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Objective: To identify the proportion of poor of glycemic control and associated factors among people with type 2 diabetes attending a regional reference outpatient clinic in Mato Grosso (Brazil). Methods: This is a cross-sectional quantitative study based on data from medical records of 338 people with type 2 diabetes who attend a state reference outpatient clinic in Mato Grosso (Brazil). Information on glycemic control, sociodemographic factors, lifestyle and clinical conditions was collected. Results: The prevalence of elevated glycated hemoglobin was 47.34%. In the Poisson multiple regression model analysis with robust variance, poor glycemic control was significantly associated (p10 years (PR = 1.58), and presence of arterial hypertension (PR = 0.79). Conclusion: Most users of the reference outpatient clinic with type 2 diabetes had poor glycemic control associated with risk factors that alter glycated hemoglobin and negatively affect the achievement of established glycemic levels. Resumen Objetivo: Identificar la proporción de falta de control glucémico y los factores asociados entre las personas con diabetes tipo 2 que acuden a un ambulatorio regional de referencia en Mato Grosso (Brasil). Métodos: Se trata de un estudio transversal basado en los datos de las historias clínicas de 338 personas con diabetes tipo 2 atendidas en un ambulatorio estatal de referencia. Se tomó información del control glucémico, los factores sociodemográficos, el estilo de vida y las condiciones clínicas. Resultados: La prevalencia de hemoglobina glicosilada elevada fue del 47.34%. En el análisis del modelo de regresión múltiple de Poisson con varianza robusta mostró que el descontrol glucémico estaba significativamente asociado (p10 años (PR = 1.58) y la presencia de hipertensión (PR = 0.79). Conclusión: Una buena parte de los usuarios del ambulatorio de referencia con diabetes tipo 2 presentaba descontrol glucémico asociado a factores de riesgo que alteran la hemoglobina glicosilada y afectan negativamente la consecución de los niveles glucémicos establecidos. Resumo Objetivo: Identificar a proporção de falta de controle glicêmico e fatores associados entre pessoas com diabetes tipo 2 que visitam um ambulatório de referência regional em Mato Grosso (Brasil). Métodos: Trata-se de um estudo transversal e quantitativo, com base em dados de prontuários de 338 pessoas com diabetes tipo 2 atendidas em ambulatório de referência estadual de Mato Grosso (Brasil). Foi recolhida informação sobre controlo glicémico, factores socio-demográficos, estilo de vida e condições clínicas. Resultados: A prevalência de hemoglobina glicada elevada foi de 47.34%. Na análise do modelo de regressão múltipla de Poisson com variância robusta, foi demonstrado que o descontrole glicêmico foi significativamente associado (p 10 anos (RP = 1.58) e apresentar hipertensão arterial (RP = 0.79). Conclusão: Boa parte dos usuários do ambulatório de referência com diabetes do tipo 2 apresentou descontrole glicêmico associados a fatores de risco que alteram a hemoglobina glicada e afeta negativamente o alcance dos níveis glicêmicos estabelecidos.

RESUMEN Fundamentos. La Diabetes Mellitus tipo 2 es una enfermedad crónica que representa un importante problema de salud pública. El objetivo de este estudio fue describir las características sociodemográficas, las antropométricas, el control metabólico, la comorbilidad y el riesgo cardiovascular de los pacientes diagnosticados de Diabetes Mellitus tipo 2 del área sanitaria de Vigo. Método. Estudio descriptivo observacional retrospectivo. Entre marzo y setiembre de 2016, se realizó entrevista telefónica y auditoria de historia clínica electrónica a 195 pacientes ≥ 18 años del área sanitaria de Vigo diagnosticados de Diabetes Mellitus tipo 2. Se seleccionaron mediante muestreo aleatorio con reposición. Se evaluó el riesgo cardiovascular mediante el método “United Kingdom Prospective Diabetes Study”, el control metabólico según las recomendaciones de la “American Diabetes Association” 2016, y la comorbilidad mediante el índice de Charlson. Se realizó un análisis descriptivo y bivariante con el paquete estadístico R. Resultados. El control glucémico era adecuado (HbA1c

INTRODUCTION: It is well known that type 2 diabetes mellitus (T2DM) produces cardiovascular autonomic neuropathy (CAN), which may affect the cardiac autonomic modulation. However, it is unclear whether the lack of glycemic control in T2DM without CAN could impact negatively on cardiac autonomic modulation. Objective: To evaluate the relationship between glycemic control and cardiac autonomic modulation in individuals with T2DM without CAN. Descriptive, prospective and cross sectional study.METHODS: Forty-nine patients with T2DM (51±7 years) were divided into two groups according to glycosylated hemoglobin (HbA1c): G1≤7% and G2>7.0%. Resting heart rate (HR) and RR interval (RRi) were obtained and calculated by linear (Mean iRR; Mean HR; rMSSD; STD RR; LF; HF; LF/HF, TINN and RR Tri,) and non-linear (SD1; SD2; DFα1; DFα2, Shannon entropy; ApEn; SampEn and CD) methods of heart rate variability (HRV). Insulin, HOMA-IR, fasting glucose and HbA1c were obtained by blood tests.RESULTS: G2 (HbA1c≤7%) showed lower values for the mean of iRR; STD RR; RR Tri, TINN, SD2, CD and higher mean HR when compared with G1 (HbA1c > 7%). Additionally, HbA1c correlated negatively with mean RRi (r=0.28, p=0.044); STD RR (r=0.33, p=0.017); RR Tri (r=-0.35, p=0.013), SD2 (r=-0.39, p=0.004) and positively with mean HR (r=0.28, p=0.045). Finally, fasting glucose correlated negatively with STD RR (r=-0.36, p=0.010); RR Tri (r=-0.36, p=0.010); TINN (r=-0.33, p=0.019) and SD2 (r=-0.42, p=0.002).CONCLUSION: We concluded that poor glycemic control is related to cardiac autonomic modulation indices in individuals with T2DM even if they do not present cardiovascular autonomic neuropathy. INTRODUÇÃO: É de conhecimento geral que o diabetes mellitus tipo 2 (DM2) produz neuropatia autonômica cardiovascular (NAC), que pode afetar a modulação autonômica cardíaca. Entretanto, não é claro se a falta de controle glicêmico em diabéticos tipo 2 sem NAC, poderia impactar negativamente na modulação autonômica cardíaca. Objetivo: Avaliar a relação entre controle glicêmico e modulação autonômica cardíaca em indivíduos com DM2 sem neuropatia autonômica cardiovascular. Estudo descritivo, prospectivo e transversal.MÉTODOS: Quarenta e nove pacientes com DM2 (51±7 anos) foram divididos em dois grupos de acordo com a hemoglobina glicosilada (HbA1c): G1: ≤ 7% e G2: >7,0%. A frequência cardíaca de repouso (FC) e intervalo RR (iRR) foram obtidos e calculados por métodos lineares (média iRR; média FC; rMSSD; STD RR; LF; HF; LF/HF, TINN e RR Tri) e não lineares (SD1; SD2; DFα1; DFα2, Entropia de Shannon; ApEn; SampEn e CD) de variabilidade de frequência cardíaca. Insulina, HOMA-IR, glicemia de jejum e HbA1c foram obtidas por análises sanguíneas.RESULTADOS: G2 (HbA1c ≤ 7%) mostrou valores menores para média de iRR; STD RR; RR Tri, TINN, SD2, CD e maiores para média de FR quando comparado com G1 (HbA1c > 7%). Adicionalmente, HbA1c correlacionou-se negativamente com media iRR (r=0,28, p=0,044); STD RR (r=0,33, p=0,017); RR Tri (r=-0,35, p=0,013), SD2 (r=-0,39, p=0,004) e positivamente com média FC (r=0,28, p=0,045). Finalmente, a glicemia de jejum correlacionou-se negativamente com STD RR (r=-0,36, p=0,010); RR Tri (r=-0,36, p=0,010); TINN (r=-0,33, p=0,019) e SD2 (r=-0,42, p=0,002).CONCLUSÃO: Conclui que o controle glicêmico deficiente relaciona-se com índices de modulação autonômica cardíaca em indivíduos com DM2, ainda que não apresentem neuropatia autonômica cardiovascular. INTRODUCCIÓN: Es de conocimiento general que la diabetes mellitus tipo 2 (DM2) produce neuropatía autonómica cardiovascular (NAC), que puede afectar la modulación autonómica cardíaca. Entretanto, no es claro si la falta de control glucémico en diabéticos tipo 2 sin NAC, podría impactar negativamente en la modulación autonómica cardíaca. Objetivo: Evaluar la relación entre control glucémico y modulación autonómica cardíaca en individuos con DM2 sin neuropatía autonómica cardiovascular. Estudio descriptivo, prospectivo y transversal.MÉTODOS: Cuarenta y nueve pacientes con DM2 (51±7 años) fueron divididos en dos grupos de acuerdo con la hemoglobina glucosilada (HbA1c): G1: ≤ 7% y G2: >7,0%. La frecuencia cardíaca de reposo (FC) e intervalo RR (iRR) fueron obtenidos y calculados por métodos lineales (promedio iRR; promedio FC; rMSSD; STD RR; LF; HF; LF/HF, TINN y RR Tri) y no lineales (SD1; SD2; DFα1; DFα2, Entropía de Shannon; ApEn; SampEn y CD) de variabilidad de frecuencia cardíaca. Fueron obtenidas insulina, HOMA-IR, glucemia en ayunas y HbA1c a través de análisis sanguíneos.RESULTADOS: G2 (HbA1c ≤ 7%) mostró valores menores para el promedio de iRR; STD RR; RR Tri, TINN, SD2, CD y mayores para el promedio de FR al ser comparado con G1 (HbA1c > 7%). Adicionalmente, HbA1c se correlacionó negativamente con el promedio iRR (r=0,28, p=0,044); STD RR (r=0,33, p=0,017); RR Tri (r=-0,35, p=0,013), SD2 (r=-0,39, p=0,004) y positivamente con el promedio FC (r=0,28, p=0,045). Finalmente, la glucemia en ayunas se correlacionó negativamente con STD RR (r=-0,36, p=0,010); RR Tri (r=-0,36, p=0,010); TINN (r=-0,33, p=0,019) e SD2 (r=-0,42, p=0,002).CONCLUSIÓN: Concluimos que el control glucémico deficiente se relaciona con índices de modulación autonómica cardíaca en individuos con DM2, aunque no presenten neuropatía autonómica cardiovascular.

RESUMEN Introducción: La diabetes mellitus fue la segunda causa de mortalidad en México en 2015, algunas causas del problema son malos estilos de vida y desconocimiento de la enfermedad. Método: estudio observacional, transversal y descriptivo, n=106, evaluando estilos de vida, nivel de conocimientos y hemoglobina glicada. Resultados: el nivel de conocimiento así como el perfil promotor de salud es regular para ambos sexos. La HbA1c se relaciona con el perfil de salud r = .271, no así con el nivel de conocimiento. Los pacientes con DM2 presentan HbA1c = 8.96, los pacientes con DM2 y comorbilidades crónicas tienen HbA1c =7.55. Conclusiones: las intervenciones propuestas a la unidad de salud, deberán tener un enfoque en la promoción de estilos de vida saludables y no necesariamente en mejorar los conocimientos de la enfermedad. ABSTRACT Introduction: Diabetes mellitus was the second cause of mortality in Mexico in 2015, some causes of the problem are poor lifestyles and low level knowledge of the disease. Method: observational, transversal and descriptive study, n = 106, evaluating lifestyles, level of knowledge and glycated hemoglobin. Results: the level of knowledge as well as the profile promoter of health is regular for both sexes. HbA1c is related to the health profile r = .271, but not to the level of knowledge. Patients with DM2 have HbA1c = 8.96, patients with DM2 and chronic comorbidities have HbA1c =7.55. Conclusions: the interventions proposed to the health unit should have a focus on the promotion of healthy lifestyles and not necessarily improve the knowledge of the disease.

Trabajo fin de grado. Defendido en junio de 2017. Con la presente revisión bibliográfica se pretende conocer el impacto de la relación parental y/o familiar en el control glucémico de niños y adolescentes con diabetes mellitus tipo 1. Para ello se seleccionaron 8 artículos y mediante los resultados obtenidos se ha llegado a la conclusión de que los conflictos familiares, la monitorización parental, el autocuidado de la diabetes, la organización familiar general, la autonomía y autocontrol en la adolescencia interfieren en el control glucémico. Abstract: The intention of this bibliographic review is to know the impact of parental and/or family relationship on children´s and adolescent´s glycemic control diagnosed with type 1 diabetes mellitus. In order to fullfil the aim of this study, 8 articles were selected. Due to the obtained results, it has been concluded that family conflicts, parental monitoring, diabetes self-management, general family organization, autonomy and self-control, interfere in glycemic control. Ordenador con navegador de Internet; Adobe Acrobat Reader 35 p. (Según el contador de la aplicación)

El 1,5 – anhidroglucitol (1,5-AG) refleja las excursiones glicémicas en estados postprandiales. Objetivos: Determinar la correlación de los niveles de 1,5-AG sérico con la hemoglobina glicosilada (HbA1C) en pacientes con diabetes mellitus tipo 2 con diferente grado de control glicémico. Materiales y Métodos: Estudio descriptivo, transversal y analítico que se realizó en pacientes del Consultorio Externo de Endocrinología del Hospital Cayetano Heredia en quienes se realizó una evaluación clínica y exámenes de laboratorio tales como 1,5-AG, hemoglobina glicosilada, glucosa, perfil lipídico, creatinina, microalbuminuria para evaluar la asociación de los niveles de 1,5-AG con la HbA1c y los grados de control glicémico y variables clínicas y de laboratorio, mediante el análisis estadístico. Resultados: Se incluyeron 100 pacientes y se encontró una correlación negativa entre las concentraciones séricas de 1,5-AG y HbA1c (r = -0.7910, p < 0.05), y con la glucosa en ayunas (r = -0.6307, p < 0.05). Los pacientes fueron divididos en tres subgrupos según el grado de control glicémico, de acuerdo a los niveles de HbA1c: buen control glicémico (HbA1c < 7.0 %), regular control glicémico (7.0 % ≤ HbA1c ≤ 8.5 %) y mal control glicémico (HbA1c > 8.5 %) y se encontró que la media de la glucosa en ayunas fue significativamente mayor en los pacientes con mal control glicémico (p < 0.01), y la media del 1,5 – AG fue significativamente menor en los pacientes con regular control glicémico y mal control glicémico (p < 0.01). La mediana de la microalbuminuria fue mayor en los pacientes con mal control glicémico (p < 0.01). Conclusiones: El 1,5-AG tiene una correlación inversa con los valores de HbA1c, consecuentemente las medias del 1,5-AG tienen también una asociación inversa significativa con los diferentes niveles de control glicémico, definido por los valores de HbA1c, < 7 %, 7-8.5 % y > 8.5 %, respectivamente. El 1,5-AG presenta asociación inversa con la glucosa en ayunas, colesterol total, triglicéridos, creatinina y microalbuminuria.

Objetivo: Evaluar si existe relación entre el nivel de hemoglobina glicosilada y la presencia de periodon-titis crónica. Materiales y método: se evaluaron 77 pacientes, agrupados en función a si presentaban o no periodontitis crónica. Los datos fueron recolectados en una ficha donde se consideró edad, género, índice de masa corporal (IMC) y antecedentes de dislipidemias, se llenaron los periodontogramas para establecer al grupo de pertenencia de los pacientes, se les envió a laboratorio clínico para recabar y pro-cesar las pruebas de hemoglobina glicosilada. Todos firmaron el consentimiento informado. Resultado: se obtuvo un 5,58% de HbA1c para el grupo con periodontitis crónica (38 pacientes), y un 5,31% para el grupo sin periodontitis (39 pacientes), valores sin ajustar, se determinó una diferencia significativa (P=0,000), al realizar el estudio de las variables de riesgo, se obtuvo que no hay influencia estadística del género ni del IMC. Considerando estos factores la diferencia sigue siendo significativa (P=0,001). No se halló diferencia significativa (P=0,921) entre varones (5,58%) y mujeres (5,60%) con periodontitis crónica. Tampoco hubo diferencia significativa (P=0,230) entre varones (5,33%) y mujeres (5,29%) sin periodontitis crónica. Conclusiones: existe diferencia significativa en el porcentaje de hemoglobina glicosilada y la presencia de periodontitis crónica. No existe diferencia significativa en los pacientes en función al género, en los grupos con y sin periodontitis crónica. El análisis de factores de riesgo, mostró que los niveles elevados de Hemoglobina Glicosilada se deben a periodontitis crónica, edad del paciente y presencia de dislipidemias, más no del género y el IMC., Objective: To evaluate the correlation between the level of glycosylated hemoglobin and the presence of chronic periodontitis. Materials and method: 77 patients, were grouped according to whether or not chronic periodontitis. Data were collected where took it age, gender, body mass index (BMI) and a history of dyslipidemia, periodontal chart were written to set membership group of patients, they were sent to clinical laboratory to collect and process glycosylated hemoglobin samples. All signed informed consent. Results: HbA1c was 5.58% for chronic periodontitis group, and 5.31% for no periodontitis group, unadjusted values, determined it there was statistically significant difference (P = 0.000). Taking the risk variables it was obtained no statistical influence of gender or BMI. Even considering these risk factors, it remained significant difference (P = 0.001). No significant differences were found (P = 0.921) among men (5.58%) and women (5.60%) with chronic periodontitis. In the group of patients without chronic periodontitis there is no significant difference (P = 0.230) between males (5.33%) and women (5.29%). Conclusions: A statistically significant difference was found in the percentage of Hemoglobin and the presence of chronic periodontitis. No significant difference was found in patients according to gender, both in the group with chronic periodontitis, such as those without chronic periodontitis. The analysis of risk factors showed that the causes of the high levels of percentage of Hemoglobin were the presence of chronic periodontitis, patient age and the presence of dyslipidemia, but not gender and Body Mass Index (BMI).

Objective: To evaluate the correlation between the level of glycosylated hemoglobin and the presence of chronic periodontitis. Materials and method: 77 patients, were grouped according to whether or not chronic periodontitis. Data were collected where took it age, gender, body mass index (BMI) and a history of dyslipidemia, periodontal chart were written to set membership group of patients, they were sent to clinical laboratory to collect and process glycosylated hemoglobin samples. All signed informed consent. Results: HbA1c was 5.58% for chronic periodontitis group, and 5.31% for no periodontitis group, unadjusted values, determined it there was statistically significant difference (P = 0.000). Taking the risk variables it was obtained no statistical influence of gender or BMI. Even considering these risk factors, it remained significant difference (P = 0.001). No significant differences were found (P = 0.921) among men (5.58%) and women (5.60%) with chronic periodontitis. In the group of patients without chronic periodontitis there is no significant difference (P = 0.230) between males (5.33%) and women (5.29%). Conclusions: A statistically significant difference was found in the percentage of Hemoglobin and the presence of chronic periodontitis. No significant difference was found in patients according to gender, both in the group with chronic periodontitis, such as those without chronic periodontitis. The analysis of risk factors showed that the causes of the high levels of percentage of Hemoglobin were the presence of chronic periodontitis, patient age and the presence of dyslipidemia, but not gender and Body Mass Index (BMI). Objetivo: Evaluar si existe relación entre el nivel de hemoglobina glicosilada y la presencia de periodon-titis crónica. Materiales y método: se evaluaron 77 pacientes, agrupados en función a si presentaban o no periodontitis crónica. Los datos fueron recolectados en una ficha donde se consideró edad, género, índice de masa corporal (IMC) y antecedentes de dislipidemias, se llenaron los periodontogramas para establecer al grupo de pertenencia de los pacientes, se les envió a laboratorio clínico para recabar y pro-cesar las pruebas de hemoglobina glicosilada. Todos firmaron el consentimiento informado. Resultado: se obtuvo un 5,58% de HbA1c para el grupo con periodontitis crónica (38 pacientes), y un 5,31% para el grupo sin periodontitis (39 pacientes), valores sin ajustar, se determinó una diferencia significativa (P=0,000), al realizar el estudio de las variables de riesgo, se obtuvo que no hay influencia estadística del género ni del IMC. Considerando estos factores la diferencia sigue siendo significativa (P=0,001). No se halló diferencia significativa (P=0,921) entre varones (5,58%) y mujeres (5,60%) con periodontitis crónica. Tampoco hubo diferencia significativa (P=0,230) entre varones (5,33%) y mujeres (5,29%) sin periodontitis crónica. Conclusiones: existe diferencia significativa en el porcentaje de hemoglobina glicosilada y la presencia de periodontitis crónica. No existe diferencia significativa en los pacientes en función al género, en los grupos con y sin periodontitis crónica. El análisis de factores de riesgo, mostró que los niveles elevados de Hemoglobina Glicosilada se deben a periodontitis crónica, edad del paciente y presencia de dislipidemias, más no del género y el IMC.

OBJECTIVE Identifying factors associated with glycemic control in people with type 2 Diabetes Mellitus (DM) registered in the Family Health Strategy (FHS) in Pernambuco, Brazil. METHOD Associations between glycemic control (glycosylated hemoglobin A lower or equal to 7%) presented by people with DM and variables related to sociodemographic conditions, lifestyle, characteristics of diabetes, treatment and follow-up of patients by health services were investigated by multiple regression. RESULTS More than 65% of the participants presented inadequate glycemic control, especially those with lower age, longer illness duration, more annual contacts with FHS and complex therapeutic regimen. People with DM without referrals to specialists presented greater glycemic control. Associations with education level and obesity did not remain significant in the multivariate model. CONCLUSION The evolution of diabetes hinders adequate control, however, attention to younger people with DM and referrals to specialists are factors that can improve glycemic control. Resumen OBJETIVO Identificar los factores asociados con el control glucémico en personas con Diabetes Mellitus (DM) tipo 2 registradas en la Estrategia Salud de la Familia (ESF) en Pernambuco, Brasil. MÉTODO Fueron investigadas, por regresión múltiple, las asociaciones entre el control glucémico (hemoglobina A glicosilada menor o mayor o igual al 7%) presentado por las personas con DM y variables relacionadas con condiciones sociodemográficas, hábitos de vida, características de la diabetes, de su tratamiento y seguimiento de los pacientes por los servicios sanitarios. RESULTADOS Más del 65% de los participantes presentaron control glucémico inadecuado, especialmente aquellos de menos edad, duración de la enfermedad más larga, más contactos anuales con la ESF y régimen terapéutico complejo. Personas con DM sin derivaciones a especialistas presentaron un mayor descontrol glucémico. Asociaciones con escolaridad y obesidad no permanecieron significativas en el modelo multivariado. CONCLUSIÓN La evolución de la diabetes dificulta el control adecuado. Sin embargo, la atención a las personas con DM más jóvenes y las derivaciones a especialistas son factores susceptibles de mejora del control glucémico. Resumo OBJETIVO Identificar fatores associados ao controle glicêmico em pessoas com Diabetes Mellitus (DM) tipo 2 cadastradas na Estratégia Saúde da Família (ESF) em Pernambuco, Brasil. MÉTODO Foram investigadas, por regressão múltipla, as associações entre o controle glicêmico (hemoglobina A glicosilada menor ou maior ou igual a 7%) apresentado pelas pessoas com DM e variáveis relacionadas com condições sociodemográficas, hábitos de vida, características do diabetes, de seu tratamento e acompanhamento dos pacientes pelos serviços de saúde. RESULTADOS Mais de 65% dos participantes apresentaram controle glicêmico inadequado, principalmente aqueles com idade menor, duração da doença mais longa, mais contatos anuais com a ESF e regime terapêutico complexo. Pessoas com DM sem encaminhamentos para especialistas apresentaram um maior descontrole glicêmico. Associações com escolaridade e obesidade não permaneceram significativas no modelo multivariado. CONCLUSÃO A evolução do diabetes dificulta o controle adequado, todavia, a atenção às pessoas com DM mais jovens e os encaminhamentos para especialistas são fatores suscetíveis de melhora do controle glicêmico.

Nephropathy constitutes the most serious type 1 diabetes mellitus (type 1 DM) complication and microalbuminuria is the initial manifestation. Objectives: To determine the role of epidemiological, clinical and biochemical factors in the development of microalbuminuria in type 1 DM patients. Design: Case and control study. Setting: Endocrinology Unit, National Institute of Child Health, Lima, Peru. Patients: Subjects less than 18 year-old with type 1 DM. Interventions: Sixty-four type 1 DM patients were studied, 22 patients with microalbuminuria (cases) and 42 patients without it (controls). Epidemiological factors studied were age at diagnosis, time from onset, gender, family history of diabetes, nephropathy, dyslipidemia, and/or hypertension; clinical factors studied were nutritional status, pubertal stage (Tanner method) and blood pressure; biochemical factors were glycated hemoglobin (HbA1c), microalbuminuria and lipid profile. Both cases and controls were followed for one year. Statistical analysis used chi square, odds ratio and multiple logistic regression calculations to determine main risk factors. Main outcome measures: Pubertal stage, lipid profile and HbA1c. Results: Risk factors determined were high diastolic blood pressure (p=0.037), puberty (p=0.008), high HbA1C (p

OBJETIVO: Determinar la asociación entre la microalbuminuria y prediabetes en los pacientes del Centro Materno Infantil del Rímac en el período comprendido desde enero a abril del 2015. METODOLOGÍA: Investigación de tipo Observacional, descriptivo, retrospectivo, transversal. Diseño: no experimental – epidemiológico. La población estuvo constituida por las pacientes que acudieron al servicio de endocrinología del Centro Materno Infantil del Rímac, siendo un total de 60 pacientes: 30 mujeres y 30 hombres. RESULTADOS: El 15% de los pacientes con prediabetes presentaron valor positivo de microalbuminuria en el servicio de endocrinología del Centro Materno infantil del Rímac. El valor promedio de la hemoglobina glicosilada de los pacientes prediabéticos fue de 5.9%, la edad media fue de 50 años y el rango de perímetro abdominal fue de 99 cm. CONCLUSIÓN: No existe relación entre la microalbuminuria y la prediabetes.

Introducción: usualmente se ha recomendado a personas diabéticas seguir una dieta baja en grasas. Sin embargo, las dietas bajas en carbohidratos (DBCH) parecen ser, al menos, igual de efectivas que las bajas en grasas, incluso aportan mejores resultados en algunos casos en cuanto a control glicémico, disminución de peso corporal y mejora de marcadores de riesgo cardiovascular.Objetivos: analizar el efecto de las DBCH con respecto a dietas bajas en grasas (DBG) u otras, en cuanto a glucemia basal, hemoglobina glicosilada (HbA1c), peso corporal, colesterol total y triglicéridos.Métodos:búsqueda bibliográfica de estudios publicados en Medline, Scopus, Cinahl, Lilacs, Dialnet, Scielo y ProQuest. Se extrajeron datos sobre la composición de las dietas evaluadas, duración y cambios respecto a glucemia basal, HbA1c, peso corporal, colesterol y triglicéridos.Resultados: se incluyen 15 estudios en la revisión: en uno de ellos se encontraron diferencias significativas entre grupos en los niveles de glucemia basal, en 6 en cuanto a HbA1c y en 3 en cuanto a peso corporal. Con respecto a los niveles de lípidos sanguíneos, no se encuentran en ningún estudio diferencias significativas entre grupos en cuanto al colesterol total, mientras que sí se encuentran en 3 estudios respecto a los niveles de triglicéridos.Conclusiones: esta revisión muestra que las DBCH pueden ser efectivas en algunos aspectos como la reducción de HbA1c, de peso corporal o de triglicéridos, aunque no hay suficiente evidencia científica que respalde su uso a largo plazo por encima de otras dietas, por lo que se precisa de más investigaciones futuras.

Background Increasing evidence suggests a mechanistic link between the glycemic environment and renal and cardiovascular events, even below the threshold for diabetes. We aimed to assess the association between HbA1c and chronic kidney disease (CKD) and cardiovascular disease (CVD). Methods A cross-sectional study involving a random representative sample of 2270 adults from southern Spain (Malaga) was undertaken. We measured HbA1c, serum creatinine and albuminuria in fasting blood and urine samples. Results Individuals without diabetes in the upper HbA1c tertile had an unfavorable cardiovascular and renal profile and shared certain clinical characteristics with the patients with diabetes. Overall, a higher HbA1c concentration was strongly associated with CKD or CVD after adjustment for traditional risk factors. The patients with known diabetes had a 2-fold higher odds of CKD or CVD. However, when both parameters were introduced in the same model, the HbA1c concentration was only significantly associated with clinical endpoints (OR: 1.4, 95% CI, 1.1-1.6, P = 0.002). An increase in HbA1c of one percentage point was associated with a 30% to 40% increase in the rate of CKD or CVD. This relationship was apparent in persons with and without known diabetes. ROC curves illustrated that a HbA1c of 37 mmol/mol (5.5%) was the optimal value in terms of sensitivity and specificity for predicting endpoints in this population. Conclusion HbA1c levels were associated with a higher prevalence of CKD and CVD cross-sectionally, regardless of diabetes status. These data support the value of HbA1c as a marker of cardiovascular and renal disease in the general population.

Nephropathy constitutes the most serious type 1 diabetes mellitus (type 1 DM) complication and microalbuminuria is the initial manifestation. Objectives: To determine the role of epidemiological, clinical and biochemical factors in the development of microalbuminuria in type 1 DM patients. Design: Case and control study. Setting: Endocrinology Unit, National Institute of Child Health, Lima, Peru. Patients: Subjects less than 18 year-old with type 1 DM. Interventions: Sixty-four type 1 DM patients were studied, 22 patients with microalbuminuria (cases) and 42 patients without it (controls). Epidemiological factors studied were age at diagnosis, time from onset, gender, family history of diabetes, nephropathy, dyslipidemia, and/or hypertension; clinical factors studied were nutritional status, pubertal stage (Tanner method) and blood pressure; biochemical factors were glycated hemoglobin (HbA1c), microalbuminuria and lipid profile. Both cases and controls were followed for one year. Statistical analysis used chi square, odds ratio and multiple logistic regression calculations to determine main risk factors. Main outcome measures: Pubertal stage, lipid profile and HbA1c. Results: Risk factors determined were high diastolic blood pressure (p=0.037), puberty (p=0.008), high HbA1C (p, La nefropatía constituye la complicación más grave de la diabetes mellitus tipo 1 (DMt1) siendo una de las manifestaciones iniciales la microalbuminuria. Objetivos: Determinar el comportamiento de los factores epidemiológicos, clínicos y bioquímicos en el desarrollo de microalbuminuria en pacientes con DMt1. Diseño: Estudio de casos y controles. Lugar: Servicio de Endocrinología del Instituto Nacional de Salud del Niño, Lima, Perú. Participantes: Pacientes diabéticos tipo 1 menores de 18 años. Intervenciones: Se estudió 64 pacientes portadores de DMt1, 22 con microalbuminuria y 42 sin esta manifestación, que constituyeron los casos y controles respectivamente. Se consignó como factores epidemiológicos la edad al diagnóstico, tiempo de evolución, género, antecedentes familiares de diabetes, nefropatía, dislipidemia, hipertensión arterial; como factores clínicos, el estado nutricional, desarrollo puberal (Tanner), presión arterial; y como factores bioquímicos, la hemoglobina glicosilada (HbA1c), microalbuminuria y perfil lipídico. Tanto los casos como los controles fueron seguidos durante un año. El análisis estadístico se hizo mediante pruebas de chi cuadrado, odds ratio y regresión logística, para establecer predominancia de factores. Principales medidas de resultados: Estadio puberal, perfil lipídico y HbA1c. Resultados: Los factores de riesgo hallados fueron la presión arterial diastólica elevada (p=0,037), la pubertad (p=0,008), HbA1c alta (p< 0,0001), hipertrigliceridemia (p= 0,007) y la hipercolesterolemia (p< 0,0001). Conclusiones: La HbA1c elevada, la hipercolesterolemia y la pubertad fueron los factores de riesgo de mayor preponderancia para el desarrollo de microalbuminuria. A fin de prevenir el desarrollo de microalbuminuria, se sugiere buen control metabólico y cuidadoso manejo de la dislipidemia, en especial en pacientes púberes.

Resumen Objetivo Describir las características de una población diabética, perfil de morbilidad, consumo de recursos, complicaciones y grado de control. Diseño Estudio transversal durante 2010. Emplazamiento Cuatro Áreas Básicas de Salud (91.301 personas) donde la organización sanitaria integrada Serveis de Salut Integrats Baix Empordà cubre la asistencia. Participantes Se han identificado 4.985 diabéticos, utilizando la codificación clínica de los contactos mediante CIE-9-MC y Clinical Risk Groups. Mediciones principales Perfil de morbilidad de los diabéticos, complicaciones y grado de control metabólico. Se analiza el consumo de recursos asistenciales, farmacéutico y de tiras reactivas de glucemia. Todas las mediciones a nivel individual. Resultados El 99,3% de los diabéticos acudió al menos una vez al centro de salud (14,9% del total de visitas). El 39,5% de la visitas de atención primaria y menos del 10% del resto de recursos analizados se dedicaron a la gestión de la diabetes. El coste de farmacia representa el 25,4% del consumo total de la población (coste medio 1.014,57?). El 36,5% de los diabéticos consumió tiras reactivas (coste medio 120,65?). Los CRG base más comunes son 5424-Diabetes (27%); 6144-Diabetes and Hypertension (25,5%) y 6143-Diabetes and Other Moderate Chronic Disease (17,2%). El grado de control de la enfermedad es mejor en pacientes que no toman fármacos o toman antidiabéticos orales no secretagogos. Conclusiones La comorbilidad es determinante en el consumo de recursos. Solo una parte de este consumo está dedicado al manejo de la diabetes. Los resultados obtenidos son consistentes y complementan desde un punto de vista poblacional los estudios existentes de ámbito estatal y autonómico.

Objective: To determine the effectiveness of pharmaceutical care to improve control of type-2 diabetes mellitus. Methods: We carried out pharmacotherapeutical intervention during 19 months on patients with type-2 diabetes mellitus who were affiliate members of the contributive regime of the General System for Healthcare and Social Security in Bogotá and Cartagena. Through an interview and evaluation of medical records, we obtained information about antidiabetic medications used, doses, other medications, along with Hemoglobin A1c level, arterial pressure, serum low-density lipoprotein cholesterol level, nephropathy screening, retinal screening, foot exams in the last year and problems associated with medication use by means of the DADER method Negative Outcomes Associated with Medication (NOM). Results: The study had a sample of 143 patients (64 intervened and 79 controls) with female predominance (67.1% and 53.1%, respectively), mean age of 63.9±11.2 years. The patients in both groups were taking an average of 6.0±2.7 medications. Initial HbA1c mean was 7.7% and 7.8%, without improvement by the end of the study (7.4% for those intervened and 7.8% for the control group). Hypertension (81.1%) and dyslipidemia (62.9%) were the most important comorbidities. About 50.4% of NOM were of effectiveness, follows 31.3% of necessity. The mean cost per patient in controls was 1.4 greater than for the intervened group. Conclusions: Increased effectiveness of the antidiabetic therapy was not demonstrated in patients intervened with pharmacotherapeutical monitoring, but we did obtain a reduction in healthcare costs. Objetivo: Determinar la efectividad del seguimiento farmacoterapéutico para mejorar el control de los pacientes diabéticos tipo 2. Métodos: Se realizó intervención farmacoterapéutica durante 19 meses a pacientes con diabetes mellitus tipo 2, afiliados al régimen contributivo del Sistema General de Seguridad Social en Salud en Bogotá y Cartagena. Mediante entrevista y revisión de la historia clínica, se obtuvo información sobre medicamentos antidiabéticos utilizados, dosis, comedicación, resultados en último año de HbA1c, tensión arterial, perfil lipídico, albuminuria, examen oftalmológico, valoración de pies y los Resultados Negativos Asociados con la Medicación (RNM) y se siguió la metodología DADER. Resultados: Participaron 143 pacientes, 64 intervenidos y 79 controles, con predominio de mujeres (67.1% y 53.1%, respectivamente), promedio de edad 63.9±11.2 años. Los pacientes de ambos grupos tomaban en promedio 6.0±2.7 medicamentos. La HbA1c inicial tuvo un promedio de 7.7% y 7.8% y al finalizar el estudio los valores fueron de 7.4% y 7.8%, respectivamente en cada grupo. El 50.4% de los RNM fueron de efectividad, seguido de 31.3% de necesidad. En la visita inicial y final la recomendación farmacéutica fue aceptada y el problema de salud resuelto en 72 casos (42.9% de RNM) y en 46 casos (38.3% de RNM), respectivamente. El cociente medio del costo por paciente en el grupo control fue 1.4 veces mayor que en el intervenido. Discusión: No se demostró aumento en la efectividad de la terapia antidiabética en pacientes intervenidos con seguimiento farmacoterapéutico, pero se consiguió una reducción en costos de la atención sanitaria.

Background: Measurement of HbA1c is the most important parameter to assess glycemic control in diabetic patients. Different point-of-care devices for HbA1c are available. The aim of this study was to evaluate two point-of-care testing (POCT) analyzers (DCA Vantage from Siemens and Afinion from Axis-Shield). We studied the bias and precision as well as interference from carbamylated hemoglobin. Methods: Bias of the POCT analyzers was obtained by measuring 53 blood samples from diabetic patients with a wide range of HbA1c, 4%–14% (20–130 mmol/mol), and comparing the results with those obtained by the laboratory method: HPLC HA 8160® Menarini. Precision was performed by 20 successive determinations of two samples with low 4.2% (22 mmol/mol) and high 9.5% (80 mmol/mol) HbA1c values. The possible interference from carbamylated hemoglobin was studied using 25 samples from patients with chronic renal failure. Results: The means of the differences between measurements performed by each POCT analyzer and the laboratory method (95% confidence interval) were: 0.28% (p Conclusions: Both POCT analyzers for HbA1c show good correlation with the laboratory method and acceptable precision.

"Explorar la asociacion entre recomendaciones dieteticas, ejercicio, acceso a seguridad social y medicamentos, y calidad de la atencion medica con el grado de control glucemico en pacientes diabeticos. Material y metodos. La informacion y muestras sanguineas se obtuvieron en 2005. Se analizo la proporcion de pacientes que se encontraban en buen control (.7%), mal control (7.01% - 9.5%) y descontrol severo (>9.5%), de acuerdo con su HbA1c. Fueron empleados modelos de regresion logistica binaria para determinar la asociacion entre los factores y niveles de glucemia. Resultados. El 30% de los pacientes diabeticos se encontraban en buen control. Conclusiones. Recibir consulta con un nutriologo disminuye la posibilidad de descontrol severo. Un alto porcentaje de los pacientes diabeticos se encuentra en alto grado de descontrol, por lo que es urgente reforzar el acceso y calidad de la atencion ofrecida a estos pacientes."

Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; OBJECTIVE This study was designed to evaluate the impact of a teleassistance system on the metabolic control of type 2 diabetes patients. RESEARCH DESIGN AND METHODS We conducted a 1-year controlled parallel-group trial comparing patients randomized (1) to an intervention group, assigned to a teleassistance system using real-time transmission of blood glucose results, with immediate reply when necessary, and telephone consultations, or (2) to a control group, being regularly followed-up at their healthcare center. Study subjects were type 2 diabetes patients >30 years of age followed in the primary care setting. RESULTS A total of 328 type 2 diabetes patients were recruited from 35 family practices in the province of Málaga, Spain. There was a reduction in hemoglobin A1c after 12 months from 7.62 +/- 1.60% to 7.40 +/- 1.43% (P = 0.027) in the intervention group and from 7.44 +/- 1.31% to 7.35 +/- 1.38% (P = 0.303) in the control group. The difference in the change between groups was not statistically significant. There was also a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and body mass index in the intervention group. In the control group, the only significant decline was in low-density lipoprotein cholesterol. CONCLUSIONS A teleassistance system using real-time transmission of blood glucose results with an option to make telephone consultations is feasible in the primary care setting as a support tool for family physicians in their follow-up of type 2 diabetes patients. Yes

Backgorund Mixed hyperlipidemia is common in patients with diabetes. Statins, the choice drugs, are effective at reducing lipoproteins that contain apolipoprotein B100, but they fail to exert good control over intestinal lipoproteins, which have an atherogenic potential. We describe the effect of prescription omega 3 fatty acids on the intestinal lipoproteins in patients with type 2 diabetes who were already receiving fluvastatin 80 mg per day. Methods Patients with type 2 diabetes and mixed hyperlipidemia were recruited. Fasting lipid profile was taken when patients were treated with diet, diet plus 80 mg of fluvastatin and diet plus fluvastatin 80 mg and 4 g of prescription omega 3 fatty acids. The intestinal lipoproteins were quantified by the fasting concentration of apolipoprotein B48 using a commercial ELISA. Results The addition of 4 g of prescription omega 3 was followed by significant reductions in the levels of triglycerides, VLDL triglycerides and the triglyceride/HDL cholesterol ratio, and an increase in HDL cholesterol (P < 0.05). Fluvastatin induced a reduction of 26% in B100 (P < 0.05) and 14% in B48 (NS). However, the addition of omega 3 fatty acids enhanced this reduction to 32% in B100 (NS) and up to 36% in B48 (P < 0.05). Conclusion Our preliminary findings therefore suggest an additional benefit on postprandial atherogenic particles when omega 3 fatty acids are added to standard treatment with fluvastatin.

Peripheral arterial disease, manifested as intermittent claudication or critical ischaemia, or identified by an ankle/brachial index < 0.9, is present in at least one in every four patients with type 2 diabetes mellitus. Several reasons exist for peripheral arterial disease in diabetes. In addition to hyperglycaemia, smoking and hypertension, the dyslipidaemia that accompanies type 2 diabetes and is characterised by increased triglyceride levels and reduced high-density lipoprotein cholesterol concentrations also seems to contribute to this association. Recent years have witnessed an increased interest in postprandial lipidaemia, as a result of various prospective studies showing that non-fasting triglycerides predict the onset of arteriosclerotic cardiovascular disease better than fasting measurements do. Additionally, the use of certain specific postprandial particle markers, such as apolipoprotein B-48, makes it easier and more simple to approach the postprandial phenomenon. Despite this, only a few studies have evaluated the role of postprandial triglycerides in the development of peripheral arterial disease and type 2 diabetes. The purpose of this review is to examine the epidemiology and risk factors of peripheral arterial disease in type 2 diabetes, focusing on the role of postprandial triglycerides and particles. Yes

RESUMEN La disglucemia en el paciente crítico (hiperglucemia, hipoglucemia, variabilidad de la glucemia y el tiempo en rango) es un marcador de severidad de la enfermedad crítica asociada a mayor mortalidad. Sin embargo, dicho impacto parece atenuarse en los pacientes con diabetes mellitus, en particular en aquellos con mal control glucémico premórbido lo cual ha sido denominado "paradoja de la diabetes". Este fenómeno determina que en los nuevos protocolos de control de la glucemia deban ser contemplados los valores de hemoglobina glucosilada (HbA1c) al ingreso a unidad de cuidados intensivos, siendo necesarios nuevos rangos de glucemia objetivos según los valores de la HbA1c. En tal sentido, la HbA1c surge como una herramienta sencilla que permite obtener información de utilidad terapéutica y valor pronóstico en la unidad de cuidados intensivos. ABSTRACT Dysglycemia in critically ill patients (hyperglycemia, hypoglycemia, glycemic variability and time in range) is a biomarker of disease severity and is associated with higher mortality. However, this impact appears to be weakened in patients with previous diabetes mellitus, particularly in those with poor premorbid glycemic control; this phenomenon has been called "diabetes paradox". This phenomenon determines that glycated hemoglobin (HbA1c) values should be considered in choosing glycemic control protocols on admission to an intensive care unit and that patients' target blood glucose ranges should be adjusted according to their HbA1c values. Therefore, HbA1c emerges as a simple tool that allows information that has therapeutic utility and prognostic value to be obtained in the intensive care unit.

ResumenObjetivoDescribir las características de una población diabética, perfil de morbilidad, consumo de recursos, complicaciones y grado de control.DiseñoEstudio transversal durante 2010.EmplazamientoCuatro Áreas Básicas de Salud (91.301 personas) donde la organización sanitaria integrada Serveis de Salut Integrats Baix Empordà cubre la asistencia.ParticipantesSe han identificado 4.985 diabéticos, utilizando la codificación clínica de los contactos mediante CIE-9-MC y Clinical Risk Groups.Mediciones principalesPerfil de morbilidad de los diabéticos, complicaciones y grado de control metabólico. Se analiza el consumo de recursos asistenciales, farmacéutico y de tiras reactivas de glucemia. Todas las mediciones a nivel individual.ResultadosEl 99,3% de los diabéticos acudió al menos una vez al centro de salud (14,9% del total de visitas). El 39,5% de la visitas de atención primaria y menos del 10% del resto de recursos analizados se dedicaron a la gestión de la diabetes. El coste de farmacia representa el 25,4% del consumo total de la población (coste medio 1.014,57?). El 36,5% de los diabéticos consumió tiras reactivas (coste medio 120,65?). Los CRG base más comunes son 5424-Diabetes (27%); 6144-Diabetes and Hypertension (25,5%) y 6143-Diabetes and Other Moderate Chronic Disease (17,2%). El grado de control de la enfermedad es mejor en pacientes que no toman fármacos o toman antidiabéticos orales no secretagogos.ConclusionesLa comorbilidad es determinante en el consumo de recursos. Solo una parte de este consumo está dedicado al manejo de la diabetes. Los resultados obtenidos son consistentes y complementan desde un punto de vista poblacional los estudios existentes de ámbito estatal y autonómico.AbstractObjectiveTo describe the characteristics of a diabetic population, morbidity profile, resource consumption, complications and degree of metabolic control.DesignCross-sectional study during 2010.LocationFour Health Areas (91.301 people) where the integrated management organization Serveis de Salut integrated Baix Empordà completely provide healthcare assistance.Participants4.985 diabetic individuals, identified through clinical codes using the ICD-9-MC classification and the 3M? Clinical Risk Groups software.Main measurementsMorbidity profile, related complications and degree of metabolic control were obtained for the target diabetic population. We analyzed the consumption of healthcare resources, pharmaceutical and blood glucose reagent strips. All measurements obtained at individual level.Results99.3% of the diabetic population were attended at least once at a primary care center (14.9% of visits). 39.5% of primary care visits and less than 10% of the other scanned resources were related to the management of diabetes. The pharmaceutical expenditure was 25.4% of the population consumption (average cost ?1.014,57). 36.5% of diabetics consumed reagents strips (average cost ?120,65). The more frequent CRG are 5424-Diabetes (27%); 6144-Diabetes and Hypertension (25,5%) and 6143-Diabetes and Other Moderate Chronic Disease (17,2%). The degree of disease control is better in patients not consumers of antidiabetic drugs or treated with oral antidiabetic agents not secretagogues.ConclusionsComorbidity is decisive in the consumption of resources. Just a few part of this consumption is specifically related to the management of diabetes. Results obtained provide a whole population approach to the main existing studies in our national and regional context.

Background A recent study using a rat model found significant differences at the time of diabetes onset in the bacterial communities responsible for type 1 diabetes modulation. We hypothesized that type 1 diabetes in humans could also be linked to a specific gut microbiota. Our aim was to quantify and evaluate the difference in the composition of gut microbiota between children with type 1 diabetes and healthy children and to determine the possible relationship of the gut microbiota of children with type 1 diabetes with the glycemic level. Methods A case-control study was carried out with 16 children with type 1 diabetes and 16 healthy children. The fecal bacteria composition was investigated by polymerase chain reaction-denaturing gradient gel electrophoresis and real-time quantitative polymerase chain reaction. Results The mean similarity index was 47.39% for the healthy children and 37.56% for the children with diabetes, whereas the intergroup similarity index was 26.69%. In the children with diabetes, the bacterial number of Actinobacteria and Firmicutes, and the Firmicutes to Bacteroidetes ratio were all significantly decreased, with the quantity of Bacteroidetes significantly increased with respect to healthy children. At the genus level, we found a significant increase in the number of Clostridium, Bacteroides and Veillonella and a significant decrease in the number of Lactobacillus, Bifidobacterium, Blautia coccoides/Eubacterium rectale group and Prevotella in the children with diabetes. We also found that the number of Bifidobacterium and Lactobacillus, and the Firmicutes to Bacteroidetes ratio correlated negatively and significantly with the plasma glucose level while the quantity of Clostridium correlated positively and significantly with the plasma glucose level in the diabetes group. Conclusions This is the first study showing that type 1 diabetes is associated with compositional changes in gut microbiota. The significant differences in the number of Bifidobacterium, Lactobacillus and Clostridium and in the Firmicutes to Bacteroidetes ratio observed between the two groups could be related to the glycemic level in the group with diabetes. Moreover, the quantity of bacteria essential to maintain gut integrity was significantly lower in the children with diabetes than the healthy children. These findings could be useful for developing strategies to control the development of type 1 diabetes by modifying the gut microbiota.

The aims of this study were to check whether different biomarkers of inflammatory, apoptotic, immunological or lipid pathways had altered their expression in the occluded popliteal artery (OPA) compared with the internal mammary artery (IMA) and femoral vein (FV) and to examine whether glycemic control influenced the expression of these genes. The study included 20 patients with advanced atherosclerosis and type 2 diabetes mellitus, 15 of whom had peripheral arterial occlusive disease (PAOD), from whom samples of OPA and FV were collected. PAOD patients were classified based on their HbA1c as well (HbA1c ≤ 6.5) or poorly (HbA1c > 6.5) controlled patients. Controls for arteries without atherosclerosis comprised 5 IMA from patients with ischemic cardiomyopathy (ICM). mRNA, protein expression and histological studies were analyzed in IMA, OPA and FV. After analyzing 46 genes, OPA showed higher expression levels than IMA or FV for genes involved in thrombosis (F3), apoptosis (MMP2, MMP9, TIMP1 and TIM3), lipid metabolism (LRP1 and NDUFA), immune response (TLR2) and monocytes adhesion (CD83). Remarkably, MMP-9 expression was lower in OPA from well-controlled patients. In FV from diabetic patients with HbA1c ≤6.5, gene expression levels of BCL2, CDKN1A, COX2, NDUFA and SREBP2 were higher than in FV from those with HbA1c >6.5.The atherosclerotic process in OPA from diabetic patients was associated with high expression levels of inflammatory, lipid metabolism and apoptotic biomarkers. The degree of glycemic control was associated with gene expression markers of apoptosis, lipid metabolism and antioxidants in FV. However, the effect of glycemic control on pro-atherosclerotic gene expression was very low in arteries with established atherosclerosis., This study was undertaken with finance from FIS “Centros de Investigación En Red” (CIBER, CB06/03/0018) and REDINSCOR RD06/0003/0015 from Instituto de Salud Carlos III, Madrid, Spain.