Diabetes care
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To review the effectiveness of diuretic or beta-blocker-based treatment of hypertension in diabetic patients. ⋯ These results show that hypertensive diabetic patients benefit from first-line treatment with diuretics. No conclusion can be drawn for beta-blockers, owing to the small sample size.
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To test quantitative sensation testing (QST) patterns of hypoesthesia and hyperalgesia as indicators of diabetic polyneuropathy (DPN) and its severity ⋯ 1) Decreased vibratory sensation (hypoesthesia) appears to be characteristic of mild DPN, whereas panmodality hypoesthesia is characteristic of severe DPN. 2) A shift of vibratory and cold detection thresholds (and also of attributes of nerve conduction and a measure of autonomic dysfunction) from low-normal (2.5th-50th percentiles) to high-normal (50th-97.5th percentiles) appears to precede overt expression of DPN and to thereby provide evidence of subclinical abnormality 3) Heat stimulus-induced hyperesthesia (low thresholds) occurs especially in mild DPN, and, because it correlates with DPN symptoms and impairments, it must be attributed to hyperalgesia rather than to supersensitivity Therefore, hypoalgesia or hyperalgesia may be an indicator of early DPN.
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Comparative Study
Evaluation of an electrochemical sensor for measuring blood ketones.
To evaluate the performance of a hand-held ketone sensor that is able to measure blood beta-hydroxybutyrate (beta-HBA) concentrations within 30 s in patients with diabetic ketoacidosis (DKA) and patients who attend a weight management clinic. ⋯ This ketone sensor accurately measures whole blood beta-HBA concentrations within 30 s.
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Type 2 diabetes is a progressive disease with a significant risk for developing late complications. This article presents evidence related to the effect of glycemic control on the outcome of daily symptoms, microvascular complications, and macrovascular complications. Literature limited to Medline and the Cochrane Library was searched primarily for randomized clinical trials. ⋯ Insulin treatment has been shown to be effective in achieving satisfactory glycemic control over several years. There is also a positive effect on hard end points such as microvascular disease in the eye, kidney, and nerves. In conclusion, present evidence shows that optimal glycemic control can be attained in people with type 2 diabetes, resulting in fewer disease-related symptoms and a reduced risk of late complications.
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To investigate the direct anti-atherosclerotic properties of statins. ⋯ These results suggest that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors exert a direct anti-atherosclerotic effect in the arterial wall, beyond their effects on plasma lipids that could translate into a more significant prevention of cardiovascular disease. These findings provide a basis for the beneficial effect of statins in clinical trials also involving diabetic patients--a population with a higher absolute risk of recurrent cardiovascular events.