[Contribution of post-breakfast plasma glucose to the glycemic control of type 2 diabetic patients]

Prevalence of cardiovascular risk factors among truck drivers in the South of Brazil

BACKGROUND

Truck drivers work under conditions that predispose them to a high prevalence of risk factors for the development of cardiovascular disease (CVD); however, these factors have not been fully evaluated and are not usually considered to be within the scope of health or labor services.

METHODS

An observational cross-sectional study was conducted on 250 long-distance truck drivers; the drivers were all male and were aged 18-60 years. The clinical evaluation consisted of an assessment of social habits and demographic data and an evaluation of risk factors for CVD at 3 time points separated by a one-week interval. To assess the associations with risk factors were used univariate and multivariate analysis. The suitability of the final model fit was assessed via the Hosmer-Lemeshow test. The significance level was set at 5%.

RESULTS

Among all of the subjects, the prevalence of physical inactivity was 72.8%; consumption of alcoholic beverages, 66.8%; routine use of some type of stimulant during work activities, 19.2%; and smoking, 29%. Only 20.8% had a healthy weight, and 58.2% had an abdominal circumference greater than 102 cm. A diagnosis of arterial hypertension was confirmed in 45.2%, and abnormal glucose levels were detected in 16.4%. Although some of the truck drivers were aware of these conditions, most were not taking specific medications. The logistic regression analysis shows that the odds of hypertension and abnormal glucose levels were increased in truck drivers with abdominal obesity. Age and the family history of premature CVD also increased the chances of hypertension and the abnormal blood glucose levels were related to II or III grade obesity.

CONCLUSION

Long-distance truck drivers showed a high prevalence of a cluster of cardiovascular risk factors; these risk factors make the drivers highly susceptible to the development of CVD. The associated risk factors, low compliance with drug treatment, and unique features of this profession suggest that traditional precautions are not sufficient to change this scenario.

[Post-prandial hyperglycemia in type 2 diabetes patients]

OBJECTIVES

Through the analysis of a group of type 2 diabetes patients, the aims of this study are: to evaluate through CGMS (continuous glucose monitoring system) the post-prandial subcutaneous glucose excursions; to analyze the correlations between subcutaneous glucose and capillary glycemia with HbA1c and to evaluate the effectiveness, safety and broad-mindedness of the CGMS.

METHODS

Forty type 2 diabetes patients were analyzed, with HbA1c until 7.3%, in use of oral agents and within less than a ten-year diagnosis. They were submitted to CGMS for 72 h, whose data were compared with HbA1c and capillary glycemia.

RESULTS

The average subcutaneous glucose excursion at breakfast was statistically bigger than at dinner (95%CI -24.96 a -1.66). The subcutaneous glucose excursion/meal carbohydrates content ratio was statistically bigger at breakfast than at other meals (p 0.001). There was no correlation between the levels of subcutaneous glucose and capillary glycemia with HbA1c. There were no complications using CGMS.

CONCLUSIONS

The subcutaneous glucose excursions were predominant at breakfast. There were no correlations between HbA1c and glycemic control parameters. CGMS showed itself efficient, secure and well tolerated in this group of patients.