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Influence of obesity on blood glucose control using continuous glucose monitoring data among patients with type 1 diabetes 利用连续血糖监测数据分析肥胖对 1 型糖尿病患者血糖控制的影响
4区 医学 Q3 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.endinu.2024.02.005
Joana Nicolau, Andrea Romano, Irene Rodríguez, Pilar Sanchís, María Puga, Lluís Masmiquel

Introduction

The global increase in the prevalence rates of overweight or obesity has also affected patients with type 1 diabetes (T1D), where this disease had traditionally been associated with a lean phenotype. On the other hand, the effect of obesity on new glycemic control metrics obtained from continuous glucose monitoring (CGM) in T1D is poorly understood. We wanted to assess whether there is any relationship between BMI (body mass index) and the different CGM metrics or HbA1c.

Methods

Two hundred and twenty-five patients with T1D (47.1% ♀, mean age 42.9 ± 14.7 years) with a CGM for a minimum of 6 months were analysed by downloading their CGM and collecting clinical and anthropometric variables.

Results

35.1% (79/225) of the T1D patients had overweight and 17.3% (39/225) lived with obesity, while the remaining 47.6% had a normal weight. A negative correlation was found between GMI (glucose management indicator) and BMI (−0.2; p = 0.008) and HbA1c (−0.2; p = 0.01). In contrast, a positive correlation was observed between the total dose of insulin and the BMI (0.3; p < 0.0001). No significant correlations were found between BMI and other CGM metrics.

Conclusions

Overweight or obesity do not imply worse glycemic control in patients with T1D or less use of CGM. Possibly, and in order to achieve a good glycemic control, more units of insulin are necessary in these patients which, in turn, makes weight control more difficult.

导言:全球超重或肥胖患病率的增加也影响到了 1 型糖尿病(T1D)患者,而这种疾病传统上与瘦弱表型相关。另一方面,人们对肥胖对通过连续血糖监测(CGM)获得的 1 型糖尿病新血糖控制指标的影响知之甚少。我们希望评估 BMI(体重指数)与不同 CGM 指标或 HbA1c 之间是否存在任何关系。结果35.1% 的 T1D 患者(79/225)超重,17.3% 的患者(39/225)肥胖,其余 47.6% 的患者体重正常。GMI(血糖管理指标)与体重指数(-0.2;p = 0.008)和 HbA1c(-0.2;p = 0.01)之间呈负相关。相反,胰岛素总剂量与体重指数呈正相关(0.3;p = 0.0001)。结论超重或肥胖并不意味着 T1D 患者的血糖控制较差或较少使用 CGM。可能的原因是,为了实现良好的血糖控制,这些患者需要使用更多单位的胰岛素,这反过来又增加了体重控制的难度。
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引用次数: 0
Factores de riesgo de hipoglicemia en pacientes diabéticos hospitalizados no críticos: revisión sistemática de la literatura y metaanálisis 非重症住院糖尿病患者发生低血糖的风险因素:系统文献综述和荟萃分析
4区 医学 Q3 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.endinu.2024.02.004
Diego Valero Garzón , Santiago Forero Saldarriaga , Ana Milena Robayo Batancourt , José David Puerta Rojas , Valentina Aranguren Pardo , Lina Paola Fajardo Latorre , Milciades Ibañez Pinilla

Objective

To determine the risk factors for hypoglycaemia in patients with diabetes on general hospital wards based on a systematic review of the literature since 2013 and meta-analysis.

Methods

Systematic review of the literature focused on the conceptual and methodological aspects of the PRISMA Declaration. The search carried out in Pub Med, Web of Science, Medline, Scielo, Lilacs, OVID, grey literature and Google Academic focused on risk factors for hypoglycaemia in patients with diabetes on general hospital wards. The CASPe (Critical Appraisal Skills Programme Spanish) tool was applied for quality control.

Results

From 805 references, 70 potentially eligible articles were identified for review of abstracts and full text. Finally, according to inclusion and exclusion criteria, seven studies with 554,601 patients of Asian, European and North American ethnicity were selected.

A meta-analysis performed using the random effects model found an association between the presence of hypoglycaemia and: the use of insulin (OR 2.89 [95% CI: 1.8-4.5]); the use of long-acting insulin (OR 2.27 [95% CI: 1.8-2.8]) or fast-acting insulin (OR 1.4 [95% CI: 1.18-1.85]); nasogastric tube feeding (OR 1.75 [95% CI: 1.33-2.3]); chronic kidney disease (OR 1.65 [95% CI: 1.14-2.38]); congestive heart failure (OR 1.36 [95% CI: 1.10-1.68]); and elevated levels of glycosylated haemoglobin (OR 1.59 [95% CI: 1.32-1.91]).

Conclusion

The factors associated with the risk of hypoglycaemia in non-critically ill hospitalised patients with type 2 diabetes were: use of any insulin; nasogastric tube feeding; elevated glycosylated haemoglobin levels; history of congestive heart failure; and chronic kidney disease.

目的 通过对 2013 年以来的文献进行系统性综述和荟萃分析,确定综合医院病房糖尿病患者低血糖的风险因素。在Pub Med、Web of Science、Medline、Scielo、Lilacs、OVID、灰色文献和Google Academic中进行了搜索,重点关注综合医院病房糖尿病患者低血糖的风险因素。结果从805篇参考文献中,确定了70篇可能符合条件的文章,并对摘要和全文进行了审阅。使用随机效应模型进行的荟萃分析发现,出现低血糖与以下因素有关:使用胰岛素(OR 2.89 [95% CI: 1.8-4.5]);使用长效胰岛素(OR 2.27 [95% CI: 1.8-2.8])或速效胰岛素(OR 1.4 [95% CI: 1.18-1.85]);鼻胃管喂养(OR 1.75 [95% CI: 1.33-2.3]);慢性肾病(OR 1.65 [95% CI:1.14-2.38]);充血性心力衰竭(OR 1.36 [95% CI:1.10-1.68]);以及糖化血红蛋白水平升高(OR 1.59 [95% CI:1.32-1.91])。结论与非重症住院 2 型糖尿病患者低血糖风险相关的因素包括:使用任何胰岛素;鼻胃管喂养;糖化血红蛋白水平升高;有充血性心力衰竭病史;以及慢性肾病。
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引用次数: 0
Lipoproteína (a): ¿está indicada su determinación sistemática? 脂蛋白(a):是否需要进行系统测定?
4区 医学 Q3 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.endinu.2024.02.003
Manuel Antonio Botana López
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引用次数: 0
Pheochromocytoma-induced acute pancreatitis: A rare presentation 嗜铬细胞瘤诱发的急性胰腺炎:罕见的表现形式
4区 医学 Q3 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.endinu.2024.02.006
Ignacio Jiménez Hernando , Laura González Fernández , Juan Carlos Percovich Hualpa
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引用次数: 0
La importancia de la técnica MLPA en el diagnóstico de la neoplasia endocrina múltiple tipo 1 MLPA 技术在诊断多发性内分泌肿瘤 1 型中的重要性
4区 医学 Q3 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.endinu.2024.02.002
Antonio Bustos-Merlo, Carlos Javier García Calvente, Antonio Rosales-Castillo
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引用次数: 0
Repetition of thyroid fine-needle aspiration cytology after an initial nondiagnostic result: Is there an optimal timing? 初次无诊断结果后重复甲状腺细针穿刺细胞学检查:是否有最佳时机?
4区 医学 Q3 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.endinu.2024.03.004
Inês Cosme , Ema Nobre , Maria João Bugalho

Introduction

It is suggested to wait at least 3 months to repeat a fine needle aspiration cytology (FNAC) to avoid possible inflammatory cytological changes induced by a previous procedure. This study evaluated the influence of the interval between 2 FNACs in a cohort with a previous non-diagnostic (ND) FNAC. We analysed the occurrence of ND or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) results in the second FNAC, based on the intervals between procedures.

Patients and methods

Retrospective study (2017–2020) including thyroid nodules with a ND result, subjected to another FNAC. Demographic, clinical and echographic data, interval between FNACs and their results were collected. We considered the intervals: ≤/>3 months and ≤/>6 months. Second FNAC results were classified as ND, AUS/FLUS or diagnostic (including the other Bethesda categories).

Results

Included 190 nodules (190 patients – 82.1% women, mean age 60 ± 13.7 years) with a first ND FNAC. The second FNAC results were: ND in 63 cases, AUS/FLUS in 9 and diagnostic in 118 cases. There were no statistical differences in FNAC results performed  3 months (13 ND, 2 AUS/FLUS, 19 diagnostic) vs >3 months (50 ND, 7 AUS/FLUS, 99 diagnostic; p = 0.71). Similarly, there were no statistical differences considering a longer time interval: ≤6 months (32 ND, 3 AUS/FLUS, 59 diagnostic) vs >6 months (31 ND, 6 AUS/FLUS, 59 diagnostic; p = 0.61).

Conclusions

Time interval between FNACs was not relevant to the final cytological result. Early FNAC repetition did not increase the cases of ND or AUS/FLUS.

导言:建议至少等待 3 个月后再重复一次细针穿刺细胞学检查(FNAC),以避免前一次检查可能引起的炎性细胞学变化。本研究评估了曾进行过一次无诊断性(ND)细针穿刺细胞学检查的人群中,两次细针穿刺细胞学检查之间间隔时间的影响。我们根据两次手术的间隔时间,分析了第二次 FNAC 中 ND 或意义未定的不典型性/意义未定的滤泡性病变(AUS/FLUS)结果的发生率。患者和方法回顾性研究(2017-2020 年)包括有 ND 结果并接受了另一次 FNAC 的甲状腺结节。收集了人口统计学、临床和超声数据、FNAC 间隔时间及其结果。我们考虑的间隔时间为:≤/>3 个月和≤/>6 个月。第二次 FNAC 结果分为 ND、AUS/FLUS 或诊断(包括其他 Bethesda 类别)。第二次 FNAC 结果为63例为ND,9例为AUS/FLUS,118例为诊断性。≤3个月进行的FNAC结果(13例ND,2例AUS/FLUS,19例诊断)与3个月进行的FNAC结果(50例ND,7例AUS/FLUS,99例诊断;P = 0.71)没有统计学差异。同样,考虑到更长的时间间隔,也没有统计学差异:≤6 个月(32 ND,3 AUS/FLUS,59 诊断) vs >6 个月(31 ND,6 AUS/FLUS,59 诊断;p = 0.61)。结论FNAC检查的间隔时间与最终细胞学结果无关,早期重复FNAC检查不会增加ND或AUS/FLUS病例。
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引用次数: 0
Evolución de la actividad de interconsultas a Endocrinología y Nutrición en planta de hospitalización en un hospital de tercer nivel 一家三甲医院住院病房内分泌与营养科咨询活动的演变
4区 医学 Q3 Nursing Pub Date : 2024-04-01 DOI: 10.1016/j.endinu.2024.02.001
Andrés Ruiz de Assín Valverde, José Joaquín Alfaro Martínez, María Carmen López García, Marina Jara Vidal, Marta Gallach Martínez, Noel Roig-Marin, Rosa Pilar Quílez Toboso, César Gonzalvo Díaz, Lourdes García Blasco, Pedro José Pinés Corrales, Cristina Lamas Oliveira, Silvia Aznar Rodríguez, Elena Parreño Caparrós, Luz María López Jiménez

Introduction

Endocrinology and Nutrition (EyN) is an outpatient and inpatient medical specialty. This study aims to understand the evolution of the activity of interdepartmental consultation (IC) carried out by EyN in hospitalization floor of a third-level hospital, comparing its evolution with other medical specialties, and comparing endocrine IC with nutritional IC.

Material and methods

Longitudinal and retrospective study which analyzes IC notes of EyN and other medical specialties between 01-01-2013 and 31-12-2022.

Results

A total of 76,093 IC notes (12,623 patients) were performed by the EyN service (average age 65.4 years; 59% male) with an average of 4.8 notes per patient. Average annual growth was 7% in notes and 4% in patients (versus 6% and 3% of all other medical services, differences statistically significant). Of all patients hospitalized for 4 or more days, EyN went from attending 7.9% (2013) to 12.3% (2022). 66% of the IC performed by EyN was for nutritional cause and 34% for other pathologies.

Conclusions

The EyN service is the one that most patients attend in hospital IC activity, with growth over the last few years greater than other medical specialties. Nutritional pathology is the main reason for IC.

导言内分泌与营养科(EyN)是一个门诊和住院医疗专科。本研究旨在了解内分泌与营养科在一家三级医院住院楼开展的科间会诊(IC)活动的演变情况,并将其与其他医学专科的演变情况进行比较,同时将内分泌科的 IC 与营养科的 IC 进行比较。材料和方法纵向和回顾性研究分析了 EyN 和其他医疗专科在 2013 年 1 月 1 日至 2022 年 12 月 31 日期间的 IC 病历。结果EyN 服务共完成 76,093 份 IC 病历(12,623 名患者)(平均年龄 65.4 岁;59% 为男性),平均每位患者 4.8 份病历。记录的平均年增长率为 7%,患者的平均年增长率为 4%(所有其他医疗服务的增长率分别为 6%和 3%,差异具有统计学意义)。在所有住院 4 天或 4 天以上的患者中,EyN 的就诊率从 7.9%(2013 年)上升到 12.3%(2022 年)。在由 EyN 实施的 IC 中,66% 是由于营养原因,34% 是由于其他病理原因。营养病理是 IC 的主要原因。
{"title":"Evolución de la actividad de interconsultas a Endocrinología y Nutrición en planta de hospitalización en un hospital de tercer nivel","authors":"Andrés Ruiz de Assín Valverde,&nbsp;José Joaquín Alfaro Martínez,&nbsp;María Carmen López García,&nbsp;Marina Jara Vidal,&nbsp;Marta Gallach Martínez,&nbsp;Noel Roig-Marin,&nbsp;Rosa Pilar Quílez Toboso,&nbsp;César Gonzalvo Díaz,&nbsp;Lourdes García Blasco,&nbsp;Pedro José Pinés Corrales,&nbsp;Cristina Lamas Oliveira,&nbsp;Silvia Aznar Rodríguez,&nbsp;Elena Parreño Caparrós,&nbsp;Luz María López Jiménez","doi":"10.1016/j.endinu.2024.02.001","DOIUrl":"10.1016/j.endinu.2024.02.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Endocrinology and Nutrition (EyN) is an outpatient and inpatient medical specialty. This study aims to understand the evolution of the activity of interdepartmental consultation (IC) carried out by EyN in hospitalization floor of a third-level hospital, comparing its evolution with other medical specialties, and comparing endocrine IC with nutritional IC.</p></div><div><h3>Material and methods</h3><p>Longitudinal and retrospective study which analyzes IC notes of EyN and other medical specialties between 01-01-2013 and 31-12-2022.</p></div><div><h3>Results</h3><p>A total of 76,093 IC notes (12,623 patients) were performed by the EyN service (average age 65.4 years; 59% male) with an average of 4.8 notes per patient. Average annual growth was 7% in notes and 4% in patients (versus 6% and 3% of all other medical services, differences statistically significant). Of all patients hospitalized for 4 or more days, EyN went from attending 7.9% (2013) to 12.3% (2022). 66% of the IC performed by EyN was for nutritional cause and 34% for other pathologies.</p></div><div><h3>Conclusions</h3><p>The EyN service is the one that most patients attend in hospital IC activity, with growth over the last few years greater than other medical specialties. Nutritional pathology is the main reason for IC.</p></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"71 4","pages":"Pages 163-170"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Resumen ejecutivo: estándares de calidad de las unidades de atención a personas con diversidad sexual y de género 执行摘要:性取向和性别差异护理单位的质量标准
4区 医学 Q3 Nursing Pub Date : 2024-04-01 DOI: 10.1016/j.endinu.2024.01.007
Emilia Gómez Hoyos , Patricia Cabrera García , Marcelino Gómez Balaguer , en nombre del Grupo de Trabajo de Gónada, Identidad y Diferenciación Sexual de la Sociedad Española de Endocrinología y Nutrición (GT-GIDSEEN)

Comprehensive biopsychosocial care for people with gender incongruence (ICD-11) who are transgender or gender diverse is a complex process in which the quality of the medical transition can only be guaranteed after a multidisciplinary approach, through teams that integrate professionals with training and experience not only in medicine but also in diversity and gender identity. Based on this, the Gonad, Identity and Sexual Differentiation Working Group of the Spanish Society of Endocrinology and Nutrition has established minimum care requirements that aim to guarantee adequate health care for these people by professionals. A position paper has been produced and is available at: https://www.seen.es/portal/documentos/estandares-calidad-gidseen-2024

对性别不协调(ICD-11)的变性者或性别多元化者提供全面的生物-心理-社会护理是一个 复杂的过程,只有通过多学科方法,由接受过医学、多元化和性别认同培训并具有相关经验的专 业人员组成的团队,才能保证医疗过渡的质量。在此基础上,西班牙内分泌与营养学会性腺、性别认同和性分化工作组制定了最低护理要求,旨在确保专业人员为这些人提供充分的医疗服务。已编写了一份立场文件,可在以下网址查阅: https://www.seen.es/portal/documentos/estandares-calidad-gidseen-2024。
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引用次数: 0
SESIÓN ORAL 8: TRATAMIENTO DE LA DIABETES MELLITUS TIPO 1 22 口头报告 8:1 型糖尿病的治疗 22
4区 医学 Q3 Nursing Pub Date : 2024-04-01 DOI: 10.1016/S2530-0164(24)00097-1
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引用次数: 0
TECNOLOGÍAS APLICADAS A LA DIABETES 糖尿病技术
4区 医学 Q3 Nursing Pub Date : 2024-04-01 DOI: 10.1016/S2530-0164(24)00110-1
{"title":"TECNOLOGÍAS APLICADAS A LA DIABETES","authors":"","doi":"10.1016/S2530-0164(24)00110-1","DOIUrl":"https://doi.org/10.1016/S2530-0164(24)00110-1","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"71 ","pages":"Pages S106-S125"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Endocrinologia, Diabetes y Nutricion
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