Effectiveness of cinnamon in the reduction of lipid levels in people with diabetes: a randomized clinical trial.

OBJECTIVE: To evaluate the effectiveness of cinnamon in reducing lipid levels in people with diabetes. METHOD: Randomized clinical trial of parallel groups, triple-blind, conducted in Basic Health Units in the state of Piauí in 2019. People with Type 2 Diabetes Mellitus, between 18 and 80 years old, using oral antidiabetics, were included, and divided into two groups. The experimental group tested 3g of cinnamon for 90 days. RESULTS: 140 people participated in the study. From these, the experimental group (n= 71) showed a reduction in mean levels of total cholesterol (p= 0.316 | CI 95% -24.9-8.1), LDL (p= 0.024 | CI 95% -29.3 -2.1) and triglycerides (p= 0.969 | 95% CI -28.6-27.5), and increased HDL (p= 0.001 | 95% CI 4.2-10.2). CONCLUSION: The use of 3g of cinnamon per day, for 90 days, seems to help reduce LDL values and increase HDL levels in patients with diabetes.

Glycemic outcomes of people with diabetes mellitus in Brazilian primary health care.

Background: The capillary blood glucose monitoring program at home a challenge in primary health care. Therefore, it is fundamental to identify the glycemic control of people with diabetes mellitus through HBA1c and to analyze its associated factors. Objective: To identify the glycemic profile of people with Diabetes Mellitus (DM) through HbA1c and analyze factors associated. Materials & methods: Cross-sectional study developed in Ribeirão Preto, São Paulo, Brazil. Secondary data from the electronic health record of people registered in the Primary Health Care system were used. A sample of 3181 participants was obtained. People with HbA1c < 7.0% (53 mmol/mol) were considered to have adequate glycemic control. For people aged ≥ 55 years, a less stringent target, < 8.0% (64 mmol/mol), was also considered. The odds ratio was the measure of effect analyzed with their respective 95% Confidence Intervals (95% CI). Results: Adequate glycemic control with HbA1c < 7.0% (53 mmol/mol) was found in 44.8% of people and, when using the less rigid target, HbA1c < 8.0% (64 mmol/mol) for people aged ≥ 55 years-old, 70.6% had adequate glycemic control. Age and drug therapy were associated with adequate glycemic control (p < 0.001), which was more frequent among older people and those who used only metformin. Conclusion: The study shows that the achievement of adequate glycemic control is still a challenge, especially with regard to younger people and those who use insulin.

Effectiveness of cinnamon in the reduction of lipid levels in people with diabetes: a randomized clinical trial / Eficacia de la canela en la reducción de los niveles de lípidos en personas con diabetes: un ensayo clínico aleatorizado / Efetividade da canela na redução de níveis lipídicos em pessoas com diabetes: ensaio clínico aleatorizado

ABSTRACT Objective: To evaluate the effectiveness of cinnamon in reducing lipid levels in people with diabetes. Method: Randomized clinical trial of parallel groups, triple-blind, conducted in Basic Health Units in the state of Piauí in 2019. People with Type 2 Diabetes Mellitus, between 18 and 80 years old, using oral antidiabetics, were included, and divided into two groups. The experimental group tested 3g of cinnamon for 90 days. Results: 140 people participated in the study. From these, the experimental group (n= 71) showed a reduction in mean levels of total cholesterol (p= 0.316 - CI 95% -24.9-8.1), LDL (p= 0.024 - CI 95% -29.3 -2.1) and triglycerides (p= 0.969 - 95% CI -28.6-27.5), and increased HDL (p= 0.001 - 95% CI 4.2-10.2). Conclusion: The use of 3g of cinnamon per day, for 90 days, seems to help reduce LDL values and increase HDL levels in patients with diabetes.

RESUMEN Objetivo: Evaluar la efectividad de la canela en la reducción de los niveles de lípidos en personas con diabetes. Método: Ensayo clínico aleatorizado, triple ciego, de grupos paralelos, realizado en Unidades Básicas de Salud de Piauí en 2019. Personas con Diabetes Mellitus tipo 2, entre 18 y 80 años, usuarias de antidiabéticos orales, fueron divididas en dos grupos. El grupo experimental probó 3g de canela durante 90 días. Resultados: 140 personas participaron en el estudio. De estos, el grupo experimental (n= 71) mostró una reducción en los niveles medios de colesterol total (p= 0,316 - IC 95% -24,9-8,1), LDL (p= 0,024 - IC 95% -29,3 - 2,1) y triglicéridos (p= 0,969 - IC 95% -28,6-27,5) y HDL elevado (p= 0,001 - IC 95% 4,2-10,2). Conclusión: El uso de 3g de canela al día durante 90 días parece ayudar a reducir los valores de LDL y aumentar los niveles de HDL en pacientes con diabetes.

RESUMO Objetivo: Avaliar a efetividade da canela na redução dos níveis lipídicos em pessoas com diabetes. Método: Ensaio clínico aleatorizado de grupos paralelos, triplo cego, realizado em Unidades Básicas de Saúde do estado do Piauí em 2019. Foram incluídas pessoas com Diabetes Mellitus tipo 2, entre 18 e 80 anos, em uso de antidiabéticos orais, e divididos em dois grupos. No grupo experimental testou-se 3g de canela por 90 dias. Resultados: 140 pessoas participaram do estudo. Destas, o grupo experimental (n= 71) apresentou redução na média dos níveis de colesterol total (p= 0,316 - IC 95% -24,9-8,1), LDL (p= 0,024 - IC 95% -29,3-2,1) e triglicerídeos (p= 0,969 - IC 95% -28,6-27,5), e aumento do HDL (p= 0,001 - IC95% 4,2-10,2). Conclusão: O uso de 3g de canela por dia, durante 90 dias, parece auxiliar na diminuição dos valores de LDL e aumento dos níveis de HDL em pacientes com diabetes.

Bolus versus continuous insulin infusion in immediate postoperative blood glucose control in liver transplantation: pragmatic clinical trial.

OBJECTIVE: To analyze the effectiveness and safety of two insulin therapy techniques (continuous and intermittent infusion) in the blood glucose control of people who have undergone liver transplantation, in the immediate postoperative period. METHODS: The study was a prospective, open, pragmatic clinical trial with 42 participants, divided into two groups of 21 patients each, in the immediate postoperative period following liver transplantation. Participants in the Experimental Group and Control Group received continuous infusion and bolus insulin, respectively, starting at capillary blood glucose ≥150mg/dL. RESULTS: There were no statistically significant differences in the blood glucose reduction time to reach the target range between the Experimental Group and Control Group in the transplanted patients (p=0.919). No statistically significant differences regarding the presence of low blood glucose (p=0.500) and in the initial blood glucose value (p=0.345) were found. The study identified the final blood glucose value in postoperative intensive care unit lower and statistically significant in the continuous infusion pump group in relation to the Bolus Group (p<0.001). Additionally, the variation of blood glucose reduction was higher and statistically significant in the continuous method group (p<0.05). CONCLUSION: The continuous infusion method was more effective in the blood glucose control of patients in the postoperative period following liver transplantation. BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-9Y5tbp.

Effectiveness of ginger in reducing pressure levels in persons with diabetes: placebo-controlled randomized clinical trial / Efectividad del jengibre en la reducción de los nivelesde presión en personas con diabetes: ensayo clínico aleatorizado controlado con placebo / Eficácia do gengibre na redução dos níveis pressóricos em pessoas com diabetes: ensaio clínico randomizado controlado por placebo

Objective: to evaluate the effectiveness of ginger in reducing blood pressure in people with type 2 diabetes. Method: randomized, double-blind clinical trial, conducted with people with type 2 diabetes, in primary health care units. Were included individuals aged between20 and 80 years, using oral antidiabetics and with glycated hemoglobin values between 6% and 10%. The participants were allocated in two distinct groups and randomized in blocks. In the experimental group, participants used 1.2 g of ginger, and in the control group, 1.2 g of a placebo, daily, for 90 days. 103 people completed the study, 47 in the experimental group, and 56 in the controlgroup. Results: the participants in the experimental group showed a reduction in blood pressure values compared to the control group, although not statistically significant. Conclusion: in our analysis, the use of ginger was not able to reduce blood pressure levels in people with diabetes.

Objetivo: evaluar la eficacia del jengibre para reducir la presión arterial en personas con diabetes tipo 2. Métodos: ensayo clínico aleatorizado, doble ciego, realizado con personas con diabetes tipo 2, en unidades de atención primaria de salud. Se incluyeronindividuos con edades comprendidas entre 20 y 80 años, que usaban antidiabéticos orales y tenían valores de hemoglobina glucosilada entre el 6 y el 10%. Los participantes fueron asignados en dos grupos distintos y asignados al azar en bloques. En el grupoexperimental, los participantesutilizaron 1,2 g de jengibre, y en el grupo de control, 1,2 g de un placebo, diariamente, durante 90 días. 103 personas completaron elestudio, 47 en el grupo experimental y 56 en el grupo de control. Resultados: los participantes del grupo experimental mostraron una reducción en los valores de presión arterial en comparación con el grupo control, aunque no estadísticamente significativa. Conclusión: en nuestro análisis, el uso de jengibre no logró reducir los niveles de presión arterial en personas con diabetes.

Objetivo: avaliar a eficácia do gengibre na redução da pressão arterial em pessoas com diabetes tipo 2. Método: ensaio clínico randomizado, duplo-cego, realizado com pessoas com diabetes tipo 2, em unidades básicas de saúde. Foram incluídos indivíduos com idade entre 20 e 80 anos, em uso de antidiabéticosorais e com valores de hemoglobina glicada entre 6% e 10%. Os participantes foram alocados em dois grupos distintos e randomizados em blocos. No grupo experimental, os participantes usaram 1,2 g de gengibre e, no grupo controle, 1,2 g de placebo, diariamente, por 90 dias. 103 pessoas completaram o estudo, 47 no grupo experimental e 56 no grupo de controle. Resultados: os participantes do grupo experimental apresentaram redução dos valores pressóricos em relação ao grupo controle, embora sem significância estatística. Conclusão: em nossa análise, o uso de gengibre não foi capaz de reduzir os níveis pressóricos em pessoas com diabetes.

Efficacy of Cinnamon as an Adjuvant in Reducing the Glycemic Biomarkers of Type 2 Diabetes Mellitus: A Three-Month, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial.

The major aim of this randomized, placebo-controlled, triple-blind clinical trial was to evaluate the efficacy of cinnamon as an adjuvant treatment in reducing glycemic levels in people with type 2 diabetes, compared to a placebo. The study was conducted between August and December 2019, with 160 people with type 2 diabetes, in five Primary Health Units, in Parnaíba, Brazil. Inclusion criteria were: persons of both genders using oral antidiabetic agents, with glycated hemoglobin ≥ 6.0%, and between 18 and 80 years of age. The primary outcome was change in glycated hemoglobin levels after 90 days of intervention. Other biomarkers evaluated were fasting blood glucose, insulin level, and HOMA-IR index. Participants were divided equally into two groups of 80 individuals each, and were given 3 g capsules of either cinnamon or placebo to be taken in combination with their usual oral antidiabetic agents. After 90 days, participants in the cinnamon group had statistically significant reductions of 0.2% of glycated hemoglobin and 0.55 mmol/L of fasting venous glucose, when compared with the placebo group. Cinnamon reduced the glycemic measures of persons with type 2 diabetes, albeit with modest reductions. TRIAL: RBR-2KKB6D.

Bolus versus continuous insulin infusion in immediate postoperative blood glucose control in liver transplantation: pragmatic clinical trial

ABSTRACT Objective: To analyze the effectiveness and safety of two insulin therapy techniques (continuous and intermittent infusion) in the blood glucose control of people who have undergone liver transplantation, in the immediate postoperative period. Methods: The study was a prospective, open, pragmatic clinical trial with 42 participants, divided into two groups of 21 patients each, in the immediate postoperative period following liver transplantation. Participants in the Experimental Group and Control Group received continuous infusion and bolus insulin, respectively, starting at capillary blood glucose ≥150mg/dL. Results: There were no statistically significant differences in the blood glucose reduction time to reach the target range between the Experimental Group and Control Group in the transplanted patients (p=0.919). No statistically significant differences regarding the presence of low blood glucose (p=0.500) and in the initial blood glucose value (p=0.345) were found. The study identified the final blood glucose value in postoperative intensive care unit lower and statistically significant in the continuous infusion pump group in relation to the Bolus Group (p<0.001). Additionally, the variation of blood glucose reduction was higher and statistically significant in the continuous method group (p<0.05). Conclusion: The continuous infusion method was more effective in the blood glucose control of patients in the postoperative period following liver transplantation. Brazilian Registry of Clinical Trials: RBR-9Y5tbp

Frequência e fatores associados à dislipidemia entre pessoas com diabetes mellitus tipo 2 / Frequency and factors associated with dyslipidemia among people with type 2 diabetes mellitus / Frecuencia y factores asociados con la dislipidemia entre las personas con diabetes mellitus tipo 2

Objetivo: avaliar a frequência e os fatores associados à dislipidemia em pessoas com Diabetes Mellitus Tipo 2. Método: estudo transversal, desenvolvido com 45 pessoas diagnosticadas com diabetes e acompanhadas por uma Unidade Básica de Saúde. Foram investigadas variáveis sociodemográficas, relacionadas ao estilo de vida e referentes à análise do perfil lipídico. Resultados: a prevalência de dislipidemia foi de 82,2%, significativamente associada ao sexo feminino (p=0,005), ao tabagismo (p=0,002) e ao sedentarismo (p=0,050). Nos componentes da dislipidemia, as taxas de colesterol total, triglicérides e LDL se mostraram elevados em 68,9%, 57,8%, 11,1%, respectivamente. Já a taxa de HDL se mostrou diminuída em 2,2% dos investigados. Conclusão: a prevalência de dislipidemia mostrou-se elevada nos pacientes analisados. A existência de associação significativa entre a ocorrência de dislipidemia e variáveis como o sexo feminino, os hábitos de tabagismo e sedentarismo chama a atenção para a necessidade de melhores condutas para essa população

Objective: to evaluate the frequency and factors associated with dyslipidemia in people with type 2 Diabetes Mellitus. Method: cross-sectional study, carried out with 45 people diagnosed with diabetes and followed up at a Basic Health Unit. Sociodemographic variables related to lifestyle and related to lipid profile analysis were investigated. Results: the prevalence of dyslipidemia was 82.2%, significantly associated with female gender (p = 0.005), smoking (p = 0.002) and sedentary lifestyle (p = 0.050). The components of dyslipidemia, total cholesterol, triglycerides and low-density lipoproteins were elevated in 68.9%, 57.8% and 11.1%, respectively. Conclusion: the prevalence of dyslipidemia was high in the patients analyzed. The existence of a significant association between the occurrence of dyslipidemia and different types of females, smoking habits and sedentary lifestyle calls attention to the need for better conduct for this population

Objetivo: evaluar la frecuencia y los factores asociados a la dislipidemia en personas con Diabetes Mellitus tipo 2. Método: estudio transversal, desarrollado con 45 personas diagnosticadas con diabetes y acompañadas por una Unidad Básica de Salud. Se investigaron las variables sociodemográficas, de estilo de vida y de análisis del perfil lipídico. Resultados: la prevalencia de dislipidemia fue del 82,2%, asociada significativamente al sexo femenino (p=0,005), al tabaquismo (p=0,002) y al sedentarismo (p=0,050). En los componentes de la dislipidemia, las tasas de colesterol total, triglicéridos y lipoproteínas de baja densidad estaban elevadas en el 68,9%, 57,8% y 11,1%, respectivamente. Conclusión: la prevalencia de la dislipidemia fue elevada en los pacientes analizados. La existencia de una asociación significativa entre la ocurrencia de dislipidemia y variables como el sexo femenino, los hábitos de tabaquismo y el sedentarismo hace que se preste atención a la necesidad de mejores conductas para esta población

Development and validation of a MHEALTH technology for the promotion of self-care for adolescents with diabetes. / Desenvolvimento e validação de uma tecnologia MHEALTH para a promoção do autocuidado de adolescentes com diabetes.

Self-care is encouraged in the type 1 Diabetes Mellitus (DM1) setting. Thus, this research aimed to develop and validate a mobile application (APP) to promote self-care for adolescents with DM1. The method was divided into two stages: development and validation, ranging from literature review, benchmarking, prototype construction to validation by specialists. The APP construction was subsidized by the seven steps proposed by the American Association of Diabetes Educators. The screens were designed and possible functions were selected. After the design, the APP prototype was developed and named "DM Agendinha". The content validation process was mediated by the Suitability Assessment of Materials tool, where the percentage obtained was 85.3%, characterizing the APP as "Superior Material". The Smartphone Usability questionnaire was employed for technical validation, and the APP reached a global Content Validity Index of 0.96. We concluded, therefore, that the use of this material by adolescents will favor the acquisition of new knowledge and adherence to healthy practices, considering that it is a highly intelligible electronic technology.

No cenário do Diabetes Mellitus tipo 1 (DM1), uma prática incentivada é o autocuidado. Dessa forma, objetivou-se elaborar e validar um aplicativo móvel (APP) para a promoção do autocuidado em adolescentes com DM1. O método foi divido em duas etapas: elaboração e validação, que vão desde a revisão de literatura, benchmarking, construção do protótipo e validação por especialistas. A construção do APP foi subsidiada pelos sete passos propostos pela American Association of Diabetes Educators. Foram desenhadas as telas e selecionaram-se as possíveis funções; após o desenho, o protótipo do APP foi desenvolvido e nomeado como "DM Agendinha". O processo de validação de conteúdo foi mediado pelo instrumento Suitability Assessment of Materials, por meio do qual o percentual obtido foi de 85,3%, caracterizando o APP como "Material Superior". Para a validação técnica, empregou-se o questionário Smartphone Usability questionnaire, que obteve um Índice de Validade de Conteúdo global de 0,96. Conclui-se, portanto, que o uso desse material por parte dos adolescentes favorecerá a aquisição de novos conhecimentos e a adesão de práticas saudáveis, tendo em vista que se trata de uma tecnologia de caráter eletrônico e de fácil compreensão.

Desenvolvimento e validação de uma tecnologia MHEALTH para a promoção do autocuidado de adolescentes com diabetes / Development and validation of a MHEALTH technology for the promotion of self-care for adolescents with diabetes

Resumo No cenário do Diabetes Mellitus tipo 1 (DM1), uma prática incentivada é o autocuidado. Dessa forma, objetivou-se elaborar e validar um aplicativo móvel (APP) para a promoção do autocuidado em adolescentes com DM1. O método foi divido em duas etapas: elaboração e validação, que vão desde a revisão de literatura, benchmarking, construção do protótipo e validação por especialistas. A construção do APP foi subsidiada pelos sete passos propostos pela American Association of Diabetes Educators. Foram desenhadas as telas e selecionaram-se as possíveis funções; após o desenho, o protótipo do APP foi desenvolvido e nomeado como "DM Agendinha". O processo de validação de conteúdo foi mediado pelo instrumento Suitability Assessment of Materials, por meio do qual o percentual obtido foi de 85,3%, caracterizando o APP como "Material Superior". Para a validação técnica, empregou-se o questionário Smartphone Usability questionnaire, que obteve um Índice de Validade de Conteúdo global de 0,96. Conclui-se, portanto, que o uso desse material por parte dos adolescentes favorecerá a aquisição de novos conhecimentos e a adesão de práticas saudáveis, tendo em vista que se trata de uma tecnologia de caráter eletrônico e de fácil compreensão.

Abstract Self-care is encouraged in the type 1 Diabetes Mellitus (DM1) setting. Thus, this research aimed to develop and validate a mobile application (APP) to promote self-care for adolescents with DM1. The method was divided into two stages: development and validation, ranging from literature review, benchmarking, prototype construction to validation by specialists. The APP construction was subsidized by the seven steps proposed by the American Association of Diabetes Educators. The screens were designed and possible functions were selected. After the design, the APP prototype was developed and named "DM Agendinha". The content validation process was mediated by the Suitability Assessment of Materials tool, where the percentage obtained was 85.3%, characterizing the APP as "Superior Material". The Smartphone Usability questionnaire was employed for technical validation, and the APP reached a global Content Validity Index of 0.96. We concluded, therefore, that the use of this material by adolescents will favor the acquisition of new knowledge and adherence to healthy practices, considering that it is a highly intelligible electronic technology.

Effectiveness of the piperine-supplemented Curcuma longa L. in metabolic control of patients with type 2 diabetes: a randomised double-blind placebo-controlled clinical trial.

There is robust evidence of using Curcuma longa L. in reducing metabolic levels in people with diabetes. This study analysed the effectiveness of Curcuma longa L. in the metabolic control of patients with type 2 diabetes in Brazil. A randomised double-blind placebo-controlled clinical trial was conducted with 71 participants divided into a Curcuma longa L. group (500 mg/day with piperine 5 mg) and a placebo group, for 120 days. Anthropometric, clinical and biochemical variables were evaluated at baseline, 60 and 120 days after the beginning of the intervention. Paired and independent Student's t-test and chi-square test were used for statistical analysis. The curcuma group presented a significantly decreased glycaemia (p=.013), glycated haemoglobin (p=.015), HOMA index (p=.037) and triglycerides (TGs) (p=.002). The use of piperine-added Curcuma longa L. was effective in the glycaemic and TG control of patients with type 2 diabetes.

Cost-Effectiveness of Passion Fruit Albedo versus Turmeric in the Glycemic and Lipaemic Control of People with Type 2 Diabetes: Randomized Clinical Trial.

BACKGROUND: Robust evidence has related yellow passion fruit albedo and long turmeric to the metabolic and glycemic control of diabetes. AIM: To analyze the incremental cost-effectiveness of the flour made from yellow passion fruit albedo versus long turmeric merged with piperine in the glycemic and lipid control of individuals with type 2 diabetes. METHOD: Eighty-nine patients were enrolled in this randomized, placebo-controlled, clinical trial for 120 days. The first group was prescribed 500 mg capsules, three times a day, of yellow passion fruit albedo flour (FAMA). The second group was prescribed long turmeric capsules (500 mg), merged with piperine (5 mg) (CURPI), at fasting. The third group followed the standard advice recommendations, and ingested a placebo of carboxymethyl cellulose (500 mg) at fasting. RESULTS: The group using FAMA showed a higher reduction (-5.9%) of glycemia after fasting, compared to placebo (+9%), and CURPI (-3.2%) (p < 0.05). Regarding HbA1c, the study observed a significant and similar statistical reduction (-0.8%) in the intervention groups, in contrast with the placebo group (p < 0.05). The reduction in HOMA-IR in the CURPI group (-9.4%) was higher than the other groups (p < 0.05). The CURPI group also showed a higher reduction of serum triglyceride levels (-20.8%) compared to the placebo (-0.09%) and FAMA (+1.8%) (p < 0.05) groups. CONCLUSION: It was concluded that turmeric is the most cost-effective in comparison with yellow passion fruit albedo, because of its decrease in the levels of triglycerides and HOMA-IR, even when adjusted for confounding variables. On the other hand, HbA1c cost-effectiveness relation was similar.

Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial.

OBJECTIVE: to evaluate the effectiveness of ginge (Zingiber officinale) in reducing blood sugar and lipid levels in people with type 2 diabetes. METHOD: a randomized and double-blind clinical trial conducted with people with type 2 diabetes in primary care facilities. The study included individuals aged between 20 and 80 years old, using oral antidiabetic drugs and with HbA1c levels between 6.0% and 10%. The participants were paired 1:1, allocated in two distinct groups, and randomized in blocks, based on their HbA1c levels. In the experimental group, the participants used 1.2g of ginger and, in the control group, 1.2g of placebo, daily for 90 days. The primary outcome was a reduction in fasting blood sugar and HbA1c, and the secondary outcome was a reduction in lipids and HOMA-IR. 103 individuals completed the study, 47 in the experimental group and 56 in the control group. RESULTS: the participants in the experimental group showed a greater reduction in the blood glucose and total cholesterol values compared to the control group. CONCLUSION: the use of ginger can help in the treatment of people with diabetes, and data support the inclusion of this herbal drug in the clinical practice of nurses. RBR-2rt2wy.

Assessment of access to first contact in the perspective of professionals.

OBJECTIVES: to evaluate the "access to first contact" attribute, from the perspective of Primary Care Health professionals. METHODS: an evaluative and cross-sectional study, carried out from February to March 2017. The sample consisted of 163 health professionals, of both genders, who worked in the basic care of the Municipality of Juazeiro do Norte, Ceará. Access to first contact was evaluated by the Primary Care Assessment Tool (PCATool). The 6.60 mark was used as the cut-off point for the evaluated attribute. RESULTS: access to first contact reached a score of 3.3, denoting a low degree of orientation for Primary Health Care. Nurses were the ones who evaluated the attribute more negatively (p=3.2). CONCLUSIONS: access to first contact obtained a low score, pointing to the fragility of the Family Health Strategy as a gateway to the Brazilian Unified Health System (Sistema Único de Saúde).

Analysis of the effectiveness of cinnamon (Cinnamomum verum) in the reduction of glycemic and lipidic levels of adults with type 2 diabetes: A study protocol.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) is a chronic disease that is increasing the number of cases worldwide. The treatments currently used have not worked as expected. Alternative and complementary medicines were inserted in health services, especially in primary care, as an attempt to minimize risks and help control diseases such as diabetes. Among the herbal medicines used stands out cinnamon, which can serve as an adjuvant in the control of diabetes. OBJECTIVE: To analyze the effectiveness of 3 grams of cinnamon (Cinnamomum verum) per day for 90 days in reducing glycemic and lipid levels in adults with T2DM compared with placebo METHODS:: A randomized, double-blind, placebo-controlled, phase II trial, which will be conducted at basic health units in the city of Parnaíba, state of Piauí, Brazil. In total, 130 people diagnosed with T2DM, followed at health units, with hemoglobin A1c > 6.5%, and using oral antidiabetic medicines, are expected to participate in the study. The intervention will last for 3 months, and each participant will receive a total of 3 bottles containing 120 capsules in each bottle of cinnamon or placebo. Each person should take 4 capsules daily, for 90 days. The patients will be distributed into the 2 groups by performing block randomization (n = 6) at a ratio of 1:1 according to a code generated by a software. Assessments of socioeconomic, clinical, lifestyle, anthropometric, and laboratory variables will be performed in 2 separate visits. DISCUSSION: This study will be the first to investigate cinnamon to reduce glycemic, lipid, and anthropometric levels in Brazil. In case of favorable results, this therapy may be used as an alternative or additional medicine in cases where only oral antidiabetic agents are used and can promote the use of the product to minimize future complications of patients with diabetes and people who do not have the disease. TRIAL REGISTRATION: RBR-2KKB6D, registered on December 11th, 2018.

Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial / Efetividade do gengibre na redução de níveis metabólicos de pessoas com diabetes: ensaio clínico randomizado / Eficacia del jengibre en la reducción de los niveles metabólicos de personas con diabetes: un ensayo clínico aleatorizado

Objective: to evaluate the effectiveness of ginge (Zingiber officinale) in reducing blood sugar and lipid levels in people with type 2 diabetes. Method: a randomized and double-blind clinical trial conducted with people with type 2 diabetes in primary care facilities. The study included individuals aged between 20 and 80 years old, using oral antidiabetic drugs and with HbA1c levels between 6.0% and 10%. The participants were paired 1:1, allocated in two distinct groups, and randomized in blocks, based on their HbA1c levels. In the experimental group, the participants used 1.2g of ginger and, in the control group, 1.2g of placebo, daily for 90 days. The primary outcome was a reduction in fasting blood sugar and HbA1c, and the secondary outcome was a reduction in lipids and HOMA-IR. 103 individuals completed the study, 47 in the experimental group and 56 in the control group. Results: the participants in the experimental group showed a greater reduction in the blood glucose and total cholesterol values compared to the control group. Conclusion: the use of ginger can help in the treatment of people with diabetes, and data support the inclusion of this herbal drug in the clinical practice of nurses. RBR-2rt2wy

Objetivo: avaliar a efetividade do gengibre (Zingiber officinale) na redução de níveis glicêmicos e lipídicos de pessoas com diabetes tipo 2. Método: ensaio clínico randomizado, duplo cego, conduzido com pessoas com diabetes tipo 2, em unidades de atenção primária à saúde. Foram incluídos no estudo indivíduos com idade entre 20 e 80 anos, em uso de antidiabéticos orais e com valores de HbA1c entre 6,0% e 10%. Os participantes foram pareados de 1:1, alocados em dois grupos distintos e randomizados em blocos, com base nos valores de HbA1c. No grupo experimental os participantes usaram 1,2g de gengibre, e no grupo controle 1,2g de placebo, diariamente, durante 90 dias. Os desfechos primários foram a redução da glicemia venosa de jejum e HbA1c, e os secundários a redução dos lipídicos e HOMA-IR. 103 pessoas concluíram o estudo, encontrando-se 47 no grupo experimental e 56 no grupo controle. Resultados: os participantes do grupo experimental apresentaram melhor redução dos valores de glicemia e colesterol total, em comparação com o grupo controle. Conclusão: o uso do gengibre pode auxiliar o tratamento das pessoas com a diabetes, e os dados dão suporte para a inserção desse fitoterápico na prática clínica dos enfermeiros. RBR-2rt2wy

Objetivo: evaluar la eficacia del jengibre (Zingiber officinale) en la reducción de los niveles glucémicos y de lípidos en personas con diabetes tipo 2. Método: ensayo clínico aleatorizado y doble ciego, realizado con personas con diabetes tipo 2 en unidades de atención primaria de salud. Se incluyeron en el estudio individuos con edades comprendidas entre 20 y 80 años, que utilizaban antidiabéticos orales y con valores de HbA1c entre 6,0% y 10%. Los participantes fueron comparados de forma equitativa (1:1), asignados a dos grupos distintos y aleatorizados en bloques, basados en sus valores de HbA1c. En el grupo experimental, los participantes utilizaron 1,2 g de jengibre, y en el grupo de control 1,2 g de placebo, diariamente durante 90 días. Los resultados primarios fueron la reducción de glucemia venosa en ayunas y de HbA1c, y los resultados secundarios fueron la reducción de lípidos y del índice HOMA-IR. El estudio contó con la participación de 103 personas, 47 en el grupo experimental y 56 en el grupo de control. Resultados: los participantes del grupo experimental presentaron una mayor reducción en los valores de glucosa y colesterol total, en comparación con el grupo de control Conclusión: el uso del jengibre puede ayudar en el tratamiento de personas con diabetes, y los datos respaldan la introducción de este fitoterapéutico en la práctica clínica de los enfermeros. RBR-2rt2wy

Assessment of access to first contact in the perspective of professionals / Evaluación del acceso de primer contacto en la perspectiva de los profesionales / Avaliação do acesso de primeiro contato na perspectiva dos profissionais

ABSTRACT Objectives: to evaluate the "access to first contact" attribute, from the perspective of Primary Care Health professionals. Methods: an evaluative and cross-sectional study, carried out from February to March 2017. The sample consisted of 163 health professionals, of both genders, who worked in the basic care of the Municipality of Juazeiro do Norte, Ceará. Access to first contact was evaluated by the Primary Care Assessment Tool (PCATool). The 6.60 mark was used as the cut-off point for the evaluated attribute. Results: access to first contact reached a score of 3.3, denoting a low degree of orientation for Primary Health Care. Nurses were the ones who evaluated the attribute more negatively (p=3.2). Conclusions: access to first contact obtained a low score, pointing to the fragility of the Family Health Strategy as a gateway to the Brazilian Unified Health System (Sistema Único de Saúde).

RESUMEN Objetivos: evaluar el atributo "acceso de primer contacto", en la perspectiva de los profesionales de la Atención Primaria de Salud. Métodos: el estudio de evaluación e transversal, realizado en el período de febrero a marzo de 2017. La muestra fue compuesta por 163 profesionales de salud, de ambos sexos, que trabajaban en la atención básica del Municipio de Juazeiro do Norte, Ceará. El acceso de primer contacto fue evaluado por el instrumento Primary Care Assessment Tool (PCATool). Se empleó la marca de 6,60 como punto de corte para el atributo evaluado. Resultados: el acceso de primer contacto alcanzó una puntuación de 3,3, denotando un bajo grado de orientación para la Atención Primaria de Salud. Los profesionales enfermeros fueron los que evaluaron de modo más negativo el atributo (p=3,2). Conclusiones: el acceso de primer contacto obtuvo bajo puntaje, apuntando a la fragilidad de la Estrategia Salud de la Familia como puerta de entrada del Sistema Único de Salud (Sistema Único de Saúde).

RESUMO Objetivos: avaliar o atributo "acesso de primeiro contato", na perspectiva dos profissionais da Atenção Primária à Saúde. Métodos: estudo avaliativo e transversal, realizado no período de fevereiro a março de 2017. A amostra foi composta por 163 profissionais de saúde, de ambos os sexos, que trabalhavam na atenção básica do Município de Juazeiro do Norte, Ceará. O acesso de primeiro contato foi avaliado pelo instrumento Primary Care Assessment Tool (PCATool). Foi empregada a marca de 6,60 como ponto de corte para o atributo avaliado. Resultados: o acesso de primeiro contato alcançou escore de 3,3, denotando um baixo grau de orientação para a Atenção Primária à Saúde. Os profissionais enfermeiros foram os que avaliaram de modo mais negativo o atributo (p=3,2). Conclusões: o acesso de primeiro contato obteve baixo escore, apontando a fragilidade da Estratégia Saúde da Família como porta de entrada do Sistema Único de Saúde.

Health-related quality of life of adolescents with type 1 diabetes mellitus.

OBJECTIVE: To evaluate the health-related quality of life of adolescents with type 1 diabetes mellitus, associating it with socio-demographic, clinical and biochemical variables. METHOD: Cross-sectional study with 92 adolescents with type 1 diabetes mellitus. A form containing socio-demographic, clinical and biochemical variables was used, as well as the Diabetes Quality of Life for Youths questionnaire. Descriptive statistics and logistic regression were used for analysis. RESULTS: Regarding socio-demographic variables, economic class showed statistically significant differences in relation to total Health Related Quality of Life (p-value =0.02) and the impact domain (p-value =0.009). However, the impact domain was more compromised. Diabetes-related complications (p-value =0.004), number of hospitalizations (p-value =0.01), number of daily insulin injections (p-value =0.02), glycated hemoglobin (p-value =0.002) and triglycerides (p-value =0.03) were associated with greater impairment of quality of life related to total health and greater dissatisfaction. CONCLUSION: Single male adolescents with lower level of education and high glycated hemoglobin levels were more likely to have lower health-related quality of life.

Assessment of the attribute "Community Orientation" from the perspective of primary care adult users.

OBJECTIVE: To assess the presence and extension of the attribute "Community Orientation" of Primary Health Care from the perspective of health services adult users from the Municipality of Juazeiro do Norte-CE. METHODS: Quantitative, cross-sectional and evaluative study, carried out in 14 Basic Health Units, from October 2016 to June 2017, using the Primary Care Assessment Tool. RESULTS: The attribute assessment was negative, reaching expressive negative responses in the seven districts, with a mean score of 3.8 (±3.8). The Raw Score (RS) reached a mean of 6.6 and the Derived Score (DS) was assigned a score of 6.4, below the cut-off point ≥ 6.60. CONCLUSION: The low value of the DS represents that units are not providers of PHC, suggesting fragility in the integration of services with the community and the need to promote greater discussion among agents, when designing measures of intervention and improvement of scores.

Assessment of the attribute "Community Orientation" from the perspective of primary care adult users / Evaluación del atributo "Orientación Comunitaria" em la óptica del usuário adulto de la atención primaria / Avaliação do atributo "Orientação Comunitária" na óptica do usuário adulto da atenção primária

ABSTRACT Objective: To assess the presence and extension of the attribute "Community Orientation" of Primary Health Care from the perspective of health services adult users from the Municipality of Juazeiro do Norte-CE. Methods: Quantitative, cross-sectional and evaluative study, carried out in 14 Basic Health Units, from October 2016 to June 2017, using the Primary Care Assessment Tool. Results: The attribute assessment was negative, reaching expressive negative responses in the seven districts, with a mean score of 3.8 (±3.8). The Raw Score (RS) reached a mean of 6.6 and the Derived Score (DS) was assigned a score of 6.4, below the cut-off point ≥ 6.60. Conclusion: The low value of the DS represents that units are not providers of PHC, suggesting fragility in the integration of services with the community and the need to promote greater discussion among agents, when designing measures of intervention and improvement of scores.

RESUMEN Objetivo: Evaluar la presencia y extensión del atributo "Orientación Comunitaria" de la Atención Primaria de Salud, bajo la perspectiva de los usuarios adultos de servicios de salud del Municipio brasileño de Juazeiro do Norte-CE. Método: Estudio cuantitativo, transversal y evaluativo, realizado en 14 unidades básicas de salud, en el período de octubre 2016 hasta junio 2017, utilizándose para las entrevistas el Primary Care Assessment Tool. Resultados: La evaluación del atributo fue negativa, alcanzando expresivas respuestas negativas en las siete regiones, con una puntuación media de 3,8 (±3,8). La Puntuación Esencial (Escore Essencial) alcanzó un promedio de 6,6 y a la Puntuación General (Escore Geral) se asignó una puntuación de 6,4, por debajo del punto de corte ≥ 6,60. Conclusión: El bajo valor del EG representa que las unidades no son proveedores de APS, sugiriendo una fragilidad a la integración de los servicios con la comunidad y la necesidad de promocionar más discusiones entre los agentes, al trazar medidas de intervención y mejoría de las puntuaciones.

RESUMO Objetivo: Avaliar a presença e extensão do atributo "Orientação Comunitária" da Atenção Primária à Saúde, na perspectiva dos usuários adultos dos serviços de saúde do Município de Juazeiro do Norte-CE. Método: Estudo quantitativo, transversal e avaliativo, realizado em 14 Unidades Básicas de Saúde, no período de outubro de 2016 a junho de 2017, utilizando-se, para as entrevistas, o Primary Care Assessment Tool. Resultados: A avaliação do atributo foi negativa, alcançando expressivas respostas negativas nos sete distritos, com escore médio de 3,8 (±3,8). O Escore Essencial (EE) alcançou média de 6,6 e ao Escore Geral (EG) foi atribuída pontuação de 6,4, abaixo do ponto de corte ≥ 6,60. Conclusão: O baixo valor do EG representa que as unidades não são provedoras de APS, sugerindo fragilidade na integração dos serviços com a comunidade e necessidade de promover maior discussão entre os agentes, ao traçar medidas de intervenção e melhoria dos escores.