Efectos secundarios y prácticas para mejorar la gestión de la diabetes tipo 2 desde el punto de vista de la vivencia del individuo y de la gestión de la atención sanitaria. Revisión narrativa / Side effects and practices to improve management of type 2 diabetes mellitus from the viewpoint of patient experience and health care management. A narrative review

Introducción: El número de enfermos de diabetes tipo 2 está creciendo de forma alarmante. Este aumento está causando problemas personales, familiares, sociales, económicos y políticos. El objetivo de este artículo es revisar los efectos secundarios de los tratamientos, complicaciones que experimentan los pacientes y prácticas para mejorar la gestión de esta enfermedad desde el punto de vista de la vivencia del individuo y de la gestión de la atención sanitaria. Material y métodos: Se realizó una revisión narrativa de los estudios sobre la diabetes tipo 2 publicados en inglés y en español indexados en PubMed, Science Direct, Cinahl, MedLine, Psychology and Behavioral Sciences Collection y Google Académico. Se identificaron 1.118 artículos, de los cuales 42 se referían a los objetivos de la revisión y cumplían los criterios de inclusión. Resultados: Los efectos secundarios y complicaciones que experimentan los pacientes y la percepción de recibir escasa información repercuten en una falta de adherencia al tratamiento. Esto implica una disminución de la salud de los pacientes y un aumento de los costes sanitarios. Las propuestas de los estudios revisados encaminan las acciones para mejorar la adherencia al tratamiento y así mejorar la calidad de vida del paciente, disminuir los efectos secundarios, la mortalidad y, por tanto, los costes asociados a esta enfermedad a través de: 1) tener un acceso a la atención médica rápido y fácil, 2) una educación de calidad y 3) permitir que el paciente participe en las decisiones de su tratamiento y autogestione su enfermedad para realizar los mínimos cambios en su estilo de vida

Introduction: There is an alarming increase in the number of patients with type 2 diabetes mellitus. This increase is causing personal, family, social, economic, and political problems. The aim of this article is to review the side effects of treatments, the complications suffered by patients, and the practices to improve management of this disease from the viewpoint of the experience of patients and health care management. Material and methods: A narrative review was conducted of studies on type 2 diabetes mellitus published in English and Spanish indexed in PubMed, Science Direct, Cinahl, MedLine, Psychology and Behavioral Sciences Collection, and Google academic. A total of 1,118 articles were found, 42 of which referred to the objectives of the review and met the inclusion criteria. Results: The side effects and complications experienced by patients and their perception that they do not receive adequate information, together with poor satisfaction, lead to non-adherence to treatment, which impairs patient health and increases health care costs. The proposals in the reviewed studies guide the actions to improve treatment adherence and, thus, quality of life of patients, to decrease side effects and mortality and, therefore, the costs associated to type 2 diabetes mellitus through: 1) quick and easy access to medical care, 2) quality health education, and 3) participation of patients in the decisions about their treatment and in self-management of their disease to make minimum changes in their lifestyles

Side effects and practices to improve management of type 2 diabetes mellitus from the viewpoint of patient experience and health care management. A narrative review. / Efectos secundarios y prácticas para mejorar la gestión de la diabetes tipo 2 desde el punto de vista de la vivencia del individuo y de la gestión de la atención sanitaria. Revisión narrativa.

INTRODUCTION: There is an alarming increase in the number of patients with type 2 diabetes mellitus. This increase is causing personal, family, social, economic, and political problems. The aim of this article is to review the side effects of treatments, the complications suffered by patients, and the practices to improve management of this disease from the viewpoint of the experience of patients and health care management. MATERIAL AND METHODS: A narrative review was conducted of studies on type 2 diabetes mellitus published in English and Spanish indexed in PubMed, Science Direct, Cinahl, MedLine, Psychology and Behavioral Sciences Collection, and Google academic. A total of 1,118 articles were found, 42 of which referred to the objectives of the review and met the inclusion criteria. RESULTS: The side effects and complications experienced by patients and their perception that they do not receive adequate information, together with poor satisfaction, lead to non-adherence to treatment, which impairs patient health and increases health care costs. The proposals in the reviewed studies guide the actions to improve treatment adherence and, thus, quality of life of patients, to decrease side effects and mortality and, therefore, the costs associated to type 2 diabetes mellitus through: 1) quick and easy access to medical care, 2) quality health education, and 3) participation of patients in the decisions about their treatment and in self-management of their disease to make minimum changes in their lifestyles.

Body weight increase in expectant males and helpers of cotton-top tamarin (Saguinus oedipus): a symptom of the Couvade syndrome?

In the cooperative breeding system of cotton-top tamarin (TCB; Saguinus oedipus) <> males gain weight during the last months of pregnancy of their partners as a way to cope with energy costs of reproduction. This phenomenon was described only in humans as a symptom of <>. As after infants' birth, TCB male and female helpers lose weight, the same as fathers do, it might be expected that previously, they also gain weight. In 8 groups of TCB, we explored body weight changes of the three categories of individuals, in periods of six months, under three different reproductive conditions: control (no pregnancy and without offspring), pregnancy (pregnancy and without offspring), and raising (with offspring). We found that across pregnancy, TCBs increase their weight in the last trimester of that period while across breeding TCBs reduce their weight in the first trimester. Expectant males and also helpers could be preparing during pregnancy in relation to the weight losses they experience when raising their young.

Body weight increase in expectant males and helpers of cotton-top tamarin (Saguinus oedipus): A sympton of the Couvade syndrome? / Aumento de peso corporal en machos expectantes y cooperantes de tití de cabeza blanca (Saguinus oedipus): ¿un síntoma del Síndrome de Couvade?

In the cooperative breeding system of cotton-top tamarin (TCB; Saguinus oedipus) «expectant» males gain weight during the last months of pregnancy of their partners as a way to cope with energy costs of reproduction. This phenomenon was described only in humans as a symptom of «Couvade syndrome». As after infants’ birth, TCB male and female helpers lose weight, the same as fathers do, it might be expected that previously, they also gain weight. In 8 groups of TCB, we explored body weight changes of the three categories of individuals, in periods of six months, under three different reproductive conditions: control (no pregnancy and without offspring), pregnancy (pregnancy and without offspring), and raising (with offspring). We found that across pregnancy, TCBs increase their weight in the last trimester of that period while across breeding TCBs reduce their weight in the first trimester. Expectant males and also helpers could be preparing during pregnancy in relation to the weight losses they experience when raising their young

En el sistema de crianza cooperativa del tití de cabeza blanca (TCB; Saguinus oedipus) los machos «expectantes» aumentan de peso durante los últimos meses de la preñez de sus parejas como una forma de enfrentarse a los costos energéticos de la reproducción. Este fenómeno se había descrito únicamente en humanos como un síntoma del «síndrome Couvade». Puesto que los cooperantes macho y hembra de TCB asumen costos reproductivos, cabría esperar que previamente también ellos aumentaran de peso. Hemos explorado en 8 grupos de TCB el cambio de peso de las tres categorías de individuos, en períodos de seis meses en tres condiciones reproductoras diferentes: control (sin preñez y sin crías), preñez (preñez y sin crías) y crianza (con crías). Hemos encontrado que durante la preñez los tamarines aumentan de peso en el último trimestre de ese período, mientras que en la crianza reducen su peso en el primer trimestre. Los machos expectantes y también los cooperantes podrían prepararse durante la preñez en relación a las pérdidas de peso que experimentan durante la crianza