A prática do autocuidado no tratamento do diabetes mellitus tipo II por usuários de insulina / The practice of self-care in the treatment of Type II Diabetes Mellitus by insulin users

Este estudo objetivou avaliar o nível de aderência ao autocuidado no tratamento do DMII entre pacientes usuários de insulina atendidos em uma unidade de saúde da família em Palmas, Tocantins, em 2023. Trata-se de uma pesquisa com abordagem quantitativa com 24 portadores de DMII em uso de insulina que responderam a dois questionários, um com perguntas sociodemográficas e o outro sobre atividades de autocuidado relacionadas ao diabetes. Os resultados mostraram que os entrevistados demonstraram baixa adesão ao exercício e à atividade física, com uma média abaixo de 2, o que representou o pior resultado obtido no QAD. Em contrapartida, a adesão ao uso dos medicamentos orais e insulina foi satisfatória, com médias superiores a seis dias por semana. A maioria dos entrevistados apresentou melhor adesão ao tratamento medicamentoso, seja de forma isolada ou associada com cuidados específicos, como cuidado com os pés, ou baixa ingestão de doces. No entanto, a prática de exercício e a atividade física e a adesão às orientações alimentares foram as áreas de menor comprometimento. Diante disso, recomenda-se que os profissionais da saúde desenvolvam estratégias clínico-educativas direcionadas aos portadores de DMII, com o intuito de promover a saúde e incentivar o uso correto dos fármacos e a adesão aos autocuidados, objetivando prevenir complicações relacionadas a essa patologia, além de reforçar a importância do autocuidado para prevenir complicações associadas à doença.

This study aimed to evaluate the level of adherence to self-care in the treatment of DMII among insulin-using patients treated at a family health unit in Palmas, Tocantins, in 2023. This is a quantitative study with 24 DMII patients using insulin who answered two questionnaires, one with sociodemographic questions and the other about self-care activities related to diabetes. The results showed that the interviewees demonstrated low adherence to exercise and physical activity, with an average below 2, which represented the worst result obtained in the QAD. In contrast, adherence to the use of oral medications and insulin was satisfactory, with averages of more than six days per week. The majority of interviewees showed better adherence to medication treatment, whether alone or associated with specific care, such as foot care, or low intake of sweets. However, exercise and physical activity and adherence to dietary guidelines were the areas of least impairment. Therefore, it is recommended that health professionals develop clinical-educational strategies aimed at people with DMII, with the aim of promoting health and encouraging the correct use of drugs and adherence to self-care, aiming to prevent complications related to this pathology, and reinforces the importance of self-care to prevent complications associated with the disease.

The role of the visceral adiposity index in the assessment of metabolic syndrome of polycystic ovary syndrome patients: a new anthropometric index.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder often linked to metabolic syndrome (MS), raising the risk of cardiovascular disease and type II diabetes. Certain indicators, such as the lipid accumulation product (LAP) and homeostatic model assessment for insulin resistance (HOMA-IR), can predict MS in PCOS patients. This study aimed to assess the predictive power of the visceral adiposity index (VAI) in comparison to LAP and HOMA-IR as predictors of MS in PCOS patients. METHODS: In this cross-sectional observational study, data from 317 diagnosed PCOS women were analyzed. VAI, LAP, and HOMA-IR were computed as indexes. Participants were categorized into two groups for index accuracy comparison: PCOS patients with and without MS. The data were assessed using a ROC curve. RESULTS: Among PCOS women with MS, 92.3% had abnormal VAI results, 94.5% had abnormal LAP results, and only 50.5% had abnormal HOMA-IR results. Conversely, the majority of PCOS women without MS had normal HOMA-IR (64.6%). When comparing these indexes using the ROC curve, VAI displayed the highest accuracy, followed by LAP and HOMA-IR. CONCLUSION: The VAI index proved to be a superior predictor of metabolic MS in PCOS women when compared to other indexes.

Evaluation of the persistent organic pollutants association with type 2 diabetes: A prospective study from Karachi, Pakistan / Avaliação da associação de poluentes orgânicos persistentes com diabetes tipo 2: um estudo prospectivo de Karachi, Paquistão

The aim of this study is to determine the association between environmental organic pollutants with type 2 diabetes. This prospective study was conducted in Federal Urdu University of Arts, Science and Technology (FUUAST) Gulshan-e-Iqbal Campus Karachi in duration from January 2016 to June 2017. This study was ethically approved from the Institutional Review Board of FUUAST. The study included 50 male and female convenient subjects with type 2 diabetes. Subject with other type of diabetes was excluded. Consent was obtained by each individual. Self-structured questionnaire was used for data collection. The comparative results suggest that the maximum level of summation polychlorinated biphenyls (PCBs) mean value was found in age group 27-33 as 0.695 mg/kg in 73% having total individual eleven. Median (interquartile range) of pesticides levels among subjects with normal weight, over weight and obesity were 0.49 (0.26-2.13), 1.53 (0.60-2.65), and 1.60 (1.23-2.05) respectively. It was observed that Organochlorine pesticides (OCS) levels of subjects with overweight and obesity were almost similar (P-value > 0.05) but significantly higher as compared to subjects with normal weight (P-value < 0.05). No significant differences were observed between PCB levels of subjects in terms of body mass index (BMI). In present study we trace the important elements involve in the deposition of persistent organic pollutants and established an association between pollutants with etiology of diabetes and associated disorders such as obesity.

O objetivo deste estudo é determinar a associação entre poluentes orgânicos ambientais com diabetes tipo 2. Este estudo prospectivo foi conduzido na Universidade Federal Urdu de Artes, Ciência e Tecnologia (FUUAST), Gulshan-e-Iqbal, Campus Karachi, com duração de janeiro de 2016 a junho de 2017. Este estudo foi eticamente aprovado pelo Comitê de Revisão Institucional da FUUAST. O estudo incluiu 50 indivíduos convenientes do sexo masculino e feminino com diabetes tipo 2. Indivíduos com outro tipo de diabetes foram excluídos. O consentimento foi obtido por cada indivíduo. Um questionário autoestruturado foi utilizado para a coleta de dados. Os resultados comparativos sugerem que o nível máximo de soma de bifenilas policloradas (PCBs) valor médio foi encontrado na faixa etária 27-33 como 0,695 mg / kg em 73%, tendo total de 11 indivíduos. A mediana (intervalo interquartil) dos níveis de pesticidas entre indivíduos com peso normal, sobrepeso e obesidade foi de 0.49 (0.26-2.13), 1.53 (0.60-2.65) e 1.60 (1.23-2.05), respectivamente. Observou-se que os níveis de pesticidas organoclorados (OCS) de indivíduos com sobrepeso e obesidade eram quase semelhantes (valor P > 0.05), mas significativamente maiores em comparação com indivíduos com peso normal (valor P < 0.05). Não foram observadas diferenças significativas entre os níveis de PCB dos indivíduos em termos de índice de massa corporal (IMC). No presente estudo, rastreamos os elementos importantes envolvidos na deposição de poluentes orgânicos persistentes e estabelecemos uma associação entre os poluentes com a etiologia do diabetes e doenças associadas, como a obesidade.

Efectos del entrenamiento de la fuerza en personas con diabetes mellitus tipo II: revisión sistemática / Effects of resistance training in people with Type II diabetes mellitus: systematic review / Efeitos do treinamento de resistência em pessoas com diabetes mellitus tipo II. revisão sistemática

El presente artículo busca analizar las evidencias aportadas del entrenamiento de la fuerza comprobando su influencia en la Diabetes Mellitus tipo II utilizando la literatura existente sobre este objeto de estudio. Se realizo una revisión sistemática siguiendo las directrices PRISMA donde el principal contexto fue el entrenamiento de la fuerza en pacientes con Mellitus II, siendo buscados en bases de datos Pubmed, Embase y Scopus donde fueron seleccionados 7 artículos. Los hallazgos señalan consistentemente que el entrenamiento de la fuerza bien programado incide gradualmente en algunos marcadores que identifican la diabetes Mellitus II al realizar intervenciones con sistemas de entrenamiento de la fuerza de forma positiva. Los autores recomiendan estudios con muestras mayores en lo posible de tipo control para verificar la incidencia del entrenamiento en las variables mencionadas en este estudio.

This Article Seeks analyzes the evidence provided by strength training, verifying its influence on Type II Diabetes Mellitus by using the existing literature on this subject of study. A systematic review was carried out following the PRISMA guidelines, where the main context was strength training in patients with Mellitus II. The search was carried out in Pubmed, Embase, and Scopus databases where 7 articles were selected. The findings consistently indicated that a well-structured strength training program gradually affected some markers that identify diabetes Mellitus II when performing interventions with strength training systems in a positive way. The authors recommend control-type studies with larger samples, if possible, to verify the incidence of training in the variables mentioned in this study.

Este artigo procura analisar as evidências fornecidas pelo treinamento de força, verificando sua influência no Diabetes Mellitus tipo II utilizando a literatura existente sobre este objeto de estudo. Foi realizada uma revisão sistemática seguindo as diretrizes PRISMA onde o principal contexto foi o treinamento de força em pacientes com Mellitus II, sendo pesquisada nas bases de dados Pubmed, Embase e Scopus onde foram selecionados 7 artigos. Os achados indicam consistentemente que o treinamento de força bem programado afeta gradualmente alguns marcadores que identificam o diabetes Mellitus II ao realizar intervenções com sistemas de treinamento de força de forma positiva. Os autores recomendam estudos do tipo controle com amostras maiores, se possível, para verificar a incidência de treinamento nas variáveis mencionadas neste estudo.

In silico approaches to develop new phenyl-pyrimidines as glycogen synthase kinase 3 (GSK-3) inhibitors with halogen-bonding capabilities: 3D-QSAR CoMFA/CoMSIA, molecular docking and molecular dynamics studies.

Glycogen synthase kinase 3 (GSK-3) is involved in different diseases, such as manic-depressive illness, Alzheimer's disease and cancer. Studies have shown that insulin inhibits GSK-3 to keep glycogen synthase active. Inhibiting GSK-3 may have an indirect pro-insulin effect by favouring glycogen synthesis. Therefore, the development of GSK-3 inhibitors can be a useful alternative for the treatment of type II diabetes. Aminopyrimidine derivatives already proved to be interesting GSK-3 inhibitors. In the current study, comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) have been performed on a series of 122 aminopyrimidine derivatives in order to generate a robust model for the rational design of new compounds with promising antidiabetic activity. The q2 values obtained for the best CoMFA and CoMSIA models have been 0.563 and 0.598, respectively. In addition, the r2 values have been 0.823 and 0.925 for CoMFA and CoMSIA, respectively. The models were statistically validated, and from the contour maps analysis, a proposal of 10 new compounds has been generated, with predicted pIC50 higher than 9. The final contribution of our work is that: (a) we provide an extensive structure-activity relationship for GSK-3 inhibitory pyrimidines; and (b) these models may speed up the discovery of GSK-3 inhibitors based on the aminopyrimidine scaffold. Finally, we carried out docking and molecular dynamics studies of the two best candidates, which were shown to establish halogen-bond interactions with the enzyme.Communicated by Ramaswamy H. Sarma.

Modelo predictivo de riesgo para el diagnóstico temprano de la diabetes mellitus de tipo 2 / Predictive model of risk for the early diagnosis of type II diabetes mellitus i: en

Introducción: El diagnóstico temprano de la diabetes mellitus de tipo 2 permite al personal de salud implementar estrategias para evitar las complicaciones crónicas que pudieran derivarse. A tales efectos, en las últimas dos décadas se han desarrollado modelos predictivos que incluyen cada día más variables. Objetivo: Elaborar un modelo predictivo para el diagnóstico temprano de la diabetes mellitus de tipo 2 en una población holguinera. Métodos: Se realizó un estudio de cohorte que incluyó a todos los pacientes atendidos en las consultas de endocrinología del área de salud Pedro Díaz Coello y del Hospital Militar Fermín Valdés Domínguez de la provincia de Holguín, para lo cual se tomaron 2 cohortes: una de análisis y otra de validación. Para el procesamiento estadístico se efectuó el análisis univariado y el multivariado; en tanto se determinó la asociación entre variables dependientes e independientes. Resultados: En la serie predominaron el sexo femenino, los pacientes sin antecedentes de diabetes mellitus e hipertensión arterial, así como los que presentaban hipotiroidismo, enfermedad periodontal y normopeso, entre otros; asimismo, el modelo resultó significativo estadísticamente (X2=31,1 y p=0,000) y explicó 80,9 % de la variable de salida, validada por las variables de análisis. La sensibilidad fue de 96,9 % y la especificidad de 86,6 %; mientras que el área bajo la curva tuvo un rango de 0,725 a 0,833. Conclusiones: El modelo predictivo elaborado es una herramienta muy útil para el diagnóstico de pacientes con riesgo de presentar diabetes mellitus de tipo 2.

Introduction: The early diagnosis of the type II diabetes mellitus allows the health staff to implement strategies in order to avoid the chronic complications that could be derived. To such effects, in the last two decades predictive models have been developed that include more variables every day. Objective: To elaborate a predictive model for the early diagnosis of type II diabetes mellitus in a population from Holguín. Methods: A cohort study was carried out that included all the patients assisted in the endocrinology services of Pedro Díaz Coello health area and Fermín Valdés Domínguez Military Hospital in Holguín province, for which 2 cohorts were taken: one of analysis and another of validation. For the statistical processing the univaried and multivaried analysis were carried out; as long as the association between dependent and independent variables was determined. Results: In the series there was a prevalence of the female sex, patients without history of diabetes mellitus and hypertension, as well as those that presented hypothyroidism, periodontal disease and normal weight, among others; also, the pattern was statistically significant (X2=31.1 and p=0.000) and explained 80.9 % of the logout variable validated by the analysis variables. The sensibility was of 96.9 % and the specificity of 86.6 %; while the area under the curve had a range from 0.725 to 0.833. Conclusions: The predictive model elaborated is a very useful tool for the diagnosis of patients with risk of type II diabetes mellitus.

Intervención educativa en pacientes con diabetes mellitus tipo II / Educational intervention in patients with type II diabetes mellitus

RESUMEN Introducción: El autocuidado constituye un elemento primordial en el control de la actividad clínica de los pacientes con diabetes mellitus tipo II. Objetivo: Realizar una intervención educativa para aumentar el nivel de conocimiento de los pacientes diabéticos sobre el autocuidado de la enfermedad. Métodos: Se realizó una investigación aplicada, cuasi experimental, donde el universo estuvo constituido por 115 pacientes con diagnóstico conformado de diabetes mellitus tipo II. La muestra quedó conformada por 90 pacientes; se determinaron el nivel de conocimiento y de control glucémico de los pacientes, sus características y las de la enfermedad. Se utilizó el cuestionario Diabetes Knowledge Questionnaire para determinar el nivel de conocimiento sobre autocuidado. Se aplicó la prueba no paramétrica de McNemar para identificar cambios provocados por la intervención educativa implementada. Resultados: Promedio de edad de 53,87 años con predominio de pacientes femeninas (73,33 %). Al inicio de la investigación predominaron pacientes con sobrepeso (53,33 %), complicaciones de la diabetes (68,89 %), nivel de conocimiento entre regular y malo (60,0 %) y control glucémico entre admisible e inadecuado (72,22 %). Después de implementado la intervención educativa el 81,33 % presentó nivel de conocimiento entre bueno y excelente y 56,56 % de los pacientes presentó un control glucémico entre adecuado y normal. Conclusiones: Se concluye que la intervención educativa implementada provocó cambios significativos en el aumento del nivel de conocimiento de los pacientes sobre autocuidado de la diabetes.

ABSTRACT Introduction: Self-care is an essential element in the control of clinical activity in patients with type II diabetes mellitus. Objective: To carry out an educational intervention to increase the level of knowledge of diabetic patients about self-care of the disease. Methods: An applied, quasi-experimental research was carried out; where the universe consisted of 115 patients with a confirmed diagnosis of type II diabetes mellitus. The sample was made up of 90 patients; the level of knowledge and glycemic control of the patients, their characteristics and those of the disease were determined. The Diabetes Knowledge Questionnaire was used to determine the level of knowledge about self-care. McNemar's non-parametric test was applied to identify changes caused by the educational intervention implemented. Results: Average age of 53.87 years with a predominance of females (73.33%). At the beginning of the investigation, overweight patients (53.33%), diabetes complications (68.89%), knowledge level between fair and bad (60.0%) and glycemic control between admissible and inadequate (72.22%) predominated. After implementing the educational intervention, 81.33% presented a level of knowledge between good and excellent and 56.56% of the patients presented a glycemic control between adequate and normal. Conclusions: It is concluded that the educational intervention implemented caused significant changes in the increase in the level of knowledge of patients about diabetes self-care.

Fundamentos que caracteriza la adherencia a la insulinoterapia de los pacientes con diabetes tipo II / Foundations that characterize adherence to the insulin therapy of patients with type II diabetes

La diabetes Mellitus es un padecimiento que empieza cuando el páncreas no realiza un uso adecuado de la insulina que produce o no puede lograr producir insulina. Se descomponen en glucosa en la sangre todos los alimentos ricos en hidratos de carbono; la insulina da ayuda a la glucosa para que esta pueda ingresar en las células. Los niveles de azúcar en la sangre al no funcionar bien el páncreas suben, lo cual debe ser controlado por medio de un tratamiento médico de por vida, y lo más importante la persona debe cambiar de hábitos en su salud. Objetivo: El objetivo principal de esta investigación es definir el efecto que produce la adherencia a la insulinoterapia en los pacientes con diabetes tipo II del Hospital del Día Mariana de Jesús. Materiales y Métodos: Se utilizó una investigación cuantitativa, transversal ya que se realizó una encuesta a los pacientes, la cual se procedió a la recolección y análisis e interpretación de datos. La muestra trabajada fue de 100 pacientes, los cuales fueron atendidos en el Hospital por concepto de diabetes tipo II en el área de emergencia. Resultados: Como resultado de la investigación tenemos que el 76% de los encuestados conocen sobre el tratamiento de la insulinoterapia, el 85% se rehusó a utilizar insulina cuando inició su tratamiento, el 75% ha tenido dificultad para la conservación de la insulina, el 63% considera que el uso de la insulina es riesgos, el 53% indicó haber recibido asesoría sobre los posibles efectos de la insulina, al 65% de encuestados su jornada laboral no le permite asistir a su control médico, el 72% ha sentido un desmejoro en su salud al dejar el tratamiento y el 63% de los encuestados indicó que ha abandonado en algún momento su tratamiento por temor a los efectos secundarios que dicen tener. Conclusiones: Se estableció el tipo de complicaciones que se dan en los pacientes ante la no adherencia a la insulinoterapia, uno de ellos fue, que al dejar el tratamiento los pacientes sintieron un desmejoro en su estado de salud, así también, los pacientes han abandonado el tratamiento en algún momento por miedo a los efectos secundarios que dicen tener la insulina(AU)

Diabetes Mellitus is a condition that begins when the pancreas does not make proper use of the insulin it produces or cannot achieve produce insulin. All foods rich in glucose are broken down into glucose in the blood. carbohydrates; insulin helps glucose to enter the cells cells. When the pancreas does not work well, blood sugar levels rise, which must be controlled by lifelong medical treatment, and most importantly the person must change their health habits. Objective: The main objective of this research is to define the effect produced by adherence to insulin therapy in patients with type II diabetes at Hospital del Día Mariana de Jesús. Materials and Methods: A quantitative, cross-sectional investigation was used since a patient survey which proceeded to the collection and analysis and interpretation of data. The sample worked was 100 patients who were treated at the Hospital for type II diabetes concept in the emergency area. Results: Like result of the investigation we have that 76% of the respondents know about the insulin therapy treatment, 85% refused to use insulin when they started their treatment, 75% have had difficulty conserving insulin, 63% considers that the use of insulin is risky, 53% indicated having received counseling about the possible effects of insulin, 65% of those surveyed did not care about their working hours. allows them to attend their medical control, 72% have felt a deterioration in their health when leaving the treatment and 63% of those surveyed indicated that they had abandoned their treatment at some point. treatment for fear of the side effects they claim to have. Conclusions: If established the type of complications that occur in patients due to non-adherence to insulin therapy, one of them was that when leaving the treatment the patients felt a deterioration in their state of health, as well as the patients have abandoned the treatment at some point for fear of the side effects that they claim to have insulin(AU)

Estudio Descriptivo: Frecuencia y factores de riesgo de la enfermedad arterial periférica en pacientes con Diabetes Mellitus II del Hospital José Carrasco Arteaga, Cuenca / Descriptive Study: Frequency and risk factors of peripheral arterial disease in patients with type II Diabetes Mellitus of Hospital José Carrasco Arteaga, Cuenca

INTRODUCCIÓN: La enfermedad arterial periférica (EAP) es más frecuente en pacientes conDiabetes Mellitus tipo 2 (DM2) que en la población general, convirtiéndolos en un grupo de alto riesgo de morbimortalidad. El objetivo del presente estudio fue determinar la frecuencia de EAP, mediante la medición del ITB y la frecuencia de sus factores de riesgo en los pacientes con Diabetes Mellitus tipo 2 del Hospital José Carrasco Arteaga. MATERIALES Y MÉTODOS: Estudio descriptivo, de corte transversal, con una muestra aleatoria simple de pacientes con diagnóstico de DM2 que acudieron a consulta externa del Hospital José Carrasco Arteaga, Cuenca-Ecuador, en el año 2017 (315 pacientes).Se aplicó una entrevista a los pacientes con datos sobre las características sociodemográficas y ciertos antecedentes médicos de importancia para el estudio; se determinó el ITB; se valoraron los exámenes complementarios de laboratorio realizados en los seis meses previos al estudio. Finalmente, se describieron frecuencias y porcentajes de cada una de las variables, se utilizó el programa IBM SPSS versión 22. RESULTADOS: Del total de pacientes se observó un promedio de edad de 62.9 años, con predominio del sexo femenino. Se determinó que la frecuencia de EAP en los pacientes con DM2 fue del 35.30%. LA EAP fue más frecuente en: el grupo de edad mayor a 50 años (38.8%), el sexo masculino (43.9%), en el grupo de pacientes con tiempo de evolución de la DM2 ≥ a 5 años (35.5%), en los pacientes con tabaquismo (38.4%), en los pacientes con niveles elevados de hemoglobina glicosilada (HbA1c ≥7%) (40.6%), los pacientes con hipertrigliceridemia, en los pacientes con LDL elevado y en hombres con HDL por debajo de valores normales. CONCLUSIÓN: Podemos concluir que la frecuencia de enfermedad arterial periférica en los pacientes con Diabetes Mellitus tipo 2, en el Hospital José Carrasco Arteaga, utilizando el índice tobillo brazo como método diagnóstico fue del 35.30%.(au)

BACKGROUND: Peripheral arterial disease (PAD) is more common in patients with type 2 Diabetes Mellitus (DM2) than in the general population, making them a high-risk group for morbidity and mortality. The aim of this study was to determine the frequency of peripheral arterial disease, by measuring ankle-brachial index, and the frequency of its risks factors in patients with type 2 Diabetes Mellitus at Hospital José Carrasco Arteaga. METHODOS: descriptive, cross-sectional study, with a simply randomized sample of patients diagnosed with Type 2 Diabetes Mellitus, who attended the outpatient clinic of Hospital José Carrasco Arteaga, Cuenca - Ecuador, in 2017 ( 315 patients). An interview was applied to the patients, to collect data on sociodemographic characteristics and certain important medical history; ankle-brachial index was determined; complementary laboratory tests made six months prior to the study were evaluated. Finally, frequencies and percentages of each variable were described; we used IMB SPSS version 22 software. RESULTS: Of the total number of patients, the average age was 62.9 years, with a predominance of the female sex. The frequency of PAD in patients with DM2 was 35.30%. PAD was more frequent in: age group over 50 years (38.8%), male sex (43.9%), disease evolution time ≥ 5 years (35.5%), in smoking patients(38.4%), in patients with elevated glycosylated hemoglobin levels (HbA1c ≥7%)(40.6%),in patients with hypertriglyceridemia, in patients with elevated LDL and in men with low HDL values. CONCLUSION: we can conclude that the peripheral arterial disease frequency in patients with type 2 Diabetes Mellitus, at Hospital José Carrasco Arteaga, using the ankle-brachial index as a diagnostic method was 35.50%.(au)

Complicaciones de la cirugía de revascularización coronaria en pacientes con diabetes mellitus de tipo II / Complications of the coronary revascularization surgery in patients with type II diabetes mellitus

Introducción: La diabetes mellitus y la cardiopatía isquémica están íntimamente relacionadas, puesto que los pacientes con la primera tienen más riesgo de presentar la segunda, así como mayor mortalidad cardiovascular. Objetivo: Identificar las complicaciones posoperatorias en pacientes con diabetes mellitus de tipo II. Método: Se realizó un estudio descriptivo de serie de casos de 203 pacientes con diabetes mellitus de tipo II, expuestos a cirugía de revascularización coronaria en el Cardiocentro del Hospital Provincial Docente Saturnino Lora de Santiago de Cuba, desde enero de 2011 hasta igual periodo de 2020. Resultados: En la casuística resultaron más afectados el sexo masculino (56,1 %) y el grupo etario de 45 - 64 años (53,7 %), quienes tenían más de 10 años con la enfermedad endocrina y se le había detectado la cardiopatía isquémica en el último, con una forma de presentación aguda. Se encontraron varios factores de riesgo, tales como enfermedad coronaria difusa, niveles de glucemia elevada en el periodo perioperatorio y fracción ventricular izquierda baja. En la mayoría de las intervenciones quirúrgicas se empleó la técnica de corazón latiendo (81,8 %), y las complicaciones predominantes fueron arritmias supraventriculares, bajo gasto cardiaco e infecciones de la herida. Conclusiones: La cirugía de coronaria en pacientes con diabetes mellitus de tipo II es el método que logra una revascularización más completa, tanto anatómica como funcional, y la técnica de corazón latiendo alcanza reducir la mortalidad, aunque aún son frecuentes las complicaciones atribuibles a causas multifactoriales.

Introduction: The diabetes mellitus and ischemic heart disease are closely related, since patients with the former have more risk of presenting the latter, as well as higher cardiovascular mortality. Objective: To identify the postoperative complications in patients with type II diabetes mellitus. Method: A serial cases descriptive study of 203 patients with type II diabetes mellitus, exposed to coronary revascularization surgery was carried out in the Heart Center of Saturnino Lora Teaching Provincial Hospital Hospital in Santiago de Cuba, from January, 2011 to the same period in 2020. Results: In the case material the male sex (56.1 %) and the 45 - 64 age group (53.7 %) were more affected, who had more than 10 years with the endocrine disease and the ischemic heart disease had been detected in the latter, with an acute form of presentation. Several risk factors were found, such as diffuse coronary disease, glycemia high levels in the perioperative period and low left ventricular fraction. In most of the surgical interventions the heart beating technique was used (81.8 %), and the predominant complications were supraventricular arrhythmias, low heart output and infections of the wound. Conclusions: The surgery of coronary in patients with type II diabetes mellitus is the method that achieves a more complete revascularization, either anatomical as functional, and the heart beating technique reduces the mortality, although the complications attributable to multifactorial causes are still frequent.

Factores influyentes en pacientes con periodontitis y diabetes mellitus tipo II / Influential Factors in Patients with Periodontitis and Diabetes Mellitus Type II

RESUMEN La enfermedad periodontal (EP) es un proceso multifactorial y progresivo que degenera en un tiempo determinado los tejidos alrededor de los dientes; esta se clasifica según su progresión en gingivitis y periodontitis, siendo la periodontitis la última y más agravante instancia de esta enfermedad. La diabetes es una enfermedad crónica e irreversible del metabolismo que afecta los niveles de azúcar del cuerpo; se clasifica en tipo I o insulinodependiente (más común en personas jóvenes), tipo II o no insulinodependiente (más común en personas adultas), y otra variedad conocida como diabetes gestacional (o del embarazo). Se cree que factores como estado socioeconómico, genética, tabaquismo y otras condiciones sistémicas tienen influencia en el control de la enfermedad periodontal y la diabetes, y se afirma que existe una relación bidireccional entre estas dos entidades. Este artículo de revisión pretende ser una herramienta de actualización para profesionales interesados en el tema. En la relación bidireccional que existe entre estas dos patologías hay una injerencia de ciertos factores como el tabaquismo; otras condiciones sistémicas como la obesidad y el embarazo; así como también algunas interacciones medicamentosas. La diabetes mellitus constituye un factor de riesgo para la periodontitis y, al mismo tiempo, el control metabó-lico de estos pacientes se hace difícil en presencia de periodontitis, poniendo de relieve no solo la relación entre estas dos entidades, sino la importancia de conocerla, con el fin de poder actuar dentro de un equipo interdisciplinario que conlleve a unos mejores resultados en salud para los pacientes afectados.

ABSTRACT Introduction: Periodontal disease is a multifactorial and progressive process that degenerates at a specific time the tissues around the teeth. This disease is classified according to its progression in gingivitis and periodontitis, being periodontitis the last and most aggravating instance of the disease. On the other hand, diabetes is a metabolic disorder that affects sugar levels in the body. Diabetes is classified as type I or insulin-dependent (more common in young people), type II or non-insulin-dependent (more common in adults) and another known variety like gestational diabetes (or pregnancy). It is believed that factors such as socioeconomic status, genetics, other systemic conditions, or influence of periodontal treatment, among others, are involved in the bidirectional relationship that exists between these two entities. This review article aims to be an updating tool for professionals interested in the subject. Conclusions: The bidirectional relationship that exists between these two pathologies is an interference of certain factors such as smoking, other systemic conditions such as obesity and pregnancy, as well as some drug interactions. Diabetes Mellitus constitutes a risk factor for periodontitis. At the same time, the metabolic control of these patients becomes difficult in the presence of periodontitis, highlighting not only the relationship between these two diseases, but also the importance of knowing it to be able to act within an interdisciplinary team that leads to better health outcomes for affected patients.

Experiences and narratives of patients with type 2 diabetes mellitus in the city of Salvador (Bahia) related to the difficulties in changing lifestyle behaviors / Experiências e narrativas de portadores de diabetes mellitus tipo 2 na cidade de Salvador (Bahia) sobre dificuldades para a mudança dos estilos de vida

Abstract It is considerably difficult for type 2 diabetes patients to change lifestyle according to professional guidelines. This contributes to controlling the disease below what is desirable and could increase morbimortality and health system costs with complications that could have been avoided. It is important to know this phenomenon for better intervention, therefore, this qualitative study explores experiences and narratives of 10 diabetic patients in the city of Salvador (state of Bahia, Brazil), comparing them to the literature to analyze how health determinants may influence them. It is concluded that it is a multifactorial phenomenon and aspects such as conceptions about the disease and its control, use and access to health care, professional-patient relationship, social support and environment personalize each experience with the disease, which facilitates or not the motivation for change. Health professionals and public authorities should be sensitized to such aspects, and will find suggestions in this article that contribute to mitigating difficulties and facilitating a preventive lifestyle for patients.

Resumo A dificuldade para os portadores de diabetes mellitus tipo 2 mudarem os estilos de vida conforme as orientações profissionais possui magnitude considerável. Tal fato contribui para manter o controle da doença aquém do desejável, e pode levar ao aumento da morbimortalidade e custos para o sistema de saúde, com complicações que poderiam ter sido evitadas. Este estudo qualitativo, diante da importância de se compreender este fenômeno para melhor intervenção, explora narrativas e experiências de 10 portadores de diabetes na cidade de Salvador, comparando-as com a literatura a fim de analisar como determinantes sociais lhe são influenciadores. Conclui-se que é um fenômeno multifatorial, e aspectos como concepções sobre a doença e seu controle, uso e acesso aos serviços de saúde, relacionamento profissional-paciente, suporte social, e ambiente, personalizam cada vivência com a doença, facilitando ou não a motivação para a mudança. Profissionais de saúde e poder público devem se sensibilizar para tais aspectos, e encontram no texto sugestões para contribuir na mitigação de dificuldades e facilitar um estilo de vida preventivo aos adoecidos.

Estilos de vida en pacientes con diabetes tipo ii que acuden al centro materno infantil "Enrique Ponce Luque", babahoyo, 2019 / The type ii diabetes patient's lifestyles that go to the maternal and infant center "Enrique Ponce Luque", Babahoyo, 2019

La Diabetes Mellitus es una enfermedad de gran importancia a nivel de Salud Pública en todo el mundo, por ser una de las enfermedades no transmisibles más frecuentes que representa una gran carga económica para los sistemas de salud y la economía mundial. Objetivo: Diagnosticar los estilos de vida en pacientes con Diabetes mellitus tipo II que acuden al Centro Materno Infantil Enrique Ponce Luque, Babahoyo 2019. Metodología: La investigación está en el paradigma cuantitativo, de modalidad de campo, de tipo descriptiva con un diseño transversal. Se aplicó como técnica una encuesta y el instrumento fue el cuestionario IMEVID. La población fue de 103 pacientes y la muestra 85 pacientes con diabetes mellitus tipo II que asistieron al Centro. Resultados: se evidenció un inadecuado manejo de la historia clínica y del registro de la información de salud, inadecuado procedimiento de evaluación del estado de salud y baja calidad de atención a los pacientes. Conclusión: De un total de 85 pacientes con diabetes mellitus tipo II se obtuvieron 32 pacientes que presentaron un estilo de vida desfavorable; 28 tuvieron un estilo de vida poco favorable y 25 presentaron un estilo de vida favorable con un 38%, 33%, 29% respectivamente. La finalidad de esta investigación es concientizar a la población de estudio para mejorar los estilos de vida y disminuir el desarrollo de esta patología(AU)

Diabetes Mellitus is a disease of great importance at the Public Health level throughout the world, because it is one of the most frequent non-communicable diseases and represents a great economic burden for health systems and the world economy. Objective: To diagnose the patient's lifestyles with type II Diabetes mellitus who attend the Maternal and Child Center Enrique Ponce Luque, Babahoyo 2019. Methodology: The research is in the quantitative paradigm, field modality, and descriptive type with a transversal design. A survey was applied as a technique and the instrument was the IMEVID questionnaire. The population was 103 patients and the sample was 85 patients with type II diabetes mellitus who attended the Center. Conclusion: From a total 85 type II diabetes mellitus patients, 32 patients were obtained who presented an unfavorable lifestyle; 28 had an unfavorable lifestyle and 25 had a favorable lifestyle with 38%, 33%, and 29% respectively. The purpose of this research is to raise awareness in the study population to improve lifestyles and reduce the development of this pathology(AU)

Effect of a 12-week endurance training program on force transfer and membrane integrity proteins in lean, obese, and type 2 diabetic subjects.

The mechanisms accounting for the loss of muscle function with obesity and type 2 diabetes are likely the result of a combination of neural and muscular factors. One muscular factor that is important, yet has received little attention, is the protein machinery involved in longitudinal and lateral force transmission. The purpose of this study was to compare the levels of force transfer and membrane integrity proteins before and after a 12-week endurance training program in lean, obese, and obese type 2 diabetic adults. Nineteen sedentary subjects (male = 8 and female = 11) were divided into three groups: Lean (n = 7; 50.3 ± 4.1 y; 69.1 ± 7.2 kg); Obese (n = 6; 49.8 ± 4.1 y; 92.9 ± 19.5 kg); and Obese with type 2 diabetes (n = 6; 51.5 ± 7.9 years; 88.9 ± 15.1 kg). Participants trained 150 min/week between 55% and 75% of VO2max for 12 weeks. Skeletal muscle biopsies were taken before and after the training intervention. Baseline dystrophin and muscle LIM protein levels were higher (~50% p < .01) in lean compared to obese and type 2 diabetic adults, while the protein levels of the remaining force transfer and membrane integrity proteins were similar between groups. After training, obese individuals decreased (-53%; p < .01) the levels of the muscle ankyrin repeat protein and lean individuals decreased dystrophin levels (-45%; p = .01), while the levels of the remaining force transfer and membrane integrity proteins were not affected by training. These results suggest that there are modest changes to force transfer and membrane integrity proteins in middle-aged individuals as a result of 12 weeks of lifestyle and training interventions.

Association of hypertension and dyslipidaemia with increasing obesity in patients with Type 2 Diabetes Mellitus

The study was performed to estimate the association of hypertension and dyslipidaemia with increasing body weight and obesity in Type II diabetics of Lahore, Pakistan. An observational study was conducted by enrolling 2708 obese diabetics from four diabetes care centres of Lahore, Pakistan. Data was collected for a period of 7 months. Associations were estimated using chi-square, binary and multinomial logistic regression. Data suggested that blood pressure, systolic and diastolic, exhibited continual increase with increasing body weight and obesity class in diabetes patients with 41.8% increase in the prevalence of hypertension in obesity class III subjects (OR; 1.91, p=0.02). Likewise, triglycerides and total cholesterol exhibited continual increase in their mean values with increasing obesity, i-e., an overall increase in the prevalence of dyslipidaemia of 27.2% in obesity class 3 subjects (OR; 1.94, p=0.29). Taken together, this data suggested that hypertension is potentially associated with increasing obesity in diabetics, while dyslipidaemia demonstrated plausible association only with obesity class 3.

Caracterização de usuários com diabetes tipo 2 cadastrados em uma estratégia de saúde da família / Characterization of diabetics type 2 users registered in a family health strategyof an undergraduate nursing student

Introdução: O Diabetes Mellitus (DM) é um problema de saúde pública relacionado a inúmeras condições adversas. Objetivo: Caracterizar indivíduos diabéticos tipo II cadastrados em uma Estratégia de Saúde da Família. Métodos: Estudo observacional de caráter transversal realizado, em visitas domiciliares, através da avaliação dos pés, da qualidade de vida, de variáveis sociodemográficas e clínicas, hábitos de vida e dos cálculos do Índice Tornozelo-Braço (ITB) e Risco Cardiovascular (RCV). Resultados: Amostra composta por 33 indivíduos com diabetes tipo 2, média etária de 62,94±11,43, a maioria acima do peso e com RCV aumentado. Não houve correlação entre ITB e RCV (p>0,05) e diferença para o valor do ITB em relação ao consumo de cigarros, bebida alcóolica e prática de atividade física (p>0,05). Conclusão: O acesso aos serviços da Atenção Básica facilita o controle do diabetes na população, mas atividades de promoção de saúde e prevenção secundária devem ser estimuladas.

Introduction: The Diabetes Mellitus (DM) is a public health problem related to numerous adverse conditions. Objective: To characterize type II diabetic patients registered in a Family Health Strategy. Methods: An observational cross-sectional study carried out during home visits, through the assessment of the feet, quality of life, socio-demographic and clinical variables, lifestyle and calculations of the ankle-brachial index (ABI) and Cardiovascular Risk (RCV). Results: The sample was composed of 33 individuals, aged 62,94±11,43, mostly overweight and with increased cardiovascular risk (CVR). There was no correlation between ABI and CVR (p> 0.05) and there was a difference between the ABI and cigarette consumption, alcohol consumption and physical activity (p> 0.05). Conclusion: The access to primary care services facilitates diabetes control in the population, however, health promotion activities and secondary prevention should be encouraged.

Effects of Cinnamomum cassia extract on oxidative stress, immunreactivity of iNOS and impaired thoracic aortic reactivity induced by type II diabetes in rats

Type II diabetes is known to cause neuropathy, nephropathy and retinopathy. However, cardiovascular disorders associated with diabetes have been ignored. In traditional medicine, cinnamon (Cinnamomum cassia) bark has been used for its abilities to relieve fever, inflammation and chronic bronchitis. In the present study, the effect of Cinnamomum cassia extract (CN) on the thoracic aorta in an experimental type II diabetes model was investigated. In rats administered with nicotinamide + streptozotocin, significant endothelial dysfunction and oxidative stress were characterised by increased inducible nitric oxide synthase (iNOS) and decreased insulin/proinsulin levels. This impairment was prevented by administering 1000 mg/kg metformin or 500-1000-1500 mg/kg CN. CN administration attenuated the inflammatory response by decreasing the levels of malondialdehyde (MDA), Nitric oxide (NO) and increasing Glutathione peroxidase (GPx), glutathione (GSH). In addition, CN administration was shown to cause down-regulating effects on iNOS in thoracic aorta. These findings reveal that CN could prevent chronic complications of experimentally induced type II diabetes by attenuating inflammation, oxidant/antioxidant imbalance, and normalised contraction and relaxion responses in the thoracic aorta.

Experiencias en el tratamiento con Heberprot-P® en pacientes con pie diabético / Experiences in the treatment with Heberprot-P® in patients with diabetic foot

Se realizó un estudio descriptivo, longitudinal y retrospectivo de 65 pacientes con pie diabético tratados con Heberprot-P®, en la consulta para tales fines, del Policlínico Docente 30 de Noviembre de Santiago de Cuba, en el período 2015-2016, con vistas a exponer la experiencia obtenida durante los 2 años de su aplicación. En la casuística predominaron los pacientes de 60-69 años y el sexo masculino, además de la hipertensión arterial, la obesidad y el hábito de fumar como factores de riesgo de mayor incidencia, así como el pie diabético neuroinfeccioso de grado 2, según la clasificación de Mc Cook. Finalmente, con la aplicación de este medicamento se logró el cierre total de la lesión en la mayoría de los afectados (76,9 por ciento) y no ocurrieron efectos adversos

A descriptive, longitudinal and retrospective study of 65 patients with diabetic foot treated with Heberprot-P®, in the service for such aims, of 30 de Noviembre Teaching Polyclinic was carried out in Santiago de Cuba, during 2015-2016, aimed at exposing the experience obtained during the 2 years of its use. Patients aged 60-69 and the male sex prevailed in the case material, besides hypertension, obesity and nicotine addiction as risk factors of higher incidence, as well as grade II neuroinfectious diabetic foot, according to Mc Cook classification. Finally, the total closing of the injury was achieved in most of those affected with the use of this medicine (76.9 percent) and there were not adverse effects

Two approaches, one problem: Cultural constructions of type II diabetes in an indigenous community in Yucatán, Mexico.

The emerging epidemic of obesity and type II diabetes in Mexico has recently propelled the nation into the public health spotlight. In the state of Yucatán, the experience of diabetes is greatly impacted by two cultural constructions of disease. In this setting, elements of Yucatec Mayan health practices as well as the biomedical model affect the approach to type II diabetes. Both frameworks offer unique understandings of the etiology of diabetes and recommend different ways to manage the condition. Based on in-depth and semi-structured interviews with both community members and clinicians, the present study seeks to understand how diabetes is understood and treated in indigenous settings in rural Yucatán. We explore the context in which community members navigate between locally available healthcare options, choose one over the other, or incorporate strategies from both into their diabetes care regimens. The tension between indigenous community members and their biomedical healthcare providers, the changing food environment of this community, and the persistence of traditional gender constructions affect the management of type II diabetes and its associated symptoms.