The aim of the study was auditing medical records examine postoperative blood glucose levels after undergoing CABG surgery. Furthermore the aim was to determine if the ward staff abides the local guidelines frame of reference concerning each ward, regarding blood glucose measurements and blood glucose levels. The study included 70 patients undergoing CABG surgery at the cardiothoracic surgery, Uppsala University Hospital. The study was conducted by retrospective medical record auditing. Studied factors were postoperative blood glucose levels, number of registered blood glucose measurements, a current diagnosis of DM and preoperative HbA1c. Mean level of blood glucose levels stayed continuously above the local guidelines frame of reference for both TIVA/TIMA and the care ward throughout the continuity of patient care. The number of registered blood glucose measurements per postoperative day at TIVA/TIMA where within the local guidelines. The result showed that the local guidelines frame of reference concerning the ward were not reached. A difference could be seen between patients with DM and patients without DM regarding the previously mentioned factors. Preoperative elevated levels of HbA1c could have influenced the number of postoperative blood glucose measurements. Recommendations will therefore be too audit the current local guideline that concerns the treatment, therapy goals and the number of blood glucose measurements. Establishing criterions regarding termination of blood glucose measurements and the transfer day between TIVA/TIMA and the care ward are recommended.

ABSTRACT Objective: The objective of this review was to describe the effects of low carbohydrate diets in people with diabetes type 2. Methods: Review. An article search was made in the databases PubMed and Medline. The search resulted in 17 studies. After review and analysis of the studies main results five categories were highlighted; bloodsugar levels, HbA1c, weight, lipid levels and antidiabetic medications. Results: The results revealed that diets low in carbohydrates may reduce blood sugar levels, fasting blood glucose and HbA1c-levels in people with type 2 diabetes. A low carbohydrate diet may reduce body weight for people with type 2 diabetes, this was shown in 12 of 17 studies. Total cholesterol was reduced in six of 17 studies. A reduction of triglycerides was found in eight of 17 studies. LDL-cholesterol was reduced in four of the studies. HDL- cholesterol was increased in eight of 17 studies. Conclusion: Some of the studies showed positive effects of a low carbohydrate diet for people with type 2 diabetes, for instance improvements in blood sugar levels, bodyweight, total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol. The study implies that a low carbohydrate diet may be an alternative for people with type 2 diabetes in short terms.Keywords: Diabetes type 2, diet, low-carbohydrate, ketogenic, HbA1c

Målsättning Att utreda skillnader i tillgänglighet till insulinpump mellan olika patientgrupper samt vad som orsakar ett byte till insulinpump. Metod Data från 7224 individer med typ 1 diabetes vid tio olika vårdenheter analyserades för att utreda effekterna av njurfunktion, kön, långtidsblodsocker, insulindos, diabetesduration samt ålder. Jämförelsen mellan patientgrupper utfördes med logistisk regression som en tvärsnittsstudie och Cox-regression för att utreda vad som föregått ett byte till pump. Resultat Genom logistisk regression erhölls en bild av hur skillnader mellan patienter som använder insulinpump och patienter som inte gör det ser ut i dagsläget. Cox-regressionen tar med ett tidsperspektiv och ger på så sätt svar på vad som föregått ett byte till insulinpump. Dessa analyser gav liknande resultat gällande variabler konstanta över tiden. Kvinnor använder pump i större utsträckning än män och andelen pumpanvändare skiljer sig åt vid olika vårdenheter. I dagsläget visar sig hög ålder sänka sannolikheten att använda insulinpump, vilket bekräftas vid den tidsberoende studien som visade hur sannolikheten att byta till pump är avsevärt lägre vid hög ålder. Långtidsblodsockret har också tydlig effekt på sannolikheten att gå över till pump där ett högt långtidsblodsocker medför hög sannolikhet att byta till insulinpump. Slutsatser I dagsläget finns det skillnader i andelen insulinpumpanvändare mellan olika patientgrupper och skillnader finns även i de olika gruppernas benägenhet att byta från andra insulinbehandlingar till insulinpump. Beroende av patienters njurfunktion, kön, långtidsblodsocker, insulindos, diabetesduration och ålder har dessa olika sannolikheter att byta till insulinpump.

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The relationship between cardiovascular conditions and the presence of Alzheimer's disease (AD) has been well-documented in a number of recent studies. Generally, the presence of cardiovascular conditions such as high total cholesterol and hypertension have been shown to significantly increase the risk for the development of AD. Given the results of these studies, it is possible that these same risk factors might also increase the risk of developing mild cognitive impairment (MCI). An analysis of 216 subjects (119 cognitively normal (CN), 77 aMCI, 20 naMCI) found that after adjusting for age, education, ethnicity, and gender, only hemoglobin A1c (HbA1c) showed a significant effect for aMCI [OR = 1.75 (1.02, 2.99) p=0.04]. Age and education also showed significant effects that were consistent with previous studies. Given recent studies linking Type 2 diabetes with AD, this finding appears to strengthen the link between diabetes-related disease processes and aMCI/AD disease processes.

Haemoglobin A1c is besides glucose the most requested analysis for diagnosing diabetes due to its ability to predict diseases that occur due a high blood sugar. The analysis has some limitations when a haemoglobin variant is present as they may cause falsely low or high results. In this study, we used whole blood from routine requested haemoglobin A1c samples for screening for haemoglobin variants with Capillarys 3 TERA. The samples with haemoglobin variants was then analysed with Cobas c501, Roche and Afinion, Alere for comparison of the methods. The aim of this study was to investigate the presence of haemoglobin variants in the county of Uppsala by screening over 3000 haemoglobin A1c samples. Samples with known haemoglobin variant was analysed as above to compare the results with those found in our county to study the possibility to identify the haemoglobin variants with Capillarys 3 TERA. The presence of haemoglobin variants in the county of Uppsala was approximately 0.5%. Correlation between Cobas c501 and Capillarys 3 TERA was strong for samples with haemoglobin F (r = 0.988) and for the samples with haemoglobin variants the correlations coefficient was 0.94. Correlation coefficients between Afinion and Capillarys 3 TERA for samples with haemoglobin F was 0.987 and for the haemoglobin variant 0.937. The presence of haemoglobin variants in the county of Uppsala is still low. Capillarys 3 TERA is capable to separate the most common variants and despite the good correlation every haemoglobin variant needs to be handled separately and the results should be answered with a comment that there is a possibility that the haemoglobin variant is giving an incorrect result.

Introducción: La depresión es un problema de salud pública, puesto que representa la primera causa de enfermedad psiquiátrica discapacitante en el Perú. Asimismo, la presencia de síntomas depresivos podría modificar la adherencia al tratamiento y mayor probabilidad de mal control glicémico en pacientes con Diabetes Mellitus tipo 2 (DM2). Materiales y Métodos: Se realizó un estudio trasversal, analítico. Se halló un tamaño muestral de 98 pacientes con diagnóstico de DM2 que acudieron al consultorio de endocrinología de un hospital del seguro social en el periodo de Octubre - Noviembre del año 2014. Se utilizaron tres escalas, la principal fue la del Inventario de Depresión de Beck II como variable de respuesta; las otras dos escalas, Escala de Áreas Problemáticas en la Diabetes (PAID) y la escala de Morisky-Green, fueron utilizadas como respuesta complementaria. En el estudio se definió como buen control glicémico una hemoglobina glicosilada ≤7. Resultados: Se estudió 104 pacientes, predominando el sexo femenino (53,8%), con edad promedio de 56 años con tendencia a ser menores de 60 años (p>0,05), casados y de grado superior. El índice de masa corporal tuvo asociación con la presencia de síntomas depresivos (p 0,003), y se encontró mayor frecuencia en aquellos con obesidad de tipo II y III. El 57,7% de la población tuvo mal control glicémico, de los cuales el 73,3% presentaban síntomas depresivos (p<0,05), y el 84,1% no tuvo adherencia al tratamiento (p<0,05). Se encontró una asociación significativa entre el mal control glicémico y la presencia de síntomas depresivos independientemente de variables potencialmente confusoras con una razón de prevalencias de 1,9 (1,1 a 3,6). Conclusiones: Se concluye la existencia de asociación entre el mal control glicémico y la presencia de síntomas depresivos en pacientes con DM2. De tal forma, se sugiere brindar un enfoque integral en dichos pacientes, en los cuales también deberá evaluarse el factor psicológico. / Introduction: Depression is an important problem of public health because it is the primary cause of disabling psychiatric illness in Peru. Also, the presence of depressive symptoms could modify the adherence to the treatment and a high probability of a bad glycemic control in patients with Diabetes Mellitus type 2 (DM2). Methods: A cross-sectional analytical study was done, with 98 patients who were diagnosed with DM2, who went to the Endocrinology Department during the period of October-November 2014 in a social security hospital. We used three scales, the first one was The Beck Depression Inventory II which evaluated the presence of depressive symptoms; the scale of Problem Areas in Diabetes (PAID) evaluates the emotional stress they faced during the illness, and the Morisky-Green Scale is the third scale used which valued the adherence to the pharmacological treatment. Results: in population, the predominance was on female sex (53,8%), with a mean age of 56 years tended to be younger than 60 years (p> 0.05), married and a superior grade. BMI was associated with the presence of depressive symptoms (p 0.003), and most often found in those with obesity, type II and III. The population had 57.7% of poor glycemic control, of which 73.3% had depressive symptoms (p <0.05), and 84.1% had no adherence to treatment (p <0.05). It was found a significant association between bad glycemic control and presence of depressive symptoms independently of the potentially confounding variables with a prevalence ratio to 1.9 (1, 1 -3, 6). Conclusions: It is concluded the association between the bad glycemic control and the presence of depressive symptoms in diabetic patients. Therefore, it is suggested to use an integral approach on such patients who will be subject to a psychological evaluation.

Diabetes mellitus affects 7.8% of the American population. National health statistic data and other research shows that racial/ethnic disparities exist in terms of prevalence and treatment outcomes. The present study investigated the role of patient health beliefs (i.e., locus of control, self-efficacy) and the doctor-patient relationship (e.g., satisfaction and collaboration with health care provider), as relative predictors of diabetic control (i.e., HbA1c levels) and overall satisfaction with diabetes care, in older adult participants with diabetes. Demographic, psychosocial, and diabetes-related data from the Health and Retirement Study (HRS) 2003 Diabetes Study were analyzed to compare treatment outcomes among non-Hispanic White, non-Hispanic Black, and Hispanic individuals with various types of diabetes. Non-Hispanic White individuals exhibited better diabetic control than their minority counterparts (F(2, 592) = 7.60, p < .001); however, no significant group differences were noted in terms of psychosocial factors. Diabetic control was best predicted by time since diagnosis (&#946; = -.21, p < .001), satisfaction with diabetes self-care (&#946; = .19, p < .001) and age (&#946; = .12, p < .01). In addition, satisfaction with provider care was best predicted by perceived collaboration with provider (&#946; = .44, p < .001), satisfaction with diabetes self-care (&#946; = .22, p < .001) and diabetes self-efficacy (&#946; = .08, p < .05). Recommendations for future research were discussed.

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Background: Glycemic control in individuals with type 1 diabetes demands support and education by caregivers in diabetes care. Patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) constitutes an important function in diabetes care The Diabetes Questionnaire has been created for clinical use with the purpose of broadening the approach to individuals with type 1 diabetes. Purpose: The purpose of this study was to map the correlation between PROM and PREM from Diabetes questionnaire and HbA1c. Method: This study was conducted with a quantitative retrospective cross-sectional design. Data was selected from a diabetes clinic in the middle part of Sweden and was retrieved from already answered Diabetes Questionnaires. 145 individuals with type 1 diabetes were included in the study. Data has been analyzed with Spearman´s correlation coefficient to produce the correlation between PROM/PREM and HbA1c. Main results: The result showed significant correlation between HbA1c and following 12 categories: General mood, Mood and strength, Comfort, Handle my diabetes, Food and exercise, Diabetes no obstacle, Blood sugar no obstacle, Availability, Availability nurse, Availability physician, Continuity and Aid and medical. The strongest correlation is Diabetes no obstacle. The other two categories Support from others and Support from the diabetes care showed no correlation with HbA1c.  Conclusion: The result showed a large spread of all categories in the Diabetes Questionnaire. Individuals with higher HbA1c had in greater occurrence fear of sequelae and felt diabetes as an obstacle. Individuals with lower HbA1c experienced better prerequisites to manage their diabetes. By exploring the relationship between PROM/PREM and glycemic control, the capacity and resources of the healthcare staff and healthcare can be targeted where the priority is highest.