High prevalence of type 2 diabetes mellitus in Xavante Indians from Mato Grosso, Brazil.

OBJECTIVE: To estimate the prevalence of diabetes, hypertension, obesity, and describe demographic, anthropometric and medical characteristics, in a genetically distinct population: the Brazilian Xavante Indians. DESIGN: Population-based survey carried out among 948 Xavante from Mato Grosso, Brazil. Fasting and 2-hour after 75 g glucose capillary glycemia were measured by a portable glucometer (HemoCue Glucose201+). Diabetes was defined according to WHO criteria. Anthropometric data and medical characteristics were measured, and fat mass (%) was evaluated using bioelectrical impedance. Blood pressure was measured by an automated device (OMRON 742INTC), and hypertension was defined according to WHO criteria. RESULTS: Age-adjusted prevalence rates with 95% confidence intervals were diabetes: 28.2% (25.3-31.1) in general, 18.4% (14.9-22.2) in men and 40.6% (36.2-45.1) in women (P<.001); impaired glucose tolerance: 32.3% (20.5-26.0) in general, 29.7% (25.4-33.9) in men and 34.4% (30.2-38.8) in women (P>.05); hypertension: 17.5% (15.1-19.9) in general. Obesity was found in 50.8% of the individuals. Fat mass (%) was associated with diabetes in men (P<.05) and women (P<.05). Thigh circumference and waist/ thigh ratio were lower in those with diabetes, in men and women (P<.001). CONCLUSIONS: The high prevalence of diabetes and obesity in Xavante is likely related to their recent change in food habits and physical activities. Our results should raise awareness about the magnitude of this health problem and also indicate that it could increase dramatically in the future if no preventive actions are adopted.

Pharmacological Treatment of Alcohol Cravings.

(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance. (2) Methods: We included original studies of alcohol abuse or dependence extracted from a controlled, blind, pharmacological treatment study which presented measures and outcomes related to alcohol cravings. (3) Results: Specific drugs used for the treatment of alcoholism, such as Naltrexone and Acamprosate, have had the best results in relieving craving symptoms, as well as promoting abstinence. Baclofen and anticonvulsants such as Gabapentin and Topiramate have shown good results in promoting abstinence and the cessation of cravings. (4) Conclusions: Specific drugs used for the treatment of alcoholism to obtain the best results can be considered the gold standard for promoting abstinence and relieving cravings. Anticonvulsants and Baclofen also had good results, with these medications being considered as second-line ones. Varenicline is an option for alcohol dependents who also concomitantly ingest tobacco.