Interventions to improve patients’ compliance with therapies aimed at lowering glycated hemoglobin (HbA1c) in type 1 diabetes: systematic review and meta-analyses of randomized controlled clinical trials of psychological, telecare, and educational interventions

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BIOMETRIC ASPECTS OF FRUIT AND SEEDS Poincianella pluviosa var. peltophoroides (Benth.) L.P. Queiroz

Species arboreal, native of the Atlantic Forest biome, Poincianella pluviosa var. peltophoroides (Benth.) L.P. Queirozis widely used in urban landscaping due to the beauty of its flowering and indicated for the recovery of degradedareas as an initial or pioneer secondary species. The objective of the study was to characterize the fruits and seedsbiometrically, thus helping in its conservation and improvement. The work was conducted at the Federal Universityof Campina Grande, campus of Patos-PB, and the fruits were collected manually in matrices located on campus, usingas a selection criterion those who were mature. To obtain the biometric data, the fruits were selected and separated100 fruits and 100 seeds at random. To measure the biometric variables (length, width and thickness) of the fruitsand seeds, a digital caliper with a precision of 0.1 mm was used and then the amplitude of the classes of each analyzedvariable was calculated. The results showed that the fruits presented variation in the length of 4.51 to 10.53 cm,however, the predominance of fruit frequency was in the class of 6.03-6.77 cm. The seed length varied from 0.918 to1.208 cm, with a higher incidence in the class of 1.064-1.112 cm, where it concentrated about 45% of the seeds. It isconcluded that the fruits Poincianella pluviosa var. peltophoroides presented greater uniformity in the variable lengthand their seeds presented greater uniformity in the biometric variables in which they were evaluated, being this afavorable criterion for its propagation.Species arboreal, native of the Atlantic Forest biome, Poincianella pluviosa var. peltophoroides (Benth.) L.P. Queirozis widely used in urban landscaping due to the beauty of its flowering and indicated for the recovery of degradedareas as an initial or pioneer secondary species. The objective of the study was to characterize the fruits and seedsbiometrically, thus helping in its conservation and improvement. The work was conducted at the Federal Universityof Campina Grande, campus of Patos-PB, and the fruits were collected manually in matrices located on campus, usingas a selection criterion those who were mature. To obtain the biometric data, the fruits were selected and separated100 fruits and 100 seeds at random. To measure the biometric variables (length, width and thickness) of the fruitsand seeds, a digital caliper with a precision of 0.1 mm was used and then the amplitude of the classes of each analyzedvariable was calculated. The results showed that the fruits presented variation in the length of 4.51 to 10.53 cm,however, the predominance of fruit frequency was in the class of 6.03-6.77 cm. The seed length varied from 0.918 to1.208 cm, with a higher incidence in the class of 1.064-1.112 cm, where it concentrated about 45% of the seeds. It isconcluded that the fruits Poincianella pluviosa var. peltophoroides presented greater uniformity in the variable lengthand their seeds presented greater uniformity in the biometric variables in which they were evaluated, being this afavorable criterion for its propagation

Produtividade de feijoeiro-caupi cultivado com estirpes rizobianas e doses de fósforo

A fixação biológica de nitrogênio tem se mostrado indispensável para a sustentabilidade da agricultura brasileira, devido ao fornecimento de nitrogênio com baixo custo econômico para as culturas e redução no impacto ambiental. Diante do exposto, objetivou-se com o presente trabalho avaliar a eficiência de estirpes rizobianas e doses de fósforo, para maximizar o crescimento de duas cultivares de feijoeiro-caupi e fixação de azoto e obtenção de melhor desempenho agronômico. O delineamento experimental utilizado foi blocos casualizados, em esquema fatorial 3 x 6 (2 estirpes de rizóbio + 1 tratamento sem inoculação x 6 doses de fósforo), contendo 4 repetições. As doses consistiram de 0, 30, 60, 90, 120 e 150 kg ha-1 de P2O5. A adubação potássica foi realizada na semeadura, utilizando 60 kg ha-1 de K2O. O suprimento de água para a cultura foi realizado com irrigação e turno de rega de dois dias, com vazão aproximada de 5 mm. As características avaliadas foram: clorofila realizada aos 45 dias após a semeadura, biomassa seca da parte aérea (g), peso de cem sementes (g), nitrogênio total da parte aérea (dag kg ha-1) e produtividade (kg ha-1). De modo geral as duas estirpes testadas apresentaram capacidade para nodulação e fixação biológica de nitrogênio. A estirpe INPA 03-11B foi a mais indicada para a cv. BRS Sempre Verde e a BR 3299 a mais indicada para a cv. BRS Vinagre de feijoeiro-caupi. A dose de fósforo que condicionou a máxima eficiência agronômica em feijoeiro-caupi variou de 70 a 110 kg ha-1. Maior teor de nitrogênio para as duas cultivares de feijoeiro foi verificado com a utilização da estirpe BR 3299

Nationwide multicenter study on the prevalence of overweight and obesity in type 2 diabetes mellitus in the Brazilian population

AIM: To evaluate the prevalence of overweight and obesity in type 2 diabetic (DM2) outpatients from different regions of Brazil. PATIENTS AND METHODS: We studied 2,519 randomly selected patients, from 11 hospitals, 2 endocrine and one general public care clinics from 10 cities. Overweight was defined as body-mass index (BMI) > 25 and obesity as BMI > 30 kg/m². Glycemic control (GC) was evaluated by GC index (GCI= patient's HbA1 or HbA1c/upper limit of normal for the method x 100). RESULTS: 39% of the population studied was male, the mean age was 58.8 ± 11.6 y, the duration from clinical diagnosis of DM2 was 9.0 ± 7.3y, and BMI was 28.3 ± 5.2 kg/m². No measurements of BMI were recorded from 265 patients (10.5%). Patients from the Northeast presented lower BMI as compared with those from the Midwest, Southeast and South areas, respectively (26.4 ± 4.7 vs. 27.9 ± 4.8 vs. 29.2 ± 5.1 vs. 29.4 ± 5.4 kg/m²; p 25 e obesidade um IMC > 30 kg/m². O controle glicêmico (CG) foi avaliado pelo índice de CG [ICG= HbA1 e ou HbA1c do paciente/limite superior de normalidade do método x 100]. RESULTADOS: Os pacientes tinham idade de 58,8 ± 11,6 anos, tempo de diagnóstico clínico de DM de 9,0 ± 7,3 anos, IMC de 28,3 ± 5,2 kg/m², e 39% eram do sexo masculino. Do total da amostra, 265 pacientes (10,5%) não apresentavam avaliação do IMC. Os pacientes da região Nordeste apresentaram menor IMC em comparação com os das regiões Centro-Oeste, Sudeste e Sul, respectivamente (26,4 ± 4,7 vs. 27,9 ± 4,8 vs. 29,2 ± 5,1 vs. 29,4 ± 5,4 kg/m²; p< 0,001). Houve maior prevalência de obesidade na região Sudeste e Sul em comparação à região Nordeste (p< 0,001) e nos pacientes do sexo feminino, respectivamente (69 vs. 31%; p< 0,001). Os pacientes com peso normal apresentaram menor ICG. Aqueles em tratamento com associação de duas ou mais drogas orais e associação de insulina + droga oral apresentaram maior IMC do que aqueles em tratamento com dieta, hipoglicemiante oral e insulina; p< 0,001. O IMC não diferiu entre os pacientes assistidos ou não por especialistas. CONCLUSÕES: Da população estudada, 75% não estava na faixa de peso ideal, sendo que um terço tinha obesidade. Nossos dados indicam que o sobrepeso e a obesidade já atingem um percentual de pacientes com DM2 no Brasil semelhante ao relatado em estudos europeus, mas ainda menor do que o observado nos EUA. A prevalência de obesidade nos pacientes diabéticos foi três vezes maior do que a observada na população brasileira em geral de acordo com os dados do IBGE.UERJUSPUNIFESP-EPMUNICAMPUNIFEUniversidade Federal do MaranhãoCEDEBVA Serviço de Endocrinologia e DiabetesHospital Agamenon Magalhães Serviços de EndocrinologiaSanta Casa Serviços de EndocrinologiaIAPSEB Serviços de EndocrinologiaHospital Geral Serviços de EndocrinologiaPAM Jaguaribe Serviços de EndocrinologiaSanta Casa Serviço de DiabetesSecretaria Municipal de SaúdeUNIFESP, EPMSciEL

Is MR Spectroscopy Really the Best MR-Based Method for the Evaluation of Fatty Liver in Diabetic Patients in Clinical Practice?

Objective: To investigate if magnetic resonance spectroscopy (MRS) is the best Magnetic Resonance (MR)-based method when compared to gradient-echo magnetic resonance imaging (MRI) for the detection and quantification of liver steatosis in diabetic patients in the clinical practice using liver biopsy as the reference standard, and to assess the influence of steatohepatitis and fibrosis on liver fat quantification.Methods: Institutional approval and patient consent were obtained for this prospective study. Seventy-three patients with type 2 diabetes (60 women and 13 men; mean age, 5469 years) underwent MRI and MRS at 3.0 T. the liver fat fraction was calculated from triple-and multi-echo gradient-echo sequences, and MRS data. Liver specimens were obtained in all patients. the accuracy for liver fat detection was estimated by receiver operator characteristic (ROC) analysis, and the correlation between fat quantification by imaging and histolopathology was analyzed by Spearman's correlation coefficients.Results: the prevalence of hepatic steatosis was 92%. All gradient-echo MRI and MRS findings strongly correlated with biopsy findings (triple-echo, rho = 0.819; multi-echo, rho = 0.773; MRS, rho = 0.767). Areas under the ROC curves to detect mild, moderate, and severe steatosis were: triple-echo sequences, 0.961, 0.975, and 0.962; multi-echo sequences, 0.878, 0.979, and 0.961; and MRS, 0.981, 0.980, and 0.954. the thresholds for mild, moderate, and severe steatosis were: triple-echo sequences, 4.09, 9.34, and 12.34, multi-echo sequences, 7.53, 11.75, and 15.08, and MRS, 1.71, 11.69, and 14.91. Quantification was not significantly influenced by steatohepatitis or fibrosis.Conclusions: Liver fat quantification by MR methods strongly correlates with histopathology. Due to the wide availability and easier post-processing, gradient-echo sequences may represent the best imaging method for the detection and quantification of liver fat fraction in diabetic patients in the clinical practice.D'Or Institute for Research and EducationFundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)DOr Inst Res & Educ, Rio de Janeiro, BrazilUniv Fed Rio de Janeiro, Rio de Janeiro, BrazilUniv Estado Rio de Janeiro, Rio de Janeiro, BrazilUniv São Paulo, Inst Phys Sao Carlos, Sao Carlos, SP, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniv Paris Diderot Sorbonne, Paris, FranceUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Lower insulin-dose adjusted A1c (IDAA1c) is associated with less complications in Individuals with Type 1 Diabetes treated with hematopoetic stem-cell transplantation and conventional therapy

Objective: To evaluate the association between insulin-dose adjusted A1C (IDAA1c) and microvascular complications (MC) and hypoglycemia in a representative Brazilian population of Type 1 diabetes mellitus (T1DM) patients. Research Design and Methods: This was a cross-sectional study based on a previous study, “Microvascular Complications in Type 1 Diabetes: a comparative analysis of patients treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) and conventional medical therapy (CT)”. The 168 patients in that study (144 from CT plus 24 from AHST) were re-subdivided into two groups, according to their IDAA1c values (30 patients had IDAA1c ≤ 9; 138 had IDAA1c > 9). Then, the prevalence of MC (diabetic renal disease, neuropathy, and retinopathy), hypoglycemia (blood glucose <60 mg/dL), and severe hypoglycemic (episode of hypoglycemia that required the assistance of another person to treat) events were compared between the groups. The groups were well-matched on these factors: duration of disease, sex, and age at the time of diagnosis of T1DM. Results: After an average of 8 years after diagnosis, only 6.6% (2/30) of the patients from IDAA1c ≤ 9 group developed any MC, whereas 21.0% (29/138) from the IDAA1c > 9 group had at least one complication (p = 0.044). Regarding hypoglycemic events, the proportion of individuals who reported at least 1 episode of hypoglycemia in the last month was 43.3 and 64.7% from the IDAA1c ≤ 9 and IDAA1c > 9 groups, respectively (p = 0.030). Regarding severe hypoglycemia, the proportion of patients presenting at least one episode in the last month and the rate of episode/patient/month were similar between groups (6.7 vs. 13.2%; p = 0.535; and 0.1/patient/month vs. 0.25/patient/month; p = 0.321). Conclusion: In a representative Brazilian population of T1DM patients, those with IDAA1c ≤ 9 presented a lower frequency of MC, as well as fewer episodes of hypoglycemia, in the month prior to the analysis.publishedVersio