Poor Blood Sugar Control Research Articles

Adherence to Diabetic Self-Care Practice and Associated Factors among Patients with Type Two Diabetes at a Public Hospital in Addis Ababa

<i>Background</i>: Self-care adherence is thought to be crucial for managing polygenic disease. This is frequently because there is a strong correlation between poor blood sugar control and self-care behaviors and the subsequent emergence of polygenic disease complications. By improving glycemic control, patients may be able to reduce their risk of developing those complications. Therefore, the purpose of this study is to evaluate the self-care behaviors of patients with type II diabetes who are attending a selected public hospital in Addis Ababa City, as well as the impact of demographic factors and clinical state on these behaviors. <i>Methods</i>: An institution-based cross-sectional study design was conducted using SPSS version 26, and multivariable binary logistic regression analysis was used. <i>Result</i>: A total of 397 study participants were interviewed with response rate of 99.25%. Data coming from this study reveals that (73.8%) of study participants has good practiced on the recommended self-care practices. Factors found to be significantly associated with adherence to diabetic self-care were BMI of respondent (AOR = 0.465, 95% CI = 0.229-0.947), diabetic compilation, place of respondent (AOR = 1.090, 95% CI =0.091-0.604), and monthly income (AOR =, 1.522 95% CI =0.871-2.659). <i>Conclusion</i>: the level of adherence to self-care practices among diabetic patients is lower compared to other areas. To improve this, the healthcare team should adopt a patient-centered approach when deliver diabetes messages, focusing on specific issues related to management practice. it is imperative to increase awareness of patients and the community as a whole in order to address important aspects such as medication adherence, glycemic control and diet management. By taking these steps, we can work towards improving self-care practice among diabetic patients and ultimately, their overall health and well-being.

A Narrative Review of Adhesive Capsulitis with Diabetes.

Background/Objectives: To update the perspectives of the association between diabetes (DM) and adhesive capsulitis (AC). Methods: Our findings were summarized in a narrative review. We searched PubMed, Embase, and Consensus databases, using keywords such as "diabetes", "adhesive capsulitis", and "frozen shoulder", for articles published from January 2015 to June 2024, covering both type 1 and type 2 DM. Results: After compiling relevant articles on DM-related AC published since 2015, we found that most studies show an increased prevalence of AC in DM patients, ranging from 3 to 10 times. A longer duration of DM is a risk factor for AC. Whether T1DM or prolonged insulin use will increase the risk of AC is still controversial. Poor blood sugar control seems to increase the risk of AC. Recent studies also show a correlation between blood sugar levels and the prevalence of AC. Cytokines, such as IL-6, IL-8, TNF-α, VEGF, and AGEs, related to inflammation and fibrosis may contribute to the pathophysiological processes of AC. Conclusions: Recent research findings have revealed new perspectives divergent from past notions, while also presenting some topics worthy of exploration. Due the close relationship between DM and AC, clinicians need to be alert to the presence of AC, especially early stage, in DM cases, and control the blood glucose level to reduce the risk of AC. Further research is still needed to provide better prevention and management for DM patients with AC.

RELATIONSHIP BETWEEN SEXUAL DYSFUNCTION AND SEXUAL SELF-CONCEPT IN PATIENTS WITH DIABETES MELLITUS: A SCOPING REVIEW

Background: An often-occurring complication of diabetes mellitus is sexual dysfunction, often linked to poor blood sugar control. Despite its significant impact on patients' lives, issues related to sexual desire, education, and timely detection and management of sexual problems have historically been overlooked in diabetes interventions. This neglect may affect individuals' sexual self-concept and overall well-being. The purpose of this study is to investigate the relationship between sexual dysfunction and sexual self-concept in diabetics. Design: This research employs a scoping review design. Data Sources: A comprehensive literature search was conducted using databases such as Web of Science, Open Alex, Crossref, Google Scholar, PubMed, Scopus, and Semantic Scholar. Articles published between January 2018 and October 2023 were included. Review Methods: The analysis followed the Arksey and O'Malley model and PRISMA guidelines. 26 quantitative articles were reviewed, including 24 cross-sectional studies and 2 observational studies, all using quantitative methodologies. Results: Sexual dysfunction is prevalent among diabetes type 1 and type 2 in both men and women, influenced by physiological factors and glycemic control. Men may experience issues like diminished libido, premature ejaculation, and difficulty achieving orgasm, while women may face reduced sexual desire, arousal difficulties, and dyspareunia. Factors contributing to sexual dysfunction include age, duration of diabetes, glycemic control, comorbidities, medication use, psychological factors, and lifestyle elements like physical activity and stress levels. Sexual dysfunction in people with diabetes has a significant impact on sexual self-concept, which includes feelings, views, and beliefs about sexual relationships. Conclusion: There hasn't been any specific research conducted on diabetic patients concerning the correlation between sexual dysfunction and sexual self-concept, highlighting the need for dedicated studies to address this association and raise awareness.

Evaluating the Role of Glycemic Control in Modulating Pulmonary Function Among Smokers With Diabetes Mellitus: A Systematic Review.

Diabetes mellitus (DM) impacts multiple body systems, including lung function, and this impact can be further complicated by smoking. The connection between blood sugar control and lung health in individuals with diabetes who smoke has been extensively studied, but findings have been varied. This systematic review sought to compile and assess the research on how blood sugar control influences lung function in smokers with diabetes. We searched several databases, including PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, CINAHL, PsycINFO, and Google Scholar, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included studies that looked at lung function tests in smokers with diabetes and examined the relationship with blood sugar control, as indicated by hemoglobin A1c (HbA1c) levels. We conducted thorough quality assessments, data extraction, and analysis. We identified five relevant studies. The data from these studies indicated a clear trend: smokers with diabetes who had higher HbA1c levels typically showed worse lung function than those with better blood sugar control. Decreases in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were the most frequently observed issues. Some studies also pointed to a complex relationship between HbA1c levels and lung function, particularly when HbA1c was below 7.0%. Our review indicates that smokers with DM who have poor blood sugar control tend to have worse lung function. These findings highlight the importance of managing blood sugar to help maintain lung health in these individuals. Further long-term research is needed to clarify the exact relationship and whether improving blood sugar control can reverse lung problems.

Effectiveness of a Digital Application-Based Self-Care Management Program in Patients with Type 2 Diabetes in Thai Nguyen Province, Vietnam

Purpose: To evaluate the effectiveness of educational communication intervention using SMDia software in improving knowledge, self-care activities, quality of life and glycemic control in patients with type 2 diabetes in Thai Nguyen province, Vietnam.
 Methodology: It was an intervention study with control group. Intervention study was conducted from March 2021 to May 2022 on 240 patient’s type 2 diabetes who was randomly assigned to the control group and intervention group, each group had 120 people. It was to evaluate the effectiveness of educational communication intervention using SMDia software for self-care knowledge, self-care activities, and quality of life, using the DSCKQ-30, SDSCA, and V.SF-36v2 toolkits for glycemic control by fasting blood sugar levels, HbA1c at times before and after intervention.
 Findings: After intervention, there was a clear improvement over time and level in the intervention group compared to the control group after 24 weeks. The self-care knowledge score in the intervention group’s 26.60 ± 2.96 points; the self-care activity score in the intervention group's 69.40 ± 9.31 points; the quality of life score for physical health in the intervention group's 73.25 ± 9.34 points; the mental health quality of life score in the intervention group's 72.74 ± 7.0 points. The intervention effect on change in self-care activities, quality of life and self-care knowledge were 167.8%, 163.6%, and 64.0%, respectively. After 24 weeks, the rates of patients with poor blood sugar control and poor HbA1c in the intervention group was 36.7% and 7.5%. The rate of blood sugar control achieved the target increased by 15.8%, HbA1c reached the target increased by 31.7%. Intervention effectiveness reached 8.2% for blood sugar control and 41.8% for HbA1c control.
 Unique contribution to theory, practice and policy: Educational communication intervention using SMDia software has shown to significantly improve self-care knowledge, self-care activities, quality of life and glycemic control for patients with type 2 diabetes.

Characteristics of Human Leukocyte Antigen Class II Genes in Japanese Patients with Type 1 Diabetes and Autoimmune Thyroid Disease.

Genetic factors, particularly human leukocyte antigen (HLA) class II genes, are known to significantly influence the onset of type 1 diabetes (T1D). Additionally, patients with T1D often develop autoimmune thyroid diseases (AITD). Despite this association, comprehensive research on individuals with both AITD and T1D in Japan, especially regarding the influence of specific HLA alleles, remains insufficient. In this retrospective study, we analyzed 44 inpatients diagnosed with T1D. These patients were predominantly female, with an average onset age of 35 years, poor blood sugar control, and approximately 43.2% had concurrent AITD. We observed significant associations of HLA-DRB1*04:05, HLA-DRB1*09:01 and HLA-DRB1*15:02 alleles with T1D regardless of AITD presence, which had been previously established for T1D in Japanese. In this context, comparing Japanese patients with AITD alone, we noted AITD comorbidity with T1D results in alterations in the frequencies of HLA-DRB1*09:01, HLA-DRB1*04:03, and HLA-DRB1*15:02. Furthermore, HLA-DRB1*04:05, HLA-DRB1*09:01, HLA-DRB1*13:02, and HLA-DRB1*15:01 alleles may be alleles whose susceptibility varies for both conditions. These findings underscore the importance of understanding the relationship between T1D, AITD, and HLA genetics, which may inform personalized treatment strategies and facilitate the development of targeted therapies. Future research endeavors should aim to elucidate underlying mechanisms and validate these findings in larger cohorts.

Case report of a person with diabetes mellitus who has tropical diabetic hand syndrome

-Introduction: Diabetes mellitus (DM) is a chronic systemic disease that causes morbidity and mortality. Diabetes often increases the incidence and severity of various infections, especially those caused by bacteria and fungi, where patients have hyperglycemia and poor blood sugar control. Tropical diabetic hand syndrome (TDHS) is a specific hand complication experienced by people with DM in tropical countries. The syndrome involves localized cellulitis, which can be progressive and fulminant to hand sepsis and gangrene. Management of patients with TDHS requires a comprehensive strategy and management to reduce mortality and morbidity. This study aimed to report a rare case of a patient with T2DM who experienced TDHS. Case Presentation: A 45-year-old man came to the emergency department of RSUD Dr. Soetomo, with a chief complaint of a wound on his right hand caused by a rusty nail that had not healed for three days. The patient said that he had uncontrolled DM for six years. In manus dextra examination, an ulcer measuring 0.5x 0.5 cm was found on the back of the hand on the ulnar side, with edema, hyperemia, and active pus discharge. The patient was hospitalized for nine days and discharged when the complaints and the blood sugar level were improved. On the seventh day after discharge, the complaints felt significantly reduced, the wound improved with granulation tissue appearing, and the blood sugar level was within normal limits. The patient was given insulin aspart injection of 10 units thrice daily, basal insulin of 16 units, ciprofloxacin 500 mg twice daily, ibuprofen 400 mg thrice daily, and cilostazol 100 mg twice daily. Conclusion: In this case report, we presented a case of a 45-year-old man with manifestations of TDHS as a complication of uncontrolled DM for six years and delay in obtaining medical services. Management of patients with TDHS includes hospitalization, elevation of the affected hand, optimal blood sugar control, administration of antibiotics, and wound care. Education for T2DM complications remains the most important preventive measure in developing countries.

Comparison of medication adherence in patients with type 2 diabetes mellitus: a pre and post study

Background: Type 2 diabetes mellitus refers to a group of heterogeneous disorders with the common elements of chronic hyperglycemia. Diabetes medications play a crucial role in lowering blood sugar levels. The study aims to compare medication adherence in patients with type 2 diabetes mellitus from urban and rural areas during pre and post visit. Methods: This pre and post-study was conducted from March to August 2022. A total of 104 participants were enrolled. Details have been obtained through data collection form. Medication adherence was measured using Hill-Bone medication adherence scale, and patient education was provided through leaflet. Results: The study included 54 females and 50 males. The correlation between medication adherence versus disease knowledge and drug knowledge was found out using Pearson’s correlation and the result is statistically significant. The medication adherence was found to be increased by 17.3% and 21.2% in rural and urban areas respectively. Inadequate follow-up and financial barriers were most accounted for medication non-adherence. Conclusions: The majority of type 2 diabetes patients have suboptimal treatment adherence which is associated with poor blood sugar control. We clinical pharmacists can tackle this problem of adherence through quality patient education.

Factors that contribute to blood sugar control in type 2 diabetes mellitus

Background: Diabetes needs to be well controlled so as not to cause acute and chronic complications. Therefore, it is necessary to comply with regimen therapy and control diet and physical exercise. Objective: This study aimed to assess the contribution of medication adherence and nonpharmacological therapy adherence, as well as other factors affecting blood sugar control. Method: This study involved 76 type 2 diabetic patients from a Community Health Center in East Surabaya. Medication adherence was measured with an ARMS questionnaire and pill count, while nonpharmacological therapy was measured with a self-developed questionnaire. Result: The majority of respondents have uncontrolled blood sugar levels, were not compliant with treatment both as measured by ARMS and by the pill count method, and are not compliant with nonpharmacological therapy with the following frequencies: 85.5% (n=65), 92.1% (n=70), 57.9% (n=44), 98.7% (n=75). The results of multiple correlation tests showed that age, duration of treatment, adherence to treatment with the ARMS method and the pill count method, and adherence to nonpharmacological therapy simultaneously affected blood sugar control by 72.7%. Conclusion: Factors that simultaneously determine poor blood sugar control are age, duration of diabetes therapy, non-adherence to treatment, and non-adherence to nonpharmacological therapy.

THU378 Presentation Of Autoimmune Destruction Of Pancreatic Beta Cells By Pembrolizumab In The Setting Of Existing Type 2 Diabetes

Abstract Disclosure: J. Seidenberg: None. M.J. Ansari: None. Background: Prembrolizumab, like other immunotherapies, have become a commonplace treatment for certain cancers. Its method of action is binding of the programmed cell death I receptor that blocks the binding of the programmed cell death ligand 1. PD1-1 receptors have been reported to cause autoimmune endocrinopathies including type 1 diabetes. Many patients who present with the adverse reaction of autoimmune diabetes type 1 present with ketoacidosis. However, patients already diagnosed with diabetes type 2 on insulin could have this strong initial presentation masked. Clinical Case: Patient is a 76 year old female who was recently diagnosed with bladder cancer and started on Pembrolizumab. She presented to the endocrinology clinic due to new onset poor blood sugar control with self-tested glucose levels ranging from 300-400. This patient was previously diagnosed with diabetes type II and was taking metformin, Levemir 18 units daily, Humalog 6 units AC. A C peptide level was obtained during euglycemia, which was undetectable, indicating autoimmune destruction of pancreas. Patient was continued on Pembrolizumab due to her clinical response to it and a low probability of pancreatic beta cells functioning again. Patient’s C peptide continued to be undetectable 1 year after her presentation. Conclusion: Autoimmune destruction of pancreatic beta cells from Pembrolizumab is a rare but important adverse effect. Pembrolizumab has been reported to be associated with autoimmune-related pancreatitis leading to type 1 diabetes in only 0.1% of all patients in clinical trials. We present this patient, who was already being treated with insulin for type 2 diabetes and thus was being tested for elevated glucose regularly. She was able to notice a significant change in glucose control prior to onset of symptoms. All patients who take Pembrolizumab, especially those with underlying diabetes, should be regularly evaluated for interference with pancreatic beta cells with regular glucose labs and if hyperglycemia occurs, with a C peptide level should then be ordered. Presentation: Thursday, June 15, 2023

Analysis of risk factors of neonatal hypoglycemia and its correlation with blood glucose control of gestational diabetes mellitus: A retrospective study.

This study aimed to investigate the risk factors associated with neonatal hypoglycemia and its correlation with blood glucose control in patients with gestational diabetes mellitus (GDM). This study was a retrospective study. 880 pregnant women with GDM and their newborns were hospitalized from January 2018 to December 2022 in our hospital. The clinical information of GDM pregnant women and their newborns were reviewed and the hemoglobin A1c (HbA1c) values measured within 1 week before delivery were collected. According to the occurrence of neonatal hypoglycemia, which was divided into the control and observation groups. Logistic regression model was used to estimate the potential factors associated with neonatal hypoglycemia. The association between HbA1c of pregnant women before delivery and abnormal glucose metabolism in newborns was examined using spearman correlation analysis. A total of 104 cases of hypoglycemia occurred in neonates delivered by 880 GDM women and the incidence of neonatal hypoglycemia was 11.82%. There were significant differences in pre-pregnancy overweight or obesity, delivery mode, maternal blood sugar control effect and neonatal feeding standard between the 2 groups of GDM women (P < .05). Pre-pregnancy overweight or obesity, poor blood sugar control in GDM women, and improper neonatal feeding were risk factors for neonatal hypoglycemia. The results of logistic regression analysis showed that abnormal glucose metabolism in newborn (odds ratio [OR]: 2.43, 95% confidence interval [CI]: 1.12-4.73) and neonatal hypoglycemia (OR: 3.04, 95% CI: 1.33-5.79) were a risk factor. We also conducted the logistic analysis to evaluate the correlation between HbA1c before delivery and abnormal glucose metabolism in newborns of pregnant women with GDM through adjusting some potential factors. The results were still significant in the abnormal glucose metabolism in newborn (OR: 2.84, 95% CI: 1.23-6.63) and neonatal hypoglycemia (OR: 3.64, 95% CI: 1.46-8.18). Overweight or obesity of GDM parturient before pregnancy, poor blood glucose control of GDM parturient and improper feeding of newborns are all risk factors for neonatal hypoglycemia. HbA1c before delivery has a certain predictive value for abnormal glucose metabolism in newborns.

Effect of Case Management for Patients with Gestational Diabetes

Objective: To explore the effect of allocating case managers for gestational diabetes patients. Methods: 200 patients with gestational diabetes mellitus from December 2021 to December 2022 were included in this study, and the collection period. They were divided into groups according to the interventions received. Each patient in the observation group was managed by a case manager, while the control group were managed with conventional methods without the supervision of a case manager. There were 100 cases in each group, and the curative effects of the two groups were compared. Results: The fasting blood glucose and 2-hour postprandial blood glucose in the observation group were significantly lower than those of the control group (P &lt; 0.05). The re-admission rate of patients due to poor blood sugar control in the observation group was lower than that in the control group (P &lt; 0.05). The pregnancy outcome of the observation group was better than that of the control group (P &lt; 0.05). Conclusion: Case management of gestational diabetes can not only control the blood glucose of pregnant women, but also improve pregnancy outcomes.

The prevalence of uncontrolled diabetes mellitus in patients with type 2 diabetes: a multicenter cross-sectional study.

The prevalence of diabetes is increasing worldwide. Studies have shown that poor blood sugar control is associated with the complications of diabetes, we aimed to determine the prevalence of uncontrolled diabetes mellitus (UDM) and its related factors. This multicenter cross-sectional study was conducted in 2021 on type 2 diabetic patients in three cities; Rasht (in Gillan province), Borujerd (in Lorestan province), and Khodabandeh (in Zanjan province). A predesigned checklist was used to extract the basic characteristics of participants, their hemoglobin A1C, and other required data from their medical records. The prevalence of uncontrolled diabetes was reported with a 95% Confidence Interval. In this study, the medical records of 460 patients with type 2 diabetes were included. The mean and standard deviation (SD) of the age of participants was 59.17 (11.59), and 73.2% (337) of participants were female. The prevalence of UDM in Rasht, Borujerd, and Khodabandeh was 58.27%, 69.38%, and 45.65% respectively. The prevalence of UDM in obese patients was 64.78% (57.03, 71.82). Based on the results of the adjusted model, an increase in diastolic blood pressure was significantly associated with UDM, meaning each unit increase in diastolic blood pressure was associated with a 3% increase in UDM (95% CI: 1.01, 1.06), adjusted for age, gender and education. According to these results, the prevalence of UDM among patients with diabetes is high. Diastolic blood pressure and low level of education were associated with UDM in diabetic patients.

Atypical Ischemic Cranial Nerve Palsy in a Diabetic Patient

Purpose: We report an atypical case of ischemic oculomotor palsy occurring sequentially in both eyes and then improving, followed by a new abducens palsy in a diabetic patient with poor blood sugar control.Case summary: A 51-year-old woman presented with diplopia, dizziness, and pain in the right eye and was diagnosed with oculomotor palsy in the right eye. Magnetic resonance imaging of her brain was normal but glycated hemoglobin concentration was 13.4%. After 2 months, the third nerve palsy in the right eye had recovered completely but a new third nerve palsy occurred in the left eye. 1 month later, the symptoms had improved, and the patient did not return to our clinic until 18 months later, when she returned with new diplopia. This time, she was diagnosed with a sixth nerve palsy in the left eye and was observed while controlling her blood sugar. She recovered after 4 months.Conclusions: Generally, cranial nerve palsies occur unilaterally in situations that can cause ischemia, such as diabetes, high blood pressure, and hyperlipidemia. Rarely, they occur bilaterally, or two or more cranial nerve palsies occur simultaneously. However, it is very rare that cranial nerve palsy occurs sequentially in both eyes under the same systemic blood sugar control. Diabetic patients with poor blood sugar control require long-term monitoring, considering the possibility of symptoms developing in both eyes with a time lag or other forms of ischemic cranial nerve palsy.

Recurrent diabetic foot ulcer: An educational image and expert opinion

Background: The occurrence of diabetic foot ulcers is commonly attributed to factors including infection, diabetic neuropathy that are commonly associated poor control of blood sugar. History of foot ulcer is generally considered an important risk factor. Keywords: Richard Asher syndrome, Iraq. Patients and methods: The case of a diabetic and hypertensive male patient who had a history of previous foot ulcer, and developed a recurrence at the same site is described with emphasis on the current evidence-based therapeutic recommendations. Results: A 55-year diabetic hypertensive male who had a history of foot ulcer which healed completely after aggressive treatment before more than one year. The first ulcer was associated with clear evidence of infection with cellulitis and pus formation, but there was no evidence of gangrene. The first ulcer was treated successfully with antibiotic therapy followed by monthly intramuscular injection of benzathine penicillin. Topical treatment included topical antibiotic (fusidic acid) and topical dexpanthenol. Pentoxifylline was used instead valsartan to control hypertension and to improve peripheral vascular impairment. The patient also received alpha-lipoic acid supplementation. Few weeks before the occurrence of the second ulcer, the patient visited the practitioner of the organization who was working with, and for unclear reason, the doctor switched pentoxifylline with Coveram (Perindopril 10 mg + Amlodipine 10 mg). The ulcer was not associated with evidence of serious infection, and cellulitis like the first ulcer. However, the patient received oral antibiotics and topical therapies. To avoid injudicious frequent changes of antihypertensive medication, oral pentoxifylline was added in a dose of 400 mg daily. The second ulcer healed within one week. Conclusion: The medical treatment of the diabetic foot ulcer follows the principles of wound healing which include treatment of soft tissue infection, in addition to controlling factors more specifically related to diabetes such as neuropathy and peripheral vascular impairment. The current expert opinion suggests the use of monthly intramuscular benzathine penicillin, alpha-lipoic acid supplementation, and pentoxifylline in the long-term preventive therapies.

Dyslipidemia as a risk factor for acute myocardial infarction in postmenopausal women: An observational study

Abstract Objective: This study has evaluated risk factors, especially dyslipidemia, for an acute myocardial infarction (AMI) in postmenopausal women. Materials and Methods: This was a hospital-based, observational, single-center study among 100 postmenopausal women admitted to the medicine ward with AMI. They were categorized based on lipid profile groups, viz., dyslipidemic group and non-dyslipidemic group. All clinical parameters were studied between the groups. Results: Among anthropometric profiles, in the comparison of mean height (cm), weight (kg), body mass index (BMI) (kg/m2), and waist circumference (WC) (cm) for the dyslipidemic group and non-dyslipidemic group, only WC was statistically significant (P &lt; 0.001). Most patients were hospitalized between 6 and 12 h after the onset of symptoms. At the time of hospitalization, most patients from both groups were observed to have diabetes and hypertension with poor control of postprandial blood sugar, glycated hemoglobin, and diastolic blood pressure (DBP) (P &lt; 0.05). The dyslipidemic group’s mean C-reactive protein was higher (P &lt; 0.05). The comparison of mean total cholesterol, triglyceride (TG), low density lipoprotein-cholesterol in mg/dL, and TG: high density lipoprotein was significantly increased (P &lt; 0.001), while high density lipoprotein-cholesterol (mg/dL) was significantly decreased (P &lt; 0.001) in the dyslipidemic group. ST-segment elevation myocardial infarction is standard in both groups. The maximum patient has regional wall motion abnormality in echocardiography after day 3 of admission. Among the dyslipidemic group, ejection fraction was on the lower side, and the predominant complication was in the left ventricular failure (LVF) (P &lt; 0.05). Conclusion: WC has a positive association with patients with AMI who have dyslipidemia and can be used as an indicator of the risk of AMI when BMI is normal. WC is a surrogate marker of abdominal fat mass (subcutaneous and intra-abdominal); increased WC is a significant component marker of metabolic syndrome and insulin resistance related to cardiovascular mortality. There was poor glycemic control and blood pressure (mainly DBP) among the dyslipidemic patients. Hypertriglyceridemia is the most common lipid abnormality, followed by hypercholesterolemia among the dyslipidemic group. LVF is the most common complication in dyslipidemic patients.

Risk Factors and Surgical Outcomes of Diabetic Foot in Diabetic Patients at King Fahad University Hospital.

Diabetes mellitus affects a large number of the population worldwide. One of the most important complications is diabetic foot ulcers, which are debilitating to the patient and the health care system. To assess the risk factors leading to diabetic foot complications and the surgical outcome of management of patients affected by diabetic foot at King Fahd University Hospital. This is a retrospective case series study conducted at King Fahd University Hospital. The study included 52 patients who were admitted from the period 2007 to 2017 with cases of diabetic foot ulcers. The study includes a review of medical charts for diabetic foot patients including demographics, diabetic profile, associated comorbidities, clinical signs, laboratory investigations and surgical outcome. Our study shows thatdiabetic foot patients had comorbidities like hypertension at 69.2% and hyperlipidemia at 55.8%. Regarding the association between comorbidities and surgical outcomes, we did not find any significance. Furthermore, we found that patients with gangrene were more likely to undergo amputation. Patients who underwent amputation had hemoglobin A1c (HbA1c) of 10.3 ± 2.4% and random blood sugar (RBS) of 259 ±107 mg/dl, indicating poor diabetic control. Diabetic foot is the result of poor blood sugar control. Surgical intervention plays an important role in the management of diabetic foot. Depending on the presentation, patients may undergo surgical debridement, revascularization, or amputation. We found that patients who developed gangrene were more likely to undergo amputation.

Matching Body Composition Confirms Decreased Phase Angle among Diabetics Compared to Controls

Background: Diabetes Mellitus refers to a group of common metabolic disorders that depicts hyperglycemia. As per WHO, the number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age rose from 4.7% in 1980 to 8.5% in 2014. Simple screening can help detect diabetes early and save lives. Many studies have found decreased phase angle among diabetics than controls but since age and BMI can be the confounders, there are few studies to match these parameters to draw the right conclusions. The objective of study was to do a matched comparison of the body composition (Body Fat%, Lean Body Mass and Total Body Water, Intracellular and Extracellular Water %) and biochemical investigations of Diabetics and Non-Diabetic Controls. Methods: The study population was taken from Indira G and hi Medical College, Shimla, which is one of the Tertiary care centers of Himachal Pradesh located in North India. All patients undergoing Body Composition measurements were diagnosed as diabetics on the basis of ADA (American Diabetic Association) diagnostic criteria. 60 diabetic patients fulfilling the inclusion criteria and 60 healthy age and sex-matched controls were enrolled in this study. Results: Matched analysis was done and it was found that the Phase angle among diabetics was lower (5.6° + 0.9°) than controls (6.3° + 1.1°) and was statistically significant, p-value &lt;0.005. A comparison of biochemical investigations shows that there was a statistically significant difference between diabetics and controls with respect to FBS, HbA1C, Cholesterol, VLDL and HDL. Conclusion: Diabetics and controls were age, Sex and BMI matched with moderate physical activity. Waist Circumference (WC) was higher in diabetics indicating central obesity. The diabetics were found to be hypertensive with poor blood sugar control and dyslipidemia. The Phase Angle was decreased in diabetics than in controls, showing the prognosis of the disease.

DIABETES AND PERIODONTAL DISEASES -THE IMPORTANCE OF ATTITUDES AND CARE PRACTICES FOR ADULT PATIENTS WITH DIABETES : A REVIEW

Each year around 1.7 million new instances of diabetes are diagnosed with 8.1 million people living with diabetes unaware of their condition. People with uncontrolled diabetes are more likely to develop a variety of oral health concerns including, periodontal diseases (gum diseases). Every person today has more bacteria in their mouth than there are humans on earth. Periodontal disease will develop if they build their homes in our gums. This inflammatory chronic condition can even destroy our teeth in place. Periodontal disease is most frequent dental disease among diabetes. Poor blood sugar control raises the risk of gum disease , especially as you get older .Poor blood sugar controls person with diabetes mellitus at a high risk for gum disease, can raise blood sugar levels. Diabetes becomes more difficult to manage as a result of diabetes .Because people with diabetes are more prone to these problems that might impair their dental health ,it is critical to practice excellent oral hygiene ,and pay a close attention to any changes in your oral health. Through this suggestions will be suggested for preventing and reducing oral health.

Diabetes Mellitus and Depression: A Literature Review

Diabetes Mellitus is a long-term condition characterized by excessive glucose or blood sugar levels. Diabetes mellitus (DM) type 2 patients are at a greater risk of developing depression. Diabetes mellitus causes vascular damage, particularly brain vascularity, which is linked to depression symptoms. Other than that, depression in diabetic patients is linked to poor blood sugar control, the family's lack of motivation to be concerned about diabetic complications The situation will create a vicious spiral that will exacerbate diabetes and sadness.