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RESUMEN Introducción: la diabetes es un trastorno endocrino-metabólico crónico que afecta a diversos órganos y tejidos. Más del 90 % de los que la padecen sufren diabetes tipo 2. Esta se acompaña de complicaciones crónicas, que pueden prevenirse mediante un control adecuado de la hiperglucemia y de los factores de riesgo cardiovascular. Objetivo: caracterizar los factores de riesgo asociados a la diabetes mellitus tipo 2, en pacientes del Consultorio del Médico de la Familia no. 27 del Policlínico Docente José Jacinto Milanés, del municipio Matanzas. Materiales y métodos: se realizó un estudio descriptivo de corte transversal, durante el período de enero a diciembre de 2019. El universo estuvo constituido por 50 pacientes pertenecientes al consultorio no. 27 del Policlínico Docente José Jacinto Milanés, del municipio Matanzas, dispensarizados con diabetes mellitus tipo 2. Resultados: el sexo femenino fue el predominante, y el 24 % de los pacientes se encontraban entre 55 y 59 años. En cuanto al estado nutricional, resultó la obesidad el de mayor frecuencia. En el 52 % existían antecedentes familiares de diabetes tipo 2. Conclusiones: la obesidad, los malos hábitos dietéticos, el sedentarismo y la hipertensión arterial constituyeron los factores de riesgo más frecuentes en estos pacientes (AU).

ABSTRACT Introduction: diabetes is a chronic endocrine-metabolic disorder that affects numerous organs and tissues. More than 90 % of those with it suffer from type 2 diabetes. This is accompanied by chronic complications, which can be prevented by adequate control of hyperglycemia and cardiovascular risk factors. Objective: to characterize the risk factors associated with type 2 diabetes mellitus in patients from the Family Physician's Office no. 27 of the Teaching Polyclinic José Jacinto Milanés, of the municipality of Matanzas. Materials and methods: a cross-sectional, descriptive study was carried out during the period from January to December 2019. The universe were 50 patients belonging to Family Physician's Office no. 27 of the Teaching Polyclinic José Jacinto Milanés, of the municipality of Matanzas, diagnosed with type 2 diabetes mellitus. Results: female sex predominated, and 24 % of patients were aged 55-59 years. According to the nutritional status, obesity was the more frequent. There was a family history of type 2 diabetes mellitus in 52 %. Conclusion: obesity, poor dietary habits, sedentary way of life, and arterial hypertension were the most frequent risk factors found in these patients (AU).

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AIM: To investigate knowledge levels concerning COVID-19 in elderly patients with T2DM. METHODS: This cross-sectional, quantitative, observational, and descriptive study was undertaken among elderly individuals with T2DM involved in a body balance rehabilitation program that had been suspended due to social isolation. The study participants comprised elderly individuals with T2DM, contactable using fixed or mobile telephones. Data concerning participants' socioeconomic variables and knowledge of COVID-19 were collated, using a Brazil Ministry of Health guidelines checklist. Mann-Whitney and Spearman's correlation tests were used to analyze their responses. RESULTS: Of 30 elderly participants, 76.7% were women and 63.3% were married. The average age was 69.96 ± 4.46 years. The most cited information medium was television (96.6%). Of a possible 24 correct responses on the checklist, the median correct response score was 7.5. No significant relationship was observed between the total checklist score and the variables studied. CONCLUSION: Elderly participants did not have in-depth knowledge concerning COVID-19, which suggests that their knowledge sources may be deficient or that their capacity to retain information was inadequate.

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BACKGROUND AND AIM: Inflammatory and methylation imbalances occur in patients with type 2 diabetes mellitus (T2DM). The aim of the present study was to analyze the effect of acute resistance exercise on the inflammatory profile and on DNA methylation of elderly patients with T2DM using metformin. METHODS: For this purpose, we enrolled 22 male and female older adults (68.2 ± 5.3 years), of whom 13 had controlled T2DM (D) under metformin use and 9 were nondiabetics (ND). All subjects underwent a neuromuscular circuit (8 exercises in 40 min, with each exercise performed in 3 sets of 40 s each and a 20-s interval between repetitions). RESULTS: The main results indicated a significant difference between groups for baseline interleukin (IL)-10, with a higher concentration in the D group compared to the ND group (p = 0.019). An increase in IL-6 concentration after intervention was observed in group D (p = 0.035). No effect was observed in total DNA methylation within or between groups. CONCLUSIONS: The resistance training protocol applied in this study modulates the IL-10 and IL-6 concentrations in elderly people with T2DM and under metformin use, possibly as a result of physiological adaptations, with no effect on nondiabetic elderly. No effects on absolute levels of DNA methylation were observed.

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Introdução: Grande parte dos idosos com diabetes tipo 2 não praticam exercício físico regular. Objetivos: Identificar os fatores que influenciam idosos com diabetes tipo 2 a praticarem exercícios físicos. Métodos: Trata-se de um estudo descritivo e analítico, transversal quantitativo. A amostra foi composta por 49 idosos, com diagnóstico de diabetes tipo 2. Foram aplicados questionários sobre adesão, permanência e desistência ao exercício e sintomas depressivos. Para análise dos dados foi calculado o alpha de Cronbach e foi realizada análise fatorial e correlação dos dados. Resultados: Os motivos para aderir a um programa de exercício físico foram indicação de amigos e familiares, intenção de melhorar a autoestima ou a autoimagem, indicação médica; e os motivos para permanecer ativo foram aliviar tensão, fazer amigos, desenvolver competências, queimar calorias, manter a flexibilidade. Conclusão: Os fatores extrínsecos são os que mais influenciaram idosos com diabetes mellitus tipo 2 a aderir a um programa de exercícios físico e a se manterem na prática.

Introduction: A great proportion of elderly people with type 2 diabetic do not regularly practice any type of physical exercise. Objectives: To identify factors that influence elderly people with type 2 diabetes to exercise. Methods: A descriptive and analytical cross-sectional quantitative study was conducted. The sample consisted of 49 elderly individuals diagnosed with type 2 diabetes. Questionnaires were applied regarding beginning, continuing and quitting exercise programs, as well as depressive symptoms. For the data analysis, Cronbach's alpha was calculated, and factor analysis and correlation of the data were performed. Results: The following reasons for beginning a physical exercise program were discovered: encouragement by friends and family, desire to improve self-esteem or self-image and medical referral. The reasons for staying active were to relieve tension, make friends, develop skills, obtain self-reward, burn calories and maintain flexibility. Conclusion: The results showed that extrinsic factors are the ones that most influence elderly people with type 2 diabetes to begin a physical exercise program and to continue with it.

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This study is a randomized controlled clinical trial that verified the resistance training efficacy on neuromuscular parameters, with muscle quality as primary outcome. Forty-four elderly with diabetes type 2 (69.7 ±â€¯6.9 years; 26 men) were randomly allocated to a 12-weeks resistance training group (RTG, 3 times a week), or an active control group with stretching classes (CG, once a week). Primary and secondary outcomes were assessed at baseline and after 12 weeks, as follow: quadriceps muscle thickness and rectus femoris muscle quality, maximal knee extension strength, rapid strength, functional performance, visceral adipose tissue, glycemic control, lipid profile and quality of life. Generalized estimating equations were used to analyses based on intention-to-treat and per-protocol approaches, which showed the same results. Among all outcomes measured there were improvements in the knee extension strength (P < 0.001) and quadriceps muscle thickness (P < 0.001) for RTG. The muscle quality did not improve for both groups (P = 0.98). For the secondary outcomes there were no improvements for functional performance, rapid strength, glycemic control, quality of life, visceral adipose tissue and lipid profile in both groups, with exception of triglyceride level reduction for RTG (P = 0.04).The resistance training program is an efficacious strategy for improve the neuromuscular health in elderly with T2DM, considering increases in lower limb strength and muscle mass, but the same was not found for muscle quality, rapid strength, functional performance and quality of life. Furthermore, the training program did not induce significant reduction in glycated hemoglobin values of patients who already had suitable glycemic control.

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INTRODUCTION: Cardiovascular autonomic dysfunction reflex of the pathophysiology of diabetes mellitus (DM) favors an increase in morbidity and mortality related to cardiovascular events, and for this reason has been one of the most studied clinical entities. METHOD: An experimental study of a randomized clinical trial type was therefore proposed to analyze the hemodynamic and glycemic response after the practice of a rehabilitation program in patients with type 2 diabetes mellitus (T2DM). In this clinical trial the patients will initially be submitted to an evaluation protocol that consists of assessing blood pressure, heart rate, Borg scale, respiratory rate, oxygen saturation, distance traveled through the 6-minute walk test, quality of life questionnaire, Pittsburgh sleep quality questionnaire, and still glycated hemoglobin and heart rate variability through the cardiofrequency meter. After careful evaluation of the patients, they will be submitted to a metabolic rehabilitation program composed of aerobic and resisted exercises, performed for 12 weeks, in 3 weekly meetings of 60 minutes each. With such evaluations, it will be possible to construct with evidence that it is possible to work safer metabolic rehabilitation programs in patients with T2DM or other diseases that generate cardiovascular risks, guaranteeing them an improvement in cardiorespiratory fitness, hemodynamic and glycemic variables, allowing improvement of the quality of life. ETHICS AND DISSEMINATION: The protocol is approved by the host institution's ethics committee under the number 1.616.721. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT3094767.

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BACKGROUND: High-intensity interval training (HIIT) improves cardiometabolic markers, but its effects on the quality of life of patients with type 2 diabetes (T2D) is not well known. AIM: To determine the effects of a 12-week HIIT exercise program on cardiometabolic and quality of life variables of T2D patients. MATERIAL AND METHODS: Nine T2D women were assigned to a HIIT + nutritional education (GE) and 10, to a nutritional education alone group (GC). At baseline and after each intervention, anthropometric and body composition parameters using bio-impedance were assessed, and a blood sample was obtained to measure serum lipid levels, blood glucose and glycated hemoglobin. Quality of life was assessed using the SF-12 questionnaire adapted for the Chilean population. RESULTS: There were no significant changes on the lipid profile variables in the GE group, although HDL cholesterol was increased significantly (p < 0.05) in the GC group. Total fat mass was decreased in the GE group from 43.5 ± 1.5 to 41.9 ± 1.5%, p < 0.01. Fasting glucose and glycated hemoglobin decreased in the GE group. There was a significant correlation between the decrease in total fat mass and that of glycated hemoglobin. There were significant increases in quality of life parameters; physical function, physical role, pain, general health, vitality, emotional role, mental health, and social function in the GE but not in the GC group. CONCLUSIONS: A 12-week program of HIIT plus nutritional education improves cardiometabolic and quality of life parameters on type 2 diabetics.

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Background: High-intensity interval training (HIIT) improves cardiometabolic markers, but its effects on the quality of life of patients with type 2 diabetes (T2D) is not well known. Aim: To determine the effects of a 12-week HIIT exercise program on cardiometabolic and quality of life variables of T2D patients. Material and Methods: Nine T2D women were assigned to a HIIT + nutritional education (GE) and 10, to a nutritional education alone group (GC). At baseline and after each intervention, anthropometric and body composition parameters using bio-impedance were assessed, and a blood sample was obtained to measure serum lipid levels, blood glucose and glycated hemoglobin. Quality of life was assessed using the SF-12 questionnaire adapted for the Chilean population. Results: There were no significant changes on the lipid profile variables in the GE group, although HDL cholesterol was increased significantly (p < 0.05) in the GC group. Total fat mass was decreased in the GE group from 43.5 ± 1.5 to 41.9 ± 1.5%, p < 0.01. Fasting glucose and glycated hemoglobin decreased in the GE group. There was a significant correlation between the decrease in total fat mass and that of glycated hemoglobin. There were significant increases in quality of life parameters; physical function, physical role, pain, general health, vitality, emotional role, mental health, and social function in the GE but not in the GC group. Conclusions: A 12-week program of HIIT plus nutritional education improves cardiometabolic and quality of life parameters on type 2 diabetics.

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Introducción: la nefropatía diabética, es un trastorno metabólico en el que la hiperglucemia induce disfunción en diversos tipos de células del riñón, que deriva en insuficiencia renal progresiva. Objetivo: describir el comportamiento de variables de funcionamiento renal en pacientes diabéticos tipo 2 en tres consultorio médicos de la familia del Policlínico Comunitario "José J. Milanés", Municipio de Matanzas, entre mayo del 2013 y mayo del 2014. Materiales y métodos: se realizó un estudio descriptivo transversal en un universo conformado por 129 pacientes con diabetes mellitus tipo 2. La muestra fueron 85 pacientes seleccionados por muestreo aleatorio simple. Variables objeto de estudio: tiempo de evolución de la enfermedad, glucemia, creatinina, microalbuminuria y filtrado glomerular. Resultados: 39 pacientes se encontraban con un período de diagnóstico entre 6 y 10 años, correspondiendo a esta etapa el mayor por ciento (45.9 %). 74 pacientes (87 %) presentó hiperglicemia y el 76,9 % (30 pacientes) presentaron cifras elevadas de creatinina. Para el filtrado glomerular predominaron los pacientes que se encuentran en el estadio II con un 43.6 % y tiempo de evolución entre los 6 y los 10 años, en la microalbuminuria, se destaca que el 42,1 % de los pacientes con menos de 5 años de evolución de la enfermedad presentaban cifras de microalbuminuria por encima de 30 mg/l). Conclusiones: predominaron los pacientes con tiempo de evolución entre los 6 a 10 años, grupo con los mayores porcentaje de pacientes con glucemia, creatinina, filtrado glomerular y microalbuminuria elevados. EL total de pacientes con más de 16 años de evolución de la enfermedad tenían cifras elevadas de filtrado glomerular y microalbuminuria (AU).

Introduction: diabetic nephropathy is a metabolic disturbance in which hyperglycemia induces dysfunction in different kinds of kidneys cells. It derives in progressive renal insufficiency. Objective: to describe the behaviour of renal function variables in type 2 diabetic patients in three family physician consultation (CMF, abbreviation in Spanish) of the Community Polyclinic "José J. Milanés", municipality of Matanzas in the period May 2013-May 2014. Materials and methods: descriptive, transversal study in a universe of 129 patients with type 2 diabetes mellitus. Simply randomized sample composed by 85 patients. The studied variables were time of disease evolution, glycemia, creatinine, microalbuminuria and glomerular filtration. Results: 39 patients were found in a diagnostic period between 6 and 10 years, the biggest percent (45.9 %) corresponding to this stage. 74 patients (87 %) presented hyperglycemia and 30 patients (76.9 %) showed high quantitites of creatinine. Patients that were in the II stage for 43.6 % and evolution time between 6 and 10 years predominated in the glomerular filtration; 42.1 % of the patients with less than 5 years of the disease evolution showed amounts of microalbuminuria of over 30 mg/l. Conclusions: it was found the predomination of patients with 6-10 years of evolution time, the group with the highest percent of patients with increased glycemia, creatinine, glomerular filtration and microalbuminuria. The total of the patients with more than 16 years of disease evolution had high amounts of glomerular filtrate and microalbuminuria (AU).

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ABSTRACT The effect of glutamine dipeptide (GDP) supplementation in patients with diabetic foot syndrome was evaluated. A total of 22 patients took part in the study. GDP was supplied in 10 g sachets, and was dissolved in water immediately before use, with ingestion once a day, after lunch or after dinner (20 g/day) over a period of 30 days. Quantification of foot insensitive areas, oxidative stress, blood cytokines, and biochemical, hematological and toxicological parameters was performed before and after GDP supplementation. We observed an increase in blood levels of interferon-α (P=0.023), interferon-γ (P=0.038), interleukin-4 (P=0.003), interleukin-6 (P=0.0025), interleukin-7 (P=0.028), interleukin-12 p40 (P=0.017), interleukin-13 (P=0.001), leukocytes (P=0.037), eosinophils (P=0.049), and typical lymphocytes (P<0.001) due to GDP administration. In addition, we observed a reduced number (P=0.048) of insensitive areas on the foot, and reduction (P=0.047) of fasting hyperglycemia. Patients also showed increased blood high density lipoprotein (P<0.01) and protein thiol groups (P=0.004). These favorable results were associated with the absence of renal and hepatic toxicity. These results are of clinical relevance, since supplementation with GDP over 30 days improved clinical responses in patients with diabetic foot syndrome.

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