The role of the concomitant intake of zinc, potassium, calcium, and magnesium in the glycemic control of individuals with type 2 diabetes mellitus (T2DM) has not been extensively discussed. We evaluated the relationship between the dietary intake of these micronutrients and glycemic markers in 95 individuals with T2DM (mean age 48.6 ± 8.4 years). Hierarchical grouping analysis was used to divide the individuals into two clusters according to their micronutrient intake, and differences between clusters were statistically assessed. Effects of individual and combination intake of micronutrients on glycated hemoglobin percentage (%HbA1c) were assessed using multiple linear regression and binary logistic regression analysis. We observed a high likelihood of inadequate intake of the four micronutrients. The group with lower micronutrient intake (cluster 1) displayed higher %HbA1c (p = 0.006) and triglyceride (p = 0.010) levels. High %HbA1c showed an association with cluster 1 (odds ratio (OR) = 3.041, 95% confidence interval (CI) = 1.131; 8.175) and time of T2DM diagnosis (OR = 1.155, 95% CI = 1.043; 1.278). Potassium (β = −0.001, p = 0.017) and magnesium (β = −0.007, p = 0.015) intakes were inversely associated with %HbA1c. Reduced concomitant intake of the four micronutrients studied proved to be associated with risk of increased %HbA1c in individuals with T2DM, which was particularly predicted by magnesium and potassium intakes.

Different dietary patterns have been positively related to the glycemic control of individuals with type 2 diabetes mellitus. However, consensual dietary pattern for these individuals is not established. We aimed to evaluate the effects of adopting different dietary patterns on glycemic control markers of individuals with type 2 diabetes mellitus. PubMed, Scopus, MEDLINE, Lilacs, Open Thesis and Google Scholar databases were searched using the Medical Subject Headings and terms related to dietary pattern and glycemic control in individuals with type 2 diabetes mellitus. Interventional studies with adults of this population without diabetes-related complications, presenting data on percentage of glycated hemoglobin, and dietary patterns were included. In vitro, animal, reviews, observational, and studies with children, adolescents, pregnant and breastfeeding women were excluded. The time of adoption dietary patterns ranged from eight weeks to four years in randomized clinical trials, and six months in the cohort study. Vegetarian, vegan, Mediterranean, and Dietary Approaches to Stop Hypertension dietary patterns reduced 0.8% on average of percentage of glycated hemoglobin, considering all included studies. It was also observed reduction in fasting glycemia and improvement in Homeostasis Model Assessment of Insulin Sensitivity. However, more randomized clinical trials are required for a full elucidation of these questions.

BACKGROUND Brazil’s prison population faces severe health inequities, with high rates of chronic, infectious, and mental health conditions. TeleSAP, a telehealth model, was launched to expand primary healthcare access through teleconsultations in prison units (PU) of Sao Paulo State. OBJECTIVE To describe the implementation process of the TeleSAP model in PU across Sao Paulo State, Brazil. METHODS This descriptive observational study was conducted using telehealth data from 68 prison units between June 2024 and June 2025. Teleconsultations were delivered by family and community physicians via a secure institutional platform. Operational metrics, clinical data, and satisfaction scores (Net Promoter Score - NPS) were analyzed. Additionally, a training program was provided for prison healthcare teams. RESULTS A total of 21,413 teleconsultations were conducted for 16,062 patients, achieving a 98.7% occupancy rate, an 87.5% effectiveness rate, and high patient satisfaction (NPS = 96). The most frequent clinical conditions were psychological (21.8%), dermatological (12.8%), and respiratory (12.3%). The training program reached 732 professionals across 34 topics, also receiving high satisfaction ratings (NPS = 89). CONCLUSIONS The TeleSAP model is a viable and scalable approach for integrating telehealth into prison healthcare, expanding access to care in Sao Paulo’s prison units and supporting staff development. These findings highlight the importance of structured training, metric monitoring, and stakeholder engagement for sustainable implementation. Future research should evaluate long-term outcomes, cost-effectiveness, and broader population health impacts. CLINICALTRIAL N/A

BACKGROUND The COVID-19 pandemic accelerated the adoption of telehealth as a key strategy within Brazil’s Unified Health System (SUS). In São Paulo State, digital health initiatives have been developed to implement telehealth-based care models across all three levels of healthcare. OBJECTIVE To describe the implementation process of the telehealth model in public health facilities in a lesser extent. METHODS This descriptive study reports on the implementation of telehealth services at the primary, secondary and tertiary levels of healthcare in São Paulo State. Thirty Primary Health Units (PHU), four Specialty Care Outpatient Clinic (AME), and eighteen hospitals were selected by the institutions participating in the project, based on technical, healthcare, and infrastructure criteria. Teleconsultations were conducted via the institutional teleconferencing platform, ensuring data security and privacy. Data were collected through REDCap between April and December 2024, including operational metrics and satisfaction scores (Net Promoter Score – NPS). All participating healthcare facilities signed a Term of Adherence and Data Sharing. Patients received care only after being informed and signed a Consent and Adherence Term for Telehealth. RESULTS Telehealth was implemented in 52 healthcare facilities across 47 municipalities in São Paulo State. A total of 19,053 teleconsultations were conducted in PHU (NPS 97), 218 in AME (NPS 74), and 4178 ICU case discussions were held (NPS 86). CONCLUSIONS The findings suggest that telehealth is a feasible strategy across all levels of healthcare, even when implemented at a limited scale, contributing to expanded access and service coverage.

Background/Objectives: Insulin resistance (IR) in adolescents contributes to the development of metabolic and immunological alterations. These alterations can lead to chronic, systemic, low-grade inflammation in adulthood. Evidence suggests that alterations in miRNA expression play a significant role in the onset of IR by influencing insulin signaling pathways. Therefore, identifying specific miRNAs may aid in the early diagnosis of cardiometabolic risk, particularly during the transition from adolescence to adulthood. Methods: This population-based study aimed to analyze the expression of 21 miRNAs in the plasma of adolescents. We considered IR status, overweight, sex, and age for the analyses. The study measured miRNA expression in plasma samples from 187 adolescents aged 12 to 19 years from the cross-sectional study of the 2015 São Paulo Health Survey (ISA-Nutrition). MiRNA expression was assessed using Exiqon^® assays on Fluidigm^® technology (Les Ulis, France). Statistical analyses were performed to identify differences in miRNA expression and correlations between variables, using a complex research design to ensure representativeness at the population level. Results: The incidence of IR and overweight was high in adolescents (44% and 33%, respectively). High-sensitivity C-reactive protein (hs-CRP) concentration was higher in overweight adolescents. IR was correlated with higher plasma expression of miR-122 and miR-139-3p. Furthermore, miR-486, miR-363, miR-30d, miR-28, miR-223, miR-21, miR-146, miR-130b, miR-126, miR-122, and miR-139-3p showed specific correlations with individual risk for IR, sex, and adolescent stage. Conclusions: The miRNAs showed differential expression according to sex and adolescent stage, and were correlated with cardiometabolic risk factors, suggesting their potential utility for early screening in adolescents. The study highlights age- and sex-related differences in miRNA levels between adolescents with IR and overweight. The cross-sectional design is a limitation of this study, as we cannot infer causality for the associations observed here.