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1.
Diabet Med ; 39(3): e14669, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34460965

RESUMEN

Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks versus benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed "remission" as the most appropriate descriptive term, and HbA1c <6.5% (48 mmol/mol) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission.


Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Endocrinología/normas , Guías de Práctica Clínica como Asunto , Cirugía Bariátrica , Glucemia/análisis , Glucemia/efectos de los fármacos , Consenso , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/terapia , Endocrinología/métodos , Hemoglobina Glucada/análisis , Estilo de Vida Saludable , Humanos , Hipoglucemiantes/administración & dosificación , Resultado del Tratamiento
2.
Br J Nutr ; 127(9): 1352-1357, 2022 05 14.
Artículo en Inglés | MEDLINE | ID: mdl-34719409

RESUMEN

In May 2021, the Scientific Advisory Committee on Nutrition (SACN) published a risk assessment on lower carbohydrate diets for adults with type 2 diabetes (T2D)(). The purpose of the report was to review the evidence on 'low'-carbohydrate diets compared with the current UK government advice on carbohydrate intake for adults with T2D. However, since there is no agreed and widely utilised definition of a 'low'-carbohydrate diet, comparisons in the report were between lower and higher carbohydrate diets. SACN's remit is to assess the risks and benefits of nutrients, dietary patterns, food or food components for health by evaluating scientific evidence and to make dietary recommendations for the UK based on its assessment(). SACN has a public health focus and only considers evidence in healthy populations unless specifically requested to do otherwise. Since the Committee does not usually make recommendations relating to clinical conditions, a joint working group (WG) was established in 2017 to consider this issue. The WG comprised members of SACN and members nominated by Diabetes UK, the British Dietetic Association, Royal College of Physicians and Royal College of General Practitioners. Representatives from NHS England and NHS Health Improvement, the National Institute for Health and Care Excellence and devolved health departments were also invited to observe the WG. The WG was jointly chaired by SACN and Diabetes UK.


Asunto(s)
Diabetes Mellitus Tipo 2 , Dietética , Adulto , Humanos , Dieta Baja en Carbohidratos , Carbohidratos , Inglaterra
3.
Diabetologia ; 64(11): 2359-2366, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34458934

RESUMEN

Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks vs benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed 'remission' as the most appropriate descriptive term, and HbA1c <48 mmol/mol (6.5%) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission.


Asunto(s)
Diabetes Mellitus Tipo 2/clasificación , Diabetes Mellitus Tipo 2/fisiopatología , Glucemia/metabolismo , Consenso , Interpretación Estadística de Datos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hemoglobina Glucada/metabolismo , Humanos , Hipoglucemiantes/uso terapéutico , Inducción de Remisión/métodos , Remisión Espontánea , Terminología como Asunto
5.
J Clin Endocrinol Metab ; 107(1): 1-9, 2022 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34459898

RESUMEN

Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks versus benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed "remission" as the most appropriate descriptive term, and HbA1c < 6.5% (48 mmol/mol) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission.


Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Endocrinología/normas , Guías de Práctica Clínica como Asunto , Cirugía Bariátrica , Glucemia/análisis , Glucemia/efectos de los fármacos , Consenso , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/terapia , Endocrinología/métodos , Hemoglobina Glucada/análisis , Estilo de Vida Saludable , Humanos , Hipoglucemiantes/administración & dosificación , Resultado del Tratamiento
6.
Diabetes Care ; 2021 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-34462270

RESUMEN

Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks versus benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed "remission" as the most appropriate descriptive term, and HbA1c <6.5% (48 mmol/mol) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission.

7.
Nat Med ; 26(4): 485-497, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32127716

RESUMEN

People with obesity commonly face a pervasive, resilient form of social stigma. They are often subject to discrimination in the workplace as well as in educational and healthcare settings. Research indicates that weight stigma can cause physical and psychological harm, and that affected individuals are less likely to receive adequate care. For these reasons, weight stigma damages health, undermines human and social rights, and is unacceptable in modern societies. To inform healthcare professionals, policymakers, and the public about this issue, a multidisciplinary group of international experts, including representatives of scientific organizations, reviewed available evidence on the causes and harms of weight stigma and, using a modified Delphi process, developed a joint consensus statement with recommendations to eliminate weight bias. Academic institutions, professional organizations, media, public-health authorities, and governments should encourage education about weight stigma to facilitate a new public narrative about obesity, coherent with modern scientific knowledge.


Asunto(s)
Consenso , Obesidad/psicología , Obesidad/terapia , Guías de Práctica Clínica como Asunto , Estigma Social , Prejuicio de Peso/prevención & control , Peso Corporal/fisiología , Humanos , Cooperación Internacional , Universidades/organización & administración , Universidades/normas
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