Phobia of self-injecting and self-testing in insulin-treated diabetes patients: opportunities for screening

NARCIS (Netherlands)

Mollema, E. D.; Snoek, F. J.; Heine, R. J.; van der Ploeg, H. M.

2001-01-01

To define clinically relevant cut-off points for severe fear of self-injecting (FSI) and self-testing (FST) (phobia) in insulin-treated patients with diabetes, and to estimate the magnitude of these phobias in our research population. FSI and FST were assessed in a cross-sectional survey using the

How to Treat Gestational Diabetes

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... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

Outpatient costs in pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting

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Bosmans Judith E

2012-02-01

Full Text Available Abstract Background To assess differences in outpatient costs among pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting. Methods A retrospective case control study over 3 years (2002-2004. Data on 7128 depressed patients and 23772 non-depressed matched controls were available from the electronic medical record system of 20 general practices organized in one large primary care organization in the Netherlands. A total of 393 depressed patients with diabetes and 494 non-depressed patients with diabetes were identified in these records. The data that were extracted from the medical record system concerned only outpatient costs, which included GP care, referrals, and medication. Results Mean total outpatient costs per year in depressed diabetes patients were €1039 (SD 743 in the period 2002-2004, which was more than two times as high as in non-depressed diabetes patients (€492, SD 434. After correction for age, sex, type of insurance, diabetes treatment, and comorbidity, the difference in total annual costs between depressed and non-depressed diabetes patients changed from €408 (uncorrected to €463 (corrected in multilevel analyses. Correction for comorbidity had the largest impact on the difference in costs between both groups. Conclusions Outpatient costs in depressed patients with diabetes are substantially higher than in non-depressed patients with diabetes even after adjusting for confounders. Future research should investigate whether effective treatment of depression among diabetes patients can reduce health care costs in the long term.

Perspectives of patients with non-insulin-treated type 2 diabetes on self-monitoring of blood glucose: A qualitative study.

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Chen, Chen-Mei; Hung, Li-Chen; Chen, Yang-Lin; Yeh, Mei Chang

2018-04-01

To explore experiences of self-monitoring of blood glucose among patients with non-insulin-treated type 2 diabetes. Self-monitoring of blood glucose is essential to diabetes care and facilitates glycaemic control. Patients' perspectives of self-monitoring of blood glucose have seldom been discussed in the literature, and engagement in self-monitoring of blood glucose is consistently low. The descriptive phenomenological method was used. Purposive sampling was conducted to recruit participants from the endocrinology departments of medical institutions in Taiwan based on the following criteria: (i) having a medical diagnosis of type 2 diabetes, (ii) not being treated with insulin, (iii) having engaged in self-monitoring of blood glucose at least once within the preceding 6 months, (iv) being at least 20 years old and (v) not having any major mental or cognitive disorders. Data were collected in outpatient consultation rooms, the participants' homes and other settings where the participants felt secure and comfortable. In-depth interviews were conducted to collect data from 16 patients with diabetes. The participants perceived that lifestyle affected blood glucose levels and did not know how to handle high or low blood glucose levels. Their willingness to continue self-monitoring of blood glucose depended on whether healthcare professionals checked or discussed their blood glucose levels with them. The patients' knowledge regarding blood glucose variation and healthcare professionals' attitudes affected the patients' self-monitoring of blood glucose behaviours. The empirical findings illustrated self-monitoring of blood glucose experiences and recommended that healthcare professionals' closely attend to patients' requirements and responses to diabetes and incorporate the self-monitoring of blood glucose into therapy plans. Healthcare professionals should reinforce patients' knowledge on appropriate responses to high and low blood glucose levels, intervene

Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia

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Hvidberg, A; Christensen, N J; Hilsted, Jannik

1998-01-01

The aim of the study was (1) to describe hormone responses in insulin-induced hypoglycaemia and (2) to investigate if a combined treatment with intravenous glucose and intramuscular glucagon (group A) would improve glucose recovery as compared to treatment with intravenous glucose alone (group B)...... significantly elevated concentrations of adrenaline and glucagon were found in diabetic patients admitted with severe hypoglycaemia to an Accident and Emergency Department.......). Eighteen adult patients with insulin-treated diabetes mellitus admitted to the Accident and Emergency Department with hypoglycaemia (plasma glucose 1.23 +/- 0.15 mmol l(-1) on admission) were randomized to one of the above treatments and plasma glucose and counterregulatory hormones were measured before...

Diet-Related Knowledge and Physical Activity in a Large Cohort of Insulin-Treated Type 2 Diabetes Patients: PROGENS ARENA Study

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Tomasz Klupa

2016-01-01

Full Text Available There is no doubt that behavioral intervention is crucial for type 2 diabetes mellitus (T2DM prevention and management. We aimed to estimate dietary habits and diet-oriented knowledge as well as the level of physical activity in 2500 insulin-treated Polish type 2 diabetes mellitus (T2DM patients (55.4% women. The mean age of the study participants was 64.9 ± 9.3 years, mean BMI was 31.4 kg/m2 ± 4.5, mean diabetes duration was 12.4 ± 6.9 years, and mean baseline HbA1c was 8.5%  ± 1.2. At the study onset, all the patients completed a questionnaire concerning health-oriented behavior. Results showed a significant lack of diet-related knowledge. For example, only 37.5% recognized that buckwheat contains carbohydrates; the percentage of correct answers in questions about fruit drinks and pasta was 56.4% and 61.2%, respectively. As for the physical activity, only 57.4% of examined T2DM patients declared any form of deliberate physical activity. To conclude, the cohort of poorly controlled insulin-treated T2DM patients studied by us is characterized by insufficient diet-related knowledge and by a very low level of physical activity. Further studies on other populations of insulin-treated T2DM patients are required to confirm these findings.

Safety test of a supplement, 5-aminolevulinic acid phosphate with sodium ferrous citrate, in diabetic patients treated with oral hypoglycemic agents

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Naohide Yamashita

2014-09-01

Full Text Available Objective: This study aimed to examine the safety of 5-aminolevulinic acid phosphate (5-ALA with sodium ferrous citrate (SFC in diabetic patients treated with one or more oral hypoglycemic agents (OHAs. Background: Recent intervention studies performed in the USA and Japan have shown that a nutritional supplement of 5-ALA with SFC efficiently reduced blood glucose levels in pre-diabetic population without any adverse events. Thus, it was anticipated that 5-ALA with SFC may potentially be taken as a beneficial supplement by diabetic patients who were being treated with OHA therapy. Nevertheless, it is important to examine its safety and efficacy in diabetic population. Methods: This study was a prospective single-blinded, randomized, placebo-controlled and parallel-group comparison study. Medically treated diabetic patients between the ages of 30 and 75 were recruited from the Tokyo metropolitan area of Japan and 45 subjects were selected after screening. These subjects were randomly assigned to three groups: daily intake of 15mg 5-ALA, 50mg 5-ALA, and a placebo (n=15, respectively. The supplement or placebo was administered for 12 weeks followed by a four week washout period. The primary endpoint was safety and occurrence of hypoglycemic attack, while the secondary endpoint was changes of fasting blood glucose (FBG and hemoglobin A1c (HbA1c. Results: Adverse events related to 5-ALA with SFC were not observed in all the groups. Abnormalities in blood and urine tests were not observed either. Significant decrease in FBG was not detected in all the groups. However, there was a small but significant decrease in HbA1c at 4 and 8 week in the 15 mg 5-ALA group. Significant decrease in HbA1c was not observed in the 50 mg 5-ALA group, although a tendency to decrease after 4 weeks was apparent. Conclusion: 5-ALA with SFC is a safe and potentially beneficial supplement if taken by diabetic patients treated with OHAs.

How Is Diabetes Treated in Children?

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... Consumers Home For Consumers Consumer Updates How Is Diabetes Treated in Children? Share Tweet Linkedin Pin it ... as diabetes gets worse over time. Type 2 Diabetes Type 2 diabetes is most often diagnosed in ...

Dramatic course of osteomyelitis in a patient treated with immediately placed dental implants suffering from uncontrolled diabetes: A case report.

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Doll, Christian; Hartwig, Stefan; Nack, Claudia; Nahles, Susanne; Nelson, Katja; Raguse, Jan-Dirk

2015-01-01

To report a rare and dramatic complication following immediate dental implant placement in a heavy smoker, who had a delayed diagnosis of uncontrolled diabetes. In this case report we present the dramatic course of a 64-year old female patient treated with five immediate post-extractive dental implants in the mandible, who developed osteomyelitis, which manifested initially as local peri-implant inflammation and progressed into a spontaneous jaw fracture, despite repeated surgical interventions and antibiotic courses over a 3-year period, until diabetes was diagnosed. A symptom-free status could be achieved only after partial mandibulectomy, treatment of diabetes and reconstruction with a microvascular fibula free flap. In the presence of mandibular osteomyelitis refractory to therapy, yet undiagnosed underlying pathologies, such as diabetes, should be investigated and treated urgently.

Prevalence of nocturnal hypoglycemia in first trimester of pregnancy in patients with insulin treated diabetes mellitus

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Hellmuth, Ellinor Adelheid; Damm, P; Mølsted-Pedersen, L

2000-01-01

BACKGROUND: Excellent metabolic control before conception and during diabetic pregnancies is the aim in order to avoid malformations and perinatal morbidity. Since an inverse correlation between median blood glucose concentration (BG) and hypoglycemia as well as a high prevalence of nocturnal...... the night, caused by either discomfort or cannula problems. Of the remaining 43 patients, 16 (37%) had at least one blood glucose ... of pregnancy in insulin treated patients. Only one patient registered the hypoglycemia. Nocturnal hypoglycemia could be predicted in the majority of patients by measurements of BG before bedtime....

Bilateral Ramsay Hunt syndrome in a diabetic patient

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Goyal Amit

2004-12-01

Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

Indonesia Cohort of IO HAT Study to Evaluate Diabetes Management, Control, and Complications in Retrospective and Prospective Periods Among Insulin-Treated Patients with Type 1 and Type 2 Diabetes

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Achmad Rudijanto

2018-04-01

Full Text Available Background: hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM or type 2 diabetes mellitus (T2DM in the Indonesian cohort. Methods: this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357. The patients of ≥18 years of age and treated with insulin for >12 months were selected for this study (ClinicalTrials.gov number: NCT02306681. Results: a total of 374 patients were enrolled in this study and completed SAQ1. All patients with T1DM (17 [100%], and 347 (97.2% patients with T2DM completed SAQ2. Almost all the patients in the 4-week prospective period reported at least one hypoglycemic event (T1DM 100%, T2DM 99.4% and the incidence rate of any hypoglycemia was 67.5 events per patient-year (PPY and 25.7 events PPY for T1DM and T2DM patients, respectively. Among patients with T1DM and T2DM, 5.9% and 36.4%, respectively, did not know what hypoglycemia was at baseline, also high proportion of patients had impaired hypoglycemic awareness in the study (82.4% and 62.7%, respectively. Conclusion: overall, high proportion of patients reported hypoglycemic events in the prospective period indicating under reporting during the retrospective period due to recall bias. Therefore, there is a need for patient education program to improve the awareness of hypoglycemia in diabetes patient in Indonesia.

Effect of change in body weight on incident diabetes mellitus in patients with stable coronary artery disease treated with atorvastatin (from the treating to new targets study).

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Ong, Kwok-Leung; Waters, David D; Messig, Michael; DeMicco, David A; Rye, Kerry-Anne; Barter, Philip J

2014-05-15

Features of the metabolic syndrome are independent risk factors for new-onset diabetes mellitus (NODM) related to statin therapy. Obesity is the predominant underlying risk factor for the metabolic syndrome and diabetes mellitus. This study investigated whether change in body weight may predict NODM in statin-treated patients. A total of 7,595 patients without prevalent diabetes mellitus at baseline from the Treating to New Targets (TNT) study were included in this analysis. They were randomized to atorvastatin 10 or 80 mg/day and monitored for a median of 4.9 years. NODM developed in 659 patients (8.1% in the 10-mg group and 9.2% in the 80-mg group). There was a significant increase in body weight (0.9 kg, p weight was greater in patients with NODM than those without NODM (1.6 vs 0.9 kg, p weight with NODM risk remained significant after adjusting for confounding factors (hazard ratios 1.33, 1.42, and 1.88 for quartiles 2, 3, and 4 compared with quartile 1, respectively). Similar results were obtained in patients with normal fasting glucose level. In conclusion, 1-year change in body weight is predictive of NODM in patients who underwent statin therapy from the TNT trial. Our study highlights the importance of weight control as a lifestyle measure to prevent statin-related NODM. Copyright © 2014 Elsevier Inc. All rights reserved.

Perioperative nursing for patients with diabetic foot receiving endovascular interventional therapy

International Nuclear Information System (INIS)

Yang Yang; Wang Feng; Li Ke; Li Cheng; Ji Donghua

2010-01-01

Objective: To study the effect of perioperative nursing on the living quality of patients with diabetic foot who are treated with endovascular interventional therapy. Methods: Specific perioperative nursing care plan was accordingly designed for 43 patients with diabetic foot. Endovascular balloon angioplasty and stent implantation were formed in these patients to treat their diabetic foot. The clinical results were observed. Results: Perioperative nursing effectively improved patient's limb blood supply, enhanced the healing of diabetic foot ulceration and increased the possibility of limb preservation. Conclusion: Endovascular therapy combined with corresponding perioperative nursing care can benefit more patients with diabetic foot. (authors)

Incidence of diabetic ketoacidosis among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors and other antihyperglycemic agents.

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Wang, Yiting; Desai, Mehul; Ryan, Patrick B; DeFalco, Frank J; Schuemie, Martijn J; Stang, Paul E; Berlin, Jesse A; Yuan, Zhong

2017-06-01

To estimate and compare incidence of diabetes ketoacidosis (DKA) among patients with type 2 diabetes who are newly treated with SGLT2 inhibitors (SGLT2i) versus non-SGLT2i antihyperglycemic agents (AHAs) in actual clinical practice. A new-user cohort study design using a large insurance claims database in the US. DKA incidence was compared between new users of SGLT2i and new users of non-SGLT2i AHAs pair-matched on exposure propensity scores (EPS) using Cox regression models. Overall, crude incidence rates (95% CI) per 1000 patient-years for DKA were 1.69 (1.22-2.30) and 1.83 (1.58-2.10) among new users of SGLT2i (n=34,442) and non-SGLT2i AHAs (n=126,703). These rates more than doubled among patients with prior insulin prescriptions but decreased by more than half in analyses that excluded potential autoimmune diabetes (PAD). The hazard ratio (95% CI) for DKA comparing new users of SGLT2i to new users of non-SGLT2i AHAs was 1.91 (0.94-4.11) (p=0.09) among the 30,196 EPS-matched pairs overall, and 1.13 (0.43-3.00) (p=0.81) among the 27,515 EPS-matched pairs that excluded PAD. This was the first observational study that compared DKA risk between new users of SGLT2i and non-SGLT2i AHAs among patients with type 2 diabetes, and overall no statistically significant difference was detected. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Improvement of the quality of diabetes control and decrease in the concentrations of AGE-products in patients with type 1 and insulin-treated type 2 diabetes mellitus: results from a 10 year-prospective, population-based survey on the quality of diabetes care in Germany (JEVIN).

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Schiel, Ralf; Franke, S; Appel, T; Voigt, U; Ross, I S; Kientsch-Engel, R; Müller, U A; Stein, G

2004-08-31

Advanced glycation end (AGE)-products are a complex group of compounds that have been implicated in diabetes related long-term complications. Up to the present only few data exist about serum levels of the AGE-proteins N-epsilon-Carboxymethyllysine (CML) and pentosidine in patients with diabetes mellitus. In the present 10-year, population-based trial of a selection-free cohort of patients with insulin-treated diabetes mellitus, serum CML and pentosidine levels were examined in correlation to the patients' quality of diabetes control and the prevalence of diabetes related long-term complications. Following the reunification of Germany in 1989 the health care system was decentralised. Up to 1994/95 the relative HbA1c (HbA1c/mean normal) of patients with type 1 diabetes increased (1.65 +/- 0.35 versus 1.52 +/- 0.31, p = 0.002). For patients with type 2 diabetes it remained constant (1.75 +/- 0.4 versus 1.78 +/- 0.31, p = 0.669). During the following period (from 1994/95 to 1999/2000) specialised diabetes care, structured treatment and teaching programmes (TTP), intensified insulin therapy and blood glucose self-monitoring for all patients were broadly implemented. This was accompanied by a substantial improvement in the relative HbA1c of both, patients with type 1 (1.48 +/- 0.3, pproduct CML in the sera of patients with type 1 and insulin-treated type 2 diabetes decreased (type 1: 1994/95: 1158.1 +/- 410.0 ng/ml versus 1999/2000: 938.5 +/- 422.4 ng/ml, pimprovement in patients' quality of diabetes control but also a decrease in the concentration of AGE-products. In patients with diabetes mellitus the AGE-products seem to be mainly influenced by the quality of diabetes control. The decline in renal function leads to increased serum pentosidine levels in patients with insulin-treated diabetes mellitus. Thus it seems that in patients with reduced renal function, higher levels may either play a causal role in the development and progression of nephropathy or they are an

Intensive Treat-to-Target Statin Therapy in High-Risk Japanese Patients With Hypercholesterolemia and Diabetic Retinopathy: Report of a Randomized Study.

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Itoh, Hiroshi; Komuro, Issei; Takeuchi, Masahiro; Akasaka, Takashi; Daida, Hiroyuki; Egashira, Yoshiki; Fujita, Hideo; Higaki, Jitsuo; Hirata, Ken-Ichi; Ishibashi, Shun; Isshiki, Takaaki; Ito, Sadayoshi; Kashiwagi, Atsunori; Kato, Satoshi; Kitagawa, Kazuo; Kitakaze, Masafumi; Kitazono, Takanari; Kurabayashi, Masahiko; Miyauchi, Katsumi; Murakami, Tomoaki; Murohara, Toyoaki; Node, Koichi; Ogawa, Susumu; Saito, Yoshihiko; Seino, Yoshihiko; Shigeeda, Takashi; Shindo, Shunya; Sugawara, Masahiro; Sugiyama, Seigo; Terauchi, Yasuo; Tsutsui, Hiroyuki; Ueshima, Kenji; Utsunomiya, Kazunori; Yamagishi, Masakazu; Yamazaki, Tsutomu; Yo, Shoei; Yokote, Koutaro; Yoshida, Kiyoshi; Yoshimura, Michihiro; Yoshimura, Nagahisa; Nakao, Kazuwa; Nagai, Ryozo

2018-06-01

Diabetes is associated with high risk of cardiovascular (CV) events, particularly in patients with dyslipidemia and diabetic complications. We investigated the incidence of CV events with intensive or standard lipid-lowering therapy in patients with hypercholesterolemia, diabetic retinopathy, and no history of coronary artery disease (treat-to-target approach). In this multicenter, prospective, randomized, open-label, blinded end point study, eligible patients were randomly assigned (1:1) to intensive statin therapy targeting LDL cholesterol (LDL-C) targeting LDL-C 100-120 mg/dL ( n = 2,524). Mean follow-up was 37 ± 13 months. LDL-C at 36 months was 76.5 ± 21.6 mg/dL in the intensive group and 104.1 ± 22.1 mg/dL in the standard group ( P target strategy in high-risk patients deserves further investigation. © 2018 by the American Diabetes Association.

Adapting to the therapeutic recommendations of patients treated of type 2 diabetes

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Natalia Alicja Świątoniowska

2017-04-01

Full Text Available Introduction.  Year after year, more and more people are suffering from diabetes, the number  of people with diabetes in 2012 confirms its fourfold increase over the last 35 years. It is estimated that in 2035, diabetes will be diagnosed in every third person. Currently the treatment of type 2 diabetes is based on glycemic control and avoidance  of complications. These goals can be achieved through lifestyle changes, the use  of hypoglycaemic drugs, and insulin injections. Achieving correct glycemic control is only possible if patients follow therapeutic recommendations. Data in the literature indicate that only 50% of patients follow established therapeutic regimens. Aim. The aim of the study is the presentation of previous state of knowledge on the adherence in type 2 diabetes. Brief description of state of knowledge. At present, there are few studies available assessing the level of adherence to the recommendations by patients with diabetes and adherence factors. Available publications indicate conflicting results regarding the influence of age, sex and duration  of the disease on the level of compliance. Conclusions. It is necessary to conduct further analysis of the causes of non-compliance, to select non-adherence-prone patients, and to implement methods to improve adherence to treatment recommendations in case of diabetes.

Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries

DEFF Research Database (Denmark)

Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund

2013-01-01

the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Methods: Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics...

CONTAMINATED PROBLEMATIC SKIN WOUNDS IN DIABETIC PATIENTS TREATED WITH AUTOLOGOUS PLATELET-RICH PLASMA (PRP: A case series study

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Tsvetan Sokolov

2016-03-01

Full Text Available OBJECTIVE: To study the effect of platelet-rich plasma (PRP on contaminated problematic skin ulcers in patients with diabetes. MATERIAL AND METHODS: A total of 6 patients had been treated within the period from 2012 to 2014; they had various types of problematic wounds and diabetes type 2. Patients’ distribution by sex was as follows: 1 man and 5 women; mean age- 68 years. Ulcer types: acute (2 patients, hard-to-heal (2 patients and chronic (2 patients ulcers. The mean size of the skin and soft tissue defect was 9,5 cm2. Pathogenic microflora was isolated in 4 patients - S. aureus in three and Е. Coli in one. Based on a scheme developed by us, all cases were treated by administering platelet-rich plasma, derived by PRGF Endoret system. Follow-up period was within 4 – 6 months (4,5 on average. We used platelet rich plasma derived by PRGF Endoret system, applied on the wound bed on a weekly basis. RESULTS: Application of PRP allowed successful closure of all wounds. There were no complications associated with treatment of PRP. Epithelialization of the wound took 15 weeks on average for all patients. One patient presented with hyperkeratosis. Initial score of followed wounds, based on the scales are as follows: Total wound score – 10 p. Total anatomic score – 8 p. Total score – 15 p. at the initial stage. At the end of the treatment period scores were as follows - 0 p., which means excellent results CONCLUSION: We believe that the application of PRP may become optimal therapy in the treatment of contaminated problematic wounds in diabetic patients. PRP not only stimulates wound healing, but also has antimicrobial properties, which may contribute to the prevention of infections.

Complications of ankle fracture in patients with diabetes.

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Chaudhary, Saad B; Liporace, Frank A; Gandhi, Ankur; Donley, Brian G; Pinzur, Michael S; Lin, Sheldon S

2008-03-01

Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Complications of impaired wound healing, infection, malunion, delayed union, nonunion, and Charcot arthropathy are prevalent in this patient population. Controversy exists as to whether diabetic ankle fractures are best treated noninvasively or by open reduction and internal fixation. Patients with diabetes are at significant risk for soft-tissue complications. In addition, diabetic ankle fractures heal, but significant delays in bone healing exist. Also, Charcot ankle arthropathy occurs more commonly in patients who were initially undiagnosed and had a delay in immobilization and in patients treated nonsurgically for displaced ankle fractures. Several techniques have been described to minimize complications associated with diabetic ankle fractures (eg, rigid external fixation, use of Kirschner wires or Steinmann pins to increase rigidity). Regardless of the specifics of treatment, adherence to the basic principles of preoperative planning, meticulous soft-tissue management, and attention to stable, rigid fixation with prolonged, protected immobilization are paramount in minimizing problems and yielding good functional outcomes.

Effect of assistance on peritonitis risk in diabetic patients treated by peritoneal dialysis: report from the French Language Peritoneal Dialysis Registry.

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Benabed, Anais; Bechade, Clemence; Ficheux, Maxence; Verger, Christian; Lobbedez, Thierry

2016-04-01

Diabetic patients treated by peritoneal dialysis (PD) have been reported to be at an increased risk of peritonitis. This has been attributed to impairment in host defense, visual impairment, disability and muscle wasting, which could compromise ability to safely perform catheter connections. This study aimed to evaluate whether assisted PD is associated with a lower risk of peritonitis in diabetic patients. This was a retrospective study based on data from the French Language Peritoneal Dialysis Registry. We included diabetic patients starting PD between 1 January 2002 and 31 December 2012. The end of the observation period was 31 December 2013. Using complementary regression analysis (Fine and Gray, Hurdle models), we assessed the relationship between peritonitis occurrence, peritonitis number over time and the type of assisted PD. Of the 3598 diabetic patients, there were 2040 patients on nurse-assisted PD. These patients were older, more comorbid and more frequently on continuous ambulatory peritoneal dialysis (CAPD). In the multivariate analysis, nurse assistance was associated with a reduced risk of peritonitis in the Fine and Gray [subdistribution hazard ratio: 0.78 (95% confidence interval, CI, 0.68-0.89)] and in the first component of the Hurdle models [rate ratio: 0.82 (95% CI 0.71-0.93)], but not a lower incidence of peritonitis after an initial episode [rate ratio: 0.82 (95% CI 0.95-1.38)]. Transplant failure, glomerulonephritis and CAPD were associated with an increased risk. In France, nurse-assisted PD is associated with a lower risk of peritonitis in diabetic patients treated by PD but not a lower incidence of peritonitis. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Effect of a polyherbal formulation cream on diabetic neuropathic pain among patients with type 2 diabetes – A pilot study

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Viswanathan, Vijay; Rajsekar, Seena; Selvaraj, Bamila; Kumpatla, Satyavani

2016-01-01

Background & objectives: Painful diabetic neuropathy is a common complication of diabetes and can severely limit patients’ daily functions. The aim of this pilot study was to evaluate the safety and effect of using a polyherbal formulation in reducing the symptoms of diabetic neuropathic pain in comparison with placebo among patients with type 2 diabetes. Methods: A total of 50 (M:F = 33:17) consecutive type 2 diabetes patients with painful diabetic neuropathy were enrolled in this study. All these patients had either two or more symptoms of diabetic neuropathy such as pain, burning and pricking sensations and numbness in their feet. They were randomly assigned to two groups: group 1 (n = 26) patients were treated with polyherbal formulation cream and group 2 (n = 24) patients were administered placebo. The patients were followed up for six months. Changes in the symptoms of painful diabetic neuropathy of each patient were recorded at baseline, third and sixth month using the Diabetic Neuropathic Score. Results: The mean age of the patients, duration of diabetes and glycated haemoglobin (HbA1c) were similar in both groups at baseline. During follow up visits, there was a decrease in the HbA1c levels in the study and control groups. The symptoms of painful diabetic neuropathy were also similar in both groups at baseline. A significant decrease in symptoms of neuropathic pain was observed among the group of patients treated with polyherbal formulation cream (76.9 per cent) compared to the placebo-treated group (12.5 per cent) (P<0.001), at the end of the final follow up. Interpretation & conclusions: In this pilot study polyherbal formulation cream was found to be effective as well as safe to treat painful diabetic neuropathy. However, its long term use needs to be evaluated for any further effectiveness and side effects. PMID:27934800

Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema : Subgroup analysis of the MEAD study

OpenAIRE

Augustin, A.J.; Kuppermann, B.D.; Lanzetta, P.; Loewenstein, A.; Li, X.; Cui, H.; Hashad, Y.; Whitcup, S.M.; Abujamra, S.; Acton, J.; Ali, F.; Antoszyk, A.; Awh, C.C.; Barak, A.; Bartz-Schmidt, K.U.

2015-01-01

Background Dexamethasone intravitreal implant 0.7?mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME. Methods Three-year, randomized, sham-controlled phase 3 study in patients with DME, best-corrected visual acuity (BCVA) of 34?68 Early Treatment...

Outcome of Diabetic and Non-Diabetic Patients Undergoing Successful Percutaneous Coronary Intervention of Chronic Total Occlusion

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Bahram Sohrabi

2011-05-01

Full Text Available Introduction: Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention (PCI. The prognosis of patients with diabetes mellitus and chronic total occlusion (CTO treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. Methods: One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15±3 months, were evaluated for the occurrence of major adverse cardiac events (MACE comprising death, acute myocardial infarction, and need for repeat revascularization.Results: No differences were found in baseline clinical and procedural variables between patients with (n=34 and without diabetes (n=129, unless for hypertension (p=0.03. Hospitalization period after PCI in diabetics (3.26±0.61 days and non-diabetics (2.86±0.52 days was similar. In-hospital MACE occurred in 8 (23.5% individuals of diabetics and 10 (7.8% individuals of non-diabetics (p=0.02, among them revascularization was significantly higher in diabetics (20.6% vs. 7%, p=0.04. Follow-up events in diabetic and non-diabetic groups were 12 (35.3% and 37 (28.5%, respectively (p was not significant. Conclusion: In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients.

A cross-sectional survey among patients and prescribers on insulin dosing irregularities and impact of mild (self-treated) hypoglycemia episodes in Spanish patients with type 2 diabetes as compared to other European patients.

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Ampudia-Blasco, Francisco J; Galán, Manuel; Brod, Meryl

2014-10-01

In Spain, data suggest that 13.8% of adults have diabetes. Two important aspects in diabetes management are mild hypoglycemic episodes and poor treatment adherence. This study assesses the impact of missed insulin doses and prevalence of mistimed and reduced insulin doses and mild hypoglycemia in patients with type 2 diabetes treated with basal insulin analogues in Spain, and compares the data collected to pooled data from 8 other European countries (OECs). GAPP2 was an international, online, cross-sectional study of diabetic patients aged ≥40 years treated with long-acting insulin analogues and their healthcare professionals. Patients and healthcare professionals were recruited from online research panels. Data reported in Spain are compared to pooled data from 8 OECs. In Spain, 1-3% of patients reported they had reduced, missed, or mistimed at least one insulin does in the previous month. Significantly more OEC patients reported dosing irregularities (15-23%; all P<0.01). In Spain, 77% of patients were worried and 59% felt guilty for missing a dose of basal insulin, while 24% reported that they were very worried about nocturnal hypoglycemia. Significantly fewer OEC patients reported worrying (47%; P<0.01) and feeling guilty (37%; P<0.01) about missing an insulin dose, or worry about nocturnal hypoglycemia (12%; P<0.01). In Spain, patients with type 2 diabetes report fewer dosing irregularities and hypoglycemic episodes as compared to patients from OECs. However, Spanish patients appear to have a reduced quality of life related to hypoglycemia as well as worry and guilt related to insulin dosing irregularities. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus.

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Rubino, Francesco; Kaplan, Lee M; Schauer, Philip R; Cummings, David E

2010-03-01

To develop guidelines for the use of gastrointestinal surgery to treat type 2 diabetes and to craft an agenda for further research. Increasing evidence demonstrates that bariatric surgery can dramatically ameliorate type 2 diabetes. Not surprisingly, gastrointestinal operations are now being used throughout the world to treat diabetes in association with obesity, and increasingly, for diabetes alone. However, the role for surgery in diabetes treatment is not clearly defined and there are neither clear guidelines for these practices nor sufficient plans for clinical trials to evaluate the risks and benefits of such "diabetes surgery." A multidisciplinary group of 50 voting delegates from around the world gathered in Rome, Italy for the first International Conference on Gastrointestinal Surgery to Treat Type 2 Diabetes--(the "Diabetes Surgery Summit"). During the meeting, available scientific evidence was examined and critiqued by the entire group to assess the strength of evidence and to draft consensus statements. Through an iterative process, draft statements were then serially discussed, debated, edited, reassessed, and finally presented for formal voting. After the Rome meeting, statements that achieved consensus were summarized and distributed to all voting delegates for further input and final approval. These statements were then formally critiqued by representatives of several sientific societies at the 1st World Congress on Interventional Therapies for T2DM (New York, Sept 2008). Input from this discussion was used to generate the current position statement. A Diabetes Surgery Summit (DSS) Position Statement consists of recommendations for clinical and research issues, as well as general concepts and definitions in diabetes surgery. The DSS recognizes the legitimacy of surgical approaches to treat diabetes in carefully selected patients. For example, gastric bypass was deemed a reasonable treatment option for patients with poorly controlled diabetes and a

Pioglitazone metabolic effect in metformin-intolerant obese patients treated with sibutramine.

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Derosa, Giuseppe; Mereu, Roberto; Salvadeo, Sibilla A T; D'Angelo, Angela; Ciccarelli, Leonardina; Piccinni, Mario N; Ferrari, Ilaria; Gravina, Alessia; Maffioli, Pamela; Cicero, Arrigo F G

2009-01-01

Metformin is the drug of choice to treat obese type 2 diabetes patients because it reduces either insulin-resistance and body weight. We aimed to comparatively test the efficacy and tolerability of pioglitazone and sibutramine in metformin-intolerant obese type 2 diabetic patients treated with sibutramine. Five hundred and seventy-six consecutive Caucasian obese type 2 diabetic patients were evaluated during a 12-months period and fifty-two patients were resulted intolerant to metformin at maximum dosage (3,000 mg/day). All intolerant patients to metformin received a treatment with pioglitazone (45 mg/day) and sibutramine (10 mg/day) and they were compared with fifty-three patients treated with metformin (3,000 mg/day) and sibutramine (10 mg/day) for 6 months in a single-blind controlled trial. We assessed body mass index, waist circumference, glycated hemoglobin, Fasting Plasma glucose, postprandial plasma glucose, fasting plasma insulin, postprandial plasma insulin, lipid profile, systolic blood pressure, diastolic blood pressure and heart rate at baseline and after 3, and 6 months. No body mass index change was observed at 3, and 6 months in pioglitazone + sibutramine group, while a significant reduction of body mass index and waist circumference was observed after 6 months in metformin + sibutramine group (psibutramine combination appears to be a short-term equally efficacious and well-tolerated therapeutic alternative respect to metformin-intolerant obese type 2 diabetic patients treated with sibutramine.

Evaluation of cardiac denervation in patients with long-standing diabetes

International Nuclear Information System (INIS)

Khurram, M.; Khar, Hamama-tul-Bushra; Malik, M.F. Fazal-ur-Rehman; Javed, S.; Hassan, Z.; Minhas, Z.; Goraya, M.F.; Shakoor, A.

2002-01-01

Objective: Evaluation of cardiac autonomic dysfunction in long-standing diabetics, comparing patients treated with insulin and oral hypo glycemic agents. Design: Observational and comparative study between two treatment groups. Place and Duration of Study: At department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, for 6 months. Subjects and Methods: Fifty diabetic patients of about 10 years illness were studied. Patients were divided into two groups, Group 1(13 males, 12 females; mean age 33.08 years) included those who received insulin, and Group II patients (12 males, 13 females; mean age 54.68 years) who received oral hypo glycemic agents for their diabetic illness. Evaluation of cardiac denervation in both the groups was done in terms of presence of resting tachycardia, loss of sinus arrhythmia and abnormalities of Valsava response. Results: At least some form of cardiac denervation was present in 62% of total subjects. 48% of Group I and 76 % of Group II patients. A significantly high number of patients treated with oral hypo glycemic agents had evidence of cardiac denervation when compared with patients who were treated with insulin (p < 0.05). Conclusion: Cardiac denervation is common in long-standing diabetics specifically in those treated with oral hypo glycemic agents. (author)

Frequency and risk factors of severe hypoglycaemia in insulin-treated Type 2 diabetes

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Akram, K; Pedersen-Bjergaard, U; Carstensen, B

2006-01-01

AIMS: The reported risk of severe hypoglycaemia in insulin-treated Type 2 diabetes is highly variable and few studies have evaluated the influence of risk factors. We assessed the incidence and the influence of potential risk factors for severe hypoglycaemia in a questionnaire survey in subjects...... with insulin-treated Type 2 diabetes receiving currently recommended multifactorial intervention. METHODS: Consecutive patients with insulin-treated Type 2 diabetes (n = 401) completed a questionnaire about occurrence of hypoglycaemia in the past, hypoglycaemia awareness and socio-demographic factors. A zero...... treatment and treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor antagonists (ARBs) were associated with reduced risk. C-peptide concentration and HbA1c were not associated with the risk of severe hypoglycaemia. CONCLUSIONS: In this cohort of insulin-treated Type 2...

Observation on Efficacy of Puerarin in Treating Diabetic Retino pathy

Institute of Scientific and Technical Information of China (English)

任平; 胡惠君; 张瑞

2002-01-01

Objective: Using the principle of promoting blood circulation to remove s tasis to observe central retinal arterial and venous blood flow indexes, and hemorrheology of diabetic retinopathy patients with puerarin. Methods: Thirty patients with diabetic retinopathy were randomly divided into the treated group (n=15) and the control group (n=15). The treated group was given puerarin 400 mg per day intravenously dripping. The control group was given Mikebao 500 μg intramuscularly, once per day. Both groups were treated for 3 co nsecutive weeks as one treatment course. Two courses later, hemorrheologic parameters, central retinal arterial and venous blood flow indexes were observed . Results: Comparison before and after treatment showed red blood cell aggregation index, the whole bloo d viscosity rate, plasma viscosity rate, fibrinogen and erythrocyte sedimentatio n rate, have all improved obviously (P<0.05, P<0.01). Compared wi th the control gro up, there was significant difference (P<0.05, P<0.01). With the treated group before and after treatment, the peak systolic velocity (P SV) of c entral retinal artery, their end diastolic volume, the acceleration, the central retinal venous reflux velocity have improved respectively. Nak ed eye visions were also improved, compared with the control group, the differe nce was significant (P<0.01). Conclusion: Puerarin could reduc e bl ood viscosity, improve microcirculation, and play a positive therapeutic role i n diabetic retinopathy.

Hypoglycemia in type 2 diabetes patients treated with insulin: the advantages of continuous glucose monitoring

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Vadim Valer'evich Klimontov

2014-03-01

Full Text Available Aims.  To determine the incidence and risk factors for hypoglycemia in elderly insulin-treated type 2 diabetes mellitus (T2DM patients by means of continuous glucose monitoring (CGM. Materials and Methods.  We observed seventy-six hospitalized patients with T2DM, aged 65 to 79 years. Treatment with basal insulin (n=36, premixed insulin (n=12 or basal-bolus insulin regimen (n=28 was followed by metformin (n=44, glimepiride (n=14 and dipeptidyl peptidase-4 inhibitors (n=14. 2-days CGM with retrospective data analysis was performed in all patients. During CGM, three fasting and three 2-h postprandial finger-prick glucose values were obtained daily with portable glucose meter. Results.  Hypoglycemia (identified as blood glucose

Impact of hyperglycemia on ischemic stroke mortality in diabetic and non-diabetic patients

International Nuclear Information System (INIS)

Kes, V.B.; Solter, V.V.; Supanc, V.; Demarin, V.

2007-01-01

Previous studies suggest that infarct expansion may be responsible for increased mortality after stroke onset in patients with prolonged stress hyperglycemia on stroke mortality in patients with and without diabetes. For 630 stroke patients admitted to the neurological intensive care department within 24 hours of stroke onset, we correlated mean blood glucose levels (MBGL) at admission and 72 hours after admission in diabetic and non-diabetic patients with final outcome. Blood glucose levels higher then 6.1 mmol/L (121mg/dL) was treated as hyperglycemia. Of 630 patients (mean age 71+-6), 410 were non-diabetic (mortality, 25%) and 220 patients were diabetic (mortality, 20%). All patients who died within 28 days of hospitalization had prolonged hyperglycemia at admission and after 72 hours, despite insulin therapy). The unadjusted relative risk of in-hospital mortality within 28 days of all stroke patients was 0.68 (95% CI, 0.14-1.9) for non-diabetic patients and 0.39 (95% CI, 0.27-1.56) for diabetic patients. The unadjusted relative risk of in-hospital mortality within 28 days in ischemic stroke in patients with MBGL> 6.1-8.0 mmol/L (121-144 mg/dL) at admission after 72 hours was 1.83 (95% CI, 0.41-5.5) for non-diabetic patients and 1.13 (95% CI, 0.78-4.5) for diabetic patients and 1.13 (95%, 0.78-4.5) for diabetic patients. Non-diabetic patients with hyperglycemia had a 1.7 times higher relative risk of in-hospital 28-day mortality than patients with diabetes. Prolonged stress hyperglycemia in ischemic stroke patients increases the risk of in-hospital 28-day mortality, especially in non-diabetic patients. (author)

A patient treated with olanzapine developing diabetes de novo : proposal for hyperglycaemia screening

NARCIS (Netherlands)

Duiverman, M. L.; Cohen, D.; van Oven, W.; Nieboer, P.

2007-01-01

We report a patient with schizophrenia who developed diabetes mellitus during treatment with olanzapine. The case confirms the pattern of atypical antipsychotic-related diabetic emergencies: rapid onset in relatively young patients, often with severe glucose derangements and serious complications.

The management of ankle fractures in patients with diabetes.

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Wukich, Dane K; Kline, Alex J

2008-07-01

Patients with diabetes mellitus have higher complication rates following both open and closed management of ankle fractures. Diabetic patients with neuropathy or vasculopathy have higher complication rates than both diabetic patients without these comorbidities and nondiabetic patients. Unstable ankle fractures in diabetic patients without neuropathy or vasculopathy are best treated with open reduction and internal fixation with use of standard techniques. Patients with neuropathy or vasculopathy are at increased risk for both soft-tissue and osseous complications, including delayed union and nonunion. Careful soft-tissue management as well as stable, rigid internal fixation are crucial to obtaining a good outcome. Prolonged non-weight-bearing and subsequently protected weight-bearing are recommended following both operative and nonoperative management of ankle fractures in patients with diabetes.

Diabetic retinopathy in two patients with congenital IGF-I deficiency (Laron syndrome).

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Laron, Zvi; Weinberger, Dov

2004-07-01

Animal and clinical studies have shown that excessive amounts of growth hormone or insulin-like growth factor-I (IGF-I) promote the development of diabetes and diabetic retinopathy. Forthwith, we present two patients with congenital IGF-I deficiency who developed type II diabetes and subsequently retinopathy. Eighteen adult patients with classical Laron syndrome (8 males, 10 females, aged 20-62 years) were followed by us since childhood or underwent fundus photography with a Nikon NF 505 instrument. Three had been treated in childhood with IGF-I, the rest were never treated, including the two patients reported. Two never-treated patients were diagnosed with type II diabetes (DM) at ages 39 and 41 respectively. There was no diabetes in the families. Oral treatment was followed by insulin injections. Metabolic control was not optimal and one patient developed proliferative diabetic retinopathy, necessitating laser surgery. He also has nephropathy and severe neuropathy. The other patient has background diabetic retinopathy and has developed, progressively, exudates, microaneurisms, hemorrhages and clinically significant macular edema. He also has subacute ischemic heart disease. Our findings show that congenital IGF-I deficiency, similar to excess, causes vascular complications of DM, denoting also that vascular endothelial growth factor can induce neovascularization in the presence of congenital IGF-I deficiency.

Orthodontic Treatment Consideration in Diabetic Patients.

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Almadih, Ahmed; Al-Zayer, Maryam; Dabel, Sukainh; Alkhalaf, Ahmed; Al Mayyad, Ali; Bardisi, Wajdi; Alshammari, Shouq; Alsihati, Zainab

2018-02-01

Although orthodontic treatment is commonly indicated for young healthy individuals, recent trends showed an increase in number of older individuals undergoing orthodontic interventions. The increased age resulted in a proportionate increase in the prevalence of systemic diseases facing dentists during orthodontic procedures, especially diabetes mellitus. This necessitates that dentists should be aware of the diagnosis of diabetes mellitus and its early signs particularly in teeth and oral cavity. It is also essential for them to understand the implications of diabetes on orthodontic treatment and the measures to be considered during managing those patients. In this review, we focused on the impact of diabetes mellitus on orthodontic treatment. We also summarized the data from previous studies that had explained the measures required to be taken into consideration during managing those patients. We included both human and animal studies to review in depth the pathophysiological mechanisms by which diabetes affects orthodontic treatment outcome. In conclusion, this review emphasizes the need to carefully identify early signs and symptoms of diabetes mellitus in patients demanding orthodontic treatment and to understand the considerations to be adopted before and during treating these patients.

Are late-night eating habits and sleep duration associated with glycemic control in adult type 1 diabetes patients treated with insulin pumps?

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Matejko, Bartlomiej; Kiec-Wilk, Beata; Szopa, Magdalena; Trznadel Morawska, Iwona; Malecki, Maciej T; Klupa, Tomasz

2015-07-01

Little is known about the impact of sleep duration and late-night snacking on glycemic control in patients with type 1 diabetes using insulin pumps. The aim of the present study was to examine whether late-night eating habits and short sleep duration are associated with glycemic control in continuous subcutaneous insulin infusion-treated type 1 diabetic patients. We included 148 consecutive adult type 1 diabetic subjects using an insulin pump (100 women and 48 men). Participants completed a questionnaire regarding sleep duration (classified as short if ≤6 h) and late-night snacking. Other sources of information included medical records and data from blood glucose meters. Glycemic control was assessed by glycated hemoglobin (HbA1c) levels and mean self-monitoring of blood glucose (SMBG) readings. The mean age of patients was 26 years, mean type 1 diabetes duration was 13.4 years and mean HbA1c level was 7.2%. In a univariate regression analysis, sleep duration was a predictor of both HbA1c (β = 0.51, P = 0.01) and SMBG levels (β = 11.4, P = 0.02). Additionally, an association was found between frequent late-night snacking and higher SMBG readings (often snacking β = 18.1, P = 0.05), but not with increased HbA1c levels. In the multivariate linear regression, independent predictors for HbA1c and SMBG were sleep duration and patient age. In a univariate logistic regression, sleep duration and frequency of late-night snacking were not predictors of whether HbA1c target levels were achieved. Short sleep duration, but not late-night snacking, seems to be associated with poorer glycemic control in type 1 diabetic patients treated with continuous subcutaneous insulin infusion.

Study of diabetes mellitus among patients with hepatitis C virus

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Mona Abdel Raouf

2012-01-01

Conclusion We can concluded that diabetic HCV patients had intermediate clinical phenotype lower BMI and LDL than control and development of type 2 diabetes mellitus in HCV patients was significantly higher in nontreated patients than treated patients. Antiviral therapy and clearance of HCV improves IR, β-cell function, the blood glucose abnormalities.

Higher mortality of patients on haemodialysis with pancreatic diabetes compared to type 2-diabetes

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Bodlaj Gert

2012-03-01

Full Text Available Abstract In rare cases (1-8% diabetic patients with end-stage renal disease (ESRD suffer from diabetic nephropathy (dNP due to pancreatic diabetes mellitus (PDM. Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes. In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD in our dialysis centre (1997-2005. In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups. The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m2 was lower (22 + 3 versus 25 + 3, and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status.

Endothelial progenitor cells in long-standing asymptomatic type 1 diabetic patients with or without diabetic nephropathy

DEFF Research Database (Denmark)

Reinhard, Henrik; Jacobsen, Peter Karl; Lajer, Maria

2011-01-01

with or without DN and to study the effect of CVD and medication on EPC numbers. Methods: We examined EPC numbers in 37 type 1 diabetic patients with DN and 35 type 1 diabetic patients with long-standing normoalbuminuria. Patients were without symptoms of CVD and the prevalence of CVD was previously shown......A decrease in the number and dysfunction of endothelial progenitor cells (EPC) may increase the risk for progression of cardiovascular disease (CVD) in type 1 diabetic patients with diabetic nephropathy (DN). Our aim was to evaluate EPC numbers in asymptomatic CVD type 1 diabetic patients...... with CVD (p > 0.05). Conventional risk factors were significantly higher in patients with DN and they received more CVD-preventive treatment. All patients receiving simvastatin or calcium-channel blockers had higher numbers of EPC compared to patients not treated with these drugs. Conclusions: Asymptomatic...

Efficacy of vitamin B12 combined with metformin in treating type 2 diabetes and its effect on homocysteine

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Na Geng

2016-03-01

Full Text Available Objective: To observe and analyze Vitamin B12 combined with metformin treat for the type 2 diabetes, which affect the homocysteine. Methods: 92 cases of type 2 diabetes were selected in our hospital for treatment and study from October 2014 to April 2014. All patients were randomly divided into control group (46 cases and observation group (46 cases. Treatment of patients in the control group: patients were treated by metformin; observation group patients: Take vitamin B12 to patients treated with metformin. Finally, patient outcomes, as well as vitamin B12 and homocysteine in patients before and after treatment were analyzed. Results: Before treatment, all patients vitamin B12 content difference comparisons were no significant differences (P>0.05. Patients were treated in January, June and 1 year after the vitamin B12 content of the observation group were significantly higher in patients with vitamin B12 levels of data compared to each other there was a significant difference (P0.05. Patients were treated in January, June and 1 year after the homocysteine content of the observation group were not significantly reduced, the control group of patients with homocysteine increased significantly (P<0.000 1. Conclusions: Vitamin B12 combined with metformin in type 2 diabetes treatment, can significantly increase a patient's body to control homocysteine, while the treatment effect is obvious, clinical recommendations widely implemented.

Increased Micronuclei Frequency in Oral and Lingual Epithelium of Treated Diabetes Mellitus Patients

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Jesús Emilo Quintero Ojeda

2018-01-01

Full Text Available Diabetes mellitus (DM is a metabolic disease characterized by persistent high levels of glucose in plasma. Chronic hyperglycemia is thought to increase oxidative stress and the formation of free radicals that in turn damage cells. Thus, we decided to determine the frequency of nuclear abnormalities in epithelial cells from cheek and tongue mucosa of DM patients with type 1 (DM1, treated only with insulin and type 2 (DM2, treated with metformin using the buccal micronucleus cytome (BMCyt assay. Micronuclei frequency in cheek epithelial cells was higher in both DM1 (0.75 ± 0.31, P<0.001 and DM2 (0.52 ± 0.27, P<0.001 patients, as compared to healthy controls (0.07  ±  0.06. Similarly, micronuclei frequency in tongue epithelium was increased in DM1 (0.81  ±  0.22, P<0.001 and DM2 (0.41  ±  0.21, P<0.001 groups, in comparison to controls (0.06  ±  0.05. Besides, we found a positive correlation between micronuclei frequency and the onset time of DM2 in both cheek (ρ = 0.69, P<0.001 and tongue epithelial cells (ρ = 0.71, P<0.001, but not with onset time of DM1 or age of the patients. Considering all this, we pose that BMCyt could serve as a fast and easily accessible test to assess genotoxic damage during dental visits of DM patients, helping to monitor their disease.

Impact of Glycemic Control on Risk of Infections in Patients with Type 2 Diabetes

DEFF Research Database (Denmark)

Mor, Anil; Dekkers, Olaf M; Nielsen, Jens S

2017-01-01

Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital.......51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients.......-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an Hb...

Correlation between pain response and improvements in patient-reported outcomes and health-related quality of life in duloxetine-treated patients with diabetic peripheral neuropathic pain

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Ogawa K

2015-08-01

Full Text Available Kei Ogawa,1 Shinji Fujikoshi,2 William Montgomery,3 Levent Alev1 1Medical Science, 2Statistical Science, Eli Lilly Japan K.K., Kobe, Japan; 3Global Patient Outcomes and Real World Evidence, Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia Objective: We assessed whether quality of life (QoL improvement in duloxetine-treated patients with diabetic peripheral neuropathic pain (DPNP correlates with the extent of pain relief.Methods: Pooled data from three multicountry, double-blind, 12-week, placebo-controlled trials of duloxetine-treated (duloxetine 60 mg once daily; total number =335 patients with DPNP were analyzed. Based on improvement in 24-hour average pain scores, patients were stratified into four groups. Improvement in QoL, which was measured as the change from baseline in two patient-reported health outcome measures (Short Form [SF]-36 and five-dimension version of the EuroQol Questionnaire [EQ-5D], was evaluated and compared among the four groups. Pearson’s correlation coefficient was calculated to assess the correlation between improvement in pain scores and improvement in QoL.Results: The group with more pain improvement generally showed greater mean change from baseline in all of the SF-36 scale scores and on the EQ-5D index. Pearson’s correlation coefficients ranged from 0.114 to 0.401 for the SF-36 scale scores (P<0.05, and it was 0.271 for the EQ-5D (P<0.001.Conclusion: Improvement in pain scores was positively correlated with improvement in QoL and patient-reported outcomes in duloxetine-treated patients. Keywords: diabetic peripheral neuropathic pain, duloxetine, efficacy, function, quality of life

Neighborhood socioeconomic disadvantage is not associated with wound healing in diabetic foot ulcer patients treated in a multidisciplinary setting.

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Hicks, Caitlin W; Canner, Joseph K; Mathioudakis, Nestoras; Sherman, Ronald L; Hines, Kathryn; Lippincott, Christopher; Black, James H; Abularrage, Christopher J

2018-04-01

Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most). Predictors of wound healing were assessed using Cox proportional hazards models accounting for patient demographics, wound characteristics, and ADI category. Six hundred twenty-one wounds were evaluated, including 59% ADI-0, 7% ADI-1, 12% ADI-2, and 22% ADI-3. After accounting for patient demographics and wound characteristics, the likelihood of wound healing was similar between groups (ADI-3 versus ADI-0: hazards ratio [HR] 1.03 [95% confidence interval 0.76-1.41]). Independent predictors of poor wound healing included peripheral arterial disease (HR 0.75), worse wound stage (stage 4: HR 0.48), larger wound area (HR 0.99), and partially dependent functional status (HR 0.45) (all, P healing was largely dependent on wound characteristics and vascular status rather than patient demographics or neighborhood socioeconomic disadvantage. Use of a multidisciplinary approach to the management of DFU may overcome the negative effects of socioeconomic disadvantage frequently described in the diabetic population. Copyright © 2017 Elsevier Inc. All rights reserved.

Efficacy and safety of sotagliflozin in treating diabetes type 1.

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Rendell, Marc S

2018-02-01

Sotagliflozin is the first dual SGLT1/SGLT2 inhibitor developed for use in diabetes. Sotagliflozin blocks SGLT2 in the kidneys and SGLT1 in the intestines resulting in reduced early phase glucose absorption and increased blood levels of GLP-1 and PYY. Urinary glucose excretion is lower than with other agents as a result of decreased glucose absorption. The primary development effort to date has been in Type 1 diabetes. Areas covered: The published information on sotagliflozin is reviewed, along with the recent results of several pivotal Type 1 diabetes trials. Expert opinion: Sotagliflozin treatment lowers HbA1c and reduces glucose variability, with a trend to less hypoglycemic events. In the Type 1 trials, sotagliflozin treated individuals experienced DKA at a higher rate than placebo treated patients. An additional safety issue arises from the as yet unknown potential risks in women of child bearing potential in whom DKA is of utmost concern. The sotagliflozin development program has now been extended to trials in Type 2 diabetes, and long term studies will be needed to assess the benefits and risks of the agent in comparison to other currently marketed SGLT2 inhibitors.

Glucose-Lowering Effects and Low Risk of Hypoglycemia in Patients With Maturity-Onset Diabetes of the Young When Treated With a GLP-1 Receptor Agonist

DEFF Research Database (Denmark)

Ostoft, S. H.; Bagger, J. I.; Hansen, Torben

2014-01-01

OBJECTIVE The most common form of maturity-onset diabetes of the young (MODY), hepatocyte nuclear factor 1 alpha (HNF1A diabetes: MODY3) is often treated with sulfonylureas that confer a high risk of hypoglycemia. We evaluated treatment with GLP-1 receptor agonists (GLP-1RAs) in patients with HNF1A...... diabetes. RESEARCH DESIGN AND METHODS Sixteen patients with HNF1A diabetes (8 women; mean age 39 years [range 23-67 years]; BMI 24.9 +/- 0.5 kg/m(2) [mean +/- SEM]; fasting plasma glucose [FPG] 9.9 +/- 0.9 mmol/L; HbA(1c) 6.4 +/- 0.2% [47 +/- 3 mmol/mol]) received 6 weeks of treatment with a GLP-1RA...

Risk and timing of clinical events according to diabetic status of patients treated with everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting stent: 2-year results from a propensity score matched comparison of ABSORB EXTEND and SPIRIT trials.

Science.gov (United States)

Campos, Carlos M; Caixeta, Adriano; Franken, Marcelo; Bartorelli, Antonio L; Whitbourn, Robert J; Wu, Chiung-Jen; Li Paul Kao, Hsien; Rosli, Mohd Ali; Carrie, Didier; De Bruyne, Bernard; Stone, Gregg W; Serruys, Patrick W; Abizaid, Alexandre

2018-02-15

to compare the occurrence of clinical events in diabetics treated with the Absorb bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular, Santa Clara, CA) versus everolimus-eluting metal stents (EES; XIENCE V; Abbott Vascular, Santa Clara, CA) BACKGROUND: There are limited data dedicated to clinical outcomes of diabetic patients treated with bioresorbable scaffolds (BRS) at 2-year horizon. The present study included 812 patients in the ABSORB EXTEND study in which a total of 215 diabetic patients were treated with Absorb BVS. In addition, 882 diabetic patients treated with EES in pooled data from the SPIRIT clinical program (SPIRIT II, SPIRIT III and SPIRIT IV trials) were used for comparison by applying propensity score matching using 29 different variables. The primary endpoint was ischemia driven major adverse cardiac events (ID-MACE), including cardiac death, myocardial infarction (MI), and ischemia driven target lesion revascularization (ID-TLR). After 2 years, the ID-MACE rate was 6.5% in the Absorb BVS vs. 8.9% in the Xience group (P = 0.40). There was no difference for MACE components or definite/probable device thrombosis (HR: 1.43 [0.24,8.58]; P = 0.69). The occurrence of MACE was not different for both diabetic status (insulin- and non-insulin-requiring diabetes) in all time points up to the 2-year follow-up for the Absorb and Xience groups. In this largest ever patient-level pooled comparison on the treatment of diabetic patients with BRS out to two years, individuals with diabetes treated with the Absorb BVS had a similar rate of MACE as compared with diabetics treated with the Xience EES. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Non-diabetic renal disease in patients with type-2 diabetes mellitus

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Sonia Yaqub

2012-01-01

diabetes was significantly less in Group-I compared with Group-II and Group-III (P = 0.04. Our study suggests that the prevalence of NDRD (either isolated or superimposed on underlying DN is high in appropriate clinical settings. Performing renal biopsy in diabetics with no extrarenal end organ damage other than nephropathy helps to diagnose and treat NDRD. This is the first report from Pakistan documenting the prevalence of NDRD in patients with type-2 diabetes.

Treating Chronically Ill Diabetic Patients with Limited Life Expectancy: Implications for Performance Measurement

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Woodard, LeChauncy D.; Landrum, Cassie R.; Urech, Tracy H.; Profit, Jochen; Virani, Salim S.; Petersen, Laura A.

2012-01-01

Background/Objectives To validly assess quality-of-care differences among providers, performance measurement programs must reliably identify and exclude patients for whom the quality indicator may not be desirable, including those with limited life expectancy. We developed an algorithm to identify patients with limited life expectancy and examined the impact of limited life expectancy on glycemic control and treatment intensification among diabetic patients. Design We identified diabetic patients with coexisting congestive heart failure, chronic obstructive pulmonary disease, dementia, end-stage liver disease, and/or primary/metastatic cancers with limited life expectancy. To validate our algorithm, we assessed 5-year mortality among patients identified as having limited life expectancy. We compared rates of meeting performance measures for glycemic control between patients with and without limited life expectancy. Among uncontrolled patients, we examined the impact of limited life expectancy on treatment intensification within 90 days. Setting 110 Veterans Administration facilities; October 2006 – September 2007 Participants 888,628 diabetic patients Measurements Hemoglobin A1c (HbA1c) Quality measurement and performance-based reimbursement systems should acknowledge the different needs of this population. PMID:22260627

Metformin and aspirin treatment could lead to an improved survival rate for Type 2 diabetic patients with stage II and III colorectal adenocarcinoma relative to non-diabetic patients.

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De Monte, Ariella; Brunetti, Davide; Cattin, Luigi; Lavanda, Francesca; Naibo, Erica; Malagoli, Maria; Stanta, Giorgio; Bonin, Serena

2018-03-01

Metformin, the drug of choice in the treatment of type 2 diabetes mellitus (DM2), in addition to aspirin (ASA), the drug prescribed for cardioprotection of diabetic and non-diabetic patients, have an inhibitory effect on cancer cell survival. The present population-based study conducted in the province of Trieste (Italy), aimed to investigate the prevalence of DM2 in patients with colorectal adenocarcinoma (CRC) and survival for CRC in diabetic and nondiabetic patients. All permanent residents diagnosed with a CRC between 2004 and 2007 were ascertained through the regional health information system. CRC-specific and relative survival probabilities were computed for each group of patients defined by CRC stage, presence or absence of DM2 treated with metformin, and presence or absence of daily ASA therapy. A total of 515 CRC patients without DM2 and 156 with DM2 treated with metformin were enrolled in the study. At the time of CRC diagnosis, 71 (14%) nondiabetic and 39 (25%) diabetic patients were taking ASA daily. The five-year relative survival for stage III CRC was 101% [95% confidence interval (CI)=76-126] in the 18 patients with DM2 treated with metformin and ASA, 55% (95% CI=31-78) in the 23 without DM2 treated with ASA, 55% (95% CI=45-65) in the 150 without DM2 not taking ASA, and 29% (95% CI=13-45) in the 43 with DM2 treated with metformin, however not with ASA. The findings support the hypothesis of a possible inhibitory effect of metformin and ASA on CRC cells. Randomized controlled trials are required to verify this hypothesis.

ANEMIA IN HEMODIALYSIS PATIENTS: DIABETIC VS NON DIABETIC PATIENTS

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SH SHAHIDI

2002-12-01

Full Text Available Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8 ± 1.7 in diabetic and non diabetic patients (P<0.05. Mean corposcular volume in diabetic patients (91±3.1 fl was more higher than non diabetic ones (87.1 ± 8.9 (P < 0.05. Other indices had no differences between two groups (P > 0.05. Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.

Relationship between metabolic control and self-monitoring of blood glucose in insulin-treated patients with diabetes mellitus.

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Soto González, Alfonso; Quintela Fernández, Niurka; Pumar López, Alfonso; Darias Garzón, Ricardo; Rivas Fernández, Margarita; Barberá Comes, Gloria

2015-05-01

To assess the relationship between metabolic control (MC) and frequency of self-monitoring of blood glucose (SMBG) in insulin-treated patients with type 1 (T1DM) and type 2 (T2DM) diabetes mellitus, and to analyze the factors associated to MC. A multicenter, cross-sectional, observational study was conducted in which endocrinologists enrolled diabetic patients treated with insulin who used a glucometer. The cut-off value for MC was HbA1c ≤ 7%. Grade of acceptance of the glucometer was assessed using a visual analogue scale (VAS). A total of 341 patients (53.5% males) with a mean age (SD) 52.8 (16.3) years, mean HbA1c of 7.69% (1.25) and 128 (37.5%) with T1DM and 211 (61.9%) with T2DM were evaluable. SMBG was done by 86.1% at least once weekly. No relationship was seen between MC and SMBG (P=.678) in the overall sample or in the T1DM (P=.940) or T2DM (P=.343) subgroups. In the logistic regression model, hyperglycemic episodes (Exp-b [risk] 1.794, P=0.022), falsely elevated HbA1c values (Exp-b 3.182, P=.005), and VAS (Exp-b 1.269, P=.008) were associated to poor MC in the total sample. Hyperglycemic episodes (Exp-b 2.538, P=.004), falsely elevated HbA1c values (Exp-b 3.125, P=.012), and VAS (Exp-b 1.316, P=.026) were associated to poor MC in the T2DM subgroup, while body mass index (Exp-b 1.143, P=.046) was associated to poor MC in the T1DM subgroup. In this retrospective, non-controlled study on patients with DM treated with insulin who used a glucometer, no relationship was seen between the degree of metabolic control and frequency of use of the glucometer. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan

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Ji Hye Suk

2014-06-01

Full Text Available BackgroundData regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients.MethodsType 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests.ResultsThree thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively.ConclusionIn our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.

Emotional disturbances among adult diabetic patients attending a diabetic clinic in a Malaysian general hospital

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Ali SabriRadeef1, Ramli Musa, NikNurFatnoonBintiNik Ahmad, Ghasak Ghazi Faisal

2014-11-01

Full Text Available Introduction: Emotional disturbances such as depression, anxiety and stress play an important role in the management of diabetes mellitus since their presence can adversely affect glycemic control, quality of life and compliance with medications. Despite this, emotional disturbances are consistently under-diagnosed and under-treated by physicians in general practice. Objectives: This study aims to determine the prevalence and severity of emotional disturbances among diabetic patients Methodology: This is a cross sectional study conducted on a sample of 200 patients with diabetes mellitus attending the diabetic clinic at the Hospital Tengku Ampuan Afzan, Pahang state, Malaysia. The prevalence and severity of depressive, anxiety and stress symptoms were assessed in those diabetic patients by using the self-rating Bahasa Malaysia version of the Depression, Anxiety and Stress Scales (DASS-42. Results: The prevalence of depression, anxiety, and stress among diabetic patients was 13.5%, 28%, 11% respectively. Most of the patients with emotional disturbances had moderate depression and anxiety symptoms. However, stress symptoms were mild. Although females showed higher prevalence of emotional disturbances, only anxiety was significantly higher than males. Conclusion: Diabetic patients are at risk to develop psychiatric illnesses in the form of depression, anxiety and stress. Anxiety symptoms were more prominent than depression and stress in diabetic patients

Glaucoma evolution in patients with diabetes.

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Apreutesei, Nicoleta Anton; Chiselita, D; Motas, O I

2014-01-01

Glaucoma and diabetes are two chronic diseases with a long suspected pathogenic relationship. Screening for glaucoma in patients with diabetes. A retrospective study on 92 eyes from 46 patients with primitive open angle glaucoma (POAG) (normal and hypertensive) and intraocular hypertension (OHT) receiving medication and/or surgery associated with diabetes mellitus (DM) (type I, type II, mixed) is presented. Participants were divided into two groups as following: 16 eyes with glaucoma and diabetic retinopathy changes (group 1) and 76 eyes with glaucoma and without diabetic retinopathy changes (group 2). The following parameters were analysed: ocular pressure (Goldmann aplanotonometry), perimeter development (computerized perimetry) and fundus condition (absence, presence or progression of diabetic retinopathy). In patients with glaucoma and diabetic retinopathy (8 patients) we found a mean difference between treated intraocular pressure (IOP) and IOP last untreated control of 4.95 mmHg; a depreciation of the MD by 4.18 dB and an average number of glaucoma medications used of 0.889 +/- 1.054. Predominant changes in proliferative diabetic retinopathy were mild. In patients with glaucoma in the absence of diabetic retinopathy, the average difference between untreated IOP and IOP under treatment at the last check-up was 1.63 mmHg, the MD depreciation was by 0.65 dB and the average number of glaucoma medications used was 0.795 +/- 0.978. No statistically significant differences in terms of initial and final pressure were found. No statistically significant differences in the evolution of changes in perimeter between the two groups were observed. The presence of non-proliferating diabetic retinopathy influenced (only marginally statistically) the glaucomatous disease progression. Large comparative prospective studies are needed for the long-term follow up.

Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

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Osman Son

2014-01-01

Full Text Available Objective. The results from Diabetes Control and Complications Trial (DCCT have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM. During this study, we tried to inquire carbohydrate (Kh count method’s positive effects on the type 1 DM treatment’s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method.

Distribution of Esophageal Motor Disorders in Diabetic Patients With Dysphagia.

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George, Nina S; Rangan, Vikram; Geng, Zhuo; Khan, Freeha; Kichler, Adam; Gabbard, Scott; Ganocy, Stephen; Fass, Ronnie

Diabetes mellitus can cause various gastrointestinal symptoms. Assessment of esophageal dysmotility in diabetic patients has been scarcely studied. The aim of this study was to determine the esophageal motor characteristics of diabetic versus nondiabetic patients who present with dysphagia. High-resolution esophageal manometries (HREMs) of 83 diabetic patients and 83 age and gender-matched nondiabetic patients with dysphagia from 2 medical centers were included in this study. Demographic information, medical comorbidities, and medication usage were recorded for each patient in a single registry. HREM of each patient was evaluated and the different functional parameters were recorded. Overall, 46% of diabetic patients were found to have an esophageal motor disorder. Diabetic patients with dysphagia were more likely to have failed swallows on HREM (50.6% vs. 33.7%; P=0.03) as compared with nondiabetic patients. Among diabetic patients, those being treated with insulin were more likely to have failed (69.0% vs. 40.7%; P=0.01) and weak (65.5% vs. 33.3%; P=0.005) swallows as compared with diabetic patients not on insulin. Among diabetic patients, those with abnormal manometry were more likely to demonstrate diabetic retinopathy (27.0% vs. 8.7%; P=0.04). There was a trend toward increased incidence of esophagogastric junction outflow obstruction in diabetic patients (10.8% vs. 2.4%; P=0.057) as compared with nondiabetic patients. Nearly half of diabetic patients with dysphagia have some type of an esophageal motility disorder. Diabetic retinopathy and the use of insulin are predictive of esophageal motor abnormalities among diabetic patients.

Improvement of glycaemic control and elevation of C-peptide following a diet free of dairy products in an insulin-treated, patient with type 2 diabetes with ulcerative colitis.

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Tandeter, Howard

2009-01-01

An insulin-treated patient with type 2 diabetes mellitus started a diet free of dairy products. Unexpectedly, she developed episodes of hypoglycaemia, without any change in her usual medication (insulin NPH at bedtime and Metformin). Laboratory tests showed an improvement of endogenous insulin secretion as demonstrated by the induction of hypoglycaemia and the elevation to normalisation of C-peptide levels. The patient was rechallenged with dairy products, leading to the lowering of the C-peptide levels back to abnormal levels, and an increase in HBA1C levels. The findings in our patient contrast with the insulinotropic effect of milk in healthy subjects described in the literature. The two main "milk debates" on the relation between milk (or its components) and diabetes are presented. Further observations will be needed to clarify the question of whether a diet free of dairy products can improve glycaemic control in other insulin-treated patients with type 2 diabetes.

[Perception of insulin therapy in uncontrolled patients with type 2 diabetes mellitus].

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Leyva Jiménez, Rafael; Hernández Zambrano, Gustavo; Ibarra Maldonado, Silvia; Ibarra Ramírez, Carlos Tomás

2016-10-01

To determine the perception of insulin therapy by patients with uncontrolled type2 diabetes mellitus, who have been treated with oral hypoglycaemic agents or insulin. Prospective comparative cross-sectional study. Family Medicine Unit No. 53 León, Guanajuato of Mexican Institute of Social Security. Patients between 40 and 80years old with uncontrolled type2 mellitus diabetes, treated with insulin or oral hypoglycaemic agents. Perception was assessed using the insulin treatment appraisal scale (ITAS). The rating of the survey is from 20 to 100 points, as such that when score increases the greater is the negative opinion. A sample of 459 diabetes patients were interviewed and split into 2 groups of patients according to their treatment. The OH group were patients treated with oral hypoglycaemic drugs only (56.9%), and the IN group were patients treated with insulin alone or combined with an oral hypoglycaemic (43.1%). Perception score was significantly higher in OH group (56.95±7.78 versus 49.55±8.89 points) than in the IN group (P1). The perception of insulin therapy was worse in patients treated with only oral hypoglycaemic agents than in patients using insulin. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Effective Nurse Communication With Type 2 Diabetes Patients

NARCIS (Netherlands)

Mulder, B.C.; Lokhorst, A.M.; Rutten, G.E.H.M.; Woerkum, van C.M.J.

2015-01-01

Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to

Constipation prevalence in diabetic patients

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Manoel Álvaro de Freitas Lins Neto

2014-04-01

Full Text Available Objective: the aim of this study was to identify the prevalence of constipation in diabetic patients treated at the endocrinology outpatient clinic at Hospital Universitário Professor Alberto Antunes and PAM Salgadinho, from April to August 2013. Methods: a descriptive and cross-sectional study, carried out through a questionnaire using the Rome III criteria in 372 patients treated at the outpatient endocrinology clinic. Results: of 372 patients evaluated, the frequency of constipation found was 31.2% among diabetic patients. Females predominated in the sample (72.8% as well as for the frequency of constipation (80.2%. The incidence of type II diabetes was 97.3% and it was observed that 80.2% of the sample was older than 50 years. One hundred and twelve patients with inadequate glycemic control (HgA1c ≥ 7 had an association with constipation. Conclusion: there was an increased frequency of constipation in patients with diabetes mellitus according to the Rome III criteria, in relation to the general population. The inadequate glycemic control in patients with diabetes mellitus increases the frequency of constipation and it is necessary to perform studies that allow the confirmation of this association to demonstrate this hypothesis. Resumo: Objetivo: analisar a prevalência da constipação intestinal em pacientes diabéticos atendidos no ambulatório de endocrinologia do Hospital Universitário Professor Alberto Antunes e no PAM Salgadinho (HUPAA, de abril de 2013 a agosto 2013. Método: estudo descritivo e transversal, realizado através da aplicação de um questionário com os critérios de Roma III no ambulatório de endocrinologia do HUPAA. Resultado: em 372 pacientes, 271 feminino, 101 masculino, 162 de etnia branca, 55 negros e 155 pardos, 297 pacientes estavam acima de 50 anos, houve uma frequência de constipação de 31,2% nos pacientes diabéticos. O gênero feminino prevaleceu na amostra (73% assim como no índice de frequ

How should we manage heart failure developing in patients already treated with angiotensin-converting enzyme inhibitors and beta-blockers for hypertension, diabetes or coronary disease?

DEFF Research Database (Denmark)

Gustafsson, Finn; Segura, Julian; Ruilope, Luis M

2010-01-01

An increasing number of patients in the community are being treated with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and beta-blockers for hypertension, coronary disease or diabetic renal and vascular complications. Some of these patients will develop heart...... failure despite such treatment. Based on data from hypertension trials it can be estimated that approximately 5% of treated patients will develop heart failure over 5 years. It is unclear whether patients developing heart failure on and off ACE-inhibitors or beta-blockers, respectively, at the time...

Insulin Storage by Patients with Diabetes Mellitus in Jos, Nigeria ...

African Journals Online (AJOL)

To determine how insulin is stored at home among insulin-treated patients with Diabetes mellitus in Jos, Nigeria, 150 such patients attending the Diabetes clinic of Jos University Teaching Hospital were interviewed. It was found that 87 (58%) kept their insulin in a refrigerator. Most of the remainder, 43 (28.7%) stored insulin ...

[Primary care for diabetic patients: a quality improvement cycle].

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Navarro-Martínez, A; Suárez-Beke, M P; Sánchez-Nicolás, J A; Lázaro-Aragues, P; de Jesús Jiménez-Vázquez, E; Huertas-de Mora, O

2014-01-01

The aim of this study was to evaluate and improve the quality of medical care provided to diabetic patients following the standards proposed by the American Diabetes Association. The study was conducted in three phases by analyzing data from the computerized clinical history of a sample of 340 patients. First phase (2010): cross-sectional, descriptive study which assessed the proportion of patients who met the standards related to the screening of diabetes, and goals of control and treatment. Subsequently, health professionals reviewed the results in order to promote the implementation of corrective action. Finally (2012), a new assessment with the same standards was performed. An increase in the number of patients treated with insulin (12.7% in 2010 and 20.2% in 2012) was observed (P < .01). There were also percentage increases in the number of patients who met the screening standards as regards analytical determinations: glycosylated hemoglobin (from 44.4% to 68.2%), lipid profile (47.6%-73.8%), creatinine (32.5% - 73.5%), and albumin-creatinine ratio (9.2%-24.4%) (P < .001). Only 6.4% (CI: 3.2- 9.8) of diabetic patients attained the composite target of glycosylated hemoglobin < 7%, blood pressure < 130/80 mmHg and low-density lipoprotein cholesterol < 100 mg/dl in 2012. This study shows that medical care has improved the goals related to analytical determinations and the number of insulin-treated diabetic type 2 patients. An optimal level was also maintained in metabolic control of diabetes, but there was still poor control of risk factors for cardiovascular disease. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Clinical value of Flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion.

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Moreno-Fernandez, Jesus; Pazos-Couselo, Marcos; González-Rodriguez, Maria; Rozas, Pedro; Delgado, Manuel; Aguirre, Miguel; Garcia-Lopez, Jose Manuel

2018-06-12

To analyze the clinical impact of the Flash glucose monitoring system in patients with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). A 24-week retrospective cohort study in CSII-treated T1DM patients exposed (1:1) to the Flash glucose monitoring system vs. self-monitoring of capillary blood glucose (SMBG). The primary outcome was the difference in hemoglobin A1c (HbA1c) levels between both groups at the end of the study. Thirty-six patients with a mean age of 38.2 years (range 22-55) and a mean T1DM duration of 20.9±7.8 years, treated with CSII for 7.1±5.4 years, were enrolled into the study. At the end of the study, mean HbA1c levels improved in patients in the Flash group (7.1±0.7 vs. 7.8±1.0, p=0.04). Only the Flash group showed a significant decrease in HbA1c levels of -0.4% (95% CI, -0.6, -0.2; p=0.004) during follow-up. Flash patients captured 93.9% of data through 17.8±9.9 scans daily. In fact, the Flash cohort showed a three-fold increase in daily self-monitoring of glucose, while daily frequency of SMBG decreased during the study (-1.8 tests/24h (95% CI -3, -0.7; p=0.01). No safety issues related to Flash use were recorded. The Flash glucose monitoring system is a novel approach to improve blood glucose control in CSII-treated T1DM patients. Randomized controlled trials are needed to assess the effectiveness of this system in CSII-treated T1DM patients. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

The long-term risk of smoking in diabetic patients with stable ischemic heart disease treated with intensive medical therapy and lifestyle modification.

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Khan, Asrar A; Chung, Matthew J; Novak, Eric; Mori Brooks, Maria; Brown, David L

2017-09-01

Introduction The long-term risk of smoking in diabetic patients with stable ischemic heart disease (SIHD) is unknown. We sought to analyze the impact of smoking on outcomes of diabetic patients with SIHD when other cardiovascular risk factors are being aggressively treated. Methods The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial randomized 2368 diabetics with SIHD to intensive medical therapy (IMT) with prompt revascularization or IMT alone. Smoking status was obtained at baseline, 6 months, and 1, 2, 3, 4 and 5 years. The primary endpoint of interest was all-cause mortality. Results Of 2360 patients, 33.1% of patients never smoked, 54.4% were former smokers, and 12.5% were current smokers. The rate of all-cause mortality was greater for current (2.5 deaths/100 patient-years) and former smokers (3.1 deaths/100 patient-years) than never smokers (2.1 deaths/100 patient-years) (P = 0.007). Cardiac death, cardiovascular death, fatal or nonfatal myocardial infarction, and fatal or nonfatal stroke were not increased in current or former smokers compared with never smokers. Compared with never smokers, current smokers experienced a 49% increased hazard of death (Hazard Ratio (HR) 1.49, 95% Confidence Interval (CI): 0.97-2.29, P = 0.07) whereas former smokers had a 37% increased hazard of death (HR 1.37, 95% CI: 1.04-2.79, P = 0.02) when considering smoking status as a time-dependent variable and adjusting for factors that differed by smoking status. Conclusions Current and former smoking are associated with increased all-cause mortality in diabetics with SIHD but not with increased cardiovascular morbidity or mortality.

Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care

NARCIS (Netherlands)

van Vugt, M.; de Wit, M.; Sieverink, Floor; Roelofsen, Y.; Hendriks, S.H.; Bilo, H.J.G.; Snoek, F.J.

2016-01-01

We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of

Glaucoma incidence in an unselected cohort of diabetic patients: is diabetes mellitus a risk factor for glaucoma? DARTS/MEMO collaboration. Diabetes Audit and Research in Tayside Study. Medicines Monitoring Unit.

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Ellis, J D; Evans, J M; Ruta, D A; Baines, P S; Leese, G; MacDonald, T M; Morris, A D

2000-11-01

To evaluate whether diabetes mellitus is a risk factor for the development of primary open angle glaucoma or ocular hypertension (OHT). A historical cohort study of an unselected population comprising all residents of the Tayside region of Scotland was performed using record linkage techniques followed by case note review. Ascertainment of prevalent diabetes was achieved using the Diabetes Audit and Research in Tayside Study (DARTS) validated regional diabetes register. Glaucoma and treated OHT were defined by encashment of community prescriptions and the statutory surgical procedure coding database. The study population comprised 6631 diabetic subjects and 166 144 non-diabetic subjects aged >40 years without glaucoma or OHT at study entry. 65 patients with diabetes and 958 without diabetes were identified as new cases of glaucoma or treated OHT during the 24 month study period, yielding a standardised morbidity ratio of 127 (95% CI, 96-158). Case note review demonstrated non-differential misclassification of prevalent glaucoma and OHT as incident disease (diabetic cohort 20%, non-diabetic cohort 24%; p=0.56) primarily as a result of non-compliance in medically treated disease. Removing misclassified cases and adjusting for age yielded an incidence of primary open angle glaucoma in diabetes of 1.1/1000 patient years (95% CI, 0.89-1. 31) compared to 0.7/1000 patient years (95% CI, 0.54-0.86) in the non-diabetic cohort; RR 1.57 (95% CI, 0.99-2.48). This study failed to confirm an association between diabetes mellitus and primary open angle glaucoma and ocular hypertension. A non-significant increase in diagnosed and treated disease in the diabetic population was observed, but evidence was also found that detection bias contributes to this association.

Negative pressure wound therapy in patients with diabetic foot.

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Ulusal, Ali Engin; Sahin, M Sükrü; Ulusal, Betül; Cakmak, Gökhan; Tuncay, Cengiz

2011-01-01

In this study our aim was to compare the results of standard dressing treatment to negative pressure wound therapy (NPWT) performed with a vacuum-assisted closure (VAC) device in patients with diabetic foot ulcers. We assessed the results of 35 patients treated for diabetic foot ulcer between 2006 and 2008. Of these cases, 20 (4 women and 16 men; mean age: 66 years; range: 52-90 years) were treated with standard wet dressings and 16 feet in 15 patients (10 men, 5 women; mean age: 58.9 years; range: 42-83 years) with VAC therapy. The success of treatment was evaluated in terms of hospitalization length and rate of limb salvation. The average hospitalization period with VAC treatment was 32 days compared to 59 days with standard dressing treatment. All patients treated with standard dressings eventually had to undergo amputation. However, the amputation rate was 37% in the VAC treated group and 88% of patients had a functional extremity at the end of treatment. VAC therapy, together with debridement and appropriate antibiotic therapy, enables a higher rate of limb salvage, especially in Wagner Grade 3 and Grade 4 ulcers.

Only a fraction of patients with ischaemic diseases or diabetes are treated to recommended target values for plasma lipids

DEFF Research Database (Denmark)

Siggaard-Andersen, Niels; Freiberg, Jacob J; Nordestgaard, Børge G

2012-01-01

We tested the hypothesis that individuals in the general population with and without ischaemic cardiovascular disease, or with diabetes, are treated to recommended target values for plasma lipids.......We tested the hypothesis that individuals in the general population with and without ischaemic cardiovascular disease, or with diabetes, are treated to recommended target values for plasma lipids....

Outcomes in Diabetic Patients Undergoing Orbital Atherectomy System.

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Lee, Michael S; Shlofmitz, Evan; Nguyen, Heajung; Shlofmitz, Richard A

2016-10-01

We evaluated the angiographic and clinical outcomes of orbital atherectomy to treat severely calcified coronary lesions in diabetic and non-diabetic patients. Diabetics have increased risk for death, myocardial infarction, and target vessel revascularization after percutaneous coronary intervention. Severely calcified coronary lesions are associated with increased cardiac events. Orbital atherectomy facilitates stent delivery and optimizes stent expansion by modifying severely calcified plaque. Outcomes in diabetic patients who undergo orbital atherectomy have not been reported. Our retrospective multicenter registry included 458 consecutive real-world patients with severely calcified coronary arteries who underwent orbital atherectomy. The primary safety endpoint was the rate of major adverse cardiac and cerebrovascular events at 30 days. Diabetics represented 42.1% (193/458) of the entire cohort. The primary endpoint was similar in diabetics and non-diabetics (1.0% vs. 3.0%%, P = 0.20), as were 30-day rates of death (0.5% vs. 1.9%, P = 0.41), myocardial infarction (0.5% vs. 1.5%, P = 0.40), target vessel revascularization (0% vs. 0%, P = 1), and stroke (0% vs. 0.4%, P > 0.9). Angiographic complications and stent thrombosis rate were low and did not differ between the 2 groups. Diabetics represented a sizeable portion of patients who underwent orbital atherectomy. Diabetics who had severely calcified coronary arteries and underwent orbital atherectomy had low event rates that were similar to non-diabetics. Orbital atherectomy appears to be a viable treatment strategy for diabetic patients. Randomized trials with longer-term follow-up are needed to determine the ideal treatment strategy for diabetics. © 2016, Wiley Periodicals, Inc.

Prediabetes in patients treated with antipsychotic drugs.

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Manu, Peter; Correll, Christoph U; van Winkel, Ruud; Wampers, Martien; De Hert, Marc

2012-04-01

In 2010, the American Diabetes Association (ADA) proposed that individuals with fasting glucose level of 100-125 mg/dL (5.6-6.9 mmol/L) or glucose level of 140-199 mg/dL (7.8-11.0 mmol/L) 2 hours after a 75-g oral glucose tolerance test or hemoglobin A(1c) 5.7%-6.4% be classified as prediabetic, indicating increased risk for the emergence of diabetes mellitus. At the same time, the ADA formulated guidelines for the use of metformin for the treatment of prediabetes. To determine the prevalence of prediabetes in a cohort of psychiatrically ill adults receiving antipsychotics and to compare the clinical and metabolic features of prediabetic patients with those of patients with normal glucose tolerance and those with diabetes mellitus. The 2010 ADA criteria were applied to a large, consecutive, single-site European cohort of 783 adult psychiatric inpatients (mean age: 37.6 years) without a history of diabetes who were receiving antipsychotics. All patients in this cross-sectional study underwent measurement of body mass index (BMI), waist circumference, oral glucose tolerance test, and fasting insulin and lipids from November 2003 through July 2007. 413 patients (52.8%) had normal glucose tolerance, 290 (37.0%) had prediabetes, and 80 (10.2%) had diabetes mellitus. The fasting glucose and/or hemoglobin A(1c) criteria were met by 89.7% of prediabetic patients. A statistically significant intergroup gradient from normal glucose tolerance to prediabetes and from prediabetes to diabetes mellitus was observed for waist circumference, triglycerides, fasting insulin levels, and frequency of metabolic syndrome (P = .02 to P prediabetic patients (6.6%) met the 2010 ADA criteria for treatment with metformin. Prediabetes is highly prevalent in adults treated with antipsychotic drugs and correlates with markers of increased intraabdominal adiposity, enhanced lipolysis, and insulin resistance. Criteria for using metformin to prevent the emergence of diabetes mellitus may need to be

Different Pathophysiological Phenotypes among Newly Diagnosed Type 2 Diabetes Patients

DEFF Research Database (Denmark)

Stidsen, Jacob

2013-01-01

Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes...... or secondary diabetes), classic obesity-associated insulin resistant diabetes ( f-P-C-peptide >= 568 pmol/l) and a normoinsulinopenic group (333 age of our new T2D patients was 61 years (range 21-95 years), 57% were men. We found that 3.0% newly diagnosed T2D patients...... suffered from LADA, 3.9% from secondary diabetes, 6.0% from steroid induced diabetes 5.9% had insulinopenic diabetes, whereas 56.7% presented the classic obesity-associated insulin-resistant phenotype. 24.6% was classified as normoinsulinopenic patients. Conclusion: We conclude that newly diagnosed T2D...

From the diabetic foot ulcer and beyond: how do foot infections spread in patients with diabetes?

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Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Pulido-Duque, Juan; Maynar, Manuel

2012-01-01

A diabetic foot infection is usually the result of a pre-existing foot ulceration and is the leading cause of lower extremity amputation in patients with diabetes. It is widely accepted that diabetic foot infections may be challenging to treat for several reasons. The devastating effects of hyperglycemia on host defense, ischemia, multi-drug resistant bacteria and spreading of infection through the foot may complicate the course of diabetic foot infections. Understanding the ways in which infections spread through the diabetic foot is a pivotal factor in order to decide the best approach for the patient's treatment. The ways in which infections spread can be explained by the anatomical division of the foot into compartments, the tendons included in the compartments, the initial location of the point of entry of the infection and the type of infection that the patient has. The aim of this paper is to further comment on the existed and proposed anatomical principles of the spread of infection through the foot in patients with diabetes. PMID:23050067

How should we manage heart failure developing in patients already treated with angiotensin-converting enzyme inhibitors and beta-blockers for hypertension, diabetes or coronary disease?

DEFF Research Database (Denmark)

Gustafsson, Finn; Segura, Julian; Ruilope, Luis M

2010-01-01

An increasing number of patients in the community are being treated with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and beta-blockers for hypertension, coronary disease or diabetic renal and vascular complications. Some of these patients will develop heart...... failure despite such treatment. Based on data from hypertension trials it can be estimated that approximately 5% of treated patients will develop heart failure over 5 years. It is unclear whether patients developing heart failure on and off ACE-inhibitors or beta-blockers, respectively, at the time...... of heart failure diagnosis have similar prognosis.Treatment options for patients developing heart failure while already treated with ACE inhibitors/ARBs and beta-blockers are very limited if current heart failure guidelines are followed. In this review possible strategies are outlined and important areas...

Long-term mortality in patients with diabetes mellitus type 2 after acute myocardial infarction

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Miljković Dušan

2014-01-01

Full Text Available Introduction. Myocardial infarction is the most common cause of death in patients with diabetes, and several studies have shown that people with diabetes have twice the risk of dying from a heart attack compared to non diabetics. Objective. The aim of this study was to determine the mortality of patients that have survived acute myocardial infarction, in population of patients with diabetes mellitus and without diabetes. Method. The study included 135 patients recovered from myocardial infarction, of whom 51 (37.8% had type 2 diabetes mellitus, and 84 (62.2% were without diabetes, mean age 55,4±9,6 years. All patients underwent a complete cardiac and hemodynamic testing, cardiac catheterization with selective coronary angiography, and in most patients the aortocoronary bypass revascularization or percutaneous coronary intervention. Start of follow-up was the date of acute myocardial infarction. The study included only patients who survived at least one month after acute myocardial infarction. All patients with diabetes and without diabetes were monitored for an average of 84 months, i.e. 7 years. Results. The average age of patients with diabetes and myocardial infarction was 57.1±8.7 years, and of patients with myocardial infarction without diabetes 54.5 ± 9.6 years (t=1.62; p>0.05. Among patients with diabetes 14 (27.5% were women and 37 (72.5% were men, and in non-diabetics 15 (17.9% were women and 69 (82.1% were men (χ2=1.66; p>0.05. In the follow-up period died 15 (29.4% patients with diabetes, and 7 (8.3% patients without diabetes. Mortality in patients with diabetes and myocardial infarction was significantly higher than the mortality of patients with myocardial infarction without diabetes (χ2=11.2; p0.05. In the group of 27 patients who were treated with insulin, died five (18.5% and in the group of 24 patients on oral therapy died 10 (41.7%. There was no significant difference in mortality in patients with diabetes treated with

Associations of HbA1c and educational level with risk of cardiovascular events in 32,871 drug-treated patients with Type 2 diabetes: a cohort study in primary care.

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Östgren, C J; Sundström, J; Svennblad, B; Lohm, L; Nilsson, P M; Johansson, G

2013-05-01

To explore the association of HbA1c and educational level with risk of cardiovascular events and mortality in patients with Type 2 diabetes. A cohort of 32 871 patients with Type 2 diabetes aged 35 years and older identified by extracting data from electronic patient records for all patients who had a diagnosis of Type 2 diabetes and had glucose-lowering agents prescribed between 1999 and 2009 at 84 primary care centres in Sweden. Associations of mean HbA1c levels and educational level with risks of cardiovascular events and all-cause mortality were analysed. The associations of HbA1c with risk of all-cause and cardiovascular mortality were J-shaped, with the lowest risk observed for cardiovascular mortality at an HbA1c level of 51 mmol/mol (6.8%) for subjects on oral agents and 56 mmol/mol (7.3%) in insulin-treated patients. The lowest risk observed for all-cause mortality was at an HbA1c level of 51 mmol/mol (6.8%) for subjects on oral agents and 56 mmol/mol (7.3%) in insulin-treated patients. There was an increased risk for cardiovascular death [hazard ratio 1.6 (1.2-2.1), P = 0.0008] at the lowest HbA1c decile for subjects in the low education category. For subjects with higher education there was no evident J curve for cardiovascular death [hazard ratio 1.2 (0.8-1.6), P = 0.3873]. Our results lend support to the recent American Diabetes Association/ European Association for the Study of Diabetes position statement that emphasizes the importance of additional factors, including the propensity for hypoglycaemia, which should influence HbA1c targets and treatment choices for individual patients. (Clinical Trials Registry No; NCT 01121315). © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

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Birhanu AM

2016-05-01

Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

Frequency and risk factors of severe hypoglycemia in insulin-treated type 2 diabetes

DEFF Research Database (Denmark)

Akram, Kamran; Pedersen-Bjergaard, Ulrik; Borch-Johnsen, Knut

2006-01-01

Intensive treatment regimens including early initiation of insulin treatment are important to prevent late complications in type 2 diabetes. The assumed risk of severe hypoglycemia (SH) is a major barrier to initiation of insulin treatment. To assess the relevance of this risk we evaluated...... the frequency of SH as reported in the literature. Using Medline and Embase search we identified 11 studies (5 retrospective and 6 prospective) including at least 50 patients with insulin-treated type 2 diabetes followed for at least 6 months in which frequency of SH was reported. The incidence of SH....... Only few studies looked into the impact of risk factors on the rate of SH. Impaired hypoglycemia awareness, high age, long duration of diabetes and insulin therapy increased the risk, while no association was found with HbA1c and insulin dose. The present knowledge of SH in insulin-treated type 2...

Wonder of Life (kalanchoe pinnata) leaves to treat diabetic foot infections in Trinidad & Tobago: a case control study.

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Cawich, Shamir O; Harnarayan, Patrick; Budhooram, Steve; Bobb, Nahmorah J; Islam, Shariful; Naraynsingh, Vijay

2014-10-01

: Wonder of Life (kalanchoe pinnata) leaves are commonly used to treat diabetic foot infections. These patients are usually non-compliant with conventional medical therapy. We surmised that these patients would have a higher incidence of treatment failures. Patients admitted with diabetic foot infections were separated into two groups: a Study Group comprised patients who used topical kalanchoe pinnata and a Medical Therapy Group contained patients who were compliant with conventional treatment. The patients were observed over the course of their hospitalisation. There were 382 patients in the Medical Therapy Group and 96 in the Study Group, who waited 9.21 ± 5.3 days (Mean ± SD) before seeking medical attention. There were similar rates of all amputations (34.8% vs. 37.5%; P = 0.643) and mortality (0.8% vs. 1.0%; P = 1.000) in the Study and Medical Therapy groups. There may be value in the use of topical kalanchoe pinnata to treat diabetic foot infections. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Edaravone offers neuroprotection for acute diabetic stroke patients.

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Zheng, J; Chen, X

2016-11-01

Edaravone, a novel free-radical scavenger, has been shown to alleviate cerebral ischemic injury and protect against vascular endothelial dysfunction. However, the effects of edaravone in acute diabetic stroke patients remain undetermined. A randomized, double-blind, placebo-controlled study was performed to prospectively evaluate the effects of edaravone on acute diabetic stroke patients admitted to our hospital within 24 h of stroke onset. The edaravone group received edaravone (30 mg twice per day) diluted with 100 ml of saline combined with antiplatelet drug aspirin and atorvastatin for 14 days. The non-edaravone group was treated only with 100 ml of saline twice per day combined with aspirin and atorvastatin. Upon admission, and on days 7, 14 post-stroke onset, neurological deficits and activities of daily living were assessed using the National Institutes of Health Stroke Scale (NIHSS) and the Barthel Index (BI), respectively. The occurrence of hemorrhage transformation, pulmonary infection, progressive stroke and epilepsy was also evaluated on day 14 post-treatment. A total of 65 consecutive acute diabetic stroke patients were enrolled, of whom 35 were allocated to the edaravone group and 30 to the non-edaravone group. There was no significant group difference in baseline clinical characteristics, but mean NIHSS scores were lower (60 %), and BI scores were 1.7-fold higher, in edaravone-treated patients vs. controls on day 14. Furthermore, the incidence of hemorrhage transformation, pulmonary infection, progressive stroke and epilepsy was markedly reduced in the edaravone vs. non-edaravone group. Edaravone represents a promising neuroprotectant against cerebral ischemic injury in diabetic patients.

Treatment Efficacy and Compliance in Patients with Diabetic Macular Edema Treated with Ranibizumab in a Real-Life Setting

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Anne-Laurence Best

2018-01-01

Full Text Available Purpose. To assess real-life efficacy of ranibizumab and treatment compliance of patients with vision loss secondary to diabetic macular edema (DME. Methods. A retrospective study was conducted in DME patients treated with ranibizumab. Patients were monitored every 4 weeks for visual acuity (VA and central retinal thickness (CRT by SD-OCT. All patients received a loading dose of 3 monthly injections followed by retreatments on an as-needed basis. The primary endpoint was the change in VA at M12. Patient compliance to the follow-up and the correlation between the injection number and VA were also investigated. Compliance was compared to that of neovascular age-related macular degeneration (nAMD patients. Results. Seventy-two eyes of 55 consecutive DME patients were included. At baseline, the mean VA was 56.5 letters and CRT was 470 μm. At M12, the mean VA was 63.4 letters (p 70 letters, the mean VA change was +6.9 letters, and the mean CRT was 361.9 μm (p=0.0001 after a mean number of 5.33 intravitreal injections. In patients who received ≥7 injections, the VA gain and final VA were significantly higher than in patients who received <7 injections. At M12, 25.45% of DME patients were lost to follow-up versus 16.8% of nAMD patients (n=55. Discussion/Conclusion. Our study confirms the real-life efficacy of ranibizumab in DME at M12 and the need for a large number of injections to achieve better visual outcomes. We also showed a trend to a lower compliance in diabetic versus nAMD patients.

Use of hypoglycemic plants by Tunisian diabetic patients

African Journals Online (AJOL)

Rym Ben Othman

2013-03-30

Mar 30, 2013 ... hypoglycemic effect among 200 diabetic patients followed up at the National Institute .... logical activities of the many herbal remedies now being used to treat many diseases ... The persuasive appeal of alternative medicine.

Heberprot-P: a novel product for treating advanced diabetic foot ulcer.

Science.gov (United States)

Berlanga, Jorge; Fernández, José I; López, Ernesto; López, Pedro A; del Río, Amaurys; Valenzuela, Carmen; Baldomero, Julio; Muzio, Verena; Raíces, Manuel; Silva, Ricardo; Acevedo, Boris E; Herrera, Luis

2013-01-01

Diabetic foot ulcer is a principal diabetic complication. It has been shown that diabetic patients have decreased growth factor concentrations in their tissues, particularly epidermal growth factor. Growth factor shortage impairs wound healing, which leads to chronic nonhealing wounds and sometimes eventual amputation. Ischemic diabetic foot ulcer is the most difficult to treat and confers the highest amputation risk. Injecting epidermal growth factor deep into the wound bottom and contours encourages a more effective pharmacodynamic response in terms of granulation tissue growth and wound closure. Epidermal growth factor injected into the ulcer matrix may also result in association with extracellular matrix proteins, thus enhancing cell proliferation and migration. Heberprot-P is an innovative Cuban product containing recombinant human epidermal growth factor for peri- and intra-lesional infiltration; evidence reveals it accelerates healing of deep and complex ulcers, both ischemic and neuropathic, and reduces diabetes-related amputations. Clinical trials of Heberprot-P in patients with diabetic foot ulcers have shown that repeated local infiltration of this product can enhance healing of chronic wounds safely and efficaciously. As a result, Heberprot-P was registered in Cuba in 2006, and in 2007 was included in the National Basic Medications List and approved for marketing. It has been registered in 15 other countries, enabling treatment of more than 100,000 patients. Heberprot-P is a unique therapy for the most complicated and recalcitrant chronic wounds usually associated with high amputation risk. Local injection in complex diabetic wounds has demonstrated a favorable risk-benefit ratio by speeding healing, reducing recurrences and attenuating amputation risk. Further testing and deployment worldwide of Heberprot-P would provide an opportunity to assess the product's potential to address an important unmet medical need.

Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji

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Riyaz Bhikoo

2017-05-01

Full Text Available AIM: To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy (STR in a low resource setting, Fiji. METHODS: A retrospective review of all new patients who presented for diabetic photo-screening at the Diabetic Eye Clinic, Suva in 2010. Fundus images were graded using standardised guidelines. Patient demographics, retinopathy grading and visual acuity data were extracted from the database and analyzed. Patients that received laser therapy and still attending follow up in 2012 were examined for disease progression RESULTS: Totally 2236 patients were photo-screened, 87% (3870/4472 of images were gradable. STR was observed in 26% (988/3870 with advanced STR (proliferative retinopathy/severe maculopathy in 10% (385/3870. Of those with STR, 59% had BCVA ≥6/18, 31% with advanced STR were <6/60. Male gender [odds ratio (OR 1.59; 1.20-2.12], history of hypertension (OR 1.36; 1.03-1.80 and peripheral neuropathy (OR 1.41; 1.01-1.95 were predictive of advanced STR. In 2012, 32% (315/988 attended follow up with 69% exhibiting advanced STR compared with 53% of the same cohort in 2010. Laser photocoagulation was administered to 212 eyes (212/3870, 5% with retinopathy and maculopathy progression observed in 52% and 33% respectively. BCVA ≥6/18 was noted in 67% (143/212 of treated eyes. Improved glycaemic control (OR 46.52; 1.50-1441.90 amongst those with advanced STR was predictive of eyes that maintained good vision. CONCLUSION: In Fiji, a quarter of new patients presenting to photo-screening have STR with a third of those with advanced STR having already loss vision. Improved glycaemic control and timely treatment of patients with sight threatening complications is important in halting disease progression.

Treated Autoimmune Thyroid Disease Is Associated with a Decreased Quality of Life among Young Persons with Type 1 Diabetes

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Alena Spirkova

2015-01-01

Full Text Available Type 1 diabetes (T1D in children and adolescents is relatively often accompanied by other immunopathological diseases, autoimmune thyroid disease (AITD or celiac disease (CD. Our aim was to assess whether these conditions are associated with changes in the health-related quality of life (HRQOL in pediatric patients with T1D. In a cross-sectional study we identified eligible 332 patients with T1D aged 8–18 years, of whom 248 (75% together with their parents responded to the PedsQL Generic and Diabetes Modules. Compared to 143 patients without thyroid autoantibodies, 40 patients with a thyroxine-treated AITD scored lower in the overall generic HRQOL (P=0.014, as well as in the overall diabetes-specific HRQOL (P=0.013. After adjustment for age, gender, duration of diabetes, type of diabetes treatment, and diabetes control, this association remained statistically significant for the generic HRQOL (P=0.023. Celiac disease was not associated with a change in the generic or diabetes-specific HRQOL (P=0.07  and   P=0.63, resp.. Parental scores showed no association with AITD or celiac disease, except a marginally significant decrease in the overall generic HRQOL (P=0.039 in the T1D + AITD compared to T1D group. Our study indicates that, in pediatric patients with T1D, concomitant thyroxine-treated AITD is associated with lower quality of life.

A randomized, controlled clinical trial of honey-impregnated dressing for treating diabetic foot ulcer

International Nuclear Information System (INIS)

Imran, M.

2015-01-01

To investigate the effect of Beri-honey-impregnated dressing on diabetic foot ulcer and compare it with normal saline dressing. Study Design: A randomized, controlled trial. Place and Duration of Study: Sughra Shafi Medical Complex, Narowal, Pakistan and Bhatti International Trust (BIT) Hospital, Affiliated with Central Park Medical College, Lahore, from February 2006 to February 2010. Methodology: Patients with Wagner's grade 1 and 2 ulcers were enrolled. Those patients were divided in two groups; group A (n=179) treated with honey dressing and group B (n=169) treated with normal saline dressing. Outcome measures were calculated in terms of proportion of wounds completely healed (primary outcome), wound healing time, and deterioration of wounds. Patients were followed-up for a maximum of 120 days. Results: One hundred and thirty six wounds (75.97%) out of 179 were completely healed with honey dressing and 97 (57.39%) out of 169 wtih saline dressing (p=0.001). The median wound healing time was 18.00 (6 - 120) days (Median with IQR) in group A and 29.00 (7 - 120) days (Median with IQR) in group B (p < 0.001). Conclusion: The present results showed that honey is an effective dressing agent instead of conventional dressings, in treating patients of diabetic foot ulcer. (author)

Pooled analysis of the CONFIRM registries: safety outcomes in diabetic patients treated with orbital atherectomy for peripheral artery disease.

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Lee, Michael S; Yang, Tae; Adams, George

2014-04-01

To compare the acute outcomes of orbital atherectomy treatment in diabetic vs. non-diabetic patients with peripheral artery disease (PAD). The CONFIRM registry series contained 1842 diabetic patients (1111 men; mean age 70.6±10.2 years) with 2819 lesions and 1247 non-diabetic patients (732 men; mean age 72.9±10.7 years) with 1885 lesions. The composite rate of procedure-related complications, including dissection, perforation, slow flow, vessel closure, spasm, embolism, and thrombus formation, was analyzed for the diabetic and non-diabetic groups. Diabetics were younger but had a higher prevalence of coronary artery disease (patherectomy resulted in similar low procedure-related complication rates in both the diabetic and non-diabetic groups, despite diabetics having more unfavorable baseline clinical and lesion characteristics. This study suggests that orbital atherectomy is a safe and effective treatment modality in both the diabetic and the non-diabetic populations.

Family physician clinical inertia in glycemic control among patients with type 2 diabetes.

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Bralić Lang, Valerija; Bergman Marković, Biserka; Kranjčević, Ksenija

2015-02-05

Many patients with diabetes do not achieve target values. One of the reasons for this is clinical inertia. The correct explanation of clinical inertia requires a conjunction of patient with physician and health care system factors. Our aim was to determine the rate of clinical inertia in treating diabetes in primary care and association of patient, physician, and health care setting factors with clinical inertia. This was a national, multicenter, observational, cross-sectional study in primary care in Croatia. Each family physician (FP) provided professional data and collected clinical data on 15-25 type 2 diabetes (T2DM) patients. Clinical inertia was defined as a consultation in which treatment change based on glycated hemoglobin (HbA1c) levels was indicated but did not occur. A total of 449 FPs (response rate 89.8%) collected data on 10275 patients. Mean clinical inertia per FP was 55.6% (SD ±26.17) of consultations. All of the FPs were clinically inert with some patients, and 9% of the FPs were clinically inert with all patients. The main factors associated with clinical inertia were: higher percentage of HbA1c, oral anti-diabetic drug initiated by diabetologist, increased postprandial glycemia and total cholesterol, physical inactivity of patient, and administration of drugs other than oral antidiabetics. Clinical inertia in treating patients with T2DM is a serious problem. Patients with worse glycemic control and those whose therapy was initiated by a diabetologist experience more clinical inertia. More research on causes of clinical inertia in treating patients with T2DM should be conducted to help achieve more effective diabetes control.

diabetic patients

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Mehraban Falahati

2016-09-01

candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8, and acidic urine pH (P<0.05. Conclusion: Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

The Prevalance of Diabetes in Psoriatic Patients Versus the Prevalance of Psoriasis in Diabetic Patients

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Nahide Onsun

2010-03-01

Full Text Available Background and Design: Previous studies reported that there are some relations between psoriasis and the diabetes mellitus. However, incidence rates of diabetes mellitus in psoriasis and also incidence rates of psoriasis in diabetes mellitus are lacking.Our aim was to assess and compare incidence rates of diabetes mellitus in patients with psoriasis and incidence rates of psorasis in diabetes mellitus and also evaluate the role of psoriasis as a risk factor for diabetes mellitus. Material and Method: Four hundred eighteen patients with psoriasis and one hundred fifty four patients with diabetes were included. Blood glucose, oral glucose tolerance test (OGTT, glycolised hemoglobine (HbA1C were performed in psoriatic patients and these results were consulted with diabetes clinic. Psoriasis screening by clinical history, dermatologic examination, skin biopsy; if it is necessary were held for patients with diabetes. Results: Prevalance of diabetes was 9.3% in psoriatic patients; prevalance of psoriasis was 1.3% in diabetic patients. The proportion of diabetes was significantly higher in psoriatic patients compared to the proportion of psoriasis in diabetic patients (odds ratio (OR: 7.82, confidence interval (CI: 1.86-32.79, p=0.001. The age and sex-adjusted proportion of diabetes was significantly higher in psoriatic patients as compared the proportion of psoriasis in diabetic patients (OR: 18.35, p<0.001. Differences of mean duration of disease and mean PASİ (psorasis area severity index were not significant between the psoriatic patients without diabetes mellitus and with diabetes mellitus.Conclusion: Risk rate of diabetes is increased in psoriatic patients. Chronic inflammation may lead insulin resistance and diabetes. We think that development of diabetes in patients with psoriasis depends on chronic inflammation. Unfortunately we could not assess the role of therapeutical agents especially effect of potent corticosteroids in development of

Effective Nurse Communication With Type 2 Diabetes Patients : A Review

NARCIS (Netherlands)

Mulder, Bob C.; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to

Alpha-lipoic acid reduces body weight and regulates triglycerides in obese patients with diabetes mellitus.

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Okanović, Azra; Prnjavorac, Besim; Jusufović, Edin; Sejdinović, Rifat

2015-08-01

To determine an influence of alpha-lipoic acid to reduction of body weight and regulation of total cholesterol concentration, triglycerides and glucose serum levels in obese patients with diabetes mellitus type 2. A prospective study includes two groups of obese patients with diabetes mellitus and signs of peripheral polyneuropathia: examined group (30 patients; 15 females and 15 males), and control group (30 patients; 12 females and 18 males). All were treated with metformin (850-1700 mg/day). Examined patients were additionally treated with alpha-lipoic acid 600 mg/day during 20 weeks. Body mass index and concentrations of total cholesterol, triglycerides and glucose in serum were compared before and after the treatment. The group treated with 600 mg alpha-lipoic acid lost significantly more weight, and had lower triglyceride level than the control group. There were no significant differences in total cholesterol and glucose serum levels between the groups. Alpha-lipoic acid of 600 mg/day treatment have influenced weight and triglycerides loss in obese patients with diabetes mellitus type 2. It should be considered as an important additive therapy in obese patients with diabetes mellitus type 2. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

Clinical outcomes of patients with diabetes mellitus treated with Absorb bioresorbable vascular scaffolds: a subanalysis of the European Multicentre GHOST-EU Registry.

Science.gov (United States)

Capranzano, Piera; Capodanno, Davide; Brugaletta, Salvatore; Latib, Azeem; Mehilli, Julinda; Nef, Holger; Gori, Tommaso; Lesiak, Maciej; Geraci, Salvatore; Pyxaras, Stelios; Mattesini, Alessio; Münzel, Thomas; Araszkiewicz, Aleksander; Caramanno, Giuseppe; Naber, Christoph; Di Mario, Carlo; Sabatè, Manel; Colombo, Antonio; Wiebe, Jens; Tamburino, Corrado

2018-02-15

Data on the clinical performance of bioresorbable scaffolds in patients with diabetes mellitus (DM) are still limited. The present study reported 1-year clinical outcomes associated with the use of everolimus-eluting bioresorbable vascular scaffolds (Absorb BVS; Abbott Vascular, Santa Clara, CA) in DM patients. This was a subanalysis from the GHOST-EU (Gauging coronary Healing with biOresorbable Scaffolding plaTforms in Europe) multicenter retrospective registry including patients treated with Absorb BVS between November 2011 and September 2014. In this study, a comparative analysis stratified according to DM was performed. The primary endpoint was target lesion failure (TLF), defined as the combination of cardiac death, target-vessel myocardial infarction (MI) and clinically-driven target-lesion revascularization (TLR). A total of 1,477 patients were treated with 2,224 Absorb BVS; 381 (25.8%) and 1,096 (74.2%) patients were with and without DM, respectively. The 1-year rate of TLF was higher among patients with DM (7.8%) than those without DM (4.3%); the increase in TLF was driven by TLR (6.5% vs. 3.3%, P = 0.009); no significant differences in cardiac death (1.1% vs. 0.9%, P = 0.68) and target-vessel MI (3.1% vs. 2.2%, P = 0.38) were observed, respectively. Definite/probable scaffold thrombosis rate tended to be higher among patients with DM than those without DM (3.0% vs. 1.7%, P = 0.14, respectively). Absorb BVS use in patients with DM was associated with increased 1-year TLF and scaffold thrombosis compared with non-diabetes patients. © 2017 Wiley Periodicals, Inc.

Optimization of surgical treatment of cataract in patients with diabetes mellitus

OpenAIRE

Lipatov, D.; Chistyakov, T.; Kuzmin, A.

2010-01-01

Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM) and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes) treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied inc...

Ethnopharmacological field study of the plants used to treat type 2 diabetes among the Cakchiquels in Guatemala.

Science.gov (United States)

Cruz, Elda Carola; Andrade-Cetto, Adolfo

2015-01-15

Type 2 diabetes is characterized by tissue resistance to the action of insulin, combined with a relative deficiency in insulin secretion. In Guatemala, type 2 diabetes results in significant mortality rates. The low incomes of the indigenous population results in the use of alternative therapies such as medicinal plants to treat the illness. We could not find any previous study related to the use of medicinal plants to treat diabetes in Guatemala. The aim of this work is to determine the most effective plant species used in traditional medicine to treat type 2 diabetes. We performed an ethnopharmacological field study among the Cakchiquels of Chimaltenango to select the most prominent plants used to treat the disease. Type 2 diabetic patients from their community health centers were interviewed using structured questionnaires. Two mathematical tools were used to identify potential plant species: the Disease Consensus Index and the Use Value. International databases, including SCOPUS, PubMed, and Google Scholar, were used to identify whether the plants with the highest scores were known to elicit hypoglycemic effects. After analyzing the data, we can propose the following plants as the most prominent among the Cakchiquels of Chimaltenango to treat type 2 diabetes: Hamelia patens Jacq., Neurolaena lobata (L.) R.Br.ex Cass., Solanum americanum Mill., Croton guatemalensis Lotsy, and Quercus peduncularis Née. The Cakchiquel patients interviewed did not understand type 2 diabetes; however, they associated the onset of their disease with a negative emotion, such as shock, sadness or anger. Despite changes in lifestyle, influences of advertising, the availability of innovative treatments and the use of oral hypoglycemic treatments provided by health facilities serving indigenous communities, the Cakchiquel continue to use medicinal plants as adjunctive treatment. While they are unaware whether the plants can cause additional harm, they consider their consumption

Effects of oral glucose-lowering drugs on long term outcomes in patients with diabetes mellitus following myocardial infarction not treated with emergent percutaneous coronary intervention--a retrospective nationwide cohort study

DEFF Research Database (Denmark)

Jørgensen, Casper H; Gislason, Gunnar H; Andersson, Charlotte

2010-01-01

The optimum oral pharmacological treatment of diabetes mellitus to reduce cardiovascular disease and mortality following myocardial infarction has not been established. We therefore set out to investigate the association between individual oral glucose-lowering drugs and cardiovascular outcomes...... following myocardial infarction in patients with diabetes mellitus not treated with emergent percutaneous coronary intervention....

Diagnosing diabetes mellitus in patients with porphyria cutanea tarda

DEFF Research Database (Denmark)

Christiansen, Anne L.; Bygum, Anette; Hother-Nielsen, Ole

2018-01-01

The prevalence of diabetes mellitus is increased in patients with porphyria cutanea tarda. Different tests are available for diagnosing and screening for type II diabetes mellitus, however choosing the most suitable test is challenging. The pitfalls in the different tests along with the interfering...... comorbidities and treatments concerning patients with porphyria cutanea tarda complicate diagnosing these patients with diabetes mellitus. HbA1c, fasting glucose, or oral glucose tolerance are the current available tests, with HbA1c as first choice. Measuring HbA1c requires no fasting, however HbA1c can...... be false low if the patient is treated with phlebotomy or has liver cirrhosis or chronic hepatitis. Instead fasting glucose and oral glucose tolerance tests can be used if the patient is not acutely ill. If either of the tests give a result in the diagnostic range, the test should be repeated...

Epidemiology and outcome in patients of diabetic foot

International Nuclear Information System (INIS)

Ashraf, M.N.; Rehman, K.U.; Malik, K.I.; Iqbal, G.S.

2011-01-01

Background: The aim of study was detailed analysis of the presentation of diabetic foot ulcers, characteristics and predictors of outcome (incidence of amputation in neuropathic, ischemic, neuro ischemic) in patients presenting with diabetic foot at our hospital. Methods: This prospective analytic study was conducted from January 2009-August 2010 at POF Hospital Wah Cantt. Diabetic patients who presented with foot ulcers were enrolled in this study. Demographics of patients along with ulcer size, type, site and Grade according to Wagner Classification were recorded. Wounds were managed with daily dressings, nursing care and de-sloughing of necrotic tissue along with appropriate antibiotic cover. Patients were followed over period until wound healed completely or a lower limb amputation performed, the outcome noted and patient was deemed to have completed study. Results: One hundred and fifteen patients with mean age 55.46 +- 8.23 years, both male and female were included in this study. Out of 115 patients 111 patients had Type-II diabetes while only 4 presented with Type-I. Mean Duration of diabetes was 14.61 +- 2.17 years. With respect to underlying causes 18.3% foot ulcers were ischemic, 22.6% were neuropathic and 59% were neuro-ischemic. Median ulcer size was 74% of ulcer classified as Wagner grade-II and III while 24% were of Grade-V. Lower limb amputation were performed in 25% of patients whereas limb salvage achieved in 75% of patients with wounds healed (median healing time 5 (3-10 weeks). Conclusion: Preservation of the limb function without endangering the patient must be a goal of treating diabetic foot. Once foot amputation is successful, rehabilitation with orthotic or prosthetic devices may allow years of a functional extremity along with preventive measures like cessation of smoking, daily foot hygiene and foot inspection. (author)

Glucometabolic hormones and cardiovascular risk markers in antipsychotic-treated patients

DEFF Research Database (Denmark)

Ebdrup, Bjørn Hylsebeck; Knop, Filip Krag; Madsen, Anna

2014-01-01

levels, non-diabetic antipsychotic-treated patients display emerging signs of dysmetabolism and a compromised cardiovascular risk profile. The appetite regulating hormones, GLP-1 and ghrelin appear not to be influenced by antipsychotic treatment. Our findings provide new clinical insight...

Amylase, Lipase, and Acute Pancreatitis in People With Type 2 Diabetes Treated With Liraglutide: Results From the LEADER Randomized Trial.

Science.gov (United States)

Steinberg, William M; Buse, John B; Ghorbani, Marie Louise Muus; Ørsted, David D; Nauck, Michael A

2017-07-01

To evaluate serum amylase and lipase levels and the rate of acute pancreatitis in patients with type 2 diabetes and high cardiovascular risk randomized to liraglutide or placebo and observed for 3.5-5.0 years. A total of 9,340 patients with type 2 diabetes were randomized to either liraglutide or placebo (median observation time 3.84 years). Fasting serum lipase and amylase were monitored. Acute pancreatitis was adjudicated in a blinded manner. Compared with the placebo group, liraglutide-treated patients had increases in serum lipase and amylase of 28.0% and 7.0%, respectively. Levels were increased at 6 months and then remained stable. During the study, 18 (0.4% [1.1 events/1,000 patient-years of observation] [PYO]) liraglutide-treated and 23 (0.5% [1.7 events/1,000 PYO]) placebo patients had acute pancreatitis confirmed by adjudication. Most acute pancreatitis cases occurred ≥12 months after randomization. Liraglutide-treated patients with prior history of pancreatitis ( n = 147) were not more likely to develop acute pancreatitis than similar patients in the placebo group ( n = 120). Elevations of amylase and lipase levels did not predict future risk of acute pancreatitis (positive predictive value pancreatitis among liraglutide-treated patients (regardless of previous history of pancreatitis) compared with the placebo group. Liraglutide was associated with increases in serum lipase and amylase, which were not predictive of an event of subsequent acute pancreatitis. © 2017 by the American Diabetes Association.

A "Family-Based" Approach to the Treatment of Obese Type II Diabetic Patients.

Science.gov (United States)

Wing, Rena R.; And Others

1991-01-01

Assigned 49 obese diabetic patients with obese spouses (diabetic or nondiabetic) to an alone or together (with spouses) treatment condition of behavioral weight control program. Found no significant differences in weight losses of patients at posttreatment or one-year followup, but did find that women did better when treated with their spouses,…

Short-term effect of red wine (consumed during meals) on insulin requirement and glucose tolerance in diabetic patients.

Science.gov (United States)

Gin, H; Morlat, P; Ragnaud, J M; Aubertin, J

1992-04-01

To determine the effect of wine on insulin requirement or glucose tolerance. Five men with insulin-treated diabetes and 10 men with non-insulin-treated diabetes ate the same lunch with the same volume of either water or red wine (2 glasses). Insulin requirement was determined with an artificial pancreas (Biostator). Glucose tolerance was evaluated from the postprandial glycemic level. There was no significant difference in insulin requirement determined with an artificial pancreas in the insulin-treated patients after the two meals (31.5 +/- 4.21 U with water and 31.8 +/- 4.3 U with wine). Glucose tolerance in the non-insulin-treated patients was lower after the meal with wine. Moderate prandial wine consumption has no adverse effect on the glycemic control of diabetic patients. Thus, it appears unnecessary to proscribe the consumption of red wine in moderation with meals to diabetic patients. Wine contains tannins and phytates that can explain its action.

[Optimizing the managment of patients with diabetes mellitus: selected clinical trials from the 2004 Congress of the American Diabetes Association].

Science.gov (United States)

Scheen, A J; Radermecker, R P; Philips, J C

2004-06-01

The 64th scientific congress of the American Diabetes Association had a special session devoted to the presentation of the results from three clinical trials: 1) the first multicentre international trial of pancreatic islet transplantation according to the so-called Edmonton protocol with the primary endpoint of restoring insulin independence in type 1 diabetic patients; 2) three pivotal studies of 30 weeks testing both the efficacy and safety of exenatide (exendin-4), a new insulin secretagogue that is a long-acting analogue of glucagon-like peptide-1, in patients with type 2 diabetes treated with either metformin, or a sulfonylurea, or a metformin-sulfonylurea combination; and 3) the "Collaborative AtoRvastatin Diabetes Study" (CARDS), a placebo-controlled primary prevention trial of cardiovascular complications using atorvastatin 10 mg in 2 838 at risk patients with type 2 diabetes. The main results and conclusions of these trials are briefly presented as they open new perspectives in the management of patients with type 1 or type 2 diabetes mellitus.

Assessment of metabolic control in patients with diabetes treated with insulin using Contour USB and A1cNow+ devices (COMET study).

Science.gov (United States)

Vinagre, Irene; Álvarez, Pilar; García, Nicolás; Roura, Guillem; Conget, Ignacio

2015-10-01

The self-determination of blood glucose is relevant for diabetes mellitus (DM) insulin-treated patients. The use of glucometers with advanced features and measuring glycated haemoglobin (HbA1c) may help improve metabolic control. The main objective of this study was to determine the percentage of insulin treated patients who reduced HbA1c by at least 0.4% after 6 months of using Contour and A1CNow+. Observational, prospective, multicentre study in adult DM insulin treated patients, with HbA1c> 8%. Of the 454 recruited patients analysed, a total of 333 were evaluable. After 6 months the HbA1c decreased (P 8% was observed, with this reaching: 41% for all, 45% in type 1 DM, and 25% in type 2 DM. In the glycaemic profile, a reduction (P<.05) was observed in pre- and post-prandial glycaemia in both groups (-20.7±36.4 and -37.1±47.1mg/dL, respectively), with 23% pre-prandial glucose < 130mg/dL and post-prandial < 180mg/dL CONCLUSION: The use of glucometers with advanced features, and measuring glycated haemoglobin (HbA1c) may help improve metabolic control and to monitor insulin treated DM patients more closely. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Reasons and barriers for using a patient portal: survey among patients with diabetes mellitus.

Science.gov (United States)

Ronda, Maaike C M; Dijkhorst-Oei, Lioe-Ting; Rutten, Guy E H M

2014-11-25

The use of a Web portal for patients with diabetes mellitus to access their own personal health record may result in improved diabetes outcomes. However, the adoption by patients is slow. This may be caused by patient characteristics, but also by the content, layout, and promotion of the portal. Detailed knowledge about this could help increase patients' participation in Web portals. The aim was to study the opinions of patients with diabetes and identify perceived barriers to using a Web portal to optimize its use. We conducted a survey among patients with type 1 and type 2 diabetes mellitus from 62 primary care practices and 1 outpatient hospital clinic in the central area of the Netherlands who all used the same electronic health record with a Web portal. Questionnaires about patient characteristics, opinions about reasons for use or nonuse, and about portal content were sent to 1500 patients with a login and 3000 patients without a login to the Web portal. Patient groups were stratified according to login frequency. Demographic and diabetes-related variables were analyzed with multivariable regression analysis. The total response rate was 66.63% (2391/4399); 1390 of 4399 patients (31.60%) were eligible for analysis. There were 413 regular users (login frequency more than once) and 758 nonusers (no login). Most nonusers (72.4%) stated that the main reason for not requesting a login was that they were unaware of the existence of the portal. Other barriers reported by patients were disinterest in managing their own disease (28.5%, 216/758) and feelings of inadequacy with the use of computers and Internet (11.6%, 88/758). Patients treated by a general practitioner were more frequently nonusers compared to patients treated by an internist (78.8%, 666/846 vs 28.3%, 92/325; Ppatient portal is the main barrier of enrollment. Users and nonusers perceive the usefulness of the portal differently and do not have the same recommendations for additional functionalities. To

Metabolic control of type 2 diabetic patients commonly treated with ...

African Journals Online (AJOL)

Fasting insulin and glucose concentrations were used to assess insulin resistance and sensitivity (%S) using Homeostasis model assessment (HOMA) method. Results: Of the 179 patients studied, 87% of male and 92% of female patients were treated with sulphonylurea drugs whereas 13% and 9% of male and female ...

Awareness of diabetic retinopathy among patients with diabetes ...

African Journals Online (AJOL)

Background: Diabetic retinopathy is a major cause of blindness worldwide. The associated loss of productivity and quality of life of the patients with diabetic retinopathy will lead to additional socioeconomic burden. This study aims to determine the level of awareness of diabetic retinopathy among diabetic patients. Materials ...

Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients.

Science.gov (United States)

Poulimeneas, Dimitrios; Grammatikopoulou, Maria G; Bougioukli, Vasiliki; Iosifidou, Parthena; Vasiloglou, Maria F; Gerama, Maria-Assimina; Mitsos, Dimitrios; Chrysanthakopoulou, Ioanna; Tsigga, Maria; Kazakos, Kyriakos

2016-01-01

Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients' medical files. Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Frequency and predictors of confirmed hypoglycaemia in type 1 and insulin-treated type 2 diabetes mellitus patients in a real-life setting: results from the DIALOG study.

Science.gov (United States)

Cariou, B; Fontaine, P; Eschwege, E; Lièvre, M; Gouet, D; Huet, D; Madani, S; Lavigne, S; Charbonnel, B

2015-04-01

DIALOG assessed the prevalence and predictors of hypoglycaemia in patients with type 1 (T1DM) or insulin-treated type 2 diabetes mellitus (T2DM) in a real-life setting. In this observational study, insulin-treated patients (n=3048) completed prospective daily questionnaires reporting the frequency and consequences of severe/confirmed non-severe hypoglycaemia over 30 days. Patients (n=3743) also retrospectively reported severe hypoglycaemia over the preceding year. In this prospective survey, 85.3% and 43.6% of patients with T1DM and T2DM, respectively, reported experiencing at least one confirmed hypoglycaemic event over 30 days, while 13.4% and 6.4%, respectively, reported at least one severe event. Hypoglycaemia frequency increased with longer duration of diabetes and insulin therapy. Strongly predictive factors for hypoglycaemia were previous hypoglycaemia, >2 injections/day, BMIinsulin therapy>10 years. HbA1c level was not predictive of hypoglycaemia in either T1DM or T2DM. The confirmed hypoglycaemia rate was increased in the lowest compared with the highest tertile of HbA1c in T1DM, but not T2DM. At the time of enrolment, physicians reported severe hypoglycaemia in 23.6% and 11.9% of T1DM and T2DM patients, respectively, during the preceding year; the retrospective survey yielded frequencies of 31.5% and 21.7%, respectively. Also, severe hypoglycaemia led to medical complications in 10.7% and 7.8% of events in T1DM and T2DM patients, respectively, over 30 days. Using a unique combined prospective and retrospective approach, the DIALOG study found a relatively high frequency of hypoglycaemia among insulin-treated patients. These findings emphasize the importance of a patient-centred approach for managing diabetes in which hypoglycaemia risk evaluation is critical. ClinicalTrials.gov: NCT01628341. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

White coat effect and masked uncontrolled hypertension in treated hypertensive-diabetic patients: Prevalence and target organ damage.

Science.gov (United States)

Leiria, Liana F; Severo, Mateus D; Ledur, Priscila S; Becker, Alexandre D; Aguiar, Fernanda M; Massierer, Daniela; Freitas, Valéria C; Schaan, Beatriz D; Gus, Miguel

2015-09-01

The association between hypertensive phenotypes of controlled hypertension (CH), white-coat effect (WCE), masked uncontrolled hypertension (MUH) and sustained hypertension (SH) with target organ damage have not been clearly established in diabetic hypertensive treated patients. The present study aims to evaluate the prevalence of the four phenotypes considering the current cut-off points for office and 24 h-ambulatory blood pressure monitoring (ABPM) and the association with left ventricle hypertrophy (LVH), diastolic function and nephropathy. Cross-sectional study with 304 patients on anti-hypertensive treatment aged 57.6 ± 6.1 years, who were submitted to ABPM and echocardiography. They were classified into CH (normal office BP and ABPM), WCE (high office BP and normal ABPM), MUH (normal office BP and high ABPM), and SH (high office BP and ABPM). Median HbA1c and diabetes duration were 7.9% (6.8-9.2), and 10 years (5-16), respectively. Prevalences of CH, WCE, MUH and SH were 27.3%, 17.1%, 18.8%, and 36.8%. MUH prevalence was higher than previously described. There was a significant increasing trend across the four groups in variables related to LVH (P ABPM beyond the traditional cardiovascular risk stratification tools has limitations, but is still useful in high-risk patients. Longitudinal studies could better evaluate the role of the use of ABPM in this scenario. Cut-off points for normality of office and ABPM influence the prevalences of WCH and MUH. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Treating infected diabetic wounds with superoxidized water as anti-septic agent: a preliminary experience

International Nuclear Information System (INIS)

Hadi, S.F.; Khaliq, T.; Zubair, M.; Saaiq, M.; Sikandar, I.

2007-01-01

To evaluate the effectiveness of superoxidized water (MicrocynTM) in diabetic patients with different wounds. One hundred known diabetic patients were enrolled. Half were randomized to the intervention group (those whose wounds were managed with superoxidized water) and half to the control group (whose wounds were treated with normal saline) using a table of random numbers. The two groups were matched for age, gender, duration of diabetes and category of wound. All patients received appropriate surgical treatment for their wounds as required. Local wound treatment was carried out daily using superoxidized water soaked gauzes on twice daily basis in the intervention group and normal saline in the control group. The treatment was continued until wound healing. The main outcome measures were duration of hospital stay, downgrading of the wound category, wound healing time and need for interventions such as amputation. Statistically significant differences were found in favour of the superoxidized water group with respect to duration of hospital stay, downgrading of the wound category and wound healing time. Although the initial results of employing superoxidized water for the management of infected diabetic wounds are encouraging, further multicentre clinical trials are warranted before this antiseptic is recommended for general use. It may offer an economical alternative to other expensive antiseptics with positive impact on the prevailing infection rates, patient outcomes and patient satisfaction. (author)

Improving self-management in insulin-treated adults participating in diabetes education. The role of overprotection by the partner.

Science.gov (United States)

Hagedoorn, M; Keers, J C; Links, T P; Bouma, J; Ter Maaten, J C; Sanderman, R

2006-03-01

To examine the role of overprotection by the partner--i.e. excessive protection, unnecessary help, excessive praise for accomplishments, or attempts to restrict activities as a consequence of underestimating the patient's capabilities--in changes in patient self-management in the context of diabetes education. Sixty-seven insulin-treated patients with a partner completed questionnaires on admission to a Multidisciplinary Intensive Education Programme (MIEP) and 3 months after completing the core module of MIEP. Factors assessed were overprotection by their partner and three aspects of diabetes self-management, namely internal locus of control, diabetes-related distress and HbA1c. Regression analyses were used to test the independent associations of patient sex, baseline overprotection and the interaction between sex and overprotection with diabetes self-management at the follow-up stage, controlling for the baseline value of the dependent variable. The increase in internal locus of control and decrease in HbA1c were both significantly less for female patients who perceived their partner to be rather overprotective than for female patients who did not perceive their partner to be overprotective. The more patients, both male and female, perceived their partner to be overprotective, the less their diabetes-related distress decreased. Overprotection by the partner showed a negative association with improvement in diabetes self-management, especially for female patients. Thus, an intervention programme with the aim of reducing overprotection by the partner, or the perception of this, may enhance self-management in patients participating in diabetes education.

Knowledge of diabetic complications in patients with diabetes mellitus

International Nuclear Information System (INIS)

Ullah, F.; Afridi, A.K.; Rahim, F.; Ashfaq, M.; Khan, S.

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. Methods: This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Results: Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 ± 10.821 years while the mean duration of diabetes mellitus was 9.75 ± 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Conclusions: Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus. (author)

KNOWLEDGE OF DIABETIC COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS.

Science.gov (United States)

Ullah, Fahim; Afridi, Ayesha Khan; Rahim, Fawad; Ashfaq, Muhammad; Khan, Sheema; Shabbier, Ghulam; Rahman, Sadiq Ur

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 +/- 10.821 years while the mean duration of diabetes mellitus was 9.75 +/- 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus.

An Overview of Diabetes Management in Schizophrenia Patients: Office Based Strategies for Primary Care Practitioners and Endocrinologists

Science.gov (United States)

Annamalai, Aniyizhai; Tek, Cenk

2015-01-01

Diabetes is common and seen in one in five patients with schizophrenia. It is more prevalent than in the general population and contributes to the increased morbidity and shortened lifespan seen in this population. However, screening and treatment for diabetes and other metabolic conditions remain poor for these patients. Multiple factors including genetic risk, neurobiologic mechanisms, psychotropic medications, and environmental factors contribute to the increased prevalence of diabetes. Primary care physicians should be aware of adverse effects of psychotropic medications that can cause or exacerbate diabetes and its complications. Management of diabetes requires physicians to tailor treatment recommendations to address special needs of this population. In addition to behavioral interventions, medications such as metformin have shown promise in attenuating weight loss and preventing hyperglycemia in those patients being treated with antipsychotic medications. Targeted diabetes prevention and treatment is critical in patients with schizophrenia and evidence-based interventions should be considered early in the course of treatment. This paper reviews the prevalence, etiology, and treatment of diabetes in schizophrenia and outlines office based interventions for physicians treating this vulnerable population. PMID:25878665

An Overview of Diabetes Management in Schizophrenia Patients: Office Based Strategies for Primary Care Practitioners and Endocrinologists

Directory of Open Access Journals (Sweden)

Aniyizhai Annamalai

2015-01-01

Full Text Available Diabetes is common and seen in one in five patients with schizophrenia. It is more prevalent than in the general population and contributes to the increased morbidity and shortened lifespan seen in this population. However, screening and treatment for diabetes and other metabolic conditions remain poor for these patients. Multiple factors including genetic risk, neurobiologic mechanisms, psychotropic medications, and environmental factors contribute to the increased prevalence of diabetes. Primary care physicians should be aware of adverse effects of psychotropic medications that can cause or exacerbate diabetes and its complications. Management of diabetes requires physicians to tailor treatment recommendations to address special needs of this population. In addition to behavioral interventions, medications such as metformin have shown promise in attenuating weight loss and preventing hyperglycemia in those patients being treated with antipsychotic medications. Targeted diabetes prevention and treatment is critical in patients with schizophrenia and evidence-based interventions should be considered early in the course of treatment. This paper reviews the prevalence, etiology, and treatment of diabetes in schizophrenia and outlines office based interventions for physicians treating this vulnerable population.

Diabetes stigma is associated with negative treatment appraisals among adults with insulin-treated Type 2 diabetes

DEFF Research Database (Denmark)

Holmes-Truscott, E.; Browne, J. L.; Ventura, A. D.

2018-01-01

and psychosocial issues. Subgroup analyses were conducted on the responses of 456 adults with insulin-treated Type 2 diabetes (38% women; mean ± sd age: 61.2 ± 8.8 years; diabetes duration: 14.5 ± 7.5 years; years using insulin: 6.4 ± 5.5). Participants completed validated measures of perceived and experienced......, BMI, years using insulin, injections per day), self-efficacy, diabetes-specific distress and diabetes stigma (all P diabetes......Aim: To explore factors associated with negative insulin appraisals among adults with Type 2 diabetes, including perceived and experienced diabetes stigma. Methods: The second Diabetes MILES - Australia study (MILES-2) is a national survey of adults with diabetes, focused on behavioural...

Myocardial glucose utilisation in type II diabetes mellitus patients treated with sulphonylurea drugs

International Nuclear Information System (INIS)

Yokoyama, Ikuo; Inoue, Yusuke; Moritan, Toshiyuki; Ohtomo, Kuni; Nagai, Ryozo

2006-01-01

Chronic sulphonylurea treatment maintains improved glycaemic control through mechanisms other than enhancement of insulin secretion and may act on various organs. The aim of this study was to investigate whether the chronic use of sulphonylurea drugs influences PET measurement of myocardial glucose utilisation (MGU) in type II diabetes mellitus. Forty-two patients with type II diabetes mellitus and 17 control subjects underwent dynamic 18 F-FDG PET to measure MGU during hyperinsulinaemic euglycaemic clamping. Twenty-one patients had been taking sulphonylurea drugs for more than 1 year (SU group), and the other 21 patients were drug naive (non-SU group). The haemoglobin A1c levels in the two patient groups were similar. Glucose disposal rate (GDR) was also determined as a marker of whole-body insulin resistance. GDR in the SU group (9.01±2.53 mg min -1 kg -1 ) was significantly higher than that in the non-SU group (4.10±2.47, p -1 100 g -1 ) was significantly higher than that in the non-SU group (5.53±2.05, p<0.01) and was similar to that in the controls (7.49±2.74). (orig.)

Diabetic Foot Risk Factors in Patients with Diabetes at the

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R. Hosseini

2008-10-01

Full Text Available Background and Objectives Diabetic foot problems are one of the major causes of mortality and disability in diabetic patients. It is considered one of the costliest conditions for health care systems. This study is designed to identify diabetic foot risk factors in patients with diabetes mellitus at Kamkar Hospital diabetes clinic in Qom, Iran during 2006.MethodsThis study was performed on 140 diabetes mellitus patients at the Kamkar Hospital diabetic clinic. International working Group on the Diabetic Foot (IWGDF guidelines were used for physical exam of diabetic foot in these patients. The physical exam consisted of inspection of foot appearance for deformity, skin keratosis and ulcer, and neurological and arterial pulse exam of the lower extremities of these patients. Patients in this study were divided into four risk groups based on the IWGDF guidelines. ANOVA method was used for analysis and comparison of the results with P<0.05 considered as significant. ResultsMean age of the participants in this study was 52.4±11.2 years old from which 67.1% were female, 37.1% of patients were illiterate, and 10% were active smokers. Mean duration of diabetes in these patients was 8.9 years. Mean body mass index (BMI was 29.4± 4.4 and HbA1C was 9.3 ± 1.9. Percentages of the patients with retinopathy and nephropathy were 33.6% and 17.7% respectively. 95% of the patients did not know the correct way of nail clipping, 95.5% were wearing uncomfortable shoes, and 14.3% of patients had history of foot ulcer. None of the them had any education about foot care. Physical examination with monofilament, ankle reflex and vibration perception were defected in 28.6%, 52.5%, and 32.1% of patients respectively. 37.7% of patients had a decreased lower extremity pulse that was not felt by touch. Based on the IWGDF classifications, 70% of the patients were in the higher-risk group for diabetic foot ulcer. In the high risk group, age, duration of diabetes, illiteracy was

Gastric emptying and timing of insulin injection in insulin-treated diabetics Using99m Te-sulfur colloid

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Sheta, M.; El-Borrolossy, H.; El-Tawil, A.

1997-01-01

Gastric emptying of 99m Tc labelled liquid and solid meals were studied in 112 long-standing insulin insulin treated diabetics to evaluate the relationship of gastroparesis to patients age, sex, gastrointestinal symptoms, diabetic neuropathic complication and glycemic control, and to evaluate the influence of gastric emptying and timing of insulin injection as modifying factors for blood glucose control aiming at objective optimization of timing of insulin injection for every individual patient using the proposed equation: time of insulin injection=onset of insulin action -solid lag time. Patients were classified into three group: A) no neuropathy; B) peripheral neuropathy; and C) peripheral and autonomic neuropathy and compared to healthy volunteers as controls. Diabetics showed statistically significant prolonged gastric lag time and T1/2 for both liquid and solid meals compared to those of controls

Association of insulin treatment versus oral hypoglycaemic agents with diabetic retinopathy and its severity in type 2 diabetes patients in Cameroon, sub-Saharan Africa.

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Jingi, Ahmadou M; Noubiap, Jean Jacques N; Essouma, Mickael; Bigna, Jean Joel R; Nansseu, Jobert Richie N; Ellong, Augustin; Mvogo, Côme Ebana

2016-10-01

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease associated with multiple macro and microvascular complications, diabetic retinopathy (DR) being the commonest one. Recent literature has reported an increased risk of DR with insulin use. We carried out a cross-sectional study at the Ophthalmology Department of the Douala General Hospital (DGH) during a 2-year period to explore the association between insulin treatment and both DR and its severity as compared with oral hypoglycemic agents (OHAs) in Cameroonian T2DM patients aged ≥35 years, and who were all screened for DR through eye examination including exhaustive retinal evaluation. In total, medical files of 134 T2DM patients were analyzed. The frequency of DR was 54.1% among patients on OHA and 73.9% among those on insulin treatment, giving an overall frequency of 57.5%. There were significantly more OHA treated patients than insulin treated patients (82.8% vs . 17.2%, Phistory of hypertension, alcohol misuse, and current tobacco smoking. DR was almost significantly more frequent in T2DM patients under insulin regimen than in patients under OHA [73.9% vs . 54.1%; odds ratio (OR) 2.4; 95% confidence interval (CI), 0.9-6.6; P=0.06]. Proliferative diabetic retinopathy (PDR) was significantly more observed in insulin treated patients than in OHA treated patients (34.8% vs . 15.3%; OR 2.95; 95% CI, 1.1-8; P=0.035). Irrespective of staging, the frequency of diabetic macular edema (DME) was significantly higher in the insulin group than in the OHA group (43.5% vs . 19.8%; OR 3.1; 95% CI, 1.2-8; P=0.019). Compared with OHA, insulin therapy may be associated with DR, DR severity and DME in these T2DM sub-Saharan African patients.

Red cell distribution width in type 2 diabetic patients

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Nada AM

2015-10-01

Full Text Available Aml Mohamed Nada Department of Internal Medicine, Unit of Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Mansoura University, Mansoura, Egypt Objective: To study the indices of some elements of the complete blood count, in type 2 diabetic patients, in comparison with nondiabetic healthy controls; and to find out the effects of glycemic control and different medications on these indices. To the best of our knowledge, this study is novel in our environment and will serve as a foundation for other researchers in this field. Methods: This retrospective study included 260 type 2 diabetic patients on treatment and 44 healthy control subjects. Sex, age, weight, height, blood pressure, complete blood count, fasting plasma glucose, hemoglobin A1c (HbA1c, and lipid profile data, were available for all of the study population. For diabetic patients, data on duration of diabetes and all medications were also available. Results: Red cell distribution width (RDW was significantly higher in diabetic patients than in control subjects (P=0.008. It was also higher in patients with uncontrolled glycemia (HbA1c >7% than those with good control (HbA1c ≤7%; P=0.035. Mean platelet volume (MPV was comparable in both diabetic patients and healthy controls (P=0.238. RDW and MPV did not significantly correlate with fasting plasma glucose, HbA1c, or duration of diabetes. Both aspirin and clopidogrel did not show a significant effect on MPV. Both insulin and oral hypoglycemic agents did not show a significant effect on RDW, mean corpuscular volume, MPV, platelet count, or white blood cell count. Diabetic patients treated with indapamide or the combined thiazides and angiotensin receptor blockers showed no significant difference in RDW when compared with the control subjects. Conclusion: RDW, which is recently considered as an inflammatory marker with a significant predictive value of mortality in diseased and healthy populations, is significantly higher in

An investigation on body weights, blood glucose levels and pituitary-gonadal axis hormones in diabetic and metformin-treated diabetic female rats

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Pouya Pournaghi

2012-06-01

Full Text Available Diabetes is a metabolic disorder which affects whole body systems including reproductive system. Diabetes is also a contributing factor to infertility. Metformin is one of the most common drugs to control hyperglycemia. In this study, 36 adult Sprague-Dawley female rats (170-210 g were divided into 3 groups (control, diabetic and diabetic-treated by metformin. In second and third groups, diabetes was induced by streptozotocin injection (45 mg kg-1, IP and the third group was treated by metformin hydrochloride (100 mg kg-1 day-1, PO for 8 weeks. Body weights were compared and blood glucose, gonadotropins and sexual hormones were measured. In diabetic group the blood glucose level significantly (P < 0.05 increased in comparison with that of control and metformin-treated diabetic rats. The results also revealed that, in the untreated diabetic rats, the mean body weights and pituitary-gonadal axis hormones were significantly (P < 0.05 reduced in comparison with the control. Although there were significant (P < 0.05 reduction in mean body weights in metformin-treated diabetic rats, reduction in pituitary-gonadal axis hormones was not as sharp as in untreated diabetic rats and only level of progesterone was significantly (P < 0.05 reduced in comparison with the control. The results of this investigation revealed that there was a clear relationship between experimental diabetes with body weight and pituitary-gonadal axis hormones, and treatment with metformin relatively restored diabetic complications.

Retinal changes in diabetic patients without diabetic retinopathy.

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Dumitrescu, Alina Gabriela; Istrate, Sinziana Luminita; Iancu, Raluca Claudia; Guta, Oana Maria; Ciuluvica, Radu; Voinea, Liliana

2017-01-01

The purpose of this study was to measure retinal vessel caliber and to examine early changes in macular thickness using optical coherence tomography (OCT). We evaluated to what extend vascular caliber and macular thickness differed between patients with type 2 diabetes mellitus without diabetic retinopathy compared with healthy individuals. 26 diabetic patients without diabetic retinopathy and 26 normal participants without any retinal and optic nerve diseases underwent ophthalmic examination, fundus photography, and OCT imaging. Temporal inferior retinal vessel diameters were measured using OCT. Also, we measured macular thickness in nine ETDRS subfields using Cirrus OCT. The mean age in the diabetic group was 61.5 years and in the control group, 55.5 years. Wider retinal arterioles and venules were found in patients with diabetes compared with healthy subjects (120 µm versus 96 µm, pdiabetes mellitus, central macular thickness was significantly thinner than that of control eyes (243.5 µm versus 269.9 µm, p value diabetes without diabetic retinopathy.

Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes

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Clausen, Tine D; Mathiesen, Elisabeth R; Hansen, Torben

2009-01-01

Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes Context: In animal studies exposure to intrauterine hyperglycemia increases the risk of cardiovascular disease through only partly understood epigenetic mechanisms....... Human long-term follow-up studies on the same topic are few. Objective: To study the risk of overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus (GDM) or type 1 diabetes, and additionally to study associations between estimates of maternal...... hyperglycemia and outcome in the offspring Design: Follow-up study of 1,066 primarily Caucasians aged 18-27 years. Setting: Center for pregnant women with diabetes, Rigshospitalet, Denmark Participants: Offspring of women with diet-treated GDM (n=168) and an un-exposed reference group (n=141). Offspring...

Chelation therapy to treat atherosclerosis, particularly in diabetes: is it time to reconsider?

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Lamas, Gervasio A; Ergui, Ian

2016-08-01

Case reports and case series have suggested a possible beneficial effect of chelation therapy in patients with atherosclerotic disease. Small randomized trials conducted in patients with angina or peripheral artery disease, however, were not sufficiently powered to provide conclusive evidence on clinical outcomes. The Trial to Assess Chelation Therapy (TACT) was the first randomized trial adequately powered to detect the effects of chelation therapy on clinical endpoints. We discuss results and future research. Expert commentary: Chelation reduced adverse cardiovascular events in a post myocardial infarction (MI) population. Patients with diabetes demonstrated even greater benefit, with a number needed to treat of 6.5 patients to prevent a cardiac event over 5 years, with a 41% relative reduction in risk of a cardiac event (p = 0.0002). These results led to the revision of the ACC/AHA guideline recommendations for chelation therapy, changing its classification from class III to class IIb. TACT2, a replicative trial, will assess the effects of chelation therapy on cardiovascular outcomes in diabetic patients with a prior myocardial infarction. We are seeking participating sites for TACT2.

Fanconi's syndrome and nephrogenic diabetes insipidus in an adult treated with ifosfamide.

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Ingemi, Amanda I; Bota, Vasile M; Peguero, Anyeri; Charpentier, Margaret

2012-01-01

Fanconi's syndrome is a serious condition characterized by type II proximal renal tubular dysfunction, with urinary loss of glucose, amino acids, phosphate, bicarbonate, and potassium. Ifosfamide-induced Fanconi's syndrome is reported in about 1.4-5% of children being treated for solid tumors, yet only a few cases have been reported in adults. We describe a 54-year-old man who came to the hospital with symptoms of neutropenic fever 4 days after his fourth cycle of ifosfamide and doxorubicin treatment for recurrent sarcoma with metastases to the lung. During admission, he was noted to have severe renal tubular dysfunction; ifosfamide-induced nephrogenic diabetes insipidus and Fanconi's syndrome were suspected. He received supportive therapy that resulted in incomplete resolution of signs and symptoms. The patient was discharged after a 5-day hospital stay when his white blood cell count increased from 0.1-2.5 × 10(3) /mm(3) and his fever had resolved. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's development of diabetes insipidus and Fanconi's syndrome and his use of ifosfamide. This dual diagnosis of diabetes insipidus and Fanconi's syndrome in an adult makes this case unusual, as well as therapeutically challenging. We conducted a review of the existing literature regarding ifosfamide-induced Fanconi's syndrome and describe the proposed mechanisms and therapeutic options. This case suggests that patients treated with ifosfamide should be monitored closely for renal function to identify, and perhaps prevent, these rare adverse events. Preliminary animal models show promise for adding N-acetylcysteine to ifosfamide treatment, but more research is necessary before using this drug as a therapeutic option. © 2012 Pharmacotherapy Publications, Inc.

Effect of GLP-1 Receptor Agonist Treatment on Body weight in Obese Antipsychotic-treated Patients with Schizophrenia

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Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V

2017-01-01

AIMS: Schizophrenia is associated with cardiovascular co-morbidity and a reduced life-expectancy of up to 20 years. Antipsychotics are dopamine D2 receptor antagonists and the standard of medical care in schizophrenia, but the drugs are associated with severe metabolic side effects like obesity...... and diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are registered for treatment of both obesity and type 2 diabetes. We investigated metabolic effects of the GLP-1RA, exenatide once-weekly, in non-diabetic, antipsychotic-treated, obese patients with schizophrenia. MATERIAL AND METHODS......: Antipsychotic-treated, obese, non-diabetic, schizophrenia spectrum patients were randomized to double-blinded adjunctive treatment with once-weekly subcutaneous exenatide (n = 23) or placebo (n = 22) injections for three months. The primary outcome was body weight loss after treatment and repeated measures...

Periodontal disease in diabetic patients - clinical and histopathological aspects.

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Corlan Puşcu, Dorina; Ciuluvică, Radu Constantin; Anghel, Andreea; Mălăescu, Gheorghe Dan; Ciursaş, Adina Nicoleta; Popa, Gabriel Valeriu; Agop Forna, Doriana; Busuioc, Cristina Jana; Siloşi, Izabela

2016-01-01

Periodontal disease is one of the most frequent diseases affecting people all over the world. The relation between periodontal disease and diabetes mellitus raised the interest both of dentists and doctors treating metabolic diseases, as the two conditions influence one another. In our study, we analyzed a number of 75 patients with diabetes mellitus and periodontal disease that presented to the medical consultory for conditions of the dental maxillary system. The clinical study showed that periodontal disease and diabetes may affect young adults as well, still this pathological association more frequently appears after the age of 50. The disease was identified especially in the women living in urban area. The clinical examination of the dental maxillary system identified the presence of gingival ulcerations, dental calculus, gingival bleeding, radicular leftovers with anfractuous margins, fixed prostheses with an inappropriate cervical adjustment. Of the systemic diseases associated to periodontal disease and diabetes mellitus, there was observed that 66.66% of the patients also suffered from cardiovascular diseases (high blood pressure, ischemic cardiopathy, heart failure), and 37.33% suffered from obesity. The histopathological and immunohistochemical tests highlighted the presence of an inflammatory chronic, intense reaction, mainly formed of lymphocytes, plasmocytes, macrophages and granulocytes, heterogeneously disseminated and alteration of the structure of marginal and superficial periodontium. The inflammatory reaction in the patients with periodontal disease and diabetes was more intense than in the patients with periodontal disease without diabetes.

Severe hypoglycaemia in 1076 adult patients with type 1 diabetes

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Pedersen-Bjergaard, Ulrik; Pramming, Stig; Heller, Simon R

2004-01-01

BACKGROUND: Differences between studies in rates of severe hypoglycaemia in type 1 diabetic cohorts are common and poorly understood. The purpose of this study was to assess the frequency of severe hypoglycaemia in unselected patients treated in different secondary care centres and to evaluate...... the influence of risk markers, clinical setting and selection. METHODS: Cross-sectional Danish-British multicentre survey of 1076 consecutive adult patients with clinical type 1 diabetes who completed a detailed questionnaire on hypoglycaemia and related issues. Key variable was the self-reported rate of severe......, the rate of severe hypoglycaemia was 0.35 episodes/patient-year and only retinopathy was a significant risk marker together with state of awareness. CONCLUSION: Severe hypoglycaemia remains a significant clinical problem in type 1 diabetes. The rate of severe hypoglycaemia and the influence of risk markers...

Effects of fenofibrate in patients with type 2 diabetes mellitus complicated by diabetic neuropathy

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Olga Nikolaevna Tkacheva

2010-03-01

Full Text Available Diabetic neuropathy is a severe complication of diabetes mellitus (DM that considerably worsens the patients quality of life and reduces life expectancy.The FIELD study for the first time demonstrated the ability of fenofibrate to prevent macro- and microvacular complications in patientswith DM2 regardless of glycated hemoglobin level and dyslipidemia at the early stage of the disease. Neuropathy being a manifestation of microangiopathy,it suggests the possibility to treat this disorder with fenofibrate.Aim. To study effects of fenofibrate in patients with type 2 diabetes mellitus complicated by diabetic neuropathy. Materials and methods. The present study included 73 patients with DM2 randomized into 2 groups to receive standard therapy (antihypertensiveand glucose control, statins or fenofibrate (Tricor 145 mg, Solvay Pharma in addition to the standard treatment. Results. Positive effect of fenofibrate on autonomous and peripheral neuropathy was apparent within 6 months after the onset of therapy when thesought parameters of AP, glycemia, and lipid spectrum were achieved. Fenofibrate improved cardiovascular function, reduced cardiac rhythm variability;QT length and dispersion, pain and paresthesia thereby enhancing quality of life and preventing cardiovascular catastrophes including death. Conclusion. It is concluded that supplementation of standard therapy of DM with fenofibrate is both safe and pathogenetically sound.

The state of lipid control in patients with diabetes in a public health care centre.

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Wong, J S; Tan, F; Lee, P Y

2007-01-01

Achieving treatment targets has been difficult in treating diabetic patients. This cross-sectional study describes the lipid profiles of patients with diabetes mellitus at a public primary health care centre in Sarawak, Malaysia. The targets for lipid control were based on the International Diabetes Federation recommendation (2002). 1031 patients (98% Type 2 Diabetes) were studied. Fasting lipid profiles were available in 990 (96%) patients. The mean total cholesterol was 5.3 +/- 1.0 mmol/L, Triglycerides 1.90 +/- 1.26 mmol/L, HDL-C 1.28 +/- 0.33 mmol/L and LDL-C 3.2 +/- 0.9 mmol/L. Overall, 22% of patients achieved the treatment target for LDL-C level 1.1 mmol/L and 42% of patients had a target TG level below 1.5 mmol/L. Of the 40% of patients who received lipid-lowering drug, 17% achieved LDL-C target, 50% had LDL-C 2.6-4.4 mmol/ L and 33% have LDL-C > 4.0 mmol/L. For the remaining 60% not receiving any lipid lowering therapy, 68% had LDL-C between 2.6-4.0 mmol/L and 7% had LDL-C level > 4 mmol/L. Dyslipidemia is still under-treated despite the availability of effective pharmacological agents and the greatly increased risk of cardiovascular diseases in diabetic patients.

Mortality after percutaneous coronary revascularization: Prior cardiovascular risk factor control and improved outcomes in patients with diabetes mellitus.

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Noman, Awsan; Balasubramaniam, Karthik; Alhous, M Hafez A; Lee, Kelvin; Jesudason, Peter; Rashid, Muhammad; Mamas, Mamas A; Zaman, Azfar G

2017-06-01

To assess the mortality in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) according to their insulin requirement and PCI setting (elective, urgent, and emergency). DM is a major risk factor to develop coronary artery disease (CAD). It is unclear if meticulous glycemic control and aggressive risk factor management in patients with DM has improved outcomes following PCI. Retrospective analysis of prospectively collected data on 9,224 patients treated with PCI at a regional tertiary center between 2008 and 2011. About 7,652 patients were nondiabetics (non-DM), 1,116 had non-insulin treated diabetes mellitus (NITDM) and 456 had ITDM. Multi-vessel coronary artery disease, renal impairment and non-coronary vascular disease were more prevalent in DM patients. Overall 30-day mortality rate was 2.4%. In a logistic regression model, the adjusted odds ratios (95% confidence intervals [CI]) for 30-day mortality were 1.28 (0.81-2.03, P = 0.34) in NITDM and 2.82 (1.61-4.94, P diabetes, this study reveals higher mortality only in insulin-treated diabetic patients following PCI for stable coronary artery disease and acute coronary syndrome. Importantly, diabetic patients with good risk factor control and managed on diet or oral hypoglycemics have similar outcomes to the non-diabetic population. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

[PERCUTANEOUS CORRECTION OF FOREFOOT DEFORMITIES IN DIABETIC PATIENTS IN ORDER TO PREVENT PRESSURE SORES - TECHNIQUE AND RESULTS IN 20 CONSECUTIVE PATIENTS].

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Yassin, Mustafa; Garti, Avraham; Heller, Eyal; Weissbrot, Moshe; Robinson, Dror

2017-04-01

Diabetes mellitus is a 21st century pandemic. Due to life-span prolongation combined with the increased rate of diabetes, a growing population of patients is afflicted with neuropathic foot deformities. Traditional operative repair of these deformities is associated with a high complication rate and relatively common infection incidence. In recent years, in order to prevent these complications, percutaneous deformity correction methods were developed. Description of experience accumulated in treating 20 consecutive patients with diabetic neuropathic foot deformities treated in a percutaneous fashion. A consecutive series of patients treated at our institute for neuropathic foot deformity was assessed according to a standard protocol using the AOFAS forefoot score and the LUMT score performed at baseline as well as at 6 months and 12 months. Treatment related complications were monitored. All procedures were performed in an ambulatory setting using local anesthesia. A total of 12 patients had soft tissue corrections, and 8 had a combined soft tissue and bone correction. Baseline AOFAS score was 48±7 and improved to 73±9 at six months and 75±7 at one year. LUMT score in 11 patients with a chronic wound decreased from 22±4 to 2±1 at one year post-op. One patient required hospitalization due to post-op bleeding. Percutaneous techniques allow deformity correction of diabetic feet, including those with open wounds in an ambulatory setting with a low complication rate.

Web-based depression treatment for type 1 and type 2 diabetic patients

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van Bastelaar, Kim M P; Pouwer, Francois; Cuijpers, Pim

2011-01-01

intervention on a large scale at relatively low costs. This study evaluated the effectiveness of Web-based CBT for depression treatment in adults with type 1 or type 2 diabetes, with minimal guidance. RESEARCH DESIGN AND METHODS: A randomized controlled trial was conducted in the Netherlands in 255 adult...... no beneficial effect on glycemic control (P > 0.05). CONCLUSIONS: Web-based CBT depression treatment is effective in reducing depressive symptoms in adults with type 1 and type 2 diabetes. In addition, the intervention reduces diabetes-specific emotional distress in depressed patients.......OBJECTIVE: Comorbid depression is common in patients with type 1 and type 2 diabetes, adversely affecting quality of life, diabetes outcomes, and mortality. Depression can be effectively treated with cognitive behavior therapy (CBT). The Internet is a new and attractive method for delivering CBT...

Agressive infection following a dental extraction in a diabetic patient :Rhinocerebral mucormycosis.

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Zehani, Alia; Smichi, Ines; Marrakchi, Jihene; Besbes, Ghazi; Haouet, Slim; Kchir, Nidhameddine

2017-05-01

Mucormycosis is a rare and acute fungal infection which is frequently lethal, usually observed in non-controlled diabetic patients. The infection usually begins in the nose but it can invade the lung, the digestive tract, and the skin. Rhinocerebral mucormycosis accounts for 40 to 49% of mucormycosis cases. We report the case of a 44-year-old diabetic man, presenting with rhinocerebral mucormycosis. Our patient was treated by an association of amphotericin B and surgical debridement.

Comparison platelet indices in diabetic patients with and without diabetic foot ulcer

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Mardia, A. I.; Gatot, D.; Lindarto, D.

2018-03-01

Diabetes Mellitus is a group of metabolic disease which incidence increases every year. Some diabetic patients have diabetic foot ulcer as acomplication. The occurrence of ulcers in diabetic patients can be caused by the presence of thrombosis due to increased platelet function. Therefore, a cross-sectional study on 40 diabetic patients was performed at RSUP Adam Malik Medan to see whether there were differences in platelet indices between diabetic patients with and without diabetic foot ulcers. Platelets indices were examined and looked for differences in diabetic patients with and without diabetic foot ulcers. Data were analyzed using Chi-Square and Mann-Whitney U test with 95% CI. P-valuediabetic patients with diabetic foot ulcers indicating more reactive and aggregatable platelet function.

Chronic ulcers: MATRIDERM® system in smoker, cardiopathic, and diabetic patients

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Barbara De Angelis

2013-08-01

Full Text Available Diabetic ulcers and pressure ulcers represent a more frequent cause of chronic wounds in aging populations. It is estimated that approximately 15% of the diabetic population will develop diabetic ulcers during their life and over half of these patients develop an infection, often osteomyelitis, with 20% requiring amputation. The authors report a case of a 65-year-old woman affected by a post-traumatic loss of substance due to road accidents with soft tissue exposure (comprising muscle tendon of the left knee combined with the fracture of the right fibula previously subjected to surgery and reconstruction of muscle tendon. The patient was affected by diabetes type II, hypertension, and ischemic heart disease. In 2008, she underwent a double bypass surgery and coronary angioplasty. Initially, the patient was treated with cycles of advanced dressings, with fibrinolytic ointments, hydrocolloid, and subsequently, when the bottom began granulated with fibrinolytic and idrocellulosa, Hydrofibra-Ag, and Ag-alginate, three times a week for 30 days. In the second step, the authors decided to treat the ulcer with the MATRIDERM system and auto skin graft. Following the first treatment, 7 days after the procedure, the authors found the reduction of the loss of substance until its complete closure. The wound’s infection was evaluated by a buffer negative confirmation performed every 2 weeks four times. We obtained decrease of limb edema and full functional rehabilitation. The skin appeared renovated, with volume restoration and an improvement of the texture.

Pregnancy outcomes in type 2 diabetic patients as compared with type 1 diabetic patients and nondiabetic controls.

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Knight, Kristin M; Thornburg, Loralei L; Pressman, Eva K

2012-01-01

To characterize the neonatal and maternal outcomes of type 2 diabetic patients as compared with type 1 diabetic patients and nondiabetic controls. We performed a retrospective cohort study reviewing perinatal outcomes of type 1 and type 2 diabetic patients and nondiabetic controls from July 2000 to August 2006. Analysis of variance, t testing and chi2 analysis were used to compare groups. Post hoc power analysis indicated 80% power was necessary to detect a 15% difference in composite poor neonatal outcomes. A total of 64 type 2 and 64 type 1 diabetic patients were compared with 256 controls. Type 1 diabetic patients had higher incidences of composite poor neonatal outcome and congenital anomalies than did type 2 diabetic and control patients. Both diabetic groups had similarly higher incidences of cesarean delivery, preeclampsia, preterm delivery, polyhydramnios and macrosomia than did controls. Type 2 diabetic patients have a decreased incidence of adverse neonatal outcomes when compared with that of type 1 diabetic patients. No difference was observed between the diabetic groups in the incidence of a majority of the adverse maternal outcomes examined, however both diabetic groups had overall worse outcomes that did nondiabetic controls.

E-healthcare for diabetes mellitus type 2 patients – a randomised controlled trial in Slovenia

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Iljaž Rade

2017-09-01

Full Text Available Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM. A new approach in treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study.

Cross-sectional analysis of adult diabetes type 1 and type 2 patients with diabetic microvascular complications from a German retrospective observational study.

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Happich, M; Breitscheidel, L; Meisinger, C; Ulbig, M; Falkenstein, P; Benter, U; Watkins, J

2007-06-01

To obtain epidemiological data on the prevalence of predefined stages of diabetic microvascular complications from a representative cross-section of patients with existing microvascular complications of type 1 or type 2 diabetes in Germany. A cross-sectional, retrospective study of medical records of 705 type 1 and 1910 type 2 adult diabetic patients with a diagnosis of retinopathy and/or peripheral neuropathy and/or nephropathy before 2002 and treated in 2002 in Germany. Of 376 patients with type 1 diabetes having retinopathy, 59.3% had mild or moderate non-proliferative retinopathy without macular oedema, 27.1% had macular oedema, and 13.6% had severe retinopathy without macular oedema. In 862 patients with type 2 diabetes, the distribution of retinopathy/maculopathy classes was 56.8%, 35.5%, and 7.7%, respectively. Of 381 type 1 diabetes patients with observed peripheral neuropathy, 81.4% had sensorimotor neuropathy, 8.9% had diabetic foot conditions, and 9.7% had lower extremity amputations because of diabetes. In 1005 patients with type 2 diabetes, the distribution of neuropathy classes was 78.2%, 12.1%, and 9.7%, respectively. The proportions of patients with renal insufficiency in type 1 and type 2 diabetes groups were 15.3% versus 13.5%, respectively. The study suggests that there are considerable proportions of patients with progressive stages of microvascular complications related to type 1 and type 2 diabetes in Germany. This underlines the importance of improvement of optimal quality of care and frequent screening for preventing late diabetic microvascular complications and the necessity of effective intervention strategies to tackle this major public health problem.

[Managing the discharge of diabetic patients from the emergency department: a consensus paper].

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Cuervo Pinto, Rafael; Álvarez-Rodríguez, Esther; González Pérez de Villar, Noemí; Artola-Menéndez, Sara; Girbés Borrás, Juan; Mata-Cases, Manel; Galindo Rubio, Mercedes; Puig Larrosa, Juan; Muñoz Albert, Ricardo; Díaz Pérez, José Ángel

2017-10-01

Eighty to 90% of patients attended in emergency departments are discharged to home. Emergency department physicians are therefore responsible for specifying how these patients are treated afterwards. An estimated 30% to 40% of emergency patients have diabetes mellitus that was often decompensated or poorly controlled prior to the emergency. It is therefore necessary to establish antidiabetic treatment protocols that contribute to adequate metabolic control for these patients in the interest of improving the short-term prognosis after discharge. The protocols should also maintain continuity of outpatient care from other specialists and contribute to improving the long-term prognosis. This consensus paper presents the consensus of experts from 3 medical associations whose members are directly involved with treating patients with diabetes. The aim of the paper is to facilitate the assessment of antidiabetic treatment when the patient is discharged from the emergency department and referred to outpatient care teams.

Hemoglobin stability in patients with anemia, CKD, and type 2 diabetes: an analysis of the TREAT (Trial to Reduce Cardiovascular Events With Aranesp Therapy) placebo arm.

Science.gov (United States)

Skali, Hicham; Lin, Julie; Pfeffer, Marc A; Chen, Chao-Yin; Cooper, Mark E; McMurray, John J V; Nissenson, Allen R; Remuzzi, Giuseppe; Rossert, Jerome; Parfrey, Patrick S; Scott-Douglas, Nairne W; Singh, Ajay K; Toto, Robert; Uno, Hajime; Ivanovich, Peter

2013-02-01

Sparse data are available about the natural history of hemoglobin (Hb) level trends in contemporary patients with anemia, chronic kidney disease (CKD), and type 2 diabetes mellitus. We intended to describe Hb level trends over time with no or minimal administration of erythropoiesis-stimulating agents. Prospective clinical trial cohort. 2,019 individuals with type 2 diabetes, moderate anemia, and CKD from the placebo arm of the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) followed up for 2.3 years with an average of 32 monthly Hb level determinations per patient. Darbepoetin alfa was administered only if Hb level decreased to protocol-directed doses of darbepoetin alfa received due to an Hb level decrease to protocol-directed darbepoetin alfa. The other patients received 1 (16%), 2-4 (16%), or 5 or more (13%) doses of darbepoetin alfa. Those who received no darbepoetin alfa doses had higher baseline Hb levels, higher estimated glomerular filtration rates (eGFRs), less proteinuria, and lower ferritin and transferrin saturation values. On average, Hb levels were stable or increased in all groups. Compared with individuals who received no darbepoetin alfa, those who received 5 or more doses were more likely to receive intravenous iron therapy and blood transfusions and progress to renal replacement therapy, but were not at higher risk of death. The strongest predictors of requiring 5 or more doses of darbepoetin alfa were lower baseline Hb level, lower eGFR, and higher proteinuria level. Post hoc analysis of a clinical trial of a specific population with diabetes, anemia, and non-dialysis-dependent CKD. In the TREAT placebo arm, Hb levels were stable with no or minimal protocol-directed darbepoetin alfa during 2.3 years of follow-up. Most patients with moderate anemia, non-dialysis-dependent CKD, and type 2 diabetes are able to maintain a stable Hb level without implementing long-term erythropoiesis-stimulating agent therapy. Copyright © 2013

Sustained glucagon-like peptide 1 expression from encapsulated transduced cells to treat obese diabetic rats.

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Moralejo, Daniel; Yanay, Ofer; Kernan, Kelly; Bailey, Adam; Lernmark, Ake; Osborne, William

2011-04-01

Obesity and type 2 diabetes (T2D) are two prevalent chronic diseases that have become a major public health concern in industrialized countries. T2D is characterized by hyperglycemia and islet beta cell dysfunction. Glucagon-like peptide 1 (GLP-1) promotes β cell proliferation and neogenesis and has a potent insulinotropic effect. Leptin receptor deficient male rats are obese and diabetic and provide a model of T2D. We hypothesized that their treatment by sustained expression of GLP-1 using encapsulated cells may prevent or delay diabetes onset. Vascular smooth muscle cells (VSMC) retrovirally transduced to secrete GLP-1 were seeded into TheraCyte(TM) encapsulation devices, implanted subcutaneously and rats were monitored for diabetes. Rats that received cell implants showed mean plasma GLP-1 level of 119.3 ± 10.2pM that was significantly elevated over control values of 32.4 ± 2.9pM (P<0.001). GLP-1 treated rats had mean insulin levels of 45.9 ± 2.3ng/ml that were significantly increased over control levels of 7.3±1.5ng/ml (P<0.001). In rats treated before diabetes onset elevations in blood glucose were delayed and rats treated after onset became normoglycemic and showed improved glucose tolerance tests. Untreated diabetic rats possess abnormal islet structures characterized by enlarged islets with α-cell infiltration and multifocal vacuolization. GLP-1 treatment induced normalization of islet structures including a mantle of α-cells and increased islet mass. These data suggest that encapsulated transduced cells may offer a potential long term treatment of patients. Copyright © 2010 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

Use of a web portal by adult patients with pre-diabetes and type 2 diabetes mellitus seen in a family medicine outpatient clinic.

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Coughlin, Steven S; Heboyan, Vahé; Young, Lufei; De Leo, Gianluca; Wilkins, Thad

2018-05-01

There has been increasing interest in the use of web portals by patients with type 2 diabetes mellitus (T2DM). Studies of web portal use by patients with pre-diabetes have not been reported. To plan studies of web portal use by adult clinic patients seen for pre-diabetes and T2DM at an academic medical center, we examined characteristics of those who had or had not registered for a web portal. Electronic records were reviewed to identify web portal registration by patients treated for pre-diabetes or T2DM by age, sex, race and ethnicity. A total of 866 patients with pre-diabetes and 2,376 patients with T2DM were seen in a family medicine outpatient clinic. About 41.5% of patients with pre-diabetes and 34.7% of those with T2DM had registered for the web portal. In logistic regression analysis, web portal registration among patients with T2DM was significantly associated with age 41-45 years, and with Hispanic ethnicity. Similar results were obtained for pre-diabetes except that the positive association with age 41-45 years and inverse association with Hispanic ethnicity were not statistically significant. Among patients with pre-diabetes or T2DM, Black men and Black women were less likely to have registered than their white counterparts. Patients who were aged 18-25 and >65 years were less likely to have registered for the web portal than those 26-65 years. Additional research is needed to identify portal design features that improve health outcomes for patients with pre-diabetes and T2DM and interventions that will increase use of patient portals by pre-diabetic and diabetic patients, especially among Black patients and older patients.

A clinician's guide to the treatment of foot burns occurring in diabetic patients.

Science.gov (United States)

Jones, Larry M; Coffey, Rebecca; Khandelwal, Sorabh; Atway, Said; Gordillo, Gayle; Murphy, Claire; Fries, Jody A; Dungan, Kathleen

2014-12-01

Diabetes mellitus affects 25.8 million Americans and is predicted to almost double by 2050. The presence of diabetes complicates hospital courses because of the microvascular complications associated with disease progression. Patients with diabetes represent 18.3% of annual burn admissions to our unit and 27% have burns to the feet. The purpose of this project was to develop an evidence-based guideline for care of the patient with diabetes and foot burns A multidisciplinary group was charged with developing an evidence-based guideline for the treatment of foot burns in patients with diabetes. Evidence was evaluated in the areas of diabetes, burn care, hyperbaric medicine, care of diabetic foot wounds and physical therapy. After guideline development and approval, key aspects were incorporated into order sets. Key aspects of this guideline are the ability to identify patients with undiagnosed diabetes, assess diabetic control, optimize glycemic and metabolic control, optimize burn wound management, treat microvascular disease, and provide education and a discharge plan. Evaluated outcomes are glycemic control, length of stay, complication rates, amputation rates, infection rates and the use of hyperbaric oxygen. Best outcomes for this high risk population will be attainable with an evidence based guideline. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Diabetic vitrectomy in a large type 1 diabetes patient population

DEFF Research Database (Denmark)

Ostri, Christoffer; la Cour, Morten; Lund-Andersen, Henrik

2014-01-01

1996 and 2010. Surgical history was obtained from The Danish National Patient Register. RESULTS: The population consisted of 3980 patients with type 1 diabetes. Median follow-up was 10.0 years. In total, 106 patients underwent diabetic vitrectomy in the observation period. Surgery indications were...... nonclearing vitreous haemorrhage (43%) or tractional retinal detachment (57%). The cumulative incidence rates of diabetic vitrectomy were 1.6% after 5 years and 2.9% after 10 years. When excluding patients with no or mild diabetic retinopathy, the corresponding rates were higher; 3.7% and 6.4%, respectively...... (p diabetic vitrectomy increased in patients experiencing glycosylated haemoglobin A1c > 75 mmol/mol in the observation period (p

Disseminated infection with Strongyloides stercoralis in a diabetic patient

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Murali A

2010-01-01

Full Text Available A 58-year-old male diabetic who was operated for carcinoma larynx 4 years back was admitted with exertional dyspnoea and bilateral leg swelling for the past 2 years. Over the last 2 months, there was a progressive worsening of symptoms. Echocardiography done 2 years back showed pericardial effusion. Echo done during the current admission also showed pericardial effusion with preserved left ventricular function; cytological examination of the pericardial fluid showed larvae of Strongyloides stercoralis. He was treated with antinematodal drugs. A follow-up echo done at discharge showed no pericardial effusion and the patient was completely asymptomatic. To our knowledge, this is the first reported case of Strongyloides pericardial effusion in a diabetic patient.

Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison

DEFF Research Database (Denmark)

Meadows, K A; Abrams, C; Sandbaek, A

2000-01-01

AIMS: To adapt the Diabetes Health Profile (DHP-1) for use with English speaking patients with Type 2 diabetes mellitus and to evaluate the psychometric properties of the adapted measure in a UK and Danish sample of insulin, tablet and diet-treated patients with Type 2 diabetes. METHODS: Following...... items (56.25%) were retained following initial item analysis. A three-factor solution accounting for 45.6% and 40.3% of the total explained variance was identified in the UK and Danish samples, respectively. Factors were interpreted as psychological distress (PD), barriers to activity (BA...

Clinical and biochemical profile of patients with Type 2 diabetes mellitus

International Nuclear Information System (INIS)

Iqbal, M.A.; Hadi, A.; Ikramullah, A.H.

2015-01-01

Objective: Diabetes is a worldwide disease that has high prevalence throughout the world. It can lead to many complications if not treated properly. Major complications are Coronary Artery Disease, retinopathy, neuropathy and nephropathy. Adequate control of blood sugar level is the key to preventing diabetic complications. Optimal blood sugar level in diabetics can be achieved with adequate therapy and good compliance to drugs and diet. Material and Methods: Hospital based observational cross sectional study. Patients were interviewed and assessed regarding duration of diabetes, type of therapy, number of drugs, compliance to drugs, and complications due to diabetes. Results: Total study population was 200. Mean age was 54.86+ 9.84 years (24-85). Male were 69 (34.8%). Types II Diabetes was present in 184 (91.5%). Newly diagnosed diabetics were 23(11.9%). Only 15% were on Insulin therapy, 3% were on both Insulin and oral treatment and the rest were taking oral medications. Only 56.7% were good compliant to medications. Among study subjects, 12.5% were taking hakim medications/alternative therapy and 5% were on diet control, 40(20%) were taking no medications and 120 (59.7%) were taking one drug. Two, three and four drugs were taken by 34 (16.9%), 4(2.3%) and 2 (1.1%) patients respectively. Diabetic complications were present in 65(32.3%) patients. Average random blood sugar was 190 mg% with + (80.68 mg%). Adverse effects of therapy were seen in 15 patients (7.5%), hypoglycaemia was the commonest adverse effects of drugs found in 3.8% patients. (author)

Pre-exercise blood glucose affects glycemic variation of aerobic exercise in patients with type 2 diabetes treated with continuous subcutaneous insulin infusion.

Science.gov (United States)

Hu, Yun; Zhang, Dan-Feng; Dai, Lu; Li, Zheng; Li, Hui-Qin; Li, Feng-Fei; Liu, Bing-Li; Sun, Xiao-Juan; Ye, Lei; He, Ke; Ma, Jian-Hua

2018-05-03

Considering the insulin sensitivity may increase by exercise particularly in patients with type 2 diabetes (T2D), glycemic variation during exercise needs to be studied when the patients are treated with insulin. This study aimed to explore the influence factors of the efficacy and safety of aerobic exercise in patients with T2D treated with Continuous Subcutaneous Insulin Infusion (CSII). A total of 267 patients with T2D, treated with CSII, were included. Glycemic variations were assessed by continuous glucose monitoring (CGM). Patients were asked to complete 30 min aerobic exercise for at least one time during CGM. The patients were divided into effective and ineffective group by incremental glucose area under curve from 0 to 60 min after exercise (AUC 0-60 min ). The patients completed a total of 776 times of aerobic exercises. Blood glucose decreased fastest in the first 60 min of exercise. Pre-exercise blood glucose (PEBG) was negatively correlated with AUC 0-60 min (standardized β = -0.386, P AUC of blood glucose ≤ 4.4 mmol/L (standardized β = -0.078, P = 0.034), and was significantly higher in effective group than in ineffective group (P AUC 0-60 min during post-dinner was significantly higher than that during pre-lunch, post-lunch and pre-dinner (P  16.7 mmol/L. Post-dinner exercise decreases the blood glucose better than other periods of the day. ChiCTR-ONC-17010400, www.chictr.org.cn. Copyright © 2018 Elsevier B.V. All rights reserved.

The Assessment of Social Support and Self-Care Requisites for Preventing Diabetic Foot Ulcer in Diabetic Foot Patients

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Mohammad Taher

2016-03-01

Full Text Available Background and Objectives: Diabetic foot as one of the most common complications of diabetes is involved in more than %25 of diabetic patients’ lives, and if not treated properly can lead to amputation up to %20. The lack of self-care is the underlying cause of mortality, morbidity and chronic complications of diabetes. Identification and rectifying of diabetic foot care needs of patients can additionally reduce readmission; also, %85 of diabetic foot problems can be prevented. Materials and Methods: In this descriptive study, 130patients with diabetic foot from Shahid Modarres hospital were selected using census method. Data in forms of demographic questionnaire, self-care requisites assessment tool for preventing diabetic foot ulcer, and Social Support Behavior Scale were completed by patients and then were collected. Data were analyzed by SPSS version 16. Results: In this study, a significant relationship was found between self-care and social support (P<0.05. This means that people with better social support reported better self-care than those with weaker social support. A significant relationship in level of education and monthly income with self-care was seen, as well as in level of education, monthly income and marital status with social support (P<0.001. Conclusions: The results showed that social support can be considered as an effective factor in individual self-care behaviors, and with regard to this factor in educational, treatment and care programs of patients, can improve their self-care, in addition to decreasing economic costs, and improve their qualities of lives as well.

Quality of Life in Caregivers of ADHD Children and Diabetes Patients.

Science.gov (United States)

Andrade, Elisa Meirelles; Geha, Laysa Minella; Duran, Paula; Suwwan, Raphael; Machado, Felipe; do Rosário, Maria Conceição

2016-01-01

Studies have shown that the presence of attention-deficit hyperactivity disorder (ADHD) causes great impairment in academic, social, and professional activities as well as in the quality of life (QoL) of its patients. Similarly, the impact caused by other chronic disorders, such as diabetes, in the patient's QoL has been emphasized in many studies. Despite its relevance, no study has yet investigated whether ADHD caregivers and diabetic patients would have similar QoL impairment. This study was conducted in order to compare the QoL scores among ADHD caregivers and diabetic patients. We evaluated 63 caregivers of ADHD children treated at the Child and Adolescent Psychiatric Unit at the Federal University of São Paulo (UPIA-UNIFESP) and 52 adult diabetic patients. Subjects were assessed with the World Health Organization quality of Life-Bref Version (WHOQOL-BREF), the Beck and Hamilton depression scales, and the Adult Self-Report Scale. When compared to the Brazilian normative data, ADHD caregivers had significantly lower scores in the social relations and environment WHOQOL domains. ADHD caregivers and diabetic patients had similar impairment in all WHOQOL domains except for the physical domain. ADHD affects the QoL of the patient's caregiver, with similar impairment, when compared to the QoL of diabetic patients. These results emphasize the need for assessing QoL of the caregivers as part of the treatment strategies. They also emphasize the need for future studies with larger sample sizes comparing how the QOL is impacted in different chronic disorders.

[Effectiveness and economic impact of a program of integrated care with telemedicine support on insulin-treated type 2 diabetic patients (Study GITDIABE)].

Science.gov (United States)

Inoriza, Jose M; Ibañez, Annabel; Pérez-Berruezo, Xavier; Inoriza-Nadal, Cristina; Coderch, Jordi

2017-03-01

To evaluate if insulin-treated type 2 diabetic patients with blood glucose self-monitoring (DIA), included in a program of integrated management of diabetes mellitus (DM), achieve a better level of metabolic control with telemedicine support than with conventional support, after 12 months follow-up. The impact on the use and cost of healthcare services, pharmaceutical expenditure, and consumption of test strips for blood glucose, was also assessed. A prospective parallel cohorts study. Four basic health areas of an integrated healthcare organisation. The study included 126 DIA patients aged 15 or more years, treated with rapid or intermediate Insulin and blood glucose self-monitoring, grouped into 42 cases and 84 controls, matched according to age, sex, level of metabolic control, and morbidity profile. Telematics physician-patient communication and download of blood glucose self-monitoring data through the Emminens eConecta ® platform; test strips home delivered according to consumption. Hidden controls with usual follow-up. Glycosylated haemoglobin (%HbA1c); perception of quality of life (EuroQol-5 and EsDQOL); cardiovascular risk; use of healthcare resources; consumption of test strips; pharmaceutical and healthcare expenditure. Reduction of 0.38% in HbA1c in the cases (95% CI:-0.89% to 0.12%). No significant differences with regard to any of the activities registered, or any significant change in the quality of life. The results obtained are similar to other equivalent studies. The profile of the patient is elderly and with multiple morbidities, who still have technological limitations. To surpass these barriers, it would be necessary to devote more time to the training and to the resolution of possible technological problems. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Transperitoneal transport in diabetic and non-diabetic patients on peritoneal dialysis

DEFF Research Database (Denmark)

Graff, J; Fugleberg, Steen; Nielsen, S L

1999-01-01

To investigate differences in the transport characteristics of the peritoneal membrane between diabetic and non-diabetic patients on chronic peritoneal dialysis, a study was conducted in 21 non-diabetic and 18 diabetic patients. Transperitoneal transport of small solutes was evaluated in terms...... of the mass transfer area coefficients (urea, creatinine and glucose), ultra-filtration sieving coefficients (urea and creatinine) and by peritoneal equilibration test results. The capacity of the peritoneal membrane to transport macromolecules was evaluated by albumin mass transfer rates and clearances......-labelled human albumin. Despite a significantly increased transcapillary escape rate of albumin in the diabetic patients, no differences in peritoneal membrane characteristics could be demonstrated between diabetic and non-diabetic patients on peritoneal dialysis....

Prevalence and Impact of Diabetes Mellitus Among Patients with Active Pulmonary Tuberculosis in South Korea.

Science.gov (United States)

Lee, Eun Hye; Lee, Jung Mo; Kang, Young Ae; Leem, Ah Young; Kim, Eun Young; Jung, Ji Ye; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Kim, Song Yee

2017-04-01

South Korea has an increasing prevalence of diabetes and a relatively high burden of tuberculosis. We aimed to determine the prevalence of diabetes in patients with active pulmonary tuberculosis (PTB) and examine the effect of diabetes on tuberculosis treatment outcomes. Data from patients ≥30 years diagnosed with and treated for PTB between January 2010 and December 2012 at Severance Hospital, a 2000-bed tertiary referral hospital in Seoul, South Korea, were analyzed and compared with data from a contemporaneous general population sample extracted from KNHANES V. Diabetes prevalence was 24.2% (252/1044) among patients with PTB and 11.6% (1700/14,655) among controls. Diabetes [odds ratios (OR) 2.56, 95% confidence interval (CI) 1.56-4.21, P Diabetes was the only factor associated with unsuccessful treatment outcomes (OR 1.67, 95% CI 1.03-2.70, P = 0.039). The prevalence of diabetes was markedly higher in patients with PTB than in a sample of the general South Korean population. Diabetes may delay sputum conversion and adversely affect treatment outcomes; detection and management of diabetes in patients with PTB is crucial.

COMPARISON OF ASTYM THERAPY AND KINESIOTAPING FOR ROTATOR CUFF TENDINOPATHY IN DIABETIC PATIENTS: RANDOMIZED CONTROLLED TRIAL

OpenAIRE

Azza Atya; Mahmoud Nasser; Aisha Hagag

2017-01-01

Background: Rotator cuff tendinopathy is a significant problem among diabetics that frequently restricts patient’s activity in terms of pain and disability. The purpose of this study was to compare between the effect of Astym therapy and kinesiotaping in treating diabetic patients with chronic rotator cuff tendinopathy. Methods: 56 diabetic patients diagnosed with chronic rotator cuff tendinopathy were randomly assigned into Astym therapy group (n=28) or kinesiotaping group (n= 28). All pa...

[Outcome of eating disorder patients treated in tertiary care].

Science.gov (United States)

Suokas, Jaana; Gissler, Mika; Haukka, Jari; Linna, Milla; Raevuori, Anu; Suvisaari, Jaana

2015-01-01

We assessed the outcome of eating disorder patients treated in a specialized treatment setting. Register-based follow-up study of adults (n = 2 450, 95% women, age range 18-62 years). For each patient four background-matched controls were selected. The hazard ratio for all-cause mortality was 6.51 in anorexia, 2.97 in bulimia and 1.77 in BED. Autoimmune diseases were more common in patients than in controls. Bulimia and BED were associated with increased type 2 diabetes risk. Pregnancy and childbirth rates were lower among patients than among controls. Eating disorders are associated with multiple health problems and increased mortality risk.

The symptoms of depression and anxiety in patients with diabetic foot treated with hyperbaric oxygen - preliminary results

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Koźmin-Burzyńska Agnieszka

2016-03-01

Full Text Available The aim of the study was to assess the level of anxiety and depressiveness in patients who had qualified for hyperbaric oxygen therapy (HBOT for the treatment of ulcerative lesions in the lower limbs, occurring as a result of diabetic foot syndrome (DFS,. A total of 50 patients with type 2 diabetes and diabetic foot syndrome were enrolled to the study. All patients have received 30 sessions of HBOT. During the therapy blood glucose was measured and photographic documentation was carried out. All patients underwent the following procedures: medical history and socioeconomic interview, psychiatric examination, self-report and objective psychometric tests to measure anxiety and depressiveness. Based on the obtained results, we reported that patients with a greater degree of tissue damage had higher levels of depressive symptoms in the self-report tests as well as in the objective evaluation of the investigator. In terms of location of ulcerative lesions - the level of depressiveness was greater when the affected area included toes, and the level of anxiety was increased when it concerned the heel. Regarding other parameters, statistically significant correlations were not observed.

Coronary artery bypass surgery or coronary stenting in diabetic patients: too soon to make a statement?

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Rodriguez, Alfredo E., E-mail: arodriguez@centroceci.com.ar

2014-11-15

Diabetic patients have been associated with poor procedural and long term outcome if they were treated either with percutaneous coronary interventions or coronary artery bypass surgery. Recently several randomized clinical trials (RCT) in this subset of patients have been published showing a greater incidence of major adverse cardiovascular events, death/myocardial infarction/stroke, if they were treated with first generation drug eluting stents (DES) which was not observed previously in the bare metal stent era. However, almost simultaneously with this data, several RCT demonstrated better safety profile with new generation DES including biocompatible polymers, biodegradable polymers and lately complete absorbable DES, all of them showed reduction in adverse cardiac events compared to 1st generation DES in patients with diabetes. In this editorial we review the old and new randomized data in diabetic patients and conclude that there are many unresolved issues to make a definitive statement regarding which is the best revascularization preference in diabetic patients and the measured final efficacy of PCI and CABG will not be reached until the arrival of RCT using next generation DES, including complete absorbable scaffolds. - Highlights: • Diabetic patients have been associated with poor procedural and long term outcome if they were treated either with percutaneous coronary interventions or coronary artery bypass surgery. Recently several randomized clinical trials (RCT) in this subset of patients have been published showing a greater incidence of major adverse cardiovascular events, death/myocardial infarction/stroke, if they were treated with first generation drug eluting stents (DES) which was not observed previously in the bare metal stent era. • In recent years, several RCT demonstrated better safety profile with new generation DES including biocompatible polymers, biodegradable polymers and lately complete absorbable DES, all of them showed reduction in

Coronary artery bypass surgery or coronary stenting in diabetic patients: too soon to make a statement?

International Nuclear Information System (INIS)

Rodriguez, Alfredo E.

2014-01-01

Diabetic patients have been associated with poor procedural and long term outcome if they were treated either with percutaneous coronary interventions or coronary artery bypass surgery. Recently several randomized clinical trials (RCT) in this subset of patients have been published showing a greater incidence of major adverse cardiovascular events, death/myocardial infarction/stroke, if they were treated with first generation drug eluting stents (DES) which was not observed previously in the bare metal stent era. However, almost simultaneously with this data, several RCT demonstrated better safety profile with new generation DES including biocompatible polymers, biodegradable polymers and lately complete absorbable DES, all of them showed reduction in adverse cardiac events compared to 1st generation DES in patients with diabetes. In this editorial we review the old and new randomized data in diabetic patients and conclude that there are many unresolved issues to make a definitive statement regarding which is the best revascularization preference in diabetic patients and the measured final efficacy of PCI and CABG will not be reached until the arrival of RCT using next generation DES, including complete absorbable scaffolds. - Highlights: • Diabetic patients have been associated with poor procedural and long term outcome if they were treated either with percutaneous coronary interventions or coronary artery bypass surgery. Recently several randomized clinical trials (RCT) in this subset of patients have been published showing a greater incidence of major adverse cardiovascular events, death/myocardial infarction/stroke, if they were treated with first generation drug eluting stents (DES) which was not observed previously in the bare metal stent era. • In recent years, several RCT demonstrated better safety profile with new generation DES including biocompatible polymers, biodegradable polymers and lately complete absorbable DES, all of them showed reduction in

Candida colonization on the denture of diabetic and non-diabetic patients

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Mohammad Hossein Lotfi-Kamran

2009-01-01

Full Text Available Background: Oral candidiasis is a common opportunistic infection in diabetic patients. Presence of denture in the oral cavity of diabetic patients can promote Candida colonization and results in the higher incidence of oral and systemic candidiasis. The general purpose of the present study was to evaluate and compare Candida colonization in denture of diabetic patients and non-diabetic control group. Methods: In current case-control study, samples for mycological examinations were collected from the palatal impression surface of maxillary dentures from 92 edentulous patients including 46 dia-betic and 46 non-diabetic denture wearers. All samples were cultured directly on sabouraud agar me-dium and isolated colonies were counted and identified based on specific tests. Data were statistically analyzed using Mann-Whitney and Spearman correlation tests. Results: The higher density of isolated colonies was seen in diabetic group in compare with control group (P = 0.0001. There was a statistically significant correlation between the blood glucose level (P = 0.0001 and the duration of denture usage (P = 0.022 with the colonization of Candida on den-ture of diabetic patients. C. albicans was the most common isolated Candida species in both groups, though diabetic patients with dentures had more non-albicans Candida isolated from their dentures compared to non-diabetic patients. Conclusions: Mycological findings from the present study revealed that diabetes mellitus can in-crease colonization of Candida in denture and mouth. By elimination of local and systemic factors in diabetic patients and improving their oral health care, Candida colonization and the risk of oral and systemic candidiasis will be decreased.

Long-term prognosis of diabetic patients with myocardial infarction: relation to antidiabetic treatment regimen. The TRACE Study Group

DEFF Research Database (Denmark)

Gustafsson, I; Hildebrandt, P; Seibaek, M

2000-01-01

a higher prevalence of known cardiovascular disease. Even though the diabetic patients had the same frequency of ST-segment elevation on the electrocardiogram and the same admission delay, treatment with thrombolysis and aspirin was less frequently prescribed to the diabetic patients than to patients......AIMS: The present study was performed to evaluate pre-admission history, presentation, initial treatment and long-term mortality in patients with myocardial infarction and diabetes. METHODS AND RESULTS: Between 1990 and 1992, 6676 patients with acute myocardial infarction were screened for entry...... into the Trandolapril Cardiac Evaluation (TRACE) study. In this cohort 719 (11%) of the patients had a history of diabetes. Among the diabetic patients 19% were treated with insulin, 52% with oral hypoglycaemic agents and 29% with diet only. The diabetic patients were slightly older, more likely to be female and had...

[Prader-Willi syndrome case with proliferative diabetic retinopathy in both eyes treated by early vitrectomy under local anesthesia].

Science.gov (United States)

Hori, Hideyuki; Sato, Yukihiro; Nakashima, Motohiro; Nakajima, Motohiro

2012-02-01

Although patients with Prader-Willi syndrome have a high rate of diabetes, to date, there have been only 4 reported cases (6 eyes) undergoing vitrectomy for proliferative diabetic retinopathy. Herein, we report a case of Prader-Willi syndrome with proliferative diabetic retinopathy that was treated by early vitrectomy OU under local anesthesia. A 30-year-old man was diagnosed as having Prader-Willi syndrome at the age of 2 years and diabetes at age 17. He was referred to our hospital as diabetic retinopathy had been detected in his first ophthalmological examination at age 29. Visual acuity was 0.6 bilaterally. Proliferative retinopathy, with cataract and macular edema, was identified in both eyes. Panretinal photocoagulation was performed on both eyes. However, proliferative membranes developed bilaterally, and vitreous hemorrhage occurred OS. Visual acuity decreased to 0.3 OU. The patient was hospitalized at our internal medicine department for blood glucose control. Subsequently, with an anesthesiologist on standby, a hypnotic sedative was injected intramuscularly, achieving retro-bulbar anesthesia. Combined cataract and vitreous surgery was performed on the left eye. One week later, a similar operation was performed on the right eye. The patient was discharged four days later. In the two years since these operation, visual acuity has been maintained at 0.8 OU. Patients with Prader-Willi syndrome should be examined for early detection and treatment of diabetic retinopathy.

Quality of life in caregivers of ADHD children and Diabetes patients

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Maria Conceição do Rosario

2016-07-01

Full Text Available Introduction: Studies have shown that the presence of ADHD causes great impairment in academic, social and professional activities, as well as in the quality of life (QoL of its patients. Similarly, the impact caused by other chronic disorders, such as diabetes, in the patient´s QoL has been emphasized in many studies. Despite its relevance, no study has yet investigated whether ADHD caregivers and diabetic patients would have similar QoL impairment. Objectives: This study was conducted in order to compare the QoL scores among ADHD caregivers and diabetic patients. Methods: We evaluated 63 caregivers of ADHD children treated at the Child and Adolescent Psychiatric Unit at the Federal University of São Paulo (UPIA-UNIFESP and 52 adult diabetic patients. Subjects were assessed with the World Health Organization quality of Life-Breef Version (WHOQOL-BREEF, the Beck and Hamilton depression scales, and the Adult Self-Report Scale. Results: When compared to the Brazilian normative data, ADHD caregivers had significantly lower scores in the social relations and environment WHOQOL domains. ADHD caregivers and diabetic patients had similar impairment in all WHOQOL domains, except for the physical domain. Conclusion: ADHD affects the QoL of the patient’s caregiver, with similar impairment when compared to the QoL of diabetic patients. These results emphasize the need for assessing QoL of the caregivers as part of the treatment strategies. They also emphasize the need for future studies with larger sample sizes comparing how the Qol is impacted in different chronic disorders.

Lipid Profile in Sudanese Diabetic Patients

Energy Technology Data Exchange (ETDEWEB)

Naway, L M. Y. [Sudan Academy of Sciences, Atomic Energy Council, Khartoum (Sudan)

2011-04-15

This study composes of two parts, the first one is an experiment to evaluate the level of blood glucose and lipid profile (TC, TG, LDL, HDL and VLDL) among diabetic patients and comparison of the result with non diabetic subjects and the second one is a survey to assess the standards of health care and patients knowledge. The subject were divided into two groups according to insulin requirement. Type 1 is insulin dependent diabetes mellitus and type 2 is non insulin dependent diabetes mellitus and then divided according to gender (males and female) subgroups. The study subjects selected for this study consist of one hundred Sudanese diabetic patients from Ribat University Hospital during January 2009 they had mean age (52{+-}11.063) years,a mean height (165.82{+-}8.573) cm and a mean weight of (70.20{+-}11.203) kg. fifty healthy non diabetic subject were chosen as controls, their mean age (45.72{+-}11.169) years, mean height (167.28{+-}9.450) cm and mean weight (71.02{+-}13.429) kg. Blood glucose and lipid profile total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were measured by enzymatic colorimetric methods in both groups, and very low density lipoprotein cholesterol were calculated for each sample. All patients were interviewed and filled out the questionnaire consisted of five parts. The result of the study found highly significant elevated level of blood glucose level among diabetic patients compared to non diabetic subjects. In addition to significant elevated level of serum lipids TC p=0.001, TG p=0.001, LDL p=0.001, and VLDL p=0.001. And decrease in HDL P=0.001 level in diabetic patient compared to non diabetic subjects. Among subgroups (type 1, type 2) diabetic patients glucose level and serum total cholesterol, triglycerides, LDL cholesterol and VLDL cholestrol were significantly higher (p<0.5) while HDL cholestrol was significantly lower when compared to non diabetic subjects. Non statistically

Risikostratificering af patienter med diabetes mellitus

DEFF Research Database (Denmark)

Qvist, Peter; Glintborg, Dorte; Andries, Alin

2008-01-01

with diabetes mellitus. MATERIAL AND METHODS: We included patients with diabetes from the catchment areas of four diabetes out-patient clinics in southern Denmark. Patients were risk-stratified to 3 follow-up levels (level 1 - follow-up only by their GP, level 2 - intensified follow-up by GP and/or shared care...... schemes, level 3 - follow-up only in out-patient clinics). The results were subsequently compared with the patients' actual follow-up status. RESULTS: A total of 647 patients (563 type 2 diabetes and 84 type 1 diabetes) were included from 15 GPs. Among these, 139 were stratified to level 1, 409 to level 2...

Treating 4,000 diabetic patients in Cambodia, a high-prevalence but resource-limited setting: a 5-year study

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Keuky Lim

2009-07-01

Full Text Available Abstract Background Despite the worldwide increasing burden of diabetes, there has been no corresponding scale-up of treatment in developing countries and limited evidence of program effectiveness. In 2002, in collaboration with the Ministry of Health of Cambodia, Médecins Sans Frontières initiated an outpatient program of subsidized diabetic care in two hospital-based chronic disease clinics in rural settings. We aimed to describe the outcomes of newly and previously diagnosed diabetic patients enrolled from 2002 to 2008. Methods We calculated the mean and proportion of patients who met the recommended treatment targets, and the drop from baseline values for random blood glucose (RBG, hemoglobin A1c (HbA1c, blood pressure (BP, and body mass index (BMI at regular intervals. Analysis was restricted to patients not lost to follow-up. We used the t test to compare baseline and subsequent paired values. Results Of 4404 patients enrolled, 2,872 (65% were still in care at the time of the study, 24 (0.5% had died, and 1,508 (34% were lost tofollow-up. Median age was 53 years, 2,905 (66% were female and 4,350 (99% had type 2 diabetes. Median (interquartile range (IQR follow-up was 20 months (5 to 39.5 months. A total of 24% (51/210 of patients had a HbA1c concentration of P P P P 2 after 1 year. Factors associated with loss to follow-up were male sex, age >60 years, living outside the province, normal BMI on admission, high RBG on last visit, and coming late for the last consultation. Conclusion Significant and clinically important improvements in glycemia and BP were observed, but a relatively low proportion of diabetic patients reached treatment targets. These results and the high loss to follow-up rate highlight the challenges of delivering diabetic care in rural, resource-limited settings.

Evaluation of Glycemic and Lipid Profile of Offspring of Diabetic Wistar Rats Treated with Malpighia emarginata Juice

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Sandra M. Barbalho

2011-01-01

Full Text Available Knowing that maternal diabetes is related to hyperglycemia and fetal hyperinsulinemia, which affect the lipid metabolism, the aim of this study was to evaluate the effects of Malpighia emarginata (acerola juice on the glycemic and lipid profile of offspring of diabetic and nondiabetic Wistar rats. The adult offspring of non-diabetic dams and of dams with severe streptozotocin-induced diabetes were divided into groups: G1, offspring (of control dams treated with water, G2, offspring (of diabetic dams treated with water, G3, male offspring (of control dams treated with acerola juice, and G4, male offspring (of diabetic dams treated with acerola juice. The offspring of diabetic dams treated with acerola juice showed significantly decreased levels of glucose, cholesterol, triglycerides, and increased HDL-c. The use of acerola juice is a potential strategy to aid in the prevention of DM and dyslipidemia and its complications or to act as an auxiliary in the treatment of these diseases.

The effect of Ramadan fasting on glycaemic control in insulin dependent diabetic patients: A literature review.

Science.gov (United States)

Alabbood, Majid H; Ho, Kenneth W; Simons, Mary R

Ramadan fasting is one of the five pillars of Islam. People with diabetes are exempted from fasting according to Islamic rules. However, many people with diabetes wish to fast. Physicians are asked frequently by their patients about their ability to fast and the possible impact of fasting on their glycaemic control. Studies about the effect of Ramadan on people with insulin-treated diabetes are scarce. This review aims to provide clinicians with the best recommendations for their patients with insulin-treated diabetes who wish to fast. Four databases (Medline, EMBASE, Scopus and PubMed) were searched using the following MeSH terms and keywords: "insulin dependent diabetes mellitus", "type 1 diabetes mellitus", 'Ramadan' "and" "fasting". In addition, a hand search of key journals and reference lists was performed. Sixteen full text articles were selected for review and critical analysis. All of the included studies except one found improvement or no change in glycaemic control parameters during Ramadan fasting. The incidence of major complications were negligible. Minor hypoglycaemic events were reported in some studies but did not adversely affect fasting. Postprandial hyperglycaemia was a major concern in other studies. However, the incidence of severe hyperglycaemia and diabetic ketoacidosis were trivial. Ramadan fasting is feasible for insulin dependent diabetic patient who wish to fast. Clinicians should advise their patients about the importance of adequate glycaemic control before Ramadan and frequent glucose monitoring during fasting. Certain types of Insulin seem to be more beneficial than other. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Metformin Increases Overall Survival in Patients with Diabetes Undergoing Surgery for Colorectal Cancer

DEFF Research Database (Denmark)

Fransgaard, Tina; Thygesen, Lau Caspar; Gögenur, Ismail

2015-01-01

-Meier estimator and the Cox regression model adjusted for important clinical risk factors were used. RESULTS: A total of 30,493 patients were included in the study, of which 3391 were diagnosed with diabetes and 1962 were treated with metformin. The adjusted HR of all-cause mortality for the diabetes group was 1......BACKGROUND: Emerging evidence suggests that metformin decreases the risk of developing colorectal cancer in patients with diabetes, but only few studies have examined potential survival benefits after surgery for colorectal cancer (CRC). The purpose of the study was to examine the association......'s National Clinical Database (DCCG). The Danish National Patient Register (NPR) records all hospital contacts in Denmark, and the diagnosis of diabetes was identified by combining NPR data with use of antidiabetic drugs identified through the Danish National Prescription Registry and DCCG. The Kaplan...

High and typical 18F-FDG bowel uptake in patients treated with metformin

International Nuclear Information System (INIS)

Gontier, Eric; Bonardel, Gerald; Mantzarides, Marina; Foehrenbach, Herve; Fourme, Emmanuelle; Wartski, Myriam; Pecking, Alain-Paul; Alberini, Jean-Louis; Blondet, Cyrille; Le Stanc, Elise

2008-01-01

This prospective and bi-centric study was conducted in order to determine the impact of antidiabetic treatments (AD) on 18 F-FDG bowel uptake in type 2 diabetic patients. Fifty-five patients with previously diagnosed and treated type 2 diabetes mellitus (group 1) were divided in two subgroups: AD treatment including metformin (n=32; group 1a) and AD treatment excluding metformin (n=23; group 1b). The 95 patients without diabetes mellitus made up controls (group 2). 18 F-FDG uptake in small intestine and colon was visually graded and semi-quantitatively measured using the maximum standardized uptake value. 18 F-FDG bowel uptake was significantly increased in AD patients (group 1) as compared to controls (group 2) (p 18 F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment before an 18 F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment. (orig.)

Dysregulation of coronary microvascular reactivity in asymptomatic patients with type 2 diabetes mellitus

Energy Technology Data Exchange (ETDEWEB)

Momose, Mitsuru; Neverve, Jodi; Nekolla, Stephan G.; Schwaiger, Markus; Bengel, Frank M. [Nuklearmedizinische Klinik und Poliklinik der Technischen Universitaet Muenchen, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675 Munich (Germany); Abletshauser, Claudia [Department of Medicine, Novartis Pharma GmbH, Nuernberg (Germany); Schnell, Oliver; Standl, Eberhard [Institut fuer Diabetesforschung, Munich (Germany)

2002-12-01

In diabetic patients, a number of studies have suggested an impairment of vascular reactivity in response to vasodilatory stimuli. The pattern of dysregulation at the coronary microcirculatory level, however, has not been clearly defined. Thus, it was the aim of this study to characterise coronary microvascular function non-invasively in a homogeneous group of asymptomatic type 2 diabetic patients. In 46 patients with type 2 diabetes, myocardial blood flow (MBF) was quantified at baseline, in response to cold pressor test (CPT) and during adenosine-mediated vasodilation using positron emission tomography and nitrogen-13 ammonia. None of the patients had been treated with insulin, and none had symptoms of cardiac disease. Decreased MBF during CPT, indicating microvascular dysregulation, was observed in 16 patients (CPT-), while 30 patients demonstrated increased MBF during CPT (CPT+). Response to CPT was mildly, but significantly correlated with response to adenosine (r=0.44, P=0.0035). There was no difference in HbA1c, serum lipid levels or serum endothelial markers between the groups. Microvascular dysregulation in the CPT- group was associated with elevated baseline MBF (P<0.0001), reduced baseline vascular resistance (P=0.0026) and an abnormal increase in resistance during CPT (P=0.0002). In conclusion, coronary microvascular dysregulation is present in approximately one-third of asymptomatic, non-insulin-treated type 2 diabetic patients. Elevated baseline blood flow and reduced microvascular resistance at rest are characteristics of this dysregulation. These data suggest a state of activation of endothelial-dependent vasodilation at baseline which appears to limit the flow response to stress conditions. (orig.)

Long-term graft and patient survival following renal transplantation in diabetic patients

DEFF Research Database (Denmark)

Rømming Sørensen, Vibeke; Schwartz Sørensen, Søren; Feldt-Rasmussen, Bo

2006-01-01

. The groups were similar with respect to age and sex. RESULTS: The patient survival rates (diabetic versus non-diabetic patients) were 88% vs 91% (p=NS) at 1 year, 68% vs 73% (p=NS) at 5 years and 31% vs 52% (pnon-diabetic patients) were 72% vs 72...... patients, 55% were smokers. Among the diabetic patients, graft and patient survival were independent of smoking habits, blood pressure, HbA1c and total cholesterol. CONCLUSIONS: Graft survival was similar in diabetic and non-diabetic patients. For the first 5 years following renal transplantation......OBJECTIVE: To study long-term graft and patient survival following renal transplantation in diabetic and non-diabetic patients. MATERIAL AND METHODS: Over the time period 1985-99, 498 transplantations in 399 non-diabetic patients and 68 transplantations in 62 diabetic patients were performed...

Lipid Profile in Sudanese Diabetic Patients

International Nuclear Information System (INIS)

Naway, L. M. Y.

2011-04-01

This study composes of two parts, the first one is an experiment to evaluate the level of blood glucose and lipid profile (TC, TG, LDL, HDL and VLDL) among diabetic patients and comparison of the result with non diabetic subjects and the second one is a survey to assess the standards of health care and patients knowledge. The subject were divided into two groups according to insulin requirement. Type 1 is insulin dependent diabetes mellitus and type 2 is non insulin dependent diabetes mellitus and then divided according to gender (males and female) subgroups. The study subjects selected for this study consist of one hundred Sudanese diabetic patients from Ribat University Hospital during January 2009 they had mean age (52±11.063) years,a mean height (165.82±8.573) cm and a mean weight of (70.20±11.203) kg. fifty healthy non diabetic subject were chosen as controls, their mean age (45.72±11.169) years, mean height (167.28±9.450) cm and mean weight (71.02±13.429) kg. Blood glucose and lipid profile total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were measured by enzymatic colorimetric methods in both groups, and very low density lipoprotein cholesterol were calculated for each sample. All patients were interviewed and filled out the questionnaire consisted of five parts. The result of the study found highly significant elevated level of blood glucose level among diabetic patients compared to non diabetic subjects. In addition to significant elevated level of serum lipids TC p=0.001, TG p=0.001, LDL p=0.001, and VLDL p=0.001. And decrease in HDL P=0.001 level in diabetic patient compared to non diabetic subjects. Among subgroups (type 1, type 2) diabetic patients glucose level and serum total cholesterol, triglycerides, LDL cholesterol and VLDL cholestrol were significantly higher (p<0.5) while HDL cholestrol was significantly lower when compared to non diabetic subjects. Non statistically variation

Polymorphism in beta fibrinogen -455 g/a gene was associated with diabetic in severe ischemic stroke patients

Science.gov (United States)

Ritarwan, Kiking; Kadri, Alfansuri; Juwita Sembiring, Rosita

2018-03-01

There is a association of polymorphism in the promoter region of the beta fibrinogen gene -455 G/A with enhancement plasma fibrinogen level. Diabetes mellitus is a risk factor for early neurologic deterioration in acute ischemic stroke. The prothrombotic fibrinogen protein is frequently elevated in patients with diabetes and may be association with poorer prognosis. This study evaluated the association of beta fibrinogen gene -455 G/A promoter polymorphism on modified Ranking Scale of Ischemic Stroke patients treated with diabetic and nondiabetic group. In a Cohort study design comprises 200 consecutive patients diabetic and a nondiabetic who, three months using completed a detailed outcome stroke. Of 200 samples genotype distribution were 27.1% for GG+GA and 0% for AA with diabetic and than 4.4% for GG+GA and 0.05% diabetic patients. Fibrinogen levels were higher in diabetic than nondiabetic group patients (307.7 + 106.3 vs 278 + 84 gr/dl, p=0.002). Fibrinogen level was found to be an independent predictor for diabetic patients. On Genotype GG+GA were associated wth diabetic and nondiabetic group patients. Modified Rankin Scale on day 90 were found associated with diabetic and nondiabetic patients. Conclusion: Elevated fibrinogen level is dose-dependently associated with 90 days outcome severity stroke with diabetic following ischemic stroke

Psoriasis risk in patients with type 2 diabetes in German primary care practices.

Science.gov (United States)

Jacob, Louis; Kostev, Karel

2017-02-01

To analyze psoriasis risk in type 2 diabetes mellitus (T2DM) patients treated in German primary care practices. The study included 87,964 T2DM patients aged 40 years or over who received their initial diabetes diagnosis between 2004 and 2013. Patients were excluded if they had been diagnosed with psoriasis prior to diabetes diagnosis or if the observation period prior to the index date was less than 365 days. After applying these exclusion criteria, 72,148 T2DM patients were included. A total of 72,148 non-diabetic controls were matched (1:1) to T2DM cases based on age, gender, type of health insurance (private or statutory), number of medical visits, and index date. The primary outcome was the diagnosis of psoriasis. Skin infections, dermatitis/eczema, hyperlipidemia, and medications associated with psoriasis (beta blockers, angiotensin-converting enzyme (ACE) inhibitors, lithium, antimalarials, nonsteroidal anti-inflammatory drugs, and benzodiazepines) were included as potential confounders. The mean age was 68.7 years (SD=12.7 years) and 48.6% of subjects were men. Hyperlipidemia, dermatitis/eczema, and skin infections were more frequent in T2DM patients than in controls. Beta blockers, ACE inhibitors, and nonsteroidal anti-inflammatory drugs were also more commonly used in people with T2DM than in controls. A total of 3.4% of T2DM patients and 2.8% of matched controls developed psoriasis within ten years of follow-up (p-value risk of developing psoriasis than controls (HR=1.18, 95% CI: 1.08-1.29). T2DM was positively associated with psoriasis in patients treated in German primary care practices. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Patient understanding of diabetes self-management: participatory decision-making in diabetes care.

Science.gov (United States)

Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min

2011-05-01

Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25-85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient-physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c. © 2011 Diabetes Technology Society.

Helicobacter pylori in Diabetic and Non-Diabetic Patients with Dyspepsia

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Mohammad Hossein Hashemi

2012-05-01

Full Text Available Helicobacter pylori (H. pylori is one of the most common chronic infections in patients with gastrointestinal disorders. Recent reports suggested that H. pylori might have high prevalence among patients with diabetes. The aim of this cross-sectional study was to assess the prevalence of H. pylori infection in diabetes mellitus and to study the relationship between histological findings and H. pylori infection in diabetic patients. Eighty patients with dyspepsia that were referred to our gastrointestinal department between May 2007 and May 2008 were included in our study. We checked fasting blood sugar for all of the study samples. All of patients underwent upper endoscopy and biopsy specimens were obtained from the antrum and the corpus. The specimens for the presence of H. pylori were colored by Giemsa stains. A single pathologist evaluated the histology slides. We found that prevalence of H. pylori infection was significantly higher in diabetics than in non-diabetics (P=0.001. Indeed, the prevalence of gastritis did differ significantly between the two groups (P=0.001. According to our results diabetes mellitus is one of the risk factor that must be considered in evaluation of H. pylori infection in diabetic patients with dyspepsia.

Outcomes of polytrauma patients with diabetes mellitus

Science.gov (United States)

2014-01-01

Background The impact of diabetes mellitus in patients with multiple system injuries remains obscure. This study was designed to increase knowledge of outcomes of polytrauma in patients who have diabetes mellitus. Methods Data from the Trauma Audit and Research Network was used to identify patients who had suffered polytrauma during 2003 to 2011. These patients were filtered to those with known outcomes, then separated into those with diabetes, those known to have other co-morbidities but not diabetes and those known not to have any co-morbidities or diabetes. The data were analyzed to establish if patients with diabetes had differing outcomes associated with their diabetes versus the other groups. Results In total, 222 patients had diabetes, 2,558 had no past medical co-morbidities (PMC), 2,709 had PMC but no diabetes. The diabetic group of patients was found to be older than the other groups (P <0.05). A higher mortality rate was found in the diabetic group compared to the non-PMC group (32.4% versus 12.9%), P <0.05). Rates of many complications including renal failure, myocardial infarction, acute respiratory distress syndrome, pulmonary embolism and deep vein thrombosis were all found to be higher in the diabetic group. Conclusions Close monitoring of diabetic patients may result in improved outcomes. Tighter glycemic control and earlier intervention for complications may reduce mortality and morbidity. PMID:25026864

Diabetic Foot Syndrome as a Possible Cardiovascular Marker in Diabetic Patients

Science.gov (United States)

Tuttolomondo, Antonino; Maida, Carlo; Pinto, Antonio

2015-01-01

Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality; in fact, some authors showed a higher prevalence of major, previous and new-onset, cardiovascular, and cerebrovascular events in diabetic patients with foot ulcers than in those without these complications. This is consistent with the fact that in diabetes there is a complex interplay of several variables with inflammatory metabolic disorders and their effect on the cardiovascular system that could explain previous reports of high morbidity and mortality rates in diabetic patients with amputations. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects confirmed the pathogenetic issue of the “adipovascular” axis that may contribute to cardiovascular risk in patients with type 2 diabetes. In patients with diabetic foot, this “adipovascular axis” expression in lower plasma levels of adiponectin and higher plasma levels of IL-6 could be linked to foot ulcers pathogenesis by microvascular and inflammatory mechanisms. The purpose of this review is to focus on the immune inflammatory features of DFS and its possible role as a marker of cardiovascular risk in diabetes patients. PMID:25883983

Risk of ischemic stroke after an acute myocardial infarction in patients with diabetes mellitus.

Science.gov (United States)

Jakobsson, Stina; Bergström, Lisa; Björklund, Fredrik; Jernberg, Tomas; Söderström, Lars; Mooe, Thomas

2014-01-01

Incidence, any trend over time, and predictors of ischemic stroke after an acute myocardial infarction (AMI) in diabetic patients are unknown. Data for 173,233 unselected patients with an AMI, including 33,503 patients with diabetes mellitus, were taken from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) during 1998 to 2008. Ischemic stroke events were recorded during 1 year of follow-up. Patients with diabetes mellitus more often had a history of cardiovascular disease, received less reperfusion therapy, and were treated with acetylsalicylic acid, P2Y12 inhibitors, and statins to a lesser extent compared with patients without diabetes mellitus. However, the use of evidence-based therapies increased markedly in both groups during the study period. The incidence of ischemic stroke during the first year after AMI decreased from 7.1% to 4.7% in patients with diabetes mellitus and from 4.2% to 3.7% in patients without diabetes mellitus. Risk reduction was significantly larger in the diabetic subgroup. Reperfusion therapy, acetylsalicylic acid, P2Y12 inhibitors, and statins were independently associated with the reduced stroke risk. Ischemic stroke is a fairly common complication after an AMI in patients with diabetes mellitus, but the risk of stroke has decreased during recent years. The increased use of evidence-based therapies contributes importantly to this risk reduction, but there is still room for improvement.

Towards a personalised virtual diabetic patient simulator

NARCIS (Netherlands)

Maas, A.H.; Tani, G.; Pul, van C.; Beijerinck, H.C.W.; Cottaar, E.J.E.; Haak, H.R.; Riel, van N.A.W.

2012-01-01

The development of a diabetes simulator, an educational software tool which can help diabetic patients to better manage their disease, is described. Education of patients with diabetes mellitus is a fundamental part of diabetes care. One of the goals of diabetes education is to support the patients

The Diabetic Foot in a Multidisciplinary Team Setting

DEFF Research Database (Denmark)

Wilbek, T E; Jansen, R B; Jørgensen, B

2016-01-01

Aim: To describe the number of minor lower extremity amputations and mortality for diabetes patients treated by a specialized multidisciplinary foot care team. Methods: A retrospective descriptive study of medical records from patients with diabetes treated with minor amputations at the Copenhagen...... Wound Healing Center (CWHC) at Bispebjerg Hospital from 1996-2013. Results: 777 diabetes patients treated with minor amputations were included. 77% were males and 23% were females. 80% had T2 diabetes and 20% had T1 diabetes. 89% of the patients had a foot ulcer at first contact. There was a total of 1...... 231 minor amputations. The amputations were mainly trans-metatarsal amputations and partial amputations of toes. There was an increase in the number of minor amputations, but there was also an increase in the number of referred diabetes patients, thus the ratio of amputations per admitted diabetes...

Vitamin B12 in metformin-treated diabetic patients: a cross-sectional study in Brazil Vitamina B12 em pacientes diabéticos usando metformina: um corte transversal no Brasil

OpenAIRE

Monique Nervo; Adriano Lubini; Fabiana Viegas Raimundo; Gustavo Adolpho Moreira Faulhaber; Carine Leite; Leonardo Moura Fischer; Tania Weber Furlanetto

2011-01-01

OBJECTIVE: The objective of this study was to evaluate the presence of vitamin B12 deficiency and the factors associated with serum vitamin B12 levels in a sample of metformin-treated Brazilian diabetic patients. METHOD: Cross-sectional study. RESULTS: 144 patients were included. Serum vitamin B12 levels were low (< 125 pmol/L) in 10 patients (6.9%) and possibly low (125 - 250 pmol/L) in 53 patients (36.8%). Serum vitamin B12 levels were negatively associated with age (B = -3.17; β= -0.1...

Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Jordan.

Science.gov (United States)

Bakkar, May M; Haddad, Mera F; Gammoh, Yazan S

2017-01-01

Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate awareness of diabetic retinopathy among a sample of type 2 diabetes mellitus patients in Jordan. The study period was from August to December 2015. The sample was selected randomly from patients with type 2 diabetes mellitus from the general population in three main cities of Jordan (Amman, Irbid, and Zarqa). A questionnaire was distributed to 237 participants with diabetes to assess their awareness and knowledge of diabetes and diabetic retinopathy. The questionnaire included questions to assess awareness about diabetic retinopathy, sources of knowledge about the disease, and patients' knowledge and compliance with available treatments and routine eye examinations. Patients were also questioned about the barriers that may interfere with early eye examination. A total of 237 participants (107 [45.1%] females and 130 [54.9%] males) with type 2 diabetes were interviewed. Mean age±SD for the study population was 54.51±10.28 years. Of the study population, 88.2% were aware that diabetes can affect the eyes and 81% reported that diabetic retinopathy can lead to blindness. Higher level of patients' awareness of diabetic retinopathy was related to higher level of formal education ( p diabetic retinopathy as reported by 47.3% patients was general practitioners. Patients' compliance with diabetes management was relatively high; however, their compliance with routine retinal assessment was poor, with only a total of 29.5% of participants having had an eye examination in the previous year. Awareness of the nature and consequences of diabetic retinopathy among patients with diabetes in Jordan is relatively high. However, patients' motivation to undergo retinal assessment was poor in the sample, thus hindering early diagnosis and management.

[Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients].

Science.gov (United States)

Roberto Robles, Nicolás; Velasco, Joaquín; Mena, Cándido; Angulo, Enrique; Garrote, Timotea

2006-11-25

Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs.

Chromium level in prediction of diabetes in pre-diabetic patients

Directory of Open Access Journals (Sweden)

Rahmatollah Rafiei

2014-01-01

Full Text Available Background: Chromium supplementations (Cr have been shown to exert beneficial effects in the management of type-2 diabetes. Prevalence of Cr deficiency in pre-diabetic patients is not well-understood, therefore, the aim of this study was to evaluate the extent of this prevalence. Materials and Methods: In this cross-sectional descriptive study, 132 pre-diabetic patients were recruited. The participants were randomly selected from those who referred to the Shariati Hospital in Isfahan, Iran. Blood samples are collected for measurement of Cr, insulin, fasting blood sugar (FBS, and two-hour post-load plasma glucose. The body mass index (BMI was calculated. Determination of Cr was carried out by atomic absorption spectrometry. Results: Thirty-four (31.5% patients had Cr deficiency and 74 (68.5% patients had normal Cr. There was no significant difference between sex, age groups (<50 years and ≥50 years and between patients with and without a family history of diabetes in both the groups. No significant differences in age, BMI, FBS or insulin were observed between two groups. In the group with a normal level of Cr, there was a significant reversed correlation between the Cr level and age, but no significant correlation existed between the Cr level and other factors in both groups. Conclusion: The levels of Cr deficiency are relatively common in patients with pre-diabetes, and it is necessary to screen patients with diabetes and pre-diabetes according to the American Diabetes Association guidelines, with regard to the Cr level and action should be taken to eliminate the Cr deficiency in these patients.

Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

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Panagiotis K. Karampinas

2012-06-01

Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

Effects of self-monitoring of glucose in non-insulin treated patients with type 2 diabetes: design of the IN CONTROL-trial

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Kostense Piet J

2009-04-01

Full Text Available Abstract Background Diabetes specific emotional problems interfere with the demanding daily management of living with type 2 diabetes mellitus (T2DM. Possibly, offering direct feedback on diabetes management may diminish the presence of diabetes specific emotional problems and might enhance the patients' belief they are able to manage their illness. It is hypothesized that self-monitoring of glucose in combination with an algorithm how and when to act will motivate T2DM patients to become more active participants in their own care leading to a decrease in diabetes related distress and an increased self-efficacy. Methods and design Six hundred patients with T2DM (45 ≤ 75 years who receive care in a structured diabetes care system, HbA1c ≥ 7.0%, and not using insulin will be recruited and randomized into 3 groups; Self-monitoring of Blood Glucose (SMBG, Self-monitoring of Urine Glucose (SMUG and usual care (n = 200 per group. Participants are eligible if they have a known disease duration of over 1 year and have used SMBG or SMUG less than 3 times in the previous year. All 3 groups will receive standardized diabetes care. The intervention groups will receive additional instructions on how to perform self-monitoring of glucose and how to interpret the results. Main outcome measures are changes in diabetes specific emotional distress and self-efficacy. Secondary outcome measures include difference in HbA1c, patient satisfaction, occurrence of hypoglycaemia, physical activity, costs of direct and indirect healthcare and changes in illness beliefs. Discussion The IN CONTROL-trial is designed to explore whether feedback from self-monitoring of glucose in T2DM patients who do not require insulin can affect diabetes specific emotional distress and increase self-efficacy. Based on the self-regulation model it is hypothesized that glucose self-monitoring feedback changes illness perceptions, guiding the patient to reduce emotional responses to

Treating fat grafts with human endothelial progenitor cells promotes their vascularization and improves their survival in diabetes mellitus.

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Hamed, Saher; Ben-Nun, Ohad; Egozi, Dana; Keren, Aviad; Malyarova, Nastya; Kruchevsky, Danny; Gilhar, Amos; Ullmann, Yehuda

2012-10-01

Bone marrow-derived endothelial progenitor cells are required for vascularization of a fat graft to form a functional microvasculature within the graft and to facilitate its integration into the surrounding tissues. Organ transplantation carries a high risk of graft loss and rejection in patients with diabetes mellitus because endothelial progenitor cell function is impaired. The authors investigated the influence of endothelial progenitor cell treatment on the phenotype and survival of human fat grafts in immunocompromised mice with experimentally induced diabetes mellitus. The authors injected 1 ml of human fat tissue into the scalps of 14 nondiabetic and 28 diabetic immunocompromised mice, and then treated some of the grafts with endothelial progenitor cells that was isolated from the blood of a human donor. The phenotype of the endothelial progenitor cell-treated fat grafts from the 14 diabetic mice was compared with that of the untreated fat grafts from 14 nondiabetic and 14 diabetic mice, 18 days and 15 weeks after fat transplantation. Determination of graft phenotype included measurements of weight and volume, vascular endothelial growth factor levels, vascular endothelial growth factor receptor-2, endothelial nitric oxide synthase, and caspase 3 expression levels, and histologic analysis of the extent of vascularization. The untreated grafts from the diabetic mice were fully resorbed 15 weeks after fat transplantation. The phenotype of endothelial progenitor cell-treated fat grafts from the diabetic mice was similar to that of the untreated fat grafts from the nondiabetic mice. Endothelial progenitor cell treatment of transplanted fat can increase the survival of a fat graft by inducing its vascularization and decreasing the extent of apoptosis.

Clinical Medicine: Endocrinology and Diabetes: Gender-associated Differences in Weight Gain, Insulin Requirement and Metabolic control in Newly Insulin-treated Type 2 Diabetic Patients with Secondary Sulfonylurea Failure–-a One-year Observation

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Georg Biesenbach

2009-01-01

Full Text Available Objective The aim of the present study was to determine differences between male and female type 2 diabetic patients concerning body weight, metabolic control, insulin requirement and prevalence of vascular diseases during the first year insulin therapy. Patients and Methods We investigated 102 newly insulin-treated type 2 diabetic patients (60 female with secondary sulfonylurea failure. Observation period was the first year insulin therapy. We compared BMI, HbA1c, lipids and insulin requirement at the begin and after one year, C-peptide and prevalence of vascular diseases at the start of insulin therapy. Results At the start of insulin substitution, omen had a higher BMI (27 + 3 versus 25 + 3; p < 0.05. Women also required a higher insulin dose than did men (28 + 6 versus 24 + 6 IU/day Mean HbA1c and cholesterol levels were similar in both groups whereas triglycerides were higher in women (244 + 88 versus 203 + 76 mg/dl; p < 0.05. Both groups achieved a similar gain in body weight after one year (+2.5% versus +2.6%; NS. HbA1c decreased from 9.2 + 1.1 to 7.4% + 0.9% (–19% in women and from 9.4 + 1.1 to 7.5% + 1.0% (–20% in men. The prevalence of vascular diseases was not significantly different in both groups. Conclusions At the start of insulin therapy female type 2 diabetic patients showed a significant higher BMI and a higher insulin requirement than male patients. The metabolic control was similar in men and women, only the triglycerides were higher in the female patients. Weight gain and increase of needed insulin as well as prevalence of macroangiopathy were the same in both groups.

Presentation of frozen shoulder among diabetic and non-diabetic patients.

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Uddin, Mohammad Moin; Khan, Aminuddin A; Haig, Andrew J; Uddin, Mohammad Kafil

2014-12-01

The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes.

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

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Chantelau, Ernst-A.; Zweck, Brigitte; Haage, Patrick

2018-01-01

ABSTRACT Background: Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic. Study design: Retrospective observational study, chart review Material and methods: Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment. Only cases without concomitant infection or skin ulcer were chosen, in whom both was documented, onset of symptomatic foot swelling and patient compliance with cast treatment. Results: From 1994 to 2017, 45 consecutive cases in 37 patients were retrieved, with 95 MRI follow-up studies (1–6 per case, average interval between studies 13 weeks). Decreasing EESC was documented in 66/95 (69%) follow-up studies. However, 29/95 (31%) studies revealed temporarily increasing, migrating or stagnating EESC. Conclusion: EESC on MRI disappear in response to prolonged offloading and immobilizing treatment; however, physiologic as well as pathologic fluctuations of posttraumatic EESC have to be considered when interpreting the MR images. Conventional MRI is useful for surveillance of active-stage Charcot foot recovery. PMID:29713425

Conjunctival bacterial flora in diabetic patients

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Najmun Nahar

2013-01-01

Full Text Available Conjunctival flora refers to population of microorganisms that dwell within the eyes of healthy individuals and is important in maintaining a healthy ocular surface and normal conjunctival function. Conjunctival flora may be altered by a variety of factors that include age, immunosuppression and geography. Immune function is compromised in diabetes mellitus. The aim of the present study was to see the pattern of conjunctival bacterial flora in diabetic and non-diabetic patients. This cross sectional study was carried out in BSMMU during the period of January 2011 to December 2011. Total 500 conjunctival swabs were collected from both eyes of 50 diabetic patients attending OPD of Endocrinology Department of BSMMU and 200 non-diabetic individuals. Significant number of culture was positive in diabetic patients (64.0% compared to that of non-diabetic individuals (38.0%. Staphylococcus epidermidis was predominant in both study groups (diabetic vs non-diabetic: 41.3% vs 65.26%. Staphylococcus aureus (15.22%, Escherichia coli (6.52% and Enterobacter (8.33% were isolated in diabetic patients. Rate of positive culture in both and single eyes were higher in diabetic (28%, 36.0% than that of non-diabetic individuals (9.5%, 28.5%. Ibrahim Med. Coll. J. 2013; 7(1: 5-8

Sensitivity and reproducibility of urinary C-peptide as estimate of islet B-cell function in insulin-treated diabetes

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Gjessing, H J; Matzen, L E; Faber, O K

1989-01-01

The aims of the present study were to evaluate the ability of urinary C-peptide determination to demonstrate presence of residual insulin secretion, and to evaluate the reproducibility of urinary C-peptide excretion in 125 insulin-treated diabetic patients. C-peptide was determined in two...

Antiobesity Pharmacotherapy for Patients with Type 2 Diabetes: Focus on Long-Term Management

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Won Seon Jeon

2014-12-01

Full Text Available Type 2 diabetes and obesity have a complex relationship; obesity is linked to insulin resistance, the precursor to type 2 diabetes. The management of obesity is an important method to delay onset of diabetes and improve the glycemic durability of antidiabetic agents. However, insulin and some of the oral hypoglycemic agents used to treat diabetes cause significant weight gain, and it is difficult for patients with diabetes to reduce and maintain their weight by life-style changes alone. Thus, antiobesity medications or bariatric surgery may be a necessary adjunct for certain obese patients with diabetes. In 2012, the U.S. Food and Drug Administration (FDA approved lorcaserin and phentermine/topiramate extended-release for the management of chronic weight, and approval for naltrexone/bupropion sustained-release as an adjunct to exercise and reduced caloric intake followed in 2014. Liraglutide is pending FDA approval for antiobesity drug. Here we review the efficacy of approved and new promising drugs for the management of obesity.

The Influence of Smoking on Pulmonary Tuberculosis in Diabetic and Non-Diabetic Patients

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Bai, Kuan-Jen; Lee, Jen-Jyh; Chien, Shun-Tien; Suk, Chi-Won; Chiang, Chen-Yuan

2016-01-01

Background Both smoking and diabetes can increase the risk and influence the manifestations and outcomes of tuberculosis (TB). It is not clear whether the influence of smoking on pulmonary TB differs between non-diabetic and diabetic patients. Herein, we assessed the manifestations and outcomes of TB in relation to smoking in both diabetic and non-diabetic TB patients. Methodology/Principal Findings All diabetic culture-positive pulmonary TB patients notified from 2005–2010 at three teaching hospitals in Taiwan were enrolled. A culture-positive pulmonary TB patient without DM who was notified to the health authority immediately prior to each diabetic TB patient was selected for comparison. The 972 patients in this study cohort included 365 (37.6%) non-diabetic non-smokers, 149 (15.3%) non-diabetic smokers, 284 (29.2%) diabetic non-smokers, and 174 (17.9%) diabetic smokers. The adjusted relative risk of a pretreatment positive smear for a smoker compared with a non-smoker was 2.19 (95% CI 1.38–3.47) in non-diabetic patients and 2.23 (95% CI 1.29–3.87) in diabetic culture-positive pulmonary TB patients. The adjusted relative risk for a positive smear among diabetic smokers was 5.61 (95% CI 3.35–9.41) compared with non-diabetic non-smokers. Smoking was significantly associated with an increased frequency of bilateral lung parenchyma involvement (AdjOR 1.84, 95% CI 1.16–2.93), far-advanced pulmonary TB (AdjOR 1.91, 95% CI 1.04–3.50), cavitary lesions (AdjOR 2.03, 95% CI 1.29–3.20), and unfavorable outcomes of TB (AdjOR 2.35, 95% CI 1.02–5.41) in non-diabetic patients. However, smoking was not associated with cavitary lung parenchyma lesions regarding the location, number or size of the cavity in diabetic TB patients. Conclusions/Significance Smoking and diabetes have joint effects on a pretreatment positive smear. Diabetic smokers had more than a 5-fold increased risk of a pretreatment positive smear than did non-diabetic non-smokers, indicating

Poor hypertension control in Greek patients with diabetes in rural areas. The VANK study in primary care.

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Skliros, E; Sotiropoulos, A; Vasibossis, A; Xipnitos, C; Chronopoulos, I; Razis, N; Merkouris, Panagiotis

2007-01-01

This study aimed to determine hypertension prevalence and levels of awareness, treatment and control of hypertension among diabetic patients using data from the VANK study. The sample consisted of 221 men and women (122/99) diagnosed with type 2 diabetes. Semi-structured interviews were conducted with all participants. Controlled hypertension definition was based on having a systolic blood pressure (BP) of hypertension was 194/221 (87.7%). In total, 34.1% of patients (66/194) were not aware of having hypertension. Of those who were aware of having hypertension (n = 128, 65.9%), all were treated. Among those treated, only 11 persons (11/194, 5.6%) had systolic BP hypertensive patients (n = 128) received antihypertensive drug therapy, in only 8.6% (11/128) the treatment was effective (BP hypertension from primary care physicians, as well as regular surveillance to detect developing hypertension in diabetic patients.

Severe diabetic ketoacidosis and acute pericarditis precipitated by concomitant Graves′ thyrotoxicosis in type 1 diabetic patient

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Muneera A Alshareef

2014-01-01

Full Text Available 20-year-old male known case of type 1 diabetes mellitus (T1DM presented to emergency department with vomiting and abdominal pain, and was diagnosed to have diabetic ketoacidosis (DKA. There was no obvious precipitating cause for DKA. Patient was started on DKA protocol and initially responded well to treatment. Later on, patient developed severe metabolic acidosis and chest pain. The cardiac evaluation established the diagnosis of acute pericarditis and ruled out acute coronary syndrome. The cause for his stormy coarse of DKA, and persistent tachycardia were further evaluated, and he was diagnosed to have concomitant thyrotoxicosis (graves′ disease complicating the DKA. He was successfully treated with aggressive management of DKA and started on thyrotoxicosis treatment. Autoimmune diseases are known to manifest in cluster but concomitant thyrotoxicosis precipitating DKA and causing acute pericarditis is rare. Prompt recognition of thyrotoxicosis in patients with persistent tachycardia, and treatment of thyrotoxicosis will improve outcome in DKA patients.

Increased prevalence of insulin-treated diabetes mellitus in Funen County, Denmark

DEFF Research Database (Denmark)

Eshøj, O; Green, A; Borch-Johnsen, K

1994-01-01

: There was a significant increase in the prevalence of insulin-treated diabetes mellitus in Funen County, Denmark from 1973 to 1987. Analysis of the data shows that an important factor for this increase is a liability to start insulin treatment of type 2 (non-insulin-dependent) diabetes mellitus at an earlier stage than...

Web-based depression treatment for type 1 and type 2 diabetic patients a randomized, controlled trial

NARCIS (Netherlands)

van Bastelaar, K.M.P.; Pouwer, F.; Cuijpers, P.; Riper, H.; Snoek, F.J.

2011-01-01

OBJECTIVE - Comorbid depression is common in patients with type 1 and type 2 diabetes, adversely affecting quality of life, diabetes outcomes, and mortality. Depression can be effectively treated with cognitive behavior therapy (CBT). The Internet is a new and attractive method for delivering CBT

Antioxidant status in diabetic and non-diabetic senile patients, with cataract or cardiovascular complications

International Nuclear Information System (INIS)

Gul, A.; Rahman, Muhammad A.

2008-01-01

Objective was to assess the total antioxidant status in diabetic and non-diabetic senile patients, with cataract or cardiovascular complications, and without complications. A comparative study on 186 senile patients and control subjects was carried from March 2004 to November 2006 on patients from Ziauddin University Hospital, Karachi, Pakistan. Among them 33 were diabetic patients without any clinical evidence of chronic diabetic complications, 32 with cardiovascular complications, 30 non-diabetic patients with cardiovascular complications, 30 diabetic patients with cataract and 31 apparently normal, age, gender and weight matched control subjects were investigated. All patients were selected on clinical grounds. Total antioxidant status was significantly decreased (p<0.001) in all diabetic patients with and without complications and non-diabetic patients with same complications (155 patients) as compared with control subjects (31 subjects). Fasting plasma glucose was increased (p<0.001) in all diabetic patients with and without complications (95 patients), and correlated significantly with glycosylated hemoglobin (HbA1c) and serum fructosamine concentrations. Fasting plasma glucose, HbA1c, and serum fructosamine were not different in diabetic patients with and without complications. Fasting plasma glucose, HbA1c, serum fructosamine and total serum protein were not different in non-diabetic patients with the same complications as compared with control subjects. Total antioxidant status is decreased in diabetic and non-diabetic senile patients with the same complication as compared with same complication as compared with control subjects. Some other factors may be responsible for decease antioxidant status. (author)

MANAGEMENT OF DIABETES MELLITUS IN DIABETIC PATIENTS: ISFAHAN. 1999

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P ABAZARI

2001-06-01

Full Text Available Introduction. Diabetic control and its acute and chronic complications needed to investigate the characteristics medical and self care in diabetics. This evaluation can detect conflicts in this field and provide the possibility of better planning to arrive the ideal control of diabetes. Methods. This study was a cross sectional survey. Samples were 344 diabetic patients who were living in Isfahan. Data was collected by a questionnaire described diabetics contextual characteristics, position of medical services use, position of diabetic education, self blood glucose monitoring (SMBG, attendance to diet regimen and so on. Questionnaires were cmpeleted through interview. Results. Mean age of patients was 56.5±13.6 years. More than fifty percent (57.7 percent were female. More than one third (57.6 percent were illiterate. Patients had 1 to 40 years history of diabetes. More than one forth (27.4 percent did not seek medical advice and 61.2 percent had referred to physician only when they were encountering with a problem for example lack of insulin or oral hypoglycemic agents. Over eighty percent never had foot examination by their physicians. Only 7.4 percent, had heared about glycosylated hemoglubine. This test had not been accomplished for 95.9 percent of patients. 46.2 percent had not performed self foot examination till study time. More than eighty percent of interviewers had reported their lost blood glucose value above 130 mg/dl. Only ten percent of the study population had performed 5MBG. About fifty percent (45.3 percent, did not educated about diabetes. Only 26.8 percent reported that they always follow their dietary regimen. Discussion. Results of this survey showed irregular calls to physicians, poor blood glucose control, high rate of hospitalization due to acute and chronic diabetes complications, irregular blood glucose monitoring. Diabetes management needs more attention in our city.

Education and patient preferences for treating type 2 diabetes: a stratified discrete-choice experiment

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Janssen EM

2017-10-01

Full Text Available Ellen M Janssen,1 Daniel R Longo,2 Joan K Bardsley,3 John FP Bridges1 1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, 3MedStar Health Research Institute and MedStar Nursing, Hyattsville, MD, USA Purpose: Diabetes is a chronic condition that is more prevalent among people with lower educational attainment. This study assessed the treatment preferences of patients with type 2 diabetes by educational attainment. Methods: Patients with type 2 diabetes were recruited from a national online panel in the US. Treatment preferences were assessed using a discrete-choice experiment. Participants completed 16 choice tasks in which they compared pairs of treatment profiles composed of six attributes: A1c decrease, stable blood glucose, low blood glucose, nausea, treatment burden, and out-of-pocket cost. Choice models and willingness-to-pay (WTP estimates were estimated using a conditional logit model and were stratified by educational status. Results: A total of 231 participants with a high school diploma or less education, 156 participants with some college education, and 165 participants with a college degree or more completed the survey. Participants with a college degree or more education were willing to pay more for A1c decreases ($58.84, standard error [SE]: 10.6 than participants who had completed some college ($28.47, SE: 5.53 or high school or less ($17.56, SE: 3.55 (p≤0.01. People with a college education were willing to pay more than people with high school or less to avoid nausea, low blood glucose events during the day/night, or two pills per day. Conclusion: WTP for aspects of diabetes medication differed for people with a college education or more and a high school education or less. Advanced statistical methods might overcome limitations of stratification and advance understanding

Blood Glucose Levels in Diabetic Patients Following Corticosteroid Injections into the Subacromial Space of the Shoulder.

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Aleem, Alexander W; Syed, Usman Ali M; Nicholson, Thema; Getz, Charles L; Namdari, Surena; Beredjiklian, Pedro K; Abboud, Joseph A

2017-09-01

Corticosteroid injections are used to treat a variety of orthopedic conditions with the goal of decreasing pain and inflammation. Administration of systemic or local corticosteroids risks temporarily increasing blood glucose levels, especially diabetic patients. The purpose of this study is to quantify the effects of corticosteroid injections on blood glucose levels in diabetic patients with shoulder pathology. Diabetic patients who regularly monitored their blood glucose levels and were indicated for a subacromial corticosteroid injection were included in this prospective investigation. The typical normal morning fasting glucose and most recent hemoglobin A1c level was recorded for each patient. After injection, patients were contacted daily to confirm their fasting morning glucose level for 10 days post-injection. Seventeen consecutive patients were enrolled. Patients with hemoglobin A1c of patients' glucose levels returned to near baseline levels around post-injection day 8, while poorly controlled patients levels remained elevated. Similarly, insulin-dependent diabetic patients had an average increase in fasting glucose level of 99 mg/dL versus 50 mg/dL in non-insulin-dependent diabetic patients ( P patients with well-controlled diabetes experience smaller elevations and faster return to baseline glucose levels than patients with poor control. Insulin dependent diabetics experienced similar findings as patients with poor control. Future studies are needed to evaluate dosing to optimize the risks of blood glucose elevation while maintaining therapeutic benefit.

Patients with diabetes mellitus and their management - a local scenario

International Nuclear Information System (INIS)

Younis, B.B.; Ahmad, R.

2010-01-01

Objective: The prevalence of diabetes is dangerously increasing esp. in this part of the world. The study is done to analyze the disease in both genders, the average age of onset of disease, the treatment which the patients are getting esp. by their family physicians and their control based upon their average random blood sugars. Material and Methods: Case series observational study was done selecting 200 patients with Type 2 Diabetes of at least one year duration, from ages 20 yrs and above. 2 centers were included in the study one at the heart of Lahore and other at peripheral district Sheikhupura. The patients which were selected were being treated by family physicians and were not consulting any specialist for the control of their disease. First 200 patients were selected 100 at each centre irrespective of their ages gender and duration of disease. Results: The gender ratio was 38 and 62 % for Males and Females respectively. The average age of onset was 40 years. On the average 26% patients were on insulin and 74% were on oral anti Diabetic medicine. The glucose control was better in patients on insulin as compared to those on oral medication. Overall 14% were controlled in our study, even when controlled BSR was taken as 200 mg %. Conclusion: There are significantly more females diabetic as compared to males in our study, the overall control was dis-appointing, however 26% of patients were on insulin and their average blood sugar random was better than others. More large observational studies are required to get to more reliable picture, Customized local guide lines needs to be developed for our family physicians, they should be included in the team for developing the guidelines, as they see majority of the patients with Type 2 Diabetes Mellitus. (author)

Examination of the esophageal function with dynamic scintigraphy in diabetic patients

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Tornoczky, J.; Pasztarak, E.; Muth, L.; Sziladi, E.; Simon, L.; Kiss, M.

1985-05-19

The disturbance of the esophageal function in diabetes was demonstrated earlier with radiological examination and intraluminal manometry. In the present paper the results of examinations carried out in 130 diabetic cases by a novel, non-invasive method, the dynamic scintigraphy for studying the function of esophagus, i.e. transit time and retention, are presented. The method is highly sensitive, harmless for the patients, inexpensive, and easily reproducible. The sup(99m)Tc-DTPA used for labelling is not absorbed, has no harmful side-effects and does not influence the results of other isotopic examinations. Based on the results, it was stated, that the esophageal function decreased significantly in patients suffering from diabetes for a longer period as compared to the controls or to patients with newly detected and still untreated diabetes. The role of instable state of equilibrium and neuropathy in the background is stressed. Stable carbohydrate metabolism has favourable effect especially in the insulin-treated group. Gastrointestinal complications such as the simultaneous occurrence of reflux esophagitis and peptic esophageal ulcer are also more frequent in cases with instable metabolism. The method is considered to be suitable for the demonstration of neuropathy and for the determination of the efficiency of the treatment. Its performance is recommended in the up-to-date treatment of diabetic patients. (author). 33 refs.; 7 figs.

Hypoglycemia Is Independently Associated with Multidimensional Impairment in Elderly Diabetic Patients

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A. Pilotto

2014-01-01

Full Text Available Aim. To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI, a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA, in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs. Methods and Results. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM, 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score. Conclusion. Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment.

Treating Type 2 Diabetes

Science.gov (United States)

... health care team is there for you. Your child's diabetes management plan should be easy to understand, detailed, ... Can Diabetes Be Prevented? Monitoring Blood Sugar Your Child's Diabetes Health Care Team Medicines for Diabetes Type 2 ...

The Impact of Patient Education on Diabetes Empowerment Scale (DES) and Diabetes Attitude Scale (DAS-3) in Patients with Type 2 Diabetes

OpenAIRE

ATAK, Nazlı; KÖSE, Kenan; GÜRKAN, Tanju

2008-01-01

Aim: This study was conducted to assess the impact of a brief, patient-centered education program on perceived self-efficacy and attitudes towards diabetes of patients with type 2 diabetes. Materials and Methods: A randomized controlled study was designed and conducted to assess the impact of education using the DES (Diabetes Empowerment Scale) and DAS-3 (Diabetes Attitude Questionnaire-3), which were administered using a pre- and post-test design. A patient-centered education program was d...

Adipsia in a Diabetes Insipidus Patient

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Maria Conceição Pereira

2015-09-01

Full Text Available Central diabetes insipidus is a very common disorder after brain surgery or/trauma or even in the presence of brain inflammatory diseases. Polyuria and polydipsia are the clinical markers, but sometimes clinical situations are presenting with no thirst. These are not frequent but are life-treating conditions. Diagnosis is not easy, and for this reason some cases are treated late. We describe here a very infrequent oncological case of dangerous adipsic diabetes insipidus in a young girl who survived.

Partial recovery of erythrocyte glycogen in diabetic rats treated with phenobarbital

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da-Silva C.A.

1997-01-01

Full Text Available Erythrocytes may play a role in glucose homeostasis during the postprandial period. Erythrocytes from diabetic patients are defective in glucose transport and metabolism, functions that may affect glycogen storage. Phenobarbital, a hepatic enzyme inducer, has been used in the treatment of patients with non-insulin-dependent diabetes mellitus (NIDDM, increasing the insulin-mediated glucose disposal. We studied the effects of phenobarbital treatment in vivo on glycemia and erythrocyte glycogen content in control and alloxan-diabetic rats during the postprandial period. In control rats (blood glucose, 73 to 111 mg/dl in femoral and suprahepatic veins the erythrocyte glycogen content was 45.4 ± 1.1 and 39.1 ± 0.8 µg/g Hb (mean ± SEM, N = 4-6 in the femoral artery and vein, respectively, and 37.9 ± 1.1 in the portal vein and 47.5 ± 0.9 in the suprahepatic vein. Diabetic rats (blood glucose, 300-350 mg/dl presented low (P<0.05 erythrocyte glycogen content, i.e., 9.6 ± 0.1 and 7.1 ± 0.7 µg/g Hb in the femoral artery and vein, respectively, and 10.0 ± 0.7 and 10.7 ± 0.5 in the portal and suprahepatic veins, respectively. After 10 days of treatment, phenobarbital (0.5 mg/ml in the drinking water did not change blood glucose or erythrocyte glycogen content in control rats. In diabetic rats, however, it lowered (P<0.05 blood glucose in the femoral artery (from 305 ± 18 to 204 ± 45 mg/dl and femoral vein (from 300 ± 11 to 174 ± 48 mg/dl and suprahepatic vein (from 350 ± 10 to 174 ± 42 mg/dl, but the reduction was not sufficient for complete recovery. Phenobarbital also stimulated the glycogen synthesis, leading to a partial recovery of glycogen stores in erythrocytes. In treated rats, erythrocyte glycogen content increased to 20.7 ± 3.8 µg/g Hb in the femoral artery and 30.9 ± 0.9 µg/g Hb in the suprahepatic vein (P<0.05. These data indicate that phenobarbital activated some of the insulin-stimulated glucose metabolism steps which were

Association of obesity and treated hypertension and diabetes with cognitive ability in bipolar disorder and schizophrenia.

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Depp, Colin A; Strassnig, Martin; Mausbach, Brent T; Bowie, Christopher R; Wolyniec, Paula; Thornquist, Mary H; Luke, James R; McGrath, John A; Pulver, Ann E; Patterson, Thomas L; Harvey, Philip D

2014-06-01

People with bipolar disorder or schizophrenia are at greater risk for obesity and other cardio-metabolic risk factors, and several prior studies have linked these risk factors to poorer cognitive ability. In a large ethnically homogenous outpatient sample, we examined associations among variables related to obesity, treated hypertension and/or diabetes and cognitive abilities in these two patient populations. In a study cohort of outpatients with either bipolar disorder (n = 341) or schizophrenia (n = 417), we investigated the association of self-reported body mass index and current use of medications for hypertension or diabetes with performance on a comprehensive neurocognitive battery. We examined sociodemographic and clinical factors as potential covariates. Patients with bipolar disorder were less likely to be overweight or obese than patients with schizophrenia, and also less likely to be prescribed medication for hypertension or diabetes. However, obesity and treated hypertension were associated with worse global cognitive ability in bipolar disorder (as well as with poorer performance on individual tests of processing speed, reasoning/problem-solving, and sustained attention), with no such relationships observed in schizophrenia. Obesity was not associated with symptom severity in either group. Although less prevalent in bipolar disorder compared to schizophrenia, obesity was associated with substantially worse cognitive performance in bipolar disorder. This association was independent of symptom severity and not present in schizophrenia. Better understanding of the mechanisms and management of obesity may aid in efforts to preserve cognitive health in bipolar disorder. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Survival in dialysis patients is not different between patients with diabetes as primary renal disease and patients with diabetes as a co-morbid condition

NARCIS (Netherlands)

Schroijen, Marielle A.; Dekkers, Olaf M.; Grootendorst, Diana C.; Noordzij, Marlies; Romijn, Johannes A.; Krediet, Raymond T.; Boeschoten, Elisabeth W.; Dekker, Friedo W.; Apperloo, A. J.; Bijlsma, J. A.; Boekhout, M.; Boer, W. H.; van der Boog, P. J. M.; Büller, H. R.; van Buren, M.; de Charro, F. Th; Doorenbos, C. J.; van den Dorpel, M. A.; van Es, A.; Fagel, W. J.; Feith, G. W.; de Fijter, C. W. H.; Frenken, L. A. M.; van Geelen, J. A. C. A.; Gerlag, P. G. G.; Gorgels, J. P. M. C.; Grave, W.; Huisman, R. M.; Jager, K. J.; Jie, K.; Koning-Mulder, W. A. H.; Koolen, M. I.; Kremer Hovinga, T. K.; Lavrijssen, A. T. J.; Luik, A. J.; van der Meulen, J.; Parlevliet, K. J.; Raasveld, M. H. M.; van der Sande, F. M.; Schonck, M. J. M.; Schuurmans, M. M. J.; Siegert, C. E. H.; Stegeman, C. A.; Stevens, P.; Thijssen, J. G. P.; Valentijn, R. M.; Vastenburg, G. H.; Verburgh, C. A.; Vincent, H. H.; Vos, P. F.

2011-01-01

On dialysis, survival among patients with diabetes mellitus is inferior to survival of non-diabetic patients. We hypothesized that patients with diabetes as primary renal disease have worse survival compared to patients with diabetes as a co-morbid condition and aimed to compare all-cause mortality

Insulin therapy does not interfere with venous endothelial function evaluation in patients with type 2 diabetes mellitus

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Antônio Marcos Vargas da Silva

2010-01-01

Full Text Available INTRODUCTION: Endothelium-dependent dilation is improved in insulin-treated diabetic patients, but this effect is probably due to improved glycemic control. The objective of the present study was to compare endothelium-dependent dilation in patients with well-controlled type 2 diabetes who are or are not using insulin as part of their therapy. METHODS: We studied 27 patients with type 2 diabetes (11 women, 60.3 years ± 6 years, with HbA1c < 7% and no nephropathy, including 16 patients treated with anti-diabetic agents (No-Ins, 8 women and 11 patients treated with insulin alone or in combination with anti-diabetic agents (Ins, 3 women. Endothelial function was evaluated by the dorsal hand vein technique, which measures changes in vein diameter in response to phenylephrine, acetylcholine (endothelium-dependent vasodilation and sodium nitroprusside (endothelium-independent vasodilation. RESULTS: Age, systolic blood pressure (No-Ins: 129.4 mmHg ± 11.8 mmHg, Ins: 134.8 mmHg ± 12.0 mmHg; P= 0.257, HbA1c, lipids and urinary albumin excretion rate [No-Ins: 9 mg/24 h (0-14.1 mg/24 h vs. Ins: 10.6 mg/24 h (7.5-14.4 mg/24 h, P=0.398] were similar between groups. There was no difference between endothelium-dependent vasodilation of the No-Ins group (59.3% ± 26.5% vs. the Ins group (54.0% ± 16.3%; P=0.526. Endothelium-independent vasodilation was also similar between the No-Ins (113.7% ± 35.3% and Ins groups (111.9% ± 28.5%; P=0.888. CONCLUSIONS: Subcutaneous insulin therapy does not interfere with venous endothelial function in type 2 diabetes when glycemic and blood pressure control are stable.

Insulin therapy does not interfere with venous endothelial function evaluation in patients with type 2 diabetes mellitus.

Science.gov (United States)

Silva, Antônio Marcos Vargas da; Penno, Luciana de Moraes; Bertoluci, Marcello Casaccia; Irigoyen, Maria Cláudia; Schaan, Beatriz D'Agord

2010-01-01

Endothelium-dependent dilation is improved in insulin-treated diabetic patients, but this effect is probably due to improved glycemic control. The objective of the present study was to compare endothelium-dependent dilation in patients with well-controlled type 2 diabetes who are or are not using insulin as part of their therapy. We studied 27 patients with type 2 diabetes (11 women, 60.3 years ± 6 years, with HbA1c < 7% and no nephropathy), including 16 patients treated with anti-diabetic agents (No-Ins, 8 women) and 11 patients treated with insulin alone or in combination with anti-diabetic agents (Ins, 3 women). Endothelial function was evaluated by the dorsal hand vein technique, which measures changes in vein diameter in response to phenylephrine, acetylcholine (endothelium-dependent vasodilation) and sodium nitroprusside (endothelium-independent vasodilation). Age, systolic blood pressure (No-Ins: 129.4 mmHg ± 11.8 mmHg, Ins: 134.8 mmHg ± 12.0 mmHg; P= 0.257), HbA1c, lipids and urinary albumin excretion rate [No-Ins: 9 mg/24 h (0-14.1 mg/24 h) vs. Ins: 10.6 mg/24 h (7.5-14.4 mg/24 h), P=0.398] were similar between groups. There was no difference between endothelium-dependent vasodilation of the No-Ins group (59.3% ± 26.5%) vs. the Ins group (54.0% ± 16.3%; P=0.526). Endothelium-independent vasodilation was also similar between the No-Ins (113.7% ± 35.3%) and Ins groups (111.9% ± 28.5%; P=0.888). Subcutaneous insulin therapy does not interfere with venous endothelial function in type 2 diabetes when glycemic and blood pressure control are stable.

Clinical observation of intravitreal injection of Conbercept treating diabetic macularedema

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Li Jiang

2017-06-01

Full Text Available AIM: To observe the clinical efficiency of intravitreal conbercept on diabetic macular edema(DME. METHODS: This was a single arm, open-babel prospective study. Twenty eyes from 20 patients(12 males and 8 femaleswith DME diagnosed by fundus fluorescein angiography(FFAand optical coherence tomography(OCTwere enrolled. Before the injection, best-corrected visual acuity(BCVAof early treatment of diabetic retinopathy study(ETDRS, non-contact tonometer, ophthalmoscope, fundus photography, fundus fluoresein angiograph(FFA, and OCT were examined. All affected eyes were treated with intravitreal conbercept 0.05mL(10mg/mL. Patients were followed up for 6 to 11mo, with a mean duration of 8.55±1.96mo. Post-treatment BCVA, CMT, leakage of macular edema and complications were compared with baseline using repeat analysis. RESULTS: The initial average visual acuity(ETDRS letterswere 43.35±17.45, range from 9 to 70. The initial average central macular thickness(CMTwas 576.30±167.92μm, range from 337 to 987μm. The mean BCVA showed significant improvement during 1, 3, 6mo post-treatment and the latest follow up, with a mean increase of 11.2±5.9, 13.8±7.9, 15.7±6.8 and 14.7±8.6, respectively(PPPPCONCLUSION: Intravitreal conbercept significantly improve visual acuity and macular edema exudation.

Adiponectin, Leptin, and Leptin Receptor in Obese Patients with Type 2 Diabetes Treated with Insulin Detemir

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Paweł Olczyk

2017-07-01

Full Text Available The aim of the present study is to quantitatively assess the expression of selected regulatory molecules, such as leptin, leptin receptor, and adiponectin in the blood of obese patients with type 2 diabetes both before treatment and after six months of pharmacological therapy with the long-lasting insulin analogue, insulin detemir. A significant decrease in the analysed regulatory molecules, i.e., leptin receptor and adiponectin, was found in blood plasma of the patients with untreated type 2 diabetes. These changes were accompanied by an increase in plasma leptin concentrations. Insulin treatment resulted in the normalization of plasma leptin receptor and adiponectin concentrations. The circulating leptin level did not change following anti-diabetic therapy with insulin detemir. Gender was a significant factor modifying the circulating level of all the analysed regulatory active compounds. Bioinformatic analysis was performed using Matlab with the Signal Processing Toolbox. The conducted discriminant analysis revealed that the leptin receptor, Δw(19, and adiponectin, Δw(21, were the parameters undergoing the most significant quantitative changes during the six-month therapy with insulin detemir. The conducted examinations indicated the contribution of adipocytokines—the biologically-active mediators of systemic metabolism, such as leptin and adiponectin in the pathomechanism of disorders being the basis for obesity which leads to development of insulin resistance, which, in turn, results in the occurrence of type 2 diabetes.

Oral hypoglycaemic agents in 118 diabetic pregnancies

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Hellmuth, E; Damm, P; Mølsted-Pedersen, L

2000-01-01

AIMS: To assess maternal and neonatal complications in pregnancies of diabetic women treated with oral hypoglycaemic agents during pregnancy. METHODS: A cohort study including all consecutively registered, orally treated pregnant diabetic patients set in a diabetic obstetrical service...... at a university hospital: 50 women treated with metformin, 68 women treated with sulphonylurea during pregnancy and a reference group of 42 diabetic women treated with insulin during pregnancy. RESULTS: The prevalence of pre-eclampsia was significantly increased in the group of women treated with metformin...

Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

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M.C. Boelter

2006-08-01

Full Text Available Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001. Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001, insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001 and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011 were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001 was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002 remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

Metformin treatment in type 2 diabetes in pregnancy: an active controlled, parallel-group, randomized, open label study in patients with type 2 diabetes in pregnancy.

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Ainuddin, Jahan Ara; Karim, Nasim; Zaheer, Sidra; Ali, Syed Sanwer; Hasan, Anjum Ara

2015-01-01

To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycemic control. The patients were followed up till delivery. Maternal, and perinatal outcomes and pharmacotherapeutic characteristics were recorded on a proforma. Maternal characteristics were comparable in metformin and insulin treated group. 84.9% patients in metformin group required add-on insulin therapy at mean gestational age of 26.58 ± 3.85 weeks. Less maternal weight gain (P pregnancy induced hypertension (P = 0.029) were observed in metformin treated group. Small for date babies were more in metformin group (P 24 hours in metformin group (P metformin group. Metformin alone or with add-on insulin is an effective and cheap treatment option for patients with type 2 diabetes in pregnancy. This trial is registered with clinical trial registration number: Clinical trials.gov NCT01855763.

Low Irisin Levels in Patients with Type 2 Diabetes Mellitus without Current Treatment: A Systematic Review

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Jaqueline Pinheiro de Alencar

2017-05-01

Full Text Available Background: The Irisin is a myokine associated with the improvement on insulin resistance caused by diet and increased physical energy expenditure. Recent studies have shown that patients with Type 2 Diabetes Mellitus (T2DM have reduced levels of irisin, showing it as a potential marker for various endocrine and cardiovascular diseases. This study aimed to verify if T2DM patients never treated or without ongoing treatment have reduced levels of irisin when compared to individuals with other metabolic profiles. Methods and Findings: Systematic review of the literature, considering the primary studies published in 2012 to 2016, with the outcome Irisin levels in patients never treated or without current treatment in the ambience of Type 2 Diabetes Mellitus. The search was conducted through the electronic database Scopus (Elsevier, using the key words: "Irisin", "Human" and "Diabetes Mellitus". From the 91 studies found, 8 met the eligibility criteria. Significant differences were found on levels of irisin in patients with T2DM compared to normoglycemic individuals, obese and/or pre-diabetic. On average, there was a reduction of 15 pg/ml in plasma levels of irisin in diabetics. However, a minority of studies says that this relationship does not exist. Conclusion: Irisin reduced levels were found in patients with T2DM and is also related to lipid profile, with the risk of developing endocrine diseases, such as diabetes and obesity, and high risk for cardiovascular diseases because of its relationship with endothelial dysfunction. This generates the need for research in order to explore the isolation and clinical use of irisin for treatment of disorders related to imbalance in energy demand, obesity and diabetes. Descriptors: Irisin, Human, Diabetes Mellitus.

Relationship between Optimum Mini-doses of Glucagon and Insulin Levels when Treating Mild Hypoglycaemia in Patients with Type 1 Diabetes - A Simulation Study

DEFF Research Database (Denmark)

Ranjan, Ajenthen; Wendt, Sabrina Lyngbye; Schmidt, Signe

2017-01-01

-treated type 1 diabetes. In each simulation, one of ten different and individualized subcutaneous insulin boluses was administered to decrease plasma glucose (PG) from 7.0 to ≤3.9 mmol/l. Insulin levels were estimated as ratio of actual to baseline serum insulin concentration (se/ba-insulin), insulin on board...... (IOB) or percentage of IOB to total daily insulin dose (IOB/TDD). Insulin bolus sizes were chosen to provide pre-defined insulin levels when PG reached 3.9 mmol/l, where one of 17 subcutaneous glucagon boluses was administered. Optimum glucagon bolus to treat mild hypoglycaemia at varying insulin...... levels was the lowest dose that in most patients caused PG peak between 5.0 and 10.0 mmol/l and sustained PG ≥ 3.9 mmol/l for 2 hr after the bolus. PG response to glucagon declined with increasing insulin levels. The glucagon dose to optimally treat mild hypoglycaemia depended exponentially on insulin...

Apolipoprotein(a) in insulin-dependent diabetic patients with and without diabetic nephropathy

DEFF Research Database (Denmark)

Gall, M A; Rossing, P; Hommel, E

1992-01-01

Insulin-dependent diabetic patients with diabetic nephropathy have a highly increased morbidity and mortality from cardiovascular diseases. To determine whether altered levels of apolipoprotein(a) (apo(a)), the glycoprotein of the potentially atherogenic lipoprotein(a) (Lp(a)), contribute...... to the increased risk of ischaemic heart disease, apo(a) was determined in 50 insulin-dependent diabetic patients with diabetic nephropathy (group 1), in 50 insulin-dependent diabetic patients with microalbuminuria (group 2), in 50 insulin-dependent diabetic patients with normoalbuminuria (group 3), and in 50...... healthy subjects (group 4). The groups were matched with regard to sex, age and body mass index. The diabetic groups were also matched with regard to diabetes duration. The level of apo(a) was approximately the same in the four groups, being: 122 (x/ divided by 4.2) U l-1, 63 (x/ divided by 4.4) U l-1...

Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

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Yan Gao

2015-04-01

Full Text Available AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy (PDR, an advanced stage of diabetic retinopathy (DR, using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy. METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR (NDR group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I Test, and corneal fluorescein staining. The non-invasive tear film break-up time (NIBUT and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy. RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls (P< 0.001. The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls (P < 0.001. Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover, significant decrease in the corneal epithelial density and morphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients. CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores, and the density of corneal epithelial cells and nerve fibers in the diabetic

Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

Institute of Scientific and Technical Information of China (English)

Yan; Gao; Yan; Zhang; Yu-Sha; Ru; Xiao-Wu; Wang; Ji-Zhong; Yang; Chun-Hui; Li; Hong-Xing; Wang; Xiao-Rong; Li; Bing; Li

2015-01-01

AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P <0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P <0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the

Choroidal thickness alterations in diabetic nephropathy patients with early or no diabetic retinopathy.

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Kocasarac, Can; Yigit, Yavuz; Sengul, Erkan; Sakalar, Yildirim Beyazit

2018-04-01

To assess changes in choroidal thickness (CT) in diabetes patients with and without diabetic nephropathy using enhanced depth imaging spectral domain optical coherence tomography (EDI-OCT). Thirty-five type 2 diabetes patients with a diagnosis of diabetic nephropathy (DNP) in nephrology department and 35 type 2 diabetes patients without nephropathy (non-DNP) were included in our prospective study consecutively. The control group comprised 34 healthy individuals. CT measurements were recorded under the fovea and at 1500 µm from the foveal center in the nasal and temporal sides. The study parameters also included age, refractive error, axial length, intraocular pressure, HbA1c, glomerular filtration rate and proteinuria amount. The subfoveal, temporal and nasal choroidal thickness was noted to be thinner in patients with DNP compared with non-DNP and normal subjects (p diabetic patients when diabetic nephropathy accompanies diabetes mellitus.

Efficacy of Aloe Vera Supplementation on Prediabetes and Early Non-Treated Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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Zhang, Yiyi; Liu, Wen; Liu, Dan; Zhao, Tieyun; Tian, Haoming

2016-06-23

The aim of this study was to evaluate evidence for the efficacy of aloe vera on managing prediabetes and early non-treated diabetes mellitus. We performed a systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials until 28 January 2016. A total of five randomized controlled trials (RCTs) involving 415 participants were included. Compared with the controls, aloe vera supplementation significantly reduced the concentrations of fasting blood glucose (FBG) (p = 0.02; weighed mean difference [WMD]: -30.05 mg/dL; 95% confidence interval [CI]: -54.87 to -5.23 mg/dL), glycosylated hemoglobin A1c (HbA1c) (p Aloe vera was superior to placebo in increasing serum high density lipoprotein-cholesterol (HDL-C) levels (p = 0.04). Only one adverse event was reported. The evidence from RCTs showed that aloe vera might effectively reduce the levels of FBG, HbA1c, triglyceride, TC and LDL-C, and increase the levels of HDL-C on prediabetes and early non-treated diabetic patients. Limited evidence exists about the safety of aloe vera. Given the small number and poor quality of RCTs included in the meta-analysis, these results are inconclusive. A large-scale, well-designed RCT is needed to further address this issue.

Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes

DEFF Research Database (Denmark)

Khunti, K.; Alsifri, S; Aronson, R

2016-01-01

study using self-assessment questionnaire and patient diaries included 27 585 patients, aged ≥18 years, with type 1 diabetes (T1D; n = 8022) or type 2 diabetes (T2D; n = 19 563) treated with insulin for >12 months, at 2004 sites in 24 countries worldwide. The primary endpoint was the proportion......AIMS: To determine the global extent of hypoglycaemia experienced by patients with diabetes using insulin, as there is a lack of data on the prevalence of hypoglycaemia in developed and developing countries. METHODS: This non-interventional, multicentre, 6-month retrospective and 4-week prospective...... of patients experiencing at least one hypoglycaemic event during the observational period. RESULTS: During the prospective period, 83.0% of patients with T1D and 46.5% of patients with T2D reported hypoglycaemia. Rates of any, nocturnal and severe hypoglycaemia were 73.3 [95% confidence interval (CI) 72...

Effect of GLP-1 receptor agonist treatment on body weight in obese antipsychotic-treated patients with schizophrenia

DEFF Research Database (Denmark)

Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V

2017-01-01

and placebo groups experienced significant ( P  = .004), however similar ( P  = .98), weight losses of 2.24 ± 3.3 and 2.23 ± 4.4 kg, respectively, after 3 months of treatment. CONCLUSIONS: Treatment with exenatide once-weekly did not promote weight loss in obese, antipsychotic-treated patients......AIMS: Schizophrenia is associated with cardiovascular co-morbidity and a reduced life-expectancy of up to 20 years. Antipsychotics are dopamine D2 receptor antagonists and are the standard of medical care in schizophrenia, but the drugs are associated with severe metabolic side effects...... such as obesity and diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are registered for treatment of both obesity and type 2 diabetes. We investigated metabolic effects of the GLP-1RA, exenatide once-weekly, in non-diabetic, antipsychotic-treated, obese patients with schizophrenia. MATERIAL...

Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries.

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Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund; Lahtela, Jorma; Jensen, Marie Markert; Östenson, Claes-Göran

2013-12-01

Hypoglycemia is a frequent side effect induced by insulin treatment of type 1 (T1DM) and type 2 diabetes (T2DM). Limited data exist on the associated healthcare resource use and patient impact of hypoglycemia, particularly at a country-specific level. This study investigated the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics, NSHE occurrence in the last 7 days, hypoglycemia-related resource use, and patient impact. NSHE were defined as events with hypoglycemia symptoms, with or without blood glucose measurement, or low blood glucose measurement without symptoms, which the patient could manage without third-party assistance. Three thousand, nine hundred and fifty-nine respondents completed at least one wave of the survey, with 57% completing all four questionnaires; 3827 respondents were used for data analyses. Overall, 2.3% and 8.9% of NSHE in patients with T1DM and T2DM, respectively, resulted in healthcare professional contact. Across countries, there was a mean increase in blood glucose test use of 3.0 tests in the week following a NSHE. Among respondents who were employed (48%), loss of work-time after the last hypoglycemic event was reported for 9.7% of NSHE. Overall, 10.2% (daytime) and 8.0% (nocturnal) NSHE led to work-time loss, with a mean loss of 84.3 (daytime) and 169.6 (nocturnal) minutes among patients reporting work-time loss. Additionally, patients reported feeling tired, irritable, and having negative feelings following hypoglycemia. Direct comparisons between studies must be interpreted with caution because of different definitions of hypoglycemia severity, duration of the studies, and methods of data collection. NSHE were associated with use of extra healthcare resources and work-time loss in all

Influence of preoperative artificial tears on tear film after phacoemulsification on dry eye of diabetes patients

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Rui Su

2015-05-01

Full Text Available AIM: To discuss the artificial tears on the tear film of diabetic patients with dry eye preoperatively, and the influence on the tear film's fuctional after phacoemulsification.METHODS: Fifty-four diabetic patients with dry eye(60 eyeswere followed up before phacoemulsification. Preoperatively, group A(30 eyes in 28 caseswas treated with Hydroxyl Indican eye drops and group B(30 eyes in 26 caseswas not treated. Postoperatively, both group A and B were treated with Tobramycin Dexamethasone eye drops, Oprah Winfrey Ibuprofen eye drops and Hydroxyl Indican eye drops. Dry eye symptoms, break up time(BUT, Schirmer Ⅰ test(S Ⅰ t, fluorescein stain test(FIwere measured at 3d preoperatively, and 1, 7, 30, 90d postoperatively.RESULTS: At 3d preoperatively, there was no statistical differences between the two groups for dry eye symptoms, BUT, SⅠt, FI(P>0.05. At 1 and 7d postoperatively, there were significant statistical differents between the two groups for dry eye symptoms(PPP>0.05.CONCLUSION: Using artificial tears before phacoemulsification can improve symptoms of the diabetic patients with dry eye and accelerate the recovery of the tear film.

[Pregnant diabetic patients: institutional experience].

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Gutiérrez Gutiérrez, Héctor Israel; Carrillo Iñiguez, Mayra Judith; Pestaña Mendoza, Silvia; Santamaría Ferreira, Mauricio

2006-04-01

Diabetes mellitus complicates 3-5% of all pregnancies and is a major cause of perinatal morbidity and mortality. The diet and insulin have revolutionized the care related with pregnancy complicated by diabetes mellitus. To report the management experience in patients with diabetes and pregnancy at the Instituto Materno Infantil, Estado de Mexico. A descriptive, retrospective, observational and cross-sectional study of pregnant women with diabetes and pregnancy was conducted from 2003 to 2004. We included 55 pregnant women who had: gestational diabetes 30 (54.4%), pregestational diabetes 24 (43.6%), and carbohydrate intolerance 1 (1.8%); every one of them were controlled either with diet, insulin or both. The mean age was 30.6, 80% with family history of type 2 diabetes mellitus, 9% gestational diabetes. Gestational diabetes was diagnosed in 33.3% by abnormal 50 g glucose screening and 46.6% with oral glucose tolerance test (OGTT). The main complications among the patients were urinary disease (61.3%) and the major fetal malformation were those related with cardiovascular disease (9.09%). The most frequent mode of delivery was cesarean section (58%) and birth weight was of 3,146 g. The main risk factors identified among women in the study group were as follow: More than 25 years of age and family history of diabetes mellitus. We observed a progressive increase in the insulin dosage. The most consistent complications among the patients were urinary infection and the major fetal malformation was cardiovascular disease.

The effect of peer support in adults with insulin pump-treated type 1 diabetes

DEFF Research Database (Denmark)

Joensen, Lene Eide; Meldgaard Andersen, Merete; Jensen, Sabrina

2017-01-01

Aim: The aim of this study was to explore the effects of a flexible and participatory peer support intervention in a clinical setting for adults with type 1 diabetes treated with an insulin pump, focusing on enhancing diabetes-specific social capital. The key questions were as follows: 1) what...... empowerment, diabetes distress, diabetes-specific social support, and diabetes loneliness. HbA1c levels were compared before and after the intervention. Results: Participants experienced enhanced diabetes-specific social capital, diabetes motivation, awareness of personal diabetes practices, and serenity...

Localized changes in Retinal Vessel Caliber after focal/grid laser treatment in Patients with Diabetic Macular Edema

DEFF Research Database (Denmark)

Lundberg, Lars Kristian; Kawasaki, Ryo; Sjølie, Anne K

2013-01-01

PURPOSE:: To compare retinal vessel caliber changes at the macula region and surrounding the optic disk after focal/grid laser treatment for diabetic macular edema. METHODS:: The study included 69 eyes from 46 patients treated with focal/grid laser for diabetic macular edema. Retinal photographs...

Prevalence of Diabetes Type 1 in Patients Suffered From Multiple Sclerosis

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Dayer

2016-04-01

Full Text Available Background Because IL2RA is considered a predisposing factor in the incidence of both type I diabetes and multiple sclerosis (MS, and considering that both are autoimmune diseases, some studies suggest a correlation between type I diabetes and MS. Objectives The aim of this study was to examine the prevalence of type I diabetes among people with MS. Patients and Methods The study subjects comprised 100 patients with MS from the Khuzestan multiple sclerosis center at rehabilitation school of Jundishapur University of Medical Sciences, whose diagnosis of MS had been confirmed by a specialist, and were not being treated with steroids. Subjects were selected from patients younger than 30 years old. After filling out an application form, 5 mL fasting venous blood and 5 mL after 2 hours were taken. The blood glucose level was measured with a kit (Zist Shimi using the enzymatic method. Results The mean age of the participants was 24.28 years. The rate of type I diabetes was equal to 4% of the total sample, while 18% of all patients had impaired fasting glucose. Conclusions Given the high level of impaired fasting glucose among patients in this study, it is likely that MS provides the basis for the incidence of glucose metabolism disorders. To prove this, further studies with larger sample sizes are required.

Diabetic patients: Psychological aspects.

Science.gov (United States)

Adili, Fatemeh; Larijani, Bagher; Haghighatpanah, Mohammadreza

2006-11-01

This study was undertaken to consider the psychological aspect of diabetes with regard to improving clinical outcomes. The review was limited to literature reports on the causes, solutions, and treatments of some common psychological problems known to complicate diabetes management. A literature search was undertaken using Pub-Med, CINAHL, Proquest, Elsevier, Blackwell Synergy, Ovid, Ebsco, Rose net, and Google websites, including studies published in English journals between 1995 and 2006. Therefore about 88 articles were selected based on the inclusion criteria. In earlier studies, relatively little empirical research was found to substantiate the effect of psychological counseling in complicated diabetes. The greatest deficits were seen in areas of mental health, self-esteem parent impact, and family cohesion. There were some different factors, which influence the psychological aspect of diabetic patients, such as age, gender, place of living, familial and social support, motivation, energy, life satisfaction, and lifestyle. There are various types of solutions for coping with the psychological problems in diabetic clients. The most essential solution lies in educating the patients and healthcare providers on the subject. Before initiating each educational intervention, a thorough assessment would be crucial. Treatment plans may benefit from cognitive behavior therapy (CBT), behavior family therapy, improving family communication, problem-solving skills, and providing motivation for diabetic patients. Moreover, it seems that the close collaboration between diabetologists and psychologists would be fruitful.

Gallbladder function in diabetic patients

International Nuclear Information System (INIS)

Shreiner, D.P.; Sarva, R.P.; Van Thiel, D.; Yingvorapant, N.

1986-01-01

Gallbladder emptying and filling was studied in eight diabetic and six normal control patients. None of the patients had gallstones. Cholescintigraphy was performed using [/sup 99m/Tc]disofenin, and gallbladder emptying was studied using a 45-min i.v. infusion of the octapeptide of cholecystokinin (OP-CCK) 20 ng/kg X hr. The peak filling rate was greater in diabetic than in normal subjects; however, emptying of the gallbladder in response to OP-CCK was significantly less in the diabetic subjects (51.6 +/- 10.4% compared with 77.2 +/- 4.9%). When the diabetic group was subdivided into obese and nonobese diabetics, the obese diabetics had a much lower percentage of emptying than the nonobese diabetics (30.0 +/- 10.4% compared with 73.1 +/- 9.3%). These findings suggest that obese diabetics may have impaired emptying of the gallbladder even in the absence of gallstones. The more rapid rate of gallbladder filling in obesity may indicate hypotonicity of the gallbladder. The combination of these abnormalities may predispose the obese diabetic to the development of gallstones

Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients

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Afkhami-Ardekani Mohammad

2008-06-01

Full Text Available Abstract Background This study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR in type 2 diabetic patients and their contributing factors. Methods 199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break up time tests and Schirmer. All the subjects underwent indirect ophthalmoscopy and retinal color photography. DR was graded according to early Treatment Diabetic Retinopathy (ETDRS criteria. Results Of 199 subjects, 108 patients (54.3% suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. But there was significantly association between dry eye syndrome and duration of diabetes (P = 0.01. Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.02. DR was found in 140 patients (70.35%, which included 34 patients (17.1% with mild non proliferative DR (NPDR, 34 patients (17.1% with moderate NPDR, 22 patients (11.1% with severe NPDR and 25 patients (25.1% with proliferative DR (PDR. There were significant relation between age, sex and duration of diabetes and DR. Conclusion In this study the prevalence of dry eye syndrome was 54.3%. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease.

Diabetic Retinopathy Awareness among Diabetic Patients Attending COMS-TH.

Science.gov (United States)

Dahal, P; Adhikari, H

Background Diabetic retinopathy (DR) is one of the leading causes of blindness in Nepal. Objective The main objective of the study is to know the awareness of diabetic retinopathy among new cases of diabetes mellitus (DM) attending the college of medical science- teaching hospital, Bharatpur, Nepal. Method All the diabetic cases referred for ophthalmic consultation and also referred outpatient department cases from other departments to ophthalmic outpatient department was carried out. Detailed demographics of the subjects and their awareness of potential ocular problems from diabetes mellitus were noted. Result Total one hundred and thirty-one patients were enrolled during the study period from 15 November 2016 to 15 May 2017. Brahmin 39.69% and 19.08% Mongolian were the most predominant ethnical group. The predominant group of patients were housewives (41.22%) then followed by service (19.85%), business (13.74%), agriculture (12.21%), others (12.98%). Among 36.64% of the literate patients, 19.85% had passed school level, 9.92% had passed intermediate level, 88.55% were aware of Diabetic retinopathy. Among them majority 88.55% were referred by physician. Family history were present in 35.68% and fundus evaluation was done for the first time in almost half of diabetic cases (64.12%) and diabetic retinopathy was found in 32.06% of total cases in right eye and 30.53% of total cases in left eye. Conclusion Along with the awareness, routine dilated fundoscopy is mandatory for slight threating stage of retinopathy and to reduce the burden of blindness from diabetic retinopathy in Nepal.

Surgical Site Infection in Diabetic and Non-Diabetic Patients Undergoing Laparoscopic Cholecystectomy

International Nuclear Information System (INIS)

Butt, U. I.; Khan, A.; Nawaz, A.; Mansoor, R.; Malik, A. A.; Sher, F.; Ayyaz, M.

2016-01-01

Objective: To compare the frequency of surgical site infections in patients with type II diabetes undergoing laparoscopic cholecystectomy as compared with non-diabetic patients. Study Design: Cohort study. Place and Duration of Study: Surgical Unit 2, Services Hospital, Lahore, from May to October 2012. Methodology: Patients were divided into two groups of 60 each, undergoing laparoscopic cholecystectomy. Group A comprised non-diabetic patients and group B comprised type II diabetic patients. Patients were followed postoperatively upto one month for the development of SSIs. Proportion of patients with surgical site infections or otherwise was compared between the groups using chi-square test with significance of p < 0.05. Results: In group A, 35 patients were above the age of 40 years. In group B, 38 patients were above the age of 40 years. Four patients in group A developed a surgical site infection. Seven patients in group B developed SSIs (p = 0.07). Conclusion: Presence of diabetes mellitus did not significantly affect the onset of surgical site infection in patients undergoing laparoscopic cholecystectomy. (author)

The diabetic patient in Ramadan.

Science.gov (United States)

Chamsi-Pasha, Hassan; Aljabri, Khalid S

2014-04-01

During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan.

Relation of retinopathy in patients with type 2 diabetes mellitus to other diabetic complications

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Shu-Hui Chen

2016-02-01

Full Text Available AIM: To investigate the correlation between systemic complications and diabetic retinopathy in the patients with type 2 diabetes mellitus.METHODS: Seven hundred and two hospitalized patients with type 2 diabetes were included. All patients were divided into two groups according to with or without retinopathy: NDR group and DR group. DR group was divided into group non-proliferative diabetic retinopathy(NPDRand group proliferative diabetic retinopathy(PDR. The relation between DR and other complications of diabetes, including diabetic macrovascular complications, diabetic nephropathy(DN, diabetic peripheral neuropathy(DPN, peripheral vascular disease of diabetes mellitus(PVD, diabetic foot(DF, diabetic ketoacidosis(DKA, was analyzed.RESULTS: The development of DR was related to hypertension, hyperlipemia, carotid atherosclerosis and plaque, lower extremity arteriosclerosis and plaque, DN, DPN, DF and PVD. PDR was closely associated with hypertension and DPN. CONCLUSION: The prevalence of DR increased in the diabetic patients with systemic complications, especially, the increase of prevalence of PDR in the patients with hypertension and DPN. Vascular endothelial injury and microcirculatory disturbance are the common pathologic base for DR and other complications. Therefore, it is important to carry out the regular fundus examination in the diabetic patients, especially in those with systemic complication, in order to decrease the rate of blindness.

IL-1 receptor antagonism and muscle gene expression in patients with type 2 diabetes

DEFF Research Database (Denmark)

Berchtold, L. A.; Larsen, C. M.; Vaag, A.

2009-01-01

). To investigate the effects of IL-1Ra in insulin-sensitive tissue, gene expression levels in skeletal muscle from type 2 diabetic patients treated with IL-1Ra were analysed. Methods. Gene expression profiles in vastus lateralis muscle biopsies from five obese patients (BMI>27) were determined before and after 13......RT-PCR, were significantly altered when comparing the number of transcripts before and after treatment for each individual. Conclusion. Treatment with IL-1Ra did not significantly affect gene expression levels in skeletal muscle in this limited and selected sample of obese patients with type 2 diabetes. Larger...

A Case Report of Rare Tracheal Mucormycosis in a Diabetic Patient

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M Parham

2012-05-01

Full Text Available

Background and Objectives: Mucormycosis is a systemic killer fungal disease in diabetes resulting in immune deficiency and malignancies that can lead to death if left untreated. Its treatment includes eliminating background diseases, performing surgery, and using anti- fungal drugs such as Amphotripcin B. The aim of this study was to report a Tracheal Mucormycosis which was treated with surgery and anti- fungal drug.

Case Report

The patient was a diabetic woman that had referred to the hospital complaining of dyspnea, nausea and vomiting. She had been suffering from fever, dyspnea, and vomiting for two weeks. She went to a public care center and was treated with Ceftriacxon, Dexamethasone and Diphenhydramin. Despite this treatment, her problem worsened, so she referred to the hospital again. On admission, she was suffering from fever, respiratory distress, tachycardia and tachypenea. Epiglottis was edematous and Erythematous. Diabetic ketoacidosis was diagnosed based on her laboratory tests. Because of worsening of the respiratory distress, tracheostomy was performed. Diagnostic Bronchoscopy and biopsy were on done on the patient on the second day of her admission and Mucormycosis was reported by the pathologist.

Effect of the dual endothelin receptor antagonist bosentan on untreatable skin ulcers in a patient with diabetes: a case report

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Brito Suárez Manuel

2011-04-01

Full Text Available Abstract Introduction Refractory skin ulcers are a major burden in patients with diabetes. Their pathogenesis is multifactorial, and data increasingly implicate endothelin as a mediator of diabetic macro- and microvasculopathy. Here we describe the first reported case of an endothelin receptor antagonist being used to successfully treat refractory skin ulcers in a patient with diabetes. Case presentation An 85-year-old Caucasian man with a 30-year history of type 2 diabetes developed multiple skin ulcerations, including a right heel ulcer. Despite appropriate treatment, the ulcer showed little improvement and the risk of amputation was high. The patient was treated with the dual endothelin receptor antagonist bosentan. After three weeks of treatment, major improvements were observed, and after 21 weeks, all ulcers had healed. No abnormalities were observed during monitoring of blood pressure, erythrocyte sedimentation rate or serum aminotransferase levels. Conclusion In patients with refractory ulceration associated with diabetes, bosentan may be of real benefit, especially in terms of amputation prevention. This case supports the proposed role for endothelin in the pathogenesis of skin ulceration in diabetes and is suggestive of a potential benefit of bosentan in this patient type. This case report is of interest to diabetologists and dermatologists.

Anti-Diabetic Potential of Ocimum gratissimum Leaf Fractions in Fortified Diet-Fed Streptozotocin Treated Rat Model of Type-2 Diabetes

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Stanley I. R. Okoduwa

2017-10-01

Full Text Available Background: Ocimum gratissimum (OG is used in the traditional management of diabetes in Nigeria. This study investigated the anti-diabetic potential of OG leaf fractions (OGLF in a rat model of Type-2 diabetes (T2D. Method: Methanol crude extract of OG leaf was fractionated with solvents of increasing order of polarity (n-hexane, chloroform, ethyl-acetate, n-butanol and water. The anti-diabetic potential of the fractions was evaluated in vivo. T2D was induced in Albino Wistar rats and treated with OGLF. Result: The T2D rats showed significant elevation in serum levels of fasting blood glucose (FBG, liver and kidney function biomarkers. At 4-weeks of intervention with OGLF, the untreated diabetic control group maintained severe hyperglycaemia in the presence of 61.7% serum insulin, 17.3% pancreatic β-cell function (HOMA-β and 51.5% Insulin sensitivity. The glucose tolerance ability was enhanced in the n-butanol-fraction (OGb treated group. With 74.8% available serum insulin and 38.6% improvement in insulin sensitivity, the OGb treated group had a 63.5% reduction in FBG and it was found to be most effective as it ameliorates a majority of the changes caused in the studied parameters in diabetic rats. Conclusions: The data from this study suggest that OGb fraction is a potential candidate for the development of an effective drug for the management of T2D.

Coronary artery bypass surgery in the diabetic patient.

LENUS (Irish Health Repository)

Maher, M

2012-02-03

Coronary artery and peripheral occlusive arterial disease frequently complicate diabetes mellitus, with death due to atherosclerotic coronary artery disease being three times more likely in diabetic compared to non-diabetic patients. The profile of 32 diabetic patients and 32 matched controls who underwent coronary artery bypass (CABG) is studied and their early and late postoperative outcomes are described. The mean age was 61 +\\/- 1 year in both groups. The diabetic group comprised 26 non-insulin dependent and 6 insulin dependent diabetics, who had a mean duration of diabetes of 8.5 years (range 2 months--35 years). The median number of grafts per patient performed in the diabetic group and the control group was 3.5 and 3 respectively. There was no mortality in the series, however considerably greater wound morbidity rates were encountered in the diabetic group when compared to matched controls. One renal transplant patient in the diabetic group suffered irreversible acute tubular necrosis and became dialysis dependent post-operatively. Longterm follow-up showed no longterm mortality in either group, with full relief of angina achieved in 75% of diabetic patients compared with 87.5% of matched controls. In addition diabetic patients suffered greater longterm cardiac morbidity than the control group (21.8% versus 12.5%). The results of this study suggest that CABG is a safe operation for the diabetic patient. Diabetic patients receive satisfactory symptomatic relief of angina, but suffer increased perioperative wound complications and greater incidence of longterm cardiac morbidity.

What type of diabetes does my patient have and is it relevant?

African Journals Online (AJOL)

example in the case of a patient with NIDDM who was being treated ... It commonly presents in childhood and adolescence, but it can occur at any age, even in ... highly associated with a family history of diabetes, older age, obesity and lack of ...

Diabetes-Related Distress Assessment among Type 2 Diabetes Patients.

Science.gov (United States)

Aljuaid, Majed O; Almutairi, Abdulmajeed M; Assiri, Mohammed A; Almalki, Dhifallah M; Alswat, Khaled

2018-01-01

Diabetes is one of the most common chronic diseases; it is a debilitating and hard to live with. Diabetes-related distress (DRD) refers to the emotional and behavioral changes caused by diabetes. Our study aims to assess the prevalence of DRD among type 2 diabetes (T2D) patients using Diabetes Distress Scale-17 items (DDS-17) and its relation to complications and treatment modalities. A cross-sectional study of adult T2D patients with follow-up visits at the Diabetes and Endocrinology Center in Taif, Saudi Arabia, between January and July 2017. We excluded patients with other forms of diabetes, untreated hypothyroidism, and psychiatric illness. The total score of DDS-17 was calculated by summing the 17 items' results and then dividing the total by 17. If the total score was >2, then it was considered as clinically significant results (moderate distress), but if it is ≥3, then it is classified as a high distress. A total of 509 T2D patients with a mean age of 58 ± 14 years were included. The majority of participants were male, married, not college educated, and reported a sedentary lifestyle. We found 25% of the screened T2D patients have moderate to high DRD. Regarding the DRD components, emotional distress was the most prevalent followed by physician-related distress. HabA1c was significantly higher in those with high combined distress and high emotional distress compared to those with mild/moderate distress ( p = 0.015 and 0.030, resp.). Our study shows that DRD is a medically relevant issue that clinicians need to address. Despite observing a low prevalence of DRD compared to other studies, we found significant correlations between DRD scores and HabA1c, triglyceride levels, BMI, T2D duration, and interval between visits.

Association between Diabetic Polyneuropathy and Cardiovascular Complications in Type 2 Diabetic Patients

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Jin Ook Chung

2011-08-01

Full Text Available BackgroundDiabetes mellitus is a major independent risk factor for cardiovascular disease (CVD, but high cardiovascular risk in diabetes mellitus patients is not completely explained by clustering traditional risk factors. Recently, associations between diabetic polyneuropathy (DPN and macrovasculopathy have been suggested. We aimed to assess associations between DPN and cardiovascular complications in type 2 diabetic patients.MethodsMicrovascular and cardiovascular complications were evaluated in 1,041 type 2 diabetic patients.ResultsIn patients with DPN, the age, prevalence of hypertension, diabetes duration, systolic blood pressure, pulse pressure, and hemoglobin glycation (HbA1c levels were significantly higher, while the high density lipoprotein cholesterol (HDL-C levels were lower than in those without DPN. The prevalence of CVD was higher in patients with DPN. In multivariate analysis, DPN was independently associated with CVD (odds ratio, 1.801; 95% confidence interval, 1.009 to 3.214.ConclusionOur results showed that DPN was associated with a high prevalence of cardiovascular disease in type 2 diabetic patients, but further studies are needed to investigate the causative nature of associations between DPN and CVD.

APPRAISAL OF MALE ERECTILE DYSFUNCTION IN PATIENTS WITH DIABETES MELLITUS

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Rajendra Prasad Suram

2016-07-01

Full Text Available BACKGROUND One of the most common adverse effects of diabetes mellitus, erectile dysfunction (ED remains difficult to treat despite advances in pharmacotherapeutic approaches in the field. This unmet need has brought about a late re-focus on the pathophysiology, so as to comprehend the cellular and molecular mechanism prompting ED in diabetes. Diabetes-induced ED is a need to find focuses that may prompt novel approaches for a fruitful treatment. Present study was tried to understand role of vascular and neurogenic alterations in the pathophysiology of diabetic sexual dysfunction. SUBJECTS AND METHODS The study was carried out on 17 male impotent patients with Diabetes Mellitus: 5 patients (Aged 43-56 years; mean age 48.4 had insulin-dependent DM, and 13 patients (Aged 40-62; mean age 53.5 non-insulin-dependent DM. None of the patients were on medications known to interfere with male erectile sexual function. All patients were told to give informed consent. Every participant underwent a physical examination including complete medical and sexual history and routine laboratory tests. Penile vascular assessment and assessment of nocturnal penile erections investigation were assessed in the study. RESULTS As showed in Table I. alterations in the vascular system was found in 13 (61.5% participants. Out of which moderate alteration noticed in 8 (47% and severe alteration in 5 (16% patients. Among the patients with non-insulin-dependent DM, 7 (41.1% had showed Nocturnal Penile Erections abnormalities. According to the history and also to the normal responses to the Nocturnal penile tumescence monitoring (NPTM, patients were diagnosed as having impotence of psychogenic origin. CONCLUSION Initial involvement of both arterial supply and of the neurological pathways can be of some interest, suggesting the need for an early screening of neural and vascular status even in patients without penile erectile failure. As is the case for other degenerative

Comparison of Oral Manifestations of Diabetic and Non-Diabetic Uremic Patients Undergoing Hemodialysis

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Seyed Javad Kia

2014-06-01

Full Text Available Background & Objectives: Chronic renal failure (CRF, also known as chronic kidney disease, caused by devastated nephron mass of the kidney results in uremia. Hypertension, diabetes mellitus and glomerulonephritis are common etiologic factors of CRF. This condition causes miscellaneous oral manifestations especially in diabetic patients. The aim of this study was to comparison oral manifestations of diabetic and non-diabetic uremic patients undergoing hemodialysis.   Methods: A total of 95 patients who undergoing hemodialysis in Razi hospital in Rasht city participated in this descriptive analytical study. Patients were divided into two diabetic and non- diabetic groups. Oral cavity examinations were done by latex gloves and single use mirror. Objective and subjective oral manifestations such as xerostomia, bad taste, mucosal pain, uremic odor, coating tongue, petechial, purpura, pale oral mucosa, ulcer, dental erosion and candida infection were recorded in questionnaire. After gathering of information, the data were analyzed by SPSS 15 software using t-test and chi square statistical test.   Results: About 60% of patients (57 person were men and 40 % (38 person were women. The mean age of patients was 48 years (range of 20 -76 years. Common subjective oral manifestation in both groups was xerostomia and most common objective oral manifestations were pale oral mucosa, uremic odor and coating tongue respectively. The DMFT index in diabetic group was significantly higher (17.3±7.63 than non-diabetic patients (12.4±8.26. There was no significant statistical correlation between the time of dialysis, number of dialysis appointment during the week and objective and subjective oral manifestations in two groups.   Conclusion: Although, the present study has shown an increase in oral manifestations in diabetic patients undergoing hemodialysis relative to non-diabetic group, but this increase was not statistically significant. On the other hand

PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

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A. Bostak

2006-11-01

Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

Alteration of melatonin secretion in patients with type 2 diabetes and proliferative diabetic retinopathy

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Hikichi T

2011-05-01

Full Text Available Taiichi Hikichi1, Naohiro Tateda2, Toshiaki Miura31Department of Ophthalmology, Ohtsuka Eye Hospital, Sapporo; 2Asahikawa National College of Technology, Asahikawa; 3Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, JapanBackground: The purpose of this study was to evaluate the dynamics of plasma melatonin secretion in patients with type 2 diabetes mellitus and diabetic retinopathy.Methods: Plasma melatonin levels were measured by high-performance liquid chromatography in 56 patients. Patients were divided into a diabetic group (30 patients and a nondiabetic group (26 patients. The diabetic group was divided further into a proliferative diabetic retinopathy (PDR group (n = 14 and a nonproliferative diabetic retinopathy (NPDR group (n = 16. Plasma melatonin levels obtained at midnight and 3 am were compared between the groups.Results: Nighttime melatonin levels were significantly lower in the diabetic group than in the nondiabetic group (P < 0.03 and lower in the PDR group than in the nondiabetic and NPDR groups (P < 0.01 and P < 0.03, respectively, but no significant difference was found between the nondiabetic and NPDR groups. The daytime melatonin level did not significantly differ between the nondiabetic and diabetic groups or between the nondiabetic, NPDR, and PDR groups.Conclusion: The nighttime melatonin level is altered in patients with diabetes and PDR but not in diabetic patients without PDR. Although patients with PDR may have various dysfunctions that affect melatonin secretion more severely, advanced dysfunction of retinal light perception may cause altered melatonin secretion. Alteration of melatonin secretion may accelerate further occurrence of complications in diabetic patients.Keywords: circadian rhythm, diabetes, proliferative diabetic retinopathy, melatonin

A Neutral Risk on the Development of New-Onset Diabetes Mellitus (NODM in Taiwanese Patients with Dyslipidaemia Treated with Fibrates

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Chien-Ying Lee

2012-01-01

Full Text Available There are no data on the incidence of new-onset diabetes mellitus (NODM in nondiabetic dyslipidaemia patients treated with fibrates. The aim of our study was to clarify these issues, to investigate the relationship between NODM and fibrate and whether the fibrates lead to increased risk for developing NODM. A retrospective cohort study was conducted by analyzing the Longitudinal Health Insurance Database (LHID 2005 of the National Health Insurance Research Database (NHIRD from 2005 to 2010 to investigate all fibrate prescriptions for patients with dyslipidaemia. We estimated the hazard ratios (HRs of NODM associated with fibrate use. We identified 145 NODM patients among 3,815 dyslipidaemic patients in the database for the study period. The risk estimates for NODM for users of fenofibrate (HR 1.30; 95% CI 0.82, 2.05 and gemfibrozil (HR 0.771; 95% CI 0.49, 1.22 were not associated with an increased risk of developing NODM (P>0.05. Our results revealed that patients with dyslipidaemia who took fenofibrate and gemfibrozil had a neutral risk of NODM. The reasons may be associated with the fibrates have the properties that activate PPARα and in some cases also activated PPARγ, leading to showing a neutral risk of NODM.

Diabetic ketoacidosis characteristics and differences in type 1 versus type 2 diabetes patients

International Nuclear Information System (INIS)

Rashid, M.O.; Sheikh, A.; Salam, A.; Farooq, S.; Kiran, Z.; Islam, N.

2017-01-01

Background: Diabetes is undoubtedly one of the most challenging health problems of the 21st century. It is well known that diabetes once develop can lead to several complications. Diabetic ketoacidosis (DKA) is one of the life-threatening complications of diabetes. This study was designed to determine the frequency of DKA in diabetes patients and find out the clinical and biochemical determinants of DKA. Methods: This descriptive study was conducted at Aga Khan University Hospital (AKUH) Karachi, Pakistan from January 2010 to February 2016. All known or newly diagnosed diabetic patients of >16 years of age irrespective of gender and type of diabetes were included. Information regarding patient’s demographics, presenting symptoms, precipitating causes of DKA, biochemical profiles and outcome at the time of discharge was collected. Results: Majority (54.7%) had moderate and 12.4% had severe DKA at presentation. Previous history of DKA was found higher in type 1 diabetes patients (T1DM) (14%) as compare to (4%) type 2 diabetes patients (T2DM) (p<0.05). DKA severity was observed more (12%) in newly diagnosed (T1DM) (p<0.05). Comorbidities were found more (81%) in (T2DM) (p<0.05) Mortality was also observed higher in Type 2 diabetes patients (p<0.05). Conclusion: Majority of the diabetics had moderate to severe DKA at presentation. Mortality and morbidity related with DKA was found considerably higher among patients with T2DM while infection, myocardial infarction and stroke found as triggering factors in these patients. (author)

Prevalence of dyslipidemia in adult Indian diabetic patients: A cross sectional study (SOLID

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Ambrish Mithal

2014-01-01

Full Text Available Context: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital of the world. Diabetic dyslipidemia in India is one of the main cause for Coronary Artery Disease (CAD mortality. Although diabetes continues to be a major lifestyle condition in India, there is a lack of studies in India on whether dyslipidemia in Indian diabetics is being adequately controlled. Our study provides critical insights into the insights into proportion of diabetes patients achieving lipid goal in India. Aims: The primary objective of our study was to assess the control of dyslipidemia in the Indian diabetic population treated with lipid lowering drugs (LLDs, as per American Diabetes Association (ADA 2010 guidelines. Settings and Design: The study was carried out in a real world Indian clinical setting involving 178 sites. This is a multicenter, noninterventional, and cross-sectional observational study. Materials and Methods: A total of 5400 adult subjects with established type-2 diabetes mellitus (T2DM and dyslipidemia were recruited for the study. Patients in the study were on LLD at a stable dose for at least last 3 months before the designated study visit. Routine lipid profile tests were conducted for all patients. Statistical Analysis Used: Descriptive statistics was used to analyze qualitative and discrete variables. Chi-square test and t-test were conducted to assess the existence of statistically significant association between the variables. Results: A total of 5400 patients with T2DM from 178 centers across India were recruited. Out of the total population, 56.75% (N = 3065 of them were males. Primary end-point of low-density lipoprotein cholesterol (LDL-C level below ADA 2010 target was achieved in a total of 48.74% (N = 2632 patients. Gender was significantly associated with lipid levels and age was significantly (P < 0.05 correlated with all lipid levels. Control rates of other lipid parameters like

Pulp necrosis following luxated injury to teeth in a patient with uncontrolled type II diabetes mellitus: a case report

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Haneol Shin,

2012-02-01

Full Text Available Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

The effectiveness of holistic diabetic management between Siriraj Continuity of Care clinic and medical out-patient department.

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Chalermsri, Chalobol; Paisansudhi, Supalerg; Kantachuvesiri, Pitchaporn; Pramyothin, Pornpoj; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Nopmaneejumruslers, Cherdchai; Chouriyagune, Charoen; Pandejpong, Denla; Phisalprapa, Pochamana

2014-03-01

Diabetes mellitus is one of the most common diseases in the Thai population, and it is well known that diabetic complications could be prevented with appropriate management. Despite published guidelines, most Thai patients with diabetes do not achieve treatment goals. Siriraj Continuity of Care clinic (CC clinic) was recently established in order to provide training for medical students and internal medicine residents. It is possible that the training component in the CC clinic may contribute to better overall outcomes in type 2 diabetes mellitus (type 2 DM) patients when compared with usual care at the medical out-patient department (OPD). To compare the effectiveness of diabetic management in type 2 diabetes mellitus patients who attended the CC clinic and the medical OPD. Retrospective chart review was performed in type 2 diabetes mellitus patients who were treated at either clinic at Siriraj Hospital in 2007-2011. Baseline demographics, treatment strategies and outcomes, and participation in an appropriate health maintenance program were assessed in both groups. Seven hundred and fifty seven medical records were reviewed, including 383 patients in the CC clinic group and 374 in the OPD group. Mean HbA1c was significantly lower in the CC clinic group compared with the OPD group (7.3 +/- 0.9% and 7.8 +/- 1.3%, respectively, < 0.001). The number of patients who achieved goal HbA1c of less than 7% in CC clinic group was 123 (32.1%) compared with 91 (24.3%) in the OPD group (p = 0.039). More patients were screened for diabetic complications in the CC clinic group compared with the OPD group, including screening for diabetic neuropathy (57.4% vs. 2.1%, p < 0.001), diabetic retinopathy (56.7% vs. 36.6%, p < 0.001), and diabetic nephropathy (80.9% vs. 36.9%, p < 0.001). Patients in the CC clinic group had a higher rate of age-appropriate cancer screening than those in the OPD group (54.2% vs. 13.3%, p < 0.001 for breast cancer; 24.0% vs. 0.9%, p < 0.001 for cervical

Predictors of Diabetic Retinopathy in Patients with Type 2 Diabetes ...

African Journals Online (AJOL)

type 2 diabetes and diabetic retinopathy (DR) and nephropathy represent one of the ... control, hypertension, dyslipidemia, age of the patient, duration of diabetes .... thus, the presence of one is believed to predict the development of the other.

Prevalence of dyslipidemia in patients with type-2 diabetes mellitus

International Nuclear Information System (INIS)

Siddiqui, S.A.; Shabbir, I.; Sherwani, M.U.I.K.; Hussain, R.

2011-01-01

Background: The dyslipidaemia associated with type-2 diabetes is associated with raised plasma triglycerides, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels and is a risk factor of cardiovascular disease. Objectives: To assess the lipid abnormalities in patients with type-2 diabetes. Study design and settings: A cohort study carried out at Diabetic Clinic of PMRC Research Centre, FJMC, Lahore, Pakistan. Patients and Methods Eight years case records of type-2 diabetic patients seen at the research centre from 1999-2006 were reviewed. The research centre is a specialized centre for diagnosing and treating diabetes mellitus. All the patients were recruited for their follow up check up and laboratory investigations for dislipidemia. Adult treatment panel III guidelines for dyslipidaemia were followed. A 12 hours fasting blood sample was collected from each patient for serum total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose as well as glycosylated hemoglobin (HbA1c) by using standard methods at Biochemistry laboratory of the research centre. LDL-C/ HDL-C ratios, Very low-density lipoprotein cholesterol (VLDL-C) and body mass index was calculated after anthropometery body mass index (BMI) less than or equal to 25 was considered as overweight while less than or equal 30 obese. HbA1c 40 mg/dl were seen in 67%. Raised VLDL-C (above 40 mg/dl) was seen in 32.9% cases. The group with high LDL and VLDL is at risk of developing cardiovascular disease. Hypertriglyceridaemia was found in 55% and hypercholesterolaemia in 45.4% cases. Obesity as indicated by body mass index was found in 53.7% patients. Statistically significant association of hypercholesterolemia, hypertriglyceridemia, hypo HDL cholesterolemia and VLDL-C was found with advancing age while only hypertriglyceridemia and VLDL-C showed a positive

[Patient education: an indispensable element of care of patients with diabetes mellitus].

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Hidvégi, Tibor

2011-11-27

Diabetes is a chronic and progressive disorder that impacts upon almost every aspect of life. The number of people with diabetes is continuously growing and diabetes is associated with a high mortality rate. Diabetes education is a critical element of care of people with diabetes in order to improve clinical outcomes. The therapeutic patient education is a planned and structured program that is comprehensive in scope, flexible in content, responsive to an individual's clinical and psychological needs, and adaptable to patients' educational and cultural background. The diabetes educator should control the implementation of education and should evaluate the patient's knowledge. The educator should be trained for care of patients with chronic diseases and for education of patients with diabetes mellitus.

Treated of type 1 diabetes mellitus in non-obese diabetic mice by transplantation of allogeneic bone marrow and pancreatic tissue

International Nuclear Information System (INIS)

Yasumizu, R.; Sugiura, K.; Iwai, H.

1987-01-01

Non-obese diabetic (NOD) mice provide a model for type 1 diabetes mellitus. We previously showed that allogeneic bone marrow transplantation (ABMT) can prevent and treat insulitis and overt diabetes in NOD mice. However, ABMT alone could not be used to treat overt diabetes in NOD mice whose islets had been completely destroyed. To provide insulin-producing cells, pancreatic tissue from newborn mice was grafted under the renal capsules in combination with ABMT. The aims of concomitant ABMT are as follows. (i) It induces immunological tolerance to the donor-type major histocompatibility complex determinants and permits the host to accept subsequent pancreatic allografts from the bone marrow donor. (ii) ABMT replaces abnormal stem cells with normal stem cells. After transplantation of bone marrow plus newborn pancreas, NOD mice showed reduction of the glycosuria and a normal response in the glucose-tolerance test. Immunohistological study revealed the presence of clustered insulin-containing beta cells in the grafted pancreatic transplants. ABMT may become a viable treatment of established type 1 diabetes mellitus in humans

Medication adherence in type 2 diabetes patients: study of patients ...

African Journals Online (AJOL)

Medication adherence in type 2 diabetes patients: study of patients in ... impact of medication adherence on the clinical outcomes of type 2 diabetes patients at ... the review of case notes of one-hundred and fifty two randomly selected patients.

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis.

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Lupi, Isabella; Cosottini, Mirco; Caturegli, Patrizio; Manetti, Luca; Urbani, Claudio; Cappellani, Daniele; Scattina, Ilaria; Martino, Enio; Marcocci, Claudio; Bogazzi, Fausto

2017-08-01

Autoimmune hypophysitis (AH) has a variable clinical presentation and natural history; likewise, its response to glucocorticoid therapy is often unpredictable. To identify clinical and radiological findings associated with response to glucocorticoids. 12 consecutive patients with AH, evaluated from 2008 to 2016. AH was the exclusion diagnosis after ruling out other pituitary masses and secondary causes of hypophysitis. Mean follow-up time was 30 ± 27 months (range 12-96 months). MRI identified two main patterns of presentation: global enlargement of the pituitary gland or panhypophysitis ( n  = 4, PH), and pituitary stalk abnormality only, or infundibulo-neuro-hypophysitis ( n  = 8, INH). Multiple tropin defects were more common in PH (100%) than those in INH (28% P  = 0.014), whereas diabetes insipidus was more common in INH (100%) than that in PH (50%; P  = 0.028). All 4 PH and 4 out of 8 INH were treated with glucocorticoids. Pituitary volume significantly reduced in all PH patients ( P  = 0.012), defective anterior pituitary function recovered only in the two patients without diabetes insipidus (50%) and panhypopituitarism persisted, along with diabetes insipidus, in the remaining 2 (50%). In all INH patients, either treated or untreated, pituitary stalk diameter reduced ( P  = 0.008) but diabetes insipidus persisted in all. Glucocorticoid therapy may improve anterior pituitary function in a subset of patients but has no effect on restoring posterior pituitary function. Diabetes insipidus appears as a negative prognostic factor for response to glucocorticoids. © 2017 European Society of Endocrinology.

[Type 2 diabetes mellitus and obesity: should we treat the obesity or the diabetes?].

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García, Santiago Durán; Sanz, Santiago Durán; Sanz, Alejandro Durán

2013-09-01

In this article, we review the results that can be expected after significant weight loss in patients with type 2 diabetes mellitus. We provide consensus-based documentation supported by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation on the importance of physical exercise, metabolic-bariatric surgery, and drug therapy. Lastly, we report the results of studies published in the last few years on glucagon-like peptide-1 analogs and the new family of oral drugs known as gliflozins, specifically studies published on dapagliflozin. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Frequency of diabetic retinopathy in hypertensive diabetic patients in a tertiary care hospital of Peshawar, Pakistan

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Rahman, S.; Khan, G.J.; Aamir, A.H.

2011-01-01

Background: Diabetic retinopathy is a common microvascular complication of both type 1 and type 2 diabetes mellitus. If left untreated, it can progress to serious visual disability. Coexistence of hypertension with diabetes has been described as another risk factor adding to the problem. We designed this study to assess the occurrence of diabetic retinopathy in hypertensive diabetic patients of this region and to compare it with normotensive diabetic patients. Methods: This cross-sectional study was carried out on 200 previously diagnosed diabetic patients. Apart from routine examination and investigations, retinopathy and blood pressure assessment of each patient was done using standard techniques. Hypertensive diabetic subjects (Group-I, n=107) were compared with non-hypertensive diabetics (Group-II, n=93) for the presence of retinopathy. Results: Retinopathy and hypertension were observed in 51% and 53.5% of the total diabetic patients respectively. Hypertensive diabetic patients had significantly higher percentage of retinopathy compared to non-hypertensive diabetic patients (58 vs 43%; p<0.05). Conclusion: Retinopathy and hypertension are highly prevalent in our diabetic patients. The proportion of retinopathy is significantly more in hypertensive as compared to normotensive diabetics. (author)

The prevalence of macrovascular complications among diabetic patients in the United Arab Emirates

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Norman John N

2007-09-01

Full Text Available Abstract Background Diabetes Mellitus (DM is a major public health problem in the UAE with a prevalence rate reaching 24% in national citizens and 17.4% in expatriates. The aim of this study was to determine the prevalence and risk factors of macrovascular complications among diabetic patients in the Al-Ain district of the United Arab Emirates (UAE. Methods The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes (DM complications among known diabetic patients in Al-Ain District, UAE. Patients were randomly selected during 2003/2004. Patients completed an interviewer-administered questionnaire carried out by treating doctors and underwent a complete medical assessment including measurement of height, weight, blood pressure and examination for evidence of macrovascular complications. A standard ECG was recorded and blood samples were taken to document fasting blood sugar, glycosylated haemoglobin (HbA1C and lipid profile. Results A sample of 513 diabetic patients was selected with a mean age of 53 years (SD ± 13.01. Overall, 29.5% of DM patients had evidence of macrovascular complications: 11.6% (95% CI: 8.8–14.4 of patients had peripheral vascular disease (PVD, 14.4% (95% CI: 11.3–17.5 had a history of coronary artery disease (CAD and 3.5% (95% CI: 1.9–5.1% had cerebrovascular disease (CVD. Of the total population surveyed 35% (95%CI: 30.8–39 had hypertension. The analysis showed that macrovascular complications in diabetic patients were more common among males, increased with age, were more common among hypertensive patients and its prevalence increased steadily with duration of DM. Conclusion Our data revealed a significant association between hypertension and presence of macrovascular disease among diabetic patients. However, the risk of CAD in the UAE was relatively low compared to that seen in patients in other geographical settings. In addition, a lack of correlation between

Novel combined management approaches to patients with diabetes, chronic kidney disease and cardiovascular disease.

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Spaak, J

2017-03-01

Most patients we care for today suffer from more than one chronic disease, and multimorbidity is a rapidly growing challenge. Concomitant cardiovascular disease, renal dysfunction and diabetes represent a large proportion of all patients in cardiology, nephrology and diabetology. These entities commonly overlap due to their negative effects on vascular function and an accelerated atherosclerosis progression. At the same time, a progressive subspecialisation has caused the cardiologist to treat 'only' the heart, nephrologists 'only' the kidneys and endocrinologists' 'only' diabetes. Studies and guidelines follow the same pattern. This often requires patients to visit specialists for each field, with a risk of both under-diagnosis and under-treatment. From the patient's perspective, there is a great need for coordination and facilitation of the care, not only to reduce disease progression but also to improve quality of life. Person-centred integrated clinics for patients with cardiovascular disease, renal dysfunction and diabetes are a promising approach for complex chronic disease management.

Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus.

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Sasaki, E; Goda, K; Nagata, K; Kitaoka, H; Ohsawa, N; Hanafusa, T

2001-01-01

Postprandial hypotension (PPH) is defined as a decrease of systolic blood pressure by more than 20 mmHg after meals. Severe PPH is a troublesome diabetic complication, which has no established means of treatment. We encountered a patient who had diabetes mellitus complicated by severe PPH and attempted to treat this problem using several medications (octreotide, midodrine hydrochloride, and acarbose). A 58-year-old male with diabetic triopathy complained of orthostatic dizziness and vertigo after meals. The blood pressure was monitored for 24 h with an ambulatory blood pressure monitor, revealing that the systolic blood pressure decreased markedly after breakfast and dinner by 45 and 50 mmHg, respectively. PPH was not improved by a subcutaneous injection of octreotide. Administration of midodrine hydrochloride reduced the frequency of hypotensive episodes from twice to once daily, but the magnitude of the postprandial fall in blood pressure was still around 30 mmHg. After the patient started to receive acarbose therapy, the postprandial fall in blood pressure was diminished to 18 mmHg and his symptoms largely disappeared. For the treatment of PPH in diabetic patients, our experience suggests that it may be appropriate to try first on alpha-glucosidase inhibitor like acarbose.

Diabetes Causation Beliefs Among Spanish-Speaking Patients.

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Concha, Jeannie Belinda; Mayer, Sallie D; Mezuk, Briana R; Avula, Danielle

2016-02-01

The purpose of this study was to explore how the inquiry of cultural diabetes causation beliefs can improve Hispanic/Latino patient self-management. Two semistructured focus groups were conducted with 13 Hispanic/Latinos adults diagnosed with type 2 diabetes mellitus. Prior to taking part in the group discussion, participants completed a demographic survey and the Illness Perception Questionnaire-Revised. The top 5 diabetes causation items endorsed by participants per the questionnaire included stress or worry, behavior, hereditary, diet/eating habits, and family problems/worries. The qualitative analysis revealed stress as a recurring theme for a cause of diabetes. Work stress was specifically identified as a contributor to unhealthy eating and diabetes. Most participants were aware of and believed in susto and referred to it as coraje (anger). Participants believed that asking patients about their diabetes causation beliefs and emotional status can help health professionals (1) better understand the patient and (2) identify and prioritize diabetes treatments. Participants also indicated that the role of doctors is important and the encouragement that they give to patients is clinically and spiritually valued. Stress was identified as a cause of diabetes in addition to unhealthy diets and heredity. Asking patients about diabetes causation beliefs and emotional status may help prioritize treatment and management goals. © 2015 The Author(s).

Are we meeting the American Diabetes Association goals for HIV-infected patients with diabetes mellitus?

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Adeyemi, Oluwatoyin; Vibhakar, Sonia; Max, Blake

2009-09-01

We determined rates of achieving the American Diabetes Association goals among human immunodeficiency virus (HIV)-infected diabetic patients. American Diabetes Association goals (for hemoglobin A1c, blood pressure, and lipid levels) were defined by 2008 American Diabetes Association guidelines. HIV-infected diabetic patients achieved American Diabetes Association goals at rates similar to those in general medicine clinic patients. A multidisciplinary approach is needed to improve diabetes management in HIV clinics.

Accommodative Ability in Prepresbyopic Diabetic Patients

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Mohammad Etezad Razavi

2015-04-01

Full Text Available Introduction: To compare various accommodative parameters in prepresbyopic diabetic patients with age-matched healthy individuals. Materials and Methods: Study populationconsisted of 32 younger-onset diabetic patients (30-40 years of age and 28 age-matched healthy normal individuals. Using the best correction for distance visual acuity (20.20 by Snellen chart, multiple accommodative ability tests such as near point of accommodation, accommodative amplitude, negative or positive accommodative facility and near point of convergence were measured in both groups. Results: Mean near point of accommodation in diabetic patients was significantly greater than the control group (18.5±4.4 centimeters [cm] versus 9.5±2 centimeters, p= 0.000. Mean accommodative amplitude was (5.93±1.75 Diopter (D and (10.95±2.16 Diopter in diabetics and normal individuals, respectively (p=0.000. Mean accommodation facility was (3.19±3.04 cycle/minute [cyl/min] in patients and 10.01±5.09 cycle/minute in the control group (p= 0.000. Mean positive relative accommodation was (–3.37±1.19 D in diabetic and (-2.11±0.99 D in healthy participants (p=0.000. Mean negative relative accommodation was lower in diabetic patients compared with the control group, however, this difference did not reach statistical significance (2.61±0.65 D versus (2.61±0.60 D, p= 0.23. Mean near point of convergence was (8.23±1.43 cm and (7.13±0.67 cm in normal and diabetic groups, respectively which had insignificant difference (p= 0.45. Conclusion: Majority of accommodative ability functions decreased in prepresbyopic diabetic patients. Early detection and rehabilitation of such patients with corrective near spectacles are strongly recommended.

Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients

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Z. Abedini

2008-07-01

Full Text Available Background and ObjectivesDiabetic patients play the main role in the management of their disease. Adequate knowledge of this disease state and self directed patient care will improve the health of these patients. Some studies have indicated a high prevalence of diabetes complication are due to the lack of knowledge of self directed patient care and practice in diabetic patient group. The objective of this study is to measure the knowledge level of self directed patient care and practice in order to evaluate their effects on improvement of diabetic patients' health in the city of Qom, Iran.MethodsIn this cross sectional study 1004 patients with diabetes participated (During year 2006. Data were collected from patients of General Hospital metabolism and endocrine research center.An interviewing method was used to asses the demographics data, history of disease, and knowledge of self directed patient care in these patients. Data were analyzed using a descriptive statistic, chi-square, and Pearson correlation coefficient, and SPSS software.ResultsOut of 1004 observed case, 154 patients were with Diabetes type I and 850 patients with Diabetes type II. The knowledge of self directed patient care and practice level of with both types of diabetes were determined to be mostly at an intermediate level. In type I diabetic patients there was a significant relation between knowledge level of self directed patient care and gender of the patients (P=0.01. Also, there was a significant correlation between practice and age (P=0.03(, and economical status (P=0.06 of the patients. In type II diabetic patients there was a significant relation between knowledge level of self directed patient care and educational level (P=0.00(, and economical status (P=0.01 of the patients. The practice level of self directed patient care was significantly related to economical status (p=0.03 in this group of patients. ConclusionThese results indicate that an increase in knowledge

Prevalence of Vitamin B12 deficiency in patients of type 2 diabetes ...

African Journals Online (AJOL)

Conclusion: Our study demonstrated significantly high prevalence of vitamin B12 deficiency in patients treated with metformin with significant effect of dose and duration of metformin use on B12 levels. Physicians must recognize this important fact and screen diabetics on metformin therapy for underlying B12 deficiency.

Diabetic ketoacidosis: a challenging diabetes phenotype

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Cliona Small

2017-02-01

Full Text Available We describe three patients presenting with diabetic ketoacidosis secondary to ketosis prone type 2, rather than type 1 diabetes. All patients were treated according to a standard DKA protocol, but were subsequently able to come off insulin therapy while maintaining good glycaemic control. Ketosis-prone type 2 diabetes (KPD presenting with DKA has not been described previously in Irish patients. The absence of islet autoimmunity and evidence of endogenous beta cell function after resolution of DKA are well-established markers of KPD, but are not readily available in the acute setting. Although not emphasised in any current guidelines, we have found that a strong family history of type 2 diabetes and the presence of cutaneous markers of insulin resistance are strongly suggestive of KPD. These could be emphasised in future clinical practice guidelines.

Optimization of surgical treatment of cataract in patients with diabetes mellitus

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Dmitriy Valentinovich Lipatov

2010-06-01

Full Text Available Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied included time of ultrasound (US ex-posure, US power, and retinal characteristics in the earlypostoperative period. In addition, analysis included data on the location of lens opacity in 1047 patients (1897 eyes with diabetic cataract. Results. Relatively low corrected and uncorrected visual acuity in the early postoperative period was attributable to concomitant DM-related retinalpathology. Analysis of lenticular opacity showed that it in the first place affected collagen fibers beneath the posterior capsule. The use of torsional USin INFINITI for cataract phacoemulsification produced almost 4-fold reduction in the exposure time of ocular tissues. As a result, the postoperativeoedema was significantly smaller than in patients undergoing combined treatment (AQUALASE hydromonitoring and OZIL ultrasound system. Conclusion. Combination of ultrasound and hydromonitoring phacoemulsification for the treatment of cataract in DM patients reduces exposure timeof ocular tissues and postoperative oedema which creates prerequisites for faster recovery of visual acuity after surgery. Functional results of surgicaltreatment of diabetic cataract can be further improved by early diagnosis of lens opacity and the use of US and hydromonitoring phacoemulsificationtechniques.

Effect of GLP-1 receptor agonist treatment on body weight in obese antipsychotic-treated patients with schizophrenia: a randomized, placebo-controlled trial.

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Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V; Bak, Nikolaj; Andersen, Ulrik B; Jørgensen, Niklas R; Holst, Jens J; Glenthøj, Birte Y; Ebdrup, Bjørn H

2017-02-01

Schizophrenia is associated with cardiovascular co-morbidity and a reduced life-expectancy of up to 20 years. Antipsychotics are dopamine D 2 receptor antagonists and are the standard of medical care in schizophrenia, but the drugs are associated with severe metabolic side effects such as obesity and diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are registered for treatment of both obesity and type 2 diabetes. We investigated metabolic effects of the GLP-1RA, exenatide once-weekly, in non-diabetic, antipsychotic-treated, obese patients with schizophrenia. Antipsychotic-treated, obese, non-diabetic, schizophrenia spectrum patients were randomized to double-blinded adjunctive treatment with once-weekly subcutaneous exenatide (n = 23) or placebo (n = 22) injections for 3 months. The primary outcome was loss of body weight after treatment and repeated measures analysis of variance was used as statistical analysis. Between March 2013 and June 2015, 40 patients completed the trial. At baseline, mean body weight was 118.3 ± 16.0 kg in the exenatide group and 111.7 ± 18.0 kg in the placebo group, with no group differences ( P = .23). The exenatide and placebo groups experienced significant ( P = .004), however similar ( P = .98), weight losses of 2.24 ± 3.3 and 2.23 ± 4.4 kg, respectively, after 3 months of treatment. Treatment with exenatide once-weekly did not promote weight loss in obese, antipsychotic-treated patients with schizophrenia compared to placebo. Our results could suggest that the body weight-lowering effect of GLP-1RAs involves dopaminergic signaling, but blockade of other receptor systems may also play a role. Nevertheless, anti-obesity regimens effective in the general population may not be readily implemented in antipsychotic-treated patients with schizophrenia. © 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

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Hern?ndez, Marta; L?pez, Carolina; Real, Jordi; Valls, Joan; Ortega-Martinez de Victoria, Emilio; V?zquez, Federico; Rubinat, Esther; Granado-Casas, Minerva; Alonso, Nuria; Mol?, Teresa; Betriu, Angels; Lecube, Albert; Fern?ndez, Elvira; Leslie, Richard David; Mauricio, D?dac

2017-01-01

BACKGROUND LADA is probably the most prevalent form of autoimmune diabetes. Nevertheless, there are few data about cardiovascular disease in this group of patients. The aim of this study was to investigate the frequency of carotid atherosclerotic plaques in patients with LADA as compared with patients with classic type 1 diabetes and type 2 diabetes. METHODS Patients with LADA were matched for age and gender in different proportions to patients with type 2 diabetes, and classic type 1 diabete...

Type 2 diabetes and pre-diabetic abnormalities in patients with bipolar disorders

DEFF Research Database (Denmark)

Leopold, Karolina; Reif, Andreas; Haack, Sarah

2016-01-01

BACKGROUND: Abnormalities in the glucose metabolism cause nervous and organic damage and are a cardiovascular risk factor. They could be a main cause for the increased morbidity and mortality rates found in patients with bipolar disorders. The exact prevalence of diabetes and pre-diabetic...... quality were assessed. RESULTS: Diabetes mellitus was found in 7% of the patients, pre-diabetic abnormalities in 27%. The group of patients with abnormalities in the glucose metabolism had significantly lower quality of life and global functioning. Higher BMI, leptin, triglycerides and CRP levels...

A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens.

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Phillips, Victoria L; Byrd, Anwar L; Adeel, Saira; Peng, Limin; Smiley, Dawn D; Umpierrez, Guillermo E

2017-01-01

The identification of cost-effective glycaemic management strategies is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has been shown to result in better glycaemic control and fewer complications than sliding scale regular insulin (SSI) in general surgery patients with type 2 diabetes mellitus (T2DM), but the effect on costs is unknown. We conducted a post hoc analysis of the RABBIT Surgery trial to examine whether total inpatient costs per day for general surgery patients with T2DM treated with BBI ( n  = 103) differed from those for patients with T2DM treated with SSI ( n  = 99) regimens. Data were collected from patient clinical and hospital billing records. Charges were adjusted to reflect hospital costs. General linearized models were used to estimate the risk-adjusted effects of BBI versus SSI treatment on average total inpatient costs per day. Risk-adjusted average total inpatient costs per day were $US5404. Treatment with BBI compared with SSI reduced average total inpatient costs per day by $US751 (14%; 95% confidence interval [CI] 20-4). Being treated in a university medical centre, being African American or having a bowel procedure or higher-volume pharmacy use significantly reduced costs per day. In general surgery patients with T2DM, a BBI regimen significantly reduced average total hospital costs per day compared with an SSI regimen. BBI has been shown to improve outcomes in a randomized controlled trial. Those results, combined with our findings regarding savings, suggest that hospitals should consider adopting BBI regimens in patients with T2DM undergoing surgery.

Explaining psychological insulin resistance in adults with non-insulin-treated type 2 diabetes

DEFF Research Database (Denmark)

Holmes-Truscott, Elizabeth; Skinner, Timothy Chas; Pouwer, F

2016-01-01

to the model. CONCLUSIONS: Psychological insulin resistance may reflect broader distress about diabetes and concerns about its treatment but not general beliefs about medicines, depression or anxiety. Reducing diabetes distress and current treatment concerns may improve attitudes towards insulin as a potential......AIMS: To investigate the contribution of general and diabetes-specific emotional wellbeing and beliefs about medicines in the prediction of insulin therapy appraisals in adults with non-insulin-treated type 2 diabetes. METHODS: The sample included Diabetes MILES-Australia cross-sectional survey...... diabetes medications (BMQ Specific); negative insulin therapy appraisals (ITAS); depression (PHQ-9); anxiety (GAD-7), and diabetes distress (DDS-17). Factors associated with ITAS Negative scores were examined using hierarchical multiple regressions. RESULTS: Twenty-two percent of the variance in ITAS...

Presentations and complications of diabetes patients presenting to diabetic clinic of Eastern Nepal

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Nabin Kumar Singh

2014-04-01

Full Text Available Objective Diabetes mellitus leads to damage, dysfunction and failure of various organs especially eyes, kidneys, nerves and heart. The latency of occurence of hyperglycemia and diagnosis may be of long duration. This study was aimed to find out the mode of presetation of diabetes mellitus in diabetic patients attending out patients clinic of B P Koirala Institute of Health Sciences. Associated complications and comorbid condition present at the time of presenation were also studied. Methods The diabetic patients attending the Diabetic Out Patient Clinic of B P Koirala Institute of Health Sciences during June 2006 to June 2007 were included in this study.The patients details were collected from the predefined Proforma for diabetes patient from the database. This included demographic data, biochemical parameters and diabetic complications. For the purpose of study a total of 775 patients were randomly selected.The Data collected were entered and analysed using excel and SPSS(version 11.5 Results Out of 775 cases 436 (56.3% were male and 339(43.7% were female. Majority of patients 81.55% (n=632 had osmotic sympmtoms or symptoms related to complication of diabetes at the time of presentation to the clinic. Asymptomatic patient constituted 18.45% (n=143. The most common presenting complaints were polyuria (44.58%, followed by polydypsia (39.62% and polyphagia (24.88%. About 54.97% (n=426 had symptoms of complications related to diabetes. Among them most common complication was neurological (39.67%, followed by renal (10.8% metabolic (4.93%, cardiac(4.46%, autonomic neuropathy (4.93% and peripheral vascular disease (3.99%. Conclusion Majority of the patients presenting in our OPD had osmotic symptoms or symptoms related to complication of diabetes. Access to diabetes care and lack of awareness of the disease and its complication might had contributed to this. Community awareness, program for early detection and managemnet may help proper diabetes care