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Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Currently, clinical practice guidelines (CPGs) recommend the prescription of metformin as a first-line treatment for patients with type 2 diabetes. However, a systematic review and network meta-analysis of randomized clinical trials published in 2022 question the role of metformin as a first-line treatment. The objective of this work was to assess the impact of scientific evidence on the prescription choice. Methods: A randomized experimental study with four arms (1.1.1.1), using clinical vignettes, was conducted in June 2023 at the Faculty of Medicine of Lyon, France, involving 160 general medicine interns present at the faculty for a teaching day. The clinical vignettes all described the same context. Nine antidiabetic medications were presented with their efficacy and safety profiles. The question focused on the choice of first-line treatment and the reasons behind it. The four arms of the study were constituted as follows: two control arms with the names of pharmacological classes (one with benefits and adverse effects (AEs), the other without AEs); two intervention arms without the names of pharmacological classes (one with benefits and AEs, the other without AEs). Results: In all groups, the choice of treatments was strictly limited to the following three pharmacological classes: SGLT2 inhibitors (ISGLT2), GLP1 receptor agonists (AGLP1), and Biguanides (metformin). In the control arm with AEs, the prescription intentions were 10%, 30%, and 60%, respectively. In the control arm without AEs, they were 44.2%, 16.3%, and 39.5%, respectively. In the intervention arm with AEs, the prescription intentions were 48.7%, 51.3%, and 0%, respectively. In the intervention arm without AEs, they were 68.4%, 28.9%, and 2.6%, respectively. There was a significant difference only for ISGLT2 and metformin, with and without mention of AEs. Conclusion: These results suggest that the therapeutic reasoning of interns in general practice is not primarily based on EBM data, but probably on their own knowledge, mainly derived from CPGs. [ABSTRACT FROM AUTHOR]

Burns in diabetics are quite frequent and serious in relation to diabetic neuropathy, which is common in this population, delaying healing and predisposing to the risk of infection. The objective of this study was to describe the characteristics of burns in diabetics hospitalized at the CTB of Tunis over 18 months. During the study period, 891 patients were hospitalized, including 43 diabetics (5%). The average age of our patients was 57 years old with a male predominance (65%). Type 2 diabetes was present in 86% of cases and type 1 diabetes in 14% of cases. Degenerative complications were reported in 10 cases (23%), such as diabetic retinopathy (n=6), diabetic nephropathy (n=4) and diabetic neuropathy (n=6). The circumstances of burns were related to a domestic accident in 2/3 of the cases (76.7%). Thermal burns were involved in 83.7% of cases. 86% of the patients had decompensated their diabetes during their hospitalization. Sepsis marked the evolution of the patients in 55.8% of cases. In our study, poor prognostic factors were: a glycosylated haemoglobin >13%, an extent of burns greater than 20%, and a delay in consultation greater than 6 hours. The mortality rate was 18.6%. [ABSTRACT FROM AUTHOR]

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clinical practice guidelines are theoretically useful to help doctors and patients make decisions. To do so, they must be reliable, i.e. their authors must have no conflicts of interest, and at the very least, the recommendations must be justified by unselected, high-level evidence studies. This is not the case for the American Diabetes Association's 2022-2023 guideline, which is problematic because it has a worldwide influence on the management of type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The recent availability in France of two sodium-glucose co-transporter type 2 (SGLT2i) inhibitors, empaglifozine and dapagliflozine, both in the treatment of type 2 diabetes and heart failure with fraction d reduced ejection, is based on very encouraging results from initial trials. They have also shown a protective effect against the progression of renal failure. These trials are consistent with real-life observations in countries where they were marketed earlier, with in particular a reduction in all-cause mortality. [ABSTRACT FROM AUTHOR]

This study explores the critical realm of Diabetic Foot Ulcers (DFUs) and proposes an innovative approach for early detection using Internet of Things (IoT) and Machine Learning (ML). A chronic metabolic condition with elevated blood glucose levels is called diabetes mellitus. A foot ulcer is an open wound that is typically located beneath the feet. It can be shallow and less severe, occurring just below the skin's surface, or it can be deep and expose the bones, tendons, and joints. However, diabetes patients may be able to avoid complications from diabetic foot ulcers if early prophylaxis is practiced. One of the complications that this condition is frequently linked to is diabetic foot ulcers. Focusing on Diabetes Mellitus, the chronic metabolic condition leading to DFUs, the study introduces a wearable shoe prototype equipped with temperature and pressure sensors. This IoT-enabled device facilitates daily foot evaluation at home, allowing for timely identification of early symptoms and severity monitoring. By integrating ML algorithms, the real-time ulcer detection system aims to prevent complications, reduce amputations, and enhance proactive diabetic care.

Diabetes mellitus (DM) is one of the most common non-communicable diseases (NCDs) globally. It is the fourth or fifth leading cause of death in most high-income countries and there is substantial evidence that it is an epidemic in newly industrialized and many economically developing countries. Diabetes mellitus is a chronic illness requiring continuous medical care with multifactorial risk reduction strategies beyond glycemic control. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Genetic factors are responsible for at least some of this. However, as evidenced by the increased incidence of diabetes mellitus in urban populations, the fast epidemiological shift linked to food pattern alterations and decreased physical activity is the main cause of the diabetes mellitus epidemic. Due to population aging, growth, urbanization, a lack of physical exercise, and a high incidence of obesity, there are more persons with DM. Lifestyle factors include eating patterns, exercise routines, alcohol consumption, and smoking. An improvement in these parameters would lead to better adherence to hypoglycemic medications. An epidemiological study on diabetes and pre-diabetes in an urban area with reference to lifestyle modification. A community-based intervention study. It was conducted in an urban area. Personal interviews using a semi-structured, pretested questionnaire were the main technique of data gathering. Detailed information has been taken on the demographic and socio-economic characteristics at both the individual and household levels. All responders provided their willingly given consent. Every second household was visited by systematic random sampling procedure to select 400 respondents. Due to non-response, inaccuracy and/or unreliability of information 50 Cases were not included in the analysis. Four more instances of diabetes were also removed from the research. Finally, analysis was carried out on 346 respondents. All respondents were questioned using a pretested, semi-structured questionnaire after giving their informed consent. Significant difference was observed with positive family history of diabetes, obesity, physical activities in male, high calorie intake, stress, chewable tobacco and blood pressure level with pre-diabetes and diabetes. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics showed more positive family histories. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics were more likely to be overweight. With regard to personal habits of the respondents, smoking was associated with more than 1-fold increase risk of obtaining serum glucose level >110 mg/dl as compared to nonsmokers. The current research was an attempt to examine the effect of intervention with reference to life style modification. From the study, it is evident that overall awareness about diabetes has been found low and no awareness has been found about pre-diabetes. The present study also demonstrated that education is the fundamental tool to make the population aware of their health issues. Awareness about pre-diabetes and diabetes, which can make them beneficial for community and nation and so, they can play an innovative role for prevention of diabetes.

Diabetes mellitus has emerged as a prevalent noncommunicable disease worldwide. It ranks among the top causes of mortality in high-income countries and has reached epidemic proportions in newly developing nations.1 Continuous medical care and monitoring is required in Diabetes mellitus along with multi-factorial risk reduction strategies along associated with glycemic control. Due to population aging, growth, urbanization, a lack of physical exercise, and a high incidence of obesity, there are more persons with DM. Lifestyle factors include eating patterns, exercise routines, alcohol consumption, and smoking. An improvement in these parameters would lead to better adherence to hypoglycemic medications. An epidemiological study on diabetes and prediabetes in an urban area with reference to lifestyle modification. An interventional community-based study was conducted in an urban setup. Personal interviews using a semi-structured, pretested questionnaire were the main technique of data gathering. Detailed information has been taken on the demographic and socio-economic characteristics at both the individual and household levels. All responders provided their willingly given consent. Every second household was visited by systematic random sampling procedure to select 400 respondents. Finally, analysis was carried out on 346 respondents. All respondents were questioned using structured a pretested, questionnaire after taking informed consent. Significant difference was observed with positive family history of diabetes, obesity, physical activities in male, high calorie intake, stress, chewable tobacco and blood pressure level with diabetes and pre-diabetes. Compared to responders with normal level of blood glucose, pre diabetics and diabetics individual showed more positive family histories. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics were more likely to be overweight. With regard to personal habits of the respondents, smoking was associated with more than 1-fold increase risk of obtaining serum glucose level >110 mg/dl as compared to non-smokers.The current research was an attempt to examine the effect of intervention with reference to life style modification. From the study, it is evident that overall awareness about diabetes has been found low and no awareness has been found about pre-diabetes. The present study also demonstrated that education is the fundamental tool to make the population aware of their health issues. Awareness about pre-diabetes and diabetes, which can make them beneficial for community and nation and so, they can play an innovative role for prevention of diabetes.

Natural toxins have been traditionally used to trigger several diseases among which bee venom (HBV) is of great importance. The present study aimed to investigate the therapeutic effects of honeybee venom (HBV) on alloxan and glucose fluid-induced Type 2 diabetes mellitus (T2DM). Therefore, a total of 20 adult laboratory male mice (Mus musculus) were selected, acclimated, and divided into four equal groups (n=5). Initially, 15 mice were fasted for 12 hrs and injected with alloxan at a single dose of 150 mg/kg of body weight. The animals were exposed to drinking glucose fluid in the morning for 4 days. Then, the blood glucose was measured. The studied animals having blood glucose of £200 mg/dl were considered non-diabetic and re-subjected to injecting alloxan (150 mg/kg body weight) and drinking glucose fluid for another 4 days. Four groups of mice population included, Group 1: non-diabetic and untreated with HBV, Group 2: diabetic and received no HBV as the potential therapeutic agent, Group 3: diabetic and received a low level of HBV at a dose of 0.5 mg/kg, Group 4: diabetic and received a high level of HBV at a dose of 1 mg/kg. At the end of the 35-day testing period, blood samples were tested to determine the levels of insulin, glucose, and lipid profiles [cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)] using Sandwich ELISA kits. The results indicated a significant increase in blood glucose in the diabetic group compared to that of the control one, while both concentrations of HBV significantly reduced the level of blood glucose compared to that of the diabetic group. Furthermore, the level of insulin was significantly decreased in the diabetic group compared to that of the controls, while HBV significantly increased the level of insulin compared to that of the diabetic group. Moreover, the diabetic mice demonstrated a significant increase in the concentration of cholesterol and TG compared to that of control mice which were significantly reversed in response to HBV treatment. The level of HDL was significantly decreased in the diabetic group compared to that of the control group which was modulated by treatment, while no significant differences were seen between all the studied groups regarding the level of LDL. Histological examination of diabetic mice revealed a significant alteration in acinar cells and destruction of b-cells of pancreatic sections with marked lacerations in the liver extended to all structures of the organ. The present study concluded that HBV could be a potential therapeutic agent to prevent and manage diabetes and its complication.

Introduction. Late complications of myocardial infarction (MI) are important causes of re-hospitalization and mortality in patients with type 2 diabetes mellitus (DM). The objective of the study was to predict the development of late complications after MI in type 2 DM patients, to improve the quality of diagnostic tests for this group of patients. Material and methods. A total of 109 patients with type 2 DM after MI was divided into two groups: the study group (n = 74) and the validation group (n = 35). The levels of adropin and C1q/tumour necrosis factor-related protein 3 (CTRP 3) were measured by enzyme-linked immunosorbent assay. The model for predicting late complications of MI was calculated using binary logistic regression. Results. The median age of patients was 61.0 (54.5 – 67.0) years and 68.8% were male. Mathematical model components on the 14th day of follow-up were qualitative adropin, qualitative CTRP3, total cholesterol (TC), triglycerides (TG), ejection fraction (EF), low-density lipoprotein (LDL), left atrium (LA). The model attained the highest under the receiver operating characteristic curve for predicting late MI complications in the study and control groups (0.949 and 0.966, respectively), with the highest diagnostic accuracy in both groups (94.6% and 97.1%, respectively). Conclusions. This study has shown that the integral assessment of adropin, CTRP 3, TC, TG, EF, LDL, LA, measured on the 14th day after MI in type 2 DM patients who underwent percutaneous coronary intervention (PCI), could predict late complications of MI after PCI.

Introduction. Deterioration of left ventricular (LV) parameters in Diabetes Mellitus (DM) can occur in the absence of other heart problems. An association between glycosylated hemoglobin (HbA1c) and changes of the LV parameters in DM has been reported. However, data regarding this association model in children with Type 1 Diabetes Mellitus (T1DM) are limited. The purpose of the work was to investigate the association between HbA1c and the LV parameters in pediatric patients. Material and methods. The study was conducted on 28 children with T1DM ((aged 10 - 18 years, gender M (15)/F (13), duration ≥5 years). The clinical (standard medical examination) and paraclinical (biochemical dosage – HbA1c, echocardiography – LV functional and structural parameters) data was carried out. Statistical analysis used the SPSS version 20. Results. The correlational study between the HbA1c and the LV parameters revealed a statistically significant positive correlation coefficient with aortic root diameter (mm) (r=0.7**, p

Background: Patients living with diabetes are primarily managed and supported by nurses in primary health care (PHC). Therefore, PHC nurses require knowledge of diabetes and confidence (self-efficacy) to perform diabetes self-management support (SMS). Aim: This study evaluated the diabetes knowledge, self-efficacy and performance of diabetes SMS by PHC nurses. Setting: Primary health care facilities in King Sabata Dalindyebo subdistrict, O.R. Tambo district, Eastern Cape. Methods: A quantitative cross-sectional and simple correlational design was used. Registered nurses (n = 100) completed a validated self-reporting questionnaire to measure diabetes knowledge, self-efficacy and performance of SMS. Results: Participants’ diabetes knowledge mean scores were high (mean of 11.9, standard deviation [s.d.] 1.8, out of 14). Self-efficacy scores (mean 18.91, s.d. 3.2 out of 24) were higher than performance of SMS scores (mean 17.81, s.d. 3.3 out of 24). Knowledge was not associated with self-efficacy or performance, but self-efficacy was positively correlated with performance of SMS (r = 0.78, p 0.01). Nurses with a postgraduate qualification in primary care nursing had significantly higher diabetes knowledge scores (mean = 92.9 vs. 83.8; p = 0.03), and years of experience as a nurse were positively correlated with the performance of SMS (r = 0.21, p = 0.05). Conclusion: Diabetes knowledge of PHC nurses in this study does not translate into self-efficacy and the performance of SMS in practice, indicating the need for specific SMS training, support by experienced mentors, appropriate guidelines and comprehensive integrated chronic care systems. Contribution: This is the first study to report on the SMS self-efficacy and performance of PHC nurses in South Africa.

Introduction: Health care providers face a multitude of challenges in providing care to patients with diabetes who are experiencing homelessness. Considering the unique circumstance faced by this population, mainstream services must be adapted and tailored to meet patients’ needs. The objective of this study was to explore both the barriers faced by providers and programs in offering comprehensive diabetes care to these patients, and their suggested areas for improvement. Methods: We conducted semi-structured interviews with providers who care for patients who have diabetes and/or who experience homelessness. Participants included primary care providers, specialist physicians, dietitians, shelter staff, outreach workers, and diabetes educators in five Canadian centres (n=96). Responses were analyzed using qualitative thematic analysis. Results: Barriers most frequently cited by providers were a lack of resources for staff. Other challenges included policy barriers (restrictions on billing codes, care professionals’ scope of practice, and the structure of financial support for this population), duplication of services, and alternative priorities of care. Participants identified several strategies to improve care, which targeted the following spheres: location of service provision and coordination of care, policy changes, and extending funding and resources for staff, such as augmented funding to hire allied health professionals in outpatient settings and increasing outreach capabilities. Conclusion: Programs that strive to address the unique needs of clients experiencing homelessness face numerous challenges. Unique potential solutions to these barriers, such as service provision in a convenient location involving social and health services, incorporating allied health care providers in care to a greater extent, and updating policies to reflect the social complexity of the population can improve diabetes care.

Background: South Africa has a high prevalence of diabetes mellitus (DM), a leading risk factor for lower limb amputation (LLA). Lower limb amputation is associated with significant morbidity and mortality. Lower limb amputation incidence can be mitigated through prompt identification and treatment of individuals at risk and engagement in self-management practices. Also, when LLA is inevitable, outcomes or prognosis can be improved with timely surgery. Aim: This study explored the knowledge, attitude and perception of persons living with diabetes towards LLA and its prevention. Setting: Nqamakwe, a rural community in the Eastern Cape province of South Africa. Method: This was a descriptive, qualitative study involving persons living with DM, with and without LLA, and community leaders. Fifteen participants were recruited purposively and conveniently from a rural community in the Eastern Cape, South Africa. Data collection took place through semistructured interviews, in English and a local language, Xhosa. Interviews were transcribed and translated, and an inductive approach was used for thematic analysis. Results: A total of 15 individual interviews were conducted. Of those, 13 were persons with DM, five with LLA, including one with bilateral LLA. There was a gap in knowledge on foot self-examination as a measure of preventing LLA amongst persons with DM. The attitude of persons without LLA was mostly fearful and their fears centred around perioperative death, risk for contralateral amputation, loss of limb and independence. Consent to LLA procedure was a last resort and only when pain levels were unbearable. Family support and information on rehabilitation services and assistive devices also fostered consent to LLA surgery. Conclusion: There is a need for awareness creation and adequate health education for persons living with DM on LLA and its prevention measures, especially foot care practices. Also, health education programmes for persons living with DM in rural areas should address the various misperceptions of LLA to reduce delays. Contribution: The article revealed gaps in knowledge on LLA and its prevention among individuals living with diabetes as well as areas of concerns that may potentially delay acceptance when LLA is inevitable. Findings from our study may assist primary health care providers to determine important issues to be addressed during routine and pre-operative patient education.

Pulmonary tuberculosis is frequently associated with diabetes mellitus and, sometimes, it may present with atypical signs. The purpose of this study is to identify the epidemiological, clinical, biological and radiological features of pulmonary tuberculosis in patients with diabetes versus patients without diabetes in order to improve treatment. We conducted a retrospective, crosssectional descriptive and analytical study in the Department of Endocrinology and Pneumology at the Joseph Raseta Befelatanana University Hospital Center and in the Department of Respiratory Diseases at the Soavinandriana Hospital Center in Antananarivo, Madagascar. It involved patients diagnosed with pulmonary tuberculosis who presented a positive bacilloscopy exam from January 2018 to January 2020 (25 months). In our study, the overall prevalence of diabetes among TB patients was 20.31 %. Older age, insidious clinical course, severe biologic inflammatory syndrome, fewer caves but more systematized opacities and diffuse radiological lesions in the basal zone (more commonly unilateral right lesions) were mainly detected in patients with diabetes compared to patients without diabetes. Knowledge of signs of pulmonary TB in patients with diabetes can help health care workers to make a diagnosis, even in patients with atypical signs. Moreover, as the majority of pulmonary tuberculosis occur in patients with unstable diabetes, a good glycemic balance can certainly reduce its incidence. [ABSTRACT FROM AUTHOR]

Introduction: Therapeutic education is a central element of the management of type 1 diabetes in children. Aim: The aim of this study was to identify the therapeutic education needs of their parents by considering the views and experiences of parents and professional carers. Methods: Four focus groups of parents and 6 focus groups of professional carers explored the difficulties parents face in relation to their child's diabetes, and the most effective support for them. Results: Parents face difficulties in the daily medical care, in the relationship to their child in the family, in the relationship to others (school, family, friends, carers) until repercussion on their psychological well-being. Carers analyse differently some difficulties and underestimate how hard it is for parents to see their child undergoing unpleasant medical treatment as well as the other people's ignorance and fears. Participants identified therapeutic education and peer exchange as appropriate responses to these challenges. Putting these suggestions into practice in a therapeutic education setting would provide an opportunity for carers to learn more about the daily lives of families and adapt their medical practice. Conclusion: Crossing the points of view has led to the development of a parental skills matrix which could prove to be a useful therapeutic education tool. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) and heart failure (HF) are often associated and each disease independently increases the risk for the other. It is well recognized that diabetes is a risk factor for mortality among individuals with heart failure. The risk of incident HF among patients with DM increases with older age, obesity, retinopathy, hypertension, coronary artery disease, peripheral arterial disease, nephropathy, longer duration of DM and higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) value. The treatment of each pathology in the presence of the other raise difficulties in the clinical practice. First-line treatment of DM in patients with HF should include metformin and SGLT2 inhibitors; conversely, saxagliptin, pioglitazone and rosiglitazone are not recommended in patients with DM and HF.

The efficacy of diabetes mellitus (DM) therapy is not only contingent on the pharmacological agents but also significantly influenced by the depth of patient comprehension regarding therapeutic management. Therefore, designed educational interventions pertinent to individual requirements must be administered, including the intricacies of DM therapy management. This qualitative study was carried out in January February 2023 at 6 Public Health Center in Salatiga City. The investigative method employed was semi-structured interviews, conducted with a cohort of DM patients between the ages of 55 to 65 years, who possessed proficient communicative skills in the Indonesian language, and voluntarily answered each question. Meanwhile, individuals concurrently engaged in healthcare vocations were excluded and the interview process was documented in the form of an audio recording. The results showed that patients still need education regarding proper diet for diabetics including the type, amount, and schedule. Guidance relating to appropriate physical activities catering to DM patients, in conjunction with the discernment of medication indications, potential side effects, storage requisites, and administration protocols, emerged as critical topics. This study stated that DM patients need educational curriculum related to diet/nutrition, physical activity, medicines, and DM complications.

Introduction: Diabetes Mellitus is a strong cardiovascular risk factor in which acute coronary syndromes (ACS) are thought to have a particular feature. We aimed to determine the characteristics of acute coronary syndromes in diabetics compared with non-diabetics patients., Patients and Methods: We carried out a prospective, descriptive and analytical study comparing diabetic and non-diabetic patients admitted for acute coronary syndrome to the cardiology department of Idrissa Pouye general hospital over a period of one year by studying socio-demographic, clinical, paraclinical, therapeutic and evolutionary parameters. We performed a multivariable logistic regression analysis to identify factors associated with chest pain and triple vessels disease., Results: Our study included 139 patients, 61 with diabetes (44%) and 78 without diabetes (56%). Among diabetics, there was a predominance of women (p = 0.0001) in contrast to non-diabetics. The mean age was 62.7 ± 10.8 years in diabetics and 56.9 ± 13.5 years in non-diabetics (p = 0.006). Chest pain was found in 88.5% of diabetics and 97.4% of non-diabetics (p = 0.03). The mean HbA1c in diabetics was 9.4 ± 3.3%. ST elevation acute coronary syndrome was predominant in both groups. The mean GRACE score was 147 ± 29 in diabetics and 132 ± 28 in non-diabetics (p = 0.003). In multivariable analysis, only diabetes was associated with triple vessels disease (aOR (IC à 95%): 2,60 (1.29-6.83); p = 0.042). A total of 31% of diabetics and 43% of nondiabetics undergoes cardiac revascularization. There was no difference between the two groups in terms of complications. The mortality was 6.6% and 3.8% respectively among diabetics and non-diabetics (p = 0.49)., Conclusion: According to our study, diabetes is frequently encountered during acute coronary syndromes. It also shows that diabetics are more likely to be female and older, with more atypical symptoms and more severe coronary disease., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Patient-centred care (PCC) is one of the pillars of Malawi’s quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific. Aim: The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management. Setting: This study was conducted in DM clinics in Southern Malawi. Methods: Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower’s work. Results: Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants’ conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic. Conclusion: Patient-centred care conceptualisation in Malawi goes beyond the patient–HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

Background: Life expectancies of HIV-positive patients have been increasing with the rapid implementation of antiretroviral therapy (ART). This has led to an increase in comorbidities such as diabetes mellitus (DM) and hypertension (HT) amongst the HIV population. The burden of the non-communicable diseases (NCDs) such as DM and HT need to be quantified in order to ensure that patients receive optimal integrated care as patients often access care at different clinics compromising holistic care. Aim: The aim of the study was to determine the prevalence of DM and HT amongst the HIV-positive population. Setting: The study was conducted at Wentworth Hospital, a district facility in South Durban, KwaZulu-Natal. Methods: This cross-sectional study was undertaken to determine the prevalence of two NCDs, namely DM and HT in HIV-positive patients attending the ART clinic at a district hospital in the eThekwini district. We compared the socio-demographic and clinical profiles of those with and without comorbidities. A sample of 301 HIV-positive patients were administered a structured questionnaire. Results: Of the 301 patients, 230 (76.41%) had HIV only (95% confidence interval [CI]: 71.25–80.89) and 71 (23.59%) had HIV and at least one comorbidity, namely DM and/or HT (95% CI: 19.11-28.75). Hypertension was the most prevalent comorbidity. This study revealed that there was no association between the duration of ART and comorbidities. Older age and body mass index (BMI) were associated with comorbidities, whilst gender and ethnicity were not associated. Conclusion: Non-communicable diseases such as DM and HT do pose a burden for HIV-positive patients attending the ARV clinic at this district facility. This study highlights the definite need to plan for the increased burden of NCDs as HIV-positive patients live longer and gain weight.

Résumé: Les inhibiteurs de la réabsorption tubulaire du glucose, ou gliflozines, sont une nouvelle classe thérapeutique. Leur mécanisme d'action original passe par l'inhibition d'un co-transporteur de réabsorption du glucose et Na+ dans le tube contourné proximal rénal. Ils réduisent la glycémie en réduisant la réabsorption rénale du glucose. Ils entraînent donc une glycosurie qui constitue une perte énergétique et aboutit, in fine, à une perte de poids de l'ordre de 2 à 3 kg. Ils réduisent la charge sodée et diminuent la pression artérielle. Cette classe améliore l'HbA1c d'environ 0,7 %. L'empagliflozine a montré une diminution de la mortalité toutes causes confondues chez les patients diabétiques de type 2 à haut risque cardiovasculaire, ainsi qu'une diminution des épisodes de décompensation cardiaque et une néphroprotection chez les sujets diabétiques ou non. L'empagliflozine, comme les autres gliflozines, n'induit pas d'hypoglycémie puisqu'ils ne stimulent pas directement la sécrétion d'insuline. Par la prévalence élevée du diabète de type 2, de l'insuffisance cardiaque et de l'insuffisance rénale chez le sujet âgé, les glifozines vont intégrer les prescriptions de gériatrie. Leur avantage et utilisation doivent être connus, d'autant plus que leur place est amenée à s'étendre à de nombreuses indications dans le champ des maladies chroniques. Glucose and sodium tubular reabsorption inhibitors, or gliflozins, are a new therapeutic class. Their novel mechanism of action involves inhibition of a glucose and Na+ reabsorption co-transporter in the renal proximal tubule. They reduce blood glucose levels by reducing renal glucose reabsorption. They therefore cause glycosuria, which constitutes an energy loss and ultimately leads to a weight loss of around 2 to 3 kg. They reduce the sodium load and lower blood pressure. This class improves HbA1c by about 0.7%. Empagliflozin has been shown to reduce all-cause mortality in type 2 diabetic patients at high cardiovascular risk and to reduce episodes of cardiac decompensation and is nephroprotective in diabetic and non-diabetic subjects. Empagliflozin, like other gliflozins, does not induce hypoglycaemia as it does not directly stimulate insulin secretion. Due to the high prevalence of type 2 diabetes, heart failure and renal failure in the elderly, gliflozins will become part of geriatric prescriptions. Their advantages and use must be known, especially as their place will be extended to numerous indications in the field of chronic diseases. [ABSTRACT FROM AUTHOR]

Introduction. Vascular risk factors have been associated with cognitive decline, although their simultaneous effects on cognition are unclear. The aim of our study was to examine the additional impact of some of the most important risk factors (ageing, arterial hypertension (AH), chronic ischemic heart disease (CIHD), tobacco-usage and alcohol) on cognitive functions of patients with diabetes mellitus (DM). Material and methods. We examined 115 patients (average age 62.47±10.60 years; 49 males, 66 females) with DM (mean disease duration 9.28±6.88 years), admitted between 2016-2017 in the Neurology Clinic of the University Hospital „Sofiamed“, Sofia, Bulgaria. We used the following neuropsychological battery: Mini Mental State Examination (MMSE), Isaack Set Test, 10 words memory test, Digit Symbol Substitution Test, Trail Making Test A and B, Clock drawing test, Logic memory test (subscale of Wechsler memory scale IV ed.), Benton visual retention test (var. A, form E). The results were summarized in tables. All the results were analyzed in 95% confidence interval. Results. Ageing was associated with a poor cognitive performance in almost all examined cognitive domains, except MMSE. CIHD is associated with low Digit Symbol Substitution Test points and more omissions and size errors on Benton Visual Retention Test. Conclusions. Ageing is associated with decline in visual and verbal memory, executive functions and visual-spatial abilities in cases with DM. CIHD leads to additional alternating attention deficits in patients with DM. AH, tobacco-usage and mild and moderate alcohol drinking are not significantly associated with additional cognitive dysfunctions in cases with DM.

Introduction. The association between cognitive functions and personal traits is a question of interest and debate. Diabetes mellitus is associated with cognitive changes. The aim of our study was to find if any relations exist between cognitive functions and personal traits in persons with diabetes. Material and methods. We examined 115 patients (average age 62.47±10.60 years; 49 males, 66 females) with diabetes (13 with diabetes type 1 and 102 with type 2 diabetes; mean duration of disease 9.28±6.8 8years), admitted during 2016-2017 in the Neurology Clinic of the University Hospital “Sofiamed”, Sofia, Bulgaria. After having signed the informed consent, all patients underwent full somatic and neurological examination, and fulfilled specific neuropsychological tests and personal questionnaire (Minnesota Multiphasic Personality Inventory 2, MMPI). Results. We found statistically significant associations between MMPI subscales and cognitive domains. Conclusions. Our data analysis shows significant associations between cognitive functions and personal traits. We suggest that cognitive-focused therapy can improve some negative personal traits and vice versa.

INTRODUCTION: The prevalence of non-communicable and chronic diseases has been on the increase globally and has been a major factor responsible for high morbidity and mortality. Multimorbidity of the chronic diseases in low/medium income countries should be a major concern for public health practitioners because of the communicable diseases they also battle with. This study was carried out to determine the prevalence of multi-morbidity of chronic diseases of lifestyle (CDL) among adult South Africans. METHODS: we employed General House Survey (GHS) data released by Statistics South Africa (Stats SA) in December 2015 with a response rate was 90.5%. Data on diabetes mellitus, high cholesterol, stroke, heart attack/myocardial infarction, hypertension were analysed using descriptive and inferential statistics. RESULTS: the outcome of this secondary data analysis showed that about 16.3% of South Africans respondents aged 18 years and above had a single/or multiple CDL. The majority of the respondents with CDL were females (10.9%), older adults (9.4%), married (8.5%), of the black racial extract (11.9%), and reside in urban areas (3.4%). Also, high blood pressure (13.7%) was the most reported prevalent chronic disease while heart attack (1.1%) was the least reported chronic disease. The outcome of regression analysis after adjustment showed that gender (OR=0.56, CI=0.53-0.60, p=0.001), age [middle-aged adult(R=0.003, CI=0.003-0.004, p=0.001), older adult (R=0.25, CI=0.23-0.26, p=0.001)] and marital status[divorced (OR=1.55, CI=1.44-1.67, p=0.001), separated (OR=1.71, CI=1.46-2.00, p=0.001), single (R=1.88, CI=1.71-2.07, p=0.001)] were among the correlates of chronic diseases of lifestyle for the 1st step of the adjustment. However, White population group (OR=1.17, CI=0.96-1.41, p=0.113), residing in farm settlement (OR=0.99, CI=0.84-1.16, p=0.910) and all the sub-scales of educational status were not correlates of the CDLs for the 2nd adjustment of regression analysis. CONCLUSION: the findings of the study suggest that CDL is endemic among the South African population and that the most susceptible groups are the older adults, females, the married, the uneducated and the coloured individuals.

Burns in diabetics are quite frequent and serious in relation to diabetic neuropathy, which is common in this population, delaying healing and predisposing to the risk of infection. The objective of this study was to describe the characteristics of burns in diabetics hospitalized at the CTB of Tunis over 18 months. During the study period, 891 patients were hospitalized, including 43 diabetics (5%). The average age of our patients was 57 years old with a male predominance (65%). Type 2 diabetes was present in 86% of cases and type 1 diabetes in 14% of cases. Degenerative complications were reported in 10 cases (23%), such as diabetic retinopathy (n=6), diabetic nephropathy (n=4) and diabetic neuropathy (n=6). The circumstances of burns were related to a domestic accident in 2/3 of the cases (76.7%). Thermal burns were involved in 83.7% of cases. 86% of the patients had decompensated their diabetes during their hospitalization. Sepsis marked the evolution of the patients in 55.8% of cases. In our study, poor prognostic factors were: a glycosylated haemoglobin > 13%, an extent of burns greater than 20%, and a delay in consultation greater than 6 hours. The mortality rate was 18.6%., (© 2024 Euro-Mediterranean Council for Burns and Fire Disasters.)

INTRODUCTION: diabetes care in Guinea Bissau (GB) is characterized by a lack of properly trained healthcare professionals (HCPs) and guidelines for diagnosis, treatment and follow up of patients. To address these issues, this project was launched with the objective to train HCPs in the management of diabetic patients and establish a specialized diabetes clinic in the Hospital Nacional Simão Mendes, a public tertiary care hospital in Bissau, capital of GB. This project is led by the Geneva University Hospitals (HUG) in collaboration with the Swiss Association for the Aid to Diabetic People in Guinea-Bissau, with the support of the International Solidairty Office (SSI) of the State of Geneva, and AIDA (Ayuda, Intercambio y Desarrollo). METHODS: specialists from the HUG in collaboration with local experts in GB developed and delivered a culturally and contextually adapted training course pertaining to diabetes care to HCPs in this hospital. Pre and post training tests were conducted to assess differences in knowledge and practices. Following the training program, a diabetes clinic was set up and an audit was conducted to assess its performance. RESULTS: a total of 24 HCP attended the training program and exhibited statistically significant improvements in their knowledge pertaining to diabetes care (mean difference between pre and post-test = 14.53, SD 11.60, t=-4.8, p= 0.001). The diabetes clinic was established and provided consultations 2 days per week. A total of 63 patients consulted at this clinic, of which 49 had type two diabetes treated with oral antidiabetic drugs and 14 were type 1 diabetics treated with insulin. Patients had blood glucose measurements and recieved therapeutic, dietary and physical activity counselling. Several barriers leading to occasional interruptions of service were encountered, including a political instability in the country and strikes of healthcare staff demanding better wages and working conditions. CONCLUSION: this study delineates the feasibility of setting up a diabetes consultation clinic in GB despite important barriers. To ensure successful running of such consultation clinics, continued buy-in and support from stakeholders should be ensured. Diabetes training should be incorporated in pre-and post-graduate training curriculums of all HCP to help shape a better workforce.

Background: Coexistence of human immunodeficiency virus (HIV) and non-communicable diseases (NCDs) is an important public health issue of increasing concern. However, the prevalence, healthcare costs and management protocols for NCDs in people living with HIV (PLHIV) remain unclear in most settings. Aim: To scope evidence on prevalence, healthcare costs and disease management protocols associated with NCDs in PLHIV from studies published before July 2019. Methods: Electronic databases were searched for published articles, and reference lists were checked for relevant studies. Key terms included were HIV/AIDS, co-morbidity or multi-morbidity, NCDs, healthcare costs, treatment protocols, diabetes mellitus, hypertension in various combinations. Results: A total of 152 records were assessed, and thereafter 25 studies were included in the final review after all the elimination. Twelve of the 25 studies mostly reported prevalence of NCDs in PLHIV, 4 reported impact of HIV–NCD co-morbidity on healthcare costs and 1 reported management protocols and capacity of antiretroviral therapy (ART) sites to manage HIV–NCD co-morbidity. Conclusions: Results showed higher prevalence rates of diabetes mellitus and hypertension in PLHIV compared with HIV-negative people. However, there was inconsistency in NCD prevalence data from studies conducted in sub-Saharan African (SSA) countries, and limited research evidence on capacity of ART sites to manage NCDs in PLHIV. Low prevalence rates of NCDs reported in SSA countries could be an indication of limited capacity to screen for NCDs because of the influence of health system and/or patient-level factors. Most studies were generally limited to cross-sectional studies, with very few interventional, longitudinal studies.

INTRODUCTION: Early diagnosis of peripheral neuropathy in people with diabetes mellitus is important. Screening tools are either expensive or cumbersome, and thus impractical in low-resource settings. The DN4 questionnaire is a simple alternative. We assessed the performance of the DN4 Questionnaire in detecting neuropathic pain associated with diabetic peripheral neuropathy in patients with type 2 diabetes.

Background: While antiretroviral therapy (ART) has markedly increased survival in people living with human immunodeficiency virus (PLHIV), emerging trends of co-existence of non-communicable diseases (NCDs) and HIV could negate the gains already achieved in controlling HIV. Aim: The study aimed to determine the prevalence of hypertension and diabetes mellitus in PLHIV on ART in Gweru district. Setting: Six high-volume ART sites in Gweru district under Midlands province in Zimbabwe. Methods: This was a cross-sectional study. Screening and data collection occurred over a 3-month cycle when all patients were expected to have visited the ART sites for their monthly ART drug supply. The process also allowed the identification of health system challenges regarding data management for HIV-NCD comorbidity. Poisson regression analysis was used to calculate NCD prevalence ratio (PR) in PLHIV. Results: Nearly 18 000 PLHIV registered for ART were identified. Hypertension (19.5%) and diabetes mellitus (8.4%) were the most common NCDs identified with a high proportion of those who did not know their diagnosis (over 50%). The prevalence of hypertension and/or diabetes mellitus among women was 74.9% compared to 25.1% in men (PR 3.22; 95% CI: 3.07–5.51, p = 0.0000). Other factors associated with increased prevalence of hypertension and/or diabetes mellitus were age group of ≥ 60 years (PR 2.5; 95% CI: 1.42–3.22, p = 0.00023), and duration of ≥ 5 years on ART (PR 6.4; 95% CI: 4.70–8.01, p = 0.0011). Separate data collection for NCDs and HIV was a key challenge affecting quantification of magnitude of HIV-NCDs comorbidity and subsequently management of NCDs in PLHIV. Conclusions: Indications of increasing prevalence of NCDs in PLHIV call for integrated electronic data management for HIV, TB and NCDs. This will allow active NCD case finding, and eventually improve prevalence data and treatment for HIV-NCD comorbidity. Future studies should focus on the health experiences and access to treatment in PLHIV diagnosed with NCDs; and to establish the accurate manner in which HIV status, ART and NCDs might be associated, through conducting a case control or cohort study.

Diabetes mellitus is a non-infectious disease and has affected about 425 million adults globally and nearly 15.9 million of them reside in Africa. Moreover, the prevalence of undiagnosed diabetes mellitus is very high in Africa and approximates to around 62%. Nearly 75% of the total deaths due to diabetes are in individuals lesser than 60 years of age. The multifaceted disease of diabetes mellitus produces chronic complications such as, neuropathy, nephropathy, retinopathy, microangiopathy etc. These patients of diabetes mellitus are more susceptible to infections due to compromised immune system. Hence these patients of diabetes mellitus and undiagnosed diabetes mellitus are at greater risk of contracting COVID-19 infections. The dual impact of pathophysiology of COVID-19 infections in diabetes mellitus may increase morbidity and mortality in these patients. Hence there is need of health awareness in diabetics as well in the high-risk group for diabetes such as persons with hypertension and obesity. The scarcity of health resources, shortage of trained medical personnel and disease burden of infectious and non-infectious diseases has laid a heavy impact on the economy in Africa and this has been further strained due to the COVID-19 pandemic. The practice of preventive measures by the risk group of undiagnosed diabetes mellitus patients will prevent them from getting infected by COVID-19 and at the same time decrease mortality rates and hence the undiscovered group that is the patients of undiagnosed diabetes mellitus needs to be vigilant regarding safe preventive practices.

INTRODUCTION: among hypertensive patients, the comorbidity of diabetes is not uncommon. Yet, little is known about diabetes prevention among non-diabetic hypertensive patients. This study sought to assess such patients’ knowledge about diabetes and its risk factors. METHODS: a cross-sectional descriptive study design and random sampling were used to recruit non-diabetic hypertensive patients from University of Calabar Teaching Hospital. A pretested 33-item questionnaire was used to assess various aspects of diabetes knowledge. Participants’ alcohol consumption, smoking habits, physical activity, and fresh fruit consumption were also assessed. The p-value was set to 0.05. RESULTS: of 212 respondents with a mean age of 45.5 ± 10.8 years, approximately half (49.1%) had inadequate knowledge of diabetes. Most participants demonstrated poor knowledge of diabetes’ clinical features (81.1%) and complications (59.4%), while fewer participants showed poor knowledge of causes and risk factors (24.5%) and diabetes management (40.6%). Older subjects, those in the wards, non-drinkers, physically active people, and those who frequently consumed fresh fruit had a significantly greater understanding of diabetes symptoms and complications (p=0.05). CONCLUSION: hypertensive patients’ diabetes knowledge is generally suboptimal, with greater knowledge deficiencies being apparent in specific areas. More strategic health education initiatives are required, about minimizing the risk of developing diabetes comorbidities.

To study the effect and clinical analysis of the application of chemical test in the diagnosis of diabetes. A total of 80 patients who came to a hospital for diabetes diagnosis from September 2020 to September 2021 were selected and randomly divided into experimental group and control group, with 40 cases in each group. The control group was given routine examination, and the experimental group was given biochemical test. The test results of the two groups were compared and analyzed. For patients requiring diabetes diagnosis, patients in the experimental group used a biochemical test, including fasting blood glucose, two-hours postprandial blood glucose, glucose tolerance, triglycerides, and hemoglobin. The accuracy of the test results in the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P

The syndromes of severe insulin resistance (IR), although rare, are very interesting and clinically important. It causes a deterioration of the glycemic control, despite the very high dose of insulin. One of the rarest etiologies is autoimmunity especially the production of insulin autoantibody. We report the case of a 61-year-old woman with a history of type 2 diabetes for 10 years. She has reported a deterioration of her glycemic control despite an increase in the dose of insulin up to 200U/day (d). The clinical examination was without particularity. There was no history of drug intake. A high titer of insulin antibodies was detected in the serum 77.6%. Prednisolone was administered with a dose of 0,5mg/Kg/d for 1month. The dosage was tapered 5mg at 15 days intervals until 5mg/d. Insulin requirement decreased by 66% and glycemic control was reached. The treatment of antibody-mediated IR is not standardized; corticosteroid therapy often gives good results.

The importance of cardiovascular/cardiometabolic risk is a special one, because it may influence atherogenesis and its clinical consequences: ischemic heart disease, cerebrovascular disease, peripheral artery disease, but also diabetes mellitus (DM). To evaluate the cardiometabolic risk associated with visceral obesity, a useful indicator for the clinical practice was searched. The visceral adiposity index (VAI) could become an easy-to-use tool to evaluate the cardiometabolic risk in everyday practice. VAI indicates the function of visceral adipose tissue and its growth is independently correlated with cardiovascular and cerebrovascular risk. The medical world tried to identify an easy way to assess cardiovascular risk, so the visceral adiposity index was introduced, whose formula includes a number of cardiovascular risk factors.

Introduction: Therapeutic patient education programs provide support to children with type 1 diabetes and their families. Nurses participate in these programs as part of a multidisciplinary team, but their activities are currently under-documented in the literature. Objective: To describe nursing activity in pediatric diabetes patient education programs. Method: Descriptive qualitative study by semi-structured individual interviews with nurses working in the hospital sector or in educational stays, with lexicometric analysis of discourse. Results: Twenty nurses, including ten child and young people nurses participated in the study. The participants describe the communication and adaptation competences mobilized to manage the educational activity and its traceability. The specific needs of patients are taken into account by the adaptability and variety of teaching methods and tools mobilized according to age, level of understanding, and culture. Discussion: Nurses seem to develop relational competences to deliver and coordinate therapeutic education, without necessarily being coordinators. They confirm the need to take into account the specific needs of the child and adolescent. Organisational constraints appear to generate collective competences between health educative professionals and patients and between peers. Conclusion: This study makes it possible to take into consideration the nurses' perception in the development of an inter-regional educational program. [ABSTRACT FROM AUTHOR]