Influencing factors of life quality in middle-aged diabetic patients in a community of Shanghai / 上海预防医学

Objective To understand the situation and the influencing factors of life quality in diabetic patients in Shanghai， and to develop effective intervention measures. Methods A total of 212 diabetic patients in Baoshan District， Shanghai were selected as the research objects. Diabetes specific quality of life scale （DSQL） was used to investigate the basic situation and quality of life of patients. Combined with biochemical detection indexes and questionnaire survey， data were analyzed by variance analysis and multiple linear stepwise regression analysis. Blood glucose level was assessed according to the 1999 WHO diagnostic criteria for type 2 diabetes. Results The overall quality of life score in the patients was 4.31±7.82， which was higher than the domestic norm. The best quality of life was in the dimension of physiological function with the score of 1.84±6.00， which was lower than the domestic norm. The next was the dimension of social relationship， and the worst was the dimension of treatment. The single factor analysis and multivariate analysis identified the following influence factors of quality of life in the patients： family history， educational level， exercise habit， blood glucose control and diet control. There was a negative correlation with educational level and blood glucose control， and a positive correlation with diet control. Conclusion The quality of life in the middle-aged diabetic patients was affected by the education level， blood glucose control and diet control. We suggest to strengthen the community management， health education， and improve the living habits.

Evolution of Lymphedema in an Obese Diabetic Patient Using Grosgrain Stockings as Monotherapy

The objective of this study was to show the evolution of lymphedema in an obese diabetic patient using grosgrain stockings as monotherapy. A 51-year-old obese male with diabetes since childhood did not perform adequate control of the condition, progressing to vision loss and diabetic neuropathy. About 10 years ago, he began to have edema in the left leg, which progressed. Therefore, bioimpedance analysis was used, which demonstrated generalized lymphedema. The use of compression stockings made of grosgrain fabric was proposed to which the patient presented good tolerability for 1 year. At one of the evaluations, the generalized edema had returned but subsequently improved again. However, the lymphedema of the trunk and lower limbs remained, despite the weight loss. Systemic clinical lymphedema evaluated by electrical bioimpedance analysis was reduced with the weight loss of the patient throughout treatment.

Importancia de predecir y tomar medidas para evitar la úlcera plantar en el paciente diabético / Importance of predicting and taking measures to avoid foot ulcer in diabetic patients

La prevención ha sido un objetivo perenne en la formación de los angiólogos y cirujanos vasculares cubanos. El lograr predecir y prevenir en las úlceras en los pacientes diabéticos, es un añorado éxito. En este texto, se hace una revisión conceptual de algunos aspectos relativos al tema, y a la vez recientes observaciones de investigadores, que nos dejan ver todas las nuevas posibilidades existentes de investigación en derredor de la prevención de la úlcera en el pie del paciente diabético(AU)

Prevention has been a perennial objective in the training of Cuban vascular surgeons and angiologists. Predicting and preventing ulcers in diabetic patients is a desired success. In this text, a conceptual review of some aspects related to this subject is made, and at the same time of recent observations of researchers, which allow us to see all the new possibilities of research on the prevention of foot ulcer in diabetic patients(AU)

Proteinuria and Hypertension with and and without type 2 diabetes mellitus: An Update

@#In this update four related areas are reviewed. They are: (1) Blood Pressure (BP) definition and classification; (2) Hypertension diagnosis; (3) Hypertension and proteinuria in non-diabetic patients; and (4) Proteinuria and hypertension in the patient with diabetes. METHODOLOGY. PubMed searches were done for papers to the above four topics published in the last five years (2014 to 2019). These were supplemented by papers from hand searches. RESULTS. For diagnosis of hypertension, the current cut off of 140/90 mmHg can be reduced to 130/80 mmHg to improve cardiovascular outcomes and all-cause mortality. Diagnosis of hypertension should not be based on office BP readings alone. Hypertension in older patients should be treated to prevent worse outcomes and should be individualised. In non-diabetic patients, both low grade and microalbuminuria needs to be treated; adequate BP control is needed to prevent cardiovascular outcomes and all-cause mortality. In the diabetic patient, a BP target of less than 140/90 mmHg applies to most patients but individualisation of the BP goal is important. CONCLUSIONS. Much development in the management of proteinuria and hypertension has taken place in the last five years.

Perioperative management of the diabetic patient referred to cardiac surgery

Abstract Currently there is a progressive increase in the prevalence of diabetes in a referred for cardiovascular surgery. Benefits of glycemic management (< 180 mg/dL) in diabetic patients compared to patients without diabetes in perioperative cardiac surgery. The purpose of this study is to present recommendations based on international evidence and adapted to our clinical practice for the perioperative management of hyperglycemia in adult patients with and without diabetes undergoing cardiovascular surgery. This update is based on the latest current literature derived from articles and guidelines regarding perioperative management of diabetic patients to cardiovascular surgery.

Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian

This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. ‘Nutrition intervention’ was 4.5 ± 0.5 for task importance, ‘nutrition assessment’ was 4.0 ± 0.7 for performance, and ‘nutrition diagnosis’ was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were ‘checking basic information,’‘checking medical history and therapy plan,’‘decision of nutritional needs,’‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ The tasks with high importance but low performance were ‘derivation of nutrition diagnosis,’‘planning of nutrition intervention,’‘monitoring of nutrition intervention process.’ The tasks of both high importance and high difficulty were ‘derivation of nutrition diagnosis,’‘planning of nutrition intervention,’‘supply of foods and nutrients,’‘education of nutrition and self-management,’ and ‘monitoring of nutrition intervention process.’ The tasks of both high performance and high difficulty were ‘documentation of nutrition assessment,’‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’

Narrative Therapy for Diabetic Patients / 임상당뇨병

Diabetic patients undergo psychosocial difficulties, including anger, because of their chronic disease, anxiousness of complications, and stress resulting from the need for self-management. These difficulties often lead to depression and other negative emotions. Thus, management of these emotions is needed. Narrative therapy can help patients discover their identity, including their own capabilities, values, and hopes. Through the process of narrative therapy, which includes externalization conversation, reauthoring conversation, re-membering conversation and definition ceremony, diabetic patients can achieve emotional stability. Furthermore, it can be helpful in blood sugar management.

Impact of ‘Community based Diabetic patient education’ on glycaemic status, life style and self care practices among type 2 diabetes patients in an urban slum of Mumbai, India.

Demographic transition combined with urbanization and industrialization has resulted in drastic changes in lifestyles of all people but its harmful impact is more in developing countries because of their rapid pace of growth in last few decades. According to the recent World Health Organization report, India has around 32 million diabetic patients and this number is projected to increase to 79.4 million by the year 2030. Our Aim of the study was to assess the impact of community based DPE on glycaemic control, life style and self care practices among type 2 diabetic patients. This community based interventional study done among 272 type 2 diabetic patients who were selected from slum area. All patients were given Community diabetic patient education (DPE) over a period of one year. Following DPE the life style parameters and self care practices have improved which is statistically significant (p value <0.05). Both fasting and postprandial blood sugar level, blood pressure & BMI had been significantly improved (p value < 0.001).

Evaluación del desempeño analítico de tres métodos de cuantificación de hemoglobina A1c / Analytical performance evaluation of three methods for hemoglobin A1c quantification / Avaliação do desempenho analítico do três métodos de quantificação de hemoglobina A1c

El laboratorio debe garantizar la exactitud de los resultados de HbA1c cumpliendo con los requisitos analíticos internacionales de calidad, cada vez más estrictos y asegurar que una variación de HbA1c de 0,5 puntos porcentuales (%-NGSP) o más entre dos controles consecutivos de un paciente diabético se deba a una variación clínica y no a una variación analítica. En este trabajo se evaluó el desempeño analítico de tres métodos comerciales para HbA1c: inmunoturbidimétrico, enzimático y cromatográfico de intercambio catiónico. Para tal fin, se procesaron por cada método distintos controles comerciales de HbA1c, con trazabilidad al método de referencia IFCC, determinándose en cada caso Coeficiente de Variación Total, Bias, Error Total, Valor de Referencia del Cambio y cambio clínico significativo de HbA1c en el punto crítico 7,0%-NGSP. En las condiciones analíticas de este trabajo, solamente el método inmunoturbidimétrico tuvo un desempeño analítico aceptable, permitiendo atribuir un cambio de 0,5%-NGSP a una variación clínica significativa del paciente. Frente a las recomendaciones internacionales sobre el uso de HbA1c en el control y diagnóstico de diabetes, es indiscutible la importancia de elegir un método que satisfaga los requerimientos analíticos mínimos de calidad para asegurar la utilidad clínica del resultado de HbA1c.

The laboratory must guarantee the accuracy of HbA1c results meeting the increasingly strict international analytical quality standards and assuring that an HbA1c variation of 0.5 percentage points (%-NGSP) or more between two consecutive controls of a diabetic patient is due to a clinical variation and not to an analytical variation. In this paper, the analytical performance of three commercial methods for HbA1c: Immunoturbidimetric, Chromatographic and Enzymatic Cation Exchange, were evaluated. For this purpose, commercial controls with assigned values traceable to the IFCC reference method for HbA1c were processed. For each methodology, total Coefficient of Variation (CV%), Bias%, Total Error (TE%), Change Reference Value and Clinically Significant Change (CSC) at the critical point of HbA1c 7.0%-NGSP were determined. Within the analytical conditions of this study, only the immunoturbidimetric method had an acceptable analytical performance, allowing attribute a change in 0.5%-NGSP to a significant clinical variation. Faced with international recommendations on the use of HbA1c on control and diagnosis of diabetes, the importance of choosing a method that meets the minimum analytical quality requirements to ensure the clinical utility of HbA1c result is undeniable.

O laboratório deve garantir a precisão dos resultados da HbA1c cumprindo com os requisitos analíticos internacionais de qualidade cada vez mais exigentes e garantir que uma variação de HbA1c de 0,5 pontos percentuais (% - NGSP) ou mais entre duas verificações consecutivas de um doente diabético seja devido a uma variação clínica e não a uma variação analítica. Neste trabalho foi avaliado o desempenho analítico de três métodos comerciais para HbA1c: imunoturbidimétrico, enzimático e cromatográfico de intercâmbio catiônico. Para esse fim, foram processados diversos controles comerciais de HbA1c por cada método, com rastreabilidade ao método de referência IFCC, determinando em cada caso Quociente de Variação Total, Bias, Erro Total, Valor de Referência da Alteração e Alteração Clinicamente Significativa de HbA1c no ponto crítico 7,0%-NGSP. Nas condições de análise deste estudo, apenas o método imunoturbidimétrico teve um desempenho analítico aceitável, permitindo atribuir uma alteração de 0,5%-NGSP a uma variação clínica significativa do paciente. Perante as recomendações internacionais sobre o uso da HbA1c no controle e diagnóstico da diabetes, é inegável a importância de escolher um método que atenda os requisitos analíticos mínimos de qualidade de análise para garantir a utilidade clínica do resultado HbA1c.

Pharmacodynamics of recombined human glucagon-like peptide-1 in Chinese type 2 diabetic patients / 中国药学杂志

OBJECTIVE: To evaluate the pharmacodynamics of recombined human glucagon-like peptide-1 (GLP-1) after multiple dose subcutaneous injection with or without oral dimethyl diguanidine in Chinese type 2 diabetic patients. METHODS: Twenty-four Chinese type 2 diabetic patients were divided into three groups randomly to receive multiple dose of GLP-1 with or without oral dimethyl diguanidine. Plasma samples were collected after injection. The concentrations of glucose and insulin were determined, and the variation of glucose and insulin was analyzed. RESULTS: There was a significant reduction of blood glucose level compared with base line within 2 h after injection of GLP-1. The reduction magnitudes in the three groups were in the following sequence: GLP-10.2 mg + dimethyl diguanidine > GLP-10.2 mg > GLP-10.1 mg. There was a rise of insulin in contrast with base line within 10 - 30 min after injection of GLP-1. CONCLUSION: There are a rise of blood insulin and a reduction of blood glucose after injection of GLP-1 in Chinese type 2 diabetic patients.

Perception and Use of Complementary and Alternative Medicine in Diabetic Patients in Busan Area / 대한지역사회영양학회지

The purpose of this study was to investigate the perception and utilization of Complementary and Alternative Medicine (CAM) for diabetic patients in Busan. The subjects were 227 patients at two general hospitals (over 400 bed). This study was performed through the interviewing process using questionnaires conducted from January to April, 2010. Of a total of subjects, 109 patients (48.0%) had taken CAM at least one time. The patients used CAM recognized that they were 'auxiliary medicines' (39.4%), 'supplementary health foods' (32.1%) and 'medicines' (19.3%), but inexperienced patients perceived them as 'supplementary health foods' (29.6%), 'unscientific treatment' (22.6%) and 'medicines' (20.2%), It was significantly different between two groups of patients (p < 0.001). The number of CAM types used for the patients was 51. The CAM types were plant foods (64.3%), dietary supplement (23.6%) and animal diets (12.1%). The patients used an average of 5.9 different kinds of CAM and an average of 3.8 years them and paid \93,345 per month. The patients with diabetic complications and for longer morbidity periods used CAM for significantly (p < 0.05) longer periods. The mean effectiveness scores of the patients used CAM were 3.31/5.00 for efficacy satisfaction, 3.58/5.00 for fewer side effects compared to those of oral drugs, 3.60/5.00 for psychological stability, 3.81/5.00 for easiness to use, and 3.06/5.00 for economic satisfaction. Of the patients that used CAM, 55.9% did not consult with doctors about CAM. More than two-thirds of the patients (77.1%) did not feel the need to consult with doctors.

A clinical trial of xenotransplantation of neonatal pig islets for diabetic patients / 中南大学学报(医学版)

ObjectiveTo ascertain the safety and function of the transplantation of neonatal pig islets (NPIs) for diabetic patients.MethodsNPIs were injected into the hepatic artery of 22 patients.After the transplantation,the patients were treated with a multiple drug immunosuppressive regimens.The first 14 patients were treated with cyclosporine (CsA),mycophenolate mofetil (MMF) and prednisolon,and porcine C-peptide was not monitored,the following 2 patients were given cyklosporin and MMF only,while the next 6 patients were given a quadruple drug regimen consisting of OKT3,takrolimus,sirolimus and prednisolon.The blood glucose levels,exogenous insulin requirement,HbA1c,porcine endogenous retrovirus (PERV) and liver function were assessed before and after NPI transplantation.The serum porcine C peptide were monitored in last 8 patients.ResultsThe first 14 patients required less insulin and the HbAlc dropped after the transplantation.In the 2 subsequent patients,the metabolic parameters remained unchanged and monitor of porcine C-peptide was negative.Insulin requirements were reduced in all 6 patients,and HbAlc was normalized 3 months after the transplantation.Significant levels of porcine C-peptide were detected in the patient serum.Two of the patients were given a second injection of NPIs,and one of them became insulin independent for 7 d.No serious adverse events were noted after the transplantation.There was no evidence of PERV transmission.Six out of the 22 patients were followed up for 4-6 years after the NPIs injection,immunosuppressive treatment was stopped 1 year after the transplantation.The patients started to take insulin at the time of follow up.Four patients restricted the intake of sugar,while the other 2 did not.One patient had ketoacidosis twice and slight diabetic retinopathy,and another patient had ketoacidosis induced by acute gastroenteritis.The remaining 4 patients did not have any complications.Assays for PERV were again negative.ConclusionXenogenic islets can survive and function in the human body.No serious adverse events are noted.

A Case of Necrotizing Fasciitis Due to Streptococcus agalactiae, Arcanobacterium haemolyticum, and Finegoldia magna in a Dog-bitten Patient with Diabetes / 대한진단검사의학회지

We report a case of necrotizing fasciitis involving Streptococcus agalactiae, Arcanobacterium haemolyticum, and Finegoldia magna in a 36-yr-old female diabetic patient, which started after a minor dog bite to the toe of the patient. This case suggested that a trivial infection after a minor dog bite in an immunocompromised patient such as diabetes patient could result in a significant complication such as necrotizing fasciitis. The life-threatening infection was cured by timely above-the-knee amputation, as well as penicillin G and clindamycin therapy.

Lumbar Pyogenic Spondylodiscitis and Bilateral Psoas Abscesses Extending to the Gluteal Muscles and Intrapelvic Area Treated with CT-guided Percutaneous Drainage: A Case Report

Bilateral psoas abscesses extending to the gluteal muscle and intrapelvic area are uncommon. We present our experience with computed tomography (CT)-guided percutaneous catheter drainage for the treatment of multiple aggressive abscesses in a diabetic patient. The abscesses completely resolved after the procedures. Psoas abscess should be considered in the differential diagnosis of older diabetic patients with fever, flank or back pain, and flexion contracture of the hip joint. CT scanning is a useful method in diagnosing abscesses, and CT-guided percutaneous catheter drainage is an effective treatment method in selected patients.

The Effects of Intensive Insulin Therapy on the ? Cell of Islets of Pancreas in Incipient Type Diabetes Patients / 医学研究杂志

0.05);The levels of basal FINS showed a significant differences between group A and group B(P0.05).Conclusions Intensive insulin treatment to newly diagnosed type 2 diabetes patients can control blood glucose rapidly to a desired level,and can recover the function of B cell better than traditional oral hypoglycemic agents by dissolving the virulence of glucose rapidly.

Relationship between the treatment targets and the blood glucose concentration and the quality of life in the diabetic patients / 中国实用护理杂志

Objective To investigate the current situation of the cognition of diabetic patients to the targets of treatment and management,and then make clear the relationship between the treatment targets and the blood glucose concentration and the quality of life among diabetic patients. Methods Investigated 150 diabetic patients randomly by 3 kinds of scales: ① targets of treatment and management scale;② quality of life scale;③ communication between the doctor and the patients questionary. Results When the patients set the targets of treatment and management,especially these targets were in agreement with those of doctor,their blood sugar were always controlled well(P

Electrorretinograma estandarizado con respuesta de conos S y onda C en diabéticos sin retinopatía / Standardized electroretinogram with response of S-cones and C wave in diabetics without retinopathy

Con la intención de probar la utilidad del electrorretinograma en el estudio funcional de la retina del paciente diabético, se registra el electrorretinograma de 30 sujetos sanos y 20 diabéticos sin retinopatía y visión de la unidad, con diferentes tipos de registros electrorretinográficos, como, electrorretinograma de bastones, mesópico, potenciales oscilatorios, de conos en general, de conos S, onda C y de respuesta macular a la estimulación mantenida. Cuando se compararon con los registros de personas sanas de similar edad, todas las respuestas electrorretinográficas, excepto la de estimulación mantenida, fueron anormales en al menos el 60 % de los casos. Los potenciales oscilatorios y la onda C se vieron afectados en el 100 %.

In order to prove the usefulness of the electroretinogram in the functional study of the retina of the diabetic patient, it was recorded the electroretinogram of 30 sound subjects and 20 diabetics without retinopathy and unit vision, with different types of electroretinographic recordings, such as vertical bar, oscillatory potential, cones in general, S-cone, and C wave electroretinogram, and that of macular response to the maintained stimulation. On comparing them with the recordings of sound persons with a similar age, all the electroretinographic responses, excepting that of maintained stimulation, were abnormal in at least 60 % of the cases. The oscillatory potentials and the C wave were affected in 100 % of the cases.

A Study on the Related Factors and the Change after Foot-reflexo-massage Education Program for Diabetic Patients / 성인간호학회지

PURPOSE: The purpose of this study was to identify the change in foot care knowledge, self care behavior, and physiologic indexes after foot reflexomassage education program, and the related factors. METHOD: Data were collected from 20 patients who were visited out patients clinic. The change and difference were analyzed with non-parametric statistics. RESULT: There were significant differences in foot care knowledge(P=.001), self care behavior(P=.000), dosalis pedis blood flow volume (P=.011), skin temperature of foot(P=.001), dorsalis pedis pulse(P=.000), capillary filling time of foot (P=.000) between pre and post. The level of changes of foot care knowledge was significant differences according to admission experience (P=.049), and negative related to systolic blood pressure(P=.028). The level of changes of self care behavior was related to age(P=.049), that of dosalis pedis blood flow was significant difference according to smoking(P=.042), that of skin temperature of foot(P=.002) and dosalis pedis pulse(P=.038) were significant difference according to weight. The level of changes of capillary filling time of foot was related to diagnosis period(P=.014). CONCLUSION: Foot- Reflexo-Massage education program is an effective nursing intervention to promote foot care in diabetic patients. And the related factors can be recommended for the management of diabetic patients.

The Effects of a Foot-Reflexo-Massage Education Program on Foot Care in Diabetic Patients / 간호학회지

PURPOSE: This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients. METHOD: A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA. RESULT: There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow. CONCLUSION: Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

Paciente diabético e información sobre su enfermedad / Diabetic patient and information about his illness

Introducción: la diabetes mellitus es la más común de las enfermedades metabólicas en los seres humanos y una de las principales causas de morbilidad y defunción. El objetivo de este estudio es determinar si existe relación entre la información del paciente diabético sobre su enfermedad y la descompensación de su padecimiento. Material y métodos: se estudiaron 30 pacientes diabéticos descompensados, hospitalizados; se excluyeron aquellos que tuvieron motivos diferentes a la descompensación diabética y se eliminaron los que pasaron a estado crítico. Se utilizó el análisis estadístico descriptivo para las características de la población y de la enfermedad; así como prueba de significancia X: para analizar la información. Resultados: predominó el género femenino (57%), edad mínima de 31 años y máxima de 81 con una x 60.3 + 13.9; en la información del padecimiento 17% de los pacientes recibió información adecuada sobre la enfermedad y 83% información deficiente; lo cual mostró chi2=13.2p > 0.001 y una índice de confianza del 95% p < 0.05 siendo estadísticamente significativa. Discusión: la información que se otorga sobre diabetes Mellitus es deficiente en la mayoría de los pacientes diabéticos descompensados.

Objetive: to determine if there is a relation between the información given to diabetic patients about their illness and the presentation of complications metabolic control. Materials and methods: we studied 30 diabetic patients with complications of their illness hospitalizad in 1999. We excluded diabetic patiens who requered intensive care. We utilized descriptive statistical analysis for the characteristics of the population and the disease. We utilized the x2 to significance test. Results: 17% of the patients had get good information about their illness and 83% get deficient information about it. We get a X2 =13,2, P > 0.001 and a = 0.05 P < 0.05. It was statistic significant. Conclusion: the information about diabetes in complicated patients is almost deficient. This patients are obese and with a long evolution in their illness.