scholarly journals A SURVIVAL OF PATIENTS IN MAINTENCE HEMODIALYSIS DEPENDING ON EXPRESSED ANAEMIA AND CHARACTER OF DEFEAT OF KIDNEY

Author(s):  
V. Savchuk

The aim of the present research was to study the survival of hemodialysis (HD) patients depending on of anemia and character of kidney damage, «hemoglobin variability” Materials and methods: We have conducted a retrospective study of 183 hemodialysis patients who were treated from 2009. to 2012. The starting point of observation was defined the first hemodialysis session. The patients were divided in accordance of hemoglobin (Hb) levels for 4 groups: the level of Hb <70 g/l (n=32) – group I, Hb 70–89 g/l (n=68) - group II, Hb 90-110 g/l (n=65) – group III, Hb≥110g/l (n=28) - IV group. Results. The cumulative survival of patients was 55% at the moment of the end of the study. The cumulative proportion surviving of patients with diabetes mellitus was significantly lower compared to non-diabetic patients – 18% and 57%, respectively. The survival of patients I & II groups was significantly lower than the patients of  groups III & IV: 83.64% and 63.75% versus 31.7% and 29.28%, respectively (criteria Geha-Wilcoxon, Cox-Mantel test, Wilcoxon-Peto, F-criterion Cox log-rank test). The survival of patients with "stable hemoglobin" was significantly higher than in patients with "low of hemoglobin variability " and "high of hemoglobin variability"(р<0,005). Conclusions. Hb level and its variability had a significant effect on the survival of patients who are treated with hemodialysis. The survival of hemodialysis patients with diabetes mellitus was significantly lower than in non-diabetic kidney failure.

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.


2021 ◽  
pp. 8-11
Author(s):  
Tridip Kumar Das ◽  
Rintu Barman

Background: Diabetic Autonomic Neuropathy (DAN) is a serious and common complication of diabetes. Despite its relationship to an increased risk of cardiovascular mortality and its association with the multiple symptoms and impairments, the signicance of diabetic autonomic neuropathy has not been fully appreciated. DAN can manifests in a spectrum of things, ranging from resting tachycardia and xed heart rate (HR) to development of “silent” myocardial infarction.The prevalence of CAN is variable based on published studies and ranges from 2% to 91% in type I diabetes mellitus (T1DM) and 25% to 75% in type 2 diabetes (T2DM). This signicant variability can likely be attributed to the lack of a uniform 2 diagnostic criteria as well as underdiagnosis in the typical hospital setting. Aim And Objectives :To study the prevalence of cardiac autonomic neuropathy in hospital admitted diabetic patients. Materials And Methods : 60 diabetic patients were taken for the study of which 48 were males and 12 were females.The study was carried out in tertiary care teaching hospital in North east India after clearance from institutional ethics committee. Subjects were divided according to duration of diabetes as Group I : 0 – 5 years(24 patients), Group II : 6 – 9 years(24patients), Group II I: 10 years or more(12 patients). Then special interest was taken to nd out cardiac autonomic neuropathy and all the 5 tests were carried out in each of the patients to detect cardiac autonomic neuropathy and were divided into 3 groups. Group I ( normal autonomic function test), group II ( early DAN), group III ( denitive DAN ). Results : In the present study it has been observed that out of 24 (40%) cases of diabetes mellitus in the 0 – 5 year duration group, 4 cases (16.7%) are having autonomic neuropathy, out of 24 cases in the duration group 6 – 9 years, 10 cases (41.7%) are having autonomic neuropathy and in the duration group ≥ 10 years, 8 cases out of 12 (66.7%) showing neuropathy. In the present study prevalence of diabetic autonomic neuropathy out of 60 number of patients taken it was seen as: 38 cases (63.3%) with normal autonomic function tests placed in group I, 12 cases (20%) with only cardiac parasympathetic damage or early DAN were placed in group II and 10 cases (16.7%) with both cardiac parasympathetic and sympathetic damage or denitive DAN were placed in group III. So out of 60 diabetic patients, 22 patients (36.7%) showed abnormal cardiovascular reex in the present study. Conclusion: It has been observed from the present study that duration of diabetes mellitus is directly proportional to development of cardiac autonomic neuropathy.


2015 ◽  
Vol 1 (1) ◽  
pp. 33
Author(s):  
Susanti Susanti

Patients with Diabetes Mellitus is necessary therapeutic regimen for prevention or treatment, care to help patients to prevent complications. One is by providing information to physical activity to increase knowledge about the effects of Diabetes Mellitus patients and physical exercise. The purpose of this study was to determine the relationship of knowledge with diabetic patient compliance in physical exercise. The research method is a correlation with cross sectional approach, the research sample are 39 people with purposive sampling technique. The tools used assess knowledge and compliance of respondents using a questionnaire. Data collection is done coding, scoring, and tabulation and correlation test by Spearman Rank Test. The results showed that the results of the statistical test of Spearman rank correlation significance value (<0.05), it shows there is a relationship then H1 accepted which means that there is a relationship between knowledge and compliance of patients with Diabetes Mellitus in physical exercise. Results of this study can assist clients in improving the quality of life program Diabetes Mellitus patients through regular physical exercise. Suggested to the nurse to use the results of this study as a reference for improving services in diabetic patients leading to the needs of the patient in physical exercise. Penderita Diabetes Mellitus membutuhkan tindakan terapeutik untuk pencegahan atau penatalaksanaan, dan tindakan lain untuk mencegah komplikasi. Hal tersebut dapat dilakukan denga menambah informasi tentang aktifitas fisik untuk meningkatkan pengetahuan pasien Diabetes Mellitus. Tujuan penelitian ini untuk mengidentifikasi hubungan antara pengetahuan dengan kepatuhan penderita Diabetes Mellitus dalam melakukan latihan fisik. Metode penelitian menggunakan korelasi dengan pendekatan potong lintang. Sampel terdiri dari 39 responden dan menggunakan teknik purposive sampling. Pengukuran pengetahuan dan kepatuhan penderita Diabetes mellitus dalam melakukan latihan fisik menggunakan kuesioner. Data diolah menggunakan Spearman rank test. Hasil menunjukkan signifikan (<0,05). Hal ini menunjukkan terdapat hubungan antara pengetahuan dan kepatuhan penderita Diabetes Mellitus dalam melakukan latihan fisik. Hasil ini dapat menunjang penderita Diabetes Mellitus untuk meningkatkan kualitas hidup dan dapat digunakan sebagai sumber pustaka bagi perawat dalam meningkatkan pelayanan bagi penderita Diabetes Mellitus dalam melakukan latihan fisik. DOWNLOAD FULL TEXT PDF >>


2021 ◽  
Vol 10 (41) ◽  
pp. 3582-3586
Author(s):  
Jayachandra Jayachandra ◽  
Harsha Vishwanath Patel ◽  
Rajendra Prasad Honnaiah

BACKGROUND Foot problems are a leading cause of hospitalization for patients having diabetes mellitus all over the world. Foot ulcers in diabetes precede 85 % of nontraumatic lower-extremity amputations. Fifteen percent develop foot ulcers during their lifetime. Individuals who develop foot ulcers have a decreased health-related quality of life and consume a lot of healthcare resources. Foot abnormalities is a frequently missed diagnosis and a focus in this area of medical education has never been optimal despite its frequency of presentation. In this study, we wanted to determine clinical and radiographic foot abnormalities in diabetic patients. METHODS A cross-sectional study was carried out on 180 type 2 diabetic patients diagnosed as per ADA definition of diabetes, they were categorized into three groups, the first consisted of 60 diabetic patients without neuropathy or foot ulcers, the second had 60 diabetic patients with neuropathy and the third had 60 diabetic patients with both neuropathy and foot ulcer. Based on the clinical examination of the foot and foot X-ray oblique and lateral view of the affected feet along with other relevant investigations were obtained and analysed using descriptive and inferential statistical analysis. RESULTS We observed that poor glycaemic control and duration of diabetes were important risk factors for foot complications in diabetic patients which were statistically significant. Among patients with only diabetes, 3.3 % had HbA1c less than 6, 35 % had HbA1c between 6 - 9 and 61.7 % with HbA1c of more than 9. Among the patients with diabetes and neuropathy, 1.7 % of people had Hba1c of less than 6, 20 % with Hba1c between 6 - 9 and 78.3 % with Hba1c of more than 9. In patients who had diabetes and neuropathy with foot ulcers, 6.7 % had HbA1c of less than 6, among the same cohort 8.3 % had HbA1c between 6 - 9 and 85 % had HbA1c above 9. The prevalence of various radiological abnormalities of the foot was more common in diabetic patients with both neuropathy and foot ulceration (group lll) (83.3 %). The most common abnormality as observed from our study was Osteopenia with osteoporotic changes seen in 36.7 % of Group III patients VS 16.7 % of Group II (patients with diabetes and neuropathy ) and only in 10 % of Group I patients (patients with diabetes without any complications). Vascular calcifications were observed in 26.7 % VS 16.7 % VS 6.7 % in Group III, Group II, Group I respectively. Periosteal reactions were also more common in Group III patients (6.7 %). Subluxation of 2nd, 3rd, 4th, and 5th metatarsals was observed only in 3.3 % of Group III patients. CONCLUSIONS Diabetic foot is one of the most devastating complications of diabetes. Preventing the diabetic foot should be the first priority. This can be achieved by identifying the high-risk individuals with the above said risk factors by proper clinical examination and use of foot X-ray. KEY WORDS Diabetic Foot, Foot Problems, Foot Infections.


2020 ◽  
Vol 87 (3-4) ◽  
pp. 55-58
Author(s):  
Yu. M. Gupalo ◽  
D. Yu. Shapovalov ◽  
V. V. Shaprynskyi ◽  
O. F. Dzygal ◽  
A. V. Shamray-Sas ◽  
...  

Objective. To analyze the results of revascularization of the shin and foot arteries in patients with diabetes mellitus in accordance to the angiosome concept. Materials and methods. Results of roentgen-endovascular interventions on 71 lower extremities, performed in 48 patients, suffering diabetes mellitus and ischemia, menaced for the extremity loss, were analyzed. All the patients had purulent-necrotic affections of the foot Degree III-IV in accordance to classification of WIFI (Wound, Ishemia and Foot Infection). In accordance to anatomic zones of revascularization all roentgen-endovascular interventions were divided into three groups: Group I - 24 (33.8%) direct angiosomic revascularizations, Group II - 38 (53.5%) indirect angiosomic revascularizations, Group III - 9 (12.7%) nonangiosomic revascularizations. Results. There was established, that following the angiosome concept raises possibility of preservation of the lower extremity (92.9%) comparing with nonangiosomic revascularization (77.8%). Conclusion. Efficacy of revascularization of the shin arteries with occlusion-stenotic lesions is significantly higher while restoration of the blood flow in accordance to the angiosome concept.


Author(s):  
Bruce R. Pachter

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1588-P
Author(s):  
JINNIE J. RHEE ◽  
YUANCHAO ZHENG ◽  
MARIA MONTEZ-RATH ◽  
WOLFGANG WINKELMAYER

2021 ◽  
Vol 7 (4) ◽  
pp. 298
Author(s):  
Teny M. John ◽  
Ceena N. Jacob ◽  
Dimitrios P. Kontoyiannis

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 788
Author(s):  
Egidia Miftode ◽  
Larisa Miftode ◽  
Ioana Coman ◽  
Cristian Prepeliuc ◽  
Maria Obreja ◽  
...  

Early research into the implications concerning the evolution of the infection caused by the new coronavirus in people with glucose metabolism dysfunction, in this case diabetics, shows that severe forms of the disease predominate in this risk category. Moreover, it seems that even in patients with normal glycaemic status, COVID-19 may predispose to the development of hyperglycaemia which modulates immune mechanisms and inflammatory responses, with direct effects on morbidity and mortality. Thus, taking into account these scientific data, as well as the increased frequency of diabetes in the general population, we aimed to assess the risk of an unfavourable outcome of diabetic patients, which is in a strong connection with the presence and severity of pulmonary disease such as interstitial pneumonia/bronchopneumonia, as well as the effectiveness of Tocilizumab administration. The results of our study indicate a three-fold higher risk of death in patients with diabetes and COVID-19 (RR = 3.03; IC95%: 2.37–3.86; p = 0.001),compared to nondiabetic patients, and the risk of developing severe forms of acute respiratory failure was 1.5 times higher in the first studied category. In conclusion, we can say that the diabetic diagnosed with SARS-CoV-2 infection is more predisposed to immunological and organic dysfunctions that may ultimately result in death, and treatment with monoclonal anti-IL-6 antibodies was more effective in diabetic patients than non-diabetics (p < 0.05). The effectiveness of Tocilizumab was significant in both studied groups, but diabetic patients responded better to this therapy compared to non-diabetes-mellitus (DM) ones (76.7% vs. 35% p = 0.001).


Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 572
Author(s):  
Suguru Mizuno ◽  
Yousuke Nakai ◽  
Kazunaga Ishigaki ◽  
Kei Saito ◽  
Hiroki Oyama ◽  
...  

The incidence of pancreatic cancer (PCa) is increasing worldwide and has become one of the leading causes of cancer-related death. Screening for high risk populations is fundamental to overcome this intractable malignancy. Diabetes mellitus (DM) is classically known as a risk factor for PCa. Recently the reverse causality is in the spotlight, that is to say, DM is considered to be a manifestation of PCa. Numbers of epidemiological studies clarified that new-onset DM (≤2-year duration) was predominant in PCa patients and the relative risk for PCa inversely correlated with duration of DM. Among patients with new-onset DM, elder onset, weight loss, and rapid exacerbation of glycemic control were reported to be promising risk factors and signs, and the model was developed by combining these factors. Several pilot studies disclosed the possible utility of biomarkers to discriminate PCa-associated DM from type 2 DM. However, there is no reliable biomarkers to be used in the practice. We previously reported the application of a multivariate index for PCa based on the profile of plasma free amino acids (PFAAs) among diabetic patients. We are further investigating on the PFAA profile of PCa-associated DM, and it can be useful for developing the novel biomarker in the near future.


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