scholarly journals Wearable Sensor for Assessing Gait and Postural Alterations in Patients with Diabetes: A Scoping Review

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1145
Author(s):  
Lorenzo Brognara ◽  
Antonio Mazzotti ◽  
Alberto Di Martino ◽  
Cesare Faldini ◽  
Omar Cauli

Background and Objectives: Diabetes mellitus is considered a serious public health problem due to its high prevalence and related complications, including gait and posture impairments due to neuropathy and vascular alterations and the subsequent increased risk of falls. The gait of patients with diabetes is characterized by alterations of the main spatiotemporal gait parameters such as gait velocity, cadence, stride time and length, which are also known to worsen with disease course. Wearable sensor systems can be used for gait analysis by providing spatiotemporal parameters and postural control (evaluated from the perspective of body sway), useful for investigating the disease progression. Thanks to their small size and low cost of their components, inertial measurement units (IMUs) are easy to wear and are cheap tools for movement analysis. Materials and Methods: The aim of this study is to review articles published in the last 21 years (from 2000 to 2021) concerning the application of wearable sensors to assess spatiotemporal parameters of gait and body postural alterations in patients with diabetes mellitus. Relevant articles were searched in the Medline database using PubMed, Ovid and Cochrane libraries. Results: One hundred and four articles were initially identified while searching the scientific literature on this topic. Thirteen were selected and analysed in this review. Wearable motion sensors are useful, noninvasive, low-cost, and objective tools for performing gait and posture analysis in diabetic patients. The IMUs can be worn at the lumber levels, tibias or feet, and different spatiotemporal parameters of movement and static posture can be assessed. Conclusions: Future research should focus on standardizing the measurement setup and selecting the most informative spatiotemporal parameters for gait and posture analysis.

2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Vinicius Borges ◽  
Aldo Barbachan

Category: Diabetes Introduction/Purpose: Diabetes mellitus has become a global public health problem. Not only has its incidence remained high in developed countries such as Japan and the United States, but, also, the number of cases has been growing alarmingly in developing countries such as Brazil. The concept of detection and management of diabetes mellitus in primary care centers is widely practiced in Brazil by the general physician. The purpose of this study was to evaluate the efficacy of our educational diabetics program for patients with diabetes mellitus and to determine the predictors of compliance. Since our patient orientation protocols and the insensitive footwear we provide reduce our hospital admission costs. Methods: A prospective study (2005-2017) was performed in a quaternary hospital where patients with diabetes were referred to the outpatient clinic of the diabetic foot group. The epidemiological profile of these patients under treatment in a specialized multidisciplinary outpatient unit was evaluated. A specific protocol included notes on the age, body mass index, length of disease, use of insulin, degree of sensation as evaluated by the Semmes-Weinstein monofilament test, deformity in feet, palpation of peripheral pulses, cigarette smoking, and previous operative procedure in foot an ankle.The same specialist orthopedic doctors in foot and ankle completed the protocol and performed the specific physical examination (reports were made on deformities regarded as risky for the incursion of ulcers such as plantar callosities, alterations of the hallux and lesser toes, loss of the longitudinal plantar arch, and all those related to Charcot arthropathy) and performed the same a guidelines for foot care. Results: Out of the 578 diabetic patients, the mean age of was 67 years, 69% being of the female gender. There was 53% made use of insulin, the time of disease was 14 years, and 85% patients were obese. Evaluation of protective sensibility showed that 68% were significantly decreased (from the 4.0 g monofilament). The ulcers was found in 64 patients, 57% had degree 1 in the Wagner classification, and 63% was affected in the forefoot. Charcot neuroarthropathy was diagnosed in 54 patients, 52% had the phase 3 in the Eichenholz classification, and 61% was affected in the midfoot. Fifty-three patients had amputations at the time of their first appointment, 66% on toes. 127 patients required surgery resulted from clinical complications: ulcers, osteomyelitis, and Charcot arthropathy. Conclusion: The costs related to the disease increase greatly with the appearance of the complications, especially if there is need of hospitalization and surgical treatment. The prevention of injuries, with adequate glycemic control and supply of protective shoes is essential.


2021 ◽  
Author(s):  
Hengameh Ferdosian ◽  
◽  
Hadi Zamanian ◽  
Sayed Ali Emami ◽  
Elahe Sedighi ◽  
...  

Review question / Objective: The aim of this systematic review is to evaluate AI-based models in identifying predictors of cardiovascular events and risk predtion in patients with diabetes mellitus type2. Condition being studied: T2DM patients have an increased risk of macrovascular and microvascular complications, lead to decreased quality of life and mortality. Considering the significance of cardiovascular complications in these patients, prediction of such events would be important. Different traditional statistical methods(such as regression) and new AI-besed algorithms are used to predict these complications in diabetic patients.


2019 ◽  
Vol 13 (Supl 1) ◽  
pp. S31
Author(s):  
Kelly Cristina Stéfani ◽  
Aldo Barbachan Rodrigues ◽  
Vinicius Quadros Borges ◽  
Gabriel Ferraz Ferreira ◽  
Leonardo Vinícius De Matos Moraes

Introduction: Diabetes mellitus (DM) has become a global public health problem. The concept of detection and management of diabetes mellitus in primary care centers is widely practiced in Brazil by the general practitioner. The aim of this study was to evaluate the efficacy of our educational program for diabetics for patients with diabetes mellitus and to determine the predictors of compliance. Methods: A cross-sectional prospective study was performed in a quaternary hospital where patients with diabetes were referred to the outpatient clinic of the diabetic foot group so that they were part of a multidisciplinary group (medical orthopedists specialists in foot and ankle, medical endocrinologists, physiotherapist and nurse) with a specific protocol for guidelines for foot care. Specialist orthopedic doctors of the foot and ankle completed the protocol and performed the specific physical examination. Results: Of the 578 diabetic patients, the mean age was 67 years, 69% were female, 53% used insulin to control the disease and the disease duration was 14 years. Obesity was diagnosed by calculation of the body mass index (BMI), and 85% patients were overweight. Evaluation of protective sensibility showed that 68% were significantly decreased, with sensation from the 4.0 g monofilament. One hundred and twenty seven patients required surgery resulting from clinical complications of the disease: 64 ulcers (Wagner classification 57% ulcers had a degree 1 Wagner classification, 63% affected forefoots), 54 Charcot arthropathies (52% Eichenholz in phase 3, 61% located in the mid-foot), and 9 cases of osteomyelitis. Fifty-three patients had one or more prior amputations at the time of their first appointment, mostly of the toes (66%). Conclusion: The costs related to the disease increased greatly with the appearance of complications, especially if there was a need for hospitalization and surgical treatment. The prevention of injuries with adequate glycemic control and the provision of protective shoes is essential.  


2021 ◽  
Author(s):  
Flora Özkalaycı ◽  
Ali Karagoz ◽  
Işıl Kutlutürk Karagöz ◽  
Süleyman Çağan Efe ◽  
Erdem Türkyılmaz ◽  
...  

Objectives: Malnutrition is a serious public health problem that is associated with adverse outcomes in a broad range of disease including cardiovascular disease and diabetes mellitus. Malnutrition is demonstrated to be accompanying to several disease, yet there is a lack of evidence on the impact of malnutrition on cardiac functions in patients with diabetic patients with diabetic retinopathy. Herewith our primary goal was to evaluate the relation between any degree malnutrition with left atrial strain in relevant patient group. Patients and Methods: Patients with diabetes mellitus with retinopathy, who were referred to the outpatient cardiology clinic were assessed. Those who had sinus rhythm, had no findings of significant valvular heart disease and coronary artery disease underwent to 2-dimensional speckle tracking echocardiography and assessed for malnutrition in their prior examinations were included to the study. Hundred and seventy patients met the inclusion criteria. Malnutrition scores such as CONUT score, NRI, and PNI were used to evaluate nutrition condition of the patients. Results: Thirty percent of all diabetic patients were demonstrated to have malnutrition according to the CONUT score. Left atrial conduit strain was demonstrated to decrease [ß: -7.5 (CI 95%, -10.7, -4.3 p<0.001)], Left atrial reservoir strain was demonstrated to increase [ß: 2.48(CI 95%,0.83- 4.13 p<0.03)] and Left atrial contractile strain was demonstrated to decrease [ß: -4.21(CI 95%, -2.21, -6.01 p<0.001)] in the presence of any degree malnutrition. Conclusion: In this study we have demonstrated that malnutrition is an important entity in patients with diabetes mellitus and also has a significant impact on Left atrial strain.


2017 ◽  
Vol 4 (5) ◽  
pp. 1437 ◽  
Author(s):  
Archana Kansal ◽  
Mahendra Chouhan ◽  
Neelima Singh ◽  
Sushma Trikha ◽  
Jijo Verghese

Background: Anemia is an increasingly recognized entity in patients with diabetes mellitus. Reduced hemoglobin levels identify diabetic patients with an increased risk of microvascular complications.Methods: A hospital based observational prospective study was conducted in Department of medicine, J.A. Group of Hospitals, Gwalior from June 2014 to October 2015. Adults with diabetes mellitus both type 1 and type 2 were selected as subjects are included and anemia due to blood loss and anemia due to chronic kidney diseases were excluded from the study. Estimation of hemoglobin was done by using capillary method by calorimetric hemoglobinometer. Anemia was defined as hemoglobin <13 g/dl in men and <12 g/ dl in women. All the patients were examined for diabetic retinopathy and graded as none, mild, moderate, severe and proliferative retinopathy as per International clinical diabetic retinopathy disease severity scale.Results: 100 patients were enrolled as subjects. Most of the patients 26 (26%) were in the age group 46-55 years. There were 53 males and 47 females. 42%, 45% and 13% had diabetes of <5 years, 5-10 years and > 10 years duration respectively. HbA1c levels were <7.5 in 74 (74%), 7.5-10 in 23 (23%) patients and > 10 in 3 (3%) patients. Overall 67 (67%) diabetics had anemia. Out of 53 males 30 (56.6%) had anemia and amongst females, out of 47 cases 37 (78.72%) had anemia P value 0.009. Anemia was more common in patients less than 50 years 36 (70.59%) compared to31 (63.2%) with anemia in patients more than 50 years. 65 (65%) patients had diabetic retinopathy (DR). 30 (46.1%) males and 35 (53.8%) females had diabetic retinopathy. All patients with diabetic retinopathy had anemia. Among 35 (35%) patients without DR only 2 (5.71%) had anemia. P value <0.001.Conclusions: Anemia is a common accompaniment to diabetes. Anemia was more common in females and in those less than 50 years. Anemia was frequently associated with diabetic retinopathy. The high prevalence of anaemia supports regular screening for anemia, alongside that for other diabetes-related complications. This might help to delay the progression of vascular complications in these patients.  


2017 ◽  
Vol 03 (01) ◽  
pp. 52 ◽  
Author(s):  
Giuseppe MC Rosano ◽  
Cristiana Vitale ◽  
Petar Seferovic ◽  
◽  
◽  
...  

Diabetes and heart failure are closely related: patients with diabetes have an increased risk of developing heart failure and those with heart failure are at higher risk of developing diabetes. Furthermore, antidiabetic medications increase the risk of mortality and hospitalisation for heart failure in patients with and without pre-existing heart failure. When the two diseases are considered individually, heart failure has a much poorer prognosis than diabetes mellitus; therefore heart failure has to be a priority for treatment in patients presenting with the two conditions, and the diabetic patient with heart failure should be managed by the heart failure team. No specific randomised clinical trials have been conducted to test the effect of cardiovascular drugs in diabetic patients with heart failure, but a wealth of evidence suggests that all interventions effective at improving prognosis in patients with heart failure are equally beneficial in patients with and without diabetes. The negative effect of glucose-lowering agents in patients with heart failure or at increased risk of heart failure has become evident after the withdrawal of rosiglitazone, a thiazolidinedione, from the EU market due to evidence of increased risk of cardiovascular events and hospitalisations for heart failure. An important issue that remains unresolved is the optimal target level of glycated haemoglobin, as recent studies have demonstrated significant reductions in total mortality, morbidity and risk of heart failure despite achieving HbA1c levels similar to those observed in the UKPDS study conducted some decades ago. Meta-analyses showed that intensive glucose lowering is not associated with any significant reduction in cardiovascular risk but conversely results in a significant increase in heart failure risk. Different medications have different risk: benefit ratios in diabetic patients with heart failure; therefore, the heart failure team must judge the required intensity of glycaemic control, the type and dose of glucose lowering agents and any change in glucose-lowering therapy, according to the clinical conditions present.


Author(s):  
S.S. Kozhakhmetov ◽  
N. Mukhanbetzhanov ◽  
А.R Kushugulova

Metabolic disorders and diabetes mellitus are one of the major complex public health problems in the world, and in fact are becoming a global epidemic. It is associated with an increased risk of a large number of complications, including dyslipidemia, cardiovascular disease. The microbiota modulates inflammation, metabolizes indigestible food components, affects intestinal permeability, glucose and lipid metabolism, insulin sensitivity, and overall energy homeostasis. The study investigated the effect of a multistrain probiotic on the intestinal microflora in diabetic patients. As a result of the work carried out, it was shown that the microbiome of patients with diabetes mellitus differs from normal and is depleted in bifidobacteria and some butyrate producers, such as Subdoligranulum, but enriched in Prevotella. The use of a multi-strain probiotic has led to an increase in the biodiversity of the intestinal microflora. Also, in the fecal samples, the content of acetate and butyrate increased, while the concentration of propionate decreased markedly.


2021 ◽  
Vol 24 (2) ◽  
pp. 132
Author(s):  
Tassone, F.

Diabetes mellitus is associated with an increased susceptibility towards infectious diseases, with a more severe course of these diseases and with an increased risk of hospitalization and death. For these reasons all vaccinations are strongly recommended in diabetic people. In this paper, after a quick review of the main pathophysiological mechanisms underlying the increased risk of infectious pathology in the diabetic patient, the main recommendations of the current guidelines on vaccination in diabetic patients will be reviewed. KEY WORDS vaccination; guidelines; influenza virus; Herpes Zoster.


Author(s):  
Giuseppe Rosano ◽  
Petar Seferovic

Patients with diabetes mellitus have an increased risk of developing heart failure and diabetes mellitus is highly prevalent amongst patients with heart failure, especially those with HFpEF. Diabetic patients with heart failure have an increased mortality and an increased risk of hospitalisations and the use of certain anti- diabetic agents increase the risk of mortality and hospitalisation in heart failure. Conversely, newer therapeutic agents have shown a significant reduction of mortality, morbidity and risk of developing heart failure in diabetic patients with proven cardiovascular disease. This highly important area is reviewed in this paper.


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