Preoperative Management of Diabetic Patients, an Overview

Glycemic control is critical in the perioperative setting, especially in diabetic patients. The consequences of surgical tension and anesthesia on blood sugar levels are distinct, and should be considered in order to maintain optimal glycemic control. Each stage of surgery presents its own set of challenges in terms of keeping glucose levels within the target range. Furthermore, there are some surgical conditions that necessitate specific glucose management protocols. Authors hope to highlight the most crucial factors to consider when developing a perioperative diabetic regimen, while still allowing for specific adjustments based on sound clinical judgement. Overall, by carefully managing glycemic control in perioperative patients, we may be able to reduce morbidity and mortality while improving surgical outcomes.

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Guidelines for Perioperative Management of the Diabetic Patient

Surgery Research and Practice ◽

10.1155/2015/284063 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Sivakumar Sudhakaran ◽

Salim R. Surani

Keyword(s):

Clinical Judgment ◽

Management Strategy ◽

Perioperative Management ◽

Surgical Stress ◽

Target Range ◽

Diabetic Patients ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Glucose Management ◽

Glycemic Management

Management of glycemic levels in the perioperative setting is critical, especially in diabetic patients. The effects of surgical stress and anesthesia have unique effects on blood glucose levels, which should be taken into consideration to maintain optimum glycemic control. Each stage of surgery presents unique challenges in keeping glucose levels within target range. Additionally, there are special operative conditions that require distinctive glucose management protocols. Interestingly, the literature still does not report a consensus perioperative glucose management strategy for diabetic patients. We hope to outline the most important factors required in formulating a perioperative diabetic regimen, while still allowing for specific adjustments using prudent clinical judgment. Overall, through careful glycemic management in perioperative patients, we may reduce morbidity and mortality and improve surgical outcomes.

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Self-Care IoT Platform for Diabetic Mellitus

Applied Sciences ◽

10.3390/app11052006 ◽

2021 ◽

Vol 11 (5) ◽

pp. 2006

Author(s):

Jai-Chang Park ◽

Seongbeom Kim ◽

Je-Hoon Lee

Keyword(s):

Blood Glucose ◽

Self Care ◽

Target Range ◽

Process Data ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Iot Platform ◽

Number Of Patients ◽

Glucose Management ◽

The Relationship

Diabetes mellitus is a severe chronic disease, and the number of patients has increased. To manage blood glucose levels, patients should frequently measure their blood glucose and analyze which lifestyle habits affect blood glucose levels. However, it is hard to record and analyze the relationship between their blood glucose levels and lifestyle. The internet of things (IoT) is useful to interconnect, monitor, obtain, and process data between various devices used in everyday life to fulfill a common objective. This paper proposes an intelligent self-care platform using IoT technology that helps patients with chronic diabetes manage their blood glucose levels in their target range. In particular, we developed various devices called the self-care IoT pack. It consists of five different types of devices to obtain blood glucose levels, physical activities, food intake, medication, sleeping, and so on. They can collect blood glucose levels with lifestyles that automatically impact the patient’s blood glucose level. We also devised a self-care application to display and analyze the data obtained from the IoT pack. Consequently, the proposed self-care IoT platform collects the blood glucose levels and the lifestyles without any burden of record. By reviewing the accumulated information, the patients can find bad habits in blood glucose management and improve their lifestyle.

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THE EFFECT OF IRON DEFICIENCY ANEMIA ON GLYCATED HEMOGLOBIN (HBA1C) IN NON DIABETIC ADULTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.473 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Dr. Suman Choudhary ◽

Dr. Sukh Dev Choudhary ◽

Dr. Himanshi Choudhary ◽

Dr. Ronak Gandhi

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Deficiency Anemia ◽

Diabetic Patients ◽

Glucose Levels ◽

Uncontrolled Diabetes ◽

Iron Deficient ◽

Healthy Control ◽

Sugar Levels ◽

Hba1c Levels

Background: Iron deficiency anemia is the most common form of anemia in India. Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. Previous studies suggest that iron deficiency anemia (IDA) affects the levels of HbA1c. Methods: A prospective observational study on 50 iron deficiency patient cases and 50 healthy control. Exclusion and inclusion criteria were used to recruit cases from the wards and OPDs of the hospital. Appropriate descriptive statistics was used to analyse the data. Results: The HbA1C was significantly higher in the iron deficiency patients as compare to the control (5.88 ± 0.41 vs 5.03 ± 0.17, respectively, P < .05). Conclusion: Our results showed that iron deficiency was associated with higher proportions of HbA1c, which could cause problems in the diagnosis of uncontrolled diabetes mellitus in iron-deficient patients. Keywords: Non-Diabetic Patient, Glycosylated Haemoglobin, Iron Deficiency Anaemia.

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Impact of Music on Type 2 Diabetes

International Journal of Diabetes & Metabolic Disorders ◽

10.33140/ijdmd/00002 ◽

2016 ◽

Vol 1 (1) ◽

Keyword(s):

Blood Sugar ◽

Fasting Blood Glucose ◽

Control Group ◽

Diabetic Patients ◽

Glucose Levels ◽

Normal Category ◽

Conventional Diet ◽

Sugar Levels ◽

In The Beginning ◽

Experimental Group

The present study is undertaken to see the effect of music on blood sugar levels among type two diabetic patients. 100 diabetic patients aged 60-75 years were randomly selected from diabetic clinics. They are divided into two groups of 50 each (25 females and 25 males) one group served as control and another experimental. Both groups received regular conventional diet, medical protocol, and exercise/yoga. The experimental group was exposed daily to music of their choice approved by a music therapist for 40 minutes in addition. The study was undertaken for 3 months. Fasting blood glucose levels were taken in the beginning and after every month. The initial average blood sugar in the control group is 160 mg/dl and in the experimental group is 158mg/dl. Grouping them into various levels showed that initially none of the patients in both groups had normal blood sugar levels. In the experimental group those in the categories of 101-120 mg/dl are 16%, 121-140 mg/dl are 28%, 141-160 mg/dl are16% and those in >160 mg/dl are 48c% after 3 months 48% patients slided over to the normal category, in the other levels are 28%, 18%, 4% and 2% respectively. In the control group the corresponding levels are 4% in the normal category and 4%, 28%, 60%, and 4% respectively. The results indicated that there is consistent decrease in the fasting levels in the experimental group indicating that listening to music of their choice probably reduced the stress levels and thereby the blood sugar levels.

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Hypoglycemia in Elderly Diabetic Patients with Good Glycemic Control attending Cardiology Out Patient Department of a Superspeciality Hospital

10.35262/jiag.v16i1.11-16 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Deepika Mittal ◽

Purushottam Mittal

Keyword(s):

Glycemic Control ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Diabetic Patients ◽

Precipitating Factors ◽

Good Glycemic Control ◽

Glucose Levels ◽

Fasting Plasma ◽

Significant Difference ◽

Hba1c Levels

Objective-Clinical trials and observational studies have provided good evidence that early glycemic control leads to a reduction in complications and improved survival in diabetics. However, elevated risk of mortality has been reported at both the lower and upper ends of long-term glucose levels. Fear of hypoglycemia has been a significant factor in suboptimal glycemic control. In this retrospective analysis we aimed to identify the incidence of hypoglycemia and their precipitating factors in elderly diabetics on good glycemic control. Material and methods- Ninety seven elderly diabetic patients attending the cardiology Out-Patients Department of a super speciality private sector hospital from 1 December 2017 to 30 November 2018 were studied retrospectively. Their demographic profile, co-morbidities and pharmacological profile were recorded. Incidence of hypoglycemic episodes and their precipitating factor were then analyzed. Result-Mean age was 71.7± 6.3 years, and 64 (66%) were male. Mean duration of diabetes was 7.3± 1.3 years. All patients had type II diabetes mellitus. Mean fasting and random capillary blood glucose levels were 116.5 ±8.7 mg/dl and 169.5±13.5mg/dl, respectively. Mean HbA1c levels of the study population was 6.8±1.14. Over the study period, 23 (23.7%) patients experienced 39 episodes of any level of hypoglycemia. HbA1c Levels in the hypoglycemia group were not significantly different from those in no-hyperglycemia group (6.85±1.13 vs. 6.63±1.04). Mean random plasma glucose values were slightly higher in no-hypoglycemia group (170.9±14.5 vs 164.9±14.9), but the difference did not reach the statistical significance. There was a markedly significant difference in mean fasting plasma glucose values between hypoglycemia and no-hypoglycemia group (101.8±8.9 vs 116.5±12.7). Sulphonylurea and insulin use was more frequent in patients experiencing hypoglycemia (9.6% and 52.2% respectively) as compared with no-hypoglycemia group (33.8% and 39.1% respectively). The most common preceding event was either skipping a meal in 12(30.8%) patients or an unplanned change in diet in 23% patients. Conclusion- Patients with longstanding diabetes and loss of warning symptoms have increased risk of severe hypoglycaemic episodes. Risk of the hypoglycemic episode is better correlated with fasting plasma glucose levels and glycemic variability rather than with HbA1c Level. Sulphonylurea drug use was the only group associated with a statistically significant risk of hypoglycemia. Skipping of a meal or a sudden change in the diet and alteration in antidiabetic drug regimen are the most important precipitating factors for hypoglycemia.

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Biochemical Parameters Determination for Prognosis of Retinal Diseases and their Relationship to Cataract, Diabetes and Hypertension Patients in Ibn Al-Haytham Hospital in Baghdad-Iraq

NeuroQuantology ◽

10.14704/nq.2021.19.5.nq21047 ◽

2021 ◽

Vol 19 (5) ◽

pp. 43-48

Author(s):

Huda H. Hassan ◽

Fayhaa M. Khaleel ◽

Khuthear A. Al Taee

Keyword(s):

Blood Sugar ◽

Pathological Condition ◽

Retinal Disease ◽

Diabetic Patients ◽

Retinal Diseases ◽

Serum Retinol ◽

Glucose Levels ◽

Healthy Control ◽

Sugar Levels ◽

Cataract Patients

The role of serum retinol activity in association with the Blood sugar level, and their link as biochemical marker risk for lens inflammation and damage stage under pandemic, for the Retinal disease patients with cataract, hypertension, and diabetes, and in healthy for both genders. Total of seventy-five patients and thirty healthy control have been studied. Retinal disease patients were subdivided on the basis of pathological condition into three subgroups (First group was cataract, second was hypertension, and the third group was diabetes. Assessment, of serum retinol activity, and blood glucose levels were done for all groups. The concentricity of serum retinol levels is decreased in diabetic patients than control (13.147±7.195 (μmol/L) with 21.930±16.241 (μmol/L) versus P = 0.011)), while for cataract patients, they showed extremely similar concentricity of serum retinol levels to healthy (20.760±15.941 (μmol/L) with P = 0.790), whilst the retinol-activity was exhibited to be higher in hypertension patients (24.190±21.972 (μmol/L) versus P = 0.663). retinol activity is correlated significantly negatively with both diabetic patients and cataract. Moreover, blood sugar levels are increased in diabetes than control (10.256±4.119 (μmol/L) versus 5.365±1.084 (μmol/L) with P = 0.0001), in comparison with cataract (5.288±0.9560 (μmol/L) with P = 782). The retinol levels are correlated significantly negatively for diabetic and cataract patients. The purpose of this work: is to investigate association between retinal diseases with cataract hypertension & diabetes for risk of fasting at least eight hours in Ramadan and out of Ramadan time, and directly pre surgery gets started by artificial intraocular lens, and by estimation of retinol and blood sugar concentrations.

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The Correlation Between the Vitamin D Level and Glycemic Control Status Among Diabetic Patients - A Clinical Observational Study

Integrative Journal of Medical Sciences ◽

10.15342/ijms.7.215 ◽

2020 ◽

Vol 7 ◽

Author(s):

Nasser Alqahtani ◽

Eisa Ghazwani ◽

Awad Alqahtani ◽

Mohammed Helaly

Keyword(s):

Vitamin D ◽

Glycemic Control ◽

Microvascular Complications ◽

Cross Sectional Study ◽

University Hospital ◽

Diabetic Patients ◽

Cross Sectional ◽

High Hba1c ◽

Sugar Levels ◽

Diabetic Microvascular Complications

Background: Vitamin D deficiency is widespread and coexisted with diabetes. However, the relation between Vitamin D level and glycemic control is not yet fully understood. This study examines the correlation between vitamin D level and glycemia indicators and diabetic microvascular complications.Methods: The study is a cross-sectional study, had been done at the outpatient department in Najran university hospital, Saudi Arabia from May 2019 to February 2020. 220 patients recruited by simple random sampling.Results: 60% of diabetes (n-130) had been using oral anti-glycemic medications, though most of them had uncontrolled glycemic status and had got microvascular complications. It is notable that among diabetes having a low vitamin D level; 55.5% had high FBS, 45.6% had high RBS and 65% had high HBA1C. Besides,17% have retinopathy, 16.6% have nephropathy, 26.2% have peripheral neuropathy and 1.9% have a diabetic foot.Conclusion: The clinical and laboratory assessments are essential to control the glycemic state in diabetes. The study noted that an inverse relationship between the level of vitamin D with blood sugar levels and diabetic microvascular complications. To assure the feasibility of the prediction of vitamin D level in assessing the progress of diabetes further studies are needed.

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Comparison of Glycated Albumin and Hemoglobin A1cConcentrations in Diabetic Subjects on Peritoneal and Hemodialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2008.00243 ◽

2010 ◽

Vol 30 (1) ◽

pp. 72-79 ◽

Cited By ~ 82

Author(s):

Barry I. Freedman ◽

Rajeev N. Shenoy ◽

Jonathan A. Planer ◽

Kimberly D. Clay ◽

Zak K. Shihabi ◽

...

Keyword(s):

Glycemic Control ◽

Glycated Albumin ◽

Serum Glucose ◽

Outcome Variable ◽

Diabetic Patients ◽

Dialysis Patients ◽

Glucose Levels ◽

Stage Renal Disease ◽

End Stage ◽

The Relationship

BackgroundRelative to hemoglobin A1c(HbA1c), percentage of glycated albumin (GA%) more accurately reflects recent glycemic control in diabetic hemodialysis (HD) patients.MethodsTo determine the accuracy of glycemic assays in a larger sample including patients on peritoneal dialysis (PD), HbA1cand GA% were measured in 519 diabetic subjects: 55 on PD, 415 on HD, and 49 non-nephropathy controls.ResultsMean ± SD serum glucose levels were higher in HD and PD patients relative to non-nephropathy controls (HD 169.7 ± 62 mg/dL, PD 168.6 ± 66 mg/dL, controls 146.1 ± 66 mg/dL; p = 0.03 HD vs controls, p = 0.13 PD vs controls). GA% was also higher in HD and PD patients (HD 20.6% ± 8.0%, PD 19.0% ± 5.7%, controls 15.7% ± 7.7%; p < 0.02 HD vs controls and PD vs controls). HbA1cwas paradoxically lower in dialysis patients (HD 6.78% ± 1.6%, PD 6.87% ± 1.4%, controls 7.3% ± 1.4%; p = 0.03 HD vs controls, p = 0.12 PD vs controls). The serum glucose/HbA1cratio differed significantly between dialysis patients and controls ( p < 0.0001 HD vs controls, p = 0.002 PD vs controls), while serum glucose/GA% ratio was similar across groups ( p = 0.96 HD vs controls, p = 0.64 PD vs controls). In best-fit multivariate models with HbA1cor GA% as outcome variable, dialysis status was a significant predictor of HbA1cbut not GA%.ConclusionsThe relationship between HbA1cand GA% differs in diabetic patients with end-stage renal disease who perform either PD or HD compared to those without nephropathy. HbA1csignificantly underestimates glycemic control in peritoneal and hemodialysis patients relative to GA%.

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Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

Diagnostics ◽

10.3390/diagnostics11030453 ◽

2021 ◽

Vol 11 (3) ◽

pp. 453

Author(s):

Pilar Pérez-Ros ◽

Emmanuel Navarro-Flores ◽

Ivan Julián-Rochina ◽

Francisco Miguel Martínez-Arnau ◽

Omar Cauli

Keyword(s):

Glycemic Control ◽

Glucose Concentration ◽

Diabetic Patients ◽

Clinical Settings ◽

Salivary Amylase ◽

Glucose Levels ◽

Non Invasive ◽

Diabetic Population ◽

Saliva Collection

Background and Objective: Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of this review is to summarize the evidence regarding the changes in salivary amylase and glucose levels, and their relationship with blood markers of glycemic control used in clinical settings such as blood glucose and glycated hemoglobin. The differences in salivary amylase levels depending on the method of saliva collection under fasting or non-fasting conditions. The changes in salivary amylase depends on the type of diabetes, the type of insulin treatment or the quality of glycemic control. Conclusions: Salivary amylase concentration is increased in diabetic patients in most of the studies and salivary glucose concentration in all studies in both fasting and non-fasting (post-prandial) conditions. Salivary amylase and glucose concentration represent potential non-invasive biomarkers to evaluate glycemic control and clinical management of diabetic patients, although it is necessary to evaluate the influence of potential modulating factors such as age, duration diseases, sex and the effects of pharmacological treatments in these outcomes which remained to be elucidated.

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Comparison of Routine and Computer-Guided Glucose Management for Glycemic Control in Critically Ill Patients

Critical Care Nurse ◽

10.4037/ccn2019431 ◽

2019 ◽

Vol 39 (4) ◽

pp. 20-27

Author(s):

Ozlem Canbolat ◽

Sevgisun Kapucu ◽

Oguz Kilickaya

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Blood Glucose Level ◽

Glucose Level ◽

Intervention Group ◽

Routine Clinical Practice ◽

Target Range ◽

Control Group ◽

Intensive Care Patients ◽

Glucose Management

Background Glycemic control is crucial for reducing morbidity and mortality in critically ill patients. A standardized approach to glycemic control using a computer-guided protocol may help maintain blood glucose level within a target range and prevent human-induced medical errors. Objective To determine the effectiveness of a computer-guided glucose management protocol for glycemic control in intensive care patients. Methods This controlled, open-label implementation study involved 66 intensive care patients: 33 in the intervention group and 33 in the control group. The blood glucose level target range was established as 120 to 180 mg/dL. The control group received the clinic’s routine glycemic monitoring approach, and the intervention group received monitoring using newly developed glycemic control software. At the end of the study, nurse perceptions and satisfaction were determined using a questionnaire. Results The rates of hyperglycemia and hypoglycemia were lower and the blood glucose level was more successfully maintained in the target range in the intervention group than in the control group (P < .001). The time to achieve the target range was shorter and less insulin was used in the intervention group than in the control group (P < .05). Nurses reported higher levels of satisfaction with the computerized protocol, which they found to be more effective and reliable than routine clinical practice. Conclusions The computerized protocol was more effective than routine clinical practice in achieving glycemic control. It was also associated with higher nurse satisfaction levels.

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