Obesity epidemic in Brazil and Argentina: a public health concern.

The obesity epidemic is rapidly advancing in South America, leading to inevitable health consequences. Argentinian and Brazilian health policies try to become adapted to the new economic and social framework that follows from this epidemic. It is in incipient and ineffective control so far since the prevalence of obesity was not restrained. The Argentine national legislation is more advanced, through the so-called "Ley de Obesidad." In Brazil, there are numerous local initiatives but still not a comprehensive law. National policies relating to decisions regarding obesity are discussed in this paper. Trends in decisions issued in higher courts of Argentina (Supreme Court of Justice of the Nation--CSJN) and Brazil (Supreme Court of Justice--STF), in the last 15 years, seek to clarify the approach of each country and court's resolutions. Marked differences were found in their positions. Finally, legal and health solutions to this obesity epidemic are proposed.

Glycemic Variability, Oxidative Stress, and Impact on Complications Related to Type 2 Diabetes Mellitus.

Chronic hyperglycemia is an established risk factor for the development of complications in both type 1 and type 2 diabetes, but glycemic variability has emerged as a possible independent risk factor for diabetes complications, possibly through oxidative stress. In this review, methods to access glycemic variability and oxidative stress, as well as their correlations, are discussed. Non-pharmacological and pharmacological strategies are also debated to achieve better glycemic control, not only by HbA1c target but also with reduced glycemic fluctuations, possibly minimizing the risk of diabetes complications.

Endocrine Disruptors and the Induction of Insulin Resistance.

INTRODUCTION: The incidence of insulin resistance syndrome and type 2 diabetes mellitus has increased at an alarming rate worldwide and constitutes a serious challenge to public health care in the 21st century. Endocrine disrupting chemicals are defined as "substances or mixtures of substances that alter the endocrine system functions and, hence, adversely affect organisms, their progeny, or sub populations" and may be associated with this increase in prevalence. OBJECTIVE: This study aimed to assess the role of endocrine disrupting chemicals in insulin resistance and the importance of approaching the subject during anamnesis. METHODS: A full review of the literature regarding insulin resistance, type-2 diabetes and endocrine disruptors were conducted. CONCLUSION: Large-scale production and distribution of endocrine disrupting chemicals coincide with the increase in the prevalence of insulin resistance globally. In recent years, studies have shown that endocrine disrupting chemicals are positively associated with insulin resistance syndrome, evidenced by worse prognoses among individuals with higher levels of exposure. Health professionals should recognize the forms of exposure, most susceptible people, and lifestyle habits that can worsen patients' prognoses.

Perfil epidemiológico do diabetes mellitus auto-referido em uma zona urbana de Juiz de Fora, Minas Gerais / Epidemiologic profile of self-reported diabetes mellitus in a urban zone of Juiz de Fora, state of Minas Gerais, Brazil

Objetivo: Delinear um perfil epidemiológico do diabetes mellitus (DM) em uma zona urbana de Juiz de For a usando os dados obtidos no cadastramento do Programa de Saúde da Família da Prefeitura Municipal de Juiz de For a. Metodologia: Foram colhidas informações em 12.695 domicílios através da aplicação de um questionário baseado no Programa Avançado de Gerência em Atenção Primária a Saúde. A aplicação foi realizada por 180 entrevistadores acadêmicos da área de saúde. Os dados foram transferidos para o programa epidemiológico EPI-INFO versão 6.03. A análise do banco de dados referentes a população entre 30 e 69 anos permitiu a elaboração de um estudo sobre a prevalência do DM e sua relação com outros fatores. Resultados: A prevalência do DM auto-referido foi de 4,2 por cento (861 pessoas) e variou de 0,9 por cento (76) entre 30 e 39 anos a 11,6 por cento (297) entre 60 e 69 anos. 17,1 por cento (147) relataram não tratar ou tratar irregularmente. Nos homens, a idade não interferiu no tratamento; nas mulheres, quanto menor a faixa etária, menor a adesão ao tratamento. O DM estava relacionado com outros agravos à saúde: cardiopatia (r=4,8), hipertensão arterial sistêmica (r=4,7), cegueira (r=3,1) e incapacidade de locomoção (r=3,9). Conclusão: A prevalência da DM auto-referido foi semelhante a de outros estudos nacionais. O índice de diabéticos com tratamento irregular foi muito alto e relaciona-se com baixa renda e faixas etárias mais jovens no sexo feminino. O DM apresentou alta correlação com outros agravos à saúde: cardiopatia, hipertensão arterial sistêmica, cegueira e incapacidade de locomoção.