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Escore Finlandês de Risco de Diabetes - FINDRISC tradução e adaptação transcultural, estudo de prevalência e aplicações /Barim, Estela Maria January 2019 (has links)
Orientador: Kátia Cristina Portero McLellan / Resumo: BARIM, E.M. Escore Finlandês de Risco de Diabetes - FINDRISC: tradução e adaptação transcultural, estudo de prevalência e aplicações. 2019. 132f. Tese (Doutorado) – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, 2019. O diabetes mellitus tipo 2 (DM2) é um problema de saúde pública a nível mundial. Existem evidências que mudanças no estilo de vida podem prevenir ou retardar o desenvolvimento de DM2 em indivíduos com risco elevado de desenvolver a doença. O Escore Finlandês de Risco de Diabetes - FINDRISC é um instrumento de rastreamento não invasivo desenvolvido com o objetivo de predizer o desenvolvimento de DM2 no futuro e vem sendo usado em diferentes países. Com o decorrer do tempo o FINDRISC também passou a ser utilizado para predizer e/ou rastrear diferentes afecções. Os objetivos desta tese foram (i) traduzir e adaptar transculturalmente a versão original do FINDRISC para o português brasileiro e avaliar a sua confiabilidade; (ii) estratificar os usuários de um centro de atenção primária quanto ao risco de desenvolver DM2 utilizando o FINDRISC e investigar os fatores associados com risco alto e muito alto; e (iii) mapear as aplicações do FINDRISC através da realização de uma revisão integrativa da literatura. Três manuscritos compuseram essa tese. O primeiro manuscrito descreveu o processo de tradução e adaptação transcultural da versão original do FINDRISC para o português do Brasil de acordo com as recomendações desenvolvidas pela força t... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: BARIM, E.M. Finnish Diabetes Risk Score - FINDRISC: translation and cross-cultural adaptation, cross-sectional study and clinical uses. 2019. 132 pages (PhD Thesis) - São Paulo State University - UNESP, Medical School, Botucatu, 2019. Type 2 diabetes mellitus (T2DM) is a public health problem worldwide. There is evidence that lifestyle changes can prevent or delay the onset of T2DM for individuals at high risk for T2DM. The Finnish Diabetes Risk Score - FINDRISC is a non-invasive screening tool initially developed to predict the risk of developing T2DM in adults and it has been used in different countries. Over time, FINDRISC has also been used to predict and detect different conditions. The aims of this thesis were (i) to describe the process of translation and cross-cultural adaptation of the original version of FINDRISC into Brazilian Portuguese and to assess its reliability; (ii) to stratify users of a primary care center according to their risk of developing T2DM using the FINDRISC questionnaire and investigate factors associated with high and very high-risk score (FINDRISC≥15 points); and (iii) to map the applications of the FINDRISC questionnaire by performing an integrative literature review. The first manuscript described the process of translation and cross-cultural adaptation of the original version of the FINDRISC questionnaire into Brazilian Portuguese in accordance with the recommendations developed by the International Society for Pharmacoeconomics and Outcomes... (Complete abstract click electronic access below) / Doutor
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Assessment of risk and prevention of type 2 diabetes in primary health careSaaristo, T. (Timo) 06 December 2011 (has links)
Abstract
Type 2 diabetes is one of the fastest increasing lifestyle diseases globally. Its cure is not yet possible, but there is firm evidence from scientific studies that it can effectively be prevented by lifestyle changes. There is limited evidence-based information on the prevention of diabetes in practice. This dissertation offers new desirable information on the issue.
The aim of this dissertation study was to describe the prevalence of risk factors for type 2 diabetes and hidden glucose disorders predicting the development of diabetes in the Finnish adult population, and to analyse whether the risk for developing diabetes could be reduced by simple lifestyle counselling. Furthermore, the ability of the Finnish Diabetes Risk Score (FINDRISC) to detect glucose disorders leading to diabetes and undiagnosed diabetes was analysed. In the dissertation data from large Finnish population surveys (the FINRISK 2002 glucose tolerance survey and the FIN-D2D 2004−2005 survey) were analysed. In addition, a prospective design and large-scale intervention were included.
We found that obesity and glucose disorders are very common in the Finnish middle-aged population. Prevalence of obesity was 24% for men and 28% for women, that of abnormal glucose metabolism 42% for men and 33% for women, and that of undiagnosed diabetes 9% for men and 7% for men. One quarter of individuals aged 45−64 years were at high risk for diabetes. Lifestyle interventions were offered to more than 10,000 high-risk individuals, 3,379 men and 6,770 women. Of the men, 43% were also at high risk for cardiovascular morbidity and 42% at high risk for cardiovascular mortality estimated through the FRAMINGHAM and SCORE risk engines, respectively. The FINDRISC, originally developed for predicting the risk of development of type 2 diabetes, also predicted the prevalence of diabetes in the population.
The effect of lifestyle interventions on weight and its association with glucose tolerance was evaluated in individuals at high risk for diabetes in a one-year follow-up. In total 17.5% of them lost ≥ 5% weight. Their relative risk for diabetes decreased 69% compared with the group that maintained their weight.
This study shows that FINDRISC predicts prevalent type 2 diabetes. A significant proportion of middle-aged Finnish population has a glucose disorder including undiagnosed type 2 diabetes. Lifestyle interventions in primary health care may promote weight loss, which decreases the risk of diabetes. / Tiivistelmä
Diabetes on yksi nopeimmin lisääntyvistä elintapasairauksista maailmassa. Sitä ei vielä voida parantaa, mutta tieteellisissä tutkimuksissa on kiistattomasti osoitettu, että sitä voidaan tehokkaasti ehkäistä elintapamuutoksilla. Diabeteksen ehkäisystä käytännössä on hyvin niukasti tutkimustietoa. Tämä väitöskirja tuo kaivattua lisätietoa aiheesta.
Väitöstutkimuksen päätavoitteena oli selvittää diabeteksen riskitekijöiden ja piilevien diabetesta ennakoivien sokerihäiriöiden yleisyyttä suomalaisessa aikuisväestössä. Tämän ohella tavoitteena oli selvittää voidaanko yksinkertaisella elintapaneuvonnalla vähentää sellaisten henkilöiden sairastumisvaaraa, joilla oli suuri riski sairastua diabetekseen. Lisäksi arvioitiin diabetesriskitestin kykyä tunnistaa ennakoivat sokerihäiriöt ja aiemmin tunnistamaton diabetes.
Tutkimuksessa käytettiin laajoja suomalaisia väestötutkimusaineistoja: FINRISKI-2002 -tutkimusta, sen alaotosta ja D2D-väestötutkimusta 2004–2005. Mukana oli myös pitkittäisasetelma ja laajamittainen interventio.
Tutkimuksen perusteella huomasimme, että lihavuus ja sokerihäiriöt ovat hyvin yleisiä keski-ikäisillä suomalaisilla. Merkittävästi lihavia (BMI ≥ 30 kg/m2) oli 24 % miehistä ja 28 % naisista ja poikkeava sokeriaineenvaihdunta oli 42 %:lla miehistä ja 33 %:lla naisista. Tunnistamaton diabetes oli 9 %:lla miehistä ja 7 %:lla naisista. Suuressa diabetekseen sairastumisvaarassa oli neljäsosa 45−64-vuotiaista. Interventioon otettiin yli 10 000 suuressa diabeteksen sairastumisriskissä olevaa henkilöä, 3 379 miestä ja 6 770 naista. Miehistä 43 % oli suuressa sairastumisvaarassa myös sydän- ja verisuonisairauteen ja 42 % suuressa kuolemanvaarassa Framingham- ja SCORE-riskilaskureilla arvioituna. Tyypin 2 diabeteksen sairastumisriskin arviointiin kehitetty Riskitesti ennusti hyvin myös diabeteksen esiintymistä väestössä.
Elintapainterventioiden vaikutusta painoon ja sokeriaineenvaihduntaan analysoitiin vuoden seurannassa sellaisilla henkilöillä, joilla oli suuri diabetesriski. Paino laski 5 % tai enemmän 17,5 %:lla, jolloin sairastumisriski diabetekseen väheni 69 % verrattuna ryhmään, jonka paino ei muuttunut.
Tutkimuksen perusteella lihavuus, sokerihäiriöt ja tunnistamaton diabetes ovat yleisiä keski-ikäisessä väestössä. Riskitesti on hyvä työkalu myös diabeteksen seulonnassa. Perusterveydenhuollossa tarjottavalla elintapaneuvonnalla voidaan saada aikaan laihtuminen, joka vähentää sairastumisvaaraa diabetekseen.
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