O adequado manejo do DM Tipo 1 tem se tornado um desafio, principalmente para as próprias crianças, em virtude da presença de comportamentos, habilidades e conhecimentos inadequados que colaboram para a não adesão ao tratamento e para aumento de complicações em longo prazo. Estudos têm demonstrado que compreender as experiências de vida das crianças nos seus diversos espaços, valorizando-as e buscando maior aproximação com as mesmas, pode contribuir para a partilha do conhecimento sobre o manejo do diabetes e para o maior envolvimento da criança no cuidado. O objetivo deste trabalho foi compreender, na perspectiva de crianças com DM Tipo 1, os fatores que interferem no manejo da doença. Trata-se de uma pesquisa qualitativa, de natureza exploratória. Participaram do estudo 19 crianças. Utilizamos a entrevista semiestruturada e, como recurso facilitador da comunicação com a criança, os fantoches. Esses brinquedos foram confeccionados pelas próprias crianças e criou-se, também, um cenário que ilustrou e complementou a utilização dos fantoches no dia da entrevista. A análise dos dados empíricos foi feita por meio da análise de conteúdo. Os resultados evidenciaram a compreensão do que é ser criança com diabetes e dos fatores relacionados à sua existência, como seus sentimentos e percepções. A compreensão da interação da criança com os conhecimentos que possui sobre a sua doença, sua inserção no processo do autocuidado, as habilidades desenvolvidas e os recursos disponíveis para lidar com as demandas da doença constituem fatores que interferem de forma positiva ou negativa no manejo da doença e merecem ser foco de atenção dos profissionais de saúde. Todos esses elementos atuam dinamicamente nos espaços do cotidiano da criança, tais como o familiar, o escolar, o de amizades, o de lazer e o dos serviços de saúde, atuando como fatores que fragilizam ou potencializam o manejo da doença. O apoio de familiares, amigos, professores e profissionais de saúde que compartilham as experiências de ser uma criança com diabetes mostrou-se essencial para o alcance do adequado manejo. Além disso, o conhecimento adquirido por estes atores e pela própria criança interfere diretamente no manejo do DM Tipo 1. Os resultados deste estudo evidenciam ações que visam a fortalecer o trabalho da equipe multidisciplinar no cuidado da criança com diabetes e apontam cenários de atuação que podem ser incrementados pelos profissionais de saúde. O enfermeiro ocupa posição privilegiada para identificar e operacionalizar ações apropriadas ao estágio de desenvolvimento da criança e às suas necessidades, em todos os espaços em que vive, atuando, assim, em consonância com todos os envolvidos em prol do sucesso do manejo da doença. / The adequate handling of Type 1 DM has become a challenge, mainly for the children themselves, due to the presence of inadequate behaviors, skills and knowledge that contribute to non-adherence to treatment and increased complications in the long term. Research has demonstrated that understanding children\'s life experiences in their different spaces, valuing them and seeking greater approximation, can contribute to knowledge sharing on diabetes management and to the children\'s greater involvement in care. This research aimed to understand, from the perspective of children with Type 1 DM, the factors that interfere in the management of this disease. This is a qualitative and exploratory research. Study participants were 19 children. Semi-structured interviews were used and, to facilitate communication with the child, puppets, which the children made themselves. A scenario was also created to illustrate and complement the use of puppets on the day of the interview. Content analysis was used for empirical data analysis. Results evidenced the understanding of what it means to be a child with diabetes and the factors related to his/her existence, such as feelings and perceptions. Understanding of these children\'s interaction with their knowledge about their disease, their insertion in the self-care process, developed skills and resources available to deal with the demands of the disease constitute factors that interfere positively or negatively in disease management and deserve further attention from health professionals. All of these elements act dynamically in the child\'s daily spaces, such as the family, school, friendships, leisure and health services, as factors that weaken or strengthen disease management. Support from relatives, friends, teachers and health professionals who share the experiences of being a child with diabetes showed to be essential to achieve adequate management. Moreover, the knowledge these actors and the children themselves acquire interferes directly in Type 1 DM management. These study results evidence actions aimed at strengthening the work of the multidisciplinary team in care delivery to children with diabetes and indicate activity scenarios which health professionals can build upon. Nurses play a privileged role to identify and put in practice actions that are appropriate for the children\'s development stage and needs, in all spaces they live in. Thus, they act in line with all parties involved with a view to successful disease management.

O diabetes é considerado uma das doenças crônicas mais prevalentes na atualidade. Para seu tratamento, é necessário que a pessoa incorpore no seu cotidiano dieta, atividade física, automonitorização da glicose sanguínea e, com o passar do tempo, uso de medicamento. Desta forma, é importante o envolvimento da família nesse processo, incentivando a pessoa a aderir aos cuidados necessários. O presente estudo, de natureza descritiva, foi desenvolvido na cidade de Passos-MG, com pessoas matriculadas no Programa de Assistência ao Diabético, com objetivo de analisar a influência do apoio social familiar no cuidado de pessoas com diabetes tipo 2. Os dados foram coletados no período entre 1 de setembro a 30 de dezembro de 2004, de 51 pessoas por meio de entrevista individual, utilizando-se a Técnica do Incidente Crítico para obtenção dos relatos positivos e negativos de eventos que envolveram os familiares, que pudessem estar influenciando no cuidado. Foram utilizados dois instrumentos, sendo o primeiro para a caracterização das pessoas participantes e o segundo para a coleta dos incidentes críticos propriamente ditos. Após análise dos relatos, foram definidas quatro categorias principais: alterações na família/amigos, alterações decorrentes da doença, práticas terapêuticas e alterações salariais/poder aquisitivo. Os relatos positivos se referiram ao apoio da família no cuidado diário, adesão a hábitos saudáveis, confraternizações com familiares/amigos, participação em grupos, entre outros. Os relatos negativos se referiram à falta de apoio da família, discussões e preocupação com familiares, depressão, sentimento de medo e isolamento, desemprego, dentre outros. Viver com diabetes significa ajustar-se a uma complexa reciprocidade entre as relações familiares, emoções, hábitos e controle da glicemia, enfim, mudanças às vezes consideradas drásticas tanto no estilo de vida pessoal quanto familiar. É imprescindível o envolvimento dos profissionais, pessoas com diabetes mellitus e familiares no cuidado. Uma estratégia utilizada é o incentivo à participação em grupos de diabéticos, envolvendo os familiares, o que poderá contribuir para a adesão aos cuidados, visando a prevenção de complicações agudas e crônicas. / Nowadays, diabetes is considered to be one of the most prevailing chronic diseases. Its treatment requires patients to incorporate a diet, physical exercise, selfmonitoring of blood glucose and, over time, use of medication, into their daily reality. This makes it very important to involve families into this process, encouraging patients to adhere to the necessary care. The current study, of descriptive nature, was developed in Passos-MG, Brazil, involving a group of people who were registered in the Diabetic Assistance Program, having as its main objective to analyze the influence of the family’s social support for type 2 diabetes patients. Data were collected from September 1st to December 30th 2004, from 51 participants by means of individual interviews. In this process, the Critical Incident Technique was used in order to obtain positive and negative reports about events involving family members who might have particular aspects of influence on the patient’s care. Two mechanisms were used: the first one for providing the depiction of the participant individuals, and the second one for collecting the critical incidents themselves. After analyzing the reports, four main categories were defined: changes in the family/friends, changes resulting from the disease, treatment procedures and salary/purchasing power changes. The positive reports were related to families’ support in daily care, adherence to healthy habits, gatherings with family members/friends, group participation, among others. Negative reports referred to the lack of family support, argumentation and worries about family members, depression, feelings of fear and isolation, unemployment, among others. Living with diabetes means adapting to a complex reciprocity among family relationships, emotions, habits and glucose control, in short, changes that are sometimes considered as drastic, both in the patient’s and the family’s lifestyle. Therefore, the existence of total commitment and involvement of the related professionals, diabetes mellitus patients and their family members in the process of care becomes essential. One strategy that is used is to encourage the patient on participating in diabetes groups, involving the family members, which can contribute to the adherence to necessary care actions, leading to prevention of acute and chronic complications.

Introdução: A propagação de conhecimentos essenciais nos cuidados necessários aos indivíduos com diabetes mellitus pode influenciá-los nas suas capacidades para desenvolver o autocuidado, primordiais à manutenção da qualidade de vida. Vídeos, valorizados por transportarem o cotidiano para o momento do aprendizado, na \"internet\" podem ser facilmente acessados pelo \"YouTube\". Porém não foram realizados estudos nacionais que explorem seu potencial e auxiliem na compreensão sobre o uso deste recurso no Brasil. Objetivo: Analisar o uso da \"internet\" como novo canal de comunicação para disseminação de conteúdo educativo de interesse de políticas públicas focadas no cuidado de indivíduos com diabetes mellitus tipo 1 e 2. Métodos: Vinte (20) vídeos foram produzidos, de acordo com planejamento educativo que buscou a maior eficácia no processo comunicativo. Foram realizadas exibições seguidas de entrevistas com o público de interesse para verificar a compreensão dos indivíduos acerca dos vídeos. Os mesmos foram divulgados no \"YouTube\", onde foi possível resgatar os dados dos internautas, como sexo e idade, número de acessos e tempo de visualização dos vídeos. Resultados: Todos os vídeos foram compreendidos satisfatoriamente pelos indivíduos entrevistados e na \"internet\" receberam 3.174 visualizações por ambos os sexos, de todas as faixas etárias, destacando-se o maior aproveitamento do conteúdo por mulheres idosas. Conclusão: A \"internet\" mostrou-se importante meio para a divulgação dos conhecimentos sobre os cuidados em diabetes mellitus no Brasil, visto que a população já utiliza este meio para buscar informações de saúde. Os vídeos podem ser utilizados como eficaz canal de disseminação de conteúdos educativos de interesse das Políticas de Saúde Pública. / Introduction: The dissemination of essential knowledge in the care of individuals with Diabetes Mellitus may influence their ability to develop self-care, which is essential to maintaining quality of life. Videos, valued for carrying \"everyday\" to the moment of learning, on the internet can be easily accessed by \"YouTube\". However, no Brazilian studies have been conducted that explore its potential and help in understanding the use of this resource in Brazil. Objective: Analyze the use of the internet as a new communication channel for the dissemination of educational content of interest to public policies focused on the care of Diabetes Mellitus type 1 and 2. Methods: Twenty (20) videos were produced according to educational planning which sought the greatest effectiveness in the communicative process. Exhibitions were followed by interviews with the audience of interest to verify the individuals\' understanding of the videos. The videos were released on YouTube, where it was possible to retrieve Internet users\' access data, such as gender and age, number of views and retention of videos. Results: All the videos presented a good understanding of the individuals interviewed and on the internet received 3,174 views by both genders, of all age groups, highlighting the greater use of content by older women. Conclusion: The internet has proven to be an important means of disseminating knowledge about diabetes care in Brazil, since the population already uses this medium to seek health information. The videos can be used as an effective channel for the dissemination of educational content of interest to Public Health Policies.

Orientador: James Venturini / Resumo: Dermatofitoses são infecções fúngicas causadas por fungos dermatofíticos que geralmente afetam a camada córnea da pele, cabelos e unhas, mas sob certas condições podem apresentar envolvimento invasivo. A espécie Trichophyton rubrum é o dermatófito mais frequentemente isolado em espécimes clínicos. Além disso, pacientes com diabetes mellitus tipo II (DM-II) são mais suscetíveis a esta infecção fúngica e a relação dermatófito-hospedeiro é pouco compreendida. Contudo, o perfil pró-inflamatório observado em pacientes com hiperglicemia é uma condição complicadora nessa relação. Os receptores de reconhecimento padrão (PRRs) presentes nos fagócitos, como os receptores de manose (MR), dectina-1, toll-like (TLR) -2 e -4, reconhecem estruturas fúngicas e são responsáveis por desencadear mecanismos de ativação e regulação celular durante o processo inflamatório. Assim, o presente estudo tem como objetivo determinar o papel desses receptores na ativação de monócitos de pacientes com DM-II e dermatofitoses por T. rubrum. Exoantígenos de T. rubrum foram obtidos de pacientes com diabetes e indivíduos normoglicêmicos. Os PRRs foram bloqueados em monócitos e monócitos THP-1 de pacientes com DM-II e indivíduos normoglicêmicos desafiados com Exo_Tr_NG e Exo_Tr_DM. Posteriormente, o TNF e MIP-1α e IL-1β foram dosados. A expressão desses receptores foi avaliada por citometria de fluxo. Nenhuma diferença estatística foi observada no ensaio de inibição de monócitos de pacientes diabéticos e indivíd... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Dermatophytoses are fungal infections caused by dermatophytic fungi that usually affect the cornea layer of the skin, hair and nails, but under certain conditions may present invasive involvement. The species Trichophyton rubrum is the dermatophyte most often isolated in clinical specimens. In addition patients with type II diabetes mellitus (DM-II) are more susceptible to this fungal infection. The dermatophyte-host relationship is poorly understood; However, the pro-inflammatory profile observed in patients with hyperglycemia is a complicating condition in this relationship. The pattern recognition receptors (PRRs) present in phagocytes, such as the mannose (MR), dectin-1, toll-like (TLR) -2 and -4 receptor, recognize fungal structures and are responsible for triggering mechanisms of cellular activation and regulation during the inflammatory process, as well as influence on the polarization of the adaptive immune response. Thus, any interference in this process may impair the host to effectively and pathogenically eliminate pathogens. Thus, the present study aims to determine the role of these receptors in the activation of monocytes of patients with DM-II. Exoantigens of T. rubrum were obtained from patients with diabetes and normoglycemic individuals. PRRs were blocked in THP-1 monocytes and monocytes from DM-II patients and normoglycemic individuals challenged with Exo_Tr_NG and Exo_Tr_DM. Subsequently, TNF and MIP-1α and IL-1β were dosed. The expression of these recepto... (Complete abstract click electronic access below) / Mestre

O diabetes mellitus tipo 2 está intimamente ligado a formação de espécies reativas de oxigênio, as quais aumentam os produtos de glicação avançada e consequentemente a inflamação e o desenvolvimento das complicações associadas a doença. Nesse contexto, destaca-se o papel do microbioma intestinal, visto que esta pode ser capaz de modificar fatores ligados ao sistema imune e sua modulação pode ser uma boa alternativa para melhora do quadro inflamatório e complicações da doença. A castanha-do-brasil, fonte de selênio, além de outros nutrientes, poderia atuar no sistema de defesa antioxidante e anti-inflamatório, além de influenciar a microbiota intestinal, resultando benefícios aos pacientes. Portanto, este estudo teve como objetivo avaliar estes efeitos da suplementação de indivíduos com diabetes mellitus tipo 2, com uma nóz de castanha-do-brasil (Bertholletia excelsa H.B.K.) por dia, durante 60 dias. Para tanto, foi delineado um ensaio clínico, longitudinal, com 29 pacientes voluntários com diabetes mellitus tipo 2, atendidos no Ambulatório de Endocrinologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Os participantes foram avaliados antes e após a intervenção, e realizaram uma coleta de fezes (caracterização da microbiota intestinal e concentração de selênio) e uma coleta de sangue (análises de status de selênio, marcadores inflamatórios, glicêmicos e lipídicos, e da permeabilidade intestinal), a avaliação da ingestão alimentar foi por meio de Registro Alimentar de 3 dias Inicialmente, determinou-se a composição centesimal e a concentração de selênio da castanha-do-brasil utilizada. A análise bioinformática foi conduzida usando o Quantitative Insight into Microbial Ecology (QIIME, versão 1.9.0). A análise estatística foi realizada com os softwares Statistical Package for the Social Sciences, versão 23.0, e R versão 1.1.463. A concentração de selênio na castanha in natura foi de 79,8&#181;g/g. A idade média dos participantes foi 54,9±3,6 anos. A ingestão de castanha-do-brasil foi capaz de melhorar significativamente os parâmetros: concentrações de selênio no plasma (&#916; 95,82, p<0,001), nos eritrócitos (&#916; 163,16, p<0,001) e nas fezes (&#916; 166,31 p<0,001), assim como na selenoproteína P (&#916; 5,36 p<0,026) e atividade da enzima glutationa peroxidase (&#916; 30,61 p<0,040) e redução da hemoglobina glicada (&#916; -0,8, p=0,001). No entanto, não houve alteração do perfil lipídico, inflamatório, ingestão alimentar e marcadores antropométricos. Apesar de não verificarmos mudança na composição global da microbiota intestinal, a diversidade interpessoal (&#946; diversidade) variou conforme a concentração de selenoproteína P (p=0,03) e porcentagem de hemoglobina glicada (p=0,04). A suplementação com castanha-do-brasil melhorou o perfil glicêmico e o status de selênio. Apesar de não ser observada influência na composição global da microbiota, a segregação observada indica certa resistência da microbiota frente a intervenção com a castanha. / Type 2 diabetes mellitus is closely linked to the formation of reactive oxygen species, such as those that increase advanced glycation products (AGEs) and, consequently, inflammation and the development of complications associated with this disease. In this context, the study of the intestinal microbiome is of extreme importance, since it may be able to alter the factors related to the immune system and its modulation may be a good alternative for the improvement of the clinical and inflammatory status. Brazil nut is rich in selenium, in addition to other nutrients, which could act in the anti-inflammatory and antioxidant defense system and influence intestinal microbiota composition. Therefore, this study had the objective of determining the supplementation with type 2 diabetes mellitus. This longitudinal clinical trial was designed with 29 patients with type 2 diabetes mellitus, attended at the Endocrinology Outpatient Clinic of the Hospital das Clínicas, Faculdade de Medicina of the University of São Paulo. The intervention with Brazil nuts lasted 60 days and the participants were evaluated before and after by a collection of feces (intestinal microbiota characterization and selenium concentration) and blood collection (analyzes of selenium status, inflammatory markers, glycemic and lipid levels, and intestinal permeability), and dietary intake by means of a 3-day Food Registry. Initially, the centesimal composition and the selenium concentration of the nut were determined used. Bioinformatic analysis was conducted using the Quantitative Insight into Microbial Ecology (QIIME, version 1.9.0). Statistical analysis was performed with the software Statistical Package for the Social Sciences, version 23.0, and R version 1.1.463. The concentration of selenium in the nut in natura was 79.8 &#181;g / g. The mean age of the participants was 54.9 ± 3.6 years, the mean time of diagnosis of the disease was 11.7 ± 6.9 years. The Brazil nut intake was able to significantly improve the parameters: plasma selenium concentrations (&#916; 95,82, p<0,001), nem da circunferência da cintura (&#916;-1 p=0,217) and GPX (&#916;30.61 p <0.040) and reduction in HbA1c (&#916; -0.8, p = 0.001). However, there were no changes in the lipid profile, inflammation, food intake and anthropometric markers. Although we did not verify a change in the global composition of the intestinal microbiota, the interpersonal diversity (&#946; diversity) varied according to the concentration of SELENOP (p = 0.03) and HbA1c percentage (p = 0.04). We conclude that brazil nut supplementation improved the glycemic profile and the status of selenium. Although no influence was observed on the overall composition of the microbiota, the observed segregation indicates some resistance of the microbiota to the intervention with the chestnut.

<p><strong>Syfte: </strong>Syftet<strong> </strong>var att beskriva hur personer med diabetes mellitus typ två upplever socialt stöd. <strong>Bakgrund:</strong> Forskning har visat att socialt stöd är betydelsefullt för personer med diabetes mellitus typ två. Personerna behöver ofta genomföra livsstilsförändringar som kan påverka den sociala miljön och vardagen. Socialt stöd är centralt för personens förmåga till livsstilsförändringar och en god egenvård. För att hjälpa personen att förbättra egenvården kan sjuksköterskan arbeta för att förbättra det sociala stödet för personen med diabetes mellitus typ två. <strong>Metod: </strong>Studien utformades som en allmän litteraturstudie med ett systematiskt arbetssätt. Resultatet utgjordes av vetenskapliga artiklar baserade på kvalitativa empiriska studier. Under analysen togs meningsenheter ut och sammanfogades till kategorier <strong>Resultat: </strong>Genom analysen utarbetades åtta kategorier: att ha någon att tala med, att uppleva förståelse, att bli accepterad, att få information och råd, att få uppmuntran, att få utvärderande kommentarer, att få assistans och att förändras tillsammans. <strong>Slutsats: </strong>För att hjälpa personen att genomföra bestående livsstilsförändringar kan sjuksköterskan inkludera omgivningen och diskutera frågor angående det sociala stödet. För att kunna hjälpa personen att hantera det sociala stödet kan sjuksköterskan uppmärksamma att socialt stöd kan upplevas både som positivt och negativ och hjälpa personen att utvärdera sina sociala influenser.</p> / <p><strong>Aim: </strong>The aim was to describe social support as experienced by people with diabetes mellitus type two. <strong>Background:</strong> Research has shown that social support is significant for persons with diabetes mellitus type two. The person often has to make life-style changes that can affect the social environment and daily life. Social support is central to the person’s ability of making life-style changes and to self-management. To help the person improve self-management nurses should try to improve the social support for the person<strong>. Methods: </strong>The study was designed as a literature review with a systematic work procedure. The findings were based on qualitative empirical studies, published in peer reviewed periodicals. Meaning units were identified and arranged into categories. <strong>Findings: </strong>Through the analysis eight categories were discovered: having someone to talk to, experiencing understanding, experiencing acceptance, receiving information and advice, receiving encouragement, receiving appraising comments, receiving assistance and changing together. <strong>Conclusions: </strong>To help the person make lasting life-style changes, nurses can include the social environment and discuss matters of social support. To help the person manage their social support, nurses can inform that social support can be experienced as positive as well as negative and help the person evaluate their social influences.</p>

Syftet med denna litteraturstudie var att beskriva hur föräldrar till barn med diabetes mellitus typ 1 upplever och hanterar sin vardag samt hur de upplever stöd och information från sjukvården. Den design som användes var beskrivande litteraturstudie. De databaser som användes var Cinahl och PubMed och resultatet formades från 15 vetenskapliga artiklar. Det resultat som framkom var att i samband med barnets insjuknande upplevde föräldrar bland annat kaos, ångest, sorg och chock. Föräldrarna fick ta ett stort ansvar över sjukdomen och de använde olika copingstrategier för att kunna hantera detta. Oron för att barnet skulle drabbas av hypoglykemi var stor hos många föräldrar och många var också oroliga över att låta barnet ta ansvar över sin sjukdom. Att kunna få stöd från sjukvården tyckte många föräldrar var viktigt, de sökte också information på andra sätt exempelvis genom föräldragrupper. De 15 vetenskapliga artiklarna kvalitetgranskades, analyserades och sammanställdes. Den slutsats som framkom var att livet förändrades på många olika sätt efter att barnet fått sin diagnos. Detta krävde stort engagemang från föräldrarna då hela familjens liv påverkades. / The purpose of this study was to describe how parents of children with type 1 diabetes mellitus experienced and coped with their everyday lives and how they experienced support and information from health care. The used design was descriptive literature study. The databases used were Cinahl and PubMed and the result was formed from 15 scientific articles. The results that emerged were that in connection with the child got sick the parents experienced including chaos, anxiety, grief and shock. The parents had to take a major responsibility of the disease and used different coping strategies to deal with it. Concern that the child would suffer from hypoglycemia was high among many parents and many were also concerned about letting the child take responsibility over their illness. Many parents found it important to be eligible support from health care professionals, they also examined the information in other ways such as parent groups. The 15 scientific articles quality were examined analyzed and summarized. The conclusion that emerged was that life changed in many different ways after the child received his diagnosis. This required considerable commitment from the parents when the entire family´s lifes were affected.

Syfte: Syftet var att beskriva hur personer med diabetes mellitus typ två upplever socialt stöd. Bakgrund: Forskning har visat att socialt stöd är betydelsefullt för personer med diabetes mellitus typ två. Personerna behöver ofta genomföra livsstilsförändringar som kan påverka den sociala miljön och vardagen. Socialt stöd är centralt för personens förmåga till livsstilsförändringar och en god egenvård. För att hjälpa personen att förbättra egenvården kan sjuksköterskan arbeta för att förbättra det sociala stödet för personen med diabetes mellitus typ två. Metod: Studien utformades som en allmän litteraturstudie med ett systematiskt arbetssätt. Resultatet utgjordes av vetenskapliga artiklar baserade på kvalitativa empiriska studier. Under analysen togs meningsenheter ut och sammanfogades till kategorier Resultat: Genom analysen utarbetades åtta kategorier: att ha någon att tala med, att uppleva förståelse, att bli accepterad, att få information och råd, att få uppmuntran, att få utvärderande kommentarer, att få assistans och att förändras tillsammans. Slutsats: För att hjälpa personen att genomföra bestående livsstilsförändringar kan sjuksköterskan inkludera omgivningen och diskutera frågor angående det sociala stödet. För att kunna hjälpa personen att hantera det sociala stödet kan sjuksköterskan uppmärksamma att socialt stöd kan upplevas både som positivt och negativ och hjälpa personen att utvärdera sina sociala influenser. / Aim: The aim was to describe social support as experienced by people with diabetes mellitus type two. Background: Research has shown that social support is significant for persons with diabetes mellitus type two. The person often has to make life-style changes that can affect the social environment and daily life. Social support is central to the person’s ability of making life-style changes and to self-management. To help the person improve self-management nurses should try to improve the social support for the person. Methods: The study was designed as a literature review with a systematic work procedure. The findings were based on qualitative empirical studies, published in peer reviewed periodicals. Meaning units were identified and arranged into categories. Findings: Through the analysis eight categories were discovered: having someone to talk to, experiencing understanding, experiencing acceptance, receiving information and advice, receiving encouragement, receiving appraising comments, receiving assistance and changing together. Conclusions: To help the person make lasting life-style changes, nurses can include the social environment and discuss matters of social support. To help the person manage their social support, nurses can inform that social support can be experienced as positive as well as negative and help the person evaluate their social influences.

Background: Adiponectin circulates in the blood in three different multimer isoforms, of which the high molecular weight form (HMW) is presumed to mediate insulin sensitivity. We examined whether adiponectin oligomer distribution is associated with aging and type 2 diabetes (T2D) in octogenarians without characteristic features of metabolic syndrome. Methods: The study included 154 octogenarians (58 men, 96 women), 24 normoglycemic middle-aged controls (11 men, 13 women; mean age 44 years), and 33 middle-aged individuals (14 men, 19 women; mean age 55 years) with T2D. Based on oral glucose tolerance test 62 octogenarians had normal, 63 impaired glucose tolerance, and 29 octogenarians had newly detected T2D. Serum adiponectin multimer isoforms were measured after overnight fast by enzyme-linked immunosorbent assays. Results:Compared to the normoglycemic middle-aged control group, male normoglycemic octogenarians revealed significantly higher total adiponectin and all adiponectin isoforms. The same was true for females with the exception of low molecular weight (LMW) adiponectin, which was not statistically higher in octogenarians. Male and female octogenarians with T2D had significantly higher levels of total, HMW, and middle molecular weight (MMW) adiponectin, but not LMW adiponectin, than middle-aged individuals with T2D. Female, but not male, octogenarians revealed significantly lower total adiponectin than normoglycemic octogenarians. Compared with normoglycemic octogenarians, male and female octogenarians with T2D were characterized by significantly lower LMW adiponectin. In male and female octogenarians, total adiponectin and all multimer isoforms were directly correlated with HDL cholesterol. LMW adiponectin in octogenarians of both sexes was inversely correlated with glucose level at 2-hour oral glucose tolerance test. Conclusions: Serum levels of total adiponectin as well as its HMW and MMW isoforms were significantly higher in octogenarians with normoglycemia or T2D than in corresponding middle-aged control groups. In male and female octogenarians without metabolic syndrome, T2D was associated with lower LMW adiponectin, while the HMW and MMW isoforms were not statistically different. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Adolescensutvecklingen är en känslig period, då övergången från att vara ett beroende barn till att bli en självständig vuxen skall äga rum. Under denna kritiska process sker identitetsutveckling och strävan efter att vara oberoende föräldrar ökar. År 2013 rapporterades att cirka 50000 personer i Sverige har typ 1 diabetes mellitus (T1DM) och statistik pekar på en ständig ökning av sjukdomen. T1DM är en ämnesomsättningssjukdom som kännetecknas av brist på hormonet insulin. Sjukdomen behandlas med insulin, kost och motion och kräver dessutom regelbundenhet och daglig egenvård. Syftet med studien var att identifiera hälsorelaterade utmaningar med T1DM under adolescensutvecklingen, ur ett personperspektiv. Studien är utförd som en litteraturstudie där 13 vetenskapliga artiklar har granskats och bearbetats. Resultatet visar att T1DM under adolescensutvecklingen medför speciella utmaningar och problematik kring föräldrarelationen, vikten av kunskap och stöd samt behovet av att vara som alla andra. Vidare forskning bör fokusera på föräldrars samt hälso- och sjukvårdspersonals perspektiv kring T1DM under adolescensutvecklingen, för att få ett helhetsperspektiv och kunna stödja den drabbade ungdomen på bästa sätt. / The adolescence is a sensitive period with the transition from being a dependent child to becoming an independent adult. During this critical process ones identity develops and the desire to be self-sustaining without parents increases. In 2013 it was reported that approximately 50 000 people in Sweden have type 1 diabetes mellitus (T1DM) and statistics point to a steady increase of the disease. T1DM is a metabolic disease characterized by a lack of the hormone insulin. The disease is treated with insulin, diet and exercise and also requires regularity and daily self-care. The purpose of this study was to identify health related challenges with T1DM during the period of adolescence, from a person perspective. This is a literature study in which 13 scientific articles have been reviewed and processed. The result shows that T1DM during the period of adolescence poses special challenges and problems relating to the parental relationship, the importance of knowledge and support, and the need to be like everyone else. Further research should focus on the perspectives of both parents and healthcare staff on T1DM during adolescence, to get an overall perspective and be able to assist the affected youth in the best possible way.