Necrotizing Fasciitis in a Patient with Type 2 Diabetes Mellitus

2006 ◽  
Vol 96 (1) ◽  
pp. 67-72 ◽  
Author(s):  
David M. Kanuck ◽  
Thomas Zgonis ◽  
Gary Peter Jolly
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Fat ◽  
Disease Process ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
High Morbidity

Necrotizing fasciitis is a soft-tissue infection characterized by extensive necrosis of subcutaneous fat, neurovascular structures, and fascia. In general, fascial necrosis precedes muscle and skin involvement, hence its namesake. Initially, this uncommon and rapidly progressive disease process can present as a form of cellulitis or superficial abscess. However, the high morbidity and mortality rates associated with necrotizing fasciitis suggest a more serious, ominous condition. A delay in diagnosis can result in progressive advancement highlighted by widespread infection, multiple-organ involvement, and, ultimately, death. We present a case of limb salvage in a 52-year-old patient with type 2 diabetes mellitus and progressive fascial necrosis. A detailed review of the literature is presented, and current treatment modalities are described. Aggressive surgical debridement, comprehensive medical management of the sepsis and comorbidities, and timely closure of the resultant wound or wounds are essential for a successful outcome. (J Am Podiatr Med Assoc 96(1): 67–72, 2006)

scholarly journals Association of KCNQ1rs2237892C ⟶ T Gene with Type 2 Diabetes Mellitus: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Wen-Jia Han ◽  
Jian-Yi Deng ◽  
Hua Jin ◽  
Li-Ping Yin ◽  
Jin-Xia Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gene Polymorphism ◽  
Genetic Model ◽  
Meta Analysis ◽  
High Morbidity ◽  
Genome Wide Association Studies ◽  
Asian Populations

Background. Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases in adults, causing high morbidity and mortality worldwide. In recent years, the prevalence of T2DM has been increasing significantly, and genome-wide association studies (GWAS) have shown that KCNQ1 significantly increases the risk of T2DM. Objective. To find large-scale evidence on whether the KCNQ1rs2237892C⟶T gene polymorphism is associated with T2DM susceptibility. Methods. A comprehensive review of the Chinese and English literature on the association of T2DM with KCNQ1rs2237892 is published by PubMed and Baidu Academic. The included literature was part or all of the studied loci which were evaluated for association with T2DM. Forest plots were made of the included literature to analyze the association of KCNQ1 with polymorphisms of the studied loci, and funnel plots and Egger’s test were used to evaluate the publication bias of the selected included literature. Results. Ten case-control studies including a total of 7027 cases and 8208 controls met our inclusion criteria. Allele (C allele frequency distribution) (OR: 1.19; 95% CI: 0.87,1.62; P < 0.00001 ), recessive (OR: 0.73; 95% CI: 0.45,1.18; P < 0.00001 ) genetic model under the full population was observed between KCNQ1rs2237892C⟶T gene polymorphism and T2DM without a significant relationship. In a stratified analysis by race, a meaningful association was found in non-Asian populations under the allelic genetic model, but no association was found in Asian populations. Conclusion. This meta-analysis showed no significant association between the rs2237892 polymorphism of the KCNQ1 gene and the risk of T2DM.

Circulating Serum Myonectin Levels in Obesity and Type 2 Diabetes Mellitus

2019 ◽  
Author(s):  
Zhu Li ◽  
Yan-Ling Yang ◽  
Yan-Juan Zhu ◽  
Chen-Guang Li ◽  
Yun-Zhao Tang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Chinese Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Model Assessment

Abstract Objective Myonectin is one of the myokines and has gained interest as a potential new strategy to combat obesity and its associated disorders, such as type 2 diabetes mellitus (T2DM).The objective of this study was to investigate circulating serum myonectin levels in nondiabetes and T2DM and elucidate possible relationships between serum myonectin levels and metabolic parameters in patients with T2DM. Design A total of 362 Chinese patients with T2DM and 100 age- and sex-matched healthy controls were recruited in this study. Clinical characteristics, blood biochemistry, and circulating myonectin levels were measured by enzyme-linked immunosorbent assay. Results Circulating myonectin levels were significantly decreased in T2DM compared with controls. Obese nondiabetic controls had significantly lower serum myonectin levels compared with lean nondiabetic controls. In diabetic patients, serum myonectin concentrations were significantly negatively correlated with body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), hemoglobin A1c (HbA1c), fasting insulin (Fins), the homeostatic model assessment of insulin resistance (HOMA-IR), visceral fat area, and subcutaneous fat area. After adjusting for covariates, multivariate stepwise regression analysis demonstrated that BMI, LDL-C, TG, HOMA-IR, and visceral fat were the main independent predictors of low serum myonectin concentrations. Conclusions Circulating myonectin levels were decreased in T2DM patients and in obese subjects. Moreover, serum myonectin levels were correlated with metabolic markers of T2DM. These data suggest that myonectin may be a useful marker in predicting the development of obesity and T2DM.

Diabetes and risk of tumors: oncologic considerations

2011 ◽  
Vol 152 (29) ◽  
pp. 1144-1155 ◽  
Author(s):  
András Rosta
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cancer Risk ◽  
Malignant Tumors ◽  
Epidemiologic Studies ◽  
Treatment Modalities ◽  
Diabetic Patients ◽  
Antidiabetic Treatment

Type 2 diabetes mellitus and malignant tumors are frequent diseases worldwide. The incidence of these two diseases is growing continuously and causes serious health care problem. Population based epidemiologic studies show that the coexistence of type 2 diabetes and malignant tumors is more frequent than expected by the age-corrected incidence and prevalence of each disease. Epidemiologic studies and meta-analyses show that type 2 diabetes increases the risk and tumor specific mortality of certain cancers. The overlapping risk factors of the diseases suggest a relationship between type 2 diabetes and malignant tumors, with a significant role of obesity as a major risk factor. In the pathophysiology of type 2 diabetes there are several biological processes, which may explain the higher cancer risk in type 2 diabetes. In vitro experiments, and in vivo animal studies show that the mitotic effect of hyperinsulinemia plays an important role in the relationship of cancer and type 2 diabetes mellitus. Recent studies show that the different treatment modalities, antidiabetic drugs and their combinations used for the treatment of type 2 diabetes can modify cancer risk. The majority of the data show that metformin therapy decreases, while insulin secretagog drugs slightly increase the risk of certain types of cancers in type 2 diabetes. Metformin can decrease cell proliferation and induce apoptosis in certain cancer cell lines. Endogenous and exogenous (therapy induced) hyperinsulinemia may be mitogenic and may increase the risk of cancer in type 2 diabetes. Human studies showed that the analogue insulin glargin increases the risk of certain cancers. As a result of conceptual weaknesses in study design, data collection, and statistical methods the results of these studies are questionable. According to present knowledge, obtaining and maintaining optimal metabolic target values with the appropriate choice of treatment modality is the aim of treatment in type 2 diabetes. Presently, study results showing elevated mitogenic potential with some antidiabetic treatment modalities are not taken into account, when considering the choice of antidiabetic treatment in type 2 diabetic patients. In the care of patients with increased cancer risk, oncologic considerations should be taken into account. Well designed, prospective, clinical studies would be necessary to demonstrate the possible correlation between treatment modalities of type 2 diabetes and change of cancer risk in type 2 diabetes mellitus. Orv. Hetil., 2011, 152, 1144–1155.

scholarly journals Risk Factors For Gestational Diabetes – An Update

2015 ◽  
Vol 22 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Carmen Dobjanschi ◽  
Rucsandra Dănciulescu Miulescu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Treatment Modalities ◽  
Substantial Impact ◽  
Short And Long Term

AbstractWomen with gestational diabetes mellitus (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). GDM has a substantial impact on maternal and foetal short and long-term health. Risk factors for GDM may be genetic or nongenetic and have been analysed in numerous studies. Researches in recent years allowed the identification of other risk factors for GDM except for those already known. Knowledge and identification of all risk factors for GDM allows the elaboration of a prevention strategy of T2DM, it may influence the screening, diagnosis, and, subsequently, treatment modalities for this disease.

scholarly journals Impact of health education on attitude regarding oral anti-diabetic drug adherence in type 2 diabetes mellitus, Bengaluru

2018 ◽  
Vol 5 (11) ◽  
pp. 4809
Author(s):  
Lakshmi Hulugappa ◽  
Chethana Ramegowda
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Education ◽  
Positive Attitude ◽  
Public Health Problem ◽  
High Morbidity ◽  
Drug Adherence ◽  
Training Centre

Background: Diabetes mellitus, especially type 2 diabetes is an emerging global epidemic and public health problem and associated with high morbidity and mortality among patients. Positive attitude is important for the management of drug adherence in diabetes, hence the present study was taken to assess the effectiveness of health education on oral anti-diabetic drug adherence.Methods: A descriptive and interventional study was conducted at urban health training centre of a medical college, Bengaluru from November 2015 to March 2016. A total of 70 type 2 diabetes mellitus patients only on oral anti-diabetic drugs willing to give informed consent were included in the study. A pre-tested semi-structured proforma was administered and information about socio-demographic profile, and impact of health education intervention on attitude was obtained.Results: Most of the subjects were female (80%), in the age group of 35-45 yrs (34%), illiterate (40%), unemployed (67%) with Class IV (78%) socio-economic status according to modified Kuppuswamy Classification 2014. The mean ±SD age was 52.47±11.06 years. Significant improvement in attitude regarding adherence to oral anti-diabetic medication was found in study subjects following health education intervention.Conclusions: The study revealed that health education regarding the importance of drug adherence is needed to build positive attitude in study subjects.

scholarly journals Anthropological Characteristic of the Distribution of Adipose Tissue in Bulgarian Females with Type 2 Diabetes Mellitus

Folia Medica ◽  
2018 ◽  
Vol 60 (3) ◽  
pp. 411-416
Author(s):  
Atanas G. Baltadjiev ◽  
Stefka V. Vladeva ◽  
Dimitar B. Bahariev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adipose Tissue ◽  
Body Fat ◽  
Fat Mass ◽  
Subcutaneous Fat ◽  
The Body ◽  
Fat Tissue

Abstract Background: The complex study of adipose tissue in women with type 2 diabetes mellitus (T2DM) is of importance for the clinical course and prognosis of the disease. Aim: To study the distribution of adipose tissue in Bulgarian females with T2DM. Patients and methods: The study included 92 women with T2DM (age range 40-60 years). The control group consisted of 40 age-matched women. Measurement parameters: height, weight, 9 skinfolds (sf) – sfTriceps, sfBiceps brachii, sfForearm, sfSubscapular, sfXrib, sfAbdomen, sfSuprailiaca, sfThigh, and sfCalf; bioelectrical impedance analysis - % body fat tissue and visceral fat tissue. Calculated indexes: body mass index (BMI), the ratio sfTrunk to sfLimbs, the ratio skin folds upper half of body/skin folds lower half of body, fat mass and subcutaneous fat mass. Results: Statistically significant differences were found in the means of sfTriceps, sfXrib, sfThigh, sfCalf, % body fat tissue, visceral fat tissue, and fat mass and subcutaneous fat mass between the diabetic and healthy women. The body composition of diabetic females aged 40-60 years contained a larger adipose component than controls. Visceral adipose tissue which determines the body composition is a reliable indicator of the health risks in diabetic women. Conclusion: The pattern of subcutaneous adipose tissue distribution in diabetic females aged 40-60 yrs was primarily in the upper torso region and less so in the limbs. In the controls adipose tissue is accumulated primarily in the limbs and in the lower part of the body.

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