Type II Diabetes Mellitus

2020 ◽  
Author(s):  
Matthew C. Riddle ◽  
Saul Genuth
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Normal Saline ◽  
Isotonic Saline ◽  
Free Water ◽  
Tissue Perfusion ◽  
Type Ii Diabetes Mellitus ◽  
Fluid Replacement

Hyperosmotic hyperglycemic nonketotic (HHNK) state (also known as hyperosmolar hyperglycemic state) is a significant acute complication of type 2 diabetes mellitus, especially for those over 65 years of age. It is characterized by extreme hyperglycemia and hyperosmolarity with little ketosis. The main clinical effect of extreme hyperosmolarity is somnolence or confusion. The absence of severe ketonemia is attributed to residual insulin secretion that is sufficient to restrain lipolysis. HHNK state is marked by extreme dehydration, with both a marked deficit of free water and serious compromise of intravascular volume and tissue perfusion. Most patients with HHNK state have hypotension, extremely dry mucous membranes, and gross elevation of urea nitrogen and creatinine. Urinary tract infection, pneumonia, stroke, myocardial infarction, and sepsis may precipitate HHNK state. Elderly patients are particularly vulnerable because their thirst mechanisms are less sensitive to a rising serum osmolality. Fluid replacement is the most important component of therapy for HHNK state. Restoration of circulating volume is an urgent first priority and is accomplished by relatively rapid intravenous infusion of 2 L of 0.9% normal saline followed by 0.45% normal saline. Later, when plasma glucose levels have declined to 250 to 300 mg/dL, 5% dextrose in water is given. Insulin treatment is started soon after administration of isotonic saline. Potassium must be added to intravenous fluids to prevent hypokalemia caused by insulin action but should not be started until hypokalemia is proven, because potassium levels can be high initially. The mortality from the HHNK state is high, ranging from 10 to 20%, and is most often from the precipitating illness. This review contains 6 figures, 7 tables, and 73 references. Key words: dehydration, fluid deficit, hyperglycemia, hyperglycemic nonketotic state, hyperosmolar, hyperosmotic insulin, potassium, type 2 diabetes mellitus

Type II Diabetes Mellitus

2020 ◽  
Author(s):  
Matthew C. Riddle ◽  
Saul Genuth
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Normal Saline ◽  
Isotonic Saline ◽  
Free Water ◽  
Tissue Perfusion ◽  
Type Ii Diabetes Mellitus ◽  
Fluid Replacement

Hyperosmotic hyperglycemic nonketotic (HHNK) state (also known as hyperosmolar hyperglycemic state) is a significant acute complication of type 2 diabetes mellitus, especially for those over 65 years of age. It is characterized by extreme hyperglycemia and hyperosmolarity with little ketosis. The main clinical effect of extreme hyperosmolarity is somnolence or confusion. The absence of severe ketonemia is attributed to residual insulin secretion that is sufficient to restrain lipolysis. HHNK state is marked by extreme dehydration, with both a marked deficit of free water and serious compromise of intravascular volume and tissue perfusion. Most patients with HHNK state have hypotension, extremely dry mucous membranes, and gross elevation of urea nitrogen and creatinine. Urinary tract infection, pneumonia, stroke, myocardial infarction, and sepsis may precipitate HHNK state. Elderly patients are particularly vulnerable because their thirst mechanisms are less sensitive to a rising serum osmolality. Fluid replacement is the most important component of therapy for HHNK state. Restoration of circulating volume is an urgent first priority and is accomplished by relatively rapid intravenous infusion of 2 L of 0.9% normal saline followed by 0.45% normal saline. Later, when plasma glucose levels have declined to 250 to 300 mg/dL, 5% dextrose in water is given. Insulin treatment is started soon after administration of isotonic saline. Potassium must be added to intravenous fluids to prevent hypokalemia caused by insulin action but should not be started until hypokalemia is proven, because potassium levels can be high initially. The mortality from the HHNK state is high, ranging from 10 to 20%, and is most often from the precipitating illness. This review contains 6 figures, 7 tables, and 73 references. Key words: dehydration, fluid deficit, hyperglycemia, hyperglycemic nonketotic state, hyperosmolar, hyperosmotic insulin, potassium, type 2 diabetes mellitus

Type II Diabetes Mellitus

2020 ◽  
Author(s):  
Matthew C. Riddle ◽  
Saul Genuth
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Normal Saline ◽  
Isotonic Saline ◽  
Free Water ◽  
Tissue Perfusion ◽  
Type Ii Diabetes Mellitus ◽  
Fluid Replacement

Hyperosmotic hyperglycemic nonketotic (HHNK) state (also known as hyperosmolar hyperglycemic state) is a significant acute complication of type 2 diabetes mellitus, especially for those over 65 years of age. It is characterized by extreme hyperglycemia and hyperosmolarity with little ketosis. The main clinical effect of extreme hyperosmolarity is somnolence or confusion. The absence of severe ketonemia is attributed to residual insulin secretion that is sufficient to restrain lipolysis. HHNK state is marked by extreme dehydration, with both a marked deficit of free water and serious compromise of intravascular volume and tissue perfusion. Most patients with HHNK state have hypotension, extremely dry mucous membranes, and gross elevation of urea nitrogen and creatinine. Urinary tract infection, pneumonia, stroke, myocardial infarction, and sepsis may precipitate HHNK state. Elderly patients are particularly vulnerable because their thirst mechanisms are less sensitive to a rising serum osmolality. Fluid replacement is the most important component of therapy for HHNK state. Restoration of circulating volume is an urgent first priority and is accomplished by relatively rapid intravenous infusion of 2 L of 0.9% normal saline followed by 0.45% normal saline. Later, when plasma glucose levels have declined to 250 to 300 mg/dL, 5% dextrose in water is given. Insulin treatment is started soon after administration of isotonic saline. Potassium must be added to intravenous fluids to prevent hypokalemia caused by insulin action but should not be started until hypokalemia is proven, because potassium levels can be high initially. The mortality from the HHNK state is high, ranging from 10 to 20%, and is most often from the precipitating illness. This review contains 6 figures, 7 tables, and 73 references. Key words: dehydration, fluid deficit, hyperglycemia, hyperglycemic nonketotic state, hyperosmolar, hyperosmotic insulin, potassium, type 2 diabetes mellitus

scholarly journals The Effect of Leg Exercise on Changes in Blood Sugar Levels in the Elderly Patients with Type II Diabetes Mellitus at the Ciracas District Health Center

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Akbar Riyanto ◽  
Fajar Susanti ◽  
Erlin Ifadah ◽  
Sugeng Hadisaputra
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Center ◽  
Blood Sugar ◽  
The Elderly ◽  
Type Ii Diabetes Mellitus ◽  
District Health ◽  
Sugar Levels

AbstractIncreasing prevalence of type 2 Diabetes Mellitus in developed and developing countries is a health problem. Therefore, type 2 Diabetes Mellitus can be prevented by regular exercise, healthy and regular life. The purpose of this study was to determine the effectiveness of foot exercise on changes in blood sugar levels in elderly people with type 2 diabetes mellitus at the Ciracas District Health Center. This type of research is experimental with one group pre-post test design. The population in this study were 36 elderly people with type 2 Diabetes Mellitus in the Ciracas District Health Center. The sample in this study were 18 elderly with type 2 diabetes mellitus in Ciracas District Health Center. The sampling technique used was convenience sampling. Methods of data collection using an observation sheet before and after being given foot exercises. The statistical test used in this study is the paired T test. The results showed that there was no change in blood sugar levels before and after doing foot exercises, the statistical test results obtained a p value of 0.870, which means 0.870> 0.05, it can be concluded that there is no significant effect between foot exercise and changes in blood sugar levels in elderly patients. Type II diabetes mellitus at the Ciracas Subdistrict Health Center. The absence of any effect of foot exercises on changes in blood sugar levels in the elderly could be due to incomplete exercise, therefore foot exercise training to change blood sugar levels must be done in the elderly. Keywords : Foot exercise, Blood Sugar Levels, DM type 2

scholarly journals Influence of Glycated Haemoglobin Levels on Intraocular Pressure in patients with Type –II Diabetes Mellitus

2019 ◽  
Vol 11 (1) ◽  
pp. 19-23
Author(s):  
Ajai Agrawal ◽  
Shubham Ahuja ◽  
Anupam Singh ◽  
Ramanuj Samanta ◽  
Sanjeev Kumar Mittal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Intraocular Pressure ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Group I ◽  
Hba1c Levels

Introduction: Patients with diabetes mellitus are at a higher risk of developing primary open angle glaucoma (POAG) as compared to non-diabetic patients. Objectives: To determine whether there is a correlation between hyperglycemic levels and intraocular pressure (IOP) and to identify patients of Type II diabetes mellitus who are at a higher risk of developing glaucoma. Materials and Methods: This was a hospital based, cross sectional study performed on patients with type II diabetes mellitus, at a tertiary health care center in Uttarakhand, India between July, 2018 and September, 2018. 318 eyes of 159 patients with Type2 diabetes mellitus were included in the study. IOP was measured by Goldmannappla nation to no meter and central corneal thickness was measured with specula microscope in all patients, in addition to glycated hemoglobin levels (HbA1c) and fasting and post-prandial blood glucose levels. The data was analysed using SPSS 22 software. Results: Mean IOP was found to be 15.75 ± 3.18 mm Hg in patients with HbA1c levels between 6.5%-12% (Group I) and 17.42 ± 2.67 mm Hg in patients with HbA1c levels more than 12 % (Group II). The difference between the two groups was statistically significant (P =0.013). Out of 159 patients with Type 2 Diabetes mellitus, a total of 11 patients had IOP more than 21mm Hg in one or both the eyes. Conclusion: Hyperglycaemic levels as determined by raised HbA1c levels are associated with higher intraocular pressures in patients with type 2 diabetes mellitus.

scholarly journals Effectiveness of Physical Activity Interventions in Type 2 Diabetes Mellitus Patients: A Literature Review

2021 ◽  
Vol 4 (4) ◽  
pp. 477-484
Author(s):  
Suardi Suardi
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Physical Activity Intervention ◽  
Type Ii Diabetes Mellitus ◽  
Online Journal ◽  
Physical Activity Interventions ◽  
Hba1c Levels

Diabetes Mellitus (DM) is a chronic disease associated with insulin deficiency and the inability of the pancreas to produce enough insulin. WHO predicts that the number of people with type II diabetes mellitus in Indonesia will increase to 12 million in 2030. The study aimed to describe Physical Activity Interventions in type 2 diabetes mellitus patients. Using the online journal database that provides free articles and journals from 2010 -2020 in PDF form such as: Scinapse, Pubmed, ProQuest, MDPI and Google Scholar using the keywords "Physical Activity", “Effectiveness of Physical Activity". Physical activity intervention can improve the condition of patient with Diabetes mellitus if routinely done. Intake of physical activity intervention can control HbA1c levels and blood sugar, body weight and other glycemic control. Physical activity intervention is able to improve the condition of Diabetes Mellitus patients  

Association of Hypertension and Ischaemic ECG Changes in Type II Diabetes Mellitus

2019 ◽  
Vol 9 (3) ◽  
pp. 79-83
Author(s):  
Chandra Kala Rai ◽  
Nimesh Poudel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Diabetic Patients ◽  
Ecg Changes ◽  
Type 2 Diabetic Patients ◽  
Diastolic Hypertension

 Background: Type 2 diabetes mellitus (T2DM) is one of the most common metabolic disorders to the current generation. It usually leads to multi-system­ic complications such as cardiovascular diseases, proteinuria, micro albumin­uria, retinopathy, hypertension, ischaemic changes and chronic kidney disease. These complications increase the morbidity and mortality of patients. The pro­longed hyperglycemia leads to vascular damage. It causes insufficient blood flow to the cardiac muscles which may cause myocardial or cardiac ischaemia. The aim of this study was to find out the prevalence of hypertension and isch­aemic ECG changes in T2DM patients attending Kathmandu Medical College. Methods: Total 360 type 2 diabetic patients were included. Blood pressure was measured and electrocardiogram (ECG) was recorded by 12 leads ECG. Statistical analysis was done using SPSS version 16. p<0.05 was considered to be statistically significant. Results: The mean age of the patients was 66.88 ± 1.52 years, age ranging from 40 – 95 years. In this study 168 patients (46.66%) had systolic hyperten­sion, 204 patients (56.67%) had diastolic hypertension and 126 (35%) had both systolic and diastolic hypertension. About 103 (28.61%) showed ECG changes in hypertensive patients. Only 4 (1.11%) non- hypertensive had ECG changes. This study showed statistically significant relation of hypertension and isch­aemic ECG changes in type 2 diabetes mellitus cases with p- value 0.03. Conclusions: There is a high prevalence of hypertension among T2DM pa­tients. In these patients, there is a statistically significant association between hypertension and ischaemic ECG changes.

scholarly journals 340. Prevalence of Type II Diabetes Mellitus Among Patients Living with HIV in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S180-S181
Author(s):  
Morgan Birabaharan ◽  
Andrew Strunk ◽  
Amit Garg ◽  
Stefan Hagmann
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
The United States ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Living With Hiv

Abstract Background An aging HIV-infected population has growing recognition for its increasing prevalence of type 2 diabetes mellitus (T2DM). Most studies of T2DM prevalence among patients living with HIV involve selected samples and/or small cohorts which limit generalizability. We sought to evaluate the overall prevalence of T2DM among patients living with HIV in the United States as well as within specific demographic subgroups. Methods A cross-sectional analysis was performed using a large, multi-institutional database (Explorys), where clinical information across 27 healthcare networks are matched and standardized to create longitudinal records for each unique patient. At present, the database contains 63 million unique lives, representing 18% of the population across all 4 census regions of the United States. Patients with all types of insurance as well as those who are self-pay are represented. The analysis included adult patients with an active status in the database during April 2014- April 2019 who, not missing data on age, gender, race, and body mass index. The Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) of “Human Immunodeficiency Virus,” “diabetes mellitus type 2,” “disorder due to type 2 diabetes mellitus,” and “Type II diabetes mellitus uncontrolled” were used to identify patients with HIV and T2DM. Results We identified 90,900 patients with HIV. The overall prevalence of T2DM among patients with HIV was 22.1% (20,080/90,900) compared with 14.9% (2,679,490/17,946,580) in the general population. In subgroup analysis, the prevalence of T2DM was highest among patients with HIV who were female, older, other race, obese, hypertensive, hyperlipidemic, smokers, alcoholics, and those with a history of hepatitis C infection. Patients with no exposure to antiretroviral therapy (ART) had higher prevalence of T2DM than those with exposure (24.9% vs. 17.6%). Conclusion In this US population-based study, we found 1 in 5 people living with HIV had prevalent T2DM. In addition, we observed that HIV-associated T2DM may not depend on chronic ART exposure. Physicians caring for patients with HIV should be aware of the association and should monitor for signs and symptoms of T2DM. Disclosures All authors: No reported disclosures.

scholarly journals The Description of Sexual Dysfunction in Patients of Type II Diabetes Mellitus in Poly Disease In Mardi Hospital Waluyo City Blitar

2015 ◽  
Vol 2 (3) ◽  
pp. 216-221
Author(s):  
Sukma Puji Rahayu ◽  
Tri Cahyo Sepdianto ◽  
Arif Mulyadi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sexual Dysfunction ◽  
Type Ii Diabetes ◽  
Sampling Technique ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Chronic Complications

Chronic complications of diabetes mellitus was the most common autonomic neuropathyresulted in sexual dysfunction. The aim of research was to described the sexual dysfunction in patientswith type 2 diabetes mellitus at Poli Penyakit Dalam Mardi Waluyo Hospital Blitar. The researchmethod used descriptive design. The population in this study were patients with type 2 diabetes mellituswho visited in poli penyakit dalam in Mardi Waluyo Hospital Blitar in April as many as 856 people, anda sample of 86 people were taken using purposive sampling technique. Collecting data used the FSFIquestionnaire for womens and IIEF for mens. These results indicate that the majority of patients withtype 2 diabetes mellitus sexual dysfunction. In patients 75% of women experience sexual dysfunction. At74% of men with erectile dysfunction, 88% experienced orgasm dysfunction, 85% experienced sexualdesire dysfunction, 86% experienced a satisfying sexual dysfunction, 89% overall satisfaction dysfunction.The suggestion in this research was expected FSFI and IIEF questionnaire could be used as a toolto monitor the presence of sexual dysfunction in Blitar.

scholarly journals Echocardiographic evaluation of diastolic dysfunction in type 2 diabetes mellitus without cardiac manifestations in rural hospital

2020 ◽  
Vol 7 (11) ◽  
pp. 1658
Author(s):  
Sachinkumar K Khade ◽  
Sudeep Kumar ◽  
Digvijay S. Hodgar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Informed Consent ◽  
Diastolic Dysfunction ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Cardiac Manifestations

Background: Diabetes is the commonest metabolic disorder affecting the people all over the world. Objective of the study was to identify the diastolic dysfunction in type 2 diabetes mellitus patient to recognize the early involvement of heart.Methods: This cross sectional study was conducted in tertiary care hospital cases of type II diabetes mellitus coming to our hospital and giving informed consent. Period of study was from September 2016 to February 2018. Consecutive type of non-probability sampling was used for the selection of study subjects. A total of 54 diagnosed patients of type II diabetes mellitus coming to our hospital and giving informed consent were included in the study.Results: Prevalence of diastolic dysfunction was observed to be 44.4% in patients of type 2 diabetes mellitus without cardiac manifestations. Prevalence of diastolic dysfunction was seen in 47.4% males in comparison to 42.9% females. Prevalence of diastolic dysfunction was 11.1%, 77.3% and 80% in cases with disease duration of 0-5 years, 6-10 years and more than 10 years respectively. Prevalence of diastolic dysfunction was more in cases with poor glycaemic control i.e. hemoglobin A1c (HbA1c) value >8% as compared to cases with good glycemic control.Conclusions: There was an association between the prevalence of diastolic dysfunction with the increasing age. We had higher percentage of patients with diastolic dysfunction as duration of diabetes increased. Diastolic dysfunction was seen in 55.2% patients receiving oral hypoglycaemic agents (OHAs) as compared to 23.5% patients who were on insulin and 50% patients who were on both insulin and OHAs.

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