Background: Diabetes mellitus (DM) is a disease characterized by hyperglycemia due to (a) insulin-insufficiency (type I DM), or (b) impaired glucose cell-entry (insulin resistance) due to the downregulation of insulin...Background: Diabetes mellitus (DM) is a disease characterized by hyperglycemia due to (a) insulin-insufficiency (type I DM), or (b) impaired glucose cell-entry (insulin resistance) due to the downregulation of insulin cell receptors (type II DM). Type I DM usually presents with florid manifestations contrary to a slowly-progressive type II. Patients and methods: Over the past 10 years, we encountered 9 obese patients with controlled insulin-requiring type II DM for years, at a dose of 62 ± 5 units/day, who developed sudden and severe insulin resistance (IR) that required 210 ± 25 units daily. All patients had very high levels of anti-Glutamic Acid Decarboxylase (GAD) antibodies. Despite a lack of previous testing for anti-GAD antibodies, they were treated, with Cyclosporin A (Cy), as an autoimmune disorder superimposed on their type II MD. Initially all patients were treated with 100 mg, of Cy, twice daily aiming at an initial trough level of 100 - 150 ng/ml. Three months later, the dose was reduced to 50 mg twice daily for a total of 2 years. Results: Amelioration of IR was achieved by 1 month with a reduction of daily insulin requirement to 123 ± 16 units that further decreased to 76 ± 11 by the end of the 3rd month. Such improvement persisted for 2 years and >1 year after Cy discontinuation. Moreover, a decline in insulin requirements was associated with a parallel decrease in anti-GAD antibody levels and an increase in C-peptide insulin without kidney disease. Conclusion: Anti-GAD antibodies can induce acute IR in type II DM, and this phenomenon can be treated safely and effectively with Cy.展开更多
Objectives: Coronary artery bypass grafting (CABG) is the preferred revascularisation option for diabetics with multivessel coronary artery disease, in current guideline recommendations. Not infrequently, coronary art...Objectives: Coronary artery bypass grafting (CABG) is the preferred revascularisation option for diabetics with multivessel coronary artery disease, in current guideline recommendations. Not infrequently, coronary artery disease causes minimal symptoms in diabetic patients, so they present late for surgery and this could have implications for clinical outcomes. We sought to examine differences in symptom severity between diabetics and non-diabetics at presentation for CABG, and the impact on in-hospital outcomes. Methods: We retrieved prospectively collected data for all patients who had CABG between January 2000 and December 2022. Perioperative variables were compared between diabetic and non-diabetics. The association between in-hospital major adverse cardiac and cerebrovascular events (MACCE) and perioperative variables was determined using multivariate analysis. Results: Of 10,834 patients, diabetics constituted 24.8% (n = 2687) with mean age 66.4 ± 8.7 years compared to non-diabetics 65.9 ± 9.4, p = 0.02. More diabetics (p Conclusions: Diabetics more often presented for non-elective CABG with advanced symptoms, impaired left ventricular function, prior myocardial infarction and coronary stenting. Advanced symptoms contributed to higher MACCE rates in diabetics. Diabetic patients should be referred early for surgery.展开更多
Objectives:The objective of this study is to assess the handgrip strength(HGS)in patients with type 2 diabetes,compare it with nondiabetes age-matched individuals,and assess the correlation between diabetic status and...Objectives:The objective of this study is to assess the handgrip strength(HGS)in patients with type 2 diabetes,compare it with nondiabetes age-matched individuals,and assess the correlation between diabetic status and HGS among diabetic patients.Materials and Methods:A community-based cross-sectional study was conducted in rural Mysore,India,for 4 months.Fifty-eight clinically diagnosed type 2 diabetics and 58 nondiabetics participated in the study.The handheld dynamometer was used to test the HGS of all subjects in their dominant hand.Independent t-test was used to analyze the differences in HGS between patients with and without diabetes.Results:The mean dynamometer reading among diabetics was 19.08±7.51,whereas that in nondiabetics was 27.474±13.11.There was a significant difference in HGSs between diabetics and nondiabetics(P<0.01).Conclusion:Decreased muscle strength and quality in the upper extremities are associated with type 2 diabetes and can lead to functional and physical limitations.Diabetic patients’HGS should be evaluated promptly to identify any disabilities and plan for appropriate therapy.展开更多
Introduction: Type 1 diabetes can have acute complications, sometimes requiring hospitalization. The aim of this study was to describe the epidemiological, clinical and evolutionary aspects of type 1 diabetes in patie...Introduction: Type 1 diabetes can have acute complications, sometimes requiring hospitalization. The aim of this study was to describe the epidemiological, clinical and evolutionary aspects of type 1 diabetes in patients at the Abass Ndao National Hospital in Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from January 01, 2010 to December 31, 2021. It focused on hospitalized type 1 diabetic patients. Epidemiological, clinical and evolutionary data were evaluated. Results: Six hundred and fifty-nine (659) patients were enrolled, representing a frequency of 11.5%. The mean age was 29.47 years, giving a sex ratio (m/f) of 0.95. Average hospital stay was 6.1 days. One hundred and forty-four (144) patients (21.8%) had inaugural diabetes. The average consultation time was 14.89 days. Acute metabolic complications were ketoacidosis in 353 patients (56%), and hypoglycemia in 1.2%. Simple hyperglycemia was noted in 113 patients (18.0%). Infection was present in 522 patients (58.3%), of whom 95 (28.2%) had a skin infection.55 patients (16.3%) had a respiratory infection. 12.3% had a dietary imbalance.176 cases (27.7%) had no imbalance.26 patients (3.9%) died, with infectious pathologies accounting for the majority of decompensation factors among the deceased (57.7%). Conclusion: Type 1 diabetes is a cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.展开更多
Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify th...Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify the different medicinal plants used by diabetic patients at the CNHU-HKM. Method: we carried out a descriptive and analytical cross-sectional study. It took place at the University Clinic of Endocrinology, Metabolism and Nutrition of CNHU-HKM over a of 3 months period from 20<sup>th</sup> of June to 16<sup>th</sup> of September, 2022, over diabetic followed-up. Results: One hundred and seventy-three (173) patients were gathered using an anonymous inquiry form. In the study population, the age of the patients varied between 31 and 75 years with an average age of 59 +/− 1.43 years, women represented 59% with a sex ratio (male/female) of 0.69. Sixty-five (65) or 37.6% of the population had used medicinal plants. Among given reasons for using medicinal plants were, mainly the positiveness on a third party. Data analysis outcome twenty-nine species of plants belonging to twenty (20) botanical families, the most represented being the Annonaceae and Fabaceae. The most used species are Phyllanthus amarus (hlenwé in fon), Mangifera indica (mangatin in fon), Momordica charantia (gninsikin in fon), Combretum micranthum (kinkéliba in fon), and Picralima nitida (ayorkpè in fon). Most used parts of the plants are the leaves. The recipes are prepared mainly by infusion and are administered exclusively by mouth. Most of the patients who used the hypoglycaemic medicinal plants were satisfied and no adverse effects were reported by them. Conclusion: Hypoglycaemic medicinal plants could be subjected to pharmacognosy and marketed due to their richness in active components, after further toxicological studies.展开更多
Aim: Sub-Saharan Africa is undergoing an epidemiological transition responsible for a change in the metabolic profile in favour of insulin resistance. The aim of this study was to assess the dynamics of the prevalence...Aim: Sub-Saharan Africa is undergoing an epidemiological transition responsible for a change in the metabolic profile in favour of insulin resistance. The aim of this study was to assess the dynamics of the prevalence of insulin resistance and associated risk factors in diabetic patients in the Democratic Republic of Congo between 2005 and 2023. Method: We measured fasting blood glucose and insulin levels and looked for metabolic syndrome parameters (2009 criteria) in type 2 diabetes patients in 2005-2008 (n = 176) and in 2018-2023 (n = 303). The HOMA model was used to measure insulin sensitivity and islet β-cell secretory function. Results: Between 2005 and 2013, the trend was towards an increase in the prevalence of insulin resistance (from 13.1% to 50.8%;p Conclusion: This present study shows an increase in insulin resistance in Congolese urban areas and a persistence of atypical diabetes mellitus in Congolese rural areas, confirming the particularity of the pathophysiology of the disease in African areas currently influenced by the epidemiological transition. Further studies using an appropriate methodology are required.展开更多
Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive a...Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.展开更多
Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descripti...Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.展开更多
In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic indiv...In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.展开更多
Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determin...Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.展开更多
Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles,...Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles, and evaluate their therapeutic strategies and outcomes. Methodology: A descriptive, analytical, comparative study with prospective and retrospective data collection was conducted from April 1, 2020, to March 31, 2021. Diabetic and non-diabetic patients with STEMI admitted to a cardiology department were included. STEMI diagnosis was based on clinical and electrocardiographic criteria showing persistent ST-segment elevation in at least two leads. All patients included in the study signed a written, informed consent form. Data analysis was performed using SPSS, with a p-value ≤ 0.05 considered statistically significant. Results: STEMI prevalence was 15.27%, with 37.11% of patients being diabetic and 62.89% non-diabetic. Diabetic patients had a mean age of 59.2 ± 10.9 years, while non-diabetics averaged 58 ± 13.4 years. Diabetics were predominantly female (72.2%), whereas non-diabetics were mainly male (83.6%). Smoking was less frequent among diabetics (25% vs. 47.54%), but hypertension, obesity, and sedentary lifestyle were more common. Diabetics had an average of 3.5 ± 1.1 risk factors compared to 2.6 ± 1.2 in non-diabetics. Admission delay was longer for diabetics (34.8 ± 51.6 hours vs. 23.3 ± 52.3 hours). Chest pain was the main symptom in both groups. Electrocardiograms showed that anterior and inferior infarctions were most frequent. Triple vessel disease and severe complications, such as cardiogenic shock, were more common in diabetics, who also had higher mortality (5.56% vs. 3.28%). Conclusion: Diabetic STEMI patients represent a high-risk group with distinct clinical features, longer admission delays, and a greater accumulation of cardiovascular risk factors, emphasizing the need for targeted interventions.展开更多
Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by ot...Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.展开更多
Background: Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S...Background: Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S. aureus pneumonia in DM is limited, we sought to make a relatively comprehensive exploration of clinical characteristics, antimicrobial resistance, and risk factors for mortality of S. aureus pneumonia in DM and non-diabetics mellitus (non-DM). Methods: A retrospective study was conducted in Ruijin Hospital from 2014 to 2017. The characteristics of DM and non-DM patients were assessed, including demographics, comorbidities, using of invasive mechanical ventilation, Hemoglobin A1c (HbA1C), confusion, urea, respiratory rate, blood pressure, age ≥65 years (CURB-65) score, length of hospital stay, clinical outcomes, antimicrobial susceptibility. Independent risk factors for mortality were identified by univariate and multivariate logistic regression analysis. Results: A total of 365 patients with S. aureus pneumonia were included in our study, including 144 with DM and 221 non-DM. DM patients were more susceptible to MRSA infection (65.3% vs. 56.1%, P > 0.05), suffered from much severer pneumonia with a higher CURB-65 score, invasive mechanical ventilation rate (46.5% vs. 28.1%, P < 0.01) and mortality rates (30.6% vs. 23.1%, P > 0.05);almost all DM patients had higher antimicrobial resistance than non-DM patients, the DM group had a higher coinfection rate (47.2% vs. 45.7%, P > 0.05), and Acinetobacter baumannii was the most common bacterium in DM, while Klebsiella pneumoniae ranked first in patients with non-DM. Independent risk factors for pneumonia-related mortality were MRSA and CURB-65. Higher HbA1c levels were linked to a higher MRSA infection and co-infection rate and more severe pneumonia, leading to an increase in mortality. Conclusions: DM patients with poor glucose control are more susceptible to MRSA infection. They suffer from higher antimicrobial resistance, a higher co-infection rate, and much severer pneumonia than non-DM. MRSA itself is an independent risk factor for mortality in all patients.展开更多
NARCOTREND index （NI） is based on studies ofnormal human brain electrical data. It uses anordinary electrode to collect and analysis brainelectrical signals immediately at any positionof the head, to display the sta...NARCOTREND index （NI） is based on studies ofnormal human brain electrical data. It uses anordinary electrode to collect and analysis brainelectrical signals immediately at any positionof the head, to display the state of consciousness and depthof anesthesia of patients on the touch screen afterautomatic analysis and classification, so as to guide doseadjustment of anesthetics. NI may make the consciousnessand depth of anesthesia monitoring safe, simple, accurate,and economic. It is important that NI is more accurate thanclassical electroencephalographic variables.^1 Weber et al2believed that the NI was an objective and true index in theevaluation of propofol sedation in children.展开更多
Diabetics is one of the world’s most common diseases which are caused by continued high levels of blood sugar.The risk of diabetics can be lowered if the diabetic is found at the early stage.In recent days,several ma...Diabetics is one of the world’s most common diseases which are caused by continued high levels of blood sugar.The risk of diabetics can be lowered if the diabetic is found at the early stage.In recent days,several machine learning models were developed to predict the diabetic presence at an early stage.In this paper,we propose an embedded-based machine learning model that combines the split-vote method and instance duplication to leverage an imbalanced dataset called PIMA Indian to increase the prediction of diabetics.The proposed method uses both the concept of over-sampling and under-sampling along with model weighting to increase the performance of classification.Different measures such as Accuracy,Precision,Recall,and F1-Score are used to evaluate the model.The results we obtained using K-Nearest Neighbor(kNN),Naïve Bayes(NB),Support Vector Machines(SVM),Random Forest(RF),Logistic Regression(LR),and Decision Trees(DT)were 89.32%,91.44%,95.78%,89.3%,81.76%,and 80.38%respectively.The SVM model is more efficient than other models which are 21.38%more than exiting machine learning-based works.展开更多
Diabetes is one of the four major non-communicable diseases,and appointed by the world health organization as the seventh leading cause of death worldwide.The scientists have turned over every rock in the corners of m...Diabetes is one of the four major non-communicable diseases,and appointed by the world health organization as the seventh leading cause of death worldwide.The scientists have turned over every rock in the corners of medical sciences in order to come up with better understanding and hence more effective treatments of diabetes.The continuous research on the subject has elucidated the role of immune disorders and inflammation as definitive factors in the trajectory of diabetes,assuring that blood glucose adjustments would result in a relief in the systemic stress leading to minimizing inflammation.On a parallel basis,microbial infections usually take advantage of immunity disorders and propagate creating a pro-inflammatory environment,all of which can be reversed by antimicrobial treatment.Standing at the crossroads between diabetes,immunity and infection,we aim in this review at projecting the interplay between immunity and diabetes,shedding the light on the overlapping playgrounds for the activity of some antimicrobial and anti-diabetic agents.Furthermore,we focused on the antidiabetic drugs that can confer antimicrobial or anti-virulence activities.展开更多
Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective stud...Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%);creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.展开更多
GUO Sai-shan was born on October 24, 1938, in Putian Fujian Province, 1960 graduated in Shanghai First Medical College （now Shanghai Medical University）. At present, she is the Professor of Peking Union Medical Coll...GUO Sai-shan was born on October 24, 1938, in Putian Fujian Province, 1960 graduated in Shanghai First Medical College （now Shanghai Medical University）. At present, she is the Professor of Peking Union Medical College. Chief Doctor,Post-doctorate Tutor, in 1991 to 2002 she was appointed as Director of Department of Traditional Chinese Medicine （TOM）;展开更多
Zinc plays a critical role in a variety of cell functions and elicits the fact that both its deficiency and excess may demonstrate deleterious situation. It has been proposed that zinc is required for multiple steps i...Zinc plays a critical role in a variety of cell functions and elicits the fact that both its deficiency and excess may demonstrate deleterious situation. It has been proposed that zinc is required for multiple steps in insulin synthesis and release. This study investigated the relationship of zinc and glucose in diabetics. Using serum samples of diabetic patients whose glucose concentrations were above the threshold (10.0 mmol/l), spectroscopic methods were used to determine the concentration of glucose and zinc. Results obtained showed a negative correlation between level of glucose and zinc. Data were analyzed using student’s t-test with the aid of Graph Pad Prism (R) version 6.01 with a p value of <0.05 considered statistically significant. We concluded that reduced concentration of zinc observed in the study could be an uncommon factor to hyperglycemia and impose risk factor to diabetics. Its evaluation along with glucose levels is highly recommended in management of diabetic patients.展开更多
Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objecti...Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objective: To compare the outcome of amiodarone prophylaxis in diabetics and non-diabetics. Design: Subgroup analysis within a randomized, controlled, double-blinded trial. Results: Development of atrial fibrillation was equally frequent among diabetics (18.2%) and non-diabetics (20.5%) (p = 1.00). Atrial fibrillation occurred in 7.1% of prophylactic diabetics and in 9.3% of prophylactic non-diabetics, while 37.5% non-prophylactic diabetics and 31.3% non-prophylactic non-diabetics experienced atrial fibrillation (p = 0.31). Prophylactic amiodarone was equally effective in diabetics as in non-diabetics with a relative risk of 3.5 (1.8 - 67.0) and the number need to treat of 4.4 (3.3 - 8.3) (p = 0.31). The length of in-hospital stay for diabetics was equal to non-diabetics with an average stay of 7.1 versus 8 days at Aarhus University Hospital (p = 0.61) with similar stays at intermediary and intensive care unit as well as total in-hospital stay of 8.9 versus 10 days (p = 0.60). Conclusions: Diabetics have the same risk of atrial fibrillation and the same benefits from prophylactic amiodarone as non-diabetics after surgery for lung cancer. Furthermore, diabetics have the same length of stay as non-diabetics. No severe adverse effects were found in either group.展开更多
文摘Background: Diabetes mellitus (DM) is a disease characterized by hyperglycemia due to (a) insulin-insufficiency (type I DM), or (b) impaired glucose cell-entry (insulin resistance) due to the downregulation of insulin cell receptors (type II DM). Type I DM usually presents with florid manifestations contrary to a slowly-progressive type II. Patients and methods: Over the past 10 years, we encountered 9 obese patients with controlled insulin-requiring type II DM for years, at a dose of 62 ± 5 units/day, who developed sudden and severe insulin resistance (IR) that required 210 ± 25 units daily. All patients had very high levels of anti-Glutamic Acid Decarboxylase (GAD) antibodies. Despite a lack of previous testing for anti-GAD antibodies, they were treated, with Cyclosporin A (Cy), as an autoimmune disorder superimposed on their type II MD. Initially all patients were treated with 100 mg, of Cy, twice daily aiming at an initial trough level of 100 - 150 ng/ml. Three months later, the dose was reduced to 50 mg twice daily for a total of 2 years. Results: Amelioration of IR was achieved by 1 month with a reduction of daily insulin requirement to 123 ± 16 units that further decreased to 76 ± 11 by the end of the 3rd month. Such improvement persisted for 2 years and >1 year after Cy discontinuation. Moreover, a decline in insulin requirements was associated with a parallel decrease in anti-GAD antibody levels and an increase in C-peptide insulin without kidney disease. Conclusion: Anti-GAD antibodies can induce acute IR in type II DM, and this phenomenon can be treated safely and effectively with Cy.
文摘Objectives: Coronary artery bypass grafting (CABG) is the preferred revascularisation option for diabetics with multivessel coronary artery disease, in current guideline recommendations. Not infrequently, coronary artery disease causes minimal symptoms in diabetic patients, so they present late for surgery and this could have implications for clinical outcomes. We sought to examine differences in symptom severity between diabetics and non-diabetics at presentation for CABG, and the impact on in-hospital outcomes. Methods: We retrieved prospectively collected data for all patients who had CABG between January 2000 and December 2022. Perioperative variables were compared between diabetic and non-diabetics. The association between in-hospital major adverse cardiac and cerebrovascular events (MACCE) and perioperative variables was determined using multivariate analysis. Results: Of 10,834 patients, diabetics constituted 24.8% (n = 2687) with mean age 66.4 ± 8.7 years compared to non-diabetics 65.9 ± 9.4, p = 0.02. More diabetics (p Conclusions: Diabetics more often presented for non-elective CABG with advanced symptoms, impaired left ventricular function, prior myocardial infarction and coronary stenting. Advanced symptoms contributed to higher MACCE rates in diabetics. Diabetic patients should be referred early for surgery.
文摘Objectives:The objective of this study is to assess the handgrip strength(HGS)in patients with type 2 diabetes,compare it with nondiabetes age-matched individuals,and assess the correlation between diabetic status and HGS among diabetic patients.Materials and Methods:A community-based cross-sectional study was conducted in rural Mysore,India,for 4 months.Fifty-eight clinically diagnosed type 2 diabetics and 58 nondiabetics participated in the study.The handheld dynamometer was used to test the HGS of all subjects in their dominant hand.Independent t-test was used to analyze the differences in HGS between patients with and without diabetes.Results:The mean dynamometer reading among diabetics was 19.08±7.51,whereas that in nondiabetics was 27.474±13.11.There was a significant difference in HGSs between diabetics and nondiabetics(P<0.01).Conclusion:Decreased muscle strength and quality in the upper extremities are associated with type 2 diabetes and can lead to functional and physical limitations.Diabetic patients’HGS should be evaluated promptly to identify any disabilities and plan for appropriate therapy.
文摘Introduction: Type 1 diabetes can have acute complications, sometimes requiring hospitalization. The aim of this study was to describe the epidemiological, clinical and evolutionary aspects of type 1 diabetes in patients at the Abass Ndao National Hospital in Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from January 01, 2010 to December 31, 2021. It focused on hospitalized type 1 diabetic patients. Epidemiological, clinical and evolutionary data were evaluated. Results: Six hundred and fifty-nine (659) patients were enrolled, representing a frequency of 11.5%. The mean age was 29.47 years, giving a sex ratio (m/f) of 0.95. Average hospital stay was 6.1 days. One hundred and forty-four (144) patients (21.8%) had inaugural diabetes. The average consultation time was 14.89 days. Acute metabolic complications were ketoacidosis in 353 patients (56%), and hypoglycemia in 1.2%. Simple hyperglycemia was noted in 113 patients (18.0%). Infection was present in 522 patients (58.3%), of whom 95 (28.2%) had a skin infection.55 patients (16.3%) had a respiratory infection. 12.3% had a dietary imbalance.176 cases (27.7%) had no imbalance.26 patients (3.9%) died, with infectious pathologies accounting for the majority of decompensation factors among the deceased (57.7%). Conclusion: Type 1 diabetes is a cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.
文摘Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify the different medicinal plants used by diabetic patients at the CNHU-HKM. Method: we carried out a descriptive and analytical cross-sectional study. It took place at the University Clinic of Endocrinology, Metabolism and Nutrition of CNHU-HKM over a of 3 months period from 20<sup>th</sup> of June to 16<sup>th</sup> of September, 2022, over diabetic followed-up. Results: One hundred and seventy-three (173) patients were gathered using an anonymous inquiry form. In the study population, the age of the patients varied between 31 and 75 years with an average age of 59 +/− 1.43 years, women represented 59% with a sex ratio (male/female) of 0.69. Sixty-five (65) or 37.6% of the population had used medicinal plants. Among given reasons for using medicinal plants were, mainly the positiveness on a third party. Data analysis outcome twenty-nine species of plants belonging to twenty (20) botanical families, the most represented being the Annonaceae and Fabaceae. The most used species are Phyllanthus amarus (hlenwé in fon), Mangifera indica (mangatin in fon), Momordica charantia (gninsikin in fon), Combretum micranthum (kinkéliba in fon), and Picralima nitida (ayorkpè in fon). Most used parts of the plants are the leaves. The recipes are prepared mainly by infusion and are administered exclusively by mouth. Most of the patients who used the hypoglycaemic medicinal plants were satisfied and no adverse effects were reported by them. Conclusion: Hypoglycaemic medicinal plants could be subjected to pharmacognosy and marketed due to their richness in active components, after further toxicological studies.
文摘Aim: Sub-Saharan Africa is undergoing an epidemiological transition responsible for a change in the metabolic profile in favour of insulin resistance. The aim of this study was to assess the dynamics of the prevalence of insulin resistance and associated risk factors in diabetic patients in the Democratic Republic of Congo between 2005 and 2023. Method: We measured fasting blood glucose and insulin levels and looked for metabolic syndrome parameters (2009 criteria) in type 2 diabetes patients in 2005-2008 (n = 176) and in 2018-2023 (n = 303). The HOMA model was used to measure insulin sensitivity and islet β-cell secretory function. Results: Between 2005 and 2013, the trend was towards an increase in the prevalence of insulin resistance (from 13.1% to 50.8%;p Conclusion: This present study shows an increase in insulin resistance in Congolese urban areas and a persistence of atypical diabetes mellitus in Congolese rural areas, confirming the particularity of the pathophysiology of the disease in African areas currently influenced by the epidemiological transition. Further studies using an appropriate methodology are required.
文摘Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.
文摘Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.
文摘In Africa, the prevalence of diabetes is escalating and remains a concern due to the numerous complications it causes. Vascular damage associated with diabetes leads to a prothrombotic state observed in diabetic individuals. Diabetes is a complex and multifactorial disease involving genetic components. With the aim of preventing complications and contributing to an efficient management of diabetes, we investigated genes likely to lead to a risk of thrombosis, in particular the C677T of MTHFR, G20210A of prothrombin, and R506Q of factor V Leiden in type 2 diabetics in Abidjan receiving ambulatory care. A descriptive cross-sectional study was carried out on consenting type 2 diabetic patients. Mutation detection was carried out using the PCR-RFLP method employing restriction enzymes. Hemostasis tests (fibrinogen, D-dimers, fibrin monomers, and von Willebrand factor) were performed using citrate tubes on the Stage? Star Max automated system. Plasminogen activator inhibitor was assayed by ELISA method, and biochemical parameters were determined using the COBAS C311. The study population consisted of 45 diabetic patients, 51.1% of whom presented vascular complications, mainly neuropathy. Disturbances in hemostasis parameters were observed, with 15.5% of patients showing an increase in fibrin monomers. Mutation analysis revealed an absence of factor V mutation (factor V Leiden) and of G20210A mutation of the prothrombin gene. However, 15.6% of subjects had a heterozygous C677T mutation of MTHFR, with 57% of them being anemic. The exploration of biological and genetic factors associated with thrombotic risk is of significant interest in the optimal management of African type 2 diabetics.
文摘Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.
文摘Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles, and evaluate their therapeutic strategies and outcomes. Methodology: A descriptive, analytical, comparative study with prospective and retrospective data collection was conducted from April 1, 2020, to March 31, 2021. Diabetic and non-diabetic patients with STEMI admitted to a cardiology department were included. STEMI diagnosis was based on clinical and electrocardiographic criteria showing persistent ST-segment elevation in at least two leads. All patients included in the study signed a written, informed consent form. Data analysis was performed using SPSS, with a p-value ≤ 0.05 considered statistically significant. Results: STEMI prevalence was 15.27%, with 37.11% of patients being diabetic and 62.89% non-diabetic. Diabetic patients had a mean age of 59.2 ± 10.9 years, while non-diabetics averaged 58 ± 13.4 years. Diabetics were predominantly female (72.2%), whereas non-diabetics were mainly male (83.6%). Smoking was less frequent among diabetics (25% vs. 47.54%), but hypertension, obesity, and sedentary lifestyle were more common. Diabetics had an average of 3.5 ± 1.1 risk factors compared to 2.6 ± 1.2 in non-diabetics. Admission delay was longer for diabetics (34.8 ± 51.6 hours vs. 23.3 ± 52.3 hours). Chest pain was the main symptom in both groups. Electrocardiograms showed that anterior and inferior infarctions were most frequent. Triple vessel disease and severe complications, such as cardiogenic shock, were more common in diabetics, who also had higher mortality (5.56% vs. 3.28%). Conclusion: Diabetic STEMI patients represent a high-risk group with distinct clinical features, longer admission delays, and a greater accumulation of cardiovascular risk factors, emphasizing the need for targeted interventions.
文摘Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.
基金the National Key R&D Program of China (No. 2017YFC1309701 and No. 2017YFC1309700)National Natural Science Foundation of China (No. 81570029)Shanghai Key Discipline for Respiratory Diseases (No. 2017ZZ02014).
文摘Background: Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S. aureus pneumonia in DM is limited, we sought to make a relatively comprehensive exploration of clinical characteristics, antimicrobial resistance, and risk factors for mortality of S. aureus pneumonia in DM and non-diabetics mellitus (non-DM). Methods: A retrospective study was conducted in Ruijin Hospital from 2014 to 2017. The characteristics of DM and non-DM patients were assessed, including demographics, comorbidities, using of invasive mechanical ventilation, Hemoglobin A1c (HbA1C), confusion, urea, respiratory rate, blood pressure, age ≥65 years (CURB-65) score, length of hospital stay, clinical outcomes, antimicrobial susceptibility. Independent risk factors for mortality were identified by univariate and multivariate logistic regression analysis. Results: A total of 365 patients with S. aureus pneumonia were included in our study, including 144 with DM and 221 non-DM. DM patients were more susceptible to MRSA infection (65.3% vs. 56.1%, P > 0.05), suffered from much severer pneumonia with a higher CURB-65 score, invasive mechanical ventilation rate (46.5% vs. 28.1%, P < 0.01) and mortality rates (30.6% vs. 23.1%, P > 0.05);almost all DM patients had higher antimicrobial resistance than non-DM patients, the DM group had a higher coinfection rate (47.2% vs. 45.7%, P > 0.05), and Acinetobacter baumannii was the most common bacterium in DM, while Klebsiella pneumoniae ranked first in patients with non-DM. Independent risk factors for pneumonia-related mortality were MRSA and CURB-65. Higher HbA1c levels were linked to a higher MRSA infection and co-infection rate and more severe pneumonia, leading to an increase in mortality. Conclusions: DM patients with poor glucose control are more susceptible to MRSA infection. They suffer from higher antimicrobial resistance, a higher co-infection rate, and much severer pneumonia than non-DM. MRSA itself is an independent risk factor for mortality in all patients.
文摘NARCOTREND index （NI） is based on studies ofnormal human brain electrical data. It uses anordinary electrode to collect and analysis brainelectrical signals immediately at any positionof the head, to display the state of consciousness and depthof anesthesia of patients on the touch screen afterautomatic analysis and classification, so as to guide doseadjustment of anesthetics. NI may make the consciousnessand depth of anesthesia monitoring safe, simple, accurate,and economic. It is important that NI is more accurate thanclassical electroencephalographic variables.^1 Weber et al2believed that the NI was an objective and true index in theevaluation of propofol sedation in children.
文摘Diabetics is one of the world’s most common diseases which are caused by continued high levels of blood sugar.The risk of diabetics can be lowered if the diabetic is found at the early stage.In recent days,several machine learning models were developed to predict the diabetic presence at an early stage.In this paper,we propose an embedded-based machine learning model that combines the split-vote method and instance duplication to leverage an imbalanced dataset called PIMA Indian to increase the prediction of diabetics.The proposed method uses both the concept of over-sampling and under-sampling along with model weighting to increase the performance of classification.Different measures such as Accuracy,Precision,Recall,and F1-Score are used to evaluate the model.The results we obtained using K-Nearest Neighbor(kNN),Naïve Bayes(NB),Support Vector Machines(SVM),Random Forest(RF),Logistic Regression(LR),and Decision Trees(DT)were 89.32%,91.44%,95.78%,89.3%,81.76%,and 80.38%respectively.The SVM model is more efficient than other models which are 21.38%more than exiting machine learning-based works.
文摘Diabetes is one of the four major non-communicable diseases,and appointed by the world health organization as the seventh leading cause of death worldwide.The scientists have turned over every rock in the corners of medical sciences in order to come up with better understanding and hence more effective treatments of diabetes.The continuous research on the subject has elucidated the role of immune disorders and inflammation as definitive factors in the trajectory of diabetes,assuring that blood glucose adjustments would result in a relief in the systemic stress leading to minimizing inflammation.On a parallel basis,microbial infections usually take advantage of immunity disorders and propagate creating a pro-inflammatory environment,all of which can be reversed by antimicrobial treatment.Standing at the crossroads between diabetes,immunity and infection,we aim in this review at projecting the interplay between immunity and diabetes,shedding the light on the overlapping playgrounds for the activity of some antimicrobial and anti-diabetic agents.Furthermore,we focused on the antidiabetic drugs that can confer antimicrobial or anti-virulence activities.
文摘Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%);creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.
文摘GUO Sai-shan was born on October 24, 1938, in Putian Fujian Province, 1960 graduated in Shanghai First Medical College （now Shanghai Medical University）. At present, she is the Professor of Peking Union Medical College. Chief Doctor,Post-doctorate Tutor, in 1991 to 2002 she was appointed as Director of Department of Traditional Chinese Medicine （TOM）;
文摘Zinc plays a critical role in a variety of cell functions and elicits the fact that both its deficiency and excess may demonstrate deleterious situation. It has been proposed that zinc is required for multiple steps in insulin synthesis and release. This study investigated the relationship of zinc and glucose in diabetics. Using serum samples of diabetic patients whose glucose concentrations were above the threshold (10.0 mmol/l), spectroscopic methods were used to determine the concentration of glucose and zinc. Results obtained showed a negative correlation between level of glucose and zinc. Data were analyzed using student’s t-test with the aid of Graph Pad Prism (R) version 6.01 with a p value of <0.05 considered statistically significant. We concluded that reduced concentration of zinc observed in the study could be an uncommon factor to hyperglycemia and impose risk factor to diabetics. Its evaluation along with glucose levels is highly recommended in management of diabetic patients.
文摘Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objective: To compare the outcome of amiodarone prophylaxis in diabetics and non-diabetics. Design: Subgroup analysis within a randomized, controlled, double-blinded trial. Results: Development of atrial fibrillation was equally frequent among diabetics (18.2%) and non-diabetics (20.5%) (p = 1.00). Atrial fibrillation occurred in 7.1% of prophylactic diabetics and in 9.3% of prophylactic non-diabetics, while 37.5% non-prophylactic diabetics and 31.3% non-prophylactic non-diabetics experienced atrial fibrillation (p = 0.31). Prophylactic amiodarone was equally effective in diabetics as in non-diabetics with a relative risk of 3.5 (1.8 - 67.0) and the number need to treat of 4.4 (3.3 - 8.3) (p = 0.31). The length of in-hospital stay for diabetics was equal to non-diabetics with an average stay of 7.1 versus 8 days at Aarhus University Hospital (p = 0.61) with similar stays at intermediary and intensive care unit as well as total in-hospital stay of 8.9 versus 10 days (p = 0.60). Conclusions: Diabetics have the same risk of atrial fibrillation and the same benefits from prophylactic amiodarone as non-diabetics after surgery for lung cancer. Furthermore, diabetics have the same length of stay as non-diabetics. No severe adverse effects were found in either group.
