Systematic Inspection of Insulin Injection Sites for Local Complications Related to Incorrect Injection Technique

1996 ◽  
Vol 26 (4) ◽  
pp. 159-161 ◽  
Author(s):  
Berhane Seyoum ◽  
Jemal Abdulkadir
Keyword(s):  
Blood Glucose ◽  
Insulin Dose ◽  
Fasting Blood Glucose ◽  
Insulin Injection ◽  
Diabetic Control ◽  
Common Finding ◽  
Injection Technique ◽  
Diabetic Patients ◽  
Local Complications ◽  
Significant Difference

We systematically inspected insulin injection sites in 100 insulin-requiring patients attending the Diabetic Clinic of the Tikur Anbassa Hospital (TAH) in order to identify local complications related to incorrect injection technique: local complications were found in 53 cases: skin hyperpigmentation and/or indurations in 30 patients; and fat atrophy or hypertrophy in 31 patients. Illiteracy was significantly more common among those with local complications (18/53 versus 6/47, χ2 5.03, P < 0.05). Mean fasting blood glucose on the day of the inspection was significantly higher (14.9 +6.3 mmol/l versus 10.5 + 6.1 mmol/l, P < 0.001) and a fasting blood glucose > 10 mmol/l more common (41/53 versus 20/47, χ2 14.1, P < 0.0005) in those with than in those without local complications. There was no significant difference between the two groups in mean duration of diabetes (6.9 + 5.6 years versus 6.6 + 5.8 years), frequency of hypoglycaemic episodes (12/53 versus 5/47, χ2 1.76, P > 0.05) or mean daily insulin dose (44 + 18 units versus 44 + 22 units per day). Therefore, we concluded that local complications resulting from incorrect injection technique, a common finding in the group of patients studied, may be common among insulin requiring diabetic patients in general. Incorrect insulin injection causes local complications and disfigurement which may compromise compliance. Furthermore, insulin absorption tends to be erratic from intradermal and fat hypertrophy sites thus interfering with effective diabetic control. Insulin injection sites should be inspected routinely to detect and correct faulty technique promptly.

scholarly journals Comparison of Frequency Distribution of Diabetes in Hepatitis B and C Patients and Other People in Birjand

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Masood Ziaee ◽  
Mahboube Saljoughi ◽  
Forough Fardinfar ◽  
Farah Madarshahian ◽  
Azadeh  Ebrahimzadeh
Keyword(s):  
Blood Glucose ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Frequency Distribution ◽  
Statistical Tests ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Retrospective Case ◽  
Glucose Levels ◽  
Significant Difference

Background: Diabetes and hepatitis are among the most common diseases in the world. Hepatitis C virus leads to extra-liver manifestations, including endocrine disease and diabetes. The prevalence of hepatitis C and B in diabetic patients and the prevalence of diabetes in hepatitis C and B patients are higher than those in normal populations, and if each is added to the other, the complications will be more and the consequences will be worse. Objectives: This study aimed to compare the frequency distribution of diabetes and serum lipid levels in hepatitis B and C patients and other people. Methods: In this retrospective case-control study, 80 patients with hepatitis B and C and 160 patients without hepatitis were included. In both groups, those with two glucose levels above 126 mg/dL were considered as diabetic subjects. Also, the tests for factors such as cholesterol, TG, LDL, HbA1c, HDL, and liver ultrasonography were performed for patients. Data were collected and entered into SPSS 23 software and analyzed using descriptive statistical tests (t test and chi-square or Fisher's exact test) at a significance level of α = 0.05. Results: A total of 240 patients [80 cases (hepatitis B or C positive) and 160 controls] were enrolled. Of them, 46.3% were females and most of them were in the age range of 45-55 years. Besides, 14 (5.8%) subjects had high fasting blood glucose levels of more than 126 mg/dl twice, and were considered to have diabetes. Among them, four (5.0%) cases (all having hepatitis B) and 10 (6.3%) controls were diabetics. Statistical analysis showed no significant difference in the mean serum lipids of cholesterol and LDL between the case and control groups (P < 0.1) but there was a significant association between HDL and TG in both groups (P = 0.02). Conclusions: All patients with hepatitis B and C should be screened for diabetes, and in addition to fasting blood glucose, we suggest that HbA1c be measured to confirm or rule out diabetes.

scholarly journals The Usage of Type 2 Diabetes Medication for Outpatients at the Ministry of Public Security Traditional Medicine Hospital

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Nguyen Thanh Hai ◽  
Ha My Ngoc ◽  
Doan Thuy Ngan ◽  
Nguyen Xuan Bach
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Traditional Medicine ◽  
Fasting Blood Glucose ◽  
Public Security ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Diabetes Medication ◽  
Significant Difference

This study aimes to analyse the usage of type 2 diabetes medication for outpatients at the Ministry of Public Security Traditional Medicine Hospital and to rate their adherence to the treatment. In this study, Type 2 diabetic patients were treated as outpatients and managed for at least 12 months at the clinic of the hospital. The results show that after 12 months of treatment, the average fasting blood glucose value decreased from 7.6 ± 1.76 mmol/l to 7.42 ± 1.81 mmol/l and the percentage of the patients either with blood glucose changes or reached the FPG target, increased from 38.3% to 70.0%, a statistically significant difference with p <0.05. After 6 months of treatment from the time of T-6 to T0, HbA1c index decreased by 7.1 ± 1.0 to 6.4 ± 0.9% and the percentage of the patients either with HbA1C value changes or achieved the target, increased from 50.0% to 75.0%. The percentage of the patients who had good compliance was 60.8%. With an additional drug in the regimen, the adherence reduced by 29% (OR = 0.71; 95% CI 0.56 - 0.89; p = 0.002). The adherence of the 1-year-older patients decreased by 9% (OR = 0.91; 95% CI 0.84 - 0.97; p = 0.03). The study concludes that most of the patients received stable treatment; the regimens promoted maximum therapeutic effect. The two factors affecting the level of compliance of the patients with the drug were the age and the number of diabetes medicines used in the application. Keywords Type 2 diabetes, adherence to treatment, outpatients. References [1] Association. American Diabetes, Standards of medical care in diabetes - 2018, https://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf, 2018 (accessed 25 May 2019).[2] A. Jafarian-Amirkhizi, A. Sarayani, K. Gholami, M. Taghizadeh-Ghehi, K. Heidari, A. Jafarzadeh-Kohneloo, D.E.Morisky, Adherence to medications, self-care activity, and HbA1c status among patients with type 2 diabetes living in an urban area of Iran, J Diabetes Metab Disord. 17(2) (2018) 165-172. https://doi: 10.1007/s40200-018-0356-4.[3] D.E. Morisky, M.R. Di Matteo, Improving the measurement of self-reported medication nonadherence: Response to Authors, J Clin Epidemiol. 64(3) (2011) 255-257; discussion 258-63. https:// doi: 10.1016/j.jclinepi.2010.09.002.[4] Y. Tominaga, T. Aomori, T. Hayakawa, D.E. Morisky, K. Takahashi, M. Mochizuki, Relationship between medication adherence and glycemic control in Japanese patients with type 2 diabetes. Pharmazie. 73(10) (2018) 609-612. https://doi: 10.1691/ph.2018.8587. [5] M.C. Govern Andrew, T. Zayd, Systematic review of adherence rates by medication class in type 2 diabetes: a study protocol, BMJ Open, 6(2) (2016) e010469. https://doi: https://doi: 10.1136/bmjopen-2015-010469.[6] M. Tiktin, S. Celik, Understanding adherence to medications in type 2 diabetes care and clinical trials to overcome barriers: a narrative review, Curr Med Res Opin. 32(2) (2016) 277-287. https:// doi: https:// doi: 10.1185/03007995.2015.1119677.      

scholarly journals A Comparison Between the Effect of Three Types of Low-Calorie Diets on Controlling Blood Glucose and Lipids in People with Type 2 Diabetes

2018 ◽  
Vol 8 (1) ◽  
pp. 18
Author(s):  
Zoleika Moazezi ◽  
Seyed Reza Hosseini ◽  
Parvin Sajadi Kaboudi ◽  
Bahareh Esbakian ◽  
Sahar Rahmani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Serum Lipids ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Low Calorie ◽  
Significant Difference

The blood glucose level of people with diabetes can be normalized through an appropriate diet, physical activity, the use of chemical drugs and medicinal plants. This study aims to investigate the effects of low-calorie diets (1200, 1500, and 1800 kcal) on glucose and serum lipids in poorly controlled type 2 diabetic patients. This clinical trial was conducted among 60 patients with type 2 diabetes mellitus. The criteria for entering the study were fasting blood glucose higher than 130 mg/dl, hemoglobin A1C higher than 7% and BMI higher than 25. Blood glucose, fasting blood glucose and lipid levels were measured before and after intervention two hours after each meal. Patients were trained by an expert. Then, the questionnaires were completed and analyzed. In this study, the mean fasting blood glucose level in patients who used 1500 and 1200 kcal diet decreased significantly after intervention (p&lt;0.05). Glucose decreased significantly after two hours using a 1500  kcal diet (p&lt;0.009). In addition, triglyceride and cholesterol levels were significantly reduced in patients who used the 1500 kcal diet (p&lt;0.05). Although, there was no significant difference in blood glucose levels between 1200, 1500 and 1800 kcal diets based on gender, residencency and BMI. Regarding the fact that there was no significant difference in reducing blood glucose and serum lipids between 1200 and 1500 kcal diets. It is recommended to use a 1500 kcal diet instead of 1200 kcal diet, which imposes fewer limitations and is easier to tolerate.

scholarly journals Effect of Aegle marmelos fruit pulp powder on glycemic status of type 2 diabetic patients

2014 ◽  
Vol 7 (2) ◽  
pp. 35-37
Author(s):  
Mkurshida Aziz ◽  
Masfida Akhter
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Attractive Potential ◽  
Diabetic Patients ◽  
Fruit Pulp ◽  
Aegle Marmelos ◽  
Type 2 Diabetic Patients ◽  
Plant Materials ◽  
Significant Difference

Plant materials are considered to be attractive potential sources of alternate agents in the prevention and management of type 2 diabetes mellitus (T2DM). Different parts of Aegle marmelos have been claimed to possess anti-glycemic property. The present study was conducted at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh from July 2010 to June 2011 to determine the anti-glycemic effect of A. marmelos unripe fruit pulp in T2DM patients. The experiment was conducted under a crossover design and the effects were analyzed during the 0-21 as well as 28-49 days with 7 days wash out period. The data were then pooled and the baseline versus endpoint values was also compared. The mean fasting blood glucose (FBG) values did not significantly differ between the two groups at any time points. No significant difference between the baseline and end point values regarding FBG. The effect on blood glucose was not significant in any of the analysis. This study did not reveal any antiglycemic effect of A. marmelos fruit pulp in T2DM patients. DOI: http://dx.doi.org/10.3329/imcj.v7i2.20109 Ibrahim Med. Coll. J. 2013; 7(2): 35-37

scholarly journals Cigarette Smoking and Hyperglycaemia in Diabetic Patients

2018 ◽  
Vol 6 (4) ◽  
pp. 634-637 ◽  
Author(s):  
Mutiara Indah Sari ◽  
Nisrina Sari ◽  
Dewi Masyithah Darlan ◽  
Raka Jati Prasetya
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glucose Level ◽  
Hba1c Level ◽  
Fasting Blood Glucose ◽  
Postprandial Glucose ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Study Population ◽  
Postprandial Glucose Level

BACKGROUND: The incidence rate of diabetes mellitus has increased throughout the year. Various studies indicate that smoking may affect glucose metabolism and cause hyperglycemia in diabetes mellitus. This study aimed to compare the blood glucose and HbA1c level in diabetic smoking patients and non-smoking diabetic patients.METHODS: This study used the cross-sectional approach. The study population consisted of 30 diabetic smoking patients and 30 non-smoking diabetic patients. The diabetes history and the smoking status of the study population obtained by questionnaire-based interview, the blood glucose and HbA1c level were measured by hexokinase and immunoturbidimetry method using cobas 6000 analyser module c501  (Roche Diagnostics, Switzerland).RESULTS: The result in this study showed the fasting blood glucose, postprandial blood glucose, and HbA1c were higher by 23.64 mg/dl (p = 0.325), 58.00 mg/dl (p = 0.016), 0.39% (p = 0.412) in smoking diabetic patients compared to non-smoking diabetic patients. After statistical analysis, there was a significant difference (p < 0.05) of postprandial glucose level between smokers group and non-smokers group, but the non-significant difference of fasting blood glucose and HbA1cCONCLUSIONS: This study concluded that there was a significant difference in postprandial glucose level between smokers group and non-smokers group but the non-significant difference of fasting blood glucose and HbA1c.

Anti-Diabetic and Angio-Protective Effect of Guluronic Acid (G2013) as a New Nonsteroidal Anti-Inflammatory Drug in the Experimental Model of Diabetes

2020 ◽  
Vol 20 (3) ◽  
pp. 446-452
Author(s):  
Seyed S. Mortazavi-Jahromi ◽  
Shahab Alizadeh ◽  
Mohammad H. Javanbakht ◽  
Abbas Mirshafiey
Keyword(s):  
Gene Expression ◽  
Blood Glucose ◽  
Food Intake ◽  
Experimental Model ◽  
Serum Insulin ◽  
Fasting Blood Glucose ◽  
Diabetic Control ◽  
The Body ◽  
Sprague Dawley ◽  
Guluronic Acid

Background: This study aimed to investigate the effects of guluronic acid (G2013) on blood sugar, insulin, and gene expression profile of oxLDL receptors (SR-A, CD36, LOX-1, and CD68) in the experimental model of diabetes. Methods: 18 Sprague Dawley rats were randomly assigned to three groups of healthy control, diabetic control, and G2013 group. Diabetes was induced through intraperitoneal (IP) injection of 60 mg/kg streptozotocin. The subjects were IP treated with 25 mg/kg of G2013 per day for 28 days. The body weight, food intake, fasting blood glucose and insulin were measured. In addition, the expression of mentioned genes was investigated through quantitative real-time PCR. Results: The data showed that the final weight increased significantly in the G2013-treated subjects compared to the diabetic control (p < 0.05). The results indicated that final food intake significantly reduced in the G2013-treated subjects compared to the diabetic control (p < 0.05). The study findings also suggested that the final fasting blood glucose significantly reduced in the G2013-treated group, whereas the final fasting serum insulin level significantly increased in this group compared to the diabetic control (p < 0.05). Moreover, the gene expression levels of SR-A, CD36, LOX-1, and CD68 in the G2013 group significantly reduced compared to the diabetic control (p < 0.05). Conclusion: This study showed that G2013, could reduce blood glucose and increase insulin levels and reduce the gene expression level of oxLDL receptors. In addition, it may probably play an important role in reducing the severity of diabetes-induced inflammatory symptoms.

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

scholarly journals The effect of oat bran consumption on gestational diabetes: a randomized controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zahra Barati ◽  
Mina Iravani ◽  
Majid Karandish ◽  
Mohammad Hosein Haghighizadeh ◽  
Sara Masihi
Keyword(s):  
Clinical Trial ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Standard Diet ◽  
Oat Bran ◽  
Significant Difference

Abstract Background Gestational diabetes is the most common medical complication in pregnancy, and it has many side effects for the mother and the fetus. The aim of this study was to evaluate the effect of oat bran consumption on gestational diabetes. Methods This study is a randomized clinical trial that was performed on 112 women with gestational diabetes treated with diet. Participants were randomly divided into two groups of 56. Participants in both groups were given a diet for gestational diabetes. In addition to the diet, the intervention group received 30 g of oat bran daily for 4 weeks at lunch and dinner. Tests of fasting blood glucose and two-hour postprandial (2hpp) glucose were taken from both groups: before the intervention, and 2 and 4 weeks after the start of the intervention. Data analysis was performed using SPSS statistical software (version 22) using independent t-test, as well as Chi-square and Mann-Whitney tests. P values less than 0.05 were considered statistically significant. Results There was no statistically significant difference between the two groups in terms of mean blood glucose before the intervention, while 2 and 4 weeks after the intervention, mean fasting blood glucose and two-hour postprandial (2hpp) glucose decreased significantly in the intervention group compared with the control group (P < 0.001). Conclusion Based on the results of this study, the addition of oat bran to the standard diet for pregnant women with gestational diabetes reduced fasting blood glucose and two-hour postprandial (2hpp) glucose. More detailed studies with higher sample sizes are recommended to prove the effectiveness of this valuable dietary supplement. Trial registration IRCT registration number:IRCT20191220045828N1. Registration date: 2020-04-18. Registered while recruiting.

scholarly journals Daily Fasting Blood Glucose Rhythm in Male Mice: A Role of the Circadian Clock in the Liver

Endocrinology ◽  
2015 ◽  
Vol 157 (2) ◽  
pp. 463-469 ◽  
Author(s):  
Hitoshi Ando ◽  
Kentaro Ushijima ◽  
Shigeki Shimba ◽  
Akio Fujimura
Keyword(s):  
Blood Glucose ◽  
Circadian Clock ◽  
Mrna Expression ◽  
Hepatic Glucose Production ◽  
Critical Role ◽  
Fasting Blood Glucose ◽  
Glucose Production ◽  
Diabetic Patients ◽  
Dark Phase ◽  
Dawn Phenomenon

Abstract Fasting blood glucose (FBG) and hepatic glucose production are regulated according to a circadian rhythm. An early morning increase in FBG levels, which is pronounced among diabetic patients, is known as the dawn phenomenon. Although the intracellular circadian clock generates various molecular rhythms, whether the hepatic clock is involved in FBG rhythm remains unclear. To address this issue, we investigated the effects of phase shift and disruption of the hepatic clock on the FBG rhythm. In both C57BL/6J and diabetic ob/ob mice, FBG exhibited significant daily rhythms with a peak at the beginning of the dark phase. Light-phase restricted feeding altered the phase of FBG rhythm mildly in C57BL/6J mice and greatly in ob/ob mice, in concert with the phase shifts of mRNA expression rhythms of the clock and glucose production–related genes in the liver. Moreover, the rhythmicity of FBG and Glut2 expression was not detected in liver-specific Bmal1-deficient mice. Furthermore, treatment with octreotide suppressed the plasma growth hormone concentration but did not affect the hepatic mRNA expression of the clock genes or the rise in FBG during the latter half of the resting phase in C57BL/6J mice. These results suggest that the hepatic circadian clock plays a critical role in regulating the daily FBG rhythm, including the dawn phenomenon.

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