Complications In Diabetes Mellitus Patients Research Articles

Impact of steroid use and glucose control on surgical outcomes in diabetic gynecologic oncology patients

<h3>Objectives:</h3> The objective of this study was to assess the impact of preoperative steroid use and glucose control on postoperative outcomes for diabetes mellitus (DM) gynecologic oncology patients undergoing surgery. <h3>Methods:</h3> This retrospective cohort study included all gynecologic oncology patients admitted for inpatient surgery on an enhanced recovery protocol (ERP) between 10/2016 and 12/2018 with the addition of further patients with DM until 9/2019. The utilization of preoperative steroids has largely been adopted in most ERP patients. At our institution, 8mg intravenous dexamethasone is frequently used. Individual chart review was completed to identify the primary outcome of postoperative complications including: DKA, surgical site infection, ileus, DVT/PE, CVA, MI, AKI, unplanned ICU admission, pulmonary complications, and blood transfusions. Secondary outcomes included length of hospital stay (LOS) and readmission rate. SPSS v. 25 was used for statistical analysis. <h3>Results:</h3> 684 patients were identified and 184 (26.9%) had coexisting type I or II DM. Demographics including CCI, race, diagnosis, and surgical complexity were similar between groups. Patients with DM tended to be older, have a larger body mass index (BMI), and longer operative times. The overall complication rate was 32.5%. Patients with DM were more likely to have postoperative complications (77.5% vs. 15.9%, P=0.0001), increased LOS (4.0±4.6 vs. 3.1±1.9 days, P=0.001), though no difference in readmission rate was observed (10.3% vs. 7.6%, P=0.25). Patients were more likely to have postoperative complications if they had at least one documented serum glucose greater than 300 (74.1% vs 26.8%, P=0.0001) or an average serum glucose greater than 180mg/dL in the first 24 hours (80.0% vs 24.8%, P=0.0001). 54.3% of DM patients got preoperative steroids with no difference in complication or readmission rates seen (p=0.1; p=0.7). <h3>Conclusions:</h3> Diabetic patients are at a much higher risk for postoperative complications after gynecologic oncology surgery. There was no increased risk for postoperative complications in DM patients who received steroids as part of the ERP. However, poorly controlled glucose levels in the immediate postoperative period were associated with a higher rate of complications. Adequate blood glucose control perioperatively for these high-risk patients undergoing surgery is vital given the increased risk of postoperative complications and length of stay.

Correlation of HbA1c levels and diabetic neuropathy complications in diabetes mellitus patients

Introduction: Type 2 Diabetes Mellitus (DM) is a metabolic disease caused by impairments in insulin secretion by pancreatic beta cells and/or impaired insulin regulation by the body (insulin resistance). Inadequate management of DM can be a trigger of several complications, such as diabetic neuropathy.

High Glucose Causes Distinct Expression Patterns of Primary Human Skin Cells by RNA Sequencing.

Diabetes-related skin problems represent the most common long-term complications in diabetes mellitus patients. These complications, which include diabetic dermopathy, diabetic blisters, necrobiosis lipoidica diabeticorum, and eruptive xanthomatosis, may dramatically impair patients’ quality of life and cause long-lasting disability. However, the cellular and molecular mechanisms linking diabetes-related hyperglycemia and skin complications are still incompletely understood. To assess the role of the various skin-cell types in hyperglycemia-induced skin disorders, we performed RNA sequencing-based transcriptome analysis, measuring gene expression patterns in biological replicates in normal- and high glucose-stimulated skin cells. Three primary human skin-cell types were examined, i.e., epidermal keratinocytes, dermal fibroblasts, and dermal microvascular endothelial cells. For each separate cell type, we identified gene expression. Comparing gene abundances and expression levels revealed that transcription profiles exhibit distinct patterns in the three skin-cell types exposed to normal (i.e., physiological) glucose treatment and high (i.e., supraphysiological) glucose treatment. The obtained data indicate that high glucose induced differential gene expression and distinct activity patterns in signaling pathways in each skin-cell type. We are adding these data to the public database in the hope that they will facilitate future studies to develop novel targeted interventions for diabetic skin complications.

EFEKTIVITAS PENGGUNAAN METODE PENDIDIK TEMAN SEBAYA DALAM MENINGKATKAN PENGETAHUAN PENCEGAHAN KOMPLIKASI KAKI DIABETES DI PUSKESMAS BANGUNTAPAN 3 BANTUL

Diabetic foot is a common complication experienced by people with diabetes mellitus. Knowledge of the complications of diabetic foot is necessary to perform self-care properly. Objective: to analyze the effectiveness of peer educator method health education to increase knowledge of diabetes foot complications prevention. Methods: Quasi experimental with pre-post test control group design was used in this study. Peer educator intervention was used in this study on all patients with type 2 diabetes mellitus at Banguntapan 3 Community Health Center Bantul, as many as 30 patients. Sampling using total sampling, the respondents were divided into 2 (15 interventions and 15 controls). The research instrument was a questionnaire of knowledge about the prevention of diabetic foot complications given before and after the intervention, analyzed by using paired t-test. Results: the pretest in the control group was in the moderate category (73.3%) and the intervention group (66.7%). The posttest results of the control group were in the moderate category (66.7%) and an increase in the intervention group (67.7%). Results: Bivariate analysis showed that there was an influence between the control and experimental groups on knowledge of foot care in patients with diabetes using peer method health education with a p-value of 0.006. Conclusion: the peer educator method is proven to be effective in increasing knowledge of the prevention of diabetes foot complications in diabetes mellitus patients in the Banguntapan 3 Community Health Center, Bantul.

RELATION OF MEDICATION ADHERENCE TO THE INCIDENCE OF COMPLICATIONS IN TYPE 2 DIABETES MELLITUS PATIENTS

Objective: The prevalence of diabetes mellitus continues to increase worldwide, followed by the incidence of complications, which ends up causing morbidity and mortality in patients. There were many factors related to the incidence of complications in diabetes mellitus. Patient’s adherence to their medication is considered to have an impact on the complications in diabetic patients.&#x0D; Methods: The study was conducted on 68 patients with a cross-sectional method with consecutive sampling. Statistical analysis was done using the Chi-square and Fisher’s exact test. p&lt;0.05 was considered statistically significant. Patients were interviewed using a demographic data questionnaire and medication adherence rating scale – 5 (MARS-5). Other data and diagnosis of complications were collected through medical records. The epidemiological analysis was carried out using the prevalence ratio.&#x0D; Results: There were 47 (69.1%) patients with type 2 diabetes mellitus (T2DM) hospitalized due to complications, and 56 (82.4%) patients have poor adherence to treatment. There was a significant relationship between treatment adherence and the incidence of complications in diabetes mellitus patients with p = 0.001 and it was found that there was a risk of 3.14 times in patients who have poor adherence to be hospitalized due to complications.&#x0D; Conclusion: Treatment adherence affects the incidence of complications in patients with T2DM.

Correlation between Risk Stratification of Complications and Types of Antihyperglycemia Drugs with Incidence of Acute Diabetic Complications in Patients with Diabetes Mellitus during Ramadan Fasting

Ramadan fasting for Diabetes Mellitus (DM) patients can lead to acute complications such as hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA) and thrombosis. Risk stratification predicts fasting safety of DM patients. Dose and timing of antihyperglycemia drugs adjusted during Ramadan fasting. Aim: To know the correlation between the risk stratification of Ramadan fasting and type of antihyperglycemia drugs with the incidence of acute complications in DM patients undergoing Ramadan fasting. Methods: DM patients in Endocrinology Clinic, dr. Saiful Anwar, General Hospital Malang who intend to fast during Ramadan classified in IDF-DAR risk stratification, conduct blood glucose monitoring and filled out a daily logbook during fasting. Results: Thirty-seven subjects were included in the study, only 1 patient with type-1 DM. Average fasting time is 18 days. Acute complications found higher in very high-risk group (5/6) compared to mild/moderate (2/13) and high-risk group (7/18) (p=0.009). Acute complications found higher in group with OAD and insulin combination regiment (2/4) compared to OAD (9/24) or insulin group (3/9) (p= 0. 731). One subject in very high-risk group suffered from acute coronary syndrome. Relationship between risk stratification and the incidence of hypoglycemia (p=0.040) and hyperglycemia (p=0.031) was significant. Relative risk in the very high-risk group was 2.538 compared to mild/moderate risk RR (95% CI)= 0.77 (0.62-0.96). Conclusions: There is a correlations between risk stratification and acute complications in DM patients undergoing Ramadan fasting. No relationship between type of antihyperglycemia drugs with acute complications of Ramadan fasting.

Association Between Metabolic Syndrome and Diabetes Mellitus According to International Diabetic Federation and National Cholesterol Education Program Adult Treatment Panel III Criteria: a Cross-sectional Study.

Lifestyle changes in diabetes mellitus leads to metabolic syndrome, thus resulting in a hike in micro and macrovascular complications in diabetes mellitus patients. The main objective of the studywas to identify the occurrence of metabolic syndrome and to evaluate the gender-associated difference in each component of metabolic syndrome by using International Diabetic Federation(IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)criteria. This is a cross-sectional study conducted in 350 type II diabetes mellitus patients. All the study participants within 30-80 years were enrolled. Subjects with type I DM and pregnant women were excluded from the study. The occurrence of metabolic syndrome among the diabetic population was found to be 42.28% and 28.85% using the IDF and the NCEP ATP III criteria respectively. It was observed that the prevalence was found to be higher in females than males as per IDF and NCEP ATP III criteria and was found to be statistically significant (p < 0.001). Central obesity elevated blood pressure, and reduced high-density lipoprotein was significantly higher in female patients. The most frequently occurring risk factor in this study population was central obesity followed by hypertension. A comparative analysis of IDF and NCEP ATP III criteria implies that when compared to diabetes patients without metabolic syndrome, all the metabolic risk elements were significantly higher in diabetes patients with metabolic syndrome. This study concluded that the occurrence of metabolic syndrome was dreadfully high among the diabetic population, especially among female subjects.

A prospective evaluation of microvascular complications in diabetes mellitus patients at time of diagnosis

Background: The microvascular complication is also showing increasing trend. This is because of lack of awareness and lack of regular screening programme. Early diagnosis and Intensive glycemic control has been the most effective approach to prevent the progress of microvascular complication.Methods: Based on exclusion and inclusion criteria 100 patients were enrolled for this study. For diagnosis of diabetes mellitus, we used American Diabetes Association (ADA) guidelines was followed. Detail history of patient was taken related to microvascular complication and they underwent extensive medical examination for the assessment of microvascular complications.Results: Mean age of patient with microangiopathy was 59.942±7.18 years and without microangiopathy was 54.31±13.15years. Microangiopathy was common in patient whose HbA1c was more than 10.7. Out of 26 patient 20 patient having microangiopathy. Neuropathy was present in 31 patients and absent in 69 patients.Conclusions: It was observed that a continuous linear association between HbA1c and microvascular complications. This is more common in patient in patient with higher HbA1c. Neuropathy is most common which is followed by nephropathy and retinopathy least among all.

Impact of diabetes on clinical outcome of patients with heart failure undergoing ICD and CRT procedures: results from the German Device Registry.

AimsDiabetes mellitus (DM) has a negative impact on prognosis in patients with heart failure (HF). The role impact of DM in HF patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) devices might differ and remains unclear. The aim of our study was to investigate the impact of DM on periprocedural complications and clinical outcome in HF patients undergoing ICD or CRT implantation.Methods and resultsWithin the German Device Registry, data from 50 German centres were collected between January 2007 and February 2014. A retrospective analysis of n = 5329 patients undergoing ICD implantation was conducted. Patients' characteristics, procedural data, periprocedural complications, and post‐procedural clinical outcome, including a composite clinical endpoint of all‐cause mortality, stroke, and myocardial infarction (MACCE), were analysed. Subgroup analysis were performed for ICD and CRT implantations. Median follow‐up was 15.7 (12.9; 20.0) and 16.2 (12.8; 21.2) months in DM and non‐DM patients. Of 5329 patients enrolled, n = 1448 (27.2%) had a diagnosis of DM. Within the cohort, 94% of DM and 90% of non‐DM patients had a diagnosis of HF. Patients with DM were older, had higher body mass index, and higher rate of cardiovascular comorbidities compared with non‐DM patients. Unadjusted and adjusted analyses revealed similar all‐over intrahospital periprocedural complication rates in both groups (4.1% vs 3.9%). Unadjusted Kaplan–Meier survival analysis showed higher all‐cause mortality after 1 year (9.0% vs 6.3%; log‐rank P = 0.001) with higher MACCE rates (10.0% vs 7.3%; P < 0.001) in the DM group versus non‐DM patients. After multivariable adjustment for relevant covariates, the association of DM to MACCE disappeared [HR 1.11 (0.89‐1.38)]. Because chronic kidney disease (CKD) was clearly associated with increased 1 year MACCE after multivariate adjustment [odds ratio (OR) 2.11 (1.68–2.64)], a subgroup analysis was performed showing a strong trend towards more perioperative complications in DM patients with CKD [OR 2.16 (0.9–5.21)], while no effect of DM was observed in patients without CKD [OR 0.73 (0.42–1.28)].ConclusionsThe overall risk of periprocedural complications and short‐term (1 year) clinical outcome in patients with DM and HF undergoing ICD or CRT defibrillator (CRT‐D) implantation was not increased. In contrast, CKD was associated with an increased risk of 1 year MACCE in HF patients undergoing ICD/CRT‐D implantation.

GLP-1 receptor agonist on cardiovascular complications of diabetes mellitus.

Effects of glucagon-like peptide-1 (GLP-1) receptor agonist on cardiovascular complications of diabetes mellitus (DM) were investigated. In total, 132 DM patients treated in Tengzhou Central People's Hospital from April 2013 to September 2016 were included. Of these, 71 cases treated with basic drugs plus GLP-1 were the research group, and 61 cases treated with glipizide controlled release tablets the control group. The improvement of clinical efficacy of patients in the two groups after treatment was observed. The concentrations of FPG, HbAlc, TC, LDL-C, and HDL-C in serum of patients in the two groups before and after treatment were compared, and the incidence rate of cardiovascular disease complications of diabetes was recorded. Expression of FPG, HbAlc, TC, LDL-C, and HDL-C of patients in the two groups were further detected. ROC curve was drawn to analyze its predictive value. In terms of markedly effective treatment rate and overall effective rate, the research group was significantly better than the control group (P<0.05). After treatment, the concentrations of FPG, HbAlc, TC, LDL-C, and HDL-C in serum of patients in the research group were significantly lower than those in the control group (P<0.05). The incidence rate of cardiovascular diseases and residual vascular risks in the research group were significantly higher than those in the control group (P<0.05). After treatment, the AUC of FPG, HbAlc, TC, LDL-C, and HDL-C in serum for predicting cardiovascular complications in DM patients were, respectively, 0.742, 0.780, 0.737, 0.726, and 0.721. In conclusion, GLP-1 receptor agonist can improve the clinical efficacy of patients. Through ROC curve, FPG, HbAlc, TC, LDL-C and HDL-C can be used as predictors of cardiovascular complications in DM patients, which has high clinical value.

Amelioration of Hyperglycemia and Dyslipidemia in Alloxan-Induced Diabetic Rats Using Citrulluslanatus and Persea Americana

Dyslipidemia has been observed to play an integral role in the pathogenesis of micro and macrovascular complications in diabetes mellitus patients. The complications were assessed via atherogenic index (AI), Coronary risk index (CRI) and Cardiovascular risk index (CVRI).The study was to investigate the amelioration of hyperglycemia and dyslipidemia in alloxan induced rats using watermelon and avocado seeds. A total of Forty rats were divided into eight groups of 5 rats accordingly. Diabetes was induced with a single dose of alloxan (100mg/kg) body weight and serum glucose was taken 72h after induction of confirm diabetes. Amelioration of hyperglycemia and dyslipidemia started on the 6th and 9th day of the experiment respectively. The result obtained from the phytochemical analysis showed that the aqueous extract of Citrulluslanatus and Persea Americana gave positive reactions for Alkaliods, tannins, flavonoids and saponins. The data showed that Alloxan caused significant increase in Glucose, TC, TGs and LDL in the untreated diabetic rats. On the other hand HDL was significantly decreased. The result showed that Citrulluslanatus and Persea Americana seeds extracts significantly and progressively lowered the glucose level, TC, TGs and LDL dose dependently while significantly causing a dose-related elevation in HDL concentration. The result shows that atorvastatin and the seeds extracts are capable of reducing risk of AI, CRI and CVRI in diabetic rats.

Diabetic Foot Spa Implementation in Early Neuropathy Diagnosis Based on Blood Glucose Levels, Foot Sensitivity and the Ankle Brachial Index in Patients with Diabetes Mellitus

Introduction: Diabetes Mellitus (DM) is a cause of morbidity mainly due to vascular complications. The prevention of diabetic foot problems can be done through metabolic control and foot exercises. The purpose of this study was to determine the effect of diabetes foot spa measures on blood glucose levels, foot sensitivity and the ankle brachial index.Methods: This research was a pre-experimental design. The population totaled 170 DM patients and the sample was finalized at 30 respondents. The independent variable was diabetic foot spa, while the dependent variables were blood glucose levels, blood sensitivity and the ankle brachial index. The data was analyzed using a t-test and Wilcoxon rank test.Results: Diabetic foot spa in early neuropathy detection testing has a blood glucose level of t=9.523 and a p value=0.000. Diabetic foot spa also significantly affects foot sensitivity with a ρ &lt;α (0.001&lt;0.05) and an ankle brachial index of (ABI) ρ&lt;α (0.008 &lt; 0.05).Conclusion: Diabetic foot spa conducted regularly and independently can reduce the level of complications in Diabetes Mellitus patients. Furthermore, the tingling and pain in the feet can be reduced or even disappear as well as preventing complications such as foot ulcers that can often become amputations.

Diabetic Foot Spa Implementation in Early Neuropathy Diagnosis Based on Blood Glucose Levels, Foot Sensitivity and the Ankle Brachial Index in Patients with Diabetes Mellitus

Introduction: Diabetes Mellitus (DM) is a cause of morbidity mainly due to vascular complications. The prevention of diabetic foot problems can be done through metabolic control and foot exercises. The purpose of this study was to determine the effect of diabetes foot spa measures on blood glucose levels, foot sensitivity and the ankle brachial index.Methods: This research was a pre-experimental design. The population totaled 170 DM patients and the sample was finalized at 30 respondents. The independent variable was diabetic foot spa, while the dependent variables were blood glucose levels, blood sensitivity and the ankle brachial index. The data was analyzed using a t-test and Wilcoxon rank test.Results: Diabetic foot spa in early neuropathy detection testing has a blood glucose level of t=9.523 and a p value=0.000. Diabetic foot spa also significantly affects foot sensitivity with a ρ &lt;α (0.001&lt;0.05) and an ankle brachial index of (ABI) ρ&lt;α (0.008 &lt; 0.05).Conclusion: Diabetic foot spa conducted regularly and independently can reduce the level of complications in Diabetes Mellitus patients. Furthermore, the tingling and pain in the feet can be reduced or even disappear as well as preventing complications such as foot ulcers that can often become amputations.

Factors Affecting Hospital Length of Stay in Patient with Diabetic Foot Ulcer

Background. Foot ulcer is one of the most common complications in diabetes mellitus patients. This condition prolongs hospital length of stay (LOS) and increases hospitalization cost. This study aims to assess factors that affect the LOS in patients with the mentioned condition.&#x0D; Methods. This is a retrospective cohort study of diabetes mellitus patients with foot ulcer who were hospitalized in Cipto Mangunkusumo General Hospital from January 2015 to April 2016. There were 120 patients recruited and then divided into two groups according to their hospitalization duration, which was short and long. Univariate analysis was conducted in predicted factors including gender, ankle-brachial index, ulcer size, ulcer depth, leukocyte count, treatment, cardiovascular comorbidity, blood pressure, smoking history, septicemia, ketoacidosis, hypoalbuminemia, and upper respiratory tract infection. Chi-Square tests were performed to analyze the association of those factors with LOS. The odds ratio of each variable was evaluated using logistic regression analysis.&#x0D; Result. In this study, the mean of LOS was 26 days (2 – 87 days). Factors that significantly correlated with LOS were ankle-brachial index (p 0.041, OR 2.275, CI 95 % 1.025 – 5.041), ulcer size (p 0.044, OR 3.038, CI 95 % 1.032 – 9.942), smoking history (p 0.022, OR 2.434, CI 95 % 1.125 – 5.265), sepsis (p &lt; 0.001, OR 4.240, CI 95 % 1.908 – 9.423), and ketoacidosis (p &lt; 0.001, OR 8.611, CI 95 % 3.396 – 21.835) In multivariate analysis, the most significant factor was ketoacidosis (p &lt; 0.001, OR 8.360, CI 95 % 3.209 – 21.780).&#x0D; Conclusion. Ketoacidosis is the most significant factor that prolonged hospital stays in a patient with diabetic foot ulcer.&#x0D; Keywords: Diabetic foot ulcer, Length of stay

Assessment of complications of diabetes mellitus patients

: Materials and Methods: The present study was conducted to assess complications in type II diabetes mellitus patients. Results: Age group <20 years had 10 males and 2 females, age group 20-40 years had 24 males and 6 females and age 40-60 years had 30 males and 24 females. The difference was statistical significant (P< 0.05). Common complications were hypertension in 124 patients, nephropathy in 89, foot ulceration in 15, impotency in 68, neuropathy in 23, visual disturbance in 142 and retinopathy in 102 patients. The difference was significant (P< 0.05). Conclusion: Authors suggested that diabetes in multiorgan multifactorial diseases. Common complications were hypertension, visual disturbances, neuropathy, foot ulceration, nephropathy, impotence and diabetic retinopathy.

Pentoxifylline for Renal Protection in Diabetic Kidney Disease. A Model of Old Drugs for New Horizons.

Diabetic kidney disease is one of the most relevant complications in diabetes mellitus patients, which constitutes the main cause of end-stage renal disease in the western world. Delaying the progression of this pathology requires new strategies that, in addition to the control of traditional risk factors (glycemia and blood pressure), specifically target the primary pathogenic mechanisms. Nowadays, inflammation is recognized as a critical novel pathogenic factor in the development and progression of renal injury in diabetes mellitus. Pentoxifylline is a nonspecific phosphodiesterase inhibitor with rheologic properties clinically used for more than 30 years in the treatment of peripheral vascular disease. In addition, this compound also exerts anti-inflammatory actions. In the context of diabetic kidney disease, pentoxifylline has shown significant antiproteinuric effects and a delay in the loss of estimated glomerular filtration rate, although at the present time there is no definitive evidence regarding renal outcomes. Moreover, recent studies have reported that this drug can be associated with a positive impact on new factors related to kidney health, such as Klotho. The use of pentoxifylline as renoprotective therapy for patients with diabetic kidney disease represents a new example of drug repositioning.

Demographic Characteristics of Diabetic Neuropathy Patients Attended at a Tertiary Care Hospital in Dhaka City

Introduction: Diabetic neuropathy is one of the early complications of diabetes mellitus patients which is very difficult to face in the daily living activities. The purpose of the present study was to see the demographic characteristics of diabetic neuropathy patients.&#x0D; Metarials &amp; Methods: This descriptive type of cross-sectional study was conducted in the Department of Neurology including Neuropathy Clinic and in collaboration with department of Endocrinology at Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2012 to December 2013 for a period of two (2) years. Adult diabetic patients presented with neuropathic pain with symmetrical involvement of distal limbs from indoor and outpatient department of Neurology including Neuropathy clinic as well as indoor and outpatient department of Endocrinology, BSMMU were enrolled in the study population. Data was collected by face to face interview. Information was collected by taking medical history and clinical examinations and subsequent laboratory investigations.&#x0D; Results: A total number of 102 cases were recruited for this study who were clinically diagnosed as painful diabetic polyneuropathy. Female was predominant than male 55(53.9%) cases and 47(46.1%) cases respectively. The male and female ratio was 1:1.2. Majority were in the age group of more than 55 years which was 55(53.9%) cases. The mean age with SD of the study population was 52.79±9.42 years. Among 102 patients type II DM was predominate than type I patients which were 95(92.2%) cases and 8(7.8%) cases respectively. The mean duration of DM with SD was 6.51±3.6 years. However the mean duration of neuropathic pain was 1.68±1.155 years.&#x0D; Conclusion: In conclusion majority of the diabetic neuropathy patients are female suffering from type II DM in the middle age.&#x0D; Medicine Today 2019 Vol.31(1): 27-30

Management of infectious complications in diabetes mellitus patients

Diabetes mellitus is a serious condition, causing multiple health problems due to the disease itself, but also to the complications that these patients are predisposed to. Being a current health problem, many patients tend to disregard the doctor's recommendations concerning the necessary measures to maintain adequate and continuous control of the glycaemia levels. This, in turn, may cause complications, which include neuropathy, microangiopathy and a predisposition to infections due to weak local defence mechanisms. In otorhinolaryngology, the infectious pathology is one of the most often causes for presentation to the physician. Ranging from common otitis, acute pharyngitis or laryngitis and sinusitis, these different entities will cause significant discomfort for the patient, prompting the need for medical care. In patients with diabetes, the natural course of the disease is altered, with more severe symptoms, a more extended period of recovery and the predisposition for aggravated cases with the tendency to complications. Such complications may be life-threatening if we take into account the complications associated with acute sinusitis for example, which include orbital or cerebral abscesses. Our paper aims to present the authors experience on the complete approach of patients with infectious pathology concerning the sinuses associating diabetes mellitus. Always, we must keep in mind that patients with diabetes represent a particular class of patients that require a personalized approach. They are predisposed to a vicious circle, in which the infection causes diabetes imbalance, which in turn decreases the defense mechanism and predisposes to complications. The correct management must always include a proper control of diabetes, a complete evaluation that will determine if complications are already present and aggressive management of the infection, with regular check-ups to determine the evolution of the patient.

Hypertensive complications in diabetes mellitus patients at tertiary health care centre

Hypertensive complications in diabetes mellitus patients at tertiary health care centre

Microvascular complications among patients with diabetes: An emerging health problem in Saudi Arabia.

Diabetes mellitus, besides disrupting the carbohydrate metabolism process, also induces vascular disease and impacts nearly all the types and sizes of blood vessels. In fact, vascular complications cause majority of the morbidity, hospitalizations and mortality of patients with diabetes mellitus. Retinopathy, nephropathy and neuropathy (microvascular complications) impact hundreds of millions of diabetics and normally target those having long-term or uncontrolled forms of the disease; however, these disorders can also exist at the time of diagnosis or in those yet to be diagnosed. The Kingdom of Saudi Arabia is the biggest country in the Middle East that occupies around four-fifths of the Arabian Peninsula supporting a population of more than 33.3 million people. The prevalence of diabetes mellitus is increasing at an alarming rate in Saudi Arabia. Over 25% of the adult population is suffering and that figure is projected to more than double by 2030. In fact, diabetes mellitus has approximately registered a 10-fold upsurge in the past three decades in Saudi Arabia. However, the prevalence and risk factors of microvascular complications in diabetes mellitus patients have not yet been clearly documented in Saudi Arabia. Hence, in this review, we aim to provide an overview of the microvascular complications among patients with diabetes in Saudi Arabia, utilizing data from the currently available published literature. This is an attempt to facilitate the government and healthcare systems aware of the enormous worth of prevention, early detection and appropriate management of such microvascular complications.