Academic literature on the topic 'Obesity, arterial hypertension, type 2 diabetes, nursing care'

This study was carried out to evaluate the risk factors of type 2 diabetic patients through sociodemographic data, habits of health, anthropometric and biochemist profiles, assisted at a basic public health care unit in Maringá, Paraná. Sixty-six patients, 56 women aged over than 50 years-old were interviewed. High prevalence factors for cardiovascular risk were observed, such as: overweight and obesity, hypertension, dyslipidemia, sedentariness and inadequate diet. Data suggested the need for multidisciplinary intervention programs in health care units associated to educative programs, adjusted diet intake and regular physical activity for these diabetic patients.

OBJECTIVE: identify the modifiable risk factors for type 2 diabetes mellitus in college students and associate these factors with their sociodemographic variables.METHOD: cross-sectional study, involving 702 college students from Fortaleza-CE, Brazil. Sociodemographic, anthropometric, physical exercise data and blood pressure and fasting plasma glucose levels were collected.RESULTS: the most prevalent risk factor was sedentariness, followed by overweight, central obesity, high fasting plasma glucose and arterial hypertension. A statistically significant association was found between overweight and sex (p=0.000), age (p=0.004) and marital status (p=0.012), as well as between central obesity and age (p=0.018) and marital status (p=0.007) and between high fasting plasma glucose and sex (p=0.033).CONCLUSION: distinct risk factors were present in the study population, particularly sedentariness and overweight.

ABSTRACTObjective: to investigate the prevalence of risk factors for diabetes mellitus type 2 among nursing students. Method: a cross-sectional study was developed in the first semester of 2009 with 99 nursing students, of both sexes, in a nursing college of Fortaleza/Ceará. Data were collected with a formulary regarding sociodemographic factors, anthropometric data, physical activity information, blood pressure levels and the capillary glycemia. The data was analyzed by the Statistical Software Package for the Social Sciences (SPSS), version 16.0. The study was approved by the committee of ethics in research involving humans of the mentioned college through the protocol number 011/2009. Results: a large portion of the sample (46.5%) presented Overweight/obesity, 74,7% presented sedentaryism, 14.1% presented prehypertension, 14.1% presented hypertension and 1% had high capillary glycemia. Conclusions: the study showed that nursing students that participated in the survey presented different risk factors for diabetes mellitus type 2. It reinforces the importance of emphasize the prevention of this illness. Descriptors: diabetes mellitus; risk factors; students.RESUMOObjetivo: investigar a prevalência dos fatores de risco para diabetes mellitus tipo 2 entre acadêmicos de enfermagem. Método: estudo quantitativo, transversal, desenvolvido no primeiro semestre de 2009 com 99 estudantes, de ambos os sexos e devidamente matriculados no curso de bacharelado em enfermagem de uma faculdade de Fortaleza-Ceará. Para a coleta de dados foi aplicado um formulário com informações de dados sociodemográficos, antropométricos, referentes à prática de atividade física, à pressão arterial e à glicemia capilar. Os dados foram armazenados em um banco e analisados por meio do software Statistical Package for the Social Sciences, versão 16.0. O estudo foi apreciado pelo Comitê de Ética em Pesquisa Envolvendo Seres Humanos da Faculdade Integrada do Ceará e aprovada através do protocolo n. 011/2009. Resultados: Grande parcela da amostra, 46,5%, apresentava sobrepeso/obesidade, 74,7% sedentarismo, 14,1% foram classificados como pré-hipertensos, 14,1% como hipertensos e 1% apresentou glicemia capilar elevada. Conclusões: o estudo mostrou que os estudantes de enfermagem, que participaram da pesquisa, possuíam uma série de fatores de risco para o desenvolvimento do diabetes mellitus tipo 2 e reforça, ainda, a importância da conscientização destes indivíduos quanto às medidas preventivas da enfermidade. Descritores: diabetes mellitus; fatores de risco; estudantes.RESUMENObjetivo: investigar la prevalencia de factores de riesgo para la diabetes mellitus tipo 2 entre académicos de enfermería. Método: estudio transversal, desarrollado en la primera mitad de 2009 con 99 alumnos de ambos sexos y debidamente inscritos en un curso de enfermería de Fortaleza-Ceará. Para recoger los datos, se aplicó un formulario con informaciones socio demográficas, datos antropométricos, datos relativos a la práctica de la actividad física, a la presión arterial y a la glucemia capilar. Los datos fueron almacenados y analizados a través del Statistical Package for the Social Sciences, versión 16.0. El estudio fue examinado por el Comité de ética en Pesquisas con seres humanos de la institución y fue aprobado a través del protocolo numero 011/2009. Resultados: una gran parte de la muestra, 46,5%, presentó sobrepeso y obesidad, 74,7% presentaron sedentarismo, 14,1% presentaron pre-hipertensión, 14,1% presentaron hipertensión y 1% fueron clasificados como portadores de glucemia capilar alta. Conclusiones: el estudio demostró que los estudiantes de enfermería que participaron del estudio tuvieron una serie de factores de riesgo para el desarrollo de diabetes mellitus tipo 2. Esto refuerza la importancia de la toma de conciencia de estos individuos en relación a las medidas de prevención de esta enfermedad. Descriptores: diabetes mellitus; factores de riesgo; estudiantes.

Objective: Describe the relationship between social determinants of health and risk of type 2 diabetes mellitus in Mexican population.Methods: This was a cross-sectional descriptive correlational study of a sample of 256 individuals from a rural community in Sinaloa, Mexico. Data collection was carried out from October 2020 to February 2021. A snowball non-probability sampling method was used. The Instruments used were the International Physical Activity Questionnaire (IPAQ), short version, the IPAQ-A for adults, the IPAQ-C for children, and a sociodemographic, anthropometric, and clinical data sheet.Results: The most frequent risk indicators for T2DM for adults are hypertension (81.7%) and overweight/obesity (68.6%); in children, it was overweight/obesity (34.9%). The risk of T2DM increased according to age (r = .560, p < .01) but decreased as education level increased (r = −.127, p < .05)Conclusions: The approach to T2DM risk factors from the perspective of social determinants of health allows strategic healthcare planning that considers the contextual factors associated with a lifestyle that reinforces the actions of healthcare providers. Objetivo: Describir la relación de los determinantes sociales de salud con el riesgo de DMT2 en población mexicana.Métodos: Estudio descriptivo correlacional transversal, con una muestra de 256 individuos de una comunidad rural de Sinaloa, México. La recolección de datos se realizó durante octubre de 2020 y febrero de 2021. El muestreo fue no probabilístico por bola de nieve. Los instrumentos utilizados fueron el cuestionario internacional de actividad física (IPAQ) versión corta, IPAQ-A, IPAQ-C y una hoja de registro datos sociodemográficos, antropométricos y clínicos.Resultados: Los indicadores de riesgo de DMT2 con mayor frecuencia para adultos fue padecer hipertensión arterial (81.7%) y SP/OB (68.6%) y para menores de edad fue tener SP/OB (34.9%). Resultó que el riesgo de DMT2 se acrecentaba según lo hacía la edad (r = .560, p < .01) pero disminuía al aumentar la escolaridad de las personas (r = -.127, p < .05).Conclusiones: El abordaje de factores de riesgo de DMT2 bajo la perspectiva de los DSS brinda la oportunidad de plantear estrategias de salud que contemplen factores contextuales simultáneos al estilo de vida que refuercen las acciones del personal de salud para contribuir a la reducción de los índices de morbimortalidad causados por la DMT2.

Background: Peripheral arterial disease and coronary artery disease have similar factors. The extent and severity of PAD is significantly associated with presence and severity of CAD.Methods: Patients were interviewed and clinical profile of patients including risk factors of coronary artery disease like diabetes, hypertension, smoking, dyslipidemia, obesity and family history of coronary artery disease were assessed and recorded in the proforma. Information regarding demographics, co morbidity, past history and family history was collected. Physical examination of each patient was carried and basic anthropometric data: height, weight, BMI and blood pressure, peripheral pulses calculated. Investigations both non- invasive and invasive including peripheral angiography were recorded.Results: In this prospective study fifty (50) type 2 diabetes patients admitted with CAD were studied whose mean age was 55.6+8.2 and mean duration of diabetes was 6.8+8.4. In this study none of the patients with PAD had single atherosclerosis risk factors including diabetes. 30% patients were having two risk factors. PAD in in patients with CAD is particularly enhanced by the concomitant occurrence of two or more of these risk factors (p=0.016). Hypertension as a predictor of PAD was statistically significant (p=0.0037). In this study the duration of diabetes was <5 years in 10%, 5-10 years in 40% and >10 years in 40% of patients with angiographically proven PAD.Conclusions: It was observed that presence and severity CAD was significantly associated with PAD.

(1) Background: Patients with schizophrenia have higher mortality, with cardiovascular diseases being the first cause of mortality. This study aims to estimate the excess risk of hospital admission for cardiovascular events in schizophrenic patients, adjusting for comorbidity and risk factors. (2) Methods: The APNA study is a dynamic prospective cohort of all residents in Navarra, Spain. A total of 505,889 people over 18 years old were followed for five years. The endpoint was hospital admissions for a cardiovascular event. Direct Acyclic Graphs (DAG) and Cox regression were used. (3) Results: Schizophrenic patients had a Hazard Ratio (HR) of 1.414 (95% CI 1.031–1.938) of hospital admission for a cardiovascular event after adjusting for age, sex, hypertension, type 2 diabetes, dyslipidemia, smoking, low income, obesity, antecedents of cardiovascular disease, and smoking. In non-adherent to antipsychotic treatment schizophrenia patients, the HR was 2.232 (95% CI 1.267–3.933). (4) Conclusions: Patients with schizophrenia have a higher risk of hospital admission for cardiovascular events than persons with the same risk factors without schizophrenia. Primary care nursing interventions should monitor these patients and reduce cardiovascular risk factors.

Objective: To evaluate the Grand-Aides Program for patients with type 2 diabetes mellitus (T2DM) according to the variables of body weight, blood pressure, medication adherence, and hospital consultation and readmissions.Methods: Patients ages 18 years or older with a past medical history of T2DM, hypertension (HTN), and/or obesity and who were recently seen in the emergency department (ED) or recently admitted to the hospital were eligible to enroll in the Grand-Aides Program. Eligible patients were identified after hospital or ED discharge and were asked to enroll in the in-home based program from March 2016 through June 2018. In-home visit protocol was defined prior to patient enrollment with intense in-home visits during the first weeks of enrollment followed by monthly visits for the duration of enrollment in the program. In-home visit frequency was adjusted on as needed basis so that patients at higher risk for ED visits or hospitalization were seen more frequently. In-home visits were performed by trained Grand-Aide who for the purpose of this study was a certified nursing assistant (CNA). The Grand-Aide underwent eighty hours of didactic training which included visit protocols, visit schedules, and data collection. The one-on-one in-home patient with every visit were supervised by a registered nurse (RN) or nurse practitioner (NP) via video or telephone contact near the conclusion of the visit. Active patients at the University of Virginia Family Medicine clinic were eligible for enrollment. Fifty-seven patients with T2DM worked with Grand-Aides for three months and an additional forty-eight T2DM patients worked with Grand-Aides for twelve months. Emergency department visits, all 30-day hospital readmissions, as well as blood pressure readings, medication adherence, weights, and glycated hemoglobin (HbA1c) were compared with the prior twelve months.Results: Systolic (p < .001) and diastolic (p < .01) blood pressures decreased (p < .01) at 1 year. At baseline 56 percent of the patients had a systolic blood pressure of >130 mmHg despite treatment; after 12 months, 48 percent of these were < 130. In those whose baseline diastolic blood pressure was > 90 mmHg, 100 percent had diastolic blood pressure < 90 mmHg at 1 year. Medication adherence by ARMS test at 1 year was 94 percent. Despite trending downward, weight and HbA1c did not change significantly. In the preceding, 58 percent had at least one ED visit, which was reduced by 50 percent (p < .01) with Grand-Aides; 30-day all-cause readmissions reduced by 50 percent to 6.3 percent. Conclusions: The Grand-Aides program was associated with a significant change in blood pressure control, high medication adherence and reductions in ED visits and readmissions that compare favorably with published comparative data. For systems “at risk” for preventable increased health care expense burden, the Grand-Aides program can result in significant savings.

Background: Non-alcoholic fatty liver disease (NAFLD) refers to a spectrum of hepatic conditions unrelated to alcohol consumption and affects around 30% of the UK adult population. It can progress from steatosis to non-alcoholic steatohepatitis (NASH), increasing the risk of cirrhosis and hepatocellular carcinoma. Methods: To explore baseline understanding and awareness, health professionals in various roles (excluding gastroenterology and hepatology) at a secondary-care teaching hospital in England received a questionnaire consisting of 21 multiple-choice questions, 16 on NAFLD and five on demographics. Results: Roles included qualified nurses, clinicians, non-clinical staff, medical students, student nurses, nursing support workers and allied health professionals. Of these, 85% had heard of NAFLD and 58% of NASH; by role, these numbers ranged from 100% for clinicians and medical students to only 54% and 8% respectively for nursing students. Knowledge of risk factors ranged from 81% for high cholesterol to 12% for depression, and only 9% identified all four features of metabolic syndrome (MetS): obesity, hypertension, dyslipidaemia and type 2 diabetes. Incorrectly identified risk factors were excessive alcohol (41%) and caffeine (18%) intake. Practitioners also reported variable understanding of early symptoms, progression, diagnostic investigations, medical history and occurrence in children. Conclusions: Practitioners were insufficiently aware that NAFLD is a spectrum of disease that is preventable and reversible in early stages. Improved practitioner education should increase early detection and allow holistic, multidisciplinary care for better patient outcomes.

Introduction: Obesity is a worldwide epidemic and people with super obesity (BMI > 50 kg/m²) have the worse prognosis, related to physical complications but also to mental illnesses, physical and verbal abuse, as well as social exclusion. Objective: To determine the profile of super obese patients treated in a referential bariatric surgery service. Methods: Retrospective analysis of 56 medical records of patients treated at the HUUFMA’s Bariatric and Metabolic Surgery Service multidisciplinary ambulatory care in 2017-2019. Incomplete records or with body mass index (BMI) < 50 kg/m² were excluded. Results are presented in mean and standard deviation. Chi-square test was used for association analysis, Shapiro-Wilks test for normality and significance was considered for p<0.05. Results: Prevalence in sample of females (80.3%), brown skin (67.8%), average age of 37.8 ± 9.8 years, and 49.1% graduated high school. The average weight and BMI were that of 136.6 ± 12.4 kg and 59 ± 6.5 kg/m², respectively, with a patient standing out with a BMI of 71 kg/m². Among the comorbidities we found obstructive sleep apnea in 100%, insomnia in 98.2%, joint problems in 53.5%, anxiety in 50%, hepatic steatosis and systemic arterial hypertension with 48.2% each, dyslipidemia in 42.8%, intestinal constipation in 32.1% and type 2 diabetes mellitus in 17.8%. There was a significant relation (p<0.05) between schooling and weight. An impact on mental health was observed, with 37.5% of the patients exhibiting depression, 44.6% binge eating and 17.6% suicidal thoughts and/or self-mutilation. Conclusion: The super obese patients’ profile is that of a young adult woman, with average schooling, various comorbidities and with significant impact on mental health.