IMPACT OF DIABETES ON OUTCOME OF HOSPITALISED PATIENTS WITH COVID -19 PNEUMONIA: SINGLE CENTRE EXPERIENCE FROM NORTH INDIA.

2021 ◽  
pp. 39-40
Author(s):  
Rajeev Kasaliwal ◽  
Srishti Jain ◽  
Naveen Gupta ◽  
Nimish Mathur ◽  
Ashish Jain ◽  
...  
Keyword(s):  
North India ◽  
Severe Illness ◽  
Diabetic Patients ◽  
Medical College ◽  
Global Pandemic ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Rapid Spread ◽  
Patients With Diabetes ◽  
Gandhi Medical College

Context: Following rapid spread of COVID-19, WHO on March 11, 2020, declared COVID-19 a global pandemic. Diabetes is known to confer increased risk for various infections. Studies from outside India have shown more aggressive course of COVID 19 Pneumonia in diabetic patients. Material and methods:Aretrospective observational study was carried out at Mahatma Gandhi Medical College and Hospital, Jaipur. Data from electronic medical records of seven thirty-one patient admitted from 15 October 2020 to 30 November 2020 were reviewed and analysed Results: Patients with diabetes had signicantly higher need of oxygen therapy and ICU admission. No difference was observed in mortality rates in the two group of patients.Conclusion: Diabetes patients appear to be at higher risk of severe illness from COVID-19 than those without diabetes.

scholarly journals Fibrinogen: Risk Factor for Cardiovascular Disease

2012 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Dilli Ram Kafle
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Independent Risk Factor ◽  
Diabetic Patients ◽  
Medical College ◽  
Increased Risk ◽  
Patients With Diabetes

Patients with diabetes mellitus have 2 to 4 times increased risk for cardiovascular disease than non-diabetic patients. However this excess risk is not fully explained by the traditional cardiovascular risk factors (Hypertension, Hypercholesterolaemia, Smoking and Obesity) which are also associated with diabetes. Fibrinogen has been identified as an independent risk factor for cardiovascular disease and it is associated with traditional cardiovascular risk factors. Studies done in the Caucasians have shown fibrinogen to be higher in diabetic than the non-diabetic patients. Elevated fibrinogen in diabetic patients may be responsible for the increased cardiovascular risk in those patients. Elevated fibrinogen is also associated with increased mortality in general population.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7281 Journal of Nobel Medical College Vol.1(1) 2011 1-8

scholarly journals New Fast Acting Glucagon for Recovery from Hypoglycemia, a Life-Threatening Situation: Nasal Powder and Injected Stable Solutions

2021 ◽  
Vol 22 (19) ◽  
pp. 10643
Author(s):  
Lucia La Sala ◽  
Antonio E. Pontiroli
Keyword(s):  
Severe Hypoglycemia ◽  
Well Being ◽  
Nasal Administration ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Increased Risk ◽  
The Us ◽  
Patients With Diabetes ◽  
Adults And Children ◽  
Fast Acting

The goal of diabetes care is to achieve and maintain good glycemic control over time, so as to prevent or delay the development of micro- and macrovascular complications in type 1 (T1D) and type 2 diabetes (T2D). However, numerous barriers hinder the achievement of this goal, first of all the frequent episodes of hypoglycemia typical in patients treated with insulin as T1D patients, or sulphonylureas as T2D patients. The prevention strategy and treatment of hypoglycemia are important for the well-being of patients with diabetes. Hypoglycemia is strongly associated with an increased risk of cardiovascular disease in diabetic patients, due probably to the release of inflammatory markers and prothrombotic effects triggered by hypoglycemia. Treatment of hypoglycemia is traditionally based on administration of carbohydrates or of glucagon via intramuscular (IM) or subcutaneous injection (SC). The injection of traditional glucagon is cumbersome, such that glucagon is an under-utilized drug. In 1983, it was shown for the first time that intranasal (IN) glucagon increases blood glucose levels in healthy volunteers, and in 1989–1992 that IN glucagon is similar to IM glucagon in resolving hypoglycemia in normal volunteers and in patients with diabetes, both adults and children. IN glucagon was developed in 2010 and continued in 2015; in 2019 IN glucagon obtained approval in the US, Canada, and Europe for severe hypoglycemia in children and adults. In the 2010s, two ready-to-use injectable formulations, a stable non-aqueous glucagon solution and the glucagon analog dasiglucagon, were developed, showing an efficacy similar to traditional glucagon, and approved in the US in 2020 and in 2021, respectively, for severe hypoglycemia in adults and in children. Fast-acting glucagon (nasal administration and injected solutions) appears to represent a major breakthrough in the treatment of severe hypoglycemia in insulin-treated patients with diabetes, both adults and children. It is anticipated that the availability of fast-acting glucagon will expand the use of glucagon, improve overall metabolic control, and prevent hypoglycemia-related complications, in particular cardiovascular complications and cognitive impairment.

Abstract 6238: Clarifying the Opportunities to Improve Survival After MI in Diabetic Patients

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Lance S Longmore ◽  
Kimberly J Reid ◽  
Mikhail Kosiborod ◽  
Frederick A Masoudi ◽  
Verna Welch ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Patient Characteristics ◽  
Psychosocial Health ◽  
Diabetic Patients ◽  
Biological Factors ◽  
Increased Risk ◽  
Wide Range ◽  
Patients With Diabetes ◽  
Multivariable Models ◽  
Adjusted Model

While diabetes is known to be associated with increased mortality after MI, whether these differences in outcome are due to patient characteristics, treatment, or other biological factors is unknown. We analyzed a contemporary cohort of MI survivors to comprehensively adjust for demographics, comorbidities, psychosocial, health status, clinical and treatment factors to determine if residual disparities in outcomes exist. We studied 2481 hospital survivors of MI in the prospective, 19-center PREMIER study (29% with diabetes). Multivariable models with sequential adjustment were employed to identify the extent to which variation in a wide range of patient characteristics (Figure ) accounted for differences in 3-year mortality in patients with and without diabetes. Unadjusted mortality was more than 2.5-fold greater for patients with diabetes (HR 2.55, 95% CI 2.08–3.14). Mortality was most attenuated by diabetes-related comorbidities (Figure ). The fully-adjusted model identified a significant, albeit attenuated, excess 3-year mortality among patients with diabetes (HR 1.57, 95% CI 1.22–1.99). Patients with diabetes experience a substantially increased risk for 3-year mortality after MI, even after accounting for a wide range of patient and treatment characteristics. This suggests that unmeasured, biologic variables associated with diabetes may mediate this difference. Further inquiry into the pathogenesis of diabetic cardiovascular disease is needed to identify new opportunities to improve the prognosis of patients with diabetes.

The Challenge of Lipid Management in Patients with Diabetes or Other Endocrine Disorders

2010 ◽  
Vol 7 (2) ◽  
pp. 92
Author(s):  
Alberico L Catapano ◽  
Liliana Grigore ◽  
Angela Pirillo ◽  
◽  
◽  
...  
Keyword(s):  
Statin Therapy ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Lipid Management ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Associated Risk Factors

Diabetes increases the risk of developing cardiovascular disease (CVD), and several guidelines suggest that subjects with diabetes are at high risk of developing CVD. The increased risk can be attributed, at least in part, to associated risk factors, including hypertension and dyslipidaemia. The role of statins in primary and secondary prevention of CVD is well established, and the positive effect has been clearly demonstrated also in patients with type 2 diabetes. A number of studies have evaluated the effect of statin therapy on incident CVD and shown that statin therapy produces a great reduction in cardiovascular risk, but a recent meta-analysis revealed a slight increase in the risk of developing diabetes. Such risk is, however, low, especially when compared with the reduction in cardiovascular events and should not interfere with the choice of treating diabetic patients with a cholesterol-lowering therapy.

scholarly journals Dermatological Manifestations in Diabetes Mellitus at NGMCTH Kohalpur

2017 ◽  
Vol 13 (2) ◽  
pp. 31-34
Author(s):  
Sumit Pandey ◽  
Pradip Mishra ◽  
Nirmala Sharma ◽  
Shyam B.K.
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Disease ◽  
Teaching Hospital ◽  
College Teaching ◽  
The Body ◽  
Diabetic Patients ◽  
Cutaneous Infections ◽  
Medical College ◽  
Patients With Diabetes ◽  
Sugar Levels

Background: Skin is the largest and most visible organ in the body. It undoubtedly determines to a great extent our appearance and plays  a  major  role  in  socio-sexual  communication.  More  than  one  third  of  diabetic  patients  have  some  type  of  dermatologic 1 manifestations during the course of their chronic disease . The association of certain skin diseases with diabetes mellitus has been 2 3 fairly well recognized with an incidence rate ranging from 11.4% to 66%.  At least 30% of patients with diabetes mellitus have some 4 5 type of cutaneous involvement during the course of their chronic disease.  Skin sugar levels run parallel to the blood sugar levels. Skin changes generally appear subsequent to the development of DM but may be the first presenting sign or even precede the 6 diagnosis by many years. Among the many skin manifestations in DM, none is pathognomonic of this disease. Cutaneous findings in DM can be classified into four categories: (1) skin disease with strong association and others with less distinct association with DM, (2) cutaneous infections, (3) dermatological disorders related to diabetic complications, and (4) skin conditions related to diabetes 7 treatments.Objectives: This study was undertaken to find out the pattern of Dermatological manifestations in Diabetes patients attending Nepalgunj Medical College Teaching Hospital, Kohalpur. Method and material: This is a hospital- based descriptive study conducted  in  the  Department  of  Dermatology,  Venereology  and  Leprology  of  Nepalgunj  Medical  College  Teaching  Hospital, Kohalpur  between   September 2013 to August 2014.  A total of 100 patients were included in the study. History and clinical examinations were performed and the data were recorded and analyzed. Results: The age of the patients ranged from 20 years to 85 years with the mean age of 51.7+12.13 years. The most common age groups were 46-55 years (36%) followed by 56-65 years (24.7%) and 36-45 years (17.3%), 66-75 years (9.3%), 76-85 years (12.7%). Among the 100 patients of diabetes ellitus, there were 44(44%) males and 56 (56%) females.  Among  the  cutaneous  disorders  commonly  associated  with  diabetes,  infections  were  the  most prevalent. 59(59%) out of 100 patients had skin infections.Conclusions: Patients with Diabetes can present with array of cutaneous disorders. Cutaneous infections formed the largest group of dermatoses in this study. Increased incidence of cutaneous infections mainly fungal and bacterial was noticed in majority diabetics emphasizing the need for more aggressive management of diabetes mellitus. Among infective dermatoses, fungal infections were the most common, with Candidal infections being more common than dermatophytosis.JNGMC Vol. 13 No. 2 December 2015, Page: 31-34

scholarly journals Implication of Current ASE/EACVI Left Ventricular Diastolic Function Classification in Predicting 2-Year MACE in Asymptomatic Patients with Diabetes and Hypertension

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Foo ◽  
K H Lam ◽  
M Igo ◽  
M N A Sulaiman ◽  
M Y Ku ◽  
...  
Keyword(s):  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Diabetic Patients ◽  
Prognostic Impact ◽  
Left Atrial Volume Index ◽  
Asymptomatic Patients ◽  
Number Of Patients ◽  
Increased Risk ◽  
Patients With Diabetes

Abstract Background Left ventricular diastolic dysfunction (LVDD) has been shown to be more prevalent in patients with diabetes, and once progress to overt heart failure, carry worse clinical outcomes. Substantial number of patients were classified as indeterminate DF based on the current ASE/EACVI guidelines. The implication of current DF classification in predicting MACE among diabetic patients is not well established. Purpose To assess prognostic impact of current guidelines-based DF classification, and determine predictors of 2-year MACE based on individual LVDD parameters. Methods A total of 111 patients with diabetes and hypertension who attended diabetic clinic follow-up at the primary healthcare settings were enrolled. All patients had no prior cardiovascular events, had preserved left ventricular (LV) ejection fraction on echocardiography and sinus rhythm on ECG at screening. Echocardiography was performed to obtain parameters of LV dimensions, LV volumes and LVDD. The 2016 ASE/EACVI guidelines were applied to classify DF. All patients were followed up until 2 years to assess MACE. Results There were 65 (58.6%) female patients. Mean age was 59.86 (7.45); mean duration of DM was 10.5 (5.41). 80 (72.1%) patients were classified as having normal DF (nDF); 24 (21.6%) patients were classified as indeterminate DF (iDF); 7 patients (6.3%) were classified as LVDD. Patients with LVDD had significantly higher LV mass index (LVMI) (mean 121.72±23.28g/m2 vs 116.62±24.66g/m2 in iDF vs 102.50±22.89g/m2 in nDF); higher left atrial volume index (LAVI) (mean 41.24±10.28ml/m2 vs 30.55±10.07ml/m2 in iDF vs 25.75±6.30ml/m2 in nDF); lower lateral e' velocity (mean 6.35±2.05cm/s vs 7.37±1.73cm/s in iDF vs 8.59±2.13cm/s in nDF); higher septal E/e' ratio (mean 14.89±3.29 vs 12.16±3.99 in iDF vs 9.99±2.35 in nDF); higher average septal-lateral E/e' ratio (mean 14.22±3.77 vs 11.34±3.74 in iDF vs 9.04±2.10 in nDF). Among these 111 patients, 10 patients (9%) reported MACE at 2 years. The risk of 2-year MACE is elevated in both iDF [odds ratio (OR) 3.80, 95% CI 0.87–16.54, p=0.075] and LVDD [OR 7.60, 95% CI 1.11–52.02, p=0.039]. LVMI (OR 1.027, 95% CI 1.004– 1.051, p=0.023), LAVI (OR 1.092, 95% CI 1.017–1.172), and average septal-lateral E/e' ratio (OR 1.276, 95% CI 1.047–1.557, p=0.016) significantly correlated with 2-year MACE. Conclusions LVDD is correlated with increased MACE at 2 years. LVMI, LAVI and average septal-lateral E/e' ratio were predictors of increased risk of MACE at 2 years. Further investigation with larger sample size is warranted. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health Malaysia

scholarly journals COVID-19 pandemic and Thyroid cancer treatment in perspective of Bangladesh

2021 ◽  
Vol 29 (2) ◽  
pp. 178-181
Author(s):  
Mahmud Asif Rifat ◽  
Mostafa Kamal Arefin ◽  
Abu Yusuf Fakir ◽  
SK Nurul Fattah Rumi ◽  
Husne Qumer Osmany ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Active Surveillance ◽  
Hospital Admissions ◽  
Lung Metastases ◽  
Vulnerable Groups ◽  
Severe Illness ◽  
Medical College ◽  
Increased Risk

Background: The COVID-19 pandemic in Bangladesh is part of the worldwide pandemic of coronavirus disease 2019 which has crowded out services for both covid and non-covid patients, in a country where the health care system was already under huge stress even before the pandemic. Objectives: To postpone non-urgent surgeries along with active surveillance of thyroid cancer patients to make sure the hospitals are not unnecessarily occupied. Methods: Document based categorization of thyroid cancer patients, like- low risk, high risk and clinically extremely vulnerable groups who are at greatest risk of severe illness from coronavirus are to be done accordingly. Individuals with thyroid cancer are mostly not susceptible to COVID- 19. However, patients with thyroid cancer (papillary or medullary) having lung metastases or undergoing certain types of cancer treatment might be at increased risk of viral infection or complications. Risk benefit ratio is checked and explained to the patient and their attendants. Recommendations: As COVID-19 is spreading across the Bangladesh, hospitals are being forced to reallocate resources to the care of critically ill. So it is crucial to adhere to the advice from experts to reduce the risk of infection. All non-essential surgeries and hospital admissions can be postponed to make sure that hospitals are not unnecessarily occupied. Conclusion: In the face of the COVID-19 pandemic, cancer care has had to adapt rapidly given recommendations to postpone nonurgent surgeries with active surveillance of thyroid cancer patients except thyroid tumors requiring acute airway management. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 178-181

scholarly journals A study to assess the correlation between HbA1c and microalbuminuria among diabetics

2020 ◽  
Vol 8 (1) ◽  
pp. 16
Author(s):  
Sruthi Kare ◽  
Vishwanath N. Reddy ◽  
Thejdeep Mahamkali
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Socioeconomic Development ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Medical College ◽  
Significant Linear Correlation ◽  
Patients With Diabetes

Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients.  Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin.  Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.

scholarly journals Role of HbA1c with mortality and severity among the patients of Acute coronary syndrome: a prospective study

2019 ◽  
Vol 6 (3) ◽  
pp. 796
Author(s):  
Satish Chandel ◽  
Shishirendu Parihar ◽  
Bharat Gramani ◽  
T. N. Dubey
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Glucose Intolerance ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Study Cohort ◽  
Medical College ◽  
Coronary Syndrome ◽  
Gandhi Medical College ◽  
A Prospective Study

Background: Blockage of coronary artery lead to a reduction of blood flow towards heart resulting in Coronary Artery Disease (CAD). CAD leads to myocardial complications. CAD is one of the important causes of death all over the world including India. Diabetes mellitus is a risk factor for CAD. Reports have also shown to increase in cardiovascular morbidity among patients with glucose intolerance. In present study we tried to find the relationship of HbA1c levels with mortality, morbidity, and severity in Acute Coronary Syndrome (ACS).Methods: Two hundred patients with ACS were studied from 2018 to 2019 at Gandhi Medical College and Hamidia Hospital, Bhopal. Following a thorough medical history routine medical examination including laboratory investigations was performed in all the patients. Electrocardiography (ECG), creatine phosphokinase-muscle/brain (CPK-MB), echocardiography and coronary angiography (CAG) was also done as part of this study.Results: Mean age of the study cohort was 59.17±8.75 years. Out of 200 subjects, 110 (55%) were non-diabetic, 52 (26%) were diabetic, 38 (19%) had weakened glucose tolerance and 82 (41%) had hypertension. Left ventricular dysfunction (LVD) and heart failure (HF) were the common complications and were more prevalent among diabetic patients than the nondiabetics (p=0.009). HbA1c level (7.01±2.23) was high among subjects with complications than the subjects without complications (6.01±1.36).Conclusions: The patients with DM have higher morbidity and mortality than the non-diabetic patients of ACS and therefore such patients should be screened for diabetes and glucose intolerance for better management of CAD.

scholarly journals Management of pregnant women in times of COVID-19 our experience from Kashmir valley

2021 ◽  
Vol 10 (4) ◽  
pp. 1379
Author(s):  
Syed Naseer ◽  
Syed Uzma Andrabi ◽  
Syed Ishfa Andrabi ◽  
Humaira Tabasum
Keyword(s):  
Pregnant Women ◽  
Severe Disease ◽  
Virus Transmission ◽  
Safe Motherhood ◽  
Normal Vaginal Delivery ◽  
Global Public Health ◽  
Transmission Potential ◽  
Medical College ◽  
Global Pandemic ◽  
Increased Risk

Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. COVID-19 is a rapidly evolving situation, and there is limited data reporting its impact on pregnant women. Our study aimed to find the symptomatology, clinical courses and outcome of pregnant women with COVID-19 and to assess the vertical transmission potential of COVID-19 in pregnancy.Methods: This prospective observational study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Medical College, Department of Gynaecology and obstetrics, Srinagar from May 2020 to September 2020. All COVID-19 positive pregnant patients admitted in our institution were included in our study.Results: The study included 100 Covid-19 positive pregnant women. Most of them were between 30 to 40 years of age. Median gestational age was 32.8 weeks. Comorbidity was present in 18 of our patients. 7 patients had gestational diabetes and 1 with overt diabetes, 5 were hypertensive, 3 had hypothyroidism, 1 with anti-phospholipid antibody syndrome (APLA) and 1 with asthma.44 patients were primigravidae and 56 were multigravidae. 27 patients delivered preterm and 44 with term pregnancy. 47 had undergone caesarean section and 24 normal vaginal delivery.88% of our patients were asymptomatic for covid-19 disease while as 12 patients had Covid-19 disease symptoms. The main complaints reported by patients related to covid-19 disease was mild dry cough and fever (9%). Two patients developed severe covid-19 pneumonia with ARDS and were put on ventilator, expired after 20 days of illness. All neonates were subjected to RT-PCR with none producing positive results.Conclusions: Appropriate and timely management of Covid-19 positive pregnant women is a principle for safe motherhood and healthy offspring in times of global pandemic. The present data do not suggest an increased risk of severe disease among pregnant women. We encourage the breast feeding immediately after delivery as benefits overweigh any potential risks of virus transmission if any.

Sign in / Sign up

Export Citation Format

Share Document