Diabetes and Metabolism

  • THE TWO-WAY STREET BETWEEN PERIODONTAL DISEASES AND DIABETES

    Periodontitis is a chronic inflammatory disease that is initiated by the accumulation of dental biofilm, where dysbiosis leads to a chronic non-resolving condition, and destructive inflammatory response. The destruction of tissues that we clinically recognize as periodontitis (that is, destruction of the periodontal ligament, periodontal pocket formation and alveolar bone resorption) is caused mainly by the host’s inflammatory response to the bacterial challenge presented by the biofilm [38]. Periodontitis affects, in its severe forms, approximately 10% of the global population, which represents almost 750 million people worldwide[16]. The prevalence of periodontitis among all adults aged 30 years and over registered by the National Health and Nutrition Examination Survey (NHANES) in the United States is 46% [8]. In addition, periodontitis has been found to be more severe and 3 times more likely to occur in patients with diabetes mellitus (DM) compared to the general population [14,25], and the level of glycemic control is the key to determining risk, and similar to other diabetes complications, the risk of periodontitis increases with a worse glycemic index [33]. DM, a chronic non-communicable metabolic disease, occurs when blood glucose levels are increased, or because the body cannot produce any, or enough insulin, or use insulin effectively [15].

  • PHOTODYNAMIC POTENTIAL OF XANTHENIC PHOTOSENSITIZERS ABOUT A STANDARD STRAIN OF PSEUDOMONES AERUGINOSA

    Introduction: Microbial control has proven to be an increasingly difficult obstacle to be controlled, making it a constant research focus. Researchers seek new alternative methods guaranteeing treatment without the use of antimicrobials or associating them, since its used has being neglected, causing an increase in the resistance of microorganisms, making it even more difficult to choose a treatment. The microorganism under study was Pseudomonas aeruginosa, a gram-negative, highly virulent bacterium found in the community and in a hospital environment, with difficult control due to its high capacity for antibiotic resistance, favored by the incorrect use of antibiotic therapies. Photodynamic Therapy consists of the use of a dye associated with the irradiation of a light on the microorganism, promotes dye-light-bacteria interaction, so that it can be inhibited or have its capacity for proliferation reduced. Objective: This research aimed to present an alternative method to its treatment through the use of xanthene dyes and a photosensitizer in a way that would sensitize the bacteria. Plants of the Baixada Maranhese (Punica granatum and Terminalia cattapa) and an LED light source that was irradiated for 40 seconds. The combinations between dye, plant extracts and elimination were organized into 7 groups. Results: The two most successful groups had combinations with the dye Rosa-bengal and in the presence of light, their bactericidal potential was strengthened. In the group in which Punica granatum extract was used alone, there was bacterial proliferation in the absence of the light source; in its presence, the reduction of colonies was not aesthetically relevant. Conclusion: Photodynamic Therapy presents itself as a new resource, acting independently of antibiotic therapy, avoiding and, concomitantly, reducing bacterial resistance. Thus, it appears as a viable alternative in the treatment of patients with “diabetic foot”, considering its possible application with different types of photosensitizers or even in combination…

  • POTENTIALS OF NUTRITIONAL FOLLOW-UP IN A DIABETIC PATIENT HOSPITALIZED WITH ULCERATION TABLE IN PLANT REGION

    Introduction: Approximately 15% of diabetic individuals are affected with foot ulceration, one of the main causes of lower limb amputation. The percentage of diabetic survival after amputation of a lower limb (MI) is 50% three years after the surgical procedure and the mortality rate varies between 39% to 68% after five years. The impact on the quality of life of diabetic people is high, not only economically, the feelings involved contribute to a negative prognosis. Therefore, adequate metabolic and nutritional control, as well as periodic assessment of immunity and comorbidities, should be part of the therapeutic routine of diabetic patients. Experience report: The work in question refers to the nutritional approach performed on a 71-year-old female patient admitted to the hospital with an ulcer in the right plantar region. In anthropometry, the nutritional status indicators indicated eutrophy with nutritional risk. The biochemical evaluation identified anemic condition and sepsis. Physical evaluation showed the presence of edema in the right and left MI. Glycemic and blood pressure levels were monitored daily. A hypercaloric and hyperprotein diet was prescribed, plus protein supplementation with specific immunomodulators for special metabolic situations that prevent energy-protein malnutrition, in addition to the adequacy of vitamins and minerals, in order to avoid nutritional deficiencies arising from the drug-nutrient interaction. Nutritional monitoring lasted 13 days. Ulceration regressed from the entire plantar region, only to the right hallux, which was amputated. Final considerations: There was an improvement in nutritional and biochemical parameters until hospital discharge.

  • SYNTHETIC MOLECULES APPLIED IN THE TREATMENT OF TYPE 2 DIABETES

    Diabetes is considered a multifactorial disease that afflicts populations of the most diverse classes worldwide, being among the main health problems today. Among the types of diabetes, type 2 diabetes mellitus (DM-2) is considered the most prevalent pathology. This is due to the direct relationship between the cause of this disease and people’s eating behavior. These factors justify the growing search for the development of drugs for DM-2, given that current drugs act on targets that are not very efficient for the treatment. Therefore, the objective of this review is to evaluate the progress of research related to the search for new synthetic drugs for a more selective treatment for DM-2. The researches were searched in the main academic databases (National Center for Biotechnology Information (NCBI), Science Direct and Google Scholar), and research tools such as Drug Bank and Clinical Trials. Seventy articles were selected that were causally related to the descriptors used. According to the survey, about 60 compounds of synthetic origin were found and present in the various phases of the study and some molecules already approved for use. A variety of strategies and new therapies related to DM-2 grows each year, as new targets involved are elucidated. Therefore, it is possible to envision a promising future for the treatment of DM-2. because studies like this show the evolution of biochemical research methods and the advances in medicinal chemistry, it will be possible in the future that a multifactorial disease of this type can be treated in a specific way for each patient.

  • DIABETES CLASSIFICATION

    The therapeutic approach established for diabetes control varies according to its classification. Understanding the differences between each type is possible a complete and distinct treatment for the individual. This chapter will address the classification of diabetes types as well as their main differences.

  • ANALYSIS OF THE KNOWLEDGE FROM DIABETICS ABOUT SAFETY OF ADMINISTRATION, PACKAGING AND DISPOSAL OF INSULIN IN THE OUTPATIENT PHARMACY AT A PHILANTHROPIC HOSPITAL IN RECIFE, STATE OF PERNAMBUCO

    Objective: In order to analysis some aspects about the knowledge from diabetics patients related to therapy with insulin it was performed an observational, descriptive and cross-sectional study in the outpatient pharmacy at a hospital in Recife. Methods: This study was between February and May 2016, and involved 60 diabetics patients that were interviewed by a semi-structured questionnaire. Results: Some positive results included: self-monitoring of blood glucose, handling and application method, however there was little knowledge about sharpener disposal. Conclusion: This study provided subsidies to identify some of the main user needs in order to guide orientations regarding the accomplishment of educational activities in the service.

  • ANXIETY AND DEPRESSION IN DIABETICS: A COMPARATIVE ANALYSIS BY GENDER

    INTRODUCTION: Diabetes Mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion and/or action. Studies indicate that type 2 Diabetes Mellitus is related to the increased prevalence of mental health problems, especially depression and anxiety. Diagnosis is associated with an approximately 27% increase on the risk of developing depression, when compared with undiagnosed cases. OBJECTIVES: The objective of this study was to evaluate the prevalence of anxiety and depression in diabetics patients, to compare and correlate these aspects between men and women. METHODOLOGY: Participants were recruited at the Mutirão Diabetes, na event promoted in 2018 by the Municipal Health Secretariat of Goiânia/GO. After this first contact, volunteers were invited through phone calls for a blood exams and interviews. Patients with age between 40 and 60 years of both sexes were selected for the study. Symptoms related to depression were assessed by the Beck Depression Inventory (BDI), which discriminates the presence or absence of depressive behaviour. Anxiety was assessed by the State-Trait Anxiety Inventory (IDATE), which assesses symptoms related to anxiety. Blood glucose was measured and the adopted reference value was ≤99 mg/dL. Mean tests, standard deviation, Student’s t-test and Mann-Whitney tests were performed to compare means between groups and Pearson and Spearman bivariate correlation. RESULTS: The sample consisted of 96 individuals, with a mean age of 56.2 ± 9.6 years, 55.3% female and 42.7% male, and with a mean time of disease (diabetes) of 10.0 ± 7.6 years. The results showed that most of the subjects (66.7%) had their blood glucose above normal values (151.4 ± 76.6), and higher levels of trait anxiety than the reference values (43, 4 ± 6.9). When compared by gender, women had higher depression scores than men (10.4 ± 7.0; 7.8 ± 4.8; p

  • TRACK (BY NEHEP) IMPLEMENTATION: A BANGLADESH SCENARIO

    With the increasing burden of non-communicable diseases in low-income and middle-income countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non- diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called “Rich Man’s Disease” live in low- and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per T2DM was $864.7, which is 52% of per capita GDP of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.

  • PROFILE AND PHARMACOLOGICAL TREATMENT OF DIABETIC PATIENTS ENROLLED IN THE PROGRAM “HERE HAS POPULAR PHARMACY” OF A COMMERCIAL DRUGSTORE

    Diabetes Mellitus it is a condition that can result from defects secretion and/or insulin action involving specific pathogenic processes. To analyze the profile of registered diabetic patients in the program “Here’s People’s Pharmacy” of a commercial drug store in the municipality of Paraná-RN, checking the type of diabetes mellitus that is more present, the most commonly used drugs and what other diseases are reported. Study applied, descriptive and quantitative and qualitative, with a questionnaire to registered diabetic patients in the program “Here’s People’s Pharmacy” in a drug store located in the city of Paraná-RN. The study sample was 50 people. Of the participants, 96 % had diabetes mellitus type 2. The use of medicines, metformin was the most used (52 %), followed by glibenclamide (46 %) and insulin (2 %). With regard to the presence of other diseases hypertension and high cholesterol prevailed about 20 % and 8 %, respectively. It is important the involvement of health professionals in the treatment of diabetes and other chronic diseases, however, it is essential that the patient is aware that the greater re-sponsibility and commitment are in himself, and ultimately with your family or caregiver.

  • SYSTEMATIZATION OF NURSING ASSISTANCE IN DIABETIC FOOT WOUND TREATMENT: CASE REPORT

    Introduction: Diabetes mellitus is considered a metabolic syndrome of multifactorial origin characterized by hyperglycemia and disorders in the metabolism of carbohydrates, proteins and fats that occurs when there is no insulin or when insulin does not perform its function properly. Diabetic foot injury is one of the most frequent implications of diabetes mellitus. It is associated with many factors, such as peripheral vascular disease and peripheral neuropathy, which in many cases may compromise the entire limb. In this context, the systematization of nursing care starts as a systematic method that makes it possible to identify and understand the needs of the patient. The application of the Systematization of Nursing Assistance brings benefits to the client, the institution, professionals and to nursing as a whole. Objectives: To verify the inference of the nursing diagnosis “Impaired skin integrity” and the use of the other steps of Nursing Care Systematization in the treatment of diabetic foot wound. Methods: This is an exploratory clinical study of the case-study type, carried out during the period of clinical nursing internship in a public hospital in the city of Recife-PE, from September 17 to October 11, 2018 Results: A 77-year-old male patient with diabetes mellitus, with MIE lesion and hallux amputation, fourth and fifth finger. During the aforementioned period, the data was collected through anamnesis, physical examination, records in the medical record and analysis of laboratory tests. In this way, it was possible to plan the Nursing Care Systematization and to apply the interventions for the diagnosis “Impaired skin integrity”, being: daily skin examination with image records and monitoring of wound healing, daily dressing with use of serum saline at 0.9%, Essential Fatty Acids (AGE) and Hydrogel in the necessary places, orientation on how to change the decubitus periodically and use of cushions in the regions, aiming…