Coincidence of juvenile idiopathic arthritis and type 1 diabetes: a case-based review

The study was aimed to review a rare coexistence of type 1 diabetes (T1D) and juvenile idiopathic arthritis (JIA) regarding different clinical approaches to the management and treatment options. Medical complications of the two autoimmune disorders in children and adolescents have been evaluated, particularly in those treated with glucocorticosteroids (GCS) and insulin. A review of the literature regarding reports on concomitant T1D and JIA was conducted using resources available in Medline, Google Scholar, and Web of Science databases, with a specific focus on the combination of T1D and JIA in a pediatric population. The review was extended by our analysis of two patients treated in a single center for this comorbidity. Eligible reports of four cases were found, and including our two original records, a total of six pediatric patients (5 females) were analyzed, of which three had also other autoimmune diseases (thyroiditis, coeliac disease, autoimmune hepatitis), whereas four had been treated with a long-term GCS, and two were receiving biological therapy (etanercept or adalimumab). Only one of them had good metabolic control of diabetes. Diabetes in childhood may coexist with other autoimmune diseases, including rheumatologic conditions. Hyperglycemia can worsen JIA therapy by induction and maintaining inflammation. Using modern diabetes technologies (like personal insulin pumps and continuous glucose monitoring) helps to minimize the deteriorating effect of JIA exacerbations and the rheumatoid treatment on metabolic control of diabetes.

Association of sensorineural hearing loss in type 2 diabetes mellitus patients: an analytical cross sectional study

<p class="Normal1"><strong>Background: </strong>The association of sensorineural hearing loss in diabetes mellitus patients is known since decades, yet there is no clear consensus among previous studies, with respect to the prevalence of SNHL in type 2 diabetes patients and the effect of duration and control of diabetes on hearing acuity. Hence the objectives of this study are to find the prevalence of SNHL in type 2 diabetes patients and to find the effect of duration and control of diabetes on hearing loss.</p><p class="Normal1"><strong>Methods: </strong>The present study was conducted on 100 type 2 diabetes patients and age and gender matched 100 non- diabetic controls in the age group of &lt;50 years, selected based on inclusion and exclusion criteria. After detailed history taking and clinical examination, all subjects underwent FBS, PPBS estimation and HbA1c evaluation was done for diabetic patients. All underwent pure tone audiometry, DPOAE and BERA and the findings were recorded and analyzed.</p><p class="Normal1"><strong>Results: </strong>Diabetes patients had insidious onset, gradually progressive, bilaterally symmetrical SNHL. SNHL is prevalent in 73% of type 2 diabetes patients compared to 16% of controls. It is aggravated with the increasing age and duration of diabetes. Poor control of diabetes showed increased prevalence of SNHL compared to good control of diabetes.</p><p class="Normal1"><strong>Conclusions: </strong>There is increased prevalence of SNHL in type 2 diabetes patients and it is more evident in patients with long duration of diabetes and more pronounced in patients with poor diabetic control.</p>

130 Impact of Low-Dose High-Frequency in situ Simulation on Inpatient Diabetes Management: A Pilot Study

Even in the presence of established institutional guidelines, failure of compliance by the clinical teams plays an important role in the control of diabetes. The identified gaps include contextual and biomedical knowledge, attitudes, clinical inertia, confidence and familiarity with existing hospital resources and guidelines with regards to hospital diabetes care We wanted to demonstrate the efficacy of low-dose high-frequency The exercise was a 15-minute session, delivered during working hours to individual nurses. This consisted of a 5-minute scenario, involving a standardized patient followed by a 10-minute debrief. Modified Diamond-model debrief with an advocacy-inquiry model was used by the debriefer, a trained fellow in simulation, and overseen by an expert. The scripted scenario involved a patient with Diabetic Ketoacidosis (DKA), with learning outcomes of recognizing DKA, managing the patient and adhering to the institutional guidelines including management of hypoglycaemia. The scenario was individualized based on the roles of the participants. Pre- and post-questionnaires were given to the participants. The simulation was repeated twice in the second week and once in the third week.This mixed-method study was conducted in a UK teaching hospital, in a ward designated for patients with diabetes, as a part of a quality improvement programme. In the first week, patients with diabetes, admitted for DKA, were chosen and their blood sugar recordings, dysglycaemic episodes and adherence to guidelines were noted. Every week data were collected as in the first week. GNU pspp 1.0.1 [version 3] free software was used. The confidence scores were given as mean and standard deviation with confidence interval (CI) of 98.75%. A p-value of <0.0125 was considered significant based on the number of data points.The Dysglycemic episodes and protocol adherence from medical recordsConsidering the T2 (increased recognition of diabetic emergencies and adherence to protocol) and T3 (improved patient outcomes) outcomes, the methodology was recommended as a modality of training the nursing staff involved in inpatient care of patients with diabetes. Future programmes including multi-disciplinary teams, to explore teamwork and communication, are planned.

Legacy in Cardiovascular Risk Factors Control: From Theory to Future Therapeutic Strategies?

In medicine, a legacy effect is defined as the sustained beneficial effect of a given treatment on disease outcomes, even after cessation of the intervention. Initially described in optimized control of diabetes, it was also observed in clinical trials exploring intensification strategies for other cardiovascular risk factors, such as hypertension or hypercholesterolemia. Mechanisms of legacy were particularly deciphered in diabetes, leading to the concept of metabolic memory. In a more discreet manner, other memory phenomena were also described in preclinical studies that demonstrated long-lasting deleterious effects of lipids or angiotensin II on vascular wall components. Interestingly, epigenetic changes and reactive oxygen species (ROS) appear to be common features of “memory” of the vascular wall.

Prospects of Aloe vera and its Bioactive Compounds in Diabetes: Critical Review

Diabetes is a significant public health issue. The global diabetes epidemic has had a tremendous impact on India, and the disease burden has increased dramatically. Diabetes is quickly increasing in prevalence, especially in Indian cities, according to data. Therefore, an ideal drug is sought that has better safety and tolerability and the most effective control of diabetes. Many effective medications come from plant sources. Natural products like onion and garlic can effectively control diabetes. In this review, we should pay attention to Aloe vera and its bioactive compounds, that with the development of traditional medicine, Aloe vera can be used to treat various diseases. Some reports have questioned the safety and efficacy of Aloe vera or its compounds, especially at different doses, and some studies have shown no side effects. In this review we also focus on benefits on human health so that Aloe vera is part of the daily diet in many countries and appears to be non-toxic, it is necessary to investigate whether aloe vera dietary supplement can be a beneficial preventive or nutritional mitigation strategy to reduce the effects of diabetes. This review focuses on Aloe vera and its biologically active compounds that play a role in the treatment or prevention of this morbid disease: diabetes, including its underlying mechanism of blood sugar lowering properties, and herbal products that have been marketed for the treatment of diabetes or the therapeutic effect of diabetes.

Effect of Ramadan Fasting on Patients With Type Ii Diabetes Mellitus (A Literature Review)

Diabetes Mellitus (DM) or commonly known as diabetes is a disease caused by impaired carbohydrate metabolism due to the pancreas cannot produce insulin or can produce insulin but the body is not able to use insulin effectively and also produces less insulin, so the body is unable to metabolize carbohydrates, fats, and proteins due to insulin deficiency. Insulin is a hormone that regulates the balance of blood glucose in the body. The writing of this article uses a method of literature review or review literature by reviewing several journals and articles about the relationship between fasting and control of diabetes mellitus management. Journals are downloaded or obtained through the journal portal of universities in Indonesia. The process of writing this article is carried out for two weeks. The results showed that Ramadan fasting is related to DM control through DM management. The conclusion is that there is a significant relationship between several journals studied.