scholarly journals OPÇÕES CONTRACEPTIVAS PARA REDUÇÃO DE EVENTOS TROMBOEMBÓLICOS EM MULHERES DIABÉTICAS

2019 ◽  
Vol 6 (1) ◽  
pp. 63-69
Author(s):  
Andressa Daiana Nascimento do Carmo ◽  
Adroaldo Lunardelli
Keyword(s):  
Diabetes Mellitus ◽  
Adverse Events ◽  
Absolute Risk ◽  
Hormonal Contraception ◽  
Public Health Problem ◽  
Hormonal Contraceptive ◽  
Diabetic Patients ◽  
Thromboembolic Events ◽  
Contraceptive Methods ◽  
Combined Hormonal Contraception

Introdução: A diabetes mellitus é um grave e crescente problema de saúde pública, podendo levar à consequências irreversíveis na saúde de seus portadores, prevendo-se crescimento no número de novos portadores para os próximos anos. O uso de métodos contraceptivos hormonais também cresceu nos últimos anos, e com o retardamento das gestações, estes números tendem a aumentar ainda mais. A prescrição de contracepção hormonal para mulheres diabéticas deve ser cuidadosamente avaliada, pois a presença da doença já confere risco para eventos adversos à saúde da paciente, em especial os eventos tromboembólicos. Objetivos: O estudo objetivou revisar a literatura quanto aos métodos contraceptivos hormonais mais adequados para pacientes diabéticos, buscando redução de eventos adversos e melhora na qualidade de vida destes. Materiais e métodos: Trata-se de uma revisão integrativa da literatura onde foram acessadas as bases de dados Medline/Pubmed, ScienceDirect e Scielo. Utilizou-se os descritores contraceptive, thrombosis e diabetes, bem como a combinação destas palavras. Resultados: Foram encontrados 4 trabalhos que se enquadraram na temática do estudo e foram incluídos na revisão. Apenas 1 foi realizado exclusivamente com pacientes diabéticas. Conclusão: A utilização de contracepção hormonal combinada apresenta a mesma probabilidade de causar eventos tromboembólicos em mulheres com e sem diabetes, mas o risco absoluto em mulheres com diabetes é maior devido à doença, que é um agravante para estes incidentes. mulheres diabéticas que utilizam contracepção com estrogênio têm risco maior de desenvolver complicações trombóticas quando comparadas às que utilizam progestogênio ou as não usuárias. Palavras-chave: diabetes mellitus; anticoncepção; estrogênios; progesterona; tromboembolia. ABSTRACT Introduction: Diabetes mellitus is a serious and growing public health problem, and may lead to irreversible consequences for the health of its patients, with a projected increase in the number of new patients for the coming years. The use of hormonal contraceptive methods has also grown in recent years, and with the delay of pregnancies, these numbers tend to increase even more. The prescription of hormonal contraception for diabetic women should be carefully evaluated, since the presence of the disease already confers risk to adverse events to the patient's health, especially thromboembolic events. Objective: The present study aimed to review the literature regarding on the most appropriate hormonal contraceptive methods for diabetic patients, seeking to reduce adverse events and improve their quality’s life. Materials and Methods: It is an integrative literature review conducted by searching the databases Medline/Pubmed, ScienceDirect and Scielo. The following descriptors were used: contraceptive, thrombosis and diabetes, as well as the combination of these words. Results: Four papers were found that fit the theme of the study and were included in the review. Only 1 was performed exclusively with diabetic patients. Conclusion: Using combined hormonal contraception has the same probability of causing thromboembolic events in women with and without diabetes, but the absolute risk in women with diabetes is greater because of the disease, which is an aggravating factor for these incidents. Diabetic women who use estrogen contraception are at greater risk of developing thrombotic complications when compared to those using progestogen or non-users. Keywords: diabetes mellitus; contraception; estrogens; progesterone; thromboembolism

scholarly journals Hormonal Contraception and Diabetes

2012 ◽  
Vol 5 ◽  
pp. CMWH.S9934
Author(s):  
L.F. Pallardo ◽  
A Cano ◽  
I Cristobal ◽  
M.A. Blanco ◽  
M Lozano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Preconception Care ◽  
Microvascular Complications ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Contraceptive Methods ◽  
Type 2 Dm ◽  
Increased Risk

Women with gestational diabetes mellitus are at increased risk for developing diabetes mellitus (DM), mainly type 2 DM, as well as metabolic syndrome. The presence of subsequent pregnancies increases the risk. In addition, pregnancy in patients with type 1 and type 2 DM also elevates the risk of morbidity and mortality for both mothers and offspring. Thus, all women with pre-existing type 1 or type 2 DM should receive preconception care to optimize glycemic control (HbA1c ≤ 6%). In those cases with macrovascular or microvascular complications, family planning is even more important in order to avoid the risk of aggravation of such complications associated with a new pregnancy. The present review analyzes the metabolic and cardiovascular repercussions of hormone contraception in non-diabetic women as well as in type 1 and type 2 DM patients with and without macrovascular and microvascular complications. Finally, the recommendations pertaining to hormonal contraceptive methods for women with diabetes are summarized.

Contraception and thrombophilia

2009 ◽  
Vol 29 (02) ◽  
pp. 193-196 ◽  
Author(s):  
H. Rott ◽  
A. Kruempel ◽  
G. Kappert ◽  
U. Nowak-Göttl ◽  
S. Halimeh
Keyword(s):  
Chronic Illness ◽  
High Risk ◽  
Children And Adolescents ◽  
Hormonal Contraception ◽  
Hormonal Contraceptives ◽  
Thromboembolic Events ◽  
Contraceptive Methods ◽  
Secondary Complications ◽  
Increased Risk ◽  
Coagulation Proteins

SummaryThe risk of thromboembolic events (TE) is increased by acquired or inherited thrombo -philias (IT). We know that some hormonal contraceptives also increase the risk of thrombosis, thus, the use of such contraceptives are discussed as contraindications in women with IT. TEs are infrequent events in children and adolescents and in the majority of cases are associated with secondary complications from underlying chronic illness. Although adolescents are not typically considered to be at high-risk for TE, this cohort is frequently using hormonal contraception, leading to an increased risk in cases with unknown IT. The risk of TE with pregnancy alone is higher than associated with combined hormonal contra -ception. Progestin-only methods have not been found to increase the risk of TE with only moderate changes of coagulation proteins compared to normal reference values. Conclusion: Thrombophilic women are good candidates for progestin-only contraceptive methods.

scholarly journals Clinical features of migraine with onset prior to or during start of combined hormonal contraception: a prospective cohort study

2021 ◽  
Author(s):  
Gabriele S. Merki-Feld ◽  
Peter S. Sandor ◽  
Rossella E. Nappi ◽  
Heiko Pohl ◽  
Christoph Schankin
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Natural Cycle ◽  
Free Interval ◽  
Migraine Frequency ◽  
Combined Hormonal Contraception ◽  
Migraine Onset

AbstractMany studies have described the features of menstrually related migraines but there is a lack of knowledge regarding the features of migraine in combined hormonal contraceptive users (CHC). Hormone-withdrawal migraines in the pill-free period could differ from those in the natural cycle. Gynaecologic comorbidities, like dysmenorrhea and endometriosis, but also depression or a family history might modify the course of migraine. A better understanding of migraine features linked to special hormonal situations could improve treatment. For this prospective cohort study, we conducted telephone interviews with women using a CHC and reporting withdrawal migraine to collect information on migraine frequency, intensity, triggers, symptoms, pain medication, gynaecologic history and comorbidities (n = 48). A subset of women agreed to also document their migraines in prospective diaries. The mean number of migraine days per cycle was 4.2 (± 2.7). Around 50% of these migraines occurred during the hormone-free interval. Migraine frequency was significantly higher in women who suffered from migraine before CHC start (5.0 ± 3.1) (n = 22) in comparison to those with migraine onset after CHC start (3.5 ± 2.1) (n = 26). Menstrually related attacks were described as more painful (57.5%), especially in women with migraine onset before CHC use (72%) (p < 0.02). Comorbidities were rare, except dysmenorrhea. The majority of migraine attacks in CHC users occur during the hormone-free interval. Similar as in the natural cycle, hormone-withdrawal migraines in CHC users are very intense and the response to acute medication is less good, especially in those women, who developed migraine before CHC use.

Estetrol and the possibilities of its clinical use

2021 ◽  
Vol 86 (3) ◽  
pp. 217-221
Author(s):  
Petr Křepelka ◽  
Keyword(s):  
Ethinyl Estradiol ◽  
Fetal Liver ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Cardiovascular Complications ◽  
Estradiol Valerate ◽  
Planned Parenthood ◽  
Menopausal Syndrome ◽  
Contraceptive Effectiveness ◽  
Combined Hormonal Contraception

Summary Combined hormonal contraceptive methods are one of the most commonly used methods of planned parenthood. They show high contraceptive effectiveness, reasonable cycle control and bring several non-contraceptive benefits. A limitation of the widespread use of combined hormonal contraception is the risk of cardiovascular complications in individuals with specific risk factors. The risk of cardiovascular complications is related to the used estrogen component. Currently, the most common use of estrogen in combined hormonal contraception is ethinyl estradiol and estradiol valerate. The good estrogenic part of combined oral contraceptives is estetrol, a hormone produced exclusively by the fetal liver. Estetrol exhibits a tissue-selective receptor activity. Unlike previously used estrogens, it does not negatively affect the production of liver proteins and blood clotting parameters. Estetrol is not a perspective for combined hormonal contraception only. It is also promising for treating and preventing osteoporosis, hormonal therapy of menopausal syndrome, and vulvovaginal atrophy syndrome.

PERBEDAAN PENGETAHUAN DAN SIKAP PASIEN DIABETES MELLITUS RAWAT INAP RUMAH SAKIT ISLAM SAMARINDA SEBELUM DAN SESUDAH KONSELING GIZI DENGAN MENGGUNAKAN MEDIA AUDIOVISUAL

2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah
Keyword(s):  
Diabetes Mellitus ◽  
Public Health Problem ◽  
Visual Media ◽  
P Value ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Disease Mortality ◽  
Before And After ◽  
Patients With Diabetes

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media

scholarly journals Férfi hormonális fogamzásgátlás: múlt, jelen, jövő

2017 ◽  
Vol 158 (46) ◽  
pp. 1819-1830 ◽  
Author(s):  
Norbert Pásztor ◽  
Borbála Eszter Hegyi ◽  
Attila Badó ◽  
Gábor Németh
Keyword(s):  
Follicle Stimulating Hormone ◽  
Hormone Secretion ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Contraceptive Methods ◽  
Luteinizing Hormone Secretion ◽  
The World ◽  
Effective Contraception ◽  
In The Beginning ◽  
Contraceptive Agent

Abstract: In certain regions of the world the enormous rate of population growth raises economic and public health concerns and widely accessible contraceptive methods would be desired. In contrast, in other countries the use of effective contraception is a question of individual preferences. Today, most of the reliable contraceptive methods are applied by women, while the options for male methods are quite limited. It is well known that significant portion of pregnancies are still unplanned and several data revealed men’s willingness to take part in family planning. Based on these needs, remarkable efforts have been made to develop a suitable hormonal contraceptive agent for men. With the exogenous suppression of follicle stimulating hormone and luteinizing hormone secretion, the inhibition of the testicular testosterone production and the spermatogenesis can be achieved. In the beginning, testosterone-derivatives, or testosterone-progestin combinations were administered, later synthetic androgen agents were developed. Despite of these efforts, unfortunately, there is no safe, widely feasible male hormonal contraception to date, but in the future this goal can be achieved by solving the key hurdles. Orv Hetil. 2017; 158(46): 1819–1830.

Managing the side effects of contraception

2021 ◽  
Vol 32 (6) ◽  
pp. 226-231
Author(s):  
Katie Boog
Keyword(s):  
Side Effects ◽  
Hormonal Contraception ◽  
Oral Contraceptive Pill ◽  
Common Reason ◽  
Evidence Based ◽  
Contraceptive Methods ◽  
Mood Change ◽  
Combined Oral Contraceptive ◽  
Free Interval ◽  
Combined Hormonal Contraception

Side effects are the most common reason for the discontinuation of contraceptive methods. Dr Katie Boog summarises the available evidence on how to manage them Although often transient, side effects are the most common reason for individuals to discontinue contraception. The evidence to prove causality is limited, as is evidence-based guidance on how to manage these side effects. This article summarises the available evidence. For individuals who have new or worsening acne on progestogen-only contraception (POC), switching to combined hormonal contraception (CHC) is likely to improve their skin. Continuous or extended CHC use may be beneficial for individuals with premenstrual mood change, and for those who experience headaches in the hormone-free interval. Unpredictable bleeding patterns on POC are common. Injectable users can try reducing the interval between injections to 10 weeks. Implant, injectable or intrauterine system users can be offered a 3-month trial of a combined oral contraceptive pill (COC). CHC and POP users with unpredictable bleeding may benefit from switching to an alternative preparation.

scholarly journals Exercise for the Management of Diabetes Mellitus: A Review of the Evidence

2013 ◽  
Vol 3 (2) ◽  
pp. 99-108
Author(s):  
Md. Shahjamal Khan
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Diabetes Mellitus ◽  
Aerobic Exercise ◽  
Public Health Problem ◽  
Moderate Intensity ◽  
Public Health Approach ◽  
Diabetic Patients ◽  
Published Evidence ◽  
Exercise Programmes

Diabetes mellitus is a public health problem in both developed and developing countries and has increased alarmingly, giving the disease the dimension of an epidemic. The aetiology of diabetes is multifactorial involving genetic, environmental, and behavioural origins. Exercise is an important part for the management of diabetes mellitus. Regularly planned exercise reduces insulin resistance, improves glucose tolerance, improves lipid profile and increases cardiovascular and cardiopulmonary function. This article critically reviews the more relevant evidence on the interrelationships between exercise and diabetes mellitus. This study included bibliography research from both the review and the research literatures on exercise in diabetes mellitus. From this review it appears that the effects of aerobic exercise are well established, and interventions with more vigorous aerobic exercise programmes resulted in greater reductions in HbA1c, greater increase in oxygen consumption and greater increase in insulin sensitivity. Considering the available evidence, it appears that resistance training could be an effective intervention to help glycaemic control, especially considering that the effects of this form of intervention are comparable with what is reported with aerobic exercise. It is well established that physical activity produces general and specific health benefits for diabetic patients. The basic principles of an effective exercise programme are the intensity, duration and frequency of exercise in an appropriate environment. Usually, moderate-intensity and long-duration exercise programmes are considered most suitable for diabetic patients. As it is supported by published evidence, encouragement to adopt increased physical activity and reduction of sedentary behaviour is a successful public health approach for diabetes mellitus prevention and management. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 99-108 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16133

scholarly journals Immunological Impacts of Diabetes on the Susceptibility of Mycobacterium tuberculosis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Birhanu Ayelign ◽  
Markos Negash ◽  
Meaza Genetu ◽  
Tadelo Wondmagegn ◽  
Tewodros Shibabaw
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Bacterial Load ◽  
Miliary Tuberculosis ◽  
Public Health Problem ◽  
Health Concern ◽  
Diabetic Patients ◽  
Global Public Health ◽  
Biochemical Basis ◽  
Dual Burden

The interaction between diabetes and major world infections like TB is a major public health concern because of rapidly rising levels of diabetes. The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health problem. Diabetes mellitus is a major risk factor for the development of active and latent tuberculosis. Immune mechanisms contributing to the increased susceptibility of diabetic patients to TB are due to the defects in bacterial recognition, phagocytic activity, and cellular activation which results in impaired production of chemokines and cytokines. The initiation of adaptive immunity is delayed by impaired antigen-presenting cell (APC) recruitment and function in hyperglycemic host, which results in reduced frequencies of Th1, Th2, and Th17 cells and its secretion of cytokines having a great role in activation of macrophage and inflammatory response of tuberculosis. In addition, impaired immune response and killing of intracellular bacteria potentially increase bacterial load, chronic inflammation, and central necrosis that facilitate bacterial dissemination and miliary tuberculosis. Understanding of the immunological and biochemical basis of TB susceptibility in diabetic patients will tell us the rational development of implementation and therapeutic strategies to alleviate the dual burden of the diseases. Therefore, the aim of this review was focused on the association between diabetes and tuberculosis, focusing on epidemiology, pathogenesis, and immune dysfunction in diabetes mellitus, and its association with susceptibility, severity, and treatment outcome failure to tuberculosis.

scholarly journals The SGLT-2 Inhibitors in Personalized Therapy of Diabetes Mellitus Patients

2021 ◽  
Vol 11 (12) ◽  
pp. 1249
Author(s):  
Mariana Cornelia Tilinca ◽  
Robert Aurelian Tiuca ◽  
Ioan Tilea ◽  
Andreea Varga
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Blood Pressure Reduction ◽  
Public Health Problem ◽  
Diabetic Patients ◽  
Major Public Health Problem ◽  
Patient Centered ◽  
Oral Antihyperglycemic Agents ◽  
Modern Drug

Diabetes mellitus (DM) represents a major public health problem, with yearly increasing prevalence. DM is considered a progressive vascular disease that develops macro and microvascular complications, with a great impact on the quality of life of diabetic patients. Over time, DM has become one of the most studied diseases; indeed, finding new pharmacological ways to control it is the main purpose of the research involved in this issue. Sodium–glucose cotransporter 2 inhibitors (SGLT-2i) are a modern drug class of glucose-lowering agents, whose use in DM patients has increased in the past few years. Besides the positive outcomes regarding glycemic control and cardiovascular protection in DM patients, SGLT-2i have also been associated with metabolic benefits, blood pressure reduction, and improved kidney function. The recent perception and understanding of SGLT-2i pathophysiological pathways place this class of drugs towards a particularized patient-centered approach, moving away from the well-known glycemic control strategy. SGLT-2i have been shown not only to reduce death from cardiovascular causes, but also to reduce the risk of stroke and heart failure hospitalization. This article aims to review and highlight the existing literature on the effects of SGLT-2i, emphasizing their role as oral antihyperglycemic agents in type 2 DM, with important cardiovascular and metabolic benefits.

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