No abstract available.
Diabetes Complications

Achieving and maintaining good glycaemic control remains an important goal in the management of this common and prevalent disorder. Recent evidence from important megatrials, ACCORD, ADVANCE, VADT, UKPDS-10 year follow-up as well as the STENO-2 follow-up study, have cleared doubts concerning the benefits of targeting good glycaemic control. For the first time, we have the reassurance that macrovascular benefits can be realised from good glycaemic control. The legacy effect of prior good glucose control from the UKPDS-10 year follow-up, reinforces the results seen from the DCCT-EDIC (for Type 1 diabetes). The Intervention Phase of the UKPDS revealed benefits for reduction of microvascular complications, while it was only at the end of the Post-Trial Monitoring Phase where significant improvements in both micro and macrovascular outcomes were seen. The other three Trials assessing the effect of glycaemic control on cardiovascular outcomes, although largely negative for CV benefit, give valuable insight towards appropriate patient characteristics for which aggressive glucose control can and should be instituted. Individualising glycaemic targets, which has been the approach that many clinicians have been practising, has received new impetus albeit with clearer details. Getting to glycaemic goal early in the course of T2DM and Doing to Safely (Avoiding hypoglycaemia) are the key ingredients to successful management. The legacy of the memory of initial good metabolic/glycaemic control is investment in good health with benefits of reductions in both micro and more importantly, macrovascular disease, years later. Multifactorial interventions that include blood pressure, lipid lowering in addition to glucose control in these individuals with the Metabolic Syndrome result in more immediate beneficial additive effects on cardiovascular outcomes.
Diabetes Complications

Investigation of 72 patients with diabetics who were ≥ 16 years old, in 20 communes of Gia Lam, Soc Son and Dong Da districts, Ha Noi, from June to September 2001. Results: the common eye complications included retinopathy, cataract, uveites, and conjunctivitis. In diabetic’s subjects, three common ophthalmic diseases such as amblyopia, retinopathy and cataract in males were more distinct than in females. But ophthalmitis (uveites, conjunctivitis) in females were more than in males. The old age and the long duration of diabetics were the risk factor related to increase of retinopathies and amblyopia
Diabetes Mellitus ; Diabetes Complications

We report a case of a diabetic patient with an infected leg wound leading to septicemia and abscess formation in the contra-lateral leg due to Streptococcus canis. This organism belongs to the Lancefield group G and is more commonly found in dogs. It is often mistaken for Streptococcus dysgalactiae which is a human strain of streptococci. Infections in humans are not common and usually involve infected wounds or ulcers and the surrounding soft tissue. In most reported cases, patients had close contact with domestic dogs and a pre-existing wound as a portal of entry. Our patient recovered after surgical debridement and drainage of abscess together with antibiotics. This organism is sensitive to common antibiotics like penicillin, amoxycillin, cephalosporins and erythromycin. The incidence of infections due to Streptococcus canis may be under-reported as laboratories may just report an isolate as group G streptococcus. Susceptible patients with wounds or ulcers should be counselled on proper wound care and advised to avoid or minimise contact with the family dog.
Diabetes Complications ; Diabetes Mellitus

From June 2001 to September 2001, 72 patients with diabetes in 20 communes Gia Lam, Soc Son and Dong Da District were enrolled in the study. The common complications reported are loss of visual capacity <8/10 (76.39%), pathology of retina (59.72%), cataract (58.33%), choroiditis (5.56%), conjunctivitis (4.17%). Pathology of retina, cataract are most common in male than in female patients, but choroditis and conjunctivitis in female than in male. The older age, and later diagnosis the more rate of complication in retina and in visual capacity, the same
Diabetes Complications ; Eye ; complications

Study on 70 patients over 15 years old with both of type 1 and type 2 diabetics at Hue Central Hospital find out the indicende of female was higher than male, most common at 60-69 years of age. Eye injuries rate in diabetes patients: common injuries 65,8%, cataract 48,6%, retina 34,4 %, non-proliferative period 62,5%, post-proliferative period 25%, proliferative 12,5%. Diabetic disease effect mostly to vision: 11,4% blind, 55,7% reduce vision. When indicended the disease over 10 years, rate of retina disease was 100%. Cataract in type 2 diabetic patients correlate closely with the age of patients. 91,6% patients >= 70 years old had cataract
Eye ; Diabetes Complications ; Diabetes Insipidus ;

Autonomic neuropathy is a common complication of diabetes mellitus. Damage to the heart occurs as part of the wider spectrum of neuropathy. The aim of the study was to determine the percentage of cardiac autonomic neuropathy (CAN) in Hue, and the correlations between CAN with age and with diabetic duration. Subclinical cardiac autonomic neurophathy may be assessed by standardized Ewing’s tests. These tests are mainly based on mesurement of changes in heart rate during three vagal activated tests: deep-breathing, changing positions from sitting to standing, and using the valsalva maneuver. Fifty individuals with mellitus, aged 18-65 years, diabetic duration 3.25 +/- 3.75 years. Results: diabetic autonomic cardiac neuropathy was detected in 76% of the patients, mild degree: 22%; moderate degree 36%; severe degree 18%. The most affected tests are: the deep breathing 36%; the changing positions: 32%; the valsalva maneuver: 68%. NAC were not correlation with age, and with diabetic duration.
Diabetes Mellitus ; complications

Diabetes develop various complications that require surgical treatment. It is hard for the internist and surgeon to agree when surgery may be safely done in the severe diabetic. There is no actual need for normoglycemia nor for the over-enthusiasm in bringing glucose level to normal to the extent that other metabolic and biochemical defects are forgotten. (Author)
Human ; SURGERY ; DIABETES COMPLICATIONS

Background: Worldwide, diabetes mellitus (DM) is a serious health issue with a global prevalence of 9.8% in 2021. According to the latest 2018 Expanded National Health and Nutrition survey done by the DOST-FNRI, the prevalence of diabetes in the Philippines have more than doubled from 3.4% in 2003 to 7.9% in 2018. The latest research conducted regarding diabetes care in the Philippines was in 2008 which showed that 85% of patients with diabetes failed to achieve the HbA1c general target of <7%. Objectives: A population-based cross-sectional study to update the current status of diabetes care in the Philippines, specifically to determine glycemic control, trends in DM management, prevalence of complications and lastly their clinico-socio demographic profile. Methods: 340 patients with diabetes were included from the clinics of the Institute for Studies on Diabetes Foundation, Inc. physicians. The following data were collected: clinico-socio demographic profile, HbA1C-based glycemic control, trend in the use of glucose lowering agents, and prevalence of diabetes complications. Results: The mean age of the 340 patients with diabetes in this study was 62 years old. Almost sixty-seven percent (66.8%) were females. The mean body mass index was 26 kg/m2. The mean duration of diabetes was 12.63 years. Close to sixty- eight percent (67.6%) had tertiary education, 58.8% were unemployed and 65% had above minimum income. The most commonly used single oral agent was biguanide (72.9%), followed by dipeptidyl peptidase-4 inhibitors (64.3%). The most common dual therapy combinations were biguanide plus dipeptidyl peptidase-4 inhibitors (43.2%), biguanide plus sulfonylureas (27.2%), and biguanide plus sodium-glucose co-transporter-2 inhibitors (11.1%). Basal insulin was the most commonly used injectable agent. The present study showed that 47.4% of patients achieved an HbA1c of <7%. For the microvascular complication group alone, most had neuropathy (30.4%) followed by nephropathy (17.3%) and by retinopathy (5.4%). For the macrovascular complication group, the most common was coronary artery disease (82%) followed by peripheral artery disease and DM foot (27%). Overall, the most frequent DM complication identified was neuropathy (30.4%) , nephropathy (17.3%) and coronary heart disease (16.1%). Discussion Compared to the 2008 study, oral glucose lowering agents’ usage shifted from sulfonylureas to more use of dipeptidyl peptidase-4 inhibitors. There was a decline in the use of thiazolidinediones, α-glucosidase inhibitors and non-use of meglitinides. For insulin use, there was a shift from the use of premixed insulin to more basal insulin usage. There was marked improvement in the diabetes care situation in the Philippines from the 2008 study to the 2020 study. Glycemic control defined as HbA1c level of <7.0 increased from 15% to 47.4%. Coronary artery disease was the most common macrovascular complication while neuropathy was the most common overall and microvascular complication.
Diabetes Complications ; Glycemic Control

Introduction: We present a patient with long-standing uncontrolled type 2 diabetes mellitus (T2 DM) who developed sudden onset of choreiform movement, which rapidly resolved after insulin therapy and haloperidol. Case Description: A 53-year-old Filipino male, with T2DM and hypertension for more than 10 years, presented with sudden onset of hyperkinetic, involuntary, non-patterned, continuous movements of the left upper and lower extremities. Investigations revealed severe hyperglycemia without acidemia and ketonuria. Cranial computed tomography scan showed hyperdensity on the right caudate and lentiform nuclei. On cranial magnetic resonance imaging, there was T1- weighted hyperintense and T2 - weighted hypointense signal involving the right putamen, globus pallidus and caudate. Cranial magnetic resonance angiography showed stenosis on the cavernous segment of the right internal carotid artery (ICA), left ICA and middle cerebral artery (MCA) junction, the A1 segment of the left anterior communicating artery and proximal P2 segments of the bilateral posterior cerebral arteries. The patient was managed with a basal-bolus insulin regimen to control the blood glucose and haloperidol to manage the extrapyramidal symptoms. Consequently, there was complete resolution of the involuntary movements. Conclusion This case illustrates the importance of a systematic approach to movement disorders and early recognition of this rare diabetes complication known as chorea hyperglycemia basal ganglia syndrome or diabetic striatopathy.
Movement Disorders ; Diabetes Complications