Common causes and treatment of hypoglycemia in older patients with diabetes at Thanh Nhan hospital

2021 ◽  
Vol 25 (2) ◽  
pp. 76-85
Author(s):  
Trung Anh Nguyen ◽  
Thi Thu Huong Nguyen ◽  
Thi Thanh Huyen Vu
Keyword(s):  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Insulin Regimen ◽  
Cross Sectional ◽  
Common Cause ◽  
Glucose Injection ◽  
Number Of Patients ◽  
Common Causes ◽  
Patients With Diabetes ◽  
The Common

Objectives: To determine common causes and treatment of hypoglycemia in oler patients with diabetes at Thanh Nhan hospital. Methods: A cross-sectional study on 1215 diabetic patients treated at Thanh Nhan Hospital from November 2018 to May 2019. Subjects were interviewed according to a uniform medical record. Hypoglycemia was diagnosed according to the ADA 2018 criteria: blood glucose ≤ 3.9 mmol/l. Results: the most common cause of hypoglycemia was a reduced diet (49.6%); eating late (24.1%); skipping meals (9.3%); overdose, wrong insulin regimen due to patients (7.4%); overdose and wrong insulin regimen by doctor (4.2%). The proportion of patients receiving intravenous hypertonic glucose injection/infusion was 7.7%; eating foods containing glucose was 63.1%; eating foods containing carbonhydrat was 29.2%. The majority of patients with symptoms of hypoglycemia lasting within 15 minutes accounted for 56.3%, the number of patients with hypoglycemia lasting more than 60 minutes accounted for 0.9%. Conclusions: The common cause of hypoglycemia in the study subjects was mainly related to the patient's diet. The treatment of the patient's hypoglycemia was not completely correct. Therefore, medical staff should have measures to advise and educate about the causes as well as how to manage hypoglycemia for this subject regularly

scholarly journals Glycaemic Control Impact on Renal Endpoints in Diabetic Patients on Haemodialysis

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Danielle Creme ◽  
Kieran McCafferty
Keyword(s):  
Glycaemic Control ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Poor Glycaemic Control ◽  
Number Of Patients ◽  
Weight Gains ◽  
Before And After ◽  
Patients With Diabetes ◽  
The Impact

Objective. To identify the number of haemodialysis patients with diabetes in a large NHS Trust, their current glycaemic control, and the impact on other renal specific outcomes.Design. Retrospective, observational, cross-sectional study.Methods. Data was collected from an electronic patient management system. Glycaemic control was assessed from HbA1c results that were then further adjusted for albumin (Alb) and haemoglobin (Hb). Interdialytic weight gains were analysed from weights recorded before and after dialysis, 2 weeks before and after the most recent HbA1c date. Amputations were identified from electronic records.Results. 39% of patients had poor glycaemic control (HbA1c > 8%). Adjusted HbA1c resulted in a greater number of patients with poor control (55%). Significant correlations were found with interdialytic weight gains (P<0.02,r=0.14), predialysis sodium (P<0.0001,r=-1.9), and predialysis bicarbonate (P<0.02,r=0.12). Trends were observed with albumin and C-reactive protein. Patients with diabetes had more amputations (24 versus 2).Conclusion. Large number of diabetic patients on haemdialysis have poor glycaemic control. This may lead to higher interdialytic weight gains, larger sodium and bicarbonate shifts, increased number of amputations, and possibly increased inflammation and decreased nutritional status. Comprehensive guidelines and more accurate long-term tests for glycaemic control are needed.

scholarly journals DOES INSULIN LIKE GROWTH FACTOR-1 (IGF-1) DEFICIENCY HAVE A “PROTECTIVE” ROLE IN THE DEVELOPMENT OF DIABETIC RETINOPATHY IN THALASSEMIA MAJOR PATIENTS?

2015 ◽  
Vol 7 ◽  
pp. e2015038 ◽  
Author(s):  
Vincenzo De Sanctis
Keyword(s):  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Cross Sectional Study ◽  
Protective Role ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Italian Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients

Objective: This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of  thalassaemia major(TM) patients with insulin dependent diabetes mellitus (IDDM). Τhis relation was not previously evaluated, despite the fact that both diseases co-exist  in the same patient. The  study   also  describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM.   Design: A population-based cross-sectional study.  Participants:The study  includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients without  IDDM who visited our out-patient clinics for an endocrine assessment Methods: An extensive medical history, with data on associated complications and current medications, was obtained. Blood samples were drawn in the morning after an overnight fast to measure the serum concentrations of IGF-1, glucose, fructosamine , free thyroxine (FT4), thyrotropin (TSH) and biochemical analysis . Serologic screening assays for hepatitis C virus seropositivity (HCVab and HCV-RNA) were also evaluated,  applying routine laboratory methods.Plasma total IGF-1 was measured by a chemiluminescent immunometric assay (CLIA) method. Ophthalmology evaluation was done by the same researcher using stereoscopic fundus biomicroscopy through dilated pupils. DR was graded using the scale developed by the Global Diabetic Retinopathy Group. Iron stores were assessed by direct and indirect methods. Results:Eighteen TM patients with IDDM (94.7 %) and 10 non-diabetic patients (32.2 %) had IGF-1 levels below the 2.5th percentile of the normal values for the Italian population. The mean serum IGF-1 concentrations were significantly lower in the diabetic versus the non-diabetic TM groups (p < 0.001). DR was present in in 4 (21 %) of 19 TM patients with IDDM and was associated with the main classical risk factors, namely inefficient glycemic control  and duration of disease but not  hypertension. Using the scale developed by the Global Diabetic Retinopathy Group, the DR in our patients was classified as non proliferative diabetic retinopathy (NPDR). Only few numbers of microaneurysms [1-3] were detected. Our data also confirm the strong association of IDDM in TM patients with other endocrine and non-endocrine complications.Conclusions: These results , although on a small number of patients, suggest a possible ‘protective’ role of low IGF-1 in the development of DR in TM patients 

scholarly journals Psychiatric Disorders in Diabetic Patients in Rafsanjan

2021 ◽  
pp. 1-4
Author(s):  
Reza Bidaki ◽  
Parvin Agha Mohamad Hasani ◽  
Maryam Alireza Zade ◽  
Rezvan Sadr Mohammadi ◽  
Reza Bidaki ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Common Mental Disorders ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Demographic Questionnaire ◽  
Patients With Diabetes ◽  
Diabetes Center

Objective: To determine prevalence rates, associated features, and risk factors for psychiatric disorders subsequent to the diagnosis of IDDM. Methods: In this cross-sectional study were been selected 100 randomly who referred to Rafsanjan Diabetes Center. The data of this study is gathered demographic questionnaire and Minnesota Multi-phasic Personality Inventory (MMPI). Data was analysed with software SPSS-17. Results: 76% of the patients were female and 24% were men 45.4% of the illiterate population. The results showed hypochondriasis (22%) and schizophrenia (19%) and depression (11%) are three psychiatric disorders that patients with diabetes in high-risk groups have reported. Conclusion: The present study demonstrated that about 30-45% of patients with diabetes suffered from common mental disorders. The prevalence of some psychiatric disorders is considerable in diabetic patients in Rafsanjan.

scholarly journals Adherence of Patients with Diabetes to a Lifestyle Advice and Management Plan in Basra, Southern Iraq

2019 ◽  
Vol 25 (3-4) ◽  
pp. 100-105 ◽  
Author(s):  
Rawnaq Adil Aladhab ◽  
Majid Hameed Alabbood
Keyword(s):  
Management Plan ◽  
Cross Sectional Study ◽  
Complex Problem ◽  
Common Reason ◽  
Diabetic Patients ◽  
Lifestyle Advice ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Patients With Diabetes ◽  
Southern Iraq

<b><i>Background:</i></b> Poor adherence to treatment regimens is a complex problem, especially for those with chronic illnesses. Noncompliance is believed to be the most common reason for treatment failure in diabetic patients, leading to the absence of metabolic control and accelerating disease-related complications. Data on the adherence of people with diabetes in Iraq are lacking. <b><i>Objectives:</i></b> The purpose of this study was to measure the rate of adherence among Iraqi patients with diabetes. <b><i>Methods:</i></b> This was a cross-sectional study conducted in the Specialized Endocrine and Diabetes Center in Basra, southern Iraq, during the period from June to August 2018. Data were collected by completing an interviewing questionnaire consisting of 13 questions. <b><i>Results:</i></b> A total of 231 patients were included in the study (54.5% were female). Mean age was 51.85 ± 13.55 years. 65.4% of the participants were taking their medications at the right times. The most common reason for not taking their medication (48.8%) was difficulty in remembering the dosage times. 40.7% of the participants were sedentary. Only one-third of the patients followed their doctors’ instructions regarding diet. <b><i>Conclusions:</i></b> The rate of adherence to medication regimens and lifestyle advice was unsatisfactory in this study group. The awareness of diabetic patients and their caring physicians about the importance of adherence to therapy, exercise, and diet should be emphasized.

scholarly journals Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Wound Management ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

scholarly journals A study to assess the correlation between HbA1c and microalbuminuria among diabetics

2020 ◽  
Vol 8 (1) ◽  
pp. 16
Author(s):  
Sruthi Kare ◽  
Vishwanath N. Reddy ◽  
Thejdeep Mahamkali
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Socioeconomic Development ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Medical College ◽  
Significant Linear Correlation ◽  
Patients With Diabetes

Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients.  Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin.  Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.

scholarly journals COVID-19 Severity and Comorbidities in Diabetic Patients

2021 ◽  
Vol 10 (3) ◽  
pp. 91-98
Author(s):  
Hamid Reza Samimagham ◽  
Mehdi Hassani Azad ◽  
Mohsen Arabi ◽  
Dariush Hooshyar ◽  
Abbas Sheikhtaheri ◽  
...  
Keyword(s):  
Disease Severity ◽  
Demographic Factors ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Severity Of Disease ◽  
Significant Difference ◽  
Laboratory Results ◽  
Patients With Diabetes ◽  
Severe Group

Background: This study aimed to investigate the demographic factors, comorbidities, and laboratory results of diabetic patients with coronavirus disease 2019 (COVID-19) severity. Materials and Methods: This cross-sectional study enrolled 171 diabetic patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital in Hormozgan, Iran from 1 March to 1 June, 2020. Reverse-transcriptase polymerase chain reaction (RT-PCR) test was performed, and the patients were divided into three groups (mild, moderate, and severe) based on the severity of disease. Then we investigated the demographic factors, comorbidities, and laboratory results of diabetic patients with severe COVID-19 severity. Results: Regarding comorbidities, there was no significant difference between the three groups. Moreover, there was a significantly lower lymphocyte count in the severe group compared to moderate and mild groups (P = 0.001). We showed the increase in blood urea nitrogen (BUN) and creatinine to be significantly associated with increased disease severity (P = 0.001 and P = 0.009, respectively). We also showed a significant difference in aspartate aminotransferase (AST) levels between different groups of patients (P = 0.002) with a higher level of AST in the severe group (P = 0.020). Lactate dehydrogenase (LDH) and troponin were also significantly associated with an increase in COVID-19 severity in patients with diabetes (P = 0.013 and P = 0.002, respectively). Conclusion: There was a significant association between disease severity and BUN, creatinine, AST, LDH, and troponin levels in diabetic patients with COVID-19. There was no significant association between different groups regarding severity of disease and comorbidities.

scholarly journals Clinical course and outcome in diabetic patients with COVID-19

2020 ◽  
Vol 7 (2) ◽  
pp. e23-e23
Author(s):  
Zahra Davoudi ◽  
Ilad Alavi Darazam ◽  
Farnaz Saberian ◽  
Sina Homaee ◽  
Shervin Shokouhi ◽  
...  
Keyword(s):  
Glycated Hemoglobin ◽  
Clinical Course ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Patients With Diabetes ◽  
The Mean

Introduction: As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Objectives: The present research aimed to evaluate the outcome of diabetic patients with COVID-19 infection, and the clinical and biochemical characteristics in survived and non-survived patients. Patients and Methods: The present single-center, cross-sectional study examined laboratory and clinical features of 160 patients with diabetes who had moderate to severe criteria. The obtained data were categorized as survived or non-survived patients and then we compared the clinical characteristics in two groups. Results: In this study, 160 diabetic patients (75 men and 85 women) admitted with moderate to severe Covid-19 were evaluated. The mean age of studied patients was 51-90 years old, with diabetes duration of 5 to 15 years. One hundred thirty-one patients (81.9%) survived, but twenty-nine patients (18.1%) did not survive. Regarding the comparison of symptoms, only the loss of consciousness on admission was higher in non- survived patients; however, a majority of the non-survivors have been admitted to ICU, 23(79.3%) and 26 (89.6%) needed invasive mechanical ventilation; in comparison to survived patients also had a shorter duration of hospital stay (5.5±5.1 versus 8.4±6.1days). Non–survivors more probably suffer from high blood pressure [23 (79.3%) patients versus 80 (61%) patients] and chronic kidney disease [20 (69%) patients versus 9 (6.9%) patients; P<0.001]. Glycated hemoglobin (HbA1c) of more than 9%, and high fasting blood sugar, severe inflammatory response, hepatic, renal, and coagulation impairment was higher in non–survived than those who survived. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients; therefore, it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death.

scholarly journals Comparing the Suicidal Ideation in Diabetic Patients Receiving Insulin with Oral Medication

2020 ◽  
Author(s):  
Mahboube Ahmad Nazari ◽  
Hamid Oliaee ◽  
Reza Bidaki ◽  
Mohammad Hossein Sorbi
Keyword(s):  
Suicidal Ideation ◽  
Significant Relationship ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medication Treatment ◽  
Patients With Diabetes ◽  
Suicidal Ideation Questionnaire

Objective: Diabetes is one of the chronic diseases which can be accompanied with suicide. The study was conducted to assess and compare the prevalence of suicidal ideation in diabetic patients receiving insulin and oralmedication treatment. Materials and Methods: In this cross-sectional study, 2000 patients with diabetes supported by diabetes institute of Rafsanjan in 2017. After giving conscious permission, the patients filled in a demographic checklist and Beck suicidal ideation questionnaire. The data were analyzed using SPSS-16. Results: Prevalence of suicidal ideation in patients with diabetes receiving insulin was 3.2% (n=32) and in people receivingoral medication treatment was 3.1% (n=31). There were no association between suicidal ideation and the method of diabetes treatment. Suicidal ideation was more prevalent in illiterate people; however, no significant relationship was seen between suicidal ideation and education level. Also, there was no significant relationship between marital status and suicidal ideation. There was no relationship between suicidal thoughts and the method of treatment ( P -value: 0.05). Conclusion: Suicidal ideation is more prevalent in diabetic patients, but there were not differences between two group under insulin therapy and oral anti-diabetic agents.

scholarly journals Diabetic Foot: Clinical Presentations and Management Outcome

2017 ◽  
Vol 6 (2) ◽  
pp. 25-31
Author(s):  
Suttam Kumar Biswas ◽  
Shilpi Rani Roy ◽  
Subbrata Sarker ◽  
Md Mustafizur Rahman Biplob ◽  
Md Mustafizur Rahman Delta ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
College Hospital ◽  
Cross Sectional ◽  
Incision And Drainage ◽  
Knee Amputation ◽  
Uncontrolled Diabetes ◽  
Number Of Patients ◽  
Surgery Department

The diabetic foot, the foot of diabetic patients with ulceration, infection and/ or destruction of the deep tissues associated with neurological abnormalities and various degrees of peripheral vascular disease in the lower limb is quite common. A descriptive, cross-sectional study was carried out with an objective of assessing the common presentations and management outcome of diabetic foot. The study was carried out in the Surgery Department of Mymensingh Medical College Hospital, Mymensingh with a conveniently selected 130 patients of diabetic foot according to inclusion and exclusion criteria. The study period was one year. Out of 130 cases, the highest number of patients 55(42.4%) were in age group 50 to 59 years with a mean age of 60.1 years and standard deviation (SD) of 9.8 years. Majority of the patients 91(70.0%) were male. Of them, 83(91.2%) were smokers. Of 130, 51(39.2%) patients were illiterate and 41(31.5%) were farmer. Majority 67(51.53%) patients had history of uncontrolled diabetes for 10-15 years. Most of the patients, 97(74.6%) were presented with neuropathic ulcer, whereas 24(18.4%) ischemic ulcers and 9(7.0%) were infective ulcers, and majority of the lesions 49(37.7%) were located on toes. Highest number of patients, 44(33.8%) were treated conservatively, while 37(28.4%) were treated by debridement, dressing and resurfacing, 17(13.1%) were treated by incision and drainage, and 32(24.6%) patients were treated by amputation. Most of the patients, 108(83.1%) were cured, of them, 36(33.3%) were treated conservatively, while 31(28.7%) by debridement and dressing, 17(15.7%) were treated by toe disarticulation, 13(12.0%) by incision and drainage, 4(3.7%) by above knee amputation, 4(3.7%) by ray amputation and 3(2.8%) by below knee amputation. Illiterate male smokers in their 6th and 7th decades of life with uncontrolled diabetes are the victim of diabetic foot. Neuropathy, vasculopathy, infections and trauma are identified risk factors. Conservative treatment, debridement and dressing, off-loading, culture-guided antibiotics therapy and amputations are the most successful modalities. CBMJ 2017 July: Vol. 06 No. 02 P: 25-31

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