scholarly journals Teleconsultation for Pediatric Patients With Type 1 Diabetes Mellitus During the COVID-19 Pandemic: Experience of a University Hospital in Brazil.

Author(s):  
YASMIN EUGENIA SANTANA ◽  
Thais Milioni Luciano ◽  
Ana Carolina Maia Teodózio ◽  
Amanda Maria Barradas Monteiro de Santana ◽  
Letícia Rodrigues Ramos ◽  
...  

Abstract Background: The SARS-CoV-2 pandemic expanded rapidly around the world in 2020 and health services needed to be reconfigured to meet the new demand and ensure the care of patients with chronic diseases, whether or not aggravated by this COVID-19 (disease caused by SARS-Cov-2). For patients with chronic diseases - such as diabetes mellitus - the teleconsultation stood out as a tool for clinical management in this period. This study aims to evaluate the impact of teleconsultation on glycemic control and prevention of acute complications related to diabetes mellitus in children and adolescents treated by the pediatric endocrinology team at Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo (HC-FMRP -USP) during the COVID-19 pandemic in 2020. Method: Descriptive study of data from pediatric diabetic patients who received teleconsultation via messages in the months of April to September 2020. Results: Regarding the patients evaluated (N = 143), there were 3.4 teleconsultations per patient in the studied period; requiring adjustment of insulin doses in 84.6% of cases. The hospital admission rate was 17.5% due to diabetic decompensation and / or the opening of diabetes mellitus. The dosage of glycosylated hemoglobin showed a worsening in 46% of the sample and an improvement in 37%. Conclusion: The teleconsultation was effective in ensuring health care for patients with DM1 during the COVID-19 pandemic.

2021 ◽  
Author(s):  
Yasmin Eugênia Santana ◽  
Thais Milioni Luciano ◽  
Ana Carolina Maia Teodózio ◽  
Amanda Maria Barradas Monteiro Santana ◽  
Letícia Rodrigues Ramos ◽  
...  

Abstract Introduction: The SARS-CoV-2 pandemic expanded rapidly around the world in 2020 and health services needed to be reconfigured to meet the new demand and ensure the care of patients with chronic diseases. For patients with diabetes mellitus, the teleconsultation stood out as a tool for clinical management in this period. Objective: Evaluate the impact of teleconsultation on glycemic control and prevention of acute complications related to diabetes mellitus in children and adolescents treated in a reference hospital during the COVID-19 pandemic in 2020. Method: Descriptive study of data from pediatric diabetic patients who received teleconsultation between April and September 2020. Results: During this period, 143 diabetic patients were evaluated, with a median of 3.4 teleconsultations per patient in the studied period; requiring adjustment of insulin doses in 84.6% of cases. The hospital admission rate was 8,4% due to diabetic decompensation. The metabolic control (HbA1c) became worsen in 46% of the sample and improved in 37%. Conclusion: The teleconsultation promoted health care for patients with diabetes mellitus during the COVID-19 pandemic, but was not able to guarantee adequate glycemic control.


2020 ◽  
Vol 38 ◽  
Author(s):  
Leonardo Calil Vicente Franco de Souza ◽  
Gabriela de Carvalho Kraemer ◽  
Adriana Koliski ◽  
José Eduardo Carreiro ◽  
Mônica Nunes Lima Cat ◽  
...  

ABSTRACT Objective: To analyze the variables associated with the presence of diabetic ketoacidosis in type 1 diabetes mellitus (T1DM) diagnosis and its impact on the progression of the disease. Methods: We reviewed the records of 274 children and adolescents under 15 years, followed in a Pediatric Endocrinology clinic of a university hospital in Curitiba-PR. They had their first appointment between January 2005 and April 2015. Results: Most patients received their T1DM diagnosis during a diabetic ketoacidosis episode. The associated factors were: lower age and greater number of visits to a physician’s office prior to diagnosis; diabetic ketoacidosis was less frequent in patients who had siblings with T1DM and those diagnosed at the first appointment. Nausea and vomiting, abdominal pain, tachydyspnea, and altered level of consciousness were more common in the diabetic ketoacidosis group. There was no association with socioeconomic status, duration of symptoms before diagnosis, and length of the honeymoon period. Conclusions: Prospective studies are necessary to better define the impact of these factors on diagnosis and disease control. Campaigns to raise awareness among health professionals and the general population are essential to promote early diagnosis and proper treatment of diabetes mellitus in children and adolescents.


2017 ◽  
Vol 14 (2) ◽  
pp. 22
Author(s):  
Meiby Lorena Rojas-Castañeda ◽  
Rosa Del Carmen Coral-Ibarra ◽  
Luz Dalila Vargas-Cruz

Objetivo: Analizar el perfil sociodemográfico, condiciones de salud y atención a personas con diabetes, a partir de la revisión de historias clínicas. Materiales y Métodos: estudio descriptivo transversal. La población fue de 821 historias clínicas de pacientes con diabetes mellitus. En total la muestra fue de 230 historias clínicas por método aleatorio simple. Se utilizó el instrumento Impacto en la Condición de Salud y Calidad de Vida de las Atenciones de Salud en Pacientes Diabéticos Tipo 2 de Macul, que evalúa el perfil sociodemográfico, las condiciones de salud y el tipo de atención otorgada. Resultados: 39 % de los pacientes presentó el valor de la última hemoglobina glicosilada mayor de 12 %, el 41,3 % no presentó ningún riesgo de pie diabético, 46,9 % tuvo diagnóstico de obesidad y el 23,9 % presentó sobrepeso. El porcentaje de cumplimiento de citas al mes por parte del médico y la enfermera fue del 100 %, a diferencia del control por parte de la nutricionista que debe realizase cada 6 meses, sólo se registró un cumplimiento del 71,7 %. No se encontró relación estadísticamente significativa entre asistencia al programa con adherencia al tratamiento, o con compensación de la enfermedad. Conclusiones: los pacientes con diabetes a pesar de estar en un programa de atención integral, no tienen un óptimo control glicémico, lo cual sugiere la revisión del cumplimiento del régimen terapéutico por parte de los profesionales de la salud para prevenir complicaciones que se puedan presentar a corto, mediano o largo plazo.PALABRAS CLAVE: atención a la salud, complicaciones crónicas, diabetes mellitus tipo 2, enfermedad crónica.SOCIO-DEMOGRAPHIC PROFILE, HEALTH CONDITIONS AND ATTENTION TO PEOPLE WITH DIABETES.ABSTRACT Objective: To analyze the socio-demographic profile, health conditions and attention to people with diabetes from a review of medical records. Materials and Methods: cross-sectional descriptive study. The population was of 821 medical records of patients with diabetes mellitus. In total the sample was of 230 medical records through a simple aleatory method. The Impact instrument was used in the Health Condition and Life Quality of the Health Care in Diabetic Patients Type 2 from Macul, that evaluates the socio-demographic profile, the health conditions and the type of attention given. Results: 39% of the patients presented the value of the last glycosylated hemoglobin greater than 12%, 41,3% did not present any risks of diabetic foot, 46,9% had an obesity diagnose and 23,9% presented overweight. The doctor and the nurse percentage of compliance of appointments per month was 100%, as opposed to the control by the nutritionist that must be performed every 6 months, only a of 71,1% of compliance was registered. A statistically significant relationship was not found between compliance to the program and treatment adherence, or with compensation for the disease. Conclusions: patients with diabetes despite of being in a program of comprehensive care, do not have an optimal glycemic control, which suggests a review of the compliance of the therapeutic regime by the health professionals to prevent complications that may occur in a short, medium, or long term.KEYWORDS: health care, chronic complications, diabetes mellitus type 2, chronic disease. PERFIL SÓCIO DEMOGRÁFICO, CONDIÇÕES DE SAÚDE E CUIDADOS PARA AS PESSOAS COM DIABETESRESUMO Objetivo: Analisar o perfil sócio demográfico, condições de saúde e cuidados para as pessoas com diabetes a partir da revisão de histórias clínicas. Materiais e Métodos: estudo descritivo transversal. A população foi de 821 historias clínicas de pacientes com diabetes mellitus. Em total a amostra foi de 230 historias clínicas por método aleatório simples. Utilizou-se o instrumento Impacto na Condição de Saúde e Qualidade de Vida das Assistências Médicas em Pacientes Diabéticos Tipo 2 de Macul, que avalia o perfil sócio demográfico, as condições de saúde e o tipo de atendimento recebido. Resultados: 39% dos pacientes apresentaram o valor da última hemoglobina glicada (Hb A1c) maior de 12%, o 41,3% não apresentou nenhum risco de pé diabético, 46,9% tiveram diagnóstico de obesidade e o 23,9% apresentaram excesso de peso. A porcentagem de cumprimento de consultas ao mês por parte do médico e a enfermeira foi do 100%, a diferença do controle por parte da nutricionista que deve realizar-se a cada 6 meses, apenas registrou-se um cumprimento do 71,7%. Não se encontrou relação estatisticamente significativa entre assistência ao programa com aderência ao tratamento, ou com compensação da doença. Conclusões: os pacientes com diabetes a pesar de estar num programa de atendimento integral, não tem um óptimo controle glicémico, o qual sugere a revisão do cumprimento do regime terapêutico por parte dos professionais da saúde para prevenir complicações que se possam apresentar a curto, médio ou longo prazo. Palavras-chave: assistência médica, complicações crónicas, diabetes mellitus tipo 2, doença crónica.


2019 ◽  
Vol 15 (6) ◽  
pp. 480-485 ◽  
Author(s):  
Mohamed R. Halawa ◽  
Mouchira Abd El-Salam ◽  
Bassem M. Mostafa ◽  
Salma S. Sallout

Background: Symbiotic interactions of microorganisms are widespread in nature, and support fundamentally important processes linking health and disease to the bacterial ecology. Intestinal microbiota is the largest source of microbial stimulation that exerts both harmful and beneficial effects on human health. It participates in the development of the postnatal immune system as well as oral tolerance and immunity. The recently explored impact of the microbiota on energy metabolism, gut hormone regulation and the gut-brain axis was judged to be a fascinating topic and of great value in the future, and can have a clinical role in the management of obesity and diabetes. Objective: To assess the impact of the gut microbe, Lactobacillus acidophilus, in patients with type 2 Diabetes Mellitus (controlled and uncontrolled) compared to healthy individuals, as a preliminary approach to future treatment with probiotics, prebiotics or diet modulation. Methods: A case control study was conducted on 30 diabetic patients and 10 control individuals. All patients were subjected to full history, thorough clinical examination, and laboratory measurement of fasting blood sugar, 2 hours post prandial, Glycosylated Hemoglobin (HbA1C), CRP (C-Reactive Protein), Lipid profile, and Identification of stool Lactobacillus acidophilus by PCR (polymerase chain reaction) technique. Results: Significantly lower Stool Lactobacillus acidophilus PCR count among diabetic patients when compared to healthy control individuals. Conclusion: Stool Lactobacillus acidophilus PCR count was lower among type 2 diabetic patients, which may show relationship of lactobacillus with type 2 diabetes mellitus. However, further studies are needed to determine correlation or causation of this relationship.


2021 ◽  
pp. 003022282110206
Author(s):  
Emine Kaplan Serin ◽  
Semra Bülbüloğlu

This study was conducted to examine the effect of attitude to death on self-management in patients with Type 2 Diabetes Mellitus during the COVID-19 pandemic. This study was carried out in a descriptive and correlational type with the participation of n = 103 type 2 diabetes mellitus patients registered in the Internal Medicine Unit at a University Hospital. Personal Information Form, Death Attitude Profile-Revised (DAP-R), Diabetes Self-Management Questionnaire and Fear of COVID-19 Scale were used in data collection. According to the results of the study, it was determined that diabetes patients' fear of COVID-19 increased their fear of death and self-management. Similarly, neuropathy and nephropathy developed in these patients. In addition, it was determined that the diabetic patients who worked 6–7 days a week outside the home had higher levels of fear. It was found that those with high fear were more attentive to social distancing, wearing masks and hand sanitizer use. Staying at home is also not always possible for patients with chronic diseases, and people struggle with COVID-19 by working in crowded workspaces. It is necessary to recognize the struggle of patients with chronic diseases and provide social, economic and psychological support.


2021 ◽  
Vol 15 (8) ◽  
pp. 2017-2019
Author(s):  
Rao Salman Aziz ◽  
Usman Saeed ◽  
Nasim Aslam Ghumman ◽  
Muhammad Arshad ◽  
Asif Sohail ◽  
...  

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).


Author(s):  
Shiva Najigivi ◽  
Seyedahmadreza Mirmotallebi ◽  
Alireza Najigivi

Nanoscience and Nanotechnology are highly growing their significance in diabetic supplies and research nowadays. It is an area that included nanomaterials, nanosensors and nanostructures as well as nanoparticle projects and also their usage in human health research. Particularly, nanotechnology helps to the production of diabetic supplies, materials together with the development of novel glucose and insulin injection devices as well as their measurement sensors by the aid of nanomaterials. These materials mostly could be metal nanoparticles together with carbon nanostructures by nano dimension delivery mechanisms modalities which hold the potential to vividly recover the excellence of life of diabetic patients. Nanoscience and nanotechnology in diabetic research have facilitated and provided more truthful data for identifying diabetes mellitus. It is also worth mentioning that the nanotechnology could highly enhance the impact of drug delivery by addition of nanoscale materials and increase the glucose feeling, temporal response as well as glucose nursing. Furthermore, it is proposing novel nanoscale methods named closed-loop insulin delivery approaches which mechanically release insulin drug in reply to fluctuating blood glucose heights. Besides, the mixture of nanotechnology by medication has shaped a novel field of nanomedicine which could enhance human health level. It is worthwhile to mention that some of the applications of nanotechnology for the treatment of diabetic patients can be the production of diabetic supplies by nanotechnology. One of the most important diabetic instruments that could highly relieve the life of patients these days could be nano diabetic shoes which will describe here. In this research, applications of nanoscience and nanotechnology in treating diabetic patients were discussed.


2020 ◽  
Author(s):  
Xiaomeng Sun ◽  
Jia Liu ◽  
Guang Wang

Abstract Background: This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Methods: Type 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n=28) and the control group (n=28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment. Results: After 180 days, the reduction of levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in two groups were no differences. In treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [-44.05(-179.47, -12.16) vs -8.15(-59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG ( r = 0.447, P = 0.042) and UA ( r = 0.478, P = 0.024) after fenofibrate treatment. Conclusion: In the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate


2013 ◽  
Vol 20 (02) ◽  
pp. 237-243
Author(s):  
GHULAM HUSSAIN BALOCH ◽  
ABDUL QADIR DALL ◽  
ATIF SITWAT HAYAT ◽  
Syed Zulfiquar Ali Shah ◽  
Bikha Ram Devrajani

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257131
Author(s):  
Abbas Al Mutair ◽  
Alya Al Mutairi ◽  
Saad Alhumaid ◽  
Syed Maaz Abdullah ◽  
Abdul Rehman Zia Zaidi ◽  
...  

Background Epidemiological features characterization of COVID-19 is highly important for developing and implementing effective control measures. In Saudi Arabia mortality rate varies between 0.6% to 1.26%. The purpose of the study was to investigate whether demographic characteristics (age and gender) and non-communicable diseases (Hypertension and Diabetes mellitus) have a significant association with mortality in COVID-19 patients. Methods Prior to data collection, an expedite approval was obtained from Institutional Review Board (IRB Log No: RC. RC20.09.10) in Al Habib Research Center at Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia. This is a retrospective design where we used descriptive and inferential analysis to analyse the data. Binary logistic regression was done to study the association between comorbidities and mortality of COVID-19. Results 43 (86%) of the male patients were non-survivors while 7 (14%) of the female patients were survivors. The odds of non-survivors among hypertensive patients are 3.56 times higher than those who are not having a history of Hypertension (HTN). The odds of non-survivors among diabetic patients are 5.17 times higher than those who are not having a history of Diabetes mellitus (DM). The odds of non-survivors are 2.77 times higher among those who have a history of HTN and DM as compared to those who did not have a history of HTN and DM. Conclusions Those patients that had a history of Hypertension and Diabetes had a higher probability of non-survival in contrast to those who did not have a history of Diabetes and hypertension. Further studies are required to study the association of comorbidities with COVID-19 and mortality.


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