Serum and erythrocyte magnesium levels in type I and type II diabetics

Summary Serum and red blood cell magnesium (RBC-Mg) concentrations of 195 type I and III type II diabetic outpatients with different degree of control and 40 control subjects have been evaluated using atomic absorption spectrophotometry. In the total group, no significant difference in serum and RBC-Mg levels in type I and II diabetic outpatients could be found. However, poor control was often associated with lower serum magnesium levels. A negative correlation was found between serum magnesium levels and HbA₁. A particular group of male patients with severe macroangiopathy showed high RBC-Mg levels; this finding was probably due to atherosclerotic and hypertensive renal involvement.     

Insulin degludec – The impact of a new basal insulin on care in type 2 diabetes

Many patients with type 2 diabetes continue to have poor glycaemic control and would benefit from insulin therapy. However, resistance to the introduction of insulin therapy can be high on both the part of the healthcare provider and the patient. A number of new, long-acting basal insulins are in development that provide good metabolic control, but with a lower risk of hypoglycaemia than currently available insulins, and greater flexibility in dosing time from day to day. These attributes may address some of the current barriers to insulin initiation and intensification that currently limit the effectiveness of diabetes care.     

Assessment of Diabetes Education in the Teaching Hospital,Addis Ababa,Ethiopia

With the aim of assessing continuing diabetes education and obtaining baseline information, we have evaluated the knowledge of 139 randomly selected diabetic patients from the Diabetes Clinic of Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia. Seventy-five Type 1 (insulin-dependent) and 64 Type 2 (non-insulin-dependent) diabetic patients, with a mean age of 36 ± 14 (± SD) (range 15–78, median 36) years, and mean duration of known diabetes 6.3 ± 5.5 (range 1–30, median 5) years participated in the study. Knowledge was assessed by a questionnaire which examined three principal areas: general knowledge on diabetes mellitus, diet plus self care, and chronic complications. Twenty-eight (20.1 %), did not attend any and 59 (42.5 %) attended the diabetes education programme more than once. The Adjusted Percentage Score (APSCORE) was 69 ± 1.4 (SEM). Type 1 diabetic patients had a significantly higher score (p < 0.001) for overall knowledge when compared to Type 2 patients. In both groups the knowledge on chronic complications was very poor when compared to the other areas (p < 0.001). No sex difference in knowledge was seen. Higher school and diabetes education attendance had a significant influence on the knowledge of diabetes. However, better knowledge about diabetes was not associated with better glycaemic control as measured by the fasting blood glucose concentration. The wide difference in knowledge, the low rate of attendance at diabetes education sessions, and the very low awareness about chronic complications is very worrying. To achieve the intended aim the diabetes education programme needs to be revised.     

Diabetes as pro-infective risk factor in total HIP replacement

Summary It is widely accepted that diabetic patients, above all poorly controlled ones, are more susceptible to infection. To verify whether diabetes might be considered a pro-infective risk factor in total hip replacement, 1,042 patients, who from 1969 to 1979 underwent an operation for arthropros thesis of the hip, were studied. The patients were subdivided into two groups according to whether they were diabetic or not. The diabetic patients, though well controlled by diet or by diet plus oral hypoglycemic agents, received insulin for at least two days before surgery. In the early post-operative phase they showed transient worsening of glycemic control rapidly corrected by increased insulin dosage. The patients of both groups were operated in low air exchange operating theaters, by the same staff and using standardized surgical techniques, and all received antibiotic coverage as preventive treatment against infections for a week after surgery. Infection and suppuration occurred in 11% of diabetic patients and only in 2% of non-diabetic patients (p<0.001); in these cases the prostheses were removed after unsuccessful antimicrobial treatment. Our study indicates that diabetes mellitus must be considered a proinfective risk factor in patients who undergo an operation for total hip replacement and suggests that a conservative approach is required in diabetic patients. Presented in part at the 2nd International Symposium on Diabetology, Montecatini Terme, Italy, 24–25 October 1981, and at the International Congress of Orthopedics, Bologna, Italy, 3–5 May 1982.     

Diabetes self-management amid COVID-19 pandemic

Background and aimsCOVID-19 pandemic has challenged the physician-centered approach of diabetes care in India that is primarily based on routine clinic visits. We aim to review the various aspects of patient-centered care via diabetes self-management education based on available literature.MethodsThis is a narrative review using Pubmed, EMBASE and Google Scholar search till March 29, 2020. Search terms were “COVID-19”, “diabetes self-care”, “diabetes self-management education”, “DSME”, “diabetes self-management in India”, “diabetes self-care in India” and “DSME in India”.ResultsWe have discussed an educational plan on diabetes self-management that can be adopted for people with diabetes mellitus in our country amid the ongoing pandemic. We have also identified the barriers to diabetes self-management in the current scenario and suggested possible solutions to overcome those.ConclusionsWe have reemphasized the need for a simultaneous patient-centered approach in routine diabetes care that has to be coordinated by a multidisciplinary team amid the ongoing COVID-19 pandemic.     

District Diabetes Centres in the United Kingdom. A report on a workshop held by the Diabetes Education Study group on behalf of the British Diabetic Association

Dissatisfaction with standards of diabetes care in general, and the traditional diabetic clinic in particular, is widespread. Problems include the large numbers of attenders, short consultation times (often with inexperienced medical staff), lack of continuity and prolonged waiting times. Standards of education and control fall woefully below those that are desired. In recent years several different strategies have been adopted to provide solutions, including general practitioner cooperative care schemes to reduce numbers and improve community care, the appointment of diabetes specialist nurses to take on the major educational role, and the commissioning of special education units designed to remove the educational element from the traditional clinic environment. Lately consideration has been given to the development of Diabetes Centres, to provide more comprehensive diabetes care, both educational and clinical. A workshop was held in January 1987 to analyse in greater detail the concept of Diabetes Centres and the consequences of their implementation.     

Current status of glucose,blood pressure and lipid management in type 2 diabetes clinic attendees in Isfahan,Iran

Aims/Introduction

To estimate the prevalence of meeting American Diabetes Association clinical practice recommendations for hemoglobin A1c (HbA1c), blood pressure (BP) and low-density lipoprotein cholesterol (LDLC) among Iranian type 2 diabetes clinic attendees, and to identify the factors associated with therapeutic target achievement.

Materials and Methods

A total of 2,640 patients with type 2 diabetes (944 men and 1,696 women) from Isfahan Endocrine and Metabolism Research Center outpatient clinics, Iran, were examined. The main outcome measures were HbA1c, BP and LDLC, in accordance with the American Diabetes Association recommendations. The mean (standard deviation) age of participants was 49.6 years (9.3 years) with a mean (standard deviation) duration of diabetes of 5.0 years (4.9 years) at initial registration.

Results

The percentages of patients who had HbA1c <7%, BP <140/90 mmHg and LDLC <100 mg/dL was 37.4% (95% confidence interval [CI] 35.6–39.3), 35.3% (95% CI 33.5–37.3) and 48.9% (95% CI 47.0–50.8), respectively. The proportion of patients meeting all three goals was 7.7% (95% CI 6.7–8.8). Lower BP, cholesterol level and higher education at registration, and higher follow up but lower number of follow-up visits affected achievement of all three goals.

Conclusions

The present study highlights that a substantial proportion of Iranian type 2 diabetes clinic attendees did not meet the American Diabetes Association clinical practice recommendations, and shows the difficult challenges physicians face when treating patients with type 2 diabetes.     

How diabetes risk assessment tools are implemented in practice: A systematic review

This review aimed to explore the extent of the use of diabetes risk assessment tools and to determine influential variables associated with the implementation of these tools. CINAHL, Google Scholar, ISI Citation Indexes, PubMed, and Scopus were searched from inception to January 2013. Studies that reported the use of diabetes risk assessment tools to identify individuals at risk of diabetes were included. Of the 1719 articles identified, 24 were included. Follow-up of high risk individuals for diagnosis of diabetes was conducted in 5 studies. Barriers to the uptake of diabetes risk assessment tools by healthcare practitioners included (1) attitudes toward the tools; (2) impracticality of using the tools and (3) lack of reimbursement and regulatory support. Individuals were reluctant to undertake self-assessment of diabetes risk due to (1) lack of perceived severity of type 2 diabetes; (2) impracticality of the tools; and (3) concerns related to finding out the results. The current use of non-invasive diabetes risk assessment scores as screening tools appears to be limited. Practical follow up systems as well as strategies to address other barriers to the implementation of diabetes risk assessment tools are essential and need to be developed.     

高血糖与胆石症40例临床报告

目的 分析胆石症和糖尿病发病率之间的关系。讨论糖尿病合并无症状胆石症时是应该手术治疗以及糖尿病病人胆道手术的围手术期处理。方法 对４０例合并高血糖的胆石症病人进行回顾性分析。结果 外科胆石症 ６９３例,其中４０例合并高血糖。男性１４例,女性２６例,平均年龄６０．１岁。确认糖尿病１５例,可疑糖尿病１１例,应激性高血糖１４例。手术治疗３３例,胆囊切除１４例,胆囊切除、胆总管探查１６例,胆肠内引流２例,     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.     

The new treatment target of diabetes: islet β-cell mass

Pancreatic islet β-cell mass is regulated by β-cell replication, nengenesis, apnptosis and cell size. β-cetl mass in diahetic patients is conspicuously less than that in normal subjects. Induction of β-cell regeneration and inhibition of β-cell apoptosis is the new target of diabetes treatment.