Biomolecular insights into North African-related ancestry, mobility and diet in eleventh-century Al-Andalus.

Historical records document medieval immigration from North Africa to Iberia to create Islamic al-Andalus. Here, we present a low-coverage genome of an eleventh century CE man buried in an Islamic necropolis in Segorbe, near Valencia, Spain. Uniparental lineages indicate North African ancestry, but at the autosomal level he displays a mosaic of North African and European-like ancestries, distinct from any present-day population. Altogether, the genome-wide evidence, stable isotope results and the age of the burial indicate that his ancestry was ultimately a result of admixture between recently arrived Amazigh people (Berbers) and the population inhabiting the Peninsula prior to the Islamic conquest. We detect differences between our sample and a previously published group of contemporary individuals from Valencia, exemplifying how detailed, small-scale aDNA studies can illuminate fine-grained regional and temporal differences. His genome demonstrates how ancient DNA studies can capture portraits of past genetic variation that have been erased by later demographic shifts-in this case, most likely the seventeenth century CE expulsion of formerly Islamic communities as tolerance dissipated following the Reconquista by the Catholic kingdoms of the north.

Mejora en el control de los diabéticos tipo 2 tras una intervención conjunta: educación diabetológica y ejercicio físico / Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical activity

ObjetivoConocer la mejora del control (metabólico, factores de riesgo cardiovascular), adherencia, autocontrol, autocuidados y actitudes/motivaciones de los diabéticos tipo 2 (DM2) de una zona de salud, tras intervención comunitaria grupal: educación diabetológica (ED) y ejercicio físico (EF).DiseñoEnsayo clínico aleatorizado controlado, simple ciego. Intervención: Grupo 1: ED grupal, Grupo 2: ED grupal y ejercicio físico, Grupo 3: solo ejercicio y Grupo 4 “control”: atención individual en consulta.EmplazamientoZona salud urbana (centro de salud/pabellón deportivo).Participantes108 DM2, 40-70 años, hemoglobina glucosilada (HbA1c) ≤ 8,5%, tensión arterial (TA)<160/90 e índice de masa corporal (IMC)<45, excluyéndose aquellos con complicaciones crónicas y/o descompensación aguda.IntervencionesDurante 6 meses, se realizaron 8 talleres de educación grupal y ejercicio físico monitorizado de intensidad moderada, 3 horas/semana.Mediciones principalesPre y post-intervención variable principal: descenso de HbA1c; demás variables: datos exploratorios, analíticos, cumplimiento terapéutico, autocontrol, autocuidados, actitudes y motivaciones (encuesta DAS-3sp).ResultadosTras intervenciones, más diabéticos bajaban HbA1c con intervención plena “ED y EF”, RR: 1,93 (0,85-4,40), así como con ejercicio, RR: 1,56 (0,65-3,76). Con ED y EF simultáneo, más sujetos descendieron IMC, RR: 1,61 (0,85-3,03) y LDL-colesterol, RR: 1,82 (0,99-3,36), aumentando cumplimiento dietético, RR: 1,29 (0,32-5,22) y de ejercicio, RR: 1,93 (0,76-4,91), realizando más autocontroles/semana, RR: 3,86 (0,90-16,55) y mejorando motivaciones/actitudes en “valoración del control estricto”, RR: 1,48 (0,94-2,34). Con ejercicio aislado la TA sistólica y diastólica descendió en más pacientes, RR: 1,35 (0,72-2,52), 1,87 (0,72-4,84), mientras que con ED grupal solo la diastólica, RR: 1,80 (0,69-4,67)(AU)

ConclusionesLos pacientes mejoran más con la combinación de ED y EF, aunque los resultados no sean estadísticamente significativos, probablemente por insuficiente tamaño muestral(AU)

ObjectiveTo study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with Type 2 Diabetes (DM2) in a specific Health Care Area after group intervention through the community: diabetes education (DE) and physical exercise (PE).DesignA single blind, randomised controlled clinical trial. Intervention: group 1: DE; group 2: ED and PE; group 3: only PE, and “control” group-4: Individual consultations.LocationUrban health centre/municipal sports centre.Participants108 DM2, age: 40-70, glycated haemoglobin (HbA1c) ≤ 8.5%, blood pressure (BP)<160/90 and body mass index (BMI)<45, excluding those with chronic complications and/or acute decompensation.InterventionsDuring 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3hours a week).Main measurementsPrimary variable pre- and post- intervention: reduction in HbA1c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey).ResultsAfter intervention, more diabetics had a lower HbA1c following a full intervention: “DE” and “PE”, RR: 1.93 (0.85-4.40) and exercise, RR: 1.56 (0.65-3.76). With simultaneous DE and PE, the BMI, RR: 1.61 (0.85-3.03) and LDL cholesterol, RR: 1.82 (0.99-3.36), of many subjects decreased. Dietary compliance, RR: 1.29 (0.32-5.22) and exercise, RR: 1.93 (0.76-4.91) also increased, more patients performing their own checks, RR: 3.86 (0.90-16.55) and improving motivation/attitudes in “strict control management”, RR: 1.48 (0.94-2.34). With PE, systolic and diastolic BP decreased in more patients RR: 1.35 (0.72-2.52), 1.87 (0.72-4.84) while in the DE group only diastolic values decreased 1.80 (0.69-4.67)(AU)

ConclusionsPatient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size(AU)

[Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical activity]. / Mejora en el control de los diabéticos tipo 2 tras una intervención conjunta: educación diabetológica y ejercicio físico.

OBJECTIVE: To study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with Type 2 Diabetes (DM2) in a specific Health Care Area after group intervention through the community: diabetes education (DE) and physical exercise (PE). DESIGN: A single blind, randomised controlled clinical trial. INTERVENTION: group 1: DE; group 2: ED and PE; group 3: only PE, and "control" group-4: Individual consultations. LOCATION: Urban health centre/municipal sports centre. PARTICIPANTS: 108 DM2, age: 40-70, glycated haemoglobin (HbA(1)c) ≤ 8.5%, blood pressure (BP)<160/90 and body mass index (BMI)<45, excluding those with chronic complications and/or acute decompensation. INTERVENTIONS: During 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3 hours a week). MAIN MEASUREMENTS: Primary variable pre- and post- intervention: reduction in HbA(1)c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey). RESULTS: After intervention, more diabetics had a lower HbA(1)c following a full intervention: "DE" and "PE", RR: 1.93 (0.85-4.40) and exercise, RR: 1.56 (0.65-3.76). With simultaneous DE and PE, the BMI, RR: 1.61 (0.85-3.03) and LDL cholesterol, RR: 1.82 (0.99-3.36), of many subjects decreased. Dietary compliance, RR: 1.29 (0.32-5.22) and exercise, RR: 1.93 (0.76-4.91) also increased, more patients performing their own checks, RR: 3.86 (0.90-16.55) and improving motivation/attitudes in "strict control management", RR: 1.48 (0.94-2.34). With PE, systolic and diastolic BP decreased in more patients RR: 1.35 (0.72-2.52), 1.87 (0.72-4.84) while in the DE group only diastolic values decreased 1.80 (0.69-4.67). CONCLUSIONS: Patient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size.