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1.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 217-221, Feb. 2022. tab
Article in English | LILACS | ID: biblio-1365360

ABSTRACT

SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.


Subject(s)
Humans , Aged , Oral Health , Diabetes Mellitus/therapy , Quality of Life , China , Prospective Studies , Problem-Based Learning , Medicine, Chinese Traditional
2.
Brasília; Fiocruz Brasília;Instituto de Saúde de São Paulo; 16 nov. 2021. 39 p. tab.
Non-conventional in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, PIE | ID: biblio-1361686

ABSTRACT

Contexto: As práticas de atividade física são fortes aliadas na redução dos riscos à saúde, bem como no tratamento de doenças. Destaca-se sua relevância no cuidado a pessoas com doenças crônicas não transmissíveis, para as quais é importante investir na qualidade de vida. Esta revisão rápida aborda os efeitos não-clínicos das intervenções de atividade física em pessoas com diabetes mellitus tipo 2, hipertensão arterial sistêmica e sobrepeso/obesidade. Pergunta: Quais são os efeitos não-clínicos de diferentes modalidades de atividade física no tratamento de pessoas com diabetes, hipertensão ou obesidade? Métodos: Seguindo protocolo prévio, foram realizadas buscas por revisões sistemáticas (RS) em oito bases eletrônicas da literatura, em setembro de 2021. Nesta revisão rápida foram incluídas RS publicadas nos últimos 10 anos, com algumas especificações quanto a contexto e população. Apenas o processo de seleção foi realizado em duplicata e de forma independente. A avaliação da qualidade das RS foi feita por um revisor e checada por outro, por meio da ferramenta AMSTAR 2. Os resultados foram reunidos em síntese narrativa conforme similaridade do tipo de atividade física e população. Resultados: De 4.421 relatos encontrados nas bases de dados, 23 RS foram incluídas após processo de seleção e elegibilidade. Na avaliação da qualidade metodológica, uma RS foi considerada de confiança moderada, uma de confiança baixa e as demais de confiança criticamente baixa. As revisões apresentaram resultados de exercícios aeróbicos, anaeróbicos, combinados e de tipo não informado, envolvendo pessoas com diabetes mellitus tipo 2, hipertensão arterial sistêmica e sobrepeso/obesidade. O tipo de atividade mais presente foi de exercícios aeróbicos e a condição mais estudada foi diabetes mellitus tipo 2. Apenas uma RS apresentou informação a respeito da segurança da prática de atividade física, sem ocorrência de eventos adversos. Diversas modalidades de atividade física mostraram promover benefícios não-clínicos no tratamento de pessoas com diabetes, hipertensão e obesidade. Considerações finais: As evidências indicam que pessoas com diabetes ou hipertensão podem ter sua qualidade de vida melhorada com a prática de exercícios, em especial os aeróbicos. Para pessoas com obesidade ou comorbidades, as evidências são menos robustas. É importante levar em consideração algumas incertezas apontadas pelas RS, bem como as falhas metodológicas da maioria dessas RS.


Context: Physical activity practices are strong allies in reducing health risks, as well as in the treatment of diseases. Its relevance in the care of people with non-communicable chronic diseases is highlighted, for whom it is important to invest in quality of life. This rapid review addresses the non-clinical effects of physical activity interventions in people with type 2 diabetes mellitus, systemic arterial hypertension, and overweight/obesity. Question: What are the non-clinical effects of different physical activity modalities in the treatment of people with diabetes, hypertension or obesity? Methods: Following a previous protocol, searches for systematic reviews (SR) were carried out in eight electronic databases of the literature, in September 2021. This rapid review included SRs published in the last 10 years, with some specifications regarding context and population. Only the selection process was carried out in duplicate and independently. The evaluation of the quality of the SRs was carried out by one reviewer and checked by another, using the AMSTAR 2 tool. The results were gathered in a narrative synthesis according to the similarity of the type of physical activity and population. Results: Of the 4,421 reports found in the databases, 23 SRs were included after the selection and eligibility process. In the evaluation of methodological quality, one SR was considered moderately reliable, one of low confidence and the others of critically low confidence. The reviews presented results of aerobic, anaerobic, combined and unreported exercises involving people with type 2 diabetes mellitus, systemic arterial hypertension and overweight/obesity. The most common type of activity was aerobic exercises and the most studied condition was type 2 diabetes mellitus. Only one SR presented information about the safety of physical activity, without the occurrence of adverse events. Several modalities of physical activity have been shown to promote non-clinical benefits in the treatment of people with diabetes, hypertension and obesity. Final considerations: The evidence indicates that people with diabetes or hypertension can have their quality of life improved with the practice of exercises, especially aerobic ones. For people with obesity or comorbidities, the evidence is less robust. It is important to take into account some uncertainties pointed out by the SRs, as well as the methodological flaws of most of these SRs.


Subject(s)
Humans , Exercise , Diabetes Mellitus/therapy , Hypertension/therapy , Obesity/therapy , Quality of Life
3.
Ciudad Autónoma de Buenos Aires; Comisión Nacional de Evaluación de Tecnologías de Salud; Marzo 2021. 30 p. (Informe de Evaluación de Tecnologías Sanitarias N°16, 16).
Monography in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1151376

ABSTRACT

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad.


Subject(s)
Insulin Infusion Systems , Child , Adolescent , Pregnant Women , Diabetes Mellitus/therapy
4.
Esc. Anna Nery Rev. Enferm ; 25(1): e20200046, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1124789

ABSTRACT

Resumo Objetivo Analisar uma ferramenta de telessaúde de um centro de referência em Diabetes Mellitus sob a ótica dos cuidadores. Método Estudo transversal, com abordagem quantitativa, desenvolvido em um centro de referência em Diabetes Mellitus, com cuidadores de crianças e adolescentes que utilizaram a Hot-Line e responderam ao questionário online, no período de novembro de 2018 a fevereiro de 2019. Resultados A amostra foi constituída de 90 participantes, sendo 76 (84,4%) do sexo feminino, tendo como o maior parentesco o materno 68 (75,6%). Quanto aos motivos das ligações, 31 (34,4%) referem-se às orientações gerais, 41 (45,6%) ao ajuste de dose de insulina, 6 (6,7%) à hipoglicemia aguda, 6 (6,7%) à hiperglicemia aguda, 2 (2,2%) aos dias de doença e 4 (4,4%) referem-se aos resultados de exames. Os participantes apresentaram um alto índice de satisfação com o uso da linha telefônica. Conclusão e implicações práticas O teleatendimento produz benefícios imediatos aos pacientes, sendo resolutivo no manejo da doença. Cabe ressaltar que o uso da telessaúde como forma de promoção da saúde contribui para a prevenção de agravos de maneira rápida, satisfatória e sem o deslocamento do paciente e sua família.


Abstract Objective To analyze a telehealth tool of a reference center in Diabetes Mellitus from the caregivers' perspective. Method A cross-sectional study, with a quantitative approach, developed at a reference center in Diabetes Mellitus, with caregivers of children and adolescents who used the Hot-Line and responded to the online questionnaire, from November 2018 to February 2019. Results The sample consisted of 90 participants, 76 (84.4%) were female, and the highest kinship was the maternal 68 (75.6%). Regarding the reasons for the telephone callings, 31 (34.4%) refer to general guidelines, 41 (45.6%) to the insulin dose adjustment, 6 (6.7%) to the acute hypoglycemia, 6 (6.7%) acute hyperglycemia, 2 (2.2%) to the days of disease and 4 (4.4%) refer to the test results. The participants presented a high level of satisfaction with the use of the telephone line.Conclusion and implications for practice: The call center produces immediate benefits to patients, being effective in the management of the disease. It should be emphasized that the use of telehealth as a form of health promotion contributes to the prevention of health problems in a fast, satisfactory way and without the displacement of the patient and his family.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Telemedicine/statistics & numerical data , Diabetes Mellitus/prevention & control , Socioeconomic Factors , Health Education/statistics & numerical data , Cross-Sectional Studies , Patient Satisfaction/statistics & numerical data , Caregivers/statistics & numerical data , Diabetes Mellitus/therapy , Age and Sex Distribution
5.
Rev. chil. endocrinol. diabetes ; 14(4): 171-177, 2021. tab
Article in Spanish | LILACS | ID: biblio-1348218

ABSTRACT

Los avances en el campo de la fibrosis quística han aumentado la esperanza de vida de estos pacientes, por lo que cada vez es más prevalente la Diabetes Relacionada con la Fibrosis Quística (DRFQ) y sus complicaciones. La DRFQ se asocia a mayor morbimortalidad, deterioro de la función pulmonar y del estado nutricional. Por lo mismo, el manejo óptimo de esta patología depende de un diagnóstico precoz, tratamiento individualizado y vigilancia de las complicaciones diabéticas. El screening de DRFQ debe realizarse anualmente a partir de los 10 años, mediante una Prueba de Tolerancia a la Glucosa Oral (PTGO), lo cual permite el diagnóstico. El manejo de esta patología tiene por objetivo estabilizar y mejorar la función pulmonar y el estado nutricional y metabólico de los pacientes. Actualmente, la insulina es el tratamiento farmacológico de elección para controlar la hiperglicemia y el esquema de uso debe ser individualizado para cada persona. En caso de enfermedades agudas pueden existir mayores requerimientos de insulina. Además, se deben tener consideraciones especiales en cuanto a la dieta y la insuficiencia pancreática exocrina que presentan estos pacientes. Para la vigilancia de complicaciones microvasculares se debe realizar una monitorización anual a partir de los 5 años desde el diagnóstico de DRFQ. Debido a la complejidad de estos pacientes, para alcanzar el mejor cuidado posible se necesita un enfoque multidisciplinario con distintos profesionales de la salud coordinados, incluyendo en la toma de decisiones al paciente y su familia.


Advances made in the field of cystic fibrosis have increased the life expectancy of these patients, which is why Cystic Fibrosis-Related Diabetes (CFRD) and its complications are becoming more and more prevalent. CFRD is associated with increased morbidity and mortality, lower lung function and inadequate weight maintenance. Therefore, the optimal management of this pathology depends on an early diagnosis, individualized treatment and monitoring of diabetic complications. For CFRD, routine screening with an Oral Glucose Tolerance Test (OGTT) should be carried out yearly from the age of 10, which allows to diagnose it. The treatment goals in CFRD are to stabilize and improve lung function and obtain adequate weight gain. Currently, insulin is the pharmacological treatment of choice to control hyperglycemia and the insulin regimen must be personalized for each person. In acute illnesses, there may be higher insulin requirements. In addition, special considerations must be taken regarding diet and exocrine pancreatic insufficiency that these patients present. For the surveillance of microvascular complications, annual monitoring should be carried out 5 years after the diagnosis of CFRD. Due to the complexity of these patients, in order to achieve the best possible care, a multidisciplinary approach is needed with different coordinated health professionals, including the patients and their family in the decision-making process.


Subject(s)
Humans , Cystic Fibrosis/complications , Cystic Fibrosis/diagnosis , Cystic Fibrosis/therapy , Diabetes Mellitus/etiology , Diabetes Mellitus/therapy , Patient Care Team , Mass Screening , Cystic Fibrosis/physiopathology , Nutrition Therapy , Diabetes Mellitus/diagnosis , Diabetes Mellitus/physiopathology , Insulins/therapeutic use , Glucose Tolerance Test , Hypoglycemic Agents/therapeutic use
8.
Ciênc. Saúde Colet ; 25(3): 845-858, mar. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1089490

ABSTRACT

Resumo Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.


Abstract The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Quality of Life , Health Behavior , Patient Acceptance of Health Care , Diabetes Mellitus/therapy , Social Determinants of Health , Facilities and Services Utilization/statistics & numerical data , Brazil , Urban Health , Cross-Sectional Studies , Middle Aged
9.
Int. j. high dilution res ; 19(3): 2-17, 2020.
Article in English | LILACS, HomeoIndex | ID: biblio-1146520

ABSTRACT

IntroductionDiabetes Mellitusis an emerging endocrine and metabolic disorder which has affected millions of people globally. Homeopathic system of medicine uses ultra-molecular doses for treatment of Diabetes Mellitus. Homeopathic medicines are prepared from plant, mineral, sarcodes,nosodes and animal parts. Insulinum 6 CH, Pancreatinum 6CH and Uranium nitricum 6 CHareused in homeopathy for treatment of Diabetes Mellitus. However,no preclinical studies have been investigated for the anti-diabetic effect and its safety.MethodsHomeopathic medicines Insulinum 6CH, Pancreatinum 6CHandUranium nitricum6CH(1012)dilution factor were used to examine antihyperglycemic effects in streptozotocin induced diabetic rats. After 28 daysoftreatment,bodyweight, Hematology, Biochemistry (serum glucose, urea, creatinine, SGPT, SGOT, ALP, Triglyceride and HDL-cholesterol), Oral Glucose Tolerance Test, HbA1C with histopathologyof (Liver, Kidney, Pancreas) weremeasured.ResultsAfter Streptozotocin induction, the animals have shown significant increase in the fasting blood glucose level (p<0.01) as compared to normal control animals. Treatment with homeopathic medicine Insulinum 6CH, Pancreatinum 6CHandUranium nitricum6CHpotency showed significant decrease in levels of Glucose (p<0.05), OGTT, Total protein (P<0.001), ALP (P<0.05), Cholesterol (P<0.001), SGPT (P<0.001), SGOT (p<0.01), Urea, HbA1C as compared to diabetic animal.ConclusionsIn the present study homeopathic medicine Insulinum 6CH, Pancreatinum 6CH andUranium nitricum6CHpotency exhibitantihyperglycemic effects in streptozotocin induced diabetic rats.(AU)


Subject(s)
Insulinum/therapeutic use , Pancreatinum/therapeutic use , Sarcodes , Uranium/therapeutic use , Streptozocin , Diabetes Mellitus/therapy , Homeopathy , Hypoglycemic Agents
10.
Rev. chil. endocrinol. diabetes ; 13(4): 170-176, 2020. tab
Article in Spanish | LILACS | ID: biblio-1123624

ABSTRACT

La diabetes mellitus ha sido asociado a una mayor probabilidad de enfermedad más grave por Covid-19. Los estudios epidemiológicos evidencian que los pacientes diabéticos tienen un riesgo mayor de un cuadro grave que requiera UCI, ventilación mecánica y probabilidad de morir. Un buen control metabólico parece fundamental para disminuir este riesgo. En el caso del manejo ambulatorio es importante asegurar la continuidad de los tratamientos crónicos, medir los niveles de glicemia capilar y minimizar la posibilidad de infección. En caso de infección por SARS-Cov2 el paciente diabético deberá hacer los ajustes necesarios en su tratamiento tanto para lograr un control glicémico adecuado como para disminuir los riesgos de algunos fármacos antidiabéticos. El uso de telemedicina constituye una excelente herramienta para facilitar el logro de los objetivos terapéuticos. En caso de requerir hospitalización, se ha evidenciado que los pacientes diabéticos tienen altos requerimientos de insulina y rápida tendencia a producir cetosis. Considerando la situación actual de pandemia las metas intrahospitalarias pueden ser más laxas y seguras, en especial en pacientes no críticos. En caso de pacientes críticos idealmente se debe mantener las metas glicémicas entre 140-180 mg/dL.


Diabetes mellitus has been associated with a higher probability of severe disease due to Covid-19. Epidemiological studies show that diabetic patients have an increased risk of a serious condition requiring ICU, mechanical ventilation and of course the probability of dying. Good metabolic control seems essential to reduce this risk. In the case of outpatient management, it is very important to ensure the continuity of chronic treatments, measure capillary blood glucose levels and minimize the possibility of infection. In case of SARS-Cov2 infection, the diabetic patient should make the necessary adjustments in their treatment, both to achieve adequate glycemic control and to reduce the risks of some antidiabetic drugs. Telemedicine is an excellent tool to facilitate the achievement to therapeutic goals. In case of requiring hospitalization, it has been shown that diabetic patients have high insulin requirements and rapid tendency to produce ketosis. Considering the current situation of a pandemic, intrahospital goals may be laxer and safer, especially in non-critically ill patients. In the case of critically ill patients, the glycemic goals should ideally be maintained between 140-180 mg/dL.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Diabetes Mellitus/epidemiology , Outpatients , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Risk , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Diabetes Mellitus/physiopathology , Diabetes Mellitus/therapy , Hospital Care , Pandemics , Ambulatory Care , Betacoronavirus , Inpatients
11.
Einstein (Säo Paulo) ; 18: eAO4723, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056049

ABSTRACT

ABSTRACT Objective To identify interventions aimed to improve adherence to medical and non-medical antihypertensive and antidiabetic therapy. Methods Scientometric study conducted in February and March 2018, based on data collected on PubMed ® and SciELO databases, using the following search terms: "interventions to improve adherence to diabetes therapy", "interventions to improve adherence to hypertension therapy" and "interventions to improve adherence to therapy for hypertension and diabetes". Results A total of 95 articles were selected. Scientific production increased as of 2009, with a higher number of studies published between 2015 and 2017. Most interventions described in literature were aimed at diabetic patients (46.31%). Face-to-face interventions were more common (46.31%), followed by telephone-based (31.58%) and digital (26.31%) interventions. North America stood out as the continent with the highest number of publications (68.42%), followed by Europe (14.74%). Most studies (63.16%) were based on a single type of intervention. Conclusion Traditional intervention methods were more widely used to promote adherence to antihypertensive and antidiabetic therapy; digital technology emerged as a trend in interventions aimed to improve hypertension and diabetes-related health behaviors.


RESUMO Objetivo Identificar as intervenções utilizadas para melhorar a adesão de terapias medicamentosas e não medicamentosas de pacientes hipertensos e diabéticos. Métodos Estudo cienciométrico realizado nos meses de fevereiro e março de 2018, utilizando os termos "intervenções para melhorar a adesão à terapia do diabetes", "intervenções para melhorar a adesão à terapia de hipertensão" e "intervenções para melhorar a adesão à terapia da hipertensão e diabetes", nas bases de dados PubMed®e SciELO. Resultados Foram selecionados 95 artigos. A partir do ano 2009, observou-se crescimento da produção científica com maior volume entre os anos 2015 e 2017. O maior número de intervenções encontradas na literatura foi para pacientes com diabetes (46,31%). A intervenções mais utilizadas foram a face a face (46,31%), por chamada telefônica (31,58%) e a digital (26,31%). A América do Norte destacou-se no número de pesquisas, com 68,42% das publicações, seguida pela Europa, com 14,74%. Dentre os estudos, a maioria (63,16%) utilizou apenas um tipo de intervenção. Conclusão Métodos de intervenção tradicionais foram mais empregados para promover a adesão às terapias anti-hipertensão e antidiabetes, embora o uso de tecnologias digitais desponte como tendência para melhorar esses comportamentos de saúde.


Subject(s)
Humans , Male , Female , Bibliometrics , Diabetes Mellitus/therapy , Treatment Adherence and Compliance/statistics & numerical data , Hypertension/therapy , Time Factors , Treatment Outcome , Hypoglycemic Agents/therapeutic use , Antihypertensive Agents/therapeutic use
12.
Brasília; Ministério da Saúde; 2020. 14 p. (Informe sobre evidências clínicas das Práticas Integrativas e Complementares em Saúde, 2020, 01).
Monography in Portuguese | MTYCI, LILACS, MTYCI | ID: biblio-1103488

ABSTRACT

As Práticas Integrativas e Complementares em Saúde (PICS), denominadas como Medicinas Tradicionais, Complementares e Integrativas (MTCI) pela Organização Mundial de Saúde (OMS), foram instituídas por meio da Política Nacional de Práticas Integrativas e Complementares no SUS (PNPIC), em maio de 2006. Estas práticas são transversais em suas ações no Sistema Único de Saúde (SUS) e estão presentes em todos os pontos da Rede de Atenção à Saúde (RAS), prioritariamente na Atenção Primária à Saúde (APS), com grande potencial de atuação em rede. As PICS são ferramentas terapêuticas potentes quando aliadas ao tratamento complementar de diversas condições crônicas. Além disso, são abordagens que ampliam o olhar dos profissionais sobre o processo saúde e doença e sobre as ofertas terapêuticas de cuidado à população. Nesse contexto, as PICS são importantes aliadas, contribuindo para a promoção, prevenção e reabilitação da saúde e manejo clínico das doenças crônicas, potencializando o projeto terapêutico singular por meio de seus benefícios. Considerando a necessidade de ampliar a resolutividade do cuidado a partir de práticas seguras, eficazes e socialmente sustentáveis, este documento tem por objetivo divulgar as evidências científicas no campo das PICS de forma a apoiar os gestores na tomada de decisão, para as condições de obesidade e diabetes mellitus. Neste contexto, evidências científicas de alto grau metodológico apontam que as PICS possuem eficácia no tratamento de indivíduos com DM. A prática do yoga auxilia na melhora dos resultados glicêmicos e de outros fatores de risco da DM. A meditação tem efeito indireto sobre a redução da hemoglobina glicada (HbA1c), além de melhorar os efeitos psicológicos que perpassam as várias condições crônicas de saúde, incluindo a DM.


Subject(s)
Humans , Complementary Therapies , Mind-Body Therapies , Diabetes Mellitus/prevention & control , Obesity/prevention & control , Obesity/therapy , Yoga , Meditation , Tai Ji , Acupuncture , Diabetes Mellitus/therapy , Obesity Management , Medicine, Chinese Traditional
13.
Salud colect ; 16: e2407, 2020. tab
Article in Spanish | LILACS | ID: biblio-1139502

ABSTRACT

RESUMEN El objetivo fue estimar la prevalencia de las prácticas autoreferidas para controlar la hipertensión y la diabetes, con y sin medicamentos, en adultos mayores de Campinas, Brasil, en tres períodos. Se analizaron los datos de las encuestas de salud realizadas en tres períodos: 2001-2002, 2008-2009 y 2014-2015. La prevalencia de hipertensión, de diabetes, del uso de medicación continua y las prácticas comportamentales aumentaron durante el período analizado, con una caída significativa en el uso no regular de medicamentos y las consultas médicas de rutina en individuos sin plan de salud privado. Los resultados evidenciaron avances en las prácticas relacionadas con la dieta en aquellas personas sin plan de salud y en quienes declararon contar con plan de salud, destacando mejoras en el tratamiento con medicamentos y la práctica de actividad física. La adherencia al uso de medicamentos y a prácticas comportamentales para controlar las morbilidades se mostró consistente en el período evaluado. Estos indicadores refuerzan la necesidad de mantener y ampliar las políticas dirigidas a la educación sanitaria y la asistencia farmacéutica en el país.


ABSTRACT The objective of this study was to estimate the prevalence of self-care management practices - both with and without medication - in elderly hypertensive and diabetic patients in Campinas, Brazil, in three periods. Data from health surveys conducted in three periods 2001-2002, 2008-2009 and 2014-2015 were analyzed. The prevalence of hypertension, diabetes, the continuous use of medication, and all behavioral practices showed an overall increase in the period analyzed, with a significant drop in both the non-regular use of medications and routine doctor visits on the part of individuals without a private health plan. The results evidenced advances in diet-related practices among individuals without health plans as well as those who reported having healthcare coverage, highlighting improvements in drug treatment and physical activity. Adherence to medication and health behaviors for the management of morbidities was shown to be consistent in the period evaluated. These indicators reinforce the need to maintain and expand policies directed at health education and pharmaceutical assistance in the country.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Self Care/methods , Diabetes Mellitus/therapy , Hypertension/therapy , Self Care/statistics & numerical data , Time Factors , Brazil/epidemiology , Exercise , Confidence Intervals , Prevalence , Health Surveys/statistics & numerical data , Insurance Coverage/statistics & numerical data , Diabetes Mellitus/epidemiology , Medication Adherence , Health Promotion , Hypertension/drug therapy , Hypoglycemic Agents/therapeutic use , Antihypertensive Agents/therapeutic use
14.
Arch. cardiol. Méx ; 90(supl.1): 77-83, may. 2020.
Article in Spanish | LILACS | ID: biblio-1152848

ABSTRACT

Resumen Se realiza una revisión sobre el riesgo de los pacientes que padecen diabetes mellitus en el contexto de morbimortalidad general y relacionada a infección por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2). Así mismo se repasan las recomendaciones generales, de alimentación y de la prevención de las comorbilidades que más frecuentemente padecen dichos enfermos. Finalmente se hace una revisión de las recomendaciones farmacológicas sobre el tratamiento tanto oral como parenteral en el paciente ambulatorio, en la hospitalización y en estados críticos infectados por el SARS-CoV-2.


Abstract A review is carried out to examine the risk of patients suffering from diabetes mellitus in the context of general morbidity and mortality and related to infection by SARS-CoV-2. Likewise, the general recommendations for food and the prevention of comorbidities that most these patients suffer most frequently are also studied. Finally, a review of the pharmacological recommendations on both oral and parenteral treatment in the outpatient, in hospitalization and in critical states infected with SARS-CoV-2 is made.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Cardiovascular Diseases/therapy , Coronavirus Infections/epidemiology , Diabetes Mellitus/therapy , Cardiovascular Diseases/mortality , Risk Factors , Critical Illness , Diabetes Mellitus/mortality , Pandemics , Ambulatory Care/methods , Betacoronavirus , SARS-CoV-2 , COVID-19 , Hospitalization
15.
Rev. enferm. UERJ ; 27: e7722, jan.-dez. 2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1005376

ABSTRACT

Objetivo: investigar a adequação do conteúdo da cartilha quanto ao seu uso para subsidiar as orientações da prática do autocuidado em diabetes. Método: estudo descritivo, exploratório, com abordagem qualitativa. Participaram 15 usuários de duas unidades básicas de saúde situadas em Belo Horizonte. Os dados foram coletados por meio de grupos focais, a partir da discussão para a adequação do conteúdo da cartilha, e tratados pelo método da análise de conteúdo. Resultados: organizados e analisados nas seguintes categorias: clareza e suficiência das informações contidas na cartilha; aparência dos desenhos e adequação do tamanho das letras; ajuda das orientações para o autocuidado. Conclusão: a avaliação da cartilha junto aos usuários foi primordial para que esse material seja utilizado na atenção primária, alcançando os objetivos de educação para o autocuidado.


Objective: to investigate the appropriateness of the booklet's content to complement diabetes self-care guidelines. Method: the participants in this qualitative, descriptive exploratory study were fifteen users of two primary health care facilities in Belo Horizonte. Data were collected in focus groups, during discussions of the suitability of the booklet's content, and were treated by the content analysis method. Results: the data were organized and analyzed into the following categories: the clarity and sufficiency of the information in the booklet; the appearance of the drawings and appropriateness of font sizes; and the usefulness of the guidance for self-care. Conclusion: users' evaluation of the booklet was of prime importance for this material to be used in primary care and attain the objectives of education for self-care.


Objective: investigar la adecuación del contenido del manual acerca de su uso para subsidiar las orientaciones de la práctica del autocuidado en diabetes. Método: estudio descriptivo, exploratorio, con enfoque cualitativo. Han participado 15 usuarios de dos unidades básicas de salud ubicadas en Belo Horizonte. Los datos han sido recolectados por medio de grupos focales, partiendo de la discusión para la adecuación del contenido del manual, y tratados por el método del análisis de contenido. Resultados: organizados y analizados en las categorías a continuación: claridad y suficiencia de la información contenida en el manual; apariencia de los dibujos y adecuación del tamaño de las letras; ayuda de las orientaciones para el autocuidado. Conclusión: la evaluación del manual junto a los usuarios fue de primordial importancia para que se utilice ese material en la atención primaria, alcanzando los objetivos de educación respecto al autocuidado.


Subject(s)
Humans , Adult , Middle Aged , Aged , Teaching Materials , Program Evaluation , Health Education , Diabetes Mellitus , Self Care , Evaluation Studies as Topic , Diabetes Mellitus/therapy
16.
Salud pública Méx ; 61(6): 876-887, nov.-dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1252175

ABSTRACT

Resumen: Objetivo: Caracterizar la atención médica y las acciones de autocuidado en población con diabetes, en localidades de menos de 100 000 habitantes. Material y métodos: Con información de la Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), se obtuvieron dos modelos de regresión logística: no realizar las cinco acciones básicas en la última consulta médica y no realizar acciones prioritarias de autocuidado. Resultados: Tener baja escolaridad, pertenecer al estrato económico bajo y hablar lengua indígena incrementan las posibilidades de no realizar acciones de autocuidado. Por el contrario, al incrementarse la edad, se disminuyen las posibilidades de autocuidado en 3%. Pertenecer a un hogar indígena y al tercil bajo incrementan las posibilidades de que el personal de salud no realice las cinco acciones básicas durante la consulta. Conclusión: Es indispensable que se establezca un programa de control de diabetes que incluya educación a pacientes y cursos de actualización al personal médico.


Abstract: Objective: To characterize medical care and self-care actions in a population with diabetes in locations smaller than 100 000 inhabitants Materials and methods: With information from the Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), two logistic regression models were obtained: not performing five basic actions in the last consultation and not taking priority self-care actions. Results: Having low schooling, belonging to the low economic stratum, and speaking indigenous language, increase the probability of not taking self-care actions. On the contrary, as age increases, the chances of self-care are reduced by 3%. Belonging to an indigenous household and the low tercile, increases the chances that health personnel will not perform the five basic actions during the consultation. Conclusions: It is essential that a diabetes control program be established that includes patient education and update courses for medical staff


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Self Care , Diabetes Mellitus/therapy , Socioeconomic Factors , Population Density
17.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4,Supl): 432-440, out.-dez. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1047350

ABSTRACT

O diabetes mellitus tipo 2 (DM2) é considerado um dos principais distúrbios metabólicos relacionados ao desenvolvimento de doenças cardiovasculares e outras comorbidades, com elevada incidência e prevalência no Brasil e no mundo. Apesar dos avanços em seu tratamento, a projeção mundial é de aumento no número de diagnósticos. No Brasil, o total de pessoas com a doença cresceu mais de 60% em 10 anos. Como o manejo dietético é um dos pilares no tratamento do DM2, este trabalho objetivou analisar os estudos que compararam as dietas restritas em carboidratos com outras abordagens dietéticas a fim de elucidar se esta seria a opção mais adequada para os pacientes com DM2. Assim, fez-se uma revisão de ensaios clínicos randomizados por meio das plataformas de pesquisa PubMed e Cochrane Library em outubro de 2018, selecionando os estudos segundo a estratégia PICO de pesquisa. Dos 398 artigos encontrados, 19 atenderam os critérios de elegibilidade. Após a análise, demonstrou-se que as dietas restritas em carboidratos favorecem o controle glicêmico, melhora do perfil lipídico e redução dos medicamentos para DM2 em relação às outras opções dietéticas, no entanto, os trabalhos apresentam vieses metodológicos e são, em geral, de curto prazo. Sendo assim, é precipitado afirmar que essas dietas são mais efetivas para o tratamento do DM


Type 2 diabetes mellitus (T2DM) is considered one of the primary metabolic disorders related to the development of cardiovascular diseases and other comorbidities, with high incidence and prevalence in Brazil and in the world. Despite advances in its treatment, an increase in the number of diagnoses is estimated worldwide. In Brazil, the total number of people with the disease has grown more than 60% in 10 years. As dietary management is one of the mainstays in the treatment of T2DM, this study aimed to analyze the studies that compared carbohydrate-restricted diets with other dietary approaches to elucidate if this would be the most appropriate option for patients with T2DM. Thus, randomized clinical trials were reviewed through the PubMed and Cochrane Library research platforms in October 2018, selecting the studies according to the PICO research strategy. Of the 398 articles found, 19 met the eligibility criteria and had their data collected. After the analysis, it was demonstrated that carbohydrate-restricted diets support glycemic control, loss of body mass, improvement of lipid profile and reduction of medications for T2DM compared to other dietary options. However, a significant part of the studies has methodological biases and is generally short-term. Therefore, the level of evidence supporting dietary restriction of carbohydrates in the management of T2DM is considered moderate. Thus, according to the principle of the null hypothesis, it is unwise to affirm that these diets are superior in the treatment of DM2


Subject(s)
Carbohydrates , Diabetes Mellitus/therapy , Diet, Carbohydrate-Restricted , Cardiovascular Diseases , Body Mass Index , Risk Factors , Glycemic Index , Diet , Obesity
18.
Arch. endocrinol. metab. (Online) ; 63(4): 445-448, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019360

ABSTRACT

SUMMARY Heterotaxy syndrome (HS) is a rare congenital condition with multifactorial heritance, characterized by an abnormal arrangement of thoraco-abdominal organs and vessels. Patients present with multiple cardiac, gastrointestinal, hepatosplenic, pancreatic, renal, neurological and skeletal disorders without any pathognomonic alteration. Despite the described increased risk of diabetes mellitus (DM) in patients with altered pancreatic anatomy, just one case was reported in Korea regarding the association of HS and DM in a 13-year-old girl. Our report refers to a 40-year-old female Brazilian patient with a history of DM and HS with polysplenia and agenesis of dorsal pancreas without cardiac abnormalities. She presented a worsening glycemic control associated with weight gain and signs of insulin resistance. After a proper clinical management of insulin and oral medications, our patient developed an improvement in glycemic control. Although it is a rare disease, HS with polysplenia and pancreatic disorders can be associated with an increased risk of DM. This case highlights the importance of investigating DM in patients with HS, especially those with pancreatic anatomical disorders, for proper clinical management of this rare condition.


Subject(s)
Humans , Female , Adult , Pancreas/abnormalities , Congenital Abnormalities/therapy , Diabetes Mellitus/therapy , Heterotaxy Syndrome/therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Blood Glucose/analysis , Insulin Resistance , Diet, Carbohydrate-Restricted , Heterotaxy Syndrome/complications
19.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3): 246-248, jul.-set. 2019. tab
Article in English, Portuguese | LILACS | ID: biblio-1022942

ABSTRACT

Já é bem conhecida a importância da terapêutica para os pacientes com diabetes mellitus (DM) no que diz respeito à redução dos eventos cardiovasculares e, por isso, existe interesse em comprovar a segurança cardiovascular das diferentes terapias anti-hiperglicêmicas disponíveis no mercado. O objetivo desta revisão consiste em discutir três grandes estudos publicados recentemente, LEADER, CANVAS e DECLARE ­ TIME 58, que avaliaram o efeito sobre morbidade e mortalidade cardiovascular das medicações em questão em comparação com placebo


The importance of therapy for patients with diabetes mellitus (DM) in reducing cardiovascular events is well-known and, therefore, there is interest in confirming the cardiovascular safety of the different antihyperglycemic therapies available on the market. The objective of this review is to discuss three large recently-published studies, LEADER, CANVAS and DECLARE ­ TIME 58, which evaluated the effect of the medications in question on morbidity and cardiovascular mortality as compared to a placebo


Subject(s)
Humans , Male , Female , Cardiovascular Diseases , Diabetes Mellitus/therapy , Evidence-Based Practice , Placebos , Risk Factors , Treatment Outcome , Peripheral Arterial Disease , Canagliflozin/therapeutic use , Metformin/therapeutic use
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