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Enlace permanente de la investigaciónEfficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials / Carlos Esteban Builes Montaño ; Natalia Andrea Ortíz Cano ; Natalia Andrea Rojas Henao
Título : Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials Tipo de documento : documento electrónico Autores : Carlos Esteban Builes Montaño, ; Natalia Andrea Ortíz Cano, ; Natalia Andrea Rojas Henao, Fecha de publicación : 2022 Títulos uniformes : Journal of Human Nutrition and Dietetics Idioma : Inglés (eng) Palabras clave : carbohydrate counting diabetes mellitus diet therapy dietary carbohydrates glycated haemoglobin A Resumen : Background and aims: Diabetes mellitus (DM) is one of the most prevalent chronic noncommunicable diseases globally, and the only way to reduce its complications is good glycaemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses as it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. The primary objective of this systematic review was to assess carbohydrate counting efficacy in reducing glycated haemoglobin (HbA1c) levels and safety by not increasing hypoglycaemia risk, inducing an increase in body weight or blood lipids, or reducing the quality of life of people with T1DM. Methods: We included randomised controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least 3 months and with no restrictions in language, age or settings. As a primary outcome, we consider the change of HbA1c levels within at least 3 months. Secondary outcomes were hypoglycaemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality-of-life changes and questionnaires on satisfaction with treatment of diabetes. Results: Data from 11 studies with 899 patients were retrieved with a mean follow-up of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1clevels (SMD-0.24%, 95% CI −0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful reduction in HbA1c levels (SMD-0.52%, 95% CI −0.82 to −0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c levels compared with usual diabetes education. Carbohydrate counting does not relate to any substantial change in blood lipids, body weight, hypoglycaemia risk or daily insulin dose. Finally, we analysed the effect of trial duration on reduction in HbA1c levels and found no significant change related to time. Conclusions: Carbohydrate counting is an efficacious technique to safely reduce the levels of HbA1c in adults and children compared with standard diabetes education, and its effect does not appear to change with prolonged time. Standardisation in reporting important outcomes such as hypoglycaemia and quality of life are vital to produce comparable evidence in carbohydrate counting clinical trials. This systematic review was registered in PROSPERO under code: CRD42020218499. Mención de responsabilidad : Carlos E. Builes-Montaño, Natalia A. Ortiz-Cano, Alex Ramirez-Rincón, Natalia A. Rojas-Henao Referencia : J Hum Nutr Diet. 2022 Dec;35(6):1030-1042. DOI (Digital Object Identifier) : 10.1111/jhn.13017 PMID : 35436364 En línea : https://onlinelibrary.wiley.com/doi/10.1111/jhn.13017 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6026 Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials [documento electrónico] / Carlos Esteban Builes Montaño, ; Natalia Andrea Ortíz Cano, ; Natalia Andrea Rojas Henao, . - 2022.
Obra : Journal of Human Nutrition and Dietetics
Idioma : Inglés (eng)
Palabras clave : carbohydrate counting diabetes mellitus diet therapy dietary carbohydrates glycated haemoglobin A Resumen : Background and aims: Diabetes mellitus (DM) is one of the most prevalent chronic noncommunicable diseases globally, and the only way to reduce its complications is good glycaemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses as it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. The primary objective of this systematic review was to assess carbohydrate counting efficacy in reducing glycated haemoglobin (HbA1c) levels and safety by not increasing hypoglycaemia risk, inducing an increase in body weight or blood lipids, or reducing the quality of life of people with T1DM. Methods: We included randomised controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least 3 months and with no restrictions in language, age or settings. As a primary outcome, we consider the change of HbA1c levels within at least 3 months. Secondary outcomes were hypoglycaemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality-of-life changes and questionnaires on satisfaction with treatment of diabetes. Results: Data from 11 studies with 899 patients were retrieved with a mean follow-up of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1clevels (SMD-0.24%, 95% CI −0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful reduction in HbA1c levels (SMD-0.52%, 95% CI −0.82 to −0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c levels compared with usual diabetes education. Carbohydrate counting does not relate to any substantial change in blood lipids, body weight, hypoglycaemia risk or daily insulin dose. Finally, we analysed the effect of trial duration on reduction in HbA1c levels and found no significant change related to time. Conclusions: Carbohydrate counting is an efficacious technique to safely reduce the levels of HbA1c in adults and children compared with standard diabetes education, and its effect does not appear to change with prolonged time. Standardisation in reporting important outcomes such as hypoglycaemia and quality of life are vital to produce comparable evidence in carbohydrate counting clinical trials. This systematic review was registered in PROSPERO under code: CRD42020218499. Mención de responsabilidad : Carlos E. Builes-Montaño, Natalia A. Ortiz-Cano, Alex Ramirez-Rincón, Natalia A. Rojas-Henao Referencia : J Hum Nutr Diet. 2022 Dec;35(6):1030-1042. DOI (Digital Object Identifier) : 10.1111/jhn.13017 PMID : 35436364 En línea : https://onlinelibrary.wiley.com/doi/10.1111/jhn.13017 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6026 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001867 AC-2022-032 Archivo digital Producción Científica Artículos científicos Disponible 
Título : El índice de fragilidad y sus características en ensayos clínicos aleatorizados de diabetes mellitus Otros títulos : The Fragility Index and its characteristics in randomized clinical trials of diabetes mellitus Tipo de documento : documento electrónico Autores : Jorge Hernando Donado Gómez, Fecha de publicación : 2022 Títulos uniformes : CES Medicina Idioma : Español (spa) Palabras clave : índice de fragilidad diabetes mellitus ensayos clínicos controlados Resumen : Introducción: para valorar la robustez de los resultados se ha propuesto una herramienta llamada el Índice de Fragilidad (IF), esta se define como el mínimo número de pacientes que se tienen que cambiar de “No eventos” a “Eventos” en el grupo de intervención para que un resultado estadísticamente significativo pase a no significativo, evidenciando que entre menor sea el IF, los resultados serán más frágiles. Diferentes autores han encontrado que la significancia de los resultados de muchos Ensayos Clínicos Controlados (ECA) dependen de pocos eventos. El objetivo del estudio fue evaluar el IF de los ECA en diabetes mellitus de cinco de las revistas médicas de mayor impacto a nivel mundial. Metodología: se realizó búsqueda electrónica en PubMed, para identificar ECA en Annals of Internal Medicine, BMJ, The Lancet, The New England Journal of Medicine y JAMA. Se revisaron los ECA en pacientes con diabetes mellitus o prediabetes y se calculó el IF para cada desenlace según el método descrito por Walsh et al, usando tablas de contingencia 2x2. Se planeó usar el coeficiente de correlación de Spearman para evaluar la correlación entre el IF y el tamaño de la muestra, el número de eventos, el valor de p y el tiempo de seguimiento. Se evaluó la significancia de todos los resultados con un valor de p Mención de responsabilidad : David Benavides-Zora, Sara Vásquez-Martínez, Jorge Hernando Donado Gómez Referencia : CES med ; 36(2): 106-121, mayo-ago. 2022. DOI (Digital Object Identifier) : 10.21615/cesmedicina.6632 Derechos de uso : CC BY-NC-SA En línea : https://revistas.ces.edu.co/index.php/medicina/article/view/6632 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6054 El índice de fragilidad y sus características en ensayos clínicos aleatorizados de diabetes mellitus = The Fragility Index and its characteristics in randomized clinical trials of diabetes mellitus [documento electrónico] / Jorge Hernando Donado Gómez, . - 2022.
Obra : CES Medicina
Idioma : Español (spa)
Palabras clave : índice de fragilidad diabetes mellitus ensayos clínicos controlados Resumen : Introducción: para valorar la robustez de los resultados se ha propuesto una herramienta llamada el Índice de Fragilidad (IF), esta se define como el mínimo número de pacientes que se tienen que cambiar de “No eventos” a “Eventos” en el grupo de intervención para que un resultado estadísticamente significativo pase a no significativo, evidenciando que entre menor sea el IF, los resultados serán más frágiles. Diferentes autores han encontrado que la significancia de los resultados de muchos Ensayos Clínicos Controlados (ECA) dependen de pocos eventos. El objetivo del estudio fue evaluar el IF de los ECA en diabetes mellitus de cinco de las revistas médicas de mayor impacto a nivel mundial. Metodología: se realizó búsqueda electrónica en PubMed, para identificar ECA en Annals of Internal Medicine, BMJ, The Lancet, The New England Journal of Medicine y JAMA. Se revisaron los ECA en pacientes con diabetes mellitus o prediabetes y se calculó el IF para cada desenlace según el método descrito por Walsh et al, usando tablas de contingencia 2x2. Se planeó usar el coeficiente de correlación de Spearman para evaluar la correlación entre el IF y el tamaño de la muestra, el número de eventos, el valor de p y el tiempo de seguimiento. Se evaluó la significancia de todos los resultados con un valor de p Mención de responsabilidad : David Benavides-Zora, Sara Vásquez-Martínez, Jorge Hernando Donado Gómez Referencia : CES med ; 36(2): 106-121, mayo-ago. 2022. DOI (Digital Object Identifier) : 10.21615/cesmedicina.6632 Derechos de uso : CC BY-NC-SA En línea : https://revistas.ces.edu.co/index.php/medicina/article/view/6632 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6054 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001898 AC-2022-062 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-062Adobe Acrobat PDF
Título : Main glucose hepatic fluxes in healthy subjects predicted from a phenomenological-based model Tipo de documento : documento electrónico Autores : Carlos Esteban Builes Montaño, Fecha de publicación : 2022 Títulos uniformes : Computers in Biology and Medicine Idioma : Inglés (eng) Palabras clave : Mathematical model Diabetes mellitus Glucose metabolism Liver Resumen : Background: The liver has a unique role in blood glucose regulation in postprandial, postabsorptive, and fasting states. In the context of diabetes technology, current maximal models of glucose homeostasis lack a proper dynamical description of main glucose-related fluxes acting over and from the liver, providing a rather simplistic estimation of key quantities as endogenous glucose production and insulin and glucagon clearance. Methods: Using a three-phase well-established phenomenological-based semi-physical modeling (PBSM) methodology, we built a detailed physiological model of hepatic glucose metabolism, including glucose utilization, endogenous glucose production through gluconeogenesis and glycogenolysis, and insulin and glucagon clearance. Mean absolute errors (MAE) were used to assess the goodness of fit of the proposed model against the data from three different in-vivo experiments -two oral glucose tolerance tests (OGTT) and a mixed meal challenge following overnight fasting-in healthy subjects. Results: Needing little parameter calibration, the proposed model predicts experimental systemic glucose mean ± std 5.4 ± 5.2, 7.5 ± 6.8, and 7.5 ± 7.5 mg/dL, in all three experiments. Low MAEs were also obtained for insulin and glucagon at the hepatic vein. Conclusions: The quantitative concordance of our model to the experimental data exhibits a potential for its use in the physiological study of glucose liver metabolism. The model structure and parameter interpretability allow the union with other semi-physical models for a better understanding of whole-body glucose homeostasis and its use in developing diabetes technology tools. Mención de responsabilidad : Carlos E. Builes-Montaño, Laura Lema-Perez, Jose Garcia-Tirado y Hernan Alvarez Referencia : Comput Biol Med. 2022 Mar;142:105232. DOI (Digital Object Identifier) : 10.1016/j.compbiomed.2022.105232 PMID : 35077932 Derechos de uso : CC BY En línea : https://linkinghub.elsevier.com/retrieve/pii/S0010482522000245 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6012 Main glucose hepatic fluxes in healthy subjects predicted from a phenomenological-based model [documento electrónico] / Carlos Esteban Builes Montaño, . - 2022.
Obra : Computers in Biology and Medicine
Idioma : Inglés (eng)
Palabras clave : Mathematical model Diabetes mellitus Glucose metabolism Liver Resumen : Background: The liver has a unique role in blood glucose regulation in postprandial, postabsorptive, and fasting states. In the context of diabetes technology, current maximal models of glucose homeostasis lack a proper dynamical description of main glucose-related fluxes acting over and from the liver, providing a rather simplistic estimation of key quantities as endogenous glucose production and insulin and glucagon clearance. Methods: Using a three-phase well-established phenomenological-based semi-physical modeling (PBSM) methodology, we built a detailed physiological model of hepatic glucose metabolism, including glucose utilization, endogenous glucose production through gluconeogenesis and glycogenolysis, and insulin and glucagon clearance. Mean absolute errors (MAE) were used to assess the goodness of fit of the proposed model against the data from three different in-vivo experiments -two oral glucose tolerance tests (OGTT) and a mixed meal challenge following overnight fasting-in healthy subjects. Results: Needing little parameter calibration, the proposed model predicts experimental systemic glucose mean ± std 5.4 ± 5.2, 7.5 ± 6.8, and 7.5 ± 7.5 mg/dL, in all three experiments. Low MAEs were also obtained for insulin and glucagon at the hepatic vein. Conclusions: The quantitative concordance of our model to the experimental data exhibits a potential for its use in the physiological study of glucose liver metabolism. The model structure and parameter interpretability allow the union with other semi-physical models for a better understanding of whole-body glucose homeostasis and its use in developing diabetes technology tools. Mención de responsabilidad : Carlos E. Builes-Montaño, Laura Lema-Perez, Jose Garcia-Tirado y Hernan Alvarez Referencia : Comput Biol Med. 2022 Mar;142:105232. DOI (Digital Object Identifier) : 10.1016/j.compbiomed.2022.105232 PMID : 35077932 Derechos de uso : CC BY En línea : https://linkinghub.elsevier.com/retrieve/pii/S0010482522000245 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6012 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001848 AC-2022-018 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-018Adobe Acrobat PDF
Título : STUDIA: An application to support carbohydrate counting by simulating glucose dynamics Otros títulos : STUDIA: una aplicación para apoyar el conteo de carbohidratos simulando la dinámica de la glucosa Tipo de documento : documento electrónico Autores : Carlos Esteban Builes Montaño, Fecha de publicación : 2022 Títulos uniformes : Revista Colombiana de Endocrinología Diabetes y Metabolismo Idioma : Inglés (eng) Palabras clave : mathematical model diabetes mellitus mobile applications computer simulation carbohydrate counting Resumen : Background: Carbohydrate counting is often considered the ideal way to calculate meal-related insulin doses. Several ways to improve carbohydrate counting have been proposed. Purpose: We propose that carbohydrate counting can be refined via simulation and, as such, we present a mobile application for the real-time simulation of postprandial glucose dynamics: STUDIA. Methods: We used a phenomenological model of the gastrointestinal tract, coupled with the minimal glucose model to recreate postprandial glucose challenges in people with type 1 diabetes (T1DM). A requirements gathering process was implemented to define the application's functionalities and technical requirements. In addition, a person-based approach was used to characterize the users. Technological stacks were evaluated under the UX/UI criteria, learning curve, flexibility, and the possibility of executing mathematical models with a resolution of differential equations. We used data from one patient with T1DM to guide users in how to use the app. Continuous glucose monitor readings were used for comparison. Results: STUDIA is a mobile app built on Android Studio® with a user interface and a web-based administrative module connected to AWS®. The app, allows glucose simulations for day-to-day carbohydrate counting refinement, and patient parameter modification based on previous glucose readings and data analysis for comparison and clinical research. Conclusions: We present the first-of-a-kind postprandial simulation app based on a phenomenological model of the GI tract for patients with T1DM and its subsequent clinical research use. STUDIA will be tested in silico with data from multiple meals from patients with T1DM, and in a clinical trial. Mención de responsabilidad : Carlos E. Builes-Montaño, Laura Lema-Pérez, Luis E. Monsalve-Arango, Miguel A. Naranjo-Cano, Carlos M. Sierra Duque, José F. García-Tirado, Hernán Darío Alvarez Zapata DOI (Digital Object Identifier) : 10.53853/encr.9.4.770 Derechos de uso : CC BY-NC-ND En línea : https://revistaendocrino.org/index.php/rcedm/article/view/770 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6074 STUDIA: An application to support carbohydrate counting by simulating glucose dynamics = STUDIA: una aplicación para apoyar el conteo de carbohidratos simulando la dinámica de la glucosa [documento electrónico] / Carlos Esteban Builes Montaño, . - 2022.
Obra : Revista Colombiana de Endocrinología Diabetes y Metabolismo
Idioma : Inglés (eng)
Palabras clave : mathematical model diabetes mellitus mobile applications computer simulation carbohydrate counting Resumen : Background: Carbohydrate counting is often considered the ideal way to calculate meal-related insulin doses. Several ways to improve carbohydrate counting have been proposed. Purpose: We propose that carbohydrate counting can be refined via simulation and, as such, we present a mobile application for the real-time simulation of postprandial glucose dynamics: STUDIA. Methods: We used a phenomenological model of the gastrointestinal tract, coupled with the minimal glucose model to recreate postprandial glucose challenges in people with type 1 diabetes (T1DM). A requirements gathering process was implemented to define the application's functionalities and technical requirements. In addition, a person-based approach was used to characterize the users. Technological stacks were evaluated under the UX/UI criteria, learning curve, flexibility, and the possibility of executing mathematical models with a resolution of differential equations. We used data from one patient with T1DM to guide users in how to use the app. Continuous glucose monitor readings were used for comparison. Results: STUDIA is a mobile app built on Android Studio® with a user interface and a web-based administrative module connected to AWS®. The app, allows glucose simulations for day-to-day carbohydrate counting refinement, and patient parameter modification based on previous glucose readings and data analysis for comparison and clinical research. Conclusions: We present the first-of-a-kind postprandial simulation app based on a phenomenological model of the GI tract for patients with T1DM and its subsequent clinical research use. STUDIA will be tested in silico with data from multiple meals from patients with T1DM, and in a clinical trial. Mención de responsabilidad : Carlos E. Builes-Montaño, Laura Lema-Pérez, Luis E. Monsalve-Arango, Miguel A. Naranjo-Cano, Carlos M. Sierra Duque, José F. García-Tirado, Hernán Darío Alvarez Zapata DOI (Digital Object Identifier) : 10.53853/encr.9.4.770 Derechos de uso : CC BY-NC-ND En línea : https://revistaendocrino.org/index.php/rcedm/article/view/770 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6074 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001918 AC-2022-082 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
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Título : Diabetes mellitus y COVID-19: fisiopatología y propuesta de tratamiento para el control glucémico en el tiempo de la pandemia Otros títulos : Diabetes mellitus and COVID-19: pathophysiology and treatment proposal for glycemic control at the time of the pandemic Tipo de documento : documento electrónico Autores : Carlos Esteban Builes Montaño, ; Clara María Arango Toro, Fecha de publicación : 2021 Títulos uniformes : Iatreia Idioma : Español (spa) Palabras clave : Coronavirus COVID-19 Diabetes Mellitus Glucosa Sanguínea Virus del SRAS Resumen : El coronavirus 2 del síndrome respiratorio agudo grave es el tercer betacoronavirus desde el año 2003 capaz de ocasionar una infección del tracto respiratorio inferior, llevando, en casos críticos, al síndrome de dificultad respiratoria aguda y la muerte. La edad avanzada, la hipertensión arterial y la diabetes mellitus son, entre otros, tres factores determinantes en los peores desenlaces clínicos. Múltiples mecanismos pueden explicar la mayor susceptibilidad de las personas diabéticas a las infecciones respiratorias. La hiperglucemia crónica altera tanto a la inmunidad humoral como al celular. Esta enfermedad predispone a la sobreexpresión de la proteína de la membrana celular que sirve como receptora del virus y a una respuesta inflamatoria exacerbada, aumentando el riesgo de una descompensación y de la aparición de crisis hiperglicémicas. Ante la ausencia de un tratamiento efectivo o de una vacuna, todos los esfuerzos deben hacerse para procurar un buen control metabólico de los pacientes con diabetes mellitus con y sin COVID-19. Por lo anterior, se plantean en este artículo de reflexión, diferentes propuestas para el tratamiento de la diabetes mellitus en la unidad de cuidados intensivos, sin descartar la forma ambulatoria, en donde la telemedicina y otras tecnologías permitirán acortar la distancia y mantener las medidas de aislamiento preventivo. Mención de responsabilidad : Alejandro Román-González, Luis Antonio Rodríguez, Carlos Alfonso Builes-Barrera, Diva Cristina Castro, Carlos Esteban Builes-Montaño, Clara María Arango-Toro, Johnayro Gutiérrez-Restrepo, Juan David Gómez Referencia : Iatreia ; 34(2): 161-171, abr.-jun. 2021. DOI (Digital Object Identifier) : 10.17533/10.17533/udea.iatreia.93 Derechos de uso : CC BY-NC-SA En línea : https://revistas.udea.edu.co/index.php/iatreia/article/view/341746 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5767 Diabetes mellitus y COVID-19: fisiopatología y propuesta de tratamiento para el control glucémico en el tiempo de la pandemia = Diabetes mellitus and COVID-19: pathophysiology and treatment proposal for glycemic control at the time of the pandemic [documento electrónico] / Carlos Esteban Builes Montaño, ; Clara María Arango Toro, . - 2021.
Obra : Iatreia
Idioma : Español (spa)
Palabras clave : Coronavirus COVID-19 Diabetes Mellitus Glucosa Sanguínea Virus del SRAS Resumen : El coronavirus 2 del síndrome respiratorio agudo grave es el tercer betacoronavirus desde el año 2003 capaz de ocasionar una infección del tracto respiratorio inferior, llevando, en casos críticos, al síndrome de dificultad respiratoria aguda y la muerte. La edad avanzada, la hipertensión arterial y la diabetes mellitus son, entre otros, tres factores determinantes en los peores desenlaces clínicos. Múltiples mecanismos pueden explicar la mayor susceptibilidad de las personas diabéticas a las infecciones respiratorias. La hiperglucemia crónica altera tanto a la inmunidad humoral como al celular. Esta enfermedad predispone a la sobreexpresión de la proteína de la membrana celular que sirve como receptora del virus y a una respuesta inflamatoria exacerbada, aumentando el riesgo de una descompensación y de la aparición de crisis hiperglicémicas. Ante la ausencia de un tratamiento efectivo o de una vacuna, todos los esfuerzos deben hacerse para procurar un buen control metabólico de los pacientes con diabetes mellitus con y sin COVID-19. Por lo anterior, se plantean en este artículo de reflexión, diferentes propuestas para el tratamiento de la diabetes mellitus en la unidad de cuidados intensivos, sin descartar la forma ambulatoria, en donde la telemedicina y otras tecnologías permitirán acortar la distancia y mantener las medidas de aislamiento preventivo. Mención de responsabilidad : Alejandro Román-González, Luis Antonio Rodríguez, Carlos Alfonso Builes-Barrera, Diva Cristina Castro, Carlos Esteban Builes-Montaño, Clara María Arango-Toro, Johnayro Gutiérrez-Restrepo, Juan David Gómez Referencia : Iatreia ; 34(2): 161-171, abr.-jun. 2021. DOI (Digital Object Identifier) : 10.17533/10.17533/udea.iatreia.93 Derechos de uso : CC BY-NC-SA En línea : https://revistas.udea.edu.co/index.php/iatreia/article/view/341746 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5767 Ejemplares(0)
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