Diabetic Patient

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.

The Diabetic Patient

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.

scholarly journals Role of Dendritic Cell in Diabetic Nephropathy

2021 ◽  
Vol 22 (14) ◽  
pp. 7554
Author(s):  
Hyunwoo Kim ◽  
Miyeon Kim ◽  
Hwa-Young Lee ◽  
Ho-Young Park ◽  
Hyunjhung Jhun ◽  
...  
Keyword(s):  
T Cells ◽  
Diabetic Nephropathy ◽  
Microvascular Complications ◽  
Treatment Options ◽  
Renal Tissue ◽  
Current Treatment ◽  
Diabetic Patients ◽  
Activated T Cells ◽  
Stage Renal Disease ◽  
Incident Cases

Diabetic nephropathy (DN) is one of the most significant microvascular complications in diabetic patients. DN is the leading cause of end-stage renal disease, accounting for approximately 50% of incident cases. The current treatment options, such as optimal control of hyperglycemia and elevated blood pressure, are insufficient to prevent its progression. DN has been considered as a nonimmune, metabolic, or hemodynamic glomerular disease initiated by hyperglycemia. However, recent studies suggest that DN is an inflammatory disease, and immune cells related with innate and adaptive immunity, such as macrophage and T cells, might be involved in its development and progression. Although it has been revealed that kidney dendritic cells (DCs) accumulation in the renal tissue of human and animal models of DN require activated T cells in the kidney disease, little is known about the function of DCs in DN. In this review, we describe kidney DCs and their subsets, and the role in the pathogenesis of DN. We also suggest how to improve the kidney outcomes by modulating kidney DCs optimally in the patients with DN.

Association of Wound Infection with Various Surgical Technique Applied for Appendectomy in Diabetic and Hypertensive Patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2163-2165
Author(s):  
Muhammad Armughan ◽  
Imran Sadiq ◽  
Shafqat Mukhtar ◽  
Hafiz Ahmad Altaf
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Surgical Procedure ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Hypertensive Patients ◽  
Duration Of Surgery ◽  
Perforated Appendix

Background: Perforated appendix in diabetic as well as hypertensive patients is associated with elevated risks of postoperative infectious complications such as wound infection and intra-abdominal abscess. Objective: To identify better appendectomy procedure for diabetic and hypertensive patients. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Surgery, Unit l, Bahawal Victoria Hospital Bahawalpur from 10th October 2020 to 9th April 2021. Methodology: Ninety eight patients meeting the criteria of perforated appendix were divided in two groups; one group consisted of 49 patients who were managed by open surgical procedure. Second group was consisted of 49 patients who were managed by laparoscopic surgical procedure. Patient outcomes in-terms of wound infections, operative time and duration of surgery was assessed. Results: Mean age of patients was 25.49±6.03 years. There were 17 hypertensive while 15 diabetic patients. Wound infection was seen in 21% and 28% open surgery diabetic and hypertensive patients respectively in comparison to 10%and 8% in laparoscopic appendectomy diabetic and hypertensive patients respectively (p<0.001). Conclusion: Laparoscopic appendectomy (LA) is associated with significantly lower rates of post-operative wound infections and shorter hospital stay in comparison to open appendectomy in diabetic and hypertensive patients of perforated appendicitis. Key Words: Perforated appendix, laparoscopic, open appendectomy

scholarly journals Institutional Blood Glucose Monitoring System for Hospitalized Patients: An Integral Component of the Inpatient Glucose Control Program

2009 ◽  
Vol 3 (5) ◽  
pp. 1168-1174 ◽  
Author(s):  
Mona Boaz ◽  
Zohar Landau ◽  
Zipora Matas ◽  
Julio Wainstein
Keyword(s):  
Blood Glucose ◽  
Diabetic Patient ◽  
Glucose Control ◽  
Medical Center ◽  
Control Program ◽  
Hospitalized Patients ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Integral Component

Background: The ability to measure patient blood glucose levels at bedside in hospitalized patients and to transmit those values to a central database enables and facilitates glucose control and follow-up and is an integral component in the care of the hospitalized diabetic patient. Objective: The goal of this study was to evaluate the performance of an institutional glucometer employed in the framework of the Program for the Treatment of the Hospitalized Diabetic Patient (PTHDP) at E. Wolfson Medical Center, Holon, Israel. Methods: As part of the program to facilitate glucose control in hospitalized diabetic patients, an institutional glucometer was employed that permits uploading of data from stands located in each inpatient department and downloading of that data to a central hospital-wide database. Blood glucose values from hospitalized diabetic patients were collected from August 2007 to October 2008. The inpatient glucose control program was introduced gradually beginning January 2008. Results: During the follow-up period, more than 150,000 blood glucose measures were taken. Mean glucose was 195.7 ± 99.12 mg/dl during the follow-up period. Blood glucose values declined from 206 ± 105 prior to PTHDP (August 2007–December 2007) to 186 ± 92 after its inception (January 2008–October 2008). The decline was associated significantly with time ( r = 0.11, p < 0.0001). The prevalence of blood glucose values lower than 60 mg/dl was 1.48% [95% confidence interval (CI) 0.36%] prior to vs 1.55% (95% CI 0.37%) following implementation of the PTHDP. Concomitantly, a significant increase in the proportion of blood glucose values between 80 and 200 mg/dl was observed, from 55.5% prior to program initiation vs 61.6% after program initiation ( p < 0.0001). Conclusions: The present study was designed to observe changes in institution-wide glucose values following implementation of the PTHDP. Information was extracted from the glucometer system itself. Because the aforementioned study was not a clinical trial, we cannot rule out that factors other than introduction of the program could explain some of the variability observed. With these limitations in mind, it nevertheless appears that the PTHDP, of which the institutional glucometer is an integral, essential component, was associated with improved blood glucose values in the hospitalized diabetic patient.

Susceptibility of Glutathione--S-Transferase Polymorphism to CVD Development in Type 2 Diabetes Mellitus - A Review

2021 ◽  
Vol 21 ◽  
Author(s):  
Santhi Priya Sobha ◽  
Kumar Ebenezar
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Metabolic Disorder ◽  
Vascular Complications ◽  
Clinical Importance ◽  
Diabetic Patients ◽  
Diabetic Vascular Complications ◽  
Metabolic Conditions ◽  
Gst Polymorphism ◽  
Gene Status

Background: Metabolic disorder affects normal homeostasis and can lead to the development of diseases. Diabetes mellitus is the most common metabolic disorder, and a cluster of metabolic conditions can lead to cardiovascular disease (CVD) development. Diabetes mellitus and CVD are closely related, with oxidative stress, playing a major role in the pathophysiology. Glutathione-S-Transferases (GST) potentially play an important role by reducing oxidative stress and is found to be the underlying pathophysiology in the development of diabetes, cardiovascular diseases (CVD), etc. Objectives: In this review, the role of GST genetic variant in the development of diabetes mellitus, CVD and diabetic vascular complications has been focused. Results: Based on the literature, it is evident that the GST can act as an important biochemical tool providing significant evidence regarding oxidative stress predominant in the development of diseases. Analysis of GST gene status, particularly detection of GSTM1 and GSTT1 null mutations and GSTP1 polymorphism, have clinical importance. Conclusion: The analysis of GST polymorphism may help identify the people at risk and provide proper medical management. Genotyping of GST gene would be a helpful biomarker for early diagnosis of CVD development in DM and also in CVD cases. More studies focusing on the association of GST polymorphism with CVD development in diabetic patients will help us determine the pathophysiology better.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN ASUPAN SERAT PENDERITA DM DI POLI PENYAKIT DALAM RSUD Dr. Hi. ABDUL MOELOEK PROVINSI LAMPUNG TAHUN 2014

2017 ◽  
Vol 1 (2) ◽  
pp. 107
Author(s):  
Usdeka Muliani
Keyword(s):  
Diabetic Patient ◽  
Bivariate Analysis ◽  
Diabetic Patients ◽  
Fiber Intake ◽  
Nutritional Counseling ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Knowledge And Attitude ◽  
Sugar Levels ◽  
Gender Knowledge

Indonesia is now facing degenerative diseases such as diabetes. From previous studies found fiber intake patients with DM is still much less than that recommended, while the fiber is very useful to control blood sugar levels in diabetic patient. The purpose of this study was to determine the factors associated with fiber intake in patients with diabetes mellitus disease in internist clinic Dr H. Abdul Moeloek Hospital Lampung 2014? The experiment was used analytic research by cross sectional approach, a sample of 48 respondents. Data were analyzed by univariate and bivariate. The study concluded  the most respondents: (1) age 46-65 years 66.7%; (2) 70.8% of the female sex; (3) sufficient knowledge of fiber 56.2% (4)  never received nutritional counseling; (7) 85.4% less fiber intake. From the results of the bivariate analysis found no relationship between gender, knowledge, attitudes, education, and nutrition counseling with fiber intake respondents. Relative levels for respondents with knowledge and attitude toward less fiber, and fiber intake respondents are less good then advice the authors need to increase cooperation between the clinic personnel in order to refer all patients with DM to nutrition clinic in order to obtain nutritional counseling. Other suggestions in order to do further research to find out why fiber intake of diabetic patients are still lacking, and the study of other factors such as psychological, social culture, physical state, and the state of nutrition associated with fiber intake in diabetic patient

scholarly journals Diabetic Peripheral Neuropathy: Epidemiology, Physiopathology, Diagnosis and Treatment

2019 ◽  
Vol 7 (1) ◽  
pp. 35-48
Author(s):  
Nazma Akter
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Clinical Evidence ◽  
Current Treatment ◽  
Diabetic Patients ◽  
First Line ◽  
Diabetic Neuropathic Pain ◽  
Current Treatment Regimen ◽  
Limb Proprioception

Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes. It affects over 90% of the diabetic patients. It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication, but several other hypotheses have been postulated. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. DPN is often misdiagnosed and inadequately treated. Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition. The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy, improving glycemic control as a prophylactic therapy and using medications to alleviate pain. First line drugs for pain relief include anticonvulsants, such as pregabalin and gabapentin and antidepressants, especially those that act to inhibit the reuptake of serotonin and noradrenaline. In addition, there is experimental and clinical evidence that opioids can be helpful in pain control, mainly if associated with first line drugs. Other agents, including for topical application, such as capsaicin cream and lidocaine patches, have also been proposed to be useful as adjuvant in the control of diabetic neuropathic pain, but the clinical evidence is insufficient to support their use. The purpose of this review is to examine proposed mechanisms of DPN, summarize current treatment regimen. A better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies. Delta Med Col J. Jan 2019 7(1): 35-48

Perioperative Management of Non-diabetic Patients with Hyperglycaemia (Stress-Induced Hyperglycaemia)

2016 ◽  
pp. 193-209
Author(s):  
Gabriel Giménez-Pérez ◽  
Isabel Salinas ◽  
Manel Puig-Domingo ◽  
Dídac Mauricio
Keyword(s):  
Perioperative Management ◽  
Diabetic Patients

Calciphylaxis and Mönckberg’s Arteriosclerosis in a Diabetic Patient

2020 ◽  
Vol 44 (2) ◽  
pp. 83-88
Author(s):  
Christina Fields
Keyword(s):  
Diabetic Patient ◽  
Subcutaneous Fat ◽  
Microvascular Disease ◽  
Limb Ischemia ◽  
Skin Lesions ◽  
Punch Biopsy ◽  
Arterial Calcification ◽  
Diabetic Patients ◽  
Large Artery ◽  
Vascular Intervention

Diffuse arterial calcification is characteristic of peripheral arterial disease (PAD), particularly in diabetic patients. In diabetic patients, the rates of PAD and the more advanced forms of vascular disease such as critical limb ischemia are higher, and vascular intervention is known to be more difficult and less effective. For 1 in 6 patients, below-knee amputations can result from microvascular disease without traditional PAD. Microvascular disease occurs in vessels with a diameter around 100 µm and is most commonly present in diabetic patients. Calciphylaxis is a life-threatening complex disorder that presents with painful ischemic skin lesions caused by occlusion of blood vessels in subcutaneous fat and dermis. Mönckberg’s arteriosclerosis results in extensive calcium deposits in the tunica media without obstruction into the lumen. This case highlights a young diabetic patient with rapidly progressing acute onset ulcers of the bilateral lower extremities status post beginning peritoneal dialysis. The patient underwent upper and lower arterial noninvasive studies, angiogram, computerized tomography angiography, and punch biopsy. The arterial duplex examinations were normal with the exception of noncompressible calcified vessels. Microvascular disease was correlated with angiogram. Computed tomography angiogram findings were conclusive for calciphylaxis and Mönckberg’s arteriosclerosis. Punch biopsy was performed to confirm calciphylaxis and patient was started on the appropriate treatment regimen. Unfortunately, limb salvage was not possible and amputations were ultimately performed. There are other vascular pathologies that are not associated with traditional large artery atherosclerosis, such as calciphylaxis and Mönckberg’s arteriosclerosis. Even with seemingly normal arterial testing, the prognosis can be catastrophic. Although rare, these additional disease processes should be considered in dialysis patients with acute ulcerations.

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