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

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

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 The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin

2020 ◽  
Vol 27 (1) ◽  
pp. 14-27
Author(s):  
Lorenzo Brognara ◽  
Iacopo Volta ◽  
Vito Michele Cassano ◽  
Emmanuel Navarro-Flores ◽  
Omar Cauli
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Glycemic Control ◽  
Cognitive Dysfunction ◽  
Cognitive Functions ◽  
Diabetic Foot ◽  
Glycated Hemoglobin ◽  
Diabetic Patients ◽  
Adherence To Treatment

Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician’s recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac > 7%) significantly (p < 0.05) associated with MMSE and adherence to treatment in the 1 month follow-up visit. Receiver operating characteristic curve analysis showed that both HB1Ac and the MNSI score significantly (p < 0.05) discriminate subsequent adherence to treatment for foot complication, with a sensitivity of 80.0–73.3% and specificity 70.6–64.7%, respectively. Proper control of foot complications in diabetic patients involves appropriate glycemic control and less severe neuropathy, and seems to be unrelated to cognitive dysfunction, and warrants further studies in order to tailor appropriate treatments to central and peripheral nervous system disorders. Poor glycemic control (Hb1Ac level > 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician’s recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged ≥ 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot.

scholarly journals Glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110230
Author(s):  
Tadesse Alemu ◽  
Tirhas Tadesse ◽  
Getasew Amogne
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Poor Glycemic Control ◽  
Diabetic Patients

Objective: The objective of the study was to explore the level of glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Addis Ababa, Ethiopia. Methods: Cross-sectional study design was employed. The sample size was determined using a single proportion formula and 245 patients with type 2 diabetes mellitus were involved in this study. Systematic sampling method was used to select the study subjects. Standard questionnaire was used to collect patient’s biographic data, economic data, self-care activities, and patient compliance to medications. Summary statistics of a given data were calculated. Logistic regression model was used to measure the relationship between the outcome and predictor variable. Direction and strength of association was expressed using odds ratio and 95% confidence interval. Result: More than three-fourth, 191 (80.3%) of diabetic patients had poor glycemic control. Poor glycemic control was found to be 7.03 times higher among diabetic patients with duration of 5–10 years (adjusted odds ratio = 7.03, 95% confidence interval = 2.7–18.6). Similarly, diabetic patients with a duration of above 10 years were poorly controlled their blood sugar level (adjusted odds ratio = 2.3, 95% confidence interval = 1.028–5.08) in comparison to diabetic patients with a duration of fewer than 5 years. It was also found that compliance with a specific diet was significantly associated with good control of blood sugar level (adjusted odds ratio = 3.7, 95% confidence interval = 1.24–11.13). Conclusion: The magnitude of patients with poor glycemic control was high. Duration of diabetes and non-compliance with diets high in fruits, vegetables, and diets low in fat and sugar were significantly related to uncontrolled blood glucose levels. Therefore, developing strategies targeted toward improving blood glucose control with special attention to diabetes mellitus (DM) patients with a duration of ⩾5 years and those who poorly comply with their diet was strongly recommended.

scholarly journals Consequences of misdiagnosis of diabetic charcot anthropathy of the ankle

1970 ◽  
Vol 4 (2) ◽  
pp. 83-86
Author(s):  
Chowdhury Iqbal Mahmud
Keyword(s):  
Diabetes Mellitus ◽  
Ankle Fracture ◽  
Ankle Arthrodesis ◽  
Fracture Dislocation ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Charcot Arthropathy ◽  
Uncontrolled Diabetes ◽  
History Of

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

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.
Keyword(s):  
Diabetes Mellitus ◽  
Influenza Vaccine ◽  
Pertussis Vaccine ◽  
Online Survey ◽  
Influenza Infection ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Patients With Diabetes ◽  
Prevention Plan

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.

scholarly journals Prevalence of Erectile Dysfunction in Patients with Diabetes Mellitus and Its Association with Body Mass Index and Glycated Hemoglobin in Africa: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Erectile Dysfunction ◽  
Body Mass ◽  
Glycated Hemoglobin ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Pooled Prevalence ◽  
Patients With Diabetes

Background. Mortality and morbidity in patients with diabetes mellitus (DM) are attributed to both microvascular and macrovascular complications. However, there is a significant amount of variation in the primary studies on DM regarding the prevalence of erectile dysfunction (ED) in Africa. Therefore, this study was aimed to estimate the pooled prevalence of ED patients with DM and its association with body mass index (BMI) and glycated hemoglobin in Africa. Methods. PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were searched for studies that looked at ED in DM patients. A funnel plot and Egger’s regression test were used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. The subgroup and meta-regression analyses were conducted by country, sample size, and year of publication. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. STATA version 14 statistical software was used for the meta-analysis. Result. A total of 13 studies with 3,501 study participants were included in this study. We estimated that the pooled prevalence of ED in patients with DM in Africa was 71.45% (95% CI: 60.22–82.69). Diabetic patients whose BMI was ≥30 kg/m2 were 1.26 times more likely to develop ED (AOR = 1.26; 95% CI: 0.73–2.16) and whose glycated hemoglobin was <7% were 7% less likely to develop ED (AOR = 0.93; 95% CI: 0.5–5.9), although they were not significantly associated with ED. Conclusions. The prevalence of ED in DM patients in Africa remains high. Therefore, situation-based interventions and country context-specific preventive strategies should be developed to reduce the prevalence of ED among patients with DM.

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.

A STUDY TO CORRELATE TOTAL CALCIUM AND GLYCATED HEMOGLOBIN IN TYPE-2 DIABETES PATIENTS.

2021 ◽  
pp. 62-63
Author(s):  
V Indhumathi ◽  
M. Priyatharshini ◽  
P. Muraliswaran ◽  
S Dhanoushyaa
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycated Hemoglobin ◽  
Diabetic Patients ◽  
Total Calcium ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Background: The risk for developing diabetic complications are related to glycemic control which is measured by estimating the glycated hemoglobin (HbA1c) level. Calcium increases the GLUT 4 activity. Change in calcium alters the insulin receptor phosphorylation, and decreases the activity of glucose transporter Objective: To nd out the correlation between serum Calcium and glycated Haemoglobin in Type 2 Diabetes Mellitus patients. Materials And Methodology: A cross sectional study which included 100 type 2 Diabetes mellitus patients, divided into 2 groups based on HbA1c levels. Group 1 : Type 2 Diabetic patients with HbA1c more than 7 percent and Group 2 : Type 2 Diabetic patients with HbA1c less than 7 percent. Total calcium level was correlated with glycated hemoglobin level. Statistical analysis was done using unpaired t test. Result: The mean value of serum total calcium was lower in the diabetic group whose HbA1c was > 7 (p value – 0.000) when compared to the diabetic group whose HbA1c was <7. A strong negative correlation (r = -0.391) between calcium and HbA1c in the T2 diabetic patients with HbA1c >7 (p = 0.000) was observed. Conclusion: Alteration in calcium levels will have adverse effects on insulin secretion and release. Estimating the level of calcium becomes important to know the status of insulin in diabetic patients and correlating the levels of HbA1c and Serum Calcium in Type 2 DM patients, can monitor the levels of glycemic control and the risk of development of complications. Calcium supplementation to the diabetic patients can help in better glycemic control and prevent diabetes related complications

scholarly journals Left ventricular diastolic dysfunction in diabetes mellitus and the therapeutic role of exercise training

2019 ◽  
Vol 10 (10.2) ◽  
pp. 145-152
Author(s):  
Adriana Albu ◽  
Ioana Para
Keyword(s):  
Diabetes Mellitus ◽  
Exercise Training ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Metabolic Disturbances ◽  
Ventricular Diastolic Dysfunction

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,

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