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1.
Med Sci Monit ; 29: e939043, 2023 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-36860122

RESUMEN

BACKGROUND Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common and costliest long-term complications. The pain and function limitations may lead to depression. This study aimed to assess the influence of demographic and clinical factors on the prevalence of depression among diabetic patients with distal symmetric polyneuropathy (DSPN). MATERIAL AND METHODS A total of 140 patients with diabetic DSPN completed the 21-item Beck Depression Inventory (BDI) measuring characteristic attitudes and symptoms of depression. The intensity of neuropathic complaints was assessed using the Neuropathy Total Symptom Score- 6 items (NTSS-6). Testing for peripheral neuropathy was performed. All patients completed questionnaires, which included anthropometric measures, social parameters, and medical aspects. Statistical analyses were done using STATISTICA 8 PL software. RESULTS Statistically significant relationships were found between the depression symptoms in diabetic patients and the intensity of subjective neuropathy symptoms evaluated by NTSS-6, body mass index (BMI), and education level. On average, each 1-point increase in NTSS-6 predicted a 16% increase in the risk of depression. Each 1 kg/m² increase in the BMI was associated with a 10% increase of depression risk. CONCLUSIONS The study showed the positive quantitative relationship between diabetic DSPN and depression symptoms. The BMI, severity of neuropathy symptoms, and lower level of education had a statistically significant association with the level of depression and may be useful in evaluating the risk of depression among DSPN patients.


Asunto(s)
Diabetes Mellitus , Neuropatías Diabéticas , Polineuropatías , Humanos , Depresión , Dolor , Demografía
2.
Med Sci Monit ; 23: 4995-5004, 2017 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-29049270

RESUMEN

BACKGROUND The fast pace of life, promoting fast food consumption and low physical activity, has resulted in obesity and/or diabetes as being serious social problems. The aim of the present study was to evaluate concentrations of selected adipokines (leptin, adiponectin, resistin, and visfatin) and to assess the leptin/adiponectin ratio in plasma of type 2 diabetes (T2D) patients in relation to degree of obesity. MATERIAL AND METHODS The study comprised 92 T2D subjects divided into 4 groups according to BMI value - I (normal body weight), II (overweight), III (obesity), and IV (severe obesity) - and 20 healthy volunteers (control group). Each group was divided into male and female subgroups. Plasma concentrations of adipokines were determined by enzyme-linked immunosorbent assay. RESULTS In women, leptin concentration was significantly higher in group IV, whereas in men it was higher in groups III and IV than in the control group and groups I and II. Irrespective of sex, a significant decrease in adiponectin level was observed in group III vs. CONTROL: There was no significant difference in resistin levels. In women visfatin was markedly enhanced in group III, whereas in men in groups II, III and IV vs. CONTROL: Leptin/adiponectin ratio was increased in groups III and IV vs. control in women, whereas in men vs. both control and group I. CONCLUSIONS The obese type 2 diabetic patients presented a disturbed adipokine profile, which seems to be an important link between obesity and T2D. The future studies concerning the question if regulating of adipokines' concentrations could be a promising approach for managing metabolic disorders seem to be well-grounded.


Asunto(s)
Adipoquinas/análisis , Obesidad/complicaciones , Adipoquinas/sangre , Adiponectina/sangre , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Humanos , Leptina/sangre , Masculino , Persona de Mediana Edad , Nicotinamida Fosforribosiltransferasa/sangre , Sobrepeso , Resistina/sangre
3.
Artículo en Inglés | MEDLINE | ID: mdl-36612433

RESUMEN

BACKGROUND: Frequency Rhythmic Electrical Modulated System (FREMS) is a method of transcutaneous treatment based on frequency-modulated electromagnetic neural stimulation. Its efficacy in neuropathic pain in diabetes mellitus still lacks enough research. METHODS: A randomized, single-blind, sham-controlled trial in individuals with symmetric distal polyneuropathy (SDPN) as an add-on therapy compared to standard therapy with alpha-lipoic acid. Participants were randomized to FREMS and standard of care (SOC) versus SOC only. The primary outcome was a change from baseline in perceived pain assessed by visual analogue scale (VAS) after 5 days of treatment and after 8 weeks of follow-up between treatment groups. RESULTS: After 5 days of treatment, patients in both groups felt significant reduction in pain as measured by VAS, although only FREMS treatment lasted for 8 weeks and induced a significant improvement in quality of life measured by EuroQol 5-Dimension 5-Level (EQ-5D-5L) and Clinical Global Impression of Change (CGI-C) questionnaires. There were non-significant differences observed in the instrument pain assessment. No relevant side effects were recorded during the study. CONCLUSIONS: FREMS as an addition to alpha-lipoic acid therapy occurred to be a beneficial method of treatment in individuals with SDPN and was associated with improvements in pain severity, quality of life and clinical global improvement.


Asunto(s)
Diabetes Mellitus , Neuropatías Diabéticas , Neuralgia , Polineuropatías , Ácido Tióctico , Humanos , Ácido Tióctico/uso terapéutico , Calidad de Vida , Método Simple Ciego , Neuropatías Diabéticas/tratamiento farmacológico , Neuropatías Diabéticas/complicaciones , Polineuropatías/complicaciones
4.
Artículo en Inglés | MEDLINE | ID: mdl-34300043

RESUMEN

Diabetes is considered an epidemic of the 21st century. On 11 March 2020, two months after the outbreak of COVID-19 (coronavirus disease of 2019) epidemic in China, the World Health Organization announced COVID-19 to be a pandemic. From that time, many hospitals and wards have started to function as both infectious and non-infectious ones; so did the Diabetes Clinic Institute of Rural Health in South-Eastern Poland. Considering the global importance of diabetes and its prevalence worldwide, it seemed important to investigate how the Diabetes Clinic passed through the individual phases of the pandemic, and the possibility of protecting hospitalized patients against future pandemic infection. We present detailed characteristics of the situation in a ward which used to treat non-infectious patients with diabetes only and, nowadays, has been obliged to take into account the risk of spreading SARS-Cov-2 (severe acute respiratory syndrome coronavirus-2) infection also. Moreover, we suggest solutions to avoid cases of infectious diseases in non-infectious wards in the future.


Asunto(s)
COVID-19 , Diabetes Mellitus , Enfermedades no Transmisibles , China , Diabetes Mellitus/epidemiología , Diabetes Mellitus/prevención & control , Hospitales , Humanos , Pandemias/prevención & control , Polonia/epidemiología , Salud Rural , SARS-CoV-2
5.
Arch Med Sci ; 17(4): 900-904, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34336018

RESUMEN

INTRODUCTION: Autoimmune diseases concomitant with diabetes may complicate the treatment and adversely affect the prognosis. The most common is Hashimoto's disease (HD). We compared diabetes control and prevalence of chronic complications in type 1 diabetes patients differing in the coexistence of HD. MATERIAL AND METHODS: Medical records of 188 type 1 diabetics were analysed. Hashimoto's disease was diagnosed based on medical history, as well as determination of the levels of thyroid peroxidase antibodies, hormones and ultrasound examination. Statistical analysis was performed using Statistica 10PL. RESULTS: HD was diagnosed in 43 (23%) patients. The mean HbA1c was 8.8 ±1.5% in the group with HD, and 9 ±1.6% in the group without HD (ns). The prevalence of diabetes complications was similar in both groups: ischaemic heart disease was diagnosed in 19% of patients with HD and 19% without HD, cerebral vascular insufficiency - 8% and 7%, peripheral neuropathy - 14% and 12%, sensory polyneuropathy - 47% and 46%, diabetic foot - 7% and 8%, Charcot osteoarthropathy - 7% and 2%, cardiovascular neuropathy - 21% and 28%, neuropathy of the gastrointestinal tract - 5% and 6%, nephropathy - 12% and 19%, retinopathy - 42% and 43%, and cataract in 28% and 19%, respectively. Impaired hypoglycaemia perception was rarer in the group with HD: 9% vs. 25% (p ≈ 0.04). CONCLUSIONS: Hashimoto's disease does not significantly affect the level of type 1 diabetes control or the development of its complications. Only autonomic neuropathy in the form of impaired awareness of hypoglycaemia is rarer in patients with that thyroiditis.

6.
Ann Agric Environ Med ; 27(2): 255-259, 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32588602

RESUMEN

INTRODUCTION: Diabetes is a civilisation disease creating a serious challenge for public health. In Poland, approximately 2 million people suffer from diabetes, of which about 25% are unaware of their illness. A considerable part of persons with diabetes experience complications related with the disease. OBJECTIVE: The aim of the study was to determine the relationship between elements of the state of health and socio-demographic characteristics of diabetic patients treated in the Diabetes Clinic at the Institute of Rural Health (IMW) in Lublin, eastern Poland, and the occurrence of depressive symptoms in these patients. MATERIAL AND METHODS: The study was conducted in 2017-2018 among patients treated in the Diabetes Clinic at the Institute of Rural Health in Lublin, by the method of a diagnostic survey using the Beck's Depression Inventory and an author-constructed questionnaire, as well as data from the patients' medical records. The study included 314 patients from the Diabetes Clinic who expressed their informed consent to participate in the research. RESULTS: The study showed that diabetes is a disease which predisposes for the occurrence of depression. The occurrence of depressive symptoms of various degrees of intensity was confirmed in more than a half of the examined patients. Among the factors which exerted a significant effect on the occurrence of depressive symptoms were: diabetic neuropathy, type 2 diabetes, high BMI value, lack of occupational activity, poor material standard, and the need to obtain assistance in daily functioning due to the fact of being ill with diabetes. CONCLUSIONS: It is necessary to implement routinely performed examinations into the diagnostic-therapeutic process to assess the state of psychological health of diabetic patients, which would allow sufficiently early application of appropriate psychological or psychiatric intervention.


Asunto(s)
Depresión/epidemiología , Trastorno Depresivo/epidemiología , Complicaciones de la Diabetes/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Depresión/psicología , Trastorno Depresivo/psicología , Complicaciones de la Diabetes/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Adulto Joven
7.
Arch Med Sci ; 15(2): 330-336, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30899284

RESUMEN

INTRODUCTION: Many epidemiological studies show a correlation between the risk of cancer and type 2 diabetes mellitus in various populations. MATERIAL AND METHODS: The material was obtained from the database of the National Health Fund. This publication presents a comparison of the incidence of new malignancies in rural and urban populations of diabetic patients in Poland based on the database of the National Health Fund for the period between 1.05.2008 and 30.09.2014. RESULTS: Comparison of the mean incidence of selected malignancies in diabetic patients in the population analysed indicated significant differences between the incidence rate in the urban and rural populations (p < 0.001). The mean incidence of gastric cancer, colorectal cancer, kidney cancer, brain tumours and leukaemia in both sexes was significantly higher in rural areas compared to urban. The mean incidence of oesophageal cancer and pancreatic cancer in females was significantly higher among in the urban population compared to the rural areas (p < 0.001). No differences in the incidence rate of these neoplasms were observed in men (p > 0.05). CONCLUSIONS: The incidence of gastric cancer, colorectal cancer, laryngeal cancer, lung cancer, testicular cancer, kidney cancer, lung cancer, lymphocytic leukaemia and myeloid leukaemia is higher in diabetic males in rural areas than the incidence in the urban population. The incidence of the malignancies liver cancer, malignant skin melanoma, malignant skin, prostate cancer, urinary bladder cancer and multiple myeloma in male diabetic patients living in urban areas is higher than the incidence in rural areas.

8.
Arch Med Sci ; 15(3): 607-612, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31110525

RESUMEN

INTRODUCTION: There are reports that diabetes mellitus reduces the risk of aortic aneurysms and many reports that diabetes mellitus reduces the risk of abdominal aortic aneurysms. In earlier years there were also studies that did not demonstrate any effects of diabetes on the rate of aortic aneurysms. MATERIAL AND METHODS: For the year 2012, between 1 January and 31 December, reports for services regarding treatment for aortic aneurysms were found. At the same time, the reports for services associated with diabetes with the main diagnosis of "diabetes mellitus" were found in National Health Fund databases for 2012 with the special determinants. RESULTS: In Poland in 2012 the mean incidence of aortic aneurysms in both sexes in the group of subjects with diabetes calculated per 100,000 subjects with diabetes was 167.78 ±49.10, and the mean incidence of aortic aneurysms in both sexes in the group of subjects without diabetes calculated per 100,000 of the general population after subtracting the number of subjects with diabetes was 27.72 ±9.40. The incidence of aortic aneurysms among subjects with diabetes was significantly higher (p < 0.001) than the incidence of aortic aneurysms among subjects without diabetes. CONCLUSIONS: Aortic aneurysms were more frequently observed in the group of patients with diabetes than in those without diabetes. Aortic aneurysms were observed three times more frequently in men than in women. In Poland in 2012, 27.20% of patients diagnosed with aortic aneurysms also had diabetes.

9.
Artículo en Inglés | MEDLINE | ID: mdl-29295491

RESUMEN

A growing interest in the role of vitamin D in metabolic diseases led us to study the relationships between 25-hydroxyvitamin D3 (25(OH)D3) and the profiles of selected adipokines in type 2 diabetic (T2DM) patients. The study comprised 92 type 2 diabetics divided into quartiles regarding 25(OH)D3 concentration. Each group was divided into male and female subgroups. All the studied patients had their anthropometric and biochemical parameters determined. Plasma 25-hydroxyvitamin D3 concentration was determined by HPLC, while the selected adipokines (leptin, adiponectin, resistin and visfatin) by ELISA methods. The ratio of leptin to adiponectin (L/A) was calculated for all the patients. In 85.3% of diabetics a full (<20 ng/mL) or moderate (20-30 ng/mL) vitamin D deficit was found. Irrespective of sex, plasma leptin concentration decreased across increasing quartiles of 25(OH)D3 level. In women, 25(OH)D3 was negatively correlated with BMI, leptin level as well as L/A ratio, and positively with adiponectin concentration. In men, 25(OH)D3 was positively correlated with HDL and negatively with systolic blood pressure (SBP), leptin level and L/A ratio. Considering all the patients, there ocurred a significant negative correlation between 25(OH)D3 and SBP, BMI, WHR, TG, leptin and L/A ratio and positive ones between 25(OH)D3 and both adiponectin and HDL. The results of the study support the existence of the relationship among vitamin D, obesity and leptin in type 2 diabetic patients.


Asunto(s)
Adipoquinas/sangre , Calcifediol/sangre , Diabetes Mellitus Tipo 2/sangre , Obesidad/sangre , Adulto , Presión Sanguínea , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología
10.
Psychiatr Pol ; 50(2): 407-15, 2016.
Artículo en Inglés, Polaco | MEDLINE | ID: mdl-27288684

RESUMEN

Diabetes itself, by its nature, can aggravate the symptoms of depression. One of its main complications is peripheral diabetic neuropathy (PDN). Based on the literature the presence of the relationship between the PDN and depression is confirmed. The symptoms connected with instability while walking and reduction of everyday activities were the strongest predictors of the intensification of depression symptoms. The relationship between the neuropathic ulcers and depression is considered as ambiguous. Additional problems in diagnosis and evaluation is the polyetiologic character of the disease, damage to the nerve fibers of different thickness, variety of methods of the diagnosis and differences in the prevalence of diabetic neuropathy (26%-50%). The presence of the described differences may be connected with diagnostic methods and the fact of the modification of perceived symptoms such as pain by the depression itself. One of the results of difficulties in describing the relationships and diagnosis are problems, described in the literature, with the selection of patients requiring treatment of PDN.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/psicología , Neuropatías Diabéticas/epidemiología , Neuropatías Diabéticas/psicología , Adaptación Psicológica , Adulto , Anciano , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Autoinforme , Factores Sexuales
11.
Wiad Lek ; 55 Suppl 1: 305-12, 2002.
Artículo en Polaco | MEDLINE | ID: mdl-15002260

RESUMEN

UNLABELLED: The aim of the study was to investigate the effect of self-monitoring of blood glucose (SMBG) on metabolic control measured as glycated hemoglobin in patients with type 1 and type 2 diabetes treated in diabetic clinic of Institute of Agricultural Medicine in Lublin. The study was conducted from February to April 2002 and it involved 64 patients with diabetes, of whom 24.43% were patients with type 1 diabetes and 70.31% with type 2 diabetes. All patients were requested to complete a questionnaire investigating demographic data, diabetes history, self-monitoring of blood glucose practice. The glycated hemoglobin levels were obtained from medical history. Overall, 48.43% subjects tested their blood glucose levels at home > or = 1 time per day, 29.63% tested their blood glucose levels > or = 1 time per week and 7.81% tested their blood glucose levels < 1 time per week, whereas 14.06% patients never practiced SMBG. CONCLUSIONS: Younger people and those with more education are more likely to practice self-monitoring. The increase in frequency of self-monitoring of blood glucose in patients with type 1 diabetes was associated with better metabolic control. The ability to adjust insulin doses in patients with type 1 diabetes was associated with better metabolic control. No association was found between glycaemic control and the frequency of self-monitoring in patients with type 2 diabetes.


Asunto(s)
Automonitorización de la Glucosa Sanguínea/estadística & datos numéricos , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 2/sangre , Adulto , Anciano , Automonitorización de la Glucosa Sanguínea/métodos , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 2/psicología , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/normas , Garantía de la Calidad de Atención de Salud , Calidad de Vida , Estudios Retrospectivos , Factores Socioeconómicos , Encuestas y Cuestionarios , Factores de Tiempo
12.
Ann Agric Environ Med ; 20(2): 346-50, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23772589

RESUMEN

INTRODUCTION: Correctness of insulin treatment depends on both the experience and skills of the doctor and knowledge and behaviour of the patient. OBJECTIVE: Evaluation the adequacy of insulin doses administered to diabetes patients in ambulatory conditions. MATERIAL AND METHODS: The treatment of 59 patients hospitalized in the Diabetology Ward was evaluated at admission, discharge and 3 months after hospitalization. RESULTS: The mean daily doses of insulin significantly differed at times of evaluation and were: 53.90, 39.31 and 43.34 units, respectively (p≈0.000001). A significant reduction of body weight, 90.86 vs. 88.25 kg (p≈0.000001), was obtained only during hospitalization, and was maintained 3 months after discharge (87.86 kg). Significant differences were also noted in the body mass index (33.44 vs. 32.48 vs. 32.37 kg/m(2), p≈0.000001). The change in waist circumference was not statistically significant (107.87 vs. 104.89 cm; p≈0.06). A decrease in the number of hypoglycaemia episodes was observed, but were statistically insignificant (25 vs. 23; p≈0.7). Three months after hospitalization an insignificant decrease of HbA1c level was noted (8.41% vs. 8.03%; p≈0.07). CONCLUSIONS: During treatment in the Diabetology Ward the procedure of choice was more frequently a reduction than an increase in insulin doses. This management led to the reduction of the patients' body weight, improvement of glycaemia, without any significant effect on the diabetes control determined by the HbA1c level.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Hiperglucemia/terapia , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Adulto , Anciano , Atención Ambulatoria , Glucemia/metabolismo , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Hiperglucemia/complicaciones , Hiperglucemia/epidemiología , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Estudios Prospectivos , Factores de Tiempo , Pérdida de Peso , Adulto Joven
13.
Ann Agric Environ Med ; 19(4): 798-801, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23311810

RESUMEN

UNLABELLED: Relationships between abdominal obesity and glucose tolerance disorders have been well documented. There are also many reports concerning body weight gain during insulin therapy. On the other hand, there are reports pertaining to the effectiveness of surgical treatment of obesity and related type 2 diabetes. The case is presented of a 39-year-old woman with morbid obesity (maximum weight - 141 kg, BMI - 48.8 kg/m(2)), who reported to the outpatient department for metabolic diseases in December 2009. The patient had suffered from diabetes for 8 years and was treated with insulin - a dose of 114 IU from the day of the first visit. The patient received education concerning the modification of lifestyle, diet and insulin therapy. A balanced diet of 1,200 kcal daily was recommended. The daily insulin dose was reduced to 56 units. The patient was considered as a potential candidate for bariatric surgery. During the preparation for this procedure she was hospitalized in the Diabetology Ward, where the doses of insulin were further reduced and then discontinued. In March 2010, gastric sleeve resection was performed. Within 18 months, the patient's body weight was reduced by 66 kg and normalization of glycaemia was obtained, despite the total discontinuation of anti-diabetic drugs. In addition, the remission of psoriatic changes was observed. CONCLUSIONS: In patients with type 2 diabetes and severe obesity, in whom a satisfactory metabolic control cannot be achieved with standard hypoglycaemic therapy, further intensification of insulin treatment does not have to be the method of choice, although it may lead to the normalization of glycaemia. In some patients there is the possibility of total remission of glucose intolerance due to bariatric surgery, irrespective of the previous method of treatment.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Obesidad Mórbida/terapia , Pérdida de Peso , Adulto , Cirugía Bariátrica , Glucemia/metabolismo , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/etiología , Femenino , Gastrectomía , Humanos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Obesidad Mórbida/complicaciones , Polonia , Resultado del Tratamiento
14.
Ann Agric Environ Med ; 19(4): 742-5, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23311800

RESUMEN

UNLABELLED: The aim of the study was to assess the association between glycemic control understanding as a glycated haemoglobin level and indices of diabetic neuropathy. METHODS: We evaluated 204 patients with diabetes (type 1 - 29; type 2 - 175). Glycated haemoglobin was determined using The Diabetes Control and Complications Trial/ National Glycohemoglobin Standardization Program method. Evaluation of complaints from the lower extremities was based on the Neuropathy Syndrome Total Score questionnaire. We used a mono lament for evaluation of touch sensation (Semmes-Weinstein 5.07-10 g), a 128 Hz calibrated tune-fork for the vibration perception test, Tip-Therm to assess temperature sensation. RESULTS: The mean glycated haemoglobin level was assessed on 8.53±1.87%. The mean Neuropathy Syndrome Total Score: 11.45±6.37. Decreased sensation of touch on both sides was determined in 30% of cases, decreased sensation of temperature in 59% and decreased sensation of vibration in 30%. For Neuropathy Syndrome Total Score and glycated haemoglobin the Pearson's correlation test was 0.00910 (p≈0.99), Spearman's rank correlation test was 0.00523 (p≈0.95). Persons with sensation deficits and neuropathy symptoms had not significantly higher (Neuropathy Syndrome Total Score, temperature sensation disturbances) and not significantly lower (vibration and touch) glycated haemoglobin level compared to patients without neuropathy. CONCLUSION: There is no correlation between prevalence and advancement of sensorial neuropathy and current diabetes control in patients with long-term established diabetes.


Asunto(s)
Diabetes Mellitus Tipo 1/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Pie Diabético/fisiopatología , Hemoglobina Glucada/metabolismo , Adulto , Anciano , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Pie Diabético/epidemiología , Pie Diabético/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducción Nerviosa , Polonia/epidemiología , Valor Predictivo de las Pruebas , Prevalencia , Umbral Sensorial , Sensación Térmica , Tacto , Vibración
15.
Ann Agric Environ Med ; 19(3): 563-6, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23020057

RESUMEN

INTRODUCTION AND OBJECTIVE: Diabetic patients are at high risk for peripheral arterial disease (PAD) characterized by symptoms of intermittent claudication or critical limb ischemia. Measurement of ankle-brachial index (ABI) has emerged as the diagnostic tool of choice, because it is relatively simple, non-invasive and inexpensive. It is also an independent marker of increased morbidity and mortality from cardiovascular diseases. The aim of the presented study was to assess the relationship between current glycemic control defined by glycated hemoglobin (HbA(1c)) level, and quantitative changes in the arteries of the lower limbs in patients with type 2 diabetes. MATERIALS AND METHODS: 175 patients with type 2 diabetes hospitalized in the Diabetology Ward were studied. VENO Doppler and a sphygmomanometer were used to assess blood flow. RESULTS: The average level of HbA(1c) was assessed at 8.48%. Although the average level of ABI indicator was 1.20 (normal), only 45% of evaluated patients had their individual index within the normal range. Signs of ischemia were found in 17.7% of examined subjects. There was no conclusive correlation between ABI and HbA(1c) levels. CONCLUSIONS: The current level of glycemic control evaluated as HbA(1c) has no direct impact on the advancement of diabetic angiopathy evaluated as ABI.


Asunto(s)
Aterosclerosis/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Angiopatías Diabéticas/complicaciones , Hemoglobina Glucada/análisis , Hiperglucemia/complicaciones , Pierna/irrigación sanguínea , Anciano , Índice Tobillo Braquial , Aterosclerosis/sangre , Diabetes Mellitus Tipo 2/sangre , Angiopatías Diabéticas/sangre , Femenino , Humanos , Hiperglucemia/sangre , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Prevalencia
16.
Ann Agric Environ Med ; 18(2): 314-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22216805

RESUMEN

Diabetes mellitus is considered to be civilization disease development of which is influenced by environmental changes. Diabetic foot (ulceration, infection, gangrene) is one of the most disabling complication of diabetes mellitus. It contributes to the increased mortality and cardiovascular death. It also frequently leads to depression, social exclusion and physical impairment. Risk factors of diabetic foot are as follows: age, race, sex, duration of diabetes, biomechanical factors, level of glycemia, smoking habits. According to international standards diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care as compared to ordinary medical team or single specialist. Multidisciplinary team consists of: diabetologist, shoemaker, orthopedist, psychologist, surgeons both vascular and general, podologists, radiologists, educators, nurses and rehabilitation team. Such coordinated attitude to a patient may be the future solution for any civilization and environment-related disease requiring treatment which cannot be successfully provided by any ordinary medical team.


Asunto(s)
Pie Diabético/diagnóstico , Pie Diabético/etiología , Pie/irrigación sanguínea , Isquemia/sangre , Amputación Quirúrgica , Pie Diabético/epidemiología , Pie Diabético/terapia , Pie/patología , Pie/cirugía , Humanos , Isquemia/patología , Isquemia/fisiopatología , Grupo de Atención al Paciente , Factores de Riesgo , Factores Socioeconómicos
17.
Ann Agric Environ Med ; 18(2): 318-22, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22216806

RESUMEN

The article presents a review of current medical and psychological literature published between 2000 - 2010, with the use of the PubMed database, concerning the occurrence of anxiety and depression in diabetic patients, with particular consideration of those affected by complications. Anxiety and fear are the most frequent emotional disorders among diabetic patients. Depression occurs in approximately 30% of patients with diabetes. Both diabetes and depression belong to so called 'life style' or 'civilization diseases'. Numerous studies have confirmed that the course of depression in patients with diabetes is more severe, and the relapses of depression episodes are more frequent. The studies show that diabetic patients experience various types of psychosocial and emotional problems due to which the monitoring of own state of health is not the priority in life. In the process of treatment of both sole diabetes and concomitant anxiety and depression it is important to adjust and motivate patients to apply widely understood therapeutic recommendations. The treatment of depression syndrome in the course of diabetes does not have to lead to improvement in glycaemic control. The following factors influencing the therapeutic eff ect should be mentioned: duration of diabetes, presence of complications, and the eff ect of the drugs applied on body weight, or possibly initial diabetes management. It seems, therefore, that the patient education model based on the provision of knowledge concerning diabetes and its complications, methods of treatment, principles of nutrition and health-promoting life style, may be insufficient, at least for patients with depression. The results of a review of reports shows that an optimum treatment of diabetes, in accordance with the current state of knowledge, requires from physicians a special consideration of psychological and psychiatric knowledge for the 2 following reasons: 1) effectiveness of therapy to a high degree depends on the proper behaviour of a patient; 2) considerably more frequent, compared to the total population, occurrence of the symptoms of emotional disorders negatively affect the course of diabetes.


Asunto(s)
Ansiedad/complicaciones , Depresión/complicaciones , Trastorno Depresivo/complicaciones , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Ansiedad/terapia , Depresión/terapia , Trastorno Depresivo/terapia , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Miedo , Femenino , Humanos , Masculino
18.
Artículo en Inglés | MEDLINE | ID: mdl-16146003

RESUMEN

The aim of the study was to investigate the frequency of self-monitoring of blood glucose in patients with type 2 diabetes and to determine its effect on metabolic control measured as glycosylated hemoglobin level. The study involved 218 patients with type 2 diabetes (68.8% of females and 31.19% of males) who reported to the Outpatient Department for Diabetes at the Institute of Agricultural Medicine in Lublin. All patients were asked to complete a questionnaire form containing questions concerning, among other things, demographic data, course of diabetes, method of treatment, ability to adjust insulin doses and frequency of self-monitoring of blood glucose level. The levels of glycosylated emoglobin were obtained based on medical records. The analysis of the data showed that 59.22% of patients tested their blood glucose levels at home > or = 1/day, 21.36% of them tested their blood glucose > or = 1/week, whereas 8.74% of patients tested glucose < or = 1/week. 10.68% of patients stated that they never racticed SMBG. Statistical differences were observed in the level of education. Among the group of patients who exercised self-monitoring the most dominant were those with secondary school or university level of education (60.66%), while among patients who did not maintain self-monitoring the greatest number had only elementary or vocational education (72.73) (p = 0.01). The greatest number of patients who most often maintained self-monitoring were office workers (52.46%), whereas among those who did not exercise self-monitoring, those employed in agriculture dominated (45.45%) (p < 0.01). Urban inhabitants exercised self-monitoring more frequently than urban inhabitants (p < 0.01). The frequency of self-monitoring did not affect glycemia control. Urban inhabitants with secondary school or university education level and those who perform office work are more keen on frequent home monitoring of glycemia. In patients with type 2 diabetes the intensity of self-monitoring does not exert any effect on diabetes control evaluated by means of glycosylated hemoglobin level.


Asunto(s)
Automonitorización de la Glucosa Sanguínea/estadística & datos numéricos , Diabetes Mellitus Tipo 2/sangre , Hemoglobina Glucada/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Quimioterapia Combinada , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Factores Socioeconómicos , Estadísticas no Paramétricas
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