Avances en Diabetología最新文献

{"title":"Eficacia y seguridad de una estrategia basal plus en pacientes con diabetes mellitus tipo 2 en la práctica clínica especializada. El estudio Basal Plus en España","authors":"Manuel Pérez-Maraver ,&nbsp;Gracia Romero Meliá ,&nbsp;Jordi Caballero Corchuelo ,&nbsp;en representación del estudio Basal Plus","doi":"10.1016/j.avdiab.2015.01.001","DOIUrl":"10.1016/j.avdiab.2015.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the efficacy and safety of a Basal Plus strategy using insulin glargine (GLA) as basal insulin and insulin glulisine (GLU) as prandial insulin in patients with type 2 diabetes mellitus (T2DM) in everyday clinical practice.</p></div><div><h3>Material and methods</h3><p>Observational, retrospective study was performed between November 2010 and December 2011 (duration of observation: January-July 2010) in 65 endocrinology departments across Spain on consecutively enrolled T2DM patients previously treated with GLA, to whom one injection of GLU was added at the main meal. Primary analysis was to evaluate the change in HbA_1c from baseline (start of basal plus therapy, basal visit [BV]) to endpoint (at least after 3 months, basal plus visit [BPV]).</p></div><div><h3>Results</h3><p>A total of 363 patients were included (age 65<!--> <!-->±<!--> <!-->10 years old, 54% male). After 6 months, the HbA_1c decreased from 8.5% to 7.4% (–1.1<!--> <!-->±<!--> <!-->.8%; 95% CI: 1.0-1.2; p<!--> <!-->&lt;<!--> <!-->.001). More than a quarter (25.9%) of patients achieved an HbA_1c <!-->&lt;<!--> <!-->7.0% (.8% of patients at baseline). The percentage of patients with target fasting plasma glucose values (&lt;<!--> <!-->130<!--> <!-->mg/dl) was 51.0% at baseline (BV), and 62.8% at the endpoint (BPV). Only 3 episodes of severe hypoglycemia were reported, of which none of them was nocturnal.</p></div><div><h3>Conclusions</h3><p>A Basal plus strategy with once daily insulin glargine plus insulin glulisine at the main meal is effective and safe in improving glycemic control in clinical practice in patients with T2DM previously not on treatment targets.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2015.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80141253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La importancia del reloj biológico en el desarrollo de la obesidad y de la diabetes","authors":"Elaine Vieira","doi":"10.1016/j.avdiab.2014.12.002","DOIUrl":"10.1016/j.avdiab.2014.12.002","url":null,"abstract":"<div><p>The circadian clock controls the sleep-awake cycles, as well as a series of metabolic processes that include the ingestion, storage and use of energy. The increase in the prevalence of type<!--> <!-->2 diabetes has become one of the major public health problems at international level. Due to the heavy social burden caused by diabetes, it essential to understand the causes of this disease and develop more effective strategies for its treatment. The correlation between type<!--> <!-->2 diabetes and the lifestyle of modern society, characterised by the changes in sleep patterns, shift work, as well as due to the exposure to artificial light during night time hours, has led to the hypothesis that changes in the circadian clock may be involved in the aetiology of type<!--> <!-->2 diabetes. In this sense, recent studies have proposed that the correction of clock changes could have a beneficial effect on glucose homeostasis and, from this that chronotherapy, without pharmaceutical intervention, presents as an option for treating patients with type<!--> <!-->2 diabetes.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91404432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asistencia a la gestante con diabetes. Guía de práctica clínica actualizada en 2014","authors":"","doi":"10.1016/j.avdiab.2014.12.001","DOIUrl":"10.1016/j.avdiab.2014.12.001","url":null,"abstract":"<div><p>Diabetes is one of the most common metabolic complications of pregnancy, and is associated with an increased risk of maternal and foetal morbidity and mortality that can be prevented and/or reduced with adequate glycaemic control. In pre-gestational diabetes, specific preparation prior to the pregnancy is essential in order to achieve glycaemic control near to normal as possible and to evaluate complications and review pharmacologic treatment prescription. The treatment of gestational diabetes has been shown to decrease the rate of maternal and perinatal complications, thus its diagnosis is justified. As regards the diagnostic strategy and due to the lack of consensus and the controversy arising after the publication of the new International Association of the Diabetes and Pregnancy Study Groups (IADPSG), the group has decided to keep the same diagnostic strategy in two stages, and with the same cut-off points, until there are solid data available that support the introduction of new criteria.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73578208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trasplante aislado de páncreas en diabetes tipo 1 de control lábil: A propósito de 3 casos","authors":"Aida Orois Añón,&nbsp;Ignacio Conget Donlo,&nbsp;Carmen Quirós López,&nbsp;Magdalena Capponi Marshall,&nbsp;Enric Esmatjes Mompó","doi":"10.1016/j.avdiab.2014.10.006","DOIUrl":"10.1016/j.avdiab.2014.10.006","url":null,"abstract":"","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75005041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El control de la diabetes a distancia. ¿Cuánto hay de verdaderamente útil bajo el término telemedicina?","authors":"Daria Roca-Espino,&nbsp;Aida Orois-Añón","doi":"10.1016/j.avdiab.2014.11.001","DOIUrl":"10.1016/j.avdiab.2014.11.001","url":null,"abstract":"<div><p>The use of telemedicine systems is increasingly common and has proven to be a safe and effective and not inferior to face-to-face visits in relation to metabolic control (HbA_1c) and quality of diabetes treatment in terms of trust in self-management and improved quality of life. A crucial factor for their application in clinical practice is the optimal selection of the frequency of data transmission, and the need for tools which are easy to use, intuitive and with minimal glitches. It is also important to determine the characteristics of patients who can benefit most from the use of telemedicine, and consequently, try to define the best strategy for its implementation in daily clinical practice.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74878862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descripción de las enfermedades autoinmunes acompañantes de la diabetes mellitus tipo 1 en un área sanitaria","authors":"Pablo del Villar-Guerra ,&nbsp;Daniel de Luis-Román ,&nbsp;Manuel González-Sagrado ,&nbsp;José Carlos Hernando-Mayor ,&nbsp;Fernando Centeno-Malfaz ,&nbsp;Rafael del Villar-Galán","doi":"10.1016/j.avdiab.2014.12.004","DOIUrl":"10.1016/j.avdiab.2014.12.004","url":null,"abstract":"<div><h3>Background and objective</h3><p>To describe the onset of autoimmune disease and monitoring associated with type 1 diabetes mellitus (T1DM) in a sample of patients under 19<!--> <!-->years, and to explain the importance of the onset and monitoring screening of T1DM in this health area.</p></div><div><h3>Patients and methods</h3><p>An observational descriptive study was conducted on patients under 19<!--> <!-->years-old with onset of type<!--> <!-->1 diabetes mellitus in the health district of West Valladolid (Spain) during the period from 2001 to 2011. The results of the diagnostic tests for diseases associated with T1DM (autoimmune polyendocrine syndromes, Addison's disease, pernicious anemia, vitiligo, thyroid disease, celiac disease) were recorded).</p></div><div><h3>Results</h3><p>Antithyroid antibodies were performed (peroxidase antibodies, anti-TPO) in 85.9% of patients (67 cases), being positive in 23.9% (16 cases) at onset and during follow-up. The most common thyroid disease was chronic lymphocytic thyroiditis. Screening for celiac disease was performed in 75.6% (59 cases) of patients, being positive in 3.4% of patients at onset, and 1.7% (1<!--> <!-->case) in the follow-up. None of the patients in our population sample presented with autoimmune polyendocrine syndromes, Addison's disease, pernicious anemia, or vitiligo.</p></div><div><h3>Conclusions</h3><p>The results suggest that it may be worthwhile screening for autoimmune diseases associated with T1DM, both at the time of diagnosis of disease and periodically during the follow-up of T1DM. Perhaps, with current international recommendations and medical consensus, screening for autoimmune diseases associated with T1DM could become routine.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79631676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proyecto manejos integral en la DM tipo 1. Acuerdo en el manejo integral del paciente con diabetes mellit us tipo 1","authors":"Edelmiro Menéndez Torre ,&nbsp;Sonia Gaztambide ,&nbsp;Itxaso Rica ,&nbsp;Luis Castaño ,&nbsp;Francisco Javier Salvador ,&nbsp;Francisco Javier Escalada","doi":"10.1016/j.avdiab.2014.10.005","DOIUrl":"10.1016/j.avdiab.2014.10.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Inadequate glycemic control in type 1 diabetes mellitus (DM1) is associated with the development of serious complications, so close monitoring of the disease is necessary, integrating the participation of both health professionals and the patient.</p></div><div><h3>Objective</h3><p>Revalidate aspects previously identified by experts, to set the performance standard for the proper management of patients with DM1.</p></div><div><h3>Material and methods</h3><p>The Spanish Society of Diabetes, the Spanish Society of Endocrinology and Nutrition, and the Spanish Society of Pediatric Endocrinology promoted among their members to assess the degree of agreement and consistency with 62 selected recommendations from the literature, by a national multicenter study Delphi in 2013.</p></div><div><h3>Results</h3><p>A total of 164 medical specialists in DM1 of all Spanish autonomous communities, completing the entire process 150. There were no disagreements, considering consistent agreements on 5 general assertions, 9 relating to insulin therapy and 7 monitoring and management aspects of patients with DM1.</p></div><div><h3>Conclusions</h3><p>None disagreed with any statements expressed by previous experts, although not all have been ratified. It's considered so important basal and posprandial glycemic control, interacting inadequate glycemic control with vascular disorders, nephropathies, polyneuropathies and retinopathies. It's required insulin with a predictable and similar effect to the physiological as with insulin analogues. Diabetes education, self-control and the coordinated, multidisciplinary and personalized monitoring for each patient is essential.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.10.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79924765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capacidad de detección de los métodos de detección de insulina. A propósito de un caso","authors":"Jessica Ares,&nbsp;Lucía Díaz,&nbsp;Alicia Martín,&nbsp;Noelia Avello,&nbsp;Edelmiro Menéndez","doi":"10.1016/j.avdiab.2014.10.008","DOIUrl":"10.1016/j.avdiab.2014.10.008","url":null,"abstract":"","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.10.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87268900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition of continuous subcutaneous insulin infusion systems in a very short time frame as a consequence of a public tender process","authors":"Paola Rios ,&nbsp;Nuria Casado ,&nbsp;Olga Matas ,&nbsp;María Martín ,&nbsp;Sandra Iglesias ,&nbsp;Marga Giménez ,&nbsp;Irene Vinagre ,&nbsp;Ignacio Conget","doi":"10.1016/j.avdiab.2014.10.004","DOIUrl":"10.1016/j.avdiab.2014.10.004","url":null,"abstract":"<div><h3>Aim</h3><p>The procurement of pumps/supplies through a tender process is common practice among public services. A report is presented on the feasibility and safety of the transition from one continuous subcutaneous insulin infusion (CSII) system to another within a very short time frame (4-weeks) as the consequence of a public tender.</p></div><div><h3>Methods</h3><p>The program consisted of: Session-1 was a system start-up training session. Patient satisfaction was evaluated. Session-2 consisted of a call from technical staff 72<!--> <span>h after Session-1 to provide support regarding the programming or the change of infusion set. Session-3 was a training session regarding the use of therapy management software. During and 2 months after Session-2, clinical events, technical issues, and training reinforcement incidents were registered. HbA1c data were collected retrospectively.</span></p></div><div><h3>Results</h3><p>A total of 219 patients were enrolled. During the second week, 81% of patients were transferred to the new system. Patient overall satisfaction scored 9.4/10 (none &lt;7). There were 30 training reinforcement events and 7 technical issues, with all 37 of them being were sorted out over the telephone. There were 31 additional clinical events (infusion set issues). Twenty-four were considered mild, and were solved by phone technical support. Medical assistance was needed in six (five unexpected hyperglycemia, one ketosis). There was only one severe event (ketoacidosis requiring hospitalization). HbA1c did not deteriorate during the transition process. One hundred twenty-eight patients attended the therapy management software training.</p></div><div><h3>Conclusions</h3><p>With the assistance of a specific program, a complete switch to a new insulin pump in a large population of patients with T1D in the context of a public tender in a very short time was carried out safely and without deterioration of metabolic control.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76548187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resultados a medio-largo plazo de pacientes con diabetes tipo 1 remitidos a una consulta monográfica de bombas de insulina","authors":"Marta Botella ,&nbsp;José Antonio Rubio ,&nbsp;Noelia Peláez ,&nbsp;Clara Tasende ,&nbsp;María Paz Gomez ,&nbsp;Julia Álvarez","doi":"10.1016/j.avdiab.2014.12.003","DOIUrl":"10.1016/j.avdiab.2014.12.003","url":null,"abstract":"<div><h3>Objective</h3><p>To analyse the first 69 type<!--> <!-->1 diabetes patients referred to a specialist team between 2005 and 2012 in order to evaluate the indication for continuous subcutaneous insulin infusion (CSII).</p></div><div><h3>Methods</h3><p>Retrospective, observational, single centre study conducted on 69 adult patients evaluated for CSII. An analysis was made on patients who did not initiate CSII (n<!--> <!-->=<!--> <!-->18) and patients who were treated with CSII (n<!--> <!-->=<!--> <!-->51). Variables included: age, gender, duration of disease, indication for CSII, HbA1c, frequency of severe hypoglycaemia events, episodes of diabetic ketoacidosis, and pump discontinuation.</p></div><div><h3>Results</h3><p>The main reason for not initiating CSII was patient refusal (49%), followed by improving of glycaemic control (33%) after optimising with multiple daily injections (MDI) therapy. The most common CSII indications were: suboptimal glycaemic control (49%), and suboptimal glycaemic control with frequent non-severe hypoglycaemia (27.5%). Baseline HbA1c was 8.6<!--> <!-->±<!--> <!-->1.5%, and there was a significant and sustained decrease of 1% over a 5 year period (<em>P</em> <!-->&lt;<!--> <!-->.001), with this reduction being greater in patients with HbA1c &gt;<!--> <!-->8%. The use of CSII was stopped by 5 patients (10%) after 1 to 6<!--> <!-->years.</p></div><div><h3>Conclusion</h3><p>In our clinical practice one in four patients evaluated for CSII did not initiate it. The switch from MDI to CSII was associated with a 1% reduction in HbA1c over 5<!--> <!-->years, being greater in patients with poor glycaemic control.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91491493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}