Diabetes and Metabolism

  • Intermittent Fasting and Adding More days to Life

    Intermittent fasting (IF) is currently one of the world’s most popular health and fitness trends. Several IF patterns have been studied. Not all were shown to be equally effective. Also, each person’s experience of intermittent fasting is individual, and different styles will suit different people. The potential health benefit list of IF is long: accelerated weight loss, reduced inflammation, lower cholesterol, longer lifespan, blood sugar stabilization, and prevention of type 2 diabetes. Emerging research suggests IF may also lead to a healthier brain, longer life, and even aid cancer treatment. Placing time restrictions on feeding has been shown to have broad systemic effects and trigger similar biological pathways as caloric restriction. One key mechanism responsible for many of these beneficial effects appears to be “flipping” of the metabolic switch. The metabolic switch typically occurs in the third phase of fasting when glycogen stores in hepatocytes are depleted and accelerated adipose tissue lipolysis produces increased fatty acids and glycerol. Just changing the timing of meals, by eating earlier in the day and extending the overnight fast, significantly benefited metabolism even in people who didn’t lose a single pound.

  • Diabetes Fact: Bangladesh Perspective

    Bangladesh is a developing country where 75% of total population lives in rural area. Subsequently they have poor healthcare access as 26% of rural professionals remain vacant and nearly 40%, absent. Although official documents indicate that 80% of the population has access to affordable essential drugs, there is plenty of evidence of a scarcity of essential drugs in government healthcare facilities. Nearly 45% rural people take medical assessment from unqualified health workers including medical assistants, mid-wives, village doctors, community health workers in comparison to that by qualified medical graduates (only 10%-20%). More than 75% women having complications sought treatment from an unqualified provider. These are mostly because concern over medical costs, and pronounced socioeconomic disparities found for care-seeking behavior in both urban and rural Bangladesh. However, the government’s expenditure on health is the third largest in the country, after education and defense. Diabetes is a complicated chronic disease; non-compliant patients are in a risk of moderate to severe complications, to much extent unexplored to maximum people of Bangladesh. Annually diabetes is responsible for 5% of all deaths globally, and its prevalence is increasing steadily. As reported by International Diabetes Federation (IDF), approximately 75–80% of people with diabetes die due to cardiovascular complications.

  • Emerging Nephrotic Problems among Diabetic Patients of Bangladesh

    Nearly 80% of people with diabetes live in low- and middle-income countries. It increases healthcare expenditure and imposes a huge economic burden on the healthcare systems. The International Diabetes Federation estimated more than 7 million people with diabetes in Bangladesh and almost an equal number with unexplored diabetes. This number is estimated to double by 2025. It is a costly condition and may cause stroke, heart attack, chronic kidney diseases, neuropathy, visual impairment and amputations. Bangladesh is a developing country where 75% of total population lives in rural area. Subsequently they have poor healthcare access as 26% of rural professionals remain vacant and nearly 40%, absent. Nearly 45% rural people take medical assessment from unqualified health workers including medical assistants, mid-wives, village doctors, community health workers in comparison to that by qualified medical graduates (only 10%-20%). More than 75% women having complications taken treatment from an unqualified provider. These are mostly because concern over medical costs, and pronounced socioeconomic disparities found for care-seeking behavior in both urban and rural Bangladesh.

  • To characterize the sociodemographic, clinical, therapeutic and quality of life of users of the Unified Health System with Diabetes mellitus

    Introduction: Descriptive study with a quantitative approach carried out between October 2015 and October 2016. Sampling was about 100 people with diabetes. Objective: To characterize the sociodemographic, clinical, therapeutic and quality of life of users of the Unified Health System with Diabetes mellitus in a Basic Health Unit (BHU) of the Rural Zone of the city of Vitória de Santo Antão. Methods: Two questionnaires, sociodemographic, clinical and therapeutic, and DQUOL-BRASIL, both validated, were used. Results and discussion: Higher prevalence of female people (75%). Of the investigators (51%) were not able to report their type of diabetes, the medication was obtained in the BHU (44%) as well as the follow-up (78%). (44%) did not receive the blood glucose strips, and (92%) did not participate in educational programs. Regarding the quality of life or impact domain, the highest mean was obtained (32.05) and the lowest for the sale of diabetes problems (6.66). Conclusion: It is concluded that the results obtained contribute to increase the knowledge about the factors studied, since knowing a population makes possible the development of effective health actions, considering the local specificities.

  • Effects of oral antidiabetics on cancer incidence and mortality

    Introduction: Type 2 diabetes mellitus is a chronic progressive disease that can be controlled by any oral hypoglycemic, with biguanides, thiazolidinediones and sulfonylureas being the main classes of these drugs in the pharmaceutical market. Epidemiological analyzes suggest that diabetics are at higher risk of developing tumors than normoglycemics. A large number of studies have shown the link between oral antidiabetic drugs and developmental rates and mortality in cancer cases. Objective: To present clinical and preclinical results on the relationship between oral hypoglycemic agents and cancer. Methodology: A bibliographical survey was carried out of the main academic journals, with prevalence of articles from the last five years. Results and Discussion: Metformin is a biguanide that phosphorylates hepatic cyclic AMP, a mechanism also proposed as antineoplastic. Epidemiological studies associate the use of metformin with the lower incidence of hepatocellular and pancreatic cancers in diabetic patients. Other studies have shown a 21% lower mortality rate in women with breast cancer and 24% lower in men with prostate cancer who took metformin. Thiazolidinediones are receptor agonists, predominantly present in adipocytes, capable of increasing glucose uptake and improving insulin sensitivity. Randomized trials have shown that pioglitazone was associated with a significant reduction in breast cancer, however, there are concerns regarding its use related to the increase in the incidence of bladder cancer. Sulphonylureas, on the other hand, increase insulin secretion by pancreatic β cells. In an observational study, glibenclamide was associated with an increased risk of 20% to 25% in the overall incidence of cancer. Conclusion: The use of oral hypoglycemic agents may decrease the incidence and mortality of certain types of cancer. However, more studies are needed to elucidate its possible effects on the neoplastic process.

  • Health care education in people with arterial hypertension and diabetes mellitus

    Introduction: The Hypertension and Diabetes Program (HIPERDIA), established in 2001 by the Ministry of Health, organizes the assistance to people with Hypertension and Diabetes, chronic diseases in evidence in public health. Assistance begins in primary health care, the main gateway to the Unified Health System’s attention network, which has a fundamental role in the prevention and control of diseases, as well as health promotion with multidisciplinary and interdisciplinary care, considering individuals in its completeness. Objectives: To report on the experience of residents of the Integrated Multiprofessional Residency Program in Family Health, in the inclusion of health promotion activities in the HIPERDIA group in a Family Health Unit in the city of Recife-PE. Methodology: This is an experience report, with data collected from the field diaries of activities in the HIPERDIA group, from August to October 2017. The group operates weekly, with 15 to 25 members. Initiated with health education activity, with professionals. The methods used were talk wheels and group dynamics with themes related to health promotion. Results and Discussion: Health education activities contribute through the exchange of experiences, to individuals’ autonomy in the care of their own health, directed to the expanded concept of health, that goes beyond the control of the disease, expecting the improvement of the quality of life and well-being. Conclusion: The activities contributed to an improvement in the quality of life and prevention of the factors conditioning the complications of chronic diseases. Discussions and exchange of knowledge based on the promotion of oral health, mental health, healthy eating, the importance of self-care, among others, have been built that have contributed to increase the bond with other participants of the group and with professionals, building together a care that provides greater autonomy and well-being.

  • The knowledge of users with diabetes mellitus of a basic health unit on diabetic foot

    Introduction: The Diabetic foot is a neuropathy responsible for several alterations and complications, particularly in the lower limbs. The way diabetics behave and how well they know about diabetic foot care is of ultmost importance, considering prior knowledge precedes an effective preventive plan. Objective: This study aims to investigate the knowledge of diabetic pacients, who are users of the Basic Health Unit in the city of Olinda, on the diabetic foot. Methodology: This is an exploratory descriptive study of quantitative methods, with a sample of 50 diabetic patients from BHU users. After signing a Free and Informed Consent Form, a questionnaire was applied and the collected data was consolidated and presented in tables and graphs charts. Results and Discussion: In total, 42% of diabetics users of the BHU reported that they had not heard about diabetic foot, while 93% reported that they knew about the risks of foot amputation; about 88% affirmed to take care of their feet and the main precautions mentioned were: washing their feet (54 %), avoiding to walk barefoot (39 %) wipe the feet properly (32%), 81% didn´t know about risk factors and approximately 69 % reported that they received no professional guidance in the basic health unit regarding foot care. Conclusion: In light of the above, it is noticeable the importance of a greater knowledge of diabetics users on the neuropathic foot and the need for specific care. Therefore, the understanding is essential for prevention of complications, such as amputation of lower limbs, and for decreased morbimortality.

  • Frequently oral alterations in diabetic patients

    Introduction: The number of Brazilians diagnosed with diabetes increased by 61.8% in the last 10 years, from 5.5% to 8.9% in 2016. The patient with diabetes has physical possibilities that reduce their immunological capacity, increasing the susceptibility of infections and, among these, countless mouthfuls. Objectives: Identify oral asbestos caused by diabetes and what the mechanisms of the body to occur and / or bypass them. Methodology: A bibliographic review was done in the virtual libraries SCIELO and PubMed, use the articles: Diabetes and Oral diseases. We used criteria for inclusion of published articles from 2013 to 2017, in the Portuguese and English languages, which relate to diabetes, dental and oral ebert. Results: The research resulted in 5,821 articles, of which 22 were separated by presenting a relation with the theme, but only four attendants to the inclusion criteria. Discussion: Diabetes is associated with loss of calcium by the body and may lead to alveolar bone decalcification. As major oral manifestations are known as glossodynia, erythema, xerostomia and taste disorders. Diabetes increases the acidity of the buccal medium, increases viscosity and reduces the flow of salivary, which are risk factors for caries. Periodontal disease, which results in a potent inflammatory response, is a common dental manifestation in poorly controlled diabetics. There are modifications of the microbiota in floating or adherent bacterial plaques at the base of the periodontal pocket, due to the high levels of glucose in the sulcular fluid. As infections lead to inflammation resulting in a stressful situation, which increases tissue resistance to insulin, making it difficult to control diabetes. It was then observed that periodontal therapy reduced the need for insulin administration by the diabetic. Conclusion: It is extremely necessary to know about a pathophysiology of diabetes to relate causes and effects and to adopt a more careful…