Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.653
Filtrar
1.
Nutrients ; 12(10)2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33008059

RESUMO

COVID-19 related restrictions aimed at curbing the spread of the coronavirus result in changes in daily routines and physical activity which can have a negative effect on eating and health habits. The aim of the study was to assess the impact of the COVID-19 pandemic on patients with diabetes and their nutrition and health behaviours. A survey conducted in July 2020 included 124 individuals with type 1 (n = 90) and 2 (n = 34) diabetes mellitus from Poland. To assess nutritional and health behaviours, an online questionnaire covering basic information, anthropometric data, and details regarding physical activity, eating, and hygiene habits was used. Almost 40% of all respondents with type 1 and 2 diabetes mellitus (DM) stated that their disease self-management had significantly improved. Over 60% of all participants declared that they had started eating more nutritious and regular meals during the COVID-19 pandemic. Enhanced hygiene, in particular, during the period, a statistically significant increase in hand sanitiser use was reported by respondents (18% vs. 82%, p < 0.001). The study demonstrated that the pandemic had a significant impact on the behaviour of patients with DM. Improved disease self-management and making healthy, informed food and hygiene choices were observed.


Assuntos
Infecções por Coronavirus , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Dieta , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Autogestão , Adolescente , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/terapia , Exercício Físico , Comportamento Alimentar , Feminino , Desinfecção das Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Inquéritos e Questionários , Adulto Jovem
2.
Medicine (Baltimore) ; 99(40): e22564, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019468

RESUMO

BACKGROUND: At present, the prevalence of type 2 diabetes mellitus (T2DM) has become a major public health issue throughout the world, especially in developing countries. Notably, traditional Chinese patent medicines (TCPMs) are of great significance in the treatment of T2DM combined with conventional Western medicine therapy. However, there is a lack of comparison among all the current common TCPMs for treating T2DM. Therefore, this study intends to explore the efficacy and safety of different TCPMs against T2DM through the Bayesian network meta-analysis (NMA). METHODS: We will conduct a comprehensive and systematic search for randomized controlled trials (RCTs) of TCPM for the treatment of T2DM in both Chinese and English databases published till August 2020. Two researchers will be responsible for screening eligible literature, extracting data, and assessing the risk of bias of included studies independently. Then, pairwise meta-analyses and Bayesian network meta-analyses will be conducted to assess all available evidence. In the end, data will be analyzed using STATA15.0 and WinBUGS1.4.3 software. CONCLUSION: This study will compare the efficacy and safety of different TCPMs against T2DM in detail. Our findings will provide a reliable evidence for selecting clinical treatment program and guideline development of T2DM.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Medicina Tradicional Chinesa/métodos , Medicamentos sem Prescrição/efeitos adversos , Teorema de Bayes , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Metanálise em Rede , Medicamentos sem Prescrição/uso terapêutico , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
3.
Ther Umsch ; 77(7): 297-301, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32996427

RESUMO

Laboratory investigations in clinical diabetic practice Abstract. Laboratory analysis are useful to diagnose the proper form of diabetes mellitus, for follow-up of the metabolic control, and to identify secondary complications or associated diseases. The proof of auto-antibodies confirms Type 1 diabetes and a broad range of endocrine entities of the polyglandular autoimmune syndrome, and genetic testing classifies monogenetic diabetes like MODY or MIDDM. In secondary diabetes forms underlying disease can be detected by clinical and laboratory investigation, and thus, causal treatment of the diabetes may be possible.


Assuntos
Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/terapia , Testes Genéticos , Humanos
4.
Medicine (Baltimore) ; 99(33): e20978, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871975

RESUMO

BACKGROUND: The number of people with diabetes is growing exponentially.Human studies have shown that vitamin D supplementation is beneficial for type 2 diabetic microangiopathy. However, owing to the low quality, small sample size, and methodological heterogeneity of these studies, this conclusion is not convincing. Consequently, in order to determine whether vitamin D supplementation is effective and safe in type 2 diabetic microangiopathy, it is necessary to conduct a meta-analysis of high-quality clinical trials. METHODS: We will search each database from the built-in until March 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. In this study, only the clinical randomized controlled trials were selected to evaluate the efficacy and safety of vitamin D in the treatment of type 2 diabetic microangiopathy. The two researchers independently conducted literature selection, data extraction and quality assessment. Statistical heterogeneity among studies will be evaluated using the Cochran Q test (x) and the I statistical value. We will utilize the Review Manage software V5.3.0 (The Nordic Cochrane Center, The Cochrane Collaboration, 2014, Copenhagen, Denmark) to statistically analyze all data. ETHICS AND DISSEMINATION: Ethics and dissemination: This study is a systematic review of vitamin D supplementation as a treatment of type 2 diabetic microangiopathy. RESULTS: This study will provide high-quality synthesis of effectiveness and safety of vitamin D supplementation for type 2 diabetic microangiopathy. CONCLUSION: This systematic review aims to provide new options for vitamin D treatment of type 2 diabetic microangiopathy in terms of its efficacy and safety. REGISTRATION NUMBER: LNPLASY202050055.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/terapia , Suplementos Nutricionais , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Vitamina D/uso terapêutico , Diabetes Mellitus Tipo 2/terapia , Humanos , Vitamina D/efeitos adversos
5.
Medicine (Baltimore) ; 99(33): e21143, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871982

RESUMO

BACKGROUND: The impact of vitamin K in ameliorating diabetes-associated complications, especially those linked with platelet activation and coagulation remains unclear. The current study aims to systematically explore and discuss the available evidence on the impact of vitamin K on the diabetes-cardiovascular disease (CVD)-associated complications. METHODS: A systematic review of studies published on the MEDLINE (PubMed), EMBASE, and Google Scholar electronic database will be conducted. The review will include studies published from inception until May 25, 2020, reporting on the effect of vitamin K on CVD-related markers, especially coagulation factors and platelet activation in type 2 diabetes mellitus. Before the full-text screening, all studies will be screened by title, abstract, and keywords. The Downs and Black checklist will be used to assess the quality of the studies. Additionally, the Cochrane collaboration tool will also be used to evaluate the risk of bias across the included studies. Kappa Cohen's calculator will be used to assess the level of agreement between the authors. DISCUSSIONS: This systematic review will not require ethical approval, and the results will be distributed through conference and peer-reviewed publications. Our results will assist current and future research scientists on the potential use of vitamin K as a protective therapy against CVD-related complications. SYSTEMATIC REVIEW REGISTRATION: This protocol is registered on the International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42020151667.


Assuntos
Transtornos da Coagulação Sanguínea/etiologia , Transtornos da Coagulação Sanguínea/terapia , Diabetes Mellitus Tipo 2/complicações , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Vitamina K/uso terapêutico , Diabetes Mellitus Tipo 2/terapia , Suplementos Nutricionais , Humanos
7.
BMC Public Health ; 20(1): 1227, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787809

RESUMO

BACKGROUND: Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. METHODS: We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. RESULTS: Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P = 0.01) and self-monitoring/self-care (OR = 2.17, P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P = 0.03). Patients with longer diabetes duration (OR = 2.33, P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. CONCLUSIONS: Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients' self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient-physician interactions.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/terapia , Cooperação do Paciente/estatística & dados numéricos , Autogestão/psicologia , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Autoeficácia , Fatores Socioeconômicos , Inquéritos e Questionários
8.
Medicine (Baltimore) ; 99(30): e21316, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791722

RESUMO

BACKGROUND: With the change of people's life style, many more people are suffering from obese type 2 diabetes mellitus (T2DM). Acupoint catgut embedding is one of the acupuncture treatment principles in traditional Chinese medicine, which is widely used in the treatment of obese T2DM. However, there is no systematic review of the therapeutic effect of acupoint catgut embedding on obesity T2DM. Therefore, this article aims at the meta-analysis of acupoint catgut embedding in the treatment of obese T2DM, to clarify its curative effect. METHODS: A structured and systemic literature search was conducted in the following databases up to December 1, 2019: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, CNKI, Wanfang Database. We will use the Review Manager 5.3 software provided by Cochrane collaborative network for statistical analysis. Then we assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This meta-analysis will further determine the beneficial efficacy of acupoint catgut embedding on obesity T2DM. CONCLUSION: The purpose of this meta-analysis is to explore the effect of acupoint catgut embedding intervention on obese T2DM patients, and provide more options for clinicians and patients to treat obese T2DM. ETHICS AND DISSEMINATION: This systemic review will evaluate the efficacy and safety of acupoint catgut embedding in the treatment of obesity T2DM. Since all the data included are published, the systematic review does not need ethical approval. REGISTRATION NUMBER: CRD42020160801.


Assuntos
Pontos de Acupuntura/classificação , Terapia por Acupuntura/tendências , Categute/efeitos adversos , Diabetes Mellitus Tipo 2/terapia , Obesidade/terapia , Bases de Dados Factuais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Estilo de Vida , Masculino , Medicina Tradicional Chinesa , Obesidade/complicações , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
9.
J Natl Black Nurses Assoc ; 31(1): 41-45, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32853495

RESUMO

This quality improvement project aimed to answer the following clinical question: Among U.S. male veterans (N = 30) living with type 2 diabetes (T2D) receiving services from a Veterans Affairs (VA) endocrinology clinic, how does a diabetes toolkit influence knowledge and glycaemic control? All the study participants were male and from 31 to 91 years of age. A pre- and post-intervention diabetes knowledge test, body mass index (BMI), lipids, blood pressure, and lifestyle data were obtained as predictor variables. A1c levels were measured at baseline and fructosamine levels at 8-12 weeks post-intervention and converted to A1c levels. A diabetes toolkit was presented as an educational intervention to participating veterans. The pre- and post-intervention knowledge test measured an increase (p = 0.001) in diabetes knowledge. The pre- and post-intervention BMI, lipids, and blood pressure assessments measured changes in such variables associated with toolkit exposure. The regression model was marginally significant (p = 0.055) and the predictor variables explained 18.8% of variance in change of A1c. A multiple regression was conducted to determine the extent to which the following post-intervention outcome variables impacted glycemic control. Of four predictors, only one was significant: a patient's change in weight predicted (p = 0.016) a decrease in A1c.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Educação de Pacientes como Assunto/métodos , Veteranos/estatística & dados numéricos , Perda de Peso , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemoglobina A Glicada/metabolismo , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade
10.
Medicine (Baltimore) ; 99(30): e21091, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791683

RESUMO

INTRODUCTION: The incidence of type 2 diabetes has been increasing year by year in recent years. Type 2 diabetes is an important risk factor in the occurrence and development of heart failure, and it is the second potential risk factor after coronary artery disease. At present, there is no unified etiology, pathogenesis, and syndrome differentiation criteria for type 2 diabetes with chronic heart failure, and it is susceptible to subjective factors. Therefore, standardized, objective, and standardized research is needed to provide reference and guidance for clinical diagnosis and treatment. In this study, the theory of syndrome differentiation is used to initially explore the distribution of traditional Chinese medicine syndromes in patients with type 2 diabetes and chronic heart failure through case data collection, syndrome extraction, and clinical data analysis. METHODS/DESIGN: In this study, we will collect at least 500 cases of type 2 diabetes with chronic heart failure that meet the standard outpatient and hospitalization, and fill out the case information collection form. Then we will collect a number of clinical diagnosis and treatment information, and judge the syndrome based on the sum of the contribution of each syndrome to the relevant syndrome. We will use Microsoft Excel to establish a database, enter the relevant diagnosis and treatment, and syndrome information of the case information collection table, and verify and correct in time to ensure the accuracy of the data. DISCUSSION: This study will provide reference and guidance for the clinical diagnosis and treatment of type 2 diabetes with chronic heart failure. TRIAL REGISTRATION: ClinicalTrials.gov, ChiCTR2000033010, Registered on May 18, 2020.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Medicina Tradicional Chinesa , Doença Crônica , Estudos Clínicos como Assunto , Humanos , Projetos de Pesquisa , Síndrome
11.
JAMA ; 324(7): 651-662, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809002

RESUMO

Importance: Mental health comorbidities are increasing worldwide and worsen outcomes for people with diabetes, especially when care is fragmented. Objective: To assess whether collaborative care vs usual care lowers depressive symptoms and improves cardiometabolic indices among adults with diabetes and depression. Design, Setting, and Participants: Parallel, open-label, pragmatic randomized clinical trial conducted at 4 socioeconomically diverse clinics in India that recruited patients with type 2 diabetes; a Patient Health Questionnaire-9 score of at least 10 (range, 0-27); and hemoglobin A1c (HbA1c) of at least 8%, systolic blood pressure (SBP) of at least 140 mm Hg, or low-density lipoprotein (LDL) cholesterol of at least 130 mg/dL. The first patient was enrolled on March 9, 2015, and the last was enrolled on May 31, 2016; the final follow-up visit was July 14, 2018. Interventions: Patients randomized to the intervention group (n = 196) received 12 months of self-management support from nonphysician care coordinators, decision support electronic health records facilitating physician treatment adjustments, and specialist case reviews; they were followed up for an additional 12 months without intervention. Patients in the control group (n = 208) received usual care over 24 months. Main Outcomes and Measures: The primary outcome was the between-group difference in the percentage of patients at 24 months who had at least a 50% reduction in Symptom Checklist Depression Scale (SCL-20) scores (range, 0-4; higher scores indicate worse symptoms) and a reduction of at least 0.5 percentage points in HbA1c, 5 mm Hg in SBP, or 10 mg/dL in LDL cholesterol. Prespecified secondary outcomes were percentage of patients at 12 and 24 months who met treatment targets (HbA1c <7.0%, SBP <130 mm Hg, LDL cholesterol <100 mg/dL [<70 mg/dL if prior cardiovascular disease]) or had improvements in individual outcomes (≥50% reduction in SCL-20 score, ≥0.5-percentage point reduction in HbA1c, ≥5-mm Hg reduction in SBP, ≥10-mg/dL reduction in LDL cholesterol); percentage of patients who met all HbA1c, SBP, and LDL cholesterol targets; and mean reductions in SCL-20 score, Patient Health Questionnaire-9 score, HbA1c, SBP, and LDL cholesterol. Results: Among 404 patients randomized (mean [SD] age, 53 [8.6] years; 165 [40.8%] men), 378 (93.5%) completed the trial. A significantly greater percentage of patients in the intervention group vs the usual care group met the primary outcome (71.6% vs 57.4%; risk difference, 16.9% [95% CI, 8.5%-25.2%]). Of 16 prespecified secondary outcomes, there were no statistically significant between-group differences in improvements in 10 outcomes at 12 months and in 13 outcomes at 24 months. Serious adverse events in the intervention and usual care groups included cardiovascular events or hospitalizations (4 [2.0%] vs 7 [3.4%]), stroke (0 vs 3 [1.4%]), death (2 [1.0%] vs 7 [3.4%]), and severe hypoglycemia (8 [4.1%] vs 0). Conclusions and Relevance: Among patients with diabetes and depression in India, a 12-month collaborative care intervention, compared with usual care, resulted in statistically significant improvements in a composite measure of depressive symptoms and cardiometabolic indices at 24 months. Further research is needed to understand the generalizability of the findings to other low- and middle-income health care settings. Trial Registration: ClinicalTrials.gov Identifier: NCT02022111.


Assuntos
Pressão Sanguínea , LDL-Colesterol/sangue , Depressão/terapia , Diabetes Mellitus Tipo 2/terapia , Hemoglobina A Glicada/análise , Adulto , Idoso , Comportamento Cooperativo , Depressão/complicações , Países em Desenvolvimento , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Autogestão , Fatores Socioeconômicos
12.
Medicine (Baltimore) ; 99(34): e21894, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846852

RESUMO

BACKGROUND: At present, metformin is mainly used in the treatment of type 2 diabetes mellitus (T2DM). When the therapeutic effect is achieved, there are side effects and secondary failure will occur if taken for a long time. It is of great significance to actively explore the clinical scheme of reducing drug use while ensuring the therapeutic effect of T2DM. OBJECTIVE: To evaluate the feasibility of Chinese massage (CM) in the treatment of T2DM. METHODS: Literature retrieval is divided into 2 aspects: Electronic Retrieval and Personal Check. We will search PubMed, EMBASE, CNKI, Cochrane Central, which were registered in international clinical trials registry platform systems, select all eligible studies published before November 2, 2019, and use Personal Check method to retrieve papers, conference papers, ongoing experiments, internal reports, and so on. With fasting blood glucose, 2-hour fasting blood glucose, glycosylated hemoglobin, and insulin index as the main observation indexes, we also pay attention to traditional Chinese medicine syndrome score scale, insulin resisting index, body mass index , serum total cholesterol, Curative effect and the occurrence of all adverse reactions in drug treatment.Of the research group 2 researchers respective selected literature, extracted data, and evaluated the risk of bias. After that we used Revman 5.7 and Stata 12.1 statistical software for meta-analysis. RESULTS: A total of 769 subjects were included in 10 studies for meta-analysis. Compared with metformin hydrochloride tablets, CM plus baseline treatment can reduce fasting plasma glucose (weighted mean difference [WMD] = -0.33, 95% confidence interval [CI] [-0.54, -0.13], Z = 3.15, P = .002), 2 hours postprandial blood glucose (WMD = -0.52, 95% CI [-0.70, -0.34), Z = 5.66, P < .00001], hemoglobin A1c (WMD = 0.12, 95% CI [0.04, 0.20], Z = 2.94, P = .003), fasting insulin (WMD = -3.59, 95% CI [-5.56, -1.42], Z = 10.29,P < .00001), traditional Chinese medicine syndrome score scale (WMD = -4.55, 95% CI [-7.58, -1.51], Z = 2.94, P = .003),homeostasis model assessment of insulin resistance (WMD = -1.76, 95% CI [-2.25, -1.27), Z = 7.08, P < .00001),body mass index (WMD = -1.28, 95% CI [-1.65, -0.92], Z = 6.91, P < .00001), serum total cholesterol (WMD = -1.01, 95% CI [-1.14, -0.83], Z = 15.51, P < .00001), meanwhile, the effective rate was increased (risk ratio [RR] = 1.31, 95% CI [1.21, 1.42], Z = 6.57, P < .00001). CONCLUSION: CM combined with metformin hydrochloride tablet has a synergistic effect. It can not only be used as an auxiliary treatment of T2DM, but also as an important reference way of reducing drug treatment of T2DM, improving Clinical Efficacy and reducing adverse reactions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020158839.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Hipoglicemiantes/uso terapêutico , Massagem/métodos , Metformina/uso terapêutico , Adulto , Idoso , Glicemia/análise , Estudos de Casos e Controles , China/epidemiologia , Terapia Combinada/métodos , Sinergismo Farmacológico , Jejum/sangue , Estudos de Viabilidade , Hemoglobina A Glicada/análise , Humanos , Hipoglicemiantes/efeitos adversos , Insulina/sangue , Resistência à Insulina , Massagem/tendências , Metformina/efeitos adversos , Pessoa de Meia-Idade
13.
Rev Med Suisse ; 16(703): 1478-1482, 2020 Aug 26.
Artigo em Francês | MEDLINE | ID: mdl-32852167

RESUMO

Glucagon-like peptide-1 receptor agonists and SGLT2 inhibitors (gliflozins), which demonstrated a cardiovascular and renal protection, have profoundly changed the management of patients with type 2 diabetes who are at cardiovascular risk. Nowadays, these antidiabetic medications occupy a preferred position, independently of glucose control. This has been emphasized in the last guidelines of the European Society of Cardiology (ESC) and the joint consensus by the American Diabetes Association and the European Association for the Study of Diabetes (ADA-EASD), both published in 2020. Nevertheless, there are some discrepancies between the two points of view, especially concerning the definition of the patient at cardiovascular risk in primary prevention and the first-choice place still to be reserved to metformin in these patients.


Assuntos
Cardiologia , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Metformina , Inibidores do Transportador 2 de Sódio-Glicose , Doenças Cardiovasculares/terapia , Diabetes Mellitus Tipo 2/terapia , Humanos , Hipoglicemiantes
14.
Am J Case Rep ; 21: e926694, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32820143

RESUMO

BACKGROUND When treating patients with comorbidities who are infected with severe acute respiratory syndrome as a result of SARS-CoV-2, it is crucial to offer multidisciplinary treatment that takes into consideration all of the health conditions with which they have been diagnosed. In particular, clinicians should not lose sight of the patient experience, which we can be assessed with the help of patient-reported outcomes (PROs). CASE REPORT An 84-year-old man infected with SARS-CoV-2 was already suffering from multiple health conditions, including Type 2 diabetes mellitus. He most likely was receiving cortisone therapy and had chronic pain with spondylosis with radiculopathy, bilateral gonarthrosis following total knee replacement, malaise, and fatigue. The patient received acute inpatient care in a hospital that provides complementary medical therapies. We collected clinical and patient-reported data on quality of life, physical functions, the sensation of pain, psychological well-being, and symptoms while taking into account the degree of chronicity of the conditions, the level of the patient's pain, and his hospitalization in an isolation ward. We stabilized clinical parameters related to the patient's main underlying health conditions (blood glucose and pain levels and oxygen saturation). The PROs we collected demonstrated a significant improvement on discharge. CONCLUSIONS Applying PROs can be helpful in obtaining a more comprehensive picture of a patient with COVID-19, in which "the patient is given a voice," in addition to being assessed by others. The knowledge gained can then be made available to the interdisciplinary treatment team to be incorporated into the treatment plan.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Equipe de Assistência ao Paciente/organização & administração , Medidas de Resultados Relatados pelo Paciente , Pneumonia Viral/epidemiologia , Qualidade de Vida , Idoso de 80 Anos ou mais , Doença Crônica , Comorbidade , Infecções por Coronavirus/terapia , Diabetes Mellitus Tipo 2/terapia , Humanos , Masculino , Pandemias , Pneumonia Viral/terapia
15.
Lancet Diabetes Endocrinol ; 8(9): 793-800, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32822601

RESUMO

Gestational diabetes, the most common medical disorder in pregnancy, is defined as glucose intolerance resulting in hyperglycaemia that begins or is first diagnosed in pregnancy. Gestational diabetes is associated with increased pregnancy complications and long-term metabolic risks for the woman and the offspring. However, the current diagnostic and management strategies recommended by national and international guidelines are mainly focused on short-term risks during pregnancy and delivery, except the Carpenter-Coustan criteria, which were based on the risk of future incidence of type 2 diabetes post-gestational diabetes. In this Personal View, first, we summarise the evidence for long-term risk in women with gestational diabetes and their offspring. Second, we suggest that a shift is needed in the thinking about gestational diabetes; moving from the perception of a short-term condition that confers increased risks of large babies to a potentially modifiable long-term condition that contributes to the growing burden of childhood obesity and cardiometabolic disorders in women and the future generation. Third, we propose how the current clinical practice might be improved. Finally, we outline and justify priorities for future research.


Assuntos
Saúde da Criança/tendências , Diabetes Gestacional/terapia , Saúde Materna/tendências , Criança , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Hiperglicemia/diagnóstico , Hiperglicemia/epidemiologia , Hiperglicemia/terapia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Gravidez
16.
Adv Exp Med Biol ; 1250: 159-176, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32601944

RESUMO

Diabetes mellitus type 2 (type-2 diabetes) is a metabolic disorder characterized by the increased blood glucose concentration and insulin resistance in peripheral tissues (e.g., muscles and adipose tissue). The initiation of the pathological cascade of events that lead to type-2 diabetes has been subject of debate; however, it has been commonly accepted that the oversecretion of human islet amyloid polypeptide (hIAPP, a hormone co-secreted with insulin) by the pancreatic 𝛽-cells is the main trigger of type-2 diabetes. In fact, 90% of the type-2 diabetes patients present hIAPP deposits in the extracellular space of the 𝛽-cells. These hIAPP supramolecular arrangements (both fibrillar and oligomeric) have been reported to be the origin of cytotoxicity, which leads to 𝛽-cell dysfunction through a series of different mechanisms, including the interaction of hIAPP oligomers with the cell membrane that leads to the influx of Ca2+ and increase in the cellular oxidative stress, among others. This overview shows the importance of developing type-2 diabetes treatment strategies able to (1) remodel of the secondary structure of cytotoxic hIAPP oligomers entrapping them into off-pathway nontoxic species and (2) reestablish physiological levels of oxidative stress. Natural polyphenols are a class of antioxidant compounds that are able to perform both functions. Herein we review the published literature of the most studied polyphenols, in particular for their ability to remodel the hIAPP aggregation pathway, to rescue the in vitro pancreatic 𝛽-cell viability and function, as well as to perform under a complex biological environment, i.e., in vivo animal models and clinical trials. Overall, natural polyphenols are able to control the cytotoxic hIAPP aggregation and minimize hIAPP-mediated cellular dysfunction and can be considered as important lead compounds for the treatment of type-2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Polipeptídeo Amiloide das Ilhotas Pancreáticas , Polifenóis , Animais , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/terapia , Modelos Animais de Doenças , Humanos , Polipeptídeo Amiloide das Ilhotas Pancreáticas/metabolismo , Polifenóis/farmacologia
17.
Lancet Diabetes Endocrinol ; 8(9): 782-792, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32687793

RESUMO

Since the initial COVID-19 outbreak in China, much attention has focused on people with diabetes because of poor prognosis in those with the infection. Initial reports were mainly on people with type 2 diabetes, although recent surveys have shown that individuals with type 1 diabetes are also at risk of severe COVID-19. The reason for worse prognosis in people with diabetes is likely to be multifactorial, thus reflecting the syndromic nature of diabetes. Age, sex, ethnicity, comorbidities such as hypertension and cardiovascular disease, obesity, and a pro-inflammatory and pro-coagulative state all probably contribute to the risk of worse outcomes. Glucose-lowering agents and anti-viral treatments can modulate the risk, but limitations to their use and potential interactions with COVID-19 treatments should be carefully assessed. Finally, severe acute respiratory syndrome coronavirus 2 infection itself might represent a worsening factor for people with diabetes, as it can precipitate acute metabolic complications through direct negative effects on ß-cell function. These effects on ß-cell function might also cause diabetic ketoacidosis in individuals with diabetes, hyperglycaemia at hospital admission in individuals with unknown history of diabetes, and potentially new-onset diabetes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Infecções por Coronavirus/sangue , Diabetes Mellitus Tipo 2/sangue , Humanos , Hiperglicemia/sangue , Hiperglicemia/epidemiologia , Hiperglicemia/terapia , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/terapia , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/terapia , Pandemias , Pneumonia Viral/sangue , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
18.
Diabetes Res Clin Pract ; 166: 108313, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32653505

RESUMO

AIMS: Evaluate the validity and reliability of the data from the Wii balance board (WBB), against a force platform (FP) in patients with type 2 diabetes mellitus (T2DM). METHODS: Forty-three adults with T2DM (age 62.1 ± 12.1 yrs) in the validity trial and 27 (age 63.5 ± 10.8 yrs) in the reliability study, were tested. Total COP area (mm) and range of antero-posterior (AP) and medio-lateral (ML) COP excursion were collected simultaneously on a FP and a WBB. RESULTS: Mean CoP sway path values were similar in all conditions in the FP when compared with the WBB. Regression model shows that WBB is able to explain most of the variation in CoP sway path data of the FP (between 42 and 72%) for all testing conditions, indicating that the WBB has good concurrent validity. Test-retest reliability for WBB was excellent, except for the COP sway area in the 'eyes open' condition (ICC = 0.55). Both conditions showed modest to excellent reliability in the AP (0.73-0.90) and the ML (0.77-0.91) directions. CONCLUSION: The WBB has been shown to be a valid and reliable method to quantify the COP displacement during different balance tests in older adults with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Equilíbrio Postural/fisiologia , Jogos de Vídeo/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
19.
Diabetes Res Clin Pract ; 166: 108311, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32673699

RESUMO

Complementary medicine (CM) treatment beliefs of people with type 2 diabetes were assessed using a validated three-domain questionnaire. Belief in holistic health, but not natural treatments or participation in treatment, was independently associated with CM use (P = 0.003). Strong holistic health beliefs could identify present/future CM use, with potential management implications.


Assuntos
Terapias Complementares/métodos , Diabetes Mellitus Tipo 2/terapia , Conhecimentos, Atitudes e Prática em Saúde , Idoso , Feminino , Humanos , Masculino
20.
Int J Exp Pathol ; 101(3-4): 68-79, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32608551

RESUMO

Type 2 diabetes (T2DM) is among the most prevalent metabolic diseases in the world and may result in several long-term complications. The crosstalk between gut microbiota and host metabolism is closely related to T2DM. Currently, fragmented data hamper defining the relationship between probiotics and T2DM. This systematic review aimed at investigating the effects of probiotics on T2DM in animal models. We systematically reviewed preclinical evidences using PubMed/MEDLINE and Scopus databases, recovering 24 original articles published until September 27th, 2019. This systematic review was performed according to PRISMA guidelines. We included experimental studies with animal models reporting the effects of probiotics on T2DM. Studies were sorted by characteristics of publications, animal models, performed analyses, probiotic used and interventions. Bias analysis and methodological quality assessments were examined through the SYRCLE's Risk of Bias tool. Probiotics improved T2DM in 96% of the studies. Most studies (96%) used Lactobacillus strains, and all of them led to improved glycaemia. All studies used rodents as models, and male animals were preferred over females. Results suggest that probiotics have a beneficial effect in T2DM animals and could be used as a supporting alternative in the disease treatment. Considering a detailed evaluation of the reporting and methodological quality, the current preclinical evidence is at high risk of bias. We hope that our critical analysis will be useful in mitigating the sources of bias in further studies.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 2/terapia , Microbioma Gastrointestinal , Probióticos/administração & dosagem , Animais , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/microbiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/microbiologia , Disbiose , Feminino , Interações Hospedeiro-Patógeno , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA