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Aims: To assess baseline and change after 26-weeks in health-related quality of life (HRQoL) among adults with type 2 diabetes mellitus (T2DM) initiating one of the new glucose lowering drugs (GLD) in daily practice., Methods: Inception cohort of patients who initiated one of dipeptidyl peptidase 4 inhibitors (DPP-4), glucagon-like peptide-1 analogues (GLP-1) or sodium-glucose cotransporter inhibitors (SGLT2) drugs. A baseline questionnaire collected socio-demographic and self-reported clinical data. HRQoL was assessed by the Euroqol-5D. Participants were divided into: (1) incident new users (INU) (who used for the first time one of the monitored GLD and had no current or prior experience with DPP-4/GLP-1/SGLT2) and (2) prevalent new users (PNU) (who had previously used at least one GLD of the monitored drug classes, but not the inception drug). Multivariate regression explored factors associated with a meaningful change in HRQoL., Results: 1303 patients. Over 26weeks, a mean positive change in the EQ-5D scores, were observed. No differences between INU and PNU were found. Participants with worse health conditions (e.g. presence and number of chronic diseases, obese) at baseline were more likely to experience larger improvements in HRQoL., Conclusions: Over 26-weeks, T2DM patients starting with, or switching to new GLD maintained or modestly increased their HRQoL., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Aims: This study aimed to characterize and estimate prevalence and frequency of mild to moderate hypoglycemia and potentially associated factors in a population of type 2 diabetes mellitus (T2DM) patients treated at ambulatory care level., Methods: HIPOS-PHARMA was a nationwide observational, cross-sectional, multicenter study conducted in community pharmacies, which surveyed T2DM patients treated for at least 3 months., Results: Overall, 233 pharmacies recruited 1890 patients (males: 50.6%) with mean 67.1 years. On average, participants reported having diabetes for 11.8 years. A total of 86.9% had at least one chronic illness or complication of diabetes, and 76.8% were usually followed in the primary care setting. Fifty eight percent were treated without a secretagogue or insulin. Overall prevalence of mild to moderate hypoglycemic episodes in the 3 months prior to recruitment was 17.8%. A 3.13% prevalence of severe hypoglycemia was observed in the last 12 months. Results suggested that men and patients on antihyperglycemic therapies excluding secretagogues or insulin were less likely to have mild to moderate hypoglycemic episodes., Conclusions: Mild to moderate hypoglycemic episodes were commonly reported, and factors like type of antihyperglycemic therapy, duration of disease and due complications may contribute. Almost half of episodes were not reported. Such factors should be considered in T2DM management., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Aims: To compare the temporal trends in the consumption patterns of glucose lowering drugs (GLD) between Portugal and the Netherlands from 2004 to 2013 and to examine possible reasons behind the cross-national variation found., Methods: All GLD (ATC pharmacological subgroup A10B) were selected for analysis. Consumption data were obtained for the 10-year period. Portuguese and Dutch drug estimates were obtained from nationwide databases., Results: The consumption of GLD increased in Portugal from 52.9 defined daily dose per 1000 inhabitants per day (DHD) in 2004 to 70.0 DHD in 2013 and in the Netherlands from 44.9 DHD in 2004 to 50.7 DHD in 2013. In Portugal, the use of fixed-dose combinations, especially with dipeptidyl peptidase-4 inhibitors (DPP-4) increased remarkably and in 2013 represented almost a quarter of total GLD consumption. In the Netherlands, the use of combinations was residual., Conclusions: The consumption of GLD rose over the 10-year period in both countries. However, Portuguese overall consumption and costs of GLD were higher. The differentially rapid uptake of DPP-4 inhibitors in Portugal was the main driver of the cost difference., (Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Background: Since 1993 the participation of Portuguese pharmacies to the national Syringe Exchange Programme (SEP) has remained high. However, no national guidelines or standard procedures are available regarding the provision of this service. We aimed to describe practices and attitudes toward syringe dispensing and other harm reduction strategies in Portuguese pharmacies., Methods: A cross-sectional survey was conducted using an anonymous self-administered questionnaire. All pharmacies in Portugal (n=2775) were invited to participate. The questionnaire addressed SEP ever involvement and discontinuation; injection equipment policies; problems and needs in service provision., Results: Participation rates were 69.6% among pharmacies involved in SEP and 42.7% in those not involved in the programme. Among current providers, 64.3% followed a strict "one-for-one" policy and 21.6% established limits on the number of syringes distributed. Syringe selling was reported by 76.2%. One-tenth of pharmacies supervised methadone consumption Problems in service provision were experienced by 12.8% of respondents. Need for increased training and improvement of referral pathways were frequently reported., Conclusions: Pharmacy-based harm reduction interventions in Portugal have tended to follow strict policies favouring conservative approaches. Training and feedback adaptation seem indispensable to avoid service discontinuation and boost an activity with an essential humanitarian dimension., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Equations to predict resting energy expenditure (REE) can be influenced by cultural and climatic factors. The purpose of this cross-sectional study was to evaluate the validity of the Harris-Benedict and Mifflin-St Jeor equations to predict REE in 48 healthy Puerto Rican adults (23 men, 25 women; aged 21 to 60 years, tested between January and March 2007) using indirect calorimetry as the criterion method for comparison. Weight, height, and skinfold thickness were measured. One-way analysis of variance was used to determine differences between the REE measured and predicted with the two equations, and independent t tests were used to detect differences between men and women. Linear and multiple regressions were conducted to determine relationships between the measured and predicted REE and to evaluate factors influencing REE. The REE predicted with Harris-Benedict and Mifflin-St Jeor were not statistically different from the REE measured with indirect calorimetry (mean±standard deviation: 1,555±268, 1,500±285, and 1,633±299 kcal/day, respectively; P=0.08). There was a strong correlation between the REE measured and predicted with Harris-Benedict and Mifflin-St Jeor (r=0.83, 0.87, respectively; P=0.0001). Mean REE was higher in men compared to women, and fat-free mass was the most influencing factor on REE. The Harris-Benedict and Mifflin-St Jeor are both valid equations for the prediction of REE in healthy Puerto Rican adults living in a tropical climate such as Puerto Rico. Both equations are appropriate for dietetics practitioners to use in assessing energy requirements in this population., (Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)