Episodes In Diabetic Patients Research Articles

Investigating the knowledge and attitude of nurses regarding hypoglycemia of diabetic patients hospitalized in Marjan Teaching Hospital in 2022

Introduction and purpose: Diabetes is the most common disease caused by carbohydrate metabolism disorder that causes damage to many organs including kidney, eyes and heart. Increasing the knowledge and attitude of nurses can reduce the chronic complications of the disease. Therefore, the present research was conducted with the aim of determining the knowledge and attitude of nurses regarding hypoglycemia of diabetic patients admitted to Marjan Teaching Hospital in the year. Research method: In this cross-sectional descriptive study, 172 nurses working in Marjan teaching hospital in Babylon city were selected by available purposive sampling method. Information was collected using three parts of questionnaire, including first part of demographic data, and tow part about knowledge assessment, and last part of questionnaire to assess nurses' attitudes regarding hypoglycemia in diabetic patients. Findings: results of the study showed that among 172 participating nurses, the majority were women (55.8%), with the largest number falling into the age group of 20-29 years. Regarding knowledge assessment, nurses scored an average of 57.47 out of a total possible score ranging from 41 to 70, indicating a moderate level of knowledge about hypoglycemia in diabetic patients. Specifically, nurses in this department scored an average of 59.86% of knowledge points related to hypoglycemia. The average score among nurses regarding hypoglycemia in diabetic patients was 17.41 out of a possible range of 9 to 24, suggesting a generally positive attitude towards managing hypoglycemic episodes in diabetic patients. Conclusion: The study highlights the importance of improving nurses' knowledge and attitudes regarding hypoglycemia in diabetic patients. While most nurses showed moderate knowledge levels, there's room for enhancement, especially in managing hypoglycemic episodes effectively. Although nurses generally displayed a positive attitude, continuous education could bolster their confidence and skills in diabetic care, potentially reducing chronic complications.

The Impact of Hypoglycemia on Patients with Diabetes Mellitus: A Cross-Sectional Analysis.

The increasing mortality and morbidity in patients with diabetes mellitus constitute a severe public health problem. The condition is recognized as a cause of impaired quality of life, high costs, and diminished productivity. In this study, we performed a cross-sectional analysis among 300 Polish participants with type 1 and type 2 diabetes to determine and classify risk factors associated with increased incidences of hypoglycemia. Including an open-access knowledge about the correlations between diabetes rates and human’s lifestyle, we confirm that the frequency of smoking and drinking alcohol, low BMI, inappropriate diet, low physical activity, lack of vaccination against influenza and pneumococci, and co-existence of other comorbidities such as cardiovascular diseases, thyroid diseases, hyperlipidemia, retinopathy, and asthma elevate the risk of hypoglycemia. Furthermore, hypoglycemic patients were more often malnourished, depressed, irritated, and exposed to stress. In sum, the analysis of the interaction between diabetes and sociodemographic, environmental, or other disease-related risk factors provides strategies to optimize glycemic control and reduce the incidence of hypoglycemia. Furthermore, we believe our findings may constitute a basis for promoting health by adjusting available and implementing new preventive services reducing hypoglycemic episodes in diabetic patients.

Characteristics of hypoglycaemic episodes in diabetic patients treated at the emergency room of a Portuguese tertiary centre, 2012-2016.

ObjectiveTo analyse changes in the characteristics of hypoglycaemic episodes treated in the emergency room of a tertiary hospital in Portugal between 2012 and 2016.Research Design and MethodsWe retrospectively analysed all emergency room reports for patients discharged with a diagnosis of hypoglycaemia between 2012 and 2016 and analysed demographic characteristics, type of diabetes and treatments, causes of hypoglycaemia and discharge destination. Patients without diabetes were excluded.ResultsIn total, 676 hypoglycaemic episodes were analysed. Most patients were female (59%) and the median age of the patients was 71 years (interquartile range, 57‐81). The proportion of hypoglycaemic episodes relative to all emergency episodes decreased from 1.5% in 2012 to 1.0% in 2016 (P < .001). The proportion of patients with type 1 diabetes increased from 15.6% to 23.8%, while that of patients with type 2 diabetes decreased from 80.3% to 72.3% (nonsignificant differences). There was an increase in the use of insulin (67.1% to 85.4%, P = .02) and a decrease in the use of insulin secretagogues (26.6% to 11.5%, P = .03) over the study period. The rate of hospitalization dropped significantly from 11% in 2012 to 4.3% in 2015 and 5.4% in 2016 (P = .02).ConclusionsDespite the increasing use of newer diabetes medications associated with a lower risk of hypoglycaemia, these episodes still require emergency care. The proportion of patients receiving insulin increased over the years, probably due to the slight increase in the prevalence of type 1 diabetes and the increasing replacement of secretagogues with insulin in type 2 diabetes.

Association of silent hypoglycemia with cardiac events in non-diabetic subjects with acute myocardial infarction undergoing primary percutaneous coronary interventions.

BackgroundSome studies have shown that hypoglycemic episodes in diabetic patients might be associated with increased cardiovascular events. It is not clear whether episodes of silent hypoglycemia had greater prognostic value on cardiac events compared with normoglycemia or hyperglycemia in non-diabetic patients, so the aim of this study was to investigate the association of silent hypoglycemia and cardiac events in non-diabetic patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (p-PCI).MethodsWe enrolled non-diabetic patients with STEMI who underwent p-PCI and whose clinical and laboratory data were collected. Interstitial glucose values were recorded using a continuous glucose monitoring system (CGMS), and Holter monitoring was recorded for 3 days in parallel. Cardiac ischemia and ventricular arrhythmia was evaluated.ResultsBased on the inclusion and exclusion criteria, we enrolled 164 STEMI patients undergoing p-PCI for final analysis. A total of 280 episodes of silent hypoglycemia (CGMS glucose <70 mg/dl) were recorded. Episodes of silent cardiac ischemia were recorded in 50 of 280 hypoglycemic episodes. The incidence of silent cardiac ischemia during hypoglycemia was significantly higher than the incidence during both hyperglycemia and normoglycemia(P < 0.01). Moreover, we found a significantly higher frequency of ventricular extrasystoles (VESs) or nonsustained ventricular tachycardias (NSVTs) in patients with silent hypoglycemia. The average number of events of silent cardiac ischemia was also significantly increased in the silent hypoglycemia group (0.91 ± 0.82 vs. 0.35 ± 0.54, P < 0.01) compared with either hyperglycemia or normoglycemia group.ConclusionsHypoglycemia was frequent and most of the time asymptomatic in non-diabetic patients with STEMI undergoing p-PCI. Silent hypoglycemia was associated with silent cardiac ischemia. STEMI patients with silent hypoglycemia had a significantly higher frequency of VESs or NSVTs.

Reliability and validity of the Japanese version of the World Health Organization‐Five Well‐Being Index in the context of detecting depression in diabetic patients

The present study had two aims. The first was to evaluate the reliability and the validity of the Japanese version of the World Health Organization (WHO)-Five Well-Being Index (WHO-5-J) as a brief well-being scale. The second was to examine the discriminatory validity of this test as a screening tool for current depressive episodes in diabetic patients. A sample of 129 diabetic patients completed the WHO-5-J. Of these, 65 were also interviewed by psychiatrists to assess whether they had any current depressive episodes according to DSM-IV. The internal consistency was evaluated using Cronbach's alpha, the Loevinger coefficient of homogeneity, and factor analysis. The external concurrent validity was evaluated by correlations with the external scales potentially related to subjective well-being. Discriminatory validity was evaluated using receiver operating characteristic (ROC) analysis. Cronbach's alpha and the Loevinger coefficient were estimated to be 0.89 and 0.65, respectively. A factor analysis identified only one factor. The WHO-5-J was significantly correlated with a number of major diabetic complications, depression, anxiety, and subjective quality of life. ROC analysis showed that the WHO-5-J can be used to detect a current depressive episode (area under curve: 0.92; 95% confidence interval: 0.85-0.98). A cut-off of <13 yielded the best sensitivity/specificity trade-off: sensitivity, 100%; specificity, 78%. The WHO-5-J was thus found to have a sufficient reliability and validity, indicating that it is a useful instrument for detecting current depressive episodes in diabetic patients.

Biosensors for glycaemic control

To overcome the problem of metabolic crashes as hypoglycaemic as well as hyperglycaemic episodes in diabetic patients the continuous or at least very frequent checking of the circulating intracorporal glucose concentration is necessary. Biosensors measuring glucose in vivo are suitable for estimating the transient interstitial glucose concentration in human beings. Biologically and/or biochemically caused processes are responsible for limiting the functional stability of implanted sensors. It is now possible to advance beyond the current practice of hand making glucose sensors in the laboratory and produce these sensors as industrial products with reproducible characteristics. This gives us a real chance to avoid hypoglycaemic and hyperglycaemic metabolic attacks.

Incidence of hypoglycemic episodes in diabetic patients under continuous subcutaneous insulin infusion and intensified conventional insulin treatment: assessment by means of semiambulatory 24-hour continuous blood glucose monitoring.

The incidence and magnitude of hypoglycemia (i.e., blood glucose values less than 50 mg/dl) were assessed by continuous blood glucose monitoring over 24 h in 10 insulin-dependent diabetic (IDD) patients treated with continuous subcutaneous insulin infusion (CSII) and 9 IDD patients under intensified conventional treatment (ICT). A newly developed, battery-powered blood glucose monitor was employed. Patients were thus enabled to move freely in the hospital premises. Despite similar quality of previous blood glucose control (HbA1: 8.0 +/- 0.05% CSII versus 8.0 +/- 0.3% ICT, mean +/- SEM), the obtained profiles showed better regulation under CSII treatment (mean blood glucose [MBG], 99.6 +/- 10.0 versus 133.1 +/- 7.4 mg/dl; M-value, 12.3 +/- 3.5 versus 26.2 +/- 4.1; mean amplitude of glycemic excursion [MAGE], 71.9 +/- 8.7 versus 132.9 +/- 14.2 mg/dl; CSII versus ICT, mean +/- SEM). The incidence of blood glucose values less than 50 mg/dl was 9/10 patients (CSII) and 5/9 patients (ICT). In both groups, hypoglycemia was most frequent at noon and was related to elevated pre- and postprandial free insulin levels. Patients became aware of hypoglycemia only in 6/23 episodes (CSII) and 6/8 episodes (ICT). Our data indicate that CSII as well as ICT may result in postprandial hyperinsulinemia leading to frequent hypoglycemic episodes of variable length, reassessing the traditional experience of close correlation between aggressive insulin therapy and enhanced hypoglycemic risk.