El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / This paper proposes a technological solution using a predictive analysis model to identify and reduce the level of risk for type 2 diabetes mellitus (T2DM) through a wearable device. Our proposal is based on previous models that use the auto-classification algorithm together with the addition of new risk factors, which provide a greater contribution to the results of the presumptive diagnosis of the user who wants to check his level of risk. The purpose is the primary prevention of type 2 diabetes mellitus by a non-invasive method composed of the phases: (1) Capture and storage of risk factors; (2) Predictive analysis model; (3) Presumptive results and recommendations; and (4) Preventive treatment. The main contribution is in the development of the proposed application. / Revisión por pares

Bakgrund: Diabetes typ 2 är en allvarlig kronisk sjukdom som uppstår antingen via ärftlighet eller osund livsstil och behandlas med livsstilsförändringar. Sjukdomen ger upphov till kroppsliga symtom och komplikationer som kan orsaka påfrestningar, vilket kan orsaka ett lidande för den som drabbas av sjukdomen.   Syfte: Att beskriva hur patienter med diabetes typ 2 upplever livsstilsförändringar.    Metod: En kvalitativ allmän litteraturöversikt baserat på tio originalartiklar, med hjälp av databaserna Cinahl och Pubmed. Inkluderade artiklar kvalitetsgranskades och enbart hög och medelhög kvalité av artiklar valdes. Samtliga artiklar bearbetades och lästes igenom för att få fram kategorier.   Slutsats: Att ha diabetes typ 2 innebär en behandling med främst livsstilsförändringar och en individanpassad vård som ska vara personcentrerat. Hälso- och sjukvårdspersonal bör bli bättre på att informera patienten med diabetes typ 2 om komplikationer som kan uppstå. Dessa komplikationer kan uppstå på grund av att patienten bland annat inte gör sina livsstilsförändringar, såsom kostförändringar. Om patienten har kunskapen om varför det är bra med livsstilsförändringar kan det motivera dem så de kan jobba för att förebygga komplikationer som kan uppstå i samband med sjukdomen.   Nyckelord: Diabetes Mellitus typ 2, patientupplevelse, livsstilsförändringar, omvårdnad, litteraturöversikt

Background: Diabetes self-management education, including nutrition education (NE) is an essential component of diabetes management. Effective NE can assist individuals with type 2 diabetes mellitus (DM) in resource limited settings to improve their dietary self-care; an area cited among the most difficult with consequent improvement in health outcomes. Aim: To develop a NE programme that is tailored to the needs of adults with type 2 DM in a resource limited setting and to evaluate the programme's effectiveness on health outcomes. Setting: Makapanstad and Mathibestad community health centres in the Moretele sub-district, North West Province (South Africa). Methods: The study was done in three phases employing mixed methods research. Qualitative methods, using focus group discussions with 31 diabetic patients (a convenience purposive sample), and an open ended self-administered questionnaire with ten health professionals serving them, assessed the NE needs and preferences (phase 1). The data were analysed according to the framework approach. The results from the needs assessment were used to plan a tailored NE programme (phase 2). A randomised controlled trial (quantitative) with a sample of 82 patients (with HbA1c ≥ 8), allocated to either intervention or control groups, evaluated the effect of the NE programme (phase 3). Outcomes [HbA1c, dietary behaviours, blood lipids, blood pressure, body mass index (BMI), diabetes knowledge and attitudes towards diabetes and its treatment] were assessed at baseline, six months and 12 months respectively. An analysis of covariance (ANCOVA) compared the groups on measured outcomes using baseline values, age, gender, and clinic as covariates. Rank ANCOVA was used for dietary intake. The level of significance for all tests was set at α < 0.05 for a two-tailed test. Results: Needs assessment Diabetes related knowledge deficits and inappropriate dietary practices, including food portion control problems, inadequate intake of vegetables and fruits and unbalanced diets, were observed. Eight barriers and two facilitators to dietary adherence were identified. Financial constraint was the major barrier while social support was the major facilitator. NE recommendations included content related to the disease and diet, group education at the clinic, a competent educator, provision of education materials and inclusion of family members. The planned NE programme consisted of eight weekly training sessions and six follow-up sessions (monthly and bi-monthly), vegetable gardening demonstrations and education materials. Nutrition education programme effects: Seventy six participants (38 per group) completed the study. The differences in HbA1c (primary outcome) between the intervention and control groups were -0.62% (p=0.15) at six months and -0.67% (p=0.16) at 12 months. Few participants, four from the intervention group and one from the control group, achieved HbA1c target (<7%) at both six and 12 months, [(p=0.20), (p=0.36)] respectively. There were no significant between group differences in BMI, lipid profile and blood pressure at six months and 12 months. Starchy foods intake (median servings) were significantly lower in the intervention group compared to the control group, 9.3 vs. 10.8 (p=0.005) at six months and 9.9 vs. 11.9 (p=0.017) at 12 months. The proportion of participants growing own vegetables significantly increased in the intervention group compared to the control group 17/41 vs. 5/40 (p=0.003) at six months and 16/38 vs. 5/38 at 12 months. No significant group differences in the intake of energy, macronutrients, vegetable and fruits, sodium, cholesterol and fibre were observed at six and 12 months. Diabetes knowledge improved in the intervention group +0.95 (p=0.033) and +2.2 (p=0.000) when compared with the control group at six and 12 months respectively. There were no significant group differences in the attitudes towards diabetes and its treatment. Conclusions: The qualitative needs assessment provided insight for planning a tailored NE programme. The NE improved some dietary behaviours (starchy foods portion control and growing own vegetables) and diabetes knowledge. A non-significant lowering of HbA1c was observed. / Thesis (Phd)--University of Pretoria, 2013. / Human Nutrition / unrestricted

Title: Physical education of individuals with type 2 diabetes mellitus Objectives: The aim of this thesis is to evaluate the effect of physical education of individuals with type 2 diabetes mellitus cured in diabetologic outpatient clinic of Genereal University Hospital in Prague. The physical education was focused on nordic walking. Methods: Eight patients of diabetological outpatient clinic were chosen by the doctor for this survey. The physical examination was carried out with seven patients. It involved anthropometrical measurements (weight, waist circumference) and blood collection for biochemical parameters assessment (glycemia, glycated hemoglobin). Two-minute step test was chosen for assessment of subject's physical fitness. Results: The physical activity education of individuals with type 2 diabetes mellitus doesn't increase the amount of their physical activity. The physical activity of type 2 diabetes mellitus individuals is rather low as well as their exercise adherence. Nordic walking exercise program can improve anthropometrical parametres (weight, waist circumference) and can reduce HbA1c levels. Lower health-related quality of life in physical and physological aspects wasn't proved in type 2 diabetes patients. Key words: nordic walking, physical activity, type 2 diabetes management,...

Bakgrund: Diabetes typ 2 (DMT2) är en växande folksjukdom som förekommer i hela världen. Den obotliga och progressiva sjukdomen kan leda till allvarliga komplikationer i både nerver och blodkärl. Symtom vid diabetes typ 2 är bland annat: trötthet, orkeslöshet, muntorrhet, yrsel och depression. Behandling vid diabetes typ 2 är i första hand livsstilsförändring, därefter läkemedelsbehandling. Egenvård i form av kostförändring och fysisk aktivitet kan minska diabeteskomplikationer och därmed minska samhälleliga kostnader. Syfte: Syftet var att beskriva personers upplevelser av egenvård vid diabetes typ 2. Metod: En litteraturöversikt utfördes med sökningar i databaserna Pubmed och Cinahl Complete. Den är baserad på tio vetenskapliga artiklar av kvalitativ design. Innehållet i artiklarna analyserades och sammanställdes som teman i resultatet enligt Friberg. Resultat: Resultatet visade att personer med diabetes typ 2 har olika upplevelser av egenvård. Vidare belyser resultatet att personer med diabetes typ 2 är i behov av kulturanpassad omvårdnad, motivation samt stöd för att uppnå god egenvård. Slutsats: Resultatet visade att personer med diabetes har olika upplevelser av egenvård, både främjande och hindrande. Stödjande insatser från både närstående och vårdpersonal med god kulturkunskap har stor betydelse för att öka motivation för livsstilsförändring samt förbättra egenvårdskapacitet hos personer med diabetes typ 2. / Background: Type 2 diabetes is a growing public health disease that occurs worldwide. The incurable and progressive disease can lead to a series of serious complications in both nerves and blood vessels. Symptoms of type 2 diabetes include among others: fatigue, lack of energy, dry mouth, dizziness and depression. Treatment for type 2 diabetes is primarily a lifestyle change, thereafter medical treatment. Self-care in the form of dietary change and physical activity can reduce diabetes complications and thereby reduce societal costs. Aim: The aim was to describe persons’ experiences of self care in type 2 diabetes. Method: A literature review was made with searches in the databases Pubmed and Cinahl Complete. It is based on ten scientific articles of qualitative design. The content of the articles were analyzed and compiled as themes in the results according to Friberg. Results: The results showed that people with type 2 diabetes have different experiences of self-care. Furthermore, the results highlight that people with type 2 diabetes are in need of cultural adapted education, motivation and support. Conclusion: The results showed that people with diabetes have different experiences of self-care, both promoting and hindering. Support from both relatives and caregivers with good cultural knowledge are of great importance for increasing motivation for lifestyle changes and improving self-care capacity in people with type 2 diabetes.

The purpose of this study was to determine if NO blood concentrations increased acutely following an 8-week course of pulsed infrared light therapy (PILT) which could be linked to an improvement in peripheral protective sensation (PPS) in patients who have profound chronic diabetic peripheral neuropathy. A total of 22 subjects with the diagnosis of type 1 (N = 2) or type 2 (N = 20) diabetes participated in the study. PILT was administered to one foot chosen at random with the other foot serving as a within-subject control (no treatment). Patients underwent 24 treatments (3 times/week, for 8 weeks) for 30 min per treatment. Venous blood samples were taken during the last 5 min of treatment from veins in the dorsum of the control and experimental feet and were later analyzed for NO concentration. Contrary to the popular supposition, PILT treatments actually resulted in a significantly (P < 0.05) decreased concentration of NO. Additionally, there were no significant differences between the treated and untreated feet. Since in individuals where PILT has significantly improved PPS, PILT did not stimulate an increased NO content in the blood, it appears that infrared light improves peripheral protective sensation in patients by a mechanism other than an increased NO production.

Pulsed infrared light therapy (PILT) has been shown to increase peripheral sensation in diabetic patients with diabetic peripheral neuropathy (DPN). However, most studies last for very short periods, with the subjects receiving only 6-20 treatments. The purpose of this study was to evaluate the effectiveness of an eight-week course of PILT in reversing long-standing, profound DPN in patients with type 1 and type 2 diabetes. Twenty-two subjects with a diagnosis of type 1 (n=2) or type 2 (n=20) diabetes participated in the study. PILT was administered to one foot chosen at random with the other foot serving as a within-subject control (no treatment). Patients underwent 24 treatments (3 times/week, for eight weeks) for 30 min per treatment. Changes in peripheral protective sensation (PPS) were measured using Semmes-Weinstein monofilaments (SWM) ranging from 3.7 to 6.48. PILT improved PPS even in patients with long-standing chronic neuropathies whose initial pre-study sensation was not measurable with a 200-g SWM. PILT significantly improves PPS. While the exact mechanism of action is not understood, infrared light may improve peripheral neuropathies by improving foot perfusion by stimulating nitric oxide production.

Background: Type 2 diabetes mellitus is one of the most common diseases globally and in Sweden. It is a chronic lifestyle disorder that requires self-care management. Self-care means that patients are responsible for managing their disease. Research shows that compliance with type 2 diabetes can be challenging. Purpose: The purpose was to describe patients' experiences with self-care in type 2 diabetes mellitus Method: A general literature review consisting of twelve qualitative scientific articles. The thematic analysis applied in the article analysis Results: Two identified themes: Living with type 2 diabetes mellitus with subthemes: Emotions associated with type 2 diabetes mellitus and lifestyle change. The other theme was patients' self-care experience for type 2 diabetes mellitus with subthemes: motivation, social support, knowledge, and counseling. Patients living with type 2 diabetes generally had positive self-care experiences in type 2 diabetes. Conclusion: Patients had different experiences of self-care in type 2 diabetes. Education contributed to increased knowledge about self-care for type 2 diabetes. By highlighting patients' experiences within diabetes care, healthcare professionals get the opportunity to improve the quality of care. / Bakgrund: Typ 2 diabetes mellitus är en av de vanligaste folksjukdomarna globalt och i Sverige. Det är en kronisk livsstilssjukdom som kräver egenvårdshantering. Med egenvård menas att patienteransvarar för hantering av sin sjukdom. Forskningen visar att följsamhet vid typ 2 diabetes kan vara svårt Syfte: Syftet var att beskriva patienters upplevelse av egenvård vid typ 2 diabetes mellitus Metod: En allmän litteraturöversikt som består av tolv kvalitativa vetenskapliga artiklar. Tematiskanalys användes vid analyseringen av artiklar. Resultat: Två tema identifierades: Att leva med typ 2 diabetes mellitus och subteman: Känslor som uppstår i samband med typ 2 diabetes mellitus och livsstilsförändring. Den andra tema: upplevelser av egenvård vid typ 2 diabetes mellitus och har subtema: motivation, socialstöd, kunskap och rådgivning. Patienter som lever med typ 2 diabetes hade överlag positiva upplevelser av egenvård vid typ 2 diabetes Slutsats: patienter hade olika upplevelser av egenvård vid typ 2 diabetes. Utbildningar bidrog till ökad kunskap om egenvård avtyp 2 diabetes. Genom att belysa patienters upplevelser inom diabetesvård, får vårdpersonalen möjligheten att öka kvalitet i omvårdnaden.

Bakgrund: Typ 2 diabetes mellitus är en av de stora folksjukdomarna och förekomsten av sjukdomen ökar i hela världen. Typ 2 diabetes mellitus kan medföra allvarliga komplikationer om sjukdomen inte behandlas korrekt. Det går inte att bli frisk från sjukdomen, men genom livsstilsförändringar kan blodsockret sänkas till normala nivåer. Detta innebär att vården har en stor uppgift att hantera för att främja hälsan hos dessa patienter. För att stödja patienten i att hantera sin situation kan sjuksköterskan använda sig av motiverande samtal. Syfte: Beskriva effekten av motiverande samtal hos patienter med typ 2 diabetes mellitus gällande levnadsvanor. Metod: En kvantitativ litteraturöversikt med 14 vetenskapliga artiklar. Resultat: Motiverande samtal visar en varierad effekt. Positiv effekt kunde ses på egenvård, midjemått samt fysisk aktivitet. Ingen effekt kunde påvisas gällande övriga utfallsmått. Vid summering av samtliga utfallsmått från artiklarna visade motiverande samtal endast ha 35% signifikant effekt. Konklusion: Trots varierande effekt av motiverande samtal kan det vara en möjlig metod för sjuksköterskor i mötet med patienter med typ 2 diabetes mellitus för att minska risken för komplikationer.Sjuksköterskan kan med hjälp av motiverande samtal främja motivation, men för att detta ska ha effekt krävs att patienten själv har motivationen att förändra sin livsstil. / Background: Type 2 diabetes mellitus is one of our primary public diseases, and the incidence of the disease is increasing worldwide. Type 2 diabetes mellitus can lead to severe complications if the disease is not controlled. It is not possible to cure the disease, but blood sugar can be lowered to normal levels through lifestyle changes. This means that healthcare has a major task to handle to promote the health of these patients. To support the patient in managing their situation, the nurse can use motivational interviewing. Aim:To describe the effect of motivational interviewing in patients with type 2 diabetes mellitus regarding lifestyle. Method: A quantitative review with 14 scientific articles. Result: Motivational interviewing showed a varying effect. The positive effects could be seen onself-care, waist measurements, and physical activity. No effect is shown regarding other outcome measures. When summarizing all outcome measures from the articles, motivational interviewing showed only a 35% significant effect. Conclusion: Despite the varying effect of motivational interviewing, it may be possible for nurses to use in care for patients with type 2 diabetes mellitus to reduce the risk of complications. With the help of motivational interviewing, the nurse can promote motivation, but for this to have an effect,the patient himself must have the motivation to change his lifestyle.

Abstract Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States with a projected increase of 552 million people worldwide who will be affected with this illness by 2030. The need to address this issue is vital to prevent complications and reduce healthcare spending. The DNP project is aimed at planning and designing a nutritional education program tailored toward specific ethnic groups in order to increase knowledge in making healthy food choices. This project is intended to educate Registered Nurses (RNs) on nutrition so that they can offer dietary knowledge to T2DM patients. Additional patients can be reached by educating the RNs rather than patients being limited to consultations with a Certified Diabetes Educator or Registered Dietician. This project focused on whether healthy nutrition tailored toward the individual's own ethnic foods helps to stabilize glycemic values for patients with Type 2 diabetes. A toolkit was utilized to aid with the RNs' learning on healthy nutrition and its impact on the management of blood glucose. It addressed areas such as food groups and calories, grocery shopping, preparation methods, and portion control. The framework for design utilized the basic concepts associated with the systems theory with an intended goal to prevent further complications and improve patients' glycemic value through consuming nutritious foods. The logic model will be used to evaluate the impact of healthy nutrition on blood glucose through pre- and post-program tests of the RNs' nutritional knowledge on healthy eating. The continuation of this program will promote positive social change by helping patients to achieve a healthier lifestyle and reduce healthcare expenditures.