ABSTRACT
Proporcionar unas recomendaciones prácticas para la evaluación y el manejo de la hipoglucemia en pacientes con diabetes mellitus. Miembros del Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición (SEEN). Las recomendaciones se formularon según el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizó una búsqueda sistemática en MEDLINE (PubMed) de la evidencia disponible para cada tema, y se revisaron artículos escritos en inglés y castellano con fecha de inclusión hasta el 28 de febrero de 2020. En este resumen ejecutivo incluimos la evidencia reciente incorporada desde 2013. El documento establece unas recomendaciones prácticas basadas en la evidencia acerca de la evaluación y manejo de la hipoglucemia en pacientes con diabetes mellitus.
To provide practical recommendations for the evaluation and management of hypoglycemia in patients with diabetes mellitus. Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN). The recommendations were made based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system to establish both the strength of the recommendations and the level of evidence. A systematic search was made in MEDLINE (PubMed) for the available evidence on each subject, and articles written in English and Spanish with an inclusion date up to 28 February 2020 were reviewed. This executive summary takes account of the evidence incorporated since 2013. The document establishes practical evidence-based recommendations regarding the evaluation and management of hypoglycemia in patients with diabetes mellitus.
Subject(s)
Humans , Diabetes Mellitus/prevention & control , Hypoglycemia/prevention & controlABSTRACT
The present study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Societies of Nutrition, Food and Dietetics Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the prevention and treatment of overweight and obesity in adults. In this part of the document the methodology and the classification of levels of evidence are described. In order to reach the strongest evidence possible, a systematic review of 543 medical studies dealing with these issues published in the last 15 years (from January 1st 1996 to January 31st 2011) has been conducted. In the executive summary, along with the obtained evidences, a set of degree-classified recommendations are established. These recommendations could constitute a useful tool to design food guides addressed to the nutritional counseling for obesity and overweight treatment.
Subject(s)
Evidence-Based Medicine , Nutritional Requirements , Obesity/prevention & control , Overweight/prevention & control , Adult , Body Weight/physiology , Consensus , Diet, Mediterranean , Dietetics , Energy Intake , Humans , Obesity/diet therapy , Overweight/diet therapy , Societies, Medical , SpainABSTRACT
This study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Nutrition, Food and Dietetetic Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the prevention and of overweight and obesity in adults. It is the result of a careful and systematic review of the data published in the medical literature from January 1st 1996 to January 31st 2011 concerning the role of the diet on obesity prevention. The conclusions obtained have been classified according several evidence levels. Subsequently, in agreement with these evidence levels, different degree recommendations are established. These recommendations could be potentially useful to design food guides as part of strategies to prevent overweight and obesity.
Subject(s)
Diet , Evidence-Based Medicine , Nutritional Requirements , Obesity/diet therapy , Obesity/prevention & control , Overweight/diet therapy , Overweight/prevention & control , Body Weight/physiology , Consensus , Diet Surveys , Diet, Mediterranean , Diet, Vegetarian , Dietary Carbohydrates , Dietary Fats , Dietary Proteins , Drinking , Eating , Energy Metabolism , Food , Glycemic Index , Humans , Plants, Edible , SpainABSTRACT
En el presente trabajo se describe la metodología y los grados de evidencia utilizados en la elaboración del documento de consenso de la Federación Española de Sociedades de Nutrición, Alimentación y Dietética (FESNAD) y la Sociedad Española para el Estudio de la Obesidad (SEEDO) sobre el papel de la dieta en la prevención y el tratamiento de la obesidad y el sobrepeso.Para obtener la mayor evidencia posible se ha efectuado una revisión sistemática de los datos de la literatura médica desde el 1 de enero de 1996 al 31 de enero de 2011 (15 años).En el resumen ejecutivo, junto a las evidencias alcanzadas, se establecen unas recomendaciones clasificadas según grados que pueden servir de guía y orientación en el diseño de pautas alimentarias dirigidas a la prevención o al tratamiento de la obesidad o el sobrepeso (AU)
The present study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Societies of Nutrition, Food and Dietetics Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the prevention and treatment of overweight and obesity in adults. In this part of the document the methodology and the classification of levels of evidence are described.In order to reach the strongest evidence possible, a systematic review of 543 medical studies dealing with these issues published in the last 15 years (from January 1st 1996 to January 31st 2011) has been conducted.In the executive summary, along with the obtained evidences, a set of degree-classified recommendations are established. These recommendations could constitute a useful tool to design food guides addressed to the nutritional counseling for obesity and overweight treatment (AU)
Subject(s)
Humans , Male , Female , Adult , Overweight/diagnosis , Overweight/therapy , Obesity/diagnosis , Obesity/therapy , Practice Patterns, Physicians'/organization & administration , Evidence-Based Practice/methods , Diet, Reducing , Disease PreventionABSTRACT
Nos planteamos conocer la utilidad de una estrategia selectiva para el diagnóstico de diabetes gestacional (DG) en nuestro medio, como la recomendada en el IV International WorkshopConference on Gestational Diabetes Mellitus. Con este fin, durante un año en todas las gestantes, se registró: edad, índice de masa corporal (IMC) pregestacional, antecedentes personales o familiares de diabetes y complicaciones obstétricas previas. Se realizó test de O´Sullivan; si el resultado era mayor de 140 mg/dl se efectuó una curva de glucemia. Cada enferma fue clasificada en uno de los tres grupos de riesgo siguiendo las recomendaciones de la ADA. Se estudiaron 369 gestantes de 29,6 ± 4 años (15,4% con menos de 25 años); 7,9% presentaban DG. Por grupos de riesgo la distribución fue: bajo 11,7%, medio 74,1%, alto 14,2%. La edad y el IMC eran superiores en DG (32,6 ± 3 años; 25,9 ± 3 kg/m 2 ) que en no-DG (29,3 ±4 años; 24,2 ± 4 kg/m ), p<0,001 y p<0,05 respectivamente. La aparición de DG en cada grupo fue: bajo 0%, medio 8,9%, alto 15,5%. El total de DG se distribuyeron 76% en medio y 24% en alto riesgo. En conclusión, la utilidad práctica, en nuestro medio, de la clasificación en grupos de riesgo de DG para limitar el número de test de despistaje es escasa (sólo se evitan el 11,7%). Si que puede ayudar para el diagnóstico precoz de casi la cuarta parte de las DG. Queda resaltada la importancia del control del peso en la prevención de DG (AU)
We try to konw how useful was a selective screening strategy for detecting gestational diabetes mellitus (GDM), as the one recommended by the IV International Workshop-Conference on Gestational Diabetes Mellitus, in our population. To this end we examined all the pregnant referred to obstetric clinic for one year and recorded: age, body mass index (BMI) before pregnancy, family history of diabetes and personal history of abnormal glucose control or poor obstetric outcome. O´Sullivan test was performed and, if the result was over 140 mg/dl, a 3-h 100-g glucose tolerance test was carry out. The sample was classified in three groups according to ADA recommendations. 369 women were studied, aged 29.6 ± 4 years (15.4% were less than 25 years), 7.9% were GDM. Distribution by groups was: low 11.7%, average 74.1%, and high 14.2%. Age and BMI were higher in GDM (32.6 ± 3 years; 25.9 ± 3 kg/m 2 ) than in non-GDM (29.3 ± 4 years; 24.2 ± 4 kg/m) p < 0.001 and p < 0.05 respectively. Frequency of GDM in each group was: 0% in low, 8.9% in average, 15.5% in high. The GDM were 76% in average group and 24% in high group. In summary: the classification in risk groups is not useful in order to limit the screening test (only 11.7% could be avoided). But this strategy can help to diagnose almost 25% of GDM. Weight control is very important in the GDM prevention (AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Diabetes, Gestational/epidemiology , Diabetes, Gestational/prevention & control , Gestational Age , Body Mass Index , Early Diagnosis , Risk Factors , Diabetes, Gestational/diagnosis , Diabetes, Gestational/therapy , Risk GroupsABSTRACT
To evaluate the influence of health care education of the diet, we studied, in a sample of 68 workers (47 men and 21 women), the usual food intake (by means of a weekly registration technique), the anthropometry and the lipid profile, before and after giving a nutritional information program which lasted one year. At the end thereof, we observed a significant reduction in the global caloric intake, at the expense of a lower supply of proteins and fats (mainly saturated fats), which translated into a percentile distribution of macronutrients, which more closely resembles the dietary recommendations. The average anthropometric parameters did not vary. With respect to the lipid profile, a decrease of the plasma levels of LDL and HDL cholesterol was observed. These results confirm the capacity of educational interventions in changing the eating habits to a more healthy style, with repercussions on the lipid profile.
Subject(s)
Feeding Behavior , Health Education , Lipids/blood , Nutritional Physiological Phenomena , Adult , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Diet , Energy Intake , Female , Humans , Male , Middle Aged , WorkABSTRACT
We studied in two groups of epileptic patients the thyroid alterations induced by anticonvulsant therapy (AC). Group I (28 cases): T4t and TSH were measured before and after 3 and 6 months on treatment with AC. Group II (75 cases on treatment): thyroid hormones were measured only once. In cases with low value of T4t or high TSH a TRH test and FT4 determination were performed. In group I two cases with low T4t were found after six months on treatment (7%), one of them with low FT4 and both with normal TSH. In group II we found 6 cases (7.8%) with low T4t and FT4, two of them with high TSH. It was not possible argue against factor and the low incidence reported argue against rutinary screening. Anycase, this screening will never be performed before the lag time observed (6 months).
Subject(s)
Anticonvulsants/pharmacology , Thyroid Gland/drug effects , Adolescent , Adult , Aged , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Carbamazepine/administration & dosage , Carbamazepine/adverse effects , Carbamazepine/pharmacology , Child , Enzyme-Linked Immunosorbent Assay , Epilepsy/blood , Epilepsy/complications , Epilepsy/drug therapy , Female , Humans , Hypothyroidism/chemically induced , Hypothyroidism/diagnosis , Male , Middle Aged , Phenobarbital/administration & dosage , Phenobarbital/adverse effects , Phenobarbital/pharmacology , Phenytoin/administration & dosage , Phenytoin/adverse effects , Phenytoin/pharmacology , Prospective Studies , Thyroid Hormones/blood , Thyrotropin/blood , Valproic Acid/administration & dosage , Valproic Acid/adverse effects , Valproic Acid/pharmacologyABSTRACT
To make an initial approach to the current nutritional situation of the Spanish infant population, we carried out an anthropometric study of the children from 6 to 15 years of age in two schools in Fuenlabrada (Madrid) in a middle to lower class social environment. A total of 1,026 children were studied, to determine weight, height, tricipital fold and arm circumference. These parameters were used to calculate the weight/height ratio (w/h) and the muscular circumference of the arm. All these parameters were tabulated in percentile terms for comparison. The sample was divided into groups according to sex and to age (under 9, 9 to 12 and over 12). We found an overall w/h ratio of 108.8 +/- 17.4, more than the theoretical 100% (p < 0.001); 20.6% of the children over 120%. The Tricipital Fold (TFp) percentile was 62.5 +/- 27, with no differences according to age or sex. The percentile for arm muscular circumference (AMCp) was 48.8 +/- 27 for girls and 41.6 +/- 28 for boys (p < 0.001). Finally, we found a positive and significant correlation (p < 0.05) between w/h and AMCp (r = 0.51) and between w/h and TFp (r = 0.57). We conclude that the population studied is significantly overweight, confirming previous studies. Girls showed better nutritional parameters than the boys, apparently less nutritionally affected by the middle to low social environment. Finally, the w/h ratio, as an isolated parameter, is a good overall index of the nutritional state of children.
Subject(s)
Adolescent Nutritional Physiological Phenomena , Anthropometry , Child Nutritional Physiological Phenomena , Nutritional Status , Adolescent , Age Factors , Child , Female , Humans , Male , Nutrition Surveys , Sex Factors , Socioeconomic Factors , SpainABSTRACT
We evaluated six patients in whom a diagnosis of Sheehan's syndrome had been made. The plasma levels of the following hormones were measured: basal thyroxine (T4), estradiol and cortisol; and also follicle-stimulating hormone (FSH), luteinizing hormone (LH), growth hormone (GH), thyrotropin (TSH), prolactin (PRL) and adrenocorticotropic hormone (ACTH), basally and after acute challenge with LH releasing hormone (LHRH), GRF (1-29)NH2 or insulin hypoglycemia, TSH releasing hormone (TRH) and lysine-8-vasopressin, respectively. Two patients underwent chronic LHRH stimulation by pulsatile subcutaneous administration with infusion pump. In 4 cases, computed tomography (CT) was performed although cranial X-ray study was normal. A severe and generalized pituitary involvement was found in all patients, 3 of whom had diabetes mellitus. Probably, more insidious cases go unnoticed. The presence of asymptomatic partial empty sella (ES) in all the CTs that were carried out raises the possibility that it is another evolutive feature of SS.
