The Diabetic Patient

Mapping Intimacies ◽

10.1093/med/9780190678333.003.0039 ◽

2018 ◽

Author(s):

Mario Patino ◽

Anna M. Varughese

Keyword(s):

Diabetic Patient ◽

Metabolic Control ◽

Pediatric Patient ◽

Surgical Procedure ◽

Perioperative Management ◽

Severe Hypoglycemia ◽

Diabetic Child ◽

Diabetic Patients ◽

Life Threatening ◽

Perioperative Risks

The perioperative management of diabetic patients is complex and requires knowledge of the patients’ pathophysiology, current regimen, and proposed surgical procedure. This chapter addresses perioperative risks, as well as the formulation of both goals of management and perioperative plan in the pediatric patient with diabetes. This chapter will enable the reader to differentiate appropriate preoperative metabolic control from nonoptimal control in a diabetic child, define the perioperative risks and complications for diabetic patients, describe perioperative goals in the management of children with diabetes and conceptualize a perioperative plan to meet these goals, and learn how to effectively manage life-threatening complications such as severe hypoglycemia.

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Diabetic Patient

10.1093/med/9780199764495.003.0046 ◽

2013 ◽

Author(s):

Mario Patino ◽

Anna M Varughese

Keyword(s):

Diabetic Patient ◽

Metabolic Disorder ◽

Surgical Procedure ◽

Perioperative Management ◽

Rapid Development ◽

Current Treatment ◽

Diabetic Patients ◽

Pediatric Endocrinologist ◽

Degree Of Control

Diabetes is the most common metabolic disorder in children, and its incidence is increasing. The rapid development of new, complex regimens for treatment and the availability of many forms of insulin make the management of these patients complex and best conducted in conjunction with a pediatric endocrinologist. Perioperative management of diabetic patients requires knowing the pathophysiology, current treatment, degree of control and compliance with therapy, previous complications, and complexity and duration of the surgical procedure.

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Amputation of a type II diabetic patient with cutaneous leishmaniasis due to Leishmania major

BMC Infectious Diseases ◽

10.1186/s12879-021-06909-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Arezki Izri ◽

Amina Bendjaballah-Laliam ◽

Denis Sereno ◽

Ihcene Kherachi Djenad ◽

Zoubir Harrat ◽

...

Keyword(s):

Diabetic Patient ◽

Leishmania Major ◽

Neglected Tropical Diseases ◽

Cutaneous Lesion ◽

Health Concern ◽

Diabetic Patients ◽

Case Presentation ◽

Chronic Alcohol Abuse ◽

Life Threatening

Abstract Background Leishmaniases are neglected tropical diseases of public health concern in Algeria. The immunocompromised patients with HIV, autoimmune diseases, or chronic alcohol abuse are at a higher risk of leishmaniasis. Herein, we present the case of an immunocompetent diabetic patient infected by Leishmania major, leading to life-threatening consequences. Case presentation An Algerian diabetic patient developed a cutaneous lesion with large polymorphous inflamed granuloma and pyoderma gangrenosum in the left foot, following L. major infection. A delayed follow-up led to a treatment failure, resulting in the amputation. Conclusions This report highlights the absence of timely treatment of Leishmania infection as a life-threatening point among high-risk diabetic patients. Clinicians should be aware of this parasitosis leading to severe complications in diabetic patients.

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Intentional overdose of liraglutide in a non-diabetic patient causing severe hypoglycemia

CJEM ◽

10.1017/cem.2017.439 ◽

2018 ◽

Vol 20 (S2) ◽

pp. S61-S63 ◽

Cited By ~ 3

Author(s):

Kevin J. Solverson ◽

Holly Lee ◽

Christopher J. Doig

Keyword(s):

Intensive Care Unit ◽

Diabetic Patient ◽

Glucose Monitoring ◽

Severe Hypoglycemia ◽

Blood Glucose Monitoring ◽

Diabetic Patients ◽

Close Monitoring ◽

Acute Presentation ◽

Diabetic Status ◽

Dextrose Infusion

ABSTRACTCases of liraglutide overdose are rare in the literature. Prior reports have not found hypoglycemia related to the medication overdose. We describe a case of a non-diabetic patient who intentionally overdosed on liraglutide leading to severe hypoglycemia. The patient required admission to the intensive care unit for a dextrose infusion and close monitoring. Glucagon-like protein-1 agonists are recognized for their safety and rarely causing hypoglycemia in diabetic patients. However, in this case the patient’s non-diabetic status may have put him at risk for hypoglycemia in contrast to prior cases showing no hypoglycemia in diabetic patients. The case highlights the possible dangers of liraglutide overdose and need for blood glucose monitoring in the acute presentation.

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Characteristics of Hypoglycemic Diabetic Patients Visiting the Emergency Room

Cardiovascular Therapeutics ◽

10.1155/2020/3612607 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Tong Min Kim ◽

Hyunah Kim ◽

Seung-Hwan Lee ◽

Jae-Hyoung Cho ◽

Hyunyong Lee ◽

...

Keyword(s):

Emergency Room ◽

Hba1c Level ◽

Glycated Hemoglobin ◽

Statistical Significance ◽

Severe Hypoglycemia ◽

Patient Characteristics ◽

Diabetes Duration ◽

Diabetic Patients ◽

Lower Body ◽

Life Threatening

Introduction. Severe hypoglycemia can be life-threatening; therefore, it is important to identify the characteristics of the hypoglycemic patients. The aim of this study is to analyze the type and characteristics of diabetic patients with hypoglycemia who visited an emergency room. Methods. We included diabetic patients with hypoglycemia who visited the emergency room of St. Mary’s Hospital in Seoul from January 2009 to August 2018 in the study. Hypo_S group patients visited the emergency room once whereas Hypo_M group patients visited twice or more. We also compared the incidence of cardiovascular disease between the groups within 5 years after hypoglycemia. Results. A total of 843 patients were included in this study, with a mean age of 71±14 years and average glycated hemoglobin (HbA1c) level of 6.7±1.4%. For patients with hypoglycemia, lower body mass index, lower HbA1c, shorter diabetes duration, and lower glomerular filtration rate have a statistically significant relationship with patient characteristics in the emergency room group (all p<0.001). Hypoglycemia symptoms were most frequently observed between 6:00 and 12:00 am (p<0.001). Cardiovascular diseases within 5 years after discharge were more frequent in the Hypo_S group than in the Hypo_M group; however, there was no statistical significance. The frequency of aneurysms was significantly higher in patients with hypoglycemia than in other patients in the emergency room (p<0.05). Conclusion. Relatively thin older patients with a diabetes duration shorter than 10 years and good blood sugar control showed higher frequency of visits to the emergency room due to hypoglycemia. For these patients, medical staff should always be mindful of their susceptibility to hypoglycemia when prescribing insulin or OHA and educate them on the prevention of hypoglycemia.

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Vitamin D3 supplementation improves glycemic control in type 2 diabetic patients: Results from an Italian clinical trial

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000673 ◽

2020 ◽

pp. 1-10

Author(s):

Giuseppe Derosa ◽

Angela D’Angelo ◽

Chiara Martinotti ◽

Maria Chiara Valentino ◽

Sergio Di Matteo ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Metabolic Control ◽

Vitamin D3 ◽

Therapy Group ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Abstract. Background: to evaluate the effects of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients with Vitamin D deficiency. Methods: one hundred and seventeen patients were randomized to placebo and 122 patients to Vitamin D3. We evaluated anthropometric parameters, glyco-metabolic control, and parathormone (PTH) value at baseline, after 3, and 6 months. Results: a significant reduction of fasting, and post-prandial glucose was recorded in Vitamin D3 group after 6 months. A significant HbA1c decrease was observed in Vitamin D3 (from 7.6% or 60 mmol/mol to 7.1% or 54 mmol) at 6 months compared to baseline, and to placebo (p < 0.05 for both). At the end of the study period, we noticed a change in the amount in doses of oral or subcutaneous hypoglycemic agents and insulin, respectively. The use of metformin, acarbose, and pioglitazone was significantly lower (p = 0.037, p = 0.048, and p = 0.042, respectively) than at the beginning of the study in the Vitamin D3 therapy group. The units of Lispro, Aspart, and Glargine insulin were lower in the Vitamin D3 group at the end of the study (p = 0.031, p = 0.037, and p = 0.035, respectively) than in the placebo group. Conclusions: in type 2 diabetic patients with Vitamin D deficiency, the restoration of value in the Vitamin D standard has led not only to an improvement in the glyco-metabolic compensation, but also to a reduced posology of some oral hypoglycemic agents and some types of insulin used.

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The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients

European Journal of Ophthalmology ◽

10.1177/1120672121990576 ◽

2021 ◽

pp. 112067212199057

Author(s):

Tomás de Oliveira Loureiro ◽

João Nobre Cardoso ◽

Carlos Diogo Pinheiro Lima Lopes ◽

Ana Rita Carreira ◽

Sandra Rodrigues-Barros ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Metabolic Control ◽

Insulin Pump Therapy ◽

Vascular Density ◽

Diabetic Patients ◽

Retinal Vasculature ◽

Increased Risk ◽

The Mean ◽

Type 1 Diabetic Patients

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.

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Prevalence of dental caries in children and adolescents with type 1 diabetes: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-019-0903-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yan Wang ◽

Lin Xing ◽

Hui Yu ◽

LiJuan Zhao

Keyword(s):

Type 1 Diabetes ◽

Dental Caries ◽

Children And Adolescents ◽

Metabolic Control ◽

Meta Analysis ◽

Preventive Treatment ◽

Diabetic Patients ◽

China National Knowledge Infrastructure ◽

Pooled Prevalence

Abstract Background Dental caries and type 1 diabetes are responsible for a large burden of global disease; however, the exact prevalence of dental caries among children and adolescents with type 1 diabetes remains controversial, and no quantitative meta-analysis exists. Thus, we performed a meta-analysis to evaluate the prevalence of dental caries among children and adolescents with type 1 diabetes. Methods We performed a systematic search strategy using PubMed, EMBASE and China National Knowledge Infrastructure for relevant studies investigating the prevalence of dental caries in children and adolescents with type 1 diabetes from July 1971 until December 2018. The pooled prevalence with 95% confidence intervals (95%CIs) and subgroup analyses were calculated using a random effects model. Results After screening 358 non-duplicated articles, a total of 10 articles involving 538 individuals were included. The overall prevalence of dental caries among children and adolescents with type 1 diabetes was 67% (95% CI: 0.56–0.77%; I2 = 83%). The prevalence was highest in South America (84%) and lowest in diabetic patients with good metabolic control (47%). Conclusions The prevalence of dental caries was high among children and adolescents with type 1 diabetes. Screening and preventive treatment should be included in dental clinical routines for diabetic children and adolescents, especially in those with poor metabolic control.

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