scholarly journals ACTRAPID AND PROTAPHANE ALLERGY: RECURRENT URTICARIA, ANGIOEDEMA. CLINICAL CASE

2017 ◽  
Vol 14 (6) ◽  
pp. 36-42
Author(s):  
A S Prylutski ◽  
O A Prylutskaya ◽  
E S Polkovnik

The increasing number of the patients with diabetes who use insulin for treatment makes the study of side effects to the above mentioned medicines important and relevant. Due to the current use of human genetically engineered insulin analogues, complications caused by their use develop less often. We described the case of an allergic reaction to the аctrapid and рrotaphane in a patient with Type 1 Diabetes manifested in the form of chronic, recurrent urticaria and angioedema. Sensitization to the above mentioned insulin preparations was proved clinically and with specific immunoallergological methods. The replacement of insulin preparations caused a stable clinical effect.

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 597-600
Author(s):  
Vesselina Yanachkova ◽  
Radiana Staynova

Insulin-induced lipoatrophy is a rare skin complication in patients with diabetes mellitus. It is characterized primarily by localized subcutaneous atrophy of the fatty tissue at the site of frequent insulin injection. We report a clinical case of a 38-year-old woman with lipoatrophy, developed during treatment with insulin analogues. Lipoatrophic zone formation began 3 months after the treatment was initiated. A lipoatrophic defect developed on the thighs and the upper outer arms, resulting from repeated insulin injections at the same site. Regarding lipoatrophic areas, treatment with topical administration of corticosteroids was attempted but without a significant clinical effect. The best prevention from lipoatrophy development is education of patients regarding rotation of insulin injection sites and more frequent needle change.


Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


Author(s):  
Eman Monir Sherif ◽  
Yasmine Ibrahim Elhenawy ◽  
Randa Mahmoud Matter ◽  
Hanan Hassan Aly ◽  
Rasha Adel Thabet ◽  
...  

Abstract Objectives COVID-19 pandemic significantly impacted the diagnosis of type 1 diabetes and its acute complications. Thus, the study aimed to evaluate the characteristics of pediatric patients with type 1 diabetes hospitalized during the first wave of the pandemic and the prevalence of new onset diabetes among patients with evidence of COVID-19 infection. Methods A single-center surveillance study included all patients with diabetes admitted to Children’s Hospital, Ain Shams University, in Egypt between May to August 2020. Data were collected to evaluate patients’ clinical and laboratory characteristics as well as their outcomes. Results Thirty-six patients were admitted during the study period. The mean age was 8.4 ± 3.8 years. Patients presented late to the emergency department with a mean delay of 3.05 ± 1.19 days from onset of symptoms. 34/36 patients presented in diabetic ketoacidosis (DKA), 50% presenting in severe DKA. Almost 81% of the patients were newly diagnosed. During the study period, SARS-CoV-2 PCR was found positive in four patients, COVID Ig M antibodies were positive in another two patients; all were symptomatic requiring ICU admission. Four patients showed a picture suggestive of the multi-inflammatory syndrome (MIS-C); cardiac affection was a constant feature. Conclusions The pandemic affected both the prevalence and severity of DKA among pediatric patients. The increased prevalence of severe DKA could be partly related to delayed hospital admission or the effect of COVID-19 in triggering DKA. Efforts should be done to continuously raise awareness about diabetes in children as well as the importance of seeking timely medical guidance.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 962 ◽  
Author(s):  
Bolla ◽  
Caretto ◽  
Laurenzi ◽  
Scavini ◽  
Piemonti

Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. Studies in the literature are indeed controversial, possibly because these diets are generally poorly defined; this, together with the intrinsic complexity of dietary interventions, makes it difficult to compare results from different studies. Despite the evidence that reducing carbohydrates intake lowers body weight and, in patients with type 2 diabetes, improves glucose control, few data are available about sustainability, safety and efficacy in the long-term. In this review we explored the possible role of low-carb and ketogenic diets in the pathogenesis and management of type 2 diabetes and obesity. Furthermore, we also reviewed evidence of carbohydrates restriction in both pathogenesis of type 1 diabetes, through gut microbiota modification, and treatment of type 1 diabetes, addressing the legitimate concerns about the use of such diets in patients who are ketosis-prone and often have not completed their growth.


2017 ◽  
Vol 34 (5) ◽  
pp. 625-631 ◽  
Author(s):  
P. L. Kristensen ◽  
L. Tarnow ◽  
C. Bay ◽  
K. Nørgaard ◽  
T. Jensen ◽  
...  

2021 ◽  
Vol 7 (12) ◽  
pp. 97-103
Author(s):  
O. Terekhova ◽  
Furtikova

All over the world, an increase in type 1 diabetes mellitus is noted annually, along with its late complications. In recent years, more and more information has appeared aimed at the prevention and rehabilitation of children with diabetes. Type 1 diabetes mellitus is a genetically determined disease, in the development of which the main component is an autoimmune process that triggers the destruction of β-cells, which leads to a decrease in insulin production, and subsequently to its absolute insufficiency, the main method of treatment is insulin replacement therapy. To select an adequate dose of insulin, it is necessary to take into account HbA1c, glycemic and glucosuric profiles. Children are advised to use semi-synthetic or genetically engineered insulins. In children, intensified insulin therapy is more often used in the form of a combination of short and medium-acting insulins or ultra-short with prolonged ones. This article presents an analysis of insulin therapy and self-control in children and adolescents with type 1 diabetes mellitus and diabetic nephropathy. It was found that children with diabetic nephropathy approached their illness less responsibly, did not always count bread units and kept records in self-control diaries. Also, this group of children were more likely to receive human insulin with the use of syringe pens. The nutrition of children with diabetes should not be inferior in calories to that of healthy adolescents, while the energy value of the daily diet should be calculated taking into account age, gender, body weight, and energy expenditures. Taking into account the possibility of regression of the initial diabetic complications when the compensation of carbohydrate metabolism is achieved, therapy for type 1 diabetes is a means of preventing the development of severe diabetic complications.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Enrico Borrelli ◽  
Domenico Grosso ◽  
Mariacristina Parravano ◽  
Eliana Costanzo ◽  
Maria Brambati ◽  
...  

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.


2020 ◽  
Author(s):  
Matthieu Wargny ◽  
Pierre Gourdy ◽  
Lisa Ludwig ◽  
Dominique Seret-Bégué ◽  
Olivier Bourron ◽  
...  

Since the start of the COVID-19 pandemic, patients with diabetes were rapidly recognized as a high-risk population for severe disease. Indeed, a high prevalence of diabetes among patients with COVID-19 who required hospitalization has been consistently reported, reaching 33.8% in 5,700 people hospitalized for COVID-19 in New York City area (1). In addition, diabetes was associated with more than a double risk of intensive care unit (ICU) admission and more than a triple risk of death (2). However, precise data regarding the type of diabetes are scarce. We report here the clinical characteristics and early prognosis of patients with type 1 diabetes (T1D) hospitalized for COVID-19 in the nationwide multicenter observational CORONADO (CORONAvirus-SARS-CoV-2 and Diabetes Outcomes) study (3).


2011 ◽  
Vol 14 (4) ◽  
pp. 29-31 ◽  
Author(s):  
Irina Arkad'evna Bondar' ◽  
Vadim Valer'evich Klimontov ◽  
Ekaterina Mikhailovna Parfent'eva ◽  
Vyacheslav Vital'evich Romanov ◽  
Alexander Petrovich Nadeev

Aim. To determine the diagnostic value of urinary excretion of type IV collagen in patients with type 1 diabetes with different stages of nephropathy.Methods. Urinary type IV collagen was determined in 60 patients with type 1 diabetes (23 with normal albuminuria, 28 with microalbuminuriaand 9 with macroalbuminuria) by an enzyme immunoassay. 10 healthy individuals were acted as the control group. Renal biopsy was performedin 22 patients. Deposits of type IV collagen were revealed by 11 individuals by immunohistochemistry. Results. The urinary excretion of type IV collagen increased with severety of diabetic nephropathy, correlating with the urinary albumin/creatinineratio, serum creatinine and parameters of daytime and nighttime systolic and diastolic blood pressure. Patients with excessive accumulation of typeIV collagen in the glomeruli had significantly higher level of type IV collagen in the urine. Conclusion. The determination of urinary type IV collagen can be used for early detection of renal fibrosis in patients with type 1 diabetes.


Sign in / Sign up

Export Citation Format

Share Document