Influence of diabetes mellitus on deep neck infection

2006 ◽  
Vol 120 (8) ◽  
pp. 650-654 ◽  
Author(s):  
H-T Lin ◽  
C-S S Tsai ◽  
Y-L Chen ◽  
J-G Liang
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Haemoglobin Level ◽  
Complication Rate ◽  
Glycosylated Haemoglobin ◽  
Haemoglobin A1c ◽  
Deep Neck Infection ◽  
Glycosylated Haemoglobin Level ◽  
Neck Infection ◽  
Patients With Diabetes

Objective: To investigate the influence of hyperglycaemia on deep neck infection (DNI) and the differences between the diabetic and non-diabetic form of DNI.Study design and setting: Retrospective review of 131 patients with DNI treated between 1993 and 2002 at Shin Kong Memorial Hospital, Taipei, Taiwan.Results: Deep neck infection was significantly more prevalent in patients with diabetes mellitus (DM) over 60 years of age than in non-DM subjects of a similar age (p = 0.004). In the DM group, Klebsiella pneumoniae was the most common aerobic pathogen and tended to involve more than two anatomical spaces (p < 0.0001). Seventeen out of 18 patients (94.4 per cent) displayed an elevated (≥7 per cent) glycosylated haemoglobin level. The DM group had a significantly higher complication rate, longer hospital stay and tracheotomy rate than the non-DM group.Conclusions: Diabetic DNI differs from non-diabetic DNI in several aspects and is associated with a higher morbidity. A greater than normal haemoglobin A1c level was commonly observed.

The association of haemoglobin A1C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus

2014 ◽  
Vol 24 (5) ◽  
pp. 980-989 ◽  
Author(s):  
Hong-Hau Wang ◽  
Shih-Hung Tsai ◽  
Chih-Yung Yu ◽  
Hsian-He Hsu ◽  
Chang-Hsien Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Haemoglobin A1c ◽  
Liver Abscesses ◽  
Patients With Diabetes

Deep neck infection in diabetic patients: Comparison of clinical picture and outcomes with nondiabetic patients

2005 ◽  
Vol 132 (6) ◽  
pp. 943-947 ◽  
Author(s):  
Tung-Tsun Huang ◽  
Fen-Yu Tseng ◽  
Tien-Chen Liu ◽  
Chuan-Jen Hsu ◽  
Yuh-Shyang Chen
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Stay ◽  
Clinical Picture ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Deep Neck Infection ◽  
Neck Infection ◽  
Duration Of Hospital Stay ◽  
Patients With Diabetes ◽  
Deep Neck Infections

OBJECTIVE: To compare the difference in the clinical picture and outcomes between diabetic and nondiabetic patients with deep neck infections. STUDY DESIGN AND SETTING: We retrospectively reviewed the records of patients who were diagnosed with deep neck infections and who received treatment at the Department of Otolaryngology of National Taiwan University Hospital between 1997 and 2002. One hundred eighty-five patients were included in our study. Fifty-six patients with diabetes mellitus were enrolled for further analysis (diabetic group) and compared with the other 129 patients without diabetes mellitus (nondiabetic group) in demography, etiology, bacteriology, treatment, duration of hospital stay, complications, and outcome. RESULTS: The parapharyngeal space was the space most commonly involved in both the diabetic (33.9%) and nondiabetic groups (40.3%). Odontogenic infections and upper airway infections were the 2 leading causes of deep neck infection in diabetic and nondiabetic groups. Streptococcus viridans is the most commonly isolated organism in the nondiabetic group (43.7%). However, the most common organism in the diabetic group was Klebsiella pneumoniae (56.1%). There were 89.3% of diabetic patients, versus 71.3% of nondiabetic patients, with abscess formation ( P = 0.0136). Surgical drainage was performed more frequently in the diabetic group than in the nondiabetic group (86.0% versus 65.2%, P = 0.0142). In comparison with the nondiabetic group, the diabetic group tended to have older mean age (57.2 y versus 46.2 y, P = 0.0007), longer duration of hospital stay (19.7 days versus 10.2 days, P >0.0001), more frequent complications (33.9% versus 8.5%, P >0.0001), and more frequent tracheostomy or intubation (19.6% versus 6.2%, P = 0.0123). CONCLUSIONS: Patients with diabetes mellitus are susceptible to deep neck infection. We should pay more attention when dealing with deep neck infections in patients with diabetes mellitus because those patients tend to have complications more frequently and a longer duration of hospital stay. Empirical antibiotics should cover K. pneumoniae in patients with deep neck infection who have diabetes mellitus.

scholarly journals Lack of association between peroxisome proliferator-activated receptor-gamma-2 gene variants and the occurrence of coronary heart disease in patients with diabetes mellitus

2002 ◽  
pp. 545-551 ◽  
Author(s):  
M Bluher ◽  
T Klemm ◽  
T Gerike ◽  
H Krankenberg ◽  
G Schuler ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Multiple Logistic Regression Analysis ◽  
Peroxisome Proliferator ◽  
Haemoglobin A1c ◽  
Peroxisome Proliferator Activated Receptor ◽  
Patients With Diabetes ◽  
Reduced Risk

OBJECTIVE: Recent evidence indicates that peroxisome proliferator-activated receptor-gamma (PPARgamma) is expressed at high levels in foam cells of atherosclerotic lesions, that PPARgamma agonists may directly modulate vessel wall function and that mutations in the PPARgamma-2 gene are associated with a reduced risk of coronary artery disease. METHODS: We investigated whether known variants in the PPARgamma-2 gene are associated with the occurrence of coronary heart disease (CHD) in 365 patients with type 2 diabetes, prospectively characterised for the presence or absence of CHD. The Pro115Gln, Pro12Ala, Pro467Leu, Val290Met mutations and two polymorphisms C478T and C161T of the PPARgamma-2 gene were examined using PCR, denaturing gradient gel electrophoresis and direct sequencing. RESULTS: The distribution of the Pro12Ala, Ala12Ala, C161T and T161T variants was not significantly different between patients with and without CHD, independent of the gender. The Pro12Ala (P=0.011) and the Ala12Ala (P=0.006) variant were associated with a higher body mass index (BMI) compared with the Pro12Pro genotype. A multiple logistic regression analysis introducing the typical risk factors for CHD (age, sex, hypertension, smoking, BMI >26 kg/m2, elevated low density lipoprotein cholesterol and haemoglobin A1c >7%) identified age >60, male gender, hypertension and a higher BMI, but not the PPARgamma-2 variants, as significant risk factors for CHD in our study groups. CONCLUSION: The PPARgamma-2 genotype was not associated with an increased or reduced risk of the occurrence of CHD and can therefore not be regarded as an independent risk factor for CHD in patients with diabetes mellitus.

scholarly journals High Risk of Deep Neck Infection in Patients with Type 1 Diabetes Mellitus: A Nationwide Population-Based Cohort Study

2018 ◽  
Vol 7 (11) ◽  
pp. 385 ◽  
Author(s):  
Geng-He Chang ◽  
Meng-Chang Ding ◽  
Yao-Hsu Yang ◽  
Yung-Hsiang Lin ◽  
Chia-Yen Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Cohort Study ◽  
Type 1 Diabetes Mellitus ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Deep Neck Infection ◽  
Research Database ◽  
Neck Infection

Objective: To investigate the risk of deep neck infection (DNI) in patients with type 1 diabetes mellitus (T1DM). Methods: The database of the Registry for Catastrophic Illness Patients, affiliated to the Taiwan National Health Insurance Research Database, was used to conduct a retrospective cohort study. In total, 5741 patients with T1DM and 22,964 matched patients without diabetes mellitus (DM) were enrolled between 2000 and 2010. The patients were followed up until death or the end of the study period (31 December 2013). The primary outcome was the occurrence of DNI. Results: Patients with T1DM exhibited a significantly higher cumulative incidence of DNI than did those without DM (p < 0.001). The Cox proportional hazards model showed that T1DM was significantly associated with a higher incidence of DNI (adjusted hazard ratio, 10.71; 95% confidence interval, 6.02–19.05; p < 0.001). The sensitivity test and subgroup analysis revealed a stable effect of T1DM on DNI risk. The therapeutic methods (surgical or nonsurgical) did not differ significantly between the T1DM and non-DM cohorts. Patients with T1DM required significantly longer hospitalization for DNI than did those without DM (9.0 ± 6.2 vs. 4.1 ± 2.0 days, p < 0.001). Furthermore, the patients with T1DM were predisposed to DNI at a younger age than were those without DM. Conclusions: T1DM is an independent risk factor for DNI and is associated with a 10-fold increase in DNI risk. The patients with T1DM require longer hospitalizations for DNI and are younger than those without DM.

Haemoglobin A1c Goal Attainment in Relation to Dose in Patients with Diabetes Mellitus Taking Metformin

2008 ◽  
Vol 28 (8) ◽  
pp. 487-493
Author(s):  
Fernie J A Penning-van Beest ◽  
Bruce H R Wolffenbuttel ◽  
Ron M C Herings
Keyword(s):  
Diabetes Mellitus ◽  
Goal Attainment ◽  
Haemoglobin A1c ◽  
Patients With Diabetes

scholarly journals Assessing efficacy of diabetes school using diabetes knowledge scale in Turkey

2019 ◽  
Vol 8 (1) ◽  
pp. 280
Author(s):  
Bengur Taskiran ◽  
Guven Baris Cansu
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Education Programme ◽  
Haemoglobin A1c ◽  
Diabetes Knowledge ◽  
Poor Knowledge ◽  
Knowledge Questionnaire ◽  
Number Of Patients ◽  
Patients With Diabetes

Background: Diabetes education, as an essential component of diabetes management, improves various aspects of diabetes mellitus including lowering Haemoglobin A1c. There is a number of surveys evaluating diabetes knowledge.Methods: The purpose of this study to measure diabetes knowledge of patients with diabetes mellitus after a structured group education programme named as diabetes school. This study is an observational study and the design is a cohort study. The study took place in 2017-2018. The duration of follow-up is 4 weeks. Fifty-four patients aged over 18 with a previous diagnosis of diabetes mellitus, who attended to the diabetes school education programme, were included to the study. Twenty-three patients participated in the true-false version of the revised Michigan diabetes knowledge questionnaire before and after the programme.Results: Twenty female and 3 male patients were aged 60.43±9.97 years. The scores improved significantly after the education programme (7.61±4.59 vs 12.39±3.35, p<0.0001). The number of patients correctly identifying more than half of the statements showed a steep increase after the programme (n=6, 26.0% vs n=17, 73.9%). Before education programme 13 had poor knowledge, 9 had moderate, and 1 had good knowledge. After completion 6 had poor knowledge, 11 had moderate, and 5 had good knowledge.Conclusions: Diabetes school is effective in improving diabetes knowledge in patients with diabetes mellitus. Revised Michigan Diabetes Knowledge Questionnaire can be used to evaluated diabetes knowledge. It may aid to detect the subgroup of patients who are lack knowledge of various aspects of diabetes mellitus.

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