المؤلفون: Juliana Marques Sá, Sara de Campos Lopes, Maria Joana Santos, Marta Alves, Adriana De Sousa Lages

المصدر: Archives of Endocrinology and Metabolism, Vol 68 (2024)

مصطلحات موضوعية: Type 1 diabetes, diabetes mellitus, hypoglycemia, insulin pumps, continuous subcutaneous insulin infusion, Medicine, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: ABSTRACT Objective: To evaluate glycemic control according to the number of daily basal rates (BRs) in type 1 diabetes patients using continuous subcutaneous insulin infusion (CSII). Subjects and methods: Cross-sectional study of patients treated with an open-loop CSII for at least 6 months and using a flash glucose monitoring system. Patients were divided into 2 groups: group 1 (G1) and group 2 (G2), with ≤4 and >4 BRs/24h, respectively. The groups were compared regarding HbA1c, time in range (TIR), time above range (TAR), time below range (TBR), glucose management indicator (GMI), glucose variability and data related to hypoglycemia. Regression models were performed. Results: The study included 99 patients (n = 55 in G1; n = 44 in G2). Median (Interquartile range) overall age was 30 (17) years, with 19.5 (48) and 51 (77) months of CSII use, respectively. The median number of different BRs was 3 (2) for G1 and 6 (2) for G2. There were no differences concerning age, sex, educational stage, weight, and insulin analog used. G2 had longer disease duration, longer CSII use, and higher total basal daily dose/kg. No significant differences regarding HbA1c, median glucose, GMI, TIR, TAR, and CV were found. G2 patients had more hypoglycemia, more asymptomatic hypoglycemia, and higher TBR. After adjusting for potential confounders, G1 maintained a lower risk of asymptomatic hypoglycemia. Conclusion: Programming open-loop CSII devices with more than 4 BRs does not improve metabolic control. Additionally, it seems to be a risk factor for hypoglycemia and was an independent predictor for asymptomatic hypoglycemia.

وصف الملف: electronic resource

العلاقة: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972024000100322&tlng=enTest; https://doaj.org/toc/2359-4292Test

الوصول الحر: https://doaj.org/article/2dcf409d518d41bea8a0c5cd5d0e0059Test

المؤلفون: Mariana Barbosa, Juliana Marques-Sá, Carla Carvalho, Vera Fernandes

المصدر: Archives of Endocrinology and Metabolism, Vol 67, Iss 6 (2023)

مصطلحات موضوعية: Hyperglycemia, SARS-CoV-2, complications, prognosis, Medicine, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: ABSTRACT Objective: Hyperglycemia has been suggested as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). The aim of our work was to evaluate the association between blood glucose levels at admission (BGA) and disease outcomes in hospitalized COVID-19 patients. Subjects and methods: Retrospective study including all adult COVID-19 patients admitted to a Portuguese hospital from March to August 2020 with BGA measurement. Subjects were categorized into two groups: BGA < 140 mg/dL and ≥ 140 mg/dL. Statistical analysis was performed using SPSSv26® (significance defined as p < 0.05). Results: We included 202 patients: median age 74 (60-86) years; 43.1% female; 31.2% with diabetes. The median BGA was 130.5 (108-158) mg/dL. When compared to normoglycemic, patients with BGA ≥ 140 mg/dL were older (p = 0.013), more vaccinated for influenza (p = 0.025) and had more comorbidities (hypertension, heart failure and peripheral arterial disease, p < 0.05). The last group presented higher leucocyte and neutrophile count, higher procalcitonin and prothrombin time, and lower lymphocyte count. Concerning prognosis, BGA ≥ 140 mg/dL was associated with higher rates of mechanical ventilation requirement and intensive care unit admission (p < 0.001), shock (p = 0.011), in-hospital mortality (p = 0.022) and 30-day mortality (p = 0.037). Considering only non-diabetic patients (n = 139), those with hyperglycemia presented higher rates of severity indicators (polypnea, SatO2 ≤ 93% and PaO2/FiO2 ≤ 300) and an association with poor outcomes was also found, namely mechanical ventilation requirement and in-hospital/30-day mortality (p < 0.05). Conclusion: Hyperglycemia at admission was associated with poor outcomes in COVID-19 patients, even in those without known pre-existing diabetes. Glycemic testing should be recommended for all COVID-19 patients.

وصف الملف: electronic resource

العلاقة: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000600206&lng=en&tlng=enTest; http://www.scielo.br/pdf/aem/v67n6/2359-4292-aem-67-06-e000649.pdfTest; https://doaj.org/toc/2359-4292Test

الوصول الحر: https://doaj.org/article/9c918f7893164fd8ac227fc0c94df500Test

المؤلفون: Juliana Marques Sá, Sara Campos Lopes, Mariana Barbosa, Inês Ferreira Barros, Maria Joana Santos

المصدر: Archives of Endocrinology and Metabolism, Vol 65, Iss 5, Pp 640-647 (2021)

مصطلحات موضوعية: Diabetes, type 1 diabetes, flash glucose monitoring, glycated hemoglobin, body mass index, Medicine, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: ABSTRACT Objective: Flash glucose monitoring (FGM) is increasingly used in type 1 diabetes mellitus (T1D) management. This study aimed to assess glycated hemoglobin (HbA1c) and body mass index (BMI) in the first year of FGM use in patients with T1D and to identify predictive factors of benefit associated with its use. Subjects and methods: Retrospective study of T1D patients, using FGM for ≥ 6 months and under intensive insulin therapy with multiple daily injections. Results: In 179 patients with a median (Md) age of 43.0 years (P25 31.0; P75 52.0) and disease duration of 18.0 years (P25 10.0; P75 28.0), initial HbA1c was 7.9% (P25 7.2; P75 8.8) and initial BMI was 24.0 kg/m2 (P25 21.9; P75 26.2). With FGM, HbA1c improved significantly to 7.6% (P25 7.0; P75 8.3) at 6 months and 7.7% (P25 6.95; P75 8.5) at 12 months (p < 0.05), with more patients with HbA1c < 7% (16.1% vs 22.5%) and fewer patients with HbA1c ≥ 8% (49.1% vs 35.8%) (p < 0.05). Initial HbA1c 8.0-8.9% (HR 1.886; 95% CI 1.321-2.450) and ≥ 9.0% (HR 3.108, 95% CI 2.454-3.761) predicted greater HbA1c reduction. BMI increased significantly, especially between 6 and 12 months (BMI Md 23.8 [P25 21.9; P75 26.2] kg/m2 and 24.0 [P25 22.0; P75 26.2] kg/m2, respectively) (p < 0.05). Overweight (HR 4.319, 95% CI 3.185-5.453) and obesity (HR 8.112, 95% CI 3.919-12.306) predicted greater weight gain. Conclusions: FGM use was associated with significant improvement in HbA1c, mainly in patients with worse previous glycemic control. It was also associated with increased BMI, especially if baseline BMI ≥ 25 kg/m2, so weight control strategies should be emphasized.

وصف الملف: electronic resource

العلاقة: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000500640&tlng=enTest; https://doaj.org/toc/2359-4292Test

الوصول الحر: https://doaj.org/article/2b36a1ad0461425db420d1055d9258bcTest

المؤلفون: Juliana Marques-Sá, Mariana Barbosa, Vera Fernandes, Maria Joana Santos

المصدر: BMJ Case Rep

مصطلحات موضوعية: Adult, medicine.medical_specialty, Adrenal disorder, 030209 endocrinology & metabolism, Hypokalemia, Case Report, 030204 cardiovascular system & hematology, Plasma renin activity, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Hyperaldosteronism, Renin, medicine, Adrenal insufficiency, Humans, Aldosterone, Hydrocortisone, business.industry, Postpartum Period, Adrenalectomy, General Medicine, medicine.disease, Blood pressure, chemistry, Hypertension, Spironolactone, Cardiology, Female, business, medicine.drug

الوصف: A previously healthy postpartum 33-year-old woman was admitted at the emergency department after two episodes of syncope. In the waiting room, she collapsed, ventricular fibrillation was detected, and she was reanimated by electric cardioversion. At admission, she was conscient, with blood pressure of 102/74 mm Hg and heart rate of 78 bpm. In the laboratory workup, severe hypokalaemia was found (K+ 1.77 mEq/L). Abdominopelvic CT revealed a 27 mm nodule in the right adrenal gland. High aldosterone and low plasma renin levels were detected, and the diagnosis of primary hyperaldosteronism was made, although she never had hypertension. Posteriorly, a cosecretion of aldosterone and cortisol was found. Two months after admission, the patient remained stable with normal K+ levels under spironolactone and a right adrenalectomy was performed. The cure of primary hyperaldosteronism and a partial adrenal insufficiency were confirmed. K+ levels and blood pressure remained normal without treatment and 10 months after surgery hydrocortisone was suspended.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f2119edc6035896b580f2e417e636b75Test
https://pubmed.ncbi.nlm.nih.gov/33753383Test

المؤلفون: Sara Campos Lopes, Juliana Marques Sá, Vera Fernandes, Catarina Machado, Ana Margarida Monteiro

المصدر: Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo.

مصطلحات موضوعية: Endocrinology, Diabetes and Metabolism

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::770b6812ffee8d0b4063b3c6d90a5495Test
https://doi.org/10.26497/cc220019Test

المؤلفون: Juliana, Marques-Sá, Joana, Santos Maria

المصدر: Endocrine Abstracts ; ISSN 1479-6848

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1530/endoabs.73.aep562Test
http://www.endocrine-abstracts.org/ea/0073/ea0073aep562.htmTest

المؤلفون: Juliana, Marques-Sá, Lopes, Sara Campos, Santos, Maria Joana

المصدر: Endocrine Abstracts ; ISSN 1479-6848

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1530/endoabs.73.aep189Test
http://www.endocrine-abstracts.org/ea/0073/ea0073aep189.htmTest

المؤلفون: Maria Joana Santos, Catarina Silva Araújo, Juliana Marques-Sá

المصدر: Journal of the Endocrine Society. 5:A609-A610

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, medicine, Hypopituitarism, medicine.disease, business, Sign (mathematics)

الوصف: Background: SIADH due to secondary adrenal insufficiency is a rare condition that can be life-threatening. Treatment with glucocorticoids is highly effective, but, as symptomatology of hypopituitarism can be mild and unspecific, a high level of clinical suspicion is necessary. Clinical Case: A 64-year-old postmenopausal woman, with a previously diagnosed and treated hypothyroidism and depressive syndrome, presented at the emergency room with nausea, vomits, asthenia and recurrent syncopes over the past three weeks and weight loss in the last months. One week before, she had been admitted at other hospital due to the same complaints and a serum Na+ of 112mmol/L (N 135-145 mmol/L) was detected. One year earlier, she had reported the same symptomology and hyponatremia had also been found, but no etiologic study was performed. At admission, she was conscient, hydrated, pale, hemodynamically stable, with unremarkable cardiopulmonary auscultation. A severe hyponatremia was found (Na+ 111mmol/L), with low serum osmolarity (241mOsm/Kg, N 280-301mOsm/Kg), low urine osmolality (125mOsm/kg N 300-900 mOsm/Kg) and low urinary sodium (33mmol/24h, N 40-220mmol/24h). Treatment with saline fluids was initiated and the patient was admitted for etiological investigation, which showed a low morning serum cortisol (3.7 µg/dl)) with inappropriately low-normal ACTH level (12.2 pg/mL), low FSH (15.07 mUI/mL, N 23.0-116.3 mUI/mL) and LH (4.28 mUI/mL, N 15.9-54 mUI/mL), estradiol of 78.81 pmol/L (N Conclusion: Hypopituitarism due to an empty sella is a relative rare disorder, whose etiology may be difficult to prove. It usually develops insidiously, with unspecific symptoms, which often delays the diagnosis. In our patient, this severe hyponatremia likely developed over a long time, allowing adaptation to such low levels of Na+. Moreover, the presence of a previously diagnosed hypothyroidism raises the suspicion if this wasn’t the first manifestation of the pituitary disease and if treatment of levothyroxine did not worsen an undetected secondary adrenal insufficiency.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::924ffe8a66f34ebb71e536c79b197d7cTest
https://doi.org/10.1210/jendso/bvab048.1243Test