Assessment of obesity stigma and discrimination among Spanish subjects with a wide weight range: the OBESTIGMA study.

Introduction: This study aims to assess the extent of rejection and instances of stigmatization linked to obesity within the Spanish population, encompassing a diverse spectrum of weights ranging from normal weight to morbid obesity. Additionally, the study seeks to identify the primary factors influencing these experiences and further examines the impact of bariatric surgery on such dynamics. Materials and methods: Multicenter observational study with involving a total of 1,018 participants who were recruited from various Obesity Units. Negatives attitudes towards people with obesity were assessed through three questionnaires: (i) Antifat Attitudes Scale (AFA), (ii) Stigmatizing Situations Inventory (SSI) and (iii) Weight Bias Internalization Scale (WBIS). Subjects were categorized into four groups based on their BMI and history of prior bariatric surgery. Results: The cumulative score across all questionnaires (AFA, SSI and WBIS) exhibited a progressive increase, from participants with normal weight to those with obesity (p < 0.001 for all). Within the AFA questionnaire, males showed more rejection towards people with obesity than women, also perceiving obesity as a disease linked to a lack of willpower (p = 0.004 and p = 0.030, respectively). The overall SSI score was negatively associated with age (r = -0.080, p = 0.011), with young participants encountering more stigmatizing experiences than their adult counterparts. Neither employment status nor educational demonstrated a significant association with any of the questionnaires. Interestingly, patients who underwent lost weight following bariatric surgery did not exhibit improved outcomes. Conclusion: Individuals with obesity demonstrate a heightened level of aversion towards the disease compared to those with normal weight. Concurrently, the incidence of stigmatizing encounters displays a concerning escalation among younger individuals.

A real-life study of the medium to long-term effectiveness of a hypercaloric, hyperproteic enteral nutrition formula specifically for patients with diabetes on biochemical parameters of metabolic control and nutritional status.

INTRODUCTION: Although current recommendations suggest the use of specific formulas in enteral nutrition in people with diabetes, there is little evidence of their long-term effectiveness in glycemic control. The main objective of this study is to evaluate the long-term efficacy (24 weeks) of a specific high-protein hypercaloric enteral nutrition formula for people with diabetes in glycemic control and in their improvement in nutritional status. METHODOLOGY: This was a multicenter, prospective, observational, real-life study of patients with long-term enteral nutrition prescription through gastrostomy or nasogastric tube who received a high protein hypercaloric formula specific for diabetes. Once the participant's informed consent was obtained and the inclusion and exclusion criteria were verified, data relating to glycemic control, inflammation parameters, biochemical data, nutritional status and gastrointestinal tolerance at 0, 12 and 24 weeks were collected. RESULTS: 112 patients were recruited, 44.6% women, age 75.0 (12.0) years and a mean time of evolution of diabetes of 18.1 (9.5) years. The percentage of patients with malnutrition according to VGS decreased throughout the treatment from 78.6% to 29.9% (p < 0.001). Glycemic and HbA1c levels were significantly reduced at 12 and 24 weeks (Blood glucose 155.9-139.0-133.9 mg/dl, p < 0.001; HbA1c 7.7-7.3-7.1%, p < 0.001) while no significant changes were observed in cholesterol, triglycerides, creatinine, or glomerular filtration. A significant increase in variables related to nutritional status was observed: weight, the BMI, albumin, prealbumin and transferrin, and CRP levels were significantly reduced and the CRP/Albumin ratio decreased. Gastrointestinal tolerance was good, the number of patients with moderate-severe symptoms was small, and did not change throughout the follow-up. CONCLUSION: Our real-life study suggests that the use of a specific hyperprotein hypercaloric formula for diabetes during a 6-month nutritional treatment allows adequate glycemic control and nutritional evolution, with good gastrointestinal tolerance.

Effectiveness and safety of dapagliflozin in real-life patients: data from the DAPA-RWE Spanish multicentre study.

BACKGROUND: This study aims to evaluate dapagliflozin in patients with type 2 diabetes (T2D) in clinical practice in Spain. METHODS: This is a retrospective study including adults with T2D under stable antidiabetic therapy, with either dapagliflozin or sitagliptin ≥6 months, before inclusion. Data about the effectiveness and safety of dapagliflozin are presented. RESULTS: A total of 594 patients (61.8±9.9 years, 21.7% cardiovascular disease) were included. After 6 months, HbA1c, weight, blood pressure, urine albumin-to-creatinine ratio and uric acid significantly decreased (1.63%, 2.88 kg, 4.82/2.70 mmHg, -17.38 mg/g and -0.30 mg/dL, respectively), whereas glomerular filtration rate and haematocrit significantly increased (3.72 mL/min/1.73 m2 and 1.8%, respectively). No cases of hypoglycaemia, diabetic ketoacidosis, Fournier gangrene, fractures or amputations were reported. CONCLUSION: Thus, dapagliflozin provides a comprehensive cardiometabolic protection in patients with T2D.

A real-life study of the medium to long-term effectiveness of a hypercaloric, hyperproteic enteral nutrition formula specifically for patients with diabetes on biochemical parameters of metabolic control and nutritional status. / Estudio en vida real de la efectividad a medio-largo plazo en parámetros bioquímicos de control metabólico y estado nutricional de una fórmula de nutrición enteral hipercalórica hiperproteica específica para pacientes con diabetes.

INTRODUCTION: Although current recommendations suggest the use of specific formulas in enteral nutrition in people with diabetes, there is little evidence of their long-term effectiveness in glycemic control. The main objective of this study is to evaluate the long-term efficacy (24 weeks) of a specific high-protein hypercaloric enteral nutrition formula for people with diabetes in glycemic control and in their improvement in nutritional status. METHODOLOGY: This was a multicenter, prospective, observational, real-life study of patients with long-term enteral nutrition prescription through gastrostomy or nasogastric tube who received a high protein hypercaloric formula specific for diabetes. Once the participant's informed consent was obtained and the inclusion and exclusion criteria were verified, data relating to glycemic control, inflammation parameters, biochemical data, nutritional status and gastrointestinal tolerance at 0, 12 and 24 weeks were collected. RESULTS: 112 patients were recruited, 44.6% women, age 75.0 (12.0) years and a mean time of evolution of diabetes of 18.1 (9.5) years. The percentage of patients with malnutrition according to VGS decreased throughout the treatment from 78.6% to 29.9% (P<.001). Glycemic and HbA1c levels were significantly reduced at 12 and 24 weeks (Blood glucose 155.9-139.0-133.9mg/dl, P<.001; HbA1c 7.7-7.3-7.1%, P<.001) while no significant changes were observed in cholesterol, triglycerides, creatinine, or glomerular filtration. A significant increase in variables related to nutritional status was observed: weight, the BMI, albumin, prealbumin and transferrin, and CRP levels were significantly reduced and the CRP / Albumin ratio decreased. Gastrointestinal tolerance was good, the number of patients with moderate-severe symptoms was small, and did not change throughout the follow-up. CONCLUSION: Our real-life study suggests that the use of a specific hyperprotein hypercaloric formula for diabetes during a 6-month nutritional treatment allows adequate glycemic control and nutritional evolution, with good gastrointestinal tolerance.

[Recommendations for clinical practice in diabetes and obesity. The Madrid Agreements. Document agreed by the working groups of the scientific societies: SENDIMAD, SOMAMFYC, SEMG Madrid, SEMERGEN Madrid and RedGDPS]. / Recomendaciones para la práctica clínica en diabetes y obesidad. Los acuerdos de Madrid. Documento consensuado por los grupos de trabajo de las sociedades científicas: SENDIMAD, SOMAMFYC, SEMG Madrid, SEMERGEN Madrid y RedGDPS.

The increase in the prevalence of type 2 diabetes and the worldwide expansion of overweight and obesity are intrinsically linked. The percentage of diabetes attributable to weight gain amounts to more than 80% in many countries. This relationship is addressed in a Spanish Consensus Document from SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN and SEMFYC published in 2015 and which gathers best available evidences. Based on the statements of this consensus document, we propose five recommendations for clinical practice to establish a diagnosis of precision and the most appropriate treatment for joint diabetes and obesity. These recommendations have been agreed by the SENDIMAD, SOMAMFYC, SEMG Madrid and RedGDPS Working Groups: 1. For every patient with diabetes and obesity, in addition to the calculation of the body mass index, the percentage of body fat and the approximation to the assessment of body composition should be evaluated throughout the whole process (both at the beginning and follow up). 2. The approximation to the degree and distribution of body fat requires the measurement and recording of the waist circumference of these patients. 3. The integrated assessment of the patient with type 2 diabetes-obesity requires the evaluation of the degree of physical activity and/or characterization of the sedentary condition. 4. The prescription of lifestyle changes should be incorporated into therapeutic education (individualized, flexible, autonomous and sustainable diet and physical activity plan. 5. The pharmacological approach in the treatment of type 2 diabetes-obesity implies the choice of anti-diabetic drugs that facilitate the loss of fat.

El aumento en la prevalencia de diabetes tipo 2 y la expansión a nivel mundial de los estados de sobrepeso y obesidad están intrínsecamente vinculados, de forma que el porcentaje de diabetes atribuible al aumento de peso llega a ser superior al 80% en muchos países. En 2015 se publica un Documento de Consenso español de SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN y SEMFYC que aborda esta doble condición de acuerdo con las mejores evidencias. Desde las afirmaciones de dicho consenso proponemos cinco recomendaciones para la práctica clínica consensuadas por los Grupos de trabajo de SENDIMAD, SOMAMFYC, SEMG Madrid y RedGDPS, con el fin de establecer un diagnóstico de precisión y el tratamiento más adecuado:1. En todo paciente con diabetes y obesidad debe abordarse, tanto al inicio como en el seguimiento, además del cálculo del índice de masa corporal (IMC), el porcentaje de grasa corporal y la valoración de la composición corporal.2. La aproximación al grado y distribución de la grasa corporal requiere incluir la medición y registro del perímetro de cintura de estos pacientes.3. La valoración integral del paciente con diabetes tipo 2-obesidad exige la evaluación del grado de actividad física y/o caracterizar la condición de sedentarismo.4. La prescripción de cambios del estilo de vida debe ser incorporada a la educación terapéutica (plan dietético y de actividad física individualizado, flexible, autónomo y sostenible).5. El abordaje farmacológico en el tratamiento de la diabetes-obesidad implica la elección de fármacos antidiabéticos que faciliten la pérdida de grasa.

Recomendaciones para la práctica clínica en diabetes y obesidad. los acuerdos de madrid. documento consensuado por los grupos de trabajo de las sociedades científicas: sendimad, somamfyc, semg madrid, semergen madrid y redgdps / Recommendations for clinical practice in diabetes and obesity. The Madrid Agreements. Document agreed by the working groups of the scientific societies: SENDIMAD, SOMAMFYC, SEMG Madrid, SEMERGEN Madrid and RedGDPS

El aumento en la prevalencia de diabetes tipo 2 y la expansión a nivel mundial de los estados de sobrepeso y obesidad están intrínsecamente vinculados, de forma que el porcentaje de diabetes atribuible al aumento de peso llega a ser superior al 80% en muchos países. En 2015 se publica un Documento de Consenso español de SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN y SEMFYC que aborda esta doble condición de acuerdo con las mejores evidencias. Desde las afirmaciones de dicho consenso proponemos cinco recomendaciones para la práctica clínica consensuadas por los Grupos de trabajo de SENDIMAD, SOMAMFYC, SEMG Madrid y RedGDPS, con el fi n de establecer un diagnóstico de precisión y el tratamiento más adecuado: 1. En todo paciente con diabetes y obesidad debe abordarse, tanto al inicio como en el seguimiento, además del cálculo del índice de masa corporal (IMC), el porcentaje de grasa corporal y la valoración de la composición corporal. 2. La aproximación al grado y distribución de la grasa corporal requiere incluir la medición y registro del perímetro de cintura de estos pacientes. 3. La valoración integral del paciente con diabetes tipo 2-obesidad exige la evaluación del grado de actividad física y/o caracterizar la condición de sedentarismo. 4. La prescripción de cambios del estilo de vida debe ser incorporada a la educación terapéutica (plan dietético y de actividad física individualizado, flexible, autónomo y sostenible). 5. El abordaje farmacológico en el tratamiento de la diabetes-obesidad implica la elección de fármacos antidiabéticos que faciliten la pérdida de grasa

The increase in the prevalence of type 2 diabetes and the worldwide expansion of overweight and obesity are intrinsically linked. The percentage of diabetes attributable to weight gain amounts to more than 80% in many countries. This relationship is addressed in a Spanish Consensus Document from SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN and SEMFYC published in 2015 and which gathers best available evidences. Based on the statements of this consensus document, we propose five recommendations for clinical practice to establish a diagnosis of precision and the most appropriate treatment for joint diabetes and obesity. These recommendations have been agreed by the SENDIMAD, SOMAMFYC, SEMG Madrid and RedGDPS Working Groups: 1. For every patient with diabetes and obesity, in addition to the calculation of the body mass index, the percentage of body fat and the approximation to the assessment of body composition should be evaluated throughout the whole process (both at the beginning and follow up). 2. The approximation to the degree and distribution of body fat requires the measurement and recording of the waist circumference of these patients. 3. The integrated assessment of the patient with type 2 diabetes-obesity requires the evaluation of the degree of physical activity and/or characterization of the sedentary condition. 4. The prescription of lifestyle changes should be incorporated into therapeutic education (individualized, fl exible, autonomous and sustainable diet and physical activity plan. 5. The pharmacological approach in the treatment of type 2 diabetes-obesity implies the choice of anti-diabetic drugs that facilitate the loss of fat

Pseudohipoparatiroidismo 1b de diagnóstico tardío / Late diagnosis of 1b pseudohypoparathyroidism

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Comentarios a «Hipercarotinemia tras cirugía bariátrica» / Comments on «Hipercarotinemia after bariatric surgery»

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Hipercarotinemia tras cirugía bariátrica / Hypercarotinemia after bariatric surgery

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The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance.

BACKGROUND: Puberty can affect vitamin D levels. OBJECTIVES: The goal of this study was to analyze the relation between vitamin D deficiency and puberty in obese Spanish children, along with the possible interrelation between vitamin D status and degree of insulin resistance. METHODS: A cross-sectional study was carried out, in which clinical and biochemical data were gathered from 120 obese and 50 normal weight children between January 2011 and January 2013. RESULTS: Mean vitamin D levels were 19.5 and 31.6 ng/mL in obese pubertal and obese prepubertal children, respectively. About 75% of the obese pubertal subjects and 46% of the obese prepubertal subjects had vitamin D deficiency. Vitamin D levels were significantly lower in pubescent subjects compared with pre-pubescent subjects in summer, fall, and winter. There was no apparent relation between vitamin D levels and homeostasis model assessment index for insulin resistence (expressed in standard deviation score for sex and Tanner stage) in either puberty or pre-puberty. CONCLUSION: Puberty may be a risk factor for the vitamin D deficiency commonly found in the obese child population. This deficiency is not associated with higher insulin resistance in obese pubertal children compared with obese prepubertal children.