scholarly journals When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

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.

2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)


2000 ◽  
Vol 6 (2-3) ◽  
pp. 313-325
Author(s):  
M. El Shazly ◽  
M. Zeid ◽  
A. Osman

A multicentre case-control study was conducted to identify and quantify risk factors that may influence the development and progression of diabetic retinopathy. A total of 200 diabetic patients with nonproliferative retinopathy were compared with 400 diabetic patients without any eye complications with regard to the development of diabetic retinopathy. They were also compared with 200 diabetic patients with major eye complications to study the progression of diabetic eye complications. Results showed that the progression of diabetic eye complications was preventable since all the variables significantly affecting the process of progression, except type of diabetes, were avoidable


1995 ◽  
Vol 41 (6) ◽  
pp. 29-34
Author(s):  
A. K. Dreval

One of the main complications leading to high disability and mortality in patients with diabetes mellitus is atherosclerotic vascular disease (diabetic macroangiopathy). At the same time, the frequency of atherosclerosis among patients with diabetes mellitus is significantly affected by the so-called risk factors for atherosclerosis. In particular, the incidence of atherosclerosis among the general population and among diabetics increases with increased levels of cholesterol (cholesterol) in the blood, blood pressure, smoking and obesity. However, in patients with diabetes mellitus, mortality, for example, from coronary heart disease increases by 3 times against any of the known risk factors. But even without risk factors, the frequency of atherosclerotic vascular damage in patients with diabetes is much higher than in non-diabetic patients, i.e. diabetes in itself is a risk factor for atherosclerosis.


2019 ◽  
Author(s):  
Sean A. Josephs ◽  
Gretchen A. Lemmink

Diabetes mellitus is a major cause of morbidity and mortality.  Nearly 30 million Americans have diabetes, more than 25% of which are undiagnosed. Patients with diabetes have multiple problems that should be addressed prior to surgery. They often have uncontrolled glucose levels that should be treated preoperatively. Current studies suggest that outcomes may be improved if perioperative glycemic control is optimized. Patients with diabetes develop end-organ dysfunction that can complicate perioperative management. Preoperative assessment of cardiac, neurologic, vascular, and renal function is necessary for all patients with diabetes that undergo major surgery. Optimization of cardiac disease in particular can reduce major adverse cardiac events for patients with risk factors such as diabetes. Diabetic patients can occasionally present for major surgery with hyperglycemic emergencies such as diabetic ketoacidosis and hyperglycemic hyperosmolar state. These conditions require urgent treatment to prevent mortality regardless of the need for surgery. This article reviews the preoperative assessment and management of these issues. This review contains 1 figure, 4 tables, and 37 references. Key Words: diabetes mellitus (DM), end-organ damage, hyperglycemia, polyuria, polydipsia, polyphagia, perioperative glycemic management, diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), perioperative cardiac risk factors


2018 ◽  
Vol 16 (2) ◽  
pp. 110-117 ◽  
Author(s):  
Bijay Maharjan ◽  
Hom Nath Chalise ◽  
Mamta Thapa

Ageing population is attributable to the growing trend of diabetes mellitus. Diabetic patients are three times greater risk of developing tuberculosis. The review aims to describe the state of tuberculosis and diabetes mellitus comorbidity, risk factors for the comorbidity from the perspective of the ageing in Nepal. It is a systematic narrative review of literature in Google Scholar and Pubmed. At first, title and abstract of an article was reviewed for relevance, and then full article was reviewed for validity. The secondary data was retrieved from the Central Bureau of Statistics of Nepal and WHO, and analysed in the Ms-Excel. In Nepal, the population is ageing. The risk factors associated with diabetes are escalating. On the other hand, tuberculosis is endemic and about 45% of the Nepalese people are infected with tuberculosis bacteria. These circumstances have laid the foundation that fosters tuberculosis and diabetes co-epidemic in the future. The clinical management of patients with the comorbid condition is a difficult task because diabetes and tuberculosis interact with each other, one worsening the other. The upsurge of the co-morbidity needs the provision of more health services threatening the public health system of Nepal. It is fundamental to create a mechanism to integrate diabetes and tuberculosis program such as screening, diagnosis and management of the both diseases at the all levels of health service delivery. Furthermore, increase awareness of healthy lifestyle and the prevention of the risk factors for tuberculosis and diabetes could reduce the occurrence of the comorbidity in the future.


Author(s):  
مريم باراس ◽  
Eidha A. Bin Hameed

Background: Diabetes is on the rise worldwide and is already considered as an epidemic by some experts. So, there is a need to raise awareness on the important factors that can help prevent bacterial infection in wounds of patients with diabetes. Objective: To study the risk factors of developing diabetic foot ulcer (DFU) in patients with diabetes. The study is the first in Yemen to investigate the prevalence of bacterial infection in wounds of diabetic patients. Materials and Methods: This is a case-control study carried out from November 2018 to May 2019. Twenty diabetic patients with foot ulcer and twenty without foot ulcer were examined. Risk factors and clinical profile of patients were studied by using a standardized questionnaire that included gender, age groups, past history of diabetes, duration of the disease, type of diabetes, DFU, type of ulcer, smoking, glucose level, and control of blood glucose level. Results: The risk factors that affected significantly the occurrence of DFU were gender (0.038), age groups (0.010), and duration of diabetes mellitus (DM) while hyperglycemic control, smoking, and family history were not. There was no significant difference (0.977) in mean fasting blood glucose (MBG) between the DM and DFU patients. Conclusions: Male diabetic patients aged more than 55 years and suffering from DM for more than 10 years were most likely to have DFU. Key words: diabetic foot ulcer, diabetes mellitus, risk factors, Yemen 


Author(s):  
Vinay Kumar A. ◽  
Raj Kumar K. ◽  
Nithin Kumar Reddy R.

Background: To study the clinical profile of pulmonary tuberculosis in diabetic patients and to study the radiographic patterns of pulmonary tuberculosis in diabetic patients.Methods: The study was undertaken on 100 patients with diabetes mellitus and pulmonary tuberculosis of both sexes admitted to Chalmeda Anand Rao Institute of Medical Sciences, Bommakal, Karimnagar.Results: The fasting blood sugar value showed a definite co-relation with pulmonary tuberculosis. 41% of the patients had fasting blood sugar value between 201 to 300mg/dl and 30% had value between 151-200mg/dl and 23% of the patients had value above 300mg/dl. Mean fasting blood sugar value was 234.4mg/dl. Right sided lung lesions were noted in 37% of the cases and left sided lesions in 33% of the cases. Upper lobe lesions were noted in 68% of the cases and bilateral lesion in 30% of the study group.Conclusions: Uncontrolled diabetes mellitus patients are more prone to develop pulmonary tuberculosis compared to non diabetics. Sputum examination tends to be positive in diabetics compared to non diabetics.


2021 ◽  
Vol 8 (7) ◽  
pp. 207-211
Author(s):  
Rishad Ahmed

Objective: There were few clinical trials which indicate altered liver biochemical findings in diabetic patients, but through investigation to compare the liver enzymes in-between hypertensive and normotensive patients with type 2 diabetes was not evaluated. Thus main objective of current study was to compare the liver enzymes in hypertensive and normotensive patients with type 2 diabetes. Materials and Methods: This was a retrospective observational study conducted in a tertiary medical teaching hospital in Kolkata. Hospital OPD reports and patients clinical case records were used to fetch the required data in a predesigned clinical record pro forma. Result: Total 180 patients were participated in this observational retrospective trial where 33% patient were normotensive but having T2DM and 67% patients were hypertensive with T2DM. There were no statistically significant differences between the study variables among both the groups. However elevated level of GGT, ALT and AST were observed in T2DM normotensive patients as compare to T2DM hypertensive patients. abnormal liver functions were recorded in patients with uncontrolled diabetes as compared to patients with good control (p<0.05). Conclusion: The current study concluded that elevated liver enzymes like bilirubin, GGT, SGOT and SGPT were common among diabetes mellitus patients and comparable with patients with hypertensive as well as normotensive patients with diabetes mellitus. Keywords: Liver enzymes, T2DM, hypertension.


2020 ◽  
Vol 3 (1) ◽  
pp. 41-48
Author(s):  
Andrada Coşoreanu ◽  
Maria Băleanu ◽  
Emilia Rusu ◽  
Mihai Marinescu ◽  
Sergiu-Andrei Iordache ◽  
...  

AbstractIntroduction. Over the last few years, lower limb amputations have represented a prevalent worldwide burden in the evolution of diabetic patients, but at what extent this burden affects the Roma population compared to Caucasians in Romania still needs further comprehension.Aim. The purpose of this study was to assess the prevalence of lower extremities amputations in a Roma population, compared to a Caucasian population, in the presence of diabetes mellitus (DM), as well as to identify the risk factors associated.Materials and methods. We included 536 patients, of whom 257 Roma subjects and 279 Romanian Caucasians, with the following socio-demographic status: the Roma group included 123 women (48.1%) and 134 men (51.9%), aged between 18 and 86 years, while the Caucasian group registered 107 women (47.9%) and 172 men (61.6%), aged between 18 and 89 years.Results. Analyzing the whole group, the prevalence of amputations was 5% (n=27). A greater proportion of amputations was found in Romanian Caucasians (n=21, 7.5%), where there were 17 men (9.9%) and 4 women (3.7%) affected, compared to the Roma population (n=6, 2.3%), where all amputations occurred in men. Noticeably, this complication is more predominantly afflicting men.Conclusions. Non-traumatic lower extremity amputation remains a challenge today in the care of diabetic patients. In our study, higher rates of amputations were observed in Romanian Caucasians, in comparison with the Roma population. Apart from this, this condition was accompanied by many cardiovascular risk factors.


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