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1.
Sci Rep ; 12(1): 15713, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127362

RESUMO

Although speech declines rapidly in some individuals with amyotrophic lateral sclerosis (ALS), longitudinal changes in speech have rarely been characterized. The study objectives were to model the rate of decline in speaking rate and speech intelligibility as a function of disease onset site, sex, and age at onset in 166 individuals with ALS; and estimate time to speech loss from symptom onset. We also examined the association between clinical (speaking rate/intelligibility) measures and patient-reported measures of ALS progression (ALSFRS-R). Speech measures declined faster in the bulbar-onset group than in the spinal-onset group. The rate of decline was not significantly affected by sex and age. Functional speech was still maintained at 60 months since disease onset for most patients with spinal onset. However, the time to speech loss was 23 months based on speaking rate < 120 (w/m) and 32 months based on speech intelligibility < 85% in individuals with ALS-bulbar onset. Speech measures were more responsive to functional decline than were the patient-reported measures. The findings of this study will inform future work directed toward improving speech prognosis in ALS, which is critical for determining the appropriate timing of interventions, providing appropriate counseling for patients, and evaluating functional changes during clinical trials.


Assuntos
Esclerose Amiotrófica Lateral , Humanos , Prognóstico , Distúrbios da Fala/etiologia , Inteligibilidade da Fala
2.
Front Neurol ; 13: 890425, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36061999

RESUMO

Neuroimaging assessment of motor neuron disease has turned into a cornerstone of its clinical workup. Amyotrophic lateral sclerosis (ALS), as a paradigmatic motor neuron disease, has been extensively studied by advanced neuroimaging methods, including molecular imaging by MRI and PET, furthering finer and more specific details of the cascade of ALS neurodegeneration and symptoms, facilitated by multicentric studies implementing novel methodologies. With an increase in multimodal neuroimaging data on ALS and an exponential improvement in neuroimaging technology, the need for harmonization of protocols and integration of their respective findings into a consistent model becomes mandatory. Integration of multimodal data into a model of a continuing cascade of functional loss also calls for the best attempt to correlate the different molecular imaging measurements as performed at the shortest inter-modality time intervals possible. As outlined in this perspective article, simultaneous PET/MRI, nowadays available at many neuroimaging research sites, offers the perspective of a one-stop shop for reproducible imaging biomarkers on neuronal damage and has the potential to become the new gold standard for characterizing motor neuron disease from the clinico-radiological and neuroscientific perspectives.

3.
J Assoc Physicians India ; 70(8): 11-12, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36082727

RESUMO

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) has become a leading cause of liver disease worldwide. The prevalence of NAFLD varies depending on population studied and type of diagnostic tools used to screen or diagnose the patients. There is a strong relationship between metabolic syndrome components and NAFLD prevalence. This study aims to understand the prevalence of NAFLD along with the associated risk factors and their interaction with other comorbidities among people living with diabetes in Indian context. MATERIALS AND METHODS: It is a retrospective, observational study based on data retrieved from electronic medical records (EMRs) of people living with diabetes from more than 250 individual diabetes centers located in more than 30 cities across 14 states in India. Medical records of 171,996 adults living with diabetes were included in the analysis. The assessment of prevalence of NAFLD in diabetes was done using algorithm based on alanine transaminase (ALT) and aspartate aminotransferase (AST). RESULTS: Overall, 44.48% of people living with diabetes were found to have NAFLD. A significantly higher proportion of males (58.64%) had NAFLD compared to females (36.91%) (p<0.001). Nonalcoholic fatty liver disease prevalence was >50% in seven of the states. People living with diabetes along with dyslipidemia and hypertension had a significantly higher prevalence of NAFLD (p<0.001). Obesity (57.1%), dyslipidemia (59.1%), and hypertriglyceridemia (42.3%) had significantly higher odds of NAFLD among people living with diabetes. CONCLUSION: This study highlighted high-risk categories for NAFLD in diabetes, like young, obese, hypertriglyceridemia, poor glycemic control, etc. This information will help health care providers in prioritizing screening among high-risk diabetes population.


Assuntos
Diabetes Mellitus , Dislipidemias , Hipertrigliceridemia , Hepatopatia Gordurosa não Alcoólica , Adulto , Alanina Transaminase , Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Dislipidemias/complicações , Registros Eletrônicos de Saúde , Feminino , Humanos , Índia/epidemiologia , Masculino , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/complicações , Prevalência , Estudos Retrospectivos , Fatores de Risco
4.
Diabetes Ther ; 13(10): 1707-1714, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36028596
5.
Diabetes Ther ; 13(10): 1723-1736, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36030317

RESUMO

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, has been shown to disrupt many organ systems in the human body. Though several medical disorders have been affected by this infection, a few illnesses in addition may also play a role in determining the outcome of COVID-19. Obesity is one such disease which is not only affected by the occurrence of COVID-19 but can also result in a worse clinical outcome of COVID-19 infection. This manuscript summarizes the most recent evidence supporting the bidirectional impact of COVID-19 and obesity. It highlights how the presence of obesity can be detrimental to the outcome of COVID-19 in a given patient because of the mechanical limitations in lung compliance and also by the activation of several thrombo-inflammatory pathways. The sociodemographic changes brought about by the pandemic in turn have facilitated the already increasing prevalence of obesity. This manuscript highlights the importance of recognizing these pathways which may further help in policy changes that facilitate appropriate measures to prevent the further worsening of these two pandemics.

6.
touchREV Endocrinol ; 18(1): 63-70, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35949363

RESUMO

Background: Indian patients with type 2 diabetes mellitus (T2D) constitute one-sixth of affected adults globally. Here, we evaluate the association of body mass index (BMI) with body fat percentage (BF%) and glycated haemoglobin (HbA1c) levels among patients with T2D in India. Method: This was a cross-sectional Indian registry study across 845 geographically diverse zones between December 2017 and August 2019. Results: Of 37,927 patients, 55.6% were men, with a mean ± standard deviation age of 54.2 ± 11.5 years and HbA1c of 8.3 ± 1.71%. Mean ± standard deviation BMI and BF% were 27.0 ± 4.6 kg/m2 and 32.0 ± 8.0%, respectively. Overall, 15.4% of patients were overweight, and 25.0% were obese. Despite fewer males (20.7%) having BMI-based obesity than females (31.2%), around three-quarters of both sexes had BF%-defined obesity (males 77.2%; females 71.2%). One-third of males (34.6%) and 41.9% of females had BF%-defined obesity despite normal BMI. The association was substantiated by a moderately significant correlation (r=0.51) between BMI and BF% in the overall population (p<0.0001). Conclusion: This pan-India registry presents a real-world reflection of the Asian Indian phenotype: high BF% despite lower BMI in people with T2D. This highlights the importance of primordial and primary prevention, and may guide decisions on the choice of agents for glycaemic control, with a preference for drugs that promote weight loss or are weight neutral.

7.
Artigo em Inglês | MEDLINE | ID: mdl-35960891

RESUMO

Objective: To estimate the prevalence and predictors of metabolic syndrome among substance users in North India.Methods: A total of 302 participants with a history of substance use (per ICD-10 code) visiting either medicine or psychiatry outpatient departments and referred to a deaddiction center in the psychiatry department of a tertiary care hospital were enrolled. The cross-sectional study was conducted over 6 months between September 2019 and February 2020. Information regarding sociodemographic profiles was collected. Weight, height, waist circumference, hip circumference, and blood pressure were measured. A fasting venous blood sample was collected to measure blood glucose; triglycerides; high-density, low-density (LDL), and very low-density lipoprotein (VLDL) levels; and other blood parameters. The International Diabetes Federation criterion was used to define metabolic syndrome. Descriptive analysis was performed, and multiple logistic regression was used.Results: The mean ± SD age of the study participants was 37.1 ± 11.4 years, and the majority were males (n = 299, 99.0%). The prevalence of metabolic syndrome among substance users was 16.9% (n = 51). Mean age, age of initiation, weight, body mass index (BMI), hip circumference, total cholesterol, LDL, and VLDL were significantly higher (all P < .05) among study participants with metabolic syndrome than among those without. On multivariable regression analysis, professional employment, high BMI, high hip circumference, and elevated VLDL were predictors of metabolic syndrome among substance users.Conclusions: Coexisting substance use and metabolic syndrome is a public health concern considering the large number of people who are substance users. It is essential to screen such patients regularly for cardio-vasculo-metabolic disorders to prevent further morbidity and mortality.


Assuntos
Síndrome Metabólica , Transtornos Relacionados ao Uso de Substâncias , Adulto , Glicemia/metabolismo , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
8.
Adv Ther ; 39(9): 4094-4113, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35788961

RESUMO

INTRODUCTION: Sarcopenic obesity (SO) represents the confluence of two epidemics-an aging population and an increasing rate of obesity. The two diseases may act synergistically, and SO may significantly affect morbidity and mortality. However, the burden is not defined to drive the policy changes. Hence the present study was done to estimate the prevalence and predictors of SO in India. METHODS: We did a secondary data analysis of the 72,250 older adults who participated in the first wave of the Longitudinal Aging Study in India (2017-18). Possible sarcopenia was defined as per the guidelines by the Asian Working Group for Sarcopenia (AWGS) criteria. The modified criterion of overweight and obesity for Asian adults was used to categorize obesity. Presence of both sarcopenia and obesity depicted SO. Weighted analysis was done to estimate the prevalence of SO, and multinomial bivariate logistics regression was used to identify the predictors of SO. RESULTS: The overall prevalence of obesity, sarcopenia, and SO was 27.1%, 41.9%, and 8.7%, respectively. The mean age, weight, body mass index (BMI), and blood pressure of adults with SO were significantly higher compared to others. Higher age, urban residence, west and south regions of India, consumption of tobacco or alcohol, no physical activity, and presence of diabetes contribute to SO. CONCLUSION: The burden of SO seems to be less but amounts to a massive number in an aging country. We stress increased screening of the geriatric age group and advocate increased physical activity and dietary modifications to realize the concept of healthy aging.


Assuntos
Sarcopenia , Idoso , Envelhecimento/fisiologia , Índice de Massa Corporal , Análise de Dados , Humanos , Obesidade/complicações , Prevalência , Sarcopenia/epidemiologia
9.
Osteoporos Sarcopenia ; 8(2): 35-57, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35832416

RESUMO

The South Asian population is rapidly ageing and sarcopenia is likely to become a huge burden in this region if proper action is not taken in time. Several sarcopenia guidelines are available, from the western world and from East Asia. However, these guidelines are not fully relevant for the South Asian healthcare ecosystem. South Asia is ethnically, culturally, and phenotypically unique. Additionally, the region is seeing an increase in non-communicable lifestyle disease and obesity. Both these conditions can lead to sarcopenia. However, secondary sarcopenia and sarcopenic obesity are either not dealt with in detail or are missing in other guidelines. Hence, we present a consensus on the screening, diagnosis and management of sarcopenia, which addresses the gaps in the current guidelines. This South Asian consensus gives equal importance to muscle function, muscle strength, and muscle mass; provides cost-effective clinical and easy to implement solutions; highlights secondary sarcopenia and sarcopenic obesity; lists commonly used biomarkers; reminds us that osteo-arthro-muscular triad should be seen as a single entity to address sarcopenia; stresses on prevention over treatment; and prioritizes non-pharmacological over pharmacological management. As literature is scarce from this region, the authors call for more South Asian research guided interventions.

10.
Int J Mol Sci ; 23(13)2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35806331

RESUMO

Coronavirus disease 2019 (COVID-19) is a highly heterogeneous disease regarding severity, vulnerability to infection due to comorbidities, and treatment approaches. The hypothalamic-pituitary-adrenal (HPA) axis has been identified as one of the most critical endocrine targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that might significantly impact outcomes after infection. Herein we review the rationale for glucocorticoid use in the setting of COVID-19 and emphasize the need to have a low index of suspicion for glucocorticoid-induced adrenal insufficiency, adjusting for the glucocorticoid formulation used, dose, treatment duration, and underlying health problems. We also address several additional mechanisms that may cause HPA axis dysfunction, including critical illness-related corticosteroid insufficiency, the direct cytopathic impacts of SARS-CoV-2 infection on the adrenals, pituitary, and hypothalamus, immune-mediated inflammations, small vessel vasculitis, microthrombotic events, the resistance of cortisol receptors, and impaired post-receptor signaling, as well as the dissociation of ACTH and cortisol regulation. We also discuss the increased risk of infection and more severe illness in COVID-19 patients with pre-existing disorders of the HPA axis, from insufficiency to excess. These insights into the complex regulation of the HPA axis reveal how well the body performs in its adaptive survival mechanism during a severe infection, such as SARS-CoV-2, and how many parameters might disbalance the outcomes of this adaptation.


Assuntos
COVID-19 , Sistema Hipófise-Suprarrenal , Glucocorticoides/uso terapêutico , Humanos , Hidrocortisona , Sistema Hipotálamo-Hipofisário , SARS-CoV-2
11.
Rev Diabet Stud ; 18(2): 100-134, 2022 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-35831938

RESUMO

The elderly population with diabetes is diverse with the majority experiencing a decline in physical and mental capabilities, impacting the entire diabetes management process. Therefore, a need for geriatric-specific guidelines, especially for the Asian population, was identified and subsequently developed by an expert panel across government and private institutions from several Asian countries. The panel considered clinical evidence (landmark trials, position papers, expert opinions), recommendations from several important societies along with their decades of clinical experience and expertise, while meticulously devising thorough geriatric-specific tailored management strategies. The creation of the ABCDE best practices document underscores and explores the gaps and challenges and determines optimal methods for diabetes management of the elderly population in the Asian region.


Assuntos
Diabetes Mellitus , Idoso , Ásia/epidemiologia , Diabetes Mellitus/terapia , Humanos
12.
Indian J Endocrinol Metab ; 26(2): 106-110, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35873934

RESUMO

Diabetes is a global public health concern. Vigilant monitoring and effective management of glycaemic variations are essential to prevent complications of diabetes. Effectively incorporating monitoring strategies in management of diabetes is a serious challenge. Patient-centered approach is necessary to customise monitoring and therapy of diabetes. This has been made possible by integrating technology with personalised therapeutic strategy. The integrated personalised diabetes management (iPDM) is a holistic, patient-centered approach that focuses on personalising diabetes management to streamline therapy and improve outcome. iPDM helps strengthen the care process, facilitates communication between patients and their healthcare team, and integrates digital tools that visualise and analyse data. The five E's which includes enthusiasm, education, expertise, empathy and engagement are the key pillars of a strong foundation for the iPDM model. iPDM model is a convenient and easily accessible tool that shifts the management paradigm from an "algorithmic" to "personalized" care to optimise treatment outcomes. Structured self-monitoring of blood glucose (SMBG) should be available as part of the self-management process for people with sub-optimally controlled type 2 diabetes, including those not on insulin therapies. Different SMBG regimens should be followed based on factors such as diabetes type, treatment approach (diet, oral antidiabetic medication, or insulin), glycaemic control, available resources, and patient's level of education.

13.
Indian J Endocrinol Metab ; 26(2): 98-105, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35873937

RESUMO

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have gained an important place in the management of diabetes management because of their exceptional glucose-lowering, weight lowering and cardiovascular (CV) benefits. Despite recommendations by various clinical practice guidelines and benefits, their usage in clinical practice was limited because of being injectable in nature. Oral semaglutide is a novel GLP-1RA with 94% homology to human GLP-1 which is co-formulated with absorption enhancer sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC), that overcomes the challenges of peptide absorption in the acidic conditions of the stomach. Oral semaglutide has been evaluated in an extensive phase 3 clinical trial programme named Peptide Innovation for Early Diabetes Treatment (PIONEER) which demonstrated its robust glucose and weight lowering effects against other comparators. The evolution of the GLP-1RA class to include an oral pill will facilitate the use of this class of agents much earlier in the diabetes treatment cascade owing to wider acceptance from patients and clinicians alike. The current review discusses the various aspects of oral semaglutide and its place in clinical practice.

14.
Diabetes Metab Syndr ; 16(8): 102528, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35863268

RESUMO

BACKGROUND AND AIMS: The rapid increase in burden of type 2 diabetes mellitus (T2DM), poses a huge medico-economic challenge, especially when the cost of care is funded by out-of-pocket expenses. The aim of this review is to highlight various issues associated with rising cost of insulin, prevalence of cost-related insulin underuse, insulin related cost-saving behaviors, and viable solutions for the benefit of patients with T2DM receiving insulin. METHODS: Electronic databases (PubMed and Google Scholar) from 2000 to 2020 were searched using the key terms uncontrolled diabetes mellitus, insulin therapy, glycemic control, direct cost, indirect cost, out-of-pocket expenses, cost-related insulin underuse, cost-saving behaviors, and biosimilar insulin in developed countries and India. RESULTS: In majority of the patients with T2DM on monotherapy, addition of another oral antidiabetic agent is required. Despite these measures, the target glycemic goals are not achieved in majority of the patients resulting in various complications. These complications can be prevented and target glycemic goals can be achieved with early initiation of insulin therapy. However, rising cost is a major deterrent to the lifelong use of insulin. This results in non-compliance and further deterioration of glycemic control. Recently, biosimilar insulins have revolutionized the management of T2DM and look promising from the economic point of view. CONCLUSIONS: Biosimilar insulins are likely to further enhance the compliance of patients and should be used whenever feasible in patients with DM. However, the patient, along with prescriber should be allowed to make shared, informed decisions regarding the insulin they wish to use.


Assuntos
Medicamentos Biossimilares , Diabetes Mellitus Tipo 2 , Insulinas , Glicemia , Humanos , Hipoglicemiantes , Insulina
15.
Int J Diabetes Dev Ctries ; : 1-8, 2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35892065

RESUMO

Background: Lifestyle modification is an integral aspect for the management of type 2 diabetes (T2D). However, it is difficult to ensure the accuracy of personalized lifestyle advice. The study aims to analyse the real-world effectiveness of personalized glycemic response based Diabefly-Pro digital therapeutics for better glycemic control. Methods: Data from continuous glucose monitoring (CGM) of 64 participants with T2D was analysed. All participants were provided with modified lifestyle plan based on their personalized glycemic response. The CGM data was analysed for a period of 7 days, before and after the introduction of modified lifestyle plan. Primary outcome of the study was change in time in range (TIR). Secondary outcomes of the study were change in mean blood glucose, time above range (TAR), time below range (TBR) and glucose management indicator (GMI). Results: Significant improvement in glycemic control was observed after the introduction of personalized lifestyle plan. Median reduction in mean blood glucose was from 139.5 (118.3 to 169.3) mg/dL to 122.0 (101.5 to 148.8) mg/dL (p < 0.0001). TIR and GMI improved from 70.50 (50.75 to 83.50) % to 75.00 (58.25 to 89.00) % (p = 0.0001) and 6.64 (6.13 to 7.35) % to 6.23 (5.74 to 6.86) % (p < 0.0001) respectively. TAR reduced significantly from 17.00 (4.25 to 38.0) % to 6.00 (1.25 to 26.0) % (p < 0.0001). No significant increase in TBR was observed (p = 0.198). Conclusion: Personalized glycemic response-based Diabefly-Pro digital therapeutics program was effective in achieving better glycemic control in people with T2D.

16.
PLoS One ; 17(6): e0269154, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709100

RESUMO

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder characterized by progressive degeneration of upper motor neurons and lower motor neurons, and frontotemporal regions resulting in impaired bulbar, limb, and cognitive function. Magnetic resonance imaging studies have reported cortical and subcortical brain involvement in the pathophysiology of ALS. The present study investigates the functional integrity of resting-state networks (RSNs) and their importance in ALS. Intra- and inter-network resting-state functional connectivity (Rs-FC) was examined using an independent component analysis approach in a large multi-center cohort. A total of 235 subjects (120 ALS patients; 115 healthy controls (HC) were recruited across North America through the Canadian ALS Neuroimaging Consortium (CALSNIC). Intra-network and inter-network Rs-FC was evaluated by the FSL-MELODIC and FSLNets software packages. As compared to HC, ALS patients displayed higher intra-network Rs-FC in the sensorimotor, default mode, right and left fronto-parietal, and orbitofrontal RSNs, and in previously undescribed networks including auditory, dorsal attention, basal ganglia, medial temporal, ventral streams, and cerebellum which negatively correlated with disease severity. Furthermore, ALS patients displayed higher inter-network Rs-FC between the orbitofrontal and basal ganglia RSNs which negatively correlated with cognitive impairment. In summary, in ALS there is an increase in intra- and inter-network functional connectivity of RSNs underpinning both motor and cognitive impairment. Moreover, the large multi-center CALSNIC dataset permitted the exploration of RSNs in unprecedented detail, revealing previously undescribed network involvement in ALS.


Assuntos
Esclerose Amiotrófica Lateral , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Canadá , Humanos , Imageamento por Ressonância Magnética , Estados Unidos
17.
J Pak Med Assoc ; 72(6): 1232-1234, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35751345

RESUMO

Faith healing has been prevalent in the South Asian society since time immemorial. This is often coupled with alternative and complementary systems of medicine and attract a large proportion of people belonging to different sects, religions, and organizations. Though based on blinded trust, it does address the psychosomatic component of chronic disorders and hence does make the patient feel better. In this article the authors highlight the significant role of modern medicine in patients with certain endocrine and systemic disorders but also explore futuristic options to utilize these different systems in amalgamation for the better control and treatment of endocrine disorders like diabetes.


Assuntos
Diabetes Mellitus , Cura pela Fé , Ásia/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Pessoal de Saúde , Humanos , Religião
18.
J Pak Med Assoc ; 72(6): 1235-1236, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35751346

RESUMO

Diabetic dermopathy (DD) is a common complication of long-standing diabetes, and is often seen in association with chronic micro- and macro-vascular dysfunction. Hence, it can be considered an equivalent of vascular complications of diabetes. Our article focuses on a proactive approach to its management, involving both dermo-cosmetic and metabolic targeted therapies. A combination of occlusive and humectant moisturisers, with anti-inflammatory and pro-regenerative topical treatments, can help manage and minimize DD, while preventing its complications. We term such topical preparations as 'healing moisturisers' or 'regenerative moisturisers.


Assuntos
Cosméticos , Complicações do Diabetes , Diabetes Mellitus , Administração Tópica , Cosméticos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Humanos , Cicatrização
19.
J Pak Med Assoc ; 72(6): 1237-1238, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35751347

RESUMO

This communication describes the style and content of obesity-friendly language, so as to create a positive and welcoming environment for the obese individual accessing health care. Attention to matters of language and conversation style will ensure better a relationship between the patient and provider and facilitate optimal outcomes.


Assuntos
Idioma , Entrevista Motivacional , Comunicação , Humanos , Obesidade/epidemiologia
20.
J Pak Med Assoc ; 72(5): 986-988, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35713073

RESUMO

The predictability of triglyceride glucose index (TyG index) as a biomarker for identification of insulin resistance (IR) is being extensively studied in various ethnic populations. TyG index could be a beneficial tool for identification of IR and populations at high risk for developing diabetes in future. However, more studies are required to standardize optimal cut-off values in different ethnicities and populations. The present review describes existing literature, and identifies merits and demerits of TyG index as a surrogate marker for IR.


Assuntos
Resistência à Insulina , Biomarcadores , Glicemia , Glucose , Humanos , Triglicerídeos
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