scholarly journals The perception of Italian diabetologists on anti-influenza and anti-diphtheria-tetanus-pertussis vaccinations in subjects with diabetes mellitus: the AMD survey

2019 ◽  
Vol 22 (3) ◽  
pp. 99
Author(s):  
Candido, R.

Diabetes mellitus is associated with an increased incidence of some infections and a greater severity and/or frequency of complications related to these diseases. Influenza is characterized by an increased severity of clinical course and risk of complications, especially in diabetic patients who are more susceptible to influenza infection. For these reasons, the Italian Vaccine Prevention Plan 2017-19 provides an active and free offer of influenza vaccine for the diabetic subjects. In addition, among the vaccinations recommended by the Italian Prevention Plan in adults, including the diabetes ones, there is the diphtheria-tetanus-pertussis vaccine and the decennial booster. To investigate what is the perception of Italian diabetologists on the role and importance of the influenza and the diphtheria-tetanus-pertussis vaccines, AMD has promoted an online survey. Participants claimed to be aware of the importance of carrying out and recommending influenza vaccination, while awareness of the usefulness of performing and suggesting the decennial booster for diphtheria-tetanus-pertussis was lower. Diabetologists attribute to patients’ resistance and lack of interest in such vaccinations the main motivation for which they are not used to recommend them, even if they acknowledge that they have little knowledge about the decennial booster of diphtheria-tetanus-pertussis vaccine. The survey shows that the percentage of patients with diabetes who seek advice on these vaccinations is inadequate and the diabetologists’ knowledge of the National Vaccination Prevention recommendations and the need to actively promote vaccinations is inappropriate. This survey has allowed to highlight the opinion, of a significant percentage of Italian diabetologists, on some key aspects of the vaccination therapy indicated in diabetic patient, allowing to gather important information to open a debate, to know strengths and weaknesses on this topic and implement training activities. KEY WORDS diabetes mellitus; influenza vaccine; diphtheria-tetanus-pertussis vaccine; survey.

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


2019 ◽  
Vol 22 (4) ◽  
pp. 219
Author(s):  
Botta, A.

Heart Failure (HF) and Type 2 Diabetes Mellitus (T2D) are important clinical conditions that often coexist, mutually influencing intra- and extra-hospital morbidity and mortality. In order to characterize the diagnostic and therapeutic management of patients with HF and T2D, a retrospective observational study was conducted on database of the last 12 months in 8 Campania Diabetology Centers. 164 patients were affected by HF and T2D. Among them, 123 patients had a medical record with reproducible data and were recruited for the study. Diabetic patients were divided into three groups: group A included patients with preserved ejection fraction (EF) (> 50 %), group B patients with midrange EF (40-49%) and the group C patients with reduced EF (< 40%). All patients had performed ECG and echocardiography, repeated every 6 months; 41 patients (33% of the sample) also performed a cardiac Holter. The most frequent causes of HF were ischemic heart disease and hypertension. After a 12 months follow up, the clinical and laboratory parameters and the treatments adopted were re-evaluated. The antidiabetic drugs resulted modified with a reduction in the use of metformin, sulfonylureas, glinids and pioglitazone; at the same time a greater use of gliptins, gliflozines and GLP1 AR and a lower use of insulin therapy was observed. Cardiological therapy was modified with a greater use of diuretics and nitrates and a reduction of ACEI and ARB, probably due to the use of sacubitril/valsartan association in the group of patients with reduced EF. According to the recent guidelines, antidiabetic therapy must be tailored to the characteristics of the patients with diabetes and heart failure, preferring the use of molecules that have shown a cardiovascular protection effect or, secondarily, those with cardiovascular neutrality. Similarly, cardiological therapies have to consider the type of antidiabetic agents used and benefit from molecules that impact clinical symptoms and natural history. Finally, the approach to the patients with both the pathologies must necessarily take place in the healthcare districts and absolutely be multidisciplinary and integrated, involving firstly Diabetologists and Cardiologists, but also other professional roles (nurses, psychologists, physiotherapists, caregivers) operating in the territorial healthcare services. KEY WORDS diabetes mellitus; heart failure; ejection fraction.


2020 ◽  
Author(s):  
Timothy P. Graham ◽  
Erich N. Marks ◽  
Joshua J. Sebranek ◽  
Douglas B. Coursin

Patients with diabetes mellitus routinely require management in the adult intensive care unit (ICU). These patients have increased morbidity, mortality, hospital length of stay, cost of care, and frequency of hospital and ICU admission. Glucose control in these patients presents challenges for the clinician. In the critically ill, hyperglycemia does not occur exclusively in patients with diabetes or prediabetes but may be related to stress-induced hyperglycemia or iatrogenic causes. Hyperglycemia can contribute to decreased wound healing and immune function and a host of cellular and molecular dysfunctions and has been linked to increased hospital mortality. Hypoglycemia in the ICU is associated with patients with preexisting diabetes, those receiving insulin and other medications, and septic individuals, among others. Insulin therapy is the mainstay of glucose management in the critically ill. ICU practitioners should be aware that point-of-care glucose meters are not as accurate as core laboratory results. Finally, both hypoglycemia and wide fluctuations in blood glucose during critical illness are also associated with increased mortality, although clear cause-and-effect relationships have not been established. This review contains 1 figure, 8 tables, and 71 references. Key words: Diabetes mellitus, glucose measurement, glucose targets, hyperglycemia, hypoglycemia, insulin


2017 ◽  
Vol 77 (1) ◽  
Author(s):  
Juan Figueroa García Juan

ANTECEDENTES: la disfunción eréctil es la incapacidad para conseguir y mantener una erección que permita una penetración sexual satisfactoria en 50% de las veces, en un periodo de tres meses. Entre las causas orgánicas, la diabetes mellitus representa 30%. A pesar de esta relación la prevalencia es poco conocida en nuestro medio.OBJETIVO: determinar la asociación entre el control glucémico y la disfunción eréctil en diabéticos.MATERIALES Y MÉTODOS: estudio observacional, transversal y analítico al que se incluyeron pacientes que no refirieron complicaciones al momento del estudio. A todos se les aplicó el cuestionario IIFE-5 (Índice Internacional de la Función Eréctil) para detectar si padecían o no disfunción eréctil, se compararon las concentraciones de hemoglobina glucosilada (HbA1c), y se analizó su asociación mediante la aplicación de la razón de momios.RESULTADOS: en 362 pacientes se encontró una prevalencia de disfunción eréctil de 72.3% (n=272), de estos 80.9% (n=212) estaban en descontrol glucémico, con una razón de momios de 6.92 (IC95%: 4.16 a 11.50).CONCLUSIONES: en los pacientes diabéticos existe una relación 7:1 de probabilidad de disfunción eréctil versus pacientes con adecuado control glucémico.PALABRAS CLAVE: diabetes mellitus, disfunción eréctil, hemoglobina glucosilada, control glucémico.  AbstractBACKGROUND: Erectile dysfunction is the inability to achieve and maintain an erection that enables satisfactory sexual penetration 50% of the time, within a 3-month period. Diabetes mellitus is the organic cause in 30% of cases, but despite this relation, the prevalence of erectile dysfunction is not well known in Mexico.OBJECTIVE: To determine the association between glycemic control and erectile dysfunction in diabetic patients.MATERIALS AND METHODS: An observational, cross-sectional, analytic study included diabetic patients that did not complain of complications at the time of the study. The International Index of Erectile Function (IIEF-5) questionnaire was applied to detect whether or not the patients presented with erectile dysfunction. Their glycated hemoglobin (HbA1c) levels were compared and the association with erectile dysfunction was analyzed through the odds ratio.RESULTS: The prevalence of erectile dysfunction in 362 patients was 72.3% (n=272). Of those patients with erectile dysfunction, 80.9% (n=212) had inadequate glycemic control, with an odds ratio of 6.92 (95% CI: 4.16 to 11.50).CONCLUSIONS: The odds ratio of presenting with erectile dysfunction for diabetic men with inadequate glycemic control and patients with adequate glycemic control was 7:1.KEY WORDS: Diabetes mellitus; Erectile dysfunction; Glycated hemoglobin; Glycemic control


1970 ◽  
Vol 4 (2) ◽  
pp. 83-86
Author(s):  
Chowdhury Iqbal Mahmud

Permanent deformity and disability can occur in diabetic Charcot arthropathy (neuropathic arthropathy) if not diagnosed and treated promptly. We report two patients with uncontrolled diabetes mellitus in whom the diagnosis of ankle neuro-arthropathy was delayed by up to six months, with misdiagnoses including ankle arthritis, osteomyelitis and cellulitis. The clinical scenario and appearances of the ankle and foot were typical of Charcot arthropathy. Unfortunately, both of them sustained ankle fracture-dislocation without a history of significant trauma. Both the patients were treated by ankle arthrodesis (fusion of joint). Prevention and early diagnosis of diabetic foot is the key to avoid the development of complications. In diabetic patients, a higher index of suspicion for the possibility of Charcot’s disease is needed. Key Words: Diabetes mellitus; Charcot arthropathy; ankle fracture-dislocation; arthrodesis. DOI: 10.3329/imcj.v4i2.6503Ibrahim Med. Coll. J. 2010; 4(2): 83-86


2021 ◽  
Vol 24 (2) ◽  
pp. 97
Author(s):  
Foglia, A.

With the outbreak of the COVID-19 pandemic and the resulting restrictions, telemedicine has enabled healthcare to be provided to patients with chronic diseases, although with some restrictions. During the lockdown The Campania region was the first to order (03/27/2020), to protect the health of citizens suffering from diabetes mellitus, the use of telemedicine and a tele-health service was activated in our clinics. At the end of the consultation, a survey was submitted to our diabetic patients in order to evaluate their opinion about the telemedicine experience in comparison with the traditional clinic visit. 100% of both type 1 and type 2 patients consider the telemedicine visit adequate, 89.2% of types 1 and 75.9% of types 2 consider the two forms of visit absolutely overlapping from a professional point of view, and even 6.9% of type 2, but none of type 1, considers the tele-visit more effective than the traditional visit. However, only 44.8% (type 2 diabetic patients) and 13,5%% (type 1 diabetic patients) expressed a preference for telemedicine visits over traditional visits. Telemedicine has allowed continuity of care for diabetic patients despite the difficulties of this emergency time. We believe that the opinion of patients and health care professionals on the telemedicine experience can be useful to assess the limitations and advantages in order to improve and enhance the use of this method. KEY WORDS diabetes mellitus; telemedicine system; survey.


2019 ◽  
Vol 10 (10.2) ◽  
pp. 145-152
Author(s):  
Adriana Albu ◽  
Ioana Para

Abstract Left ventricular diastolic dysfunction (LVDD) with normal ejection fraction is considered common among people with diabetes mellitus (DM). LVDD is a progressive condition and an independent predictor of mortality in diabetic patients. The etiopathogenesis of LVDD is multifactorial, including diabetes associated comorbidities, such as hypertension, coronary atherosclerosis and obesity, as well as myocardial vascular and metabolic disturbances which lead to diabetic cardiomyopathy. Early stages of LVDD may be detected using echocardiographic techniques. Treatment strategies evolve, based on a better understanding of pathogenic mechanisms, although it is still difficult to efficiently control LVDD evolution. This review synthesizes the main pathophysiological processes and clinical features that characterize DM associated LVDD. Among treatment options, the therapeutic relevance of exercise training programs is underlined. Key words: diabetes mellitus, left ventricular diastolic dysfunction, physical training,


2020 ◽  
Vol 2 (2) ◽  
pp. 97-102
Author(s):  
I Nengah Sumirta ◽  
I wayan Candra ◽  
IGA Harini

Degenerative diseases especially diabetes mellitus in indonesia has increased in line with the progress work in social economic and the changing lifestyle .International diabetic federation ( idf ) reckon incidence diabetes mellitus in the world 2012 as many as 371 million people , 2013 increased to 382 million people and diperirakan in the 2035 increased to 592 million people . In indonesia, according to the basic health research ( riskesdas ) years 2013 mentioned an increasing prevalence of diabetes mellitus based on the doctor diagnosis in at age ≥15 year in 2013 as much as 1,5 % and in 2018 2,00 %. as much as. This community service aims to reduce the level of stress in patients with Diabetes Mellitus. Using training methods, conduct stress level measurements before and after training, with a total target of 20 people. Data analysis using Paired Sample T-Test. The results show there is the influence of training visualize on the level of stress patients diabetes mellitus with p value much as 0.021 ( lt; 0.05 ) .Suggested in research locations to consider the use of visualize as one of the act of to reduce the level of stress patients diabetes mellitus and to respondents to conduct visualize continuously in any given period of time .Key Words: Diabetes Mellitus, Stress, Visualisasi


1970 ◽  
Vol 6 (2) ◽  
pp. 95-99
Author(s):  
MK Biswas ◽  
AK Biswas ◽  
G Biswas ◽  
J Begum

Diabetes Mellitus (DM) is a public health challenge all over the world. Recent evidence suggests that there is a positive association between smoking and the risk of diabetes. This descriptive cross-sectional study was conducted from March to June 2008 at BIRDEM Hospital, Shahbagh, Dhaka to find out pattern of tobacco consumption among diabetic patients. Age of the respondents was >15 years. With purposive sampling total 255 respondents were selected. Data was collected through face-to-face interview with structured questionnaire. Out of 255 respondents, 51.4% consumed deferent type of tobacco. Smoker was 63.36% and smokeless tobacco user was 52.67%. The highest (45.80%) had habit of smoking, 36.64% had habit of smokeless tobacco and 17.56% had habit both types of tobacco consumption. The highest smoking and smokeless tobacco consumption found within 50-60 years age group. Total 60.80% male had smoking habit and 32.82% female were smokeless tobacco consumer but no female was smoker. Twenty nine percent tobacco consumers were primarily educated, 16.08% service holders were tobacco consumer and 13.75% service holders were smoker. Among respondents lung diseases and heart diseases were common (78.54.0% and 49.36%). Respondents who consumed tobacco were suffered (74.36%) more complication than non-tobacco consumer (25.64%). So an effective awareness program is required to discourage the consumption of tobacco to protect diabetic patients. Key words: Diabetes mellitus; Smoking; Tobacco DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9210 FMCJ 2011; 6(2): 95-99


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).


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