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Mots clés: enseignement sur le diabète pied diabétique soins de pieds prévention a b s t r a c t Objective: The aim of this study is to design and implement a foot care program for minority patients with type 2 diabetes mellitus of Zhuang tribe in Guangxi, China, which will achieve the following: 1) improve patients' foot care behaviour, 2) improve their glycated hemoglobin (A1C) and 3) decrease the incidence of foot ulcers and amputation. Background: In Guangxi, China, foot care resources are limited, and diabetes self-management and foot care is poor for patients with diabetes. Thus developing a program with the limited resources for diabetes foot care is very important. Methods: A multidisciplinary team led by a diabetes nurse was established. A foot care kit and set of teaching materials focusing on foot care and diabetes self-management was developed. Sixty-two inpatients with type 2 diabetes mellitus, under the same attending physician's service, were screened to be at high risk for foot ulcers and randomized into 2 groups. The subjects in the study group received didactic diabetes education, tailored foot care and focused teaching for 2 hours. Every patient was given a foot care kit during hospitalization and then followed up in the clinic monthly with a systematic foot exam. Subsequently, diabetes education classes were given every 3 to 6 months. The subjects in the control group were just given usual care according to 2007 Americans with Disabilities Act standards. Results: For patients in the study group, the average score of knowledge and self foot care behaviours were higher than those of the patients in the control group both after 1 year (88.31 AE 8.15, 86.35 AE 5.17 vs. 70.27 AE 7.92, 75.86 AE 6.19) and 2 years (87.24 AE 6.20, 89.56 AE 7.00 vs. 71.43 AE 5.17, 67.87 AE 5.26). The mean A1C (6.5% AE 2.3% vs. 7.9% AE 4.2%), the incidence of foot ulcer (0% vs. 24.14%), and amputation (0% vs. 6.90%) were much lower than that of the patients in the control group after 2 years. Conclusion: The foot care program delivered by a multidisciplinary team can markedly improve foot care behaviours and reduce complications of the minority diabetes patients who are at risk of developing foot ulcer, thereby reducing the incidence of foot ulcer and amputation. In areas where resources are limited, the foot care program will be a cost-effective approach to reduce the incidence of diabetes foot ulcer.Ó 2012 Canadian Diabetes Association r é s u m é Objectifs : Le but de cette étude est de concevoir et de mettre en oeuvre un programme de soins de pieds pour les patients minoritaires de la tribu Zhuang, en Chine, ayant un diabète sucré de type 2 (DST2), qui permettra d'atteindre les objectifs suivants: 1) améliorer les habitudes des patients en ce qui a trait aux soins des pieds; 2) améliorer leur HbA1c; 3) diminuer l'incidence des ulcères du pied et de l'amputation. Introduction : Dans la région du Guangxi, en Chine, les ressources en soins de pieds sont limitées, et la prise en charge autonome du diabète et les soins de...

Background: Both lipid and glucose abnormalities are associated with hypertension (HTN). However, it is unclear whether the triglyceride-glucose (TyG) index is associated with HTN. Therefore the aim of this study is to investigate the association of the TyG index and HTN and to compare the discriminative power of the TyG index, lipid, glycemic parameters for the risk of HTN in elderly individuals. Methods: The present study was nested in a longitudinal (REACTION) study from May 2011 to December 2011, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. In total, 47,808 participants were recruited in this cross-sectional study. The TyG index was divided into five groups: the < 20% group, the 20-39% group, the 40-59% group, the 60-79% group and the ≥ 80% group, according to quintile division of the subjects. Three multivariate logistic regression models were used to evaluate the association between the TyG vs. lipid parameters, glycemic parameters and HTN. Results: Multivariate logistic regression analysis shows that compared with lipid and glycemic parameters, the TyG index remains significantly associated with HTN in either total subjects or subjects separated into men and women (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.18-1.51, p < 0.0001 in total subjects; OR 1.39, 95% CI 1.11-1.74, p = 0.0042 in men; OR 1.28, 95% CI 1.11-1.49, p = 0.0010 in women). In a stratified analysis, an elevated TyG index is significantly associated with HTN in the subgroup of the oldest age (≥ 65) (OR 1.67, 95% CI 1.30-2.14, p < 0.0001), as well as with obesity (Body mass index (BMI) ≥ 28 kg/m 2) (OR 1.85, 95% CI 1.29-2.66, p = 0.0009) or lower estimated glomerular filtration rate (eGFR) (< 90 mL/(min•1.73 m 2)) (OR 1.72, 95% CI 1.33-2.21, p < 0.0001). Conclusion: The TyG index is significantly associated with HTN and shows the superior discriminative ability for HTN compared with lipid and glycemic parameters in the Chinese elderly population.