Thyroidectomy Complications in Patients with Diabetes Mellitus

2019 ◽  
Vol 161 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Sei Y. Chung ◽  
Aparna Govindan ◽  
Archana Babu ◽  
Andrew Tassler
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Mortality ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Adverse Outcomes ◽  
Hospital Charges ◽  
Multivariate Techniques ◽  
Vocal Cord Paresis ◽  
Significant Difference ◽  
Patients With Diabetes

Objective To (1) analyze postoperative thyroidectomy outcomes in patients with diabetes mellitus (DM), who are prone to deleterious effects of glucose dysmetabolism, and (2) apply findings to optimize perioperative management of diabetics requiring thyroid surgery. Study Design Retrospective database analysis. Setting University hospital. Subjects and Methods The National Inpatient Sample was queried using International Classification of Diseases, Ninth Revision, Clinical Modification and Procedure Coding System (PCS) codes for patients with benign or malignant thyroid disease who underwent thyroid surgery between 2002 and 2013. An analysis of demographics, comorbidities, and postoperative outcomes was conducted between a DM vs non-DM cohort using bivariate and multivariate techniques. Results In total, 103,842 cases met inclusion criteria; 14.2% were diabetics. Diabetics had significantly higher rates of baseline comorbid chronic pulmonary disease, hypertension, obesity, and anemia. Following thyroidectomy, patients with DM were more likely to have vocal cord paresis or paralysis compared to non-DM patients (2.0% vs 1.3%; P < .001). However, when adjusting for demographics and comorbidities, there was no significant difference in this complication between the 2 groups. Diabetics had independently higher rates of cardiac, pulmonary, and urinary complications, as well as transfusion, reintubation, and in-hospital mortality. Diabetics had longer hospital stays (2.76 vs 1.97; P < .001) with higher incurred hospital charges (32,921 vs 25,198; P < .001). Conclusion Although DM often confers metabolic and ischemic derangements secondary to hyperglycemia such as neuropathy, this comorbidity was not independently associated with higher rates of vocal cord paresis or paralysis following thyroid surgery. However, DM predicted other adverse outcomes, including greater cardiac, pulmonary, and urinary complications, as well as transfusion, reintubation, and in-hospital mortality.

scholarly journals Outcomes in Hospitalizations for Patients Admitted With Hyperosmolar Hyperglycemic State and Obesity: Analysis of National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A428-A429
Author(s):  
Hafeez Shaka ◽  
Genaro Velazquez ◽  
Hernan Gerardo Marcos-Abdala ◽  
Ehizogie Edigin ◽  
Iriagbonse Asemota ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Adverse Outcomes ◽  
Hospital Charges ◽  
Obese Patients ◽  
Secondary Diagnosis ◽  
Total Hospital ◽  
Significant Difference

Abstract Introduction: Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS) is a highly lethal disease with an estimated mortality rate of up to 20%. Although mortality has decreased in recent years, its incidence has increased in the setting of a higher prevalence of underlying conditions that have been previously well described, such as uncontrolled diabetes, Obesity, and a high-carbohydrate diet. All these comorbidities usually overlap with acute complications such as infections or dehydration, which incite the onset of HHS. Currently, limited literature exists for the role of obesity in mortality, hospital stay, and other adverse outcomes in patients with HHS. It is important to know which underlying conditions truly affect outcomes for patients being treated for this condition so further studies can be done, and treatment optimized. Objective: We aim to prove if obesity plays a role in increasing mortality and secondary adverse outcomes in patients with HHS compared to non-obese patients. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. 42,740 hospitalizations who had HHS as primary diagnosis were enrolled and further stratified based on the presence or absence of Obesity as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, total hospital charges, Sepsis, Septic Shock, Acute Kidney Injury (AKI), and Acute Respiratory Failure (ARF). Multivariate regression analysis was done to adjust for confounders. Results: Out of the 42 740 hospitalizations with HHS, 9,630 had Obesity. The in-hospital mortality for patients with HHS was 45 overall, out of which 45 patients had Obesity as a secondary diagnosis. Compared with patients without Obesity, non-obese patients had similar in-hospital mortality (OR 0.77, 95% CI 0.39–1.52, p=0.45) when adjusted for patient and hospital characteristics. Patients with HHS and Obesity had similar lengths of hospital stay, total hospital charges, rate of Sepsis, Septic Shock, and ARF in comparison to patients without Obesity; however, non-obese patients had higher odds of developing AKI throughout hospitalization. Conclusion: Although it is known and described that being obese plays a significant role in the onset of diabetes, and consequently HHS, there is no statistically significant difference in mortality or most other adverse outcomes compared to patients that are not obese and develop HHS. Although being obese plays a major role in inciting HHS in the general population, there is no need for a different approach to treatment, and outcomes are similar to non-obese patients with HHS.

Features of the course of coronavirus infection in patients with diabetes mellitus

2022 ◽  
pp. 18-21
Author(s):  
Vladimir Anatolievich Klimov ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Human Population ◽  
Fatal Outcome ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Concomitant Disease ◽  
Patients With Diabetes ◽  
Coronavirus Infection ◽  
Population Mortality

Diabetesmellitus, overweight and the age of a patient over 65 years old are identified by clinicians as themain factors that can complicate the course of the coronavirus infection and increase the likelihood of fatal outcome. Although in the general human population mortality from coronavirus fluctuateswithin 3–5 %, sometimes very significantly differing in individual countries, this level can reach 15–25 % among patientswith diabetes, especially for those receiving insulin therapy. Diabetes mellitus as a concomitant disease in COVID-19 is considered one of the most significant risk factors for the development of adverse outcomes due to a more severe course of infection in conditions of hyperglycemia and other aggravating factors.

scholarly journals EFFECT OF FAMILY PSYCHOEDUCATION ON CAREGIVER SUPPORT IN THE TREATMENT OF PATIENTS WITH TYPE II DIABETES MELLITUS

2018 ◽  
Vol 4 (1) ◽  
pp. 112-119
Author(s):  
Andika Siswoaribowo ◽  
Mateus Sakundarno ◽  
Muhammad Mu’in
Keyword(s):  
Diabetes Mellitus ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Family Psychoeducation ◽  
Control Group Design ◽  
Caregiver Support ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
And Control

Background: Diabetes Mellitus is a chronic disease that requires treatment for long periods of time so it can cause physical and psychological problems for sufferers and families (caregiver). Caregiver's role is expected to provide support for people with diabetes mellitus. Family psychoeducation is a strategy that can be applied for caregiver in overcoming problems that arise during the treatment of patients with diabetes mellitus.Objective: This study aims to determine the effect of family psychoeducation on caregiver support in the treatment of patients with diabetes mellitus type II.Methods: This research used a quasi experiment with  pre-test post-test control group design. A total of 46 caregivers and patients with diabetes mellitus were recruited puposively, with 23 respondents assigned in the experiment and control group. Caregiver support scale was used to measure caregiver support, and Hensarling Diabetes Family Support Scale (HDFSS) for measuring perception of patients toward the treatment of caregiver.  Data were analyzed using paired t-test and independent t-test. Results: Findings showed there was an increase of caregiver knowledge from 5.39 to 9.09 and an improvement of caregiver treatment from 40.30 to 67.04 after given family psychoeducation. There was a significant difference of caregiver support in the experimental and control group with p-value <0.001 (<0.05).Conclusion: Family psychoeducation can increase caregiver support in the treatment of diabetes mellitus patients. The intervention can be one of nurses interventions in the empowerment of family in improving the treatment of chronic diseases, particularly in diabetes mellitus.

Nursing patients with endocrine problems

2009 ◽  
pp. 303-326
Keyword(s):  
Diabetes Mellitus ◽  
Thyroid Surgery ◽  
Diagnostic Tests ◽  
Nursing Interventions ◽  
Endocrine Gland ◽  
Nursing Management ◽  
Nursing Assessment ◽  
Patients With Diabetes ◽  
Treatment Of Diabetes

Hormones 304 Nursing assessment of patients with endocrine problems 306 Diagnostic tests 308 Endocrine gland disorders 310 Thyroid surgery 314 Diabetes mellitus 316 Presentation and treatment of diabetes 318 Nursing management of the patient with diabetes who is admitted to hospital 320 Nursing interventions for patients with diabetes ...

scholarly journals The Prevalence of Giardia Intestinalis in Dyspeptic and Diabetic Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Gözde Derviş Hakim ◽  
Şafak Kızıltaş ◽  
Hilmi Çiftçi ◽  
Şafak Göktaş ◽  
İlyas Tuncer
Keyword(s):  
Diabetes Mellitus ◽  
Giardia Intestinalis ◽  
Diabetic Patients ◽  
Elisa Method ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Stool Specimens ◽  
Positive Results ◽  
Healthy Persons

Background and Aims. We aimed to investigate the prevalence of Giardiasis in patients with dyspepsia and patients with diabetes mellitus. Methods. 400 patients and 100 healthy persons were included in this clinical prospective study. The number of patients in each group was equal, 200 dyspeptic and 200 diabetic, respectively. The antigen of G. lntestinalis was determined in the stool specimens by ELISA method. Results. The frequency of Giardiasis was 7% in dyspeptic and 15% in diabetic patients. There was no positive results in any of the healthy persons. There was a significant difference in prevalence rate of Giardiasis between patients with dyspepsia and diabetes mellitus (P<0.05). Conclusions. These results revealed that the prevalence of Giardiasis in dyspepsia and with diabetes mellitus was high in our country. This is the first study investigating the prevalence of Giardiasis in diabetic patients. To investigate Giardiasis in diabetic patients, who have dyspepsia or not, may be a good approach for public health.

scholarly journals Predicting Adverse Outcomes After Myocardial Infarction Among Patients With Diabetes Mellitus

2016 ◽  
Vol 9 (4) ◽  
pp. 372-379 ◽  
Author(s):  
Suzanne V. Arnold ◽  
John A. Spertus ◽  
Philip G. Jones ◽  
Darren K. McGuire ◽  
Kasia J. Lipska ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Adverse Outcomes ◽  
Patients With Diabetes

scholarly journals Oral Symptoms and Mucosal Lesions in Patients with Diabetes Mellitus Type 2

2017 ◽  
Vol 21 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Ana Cicmil ◽  
Olivera Govedarica ◽  
Jelena Lečić ◽  
Snežana Mališ ◽  
Smiljka Cicmil ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Oral Cavity ◽  
Healthy Subjects ◽  
Control Level ◽  
Type 2 Diabetics ◽  
Significant Difference ◽  
Oral Mucosal Lesions ◽  
Patients With Diabetes ◽  
Mucosal Lesions

Summary Background: Good glycoregulation at patients with diabetes mellitus is essential for prevention of many complications, including those in oral cavity. Results of numerous studies indicate that xerostomia and neurosensory oral disorders are present in type 2 diabetics. A review of the literature shows contradictory results about prevalence of oral mucosal lesions in diabetics. The aim of this study was to evaluate the presence of xerostomia, neurosensory disorders and mucosal lesions in oral cavity of type 2 diabetics. Material and Methods: This study involved 90 adults, 60 with type 2 diabetes and 30 healthy subjects, aged 45-65 years. With regard to value of HbA1c level diabetics were divided into two groups: 30 subjects with satisfactory glycoregulation (HbA1c<9%) and 30 subjects with poor glycoregulation (HbA1c≥9%). All patients recruited into the study completed a questionnaire that included their demographic, medical and oral health data. Clinical examination of the oral mucosa was performed by a single examiner. Results: In relation to the presence of xerostomia and dysgeusia between satisfactory controlled diabetics and healthy subjects a significant difference was observed (p<0.05). Compared with healthy subjects, poor controlled diabetics had significantly higher presence of xerostomia (p<0.001) and neurosensory disoders (p<0.05). A higher prevalence of oral mucosal lesions was found in poor controlled diabetics, but significant difference between groups was not observed (p>0.05). A significant positive correlation was revealed between smoking and glossodynia as well as smoking and glossopyrosis (p>0.05). Conclusion: Glycemic control level seems to influence the susceptibility of type 2 diabetics to xerostomia and neurosensory disorders. Less clear is whether diabetes are corellated to oral mucosal lesions.

scholarly journals Angina Severity at the Time of Revascularization in Patients With Diabetes Mellitus and Its Association With Long-term Outcomes: A Multicenter Cohort Study.

2021 ◽  
Author(s):  
Nozomi Niimi ◽  
Satoshi Shoji ◽  
Mitsuaki Sawano ◽  
Nobuhiro Ikemura ◽  
Yasuyuki Shiraishi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Contributing Factors ◽  
Long Term Outcomes ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Patients With Diabetes

Abstract Background: While angina severity is pertinent in determining the management strategy for patients with stable ischemic heart disease (SIHD), its contributing factors and prognostic effect remain unclear, particularly in patients with diabetes mellitus (DM). Methods: From a multicenter percutaneous coronary intervention (PCI) registry, 1,911 consecutive SIHD patients without previous revascularization or heart failure between 2008 and 2015 were analyzed. Angina severity was assessed by the Canadian Cardiovascular Society (CCS) functional classification at the time of PCI. We assessed the contributing factors of CCS III/IV angina. Further, the association between CCS III/IV angina and subsequent occurrence of major adverse cardiac and cerebrovascular events (MACCE: all-cause death, acute coronary syndrome, heart failure, and stroke) within 2 years were analyzed in patients with DM and without DM.Results: A total of 771 SIHD patients (40.3% of all SIHD patients) had DM at the time of revascularization. In the total cohort, 52.4% had CCS I/II, and 13.0% had CCS III/IV angina, with less prevalence of CCS III/IV angina in patients with DM than in those without DM (11.3% vs. 14.2%, P<0.001). In patients with DM, the prevalence of unprotected left main coronary trunk lesions and proximal left anterior descending lesion increased with angina severity. The presence of severe angina at the time of PCI was associated with MACCE in patients with DM (adjusted hazard ratio 1.93; [95% CI 1.01, 3.71]; P=0.047), while no significant difference in those without DM (adjusted hazard ratio 0.82; [95% CI 0.42, 1.59]; P=0.55).Conclusions: In SIHD patients with DM that underwent PCI, severe angina at the time of revascularization was associated with complex coronary anatomies and long-term outcomes. These findings underscore the importance of evaluating angina-related health status while considering revascularization in SIHD patients with DM.

scholarly journals EFEKTIFITAS KAPSUL MENGKUDU (Morinda citrifolia) TERHADAP PENURUNAN KADAR GULA DARAH PADA PASIEN DIABETES MELLITUS DI RS BRAWIJAYA

2017 ◽  
Vol 10 (01) ◽  
Author(s):  
Yuni Irianti ◽  
Ngadiani Ngadiani
Keyword(s):  
Diabetes Mellitus ◽  
Blood Sugar ◽  
Alternative Hypothesis ◽  
Morinda Citrifolia ◽  
Control Group ◽  
Control Group Design ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Post Test ◽  
Sugar Levels

We report the supplementation of noni (Morinda citrifolia) to decrease blood sugar levels in patients with diabetes mellitus Brawijaya Hospital Surabaya, and noni problems whether supplementation is effective in reducing blood sugar levels in diabetes patients mellitus.The goal of this study was to determine the effectiveness of capsule morinda to decrease blood sugar levels in patients with Diabetes Mellitus in Brawijaya Hospital Surabaya. This type of research is to ekperimem quasi control group design with pre-test and post test. The population in this study are patients with diabetes mellitus in hospital outpatient Brawijaya. The sampling technique with a number of 60 people who were divided into 30 groups of control (can drug from a doctor) and 30 in the experimental group (can medicine from the doctor and consumption of noni capsules) .Instrumen this study is the laboratory results of random blood sugar levels with the tools glucometer ( gluko Dr). Data analysis was performed using univariate and bivariate (parametric test, Kolmogorov-Smirnov test z and Independent T-Test). From the results, no significant difference the difference in the results of pre-test and post-test in the control group and the experiment is p = 0.020 (<0.05), then the alternative hypothesis (Ha) is accepted (the results are meaningful). It is concluded that supplementation of noni effective in helping to decrease blood sugar levels of patients with diabetes mellitus, it is advisable to consume noni capsules and routine checks of blood sugar levels so that the blood sugar levels under control.

scholarly journals Inverse Association between High-Density Lipoprotein Cholesterol and Adverse Outcomes among Acute Ischemic Stroke Patients with Diabetes Mellitus

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1947
Author(s):  
Guoliang Hu ◽  
Yuesong Pan ◽  
Mengxing Wang ◽  
Xia Meng ◽  
Yong Jiang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
High Density Lipoprotein ◽  
Acute Ischemic Stroke ◽  
High Density Lipoprotein Cholesterol ◽  
Recurrent Stroke ◽  
Density Lipoprotein ◽  
Adverse Outcomes ◽  
Lipoprotein Cholesterol ◽  
Patients With Diabetes

A low high-density lipoprotein cholesterol (HDL-C) level is an identified risk factor for cardiovascular diseases. However, results on the association between HDL-C levels and adverse outcomes in diabetic status still remain limited and controversial. Herein, we evaluated the association between HDL-C levels and adverse outcomes among acute ischemic stroke (AIS) patients with diabetes mellitus. The cohort comprised 3824 AIS patients with diabetes mellitus (62.7 ± 10.5 years; 34.2% women) from the Third China National Stroke Registry (n = 15,166). Patients were classified into five groups by quintiles of HDL-C. The outcomes included recurrent stroke and major adverse cardiovascular events (MACEs) within 1 year. The relationship between HDL-C levels and the risk of adverse outcomes was analyzed by Cox proportional hazards models. Patients in the lowest quintile of HDL-C had a higher risk of recurrent stroke (hazard ratio (HR) 1.59, 95% confidence interval (CI), 1.12–2.25) and MACEs (HR 1.53, 95% CI, 1.09–2.15) during 1-year follow-up compared with those in the highest quintile of HDL-C. There were linear associations between HDL-C levels and the risks of both recurrent stroke and MACEs. Low HDL-C levels were associated with higher risks of recurrent stroke and MACEs within 1 year in AIS patients with diabetes mellitus.

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