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  1. Article ; Online: Diabetic microvascular disease in non-classical beds: the hidden impact beyond the retina, the kidney, and the peripheral nerves.

    Mauricio, Dídac / Gratacòs, Mònica / Franch-Nadal, Josep

    Cardiovascular diabetology

    2023  Volume 22, Issue 1, Page(s) 314

    Abstract: Diabetes microangiopathy, a hallmark complication of diabetes, is characterised by structural and functional abnormalities within the intricate network of microvessels beyond well-known and documented target organs, i.e., the retina, kidney, and ... ...

    Abstract Diabetes microangiopathy, a hallmark complication of diabetes, is characterised by structural and functional abnormalities within the intricate network of microvessels beyond well-known and documented target organs, i.e., the retina, kidney, and peripheral nerves. Indeed, an intact microvascular bed is crucial for preserving each organ's specific functions and achieving physiological balance to meet their respective metabolic demands. Therefore, diabetes-related microvascular dysfunction leads to widespread multiorgan consequences in still-overlooked non-traditional target organs such as the brain, the lung, the bone tissue, the skin, the arterial wall, the heart, or the musculoskeletal system. All these organs are vulnerable to the physiopathological mechanisms that cause microvascular damage in diabetes (i.e., hyperglycaemia-induced oxidative stress, inflammation, and endothelial dysfunction) and collectively contribute to abnormalities in the microvessels' structure and function, compromising blood flow and tissue perfusion. However, the microcirculatory networks differ between organs due to variations in haemodynamic, vascular architecture, and affected cells, resulting in a spectrum of clinical presentations. The aim of this review is to focus on the multifaceted nature of microvascular impairment in diabetes through available evidence of specific consequences in often overlooked organs. A better understanding of diabetes microangiopathy in non-target organs provides a broader perspective on the systemic nature of the disease, underscoring the importance of recognising the comprehensive range of complications beyond the classic target sites.
    MeSH term(s) Humans ; Microcirculation ; Diabetes Mellitus ; Diabetic Angiopathies ; Hyperglycemia ; Retina ; Kidney ; Microvessels ; Peripheral Nerves
    Language English
    Publishing date 2023-11-15
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2093769-6
    ISSN 1475-2840 ; 1475-2840
    ISSN (online) 1475-2840
    ISSN 1475-2840
    DOI 10.1186/s12933-023-02056-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Moving from the stratification of primary and secondary prevention of cardiovascular risk in diabetes towards a continuum of risk: need for a new paradigm.

    Garcia-Moll, Xavier / Barrios, Vivencio / Franch-Nadal, Josep

    Drugs in context

    2021  Volume 10

    Abstract: Traditionally, patients with type 2 diabetes have been stratified according to cardiovascular (CV) risk to requiring either primary prevention (those without atherosclerotic CV disease) or secondary prevention (those with atherosclerotic CV disease in ... ...

    Abstract Traditionally, patients with type 2 diabetes have been stratified according to cardiovascular (CV) risk to requiring either primary prevention (those without atherosclerotic CV disease) or secondary prevention (those with atherosclerotic CV disease in any of the vascular beds). However, this classification is misleading and arbitrary, as not all patients requiring secondary prevention have the same risk for such events, which also holds true for those requiring primary prevention (i.e. CV risk ranges from moderate to very high). In addition, in some cases, the definitions of primary and secondary prevention do not rely on symptoms but rather on the results of supplementary tests. Furthermore, patients with type 2 diabetes may also develop heart failure or chronic kidney disease. Importantly, reducing CV risk stratification to primary and secondary prevention does not provide a comprehensive approach for the management of patients with diabetes, leading to an underuse of drugs with proven CV benefit regardless of the presence of atherosclerotic CV disease. Therefore, patients with diabetes should be treated according to their CV risk considered as a continuum and not simply as falling within primary or secondary prevention.
    Language English
    Publishing date 2021-08-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2021-6-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Clinical characteristics and degree of cardiovascular risk factor control in patients with newly-diagnosed type 2 diabetes in Catalonia.

    Ramírez-Morros, Anna / Franch-Nadal, Josep / Real, Jordi / Miró-Catalina, Queralt / Bundó, Magdalena / Vlacho, Bogdan / Mauricio, Didac

    Frontiers in endocrinology

    2024  Volume 15, Page(s) 1339879

    Abstract: Introduction: Women with type 2 diabetes mellitus (T2DM) face a greater risk of cardiovascular disease (CVD) and encounter challenges in managing cardiovascular risk factors (CVRF); however, limited data are available in individuals with newlydiagnosed ... ...

    Abstract Introduction: Women with type 2 diabetes mellitus (T2DM) face a greater risk of cardiovascular disease (CVD) and encounter challenges in managing cardiovascular risk factors (CVRF); however, limited data are available in individuals with newlydiagnosed T2DM.
    Methods: This study aimed to examine differences between women and men at the onset of T2DM in terms of clinical characteristics, glycaemic status, and CVRF management. This was a retrospective cohort study including subjects with newly-diagnosed T2DM from the System for the Development of Research in Primary Care (SIDIAP) database in Catalonia (Spain). Sex differences (Dif) were assessed at baseline and 1-year post-diagnosis, by calculating the absolute difference of means or proportions.
    Results: A total of 13,629 subjects with newly-diagnosed T2DM were analyzed. Women were older and had a higher BMI than men. At baseline, women had higher total cholesterol [Dif (95%CI) 10 mg/dL (9.1/10.8)] and low-density lipoprotein cholesterol (LDL-c) [Dif (95%CI) 7 mg/dL (6.3/7.7)], while men had higher rates of smoking and alcohol intake. Lipid target achievement was lower in women, in both primary prevention (LDL-c < 100 mg/dL) [Dif (95%CI) -7.3 mg/dL (-10.5/-4.1)] and secondary prevention (LDL-c < 70 mg/dL) [Dif (95%CI) -8.3 mg/dL (-17.3/0.7)], along with lower statin and antiplatelet prescriptions, especially one year after diagnosis. Changes in clinical and laboratory data one year post-diagnosis revealed that, in the primary prevention group, men experienced greater improvements in total cholesterol, LDL-c and triglycerides, while women had less success in achieving CVRF control targets compared to men. Additionally, cardiovascular events, such as coronary artery disease and peripheral artery disease increased more in men than in women within the first year of diagnosis, especially in primary prevention subjects.
    Conclusion: Differences between men and women CVRF are already apparent at the onset of T2DM, particularly in primary prevention, with notable differences in lipid profile and target level attainment.
    MeSH term(s) Humans ; Female ; Male ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Spain/epidemiology ; Cholesterol, LDL ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/epidemiology ; Retrospective Studies ; Risk Factors ; Heart Disease Risk Factors
    Chemical Substances Cholesterol, LDL
    Language English
    Publishing date 2024-02-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2024.1339879
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Trends in the prevalence of gestational diabetes in Catalonia from 2010 to 2019.

    Soldevila, Berta / Alarcón, Lourdes / Vlacho, Bogdan / Real, Jordi / Hernández, Marta / Cos, Xavier / Franch-Nadal, Josep / Mauricio, Dídac

    Primary care diabetes

    2024  Volume 18, Issue 2, Page(s) 169–176

    Abstract: Introduction: Gestational diabetes mellitus (GDM) is globally increasing due to changes in risk factors such as gestational age, obesity, and socioeconomic status (SES). This study examined trends of GDM prevalence over ten years using a real-world ... ...

    Abstract Introduction: Gestational diabetes mellitus (GDM) is globally increasing due to changes in risk factors such as gestational age, obesity, and socioeconomic status (SES). This study examined trends of GDM prevalence over ten years using a real-world Primary Health Care database from Catalonia (Spain).
    Methods: A retrospective analysis of pregnant women screened for GDM was conducted, using clinical and SES data from the SIDIAP database.
    Results: Among 221,806 women studied from 2010 to 2019,17,587 had GDM, equating to a 7.9% prevalence (95% CI 7.8-8.04). GDM subjects were older (33.5 ± 5.1 vs. 31.2 ± 5.6 years; p < 0.001) and had higher BMI (29.2 ± 5.1 vs .27.8 ± 4.8 kg/m²; p < 0.001) than non-GDM individuals. Overall GDM prevalence remained unchanged throughout the study, although an increase was observed in younger women (below 20 years: 1.28% [95% CI 0.59-2.42] in 2010 to 2.22% [95% CI 0.96-4.33] in 2019, p = 0.02; ages 20-25.9 years: 3.62% [95% CI 3.12-4.17] in 2010 to 4.63% [95% CI 3.88-5.48)] in 2019, p = 0.02). Age, BMI ≥ 25 kg/m2, deprived SES, and previous hypertension and dyslipidaemia were positively associated with GDM.
    Conclusions: This study offers insights into GDM prevalence in Catalonia (Spain),showing overall stability except for a rising trend among younger women.
    MeSH term(s) Pregnancy ; Female ; Humans ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/epidemiology ; Spain/epidemiology ; Retrospective Studies ; Prevalence ; Obesity/diagnosis ; Obesity/epidemiology ; Obesity/complications ; Risk Factors
    Language English
    Publishing date 2024-01-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2273997-X
    ISSN 1878-0210 ; 1751-9918
    ISSN (online) 1878-0210
    ISSN 1751-9918
    DOI 10.1016/j.pcd.2023.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Diabetes and tuberculosis: A syndemic complicated by COVID-19.

    Antonio-Arques, Violeta / Franch-Nadal, Josep / Caylà, Joan A

    Medicina clinica (English ed.)

    2021  Volume 157, Issue 6, Page(s) 288–293

    Abstract: Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an ... ...

    Abstract Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an important risk factor for developing TB, also presenting more complicated TB, more relapses and higher mortality. The DCs and the fourth world of the large cities are those with the highest incidence of TB and an increase in DM, which will make it difficult to control tuberculosis disease. At the same time, the COVID-19 pandemic is complicating the management of both diseases due to the difficulty of access to control and treatment and the worsening of socioeconomic inequalities. It is necessary to establish a bidirectional screening for TB and DM and promote recommendations for the joint management of both diseases.
    Language English
    Publishing date 2021-09-11
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 2387-0206
    ISSN (online) 2387-0206
    DOI 10.1016/j.medcle.2021.04.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Diabetes and tuberculosis: a syndemic complicated by COVID-19.

    Antonio-Arques, Violeta / Franch-Nadal, Josep / Caylà, Joan A

    Medicina clinica

    2021  Volume 157, Issue 6, Page(s) 288–293

    Abstract: Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an ... ...

    Title translation Diabetes y tuberculosis: una sindemia complicada por la COVID-19.
    Abstract Tuberculosis (TB) is the leading cause of infectious mortality in the world, affecting mainly developing countries (DC), while diabetes (DM) is one of the most prevalent chronic diseases. This review analyzes the fact that diabetes is currently an important risk factor for developing TB, also presenting more complicated TB, more relapses and higher mortality. The DCs and the fourth world of the large cities are those with the highest incidence of TB and an increase in DM, which will make it difficult to control tuberculosis disease. At the same time, the COVID-19 pandemic is complicating the management of both diseases due to the difficulty of access to control and treatment and the worsening of socioeconomic inequalities. It is necessary to establish a bidirectional screening for TB and DM and promote recommendations for the joint management of both diseases.
    MeSH term(s) COVID-19 ; Diabetes Mellitus/epidemiology ; Humans ; Pandemics ; Risk Factors ; SARS-CoV-2 ; Syndemic ; Tuberculosis/complications ; Tuberculosis/diagnosis ; Tuberculosis/epidemiology
    Language Spanish
    Publishing date 2021-05-06
    Publishing country Spain
    Document type Journal Article ; Review
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2021.04.004
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  7. Article: Sex Differences in Cardiovascular Prevention in Type 2: Diabetes in a Real-World Practice Database.

    Ramírez-Morros, Anna / Franch-Nadal, Josep / Real, Jordi / Gratacòs, Mònica / Mauricio, Didac

    Journal of clinical medicine

    2022  Volume 11, Issue 8

    Abstract: Women with type 2 diabetes mellitus (T2DM) have a 40% excess risk of cardiovascular diseases (CVD) compared to men due to the interaction between sex and gender factors in the development, risk, and outcomes of the disease. Our aim was to assess ... ...

    Abstract Women with type 2 diabetes mellitus (T2DM) have a 40% excess risk of cardiovascular diseases (CVD) compared to men due to the interaction between sex and gender factors in the development, risk, and outcomes of the disease. Our aim was to assess differences between women and men with T2DM in the management and degree of control of cardiovascular risk factors (CVRF). This was a matched cross-sectional study including 140,906 T2DM subjects without previous CVD and 39,186 T2DM subjects with prior CVD obtained from the System for the Development of Research in Primary Care (SIDIAP) database. The absolute and relative differences between means or proportions were calculated to assess sex differences. T2DM women without previous CVD showed higher levels of total cholesterol (12.13 mg/dL (0.31 mmol/L); 95% CI = 11.9−12.4) and low-density lipoprotein cholesterol (LDL-c; 5.50 mg/dL (0.14 mmol/L); 95% CI = 5.3−5.7) than men. The recommended LDL-c target was less frequently achieved by women as it was the simultaneous control of different CVRF. In secondary prevention, women showed higher levels of total cholesterol (16.89 mg/dL (0.44 mmol/L); 95% CI = 16.5−17.3), higher levels of LDL-c (8.42 mg/dL (0.22 mmol/L); 95% CI = 8.1−8.8), and higher levels of triglycerides (11.34 mg/dL (0.13 mmol/L); 95% CI = 10.3−12.4) despite similar rates of statin prescription. Recommended targets were less often achieved by women, especially LDL-c < 100 mg/dL (2.59 mmol/L). The composite control was 22% less frequent in women than men. In conclusion, there were substantial sex differences in CVRF management of people with diabetes, with women less likely than men to be on LDL-c target, mainly those in secondary prevention. This could be related to the treatment gap between genders.
    Language English
    Publishing date 2022-04-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11082196
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  8. Article: Correction: Ramírez-Morros et al. Sex Differences in Cardiovascular Prevention in Type 2: Diabetes in a Real-World Practice Database.

    Ramírez-Morros, Anna / Franch-Nadal, Josep / Real, Jordi / Gratacòs, Mònica / Mauricio, Didac

    Journal of clinical medicine

    2022  Volume 11, Issue 15

    Abstract: In the original publication [ ... ]. ...

    Abstract In the original publication [...].
    Language English
    Publishing date 2022-08-02
    Publishing country Switzerland
    Document type Published Erratum
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11154492
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Epidemiology of the first-ever cardiovascular event in people with type 1 diabetes: a retrospective cohort population-based study in Catalonia.

    Giménez-Pérez, Gabriel / Viñals, Clara / Mata-Cases, Manel / Vlacho, Bogdan / Real, Jordi / Franch-Nadal, Josep / Ortega, Emilio / Mauricio, Dídac

    Cardiovascular diabetology

    2023  Volume 22, Issue 1, Page(s) 179

    Abstract: Background: Knowledge of the characteristics of first-ever cardiovascular events in type 1 diabetes may impact primary prevention strategies. This study describes the first-ever manifestation of cardiovascular disease (CVD) in patients with type 1 ... ...

    Abstract Background: Knowledge of the characteristics of first-ever cardiovascular events in type 1 diabetes may impact primary prevention strategies. This study describes the first-ever manifestation of cardiovascular disease (CVD) in patients with type 1 diabetes (T1D) in Catalonia (Spain) and evaluates differences according to age and sex.
    Methods: Retrospective cohort study of patients with T1D > 30 years without CVD before 2010 registered in the SIDIAP database. The occurrence of a first cardiovascular event up to the end of 2016, the type of CV event and associations with baseline characteristics were analysed.
    Results: Of 8412 patients, 884 suffered a first CV event (incidence rate 1.62 per 100 persons-years). Overall, peripheral vascular disease (39.5%) was the most frequent event. We observed a higher proportion of heart failure in women (21.7%) than in men (10.1%). In women, heart failure was the most frequent event in those > 65 years (40.5%). Decreased glomerular filtration rate (hazard ratio [HR] 5.42 [95% CI 4.32;6.80]), elevated albumin/creatinine ratio (HR 3.39 [95% CI [2.47;4.66], microvascular complications (HR 3.27 [95% CI 2.85;3.75]), and hypertension (HR 3.21 [95% CI [2.80;3.67]) were most strongly associated with a first CV event. HbA1c > 7.0% was associated with incident CVD only in patients aged < 55/60 years.
    Conclusions: Peripheral artery disease in the whole cohort, and heart failure in elder subjects are the most frequent first-ever CVD events in T1D in our region. These findings deserve to be taken into account when considering primary prevention measures and when estimating CV risk in people with T1D.
    MeSH term(s) Male ; Humans ; Female ; Aged ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/epidemiology ; Retrospective Studies ; Spain/epidemiology ; Risk Factors ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Heart Failure/epidemiology ; Incidence
    Language English
    Publishing date 2023-07-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2093769-6
    ISSN 1475-2840 ; 1475-2840
    ISSN (online) 1475-2840
    ISSN 1475-2840
    DOI 10.1186/s12933-023-01917-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Adherence to the therapeutic guidelines recommendations among the people with type 2 diabetes mellitus and obesity, frailty, or recent diagnosis, attended in primary health care centers in Spain: A cross-sectional study.

    Vlacho, Bogdan / Mata-Cases, Manel / Fernandez-Camins, Berta / Romera Liébana, Laura / Barrot-de la Puente, Joan / Franch-Nadal, Josep

    Frontiers in medicine

    2023  Volume 10, Page(s) 1138956

    Abstract: Introduction: Clinical practice guidelines are helpful for clinicians, and their proper implementation could improve the quality of care and management of participants with diabetes. This study aimed to evaluate the degree of adherence to the Clinical ... ...

    Abstract Introduction: Clinical practice guidelines are helpful for clinicians, and their proper implementation could improve the quality of care and management of participants with diabetes. This study aimed to evaluate the degree of adherence to the Clinical Practice Guidelines (CPG) recommendations among obese, frail, or recently diagnosed type 2 diabetes mellitus (T2DM) participants in primary care centers in Spain.
    Methods: We perform a cross-sectional study on a national level in two phases. In the first phase, study participants were recruited, and their clinical data were collected. In the second phase, data related to the participating physicians were collected.
    Results: In total, 882 participants from 240 physicians were analyzed. According to the study questionnaire, most participants from all three clinical groups had adequate adherence to the CPG. This percentage was highest among the recently diagnosed T2DM (91.6%) and lowest percent of frail T2DM persons (74.7%). The inadequate adherence to the guidelines was observed mainly among the obese and frail participants with T2DM from medical doctors with low CPG knowledge (3.4% and 3.5%, respectively). Regarding the patient's characteristics and degree of adherence to the guidelines, the participants with inadequate adherence were generally older, with higher BMI, poorer HbA1c control, and fewer visits with primary care physicians. Most (57%) primary care physicians had moderate CPG knowledge. In our multivariable logistic model, we did not observe statistically significant odds ratios for different characteristics related to the physicians/consultation and low CPG knowledge.
    Discussion: The results of our cross-sectional study observe adequate adherence to the clinical guidelines by the primary care physicians for the majority of the participants with obesity, frailty, or newly diagnosed with T2DM.
    Language English
    Publishing date 2023-03-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2023.1138956
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