Search

Phase angle (PhA) has been identified as a poor prognostic factor in patients with COVID-19. This study aimed to achieve a systematic review, where we discussed the potential role of PhA value as a prognostic marker of adverse clinical outcomes such as mortality and complication in hospitalized with SARS-CoV2 infection and established the strength of recommendations for use. A systematic literature review with meta-analysis was done in the main electronic databases from 2020 to January 2023. The selected articles had to investigate adverse consequences of the COVID-19 population and raw bioimpedance parameters such as PhA and published in peer-reviewed journals. GRADE tools regarded the quality of the methodology. The review protocol was registered in PROSPERO. Only eight studies, 483 studies, were eligible for the analysis. In general, differences in PhA were seen between the comparative study groups. Patients with a low PhA experienced poor outcomes. A low PhA was associated with a significantly increased mortality risk [RR: 2.44; 95% CI (1.20–4.99), p = 0.01; I2 = 79% (p = 0.0008)] and higher complications risk [OR: 3.47, 95% CI (1.16 – 10.37), p = 0.03; I2 = 82% (p = 0.004)] in COVID-19 patients. Our analysis showed four evidence-based recommendations on the prognostic value of PhA with two strong recommendations, one of moderate and another of low-moderate quality, for predicting mortality and complications, respectively. We recommend using PhA as a prognostic marker for mortality and complications in this population. Although the results are promising, future studies must identify the PhA cut-off to guide therapeutic decisions more precisely.Registration code in PROSPERO: CRD42023391044

Resumen Objetivo Proporcionar unas recomendaciones practicas para la evaluacion y el manejo de la hipoglucemia en pacientes con diabetes mellitus. Participantes Miembros del Grupo de Trabajo de Diabetes Mellitus de la Sociedad Espanola de Endocrinologia y Nutricion (SEEN). Metodos Las recomendaciones se formularon segun el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizo una busqueda sistematica en MEDLINE (PubMed) de la evidencia disponible para cada tema, y se revisaron articulos escritos en ingles y castellano con fecha de inclusion hasta el 28 de febrero de 2020. En este resumen ejecutivo incluimos la evidencia reciente incorporada desde 2013. Conclusiones El documento establece unas recomendaciones practicas basadas en la evidencia acerca de la evaluacion y manejo de la hipoglucemia en pacientes con diabetes mellitus.

The Southern Europe Atlantic Diet (SEAD) is the traditional diet consumed in the Northwestern region of the Iberian Peninsula: Galicia (Spain) and North of Portugal. These regions have geographical, climatic and cultural characteristics that had led them to develop their own dietary pattern. This dietary pattern integrated into its environment is based on fresh, local and seasonal products intake. In this diet there is a high intake of fish, seafood, cereals, potatoes, legumes, fruits, dairy products and vegetables. Meat, preferably lean meat, is consume moderately as well as eggs and wine. SEAD is more than a diet, it is a lifestyle where exercise, simples cooking techniques, respect for the traditions and pleasure of eating accompanied are constants. Although this pattern has been known for centuries, it did not begin to be define as such until the signing of "Baione Declaration" in 2006. Some bioactive compounds of SEAD had showed health benefits and protect against acute myocardial infarction. Data supports that SEAD is a sustainable diet. In the presented review, results of studies on the SEAD are presented and discussed. Also, a recent proposal of SEAD Index is reported. Therefore, SEAD should be considered as an excellent dietary pattern and lifestyle.

Dyslipidemia is commonly found in T1D adults and increases the risk of CVD. There is no research on dyslipidemia in T1D adults in Spain so far. The aim of the study was to evaluate the prevalence and the pattern of dyslipidemia and its relationship with other risk factors or comorbidities. Methods: A multicentric, cross-sectional study in Spain included 1252 adults with T1D who visited Diabetes Clinic from December 2017 to December 2018. Cut-off points for abnormal lipid levels (total cholesterol (TC) ≥200 mg/dL, LDL ≥130 mg/dL, HDL ≤35 mg/dL, and triglycerides (TG) ≥150 mg/dL) were taken from the Third Report of the National Cholesterol Education Program and the ADA. Dyslipidemia was defined by the presence of one or more abnormal serum lipid concentrations. Results: Among 1252 patients 50,3% were male. Median age 40,5+/-13 years old and the median duration of diabetes was 20+/-13 years. Median A1c 7,96+/-2,49% and BMI 25,7+/-4,6kg/m2 The overall lipid profile was TC 188+/-42 mg/dL, LDL 109+/-36 mg/dL, HDL 59+/-17 mg/dL and TG 96+/-96 mg/dL. The prevalence of dyslipidemia was 43,5%. The most frequent dyslipidemia found wash high TC (34,6%), followed by high LDL (26,6%), high TG (11,3%) and low HDL (1,8%). Comparison between the dyslipidemic (D) group and normolipidemic (No D) group age was significantly higher in the D group P< 0,001). The frequency of dyslipidemia was higher in male, current smokers and hypertension. There were no differences between the D and No D groups in terms of A1c, BMI, family background, hypoglycemic treatment or duration of diabetes. The prevalence of microvascular complications was higher in the D group (p< 0,0001), there were no differences in macrovascular complications. Conclusions: Our study was the first report of lipid data in Spanish T1D adults. We have shown that the overall lipid pattern was comparable to that in nondiabetic individuals. There is high prevalence of dyslipidemia which was associated with age, sex (male), smoking and comorbidities but not with glycemic control. Disclosure M. Rodriguez Carnero: None. D. Bellido Guerrero: None. C. Tejera: None. M. López de la Torre: None. A. Soto González: None. F.J. Escalada: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; Esteve, Lilly Diabetes. Speaker's Bureau; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. A. Hernandez-Mijares: None. L. Suarez Gutierrez: None. C. Morales: Other Relationship; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. L. Gutiérrez Carrasqu: None. A. Cadenas: Advisory Panel; Self; Janssen Pharmaceuticals, Inc. O. Díaz Trastoy: None. J. Amigó-Farran: None. I. Gonzalez molero: None. V. Bellido: None. F. Arrieta: None. F. Tinahones: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Regeneron Pharmaceuticals, Sanofi-Aventis. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Danone Nutricia Research, Lilly Diabetes, Novo Nordisk A/S, Regenerative Medical Solutions, Sanofi-Aventis.

Introduction: Cardiovascular disease (CVD) is the major cause of mortality in T1D. Lipid-lowering treatment (LLT) with statins prevent major cardiovascular events and dead in a broad spectrum of patients. However, evidence of CVD risks factors and its management are based on subgroup analyses and extrapolations of effects demonstrates in other populations. Objectives: The aim of the study was to analyze the differences between T1D adults on lipid-lowering treatment (T group) and without treatment (No T group). We pay special attention to CVD risk factors, comorbidities and which factors are associated with receiving lipid-lowering treatment. Research design and Methods: A multicentric, cross-sectional study in Spain included 1252 T1D adults who visited Diabetes Clinic from December 2017 to December 2018. Results: Among 1252 patients 344 were on LLT. In terms of lipid profile LDL (131 vs. 100 mg/dL), HDL (57 vs. 60 mg/dL), total cholesterol (213 vs. 178 mg/dL) and triglycerides (125 vs. 85 mg/dL) levels were statistically significant while compared between T and No T groups. T group was older (48 vs. 37 years old) and the median duration of diabetes was higher (25 vs. 18 years)than No T group (p< 0.000). BMI in T group was 27 kg/m2 higher than no T group (25 kg/m2) (p < 0,0001). There was a trend toward higher prevalence of microvascular (57% vs. 23,8%) and macrovascular complications (13,7% vs. 3,6%) in T group than in No T (p < 0,000). A positive association was found between sex (male), smoking, high blood pressure and to be on treatment. There were no differences between the T group and No T group in terms of A1c (A1c 7,90% vs. 7,99%) or fasting glucose (157 vs.161 mg/dl). Conclusions: This multicentric study shows that starting LLT is associated with LDL > 100 mg/dL, aged, sex (male), duration of diabetes, high BMI, comorbidities, smoking and a high blood pressure. Our results show compliance with the recommendations of 2014 AHA/ADA scientific statement type 1 diabetes mellitus and Cardiovascular Disease. Disclosure M. Rodriguez Carnero: None. D. Bellido Guerrero: None. C. Tejera: None. M. López de la Torre: None. A. Soto González: None. F.J. Escalada: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; Esteve, Lilly Diabetes. Speaker's Bureau; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. A. Hernandez-Mijares: None. L. Suarez Gutierrez: None. C. Morales: Other Relationship; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. L. Gutiérrez Carrasqu: None. A. Cadenas: Advisory Panel; Self; Janssen Pharmaceuticals, Inc. O. Díaz Trastoy: None. J. Amigó-Farran: None. I. Gonzalez molero: None. V. Bellido: None. F. Arrieta: None. F. Tinahones: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Regeneron Pharmaceuticals, Sanofi-Aventis. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Danone Nutricia Research, Lilly Diabetes, Novo Nordisk A/S, Regenerative Medical Solutions, Sanofi-Aventis.

Background and Aims: “T-Coach® program” is a telephone support platform for type 2 diabetes (T2D) on glargine U300 insulin. This study aimed to evaluate whether this program was effective in helping patients reach their optimal insulin dose. Materials and Methods: Both T2D patients who were initiating glargine U300 or requiring dose titration, enrolled in T-Coach® program, were included in the study. Telephone intervention was delivered by diabetes nurse educators and consisted of regular telephone sessions, aimed at achievement of target fasting blood glucose (FBG) and reinforce diabetes education. The optimal insulin dose (OID) was defined as the dose of Glargine U300 required to achieve target FBG. The primary outcome was whether a patient reached the OID dose within 6 months. Results: A total of 589 patients consented and were included in TCoach program®. Median age was 65.4±11.2 years; 51.8% men; BMI 30.3±6 kg/m2. Of them, 65.9% were already on basal insulin (17.7% on Glargine U300). Mean glargine U300 dose was 27.4±15.9 UI. Mean baseline HbA1c was 9.4±1.8%, and basal FBG was 215.2±66.2 mg/dL. Mean FBG target was 88.7-132.3 mg/dl. Of them, 77.6% reached their OID at 6 months (75.7% at 3 months, and 41.2% at 1 month), and they did so in an average of 2.2±1.8 months. Mean FBG levels fell from 215.2 mg/dL to 137.9 mg/dL, 117.9 mg/dL and 115.9 mg/dL at months 1,3 and 6, respectively. Mean glargine U300 dose increased from 27.4 UI to 30.4 UI at month 6. Knowledge and adherence questionnaires were given to the patients. Mean score in knowledge questionnaire increased from 4.8 to 7.6 after the program. Moreover, a satisfaction survey was completed by 208 patients. The program was very well graded, with an average score of 9.1 out of 10. Conclusion: The T-Coach® program is an effective way to help patients reach their optimal insulin glargine U300 dose, improves glycemic control and can be an effective support for diabetes education. Disclosure D. Bellido Guerrero: None. V. Bellido: None. C. Morales: Other Relationship; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. J. García: None. A. Muñoz-Garach: Speaker's Bureau; Self; Lilly Diabetes, Novo Nordisk A/S, Sanofi-Aventis. J.L. Fernandez Morera: None. B. Gonzalez Aguilera: None. M. López de la Torre: None. P. Fuentealba: Employee; Self; Sanofi.

Highlights • COVID-19 pandemic had affected to healthcare assistance for people with diabetes. • Data about effect of lockdown in glycemic control in people with diabetes at tome are scarce. • Use of glucose monitoring system help people with to diabetes to improve their self-care., SARS-CoV-2 pandemic had changed self-care in diabetes. The aim of this work is to analyze the effect of lockdown on glycemic control in people with type 1 diabetes on multiple daily insulin injections using FGM. During lockdown no deleterious effect on glycemic control measured by FGM.

Diabet. Med. 28, 731–740 (2011) Abstract Aims To assess blood glucose control and quality of health care provided to non-insulin-treated patients with Type 2 diabetes mellitus in routine clinical practice in Spain. Methods In this observational, retrospective, cross-sectional study, patients were grouped as either having good or suboptimal blood glucose control according to International Diabetes Federation or American Diabetes Association HbA1c goals. Clinical and socio-demographic data and compliance with the main standard level of care recommendations of the International Diabetes Federation were recorded during a routine visit. Correlates of glucose control were analysed by logistic regression. Results Many patients were grouped as having suboptimal control under International Diabetes Federation (61.9%) or American Diabetes Association (45.0%) criteria. The mean number of accomplished International Diabetes Federation recommendations (7.3 out of 11) was higher for endocrinologists (than for internists or primary care physicians), and significantly more patients under their care were in the good glucose control group (than with primary care physicians). More recommendations were associated with blood glucose control using International Diabetes Federation than American Diabetes Association criteria, demanding higher quality of health care for achieving stricter goals. Some recommendations were poorly observed, particularly those concerning patients’ education on diabetes, the prompt prescription of effective treatments and monitoring of complications. Diabetes complications were associated with being in the suboptimal control group. Patients’ education on diabetes and HbA1c monitoring were associated with being in the good control group. Conclusions These results demonstrate the need for improvement in the management of patients with non-insulin-treated Type 2 diabetes in actual clinical practice in Spain. Such improvement would entail a stricter adherence to International Diabetes Federation recommendations.

Resumen Introduccion En el diseno de un tratamiento integral y personalizado para el control del peso es necesario que la recogida de informacion que nos da el paciente obeso sobre sus habitos se haga de manera correcta. Nuestro objetivo fue la elaboracion y validacion de un nuevo cuestionario de habitos alimentarios para pacientes obesos y con sobrepeso que pudiera ser utilizado en la clinica. Material y metodos La elaboracion y validacion del nuevo cuestionario se realizo a traves de un proceso en el que primero se analizo un cuestionario ya existente; en segundo lugar se elaboro el nuevo cuestionario incluyendo nuevos items, y en tercer lugar se elaboraron baremos para su interpretacion en la clinica. Se valoro la validez de constructo mediante un analisis factorial. Se analizo la fiabilidad de consistencia interna. Resultados Se confirmaron la validez y fiabilidad del nuevo cuestionario. Los valores de las respuestas de los pacientes al nuevo cuestionario se relacionan con variables como la edad, el sexo, el indice de masa corporal, y con el hecho de estar o no en tratamiento para la hipertension arterial, la diabetes mellitus o la dislipemia. Conclusion La validez y fiabilidad de este cuestionario y los baremos que facilitan su interpretacion lo hacen un instrumento util para la valoracion inicial y el seguimiento de la modificacion de habitos nutricionales en respuesta al tratamiento tanto de manera individual como colectiva a la poblacion espanola.

OBJECTIVE: For many patients with type 2 diabetes, oral antidiabetic agents (OADs) do not provide optimal glycaemic control, necessitating insulin therapy. Fear of hypoglycaemia is a major barrier to initiating insulin therapy. The AT.LANTUS study investigated optimal methods to initiate and maintain insulin glargine (LANTUS, glargine, Sanofi-aventis, Paris, France) therapy using two treatment algorithms. This subgroup analysis investigated the initiation of once-daily glargine therapy in patients suboptimally controlled on multiple OADs. RESEARCH DESIGN AND METHODS: This study was a 24-week, multinational (59 countries), multicenter (611), randomized study. Algorithm 1 was a clinic-driven titration and algorithm 2 was a patient-driven titration. Titration was based on target fasting blood glucose < or =100 mg/dl (< or =5.5 mmol/l). Algorithms were compared for incidence of severe hypoglycaemia [requiring assistance and blood glucose 1 OAD. Incidence of severe hypoglycaemia was 1 OAD (-1.7%, p < 0.001; algorithm 1 -1.5% vs. algorithm 2 -1.8%; p = 0.001). CONCLUSIONS: This study shows that initiation of once-daily glargine with OADs results in significant reduction of HbA(1c) with a low risk of hypoglycaemia. The greater reduction in HbA(1c) was seen in patients randomized to the patient-driven algorithm (algorithm 2) on 1 or >1 OAD.

Resumen Objetivo Proporcionar unas recomendaciones practicas para la evaluacion y el manejo de la hipoglucemia en pacientes con diabetes mellitus. Participantes Miembros del Grupo de Trabajo de Diabetes Mellitus de la Sociedad Espanola de Endocrinologia y Nutricion (SEEN). Metodos Las recomendaciones se formularon de acuerdo al sistema Grading of Recommendations, Assessment, Development, and Evaluation para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizo una busqueda sistematica en MEDLINE (PubMed) de la evidencia disponible para cada tema, y se revisaron articulos escritos en ingles y castellano con fecha de inclusion hasta el 15 de febrero de 2013. Para las recomendaciones acerca del uso de farmacos, se consideraron tratamientos aprobados por la Agencia Europea de Medicamentos con esa misma fecha. Tras la formulacion de las recomendaciones estas se discutieron conjuntamente por el Grupo de trabajo. Conclusiones El documento establece unas recomendaciones practicas basadas en la evidencia acerca de la evaluacion y manejo de la hipoglucemia en pacientes con diabetes mellitus.