Clinical Features of Urinary Infections in Pregnant Women with Type 1 Diabetes Mellitus

2020 ◽  
Vol 27 (3) ◽  
pp. 18-31
Author(s):  
I. V. Alekseenko ◽  
L. A. Ivanova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Urinary Tract ◽  
Type 1 Diabetes Mellitus ◽  
Pregnant Women ◽  
Comparison Group ◽  
Pregnancy Termination ◽  
Main Group ◽  
Tract Infections

Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.

scholarly journals Effect of a complex therapy including a nonspecific immune correction in pregnant women with type 1 diabetes mellitus on the health status of their children

2018 ◽  
pp. 178-181
Author(s):  
О.В. Папышева ◽  
Т.С. Будыкина ◽  
А.М. Проценко ◽  
И.А. Захарова ◽  
Е.Н. Кожевникова ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Pregnant Women ◽  
Main Group ◽  
Healthy Children ◽  
Complex Therapy ◽  
Immune Correction ◽  
Cns Pathology

Цель. Влияние комплексной терапии с включением неспецифической иммунокоррекции (ингаляции гепарина в гестационном периоде у женщин с сахарным диабетом 1-го типа (СД1) с установленной гиперпродукцией аутоантител к инсулину и его рецепторам), на здоровье рожденных ими детей. Материалы и методы. Проведен сравнительный анализ нервно-психического развития, соматического состояния и иммунологических особенностей у детей от рождения до 3 лет от матерей с СД1, получавших традиционную терапию (основная группа, n = 101) и детей от матерей с СД1, получавших во время беременности в составе комплексной терапии ингаляции гепарином (экспериментальная группа, n = 40). Контрольную группу (n = 30) составили дети от соматически здоровых матерей без инфекционной и эндокринной патологии. Результаты. При анализе частоты регистрируемой у детей в период новорожденности патологии ЦНС установлено увеличение данного показателя по сравнению с контролем обеих группах детей, рождённых от матерей с СД1. Однако по результатам балльной оценки (методика «ГНОМ») выявлено, что в экспериментальной группе было достоверно больше здоровых детей и, наоборот, меньше детей с патологией нервной системы, нуждающихся в лечении. При этом что уровень антител к инсулину у детей экспериментальной группы в возрасте 1 год оказался значимо ниже (р < 0,05), чем в основной группе. Заключение. Своевременное применение неспецифической иммунокоррекции в период беременности в составе комплексной терапии беременных женщин с СД1 позволяет нормализовать уровень органоспецифических аутоантител, улучшить клиническое состояние новорожденных детей и прогноз их последующего неврологического развития. Aim. To study the effect of a complex therapy including a nonspecific immune correction (heparin inhalation in the gestational period of women with type 1 diabetes mellitus (DM1) with documented overproduction of insulin and insulin receptor autoantibodies) on the health of their children. Methods. A comparative analysis of neuropsychic development, somatic status, and immunological features was performed in children from birth to three years born by mothers with DM1 who received a standard complex therapy (main group, n = 101) and children from mothers with DM1 who received heparin inhalation as a part of the complex therapy during pregnancy (study group, n = 40). The control group (n = 30) consisted of children from somatically healthy mothers without infectious and endocrine pathology. Results. Analysis of the incidence of CNS pathology observed in newborns during the neonatal period showed an increase in this index in both groups of children born from mothers with DM1 compared to the control. However, according to the results of scoring (GNOM method) the number of healthy children was significantly greater whereas the number of children with CNS pathology who needed treatment was significantly less. Moreover, the level of insulin antibodies was significantly lower (p <0.05) in children of the experimental group at the age of one year than in the main group. Conclusion. The timely use of nonspecific immune correction as a part of the complex therapy of pregnant women with DM1 allows to normalize the level of organ-specific autoantibodies, improve both the clinical condition of newborns and the prediction for their subsequent neurological development.

scholarly journals CLINICAL STUDY OF OPTIMIZED APPROACHES TO LOCAL PREVENTION OF DENTAL CARIES IN PATIENTS WITH TYPE 1 DIABETES MELLITUS

2019 ◽  
pp. 10-15
Author(s):  
O.A. Udod ◽  
A.S. Kulish
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Dental Caries ◽  
Type 1 Diabetes Mellitus ◽  
Preventive Measures ◽  
Comparison Group ◽  
Main Group ◽  
The State ◽  
Degree Of Risk

The prevalence of dental caries is high in people with type 1 diabetes mellitus and it is about 81.1-100%, however 57.1% are diagnosed with multiple dental caries. The effectiveness of caries prevention is only 48.3%. In the prevention of dental caries has significant role to exogenous methods of prevention with fluorides, but fluoride compounds adversely affect the condition of patients with diabetes mellitus. It’s advisable to use in patients with caries preventive measures containing nanohydroxyapatite and xylitol. The purpose is to conduct a research of optimized approach to local prevention of dental caries in patients with type 1 diabetes mellitus by the fluoride-free agents, taking into account the degree of risk of dental caries in patients and the state of diabetes compensation. Materials and methods. The review of  95 patients with type 1 diabetes mellitus in the state of compensation, subcompensation and decompensation was from 18 to 35 years and disease duration was from 1 to 24 years. The main group included 50 people, the comparison group was 45 people. The index of caries intensity DMF, structure functional indices of enamel acid resistance (TER) were determined in patients. Also the increase in the intensity of dental caries after 6 and 12 months, reducing the increase in caries after 12 months were defined.The patients of the main group, according to individualized approaches, taking into account the degree of risk of dental caries and the state of compensation of diabetes mellitus were subjected to local caries preventive measures, which included the use of fluoride-free products containing nanohydroxyapatite and xylitol, and means of enzymes lactoperoxidase system, patients of the comparison group - traditional local fluoroprophylaxis. Results and discussion. In patients of the main group after 6 months of caries-preventive measures of structure functional indices of enamel acid resistance was 3.52±0.19 points, 12 months – 3.14±0.16 points, the index improved to 1.7 times (p<0,05), compared to baseline (5.26±0,27 points). In the comparison group of patients, after 6 months, enamel acid resistance was 4.09±0.21 points, after 12 months - 3.86±0.18 points, which is only 1.3 times better (p<0.05) than the baseline index (5.02±0.25 points). Before the start of caries preventive measures, the caries intensity index DMF in patients of the main group was 13.7±0.84, after 6 months it increased to 13.8±0.86, the increase in the intensity of caries was 0.1. In the patients of the comparison group, the corresponding indexes of DMF were 12.3±0.85 and 12.6±0.91, increase the intensity of caries was 0.3 and was higher by 3 times. After 12 months, patients in the main group DMF index slightly increased to 14.0±0.87, increase the intensity of caries was 0.3. In the comparison group DMF index value was 13.1±0.93, increase the intensity was significantly higher (2.7 times) and it was 0.8. Reduction of increase the intensity of dental caries was 62.5%. Conclusion. Topical application in patients with type 1 diabetes mellitus of caries prophylactic agents containing nanohydroxyapatite and xylitol, as well as agents with enzymes of the lactoperoxidase system for 12 months on individualized approaches taking into account the degree of risk of dental caries and the state compensation of diabetes mellitus promoted caries resistance of enamel 1.7 times, reducing the intensity of caries by 2.7 times, allowed to reduction the dental caries growth by 62.5%.

scholarly journals Continuous subcutaneous insulin infusion reduces neonatal risk in pregnant women with type 1 diabetes mellitus

2019 ◽  
Vol 90 (3) ◽  
pp. 154-160
Author(s):  
Urszula Mantaj ◽  
Pawel Gutaj ◽  
Katarzyna Ozegowska ◽  
Agnieszka Zawiejska ◽  
Katarzyna Wroblewska-Seniuk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Pregnant Women ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Subcutaneous Insulin

scholarly journals Glycosylated Hemoglobin Levels and Lipid Profile in Type 1 Diabetes Mellitus and Precipitating Factorsin Diabetic Ketoacidosis

2020 ◽  
Vol 8 (1) ◽  
pp. 47-51
Author(s):  
Chilumula Monica ◽  
Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Tract Infection ◽  
Type 1 Diabetes ◽  
Urinary Tract ◽  
Type 1 Diabetes Mellitus ◽  
Lipid Profile ◽  
Diabetic Ketoacidosis ◽  
Glycosylated Hemoglobin ◽  
Precipitating Factors

Background: Type-1 Diabetes Mellitus is the most common endocrine-metabolic disorder of childhood and adolescence. The diseases has a prevalence of approximately 1 in 2500 children at age 5 years to approximately 1 in 300 children by age 18 years. A recent study from Madras suggests that diabetes in Indian children is present in a frequency of 10.5 per 1,00,000 patient years. Prevalence of childhood diabetes among urban population in India is 0.26 per 1000. Type-1 diabetes constituted nearly 90 to 100% of all children with diabetes. Objective: The objectives of this research were to study the levels of glycosylated hemoglobin and lipid profile in type 1 diabetes mellitus in children attending Gandhi Hospital Secunderabad, Telangana and to study the precipitating factors in Diabetic Ketoacidosis (DKA). Subjects and Methods:Design: This was a Cross-Sectional study. Duration: One year and six months i.e. from January 2017 to June 2018. Participants: 50 diabetic children of age less than 18 years attending Gandhi Hospital, Secunderabad, Telangana were included in the study.The diabetic cases were studied using a predesigned and pretested proforma. A detailed clinical examination was carried out with detailed anthropometric measurements and necessary lab investigations were done. Metabolic profile was assessed by investigating for blood sugar levels, glycosylated hemoglobin, and lipid profile. Rates, ratios and percentages of presentations and significance were calculated using Chi-square test.Result:48 % cases had onset of diabetes Mellitus at 13-18 years with Male: female ratio of 1.27: 1. 20 % had family history of diabetes. 16 % children had normal nutrition, 20 % children had grade I and grade II, 38% had grade III and 6 % children had grade IV. 54% children had glycosylated hemoglobin level of more than 10% indicating poor glycemic control, 32 % had fair control, and 14 % had good glycosylated hemoglobin levels. 62 % presented with fever , 40 % presented with symptoms of polyuria, polydipsia and polyphagia, 37.5 % presented with vomiting, 18 % children with loose stools, abdominal pain, 20 % children had breathlessness, 6% presented with seizures. 88.9% were diagnosed to have diabetic ketoacidosis as their initial presentation of diabetes mellitus Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia (22 %) and urinary tract infection(16 %), Non availability of insulin doses (25%), non-acceptance by child (16.66 %). Recurrent hospitalization in the patients with 5 years diabetic duration was statistically significant. Common causes being hypoglycemia (38 %) recurrent DKA (24 %), pneumonia (12 %) and urinary tract infections (8 %). 23.52% cases were non-compliant.Conclusion:More than half of the cases(54%) had poor glycemic control. Majority presented with classical symptoms of polyuria, polydipsia, polyphagia, fever, breathlessness and diabetic ketoacidosis as clinical presentation. Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia and urinary tract infection, non-availability of insulin doses and non- acceptance by child.

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