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1.
Braz. j. biol ; 84: e250739, 2024. tab
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1355896

ABSTRACT

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.


Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.


Subject(s)
Humans , Receptors, Calcitriol/genetics , Diabetes Mellitus, Type 2/genetics , Diabetes Mellitus, Type 2/epidemiology , Saudi Arabia , Case-Control Studies , Polymorphism, Single Nucleotide , Gene Frequency , Genotype
3.
Arq. bras. cardiol ; 118(2): 388-397, 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1364319

ABSTRACT

Resumo Fundamentos A alimentação saudável é um fator de proteção contra o diabetes tipo 2 e desempenha importante papel no tratamento do diabetes e das comorbidades associadas. Objetivo Caracterizar o hábito alimentar de idosos diabéticos e não diabéticos com 65 anos ou mais, residentes nas capitais brasileiras e no Distrito Federal. Métodos Estudo transversal com dados da pesquisa Vigilância de Fatores de Risco e Proteção para as Doenças Crônicas por Inquérito Telefônico (Vigitel, 2016). Foram estimadas as prevalências de diabetes melito segundo variáveis sociodemográficas, inatividade física, autoavaliação da saúde e índice de massa corporal (IMC). O hábito alimentar foi avaliado pela frequência (semanal e diária) de consumo de alimentos saudáveis e não saudáveis, e pela substituição da comida por lanches. As diferenças foram verificadas por meio do teste Qui-quadrado de Pearson (Rao-Scott) com nível de significância de 5%. Resultados Foram entrevistados 13.649 idosos, e a prevalência de diabetes autorreferido foi de 27,2% (IC95%:25,5; 29,0). Nos pacientes diabéticos, observou-se maior consumo de hortaliças cruas (32,1% vs. 26,5%/3-4 dias/semana) e menor de frango (3,8% vs. 6,4%/quase nunca/nunca), suco (24,0% vs. 29,6%) e doces (6,8% vs. 16,2%) ≥5 dias/semana. Os percentuais de idosos com consumo de leite desnatado (51,5% vs. 44,6%) e refrigerante dietético (60,0% vs. 17,3%) ≥5 dias/semana, hortaliças cruas (9,1% vs. 2,5%/no jantar) e doces (37,7% vs. 20,5%/2 vezes/dia) 3-4 dias/semana foram maiores nos diabéticos, comparados aos não diabéticos. Conclusão As diferenças observadas sinalizam a necessidade de promover intervenções para alimentação saudável entre todos os idosos, bem como orientações específicas para os diabéticos.


Abstract Background A healthy diet is a protection factor against type 2 diabetes and plays an important role in the treatment of the disease, as well as associated comorbidities. Objective Characterize the eating habits of older adults (≥ 65 years) with and without diabetes residing in capital cities and the Federal District of Brazil. Methods A cross-sectional study was conducted using data from the Surveillance of Risk and Protection Factors for Chronic Diseases Through a Telephone Survey (Vigitel, 2016). The prevalence of diabetes mellitus was estimated according to sociodemographic variables, physical inactivity level, self-rated health status and body mass index. Dietary habits were assessed based on the frequency (weekly and daily) of consumption of healthy and unhealthy foods and the replacement of food by snacks. Differences were determined using Pearson's chi-square test (Rao-Scott), with the significance level set at 5%. Results A total of 13,649 older adults were interviewed. The prevalence of self-reported diabetes was 27.2% (95% CI: 25.5; 29.0). Compared to non-diabetics, diabetic individuals had a higher consumption of raw vegetables (32.1% vs. 26.5%/3-4 days/week) and lower consumption of chicken (3.8% vs. 6.4%/hardly ever/never), fruit juice (24.0% vs. 29.6%) and sweets (6.8% vs. 16.2%) ≥ 5 days/week. Compared to non-diabetics, diabetic individuals consumed more skim milk (51.5% vs. 44.6%) and diet soda (60.0% vs. 17.3%) ≥ 5 days/week, raw vegetables (9.1% vs. 2.5%/at dinner) and sweets (37.7% vs. 20.5%/twice/day) 3-4 days/week. Conclusion The observed differences emphasize the need for healthy eating interventions for all older adults, as well as specific counseling for those with diabetes.


Subject(s)
Humans , Aged , Diabetes Mellitus, Type 2/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Diet , Feeding Behavior
4.
Más Vita ; 3(4): 65-72, dic. 2021. tab
Article in Spanish | LILACS | ID: biblio-1355027

ABSTRACT

Una de las principales dificultades en la atención al adulto mayor diabético continúa siendo la falta de educación hacia un estilo de vida y una actitud favorable hacia la enfermedad, lo cual solo puede lograrse mediante estrategias educativas. Objetivo: Validar los instrumentos AM1 ­ MO de la investigación factores modificables y su influencia en la presencia de complicaciones en adultos mayores con Diabetes Mellitus tipo 2 en el club de adultos mayores Lupita Nolivos en la Carrera de Enfermería de la Universidad de Guayaquil, en los periodos de septiembre a diciembre 2019. Materiales y Métodos: El Instrumento AM1 ­MO se realizó un estudio descriptivo, exploratorio y transversal, este instrumento cuantitativo se aplicó al universo de 50 adultos mayores entre 55 y 65 años y más, utilizando el SOFTWARE IBM SPSS Statistics Base 22.0. Resultados: Del total de pacientes con DMT2, el sexo femenino estuvo representado con 60,0 % y el masculino aportó 40,0 %. El grupo de edad de 70-79 fue el de mayor predominio de dicha afección con 62,0 %, de ellos 18 eran mujeres y 13 hombres. En cuanto a los hábitos alimentarios resulto se obtuvo los siguientes resultados que hay un alto consumo de gaseosas y dulces 24%. Conclusiones: En este trabajo se identificó que las personas que tienen mayor riesgo de desarrollar DMT2 son aquellas que tienen una edad superior a 55 años, presentan antecedentes familiares para esta enfermedad, son del sexo femenino, presentan exceso de peso, son físicamente inactivas y padecen HTA. En conclusión, el instrumento construido constituye una aproximación para determinar los factores modificables y su influencia en la presencia de complicaciones en adultos mayores con diabetes mellitus tipo 2. Los resultados obtenidos por las diferentes vías para evaluar los instrumentos utilizados fueron adecuados. Está disponible un instrumento válido y confiable que justifica su uso y aplicación en el ámbito investigativo(AU)


One of the main difficulties in caring for the elderly with diabetes continues to be the lack of education towards a lifestyle and a favorable attitude towards the disease, which can only be achieved through educational strategies. Objective: to validate the AM1 ­ MO instrument of the research, modifiable factors and their influence on the presence of complications in older adults with Type 2 Diabetes Mellitus in the Lupita Nolivos club for older adults in the Nursing Career of the University of Guayaquil, in the periods from September to December 2019. Materials and Methods: The AM1-MO Instrument was carried out a descriptive, exploratory and cross-sectional study, this quantitative instrument was applied to the universe of 50 older adults between 55 and 65 years old and over, using the IBM SPSS SOFTWARE Statistics Base 22.0. Results: Of the total number of patients with T2DM, the female sex was represented with 60.0% and the male contributed 40.0%. The age group 70-79 was the one with the highest prevalence of this condition with 62.0%, of which 18 were women and 13 were men. Regarding eating habits, the following results were obtained that there is a high consumption of soda and sweets 24%. Conclusions: In this work it was identified that the people who have a higher risk of developing T2DM are those who are older than 55 years, have a family history for this disease, are female, are overweight, are physically inactive and suffer from HTA. In conclusion, the instrument constructed constitutes an approximation to determine the modifiable factors and their influence on the presence of complications in older adults with type 2 diabetes mellitus. The results obtained by the different ways to evaluate the instruments used were adequate. A valid and reliable instrument is available that justifies its use and application in the research field(AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Teaching , Aged , Diabetes Mellitus, Type 2/epidemiology , Elderly Nutrition , Life Style , Risk Factors , Overweight , Hypertension
5.
Arch. endocrinol. metab. (Online) ; 65(6): 801-810, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1349996

ABSTRACT

ABSTRACT Objective: To evaluate the prevalence of osteosarcopenia and the association of osteosarcopenia with trabecular bone score (TBS) in a group of patients with type 2 diabetes mellitus(T2DMG) compared with a paired control group (CG). Materials and methods: Cross-sectional study with men and women ≥ 50 years recruited by convenience. Patients in both groups answered questionnaires and underwent evaluation of bone mineral density (BMD), handgrip strength (HGS), and TBS. The T2DMG also underwent a gait speed (GS) test. Sarcopenia was defined as low lean mass plus low HGS or GS according to the Foundation for the National Institute of Health Sarcopenia Project, and osteosarcopenia was deemed present when sarcopenia was associated with osteopenia, osteoporosis, or low-energy trauma fractures. Results: The T2DMG (n = 177) and CG (n = 146) had, respectively, mean ages of 65.1 ± 8.2 years and 68.8 ± 11.0 years and 114 (64.4%) and 80 (54.7%) women. T2DMG versus the CG had higher rates of osteosarcopenia (11.9% versus 2.14%, respectively, p = 0.010), sarcopenia (12.9% versus 5.4%, respectively, p < 0.030), and fractures (29.9% versus 18.5%, respectively, p = 0.019), and lower HGS values (24.4 ± 10.3 kg versus 30.9 ± 9.15 kg, respectively, p < 0.001), but comparable BMD values. Mean TBS values were 1.272 ± 0.11 and 1.320 ± 0.12, respectively (p = 0.001). On multivariate analysis, age, greater waist circumference, fractures, and osteoporosis increased the risk of degraded TBS. Osteosarcopenia was associated with diabetes complications (p = 0.03), calcium and vitamin D supplementation (p = 0.01), and all components of osteosarcopenia diagnosis (p < 0.05). Conclusion: Compared with the CG, the T2DMG had a higher prevalence of osteosarcopenia, sarcopenia, and fractures and lower bone quality assessed by TBS.


Subject(s)
Humans , Male , Female , Aged , Osteoporosis/etiology , Osteoporosis/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Sarcopenia/etiology , Sarcopenia/epidemiology , Absorptiometry, Photon , Bone Density , Cross-Sectional Studies , Hand Strength , Cancellous Bone/diagnostic imaging , Middle Aged
6.
Ciênc. Saúde Colet ; 26(supl.3): 5081-5088, Oct. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1345760

ABSTRACT

Resumo O objetivo deste estudo foi analisar o uso e o acesso aos medicamentos para o diabetes mellitus tipo 2 em idosos atendidos na Estratégia Saúde da Família de Ribeirão Preto, São Paulo. Trata-se de um inquérito domiciliar de base populacional realizado com 338 idosos, em amostragem por conglomerados. Investigou-se a farmacoterapia do diabetes e o acesso por meio de um questionário estruturado em entrevistas face a face. O número de medicamentos usados no tratamento do diabetes variou de um a quatro. Observou-se o predomínio de antidiabéticos orais, sendo o uso de apenas metformina autorreferido por 37,9% dos idosos, e 9,8% usavam sulfonilureia isoladamente. No grupo de idosos com idade igual ou superior a 80 anos, percebeu-se maior frequência (38,9%) no uso de insulina do que nos outros grupos etários. O acesso total foi estimado em 96,4%, a forma de financiamento gratuita correspondeu a 78,1% e as farmácias do Sistema Único de Saúde foram os principais locais de provisão dos medicamentos (74,8%). A metformina foi o antidiabético oral mais usado pelos idosos, em conformidade com as atuais recomendações para o tratamento da doença. Contudo, verificou-se usos inapropriados, especificamente na utilização isolada de sulfonilureia. Além disso, evidenciou-se a importância do sistema público de saúde para o fornecimento dos medicamentos.


Abstract The objective of this study was to analyze the use and access to medications for type 2 diabetes among older people registered in the family health strategy in Ribeirão Preto, São Paulo. A population-based household survey was undertaken with 338 older adults selected using two-stage cluster sampling. Pharmacotherapy of diabetes and access to medications was investigated using a structured questionnaire administered by means of face-to-face interviews. The number of medicines used to treat diabetes ranged between 1 and 4. Respondents predominantly used only oral antidiabetic agents. The use of metformin and sulfonylureas on their own was reported by 37.9% and 9.8% of respondents, respectively. Frequency of insulin use was greatest in the 80 years and overage group (38.9%). The large majority of respondents (96.4%) had full access to medicines. Means of payment was "free of charge" in 78.1% of the respondents and public pharmacies were the main source of medication (74.8%). The most commonly used oral antidiabetic was metformin, which is consistent with current treatment guidelines. However, the findings show inappropriate medication use among older people, more specifically the use of sulfonylureas on their own. The findings of this study highlight the important role played by the public health service in providing medications for type 2 diabetes.


Subject(s)
Humans , Aged , Pharmacies , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Brazil , Health Services Accessibility , Hypoglycemic Agents
7.
Rev. medica electron ; 43(3): 716-731, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289814

ABSTRACT

RESUMEN Introducción: los carcinomas diferenciados de tiroides se originan en el epitelio folicular. De ellos el carcinoma papilar muestra una mayor incidencia. Una variante del mismo es la folicular, que en ocasiones muestra un patrón arquitectural que imita a un adenoma folicular. Objetivo: contribuir al diagnóstico diferencial entre el carcinoma papilar variante folicular y el adenoma folicular de tiroides, utilizando variables cariométricas de las células foliculares. Materiales y métodos: se aplicaron técnicas morfométricas a muestras de biopsias de tiroides con carcinoma papilar variante folicular y adenoma folicular, así como a muestras sin patología, en el período comprendido de enero de 2013 a diciembre de 2016, obtenidas en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas. Las técnicas aplicadas se basaron en las variables cuantitativas: área, perímetro y factor de forma nuclear de las células foliculares. Los resultados se expresaron en porcentajes; la media aritmética como medida de tendencia central; desviación típica, incluyéndose el cálculo de los valores máximo, mínimo y recorrido para cada variable comprendida en el estudio, reflejados en tablas y gráficos realizados a través del software Microsoft Office Excel. Resultados: se obtuvieron valores elevados de área y perímetro nuclear de las células foliculares del carcinoma papilar variante folicular con relación al adenoma folicular, mientras que el factor de forma no arrojó resultados significativos para la diferenciación de dichas enfermedades tiroideas. Conclusiones: la aplicación de técnicas morfométricas a variables cariométricas en el tiroides, para el diagnóstico diferencial entre el carcinoma papilar variante folicular y el adenoma folicular, ofrece resultados aplicables en estudios histopatológicos (AU).


ABSTRACT Introduction: differentiated thyroid carcinomas are originated in the follicular epithelium. Of them, the papillary carcinoma shows higher incidence. Follicular carcinoma, one of its variants, occasionally shows an architectural pattern imitating a follicular adenoma. Objective: to contribute to the differential diagnosis between the papillary carcinoma, follicular variant, and thyroid follicular adenoma, using karyometric variables of follicular cells. Materials and methods: morphometric techniques were applied to samples of biopsies of thyroids with papillary carcinoma, follicular variant, and follicular adenoma, and also to samples without any pathology, in the period from January 2013 to December 2016, gathered in the University Hospital Comandante Faustino Perez, of Matanzas. The applied techniques were based on quantitative variables: area, perimeter and nuclear form factor. Results were expressed in percentages; the arithmetic median as measure of central tendency; typical deviation, including the calculation of maximal, minimal values and the course for each variable included in the study, were drawn in tables and graphics using Microsoft Office Excel software. Results: highs values of area and nuclear perimeter of the follicular cells of the papillary carcinoma, follicular variant, were obtained, while the shape factor did not show significant results for those thyroidal diseases differentiation. Conclusions: the application of morphometric techniques to karyometric variables in the thyroids, for the differential diagnosis between the papillary carcinoma, follicular variant, in follicular carcinoma, offers results that can be applied in histopathological studies (AU).


Subject(s)
Humans , Male , Female , Adult , Diabetes Insipidus/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Diabetes Insipidus/complications , Diabetes Insipidus/congenital , Diabetes Insipidus/pathology , Diabetes Mellitus, Type 2/diagnosis
8.
Rev. cuba. med. gen. integr ; 37(1): e1355, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280315

ABSTRACT

Introducción: La diabetes mellitus es un reto para los sistemas de salud pública de todas las naciones. Objetivo: Identificar el riesgo de padecer diabetes mellitus tipo 2 en pacientes que debutaron con hipertensión arterial que tienen tratamiento farmacológico. Métodos: Se realizó un estudio observacional, descriptivo de tipo serie de casos. El universo estuvo constituido por los 74 pacientes pertenecientes al área de salud del Policlínico Docente Universitario Alex Urquiola Marrero que debutaron con hipertensión arterial, en el año 2019; se estudió todo el universo. Las variables estudiadas fueron: edad, sexo, factores de riesgo asociados a la diabetes mellitus, antecedentes familiares de diabetes mellitus y riesgo de padecer diabetes mellitus. Luego de recolectar la información, esta fue digitalizada para su posterior procesamiento. La base de datos y su procesamiento se realizó utilizando el paquete de programas estadísticos SPSS. Se utilizó la escala Finnish Diabetes Risk Score para calcular el riesgo de padecer diabetes mellitus tipo 2. Resultados: 40 pacientes pertenecían al sexo masculino; 29,7 por ciento estaban entre 55 y 64 años; obesidad, sedentarismo y hábitos alimentarios inadecuados estuvieron presentes en más del 50 por ciento de los pacientes; 59,5 por ciento tenían antecedentes familiares de diabetes mellitus de 2do grado; 52,7 por ciento presentaron riesgo de padecer diabetes mellitus tipo 2 alto o muy alto. Conclusiones: En pacientes con hipertensión arterial de debut el riesgo de padecer diabetes mellitus tipo 2 es predominantemente alto y muy alto(AU)


Introduction: Diabetes mellitus is a challenge for the public health systems of all nations. Objective: To identify the risk of suffering type 2 diabetes mellitus in patients who debuted with arterial hypertension under pharmacological treatment. Methods: An observational, descriptive study pf case series was carried out. The universe was made up of the 74 patients belonging to the health area of Alex Urquiola Marrero University Teaching Polyclinic who debuted with arterial hypertension in 2019. The entire universe was studied. The variables studied were age, sex, risk factors associated with diabetes mellitus, family history of diabetes mellitus, and risk of suffering from diabetes mellitus. After collecting the information, it was entered into computer software for further processing. The database was processed using the SPSS statistical software package. The Finnish Diabetes Risk Score was used to calculate the risk of suffering from type 2 diabetes mellitus. Results: Of the total of patients, 40 belonged to the male sex. 29.7 percent were aged 55-64 years. Obesity, sedentary lifestyle and inadequate eating habits were present in more than 50 percent of the patients. 59.5 percent had a family history of diabetes mellitus, through a second-degree relative. 52.7 percent had a high or very high risk of suffering from type 2 diabetes mellitus. Conclusions: In patients who debuted with hypertension, the risk of suffering from type 2 diabetes mellitus is predominantly high or very high(AU)


Subject(s)
Humans , Male , Female , Prediabetic State , Risk Factors , Diabetes Mellitus, Type 2/epidemiology , Epidemiology, Descriptive , Observational Study , Hypertension/epidemiology
9.
Säo Paulo med. j ; 139(1): 10-17, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156965

ABSTRACT

ABSTRACT BACKGROUND: Diabetic ketoacidosis is the most frequent hyperglycemic complication in the evolution of diabetes mellitus. Common precipitating factors include newly diagnosed diabetes mellitus, noncompliance with therapy and infections. However, few studies have been conducted in Brazil and none were prospective in design. OBJECTIVE: To describe the incidence, clinical and laboratory characteristics and precipitating factors of diabetic ketoacidosis among emergency department patients in a tertiary-level teaching hospital in Brazil. We also aimed to identify immediate and long-term mortality within two years. DESIGN AND SETTING: Prospective prognosis cohort study conduct at a tertiary-level teaching hospital in São Paulo, Brazil. METHODS: All patients > 12 years old presenting diabetic ketoacidosis who were admitted to the emergency department from June 2015 to May 2016 were invited to participate. RESULTS: The incidence of diabetic ketoacidosis per 1,000 admissions was 8.7. Treatment noncompliance and infection were the most common causes of diabetic ketoacidosis. The immediate mortality rate was 5.8%, while the six-month, one-year and two-year mortality rates were 9.6%, 13.5% and 19.2%, respectively. Death occurring within two years was associated with age, type 2 diabetes, hypoalbuminemia, infection at presentation and higher sequential organ failure assessment (SOFA) score at admission. CONCLUSIONS: Diabetic ketoacidosis among patients presenting to the emergency department was relatively frequent in our hospital. Treatment noncompliance and infection were major precipitating factors and presence of diabetic ketoacidosis was associated with immediate and long-term risk of death.


Subject(s)
Humans , Child , Diabetic Ketoacidosis/complications , Diabetic Ketoacidosis/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Prognosis , Brazil/epidemiology , Incidence , Prospective Studies , Retrospective Studies , Cohort Studies , Emergency Service, Hospital
10.
Rev. Assoc. Med. Bras. (1992) ; 67(1): 45-51, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287798

ABSTRACT

SUMMARY OBJECTIVE: To investigate sleep alterations and associated factors in pregnant diabetic women (n=141). METHODS: Sleep profile, sociodemographics and clinical information were collected. Poor sleep quality (Pittsburgh Sleep Quality Index >5) and excessive daytime sleepiness (Epworth Sleepiness Scale ≥10), sleep duration (h), sleep latency (min), frequent sleep interruption and short sleep (≤6 h) were assessed in type 1 diabetes mellitus (16.3%), type 2 diabetes mellitus (25.5%) and gestational diabetes mellitus (58.2%). RESULTS: Poor sleep quality was found in 58.8% of patients and daytime sleepiness in 25.7%, regardless of hyperglycemia etiology. No correlation existed between daytime sleepiness and poor sleep quality (Pearson correlation r=0.02, p=0.84). Short sleep duration occurred in 1/3 of patients (31.2%). Sleep interruptions due to frequent urination affected 72% of all and sleep interruptions due to any cause 71.2%. Metformin was used by 65.7% of type 2 diabetes mellitus and 28.7% of gestational diabetes mellitus. In gestational diabetes mellitus, parity number was independently associated with poor sleep quality (p=0.02; OR=1.90; 95%CI 1.07-3.36) and metformin use was also independently associated with poor sleep quality (p=0.03; OR=2.36; 95%CI 1.05-5.29). CONCLUSIONS: Our study originally shows that poor sleep quality and excessive daytime sleepiness are frequent in diabetic pregnancy due to different etiologies. Interestingly, only in gestational diabetes mellitus, metformin therapy and higher parity were associated with poor sleep quality.


Subject(s)
Humans , Female , Pregnancy , Sleep Wake Disorders/epidemiology , Diabetes, Gestational/drug therapy , Diabetes, Gestational/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Hyperglycemia/epidemiology , Disorders of Excessive Somnolence , Sleep
11.
Rev. chil. endocrinol. diabetes ; 14(2): 90-94, 2021.
Article in Spanish | LILACS | ID: biblio-1283560

ABSTRACT

La diabetes mellitus tipo 2 (DM2), habitualmente asociada a adultos en edad media y adulto mayor, ha presentado un aumento en su incidencia en pacientes menores de 40 años, lo que se conoce como DM2 de inicio en paciente joven. Varios estudios sugieren que este tipo de diabetes presenta no sólo un deterioro más rápido de las células beta-pancreáticas en comparación con la DM2 de inicio más tardío, sino que también un mayor riesgo de complicaciones que pacientes con DM Tipo1, lo que sugiere una variable independiente de los años de exposición a la enfermedad y por tanto, un fenotipo más agresivo. Por otra parte, hay evidencia que afirma que existen grupos poblacionales en mayor riesgo de desarrollar esta patología, particularmente ciertas etnias. En el presente trabajo se exponen los principales hallazgos de una reciente revisión del tema y se los compara con los datos nacionales disponibles. Dada la alta prevalencia de DM2 en la población chilena y la escasa cantidad de estudios epidemiológicos de calidad que permitan conocer nuestro panorama con mayor precisión, es que se destaca la importancia de estos últimos para poder tomar medidas de salud pública adecuadas.


Type 2 diabetes mellitus type 2 (T2DM), commonly associated with the middle to old aged adults group, has shown an increase in incidence in patients younger than 40 years old, which is known as young-onset type 2 diabetes mellitus. Several studies suggest that this type of diabetes not only exhibits a faster deterioration of the beta-pancreatic cells in comparison with type 1 diabetes mellitus patients, but also a greater risk of complications not regarding the time of exposure to the disease, therefore a more aggressive phenotype. Otherwise, there is evidence which asserts that some population groups are in mayor risk of developing this disease, especially certain ethnics. In this work it is exposed the main findings of a recent review of the subject and it is contrasted with available national data. Given the high prevalence of T2DM in the chilean population and the little amount of epidemiological high-quality studies that allows us to know our outlook with greater precision, it is highlighted the need for them in order to make adequate public health decisions.


Subject(s)
Humans , Adult , Age Factors , Diabetes Mellitus, Type 2/epidemiology , Chile/epidemiology , Risk Factors , Age of Onset , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/mortality , Diabetic Nephropathies/etiology , Diabetic Nephropathies/epidemiology , Diabetic Neuropathies/etiology , Diabetic Neuropathies/epidemiology
12.
Chinese Medical Journal ; (24): 1191-1198, 2021.
Article in English | WPRIM | ID: wpr-878170

ABSTRACT

BACKGROUND@#The prevalence of skin diseases and diabetes mellitus (DM) are prominent around the world. The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM (T2DM) is limited, leading to limited recognition of the correlations between skin diseases and T2DM.@*METHODS@#We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st, 2016. The subjects were categorized into three groups: Normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. The prevalence and clinical characteristics of skin diseases were recorded and investigated.@*RESULTS@#In this cross-sectional study, 383 individuals with ages ranging from 53 to 89-year-old were recruited. The overall prevalence of skin diseases was 93.5%, and 75.7% of individuals had two or more kinds of skin diseases. Additionally, there were 47 kinds of comorbid skin diseases in patients with T2DM, of which eight kinds of skin diseases had a prevalence >10%. The prevalence of skin diseases in NGT, IGT, and T2DM groups were 93.3%, 91.5%, and 96.6%, respectively; stratified analysis by categories showed a statistically significant difference in "disturbances of pigmentation" and "neurological and psychogenic dermatoses". The duration of T2DM also significantly associated with the prevalence of "disturbances of pigmentation" and "neurological and psychogenic dermatoses". Subsequently, the prevalence of "disturbances of pigmentation" was higher in males than females in NGT (P < 0.01) and T2DM (P < 0.01) groups. In addition, the difference in the prevalence of "disturbances of pigmentation" was also significant in NGT and T2DM groups (P < 0.01).@*CONCLUSIONS@#There was a high prevalence of skin diseases in the Da Qing Diabetes Study. To address the skin diseases in the Da Qing Diabetes Study, increased awareness and intervention measures should be implemented.


Subject(s)
Aged , Aged, 80 and over , Blood Glucose , Cross-Sectional Studies , Diabetes Mellitus, Type 2/epidemiology , Female , Glucose Intolerance/epidemiology , Glucose Tolerance Test , Humans , Male , Middle Aged , Skin Diseases/epidemiology
13.
ABCD arq. bras. cir. dig ; 34(3): e1610, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1355504

ABSTRACT

ABSTRACT Background: The increased prevalence of obesity has led to a significant increase in the occurrence of metabolic syndrome, a recognized risk factor for increased morbidity and mortality from cardiovascular diseases. Hyperglycemia or type 2 diabetes mellitus, dyslipidemia and arterial hypertension are its main components. Since 2015, international guidelines have recognized the benefits of bariatric surgery in each isolated factor of this syndrome. Aim: To evaluate the impact of Roux-en-Y gastric bypass in this syndrome comparing pre- and postoperative periods with laboratory analysis and to compare waist/height ratio and BMI in relation to the determination of the cardiometabolic risk profile. Methods: A retrospective study was carried out, selecting 80 patients undergoing Roux-en-Y gastric bypass. Total cholesterol, HDL, LDL, triglycerides, fasting glucose, glycated hemoglobin, insulin, body mass index (BMI), vitamin D, vitamin B12, waist circumference and waist/height ratio in three periods were analyzed: the preoperative period from 1 to 6 months, postoperative from 1 to 6 months and postoperative from 1 to 2 years. Results: There was an improvement in all parameters of the clinical analyses. The preoperative BMI had a mean value of 39.8, in the preoperative period from 1 to 6 months, the values ​​dropped to 33.2 and in the postoperative period of 1 year, the mean was 26. The perimeter mean values ​​of 118.5 preoperatively, 105.2 postoperatively from 1 to 6 months and 90.3 postoperatively from 1 to 2 years. Waist/height ratio was 0.73, 0.65 and 0.56 in pre, post 1 to 6 months and 1 to 2 years respectively. Conclusion: Roux-en-Y gastric bypass improves metabolic syndrome and waist-to-height ratio is superior to BMI in the assessment of the cardiometabolic risk profile.


RESUMO Racional: O aumento da prevalência da obesidade levou ao aumento significativo da ocorrência de síndrome metabólica, fator de risco reconhecido para aumento da morbimortalidade por doenças cardiovasculares. A hiperglicemia ou diabetes mellitus do tipo 2, dislipidemia e hipertensão arterial são seus principais componentes. Desde 2015, diretrizes internacionais reconheceram os benefícios da cirurgia bariátrica em cada fator isolado desta síndrome. Objetivos: Avaliar o impacto do bypass gástrico em Y-de-Roux nesta síndrome comparando períodos pré e pós-operatório com análise laboratorial, e comparar a razão cintura/estatura e o IMC em relação a determinação do perfil de risco cardiometabólico. Métodos: Realizou-se um estudo retrospectivo com base prospectiva selecionando 80 pacientes submetidos à bypass gástrico em Y-de-Roux. Foram analisados o colesterol total, HDL, LDL, triglicerídeos, glicemia de jejum, hemoglobina glicada, insulina, índice de massa corpórea (IMC), vitamina D, vitamina B12, perímetro abdominal e relação cintura/estatura em três períodos: o pré-operatório de 1 a 6 meses, pós-operatório de 1 a 6 meses e pós-operatório de 1 a 2 anos. Resultados: Houve melhora em todos os parâmetros das análises clínicas. O IMC, no pré-operatório, teve a média dos valores de 39,8, no pré-operatório de 1 a 6 meses, os valores caíram para 33,2 e no pós-operatório de 1 ano média foi de 26. O perímetro abdominal teve média dos valores de 118,5, no pré-operatório, 105,2 no pós-operatório de 1 a 6 meses e 90,3 no pós-operatório de 1 a 2 anos. A relação cintura/estatura teve 0,73, 0,65 e 0,56 no pré, pós 1 a 6 meses e 1 a 2 anos respectivamente. Conclusão: O bypass gástrico em Y-de-Roux melhora a síndrome metabólica e a relação cintura/estatura é superior ao IMC na avaliação do perfil do risco cardiometabólico.


Subject(s)
Humans , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Gastric Bypass , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Body Mass Index , Retrospective Studies , Risk Factors , Obesity
14.
Cad. Saúde Pública (Online) ; 37(9): e00255920, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345630

ABSTRACT

Abstract: There is a conflict in the literature regarding the association between serum uric acid (SUA) levels and glycemic status. Therefore, we evaluated the association between SUA level and glycemic status - impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus - and insulin resistance, in a large Brazilian study. This is a cross-sectional, observational study with 13,207 participants aged 35-74 years, at baseline (2008-2010) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). A multinomial regression analysis was performed to test the association between SUA and glycemic status (IFG, IGT, and newly diagnosed type 2 diabetes at the cohort baseline) after adjustments by age, sex, skin color, body mass index, physical activity, smoking, alcohol consumption, comorbidities, and medicines use. Logistic regression model was used to evaluate the association between SUA and insulin resistance by HOMA-IR. Stratified analyses by sex were performed. The mean age (standard deviation) was 51.4 (8.9) years, 55.2% of participants were women. There were 1,439 newly diagnosed diabetes. After all adjustments, higher SUA was associated with IFG, IGT, and diabetes, with odds ratio (OR) = 1.15 (95%CI: 1.06; 1.25), 1.23 (95%CI: 1.14; 1.33), and 1.37 (95%CI: 1.24; 1.51), respectively. There was association between SUA levels and insulin resistance with OR = 1.24 (95%CI: 1.13; 1.36). In analysis stratified by sex, higher SUA persisted independently associated with impaired glycemic status. Our results suggest that a higher SUA levels were significantly associated with glycemic status in a large Latin American population, mainly among women.


Resumo: Há uma controvérsia na literatura a respeito da associação entre níveis de ácido úrico sérico (AUS) e glicemia. Portanto, avaliamos a associação entre AUS e glicemia (glicemia em jejum alterada, intolerância glicêmica e diabetes mellitus), além da resistência insulínica, em uma amostra grande no Brasil. O estudo transversal observacional incluiu 13.207 participantes com idade entre 35 e 74 anos na linha de base (2008-2010) do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Foi realizada análise de regressão multivariada para testar a associação entre AUS e glicemia (glicemia em jejum alterada, intolerância glicêmica e diagnóstico novo de diabetes tipo 2 na linha de base da coorte) depois de ajustar para idade, sexo, cor, índice de massa corporal, atividade física, tabagismo, consumo de álcool, comorbidades e uso de medicação. O modelo de regressão logística foi usado para avaliar a associação entre AUS e resistência insulínica por HOMA-IR. Foram realizadas análises estratificadas por sexo. A média de idade (DP) foi 51,4 (8,9) anos, e 55,2% dos participantes eram mulheres. Houve 1.439 novos diagnósticos de diabetes. Depois de todos os ajustes, o AUS esteve associado à glicemia em jejum alterada, intolerância glicêmica e diabetes, com odds ratio (OR) = 1,15 (IC95%: 1,06; 1,25), 1,23 (IC95%: 1,14; 1,33) e 1,37 (IC95%: 1,24; 1,51), respectivamente. Houve uma associação entre níveis de AUS e resistência insulínica, com OR = 1,24 (IC95%: 1,13; 1,36). Na análise estratificada por sexo, persistiu a associação independente entre AUS elevado e glicemia. Os resultados sugerem que níveis elevados de AUS estão associados de maneira significativa com a glicemia em uma população latino-americana grande, sobretudo entre mulheres.


Resumen: Hay un conflicto en la literatura respecto a la asociación entre los niveles de ácido úrico sérico (AUS) y el estado glucémico. Por eso, evaluamos la asociación entre el nivel AUS y el estatus glucémico: glucosa alterada en ayunas (GAA), tolerancia a la glucosa alterada (TGA) y diabetes mellitus (diabetes), comparados con la resistencia a la insulina en un amplio estudio en Brasil. Se realizó un estudio transversal, observacional con 13.207 participantes, con edades comprendidas entre los 35-74 años, en la base de referencia del Estudio Longitudinal de Salud entre Adultos brasileños (2008-2010) (ELSA-Brasil). Se realizó un análisis de regresión multinomial para probar la asociación entre AUS y el estado glucémico (GAA, TGA y de nuevo la diabetes tipo 2, diagnosticada en la cohorte como base de referencia) tras los ajustes por edad, sexo, color de piel, índice de masa corporal, actividad física, fumar, consumo de alcohol, comorbilidades, uso de medicinas. Se usó el modelo de regresión logística para evaluar la asociación entre AUS y la resistencia a la insulina por el HOMA-IR. Se realizó también un análisis estratificado por sexo. La media de edad (desviación estándar) fue 51,4 (8,9) años, un 55,2% de los participantes eran mujeres. Hubo 1.439 nuevos casos de diabetes diagnosticados. Tras todos los ajustes, una AUS más alta estuvo asociada con GAA, TGA y diabetes, con odds ratio (OR) = 1,15 (IC95%: 1,06; 1,25), 1,23 (IC95%: 1,14; 1,33), y 1,37 (IC95%: 1,24; 1,51), respectivamente. Hubo asociación entre los niveles AUS y la resistencia a la insulina con OR = 1,24 (IC95%: 1,13; 1,36). En el análisis estratificado por sexo, una AUS más alta persistía independientemente asociada con un estado glucémico alterado. Nuestros resultados sugieren que unos niveles más altos de AUS estuvieron significativamente asociados con el estado glucémico en una amplia población latinoamericana, principalmente entre mujeres.


Subject(s)
Humans , Female , Adult , Glucose Intolerance/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Uric Acid , Blood Glucose , Brazil/epidemiology , Cross-Sectional Studies , Longitudinal Studies , Fasting , Middle Aged
15.
Rev. bras. epidemiol ; 24(supl.1): e210010, 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1288493

ABSTRACT

ABSTRACT: Objective: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. Methods: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. Results: The prevalence of diabetes was 6.2% (95%CI 5.54 - 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. Conclusion: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.


RESUMO: Objetivo: Analisar os fatores contextuais associados ao diabetes mellitus tipo II em Belo Horizonte (MG). Métodos: Estudo transversal com 5.779 adultos residentes em Belo Horizonte, participantes do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, nos anos de 2008, 2009 e 2010. Foram utilizados modelos de regressão multinível para testar a associação entre indicadores contextuais do ambiente físico e social e diagnóstico autorreferido de diabetes, ajustados por fatores individuais sociodemográficos e de estilo de vida. Utilizaram-se análises descritivas e modelos de regressão logística multinível, considerando um nível de significância de 5%. Resultados: A prevalência de diabetes foi de 6,2% (IC95% 5,54-6,92), e 3,1% da variabilidade da chance de diabetes nas áreas de abrangência estudadas foi explicada por características contextuais. Residir em áreas com alta densidade de locais privados para prática de atividade física e com alta renda associou-se a menor chance de ter diabetes. As áreas com alto índice de vulnerabilidade social foram fortemente associadas ao diabetes, independentemente de características individuais. Conclusão: A ocorrência de diabetes está associada com as características do ambiente físico e social. Centros urbanos com oportunidades para adoção de comportamentos saudáveis podem ajudar a reduzir a ocorrência de diabetes e as suas complicações.


Subject(s)
Humans , Adult , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Socioeconomic Factors , Brazil , Cross-Sectional Studies , Cities , Multilevel Analysis , Self Report
16.
Rev. enferm. UERJ ; 28: e49109, jan.-dez. 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1146588

ABSTRACT

Objetivo: verificar associação entre diabetes mellitus e doenças oculares em pessoas com deficiência visual. Método: estudo transversal com 51 pessoas com diabetes e deficiência visual, em um centro de reabilitação visual do interior paulista, que participaram de entrevista estruturada, em 2018. Utilizou-se os testes: Kolmogorov Smirnov, Regressão de Poisson, Regressão de Logística Binária, e Correlação de Spearman. Resultados: a maioria das pessoas era cega e relatou que a retinopatia diabética, o glaucoma e a catarata foram causa da deficiência visual; com tempo de diagnóstico do diabetes acima de 109 meses. A catarata apresentou um nível de correlação baixa (r=0,280 e p=0,047), e a retinopatia diabética um nível de correlação moderada (r=0,565 e p=0,000), considerando o tempo de diagnóstico do diabetes. Conclusão: associação estatisticamente significante entre o tipo de diabetes e a retinopatia, e correlação estatisticamente significante entre o tempo de diagnóstico do diabetes, a catarata e a retinopatia diabética.


Objective: to verify the association between diabetes mellitus and eye diseases in people with visual impairment. Method: this cross-sectional study involved 51 people with diabetes and visual impairment at a Visual Rehabilitation Center in São Paulo, who participated in a structured interview in 2018. The tests used were: Kolmogorov Smirnov, Poisson Regression, Binary Logistic Regression, and Spearman Correlation. Results: most participants were blind, reported that diabetic retinopathy, glaucoma and cataracts were the causes of their visual impairment, and had been diagnosed with diabetes over 109 months earlier. Cataract returned a low level of correlation with time with diagnosis of diabetes (r = 0.280 and p = 0.047), and diabetic retinopathy, moderate correlation (r = 0.565 and p = 0.000). Conclusion: a statistically significant association was found between type of diabetes and retinopathy, and statistically significant correlations between the time diagnosed with diabetes, cataracts and diabetic retinopathy.


Objetivo: verificar la asociación entre diabetes mellitus y enfermedades oculares en personas con discapacidad visual. Método: este estudio transversal involucró a 51 personas con diabetes y discapacidad visual en un Centro de Rehabilitación Visual en São Paulo, quienes participaron en una entrevista estructurada en 2018.Las pruebas utilizadas fueron: Kolmogorov Smirnov, Regresión de Poisson, Regresión Logística Binaria y Spearman Correlación. Resultados: la mayoría de los participantes eran ciegos, informaron que la retinopatía diabética, el glaucoma y las cataratas eran las causas de su discapacidad visual y habían sido diagnosticados con diabetes más de 109 meses antes. La catarata devolvió un bajo nivel de correlación con el tiempo con el diagnóstico de diabetes (r = 0,280 yp = 0,047) y la retinopatía diabética, correlación moderada (r = 0,565 yp = 0,000). Conclusión: se encontró asociación estadísticamente significativa entre tipo de diabetes y retinopatía, y correlaciones estadísticamente significativas entre el tiempo de diagnóstico de diabetes, cataratas y retinopatía diabética.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Vision Disorders/epidemiology , Cataract/epidemiology , Glaucoma/epidemiology , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Diabetic Retinopathy/epidemiology , Brazil/epidemiology , Logistic Models , Poisson Distribution , Prevalence , Risk Factors , Statistics, Nonparametric , Visually Impaired Persons/statistics & numerical data , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 2/diagnosis
17.
Medisan ; 24(6) tab
Article in Spanish | LILACS, CUMED | ID: biblio-1143264

ABSTRACT

Introducción: La diabetes mellitus de tipo 2 es una enfermedad crónica, considerada como un importante problema de salud a nivel mundial por su alta prevalencia y repercusión socioeconómica. Objetivo: Caracterizar a pacientes con diabetes mellitus de tipo 2 según variables clínicas y epidemiológicas. Métodos: Se realizó un estudio retrospectivo de 96 pacientes con dicha enfermedad (seleccionados por muestreo aleatorio simple), quienes estuvieron ingresados en el Servicio de Medicina Interna del Hospital General Docente Dr. Guillermo Luis Fernández Hernández-Baquero del municipio de Moa, en Holguín, en el periodo de julio a noviembre del 2018. Resultados: En la serie predominaron el sexo femenino (58,3 %), sobre todo en las edades de 50 a 59 años (34,3 %), el antecedente familiar de diabetes mellitus como factor de riesgo (63,5 %) y la polineuropatía como complicación de mayor gravedad en los pacientes (47,9 %). Se evidenció, además, que el mayor tiempo de evolución de la enfermedad y los factores de riesgo condicionaron la aparición de complicaciones, lo que alargó la estadía hospitalaria. Conclusiones: Los resultados coincidieron con los de varios estudios, lo que demuestra que la diabetes mellitus de tipo 2 tiene un impacto demoledor en la salud del ser humano y, por tanto, una importante repercusión socioeconómica.


Introduction: Type 2 diabetes mellitus is a chronic disease that is considered as an important health problem worldwide due to its high socioeconomic prevalence and repercussion. Objective: To characterize patients with type 2 diabetes mellitus according to clinical and epidemiological variables. Methods: A retrospective study of 96 patients with this disease was carried out, selected by simple random sampling who were admitted in the Internal Medicine Service of the Guillermo Luis Fernández Hernández-Baquero Teaching General Hospital in Moa, Holguín, from July to November, 2018. Results: In the series there was a prevalence of women (58.3 %), mainly in the ages of 50 to 59 (34.3 %), and the family history of diabetes mellitus as risk factor (63.5 %), as long as polyneuropathy was the most serious complication in the patients (47.9 %). It was also evidenced, that the greater clinical course time of the disease and the risk factors conditioned the emergence of complications, what prolonged the hospital stay. Conclusions: The results coincided with those of several national studies, what demonstrates that type 2 diabetes mellitus have a devastating impact in the human being health and, therefore, an important socioeconomic repercussion.


Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Length of Stay , Risk Factors , Diabetes Mellitus, Type 2/complications
18.
Arch. endocrinol. metab. (Online) ; 64(5): 584-590, Sept.-Oct. 2020. tab
Article in English | LILACS | ID: biblio-1131123

ABSTRACT

ABSTRACT Objective In this study, we aimed to determine the frequency of and the clinical and metabolic features of patients with latent autoimmune diabetes in adults (LADA) at a single center in Turkey. Subjects and methods Patients over 30 years of age diagnosed with type 2 diabetes who did not require insulin for a minimum of 6 months following diagnosis were included. Data from 324 patients (163 women; 161 men), with a mean age of 54.97 ± 7.53 years, were analyzed in the study. Levels of antibodies to glutamate decarboxylase (anti-GAD) were measured in all patients, and LADA was diagnosed in patients testing positive for anti-GAD antibodies. Results Anti-GAD positivity was identified in 5 patients (1.5%). Family history of diabetes, body mass index (BMI), age, sex distribution, insulin resistance, serum triglycerides, high-density lipoprotein, and low-density lipoprotein were similar in the LADA and type 2 diabetes patients. Median HbA1c was significantly higher (10.8% vs. 7.38%, p = 0.002) and fasting C-peptide was lower (0.75 ng/mL vs. 2.82 ng/mL, p = 0.009) in patients with LADA compared to in those with type 2 diabetes. Among the 5 patients with LADA, 4 were positive for antithyroid peroxidase antibodies. The median disease duration was relatively shorter among patients with LADA (4 years vs. 7 years, p = 0.105). Conclusion We observed a LADA frequency of 1.5% among Turkish patients followed for type 2 diabetes. The presence of obesity and metabolic syndrome did not exclude LADA, and patients with LADA had worse glycemic control than patients with type 2 diabetes did.


Subject(s)
Humans , Male , Female , Infant , Adult , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Latent Autoimmune Diabetes in Adults/epidemiology , Autoantibodies , Turkey/epidemiology , C-Peptide , Glutamate Decarboxylase , Middle Aged
19.
Rev. cuba. endocrinol ; 31(2): e228, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1138895

ABSTRACT

RESUMEN Introducción: La diabetes mellitus tipo 2 es considerada una situación de alto riesgo cardiovascular. En la mujer con diabetes se añade el riesgo que representa el déficit estrogénico posmenopáusico. Objetivo: Determinar la frecuencia de enfermedad cardiovascular en las etapas del climaterio. Métodos: Se realizó un estudio transversal y descriptivo con 611 mujeres con diabetes mellitus tipo 2 en edad mediana (40-59 años), que ingresaron consecutivamente en el Centro de Atención al Diabético de Bayamo, Granma, desde el año 2010 al 2017. Se excluyeron los casos con menopausia artificial. Se empleó la prueba de chi cuadrado para comprobar la relación que pudiera existir entre las variables cualitativas, mientras que para comparar los valores promedio de las variables cuantitativas entre los grupos se utilizó t de Student. Resultados: La frecuencia de hipertensión arterial, hipercolesterolemia y síndrome metabólico fue claramente superior en las mujeres posmenopáusicas que en las premenopáusicas (p = 0,0257; p = 0,0391 y p = 0,0591, respectivamente). Las enfermedades cardiovasculares aumentaron significativamente con la menopausia y con el tiempo de ocurrencia de este evento (p = 0,0014). La relación fue más notoria en el caso de la cardiopatía isquémica y la enfermedad arterial periférica (p = 0,0521 y p = 0,0011, respectivamente). Conclusiones: En las mujeres con diabetes mellitus tipo 2 la enfermedad cardiovascular aumenta significativamente con el avance de la peri a la posmenopausia tardía, fundamentalmente la cardiopatía isquémica y la enfermedad arterial periférica(AU)


ABSTRACT Introduction: Type 2 diabetes mellitus is considered a situation of high cardiovascular risk. Among diabetic women, the risk for postmenopausal estrogen deficiency is added. Objective: To determine the frequency of cardiovascular disease in climacteric stages. Methods: A cross-sectional and descriptive study was carried out with 611 middle-aged (40-59 years old) women with type 2 diabetes mellitus and who were admitted consecutively to the Diabetic Care Center in Bayamo city, Granma, from 2010 to 2017. The cases with artificial menopause were not included in the study. The chi-square test was used to verify the relationship that might exist between qualitative variables, while Student's t test was used to compare the average values of the quantitative variables between the groups. Results: The frequency of arterial hypertension, hypercholesterolemia and metabolic syndrome was clearly higher among postmenopausal women than among premenopausal women (p = 0.0257, p = 0.0391, and p = 0.0591, respectively). Cardiovascular disease increased significantly with menopause and with the time of occurrence of this event (p = 0.0014). The relationship was more noticeable in the case of ischemic heart disease and peripheral arterial disease (p = 0.0521 and p = 0.0011, respectively). Conclusions: In women with type 2 diabetes mellitus, cardiovascular disease increases significantly with the progression from the perimenopausal stage to the late postmenopausal stage, mainly ischemic heart disease and peripheral arterial disease(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Climacteric , Cardiovascular Diseases/etiology , Myocardial Ischemia/etiology , Postmenopause , Diabetes Mellitus, Type 2/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Metabolic Syndrome/etiology
20.
Medicina (B.Aires) ; 80(3): 203-210, jun. 2020. graf, tab
Article in English | LILACS | ID: biblio-1125071

ABSTRACT

Social vulnerability has proved to be an independent risk factor for hypoglycemia in patients with diabetes. In some countries, patients who are in a vulnerable situation are assisted in the public health system which provides free medical care. This study compares the prevalence of hypoglycemia among patients with type 2 diabetes (T2D), in public versus private sector and its relationship with social vulnerability. This multicentric descriptive study included 600 patients with T2D from public and private care institutions of Argentina. Socioeconomic level (SEL) was evaluated through the Marketing Argentinean Association survey. Number of severe, documented symptomatic and asymptomatic hypoglycemias were registered. Among the patients included, 66% were assisted in the public sector. The 41% of patients (n = 246) registered at least 1 episode of any hypoglycemia event being more prevalent in the public sector compared to the private sector (50% vs. 22%). In the adjusted analysis it was observed a greater risk of hypoglycemia in public sector (OR 4, 95% CI 2.65-6.04) and in patients that did not have diabetological education (OR 2.28 95% CI 1.35-3.84). Similarly, unemployment (OR 5.04 95% CI 2.69-9.46), and marginal SEL (OR 60.79 95% CI 14.89-248.13) increased the risk of hypoglycemia. Several factors related to social vulnerability as unemployment, marginal SEL and poor sanitary education showed a significant increase in the hypoglycemia risk. Professionals working with people with diabetes must take into account these factors for a safe treatment of the disease.


La vulnerabilidad social ha demostrado ser un factor de riesgo independiente de hipoglucemia en pacientes con diabetes. Los pacientes que se encuentran en situación de vulnerabilidad social reciben asistencia en el sistema de salud pública que brinda atención médica gratuita. Este estudio compara la prevalencia de hipoglucemia en pacientes con diabetes tipo 2 en el sector público frente al privado y su relación con la vulnerabilidad social. Se realizó un estudio multicéntrico descriptivo que incluyó 600 pacientes con diabetes tipo 2 de instituciones de atención pública y privada de Córdoba. El nivel socioeconómico se evaluó a través de la encuesta de la Asociación Argentina de Marketing que evalúa la dimensión social, educativa y económica para estratificar el nivel socioeconómico. Se registró el número de hipoglucemias graves, documentadas sintomáticas y asintomáticas. El 66% de los pacientes pertenecían al sector público. El 41% de los pacientes (n = 246) registró al menos 1 episodio de cualquier evento de hipoglucemia. En el análisis ajustado, se observó un mayor riesgo de hipoglucemia en el sector público (OR 4, 95% CI 2.65-6.04), en pacientes que no tenían educación diabetológica previa (OR 2.28, 95% CI 1.35-3.84), en desempleados (OR 5.04, 95% CI 2.69-9.46) y en aquellos con nivel socioeconómico marginal (OR 60.79 95% CI 14.89-248.13). Factores relacionados con la vulnerabilidad social como el desempleo, el nivel socioeconómico marginal y educación sanitaria deficiente mostraron un aumento en el riesgo de hipoglucemia. Los profesionales que trabajan con personas con diabetes deben tener en cuenta estos factores para un tratamiento seguro de la enfermedad.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hospitals, Private/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Diabetes Mellitus, Type 2/epidemiology , Hospitals, Public/statistics & numerical data , Hypoglycemia/epidemiology , Argentina/epidemiology , Socioeconomic Factors , Logistic Models , Prevalence , Cross-Sectional Studies , Risk Factors , Public Sector , Private Sector , Vulnerable Populations/statistics & numerical data , Diabetes Complications/epidemiology , Diabetes Mellitus, Type 2/physiopathology , Social Determinants of Health , Hypoglycemia/physiopathology
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