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INTRODUCTION: The incidence of post-transplant diabetes mellitus (PTDM) can reach 30% during the first 6 months after kidney transplantation (KT), increasing the risk of graft failure and mortality. There is no well-established biomarker for predicting PTDM occurrence. This study evaluated the association between the abnormal 2-hour oral glucose tolerance test (OGTT) and the PTDM incidence. METHODS: A retrospective single-center study, including adult kidney transplant recipients from deceased donors, was performed between March 2021 and June 2022. EXCLUSION CRITERIA: age <18 years; pretransplant diabetes mellitus (DM); death with a functioning graft; loss of follow-up and/or graft failure before 6 months post-transplant. The results of pretransplant OGTT, fasting (FPG), and afternoon plasma glucose levels at hospitalization and FPG in the first, second, and third months post-transplant were evaluated. For analysis, patients were grouped according to the PTDM diagnosis: PTDM and non-PTDM. RESULTS: From 164 KT performed in the period, 50 (30%) were included, most male (n = 34, 68%), with a mean age of 48.3 ± 12.5 years. Nine patients (18%) developed PTDM, 44% between 3 and 6 months. General characteristics and immunosuppressive therapy were similar between the groups. The mean FPG in the pretransplant OGTT was significantly higher in the PTDM group compared with the non-PTDM group (85.7 ± 7.9 vs 79.1 ± 8.2, P = .03). The number of patients classified as impaired glucose tolerance (IGT) on the pre-transplant OGTT was significantly higher in the PTDM group. CONCLUSION: IGT in the pretransplant OGTT was associated with PTDM cases in kidney transplant recipients without a previous diagnosis of DM.
ABSTRACT
Introduction: Kidney transplantation is associated with an increased risk of posttransplant diabetes mellitus (PTDM), impacting recipient and graft survivals. The incidence of PTDM ranges from 15% to 30%, with most cases occurring in the first year post-transplant. Some clinical and laboratory characteristics pre- and post-transplant may be associated with a higher PTDM incidence in a more extended follow-up period. This study aimed to analyze the prevalence of PTDM among renal transplant recipients without previous DM diagnosis during a five-year post-transplant follow-up, as well as clinical and laboratory characteristics associated with a higher incidence of PTDM during this period. Material and methods: Single-center retrospective cohort including kidney transplant recipients older than 18 years with a functioning graft over six months of follow-up between January and December 2018. Exclusion criteria were recipients younger than 18 years at kidney transplantation, previous diabetes mellitus diagnosis, and death with a functioning graft or graft failure within six months post-transplant. Results: From 117 kidney transplants performed during the period, 71 (60.7%) fulfilled the inclusion criteria, 18 (25.3%) had PTDM diagnosis, and most (n=16, 88.9%) during the 1st year post-transplant. The need for insulin therapy during the hospital stay was significantly higher in the PTDM group (n=11, 61.1% vs. n=14, 26.4%, PTDM vs. non-PTDM). Other PTDM risk factors, such as older age, high body mass index, HLA mismatches, and cytomegalovirus or hepatitis C virus infections, were not associated with PTDM occurrence in this series. During 5-year post-transplant follow-up, the graft function remained stable in both groups. Conclusion: The accumulated incidence of PTDM in this series was similar to the reported in other studies. The perioperative hyperglycemia with the need for treatment with insulin before hospital discharge was associated with PTDM.
ABSTRACT
RESUMO Introdução: Os atletas de alto rendimento sofrem com uma série de fatores causadores de perturbações psicológicas, que podem acarretar danos ao seu desempenho final. Com a competitividade elevada e o nivelamento nos treinamentos físico e tático, as estratégias de coping (enfrentamento) para superar essas perturbações podem fazer a diferença entre um elenco campeão ou perdedor. Objetivos: Analisar e comparar as estratégias de coping entre atletas de alto rendimento e praticantes de futebol feminino. Métodos: Trata-se de um estudo quantitativo, descritivo, transversal e com amostragem não probabilística. A amostra foi composta por 56 atletas, divididas em dois grupos: G1 - atletas de alto rendimento e G2 - praticantes de futebol feminino. O instrumento utilizado foi o Athletic Coping Skills Inventory-28 (ACSI-28), validado para o Brasil (ACSI-25BR) e um questionário sociodemográfico contendo 12 questões, elaborado pelos próprios autores. Para a análise dos dados foi usada a estatística descritiva, teste de normalidade de Shapiro-Wilk e o teste t de Student para dados independentes. O nível de confiança adotado foi de 95%. Resultados: Atletas de alto rendimento obtiveram maior pontuação média, estatisticamente significante, com relação às praticantes de futebol feminino nas dimensões: "desempenho sob pressão" (p = 0,048), "concentração" (p = 0,020) e "confiança/motivação" (p = 0,009). Conclusão: Atletas de alto rendimento obtiveram melhor desempenho em todas as dimensões, exceto em "treinabilidade" e "ausência de preocupação", quando comparadas ao grupo de praticantes de futebol feminino.
ABSTRACT Introduction: High-performance athletes suffer a series of psychological disorders that can harm their overall performance. With the high levels of competitiveness and physical/tactical training that are required today, coping strategies to overcome these psychological disorders can make the difference between a winning team and a losing team. Objective: To compare coping strategies among high-performance athletes and amateur women's soccer players. Methods: This is a quantitative, descriptive, cross-sectional, non-probability study. The sample consisted of 56 athletes, divided into two groups: G1 - high-performance athletes and G2 - amateur women's soccer players. The instrument used was the Athletic Coping Skills Inventory-28 (ACSI - 28), validated for Brazil (ACSI - 25BR) and a demographic questionnaire containing 12 questions, developed by the authors themselves. For the data analysis, descriptive statistics, the Shapiro- Wilk test and the Student t test for independent data were used. A confidence level of 95% was adopted. Results: The high performance athletes had higher average scores, which were statistically significant, comparing to the amateur athletes, in the dimensions: "performance under pressure" (p=0.048), "concentration" (p=0.020) and "confidence/motivation" (p=0.009). Conclusion: The high performance athletes performed better in all dimensions except for "trainability" and "freedom from worry", when compared to the amateur athletes.
RESUMEN Introducción: Las atletas de alto rendimiento padecen de una serie de factores que causan trastornos psicológicos que pueden causar daños a su rendimiento final. Con la alta competitividad y nivelación en el entrenamiento físico y táctico, las estrategias de coping (afrontamiento) para superar estos trastornos pueden hacer la diferencia entre un equipo campeón o un perdedor. Objetivos: Analizar y comparar las estrategias de coping (afrontamiento) entre las atletas de alto rendimiento y aficionadas de fútbol femenino. Métodos: Se trata de un muestreo cuantitativo, descriptivo, transversal y no probabilístico. La muestra estaba compuesta por 56 atletas, divididas en dos grupos: G1 - atletas profesionales y G2 - jugadoras aficionadas de fútbol femenino. El instrumento utilizado fue el Athletic Coping Skills Inventory-28 (ACSI-28), validado para Brasil (ACSI-25BR) y un cuestionario sociodemográfico que contenía 12 preguntas preparadas por los autores. Para el análisis de datos se utilizó la estadística descriptiva, prueba de normalidad de Shapiro-Wilk y la prueba t de Student para datos independientes. El nivel de confianza adoptado fue 95%. Resultados: Las atletas de alto rendimiento tuvieron puntuaciones medias más elevadas, estadísticamente significativas en relación con las jugadoras de fútbol femenino en las dimensiones: "rendimiento bajo presión" (p = 0,048), "concentración" (p = 0,020) y "confianza/motivación" (p = 0,009). Conclusión: Las atletas de alto rendimiento obtuvieron mejores resultados en todas las dimensiones excepto en "capacidad de entrenamiento" y "ausencia de preocupación", en comparación con el grupo de jugadoras de fútbol femenino.
