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1.
Glob Heart ; 20(1): 9, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39896314

RESUMO

Background: The World Health Organization HEARTS Technical Package is a widely implemented global initiative to improve the primary care management of cardiovascular disease risk factors. The study's objective is to report outcomes from a pilot implementation trial of integrated hypertension and diabetes management based on the HEARTS model in Guatemala. Methods: We conducted a single-arm pilot implementation trial over six months from October 2023 to May 2024 in 11 Guatemalan Ministry of Health primary care facilities in two districts. The pilot evaluated a package of five HEARTS-aligned implementation strategies to improve the pharmacological treatment of hypertension and diabetes. The primary outcomes were feasibility and acceptability, measured through 20 structured interviews with Ministry of Health employees and by examining enrolment and retention data. Secondary outcomes included a suite of implementation and clinical outcomes, including treatment rates. When baseline data were available, we analyzed secondary outcomes as the net change from baseline or using an interrupted time series approach. Results: The study enrolled 964 patients, of whom 58.8% had hypertension only, 30.4% had diabetes only, and 10.8% had both conditions. Surveys on feasibility and acceptability among Ministry of Health staff had a median score of 5.0 (IQR: 5.0 to 5.0) and 5.0 (IQR range: 4.8 to 5.0), respectively, exceeding the prespecified benchmark of ≥3.5. Both districts achieved the prespecified benchmark of enrolling ≥25 hypertension patients and ≥25 diabetes patients. Only 36% of patients attended a follow-up visit within three months, lower than the prespecified benchmark of ≥75%. Monthly treatment rates during the pilot increased by 22.3 (95% CI: 16.2 to 28.4; P < 0.001) and 3.5 (95% CI: -1.6 to 8.7; P = 0.17) patients per month for hypertension and diabetes, respectively. Conclusions: Implementation of an integrated hypertension and diabetes model based on HEARTS was generally feasible and acceptable in the Ministry of Health in Guatemala. Findings can refine national scale-up in Guatemala and inform HEARTS implementation projects in other settings.


Assuntos
Diabetes Mellitus , Hipertensão , Organização Mundial da Saúde , Humanos , Hipertensão/terapia , Hipertensão/epidemiologia , Guatemala/epidemiologia , Projetos Piloto , Masculino , Feminino , Pessoa de Meia-Idade , Diabetes Mellitus/terapia , Diabetes Mellitus/epidemiologia , Gerenciamento Clínico , Adulto , Atenção Primária à Saúde/organização & administração , Idoso
2.
Bol. latinoam. Caribe plantas med. aromát ; 24(1): 76-100, ene. 2025. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1584679

RESUMO

"Gordolobo" (Gnaphalium sp) is a Mexican medicinal plant understudied for the treatment of diabetes; therefore, the aim was to evaluate the chloroformic extract of G sp. (CEG) in alloxan-induced diabetic rats. Sesquiterpene lactones, polyphenolic compounds, triterpenes and steroids, apigenin, and lauric and myristic acid were identified in CEG by phytochemical, HPLC and GC-MS analysis; and the antioxidant capacity evaluated by FRAP, DPPH and ABTS, inhibited the formation of free radicals. There was no lethality or toxicity at doses of 2000 mg/kg. At doses of 200 mg/kg it did not decrease hyperglycemia; however, it did decrease biomarkers of oxidative stress (malondialdehyde, oxidized proteins, superoxide dismutase) associated with diabetes in pancreas. The ß-cell function, insulin resistance and insulin sensitivity were not improved. In conclusion, CEG showed no hypoglycemic activity, but antioxidantactivity in pancreatic tissue.


"Gordolobo" (Gnaphalium sp) es una planta medicinal mexicana poco estudiada para el tratamiento de la diabetes; por el cual, el objetivo fue evaluar el extracto clorofórmico de G sp. (CEG) en ratas diabéticas inducidas por aloxana. Lactonas sesquiterpénicas, compuestos polifenólicos, triterpenos y esteroides, apigenina, y ácido láurico y mirístico, fueron identificados en CEG por análisis fitoquímico, HPLC y GC-MS; y, la capacidad antioxidante evaluada por FRAP, DPPH y ABTS, inhibió la formación de radicales libres. No hubo letalidad o toxicidad a dosis de 2000 mg/kg. A dosis de 200 mg/kg no disminuyó la hiperglucemia; sin embargo, si disminuyó los biomarcadores de estrés oxidativo (malondialdehído, proteínas oxidadas, superóxido dismutasa) asociados a la diabetes en páncreas. La función de las células ß, la resistencia a la insulina y la sensibilidad a la misma no se vieron mejoradas. En conclusión, CEG no mostró actividad hipoglucemiante, pero si actividad antioxidante en tejido pancreático.


Assuntos
Animais , Ratos , Plantas Medicinais/química , Gnaphalium/metabolismo , Gnaphalium/química , Diabetes Mellitus/tratamento farmacológico , Ratos Wistar , Diabetes Mellitus/prevenção & controle , Medicina Tradicional/métodos
3.
Rev Lat Am Enfermagem ; 33: e4428, 2025.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-39879481

RESUMO

OBJECTIVE: to map the available evidence on the characteristics of care coordination between Primary Health Care and Specialized Outpatient Care for users with diabetes and hypertension. METHOD: this is a scoping review with 40 articles as the final sample, evaluated by means of Content Analysis, of the thematic-categorical type, with the aid of a technological tool. RESULTS: care coordination was defined by means of eight categories: information and communication, integration of care, improvement and quality, care management, care sharing, fundamental attribute, health professionals and health service users, with the results of the articles concentrating mainly on four categories, with information and communication standing out, followed by the category of care management and the category of care sharing, in parallel with improvement and quality. CONCLUSION: technological tools are a first step in ensuring the coordination of care, proving to be a significant feature, with emphasis on studies on the sharing of information between health services through electronic medical records. However, although this technology has proved to be advantageous for the health system, with good results, it is not the only means of ensuring the coordination of care.


Assuntos
Diabetes Mellitus , Hipertensão , Humanos , Diabetes Mellitus/terapia , Hipertensão/terapia , Atenção à Saúde/organização & administração , Atenção Primária à Saúde/organização & administração
4.
Cien Saude Colet ; 30(1): e14792023, 2025 Jan.
Artigo em Português, Inglês | MEDLINE | ID: mdl-39879466

RESUMO

This review aimed to identify the impact of the ECHO® model on monitoring people diagnosed with diabetes mellitus. It followed the Joanna Briggs Institute and the PRISMA-ScR Checklist. The search was conducted in the Cochrane Library, Embase, Virtual Health Library, PubMed/MEDLINE, Scopus, and Web of Science databases. The strategy included the descriptors "Diabetes mellitus," "Diabetes Melito," "Diabetes," "Diabetes Melito," "Model ECHO," "Project ECHO," and "Extension for Community Healthcare Outcomes." Two independent reviewers selected the studies using the Rayyan-Intelligent Systematic Review management software. Nine of the 151 studies initially identified were selected, and one study was identified through gray literature. The ten studies were published in English between 2012 and 2022. Improvements were found in the professionals' knowledge and self-confidence, besides decreased glycated hemoglobin levels, hospital admissions, and hospitalization costs among people with diabetes. The conclusion is that the ECHO® Model positively impacted the monitoring of people with diabetes mellitus, especially in vulnerable communities.


A presente revisão teve como objetivo identificar o impacto do modelo ECHO® no acompanhamento de pessoas com diagnóstico de diabetes mellitus. O trabalho foi desenvolvido de acordo com as recomendações do Joanna Briggs Institute e do Checklist PRISMA-ScR, cujas buscas foram realizadas nas bases de dados Cochrane Library, Embase, Biblioteca Virtual em Saúde, PubMed/MEDLINE, Scopus e Web of Science, por meio de estratégias compostas pelos descritores "Diabetes mellitus", "Diabete Melito", "Diabetes", "Diabetes Melito", "model ECHO", "Project ECHO" e "Extension for Community Healthcare Outcomes". A seleção dos estudos contou com dois revisores trabalhando de forma independente através do software de gestão Rayyan-Intelligent Systematic Review. Dos 151 trabalhos identificados, nove foram selecionados. Um estudo foi identificado na literatura cinzenta. Os dez estudos incluídos foram publicados em inglês, entre os anos de 2012 a 2022. Observou-se melhorias no conhecimento e na autoconfiança dos profissionais, além de diminuição da hemoglobina glicada, redução de hospitalizações e de gastos com internações das pessoas com diabetes. Conclui-se que este trabalho expõe um impacto positivo do Modelo ECHO® no acompanhamento de pessoas com diabetes mellitus, principalmente em comunidades de maior vulnerabilidade.


La presente revisión tuvo como objetivo identificar el impacto del modelo ECHO® en el seguimiento de personas diagnosticadas con diabetes mellitus. El trabajo se desarrolló de acuerdo con las recomendaciones del Instituto Joanna Briggs y el PRISMA-ScR Checklist, cuyas búsquedas se realizaron en las bases de datos Cochrane Library, Embase, Biblioteca Virtual de Salud (BVS), PubMed/MEDLINE, Scopus y Web of Science, mediante estrategias compuestas por los descriptores "Diabetes mellitus", "Diabete Melito", "Diabetes", "Diabetes Melito", "model ECHO", "Project ECHO" y "Extension for Community Healthcare Outcomes". La selección de estudios incluyó a dos revisores que trabajaron de forma independiente utilizando el software de gestión Rayyan-Intelligent Systematic Review. Se seleccionaron nueve de las 151 obras identificadas y se identificó un estudio por medio de la literatura gris. Los diez estudios incluidos fueron publicados en inglés entre 2012 y 2022. Se observaron mejoras en el conocimiento y la confianza en sí mismos de los profesionales, además de una reducción de la hemoglobina glucosilada, de las hospitalizaciones y de los costos de hospitalización de las personas con diabetes. Se concluye que este trabajo expuso un impacto positivo del Modelo ECHO® en el seguimiento de personas con diabetes mellitus, especialmente en comunidades más vulnerables.


Assuntos
Diabetes Mellitus , Humanos , Diabetes Mellitus/terapia , Diabetes Mellitus/diagnóstico , Hospitalização , Hemoglobinas Glicadas/análise , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde Comunitária/organização & administração , Serviços de Saúde Comunitária/métodos
5.
Rev. Bras. Med. Fam. Comunidade (Online) ; 19(46): e-3678, 20241804.
Artigo em Inglês, Português | LILACS, Coleciona SUS | ID: biblio-1572887

RESUMO

Introdução: Diabetes mellitus (DM) é uma doença crônica, não transmissível, cuja prevalência tem aumentado mundialmente. Seu manejo adequado na Atenção Primária à Saúde (APS) pode reduzir suas complicações e as internações por condições sensíveis à atenção primária. Objetivo: Comparar indicadores de qualidade da atenção a pessoas com diabetes atendidas na rede básica de saúde do Brasil e suas diferenças por região. Métodos: Com delineamento transversal, utilizaram-se dados dos Ciclos I e III do Programa de Melhoria do Acesso e da Qualidade (PMAQ). Os desfechos foram indicadores sintéticos, operacionalizados a partir de 24 variáveis: i) acesso; ii) disponibilidade de insumos e equipamentos em condições de uso; iii) disponibilidade de medicamentos em quantidade suficiente; iv) organização e gestão; v) cuidado clínico; e vi) relato de cuidado adequado. Foram calculadas as diferenças em pontos percentuais (p.p.) dos indicadores entre 2012 e 2018, e os dados foram estratificados por região. Resultados: No geral, houve uma melhora no cuidado à pessoa com DM na APS do Brasil e regiões entre as equipes participantes do PMAQ, entre 2012 e 2018. As prevalências de acesso, disponibilidade de insumos/equipamentos, medicamentos, oferta, organização e gestão apresentaram aumento de, no mínimo, 10 p.p. no período de 6 anos, mas podem melhorar. Conclusões: Considerando que a ocorrência de DM está aumentando no país, faz-se necessário maior investimento na estrutura dos serviços e em programas de educação permanente dos profissionais de saúde.


Introduction: Diabetes Mellitus (DM) is a non-communicable chronic disease whose prevalence has been increasing worldwide. Its adequate management in Primary Health Care (PHC) can reduce complications and hospitalizations for conditions sensitive to primary care. Objective: To compare quality indicators for the care of people with diabetes treated in the basic health network in Brazil and their differences by region. Methods: With a cross-sectional design, data from Cycles I and III of the PMAQ were used. The outcomes were synthetic indicators, operationalized from 24 variables: i) access; ii) availability of supplies and equipment in usable conditions; iii) availability of medications in sufficient quantities; iv) organization and management; v) clinical care; and vi ) report of adequate care. Differences in percentage points (p.p.) of the indicators between 2012 and 2018 were calculated, and the data were stratified by region. Results: Overall, there was an improvement in the care of people with DM in PHC in Brazil and regions among the teams participating in PMAQ, between 2012 and 2018. The prevalence of access, availability of supplies/equipment, medications, demand, organization, and management showed an increase of at least 10 p.p. within six years, but they can improve. Conclusions: Considering that the occurrence of DM is increasing in the country, greater investment is necessary in the structure of services and in continuing education programs for health professionals.


La Diabetes Mellitus es una enfermedad crónica no transmisible cuya prevalencia ha aumentado en todo el mundo. Su manejo adecuado en la Atención Primaria puede reducir sus complicaciones y las hospitalizaciones por afecciones sensibles a la Atención Primaria. Objetivo: comparar indicadores de calidad de la atención a personas con diabetes atendidas en la red básica de salud de Brasil y sus diferencias por región. Métodos: Con delineamiento transversal, se utilizaron datos de los Ciclos I y III del PMAQ. Los defectos fueron indicadores sintéticos, operacionalizados a partir de 24 variables: i) acceso, ii) disponibilidad de insumos y equipos en condiciones utilizables, iii) disponibilidad de medicamentos en cantidad suficiente, iv) organización y gestión, v) atención clínica y vi) reporte de atención adecuada. Se calcularon las diferencias en puntos porcentuales (p.p.) de los indicadores entre 2012 y 2018, y los datos se estratificaron por regiones. Resultados: En general, hubo una mejora en la atención a las personas con DM en APS en Brasil y regiones entre los equipos participantes en el PMAQ entre 2012 y 2018. La prevalencia del acceso, la disponibilidad de insumos/equipos, los medicamentos, el suministro, la organización y la gestión mostraron un aumento de al menos 10 p.p. en el periodo de seis años, pero pueden mejorar. Conclusiones: Considerando que la ocurrencia de DM está aumentando en el país, es necesario invertir más en la estructura de los servicios y en programas de educación continuada para los profesionales de salud.


Assuntos
Humanos , Atenção Primária à Saúde , Diabetes Mellitus , Doença Crônica , Indicadores de Qualidade em Assistência à Saúde
6.
Rev. Bras. Med. Fam. Comunidade (Online) ; 19(46): e-4458, 20241804. ilus, tab, graf
Artigo em Português | LILACS, Coleciona SUS | ID: biblio-1587164

RESUMO

Introdução: Até o século passado, as principais causas de mortalidade no Brasil e no mundo eram as doenças infecciosas e a fome. No entanto, com as mudanças no perfil epidemiológico ao longo do século XXI, as doenças crônicas não transmissíveis, como Diabetes Mellitus (DM) e Hipertensão Arterial Sistêmica (HAS), passaram a predominar na morbimortalidade. Nesse sentido, Atenção Primária à Saúde (APS) desempenha um papel crucial na prevenção, detecção precoce, tratamento e acompanhamento dessas condições, ainda que muitos pacientes continuem a enfrentar complicações graves, como doenças cardiovasculares e renais. Objetivo: O objetivo deste estudo foi descrever a prevalência e o perfil epidemiológico de internações e óbitos por DM e HAS no estado da Bahia entre 2010 e 2022. Métodos: Foi realizado um estudo ecológico e descritivo com base nos dados dos Sistemas de Informação Hospitalar e de Mortalidade do DataSUS. A população-alvo incluiu residentes do estado da Bahia, com descrição de variáveis como internação e óbito de acordo com sexo, cor/raça, faixa etária, escolaridade, estado civil, caráter e regime de atendimento e local do óbito. Por se tratar de dados de domínio público, não foi necessária a aprovação do Comitê de Ética em Pesquisa. Resultados: No período, foram registradas 164.176 internações por DM, sendo a maioria de pacientes mulheres, com 60 anos ou mais e que se autodeclararam pardas. Em relação à HAS, ocorreram 127.080 internações, com o mesmo perfil de prevalência: pacientes do sexo feminino, com 60 anos ou mais e que se autodeclararam pardas. Foram registrados 67.385 óbitos atribuídos ao DM e 55.485 à HAS, com perfil de prevalência semelhante: pessoas do sexo feminino, maiores de 70 anos, pardas e com baixa escolaridade. O coeficiente de mortalidade para DM variou de 28,8 por 100.000 habitantes em 2010 para 46,5 em 2022, e o para HAS variou de 24,8 em 2010 para 43 em 2022. Ademais, 97,7% dos atendimentos relacionados ao DM e 98,8% à HAS ocorreram em situações de urgência. Conclusões: Esses achados evidenciam a necessidade de fortalecer a APS, com foco na prevenção, no diagnóstico precoce, no tratamento adequado e no controle do DM e da HAS para evitar complicações graves, hospitalizações e óbitos por essas causas. A implementação de programas de educação em saúde, visando à promoção de estilos de vida saudáveis, é crucial para reduzir a incidência dessas doenças. Além disso, é fundamental garantir condições de vida e trabalho que promovam escolhas saudáveis e o acesso equitativo aos serviços de saúde, especialmente para as populações mais vulneráveis, a fim de reduzir as desigualdades em saúde.


Introduction: Until the last century, the leading causes of mortality in Brazil and worldwide were infectious diseases and hunger. However, with changes in the epidemiological profile throughout the 21st century, noncommunicable chronic diseases, such as Diabetes Mellitus (DM) and Systemic Arterial Hypertension (SAH), have become predominant in terms of morbidity and mortality. Primary Health Care (PHC) plays a crucial role in the prevention, early detection, treatment, and follow-up of these conditions, although many patients still face severe complications such as cardiovascular and kidney diseases. Objective: The objective of this study was to describe the prevalence and epidemiological profile of hospitalizations and deaths due to DM and SAH in the state of Bahia, Brazil, between 2010 and 2022. Methods: An ecological and descriptive study was conducted based on data from the DataSUS Hospital Information and Mortality Systems. The target population included residents of the state of Bahia, with variables such as hospitalization and death described according to sex, skin color/ethnicity, age group, level of education, marital status, type of care, and place of death. As public domain data were used for this study, approval from the Research Ethics Committee was not required. Results: During the period, 164,176 hospitalizations due to DM were recorded, most of them involving women aged 60 years or older who self-identified as brown. For SAH, there were 127,080 hospitalizations, with the same prevalence profile: women aged 60 years or older who self-identified as brown. A total of 67,385 deaths attributed to DM and 55,485 to SAH were recorded, with a similar prevalence profile: women, over 70 years old, brown, and with low levels of education. The DM mortality rate ranged from 28.8 per 100 thousand inhabitants in 2010 to 46.5 in 2022. The SAH mortality rate ranged from 24.8 in 2010 to 43 in 2022. Furthermore, 97.7% of DM-related care and 98.8% of SAH-related care occurred in urgency situations. Conclusions: Our findings highlight the need to strengthen PHC, focusing on prevention, early diagnosis, appropriate treatment, and control of DM and SAH to prevent severe complications, hospitalizations, and deaths from these causes. Implementing health education programs aimed at promoting healthy lifestyles is crucial to reduce the incidence of these diseases. In addition, it is essential to ensure living and working conditions that promote healthy choices and equitable access to healthcare services, especially for the most vulnerable populations, in order to reduce health inequalities.


Introducción: Hasta el siglo pasado, las principales causas de mortalidad en Brasil y en el mundo eran las enfermedades infecciosas y el hambre. Sin embargo, con los cambios en el perfil epidemiológico a lo largo del siglo XXI, las enfermedades crónicas no transmisibles, como la Diabetes Mellitus (DM) y la Hipertensión Arterial Sistémica (HAS), pasaron a predominar en la morbilidad y mortalidad. La Atención Primaria de Salud (APS) desempeña un papel crucial en la prevención, detección temprana, tratamiento y seguimiento de estas condiciones, aunque muchos pacientes siguen enfrentando complicaciones graves, como enfermedades cardiovasculares y renales. Objetivo: El objetivo de este estudio fue describir la prevalencia y el perfil epidemiológico de hospitalizaciones y muertes por DM y HAS en el estado de Bahía entre 2010 y 2022. Métodos: Se realizó un estudio ecológico y descriptivo basado en los datos de los Sistemas de Información Hospitalaria y de Mortalidad de DataSUS. La población objetivo incluyó residentes del estado de Bahía, con la descripción de variables como hospitalización y muerte según sexo, raza/etnia, grupo de edad, nivel educativo, estado civil, tipo de atención y lugar del fallecimiento. Al tratarse de datos de dominio público, no fue necesaria la aprobación del Comité de Ética en Investigación. Resultados: Durante el período, se registraron 164,176 hospitalizaciones por DM, siendo la mayoría mujeres, con 60 años o más y que se autodeclararon de raza mixta. Con relación a la HAS, ocurrieron 127,080 hospitalizaciones, con el mismo perfil de prevalencia: pacientes de sexo femenino, de 60 años o más y que se autodeclararon de raza mixta. Se registraron 67,385 muertes atribuidas a la DM y 55,485 a la HAS, con un perfil de prevalencia similar: personas de sexo femenino, mayores de 70 años, de raza mixta y con baja escolaridad. El coeficiente de mortalidad por DM varió de 28,8 por 100,000 habitantes en 2010 a 46,5 en 2022. El coeficiente de mortalidad por HAS varió de 24,8 en 2010 a 43 en 2022. Además, el 97,7% de las atenciones relacionadas con la DM y el 98,8% con la HAS ocurrieron en situaciones de urgencia. Conclusiones: Estos hallazgos evidencian la necesidad de fortalecer la APS, con un enfoque en la prevención, diagnóstico temprano, tratamiento adecuado y control de la DM y la HAS para evitar complicaciones graves, hospitalizaciones y muertes por estas causas. La implementación de programas de educación en salud, orientados a la promoción de estilos de vida saludables, es crucial para reducir la incidencia de estas enfermedades. Además, es fundamental garantizar condiciones de vida y trabajo que promuevan elecciones saludables y el acceso equitativo a los servicios de salud, especialmente para las poblaciones más vulnerables, con el fin de reducir las desigualdades en salud.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus , Hipertensão , Atenção Primária à Saúde , Indicadores de Morbimortalidade , Determinantes Sociais da Saúde , Doenças não Transmissíveis
7.
P R Health Sci J ; 43(4): 226-229, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39671417

RESUMO

OBJECTIVE: Evaluate the relationship between diabetes and hypertension and COVID-19 booster uptake. METHODS: Members of the Community Outreach Group of the Puerto Rico Community Engagement Alliance Against COVID-19 Disparities (PR-CEAL) administered a survey at 229 community events between November 2021 and May 2023. Information on 2,145 participants' sociodemographic information and chronic disease diagnoses was gathered. Characteristics distributions were described using frequency and percentages. The associations between demographic factors and booster uptake were assessed using chi-squared analysis for categorical variables. Multivariate logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI), adjusting for age, sex, education, and medical insurance, to investigate the relationship between hypertension and diabetes and booster uptake. RESULTS: Participants' mean age was 43.8 years. Most (80%) were women and had received a COVID-19 booster (84%). A high prevalence of hypertension (43%) and diabetes (33%) was observed in this study sample. Bivariate analyses showed a statistically significant association between receiving the booster and having hypertension or diabetes (p<0.05). Adjusted multivariate analysis showed that participants with diabetes were 3% more likely to have the booster than those without diabetes (OR=1.03, 95% CI: (1.01-1.05), p<0.05). No significant association was found between hypertension and booster uptake in the adjusted multivariate analysis (OR=1.01, 95% CI: (0.99-1.03), p=0.13). CONCLUSION: Insights from this study can inform future vaccination campaigns through improved awareness and prevention strategies by targeting vulnerable populations in Puerto Rico.


Assuntos
COVID-19 , Diabetes Mellitus , Hipertensão , Humanos , Hipertensão/epidemiologia , Feminino , Masculino , COVID-19/epidemiologia , COVID-19/prevenção & controle , Adulto , Diabetes Mellitus/epidemiologia , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Idoso , Inquéritos e Questionários , Adulto Jovem
8.
Int J Geriatr Psychiatry ; 39(12): e70029, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39643588

RESUMO

OBJECTIVE: With an increasing prevalence, Alzheimer's Disease (AD) is the most common cause of dementia. However, a percentage of potentially modifiable cases have been reported. This article describes the prevalence of four of these potentially modifiable risk factors: hearing loss, diabetes mellitus (DM), obesity, and hypertension. METHODS: Descriptive cross-sectional study with data from 2018 to 2022, using the Colombian health system database SISPRO. The population of this study consisted of all people within the age range 50-100 with a main diagnosis of AD according to the ICD-10 codes. Subjects were divided by decades, and the prevalence ratio (PR) for the outcome of AD and each of its potentially modifiable risk factors was then calculated and adjusted by age using the Mantel-Haenszel formula. RESULTS: 167,556 cases of AD were identified, with 66.4% being females. Peak age was in octogenarians, and the five-years period prevalence for people older than 50 was 12.6 cases/1000 people. The PRs showed a positive association for all risk factors, except obesity. Following age correction, obesity's PR value shifted to positive in males and overall population but remained negative for females. The highest post-correction PR in the overall population was hypertension (1.44), followed by DM (1.34), hearing loss (1.31) and obesity (1.12). Notably, PRs had a greater magnitude in younger and male age groups. CONCLUSION: The results of this study are consistent with the fact that the prevalence of potentially modifiable risk factors is higher within the group of people with AD as their main diagnosis.


Assuntos
Doença de Alzheimer , Diabetes Mellitus , Perda Auditiva , Hipertensão , Obesidade , Humanos , Colômbia/epidemiologia , Masculino , Feminino , Doença de Alzheimer/epidemiologia , Idoso , Fatores de Risco , Estudos Transversais , Pessoa de Meia-Idade , Prevalência , Idoso de 80 Anos ou mais , Perda Auditiva/epidemiologia , Obesidade/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Bases de Dados Factuais
9.
Arch Osteoporos ; 20(1): 6, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-39738980

RESUMO

The FRAX® algorithm showed good accuracy in women living with DM followed in primary care. There were no differences between the ROC curve with and without adjustments for major and hip fractures. The FRAX® 10-year and FRAX® AR were better calibrated in this population. PURPOSE: An increased risk of fractures in people living with diabetes has been described. Screening instruments to calculate this risk have been proposed, including the FRAX® algorithm. Some studies suggest that minor modifications to this instrument can improve its performance. These modifications work well in other countries, but we do not know if they work in Brazil. The objective of our study was to evaluate the performance of the FRAX® algorithm with and without adjustments for women living with DM (WLDM) in primary care in Brazil. METHODS: A cohort study that included post-menopausal women attending primary care in Santa Maria, Brazil, was conducted from 2013 to 2018. The risk for major and hip fractures was calculated using the FRAX® tool. The FRAX® risk was calculated: (1) without adjustments (unadjusted FRAX®); (2) increasing the entered age by 10 years in individuals with DM (FRAX® 10 years); and (3) inserting the diagnosis of DM as rheumatoid arthritis (FRAX® AR). RESULTS: The accuracy for major fracture was 0.948 (unadjusted FRAX®), 0.947 (FRAX® 10 years), and 0.946 (FRAX® AR). For hip fractures, the accuracies were 0.989 (unadjusted FRAX®), 0.988 (FRAX® 10 years), and 0.988 (FRAX® AR). Furthermore, there were no differences between the area under the ROC curve with and without adjustments for major and hip fractures. Conversely, the FRAX® 10 years and the FRAX® AR were better calibrated, presenting a lower Chi-square. CONCLUSION: The FRAX® algorithm showed good accuracy in WLDM followed in primary care. The FRAX® 10 years and FRAX® AR were better calibrated in this population.


Assuntos
Algoritmos , Fraturas do Quadril , Fraturas por Osteoporose , Atenção Primária à Saúde , Humanos , Feminino , Brasil/epidemiologia , Pessoa de Meia-Idade , Idoso , Atenção Primária à Saúde/estatística & dados numéricos , Medição de Risco/métodos , Fraturas por Osteoporose/epidemiologia , Fraturas do Quadril/epidemiologia , Estudos de Coortes , Fatores de Risco , Diabetes Mellitus/epidemiologia , Idoso de 80 Anos ou mais
10.
BMC Med Inform Decis Mak ; 24(1): 383, 2024 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-39695649

RESUMO

BACKGROUND: Diabetes mellitus (DM) is a chronic disease prevalent worldwide, requiring a multifaceted analytical approach to improve early detection and subsequent mitigation of morbidity and mortality rates. This research aimed to develop an explainable analysis of DM by combining sociodemographic and clinical data with statistical and artificial intelligence (AI) techniques. METHODS: Leveraging a small dataset that includes sociodemographic and clinical profiles of diabetic and non-diabetic individuals, we employed a diverse set of statistical and AI models for predictive purposes and assessment of DM risk factors. The statistical tests used were Student's t-test and Chi-square, while the AI techniques were fuzzy cognitive maps (FCM), artificial neural networks (ANN), support vector machines (SVM), and XGBoost. RESULTS: Our statistical models facilitated an in-depth exploration of variable associations, while the resulting AI models demonstrated exceptional efficacy in DM classification. In particular, the XGBoost model showed superior performance in accuracy, sensitivity and specificity with values of 1 for each of these metrics. On the other hand, the FCM stood out for its explainability capabilities by allowing an analysis of the variables involved in the prediction using scenario-based simulations. CONCLUSIONS: An integrated analysis of DM using a variety of methodologies is critical for timely detection of the disease and informed clinical decision-making.


Assuntos
Inteligência Artificial , Diabetes Mellitus , Humanos , Redes Neurais de Computação , Pessoa de Meia-Idade , Feminino , Masculino , Modelos Estatísticos , Máquina de Vetores de Suporte , Adulto , Idoso
11.
Int J Mol Sci ; 25(23)2024 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-39684379

RESUMO

A large number of studies have reported the relationships between leptin levels and diabetes or obesity. However, the results are still controversial, and no consensus has been reached. Therefore, the purpose of the study was to collect data from various databases to perform a meta-analysis and address the inconsistencies in these studies. A systematic literature search was conducted on PubMed, Web of Science, and EBSCO for relevant available articles. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was used to estimate the association by a meta-analysis. Fifteen reports with 1,388 cases and 3,536 controls were chosen for the meta-analysis. First, an increase in leptin levels in serum (SMD 0.69; 95% CI 0.36-1.02 ng/mL) and plasma (SMD 0.46; 95% CI 0.18-0.74 ng/mL) was observed in individuals with diabetes compared to controls. This increased level was also observed by gender and population. Second, statistical analysis showed that leptin levels in serum were significantly increased in individuals with obesity (SMD 1.03; 95% CI 0.72-1.34 ng/mL). This meta-analysis analyzed leptin in individuals with diabetes or obesity and emphasized the importance of monitoring serum/plasma leptin levels in patients with these diseases. However, more comprehensive studies are necessary in order to draw firm conclusions.


Assuntos
Leptina , Obesidade , Leptina/sangue , Humanos , Obesidade/sangue , Doenças Metabólicas/sangue , Diabetes Mellitus/sangue , Feminino , Masculino , Biomarcadores/sangue
12.
Medicina (B Aires) ; 84(6): 1049-1060, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39666397

RESUMO

INTRODUCTION: Since the onset of the COVID-19 pandemic, cases of COVID-19-associated pulmonary aspergillosis (CAPA) have been described. Possible risk factors for the development of this condition have been proposed, although evidence in Latin American populations is limited. The objectives were to identify risk factors for the development of CAPA and describe the characteristics of this infection. MATERIALS AND METHODS: A retrospective case-control study was conducted. The population consisted of adult patients with severe COVID-19, hospitalized in ICU and who had undergone diagnostic tests for invasive pulmonary aspergillosis. RESULTS: Seventy-five patients were evaluated, 21 in the case group and 54 in the control group. 64% were male, with an average age of 62.7 years. It was found that a history of diabetes (OR 3.3, CI 1.09-9.95, p=0.03), smoking (OR 3.47, CI 1.20-10, p=0.02), coronary artery disease (OR 5, CI 1.24-20.08, p=0.02), and a Charlson score equal to or greater than 5 (OR 1.27, CI 1-1.60, p=0.013) could be associated with the development of CAPA. Most cases were considered as possible CAPA (87.5%). The time between orotracheal intubation to the diagnosis of CAPA was 11.5 days. Fever was the most common symptom (90%), and only 24% of patients had compatible radiographic findings. Mortality in the case group was 61.9%. DISCUSSION: A history of diabetes, smoking, coronary artery disease, and a Charlson score equal to or greater than 5 may increase the risk of developing CAPA.


Introducción: La evidencia sobre factores de riesgo para el desarrollo de aspergilosis pulmonar asociada a COVID-19 (CAPA), en poblaciones de Latinoamérica, es escasa. Los objetivos del presente estudio fueron identificar factores de riesgo para el desarrollo de CAPA en pacientes con COVID-19 grave y describir las características de la infección. Materiales y métodos: Estudio retrospectivo de casos y controles. La población incluyó pacientes adultos, con COVID-19 grave, sometidos a pruebas diagnósticas para CAPA. Resultados: Se evaluaron 75 pacientes, 21 casos y 54 controles (relación 1:2.6). El promedio de edad fue 62.7 años. El antecedente de diabetes (OR 3.3 IC 1.09 - 9.95, p=0.03), tabaquismo (OR 3.47 IC 1.20-10, p=0.02), enfermedad coronaria (OR 5 IC 1.24-20.08, p=0.02) y score de Charlson ≥ 5 (OR 1.27, IC 1- 1.60, p=0.013) podrían asociarse al desarrollo de CAPA. El 87.5% de los casos se consideraron como CAPA posible. El tiempo entre la intubación orotraqueal y el diagnóstico de CAPA fue de 11.5 días. El síntoma más frecuente fue la fiebre (90%) y solo el 24% de los pacientes presentó hallazgos radiológicos compatibles con aspergilosis. La mortalidad en el grupo de casos fue de 61.9%. Discusión: El antecedente de diabetes, tabaquismo, enfermedad coronaria y score de Charlson igual o mayor a 5 podría aumentar el riesgo de desarrollar CAPA en pacientes con COVID-19 grave.


Assuntos
COVID-19 , Aspergilose Pulmonar Invasiva , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Fatores de Risco , COVID-19/complicações , Aspergilose Pulmonar Invasiva/epidemiologia , Aspergilose Pulmonar Invasiva/complicações , Estudos Retrospectivos , Estudos de Casos e Controles , Idoso , Índice de Gravidade de Doença , SARS-CoV-2 , Fumar/efeitos adversos , Diabetes Mellitus/epidemiologia
13.
Medicina (B Aires) ; 84(6): 1226-1234, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-39666416

RESUMO

Continuous glucose monitoring (CGM) provides comprehensive and dynamic information to guide the management of diabetes mellitus (DM). This paper summarizes the evidence and implications of the use of the new CGM system, FreeStyle Libre 2 (FSL2). A global review of the literature on the use of FSL2 in people with DM was performed. All types of studies were included. The evidence is presented qualitatively together with expert clinical opinion. FSL2 is an integrated CGM system with real-time glucose readings (no scanning required) and customizable alarms. In studies of subjects aged 2 years and older with DM1 or DM2, the overall mean absolute relative difference for FSL2 was 8.2%, with a high degree of clinical accuracy. Compared to blood monitoring in DM1, studies show higher time within range, lower time below range and lower time above range at 4, 8 and 12 weeks of FSL2 use. These results were confirmed in observational studies in DM, where the majority of FSL2 users reported greater satisfaction with treatment and a significant improvement in quality of life. In concluded, Including the FSL2 system in the management of people with DM would also reduce the risks associated with DM complications, improving the prognosis of this population and allowing for the appropriate use of healthcare resources.


El monitoreo continuo de glucosa (MCG) proporciona información completa y dinámica para guiar el tratamiento de la diabetes mellitus (DM). Este documento sintetiza la evidencia e implicancias del uso del FreeStyle Libre 2 (FSL2), un sistema integrado de MCG con lecturas de glucosa en tiempo real (sin necesidad de escaneo) y alarmas personalizables. Se realizó una revisión global de la literatura que incluyó todo tipo de estudios y se presentó la evidencia de manera cualitativa junto con la opinión de expertos clínicos. Se identificaron estudios en sujetos a partir de los 2 años de edad con DM1/DM2, que han registrado una diferencia media relativa absoluta global del 8.2% para FSL2, con un alto grado de exactitud clínica. En comparación con la monitorización sanguínea en DM1, los ensayos muestran mayor tiempo dentro del rango, menor tiempo por debajo del rango y menor tiempo por encima del rango, a 4, 8 y 12 semanas de uso del FSL2. Estos resultados se han confirmado en estudios observacionales en DM, en los que la mayoría de los usuarios de FSL2 reportaron mayor satisfacción con el tratamiento y mejor calidad de vida. En conclusión, la inclusión del sistema FSL2 en el manejo de la DM reduciría los riesgos asociados a las complicaciones de la DM, mejorando el pronóstico de esta población y permitiendo un uso adecuado de los recursos sanitarios.


Assuntos
Automonitorização da Glicemia , Glicemia , Humanos , Automonitorização da Glicemia/instrumentação , Automonitorização da Glicemia/métodos , Glicemia/análise , Diabetes Mellitus/sangue , Qualidade de Vida , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 1/sangue , Monitoramento Contínuo da Glicose
14.
Rev Gaucha Enferm ; 45: e20230279, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39699431

RESUMO

OBJECTIVE: to verify the effect of educational technologies on the quality of life of people with diabetes. METHOD: quasi-experimental study, before-and-after type, developed with a group of 34 people. Six interventions were carried out, in groups or individually, using educational technologies, such as clinical simulators and physical educational games. A questionnaire was used to extract sociodemographic and clinical data. To assess quality of life, the Diabetes Quality of Life Measure (DQOL) was applied at the initial (T0) and final (T1) moments. The paired Student's t-test was used to compare the mean scores at T0 and T1, adopting a significance level ≤ 0.05. RESULTS: the mean overall DQOL score revealed an increase from 142.7 (±11.8) to 162.2 (±9.1), with a statistically significant difference (p<0.001). The domains of satisfaction, impact and concerns related to diabetes also showed an increase with statistical difference. There was a significant reduction in postprandial blood glucose levels after the interventions, with a statistically significant difference (p<0.001). CONCLUSION: the use of educational technologies in educational interventions demonstrated an improvement in the quality of life of people living with diabetes.


Assuntos
Diabetes Mellitus , Educação de Pacientes como Assunto , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Diabetes Mellitus/terapia , Diabetes Mellitus/psicologia , Educação de Pacientes como Assunto/métodos , Tecnologia Educacional , Adulto , Idoso , Inquéritos e Questionários , Estudos Controlados Antes e Depois
15.
BMJ Paediatr Open ; 8(1)2024 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-39725454

RESUMO

BACKGROUND: Post-transplantation diabetes mellitus and carbohydrate intolerance (PTDM/iCHO) are complications following solid organ transplantation, which significantly increases the risk of graft loss and mortality. However, data concerning long-term outcomes in paediatric kidney transplant recipients with PTDM/iCHO are scarce. This study aimed to evaluate the risk of graft loss in paediatric kidney transplant recipients with PTDM or iCHO compared with non-PTDM/iCHO. METHODS: The study cohort included patients aged <18 who underwent a kidney transplant in a transplant centre from 2005 to 2022. The primary outcome was graft survival loss; secondary outcomes were acute rejection, renal function and mortality. Cumulative incidence of graft loss and acute rejection was estimated, considering death a competing risk. Fine and Gray's proportional subdistribution hazard model was used to analyse the effect of PTDM/iCHO status on the event. RESULTS: Seventy-six paediatric kidney transplant recipients were included. The incidence of PTDM and iCHO was 6.6% and 9.2%, respectively. Patients with PTDM/iCHO had a significantly higher cumulative graft loss incidence than those without (34.4% vs 13.9% at 36 months, p<0.008). Multivariable analysis revealed a threefold increased risk of graft loss in patients with PTDM/iCHO (HRadjusted 3.33, 95% CI 1.19 to 9.30, p=0.022). PTDM/iCHO was associated with a higher incidence of acute rejection (33.3% vs 14.5% at 1 year, p=0.025). Patients with PTDM/iCHO also exhibited significantly worse eGFR at all time points compared with patients without PTDM/iCHO (p=0.036) CONCLUSION: Patients with PTDM and iCHO had a higher risk of graft loss and lower renal function in paediatric kidney transplant recipients. This justifies close monitoring of metabolic complications in these patients.


Assuntos
Rejeição de Enxerto , Sobrevivência de Enxerto , Transplante de Rim , Humanos , Transplante de Rim/efeitos adversos , Masculino , Feminino , Criança , Adolescente , Rejeição de Enxerto/epidemiologia , Diabetes Mellitus/epidemiologia , Incidência , Estudos Retrospectivos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/etiologia , Análise de Sobrevida , Pré-Escolar , Transplantados/estatística & dados numéricos , Fatores de Risco
16.
J Nanobiotechnology ; 22(1): 802, 2024 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-39734205

RESUMO

Diabetes mellitus (DM) prevalence is rising worldwide. Current therapies comprising subcutaneous insulin injections can cause adverse effects such as lipodystrophy, local reactions like redness and swelling, fluid retention, and allergic reactions. Nanoparticle carriers for oral insulin are groundbreaking compared to existing methods because they are non-invasive treatments, showing operational convenience, controlled release profile, and ability to simulate the physiological delivery route into the bloodstream. These systems improve patient adherence and have demonstrated the potential to lower blood glucose levels in DM. We present a systematic review and meta-analysis aimed at compiling relevant data to pave the way for developing innovative nano- and microparticles for the oral delivery of insulin. Our analysis of 85 articles revealed that the diminution of glucose levels is not proportional to the administered insulin dosage, which ranged from 1 to 120 International Units (IU). The meta-analysis data indicated that 25 IU of encapsulated porcine insulin did not produce a statistically significant outcome (p = 0.93). In contrast, a dosage of 30 IU was efficacious in eliciting an optimal hypoglycemic effect compared to excipient controls. Parameters such as a high degree of encapsulation (~ 90%), particle size (200-400 nm), and polydispersity index (0.086-0.3) are all associated with lower blood glucose levels. These parameters were also significant in the linear regression analysis. Among the excipients employed, chitosan emerged as a prevalent excipient in formulations due to its biocompatible and biodegradable properties and its ability to establish stable polymeric matrices. Even though oral insulin administration is a promising therapeutic method, it cannot guarantee preclinical safety and therapeutic efficacy yet in regulating glucose levels in diabetic conditions.


Assuntos
Insulina , Nanopartículas , Administração Oral , Insulina/administração & dosagem , Humanos , Animais , Nanopartículas/química , Glicemia/efeitos dos fármacos , Diabetes Mellitus/tratamento farmacológico , Tamanho da Partícula , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Portadores de Fármacos/química , Sistemas de Liberação de Medicamentos/métodos
17.
Ciudad de México; OPS; 2024-12-26.
em Espanhol | PAHO-IRIS | ID: phr2-63545

RESUMO

Este boletín es elaborado por la Representación de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) en México. Su objetivo primordial es difundir las actividades de cooperación técnica entre la OPS y la Secretaría de Salud Federal, así como con otras instituciones que son parte del Sistema de Salud en el país.


Assuntos
Cooperação Técnica , Cooperação Internacional , Declaração de Alma-Ata , Saúde Mental , Wolbachia , Infecções por Arbovirus , Dengue , Malária , Rickettsia , Hipertensão , Diabetes Mellitus , Políticas, Planejamento e Administração em Saúde , Aleitamento Materno , Epidemiologia , Saúde Ambiental , Educação em Saúde
18.
Respirar (Ciudad Autón. B. Aires) ; 16(4): 421-423, Dic.2024.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1580726

RESUMO

Los empiemas fúngicos representan una entidad potencialmente fatal, con tasas de mortalidad elevadas en la mayoría de las series. Se presenta el caso de un empiema por Candida albicans tratado exitosamente en un paciente diabético. Se demuestra la importancia del inicio precoz y agresivo del tratamiento.


Fungal empyemas represent a potentially fatal entity, with high mortality rates in most series. A case of empyema due to Candida albicans successfully treated in a diabetic patient is presented, demonstrating the importance of early and aggressive initiation of treatment.


Assuntos
Humanos , Masculino , Adulto , Derrame Pleural , Candida albicans/isolamento & purificação , Doença Celíaca , Diabetes Mellitus , Empiema/tratamento farmacológico , Toracoscopia , Ferimentos e Lesões , Incidência , Mortalidade , Febre , Laparotomia , Leucocitose , Antifúngicos/uso terapêutico
19.
Revista Digital de Postgrado ; 13(3): e404, dic.2024. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1584737

RESUMO

Introducción: El estudio fue diseñado como una simulación, basada en el aprendizaje experiencial, orientada a sensibilizar a los participantes del Diplomado Multidisciplinario en Educación en Diabetes de la Universidad Central de Venezuela y a tomar conciencia de las barreras que enfrentan y deben superar las personas con diabetes al intentar adquirir hábitos de vida saludable. Método: La undécima cohorte del Diplomado se distribuyó en cuatro grupos y a cada participante se le pidió que se fijara una meta de actividad física a alcanzar en un mes, así como dar apoyo a sus compañeros en su esfuerzo individual. Toda la interacción dentro del grupo se llevó a cabo de manera virtual. Al final de la actividad, se les pidió que escribieran una reflexión sobre la experiencia. Se trató de una investigación aplicada de tipo cualitativo en el cual serealizó un muestreo por conveniencia y todas las reflexiones fueron analizadas cualitativamente, utilizando un análisis de contenido convencional que permitió la creación de categorías y subcategorías. Resultados: Se distinguen 4 categorías: 1) Impacto personal (3 subcategorías), 2) Reforzamiento por el grupo, 3) Empatía hacia los pacientes y 4) Conocimiento práctico (2 subcategorías). Conclusión: El análisis de las reflexiones de los participantes mostró que se involucraron emocionalmente en la actividad,lo que los llevó a comprender de manera empática las dificultades que experimentan los pacientes con diabetes al intentar cambiar sus hábitos. Además, la experiencia los llevó a sugerir formas de superar estas dificultades, consecuencia de las que ellos mismos pusieron en práctica sobre las suyas.


ntroduction: Participants of the Multidisciplinary Diploma in Diabetes Education at the Central University of Venezuela were subject of the study. It was designed as a stratagem, based on experiential learning, aimed at raising awareness of the barriers that diabetes patients face and must overcome when trying to acquire healthy lifestyle habits. Method: The eleventh cohort of the Diploma were distributed into four groups and each participant was asked to set a goal to achieve within a month regarding physical activity, as well as trying to support their peers. All interactions within the group were carried out virtually. At the end of the activity, they were asked to write a reflection on the experience. A convenience sampling was carried out and all thereflections were analyzed qualitatively, using a conventional content-analysis that allowed the creation of categories and subcategories. Results: Four categories were obtained: 1) Personal impact (3 subcategories), 2) Reinforcement by the group, 3) Empathy towards patients and 4) Practical knowledge (2 subcategories). Conclusion: Analysis of the participants' reflections showed that they were emotionally involved in the activity, leading them to an empathetic understanding of the difficulties experienced by diabetics when trying to change their habits. In addition, the experience led them to suggest ways to overcome these difficulties, consequential to those they themselves put into practice over their own.


Assuntos
Humanos , Masculino , Feminino , Diabetes Mellitus/prevenção & controle , Empatia , Treinamento por Simulação/métodos , Aprendizagem , Equipe de Assistência ao Paciente , Exercício Físico , Conhecimentos, Atitudes e Prática em Saúde , Educação em Saúde , Cursos de Capacitação , Assistência ao Paciente
20.
Semina cienc. biol. saude ; 45(2): 145-156, jul./dez. 2024. ilus; tab.
Artigo em Português | LILACS | ID: biblio-1579176

RESUMO

Objetivo: verificar a prevalência de diabetes mellitus (DM) autorreferida na população adulta no Brasil. Método: estudo epidemiológico ecológico descritivo realizado no período de 2006 a 2020, com base nos dados do Sistema de Monitoramento de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel), para doenças crônicas não transmissíveis. A população foi constituída por adultos (≥ 18 anos de idade) brasileiros de todas as capitais dos 26 estados brasileiros e o Distrito Federal e que participaram do Vigitel. As variáveis de interesse foram: ano, sexo, faixa etária, escolaridade, região e capital. Resultados: observou-se maior prevalência de DM autorreferida nas capitais do Rio de Janeiro (8,1%) e de São Paulo (7,8%), e a menor taxa em Palmas (4,1%). Com relação às grandes regiões, a maior prevalência foi na região Sudeste (7,1%) e a menor na região Norte (5,1%). Verificou-se ainda, maior prevalência no sexo feminino e entre as pessoas com 0 a 8 anos de estudo (11,7%). Conclusão: a prevalência de diabetes mellitus autorreferida na população adulta no Brasil entre os anos de 2006 e 2020 apresentou crescimento em todas as capitais dos estados brasileiros e o Distrito Federal por triênio, destacando-se as capitais do Rio de Janeiro e de São Paulo com os maiores valores e Palmas com o menor valor.


Objective: to verify the prevalence of self-reported diabetes mellitus (DM) in the adult population in Brazil. Method: descriptive ecological epidemiological study conducted in the period of 2006-2020, based on data from the Surveillance Monitoring System of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel) for chronic non-communicable diseases. The population Abstract consisted of Brazilian adults (≥ 18 years of age) from all the 26 Brazilian state capitals and the Federal District who participated in Vigitel. The variables of interest were data collection year, sex, age, schooling, region, and capital. Results: there was a higher prevalence of self-reported DM in the capitals of Rio de Janeiro (8.1%) and São Paulo (7.8%), and the lowest rate in Palmas (4.1%). Regarding the five- major geographic regions of Brazil, the highest prevalence was in the Southeast (7.1%) and the lowest in the North (5.1%). There was also a higher prevalence in females and among people between 0 to 8 years of schooling (11.7%). Conclusion: the prevalence of self-reported diabetes mellitus in the adult population in Brazil from 2006 to 2020 showed a growth in all capitals of the Brazilian states and the Federal District every triennium. The capitals of Rio de Janeiro and São Paulo showed the highest values and Palmas the lowest one.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , População , Estudos Epidemiológicos , Doença Crônica , Risco , Inquéritos e Questionários , Fatores de Risco , Diabetes Mellitus , Pessoas
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