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Background & Objective: Despite evidence of an increase in the incidence of diabetes in youth, there are few characteristic data in diabetic patients in the Islamic Republic of Iran. The present study sought to investigate the Characteristic data of childhood diabetes in a University Hospital in Iran. Materials & Methods: Hospital admission data were obtained from discharge database of Vali-Asr tertiary care teaching hospital in the capital city of Fasa, Iran. Accordingly, 45 patients younger than 18 years old diagnosed with diabetes during the period of March 2014 to June 2016, were selected to participate in the study. World Health Organization (WHO) registry criteria and SPSS software version 13 were used to study and analyze the data. Results: The results indicated that nearly half of the children presented with ketoacidosis in which most of them were in the mild or moderate group. Positive family history of diabetes was found in 22.2% of the patients. Conclusion: Theoretically, it seems the frequency of diabetic ketoacidosis (DKA) in type 1 diabetic children was significant in this region of Iran. In addition, it was observed that polydipsia, polyuria, weakness, and fatigue were the most frequent clinical symptoms reported during the diagnosis....
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Background & Objective: Despite evidence of an increase in the incidence of diabetes in youth, there are few characteristic data in diabetic patients in the Islamic Republic of Iran. The present study sought to investigate the Characteristic data of childhood diabetes in a University Hospital in Iran. Materials & Methods: Hospital admission data were obtained from discharge database of Vali-Asr tertiary care teaching hospital in the capital city of Fasa, Iran. Accordingly, 45 patients younger than 18 years old diagnosed with diabetes during the period of March 2014 to June 2016, were selected to participate in the study. World Health Organization (WHO) registry criteria and SPSS software version 13 were used to study and analyze the data. Results: The results indicated that nearly half of the children presented with ketoacidosis in which most of them were in the mild or moderate group. Positive family history of diabetes was found in 22.2% of the patients. Conclusion: Theoretically, it seems the frequency of diabetic ketoacidosis (DKA) in type 1 diabetic children was significant in this region of Iran. In addition, it was observed that polydipsia, polyuria, weakness, and fatigue were the most frequent clinical symptoms reported during the diagnosis.
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Diabetes is a complex medical condition that requires evidence-based care. This article discusses the current diabetes screening, diagnostic criteria, and treatment recommendations for patients with type 1 diabetes, type 2 diabete...
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Diabetes is a complex medical condition that requires evidence-based care. This article discusses the current diabetes screening, diagnostic criteria, and treatment recommendations for patients with type 1 diabetes, type 2 diabetes, gestational diabetes, and prediabetes.
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Medical history and clinical findings: We report on a 17-year-old boy with elevated blood glucose levels, elevated liver enzymes and obesity (BMI 32.3 kg/m2). Clinical examination showed acanthosis nigricans and a vitiligo. The re...
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Medical history and clinical findings: We report on a 17-year-old boy with elevated blood glucose levels, elevated liver enzymes and obesity (BMI 32.3 kg/m2). Clinical examination showed acanthosis nigricans and a vitiligo. The rest of the physical examination was without pathological findings. Investigations: The HbA1c value was 8.6% (71 mmol/mol), and postprandial C-peptide showed a maximum level of 1.3 nmol/l. The type 1 diabetes-associated autoantibodies against protein tyrosine phosphatase IA-2 and zinc-transporter-8 were positive, while autoantibodies to glutamic acid decarboxylase and insulin were negative. There was no ketonuria. Ultrasound showed steatohepatitis. Treatment and course: Under therapy with metformin up to 2×1 g, blood glucose levels and liver enzymes normalized after a few weeks. After two months, the HbA1cvalue was 6.0% (42.1 mmol/mol), and a weight loss of 5 kg was recorded. Conclusion: In obese adolescent patients with diabetes, a clear classification right from the beginning is not always possible. Characteristic findings of type 1 and type 2 diabetes may be present simultaneously. In the presented patient, monotherapy with metformin was sufficient in the first year. Close monitoring is essential to detect the transition to insulin dependence in time.
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Abstract Diabetes is an increasingly common chronic metabolic disorder in children worldwide. The discovery of insulin in 1921 resulted in unprecedented advancements that improved the lives of children and youth with diabetes. The...
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Abstract Diabetes is an increasingly common chronic metabolic disorder in children worldwide. The discovery of insulin in 1921 resulted in unprecedented advancements that improved the lives of children and youth with diabetes. The purpose of this article is to review the history of diabetes in children and youth over the last century and its implications for future developments in the field. We identified 68 relevant events between 1921 and 2021 through literature review and survey of pediatric endocrinologists. Basic research milestones led to the discovery of insulin and other regulatory hormones, established the normal physiology of carbohydrate metabolism and pathophysiology of diabetes, and provided insight into strategies for diabetes prevention. While landmark clinical studies were initially focused on adult diabetes populations, later studies assessed etiologic factors in birth cohort studies, evaluated technology use among children with diabetes, and investigated pharmacologic management of youth type 2 diabetes. Technological innovations culminated in the introduction of continuous glucose monitoring that enabled semi‐automated insulin delivery systems. Finally, professional organizations collaborated with patient groups to advocate for the needs of children with diabetes and their families. Together, these advances transformed type 1 diabetes from a terminal illness to a manageable disease with near‐normal life expectancy and increased our knowledge of type 2 diabetes and other forms of diabetes in the pediatric population. However, disparities in access to insulin, diabetes technology, education, and care support remain and disproportionately impact minority youth and communities with less resources. The overarching goal of diabetes management remains promoting a high quality of life and improving glycemic management without undermining the psychological health of children and youth living with diabetes.
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The prevalence of diabetes mellitus is quickly growing in the U.S. population, and among these individuals, many suffer from auditory impairment of increased severity compared with healthy individuals without diabetes. Clinical im...
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The prevalence of diabetes mellitus is quickly growing in the U.S. population, and among these individuals, many suffer from auditory impairment of increased severity compared with healthy individuals without diabetes. Clinical implications of diabetes mellitus and its affect on the auditory system have been widely recognized in the literature. This article reviews current evidence detailing the association between hearing loss and diabetes mellitus. Traditional and novel methods used in research of this association will be discussed, and descriptions for general audiological precautions for diabetic patients will be outlined. Although controversy exists in the literature, knowledge of the possible audiological aspects of the diabetic individual is paramount and exceedingly relevant to audiological practice as this population continues to increase. Continued research will provide further insight for which specific audiological management of these patients may be established.
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Diabetic ketoacidosis (DKA) was once known to be specific to type-1 diabetes-mellitus (T1D); however, many cases are now seen in patients with type-2 diabetes-mellitus (T2D). Little is known about how this etiology shift affects D...
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Diabetic ketoacidosis (DKA) was once known to be specific to type-1 diabetes-mellitus (T1D); however, many cases are now seen in patients with type-2 diabetes-mellitus (T2D). Little is known about how this etiology shift affects DKA's outcomes.We studied consecutive index DKA admissions from January 2015 to March 2021. Descriptive analyses were performed based on pre-existing T1D and T2D (PT1D and PT2D, respectively) and newly diagnosed T1D and T2D (NT1D and NT2D, respectively).Of the 922 patients, 480 (52%) had T1D, of which 69% had PT1D and 31% NT1D, whereas 442 (48%) had T2D, of which 60% had PT2D and 40% NT2D. The mean age was highest in PT2D (47.6 ± 13.1 years) and lowest in PT1D (27.3 ± 0.5 years) (P < 0.001). Patients in all groups were predominantly male except in the PT1D group (55% females) (P < 0.001). Most patients were Arabic (76% in PT1D, 51.4% in NT1D, 46.6% in PT2D) except for NT2D, which mainly comprised Asians (53%) (P < 0.001). Patients with NT2D had the longest hospital length of stay (LOS) (6.8 ± 11.3 days) (P < 0.001), longest DKA duration (26.6 ± 21.1 h) (P < 0.001), and more intensive-care unit (ICU) admissions (31.2%) (P < 0.001). Patients with PT1D had the shortest LOS (2.5 ± 3.5 days) (P < 0.001), DKA duration (18.9 ± 4.2 h) (P < 0.001), and lowest ICU admissions (16.6%) (P < 0.001).We presented the largest regional data on differences in DKA based on the type and duration of diabetes- mellitus (DM), showing that T2D is becoming an increasing cause of DKA, with worse clinical outcomes (especially newly diagnosed T2D) compared to T1D.
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Preeclampsia is diagnosed in women presenting with new onset hypertension accompanied by proteinuria or other signs of severe organ dysfunction in the second half of pregnancy. Preeclampsia risk is increased 2- to 4-fold among wom...
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Preeclampsia is diagnosed in women presenting with new onset hypertension accompanied by proteinuria or other signs of severe organ dysfunction in the second half of pregnancy. Preeclampsia risk is increased 2- to 4-fold among women with type 1 or type 2 diabetes. The limited number of pregnant women with preexisting diabetes and the difficulties associated with diagnosing preeclampsia in women with proteinuria prior to pregnancy are significant barriers to research in this high-risk population. Gestational diabetes mellitus (GDM) also increases preeclampsia risk, although it is unclear whether these two conditions share a common pathophysiological pathway. Nondiabetic women who have had preeclampsia are more likely to develop type 2 diabetes later in life. Among women with type 1 diabetes, a history of preeclampsia is associated with an increased risk of retinopathy and nephropathy. More research examining the pathophysiology, treatment, and the long-term health implications of preeclampsia among women with preexisting and gestational diabetes is needed.
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Purpose To clarify the relevance between smoking and diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus. Methods Published evidence were searched in MEDLINE and EMBASE from the databases began until Feb. 201...
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Purpose To clarify the relevance between smoking and diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus. Methods Published evidence were searched in MEDLINE and EMBASE from the databases began until Feb. 2017. Studies evaluating the association between smoking and diabetic retinopathy or evaluating the risk factors of diabetic retinopathy including smoking were included. Results Totally 73 studies were identified, among which 19 studies included type 1 diabetes patients and 56 studies included type 2 diabetes patients. In type 1 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers (risk ratio (RR)?=?1.23, 95% CI 1.14, 1.33, P ?收起
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