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A Adaptação Psicológica à Diabetes dos Jovens Adultos com Diabetes Tipo 1

Nabais, Joao; Serrabulho, Lurdes; Gaspar de Matos, Margarida; Raposo, Joao
Fonte: Sociedade Portuguesa de Diabetes Publicador: Sociedade Portuguesa de Diabetes
Tipo: Artigo de Revista Científica
POR
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46.4%
Introduction: Quality of life of young adults can be affected by the social, occupational, familiar and emotional changes. Aims: Evaluation of life satisfaction, social support, treatment adherence and psychological adaptation of young adults with type 1 diabetes. Methods: Quantitative study with questionnaires Àlled by 278 young adults with type 1 diabetes (18-35 years). Results: Participants consider having good social support. Satisfaction with life was 6.6 ±1.7 (scale 0-10). Most of youngsters show good dietary intake, one third practice recommended physical activity. Adherence to insulin therapy and glucose monitoring is satisfactory. They present 8.7±1.6% as mean value for HbA1c. Factorial analysis relating psychological adjustment to diabetes scale allowed to Ànd 4 factors explaining 50% of total variance: diabetes adaptation (29%), diabetes control (8%), diabetes management competences (7%) e attitudes relating to diabetes (6%). Youngsters with better psychological adaptation to diabetes have better adherence to diabetes treatment relating to nutrition, insulin therapy and glucose monitoring. Conclusions: Young adults showed good social support and satisfaction with life, a reasonable global adherence to diabetes treatment...

Controlo glicémico e tratamento da diabetes tipo 1 da criança e adolescente em Portugal

Fagulha, A; Santos, I; Grupo de Estudos da Diabetes Mellitus
Fonte: Centro Hospitalar e Universitário de Coimbra Publicador: Centro Hospitalar e Universitário de Coimbra
Tipo: Artigo de Revista Científica
Publicado em //2004 POR
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46.31%
OBJECTIVE: The Pediatric Portuguese Society of Endocrinology and Diabetology established in 2001 a Study Group with the aim of investigate glycemic control, prevalence of microvascular complications and modalities of treatments in type1 diabetic patients. PATIENTS AND METHODS: The cases for registration were those who were born between June 1, 1979 and June 1, 2001 (until 22 yr of age). A front sheet was constructed to record, age at diabetes diagnosis, diabetes duration, presence or absence of diabetes microvascular complications, HbA1c, number of capillary glycemic tests per week and type of insulin treatment. RESULTS: Twenty-two Hospitals participated and a total of 1009 patients were registered. The mean age was 13.6 yr+/-4.7, mean age at diabetes diagnosis 8.4 yr+/-4.4, and diabetes duration 5.2 yr+/-3.95. Diagnosis of diabetes was done in 22.8% by the age group 0-4 yr, in 36.4% by the age group 5-9 yr, in 32.4% by the age group 10-14, in 6.7% by the age group 15-19, and in 1.5% by the age group 20-22. Retinopathy was present in 1.4% and nephropathy in 6.4%. Values of HbA1c <7.5% were achieved in 12.5%, > or =7.5 and < 8% in 11.3%, > or =8 and <9.5 in 33.5% and > or =9.5 in 40.9%. Insulin treatment with one daily injection was used in 1.5%...

The “Perfect Storm” for Type 1 Diabetes: The Complex Interplay Between Intestinal Microbiota, Gut Permeability, and Mucosal Immunity

Vaarala, Outi; Atkinson, Mark A.; Neu, Josef
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em /10/2008 EN
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46.31%
It is often stated that type 1 diabetes results from a complex interplay between varying degrees of genetic susceptibility and environmental factors. While agreeing with this principal, our desire is that this Perspectives article will highlight another complex interplay potentially associated with this disease involving facets related to the gut, one where individual factors that, upon their interaction with each another, form a “perfect storm” critical to the development of type 1 diabetes. This trio of factors includes an aberrant intestinal microbiota, a “leaky” intestinal mucosal barrier, and altered intestinal immune responsiveness. Studies examining the microecology of the gastrointestinal tract have identified specific microorganisms whose presence appears related (either quantitatively or qualitatively) to disease; in type 1 diabetes, a role for microflora in the pathogenesis of disease has recently been suggested. Increased intestinal permeability has also been observed in animal models of type 1 diabetes as well as in humans with or at increased-risk for the disease. Finally, an altered mucosal immune system has been associated with the disease and is likely a major contributor to the failure to form tolerance, resulting in the autoimmunity that underlies type 1 diabetes. Herein...

Data Mining Technologies for Blood Glucose and Diabetes Management

Bellazzi, Riccardo; Abu-Hanna, Ameen
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em /05/2009 EN
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46.29%
Data mining is the process of selecting, exploring, and modeling large amounts of data to discover unknown patterns or relationships useful to the data analyst. This article describes applications of data mining for the analysis of blood glucose and diabetes mellitus data. The diabetes management context is particularly well suited to a data mining approach. The availability of electronic health records and monitoring facilities, including telemedicine programs, is leading to accumulating huge data sets that are accessible to physicians, practitioners, and health care decision makers. Moreover, because diabetes is a lifelong disease, even data available for an individual patient may be massive and difficult to interpret. Finally, the capability of interpreting blood glucose readings is important not only in diabetes monitoring but also when monitoring patients in intensive care units. This article describes and illustrates work that has been carried out in our institutions in two areas in which data mining has a significant potential utility to researchers and clinical practitioners: analysis of (i) blood glucose home monitoring data of diabetes mellitus patients and (ii) blood glucose monitoring data from hospitalized intensive care unit patients.

Diabetes Information Technology: Designing Informatics Systems to Catalyze Change in Clinical Care

Lester, William T.; Zai, Adrian H.; Chueh, Henry C.; Grant, Richard W.
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em /03/2008 EN
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46.29%
Current computerized reminder and decision support systems intended to improve diabetes care have had a limited effect on clinical outcomes. Increasing pressures on health care networks to meet standards of diabetes care have created an environment where information technology systems for diabetes management are often created under duress, appended to existing clinical systems, and poorly integrated into the existing workflow. After defining the components of diabetes disease management, the authors present an eight-step conceptual framework to guide the development of more effective diabetes information technology systems for translating clinical information into clinical action.

Self-Monitoring of Blood Glucose as Part of the Integral Care of Type 2 Diabetes

Boutati, Eleni I.; Raptis, Sotirios A.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em /11/2009 EN
Relevância na Pesquisa
46.29%
Results from landmark diabetes studies have established A1C as the gold standard for assessing long-term glycemic control. However, A1C does not provide “real-time” information about individual hyperglycemic or hypoglycemic excursions. Real-time information provided by self-monitoring of blood glucose (SMBG) represents an important adjunct to A1C, because it can differentiate fasting, preprandial, and postprandial hyperglycemia; detect glycemic excursions; identify hypoglycemia; and provide immediate feedback about the effect of food choices, physical activity, and medication on glycemic control. The importance of SMBG is widely appreciated and recommended as a core component of management in patients with type 1 or insulin-treated type 2 diabetes, as well as in diabetic pregnancy, for both women with pregestational type 1 and gestational diabetes. Nevertheless, SMBG in management of non–insulin-treated type 2 diabetic patients continues to be debated. Results from clinical trials are inconclusive, and reviews fail to reach an agreement, mainly because of methodological problems. Carefully designed large-scale studies on diverse patient populations with type 2 diabetes with the follow-up period to investigate long-term effects of SMBG in patients with type 2 diabetes should be carried out to clarify how to make the best use of SMBG...

The Scope of Cell Phones in Diabetes Management in Developing Country Health Care Settings

Ajay, Vamadevan S; Prabhakaran, Dorairaj
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em 01/05/2011 EN
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46.35%
Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes.

Closing the Gap: Eliminating Health Care Disparities among Latinos with Diabetes Using Health Information Technology Tools and Patient Navigators

López, Lenny; Grant, Richard W
Fonte: Diabetes Technology Society Publicador: Diabetes Technology Society
Tipo: Artigo de Revista Científica
Publicado em 01/01/2012 EN
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46.31%
Latinos have higher rates of diabetes and diabetes-related complications compared to non-Latinos. Clinical diabetes self-management tools that rely on innovative health information technology (HIT) may not be widely used by Latinos, particularly those that have low literacy or numeracy, low income, and/or limited English proficiency. Prior work has shown that tailored diabetes self-management educational interventions are feasible and effective in improving diabetes knowledge and physiological measures among Latinos, especially those interventions that utilize tailored coaching and navigator programs. In this article, we discuss the role of HIT for diabetes management in Latinos and describe a novel “eNavigator” role that we are developing to increase HIT adoption and thereby reduce health care disparities.

The Reality of Type 2 Diabetes Prevention

Kahn, Richard; Davidson, Mayer B.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.31%
Efforts to reduce the burden of type 2 diabetes include attempts to prevent or delay the onset of the disease. Landmark clinical trials have shown that lifestyle modification programs focused on weight loss can delay the onset of type 2 diabetes in subjects at high risk of developing the disease. Building on this knowledge, many community-based studies have attempted to replicate the trial results and, simultaneously, payers have begun to cover diabetes prevention services. This article focuses on the evidence supporting the premise that community prevention efforts will be successful. Unfortunately, no study has shown that diabetes can be delayed or prevented in a community setting, and efforts to replicate the weight loss achieved in the trials have been mostly disappointing. Furthermore, both the clinical trials and the community-based prevention studies have not shown a beneficial effect on any diabetes-related clinical outcome. While the goal of diabetes prevention is extremely important, the absence of any persuasive evidence for the effectiveness of community programs calls into question whether the use of public funds or national prevention initiatives should be supported at this time.

Levels of Oxidized LDL and Advanced Glycation End Products–Modified LDL in Circulating Immune Complexes Are Strongly Associated With Increased Levels of Carotid Intima-Media Thickness and Its Progression in Type 1 Diabetes

Lopes-Virella, Maria F.; Hunt, Kelly J.; Baker, Nathaniel L.; Lachin, John; Virella, G.; Nathan, David Matthew; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
EN_US
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46.31%
OBJECTIVE High cholesterol levels in circulating immune complexes (IC), surrogate markers of modified LDL, are associated with increased carotid intima-media thickness (IMT) and cardiovascular events in type 1 diabetes. Different modifications of LDL are involved in IC formation, but which of these are predictive of vascular events is not known. Therefore, we measured oxidized LDL (oxLDL), advanced glycation end products–modified LDL (AGE-LDL), and malondialdehyde-modified LDL (MDA-LDL) in IC and determined their relationship with increased carotid IMT and compared the strength of the association with that observed with conventional risk factors. RESEARCH DESIGN AND METHODS Levels of oxLDL, AGE-LDL, and MDA-LDL were measured in circulating IC isolated from sera of 479 patients of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort, collected at baseline. Internal and common carotid IMT were measured 8 and 14 years later by DCCT/EDIC. RESULTS OxLDL, AGE-LDL, and MDA-LDL levels in circulating IC were significantly correlated with diabetes duration, BMI, and lipid and blood pressure, but not with age. Multivariate logistic regression models indicated that individuals in the highest versus lowest quartile of oxLDL and AGE-LDL in IC had a 6.11-fold [confidence interval (CI) 2.51–14.8] and a 6.4-fold (CI 2.53–16.2) increase in the odds of having high carotid IMT...

Perceived Impact of Diabetes Genetic Risk Testing Among Patients at High Phenotypic Risk for Type 2 Diabetes

Markowitz, Sarah M.; O’Brien, Kelsey E.; Park, Elyse Richelle; Delahanty, Linda Michele; Grant, Richard W.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.36%
Objective: Rapid advances in diabetes genetic epidemiology may lead to a new era of “personalized medicine” based on individual genetic risk assessment. There is minimal experience to guide how best to clinically implement such testing so that results (e.g., “higher” or “lower” relative genetic risk) improve rather than reduce patient motivation for behavior change. Research Design and Methods: Between November 2009 and May 2010, we conducted in-depth interviews with 22 overweight participants at high phenotypic risk for type 2 diabetes to explore perceptions of diabetes genetic risk testing compared with currently available prediction using nongenetic risk factors (e.g., family history, abnormal fasting glucose, obesity). We used hypothetical scenarios to specifically investigate the impact of both “higher” and “lower” relative genetic risk results on participants’ views about diabetes prevention. Results: Many participants conferred a unique value on personal genetic risk information relative to nongenetic risk based on the perceived scientific certainty and durability of genetic results. In contrast, other participants considered their genetic risk within the overall context of their other measured risk factors. Reactions to diabetes genetic test results differed by current motivation levels. Whereas most subjects reported that “higher” risk results would motivate behavior change...

Protection From Retinopathy and Other Complications in Patients With Type 1 Diabetes of Extreme Duration

Asztalos, Bela F.; Schaefer, Ernst J.; Sell, David R.; Strauch, Christopher M.; Monnier, Vincent M.; Sun, Jennifer Katherine; Keenan, Hillary; Cavallerano, Jerry D.; Doria, Alessandro; Aiello, Lloyd Paul; King, George Liang
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.29%
Objective: To assess complication prevalence and identify protective factors in patients with diabetes duration of (geq)50 years. Characterization of a complication-free subgroup in this cohort would suggest that some individuals are protected from diabetes complications and allow identification of endogenous protective factors. Research Design and Methods: Cross-sectional, observational study of 351 U.S. residents who have survived with type 1 diabetes for (geq)50 years (Medalists). Retinopathy, nephropathy, neuropathy, and cardiovascular disease were assessed in relation to HbA(_{1c}), lipids, and advanced glycation end products (AGEs). Retrospective chart review provided longitudinal ophthalmic data for a subgroup. Results: A high proportion of Medalists remain free from proliferative diabetic retinopathy (PDR) (42.6%), nephropathy (86.9%), neuropathy (39.4%), or cardiovascular disease (51.5%). Current and longitudinal (the past 15 years) glycemic control were unrelated to complications. Subjects with high plasma carboxyethyl-lysine and pentosidine were 7.2-fold more likely to have any complication. Of Medalists without PDR, 96% with no retinopathy progression over the first 17 years of follow-up did not experience retinopathy worsening thereafter. Conclusions: The Medalist population is likely enriched for protective factors against complications. These factors might prove useful to the general population with diabetes if they can be used to induce protection against long-term complications. Specific AGE combinations were strongly associated with complications...

Diabetes, depression, and quality of life - A population study

Goldney, R.; Phillips, P.; Fisher, L.; Wilson, D.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
Relevância na Pesquisa
46.31%
Objective: The aim of the study was to assess the prevalence of diabetes and depression and their associations with quality of life using a representative population sample. Research design and methods: the study consisted of a representative population sample of individuals aged {greater than or equal to} 15 years living in South Australia comprising 3,010 personal interviews conducted by trained health interviewers. The prevalence of depression I those suffering doctor-diagnosed diabetes and comparative effects of diabetic status and depression on quality-of-life dimensions were measured. Results: the prevalence of depression in the diabetic population was 24% compared with 17% in the nondiabetic population. Those with diabetes and depression experienced an impact with a large effect size on every dimension of the Short Form Health-Related Quality-of-Life Questionnaire (SF-36) as compared with those who suffered diabetes and who were not depressed. A supplementary analysis comparing both depressed diabetic and depressed nondiabetic groups showed there were statistically significant differences in the quality-of-life effects between the two depressed populations in the physical and mental component summaries of the SF-36. Conclusion: depression for those with diabetes is an important comorbity that requires careful management because of its severe impact on quality of life.; Robert D. Goldney...

Endothelial dysfunction relates to folate status in children and adolescents with type 1 diabetes

Wiltshire, E.; Gent, R.; Hirte, C.; Pena Vargas, A.; Thomas, D.; Couper, J.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
46.33%
Endothelial dysfunction occurs early in the development of vascular disease in diabetes. Total plasma homocyst(e)ine (tHcy) is associated with endothelial dysfunction. We therefore aimed to assess endothelial function in children with type 1 diabetes in relation to tHcy and its determinants. Endothelial function was assessed in 36 children with type 1 diabetes aged 13.7 +/- 2.2 years and 20 age- and sex-matched control subjects using ultrasound assessment of flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)-dependent brachial artery responses. von Willebrand factor (vWF) and thrombomodulin, markers of endothelial activation, were measured in 64 children with type 1 diabetes and 52 control subjects. Fasting glucose, tHcy, serum and red cell folate, vitamin B12, HbA(1c), creatinine, and lipids were also measured. FMD (5.2 +/- 4.7 vs. 9.1 +/- 4.0%, P = 0.002) and the ratio of FMD:GTN-induced dilatation (0.22 +/- 0.39 vs. 0.41 +/- 0.29%, P = 0.008) were significantly lower in diabetic subjects, indicating endothelial dysfunction. In diabetic subjects, red cell folate correlated independently with FMD (beta = 0.42, P = 0.028) and the ratio of FMD:GTN-induced dilatation (beta = 0.59, P < 0.001). Resting vessel diameter correlated independently with tHcy (beta = -0.51...

Dietary fats do not contribute to hyperlipidemia in children and adolescents with type 1 diabetes

Wiltshire, E.; Hirte, C.; Couper, J.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
46.33%
OBJECTIVE: To determine the relative influence of diet, metabolic control, and familial factors on lipids in children with type 1 diabetes and control subjects. RESEARCH DESIGN AND METHODS: We assessed fasting serum cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, lipoprotein(a), apolipoprotein (apo)-A1, and apoB in 79 children and adolescents with type 1 diabetes and 61 age- and sex-matched control subjects, together with dietary intakes using a quantitative food frequency questionnaire. RESULTS: Total cholesterol, LDL cholesterol, apoB, HDL cholesterol, and apoA1 were significantly higher in children with diabetes. Children with diabetes had higher percentage energy intake from complex carbohydrates (P = 0.001) and fiber intake (P = 0.02), and they had lower intake of refined sugar (P < 0.001) and percentage energy from saturated fat (P = 0.045) than control subjects. Total cholesterol (beta = 0.43, P < 0.001), LDL cholesterol (beta = 0.4, P < 0.001), and apoB (beta = 0.32, P = 0.006) correlated independently with HbA(1c) but not dietary intake. HDL cholesterol (beta = 0.24, P = 0.05) and apoA1 (beta = 0.32, P = 0.004) correlated independently with HbA(1c), and HDL cholesterol (beta = -0.34, P = 0.009) correlated with percentage energy intake from complex carbohydrates. Triglycerides correlated independently with percentage energy intake from complex carbohydrates (beta = 0.33...

Pancreatic β-cell function and immune responses to insulin after administration of intranasal insulin to humans at risk for type 1 diabetes; Pancreatic beta-cell function and immune responses to insulin after administration of intranasal insulin to humans at risk for type 1 diabetes

Harrison, L.; Honeyman, B.; Steele, C.; Stone, N.; Sarugeri, E.; Bonifacio, E.; Couper, J.; Coleman, P.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
Relevância na Pesquisa
46.31%
OBJECTIVE: Mucosal administration of insulin retards development of autoimmune diabetes in the nonobese diabetic mouse model. We conducted a double-blind crossover study in humans at risk for type 1 diabetes to determine if intranasal insulin was safe, in particular did not accelerate beta-cell destruction, and could induce immune effects consistent with mucosal tolerance. RESEARCH DESIGN AND METHODS: A total of 38 individuals, median age 10.8 years, with antibodies to one or more pancreatic islet antigens (insulin, GAD65, or tyrosine phosphatase-like insulinoma antigen 2) were randomized to treatment with intranasal insulin (1.6 mg) or a carrier solution, daily for 10 days and then 2 days a week for 6 months, before crossover. The primary outcome was beta-cell function measured as first-phase insulin response (FPIR) to intravenous glucose at 0, 6, and 12 months and then yearly; the secondary outcome was immunity to islet antigens, measured monthly for 12 months. RESULTS: No local or systemic adverse effects were observed. Diabetes developed in 12 participants with negligible beta-cell function at entry after a median of 1.1 year. Of the remaining 26, the majority had antibodies to two or three islet antigens and FPIR greater than the first percentile at entry...

Macrovascular risk and diagnostic criteria for type 2 diabetes - Implications for the use of FPG and HbA1c for cost-effective screening

Jesudason, D.; Leong, D.; Dunstan, K.; Wittert, G.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
46.33%
Objective - The use of fasting plasma glucose (FPG) level 7.0 mmol/l leads to underdiagnosis of type 2 diabetes compared with the oral glucose tolerance test (OGTT). The OGTT is of limited use for population screening. Most of the increase in cardiovascular risk in relation to increasing blood glucose occurs before the threshold at which the diagnosis of type 2 diabetes is made. The aim of this study was to evaluate the use of HbA1c and FPG as predictors of type 2 diabetes and cardiovascular risk and, accordingly, to develop a rational approach to screening for abnormalities of glucose tolerance. Research design and methods - OGTT and measurement of HbA1c and FPG levels were performed in 505 subjects screened for type 2 diabetes. Anthropomorphic measurements were obtained. A cardiovascular risk factor questionnaire was completed. Results - The subjects were aged 19–88 years (mean 53.8). The incidence of type 2 diabetes was 10.4% based on the OGTT and 4% based on an FPG level 7.0 mmol/l. Using high-performance liquid chromatography (HPLC), HbA1c of <4.7 and 6.2% predicted with certainty the absence or presence of type 2 diabetes as defined by the OGTT. The corresponding cutoffs were <5.0 and 6.8% for HbA1c (DCA2000 HPLC device; Bayer Diagnostics...

Incidences, treatments, outcomes, and sex effect on survival in patients with end-stage renal disease by diabetes status in Australia and New Zealand (1991-2005)

Villar, E.; Chang, S.; McDonald, S.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
46.31%
OBJECTIVE: We aimed to update the epidemiology of type 1 and type 2 diabetic patients among the incident end-stage renal disease (ESRD) population in Australia and New Zealand (ANZ) and to determine whether outcome is worse for diabetic women, as described in the general population. RESEARCH DESIGNS AND METHODS: All resident adults of ANZ who began renal replacement therapy (RRT) from 1 April 1991 to 31 December 2005 were included using data from the ANZ Dialysis and Transplant Registry. Incidence rates, RRT, and survival were analyzed. Risk factors for death were assessed using Cox regression. RESULTS: The study included 1,284 type 1 diabetic (4.5%), 8,560 type 2 diabetic (30.0%), and 18,704 nondiabetic (65.5%) patients. The incidence rate of ESRD with type 2 diabetes increased markedly over time (+10.2% annually, P < 0.0001). In patients aged <70 years, rates of renal transplantation in type 1 diabetic, type 2 diabetic, and nondiabetic patients were 41.8, 6.5 (P < 0.0001 vs. other patients), and 40.9% (P = 0.56 vs. type 1 diabetic patients), respectively. Compared with nondiabetic patients, the adjusted hazard ratio (HR) for death was 1.64 (P < 0.0001) in type 1 diabetes and 1.13 (P < 0.0001) in type 2 diabetes. Survival rates per 5-year period improved by 6% in type 1 diabetic patients (P = 0.36)...

Early atherosclerosis relates to urinary albumin excretion and cardiovascular risk factors in adolescents with type 1 diabetes: adolescent type 1 Diabetes cardiorenal Intervention Trial (AdDIT)

Maftei, O.; Pena, A.S.; Sullivan, T.; Jones, T.W.; Donaghue, K.C.; Cameron, F.J.; Davis, E.; Cotterill, A.; Craig, M.E.; Gent, R.; Dalton, N.; Daneman, D.; Dunger, D.; Deanfield, J.; Couper, J.J.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
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46.34%
OBJECTIVE: The origins of cardiovascular and renal disease in type 1 diabetes begin during childhood. We aimed to evaluate carotid (cIMT) and aortic intima-media thickness (aIMT) and their relationship with cardiovascular risk factors and urinary albumin excretion in adolescents with type 1 diabetes in the Adolescent Type 1 Diabetes cardio-renal Intervention Trial (AdDIT). RESEARCH DESIGN AND METHODS: A total of 406 adolescents with type 1 diabetes, who were 14.1 ± 1.9 years old with type 1 diabetes duration of 6.7 ± 3.7 years, and 57 age-matched control subjects provided clinical and biochemical data and ultrasound measurements of vascular structure (cIMT and aIMT). Vascular endothelial and smooth muscle function was also measured in 123 of 406 with type 1 diabetes and all control subjects. RESULTS: In type 1 diabetic subjects, mean/maximal aIMT (P < 0.006; <0.008), but not mean/maximal cIMT, was greater than in control subjects. Mean/maximal aIMT related to urinary albumin-to-creatinine ratio (multiple regression coefficient [SE], 0.013 [0.006], P = 0.03; 0.023 [0.007], P = 0.002), LDL cholesterol (0.019 [0.008], P = 0.02; 0.025 [0.011], P = 0.02), and age (0.010 [0.004], P = 0.004; 0.012 [0.005], P = 0.01), independent of other variables. Mean/maximal cIMT was greater in males (0.023 [0.006]...

The Role of Haemoglobin A1c in Screening Obese Children and Adolescents for Glucose Intolerance and Type 2 Diabetes; O Papel da Hemoglobina A1c no Rastreio de Intolerância à Glicose e da Diabetes Tipo 2 em Crianças e Adolescentes Obesos

Galhardo, Júlia; Unidade de Endocrinologia Pediátrica e Diabetes. Hospital de Dona Estefânia. Centro Hospitalar de Lisboa Central. Lisboa. Portugal. Department of Clinical Sciences. Institute of Child Life & Health. University of Bristol. Bristol. Rein
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf; application/pdf
Publicado em 30/06/2015 POR; ENG
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46.35%
Introduction: In 2012, an international expert committee in diabetes wrote in favor of screening adult and paediatric patients for glucose intolerance and type 2 diabetes using glycated haemoglobin. The aim of this study was to evaluate glycated haemoglobin utility as a screening tool in a young obese mainly Caucasian population.Material and Methods: Children [(n = 266), body mass index z-score 3.35 ± 0.59, 90% Caucasian 90%, 55% female, median age 12.3 (range: 8.9 - 17.6) years old] recently referred to a tertiary hospital-based obesity clinic underwent a routine oral glicose tolerance test and glycated haemoglobin measurement. Exclusion criteria: abnormal forms of haemoglobin and conditions linked to increased erythrocyte turnover.Results: The oral glicose tolerance test diagnosed 13 (4.9%) subjects as prediabetic but none as diabetic. According to glycated haemoglobin, 32 would be prediabetic (29 false positives) and one would be diabetic (when he was only glucose intolerant). On the other hand, 10 prediabetic patients would not have been identified (false negatives). Glycated haemoglobin receiver operator characteristic analysis area under the curve was 0.59 (CI 95% 0.40 - 0.78), confirming its reduced capacity to identify prediabetes. Better results were achieved when calculating receiver operator characteristic analysis area under the curve for fasting glucose (0.76;CI 95% 0.66 - 0.87)...