Prehospital Treatment of Severe Hypoglycaemia: A Comparison of Intramuscular Glucagon and Intravenous Glucose

1998 ◽  
Vol 13 (2-4) ◽  
pp. 44-50 ◽  
Author(s):  
Søren Carstens ◽  
Michael Sprehn
Keyword(s):  
Recovery Time ◽  
Insulin Treatment ◽  
Severe Hypoglycaemia ◽  
Demographic Data ◽  
Intravenous Glucose ◽  
Prehospital Treatment ◽  
Patient Interviews ◽  
Patient Will ◽  
Intensified Insulin Treatment

AbstractIntroduction:By introducing an intensified insulin treatment regime to patients with insulin-dependant diabetes mellitus (IDDM), the frequency of long-term complications that the patient will experience has been shown to decrease. The price is an increase in the frequency of severe and mild hypoglycaemic events. Therefore, constant monitoring of these patients is necessary.Hypothesis:This study compares the time until full recovery of IDDM patients with severe hypoglycaemia after treatment with either intravenous glucose or intramuscular glucagon.Methods:14 patients with IDDM with severe hypoglycaemia requiring treatment by the medical staff was randomised to treatment either with 50 ml of 50% glucose intravenously or intramuscular 1 mg glucagon. The time to recovery was recorded. Plasma glucose was measured at fixed intervals to achieve a glycaemia profile. Demographic data were acquired through patient interviews following recovery.Results:Recovery time between the two groups was significantly different statistically. Recovery time ranged for 1 to 3 minutes for those receiving glucose intravenously and 8 to 21 minutes for those receiving intramuscular glucagon. Characteristic glycaemia profiles were identified and differences were present between the two groups with a greater fluctuating pattern for the glucose group compared to the steadily increasing pattern seen after glucagon treatment. Alcohol was believed to be involved in 8 out of the 14 cases, and thereby, is the major confounding factor in this study.Conclusion:Intramuscularly administered glucagon is a safe and reliable alternative to intravenous glucose infusion. The fluctuating glyceamia pattern seen after glucose treatment indicates a low risk for secondary hypoglycaemia. However, further studies are necessary to support this assertion.

Long-term effect of intensified insulin treatment on lipid parameters in diabetes mellitus type I

1991 ◽  
Vol 69 (11) ◽  
pp. 483-485
Author(s):  
A. Dzien ◽  
M. Lechleitner ◽  
T. Hopferwieser ◽  
H. Drexel ◽  
J. R. Patsch ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Treatment ◽  
Term Effect ◽  
Diabetes Mellitus Type ◽  
Type I ◽  
Diabetes Mellitus Type I ◽  
Long Term Effect ◽  
Intensified Insulin Treatment ◽  
Lipid Parameters

Oscillatory Potentials, Macular Recovery Time, and Diabetic Retinopathy Through 3 Years of Intensified Insulin Treatment

Ophthalmology ◽  
1988 ◽  
Vol 95 (10) ◽  
pp. 1358-1366 ◽  
Author(s):  
Olaf Brinchmann-Hansen ◽  
Knut Dahl-Jørgensen ◽  
Kristian F. Hanssen ◽  
Leiv Sandvik
Keyword(s):  
Diabetic Retinopathy ◽  
Recovery Time ◽  
Insulin Treatment ◽  
Oscillatory Potentials ◽  
Intensified Insulin Treatment ◽  
Macular Recovery

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

scholarly journals Patient characteristics predict patency of early-cannulation arteriovenous grafts

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
David B. Kingsmore ◽  
Karen S. Stevenson ◽  
S. Richarz ◽  
Andrej Isaak ◽  
Andrew Jackson ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Vascular Access ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Patient Characteristics ◽  
Peripheral Vascular ◽  
Arteriovenous Grafts ◽  
One Year

AbstractThere is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history. On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI. When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly, strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.

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