RESUMO
The effect of 0.2% chlorhexidine gluconate on in vitro adhesion of Candida albicans to buccal epithelial cells (BEC) was studied in 12 healthy subjects and 12 patients with diabetes mellitus. Exposure of BEC for one minute with 0.2% chlorhexidine gluconate in vitro, or by rinsing the mouth in vivo, resulted in a significant reduction in candidal adhesion to BEC in both diabetic and non-diabetic subjects and between both groups. In addition to the known fungicidal effect of chlorhexidine, it also reduces Candida albicans adhesion to oral mucosal cells, a factor of importance in the establishment of candidal infection.
Assuntos
Candida albicans/efeitos dos fármacos , Clorexidina/análogos & derivados , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/patologia , Mucosa Bucal/patologia , Adulto , Candida albicans/citologia , Candida albicans/crescimento & desenvolvimento , Estudos de Casos e Controles , Adesão Celular/efeitos dos fármacos , Clorexidina/farmacologia , Contagem de Colônia Microbiana , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Epitélio/efeitos dos fármacos , Epitélio/patologia , Feminino , Humanos , Técnicas In Vitro , Masculino , Mucosa Bucal/efeitos dos fármacosRESUMO
To improve flexibility and acceptability of diabetic management five patients (age 15-26 years) were changed to NovoPen therapy (Human Actrapid Insulin 3 x daily + Human Ultratard Insulin at night). Diabetic ketoacidosis developed within 2-4 months of commencing this regimen and in one patient twice in only 4 weeks. All failed to increase their insulin dose in response to hyperglycaemia and two patients omitted insulin when they did not take meals believing this to be appropriate irrespective of the prevailing blood glucose. The NovoPen regimen may increase the risk of diabetic ketoacidosis in patients who do not monitor and control their diabetes assiduously and should not be seen as a solution for poorly motivated or ill-educated patients.
Assuntos
Cetoacidose Diabética/etiologia , Insulina/administração & dosagem , Autoadministração , Adolescente , Adulto , Feminino , Humanos , Injeções/instrumentaçãoAssuntos
Diabetes Mellitus/metabolismo , Infecções/complicações , Adolescente , Idoso , Bicarbonatos/sangue , Glicemia/análise , Temperatura Corporal , Transtornos Cerebrovasculares/complicações , Complicações do Diabetes , Diabetes Mellitus/mortalidade , Escherichia coli/isolamento & purificação , Feminino , Humanos , Hiperglicemia/etiologia , Hipotermia/complicações , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Pneumonia/complicações , Proteus mirabilis/isolamento & purificação , Infecções Respiratórias/complicações , Infecções Respiratórias/microbiologia , Sepse/complicações , Dermatopatias Infecciosas/complicações , Staphylococcus/isolamento & purificação , Streptococcus/isolamento & purificação , Infecções Urinárias/complicações , Infecções Urinárias/microbiologiaRESUMO
Of a series of 211 episodes of diabetic metabolic decompensation 37 had severe euglycaemic ketoacidosis (a blood sugar level of less than 300 mg/100 ml and a plasma bicarbonate of 10 mEq/1. or less). All were young insulin-dependent diabetics, only one being previously undiagnosed. Vomiting was a common factor, and in all carbohydrate reduction occurred with continued or increased daily insulin dose. Treatment comprised fluid and electrolyte replacement and large doses of insulin covered by adequate carbohydrate, many receiving 10% dextrose. Alkali was either withheld or given sparingly and the therapy was monitored by serial estimations of plasma bicarbonate. All the patients survived.
