scholarly journals Diabetes management in telemedicine: patients’ opinion (preliminary data)

2021 ◽  
Vol 24 (2) ◽  
pp. 97
Author(s):  
Foglia, A.
Keyword(s):  
Diabetes Mellitus ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Telemedicine System ◽  
Campania Region

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.

scholarly journals Does 'Honeymoon Period' Exist in Type 2 Diabetes Mellitus?

1970 ◽  
Vol 2 (2) ◽  
pp. 67-69
Author(s):  
SM Ashrafuzzaman ◽  
Zafar A Latifd
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes

Temporary remission of type 1 diabetes mellitus (T1DM) occurs following initiation of insulin therapy. This period of temporary remission without insulin therapy is called ‘honeymoon period'. But no such temporary remission usually occurs in type 2 diabetes (T2DM). We report here two cases of type 2 diabetes mellitus where such honey moon period was observed. Ibrahim Med. Coll. J. 2008; 2(2): 67-69   Key words: Diabetes Mellitus doi: 10.3329/imcj.v2i2.2942  

Relationship of Soluble RAGE and RAGE Ligands HMGB1 and EN-RAGE to Endothelial Dysfunction in Type 1 and Type 2 Diabetes Mellitus

2012 ◽  
Vol 120 (05) ◽  
pp. 277-281 ◽  
Author(s):  
J. Škrha Jr ◽  
M. Kalousová ◽  
J. Švarcová ◽  
A. Muravská ◽  
J. Kvasnička ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Advanced Glycation Endproducts ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Glycation Endproducts ◽  
Diabetic Vascular Complications ◽  
Soluble Rage

AbstractReceptor for advanced glycation endproducts (RAGE) plays the essential role in the pathogenesis of diabetic vascular complications. The aim of the study was to compare concentration of soluble RAGE and its ligands (EN-RAGE and HMGB1) with different biochemical parameters in Type 1 (T1DM) and Type 2 (T2DM) diabetes mellitus.Total number of 154 persons (45 T1DM, 68 T2DM, 41 controls) was examined and concentrations of sRAGE, EN-RAGE and HMGB1 were measured and compared to diabetes control, albuminuria, cell adhesion molecules and metalloproteinases (MMPs).Mean serum sRAGE concentration was higher in T1DM as compared to controls (1137±532 ng/l vs. 824±309 ng/l, p<0.01). Similarly, EN-RAGE was significantly higher in both diabetic groups (p<0.001) and HMGB1 concentrations were elevated in T2DM patients (p<0.01). Significant relationship was found between MMP9 and HMGB1 and EN-RAGE in diabetic patients. Inverse relationship was observed between MMP2 and MMP9 in both types of diabetic patients (r= − 0.602, p<0.002 and r= − 0.771, p<0.001). Significant positive correlation was found between sRAGE and ICAM-1, VCAM-1 or vWF (p<0.01 to p<0.001).We conclude that serum sRAGE and RAGE ligands concentrations reflect endothelial dysfunction developing in diabetes.

scholarly journals Effect of Type 1 and Type 2 Diabetes Mellitus on Complication and Reoperation Rates of Ankle Arthrodesis and Total Ankle Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0049
Author(s):  
William Tucker ◽  
Brandon Morris ◽  
Armin Tarakemeh ◽  
Scott Mullen ◽  
Paul Schroeppel ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Independent Risk Factor ◽  
Surgical Intervention ◽  
Ankle Arthrodesis ◽  
Diabetic Patients ◽  
Ankle Arthritis ◽  
End Stage ◽  
Reoperation Rates

Category: Diabetes Introduction/Purpose: Diabetes mellitus (DM) poses a risk for increased rate of complications in many orthopaedic procedures, especially in patients undergoing elective arthroplasty procedures. Treatment of end-stage ankle arthritis includes both arthroplasty and arthrodesis. Current literature provides minimal guidance regarding outcomes of total ankle replacement (TAR) or ankle arthrodesis (AA) in diabetic patients. The authors of this study utilized a large database to compare rates of postoperative complications and reoperations of diabetic patients undergoing surgical management of ankle arthritis to rates seen in non-diabetic patients. Methods: Using the PearlDiver Technologies, Inc. database, Medicare patients diagnosed with ankle arthritis using ICD-9 codes were identified from 2005 to 2014. Patients were then sorted as diabetic or non-diabetic. Diabetic patients were then further stratified into Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM). Type 2 diabetics requiring insulin (T2ID) and not requiring insulin (T2NID) were also isolated. Patients were identified who underwent either AA or TAR utilizing ICD-9 procedure and CPT codes. These groups were evaluated for postoperative complications and reoperation rates. Chi-Squared testing was used to determine significance. Multivariate analysis was performed to determine whether diabetes represents an independent risk factor. Results: 1477 diabetic patients underwent TAR and 5399 underwent AA versus 3900 TAR and 7838 AA in nondiabetics. Diabetics undergoing AA experienced complications at 32.2%, reoperations at 30.8%, and revisions at 18.7% versus 13.3%, 22.3%, and 19.2% respectively in patients without diabetes(P<0.05). In diabetics undergoing TAR, the complication rate was 21.6% and reoperation rates were 16.9% versus 12.5% and 13% respectively in their non-diabetic counterparts(P<0.05). Revision rates were similar. Patients with T1DM had more reoperations and complications in both TAR and AA compared to those with T2DM (P<0.05). In both surgical groups, Patients with T2ID had more complications and reoperations than those with T2NID(P<0.05). Multivariate analysis revealed diabetes as an independent risk factor for complication and reoperation in AA but only complication in TAR(P <0.05). Conclusion: Patients with a diagnosis of diabetes mellitus experienced higher complication and total reoperation rates when undergoing either TAR or AA. T1DM appears to impart a greater risk of surgical complication and repeat surgical intervention than does T2DM. However when insulin is required in T2DM, complication and reoperation rates are similar to those of T1DM. Patient selection for surgical management of end-stage ankle arthritis should incorporate diabetic type and insulin dependency when considering surgical intervention.

scholarly journals A Mobile Computerized Decision Support System to Prevent Hypoglycemia in Hospitalized Patients With Type 2 Diabetes Mellitus

2016 ◽  
Vol 11 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Stephan Spat ◽  
Klaus Donsa ◽  
Peter Beck ◽  
Bernhard Höll ◽  
Julia K. Mader ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Decision Support ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Insulin Dose ◽  
User Acceptance

Background: Diabetes management requires complex and interdisciplinary cooperation of health care professionals (HCPs). To support this complex process, IT-support is recommended by clinical guidelines. The aim of this article is to report on results from a clinical feasibility study testing the prototype of a mobile, tablet-based client-server system for computerized decision and workflow support (GlucoTab®) and to discuss its impact on hypoglycemia prevention. Methods: The system was tested in a monocentric, open, noncontrolled intervention study in 30 patients with type 2 diabetes mellitus (T2DM). The system supports HCPs in performing a basal-bolus insulin therapy. Diabetes therapy, adverse events, software errors and user feedback were documented. Safety, efficacy and user acceptance of the system were investigated. Results: Only 1.3% of blood glucose (BG) measurements were <70 mg/dl and only 2.6% were >300 mg/dl. The availability of the system (97.3%) and the rate of treatment activities documented with the system (>93.5%) were high. Only few suggestions from the system were overruled by the users (>95.7% adherence). Evaluation of the 3 anonymous questionnaires showed that confidence in the system increased over time. The majority of users believed that treatment errors could be prevented by using this system. Conclusions: Data from our feasibility study show a significant reduction of hypoglycemia by implementing a computerized system for workflow and decision support for diabetes management, compared to a paper-based process. The system was well accepted by HCPs, which is shown in the user acceptance analysis and that users adhered to the insulin dose suggestions made by the system.

scholarly journals Placement of insulin pump by telemedicine

2020 ◽  
Vol 23 (4) ◽  
pp. 281
Author(s):  
Foglia , A.
Keyword(s):  
Insulin Therapy ◽  
Insulin Pump ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Insulin Pumps ◽  
Pump System ◽  
Telemedicine System ◽  
Glycemic Monitoring

In the lockdown period, during the recent pandemic from COVID-19, the use of telemedicine for all categories of chronic patients has been encouraged by all scientific societies and governing bodies. In type 1 diabetic patients, telemedicine has been used for some time to control and verify the state of metabolic balance, through specific platforms for data download. There are numerous evidences that support the positive effect of insulin therapy by insulin pump (CSII) compared to multinjective insulin therapy and the use of continuous blood glucose monitoring systems (CGM) and integrated insulin pump systems and glycemic monitoring (SAP). The purpose of our study is to describe the results of our first experience of remote implants through the use of telemedicine of insulin pumps and continuous glycemic monitoring in four patients with type 1 diabetes in low metabolic compensation complicated by hypoglycemias. Two weeks after the insulin pump has been implanted, a hypoglycemic episode reset was recorded in all patients and the ‘time in range’ was greater than 90% in three of the four patients. Furthermore, the implanted patients were given a survey to evaluate their experience and everyone declared that they were satisfied overall. Our first and small experience of pump system through the use of remote technologies has obtained encouraging results and could be taken into consideration for the therapeutic management of selected patients, trained in the use of technologies and followed over time. KEY WORDS diabetes mellitus; insulin pumps; telemedicine system.

scholarly journals Chronic pancreatitis and diabetes mellitus: a review of the literature

2019 ◽  
Vol 47 (6) ◽  
pp. 525-534
Author(s):  
E. Yu. Lomakina ◽  
O. V. Taratina ◽  
E. A. Belousova
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Pancreatitis ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Pancreatic Insufficiency ◽  
Diabetic Patients ◽  
Pancreatic Diseases ◽  
Pathophysiological Mechanisms

Background: For a long time there has been a discussion about how chronic pancreatitis (CP) and diabetes mellitus (DM) are related to each other. If a patient has both conditions, should they be viewed as two separate disorders, or one of them is a plausible consequence of the other? If the latter is true, what are pathophysiological mechanisms of DM in CP? Current consensus documents by specialists in pancreatic diseases pay little attention to this issue, and their main statements have low level of evidence. The Russian consensus on the diagnosis and treatment of CP (2016) contains no statements on DM. In the Russian guidelines and consensus documents to be developed, it is necessary to include provisions on the pancreatogenic DM as an independent “other type DM’, with consideration of its pathophysiological mechanisms and clinical particulars.Aim: To characterize the state-of-the-art in pancreatogenic DM, to demonstrate its differences from DM types 1 and 2 from pathogenetic and clinical perspectives.Methods: The review is based on the results of meta-analyses, systematic reviews and main provisions of the existing clinical guidelines and consensus documents available from PubMed and E-library.Results: According to various sources, Type 3c DM, or latent impaired glucose tolerance in CP, can eventually develop in 25 to 80% patients with CP. Impaired glucose tolerance is found in 40 to 60% of patients with acute pancreatitis, with persistent hyperglycemia after acute episode seen in 15 to 18% of the patients. Exocrine pancreatic insufficiency is commonly seen in Type 1 and Type 2 diabetic patients, although the data on its prevalence are highly contradictory indicating a lack of knowledge in the field. Type 3c DM is characterized by its manifestation at later stages of CP, concomitant excretory deficiency of the pancreas, brittle course with proneness to hypoglycemia and no ketoacidosis. The highest risk group includes patients with longstanding CP, previous partial pancreatic resection and patients with early calcifying pancreatitis, mainly of the alcoholic origin. Optimal and rational medical treatment of pancreatogenic DM still remains disputable, while the evidence base of the efficacy and safety of various anti-diabetic agents in this disease is lacking, and no consensus on the issue has been yet reached. General treatment guidelines given in a number of international consensus documents are limited to cautious insulin administration.Conclusion: Pancreatogenic DM differs from Type 1 and Type 2 DM in a number of aspects, namely, mechanisms of hyperglycemia, hormonal profiles, clinical particulars and treatment approaches. Endocrine pancreatic insufficiency in CP is caused by secondary inflammatory injury of the pancreatic islets. The key to specifics of Type 3c DM lies in anatomical and physiological interplay of the exocrine and endocrine compartments of the pancreas. At presents, most provisions on pancreatogenic DM are empirical and seem to be rather declarative, because intrinsic mechanisms of this type of diabetes and moreover its pathogenetically based treatment have been poorly studied. Nevertheless, all patients with CP or other pancreatic diseases should be assessed for pancreatogenic DM.

scholarly journals Asociación del control glucémico con la disfunción eréctil en pacientes diabéticos

2017 ◽  
Vol 77 (1) ◽  
Author(s):  
Juan Figueroa García Juan
Keyword(s):  
Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Glycemic Control ◽  
Odds Ratio ◽  
Glycated Hemoglobin ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Control Glucémico ◽  
Inadequate Glycemic Control

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

scholarly journals THE EFFECTIVENESS OF CELL PHONE-BASED MENTORING THROUGH SMS ON DIET COMPLIANCE AMONG TYPE 2 DIABETES MELLITUS (T2DM) PATIENTS

2019 ◽  
Vol 2 (3) ◽  
pp. 135-141
Author(s):  
Ratna Dewi ◽  
Rostinah Manurung ◽  
Sarmaida Siregar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cell Phone ◽  
Diabetes Management ◽  
Control Group ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Diet Compliance

Appropriate diet and physical exercise is part of diabetes management. The role of health professionals is critical to regulating the lifestyle of type 2 DM patients. The study aimed at examining the effectiveness of cell phone-based mentoring on dietary compliance. A quasi-experimental study design, pre and post-test equivalent with the control group. The research was conducted at Bromo Medan Health Center. We recruited 84 diabetic patients and divided into the experimental and control group. The findings showed there was a positive effect on the patients in the experimental group who received the program than patients in the control group who did not receive the application. This strategy is essential and recommended to apply in the routine diet at home. Keywords: short message service (SMS), diet compliance, type 2 diabetes mellitus

scholarly journals Genetic Aspects of Diabetes Mellitus

2001 ◽  
Vol 44 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Eliška Marklová
Keyword(s):  
Diabetes Mellitus ◽  
Gene Mutations ◽  
Specific Gene ◽  
Diabetic Patients ◽  
Complex Interactions ◽  
Hla Dq ◽  
Genetic And Environmental Factors ◽  
Type 1 Dm

Practically all types of diabetes mellitus (DM) result from complex interactions of genetic and environmental factors. Multifactorial and polygenic Type 1 DM is strongly influenced by genes controlling the immune system, mainly HLA-DQ and DR. In addition to this, many other predisposition loci, interacting with each other, have some influence on susceptibility to DM. Heterogeneous Type 2 DM, accounting for about 85 % of all diabetic patients, is supposed to be induced by multiple genes defects involved in insulin action and/or insulin secretion. Other genetically influenced traits like obesity and hyperlipidemia are strongly associated with the Type 2. The group called Other specific types of DM include monogenic forms MODY 1-5 and many various subtypes of the disease, where the specific gene mutations have been identified. Both genetic and intrauterine environmental influences are likely to contribute to the abnormalities defined as Gestational DM.

scholarly journals Self-monitoring of blood glucose in Black Caribbean and South Asian Canadians with non-insulin treated Type 2 diabetes mellitus: a qualitative study of patients’ perspectives

2021 ◽  
Author(s):  
Enza Gucciardi ◽  
Mariella Fortugno ◽  
Andrea Senchuk ◽  
Heather Beanlands ◽  
Elizabeth McCay ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
South Asian ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Management Tool ◽  
Structured Interviews ◽  
Black Caribbean

Background: To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus. Methods: Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis. Results: The frequency of monitoring among participants varied from several times a day to once per week. Most participants expressed similar experiences regarding their views and practices of SMBG. Minor differences across gender and culture were observed. All participants understood the benefits, but not all viewed SMBG as beneficial to their personal diabetes management. SMBG can facilitate a better understanding and maintenance of self-care behaviours. However, it can trigger both positive and negative emotional responses, such as a sense of disappointment when high readings are not anticipated, resulting in emotional distress. Health care professionals play a key role in the way SMBG is perceived and used by patients. Conclusion: While the majority of participants value SMBG as a self-management tool, barriers exist that impede its practice, particularly its cost. How individuals cope with these barriers is integral to understanding why some patients adopt SMBG more than others.

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