Prevalence and Distribution of Diabetes Mellitus in a Maximum Care Hospital: Urgent Need for HbA1c-Screening

2017 ◽  
Vol 126 (02) ◽  
pp. 123-129 ◽  
Author(s):  
Johannes Kufeldt ◽  
Marketa Kovarova ◽  
Michael Adolph ◽  
Harald Staiger ◽  
Michael Bamberg ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Stay ◽  
Diabetes Prevalence ◽  
University Hospital ◽  
Diabetic Patients ◽  
Diabetes Diagnosis ◽  
Care Hospital ◽  
Negative Consequences ◽  
Number Needed To Screen ◽  
The University

Abstract Objective Diabetes mellitus affects almost one in 10 individuals in Germany. So far, little is known about the diabetes prevalence in maximum care hospitals. We assessed the diabetes prevalence, proportion of undiagnosed cases, the effectiveness of diabetes screening in a university hospital, the consequences for hospital stay and acquired complications. Research Design and Methods Over a 4 week period we determined HbA1c from 3 733 adult patients which were hospitalized at the university hospital of Tuebingen and had an available blood sample. Diabetes diagnosis was defined as HbA1c≥6.5% and/or previously documented diabetes diagnosis, prediabetes was defined as HbA1c≥5.7% and <6.5% without history of previous diabetes. Results 23.68% of the patients had prediabetes and 22.15% had diabetes with a high variation between the specialised departments (range 5–43%). The rate of unknown diabetes was 3.7%, the number needed to screen was 17 in patients older than 50 years. Patients with diabetes had a prolonged hospital stay compared to the mean length of stay for their diagnosis related group (diabetes: 1.47±0.24 days; no diabetes: −0.18±0.13 days, p=0.0133). The prevalence of hospital acquired complications was higher in diabetic patients (diabetes: 197 of 630; no diabetes: 447 of 2 459, p<0.0001). Conclusions Every fourth patient in the university hospital had diabetes and every second had either prediabetes or diabetes. It is also worthwhile to screen for unknown diabetes in patients over the age of 50. The high prevalence and negative consequences of diabetes require screening and intensified specialized diabetes treatment in hospitals.

scholarly journals TYPE II DIABETES MELLITUS

2018 ◽  
Vol 25 (09) ◽  
pp. 1369-1373
Author(s):  
Ijaz Ahmed ◽  
Umer Jahangir ◽  
Humaira Talat ◽  
Fatima Akhund
Keyword(s):  
Diabetes Mellitus ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Cutaneous Manifestations ◽  
Cutaneous Infections

Introduction: Diabetes Mellitus is a syndrome with disordered metabolismand inappropriate hyperglycemia due to either deficiency of insulin secretion or combinationof insulin resistance and inadequate insulin. Infections constitute the main bulk of cutaneousmanifestations of diabetes mellitus with incidence ranging between 20–50%. Bacteria andfungi can cause infective complications involving skin and nails of the diabetic patients. Themajor share of infections in Diabetes Mellitus is contributed by bacteria. The most commoncausative organisms are Staphylococcus aurous and beta-hemolytic Streptococci. Objective:to determine the frequency of cutaneousbacterial Infections in patients with type II DiabetesMellitis, attending outpatient clinic in a tertiary care hospital. Study Design: Cross sectionalstudy. Setting: Department of Dermatology and Medicine, Dr. Ziauddin University Hospital,KDLB Campus, Karachi. Period: 1st January 2017 till 31st March 2017 over a period of threemonths. Material and methods: Adult patients already diagnosed to be suffering from type 2Diabetes Mellitis presenting with cutaneous manifestations were included in the study. Patientsfulfilling the selection criteria were enrolled after an informed consent. Relevant laboratoryinvestigations were advised where required. Current study targeted bacterial infections onlyand Chi-square test was used to determine P value. Data obtained was compiled, tabulatedand analyzed by SPSS. Result: Total of 302 cases of Type 2 Diabetes Mellitis having somecutaneous manifestations were enrolled. There were 124 (41%) males and 178 (59%) females.Mean age of presentation was 50 ± 11 years, the age range being 30-80 years. The meanduration of diabetes was 8.5 ± 7 years (range being 1-30 years). Unsatisfactory glycemic controlwas present in 205 (68%) patients. Among the enrolled subjects bacterial infections were themost frequently seen skin disease accounting for 79 patients (26%). Among the patients withthese bacterial infections uncontrolled Diabetes was a feature in 61 (77%). The breakup ofbacterial infections (59) in the descending order of frequency stood as follows: cellulitis 22(28%), carbuncle 17 (21%), furuncle 14 (18%), ecthyma 13 (16%), folliculitis 09 (12%), andimpetigo 04 (5%). Conclusion: Cutaneous infections are a common feature in patients withType II Diabetes Mellitis, bacterial infections being the most common.

scholarly journals Compliance of checking HbA1c in a tertiary care hospital of Pakistan

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Abdul Aziz ◽  
Syed Ahsan Ali
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Creative Commons ◽  
Glucose Levels ◽  
Uncontrolled Diabetes

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world. Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c. Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%. Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c. doi: https://doi.org/10.12669/pjms.37.1.2814 How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145.  doi: https://doi.org/10.12669/pjms.37.1.2814 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.

scholarly journals EFFECT OF ORAL AZITHROMYCIN AND METRONIDAZOLE AS AN ADJUNCT TO SCALING AND ROOT PLANING ON GLYCEMIC CONTROL IN TYPE II DIABETIC PATIENTS WITH CHRONIC PERIODONTITIS

2017 ◽  
Vol 10 (3) ◽  
pp. 449
Author(s):  
Dhivya K ◽  
Yogarajan K ◽  
Shanmugarajan T S
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Chronic Periodontitis ◽  
Alveolar Bone ◽  
Tertiary Care ◽  
Periodontal Therapy ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Oral Azithromycin

ABSTRACTObjective: Periodontitis, a chronic inflammatory disease characterized by destruction of the periodontal ligament and alveolar bone is the sixthcomplication of diabetes mellitus. Periodontal treatment that reduces gingival inflammation aids in the control of hyperglycemia. Therefore, thepresent study was designed to determine the effect of treating chronic periodontitis with oral antibiotics azithromycin and metronidazole on the levelof serum glycated hemoglobin in type-II diabetic patients.Methods: This prospective observational study was carried out in the dental department of a tertiary care hospital for 9 months. Clinical andbiochemistry reports of 90 patients were collected in designed case report forms. All statistical analyses were performed using IBM Statistical Packagefor Social Sciences 17 and Graph Pad Prism 7.0.Results: Significant reduction in all the clinical and dental parameters was comparatively higher in patients who received azithromycin than inpatients who received metronidazole and scaling and root planning alone.Conclusion: Periodontal therapy with oral azithromycin can be employed as a supportive strategy for the management of diabetes mellitus.Henceforth, prevention and control of periodontal disease along with antibiotics must be considered an integral part of glycemic control. However,due to the lesser sample size in this study, further investigations are required to confirm the effect of periodontal therapy on systemic diseases.Keywords: Periodontitis, Azithromycin, Metronidazole, Glycemic control, Diabetes mellitus.

scholarly journals Locked intramedullary nailing technique of the femur without brilliance amplifier at the trauma and orthopedics department of the university hospital of peace series on 35 cases during 1 year

2021 ◽  
Vol 13 (5) ◽  
pp. 95-97
Author(s):  
Augustin Delange Hendrick ◽  
Almenord Pharol ◽  
Khawly Clifford PG ◽  
Augustin Delange ◽  
Pierre Marie Woolley
Keyword(s):  
Hospital Stay ◽  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Patient Morbidity ◽  
Duration Of Hospitalization ◽  
The Cost ◽  
The University

Femoral fractures increase the length of hospital stay for our patients for several reasons such as lack of blood, economic resources, and lack of infrastructure. The use of a C-arm has been shown to reduce patient morbidity due to early functional recovery and reduced hospital stay. Objective: To develop an intramedullary nailing technique without c-arm with a closed focus to reduce the duration of hospitalization of its patients as well as the cost related to the equipment used for follow-up. Methodology: prospective study on 35 patients for 1 year August 2020 to August 2021 Results: We followed 35 patients in which the mean age was 37.83 years with extremes of 18 and 78 years. The male sex predominates 21 against 14 women or 60% against 40% respectively. The sex ratio is 1.5. A total of 19 diaphyseal fractures (54.3%) were nailed, 9 supracondylar (25.7%) and 7 subtrochanteric (20%). Twenty-seven were closed fractures (71.1%), and 8 were open fractures (22.9%). The length of hospitalization was less than 3 days for 30 patients (85.7%), and more than 3 days for 5 patients (14.3%). Conclusion: We recommend that we promote this closed-hearth technique because it improves the postoperative follow-up of patients. Additionally, it would reduce exposure to radiation from c-arm in hospitals that have this equipment.

scholarly journals TYPE 2 DIABETES MELLITUS;

2013 ◽  
Vol 20 (02) ◽  
pp. 237-243
Author(s):  
GHULAM HUSSAIN BALOCH ◽  
ABDUL QADIR DALL ◽  
ATIF SITWAT HAYAT ◽  
Syed Zulfiquar Ali Shah ◽  
Bikha Ram Devrajani
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
University Hospital ◽  
Diabetic Patients ◽  
Haemoglobin A1c ◽  
Type 2 Diabetic Patients ◽  
History Of ◽  
Upper Molar

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.

scholarly journals Knowledge, attitude and practice of diabetic retinopathy amongst diabetic patients in a tertiary care hospital of Jammu

2020 ◽  
Vol 8 (3) ◽  
pp. 836
Author(s):  
Pallavi Sharma ◽  
Bhavani Raina ◽  
Anuradha Bharti
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Ocular Complications ◽  
Attitude And Practice ◽  
Eye Disorders ◽  
Knowledge Practice ◽  
Knowledge Attitude And Practice

Background: Diabetes mellitus is a common metabolic disorder which is characterized by elevated blood sugar level. It is a major cause of blindness in our country, which is preventable and treatable, if healthy practice and knowledge regarding this disease is applied. The study was undertaken to assess the knowledge, attitude and practice of Diabetic Retinopathy, amongst diabetic patients attending eye OPD in GMC Jammu.Methods: 300 patients diagnosed with diabetes mellitus attending eye OPD, over a period of 10 months, in GMC Jammu, were incorporated in this study. Self administered questionnaires were used to assess knowledge, practice and attitude of diabetic retinopathy amongst the diabetic patient, after their due consent.Results: This study incorporated 300 diabetic patients out of which 168 (56%) were males and 132 (44%) were females. Most of the patients (70%) were aware of the fact that diabetes can cause eye disorders. 67.33% believed that they should go for regular eye check-ups. 79.33% agreed that timely intervention can delay the complications in diabetic eye disease.Conclusions: Diabetes can lead to serious ocular complications which can be prevented by appropriate awareness and optimistic attitude and good approach towards the disease.

BIDIRECTIONAL SCREENING FOR TUBERCULOSIS AND DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

2021 ◽  
pp. 93-95
Author(s):  
Arun Babu.V ◽  
Deepak Kanna.K
Keyword(s):  
Diabetes Mellitus ◽  
Health Outcomes ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Hiv Screening ◽  
Care Hospital ◽  
Tuberculosis Patients ◽  
Bidirectional Relationship

Screening for Tuberculosis in people with Diabetes and screening for Diabetes in people with Tuberculosis will allow earlier detection of co-morbidities, leading to better health outcomes. This study carried out in a tertiary care hospital in South India consisted of 500 Diabetic patients and 250 patients of Tuberculosis. In 250 Tuberculosis patients screened for DM, the overall prevalence of DM in TB patients was 24.8%,out of which 17.2 % already had Diabetes and 7.6% was the additional yield during screening. About 500 Diabetes cases screened for tuberculosis, 7.6% had symptoms suggestive of tuberculosis. On further evaluation of these subjects none of them revealed evidence for tuberculosis. There exists a bidirectional relationship between TB and diabetes, and they both impact the presentation of each other. This study highlights the need of routine screening for dysglycemia for all TB patients, especially at the time of diagnosis, similar to HIV screening.

scholarly journals Caracterização do perfil e complicações intra-hospitalares dos pacientes submetidos ao cateterismo cardíaco em um hospital terciário

2017 ◽  
Vol 27 (1) ◽  
pp. 24806
Author(s):  
Débora Ferreira Braga ◽  
Gustavo Paes Silvano ◽  
Thainá Ferreira Furtado Pereira ◽  
Fabiana Schuelter-Trevisol ◽  
Daisson José Trevisol
Keyword(s):  
Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Hospital Stay ◽  
Cardiac Catheterization ◽  
Tertiary Care ◽  
Care Hospital ◽  
Puncture Site ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Triple Vessel Disease

DOI: 10.15448/1980-6108.2017.1.24806 Aims: To evaluate the profile of patients undergoing cardiac catheterization and in-hospital complications associated with the procedure.Methods: Cross-sectional analysis of baseline data of a retrospective cohort study conducted in a tertiary care hospital in southern Brazil between 2007 and 2013. The study included patients undergoing diagnostic or therapeutic cardiac catheterization. The data were extracted from electronic medical records using a standardized form and stored in a database for further analysis.Results: Out of 994 assessed patients, 584 (58.8%) were male. The mean age was 61.4 years. Hypertension was the most prevalent risk factor, followed by dyslipidemia and diabetes mellitus. Regarding clinical presentation, 550 (55.3%) patients had acute coronary syndrome, 402 (40.4%) had stable angina, and 42 (4.2%) were asymptomatic. Cineangiography was normal in 152 (15.3%) patients and abnormal in 842 (84.7%). Of these, 251 (29.8%)  had single vessel disease, 190 (22.6%) had double vessel disease, and 401 (47.6%) had triple vessel disease. The overall incidence of complications was 15.6%, and 1% of the patients suffered some kind of major event (death during the procedure and neurological complications during their hospital stay). Other complications included acute kidney injury (1.4%) and local vascular complications (13.2%), mainly hematoma at the puncture site. Fifty (5%) patients died during the hospital stay, 46 (92%) of them from cardiac causes. Conclusions: The patients undergoing cardiac catheterization were predominantly male, with mean age of 61.4 years. The most frequent risk factors for cardiovascular disease included hypertension, dyslipidemia, and diabetes mellitus. Most of the patients had triple vessel disease. The main indication for the procedure was acute coronary syndrome. The overall incidence of complications was 15.6% with predominance of hematoma at the puncture site.

scholarly journals The Prevalence of Nondiabetic Renal Diseases in Patients with Diabetes Mellitus in the University Hospital of Ribeirão Preto, São Paulo

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Diego Agra Souza ◽  
Gyl Eanes Barros Silva ◽  
Igor Lima Fernandes ◽  
Dyego José Araújo de Brito ◽  
Monique Pereira Rêgo Muniz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Membranous Glomerulonephritis ◽  
Sao Paulo ◽  
Group Iv ◽  
University Hospital ◽  
Renal Diseases ◽  
Group I ◽  
Patients With Diabetes ◽  
The University ◽  
Time Since Diagnosis

Objective. To evaluate the prevalence of nondiabetic renal diseases (NDRDs) in renal biopsies of patients with diabetes mellitus (DM) in the University Hospital of Ribeirão Preto, São Paulo. Research Design and Methods. We conducted a retrospective study including kidney biopsies performed in diabetic patients between 1987 and 2013. We evaluated 79 biopsies during this period. The primary variable was the prevalence of NDRD in patients with DM. The secondary variables were the presence of systemic arterial hypertension (SAH), hematuria, time since diagnosis of DM, serum creatinine, and proteinuria levels. The cases were divided into the following groups: isolated diabetic nephropathy (DN—group I), isolated nondiabetic renal diseases (NDRD—group II), associated NDRD/DN (group III), and associated NDRD+NDRD/DN (group IV). Results. Most of the patients (58.22%) presented only alterations arising from DN. NDRDs were present in 41.77% of the patients. Membranous glomerulonephritis (30.3%) and IgA nephropathy (24.24%) were the most prevalent NDRDs. We found no differences between female and male patients with NDRD when assessing the secondary variables. A time since diagnosis of five years or less revealed a statistical difference (p=0.0005) in the comparison between the isolated DN (group I) and the NDRD+NDRD/DN (group IV). The other secondary variables were not significant in the comparison of the groups. Conclusions. We concluded that the prevalence of NDRD is 41.77%. Membranous glomerulonephritis was the most prevalent NDRD in our study. We also conclude that the probability of the presence of NDRD with or without concomitant DN is greater for patients who had biopsies with a time since diagnosis of five years or less. A time since diagnosis of ten years or more does not allow the exclusion of the presence of NDRD.

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