Search

Diabetes is one of the endocrine disorders that occurs when the pancreas is either not producing enough insulin for body`s need or the cells are not responding to an insulin secreted (Kumsar, Celik, & Yilmaz, 2019). The prolonged hyperglycemia will predispose individual with type 2 diabetes mellitus to early development of diabetic associated complications such as lower limb amputation, nephropathy, retinopathy, neuropathy, and cardiovascular sequela (Molinaro & Dauscher, 2017). Seven percent of the population of Prince George's county, Maryland - or 52,448 people - has been diagnosed with diabetes, with most of these patients suffering from one or more diabetes-related complications attributed to lack of self-care management activities. This led to utilizing a mobile self-management application to enhance self-care management. The best option is to keep plasma glucose level under proper control. The Chronic Care Model will be a valuable theory that will guide the implementation of self-care behavior by individuals with type 2 diabetes mellitus, leading to improvement in knowledge for self-care. A quantitative methodology with a pre-test, post-test design will be used to assess the impact of mobile self-management App on self-care activities of patients with type 2 diabetes mellitus. The study will enroll participants between the ages of 18 to 65-year-old, receiving care in a wellness clinic located at Prince George County, Maryland, and will be selected through consecutive sampling. Statistical Package for Social Sciences (SPSS) version 25.0 will be used to determine relation between the independent variable (mobile self-management App) and dependent variable (Knowledge for self-care). The Mobile Self-App (Glucose buddy Pro) will be used as reminders for individuals with type 2 diabetes mellitus to engage in self-management behavior. Keywords: Type 2 diabetes mellitus, Plasma glucose level, Knowledge for self-care mobile self-App

Introduction: Mexico is among the top 10 countries with the highest prevalence of diabetes in the world. It is estimated that approximately 70% of non-traumatic amputations are due to this disease, and according to the IWGDF, they are highly preventable through self-care activities. However, in Mexico, less than 50% of patients engage in these activities, according to previous results. Method: An observational, descriptive, cross-sectional, and prolective study was conducted with a sample of 346 patients. The sample was determined using the formula for a finite proportion through simple random probabilistic sampling. Included were patients affiliated with the IMSS, assigned to the UMF 62 in Cuautitlán, Mexico, with type 2 diabetes, over 30 years old, and with previously signed informed consent. The SDSCA (Summary of Diabetes Self-Care Activities measure) and the IWGDF (International Working Group on the Diabetic Foot) questionnaires were applied. Results: It was observed that 32.9% (114 patients) of the participants in this study had a low level of self-care activities and a high risk of developing diabetic foot. Conclusions: A low level of self-care activities was found among patients, as well as a high risk of developing diabetic foot. These findings suggest that due to the low adherence to self-care activities, there is a higher incidence of complications related to diabetic foot in these patients., Introducción: México se encuentra entre los 10 países con mayor prevalencia de diabetes en el mundo. Se estima que aproximadamente el 70% de las amputaciones no traumáticas se deben a esta enfermedad, y según la IWGDF, son altamente prevenibles mediante la realización de actividades de autocuidado. Sin embargo, en México, menos del 50% de los pacientes llevan a cabo estas actividades, según los resultados previos. Método: Se realizó un estudio de tipo observacional, descriptivo, transversal y prolectivo con una muestra de 346 pacientes. La muestra se determinó utilizando la fórmula de una proporción finita mediante muestreo probabilístico aleatorio simple. Se incluyeron pacientes derechohabientes del IMSS, adscritos a la UMF 62 de Cuautitlán, México, con diabetes tipo 2, mayores de 30 años y que contaban con consentimiento informado previamente firmado. Se aplicaron el cuestionario de la SDSCA (Summary of Diabetes Self-Care Activities measure) y el cuestionario de la IWGDF (International Working Group on the Diabetic Foot). Resultados: Se observó que el 32.9% (114 pacientes) de los participantes en este estudio presentaban un nivel bajo de actividades de autocuidado y un riesgo alto de desarrollar pie diabético. Conclusiones: Se encontró un nivel bajo de realización de actividades de autocuidado en los pacientes, así como un nivel alto de riesgo de desarrollar pie diabético. Estos hallazgos sugieren que, debido a la baja adhesión a las actividades de autocuidado, hay una mayor incidencia de complicaciones relacionadas con el pie diabético en estos pacientes.

Introduction: Nurse-led programs have a determinant role in the engagement of individuals in the self-management of type 2 diabetes mellitus (T2DM), as they contribute to improving quality of life. Self-management assisted by social support is vital, especially as it describes the importance of nurses in promoting health for people with T2DM, as this intervention can help reduce the consequences and progression of the disease. Objective: To map programs focused on nurse-led social support for people with T2DM. Materials and Methods: This is a scoping review in line with the methodological guidelines of the Joanna Briggs Institute. The search descriptors used were “autocuidado” (self-care), “intervenção liderada por enfermeiro” (nurse-led intervention), and “diabetes mellitus tipo 2” (type 2 diabetes mellitus), with searches in the Web of Science, Medline, CINAHL, Capes Theses and Dissertations Catalog, Scopus, JBI Evidence Synthesis, PsycINFO, and the Portuguese Open Access Scientific Repositories databases conducted between February and March 2022. The eligibility criteria were studies published within the last 10 years, in English, Spanish, and Portuguese, covering the individual’s experience in programs focused on self-management through nurse-led social support. Results: A total of 12 studies were included, all of which were published in the United States, England, and Iran, focusing on social support for self-management in people with T2DM, and centered on care facilities for people with chronic diseases. It was found that most nurse-led programs have been implemented in developed countries and that their main characteristic is their emphasis on social cognitive theory. The population was characterized by being mostly women, aged over 22, with a low level of education. Conclusions: The study met the proposed objective by demonstrating that, despite the low implementation cost with high social and economic returns, the development of these programs is still scar, Introdução: os programas liderados por enfermeiros desempenham um papel fundamental no engajamento do indivíduo na autogestão do diabetes mellitus tipo 2 (DM2), pois impactam na melhoria da qualidade de vida. A autogestão apoiada pelo suporte social torna-se crucial, sobretudo por descrever a importância do enfermeiro na promoção da saúde da pessoa com DM2, tendo em vista que essa intervenção pode contribuir para reduzir as consequências e os agravamentos da doença. Objetivo: mapear os programas com foco no suporte social para pessoas com DM2 liderados por enfermeiros. Materiais e método: revisão de escopo que seguiu as diretrizes metodológicas do Joanna Briggs Institute. Utilizou-se como descritores de busca “autocuidado”, “intervenção liderada por enfermeiro”, “diabetes mellitus tipo 2”, com busca nos bancos de dados Web of Science, Medline, CINAHL, Catálogo de Teses e Dissertações da Capes, Scopus, JBI Evidence Synthesis, PsycINFO e Repositórios Científicos de Acesso Aberto de Portugal, entre fevereiro e março de 2022. Os critérios de elegibilidade foram estudos publicados nos últimos 10 anos, em inglês, espanhol e português, abrangendo a experiência do indivíduo em programas com foco na autogestão por meio do suporte social liderados por enfermeiros. Resultados: 12 estudos incluídos, publicados nos Estados Unidos, na Inglaterra e no Irã, com foco no suporte social de apoio à autogestão de pessoas com DM2 e com concentração em locais de atendimento às pessoas com doenças crônicas. Observou-se que a maioria dos programas liderados por enfermeiros é implementada em países desenvolvidos e apresenta como característica principal ênfase na teoria social cognitiva. O público se caracterizou por ser maioria mulheres, faixa etária de adultos maiores de 22 anos, com baixa escolaridade. Conclusões: o estudo respondeu ao objetivo proposto ao demonstrar que, apesar do baixo custo para a implementação com alta devolutiva social e econômica, ainda é considerado escasso o desen, Introducción: los programas dirigidos por enfermeras desempeñan un papel fundamental a la hora de implicar a las personas en el autocontrol de la diabetes mellitus tipo 2 (DM2), ya que repercuten en la mejora de la calidad de vida. El autocontrol respaldado por el apoyo social es crucial, especialmente porque describe la importancia de los profesionales de enfermería en la promoción de la salud de las personas con diabetes mellitus tipo 2 (DM2), dado que esta intervención puede ayudar a reducir las consecuencias y el empeoramiento de la enfermedad. Objetivo: mapear los programas centrados en el apoyo social para personas con DM2 dirigidos por enfermeros. Materiales y método: una revisión de alcance que siguió las directrices metodológicas del Instituto Joanna Briggs. Los descriptores de búsqueda utilizados fueron “autocuidado”, “intervención dirigida por enfermeros”, “diabetes mellitus tipo 2”, con búsqueda en la Web of Science, Medline, CINAHL, Catálogo de Tesis y Disertaciones de la Capes [Coordinación de Perfeccionamiento de Personal de Nivel Superior], Scopus, JBI Evidence Synthesis, PsycINFO y Repositorios Científicos de Acceso Abierto de Portugal, entre febrero y marzo de 2022. Los criterios de elegibilidad fueron estudios publicados en los últimos 10 años, en inglés, español y portugués, que cubrieran la experiencia individual de programas dirigidos por profesionales de enfermería centrados en la autogestión a través del apoyo social. Resultados: se incluyeron 12 estudios, publicados en Estados Unidos, Inglaterra e Irán, centrados en el apoyo social para la autogestión de personas con DM2 y en entornos de atención a personas con enfermedades crónicas. Se observó que la mayoría de los programas dirigidos por enfermeros se aplican en países desarrollados y tienen como característica principal el énfasis en la teoría cognitiva social. El público se caracterizó por ser mayoritariamente femenino, mayor de 22 años y con bajo nivel de estudios. Conclusiones: el estu

Background: Bladder cancer (BC) and Renal cell carcinoma (RCC) are the most common urogenital cancers among both sexes, with a yearly global incidence of around 500 000 each. Both BC and RCC have been linked to diabetes. Poor glycemic control (malglycemia) is a serious consequence of diabetes and a possible consequence of systemic treatments used in BC and RCC. The objective of this study was to investigate the prevalence of diabetes and use of hospital-based care for malglycemia in people with BC or RCC. Methods: This Swedish retrospective population-based register study used national health-data registers for longitudinal data on cancer incidence covering 15 years, use of hospital-based health care, and filled prescriptions of outpatient medications. Study endpoints included co-prevalence of diabetes in individuals with BC/RCC, healthcare resource utilization due to malglycemia, use of systemic corticosteroids, and changes in diabetes management for people with concomitant type 2 diabetes. Results: We identified 36,620 and 15,581 individuals diagnosed with BC and RCC, respectively, between 2006 and 2019. The proportion of individuals registered with diabetes was 24% in BC and 23% in RCC. An association between BC/RCC and poor glycemic control was found, although the number of malglycemic events in hospital-based care were few (65/59 per 1000 individuals with diabetes and BC/RCC respectively with at least one event). An earlier switch to insulin-based diabetes management was observed in BC/RCC compared to matched individuals with type 2 diabetes but no cancer. The results also indicated an association between steroid treatment and poor glycemic control, and that systemic corticosteroids were more common among people with BC/RCC compared to diabetes controls. Conclusion: The high prevalence of diabetes and increased use of systemic corticosteroid treatment observed in this large national study highlights the need for specific clinical management, risk-assessment, an

Background: Measuring treatment burden is important for the effective management of Type 2 Diabetes Mellitus (T2DM) care. The purpose of this systematic review was to identify the most robust approach for measuring treatment burden in people with T2DM based on existing evidence. Methods: Articles from seven databases were retrieved. Qualitative, quantitative, and mixed-methods studies examining treatment burden in adults with T2DM and/or reporting relevant experiences were included. A convergent segregated approach with a mixed-methods design of systematic review was employed, creating a measurement framework in a narrative review for consistent critical appraisal. The quality of included studies was assessed using the Joanna Briggs Institute tool. The measurement properties of the instruments were evaluated using the Consensus based Standards for selection of Health Measurement Instruments (COSMIN) checklist. Results: A total of 21,584 records were screened, and 26 articles were included, comprising 11 quantitative, 11 qualitative, and 4 mixed-methods studies. A thematic analysis of qualitative data extracted from the included articles summarised a measurement framework encompassing seven core and six associated measurements. The core measurements, including financial, medication, administrative, lifestyle, healthcare, time/travel, and medical information burdens, directly reflect the constructs pertinent to the treatment burden of T2DM. In contrast, the associated measurement themes do not directly reflect the burdens or are less substantiated by current evidence. The results of the COSMIN checklist evaluation demonstrated that the Patient Experience with Treatment and Self-management (PETS), Treatment Burden Questionnaire (TBQ), and Multimorbidity Treatment Burden Questionnaire (MTBQ) have robust instrument development processes. These three instruments, with the highest total counts combining the number of themes covered and "positive" ratings in COSMIN evaluati

Aim: To quantify the relationship of neutrophil-to-lymphocyte ratio (NLR) with cardiovascular events and all-cause mortality in patients with type 2 diabetes (T2D), independent of C-reactive protein (CRP). Methods: Patients with T2D from the UCC-SMART-cohort were studied using multivariable-adjusted Cox regression. The relationship of NLR and CRP with vascular events (cerebrovascular events, myocardial infarction and vascular death) and all-cause mortality was quantified. Results: During 10,833 person-years, 232 vascular events and 302 deaths occurred in 1,239 patients with T2D. Risk of vascular events and all-cause mortality increased per standard deviation (SD) in NLR (hazard ratio (HR) 1.27; 95 % confidence interval (CI):1.11–1.46) and 1.15; 95 % CI:1.02–1.30) after adjustment for CRP. CRP was not associated with vascular events after adjustment for NLR, (HR per SD 1.03; 95 % CI: 0.90–1.19), but was associated with all-cause mortality (HR per SD 1.18; 95 % CI: 1.04–1.33). Notably, NLR was related to vascular events in patients with CRP < 2 mg/L (HR per unit 1.45; 95 % CI: 1.19–1.77). Conclusion: In patients with T2D, NLR is related to higher risk of CVD and all-cause mortality, independently from CRP. NLR is related to CVD even when CRP is low, indicating that NLR is a marker of CVD-risk in addition to CRP. Both NLR and CRP are independently related to all-cause mortality in T2D patients.

Objetivo: Disponer de la evidencia más actual en relación con la evaluación de la asistencia sanitaria médica del paciente con diabetes en atención primaria. Método Durante el proceso de revisión, seguimos las recomendaciones para mejorar la publicación de revisiones sistemáticas y metaanálisis y los puntos de notificación preferidos para las revisiones sistemáticas PRISMA. La búsqueda bibliográfica se realizó en bases de datos Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, Scielo, MedLine /PubMed, Cochrane y en el buscador Google Scholar, con lenguaje libre y controlado, utilizando los términos de búsqueda MeSh: «Physicians, Primary Care», «Diabetes Mellitus, Type 2». Se analizaron 8 artículos seleccionados. Los artículos fueron seleccionados en función de su relevancia, publicados en revistas académicas revisadas por pares y publicados entre 2019 y 2023. Resultados: La herramienta principal de estudio representan las intervenciones en el conocimiento y la práctica sobre la atención de los pacientes con diabetes entre los médicos de atención primaria. Los temas de discusión más importantes extraídos en los artículos analizados hacen referencia a los conocimientos, la inercia clínica, los problemas de vivienda de los pacientes, los programas de intervención de la adherencia y una aplicación de autocuidado para los pacientes con diabetes. Conclusiones: Los hallazgos de este estudio indican la necesidad de mejorar la atención sanitaria médica mediante conocimientos, actitudes y prácticas en atención primaria con respecto los pacientes con diabetes. De este modo, podría ser considerada una herramienta útil para promover la asistencia sanitaria médica en atención primaria., Objective: Have the most current evidence in relation to the evaluation of medical healthcare for patients with diabetes in primary care. Method: During the review process, we followed the recommendations to improve the publication of systematic reviews and meta-analyses and the preferred reporting points for PRISMA systematic reviews. The bibliographic search was carried out in Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, Scielo, MedLine / PubMed, Cochrane databases and in the Google Scholar search engine, with free and controlled language, using the MeSh search terms: «Physicians, Primary Care», «Diabetes Mellitus, Type 2». Eight selected articles were analyzed. The articles were selected based on their relevance, published in peer-reviewed academic journals and published between 2019 and 2023. Results: The main study tool represents interventions in knowledge and practice about the care of patients with diabetes among primary care physicians. The most important discusión topics extracted in the analyzed articles refer to knowledge, clinical inertia, patients’ housing challenges, adherence intervention programs, and a self-care application for patients with diabetes. Conclusions: The findings of this study indicate the need to improve medical health care through knowledge, attitudes and practices in primary care regarding patients with diabetes. In this way, it could be considered a useful tool to promote medical healthcare in primary care.

Bakgrund: Diabetes Mellitus typ 2 (DM2) är en global hälsoutmaning med ökande prevalens. Trots evidensbaserade riktlinjer för egenvård finns många fall av bristande följsamhet. Genom att undersöka personernas upplevelser av den förskrivna egenvården är förhoppningen att en djupare förståelse kan uppnås och integrera detta i framtida omvårdnadspraxis. Syfte: Syftet med detta arbete är att beskriva egenvårdsupplevelser hos personer som lider av Diabetes Mellitus Typ 2. Metod: Allmän litteraturstudie med kvalitativ design som följer Polit och Becks niostegsmodell. Originalartiklar inhämtades från databaserna Pubmed och Cinahl och analyserades med Braun och Clarks modell för tematisk analys. Resultat: Resultatet bygger på data från åtta originalartiklar och identifierar tre huvudteman, formulerade som relationer: ”Relationen till hälso- & sjukvården”, ”De sociala relationernas betydelse” samt ”Relationen till sig själv”, vilka i sin tur beskrivs utifrån två underteman vardera. Slutsats: Studien visade att originalstudiernas deltagare upplevde både emotionella och praktiska utmaningar, men också känslor av hopp och framgång. Familje- och närståendestöd var viktiga trygghetsfaktorer, och kontinuitet i kontakten med vårdpersonal visade sig ha en betydande inverkan på hur egenvården upplevdes. Fortsatt forskning behövs för att förstå dessa upplevelser bättre och hur de påverkar egenvårdsförmågan hos de personer som lider av DM2, och bidra till en förbättrad och mer jämlik vård, särskilt för dem som upplever svårigheter med egenvården., Background: Diabetes Mellitus type 2 is a global health challenge with increasing prevalence. Despite evidence-based guidelines for self-care, there are many cases of lacking compliance. By exploring people's experiences of prescribed self-care, the hope is to achieve a deeper understanding and integrate this into future nursing practices. Aim: The purpose of this study is to describe self-care experiences among persons suffering from Diabetes Mellitus Type 2. Method: A general literature review with a qualitative design that follows Polit and Beck's nine-step model. The data was collected from original studies found in the databases Pubmed and Cinahl and was analyzed using Braun and Clark's model for thematic analysis. Results: The results are based on eight original studies and identifies three main themes, expressed as Relationships: “The relationship to health care”, “The importance of social relationships" and “The relation to oneself", each theme is described as two sub-themes. Conclusion: The study revealed that participants in the original studies experienced both emotional and practical challenges, alongside feelings of hope and success. Family and peer support were crucial sources of comfort, and continuity in healthcare contacts significantly influenced the perception of self-care. Further research is needed to better understand these experiences and their impact on self-care abilities in people suffering from DM2, aiming to contribute to improved and more equitable healthcare, especially for those facing difficulties with self-care.

Bakgrund: Bakgrunden bearbetar grundläggande information om vad Diabetes Mellitus typ 2 innebär och vad för behandling kan vara aktuell. Information kring omvårdnads teoretikern Dorothea Orem behandlas och hur denna kan relatera till personcentrerad vård. Även information om hur patienter upplever denna teori och vad deras pedagogiska behov består av. Syfte: Syftet med denna studie är att belysa patientperspektivet av egenvård för Diabetes Mellitus typ 2. Metod: Metoden för denna studie är en litteraturöversikt med inriktning på kvalitativa artiklar och induktiv ansats. Analysen utförts med hjälp av Fribergs analys i fyra steg för att bygga resultatet av studien. Resultat: Resultatet av detta arbete producerade fyra teman: ”Känslor”, ”Patientens delaktighet” och ”Hur patienterna upplever stöd” och ” kunskap” med relaterade undertema: ”Individuella aspekter”. Dessa teman bearbetar patientperspektivet av Diabetes Mellitus typ 2 och egenvård. Konklusion: I denna litteraturöversikt framkom insikter kring patienters erfarenheter och deras egenvård vid Diabetes Mellitus typ 2. Det var framträdande hur kritiskt det är för patienter att uppleva stöd i deras egenvårdsåtgärder samt betydelsen av att utveckla kunskap på olika sätt hos individen., Background: The background processes basic information about what Diabetes Mellitus type 2 means and what treatment may be relevant. Information about the nursing theorist Dorothea Orem is treated and how this can relate to patient-centred care. The author also processed information about how patients experience this theory and their educational needs. Aim: This study highlights the patient perspective of self-care for Diabetes Mellitus type 2. Method: The method for this study is a literature review focusing on qualitative articles and an inductive approach. The analysis was conducted using Friberg's analysis in four steps to build the study results. Findings: The result of this work produced four themes: "Feelings", "Patient participation" and "How patients experience support" and "knowledge" with a related subtheme: "Individual aspects". These themes process the patient's perspective of Diabetes Mellitus type 2 and self-care. Conclusion: In this literature review, insights emerged regarding patients' experiences regarding their self-care for Diabetes Mellitus type 2. It was prominent how critical it is for patients to experience support in their self-care measures and the importance of developing knowledge in diverse ways in the individual.

Bakgrund Diabetes mellitus typ 2 är en kronisk sjukdom och är idag ett globalt folkhälsoproblem. Sjukdomen orsakas av insulinresistens och behandlingen kräver både medicinska åtgärder och egenvårdsåtgärder. Ofta behövs omfattande livsstilsförändringar för att förebygga komplikationer av diabetes. Egenvården är en central del av behandlingen där också sjuksköterskan har ett ansvar att informera, utbilda och stödja patienten. Det är därför betydelsefullt att ha en fördjupad förståelse för hur patienter med diabetes upplever sin situation med egenvård. Det kan underlätta att ge en god och personcentrarad vård. Syfte Syftet var att belysa patienters upplevelser av egenvård vid diabetes. Metod En allmän litteraturöversikt har utfört och resultat grundades på tio kvalitativa vetenskapliga artiklar. Sökningen av artiklarna gjordes i databaserna CINAHL Complete och PubMed. Resultat Det framkom tre huvudteman och tre underteman; livstilförändringar, stöd och egenvårdutmaningar med underteman; kunskap och förståelse, motivation och ekonomiska utmaningar. Slutsats Utifrån litteraturensöversikt har det visat att patienterna upplever att de påverkas av olika faktorer. Men att kunna behandla sjukdomen krävs olika behandlingsinsatser som medicinska respektive egenvård. I genomförandet av egenvården ligger största ansvaret hos patienten med stöd av sjuksköterskan i form av patientutbildning, stöd samt motivation. Patienternas utmaningar i egenvården inkluderade livsstilsförändringar, brist på kunskap samt motivation. Stöd från familjemedlemmar samt kunskap och stöd från sjukvårdspersonal upplevde patienterna som en främjande faktor till att fortsätta med egenvården., Background Diabetes mellitus type 2 is a chronic disease and is today a global public health problem. The disease is caused by insulin resistance, and the treatment requires both medical measures and self-care measures. Extensive lifestyle changes are often needed to prevent complications from diabetes. Self-care is a central part of the treatment where the nurse also has a responsibility to inform, educate and support the patient. It is therefore important to have a deeper understanding of how patients with diabetes experience their situation with self-care. It can make it easier to provide good, person-centred care. Aim The aim was to shed light on patients' experiences of self-care in diabetes mellitus type 2. Method A general literature review has been performed and results were based on ten qualitative scientific articles. The search for the articles was done in the databases CINAHL Complete and PubMed. Results Three main themes and three sub-themes emerged; lifestyle changes, support and self-care challenges with sub-themes; knowledge and understanding, motivation and financial challenges. Conclusion Based on the literature review, it has shown that the patients felt that they were affected by various factors. But being able to treat the disease requires various treatment interventions such as medical and self-care. In carrying out self-care, the greatest responsibility lies with the patient with the support of the nurse in the form of patient education, support as well motivation. The patients' challenges in self-care included lifestyle changes, lack of knowledge and motivation. Support from family members as well as knowledge and support from healthcare professionals was perceived by the patients as a promoting factor to continue with self-care.

Bakgrund: Diabetes typ 2 är en global folksjukdom som med lämpliga åtgärder kan förebyggas och behandlas, vilket minskar risken för komplikationer och dödsfall. Behandlingen grundar sig till stor del i egenvård vilket är något som många personer upplever som utmanande. Sjuksköterskan har en viktig roll i behandlingen som innebär att stötta, vägleda och motivera personer till att genomföra nödvändiga livsstilsförändringar. Syfte: Syfte var att belysa den inverkan personer med diabetes typ 2 upplever att sjuksköterskans konsultationer har på egenvården. Metod: Arbetet är en allmän litteraturöversikt med kvalitativ ansats. 11 originalartiklar analyserades med Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: I resultatet framkom två kategorier och sex underkategorier. Kategorier; Ett behov av interaktivt stöd med personen i fokus och Ett behov av relationell trygghet för bättre egenvård Slutsats: Personer upplevde sjuksköterskans vård som betydelsefull. Dock så påvisar det föreliggande resultatet att personer upplevde att ytterliga stöd behövs. Bra information, personcentrerad vård och ett generellt gott möte leder till ökat självförtroende och till bättre egenvård. I enlighet med detta tycks bristande kunskap och ett likgiltigt bemötande minska egenvårdsförmågan och leda till sänkt självsäkerhet i hanteringen av sin sjukdom., Background: Diabetes type 2 is a global public disease that can be prevented or treated with appropriate measures, which reduces the risk of complications and death. The treatment is largely based on self-care, which many find challenging. The nurse has an important role in the treatment, which involves supporting, guiding and motivating patients to lifestyle changes that prevent complications. Aim: The purpose was to highlight the impact that individuals with type 2 diabetes perceive nurse consultations have on self-care. Method: The study is a general literature review with a qualitative approach. 11 original articles were analyzed using Graneheim and Lundman's qualitative content analysis. Result: The results revealed two categories and six subcategories. Categories; A need for interactive support with the person in focus and A need for relational security for better self-care. Conclusion: People found the nurse's care significant. The results show that people felt that additional support from the nurse is necessary. Good information, person-centered care and good meetings lead to better self-confidence and self-care. In accordance with this, a lack of knowledge and an indifferent attitude seem to reduce self-care skills and lead to lower self-confidence in managing one's illness.

Bakgrund Diabetes mellitus typ 2 är en folkhälsosjukdom som ständigt växer både i Sverige och globalt. Egenvårdsåtgärder sätts in i tidigt skede av behandlingen där kostförändringar har en central del.Sjukdomen innebär ofta behov av förändringar gällande kost, motion och livsstil i resten av livet samt för många innebär det även regelbunden medicinering. Kunskap och förståelse kan vara viktiga faktorer för att anpassa sig till den nya livsstilen. I sjuksköterskans ansvar ingår att främja hälsa och att vägleda patienten till en hälsosam livsstil, detta genom att se till personens egenvårdsbehov och utifrån det bidra med stöd samt kunskap. Med kunskap och bättre förståelse om vad kostförändringar har för påverkan på individen kan sjuksköterskor bättre hjälpa, stödja samt förbättra personers upplevelser. Syfte Att undersöka upplevelser av att genomföra förändringar av kostvanor hos personer med diabetes mellitus typ 2. Metod Självständigarbetet är skriven enligt en litteraturöversikt som metod. Sökning för litteratur söktes via de två databaserna PubMed och Cinahl Complete där tio kvalitativa vetenskapliga originalartiklar valdes ut. Dessa kvalitetsgranskades sedan enligt Friberg (2017) granskningsmodell och granskningsfrågor innan resultatet sammanställdes. Resultat Resultatet delades upp och presenterades i tre huvudteman, dessa var: känslomässiga och fysiska aspekter av kostförändringar, faktorer som utmanar eller begränsar samt faktorer som underlättar eller stödjer. Slutsats Kostförändringar ses ofta som begränsande och utmanande att tillämpa. Bristande kunskap kring kostförändringar bidrog till osäkerhet och mer djupgående information från vårdpersonal önskades ofta. Utomstående stöd ansågs även hjälpsamt., Background Diabetes mellitus type 2 is a public health disease that is constantly growing both in Sweden and globally. Self-care measures are introduced in the early stages of treatment, were dietary changes play a central role.The disease often involves a need for changes in diet, exercise and lifestyle for the rest of their life’s and for many it also involves regular medication. Knowledge and understanding can be important factors in adapting to the new lifestyle. The nurse’s responsibility is to promote health and guidance the patient to a healthy lifestyle by adressing their self-care needs and providing support and knowledge. With knowledge and a better understanding of the impact of dietary changes on the individual, can nurses better help, support and improve people's experiences. Aim Was to investigate experiences of implementing changes in dietary habits among people with diabetes mellitus type 2. Method The independent work is written according to a literature review as a method. Search for literature was searched via the two databases PubMed and Cinahl Complete where ten qualitative scientific original articles were selected. These were the quality reviewed according to Friberg’s (2017) review model and review questions before the results were complied. Results The results were divided and presented in three main themes, these were: emotional and physical aspects of dietary changes, factors that challenge or limit and factors that facilitate or support. Conclusions Dietary changes are often seen as limiting and challenging to apply. Lack of knowledge about dietary changes contributed to uncertainty and more in-depth information from health professionals was desired. External support was alsoconsidered helpful.

Bakgrund: Folksjukdomen diabetes mellitus typ 2 (DMT2) är en kronisk sjukdom som kräver livslång behandling och anses vara ett globalt problem. I Sverige är det cirka 5 procent av befolkningen som har sjukdomen diabetes och en majoritet av dessa har DMT2. Risken för eventuella komplikationer kan minska om personen håller blodsockernivån under kontroll och är följsam i sin egenvård. En fördjupad kunskap om patienters upplevelser av egenvård vid DMT2 möjliggör för sjuksköterskan att erbjuda ett personcentrerat stöd och vägledning relaterat till sjukdomen. Syfte: Syftet med litteraturstudien var att belysa patienters upplevelser av egenvård vid diabetes mellitus typ 2. Metod: Litteraturstudie genomfördes baserad på tio vetenskapliga artiklar med kvalitativ ansats, som kvalitetsgranskades samt analyserades. Artiklarna har hämtats från databaserna Cinahl och PubMed. Resultat: Utifrån analysen kunde tre huvudkategorier och sex underkategorier identifieras. Huvudkategorierna består av Hinder för egenvård, Tillämpning av strategier och Förekomst av förutsättningar. Upplevelserna av egenvård vid DMT2 varierade, och påverkades av faktorer som varierande känslor, kunskapsbrist, kostvanor, fysisk aktivitet, stöd och motivation. Gemensamt för studierna var att personer med DMT2 beskrev olika hinder, strategier och förutsättningar som de upplevde kring sin sjukdom. Konklusion: Det kan antas att sjuksköterskor i mötet med patienter med DMT2, behöver tillämpa ett personcentrerat förhållningssätt inom sitt omvårdnadsarbete, vilket kan ha en direkt påverkan på patienters upplevelser av egenvård., Background: The endemic disease diabetes mellitus type 2 (DMT2) is a chronic disease that requires lifelong treatment and is considered to be a global issue. Approximately 5 percent of the Swedish population have diabetes, and a majority of these have DMT2. The risk of possible complications can lessen if the person keeps their blood sugar level under control and is compliant in their self-care. An increased knowledge regarding patients’ experiences of self-care in DMT2 enables nurses to offer person-centered support and guidance related to the disease. Aim: The aim of the literature study was to illustrate patients’ experience of self-care in diabetes mellitus type 2. Method: The literature study was based on ten scientific articles with a qualitative approach, that went through quality assessment and was then further analysed. All studies were obtained from the databases Cinahl and PubMed. Results: Based on the analysis, three categories and six subcategories were identified. The three main consist of: Obstacles for self-care, Application of Strategies and Presence of Ideal Circumstances. The experiences of self-care in DMT2 varied and were influenced by factors such as emotions, lack of knowledge, diet, physical activity, support and motivation. The common denominator in the studies was that persons with DMT2 described different obstacles, strategies and ideal circumstances that they experienced regarding their illness. Conclusion: It can be presumed that nurses, in meeting patients with DMT2, need to apply a person-centred approach in their nursing work, which can have a direct impact on patients’ experiences of self-care.

Bakgrund: DMT2 är en kronisk folkhälsosjukdom som uppstår när en människa har en ohälsosam livsstil eller hereditet. DMT2 ger upphov till mikro- och makrovaskulära komplikationer men kan behandlas med livsstilsförändringar. Patienter som lever med DMT2 upplever påfrestningar som de lider av. Syfte: Syftet med studien är att belysa patienters upplevelser av livsstilsförändringar i samband med DMT2. Metod: En kvalitativ allmän litteraturöversikt, baserat på tio vetenskapliga artiklar som analyserades ur ett patientperspektiv. Resultat: Det som framkommer är att patienter med DMT2 upplever svårigheter med att införa fysisk aktivitet och hälsosamma kostvanor i vardagen. Svårigheten inkluderar bland annat tidsbegränsningar, brist på motivation samt kulturella och sociala aspekter. Vidare framkommer det i resultatet att stöd från närstående och sjuksköterska är betydelsefull och viktig. Trots detta möter majoriteten av patienter med DMT2 utmaningar som är kopplat till brist på empati, tillit och respekt från vården. Konklusion: Slutligen framkommer det att när patienter får DMT2 behöver de införa livsstilsförändringar i vardagen. Livsstilsförändringarna kräver gott stöd och motivation från både närstående och sjuksköterskan. Förändringarna orsakar emotionella känslor, och därför är det viktigt att sjuksköterskan är lyhörd och visar respekt för patientens livsvärld, vilket bidrar till lindrat lidande och hälsa och välbefinnande., Background: DMT2 is a chronic public health disease that occurs when a person has an unhealthy lifestyle. DMT2 causes micro- and macrovascular complications but can be treated with lifestyle changes. Patients who are living with DMT2 experience stresses that they suffer from. Aim: The purpose of this study is to illustrate patient's experience of lifestyle change in connection with DMT2. Method: A qualitative general literature review, based on ten scientific articles that were analyzed from a patient perspective. Findings: What arises is that patients with DMT2 experience difficulties in introducing physical activity and healthy eating habits into their everyday lives. The difficulty includes, time constraints, lack of motivation, and cultural and social aspects. Furthermore, it appears in the results that support from relatives and nurses is significant and important. Despite this, the majority of patients with DMT2 face challenges linked to a lack of empathy, trust and respect from healthcare. Conclusion: Finally, it appears that when patients receive DMT2, they need to adopt lifestyle changes in their daily life. The lifestyle changes require good support and motivation from both relatives and the nurse. The changes cause emotional feelings, and therefore it is important that the nurse is sensitive and shows respect to the patient's wellbeing.

Bakgrund: Sjuksköterskans specifika kompetens är omvårdnad. Personcentrerad vård fokuserar på att se varje patient som en unik person med individuella behov. Vid diabetes har sjuksköterskan en viktig pedagogisk och handledande funktion för att stärka patientens förmåga att hantera sjukdomen. Sjuksköterskans ansvarsområde vid diabetes består av att ge information och bedöma patientbehov samt ge teoretisk och praktisk utbildning till alla diabetespatienter för att underlätta egenvården. Syfte: Att beskriva personer med diabetes typ 2 erfarenheter av att utföra egenvård. Metod: En beskrivande litteraturstudie innehållande 9 kvalitativa vetenskapliga artiklar. De vetenskapliga artiklarna har hittats eftersökning i databasen PubMed. Huvudresultat: Vid sociala sammanhang förekommer det svårigheter med att hålla sin kost, vilket kan leda till skuldkänslor och bli en psykologisk börda för personer med diabetes typ 2. Flera hinder för egenvård presenterades, alla med påverkan på blodsockernivån. Användning av mobilapp resulterade i att många av användarna lärde sig tolka blodsockervärden och identifiera mönster i aktivitetsnivå, kost och blodsockernivå och samband mellan dem för att kunna hålla blodsockret på en bra nivå. Utbildning är en viktig del i att ändra beteende gällande egenvård. Tillräcklig kunskap om sjukdomen, sekundära sjukdomar och åtgärder för att påverka sjukdomen möjliggör anpassning gällande livsstilen. Slutsats: Sjuksköterskor bör arbeta personcentrerat och för att kunna göra det är det bra att de får en inblick i hur diabetes typ 2 kan påverka personens liv och att det är mer som tillhör egenvård än vad man tänker på när man hör ordet., Background: The nurse's specific competence is nursing. Person-centered care focuses on seeing each patient as a unique person with individual needs. In the case of diabetes, the nurse has an important educational and supervisory function to strengthen the patient's ability to manage the disease, also providing information and assessing patient needs as well as providing theoretical and practical training to all diabetes patients to facilitate self-care. Purpose: To describe people with diabetes type 2 experience with self-care. Method: A descriptive literature study including 9 qualitative scientific articles. The scientific articles were found through searching the database PubMed. Main result: Social contexts can mean difficulties with maintaining one's diet and feelings of guilt. It is a psychological burden for people with type 2 diabetes. Several barriers to self-care were presented. Using the mobile app resulted in many of the users learning to interpret blood sugar values and identify patterns in activity level, diet and blood sugar level and the relationship between them to keep blood sugar at a satisfactory level. Sufficient knowledge of the disease, secondary diseases, and measures to influence the disease enable adaptation regarding the lifestyle. Conclusion: Nurses should work person-centered and to be able to do that it is good that they get an insight into how diabetes type 2 can affect the person's life and that there is more to self-care then what comes to mind when you hear the word.

Bakgrund: Antalet personer som lider av typ 2 diabetes växer varje år. Typ 2diabetes är en av de vanligaste kroniska sjukdomarna i världen. Typ 2 diabetes kan också betraktas som en livsstilsrelaterad sjukdom baserad på en ohälsosam livsstil som ökar risken för sjukdom på grund av ohälsosamma matvanor, brist på fysisk aktivitet, stress, sömnbrist och tobaks- och alkoholkonsumtion. Således var livsstilsförändringarna en behandling som skulle kunna hjälpa patienter att förbättra hälsan utan medicinering, samt förbättra livsskvaliteten. Syfte: Litterturstudiens syfte var att belysa patienters upplevelser av lisstilsförändringar vid typ 2 diabetes. Metod: Litterturstudien sammanställde tio vetenskapliga artiklar dör patienters upplevelser av livsstilsförändirngar vid typ 2 diabetes studerats med en kvalitativ metod. Artiklarna hämtades från databaserna Pubmed och Cinahl samt kvalitetsgranskades enligt Statens beredning för medicinsk och social utvärdering. Resultat: De vetenskapliga artiklarna kom från nio länder dör det identifierades fyra huvudteman som presenterades i resultatet: 1) kostens betydelse 2) Den fysiska aktiviitetens betydelse 3) Motivationens betydelse 4) Informationens och kunskapens betydelse. Konklusion: Studien visade att kosten hade ens stor påverkan på patienternas livsstilsförändringar. Att utöva någon form av fysisk aktivitet visade sig också ha en stor inverkan på patientens möjligheter till livsstilsförändring. Den egna motivationen och stöd från familj och sjuksköterskan visade sig vara viktiga komponenter för att lyckas med sin förändring. Slutligen visade studien att patienterna behöver information om diabetes för att framgångsrikt kunna omvandla en ohälsosam livsstil till en hälsosam och få en bättre livskvalitet., Background: The number of persons suffering from type 2 diabetes is growing annually. Type 2 diabetes is one of the most common chronic diseases globally. Type 2 diabetes can also be considered a lifestyle-related disease based on an unhealthy lifestyle that increases the risk og disease due to unhealthy eating habits, lack of physical activity, stress, lack of sleep, tobacco and alcohol consumption. Thus, lifestyle changes were one of the treatments that could have helped patients improve their health without medicationm as well as improve their quality of life. Aim: The purpose of the literature study was to describe patients´experience of lifestyle changes in type 2 diabetes. Method: The literature study complies ten scientific articals in which the patients´experiences of lifestyle changes in type 2 diabetes were included using a qualitative method. The articles were procured from the database Pubmed and Cinhal and were quality checked according to the Goverment´s preparation for medical and social evaluation. Results: The sciemtific articles were from nine contries where four main themes emerged as presented in the results: 1) Impotance of diet 2) Importance of physical activity 3) Importance of motivation 4) Importance of information and knowledge. Conclusion: The study showed that diet had a significant impact on patients´lifestyle changes. Engaging in some form of physical activity also proved to have a major impact on the patients´ability to change their lifestyle. Self-motivation and support from family and nurses were found to be important components for succsessful change. Finally, the study showed that patients need infromation about diabetes in order to successfully transform an unhealthy lifestyle into a healthy one and have a better quality of life.

Bakgrund Typ 2-diabetes är en globalt växande kronisk sjukdom som kräver en omfattande behandlingsinsats som kombinerar medicinsk intervention med egenvård. Egenvården är av särskild betydelse för individer som lever med typ 2-diabetes för att kunna effektivt hantera sjukdomen och bibehålla en hög livskvalitet utan att drabbas av de obehag som ofta följer med en kronisk sjukdom. Sjuksköterskor har en central roll i att stödja patienternas egenvård genom att tillhandahålla skräddarsytt stöd som är anpassat till varje enskild individ. Det är av avgörande betydelse för varje individ som är drabbad av typ 2-diabetes att ha adekvata kunskaper i egenvård för att främja livskvaliteten. Samma gäller vårdpersonal och anhöriga som är engagerade i dessa relationer. Syfte Att beskriva vuxnas personers upplevelse av egenvård vid typ 2 diabetes Metod Metoden är en litteraturöversikt baserad på 14 vetenskapliga kvalitativa artiklar. Resultat Resultaten beskriver egenvårdsrutiner för personer med typ 2-diabetes, vilka utforskas inom olika övergripande teman, nämligen: Slutsats Det har observerats att faktorer såsom kultur, ekonomisk ställning och utbildningsnivå alla kan negativt påverka individernas förmåga att ta hand om sin hälsa om de befinner sig på en låg nivå. Personer med begränsad utbildning visade mindre kunskap om egenvård, och deras följsamhet till den rekommenderade kosten påverkades av ekonomiska utmaningar. Etnisk diskriminering ledde till lägre medvetenhet om egenvård. Resultaten belyser vikten av skräddarsydd vård och stöd, speciellt med tanke på kulturella och socioekonomiska skillnader., Background Type 2 diabetes is a globally growing chronic disease that necessitates a comprehensive treatment approach combining medical intervention with self-care. Self-care is of particular significance for individuals living with type 2 diabetes to effectively manage the disease and uphold a high quality of life without succumbing to the discomfort often associated with a chronic illness. Nurses play a pivotal role in supporting patients' self-care by offering tailored support customized to each individual. It is crucial for every individual affected by type 2 diabetes to possess adequate self-care knowledge to promote an enhancement in their quality of life. The same applies to healthcare professionals and relatives involved in these relationships. Aim To describe adults' experience of self-care in type 2 diabetes. Method The method is a literature review based on 14 scientific qualitative articles. Results The results depict the life experiences of self-care routines for individuals with type 2 diabetes, which are explored within various overarching themes. Conclusions It has been observed that factors such as race, economic status, and level of education can negatively impact an individual's ability to takecare of their health if they are at a low level. Individuals with lower levels of education showed less awareness of self-care, and their adherence to the recommended diet was affected by economic challenges. Ethnic discrimination resulted in decreased awareness of selfcare. The results emphasize the importance of tailored care and support, especially considering cultural and socioeconomic differences.

Bakgrund: Diabetes mellitus typ 2 är en folksjukdom vars prevalens ökar varje år. Behandlingen består främst av patientens egenvård där sjuksköterskan har en central funktion i att stödja, ge råd och informera. Genom ökad förståelse om sjuksköterskans upplevelser av att vårda patienter med diabetes mellitus typ 2, kan det underlätta för sjuksköterskan och förbättra vården av patienter med diabetes mellitus typ 2. Syfte: Undersöka sjuksköterskors upplevelser av att vårda patienter med diabetes mellitus typ 2. Metod: En litteraturöversikt baserad på vetenskapliga artiklar med kvalitativ och kvantitativ design. Resultat: Resultatet presenteras i fyra teman; Samtalet som grund till en god relation, Se patienten ur ett helhetsperspektiv, Det finns hinder att övervinna och Organisationen begränsar. Konklusion: Resultatet visar på hur sjuksköterskan har en viktig och bärande roll i diabetesvården och hur samtalet ligger till grund för att kunna stödja patienten till egenvård. Resultatet visar också på betydelsen av att arbeta personcentrerat men även på hinder i form av arbetsbelastning, bristande kompetens och organisatoriska problem sjuksköterskan upplever i arbetet. Genom att synliggöra dessa aspekter kan sjuksköterskans utbildning och arbetsmiljö förbättras och därmed säkra en tryggare vård., Background: Diabetes mellitus type 2 is a public disease whose prevalence increases every year. The treatment mainly consists of the patient's self-care, where the nurse has a central role in supporting, advising and informing. With increased understanding of the nurse's experiences of caring for patients with diabetes mellitus type 2, the acquired knowledge can make it easier for the nurse and thus streamline the treatment of patients with diabetes mellitus type 2. Aim: Investigate nurses’ experiences of caring for patients with Diabetes mellitus type 2. Method: A literature review based on scientific articles with qualitative and quantitative designs. Findings: The results are presented in four themes; The conversation - the basis of a good relationship, See the patient from a holistic perspective, There are obstacles to overcome and The organization limits. Conclusion: The result shows how the nurse has an important and supporting role in diabetes care and how the conversation forms the basis of being able to support the patient's self care. The results also show the importance of person-centred work but also the obstacles in form of workload, lack of competence and organizational problems the nurse experiences in her work. By making these aspects visible, the nurse's training and work environment are improved and thereby ensure safer care.

Objective: Describe a method in a real-world setting to identify persons with undiagnosed prediabetes and type 2 diabetes through an interprofessional collaboration between Public Dental Services and Primary Health Care in Regions Stockholm. Design: A descriptive observational study. Setting: The study was conducted at seven sites in the region of Stockholm, Sweden. Each collaborating site consisted of a primary health clinic and dental clinic. Subjects: Study participants included adults over 18 years of age who visited the Public Dental Services and did not have a medical history of prediabetes or type 2 diabetes. Main outcome measures: Selective screening is conducted in accordance with a risk assessment protocol at the Public Dental Services. In the investigated method, DentDi (Dental and Diabetes), adults diagnosed with caries and/or periodontitis over a cut-off value are referred to the Primary Health Care clinic for screening of prediabetes and type 2 diabetes. Results: DentDi, introduced at seven sites, between the years 2017 and 2020, all of which continue to use the method today. A total of 863 participants from the Public Dental Services were referred to the Primary Health Care. Of those 396 accepted the invitation to undergo screening at the primary health care centre. Twenty-four individuals did not meet the inclusion criteria, resulting in a total of 372 persons being included in the study. Among the 372 participants, 27% (101) had elevated glucose levels, of which 12 were diagnosed with type 2 diabetes and 89 with prediabetes according to the study classification. Conclusions: DentDi is a feasible method of interprofessional collaboration where each profession contributes with the competence included in everyday clinical practice for early identification of persons with prediabetes and type 2 diabetes with a complete chain of care. The goal is to disseminate this method throughout Stockholm County and even other regions in Sweden.

Introduction Treatment burden is the perceived workload of care by individuals. The treatment burden experienced by individuals with Type 2 Diabetes Mellitus (T2DM) is a major obstacle to achieving effective healthcare outcomes. The aim of this research is to facilitate better management of treatment burden in people with T2DM in primary care settings. Methods A systematic review, encompassing narrative analysis was used to characterise the treatment burden of T2DM and critical appraisal was used to identify the appropriate patient-reported outcome measures (PROMs) for measuring this burden. The selected instruments were employed with subsequent questionnaires, followed by patient focus groups. A convergent segregated approach was utilised to explore the T2DM treatment burden in China's primary care settings and to develop the conceptual framework of this burden, which contributed to qualitative data analysis in subsequent studies. An analysis of video recordings of consultations between general practitioners (GPs) and individuals with T2DM was conducted to identify current response approaches to the multifaceted issues related to this burden. Finally, GP focus groups involving a group decision-making process was facilitated, providing insights aimed at improving GP’s strategies for managing the T2DM treatment burdens in China's primary care settings. Results From the narrative review, a thematic framework for understanding the treatment burden of T2DM was developed. This framework underscores the complexity of this burden and guided the critical appraisal. The appraisal identified the treatment burden questionnaire (TBQ), the multimorbidity treatment burden questionnaire (MTBQ), and the patient experience with treatment and self-management (PETS) as the most robust PROMs. The TBQ was selected for the subsequent questionnaire, which found that treatment burden scores varied significantly according to individuals' socio[1]economic statuses. Qualitative insight was al

Introduction: The use of medicinal plants in the treatment of non-communicable chronic diseases such as type 2 diabetes mellitus, arterial hypertension, and dyslipidemia has been increasing. According to the World Health Organization, 80 % of people have used medicinal plants at some point in their lives. Despite the rich biodiversity of medicinal plants in Colombia, only a small percentage has been approved for medical use, and a lack of understanding of the complexity of these plants can lead to irrational use, toxicity, adverse effects, or pharmacological interactions. Objective: To describe the knowledge and popular wisdom that medicinal plant vendors have and use regarding medicinal plants to treat metabolic syndrome and its associated pathologies. Methods: This is a cross-sectional study using a semi-structured survey applied to merchants and distributors of medicinal plants from the three main marketplaces in Cali, Colombia. Taxonomic identification was conducted on the most cited plant species, which were not reported in the Colombian Vademecum of Medicinal Plants –VCPM–. Additionally, information available in the VCPM was compared with scientific literature extracted from various sources such as ScienceDirect, PubMed, and Google Scholar. Results: The most recommended plants by medicinal plant vendors for treating pathologies associated with metabolic syndrome are walnut, insulin, chaparro rojo, papunga, chicharrón de loma, moringa, mastranto, cáscara de mandarina, dandelion, nettle, zarzaparrilla, cofrei y artichoke. The interviewees demonstrated little knowledge of contraindications and adverse effects, and some of the plants are not listed and/or described in the VCPM. Conclusion: This study highlights the importance of knowledge and use of medicinal plants in the treatment of non-communicable chronic diseases associated with metabolic syndrome. Medicinal plant vendors in Cali, Colombia, offer a wide range of options to address these pathologies, although, Introducción: El uso de plantas medicinales en el tratamiento de enfermedades crónicas no transmisibles como la diabetes mellitus tipo 2, la hipertensión arterial y la dislipidemia ha venido en aumento. Según cifras de la Organización Mundial de la Salud, el 80 % de las personas ha utilizado en algún momento de su vida plantas medicinales. A pesar de la rica biodiversidad de plantas medicinales en Colombia, solo un pequeño porcentaje ha sido aprobado para uso médico y la falta de comprensión sobre la complejidad de estas plantas puede conllevar un uso irracional, toxicidad, efectos adversos o interacciones farmacológicas. Objetivo: Describir los conocimientos y saberes populares que los vendedores de plantas medicinales tienen y utilizan con respecto a las plantas medicinales para tratar el síndrome metabólico y sus patologías asociadas. Métodos: Estudio de corte transversal mediante la aplicación de una encuesta semiestructurada a comerciantes y distribuidores de plantas medicinales de las tres principales plazas de mercado de Cali, Colombia. Se realizó una identificación taxonómica de las especies vegetales más citadas, las cuales no estaban reportadas en el Vademécum colombiano de plantas medicinales –VCPM–. Además, se comparó la información disponible en el VCPM con la literatura científica extraída de diversas fuentes como ScienceDirect, PubMed y Google Scholar. Resultados: Las plantas más recomendadas por los vendedores de plantas medicinales para tratar las patologías asociadas al síndrome metabólico son el nogal, insulina, chaparro rojo, papunga, chicharrón de loma, moringa, mastranto, cáscara de mandarina, diente de león, ortiga, zarzaparrilla, cofrei y alcachofa. Los entrevistados demostraron poco conocimiento de contraindicaciones y los efectos adversos y algunas de las plantas no se encuentran listadas y/o descritas en el VCPM. Conclusión: Este estudio destaca la importancia del conocimiento y uso de plantas medicinales en el tratamiento de enfermedades

Currently, the field of phytopharmacology has demonstrated the antidiabetic potential of several traditional plants, including Pseudoelephantopus spicatus (amargon); however, studies demonstrating the hypoglycemic effect of this plant are little known. Therefore, in the present study, its glycemia-regulating effect was evaluated in a Wistar rat model. The experiments were performed as a pilot test and were validated in a kinetic of 0, 1, 1, 2, 6 and 24 hours using five experimental groups (control, diabetics induced with alloxan, diabetics treated with metformin and diabetics treated with P. spicatus extract with doses of 250 and 500 mg/kg). The treatments were applied for 1, 5 and 21 days and the data obtained were validated by ANOVA/Neuman-Keuls (p< 0.05) using the GraphPad Prism V.5. statistical package. The results showed that alloxan at 120 mg/kg induced diabetes mellitus in 100 % of the rats. The extract at 250 and 500 mg/kg achieved a significant reduction in blood glucose levels compared to diabetic rats, showing no significant difference between doses. The reduction in blood glucose levels caused by metformin at 500 mg/kg p< 0,05, and the different doses of the extract showed no significant differences. According to the results of the study, the extract of P. spicatus induces a hypoglycemic effect in rats., En la actualidad, el campo de la fitofarmacología ha demostrado el potencial antidiabético de distintas plantas tradicionales, entre las que se encuentra el Pseudoelephantopus spicatus (amargón) sin embargo, los estudios que demuestran el efecto hipoglucemiante de esta planta son poco conocidos. Por ello, en el presente estudio se evaluó su efecto regulador de la glicemia en un modelo de rata Wistar. Los experimentos se realizaron como prueba piloto y se validaron en una cinética de 0, 1, 2, 6 y 24 horas mediante cinco grupos experimentales (control, diabéticos inducidos con alloxan, diabéticos tratados con metformina y diabéticos tratados con extracto de P. spicatus con dosis de 250 y 500 mg/kg). Los tratamientos se aplicaron durante 1, 5 y 21 días y los datos obtenidos se validaron por ANOVA/Neuman-Keuls (p< 0,05) usando el paquete estadístico GraphPad Prism V.5. Los resultados demostraron que el alloxan a 120 mg/kg indujo la diabetes mellitus en el 100 % de las ratas. El extracto a 250 y 500 mg/kg logró una reducción significativa de los niveles de glucosa en sangre en comparación con las ratas diabéticas p< 0,05, sin mostrar diferencias significativas entre las dosis. La reducción de los niveles de glucosa en sangre provocada por la metformina a 500 mg/kg y las distintas dosis del extracto no mostraron diferencias significativas. Según los resultados del estudio, el extracto de P. spicatus induce un efecto hipoglucémico en las ratas.

Background: Plant-based diets are becoming increasingly popular due to favourable environmental footprints and have been associated with lower risk of type 2 diabetes mellitus (T2DM). Here, we investigated the potential mechanisms to explain the lower T2DM risk observed among individuals following plant-based diets. Methods: Prospective data from the UK Biobank, a cohort study of participants aged 40 to 69 years at baseline, was evaluated. Associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and T2DM risk were analysed by multivariable Cox regression models, followed by causal mediation analyses to investigate which cardiometabolic risk factors explained the observed associations. Results: Of 113,097 study participants 2,628 developed T2DM over 12 years of follow-up. Participants with the highest hPDI scores (Quartile 4) had a 24 % lower T2DM risk compared to those with the lowest scores (Quartile 1) [Hazard Ratio (HR): 0.76, 95 % Confidence Interval (CI): 0.68–0.85]. This association was mediated by a lower BMI (proportion mediated: 28 %), lower waist circumference (28 %), and lower concentrations of HBA1c (11 %), triglycerides (9 %), alanine aminotransferase (5 %), gamma glutamyl transferase (4 %), C-reactive protein (4 %), insulin-like growth factor 1 (4 %), cystatin C (4 %) and urate (4 %). Higher uPDI scores were associated with a 37 % higher T2DM risk [HR: 1.37, 95 % CI:1.22- 1.53], with higher waist circumference (proportion mediated: 17 %), BMI (7 %), and higher concentrations of triglycerides (13 %) potentially playing mediating roles. Conclusion: Healthful plant-based diets may protect against T2DM via lower body fatness, but also via normoglycaemia, lower basal inflammation as well as improved kidney and liver function.

The following research aims to determine the association of depressive disorder and anxiety with poor glycemic control in patients with DM2 between 18 and 59 years of age in the Family Medicine Unit 57.A study was carried out with an analytical, observational, ambispective, longitudinal approach, probabilistic convenience sampling in the Family Medicine Unit No. 57 in Irapuato, Guanajuato during the period from December 2022 to July 2023, which has 2547 patients with DM2 between 18 and 59 years of age who met the inclusion criteria, of which only 242 patients were studied, which were divided into 2 groups; one with 121 patients with uncontrolled DM 2 and another with 121 patients with DM 2 in control. According to the Beck test of depression and anxiety, it was observed that patients with lack of control presented a greater number of cases of moderate and severe depression with 40.5% compared to those with good control with 5.8%, and similarly it was observed than patients with moderate anxiety with 28.1% in patients in poor control compared to those with good control with 1.7%, thus giving an important degree of significance for the association of depressive disorder and anxiety with glycemic lack of control., La siguiente investigación pretende determinar la asociación del trastorno depresivo y ansiedad con el descontrol glucémico en pacientes con DM2 de 18 a 59 años de edad en la Unidad de Medicina Familiar 57. Se realizó un estudio con enfoque analítico, observacional, ambispectivo, longitudinal, muestreo probabilístico por conveniencia en la Unidad de Medicina Familiar No. 57 en Irapuato, Guanajuato durante el periodo de diciembre del año 2022 a julio del año 2023, la cual cuenta con 2547 pacientes con DM2 entre los 18 a 59 años de edad que cumplieron con los criterios de inclusión, de los cuales solo se estudiaron 242 pacientes, los cuales se dividieron en 2 grupos; uno con 121 pacientes con DM 2 descontrolados y otro de 121 pacientes con DM 2 en control. De acuerdo con el test de Beck de depresión y ansiedad, se observó que los pacientes con descontrol presentaron un número mayor de casos de depresión moderada y grave con 40.5% en comparación con los de buen control con 5.8%, y de igual forma se observó que los pacientes con ansiedad moderada con un 28.1% en pacientes en descontrol en comparación con los de buen control con 1.7%, dando así un grado de significancia importante para la asociación de trastorno depresivo y ansiedad con descontrol glucémico.

Diabetes mellitus type 2 (T2DM) is a metabolic disease related to obesity, and both are characterized by insulin resistance, generally defined as a reduction in the capacity of insulin to exert its metabolic effects on tissues. A strong association between T2DM and certain types of cancer has been reported. The main reasons for this association could be due to hyperglycemia, the relationship between insulin resistance and hyperinsulinemia, or because the link is indirect and mediated by common risk factors such as obesity. The PTEN (phosphatase and tension homologue) gene on chromosome 10q23.3 was the first phosphatase characterized as a tumor suppressor gene. PTEN protein controls nutrient metabolism in the body and cell growth, so variations in protein expression are closely related to metabolism and the risk of developing cancer. PTEN exerts its tumor-suppressive effect by regulating phosphatidylinositol-3-kinase (PI3K). Through this kinase, intracellular signaling pathways of growth factors and insulin are connected. PI3K and, therefore, PTEN are involved in insulin’s actions, and its signaling pathway is reduced in patients with T2DM. Possible causes of PTEN expression loss include mutations, genetic epigenetic silencing through promoter hypermethylation, and loss of heterozygosity at the PTEN locus. Hypermethylation of the PTEN promoter is considered an alternative mechanism of gene inactivation compared to mutations and deletions. In tumor cells, CpG regions of the promoters are methylated in most genes related to tumor suppressor activities and the control of normal cell growth. Gene “silencing” due to methylation in CpG islands allows the expression of oncogenes that trigger the carcinogenesis cascade. This study aims to evaluate the levels of gene and protein expression, as well as the methylation status of the PTEN promoter, as a biomarker for cancer development in patients with T2DM. For this purpose, healthy individuals, patients with diabetes, patients, La diabetes mellitus tipo 2 (DBTM2) es una enfermedad metabólica relacionada a la obesidad y ambas se caracterizan por un estado de resistencia a la insulina, generalmente definido como una reducción en la capacidad de la insulina para ejercer sus efectos metabólicos en los tejidos. Se ha reportado una fuerte asociación entre DBTM2 y determinados tipos de cáncer; las principales razones podrían deberse directamente a la hiperglucemia, la relación de la resistencia a la insulina y la hiperinsulinemia o a que la asociación es indirecta y mediada por factores de riesgo comunes a ambas condiciones, como por ejemplo la obesidad. El gen PTEN (phosphatase and tensin homologue) que se localiza en el cromosoma 10q23.3, fue la primera fosfatasa caracterizada como un gen supresor tumoral. La proteína PTEN controla el metabolismo de nutrientes en el organismo y el crecimiento celular, por lo cual variaciones en la expresión proteica está íntimamente relacionado al metabolismo y riesgo de contraer cáncer. PTEN ejerce su efecto supresor de tumores mediante la regulación del fosfatidilinositol-3-quinasa (PI3K). Es mediante esta quinasa que las vías de señalización intracelular de factores de crecimiento y de la insulina se relacionan. PI3K y por lo tanto PTEN, están involucrados en las acciones de la insulina, cuya vía de señalización se encuentra disminuida en pacientes con DBTM2. Las posibles causas de la pérdida de la expresión de PTEN incluyen mutaciones, epi-silenciamiento genético a través de la hipermetilación del promotor y una pérdida de la heterocigosidad en el locus de PTEN. La hipermetilación del promotor de PTEN es considerada como una alternativa a las mutaciones y deleciones como mecanismo de inactivación de genes. En células tumorales, las regiones CpG de los promotores se encuentran metiladas en la mayoría de los genes relacionados con actividades supresoras de tumores y de control del crecimiento celular normal. El “silenciamiento” génico debido a la metilación e

Background: Understanding treatment burden is a critical element to the effective management of Type 2 Diabetes Mellitus (T2DM). The current study aims to address the knowledge gap surrounding treatment burden of T2DM from the patient’s perspective in China’s primary care settings. Methods: A narrative review informed the creation of an a priori coding structure to identify aspects of T2DM treatment burden. Focus groups were conducted, employing a maximum variation sampling strategy to select participants from diverse sociodemographic backgrounds across urban, suburban, rural, and remote areas in China. Participants included adults with T2DM care in primary care settings for over a year and a Treatment Burden Questionnaire score of 25 or higher. Deductive thematic analysis, guided by the coding structure, facilitated a comprehensive exploration and further development of the conceptual framework of T2DM treatment burden. Results: Four focus groups, each comprising five participants from diverse areas, were conducted. Utilising the Cumulative Complexity Model and Normalisation Process Theory as theoretical underpinnings, the thematic analysis refined the conceptual framework based on the coding structure from the narrative review. Five key themes were refined, encompassing medical information, medication, administration, healthcare system, and lifestyle. Additionally, the financial and time/travel themes merged into a new theme termed "personal resources", illustrating their overlapping within the framework. Participants in these focus groups highlighted challenges in managing medical information, an aspect often underrepresented in prior treatment burden research. The thematic analysis culminated in a finalised conceptual framework, offering a comprehensive understanding of the treatment burden experiences of people with T2DM in China’s primary care settings. This framework includes six key constructs, delineating T2DM treatment burden and associated factors, such a

Introduction/Background: Fructose is a monosaccharide that can also be extracted from sugar beet and sugar cane. There are several foods with high fructose content and affect people’s healthy lifestyle. Dental caries is defined as a dental disease caused by bacteria and the presence of fermentable sugars. Diabetes mellitus type 2 previously known as adult-onset diabetes and referred to as non-insulin-dependent diabetes mellitus. It is the most common type of diabetes, accounting for approximately 90-95% of all diabetes cases. Aim: The aim of this study was to investigate fructose's influence and its effect on dental caries and in diabetes mellitus type 2 by answering questions: Does fructose have influence and effect on dental caries? Does fructose have an influence and effect on the plasma glucose in diabetes type 2? Method: The study was a literature review of articles from PubMed, CINAHL and Scopus. The selection process followed three steps and underwent quality reviews. There were 18 articles that were included in the study. Results: The result shows that fructose has some impacts and effects on caries and on plasma glucose. Fructose contributes to the growth of Streptococcus mutans. High intake of fructose increases the risk for diabetes mellitus type 2 and the development of dental caries. Conclusion: When fructose is consumed in large quantities, the caries-causing microorganisms produce acid to such an extent that demineralization of tooth substance can occur. High intake of fructose can also raise the level of plasma glucose and induce fatty liver in diabetes mellitus type 2.

Title: Nurses’ experiences of health promotion to patients with diabetes type 2 in VietnamBackground: Diabetes is one of the seven major causes leading to death and disability in Vietnam. In the year 2021 the amount of people aged 20-79 with diabetes in Vietnam were 3.9 million, which is equal to 6.1% of Vietnam’s population. Health promotion is a central part of nursing and is the process of enabling people to increase control over, and to improve their health. Person centered care is defined as to promote health based on how the individual person perceives health and sickness.Aim: Investigate Vietnamese nurses’ experiences of health promotion to patients with diabetes type 2. Method: A qualitative design with an inductive approach. Nine nurses have been interviewed at one hospital in Vietnam through semi-structured interviews. Result: Three main categories, 1. Experiences of the importance of knowledge about health promotion, 2. Experiences of the importance of support to the patients to promote health, 3. Experiences of health promotion through educating and informing the patientConclusion: The Vietnamese nurses explained their knowledge and experiences of health promotion to patients with diabetes mellitus type 2 (DM2), which included educating, supporting, and informing the patients. Vietnamese nurses have a need for more knowledge about health promotion., Titel: Sjuksköterskors erfarenheter av att arbeta hälsofrämjande med diabetes typ 2 i Vietnam.Bakgrund: Diabetes är en utav de sju främsta anledningarna till dödsfall och funktionsnedsättning i Vietnam. År 2021 var 3.9 miljoner i åldrarna 20–79 diagnostiserade med diabetes, vilket motsvarar 6.1% utav Vietnams population. Hälsofrämjande arbete är en utav sjuksköterskans främsta arbetsuppgifter och innebär möjliggörandet för individer att öka kontrollen över samt förbättra sin hälsa. Personcentrerad omvårdnad beskrivs som att anpassa och främja hälsa utifrån hur den enskilde individen uppfattar hälsa och sjukdom. Syfte: Undersöka vietnamesiska sjuksköterskors erfarenheter av att arbeta hälsofrämjande för patienter med diabetes typ 2.Metod: En kvalitativ design med en induktiv ansats. Nio sjuksköterskor har intervjuats på ett sjukhus i Vietnam genom semistrukturerade intervjuer.Resultat: Tre huvudkategorier, 1. Erfarenheter av vikten av kunskap om hälsofrämjande arbete, 2. Erfarenheter av vikten av att främja hälsa genom att stödja patienten, 3. Erfarenheter av att främja hälsa genom att undervisa och informera patienten.Slutsats: De vietnamesiska sjuksköterskorna beskrev deras kunskap och erfarenheter om hälsofrämjande arbete med diabetes mellitus typ 2 (DM2), som inkluderade undervisning, att ge support och att informera patienterna. Vietnamesiska sjuksköterskor har behov av mer kunskap om hälsofrämjande arbete.

Bakgrund: Diabetes Mellitus (DM) är en kronisk sjukdom som kan påverka flera kroppsliga funktioner, vilket i sin tur kan leda till svåra komplikationer. En av dessa är svårläkta sår, vilket är förknippat med en omfattande börda för patienterna. Syfte: Att beskriva patienters upplevelser av att leva med diabetiska fotsår vid DM typ 1 och 2. Metod: Studien genomfördes genom en litteraturöversikt med kvalitativ metod. Studien baserades på elva vetenskapliga artiklar som återfanns genom artikelsökning i databaserna CINAHL och MEDLINE samt manuell sökning. Artiklarna analyserades enligt analys av Friberg i fem steg. Resultat: Litteraturöversikten resulterade i fyra huvudteman; upplevelser av fysisk påverkan, upplevelser av ekonomisk påverkan, upplevelser av social påverkan och upplevelser av emotionell påverkan. Vidare sammanställdes nio subteman. Slutsats: Diabetiska fotsår hos personer med diabetes påverkar psykologiska och sociala aspekter, begränsar rörlighet och orsakar funktionsnedsättning. Brist på stöd leder till ensamhet och börda, medan smärta hindrar social interaktion. Sjuksköterskor kan med kunskap och gott bemötande bidra till ökad kunskap om egenvård och psykosociala effekter och främjar patientens självständighet, hälsa och välbefinnande., Background: Diabetes Mellitus (DM) is a chronic disease that can affect several bodily functions, which in turn can lead to severe complications. One of these are hard-to-heal wounds, which is associated with an extensive burden for the patients. Aim: To describe patients’ experience of living with diabetic foot ulcers in DM type 1 and 2. Method: The study was conducted through a literature review using a qualitative method. The study was based on eleven scientific articles that were found through an article-search in the databases CINAHL and MEDLINE as well as through manual search. The articles were analyzed according to analysis by Friberg in five steps. Results: The literature review resulted in four main themes; experiences of physical impact, experiences of financial impact, experiences of social influence and experiences of emotional impact. Furthermore, nine subthemes were compiled. Conclusion: Diabetic foot ulcers in people with diabetes affect psychological and social aspects, limits mobility and cause disability. Lack of support leads to loneliness and a feeling of being a burden to others, while pain hinders social interaction. With knowledge and compassion, nurses can contribute to increase the patient’s knowledge about self-care and psychosocial effects which can promote the patient's independence, health, and well-being.

Bakgrund: Diabetes mellitus typ 2 är en folksjukdom där antalet ökar varje år. Bidragande faktorer till ökningen är bland annat ohälsosamma levnadsvanor samt en stillasittande livsstil. Då ett förhöjt blodglukos kan medföra diabetesrelaterade komplikationer har sjuksköterskor som roll att stödja personer med DM2 till att bibehålla ett normalt blodglukos vilket kan uppnås genom förändrade levnadsvanor. Syfte: Sjuksköterskans erfarenheter av att stödja personer med diabetes mellitus typ 2 att förändra levnadsvanor. Metod: Examensarbetet genomfördes som en litteraturstudie med kvalitativ ansats. Från databaserna Cinahl och Pubmed utvanns tio artiklar som kvalitetsgranskades utifrån SBU:s Granskningsmall för kvalitativ forskning och analyserades utifrån Popenoe’s kvalitativa analysmetod. Resultat: Efter analys av samtliga artiklar identifierades tre huvudkategorier; Faktorer som påverkar egenvården, sjuksköterskans förhållningssätt och alternativa metoder för underlättande av stöd där resultatet presenteras i åtta underkategorier. Slutsats: Sjuksköterskor erfor flera faktorer som påverkade hur stöd kunde bidra till främjandet av förändrade levnadsvanor. God kunskap och kommunikation samt personcentrerad omvårdnad. Sjuksköterskor beskrev svårigheter kring att besitta rätt kunskap till att förmedla personer med DM2. Sjuksköterskor ansåg även att e-hälsa borde få större plats inom diabetesvården då det upplevdes underlätta kommunikationen., Background: Type 2 diabetes mellitus is a folk disease where the number increases every year. Contributing factors to this increase includes unhealthy life habits and sedentary lifestyle. Elevated blood sugar can entail diabetes-related complications where the nurse has a role to support people with DM2 to maintain a controlled blood sugar which can be achieved through changes in lifestyle. Purpose: Describe nurse’s experiences of supporting people with diabetes mellitus type 2 to change lifestyle habits. Method: This degree project was conducted as a literature review based on articles with a qualitative approach. The literature study was based on ten scientific articles found in databases Cinahl and Pubmed. Quality review of the articles according to SBU:s Review template for qualitative research and data analyses based on Popenoe’s qualitative analysis method was conducted. Findings: After analysis of all articles, three main categories were identified; factors that affect self-care, the nurse’s approach and alternative methods for facilitating support. The results were categorized into a total of eight subcategories. Conclusion: Nurses experienced multiple factors that affected how support could contribute to promoting a change in lifestyle habits. Good knowledge and communication along with person-centered care. Nurses described difficulties about possessing the right knowledge to convey to people with DM2. Nurses also perceived that e-health should get a bigger spot within diabetic care as it was perceived that it facilitated communication.

Bakgrund: Diabetes mellitus typ 2 är en global kronisk sjukdom. I Sverige har cirka en halv miljon av befolkningen sjukdomen och ungefär 350 miljoner i hela världen. Sjukdomen är allvarlig och orsakar konsekvenser såsom kardiovaskulära sjukdomar och för tidig dödlighet. Syfte: Syftet med litteraturöversikten var att belysa upplevelser av livsstilsförändringar hos patienter diagnostiserade med diabetes mellitus typ 2 Metod: Litteraturöversikten var baserad på elva vetenskapliga artiklar som har använts i resultatet. Databaser som användes var Cinahl Complete och PubMed. Artiklar var kvalitativa. Artiklarna granskades med Fribergs analysmetod (Friberg, 2022). Resultat: Resultatet presenterades i fyra teman. Negativa aspekter av livsstilsförändringar i dagligt liv, Positiva aspekter av livsstilsförändringar i dagligt liv, upplevelser av nödvändig kunskap vid livsstilsförändringar och upplevelserna av den egna motivationen av livsstilsförändringarna. Sammanfattning: Deltagarna i litteraturöversikten som blev diagnostiserade med DMT2 hade olika upplevelser samt uppfattningar av livsstilsförändringar. Olika upplevelser av fysiska hälsa och psykiska hälsa förekom bland studierna. Inom hälso- och sjukvården bör sjuksköterskor arbeta utifrån deras profession genom att omhänderta dessa individer och erbjuda evidensbaserad vård där individer blir inkluderade i sin behandling., Background: Diabetes mellitus type 2 is a global chronic disease. In Sweden, approximately half a million of the population have the disease and approximately 350 million worldwide. The disease is serious and causes consequences such as cardiovascular diseases and premature mortality Aim: The purpose of this literature review was to light up the experiences of lifestyle changes in patients diagnosed with diabetes mellitus type 2. Method: The literature review was based on eleven scientific articles that have been used in the results. Databases used were Cinahl Complete and PubMed. Articles were qualitative. The articles were reviewed using Friberg's analysis method (Friberg, 2022). Results: The results were presented in four themes. Negative aspects of lifestyle changes in daily life, Positive aspects of lifestyle changes in daily life, experiences of necessary knowledge during lifestyle changes and the experiences of the own motivation of the lifestyle changes. Summary: The participants in the literature review who were diagnosed with DMT2 had different experiences and perceptions of lifestyle changes. Different experiences of physical health and mental health occurred among the studies. Within health care, nurses should work based on their profession by caring for these individuals and offering evidence-based care where individuals are included in their treatment.

Bakgrund: Diabetes mellitus typ 2 är en kronisk sjukdom som främst drabbar äldre människor men som numera kryper neråt i åldrarna. I samband med sjukdomen är kroppens förmåga att producera insulin nedsatt. Diabetes mellitus typ 2 kräver livsstilsanpassningar och stöd från sjuksköterskan för att hantera sjukdomen. Sjuksköterskans roll är att stödja patienterna med råd och information för att klara av utmaningen att leva med diabetes mellitus typ 2. Syfte: Syftet med studien var att belysa patienternas upplevelser av stöd från sjuksköterskan vid diabetes mellitus typ 2. Metod: En litteraturöversikt baserad på åtta kvalitativa artiklar och två artiklar med mixad metod. Resultat: Tre teman identifierades under analysen som svarade på patienternas upplevelse av stöd från sjuksköterskan vid diabetes mellitus typ 2. Dessa teman var: viktigt att bygga en förtroendefull relation, sjuksköterskans tillgänglighet är värdefull och individanpassad rådgivning är betydelsefullt. Konklusion: Vikten av en förtroendefull relation mellan patienterna och sjuksköterskan var avgörande för upplevelsen av stöd. Patienternas behov av stöd varierande utefter anhörigas delaktighet vilket visar på att sjuksköterskan bör inkludera anhöriga i vårdandet. Individanpassad rådgivning i form av språkligt anpassad information är avgörande för allas möjlighet till att tillgodose sig vård på lika villkor., Background: Diabetes mellitus type 2 is a chronic disease that mainly affects older people, but which is now creeping downward in age. In connection with the disease, the body's ability to produce insulin is reduced. Diabetes mellitus type 2 requires lifestyle adaptations and support from the nurse to manage the disease. The nurse's role is to support the patients with advice and information to cope with the challenge of living with diabetes mellitus type 2. Aim: The aim of the study was to highlight patients' experiences of support from the nurse in diabetes mellitus type 2. Method: A literature review based on eight qualitative articles and two articles with a mixed method. Findings: Three themes were identified during the analysis that responded to the patients' experience of support from the nurse in diabetes mellitus type 2. These themes were: it is important to build a trusting relationship, the nurse´s availability is valuable and individualized counseling is significant. Conclusion: The importance of a trusting relationship between patients and nurses was decisive for the experience of support. The patients' need for support varies according to the participation of relatives, which shows that the nurse should include relatives in the care. Individually adapted advice in the form of linguistically adapted information is crucial for everyone's opportunity to receive care on equal terms.

Bakgrund: Diabetes typ 2 är en av de vanligaste sjukdomarna både i Sverige och globalt. Sjukdomen är progressiv vilket leder till ökade sociala kostnader för samhället och kan dessutom leda till lidande för den enskilde individen. Egenvård är en viktig del av vård vid diabetes typ 2. Sjuksköterskans ansvar är att förebygga hälsorisker samt förändra levnadsvanor genom att stötta patienter. I diabetes typ 2 är omvårdnaden viktig att utgå ifrån patienternas specifika grundläggande levnadsvanor och behov för att förstärka patientens egenvård. Syftet: Att beskriva patienters erfarenheter av egenvård vid diabetes typ 2. Metod: En litteraturstudie med Polit och Beck niostegsmodell har använts i arbetet. Vald analysmetod är kvalitativ innehållsanalys. Resultat: Två kategorier används ”behov av stöd och kunskap” och ”utmaningar med livsstilsförändringar”. Resultatet visade att stöd från anhöriga och sjuksköterskor var en viktig del för att främja god egenvård hos patienten. Slutsats: Diabetes typ 2 är en utmanande folkhälsosjukdom utifrån patientens förmåga av egenvård. Personerna med diabetes typ 2 kan behöva implementera nya egenvårdsaktiviteter i sina dagliga rutiner för att upprätthålla god hälsa. Stöd från både anhöriga och vårdpersonal är viktigt för att egenvården ska vara framgångsrik., Background: Diabetes type 2 is one of the most common diseases both in Sweden and globally. The disease is progressive, which leads to increased social costs for society and can also lead to suffering for the individual. Self-care is an important part of care for type 2 diabetes. The nurse's responsibility is to prevent health risks and change lifestyle habits by supporting patients. In type 2 diabetes, it is important for nursing care to be based on the patients' specific basic lifestyle habits and needs in order to strengthen the patient's self-care. Aim: To describe patients' experiences of self-care in type 2 diabetes.Method: A literature study with Polit and Beck's nine-step model was used in the work. The chosen analysis method is qualitative content analysis. Results: Two categories are used: "need for support and knowledge" and "importance of lifestyle changes". The results showed that support from relatives and nurses was an important part of promoting good self-care in the patient. Conclusion: Diabetes type 2 is a challenging public health disease based on the patient's ability to self-care. People with type 2 diabetes may need to implement new self-care activities into their daily routines to maintain good health. Support from both relatives and healthcare professionals is important for self-care to be successful.

Bakgrund: Diabetes typ 2 är en kronisk sjukdom som ökar globalt och innebär stora samhällskostnader. I tidigt sjukdomsförlopp kan symptom av diagnosen vara svåra att uppmärksamma. I senare sjukdomsförlopp är nerv och kärlatrofi vanligt. Att leva med sjukdomen innebär i de flesta fallen en medicinsk och icke-medicinsk behandling. Den icke-medicinska behandlingen är egenvård med livsstilsförändringar i fokus.​ Syfte: Syftet var att beskriva vuxnas upplevelser av egenvård vid diabetes mellitus typ 2. Metod: En ​litteraturöversikt beskriven av Friberg med totalt tio kvalitativa artiklar. Hälften av artiklarna har valts ut från databasen Cinahl Complete medan andra hälften från databasen Pubmed. Innehållet är analyserat efter en analysmetod som är beskriven av Friberg för en allmän litteraturöversikt. Resultat: Fyra huvudteman identifierades; Utmaningar och hinder, Ta tillbaka kontrollen, Ambivalens och Strategier för egenvård. Fyra subteman uppkom i analysen under temaområdet Utmaningar och hinder. Dessa var Kostintag, Medicinering, Fysisk aktivitet och Övervakning av blodsockernivåer. Sammanfattning: Egenvård av diabetes typ 2 kommer med positiva som negativa upplevelser. Detta verkar ha resulterat i en ambivalens inför egenvård för många med diagnosen. Följsamhet till egenvården var i många fall utmanande trots personers kunskap kring riktlinjerna. Speciellt svårt var livsstilsförändringar där utmaningarna även ibland blivit ett hinder. Egenvården verkar hjälpa personer återfå kontroll över sin hälsa. För upprätthållandet av egenvård nyttjar personer olika strategier beroende på deras livssituation., Background: Diabetes type 2 is a chronic disease with a prevalence globally increasing resulting in large societal costs. In the early stages of the disease, symptoms of the diagnosis can be difficult to notice. In later stages of the disease, nerve and vascular atrophy is common. Living with the disease means in most cases medical and non-medical treatment. The non-medical treatment is self-care with focus on lifestyle changes. Aim: The aim was to describe adults experience of selfcare in diabetes mellitus type 2. Method: A general literature review described by Friberg in a total of ten qualitative articles. Half of the articles where selected from the database Cinahl Complete, while the other half was from the database Pubmed. The content is analyzed according to the analysis method described by Friberg for a general literature review. Results: Four main themes where identified: Challenges and obstacles, Taking back control, Ambivalence and Strategies for self-care. Four subthemes emerged in the analysis under the theme Challenges and obstacles. These were Food intake, Medication, Physical Activity and Blood Sugar Level Monitoring. Summary: Self-care for type 2 diabetes comes with both positive and negative experiences. This seems for many to have resulted in an ambivalence towards self-care. Adherence to self-care faced in most cases challenges despite the person having knowledge about it. Lifestyle changes were especially difficult, where the challenge itself sometimes became an obstacle. Self-care seems to help people regain control over their health. To achive good self-care, people use different strategies based on their situation.

Background Diabetes type 2 is a metabolic disease in which insulin production is either completely absent or too small in relation to the body's needs and/or the body's ability to assimilate the insulin is reduced. Untreated, the disease leads to harmfully high blood sugar levels and subsequent complications such as damage to vital organs and death. The incidence has increased significantly globally during the last thirty years, especially within the group of young adults. Reduced physical activity, overweight and obesity, and increased longevity are the driving factors behind the increased incidence in Sweden. Self-care is an important part of treating the disease and new technological innovations have paved the way for a new type of digital support for patients in their self-care. Aim The aim was to describe patients' experience of self-care with the help of m-health in diabetes type 2. Method The study was done with a non-systematic literature review which included 15 scientific articles from two databases (PubMed and CINAHL). Of the included articles, 13 had a qualitative approach and 2 had a quantitative approach, all of which have undergone a quality review. The result was iterated through integrated data analysis. Results The result generated 3 main themes: perceived enablers for the use of m-health, perceived barriers to the use of m-health, and the experience of interaction and information sharing. The results showed that most participants experienced positive effects from the use such as strengthened self-confidence, increased knowledge, and increased self-care skills. Some of the participants, however, experienced obstacles before use, in the form of prejudices, but also obstacles during use which was identified as a barrier to integrating the application into everyday life. Conclusions The experience of using a mobile application for self-care support largely depends on the individual's personal characteristics, life situation, and possible co-morbiditie, Bakgrund Diabetes typ 2 är en metabol sjukdom där insulinproduktionen antingen helt saknas eller är för liten i relation till kroppens behov och/eller att kroppens förmåga att tillgodogöra sig insulinet är nedsatt. Obehandlat leder sjukdomen till skadligt höga blodsockernivåer och följdkomplikationer som skador på vitala organ och dödsfall. Förekomsten har ökat kraftigt globalt under de senaste trettio åren, speciellt inom gruppen unga vuxna. Minskad fysisk aktivitet, övervikt och fetma samt ökad livslängd pekas ut som de drivande faktorerna bakom den ökade förekomsten i Sverige. Egenvård är en viktig del av behandling av sjukdomen och nya tekniska innovationer har banat väg för en ny typ av digitalt stöd för egenvård. Syfte Syftet var att beskriva patienters upplevelser av m-hälsa som stöd för egenvård vid diabetes typ 2. Metod Studien gjordes som en icke-systematisk litteraturöversikt vilken inkluderade 15 vetenskapliga artiklar från 2 databaser (PubMed och CINAHL). Av de inkluderade artiklarna hade 13 av dem kvalitativ ansats och 2 kvantitativ ansats, samtliga har genomgått en kvalitetsgranskning. Resultatet arbetades fram genom en integrerad dataanalys. Resultat Resultatet genererade 3 huvudteman: upplevda möjliggörare för användandet av m-hälsa, upplevda hinder för användandet av m-hälsa och upplevelsen av interaktion och informationsdelande. Resultatet visade att majoriteten av deltagarna upplevde positiva effekter av användandet såsom stärkt självförtroende, ökad kunskap och ökad egenvårdsförmåga. En del av deltagarna upplevde dock hinder inför användandet i form av fördomar, men även hinder under användandet som gav svårigheter att integrera applikationen i vardagen. Slutsats Upplevelsen av användandet beror till stor del på individens personliga egenskaper, livssituation och eventuell samsjuklighet. I litteraturstudien dras slutsatsen att dessa insikter är viktig kunskap för sjuksköterskan för att ge adekvat stöd i egenvården till varje patient.

Bakgrund: Diabetes mellitus förekommer i två huvudformer och delas in i typ 1 (DM1) och 2 (DM2). DM1 grundar sig i insulinbrist och DM2 i insulinresistens. Förekomsten av DM2 är ett folkhälsoproblem som ökar både i Sverige och globalt. För att kunna lindra sjukdomen krävs det medicinska behandlingar men även egenvård. Egenvården är en stor del av behandlingen för att kunna lindra sjukdomen och minska komplikationer som kan uppstå vid icke behandlad DM2. Syfte: Syftet med litteraturöversikten var att belysa hur patienter upplever egenvård vid Diabetes mellitus typ 2. Metod: Denna litteraturöversikt byggdes på 10 kvalitativa vetenskapliga artiklar. Artiklarna hämtades från databaserna CINAHL Complete och PubMed och analyserades enligt Fribergs beskrivning. Resultat: Sex huvudteman identifierades: Kontroll över sin sjukdom, Kost och fysisk aktivitet, Stöd från familj, Kunskap och kompetens, Patienters upplevelse av hälso- och sjukvården och Ekonomiska aspekter. Sammanfattning: Resultatet av denna litteraturöversikt visade att patienter upplevde att egenvården vid DM2 påverkades av olika grundläggande faktorer. Ansvaret för ett friskt och därmed långt liv låg på deltagarna. Detta hanterades olika beroende på de förutsättningar som individerna hade samt graden av ansvar som individen tog i förhållande till sin sjukdom. Stödet deltagarna fick från sina familjemedlemmar, vänner och grannar motiverade och uppmuntrade dem. Kunskap och stöd från sjukvårdspersonal var också en främjande faktor till att deltagarna blev motiverade till att lära sig mer om sjukdomen och upprätthålla egenvården., Background: Diabetes mellitus occurs in two main forms: type 1 (DM1) and 2 (DM2). DM1 is based on insulin deficiency and DM2 on insulin resistance. Diabetes mellitus, type 2 is a public health problem that is increasing both in Sweden and globally. To alleviate the disease medical treatments are required but also self-care. Self-care is a large part of the treatment to alleviate the disease and reduce complications that can occur with untreated DM2. Aim: The aim of this literature review was to elucidate how patients experience self-care in diabetes mellitus type 2. Method: A literature review with 10 qualitative scientific articles that were chosen from the databases CINAHL Complete and PubMed. These articles were analyzed through Friberg`s method. Results: Six main themes were identified: Control over one`s illness, Diet and physical activity, Support from family, Knowledge and competence, Patients' experience of health care and Financial aspects. Summary: The results of this literature review showed that patients felt that self-care in DM2 was influenced by various basic factors. The responsibility for wanting to live and get healthy was on the participants, and that it was something no one else can take responsibility for. Getting support from their family members, friends and neighbors motivated and encouraged them. Knowledge and support from health care professionals was also a promoting factor for the participants to become motivated to learn more about the disease and maintain self-care.

Bakgrund: Diabetes mellitus typ 2 är en kronisk sjukdom och en folkhälsosjukdom som förväntas att ökas i världen. Diabetes mellitus typ 2 vanligen drabbar vuxna personer men faktorer som övervikt, fetma, ärftlighet och en försämrad livskvalité kan orsaka att få sjukdomen. Egenvård är den centrala åtgärden för att förebygga komplikationer samt främja hälsan. Sjuksköterskans ansvar är att stödja, motivera och informera patienten genom att tillämpa ett individanpassad vård. Att självständigt kunna hantera sin egenvård kan vara utmanande då livsstilsförändringar bör göras. Genom kunskap och stöd från familjen, närstående och vårdpersonalen kan personer med diabetes mellitus typ 2 stärka sin egenvårdsförmåga. Syfte: Att beskriva personers upplevelser av egenvård hos vuxna personer med diabetes mellitus typ 2. Metod: Databaserna CINAHL Complete och PubMed användes i sökningen för att hitta vetenskapliga artiklar. Tio kvalitativa vetenskapliga artiklar valdes för att använda i resultatet och identifiera teman. Resultat: I resultatet identifierades tre teman; Att tillämpa nya livsstilsförändringar, Betydelsen av kunskap och Vikten av stöd. Sammanfattning: Personer med DMT2 upplevde att egenvård är en utmanade process som kräver livsstilsförändringar i syfte att främja och bibehålla hälsan. Vårdpersonalen och närstående hade en viktig roll att stötta och motivera till att utföra egenvård., Background: Diabetes mellitus type 2 is a chronic disease and a public health disease that is expected to increase worldwide. Diabetes mellitus type 2 usually affects adults, but causes such as overweight, obesity, heredity and a reduced quality of life can cause getting the disease. Selfcare is the central measure for preventing complications and promoting health. The nurse's responsibility is to support, motivate and inform the patient by applying individual care. Being able to manage your own selfcare independently can be challenging as lifestyle changes need to be made. Through education and support from the family, relatives and healthcare staff, can people with diabetes mellitus type 2 strengthen their self-care skills. Aim: Describe adult person's experiences of self-care in type 2 diabetes. Method: The databases CINAHL Complete and PubMed were used in the search to find scientific articles. Ten qualitative scientific articles were selected to be used in the results and to identify themes. Results: In the result, three themes were identified; Applying new lifestyle habits, the importance of knowledge and the importance of support. Summary: People with diabetes mellitus type 2 felt that self-care is a challenging process that requires lifestyle changes in order to promote and maintain health. The nursing staff and relatives had an important role to support and motivate to perform self-care.

Bakgrund: Diabetes typ 2 är ett växande folkhälsoproblem både i Sverige och i resten av världen. Vid diabetes typ 2 har kroppen svårt att hålla sockerhalten i blodet på en tillräcklig låg nivå. Diabetes typ 2 som inte är under kontroll kan utveckla allvarliga diabeteskomplikationer. Då egenvård är en viktig del av behandlingen och patienten har det största ansvaret för egenvården har sjuksköterskan en viktig roll att genom en individuell anpassad kommunikation och information ge det stöd och råd som patienten behöver för att genomföra egenvård. Syfte: Syftet var att beskriva personers upplevelser av diabetes typ 2 Metod: Litteraturöversikten genomfördes utifrån 10 kvalitativa vetenskapliga artiklar. Databaserna PubMed och Cinahl Complete användes för insamling av resultatartiklar. Artiklarna analyserades för att skapa gemensamma teman. Resultat: Resultatet presenteras i fyra huvudteman: Svårigheter att förändra kostvanor, Svårigheter att förändra vanor kring fysisk aktivitet, Det professionella stödet, Stöd från närstående. Sammanfattning: Litteraturöversikten visade det att personer med diabetes typ 2 saknade individ anpassad information och hade negativa upplevelser från vårdmöten. Att upprätthålla hälsosamma levnadsvanor upplevdes tidskrävande och komplicerad. Personer med diabetes typ 2 har behov av stöd och information anpassad efter deras behov för att genomföra egenvårdsrutiner., Background: Diabetes type 2 is a growing public health care both in Sweden and the rest of the world. In type 2 diabetes, the body has difficulty keeping the sugar level in the blood low enough. Type 2 diabetes that is not under control can create serious diabetes complications. Since self-care is the most important part of the treatment and the patient has the greatest responsibility for self-care, the nurse has an important role to provide, through individually adapted communication and information, the support and advice the patient needs to carry out self-care. Aim: The aim of this study was to describe persons’ experiences of self-care in type 2 diabetes Method: A literature review has been carried out based on ten qualitative scientific articles. The databasens PubMed and Cinahl Complete were used for the collection of outcome articles. The articles were analyzed to create common themes. Results: The results are presented in four main themes: Difficulties in changing dietary habits, Difficulties in changing habits around physical activity, The professional support, Support from relatives. Summary: The literature rewiew showed that persons with type 2 diabetes lacked individually adapted information and hade negative experiences from care meetings. To maintain healty lifestyle habits was perceived as time-consuming and complicated. Persons with type 2 diabetes need support and information adapted to their needs for to carry out self-care routines.

Background: Heart failure is a clinical syndrome characterized by impaired quality of life, frequent use of medical services, and premature mortality. Its prevalence is between 1% and 14% in the US and European population, for Colombia a prevalence of approximately 2.3% of the population is estimated; 1, 2 recent studies point to an increase in the number of deaths from this aetiology in the United States, from 275,000 in 2009 to 310,000 in 2014, this associated with a phenomenon in which there is an increase in the life expectancy of heart patients, in addition to population aging. Methodology: A bibliographic review was carried out through various databases from 2016 to 2022; The search and selection of articles was carried out in indexed journals in English and Spanish. Key words were used: Heart Failure; Sodium-glucose transporter type 2 inhibitors; Diabetes mellitus type 2; antidiabetic agents. Results: ISGLT-2 have a mechanism of action in the first instance due to nutriereis and glycosuria since it decreases preload and afterload, this is responsible for reducing interstitial edema which is associated with ventricular hypertrophy, it also decreases BP , sympathetic tone due to direct inhibition of norepinephrine synthesis due to renal tyrosine hydroxylase blockade, another mechanism is the reduction of glucose consumption given to the cardiomyocyte in favor of fatty acid and acetone consumption. Conclusion: Sodium-glucose cotransporter type 2 inhibitors have shown benefits on morbidity and mortality in patients with heart failure with preserved and decreased ejection fraction, as well as improvements on diseases such as metabolic syndromes, kidney disease, and sudden death., Antecedentes. La falla cardiaca es un síndrome clínico caracterizado por deterioro de la calidad de vida, uso frecuente de servicios médicos y mortalidad prematura. Su prevalencia se encuentra entre un 1% y un 14% en población estadounidense y Europea, para Colombia se estima una prevalencia de aproximadamente el 2.3% de la población; 1, 2 estudios recientes señalan un aumento del número de muertes por esta etiología en los estados unidos, de 275,000 en 2009 a 310,000 en 2014, esto asociado a un fenómeno en el cual hay un aumento de la expectativa de vida de los pacientes cardiópatas, además del envejecimiento poblacional. Metodología. Se realizó una revisión bibliográfica a través de diversas bases de datos desde el año 2016 al año 2022; la búsqueda y selección de artículos fue llevada a cabo en revistas indexadas en idioma inglés y español. Se utilizaron como palabras clave: Insuficiencia Cardíaca; Inhibidores del transportador sodio-glucosa t ipo 2; Diabetes Mellitus Tipo 2; Agentes antidiabéticos. Resultados. Los ISGLT-2 tienen un mecanismo de acción en primera instancia por la nutriereis y la glucosuria ya que disminuye la precarga y la poscarga, este se encarga de disminuir el edema intersticial lo cual está asociado a la hipertrofia ventricular, también disminuye la PA, el tono simpático debido a la inhibición directa de la síntesis de noradrenalina a causa del bloqueo de la hidroxilasa de t irosina renal, otro mecanismo es la reducción del consumo de glucosa dado al cardiomiocito a favor del consumo de ácidos grasos y acetona. Conclusión. Los inhibidores del cotransportador sodio-glucosa tipo 2 han demostrado beneficio sobre la morbimortalidad de los pacientes con falla cardiaca con fracción de eyección preservada como disminuida, también mejorías sobre enfermedades como síndromes metabólicos, enfermedad renal y muerte súbita.

Introduction: Given the increase in cases of prediabetes and type 2 diabetes mellitus (DM2) worldwide, and the limited access to laboratory analysis in several places, it is necessary to have the implementation of a simple, fast, and without-detection method. laboratory: the American Diabetes Association (ADA) risk test: the ADA test risk score (ADATRS). Objective: To carry out a systematic review (SR) with meta-analysis on the diagnostic utility of the ADATRS for prediabetes and DM2.Methodology: SR with meta-analysis of studies of diagnostic tests. The search was conducted in four databases: PubMed/Medline, SCOPUS, Web of Science and EMBASE. True positives, true negatives, false positives, and false negatives were obtained for each study. 2×2 tables were constructed based on the information from the article or from the authors. Thus, forest diagrams were presented with a 95% confidence interval (95%CI), both for the overall sensitivity and specificity of the ADATRS for both events of interest.Results: Forest plots revealed that the sensitivity and specificity for prediabetes were 0.91 (95%CI: 0.82-0.96) and 0.52 (95%CI: 0.36-0.67), respectively. While for DM2, the combined sensitivity and specificity were 0.85 (95%CI: 0.71-0.93) and 0.56 (95%CI: 0.47-0.65), respectively.Conclusions: Our systematic review and meta-analysis of the current literature suggests that the ADATRS may be useful as a screening method for prediabetes and DM2, given its high sensitivity. However, there is a lot of heterogeneity and few studies even in this regard; therefore, more research work is needed in different populations and with more standardized methods to finally determine the clinical importance of this questionnaire as a screening or diagnostic tool for prediabetes or DM2., Introducción: Dado el aumento de los casos de prediabetes y diabetes mellitus tipo 2 (DM2) a nivel mundial, y al poco acceso de análisis de laboratorio en varios lugares, es necesario contar con la implementación de un método de detección simple, rápido y sin laboratorio: la prueba de riesgo de la Asociación Americana de Diabetes (ADA): el ADA test risk score (ADATRS). Objetivo: Realizar una revisión sistemática (RS) con metaanálisis sobre la utilidad diagnóstica del ADATRS para prediabetes y DM2. Metodología: RS con metaanálisis de estudios de pruebas diagnósticas. Se realizó la búsqueda en cuatro bases de datos: PubMed/Medline, SCOPUS, Web of Science y EMBASE. Se obtuvieron los verdaderos positivos, verdaderos negativos, falsos positivos y falsos negativos de cada estudio. Se construyeron tablas de 2×2 con base en la información del artículo o de los autores. Así, se presentaron diagramas de bosque con un intervalo de confianza al 95% (IC95%), tanto de la sensibilidad como especificidad en conjunto del ADATRS para ambos eventos de interés. Resultados: Los diagramas de bosque revelaron que la sensibilidad y especificidad para prediabetes fueron 0,91 (IC95%: 0,82-0,96) y 0,52 (IC95%: 0,36-0,67), respectivamente. Mientras que, para DM2, la sensibilidad y especificidad, combinados fueron 0,85 (IC95%: 0,71-0,93) y 0,56 (IC95%: 0,47-0,65), respectivamente. Conclusiones: Nuestra revisión sistemática y metaanálisis de la literatura actual sugiere que el ADATRS pue-de ser útil como método de cribado para prediabetes y DM2, dado su alta sensibilidad. Sin embargo, existe mucha heterogeneidad y pocos estudios aun al respecto; por lo tanto, se necesitan más trabajos de investigación en diferentes poblaciones y con métodos más estandarizados para finalmente determinar la importancia clínica de este cuestionario como herramienta de cribado o diagnóstico para la prediabetes o DM2.

Bakgrund: Diabetes typ 2 är en kronisk sjukdom som orsakar höga blodsockernivåer på grund av nedsatt insulinkänslighet i kroppen. Livsstilsfaktorer som kost, brist på motion och övervikt är starkt kopplade till denna sjukdom. Livsstilsförändringar inklusive kost och motion är avgörande för sjukdomshanteringen. Forskning visar att patienters erfarenheter och utmaningar med dessa förändringar påverkar sjukdomshantering och behandlingsresultat. Syfte: Syftet är att undersöka patienters upplevelser av livsstilsförändringar vid diabetes mellitus typ 2. Metod: En systematisk litteraturstudie utfördes där kvalitativa artiklar analyserades med tematisk syntes enligt Thomas och Harden. Resultat: Studiens resultat baserades på 13 kvalitativa artiklar. Dataanalysen mynnade ut i tre analytiska teman som inkluderade flera deskriptiva teman. Det analytiska temat: Det är en gradvis process när det kommer till kost och motion med deskriptiva teman: Svårt med förändring av gamla vanor samt Insikt och acceptans skapar goda förutsättningar till förändring. Nästa analytiska tema: Självkännedom, fysisk aktivitet och balanserad kost ger goda resultat med deskriptiva teman: Självinsikt och motivation, Fysisk aktivitet skapar välbefinnande samt Den balanserade kostens betydelse. Sista analytiska temat: Interaktion, uppmuntran och kunskap med deskriptiva teman: Socialt stöd och Gemenskap, Kunskapens grundläggande roll samt Vårdrelationens betydelse. Slutsats: Genom utbildning, god kommunikation och ett personcentrerat förhållningssätt från distriktssköterskan ökar chanserna för bestående livsstilsförändringar hos personer med diabetes mellitus typ 2., Background: Type 2 diabetes is a chronic disease that leads to high blood sugar levels due to reduced insulin sensitivity in the body. Lifestyle factors such as diet, lack of physical activity and obesity are strongly linked to this condition. Effective lifestyle changes, including diet and exercise are crucial for managing diabetes. Research has shown that patients ́experiences and challenges with these changes influence disease management and treatment outcomes. Aim: The aim is to investigate the patients ´experience of lifestyle changes in Type 2 Diabetes. Method: A systematic literature review was conducted where qualitative articles were analyzed using thematic synthesis according to Thomas and Harden. Result: The study's results are based on 13 qualitative articles. The data analysis resulted in three analytical themes that include several descriptive themes. The first analytical theme is: It's a gradual process for diet and exercise, with descriptive themes: Challenging to change old habits and Insight and acceptance create favorable conditions for change. The next analytical theme is the Self-awareness, physical activity, and a balanced diet yield positive results, with descriptive themes: Self-awareness and motivation, Physical activity promotes well-being, and The importance of a balanced diet. The final analytical theme is Interaction, encouragement, and knowledge with descriptive themes: Social Support and Community, The fundamental role of knowledge, and The importance of the caregiver-patient relationship. Conclusion: Through education, good communication and a person-centered approach from the district nurse, the chances of lasting lifestyle changes in people with type 2 diabetes increase.

AIMS: To evaluate whether dog ownership from the time of type 2 diabetes diagnosis improved glycaemic control, increased achievement of major guideline treatment goals or reduced the risk of all-cause death. METHODS: Patients diagnosed with type 2 diabetes were followed by linkage of four Swedish national registers covering diabetes, dog ownership, socioeconomics, and mortality. Linear regression was used to estimate the mean yearly change in glycated haemoglobin (HbA1c). Cox survival analysis and logistic regression were used to analyse associations between dog ownership and all-cause death and achievement of treatment goals, respectively. RESULTS: Of 218,345 individuals included, 8,352 (3.8%) were dog-owners. Median follow-up was 5.2 years. Dog-owners had worse yearly change in HbA1c, and were less likely to reach HbA1c, low-density lipoprotein (LDL), and systolic blood pressure (SBP) treatment goals than non-dog-owners (adjusted odds ratios [95% CI] of 0.93 [0.88-0.97], 0.91 [0.86-0.95], and 0.95 [0.90-1.00], respectively). There was no difference in the risk of all-cause death (adjusted hazard ratio [95% CI] 0.92 [0.81-1.04], dog owners versus not). CONCLUSION: Owning a dog when diagnosed with diabetes did not lead to better achievement of treatment goals or reduced mortality, but was in fact associated with a smaller reduction in HbA1c and reduced likelihood of achieving treatment goals., The author(s) declare financial support was received for the research, authorship, and/or publication of this article. KR was funded by a County Council of Östergötland international fellowship [grant number RÖ-601981] and the Rolf Luft Foundation for Diabetes Research Fellowship in Memory of Jeanette Bonnier. MW received an Australian National Health and Medical Research Council (NHMRC) [grant number APP1149987]. JC received research grants from the Australian National Health and Medical Research Council (NHMRC) and OR was funded by Västerbotten County Council, and Umeå University.

Introduction: Managing Type 2 Diabetes Mellitus (T2DM) demands innovative approaches beyond conventional treatment. This article explores the integration of surgical and medical strategies, emphasizing the efficacy of metabolic surgery and an interdisciplinary approach. From improving glycemic control to reducing comorbidities, this approach promises to transform care for refractory T2DM patients. Development: Addresses the complexity of managing Type 2 Diabetes Mellitus (T2DM) through surgical and medical strategies. In conventional treatment, we highlight medications like metformin and combined approaches. Metabolic surgery, including procedures like gastric bypass, shows substantial improvements in glycemic control and comorbidities. Practical applications: Involve improving glycemic control and reducing comorbidities in Type 2 Diabetes Mellitus patients. Conclusions: Integrating surgical and medical strategies in Type 2 Diabetes Mellitus management holds promising advancements. This comprehensive approach, supported by an interdisciplinary approach, not only optimizes glycemic control but also enhances the quality of life for patients., Introducción: La gestión de la Diabetes Mellitus Tipo 2 (DM2) requiere enfoques innovadores que vayan más allá del tratamiento convencional. Este artículo explora la integración de estrategias quirúrgicas y médicas, destacando la eficacia de la cirugía metabólica y el enfoque interdisciplinario. Desde la mejora del control glucémico hasta la reducción de comorbilidades, este enfoque promete transformar la atención a pacientes con DM2 refractaria. Desarrollo: Aborda la complejidad de gestionar la Diabetes Mellitus Tipo 2 (DM2) mediante estrategias quirúrgicas y médicas. En el tratamiento convencional, destacamos medicamentos como la metformina y enfoques combinados. La cirugía metabólica, con procedimientos como el bypass gástrico, muestra mejoras sustanciales en el control glucémico y comorbilidades. Un enfoque interdisciplinario, evaluando cuidadosamente candidatos y considerando factores psicológicos, emerge como crucial. Aplicaciones prácticas: Incluyen la mejora del control glucémico y la reducción de comorbilidades en pacientes con Diabetes Mellitus Tipo 2. Conclusiones: La integración de estrategias quirúrgicas y médicas en la gestión de la Diabetes Mellitus Tipo 2 promete mejoras significativas. Este enfoque integral, respaldado por un abordaje interdisciplinario, no solo optimiza el control glucémico, sino también mejora la calidad de vida de los pacientes.

40 p. -- Bibliogr.: p. 19-22, Introducción: la diabetes mellitus 2 (DM2) es el tipo de diabetes más prevalente. La educación diabetológica, realizada por enfermería, es clave para evitar el desarrollo de complicaciones agudas y crónicas. Desde hace varios años se pauta la práctica regular de ejercicio aeróbico por sus beneficios en el control glucémico. Pero algunos estudios sugieren que los ejercicios de resistencia producen mayores beneficios que los aeróbicos. Objetivo: identificar el efecto del ejercicio de resistencia, solo o combinado con ejercicio aeróbico, en el nivel de hemoglobina glicosilada (HbA1c) en personas con DM2. Metodología: se realizó una revisión crítica de la literatura. Se llevó a cabo una búsqueda en Medline, Cinalh, Cuiden, Cocranhe library, PEdro, Sportdiscus y WOS y una búsqueda manual en Google Académico y Science direct. Los filtros aplicados fueron artículos publicados en los últimos 10 años en inglés y castellano, con acceso a resumen y texto completo. Se identificaron 841 artículos y se incluyeron en la revisión 16. Resultados: en 7 estudios se observó una reducción significativa de la HbA1c tras la ejecución de ejercicios de resistencia, y en la mayoría de ellos (5 investigaciones) las personas tenían una HbA1c inicial >7,5%. En 7 estudios se observó una reducción significativa de la HbA1c tras la realización de ejercicios de resistencia combinados con aeróbicos, con independencia del nivel inicial de HbA1c. Conclusión: el ejercicio de resistencia puede ser beneficioso para mejorar el control glucémico en personas con DM2 que tienen una HbA1c inicial superior a 7,5%, pero combinado con ejercicio aeróbico se puede obtener el mismo beneficio con independencia del nivel inicial de dicho parámetro.

Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. The goal of the study was to determine the link between lipid damage (MDA), enzymatic and non-enzymatic antioxidants, and various biochemical indicators in patients with NAFLD who had diabetes and obese adults. This study included comparison 100 patients and healthy control group, aged 18 to 75 years while BMI range from 15.9 to 50.9 Kg/m2. Enzymatic antioxidants (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx)); non-enzymatic antioxidants (GSH, vit E and direct and total bilirubin); lipid damage (malondialdehyde (MDA)), and biochemical markers (liver enzyme (ALT, AST & ALP), glucose, Albumin and lipid profile in the serum samples were measured. The NAFLD with DM and obese adult showed increasing of glucose, BMI, ALT, AST, ALP, T. CHOL, LDL, TG, VLDL, SOD and CAT levels excepted HDL. It showed a decreasing. Whereas decrease of Vitamin E and ALB levels compared to control group. Our findings show that the serum enzymatic anti-oxidant, non-enzymatic anti-oxidant, dyslipidemia and liver disfunction and vitamin E decrease are tightly and independently related to NAFLD with diabetes and obese adult status.

Aims: Common Psychiatric Disorders (CPDs) are associated with the development of overweight and obesity, the strongest risk factors for the onset and maintenance of Type 2 Diabetes mellitus (T2D). To the best of our knowledge, this is the first study to assess the prevalence of CPDs in patients with T2D in Italy. Methods: This is a monocentric cross-sectional study; n = 184 T2D patients were screened for CPDs using the Patient Health Questionnaire (PHQ). Primary outcome was to evaluate the prevalence of CPDs. To assess association between CPDs and risk factors, we have utilized univariable logistic regression models. Results: 64.1% were men, median age was 67 (59–64) and median BMI 27 (25–30) kg/m2. The 42.9% tested positive for one or more mental disorders, 25.6% for depression. Patients with higher BMI (p = 0.04) had an increased likelihood of testing positive to the PHQ. Patients who had implemented lifestyle changes (p < 0.01) and were aware that mental health is linked to body health (p = 0.07) had a reduction in the likelihood of testing positive. Conclusions: Prevalence of CPDs in T2D patients is higher than in the general population. Since CPDs favor the onset and subsistence of T2D, integrated diabetic-psychiatric therapy is required for improvement or remission of T2D in patients with comorbid CPDs.

Background: There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support. Objective: The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems. Methods: This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 “testing and evaluation” phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening. Results: The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative appro

Background: Diabetes mellitus type 2 (DMT2) is a chronic disease and is one of the most common and rapidly growing diseases globally. Treatment and self-care of the disease requires plenty of lifestyle changes. The risk for physical diseases and mental illness is higher for people living with DMT2. The quality of life can be affected from chronic diseases. Aim: The purpose of this study was to describe people's experiences of living with DMT2. Method: Literature study with a qualitative approach. The results consist of ten qualitative research articles which were analysed with thematic analysis method. Results: Three main themes and six subthemes were identified. The first main theme: To manage Emotions included Fear from disease and Acceptance/normalization of living with a disease as subthemes. Second main theme: The need of support included Family and friends, and Knowledge of disease and selfcare. Third main theme: To be faced with lifestyle changes included Restrictions: Diet and physical activity, and Medication and blood sugar controls as subthemes. Conclusion: Based on the results, people had many similar experiences globally and felt that their lives and quality of life had been affected after they had been diagnosed with DMT2., Bakgrund: Diabetes mellitus typ 2 (DMT2) är kronisk sjukdom som är en av de snabbast växande och vanligaste folksjukdomarna globalt. Behandling och egenvård av sjukdomen innebär flertalet livsstilsförändringar. Risken för fysisk och psykisk ohälsa är större för personer med DMT2. Livskvaliteten kan påverkas av kroniska sjukdomar. Syfte: Syftet med denna studie var att beskriva erfarenheter av att leva med DMT2. Metod: Litteraturstudie med kvalitativ ansats. Resultatet grundar sig på tio vetenskapliga artiklar som analyserades via tematisk analysmetod. Resultat: Tre huvudteman och sex subteman identifierades. Det första huvudtemat, Att hantera känslor inkluderade Rädsla av sjukdom samt Acceptans/normalisering av att leva med sjukdom som subteman. Andra huvudtemat, Att vara i behov av stöd inkluderade Familj och vänner samt Kunskap om sjukdom och egenvårdshantering som subteman. Det tredje huvudtemat, Att ställas inför livsstilsförändringar inkluderade Restriktioner: Kost och fysisk aktivitet samt Medicinering och blodsockerkontroller som subteman. Slutsats: Utifrån resultatet hade personer många liknande erfarenheter globalt och upplever att deras liv och livskvalitet har påverkats efter att de hade fått diagnosen DMT2.