Development and evaluation of a pharmaceutical care program to reduce modifiable risk of chronic complications in brazilian type 2 diabetic patients

In this study we developed and evaluated a pharmaceutical care program (PCP) to reduce modifiable risk factors of chronic complications of type 2 diabetes. Patients who acquired their anti-diabetic drugs from a Brazilian community pharmacies chain were invited to participate in the PCP. The recruited patients were monthly interviewed and information about pharmacotherapy, comorbidities, diet, physical activity, body mass index (BMI), blood pressure (BP), and waist circumference (WC) were obtained. Evaluation of glycemia, glycated hemoglobin A1c (HbA1c), and lipid profile analyses was done after the first interview and repeated every four months until finish the PCP. The 51 (91.1 %) patients who completed the PCP (12 months) showed improvement in the nutritional habits, physical activity, pharmacoterapeutic follow-up, HbA1c, lipid profile, BP, WC, and BMI. Thus, the PCP was applicable to the type 2 diabetic patients improving diabetes education and reducing modifiable risk factors of chronic complications.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Desenvolvimento de um Modelo de Consulta Farmacêutica para Avaliação e Acompanhamento de Pacientes Diabéticos Tipo 2

Objectives: The purposes of this study were the development and evaluation of a pharmaceutical consultation (PC) program to reduce the risks of chronic complications in type 2 diabetic patients (T2DP). Methods: T2DP receiving conventional medical treatment but showing ineffective glicemic control (fasting glycemia > 140 mg/dl and/or glycated hemoglobin > 7) were selected among patients from the Pharmacy School or popular pharmacy of State University of Maringá (Paraná state, Brazil). The PC evaluated drug therapy and its monitoring through the clinical laboratory parameters, vital signs and anthropometry. The PC was repeated every 4 months during 1 year. The PC includes strategies that have been used successfully in other pharmaceutical care models, namely Dader’s method, SOAP’s (Subjective data, Objective data, Assessment, and Plan of care) method, Pharmacist´s Workup of Drug Therapy (PWT) method and models of nurse care used in Brazil. Results: Fifty patients completed the study (1 year). There was a reduction of glycemia (P<0.0001), glycated hemoglobin (P = 0.0022), total cholesterol (P = 0.0072), triacylglycerol (P = 0.0204), systolic blood pressure (P<0.0001), diastolic blood pressure (P<0.0001) and elevation of low density lipoprotein (p = 0.0042). The pharmacological profile and therapeutic schedule of drugs consumption after starting (0 month) and finish (12 months) the study were very similar. For this reason the increased concordance with drug treatment and the pharmacological correction of drug-related problems contributed to improve the medical treatment of diabetes. Conclusions: The PC program developed in this study was suitable to promote reduction of chronic complications risk factors in T2DP

Hepatic gluconeogenesis in rats trained to eat a single meal daily. Role of eating periodicity and the amount of food ingested in the last meal

Rats trained to eat a single daily meal (MF rats), from 8:00-10:00 a.m., increased food intake from the 1 st to the 12 th (125%) day of feeding training. In this work we compared the influence of the higher food ingestion in the last meal and feeding training on hepatic gluconeogenesis. Thus, rats at the 1 st (MF 1st day-5g group) and 13 th day (MF 13th day-5g group) of training, refed with a fixed amount of food (5g) were employed. In addition, a third group of MF rats, refed on day 12 with 75% (12g) of the food ingested by MF rats on the 13 th day of the feeding training (MF 13th day-12g) was included. The experiments were performed at 22 h after meal (8:00 a.m.). Our results demonstrated that feeding training had a crucial role in determining gluconeogenesis from pyruvate (5 mM). Additionally, gluconeogenesis from L-glutamine (5 mM) was influenced by periodicity of eating and the amount of food ingested in the last meal. In contrast, gluconeogenesis from L-alanine (5 mM) was not influenced by both factors. In conclusion, our findings suggested that the hepatic gluconeogenesis was influenced by food ingestion and/or feeding training depending of the substrate investigated. These effects on gluconeogenesis may have implications for use in diabetic regimens.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq