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  1. Article: Effect of night-shift work on cortisol circadian rhythm and melatonin levels.

    Brum, Maria Carlota Borba / Senger, Martha Bergan / Schnorr, Claudia Carolina / Ehlert, Lethicia Rozales / Rodrigues, Ticiana da Costa

    Sleep science (Sao Paulo, Brazil)

    2022  Volume 15, Issue 2, Page(s) 143–148

    Abstract: Objectives: Night-shift work has been associated with several negative effects on worker's health, possibly due to circadian desynchronization, sleep deprivation and suppression of nocturnal melatonin secretion including exposure to light during the ... ...

    Abstract Objectives: Night-shift work has been associated with several negative effects on worker's health, possibly due to circadian desynchronization, sleep deprivation and suppression of nocturnal melatonin secretion including exposure to light during the work shift. The objective of this study was to evaluate the impact of fixed night-shift work versus day-shift work on the sleep-wake cycle and on the night and day levels of cortisol and melatonin.
    Material and methods: Saliva samples were obtained from 36 individuals, 19 day workers (12 women and 7 men) and 17 night workers (12 women and 5 men) from a university hospital in southern Brazil, with no history of chronic diseases. Demographic and personal information were obtained through a self-administered questionnaire and sleep information by the Munich chronotype questionnaire.
    Results: Salivary cortisol showed normal circadian rhythm in day- and night-shift workers, but was attenuated in night-shift workers during their working hours and on leave days. Night workers sleep fewer hours at night and have higher negative social jet lag than day workers.
    Conclusion: Intervals between night shifts can be beneficial for the recovery of the hypothalamic-pituitary-adrenal axis, minimizing the negative effects on workers' health, in addition to a preventive approach to aspects related to sleep hygiene and healthy life habits.
    Language English
    Publishing date 2022-06-21
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2697016-8
    ISSN 1984-0063 ; 1984-0659
    ISSN (online) 1984-0063
    ISSN 1984-0659
    DOI 10.5935/1984-0063.20220034
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  2. Article: Ketoconazole as second-line treatment for Cushing's disease after transsphenoidal surgery: systematic review and meta-analysis.

    Viecceli, Camila / Mattos, Ana Carolina Viana / Hirakata, Vânia Naomi / Garcia, Sheila Piccoli / Rodrigues, Ticiana da Costa / Czepielewski, Mauro Antônio

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1145775

    Abstract: Introduction: The first-line treatment for Cushing's disease is transsphenoidal surgery for pituitary tumor resection. Ketoconazole has been used as a second-line drug despite limited data on its safety and efficacy for this purpose. The objective of ... ...

    Abstract Introduction: The first-line treatment for Cushing's disease is transsphenoidal surgery for pituitary tumor resection. Ketoconazole has been used as a second-line drug despite limited data on its safety and efficacy for this purpose. The objective of this meta-analysis was to analyze hypercortisolism control in patients who used ketoconazole as a second-line treatment after transsphenoidal surgery, in addition to other clinical and laboratory criteria that could be related to therapeutic response.
    Methods: We searched for articles that evaluated ketoconazole use in Cushing's disease after transsphenoidal surgery. The search strategies were applied to MEDLINE, EMBASE, and SciELO. Independent reviewers assessed study eligibility and quality and extracted data on hypercortisolism control and related variables such as therapeutic dose, time, and urinary cortisol levels.
    Results: After applying the exclusion criteria, 10 articles (one prospective and nine retrospective studies, totaling 270 patients) were included for complete data analysis. We found no publication bias regarding reported biochemical control or no biochemical control (p = 0.06 and p = 0.42 respectively). Of 270 patients, biochemical control of hypercortisolism occurred in 151 (63%, 95% CI 50-74%) and no biochemical control occurred in 61 (20%, 95% CI 10-35%). According to the meta-regression, neither the final dose, treatment duration, nor initial serum cortisol levels were associated with biochemical control of hypercortisolism.
    Conclusion: Ketoconazole can be considered a safe and efficacious option for Cushing's disease treatment after pituitary surgery.
    Systematic review registration: https://www.crd.york.ac.uk/prospero/#searchadvanced, (CRD42022308041).
    MeSH term(s) Humans ; Ketoconazole/therapeutic use ; Pituitary ACTH Hypersecretion/drug therapy ; Pituitary ACTH Hypersecretion/surgery ; Cushing Syndrome ; Hydrocortisone ; Prospective Studies ; Retrospective Studies
    Chemical Substances Ketoconazole (R9400W927I) ; Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2023-05-08
    Publishing country Switzerland
    Document type Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1145775
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  3. Article: Enhancing Cushing's disease diagnosis: exploring the impact of desmopressin on ACTH gradient during BIPSS.

    de Almeida, Tobias Skrebsky / Rodrigues, Ticiana da Costa / Costenaro, Fabíola / Scaffaro, Leandro Armani / Farenzena, Maurício / Gastaldo, Fernando / Czepielewski, Mauro Antônio

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1224001

    Abstract: Introduction: The differential diagnosis between Cushing's disease (CD) and ectopic ACTH syndrome (EAS) is complex, and bilateral inferior petrosal sinus sampling (BIPSS) is considered the gold-standard test. However, BIPSS with corticotropin-releasing ... ...

    Abstract Introduction: The differential diagnosis between Cushing's disease (CD) and ectopic ACTH syndrome (EAS) is complex, and bilateral inferior petrosal sinus sampling (BIPSS) is considered the gold-standard test. However, BIPSS with corticotropin-releasing hormone (CRH) stimulation is rarely available.
    Objective: This retrospective cohort study aimed to assess the accuracy of the inferior petrosal sinus to peripheral ACTH gradient (IPS:P) before and after desmopressin stimulation for the differential diagnosis of ACTH-dependent Cushing's syndrome (CS), applying different cutoff values.
    Methods: A total of 50 patients (48 with CD and 2 with EAS) who underwent BIPSS were included in this study. The sensitivity and specificity of IPS:P in BIPSS before and after desmopressin stimulation were evaluated. Various cutoff values for IPS:P were examined to determine their diagnostic accuracy.
    Results: Using the traditional IPS:P cutoff, the sensitivity was 85.1% before stimulation, 89.6% after stimulation, and a combined sensitivity of 91.7%. Applying cutoff values of IPS:P >1.4 before and >2.8 after stimulation, the sensitivity was 87.2% and 89.6%, respectively, with a combined sensitivity of 91.7%. Receiver operating characteristic (ROC) curve analysis determined optimal cutoff values of 1.2 before stimulation and 1.57 after stimulation, resulting in a sensitivity of 93.6% and 93.8%, respectively, with a combined sensitivity of 97.9%. Specificity remained at 100% throughout all analyses. Among the 43 patients who responded positively to stimulation, 42 (97.7%) did so within the first three minutes, and all 43 (100%) did so within the first five minutes. None of the assessed clinical variables predicted the ACTH response to stimulation in BIPSS with statistical significance.
    Discussion: ACTH stimulation with desmopressin during BIPSS improves the accuracy of IPS:P, making it a valuable tool for investigating ACTH-dependent Cushing's syndrome. Considering the low risk of complications, we recommend the use of desmopressin stimulation during BIPSS for the differential diagnosis of ACTH-dependent CS.
    MeSH term(s) Humans ; ACTH Syndrome, Ectopic/diagnosis ; Adrenocorticotropic Hormone/metabolism ; Cushing Syndrome/diagnosis ; Deamino Arginine Vasopressin/pharmacology ; Petrosal Sinus Sampling ; Pituitary ACTH Hypersecretion/diagnosis ; Retrospective Studies
    Chemical Substances Adrenocorticotropic Hormone (9002-60-2) ; Deamino Arginine Vasopressin (ENR1LLB0FP)
    Language English
    Publishing date 2023-08-03
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1224001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Association of Eating Patterns and Diabetic Kidney Disease in Type 2 Diabetes: A Cross-Sectional Study.

    Real Rodrigues, Cíntia Corte / Riboldi, Bárbara Pelicioli / Rodrigues, Ticiana da Costa / Sarmento, Roberta Aguiar / Antonio, Juliana Peçanha / de Almeida, Jussara Carnevale

    Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation

    2022  Volume 33, Issue 2, Page(s) 261–268

    Abstract: Objective: The aim of this cross-sectional study was to evaluate the relationship between eating patterns and diabetic kidney disease in patients with type 2 diabetes.: Methods: Outpatients underwent clinical and nutritional evaluation. Dietary ... ...

    Abstract Objective: The aim of this cross-sectional study was to evaluate the relationship between eating patterns and diabetic kidney disease in patients with type 2 diabetes.
    Methods: Outpatients underwent clinical and nutritional evaluation. Dietary information was obtained through a validated quantitative food frequency questionnaire, and eating patterns were identified by cluster analysis. Diabetic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m
    Results: A total of 329 patients were evaluated: mean age 62 ± 10 years, body mass index 30.9 ± 4.2 kg/m
    Conclusion: In this sample of outpatients with type 2 diabetes, the patterns of snacks and red meat were associated with diabetic kidney disease as compared to a healthy pattern.
    MeSH term(s) Humans ; Middle Aged ; Aged ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Cross-Sectional Studies ; Risk Factors ; Diabetic Nephropathies/epidemiology ; Diet
    Language English
    Publishing date 2022-10-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1080003-7
    ISSN 1532-8503 ; 1051-2276
    ISSN (online) 1532-8503
    ISSN 1051-2276
    DOI 10.1053/j.jrn.2022.09.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3273: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  5. Article: Evaluation of ketoconazole as a treatment for Cushing's disease in a retrospective cohort.

    Viecceli, Camila / Mattos, Ana Carolina Viana / Costa, Maria Carolina Bittencourt / de Melo, Rafael Borba / Rodrigues, Ticiana da Costa / Czepielewski, Mauro Antonio

    Frontiers in endocrinology

    2022  Volume 13, Page(s) 1017331

    Abstract: Objective: The first-line treatment for Cushing's disease is transsphenoidal surgery, after which the rates of remission are 60 to 80%, with long-term recurrence of 20 to 30%, even in those with real initial remission. Drug therapies are indicated for ... ...

    Abstract Objective: The first-line treatment for Cushing's disease is transsphenoidal surgery, after which the rates of remission are 60 to 80%, with long-term recurrence of 20 to 30%, even in those with real initial remission. Drug therapies are indicated for patients without initial remission or with surgical contraindications or recurrence, and ketoconazole is one of the main available therapies. The objective of this study was to evaluate the safety profile of and the treatment response to ketoconazole in Cushing's disease patients followed up at the endocrinology outpatient clinic of a Brazilian university hospital.
    Patients and methods: This was a retrospective cohort of Cushing's disease patients with active hypercortisolism who used ketoconazole at any stage of follow-up. Patients who were followed up for less than 7 days, who did not adhere to treatment, or who were lost to follow-up were excluded.
    Results: Of the 172 Cushing's disease patients who were followed up between 2004 and 2020, 38 received ketoconazole. However, complete data was only available for 33 of these patients. Of these, 26 (78%) underwent transsphenoidal surgery prior to using ketoconazole, five of whom (15%) had also undergone radiotherapy; seven used ketoconazole as a primary treatment. Ketoconazole use ranged from 14 days to 14.5 years. A total of 22 patients had a complete response (66%), three patients had a partial response (9%), and eight patients had no response to treatment (24%), including those who underwent radiotherapy while using ketoconazole. Patients whose hypercortisolism was controlled or partially controlled with ketoconazole had lower baseline 24-h urinary free cortisol levels than the uncontrolled group [times above the upper limit of normal: 0.62 (SD, 0.41)
    Conclusion: Ketoconazole effectively controlled hypercortisolism in 66% of Cushing's disease patients, being a relatively safe drug for those without remission after transsphenoidal surgery or whose symptoms must be controlled until a new definitive therapy is carried out. Hypokalemia is a frequent metabolic effect not yet described in other series, which should be monitored during treatment.
    MeSH term(s) Humans ; Pituitary ACTH Hypersecretion/complications ; Pituitary ACTH Hypersecretion/drug therapy ; Pituitary ACTH Hypersecretion/surgery ; Ketoconazole/therapeutic use ; Retrospective Studies ; Hydrocortisone ; Cabergoline ; Hypokalemia/drug therapy ; Cushing Syndrome/drug therapy
    Chemical Substances Ketoconazole (R9400W927I) ; Hydrocortisone (WI4X0X7BPJ) ; Cabergoline (LL60K9J05T)
    Language English
    Publishing date 2022-10-07
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2022.1017331
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Effect of night-shift work on cortisol circadian rhythm and melatonin levels

    Brum, Maria Carlota Borba / Senger, Martha Bergan / Schnorr, Claudia Carolina / Ehlert, Lethicia Rozales / Rodrigues, Ticiana da Costa

    Sleep Science

    2022  Volume 15, Issue 02, Page(s) 143–148

    Abstract: Objectives: Night-shift work has been associated with several negative effects on worker’s health, possibly due to circadian desynchronization, sleep deprivation and suppression of nocturnal melatonin secretion including exposure to light during the ... ...

    Abstract Objectives: Night-shift work has been associated with several negative effects on worker’s health, possibly due to circadian desynchronization, sleep deprivation and suppression of nocturnal melatonin secretion including exposure to light during the work shift. The objective of this study was to evaluate the impact of fixed night-shift work versus day-shift work on the sleep-wake cycle and on the night and day levels of cortisol and melatonin.
    Material and Methods: Saliva samples were obtained from 36 individuals, 19 day workers (12 women and 7 men) and 17 night workers (12 women and 5 men) from a university hospital in southern Brazil, with no history of chronic diseases. Demographic and personal information were obtained through a self-administered questionnaire and sleep information by the Munich chronotype questionnaire.
    Results: Salivary cortisol showed normal circadian rhythm in day- and night-shift workers, but was attenuated in night-shift workers during their working hours and on leave days. Night workers sleep fewer hours at night and have higher negative social jet lag than day workers.
    Conclusion: Intervals between night shifts can be beneficial for the recovery of the hypothalamic-pituitary-adrenal axis, minimizing the negative effects on workers’ health, in addition to a preventive approach to aspects related to sleep hygiene and healthy life habits.
    Keywords Cortisol ; Melatonin ; Night Work ; Circadian Rhythm ; Desynchronization
    Language English
    Publishing date 2022-06-01
    Publisher Thieme Revinter Publicações Ltda.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2697016-8
    ISSN 1984-0063 ; 1984-0659 ; 1984-0063
    ISSN (online) 1984-0063
    ISSN 1984-0659 ; 1984-0063
    DOI 10.5935/1984-0063.20220034
    Database Thieme publisher's database

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  7. Article ; Online: Multifactorial intervention for diabetes control among older users of insulin.

    Machry, Rafael Vaz / Pedroso, Henrique Umpierre / Vasconcellos, Luthiele Silva / Nunes, Rafaela Ramos / Evaldt, Cibelle de Abreu / Yunes Filho, Eduardo Bardou / Rodrigues, Ticiana da Costa

    Revista de saude publica

    2018  Volume 52, Page(s) 60

    Abstract: Objective: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy.: ... ...

    Abstract Objective: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy.
    Methods: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day). Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention.
    Results: Glycated hemoglobin at baseline was 10.34% (SE = 0.22%) and 8.54% (SE = 0.24%, p < 0.001) and 8.09% (SE = 0.21%, p < 0.001) at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline.
    Conclusions: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up). Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes.
    MeSH term(s) Aged ; Blood Glucose/drug effects ; Brazil ; Diabetes Mellitus, Type 2/prevention & control ; Female ; Glycated Hemoglobin A ; Glycemic Index/drug effects ; Humans ; Hypoglycemic Agents/administration & dosage ; Insulin/administration & dosage ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Socioeconomic Factors
    Chemical Substances Blood Glucose ; Glycated Hemoglobin A ; Hypoglycemic Agents ; Insulin
    Language English
    Publishing date 2018
    Publishing country Brazil
    Document type Controlled Clinical Trial ; Journal Article
    ZDB-ID 732179-x
    ISSN 1518-8787 ; 0034-8910
    ISSN (online) 1518-8787
    ISSN 0034-8910
    DOI 10.11606/s1518-8787.2018052000144
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 864: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Influence of age at diagnosis and duration of diabetes on the positivity of glutamic acid decarboxylase antibody in South-Brazilian type 1 diabetes mellitus.

    Maraschin, Jorge de Faria / Weinert, Letícia Schwerz / Murussi, Nádia / Witter, Vanessa / Rodrigues, Ticiana da Costa / Rossato, Egna Regina / Silveiro, Sandra Pinho

    Annals of clinical biochemistry

    2013  Volume 50, Issue Pt 3, Page(s) 262–266

    Abstract: Aim: To evaluate the influence of age of onset and duration of diabetes on the positivity of glutamic acid decarboxylase antibody (GADA) in South-Brazilian type 1 diabetes mellitus (DM) patients.: Methods: GADA was evaluated in 92 patients with type ... ...

    Abstract Aim: To evaluate the influence of age of onset and duration of diabetes on the positivity of glutamic acid decarboxylase antibody (GADA) in South-Brazilian type 1 diabetes mellitus (DM) patients.
    Methods: GADA was evaluated in 92 patients with type 1 diabetes, in 147 gestational DM patients, and in 59 subjects with normal glucose tolerance.
    Results: Type 1 patients with positive GADA (N = 44, 48%) were older at the onset of diabetes (22 ± 9 versus 18 ± 10 y, P = 0.043) and had a shorter DM duration (12 ± 8 versus 19 ± 9 y, P < 0.001), as compared with negative GADA patients. A logistic regression with antibody positivity as the dependent variable and diabetes duration as the independent variable, showed that the shorter diabetes duration was related to the presence of the antibody with an odds ratio (OR) = 5.6; (CI 95% = 2.1-14.6); P < 0.001. Another model, with age at diagnosis as the independent variable, did not show any association with antibody positivity. However, analysing only men, a shorter DM duration (OR = 6.5; CI = 1.7-24.0; P = 0.006), and also a higher age at diagnosis (OR = 5.5; CI = 1.5-21.0; P = 0.01) were significantly related to the antibody positivity. The performance of GADA was similar in up to 15 y of duration of DM (P = 0.78), but significantly diminished with higher duration (P = 0.001).
    Conclusion: GADA testing is a helpful tool in the diagnosis of type 1 DM starting in young adults and older individuals. Even though the positivity rate declines along the course of disease, it still provides useful information up to 15 y after the diabetes diagnosis.
    MeSH term(s) Adult ; Age Factors ; Age of Onset ; Autoantibodies/blood ; Brazil ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/immunology ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/immunology ; Female ; Glucose Tolerance Test ; Glutamate Decarboxylase/immunology ; Humans ; Logistic Models ; Male ; Middle Aged ; Pregnancy ; Young Adult
    Chemical Substances Autoantibodies ; Glutamate Decarboxylase (EC 4.1.1.15)
    Language English
    Publishing date 2013-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563212474560
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 889: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Physical activity level and exercise in patients with diabetes mellitus.

    Duarte, Camila Kümmel / Almeida, Jussara Carnevale de / Merker, Aline Juliana Schneider / Brauer, Fabiane de Oliveira / Rodrigues, Ticiana da Costa

    Revista da Associacao Medica Brasileira (1992)

    2012  Volume 58, Issue 2, Page(s) 215–221

    Abstract: Objective: To compare physical activity level (PAL) and care related to exercise in patients with diabetes mellitus (DM).: Methods: DM outpatients (adult, insulin-user patients) were assessed for PAL (international questionnaire; moderate- and high- ... ...

    Abstract Objective: To compare physical activity level (PAL) and care related to exercise in patients with diabetes mellitus (DM).
    Methods: DM outpatients (adult, insulin-user patients) were assessed for PAL (international questionnaire; moderate- and high-level activities, as well as walking, over a typical week) and questioned about formal exercise practice, self-care, and hypoglycemic episodes related to exercise or reasons for not exercising.
    Results: Two hundred twenty five patients were assessed: 107 (47.6%) had type 2 diabetes mellitus (DM2) and 118 (52.4%) had type 1 diabetes mellitus (DM1), with a larger percentage of patients with DM2 being classified as poorly active [33 (30.7%) versus 12 (10.3%)] and a lower percentage being classified as highly active [9 (8.7%) versus 29 (25%)], compared with patients having DM1. Patients who do not exercise (n = 140) gave different reasons for not doing so: patients with DM2 claimed that they "felt uncomfortable", "presented medical restrictions", and "did not like it"; DM1 patients claimed that they "had no time to exercise", "were lazy", and "had hypoglycemic episodes". Only 85 patients exercised regularly, regardless of the PAL, and 38.8% performed self-care, such as eating, stretching, and capillary glucose monitoring. Patients with DM2 [5 (14.3%)] reported a lower number of hypoglycemic episodes related to exercise than those with DM1 [17 (34%)].
    Conclusion: Patients with DM2 have different PAL and behavior related to exercise than those seen in DM1 patients.
    MeSH term(s) Adult ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1/psychology ; Diabetes Mellitus, Type 2/psychology ; Exercise/physiology ; Humans ; Hypoglycemia/physiopathology ; Leisure Activities ; Male ; Middle Aged ; Nutritional Status ; Self Care/psychology ; Surveys and Questionnaires
    Language Portuguese
    Publishing date 2012-03
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2027973-5
    ISSN 1806-9282 ; 0104-4230
    ISSN (online) 1806-9282
    ISSN 0104-4230
    Database MEDical Literature Analysis and Retrieval System OnLINE

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