Evaluation of the Effectiveness of In-Hospital Exercise Rehabilitation in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus Combined with Sarcopenia Effect of Lifestyle Management on Disease Status in Patients with Type 2 Diabetes Mellitus.

OBJECTIVE: The aim of this study was to explore the effects of in-hospital exercise rehabilitation on glucose and lipid metabolism and healthy physical fitness in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM) combined with sarcopenia, and to provide a reference for the effective implementation of exercise rehabilitation for middle-aged and elderly patients with T2DM combined with sarcopenia in healthcare institutions. METHODS: This study retrospectively included 122 patients with T2DM combined with sarcopenia treated at the General Hospital of Ningxia Medical University from August 2017 to August 2020 and randomly divided into a control group and an experimental group. The control group was given conventional treatment and the experimental group was given exercise rehabilitation in the hospital for 12 weeks to compare the indexes related to glucose and lipid metabolism and healthy fitness in the two groups. RESULTS: After the intervention, the experimental group showed significant decreases in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density cholesterol (LDL-C) and body fat percentage (p < 0.05), while high-density cholesterol (HDL-C), grip strength, lower limb extension, lower limb flexion, peak oxygen uptake were significantly higher (p < 0.05) and were more significant at 12 weeks compared to the 6-week intervention (p < 0.05). However, there were no significant changes in any of the glucose metabolism indicators in the control group before and after the intervention. A two-way repeated measures ANOVA showed that at control baseline levels, HbA1c decreased significantly in the experimental group after both 6 and 12 weeks of intervention compared to the control group (p < 0.05). After 6 weeks of intervention, the experimental group showed a significant decrease in body fat percentage and a significant increase in grip strength. After 12 weeks of intervention, the experimental group showed an increase in glycemic control from 33.3% to 73.3%, a significant decrease in body fat percentage and a significant increase in grip strength, lower limb extension and lower limb flexion strength and peak oxygen uptake. CONCLUSION: In-hospital exercise rehabilitation can effectively improve the glycemic and lipid profiles of patients with T2DM combined with sarcopenia and enhance their health fitness, with good clinical rehabilitation effects.

Tele-rehabilitation for Type II diabetics with heart failure with preserved ejection fraction.

Objective: This study aims to determine whether tele-rehabilitation has similar effects to conventional face-to-face physical rehabilitation for diabetic patients with heart failure with preserved ejection fraction (HFpEF). Materials and methods: Demographic, laboratory, diagnostic and rehabilitation information for patients with type 2 diabetes with HFpEF were extracted from disease-specific databases. Outcome measures, including the Short Physical Performance Battery (SPPB), 6-minute walk distance, frailty status, European Quality of Life 5-Dimension 5-Level questionnaire (EQ-5D-5L) and reduction in HbA1c from admission, patients who received tele-rehabilitation therapy were compared to those received face-to-face rehabilitation. Results: In this study, 90 patients with type 2 diabetes and HFpEF using tele-rehabilitation were matched with 90 patients with type 2 diabetes and HFpEF using face-to-face physical rehabilitation. Improvements in the results of the SPPB scores, 6-min walk distance and gait speed and EQ-5D-5L were noted from the follow-up time point 3 months to 6 months in both two groups. There were no significant differences in functional tests and quality of life between the two groups. Conclusion: Our study proved that mobile-based tele-rehabilitation programs are non-inferior to face-to-face physical rehabilitation for diabetes patients after HFpEF. In addition, adherence to the telerehabilitation program showed that the novel technology was accepted well and could be an alternative to the conventional face-to-face rehabilitation program.

Factores de riesgo asociados a diabetes mellitus tipo 2. Policlínico Docente José Jacinto Milanés. Matanzas, 2019 / Risk factors associated with type 2 diabetes mellitus. Teaching Polyclinic José Jacinto Milanés. Matanzas, 2019

RESUMEN Introducción: la diabetes es un trastorno endocrino-metabólico crónico que afecta a diversos órganos y tejidos. Más del 90 % de los que la padecen sufren diabetes tipo 2. Esta se acompaña de complicaciones crónicas, que pueden prevenirse mediante un control adecuado de la hiperglucemia y de los factores de riesgo cardiovascular. Objetivo: caracterizar los factores de riesgo asociados a la diabetes mellitus tipo 2, en pacientes del Consultorio del Médico de la Familia no. 27 del Policlínico Docente José Jacinto Milanés, del municipio Matanzas. Materiales y métodos: se realizó un estudio descriptivo de corte transversal, durante el período de enero a diciembre de 2019. El universo estuvo constituido por 50 pacientes pertenecientes al consultorio no. 27 del Policlínico Docente José Jacinto Milanés, del municipio Matanzas, dispensarizados con diabetes mellitus tipo 2. Resultados: el sexo femenino fue el predominante, y el 24 % de los pacientes se encontraban entre 55 y 59 años. En cuanto al estado nutricional, resultó la obesidad el de mayor frecuencia. En el 52 % existían antecedentes familiares de diabetes tipo 2. Conclusiones: la obesidad, los malos hábitos dietéticos, el sedentarismo y la hipertensión arterial constituyeron los factores de riesgo más frecuentes en estos pacientes (AU).

ABSTRACT Introduction: diabetes is a chronic endocrine-metabolic disorder that affects numerous organs and tissues. More than 90 % of those with it suffer from type 2 diabetes. This is accompanied by chronic complications, which can be prevented by adequate control of hyperglycemia and cardiovascular risk factors. Objective: to characterize the risk factors associated with type 2 diabetes mellitus in patients from the Family Physician's Office no. 27 of the Teaching Polyclinic José Jacinto Milanés, of the municipality of Matanzas. Materials and methods: a cross-sectional, descriptive study was carried out during the period from January to December 2019. The universe were 50 patients belonging to Family Physician's Office no. 27 of the Teaching Polyclinic José Jacinto Milanés, of the municipality of Matanzas, diagnosed with type 2 diabetes mellitus. Results: female sex predominated, and 24 % of patients were aged 55-59 years. According to the nutritional status, obesity was the more frequent. There was a family history of type 2 diabetes mellitus in 52 %. Conclusion: obesity, poor dietary habits, sedentary way of life, and arterial hypertension were the most frequent risk factors found in these patients (AU).

Fatores de adesão e permanência de idosos com diabetes tipo 2 a um programa de exercício físico / Factors influencing the initiation and continuation of physical exercise programs by elderly individuals with type 2 diabetes

Introdução: Grande parte dos idosos com diabetes tipo 2 não praticam exercício físico regular. Objetivos: Identificar os fatores que influenciam idosos com diabetes tipo 2 a praticarem exercícios físicos. Métodos: Trata-se de um estudo descritivo e analítico, transversal quantitativo. A amostra foi composta por 49 idosos, com diagnóstico de diabetes tipo 2. Foram aplicados questionários sobre adesão, permanência e desistência ao exercício e sintomas depressivos. Para análise dos dados foi calculado o alpha de Cronbach e foi realizada análise fatorial e correlação dos dados. Resultados: Os motivos para aderir a um programa de exercício físico foram indicação de amigos e familiares, intenção de melhorar a autoestima ou a autoimagem, indicação médica; e os motivos para permanecer ativo foram aliviar tensão, fazer amigos, desenvolver competências, queimar calorias, manter a flexibilidade. Conclusão: Os fatores extrínsecos são os que mais influenciaram idosos com diabetes mellitus tipo 2 a aderir a um programa de exercícios físico e a se manterem na prática.

Introduction: A great proportion of elderly people with type 2 diabetic do not regularly practice any type of physical exercise. Objectives: To identify factors that influence elderly people with type 2 diabetes to exercise. Methods: A descriptive and analytical cross-sectional quantitative study was conducted. The sample consisted of 49 elderly individuals diagnosed with type 2 diabetes. Questionnaires were applied regarding beginning, continuing and quitting exercise programs, as well as depressive symptoms. For the data analysis, Cronbach's alpha was calculated, and factor analysis and correlation of the data were performed. Results: The following reasons for beginning a physical exercise program were discovered: encouragement by friends and family, desire to improve self-esteem or self-image and medical referral. The reasons for staying active were to relieve tension, make friends, develop skills, obtain self-reward, burn calories and maintain flexibility. Conclusion: The results showed that extrinsic factors are the ones that most influence elderly people with type 2 diabetes to begin a physical exercise program and to continue with it.

Ejercicio intermitente y consejería nutricional mejoran control glicémico y calidad de vida en pacientes con diabetes mellitus tipo 2 / Effects of high-intensity interval training and nutritional education in patients with type 2 diabetes

Background: High-intensity interval training (HIIT) improves cardiometabolic markers, but its effects on the quality of life of patients with type 2 diabetes (T2D) is not well known. Aim: To determine the effects of a 12-week HIIT exercise program on cardiometabolic and quality of life variables of T2D patients. Material and Methods: Nine T2D women were assigned to a HIIT + nutritional education (GE) and 10, to a nutritional education alone group (GC). At baseline and after each intervention, anthropometric and body composition parameters using bio-impedance were assessed, and a blood sample was obtained to measure serum lipid levels, blood glucose and glycated hemoglobin. Quality of life was assessed using the SF-12 questionnaire adapted for the Chilean population. Results: There were no significant changes on the lipid profile variables in the GE group, although HDL cholesterol was increased significantly (p < 0.05) in the GC group. Total fat mass was decreased in the GE group from 43.5 ± 1.5 to 41.9 ± 1.5%, p < 0.01. Fasting glucose and glycated hemoglobin decreased in the GE group. There was a significant correlation between the decrease in total fat mass and that of glycated hemoglobin. There were significant increases in quality of life parameters; physical function, physical role, pain, general health, vitality, emotional role, mental health, and social function in the GE but not in the GC group. Conclusions: A 12-week program of HIIT plus nutritional education improves cardiometabolic and quality of life parameters on type 2 diabetics.

Marcadores de funcionamiento renal en pacientes diabéticos tipo 2. Policlínico "Milanés". Municipio Matanzas / Renal function markers type 2 diabet ic patients. Polyclinic "José J. Milanés". Municipality of Matanzas

Introducción: la nefropatía diabética, es un trastorno metabólico en el que la hiperglucemia induce disfunción en diversos tipos de células del riñón, que deriva en insuficiencia renal progresiva. Objetivo: describir el comportamiento de variables de funcionamiento renal en pacientes diabéticos tipo 2 en tres consultorio médicos de la familia del Policlínico Comunitario "José J. Milanés", Municipio de Matanzas, entre mayo del 2013 y mayo del 2014. Materiales y métodos: se realizó un estudio descriptivo transversal en un universo conformado por 129 pacientes con diabetes mellitus tipo 2. La muestra fueron 85 pacientes seleccionados por muestreo aleatorio simple. Variables objeto de estudio: tiempo de evolución de la enfermedad, glucemia, creatinina, microalbuminuria y filtrado glomerular. Resultados: 39 pacientes se encontraban con un período de diagnóstico entre 6 y 10 años, correspondiendo a esta etapa el mayor por ciento (45.9 %). 74 pacientes (87 %) presentó hiperglicemia y el 76,9 % (30 pacientes) presentaron cifras elevadas de creatinina. Para el filtrado glomerular predominaron los pacientes que se encuentran en el estadio II con un 43.6 % y tiempo de evolución entre los 6 y los 10 años, en la microalbuminuria, se destaca que el 42,1 % de los pacientes con menos de 5 años de evolución de la enfermedad presentaban cifras de microalbuminuria por encima de 30 mg/l). Conclusiones: predominaron los pacientes con tiempo de evolución entre los 6 a 10 años, grupo con los mayores porcentaje de pacientes con glucemia, creatinina, filtrado glomerular y microalbuminuria elevados. EL total de pacientes con más de 16 años de evolución de la enfermedad tenían cifras elevadas de filtrado glomerular y microalbuminuria (AU).

Introduction: diabetic nephropathy is a metabolic disturbance in which hyperglycemia induces dysfunction in different kinds of kidneys cells. It derives in progressive renal insufficiency. Objective: to describe the behaviour of renal function variables in type 2 diabetic patients in three family physician consultation (CMF, abbreviation in Spanish) of the Community Polyclinic "José J. Milanés", municipality of Matanzas in the period May 2013-May 2014. Materials and methods: descriptive, transversal study in a universe of 129 patients with type 2 diabetes mellitus. Simply randomized sample composed by 85 patients. The studied variables were time of disease evolution, glycemia, creatinine, microalbuminuria and glomerular filtration. Results: 39 patients were found in a diagnostic period between 6 and 10 years, the biggest percent (45.9 %) corresponding to this stage. 74 patients (87 %) presented hyperglycemia and 30 patients (76.9 %) showed high quantitites of creatinine. Patients that were in the II stage for 43.6 % and evolution time between 6 and 10 years predominated in the glomerular filtration; 42.1 % of the patients with less than 5 years of the disease evolution showed amounts of microalbuminuria of over 30 mg/l. Conclusions: it was found the predomination of patients with 6-10 years of evolution time, the group with the highest percent of patients with increased glycemia, creatinine, glomerular filtration and microalbuminuria. The total of the patients with more than 16 years of disease evolution had high amounts of glomerular filtrate and microalbuminuria (AU).

Glutamine dipeptide supplementation improves clinical responses in patients with diabetic foot syndrome

ABSTRACT The effect of glutamine dipeptide (GDP) supplementation in patients with diabetic foot syndrome was evaluated. A total of 22 patients took part in the study. GDP was supplied in 10 g sachets, and was dissolved in water immediately before use, with ingestion once a day, after lunch or after dinner (20 g/day) over a period of 30 days. Quantification of foot insensitive areas, oxidative stress, blood cytokines, and biochemical, hematological and toxicological parameters was performed before and after GDP supplementation. We observed an increase in blood levels of interferon-α (P=0.023), interferon-γ (P=0.038), interleukin-4 (P=0.003), interleukin-6 (P=0.0025), interleukin-7 (P=0.028), interleukin-12 p40 (P=0.017), interleukin-13 (P=0.001), leukocytes (P=0.037), eosinophils (P=0.049), and typical lymphocytes (P<0.001) due to GDP administration. In addition, we observed a reduced number (P=0.048) of insensitive areas on the foot, and reduction (P=0.047) of fasting hyperglycemia. Patients also showed increased blood high density lipoprotein (P<0.01) and protein thiol groups (P=0.004). These favorable results were associated with the absence of renal and hepatic toxicity. These results are of clinical relevance, since supplementation with GDP over 30 days improved clinical responses in patients with diabetic foot syndrome.

O preparo para o autocuidado do cliente diabético e família / The nursing care oriented to conduct to the realization of the care by the client and relatives

Relato parcial, quanti-qualitativo, de pesquisa-açäo realizada em unidade de internaçäo piloto/ambulatório do Hospital de Ensino, extensivo a moradia. Objetivo: estabelecer modelos de integraçäo hospital/comunidade, visando o indivíduo na unidade familiar, face à recuperaçäo/reabilitaçäo e integraçäo ao trabalho/sociedade, considerando os problemas de moradia/trabalho e aplicando a proposiçäo do SUDS na extensäo das açöes hospitalares a comunidade. Visitas domiciliares levantam as condiçöes da moradia, consolidando a participaçäo familiar no processo. Durante a internaçäo os cuidados de enfermagem realizados säo orientados, conduzindo à participaçäo e à realizaçäo destes, pelo cliente e familiares.