scholarly journals Correction of stress hyperglycemia in surgical patients with metabolic syndrome

2020 ◽  
pp. 26-30
Author(s):  
I.G. Kryvorchuk ◽  
◽  
I.M. Leshchishin ◽  
◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Intensive Care ◽  
Postoperative Period ◽  
Perioperative Period ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Control Group ◽  
Stress Hyperglycemia ◽  
Patients With Diabetes

Taking into account that stress and diabetic hyperglycemia is an independent risk factor for increased mortality in surgical patients with metabolic syndrome, an increase in the time spent by patients in intensive care units and the cost of treatment, it is important to carry out treatment, in particular, infusion therapy with the appointment of drugs that do not increase glucose levels and help to reduce the need for insulin in patients with diabetes mellitus in the postoperative period. Aim is to assess the effectiveness of the drug Xylat as an integral component of intensive care for patients with metabolic syndrome in perioperative period. Materials and methods. The study was conducted in 21 women with metabolic syndrome who underwent urgent surgical intervention for tumors in pelvic area. All patients received Xylat (Yuria-Pharm) – 5-6 ml/kg/day, 50-70 drops/min for 3 days in the postoperative period. The control group consisted of 15 women with metabolic syndrome, who underwent surgical treatment in the regional clinical hospital for ovarian tumors, but received alternative infusion therapy during the postoperative period (according to archived case histories). Results. The data of our study showed that the drug Xylatum (Yuria-Pharm) helps to reduce the risk of the severity of stress hyperglycemia, suppresses the risk of lactacidemia, provides energy support for postoperative patients with diabetes mellitus with an insulin+independent metabolism, and stimulates the production of endogenous insulin in critically ill patients. Conclusions. With the use of Xylate, the tolerance to carbohydrates increases. It has a very low glycemic index, antiketogenic properties, does not adversely affect the central nervous system, the exchange of hormones and neurotransmitters. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: surgical patients, diabetes mellitus, hyperglycemia, infusion therapy, metabolic syndrome, Xylatum.

scholarly journals Prevalence of Metabolic Syndrome in Patients with Diabetes Mellitus Type 2 Attending Tribhuwan University Teaching Hospital

2015 ◽  
Vol 1 (2) ◽  
pp. 23-26
Author(s):  
Lilee Shrestha ◽  
Saroj Sharma ◽  
Bharat Jha ◽  
Prem Khadga
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Control Group ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cross Sectional ◽  
Physical Conditions ◽  
Patients With Diabetes

BACKGROUND: Metabolic syndrome (Met S) is a cluster of biochemical and physical conditions that presage the development of atherosclerotic cardiovascular disease. Its association with diabetes mellitus has long been a topic of study. This study intends to find out the prevalence of Met S in Nepalese population using IDF criteria.METHODS: This cross-sectional study was carried out in department of medicine and department of biochemistry, Tribhuwan University teaching hospital, Maharajgunj, Kathmandu. 204 diabetic subjects, with age ranging between 31 to 80 years and similar number of healthy controls were recruited for study. Demographic, anthopometric and biochemical data were obtained as per preformed profoma. Statistical analysis was done using SPSS statistical software version 17.0.RESULTS: Prevalence of metabolic syndrome in diabetic population was found to be 67.3%, while it was only 7.84% in control group. Prevalence was found to be higher in females compared to males.CONCLUSIONS: Prevalence of metabolic syndrome is significantly higher in diabetic subjects, making them highly prone to the ill effects of cardiovascular diseases.

Evaluating Perioperative Glycemic Control of Non-cardiac Surgical Patients with Diabetes

2020 ◽  
Author(s):  
L Alan Todd ◽  
Robert A Vigersky
Keyword(s):  
Diabetes Mellitus ◽  
Cardiac Surgery ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Perioperative Period ◽  
Poor Glycemic Control ◽  
Surgical Patients ◽  
Patients With Diabetes

ABSTRACT Introduction Hyperglycemia during the perioperative period has generally been accepted as a contributor of poor outcomes in patients with diabetes mellitus undergoing surgery. Although an optimal glycemic range has not been clearly established in the literature, a consensus among national medical organizations generally recommends serum glucose levels to be maintained less than 180 mg/dL during the perioperative period. Materials and Methods The primary purpose of this evidence-based project was to identify the range of blood glucose values obtained from adult patients with diabetes mellitus undergoing non-cardiac surgery at a large military medical facility. The secondary purpose of this project was to assess the need for change in future practice. A retrospective review of the electronic medical record was conducted to identify adult surgical patients with diabetes scheduled for non-cardiac surgery. Preoperative and postoperative blood glucose values were obtained from the electronic medical record. The frequency of blood glucose values maintained within the recommended range of 140-180 mg/dL was recorded. Additional demographic data were collected to include age, height, weight, body mass index, length of surgery, and insulin/oral glycemic medications. Results Of the 9,449 surgeries performed between January 1, 2013, and December 31, 2013, there were 762 (8%) adult non-cardiac surgical patients identified with either a diagnosis of diabetes or a blood glucose value reported during the perioperative period. The recommended blood glucose range of 140-180 mg/dL was achieved in 31.3% (179 of 572) of patients before surgery and 28.6% (71 of 248) after surgery. A blood glucose value was not recorded before or after surgery in 24.9% (190 of 762) of patients identified as having pre-diabetes or diabetes. Conclusion Diabetes is a frequent finding in surgical patients. Monitoring blood glucose values during the perioperative period may allow for early treatment and prevent complications related to poor glycemic control. The results of this project revealed 2 potential areas of improvement in the care of non-cardiac surgical patients with diabetes: (1) improving compliance with obtaining blood glucose values before and after surgery and (2) reducing the incidence of postoperative hyperglycemia (>180 mg/dL) which potentially could prevent avoidable complications related to poor glycemic control.

scholarly journals Correction of electrolyte balance in surgical patients with urgent surgical interventions

2021 ◽  
Vol 25 (4) ◽  
pp. 620-622
Author(s):  
P. I. Bignyak
Keyword(s):  
Acute Appendicitis ◽  
Postoperative Period ◽  
Oral Rehydration Therapy ◽  
Electrolyte Imbalance ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Oral Rehydration ◽  
Postoperative Therapy

Annotation. Acute appendicitis is one of the most common acute pathologies of the abdominal cavity, which requires immediate surgical intervention and can lead to water-electrolyte imbalance. The aim of the study was to investigate the clinical significance of electrolyte imbalance in patients operated on for acute appendicitis and their correction. We examined 20 urgent surgical patients who were part of the control group and received “traditional” postoperative therapy and 23 patients of the study group who received oral rehydration therapy in the postoperative period to correct water-electrolyte disorders. To analyze the results of the study, profile analysis was used as a modification of multidimensional covariance analysis with repeated measurements. As can be seen from the results of testing the hypothesis of normalization of homeostasis due to the use of oral rehydration therapy schemes, the hypothesis was confirmed with a threshold significance of p=0.0642. The only significant effect of the rate of normalization of potassium concentration in blood plasma is the appointment of oral rehydration therapy with p=0.045. Also, the appointment of oral rehydration therapy is a significant effect of the rate of normalization of sodium and glucose in plasma (normalization of plasma glucose is significantly better in the dynamics of younger patients (p=0.045)). Thus, normalization of potassium and glucose, which correlates with the patient's age, was better in patients receiving oral rehydration mixture in the postoperative period than in patients receiving “traditional” postoperative therapy. Oral rehydration therapy is an acceptable alternative to infusion therapy in patients undergoing surgery for acute appendicitis in the postoperative period.

SUPPORTIVE EDUCATIVE SYSTEM DALAM MENINGKATKAN KEMANDIRIAN MERAWAT KAKI PADA PASIEN DIABETES MELLITUS TIPE II

2019 ◽  
Vol 9 (2) ◽  
pp. 63-72
Author(s):  
Nova Nurwinda Sari ◽  
Herlina Herlina
Keyword(s):  
Diabetes Mellitus ◽  
Health Center ◽  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Type Ii ◽  
Foot Care ◽  
Control Group Design ◽  
Patients With Diabetes

Diabetes mellitus dapat menyebabkan cukup banyak komplikasi seperti kelainan mata, kelainan ginjal, kelainan pembuluh darah dan kelainan pada kaki. Penderita diabetes mellitus yang mengalami komplikasi kronis perlu diberikan upaya preventif untuk mencegah komplikasi, salah satunya adalah kemampuan perawatan kaki. Penelitian ini dilakukan untuk menguji efektivitas supportive educative system dalam meningkatkan kemandirian perawatan kaki pada pasien dengan diabetes mellitus Tipe II di Puskesmas Permata Sukarame, Bandar Lampung. Penelitian ini menggunakan metode quasy eksperimen dengan desain pretest-posttest with control group dengan total masing-masing kelompok sebanyak 18 responden. Pengumpulan data dilakukan dengan menyebarkan kuesioner kepada responden yang memenuhi kriteria inklusi penelitian. Penelitian ini diuji menggunakan analisis univariat, bivariat dan uji T-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan rata-rata dalam kemandirian perawatan kaki pada kelompok intervensi dan kelompok kontrol dengan p-value 0,000. Pendidikan dan praktik perawatan kaki harus diberikan sejak dini sebagai upaya pencegahan untuk komplikasi.   Kata kunci : Supportive educative system, kemandirian perawatan kaki   SUPPORTIVE EDUCATIVE SYSTEM IN IMPROVING INDEPENDENCE OF FOOT CARE IN PATIENTS WITH DIABETES MELLITUS TYPE II   ABSTRACT Diabetes mellitus can cause quite a lot of complications such as eye disorders, kidney disorders, vascular disorders and abnormalities in the legs. Patients with diabetes mellitus who have chronic complications need to be given a preventive effort to prevent complications, one of which is foot care ability. This research was conducted to examine the effectiveness of supportive educative systems in increasing the independence of foot care in patients with Type II diabetes mellitus in the Permata Sukarame Health Center Bandar Lampung Working Area. This study used a quasi-experimental method with pretest-posttest with control group design with a total of 18 respondents each. Data collection is done by distributing questionnaires to respondents who meet the research inclusion criteria. This study was tested using univariate, bivariate, T-Test analysis. The results showed that the mean differences in the independence of foot care in the intervention group and the control group in the Permata Sukarame Community Health Center work area with a p-value of 0,000. Education and practice of foot care should be given early as a preventative effort for complications.   Keywords: Supportive educative system, independence of foot care

Diabetes-induced Alterations in HDL Subfractions Distribution

2020 ◽  
Vol 26 (27) ◽  
pp. 3341-3348 ◽  
Author(s):  
Marek Femlak ◽  
Anna Gluba-Brzozka ◽  
Beata Franczyk ◽  
Jacek Rysz
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Public Health Problem ◽  
Statin Treatment ◽  
Oxidative Modification ◽  
Control Group ◽  
Newly Diagnosed ◽  
Hdl Subfractions ◽  
Patients With Diabetes ◽  
Healthy Control

Introduction: Diabetes mellitus (DM) due to its increasing prevalence and associated morbidity and mortality has become a serious public health problem. In DM, HDL may lose its beneficial features and become proatherogenic due to its altered biological activity thus increasing cardiovascular risk. The aim of this study was to assess the influence of the presence of diabetes mellitus type 2 and its duration on the distribution of HDL subfractions. Moreover, the effect of statin treatment on HDL subfraction share was analysed in this study. Methods: The study group consisted of 50 patients with newly diagnosed DM and 50 persons with DM for longer than 10 years while the control group consisted of 50 healthy volunteers. HDL subfractions were analysed with the use of Lipoprint. Results: We demonstrated progressive worsening of heart functioning and impairment of its structure in the course of diabetes mellitus. Moreover, we observed that HDL-6 subfraction and intermediate HDL fraction are lowest in the group with advanced DMt2 compared to the group with newly diagnosed DM and a healthy control group. Finally, the results of our study indicated the effect of statin treatment on HDL subfractions that seems not to be advantageous. Conclusion: It seems that in patients with diabetes mellitus compromised antiatherogenic properties of HDL, as a result of oxidative modification and glycation of the HDL protein as well as the transformation of the HDL proteome into a proinflammatory protein, increase cardiovascular risk.

Evaluation of Salivary Antioxidants and Oxidative Stress Markers in Type 2 Diabetes Mellitus: A Retrospective Cohort Study

2020 ◽  
Vol 20 (4) ◽  
pp. 584-590 ◽  
Author(s):  
Shima Fathi ◽  
Shiva Borzouei ◽  
Mohammad Taghi Goodarzi ◽  
Jalal Poorolajal ◽  
Fatemeh Ahmadi-Motamayel
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Control Group ◽  
Oxidative Stress Markers ◽  
Stress Markers ◽  
Type 2 Dm ◽  
Patients With Diabetes ◽  
The Difference ◽  
And Oxidative Stress

Background: Diabetes Mellitus (DM) is a progressive metabolic disorder. Objective: The aim of this study was to investigate the relationship between antioxidant and oxidative stress markers in the saliva of patients with type 2 DM and a healthy control group. Methods: In this study, 20 patients with diabetes and 20 healthy individuals were evaluated. Salivary antioxidants markers consisted of total antioxidant capacity (TAC), uric acid (UA), peroxidase and catalase. Oxidative stress markers included total oxidant status (TOS), malondealdehyde (MDA) and total thiol (SH). Sialochemical analysis was performed with spectrophotometric assay. All the statistical analyses were conducted using STATA software. Results: TAC decreased significantly in patients with diabetes. Although salivary UA and peroxidase were lower in patients with diabetes compared to the control group, the difference was not significant. Salivary catalase in patients with diabetes was significantly lower than that in the control group. MDA and TOS exhibited significantly higher levels in type 2 DM. SH levels were slightly higher in DM. Conclusions: According to the results of the present study, there were some changes in the salivary levels of some antioxidants and oxidative stress markers in patients with type 2 DM and could be measured as an indicator of serum changes..

scholarly journals Depression among patients with diabetes mellitus in a Nigerian teaching hospital

2010 ◽  
Vol 16 (2) ◽  
pp. 4 ◽  
Author(s):  
Bawo Onesirosan James ◽  
Joyce Ohiole Omoaregba ◽  
George Eze ◽  
Olufemi Morakinyo
Keyword(s):  
Diabetes Mellitus ◽  
Control Group ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Treatment Goals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Patients With Diabetes ◽  
Diabetes Patients

<p><strong>Objectives.</strong> Depression is associated with diabetes mellitus and affects treatment goals negatively. We aimed to determine the prevalence of depression and identify its socio-demographic or clinical correlates among patients with diabetes mellitus attending an out-patient clinic in Nigeria.</p><p><strong>Methods.</strong> Two hundred consecutively recruited diabetes patients (index group) were compared with a similar number of apparently healthy controls in a cross-sectional survey. In both groups, in addition to obtaining socio-demographic details, depression was diagnosed using the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN), while the Beck Depression Inventory (BDI) was used to assess depression symptom severity. <strong></strong></p><p><strong>Results.</strong> Sixty (30%) diabetes patients met a SCAN diagnosis for clinical depression, compared with 19 (9.5%) in the control group. Having a smaller income and more children were significantly correlated with higher depression symptoms on the BDI.</p><p><strong>Conclusion.</strong> Depression is highly co-morbid with diabetes mellitus. The care of individuals with diabetes mellitus should include the screening and possible treatment for depression in order to achieve and sustain treatment goals.</p>

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