Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas / Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years

Objetivo: Describir los cambios en las características antropométricas, control metabólico, tratamiento y prevalencia de sobrepeso en los niños diabéticos en los últimos 20 años. Pacientes y métodos: Estudio observacional retrospectivo de dos grupos de niños diagnosticados de DM1 (n=90) realizado en dos cortes transversales, 1986 y finales del año 2007. Las variables estudiadas fueron: edad, años de DM1, sexo; peso, talla, IMC y sus valores Z; HbA1c, unidades NGSP/DCCT (%) e IFCC (mmol/mol), y el tratamiento con insulina (tipo, número de dosis, U/día y U/kg/día). Resultados: En relación con el grupo de 1986, en el grupo de 2007 hay un incremento significativo (p=0,001) en las variables Z-peso y Z-IMC. Hay una relación negativa entre los años de DM1 y la talla (Z-talla) en el grupo de 1986 (p<0,05). La HbA1c es menor en el grupo 2007 (p=0,001), pero la dosis de insulina (U/día y U/kg/día) es similar en ambos grupos. El número de dosis diarias de insulina es mayor en el grupo 2007 (p<0,001) y predomina el uso de análogos de la insulina. No se encontró una relación estadísticamente significativa entre la HbA1c y el tratamiento insulínico (dosis, número de inyecciones y tipo de insulina). La prevalencia de sobrepeso (14,6% vs 2,4%) es significativamente mayor en el grupo de 2007 (p=0,001). Conclusiones: El control metabólico ha mejorado y el uso de múltiples dosis diarias de insulina se ha convertido en la norma, pero ha aumentado la prevalencia de sobrepeso que puede incrementar el riesgo cardiovascular de los niños diabéticos (AU)

Objective: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986. Patients and methods: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA1c and treatment with insulin (type, number of doses, IU/day and IU/kg/day). Results: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=0.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=0.05) in the 1986 group. The value of HbA1c was lower in the 2007 group (P=0.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<0.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA1c and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=0.001). Conclusions: The metabolic control (HbA1c) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease (AU)

[Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years]. / Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas.

OBJECTIVE: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986. PATIENTS AND METHODS: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA(1c) and treatment with insulin (type, number of doses, IU/day and IU/kg/day). RESULTS: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=.05) in the 1986 group. The value of HbA(1c) was lower in the 2007 group (P=.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA(1c) and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=.001). CONCLUSIONS: The metabolic control (HbA(1c)) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease.

Dietary fatty acids in athero-thrombogenesis: influence of palm oil ingestion.

Dietary experiments, performed in metabolic wards, gave rise to predictive regression equations relating changes of plasma cholesterol concentration to the intake of fatty acids of the diet. It has been established that polyunsaturated fatty acids diminish and most saturated fatty acids increase plasma cholesterol concentration. This information led to expect that dietary use of palm oil may induce an unfavorable plasma lipoprotein profile. This has not been the case as shown in various dietary experiments. The reasons for this discrepancy is discussed. The influence of palm oil enriched diets on prothrombotic variables show that platelets are not affected in their function during prolonged dietary intervention. It is important to continue research on the effects of palm oil based diet on plasma fibrinogen, factor VII. There is still discordant information in this field.