ABSTRACT
Aims: To evaluate the synergistic impact of diet, lifestyle and technology on glycemic control in children with type 1 diabetes (T1D). Methods: This cross-sectional study included 112 randomly selected patients with T1D from Gran Canaria (median age 12 years; 51.8% female). The study collected data on height, weight, body composition (bioimpedance), age, disease duration, and method of insulin delivery. Physical activity was evaluated using the Krece questionnaire and an accelerometer (GENEActiv). Adherence to the Mediterranean diet was assessed using the KIDMED Quick Nutrition Test. Glycemic control was evaluated using HbA1c and the percentage of time in range. SPSS version 21 and RStudio were used for statistical analysis of the data. Stepwise linear regression analysis (backwards) was used to identify factors independently associated with metabolic control. Results: Insulin pump use, age and adherence to the Mediterranean diet were found to be significantly and independently associated with better glycemic control, whereas years with T1D was associated with worse HbA1c values. No relationship was found between body composition and physical activity measured by accelerometry or questionnaire. Conclusion: Adherence to the Mediterranean diet, insulin delivery methods, age, and number of years with T1D are important factors to consider in the management of T1D in children.
ABSTRACT
El arsénico es un elemento químico del grupo de los metaloides o semimetales presente en el aire, en el agua y en la tierra en forma orgánica o inorgánica. La intoxicación por arsénico puede ser aguda (menos de 14 días de exposición), crónica o arsenicosis (por exposición más de 6 meses) y subcrónica. El ayurveda es un sistema de medicina tradicional india; sus medicinas se dividen en hierbas y rasa-shastra, combinación de hierbas, metales, minerales y gemas. Sus expertos mantienen que, preparadas y administradas apropiadamente, son seguras. Sin embargo, se han demostrado múltiples casos de intoxicación por metales pesados relacionados con su uso. Presentamos un caso clínico de exposición al arsénico secundario a la ingesta mantenida de medicamentos ayurvédicos (AU)
Arsenic is a chemical element that belongs to the group of metalloids or semi-metals, present in air, water and soil in organic or inorganic form. Arsenic poisoning can be acute (fewer than 14 days exposure), chronic (arsenicosis, more than 6 months) or subchronic. Ayurveda is a traditional medical system in which medicines are divided into herbal and rasashastra, combining herbs, metals, minerals and gems. Experts assert that they are safe when properly prepared and administered. However, multiple cases of heavy metal poisoning related to their use have been reported. We present a clinical case of subchronic arsenic poisoning secondary to sustained intake of ayurvedic medicine. (AU)
Subject(s)
Humans , Female , Child , Medicine, Ayurvedic/adverse effects , Arsenic/toxicity , 34709 , Risk Factors , Arsenic/bloodABSTRACT
Dentro de las alergias no mediadas por IgE, la enterocolitis inducida por proteínas alimentarias (FPIES) es el cuadro de mayor gravedad, pudiendo cursar con una clínica muy variada. El FPIES crónico se suele manifestar con letargia, palidez cutánea, desnutrición, vómitos intermitentes y/o diarrea crónica, asociados a múltiples alteraciones analíticas (leucocitosis con desviación a la izquierda, eosinofilia, anemia, trombocitosis, hipoproteinemia, hipoalbuminemia, metahemoglobinemia y acidosis metabólica). La resolución ocurre entre los 3 a 10 días tras la exclusión del alérgeno causante; vuelven a tolerarlo aproximadamente a los 3-5 años de edad. Se presenta el caso clínico de un lactante de 47 días alimentado con fórmula de inicio, que debuta con un cuadro de vómitos y diarreas con deshidratación grave, acidosis metabólica, metahemoglobinemia, hipoproteinemia, hipoalbuminemia e hiperamoniemia, siendo esta última una característica solo referenciada en un caso hasta la actualidad (AU)
Food protein-induced enterocolitis syndrome (FPIES) is the most severe non-IgE-mediated allergies, and has a broad clinical spectrum. Chronic FPIES usually manifests with lethargy, pallor, undernutrition, intermittent vomiting and/or chronic diarrhoea associated with multiple laboratory abnormalities (leucocytosis with left shift, eosinophilia, anaemia, thrombocytosis, hypoproteinaemia, hypoalbuminaemia, methemoglobinemia and metabolic acidosis). It resolves 3 to 10 days after exclusion of the causative allergen, and most patients develop tolerance to the protein again at approximately 3 to 5 years of age. We present the case of a 47-day-old infant who presented with vomiting and diarrhoea with severe dehydration, metabolic acidosis, methaemoglobinaemia, hypoproteinaemia, hypoalbuminaemia and hyperammonaemia, the latter being a feature that has only been described in one other case before. (AU)
