Diabetes and Metabolism

  • 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…

  • 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.