Medicine Matters: Special Considerations For Sglt2 Inhibitors And Prolonged Nothing Per Os Status Following Free Flap Surgery (Preprint)

2021 ◽  
Author(s):  
Franca Kraenzlin ◽  
Visakha Suresh ◽  
Bradford Winters ◽  
Kristen Broderick
Keyword(s):  
Type Ii Diabetes ◽  
Perforator Flap ◽  
Type Ii ◽  
Flap Surgery ◽  
Autologous Breast Reconstruction ◽  
Glucose Levels ◽  
Free Flap Surgery ◽  
Sodium Glucose Cotransporter ◽  
Deep Inferior Epigastric Perforator ◽  
Work Up

UNSTRUCTURED A 59-year-old female patient undergoing deep inferior epigastric perforator flap surgery for autologous breast reconstruction became acutely ill with tachypnea, nausea, and vomiting on post-operative day three. A work-up elucidated a diagnosis of diabetic ketoacidosis (DKA) with lower-than-expected glucose levels as a result of recent semaglutide use. She required intensive care unit resuscitation with an insulin drip and glucose administration. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a class of oral anti-hyperglycemic agents used for the treatment of type II diabetes (DMII). As the use of these medications become more prevalent, surgeons must be educated of this serious complication and plan for patient management in advance of minor and major surgeries.

scholarly journals EFFECTIVENESS OF AMLA JUICE IN REDUCING BLOOD GLUCOSE LEVEL AMONG PATIENTS WITH TYPE II DIABETES IN A SELECTED AREA OF KANYAKUMARI DISTRICT

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mrs. Vanitha. S s ◽  
Dr. Pramjit kaur
Keyword(s):  
Blood Glucose ◽  
Standard Deviation ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Type Ii Diabetes ◽  
Control Group ◽  
Type Ii ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Experimental Group

Challenges in lifestyle, such as increasesin energy intake and decreasesin physical activity are causing overweight and obesity leading to epidemic increases in type II Diabetes Mellitus. The research approach used for this study was evaluative approach and the research design was true experimental design. 60 patients with type II diabetes, 30 in experimental group and 30 in control group were selected for this study by using purposive sampling technique. Data was collected with the help of self-structured interview schedule. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (chi-square, paired ‘t’ test) were used to analyse the data and to test the hypotheses. In the experimental group,the pre-test mean score was 2.966, mean percentage was 59% and standard deviation was 1.129 and in post-testmean score was 2.533, mean percentage was 50.66% and standard deviation was 1.074 with effectiveness of 8.34% and paired‘t’ test value of t=3.971,which was statistically significant (p<0.05) which is an evidence ofthe effectiveness of Amla juice in reducing blood glucose level. Comparison of blood glucose levels in experimental and control groups, shows that the value is statistically highly significant, as was observed from the unpaired ‘t’ test value of 13.39 with P value of <0.05, which is an evidence indicatingthe effect of Amla juice in reducing postprandial blood glucose levels. The resultsfound that the administration of Amla juice did have aneffect in reducing blood glucose level in the experimental group. By comparing the findings of pre-test and post test between the experimental group and the control group,the effect was identified (assessed). The study concluded that the Amlajuice is effective in reducing blood glucose level.

scholarly journals Effect of Insulin Sensitizers and Sodium Glucose Cotransporter 2 Inhibitor on Glycemic State and Cardiovascular Performance in Type II Diabetic Rats

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S F Ewida ◽  
A M H Shabaan ◽  
H F Eldomiaty ◽  
G S Y Hanna ◽  
S E Hassabelnabi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lipid Profile ◽  
Type Ii Diabetes ◽  
Glycosylated Hemoglobin ◽  
Diabetic Rats ◽  
Cardiac Performance ◽  
Aortic Tissue ◽  
Type Ii ◽  
Arterial Blood ◽  
Sodium Glucose Cotransporter

Abstract Background Cardiovascular disease is the most life-threatening diabetic complication. Type II diabetes may lead to damage of the heart muscle. Sodium glucose cotransporter 2 (SGL2) inhibitors are a new class of diabetic medications indicated only for the treatment of type II diabetes. Aim This investigation was assigned to compare the effect of metformin and SGL2 inhibitors (dapaglifilizone) in type II diabetic rats. Design and methods: Eighty rats divided into four groups were used: non diabetic; diabetic; diabetic metformin -treated; diabetic dapagliflizoline- treated. At the end, arterial blood pressure and cardiac performance (cardiac contractility and heart rate) were assessed. Serum glucose, glycosylated hemoglobin (HbA1c), insulin, lipid profile, total antioxidant capacity, malondialdehyde, tumor necrosis factor α were measured. HOMA-IR index was calculated. DNA changes were assessed from hearts and aortea. Aortic endothelial changes recorded using H&E and masson trichome techniques. Results Glycemic index, lipid profile, oxidative stress and inflammatory parameters were significantly improved in both metformin and dapagliflizoline treated groups with also significant improvement in blood pressure, Cardiac performance and reduction in collagen deposition in aortic tissue and DNA fragmentation. Dapagliflizoline treatment results were significantly improved in all parameters compared to metformin treatment. Conclusion SGL2 inhibitors (dapaglifilizone) successfully restored glycemic state, cardiac performance, DNA and endothelial changes in type II diabetic rats compared to metformin.

Effective control of glycemic status and toxicity in Zucker diabetic fatty rats with an orally administered vanadate compound

2004 ◽  
Vol 82 (10) ◽  
pp. 888-894 ◽  
Author(s):  
Tod A Clark ◽  
Andrea L Edel ◽  
Clayton E Heyliger ◽  
Grant N Pierce
Keyword(s):  
Blood Glucose ◽  
Type Ii Diabetes ◽  
Black Tea ◽  
Diabetic Rats ◽  
Type Ii ◽  
Sodium Orthovanadate ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Zucker Diabetic Fatty Rats ◽  
Insulin Dependent

A novel black tea decoction containing vanadate has successfully replaced insulin in a rat model of insulin-dependent diabetes but is untested in non-insulin-dependent diabetic animals. A tea-vanadate decoction (TV) containing 30 or 40 mg sodium orthovanadate was administered by oral gavage to two groups of Zucker diabetic fatty rats and a conventional water vehicle containing 30 or 40 mg of sodium orthovanadate to two others. In the latter group receiving the 30-mg dose, vanadate induced diarrhea in 50% of the rats and death in 10%. In contrast, TV-treated rats had no incidence of diarrhea and no deaths. Symptoms were more severe in both groups with higher vanadate doses, so these were discontinued. After ~16 weeks, the level of vanadium in plasma and tissue extracts was negligible in a further group of untreated rats but highly elevated after vanadate treatment. Vanadium levels were not significantly different between the TV-treated diabetic rats and the diabetic rats given vanadate in a water vehicle. Over the 115 days of the study, blood glucose levels increased from ~17 to 25 mmol/L in untreated diabetic rats. This was effectively lowered (to <10 mmol/L) by TV treatment. Fasting blood glucose levels were 5, 7, and 20 mmol/L in control (nondiabetic, untreated), TV-treated and untreated diabetic rats, respectively. Rats required treatment with TV for only ~50% of the days in the study. Increase in body mass during the study was significantly lower in untreated diabetic rats (despite higher food intake) than the other groups. Body mass gain and food intake were normal in TV-treated rats. Water intake was 28 mL/rat daily in control rats, 130 mL/rat daily in untreated diabetic rats, and 52 mL/rat daily in TV-treated diabetic rats. Plasma creatinine and aspartate aminotransferase levels were significantly depressed in untreated diabetic rats, and TV treatment normalized this. Our results demonstrate that a novel oral therapy containing black tea and vanadate possesses a striking capacity to regulate glucose and attenuates complications in a rat model of type II diabetes. Key words: diabetes mellitus, tea, glycemia, type II diabetes.

scholarly journals Frequency of impaired fasting glucose in first degree relatives of Type-II diabetic patients and its association with Body Mass Index

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Alia Ali Muhammed ◽  
Azeem Taj ◽  
Muhammed Uthman Ahmed ◽  
Elsa Tabrez
Keyword(s):  
Body Mass Index ◽  
Blood Glucose ◽  
Impaired Fasting Glucose ◽  
Type Ii Diabetes ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Type Ii ◽  
Glucose Levels ◽  
First Degree Relatives

Objectives: To determine the frequency of impaired fasting glucose in first degree relatives of people with Type-II diabetes and its association with BMI. Methods: This cross-sectional study was conducted in Diabetic clinic of Shaikh Zayed Hospital, Lahore from July to December 2017. Individuals aged ≥35 years, first degree relatives of people with Type-II diabetes, were selected and their fasting blood glucose levels were checked twice a week apart. Study participants were divided into 3 groups. Group-I were those with normal fasting blood glucose (FBS: <100mg/dl), Group-II were those with impaired fasting glucose (100-125mg/dl), considered as high risk and Group-III included those who turned out to be having frank diabetes (FBS: ≥126mg/dl). Exclusion criteria were known diabetes and pregnancy. Proportions of impaired fasting glucose levels versus BMI were compared using Chi-square test. Significance was considered at P <0.001. Results: A total of hundred subjects were included in the study with the mean age of 44.27 years. Sixty percent participants had normal FBS, 31% showed impaired FBS and 09% had frank diabetes (P <0.001). Significant association was found between impaired fasting glucose and BMI, as with increasing BMI the frequency of impaired fasting glucose increases. Conclusion: First-degree relatives of people with Type-II diabetes showed higher frequency of impaired fasting glucose and obesity was an important risk factor. doi: https://doi.org/10.12669/pjms.36.3.57 How to cite this:Ali A, Taj A, Ahmed MU, Tabrez E. Frequency of impaired fasting glucose in first degree relatives of Type-II diabetic patients and its association with Body Mass Index. Pak J Med Sci. 2020;36(3):407-411. doi: https://doi.org/10.12669/pjms.36.3.57 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The possible role of Saponin in Type-II Diabetes- A review

2020 ◽  
Vol 16 ◽  
Author(s):  
Neeraj Choudhary ◽  
Gopal Lal Khatik ◽  
Ashish Suttee
Keyword(s):  
Secondary Metabolites ◽  
Type Ii Diabetes ◽  
Structural Diversity ◽  
Complete Information ◽  
Current Data ◽  
Type Ii ◽  
Glucose Levels ◽  
Therapeutic Benefits ◽  
The Impact

Background: The possible role of secondary metabolites in the management of diabetes is a great concern and constant discussion. This characteristic seems relevant and should be the subject of thorough discussion with respect to saponin. Objective: Current data mainly focus on the impact of saponin in the treatment of type-II diabetes. The majority of studies emphasis on other secondary metabolites such as alkaloids and flavonoids but very few papers are there representing the possible role of saponin as these papers express the narrow perspective of saponin phytoconstituents but lacking in providing the complete information on various saponin plants. The aim of the study was to summarize all available data concerning the saponin containing plant in the management of type-II diabetes. Methods: All relevant papers on saponin were selected. This review summarizes the saponins isolation method, mechanism of action, clinical significance, medicinal plants and phytoconstituents responsible for producing a therapeutic effect in the management of diabetes. Results: The saponin is of high potential with structural diversity and inhibits diabetic complications along with reducing the hyperglycemia through different mechanisms thereby providing scope for improving the existing therapy and developing the novel medicinal agents for curing diabetes. Conclusion: Saponins having potential therapeutic benefits and are theorized as an alternative medication in decreasing serum blood glucose levels in the patient suffering from diabetes.

Fat-Augmented Latissimus Dorsi versus Deep Inferior Epigastric Perforator Flap: Comparative Study in Delayed Autologous Breast Reconstruction

2020 ◽  
Author(s):  
Efterpi C. Demiri ◽  
Antonios Tsimponis ◽  
Anastasios Pagkalos ◽  
Eleni Georgiadou ◽  
Olga-Christina Goula ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Demographic Data ◽  
Perforator Flap ◽  
Diep Flap ◽  
Breast Volume ◽  
Autologous Breast Reconstruction ◽  
Patients Satisfaction ◽  
Delayed Breast Reconstruction ◽  
Group A ◽  
Deep Inferior Epigastric Perforator

Abstract Background The use of autologous tissues is considered the mainstay for delayed breast reconstruction. Aside the free abdominal flaps, which are most commonly used, the fat-augmented latissimus-dorsi (FALD) flap has been recently shown a reliable alternative option for pure autologous breast reconstruction. In this retrospective study, we aim to compare outcomes of autologous breast reconstructions using the extended FALD and deep inferior epigastric perforator flap (DIEP) flap, with an emphasis on patients' characteristics, demographic data, complications, and patients' satisfaction after a minimum 12-month follow-up. Methods Our series consists of 135 women who underwent a delayed postmastectomy unilateral autologous breast reconstruction from 2011 to 2017: 36 patients (Group A) had an extended FALD flap and 99 (Group B) a free DIEP flap performed by the same surgeons. Demographic data, breast volume, medical history, smoking, complications, and patients' satisfaction were recorded and analyzed. Student's t-test for independent variables, Mann–Whitney U-test, and Chi-squared test were used to compare the reported variables. Results Patients' age, body mass index (BMI), and pregnancy history were statistically different between groups (p < 0.001, p = 0.004, p < 0.001, respectively); younger age (35.1 vs. 41.2 years), lower BMI (25.6 vs. 28.4), and fewer pregnancies were recorded in Group A. Breast volume was also found significantly smaller in Group A patients (p = 0.009). Past medical history using the ASA physical status classification score, previous radiation therapy, history of smoking, and incidence of overall complications were similar in both groups. Overall satisfaction scores were found slightly higher, but not statistically significant, in the free-flap group (p = 0.442). Conclusion The use of the FALD flap may provide comparable outcome to the DIEP flap in delayed breast reconstruction in terms of complications and patients' satisfaction; it should be considered a good reconstructive option for young and thin nulliparous patients, with small to medium size opposite breast.

Effect of sulfonylurea therapy and plasma glucose levels on hemoglobin A1c in type II diabetes mellitus

1981 ◽  
Vol 70 (2) ◽  
pp. 373-378 ◽  
Author(s):  
T.A. Schultz ◽  
S.B. Lewis ◽  
J.L. Davis ◽  
C.R. Rost ◽  
M.M. Bliziotes
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Type Ii Diabetes ◽  
Hemoglobin A1c ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Glucose Levels

scholarly journals Applicability of Isolates and Fractions of Plant Extracts in Murine Models in Type II Diabetes: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-25 ◽  
Author(s):  
Gabriela Diniz Pinto Coelho ◽  
Vanessa Soares Martins ◽  
Laura Vieira do Amaral ◽  
Rômulo Dias Novaes ◽  
Mariáurea Matias Sarandy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plant Extracts ◽  
Type Ii Diabetes ◽  
Study Groups ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Glucose Levels ◽  
Animal Data ◽  
Plasma Insulin Levels ◽  
Clinical Conditions

Type II diabetes mellitus is one of the most common public health problems worldwide. Its increasing prevalence in several countries and the difficult metabolic control of individuals with the disease justify studying strategies for primary prevention. The population has sought alternative and cheaper ways to treat the disease, including the use of plants considered medicinal by the population. In this study, we carried out a systematic review on the applicability of isolates and fractions of plant extracts in animal models in type II diabetes. A literature search was performed in MEDLINE/PubMed and Scopus databases. Studies using other experimental animals (horses, rabbits, and monkeys) and humans as well as articles in Chinese, German, and Russian were excluded. We assessed the quality of the studies included by using the criteria described in the ARRIVE guidelines. In general, the animals that received fractions or isolates presented reduced blood glucose levels, normalization of body weight and plasma insulin levels, and reduced total triglycerides and cholesterol. In addition, we observed wide variation among the analyzed parameters, which hindered comparison between the studies found. In further studies, standardized reports and experimental design would help to establish comparable study groups and advance the overall knowledge, thus facilitating translatability from animal data to human clinical conditions.

scholarly journals Controlled Type -II Diabetes Mellitus - No More Contra-Indication for Delayed Loading of Two Piece Dental Implants - A Case Report

2019 ◽  
Vol 7 (1) ◽  
pp. 1-4
Author(s):  
Alekhya Ayalapuram
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Type Ii Diabetes ◽  
Survival Rates ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type Ii ◽  
Obesity Prevalence ◽  
Glucose Levels ◽  
Blood Glucose Levels

With changing lifestyle and increasing obesity, prevalence of type -II Diabetes Mellitus is increasing in geriatric individuals, who are generally prone to tooth loss. As a result the demand for implants in these patients is also increasing and planning implants has been a challenge to present day dentists. Diabetes Mellitus causes impaired metabolism in general, especially bone metabolism resulting in impaired Osseointegration and poor wound healing. Growing demand of implants in Type II DM patients has initiated research towards implants survival rates. Extensive research till now states - poorly controlled diabetic patients have higher implant failure rates, where as Diabetic patients with controlled blood glucose levels respond to implants in similar way as healthy patients. The present article is one such trail to confirm that type II Diabetes Mellitus is no more contra-indication for Implants till Blood glucose levels are controlled to normal levels. Key words: Type-II Diabetes Mellitus; Two-piece implant; Delayed loading;

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