scholarly journals Cardiovascular ultrasound implementation for a pragmatic approach to the diabetic patient

2021 ◽  
Vol 24 (3) ◽  
pp. 178
Author(s):  
Greco, E.L.
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Patient ◽  
Therapeutic Approach ◽  
Cardiovascular Complications ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Patient Stratification ◽  
Pragmatic Approach ◽  
Ultrasound Machine ◽  
Natural Context

The tailoring of the management of diabetes is the fundamental task of the diabetologist who requires very different skills to guarantee the best diagnostic path and the best treatment for patients. To enrich the range of “measures” necessary for this customization process, it is now possible to use a tool that is now accessible to everyone: the ultrasound machine. Through some simple ultrasound scans, using a minimum amount of time, it is possible to acquire useful information for correct patient stratification and for a rational therapeutic approach, as recommended by the guidelines. The path for the certification of the skills of the diabetologist expert in the management of cardiovascular complications could be the natural context for the placement of these techniques. KEY WORDS diabetes mellitus; cardiovascular complications; tailoring of therapy; echocolordoppler; echocardiography.

Evaluation of complications of the late postoperative period in patients with diabetes mellitus after drainage surgery of neovascular glaucoma

2021 ◽  
pp. 10-12
Author(s):  
V.A. Biletskaya ◽  
◽  
D.V. Lipatov ◽  
M.A. Frolov ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Neovascular Glaucoma ◽  
Research Centre ◽  
Federal State ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Surgical Methods

Today diabetes mellitus (DM) is one of the leading medical and social problems. Its complications lead to terrible concomitant pathologies that qualitatively affect the lives of patients. At the end of 2019, there were more than 463 million people with diabetes in the world and this number is increasing every year. Diabetic retinopathy (DR) is one of the most severe complications of DM on the organ of vision. Secondary neovascular glaucoma (NG) is a manifestation of the end-stage proliferative DR. This is a relatively rare but difficult-to-treat pathology that often leads working-age patients to disability and impaired social adaptation. The main objective of treatment for NG is to compensate for intraocular pressure (IOP), but conservative (drug) therapy is often ineffective. Therefore, doctors are forced to use surgical methods of treatment. At the same time, do not forget about the multiple complications during the operation, as well as in the early and late postoperative periods. A special feature of the course of NG in patients with DM is its combination with the failure of the ligamentous-capsular apparatus of the lens, iris bombage, anterior and posterior synechiae, traction retinal detachment and various hemorrhagic complications. All this allows us to talk about the so-called diabetic glaucoma (DG). Currently, drainage devices have become the standard in the treatment of refractory NG. The effectiveness of such operations according to various sources is about 70-80% of success. Purpose. To assess the condition of patients with DM in the late (10-15 years) postoperative period after performing NG drainage surgery, to analyze the effectiveness of the intervention by studying the dynamics of IOP, the presence or absence of pain syndrome and various intraocular complications. Material and methods. During the period 2006-2020, 150 patients with NG and DM were operated on in the Department of Diabetic Retinopathy of the Federal State Budgetary Institution «Endocrinology Research Centre» of the Ministry of Health of the Russian Federation. Results. In 100% of the postoperative period, the pain syndrome was stopped. And also, in 59.7% of cases, the presence of late complications: vascular thorn, EED, subatrophy and anophthalmos. Conclusion. Despite the presence of complications, drainage surgery in patients with DM continues to be an effective method of choosing surgical treatment for patients with uncompensated NG. Key words: diabetes mellitus; diabetic retinopathy; neovascular glaucoma; drainage surgery.

Glucose Control

2020 ◽  
Author(s):  
Timothy P. Graham ◽  
Erich N. Marks ◽  
Joshua J. Sebranek ◽  
Douglas B. Coursin
Keyword(s):  
Diabetes Mellitus ◽  
Critically Ill ◽  
Glucose Control ◽  
Cost Of Care ◽  
Hospital Length Of Stay ◽  
Glucose Measurement ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Adult Intensive Care Unit ◽  
Patients With Diabetes

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

scholarly journals Effect of Fenugreek (Methi) on Cortical Thickness of the Thymus in Streptozotocin-Induced Diabetic Rats

1970 ◽  
Vol 7 (1) ◽  
pp. 37-41
Author(s):  
DK Mondal ◽  
MMA Moinuddin ◽  
MM Saha ◽  
AM Khanom ◽  
BMA Yousuf ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cortical Thickness ◽  
Diabetic Control ◽  
Diabetic Rats ◽  
Control Group ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Nondiabetic Control ◽  
The Mean ◽  
Long Evans

Objective: To find out microscopically whether Trigonella foenumgraecum (fenugreek seeds/methi seeds) has got any preventive role against the lowering of cortical thickness of the thymic lobules in diabetes mellitus. Design: An experimental study on Long Evans rats which were divided into three equal groups depending on their different shorts of dietary feeding and drug treatment. Setting: Anatomy department of IPGMR (Institute of Post Graduate Medicine and Research) at present BSMMU (Bangabandhu Sheikh Mujib Medical University) and BIRDEM (Bangladesh Institute of Research and Rehabilitation in diabetes, Endocrine & Metabolic Disorders). Subjects: Fifty eight healthy young Long Evans rats of either sex weighing 72 to 174gm aged between 50 to 60 days were used in this study. Main outcome measures: Variation of cortical thickness of the thymic lobules in different groups of rat. Result: Cortical thickness in the nondiabetic control group, which ranges from 30.17 to 36.99. and the mean was 34.83 ± 0.60. In diabetic control group the cortical thickness ranges from 17.78 to 26.46 and the mean was 21.85 ± 1 On the other hand, in the fenugreek- treated diabetic rats the cortical thickness ranges from 25.71 to 32.95 and mean cortical thickness was 30.49 ± 0.75. Conclusion: Fenugreek showed a tendency of acting against lowering of the cortical thickness of the thymic lobule of Streptozotocin-induced diabetes mellitus. However, further investigations are recommended for establishing fenugreek as a safe, useful effective agent to preserve the cortical thickness improving the diabetic condition by acting as antidiabetogenic agent. Key words: Diabetes mellitus, Differential lymphocyte count, Fenugreek, Thymus   doi: 10.3329/bja.v7i1.3017 Bangladesh Journal of Anatomy January 2009, Vol. 7 No. 1 pp. 37-41

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

THE EFFECT OF HEALTH EDUCATION THROUGH SESSION-HEALTH APPLICATION MEDIA ON BEHAVIOR MANAGEMENT BEHAVIOR OF DIABETES MELITUS IN BENGKULU CITY

2019 ◽  
Vol 8 (2) ◽  
pp. 115-123
Author(s):  
Hanifah Hanifah ◽  
Vike Pebri Giena ◽  
Ruri Maiseptya Sari
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Behavior Management ◽  
Sampling Technique ◽  
Diabetic Complication ◽  
Self Management ◽  
Key Words Diabetes Mellitus ◽  
Cluster Sampling ◽  
Key Words Diabetes ◽  
Management Behavior

Background: Diabetes mellitus (DM) is a chronic disease that requires specific self-management behavior for a lifetime, to avoid long-term diabetic complication. Education about diabetes self-management for people with diabetes mellitus and families is absolutely necessary to overcome diabetic complications. The use of smartphones as educational media provides space for people with DM without restrictions on place and time.Objective: The aims of this study was to identify the effect of health education through the Salam-Sehat application media on diabetes self-management behavior.Method: This research is quantitative with pre-experiment design with one group pre-test post-test. The population of this study was all people with DM in Bengkulu City. Sample was selected by using Multi Stages Cluster Sampling technique. The sample size was determined using the Slovin formula which results are 384 respondents. The sample was selected by using proportional random sampling. The Data were analyzed by using the Wilcoxon Signed Rank Test.Result: The results showed that the average DM self-management behavior before being given education through the Salam-Sehat application was 35.42 and the average DM self-management behavior after being given education through the Salam-Sehat application was 65.18. There is significant influence of health education through Salam-Sehat application media for self-management behavior among diabetes mellitus people in Bengkulu City, with Asymp value. Sig (p) = 0.000.Conclusion: It is expected that the research results of the Salam-Sehat application can be used as an online-based health education media that provides convenience in obtaining health information without being limited by space and time for people with DM in Bengkulu City. Key words: Diabetes Mellitus, Self-Management, Application.

Preoperative Assessment of the Patient with Diabetes Mellitus

2019 ◽  
Author(s):  
Sean A. Josephs ◽  
Gretchen A. Lemmink
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Ketoacidosis ◽  
Preoperative Assessment ◽  
Major Surgery ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Hyperglycemic Hyperosmolar State ◽  
Patients With Diabetes

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

The method of viscodissection with contrast enhancement of posterior hyaloid membrane for proliferative diabetic retinopathy surgery

2021 ◽  
pp. 127-129
Author(s):  
D.V. Petrachkov ◽  
◽  
A.G. Matyuschenko ◽  
L. Alkharki ◽  
A.L. Sidamonidze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Contrast Enhancement ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreoretinal Surgery ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Posterior Hyaloid ◽  
Retinal Breaks

Purpose. Study is to evaluate the efficacy of the method of viscodissection with contrast enhancement of posterior hyaloid membrane in PDR surgery. Material and methods. The study involved 26 patients with type 1 diabetes mellitus and severe PDR with the presence of tractional retinal detachment (TRD). All patients received treatment in the volume of lensectomy and IOL implantation, microinvasive vitrectomy, viscodissection with contrasting of epiretinal structures was performed, followed by segmentation and removal of membranes, endolaser coagulation followed by tamponade with sterile air of the vitreous cavity. Results. In all patients included in the study, with dynamic observation, there was a positive dynamics of morphofunctional indicators - best corrected visual acuity (BCVA) from 32.5-16.1 to 62.2-15.7 and central retinal thickness (CRT) according to optical coherence tomography (OCT) from 775.9-78.4 to 492.1-73.8 µm. Conclusion. The method of viscodissection with simultaneous contrast of the posterior hyaloid membrane facilitates the assessment of the quality of the separation of pathological membranes and improves the quality of visual control over the process of their separation, which reduces the risks of iatrogenic retinal breaks. Key words: diabetes mellitus, proliferative diabetic retinopathy, vitreoretinal surgery, viscodissection.

Heart failure in patients with diabetes in Campania

2019 ◽  
Vol 22 (4) ◽  
pp. 219
Author(s):  
Botta, A.
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Clinical Symptoms ◽  
Healthcare Services ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Antidiabetic Therapy ◽  
Patients With Diabetes

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.

scholarly journals Effect of Fenugreek (Methi) on Amount of Connective Tissue in Thymic Sections in Streptozotocin-induced Diabetic Rats

1970 ◽  
Vol 9 (1) ◽  
pp. 49-52
Author(s):  
DK Mondal ◽  
MMM Ahmed ◽  
PK Chowdhury ◽  
A Khanom ◽  
S Mohal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Connective Tissue ◽  
Diabetic Control ◽  
Diabetic Rats ◽  
Control Group ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Diabetic Control Group ◽  
Nondiabetic Control ◽  
Long Evans

Context: Diabetes mellitus causes a marked increased in amount of connective tissue in thymus. Fenugreek has the hypoglycaemic effect. The study was carried out to find out whether Trigonella foenumgraecum (fenugreek seeds/methi seeds) has got any preventive role against the increment in amount of connective tissue in thymic section in diabetes mellitus. Study type: an experimental study on Long Evans rats which were divided into three equal groups depending on their different sorts of dietary feeding and drug treatment. Setting: Anatomy department of the then IPGMR (Institute of Post Graduate Medicine and Research) at present BSMMU (Bangabandhu Sheikh Mujib Medical University) and BIRDEM (Bangladesh Institute of Research and Rehabilitation in diabetes, Endocrine & Metabolic Disorders). Subjects: Fifty eight healthy young Long Evans rats of either sex weighing 72 to 174gm aged between 50 to 60 days were used in this study. Main outcome measures: variation in amount of connective tissue in thymic sections in different groups of rats. Result: in the nondiabetic control group the increased in amount of connective tissue in thymic section is lower than in diabetic control group. On the other hand, the increased in amount of connective tissue in thymic section in the fenugreek-treated diabetic rats is also lower than the amount of connective tissue in thymic section in diabetic control group but it is more or less similar to the amount of connective tissue in thymic section in nondiabetic control group. Conclusion: Fenugreek showed a tendency of acting against the increased in amount of connective tissue in thymic section in Streptozotocin-induced diabetes mellitus. However, further investigations are recommended for establishing fenugreek as a safe, useful effective agent to minimize the increment in amount of connective tissue in thymic section improving the diabetic condition by acting as antidiabetogenic agent. Key words: Diabetes mellitus; Connective tissue; Fenugreek; Thymus DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8149 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 49-52

scholarly journals The effects of gallic acid and metformin on male reproductive dysfunction in diabetic mice induced by methylglyoxal: An experimental study

2021 ◽  
pp. 715-724
Author(s):  
Zeinab Behdarvand-Margha ◽  
Akram Ahangarpour ◽  
Mohammadreza Shahraki ◽  
Gholamreza Komeili ◽  
Layasadat Khorsandi
Keyword(s):  
Diabetes Mellitus ◽  
Experimental Study ◽  
Gallic Acid ◽  
Sperm Count ◽  
Control Group ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Diabetic Mice ◽  
Male Adult ◽  
Histological Changes

Background: Diabetes mellitus is a disease that has reached a dangerous point. Today, nearly 500 million men and women around the world live with diabetes. Gallic acid (Gal) affects diabetes. Objective: To evaluate the effects of Gal and metformin (met) on the levels of glucose, insulin, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sperm count, antioxidant status, and histological changes in the testes of diabetic mice induced by methylglyoxal (MGO). Materials and Methods: In this experimental study, 50 male adult NMRI mice, weighting 25-30 gr, aged 3-4 months were randomly divided into five equal groups (n = 10/each). (i) Control (vehicle, normal saline), (ii) MGO (600 mg/kg/d) orally for 28 days, (iii) Gal (50 mg/kg/d), (iv) MGO+Gal, and (v) MGO+met (200 mg/kg/d). Gal and met were administered orally for 21 consecutive days after the induction of diabetes. Blood samples were taken at 24 hr after the latest doses of treatment. Histological assessment of the testis was done, and the epididymis sperm count was obtained. Antioxidant indices, glucose, insulin, LH, FSH, and testosterone levels were measured. Results: In the MGO group compared to the control group, insulin, glucose (p = 0.001), LH (p = 0.04) and malondialdehyde (p = 0.001) were increased. However, the level of testosterone (p = 0.001), seminiferous tubule diameters, epithelial height, sperm count, superoxide dismutase activity (p = 0.02), and testis volume (p = 0.01) were decreased. The results indicated that Gal and met ameliorated the MGO effects. Conclusion: These findings suggested that the animals receiving MGO became diabetic. According to the results, Gal and met can effectively prevent MGO-induced diabetes. The effect of Gal was equivalent and sometimes better than metformin. Key words: Diabetes mellitus, Gallic acid, Male reproductive system, Metformin, Mice.

Sign in / Sign up

Export Citation Format

Share Document