Search

Cardiorenal syndrome; Diabetes mellitus; Heart failure Síndrome cardiorrenal; Diabetes mellitus; Insuficiencia cardiaca Síndrome cardiorenal; Diabetis mellitus; Insuficència cardíaca Cardiorenal syndrome (CRS) is a pathology where the heart and kidney are involved, and the deterioration of one of them leads to the malfunction of the other. Diabetes mellitus (DM) carries a higher risk of HF and a worse prognosis. Furthermore, almost half of people with DM will have chronic kidney disease (CKD), which means that DM is the main cause of kidney failure. The triad of cardiorenal syndrome and diabetes is known to be associated with increased risk of hospitalization and mortality. Cardiorenal units, with a multidisciplinary team (cardiologist, nephrologist, nursing), multiple tools for diagnosis, as well as new treatments that help to better control cardio-renal-metabolic patients, offer holistic management of patients with CRS. In recent years, the appearance of drugs such as sodium-glucose cotransporter type 2 inhibitors, have shown cardiovascular benefits, initially in patients with type 2 DM and later in CKD and heart failure with and without DM2, offering a new therapeutic opportunity, especially for cardiorenal patients. In addition, glucagon-like peptide-1 receptor agonists have shown CV benefits in patients with DM and CV disease in addition to a reduced risk of CKD progression.

Hiperglucemia; Diabetes; Sarcopenia Hyperglycemia; Diabetes; Sarcopenia Hiperglucèmia; Diabetis; Sarcopènia La sarcopenia se describe como una afección multidimensional que afecta negativamente a la masa muscular, la fuerza muscular y el rendimiento físico. La prevalencia de sarcopenia en personas con diabetes es muy superior a la de la población general, especialmente en individuos que presentan un estado nutricional deficiente. Tanto la sarcopenia como la desnutrición son condiciones susceptibles de intervención para mejorar el pronóstico clínico. El presente artículo describe los resultados del consenso de expertos y las respuestas de los panelistas sobre el manejo nutricional en la práctica clínica habitual de los pacientes con diabetes/hiperglucemia hospitalizados en planta (no críticos) con sarcopenia concurrente. Sarcopenia is a multidimensional condition that negatively affects muscle mass, muscle strength, and physical performance. The prevalence of sarcopenia in people with diabetes is much higher than that of the general population, especially in individuals with poor nutritional status. Both sarcopenia and malnutrition are conditions amenable to intervention to improve clinical prognosis. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with sarcopenia.

Diabetes; Surgery; Perioperative setting Diabetes; Cirugía; Periodo perioperatorio Diabetis; Cirurgia; Període perioperatori Las personas con diabetes tienen un riesgo elevado de requerir una intervención quirúrgica a lo largo de su vida y de tener complicaciones perioperatorias en caso de un control metabólico deficiente. La hospitalización representa un evento estresante que, unido a otros factores asociados a procedimientos diagnósticos y terapéuticos, conlleva un deterioro del estado nutricional de los pacientes. Se ha observado una asociación entre un estado nutricional deficiente y resultados adversos en pacientes quirúrgicos. El presente artículo describe los resultados del consenso de expertos y las respuestas de los panelistas sobre el manejo nutricional en la práctica clínica habitual de los pacientes con diabetes/hiperglucemia hospitalizados en planta (no críticos) en el periodo perioperatorio. People with diabetes are at high risk of requiring surgical intervention throughout their lives, and of perioperative complications in case of poor metabolic control. Hospitalization represents a stressful event that, together with other factors associated with diagnostic and therapeutic procedures, leads to a deterioration in the nutritional status of the patients. An association between poor nutritional status and adverse outcomes in surgical patients has been observed. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) in the perioperative setting.

Diabetes; Cáncer; Caquexia tumoral Diabetis; Càncer; Caquèxia tumoral Diabetes; Cancer; Tumoral cachexia La diabetes es una comorbilidad frecuente en pacientes con cáncer, ya que comparten factores de riesgo comunes. En la enfermedad oncológica, la presencia de caquexia tumoral representa un factor de mal pronóstico, que se ve agravado por un estado nutricional deficiente. Clínicamente, la caquexia se manifiesta como una reducción significativa del peso corporal, acompañado de cambios en la composición corporal y alteraciones en el equilibrio del sistema biológico, y causa una disfunción progresiva. El presente artículo describe los resultados del consenso de expertos y las respuestas de los panelistas sobre el manejo nutricional en la práctica clínica habitual de los pacientes con diabetes/hiperglucemia hospitalizados en planta (no críticos) con caquexia tumoral concurrente. Diabetes is a frequent comorbidity in cancer patients, since they share common risk factors. In cancer, the concurrence of cachexia represents a poor prognostic factor, which is aggravated by poor nutritional status. Clinically, cancer cachexia manifests as a significant reduction in body weight, accompanied by changes in body composition and alterations in the balance of the biological system, and causes progressive dysfunction. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with cancer cachexia.

Background During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. Objectives The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. Methods We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. Results Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p Conclusion Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.

Pacients diabètics; Atenció podològica; Despesa sanitària Pacientes diabéticos; Atención podológica; Gasto sanitario Diabetic patients; Podiatric care; Health expenditure La diabetis mellitus (DM) és una malaltia crònica del metabolisme, de prevalença creixent, que cursa amb hiperglucèmia deguda a una manca absoluta o relativa d’insulina. Deixada a la lliure evolució és causa important de morbiditat i mortalitat. Requereix atenció continuada que ha d’incloure aspectes d’educació en salut i apoderament de les persones afectades amb l’objectiu de millorar la qualitat de vida i reduir les complicacions associades. Es calcula que un 70% de les persones amb DM tipus 2 entre 14 i 80 anys té un bon control de la seva malaltia. Els peus són especialment vulnerables en les persones amb DM: qualsevol lesió, per petita que sigui, pot donar a trastorns greus. Per aquest motiu, és important revisar i cuidar els peus: La instrucció 05/2009 del CatSalut regula la implantació de l'atenció podològica a les persones diabètiques, com a prestació complementària a les prestacions comunes. La diabetes mellitus (DM) es una enfermedad crónica del metabolismo, aumentando la prevalencia, que con hiperglucemia debido a una falta relativa o absoluta de insulina. La izquierda para liberar la evolución es una causa importante de morbilidad y mortalidad. Requiere atención continua debe incluir aspectos de la educación en salud y empoderamiento de las personas afectadas con el objetivo de mejorar la calidad de vida y reducir las complicaciones asociado con. Se estima que el 70% de las personas con tipo 2 DM entre 14 y 80 años tiene un buen control de su enfermedad. Los pies son especialmente vulnerables en las personas con DM: cualquier lesión, no importa lo pequeño que puede ser, puede dar graves trastornos. Por esta razón, es importante revisar y cuidar los pies: la instrucción 05/2009 de CatSalut regula la implementación de la atención de podología para las personas con diabetes, como una disposición complementaria en beneficios públicos Diabetes mellitus (DM) is a chronic disease of the metabolism, increasing prevalence, which with hyperglycemia due to a relative or absolute lack of insulin. Left to free evolution is important cause of morbidity and mortality. Requires continued attention should include aspects of health education and empowerment of people affected with the aim of improving the quality of life and reduce complications associated with. It is estimated that 70% of people with type 2 DM between 14 and 80 years has a good control of their disease. The feet are especially vulnerable in people with DM: any injury, no matter how small it may be, can give serious disorders. For this reason, it is important to review and take care of the feet: the instruction 05/2009 of CatSalut regulates the implementation of the podiatry care for people with diabetes, as a complementary provision in public benefits.

Inhibidors del cotransportador sodi-glucosa 2 (SGLT2); Diabetis mellitus; Triple teràpia; Sodium-Glucose Cotransporter 2 Inhibitors; Diabetes Mellitus; Triple therapy; Inhibidores del cotransportador sodio-glucosa 2; Triple terapia Dapagliflozina és el primer principi actiu d'una nova classe d'antidiabètics orals que actua incrementant l'eliminació renal de glucosa per inhibició selectiva i reversible del cotransportador sodi-glucosa 2 (SGLT2). La seva acció és independent de la insulina.