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1.
Rev. chil. endocrinol. diabetes ; 13(2): 64-71, 2020. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-1095597

ABSTRACT

La Diabetes Mellitus tipo 2 (DM2) y las enfermedades crónicas del hígado(ECH), definida para esta revisión como cualquier alteración funcional o estructural de este órgano, desde inflamación hasta fibrosis, son patologías que frecuentemente se asocian, y su coexistencia se relaciona con peor pronóstico y mayores complicaciones de ambas entidades. El objetivo de este artículo es describir la relación entre hiperglicemia y enfermedades del hígado, sus procesos fisiopatológicos comunes y tratamiento, distinguiendo las patologías más relevantes, entre ellas la Diabetes Hepatogénica (DH), la enfermedad hepática por Virus Hepatitis C (VHC) y la Enfermedad Hepática Grasa No Alcohólica (EHGNA). La DH es aquella diagnosticada en pacientes con cirrosis asociada a insuficiencia hepática, sin antecedentes previos de alteración de la glicemia. En la actualidad el diagnóstico se realiza en etapas tardías de la enfermedad. El VHC tiene un efecto diabetogénico conocido. Algunas terapias antivirales usadas para VHC evidencian mejoría de las alteraciones metabólicas al lograr respuestas virológicas sostenidas. En DM2, la EHGNA es frecuente, con mayor incidencia de fibrosis, hepatocarcinoma (HCC) y riesgo cardiovascular (RCV). Es necesario realizar una pesquisa e intervención precoz de EHGNA a los pacientes con DM2. En el manejo de éstos, la baja de peso ha demostrado ser efectiva en el control glicémico y en la mejoría histológica. Dentro de las terapias antidiabéticas, además del uso de metformina, debería considerarse aquellas que han demostrado a la fecha beneficios en EHGNA, como son tiazolidinedionas (pioglitazona) y/o análogos de GLP-1 (liraglutide) y optimizar el control de otros factores de RCV.


Type 2 Diabetes Mellitus (DM2) and chronic liver diseases (CLD) defined in this revision as any functional or structural alteration in the organ, covering from inflammation to fibrosis, are pathologies that are frequently associated, and when found together are related to worse prognosis and higher complications in both conditions. The objective of this article is to describe the relationship between hyperglycemia and liver diseases, their common physio-pathological processes and treatments, identifying the most important pathologies, including Hepatogenic Diabetes (HD), Hepatitis C Virus (HCV) liver disease and Non-Alcoholic Fatty Liver Disease (NAFLD). Hepatogenic diabetes (HD) is diagnosed in patients with liver failure associated to cirrhosis with no previous record of impaired glycemia. Currently, diagnosis is made during the late stages of the disease. Hepatitis C virus (HCV) has a known diabetogenic effect. Some antiviral therapies used for HCV show improvement in metabolic alterations by achieving sustained virological responses. Non-alcoholic fatty liver disease (NAFLD) in DM2 patients is common, presenting higher risk for fibrosis, hepatocellular carcinoma (HCC) and increased cardiovascular risk (CVR). Early screening and interventions for NAFLD in DM patients are necessary. Weight loss has been shown to be effective in glycemic control and histological improvement. Anti-diabetic therapies, in addition to the use of metformin, should consider therapies that have shown benefits for managing NAFLD, such as thiazolidinedione (pioglitazones) and/or aGLP-1 (Liraglutide), and optimally controlling other cardiovascular risk (CVR) factors.


Subject(s)
Humans , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Liver Diseases/etiology , Liver Diseases/epidemiology , Hepatitis C/etiology , Hepatitis C/epidemiology , Non-alcoholic Fatty Liver Disease/etiology , Non-alcoholic Fatty Liver Disease/epidemiology
2.
Rev. medica electron ; 41(4): 850-861, jul.-ago. 2019. tab
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1094093

ABSTRACT

RESUMEN Introducción: la Organización Mundial de la Salud, estima que la enfermedad renal crónica estará incluida dentro de las principales causas de discapacidad para el 2020. La prevalencia en países desarrollados es aproximadamente de 500 a 1400 pacientes por millón de habitantes y la incidencia anual se encuentra alrededor de 350 pacientes por millón de población. Objetivo: determinar la prevalencia de la enfermedad renal oculta e identificar algunos factores de riesgos predisponentes en adultos mayores con diabetes mellitus tipo 2 pertenecientes al Policlínico Universitario "Jimmy Hirzel", Bayamo, Granma, en el período comprendido entre junio 2016 - junio 2017. Materiales y métodos: se realizó estudio observacional descriptivo, de corte transversal en el que se incluyeron 180 gerontes con diabetes mellitus tipo 2. Resultados: se estableció el diagnóstico de enfermedad renal oculta en 167 individuos de 180 sujetos estudiados, el grupo de 70 - 79 años de edad fue el más afectado por la nefropatía crónica, mientras que el sexo femenino y la raza blanca fueron los de mayor prevalencia. Los principales factores de riesgo predisponentes de enfermedad renal oculta fueron: cardiopatía isquémica crónica, dislipemias e hipertensión arterial. Conclusiones: existe una alta morbilidad de enfermedad renal oculta en los senescentes estudiados.


ABSTRACT Introduction: the World Health Organization (WHO) estimates that chronic hidden renal disease (ERC) will be included within the principal causes of disability by 2020. The prevalence in developed countries is around 500 to 1400 patients per million inhabitants, and the yearly incidence is around 350 patients per million people. Objective: to determine the prevalence of the hidden renal disease and to identify some predisposing risk factors in elder people with type II diabetes mellitus belonging to the University Policlinic "Jimmy Hirzel", Bayamo, Gramma, in the period between June 2016 and June 2017. Material and methods: an observational descriptive, cross-sectional study was carried out in 180 elder people with type 2 diabetes mellitus. Results: the chronic hidden renal disease was diagnosed in 167 individuals from the 180 studied subjects; the 70-79 years-old-group was the most affected one by chronic renal disease, while the female sex and white race showed the highest prevalence. The main risk factors predisposing to chronic hidden renal disease were: chronic ischemic heart disease, dyslipidemia and arterial hypertension. Conclusions: there is a high morbidity due to hidden renal disease in the studied senescent people.


Subject(s)
Humans , Female , Aged , Prevalence , Risk Factors , Morbidity , Myocardial Ischemia/etiology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/etiology , Diabetes Mellitus, Type 2/epidemiology , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/prevention & control , Renal Insufficiency, Chronic/epidemiology , Dyslipidemias/etiology , Hypertension/etiology , Epidemiology, Descriptive , Cross-Sectional Studies , Diabetic Nephropathies/etiology , Observational Study , Kidney Diseases/etiology
3.
Rev. chil. endocrinol. diabetes ; 12(3): 170-174, jul. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1006512

ABSTRACT

Objetivo: El objetivo del estudio fue describir las características y evolución de los pacientes que acudieron a las urgencias de nuestro hospital y fueron diagnosticados de cetoacidosis diabética (CAD) utilizando la novedosa herramienta de Big Data Savana. Método: Estudio retrospectivo descriptivo de los pacientes atendidos en urgencias del Hospital Universitario Infanta Leonor durante los años 2011 al 2016 con diagnóstico de CAD. La búsqueda se realizó con Savana Manager. Resultados: Se diagnosticaron 95 episodios de CAD en 68 pacientes. Del total de episodios de CAD, 57 fueron en diabéticos tipo 1 (de ellos 4 LADA), 25 en diabéticos tipo 2, 2 en diabéticos postpancreatectomía y 12 fueron debuts diabéticos. Del total, 61 (64,2%) requirieron ingreso hospitalario, de ellos 23 (24,2%) ingresaron en UCI. La media de HbA1c fue de 10,6 ± 2,1%. Tres pacientes requirieron reingreso tras el alta. La mortalidad fue muy baja con el fallecimiento en 1 paciente diagnosticado simultáneamente de cáncer pulmonar. Los desencadenantes de la CAD fueron: 35 casos (36,8%) falta de adherencia al tratamiento, 31 (32,6%) infecciones, 12 (12,6%) debuts, 8 (8,4%) varias causas y 9 (9,5%) no se pudo determinar la causa. Se clasificaron como CAD de gravedad leve un 28%, un 38% como de gravedad moderada y 34% como graves. La duración del ingreso no se relacionó con la severidad de la cetoacidosis. Conclusiones: La CAD es una complicación grave que afecta tanto a diabéticos tipo 1 como a tipo 2 con elevado porcentaje de ingresos hospitalarios y en UCI, aunque con baja mortalidad en nuestro medio. La duración de los ingresos no se relaciona con la severidad del cuadro.


Objective: the study was designed to describe the clinical features and evolution of the diabetic patients attended in our hospital emergency department with diabetic ketoacidosis (DKA) using the novel Big Data tool Savana. Method: Retrospective descriptive study of the patients attended in the emergency room of the Infanta Leonor University Hospital during the years 2011 to 2016 with diagnosis of CAD. The search was made with Savana. Results: 95 episodes of DKA were diagnosed in 68 patients. Of the total episodes of CAD 57 were in type 1 diabetics (of which 4 were LADA), 25 in type 2 diabetics, 2 in diabetics postpancreatectomy and 12 were new onset of diabetes. Of the total, 61 (64.2%) required hospital admission, of which 23 (24.2%) were admitted to the intensive care unit (ICU). The mean HbA1c was 10.6 ± 2.1%. Three patients required readmission after discharge. Mortality was very low with death in 1 patient simultaneously diagnosed of lung cancer. The triggers of CAD were: 35 cases (36,8%) lack of adherence to treatment, 31 (32.6%) infections, 12 (12.6%) new onset, 8 (8,4%) various causes and 9 (9.5%) the cause could not be determined. They were classified as mild DKA 28%, 38% as moderate and 34% as severe. The duration of admission was not related to the severity of ketoacidosis. Conclusions: DKA is a serious complication that affects both, type 1 and type 2 diabetics patients, with a high percentage of hospital and ICU admissions, although with low mortality in our environment. The lenght of the stay in hospital is not related to the severity of the DKA.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Diabetic Ketoacidosis/epidemiology , Diabetes Complications/epidemiology , Spain/epidemiology , Medical Informatics , Epidemiology, Descriptive , Retrospective Studies , Diabetic Ketoacidosis/etiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Emergency Service, Hospital , Hyperglycemia/complications , Hyperglycemia/epidemiology
4.
Licere (Online) ; 22(2): i:01-f:17, junho.2019. ilus, tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1007635

ABSTRACT

Este estudo teve por objetivo verificar os fatores associados à prática de atividade física de lazer em idosos com diabetes tipo 2. Realizou-se um estudo transversal de base populacional, com 204 idosos com diabetes tipo 2, cadastrados em 4 unidades da saúde da família de Passo Fundo, Rio Grande do Sul. Utilizou-se questionários as variáveis sociodemográficas e de saúde, e o nível de atividade física o questionário internacional de atividade física IPAQ. Foram realizadas análises brutas e multivariadas por regressão de Poisson, com intervalos de confiança de 95% a um p≤0.050. Após análise ajustada para a prática de atividade física de lazer se manterão associadas significativamente as variáveis: faixa etária de 60 a 69 anos (RP: 1,96; IC95%: 1,06-3,62), não ter apresentador dor (RP: 7,20; IC95%: 3,42-15,16) e não ter sofrido quedas nos últimos 6 meses (RP: 1,88; IC95%: 1,01-3,52).


This study aimed to verify the factors associated witch the practice of physical activity of leisure in elderly people with type 2 diabetes. A population-based cross-sectional study was carried out with 204 elderly people with type 2 diabetes, enrolled in 4 health units of the Family of Passo Fundo, Rio Grande do Sul. The sociodemographic and health variables questionnaires were used, and the physical activity level was the International IPAQ physical activity questionnaire. Gross and multivariate analyses were performed by Poisson regresseion, with confidence intervals of 95% at a p≤0.050. After the adjusted analysis for the practice of leisure physical activity, the following variables will be significantly associated: age range from 60 to 69 yeras (RP: 1,96; 95%CI: 1,06-3,62), no presenter pain (RP: 7,20; IC95%: 3,42- 15,16) and did not suffer falls in the last 6 months (RP: 1,88; IC95%: 1,01-3,52).


Subject(s)
Humans , Aged , Quality of Life , Aged , Poisson Distribution , Population Dynamics , Chronic Disease , Multivariate Analysis , Diabetes Mellitus, Type 2/epidemiology , Public Health Policy , Sedentary Behavior , Healthy Aging , Health Promotion , Leisure Activities , Motor Activity , Obesity/epidemiology
5.
Rev. cuba. oftalmol ; 32(1): e699, ene.-mar. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1093675

ABSTRACT

Objetivo: Determinar las características oculares de los diabéticos tipo II con catarata senil bilateral. Métodos: Se realizó un estudio descriptivo transversal a 248 diabéticos tipo II con catarata senil bilateral, en el Instituto Cubano de Oftalmología Ramón Pando Ferrer, desde septiembre del año 2015 a septiembre de 2016. Resultados: Predominó el sexo femenino (69,6 Ophthalmological characterization of type 2 diabetics with bilateral senile cataract), la edad de 70,6 años, el índice de masa corporal en pacientes con sobrepeso (46,5 por ciento), el tiempo de evolución de 5-9 años (52,2 por ciento), el tratamiento con hipoglucemiantes orales (95,2 por ciento), la mejor agudeza visual sin corrección con daño retinal 0,1 y sin daño 0,3; y corregida sin daño 0,5 y con daño retinal 0,2, todas con la cartilla de Snellen; promedio de densidad celular endotelial de 2 143,15 ± 326,08 cel/mm2, un coeficiente de variabilidad de 53,18 ± 7,14 por cientoy una hexagonalidad de 42,68 ± 18,70 por ciento. Conclusiones: La asociación de diabetes mellitus tipo 2 y catarata senil bilateral es más frecuente en mujeres mayores de 70 años, sobrepeso u obesa con un tiempo de evolución de la diabetes mellitus de 5 a 9 años y controladas con hipoglucemiantes orales. La peor agudeza visual está relacionada con el daño en la retina; sin embargo, presentan queratometrías, biometrías y tensión ocular normal. No hay alteraciones en la densidad endotelial, pero sí pleomorfismo y polimegatismo(AU)


ABSTRACT Objective: Determine the ocular characteristics of type 2 diabetics with bilateral senile cataract. Methods: A descriptive cross-sectional study was conducted of 248 type 2 diabetics with bilateral senile cataract at Ramón Pando Ferrer Cuban Institute of Ophthalmology from September 2015 to September 2016. Results: A predominance of the female sex (69.6 percent), mean age 70.6 years, body mass index in overweight patients 46.5 percent, time of evolution 5-9 years (52.2 percent), treatment with oral hypoglycemic agents 95.2 percent, best visual acuity without correction with retinal damage 0.1 and without damage 0.3; best corrected visual acuity without retinal damage 0.5 and with damage 0.2, all according to the Snellen chart; average endothelial cell density 2 143.15 ± 326.08 cell/mm2, coefficient of variability 53.18 ± 7.14 percent and hexagonality 42.68 ± 18.70 percent. Conclusions: Coexistence of type 2 diabetes mellitus and bilateral senile cataract is more common among women aged over 70 years, overweight or obese, with a time of evolution of diabetes mellitus of 5 to 9 years, and controlled with oral hypoglycemic agents. The worst visual acuity is related to retinal damage. However, keratometries, biometries and ocular tension results were all normal. There were no endothelial density alterations, but there was pleomorfism and polymegethism(AU)


Subject(s)
Humans , Male , Female , Aged , Review Literature as Topic , Cataract Extraction/methods , Diabetes Mellitus, Type 2/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic
6.
Repert. med. cir ; 28(3): 157-163, 2019. Il., cuadros, tablas
Article in English, Spanish | LILACS (Americas), COLNAL | ID: biblio-1095105

ABSTRACT

Objetivo: determinar el riesgo de desarrollar diabetes mellitus tipo 2 y prediabetes por medio del cuestionario FINDRISK en pacientes entre 35 y 75 años que asisten a consulta externa. Métodos: estudio descriptivo transversal, aplicando el cuestionario FINDRISK validado para Colombia. A aquellos con puntajes igual o mayor a 12 se les investigaron marcadores glicémicos y perfil lipídico. Con los datos obtenidos se realizó análisis univariado y de correspondencias múltiples. Resultados: de 796 participantes 11% (n= 88) presentaron prediabetes y 0,7% (n=6) diabetes, 36,8% (n=293) tuvieron un FINDRISK igual o mayor de 12, de éstos a 30% se le diagnosticó prediabetes y 2% diabetes; el 54,9% cursó con hipertensión, 50% con historia familiar de diabetes, 43% antecedentes de dislipidemia, 86% perímetro abdominal mayor de los rangos establecidos y dislipidemia en más de 50%. Conclusión: el cuestionario FINDRISK es una herramienta útil en la detección de estados prediabéticos y diabetes, favoreciendo el manejo temprano y la prevención de complicaciones. Además, aquellos con trastornos glicémicos y puntaje FINDRISK mayor o igual a 12 muestran tendencia a cursar con dislipidemia, lo que indica la necesidad del estudio metabólico completo.


Objective: to determine the risk for developing type 2 diabetes mellitus and prediabetes using the FINDRISC questionnaire in patients aged between 35 and 75 years at the outpatient clinic. Methods: a descriptive cross-sectional analysis applying the FINDRISC questionnaire for Colombia. Patients with a FINDRISC score of 12 or higher were studied measuring glycemic markers and lipid profile. Univariate and bivariate data analysis was used, as well as multiple correspondences. Results: out of 796 participants 11% (n= 88) had prediabetes and 0.7% (n=6) had diabetes, 36.8% (n=293) had a FINDRISC score equal or greater than 12, of these, 30% were diagnosed with prediabetes and 2% with diabetes; 54.9% had associated hypertension, 50% had family history for diabetes, 43% history of dyslipidemia, 86% had a waist circumference greater than the established values and dyslipidemia was present in more than 50%. Conclusion: the FINDRISC questionnaire is a useful screening tool for prediabetes and diabetes, favoring early treatment and the prevention of complications. Additionally, those with glycemic disorders and a FINDRISC score greater or equal to 12 showed a tendency to have associated dyslipidemia, which indicate the need to perform a comprehensive metabolic panel.


Subject(s)
Humans , Middle Aged , Diabetes Mellitus, Type 2/diagnosis , Prediabetic State , Risk Factors , Validation Study , Diabetes Mellitus , Diabetes Mellitus, Type 2/epidemiology
7.
Rev. cub. inf. cienc. salud ; 29(4): 1-14, oct.-dic. 2018. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-991005

ABSTRACT

Las enfermedades no transmisibles se han incrementado en los últimos años y han causado gran morbi-mortalidad. Entre ellas, la diabetes mellitus tipo 2 se ha convertido en una epidemia que se asocia a una de las principales causas de muerte a nivel mundial. Su manejo es principalmente preventivo, ya que se encuentra asociada a hábitos y estilos inadecuados, entre los que se resaltan los alimenticios y el sedentarismo. Este trabajo tuvo como objetivo identificar las características y los resultados del uso de la tecnología multimedia para el manejo de la diabetes mellitus tipo 2 en las diferentes investigaciones reportadas por la literatura científica para la prevención, el control y el manejo de la enfermedad. Se consultaron las bases de datos EBSCO, SCIENCE DIRECT, LILACS y SCOPUS, y se encontraron un total de 156 artículos potencialmente útiles, pero al aplicar los criterios de tipificación se alcanzó un total de 13. La tecnología multimedia muestra utilidad para el manejo preventivo y el control de la diabetes, y en general de las enfermedades no transmisibles; sin embargo, los artículos no son precisos al determinar la efectividad de la multimedia utilizada. Los mensajes de texto y los videos muestran mayor tendencia de uso en las diferentes intervenciones(AU)


Noncommunicable diseases have increased in recent years and have caused great morbidity and mortality. Among them, type 2 diabetes mellitus has become an epidemic that is associated with one of the leading causes of death worldwide. Its management is mainly preventive, since it is associated with inadequate habits and styles, among which food-related and sedentary lifestyle stand out. The objective of this work is to identify the characteristics and outcomes of using multimedia technology for the management of type 2 diabetes mellitus in the different researches reported by the scientific literature for the prevention, control and management of the disease. The databases EBSCO, SCIENCE DIRECT, LILACS and SCOPUS were consulted, and a total of 156 potentially useful articles were found, but when the typing criteria were applied, a total of 13 was reached. Multimedia technology shows usefulness for preventive management and control of diabetes, and in general of noncommunicable diseases; however, the articles are not precise when determining the effectiveness of the multimedia used. Text messages and videos show a greater tendency of usage in different interventions(AU)


Subject(s)
Humans , Multimedia/statistics & numerical data , Diabetes Mellitus, Type 2/epidemiology , Information Technology/statistics & numerical data , Noncommunicable Diseases/prevention & control , Review Literature as Topic , Databases, Bibliographic/statistics & numerical data
8.
Rev. chil. cardiol ; 37(2): 126-133, ago. 2018. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-959351

ABSTRACT

Introducción : En la actualidad, la Minería de Datos es cada vez más popular en el campo de la salud porque existe una necesidad de eficiencia metodológica y analítica para detectar información desconocida y valiosa en datos de salud. Objetivo : Desarrollar un modelo predictivo utilizando técnicas de minería de datos, específicamente Arboles de Decisión, para pesquisar pacientes con propensión a desarrollar Diabetes Tipo II (DM II), Hipertensión Arterial (HTA) o Dislipidemia (DLP). Método : Se analizó el problema de los Factores de Riesgo Cardiovascular Mayores desde una perspectiva de procesos y se estudiaron las técnicas que permiten descubrir el conocimiento del fenómeno almacenado en las bases de datos de Examen de Medicina Preventiva del Adulto (EMPA) de la Población en Control Cardiovascular que presenta DM II, HTA o DLP Resultados : El Algoritmo C5, presenta un mayor poder predictivo, respecto de otros algoritmos de Árbol de Decisión. Se comprobó que las variables Edad y Circunferencia de Cintura fueron las de mayor poder de discriminación en el padecimiento de DM2, HTA o DLP. El algoritmo C5 alcanzó una precisión global de un 83,01% en la partición de prueba, luego en la misma partición el modelo logra discriminar un paciente con algunas de las patologías en el 85,25% de los casos, y uno que no presenta alguna de las patologías en un 80,27% de las oportunidades. Conclusión : La Minería de Datos y en este caso, específicamente los Modelos de Árboles de Decisión son una alternativa válida para la pesquisa cardiovascular temprana.


Introduction : Data Mining is increasingly popular in the health field because there is a need for an efficient analytical methodology to detect unknown and valuable information of health data. Objective : To develop a predictive model using data mining techniques, specifically Decision Trees, to investigate patients with a propensity to develop Type II Diabetes, Arterial Hypertension or Dyslipidemia. The data of adult patients presenting Type II diabetes, Hypertension or Dyslipidemia being followed in a preventive cardiovascular control program were analyzed with the aim of unveiling phenomena that could help develop the prediction of these risk factors. Results : With respect to other decision tree algorithms, Algorithm C 5, showed a greater predictive power. The variables age and waist circumference had the greatest power of discrimination for DM2, HTA or DLP. The C 5 algorithm reached a global precision of 83.01% in the test partition. Then, in the same partition the model managed to discriminate a patient with some of the risk factors in 85.25% of cases, and to rule out any of them in 80.27% of cases. Conclusion : Data Mining, specifically decisión tree models, is a valid alternative for early detection of cardiovascular of risk factors.


Subject(s)
Humans , Male , Female , Cardiovascular Diseases/diagnosis , Diabetes Mellitus, Type 2/diagnosis , Dyslipidemias/diagnosis , Data Mining , Hypertension/diagnosis , Prognosis , Decision Trees , Cardiovascular Diseases/epidemiology , Risk Assessment , Early Diagnosis , Diabetes Mellitus, Type 2/epidemiology , Dyslipidemias/epidemiology , Hypertension/epidemiology
9.
Medisan ; 22(7)jul.-ago. 2018. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-955053

ABSTRACT

Se realizó un estudio descriptivo y trasversal, en el 2016, en 350 personas con diabetes mellitus de tipo 2, pertenecientes al Policlínico Docente Julián Grimau García del municipio de Santiago de Cuba y seleccionadas por muestreo probabilístico, bietápico, sistemático en fase, a fin de caracterizarles según variables clínicas y epidemiológicas. En la casuística predominaron el sexo femenino y el grupo etario de 60-69 años, así como la hipertensión arterial y la obesidad entre las comorbilidades; la neuropatía diabética y la enfermedad vascular periférica fueron las complicaciones referidas con más frecuencia, y primaron las personas diabéticas con 10 años o menos de tiempo de evolución. El tabaquismo y la ingestión de bebidas alcohólicas resultaron más frecuentes en los hombres, mientras que la ingestión de bebidas azucaradas y el sedentarismo se manifestaron de manera similar en ambos sexos. Los hipoglucemiantes de consumo oral constituyeron el tratamiento farmacológico preponderante, en tanto los conocimientos sobre la enfermedad resultaron adecuados, pero la conducta fue incorrecta en cuanto al cumplimiento terapéutico, y existió una pobre práctica de estilos saludables, así como insuficientes percepción y práctica del autocuidado y la autorresponsabilidad.


A descriptive and cross-sectional study was carried out in the 2016 with 350 patients with diabetes mellitus type 2, belonging to Julián Grimau García Teaching Polyclinic of Santiago de Cuba municipality who were selected through systematic in phase double-staged probabilistic sampling aimed at characterizing them according to clinical and epidemiological variables. Female sex and the age group 60-69 prevailed in the case material, as well as the hypertension and obesity among the comorbilities; diabetic neuropathy and the peripheric vascular disease were the most common complications referred more frequently, and diabetic patients with 10 years or less of clinical course prevailed. The smoking habit and alcohol consumption were more frequent in the men, while the consumption of sugared drinks and sedentarism had similar patterns in both sexes. Hypoglucemics of oral consumption constituted the predominant pharmacological treatment, while the knowledge on the disease was appropriate, but the behaviour was not adequate as for the therapeutic fulfillment, and there was a poor practice of healthy styles, as well as scarce perception and practice of self-care and self-responsability.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Primary Health Care , Cross-Sectional Studies , Noncommunicable Diseases/epidemiology
10.
Rev. Hosp. Ital. B. Aires (2004) ; 38(2): 62-69, jun. 2018. graf.
Article in Spanish | LILACS (Americas) | ID: biblio-1023082

ABSTRACT

Objetivo: conocer e interpretar las representaciones sociales que tienen las personas con diabetes mellitus (DM) tipo 2 en una comunidad de bajo nivel socioeconómico del Gran Buenos Aires. Metodología: investigación cualitativa, tipo estudio de caso. Se realizaron entrevistas semiestructuradas a personas con diagnóstico de DM tipo 2, atendidas en un centro de atención primaria del Bajo Boulogne, partido de San Isidro, Buenos Aires. Mediante un muestreo teórico o por conveniencia, a partir de las historias clínicas generadas entre enero de 2001 y julio de 2017. Se incluyeron personas con diagnóstico reciente y otras con más de 15 años de evolución, hasta la saturación del discurso. Se realizó un análisis temático. Resultados: se realizaron 20 entrevistas. La mayoría de las personas entrevistadas tenían entre 60 y 69 años y eran de sexo femenino. La DM es vivida como una enfermedad que no tiene cura y que no condiciona a quienes la padecen en lo cotidiano. No impresionó ser una carga, excepto para las personas insulinizadas, quienes le asignan una connotación negativa a esa terapia. No encontramos diferencias de acuerdo con el sexo, la edad o los años de evolución. Los entrevistados asociaron la DM con malos hábitos alimentarios y escasa o nula actividad física. Conclusiones: en esta comunidad, la DM es vivida con naturalidad, en especial por quienes llevan años padeciéndola. La red familiar constituye la principal fuente de apoyo, acompañamiento, contención y provisión de cuidados. No se identificaron otras redes además de la familia o el sistema médico tradicional. (AU)


Objective: to recognize and to understand the social representations of people with type 2 diabetes mellitus (DM) in a community with a low socioeconomic level of suburban Buenos Aires. Methods: qualitative research, case study type. Semi-structured interviews were administered to people diagnosed with type 2 DM, who attended a primary care center in Bajo Boulogne, San Isidro district, Buenos Aires. Through a theoretical or convenience sampling, from the clinical records generated between January 2001 and July 2017. We included people with a recent diagnosis and others with more than 15 years of evolution, until speech saturation. We carried out a thematic analysis. Results: we conducted 20 interviews. Most of the people were aged between 60 and 69 years and were female. DM is lived as a disease without a cure and which does not condition the daily activities of people who suffer from it. It did not impress to be a burden, except for insulinized people, who assigned a negative connotation to that therapy. We did not find differences according to sex, age or years of evolution. Patients associated DM with poor eating habits and little or no physical activity. Conclusions: in this community, DM is lived naturally, especially by those who have been suffering from it for years. The family network constitutes the main source of support, accompaniment, containment, and provision of care. No other networks were identified, besides the family or the traditional medical system. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Self Care/psychology , Social Perception , Diabetes Mellitus, Type 2/epidemiology , Preventive Health Services/trends , Social Change , Social Class , Social Environment , Social Medicine , Evaluation Studies as Topic/statistics & numerical data , Health-Disease Process , Public Health/education , Chronic Disease/psychology , Surveys and Questionnaires , Diabetes Mellitus, Type 2/prevention & control , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapy , Family Practice , Feeding Behavior , Sedentary Behavior , Treatment Adherence and Compliance , Health Promotion/trends
11.
Medisan ; 22(5)mayo 2018. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-955035

ABSTRACT

Se realizó un estudio observacional, descriptivo y transversal para determinar la estratificación del pie de riesgo y los factores concurrentes en 534 pacientes con diabetes mellitus de tipo 2, pertenecientes a las áreas de salud de los policlínicos docentes Dr Carlos J Finlay y Julián Grimau del municipio de Santiago de Cuba, durante el segundo trimestre de 2016 y dispensarizados en los consultorios médicos correspondientes. Entre los principales resultados sobresalió la frecuencia elevada en los grados 1, 2 y 3 de la estratificación del pie de riesgo y la baja en la categoría sin riesgo, mientras que entre los factores concurrentes predominaron la hiperqueratosis plantar, el hallux valgus, la edad mayor de 40 años, la neuropatía periférica, la enfermedad arterial periférica, el calzado inadecuado y la obesidad


An observational, descriptive and cross-sectional study to determine the stratification of the risky feet and the concurrent factors in 534 patients with diabetes mellitus type 2, belonging to the health areas of Dr Carlos J Finlay and Julián Grimau Teaching polyclinics in Santiago de Cuba municipality was carried out during the second trimester of 2016 and they were classified in their corresponding doctors´ offices. Among the main results there were the increased frequency in the 1, 2 and 3 degrees of the stratification of the risky foot and the low frequency in the category without risk, while among the concurrent factors the plantar hyperkeratosis, the hallux valgus, more than 40 years of age, peripheral neuropathy, the peripheral arterial disease, inadequate shoes and obesity prevailed


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Diabetic Foot/classification , Diabetic Foot/epidemiology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Primary Health Care , Cross-Sectional Studies , Risk Factors , Observational Studies as Topic
12.
Medisan ; 22(1)ene. 2018. tab
Article in Spanish | LILACS (Americas) | ID: biblio-894666

ABSTRACT

Se realizó un estudio observacional, descriptivo, de serie de casos, para determinar la presencia de microalbuminuria en pacientes con diabetes mellitus de tipo 2, dispensarizados en el consultorio médico No. 42 del Policlínico Docente José Martí Pérez de Santiago de Cuba, desde octubre de 2016 hasta igual mes de 2017. En la serie, el grupo etario de mayor connotación epidemiológica, relacionado con la microalbuminuria de rango elevado, resultó ser el de 60-64 años (86,7 por ciento). El tiempo de evolución de la diabetes estuvo estrechamente vinculado con la detección de microalbuminuria elevada; asimismo, los diferentes estadios de la enfermedad renal crónica guardaron relación con el tiempo de evolución de la enfermedad, es decir, el estadio 1 se correspondió con el inicio de la diabetes y los estadios 4 y 5 con los enfermos con más de 10 años de evolución. Se evidenció la importancia del estudio de la microalbuminuria en enfermos con pocos años de evolución de la enfermedad


An observational, descriptive and serial cases study, to determine the presence of microalbuminuria in 80 patients with type 2 diabetes mellitus, classified in the doctor's office No. 42 of José Martí Pérez Teaching Polyclinic was carried out in Santiago de Cuba, from October, 2016 to the same month in 2017. In the series, the 60-64 age group was the one with higher epidemiological connotation, related to the microalbuminuria of high range (86.7 percent). The course time of the diabetes was closely linked with the detection of high microalbuminuria; also, the different stages of the chronic renal disease bore no relation with the course time of the illness, that is to say, the stage 1 was in correspondence with the beginning of the diabetes and the stages 4 and 5 with the patients with more than 10 years of clinical course. The importance of studying the microalbuminuria was evidenced in patients with few years of the disease course


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Physicians' Offices , Diabetes Mellitus, Type 2/epidemiology , Albuminuria/epidemiology , Primary Health Care , Residence Characteristics , Epidemiology, Descriptive , Observational Study
13.
Esc. Anna Nery Rev. Enferm ; 22(4): e20180046, 2018. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-953471

ABSTRACT

Objective: To verify self-care activities of patients with type 2 diabetes mellitus and to analyze the relationship with sociodemographic and clinical variables. Method: A cross-sectional study was performed of 149 people using the Diabetes Self-Care Activities Questionnaire. Results: Of the 15 self-care activities analyzed, appropriate behavior was observed for aspects related to medication use and inadequate for fruit/vegetable consumption, blood sugar testing and physical exercise. The correct use of medications was correlated to marital status. Regarding inadequate behaviors, there were associations of fruit/vegetable consumption with skin color and place of residence and blood sugar testing with marital status and inverse correlations of physical exercise with systolic blood pressure, pulse pressure, waist circumference and postprandial glycemia. Conclusion: The results of this research contribute by strengthening the line of care in chronic diseases and assist in divulging the importance of supported self-care. Implications for practice: The findings of this research provided information relevant to the planning of care.


Objetivo: Verificar actividades de autocuidado de pacientes con diabetes mellitus tipo 2 y analizar su relación con variables sociodemográficas y clínicas. Método: Estudio transversal, con 149 personas. Se utilizó el Cuestionario de Actividades de Autocuidado con Diabetes. Resultados: De las 15 actividades de autocuidado analizadas, se observó comportamiento adecuado a las relacionadas con el uso de medicamentos e inadecuado para el consumo de frutas/vegetales, monitorización glucémica y actividad física. El uso de medicamentos se relacionó con la situación conyugal. Con respecto a los comportamientos inadecuados, se observó relación entre consumo de frutas/vegetales con el color de la piel y residencia; la monitorización de la glucemia con la situación conyugal y la correlación inversa entre actividad física y presión arterial sistólica, presión de pulso, circunferencia abdominal y glucemia postprandial. Conclusión: Los resultados de esta investigación contribuyen para fortalecer la línea de cuidado en enfermedades crónicas y auxilian a enfatizar el autocuidado apoyado. Implicaciones para la práctica: Los hallazgos de esta investigación suministran informaciones relevantes para la planificación de la asistencia.


Objetivo: Verificar atividades de autocuidado de pacientes com diabetes mellitus tipo 2 e analisar sua relação com variáveis sociodemográficas e clínicas. Método: Estudo transversal, com 149 pessoas. Utilizou-se o Questionário de Atividades de Autocuidado com Diabetes. Resultados: Das 15 atividades de autocuidado analisadas, observou-se comportamento adequado naquelas relacionadas ao uso de medicamentos e inadequado para consumo de frutas/vegetais, monitorização glicêmica e atividade física. O uso de medicamentos relacionou-se com situação conjugal. No tocante aos comportamentos inadequados, observou-se relação entre consumo de frutas/vegetais e cor da pele e residência; monitorização da glicemia com situação conjugal e correlação inversa entre atividade física e pressão arterial sistólica, pressão de pulso, circunferência abdominal e glicemia pós-prandial. Conclusão: Os resultados desta investigação contribuem para fortalecer a linha de cuidado em doenças crônicas e auxiliam na ênfase ao autocuidado apoiado. Implicações para a prática: Os achados desta investigação propiciaram informações relevantes para o planejamento da assistência.


Subject(s)
Humans , Primary Health Care/statistics & numerical data , Self Care , Family Health Strategy , Diabetes Mellitus, Type 2/nursing , Diabetes Mellitus, Type 2/prevention & control , Diabetes Mellitus, Type 2/epidemiology
14.
Clin. biomed. res ; 38(4): 324-331, 2018.
Article in English | LILACS (Americas) | ID: biblio-1023778

ABSTRACT

Introduction: Evidence in the literature indicates that patients with type 2 diabetes (T2D) have a very low level of adherence to pharmacological treatment and that despite several interventions to improve it, a number of obstacles to optimal care limit the extent to which such goals can be achieved. This study attemts to assess the sociodemographic profile of patients with T2D, and to identify the main reasons for nonadherence. Methods: This cross-sectional study evaluated patients with T2D for at least 6 months who are regularly followed at an endocrinology outpatient clinic or who have been admitted to a university hospital. Adherence was assessed by a modifed Morisky Green test and the Batalla test. Results: Ninety-six patients were included, mostly women (59%), white (76%), and with mean age of 52 ± 12 years. Only 49% of patients adhered to drug treatment according to the Batalla test, while 24% were classifed as high adherence, 41% as moderate adherence and 34% as low adherence to drug treatment according to the modifed Morisky Green test. Considering glycated hemoglobin levels as a reference method, only 37% of patients were within the currently recommended values, with higher adherence among women compared to men (44% vs. 23%, P = 0.044). Conclusions: The prevalence of adherence among patients with T2D was very low. Older age, insulin therapy and male sex were more strongly associated with worse adherence. The main barrier limiting treatment adherence was lack of motivation, especially due to difculties in adopting a healthy and balanced diet. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Medication Adherence/statistics & numerical data , Chronic Disease/drug therapy , Morbidity
15.
Rev. inf. cient ; 97(3): i:528-f:537, 2018. tab
Article in Spanish | LILACS (Americas) | ID: biblio-999913

ABSTRACT

Introducción: en Cuba la diabetes mellitus se encuentra dentro de las afecciones más frecuentes del adulto mayor. Objetivo: caracterizar el comportamiento de las complicaciones crónicas de la diabetes mellitus tipo II en pacientes adultos mayores del Consultorio Médico de la Familia número 5 del municipio Caimanera entre septiembre de 2016 y febrero de 2017. Método: se realizó un estudio descriptivo de corte transversal donde fueron empleadas técnicas de análisis cualitativas y cuantitativas. La población estudiada quedó constituida por 26 pacientes. Entre las variables estudiadas están: tipo de complicación crónica de la diabetes, edad, sexo, años de evolución de la enfermedad, cantidad de complicaciones crónicas de la diabetes y nivel de depresión psicológica. Resultados: la complicación crónica más frecuente en los pacientes estudiados fue la neuropatía diabética. Predominaron los enfermos con menor cantidad de complicaciones; a menor edad y período evolutivo de la diabetes mellitus aparecieron las complicaciones. Un elevado por ciento de los pacientes tuvo niveles de depresión entre medio y alto. Conclusiones: las complicaciones crónicas de esta enfermedad en los pacientes adultos mayores aparecieron a menor edad y menor período evolutivo, además, de que se asoció a niveles altos de depresión psicológica, por lo que se ensombrece el pronóstico de la enfermedad, lo que pudiera incrementar la demanda y gastos de los servicios de salud que ellos demandan(AU)


Introduction: in Cuba, diabetes mellitus is one of the most frequent conditions in the elderly. Objective: to characterize the behavior of the chronic complications of type II diabetes mellitus in elderly patients of the Medical Clinic of Family Number 5 of Caimanera municipality from September 2016 to February 2017. Method: a descriptive cross-sectional study was carried out where qualitative and quantitative analysis techniques were used. The studied population was constituted by 26 patients. Among the variables are studied the following: type of chronic complication of diabetes, age, sex, years of evolution of the disease, number of chronic complications of diabetes and level of psychological depression. Results: the most frequent chronic complication in the patients was diabetic neuropathy. Patients with fewer complications; lower age and evolutive period of diabetes mellitus complications are presented. A high percentage of patients had levels of depression between medium and high. Conclusions: the chronic complications of the DM II in the elderly patients appeared at a younger age and a shorter period of evolution, in addition to being associated with high levels of psychological depression, which makes the prognosis of the disease darker, which could increase the demand and expenses of the health services that they demand(AU)


Subject(s)
Humans , Aged , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Epidemiology, Descriptive
16.
Clin. biomed. res ; 38(3): 237-244, 2018.
Article in Portuguese | LILACS (Americas) | ID: biblio-1046746

ABSTRACT

Introdução: O número de farmacêuticos que atuam em unidades básicas de saúde é reduzido, dificultando a execução do acompanhamento farmacoterapêutico (AFT) para um elevado número de pacientes. Portanto, deve-se estabelecer um período de execução do AFT, para que muitos pacientes sejam contemplados, contudo são escassos os estudos que avaliam a continuidade do controle da doença após a alta do serviço. Dessa forma, este estudo propôs avaliar o desfecho clínico de pacientes diagnosticados com Diabetes mellitus tipo 2 (DM2) após a alta de um serviço de AFT. Métodos: Estudo de coorte retrospectiva após estudo de intervenção de um acompanhamento farmacoterapêutico, que avaliou 64 pacientes divididos em dois grupos: estudo (participaram de um programa de AFT) e controle (não participaram do programa de AFT). Foram coletados dados clínicos e laboratoriais destes pacientes ao final do programa de AFT (baseline - março/2006 a fevereiro/2007), e nos quatro anos após o término do programa de AFT (março/2007 a agosto/2011). Resultados: Dentre os 64 pacientes, 56 foram incluídos. Nos quatro anos posteriores ao serviço observou-se nove óbitos, sendo seis do grupo controle e três do grupo de estudo (p=0,151). O grupo de estudo manteve os valores de hemoglobina glicada após AFT (HbA1c) (8,5% vs 8,0%, p = 0,082), enquanto que o grupo controle reduziu os valores de hemoglobina glicada (HbA1c) (9,1% vs 8,1%; p = 0,004). O controle da glicemia de jejum (GJ) do grupo de estudo foi mantido após quatro anos (149,5 mg/dL vs 148,8 mg/dL, p = 0,884), bem como o grupo controle (170,7 mg/dL vs 170,6 mg/dL, p = 0,993), no entanto ao comparar os dois grupos após AFT, o grupo de estudo apresenta valor significativamente menor que o grupo controle (p = 0,047). Conclusão: Apesar das diferenças obtidas entre os grupos com o AFT não permanecerem após quatro anos, os resultados clínicos e laboratoriais não apresentaram piora significativa nesse período. (AU)


Introduction: The number of pharmacists working at primary health care units is small, which means that pharmacotherapy follow-up (PFU) cannot be offered to a high number of patients. An established period of PFU could then lead to more patients being treated. However, studies assessing management of chronic diseases after discharge from this service are scarce. Thus, this study evaluated clinical outcomes of patients diagnosed with diabetes mellitus type 2 (DM2) after PFU discharge. Methods: This retrospective cohort study was conducted after a PFU intervention study, which evaluated 64 patients divided into two groups: study (who participated in a PFU program) and control (who did not participate in a PFU program). Laboratory and clinical data were collected from these patients at the end of the program (baseline ­ March 2006 to February 2007) and for four years after the end of the program (March 2007 to August 2011). Results: Of 64 patients, 56 were enrolled. In four years after discharge, nine patients died, six of them were from the control group and three from the study group (p = 0.151). The study group maintained glycated hemoglobin A (HbA1c) levels after PFU (8.5% vs. 8.0%, p = 0.082), while the control group showed reduced levels (9.1% vs. 8.1%; p = 0.004). Fasting glucose remained under control in the study group (149.5 mg/dL vs. 148.8 mg/dL, p = 0.884) as well as in the control group (170.7 mg/dL vs. 170.6 mg/dL, p = 0.993) after four years. However, when the groups were compared after PFU, the study group showed a significantly lower value than the control group (p = 0.047). Conclusion: Although the differences observed between the groups during PFU did not remain after four years, clinical and laboratory results did not show significant worsening in the period. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pharmaceutical Services/supply & distribution , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/prevention & control , Diabetes Mellitus, Type 2/epidemiology , Glycated Hemoglobin A/analysis , Glycemic Index
17.
Rev. bras. neurol ; 53(4): 17-26, out.-dez. 2017. tab, graf
Article in Portuguese | LILACS (Americas) | ID: biblio-876889

ABSTRACT

Fundamento: a Doença de Alzheimer (DA) é o tipo mais comum de demência, sendo histologicamente caracterizada pela deposição de peptídeo ß-amiloide, hiperfosforilação da proteína tau, neuroinflamação e perda neuronal, favorecida por diferentes mecanismos fisiopatológicos. O diabetes mellitus tipo 2 (DM2) ocorre devido à resistência periférica à insulina e à insuficiência insulínica (em fases mais avançadas da doença). Dados epidemiológicos sugerem relação entre DA e DM2, embora os supostos mecanismos fisiopatológicos comuns dessa inter-relação sejam obscuros. Objetivos: revisar os principais mecanismos fisiopatológicos compartilhados pela DA e DM2. Métodos: foram pesquisados artigos de 2000 a 2017 nas bases de dados do Portal CAPES/MEC, utilizando as palavras-chave: doença de Alzheimer, diabetes mellitus tipo 2, lesão vascular, resistência à insulina e estresse oxidativo. Resultados: 127 publicações foram analisadas e 73 incluídas. Lesão endotelial, resistência à insulina e estresse oxidativo foram os aspectos fisiopatológicos mais importantes e comuns à DA e DM2. Conclusão: há indícios de relação entre DA e DM2, embora não esteja clara se a relação é causal. Consequentemente, há a necessidade de estudos mais aprofundados sobre marcadores e mecanismos relacionados, visando o desenvolvimento de programas de prevenção e intervenção nas duas doenças em conjunto. (AU)


Introduction: Alzheimer's Disease (AD) is the most common type of dementia and is histologically characterized by deposition of ß-amyloid peptide, hyperphosphorylation of tau protein, neuronal loss and neuroinflammation, favored by different pathophysiological mechanisms. The type 2 diabetes mellitus (T2DM) occurs due to peripheral insulin resistance and insulin insufficiency (in later stages of the disease). Epidemiological data suggest a relationship between AD and T2DM, although the supposed common pathophysiological mechanisms of this interrelation are obscure. Objectives: to review the main pathophysiological mechanisms possibly shared by AD and T2DM. Methods: articles were searched from 2000 to 2017 in the databases of Portal CAPES / MEC, using the key words: Alzheimer's disease, type 2 diabetes mellitus, vascular injury, insulin resistance and oxidative stress. Results: we selected 73 from 127 articles. Endothelial injury, insulin resistance and oxidative stress are pathophysiological aspects common to AD and T2DM. Conclusion: there is evidence of a relationship between AD and T2DM, although it is unclear whether the relation is causal. There is a need for more studies about markers and related mechanisms, aiming at the development of prevention and intervention programs in both diseases. (AU)


Subject(s)
Humans , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2/epidemiology , Alzheimer Disease/complications , Alzheimer Disease/physiopathology , Alzheimer Disease/epidemiology , Insulin Resistance , Risk Factors , Amyloid beta-Peptides/metabolism , Oxidative Stress , Disease Progression
18.
Rev. cuba. endocrinol ; 28(3): 1-10, set.-dic. 2017. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-901023

ABSTRACT

Antecedentes: la valoración del riesgo cardiovascular global es importante para establecer medidas preventivas en pacientes con alto riesgo de presentar enfermedad cardiovascular. Objetivo: estimar el riesgo cardiovascular global en mujeres diabéticas tipo 2 de edad mediana. Métodos: se realizó un estudio transversal y descriptivo con 458 mujeres en edad mediana (40 a 59 años), que ingresaron consecutivamente en el Centro de Atención al Diabético de Bayamo, Granma, desde el año 2010 a 2016. El riesgo cardiovascular global se determinó según los modelos propuestos por la Organización Mundial de la Salud para nuestro país. Resultados: el riesgo cardiovascular global de las mujeres diabéticas en edad mediana fue moderado en el 10,1 por ciento (46 pacientes), alto en el 3,1 por ciento (14 pacientes) y muy alto en el 2,4 por ciento (11 pacientes). Las mujeres posmenopáusicas exhibieron un riesgo cardiovascular global significativamente mayor que aquellas que no estaban en esta etapa (OR= 1,89; IC= 1,03-3,1; p= 0,0413). El riesgo se incrementó claramente a medida que aumentó el tiempo de ocurrencia de la menopausia (p= 0,0245). La prevalencia de hipertensión sistólica, hipercolesterolemia y hábito de fumar fue mayor en las mujeres posmenopáusicas, sin que llegara a ser estadísticamente relevante. Conclusiones: el riesgo cardiovascular global de las mujeres diabéticas tipo 2 en edad mediana, de nuestro medio, se incrementa con la menopausia y con el tiempo de ocurrencia de este evento(AU)


Background: the assessment of overall cardiovascular risk is important to establish preventive measures in patients with high risk of cardiovascular disease. Objective: to estimate the overall cardiovascular risk in type 2 diabetic middle-aged women. Methods: a transversal and descriptive study was carried out with 458 middle-aged women (40 to 59 years old) who consecutively attended the Diabetics Care Center of Bayamo, Granma from 2010 to 2016. The overall cardiovascular risk was determined according to the models proposed by the World Health Organization for our country. Results: the overall cardiovascular risk of diabetic middle-aged women was moderate in the 10.1 percent (46 patients), high in the 3.1 percent (14 patients), and very high in the 2.4 percent (11 patients). Postmenopausal women showed a significantly higher overall cardiovascular risk than those who were not in this stage (OR= 1.89, CI= 1.03-3.1, p= 0.0413). The risk clearly increased as the time of occurrence of the menopause increased (p= 0.0245). The prevalence of systolic hypertension, hypercholesterolemia and smoking habit was higher in postmenopausal women but this didn´t become statistically relevant. Conclusions: the overall cardiovascular risk of type 2 diabetic middle-aged women increases with the menopause and with the time of occurrence of this event(AU)


Subject(s)
Humans , Female , Middle Aged , Cardiovascular Diseases , Risk Factors , Diabetes Mellitus, Type 2/epidemiology , Hypercholesterolemia/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Postmenopause
19.
Rev. cuba. endocrinol ; 28(3): 1-19, set.-dic. 2017. tab
Article in Spanish | LILACS (Americas) | ID: biblio-901026

ABSTRACT

Introducción: la diabetes mellitus tipo 2 en niños y adolescentes está alcanzando proporciones alarmantes. Desde la década de los 90, se asiste a la aparición, cada vez más frecuente, de este fenómeno, el cual parece ser una consecuencia del preocupante aumento de la obesidad en la población, proceso que va acompañado también de insulinorresistencia. Objetivo: describir el comportamiento del incremento de la incidencia de la diabetes mellitus tipo 2 con respecto a la tipo 1, en individuos hasta 18 años de edad, Cuba, 2013-2015. Métodos: se realizó un estudio observacional descriptivo. La población de estudio fue la diagnosticada como diabética de 1 a 18 años, tipo 1 y tipo 2. Los datos estadísticos se tomaron del Registro Nacional de Dispensarización de Diabetes Mellitus correspondiente a los años 2013, 2014 y 2015. Resultados: el comportamiento global de la Razón de Tasas de Incidencia, en los años estudiados, fue fluctuante en la diabetes mellitus tipo 2; mientras que, en la diabetes mellitus tipo 1, se elevó en el periodo 2013-2014 y durante el 2014-2015 existió un notable descenso. La Razón de Tasas de Incidencia (diabetes mellitus tipo 2/diabetes mellitus tipo 1) es mayor que 1, solo en el grupo de edad de 15 a 18 años, correspondientes a los años 2013 y 2014. A medida que incrementa la edad, se eleva esta Razón de Tasas de Incidencia. Conclusiones: la incidencia de diabetes mellitus tipo 2 en los grupos de edades estudiados, se incrementa a medida que incrementa la edad, mientras que la incidencia de la DM 1 disminuye con el incremento de esta(AU)


Introduction: type 2 diabetes mellitus in children and adolescents is reaching alarming proportions. Since the 1990s, we are witnessing the increasingly frequent appearance of this phenomenon, which seems to be a consequence of the worrying increase in obesity in the population, a process that is also accompanied by insulin resistance. Objective: to describe the behavior of the increase in the incidence of type 2 diabetes mellitus with respect to type 1 in individuals up to 18 years old in Cuba from 2013 to 2015. Methods: a descriptive observational study was carried out. The study population was the one diagnosed as diabetic from 1 to 18 years old, type 1 and type 2. The statistical data were taken from the National Registry of Classification of Diabetes Mellitus corresponding to the years 2013, 2014 and 2015. Results: the overall behavior of the Incidence´s Rate Ratio in the years studied was fluctuating in type 2 diabetes mellitus; while in type 1 diabetes mellitus, it increased in the period 2013-2014, and during 2014-2015 there was a notable decrease. The Incidence´s Rate Ratio (diabetes mellitus type 2/diabetes mellitus type 1) is higher than 1 only in the age group of 15 to 18 years, corresponding to the years 2013 and 2014. As the age increases, it raises this Incidence´s Rate Ratio. Conclusions: the incidence of type 2 diabetes mellitus in the age groups studied increases as age increases, while the incidence of type 1 decreases with the increase of age(AU)


Subject(s)
Humans , Child , Adolescent , Statistics as Topic/methods , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Pediatric Obesity/epidemiology , Epidemiology, Descriptive , Observational Study
20.
Rev. cuba. endocrinol ; 28(3): 1-15, set.-dic. 2017. tab
Article in Spanish | LILACS (Americas) | ID: biblio-901022

ABSTRACT

Introducción: la dislipidemia constituye un factor de riesgo vascular frecuente en la diabetes tipo 2. Objetivo: identificar la relación entre las alteraciones lipídicas y el riesgo vascular en la diabetes tipo 2. Métodos: estudio transversal y correlacional de 111 personas con diabetes tipo 2 y dislipidemia (41 con primaria y 70 con secundaria), atendidas en el Centro de Atención al Diabético del Instituto Nacional de Endocrinología, durante 2014-2015. Se analizaron las variables: edad, sexo, tabaquismo, índice de masa corporal, circunferencia de cintura, índices cintura-cadera y cintura-talla, presión arterial sistólica y de pulso, colesteroles total, lipoproteínas de baja densidad y las lipoproteínas de alta densidad, triglicéridos, apoproteínas A y B, hemoglobina glucosilada, complejo íntima-media carotídeo y riesgo cardiovascular por tablas de la OMS y Gaziano. Para comparar variables cualitativas (porcentaje), se utilizó prueba de Fisher y para cuantitativas ( ± DE), U de Mann-Whitney. Para todos los análisis, se asumió una p< 0,05. Resultados: la disminución de lipoproteínas de alta densidad-colesterol fue la alteración de fracción lipídica que más se relacionó con alteración de variables clínicas y bioquímicas, para ambas dislipidemias. La dislipidemia primaria se asoció con mayor riesgo cardiovascular según tablas de la OMS (p= 0,015). Conclusiones: la dislipidemia primaria y la disminución de lipoproteínas de alta densidad-colesterol se relacionaron con mayor riesgo vascular(AU)


Introduction: dyslipidemia is a frequent vascular risk factor in type 2 diabetes. Objective: to identify the relation between lipid alterations and vascular risk in type 2 diabetes. Methods: cross-sectional and correlational study of 111 people with type 2 diabetes and dyslipidemia (41 of them with primary and 70 with secondary) attended at the Diabetics Care Center of the National Institute of Endocrinology during 2014-2015. The variables analyzed were: age, sex, smoking habit, body mass index, waist circumference, waist-hip and waist-height indexes, systolic and pulse blood pressure, total cholesterol, low density lipoproteins and high density lipoproteins, triglycerides, apoproteins A and B, glycosylated hemoglobin, carotid intima-media complex; and cardiovascular risk by WHO and Gaziano tables. To compare qualitative variables (percentage), Fisher's test was used, and for quantitative ( ± DE), Mann-Whitney U. For all analyzes, a p< 0.05 was assumed. Results: the decrease of high density-cholesterol´s lipoproteins was the alteration of lipid fraction that was more related to the alteration of clinical and biochemical variables, for both dyslipidemias. Primary dyslipidemia was associated with a higher cardiovascular risk according to WHO tables (p= 0.015). Conclusions: primary dyslipidemia and the decrease of high density-cholesterol´s lipoproteins were associated with a higher vascular risk(AU)


Subject(s)
Humans , Risk Factors , Diabetes Mellitus, Type 2/epidemiology , Diabetic Angiopathies/etiology , Dyslipidemias/etiology , Evaluation Studies as Topic/statistics & numerical data , Cross-Sectional Studies , Data Interpretation, Statistical
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