Proposta de intervenção visando à prevenção de amputação de membros inferiores em portadores de diabetes mellitus no PSF Campo Grande, Delmiro Gouveia - Alagoas

A amputação de membros inferiores é uma das principais consequências do diabetes mellitus e das ulcerações nos pés. Os doentes diabéticos têm um risco 15 vezes maior de serem submetidos às amputações de membros inferiores e essas complicações são evitáveis com um tratamento bem implementado e devidamente acompanhado. O objetivo desse trabalho foi elaborar uma proposta de intervenção visando à prevenção de amputação de membros inferiores em portadores de diabetes mellitus no PSF Campo Grande, em Delmiro Gouveia -Alagoas. A proposta foi desenvolvida com base em estudo da própria área de abrangência da equipe de saúde e em estudo de projetos que já foram realizados e colocados em prática com sucesso. Foram selecionados os nós críticos da área de abrangência da equipe e algumas possíveis soluções para esses entraves que são descritos ao longo do trabalho. A analise dos dados concluiu que com o esforço proposto aqui, os números de amputações caem de forma marcante, trazendo beneficio pessoal, aos pacientes e familiares, e econômico ao país

Prevenção de complicações em adultos com diabetes mellitus 2 da Estratégia Saúde da Família Collen do município Cambui, Minas Gerais

A diabete mellitus, embora conhecida desde os tempos antigos, é uma das doenças que mais preocupam as autoridades da saúde até hoje em todo o mundo. A alta prevalência da doença, a dificuldade de controle, em alguns casos, bem como as alterações morfológicas e funcionais em outros órgãos, como as cardiovasculares, faz com que o Diabete Mellitus seja um dos problemas prioritários nacionalmente. Este estudo objetivou propor um plano de ação para prevenir complicações em pacientes com Diabetes Mellitus, da ESF Collen no município de Cambuí, Minas Gerais. Foi realizada uma revisão da literatura narrativa, no período de 2005 a 2015, na Biblioteca Virtual em Saúde (BVS),na Scientific Eletronic Library Online (SciELO), entre outros documentos pertinentes à temática, como linhas guias, protocolos, dados municipais. O plano de ação foi preparado seguindo o método do Planejamento Estratégico Situacional (PES). O diagnostico situacional da comunidade Collen, apontou que dos 28.000 habitantes de nosso município, 27 % são diabéticos. Além disso, percebeu-se relevância nas internações hospitalares por complicações da doença, situações que junto com a equipe da Estratégia de Saúde da Família (ESF), nos motivou a estabelecer um plano de ação para melhorar o diagnóstico e acompanhamento de pacientes diagnosticados com Diabete Mellitus. Após realizar o diagnóstico da situação de Saúde e saber o território estudado pelo método da estimativa preliminar, incluindo os principais problemas que surgem na nossa área, as intervenções são projetadas para garantir uma melhoria no atendimento de pacientes com DM. Concluiu-se que o DM realmente tem um grande impacto sobre a área de influência da comunidade e a sua abordagem é vital para enriquecer o conhecimento pessoal dos usuários sobre a saúde, bem como dos pacientes, para poder estimular uma mudança no estilo de vida e a participação em projetos sociais, especialmente os culturais, que desenvolvam atividades físicas. Através destes projetos,pode-se entrar em contato com as famílias da comunidade, conscientizando-as sobre os riscos e cuidados necessários. Isto exige a integração da equipe com a possível articulação de diferentes estratégias, setores sociais e governamentais, para incorporar ações conjuntas voltadas para a saúde pública visando o controle mais eficaz dos doentes diabéticos a fim de evitar as complicações da doença

Educação e prevenção em diabetes mellitus na estratégia saúde da família em Ibiá - MG: melhora metabólica e ganho na qualidade de vida

Nos dias atuais, as mudanças na alimentação e nos hábitos de vida têm sido uma grande preocupação para a área da saúde, pois se observa o aumento do sedentarismo e da alimentação inadequada, o que pode provocar ou agravar doenças como o Diabetes Mellitus (DM). Este trabalho objetivou elaborar um plano de intervenção com vistas à prevenção, controle e tratamento do Diabetes Mellitus. Na construção deste trabalho, realizou-se inicialmente uma pesquisa bibliográfica para subsidiar a elaboração do plano. O DM é uma enfermidade, que se não diagnosticada e tratada corretamente, acarreta uma série de consequências como cegueira, cardiopatias, amputação, entre outras. Além disso, seu tratamento é complexo e exige cuidado e disciplina. Por esse motivo, a importância de um trabalho educativo, buscando o controle e tratamento do paciente portador de Diabetes Mellitus. Com esta pesquisa, pode-se observar que foi importante a abordagem educativa por meio de projetos e informações para os diabéticos e a população em geral. A melhoria do atendimento também contribuiu muito para os participantes, pois nas reuniões e nas atividades desenvolvidas, os diabéticos participaram ativamente, e os relatórios mostraram melhoria no estado de saúde e no atendimento dos mesmos

Antioxidant And Anti-diabetic Potential Of Passiflora Alata Curtis Aqueous Leaves Extract In Type 1 Diabetes Mellitus (nod-mice).

Leaves of Passiflora alata Curtis were characterized for their antioxidant capacity. Antioxidant analyses of DPPH, FRAP, ABTS, ORAC and phenolic compounds were made in three different extracts: aqueous, methanol/acetone and ethanol. Aqueous extract was found to be the best solvent for recovery of phenolic compounds and antioxidant activity, when compared with methanol/acetone and ethanol. To study the anti-inflammatory properties of this extract in experimental type 1 diabetes, NOD mice were divided into two groups: the P. alata group, treated with aqueous extract of P. alata Curtis, and a non-treated control group, followed by diabetes expression analysis. The consumption of aqueous extract and water ad libitum lasted 28 weeks. The treated-group presented a decrease in diabetes incidence, a low quantity of infiltrative cells in pancreatic islets and increased glutathione in the kidney and liver (p<0.05), when compared with the diabetic and non-diabetic control-groups. In conclusion, our results suggest that the consumption of aqueous extract of P. alata may be considered a good source of natural antioxidants and compounds found in its composition can act as anti-inflammatory agents, helping in the control of diabetes.

Reduced Lrp6 Expression And Increase In The Interaction Of Gsk3β With P53 Contribute To Podocyte Apoptosis In Diabetes Mellitus And Are Prevented By Green Tea.

In diabetes mellitus (DM), podocyte apoptosis leads to albuminuria and nephropathy progression. Low-density lipoprotein receptor-related protein 6 (LRP6) is WNT pathway receptor that is involved in podocyte death, adhesion and motility. Glycogen synthase kinase 3 (GSK3) interaction with p53 (GSK3-p53) promotes apoptosis in carcinoma cells. It is unknown if GSK3-p53 contributes to podocyte apoptosis in DM. In experimental DM, green tea (GT) reduces albuminuria by an unknown mechanism. In the present study, we assessed the role of the GSK3β-p53 in podocyte apoptosis and the effects of GT on these abnormalities. In diabetic spontaneously hypertensive rats (SHRs), GT prevents podocyte's p-LRP6 expression reduction, increased GSK3β-p53 and high p53 levels. In diabetic SHR rats, GT reduces podocyte apoptosis, foot process effacement and albuminuria. In immortalized mouse podocytes (iMPs), high glucose (HG), silencing RNA (siRNA) or blocking LRP6 (DKK-1) reduced p-LRP6 expression, leading to high GSK3β-p53, p53 expression, apoptosis and increased albumin influx. GSK3β blockade by BIO reduced GSK3β-p53 and podocyte apoptosis. In iMPs under HG, GT reduced apoptosis and the albumin influx by blocking GSK3β-p53 following the rise in p-LRP6 expression. These effects of GT were prevented by LRP6 siRNA or DKK-1. In conclusion, in DM, WNT inhibition, via LRP6, increases GSK3β-p53 and podocyte apoptosis. Maneuvers that inactivate GSK3β-p53, such as GT, may be renoprotective in DM.

Association Of Single Nucleotide Polymorphisms In The Gene Encoding Glut1 And Diabetic Nephropathy In Brazilian Patients With Type 1 Diabetes Mellitus.

Mesangial cells subject to high extracellular glucose concentrations, as occur in hyperglycaemic states, are unable to down regulate glucose influx, resulting in intracellular activation of deleterious biochemical pathways. A high expression of GLUT1 participates in the development of diabetic glomerulopathy. Variants in the gene encoding GLUT1 (SLC2A1) have been associated to this diabetic complication. The aim of this study was to test whether polymorphisms in SLC2A1 confer susceptibility to diabetic nephropathy (DN) in Brazilian type 1 diabetes patients. Four polymorphisms (rs3820589, rs1385129, rs841847 and rs841848) were genotyped in a Brazilian cohort comprised of 452 patients. A prospective analysis was performed in 155 patients. Mean duration of follow-up was 5.6±2.4years and the incidence of renal events was 18.0%. The rs3820589 presented an inverse association with the prevalence of incipient DN (OR: 0.36, 95% CI: 0.16 - 0.80, p=0.01) and with progression to renal events (HR: 0.20; 95% CI: 0.03 - 0.70; p=0.009). AGGT and AGAC haplotypes were associated with the prevalence of incipient DN and the AGAC haplotype was also associated with the prevalence of established/advanced DN. In conclusion, rs3820589 in the SLC2A1 gene modulates the risk to DN in Brazilian patients with inadequate type 1 diabetes control.

(-)-tarchonanthuslactone Exerts A Blood Glucose-increasing Effect In Experimental Type 2 Diabetes Mellitus.

A number of studies have proposed an anti-diabetic effect for tarchonanthuslactone based on its structural similarity with caffeic acid, a compound known for its blood glucose-reducing properties. However, the actual effect of tarchonanthuslactone on blood glucose level has never been tested. Here, we report that, in opposition to the common sense, tarchonanthuslactone has a glucose-increasing effect in a mouse model of obesity and type 2 diabetes mellitus. The effect is acute and non-cumulative and is present only in diabetic mice. In lean, glucose-tolerant mice, despite a slight increase in blood glucose levels, the effect was not significant.

Contribution of skin immunohistochemistry in the evaluation of nerve fibers in diabetes mellitus type 2

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Qualidade de vida de portadores de Diabetes Mellitus tipo II frente às oscilações no nível de atividade física, aspectos socioeconômicos e presença de comorbidades

Universidade Estadual de Campinas . Faculdade de Educação Física

Prevalence of diabetes mellitus and impaired glucose tolerance in a rural community of Angola

Background: To determine the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in a rural community (Bengo) of Angola. Methods: A random sample of 421 subjects aged 30 to 69 years (30% men and 70% women) was selected from three villages of Bengo province. This cross-sectional home survey was conducted using a sampling design of stage conglomerates. First, clinical and anthropometric data were obtained and fasting capillary glucose level was determined. Subjects who screened positive (fasting capillary glucose >= 100 mg/dl and < 200 mg/dl) and each sixth consecutive subject who screened negative (fasting capillary glucose < 100 mg/dl) were submitted to the second phase of survey, consisting of the 75 g oral glucose tolerance test. Data was analyzed by the use of SAS statistical software. Results: The prevalence rates of diabetes mellitus and IGT were 2.8% and 8.1%, respectively. The age group with the highest prevalence of diabetes was 60 to 69 years (42%). Impaired glucose tolerance prevalence was 38% in the 40 to 49 year age group and it increased with age, considering that the 50 to 59 and 60 to 69 year age groups as a whole represent 50% of all subjects with impaired glucose tolerance. The prevalence of diabetes mellitus did not differ significantly between men (3.2%) and women (2.7%) (p = 0.47). On the other hand, the prevalence of impaired glucose tolerance among women showed almost twice that found in men (9.1% vs. 5.6%, respectively). Overweight was present in 66.7% of the individuals with diabetes mellitus and 26.5% of individuals with impaired glucose tolerance showed overweight or obesity. Conclusions: Although the prevalence of diabetes mellitus was low, the prevalence of impaired glucose tolerance is considered to be within an intermediary range, suggesting a future increase in the frequency of diabetes in this population.

Theoretical study on the molecular and electronic properties of some substances used for diabetes mellitus treatment

Diabetes mellitus (DM) is a disease that affects a large number of people, and the number of problems associated with the disease has been increasing in the past few decades. These problems include cardiovascular disorders, blindness and the eventual need to amputate limbs. Therefore, the quality of life for people living with DM is less than it is for healthy people. In several cases, metabolic syndrome (MS), which can be considered a disturbance of the lipid metabolism, is associated with DM. In this work, two drugs used to treat DM, pioglitazone and rosiglitazone, were studied using theoretical methods, and their molecular properties were related to the biological activity of these drugs. From the results, it was possible to correlate the properties of each substance-particularly electronic properties-with the biological interactions that are linked to their pharmacological effects. These results suggest that there are future prospects for designing or developing new drugs based on the correlation between theoretical and experimental properties.

Promoting health in families of children with type 1 diabetes mellitus

This paper presents a study of families of children with type 1 diabetes mellitus, emphasizing the identification of social supports and networks to strengthen interventions aimed at health promotion. The approach selected was a qualitative research, using a case study design. Four families of children with diabetes type 1 were studied, totalling seven participants. Data were collected between April and June 2007, through in-depth interviews and the construction of a genogram and an ecomap. The results presented the families` characterization and testimonies grouped in the following categories: social support, social networks and family roles. To promote care in practice, there is a need to identify the characteristics of each family and resources available that provide better living conditions. We concluded that identifying supports and social networks allows for more personalized care delivery to each family with a view to health promotion.

Biomarkers of oxidative stress and endothelial dysfunction in glucose intolerance and diabetes mellitus

Objectives: To evaluate biomarkers of endothelial dysfunction and oxidative stress in glucose intolerance (GI) compared to overt diabetes (DM2). Design and methods: 140 volunteers including 96 with DM2, 32 with GI and 12 controls (C) were Studied. NO metabolites, NO synthase inhibitors. thiols and N-acetyl-beta-glucosaminidase (NAGase) activity were analyzed by chemiluminescence, capillary electrophoresis, ELISA and colorimetric assay, respectively. Results: (center dot)NO metabolites were higher in GI (NOx: P=0.03 S-nitrosothiols: p=0.001) and DM2 (p=0.006; p=0.0006) groups in relation to group C, while nitrotyrosine was higher only in the DM2 group in comparison 10 the other groups. NAGase activity was elevated in GI (p=0.003) and DM2 (p=0.0004) groups in relation to group C, as well as, ADMA (p=0.01: p=0.003) and GSSG (p=0.01 p=0.002). Conclusions: (center dot)NO metabolites. (center dot)NO synthase inhibitors. thiols and NAGase are biomarkers Suitable to indicate endothelial dysfunction and oxidative stress in the early stages of impaired response to insulin. (c) 2008 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

The Pharmaceutical care of patients with type 2 diabetes mellitus

Objective To evaluate the efficiency of pharmaceutical care on the control of clinical parameters, such as fasting glycaemia and glycosylated haemoglobin in patients with Type 2 Diabetes mellitus. Setting This study was conducted at the Training and Community Health Centre of the College of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil. Methods A prospective and experimental study was conducted with 71 participants divided in two groups: (i) pharmaceutical care group (n=40), and (ii) the control group (n=31). The distribution of patients within these groups was made casually, and the patients were monitored for 12 months. Main outcome measure: Values for fasting glycaemia and glycosylated haemoglobin were collected. Results Mean values of fasting glycaemia in the pharmaceutical care group were significantly reduced whilst a small reduction was detected in the control group at the same time. A significant reduction in the levels of glycosylated haemoglobin was detected in patients in the pharmaceutical care group, and an average increase was observed in the control group. Furthermore, the follow-up of the intervention group by a pharmacist contributed to the resolution of 62.7% of 142 drug therapy problems identified. Conclusion In Brazil, the information provided by a pharmacist to patients with Type 2 Diabetes mellitus increases compliance to treatment, solving or reducing the Drug Therapy Problem and, consequently, improving glycaemic control.