Correlation of physical and cognitive impairment in diabetic and hypertensive frail older adults

Cardiovascular Diabetology, Journal Year: 2022, Volume and Issue: 21(1)

Published: Jan. 19, 2022

Abstract Background Diabetes and hypertension are common in older adults represent established risk factors for frailty. Frailty is a multidimensional condition due to reserve loss susceptibility stressors with high of death, hospitalizations, functional cognitive impairment. Comorbidities such as diabetes play key role increasing the mortality, hospitalization, disability. Moreover, frail patients known have an increased physical Nevertheless, no study assessed correlation between impairment hypertension. Methods We evaluated consecutive who presented at ASL (local health unit Italian Ministry Health) Avellino, Italy, from March 2021 October 2021. The inclusion criteria were: previous diagnosis evidence secondary causes; age > 65 years; frailty status; Montreal Cognitive Assessment (MoCA) score < 26. Results 179 successfully completed study. found strong significant MoCA 5-m gait speed test (r: 0.877; p 0.001). To further verify our results, we performed linear multivariate analysis adjusting potential confounding factors, dependent variable, which confirmed association glycemia (p Conclusions This first showing diabetic hypertensive adults.

Language: Английский

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Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission: An Expert Consensus Statement from the American College of Lifestyle Medicine

American Journal of Lifestyle Medicine, Journal Year: 2022, Volume and Issue: 16(3), P. 342 - 362

Published: May 1, 2022

Objective: The objective of this Expert Consensus Statement is to assist clinicians in achieving remission type 2 diabetes (T2D) adults using diet as a primary intervention. Evidence-informed statements agreed upon by multi-disciplinary panel expert healthcare professionals were used. Methods: Panel members with expertise treatment, research, and followed an established methodology for developing consensus modified Delphi process. A search strategist systematically reviewed the literature, best available evidence was used compose regarding dietary interventions 18 years older diagnosed T2D. Topics significant practice variation those that would result T2D prioritized. Using iterative, online process, expressed levels agreement statements, resulting classification consensus, near-consensus, or non-consensus based on mean responses number outliers. Results: identified 131 candidate focused addressing following high-yield topics: (1) definitions basic concepts; (2) T2D; (3) specifics types diets; (4) adjuvant alternative interventions; (5) support, monitoring, adherence therapy; (6) weight loss; (7) payment policy. After 4 iterations survey removal duplicative 69 met criteria 5 designated near 60 no consensus. In addition, reached key issues: (a) Remission should be defined HbA1c <6.5% at least 3 months surgery, devices, active pharmacologic therapy specific purpose lowering blood glucose; (b) intervention can achieve many related intensity intervention; (c) most effective when emphasizing whole, plant-based foods minimal consumption meat other animal products. Many additional achieved are highlighted tabular presentation manuscript elaborated discussion section. Conclusion: pertaining T2D, diets, interventions, therapy, loss, Clinicians use these improve quality care, inform policy protocols, identify areas uncertainty.

Language: Английский

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Metas no tratamento do diabetes

Conectando Pessoas eBooks, Journal Year: 2022, Volume and Issue: unknown

Published: Jan. 1, 2022

Em pacientes com diabetes, o controle glicêmico deve ser individualizado de acordo a situação clínica.Os parâmetros avaliação indicados são hemoglobina glicada A1c (HbA1c) e as glicemias capilares (ou plasmáticas) determinadas em jejum, nos períodos préprandiais, 2h após refeições ao deitar.1 ,

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Lifestyle Intervention Strategy to Treat Diabetes in Older Adults: A Randomized Controlled Trial

Diabetes Care, Journal Year: 2022, Volume and Issue: 45(9), P. 1943 - 1952

Published: July 26, 2022

Lifestyle intervention is recommended as first-line treatment of diabetes at all ages; however, little known about the efficacy lifestyle in older adults with diabetes. We aimed to determine whether would improve glycemic control and age-relevant outcomes comorbidities.A total 100 were randomly assigned 1-year intensive (ILI) (diet exercise a facility transitioned into community-fitness centers homes) or healthy (HL) group. The primary outcome was change HbA1c. Secondary included glucoregulation, body composition, physical function, quality life. Changes between groups analyzed mixed-model repeated-measures ANCOVA following intention-to-treat principle.HbA1c improved more ILI than HL group (mean ± SE -0.8 0.1 vs. 0.1%), associated insulin sensitivity (1.2 0.2 -0.4 0.2) disposition (26.0 8.9 -13.0 8.4 109 min-1) indices (between-group P < 0.001 0.04). Body weight visceral fat decreased (-8.4 0.6 -0.3 kg, 0.001, -261 29 -30 27 cm3, respectively). Physical Performance Test score increased (2.9 -0.1 0.4, 0.001) did VO2peak (2.2 0.3 -1.2 mL/kg/min, 0.001). Strength, gait, 36-Item Short Form Survey (SF-36) Component Summary also (all Total dose by 19.8 4.4 units/day. Adverse events episodes mild hypoglycemia group.A strategy highly successful improving metabolic functional health

Language: Английский

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The gut microbiota‐astrocyte axis: Implications for type 2 diabetic cognitive dysfunction

CNS Neuroscience & Therapeutics, Journal Year: 2023, Volume and Issue: 29(S1), P. 59 - 73

Published: Jan. 4, 2023

Abstract Background Diabetic cognitive dysfunction (DCD) is one of the most insidious complications type 2 diabetes mellitus, which can seriously affect ability to self‐monitoring blood glucose and quality life in elderly. Previous pathological studies have focused on neuronal dysfunction, characterized by extracellular beta‐amyloid deposition intracellular tau hyperphosphorylation. In recent years, astrocytes been recognized as a potential therapeutic target for important participants central control metabolism. The disorder gut microbiota their metabolites linked series metabolic diseases such mellitus. imbalance intestinal flora has effect promoting occurrence deterioration several diabetes‐related complications. Gut microbes drive astrocyte activation. Aims We reviewed progress DCD related “gut microbiota‐astrocyte” axis terms peripheral inflammation, blood–brain barrier (BBB) systemic brain energy metabolism disorders deepen research explore targets. Conclusion “Gut axis, unique bidirectional crosstalk brain‐gut mediates intermediate process neurocognitive secondary

Language: Английский

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