Impact of type 1 diabetes mellitus and celiac disease on nutrition and quality of life.

OBJECTIVE: Type 1 diabetes mellitus (T1DM) and celiac disease (CD) are autoimmune diseases and have similar genetic patterns. T1DM treatment is based on diet, physical activity and insulin therapy, whereas CD depends on dietary changes with restriction of wheat, rye and barley. The aim of the study was to evaluate the quality of life (QoL) of individuals with the association of T1DM and CD, to characterize their nutritional status and to compare it with those with only one disease and healthier controls. SUBJECTS/METHODS: Sixty patients controlled by sex, age and body mass index (BMI) were stratified by previous diagnosis in: T1DM and CD (DMCD group); T1DM (DM group); CD (CD group); or healthy participants (HC). The SF-36 questionnaire was applied to assess psychological well being and results were compared with glycemic control and presence of complications related to diabetes, adhesion to gluten-free diet (GFD). Nutritional status and body mass composition were determined by BMI, waist circumference, bioimpedance, general laboratory tests and whole-body densitometry. RESULTS: The time of diagnosis of T1DM was similar between DMCD and DM groups; however, the duration of CD was significantly higher in the CD group compared with DMCD. The SF-36 analysis revealed statistically significant differences between DM and HC groups in two domains: general health (P=0.042) and energy/vitality (P=0.012). QoL was also correlated with compliance to a GFD, and scores were similar in both groups: DMCD and CD. Forty percent of individuals in the CD group had visceral fat area above 100 cm2, as opposed to 20% in the other groups. CONCLUSIONS: Individuals of DMCD group had similar scores to DM, CD and HC on QoL, as well as on their nutritional status and bone metabolism. Thereby, we should conclude that the association of T1DM and CD did not deteriorate their health status.

Avaliaçäo de atletas: metodologia do grupo de Medicina Esportiva do IOT/HC-FMUSP. Aplicaçäo em 11 maratonistas de elite / Evaluation of athetes: method of the IOT/HC-FMUSP Sports Medicine Group. Application in 11 high level marathon athletes

Foram avaliados 11 atletas de elite praticantes de maratona através do protocolo do Grupo de Medicina Esportiva do IOT-HC/FMUSP, criado para a avaliaçäo de 500 atletas jovens (8 a 18 anos), de dez modalidades esportivas (5 coletivas e 5 individuais). Os atletas responderam a questionário geral, ortopédico, nutricional e psicológico. Passaram por exame clínico e ortopédico completo. Foram submetidos a mensuraçäo antropométrica e de flexibilidade. Foram feitas a avaliaçäo e orientaçäo nutricional ao lado de provas laboratoriais, densitometria, cintilografia e eletrocardiografia. Para a análise do dicionamento cardiorrespiratório foram utilizados os testes de Harvard e Ruffier modificados, obtendo-se nas provas de pista a avaliaçäo final. Os 11 atletas mostraram-se, em sua maioria, aptos para a prática da maratona, com pequenas correçöes já transmitidas pelos avaliadores.