Diabetes mellitus: el desafio del diagnóstico temprano, llegando antes de las complicaciones

Abstract

La Diabetes Mellitus enfermedad asociada a un disturbio metabólico con hiperglucemia crónica y defecto funcional de la insulina, que inadecuadamente tratada evoluciona a disfunciones y falla de varios órganos y sistemas y a un riesgo mayor de enfermedad endotelial prematura. La prevalencia va en aumento con un cálculo mundial estimativo de 450 millones de personas con Diabetes. El objetivo general de esta investigación es: Identificar en pacientes diabéticos y no diabéticos con antecedentes familiares que concurren a efectores de salud de la ciudad de Santa Fe y de otras como San Justo, Reconquista, Esperanza, Rafaela, Súnchales y municipios relacionados con la FCM UNL, presencia de parámetros clínicos llamados bioindicadores de distrés metabólico modificables, estableciendo relación entre la presencia de los mismos y los comportamientos evolutivos de la DBT como enfermedad crónica. Determinar el grado de influencia del Distres metabólico en los pacientes con complicaciones y correlacionar el mismo con la aparición y grado de severidad de complicaciones y respuesta terapéutica. Se pretende realizar un relevamiento epidemiológico de personas con Diabetes y probabilidad de enfermarse por antecedentes, mediante una evaluación clínica que incluiría: entrevista clínica con entrega de información e invitación a participación en el proyecto avalando con la firma de un consentimiento informado que estará validado por el comité de ética de la FCM. Posterior a la firma se realizarían estudios protocolizados con inclusión de parámetros bioquímicos, biomarcadores reconocidos genéticos y bioindicadores clínicos. También se plantea dentro de esta investigación, trabajar en la educación a la población mediante actividades relacionadas con capacitaciones a personas con riesgo y a pacientes para el autocuidado y prevención de complicaciones, así como también, capacitaciones al equipo de salud acerca del Distres y sus implicancias metabólicas para acciones comunitarias y e individuales que mejoren la vida de la población de Diabetes.

Diabetes Mellitus is a disease associated with a metabolic disorder with chronic hyperglycemia and a functional insulin defect that, if inadequately treated, evolves into dysfunction and failure of various organs and systems and a greater risk of premature endothelial disease. The prevalence is increasing with an estimated global estimate of 450 million people with Diabetes. Multisystem involvement implies an interactive therapeutic approach by a multidisciplinary team. The present project involves the work of an interdisciplinary team with expertise from participation in basic, clinical and translational research related to Diabetes that raises the hypothesis that the application of innovative strategies, applicable at the first level of care, related to genetics and epigenetics Using the identification of early parameters of metabolic distress with biomarkers and bio indicators (whose clinical usefulness needs to be validated in early and late stages), the evolution of complications with such high costs for the patient and the health system could be avoided. The general objective of this research is: Identify in diabetic and non-diabetic patients with a family history those who attend health providers in the city of Santa Fe and others such as San Justo Reconquista, Esperanza Rafaela Súnchales and municipalities related to the FCM UNL presence of clinical parameters called bio indicators of modifiable metabolic distress, establishing relationship between their presence and the evolutionary behaviors of DBT as a chronic disease. Determine the degree of influence of metabolic distress in patients with complications and correlate it with the appearance and degree of severity of complications and therapeutic response. Within the specific objectives Reflective bibliographic update by responsible group Implementation of a protocol for: -Conduct a survey with the probability of being diabetic and with a diagnosis of DBT Metabolic distress in people who attend clinics in cities and municipalities of the province of Santa Fe related to the FCM UNL -Epidemiological survey of people with Diabetes and probability of becoming ill due to a history through a clinical evaluation that would include: clinical interview with delivery of information and invitation to participate in the project endorsed by the signing of an informed consent Dependencia: Secretaria de Ciencia, Bv. Pellegrini 2750 S3000ADQ Santa Fe Arte y Tecnología Tel: (0342) 457 1110 int.: 195 Email: cienciaytecnica@unl.edu.ar that is validated by the ethics committee of the FCM. -After signing, protocol zed studies would be carried out with the inclusion of biochemical parameters, recognized genetic biomarkers and clinical bio indicators. It is also proposed within this research *Education of the population through activities related to training for people at risk and patients for self-care and prevention of complications, as well as training for the health team about Distress and its metabolic implications for community and individual actions that improve the lives of people. the Diabetes population. *Statistical analysis and validation of the data obtained from observation, clinical evaluation, complementary studies and biochemical determinations, with which a database will be built for subsequent statistical evaluation, taking the necessary precautions to guarantee confidentiality. of the data in order to contemplate the principles of the National Personal Data Protection Laws and the Patient Rights Law in their relationship with health professionals and institutions. The data generated will be subjected to a validation process. The variables will be studied to determine those that will intervene in the statistical model and modify some of their parameters in order to carry out simulations that allow predicting different experimental situations. This stage will be carried out in the clinical biostatistics unit of the Faculty of Medical Sciences of the National University of the Litoral. *Generation and Participation in multicenter studies related to metabolic distress, diabetic foot, diabetic nephropathy, diabetic retinopathy, polyneuropathy and neurocognitive impairment in diabetics. *Dissemination of results through courses to health professionals, preparation of publications, attendance at conferences, status reports and final results of the research. *Participation in education and concentration programs for health team professionals and the entire community