1
|
Oliveira Junior PPD, Castro FAGD. Avaliação do rastreio de retinopatia diabética por meio de uma auditoria clínica em uma Unidade de Atenção Primária à Saúde rural no interior de Minas Gerais. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introdução: A retinopatia diabética é uma complicação do diabetes mellitus com grande impacto na saúde, mas seu diagnóstico por oftalmoscopia e a instituição do tratamento precoce comprovadamente reduzem a progressão para a perda visual. No território adscrito pela Unidade de Atenção Primária à Saúde (UAPS) onde realizou-se o presente estudo a equipe médica percebeu uma quantidade significativa de pessoas que não realizam fundo de olho periodicamente. Objetivo: Avaliar a taxa de pessoas adequadamente rastreadas quanto à retinopatia entre os diabéticos tipo 2 dessa localidade rural. Métodos: Este estudo consiste em um relato de experiência da realização de uma auditoria clínica para avaliar a taxa de rastreio de retinopatia entre diabéticos tipo 2 de uma UAPS. Para isso foi gerada uma planilha com os pacientes diabéticos de forma eletrônica pelo prontuário e-SUS, com posterior leitura de prontuário dos últimos dois anos em busca de menção à realização de oftalmoscopia. Resultados: O relatório gerou 3.736 cadastros ativos, dos quais 181 eram diabéticos. Destes, 156 foram selecionados para análise por serem comprovadamente diabéticos tipo 2. A taxa de rastreio nos últimos dois anos foi de 13,4%. Em 61,9% dos casos, a realização de fundoscopia foi realizada na própria UAPS. Conclusão: A auditoria clínica foi uma ferramenta útil para confirmar e delimitar a suspeita de baixa taxa de rastreio de retinopatia diabética. A realização de fundoscopia pelo médico de família e comunidade com treinamento foi uma estratégia que permitiu elevar essa porcentagem.
Collapse
|
2
|
Galvão FM, Silva YP, Resende MILD, Barbosa FR, Martins TA, Carneiro LB. Prevalência e fatores de risco para retinopatia diabética em pacientes diabéticos atendidos por demanda espontânea: um estudo transversal. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
3
|
Mota RI, Morgan SE, Bahnson EM. Diabetic vasculopathy: macro and microvascular injury. CURRENT PATHOBIOLOGY REPORTS 2020; 8:1-14. [PMID: 32655983 PMCID: PMC7351096 DOI: 10.1007/s40139-020-00205-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Diabetes is a common and prevalent medical condition as it affects many lives around the globe. Specifically, type-2 Diabetes (T2D) is characterized by chronic systemic inflammation alongside hyperglycemia and insulin resistance in the body, which can result in atherosclerotic legion formation in the arteries and thus progression of related conditions called diabetic vasculopathies. T2D patients are especially at risk for vascular injury; adjunct in many of these patients heir cholesterol and triglyceride levels reach dangerously high levels and accumulate in the lumen of their vascular system. RECENT FINDINGS Microvascular and macrovascular vasculopathies as complications of diabetes can accentuate the onset of organ illnesses, thus it is imperative that research efforts help identify more effective methods for prevention and diagnosis of early vascular injuries. Current research into vasculopathy identification/treatment will aid in the amelioration of diabetes-related symptoms and thus reduce the large number of deaths that this disease accounts annually. SUMMARY This review aims to showcase the evolution and effects of diabetic vasculopathy from development to clinical disease as macrovascular and microvascular complications with a concerted reference to sex-specific disease progression as well.
Collapse
Affiliation(s)
- Roberto I. Mota
- Department of Surgery, Division of Vascular Surgery; University of North Carolina at Chapel Hill, NC 27599
- Center for Nanotechnology in Drug Delivery; University of North Carolina at Chapel Hill, NC 27599
- McAllister Heart Institute, University of North Carolina at Chapel Hill, NC 27599
| | - Samuel E. Morgan
- Department of Surgery, Division of Vascular Surgery; University of North Carolina at Chapel Hill, NC 27599
- Center for Nanotechnology in Drug Delivery; University of North Carolina at Chapel Hill, NC 27599
| | - Edward M. Bahnson
- Department of Surgery, Division of Vascular Surgery; University of North Carolina at Chapel Hill, NC 27599
- Center for Nanotechnology in Drug Delivery; University of North Carolina at Chapel Hill, NC 27599
- McAllister Heart Institute, University of North Carolina at Chapel Hill, NC 27599
- Department of Cell Biology and Physiology. University of North Carolina at Chapel Hill, NC 27599
| |
Collapse
|
4
|
Wichnieski C, Kirchhof FNS, Beraldo PC, Bertassoni Neto L, Jara CC. Physiotherapeutic intervention in peripheral arterial disease by functional hyperemia in diabetic patients. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.004.ao10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction : Diabetes Mellitus (DM) is conceptualized as a public health problem with varying degrees of morbidity. The physical and functional alternatives for the treatment of circulatory complications of diabetes, such as intermittent claudication, are poorly explored. This indicates the need to search for ancillary techniques that can be used in the physical therapy treatment of diabetic patients. Objective : To investigate the effects of functional hyperemia on peripheral arterial disease in patients with diabetes. Materials and methods: This study was conducted with a group of five volunteers from the Diabetics Association of Parana (Associação Paranaense do Diabético , APAD ), who suffered from peripheral vascular disorders in the lower limbs. All subjects attended 10 sessions (twice weekly). Functional hyperemia was induced by programmed exercise therapy that consisted of walking on a treadmill. Results : There was a significant increase in mean activity time (F9,36 = 13.710; p < 0.001 ), mean walking distance (F9,36 = 27.689 ; p < 001), and mean speed (F9,36 = 15.638 ; p < .001). No statistically significant differences in the ankle-brachial index were noted. Conclusion : There was a significant increase in walking distance, time, and speed for diabetic subjects. Our findings indicate the importance of physical therapists in the supervised treatment of peripheral vascular disorders in diabetic patients.
Collapse
|
5
|
Rodrigues Júnior W, Gaban SCN, Pontes ERJC, Souza CC, Gimenes LP, Lacerda PF, Cunha MLMN, Stefanello II JVL, Brum LM, Oliveira LA, Silva CR, Ribeiro ALD. Diabetes mellitus and impaired glucose tolerance in urban adult population. Rev Assoc Med Bras (1992) 2015; 60:118-24. [PMID: 24918998 DOI: 10.1590/1806-9282.60.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 08/30/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Estimating the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in the urban population aged between 30 and 69 years in the municipality of Campo Grande, state of Mato Grosso do Sul, Brazil. METHODS Population-based cross-sectional study conducted between October/2009 and February/2011. The investigation included the determination of fasting glucose and participants with blood glucose ≥ 200 mg/dL were considered diabetic. Nondiabetic patients, which showed blood glucose ≥ 100 mg/dL and < 200 mg/dL, underwent an oral glucose tolerance test (OGTT) to investigate whether they had DM or IGT. RESULTS 1.429 individuals participated in this investigation. The general prevalence, adjusted for sex and age, were: 12.3% for DM (95%CI: 10.5 to 13.9%) and 7.1% for IGT (95%CI: 5.7 to 8.4%). There was a higher prevalence of DM with increasing age in people with low educational level, family history of diabetes, overweight, obesity and central obesity. Among diabetic patients (n = 195), 25% were unaware they had the disease and were diagnosed through investigation. Among patients who already knew they had DM (n = 146), 37% were unaware of the potential chronic complications. CONCLUSION This study confirms the increased prevalence of DM in Brazil and emphasizes the need for early diagnosis, as well as the importance of strict adherence to medical treatment in order to prevent its much feared complications.
Collapse
|
6
|
Knowledge of diabetes mellitus: does gender make a difference? Osong Public Health Res Perspect 2014; 5:199-203. [PMID: 25379370 PMCID: PMC4215000 DOI: 10.1016/j.phrp.2014.06.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 06/24/2014] [Accepted: 06/24/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Diabetes mellitus (DM) is a chronic disease considered an important public health problem. In recent years, its prevalence has been exponentially rising in many developing countries. Chronic complications of DM are important causes of morbidity and mortality among patients, which impair their health and quality of life. Knowledge on disease prevention, etiology, and management is essential to deal with parents, patients, and caregivers. The aim of this study was to evaluate the knowledge regarding DM in an adult population from a Middle-western Brazilian city. METHODS This was a cross-sectional study covering 178 adults, aged 18-64 years, who answered a diabetes knowledge questionnaire. In order to identify the difference between groups, analysis of variance was used. RESULTS Higher knowledge scores were found regarding the role of sugars on DM causality, diabetic foot care, and the effects of DM on patients (blindness, impaired wound healing, and male sexual dysfunction). However, lower scores were found amongst types of DM, hyperglycemic symptoms, and normal blood glucose levels. Females tended to achieve better knowledge scores than males. CONCLUSION Women had better knowledge regarding types of DM, normal blood glucose values, and consequences of hyperglycemia revealed that diabetes education should be improved.
Collapse
|
7
|
Viana MV, Moraes RB, Fabbrin AR, Santos MF, Torman VBL, Vieira SR, Gross JL, Canani LH, Gerchman F. Contrasting effects of preexisting hyperglycemia and higher body size on hospital mortality in critically ill patients: a prospective cohort study. BMC Endocr Disord 2014; 14:50. [PMID: 24941997 PMCID: PMC4072488 DOI: 10.1186/1472-6823-14-50] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 06/11/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Obesity and diabetes mellitus are well-defined risk factors for cardiovascular mortality. The impact of antecedent hyperglycemia and body size on mortality in critical ill patients in intensive care units (ICUs) may vary across their range of values. Therefore, we prospectively analyzed the relationship between in-hospital mortality and preexisting hyperglycemia and body size in critically ill ICU patients to understand how mortality varied among normal, overweight, and obese patients and those with low, intermediate, and high glycated hemoglobin (HbA1c) levels. METHODS Medical history, weight, height, physiologic variables, and HbA1c were obtained during the first 24 h for patients who were consecutively admitted to the high complexity ICU of Hospital de Clínicas de Porto Alegre, Brazil, from April to August 2011. The relationships between mortality and obesity and antecedent hyperglycemia were prospectively analyzed by cubic spline analysis and a Cox proportional hazards model. RESULTS The study comprised 199 patients. The overall hospital mortality rate was 43.2% during a median 16 (8-28) days of follow-up. There was a progressive risk of in-hospital mortality with higher HbA1c levels, with the relationship becoming significant at HbA1c >9.3% compared with lower levels (hazard ratio 1.74; 95% confidence interval with Bonferroni correction 1.49-2.80). In contrast, mean body mass index (BMI) was higher in survivors than in nonsurvivors (27.2 kg/m2 ± 7.3 vs. 24.7 kg/m2 ± 5.0 P = 0.031, respectively). Cubic spline analysis showed that these relationships differed nonlinearly through the spectrum of BMI values. In a Cox proportional hazards model adjusted for Acute Physiology and Chronic Health Evaluation II score and HbA1c, the risk of in-hospital mortality progressively decreased with increasing BMI (BMI <20 vs. 20-23.9 kg/m2, P = 0.032; BMI <20 vs. 24-34.9 kg/m2, P = 0.010; BMI <20 vs. ≥35 kg/m2, P = 0.032). CONCLUSIONS Our findings suggest that significant hyperglycemia prior to ICU admission is a risk factor for in-hospital mortality. Conversely, increasing BMI may confer an advantageous effect against mortality in critical illness independently of previous glycemic control.
Collapse
Affiliation(s)
- Marina Verçoza Viana
- Intensive Care Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafael Barberena Moraes
- Intensive Care Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Amanda Rodrigues Fabbrin
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Manoella Freitas Santos
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa Bielefeldt Leotti Torman
- Department of Statistics, Federal University of Rio Grande do Sul, and Research and Post-Graduation Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Silvia Regina Vieira
- Intensive Care Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jorge Luiz Gross
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis Henrique Canani
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Gerchman
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
8
|
Paim CP, Azzolin KDO, Moraes MAPD. Dor torácica no infarto agudo do miocárdio entre pacientes diabéticos e não diabéticos. Rev Bras Enferm 2012; 65:77-82. [DOI: 10.1590/s0034-71672012000100011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 03/02/2012] [Indexed: 11/22/2022] Open
Abstract
Considerando-se que pacientes diabéticos acometidos de Infarto Agudo do Miocárdio (IAM) podem, ou não, apresentar dor torácica, objetivou-se neste estudo comparar a presença e intensidade de dor torácica no IAM entre pacientes diabéticos e não diabéticos. Realizou-se um estudo transversal, que incluiu pacientes com IAM, idade ≥18 anos, ambos os sexos. Utilizou-se uma escala numérica verbal para avaliar a presença e a intensidade da dor.Foram incluídos 88 pacientes no estudo, dentre os quais 77 (87,5%) não diabéticos e 11 (12,5%) diabéticos. A dor esteve presente em 11 (100%) dos diabéticos e 76 (98,7%) dos não diabéticos. A intensidade da dor nos diabéticos foi de 8,91 versus 8,23 nos não diabéticos. O estudo mostrou semelhança na presença e intensidade da dor torácica entre pacientes diabéticos e não diabéticos acometidos de IAM.
Collapse
|