OBJECTIVE -The goal of this study was to estimate the health care resources spent by type 1 and type 2 diabetic patients in Spain during the year 2002. RESEARCH DESIGN AND METHODS-This is a cost-of-illness study focusing on direct health care costs estimated from primary and secondary sources of information. A prevalence of diabetes ranging from 5 to 6% of the adult population was determined. Total cost is composed of six items: insulin and oral hypoglycemic agents, other drugs, disposable and consumable goods (glucose test strips, needles, and syringes), hospitalization, primary care visits, and visits to endocrinologists and dialysis.RESULTS -The estimated direct cost of diabetes in 2002 ranges from €2.4 to 2.67 billion. Hospital costs were the most (€933 million), followed by noninsulin, nonhypoglycemic agent drugs (€777-932 million). Much lower are the costs of insulin and oral hypoglycemic agents (€311 million), primary care visits (€181-272 million), specialized visits (€127-145 million), and disposable elements (€70 -81 million). Expenditures for all drugs and consumable goods ranged between €1.16 and 1.3 billion, representing 48 -49% of total cost, which is 15% higher than hospital costs.CONCLUSIONS -The direct health care costs of diabetic patients are high (6.3-7.4% of total National Health System expenditure). Their average annual cost is €1,290 -1,476. For individuals without diabetes, the average annual cost is €865.
Background: The term conjugated linoleic acid (CLA) refers to several positional and geometric conjugated dienoic isomers of linoleic acid (LA), of which the trans-10,cis-12 isomer has been reported to reduce adiposity and increase lean mass in mice and other animals when included at #1% of the diet. However, most dietary CLA in humans is obtained from dairy products, accounting for the cis-9,trans-11 CLA isomer, also known as rumenic acid, for more than 90% of the total CLA intake. Commercial CLA preparations industrially produced, containing trans-10,cis-12 and cis-9,trans-11 CLA isomers in diverse proportions, are attracting consumers' interest because of the purported body fat-lowering effects of CLA, coupled to the perception of a 'natural' compound devoid of harmful effects. Nevertheless, despite numerous studies on CLA effects on body composition for nearly a decade, the mechanisms by which CLA isomers elicit their effects remain largely unknown. The purpose of this paper is to provide an updated review of the studies performed on animals and humans, as well as to describe the potential mechanisms involved in CLA effects on body weight and composition and metabolism. Method: Literature review. Results: Experiments in humans have not been able to show a significant effect on body weight, body composition or weight regain related to either of the CLA isomers. In fact, some studies suggest a tendency towards a decrease in body fat mass and an increase in body lean mass, while some others raise concern about the possibility of deleterious effects of trans-10,cis-12 CLA on lipid profile, glucose metabolism and insulin sensitivity. Conclusions: Evidence regarding effectiveness of CLA in humans is not concluding.
The increase in sedentary behaviors during the COVID-19-induced lockdown may have led to a significant weight gain. To investigate this hypothesis, a representative sample of the Spanish adult population comprising 1000 subjects was enrolled in a cross-sectional study between 26 May and 10 June 2020. Computer-assisted telephone interviews were conducted consisting of 29 questions on the topic of lifestyle habits during the lockdown. The cohort comprised 51.5% women and 51% overweight or obese subjects and had a mean age of 50 ± 18 years. Of the respondents, 44.5% self-reported weight gain during the lockdown; of these, 58.0% were women, 69.9% had previous excess weight, 44.7% lived with a relative who also gained weight, and 73.5 experienced increased appetite. Further, an increased consumption of energy-dense products was found relative to respondents who did not gain weight (p ≤ 0.016 for all). Additionally, respondents were unaware that obesity is a poor prognostic factor for COVID-19 infection, lived in smaller flats, and had a lower level of education and lower monthly income. The factors independently associated with weight gain were female gender, previous overweight or obesity, lack of food care, increased appetite, and increased consumption of sugar-sweetened beverages, alcoholic beverages, and snacks (p ≤ 0.023 for all). Should another lockdown be mandated, extra caution is warranted to prevent weight gain.
Pregnancy should be scheduled at least 1 year after BS. Malabsorptive procedures are associated to a higher rate of SGA births.
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