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1.
Biochem Med (Zagreb) ; 30(1): 010704, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31839724

RESUMO

Introduction: Diabetes mellitus (DM) is one of the most prevalent diseases worldwide. The objective of this study was to find out under what preanalytical conditions routine and diagnostic glucose tests are performed across Spanish laboratories; and also what criteria are used for DM diagnosis. Materials and methods: An online survey was performed by the Commission on Quality Assurance in the Extra-Analytical Phase of the Spanish Society of Laboratory Medicine (SEQC-ML). Access to the questionnaire was available on the home page of the SEQC-ML website during the period April-July 2018. Data analysis was conducted with the IBM SPSS© Statistics (version 20.0) program. Results: A total of 96 valid surveys were obtained. Most laboratories were in public ownership, serving hospital and primary care patients, with high and medium workloads, and a predominance of mixed routine-urgent glucose testing. Serum tubes were the most used for routine glucose analysis (92%) and DM diagnosis (54%); followed by lithium-heparin plasma tubes (62%), intended primarily for urgent glucose testing; point-of-care testing devices were used by 37%; and plasma tubes with a glycolysis inhibitor, mainly sodium fluoride, by 19%. Laboratories used the cut-off values and criteria recognized worldwide for DM diagnosis in adults and glucose-impaired tolerance, but diverged in terms of fasting plasma glucose and gestational DM criteria. Conclusion: Preanalytical processing of routine and DM diagnostic glucose testing in Spain does not allow a significant, non-quantified influence of glycolysis on the results to be ruled out. Possible adverse consequences include a delay in diagnosis and possible under-treatment.


Assuntos
Glicemia/análise , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/instrumentação , Diabetes Mellitus/diagnóstico , Humanos , Laboratórios Hospitalares/normas , Fase Pré-Analítica , Espanha , Inquéritos e Questionários
2.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852069

RESUMO

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Assuntos
Assistência Ambulatorial , Pressão Sanguínea/fisiologia , Diabetes Mellitus/fisiopatologia , Hipertensão/fisiopatologia , Oscilometria/métodos , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Sístole
3.
Klin Lab Diagn ; 64(8): 453-458, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31479598

RESUMO

The article contains the literature review on laboratory criteria of detection and monitoring of the progression of the disease in patients with the diagnosis of diabetes mellitus. It also covers the issues of methodical approaches to the identification of glycated hemoglobin (HbA1c). The findings of author's researches of glycated hemoglobin in 149 patients have been given within the framework of comparison of two methodical approaches and comparison of the results with the subsequent classification of the received data. A random laboratory finding of qualitative hemoglobinopathy has been demonstrated, and the results recognized as unqualifiable and the approach to classification of such values have been discussed.Comparison of the results of glycated hemoglobin identification performed by different methods. 149 patients underwent a one-stage identification of glycated hemoglobin from plasma stabilized with K2-EDTA on Bio-Rad D10 and Sebia Capillarys Flex Piercing 2. Comparative study of the results of glycated hemoglobin identification has shown a difference in absolute values. However, a statistically reliable (p < 0.05) correlation between the values of glycated hemoglobin, expressed as a percentage obtained by different methods, has been revealed. In this case, the choice of a method for identifying glycated hemoglobin is not a matter of principal but it is important to adhere to the same method in treatment and long-term monitoring.


Assuntos
Diabetes Mellitus/diagnóstico , Hemoglobina A Glicada/análise , Eletroforese Capilar , Humanos
4.
BMC Infect Dis ; 19(1): 799, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510930

RESUMO

BACKGROUND: The accuracy of different laboratory tests for diagnosis of diabetes mellitus (DM) and prediabetes (preDM) in populations exposed to tuberculosis (TB) remains poorly understood. Here, we examined the prevalence of DM and preDM in TB affected people in Lima, Peru. METHODS: A prospective cohort study of patients affected TB and their household contacts (HHC), was conducted between February and November 2017 in Lima, Peru. Fasting plasma glucose (FPG), HbA1c and oral glucose tolerance test (OGTT) were used to detect DM and preDM in a prospective cohort of TB patients (n = 136) and household contacts (n = 138). Diagnostic performance of the laboratory tests was analyzed. Potential effects of sociodemographic and clinical factors on detection of dysglycemia were analyzed. RESULTS: In TB patients, prevalence of DM and preDM was 13.97 and 30.88% respectively. Lower prevalence of both DM (6.52%) and preDM (28.99%) were observed in contacts. FPG, HbA1c and OGTT had poor agreement in detection of preDM in either TB cases or contacts. TB-DM patients had substantially lower hemoglobin levels, which resulted in low accuracy of HbA1c-based diagnosis. Classic sociodemographic and clinical characteristics were not different between TB patients with or without dysglycemia. CONCLUSION: High prevalence of DM and preDM was found in both TB patients and contacts in Lima. Anemia was strongly associated with TB-DM, which directly affected the diagnostic performance of HbA1c in such population.


Assuntos
Diabetes Mellitus/diagnóstico , Estado Pré-Diabético/diagnóstico , Tuberculose/patologia , Adulto , Glicemia/análise , Complicações do Diabetes/patologia , Diabetes Mellitus/epidemiologia , Feminino , Teste de Tolerância a Glucose , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Estado Pré-Diabético/complicações , Estado Pré-Diabético/epidemiologia , Prevalência , Estudos Prospectivos , Tuberculose/complicações
5.
Int J Med Inform ; 129: 107-113, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31445244

RESUMO

OBJECTIVE: Use symptoms to stratify temporal disease trajectories. MATERIALS AND METHODS: We use data from the Danish National Patient Registry to stratify temporal disease pairs by the symptom distributions they associate to. The underlying data comprise of 6.6 million patients collectively assigned with 7.5 million symptoms from chapter XVIII in the WHO International Classification of Disease version 10 terminology. RESULTS: We stratify 33 disease pairs into 67 temporal disease-symptom-disease trajectories from three main diagnoses (two diabetes subtypes and COPD), where the symptom significantly changes the risk of developing the subsequent diseases. We combine these trajectories into three temporal disease networks, one for each main diagnosis. We confirm apparent relations between diseases and symptoms and discovered that multiple symptoms decrease the risk for diabetes progression. CONCLUSION: Symptoms can be used to stratify disease trajectories, and we suggest that this approach can be applied to temporal disease trajectories systematically using structured claims data. The method can be extended to also use text-mined symptoms from unstructured data in health records.


Assuntos
Diabetes Mellitus/diagnóstico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Diabetes Mellitus/epidemiologia , Progressão da Doença , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adulto Jovem
6.
Rev Med Suisse ; 15(659): 1444-1447, 2019 Aug 21.
Artigo em Francês | MEDLINE | ID: mdl-31436059

RESUMO

Continuous glucose monitoring is a technique that allows near-continuous measurement of interstitial glucose concentration. Much progress has been made in this area. The management of certain diabetic patients, in particular type 1, has been considerably improved thanks to the use of this technique. Many pitfalls have been crossed to allow its commercialization. There is still a lot of progress to be made. A good knowledge of these new devices is necessary to understand their strengths and weaknesses. This article briefly discusses the state of the art in this area and the expected perspectives of this attractive but expensive technology that must meet the ever-increasing but legitimate expectations of diabetic patients.


Assuntos
Automonitorização da Glicemia , Diabetes Mellitus , Glicemia/análise , Automonitorização da Glicemia/economia , Automonitorização da Glicemia/instrumentação , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/terapia , Testes Hematológicos/instrumentação , Humanos
7.
J Stroke Cerebrovasc Dis ; 28(8): 2302-2310, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31174954

RESUMO

BACKGROUND: Aggregation of platelets is a trigger for additional development of larger thrombi. This study aimed to identify factors that may affect platelet aggregability and their role in clinical outcomes in acute ischemic stroke. METHODS: Consecutive acute ischemic stroke patients (n = 352) who were transferred within 24 hours after its onset were enrolled. Peripheral venous blood was sampled to measure platelet aggregability and other parameters. RESULTS: Mean values of spontaneous small-sized platelet aggregates and collagen- or adenosine diphosphate (ADP)-induced large-sized aggregates were elevated in acute ischemic stroke. In atherothrombotic stroke (n = 178), collagen and ADP-induced large-sized aggregates were positively correlated with HbA1c, respectively. High incidence of the modified Rankin Scales (mRS) 5-6 at discharge was associated with diabetes complication (odds ratio [OR] 8.77, 95% confidence interval [CI] 1.32-57.56). The proportion of patients who were functionally independent (the mRS 0-2) at discharge was lower in the middle tertile of collagen and ADP-induced large-sized aggregates than their low tertile (OR 2.46, 95% CI 1.09-5.58; OR 2.43, 95% CI 1.05-5.59, respectively). Prestroke administration of aspirin recovered the proportion of independence at discharge (OR 0.25, 95% CI 0.06-0.99), and ameliorated incidence of the mRS 5-6. On logistic regression analysis, diabetes, HbA1c, collagen-induced large-sized aggregates, and prestroke administration of aspirin remained independent predictors of clinical outcomes in atherothrombotic stroke. In cardioembolic and lacunar stroke, no relations with clinical outcomes were found. CONCLUSIONS: High plasma level of HbA1c is involved in enhanced platelet aggregability in acute atherothrombotic stroke patients, and prestroke administration of aspirin may be beneficial to clinical outcomes.


Assuntos
Aspirina/uso terapêutico , Plaquetas/efeitos dos fármacos , Isquemia Encefálica/tratamento farmacológico , Diabetes Mellitus/sangue , Hemoglobina A Glicada/metabolismo , Inibidores da Agregação de Plaquetas/uso terapêutico , Agregação Plaquetária/efeitos dos fármacos , Testes de Função Plaquetária/métodos , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Aspirina/efeitos adversos , Biomarcadores/sangue , Plaquetas/metabolismo , Isquemia Encefálica/sangue , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/epidemiologia , Comorbidade , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Avaliação da Deficiência , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação de Plaquetas/efeitos adversos , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Regulação para Cima
8.
Eur J Endocrinol ; 181(2): R73-R105, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31242462

RESUMO

In the currently overwhelming era of polypharmacy, the balance of the dynamic and delicate endocrine system can easily be disturbed by interfering pharmaceutical agents like medications. Drugs can cause endocrine abnormalities via different mechanisms, including direct alteration of hormone production, changes in the regulation of the feedback axis, on hormonal transport, binding and signaling, as well as similar changes to counter-regulatory hormone systems. Furthermore, drugs can interfere with the hormonal assays, leading to erroneous laboratory results that disorientate clinicians from the right diagnosis. The purpose of this review is to cover a contemporary topic, the drug-induced endocrinopathies, which was presented in the monothematic annual Combo Endo Course 2018. This challenging part of endocrinology is constantly expanding particularly during the last decade, with the new oncological therapeutic agents, targeting novel molecular pathways in the process of malignancies. In this new context of drug-induced endocrine disease, clinicians should be aware that drugs can cause endocrine abnormalities via different mechanisms and mimic a variety of clinical scenarios. Therefore, it is extremely important for clinicians not only to promptly recognize drug-induced hormonal and metabolic abnormalities, but also to address the therapeutic issues for timely intervention.


Assuntos
Diabetes Mellitus/metabolismo , Doenças do Sistema Endócrino/induzido quimicamente , Doenças do Sistema Endócrino/patologia , Sistema Endócrino/patologia , Endocrinologia/métodos , Animais , Diabetes Mellitus/diagnóstico , Sistema Endócrino/efeitos dos fármacos , Humanos
9.
High Blood Press Cardiovasc Prev ; 26(3): 227-237, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31228169

RESUMO

INTRODUCTION: Contribution of risk factors for cardiovascular-related deaths in the Eastern Mediterranean Region Organization (EMRO) is not estimated quantitatively. AIM: To determine the avoidable burden of cardiovascular diseases (CVDs) due to hypertension, diabetes, smoking, overweight, and obesity in countries of EMRO of the WHO. METHODS: The comparative risk assessment methodology was used to calculate the potential impact fraction (PIF) and percentage of the avoidable burden of CVD-related death due to associated risk factors. Population exposure levels for CVDs and corresponding measures of association were extracted from published studies. The attributable burden was calculated by multiplying the Disability-Adjusted Life-Years (DALYs) for CVDs by the estimated impact fraction of risk factors. DALYs of the CVDs in all countries of the EMRO were extracted from the GBD official website in 2016. RESULTS: Following reduction of the current prevalence of smoking, obesity, hypertension, diabetes, and overweight to a feasible minimum risk exposure level in Lebanon, about 12.4%, 4.2%, 10.2%, 3.8%, and 5.7% of the burden of CVD-related mortality could be avoidable, respectively. The corresponding values of avoidable burden in selected EMRO countries were 5.1%, 3.5%, 9.4%, 5.9% and 5.3% in Iran and 9.5%, 4.1%, 11%, 8.2% and 5.4% in Egypt. CONCLUSIONS: Findings suggest that health policy makers of all EMRO countries should take into account the attributable burden of CVD-related mortality due to associated risk factors to effectively develop preventive interventions.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , África do Norte/epidemiologia , Ásia/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidade , Diabetes Mellitus/terapia , Estilo de Vida Saudável , Humanos , Hipertensão/diagnóstico , Hipertensão/mortalidade , Hipertensão/terapia , Obesidade/diagnóstico , Obesidade/mortalidade , Obesidade/terapia , Prevalência , Serviços Preventivos de Saúde , Prognóstico , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Fumar/efeitos adversos , Fumar/mortalidade , Abandono do Hábito de Fumar
10.
Lakartidningen ; 1162019 Jun 18.
Artigo em Sueco | MEDLINE | ID: mdl-31237664

RESUMO

Latent Autoimmune Diabetes in Adults (LADA) is a common serious disease. To differ LADA from type 2 diabetes is clinically important. Adults with diabetes should get as correct diagnosis as possible, with determination of autoantibodies, HLA and C-peptide.


Assuntos
Diabetes Autoimune Latente em Adultos/diagnóstico , Adulto , Diabetes Mellitus/diagnóstico , Humanos
11.
BMC Public Health ; 19(1): 817, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234815

RESUMO

BACKGROUND: There are few available data regarding the prevalence of diabetes in the sub-Himalayan region of India. The aim of this study was to determine the prevalence of pre-diabetes and diabetes in rural Garhwal based on glycosylated hemoglobin. METHODS: In a cross-sectional survey of 500 adults from five randomly selected villages in Chamba, a mountainous Tehri Garhwal district in Uttarakhand in north-west India, we determined the prevalence of diabetes (hemoglobin (Hb) A1c ≥ 6.5%) and pre-diabetes (5.7% ≤ HbA1c ≤ 6.4%). In a sub-sample of those diagnosed with diabetes or pre-diabetes (n = 140), fasting blood glucose (FBG, n = 117) or postprandial blood glucose (PBG, n = 23), and blood hemoglobin concentration, was measured at follow-up. RESULTS: Based on HbA1c, 10.0% had diabetes and 56.4% pre-diabetes. Of those diagnosed as diabetic by HbA1c, 10 of 16 (62.5%) were diagnosed as diabetic by FBG (> 125 mg/dL) or PBG (≥200 mg/dL). In those diagnosed as pre-diabetic by HbA1c, only 55 of 124 (44.4%) were diagnosed as pre-diabetic by FBG (100-125 mg/dL) or PBG (140-199 mg/dL). A large proportion of these 140 individuals (67.1%) were moderately to severely anemic (Hb < 11.4 mg/dL). The diagnostic gap for pre-diabetes between HbA1c and FBG/PBG was similar for the groups with and without moderate to severe anemia. CONCLUSIONS: HbA1c and FBG/PBG have similar diagnostic performance for diabetes in this population. However, many individuals were diagnosed with pre-diabetes by HbA1c but not FBG/PBG. The relative excess diagnosis of pre-diabetes with HbA1c does not appear to be explained by anemia, an endemic condition in India. The prognostic significance of diagnosis of pre-diabetes by HbA1c but not FBG/PBG remains unknown, but merits investigation.


Assuntos
Diabetes Mellitus/epidemiologia , Estado Pré-Diabético/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Glicemia/análise , Estudos Transversais , Diabetes Mellitus/diagnóstico , Feminino , Hemoglobina A Glicada/análise , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Estado Pré-Diabético/diagnóstico , Prevalência
12.
Orv Hetil ; 160(21): 807-814, 2019 May.
Artigo em Húngaro | MEDLINE | ID: mdl-31104498

RESUMO

Diabetes and depression are considered global epidemics. Both have multifactorial aetiologies, including external, environmental factors and internal factors in connection with physiological processes as well as genetic variants triggering disease onset. Although the co-occurrence of diabetes and depression is well described, the mechanisms underlying these diseases and their interactions are still not entirely revealed. The authors aimed to present known and potential explanations of the co-occurrence of these diseases and to highlight the importance of their timely diagnosis and effective treatment, as their co-occurrence may increase morbidity and mortality. Screening for depression among diabetes patients and for diabetes among patients with depression may decrease the incidence of complications and consequences of this comorbidity and may foster more effective treatment. General practitioners play a key role in the care of both diseases by providing timely diagnosis and adequate treatment potentially leading to a better quality of life, slower disease progression and decreased risk of complications. Orv Hetil. 2019; 160(21): 807-814.


Assuntos
Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Qualidade de Vida , Comorbidade , Depressão/diagnóstico , Depressão/psicologia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/psicologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/psicologia , Humanos , Hungria/epidemiologia , Programas de Rastreamento
13.
Diabetes Res Clin Pract ; 152: 71-78, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31082446

RESUMO

AIMS: Using routine HbA1c measurement to determine the prevalence of diabetes mellitus (known and previously unrecognized) and their hospital outcomes among hematology and oncology inpatients. METHODS: This was a prospective, observational study. Routine automated HbA1c testing was performed in all hematology and oncology inpatients aged ≥54 years at a tertiary hospital, July 2013-January 2015. The outcome measures were: (i) prevalence of known and previously unrecognized diabetes, and (ii) hospital outcomes: length-of-stay (LOS), intensive-care-unit (ICU) admission, 30-day/18-month readmission, and 18-month mortality. RESULTS: Over the 18-month study period, 1076 inpatients aged ≥54 years were admitted to hematology (n = 298) and oncology (n = 778) units: 21% had known diabetes and 7% had previously unrecognized diabetes. Patients with known diabetes had a longer LOS (IRR: 1.18, 95%CI: 1.02-1.37, p = 0.03), compared to those without diabetes, adjusting for age, hemoglobin level, estimated-glomerular-filtration-rate, admission specialty unit, Charlson's comorbidity index score, and glucocorticoid exposure. No significant differences were observed in ICU admission, 30-day/18-month readmission, and 18-month mortality among patients with known, previously unrecognized and no diabetes (p ≥ 0.05). CONCLUSIONS: Approximately one in five hematology or oncology inpatients aged ≥54 years had known diabetes, and one in fourteen had previously unrecognized diabetes. Those with known diabetes had a longer hospital stay. Routine HbA1c measurement is can be useful for identifying previously unrecognized diabetes, particularly among patients with high glucocorticoid exposure. Further study is required to determine cost-effectiveness in screening for unrecognized diabetes and optimal management of these patients.


Assuntos
Diabetes Mellitus/diagnóstico , Testes Diagnósticos de Rotina , Hemoglobina A Glicada/análise , Doenças Hematológicas/sangue , Neoplasias/sangue , Idoso , Idoso de 80 Anos ou mais , Complicações do Diabetes/sangue , Complicações do Diabetes/diagnóstico , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Testes Diagnósticos de Rotina/métodos , Feminino , Hemoglobina A Glicada/metabolismo , Doenças Hematológicas/complicações , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Pacientes Internados , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Prevalência , Prognóstico , Centros de Atenção Terciária
14.
Clin Podiatr Med Surg ; 36(3): 349-354, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31079601

RESUMO

Diabetes prevalence is increasing in the United States. As of 2017, 30.3 million people in the United States have diabetes (9.4% of population). Of these, an estimated 7.2 million persons are undiagnosed. Prediabetes, a condition that is associated with peripheral neuropathy and is a precurser to diabetes, affects 83.1 million or 33.9% of adults in the United States. Diabetes is most commonly diagnosed by fasting plasma glucose or by an A1C test. An oral glucose tolerance test can also be used, but its use is primarily restricted to research settings.


Assuntos
Diabetes Mellitus/terapia , Gerenciamento Clínico , Análise Custo-Benefício , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Dieta , Exercício , Hemoglobina A Glicada/análise , Humanos , Hipoglicemiantes/uso terapêutico , Estilo de Vida , Assistência Centrada no Paciente , Estado Pré-Diabético/diagnóstico , Estados Unidos/epidemiologia
17.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(5): 330-337, mayo 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-182808

RESUMO

Introduction: The number of mobile applications (apps) related to health is increasing, and diabetes mellitus (DM) is not an exception. The aim of this study was to assess the free mobile applications for the management of diabetes available, in Spanish, in the Spanish market. Methods: GooglePlay (Android) and AppStore (iOS) were reviewed to identify free apps, in Spanish, aimed at people with diabetes. Their main functions and a series of quality and usability features were evaluated and scored. These scores were used to make a top list with the best apps. Results: Out of 794 registered apps, 42 were evaluated and included in the quality assessment, while 34 apps were included in the usability assessment. The main function of most of the apps was to act as a blood glucose diary (n: 30; 71.43%). As for privacy, most of the applications (33 apps; 78.6%) access device/personal data. Only a minority of apps [3 (7.1%)] reported being based on evidence, and only 3 apps (7.1%) had a quality label. The top scored apps were: OneTouch Reveal(TM), Social Diabetes(TM), mySugr: App Diario de diabetes(TM), Diabetes menú(TM), Tactio SALUD(TM) and Diabetes:M(TM). Conclusions: There are few free apps for diabetes management available in Spanish, most lack quality certification and very few provide scientific references about their content. Furthermore, most of the apps access personal/device data


Introducción: La cantidad de aplicaciones móviles (apps) relacionadas con la salud está aumentando, y la diabetes mellitus (DM) no es una excepción. El objetivo de este estudio es evaluar las apps móviles gratuitas disponibles en español para el manejo de la diabetes. Métodos: Google Play (Android) y App Store (iOS) fueron revisados para identificar apps gratuitas, en español, dirigidas a personas con diabetes. Sus principales funciones y una serie de características de calidad y usabilidad fueron evaluadas y calificadas. Estas puntuaciones se usaron para hacer una lista de las mejores apps. Resultados: De las 794 apps registradas, 42 fueron incluidas en la evaluación de calidad, mientras que 34 apps se incluyeron en la evaluación de usabilidad. La función principal de la mayoría de las apps era actuar como un diario de glucosa en sangre (n: 30; 71,43%). En cuanto a la privacidad, la mayoría de las apps (33 apps, 78,6%) acceden a datos del dispositivo/personales. Solo una minoría de apps (3 [7,1%]) informaron que se basaban en evidencia científica y solo 3 apps (7,1%) tenían un certificado de calidad. Las apps mejor puntuadas fueron: OneTouch Reveal(R), SocialDiabetes, mySugr: app Diario de diabetes(R), Diabetes menú(R), Tactio SALUD(R) y Diabetes:M(R). Conclusiones: Hay pocas apps gratuitas disponibles en español para el manejo de la diabetes, la mayoría carecen de certificado de calidad, y muy pocas proporcionan referencias científicas sobre su contenido. Asimismo, la mayoría de las apps acceden a datos del dispositivo/personales


Assuntos
Humanos , Diabetes Mellitus/terapia , Aplicativos Móveis/tendências , Telemedicina/métodos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Telefone Celular , Autocuidado , Telemonitoramento
18.
Exp Clin Transplant ; 17(2): 138-146, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30945628

RESUMO

Diabetic nephropathy is one of the main long-term diabetic microangiopathies that can complicate type 1 and 2 and other secondary forms of diabetes mellitus, including posttransplant diabetes mellitus. Posttransplant diabetes mellitus was initially reported in the 1960s, with case reports of recurrent and de novo diabetic nephropathy after kidney transplant reported in the early 2000s, mostly as a result of same-risk and precipitating factors of diabetic nephropathy as in native kidneys. The disease may appear early in view of the hyperfiltration risk of being a single grafted kidney. Here, we discuss risk factors, early serologic and genetic biomarkers for early detection, and strategies to avoid and delay the progression of diabetic nephropathy after posttransplant diabetes mellitus. In this overview of published literatures, we searched PubMed and MEDLINE for all articles published in English language between January 1994 and July 2018. Included studies reported on the prevalence, incidence, or determinants of post-transplant diabetes among renal transplant recipients and studies reporting diabetic nephropathy in their cohorts. Our review showed that avoidance or good control of posttransplant diabetes is the cornerstone in management of posttransplant diabetes mellitus and hence diabetic nephropathy. Control and avoidance can be commenced in the preparatory stage before transplant using validated genetic markers that can predict posttransplant diabetes mellitus. The use of well-matched donors with tailored immunosuppression (using less diabetogenic agents and possibly steroid-free regimens) and lifestyle modifications are the best preventative strategies. Tight glycemic control, early introduction of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and possibly conversion to less diabetogenic regimens can help to delay progression of diabetic nephropathy.


Assuntos
Diabetes Mellitus/terapia , Nefropatias Diabéticas/terapia , Transplante de Rim/efeitos adversos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/epidemiologia , Progressão da Doença , Diagnóstico Precoce , Humanos , Imunossupressores/efeitos adversos , Fatores de Proteção , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
19.
BMC Res Notes ; 12(1): 227, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992066

RESUMO

OBJECTIVES: The present study aimed to compare the effect of Peer Assisted Learning (PAL) method and routine lecture on knowledge, attitudes, and behaviors of participants in the prevention of diabetes. RESULTS: The results showed that one month after the intervention and the implementation of the educational program, the mean scores of the two groups in terms of knowledge, attitude, and behavior increased significantly.


Assuntos
Diabetes Mellitus/terapia , Educação de Graduação em Medicina/métodos , Conhecimentos, Atitudes e Prática em Saúde , Aprendizagem , Infuência dos Pares , Estudantes de Medicina/psicologia , Adulto , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Avaliação Educacional/métodos , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos
20.
J Diabetes Res ; 2019: 4916546, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30993116

RESUMO

We attempted to clarify the severity of the risk of diabetes mellitus (DM) in the individuals who repeatedly fulfill the criteria for prediabetes in both fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). The subjects were 2347 individuals who underwent annual health checkup at our hospital. They were classified as normal glucose tolerance or prediabetes as their yearly status of glucose tolerance for three years; furthermore, the individuals classified as prediabetes were subclassified into 3 groups. Among them, we focused the individuals who fulfilled the criteria for prediabetes in both FPG and HbA1c, and this group was named as PD3. Similarly, all subjects were categorized into 4 groups by the frequency of the status of PD3 during three years. Moreover, all subjects were categorized into 8 patterns when PD3 status was positive. Then, we surveyed the development of diabetes for 5 years, and the incidence rates (IRs) and the age- and sex-adjusted odds ratios (ORs) were obtained. A total of 188 subjects developed diabetes. The individuals in the group of PD3 showed the highest IR of DM (33.6%). The values of ORs were 11.5, 20.0, and 63.5 when the frequencies of PD3 were one, two, and three, respectively. In the group whose frequency of PD3 was two, the individuals who had repeated the status of PD3 twice then moved to the status other than PD3 showed smaller risk of DM than the others in the same group. In conclusion, individuals who fulfill the criteria for prediabetes in both FPG and HbA1c were at a high risk of developing DM, and the risk was enhanced by repeating this status. On the other hand, changing the status from PD3 to others might reduce the risk of DM.


Assuntos
Diabetes Mellitus/diagnóstico , Hemoglobina A Glicada/análise , Estado Pré-Diabético/fisiopatologia , Adulto , Antropometria , Glicemia , Comorbidade , Diabetes Mellitus/sangue , Progressão da Doença , Feminino , Teste de Tolerância a Glucose , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
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