scholarly journals COVID-19 Pneumonia, Diabetes and Alteration of the Biochemical Values of Blood: A Case Report and Review of the Literature

Author(s):  
Petronela Vicoveanu ◽  
Roxana Covali ◽  
Laura Riscanu ◽  
Demetra Socolov ◽  
Ioana Pavaleanu ◽  
...  

Aims: The variability in evolution of the novel coronavirus has perplexed the medical community. We herein report the case of a patient with specific characteristics, somewhat outside the reported average values. Presentation of Case: A 60-year-old type I diabetic patient was admitted as an outpatient to a university hospital for the following symptoms: fever up to 38.1˚C, malaise, and shortness of breath. Upon admittance, the chest X-ray revealed a homogenous triangular opacity, of medium intensity, located in the lower lobe of the left lung, suggesting pneumonia. Altered biochemistry values in our hospital included ALT = 86U/L, AST = 118 U/L, serum urea = 43.4 mg/dL, serum creatinine = 1.43 mg/dL, fasting blood glucose = 167.9 mg/dL (she had type 1 diabetes and received insulin only in the evening), triglycerides = 214.9 mg/dL, serum magnesium = 1.48 mg/dL, serum iron = 14.1 mg/dL. Fever, malaise, and shortness of breath, together with the X-ray image of the chest suggested COVID-19. RT-PCR confirmed the diagnosis 12 hours later. Three days after admission, she felt dyspneic, and oxygen therapy was administered for 7 days, together with Lopinavir/Ritonavir, Dexamethasone, Heparin and Vitamin C. After 18 days in the hospital, she felt good, and was released from the hospital. Conclusion: Despite the numerous aggravating factors for COVID-19 (age [60 years old], type 1 diabetes, increased values of ALT, AST, serum urea, serum creatinine, fasting blood glucose, low serum magnesium, one whole lobe pneumonia, and only one favorable factor–low serum iron), the patient survived and recovered.

2020 ◽  
Vol 16 (4) ◽  
pp. 364-369
Author(s):  
Ihsan Salah Rabeea ◽  
Karrar Al-Gburi ◽  
Ihsan Adnan ◽  
Bilal Hasan ◽  
Massa Mohammed ◽  
...  

Background: Nowadays, there is an accumulated data about the relation between hypomagnesemia (low Serum Mg level < 0.7 mmol/l) and diabetes. Objective: In this study, we aimed to determine the prevalence of hypomagnesemia in a carefully diagnosed diabetes patients and to show how some factors could contribute to the prevalence of low serum Mg level among the population under study. Methods: In short, 62 patients of both type 1 and 2, who attended AL-Sadir medical city/ diabetes and endocrinology centre during the period of the study were included in the study. A detailed history was taken and participants were informed verbally about the procedure of this study. Serum magnesium and creatinine were measured using standardized methods. Results: The overall prevalence of the hypomagnesemia, among diabetic population involved in this study, was 29.03 % and it was nearly similar in male (29.41 %) and female (28.57 %). The means(SD) of serum Mg level were similar in type 1 and type 2 diabetic patients. Other difference in prevalence among other characteristics has been reported. Within all participants, gender (r = -0.02), fasting blood glucose (r = -0.514) and metformin use (r = -0.014) were negatively correlated with serum Mg level, in contrast to other variables, which were positively correlated. While among type 1 DM, age (r= 0.193), serum creatinine (r= 0.031) and insulin use (r= 0.217) were positively correlated with serum Mg level. In contrast, others were negatively correlated. In type 2 DM, age (r = -0.283) and fasting blood glucose (r = -0.496) were negatively correlated with serum Mg level. On the other hand, other variables were positively correlated with serum Mg level. Conclusion: Hypomagnesemia prevalence was detected in nearly one-third of the diabetic population, which is quite high prevalence. Some factors have shown to play an essential role in this prevalence. A large study is warranted to address this issue.


PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e96264 ◽  
Author(s):  
Petter Bjornstad ◽  
R. Brett McQueen ◽  
Janet K. Snell-Bergeon ◽  
David Cherney ◽  
Laura Pyle ◽  
...  

2016 ◽  
Vol 63 (7) ◽  
pp. 603-609 ◽  
Author(s):  
Chihiro Yoneda ◽  
Kanako Tashima-Horie ◽  
Sayaka Fukushima ◽  
Satoko Saito ◽  
Sayoko Tanaka ◽  
...  

2020 ◽  
Vol 29 ◽  
pp. 096368972091325
Author(s):  
Sai Bo Bo Tun ◽  
Minni Chua ◽  
Riasat Hasan ◽  
Martin Köhler ◽  
Xiaofeng Zheng ◽  
...  

Replacement of the insulin-secreting beta cells through transplantation of pancreatic islets to the liver is a promising treatment for type-1 diabetes. However, low oxygen tension, shear stress, and the induction of inflammation lead to significant islet dysfunction and loss. The anterior chamber of the eye (ACE) has gained considerable interest and represents an alternative therapeutic islet transplantation site because of its accessibility, high oxygen tension, and immune-privileged milieu. We have previously demonstrated the feasibility of intraocular islet transplant in mouse and nonhuman primate models of type-1 diabetes and are now assessing its efficacy on glucose homeostasis in a nonhuman primate model of type-2 diabetes. We transplanted allogeneic donor islets (1,500 islet equivalents/kg) into the anterior chamber of one eye in a cynomolgus monkey with high-fat-diet-induced type-2 diabetes. Repeated examinations of the anterior and posterior segments of both eyes were done to monitor the engrafted islets and assess the overall ocular health. Fasting blood glucose level, blood biochemistry, and other metabolic parameters were routinely evaluated to determine the function of the islet graft and diabetes status. The transplanted islets were rapidly engrafted onto the iris and became vascularized 1 month after transplantation. We did not detect changes in intraocular pressure, cataract formation, ophthalmitis, or retinal vessel deformation. A significant lower fasting blood glucose level was observed while the graft was in place, and the transplantation reverts the progression of diabetes. The metabolic markers, hemoglobin A1C and fructosamine, demonstrated improvement following islet transplantation. As a conclusion, intraocular islet transplantation in one eye of a cynomolgus monkey with type-2 diabetes improved its overall plasma glucose homeostasis, as evidenced by short-term measures and long-term metabolic markers. These results further support the future application of the ACE as an alternative site for clinical islet transplants in the context of type-2 diabetes.


2021 ◽  
Author(s):  
Toshitaka Sawamura ◽  
Shigehiro Karashima ◽  
Azusa Ohbatake ◽  
Takuya Higashitani ◽  
Yuko Katsuda ◽  
...  

Abstract Background: Degludec (Deg) and Glargine U300 (Gla-300) are new insulin analogues with longer and smoother pharmacodynamic action than Glargine U100. Both improve glycemic variability (GV) unlike Glargine U100. However, it is not clear which insulin analogue has a better effect on GV in insulin-dependent type 1 diabetes. We evaluated the effects of switching from Deg to Gla-300 on day-to-day GV in patients with insulin-dependent type 1 diabetes treated with Deg.Methods: We conducted a retrospective study on 22 insulin-dependent type 1 diabetes patients having large day-to-day GV or frequent hypoglycemia who were treated with multiple insulin injection therapy including Deg and were advised to switch from Deg to Gla-300. We evaluated day-to-day GV and frequency of hypoglycemia in two groups. The first group included patients whose treatment was changed to Gla-300, and the second group included patients who opted to continue receiving Deg. We evaluated the change in standard deviation (SD) of fasting blood glucose (SD-FBG) calculated from self-monitoring of blood glucose (SMBG) and frequency of hypoglycemia (total, severe, and nocturnal).Results: SD-FBG and frequency of nocturnal hypoglycemia decreased in Gla-300 group compared to those in Deg group. The change in SD-FBG had a negative correlation with SD-FBG and hemoglobin A1c (HbA1c) at baseline and positive correlation with serum albumin levels at baseline in Gla-300 group. On the other hands, the change in SD-FBG had no correlation with these markers in Deg group.Conclusions: Switching from Deg to Gla-300 effectively stabilized blood glucose levels and decreased nocturnal hypoglycemia in insulin-dependent type 1 diabetes treated with Deg, especially in cases with low serum albumin, large GV, and high HbA1c.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yikai Liu ◽  
Zhiying Chen ◽  
Junlin Qiu ◽  
Hongzhi Chen ◽  
Zhiguang Zhou

BackgroundType 1 diabetes (T1D) is an autoimmune disease with a complex aetiology. B cells play an important role in the pathogenesis of T1D. Regulatory B cells (Bregs) are a subset of B cells that produce and secrete the inhibitory factor interleukin-10 (IL-10), thereby exerting an anti-inflammatory effect. It was recently discovered that T-cell immunoglobulin mucin domain 1 (Tim-1) is essential for maintaining Bregs function related to immune tolerance. However, the detailed understanding of Tim-1+ Bregs and IL-10+ Bregs in T1D patients is lacking. This study aimed to characterize the profile of B cell subsets in T1D patients compared with that in controls and determine whether Tim-1+ Bregs and IL-10+ Bregs play roles in T1D.Materials and MethodsA total of 47 patients with T1D, 30 patients with type 2 diabetes (T2D) and 24 healthy controls were recruited in this study. Flow cytometry was used to measure the levels of different B cell subsets (including B cells, plasmablasts, and Bregs) in the peripheral blood. Radiobinding assays were performed to detect the antibody titres of T1D patients. In addition, the correlations between different B cell subsets and patient parameters were investigated.ResultsCompared with healthy controls, differences in frequency of Tim-1+ Bregs were significantly decreased in patients with T1D (36.53 ± 6.51 vs. 42.25 ± 6.83, P=0.02*), and frequency of IL-10+ Bregs were lower than healthy controls (17.64 ± 7.21vs. 24.52 ± 11.69, P=0.009**), the frequency of total Bregs in PBMC was also decreased in patients with T1D (1.42 ± 0.53vs. 1.99 ± 0.93, P=0.002.**). We analyzed whether these alterations in B cells subsets were associated with clinical features. The frequencies of Tim-1+ Bregs and IL-10+ Bregs were negatively related to fasting blood glucose (FBG) (r=-0.25 and -0.22; P=0.01* and 0.03*, respectively). The frequencies of Tim-1+ Bregs and IL-10+ Bregs are positively correlated with fast C-peptide (FCP) (r=0.23 and 0.37; P=0.02* and 0.0001***, respectively). In addition, the frequency of IL-10+ Breg was also negatively related to glycosylated haemoglobin (HbA1c) (r=-0.20, P=0.04*). The frequencies of Tim-1+ Bregs, IL-10+ Bregs and Bregs in T2D patients were reduced, but no statistically significant difference was found between other groups. Interestingly, there was positive correlation between the frequencies of Tim-1+ Bregs and IL-10+ Bregs in T1D (r=0.37, P=0.01*). Of note, it is worth noting that our study did not observe any correlations between B cell subsets and autoantibody titres.ConclusionsOur study showed altered Tim-1 and IL-10 expression in regulatory B cell in T1D patients. Tim-1, as suggested by the present study, is associated with islet function and blood glucose levels. These findings indicate that Tim-1+ Bregs and IL-10+ Bregs were involved in the pathogenesis of T1D.


2015 ◽  
Vol 17 (5) ◽  
pp. 307-310 ◽  
Author(s):  
Alysa J. Sampson Perrin ◽  
Russell C. Guzzetta ◽  
Kellee M. Miller ◽  
Nicole C. Foster ◽  
Anna Lee ◽  
...  

Author(s):  
Bedowra Zabeen ◽  
Jebun Nahar ◽  
Nasreen Islam ◽  
Kishwar Azad ◽  
Kim Donaghue

<b><i>Objective:</i></b> The objective of this study was to assess the effects of continuous subcutaneous insulin infusion (CSII) therapy on glycaemic control and acute complications in children, adolescents, and young adults with type 1 diabetes mellitus (T1DM). <b><i>Methods:</i></b> The prospective observational study was done in patients on multiple daily injection (MDI) switching to pump system. All patients were followed at the Paediatric Diabetes Clinic at BIRDEM Hospital. They were trained on carbohydrates counting and started on continuous basal insulin infusion in addition to meal and high blood glucose correction insulin boluses. They were followed on insulin pump therapy for a 6-month period. <b><i>Results:</i></b> Twenty patients were analysed, from baseline to visit 2 after 6 months. The patients included in the study had T1DM for a mean duration of 4.7 ± 3.1 years. The age ranged from 3 to 25 years (mean 13.7 ± 6.1). There was 1% reduction in haemoglobin A1c (HbA1c) after 6 months, though it did not reach the statistical significance (<i>p</i> = 0.084). There was significant reduction of mean fasting blood glucose level 13.4 ± 7.0 versus 6.9 ± 1.6 mmol/L (<i>p</i> = 0.001), total insulin requirement (<i>p</i> = 0.043), frequency of hypoglycaemic episodes (<i>p</i> = 0.006), and diabetic ketoacidosis (<i>p</i> = 0.002) events during CSII therapy. <b><i>Conclusion:</i></b> In our study, we found that switching young T1DM patients from MDI to insulin pump had been effective with achievement of a reduction in fasting blood glucose, HbA1c, and acute complications.


2021 ◽  
Author(s):  
Toshitaka Sawamura ◽  
Shigehiro Karashima ◽  
Azusa Ohbatake ◽  
Takuya Higashitani ◽  
Yuko Katsuda ◽  
...  

Abstract Background: Degludec (Deg) and Glargine U300 (Gla-300) are new insulin analogues with longer and smoother pharmacodynamic action than Glargine U100. Both improve glycemic variability (GV) unlike Glargine U100. However, it is not clear which insulin analogue has a better effect on GV in insulin-dependent type 1 diabetes. We evaluated the effects of switching from Deg to Gla-300 on day-to-day GV in patients with insulin-dependent type 1 diabetes treated with Deg.Methods: We conducted a retrospective study on 22 insulin-dependent type 1 diabetes patients having large day-to-day GV or frequent hypoglycemia who were treated with multiple insulin injection therapy including Deg and were advised to switch from Deg to Gla-300. We evaluated day-to-day GV and frequency of hypoglycemia in two groups. The first group included patients whose treatment was changed to Gla-300, and the second group included patients who opted to continue receiving Deg. We evaluated the change in standard deviation (SD) of fasting blood glucose (SD-FBG) calculated from self-monitoring of blood glucose (SMBG) and frequency of hypoglycemia (total, severe, and nocturnal).Results: SD-FBG and frequency of nocturnal hypoglycemia decreased in Gla-300 group compared to those in Deg group. The change in SD-FBG had a negative correlation with SD-FBG and hemoglobin A1c (HbA1c) at baseline and positive correlation with serum albumin levels at baseline in Gla-300 group. On the other hands, the change in SD-FBG had no correlation with these markers in Deg group.Conclusions: Switching from Deg to Gla-300 effectively stabilized blood glucose levels and decreased nocturnal hypoglycemia in insulin-dependent type 1 diabetes treated with Deg, especially in cases with low serum albumin, large GV, and high HbA1c.


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