Alteraciones lipídicas y su relación con los niveles de vitamina D en menores de 18 años con diabetes tipo 1 / Lipid changes and their relationship with vitamin D levels in children under 18 years with type 1 diabetes

Objetivo: Analizar en menores de 18 años con diabetes mellitus tipo 1 (DM1) las alteraciones lipídicas y su relación con los niveles de 25 hidroxi vitamina D3 (25-OH-D). Material y métodos: Estudio transversal y descriptivo. Se incluyen menores de 18 años con DM1 mediante un muestreo no aleatorizado consecutivo. Determinaciones: sexo, edad, estadio puberal, tiempo de evolución de la DM1, peso, talla, índice de masa corporal, perímetro abdominal, hemoglobina glucosilada (HbA1c) 25-OH-D, colesterol total, LDL-colesterol, HDL-colesterol y triglicéridos (TG). Se estratifican los resultados para sexo, edad y estadio puberal. Se analizan los datos con el programa SPSS®. Resultados: Se recogen 90 pacientes: edad media de 11,7 ± 3,6 años, predominio masculino (51,1%) y HbA1c media de 7,5 ± 1,3%. El 26,6% presentan 25-OH-D < 20 ng/ml y el 13,3% 25-OH-D ≤ 15 ng/ml. No se observan diferencias en la 25-OH-D en pacientes con sobrepeso-obesidad respecto al resto. El 1,1% presentan HDL-colesterol < 40 ng/ml, el 34,4% LDL-colesterol ≥ 100 mg/dl y el 2,2% TG ≥ 150 mg/dl. Los pacientes con 25-OH-D < 20 ng/ml presentan valores superiores de TG que el resto (76,80 ± 45,62 vs 57,55 ± 26,08; p = 0,04) en el análisis multivariante para índice de masa corporal, perímetro abdominal y HbA1c. Se observa correlación entre los niveles de 25-OH-D y los TG (–0,230; p = 0,029). Conclusión: En nuestra población los pacientes con insuficiencia de vitamina D muestran valores de TG superiores. Debe realizarse un seguimiento a largo plazo para conocer las repercusiones sobre las complicaciones relacionadas con la diabetes (AU)

Objective: To analyze lipid changes and their relationship with 25-hydroxy vitamin D3 (25-OH-D) levels in patients under 18 years old with type 1 diabetes mellitus (T1DM). Material and methods: A cross-sectional, descriptive study. Patients under 18 years with T1DM were enrolled by consecutive, nonrandomized sampling. Data collected included sex, age, pubertal stage, time since T1DM onset, weight, height, body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), 25-OH-D, total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and triglycerides (TG). Results were stratified by sex, age, and pubertal stage. Data were analyzed using SPSS®. Results: Ninety patients with a mean age of 11.7 ± 3.6 years (51.1% males) and mean HbA1c levels of 7.5 ± 1.3% were enrolled. Of these, 26.6% had 25-OH-D levels < 20 ng/mL and 13.3% 25-OH-D levels ≤ 15 ng/mL. No differences were found in 25-OH-D between patients with overweight or obesity and the rest. HDL-C levels < 40 ng/mL were found in 1.1%, 34.4% had LDL-C levels ≥ 100 mg/dL, and 2.2% had TG levels ≥ 150 mg/dL. Patients with 25-OH-D < 20 ng/mL had higher TG levels than the rest (76.80 ± 45.62 vs 57.55 ± 26.08; P = .04) in the multivariate analysis controlled for BMI, waist circumference, and HbA1c. A correlation was found between 25-OH-D and TG levels (-0.230;P = .029). Conclusions: Patients in our population with vitamin D deficiency had higher TG levels. Long-term follow-up should be performed to understand the potential impact of such levels on diabetes-related complications (AU)

Lipid changes and their relationship with vitamin D levels in children under 18 years with type 1 diabetes.

OBJECTIVE: To analyze lipid changes and their relationship with 25-hydroxy vitamin D3 (25-OH-D) levels in patients under 18 years old with type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: A cross-sectional, descriptive study. Patients under 18 years with T1DM were enrolled by consecutive, nonrandomized sampling. Data collected included sex, age, pubertal stage, time since T1DM onset, weight, height, body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), 25-OH-D, total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and triglycerides (TG). Results were stratified by sex, age, and pubertal stage. Data were analyzed using SPSS(®). RESULTS: Ninety patients with a mean age of 11.7 ± 3.6 years (51.1% males) and mean HbA1c levels of 7.5 ± 1.3% were enrolled. Of these, 26.6% had 25-OH-D levels<20 ng/mL and 13.3% 25-OH-D levels ≤ 15 ng/mL. No differences were found in 25-OH-D between patients with overweight or obesity and the rest. HDL-C levels<40 ng/mL were found in 1.1%, 34.4% had LDL-C levels ≥ 100 mg/dL, and 2.2% had TG levels ≥ 150 mg/dL. Patients with 25-OH-D<20 ng/mL had higher TG levels than the rest (76.80 ± 45.62 vs 57.55 ± 26.08; P=.04) in the multivariate analysis controlled for BMI, waist circumference, and HbA1c. A correlation was found between 25-OH-D and TG levels (-0.230; P=.029). CONCLUSIONS: Patients in our population with vitamin D deficiency had higher TG levels. Long-term follow-up should be performed to understand the potential impact of such levels on diabetes-related complications.

Análisis del control del paciente diabético en el área de atención primaria Mancha-Centro de Castilla-La Mancha. Barómetro de la diabetes / Analysis of diabetic patient control in the Primary Care Area of La Mancha-Centro, in the Castile-La Mancha region. Diabetes barometer

OBJETIVOS: Evaluar el control del paciente con diabetes mellitus (DM) en atención primaria(AP), analizando el sistema de registro informático del Sevicio de Salud de Castilla-La Mancha(SESCAM). MATERIAL Y MÉTODOS: Muestra de 938 pacientes con diagnóstico de DM sobre 14.733 individuos incluidos en el año 2009 en el registro informático del SESCAM del área Mancha Centro (Turriano), que comprende 25 centros de AP. Se analizaron distintos parámetros clínicos y analíticos: hemoglobina glicosilada (HbA1c), colesterol total (CT), presión arterial (PA) e índice de masa corporal(IMC), así como el número de procesos por paciente/año: análisis de HbA1c y lípidos, controles de PA, monitorizaciones de pie diabético y revisiones oculares. RESULTADOS: La prevalencia de diabetes conocida fue del 6,36% en la población general. El 54%de los pacientes presentaron una HbA1c < 7%, y el 24,1%, > 8%. El 79% asociaban sobrepeso u obesidad. El 38% eran hipertensos. No se realizó control de CT en el 16% de los individuos, obteniendo valores por debajo de 200 mg/dl en el 45%. Se registró menos de una revisión de pie al año, ninguna revisión ocular, ni control de microalbuminuria. CONCLUSIONES: El sistema «Turriano» es eficaz en el registro de pacientes con diabetes. La mayoría de los pacientes de nuestro estudio presentan un buen control metabólico y de los factores de riesgo cardiovascular

AIMS: To determine the clinical control of patients with diabetes in Primary Care in the a Mancha Centro area (Castile-La Mancha region).MATERIAL AND METHODS: The computerised records system of the Regional Health Service in Castile-La Mancha (Turriano) included 14,733 patients in 2009, in which 938 patients with diabetes were identified in the 25 centres belonging to La Mancha Centro area. Several parameters were collected: HbA1c, total cholesterol, blood pressure, and body mass index (BMI). The number of process per patient/year also were also collected, including number of: HbA1c, total cholesterol, blood pressure controls, feet controls, and eyes controls. RESULTS: Diabetes prevalence was 6.36% of the general population. The HbA1c was measured on average once a year. An HbA1c under 7 mg/dL was found in 54% of patients, and greater than 8 mg/dL in 24.1% of them. The large majority (79%) of patients with diabetes were overweight or obese. Hypertension was found in 40% of the patients. Total cholesterol was not controlled in 16% of patients; 45% had a total cholesterol under 200 mg/dL. Less than one check-up of the feet was done, and no eye control nor microalbuminuria were registered. CONCLUSIONS: The Turriano system is effective for recording the diabetic population. Most patients in our study showed good metabolic control as well as of cardiovascular risk factors

Prevalencia de diabetes y diabetes oculta en adultos de Castilla-La Mancha / Prevalence of known diabetes mellitus and unknown diabetes in adults from Castilla-La Mancha, Spain

Fundamento y objetivo: Los objetivos de este estudio fueron estimar la prevalencia de diabetes mellitus (DM) conocida, diabetes oculta (DO) y alteraciones del metabolismo de los hidratos de carbono en la población de Castilla-La Mancha de edad ≥ 30 años, y valorar los factores de riesgo cardiovascular asociados con diabetes. Pacientes y método: Para estimar la prevalencia se realizó un estudio poblacional trasversal con fecha de referencia del 01-06-2007. Fueron seleccionados 3.092 sujetos, de los que participaron 1.181 (38,1%). Se realizó cuestionario, exploración y sobrecarga oral de glucosa (SOG). Se utilizaron los criterios diagnósticos establecidos por la Asociación Americana de Diabetes (ADA) y se compararon los resultados con los criterios de la Organización Mundial de la Salud (OMS). Resultados: La prevalencia de diabetes en sujetos de edad ≥ 30 años fue del 17,9% (DM 10,7%, DO 7,2%, razón DO/DM 0,7), la de intolerancia a la glucosa (ITG) del 5,6% y la de glucosa basal alterada (GBA) del 22,3% según criterios ADA y 7,2% según criterios OMS. La DM, ITG y GBA aumentaron con la edad. Se observó una mayor prevalencia de diabestes en global en varones (20,9%) frente a mujeres (14,5%), pero a partir de los 75 años es más prevalente en sexo femenino. Se encontró asociación con la obesidad, el género masculino, la edad y la presencia de antecedentes familiares de diabetes.Conclusiones: La prevalencia de diabetes en la población adulta de Castilla-La Mancha es muy elevada, es mayor en varones y aumenta con la edad. Un alto porcentaje de personas con diabetes o con alteración en el metabolismo de los hidratos de carbono desconoce su condición, lo que pone de manifiesto la necesidad de implantar estrategias de detección precoz (AU)

Background and objetive: To estimate the prevalence of known diabetes mellitus (KD), unknown diabetes (UD), and carbohydrate metabolism disturbances in a population of Castilla-La Mancha (CLM) older than 30 years old; To study the cardiovascular risk factors related with diabetes.Patients and methods: A transversal study was performed in order to determine these prevalence data. Reference date: 2007/06/01. 3,092 subjects were selected, and 1,181 of them (38.1%) participated in the study. A questionnaire, physical exploration and glucose tolerance test were performed. The diagnostic criteria of diabetes were those established by the American Association of Diabetes (ADA) and were compared with the World Health Organization criteria (WHO).Results: Prevalence of diabetes in individuals younger than 30 years: 17.9% (DM 10.7%, DO 7.2%). Ratio UD/KD: 0.7. Prevalence of impaired glucose tolerance (IGT) 5.6% and impaired fasting glucose (IFG) 22.3% based on ADA criteria and 7.2% if WHO criteria applied. KD, IFT and IFG increased with age. Global prevalence was higher in males (20.9%) than females (14.5%), but the prevalence was higher in females older than 74 years. A positive relationship was found with obesity, male sex, age and familiar history of diabetes.Conclusions: Prevalence of diabetes in the adult population of CLM is very high, higher in males and increase with age. A great percentage of diabetic people or with carbohydrate metabolism alterations do not know that condition. This situation makes necessary to create early detection strategies (AU)

[Prevalence of known diabetes mellitus and unknown diabetes in adults from Castilla-La Mancha, Spain]. / Prevalencia de diabetes y diabetes oculta en adultos de Castilla-La Mancha.

BACKGROUND AND OBJECTIVE: To estimate the prevalence of known diabetes mellitus (KD), unknown diabetes (UD), and carbohydrate metabolism disturbances in a population of Castilla-La Mancha (CLM) older than 30 years old; To study the cardiovascular risk factors related with diabetes. PATIENTS AND METHODS: A transversal study was performed in order to determine these prevalence data. Reference date: 2007/06/01. 3,092 subjects were selected, and 1,181 of them (38.1%) participated in the study. A questionnaire, physical exploration and glucose tolerance test were performed. The diagnostic criteria of diabetes were those established by the American Association of Diabetes (ADA) and were compared with the World Health Organization criteria (WHO). RESULTS: Prevalence of diabetes in individuals younger than 30 years: 17.9% (DM 10.7%, DO 7.2%). Ratio UD/KD: 0.7. Prevalence of impaired glucose tolerance (IGT) 5.6% and impaired fasting glucose (IFG) 22.3% based on ADA criteria and 7.2% if WHO criteria applied. KD, IFT and IFG increased with age. Global prevalence was higher in males (20.9%) than females (14.5%), but the prevalence was higher in females older than 74 years. A positive relationship was found with obesity, male sex, age and familiar history of diabetes. CONCLUSIONS: Prevalence of diabetes in the adult population of CLM is very high, higher in males and increase with age. A great percentage of diabetic people or with carbohydrate metabolism alterations do not know that condition. This situation makes necessary to create early detection strategies.