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Objetivo: construir e validar o guia de aplicação da Dinâmica do Betinho para mediar as ações de educação em saúde com crianças e adolescentes que convivem com Diabetes Mellitus Tipo 1. Método: estudo metodológico realizado em três etapas: revisão de literatura, construção do guia, validação do conteúdo em ambiente virtual e em âmbito nacional. Participaram especialistas da área da saúde por meio de um questionário. Aplicou-se análise estatística descritiva e cálculo do Índice de Validade de Conteúdo (IVC). Resultados: da revisão emergiram 14 temas. Após a construção configurou-se a primeira versão; na etapa de validação obteve IVC de 0,83. As sugestões foram utilizadas na versão final. Conclusão: o guia foi considerado adequado e poderá ser usado quando da aplicação da Dinâmica do Betinho, que é um recurso tecnológico interativo e lúdico.

O Diabetes Mellitus (DM) é um distúrbio metabólico caracterizado por hiperglicemia persistente decorrente da deficiência na produção de insulina. No Brasil, 11, 4 % da população, com idades entre 20 e 79 anos, têm o diagnóstico. Nessa perspectiva, a bomba de infusão é um recurso terapêutico que tem contribuído para a obtenção de melhor qualidade de vida do DM1. Objetivo: Identificar, na literatura, a utilização da bomba de infusão de insulina no tratamento do Diabetes Mellitus tipo 1. Método: Revisão integrativa, realizado no período de junho a outubro de 2022, através de artigos publicados na íntegra entre 2016 e 2021, nas seguintes bases de dados: PubMed, Medline, Lilacs Science e Science Direct. Resultados: Obteve-se uma amostra de 20 artigos. Foi confirmado nos estudos que o uso da terapia com a bomba de insulina no tratamento da patologia trouxe melhoria para o tratamento, uma vez que ocorre a redução da hemoglobina glicada, demonstrando um melhor controle glicêmico e assim, trazendo qualidade de vida ao usuário. Por outro lado, o uso da terapia representa desvantagens para algumas pessoas, uma vez que se sentem limitadas a estarem permanentemente conectadas a um aparelho. Considerações finais: O uso das inovações tecnológicas no tratamento do DM1 tem o potencial de contribuir para adesão e prevenção de complicações, nesse intuito é de grande valia o conhecimento e domínio dos profissionais enfermeiros independentes da área e faixa etária de atuação.

Objective: To validate the Inventory of Teachers' Negative Attitudes towards the Care of Students with Diabetes Mellitus type 1 (INAPAD) and to study its reliability using Cronbach's Alpha and McDonald's Omega coefficients. Methods: This study describes the design and validation process of the INAPAD nursing scale in a sample of 382 teachers in the stages of Early Childhood Education, Primary Education, Compulsory Secondary Education, Baccalaureate and Vocational Training in a Spanish province. In order to validate the INAPAD, its reliability has been studied using Cronbach's Alpha and McDonald's Omega Coefficients. Hence, the construct validity has been evaluated through exploratory factor analysis by principal components and varimax rotation. Results and conclusion: The findings obtained inform the viability of the INAPAD to be used as an effective instrument for the diagnosis of prejudice or predisposition of educators towards the care of learners with type 1 DM and for the prediction of the success of psycho-pedagogical measures and of the care for children and adolescents with diabetes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Type 2 polyglandular autoimmune syndrome is a rare condition characterized by at least two glandular failures induced by autoimmunity, which always includes Addison's disease, plus type 1 diabetes mellitus and/or autoimmune thyroid diseases. CLINICAL CASE: A 38-year-old female patient with a history of type 1 diabetes mellitus who was admitted to Internal medicine service with a diagnosis of "septic shock of urinary origin", without elevation of acute phase reactants or data of systemic inflammatory response, with gastrointestinal symptoms, plus hyperchromic lesions in mucosa, electrolyte disturbance sodium 119.13 mEq/L, potassium 6.1 mEq/L, cortisol levels 1.63 µg/dL and antithyroperoxidase titers greater than 2000 ng/dL, leading to a diagnosis of autoimmune polyglandular syndrome type II. CONCLUSIONS: Autoimmune polyglandular syndrome should be considered in all patients with primary glandular disease, as in this case, with the purpose of perform a timely diagnosis, treatment, and follow-up of this affection to avoid fatal complications such as adrenal crises, present in this case. [ABSTRACT FROM AUTHOR]

Foundation: the support of family members and the health team for parents caring for their diabetic children is essential for facing with the changes that this disease causes in family dynamics.Objective: to describe the perception of parent caregivers about family support and Health Systems at the beginning of their children with type 1 diabetes mellitus.Methods: qualitative descriptive study carried out through semi-structured interviews with four parent caregivers of children with a diagnosis of type 1 diabetes. Informed consent was carried out via Google forms and the interview was via the ZOOM platform. The interviews lasted 30 minutes. The analysis of the interviews was carried out using the ATLAS.ti version 22 program.Results: the beginning of the children's illness was received by parents with much confusion and lack of knowledge. Regarding the support networks, the parents declared loneliness in the experience of caring for the children and, in relation to the health teams, they reported that it is focused on the basic care that they had to fulfill, such as food and hygiene, glycemic control, with absence of concern for emotional support.Conclusions: the support needs from health teams to parent caregivers, beyond disease control, is an explicit need from the evidence, which has not yet been considered by Health Systems. Support must go beyond the family, with important action by health professionals and the entire context in which children are inserted, to contribute to adequate management of the disease.

Objective: To perform a systematic review of randomized controlled trials, evaluating the effect of probiotics, prebiotics or symbiotics supplementation on glycemic and inflammatory control in children with Type 1 Diabetes Mellitus (T1DM). Data source: The Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Clinical Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO) databases were searched. Randomized clinical trials of pediatric patients with DM1 using probiotics, prebiotics or symbiotics were included, regardless of year or language of publication. Studies that did not evaluate glycated hemoglobin (HbA1c) were excluded. Metabolic results (HbA1c, total insulin dose and C-peptide) and inflammatory control [interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ)] during probiotic supplementation or similar, related to modification of the intestinal microbiota, were analyzed. PROSPERO ID: CRD42022384485. Data synthesis: Five studies were selected for a systematic review. Regarding metabolic markers, only one of the articles that analyzed HbA1c showed a significant decrease (p=0.03) in the intervention group. One study identified a reduction in the total dose of insulin and increased C-peptide levels. Regarding the evaluation of inflammatory parameters (IL-10, TNF-α, INF-γ), there were no statistical relevant modifications. Conclusions: Current data from the literature were not conclusive in identifying an improvement in glycemic control and did not observe changes in inflammatory parameters with the use of probiotics, prebiotics or symbiotics in pediatric patients with T1DM. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Foundation: the support of family members and the health team for parents caring for their diabetic children is essential for facing with the changes that this disease causes in family dynamics. Objective: to describe the perception of parent caregivers about family support and Health Systems at the beginning of their children with type 1 diabetes mellitus. Methods: qualitative descriptive study carried out through semi-structured interviews with four parent caregivers of children with a diagnosis of type 1 diabetes. Informed consent was carried out via Google forms and the interview was via the ZOOM platform. The interviews lasted 30 minutes. The analysis of the interviews was carried out using the ATLAS.ti version 22 program. Results: the beginning of the children's illness was received by parents with much confusion and lack of knowledge. Regarding the support networks, the parents declared loneliness in the experience of caring for the children and, in relation to the health teams, they reported that it is focused on the basic care that they had to fulfill, such as food and hygiene, glycemic control, with absence of concern for emotional support. Conclusions: the support needs from health teams to parent caregivers, beyond disease control, is an explicit need from the evidence, which has not yet been considered by Health Systems. Support must go beyond the family, with important action by health professionals and the entire context in which children are inserted, to contribute to adequate management of the disease. [ABSTRACT FROM AUTHOR]

La pandemia por SARS-CoV-2 constituyó una emergencia de salud pública de preocupación internacional sin precedentes en el siglo XXI. Provocó una crisis histórica con impacto en el bienestar y en el desarrollo en todas las sociedades del mundo, generando profundos cambios en los órdenes político, social, económico y sanitario. Como toda crisis, demostró las fortalezas y debilidades a las que las sociedades están expuestas. El extraordinario desarrollo de la biología molecular, con logros sin precedentes, posibilitó que los científicos, al mes del primer caso, secuenciaran el genoma del virus y lo publicaran en línea para dar posibilidad a que el mismo fuera usado por los distintos laboratorios del mundo con fines de investigación y diagnóstico, mientras comenzó la carrera contrarreloj para lograr la fórmula de las vacunas que llegaron en menos de un año. Adicionalmente, Internet se convirtió en una aliada fundamental para dar respuestas en salud, educación y contactos sociales.

Resumo Objetivo Identificar os fatores que facilitam ou dificultam a construção da autonomia na adolescência através da experiência de jovens adultos com diabetes tipo 1 e seus pais. Métodos Estudo de natureza qualitativa, descritiva e exploratória. Foram realizadas duas entrevistas de grupo focal, uma com nove jovens adultos peritos na gestão de sua doença e outra com sete pais. Para análise dos dados, foram usados análise de conteúdo temática e categorial, com particularidades de entrevista de grupo focal, e recurso ao software NVIVO 12. Resultados Emergiram duas grandes categorias e dez subcategorias relativas aos fatores que facilitaram (sistemas de suporte, conhecimentos, alimentação, bomba de insulina, responsabilização precoce pela gestão da terapêutica, características dos jovens), e dificultaram (regime terapêutico, estigma, atitude dos profissionais de saúde, características dos jovens, conhecimento) o desenvolvimento da autonomia na gestão da doença. Conclusão A autonomia na gestão do diabetes envolve vários desafios aos adolescentes, o que requer adequação de atitudes e intervenções de profissionais. Além da gestão tradicional da condição de saúde, é essencial abordar temas relacionados com a socialização dos adolescentes, procurando estratégias inovadoras que promovam o coping e a qualidade de vida. Os resultados deste estudo possibilitam refletir sobre a relação terapêutica com os adolescentes, salientando a importância de individualizar cuidados e respostas inovadoras às suas necessidades específicas.

Fundamento: en diversas enfermedades crónicas, el apoyo social puede influir significativamente en la adhesión al tratamiento, la gestión de la enfermedad y el bienestar emocional. Objetivo: analizar la relación entre el apoyo social percibido y la eficacia de la autogestión del tratamiento de la diabetes en jóvenes. Método: se llevó a cabo un estudio descriptivo, correlacional de corte transversal en dos clínicas de diabetes del norte y centro de la ciudad en el período de febrero a abril de 2023. Se realizó un muestreo selectivo. El estudio comprendió la evaluación de un grupo de 100 jóvenes diabéticos de 16 a 18 años. La técnica empleada para la recopilación de los datos fue la encuesta. Se utilizaron el Cuestionario de Apoyo Social y el Cuestionario de Autogestión de la Diabetes para caracterizar la muestra. Se realizaron pruebas cuantitativas para la medición de la hemoglobina glucosilada como indicador médico. Los resultados se analizaron estadísticamente mediante pruebas no paramétricas y análisis de varianza con el paquete estadístico SPSS 25.0. Resultados: el análisis de los resultados de las pruebas no reveló diferencias significativas en el apoyo social entre los pacientes con alto y bajo autocontrol. Los pacientes con mal resultado del tratamiento percibieron menos red de apoyo social, pero estaban más satisfechos que los pacientes con buen control de la diabetes, además, la duración de la morbilidad de la diabetes fue moderada y negativamente correlacionada con la red de apoyo y el grado de satisfacción con la ayuda recibida. Conclusiones: aunque se esperaba que los pacientes con malos resultados terapéuticos recibieran menos apoyo, los resultados mostraron que ambos grupos recibían la misma cantidad de apoyo y estaban igualmente satisfechos con él.

El conocimiento de los mecanismos etiopatogénicos de la diabetes mellitus tipo 1 (DM1) y la posibilidad de identificar en estadios tempranos individuos en riesgo de desarrollar la enfermedad (fase presintomática o prediabetes 1), han sido las bases para los estudios de prevención por más de tres décadas. A partir de la aprobación del uso teplizumab (TPB) por la Food and Drug Administration (FDA) en personas con riesgo de desarrollar DM1, la Sociedad Argentina de Diabetes ha resuelto comisionar a un grupo de expertos para elaborar una toma de posición al respecto. En este sentido, se responderán las siguientes preguntas: ¿Cuáles son las determinaciones inmunológicas que se utilizan en la predicción de la DM1? ¿Cuál es el valor predictivo positivo, la sensibilidad y la especificidad de los autoanticuerpos? ¿Está indicada la predicción en DM1? ¿En qué grupo? ¿Qué es TPB? ¿Cuál es la eficacia farmacológica y cuáles son los efectos adversos? En la actualidad el TPB está aprobado para retrasar el desarrollo de la DM1 en personas en estadio 2 de prediabetes. La población considerada de riesgo para estudios de predicción son los familiares de primer grado de pacientes con DM1. Si bien la predicción y prevención con TPB no constituyen una recomendación universal, su empleo puede ser considerado en casos individuales cuando los pacientes sean identificados en estadio 2 de prediabetes tipo 1.

La diabetes mellitus 1 (DM1) es una enfermedad autoinmune órgano-específica que resulta de la destrucción crónica inmunomediada de las células β productoras de insulina y que afecta a más de 14 millones de personas en el mundo. Es un proceso progresivo caracterizado por una fase preclínica de evolución asintomática variable, con la aparición de múltiples autoanticuerpos que preceden al desarrollo de la disglucemia y, posteriormente, por una fase clínica con los síntomas cardinales típicos que contribuyen al diagnóstico. Aunque la insulina se descubrió hace un siglo y el desarrollo de nuevas tecnologías para administrar y monitorear el tratamiento ha permitido reducir la tasa de complicaciones y mejorar la calidad de vida de las personas con DM, la enfermedad aún es incurable. Los pacientes requieren administrarse múltiples inyecciones al día o sistemas de infusión continua de insulina para mantener niveles aceptables de glucemia. Y, a pesar de estos avances en los monitoreos y tratamientos intensivos, la mayoría no alcanza los objetivos metabólicos. La carga de vivir con DM es considerable para el paciente, la familia y la sociedad.

Copyright of RIIS: Revista de Investigação & Inovação em Saúde is the property of RIIS: Revista de Investigacao & Inovacao em Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: desenvolver, validar e implementar tecnologia educativo-terapêutica, no formato de protocolo institucional padrão, destinada ao cuidado da criança com diabetes mellitus tipo 1. Método: estudo metodológico, realizado em hospital público no Distrito Federal, participaram sete enfermeiros na validação, cinco crianças e familiares, na implementação, entre agosto/2021 e outubro/2022. Realizou-se validação de maneira on-line, utilizado instrumento de escala do tipo Likert e análise pelo Índice de Validade de Conteúdo e Coeficiente de Correlação Intraclasse. Na sessão educação em saúde, de maneira presencial, foram realizadas entrevistas e anotações no diário de campo. Resultados: tecnologia elaborada apresentou assuntos relacionados aos cuidados diários de crianças e à doença diabetes mellitus. A validação alcançou um índice de concordância de 0,78%, coeficiente de correlação de 0,525. A implementação identificou potencialidades e fragilidades relacionadas no cuidado da saúde. Conclusão: considerou-se o protocolo abrangente, promovedor na adesão ao tratamento subsidiando cuidado com qualidade e segurança.

O objetivo foi analisar o perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19. Trata-se de um estudo transversal com dados oriundos da websurvey DIABETESvid que ocorreu nos meses de setembro e outubro de 2020. Verificou-se que 45 participantes recorreram à telefarmácia, sendo que 55,6% eram do sexo masculino, 42,2% tinham idade compreendida entre 18 e 34 anos e 46,7% estudaram 12 ou mais anos. Além disso, 48,9% autorreferiram diabetes mellitus tipo 1. A maioria usava insulina (55,6%) e obteve os medicamentos para o diabetes em farmácias do sistema público de saúde (60%). Ademais, as pessoas que tiveram o diagnóstico de covid-19 buscaram mais pela telefarmácia (RP=2,20; IC95% 1,23–3,94). Sabe-se que os medicamentos são essenciais para o tratamento do diabetes. Logo, no período estudado em que se preconizava o distanciamento físico, os participantes apropriaram-se da telefarmácia a fim de obter a integralidade do cuidado.

These recommendations seek to provide a safety framework for the prescription of physical activity in children and adolescents with DM1, considering the evaluation of the situations that may arise before, during and after the practice of physical activity. It includes therapeutic strategies on the type of exercise, intensive capillary glycemic control or through the use of continuous glucose monitoring (CGM) and the adequacy of insulin therapy and carbohydrate intake. It is prioritized that to optimize the benefits of exercise as part of the treatment of DM1, a complete and constant diabetes education is important, provided by an interdisciplinary team trained in the comprehensive management of children and adolescents with DM1.

Background: Studies show that among the drugs most commonly used in judicial litigation in Brazil, are those used to treat diabetes mellitus, especially insulin analogues. Objective: Evaluate the use of the Unified Health System (SUS) by patients with type 1 diabetes mellitus (T1DM), who receive insulin analogues through judicial action, before and after this process. Method: In a retrospective longitudinal observational study, secondary data was used from these patients in Minas Gerais, Brazil, in 2018. Socio-demographic information was collected and related to the follow-up of these patients in the SUS. The McNemar χ2 test was used to compare the proportions of the variables. Results: Of the 89 patients analyzed, women (53.9%) were predominant. Most patients were aged between 20 and 39 years (52.8%), and more than half, 55.1%, use only a private health system. After the judicial action, there was a significant increase (p <0.05) in the number of patients who had consultations in primary health care (from 19.1% to 30.3%) and emergency medical appointments (from 1.1% to 9.0%). Conclusion: It is observed that the majority of patients with T1DM via judicial action in the SUS are not monitored by this health system through examinations, consultations, and hospitalizations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: La Diabetes Mellitus Tipo 1 es una de las enfermedades crónicas con mayor prevalencia en la adolescencia, es una condición caracterizada por los altos niveles de glucosa en el torrente sanguíneo, consecuente a la disfunción del páncreas, su abordaje depende de una variedad de factores que sumandos al tratamiento farmacológico facilitan un mejor control metabólico y la reagudización de la enfermedad. Objetivo: determinar los factores asociados a la adherencia del tratamiento de la DM1 en adolescentes, publicados en la literatura científica durante el periodo 2017 a 2022. Metodología: se realizó una revisión de alcance siguiendo el enfoque de cinco etapas, sugerido por Arksey y O’Malley, así como también, utilizando el método PRISMA. Resultados: Se revisaron 14 artículos científicos, los cuales permitieron determinar que entre los factores asociados a la adherencia del tratamiento de la DM1 se encuentran los relacionados con la salud mental del adolescente, la red de apoyo familiar, el régimen alimentario, los hábitos sedentarios, la desescolarización, el estrato social y los hábitos del sueño. Conclusión: la adherencia del tratamiento de la Diabetes Tipo 1 (DM1), en la población adolescente, depende de diferentes factores como la depresión y/o estrés, el régimen alimentario inadecuado, las prácticas sedentarias y algunas dinámicas sociofamiliares de la persona, los cuales, sumados a los cambios evolutivos propios de la adolescencia, determinan en gran medida el control o la complicación de la enfermedad.

Objetivo: Evaluar, a lo largo de un seguimiento de 79,2 meses, el comportamiento de la densidad mineral ósea (DMO) determinada mediante Densitometría Axial Computarizada (DXA), la densidad mineral ósea volumétrica (DMOvol) y su relación con los datos antropométricos, junto con los parámetros relativos al metabolismo óseo (calcio, fósforo, fosfatasa alcalina, parathormona (PTH) y vitamina D (25-OH-D3)) en una población infantil con Diabetes Mellitus Tipo 1 (DM1) sin complicaciones microvasculares y un grupo control de referencia de similares características. Material y métodos: Inicialmente, se realizó un estudio transversal en 40 niños diabéticos (edad media 9,4±2,8 años) y 108 controles (9,3±1,5 años) para valorar las posibles diferencias entre ambas poblaciones. 26 pacientes del grupo diabético inicial, fueron reevaluados tras 79,2 meses de seguimiento. Resultados: Se observó que, al inicio, la masa ósea fue similar en los diabéticos y controles. Después del seguimiento, la DMO de los niños diabéticos era muy inferior a la esperada en población infantil no diabética. El peso, la altura y el Índice de Masa Corporal (IMC) siguieron el mismo patrón que la DMO. Los valores de calcio, fósforo, fosfatasa alcalina, PTH y vitamina D, aunque en rango de normalidad, fueron más bajos que en los controles. La fosfatasa alcalina no se incrementó en el periodo puberal. Conclusiones: El presente estudio demuestra que los niños y adolescentes con un diagnóstico reciente de DM1 tienen una DMO normal. Sin embargo, con el paso del tiempo, y sobre todo durante la adolescencia, muestran una menor ganancia de masa ósea y alteraciones en los parámetros de recambio óseo.

Objetivos: Comparar função residual de célula beta pancreática através do cálculo do IDAA1C (dose de insulina ajustada para HbA1C) entre pacientes pediátricos com diabetes mellitus tipo 1 (DM1) que desenvolveram nefropatia diabética e aqueles sem complicações microvasculares. Metodologia: Estudo retrospectivo descritivo realizado através da análise de prontuários de pacientes DM1 acompanhados no ambulatório de Endocrinologia Pediátrica do Hospital Universitário Walter Cantídio (HUWC). Os dados coletados foram: sexo, idade, dados antropométricos, estágio puberal, tempo de doença, tipo de insulina, dose diária de insulina, dosagem de microalbuminúria e níveis de HbA1C. Resultados: A mediana de duração do diabetes em anos até o diagnóstico de nefropatia foi 3.2 anos. No ano anterior ao diagnóstico de nefropatia, 15,4% dos pacientes nefropatas ainda possuíam reserva pancreática (IDAA1C

O Diabetes Mellitus (DM) é uma doença pertencente ao grupo de doenças metabólicas crônicas, caracterizada por hiperglicemia. O objetivo deste estudo foi relatar um caso clínico de um paciente pediátrico com DM tipo 1, descrevendo as características clínicas da patologia e mencionar a ação de um projeto de extensão com equipe multidisciplinar de um hospital em Manaus-Amazonas. Paciente de 10 anos de idade, gênero masculino, procedente da Venezuela, internado no Instituto de Saúde da Criança do Amazonas (ICAM) com quadro de hipoglicemia, decorrente de DM tipo 1. Após ajuste da insulina, a equipe odontológica foi acionada. No exame clínico houve confirmação da presença de foco infeccioso na cavidade oral no elemento 26. O atendimento foi realizado na Policlínica Odontológica da Universidade do Estado do Amazonas (UEA). O caso descrito demonstra a relevância do cuidado integral do paciente diabético por uma equipe multidisciplinar hospitalar e de como ações de extensão podem contribuir na formação dos graduandos.

Objetivo: identificar o perfil social e clínico de crianças e adolescentes com diabetes mellitus tipo 1. Método: pesquisa quantitativa, transversal e descritiva, desenvolvida com 81 responsáveis de crianças e adolescentes com diabetes mellitus tipo 1 entre março e setembro/2021, em dois centros de referência da Paraíba. A análise descritiva foi realizada com auxílio do software Statistical Package for the Social Science, versão 18. Resultados: predominantemente, os acompanhantes das crianças e adolescentes eram as próprias mães, 90,1%, e cerca de 40% viviam com renda familiar menor que um salário mínimo. Entre as crianças e adolescentes, 54% apresentaram valores elevados de hemoglobina glicada, mesmo estando em tratamento; 65,4% indicaram desconhecimento na forma correta de armazenamento da insulina, e 77,6% possuía lipohipertrofia. Conclusão: foram preponderantes a vulnerabilidade socioeconômica e o manejo clínico ineficaz do diabetes mellitus tipo 1 em crianças e adolescentes.

Objective: developing, validating, and implementing educational-therapeutic technology in the format of an institutional standard protocol aimed at the care of children with type 1 diabetes mellitus. Method: a methodological study was carried out in a public hospital in the Federal District of Brazil with the participation of seven nurses in the validation stage and five children and their family members in the implementation stage between August/2021 and October/2022. The validation was carried out online using a Likert scale instrument, and an analysis using the Content Validity Index and the Intraclass Correlation Coefficient was performed. During the health education session, in-person interviews were conducted, and notes were taken in the field diary. Results: The developed technology raised topics related to the daily care of children and diabetes mellitus disease. Validation achieved an agreement rate of 0.78% and a correlation coefficient of 0.525. The implementation stage identified potentialities and weaknesses regarding health care. Conclusion: the protocol was considered comprehensive, thus promoting adherence to treatment and supporting quality and safe care. [ABSTRACT FROM AUTHOR]

Objective: to identify the social and clinical profile of children and adolescents with type 1 diabetes mellitus. Method: quantitative, cross-sectional and descriptive research, developed with 81 guardians of children and adolescents with type 1 diabetes mellitus between March and September/2021, in two reference centers in Paraíba. The descriptive analysis was performed using the Statistical Package for the Social Science software, version 18. Results: predominantly, the companions of the children and adolescents were the mothers themselves, 90.1%, and about 40% lived with family income lower than a minimum wage. Among the children and adolescents, 54% had high glycated hemoglobin values, even though they were undergoing treatment; 65.4% indicated ignorance of the correct form of insulin storage, and 77.6% had lipohypertrophy. Conclusion: socioeconomic vulnerability and ineffective clinical management of type 1 diabetes mellitus in children and adolescents were predominant. [ABSTRACT FROM AUTHOR]

This review verified cognitive domains affected by type 1 diabetes mellitus (T1DM) and the instruments used for its assessment. We performed a search in three databases using the descriptors "type 1 diabetes" AND "cognitive dysfunction". Only six of the 120 articles found met the criteria for inclusion in the review. The analysis of these articles indicates that the main cognitive functions compromised by T1DM are attention, visual attention, verbal memory, immediate and late recovery, and psychomotor speed. Among the selected articles, we found that the most used instruments were the Montreal Cognitive Assessment (MoCA), the Wechsler scales (WMS-III and WMS-RC), the Trail Making Test, The Grooved Pegboard, and substitution (letter-symbol, digit-symbol). Due to the different impairments found, we suggest the importance of standardizing a battery of cognitive assessments and greater efforts to understand the functional impairments resulting from damage to cognition in individuals with T1DM. [ABSTRACT FROM AUTHOR]

Introduction: type 1 diabetes mellitus. It is one of the most prevalent chronic noncommunicable diseases in the child population. Its incidence is variable. The causal multifactoriality is proposed where genetic, environmental and immunological factors are involved. Objective: to characterize clinically and epidemiologically patients who debuted with type 1 diabetes mellitus in the child population of Villa Clara in the period from January 2007 to December 2016. Methods: an epidemiological, observational, descriptive, retrospective longitudinal study was carried out at the José Luis Miranda Pediatric Hospital in Santa Clara. The population of 229 children diagnosed with the disease between 1/1/2007 and 12/31/2016 followed up at the institution was studied. Carrying out the review of medical records. Results: 183 patients were identified, representing an average of 1.3/1,000 discharges/year. The absolute number of cases and their relationship with the number of discharges was variable (age, form of debut and sex). The average incidence was 13.12 cases per 100,000 pediatric population, with an average annual increase of 2.3 cases/year. The mean age at diagnosis was 9.74 ± 4.58 years, with greater frequency, respectively. Conclusions: type 1 diabetes mellitus has a high incidence in Villa Clara, the debut occurs frequently between 5 and 14 years, without differences between the sexes, in the form of diabetic ketoacidosis and ketosis, with a very low frequency of complications. Some epidemiological characteristics were similar to those described in the literature. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the relationship between eating behavior, disease control, and quality of life in adults with type 1 diabetes mellitus (DM1). This cross-sectional study was conducted using an online questionnaire based on the Brazilian version of the Diabetes Quality of Life Measure (DQOL-Brazil), comprising questions on dietary control. A total of 103 volunteers (85.4% women) were included in this study. In relation to food, 68.9% said that they felt like eating when they were anxious, worried, or tensed. The overall score was 2.36 ± 0.75 on the DQOL-Brazil, with higher scores for the domains "satisfaction" and "diabetes-related concerns." The age variable had a negative correlation with the global DQOL-Brazil score and with the domains "impact," "social/vocational concerns," and "diabetes-related concerns." This study demonstrated an association between the act of eating and DM1 control, affecting the quality of life in these individuals. [ABSTRACT FROM AUTHOR]

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La diabetes mellitus tipo 1 se encuentra entre las enfermedades no trasmisibles más frecuentes de la infancia. La educación terapéutica que ejerce el personal de enfermería durante la hospitalización juega un papel importante en el autocuidado, por tal motivo deben de mantener una capacitación activa. El objetivo fue evaluar el efecto de la capacitación sobre autocuidado de niños y adolescentes con diabetes mellitus tipo 1 en el conocimiento del personal de enfermería. Estudio descriptivo longitudinal, en 100 enfermeros del Hospital Pediátrico Centro Habana, mediante muestreo no probabilístico de tipo intencional por conveniencia. Se aplicó test de conocimiento antes y después de la capacitación. Se realizó prueba no paramétrica de los rangos con signos de Wilcoxon para medidas pareadas. El 57 % del personal de enfermería era técnico. El 58 % tenía más de 10 años de experiencia laboral y el 100 % no había recibido capacitación en diabetes. El pre- test arrojó conocimiento bajo en 100 % de los enfermeros, mientras que el post test después de la capacitación arrojó conocimiento alto en el 80 %. La capacitación tuvo un efecto favorable en el conocimiento del personal de enfermería sobre el autocuidado de los niños y adolescentes con diabetes mellitus tipo 1.

Enquadramento: a Diabetes Mellitus tipo 1 é uma doença crónica que afeta maioritariamente crianças e jovens. No seu tratamento a insulinoterapia é essencial. A insulina pode ser administrada por Múltiplas Injeções Diárias (MID) ou por sistema de Perfusão Subcutânea Contínua de Insulina (PSCI). Este último tem vantagens, mas o processo de adaptação é exigente. Objetivo: conhecer a perceção das mães relativa ao sistema de PSCI no tratamento da DM1 dos adolescentes. Metodologia: estudo qualitativo descritivo e exploratório. A recolha de dados foi realizada por entrevista semiestruturada a 10 mães de adolescentes com DM1 com tratamento por PSCI. A análise foi realizada pelo método de análise de conteúdo de Bardin. Resultados: da análise das entrevistas emergiram quatro categorias: A transição para PSCI, Bem-estar do adolescente e família, Autonomia do adolescente e Limitações do dispositivo e respetivas subcategorias que expõem a perceção das mães de adolescentes com DM1 sobre tratamento com PSCI. Conclusão: o tratamento com PSCI proporciona melhor qualidade de vida ao adolescente e à sua família e favorece a autonomia dos adolescentes. O processo de adaptação coloca-lhes desafios sendo fulcral o suporte dos profissionais de saúde. Identificaram-se limitações no dispositivo que se desejam ultrapassadas atendendo à inovação tecnológica atual.

The exponential increase in the prevalence of diabetes mellitus (DM) throughout the world also includes the increase in people with type 1 diabetes (T1D)1. This disease is characterized by the autoimmune and progressive destruction of pancreatic Beta cells, causing an endogenous insulin insufficiency and hyperglycemia that can only be controlled by exogenous insulin administration. Intensive insulinization with multiple doses of insulin is the best therapeutic option to blood glucose control and achieve glycosylated hemoglobin A1c goals, with the least number of hypoglycemia and risk of chronic complications. This requires an active and frequent participation of the patient with T1D and that could be a barrier to achieve optimal control in the medium term. In pursuit of these objectives, the technological therapeutic growth for T1D has been broad and fast, through the development of continuous glucose sensors (continuous glucose monitor, CGM) and subcutaneous insulin infusion pumps (continuous subcutaneous insulin infusion, CSII). Since its approval, the use of automated insulin administration systems (2017) by adolescent adults and children with T1D has shown to be effective and safe to achieve adequate glycemic control in nighttime or basal conditions. Automatic insulin infusion (IAI) or closed loop (CL) requires the use of CSII and CGM communicated with each other (by Bluetooth) and functionally integrated through control algorithms that regulate the administration of insulin according to subcutaneous glucose bringing blood glucose to the desired ranges for the patient. These algorithms are hosted on different platforms, such as a pump infuser or cell phone, or remotely (Do It Yourself or DIY) and from there they control the insulin infusion according to the subcutaneous glucose, automatically. CL systems can be monohormonal (insulin only) or bihormonal (insulin and glucagon) and depending on whether or not they require the participation of the patient in the programming of the pre-meal insulin bolus, they are called hybrids (Hybrid Closed Loop, HCL) or fully automatic (Fully Self-closing loop, FCL), respectively. While the evidence observed on glycemic control with these HCL systems is encouraging, users continue to experience the burden of carbohydrate counting for boluses of pre-meal insulin. Patients with poor metabolic control due to skipping or delaying the administration of boluses of food would benefit from FCL. These FCL algorithms monitor prandial blood glucose without requiring a meal announcement and rapidly anticipate and predictively detect changes in blood glucose based on carbohydrate load, alleviating the daily load of carbohydrate calculation for patients with T1D. Few consortiums in the world are advancing with the difficult challenge that the validation of these FCL algorithms implies, one of them is in Argentina (automatic regulator of glucose, ARG) and that would allow to achieve an adequate metabolic control with the best quality of life.

Objetivo: Mapear e identificar na evidência científica as intervenções facilitadoras na transição para a comunidade da criança em idade escolar com Diabetes Mellitus Tipo 1. Método: Revisão Scoping foi realizada seguindo a metodologia do Joanna Briggs Institute. Foram incluídos estudos publicados de natureza quantitativa, qualitativa, ou mistos, assim como a literatura cinzenta, em Português, inglês, espanhol ou francês, produzidos entre 2016 e 2021. Foram incluídos nesta revisão 8 estudos, selecionados nas seguintes bases de dados: CINHAL; MEDLINE; MedicLatina; Eric; Cochrane CRCT; Cochrane CA; Cochrane DSR; Cochrane MR); Nursing Reference; JBI. Os resultados obtidos foram extraídos com recurso a um instrumento construído pelas autoras e alinhado com a questão/objetivo e expressos num resumo narrativo, incluindo áreas de destaque para pesquisas futuras. Resultados: Identificaram-se 3 grandes categorias no âmbito das intervenções facilitadoras na transição para a comunidade da criança em idade escolar com Diabetes Mellitus Tipo 1, nomeadamente, a existência de recursos e sistemas de suporte; o desenvolvimento de competências na gestão da doença (conhecimentos, modelagem e treino); comunicação e a continuidade dos cuidados. Conclusões: A transição para a comunidade da criança em idade escolar com Diabetes Mellitus tipo1 é influenciada por fatores relacionados com as condições ambientais, profissionais, organizacionais e da própria família. Os sistemas de suporte, o desenvolvimento de competências de gestão da DM1 (conhecimento e treino) e a comunicação/continuidade são destacados como foco de atenção no desenvolvimento das intervenções promotoras de uma transição segura.

Introduction: diabetes mellitus is an important public health problem and constitutes one of the priorities of chronic non-communicable diseases. Objective: to clinically and epidemiologically characterize the type 1 diabetic population with onset before the age of 15 years. Methods: a cross-sectional and descriptive study was carried out in patients with type 1 diabetes mellitus under 15 years old in Pinar del Río province from January 1st, 1980 to December 31, 2019. The universe was constituted by 294 patients. The data were obtained from the medical records. For the analysis of the information the Statistical Package for Social Sciences statistical system was used, univariate analysis of descriptive character was applied, descriptive statistics such as the distribution of absolute and relative frequencies were used. The non-parametric Chi-square test was applied with a significance level of 95 % (p

La atención de los pacientes con diabetes mellitus tipo 1 siempre será categorizado como un reto médico, en vista de lo complejo de su manejo y enfrentarse a situaciones de diversas índoles, que va desde lograr reducir valores de glicemias y mantenerlos en metas previamente establecidas, así como la integración de la dieta. Sin embargo, todo esto se hace posible gracias a la integración del paciente con un equipo multidisciplinario que favorece alcanzar dichas metas. Cada uno de los pacientes que viven con diabetes mellitus tipo 1 acarrean altos costos para su manejo farmacológico, ya que la deficiencia absoluta de insulina, hace que la adquisición de fármacos óptimos muchas veces sea deficiente. Cuando analizamos de forma integral a los pacientes, podemos darnos cuentas que su entorno psicosocial intervienen en un mejor control metabólico, es por esa razón que cada uno de los pacientes deben acudir a consultas con: Nutrición clínica, educación en diabetes y psicología además de la consulta con el médico endocrinólogo o especialista en diabetes. En el Centro Médico Docente La Trinidad, en el servicio de Endocrinología realizamos este estudio de tipo retrospectivo donde encontramos que los pacientes que acudían a las consultas de manejo multidisciplinario durante el periodo de Enero 2021 y enero 2022, tuvieron reducción no solo de valores paraclínicos de Glucemia y A1c, sino también de complicaciones agudas y crónicas asociadas. Por lo que se comparó con estudios internacionales y encontramos que todo paciente puede tener un control metabólico utilizando esta secuencia de atención.

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Introduction: in type 1 diabetes mellitus (DM1) there is autoimmune destruction of pancreatic ß cells with metabolic decompensation. In the first months of starting treatment, a period of partial remission or "honeymoon" may appear, in which there is a decrease in exogenous insulin requirements. Objective: to identify factors associated with partial remission in pediatric patients with DM1, during the first 12 months after diagnosis. Material and methods: retrospective study of a cohort of pediatric patients initially diagnosed with DM1, in a private hospital in Mexico City. We analyzed the clinical characteristics at diagnosis, subsequent management, and the stay in partial remission during the first 12 months after diagnosis. Results: forty-four patients with a median age of nine years were included, 25 were male (56.8%). 70.5% (31/44) presented partial remission at some point during follow-up, but for 12 months only 22 (50%) maintained partial remission. Factors associated with losing partial remission at 12 months were: age less than six years (OR: 6.9, 95% CI 1.06-44.9) and do not perform continuous blood glucose monitoring (OR = 6.7, 95% CI 1.3-34.4). Conclusion: during the first year of treatment, up to 70% of patients with a recent diagnosis of DM1 may have partial remission. Better blood glucose monitoring and being a patient older than six years are associated with partial remission. [ABSTRACT FROM AUTHOR]

Objective: To update the incidence rate (IR) and trends of type 1 diabetes mellitus (T1DM) in children aged 0-14 years from 2003 to 2022, in Biscay, Spain., Subjects and Method: We used the capture-recapture method: primary cases were prospectively extracted from the hospital registry and a secondary independent data source was obtained from diabetes associations and a public health database. The IRs standardized by age and sex were calculated using the direct method, assuming an equal distribution in each age/sex group. The IR occurring during the various COVID-19 waves was compared with the pre-pandemic IR., Results: A total of 378 new cases were identified. The mean age at diagnosis was 9.7 years (5.8-11.9). The completeness of ascertainment was 99.1%. The mean annual age-standardized IR was 12.92 (95%CI, 11.35-13.91). The mean IRs for the 0-4, 5-9, and 10-14 age groups were 7.67, 13.41 and 17.83 cases/100,000 children/year, respectively. The IR trend was statistically significant in the entire group and in the 5-9 year-old group with a mean annual increase of 1.9% (95%CI, 0.1-3.8) and 3.3% (95%CI, 1.002-1.065); p=0.039. The 5-year period analysis confirmed that the increase was significant only in the last 5 years (20%). When 2020-2022 (pandemic) and 2017-2019 (pre-pandemic) periods were compared this difference goes up to 44.5%; p=0.029., Conclusions: After a long period of stability in the IR of T1DM in children younger than 15 years of age in Biscay, Spain, an increase in recent years has been reported, which is consistent with the SARS-CoV2 pandemic, with the largest increase being reported in the 5-to 9-year-old age group., (Copyright © 2024 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: The objective of this article was to estimate the type 1 diabetes mellitus (T1DM) incidence in the child population of the Community of Madrid (CM) and its evolution between 1997 and 2016, using the medical-administrative data of the regional registry of T1DM. Methods: T1DM cases of children under 15 years of age, reported to the regional registry or collected from secondary sources were included: Spanish Diabetics Association (1997−2013), and from 2014 on the Basic Minimum Data Set (BMDS). Annual incidence rates were estimated per 100 000 person-years. The comparison of the rates was analysed using Poisson regression models using incidence ratios (IR). Results: A total of 2658 cases were identified as new diagnoses of T1DM. The mean incidence rate for 1997−2013 was 13.7 cases per 100 000 person-years. In the 2014−2016 period, 20 cases per 100 000 persons-years were registered using the BMDS. The age group with the highest incidence was 10−14 years in the two periods (16.6 vs. 25.5). In boys, the age with the highest incidence was 10–14 years in both periods (17.9 vs 30.4), and in girls, the age of 5–9 years (17.0 vs 25.1). Incidence rates decreased slightly in both genders until 2013 (from 15.0 to 11.6). In 2014−2016, the annual incidence rate varied between 18.4 and 21.1 cases (IR: 1.77). The incidence remained stable in children under 5 years old and increased from 5 to 14 years old. Conclusions: The CM is among the regions with a high incidence of T1DM. In its first phase, the regional registry underestimated the incidence of T1DM, and with the incorporation of the MBDS as a source of information, the estimates for the second period (2014−2016) are possibly closer to the actual incidence of T1DM. The data presented suggests the need to know the real evolution of the incidence of the disease by incorporating computerised health records. Resumen: Introducción: El objetivo fue estimar la incidencia de diabetes mellitus tipo 1 (DM1) en la población infantil de la Comunidad de Madrid (CM) y su evolución entre 1997 y 2016, a partir de los datos médicos-administrativos del registro regional de DM1. Métodos: Fueron incluidos los casos de DM1 de menores de 15 años, notificados al registro regional o captados de fuentes secundarias: Asociación Diabéticos Españoles (1997−2013) y a partir de 2014 del Conjunto Mínimo Básico de Datos hospitalario (CMBDS). Se estimaron tasas de incidencia anual por 100.000 personas-año. La comparación de las tasas se analizó mediante modelos de regresión de Poisson a través de razones de incidencia (RI). Resultados: Un total de 2658 casos fueron identificados como nuevos diagnósticos de DM1. La tasa de incidencia media de 1997−2013 fue de 13,7 casos por 100.000 personas-año. En el periodo 2014−2016, utilizando el CMBDS se registraron 20,0 casos por 100.000. El grupo de edad con mayor incidencia fue el de 10−14 años en los dos periodos (16,6 vs 25,5). En los niños, la edad de mayor incidencia fue de 10 a 14 años en ambos periodos (17,9 vs 30,4) y en las niñas el de 5 a 9 años (17,0 vs 25,1). Las tasas de incidencia descendieron ligeramente en ambos sexos hasta 2013 (de 15,0 a 11,6); en 2014–2016 la tasa de incidencia anual varió entre 18,4 y 21,1 casos (RI: 1,77). La incidencia permaneció estable en menores de 5 años y aumentó de 5 a 14 años. Conclusiones: La CM se sitúa entre las regiones de alta incidencia de DM1. En su primera fase, el registro regional infraestimaba la incidencia de DM1. Con la incorporación del CMBDS como fuente de información, las estimaciones del segundo periodo (2014−2016) son posiblemente más próximas a la incidencia real de DM1. Los datos que presentamos sugieren la necesidad de conocer la evolución real de la incidencia de la enfermedad incorporando los registros digitales sanitarios.