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Agarwal, Pushpendra, Shivam Omar, and Madhurya Bajpayi. "EVALUATION OF VARIOUS PROGNOSTIC FACTORS FOR DIABETIC FOOT IN COVID 19 PANDEMIC: A CLINICAL STUDY." International Journal of Advanced Research 10, no. 04 (2022): 958–67. http://dx.doi.org/10.21474/ijar01/14631.
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Background: Diabetes mellitus is a well-known metabolic disorder of varying severity, especially involving carbohydrate metabolism. It is present in 2-3% of the general population, which may be higher (4-5%) in populations above 40 years of age. Aims and Objectives: (1) To study the clinical presentation of diabetic foot infection, (2) to study the various factors having causal relation with diabetic foot infection, (3) to study various modalities available for treatment of diabetic foot infection, (4) to correlate these factors and management strategies with prognosis of diabetic foot infection. Materials and Methods: A prospective study was carried out in patients of diabetes mellitus Type II presenting with foot infection. This study was carried out in the Department of Surgery in collaboration with Department of Medicine, Maharani LaxmiBai Medical College Jhansi U.P. from January 2020 to June 2021 over the period of 18 months. Result: In our study of 300 Type II diabetes patients who attended medical and surgical Out Patient Departments (OPD) in M.L.B m Medical College Jhansi from January, 1st 2020 to June 30st 2021 over a period of 16 months. A total of 50 patients were found to have a variety of diabetic foot infection. Conclusion: Totally 50 patients of diabetic foot infection were studied in patients from Jhansi and the surrounding areas for a period of 18 months from January, 1st 2020 to June 30st 2021. In our study, the incidence of diabetic foot infection in patients with Type II diabetes was found to be 16.64%.
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Dmitriyeva, Mariya, Saken K. Kozhakhmetov, Dulat K. Turebayev, et al. "Monitoring and Prevention the Risk of Diabetic Foot Ulcer Infection during Coronavirus Disease-19 Pandemic: A Narrative Review and Perspective Algorithm." Open Access Macedonian Journal of Medical Sciences 9, B (2021): 577–82. http://dx.doi.org/10.3889/oamjms.2021.6135.
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BACKGROUND: The coronavirus disease (COVID)-19 pandemic leads to significant changes in the healthcare system and undermining best practices for maintaining a diabetic limb. A large number of patients with diabetic foot are left without timely medical care and are at increased risk of complications, hospitalization, lower limb amputation, and death. A new paradigm must be adopted for the transition from inpatient care to community-based care. The introduction of a pandemic remote management for patients with diabetic foot ulcer includes an assessment of the risk of complications through telemedicine and further stratification of patients according to the developed algorithm. METHODS: A literature review was performed for articles related to telemedicine. We used PubMed, Google Scholar, Cochrane Library, and Ovid MEDLINE to search published articles. We used the following keywords: “Telemedicine,” “diabetes mellitus,” “COVID-19,” “diabetic foot ulcer,” and “remote monitoring.” RESULTS: Implementation of the proposed pandemic care includes telemedicine for remote monitoring and treatment of patients with diabetic foot ulcers, as well as an algorithm for determining the risk of diabetic ulcer infection and patient management tactics according to the identified risk. CONCLUSION: The management of patients with diabetic foot ulcers during a pandemic includes the following goals – to reduce the burden on the health-care system, maintain the safety and functionality of diabetic foot at home, and reduce the risk of COVID-19 in patients with diabetic foot ulcers.
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Alieva, A. V. "Indicators of endothelial dysfunction and the rate of thrombotic complications in patients with type 2 diabetes mellitus at different periods after COVID-19." Juvenis Scientia 9, no. 4 (2023): 35–41. http://dx.doi.org/10.32415/jscientia_2023_9_4_35-41.
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Introduction. Damage to the vascular endothelium and hypercoagulation are two of the main causes of post-COVID-19 complications. The aim of our study was to evaluate endothelial dysfunction and thrombotic complications at different periods after COVID-19 in patients with type 2 diabetes mellitus. Patients and methods. We conducted a cross-sectional study of 135 patients with type 2 diabetes mellitus who applied for inpatient treatment at the RSSPMCE clinic (Tashkent, Uzbekistan) in the period from 3 to 24 months after the acute period of COVID-19. The following laboratory parameters were assessed: fibrinogen, INR, APTT, D-dimer, von Willebrand factor, and cell adhesion molecules (VCAM-1, ICAM-1). Results. Despite normal or near-normal INR, APTT and fibrinogen levels, many patients had elevated levels of D-dimer (41.4 % of cases), von Willebrand factor (27.6 % of cases) and vascular cell molecules up to 24 months after infection. The concentrations of ICAM-1 and VCAM-1 did not have statistically significant correlations with the degree of compensation of diabetes mellitus (HbA1c level). At various times after COVID-19, cases of ischemic forms of diabetic foot syndrome and thrombosis affecting the cavernous sinus and upper extremities were recorded. Conclusion. Taking into account the results obtained, patients with type 2 diabetes mellitus after SARS-CoV-2 infection require careful monitoring, and, in addition to assessing standard coagulation parameters, determining the level of cell adhesion molecules may have diagnostic value.
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Schmidt, Brian M., and Laura Shin. "Tackling diabetic foot: limb salvage during the COVID-19 pandemic." Therapeutic Advances in Endocrinology and Metabolism 14 (January 2023): 204201882311572. http://dx.doi.org/10.1177/20420188231157203.
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Purpose: Lower extremity amputation resulting from diabetic foot ulcer, with neuropathic and/or ischemic etiologies, remains a devastating and costly complication of diabetes mellitus. This study evaluated changes in care delivery of diabetic foot ulcer patients during the COVID-19 pandemic. A longitudinal assessment evaluating the ratio of major lower extremity amputation to minor lower extremity amputations after implementation of novel strategies to combat access restrictions was compared to the pre-COVID-19 era. Methods: The ratio of major to minor lower extremity amputation (i.e. the high-to-low ratio) was assessed at two academic institutions, the University of Michigan, and University of Southern California, in a population of patients with diabetes who had direct access to multidisciplinary foot care clinics in the 2 years prior to the pandemic and the first 2 years of the COVID-19 pandemic. Results: Patient characteristics and volumes including patients with diabetes and those with a diabetic foot ulcer were similar between eras. In addition, inpatient diabetic foot-related admissions were similar, but were suppressed by government shelter in placed mandates and subsequent COVID-19 variants surges (e.g. delta, omicron). In the control group, the Hi-Lo ratio increased every 6 months by an average of 11.8%. Meanwhile, following STRIDE implementation during the pandemic, the Hi-Lo ratio reduced by (−)11% ( p < 0.001) and doubled limb salvage efforts as compared to the baseline era. The reduction of the Hi-Lo ratio was not influenced significant by patient volumes or inpatient admissions for foot infections. Conclusion: These findings signify the importance of podiatric care in the at-risk diabetic foot population. Through strategic planning and rapid implementation of at-risk diabetic foot ulcer triage, multidisciplinary teams were able to maintain accessible care during the pandemic which resulted in a reduction of amputations. Furthermore, this manuscript highlights the value of the Hi-Lo ratio as an indicator of institutional limb salvage efforts.
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Yakout, Marwa A., and Ibrahim A. Abdelwahab. "Diabetic Foot Ulcer Infections and Pseudomonas aeruginosa Biofilm Production During the COVID-19 Pandemic." Journal of Pure and Applied Microbiology 16, no. 1 (2022): 138–46. http://dx.doi.org/10.22207/jpam.16.1.02.
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During the different waves of the coronavirus (COVID-19) pandemic, there has been an increased incidence of diabetes mellitus and diabetic foot infections. Among gram-negative bacteria, Pseudomonas aeruginosa is the predominant causative agent for diabetic foot ulcer infections in low-resource countries. P. aeruginosa possesses a variety of virulence factors, including biofilm formation. Biofilm formation is an important benchmark characteristic in the pathophysiology of diabetic foot ulceration. The main objective of the current study was to identify the most commonly isolated organisms and their antibiotic susceptibility patterns in diabetic foot patients during the COVID-19 pandemic. We also determined the genes associated with bacterial persistence and biofilm formation in the predominantly isolated organism. Accordingly, 100 wound swab samples were collected from diabetic foot patients from different hospitals in Alexandria, Egypt. Through phenotypic detection of biofilm formation, 93% (40) of the 43 P. aeruginosa isolates examined were categorized as biofilm producers. Molecular detection of the biofilm-encoding genes among the 43 P. aeruginosa isolates was as follows: algD (100%), pelF (88%) and pslD (49.7%), and this highlights a need for biofilm formation inhibitors to prevent the persistence of bacterial pathogens, and thus achieve better clinical outcomes in diabetic foot ulcer infections.
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Wantonoro Wantonoro, Dwi Prihatiningsih, and Endang Koni Suryaningsih Endang Koni Suryaningsih. "Comprehensive home based diabetic wounds care program during covid-19 pandemic in Yogyakarta." Jurnal Pengabdian dan Pemberdayaan Masyarakat Indonesia 1, no. 6 (2021): 240–45. http://dx.doi.org/10.59247/jppmi.v1i6.29.
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Patients with COVID-19 disease who have comorbidities are strongly correlated with increased disease severity and significantly increased risk of death. Diabetes Mellitus is one of important risk factor and contributes to the severity and mortality of patients with COVID-19. Patients with chronic wounds have delayed treatment during the COVID-19 pandemic. Therefore, management of patients with chronic wounds should be improved during this pandemic. Home based wound care and education program for the family caregiver is proposed to solve the problem. Eight participants were completed this program. Evaluation of wound for each patient were conducted (at the first meeting and four- or five-months follow-up) using the diabetic foot ulcer assessment scale (DFUAS). In general, the wound depth, wound size, infection, granulation, necrotic being better compared in the first assessment. Home-based care, and education for patients and family caregiver program have benefit for diabetic wound care management during Covid-19 pandemic in this area (Yogyakarta, Indonesia). The comprehensive with multidiscipline approach are recommended for future work.
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Pratamawerdi, I. Gede Sadu, Jason Raymond Hotama, and I. Made Suma Wirawan. "The treatments of COVID-19 patient with diabetes mellitus: a case report." International Journal of Advances in Medicine 8, no. 3 (2021): 450. http://dx.doi.org/10.18203/2349-3933.ijam20210606.
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Diabetes mellitus or uncontrolled blood sugar is one of the factors causing the severity risk of COVID-19 infection. The researchers from China and Italy also find a profound connection of the old age patients who have chronic illness comorbid are tend to have a higher risk of enduring serve COVID-19, and have a higher number of deaths. Until this report is written, there are no medicines nor vaccines to treat COVID-19 completely. This article reports KTK, a 57 years old woman, Balinese, was diagnosed with COVID-19 and was treated because of the loss of consciousness. Patient had already done the op debridement amputation for left foot digit II-V and the wound of the patient got worsen. Patient also had blood sugar variability which complicated the insulin therapy and inhibits the patient’s recovery. On her way, the patient’s respiratory system got worsen. Diabetes is strongly connected with a higher risk of severe COVID-19 and has a higher death rate compared to controlled blood sugar. The purpose of the guidance for COVID-19 patients with Diabetes is to prove that comprehensive glycemic control and blood glucose monitoring have a good result of the treatments for COVID-19 patients with Diabetes, also reduce the complication from the comorbid of chronic illness (diabetes), and avoiding the undesirable possibilities about the treatments.
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Hannan Sajid, Zakir Jamal, Rabia Irfan, Fatima Shahzad, and S H Waqar. "Diabetic Foot: Its Mode of Presentation and its Grades according to WIfI classification at A Tertiary Care Hospital." Journal of Islamabad Medical & Dental College 13, no. 4 (2025): 654–59. https://doi.org/10.35787/jimdc.v13i4.1322.
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Abstract Background: Diabetes Mellitus (DM) is a prevalent metabolic disease that has a major impact on public health. One of the major side effects of diabetes is diabetic foot ulcers (DFU). Objective: To ascertain the method of presentation, analyze, and distribute the diabetic foot lesions in accordance with the WIfI classification of diabetic foot ulceration in a tertiary care hospital of Pakistan. Methodology: This cross sectional study was carried out at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad, from January to December 2022. All adult patients with DFUs were enrolled consecutively. Patients with healed foot ulcerations were excluded. Data regarding age, gender, duration of diabetes, co morbidities, severity of wound, ischemia, severity of infection was noted on a proforma according to WIfI classification. Results: A total of 76 patients presented with DFUs with mean age of 51.03±7.041 years, (range 40 - 70 years). There were 52(68.4%) males and 24(31.6%) females. The duration of diabetes was <5 years in 40(52.6%) followed by 5-10 years in 21(27.6%) patients. According to wound severity, 55(72.4%) patients presented with grade 2 (Deep Ulcer with exposed bone, joints or tendons) followed by 16 (21.1%) with grade 1 (Small Superficial Ulcer without gangrene). According to Ischemia, 44 (57.9%) patients presented with grade 1, 13(17.1%) presented with grade 2 and 19(25.0%) presented with grade 3. There is a significant association of severity of DFUs with age and duration of disease. Conclusion: Diabetic patients commonly present with grade 2 of DFUs followed by grade 1, while presentation with ischaemia were of grade 1. Keywords: Diabetic Foot Ulcer, Diabetic Mellitus, WIfI classification
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Kar, Sonali, Shalini Ray, and Dayanidhi Meher. "Infection and Foot Care in Diabetics Seeking Treatment in a Tertiary Care Hospital, Bhubaneswar, Odisha State, India." Advances in Public Health 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/765145.
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Diabetes mellitus is a major public health problem that can cause a number of serious complications. Foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among diabetics. The present study was undertaken in the diabetes outpatient department of a tertiary care hospital to assess the practices regarding foot care in diabetes, find out the determinants of foot ulcer in diabetics, and offer suggestions to improve care. After informed consent, a total of 124 diabetics were interviewed to collect all relevant information. The diabetic foot care practice responses were converted into scores and for the sake of analysis were inferred as poor (0–5), fair (6-7), and good (>7) practices. Of the study population, 68.5% (85/124) consisted of men. The disease was diagnosed within the last 5 years for 66% (81/124) of the study participants. Of the study subjects, 83% (103/124) were on oral hypoglycemic agents (OHAs), 15.3% (19) on insulin, and 2 on diet control only. Among them about 18.5% had a history of foot ulcer. 37.9% reported using special slippers, 12% diabetics used slippers indoors, and 66.9% used slippers while using toilet. Of the study subjects, 67.8% said that feet should be inspected daily. 27.4% said they regularly applied oil/moisturizer on their feet. There is a need on part of the primary or secondary physician and an active participation of the patient to receive education about foot care as well as awareness regarding risk factors, recognition, clinical evaluation, and thus prevention of the complications of diabetes.
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Niko Azhari Hidayat, Abed Nego Okthara Sebayang, Amila Shofia, and Shofa Aulia Aldharma. "DEVELOPMENT OF TELEMEDICINE APPLICATION BASED ON ARTIFICIAL INTELLIGENCE IN THE HANDLING OF DIABET FOOT." Jurnal Layanan Masyarakat (Journal of Public Services) 6, no. 1 (2022): 205–11. http://dx.doi.org/10.20473/jlm.v6i1.2022.205-211.
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Introduction: Diabetes mellitus is a metabolic disorder characterized by increased blood glucose levels (hyperglycemia) due to impaired insulin secretion and insulin action. Diabetic foot ulcers are chronic and difficult to heal is the most common cause of non-traumatic amputations in patients with diabetes mellitus which reaches 82%. Telemedicine technology based on artificial intelligence can be used as a facility for diabetic foot patients by providing education, consultation and direction in treating diabetic feet. Research Methods: The method used in this research is literature study. Literature study conducted by the author is to look for various written sources, either in the form of books, archives, magazines, articles and journals, as well as documents relevant to the problem being studied. Result: Telemedicine application based on artificial intelligence is a solution for DM patients, especially diabetic foot complications. Discussion: The telemedicine application provides 24-hour service by providing education about diabetic foot care to avoid infection, consultation on the administration of drugs such as insulin and other diabetes drugs. Artificial intelligence in telemedicine allows this application to work 24 hours a day. Conclusion: Diabetes mellitus is still a complex problem worldwide. Complications that occur, especially diabetic feet reduce the quality of life of DM patients. Telemedicine application based on artificial intelligence is a solution that can be used to perform routine care for diabetic foot patients.
 Keywords: Telemedicine, Artificial intelligence, Diabetic foot, Diabetes Mellitus
 
 DAFTAR PUSTAKA
 
 Braza DW, Martin JNY. Diabetic Foot and Peripheral Arterial Disease [Internet]. Fourth Edi. Essentials of Physical Medicine and Rehabilitation. Elsevier Inc.; 2020. 719-723 p. Available from: https://doi.org/10.1016/B978-0-323-54947-9.00129-2
 denDekker AD, Gallagher KA. Dysregulated inflammation in diabetic wounds [Internet]. Wound Healing, Tissue Repair, and Regeneration in Diabetes. Elsevier Inc.; 2020. 81-95 p. Available from: http://dx.doi.org/10.1016/B978-0-12-816413-6.00005-8
 Grennan D. Diabetic Foot Ulcers. JAMA - J Am Med Assoc. 2019;321(1):114.
 Boulton AJM, Young MJ. The Diabetic Foot [Internet]. Diabetes in Old Age: Third Edition. Elsevier Inc.; 2009. 113-135 p. Available from: http://dx.doi.org/10.1016/B978-0-12-816413-6.00001-0
 Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract [Internet]. 2018;138:271–81. Available from: https://doi.org/10.1016/j.diabres.2018.02.023
 Khandelwal P, Khanna S. Diabetic peripheral neuropathy: An insight into the pathophysiology, diagnosis, and therapeutics [Internet]. Wound Healing, Tissue Repair, and Regeneration in Diabetes. Elsevier Inc.; 2020. 49-77 p. Available from: http://dx.doi.org/10.1016/B978-0-12-816413-6.00004-6
 Reddy SSK, Tan M. Diabetes mellitus and its many complications [Internet]. Diabetes Mellitus. Elsevier Inc.; 2020. 1-18 p. Available from: https://doi.org/10.1016/B978-0-12-820605-8.00001-2
 Vennos C, Schwabl H, Pinto D. Phytotherapeutics in Diabetes and Diabetic Complications. Bioact Food as Diet Interv Diabetes. 2019;309–15.
 Meloni M, Izzo V, Giurato L, Gandini R, Uccioli L. Management of diabetic persons with foot ulceration during COVID-19 health care emergency: Effectiveness of a new triage pathway. Diabetes Res Clin Pract [Internet]. 2020;165:108245. Available from: https://doi.org/10.1016/j.diabres.2020.108245
 Prandi V, Lenta E, Bracco A, Conterno E, Nigro E, Costa CD. Patient satisfaction assessment in telemedicine. Clin Nutr ESPEN [Internet]. 2020;40:487. Available from: https://doi.org/10.1016/j.clnesp.2020.09.244
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 D’Arqom A, Indiastuti D, Nasution Z, Melbiarta R. PENGEMBANGAN KADER SEKOLAH MENENGAH UNTUK MENURUNKAN INSIDEN THALASSEMIA DI KABUPATEN BULAK, SURABAYA. 2021. Jurnal Layanan Masyarakat. 2021;5(2)
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Prasad Pilla, Earnest Daniel, Rajendra Desai, and Prashant Ramdas Kokiwar. "A multi centric study of diabetic foot ulcer: causes and complications." International Surgery Journal 6, no. 4 (2019): 1327. http://dx.doi.org/10.18203/2349-2902.isj20191271.
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Background: Diabetes mellitus is a metabolic disorder and has become an epidemic. 73 million people in India have diabetes mellitus. Presently India has ranked the second highest country with diabetics in the world. Diabetic foot ulcer is a result of one or both of the complications of diabetes such as neuropathy and ischemia. The objective of the study was to study the causes for the ulcer formation on the toes.Methods: A prospective study was carried out from January 2016 to August 2018 from multiple diabetic clinics in Hyderabad, India. All the patients had undergone the following tests. 1) X-ray foot, 2) ABI (ankle brachial index) test, 3) Neuropathy test by VPT (vibration perception test) and monofilament.Results: The age of the patients mostly ranged from 50 to 70 years. 61% of the patients had neuropathic ulcer, 20% had ischemic ulcer, 19% had neuro-ischemic ulcer. 69% of these patients had osteomyelitis. 52% had ulcer on the right foot and 48% on the left. 15% had dry gangrene with ulcer where as 85% had infected ulcers. 60% of the ulcers were only on the plantar aspect and 24% had ulcers all around the toe. ABI (ankle brachial index) was normal 0.9 to 1.2 in 80% of patients whereas 20% had abnormal (<0.9). 60% of patients had ulcers involving the 1st and 2nd toes and both feet were almost equally affected.Conclusions: Neuropathy is the leading cause for ulcers on the toes followed by ischemia and then infection. Treating the neuropathic ulcer early can bring down the amputation rate of the toes by 50%.
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Sood, Mona, Fayaz A. Bhat, Shariq R. Masoodi, et al. "A Comparative Analysis of Spectrum and Outcome of Common bacterial Infections in Patients with and without Diabetes-a Prospective Hospital Based Study." JMS SKIMS 21, no. 2 (2019): 84–90. http://dx.doi.org/10.33883/jms.v21i2.358.
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Objective: In this prospective study we analyzed clinical spectrum of infections and there outcome in patients with diabetes mellitus and compared it with nondiabeticcontrols admitted in Endocrinology division of a tertiary care hospital.Methods: This was a prospective, longitudinal study of 242 diabetic and non-diabetic subjects. Patients were studied in terms of clinical picture, biochemical, hematological and microbiological profile, type and severity of infection, treatment received, and final outcome. There were 142 diabetic patients in group 1 and 100 nondiabetic patients in group 2 served as control. Study subjects were followed for a median period of one year (52 weeks in diabetics, 65 weeks in non-diabetics) after discharge from the ward.Results: Diabetic patients admitted because of infections were older than their non-diabetic counterparts (74% vs 51%> 50 years; p<0.001) and mounted a less inflammatory response in terms of fever and leucocytosis(55% vs 82%:P<0.001).Urinary tract infections were the commonest infections observed among in-hospital diabetic as well as non-diabetic patients (36% vs. 30%; P>0.3). Diabetics contract some specific infections exclusively, like emphysematous pyelonephritis and foot infections, while respiratory infections were more commonly seen in nondiabetic patients (31% vs. 11%; P<0.001).Staphylococcus aureus was the commonest organism involved in soft tissue and diabetic foot infections (32% vs. 19%; P<0.03). Though mean hospital stay was equal in either group it was significantly longer in diabetic subjects when statistically adjusted for APACHE score.Comparative mortality rates were higher in non-diabetics with in-hospital deaths, followup deaths and total deaths of11%, 6.1% and 17.2% vs 4.9%, 4% and 9.1% respectively but re-infections on follow-up occurred more in diabetics (15% vs.2.6%; P=0.005).Conclusion: Poor glycaemic control and less inflammatory response in terms of fever and leucocytosis, longer hospital stay with increased chances of reinfections are poor prognostic indicators for outcomes in diabetic patients admitted with infections. Urinary tract infections and soft tissue infections particularly foot infectionsare causes of concern in our diabetic patients. JMS 2018: 21 (2):84-90
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Nnachetam, Unegbu Valentine. "Risk Factors for Methicillin Resistant Staphylococcus aureus (MRSA) from Diabetes Patients with Foot Ulcers (DFU) in a Tertiary Hospital." Diabetes & Obesity International Journal 7, no. 2 (2022): 1–8. http://dx.doi.org/10.23880/doij-16000254.
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Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus. Risk of MRSA should be considered in selecting empirical antibiotics. This study was aimed to determine the Risk factors of Methicillin Resistant Staphylococcus aureus (MRSA) from Diabetes patients with foot ulcers (DFU). A total of 204 patients with diabetic foot were included in the study. Data collected using a pre-designed questionnaire included patient characteristics and medical history to determine risk factors for developing an MRSA infection in the foot. Specimens were obtained by scraping the ulcer base or the deep portion of the wound edge with a sterile curette, and were promptly sent to the laboratory for culture and identification. The prevalence of MRSA in DFU patients was 22.1%. Male patients with DFU were more infected with MRSA 26(12.7%) than females 19(9.3%) with statistical significance (p < 0.04). The age group 41 – 60 years had the highest prevalence of 27(13.2%) with statistically significance (p < 0.03). Farmers and DFU patients of 6 – 10 years had the highest prevalence of 20(9.8%) and 22(10.8%) without statistical significance. Risk factors were all significantly associated to MRSA colonization of diabetic foot ulcers and includes patients who had Type 2 diabetes for 1 – 5 years, and fasting blood sugar greater than >126, patients who smoked and drank for more than 10 years, and patients with body mass >30kg/m2. The prevalence of MRSA in DFU patients was 22.1% which was high. Risk factors were all statiatically associated to MRSA colonization of diabetic foot ulcers. The results from this study will guide healthcare workers on how to educate the patients in the study environment on the possible risk factors contributing to the colonization of MRSA in diabetic foot ulcers and the use of antibiotic therapy to eliminate MRSA from colonized wounds.
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Mokrysheva, N. G., M. V. Shestakova, O. K. Vikulova, et al. "Analysis of risk factors for COVID-19-related fatal outcome in 337991 patients with type 1 and type 2 diabetes mellitus in 2020–2022 years: Russian nationwide retrospective study." Diabetes mellitus 25, no. 5 (2022): 404–17. http://dx.doi.org/10.14341/dm12954.
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BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death.AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2).MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)).RESULTS: Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1–8.8%; DM2–17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age ≥65 years (OR =4.01, 95% CI: 1.42–11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98–26.29); for T2DM: age ≥ 65 years (OR =2.53, 95% CI: 1.96–3.27), male (OR =1.51, 95% CI: 1.23–1.84), duration DM ≥10 years (OR =2.01, 95% CI: 1.61–2.51), BMI ≥ 30 kg/m2 (OR =1.26, 95% CI: 1.02–1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01–2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89–88.99) and presence of disability ( OR =1.40, 95% CI: 1.14–1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30–2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23–1.84)); dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39–0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46–0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06–0.59; SD2 OR =0.20, 95% CI: 0.16–0.26.CONCLUSION: The common risk factor for fatal outcome in both DM1 and DM2 was age ≥65 years; in DM1 — history of hypertension and DFS, in DM2 — male sex, diabetes duration ≥10 years, BMI ≥30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively.
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Singh, Balraj, Parminder Kaur, Nicole Majachani, Prem Patel, Ro-Jay Romor Reid, and Michael Maroules. "COVID-19 and Combined Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Coma: Report of 11 Cases." Journal of Investigative Medicine High Impact Case Reports 9 (January 2021): 232470962110212. http://dx.doi.org/10.1177/23247096211021231.
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We report 11 cases of combined diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic coma (HHNK) in coronavirus 2019 patients who presented to our institution in New Jersey, USA. The median age was 47 years (range 12-88 years). Out of the 11 patients, 7 were male and 4 were female. Out of 11 patients, 8 had type 2 diabetes mellitus (DM), 2 had undiagnosed DM, and 1 had type 1 DM. Presenting complaints included altered mental status, weakness, shortness of breath, cough, fever, vomiting, abdominal pain, chest pain, and foot pain. Out of 11 patients, pneumonia was diagnosed at presentation in 8 patients, while in 3 patients, chest X-ray was clear. Median value of initial glucose on presentation was 974 mg/dL (range 549-1556 mg/dL), and hemoglobin A1c on presentation was 13.8%. The median value of anion gap was 34 mEq/L. Out of the 11 patients, ketonemia was moderate in 6 patients, large in 3, and small in 2 patients. Acute kidney injury (AKI) occurred in 9 patients and 2 patients required renal replacement therapy. Out of the 11 patients, 6 required mechanical ventilation and 7 patients died. All the 6 patients requiring mechanical ventilation died. Our case series shows COVID-19 infection can precipitate acute metabolic complications in known DM patients or as first manifestation in undiagnosed DM patients. Patients can present with DKA/HHNK symptoms and/or respiratory symptoms. Mechanical ventilation is a poor prognostic factor. Further studies are needed to characterize prognostic factors associated with mortality in this vulnerable patient population.
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Navarro-Pérez, David, José Luis Lázaro-Martínez, Sara García-Oreja, Teresa Pérez-Pérez, Francisco Javier Álvaro-Afonso, and Aroa Tardáguila-García. "Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study." Journal of Fungi 10, no. 11 (2024): 790. http://dx.doi.org/10.3390/jof10110790.
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Background: A cross-sectional study was conducted to investigate the prevalence of onychomycosis (ONM) and its causative pathogens in populations with and without diabetes in Spain. The association between the presence of ONM, different risk factors, and comorbidities was also examined. Methodology: A total of 160 patients with diabetes and 160 individuals without diabetes were recruited consecutively. A single investigator recorded the relative data of each patient and sampled nail dust and detritus for microbiological culture and polymerase chain reaction (PCR) analyses of patients who showed clinical signs of fungal infection. Results: The prevalence of ONM was 36.88% (59/160) in the population with diabetes, 17.5% (28/160) in the population without diabetes, and 34.35% (45/131) in the population with diabetic foot. Dermatophyte fungi were most frequently identified, although the proportion was higher among those without diabetes than those with diabetes (19/28 and 28/59, respectively). However, the rate of mixed infections was higher in the population with diabetes compared to those without diabetes (13/59 and 2/28, respectively). A statistically significant association was found between the presence of diabetes and the risk of ONM (p < 0.001; odds ratio (OR) = 2.754; 95% confidence interval (CI) 1.652–4.679). The risk factors associated with ONM among the patients with diabetes were a history of minor amputation, revascularisation, or cardiovascular disease, a low educational level, HbA1c values > 7%, hyperkeratosis, and subungual detritus. Among the patients without diabetes, nail thickening and chromonychia were associated with ONM. Conclusion: The results of this study suggest that the early diagnosis of ONM and knowledge of risk factors among patients with diabetes could enable the prevention of ONM, complications, and serious injuries through education for professionals and patients.
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Klimi, Eleni, and Dionysia Vasdeki. "Acral purpura and pityriasis rosea-like eruption following COVID-19 infection." Our Dermatology Online 13, no. 3 (2022): 324–25. http://dx.doi.org/10.7241/ourd.20223.24.
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Sir, A 74-year-old female patient treated with angiotensin-converting enzyme inhibitor for arterial hypertension with metformin and atorvastatin for insulin-independent diabetes mellitus and hyperlipidemia, respectively, consulted the outpatient dermatological clinic for a rash that appeared fifteen days prior to consultation. The patient received the second dose of mRNA COVID-19 vaccine on July 29, 2021, and was due to receive the third dose on December 29, yet she fell ill on day 6 of the same month, probably being infected by one of her grandchildren. The eruption consisted of erythematous, purpuric macules on the anterior face of both tibia (Fig. 1a), of a solitary papule on the left hand (Fig. 1b), and of erythematous papules with a scale on the border on the left buttock (Fig. 1c). A collarette formed on the trailing edge of the advancing border of the hand lesion, a clinical sign pathognomonic of pityriasis rosea. Intense pruritus accompanied the eruption. No herald patch was observed, nor lesions on the trunk, being the typical location of lesions of pityriasis rosea, while lesions on the hands are absent in the typical cases of the disease. The oral and genital mucosae were intact. The cutaneous manifestations of COVID-19 include purpuric, chilblain, vesicular, urticarial, and pityriasis rosea-like lesions. Acral lesions are the most frequent location of the cutaneous manifestations associated with COVID-19 infection [1]. An acral distribution of lesions is a feature of mouth, hand, and foot disease due to infection with Coxsackie A16 virus [2], although no reactivation of this virus has been detected during the COVID-19 pandemic, while the reactivation of herpes 6 and herpes 7 virus associated with pityriasis rosea has occurred
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Rachmawati, N. A., M. Astawan, T. Wresdiyati, and R. M. Yoshari. "The effects of tempe protein isolate from non-germinated and germinated soybean on oxidative stress in diabetic rats." Food Research 7, Supplementary 1 (2023): 14–26. http://dx.doi.org/10.26656/fr.2017.7(s1).19.
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Diabetes mellitus (DM) patients tend to be more susceptible to the COVID-19 virus. Evidence suggests that infection with the COVID-19 virus leads to increase reactive oxygen species (ROS) production. Moreover, hyperglycaemic conditions also produce excess ROS. Those can lead to oxidative stress in DM patients. This study aimed to prevent oxidative stress by using innovative functional food called tempe protein isolates, which were isolated from both non-germinated soybean (TPIN) and germinated soybeans (TPIG). TPIN, TPIG and commercial soy protein isolate (CSPI) were given 900 mg/kg BW to DM rats for 28 days. The DM rats were modelled by inducing an alloxan dose of 110 mg/kg BW intraperitoneally. Results showed there were no significant differences (p>0.05) in feed intake and blood profile. TPIN significantly prevented excessive weight loss and reduced blood glucose (p<0.05) better than TPIG and CSPI. TPIN and TPIG significantly (p<0.05) prevent the formation of MDA in the kidney, increase the activity of the SOD enzyme in both liver and kidney tissues and increase Cu,Zn-SOD antioxidant. This study concluded that the administration of TPIG and TPIN could prevent liver and kidney tissue damage by free radicals. Furthermore, TPIN has better potential than TPIG to prevent oxidative stress.
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Darwis, Iswandi, Hidayat Hidayat, Gusti Ngurah P. Pradnya Wisnu, and Sekar Mentari. "Bacteriological Profile and Antibiotic Susceptibility Pattern of Diabetic Foot Infection in a Tertiary Care Hospital in Lampung, Indonesia." Malaysian Journal of Medical Sciences 28, no. 5 (2021): 42–53. http://dx.doi.org/10.21315/mjms2021.28.5.4.
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Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus and identification of the causative bacteria is an essential step in selecting the appropriate antibiotic therapy. This study aimed to evaluate the bacterial pattern and antibiotic susceptibility of the bacteria causing DFI in Lampung Province in Indonesia. Methods: This study is a retrospective study reviewing the medical records of DFI patients admitted to the Dr Hi Abdul Moeloek Regional General Hospital in 2017–2019. DFI patients with complete medical record data were included in this study. Demographic, clinical, laboratory, wound culture and antibiotic susceptibility data were collected from the medical records using a short structural chart. The data obtained then reviewed. Results: In this study, 131 DFI patients met the study criteria and were included. Based on the wound culture results, Gram-negative bacteria were obtained in 112 (85.5%) subjects with Enterobacter spp. as the predominant bacteria. Gram-positive bacteria were found in 19 (14.5%) subjects with Staphylococcus spp. as the predominant bacteria. Gram-negative bacteria found in this study showed high susceptibility to amikacin, meropenem and sulbactam/cefoperazone. Meanwhile, the Gram-positive bacteria showed high susceptibility to meropenem, sulbactam/ cefoperazone and amikacin. Conclusion: The findings of the study revealed Enterobacter spp. as the most predominant bacteria causing DFI in the studied population. The highest antibiotic susceptibility was seen for amikacin, meropenem and sulbactam/cefoperazone.
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Lee, Eugene, Jakrapun Pupaibool, and Laura Certain. "188. The Role of Bone Pathology in the Management of Residual Osteomyelitis After Amputation for Diabetic Foot Infections." Open Forum Infectious Diseases 7, Supplement_1 (2020): S222—S223. http://dx.doi.org/10.1093/ofid/ofaa439.498.
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Abstract Background Diabetic foot osteomyelitis is a common infection often treated by a combination of antibiotic therapy and limb-sparing amputation. During amputation, IDSA guidelines recommend histopathological analysis of the proximal resection margin, but there are few studies evaluating the prognostic value of such analysis. We did a retrospective cohort study to evaluate whether histopathologic findings predict the clinical outcomes of further proximal amputation or death. Methods We conducted a retrospective cohort study at a VA hospital reviewing 84 patients. We evaluated patients who had a diagnosis of diabetes mellitus with diabetic foot osteomyelitis who were treated with limb-sparing amputations. All cases that were included had adequate histopathological description of the proximal margin of the amputation site. We also collected relevant clinical data including comorbidities, labs, culture data and pre-op and post-op antibiotics. The primary outcome was defined as the need for further proximal resection at the amputation site within six months of the original amputation or death from all causes within three months of the original amputation. Categorical variables were compared using Fischer’s exact test or the Chi-Square test. Continuous variables were compared using the t-test. Results We found a statistically significant difference (p=0.0003) of the primary outcome with 10 of 19 (53%) patients with positive margins needing further surgical resection and 1 of 19 (5%) patients dying. Of the patients with negative margins, 9 of 55 (14%) patients needed further surgery and none died. Conclusion Our study showed that patients with residual osteomyelitis at the proximal margin were more likely to need further proximal amputation or die. We did not have adequate power to assess whether extended antibiotic therapy improved outcomes for patients with positive margins, but there was no suggestion that it did. Further research will be needed to elucidate what the ideal duration of antibiotic therapy is for residual osteomyelitis after amputation for diabetic foot osteomyelitis. Disclosures All Authors: No reported disclosures
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Lien, Angela Shin-Yu, Chen-Yao Lai, Jyh-Da Wei, Hui-Mei Yang, Jiun-Ting Yeh, and Hao-Chih Tai. "A Granulation Tissue Detection Model to Track Chronic Wound Healing in DM Foot Ulcers." Electronics 11, no. 16 (2022): 2617. http://dx.doi.org/10.3390/electronics11162617.
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Diabetes mellitus (DM) foot ulcer is a chronic wound and is highly related to the mortality and morbidity of infection, and might induce sepsis and foot amputation, especially during the isolation stage of the COVID-19 pandemic. Visual observation when changing dressings is the most common and traditional method of detecting wound healing. The formation of granulation tissues plays an important role in wound healing. In the complex pathophysiology of excess and unhealthy granulation induced by infection, oxygen supply may explain the wound healing process in DM patients with multiple complicated wounds. Thus, advanced and useful tools to observe the condition of wound healing are very important for DM patients with extremities ulcers. For this purpose, we developed an artificial intelligence (AI) detection model to identify the growth of granulation tissue of the wound bed. We recruited 100 patients to provide 219 images of wounds at different healing stages from 2 hospitals. This was performed to understand the wound images of inconsistent size, and to allow self-inspection on mobile devices, having limited computing resources. We segmented those images into 32 × 32 blocks and used a reduced ResNet-18 model to test them individually. Furthermore, we conducted a learning method of active learning to improve the efficiency of model training. Experimental results reveal that our model can identify the region of granulation tissue with an Intersection-over-Union (IOU) rate higher than 0.5 compared to the ground truth. Multiple cross-repetitive validations also confirm that the detection results of our model may serve as an auxiliary indicator for assessing the progress of wound healing. The preliminary findings may help to identify the granulation tissue of patients with DM foot ulcer, which may lead to better long-term home care during the COVID-19 pandemic. The current limit of our model is an IOU of about 0.6. If more actual data are available, the IOU is expected to improve. We can continue to use the currently established active learning process for subsequent training.
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Kibunto, Peter, Barker Peter, Yasin Munisi, et al. "Patterns of Pathogens and Antimicrobial Susceptibility Profiles in Diabetic Foot Ulcers’ Infections among Patients at Bugando Medical Centre in Mwanza, Tanzania." Middle East Research Journal of Medical Sciences 3, no. 02 (2023): 17–27. http://dx.doi.org/10.36348/merjms.2023.v03i02.001.
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Background: Diabetic foot ulcer (DFU) is an open sore or wound on the foot of a person with diabetes, and is most commonly located on the plantar surface, or bottom of the foot. The defect is relatively common in adult and elders with diabetes mellitus. Infected lower extremities wound with multi-drug resistant bacteria usually are associated with increased morbidity, mortality and long-term disabilities among diabetic patients. Although the burden of DFU is known in Tanzania (and Mwanza in particular), there is limited information on the patterns of pathogens associated with DFU in our setting, on bacterial and fungal pathogens which in turn limit specific management options to these patients. Methodology: Analytical cross section hospital-based study was conducted among patients with DFU admitted or attending outpatient clinics at BMC from May to July 2022. A structured questionnaire was used to collect socio-demographic, clinical and laboratory data from patients with DFU. Tissue culture was obtained from the base of the ulcer after cleaning with normal saline followed by removing of cellular debris and normal flora over the lesion. Finally, the obtained samples were subjected to culture methods to identify the presence of pathogens (bacteria and fungi) and antimicrobial susceptibility profiles of bacteria. Result: During the study period and based on inclusion criteria, a total of 71 patients, with a mean age of 59.2 ± 13.0 years were recruited. The majority of the participants were male 47 (66.2%). A total of 60 (84.5%) samples were culture positive, resulting into a total of 92 microorganisms isolated. More than half of cultures 34 (56.7%) revealed the presence of single microorganisms. Pathogens isolated were both bacterial 70 (76.1%) and fungi species 22 (23.9%), all bacterial isolates were aerobic. P. aeruginosa and E. coli were most frequent isolated gram-negative bacteria 12(23.5%) and 9(17.6%) respectively. On other hand common isolated gram-positive strains were S. aureus 13 (68.4%) out of all 19 gram-positive culture isolates. A total of 22 fungi spp were isolated, among them 7 (31.8%) were yeast C. albicans 3 (42.8%), A. fumigatus were frequent isolated 13 (86.7%). Polymicrobial growth was observed in 43.3% samples against 56.7% of monomicrobial growth. Most prevalent gram-negative bacteria Pseudomonas aeruginosa showed low resistance to ciprofloxacin, meropenem, gentamicin, piperacillin tazobactam (7.1%, 21.4%, 21.4% and 21.4 respectively) but more resistant to cephalosporins. Staphylococcus aureus showed low resistance to ciprofloxacin, gentamicin and clindamycin (30.8%, 15.4%, and 38.5% respectively), Total MDR bacteria isolates were 64.3%, where methicillin resistance staphylococcus aureus (MRSA) were 76.9%. More than 85.7% of the patient with higher grade ulcer, stage 3 and 4 according to Wagner’s classification were positive to diabetic foot infection and 14.3% of patients with Wagner’s stage 3 and 4 were not infected on their ulcers. Conclusion: Gram negative bacteria were most commonly isolated than gram positive bacteria in causing DFU infections. For gram negative spp the most effective antibiotic were ciprofloxacin, gentamicin, piperaccilin tazobactam and meropenem. Third generation cephalosporins, amoxicillin clavulanate showed poor effectiveness. All cases of DFU infection should therefore be subjected to culture and antimicrobial sensitivity testing for targeted infection management. More studies involving anaerobic pathogens and antifungal susceptibility patterns
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Kenanoğlu, Olcay Buse, Gunel Quliyeva, Tansu Yamazhan, et al. "249. Evaluation of 99 Radiologically-proven Osteomyelitis Cases." Open Forum Infectious Diseases 8, Supplement_1 (2021): S232. http://dx.doi.org/10.1093/ofid/ofab466.451.
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Abstract Background Herein we aimed to evaluate osteomyelitis cases in our setting. Methods We evaluated the hospital records of patients with osteomyelitis between January 2013 and December 2020 retrospectively. Osteomyelitis was confirmed by direct radiography or magnetic resonance imaging or pathology. Demographic features, risk factors, clinical/laboratory findings, treatment response and mortality rates were evaluated. Clinical response was defined as (resolution of clinical signs including fever and purulent discharge and other symptoms) and/or negative culture at the end of antimicrobial therapy. Results Patients were 33 female, aged 29–85 years (mean 59±12.6). Fourty nine of the patients were diabetic foot infection, 30 were spondylodiscitis, eight were primary, seven were post-traumatic, and five were post-surgical osteomyelitis. Overall 62 patients had diabetes mellitus and 16 patients had chronic renal failure. Peripheral arterial disease, neuropathy, diabetic retinopathy and venous insufficiency rate in the DM subgroup is shown in table. Fever was present in 24.2% of the cohort. İncreasing of CRP was in 95,9%, erythrocyte sedimentation rate in 83,9%, and leukocytosis in 37.3%. The radiological findings of osteomyelitis were detected via magnetic resonance imaging in 73 patients. Etiology in biopsy cultures were elucidated in 59.5% and the most common pathogen was S. aureus (30%) Table1. The most common empirical treatment regimens were tigecycline in 27 patients, ampicillin/sulbactam in 19 patients and ceftriaxone+teicoplanin in 12 cases. Duration of treatment was 36,2±17.3 days (range 6-104 days). Overall, clinical response was obtained in 91.9%. Fifty patients were performed surgical procedure + antibacterial treatment, clinical response was 96% (p:0.091). Surgical debridement could be performed in 22 patients, clinical response was obtained in all (p:0.193). Thirteen patients developed recurrence within one year. Sixty-seven patients received oral consecutive treatment after discharge. In hospital mortality rate was 2/99 (2,02%). Conclusion Despite surgical debridement and/or developed antimicrobial treatment, approximately 1/5 of osteomyelitis cases required further treatment Further interventions seem to be needed to reach better outcomes. Disclosures All Authors: No reported disclosures
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Ставчиков, Е. Л., and С. Д. Федянин. "Rational Antibiotic Therapy in the Patients with Diabetic Foot Syndrome." Хирургия. Восточная Европа, no. 1 (April 5, 2023): 80–89. http://dx.doi.org/10.34883/pi.2023.12.1.018.
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Введение. Синдром диабетической стопы (СДС) как одно из наиболее важных и частых осложнений у пациентов с сахарным диабетом (СД) характеризуется развитием гнойно-некротических изменений мягких тканей нижних конечностей, что повышает риск инвалидизации пациентов. Для повышения эффективности контроля инфекции необходим локальный мониторинг микрофлоры в каждом учреждении, занимающемся лечением СДС. Хирургическое лечение, применение разгрузочных повязок и коррекция гликемического профиля являются наиболее важными направлениями в купировании инфекционно-воспалительного процесса у пациентов с СДС, однако они могут оказаться неэффективными при неадекватной антибактериальной терапии. В связи с этим проблема рационального использования антибиотиков в комплексном лечении СДС остается актуальной и требует дальнейшей разработки. Цель. Изучить этиологическую структуру и антибиотикорезистентность микробной флоры у пациентов с СДС для разработки протокола рациональной эмпирической антибиотикотерапии. Материалы и методы. В исследование включены 66 пациентов с СДС, находившихся на стационарном лечении в отделении гнойной хирургии УЗ «Могилевская областная клиническая больница» с 2020 по 2022 г. Выполнен комплекс бактериологических исследований. Идентификация и определение чувствительности микроорганизмов к антибиотикам проводились с помощью тест-систем на биохимическом анализаторе Vitek 2 Compact (bioMerieux, Франция). Результаты. У пациентов с СДС из ран выделено 19 изолятов (28,8%) рода стафилококков, 18 изолятов (27,2%) семейства энтеробактерий, 8 изолятов (12,1%) P. aeruginosa, 5 изолятов (7,5%) А. baumannii, 5 изолятов (7,5%) энтерококков. Кроме того, идентифицировано 43 представителя облигатных анаэробов: 14 – рода Bacteroides (32,5%), из которых наиболее часто встречался B. fragilis – 13 штаммов (30,2%); по 9 представителей Peptococcus spp. (20,9%) и Peptostreptococcus spp. (20,9%), 5 изолятов Prevotella spp. (11,7%), 4 изолята Fusobacterium spp. (9,3%). Недифференцированные неспорообразующие грамположительные анаэробные палочки (ННГАП) выделены в 3 случаях (6,9%). Аэробная и факультативно-анаэробная микрофлора характеризовалась высоким уровнем устойчивости к антибактериальным лекарственным средствам. На основании полученных результатов разработан протокол эмпирической антибактериальной терапии СДС. Выводы: 1. Ведущая роль в этиологической структуре микроорганизмов у пациентов с СДС принадлежит стафилококкам, энтеробактериям и синегнойной палочке. Среди облигатных анаэробов лидирующие позиции занимает B. fragilis. 2. Представители аэробной и факультативно-анаэробной микрофлоры характеризуются высоким уровнем устойчивости к антибактериальным лекарственным средствам. 3. Разработанный протокол эмпирической антибактериальной терапии СДС характеризуется высокой клинической эффективностью. Introduction. Diabetic foot syndrome (DFS), as one of the most important and frequent complications in the patients with diabetes mellitus (DM), is characterized by the development of purulent-necrotic changes in the soft tissues of the lower extremities, which increases the risk of disability of patients. To increase the effectiveness of infection control, local microflora monitoring is necessary in each hospital that treats DFS. Surgical treatment, the use of discharge dressings and correction of the glycemic profile are the most important directions in the relief of the infectious and inflammatory process in patients with DFS, however, they may be ineffective with inadequate antibacterial therapy. In this regard, the problem of rational use of antibiotics in the complex treatment of DFS remains relevant and requires further development. Purpose. To study the etiological structure and antibiotic resistance of microflora in the patients with DFS for the development of a protocol of rational empirical antibiotic therapy. Materials and methods. The study included 66 patients with DFS, who were hospitalized in the department of purulent surgery of the Mogilev Regional Clinical Hospital from 2020 to 2022. A complex of bacteriological studies was performed. Identification and determination of the sensitivity of microorganisms to antibiotics was carried out using test-systems on the Vitek 2 Compact biochemical analyzer (BioMerieux, France). Results. In the patients with DFS, 19 isolates (28.8%) of Staphylococcus spp., 18 isolates (27.2%) of Enterobacteriaceae, 8 isolates (12.1%) of P. aeruginosa, 5 isolates (7.5%) of А. baumannii, 5 isolates (7.5%) of Enterococcus spp. were isolated from the wounds. 43 representatives of obligate anaerobes were identified: 14 – of the genus of Bacteroides (32.5%), of which 13 strains of B. fragilis were most common (30.2%); 9 representatives of Peptococcus spp. (20.9%) and Peptostreptococcus spp. (20.9%), 5 isolates of Prevotella spp. (11.7%), 4 isolates of Fusobacterium spp. (9.3%). Undifferentiated non-spore-forming gram-positive anaerobic rods (UNGAP) were isolated in 3 cases (6.9%). The aerobic and facultative anaerobic microflora was characterized by a high level of resistance to antibacterial drugs. Based on the results obtained, a protocol for empirical antibacterial therapy of DFS has been developed. Conclusions: 1. The leading role in the etiological structure of microorganisms in the patients with DFS belongs isolates of Staphylococcus spp., Enterobacteriaceae and P. aeruginosa. Among obligate anaerobes, B. fragilis occupies a leading position. 2. Representatives of aerobic and facultative anaerobic microflora are characterized by a high level of resistance to antibacterial drugs. 3. The developed protocol of empirical antibacterial therapy of DFS is characterized by high clinical efficacy.
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Olunusi, Patience Abosede, and Motunrayo Risikat Asunmo. "Enhancing Reduced Risk of Obese Patient Exposure to COVID-19 Attack through Food and Nutritional Adjustment." International Journal of Home Economics, Hospitality and Allied Research 2, no. 2 (2023): 206–18. https://doi.org/10.57012/ijhhr.v2n2.016.
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<strong>Abstract: </strong>The COVID-19 pandemic is a major global challenge. There are several risk factors associated with mortality in patients with COVID-19, including age, gender, diabetes mellitus, cerebrovascular, cardiovascular, and pulmonary diseases. Among these factors, patients with cardiovascular disease, diabetes mellitus, and obesity have the highest mortality rates. This paper aims to review how adjusting food and nutrition can help reduce the risk of obese patients contracting COVID-19. Various literature sources were examined, including studies on the genetics of obesity and the consequences it can have, such as diabetes, heart and vascular diseases, cancer, trauma, and infection. Consequently, the role of nutrition in reducing the risk of obese patients being exposed to COVID-19 was described. It is recommended that obese patients strictly adhere to a diet that includes adequate and balanced food intake in order to reduce their risk of contracting COVID-19.
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Melicharova, Karolina, Marie Kusalova, Alena Smahelova, Radomir Hyspler, Dagmar Solichova, and Bohuslav Melichar. "Urinary Neopterin in Patients with Diabetes Mellitus and Foot Ulcers." Pteridines 18, no. 1 (2007): 128–31. http://dx.doi.org/10.1515/pteridines.2007.18.1.128.
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Abstract Increased urinary or serum concentrations of neopterin have been reported in disorders associated with systemic immune activation, e.g. viral infections, cancer, or autoimmune diseases, but the data on neopterin concentrations in patients with diabetes mellitus are limited. The aim of the present study was to investigate urinary neopterin concentrations in patients with diabetes mellitus and with or without diabetic foot. Urinary neopterin was determined by high-performance liquid chromatography in 51 patients with diabetes mellitus, including 19 patients with diabetic foot, and 18 healthy controls. Neopterin concentrations were significantly increased in patients with diabetes mellitus compared to controls (mean ± standard deviation; 221 ± 149 vs. 139 ± 66 μmol/mol creatinine; Mann-Whitney U test, p = 0.003). Urinary neopterin concentrations in patients with or without diabetic foot were identical (224 ± 113 vs. 219 ± 169 μmol/mol creatinine). No significant difference was also observed between patients with type 1 and type 2 diabetes mellitus, between patients treated with insulin compared to patients not treated with insulin, patients with or without diabetic retinopathy, with or without diabetic neuropathy, with or without diabetic nephropathy, with or without ischemic heart disease, with or without ischemic disease of lower extremities, and with or without ischemic cerebrovascular disease. Atrend of higher neopterin concentrations was observed in patients with any complication of diabetes compared to no complications (234 ± 164 vs. 176 ± 73 μmol/mol creatinine), and compared to controls, urinary neopterin was significantly increased only in patients with complications. No significant correlation was observed between urinary neopterin and glycosylated hemoglobin (rs = - 0.14, p = 0.39) or the duration of diabetes (rs = 0.25, p = 0.09). In conclusion, present results demonstrate that urinary neopterin is increased in patients with diabetes mellitus. No differences were observed in urinary neopterin concentrations based on type of diabetes, therapy or presence of diabetic foot, and urinary neopterin did not correlate with the glycosylated hemoglobin levels or duration of diabetes. Increased urinary neopterin concentrations in patients with diabetes mellitus is associated with the presence of complications and may reflect systemic immune activation associated with atherosclerosis.
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Gomaa, Ahmed Fathy, Reda M. Elghmary, Mahmoud A. Sharafeddin, Salem Youssef Mohamed, and Ayman Fathy Elsayed. "COVID-19 Infection and Diabetes." Infectious Diseases in Clinical Practice 31, no. 6 (2023): 1–6. http://dx.doi.org/10.1097/ipc.0000000000001295.
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Abstract Background Hyperglycemia is one of the most important independent risk factors that affect the prognosis and outcome of COVID-19 patients. Coronavirus disease 2019 infection is associated with poor glycemic control. This study's objectives were to determine the effect of hyperglycemia on the prognosis and outcome of COVID-19 patients and to detect whether COVID-19 infection can induce new-onset diabetes. Patients and Methods This cohort study was carried out on 240 hospitalized Egyptian COVID-19 patients, at Zagazig University Hospital isolation intensive care unit, between March 2020 and March 2021. They compared patients with diabetes and uncontrolled hyperglycemia against each other and COVID-19 patients without diabetes or uncontrolled hyperglycemia. Baseline demographic data, clinical features, and laboratory analysis were collected. Clinical outcome was evaluated via hospital stay and survival rate. Patients with uncontrolled hyperglycemia and nondiabetic patients were followed up 1 year after the hospital discharge to detect the development of new-onset diabetes. Result The diabetic group had the highest creatinine level, and the nondiabetic group had a minor C-reactive protein and D-dimer. The difference is significant between diabetic and nondiabetic groups concerning hospital stay. The nondiabetic group had the shortest hospital stay. There is a statistically substantial relationship between mortality and the glycosylated hemoglobin, serum creatinine, C-reactive protein, D-dimer, and serum ferritin. A total of 46.6% of survivors in the uncontrolled hyperglycemic group and 3.4% in the nondiabetic group developed diabetes mellitus during follow-up. There is a statistically significant relationship between new-onset diabetes mellitus and D-dimer. Conclusions Coronavirus disease 2019 can induce diabetes mellitus in vulnerable patients (presented with uncontrolled hyperglycemia at admission). In addition, COVID-19 patients with diabetes or uncontrolled hyperglycemia have worse outcomes and poor prognoses.
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Qona'ah, Arina, Anestasia Pangestu Mei Tyas, Andri Setiya Wahyudi, and Amellia Mardhika. "Diabetic foot exercise training for diabetes mellitus patients to control blood glucose during the COVID-19 pandemic." Abdimas: Jurnal Pengabdian Masyarakat Universitas Merdeka Malang 7, no. 4 (2022): 708–18. http://dx.doi.org/10.26905/abdimas.v7i4.7672.
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Physical activity restriction during the pandemic increases the risk of developing diabetic foot ulcers in patients with diabetes mellitus. Community service activities in the form of diabetic foot exercise training aim to increase knowledge and blood glucose control of diabetic mellitus patients' during the pandemic. The activities were carried out in the Tlogorejo and Madulegi villages in Sukodadi Primary Health Care for 60 patients with diabetes mellitus who are members of prolanis. Community service activities include health education about diabetes and foot care, foot exercise training and physical examination, and fasting blood glucose testing. Post-test results showed that 80% of the participants had good knowledge, 15% had sufficient knowledge, and 5% lacked knowledge. Most participants could do foot exercises, and the average fasting blood glucose level of the participants after being given counseling and training was 171.60 mg/dL. Foot exercise training can increase participants' knowledge and can be used as a way to control blood glucose during the COVID-19 pandemic.
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Patience Abosede, Olunusi, and Asunmo Motunrayo Risikat. "Enhancing Reduced Risk of Obese Patient Exposure to COVID-19 Attack through Food and Nutritional Adjustment." International Journal of Home Economics, Hospitality and Allied Research 2, no. 2 (2023): 206–18. http://dx.doi.org/10.57012/ijhhr.v2n2.016.
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The COVID-19 pandemic is a major global challenge. There are several risk factors associated with mortality in patients with COVID-19, including age, gender, diabetes mellitus, cerebrovascular, cardiovascular, and pulmonary diseases. Among these factors, patients with cardiovascular disease, diabetes mellitus, and obesity have the highest mortality rates. This paper aims to review how adjusting food and nutrition can help reduce the risk of obese patients contracting COVID-19. Various literature sources were examined, including studies on the genetics of obesity and the consequences it can have, such as diabetes, heart and vascular diseases, cancer, trauma, and infection. Consequently, the role of nutrition in reducing the risk of obese patients being exposed to COVID-19 was described. It is recommended that obese patients strictly adhere to a diet that includes adequate and balanced food intake in order to reduce their risk of contracting COVID-19.
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Kusuma, Victor Perdana, and Deasy Ardiany. "The Pathophysiology and Outcomes of Diabetic Patients with Coronavirus Disease 2019 (COVID-19)." Biomolecular and Health Science Journal 4, no. 2 (2021): 124. http://dx.doi.org/10.20473/bhsj.v4i2.30030.
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Introduction: Coronavirus Disease 2019 (COVID-19) is a respiratory tract infection caused by the SARS-CoV-2 virus, which was announced a pandemic by the World Health Organization (WHO) on March 11, 2020. On March 2, 2020, two confirmed cases of COVID-19 were initially reported in Indonesia. COVID-19 has been reported in 96.2 million people around the world. COVID-19 has already stolen the lives of almost 2 million individuals. Diabetes mellitus patients face an additional challenge with this disease (DM). Several studies have found a link between diabetes mellitus and COVID-19, as well as a bad prognosis for persons with DM and COVID-19. Aim of this study was to learn more about the link between diabetes and COVID-19, as well as the pathophysiology of diabetes.Methods: We searched for articles in PubMed and Google Scholar databases till February 2021, with the following keywords: “SARS-CoV-2”, “COVID-19”, “infection”, “pathogenesis”, “diabetes”Results: Diabetes Mellitus increased the severity and mortality of COVID-19 patients due to mechanisms involving inflammation and immune system activation, increased coagulation activity, oxidative stress, glucotoxicity, endoplasmic reticulum stress, renin-angiotensin-aldosterone system disorders, apoptotic mechanisms, mitochondrial dysfunction, and damage to pancreatic beta cells. COVID-19 infection can also lead to hyperglycemia and new-onset diabetes.Conlusion: Diabetes Mellitus is one of the comorbidities linked to a worse COVID-19 prognosis, according to the findings of this literature study. Furthermore, current research suggests that COVID-19 might cause hyperglycemia or new-onset diabetes, which has a poorer prognosis than COVID-19 patients with pre-existing diabetes.
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Ayachit, Kesharwani, Mandloi Sanjay, Kumar Gupta Diviyant, and Singh Rajput Prateek. "Study of the Association between Diabetes Mellitus and Clinical Outcomes in Patients with COVID-19 Infection." International Journal of Pharmaceutical and Clinical Research 16, no. 7 (2024): 679–82. https://doi.org/10.5281/zenodo.13119352.
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<strong>Background:</strong> The COVID-19 pandemic has profoundly impacted globally, with various comorbidities influencing patient outcomes. Diabetes mellitus has been identified as a significant risk factor for adverse outcomes in COVID-19 patients. This study aims to evaluate the association between diabetes mellitus and clinical outcomes in patients with COVID-19. <strong>Aim and Objectives:</strong> To determine the impact of diabetes mellitus on the severity of COVID-19, hospitalisation rates, ICU admission, need for mechanical ventilation, and mortality. <strong>Materials and Methods:</strong> This retrospective cohort study analyzed medical records of 500 COVID-19 patients admitted to a tertiary care hospital between January 2022 and December 2023. Patients were categorized into two groups: those with diabetes mellitus (n=200) and those without (n=300). Demographic data, clinical characteristics, and outcomes were compared between the two groups. Statistical analysis was conducted using chi-square tests for categorical variables and t-tests for continuous variables, with a significance level set at p<0.05. <strong>Results:</strong> Diabetic patients had significantly higher rates of severe and critical COVID-19 compared to non-diabetic patients (p<0.001). The hospitalization rate was higher in the diabetic group (85%) compared to the non-diabetic group (60%) (p<0.01). ICU admission rates were 40% in diabetic patients versus 25% in non-diabetic patients (p=0.02). The need for mechanical ventilation was also higher in diabetic patients (30%) compared to non-diabetic patients (15%) (p=0.03). Mortality rates were significantly higher in diabetic patients (20%) compared to non-diabetic patients (10%) (p=0.04). <strong>Conclusions:</strong> Diabetes mellitus is associated with worse clinical outcomes in COVID-19 patients, including increased severity of disease, higher rates of hospitalization, ICU admission, need for mechanical ventilation, and mortality. These findings underscore the importance of rigorous management of diabetic patients with COVID-19 to improve clinical outcomes.
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Mishra, Reshmi, Jyoti Ranjan Behera, P. Ramkumar, and Mukesh Kumar Jain. "COVID-19 Infection with Refractory Diabetic Ketoacidosis- A case Report." Journal of Medical Research 7, no. 2 (2021): 54–56. http://dx.doi.org/10.31254/jmr.2021.7206.
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Diabetic ketoacidosis is an acute life-threatening complication of type 1 diabetes. Sometimes it is the first presentation in an undiagnosed child. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) and diabetes mellitus are very much interrelated as diabetes mellitus is associated with an increased risk of severe COVID19 at the same time, many cases of new-onset diabetes had been diagnosed. Hyperglycemia, metabolic acidosis, and ketonemia are classical presentations. It is essential to correct the acidosis and fluid correction and insulin therapy in these patients, leading to vital organ dysfunction. In refractory metabolic acidosis, renal replacement therapy may help
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Bhattacharyya, Kumkum. "WHY MUCORMYCOSIS(BLACK FUNGUS) CAN NOT BE DECLARED AS EPIDEMIC IN INDIA." International Journal of Advanced Research 9, no. 5 (2021): 860–63. http://dx.doi.org/10.21474/ijar01/12914.
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While the whole world is under attack of a second wave and of a more severe potent mutant form of SARS CoV-2 virus causing SEVERE COVID 19 PNEUMONIA pandemic ,a new disease is on the verge of getting declared as an epidemic named MUCORMYCOSIS OR BLACK FUNGUS (in common term). MUCORMYCOSIS is an umbrella term used for an opportunistic infection caused by several fungi belong to GLOMEROMYCOTAFAMILY(mucor, zygomucor,lichtheimia,syncephalastrumetc) these saprophytic fungi can be found in soil,food damped walled in the environment which were actually considered as an non pathogenic organism to human. In current days it has become an emerging disease in the world especially in india. Now the COVID ASSOCIATED MUCORMYCOSIS has raised a severe threat and fear in india during these second wave of CORONAVIRUS INFECTION.Due to irrational use of the drug PREDNISOLON OR DEXAMETHSONE(which basically belong to steroid group of drugs) for the management of COVID 19 AQUIRED PNEUMONIAMOR,ESPECIALLY FOR THOSE WHO ARE ON HIGH O2 REQUIREMENT has raise 2 issuesone is improper glycemic control,second is severe immunosupressant stage HERE IS A CASE REPORT THAT CAN PROVE THAT CASES OF MUCORMYCOSIS WERE INEVIDENTLY PRESENT IN INDIA EVEN BEFORE THIS PANDEMIC STARTED. A 40 years old male,a cotton mill worker ,was admitted in the emergency observation ward OF IPGME&R AND SSKM HOSPITAL,KOLKATA AROUND THE MONTH OF OCTOBER IN 2018 with random blood glucose level(RBS) 702 gm/dl along with a history of necrotic oral ulcer over the hard pallete extending posteriorly along with left sided nasal blockage with complaint of difficulty to eat and swallow both liquid and solid and rhinolalia since 45 days. There was no history of fever,cough,haemoptysis,no history of trauma to the affected site or tuberculosis. At this point with a high RBS and elevated urea creatinin level patient was diagnosed to be in diabetic ketoacidosis and he was managed with iv. Insuline and hence forth his blood glucose level was kept under control with insulin therapy. While taking the history it came into our notice that the patient is a known case of type 2 diabetes mellitus and CKD-STAGE V due to IgA Nephropathy for which he was receiving Prednisolon which he suddenly discontinued 15 days before admission and he also underwent haemodialysis twice. On local examination he had a necrotic ulcer over the hard palate and necrotic debris in the nasal cavity(as evident in the nasal endoscopy).CT —nose+PNS showed left sided maxi antrum opacity suggestive of pansinusitis . All broad spectrum antibiotics along with iv voriconazol was started as the patient was immune compromised. After 2 days of his admission though his diabetes was under control patient suddenly showed orbital involvement and visual impairement on the left eye.A repeat CT showed progression of the sinusoidal opacity toward the retro orbital space and a bulky oedematous left inferior rectus due to inflammation and then he was refered to microbiology department with a suspection of mucormicosis?.scrapping material was collected from the oral ulceration site and KOH mount was done ? broad aseptate hyphae with acute angle branching? Suggestive of mucormicosis and culture was done in SDA and SDCA media. Culture growth revealed abundant, erected mycelium(around 0.5cm tall) .the surface colour of the colony was at first white to yellow,after a few days the centre tured black?.Lactophenol cotton blue(LPCB) stain from the growth showed wide ribbon like aseptate hyphae with sporangiophores terminated in swollen vesicles with radial merosporangiae with spores A confirmed diagnosis of Rhino orbital zygomycosis due to Syncephalastrum racemosum was made. The patient was put on intensive short acting insulin to achieve optimum glycemic control.As there was high risk of vascular invasion of mucormicosis(which is the most common mode of pathogenecity of these group of fungi) leading to sudden stroke following ischemia a surgical debridement was done and infected tissue was removed. He was put on intravenous liposomal Amphotricine B 300mg daily OD and later shifted to take voriconazole 200 BD.the patient got discharged in favourable condition. Now literature shows Fluconazole, voriconazole, and itraconazole do not have reliable activity against mucormycosis.DRUGS OF CHOICE should be Liposomal amphotericin, Amphotericin B lipid complex, Posaconazole, Echinocandins, Deferasirox. In recent senario during the pandemic many COVID 19 positive patients are getting advices from tele medicine or vedio consultation or many patients are self medicating themseleves learning from various social media in india.Now the taking drugs like prednisolon with out proper monitoring and sudden discontinuation the drug once the patient is feeling better is giving rise to stage of absolute lack of circulating neutrophils causing either pulmonary ,or rhinocerebral or rhino orbital mucormycosis in those patients even after recovering from COVID 19 INFECTION.The HRCT CHEST of those patients with pulmonary mucormycosis is very difficult to differentiate from the ground glass opacity formed in the lungs caused by COVID 19 PNEUMONIA So unsupervised intake of steroids or prolonged use of steroids along with improper use of antifungals are causing the rise of the this opportunistic infection in india which is increasing rate of fatality.
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Kreutzenberg, Saula Vigili de. "Long COVID-19 and diabetes mellitus: a short review." Metabolism and Target Organ Damage 3, no. 1 (2023): 4. http://dx.doi.org/10.20517/mtod.2022.30.
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The persistence of Covid-19 infection for more than four weeks after the acute phase is defined as the long Covid-19 syndrome. This condition, otherwise defined by the persistence of signs and symptoms for more than 12 weeks, shares several features with diabetes mellitus: diabetes mellitus and Covid-19 infections have a pandemic dimension, are characterized by an inflammatory milieu, and show a bidirectional relationship. Diabetic patients appear more likely to develop long Covid-19 syndrome than non-diabetic individuals. The chronicity of Covid-19 favors the development of new cases of diabetes. In this short review, we discuss the evidence supporting the link between Covid-19 and diabetes mellitus, focusing on the epidemiological and pathophysiological aspects of this dangerous relationship.
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Suyanto, Suyanto, and Sri Lestari Dwi Astuti. "Developing integrated care: Treating foot wounds in people with diabetes mellitus exposed by Covid-19." Malahayati International Journal of Nursing and Health Science 6, no. 1 (2023): 1–8. http://dx.doi.org/10.33024/minh.v6i1.9044.
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Background: Diabetes mellitus is a chronic disease that affects many people around the world. WHO predicts the prevalence in 2030 will increase to 61 percent and it is estimated that 70 percent will become a pandemic in developing countries including Indonesia. Various complications require long-term care and require regular monitoring. One of the complications that is often experienced is diabetic foot ulcers which have increased in cases during the Covid-19 pandemic so that they require optimal service.Purpose: Developing a nursing service model for type 2 diabetes mellitus (DM) patients, especially the treatment of diabetic foot wounds associated with the covid-19 pandemic.Method: Research design using quasi-experiment with a plan pre and post-test without control group design, namely comparing the condition of the wound, the effectiveness of the length of time for healing based on the frequency of wound care between 26 respondents who were exposed to covid-19 and 34 respondents who were not exposed. Data analysis used the chi-square test.Results: There is a difference in healing based on the frequency of treating diabetic foot wounds between those exposed to covid-19 and not exposed to obtain a p-value of 0.013 <0.05. There is a difference in healing based on the frequency of treating diabetic foot wounds in patients exposed to covid-19 between those who have arterial injuries and those who do not have arterial injuries, obtaining a p-value of 0.049 <0.05. Then there are differences in the condition of leg injuries before and after being treated in patients who are not exposed to covid-19, obtaining a p-value of 0.00 <0.05. Whereas in patients exposed to covid-19, there was no difference with a p-value of 0.160 > 0.05.Conclusion: All hypotheses proposed except for the hypothesis that there is a difference in the condition of the wound between those exposed to covid-19 and those who were not exposed before and after being given treatment.Suggestion: In providing wound care to diabetic patients, it should be started by reviewing their history of having been exposed to covid-19. Furthermore, an assessment is made of whether the patient has an arterial wound so that the wound care that will be given is more appropriate and effective.
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Suardi, Suardi, Patmawati Patmawati, Wirda Wirda, Ernawati Ernawati, and Dewiyanti Dewiyanti. "Relationship Between Family Support and Foot Care in Diabetes Mellitus Type 2 Patients During Covid-19 Pandemic." International Journal of Nursing and Health Services (IJNHS) 6, no. 5 (2023): 330–37. http://dx.doi.org/10.35654/ijnhs.v6i5.719.
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Background: Diabetes Mellitus (DM) is one of the dangerous factors to expand the seriousness of the COVID-19 disease. Older diabetes patients (>60 years), uncontrolled glucose levels, and the presence of diabetic complications were associated with worse COVID-19 suspicion. Aim: The purpose of the study was to determine the relationship between family support and foot care in Type 2 Diabetes Mellitus Patients during the Covid-19 Pandemic in Takalar Regency. Method: The method used is an analytical survey research with a Cross Sectional approach. The sampling technique is Accedential Sampling. The research location is in the Work Area of ??the Bulukunyi Health Center, Takalar Regency with a total sample of 49. The data analysis used the Chis-quare test. Results: The results showed that the value of 0.001 (0.05) this indicates that Ha is accepted and H0 is rejected. Conclusion: There is a relationship between family support and foot care in type 2 diabetes mellitus patients during the Covid-19 pandemic in Takalar Regency. For clinical practitioners, it is necessary to improve foot care in DM patients to prevent further complications through family support, and further research needs to be carried out by looking at HbA1C
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Sharma, Aditi, Rukmini M. S., Poornima A. Manjrekar, Neelam M. Pawar, and Sowndarya K. "D-dimer level and inflammatory markers in COVID-19 patients with and without diabetes mellitus - A comparative study during the first wave of the pandemic." Biomedicine 43, no. 6 (2024): 1759–64. http://dx.doi.org/10.51248/.v43i6.3665.
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Introduction and Aim: High prevalence of diabetes mellitus makes it crucial to understand the distinctive inflammatory features of COVID-19 infection. Hyperglycemia and diabetes mellitus are independent prognosticators for mortality and morbidity in SARS-CoV-2 infection. This study compares D-dimer and inflammatory markers in COVID-19 patients with and without T2DM during the first wave of the pandemic. Materials and Methods: A retrospective study was conducted at a tertiary care hospital. D-dimer, IL-6, Ferritin, CRP and LDH levels in COVID-19 patients with and without T2DM were compared. D-dimer values were correlated with the IL-6, Ferritin, CRP, LDH and checked for statistical evidence. HbA1c levels were assessed for association of the severity of COVID-19 infection. Results: Serum levels of inflammatory biomarkers of 205 COVID-19 patients were compared in which 106 had T2DM and 99 were non- diabetic. Ferritin and LDH showed statistically significant elevation in diabetic COVID-19 patients. D-dimer showed positive correlation with all the inflammatory markers both in diabetic and non-diabetic COVID-19 patients. HbA1c showed statistically significant positive correlation only with Ferritin in COVID-19 patients with T2DM. Conclusion: Ferritin was significantly associated with severity of diabetes as indicated by correlation to HbA1c. D-dimer, Ferritin, IL-6 and LDH levels were significant in COVID 19 patients having diabetes and those without.
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Koneru, Gopala, Hager H. Sayed, Nayera A. Abd-elhamed, et al. "COVID-19 and Diabetes Mellitus: A Complex Interplay." Journal of Pure and Applied Microbiology 15, no. 2 (2021): 512–23. http://dx.doi.org/10.22207/jpam.15.2.16.
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COVID-19 pandemic, which caused by the newly emerged severe acute respiratory syndrome coronavirus-2 (SARS- CoV-2), puts the entire world in an unprecedented crisis, leaving behind huge human losses and serious socio-economical damages. The clinical spectrum of COVID-19 varies from asymptomatic to multi-organ manifestations. Diabetes mellitus (DM) is a chronic inflammatory condition, which associated with metabolic and vascular abnormalities, increases the risk for SARS-CoV-2 infection, severity and mortality. Due to global prevalence, DM effect on COVID-19 outcomes as well as the potential mechanisms by which DM modulates the host-viral interactions and host-immune responses are discussed in this review. This review also highlights the effects of anti-diabetic drugs on treatment of SARS-CoV-2 infection and vice versa.
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Memon, Ali Raza, Muhammad Akram, Farheen Shaikh, Muhammad Zohaib Shaikh, Rizwan Ahmed Memon, and Fazeela Rizwan. "Diabetic COVID -19 Patients are prone to Respiratory Distress Syndrome as compared to Non-Diabetic COVID -19 Patients." Pakistan Journal of Medical and Health Sciences 15, no. 12 (2021): 3271–72. http://dx.doi.org/10.53350/pjmhs2115123271.
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Background: COVID-19 is the alarming problem for all over the world due to its fast spread infection mode and uncertainty in mortality rate. The diabetic population is prone for comorbidity with COVID-19 due to injurious fashion develops in respiratory system. Aim: To compare the serum Lactate dehydrogenase levels in diabetic patients with COVID-19 & non diabetic patients with COVID-19. Methodology: This comparative study was done at Ali medical center Hala New District Matiari Sindh. 42 diabetic & non diabetic clinically suspected cases COVID -19 with fever, cough, shortness of breath, non-pneumonic opacities on digital X.ray with raised TLC, ESR & CRP. The data analyzed for significance on SPSS 19 by applying student t test. Results: The serum LDH levels was significantly raised (p<0.001) in group A contained COVID-19 patients with diabetes as compared to COVID-19 patients with no diabetes mellitus. Conclusion: COVID -19 diabetic population will be more prone to develop the respiratory complications. Keywords: COVID-19, Serum LDH, Diabetes Mellitus, Respiratory Distress Syndrome.
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Hayat, Amir, Sohail Siddique, and Syed Rehan Shamim. "COVID-19 infection-induced type one Diabetes Mellitus and Diabetic Ketoacidosis." Journal of Rawalpindi Medical College 25, no. 1 (2021): 154–56. http://dx.doi.org/10.37939/jrmc.v25i1.1516.
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A 63 year old female patient presented with one week history of reduced appetite, weakness, nausea, polyuria and occasional vomiting on a back ground of recurrent urinary tract infection and hypothyroidism. She appeared lethargic and dehydrated. The arterial blood gas showed a picture of diabetic ketoacidosis (DKA) which was treated according to the protocol. Viral polymerase chain reaction (PCR) for COVID-19 was positive. The diagnosis of new onset type one diabetes made on the basis of specific antibodies test. Computerized Tomography (CT) of abdomen excluded pancreatic cancer as a cause of new onset diabetes. Hence, the patient was labelled as type one diabetes mellitus induced by COVID-19 virus. She was treated accordingly and sent home on insulin. Follow-up appointment was arranged in the diabetes center of the hospital.
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Halushko, Oleksandr A., Maryna A. Trishchynska, Tetiana M. Povietkina, and Mariana V. Boliuk. "DIABETES MELLITUS IN COVID-19 PATIENTS: VERDICT OR NOT?" Wiadomości Lekarskie 73, no. 12 (2020): 2672–76. http://dx.doi.org/10.36740/wlek202012121.
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The aim: To investigate the causes of the negative impact of diabetes mellitus co-morbidity on the onset and development of COVID-19 in diabetic patients. Materials and methods: Electronic databases of MEDLINE and Google Scholar were searched using keyword searches. Conclusions: 1. Diabetes mellitus is not a verdict. Diabetic patients can have COVID-19 with the same frequency as other people. And diabetes mellitus co-morbidity does not increase the probability of development COVID-19. 2. Previous diabetes can contribute the complications of COVID-19, patient’s severe condition and can increase the mortality. 3. The reasons for the negative results of COVID 19 treatment in patients with diabetes may be: features of autonomic innervation in patients with diabetes, impaired function of pancreatic islet cells due to the influence of SARS-CoV-2, use of some cardiac drugs, expression of inflammatory factors due to infection.
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Milyutkina, S. O. "Eye lesions in type 2 diabetes mellitus patients after pneumonia caused by the new coronavirus infection COVID-19." POINT OF VIEW. EAST – WEST, no. 3 (November 7, 2022): 33–37. http://dx.doi.org/10.25276/2410-1257-2022-3-33-37.
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Purpose. Аnalysis of eye lesions in type 2 diabetes mellitus patients after pneumonia caused by the new coronavirus infection (COVID-19) in the Voronezh Regional Diabetes Center during 6 months. Material and methods. 70 patients with type 2 diabetes mellitus (140 eyes): group 1 (n = 35, 70 eyes): patients after pneumonia of 1–3 degrees of severity caused by COVID-19; group 2 (n = 35, 70 eyes): patients with diabetes mellitus without a pneumonia. All patients underwent a standard ophthalmological examination and Norn's test. The 1st examination in group 1 was carried out 1–2 months before COVID-19, the 2nd examination was 6 months after discharge from the hospital, the patients of group 2 were delayed with an interval of 6 months. Results. 45.7 % of patients in group 1 showed progression of presbyopia which required replacement of glasses versus 25.7 % in group 2. Signs of dry eye syndrome were found in 25.7 % of patients in group 1 and in 11.4 % of patients in group 2. The number of cases of dry eye syndrome increased after treatment with COVID-19 from 11.4 % (8 eyes) to 25.7 % (18 eyes) in group 1, 55.5 % of them (10 eyes) had symptoms of conjunctivitis during the manifestation COVID-19. The progression of the stage of diabetic retinopathy in patients of group 2 was observed in 2.9 % of patients and was absent in group 1. Conclusion. Diabetes mellitus patients after the new coronavirus infection (COVID-19) show the progression of presbyopia and signs of dry eye syndrome 2 times more often. There was no case of onset or progression of diabetic retinopathy after COVID-19. Keywords: diabetes mellitus, diabetic retinopathy, dry eye syndrome, presbyopia, new coronavirus infection
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Sapkota, P., S. Chalise, and P. Shrestha. "Clinical Dilemma of Diabetic Ketoacidosis and COVID-19 Infection." Kathmandu University Medical Journal 19, no. 4 (2021): 525–27. http://dx.doi.org/10.3126/kumj.v19i4.49791.
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The COVID-19 Pneumonia with diabetic ketoacidosis is a dreadful health condition. Diabetic ketoacidosis is one of the severe metabolic complications and it can be precipitated by infection. We presented a case of 48 years female with no known comorbidities who presented with COVID-19 symptoms and with Diabetic Ketoacidosis. The case presented with elevated inflammatory markers, high anion gap metabolic acidosis with type I respiratory failure. During admission, the oxygen saturation had marked drop, later her improvement was steady followed by gradual tapering of the oxygenation. Marked improvement was noticed in the subsequent follow-up. COVID-19 infection can be precipitated by preexisting diabetes or newly diagnosed diabetes and the severity of COVID-19 infection is more pronounced in patients with diabetes mellitus, thus should be managed timely and accordingly. The scarce studies among the COVID-19 cases with diabetic ketoacidosis reflect the need for further studies for the availability of a wider range of information.
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da Silva, Pedro Henrique Abreu, Andressa Santos Garcia, Fábio Aguiar Alves, André Luis Souza dos Santos, and Cátia Lacerda Sodré. "COVID-19 and Diabetes Mellitus: Potential Metabolic Associations." Current Topics in Medicinal Chemistry 21, no. 11 (2021): 929–36. http://dx.doi.org/10.2174/1568026621666210612025938.
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The COVID-19 pandemic turned the SARS-CoV-2 into the main target of scientific research all around the world. Many advances have already been made, but there is still a long way to go to solve the molecular mechanisms related to the process of the SARS-CoV-2 infection, as well as the particularities of the disease, its course and the complex host-pathogen relationships. However, a lot has been theorized and associated with COVID-19, like the worst prognosis of the disease among individuals with some comorbidities, like diabetes mellitus. In this perspective, diabetic patients are repeatedly associated with more severe cases of COVID-19 when compared to non-diabetic patients. Even though ACE2 (angiotensin-converting enzyme 2) was recognized as the host cell receptor for both binding and entering of SARS-CoV-2 particles, it was also pointed out that this enzyme plays an important protective role against pulmonary damage. Therefore, paradoxically as it may seem, the low baseline level of this receptor in diabetics is directly linked to a more expressive loss of ACE2 protective effect, which could be one of the possible factors for the worst prognosis of COVID-19. Still, COVID-19 may also have a diabetogenic effect. From this point of view, the main topics that will be highlighted are (i) the mechanism of the viral entry, with special attention to the cellular receptor (ACE2) and the viral binding protein (spike), (ii) the relationship among the renin-angiotensin system, the infection process and the patients' prognosis, (iii) the glucose control and the medicines used in this event, and (iv) a brief analysis on diabetes triggered by COVID-19.
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Xhardo, E., P. Kapisyzi, and A. Rada. "Diabetic ketoacidosis precipitated by COVID-19 in patient with newly diagnosed diabetes mellitus." INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) 17, no. 5 (2022): 422–25. http://dx.doi.org/10.22141/2224-0721.17.5.2021.241521.
Full textAbstract:
Background. Coronavirus disease 2019 (COVID-19) is a viral infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes mellitus (DM) have been reported frequently in patients with the new corona virus disease — 2019, COVID-19. It has been associated with progressive course and worse outcome. There is scarce data on diabetic ketoacidosis (DKA) in COVID-19 infection. There has been several cases reported on COVID-19 infection precipitating a new diagnosis of type 2 DM (T2DM). However, there is a lack of evidence regarding type 1 DM (T1DM). We report a case of DKA precipitated by COVID-19 in a patient with newly diagnosed T1DM. Recently, case reports and small cross-sectional studies described diabetic patients who develop DKA when infected with COVID-19. The incidence of DKA has been found to be high in patients with T1DM and T2DM admitted to hospital with COVID-19. Case presentation. We present a 29 year-old, previously healthy man with 5 days history of fever, fatigue, vomiting, polydipsia and polyuria. His lab results showed high blood glucose, high anion gap metabolic acidosis and ketonuria diagnostic of DKA. He also tested positive for COVID-19 and his Chest CT was consistent with bilateral COVID 19 pneumonia (ground-glass opacity, consolidation, and crazy-paving pattern). He was successfully managed with intravenous fluids and insulin as per DKA protocol. He required intravenous antibiotics, steroids and oxygenotherapy for COVID-19 pneumonia. He was discharged after 14 days in stable condition. Conclusions. COVID-19 infection can be complicated by DKA and development of DM in previously non-diabetic individuals. It is possible that SARS-CoV-2 may aggravate pancreatic beta cell function and precipitate DKA. Very few cases have been reported in the literature on COVID-19 infection precipitating DKA in a newly diagnosed patient of type 1 diabetes mellitus.
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ULLAH, T., J. SHEHZAD, A. AHMAD, et al. "PREVALENCE OF MORTALITY IN SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 WITH DIABETES MELLITUS." Biological and Clinical Sciences Research Journal 2024, no. 1 (2024): 688. http://dx.doi.org/10.54112/bcsrj.v2024i1.688.
Full textAbstract:
The coexistence of Diabetes Mellitus (DM) and COVID-19 has garnered considerable attention due to the elevated prevalence of DM among COVID-19 patients. Understanding the impact of DM on the severity of COVID-19 infections is imperative for effective treatment, given the challenges it poses across various healthcare systems. This study aimed to assess the frequency of Type II Diabetes Mellitus among symptomatic COVID-19-positive individuals and calculate the mortality rate among those diagnosed with Type II Diabetes Mellitus contracting COVID-19. Utilizing a cross-sectional approach, 142 samples were randomly selected for analysis to determine the prevalence of Diabetes Mellitus among individuals diagnosed with COVID-19. The findings revealed that out of the 142 COVID-19-positive individuals tested via RT-PCR, 66.2% were diabetic, while 33.8% were non-diabetic. Among the entire sample, 31% of patients succumbed to the infection, while 69.0% achieved full recovery. Specifically, within the diabetic group, 81.8% experienced mortality, with 59.2% recovering fully, whereas among the non-diabetic group, 18.2% passed away, and 40.8% recovered fully. The highest mortality rate was observed among individuals aged 60-74, comprising 45.1% of the total population under observation. The study underscores the elevated mortality risk associated with COVID-19 among diabetic individuals, with a mortality rate of 25.35%, significantly higher than the 5.63% mortality rate observed among non-diabetic individuals. Notably, the vulnerability to COVID-19 and increased mortality rates were particularly pronounced among individuals aged 45-74, with a notable emphasis on the heightened risk among those aged 60-74. Furthermore, the study found no significant disparity in mortality rates between male and female patients. These findings shed light on the heightened susceptibility of diabetic individuals to severe outcomes of COVID-19 and underscore the importance of targeted interventions and preventive measures, especially among the elderly diabetic population.
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Anjum, Shaheen, Noreen Rashid, Amjad Bari, Atif Zulfiqar, Mazhar Rasool, and Shabana Asif. "Fungal osteomylitus in diabetic patients and COVID-19." Journal of Fatima Jinnah Medical University 16, no. 1 (2022): 16–19. http://dx.doi.org/10.37018/cclw6277.
Full textAbstract:
Background: COVID-19 pandemic has become a big medical problem worldwide. In this era, COVID-19 patients’ along with diabetes mellitus are at an increased risk of developing opportunistic infections. This study demonstrate association of COVID-19 infection in patients having uncontrolled diabetes with the fungal osteomyelitis.
 Subjects and methods: This prospective cross-sectional study was done at a Nishter Institute of Dentistry, Multan. Patients diagnosed with fungal osteomyelitis of jaw bones presented during April to December 2021 were included in this study. Data was collected from the patients regarding history of the disease, clinical diagnosis, imaging findings by plain radiographs and CT scans, histopathology. Association of disease process with diabetes and COVID-19 was analyzed in SPSS.
 Results: Between the period April 2021 to December 2021, 23 cases presented in Nishter Institute of Dentistry Multan with fungal osteomylitus were diagnosed clinically and fungal organism was identified by immunohistochemical studies by PAS and GMA stains. 22/23 (95.6%) patients were with uncontrolled diabetes mellitus and 18/23(78.2%) gave the history of Covid 19 infection 2 to 3 months before with moderate to severe symptoms.11/23 (47.8%) gave the history of treatment with systemic steroid. Age range was 38-72 years of age with mean age 53.26. 12/23(52.1%) were males and 11/23 (47.8%) were females. 17/23 (73.9%) patients presented with pain in jaws with exposed bone and 6/23(23%) complained of pain and loose teeth in arch. In 22/23 (95.6%) involved jaw was maxilla. In one patient associated medical condition was hepatitis C virus infection also with diabetes. 2 patients were cardiac and 3 were hypertensive along with diabetes. One patient was previously treated with radiotherapy of mandible due to alveolar cancer. Only one (0.04%) patient was non diabetic.
 Conclusion: There is increased incidence of fungal osteomyelitis of jaws mostly maxilla in diabetic and COVID-19 infected patients.
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Mahardhika, Gembong Satria, Azizah Fitriana Nurul Ilmi, Pugud Samodro, and Dhadhang Wahyu Kurniawan. "Type 1 Diabetes Mellitus Due to COVID-19: Do We Need to Worry?" Keluwih: Jurnal Kesehatan dan Kedokteran 3, no. 2 (2022): 126–33. http://dx.doi.org/10.24123/kesdok.v3i2.4931.
Full textAbstract:
Abstract—SARS-CoV-2, a Coronaviridae virus related to angiotensin-converting enzyme 2 (ACE2), is the virus that causes the COVID-19 pandemic. Diabetes mellitus is a condition that is reported to have a connection with the emergence of COVID-19. A diabetic patient has a higher risk of infection compared to other nondiabetic patients. In addition, some reports showed the possibility of infection that can stimulate diabetes in an individual without a hyperglycemia history. COVID-19 was also found to show a hyperglycemic conditions that may affect mortality. Therefore, a proper monitoring as well as management of glucose level is needed for COVID-19 patients regardless of their diabetes status, to minimize the risk of mortality and development of diabetes. The possibility of diabetes mellitus induced by COVID-19 infection is investigated in this paper, as well as the monitoring of COVID-19 patients with hyperglycemic conditions. Further investigation might be needed to confirm the relationship between COVID-19 and diabetes mellitus type 1.
 Keywords: diabetes mellitus type 1, sars-cov-2, insulin
 Abstrak—SARS-CoV-2, virus Coronaviridae yang berkaitan dengan enzim pengubah angiotensin 2 (ACE2), adalah virus yang menyebabkan pandemi COVID-19. Diabetes mellitus adalah suatu kondisi yang diyakini memiliki hubungan dengan adanya COVID-19. Pasien dengan diabetes memiliki risiko infeksi yang tinggi dibandingkan dengan pasien nondiabetes lainnya. Meskipun demikian, beberapa laporan menunjukkan kemungkinan infeksi yang dapat merangsang diabetes pada individu tanpa riwayat hiperglikemia sebelumnya. COVID-19 juga ditemukan menunjukkan kondisi hiperglikemik yang dapat menyebabkan angka kematian yang cukup signifikan. Oleh karena itu, diperlukan pemantauan serta pengelolaan kadar glukosa yang tepat untuk pasien COVID-19. Kemungkinan diabetes mellitus yang disebabkan oleh infeksi COVID-19 akan diselidiki dalam makalah ini, serta pemantauan pasien COVID-19 dengan kondisi hiperglikemik. Penelitian lebih lanjut mungkin diperlukan untuk mengetahui hubungan antara COVID-19 dan diabetes melitus tipe 1.
 Kata Kunci: diabetes mellitus tipe 1, sars-cov-2, insulin
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Prosperi, Sara, and Francesco Chiarelli. "COVID-19 and diabetes in children." Annals of Pediatric Endocrinology & Metabolism 27, no. 3 (2022): 157–68. http://dx.doi.org/10.6065/apem.2244150.075.
Full textAbstract:
This review describes the impact of coronavirus disease 2019 (COVID-19) in children and adolescents, investigating changes in diabetes presentation during the COVID-19 pandemic, possible links between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and diabetes, and mechanisms of pancreatic β-cell destruction. Although glycemic control in individuals with already known diabetes mellitus did not worsen during the pandemic, there was a worrying increase in diabetic ketoacidosis in children with new-onset diabetes, probably due to containment measures and delayed access to emergency departments. Moreover, new evidence suggests that SARS-CoV-2 has the capacity to directly and indirectly induce pancreatic β-cell destruction, and the risk of newly diagnosed diabetes after COVID-19 increased in both children and adults. While long-term studies continue to follow children with SARS-CoV-2 infection, this review discusses available findings on the relationship between COVID-19 and diabetes. It is important to emphasize the need to maintain close links between families of children with chronic conditions and their pediatricians, as well as to promote early access to healthcare services, in order to reduce dangerous delays in diabetes diagnosis and prevent diabetic ketoacidosis.
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Mirzayeva, G.P. Jabbarov O.O. Maksudova M.X. Saydaliev R.S. Xodjanova Sh.I. Jumanazarov S.B. Buvamuhamedova N.T. "CLINICAL AND FUNCTIONAL STATUS OF THE CARDIOVASCULAR SYSTEM IN DIABETIC PATIENTS WITH COVID-19." EURASIAN JOURNAL OF ACADEMIC RESEARCH 3, no. 3 (2023): 105–8. https://doi.org/10.5281/zenodo.7701084.
Full textAbstract:
In December 2019, the first cases of a new coronavirus infection, later declared a pandemic, were reported. COVID-19 has been found to be much more severe in patients with diabetes mellitus. Diabetes mellitus and hypertension are known to be much more common together. That is why the potentially dangerous combination of a new infectious disease and diabetes mellitus has become an important problem in cardiology.