Diabetes In Hospitalized Patients Research Articles

Evaluating Preferences of Hospitalized Diabetes Patients for Hospital-Wide Glycemic Control Programme: A Discrete Choice Experiment.

Background: Effective glycemic control is crucial for hospitalized patients, leading to benefits such as shorter hospital stays and reduced postoperative infection rates. While previous studies have emphasized the effectiveness of multidisciplinary collaborative stewardship for hospital-wide hyperglycemia management, patient perspectives and preferences have not been adequately considered. Objective: To identify factors influencing treatment preferences of Chinese hospitalized diabetes patients using discrete choice experiments (DCEs) and provide practical insights for the construction of a hospital-wide glycemic control programme. Methods: A face-to-face survey was conducted among diabetes patients admitted to nonendocrine departments in a tertiary hospital in Nanjing, China. The attributes and levels were determined based on DCE principles, and a conditional logit model was used to quantify patients' preferences. Results: A total of 157 respondents were analyzed. Antihyperglycemic effectiveness, healthcare providers, treatment regimen, monitoring frequency, and adverse reactions were the five attributes that significantly influenced patient preference (p < 0.05). Notably, an 80% glycemic control rate (β = 2.009) and a multidisciplinary management team involving clinical pharmacists (β = 1.346) had the greatest impact. Negative effects were observed for hypoglycemia (β = -1.008), insulin pump use (β = -0.746), and frequent glucose monitoring (β = -0.523). Female patients exhibited higher concern for healthcare providers (β = 1.172) compared to males. Younger and shorter-course patients prioritized antihyperglycemic effectiveness (β = 3.330, β = 1.510), while older patients preferred multidisciplinary management (β = 1.186) and opposed increased monitoring frequency (β = -0.703). Patients with higher educational backgrounds showed greater acceptance of continuous glucose monitoring (β = 1.983), and those with higher annual income placed more emphasis on glycemic control rate. Conclusion: Treatment preferences of hospitalized diabetes patients are mainly influenced by antihyperglycemic effectiveness, adverse reactions, healthcare providers, and individual characteristics. Comprehensive consideration and an individualized therapy strategy should be given when constructing a hospital-wide glycemic control programme.

Outcomes of Diabetes Care Intervention on Knowledge and Practice of Self-care in Some Rural and Urban Healthcare Facilities, Edo State

Abstract: Background: Diabetes Mellitus (DM) is on the increase in Nigeria; consequently, there is a need to promote self-care practices among all patients. The study aimed to evaluate outcomes of diabetes care intervention on knowledge and practice of self-care among diabetes patients in rural and urban healthcare facilities in Edo State. Materials and Methods: In a descriptive cross-sectional, data on knowledge and practice of selfcare among Diabetes patients were collected using self-developed and Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. Analysis was both descriptive and inferential. Paired t-test was performed to compare the results from diabetes patients from General Hospital (GH), Abudu and Specialist Hospital (SH), Benin, and results were considered significant with P<0.05. Results: There was a significant difference (P<0.05) in the knowledge of self-care among patients. Diabetes patients in specialist hospital, Benin had a better knowledge of self-care (mean score >3) than those in general hospital, Abudu. Diabetes patients from general hospital, Abudu (rural) comply more with a mean practice of diabetes self-care in general exercise (5.58±1.42) and specific exercises (5.44±0.98). Diabetes patients from specialist hospital, Benin test their blood sugars themselves and the number of times recommended. After 6 months of educational intervention on diabetes care, knowledge and practice of diabetes selfcare improved significantly (p<0.05) across the various domains, but with better performance in specialist hospital, Benin. Conclusion: The study justifies a low quality of diabetes care delivery in both rural and urban health care facilities and significantly improved with educational interventions. Keywords: Diabetes, Prevalence, Self-care, Knowledge, Practice.

Study the association of the cardiac risk indices and high sensitive C-reactive protein for Type 2 diabetes patients in tertiary care hospital, Puducherry

Background: Diabetes mellitus (DM) is a metabolic disorder with hyperglycemia. Dyslipidemia associated with DM patient and contributing to atherovascular events and increases the likelihood of cardiovascular disease (CVD) in future. Measurement of inflammatory marker like hs-CRP will improve the prediction of the risk of these events. This study aimed to assess the cardiac risk indices and determine their association with hs-CRP in diabetic patients. Aims and Objectives: This study is aimed to assess the association of the cardiac risk indices and hs-CRP in diabetic patients. Materials and Methods: This study included each 125 subjects of Type 2 diabetic patients and healthy control. The anthropometric parameters (BMI and WHR) and blood parameters such as fasting glucose, glycosylated hemoglobin (HbA1c), lipid profile (total cholesterol, TGL, HDL, and LDL), hs-CRP, and microalbumin were measured. Cardiac risk indices calculated from lipid profile. Results: High cardiac risk indices were observed in diabetic subjects. The cardiac risk indices were showed that significant positive correlation with BMI, fasting sugar, HbA1c, total cholesterol, TGL, LDL and HDL shows negative correlation. Furthermore, hs-CRP and microalbumin showed significant positive correlation with cardiac risk indices in Type 2 DM patients. Conclusion: The increased in values of cardiac risk indices in diabetic patients shows increasing the susceptibility of CVD in these patients in future. The correlation of indices values with hs-CRP (inflammatory marker)shows the direct association of inflammation with CVD risks in Type 2 DM patients. Screening of these indices among diabetic patients will help the propensity of future development of CVD which can be arrested by encouragement of healthy lifestyle.

Abstract #1155435: Use of Glucagon-like Peptide 1 Receptor Agonist Therapy for Inpatients with Type II Diabetes and Chronic Kidney Disease: A Retrospective Analysis

The use and overall benefit of non-insulin glucose lowering agents for hospitalized patients is unclear due to limited data. Our study aims to determine the impact and safety of GLP-1 receptor agonist therapy in hospitalized diabetes patients with chronic kidney disease.

Pharmacists’ Role in Medication Consultation of Outpatients Type 2 Diabetes

This study aimed to evaluate the efficiency of pharmacists’ consultation about special dosage forms in diabetes outpatients at Ha Long Medical Center. Subjects and method: Diabetes type 2 patients were treated as outpatients and managed at Ha Long Medical Center between 01/3/2019 and 01/9/2019. This study is a prospective cohort study. Results: After the Pharmacist performs routine consulting duties, the percentage of patients with correct knowledge and appropriate use of insulin increased statistically (p&lt;0.05). The proportions of patients who did not swallow whole tablets of Diamicron MR and Glucophage XR decreased significantly from 62.3% to 15.8% and from 56.6% to 15.9%, respectively. Conclusion: Pharmacists’ consultation plays a vital role in improving knowledge and use of special dosage forms in diabetes outpatient.&#x0D; Keyword: Medication counseling, modified release, insulin, diabetes.*&#x0D; &#x0D; &#x0D; * Corresponding author.&#x0D; E-mail address: haint@hup.edu.vn&#x0D; https://doi.org/10.25073/2588-1132/vnumps.4360&#x0D; This study aimed to evaluate the efficiency of pharmacists’ consultation about special dosage forms in diabetes outpatients at Ha Long Medical Center. Subjects and method: Diabetes type 2 patients were treated as outpatients and managed at Ha Long Medical Center between 01/3/2019 and 01/9/2019. This study is a prospective cohort study. Results: After the Pharmacist performs routine consulting duties, the percentage of patients with correct knowledge and appropriate use of insulin increased statistically (p&lt;0.05). The proportions of patients who did not swallow whole tablets of Diamicron MR and Glucophage XR decreased significantly from 62.3% to 15.8% and from 56.6% to 15.9%, respectively. Conclusion: Pharmacists’ consultation plays a vital role in improving knowledge and use of special dosage forms in diabetes outpatient.&#x0D; Keyword: Medication counseling, modified release, insulin, diabetes.&#x0D; References&#x0D; [1] International Diabetes Federation, IDF Diabetes Atlas 9th Edition, 2019.[2] S. Ahmad, M. T. Osman et al., Education of Correct Insulin Injection Technique amongst Diabetic Patients: Outcome Study from Malaysia, International Journal of Medical Research &amp; Health Sciences, Vol. 5, No. 6, 2016, pp. 198-205.[3] F. A. Sefidani, E. P. Riazi, Impact of Pharmacist Intervention on Appropriate Insulin Pen Use in Older Patients with Type 2 Diabetes Mellitus in a Rural Area in Iran, Journal of Research in Pharmacy Practice, Vol. 6, No. 2, 2017, pp. 114-119, https://doi.org/10.4103/jrpp.JRPP_16_151.[4] D. T. Hang, N. T. Hai, et al., Survey Onknowledge and Impacts of Medication Consultation in Diabetes Patients in Phuc Yen Region General Hospital, VNU Journal of Science: Medical and Pharmaceutical Sciences, Vol. 33, No. 2, 2017, pp. 85-93, https://doi.org/10.25073/2588-1132/vnumps.4076 (in Vietnamese).[5] Electronic Medicines Compendium (EMC), Diamicron 30 mg MR Tablets, https://www.medicines.org.uk/emc/product/1321/smpc, (accessed on: January 10th, 2019).[6] Electronic Medicines Compendium (EMC), Glucophage XR 500 mg Prolonged Release Tablets, http:// www.medicines.org.uk/emc/ medicine /20952 (accessed on: January 10th, 2019).[7] Electronic Medicines Compendium (EMC), Lantus SoloStar 100 units/ml Solution for Injection in a Pre-filled Pen, http://www.medicines.org.uk/emc/medicine/22447, (accessed on: January 10th, 2019). [8] Electronic Medicines Compendium (EMC), Mixtard 100 units/ml Solution for Injection in a Pre-filled Pen, http://www.medicines.org.uk/emc/medicine/21366 (accessed on: January 10th, 2019).[9] J. Jiajia, L. Qingqing, Insulin Pen Injection Technique Survey in Patients with Type 2 Diabetes in Mainland China in 2010, Current Medical Research and Opinion, Vol. 30, No. 6, 2014, pp. 1087-1093 , https://doi.org/10.1185/03007995.2014.895711.[10] N. T. Kien, Implemented the Pharmacist's Consultation in Using Insulin in Diabetes Outpatients at Dan Phuong District General Hospital, Master Thesis, Hanoi University of Pharmacy, 2020, pp. 49-50.&#x0D; &#x0D; &#x0D;

Risk and outcomes of diabetes in patients with epilepsy

The risk and outcomes of diabetes in patients with epilepsy remains unclear. We evaluated these risks using an epilepsy cohort analysis and a diabetes admission analysis. In the epilepsy cohort analysis, we identified 2854 patients with newly diagnosed epilepsy in 2000–2008 from the research data of National Health Insurance in Taiwan. Using Propensity-score matching by sociodemographic factors and medical conditions, we selected 22,832 people without epilepsy as a non-exposed cohort for comparison. Follow-up events of diabetes from January 1, 2000 until December 31, 2013 were ascertained from medical claims. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of diabetes associated with epilepsy were calculated using multiple Cox proportional hazard models. In the diabetes admission analysis, we identified 92,438 hospitalized diabetes patients, 930 of whom had a history of epilepsy. Adjusted odds ratios (ORs) and 95% CIs of adverse events after diabetes associated with previous epilepsy were calculated using multiple logistic regressions. The adjusted HR of diabetes in the cohort with epilepsy was 1.31 (95% CI 1.14–1.50) compared to the non-epilepsy cohort. Previous epilepsy was associated with post-diabetes adverse events, such as pneumonia (OR 1.68, 95% CI 1.37–2.07), urinary tract infection (OR 1.83, 95% CI 1.55–2.16), and septicemia (OR 1.34, 95% CI 1.09–1.65). In conclusion, epilepsy was associated with higher risk of diabetes and adverse post-diabetes outcomes. Diabetes prevention and attention to post-diabetes adverse events are needed for this susceptible population.

COVID-19 Pandemic Influence on Diabetes Management in Croatia.

The study aims to investigate the effects of the COVID-19 pandemic on diabetes management and diabetes patients' healthcare utilization patterns in Croatia. Using data contained in the Croatian diabetes registry (CroDiab), Central Health Information System of the Republic of Croatia (CEZIH), and the Croatian hospitalization database (BSO), indicators including the total number of registered diabetes patients, number of newly diagnosed diabetes cases, number of diabetes-related primary care visits and hospitalizations, and key diabetes control indicators were analyzed. Yearly values from 2017 until 2020 were compared. The age-adjusted prevalence rate increased significantly from 2017 until 2019 (2017: 6,858/100,000; 2018: 7,053/100,000; 2019: 7,160/100,000). In 2020 the age-adjusted prevalence rate was 7,088/100,000, but the decrease was insignificant compared to 2019. The age-adjusted rate of new cases decreased from 2017 until 2019 (2017: 910/100,000; 2018: 876/100,000; 2019: 845/100,000), with a significant decrease in 2020 (692/100,000) compared to 2019. The number of diabetes panels increased from 2017 (117,676) to 2018 (131,815), with a slight decrease in 2019 (127,742) and a sharp decrease in 2020 (104,159). A similar trend was observed regarding the numbers of diabetes patients with panels, visits to primary healthcare providers for diabetes-related problems and diabetes patients who visited their primary healthcare provider. A slightly different trend was observed regarding diabetes-related hospitalizations. In 2017 there were 91,192 diabetes-related hospitalizations; the number decreased to 83,219 in 2018, increased again to 102,087 in 2019 and decreased to 85,006 in 2020. The number of hospitalized diabetes patients displayed a similar tendency. The COVID-19 pandemic has had a negative effect on the utilisation of healthcare by diabetes patients, which may have long-term consequences for their general health.

Heart failure therapy in patients with diabetes

The great interest in the problem “Heart failure” (HF) by the diabetolo­gist has been born in recent years and is mainly linked to the availabil­ity of new antidiabetic drugs which have shown a significant benefit in reducing hospitalizations for heart failure and cardiovascular mortality. Diabetes patients have more than double the risk of developing HF compared to patients without diabetes. The Framingham study has shown that diabetes increases the risk of heart failure up to 2 times in men and 5 times in women compared to controls over age. In addition, 12% of patients with DMT2 have heart failure and 30% of patients with heart failure are diabetic. Hospitalization for HF is associated with very high rates of both post-dis­charge mortality and new hospitalizations. Readmission rates for clinically stable patients discharged after recent hospitalization for HF are approximately 25% at 6 months and all-cause mortality exceeds 30% at 1 year. In particular, a worse prognosis and a longer hospital stay are associated with hospitalized diabetes patients. There is a close correlation between metabolic compensation and HF. In fact, in patients with diabetes a 1% increase in HbA1c is associated with an 8% increase in the risk of HF and still the improvement of the glycometabolic control reduces the risk of HF (in the UKPDS the 1% re­duction in HbA1c was associated with a 16% reduction in the risk of HF occurring). KEY WORDS T2DM; heart failure; SGLT2-inhibitors; diabetic cardiomyopathy.

Validation and Comparison of Two 30-Day Re-Admission Prediction Models in Patients with Diabetes

Objective: The objective was to evaluate the 30-day re-admission predictive performance of the HOSPITAL score and Diabetes Early Re-admission Risk Indicator (DERRI™) in hospitalized diabetes patients. Methods: This was a case-control study in an academic, tertiary center in the United States. Adult hospitalized diabetes patients were randomly identified between January 1, 2014, and September 30, 2017. Patients were categorized into two groups: (1) re-admitted within 30 days, and (2) not re-admitted within 30 days. Predictive performance of the HOSPITAL and DERRI™ scores was evaluated by calculating receiver operating characteristics curves (c-statistic), Hosmer-Lemeshow goodness-of-fit tests, and Brier scores. Results: A total of 200 patients were included (100 re-admitted, 100 non-re-admitted). The HOSPITAL score had a c-statistic of 0.731 (95% confidence interval [CI], 0.661 to 0.800), Hosmer-Lemeshow test P = .211, and Brier score 0.212. The DERRI™ score had a c-statistic of 0.796 (95% CI, 0.734 to 0.857), Hosmer-Lemeshow test P = .114, and Brier score 0.212. The difference in receiver operating characteristic curves was not statistically significant between the two scores but showed a higher c-statistic with the DERRI™ score (P = .055). Conclusion: Both HOSPITAL and DERRI™ scores showed good predictive performance in 30-day re-admission of adult hospitalized diabetes patients. There was no significant difference in discrimination and calibration between the scores. Abbreviations: CI = confidence interval; DERRI™ = Diabetes Early Re-admission Risk Indicator; IQR = interquartile range.

A Comparative Study of Metformin plus Sulfonylureas Versus Metforminalone for Its efficacy In Type 2 Diabetes patients In South Indian Tertiary Care Teaching Hospital

A Comparative Study of Metformin plus Sulfonylureas Versus Metforminalone for Its efficacy In Type 2 Diabetes patients In South Indian Tertiary Care Teaching Hospital

Survey Onknowledge and Impacts of Medication Consultation in Diabetes Patients in Phuc Yen Region General Hospital

Objectives: This study aimed to survey the knowledge and impacts of medication consultation about special dosage form in diabetespatients in Phuc Yen Hospital. Subjects and method: Diabetes patients in Endocrinology Department of Phuc Yen hospital who use one of diabetes medications including Diamicron MR, Panfor SR and Insulin in a period from 01/9/2016 to 15/01/2017. These patients was consulted on the use of diabete medication by clinical pharmacists and periodically evaluated in each month.Results: At the beginning of research, percentage of patients using accurately diabetes medication was approximately 50%. After 3 months, there was a significant increase in knowledgeof patients (p&lt;0.05). The percentage of patients knowledge was approximately 90%.Conclusion: Medication consulting activities improved significantly the knowledge of patients on using diabetes medications.

Epidemiological and clinical features of newly diagnosed diabetes cases in hospitalized children in a single center from 2010 to 2016

Objective To analyze the epidemiological features, clinical classification, clinical manifestation and the detection of islet autoantibody of the children with diabetes hospitalized in a single center. Methods A retrospective analysis was performed on the 431 patients with diabetes newly diagnosed at the Department of Endocrinology, Capital Institute of Pediatrics-Peking University Teaching Hospital from January 2010 to December 2016.The medical records, including the number of children per year, the proportion of various types of diabetes, children′s general situation, family history, blood sugar, urine and urine ketone body, blood gas analysis, fasting C peptide, and islet autoantibody test results, were analyzed. Results Of the 431 patients, there were 309 cases (71.7%) of type 1 diabetes mellitus (T1DM), 86 cases (20.0%) of type 2 diabetes mellitus (T2DM), 22 cases (5.1%)of special type of diabetes and 14 cases (3.2%) of undetermined type of diabetes.Maturity onset diabetes in young (MODY) was found in 16 cases out of 22 special type of diabetes.Nine MODY children underwent gene detection, and 2 children were detected with mutation in the GCK gene(c.370G>C, p.D124H; c.707A>G, p.E236G) and the types were MODY2.The annual number of children with diabetes from 2010 to 2016 were 43 cases, 50 cases, 65 cases, 65 cases, 68 cases, 75 cases and 65 cases respectively, and the growth rate increased 51.2% from 2010 to 2016.The median age of T1DM patients at diagnosis was 7.0 years old, compared with 12.7 years of T2DM patients; 94.5% (292 cases) of T1DM patients had typical three polys and one little symptoms of diabetes, compared with 75.6% (65 cases) of T2DM patients; 41.1%(128 cases) of T1DM patients had ketoacidosis at the onset of diabetes, compared with 16.2%(14 cases) of T2DM patients; 33.0%(102 cases) of T1DM patients had family history of diabetes, compared with 74.4% (64 cases)of T2DM patients; the median of fasting C peptide of 302 T1DM patients was 0.20 μg/L, compared with 2.14 μg/L of 85 T2DM patients; the differences above were all statistically significant(Z=-11.127, P=0.00; χ2=27.689, P=0.000; χ2=18.473, P=0.000 017; χ2=47.348, P=0.000; Z=-12.865, P=0.00). Two hundred and seventy-nine T1DM patients were tested for islet cell antibody (ICA), insulin autoantibody (IAA), glutamic acid decarboxylase antibody (GADA) at the same time, and the positive rate was 2.9%(8/279 cases), 14.7%(41/279 cases), and 9.3%(26/279 cases) respectively, and there were 65 cases (23.3%) with at least one positive result.One hundred and three T1DM patients were detected by the combination of 5 islet autoantibodies (ICA, IAA, GADA, islet antigen-2 antibody, Zinc transporter type 8 autoantibodies), and the positive rate of at least 1 antibody was 53.4%(55/103 cases), while 23 T2DM patients were tested for these five auto-antibodies, and the positive rate of at least 1 antibody was 13.0%(3/23 cases), and the difference between 2 groups was statistically significant(χ2=12.325, P=0.000 447). Conclusions (1)The number of hospitalized diabetes of children and adolescents in our center was increasing gradually.(2)In the center′s hospitalized diabetes patients, T1DM accounted for the most, T2DM took the second place, and there were minority of special type of diabetes.MODY accounted for the most part of special type of diabetes, and the main gene mutation was GCK gene mutation with type of MODY2.(3)T1DM had the characteristics of early onset age, typical three polys and one little symptoms of diabetes, more ketoacidosis at onset, low fasting C peptide, fewer family history of diabetes compared with T2DM.(4)The combined detection of islet autoantibodies could improve the detection rate of T1DM. Key words: Diabetes mellitus; Child; Epidemiological features; Clinical classification; Clinical features; Autoantibodies

Prevalence of Metabolic Syndrome Among Diabetes Patients in Central Regional Hospital, Cape Coast, Ghana

Background: Metabolic syndrome (MetS) is a combination of complex group of cardiovascular risk factors, which include central adiposity, high blood pressure, dyslipidaemia and elevated fasting blood glucose. Generally, the prevalence of MetS in diabetes patients is high and the syndrome tends to promote the development of diabetes and other chronic diseases. Diabetes is characterised by high random plasma glucose as well as polyuria, polydipsia and weight loss etc. Aim: This study aims to determine the prevalence of MetS in diabetics’ patients using the National Cholesterol Education Programme (NCEP) ATP III criteria, World Health Organisation and International Diabetes Federation definitions in quantifying the syndrome. Method: This cross-sectional study involved 103 diabetes patients in the Cape Coast Metropolis, Central Region. Anthropometric measurements and fasting blood samples for blood sugar and lipids were taken. Blood pressures were recorded from their personal health record files. The NCEP ATP III, WHO and IDF criteria were used to define diabetes patients with the metabolic syndrome. Results: A total of 42 (40.8%), 31(30.1%), 81 (78.6%) were obese, overweight and have high waist circumference (IDF) respectively. Also all the participants had a low high density lipoprotein (HDL) level with 42(95.5%) having high triglycerides (TG). Significant associations were found for age range of 66-75(OR= 16.00, CI= 1.32-194.62), women (OR= 14.06; CI= 2.50-79.05) and high blood pressure (OR= 5.83, CI= 1.22-39.93). Prevalence of MetS was 38.60%, 59.09% and 75.00% using WHO, NCEP ATP III and IDF criteria respectively. Conclusion: A high prevalence of MetS was observed among the diabetes patients. The prevalence among the females was higher than that of the males.

Circulating angiogenic factors in diabetes patients in a tertiary hospital in Ghana

Circulating angiogenic factors in diabetes patients in a tertiary hospital in Ghana

The Effect of Timing on Breast Reconstruction Outcomes in Diabetic Women.

Background:This study examines the effect of timing (immediate vs delayed) on postoperative morbidity in diabetic women undergoing breast reconstruction after mastectomy.Methods:We reviewed the National Surgical Quality Improvement Program (NSQIP) databases from 2005 to 2012 for all diabetic women undergoing breast reconstruction. Multivariable logistic regression was used to estimate the risk of 30-day overall complications in the immediate versus delayed cohorts. Additionally, we retrospectively reviewed outcomes for all Johns Hopkins Hospital diabetic patients undergoing breast reconstruction from 2005 to 2014.Results:In the NSQIP, 1,408 diabetic women underwent breast reconstruction: 958 (68%) immediate and 450 (32%) delayed. In the immediate group, 10.75% of patients developed a 30-day overall complication, compared with 7.78% of patients in the delayed group. On multivariable analysis, the odds of developing 30-day overall complications were significantly higher (adjusted odds ratio = 1.68; P = 0.033) for the immediate compared with the delayed cohort. In the Johns Hopkins Hospital cohort, 114 reconstructions were performed in 52 diabetic women: 59 (51.8%) immediate and 55 (47.2%) delayed. On long-term follow-up (median = 16.5 months), 41.0% of immediate reconstructions developed a surgical complication compared with 27.8% of delayed reconstructions. Deep infections (P = 0.026), seroma formation (P = 0.003), reconstruction failure (P = 0.001), and reoperation rates (P = 0.001) were significantly increased in the immediate cohort.Conclusions:Among diabetics seeking breast reconstruction, delaying the reconstructive surgery from the mastectomy is associated with decreased postoperative morbidity. It also appears that the 30-day postoperative time point available in the NSQIP does not fully reflect the magnitude of the long-term complications these diabetic patients will develop.

Application of the improved abdominal rotation card method in insulin injection

Objective To explore the effect of the improved abdominal rotation card method in insulin injection. Methods A total of 100 hospitalized diabetes patients were randomly divided into control group (n=50) and observational group (n=50) according to the random number method. In the control group, insulin was injected to the subcutaneous tissue of abdomen with traditional method annular rotating method. Insulin was injected using improved abdominal rotation card method in the observational group. Compare accuracy and mastery rate of injection site rotation between the two groups. Compare fasting blood glucose (FBG), postprandial 2H blood glucose (PBG), HbA1c, the incidence of hypoglycemia and endermic induration between the two groups after three months. Results The nurses in the observation group had higher accuracy rate of the injection site rotation compared to the control group [98.6% (690/700) vs. 38.6% (270/700), χ2=584.66, P < 0.01]. Mastery rate of the injection site rotation for the patients in the observation group were significantly higher than the control group [70.0% (35/50) vs. 20.0% (10/50), χ2=25.74, P < 0.01]. The incidence of endermic induration were significantly lower in observation group compared to the control group [2.0% (1/50) vs.16.0% (8/50), χ2=5.98, P < 0.01]. The incidence of hypoglycemia were significantly lower in observation group compared to the control group [4.0% (2/50) vs. 16.0% (8/50), χ2=4.00, P < 0.01]. Conclusions The new abdominal rotation method in insulin injection can be a safe and effective therapy in patients with type 2 diabetes. Key words: Diabetes mellitus; Insulin; Hypodermic injection; The new abdominal rotation method in insulin injection

Seasonal variation of hemoglobin A1c levels in patients with type 2 diabetes

The purpose of our study was to retrospectively examine the association between hemoglobin A1c (HbA1c) with season variation in patients with type 2 diabetes from the Chinese mainland. Monthly average of HbA1c values of type 2 diabetes patients in Jinan Central Hospital between 2008 and 2011 were respectively reviewed. The effects of sex, age, and season on HbA1c levels were analyzed. Moreover, a multiple linear regression analysis was performed to discuss the correlations between HbA1c levels and sex, age, and season. The HbA1c levels were significantly higher in winter (December, January, and February) and significantly lower in summer (June, July, and August). Significant difference was found for HbA1c between men and women in the elderly group (P 0.05), but significantly lower in the elderly group (P < 0.05). Additionally, negative correlations of HbA1c with season, age, and gender were identified (P < 0.01). Our study suggests that cold weather may elevate the levels of HbA1c in type 2 diabetic patients in mainland China. However, more detailed studies are needed to reveal the variation of HbA1c with age and gender.

Profile Study of Hospitalized Diabetes Patients at Indian Private Specialty Hospital

Profile Study of Hospitalized Diabetes Patients at Indian Private Specialty Hospital

A study on carpal tunnel syndrome among diabetes patients in tertiary care hospital

Background: The carpal tunnel syndrome (CTS) is one of the major problems in diabetes mellitus. There are certain risk factors like age, sex, status of diabetes influence the occurrence of carpal tunnel syndrome among diabetes. Methods: This study was conducted among 106 diabetes patients attending tertiary care hospital diabetes OPD to find out occurrence of CTS. The patients were selected randomly. The clinical examination of CTS along with electro diagnostic study was done. The blood investigation like blood sugar, HbA1c and Thyroid function were performed. The statistical analysis as Chi-square test was applied. Results: Among the study population 56% were female and 44% were male. The prevalence of carpal tunnel syndrome was 19.8% according to electro diagnostic study among diabetes patients. The carpal tunnel syndrome found in 29% of the female compare to 9% among male, this increase occurrence in female was statistically significant. This study found out the uncontrolled diabetes was one of the major risk factor for CTS. Conclusions: The uncontrolled diabetes rather than duration of the diabetes is also major cause for CTS. It is the duty of the physician and the patient to control the diabetes to prevent the CTS.

A Patient Survey of Diabetes Patients in Hospital: Implications for Quality Improvement Strategies

s / Can J Diabetes 39 (2015) 529e547 541 maintaining TG 62.2mmol/L; patient #2 -10.8 and 44.0 mmol/L; and patient #3 41.7 and >62.2 mmol/L respectively. Partial lipoprotein lipase deficiency was demonstrated molecularly in patient #3. Patients #1 and #2 received no PLEx, while patient #3 received a single course of PLEx within 24 hours of admission. By 72hours, plasma TGwas reduced by68%, 77% and 73% in patients #1, #2 and #3, respectively. All three patients were eventually discharged with essentially normal profiles. Conclusion: The clinical course in these three patients with severe HTG-induced pancreatitis suggests that PLEx is not necessary even in very severe cases, and that TG levels will correct rapidly with conservative measures. The role of PLEx in this situation should be addressed more formally in a clinical trial format. 044-2015. CLINICAL CARE A Patient Survey of Diabetes Patients in Hospital: Implications for Quality Improvement Strategies PETRA O’CONNELL*, JULIE A. MCKEEN, KARMON E. HELMLEy, GLENDA MOORE, EDWIN ROGERS