1.Enhanced Recovery After Surgery (ERAS) outcomes in patients with prior diagnosis of diabetes.
Katrina Marie Festejo VILLAMIEL ; Christy YAO ; Marianna SIOSON
Journal of the ASEAN Federation of Endocrine Societies 2019;34(1):73-79
OBJECTIVE: To determine whether a prior diagnosis of diabetes mellitus (DM) is associated with longer postoperative length of stay (LOS) and higher complication rates among patients who underwent colorectal surgery under an Enhanced Recovery After Surgery (ERAS) protocol in a single hospital setting.
METHODOLOGY: In a cross-sectional study, we grouped 157 consecutive patients who underwent elective colorectal surgery under ERAS protocol according to preoperative DM status. Patient data was abstracted from the ERAS Interactive Audit Database from January 2016 to December 2017. We compared LOS between groups. Secondary outcomes were postoperative complications, reoperations, pneumonia and wound infection. Categorical and continuous variables were analyzed with Fisher's exact test and student's t-test, respectively, using Stata/SE version 13 with a significance level of p=0.05.
RESULTS: One hundred thirteen subjects did not have diabetes (no T2DM) while 44 patients had type 2 diabetes mellitus (T2DM). Mean postoperative length of hospital stay was 6.4±5.1 days for the no T2DM group versus 5.8±3.8 in the T2DM group (p=0.476). Complications, reoperation rate, pneumonia and wound infection did not differ between groups. Among subjects in the T2DM group, LOS did not differ between patients with preoperative HbA1c ?7.0% and those with HbA1c >7.0% (5.7±3.7 versus 6.1±4.2 days, p=0.748).
CONCLUSION: Among patients who underwent colorectal surgery under ERAS protocol, a prior diagnosis of diabetes was not associated with longer LOS or more complications. A preoperative HbA1c of <7% did not affect length of stay in ERAS among patients with T2DM.
Human ; Colorectal Surgery ; Diabetes Mellitus ; Length Of Stay
2.Comparison of maternal and neonatal outcomes among high-risk Filipino Women with Gestational Diabetes diagnosed before and after 24 weeks of Gestation
Journal of the ASEAN Federation of Endocrine Societies 2022;37(2):9-14
Objectives:
This study determined the prevalence, clinical characteristics and pregnancy outcomes of high-risk women diagnosed with gestational diabetes mellitus (GDM) before and after 24 weeks of gestation.
Methodology:
This retrospective study included all singleton deliveries with GDM at the Pasig City General Hospital from January 2018 to December 2019. Subjects were grouped into those who were diagnosed with GDM before 24 weeks of gestation (<24 weeks, n=61) and thereafter (≥24 weeks, n=219). Outcomes examined were preeclampsia, cesarean delivery, preterm birth, macrosomia, large-for-gestational age, small-for-gestational age, neonatal hypoglycemia, neonatal ICU admission, congenital malformations and perinatal mortality.
Results:
The group diagnosed with GDM before 24 weeks was significantly older (33.0 ± 5.7 years versus 29.4 ± 5.9 years, p<0.001), had higher 2-hour 75 g oral glucose tolerance test (OGTT) results (158.2 ± 20.0 mg/dL versus 150.0 ± 23.7 mg/dL, p=0.014), and had more pregnancies with preeclampsia (23.0% versus 9.6%, p=0.005).
Conclusion
High-risk women diagnosed with GDM before 24 weeks of gestation had a higher incidence of preeclampsia compared with high-risk women diagnosed with GDM after 24 weeks of gestation.
Prenatal Diagnosis
;
Pregnancy Outcome
3.Accuracy of blood glucose measurements using capillary and arterial line of extracorporeal circuit of hemodialysis among diabetic patients undergoing outpatient hemodialysis at The Medical City
Genevieve F. Sia ; Christy S. Yao
Philippine Journal of Internal Medicine 2017;55(4):1-5
Introduction:
Accurate and reliable glucose level
measurements are essential for ensuring safe and effective
glycemic control among diabetic patients undergoing
hemodialysis (HD). Capillary blood glucose (CBG) monitoring
is the standard of care of glycemic control assessment in
patients with diabetes on maintenance HD. In the Philippines,
glucose monitoring during HD involves either standard finger
stick (CBG) or blood sample from the arterial line (AL) of
extracorporeal circuit of HD machine. However, anecdotal
observations noted over the years have shown discrepancies
in the glucose values from the two sites. This study aimed to
determine the accuracy of blood glucose measurements
of capillary and AL of extracorporeal circuit of HD machine
using point-of-care (POC) glucose meter in comparison to
central laboratory venous plasma among diabetic patients
undergoing outpatient HD in a private tertiary hospital in
the Philippines. Determining the most accurate and reliable
method of glucose level measurement is vital in helping
patients attain glycemic control. To date, there is limited
published data regarding the accuracy of blood glucose
values obtained through CBG and AL of extracorporeal
circuit of HD machine while patients are undergoing dialysis.
Methods:
This is a prospective, cross-sectional, analytical
study involving thirty patients. Forty blood samples from
30 patients obtained through CBG, AL and the peripheral
venous plasma of the opposite arm were simultaneously
analyzed. Specifically, StatStrip was utilized as the POC glucose meter. Accuracy of AL of extracorporeal circuit
and CBG were determined and assessed in accordance
with International Organization for Standardization (ISO)
15197:2013 minimum accuracy criteria for glucose meters.
Regression analysis was used to determine whether AL and
CBG significantly predict peripheral venous blood glucose
levels.
Results:
Analysis showed that there is a statistically significant
difference in the glucose values obtained from AL and
CBG (p-values 0.005 and <0.0001) when compared to
venous plasma glucose. However, this may not pose clinical
significance in routine practice. It is noteworthy that both
AL (concordance rate (CR)=100%) and CBG (CR=96.5%)
satisfied the revised ISO 15197:2013 accuracy criteria for
glucose value greater than or equal to 100mg/dL.
Conclusion
Both CBG and AL blood glucose measurement
significantly predict venous plasma blood glucose level.
POC blood glucose value from both AL of extracorporeal
circuit during HD and CBG satisfied the accuracy criteria set
by ISO 15197: 2013 for glucose value greater than or equal
to 100mg/dL. Thus, confirming the glucose level by CBG
monitoring is not necessary in patients with arterial glucose
value of greater than or equal to 100 mg/dL during HD.
Vascular Access Devices
;
Renal Dialysis
4.The effects of GCSF on the recovery time and duration of hospitalization in patients with anti-thyroid drug-induced agranulocytosis in a tertiary hospital.
Maria Monina Clauna-Lumanta ; Christy Yao ; Johann Fabrian Bolinao
Journal of the ASEAN Federation of Endocrine Societies 2016;31(2):131-136
OBJECTIVES: This study aims to determine if there is a significant difference in the recovery time and duration of hospital stay of patients with anti-thyroid drug-(ATD) induced agranulocytosis with and without granulocyte colony-stimulating factor (GCSF) therapy. It also aims to describe the clinical characteristics of patients who had anti-thyroid drug-induced agranulocytosis.
METHODOLOGY: This is a retrospective study of hyperthyroid patients on anti-thyroid drugs (ATD) who had an absolute neutrophil count (ANC) of less than 500/?L. Their charts were reviewed for collection of data on age, gender, body mass index (BMI), type and duration of ATD and use of antibiotic and steroid. Recovery time and length of hospital stay were compared between those who received and did not receive GCSF.
RESULTS: With similar clinical features between the GCSF and non-GCSF groups, the recovery time from agranulocytosis and duration of hospitalization were significantly shorter in the GCSF group, despite lower ANC.
CONCLUSION: GCSF significantly decreased recovery time (4 versus 7 days, p=0.005) and duration of hospital stay (5 versus 7 days, p=0.009) of hyperthyroid patients with anti-thyroid drug-induced agranulocytosis compared to patients not given GCSF.
Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Granulocytes ; Neutrophils ; Neutropenia ; Hyperthyroidism ; Granulocyte Colony-stimulating Factor ; Anti-bacterial Agents ; Antithyroid Agents ; Agranulocytosis ; Methimazole ; Propylthiouracil
5.Low-density lipoprotein cholesterol target attainment in patients with stable or acute coronary heart disease in the Philippines: Results from the Dyslipidemia international study II
Rody G. Sy ; Maria Teresa B. Abola ; Baishali Ambegaonkar ; Roy Joseph M. Barcinas ; Philippe Brudi ; Martin Horack ; Dominik Lautsch ; Aurora G. Macaballug ; Eugenio B. Reyes ; Noel L. Rosas ; Domingo P. Solimen ; Ami Vyas ; Christy S. Yao ; Maria Delfa T. Zanoria ; Anselm K. Gitt
Acta Medica Philippina 2018;52(61):494-501
Objective:
To quantify the extent of hyperlipidemia and its treatment in patients with stable coronary heart disease (CHD) or an acute coronary syndrome (ACS) in the Philippines.
Methods:
The Dyslipidemia International Study (DYSIS) II was an observational, multinational study conducted in patients aged ≥18 years with stable CHD or being hospitalized with an ACS. A full lipid profile was evaluated at baseline, and for the ACS cohort, at 4 months after discharge from hospital. Achievement of low-density lipoprotein cholesterol (LDL-C) targets and the use of lipid-lowering therapy (LLT) were assessed.
Results:
A total of 232 patients were enrolled from 10 centers in the Philippines, 184 with stable CHD and 48 being hospitalized with an ACS. The mean LDL-C level for the CHD patients was 88.0±40.1 mg/dL, with 33.3% achieving the target of <70 mg/dL recommended for very high-risk patients. For the ACS cohort, the mean LDL-C level was 109.0±48.5 mg/dL, with target attainment of 25.0%. The majority of the CHD cohort was being treated with LLT (97.3%), while 55.3% of the ACS patients were receiving LLT prior to hospitalization, rising to 100.0% at follow-up. There was little use of non-statins.
Conclusions
For these very high-risk patients from the Philippines, LDL-C target attainment was poor. Opportunities for better monitoring and treatment of these subjects are being missed.
Cholesterol
;
Hydroxymethylglutaryl-CoA Reductase Inhibitors
;
Coronary Disease
;
Acute Coronary Syndrome
;
Myocardial Infarction