficios en la sensibilidad a la insulina y otros reportando efectos nulos. Además, se identificó que los efectos de los ENN en los receptores de sabor dulce y la respuesta hormonal de incretinas, juegan un papel clave en la homeostasis de la glucosa. En cuanto a apetito-saciedad, los ENN podrían no tener el mismo poder saciante que la sacarosa, potencialmente estimulando el apetito y el consumo excesivo. Es fundamental destacar que la heterogeneidad en la metodología de los estudios revisados, en aspectos como el tamaño muestral, la duración, la dosis y la vía de administración de los edulcorantes, dificulta la obtención de conclusiones firmes. CONCLUSIÓN: Aunque la ingestión de estevia y sucralosa ha revelado efectos beneficiosos en el metabolismo glucídico, se subraya la necesidad de llevar a cabo más investigaciones para comprender más a fondo los efectos metabólicos y sobre el apetito-saciedad, especialmente en la población con diabetes adulta y pediátrica.


INTRODUCTION: The global increase in the prevalence of diabetes has sparked a growing interest in alternative therapies, including the use of non-nutritive sweeteners (NNS) as a substitute for sucrose. In the Chilean market, sucralose and stevia are the most widely used. OBJECTIVE: To describe the effects of stevia and sucralose intake on metabolic outcomes and appetite-satiety in individuals with type 1 (DM1) and type 2 (DM2) diabetes, considering the available evidence. METHODS: Descriptive review. A search was conducted on PubMed, WoS, and Scopus using the following terms and keywords: "stevia rebaudiana," "blood glucose," "insulin," "metabolic processes," "sucralose," "diabetes type 1 and 2," "appetite," or "satiety." The analysis of selected studies was discretionary. RESULTS: Evidence regarding glycemic and insulin response is variable, with some studies suggesting benefits in insulin sensitivity and others reporting null effects. Additionally, it was identified that the effects of NNS on sweet taste receptors and the hormonal response of incretins play a key role in glucose homeostasis. Regarding appetite-satiety, NNS may not have the same satiating power as sucrose, potentially stimulating appetite and excessive consumption. It is crucial to highlight that the heterogeneity in the methodology of reviewed studies, including sample size, duration, dose, and route of administration of sweeteners, complicates drawing firm conclusions. CONCLUSION: Although the ingestion of stevia and sucralose has demonstrated beneficial effects on carbohydrate metabolism, there is a pressing need for further research to better understand the metabolic effects and their impact on appetite-satiety, especially in the adult and pediatric diabetic population.


Subject(s)
Humans , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Non-Nutritive Sweeteners/administration & dosage , Appetite/drug effects , Satiation/drug effects , Sucrose/administration & dosage , Blood Glucose/drug effects , Stevia , Non-Nutritive Sweeteners/pharmacology , Insulin , Metabolism/drug effects
7.
Rev. latinoam. enferm. (Online) ; 31: e4088, Jan.-Dec. 2023. tab, graf
Article in Spanish | LILACS, BDENF | ID: biblio-1530190

ABSTRACT

Objetivo: analizar la correlación entre el tiempo en rango y la hemoglobina glicosilada de personas que viven con diabetes mellitus y realizan la monitorización continua de la glucemia o el automonitoreo de la glucemia capilar Método: revisión sistemática de etiología y riesgo basada en las directrices del JBI e informada según los Preferred Reporting Items for Systematic Reviews and Meta-Analyses, abarcando seis bases de datos y la literatura gris. La muestra incluyó 16 estudios y la calidad metodológica fue evaluada utilizando las herramientas del JBI. Protocolo registrado en Open Science Framework, disponible en https://doi.org/10.17605/OSF.IO/NKMZB. Resultados: tiempo en rango (70-180 mg/dl) mostró una correlación negativa con la hemoglobina glicosilada, mientras que el tiempo por encima del rango (>180 mg/dl) mostró una correlación positiva. Los coeficientes de correlación variaron entre -0,310 y -0,869 para el tiempo en rango, y entre 0,66 y 0,934 para el tiempo por encima del rango. Un estudio se realizó en una población que hacía el automonitoreo. Conclusión: hay una correlación estadísticamente significativa entre el tiempo en rango y el tiempo por encima del rango con la hemoglobina glicosilada. Cuanto mayor sea la proporción en el rango glucémico adecuado, más cerca o por debajo del 7% estará la hemoglobina glicosilada. Se necesitan más estudios que evalúen esta métrica con datos del automonitoreo de la glucemia.


Objective: to analyze the correlation between time on target and glycated hemoglobin in people living with diabetes mellitus and carrying out continuous blood glucose monitoring or self-monitoring of capillary blood glucose. Method: systematic review of etiology and risk based on JBI guidelines and reported according to Preferred Reporting Items for Systematic Reviews and Meta- Analyses, covering six databases and grey literature. The sample included 16 studies and methodological quality was assessed using JBI tools. Protocol registered in the Open Science Framework, available at https://doi.org/10.17605/OSF.IO/NKMZB. Results: time on target (70-180 mg/dl) showed a negative correlation with glycated hemoglobin, while time above target (>180 mg/dl) showed a positive correlation. Correlation coefficients ranged between -0.310 and -0.869 for time on target, and between 0.66 and 0.934 for time above target. A study was carried out on a population that performed self-monitoring. Conclusion: there is a statistically significant correlation between time on target and time above target with glycated hemoglobin. The higher the proportion in the adequate glycemic range, the closer to or less than 7% the glycated hemoglobin will be. More studies are needed to evaluate this metric with data from self-monitoring of blood glucose.


Objetivo: analisar a correlação entre o tempo no alvo e a hemoglobina glicada de pessoas que vivem com diabetes mellitus e realizam a monitorização contínua da glicemia ou a automonitorização da glicemia capilar. Método: revisão sistemática de etiologia e de risco pautada nas diretrizes do JBI e reportada conforme Preferred Reporting Items for Systematic Reviews and Meta-Analyses, abrangendo seis bases de dados e a literatura cinzenta. A amostra incluiu 16 estudos e a qualidade metodológica foi avaliada utilizando as ferramentas do JBI. Registrado protocolo no Open Science Framework, disponível em https://doi.org/10.17605/OSF.IO/NKMZB. Resultados: tempo no alvo (70-180 mg/dl) apresentou correlação negativa com a hemoglobina glicada, enquanto o tempo acima do alvo (>180 mg/dl) mostrou correlação positiva. Os coeficientes de correlação variaram entre -0,310 e -0,869 para o tempo no alvo, e entre 0,66 e 0,934 para o tempo acima do alvo. Um estudo foi efetuado com população que realizava a automonitorização. Conclusão: há correlação estatisticamente significativa entre o tempo no alvo e o tempo acima do alvo com a hemoglobina glicada. Quanto maior a proporção na faixa glicêmica adequada, mais próxima ou inferior a 7% estará a hemoglobina glicada. São necessários mais estudos que avaliem essa métrica com dados da automonitorização da glicemia.


Subject(s)
Humans , Blood Glucose , Glycated Hemoglobin , Blood Glucose Self-Monitoring , Diabetes Mellitus, Type 2
8.
Medicentro (Villa Clara) ; 27(2)jun. 2023.
Article in Spanish | LILACS | ID: biblio-1440526

ABSTRACT

Introducción: La enfermedad hepática grasa no alcohólica se caracteriza por: una acumulación de grasa en el hígado en forma de triacilglicéridos, ausencia de inflamación, fibrosis y un consumo de menos de 30 grados de alcohol al día. Esta afección se asocia a la diabetes mellitus (sobre todo tipo 2), y se observa un creciente aumento en el número de consultas hospitalarias por esta causa. Objetivo: Determinar la relación de los marcadores humorales y el estudio ultrasonográfico en pacientes diabéticos con enfermedad hepática grasa no alcohólica. Métodos: Se realizó una investigación descriptiva y transversal en la Consulta Provincial de Hepatología del Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro», en el período de marzo 2019 a diciembre 2020. El universo de estudio estuvo conformado por 89 pacientes (con edades mayores o iguales a 19 años, de ambos sexos); la muestra estuvo constituida por 66 pacientes que fueron seleccionados por muestreo no probabilístico. Resultados: Predominaron los pacientes con edades entre 40 y 59 años, masculinos, de piel blanca, y procedencia urbana. El grado de esteatosis predominante fue el grado 1 (leve). Los marcadores humorales (glicemia, gamma glutamil transpeptidasa, albúmina e índice de Ritis) fueron los más afectados patológicamente. Conclusiones: Los estudios ultrasonográficos mostraron una asociación estadísticamente significativa con alteración de los marcadores humorales de lesión hepática, lo cual puede alertar de una posible evolución desfavorable de esta enfermedad.


Introduction: non-alcoholic fatty liver disease is characterized by an accumulation of fat in the liver in the form of triacylglycerides, absence of inflammation, fibrosis and a consumption of less than 30 degrees of alcohol per day. This condition is associated with diabetes mellitus (especially type 2), and there is a growing increase in the number of hospital visits for this cause. Objective: to determine the relationship between humoral markers and ultrasonographic study in diabetic patients with non-alcoholic fatty liver disease. Methods: a descriptive and cross-sectional investigation was carried out in the provincial hepatology consultation at "Arnaldo Milián Castro" Clinical and Surgical University Hospital from March 2019 to December 2020. The study universe consisted of 89 patients (older than or equal to 19 years, of both genders); the sample consisted of 66 patients who were selected by non-probabilistic sampling. Results: white male patients aged between 40 and 59 years living in urban areas predominated. The predominant degree of steatosis was grade 1 (mild). Humoral markers (glycemia, gamma- glutamyl transpeptidase, albumin and De Ritis ratio) were the most pathologically affected. Conclusions: ultrasonographic studies showed a statistically significant association with changes in humoral markers of liver injury, which may alert to a possible unfavorable evolution of this disease.


Subject(s)
Blood Glucose , Diabetes Mellitus, Type 2 , Albumins , Non-alcoholic Fatty Liver Disease , Transaminases
9.
Rev. méd. Maule ; 38(1): 35-43, jun. 2023. tab
Article in Spanish | LILACS | ID: biblio-1562331

ABSTRACT

INTRODUCTION: Type 2 diabetes mellitus is a metabolic disorder that affects all aspects of the life and family of the person who suffers from it. The SARS-COV-2 infection pandemic has generated an immense problem at the health system level, causing a significant overload and a complexity of the services to attend to the infection. The foregoing has led many people to lose their chronic controls and cannot take care of themselves properly. OBJECTIVES: To measure the impact of the SARS-COV2 pandemic on the control of diabetic patients at CESFAM Las Américas, Talca city. METHODS: Observational, descriptive/analytical study of the Cardiovascular Health Program at CESFAM Las Américas in the city of Talca, of type 2 diabetic patients, enrolled under control, evaluated between December 2019 and September 2021. Information cutoffs will be 12 months and 15 months RESULTS: In a comparative analysis, we found significant differences with an increase in the indicators BMI, Glycemia, HAb1c and Triglycerides during the time of the Pandemic. However, clinically modest.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2/physiopathology , COVID-19/complications , Signs and Symptoms , Blood Glucose/analysis , Demography , Epidemiology, Descriptive , Clinical Laboratory Techniques , Family Practice
10.
Rev. méd. Chile ; 151(6): 687-695, jun. 2023. tab, ilus
Article in Spanish | LILACS | ID: biblio-1560240

ABSTRACT

INTRODUCCIÓN: El nuevo índice de obesidad basado en el volumen corporal (ABSI) ha sido asociado con enfermedades crónicas no transmisibles y mortalidad, independientemente de los valores del índice de masa corporal (IMC); sin embargo, se desconoce su asociación con diabetes mellitus tipo 2 (DMT2) en población chilena. OBJETIVO: determinar la asociación entre ABSI con glicemia, hemoglobina glicosilada (HbAc1) y DMT2 en población adulta chilena. MATERIALES Y MÉTODOS: Estudio transversal, incluyó a 4.874 participantes (edad media 43,3 años, 50,9% mujeres) de la Encuesta Nacional de Salud 2016-2017. ABSI fue calculado según la fórmula propuesta (basado en circunferencia de cintura, IMC y estatura. La Regresión de Poisson fue utilizada para investigar la asociación entre ABSI con DMT2 y regresión lineal para glicemia y HbAc1. Los análisis se ajustaron según factores sociodemográficos, de estilos de vida e IMC. RESULTADOS: ABSI fue positivamente asociado con glicemia (p < 0,001), HbA1c (p < 0,001) y DMT2 (p < 0,001). En el modelo más ajustado, por cada 0.025 unidad de aumento de ABSI, la glicemia aumentó en 1,78 mg/dL (95% IC: 1,21; 2,35) y la HbAc1en un 0,92% (95% IC: 0,49; 1,35). En cuanto a DMT2, la razón de prevalencia fue de 1,14 (95% IC: 1,09; 1,20), independiente de factores sociodemográficos, estilos de vida e IMC. CONCLUSIONES: ABSI se asoció de forma lineal con una mayor probabilidad de padecer DMT2, mayores niveles de glicemia y HbA1c en adultos chilenos. En este contexto, ABSI podría ser un índice complementario, independiente del IMC, para evaluar el riesgo de alteraciones metabólicas asociadas a obesidad.


INTRODUCTION: A Body Shape Index (ABSI) is a new obesity index based on body volume; this has been associated with chronic non-communicable diseases and mortality, independent of the values of the body mass index (BMI); however, its association with type 2 diabetes mellitus (T2DM) in the Chilean adult population is unknown. OBJECTIVE: To determine the association between ABSI, glycemia, glycosylated hemoglobin (HbAc1), and self-reported T2DM in the Chilean adult population. MATERIALS AND METHODS: In a cross-sectional study, 4,874 participants were included (mean age 43.3 years, 50.9% women) from the 2016-2017 National Health Survey. ABSI was calculated according to the proposed formula (based on waist circumference, BMI, and height). The Poisson regression was used to investigate the association between ABSI and T2DM, and linear regression was used to investigate the association between ABSI, glycemia, and HbAc1. Sociodemographic factors, lifestyle, and BMI adjusted the analyses. RESULTS: ABSI was positively associated with glycemia (p < 0.001), HbA1c (p < 0.001), and DMT2 (p < 0.001). In the most adjusted model, for every 0.025 unit increase in ABSI, glycemia increased by 1.78 mg/dL (95% CI: 1.21, 2.35) and HbAc1 by 0.92% (95% CI: 0.49, 1.35). Regarding T2DM, the prevalence ratio was 1.14 (95% CI: 1.09, 1.20), independent of sociodemographic factors, lifestyles, and BMI. CONCLUSIONS: ABSI was linearly associated with a higher probability of suffering from T2DM and higher levels of glycemia and HbA1c in Chilean adults. In this context, ABSI could be a complementary index, independent of BMI, to assess the risk of metabolic disorders associated with obesity.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Glycated Hemoglobin/analysis , Body Mass Index , Diabetes Mellitus, Type 2/epidemiology , Obesity/complications , Obesity/epidemiology , Socioeconomic Factors , Blood Glucose/analysis , Chile/epidemiology , Cross-Sectional Studies , Risk Factors , Waist Circumference
11.
Article in Spanish | LILACS | ID: biblio-1513950

ABSTRACT

El presente artículo busca analizar las evidencias aportadas del entrenamiento de la fuerza comprobando su influencia en la Diabetes Mellitus tipo II utilizando la literatura existente sobre este objeto de estudio. Se realizo una revisión sistemática siguiendo las directrices PRISMA donde el principal contexto fue el entrenamiento de la fuerza en pacientes con Mellitus II, siendo buscados en bases de datos Pubmed, Embase y Scopus donde fueron seleccionados 7 artículos. Los hallazgos señalan consistentemente que el entrenamiento de la fuerza bien programado incide gradualmente en algunos marcadores que identifican la diabetes Mellitus II al realizar intervenciones con sistemas de entrenamiento de la fuerza de forma positiva. Los autores recomiendan estudios con muestras mayores en lo posible de tipo control para verificar la incidencia del entrenamiento en las variables mencionadas en este estudio.


This Article Seeks analyzes the evidence provided by strength training, verifying its influence on Type II Diabetes Mellitus by using the existing literature on this subject of study. A systematic review was carried out following the PRISMA guidelines, where the main context was strength training in patients with Mellitus II. The search was carried out in Pubmed, Embase, and Scopus databases where 7 articles were selected. The findings consistently indicated that a well-structured strength training program gradually affected some markers that identify diabetes Mellitus II when performing interventions with strength training systems in a positive way. The authors recommend control-type studies with larger samples, if possible, to verify the incidence of training in the variables mentioned in this study.


Este artigo procura analisar as evidências fornecidas pelo treinamento de força, verificando sua influência no Diabetes Mellitus tipo II utilizando a literatura existente sobre este objeto de estudo. Foi realizada uma revisão sistemática seguindo as diretrizes PRISMA onde o principal contexto foi o treinamento de força em pacientes com Mellitus II, sendo pesquisada nas bases de dados Pubmed, Embase e Scopus onde foram selecionados 7 artigos. Os achados indicam consistentemente que o treinamento de força bem programado afeta gradualmente alguns marcadores que identificam o diabetes Mellitus II ao realizar intervenções com sistemas de treinamento de força de forma positiva. Os autores recomendam estudos do tipo controle com amostras maiores, se possível, para verificar a incidência de treinamento nas variáveis mencionadas neste estudo.


Subject(s)
Humans , Diabetes Mellitus, Type 2 , Resistance Training , Blood Glucose , Insulin Resistance
12.
Int. j interdiscip. dent. (Print) ; 16(1): 16-19, abr. 2023. tab
Article in Spanish | LILACS | ID: biblio-1440268

ABSTRACT

Objetivo: Conocer la ocurrencia de periodontitis a partir de un cuestionario de auto-reporte en una población de diabéticos en Montevideo, Uruguay. Materiales y métodos: Fueron invitados los participantes del 1er Encuentro de Diabetes en Uruguay, con diagnóstico de diabetes según auto-reporte, con al menos 18 años de edad y que firmaron el consentimiento informado. En todos los casos, fue aplicado un cuestionario con ocho preguntas previamente validadas al español de forma de estimar la ocurrencia de la Periodontits además de identificar indicadores asociados. Resultados: Un total de 37 personas respondieron el cuestionario suministrado, en su mayoría correspondientes al sexo femenino y de 45 años de edad promedio. La ocurrencia de periodontits fue del 68% de los encuestados, no existiendo diferencias significativas para el tipo de diabetes y las franjas etarias consideradas. Sin embargo las personas que presentaban periodontits tuvieron menos dientes naturales (según auto-reporte) al ser comparados con quienes no tenían periodontitis (27.5 vs. 20.4, p=0.01). Conclusiones: Los resultados del estudio permiten apreciar una condición oral deficitaria en aquellos diabéticos con periodontitis auto-reportada debido a la ocurrencia elevada de la misma así como la menor cantidad de dientes naturales.


Objective: To determine the occurrence of periodontitis from a self-report questionnaire in a population of diabetics in Montevideo, Uruguay. Materials and methods: Participants of the 1st Diabetes Meeting in Uruguay, with a diagnosis of diabetes according to self-report, with at least 18 years of age and signed the informed consent, were invited. In all cases, a questionnaire with eight questions previously validated in Spanish was applied in order to estimate the occurrence of Periodontits in addition to identifying associated indicators. Results: A total of 37 people answered the supplied questionnaire, mostly corresponding to the female sex and an average age of 45 years. The occurrence of periodontitis was 68%, with no significant differences for the type of diabetes and the age groups considered. However, people with periodontitis had fewer natural teeth (according to self-report) when compared to those who did not have periodontitis (27.5 vs. 20.4, p = 0.01). Conclusions: The results of the study allow us to appreciate a poor oral condition in those diabetics with self-reported periodontitis due to its high occurrence as well as the lower number of natural teeth.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Periodontitis/epidemiology , Diabetes Mellitus , Uruguay , Blood Glucose , Oral Health , Prevalence , Surveys and Questionnaires , Self Report
13.
Med. U.P.B ; 42(1): 2-9, ene.-jun. 2023. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1416060

ABSTRACT

Objetivo: determinar el efecto de dos tipos de ayuno sobre parámetros de satisfacción, náuseas, vómito, presión arterial y glucometría en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local en un servicio de hemodinámica en Medellín, 2019. Metodología: ensayo clínico aleatorizado abierto de dos brazos en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local durante tres meses. Cada brazo con 153 participantes; se asignó un ayuno de seis horas y al grupo de exposición un ayuno de dos horas para alimentos de fácil digestión; no hubo cega­miento, se realizó cálculo de muestra, y se hizo análisis univariado, bivariado y modelo de regresión logística con la variable satisfacción. Resultados: en el grupo de ayuno de seis horas el 2.6% presentó náuseas y en el grupo de exposición el 1.3%; se observó un caso de vómito. La presión arterial y glucometría mostraron diferencias estadísticas sin relevancia clínica. Se encontró significancia esta­dística para mareo, cefalea, hambre, sed y tipo de ayuno respecto con la satisfacción del paciente. Los pacientes con ayuno tuvieron un puntaje de satisfacción entre 60 y 100 y los de dieta ligera entre 82.5 y 100 puntos. Conclusiones: El ayuno de dos horas en dieta ligera mejora la satisfacción de los pa­cientes, disminuye la sensación de hambre, sed, presencia de cefalea y mareo, compa­rado con un ayuno de seis horas. Este estudio no encontró diferencias en las variables hemodinámicas ni en la frecuencia de náuseas y vómito.


Objective: to determine the effect of two types of fasting on parameters of satisfaction, nausea, vomiting, blood pressure and glucose measurement in patients undergoing percutaneous intervention procedures under local anesthesia in a hemodynamic service in Medellín, 2019. Methodology: Two-arm open-label randomized clinical trial in patients undergoing percutaneous interventional procedures under local anesthesia for three months, each arm with 153 participants, who were assigned a six-hour fast and the exposure group a two-hour fast for easily digestible foods. There was no blinding, sample calculation was performed, and univariate and bivariate analysis and logistic regression model were performed with the satisfaction variable. Results: in the six-hour fasting group, 2.6% presented nausea and in the exposure group, 1.3%; one case of vomiting was observed. Blood pressure and blood glucose showed statistical differences without clinical relevance. Statistical significance was found for dizziness, headache, hunger, thirst, and type of fasting with respect to patient satisfaction. Fasting patients had a satisfaction score between 60 and 100 and those on a light diet between 82.5 and 100 points. Conclusions: Fasting for two hours on a light diet improves patient satisfaction, decreases the sensation of hunger, thirst, headache and dizziness, compared to a six-hour fast. This study found no differences in the hemodynamic variables, nor in the frequency of nausea and vomiting.


Objetivo: determinaro efeito de dois tipos de jejum nos parâmetros de satisfação, náuseas, vômitos, pressão arterial e glicemia em pacientes submetidos a procedimentos de intervenção percutânea sob anestesia local em um serviço de hemodinâmica em Medellín, 2019. Metodologia: Ensaio clínico randomizado aberto de dois braços em pacientes submetidos a procedimentos intervencionistas percutâneos sob anestesia local por três meses. Cada braço com 153 participantes; um jejum de seis horas foi designado e o grupo de desafio um jejum de duas horas para alimentos facilmente digeríveis; não houve cegamento, foi realizado cálculo amostral, análise univariada, bivariada e modelo de regressão logística com a variável satisfação. Resultados: no grupo de jejum de seis horas, 2,6% apresentaram náuseas e no grupo de exposição, 1,3%; foi observado um caso de vômito. A pressão arterial e a glicemia apresentaram diferenças estatísticas sem relevância clínica. Foi encontrada significância estatística para tontura, dor de cabeça, fome, sede e tipo de jejum em relação à satisfação do paciente. Os pacientes em jejum tiveram um escore de satisfação entre 60 e 100 e os em dieta light entre 82,5 e 100 pontos. Conclusões: O jejum de duas horas com dieta leve melhora a satisfação do paciente, diminui a sensação de fome, sede, dor de cabeça e tontura, em comparação com o jejum de seis horas. Este estudo não encontrou diferenças nas variáveis hemodinâmicas ou na frequência de náuseas e vômitos.


Subject(s)
Humans , Fasting , Vomiting , Blood Glucose , Patient Satisfaction , Hemodynamics , Anesthesia, Local
14.
Bol. latinoam. Caribe plantas med. aromát ; 22(1): 68-85, ene. 2023. tab, graf, ilus
Article in English | LILACS | ID: biblio-1555040

ABSTRACT

Ibervillea sonorae (S. Watson) Greene, is a plant native to Mexico, where its roots have been used traditionally for treating Diabetes Mellitus. The aim of this work was to establishment of cell cultures of stem explants of I. sonorae and evaluation of the anti-hyperglycemic activity of cell aqueous extract on a murine model of streptozotocin-induced diabetic rats. Cell extracts had 2.29 mg palmitic acid/g extracted, and other compounds with pharmacological activities like palmitoyl ethanolamide and palmitoyl tryptamine were also identified. Diabetic rats treated with aqueous cell extract decreased glucose levels from 350 mg/dL to 145 mg/dL, AST and ALT from 164 U/L to 49 U/L and 99 U/L to 53 U/L, respectively. Additionally, there were no changes in the cellular morphology of the pancreas, liver, kidneys, and spleen. These results revealed that the cell aqueous extract from stem explants has anti-hyperglycemic activity.


Ibervillea sonorae (S. Watson) Greene, es una planta originaria de México, donde sus raíces se han utilizado tradicionalmente para el tratamiento de la Diabetes Mellitus. El objetivo de este trabajo fue el establecimiento de cultivos celulares de explantes de tallo de I. sonorae y la evaluación de la actividad anti-hiperglucémica del extracto acuoso celular en un modelo de ratas diabéticas inducidas con estreptozotocina. El extracto celular contiene 2.29 mg de ácido palmítico/g extracto y se identificaron otros compuestos como palmitoil etanolamida y palmitoil triptamina. Las ratas diabéticas tratadas con extracto celular disminuyeron los niveles de glucosa de 350 mg/dL a 145 mg/dL, AST y ALT de 164 U/L a 49 U/L y 99 U/L a 53 U/L, respectivamente. Además, no hubo cambios en la morfología celular del páncreas, hígado, riñones y bazo. Estos resultados indican que el extracto de células de explantes de tallo de I. sonorae tiene actividad anti-hiperglucémica.


Subject(s)
Animals , Male , Rats , Plant Extracts/administration & dosage , Hyperglycemia/drug therapy , Hypoglycemic Agents/administration & dosage , Phenols/analysis , Flavonoids/analysis , Blood Glucose/drug effects , Plant Extracts/chemistry , Chromatography, High Pressure Liquid , Rats, Wistar , Cell Culture Techniques , Disease Models, Animal , Fatty Acids/analysis , Hypoglycemic Agents/chemistry , Mexico
15.
Chinese Journal of Epidemiology ; (12): 592-597, 2023.
Article in Chinese | WPRIM | ID: wpr-985532

ABSTRACT

Objective: This study aimed to investigate the epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in (Hebei, Zhejiang, Shaanxi, Hunan) 4 provinces of China and the influence of demographic and economic characteristics on them. Methods: A total of 1 747 children and adolescents aged 7-17 from a Community-based Cohort Study on Nervous System Disease in 2018 were selected. High waist circumference, central obesity, elevated TG, elevated TC, elevated LDL-C, decreased HDL-C, elevated blood pressure, elevated blood glucose, and clustering of risk factors was analyzed. χ2 test was used for univariate analysis, multivariate logistic regression was used to analyze the correlation between demographic and economic factors and risk factors, and the Cochran-Armitage trend test was used for trend analysis. Results: The detection rates of high waist circumference, decreased HDL-C, elevated blood pressure, elevated TG, elevated blood glucose, central obesity, elevated TC, and elevated LDL-C were 29.08%, 15.28%, 13.17%, 13.05%, 11.79%, 7.33%, 6.53%, and 5.15%, respectively. The rate of clustering of risk factors was 18.37%. Multivariate logistic regression analysis showed that the risk of high waist circumference in girls was higher than that in boys (OR=1.67, 95%CI: 1.26-2.22), and the risk of elevated blood glucose and clustering of risk factors was lower than that in boys (OR=0.69, 95%CI: 0.49-0.99; OR=0.72, 95%CI: 0.53-0.99). The risk of high waist circumference, decreased HDL-C, and clustering of risk factors in 13-17 years old group was higher than that in the 7-year-olds group (OR=2.24, 95%CI: 1.65-3.04; OR=1.59, 95%CI: 1.20-2.11; OR=1.75, 95%CI: 1.26-2.44), but the risk of central obesity was lower (OR=0.54, 95%CI: 0.37-0.78). The risk of elevated TC, elevated TG, and decreased HDL-C in children and adolescents in southern was higher than that in northern parts of China (OR=1.88, 95%CI: 1.25-2.83; OR=1.61, 95%CI: 1.17-2.22; OR=1.55, 95%CI: 1.19-2.04), but the risk of high waist circumference and central obesity was lower than that in northern China (OR=0.57, 95%CI: 0.43-0.75; OR=0.62, 95%CI: 0.42-0.90). The risk of decreased HDL-C in rural children and adolescents was higher than in urban children and adolescents (OR=1.36, 95%CI: 1.02-1.83). The risk of multiple risk factors increased with the increase in average monthly household income per capita and BMI level. Conclusions: High waist circumference, decreased HDL-C and elevated blood pressure were prominent cardio-metabolic risk factors among children and adolescents aged 7-17 years in 4 provinces of China in 2018. The region, average monthly household income per capita, and BMI were the main influencing factors of cardio-metabolic risk factors.


Subject(s)
Male , Female , Humans , Child , Adolescent , Obesity, Abdominal/epidemiology , Cholesterol, LDL , Blood Glucose , Cohort Studies , Body Mass Index , Risk Factors , Obesity , Hypertension , China/epidemiology , Waist Circumference
16.
Zhonghua Nei Ke Za Zhi ; (12): 891-895, 2023.
Article in Chinese | WPRIM | ID: wpr-986004

ABSTRACT

A 50-year-old man with a 15-year history of elevated blood glucose and an approximately 2-year history of diarrhea was admitted to the Peking Union Medical College Hospital. The initial diagnosis was type 2 diabetes. After repeated pancreatitis and pancreatoduodenectomy, severe pancreatic endocrine and exocrine dysfunction including alternating high and low blood glucose and fat diarrhea occurred. Tests for type 1 diabetes-related antibodies were all negative, C-peptide levels were substantially reduced, fat-soluble vitamin levels were reduced, and there was no obvious insulin resistance. Therefore, a diagnosis of pancreatic diabetes was clear. The patient was given small doses of insulin and supplementary pancreatin and micronutrients. Diarrhea was relieved and blood glucose was controlled. The purpose of this article is to raise clinicians' awareness of the possibility of pancreatic diabetes after pancreatitis or pancreatic surgery. Timely intervention and monitoring may reduce the occurrence of complications.


Subject(s)
Male , Humans , Middle Aged , Blood Glucose , Diabetes Mellitus, Type 2/complications , Pancreaticoduodenectomy/adverse effects , Pancreatitis, Chronic/complications , Malnutrition/complications
17.
Beijing Da Xue Xue Bao ; (6): 450-455, 2023.
Article in Chinese | WPRIM | ID: wpr-986875

ABSTRACT

OBJECTIVE@#To investigate the mechanism of self-efficacy between self-management ability and self-management behavior and its differences among patients with different disease courses through mediation tests.@*METHODS@#In the study, 489 patients with type 2 diabetes who attended the endocrinology departments of four hospitals in Shanxi Province and Inner Mongolia Autonomous Region from July to September 2022 were enrolled as the study population. They were investigated by General Information Questionnaire, Diabetes Self-Management Scale, Chinese version of Diabetes Empowerment Simplified Scale, and Diabetes Self-Efficacy Scale. Mediation analyses were performed using the linear regression model, Sobel test, and Bootstrap test in the software Stata version 15.0 and divided the patients into different disease course groups for subgroup analysis according to whether the disease course was > 5 years.@*RESULTS@#In this study, the score of self-management behavior in the patients with type 2 diabetes was 6.16±1.41, the score of self-management ability was 3.99±0.74, and the score of self-efficacy was 7.05±1.90. The results of the study showed that self-efficacy was positively correlated with self-management ability (r=0.33) as well as self-management behavior (r=0.47) in the patients with type 2 diabetes (P < 0.01). The mediating effect of self-efficacy accounted for 38.28% of the total effect of self-management ability on self-management behaviors and was higher in the behaviors of blood glucose monitoring (43.45%) and diet control (52.63%). The mediating effect of self-efficacy accounted for approximately 40.99% of the total effect for the patients with disease course ≤ 5 years, while for the patients with disease course > 5 years, the mediating effect accounted for 39.20% of the total effect.@*CONCLUSION@#Self-efficacy enhanced the effect of self-management ability on the behavior of the patients with type 2 diabetes, and this positive effect was more significant for the patients with shorter disease course. Targeted health education should be carried out to enhance patients' self-efficacy and self-management ability according to their disease characteristics, to stimulate their inner action, to promote the development of their self-management behaviors, and to form a more stable and long-term mechanism for disease management.


Subject(s)
Humans , Diabetes Mellitus, Type 2/therapy , Self Efficacy , Self-Management , Blood Glucose Self-Monitoring , Blood Glucose , Self Care
18.
Article in Chinese | WPRIM | ID: wpr-986978

ABSTRACT

OBJECTIVE@#To investigate the effect of Zuogui Jiangtang Jieyu Decoction (ZJJ) on Shh signaling and self-renewal of neural stem cells in the hippocampal dentate gyrus of diabetic rats with depression.@*METHODS@#Diabetic rat models with depression were randomly divided into model group, positive drug (metformin + fluoxetine) group, and low-, medium-, and high-dose ZJJ groups (n=16), with normal SD rats as the control group. The positive drugs and ZJJ were administered by gavage, and the rats in the control and model groups were given distilled water. After the treatment, blood glucose level was detected using test strips, and behavioral changes of the rats were assessed by forced swimming test and water maze test. ELISA was used to examine the serum level of leptin; The expressions of nestin and Brdu proteins in the dentate gyrus of the rats were detected using immunofluorescence assay, and the expressions of self-renewal marker proteins and Shh signaling proteins were detected using Western blotting.@*RESULTS@#The diabetic rats with depression showed significantly increased levels of blood glucose and leptin (P < 0.01) and prolonged immobility time in forced swimming test (P < 0.01) and increased stage climbing time with reduced stage seeking time and stage crossings in water maze test (P < 0.01). The expressions of nestin and Brdu in the dentate gyrus, the expressions of cyclin D1, SOX2, Shh, Ptch1, Smo in the hippocampus and the nuclear expression of Gli-1 were decreased (P < 0.01) while hippocampal Gli-3 expression was increased significantly (P < 0.01) in the rat models. Treatment of rat models with high-dose ZJJ significantly reduced the blood glucose (P < 0.01) and leptin level (P < 0.05) and improved their performance in behavioral tests (P < 0.01). The treatment also obviously increased the expressions of nestin, Brdu, cyclin D1, SOX2, Shh, Ptch1, and Smo and the nuclear expression of Gli-1 in the dentate gyrus (P < 0.01) and reduced hippocampal expression of Gli-3 (P < 0.05) in the rat models.@*CONCLUSION@#ZJJ can significantly improve the self-renewal ability of neural stem cells and activate Shh signaling in dentate gyrus of diabetic rats with depression.


Subject(s)
Animals , Rats , Blood Glucose , Bromodeoxyuridine , Cell Self Renewal , Cyclin D1 , Dentate Gyrus , Depression , Diabetes Mellitus, Experimental , Hippocampus , Leptin , Nestin , Rats, Sprague-Dawley
19.
Chinese Journal of Epidemiology ; (12): 401-407, 2023.
Article in Chinese | WPRIM | ID: wpr-969920

ABSTRACT

Objective: To explore the associations of glycated hemoglobin (HbA1c) with FPG and oral glucose tolerance test 2-hour (OGTT-2 h) in areas at different altitude in China. Methods: Subjects who participated in 2018-2019 China Chronic Disease and Risk Factor Surveillance and had no prior type 2 diabetes diagnosis were included. Subsequently, they were categorized into three groups based on altitude of living area (<2 000, 2 000- and ≥3 000 m). With adjustment for intracluster correlation, multivariable linear regression analysis was performed to evaluate the associations of HbA1c with FPG and OGTT-2 h in the context of HbA1c was normal (<5.7%) or abnormal (≥5.7%). Furthermore, the shape of relationships between HbA1c and glucose indicators was examined using restricted cubic spline. Finally, receiver operating characteristic curve was used to evaluate the diagnostic performance of HbA1c for diabetes. Results: A total of 157 277 subjects were included in the analysis. While FPG and OGTT-2 h levels gradually decreased with increase of altitude, HbA1c level was similar among the three groups. When HbA1c was <5.7%, its association with FPG and OGTT-2 h was weak and no obvious difference was observed among the three groups. When HbA1c was ≥5.7%, the FPG and OGTT-2 h increased by 15.45% (95%CI:14.71%- 16.18%) and 24.54% (95%CI:23.18%-25.91%) respectively per one standard deviation increase in HbA1c in group in area at altitude <2 000 m. However, the FPG and OGTT-2 h increased by 13.08% (95%CI:10.46%-15.76%) and 21.72% (95%CI:16.39%-27.31%), respectively, in group in area at altitude 2 000- m, and increased by 11.41% (95%CI:9.32%-13.53%) and 20.03% (95%CI:15.38%- 24.86%), respectively, in group of altitude ≥3 000 m. The restricted cubic spline indicated that the curve showing the association of HbA1c with FPG and OGTT-2 h was flat when HbA1c was <5.7%, but showed a positive linear relationship when HbA1c was ≥5.7%. The area under curve for detecting diabetes was 0.808 (95%CI:0.803-0.812) in group of altitude <2 000 m and 0.728 (95%CI:0.660-0.796, P=0.022) in group of altitude ≥3 000 m. The relevant optimal cutoff value of HbA1c was 5.7%, with a sensitivity of 65.4% and a specificity of 83.0%, and 6.0%, with a sensitivity of 48.3% and a specificity of 93.7%, respectively. Conclusions: When HbA1c was ≥5.7%, the association between HbA1c and glucose indicators became weaker as the increase of altitude. In the area at altitude ≥3 000 m, it may not be appropriate to use HbA1c in the diagnosis of diabetes.


Subject(s)
Adult , Humans , Glycated Hemoglobin , Diabetes Mellitus, Type 2/diagnosis , Blood Glucose/analysis , Glucose , Altitude , Fasting , China/epidemiology , Diabetes Mellitus/epidemiology
20.
Zhongguo zhenjiu ; (12): 53-59, 2023.
Article in Chinese | WPRIM | ID: wpr-969947

ABSTRACT

OBJECTIVE@#To observe the hypoglycemic effect of electroacupuncture (EA) at "Tianshu" (ST 25) combined with metformin on rats with type 2 diabetes mellitus (T2DM) as well as its effect on expression of adenosine monophosphate activated protein kinase (AMPK) in liver and pancreas.@*METHODS@#Thirty-six male SD rats were randomly divided into a blank group (6 rats) and a model establishing group (30 rats). The rats in the model establishing group were fed with high-fat diet and treated with intraperitoneal injection of low-dose streptozotocin (STZ) to establish T2DM model. The rats with successful model establishment were randomly divided into a model group, a control group, a metformin group, an EA group and a combination group, 6 rats in each group. The rats in the EA group were treated with EA at "Tianshu" (ST 25), dense-disperse wave, 2 Hz/15 Hz in frequency and 2 mA in current intensity, 20 min each time. The rats in the metformin group were treated with intragastric administration of metformin (190 mg/kg) dissolved in 0.9% sodium chloride solution (2 mL/kg). The rats in the combination group were treated with EA at "Tianshu" (ST 25) and intragastric administration of metformin. The rats in the control group were treated with intragastric administration of 0.9% sodium chloride solution with the same dose. All the treatments were given once a day for 5 weeks. After the intervention, the body mass and random blood glucose were detected; the serum insulin level was detected by ELISA; the expression of AMPK and phosphorylated adenosine monophosphate activated protein kinase (p-AMPK) in liver and pancreas was detected by Western blot method; the expression of protein gene product 9.5 (PGP9.5) was detected by immunofluorescence.@*RESULTS@#①Compared with the blank group, the body mass in the model group was decreased (P<0.05); compared with the model group, the body mass in the EA group and the combination group was decreased (P<0.05); the body mass in the EA group and the combination group was lower than the metformin group (P<0.05). Compared with the blank group, the random blood glucose in the model group was increased (P<0.01); compared with the model group, the random blood glucose in the metformin group, the EA group and the combination group was decreased (P<0.01). The random blood glucose in the combination group was lower than the metformin group and the EA group (P<0.05). ②Compared with the blank group, the insulin level in the model group was decreased (P<0.05); compared with the model group, the insulin level in the metformin group, the EA group and the combination group was all increased (P<0.05). The insulin level in the combination group was higher than the metformin group and the EA group (P<0.05). ③Compared with the blank group, the protein expression of AMPK and p-AMPK in liver tissue was decreased (P<0.05), and the protein expression of AMPK and p-AMPK in pancreatic tissue was increased (P<0.05) in the model group. Compared with the model group, the protein expression of AMPK and p-AMPK in liver tissue in the metformin group, the EA group and the combination group was increased (P<0.05, P<0.01); the protein expression of AMPK in pancreatic tissue in the metformin group was increased (P<0.05); the protein expression of AMPK in pancreatic tissue in the EA group and the combination group was decreased (P<0.05); the protein expression of p-AMPK in pancreatic tissue in the metformin group, the EA group and the combination group was decreased (P<0.05). The protein expression of AMPK and p-AMPK in liver tissue in the combination group was higher than that in the metformin group and the EA group (P<0.05); the protein expression of AMPK in pancreatic tissue in the EA group and the combination group was less than that in the metformin group (P<0.05), and the expression of p-AMPK protein in pancreatic tissue in the combination group was less than that in the metformin group and the EA group (P<0.05). ④Compared with the blank group, the expression of PGP9.5 in pancreatic tissue in the model group was increased (P<0.01); compared with the model group, the expression of PGP9.5 in pancreatic tissue in the metformin group, the EA group and the combination group was decreased (P<0.05, P<0.01). The expression of PGP9.5 in pancreatic tissue in the EA group was lower than the metformin group and the combination group (P<0.05).@*CONCLUSION@#Electroacupuncture at "Tianshu" (ST 25) could promote the effect of metformin on activating AMPK in liver tissue of T2DM rats, improve the negative effect of metformin on AMPK in pancreatic tissue, and enhance the hypoglycemic effect of metformin. The mechanism may be related to the inhibition of pancreatic intrinsic nervous system.


Subject(s)
Animals , Male , Rats , Acupuncture Points , AMP-Activated Protein Kinases/genetics , Blood Glucose , Diabetes Mellitus, Type 2/drug therapy , Electroacupuncture , Hypoglycemic Agents , Insulins , Metformin , Rats, Sprague-Dawley
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