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Introduction: Diabetes and stress hyperglycemia have been related with poorer clinical outcomes in patients infected by SARS-CoV-2 and at risk for severe disease., Objective: To evaluate clinical outcomes in three groups of patients (with diabetes, without diabetes and with stress hyperglycemia) with SARS-CoV-2 infection., Materials and Methods: A retrospective cohort study was conducted in Cali (Colombia). We included patients 18 years old or older with a diagnosis of SARS-CoV-2 infection, managed in the emergency room, hospitalization, or intensive care unit between March 2020 and December 2021. Immunocompromised patients and pregnant women were excluded. Patients were classified into three groups: without diabetes, with diabetes, and with stress hyperglycemia. A comparison between the groups was performed., Results: A total of 945 patients were included (59.6% without diabetes, 27% with diabetes, and 13.4% with stress hyperglycemia). Fifty-five-point three percent required intensive care unit management, with a higher need in patients with stress hyperglycemia (89.8%) and diabetes (67.1%), with no difference between these groups (p = 0.249). We identified a higher probability of death in the group with stress hyperglycemia versus the one without diabetes (adjusted OR = 8.12; 95% CI: 5.12-12.88; p < 0.01). Frequency of acute respiratory distress syndrome, need for invasive mechanical ventilation, use of vasopressors and inotropes, need for de novo renal replacement therapy, and mortality was higher in patients with metabolic alterations (diabetes and stress hyperglycemia)., Conclusions: Diabetes and stress hyperglycemia were associated with worse clinical outcomes and mortality in patients with COVID-19. These patients should be identified early and considered them high risk at the COVID-19 diagnosis to mitigate adverse outcomes.

Objective: The objective of the study is to describe the clinical and epidemiological characteristics of our patients with elevated Lp(a)., Materials and Methods: A descriptive cross-sectional study was conducted on 316 patients with elevated Lp(a) (>125 nmol/L) in a random sample between January and August 2022. We measured epidemiological, anthropometric, clinical and laboratory variables (lipid metabolism parameters, carbohydrates and hormones)., Results: Mean age of our sample subject's was 59 ± 15 years with 56% males. The average BMI was 27.6 kg/m2 (71% with elevated BMI). Elevated waist circumference was observed in 54.1% of men and 77.8% of women. 48% had hypertension, 30.7% had diabetes mellitus and 91.5% dyslipidemia. Only 39.7% of the patients had never smoked. The mean values of total cholesterol were 158 ± 45 mg/dl, LDL was 81 ± 39 mg/dl, HDL was 53 ± 17 mg/dl, Triglycerides were 127 ± 61 mg/dl, and Lp(a) was 260 ± 129 nmol/L. Regarding lipid lowering treatment, 89% were on statins, 68.6% on ezetimibe, and 13.7% on PCSK9 inhibitors. 177 patients (57,7%) had established cardiovascular disease (CVD), 16.3% had polyvascular disease, 11.7% had subclinical CVD, and 30.6% had no known CVD. Among patients with established CVD, 174 (98.3%) were on lipid-lowering treatment (97.2% on statins) and 86.4% were on antiplatelet therapy. The mean age of cardiovascular events was 55 ± 12 years in males and 60 ± 11 years in females. 65,1% of female and 56,2% of male patients suffered an early cardiovascular event., Conclusions: Patients with elevated Lp(a) are at very high cardiovascular risk, particularly for early cardiovascular disease., (Copyright © 2023 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

The estimated glomerular filtration rate (eGFR) using serum creatinine is widely utilized for assessing renal function. Its decrease with age and in the presence of chronic diseases such as diabetes, hypertension, and obesity is well-known. However, there are no representative data for the Chilean population., Aim: To estimate the decline in eGFR with age according to gender and the presence of chronic diseases in the adult Chilean population., Methods: This cross-sectional study involved 5,638 participants aged ≥18 years from the National Health Survey 2009 and 2017. The eGFR was estimated using the CKD-EPI formula based on serum creatinine. The decline in eGFR was compared by gender and the presence of chronic diseases (diabetes, hypertension, dyslipidemia, and/or obesity)., Results: eGFR declined with age in both genders, with a steeper decrease in women (-0.88 vs. -0.78 mL/min/1.73 m2/year, p<0.01). The decline in eGFR started early and uniformly from the age of 18. In the presence of chronic diseases, the slope was significantly steeper (-0.94 vs. -0.83 mL/min/1.73 m2/ year, p<0.001), with women with chronic diseases experiencing the greatest decline (-1.00 mL/min/1.73 m2/year)., Conclusion: eGFR progressively decreased with age in the Chilean population, showing an early decline starting from 18 years, more pronounced in women, and in the presence of chronic diseases. Our findings provide relevant population-based information for interpreting eGFR across different age groups and risk categories.

Eighty percent of depressed patients in Primary Health Care (PHC) have a comorbidity. It is essential to contribute local evidence on the characteristics of patients with physical and psychiatric comorbidities to better address clinical practice., Aim: To characterize depressed patients from the cardiovascular program (PCV) of eight family health centers (CESFAM) in two communes of the Metropolitan Region., Material and Methods: Secondary analysis of data from a cluster-randomized clinical trial recruiting 359 program enrollees aged 18 years or older with a Patient Health Questionnaire 9-item (PHQ-9) score greater than or equal to 15. The inclusion criteria for participants were to be 18 years of age or older, to have a score on the Patient Health Questionnaire 9-item (PHQ-9) greater than or equal to 15, and to be enrolled in the cardiovascular program of the respective health center., Results: These are mainly women users of the cardiovascular program with depressive symptoms of moderate to severe intensity with a previous depressive history (60.39%), previously treated in a (75.69%). Only 17.7% were using antidepressant drugs at the time of the interview.97.1% of the interviewees were using drugs for hypertension and/or diabetes., Conclusions: These are people with depressive episode, hypertension and/or diabetes who, having a personal and family history of depression, are not receiving pharmacological treatment for depression, which probably affects their quality of life. Better adherence to clinical guidelines for the treatment of depression is required.

Diabetes affects men and women differently and the mistaken assumption of equality in its clinical expression can lead to errors and delays in the diagnostic process and the therapeutic strategy adopted. The objective is to show the gender differences that influence the approach to this pathology and what the role of the family doctor is in the monitoring of women with diabetes. It is a review of the impact of diabetes at different stages of a woman's life, how hormonal changes affect glycemic control, gestational diabetes, how diabetes affects the development of chronic complications in women and their consequences, the existing differences in the control of cardiovascular risk factors and the differential aspects by sex of the different families of drugs used in the treatment of diabetes., (Copyright © 2023 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Obstructive sleep apnoea (OSA) and diabetes mellitus (DM) are very prevalent diseases frequently associated. Their coexistence is independently associated with an increased prevalence of cardiovascular comorbidities. As this association is underdiagnosed, it is necessary to optimise clinical suspicion by studying independent predictors of DM or prediabetes (preDM) in patients with OSA., Method: A simple randomised case-control study, matched for sex, body mass index (BMI) and age, aimed to study the association of OSA with DM and preDM and to identify independent predictors for both diseases in people with OSA., Results: We included 208 cases with OSA and 208 controls without OSA. In the former, 18.8% had DM compared to only 10.1% in the latter (P=.00). Prevalence of preDM was 41.8% vs. 10.6%, respectively (P=.00). One hundred and twenty-four cases (59.6%) reported excessive daytime sleepiness (EDS) (Epworth scale, 10.5±3.1) vs. 24.5% of the control group (Epworth scale, 6.6±2.9). Apnoea-hypopnoea index (AHI) and O 2 desaturation indices (IDO, CT90 and CT80) were significantly higher in the case group. The risk of MD was related to age, nocturnal hypoxaemia and EDS. The risk of pre-MD was related to BMI and AHI., Conclusions: OSA is associated with DM and preDM. Age, nocturnal hypoxaemia and EDS are predictors of DM. BMI and AHI are predictors of pre-MD., (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)

Introduction. Diabetes is a chronic disease characterized by a high blood glucose level. It can lead to complications that affect the quality of life and increase the costs of healthcare. In recent years, prevalence and mortality rates have increased worldwide. The development of models with high predictive performance can help in the early identification of the disease. Objective. To develope a model based on artificial intelligence to support clinical decisionmaking in the early detection of diabetes. Materials and methods. We conducted a cross-sectional study, using a dataset that contained age, signs, and symptoms of patients with diabetes and of healthy individuals. Pre-processing techniques were applied to the data. Subsequently, we built the model based on fuzzy cognitive maps. Performance was evaluated with three metrics: accuracy, specificity, and sensitivity. Results. The developed model obtained an excellent predictive performance with an accuracy of 95%. In addition, it allowed to identify the behavior of the variables involved using simulated iterations, which provided valuable information about the dynamics of the risk factors associated with diabetes. Conclusions. Fuzzy cognitive maps demonstrated a high value for the early identification of the disease and in clinical decision-making. The results suggest the potential of these approaches in clinical applications related to diabetes and support their usefulness in medical practice to improve patient outcomes.

Introduction. Non-communicable chronic diseases represent the leading cause of death worldwide, and their prevalence is increasing due to the epidemiological transition. Despite the advances in their management, control rates are deficient, attributed to multiple factors like adherence to pharmacological treatment, one of the most significant and least studied in the Colombian population. Objective. To calculate adherence to treatment in Colombian patients with arterial hypertension, cerebrovascular disease, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and dyslipidemia between 2005 and 2022. Materials and methods. We performed a systematic literature review and a meta-analysis of studies identified through the Medline and LILACS databases to quantitatively synthesize treatment adherence percentage. Results. Fourteen studies met the inclusion criteria, and 5,658 patients were analyzed. The treatment adherence was 59%, with significant heterogeneity among the included studies (95% CI= 46- 71%; I2 = 98.8%, p< 0.001). Higher adherence rates were observed for diabetes mellitus (79%; 95% CI = 65- 90%) and dyslipidemia (70%; 95% CI = 66- 74%). Adherence to arterial hypertension treatment was 51% (95 %; CI = 31- 72%). Conclusions. This systematic review showed low adherence to recommendations regarding pharmacological management in non-communicable chronic diseases, which can have implications for long-term clinical outcomes and disease burden.

Introduction: Chile has one of the highest prevalences of Diabetes Mellitus (DM) in Latin America. Therefore, it is relevant to conduct a scientific analysis to identify national scientific productivity in this field objectively and determine if the research efforts are directed toward clinical priorities., Materials and Methods: A systematic review of research conducted on DM in Chile was designed. Scientific evidence from the years 2010 to 2022 was considered. The scientific search was conducted in four databases (PubMed, EMBASE, Scopus, and Scielo) and guided by the PRISMA statement (Preferred Reporting Items for Systematic Review and Meta-Analysis) executed through the COVIDENCE® platform., Results: Out of the 1,953 articles identified in the bibliographic search, 1,542 were discarded. After full-text analysis, 411 articles were obtained involving over 75,000 subjects. The articles were categorized into fourteen themes. The total scientific productivity showed a constant increase between 2010 and 2016 and an exponential increase between 2017-2022. However, there is a downward trend in the years 2021-2022. The international and national prevalence explains the number of studies associated with type 2 diabetes (DM2), followed by gestational and type 1 diabetes. When analyzing the complications of DM in Chile, its prevalence is not reflected in the number of articles published for each., Conclusions: These results highlight the need to promote research in academic and/or clinical institutions, emphasizing reducing the incidence of DM2 due to the low number of articles with this type of design and the more prevalent complications.

Introduction: Patients with type 2 diabetes mellitus are susceptible to acquire Candida spp. infections, sometimes involving more than one species. The resistance of some species to antimycotic agents can cause treatment failure., Objectives: To determine the frequency and clinical varieties of mixed oral candidiasis in patients with type 2 diabetes mellitus, the involved species, and its sensitivity spectra when exposed to antifungals used as candidiasis treatment., Material and Methods: We developed an analytical cross-sectional study with 72 patients with type 2 diabetes mellitus with hyperglycemia (HbA1C ≥ 7%) and an oral candidiasis diagnosis. The causal species of oral candidiasis were identified through microbiological techniques, and sensitivity tests were carried out using the diffusion method in a plate with strips (E-test ®)., Results: We included 72 patients in the study, 32 (44%) males and 40 (56%) females. Patients were divided into three age groups: young adults (17%), adults (74%), and older adults (9%). The mean age of the patients was 51 years. No significant differences were found between mixed oral candidiasis and groups (sex and age), or between mixed oral candidiasis and gender, glycosylated hemoglobin level (HbA1C), antihyperglycemic treatment, or type 2 diabetes mellitus time of diagnosis. We found a correlation between the adult group and development of mixed or simple oral candidiasis. The results showed eight (13%) cases of mixed oral candidiasis: seven with a coinfection of two species and one with a coinfection of three species. The identified species were Candida albicans, C. glabrata, C. dubliniensis, C. kefyr, C. tropicalis, and C. krusei. Most of these species presented sensitivity against ketoconazole and fluconazole, and higher resistance to itraconazole., Conclusions: Mixed oral candidiasis occurs in approximately 10% of the patients with type 2 diabetes mellitus and its treatment can be ineffective when the etiological agent is not identified.

Background: Traditionally, diabetes management has involved a face-to-face meeting between the doctor and the patient. However, incorporating new tools such as telemedicine into clinical practice may be beneficial for controlling this disease., Objective: To describe, according to sociodemographic and clinical characteristics, the people treated through telemedicine by the diabetes cell of the Digital Hospital in Chile., Material and Method: descriptive study with secondary data of 1427 people from the clinical registry of the diabetes cell of the Digital Hospital. The analysis included percentages, measures of central tendency, and X2 or UMann-Whitney test (p-value < 0.05) to test for independence between gender strata., Results: 61% of the people were women, and the median age was 62 years. About 65% presented arterial hypertension and/or dyslipidemia, almost 55% of adults presented obesity, and more than 90% did not perform physical activity. More than 80% use insulin, and just over 45% of adults have HbA1c > 10%. Approximately 20% presented retinopathy, 17% neuropathy, and 13% risk offoot ulceration. Almost 45% of those diagnosed with nephropathy had a prognosis of very high-risk chronic kidney disease., Conclusion: The people who are treated through telemedicine by the diabetes cell of the Digital Hospital are mostly women and older adults from Familiy Health Care Centres (CESFAM), who present comorbidities, use insulin, are sedentary, have malnutrition due to excess, deficient metabolic control and their main diabetic complication is retinopathy.

Introduction: Diabetes mellitus is one of the most prevalent chronic diseases in the pediatric and juvenile population that affects the quality of life of patients. Objective: To evaluate the quality of life of a pediatric population under 18 years of age diagnosed with type 1 diabetes from two pediatric institutions in the city of Bogotá. Material and methods: We collected of sociodemographic data and clinical variables and application of the PedsQL 4.0™ questionnaire, and the diabetes module 3.2 version validated in Spanish. The sociodemographic data, the clinical variables and the PedsQL™ were processed in the statistical software Stata 17™. Results: In the global score of the PedsQL™ 3.2, diabetes version, men presented better quality of life compared to women. The correlation between the hemoglobin A1c (HbA1c) values and the PedsQL scale in the global score was evaluated. Patients with HbA1c values below 9% presented a better health-related quality of life, while in the group with HbA1c greater than 9% a perception of low quality of life was observed (p=0.025). Regarding the type of therapy and the relationship with the domains of the PedsQL 3.2, diabetes version, patients who used insulin pumps had better scores in the domains barriers, adherence, concern, communication and in the global score compared to patients who used multiple daily injections of insulin as treatment (p=0.0363). Conclusions: In our patients, a better metabolic control (measured by the HbA1c value) and the use of an insulin pump contribute to a better perception of quality of life.

Introduction: Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors., Methods: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined., Results: The crude prevalence of CKD was 11.48% (95%CI: 10.72-12.27%), without significant difference between men (11.64% [95%CI: 10.49-12.86%]) and women (11.35% [95%CI: 10.34-12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m 2 ) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30-8.61) and 5.98% (95%CI: 5.41-6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54-80.49) of the population with CKD., Conclusions: The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD., (Copyright © 2022 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Mexico has a very high mortality rate from COVID19, risk factors, clinical manifestations of our population are unknown., Objective: To know risk factors for mortality from COVID19 in hospitalized patients of the Secretary of Health (SSA) Puebla, and clinical characteristics., Material and Methods: Case-control, observational, retrospective, cross-sectional study in COVID-19 patients. 2 groups: COVID-19 patients who died and those who did not die., Results: 502  patients,  314  men  (62.5%  CI95%  58-66%),  188  women  (37.5%  CI95%  33-42%),  mean  age  54.14  +13.8,  interquartile  range  (IQR)  45-63, age interval 19 and 90 years, hospital stay (DEIH) 1-43 days, mean 9.8+7.8 days, median 8, IQR 4-13 days. Symptoms associated with mortality: dyspnea, chest pain, MR>1. Variables associated with mortality: age = or > 65 years, greater IHD, having > 2 comorbidities (OR 1.453), diabetes (OR 1.759), hypertension (OR 6.29) and chronic kidney failure (CRF) (OR 3.16) , (p<0.05). Ferritin >500ng/ml (OR 5.1799), DHL >400 IU/L (OR 3.313) and D-dimer >2000 m/ml (OR 2.868)., Conclusions: Age > or = 65 years, greater IHD, > 2 comorbidities, diabetes, hypertension or CRF, increased ferritin, D-dimer or DHL, are risk factors for mortality from COVID-19.

Introduction: There is scarce information on longterm evolution of hospitalized patients with moderate (MP) and severe (SP) COVID-19 pneumonia., Objective: to determine clinical, respiratory function, and tomographic (HRCT) impact after being discharged 12 months after diagnosis., Methods: Analysis according to MP and SP, desaturator patients (DP) in 6-minute walking test (6MWT) and HRCT fibrotic-like pattern (FLP). Results compared at 3 and 12 months of follow-up., Results: 194 patients enrolled and one year later 103 (53%) were evaluated: gender male (62.4%), age 57.7 ± 10.9 years, comorbidities (arterial hypertension 38.8%, diabetes 29.6%, and respiratory diseases-RD-18.4%). Variables compared 3 months to 12 months (mean/SD): FVC: 84%( 19) to 88%( 19) (p= 0.01). A 27% of patients had FVC<80% at one year. In 6MWT:426 (108) to 447 (92) (p = <0.01). 12.8% are DP in one year. SP had a greater FLP than MP (40% vs. 27.9%, p = 0.021). The FLP group was related to FVC < 80% (p = 0.004) in all patients but only in SP (p < 0.001). After one year, in multivariate analysis, FVC < 80% was associated with RD (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) and FLP (OR 3.51, 1.25-9.88). DP were associated with RD (OR 12.2, 2.41-61.85)., Discussion: Improvement was observed in all variables when comparing 3 to 12 months. However, after one year, functional and tomographic alterations persist in less than 50% of patients. DP subgroup was related to RD. Protocolled follow-up of hospitalized patients is important, especially in SP, DP, and FLP groups.

Introduction: Sarcopenia is a multidimensional condition that negatively affects muscle mass, muscle strength, and physical performance. The prevalence of sarcopenia in people with diabetes is much higher than that of the general population, especially in individuals with poor nutritional status. Both sarcopenia and malnutrition are conditions amenable to intervention to improve clinical prognosis. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with sarcopenia.

Background: In Mexico, diabetes mellitus (DM) and diseases cardiovascular, register an upward trend., Objective: To estimate the number of complications due to cardiovascular events (CVD) and complications derived from DM (CDM) accumulated in beneficiaries of the Mexican Institute of Social Security (IMSS) from 2019 to 2028, as well as the expense for medical and economic benefits in a scenario baseline and one of change in metabolic profile due to lack of medical follow-up during the COVID-19 pandemic., Material and Methods: The number of CVD and CDM was estimated from 2019, with a 10-year risk projection using the ESC CVD Risk Calculator and United Kingdom Prospective Diabetes Study, considering risk factors registered in the institutional databases., Results: From 2019 to 2028, cumulative CVD cases were estimated at 2 million and those of CDM in 960 thousand, with an impact on medical spending of 439,523 million pesos and on the economic benefits of 174,085 millions. When considering the COVID-19 pandemic, CVD events and CDM increased by 589 thousand, with an increase in spending of 93,787 million pesos for medical care and 41,159 million for economic benefits., Conclusions: Without a comprehensive intervention in the management of CVD and CDM, the cost by both diseases will continue to increase, with financial pressures getting older., (© 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Objective: Identify risk factors for severe outcome in Mexican patients with COVID-19 in the population of Quintana Roo., Material and Methods: Study of 5,916 who met the criteria for suspected cases of COVID-19, 2,531 confirmed by qrTPCR-Sars-CoV-2 tests, of which 1,486 were positive, among which they were classified as hospitalized (severe COVID-19) and outpatients. Multivariate logistic regression analysis was performed to explore the factors associated with the severity of COVID-19 and death as clinical outcomes. The basic reproduction number (R0) was calculated Statistical analysis) Endorsement of the ethics committee 2301., Results: SARS-CoV-2 positive patients presented a high prevalence of hypertension 29.1%, diabetes 23.5%, obesity 24%, and 48.5% have at least one chronic disease. There is a high risk of severity for COVID-19 in patients with diabetes OR=3.14, hypertension OR=1.88, obesity OR=1.68, kidney disease OR=3.2, older than 65 years OR=13.6 and men OR=1.7. These factors also increase the risk of death up to 7.7 times. The maximum R0 during the epidemic was 2.4., Conclusion: Liver and kidney disease, diabetes, hypertension, and obesity are significantly associated with severe COVID-19 and death., (© 2022 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: SARS-CoV-2 affects all age groups, but higher mortality rates are recorded in older people, men and with comorbidities, mainly hypertension, diabetes and obesity., Aim: To describe the main clinical characteristics, evolution and prognostic factors for death in older patients hospitalized for COVID-19., Materials and Methods: Retrospective analysis of 128 patients aged 73 years, 66% men, hospitalized at a clinical hospital, with a diagnosis of COVID-19, admitted from May 1 to August 1, 2020. Data were collected from the clinical records, a description of the study population was made, and a univariate analysis and logistic regression were performed., Results: Seventy-two percent of patients had two or more comorbidities, mainly arterial hypertension in 66%, diabetes mellitus in 34% and cardiovascular disease in 19%. Forty-one percent were admitted to intensive care and 31% were connected to mechanical ventilation. In-hospital mortality was 26.6%. A multivariate analysis was performed in two blocks, finding in the first that arterial hypertension and older age significantly predict mortality. However, when previous institutionalization and immuno-suppression were included as variables in the second block, age ceased to be a significant predictor., Conclusions: Prognostic factors associated with death in this age group are arterial hypertension and previous institutionalization.

Background: The main risk factors studied that have an influence on mortality from COVID-19 have so far been inconclusive in the world literature, mainly in relation to the male gender., Objective: To determine which are the main risk factors that influence a higher mortality from COVID-19., Material and Methods: A case-control study was conducted, including 1190 patients with positive RT-PCR. The risk factors studied were: gender, age, systemic arterial hypertension (SAH), Diabetes mellitus (DM), obesity, Chronic Obstructive Pulmonary Disease (COPD), asthma, smoking, immunosuppressants, Human Immunodeficiency Virus (HIV), influenza vaccine. In the Group of Cases: they died from COVID-19 (n = 576), while in the Controls group: they survived (n = 614). The statistical plan included cross-tables and multivariate logistic regression model to determine the influence of these risk factors on mortality from COVID-19., Results: We found no statistically significant differences between cases and controls in relation to gender. However, the cases were aged >60 years, SAH, DM, obesity compared to controls., Conclusions: Male gender was not a risk factor for mortality from COVID-19, however, other risk factors such as age over 60 years, being hypertensive, diabetic and obese, were corroborated as such for a higher mortality from COVID-19., (© 2022 Revista Medica del Instituto Mexicano del Seguro Social.)

Introduction: Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes., Methods: Cross-sectional observational study conducted in Primary Care. Based random sample: 6,588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1) prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110-125mg/dL or HbA1c 6.0% -6.4%; 2) prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100-125mg/dL or HbA1c 5.7%-6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed., Results: The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95% CI 7.3-8.6%), and 22.0% (95% CI 21.0-23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5-72.6%) and 61.7% (95%CI 59.1-64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA., Conclusions: The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high cardiovascular risk. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier., (Copyright © 2021 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To know the epidemiological behavior and associations of AF in Mexican population., Material and Methods: 8,686 patients from 38 cardiologists participating in REMECAR were analyzed. They were divided by gender and age, the comorbidities studied were obesity, chronic kidney disease (CKD), high blood pressure (HBP), diabetes mellitus (DM), dyslipidemia,stroke, chronic obstructive pulmonary disease (COPD), hypothyroidism, heart failure (HF) and ischemicheart disease (IHD). Program used: IBM SPSS Statistic., Results: AF was diagnosed in 498 patients (5.7%), with higher prevalence in men (6.1% vs. 5.3%) and older age in women (74.3 ± 12.1 vs. 70.5 + -12.3 years, p<0.0001). In those under 60 years, AF was associated in women with HF, in men with CKD, DM, stroke, hypothyroidism and HF. In women older than 60 years, AF was associated with CKD, dyslipidemia, stroke, chronic COPD and HF, in men with CKD, stroke, COPD, hypothyroidism, HF and IHD. AF in women increase the probability 1.13 for obesity, 1.13 for HBP, 2.8 for CKD, 2.9 for COPD, 4.3 for stroke and 6.5 for HF, in men increase the probability 1.05 for HBP, 1.4 for DM, 2.1 for CKD, 2.4 for COPD, 3.0 for hypothyroidism, 4.7 for stroke and 6.0 for HF., Conclusions: AF is a very common arrhythmia, with a higher prevalence in patients attending the cardiology consultation, in men and with an older age of presentation in women. The older the age, the higher the prevalence of AF and comorbidities, HF is the most frequent condition associated with AF.

Objectives: There are several retrospective studies that establish a relationship between some risk factors (cardiovascular risks mainly) and the development of COVID-19 and a severe outcome. Thus, our aim with this study is to find out the former relationship among the population within our basic health area., Method: Cohort study. The study sample consisted of 372 patients aged 14 or older who had tested positive for COVID-19 in our health centre by consecutive sampling. Data collected from medical records will be analysed using Frequencies, X2 with a Confidence interval of 95% and those carrying out the study will have prior experience/training in research and will be specifically trained for the aim of this research., Results: A worse outcome in patients aged 76 years old on average was found versus patients aged 48.7. Regarding high blood pressure patients, X2 was < .001 and OR between 3.975 and 21.425 with confidence interval of 95%, finding a worse outcome in these patients. With regard to Diabetes Mellitus (DM), X2 was < .001 and OR rated between 2.766 and 12.690 with a confidence interval of 95%, also resulting in a worse outcome in these patients. No significant differences regarding a worse outcome were found in Body Mass Index, gender, or toxic habits., Conclusions: Older patients had a worse outcome from COVID- 19, as well as patients with high blood pressure or DM. We found no differences regarding gender and neither could we find any differences regarding BMI., (© 2022 Published by Elsevier España, S.L.U.)

Introduction: Statins are used with the understanding that a slightly increased risk of diabetes is outweighed by their cardiovascular benefits. However, it may be necessary to reconsider whether statin therapy really increase this risk mainly in the population with prediabetes., Methods: A multicenter, cross-sectional, observational study was conducted to assess the relationship between statin therapy and glucose metabolism in 407 patients aged 63.1 years (11SD) diagnosed with dyslipidemia and prediabetes treated in specialized lipid clinics in Spain., Results: Significant differences were found in HbA1c values among treatment groups (p=0.015). Patients treated with pitavastatin (1-4mg/day) showed the lowest HbA1c levels, with significant differences compared to patients treated with atorvastatin 40-80mg/day (p=0.016) and simvastatin 10-40mg/day (p=0.036). By contrast, patients treated with atorvastatin 40-80mg/day showed the highest HbA1c levels compared to those receiving atorvastatin 10-20mg/day (p=0.003), pitavastatin 1-4mg/day (p=0.016), pravastatin 20-40mg/day (p=0.027), rosuvastatin 5-10mg/day (p=0.043), and no statin treatment (p=0.004). Patients treated with simvastatin 10-40mg/day also had higher values than those treated with atorvastatin 10-20mg/day (p=0.016) and pitavastatin 1-4mg/day (p=0.036) or with no statin treatment (p=0.018)., Conclusions: This study suggests that there are differences in the diabetogenic effect of statins. Simvastatin and high doses of atorvastatin may be associated with greater impairment in glucose metabolism than pitavastatin and other statins with less lipid-lowering potency such as pravastatin., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Objectives: To know the degree of simultaneous optimal control of diabetes (DM), high blood pressure (BP) and hypercholesterolemia and determine the associated factors., Material and Method: Cross-sectional descriptive study in diabetic patients 18 years aged or older selected consecutively in primary care centers (PC). Patient data were obtained through access to electronical clinical history. Clinical and analytical variables of interest were registered. Good metabolic control was considered as HbA1c < 7%, good blood pressure control (PA) as values < 140/80 mmHg and good LDL cholesterol control (c-LDL) as values < 100 mg/dL. Bivariate analysis was performed and odds ratio were calculated in a logistic regression model. The study was approved by the San Carlos Clinical Hospital's Clinical Research Ethics Committee (CREC), in Madrid., Results: 1420 patients (55.8% male), with an average (SD) age of 70.6 (10.8) years were included. 75.9% were hypertensive patients, and 69.1% dyslipemic. HbA1c values were 6.9 (1.2) %, sistolic BP 135.0 (16.8) mmHg, diastolic BP 75.9 (10.6) mmHg and LDL-cholesterol 93.7 (32.8) mg/dL. Good metabolic control of DM was achieved at 63.0% (95% CI: 60.4-65.5), good control of HTA at 42.6% (95% CI: 40.0-45.2) and good LDL cholesterol control in 61.1% (95% IC: 58.4-63.7) of patients. Good simultaneous control of the three cardiovascular risk factors (CVRF) was reached at 16.1% (95% CI: 14.2-18.1). A positive and independent association (p<0.05) was observed between good simultaneous control of CVRF with age (OR: 1.017) and with personal history of cardiovascular disease (OR: 1.596)., Conclusions: The results of our study indicate that a small proportion, less than two out of 10 patients, meet the good control goals recommended by clinical practice guidelines. We found important differences between patients with and without cardiovascular disease., (Copyright © 2021 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Emergency department (ED) visits due to hypoglycaemia are frequent in elderly patients. The main objective of the study is to evaluate the risk factors associated to ED re-visits at 90days in elderly patients who visited ED with an episode of hypoglycaemia., Material and Methods: A retrospective observational study was designed, including elderly diabetic patients (>65years) attended in a fragility area of an ED for an episode of hypoglycaemia. To evaluate the risk factors associated to ED re-visits at 90days a multivariate analysis with logistic regression was performed, including those variables related to comorbidity and antidiabetic treatment with a P<0.2 in a previous univariate analysis., Results: 106 patients were included. %HbA1c value was available in 87 (82.1%) patients. Ten (11.5%) patients presented a value of HbA1c ≤5.5%. Antidiabetic treatment was changed to 63 (59.4%) patients at discharge. Thirty-eight (36.1%) patients re-visited the ED at 90days, 9 for glycaemic alterations. The risk factors associated to 90days ED re-visit were: being man (OR: 3.62 [95%CI: 1.24-10.51)), treatment modified at discharge (OR: 0.31 [0.11-0.91]) and to present an HbA1c value ≤5.5% (OR: 5.33 [1.16-14.51])., Conclusions: Fragile patients with diabetes who visit ED for hypoglycaemia present, in high frequency, HbA1c values lower than those recommended, being associated to an increase of ED re-visit risk at 90days., (Copyright © 2021 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Atherosclerotic cardiovascular disease and heart failure are the leading cause of morbidity and mortality in patients with diabetes. The objective of this work is to know the prevalence of atherosclerotic cardiovascular diseases and heart failure in people diagnosed with diabetes in Spain during 2017 and compare them with those not diagnosed with diabetes according to age and sex., Methods: Data for diagnoses of diabetes mellitus (DM), acute myocardial infarction (AMI), stroke, peripheral artery disease (PAD) or heart failure (HF) for 2017 were obtained from the National Health System's Primary Care Clinical Database (BDCAP)., Results: Comparing people with diabetes and people without diabetes over 35 years of age, the Odds Ratio (OR) for being diagnosed with acute myocardial infarction, stroke, peripheral artery disease or heart failure is about 2 in those over 64 years of age and more than 4 in patients under that age. This OR is superior in females versus males for all diagnoses apart from peripheral artery disease., Conclusions: This study shows the high cardiovascular comorbidity of patients with diabetes in Spain, with a greater excess of risk in patients under 65 years of age, more pronounced in women. We should offer more intensive treatment for DM2 in women., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Background and Objectives: Hemoglobinopathies are monogenic disorders with autosomal recessive inheritance. In Europe, with increased migration flows these conditions are appearing more frequently in non-endemic regions. HbA 1c testing is useful for evaluating long-term glycaemic status in diabetes mellitus patients. During HbA 1c evaluation, other hemoglobin fractions are detected, such as structural hemoglobinopathies. The principal objective of this work is to study the incidence of structural hemoglobinopathies in our area and their management., Material and Methods: Total population of 65,000 patients for glycaemic monitoring was evaluated with HPLC equipment (HPLC-ARKRAY® ADAMS, Menarini Diagnostics, Italy). This equipment quantifies different hemoglobin fractions., Results: We identified a total of 128 variants, representing an incidence with respect to the study population of 0.19% (1.97‰). Most (69) were identified in the foreign population, and the most frequent variant identified was heterozygous S hemoglobinopathy. In six families, structural hemoglobinopathy was identified. Three patients with HbS/HbS were detected. Primary Health Centers were the origin of an important part of these variants (82)., Conclusions: Our study describes a low incidence for structural variants compared with the estimated incidence in Spain. These variants can interfere with HbA 1c testing. In these cases, glycated protein study is an appropriate alternative to monitor diabetic therapy., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

The main objective was to estimate the prevalence of diabetes mellitus (DM) among patients with COVID-19, to explore associated factors; and to describe clinical evolution of hospitalized patients. A cross-sectional study was conducted, which included adults confirmed with COVID-19 between 03/12/2020 and 10/15/2020, at Hospital Italiano de Buenos Aires. From 6009 people with COVID-19, 408 had previous diagnosis of DM, yielding a prevalence of 6% (95%CI 6-7), higher prevalence was associated with age (12% in = 60 years and 3% in < 60 years; p = 0.01). In-hospital mortality was 6% (95%CI 6-7), being 15% in DM and 6% compared in non-diabetics (p < 0.01). Associated factors with DM were cardiovascular variables such as male sex, hypertension, smoking, chronic renal failure, heart failure, previous coronary disease; and clinical variables proxy of frailty such as: age, dementia and previous institutionalization (all with p < 0.01). Only 23% (96/408) of DM had an HbA1c measurement in the last 3 months and 76% in the last year, with an average 8.6%, and 25% in goal (HbA1c = 7%). Management was mostly in-hospital (59%), with an average hospital stay of 12 days, with the following complications during hospitalization: 6% presented a hypoglycemic value (< 70 mg/dl), 42% required oxygen therapy, 19 % went to intensive care unit, 15% required invasive mechanical ventilation (mean 11 days), and 25% (95%CI 20-31) of in-hospital mortality (mean 82 years).

Objective: To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors., Materials and Methods: We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors., Results: The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control., Conclusion: Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.

Background: Diabetes Mellitus (DM) and heart diseases, which include Systemic Arterial Hypertension (SAH), have been positioned as the two main causes of mortality in Mexico, which represents important challenges for the different health institutions., Objective: To analyze the spatio-temporal trend of DM and SAH based on the detections made in first and and second level units of the Instituto Mexicano del Seguro Social, during the period 2004-2019., Material and Methods: Ecological study in which detection rates of both diseases were calculated per 1,000 persons according to year, triennium and representation. The spatiotemporal trend was analyzed by spatial statistics using Geographic Information Systems., Results: During 2004-2019 therere were 9 399 889 and 11 862 069 detections on average of DM and SAH, respectively. Regarding DM, the detection rate ranged from 203.4 (2004) to 384.4 (2019) per 1000 persons, this trend increased in Tamaulipas. While SAH decreased from 1140.2 (2004) to 352 (2019) per 1000 persons in Veracruz Sur and Tamaulipas, respectively., Conclusions: The observed spatio-temporal trend can contribute to organizing and guiding, according to representation and level of care, institutional programs, integrated care protocols, clinical practice guidelines and other public policy instruments available at the Instituto Mexicano del Seguro Social to improve early detection, care, control and access to medications for DM and SAH., (© 2021 Instituto Mexicano del Seguro Social.)

Objectives: To analyze the behavior of mortality from diabetes mellitus (DM) for both sexes in Mexico from 1998 to 2018, and its impact on life expectancy (LE) from 60 to 85 years of age in the three-year periods 1998-2000 and 2016-2018, compared with other causes of death, as well as to determine the loss of years of life expectancy associated with DM in each three-year period., Methods: The current study is observational and descriptive. Age-adjusted rates of mortality from DM were calculated for each sex from 1998 to 2018. Sex-specific life tables were constructed for 1998-2000 and 2016-2018, and both LE between 60 and 85 years, and years of life expectancy lost (YLELL) due to DM and selected causes between both ages were calculated., Results: Between 1998 and 2018, the adjusted DM-resulting male mortality rate grew 55% in the population aged 60 and over, while the female mortality rate grew 20%. Between 1998-2000 and 2016-2018, male LE for 60-85 age group decreased 0.22 years, while female LE increased 0.24. In 2016-2018, DM was responsible for 1.30 YLEL among men of 60 to 85 years (19% of the total YLEL), and 1.24 YLEL for women (24% of the total), more than the other causes analyzed., Conclusions: The increase in mortality from DM has substantially contributed both to reduce LE of older adult men, and to slow the increase of LE among women aged 60 years and older so far this century. Thus, preventive policies should be implemented since early ages to reduce the high levels of overweight and obesity in the country and, therefore, the significant population ratio suffering from DM.

Introduction: Introduction: coronavirus disease 2019 (COVID-19) encompasses a wide spectrum of symptoms, including respiratory, gastrointestinal, hematological, and dermatological manifestations. The virus interaction with cells located in the respiratory tract causes the release of inflammatory mediators, whose involvement could be exacerbated by co-existing obesity, diabetes, and cardiovascular events. Objectives: the objective of this research was to analyze the clinically metabolic status in patients who have suffered COVID-19 disease in order to predict the outcome. Methods: this research is a retrospective study based on a cohort of 165 consecutively admitted patients with criteria for COVID-19 pneumonia according to WHO guidelines at the Hospital Universitario Puerta de Hierro between March and April 2020. Recorded variables included demographic and epidemiological data plus diagnoses as well as morbid complications during hospitalization. The Biochemistry Unit Laboratory carried out laboratory analyses according to validated operational procedures. The statistical tests included univariate and multivariate models adjusted for baseline characteristics and clinically relevant features. Results: the most frequent comorbidity in our cohort was arterial hypertension (44.0 %), followed by dyslipidemia (32.1 %), obesity (30.9 %), and diabetes mellitus (20.0 %). The association between admission to the intensive care unit (ICU) with body mass index (BMI) in a multivariate model was statistically significant, evidencing that obese subjects (BMI ≥ 30 kg/m2) have a 19 % higher risk of requiring ICU care. The univariate model revealed a statistically significant association between obesity and ICU admission and length of hospital stay (p < 0.05). The relationship between baseline blood glucose and in-hospital mortality was also statistically significant (p = 0.03), as well as with total cholesterol and ICU admission (p = 0.007). Conclusions: obesity is related to a longer time of hospitalization and a higher rate of admissions to the ICU. Low total cholesterol levels and abnormal baseline blood glucose were risk factors for ICU requirement and in-hospital mortality. Patient categorization based on obesity could be valuable in the development of a precision medicine model within the COVID-19 pandemic.

Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an important risk factor for developing TB, also presenting more complicated TB, more relapses and higher mortality. The DCs and the fourth world of the large cities are those with the highest incidence of TB and an increase in DM, which will make it difficult to control tuberculosis disease. At the same time, the COVID-19 pandemic is complicating the management of both diseases due to the difficulty of access to control and treatment and the worsening of socioeconomic inequalities. It is necessary to establish a bidirectional screening for TB and DM and promote recommendations for the joint management of both diseases., (Copyright © 2021 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Gran Canaria is a region of genetic isolation of familial hypercholesterolemia due to a founder mutation, p. [Tyr400&#95;Phe402del], in the LDL receptor (LDLR) gene. Initial data suggest that its carriers could have a high prevalence of diabetes., Material and Methods: Patients over 30 years of age with familial hypercholesterolemia and a confirmed mutation in LDLR were recruited from a tertiary hospital in Gran Canaria. The prevalence of diabetes and other clinical data were compared among carriers of p. [Tyr400&#95;Phe402del] and those with other LDLR mutations., Results: 76.4% of the 89 participants were carriers of p.[Tyr400&#95;Phe402del]. The prevalence of diabetes in this group was significantly higher (25 vs. 4%, P=.045). These cases also had a higher prevalence of cardiovascular disease and higher levels of LDL cholesterol and triglycerides. There were no differences in age, weight, body mass index, waist, age of onset, and time of statin treatment. However, they required PCSK9 inhibitors more often (51.5 vs 24%, P=.027)., Conclusions: The mutation p.[Tyr400&#95;Phe402del] is associated with a high prevalence of diabetes, not explained by classic risk factors, such as age, obesity, or long-term use of statins., (Copyright © 2021 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Has been performed of the prognostic value of coronary physiological indices in patients with diabetes mellitus (DM) after coronary revascularization deferral., Methods: We analyzed 714 patients (235 with DM) with deferred revascularization according to fractional flow reserve (> 0.80). A comprehensive physiological evaluation including coronary flow reserve (CFR), index of microcirculatory resistance, and fractional flow reserve was performed at the time of revascularization deferral. The median values of the CFR (2.88), fractional flow reserve (0.88), and index of microcirculatory resistance (17.85) were used to classify patients into high- or low-index groups. The primary outcome was the patient-oriented composite outcome (POCO) at 5 years, comprising all-cause death, any myocardial infarction, and any revascularization., Results: Compared with the non-DM population, the DM population showed higher risk of POCO (HR, 2.49; 95%CI, 1.64-3.78; P<.001). In the DM population, the low-CFR group had a higher risk of POCO than the high-CFR group (HR, 3.22; 95%CI, 1.74-5.97; P <.001). In contrast, CFR values could not differentiate the risk of POCO in the non-DM population. There was a significant interaction between CFR and the presence of DM regarding the risk of POCO (P for interaction=.025). Independent predictors of POCO were a low CFR and family history of coronary artery disease in the DM population and percent diameter stenosis and multivessel disease in the non-DM population., Conclusions: The association between coronary physiological indices and clinical outcomes differs according to the presence of DM. In deferred patients, CFR is the most important prognostic factor in patients with DM, but not in those without DM., (Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Background: It is a fact that coronary artery disease (CAD) is more prevalent in India as compared to western countries. The major risk factors associated with the early CAD are a high prevalence of diabetes mellitus, atherogenic lipid profile, smoking habits, sedentary lifestyle, low socioeconomic condition and high prevalence of obesity. Is this true for restenosis after drug-eluting stent (DES) implantation and factors associated with it? The main objective of the study was to determine the rate of in-stent restenosis (ISR) in patients with DES and risk factors associated with it from our region., Methods: It was a single-center, retrospective cohort study in which 550 patients who underwent DES implantation were included. Patient's demographic data, coronary angiography findings, procedural characteristics and development of ISR were noted., Results: Out of 550 patients, 31 developed ISR with a rate of restenosis of 5.63% and target lesion revascularization (TLR) of 5.63%. On multiple Cox-regression analysis, only diabetes mellitus (DM) (p=0.008, adjusted hazard ratio (HR): 2.757, 95% confidence interval (CI): 1.296-5.863), deployment of stent in the left anterior descending (LAD) artery (p=0.031, adjusted HR: 3.342, 95% CI: 1.115-10.017) and periprocedural complication during percutaneous coronary intervention (p=0.040, adjusted HR: 2.824, 95% CI: 1.049-7.603) were found to be significantly associated with increased risk of ISR. Kaplan-Meier survival analysis of event-free survival for restenosis showed patients with DM had significantly lower event-free survival compared to patients without DM (p=0.005 by log-rank test)., Conclusions: In our study, the rate of restenosis after DES implantation was 5.63%. The presence of DM, the stent in the LAD territory and the periprocedural complication is strongly associated with the development of ISR., (Copyright © 2020 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causal agent of coronavirus disease 2019 (COVID-19). Diabetes is one of the most frequent comorbidities in people with COVID-19 with a prevalence that varies between 7 and 30%. Diabetics infected with SARS-CoV-2 have a higher rate of hospital admission, severe pneumonia, and higher mortality compared to non-diabetic subjects. Chronic hyperglycemia can compromise innate and humoral immunity. Furthermore, diabetes is associated with a low-grade chronic inflammatory state that favors the development of an exaggerated inflammatory response and therefore the appearance of acute respiratory distress syndrome. Recent evidence has shown that SARS-CoV-2 is also capable of causing direct damage to the pancreas that could worsen hyperglycemia and even induce the onset of diabetes in previously non-diabetic subjects. Therapeutic strategies should be aimed at facilitating patient access to the healthcare system. Control of blood glucose and comorbidities must be individualized in order to reduce the incidence of complications and decrease the burden on health systems. In this article we will review the pathophysiological mechanisms that explain the bidirectional relationship between COVID-19 and diabetes mellitus, its implication in the prognosis and management of hyperglycemia in this group of patients., (Copyright © 2020 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Objective: we conducted a systematic review of the main scientific evidence that associates food insecurity with a higher frequency of obesity and cardiometabolic risks in Mexican women. Design: a systematic review. Data sources: MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts and PAIS Index. Selection criteria: articles that met the journal quality criteria and integrated food status with health insecurity, in which the situation of vulnerability in the current statistics for cardiometabolic diseases and risks that are associated with food insecurity was shown in women and their homes. Data analysis: relevance and quality of the results regarding food security, the presence of overweight and obesity, and socio-environmental indicators in women. Results: households headed by women who are at higher risk of having some degree of food insecurity or food assistance associated with the presence of obesity and overweight (RR = 1.28 to 2.97; 95 % CI: 1.08-1.44 to 1.52-6.14) as well as the development of cardiometabolic diseases such as diabetes mellitus (with a history of pregnancy as risk factor for developing diabetes and hypertension) presenting premature labor, shorter stature in the adult stage, a deficiency in micronutrients such as iron and antioxidant vitamins. Conclusion: the evidence found shows an association of food insecurity as found in women and their homes with a greater risk of being overweight and obese, as well as the development of a cardiometabolic disease (diabetes, hypertension), in addition to anemia and vitamin deficiency.

Objective: To describe the characteristics of adult patients with tuberculosis (TB) and diabetes mellitus (DM) in Peru, and to explore the association of DM and mortality in people with TB., Materials and Methods: We carried out a secondary analysis of the database of the Management Information System of Tuberculosis of the Tuberculosis Prevention and Control Directorate of the Ministry of Health of Peru. Adult patients who started treatment with the scheme for drug-sensitive TB in 2016, 2017 and 2018 were included. We carried out a descriptive analysis of patients with TB and DM, and an exploratory analysis to assess the association of DM with mortality using a Poisson regression to determine the relative risk (RR)., Results: We registered 67,524 adults with drug-sensitive TB, of which 6,529 (9.7%) people were reported as having TB and DM; and 4,048 (6.0%) had HIV infection. Of the patients reported with TB and DM, most were men (60.2%) with a median age of 53 years. Regarding mortality, people with TB and DM had a higher frequency of death compared to those with TB without DM (7.2% vs 5.4%). In the exploratory analysis of factors associated with mortality, DM had a crude RR of 1.32 (95% CI: 1.20-1.50); however, this association varied in the adjusted model with a RR of 0.93 (95% CI: 0.84-1.04)., Conclusions: DM is the most frequent comorbidity in patients with TB in Peru, although no association with higher mortality was found.

Introduction: During the COVID-19 pandemic, the national transplant activity has been reduced due to the overload of the health system and concern for patient safety in this situation. The aim of our work is to expose the activity of kidney transplantation in Cantabria during the state of alarm, as well as to assess the safety of the transplantation program., Material and Methods: Retrospective study of kidney transplants performed in our Center from the beginning of the state of alarm until the beginning of the lockdown easing in Cantabria. Descriptive analysis of the demographic data of recipients and their donors, intraoperative data and postoperative outcomes. Comparative analysis with the data of the same period in 2017-2019, by means of the χ 2 for categorical variables, Student's T and Mann-Whitney U tests in case of quantitative variables of normal and non-normal distribution, respectively., Results: Fifteen kidney transplants were performed in the period described. Delayed renal function (DRF) was seen in 7.5% of patients, and 26.6% showed data of acute rejection; no patient presented COVID-19 disease. Comparative analysis showed a remarkable increase in the number of transplants in comparison with previous periods (15 vs 5.6), at the expense of donors from outside Cantabria (93.3%). We found no statistically significant differences in terms of cold ischemia time (p=0.77), DRF (p=0.73), need for dialysis (p=0.54), or appearance of post-surgical complications (p=0.61)., Conclusions: The evolution of the pandemic in our region, and the adoption of strict protective measures has allowed the early and safe resumption of the renal transplantation program, increasing the number of transplants performed compared to previous years and maintaining comparable early post-operative results., (Copyright © 2020 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)