Time filter

Source Type

Ymittos Athens, Greece

Benroubi M.,Athens Polyclinic General Hospital
Diabetes Research and Clinical Practice

Diabetes self management education, the process of teaching individuals to manage their diabetes, has been considered the cornerstone of the clinical management of individuals with diabetes since the work of the Joslin Diabetes Center. The goals of self-management education are to optimize metabolic control, prevent acute and chronic complications, and optimize quality of life. The keystone to successful management is to involve the patient in his treatment. Clearly, factors other than knowledge and effective therapies affect the behaviors of patients and health care professionals and influence their ability to make optimal use of available treatments. The DAWN study has shown that both health care providers and patients may have a negative attitude toward starting insulin therapy. Patients with type 2 diabetes are very often reluctant to accept insulin therapy. The reasons most commonly encountered, for this negative attitude are:. Patients blame themselves, for they consider that starting insulin therapy would indicate they had " failed" proper diabetes self-management.For some patients taking insulin means life will be more restricted or it means they have reached their last resort.Fear of hypoglycemia is a very common barrier for insulin therapy.Physicians may, unconsciously, negatively influence their patients. For some physicians putting his patient on insulin, means that he has failed to control his patient's diabetes on oral agents and now has to force him in a troublesome therapeutic regime. In order to overcome these barriers, health care professionals, rather than trying to " convince" their patients of the necessity of the treatment, should assess, by active listening, the precise reason for which his/her patient denies it. © 2011 Elsevier Ireland Ltd. Source

Valassi E.,Hospital Sant Pau | Santos A.,Hospital Sant Pau | Yaneva M.,Medical University-Sofia | Toth M.,Semmelweis University | And 15 more authors.
European Journal of Endocrinology

Objective: The European Registry on Cushing's syndrome (ERCUSYN) is designed to collect prospective and follow-up data at EU level on Cushing's syndrome (CS). Design and methods: Baseline data on 481 CS patients (390 females, 91 males; mean age (±S.D.): 44 ±14 years) collected from 36 centres in 23 countries, including new patients from 2008 and retrospective cases since 2000. Patients were divided into four major aetiologic groups: pituitarydependent CS (PIT-CS) (66%), adrenal-dependent CS (ADR-CS) (27%), CS from an ectopic source (ECT-CS) (5%) and CS from other aetiologies (2%). Results: Proportion of men in the ECT-CS group was higher than in the other groups (P<0.05). The ADR-CS group was older than the PIT-CS (P<0.05). Prevalence of hirsutism (92%) and diabetes (74%) in ECT-CS was higher than in the other groups (P<0.05 and P<0.01 respectively). PIT-CS had more skin alterations, menstrual irregularities and hirsutism than ADR-CS (P<0.01). Reduced libido was more prevalent in men than women (P<0.01). Prevalence of spine osteoporosis was higher in men than women (P<0.05), and males had more vertebral and rib fractures than females (52 vs 18% for vertebrae; P<0.001 and 34 vs 23% for ribs; P<0.05). ECT-CS consulted a diabetologist more frequently than ADR-CS (P<0.05), while a gynaecologist was consulted more often by women with PIT-CS or ADR-CS than with ECT-CS (P<0.05). Overall, weight gain was more common in women than men (P<0.01). CushingQoL and EuroQoL visual analogue scale scores did not differ between the groups. Conclusions: The ERCUSYN project demonstrates a heterogeneous clinical presentation of CS at a European level, depending on gender and aetiology. © 2011 European Society of Endocrinology. Source

Discover hidden collaborations