Estudio traslacional para el manejo de la obesidad utilizando el Programa de Prevención de Diabetes “Grupo de Equilibrio de Estilo de Vida” en clínicas de primer nivel y hospitales públicos de México: protocolo de estudio

Introduction: Obesity is the main modifiable risk factor for the development of chronic diseases in Mexico. Several randomized controlled trials have shown that intensive lifestyle programs are efficacious for the management of obesity. These programs include frequent sessions (14 or more contacts in the first 6 months) focused on diet and physical activity and use a behavior change protocol. However, most Mexican primary care clinics and public hospitals apply traditional treatments for obesity management with limited results on weight loss. The purpose of the study is to evaluate the effectiveness of the Diabetes Prevention Program (DPP) “Group Lifestyle Balance” for weight loss among adults with overweight and obesity from baseline to 6 months and from baseline to 12 months in primary care clinics and public hospitals from Sonora, Mexico.Material and Methods: This is a translational, multi-center, non-controlled, 6 and 12-month follow-up clinical study with a pre-test and post-test design. Healthcare providers from two primary care clinics, two hospitals and one university clinic will be trained with the DPP protocol to implement on their patients with overweight and obesity. Body weight, body mass index, waist circumference, systolic and diastolic blood pressure, depression, quality of life and stress scales will be measured in participants receiving the program at baseline, 6 and 12 months. Biochemical parameters will be measured at baseline and 12 months. The primary outcome is the change in body weight at 6 and 12 months.Discussion: This study will provide scientific evidence of the effectiveness of the DPP protocol as a model for obesity management in real world clinical practice among the adult Mexican population.Introducción: La obesidad es el principal factor de riesgo para el desarrollo de enfermedades crónicas en México. Varios ensayos clínicos controlados han mostrado que los programas intensivos de cambio de estilo de vida son eficaces para el manejo de obesidad. Estos programas incluyen sesiones frecuentes (14 o más los primeros 6 meses), centradas en hacer mejoras en la dieta y actividad física utilizando un protocolo de cambio de comportamiento. Sin embargo, la mayoría de clínicas de primer nivel y los hospitales públicos aplican tratamientos tradicionales para el manejo de obesidad que tienen resultados limitados. El propósito del estudio es evaluar la efectividad del Programa de Prevención de Diabetes “Grupo de Equilibrio de Estilo de Vida” sobre la pérdida de peso en adultos con sobrepeso y obesidad del inicio a 6 meses y del inicio a 12 meses del seguimiento en clínicas de primer nivel y hospitales públicos de Sonora, México.Material y Métodos: Este es un estudio clínico multicéntrico traslacional, no controlado con diseño pre y post-prueba a 6 y 12 meses. Los proveedores de salud de dos clínicas de primer nivel, dos hospitales públicos y una clínica universitaria serán entrenados con el protocolo del Programa de Prevención de Diabetes, para implementarlo en sus pacientes adultos con sobrepeso y obesidad. Se medirá el peso corporal, índice de masa corporal, circunferencia de cintura, presión sistólica y diastólica, así como escalas de depresión, calidad de vida y estrés, al inicio, 6 y 12 meses. Los parámetros bioquímicos se medirán al inicio y a los 12 meses. La variable de desenlace primaria será el cambio de peso a 6 y 12 meses.Discusión: Este estudio proveerá evidencia científica de la efectividad del protocolo del Programa de Prevención de Diabetes como un modelo para el manejo de obesidad en adultos mexicanos en condiciones de la práctica clínica del mundo real

Proceedings of the 24th Paediatric Rheumatology European Society Congress: Part three

From Springer Nature via Jisc Publications Router.Publication status: PublishedHistory: collection 2017-09, epub 2017-09-0

Efecto de una intervención en línea de cambio en el estilo de vida sobre el puntaje zIMC de escolares mexicanos: protocolo de ensayo controlado aleatorizado piloto cegado a evaluadores durante la pandemia por COVID-19

Introduction: School closures due to the COVID-19 pandemic represent a risk factor for the development of childhood obesity, due to the increase in unhealthy behaviors. Online lifestyle interventions in schoolchildren could help to mitigate this problem. However, to our knowledge, no randomized controlled trials have been conducted to prevent obesity in schoolchildren during COVID-19. The aim of this study is to evaluate the effect of a 4-month online lifestyle intervention on the BMI Z-score of Mexican schoolchildren during the COVID-19 pandemic in an intervention group compared to a control group. Material and Methods: This is a protocol for an outcome assessor-blinded pilot randomized controlled trial. Schoolchildren from a public elementary school in Hermosillo, Sonora, Mexico will be invited to participate. Participants will be randomized to an intervention group (online lifestyle intervention) or a control group. The intervention will include online sessions of nutrition education and physical activity (60 minutes per session, 30 minutes for nutrition education and 30 minutes for physical activity) and nutrition information for parents. The control group will receive a digital brochure with nutrition recommendations at the beginning of the study and access to the program materials at the end of the study. The measurements will be performed at baseline and at 4 months. The primary outcome will be the BMI Z- score. Secondary outcomes will be waist circumference, body fat percentage, nutrition knowledge, lifestyle parameters, participation, retention and acceptance of the intervention. The changes on the outcomes will be analyzed using an intention to treat analysis. The protocol was approved by the Research Ethics Committee of the University of Sonora Nursing Department and registered in Clinical Trials. Conclusion: To our knowledge, the study will provide the first evidence of the evaluation of online interventions for the prevention of obesity in schoolchildren derived from a randomized controlled trial, which could be useful in the fight against childhood obesity.Introducción: El cierre de escuelas por la pandemia de COVID-19, representa un factor de riesgo para el desarrollo de obesidad en los niños, debido al aumento de conductas no saludables. Las intervenciones de cambio de estilo de vida en línea en escolares podrían ayudar a mitigar este problema. Sin embargo, en nuestro conocimiento no se han realizado ensayos controlados aleatorizados para prevenir obesidad en escolares durante COVID-19. El objetivo del presente estudio es evaluar el efecto de una intervención en línea de cambio de estilo de vida sobre el puntaje Z de IMC de escolares mexicanos a 4 meses durante la pandemia por COVID-19 en un grupo intervención en comparación a un control. Material y Métodos: Protocolo de un ensayo controlado aleatorizado piloto cegado a los evaluadores. Se invitará a participar a escolares de una primaria pública de Hermosillo, Sonora, México. Los participantes serán aleatorizados a un grupo de intervención o a un grupo control. La intervención incluirá 3 sesiones semanales en línea de educación nutricional y actividad física (60 minutos por sesión, 30 minutos de educación nutricional y 30 minutos para la actividad física) e información para padres de familia. El grupo control recibirá un folleto digital con recomendaciones de una dieta saludable al inicio del estudio y acceso a los materiales del programa al finalizar. Las mediciones del estudio se realizarán al inicio y a los 4 meses. La variable primaria será el puntaje Z de IMC. Las variables secundarias serán circunferencia de cintura, porcentaje de grasa, conocimientos en nutrición, parámetros de estilo de vida, retención, aceptación y participación en la intervención. Los cambios de las variables se analizarán mediante pruebas de comparación de medias por intención de tratamiento. El protocolo fue aprobado por el Comité de Ética en Investigación del Departamento de Enfermería de la Universidad de Sonora y registrado en la plataforma Clinical Trials. Conclusión: En nuestro conocimiento, el estudio aportará la primera evidencia de la evaluación de intervenciones en línea para la prevención de obesidad en escolares derivada de un ensayo controlado aleatorizado, lo cual podría ser útil en el combate de la obesidad infantil

Agreement between hemocue and glucose oxidase methods for blood glucose measurement in a field work study of diabetes: the Comcaac project

Abstract To monitor and detect blood glucose (BG) abnormalities, health professionals use glucose meters. The study’s objective was to compare HemoCue (HC) versus glucose oxidase (GOx) for the measurement of BG using 368 measurements of BG by both methods. Bland & Altman graphs, paired t-test and linear regression were used to compare the methods. Concordance was found between the methods in most glucose levels, except at glucose concentrations ≥ 6.993 mmol / L. HC glucose analyzer is good for use in field studies because it is technically easy and requires very little maintenance; however, it is recommended to take special care with people whose glucose values are within the limit of the diagnosis of diabetes, since with the HC method there is a risk of misclassifying people who already have diabetes, as non-diabetics. Therefore, given the importance of knowing the actual values of glucose levels in this group of people for an accurate diagnosis, considering a subsequent analysis with the GOx method to corroborate the result is recommended

Translational study of obesity management using the Diabetes Prevention Program “Group Lifestyle Balance” in primary care clinics and public hospitals from Mexico: study protocol

Introduction: Obesity is the main modifiable risk factor for the development of chronic diseases in Mexico. Several randomized controlled trials have shown that intensive lifestyle programs are efficacious for the management of obesity. These programs include frequent sessions (14 or more contacts in the first 6 months) focused on diet and physical activity and use a behavior changeprotocol. However, most Mexican primary care clinics and public hospitals apply traditional treatments for obesity management with limited results on weight loss. The purpose of the study is to evaluate the effectiveness of the Diabetes Prevention Program (DPP) “Group Lifestyle Balance” for weight loss among adults with overweight and obesity from baseline to 6 months and from baseline to 12 months in primary care clinics and public hospitals from Sonora, Mexico. Material and Methods: This is a translational, multi-center, non-controlled, 6 and 12-month follow-up clinical study with a pre-test and post-test design. Healthcare providers from two primary care clinics, two hospitals and one university clinic will be trained with the DPP protocol to implement on their patients with overweight and obesity. Body weight, body mass index, waist circumference, systolic and diastolic blood pressure, depression, quality of life and stress scales will be measured in participants receiving the program at baseline, 6 and 12 months. Biochemical parameters will be measured at baseline and 12 months. The primary outcome is the change in body weight at 6 and 12 months. Discussion: This study will provide scientific evidence of the effectiveness of the DPP protocol as a model for obesity management in real world clinical practice among the adult Mexican population.Introducción: La obesidad es el principal factor de riesgo para el desarrollo de enfermedades crónicas en México. Varios ensayos clínicos controlados han mostrado que los programas intensivos de cambio de estilo de vida son eficaces para el manejo de obesidad. Estos programas incluyen sesiones frecuentes (14 o más los primeros 6 meses), centradas en hacer mejoras en la dieta y actividad física utilizando un protocolo de cambio de comportamiento. Sin embargo, la mayoría de clínicas de primer nivel y los hospitales públicos aplican tratamientos tradicionales para el manejo de obesidad que tienen resultados limitados. El propósito del estudio es evaluar la efectividad del Programa de Prevención de Diabetes “Grupo de Equilibrio de Estilo de Vida” sobre la pérdida de peso en adultos con sobrepeso y obesidad del inicio a 6 meses y del inicio a 12 meses del seguimiento en clínicas de primer nivel y hospitales públicos de Sonora, México. Material y Métodos: Este es un estudio clínico multicéntrico traslacional, no controlado con diseño pre y post-prueba a 6 y 12 meses. Los proveedores de salud de dos clínicas de primer nivel, dos hospitales públicos y una clínica universitaria serán entrenados con el protocolo del Programa de Prevención de Diabetes, para implementarlo en sus pacientes adultos con sobrepeso y obesidad. Se medirá el peso corporal, índice de masa corporal, circunferencia de cintura, presión sistólica y diastólica, así como escalas de depresión, calidad de vida y estrés, al inicio, 6 y 12 meses. Los parámetros bioquímicos se medirán al inicio y a los 12 meses. La variable de desenlace primaria será el cambio de peso a 6 y 12 meses. Discusión: Este estudio proveerá evidencia científica de la efectividad del protocolo del Programa de Prevención de Diabetes como un modelo para el manejo de obesidad en adultos mexicanos en condiciones de la práctica clínica del mundo real

Translational study of obesity management using the Diabetes Prevention Program "Group Lifestyle Balance" in primary care clinics and public hospitals from Mexico: study protocol

Introduction: Obesity is the main modifiable risk factor for the development of chronic diseases in Mexico. Several randomized controlled trials have shown that intensive lifestyle programs are efficacious for the management of obesity. These programs include frequent sessions (14 or more contacts in the first 6 months) focused on diet and physical activity and use a behavior change protocol. However, most Mexican primary care clinics and public hospitals apply traditional treatments for obesity management with limited results on weight loss. The purpose of the study is to evaluate the effectiveness of the Diabetes Prevention Program (DPP) “Group Lifestyle Balance” for weight loss among adults with overweight and obesity from baseline to 6 months and from baseline to 12 months in primary care clinics and public hospitals from Sonora, Mexico. Material and Methods: This is a translational, multi-center, non-controlled, 6 and 12-month follow-up clinical study with a pre-test and post-test design. Healthcare providers from two primary care clinics, two hospitals and one university clinic will be trained with the DPP protocol to implement on their patients with overweight and obesity. Body weight, body mass index, waist circumference, systolic and diastolic blood pressure, depression, quality of life and stress scales will be measured in participants receiving the program at baseline, 6 and 12 months. Biochemical parameters will be measured at baseline and 12 months. The primary outcome is the change in body weight at 6 and 12 months. Discussion: This study will provide scientific evidence of the effectiveness of the DPP protocol as a model for obesity management in real world clinical practice among the adult Mexican population

Effectiveness of a Lifestyle Change Program on Insulin Resistance in Yaquis Indigenous Populations in Sonora, Mexico: PREVISY

To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆ = −0.91 and ∆ = −1.29, p ≤ 0.05) and the TyG index (∆ = −0.24 y ∆ = −0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆ = −3.32 and ∆ = −4.89, p ≤ 0.05) and the TyG index (∆ = −0.80 and ∆ = −0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes

Effectiveness of a Lifestyle Change Program on Insulin Resistance in Yaquis Indigenous Populations in Sonora, Mexico: PREVISY

Objective: To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Methods: Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆=-0.91 and ∆=-1.29, p ≤ 0.05) and the TyG index (∆=-0.24 y ∆=-0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆=-3.32 and ∆=-4.89, p ≤ 0.05) and the TyG index (∆=-0.80 and ∆=-0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). Conclusion: The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes