In Patients with Lower Extremity Burns and Osteomyelitis, Diabetes Mellitus Increases Amputation Rate

2021 ◽  
Author(s):  
Kathleen A Iles ◽  
Stephen Heisler ◽  
Lori Chrisco ◽  
Booker King ◽  
Felicia N Williams ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Lower Extremity ◽  
Healthcare Utilization ◽  
Burn Injury ◽  
Average Length ◽  
Amputation Rate ◽  
P Value ◽  
Diabetic Patients ◽  
The Impact

Abstract In this retrospective analysis, we investigated the rate of radiologically confirmed osteomyelitis, extremity amputation and healthcare utilization in both the diabetic and non-diabetic lower extremity burn populations to determine the impact of diabetes mellitus on these outcomes. The burn registry was used to identify all patients admitted to our tertiary burn center from 2014 to 2018. Only patients with lower extremity burns (foot and/or ankle) were included. Statistical analysis was performed using Student’s t test, chi-squared test, and Fischer’s exact test. Of the 315 patients identified, 103 had a known diagnosis of diabetes mellitus and 212 did not. Seventeen patients were found to have osteomyelitis within three months of the burn injury. Fifteen of these patients had a history of diabetes. Notably, when non-diabetics were diagnosed with osteomyelitis, significant differences were observed in both length of stay and cost in comparison to their counterparts without osteomyelitis (36 vs 9 days; p=0.0003; $226,289 vs $48,818, p=0.0001). Eleven patients required an amputation and 10 (90.9%) of these patients had comorbid diabetes and documented diabetic neuropathy. Compared to non-diabetics, the diabetic cohort demonstrated both a higher average length of stay (13.7 vs 9.2 days, p-value=0.0016) and hospitalization cost ($72,883 vs $50,500, p-value=0.0058). Our findings highlight that diabetic patients with lower extremity burns are more likely to develop osteomyelitis than their non-diabetic counterparts and when osteomyelitis is present, diabetic patients have an increased amputation rate. Further study is required to develop protocols to treat this population, with the specific goal of minimizing patient morbidity and optimizing healthcare utilization.

122 In Patients with Lower Extremity Burns and Osteomyelitis, Diabetes Mellitus Increases Amputation Rate

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S81-S82
Author(s):  
Kathleen A Iles ◽  
Lori Chrisco ◽  
Stephen Heisler ◽  
Booker King ◽  
Felicia N Williams ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Lower Extremity ◽  
Burn Injury ◽  
Healing Process ◽  
Common Mechanism ◽  
P Value ◽  
Diabetic Patients ◽  
Significant Difference ◽  
History Of ◽  
The Impact

Abstract Introduction Diabetes mellitus (DM) is a critical comorbidity with burn injury due to the disrupted healing process. Previous reports have confirmed the increased rate of osteomyelitis (OM) and subsequent amputation in this cohort, however this has yet to be studied in comparison to non-diabetic patients. In this retrospective analysis, we investigate OM and amputation in both the diabetic and non-diabetic lower extremity burn populations to determine the impact of DM on these outcomes. Methods The burn registry was used to identify all patients admitted to our tertiary burn center from January 1, 2014 to December 31, 2018. Only patients with lower extremity burns (foot and/or ankle) were included. Patients with burns to additional body areas were excluded. Amputations were categorized by time from injury. Statistical analysis was performed using Student’s t test, chi-squared test, and Fischer’s exact test. Results Of the 315 patients identified, 103 had a known diagnosis of DM and 212 did not. Scald injury was the most common mechanism and average TBSA was similar. Differences were observed in average length of stay (LOS) and admission cost, with diabetics demonstrating both a higher LOS (13.7 days vs 9.2 days, p-value= 0.0016) and cost ($72,883 vs $50,500, p-value= 0.0058) (Table 1). In total, 17 patients were found to have radiologically confirmed OM within three months of the burn injury. Fifteen of these patients had a history of DM and two had no history of DM (p-value= < 0.001) (Table 2). The DM OM patients were found to have a higher blood glucose level on admission (219 mg/dL vs 110 mg/dL, p-value= 0.0452). No significant difference was seen in Hgb A1c in diabetics with or without OM (9.26% vs 8.81%, p= 0.2743). Notably, when non-diabetics were diagnosed with OM, significant differences were observed in both LOS and cost in comparison to their counterparts without OM (36 days vs 9 days; p= 0.0003; $226,289 vs $48,818, p=0.0001). Of the 11 patients who required an amputation, 10 (90.9%) of these patients had comorbid DM. Conclusions DM patients with lower extremity burns are more likely to develop OM than their non-diabetic counterparts. When radiologically confirmed OM is present, DM patients have an increased rate of amputation. OM incurs significant healthcare utilization and cost in both the diabetic and non-diabetic populations.

530 Osteomyelitis Increases the Rate of Amputation in Patients with Type 2 Diabetes and Lower Extremity Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Rabia Nizamani ◽  
Stephen Heisler ◽  
Lori Chrisco ◽  
Harold Campbell ◽  
Samuel W Jones ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Extremity ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Amputation Rate ◽  
Diabetic Patients ◽  
Inpatient Hospitalization ◽  
Burn Center ◽  
Hospitalization Costs

Abstract Introduction In patients with type 2 diabetes (DM2), amputation rates exceed 30% when lower extremity osteomyelitis is present. We sought to determine the rate of osteomyelitis and any subsequent amputation in our patients with DM2 and lower extremity burns. Methods We performed a single site, retrospective review at our burn center using the institutional Burn Center registry with links to clinical and administrative data. Adults (≥18 years old) with DM2 admitted from January 1, 2014 to December 31, 2018 for isolated lower extremity burns were eligible for inclusion. We evaluated demographics, burn characteristics, comorbidities, admission laboratory values, presence of radiologically-confirmed osteomyelitis, length of stay (LOS), inpatient hospitalization costs, and amputation rate at 3 months and 12 months after injury. Statistical analysis was performed with Students’ t-test, chi-squared, and Fischer’s exact test. Results For 103 patients identified with DM2 and isolated lower extremity burns, the average age was 54 years old. The majority of patients were male (78.6%) and white (55.3%). The average total body surface area (TBSA) of burn was 1.8% and 53.4% were scald burns. Thirty percent of patients had a history of heart disease and 22% were current smokers. The average hemoglobin A1c was 9.19 and average creatinine was 2.01. Overall rates of any amputation were 14.6% at 3 months and 18.4% at 12 months. Fifteen patients (14.6%) had radiologically-confirmed osteomyelitis within 90 days of the burn injury. Compared to patients without osteomyelitis, this subset of patients had significantly increased LOS (average LOS 22.7 days vs 12.1 days, p=0.0041), inpatient hospitalization costs (average $135,345 vs $62,237, p=0.0008), amputation rate within 3 months (66.7% vs 5.70%, p< 0.00001), and amputation rate within 12 months (66.7% vs 10.2%, p< 0.0001). There were no significant differences in other characteristics between patients with osteomyelitis and those without. Conclusions Patients with DM2 and lower extremity burns incurred increased LOS, higher inpatient hospitalization costs, and increased amputation rates if radiologically-confirmed osteomyelitis was present. Applicability of Research to Practice Osteomyelitis in diabetic patients with lower extremity burns may predict need for amputation within one year of burn injury. Further study could aid in development of protocols for early identification and aggressive treatment of osteomyelitis in burn patients, which may improve LOS, cost, and amputation rates.

Osteomyelitis Increases the Rate of Amputation in Patients With Type 2 Diabetes and Lower Extremity Burns

2020 ◽  
Vol 41 (5) ◽  
pp. 981-985
Author(s):  
Rabia Nizamani ◽  
Stephen Heisler ◽  
Lori Chrisco ◽  
Harold Campbell ◽  
Samuel W Jones ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Lower Extremity ◽  
Burn Injury ◽  
Amputation Rate ◽  
Inpatient Hospitalization ◽  
Burn Center ◽  
Hospitalization Costs ◽  
Patients With Diabetes

Abstract In patients with diabetes mellitus (DM), amputation rates exceed 30% when lower extremity osteomyelitis is present. We sought to determine the rate of osteomyelitis and any subsequent amputation in our patients with DM and lower extremity burns. We performed a single-site, retrospective review at our burn center using the institutional burn center registry, linked to clinical and administrative data. Adults (≥18 years old) with DM admitted from January 1, 2014 to December 31, 2018 for isolated lower extremity burns were eligible for inclusion. We evaluated demographics, burn characteristics, comorbidities, presence of radiologically confirmed osteomyelitis, length of stay (LOS), inpatient hospitalization costs, and amputation rate at 3 months and 12 months after injury. We identified 103 patients with DM and isolated lower extremity burns. Of these, 88 patients did not have osteomyelitis, while 15 patients had radiologically confirmed osteomyelitis within 3 months of the burn injury. Compared to patients without osteomyelitis, patients with osteomyelitis had significantly increased LOS (average LOS 22.7 days vs 12.1 days, P = .0042), inpatient hospitalization costs (average $135,345 vs $62,237, P = .0008), amputation rate within 3 months (66.7% vs 5.70%, P < .00001), and amputation rate within 12 months (66.7% vs 9.1%, P < .0001). The two groups were otherwise similar in demographics, burn injury characteristics, access to healthcare, and preexisting comorbidities. Patients with DM and lower extremity burns incurred increased LOS, higher inpatient hospitalization costs, and increased amputation rates if radiologically confirmed osteomyelitis was present within 3 months of the burn injury.

11 Vitamin D Deficiency on Admission and the Association with Length of Stay in Patients with Thermal Injury: A Multi-center Analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S13-S14
Author(s):  
Sarah Zavala ◽  
Kate Pape ◽  
Todd A Walroth ◽  
Melissa A Reger ◽  
Katelyn Garner ◽  
...  
Keyword(s):  
Vitamin D ◽  
Length Of Stay ◽  
Vitamin D Deficiency ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Inhalation Injury ◽  
Hospital Length Of Stay ◽  
Burn Patients ◽  
Comfort Care ◽  
The Impact

Abstract Introduction In burn patients, vitamin D deficiency has been associated with increased incidence of sepsis. The objective of this study was to assess the impact of vitamin D deficiency in adult burn patients on hospital length of stay (LOS). Methods This was a multi-center retrospective study of adult patients at 7 burn centers admitted between January 1, 2016 and July 25, 2019 who had a 25-hydroxyvitamin D (25OHD) concentration drawn within the first 7 days of injury. Patients were excluded if admitted for a non-burn injury, total body surface area (TBSA) burn less than 5%, pregnant, incarcerated, or made comfort care or expired within 48 hours of admission. The primary endpoint was to compare hospital LOS between burn patients with vitamin D deficiency (defined as 25OHD < 20 ng/mL) and sufficiency (25OHD ≥ 20 ng/mL). Secondary endpoints include in-hospital mortality, ventilator-free days of the first 28, renal replacement therapy (RRT), length of ICU stay, and days requiring vasopressors. Additional data collected included demographics, Charlson Comorbidity Index, injury characteristics, form of vitamin D received (ergocalciferol or cholecalciferol) and dosing during admission, timing of vitamin D initiation, and form of nutrition provided. Dichotomous variables were compared via Chi-square test. Continuous data were compared via student t-test or Mann-Whitney U test. Univariable linear regression was utilized to identify variables associated with LOS (p < 0.05) to analyze further. Cox Proportional Hazard Model was utilized to analyze association with LOS, while censoring for death, and controlling for TBSA, age, presence of inhalation injury, and potential for a center effect. Results Of 1,147 patients screened, 412 were included. Fifty-seven percent were vitamin D deficient. Patients with vitamin D deficiency had longer LOS (18.0 vs 12.0 days, p < 0.001), acute kidney injury (AKI) requiring RRT (7.3 vs 1.7%, p = 0.009), more days requiring vasopressors (mean 1.24 vs 0.58 days, p = 0.008), and fewer ventilator free days of the first 28 days (mean 22.9 vs 25.1, p < 0.001). Univariable analysis identified burn center, AKI, TBSA, inhalation injury, admission concentration, days until concentration drawn, days until initiating supplementation, and dose as significantly associated with LOS. After controlling for center, TBSA, age, and inhalation injury, the best fit model included only deficiency and days until vitamin D initiation. Conclusions Patients with thermal injuries and vitamin D deficiency on admission have increased length of stay and worsened clinical outcomes as compared to patients with sufficient vitamin D concentrations.

Increased Serum WISP1 Levels are Associated with Lower Extremity Atherosclerotic Disease in Patients with type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Yangyang Cheng ◽  
Xiaohui Du ◽  
Bilin Zhang ◽  
Junxia Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Extremity ◽  
Interleukin 6 ◽  
Atherosclerotic Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Newly Diagnosed

Abstract Background Serum wnt1-induced signaling pathway protein 1 (WISP1) levels are increased with obesity, which is a common complication associated with lower extremity atherosclerotic disease (LEAD). However, to date, the relationship between elevated WISP1 levels and the incidence of lower extremity atherosclerotic disease (LEAD) in type 2 diabetes mellitus (T2DM) remains unclear. Methods 174 newly diagnosed type 2 diabetic patients were enrolled in our study. Patients were divided into two groups, LEAD group (n=100) and control group (n=74). Anthropometric parameters, blood pressure and some biochemical parameters were obtained. Body composition was detected by bioelectrical impedance analysis (BIA). Levels of serum insulin were determined by radioimmunoassay. Serum WISP1 and interleukin 6 (IL-6) levels were determined using an enzyme-linked immunosorbent assay. Results It was shown that serum WISP1 levels in diabetic patients with LEAD were higher than those without LEAD (P<0.001). Serum WISP1 levels were positively related with waist circumference (r=0.237, P=0.003), waist-hip ratio (r=0.22, P=0.006), visceral fat area (r=0.354, P<0.001), serum creatinine (r=0.192, P=0.012), interleukin 6 (r=0.182, P=0.032), c-reactive protein (r=0.681, P<0.001), triglycerides (r=0.119, P<0.001), fasting glucose (r=0.196, P=0.011), glycated hemoglobin (r=0.284, P<0.001), and HOMA-IR (r=0.285, P<0.026). Compared with the lowest tertile, the odds ratio of the middle tertile for LEAD incidence was 3.27 (95% CI, 1.24–8.64) and 4.46 (95% CI, 1.62–12.29) for the highest tertile after adjusting confounding factors. Conclusion The results suggest that increased serum WISP1 levels independently contribute to the incidence of LEAD in patients with newly diagnosed T2DM.

scholarly journals Times of change in complex environments - Evaluating hospital co-payments in Palestine refugee camps

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S V Valente de Almeida ◽  
H Ghattas ◽  
G Paolucci ◽  
A Seita
Keyword(s):  
Length Of Stay ◽  
Policy Change ◽  
Negative Binomial ◽  
Negative Impact ◽  
Average Length ◽  
Lessons Learned ◽  
Policy Impact ◽  
Average Length Of Stay ◽  
Ex Post ◽  
The Impact

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.

617 Who Benefits the Most from Burn Camps?

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S162-S163
Author(s):  
Jennifer B Radics-Johnson ◽  
Daniel W Chacon ◽  
Li Zhang
Keyword(s):  
Retrospective Review ◽  
Burn Injury ◽  
Statistical Significance ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Self Evaluation ◽  
Significant Difference ◽  
Return Home ◽  
The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value&lt; 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

Adjuvant Supplementation with L-Carnitine in Diabetic Population and its effects on Lipid Parameters

2021 ◽  
Vol 15 (8) ◽  
pp. 2017-2019
Author(s):  
Rao Salman Aziz ◽  
Usman Saeed ◽  
Nasim Aslam Ghumman ◽  
Muhammad Arshad ◽  
Asif Sohail ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Triglyceride Level ◽  
Clinical Care ◽  
Diabetic Patients ◽  
Healthy Population ◽  
Patients With Diabetes ◽  
Diabetic Population ◽  
Large Discount ◽  
The Impact ◽  
Lipid Parameters

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).

PERBEDAAN PENGETAHUAN DAN SIKAP PASIEN DIABETES MELLITUS RAWAT INAP RUMAH SAKIT ISLAM SAMARINDA SEBELUM DAN SESUDAH KONSELING GIZI DENGAN MENGGUNAKAN MEDIA AUDIOVISUAL

2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah
Keyword(s):  
Diabetes Mellitus ◽  
Public Health Problem ◽  
Visual Media ◽  
P Value ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Disease Mortality ◽  
Before And After ◽  
Patients With Diabetes

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media

scholarly journals Contribution of Nanotechnology and Nanomaterials to the Treatment of Diabetic Patients by Aid of Novel Inventions

2020 ◽  
pp. 29-40
Author(s):  
Shiva Najigivi ◽  
Seyedahmadreza Mirmotallebi ◽  
Alireza Najigivi
Keyword(s):  
Diabetes Mellitus ◽  
Drug Delivery ◽  
Human Health ◽  
Carbon Nanostructures ◽  
Closed Loop ◽  
Insulin Injection ◽  
Diabetic Patients ◽  
Temporal Response ◽  
Nanoscience And Nanotechnology ◽  
The Impact

Nanoscience and Nanotechnology are highly growing their significance in diabetic supplies and research nowadays. It is an area that included nanomaterials, nanosensors and nanostructures as well as nanoparticle projects and also their usage in human health research. Particularly, nanotechnology helps to the production of diabetic supplies, materials together with the development of novel glucose and insulin injection devices as well as their measurement sensors by the aid of nanomaterials. These materials mostly could be metal nanoparticles together with carbon nanostructures by nano dimension delivery mechanisms modalities which hold the potential to vividly recover the excellence of life of diabetic patients. Nanoscience and nanotechnology in diabetic research have facilitated and provided more truthful data for identifying diabetes mellitus. It is also worth mentioning that the nanotechnology could highly enhance the impact of drug delivery by addition of nanoscale materials and increase the glucose feeling, temporal response as well as glucose nursing. Furthermore, it is proposing novel nanoscale methods named closed-loop insulin delivery approaches which mechanically release insulin drug in reply to fluctuating blood glucose heights. Besides, the mixture of nanotechnology by medication has shaped a novel field of nanomedicine which could enhance human health level. It is worthwhile to mention that some of the applications of nanotechnology for the treatment of diabetic patients can be the production of diabetic supplies by nanotechnology. One of the most important diabetic instruments that could highly relieve the life of patients these days could be nano diabetic shoes which will describe here. In this research, applications of nanoscience and nanotechnology in treating diabetic patients were discussed.

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