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1. Comité de Obesidad. Riesgos en la salud materno fetal en mujeres con diagnóstico de obesidad pregestacional

Author

Susana Gutt, Juliana Mociulsky, and María Yuma

Subjects
obesidad materna, salud materna, salud fetal, Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

La obesidad materna se relaciona con resultados desfavorables para la madre y el recién nacido. El criterio utilizado para la revisión de la bibliografía en relación a la obesidad y el peso saludable fueron los parámetros de la Organización Mundial de la Salud (OMS). Se tomaron de la bibliografía solo revisiones sistemáticas de estudios de cohorte, artículos revisados por pares, estudios de caso utilizando de referencia la publicación de Marchi J et al., una revisión sistemática de revisiones con el método de selección el texto completo, utilizando la herramienta AMSTAR para el control de calidad. Se incluyeron 22 revisiones. Los resultados se buscaron en relación a los riesgos y las complicaciones para el embarazo, la madre y/o el recién nacido. El objetivo fue identificar los riesgos de hipertensión arterial pregestacional, preeclampsia, depresión, parto por cesárea e infección en el sitio de la cesárea (si el parto fue por esa vía) para las mujeres con obesidad pregestacional en comparación con las embarazadas con peso saludable. La obesidad pregestacional se asocia a morbilidad materno fetal, parto por cesárea, y menor posibilidad de iniciar y sostener la lactancia. Las mujeres en edad fértil con obesidad que buscan un embarazo deben programarlo y formar parte de un programa de descenso de peso previo al inicio de la gesta a fin de reducir la carga de resultados maternos y fetales causados por la obesidad materna.

Published
2024
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2. Consenso intersocietario para el tratamiento de la obesidad en adultos en Argentina

Author

Marianela Aguirre Ackermann, María Victoria Salinas, Marina Torresani, Ana María Cappelletti, Lilia Cafaro, Estrella Menéndez, Lucila Minotti, Begoña Zugasti, Marcos Mayer, Paola Harwicz, María José Almada, Romina Clemente, Emilio Masabeu, Cynthia Mariana Villalba, Vanesa Anger, Viviana Lasagni, Julieta Carreras, Romina Palma, Maximiliano Smith, Fabiana Stolman, María Graciela Álvarez, Susana Fuentes, Susana Gutt, Juliana Mociulsky, Carla Musso, María Yuma, María del Pilar Quevedo, Mariana Prieto, Sandra Andino, José Cooke, Norman Jalil, Magalí Sánchez, Edgardo E. Serra, Mónica Katz, and María Cecilia de Pizzol

Subjects
obesidad, abordaje nutricional, actividad física, intervenciones psicológicas, farmacoterapia, cirugía bariátrica, Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

La obesidad es una enfermedad crónica que genera altos costos en salud, cuyo tratamiento, en ocasiones, no se aborda o se lo hace de forma inadecuada, y muchas veces no se basa en la evidencia disponible. Es por ello que, a partir de una iniciativa de la Sociedad Argentina de Nutrición, diferentes sociedades científicas se reunieron con el objetivo de construir un documento actualizado, basado en una metodología científica, que aporte al mejor tratamiento de las personas que viven con obesidad en Argentina. Este es el primer Consenso Intersocietario para el tratamiento de la Obesidad en adultos en Argentina a partir del cual se obtuvieron recomendaciones para la práctica clínica basadas en la evidencia científica. Es una necesidad primordial contar con herramientas, adecuadas a la realidad local y consensuadas por expertos de distintas disciplinas.

Published
2023
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3. Recomendations for the first appointment of adult persons with obesity

Author

Susana Gutt, Noelia Sforza, Alejandra Cicchitti, Jimena Coronel, Carla Gauna, Sandra González, Paula Lifszyc, Juliana Mociulsky, María Natalia Nachón, Paola Polo, Adriana Primerano, Guadalupe Vanoli, and María Yuma

Subjects
obesidad, diabetes mellitus, entrevista motivacional, ejercicio físico, índice de masa corporal., Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

The main objective of this recommendation is to establish the best strategies for obesity management in the first medical appointmet. For this, we formulated three “PICO questions” and we have answered based on the analysis of the available scientific evidence. Our main conclusions were: • In the first medical appointment of an adult patient with obesity, the motivational interview is more effective compared to the traditional approach for weight loss since it also allows to reinforce the patient's motivation and stimulate their participation in a behavioral change. • For the obesity diagnosis, the body mass index continues to be a useful and simple detection tool; however, it is imperative to extend the view of obesity and establish the risk of complications in the first appointment, for this both the Edmonton staging system and the ABCD method are useful tools in addition to the body mass index. • Aerobic physical activity is still recommended for its benefit in fat mass loss, mainly visceral, however, when combining anaerobic physical activity, the results are superior to the isolated aerobic strategy.

Published
2022
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4. UPDATE OF BARIATRIC AND METABOLIC SURGERY

Author

Graciela Álvarez, Susana Fuentes, Juliana Mociulsky, Victoria Salinas, María Yuma, Susana Gutt, Marianela Ackerman, Paula Lifszyc, and Frank Espinoza

Subjects
diabetes tipo 2, obesidad mórbida, cirugía bariátrica, cirugía metabólica., Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Obesity increases the risk of developing or worsening many disorders particularly type 2 diabetes, a difficult-to-control chronic disease, treated with different drugs even with insulin, frequently without reaching therapeutic goals neither reducing cardiovascular risk. Therapy becomes more complex when type 2 diabetes is associated with severe obesity. The use of bariatric and metabolic surgery in patients with severe obesity and diabetes is assessed, and the different surgical techniques, assumptions about its mechanism of action, selection of patients and results are also reviewed. Bariatric surgery has proven to be effective in the treatment of severe obesity and type 2 diabetes in patients with BMI >35 kg/m2. This type of surgery has shown to be acceptable and well tolerated in selected and low risk patients capable of treatment Bariatric surgery has sufficient scientific evidence in these patients. However, there is no strong evidence of metabolic surgery in patients with BMI

Published
2020
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5. Situation of obesity and diabetes mellitus in Argentina

Author

Juliana Mociulsky

Subjects
sobrepeso, obesidad, argentina, Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Overweight and obesity are frequent causes, on the rise, of malnutrition in Argentina. The National Survey of Risk Factors (ENFR) reflects that self-reported excess weight (the sum of Overweight and obesity increased continuously throughout the four editions of the survey: 49%, 53.4% , 57.9% and 61.6% (2005, 2009, 2013 and 2018, respectively). This remarkable growth at the expense of obesity increased by almost 75% between 2005 and 2018. The self-reported prevalence of excess weight was higher in males compared to females (68.5% vs. 55.0%). According to anthropometric measurements carried out during the 4th ENFR of 2018, the prevalence of excess weight was even higher than the self-reported (66.1% vs. 61.6%). Lower-income social groups showed higher rates of excess weight at the expense of a higher prevalence of obesity, which was 21% higher in the lowest income quintile compared to the highest. Coinciding with the trend in the region of weight gain in the child and adolescent population, an increase of 10% in overweight is observed in the population under 5 years of age and 3.6% in obesity. The proportion of overweight and obesity in the population aged 5 to 17 years was 20.7% and 20.4%, respectively. Adolescents from a low socioeconomic level are 31% more likely to be overweight compared to adolescents from a higher socioeconomic level, and the population with an educational level "up to incomplete primary" is more obese.

Published
2022
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6. POSTPRANDIAL HYPERINSULINEMIC HYPOGLYCEMIA AFTER BARIATRIC SURGERY

Author

María Graciela Álvarez, Susana Gutt, María Yuma, Paola Polo, Sandra González, Estrella Menéndez, Guadalupe Vanoli, Hugo Montemerlo, Marianela Ackerman, Jimena Coronel, Carla Gauna, Victoria Salinas, Carla Musso, Juliana Mociulsky, and Susana Fuentes

Subjects
hipoglucemia hiperinsulinémica, hipoglucemia postprandial, cirugía bariátrica, bypass gástrico, dumping tardío, Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Associated with the obesity epidemic and the growing number of bariatric surgery procedures being performed worldwide, the incidence of reported complications has increased as well. Among these, the postprandial hyperinsulinemic hypoglycemia (PHH) warrants further attention. This condition is not entirelly understood and is probably underdiagnosed. The PHH is characterized by hypoglycemic symptoms occurring after a meal accompanied by a low plasma glucose value, typically preceded by a high rise in both glucose and insulin concentrations. Patients with PHH have shown increased glucose variability with a rapid increase in glucose absorption into the systemic circulation and an increase in glucose disappearance, with glucose values reaching both the hyperglycemic and hypoglycemic areas. It should be suspected in patients with postprandial adrenergic or neuroglycopenic symptoms after bariatric surgery1. It was considered most commonly associated with Roux-en Y gastric bypass (RYGB), although it was also described after biliopancreatic diversion (BPD), BPD with duodenal switch2, sleeve gastrectomy, and other surgical procedures which compromises the pylorus and the gastric emptying3. It has not been observed after adjustable gastric banding, an intervention that does not alter the gastrointestinal anatomy4-5.

Published
2019
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7. TREATMENT OF NON-ALCOHOLIC FATTY LIVER DISEASE

Author

Susana Gutt, María Álvarez, María Yuma, Marianela Ackermann, María Coronel, Carla Gauna, Sandra González, Paula Lifszyc, Estrella Menéndez, Juliana Mociulsky, Carla Musso, Paola Polo, Victoria Salinas, Guadalupe Vanoli, and Susana Fuentes

Subjects
estatosis, diabetes e hígado graso, hígado graso y farmacoterapia, Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Nonalcoholic fatty liver disease (NAFLD) is a fatty disease of the liver that is not associated with alcohol. Its prevalence increases along with the epidemic of obesity and type 2 diabetes, and the risk of suffering a more aggressive liver disease is greater with the consequent increase in cirrhosis, hepatocellular carcinoma and cardiovascular disease (CVD). The ectopic accumulation of fat is associated with high-fat diets and high energy density, hyperglycemia and insulin resistance that lead to the suppression of hepatic glucose production and decreased glucose uptake by the skeletal muscle which promotes the lipogenesis of novo and generates a vicious circle that favors even more steatosis.

Published
2018
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8. P27 Prevalence of microvascular dysfunction in diabetic patients with normal gated spect

Author

Hugo Daniel Sanabria, María Inés Vera, Santiago Bruzone, Gustavo Javier Daquarti, Juliana Mociulsky, Alejandro Meretta, María Cristina Faingold, and Isaac Sinay

Subjects
disfunción microvascular, diabetes tipo 1 y 2, gated-spectnormal, Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Introduction: Patients with diabetes have an increased risk for cardiovascular events. Microvascular dysfunction is an early sign of damage, associated with poorer prognosis in these patients, including those with normal gated SPECT. Objective: The aim of this study was to assess the prevalence of microvascular dysfunction according to the type of diabetes through quantification of coronary flow reserve (CFR) in patients with normal gated SPECT. Materials and methods: Patients included in the study had diabetes without known history of coronary disease, without perfusión defects in c99-MIBI gated SPECT and preserved ventricular function. CFR was calculated by means of peak/resting coronary flow velocity ratio after dipyridamole with 4DM®-SPECT software with cadmium zinc telluride detectors (CZT-SPECT). CFR < 2 was considered to be microvascular dysfunction, and CFR < 1.6 was regarded as severe dysfunction.

Published
2020
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9. BARIATRIC SURGERY IN WOMEN IN REPRODUCTIVE AGE. RECOMMENDATION FROM 'DIABETES AND PREGNANCY COMMITTEE AND DIABETES AND OBESITY COMMITTEE FROM SOCIEDAD ARGENTINA DE DIABETES

Author

Susana Gutt, Gabriela Rovira, Alicia Jawerbaum, Frank Espinoza, Juliana Mociulsky, Stella Sucani, Verónica Kojdamanian, Marianela Ackerman, Graciela Álvarez, Alejandro Camaño, Liliana Glastein, Paula Lifszyc, Carolina Gómez, Patricio Mendes, Estrella Menéndez, María Yuma, Celina Bertona, Lilia Cafaro, Susana Fuentes, Susana Salzberg, Natalia Basualdo, Sandra González, Beatriz Villarroel, and Carla Musso

Subjects
cirugía bariatrica, obesidad, embarazo, diabetes gestacional., Nutritional diseases. Deficiency diseases, RC620-627, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

The impact of obesity prevalence at early stages of life has been affected women at reproductive ages. Fertility rates, risk pregnancies, low weight at birth and cesarean section have been modified considerably. Bariatric surgery is a validated tool to improved fertility but malabsortion of nutrients as a consequence of surgery could affect mother and fetus nutrition and development. Gestacional diabetes diagnosis turns difficult in this group of obese patients after bariatric surgery. The aim of the recommendation was to offer tools for a good control and follow up of women at reproductive age.

Published
2015
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10. 315-LB: Intervention Program on Lifestyle Changes and Weight Reduction for Workers in Remote Areas, Based on Therapeutic Education and Telemedicine Coordination

Author

Mercedes M. Ganduglia Cazaban, Pablo Ruiz, Pablo C. Zarate, Leila Cura, and Juliana Mociulsky

Subjects
education.field_of_study, medicine.medical_specialty, Telemedicine, business.industry, Endocrinology, Diabetes and Metabolism, Population, Motivational interviewing, Overweight, medicine.disease, Obesity, Weight loss, Family medicine, Health care, Internal Medicine, Medicine, medicine.symptom, business, education, Dyslipidemia
Abstract

Introduction: Overweight and obesity are frequently found risk factors in oil industry workers in Argentinian Patagonia with limited access to health care system. Objective: Implement an intervention program based on lifestyle changes for weight reduction among oil industry workers of Patagonia; coordinated by telemedicine from the City of Buenos Aires and carried out by local nurses. Materials and Methods: Nurses in 10 different oil fields, were trained in motivational interviewing, nutrition and physical activity fundamentals. Employees were invited to a 3 months structured program, including workshops on healthy nutrition habits, and weekly consultations to infirmaries for weight control and brief motivational interviews. Participants received a health notebook for self-record of: food intake, physical activity, weight progress and therapeutic objectives. Coordinators monitored the program through video and teleconferences, plus 3 on-site visits. Results: Of 220 participants, 178 (94% males) were included for data analysis, excluding those with BMI Conclusions: A structured intervention program in remote areas, coordinated by telemedicine can be a successful tool for weight loss and reduction of cardiometabolic risk factors. Disclosure J. Mociulsky: None. P. Ruiz: None. P.C. Zarate: None. L. Cura: None. M.M. Ganduglia Cazaban: Consultant; Self; AstraZeneca. Speaker’s Bureau; Self; Merck & Co., Inc.

Published
2019
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11. P27 Prevalencia de disfunción microvascular en pacientes con diabetes tipo 1 y 2 con GATED-SPECTnormal

Author

Alejandro Meretta, Santiago Bruzone, Isaac Sinay, Gustavo Daquarti, María Inés Vera, María Cristina Faingold, Juliana Mociulsky, and Hugo Sanabria

Subjects
medicine.medical_specialty, Ventricular function, business.industry, Gated SPECT, Coronary flow reserve, medicine.disease, Dipyridamole, Increased risk, Diabetes mellitus, Internal medicine, medicine, Cardiology, General Earth and Planetary Sciences, In patient, business, Perfusion, General Environmental Science, medicine.drug
Abstract

Introducción: los pacientes con diabetes tienen un mayor riesgo de presentar eventos cardiovasculares. La disfunción microvascular es un marcador de daño precoz y su presencia se ha asociado con peor pronóstico en estos pacientes, incluso con pruebas funcionales evocadoras de isquemia, como GATED-SPECT, normales.Objetivos: evaluar la prevalencia de disfunción microvascular de acuerdo a tipo de diabetes a través de la cuantificación de reserva de flujo coronario (RFC) en pacientes con GATED-SPECT normal.Materiales y métodos: se incluyeron pacientes con diabetes tipo 1 (DM1) y tipo 2 (DM2) sin historia de enfermedad coronaria conocida que presentaron un estudio GATED-SPECT Tc99-MIBI con dipiridamol, sin defectos de perfusión y con función ventricular conservada. La RFC se calculó mediante la relación flujo pico post dipiridamol/flujo en reposo con el software 4DM® mediante SPECT con detectores Cadmio Zinc Telurio (CZT-SPECT). Se consideró presencia de disfunción microvascular una RFC

Published
2020
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12. Postprandial hyperinsulinemic hypoglycemia after bariatric surgery

Author

Susana Fuentes, María Yuma, Carla Gauna, Carla Musso, Jimena Coronel, Victoria Salinas, Estrella Menéndez, Hugo Montemerlo, Marianela Ackerman, Sandra Limia González, María Graciela Álvarez, Paola Polo, Juliana Mociulsky, Susana Gutt, and Guadalupe Vanoli

Subjects
medicine.medical_specialty, Sleeve gastrectomy, Hipoglucemia hiperinsulinémica, Gastric emptying, business.industry, medicine.medical_treatment, Insulin, Bypass gástrico, Dumping tardío, Pylorus, medicine.disease_cause, Gastroenterology, Duodenal switch, medicine.anatomical_structure, Postprandial, Internal medicine, medicine, General Earth and Planetary Sciences, Hyperinsulinemic hypoglycemia, business, Biliopancreatic Diversion, General Environmental Science, Hipoglucemia postprandial, Cirugía bariátrica
Abstract

Fil: Álvarez, María Graciela. Centro de Estudio y Tratamiento de la Obesidad Severa; Argentina. Fil: Gutt, Susana. Hospital Italiano de Buenos Aires; Argentina. Fil: Yuma, María. Hospital Italiano de Buenos Aires; Argentina. Fil: Polo, Paola. Sanatorio Las Lomas. Servicio de Endocrinología; Argentina. Fil: González, Sandra. Clínica IMA. Consultorio de Diabetes; Argentina. Fil: Menéndez, Estrella. CEMIC. Instituto Universitario; Argentina. Fil: Vanoli, Guadalupe. Hospital General de Agudos José María Ramos Mejía; Argentina. Fil: Montemerlo, Hugo. Sanatorio Mater Dei; Argentina. Fil: Ackerman, Marianela. Universidad Nacional del Nordeste. Facultad de Medicina; Argentina. Fil: Coronel, Jimena. Centro Médico Maffei; Argentina. Fil: Gauna, Carla. Novo Nordisk. Medical Scientific Liason Diabetes y Obesidad; Argentina. Fil: Salinas, Victoria. CEMIC. Departamento de Clínica Médica y Nutrición; Argentina. Fil: Musso, Carla. PAMI. Unidad Asistencial César Milstein; Argentina. Fil: Mociulsky, Juliana. Instituto Cardiovascular Buenos Aires. Unidad de Nutrición; Argentina. Fil: Fuentes, Susana. Hospital El Cruce S.A.M.I.C; Argentina. La incidencia de complicaciones informadas luego de la cirugía bariátrica (CB) ha ido en aumento en relación con la epidemia de obesidad y el mayor número de procedimientos quirúrgicos realizados a nivel mundial. Entre las complicaciones, la hipoglucemia hiperinsulinémica postprandial (HHP) adquirió relevancia, aunque es una de las menos conocidas y comprendidas de la cirugía bariátrica (CB), frecuentemente inadvertida y por lo tanto subdiagnosticada. Se distingue de la hipoglucemia de ayuno en que su presentación es típicamente posterior a la ingesta, asociada a valores de hipoglucemia precedidos por hiperglucemia e hiperinsulinemia en sangre. Se caracteriza por el incremento de la variabilidad de la glucemia, con absorción acelerada, aumento y caída rápida de azúcar en sangre, por lo que comprende valores de hiper e hipoglucemia. Debe sospecharse cuando se detectan síntomas adrenérgicos o de neuroglucopenia postprandiales luego de la CB. Ha sido considerada más frecuente luego del bypass gástrico en-Y-Roux (BGYR), pero también fue descripta asociada a otras técnicas quirúrgicas, como la derivación biliopancreática/switch duodenal (DBP/SD) y la gastrectomía vertical en manga (GVM), y de otras intervenciones que comprometen el píloro o el vaciamiento gástrico. No se observó luego de la cirugía con banda gástrica ajustable, un procedimiento que no altera la anatomía gastrointestinal. Associated with the obesity epidemic and the growing num ber of bariatric surgery procedures being performed worldwi de, the incidence of reported complications has increased as well. Among these, the postprandial hyperinsulinemic hypo glycemia (PHH) warrants further attention. This condition is not entirelly understood and is probably underdiagnosed. The PHH is characterized by hypoglycemic symptoms occurring after a meal accompanied by a low plasma glucose value, typically preceded by a high rise in both glucose and insulin concen trations. Patients with PHH have shown increased glucose variability with a rapid increase in glucose absorption into the systemic circulation and an increase in glucose disappearan ce, with glucose values reaching both the hyperglycemic and hypoglycemic areas. It should be suspected in patients with postprandial adrenergic or neuroglycopenic symptoms after bariatric surgery. It was considered most commonly associated with Roux-en Y gastric bypass (RYGB), although it was also described after biliopancreatic diversion (BPD) with duodenal switch and slee ve gastrectomy, and other surgical procedures which compro mises the pylorus and the gastric emptying. It has not been observed after adjustable gastric banding, an intervention that does not alter the gastrointestinal anatomy.

Published
2019

13. Cirugía bariátrica en mujeres en edad fértil: recomendaciones de los Comités de Trabajo de 'Diabetes y Embarazo' y 'Diabetes y Obesidad' de la Sociedad Argentina de Diabetes

Author

Susana Salzberg, Beatriz Villarroel Parra, Verónica Kojdamanian, Estrella Menéndez, Frank Espinoza, Juliana Mociulsky, Alicia Jawerbaum, María Graciela Álvarez, Celina Bertona, Patricio Mendes, Paula Lifszyc, Carla Musso, Liliana Glatstein, Sandra González, Susana Fuentes, Natalia Basualdo, Gabriela Rovira, Carolina Gómez Martín, Alejandro Camaño, María Yuma, Stella Sucani, Susana Gutt, Marianela Aguirre Ackermann, and Lilia Cafaro

Subjects
medicine.medical_specialty, Nutrición, Dietética, CIENCIAS MÉDICAS Y DE LA SALUD, media_common.quotation_subject, Total fertility rate, Ciencias de la Salud, Fertility, Good control, Reproductive age, purl.org/becyt/ford/3.3 [https], CIRUGÍA BARIÁTRICA, Cirugia bariatrica, Medicine, General Environmental Science, media_common, Gynecology, Fetus nutrition, business.industry, Diabetes diagnosis, EMBARAZO, medicine.disease, Obesity, OBESIDAD, DIABETES GESTACIONAL, General Earth and Planetary Sciences, purl.org/becyt/ford/3 [https], business
Abstract

El incremento de la obesidad en el mundo, a edades más tempranas, ha tenido un impacto negativo especialmente en las mujeres en edad reproductiva. Se ven afectadas tanto la fertilidad como la tasa de embarazos de riesgo, de niños con bajo peso al nacer, pretérmino e índice de cesáreas. La cirugía bariátrica como alternativa de tratamiento de la obesidad ha mejorado la fertilidad, pero el trastorno malabsortivo que provoca modifica la absorción de nutrientes en la madre y en el feto. El diagnóstico de diabetes gestacional se dificulta dado que la prueba de tolerancia oral a la glucosa estaría contraindicada en estos casos. El objetivo de estas recomendaciones es proveer herramientas para el control y seguimiento de mujeres en edad reproductiva sometidas a cirugía bariátrica. Worldwide increased obesity prevalence at early ages particularly affects women of reproductive ages. Both fertility and risk pregnancy rates are affected, of low birth weight infants, prematures and cesarean section rates have been modified considerably. Bariatric surgery is a validated tool to improve fertility but nutrient malabsorption as a consequence of surgery could affect mother and fetus nutrition and development. Gestational diabetes diagnosis turns difficult in this group of obese patients after bariatric surgery since oral glucose tolerance testing would be contraindicated in these cases. The aim of these recommendations was to offer tools for a good control and follow up of women at reproductive age. Fil: Gutt, Susana. Hospital Italiano de Buenos Aires; Argentina Fil: Rovira, Gabriela. Universidad de Buenos Aires. Facultad de Medicina. Sede Hospital Britanico Bs.as; Argentina Fil: Jawerbaum, Alicia Sandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos; Argentina. Universidad de Buenos Aires. Facultad de Medicina; Argentina Fil: Espinoza, Frank. Instituto Cardiovascular Lezica; Argentina Fil: Mociulsky, Juliana. Clínica de Nutrición y Salud Dr. Cormillot; Argentina Fil: Sucani, Stella. Provincia de Misiones. Hospital Escuela de Agudos Dr. Ramon Madariaga; Argentina Fil: Kojdamanian, Verónica. Centro de Educación, Prevención y Asistencia al paciente diabético; Argentina Fil: Aguirre Ackermann, Marianela. Centro Integral de Endocrinología y Nutrición; Argentina Fil: Álvarez, María Graciela. Centro de Estudio y Tratamiento de la Obesidad Severa; Argentina Fil: Camaño, Alejandro. Centro Médico de Especialidades y Diagnósticos Privado para la Salud; Argentina Fil: Glatstein, Liliana. Centro Médico San Andrés; Argentina Fil: Lifszyc, Paula. Hospital Carlos G. Durand; Argentina Fil: Gómez Martin, Carolina. Centro Integral de Endocrinología y Diabetes; Argentina Fil: Mendes, Patricio. Maternidad San Lucas; Argentina Fil: Menéndez, Estrella. Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno; Argentina Fil: Yuma, María. Hospital Italiano de Buenos Aires; Argentina Fil: Bertona, Celina. Universidad Nacional de Cuyo; Argentina Fil: Cafaro, Lilia. Obesidad y Cirugía Mini Invasiva; Argentina Fil: Fuentes, Susana. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad En Red El Cruce Dr. Nestor Carlos Kirchner Samic; Argentina Fil: Salzberg, Susana. Instituto Centenario; Argentina Fil: Basualdo, Natalia. Hospital Materno Infantil Ramón Sardá; Argentina Fil: González, Sandra . Cínica IMA; Argentina Fil: Villarroel Parra, Beatriz. Hospital de Agudos Dalmacio Vélez Sarsfield; Argentina. Sanatorio Santa Isabel; Argentina Fil: Musso, Carla. Fundacion Favaloro; Argentina

Published
2015

14. Diabetes and Quality of Life: Initial Approach to Depression, Physical Activity, and Sexual Dysfunction

Author

Liliana Lemme, Andrea Peloche, Adrian Sapetti, Juliana Mociulsky, Javier M Farias, Alberto Cafferata, Esteban T Martinez, Guido Senatore, Patricia Gonzalez, M Gabriela Sanzana, and M Josefina Pozzo

Subjects
medicine.medical_specialty, 030209 endocrinology & metabolism, Disease, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Risk Factors, Diabetes mellitus, medicine, Diabetes Mellitus, Humans, Pharmacology (medical), 030212 general & internal medicine, Sexual Dysfunctions, Psychological, Intensive care medicine, Psychiatry, Exercise, Depression (differential diagnoses), Pharmacology, business.industry, Depression, General Medicine, medicine.disease, Mood, Sexual dysfunction, Erectile dysfunction, Mood disorders, Quality of Life, medicine.symptom, business
Abstract

The different aspects that contribute to quality of life in patients with diabetes mellitus, such as mood, are of great importance for the treatment of this disease. These aspects not only influence the well-being of patients but also influence treatment adherence, therefore affecting the course of the disease. A panel of experts from Argentina, Chile, and Uruguay performed a review of the main aspects affecting quality of life in patients with diabetes: physical activity, mood disorders, and sexual activity. The consensus of the panel was that physical activity is important in the treatment of patients with diabetes because it reduces morbidity, mortality, and disease complications, and it should be performed on a regular basis, bearing in mind the patient's characteristics. Increased physical activity is associated with better glycemic control, and in individuals with glucose intolerance, it delays progression toward diabetes. In patients with diabetes, there is a high prevalence of depression, which can influence treatment adherence. Therefore, early detection of depression is essential to improve the course of diabetes. Regarding sexual activity, erectile dysfunction may be a significant sign in the case of suspected diabetes and the early diagnosis of vasculopathy in patients with diabetes. In conclusion, greater emphasis should be placed on improving patient knowledge, early detection, and multidisciplinary approaches to deal with the aspects of diabetes that affect patients' quality of life.

Published
2014

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