scholarly journals Diabetic Myonecrosis: A Rare Complication of Uncontrolled Diabetes Mellitus

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A377-A378
Author(s):  
Gayane Tumyan ◽  
Aaron Oubre ◽  
Mark Feldman
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
Rare Complication ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Type I ◽  
Ct Angiogram ◽  
Adductor Muscles ◽  
History Of ◽  
The Right

Abstract Background: Diabetic myonecrosis is a rare complication of long-standing, poorly controlled diabetes mellitus, and is more common in patients with microvascular complications. The diagnosis is frequently missed due to symptoms mimicking other conditions associated with diabetes mellitus. Clinical Case: A 31-year-old woman with a past medical history of long-standing type I diabetes mellitus, end-stage renal disease, diabetic retinopathy, and cataracts presented to our hospital with a chief complaint of right thigh pain and swelling for a week. She did not have any other relevant symptoms and denied a history of trauma. On admission, physical examination revealed right thigh edema, induration, tenderness on palpation, more pronounced in the medial aspect of the thigh, and decreased range of motion of the right hip. Laboratory analysis showed leukocytosis of 13.29 k/uL (normal = 4.23 - 9.71 k/uL) with neutrophilic predominance of 91.4 %, elevated inflammatory markers (ESR > 130 mm/h (normal = 0 - 30 mm/h), CRP 33.84 mg/dL (normal <= 0.49 mg/dL)) and elevated CK levels of 1675 U/L (normal = 29 - 168 U/L). Additionally, the patient was anemic with a hemoglobin level of 8.4 g/dL (normal = 11.0 - 15.0 g/dL) and had a creatinine level of 2.67 mg/dL (normal = 0.55 - 1.11 mg/dL). Hemoglobin A1C level was 10.8 % (normal = 4.0 - 6.0 %). Blood cultures were drawn and did not grow any organisms. A doppler ultrasound of the right leg was negative for a deep venous thrombosis. CT angiogram of right lower extremity revealed diffuse calcifications in the walls of small and medium vessels and edematous changes in thigh musculature associated with subcutaneous edema. Noncontrast MRI revealed localized edema within the vastus medialis, sartorius, and right thigh adductor muscles. The patient improved with analgesics, rest, and gentle physical therapy. She was counseled on compliance with insulin and advised for a close follow up with her endocrinologist. Conclusion: This case reinforces the importance of including diabetic myonecrosis in the differential diagnosis of acute to subacute nontraumatic muscular pain in diabetic patients, particularly in patients with poor glycemic control and known complications. While muscle biopsy can be performed for histological confirmation, the typical imaging findings and clinical presentation can lead to the diagnosis, making further invasive testing unnecessary. In most described cases, the course of this condition is self-limiting.

scholarly journals Calcium Homeostasis in Ventricular Myocytes of Diabetic Cardiomyopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Lina T. Al Kury
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Cardiomyopathy ◽  
Contractile Function ◽  
Type I Diabetes ◽  
Heart Function ◽  
Diabetic Rat ◽  
Diabetic Patients ◽  
Type I ◽  
High Blood Glucose ◽  
Cardiac Contractile

Diabetes mellitus (DM) is a chronic metabolic disorder commonly characterized by high blood glucose levels, resulting from defects in insulin production or insulin resistance, or both. DM is a leading cause of mortality and morbidity worldwide, with diabetic cardiomyopathy as one of its main complications. It is well established that cardiovascular complications are common in both types of diabetes. Electrical and mechanical problems, resulting in cardiac contractile dysfunction, are considered as the major complications present in diabetic hearts. Inevitably, disturbances in the mechanism(s) of Ca2+ signaling in diabetes have implications for cardiac myocyte contraction. Over the last decade, significant progress has been made in outlining the mechanisms responsible for the diminished cardiac contractile function in diabetes using different animal models of type I diabetes mellitus (TIDM) and type II diabetes mellitus (TIIDM). The aim of this review is to evaluate our current understanding of the disturbances of Ca2+ transport and the role of main cardiac proteins involved in Ca2+ homeostasis in the diabetic rat ventricular cardiomyocytes. Exploring the molecular mechanism(s) of altered Ca2+ signaling in diabetes will provide an insight for the identification of novel therapeutic approaches to improve the heart function in diabetic patients.

scholarly journals Melioidosis in a Patient with Type I Diabetes Mellitus - A Case Report

2018 ◽  
Vol 42 (1) ◽  
pp. 46-48
Author(s):  
Tasnima Ahmed ◽  
Md Abid Hossain Mollah ◽  
Fauzia Mohsin ◽  
Jebun Nahar ◽  
Abu Talha
Keyword(s):  
Diabetes Mellitus ◽  
Burkholderia Pseudomallei ◽  
Type I Diabetes ◽  
Correct Diagnosis ◽  
Abdominal Distension ◽  
Renal Diseases ◽  
Type I ◽  
Negative Bacterium ◽  
The Right ◽  
Underlying Diseases

Melioidosis is a relatively uncommon but fatal infectious disease caused by the gram negative bacterium, Burkholderia pseudomallei which is usually found in the wet soil, mud and pooled surface water in tropic and subtropics. Documented reports of melioidosis from Bangladesh have been few and sporadic. All of the reported cases in Bangladesh were on adult. Melioidosis is commonly associated with underlying diseases like diabetes mellitus, renal diseases and immunodeficiency disorders. Early and correct diagnosis is important, as mortality in untreated melioidosis is high. Our patient, an eleven years old boy, a known case of diabetes mellitus, presented with fever for one month associated with right sided neck swelling, abdominal distension & pain for 10 days. He had an abscess on the right side of the neck and hepatosplenomegaly. Ultrasonography of abdomen showed multiple abscesses in the liver and spleen. Culture of pus drained from the neck abscess revealed growth of Burkholderia pseudomallei. After getting parenteral antibiotics and insulin, his abscesses gradually resolved and cured completely.Bangladesh J Child Health 2018; VOL 42 (1) :46-48

scholarly journals A Rarely Seen Multilevel Thoracic Vertebral Fracture after a Nocturnal Hypoglycemic Convulsion Attack

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ebru Atalar ◽  
Cuneyd Gunay ◽  
Hakan Atalar ◽  
Tugba Tunc
Keyword(s):  
Back Pain ◽  
Thoracic Spine ◽  
Type I Diabetes ◽  
Compression Fracture ◽  
Diabetic Patients ◽  
Type I ◽  
Rare Injury ◽  
Compression Fractures ◽  
History Of ◽  
Insulin Dependent Diabetic

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulin-induced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack.

Natural History of Type I Diabetes Mellitus in Childhood

1987 ◽  
Vol 29 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Z. Laron ◽  
M. Karp ◽  
P. Fainmesser ◽  
S. Assa ◽  
Y. Aurbach
Keyword(s):  
Diabetes Mellitus ◽  
Natural History ◽  
Type I Diabetes ◽  
Type I Diabetes Mellitus ◽  
Type I ◽  
History Of

scholarly journals High Prevalence of Toxoplasma gondii Infection in Type I Diabetic Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qasem Asgari ◽  
Mohammad Hossein Motazedian ◽  
Amir Khazanchin ◽  
Davood Mehrabani ◽  
Shahrbanou Naderi Shahabadi
Keyword(s):  
Family History ◽  
Type I Diabetes ◽  
Positive Family History ◽  
Control Group ◽  
Diabetic Patients ◽  
Type I ◽  
Toxoplasma Infection ◽  
Family History Of Diabetes ◽  
History Of ◽  
Toxoplasma Gondii Infection

Background. Type I diabetes (TΙDM) is a genetic or autoimmune disorder, which may be stimulated by induced immune system components due to the underlying infectious diseases. This study was undertaken to find out any possible association between Toxoplasma gondii infection and TIDM. Materials and Methods. One hundred and eighty-two blood samples were taken from individuals who were referred to outpatient clinics in Shiraz city, Southern Iran, during a 6-month period. The age of type I diabetic subjects ( n = 91 ) and the control group ( n = 91 ) was identical, which were less than 30 years. The sera were examined for IgG and IgM antibodies by ELISA and correlated with epidemiological factors such as age, sex, and family history of diabetes. Results. Out of 91 diabetic patients, 54 (59.3%) were female and 37 (40.7%) were male. The highest frequency of diabetes belonged to 6-10- and 11-15-year groups ( P = 0.17 ). Toxoplasma infection prevalence in diabetic and control groups was 28.6% and 7.7%, respectively ( P = 0.001 ). A significantly positive family history of diabetes was observed between diabetic patients (31 cases, 34.1%) and the control group (3 cases, 3.3%) ( P = 0.01 ). Interestingly, IgG positivity was seen in 13 cases (41.9%) of patients with positive family history of type I diabetes and 13 cases (21.7%) of subjects with no positive family history of type I diabetes ( P = 0.04 ). Conclusion. Our study showed a higher prevalence of Toxoplasma infection in type I diabetes patients. It is likely that the prevalence of TIDM decreases by increasing hygiene and preventing toxoplasmosis.

Characteristics of Long Term Peritoneal Dialysis Survivors: 18 Years Experience in One Center

1997 ◽  
Vol 17 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Emaad M. Abdel-Rahman ◽  
Maureen Wakeen ◽  
Stephen W. Zimmerman
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Type I Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type I ◽  
Term Survival ◽  
Hospital Days ◽  
Long Term Survivors

Objectives Long-term experience of patients on peritoneal dialysis (PD) in general, and in diabetic patients specifically, is limited. Few patients have been followed on PD for over 8 years. Our aim was to evaluate and characterize long-term survivors (L TS) on PD for more than 100 months. A retrospective analysis of 20 patients who survived on PD for more than 100 months was performed. Data on long-term survivors was compared to data of 103 patients who died or switched to hemodialysis (HD) in less than 100 months. Design The study included all patients starting PD prior to 1 January 1986. Demographic, biochemical, dialysis prescription, and morbidity data were obtained on these patients. Characteristics of long-term survivors on PD (more than 100 months), was compared with those who died or switched to HD in less than 100 months, using Student t-test. Setting An experienced single center, university-based dialysis program. Patients 165 patients started PD at the University of Wisconsin prior to 1 January 1986. Forty three had type I diabetes mellitus and 24 had type II diabetes mellitus as the cause of their renal failure. Results Twenty patients survived on PD more than 100 months (L TS). Long-term survival of type I diabetic patients was seen in 7 of 43 patients at risk. Seventeen type I diabetics received renal transplants and ten died. 103 patients either died or switched to HD in less than 100 months. Long-term survivors were significantly younger, weighed less, had fewer episodes of peritonitis, fewer hospital days, and were prescribed more dialysis per kg body weight, than those who died or switched to HD prior to 100 months. Conclusions Long-term survival on CAPD for longer than 100 months is possible with survival periods up to 18 years in both males and females and in nondiabetics as well as patients with type I diabetes mellitus. No patient with type II diabetes mellitus survived longer than 100 months on CAPD. In comparison to short-term survivors, long-term survivors were characterized by being younger, weighing less, having fewer episodes of peritonitis, fewer hospital days, and were prescribed more dialysis/kg body weight.

Evaluation of α-klotho level in insulin dependent diabetes mellitus (IDDM) children

2020 ◽  
Vol 33 (6) ◽  
pp. 761-765
Author(s):  
Fariba Tarhani ◽  
Ghobad Heidari ◽  
Alireza Nezami
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
Sandwich Elisa ◽  
Serum Levels ◽  
Dependent Diabetes Mellitus ◽  
Control Group ◽  
Case Group ◽  
Diabetic Patients ◽  
Type I ◽  
And Control

AbstractObjectivesReduced levels of α-Klotho is associated with the pathogenesis of various diseases including diabetes. In type I diabetes, decrease in Klotho leads to apoptosis of β-cells of pancreases. The aim of this study was to evaluate the levels of α-Klotho in type I diabetic pediatric patients.MethodsIn this cross-sectional single centered study, 46 patients presenting type I diabetes mellitus (case group) and 78 control group under the age of 12, referred to our clinic were included in our study. Serum levels of soluble Klotho were measured by sandwich ELISA in case and control groups. Statistical analysis was conducted for the data recorded via questionnaire.ResultsMean age of the patients in the case and control group was 7.65 ± 3.09 and 7 ± 2.37, respectively. Type I diabetes patients had a significant reduction in the levels of serum Klotho, as compared to controls (p<0.001). However, gender and age-based comparison between patient and control group was not significant.ConclusionsThis study reports a significant decrease in the serum levels of α-Klotho in type 1 diabetic patients. Low levels of Klotho can be associated with diabetic nephropathy and other comorbidities in these patients.

scholarly journals Estimating the Levels of Autoantibodies to NMDA And Dopamine Receptors in Children with Diabetes Mellitus Type I, Subject to the Condition Severity

Medicina ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 41-48
Author(s):  
Yu. V. Bykov ◽  
◽  
V. A. Baturin ◽  
T. I. Uglova ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Nmda Receptors ◽  
Children And Adolescents ◽  
Dopamine Receptors ◽  
Type I Diabetes ◽  
Enzyme Linked Immunosorbent Assay ◽  
Type I ◽  
Diabetes Mellitus Type I ◽  
History Of

Type I Diabetes Mellitus (DM) is among the most common endocrinological diseases in adolescents. The purpose of this study was to research the level of autoantibodies (AAT) to NMDA receptors and Type 2 dopamine receptors (DAR2) in children with varying severity condition of Type I Diabetes. We examined 38 children and adolescents aged 2 to 17 years. In order to determine the levels of AAT to NMDA receptors and dopamine receptors (DR2) in blood serum, we applied the enzyme-linked immunosorbent assay (ELISA). We found higher levels of AAT to NMDA receptors and dopamine receptors (DAR2) in children with chronic Type I Diabetes against the background of diabetic ketoacidosis (DKA), as compared to children with the diabetes onset or compensation of the disease. The increased levels of AAT to NMDA and dopamine receptors (DAR2) were found in children and adolescents against the background of a long history of the disease and frequent hospitalization to the intensive care unit.

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