scholarly journals Multidisciplinary Foot Clinics Impact on the Diabetic World

2015 ◽  
Vol 8 (3) ◽  
Author(s):  
Chavan Williams
Keyword(s):  
Type I Diabetes ◽  
The Body ◽  
Lower Limbs ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Foot Complications ◽  
After Care ◽  
Health Complications ◽  
And Function

In today’s society, diabetes is a prevalent illness afflicting people of various races, ages, genders and social statuses(1). Diabetes is a chronic illness in which the body is unable to break down sugars due to poor insulin production and function(3). Diabetes can be classified as type I or as type II, and may be categorized as moderate or advanced. In type I diabetes, a person isn’t able to produce insulin, while someone with type II diabetes cannot produce enough insulin and suffers from “insulin resistance”(3). Diabetic patients may suffer from health complications as the illness becomes more advanced, such as foot complications. Often, foot complications can result in amputation of the lower limbs or in some cases, mortality. To address this problem, multidisciplinary foot clinics have been created to aid patients, reduce mortality rates, and decrease the occurrence of limb amputations. These programs provide information to diabetic patients and their families, providing foot-oriented treatments and monitoring patients’ progress through after care. This article will argue that the practices and procedures in multidisciplinary foot clinics help significantly reduce diabetic foot complications, resulting in amputation or death for diabetic patients.

Type I diabetes suppresses intracellular calcium ion increase normally evoked by heat stress in rat skeletal muscle

2021 ◽  
Author(s):  
Ryo Ikegami ◽  
Hiroaki Eshima ◽  
Toshiaki Nakajima ◽  
Shigeru Toyoda ◽  
David C. Poole ◽  
...  
Keyword(s):  
Heat Stress ◽  
Protein Expression ◽  
Type I Diabetes ◽  
Diabetic Rats ◽  
Diabetic Patients ◽  
Type I ◽  
Male Wistar Rats ◽  
Intracellular Calcium Ion ◽  
And Function

Heat stress, via its effects on muscle intracellular Ca2+ concentrations ([Ca2+]i), has been invoked as a putative therapeutic countermeasure to Type 1 diabetes-induced muscle atrophy. Using in vivo muscle preparation we tested the hypothesis that impaired muscle Ca2+ homeostasis in type I diabetic rats is due to attenuated heat stress tolerance mediated via TRPV1. Male Wistar rats were assigned to 1 of 4 groups: 1.control 30oC (CONT 30oC), 2.CONT 40oC, 3.diabetes 30oC (DIA 30oC), 4.DIA 40oC. 40oC was selected because it just exceeds the TRPV1 activation threshold. Spinotrapezius muscles were exteriorized in vivo and loaded with the fluorescent Ca2+ probe Fura-2AM. [Ca2+]i was estimated over 20min using fluorescence microscopy in quiescent muscle held at the required temperature using calibrated heat source applied to the ventral muscle surface. Western blotting was performed to determine the protein expression levels of TRPV1 in spinotrapezius muscle. After 20min of heat stress, the CONT 40oC condition induced a 12.3% [Ca2+]i elevation that was absent from the DIA 40oC or other conditions. Thus, no significant differences were found among DIA 40oC, DIA 30oC and CONT 30oC. TRPV1 protein expression was decreased by 42.0% in DIA compared with CONT (P<0.05) and, unlike CONT, heat stress did not increase TRPV1 phosphorylation. In conclusion, diabetes suppresses TRPV1 protein expression and function and inhibits the elevated myocyte [Ca2+]i evoked normally by heat stress. These results suggest that capsaicin or other therapeutic strategies to increase Ca2+ accumulation via TRPV1 might be more effective than hyperthermic therapy for Type I diabetic patients.

Haemostasis Disturbances in Type I and II Diabetes Mellitus.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4032-4032
Author(s):  
Patrick Van Dreden ◽  
Aurelie Rousseau ◽  
Thomas Exner ◽  
Marc Vasse ◽  
Geneviéve Ozenne ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Platelet Activation ◽  
Type Ii Diabetes ◽  
Type I Diabetes ◽  
Factor Xa ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Small Pilot Study

Abstract Diabetes is associated with disturbances in haemostasis that are thought to result in an increased incidence of thrombotic complications and cardiovascular disease. The aim of this pilot study was to monitor activation of haemostasis using specific markers for platelet activation and coagulation. Plasma samples (all blood collected and plasma prepared in the same hospital under the same conditions) were obtained from twenty diabetic patients (8 with type I and 12 with type II) and twenty one normal control volunteers. To monitor coagulation these samples were evaluated with the partial thromboplastin time (APTT), prothrombin time (PT) and D-dimer (D-Di) - all reagents from Diagnostica Stago, Asniéres, France. Platelet activation was monitored with a novel method for monitoring procoagulant phospholipids microparticles (PPM) using a factor Xa-based coagulation assay. In this assay shortened clotting times are associated with increased levels of PPM and thus platelet activation. APTT Sec. PT % PPM Sec. D-Di μg/l Controls 34.6 (29.4–39.6) 93.1 (79–109) 57.5 (51.1–74.9) 0.22 (0.22–0.45) Type I Diabetes 34.5 (33.1–36.7) 96.9 (92–102.5) 33.8 (19.1–44.2) 1.6 (0.22–3.6) Type II Diabetes 36.8 (33.2–40.4) 96 (59.4–112.5) 48.3 (44.2–51.2) 0.7 (0.22–1.7) Significantly higher levels of both PPM and DD were found in Type I diabetes patients compared with controls (both P&lt;0.001). In type II diabetes the levels of both were lower than those found in Type I diabetes but both were still higher than the controls (PPM and DDi at p&lt;0.001 and p&lt;0.01 level respectively), only the differences in levels of PPM reaching significance between type I and type II diabetes (p&lt;0.01). The more severe the diabetes (type I &gt; type II) the greater the level activation of haemostasis that is observed. The increases in PPM could account in part for the development or progression of arthrosclerosis in patients with diabetes mellitus. The increased level of D-Di confirms the increased hypercoagulability of these patients. Although this was a small pilot study and further studies are needed to confirm these findings it is interesting to speculate on the usefulness of both the PPM assay and D-Di assays in monitoring the development/severity of diabetes and its complications. The PPM assay may prove to be especially useful in monitoring progression of the disease.

Does Type II Diabetes Predispose to Retinal Vein Occlusion?

1993 ◽  
Vol 3 (3) ◽  
pp. 109-113 ◽  
Author(s):  
P.M. Dodson ◽  
C.G. Clough ◽  
S.M. Downes ◽  
E.E. Kritzinger
Keyword(s):  
Retinal Vein Occlusion ◽  
Type I Diabetes ◽  
Microvascular Complications ◽  
Control Group ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Medical Conditions ◽  
Vein Occlusion ◽  
Diabetic Microvascular Complications

Retinal vein occlusion (RVO) not infrequently occurs in diabetic patients. Although the aetiology is unclear, it could relate to the other microvascular complications of diabetes. In the non-diabetic, both the central (CRVO) and branch (BRVO) forms are commonly associated with hypertension and hyperlipidaemia. We have therefore studied fifty type II diabetic patients with RVO compared to a carefully matched diabetic control group (n = 50) to elucidate underlying medical conditions and hence the aetiology of RVO in diabetic patients. The two groups were well matched. Diabetics with RVO showed a strikingly high prevalence of hypertension compared to the controls (72% versus 32%: p < 0.001) and a trend to increased hyperlipidaemia (54% versus 36%). Diabetic microvascular complications were more common in the control group (diabetic retinopathy and proteinuria). No significant differences were observed in mean HbA1 or weight, but current smoking habits and blood pressure levels were increased in the diabetics with RVO. 80% of diabetic patients with the BRVO form, were hypertensive. We conclude that the main underlying medical conditions for RVO in diabetics are hypertension and hyperlipidaemia, and these may be important in the aetiology as in the non-diabetic. RVO is more common in type II rather than type I diabetes, and does not associate with the presence of diabetic microvascular complications. Clinical assessment for hypertension and hyperlipidaemia is therefore important in diabetic patients with RVO, especially if recurrence of the condition and further visual loss is to be prevented.

scholarly journals HYPOGLYCAEMIA

2016 ◽  
Vol 23 (07) ◽  
pp. 64-869
Author(s):  
Muhammad Umar Khan ◽  
Darshan Kumar ◽  
Adil Faraz ◽  
Muhammad Adnan ◽  
Hala Soomro
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
University Hospital ◽  
Hypoglycemic Agents ◽  
Renal Diseases ◽  
Severe Malnutrition ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Study Results

Objectives: Find out the hypoglycaemia in patients with diabetic nephropathicpatients. Study Design: Cross sectional study. Setting: National Institute of Diabetes &Endocrinology at Dow University Hospital, Ojha Campus, Karachi. Duration of Study: For theperiod of one year, from October 2014 to November 2015. Methodology: Known “diabeticpatients” with nephropathy which were present at National Institute of Diabetes & Endocrinology,Dow University Hospital, Ojha Campus, Karachi Patients presenting with signs and symptomsof hypoglycemia are diagnosed cases of “diabetes mellitus with nephropathy”, age 30 andabove, Type-I and type-Il diabetes mellitus, on oral hypoglycemic agents I insulin were includedin this study. Questions regarding the time period for which patient has been using these drugsand if the patient is suffering from illness which may be acute or chronic, should be askedregarding the relevant disease & its association with hypoglycaemia be mentioned, & patientsurine D/R & Serum Creatinine & Urea are measured by sending to the appropriate laboratory.Patients with severe malnutrition and starvation, chronic liver disease, alcoholics, chronicdisease as tuberculosis, patients with renal diseases without diabetes, any other malignancypatients were excluded from this study. Results: Depending upon the selection of 200 patients,the result concluded in our study consisted of 54% male patients and 46% were females, out ofwhich 11% had type I and diabetes and type II diabetics constituted 89%. Most of the patientsage between 60 to 75 years of age. The average duration of diabetes was 12.20 + 6.14 years.Out of 24 hypoglycaemic patients, 6 (25%) had type-I diabetes in which 4 were male and 2 wasfemale while 18 (75%) had type-II diabetes in which 10 were male and 8 were female patients.Conclusion: Observed that hypoglycaemia was common in diabetic patients, who developedrenal failure due to diabetic nephropathy.

scholarly journals DIABETES MELLITUS;

2017 ◽  
Vol 24 (11) ◽  
pp. 1615-1620
Author(s):  
Muhammad Aizaz Ashraf ◽  
Talha Shamshad ◽  
Muhammad Waseem Abbas ◽  
Naveed Asghar ◽  
Muhammad Umer Bin Arshad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Side Effects ◽  
Treatment Satisfaction ◽  
Type I Diabetes ◽  
Educational Status ◽  
P Value ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Satisfaction Questionnaire

Objectives: Diabetes Mellitus being a major issue faced by developingcountries like Pakistan. Non-adherence is a major issue in achieving a desired therapeuticgoal. This study aims at determining relation with the drug non-adherence associated with thetreatment regime, treatment satisfaction and educational status of the person. Study Design:This was a cross sectional study. Place and Duration: This study was done at the Diabetesclinic, Nishtar hospital, Multan. Total 242 diabetic patients were studied over a period of 10months. Methodology: The inclusion criteria was set as patients who have been diagnosedwith Diabetes Type II and had been on oral hypoglycemic medications for about last 5 monthsor more. Those patients who were diagnosed with Type I diabetes and Type II diabetesless than 5 months were not included in the study. Also those patients who were on Insulintherapy were also excluded. Socio-demographic data was obtained along with therapy typeand educational status. Drug adherence level was studied with the 8-item Morisky (MMAS-8). Treatment satisfaction was studied with the help of treatment satisfaction questionnaire formedication. The data was analyzed on the SPSS version 23 with significant p-value <0.05.Results: Among 242 patients 152(62.81%) were females and 90(37.19%) were males. Meanage of the patients were 47.68±15.13 years. Patients on combination therapy were (n=134,55.3%) and on monotherapy were (n=108, 44.6%). Mean adherence score was 5.4±1.1.Themean for four domains of Treatment Satisfaction Questionnaire for Medication(TSQM) were:effectiveness= 66.93±15.27, side effects=32.09±26.91, convenience =62.59±14.49 andsatisfaction= 65.49±16.13.Non-adherence was found to be associated with age, illiteracy,side-effects, satisfaction and convenience (p<0.05). Conclusion: Non-adherence must beovercome in patients to achieve appropriate glucose levels. Significant factors affecting theadherence levels were Illiteracy, Side effects, convenience and satisfaction of the patient. Publicawareness campaigns and regular clinic visits should be encouraged. Drugs having lower sideeffects,higher satisfaction levels and combined generics for once daily dosing having greaterconvenience should be used.

Stem Cell-Based Therapies: A New Ray of Hope for Diabetic Patients

2019 ◽  
Vol 14 (2) ◽  
pp. 146-151 ◽  
Author(s):  
Junaid Khan ◽  
Amit Alexander ◽  
Mukta Agrawal ◽  
Ajazuddin ◽  
Sunil Kumar Dubey ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Drug Therapy ◽  
Type I Diabetes ◽  
Embryonic Stem ◽  
Health Concern ◽  
Future Research ◽  
Diabetic Patients ◽  
Successful Implementation ◽  
Type I

Diabetes and its complications are a significant health concern throughout the globe. There are physiological differences in the mechanism of type-I and type-II diabetes and the conventional drug therapy as well as insulin administration seem to be insufficient to address the problem at large successfully. Hypoglycemic swings, frequent dose adjustments and resistance to the drug are major problems associated with drug therapy. Cellular approaches through stem cell based therapeutic interventions offer a promising solution to the problem. The need for pancreatic transplants in case of Type- I diabetes can also be by-passed/reduced due to the formation of insulin producing β cells via stem cells. Embryonic Stem Cells (ESCs) and induced Pluripotent Stem Cells (iPSCs), successfully used for generating insulin producing &#946; cells. Although many experiments have shown promising results with stem cells in vitro, their clinical testing still needs more exploration. The review attempts to bring into light the clinical studies favoring the transplantation of stem cells in diabetic patients with an objective of improving insulin secretion and improving degeneration of different tissues in response to diabetes. It also focuses on the problems associated with successful implementation of the technique and possible directions for future research.

A program to reduce onset distress in unselected type I diabetic patients: effects on psychological variables and metabolic control

1995 ◽  
Vol 132 (5) ◽  
pp. 580-586 ◽  
Author(s):  
K Spiess ◽  
G Sachs ◽  
P Pietschmann ◽  
R Prager
Keyword(s):  
Patient Education ◽  
Metabolic Control ◽  
Type I Diabetes ◽  
Intensive Treatment ◽  
Medical Psychology ◽  
Diabetic Patients ◽  
Type I ◽  
Psychological Variables ◽  
Reduction Program

Spiess K, Sachs G, Pietschmann P, Prager R. A program to reduce onset distress in unselected type I diabetic patients: effects on psychological variables and metabolic control. Eur J Endocrinol 1995;132:580–6. ISSN 0804–4643 This paper reports the results of a prospective controlled trial of a program addressing reduction of onset distress and better future adaptation in adults who were enrolled at the time of diagnosis of type I diabetes mellitus. Patients were assigned randomly to either standard intensive treatment and patient education with the distress reduction program (N = 10) or to standard intensive treatment and patient education without this program (N = 13). Prospective follow-up of patients with multiple validated measures of treatment outcome showed less anxious coping behavior, less depression and less denial at the 9-month follow-up and less denial at the 15-month follow-up in the group with the distress reduction program, but no differences in metabolic control between the two groups at any time. We conclude that our program has a positive impact on the crisis at diabetes onset; the lower denial in the treatment group may lead to improved regimen adherence in the long term. Klaus Spiess, Institute of Medical Psychology, University of Vienna, Severingasse 9, A-1090-Vienna, Austria

THE EFFECTS OF ALTERED AQUATIC AND AERIAL RESPIRATORY GAS CONCENTRATIONS ON AIR-BREATHING PATTERNS IN A PRIMITIVE FISH (AMIA CALVA)

1993 ◽  
Vol 181 (1) ◽  
pp. 81-94 ◽  
Author(s):  
M. S. Hedrick ◽  
D. R. Jones
Keyword(s):  
Air Flow ◽  
The Body ◽  
Type I ◽  
Type Ii ◽  
Breathing Frequency ◽  
Breathing Patterns ◽  
Flow Measurements ◽  
Air Breathing ◽  
Gas Bladder ◽  
Amia Calva

The mechanisms and physiological control of air-breathing were investigated in an extant halecomorph fish, the bowfin (Amia calva). Air flow during aerial ventilation was recorded by pneumotachography in undisturbed Amia calva at 20–24°C while aquatic and aerial gas concentrations were independently varied. Separation of aquatic and aerial gases was used in an attempt to determine whether Amia calva monitor and respond to changes in the external medium per se or to changes in dissolved gases within the body. Air flow measurements revealed two different types of ventilatory patterns: type I air-breaths were characterized by exhalation followed by inhalation; type II air-breaths, which have not been described previously in Amia calva, consisted of single inhalations with no expiratory phase. Expired volume (Vexp) for type I breaths ranged from 11.6+/−1.1 to 26.7+/− 2.9 ml kg-1 (95 % confidence interval; N=6) under normoxic conditions and was unaffected by changes in aquatic or aerial gases. Gas bladder volume (VB), determined in vitro, was 80 ml kg-1; the percentage of gas exchanged for type I breaths ranged from 14 to 33 % of VB in normoxia. Fish exposed to aquatic and aerial normoxia (PO2=19-21 kPa), or aerial hypercapnia (PCO2=4.9 kPa) in normoxic water, used both breath types with equal frequency. Aquatic or aerial hypoxia (PO2=6-7 kPa) significantly increased air-breathing frequency in four of eight fish and the ventilatory pattern changed to predominantly type I air-breaths (75–92 % of total breaths). When fish were exposed to 100 % O2 in the aerial phase while aquatic normoxia or hypoxia was maintained, air-breathing frequency either increased or did not change. Compared with normoxic controls, however, type II breaths were used almost exclusively (more than 98 % of total breaths). Type I breaths appear to be under feedback control from O2-sensitive chemoreceptors since they were stimulated by aquatic or aerial hypoxia and were nearly abolished by aerial hyperoxia. These results also indicate that Amia calva respond to changes in intravascular PO2; however, externally facing chemoreceptors that stimulate air-breathing in aquatic hypoxia cannot be discounted. Type II air- breaths, which occurred in aerial hyperoxia, despite aquatic hypoxia, appear to be stimulated by reductions of VB, suggesting that type II breaths are controlled by volume-sensitive gas bladder stretch receptors. Type II breaths are likely to have a buoyancy-regulating function.

Electroreception in Gymnotus carapo: pre-receptor processing and the distribution of electroreceptor types

2000 ◽  
Vol 203 (21) ◽  
pp. 3279-3287 ◽  
Author(s):  
M.E. Castello ◽  
P.A. Aguilera ◽  
O. Trujillo-Cenoz ◽  
A.A. Caputi
Keyword(s):  
Electric Fields ◽  
Electric Fish ◽  
Fish Tissue ◽  
Field Vector ◽  
The Body ◽  
Type I ◽  
Type Ii ◽  
Field Patterns ◽  
Different Types ◽  
Very High

This paper describes the peripheral mechanisms involved in signal processing of self- and conspecific-generated electric fields by the electric fish Gymnotus carapo. The distribution of the different types of tuberous electroreceptor and the occurrence of particular electric field patterns close to the body of the fish were studied. The density of tuberous electroreceptors was found to be maximal on the jaw (foveal region) and very high on the dorsal region of the snout (parafoveal region), decaying caudally. Tuberous type II electroreceptors were much more abundant than type I electroreceptors. Type I electroreceptors occurred exclusively on the head and rostral trunk regions, while type II electroreceptors were found along as much as 90 % of the fish. Electrophysiological data indicated that conspecific- and self-generated electric currents are ‘funnelled’ by the high conductivity and geometry of the body of the fish. These currents are concentrated at the peri-oral zone, where most electroreceptors are located. Moreover, within this region, field vector directions were collimated, constituting the most efficient stimulus for electroreceptors. It can be concluded that the passive properties of the fish tissue represent a pre-receptor device that enhances exafferent and reafferent electrical signals at the fovea-parafoveal region.

Sign in / Sign up

Export Citation Format

Share Document