INTRODUÇÃO: a cirurgia bariátrica tem se mostrado efetiva no tratamento de comorbidades relacionadas à obesidade como o Diabetes Mellitus tipo 2 (DM2), sugerindo que mecanismos além da perda de peso estão envolvidos. Diversos estudos têm atribuído a melhora da regulação glicêmica à secreção de incretinas pelo intestino distal, devido ao estímulo da rápida passagem de alimento por esta região; outra hipótese confere o resultado à exclusão do intestino proximal, porém detalhes dos mecanismos de ação e do seu papel em indivíduos não obesos ainda precisam ser esclarecidos. Indivíduos com DM2 operados por motivos diferentes da obesidade representam adequado modelo para analisar resultados clínicos da exclusão duodenal. OBJETIVO: analisar a mudança da glicemia em pacientes diabéticos submetidos a gastrectomia total ou subtotal com derivação em Y de Roux por câncer gástrico. PACIENTES E MÉTODOS: estudo observacional, analítico, tipo coorte com abordagem retrospectiva, desenvolvido em duas instituições públicas de saúde no município de São Paulo, aprovado por comitê de ética em pesquisa. Foram verificados os prontuários físicos e eletrônicos, com respeito às variáveis demográficas (sexo, idade) e clínicas (comorbidades, Índice de Massa Corpórea-IMC, glicemia de jejum, hemoglobina glicada e uso de medicamentos) antes da operação (T0) e um ano após (T1). A amostra foi composta por 129 pacientes acima de 18 anos, com diagnóstico de DM2 e Adenocarcinoma gástrico, submetidos a gastrectomia com reconstrução em Y de Roux. Foram excluídos 26 pacientes por falta de acompanhamento ou óbito antes de um ano de pós-operatório; a amostra de análise (n=103) foi representada por 50,5% (n=52) de mulheres e 49,5% homens (n=51), com idade média de 65,5 ± 9,57 anos (41-89 anos). A distribuição do IMC foi de 25 a 30 kg/m2 em 44,7% (n=46), abaixo de 25 kg/m2 em 38,8% (n=40) e maior que 30 kg/m2 em 16,5% (n=17). A gastrectomia subtotal foi realizada em 79,6% (n=82) dos pacientes. Para a análise estatística, usaram-se medidas de tendência central, teste t de Student e regressão logística com o modelo CART. RESULTADOS: após um ano de pós-operatório, a média de glicemia diminuiu de 147,6 mg/dL (T0) para 134 mg/dL (T1) (p=0,046), porém 70% dos pacientes com glicemia > 100 no T0 permaneceram com o mesmo valor no T1. A hemoglobina glicada não teve mudança significativa (7,5% no T0 vs 7,0% no T1, p=0,988). A média do IMC diminuiu de 26,5 kg/m2 (T0) para 24,3 kg/m2 (T1) (p < 0,001). Após um ano, 6,7% (n=6) tiveram suspensão da medicação com resolução do DM2 e 11,2% (n=10) diminuíram a medicação hipoglicemiante, enquanto que, em 60,7% (n=54), permaneceu inalterada e, em 21,4% (n=19), piorou. Os pacientes com IMC entre 30-35 kg/m2 foram os que tiveram melhor resposta em relação à normalização dos níveis glicêmicos. O modelo de regressão logística mostrou como preditores da mudança na medicação a idade ( < 62,5 anos) e o IMC ( > 30,2 kg/m2) com valor preditivo 71,4%. CONCLUSÕES: o estudo demonstrou que não houve melhora da glicemia nos pacientes com DM2 submetidos a gastrectomia total ou subtotal com reconstrução em Y Roux, com IMC abaixo de 30 kg/m2, nem foram observadas evidências que corroborem a Teoria do Intestino Proximal. Há indícios de que a cirurgia possa influenciar o controle glicêmico quando o IMC é > 30 kg/m2 e a idade, inferior a 62,5 anos / INTRODUCTION: Bariatric surgery has been shown to be effective in the treatment of obesity-related comorbidities such as Type 2 Diabetes Mellitus (DM2), suggesting that mechanisms in addition to weight loss are involved. Several studies have attributed the improvement of glycemic regulation to the secretion of incretins in the distal intestine, due to the stimulation of the fast passage of food by this region. Another hypothesis confers the result to the exclusion of the proximal intestine; however, details of the mechanisms of action and their role in non-obese individuals have yet to be clarified. Individuals with DM2 operated for other reasons than obesity, represent an adequate model to analyze clinical outcomes of duodenal exclusion. AIM: to analyze the glycemia changes in diabetic patients submitted to total or subtotal gastrectomy with Roux-en-Y derivation for gastric cancer. PATIENTS AND METHODS: An observational, analytical, cohort study with a retrospective approach, developed in two public health institutions in the city of São Paulo, approved by a research ethics committee. The physical and electronic charts concerning to demographics (sex, age) and clinical variables (comorbidities, Body Mass Index (BMI), fasting glycemia, glycated hemoglobin and medication use) were checked before surgery (T0) and one year after (T1). The sample consisted of 129 patients over 18 years of age, diagnosed with DM2 and Gastric Adenocarcinoma, who underwent gastrectomy with Roux-en-Y reconstruction. Twenty-six patients were excluded due to lack of follow-up or death before one year of postoperative; the analysis sample (n=103) was represented by women 50.5% (n=52) and 49.5% men (n=51), with a mean age of 65.5 years (SD=9.57; 41-89 years). The distribution of BMI was 25 to 30 kg/m2 in 44.7% (n=46), below 25 kg/m2 in 38.8% (n=40) and greater than 30 kg/m2 in 16.5 % (n=17). Subtotal gastrectomy was performed in 79.6% (n=82) of the patients. Statistical analysis used central tendency measures, Student\'s t-test and logistic regression with the CART model. RESULTS: After one year of postoperative, mean glucose levels decreased from 147.6 mg/dL (T0) to 134 mg/dL (T1) (p=0.046), but 70% of patients with glycemia > 100 at T0, remained with the same value in T1. Glycated hemoglobin had no significant change (7.5% in T0 vs. 7.0% in T1, p=0.988). The mean BMI decreased from 26.5 kg/m2 (T0) to 24.3 kg/m2 (T1) (p < 0.001). After one year, 6.7% (n=6) had discontinuation of the medication with the resolution of DM2, and 11.2% (n=10) decreased the hypoglycemic medication, while in 60.7% (n=54) there no was change, and in 21.4% (n=19) it worsened. Patients with BMI between 30-35 kg/m2 were the ones that had the best response regarding the normalization of glycemic levels. The logistic regression model showed predictors of change in medication, age ( < 62.5 years) and BMI ( > 30.2 kg/m2) with a predictive value of 71.4%. CONCLUSIONS: The study demonstrated that there was no improvement of glycemia in patients with DM2 who underwent total or subtotal gastrectomy with Roux-in-Y reconstruction, with a BMI below 30 kg/m2. No evidence was found corroborating the theory of the proximal intestine. There are indications that surgery may influence glycemic control when BMI > 30 kg/m2 and age less than 62.5 years

INTRODUÇÃO:A rigidez arterial aumentada é um importante determinante do risco cardiovascular e um forte preditor de morbimortalidade. Além disso, estudos demonstram que o enrijecimento vascular pode estar associado a fatores genéticos e metabólicos. Portanto,os objetivos do presente estudo são determinar a herdabilidade da velocidade de onda de pulso (VOP) e avaliar a associação do perfil lipídico e do controle glicêmico com o fenótipo de rigidez arterial em uma população brasileira.MÉTODOS:Foram selecionados 1675 indivíduos (ambos os gêneros com idade entre 18 e 102 anos) distribuídos em 109 famílias residentes no município de Baependi-MG. A VOP carótida-femoral foi avaliada de forma não invasiva através de um dispositivo automático.As variáveis lipídicas e a glicemia de jejum foram determinadas pelo método enzimático colorimétrico. Os níveis de hemoglobina glicada (HbA1c) foram determinados pelo método de cromatografia líquida de alta eficiência. As estimativas da herdabilidade da VOP foram calculadas utilizando-se a metodologia de componentes de variância implementadas no software SOLAR. RESULTADOS: A herdabilidade estimada para a VOP foi de 26%, sendo ajustada para idade, gênero, HbA1c e pressão arterial média. Os níveis de HbA1c foram associados a rigidez arterial, onde a elevação de uma unidade percentual da HbA1c representou um incremento de 54% na chance de risco para rigidez arterial aumentada. As variáveis lipídicas (LDL-c, HDL-c, colesterol não- HDL-c, colesterol total e triglicérides) apresentaram fraca correlação com a VOP. Além disso, uma análise de regressão linear estratificada para idade (ponto de corte >= 45 anos) demonstrou uma relação inversa entre LDL-c e VOP em mulheres com idade >= 45 anos. CONCLUSÃO: Os resultados indicam que a VOP apresenta herdabilidade intermediária (26%); a HbA1c esta fortemente associada a rigidez arterial aumentada; o LDL-c é inversamente relacionado com a VOP em mulheres com idade >= 45 anos, possivelmente devido às alterações metabólicas associadas à falência ovariana / INTRODUCTION: Increased central arterial stiffness is an important determinant of cardiovascular risk and a strong predictor of morbimortality. Moreover, studies showed that vascular stiffening can be associated with genetic and metabolic factors. Thus, the aims of this study are to estimate the heritability of pulse wave velocity (PWV) and to assess the association of lipid profile and glycemic control with arterial stiffness in a sample from the Brazilian population. METHODS: For this study, 1675 individuals (both genders aged from 18 to 102 years) were selected and they were distributed within 109 families residents in the municipality of Baependi - MG. The PWV was measured with a non-invasive automatic device. Lipid profile parameters and fasting glucose were determined by enzymatic colorimetric method. HbA1c levels were determined by high-performance liquid chromatography. Variance component approaches implemented in the SOLAR software were applied to estimate the heritability of PWV. RESULTS: Heritability estimates for carotid-femoral PWV was 26%, after adjustment for age, gender, HbA1c, and mean blood pressure. HbA1c levels were associated with arterial stiffness and the elevation of a single unit percentage of HbA1c represented an increase of 54 % in the odds of increased arterial stiffness. The lipid variables (LDL-c, HDL-c, non-HDL-c, total cholesterol and triglycerides) presented weak correlation with PWV. In addition, a linear regression analysis stratified by age (cutoff >= 45 years) showed an inverse relation between LDL-c and PWV in women aged 45 or older. CONCLUSION: Our findings indicate that PWV demonstrated an intermediate heritability (26%); HbA1c proved to be a good marker for risk stratification for increased arterial stiffness; LDL-c was inversely related with PWV in women aged 45 or older, possibly due to the metabolic alterations associated with ovarian failure

Kwan, Yee Mei. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 152-171). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendixes includes Chinese.

Made available in DSpace on 2014-07-29T15:23:44Z (GMT). No. of bitstreams: 1 Dissertacao Lorena Pereira de Souza Rosa.pdf: 1123488 bytes, checksum: 000fc4bd56ef5274dcff8c52cd78ed45 (MD5) Previous issue date: 2011-04-08 / The morbidity and mortality profile of the Brazilian population has changed recently in light of the increasing prevalence of chronic noncommunicable diseases. Of particular importance among these diseases is diabetes, a multiple-etiology disease characterized by insulin deficiency or decreased insulin production, or both. A major treatment goal is glycemic control, which requires medications that are expensive and have side effects. As a result, the demand for functional foods to complement this treatment is increasing. Among these foods is the yacon potato. To confirm its antidiabetic activity, glycemic profile studies in animals and humans have been carried out. The aim of this study was to evaluate the effect of yacon potato (Smallanthus sonchifolius) flour on glycemic control in nondiabetic rats and rats with streptozotocin-induced diabetes. Flour was prepared from vacon potato pulp and later a biological assay was carried out. Yacon potato flour was able to lower mean glycemia in diabetic rats, which can be explained by the FOS reserve. Animals treated with a FOS diet also had reduced blood glucose levels, confirming the ability of these fructans to control glycemia. The diabetes mellitus induction methodology proved effective, which validated the induction protocol developed. These results suggest that long-term studies with the diabetes model can best be assessed in relation to glycemic control, since there was better control starting in the third week of experiment. / Nos últimos tempos observaram-se mudanças no perfil de morbimortalidade da população brasileira, em função do aumento de prevalência das doenças crônicas não transmissíveis. Pode-se destacar entre elas o diabetes que é uma doença de etiologia múltipla que se caracteriza pela deficiência de produção de insulina, diminuição dessa produção ou ambas as condições. Um dos principais objetivos do tratamento é o controle glicemico, e para esse controle utiliza-se medicamentos que são caros e apresentam efeitos colaterais e por isso aumenta cada vez mais a busca de alimentos funcionais capazes de complementar esse tratamento. Entre esses alimentos destaca-se a batata yacon. Na busca da confirmação da atividade antidiabetica desse tubérculo, estudos são desenvolvidos com animais e humanos com avaliação do perfil glicemico. O objetivo deste trabalho foi avaliar o efeito da farinha da batata yacon (Smallanthus sonchifolius) no perfil glicêmico de ratos não diabéticos e diabéticos induzidos por streptozotocina. Elaborou-se uma farinha com a polpa da batata yacon e posteriormente foi realizado um ensaio biológico. A farinha da batata yacon foi capaz de diminuir a média da glicemia dos ratos diabéticos, o que pode ser justificado pela reserva de FOS. Os animais tratados com dieta FOS também reduziram a glicemia confirmando a capacidade de controle glicêmico desses frutanos. Foi possível observar a eficácia da metodologia de indução do diabetes melitus, validando o protocolo de indução elaborado. Tais resultados sugerem que estudos crônicos com o modelo de diabetes podem ser melhor avaliados em relação ao controle glicêmico, já que observou-se um melhor controle a partir da terceira semana de experimento.

A Diabetes Mellitus Gestacional é definida como intolerância à glicose durante a gestação, excluídos os casos de diabetes pré-gestacional. A telemedicina tem sido citada como ferramenta útil para proporcionar melhor qualidade à saúde de portadores de doenças crônicas. Objetivo: analisar a influência da orientação telefônica feita por um profissional de saúde sobre os resultados da automonitorização glicêmica em pacientes com diabetes mellitus gestacional. Método: estudo randomizado controlado-cego, longitudinal, com gestantes diagnosticadas com diabetes gestacional, acompanhadas no Setor de Endocrinopatias e Gestação da Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo atendidas no período de agosto de 2012 a maio de 2014. O diagnostico de DMG foi realizado por meio de glicemia de jejum e teste de tolerância à glicose de 75 gramas. As pacientes foram convidadas a participar da pesquisa após receberem instruções de uma equipe multiprofissional. Foram alocadas, de acordo com a randomização em dois grupos: Grupo 1 (receberiam ligação telefônica três dias após as orientações multiprofissionais, n=122) e grupo 2 (não receberiam ligação telefônica n= 122),. A enfermeira ligou para as pacientes e aplicou questionário sobre manuseio do aparelho para verificação da glicemia capilar, dieta, horário de aferições, desconforto e dificuldade em realizar a automonitorização glicêmica. Foram analisados os valores glicêmicos por meio das porcentagens de valores alterados, de hiperglicemia, de hipoglicemia e da média glicêmica nos sete primeiros dias após a participação no grupo multiprofissional. O número de aferições glicêmicas e as respostas ao questionário aplicado durante o contato telefônico também foram analisados. Resultados: Não houve diferença estatisticamente significativa entre os grupos quanto à cor, idade, presença de outras doenças clínicas maternas e quanto ao tipo de teste usado para diagnóstico de diabetes mellitus gestacional. Analisando os valores da glicemia capilar, o grupo que recebeu orientações telefônicas apresentou menor porcentagem de valores alterados (p= 0,001), menor frequência de hiperglicemia (p= 0,002) e maior número de aferições da glicemia capilar (p= 0,001). Conclusões: O contato telefônico influenciou significativamente o número de aferições da glicemia capilar e a frequência de resultados alterados, especialmente na hiperglicemia, sugerindo ser essa ferramenta útil na melhora da atenção a gestantes portadoras de diabetes gestacional / Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance during pregnancy, excluding cases of pre-gestational diabetes. Telemedicine has been cited as useful tool to provide better quality health care for patients with chronic diseases. Objective: To analyze the influence of telephone advice, by a health care professional, on the results of blood glucose monitoring in patients with gestational diabetes. Method: A randomized controlled blind trial, in pregnant women diagnosed with gestational diabetes, attended in Setor de Endocrinopatias e Gestação da Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo was carried out from August 2012 to May 2014 The diagnosis of GDM was made by means of fasting glucose and glucose tolerance test 75 grams. Patients were invited to participate in the study after receiving instructions from a multidisciplinary team. According to randomization, patients were allocated into two groups: Group 1 (receive phone call three days after multidisciplinary instructions, n = 122) and group 2 (not receive phone call, n = 122). The nurse called the patient and applied questionnaire on handling the device for checking blood glucose, diet, time of measurements, discomfort and difficulty in performing the blood glucose monitoring. Glycemic values were analyzed by means of the percentage of abnormal values, hyperglycemia, hypoglycemia and glycemic average in the first seven days after participation in the multidisciplinary group. The number of glucose measurements and the questionnaire answer questionnaire were also analyzed. Results: There was no statistically significant difference between groups regarding race, age, presence of other maternal medical illnesses and the type of test used to diagnose gestational diabetes. Analyzing the glycemic values , a group that received telephone guidelines showed lower percentage of abnormal values (p = 0.001), lower incidence of hyperglycemia (p = 0.002) and greater number of measurements of blood glucose (p = 0.001) Conclusion: The telephone contact significantly influenced the number of measurements of blood glucose and the frequency of abnormal results, especially in hyperglycemia, suggesting that this is useful tool in improving attention to pregnant women with gestational diabetes

It is currently accepted that the most appropriate diet in the treatment of non-insulin-dependent diabetes mellitus &quoteNIDDM&quote is high in carbohydrates, high in fibre and low in fat. Dietary fibre reduces the rate of carbohydrate absorption, which may have a beneficial effect on insulin action. Furthermore, high fibre diets also increase the amount of carbohydrates which are not absorbed from the small intestine. These malabsorbed carbohydrates are fermented by the bacterial population in the large intestine, producing short chain fatty acids &quoteSCFA&quote, including propionate, which has been shown to alter liver carbohydrate metabolism. This thesis investigated the actions of slowed carbohydrate absorption and carbohydrate malabsorption in streptozotocin-induced &quoteSTZ&quote diabetic rats. High carbohydrate diet supplemented with guar gum, a soluble dietary fibre, fed to STZ diabetic rats improved insulin sensitivity. investigation of the alterations in the stomach and small intestine demonstrated that guar increased the viscosity of the meal in the intestine. The action of increased fermentation, producing more propionate, was investigated by supplementing propionate into the diets of STZ diabetic rats or when perfused into isolated rat livers. No changes in insulin action or liver glucose metabolism were measured. in addition, it was shown that guar gum reduces food intake in STZ diabetic rats. Mild reductions in food intake in STZ diabetic rats were shown to increase insulin action. In summary, STZ diabetic rats fed high carbohydrate, high fibre diets reductions in food consumption and slowed carbohydrate absorption are important factors which may lower blood glucose concentrations and increase insulin action. increased SCFA production is unlikely to contribute significantly to the improvements in insulin action.

<p>The primary aim was to register the incidence of surgical wound infections (SWI) in sternotomy and leg incisions and potential risk factors for SWI following coronary artery by-pass graft (CAGB) procedures. Patients’ perspectives of SWI and the subsequent treatment were also considered. </p><p>Risk factors were registered for 374 patients. Patients were contacted by telephone 30 and 60 days after surgery and interviewed according to a questionnaire about symptoms and signs of wound infections. SWI was defined according to The Centers for Disease Control. Patients with mediastinitis were also interviewed within four months about how they experienced care, how they coped and how they thought the mediastinitis would influence their future life. </p><p>SWIs were diagnosed in 30 % of the patients. Seventy-three percent of the SWIs of the leg were diagnosed within 30 days of surgery and 27% were diagnosed within 31 to 60 days. Female gender and use of a monofilament suture for skin closure were the most important risk factors for SWI of the leg. Low preoperative haemoglobin concentration was the most important risk factor for sternal SWI. Patients with mediastinitis had higher BMI and had more often received erythrocyte transfusions on postoperative day 2 or later than those without infections. Patients without a diagnosis of diabetes who had increased blood glucose concentrations during the intermediate postoperative period had an increased risk of mediastinitis. It was not possible to separate the effect of diabetes as a risk factor for SWI from that of hyperglycaemia as such. Patients’ experiences were influenced by the staffs’ medical knowledge, how care was given and how well information was provided. Perceived danger and stress influenced how they coped with the situation. The patients believed that the mediastinitis would not affect the final outcome of the CABG procedure, even though their confidence in this was influenced by uncertainties about the rehabilitation process.</p>

Thesis (Ph.D. (Electronical Engineering))--North-West University, Potchefstroom Campus, 2008.

The primary aim was to register the incidence of surgical wound infections (SWI) in sternotomy and leg incisions and potential risk factors for SWI following coronary artery by-pass graft (CAGB) procedures. Patients’ perspectives of SWI and the subsequent treatment were also considered. Risk factors were registered for 374 patients. Patients were contacted by telephone 30 and 60 days after surgery and interviewed according to a questionnaire about symptoms and signs of wound infections. SWI was defined according to The Centers for Disease Control. Patients with mediastinitis were also interviewed within four months about how they experienced care, how they coped and how they thought the mediastinitis would influence their future life. SWIs were diagnosed in 30 % of the patients. Seventy-three percent of the SWIs of the leg were diagnosed within 30 days of surgery and 27% were diagnosed within 31 to 60 days. Female gender and use of a monofilament suture for skin closure were the most important risk factors for SWI of the leg. Low preoperative haemoglobin concentration was the most important risk factor for sternal SWI. Patients with mediastinitis had higher BMI and had more often received erythrocyte transfusions on postoperative day 2 or later than those without infections. Patients without a diagnosis of diabetes who had increased blood glucose concentrations during the intermediate postoperative period had an increased risk of mediastinitis. It was not possible to separate the effect of diabetes as a risk factor for SWI from that of hyperglycaemia as such. Patients’ experiences were influenced by the staffs’ medical knowledge, how care was given and how well information was provided. Perceived danger and stress influenced how they coped with the situation. The patients believed that the mediastinitis would not affect the final outcome of the CABG procedure, even though their confidence in this was influenced by uncertainties about the rehabilitation process.

Bakgrund Diabetes typ II är ett globalt och nationellt växande hälsoproblem. Lågkolhydratkost har väckt debatt i samhället, men har enligt studier resulterat i gynnsamma effekter för patientgruppen. Socialstyrelsen rekommenderar måttlig lågkolhydratkost som en av flera primära alternativ till kosthållning för patienter med diabetes typ II. Syfte Att undersöka diabetessjuksköterskors attityd och kunskap gällande lågkolhydratkost vid diabetes typ II. Metod Kvalitativa semi-strukturerade intervjuer med sju diabetessjuksköterskor inom Uppsalas primärvård. Resultat Diabetessjuksköterskorna hade observerat positiva effekter i sitt kliniska arbete av kolhydratreduktion, men ingen sjuksköterska gav måttlig lågkolhydratkost som rekommendation i första hand till patienterna. Farhågor för att lågkolhydratkost, främst orsakat av ett ökat fettintag, skulle kunna resultera i en ökning av risken för hjärt-kärlsjukdom eller andra negativa hälsoeffekter skildrades. Medvetenheten gällande kostrekommendationer och uppdateringen kring aktuell forskning varierade. Slutsats Medvetenhet och kunskap gällande lågkolhydratkost som kosthållning vid diabetes typ II varierade hos diabetessjuksköterskor inom Uppsalas primärvård. Generellt kunde en negativ attityd till lågkolhydratkost urskiljas. För att upprätthålla en evidensbaserad hälso- och sjukvård är det av största vikt att diabetessjuksköterskor får möjlighet att inom arbetsplatsen hålla sig uppdaterade om aktuella forskningsresultat samt att skapa reflektion kring vilken extern och intern påverkan sjuksköterskor kan exponeras för. / Background Diabetes type II is an increasing problem on a national and global scale. Low carbohydrate diets have created debate in today society, all though it has come to show positive effects in studies made on this patient group. In the national guidelines by The National Board of Health and Welfare moderate low-carbohydrate diet is described as a primary diet recommendation for patients with diabetes type II. Aim To investigate the attitude and knowledge of nursing staff towards low-carbohydrate diets as a method for patients with diabetes type II to achieve positive health benefits. Method Qualitative semi-structured interviews with seven nurses in district health centers in Uppsala, Sweden. Result The nursing staff had observed health benefits as a result from low-carbohydrate diets in their daily clinical work with patient suffering from diabetes type II, yet none of the nurses did suggest patients to eat according to this diet. Apprehensions that low-carbohydrate diets, and specifically the increased intake of fat, would contribute to an increased risk of heart disease or cause other harmful bodily effects over a long period of time were described. The awareness of national guidelines and recommendation did vary widely among the nurses. Conclusion Awareness and knowledge regarding a low carbohydrate diet when it comes to patients with diabetes type II ranged with the diabetic nurses in Uppsala Primary Care. Generally, a negative attitude towards low carbohydrate diet could be distinguished. To maintain an evidence-based health care, it is important that diabetes nurses have the opportunity to be updated of current research and to make reflections on what kind of external and internal influences nurses may be exposed to.