Diabetic medicine : a journal of the British Diabetic Association
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Randomized Controlled Trial Clinical Trial
Application of OpSite film: a new and effective treatment of painful diabetic neuropathy.
The aim of the study was to assess the effect of application of OpSite dressings on the pain and quality of life in 33 patients with chronic diabetic neuropathy. The effect of OpSite was compared with no treatment. After a run-in period of 2 weeks, OpSite was applied to one of the painful legs for 4 weeks. ⋯ There was a significantly greater reduction in pain in the OpSite treated limbs than the control limbs (p < 0.001). By week 4 paracetamol intake also declined significantly (p = 0.034) and patients experienced a significant improvement in contact discomfort, sleep, mood, appetite, and mobility (p < 0.002 for all 5 variables). OpSite appeared to alleviate the pain associated with diabetic painful neuropathy and thus improved patients' quality of life.
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With the aim of assessing continuing diabetes education and obtaining baseline information, we have evaluated the knowledge of 139 randomly selected diabetic patients from the Diabetes Clinic of Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia. Seventy-five Type 1 (insulin-dependent) and 64 Type 2 (non-insulin-dependent) diabetic patients, with a mean age of 36 +/- 14 (+/- SD) (range 15-78, median 36) years, and mean duration of known diabetes 6.3 +/- 5.5 (range 1-30, median 5) years participated in the study. Knowledge was assessed by a questionnaire which examined three principal areas: general knowledge on diabetes mellitus, diet plus self care, and chronic complications. ⋯ However, better knowledge about diabetes was not associated with better glycaemic control as measured by the fasting blood glucose concentration. The wide difference in knowledge, the low rate of attendance at diabetes education sessions, and the very low awareness about chronic complications is very worrying. To achieve the intended aim the diabetes education programme needs to be revised.
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Obesity is a common problem among Type 2 diabetic patients. To investigate the role of energy expenditure in the maintenance of obesity in diabetic subjects, total energy output was measured during weight stability in 23 diabetic patients: 8 lean, 5 overweight, and 10 obese. Free living total energy expenditure was measured over 14 days using doubly labelled water method, resting metabolic rate by indirect calorimetry, and urinary energy losses were assessed. ⋯ Thermogenesis plus physical activity was substantial and not lower in the obese (5.77 versus lean 4.97 MJ 24 h-1). The mean ratio of total energy expenditure to resting metabolic rate was in the moderate exercise category and similar in lean (1.87) and obese (1.80). Resting metabolic rate, total energy expenditure, and thermogenesis and physical activity were similar in all three groups when corrected for differences in lean body mass.(ABSTRACT TRUNCATED AT 250 WORDS)
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The incidence of moderate visual impairment and blindness due to diabetic retinopathy was studied 5 years after introducing a screening system for early detection of treatable retinopathy. Photocoagulation was performed in patients with clinically significant macular oedema, severe preproliferative, and proliferative retinopathy. Eighty-eight percent of 470 Type 1 and 88% of 388 Type 2 diabetic patients were still available for follow-up. ⋯ The majority of patients with loss of vision had severe retinopathy at baseline. Among those who entered the screening programme with no or mild retinopathy, loss of vision occurred in only one of the Type 1 and four of the Type 2 diabetic patients. It is concluded that the risk for visual impairment and blindness due to diabetes can be substantially reduced by using programmes for early detection of and effective treatment of diabetic retinopathy.