Pub Date : 2021-02-25DOI: 10.15406/JDMDC.2021.08.00218
M. Burge, Imaneh Fallahi, M. Garimella, S. Mitchell
Background: Insulin detemir is long-acting insulin analog that is weight-neutral compared with other long-acting insulins in patients with type 1 diabetes. One mechanism for this may be an effect of insulin detemir to enhance satiety. We hypothesized that type 1 diabetes patients on insulin detemir will eat fewer calories when presented with a standardized buffet meal following a 24-hour fast as compared to those on insulin glargine. Methods: Ten subjects with C-peptide negative type 1 diabetes participated in a randomized, double-blind crossover study in which they received equivalent doses of either insulin detemir or insulin glargine twice daily for at least 3 weeks. They were subsequently admitted to the UNM Clinical Research Unit for a 24-hour fast, after which they were allowed to eat to satiety from a standardized buffet. Caloric consumption, hunger score and body compositions were measured. Leptin, Ghrelin and Peptide YY were assessed at baseline, after 24-hour fast, and after ingestion of the meal. Results: Subjects were aged 35±11 years, had diabetes for 18±11 years, had A1c levels of 8±1% and BMI of 30±8 kg/m2. Short acting insulin doses were higher for subjects receiving insulin detemir versus insulin glargine (p<0.001). Hunger scores, total energy ingested following the 24-hour fast, and Resting Energy Expenditure did not significant differ between the two study conditions. Conclusion: The weight-neutrality of insulin detemir in type 1 diabetes is not attributable to reduced caloric intake following a fast, or to serum satiety factors.
{"title":"Effects of insulin detemir versus insulin glargine on food intake and satiety factors in type 1 diabetes","authors":"M. Burge, Imaneh Fallahi, M. Garimella, S. Mitchell","doi":"10.15406/JDMDC.2021.08.00218","DOIUrl":"https://doi.org/10.15406/JDMDC.2021.08.00218","url":null,"abstract":"Background: Insulin detemir is long-acting insulin analog that is weight-neutral compared with other long-acting insulins in patients with type 1 diabetes. One mechanism for this may be an effect of insulin detemir to enhance satiety. We hypothesized that type 1 diabetes patients on insulin detemir will eat fewer calories when presented with a standardized buffet meal following a 24-hour fast as compared to those on insulin glargine. Methods: Ten subjects with C-peptide negative type 1 diabetes participated in a randomized, double-blind crossover study in which they received equivalent doses of either insulin detemir or insulin glargine twice daily for at least 3 weeks. They were subsequently admitted to the UNM Clinical Research Unit for a 24-hour fast, after which they were allowed to eat to satiety from a standardized buffet. Caloric consumption, hunger score and body compositions were measured. Leptin, Ghrelin and Peptide YY were assessed at baseline, after 24-hour fast, and after ingestion of the meal. Results: Subjects were aged 35±11 years, had diabetes for 18±11 years, had A1c levels of 8±1% and BMI of 30±8 kg/m2. Short acting insulin doses were higher for subjects receiving insulin detemir versus insulin glargine (p<0.001). Hunger scores, total energy ingested following the 24-hour fast, and Resting Energy Expenditure did not significant differ between the two study conditions. Conclusion: The weight-neutrality of insulin detemir in type 1 diabetes is not attributable to reduced caloric intake following a fast, or to serum satiety factors. ","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"499 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78136030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-22DOI: 10.15406/jdmdc.2021.8.00217
R. Chatterjee, P. Halder, S. Mallik, B. Saha
Forbes Albright syndrome is a hyperprolactinemia syndrome characterised by galactorrhea and amenorrhea associated with a pituitary tumour. Here we report a case of 30 years female who was admitted with menstrual irregularities for 4 months, galatorrhea and headache with recurrent episodes of loss of consciousness for 3months. Her serum prolactin level was highly raised. MRI brain (plain plus contrast) showed enlarged pituitary gland- pituitary macroadenoma. She was diagnosed as a case of Forbes Albright Syndrome and was treated with Tablet Cabergoline. With the medication, size of her tumour markedly reduced and symptoms resolved as she was followed up after 3 months.
{"title":"Forbes albright syndrome: galactorrhea–amenorrhea associated with a pituitary tumour: a case report","authors":"R. Chatterjee, P. Halder, S. Mallik, B. Saha","doi":"10.15406/jdmdc.2021.8.00217","DOIUrl":"https://doi.org/10.15406/jdmdc.2021.8.00217","url":null,"abstract":"Forbes Albright syndrome is a hyperprolactinemia syndrome characterised by galactorrhea and amenorrhea associated with a pituitary tumour. Here we report a case of 30 years female who was admitted with menstrual irregularities for 4 months, galatorrhea and headache with recurrent episodes of loss of consciousness for 3months. Her serum prolactin level was highly raised. MRI brain (plain plus contrast) showed enlarged pituitary gland- pituitary macroadenoma. She was diagnosed as a case of Forbes Albright Syndrome and was treated with Tablet Cabergoline. With the medication, size of her tumour markedly reduced and symptoms resolved as she was followed up after 3 months.","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91255501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-09DOI: 10.15406/JDMDC.2021.08.00216
K. Kaur, G. Allahbadia, M. Singh
The incidence of obesity is increasing in mammoth proportions so much so that associated comorbidity T2DM incidence is increasing markedly that we had to coin a term Diabesity to target both together. Earlier trying to review etiopathogenesis of both obesity and type 2 DM we found that whatever drugs that are formulated usually do not work with some complications and till now other than bariatric surgery we have no permanent cure for long term maintenance.Further T2DM might be a disease of 2 etiopathogenesis, namely inflammatory, as well as metabolic.Although metabolic inflammation has the properties of being systemic, their common initiating point is tissue resident macrophages, whose successful physiological or abnormal pathological adaptation to its microenvironment dictates disease course as well as severity. Earlierv we reviewed macrophage polarization in case of non alcoholic fatty liver disease (NAFLD) . Here we review it more comprehensively regarding crucial modes, of macrophage polarization, inflammatory, as well as non inflammatory which sees to the formation Of insulin resistance(IR) as well as Type 2 diabetes mellitus(T2DM) .Details of macrophage polarization, bioenergetics macrophage adaptations in different scenario is discussed in detail along with role of transcription factors like Interferon Regulatory Factor 5(IRF5), Nuclear Factor Kappa B(NFKB), Toll Like Receptor 4 (TLR4) Liver X Receptor (LXR), Activator Protein 1(AP1), Hypoxia Inducible Factor 1(HIF1), Signal Transducers and Activators of Transcription (STATS) in all these signaling besides per oxisome Proliferator Activated Receptor (PPAR) .
{"title":"Targeting macrophage polarization for therapy of diabesity–the feasibility of early improvement of insulin sensitivity and insulin resistance-a comprehensive systematic review","authors":"K. Kaur, G. Allahbadia, M. Singh","doi":"10.15406/JDMDC.2021.08.00216","DOIUrl":"https://doi.org/10.15406/JDMDC.2021.08.00216","url":null,"abstract":"The incidence of obesity is increasing in mammoth proportions so much so that associated comorbidity T2DM incidence is increasing markedly that we had to coin a term Diabesity to target both together. Earlier trying to review etiopathogenesis of both obesity and type 2 DM we found that whatever drugs that are formulated usually do not work with some complications and till now other than bariatric surgery we have no permanent cure for long term maintenance.Further T2DM might be a disease of 2 etiopathogenesis, namely inflammatory, as well as metabolic.Although metabolic inflammation has the properties of being systemic, their common initiating point is tissue resident macrophages, whose successful physiological or abnormal pathological adaptation to its microenvironment dictates disease course as well as severity. Earlierv we reviewed macrophage polarization in case of non alcoholic fatty liver disease (NAFLD) . Here we review it more comprehensively regarding crucial modes, of macrophage polarization, inflammatory, as well as non inflammatory which sees to the formation Of insulin resistance(IR) as well as Type 2 diabetes mellitus(T2DM) .Details of macrophage polarization, bioenergetics macrophage adaptations in different scenario is discussed in detail along with role of transcription factors like Interferon Regulatory Factor 5(IRF5), Nuclear Factor Kappa B(NFKB), Toll Like Receptor 4 (TLR4) Liver X Receptor (LXR), Activator Protein 1(AP1), Hypoxia Inducible Factor 1(HIF1), Signal Transducers and Activators of Transcription (STATS) in all these signaling besides per oxisome Proliferator Activated Receptor (PPAR) .","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82447611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-09DOI: 10.15406/JDMDC.2021.08.00215
S. Chaudhuri, A. Majumder, D. Sanya
Background: Majority of the Type 2 Diabetic (T2D) subjects in the course of the disease require insulin therapy to achieve glycaemic control. Basal insulin supported oral therapy (BOT) has become a common approach for glycaemic control nowadays thus leading to early insulin initiation The newly introduced ultra long acting basal insulin glargine u 300 is a concentrated form of the gold standard basal insulin Glargine u 100 with a different pharmacokinetic and pharmacodynamic profile (PK/PD) with claimed advantages with regards to daylong durability of action and less incidence of hypoglycaemia. Aims and objectives: To evaluate the efficacy, and safety of Glargine U300 when used along with oral anti diabetic agents (OAD) in insulin naive Indian T2D subjects Materials and methods: This is a retrospective real world medical registry based observational study which looked at insulin naive patients initiated on insulin Glargine U 300 over and above standard of care and were followed up for a minimum of 12 weeks. DMT2 subjects presenting with osmotic symptoms or with OAD failure as per Indian Insulin Guidelines and completed the minimum 12 weeks of Glargine U 300 therapy maintaining all data and without requiring rescue doses of prandial insulin, were included. The primary efficacy parameters evaluated at the end of 12 weeks was glycated hemoglobin (HbA1c) along with of fasting plasma glucose (FPG), post prandial plasma glucose (PPPG). Safety was mainly assessed by self-reported hypoglycemia by the patients and weight gain measured at the clinic. Results: A database of 61 patients (34 male and 27 female) was looked into and there was a statistically significant reduction of all glycaemic parameters (p<0.001) and patients reached target HbA1c <7% at 12 weeks. On the safety front, average weight gain was less than a kilogram (0.71+/-0.13 kg) and there were 5 episodes of symptomatic hypoglycaemia and one episode of severe hypoglycaemia and no incidence of nocturnal hypoglycaemia. Severe hypoglycemia was defined as severe cognitive impairment requiring external assistance for recovery. There were no statistically significant changes in creatinine, systolic and diastolic blood pressure values though there was a statistical significant (p=0.042 and p=0.029 respectively) reduction in triglyceride and low density lipoprotein cholesterol. Conclusion: Glargine U300, from this data appears to be safe and effective basal insulin for initial use in insulin naive OAD failure subjects with low risk of hypoglycaemia and insignificant weight gain.
{"title":"An initial look form eastern India into the efficacy and safety of glargine U 300-the new ultra long basal insulin","authors":"S. Chaudhuri, A. Majumder, D. Sanya","doi":"10.15406/JDMDC.2021.08.00215","DOIUrl":"https://doi.org/10.15406/JDMDC.2021.08.00215","url":null,"abstract":"Background: Majority of the Type 2 Diabetic (T2D) subjects in the course of the disease require insulin therapy to achieve glycaemic control. Basal insulin supported oral therapy (BOT) has become a common approach for glycaemic control nowadays thus leading to early insulin initiation The newly introduced ultra long acting basal insulin glargine u 300 is a concentrated form of the gold standard basal insulin Glargine u 100 with a different pharmacokinetic and pharmacodynamic profile (PK/PD) with claimed advantages with regards to daylong durability of action and less incidence of hypoglycaemia. Aims and objectives: To evaluate the efficacy, and safety of Glargine U300 when used along with oral anti diabetic agents (OAD) in insulin naive Indian T2D subjects Materials and methods: This is a retrospective real world medical registry based observational study which looked at insulin naive patients initiated on insulin Glargine U 300 over and above standard of care and were followed up for a minimum of 12 weeks. DMT2 subjects presenting with osmotic symptoms or with OAD failure as per Indian Insulin Guidelines and completed the minimum 12 weeks of Glargine U 300 therapy maintaining all data and without requiring rescue doses of prandial insulin, were included. The primary efficacy parameters evaluated at the end of 12 weeks was glycated hemoglobin (HbA1c) along with of fasting plasma glucose (FPG), post prandial plasma glucose (PPPG). Safety was mainly assessed by self-reported hypoglycemia by the patients and weight gain measured at the clinic. Results: A database of 61 patients (34 male and 27 female) was looked into and there was a statistically significant reduction of all glycaemic parameters (p<0.001) and patients reached target HbA1c <7% at 12 weeks. On the safety front, average weight gain was less than a kilogram (0.71+/-0.13 kg) and there were 5 episodes of symptomatic hypoglycaemia and one episode of severe hypoglycaemia and no incidence of nocturnal hypoglycaemia. Severe hypoglycemia was defined as severe cognitive impairment requiring external assistance for recovery. There were no statistically significant changes in creatinine, systolic and diastolic blood pressure values though there was a statistical significant (p=0.042 and p=0.029 respectively) reduction in triglyceride and low density lipoprotein cholesterol. Conclusion: Glargine U300, from this data appears to be safe and effective basal insulin for initial use in insulin naive OAD failure subjects with low risk of hypoglycaemia and insignificant weight gain.","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90209127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-29DOI: 10.15406/JDMDC.2020.07.00214
A. M. Mbisi, D. M. Ngari
Background: Diabetes mellitus is becoming a major public health concern of the 21st century globally, with disproportionately great socioeconomic liability in the emerging world. The prevalence of diabetes mellitus continues to rise resulting in significant morbidity and mortality. This is as a result of the development of chronic complications such as cardiovascular, eye, renal diseases and foot problems. Foot ulcerations related to peripheral neuropathy and vascular disease has led to distressing health consequences as well as amputations among the diabetics. Thus, the study aimed at establishing barriers to foot care practice among diabetes patients attending diabetes clinic in Embu County, Kenya. Method: A descriptive survey targeting a population of 1413 type 2 diabetic patients and 12 key informants was the target population of the study. From this, a sample size of 301 participants and 12 key informants were drawn to take part in the study using fischer et al formular . The participants were conveniently sampled from the selected DM clinics respectively. Self-administered questionnaires and focused group discussion was used for data collection. Data from study was thematically analyzed and the results presented in narration and tables. Results: Major barriers identified were impaired vision and knowledge deficit. This was backed by health care provider perception barrier that; health education given had little effect on foot care practices. Evident from the findings was inadequate delivery of services due to staff shortage as well as a communication barrier and patients negative attitude. Discussion: Intensive campaigns on the practice of the recommended diabetic foot care practices in management of diabetes should be done. Facilitation through the provision of adequate human and material resource by the government to ensure adequate delivery of health services to her citizen is also paramount.
{"title":"Barriers to diabetes foot care practices among diabetes patients attending diabetes clinic in Embu county, Kenya","authors":"A. M. Mbisi, D. M. Ngari","doi":"10.15406/JDMDC.2020.07.00214","DOIUrl":"https://doi.org/10.15406/JDMDC.2020.07.00214","url":null,"abstract":"Background: Diabetes mellitus is becoming a major public health concern of the 21st century globally, with disproportionately great socioeconomic liability in the emerging world. The prevalence of diabetes mellitus continues to rise resulting in significant morbidity and mortality. This is as a result of the development of chronic complications such as cardiovascular, eye, renal diseases and foot problems. Foot ulcerations related to peripheral neuropathy and vascular disease has led to distressing health consequences as well as amputations among the diabetics. Thus, the study aimed at establishing barriers to foot care practice among diabetes patients attending diabetes clinic in Embu County, Kenya. Method: A descriptive survey targeting a population of 1413 type 2 diabetic patients and 12 key informants was the target population of the study. From this, a sample size of 301 participants and 12 key informants were drawn to take part in the study using fischer et al formular . The participants were conveniently sampled from the selected DM clinics respectively. Self-administered questionnaires and focused group discussion was used for data collection. Data from study was thematically analyzed and the results presented in narration and tables. Results: Major barriers identified were impaired vision and knowledge deficit. This was backed by health care provider perception barrier that; health education given had little effect on foot care practices. Evident from the findings was inadequate delivery of services due to staff shortage as well as a communication barrier and patients negative attitude. Discussion: Intensive campaigns on the practice of the recommended diabetic foot care practices in management of diabetes should be done. Facilitation through the provision of adequate human and material resource by the government to ensure adequate delivery of health services to her citizen is also paramount.","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"171 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78112028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-25DOI: 10.15406/JDMDC.2020.07.00213
R. Chatterjee, S. Bhattacharyya
Chorea hyperglycemia basal ganglia syndrome is a rare condition that manifests in setting of uncontrolled nonketotic diabetes mellitus. The objective of this case report is to highlight the importance of a physician to be aware of hyperglycemia as a cause of hemichorea/ hemiballismus which is referred to in medical literature as chorea-hyperglycemia-basal ganglia syndrome. 1 This case involves a 60 years old Hypertensive and poorly controlled diabetic female who presented with choreiform movements of right upper and lower limbs for last one month. Her initial glucose level was 352 mg/dl. CT scan of her brain showed no obvious abnormality except for hyper density left basal ganglia region. MRI brain (Plain+Contrast) revealed hyperintense lesion in left basal ganglia region; Left putaminal region showing signal changes likely metabolic in nature. With gradual control of her hyperglycemia, the movement disorder resolved. With exclusion of other causes of the movement disorder and resolution of her symptoms with control of blood sugar can lead to the inference that it was due to her uncontrolled diabetic
{"title":"A case of chorea-hyperglycemia-basal ganglia syndrome: a rare case of movement disorder","authors":"R. Chatterjee, S. Bhattacharyya","doi":"10.15406/JDMDC.2020.07.00213","DOIUrl":"https://doi.org/10.15406/JDMDC.2020.07.00213","url":null,"abstract":"Chorea hyperglycemia basal ganglia syndrome is a rare condition that manifests in setting of uncontrolled nonketotic diabetes mellitus. The objective of this case report is to highlight the importance of a physician to be aware of hyperglycemia as a cause of hemichorea/ hemiballismus which is referred to in medical literature as chorea-hyperglycemia-basal ganglia syndrome. 1 This case involves a 60 years old Hypertensive and poorly controlled diabetic female who presented with choreiform movements of right upper and lower limbs for last one month. Her initial glucose level was 352 mg/dl. CT scan of her brain showed no obvious abnormality except for hyper density left basal ganglia region. MRI brain (Plain+Contrast) revealed hyperintense lesion in left basal ganglia region; Left putaminal region showing signal changes likely metabolic in nature. With gradual control of her hyperglycemia, the movement disorder resolved. With exclusion of other causes of the movement disorder and resolution of her symptoms with control of blood sugar can lead to the inference that it was due to her uncontrolled diabetic","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82765795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-25DOI: 10.15406/jdmdc.2020.07.00212
Alamin Alkundi, R. Momoh
Diabetes mellitus (among other conditions) has received attention as an important co- morbidity predisposing to a COVID-19 infection and its control determining prognosis from this infection. We have evaluated important associations about how diabetes mellitus (and hyperglycaemia) can affect the course of a COVID-19 infection as well as reviewing the impact of the COVID-19 pandemic on diabetic services. Existing literatures have captured aspects of the interaction of these two entities. We hope to give a vantage view for ease of knowledge.
{"title":"COVID-19 infection and diabetes mellitus","authors":"Alamin Alkundi, R. Momoh","doi":"10.15406/jdmdc.2020.07.00212","DOIUrl":"https://doi.org/10.15406/jdmdc.2020.07.00212","url":null,"abstract":"Diabetes mellitus (among other conditions) has received attention as an important co- morbidity predisposing to a COVID-19 infection and its control determining prognosis from this infection. We have evaluated important associations about how diabetes mellitus (and hyperglycaemia) can affect the course of a COVID-19 infection as well as reviewing the impact of the COVID-19 pandemic on diabetic services. Existing literatures have captured aspects of the interaction of these two entities. We hope to give a vantage view for ease of knowledge.","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87130274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-23DOI: 10.15406/JDMDC.2020.07.00211
Waseem N. Ahmed
Proper glycemic control is important in diabetes management, particularly during the COVID-19 pandemic. Lockdown restrictions led to increased stress and hampered the daily living of many individuals. The evidence available on the impact of the pandemic on diabetes management is predominantly from cities and through online mode. Teleconsultation is an option to be made available to rural areas as well. During the lockdown, reaching out to the doctor and procurement of medications was a huge task for the underprivileged and inadequately addressed. There have been reports claiming that glycemic control even improved during the lockdown from cities. Family practitioners are silently upholding the backbone of the nation’s primary healthcare even at times of crisis. Further research activities need to be fostered even in the less accessible areas to identify the gaps and correct them.
{"title":"Lockdown and diabetes–what actually happened?","authors":"Waseem N. Ahmed","doi":"10.15406/JDMDC.2020.07.00211","DOIUrl":"https://doi.org/10.15406/JDMDC.2020.07.00211","url":null,"abstract":"Proper glycemic control is important in diabetes management, particularly during the COVID-19 pandemic. Lockdown restrictions led to increased stress and hampered the daily living of many individuals. The evidence available on the impact of the pandemic on diabetes management is predominantly from cities and through online mode. Teleconsultation is an option to be made available to rural areas as well. During the lockdown, reaching out to the doctor and procurement of medications was a huge task for the underprivileged and inadequately addressed. There have been reports claiming that glycemic control even improved during the lockdown from cities. Family practitioners are silently upholding the backbone of the nation’s primary healthcare even at times of crisis. Further research activities need to be fostered even in the less accessible areas to identify the gaps and correct them.","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83390960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-20DOI: 10.15406/JDMDC.2020.07.00210
R. Mallipudi, A. Singh, V. A. Shenoy, J. Palumbo, T. Firoz, K. Sikorski
Admissions for diabetic foot osteomyelitis (DFO) are associated with increased length of stay due to several modifiable barriers and one of which includes setting up intravenous (IV) antibiotics upon discharge. The aim of this study was to reduce the length of stay (LOS) by at least 10% for all DFO patients who underwent surgical amputation and required IV antibiotics upon discharge. Using a quality improvement approach, the patient journey was mapped out using Lean principles and areas of waste were identified. An innovative electronic order was created and implemented to facilitate placement of a PICC (peripherally inserted central catheter) line to be placed immediately after podiatry surgery to reduce the length of time between surgery and PICC line placement. Pre-intervention and post-intervention LOS was compared using Mann-Whitney test to analyze the non-parametric distribution of the data. The post-intervention group had a mean LOS of 7 days (pre-intervention group: 10 days, p-value=0.027), and the length of time between podiatry surgery to placement of the PICC line was a mean of 2 days (pre-intervention: 5.29 days; p-value=0.008). This study used Lean methodology to identify areas of waste, facilitate discharge and subsequently reduce the LOS for DFO surgical patients.
{"title":"Reducing length of stay for diabetic foot osteomyelitis patients","authors":"R. Mallipudi, A. Singh, V. A. Shenoy, J. Palumbo, T. Firoz, K. Sikorski","doi":"10.15406/JDMDC.2020.07.00210","DOIUrl":"https://doi.org/10.15406/JDMDC.2020.07.00210","url":null,"abstract":"Admissions for diabetic foot osteomyelitis (DFO) are associated with increased length of stay due to several modifiable barriers and one of which includes setting up intravenous (IV) antibiotics upon discharge. The aim of this study was to reduce the length of stay (LOS) by at least 10% for all DFO patients who underwent surgical amputation and required IV antibiotics upon discharge. Using a quality improvement approach, the patient journey was mapped out using Lean principles and areas of waste were identified. An innovative electronic order was created and implemented to facilitate placement of a PICC (peripherally inserted central catheter) line to be placed immediately after podiatry surgery to reduce the length of time between surgery and PICC line placement. Pre-intervention and post-intervention LOS was compared using Mann-Whitney test to analyze the non-parametric distribution of the data. The post-intervention group had a mean LOS of 7 days (pre-intervention group: 10 days, p-value=0.027), and the length of time between podiatry surgery to placement of the PICC line was a mean of 2 days (pre-intervention: 5.29 days; p-value=0.008). This study used Lean methodology to identify areas of waste, facilitate discharge and subsequently reduce the LOS for DFO surgical patients.","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82505213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-13DOI: 10.15406/JDMDC.2020.07.00209
L. D. B. C. Fontes, C. Barros, M. Correia, Leonardo Cavalcanti Bezerra Santos, Kátia Maria Gonçalves Marques, R. M. M. M. S. M. Coury, Niedje Siqueira de Lima
{"title":"Mental health and metabolic disorders in children and adolescentes during the COVID-19 pandemic","authors":"L. D. B. C. Fontes, C. Barros, M. Correia, Leonardo Cavalcanti Bezerra Santos, Kátia Maria Gonçalves Marques, R. M. M. M. S. M. Coury, Niedje Siqueira de Lima","doi":"10.15406/JDMDC.2020.07.00209","DOIUrl":"https://doi.org/10.15406/JDMDC.2020.07.00209","url":null,"abstract":"","PeriodicalId":92240,"journal":{"name":"Journal of diabetes, metabolic disorders & control","volume":"46 1","pages":"106-107"},"PeriodicalIF":0.0,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80071176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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