Sindrome hiperosmolar en 3 pacientes diabéticos del Instituto Nacional de Diabetes, Endocrinología y Nutrición (INDEN) / Hiperosmolar syndrome in 3 diabetic patients from Instituto Nacional de Diabetes, Endocrinología y Nutrición (INDEN)

Reportamos 3 casos de pacientes diabéticos que se presentaron al Hospital del Instituto Nacional de Endocrinología y Diabetes (INDEN) en estado de coma y a quienes se les diagnosticó tempranamente sindrome hiperosmolar. Fueron manejados con exito en un período de 72 horas con una agresiva hidratación con soluciones hipotónicas

Terapéutica farmacológica en pacientes diabéticos hospitalizados / Pharmacologica therapeutica in hospitalized diabetic patients

Se realizó un estudio prospectivo en 100 pacientes diabéticos hospitalizados de manera consecutiva en el Instituto Nacional de Diabetes, Endocrinología y Nutrición (INDEN). Se estudió en ellos las patologías presentes, la terapeutica utilizada y los dias de estancia hospitalaria. La edad promedio de los pacientes fue de 54 años 42 por ciento eran masculinos y 58 por ciento femeninos. La estancia hospitalaria tuvo una duración promedio de 4 dias. Las patologías mas frecuentes fueron cardiovasculares 40 por ciento y las infecciosas 33 por ciento . En el aspecto terapeutico, 82 por ciento de los pacientes recibió insulina y 11 por ciento sulfonilureas. En antibióticos, los mas usados fueron Ampicilina 33 por ciento , Penicilina 16 por ciento y Gentamicina 13 por ciento . Para las afecciones cardiovasculares 20 por ciento recibió ifedipina, 16 por ciento Furosemida, 14 por ciento Digoxina y 11 por ciento Nitritos

Diabetes mellitus en el envejecimiento

Diabetes mellitus represents one of the major chronic disorders of the growing population. The reasons for the glucose intolerance of the aged and the increased prevalence of diabetes mellitus in elderly persons are multifactorial. Diabetes also directly damages the myocardium, predisposing elderly diabetic patients to cardiac failure. Hypertension is also a common problem in elderly patients with diabetes, in these patients, hypertension is primarily related to obesity. The obesity related hyperinsulinemia diabetes of the elderly is seldom ketogenic and does not tend to produce acidosis and coma; atherosclerotic cardiovascular sequelas therefore, present the major hazards. The gravest neurologic complication in elderly patients are cerebrovascular accidents. Diabetes appears to be responsible for impotence in 10 to 20 percent of older patients attending primary care physicians. The occurrence of Diabetic retinopathy is common. Diabetic patients have an increased incidence of cataracts. Diabetes and infections are both common in the elderly

Dislipoproteinemias en diabetes mellitus

Althoug Diabetes Mellitus is, by definition, a state of abnormal carbohydrate metabolism, defects in lipoprotein metabolism are a prominent feature of the diabetic syndrome. In Type I diabetic patients, hiper lipidemia may occur as the result of increased production of lipoprotein, decreased removal or a combination of both. The abnormalities in plasma lipoprotein concentration most likely to be seen in non-insulin dependent diabetes mellitus, are an increase in VLDL-triglyceride and a decrease in HDL-cholesterol levels. Abnormalities of cholesterol on lipid metabolism often precede diabetes, vascular disease, particularly intermittent claudication is common in diabetic patients and may precede the onset of diabetes mellitus. Obesity is a powerful independent contributor to the occurrence of diabetes and the risk is related to the degree of adiposity. In clinical practice control of diabetes mellitus should be expanded to include not only the normalization of blood sugar levels, but also correction of blood lipid levels, reduction of elevated blood pressure, avoidance of cigarrettes, and correction of obesity