Chronic gastroduodenal ulcers in patients with diabetes mellitus

2003 ◽  
Vol 49 (1) ◽  
pp. 5-10
Author(s):  
Yu. L. Fedorchenko

The clinical picture, course, and treatment of gastroduodenal ul­cers (GDU) in diabetics were studied. A total of 395 diabetics were examined; GDU were detected in 36. The incidence of gas­tric and duodenal ulcers was similar in patients with insulin-de­pendent diabetes mellitus, while in patients with non-insulin-de- pendent diabetes gastric ulcers predominated. The clinical pic­ture of the disease, gastric acid production, Helicobacter pylori infection, and blood gastrin levels were studied in all patients with ulcers. The efficiency of GDU treatment with quamatel, raniti­dine, and antacids was evaluated. The clinical course of GDU in diabetics was asymptomatic. The highest incidence of H. pylori, infection was observed in patients with type 1 diabetes with con­comitant peptic ulcers. Serum gastrin levels were more frequently increased in patients with type 1 diabetes and duodenal ulcers and normal in patients with type 2 diabetes. Quamatel therapy was highly effective in diabetics with GDU. Ulcers healed in 85% patients and blood gastrin level significantly decreased after 3- week therapy. GDU in diabetics are characterized by specific lo­cation, clinical course, laboratory and instrumental features, which allows a differentiated approach to therapy of these pa­tients.

2003 ◽  
Vol 49 (1) ◽  
pp. 5-10
Author(s):  
Yu. L. Fedorchenko

The clinical picture, course, and treatment of gastroduodenal ul­cers (GDU) in diabetics were studied. A total of 395 diabetics were examined; GDU were detected in 36. The incidence of gas­tric and duodenal ulcers was similar in patients with insulin-de­pendent diabetes mellitus, while in patients with non-insulin-de- pendent diabetes gastric ulcers predominated. The clinical pic­ture of the disease, gastric acid production, Helicobacter pylori infection, and blood gastrin levels were studied in all patients with ulcers. The efficiency of GDU treatment with quamatel, raniti­dine, and antacids was evaluated. The clinical course of GDU in diabetics was asymptomatic. The highest incidence of H. pylori, infection was observed in patients with type 1 diabetes with con­comitant peptic ulcers. Serum gastrin levels were more frequently increased in patients with type 1 diabetes and duodenal ulcers and normal in patients with type 2 diabetes. Quamatel therapy was highly effective in diabetics with GDU. Ulcers healed in 85% patients and blood gastrin level significantly decreased after 3- week therapy. GDU in diabetics are characterized by specific lo­cation, clinical course, laboratory and instrumental features, which allows a differentiated approach to therapy of these pa­tients.


Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


2009 ◽  
Vol 23 (9) ◽  
pp. 604-608 ◽  
Author(s):  
Marcel JM Groenen ◽  
Ernst J Kuipers ◽  
Bettina E Hansen ◽  
Rob J Th Ouwendijk

BACKGROUND/OBJECTIVES: As recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. The discovery of Helicobacter pylori had a further major impact on the incidence of ulcer disease. Our aim was to evaluate the trends in the incidence and bleeding complications of ulcer disease in the Netherlands.METHODS: From a computerized endoscopy database of a district hospital, the data of all patients who underwent upper gastrointestinal endoscopy from 1996 to 2005 were analyzed. The incidence of duodenal and gastric ulcers, with and without complications, were compared over time.RESULTS: Overall, 20,006 upper gastrointestinal endoscopies were performed. Duodenal ulcers were diagnosed in 696 (3.5%) cases, with signs of bleeding in 158 (22.7%). Forty-five (6.5%) of these ulcers were classified as Forrest I and 113 (16.2%) as Forrest II. Gastric ulcers were diagnosed in 487 cases (2.4%), with signs of bleeding in 60 (12.3%). A Forrest 1 designation was diagnosed in 19 patients (3.9%) and Forrest 2 in 41 patients (8.4%). The incidence of gastric ulcers was stable over time, while the incidence of duodenal ulcers declined.CONCLUSIONS: The incidence of duodenal ulcer disease in the Dutch population is steadily decreasing over time. Test and treatment regimens for H pylori have possibly contributed to this decline. With a further decline in the prevalence of H pylori, the incidence of gastric ulcers is likely to exceed the incidence of duodenal ulcers in the very near future, revisiting a similar situation that was present at the beginning of the previous century.


2009 ◽  
Vol 12 (3) ◽  
pp. 91-93
Author(s):  
Aleksey Vasil'evich Kiyaev ◽  
Maria Sergeevna Karacheva ◽  
Konstantin Alexandrovich Aleksandrov ◽  
Irina Orestovna Zaykova ◽  
Larisa Gennadievna Fechina ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Kexin Wang ◽  
Fangna Li ◽  
Yixin Cui ◽  
Chunhui Cui ◽  
Zhenzhen Cao ◽  
...  

The depression incidence is much higher in patients with diabetes mellitus (DM), and the majority of these cases remain under-diagnosed. Type 1 diabetes mellitus (T1D) is now widely thought to be an organ-specific autoimmune disease. As a chronic autoimmune condition, T1D is characterized by T cell-mediated selective loss of insulin-producing β-cells. The age of onset of T1D is earlier than T2D, and T1D patients have an increased vulnerability to depression due to its diagnosis and treatment burden occurring in a period when the individuals are young. The literature has suggested that inflammatory cytokines play a wide role in both diseases. In this review, the mechanisms behind the initiation and propagation of the autoimmune response in T1D and depression are analyzed, and the contribution of cytokines to both conditions is discussed. This review outlines the immunological mechanism of T1D and depression, with a particular emphasis on the role of tumor necrosis factor-α (TNF-α), IL-1β, and interferon-γ (IFN-γ) cytokines and their signaling pathways. The purpose of this review is to highlight the possible pathways of the cytokines shared by these two diseases via deciphering their cytokine cascades. They may provide a basic groundwork for future study of the possible mechanism that links these two diseases and to develop new compounds that target the same pathway but can conquer two diseases.


PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 410-414
Author(s):  
Brendan Drumm ◽  
J. Marc Rhoads ◽  
David A. Stringer ◽  
Phillip M. Sherman ◽  
Lynda E. Ellis ◽  
...  

The records of all children with peptic ulcer disease at the Hospital for Sick Children were retrospectively evaluated, excluding neonates, throughout a 5-year period. Only cases with a definite ulcer crater identified either at endoscopy or at surgery were included. There were 36 patients, 20 boys and 16 girls. Duodenal ulcers were more common than gastric ulcers (2.8:1). Ages ranged from 3 months to 17 years, with a mean age of 10 years. Patients were reviewed with respect to etiology of peptic ulcer disease, age when first examined, initial symptoms, and clinical course. Patients were divided into two groups, those with primary (n = 19) and those with secondary (n = 17) peptic ulcer disease. All peptic ulcers in patients younger than 10 years of age were secondary in nature. Secondary ulcers occurred generally in association with a severe underlying illness (11/17), and many ulcers necessitated emergency surgery because of perforation and/or severe hemorrhage (8/17). None of these patients had chronic or recurrent symptoms. In contrast, in children with primary peptic ulcer disease, initial symptoms were more benign. Most patients had abdominal pain and only one required emergency surgery. Children with primary duodenal ulcer disease had a high incidence of recurrent symptoms (67%), however, with surgery for intractable disease necessitated in 40%. Single-contrast barium meals were found to be unreliable in establishing a diagnosis of peptic ulcer disease, particularly cases of gastric ulcer disease.


Author(s):  
Abbas E. Kitabchi ◽  
Ebenezer Nyenwe

Diabetic ketoacidosis (DKA) and hyperosmolar nonketotic state (HONK; also referred to, in the USA, as hyperglycaemic hyperosmolar state) are the two most serious, potentially fatal acute metabolic complications of diabetes mellitus. In the USA, the annual incidence rate for DKA ranges from 4.6 to 8 episodes per 1000 patients with diabetes of all ages, and 13.4 per 1000 patients in subjects younger than 30 years old (1). The incidence rate in the USA is comparable to the rates in Europe, with estimates of 13.6 per 1000 patients with type 1 diabetes in the UK (2), and 14.9 per 1000 patients with type 1 diabetes in Sweden (3). In the USA, hospitalization for DKA has risen by more than 30% in the last decade, with DKA accounting for approximately 1 35 000 hospital admissions in 2006 (4). The incidence of HONK is difficult to determine because of the lack of population–based studies and the multiple combined illnesses often found in these patients. In general, it is estimated that the rate of hospital admissions due to HONK is lower than it is for DKA and HONK accounts for less than 1% of all primary diabetic admissions (5). The mortality rate in patients with DKA has significantly decreased in experienced centres since the advent of low-dose insulin and appropriate fluid-/electrolyte-replacement protocols. Among adults with DKA in the USA, the overall mortality rate is less than 1% (4). A trend toward remarkable reduction in mortality from DKA has been reported in Europe as well, with one UK university recording no deaths among 46 patients who were admitted for DKA between 1997 and 1999 (2). The incidence and mortality of DKA remains high in developing countries, owing to socioeconomic factors. For instance, in Nairobi, Kenya, the incidence of DKA was about 80 per 1000 hospitalized diabetic patients in a study reported in 2005, and mortality rate was as high as 30% (6). The mortality rate of patients with HONK remains high even in the developed world, at approximately 11%. The prognosis of both conditions is substantially worsened with increased age, presence of coma, and hypotension (7). Despite threat to life, DKA is also expensive, with estimated annual direct and indirect cost of 2 billion US dollars (8).


2002 ◽  
Vol 92 (3) ◽  
pp. 136-142 ◽  
Author(s):  
Paul Tinley ◽  
Michael Taranto

Thirty subjects with type 1 diabetes, 30 subjects with type 2 diabetes, and 30 age- and sex-matched controls were evaluated through clinical goniometry and two-dimensional motion analysis systems to determine the dynamic and static range of motion of the knee, ankle, and hallux joints. The purpose of this study was to determine if the knee and ankle joints of patients with diabetes mellitus are affected by limited joint mobility syndrome. The study results support previous medical literature showing significant reduction of range of motion of the hallux in subjects with type 1 diabetes. Significant differences were found between the range of motion of male and female subjects in all lower-limb joints for both subject groups with diabetes compared to the control group, and male subjects in all groups recorded less range of motion than female subjects. (J Am Podiatr Med Assoc 92(3): 136-142, 2002)


2019 ◽  
Vol 23 (4) ◽  
pp. 652-658
Author(s):  
A.P. Dnistryanska ◽  
O.S. Musienko ◽  
L.V. Yaremchuk

Annotation. In the structure of causes of maternal mortality, extragenital pathology accounts for 25%. Among them, endocrine pathology is 6%, diabetes accounts for 31.9%. 1% of women of childbearing age suffer from type 1 diabetes, and 2–17% has gestational diabetes (GD). The aim is to compare the condition of the fetoplacental complex in the third trimester of pregnancy in 9 pregnant women with type 1 diabetes (group 1) and in 12 women with GD (group 2) who were observed at “Vinnitsa City Clinical Hospital and child” for 2016–2019. The control group included 10 patients with physiological pregnancy. Women with diabetes had a history of gynecological diseases: colpitis (8 patients (88.8%)), cervical erosion (2 (22.2%)), chronic adnexitis (5 (55.5%)). Among the complications of previous pregnancies in the group of patients with diabetes mellitus (5 births) were unauthorized miscarriages (1 (11.1%)), the risk of termination of pregnancy (5 (55%)). In women with a history of GD, colpitis was observed in 3 (24.9%), which is significantly less than in women with type 1 diabetes. There were 2 pregnant women with GD: preterm births (16.6%). Among the complications of pregnancy in 1 patient was the threat of abortion in previous cases. Changes in the indexes of hemodynamics of the uterine-placental complex were evaluated on the basis of cardiotocography, ultrasound on ultrasound machine “Logic-5” with 2D measurement, Doppler, evaluation of the biophysical profile of the fetus (BPF). Statistical data processing was performed by calculating Student coefficients (+) using the Microsoft Excel program. It was established that in the 1st trimester of pregnancy, 5 (55.5%) women with type 1 diabetes were diagnosed with a threat of termination of pregnancy (TTP), and in the 1st (11.1%), they had a retroplacental hematoma. Two (22.2%) women with GD were diagnosed with TTF. In the 2nd trimester, 2 women with GD remained symptomatic of TTF. Six (66.7%) women with type 1 diabetes have symptoms of TTF. In the 1 pregnant woman developed pyelonephritis. Childbirth in 8 (88.8%) women with type 1 diabetes ended through natural birth canal, in 1 woman — a caesarean section. The weight of the child was 4435±2 g. In women with GD the weight of the child was 3756±12. In 7 (77.8%) patients, fetal weight exceeded 4000 g. BPF in the group of patients with diabetes was significantly different from the group with GD at 37–38 weeks of pregnancy. BPF in the 1st group — 7.6±0.2, in the 2nd group — 8.7±0.2, resistance index (RI): 1st group — 0.61±0.01, 2-ha group — 0.57±0.01, CO/K: in the 1st group — 3.2±0.1, in the 2nd group — 3.1±0.1. The correlation between the level of GD compensation and pathological changes in the fetoplacental complex has been established. The data obtained indicate that early screening of this pathology and appropriate compensation for carbohydrate metabolism in the presence of diabetes mellitus should be noted as one of the methods for the prevention of the development of complications in GD.


2019 ◽  
Vol 14 (4) ◽  
pp. 206-209
Author(s):  
Margarita S. Mikhina ◽  
Ekaterina A. Troshina ◽  
Tatiana V. Nikonova

Diabetes mellitus and primary hypothyroidism, in the outcome of chronic autoimmune thyroiditis, the two most common diseases in endocrinology and the practicing doctor are important not to forget about the possible association of these pathologies. This applies to patients with diabetes mellitus, both 1 and 2 types. However, the combination of these two pathologies is more common in type 1 diabetes, which is due to the autoimmune nature of these diseases. A clinical case of a patient with type 1 diabetes mellitus, which is on pump insulin therapy, is presented, which, in the background of previously selected therapy, during the last 2 months, episodes of hypoglycemia increased. In the course of the survey, primary subclinical hypothyroidism was identified, in the outcome of chronic autoimmune thyroiditis. Against the background of the achievement of euthyroidism, it was possible to achieve compensation of carbohydrate metabolism without correction of previously selected insulin therapy. The high incidence of thyroid dysfunction in patients with diabetes mellitus, and as a consequence, the deterioration in the compensation of carbohydrate metabolism, requires a systematic screening of thyroid disorders in the presence of diabetes mellitus.


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