The majority of patients did not meet metabolic control goals and a substantial proportion was not screened for diabetic complications. These issues may increase the risk of chronic complications and negatively impact public health.

BackgroundStudies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation.MethodsThis study presents cross sectional, baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications.ResultsPatients with ulcer had longer disease duration (17.2 ± 9.9 vs. 13.2 ± 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 ± 2.03 vs. 8.35 ± 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2–3.7), smoking (OR 1.78; 95 % CI 1.09–2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31–44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47–3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08–2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65–13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2–3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01–11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43–112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14–0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1–4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67–19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64–7.33). There was no association between either outcome and ethnicity.ConclusionsUlcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population.

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Blood Pressure, Capilar Glucose and Anthropometric Measures in a Yanomámi Population. Cad. Saúde Públ., Rio de Janeiro, 9 (4): 428-438, oct/dec, 1993. Seventy-two Yanomámi Indians from Surucucus, Roraima, Brazil, were examined

Type 1 diabetes (T1D) is characterized by an immuno-mediated progressive destruction of the pancreatic β cells. Due to the ability of NK cells to kill target cells as well as to interact with antigen-presenting and T cells, it has been suggested that they could be involved in one or multiple steps of the immune-mediated attack that leads to T1D. Abnormalities in the frequency and activity of NK cells have been described both in animal models and patients with T1D. Some of these alterations are linked to its onset while others seem to be a consequence of the disease. Here, we discuss the main characteristics of NK cells and review the studies that investigated the role of NK cells in T1D, both in mouse models and humans.

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TSH levels of 0.4-2.5 mU/l are associated with a lower risk of diabetic retinopathy and renal failure in individuals with Type 1 diabetes, independently of glycaemic control and duration of the disease.

RESUMOA cetoacidose diabética é uma complicação aguda do Diabetes Mellitus (DM) caracterizada por hiperglicemia, acidose metabólica, desidratação e cetose, na vigência de deficiência profunda de insulina. Acomete principalmente pacientes com DM tipo 1 e geralmente é precipitada por condições infecciosas, uso inadequado de insulina ou desconhecimento do diagnóstico de diabetes. Os autores revisam mecanismos fisiopatológicos, critérios diagnósticos e opções terapêuticas do distúrbio em adultos, bem como suas possíveis complicações. ACETOACIDOSE DIABÉTICA (CAD) é uma complicação aguda do Diabetes Mellitus (DM) caracterizada por hiperglicemia, acidose metabólica, desidratação e cetose, na vigência de deficiência profunda de insulina. Acomete principalmente pacientes com DM tipo 1 (DM1) e geralmente é precipitada por condições infecciosas ou omissão da administração de insulina. Por vezes, a CAD pode ser a forma de apresentação clínica inicial do DM1 ou mesmo do tipo 2 (DM2). A CAD é observada ao diagnóstico de DM1 em 3 a 40% dos pacientes diagnosticados com DM1 (1-4). Recentemente, identificamos que, em nossa população, essa freqüência é de 32,8% (5).Estima-se que a CAD tenha uma incidência anual de cerca de 1 a 5% da população, sem alterações significativas nos últimos anos (2). Existe uma incidência de CAD discretamente maior no sexo feminino, principalmente entre os adolescentes (6). No Brasil, existem poucos dados nacionais de incidência dessa complicação aguda (7-9).Se diagnosticada e tratada de forma rápida e correta, a CAD tem bom prognóstico, sendo prontamente revertida na maioria das vezes (10). A mor-