Body Mass Index as a Proxy Indicator for Poor Oral Hygiene Habits in Adult Diabetic Patients

AimTo analyse if body mass index (BMI) could be used as a fast proxy indicator of poor oral hygiene habits (POHH) among the adult population with diabetes mellitus.MethodsAdults, aged 25-74, from the Slovenian 2016 nationwide cross-sectional survey based on the Countrywide Integrated Non-Communicable Disease Intervention (CINDI) Health Monitor methodology, who reported being diabetic, were included in the study (n=560). We assessed the relationship between POHH and BMI, adjusted to confounders, using multiple binary logistic regression.ResultsIn the total sample, the POHH prevalence was 50.9%. Taking into account BMI, POHH prevalence in participants with normal BMI values was only 37.8%, in the overweight group it was 1.22-times higher (46.0%), while in the obese group it was 1.63-times higher (61.6%) (p<0.001). Also, the odds for POHH were 2.64-times higher in the obese group in comparison to the normal BMI group (95% CI: 1.55-4.51; p<0.001). After adjustment for confounders, this OR decreased only moderately (OR=2.45; 95% CI: 1.35-4.44; p=0.003).ConclusionsBMI could be used as a readily assessable, fast, simple, and cheap tool indicating higher odds for having POHH among the diabetic population. By defining the high-risk group it could be easier for physicians and dentists to take further referrals and actions for promoting oral health in this group. The suggested tool can save time and could have an important positive impact on the quality of life of diabetics, as well as on health expenditures.     

Osteodystrophy of diabetics in chronic dialysis: A histomorphometric study

Summary A decreased incidence of hyperparathyroidism in diabetic uremic patients has been reported, but comprehensive bone histomorphometric studies on uremic diabetic osteodistrophy are scarce. We present here the results of static and dynamic bone morphometry in 13 diabetic patients on dialysis (DCD) and their comparison with a pairmatched group of nondiabetic uremics with similar age, sex, and time on dialysis (NCDC), and with a group of 17 normals (N). Diabetic bone showed: (1) Low trabecular volume (Vt 9.9% in DCD and 22.8% in N), (2) Moderately increased remodeling values of intermediate intensity between N and NDCD values (Sf=19.3% in DCD, 37.4% in NDCD, and 8.8±6% in N, Sr=4.3% in DCD, 7.3% in NDCD and 2.04±0.9% in N), and (3) Moderate fibrosis (Sfib 1.2% in DCD, 12.9% in NDCD). Besides these confirmatory results, two suggestions emerged from the study: (1) The relative number of cells: osteoclast density (OI) and osteoblasts (Ob/OID) appears to be lower not only than NDCD values but also lower than N values (OI=0.04 c/mm. in DCD, 0.31 in NDCD, and 0.14 in N; Ob/OID=5.58% in DCD, 14.6 in NDCD and 22.12±9% m N). (2) Dynamic behavior in tetracycline based studies disclosed the appearance of two populations of DCD: a subgroup of preserved calcification dynamics with values not quite different than the NDCD group and a subgroup with a significant derangement of mineralization with no measurable bone trabecular dynamics. This late subgroup also showed significantly lower number of Ob/OID values compared with the former with preserved calcification. Both findings may agree with other reported experimental evidences on diabetes.     

Islet-cell antibodies and beta-cell function in insulin-dependent diabetics

Summary Residual insulin secretion and islet-cell antibodies were studied in 399 insulin-dependent diabetics with age at onset of between 10–19.9 years (248 patients) or 30–39.9 years (151 patients). We found the prevalence of islet-cell antibodies to be independent of residual beta-cell function as measured by serum C-peptide and age at onset. The cause and role of the persistence of islet-cell antibodies in insulin-dependent diabetics remain obscure.     

B-CELL RESPONSE TO EXERCISE IN DIABETIC AND NON-DIABETIC CHILDREN

Abstract. Heding, L. G. and Ludvigsson, J. (Novo Research Institute, DK-2880 Bagsvaerd, Denmark and the Department of Pediatrics, Linköping University, S-581 85 Linköping, Sweden). B-cell response to exercise in diabetic and non-diabetic children. Acta Pediatr Scand, Suppl. 283: 57, 1980.—20 non-diabetic and 11 insulin dependent diabetic (IDD) children underwent short time (20 min) bicycle ergometer exercise followed by a 10 min rest period. Glucose, IRI, C-peptide and proinsulin were determined prior to and at the end of the exercise, and again after 10 min rest. While no significant change in mean glucose was observed during exercise in the non-diabetics, significant decreases were observed in IRI, C-peptide and proinsulin. After 10 min rest glucose as well as the three B-cell secretory products increased significantly. The change in glucose was Significantly ( p <0.001) correlated to the change in IRI. In the resting period IRI rose more than C-peptide in some subjects. IRI even rose without simultaneous rise in C-peptide indicating a release of tissue bound IRI. The group of IDD children did not show any significant changes in glucose and total IRI, while the endogenous insulin, as measured by C-peptide, did show a fall during exercise. The same was found for proinsulin. The lack of increased endogenous secretion during the rest period was most likely due to suppression of B-cell due to hyperinsulinism and lack of increased glucose concentrations during the rest period.     

Vitrectomy Seems to be Beneficial for Advanced Diffuse Diabetic Macular Oedema not Responding to Laser Treatment

Background: To evaluate the surgical efficacy of vitrectomy, with optical coherence tomography, in patients with non-ischemic and ischemic diffuse diabetic macular oedema not responding to laser treatment. Methods: Ten eyes from nine patients (aged 46.0 ± 20 years, diabetes duration 12.4 ± 4 years) operated with vitrectomy for diabetic macular oedema not responding to laser treatment were evaluated before and 6 months postoperatively. Retinal thickness was assessed with optical coherence tomography, OCT, measuring the mean values of the centre of fovea and the second and third concentric rings from foveola. Four patients with type 1 diabetes had ischemic and five patients (6 eyes) with type 2 diabetes had non-ischemic diffuse macular oedema diagnosed on fluorescein angiography (FA). All eyes had an attached vitreous diagnosed on OCT. Results: Mean foveal thickness for the three concentric rings from centre and out was significantly less 6 months postoperatively 437 ± 125 vs. 286 ± 67 μm; p = 0.027, 426 ± 105 vs. 308 ± 35 μm; p = 0.019 and 404 ± 69 μm vs. 318 ± 29 μm; p = 0.011 respectively. The decrease in foveal thickness was similar for eyes with and without signs of ischemic maculopathy. There was a trend toward improved visual acuity (VA) 6 months after surgery 0.4; range 0.2–0.6 compared to 0.3; range 0.1–0.5 before vitrectomy; p = 0.107). Conclusion: Vitrectomy seems to be a beneficial treatment for both ischemic and non-ischemic advanced diffuse diabetic macular oedema not responding to laser treatment.     

疏肝理浊法干预早期糖尿病微观辨证要素研究

目的：从中医药理论探讨疏肝理浊法对改善湿热型早期糖尿病患者眼底微血管病变的疗效研究。 方法：选取56例体质辨证为湿热型的早期糖尿病患者,其中治疗组28例,对照组28例。治疗组口服疏肝理浊方（舒和胶囊）,对照组口服阿卡波糖片,均连续用3个疗程。观察两组治疗前后中医各项症候表现、视力、视野以及负荷后2h血糖（P2HBG）、糖化血红蛋白（HbA1c）。 结果：治疗组能显著改善患者各项症候体征（P〈0.01）、P2HBG和HbA1c,提高眼视力（P〈0.05）,降低视野平均缺损MD值（P〈0.01）。 结论：疏肝理浊法有改善湿热型早期糖尿病患者眼底微观病变的作用,可能与其通过改善全身症候有关。     

Limited joint mobility (LJM) in elderly subjects with type II diabetes mellitus

LJM is frequently observed in young subjects with insulin-dependent diabetes mellitus (IDDM). Aim of this study was to evaluate whether non-insulin-dependent diabetes mellitus (NIDDM) increases the risk of LJM in elderly subjects. Thirty patients (15 males, 15 females, mean age 73.93 ± 12.72 years) with NIDDM in good glycemic control were compared with thirty non-diabetic elderly, well matched for sex and age (15 males, 15 females, mean age 74.3 ± 4.24 years), and with ten young normal subjects (5 males, 5 females, mean age 26.3 ± 1.56 years). In these subjects, the range of motion (ROM) of ankle, knee, hip, elbow and shoulder were measured with a double-armed goniometer. Moreover, abnormalities of supraspinatus, patellar and Achilles tendons were evaluated with a standardized ultrasound (US) procedure. A significant reduction in the mobility of all joints was found in elderly subjects, compared to younger ones, with exception for the knee and elbow flexion. Elderly patients with diabetes, compared with their age-matched counterpart, showed LJM for ankle dorso- and plantar flexion, hip flexion and adduction, shoulder abduction and flexion. Moreover, tendons sonographic abnormalities were more frequently observed in diabetics. Our data confirm that diabetes worsens the LJM in the elderly, increasing the cross-linking of collagen by the non-enzymatic advanced glycation end products formation.     

2型糖尿病患者社区获得性肺炎的临床特征分析

目的通过对住院2型糖尿病患者和2型糖尿病合并肺部感染患者的观察,探讨2型糖尿病患者合并社区获得性肺炎的危险因素和病原菌特点。方法对58例2型糖尿病合并肺炎患者和74例单纯2型糖尿病患者的一般指标进行对比分析,并取痰进行细菌学培养。结果 2型糖尿病合并肺炎组血糖、白细胞计数、C反应蛋白、胆固醇、胰岛素抵抗指数均明显高于单纯2型糖尿病组,相反胰岛素分泌指数则明显低于单纯2型糖尿病组。白细胞计数、C反应蛋白、空腹血糖、糖化血红蛋白是2型糖尿病患者发生肺炎的危险因素,肺部感染病原菌主要以G-杆菌多见。结论 2型糖尿病患者血糖控制不佳容易并发肺部感染,在选择抗生素时,首选有效、敏感的抗生素是治疗的关键。     

安徽某县村级门诊糖尿病筛检结果分析与评价

目的:探讨在村级门诊中进行糖尿病筛查的可行性,加强糖尿病患者预防的积极性.方法:通过随机抽样和现场调查收集资料,对安徽省某县村级门诊的1248条有效血糖检测信息进行记录并做统计分析.结果:糖尿病患者112人(2型糖尿病),其中包括以往已确诊糖尿病患者25人,糖尿病总体患病率为9.0%;随着年龄增加,患病率升高(P<0.05);男性组糖尿病患病率高于女性组(P<0.05);肥胖人群组糖尿病发病率高于非肥胖组(P<0.05).结论:村级门诊开展糖尿病筛检有利于糖尿病早发现、早诊断、早治疗,有利于加强糖尿病患者自我保健积极性和减轻农村居民经济负担,可行性较高.