Features of Stroke in Chinese Diabetes Patients: A Hospital-based Study

2007 ◽  
Vol 35 (4) ◽  
pp. 540-546 ◽  
Author(s):  
X-D Zhang ◽  
Y-R Chen ◽  
L Ge ◽  
Z-M Ge ◽  
Y-H Zhang
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Ischaemic Stroke ◽  
Cerebral Haemorrhage ◽  
Mortality Rates ◽  
Demographic Characteristics ◽  
Major Influence ◽  
Diabetic Patients ◽  
Clinical Factors ◽  
Patients With Diabetes

In this study, demographic characteristics, risk factors, stroke subtypes and outcome were compared in 2532 patients with and without diabetes hospitalized for first-ever stroke. Diabetes was present in 471 (18.6%) of the patients. Patients with diabetes presented more frequently with ischaemic stroke (92.1% versus 71.3%), especially lacunar infarction (41.2% versus 35.2%), compared with non-diabetics. Cerebral haemorrhage was less frequent in diabetics than non-diabetics (4.2% versus 18.1%). In-hospital mortality rates from ischaemic stroke were similar in the two groups (18.2% in diabetics and 16.9% in non-diabetics). Predictors of in-hospital mortality in diabetic patients included decreased consciousness, congestive heart failure and atrial fibrillation. In conclusion, stroke in diabetic patients was different to stroke in non-diabetic patients: in diabetics the frequency of cerebral haemorrhage was lower and the rate of lacunar infarct syndrome was higher, but in-hospital mortality from ischaemic stroke was not increased. Clinical factors evident at the onset of stroke have a major influence on in-hospital mortality and may help clinicians provide a more accurate prognosis.

scholarly journals When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

2021 ◽  
Vol 7 (4) ◽  
pp. 298
Author(s):  
Teny M. John ◽  
Ceena N. Jacob ◽  
Dimitrios P. Kontoyiannis
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Clinical Features ◽  
The Other ◽  
Diabetic Patients ◽  
Epidemiological Factors ◽  
Uncontrolled Diabetes ◽  
Diagnostic Certainty ◽  
Patients With Diabetes ◽  
Perfect Storm

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.

Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Essential Components ◽  
Patients With Diabetes ◽  
Epidemiologic Risk

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)

scholarly journals Echocardiography, an Indispensable Tool for the Management of Diabetics, with or without Coronary Artery Disease, in Clinical Practice

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 709
Author(s):  
Konstantinos Katogiannis ◽  
Dimitrios Vlastos ◽  
Foteini Kousathana ◽  
John Thymis ◽  
Aikaterini Kountouri ◽  
...  
Keyword(s):  
Target Organ Damage ◽  
Organ Damage ◽  
Mortality Rates ◽  
Target Organ ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Reproducible Method ◽  
Artery Disease ◽  
Indispensable Tool ◽  
Early Alteration

Diabetes mellitus is a major factor contributing to the development of cardiovascular disease. As morbidity and mortality rates rise dramatically, when target organ damage develops pre-symptomatic assessment is critical for the management of diabetic patients. Echocardiography is a noninvasive and reproducible method that may aid in risk stratification and in evaluation of treatment effects. The aim of this review is to analyze the echocardiographic techniques which can detect early alteration in cardiac function in patients with diabetes.

scholarly journals Survival and factors predicting mortality after major and minor lower-extremity amputations among patients with diabetes: a population-based study using health information systems

2020 ◽  
Vol 8 (1) ◽  
pp. e001355
Author(s):  
Silvia Cascini ◽  
Nera Agabiti ◽  
Marina Davoli ◽  
Luigi Uccioli ◽  
Marco Meloni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Renal Disease ◽  
High Mortality ◽  
Chronic Renal Disease ◽  
Mortality Rates ◽  
Population Based ◽  
Term Survival ◽  
Factors Associated ◽  
Patients With Diabetes

IntroductionThe aim of the study was to identify the sociodemographic and clinical factors associated with death after the first lower-extremity amputation (LEA), minor and major separately, using data from regional health administrative databases.Research design and methodsWe carried out a population-based cohort study including patients with diabetes residing in the Lazio region and undergoing a primary amputation in the period 2012–2015. Each individual was followed up for at least 2 years. Kaplan-Meier analysis was used to evaluate long-term survival; Cox proportional regression models were applied to identify factors associated with all-cause mortality.ResultsThe cohort included 1053 patients, 72% were male, 63% aged ≥65 years, and 519 (49%) died by the end of follow-up. Mortality rates at 1 and 4 years were, respectively, 33% and 65% for major LEA and 18% and 45% for minor LEA. Significant risk factors for mortality were age ≥65, diabetes-related cardiovascular complications, and chronic renal disease for patients with minor LEA, and age ≥75 years, chronic renal disease and antidepressant drug consumption for subjects with major LEA.ConclusionsThe present study confirms the high mortality rates described in patients with diabetes after non-traumatic LEA. It shows differences between minor and major LEA in terms of mortality rates and related risk factors. The study highlights the role of depression as specific risk factor for death in patients with diabetes after major LEA and suggests including its definition and management in strategies to reduce the high mortality rate observed in this group of patients.

scholarly journals Risk factors for non-diabetic renal disease in diabetic patients

2020 ◽  
Author(s):  
Sheila Bermejo ◽  
Ester González ◽  
Katia López-Revuelta ◽  
Meritxell Ibernon ◽  
Diana López ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
Analytical Data ◽  
Multivariate Logistic Regression Analysis ◽  
Older Age ◽  
Diabetic Patients ◽  
Diabetic Renal Disease ◽  
Patients With Diabetes ◽  
Renal Prognosis ◽  
Independent Risk Factors

Abstract Background Diabetic patients with kidney disease have a high prevalence of non-diabetic renal disease (NDRD). Renal and patient survival regarding the diagnosis of diabetic nephropathy (DN) or NDRD have not been widely studied. The aim of our study is to evaluate the prevalence of NDRD in patients with diabetes and to determine the capacity of clinical and analytical data in the prediction of NDRD. In addition, we will study renal and patient prognosis according to the renal biopsy findings in patients with diabetes. Methods Retrospective multicentre observational study of renal biopsies performed in patients with diabetes from 2002 to 2014. Results In total, 832 patients were included: 621 men (74.6%), mean age of 61.7 ± 12.8 years, creatinine was 2.8 ± 2.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2–5.4) g/24 h. About 39.5% (n = 329) of patients had DN, 49.6% (n = 413) NDRD and 10.8% (n = 90) mixed forms. The most frequent NDRD was nephroangiosclerosis (NAS) (n = 87, 9.3%). In the multivariate logistic regression analysis, older age [odds ratio (OR) = 1.03, 95% CI: 1.02–1.05, P < 0.001], microhaematuria (OR = 1.51, 95% CI: 1.03–2.21, P = 0.033) and absence of diabetic retinopathy (DR) (OR = 0.28, 95% CI: 0.19–0.42, P < 0.001) were independently associated with NDRD. Kaplan–Meier analysis showed that patients with DN or mixed forms presented worse renal prognosis than NDRD (P < 0.001) and higher mortality (P = 0.029). In multivariate Cox analyses, older age (P < 0.001), higher serum creatinine (P < 0.001), higher proteinuria (P < 0.001), DR (P = 0.007) and DN (P < 0.001) were independent risk factors for renal replacement therapy. In addition, older age (P < 0.001), peripheral vascular disease (P = 0.002), higher creatinine (P = 0.01) and DN (P = 0.015) were independent risk factors for mortality. Conclusions The most frequent cause of NDRD is NAS. Elderly patients with microhaematuria and the absence of DR are the ones at risk for NDRD. Patients with DN presented worse renal prognosis and higher mortality than those with NDRD. These results suggest that in some patients with diabetes, kidney biopsy may be useful for an accurate renal diagnosis and subsequently treatment and prognosis.

scholarly journals The Association of Depression and the Cardiovascular Risk Factors of Blood Pressure, HbA1c, and Body Mass Index among Patients with Diabetes: Results from the Translating Research into Action for Diabetes Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lindsay B. Kimbro ◽  
W. Neil Steers ◽  
Carol M. Mangione ◽  
O. Kenrik Duru ◽  
Susan L. Ettner
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Health ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Patient Health ◽  
Hba1c Levels

Diabetic patients are nearly three times as likely to have depression as their nondiabetic counterparts. Patients with diabetes are already at risk for poor cardiovascular health. Using cross-sectional data from the translating research into action for diabetes (TRIAD) study, the authors tested the association of depression with cardiovascular risk factors in diabetic patients. Depression was measured using the patient health questionnaire (PHQ8). Patients who scored greater than 9 on the PHQ8 were classified as depressed and were compared with those who were not depressed(n=2,341). Depressed patients did not have significantly different blood pressure levels than those who were not depressed. However, those who were depressed had higher HbA1c levels than those who were not depressed(P<0.01)and higher BMIs than those who were not depressed(P<0.01). These results indicate that depressed diabetic patients are at greater risk of having poor control of cardiovascular risk factors and suggest that depression screening should be a standard practice among this patient group.

scholarly journals Stress hyperglycemia is associated with in-hospital mortality in patients with diabetes and acute ischemic stroke

2020 ◽  
Author(s):  
Donghua Mi ◽  
Zixiao Li ◽  
Hongqiu Gu ◽  
Yin Yang ◽  
Chunjuan Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Acute Ischemic Stroke ◽  
Cardiovascular Risk Factors ◽  
Fasting Blood Glucose ◽  
Hospital Death ◽  
Diabetic Patients ◽  
Stress Hyperglycemia ◽  
Patients With Diabetes

Abstract Background and Objective: Stress hyperglycemia may occur in diabetic patients with acute severe cerebrovascular disease, but the results regarding its association with stroke outcomes are conflicting.Our study aimed to examine the association between stress-induced hyperglycemia and the occurrence of in-hospital death in patients with diabetes and acute ischemic stroke. Research Design and Methods: All data were from the Chinese Stroke Center Alliance (CSCA) database and were collected between 2016 and 2018 from > 300 centers across China. Patients’ demographics, clinical presentation, and laboratory data were extracted from the database. The primary endpoint was in-hospital death. The ratio of fasting blood glucose (FBG) to HbA1c was calculated, i.e., the stress-induced hyperglycemia ratio (SHR), to determine stress hyperglycemia following acute ischemic stroke. Results A total of 168,381 patients were included. The mean age was 66.2 ± 10.7, and 77,688 (43.0%) patients were female. The patients were divided into two groups: survivors (n = 167,499) and non-survivors (n = 882), as well as into four groups according to their SHR quartiles (n = 42,090 − 42,099/quartile). The frequencies of traditional cardiovascular risk factors increased with the SHR quartiles. There were 109 (0.26%), 142 (0.34%), 196 (0.47%), and 435 (1.03%) patients who died in the Q1, Q2, Q3, and Q4 quartiles, respectively. Compared with Q1 patients, the death risk was higher in Q4 patients (odds ratio (OR) = 4.02) (adjusted OR = 1.89, 95% confidence interval [CI] = 1.14–3.12, P = 0.026 after adjustment for traditional cardiovascular risk factors). Conclusions The SHR may serve as an accessory parameter for the prognosis of patients with diabetes after acute ischemic stroke.Hyperglycemia in stroke patients with diabetes mellitus is associated with a higher risk of in-hospital death.

scholarly journals Risk factors for eye complications in patients with diabetes mellitus: development and progression

2000 ◽  
Vol 6 (2-3) ◽  
pp. 313-325
Author(s):  
M. El Shazly ◽  
M. Zeid ◽  
A. Osman
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Case Control Study ◽  
Case Control ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Control Study

A multicentre case-control study was conducted to identify and quantify risk factors that may influence the development and progression of diabetic retinopathy. A total of 200 diabetic patients with nonproliferative retinopathy were compared with 400 diabetic patients without any eye complications with regard to the development of diabetic retinopathy. They were also compared with 200 diabetic patients with major eye complications to study the progression of diabetic eye complications. Results showed that the progression of diabetic eye complications was preventable since all the variables significantly affecting the process of progression, except type of diabetes, were avoidable

scholarly journals Prevention and treatment of diabetic microangiopathy: A lecture

1995 ◽  
Vol 41 (6) ◽  
pp. 29-34
Author(s):  
A. K. Dreval
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Atherosclerotic Vascular Disease ◽  
Diabetic Macroangiopathy ◽  
Prevention And Treatment ◽  
Patients With Diabetes

One of the main complications leading to high disability and mortality in patients with diabetes mellitus is atherosclerotic vascular disease (diabetic macroangiopathy). At the same time, the frequency of atherosclerosis among patients with diabetes mellitus is significantly affected by the so-called risk factors for atherosclerosis. In particular, the incidence of atherosclerosis among the general population and among diabetics increases with increased levels of cholesterol (cholesterol) in the blood, blood pressure, smoking and obesity. However, in patients with diabetes mellitus, mortality, for example, from coronary heart disease increases by 3 times against any of the known risk factors. But even without risk factors, the frequency of atherosclerotic vascular damage in patients with diabetes is much higher than in non-diabetic patients, i.e. diabetes in itself is a risk factor for atherosclerosis.

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