#chronic complication of diabetes mellitus

[diabetes-health-corner]

Long term Complications of Diabetes Mellitus

Failure to control blood sugar will damage the body’s blood vessels, and this damage leads to complications of diabetes. These problems do not happen overnight, but their very insidious nature makes them all the more dangerous.

Read the full blog: https://www.freedomfromdiabetes.org/blog/post/long-term-complications-of-diabetes-mellitus/394

[mistydeyes]

141 and what their patient file looks like

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summary: This is what I imagine everyone's favorite pharmacist as well as medics see when they look at 141's medical file.

Based on this pharmacist and 141 interactions

pairing: Task Force 141 x pharmacist!Reader

warnings: medical/pharmacy terminology, medical inaccuracies, swearing, depiction of wounds, mention of substance use disorder and abuse

Terms

PMH - Past medical history - the total sum of a patient's health status prior to the presenting problem

FH - Family history - contributing family history, generally parents and siblings

SH - Social history - contributing social behavior and routine

a/n: not canon at all! this is just a reference for me

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Price

PMH

Height: 1.88 m (6' 2'')

Weight: 93 kg (205 lbs)

Blood type: O+

Extensive physical injuries

21+ stab wounds - 2 required antibiotics for recurrent infection

9x bullet wound - 5x in the extremities, 4x in the chest (no perforation of vital organs), healed without complication

5x abrasion collar - 1 near right eyebrow became infected following medical eval and stitches

3x diagnosed concussion

Aspirin-sensitivity

Previously evaluated for tinnitus and hearing loss

FH

Father - deceased at 76 from liver disease - 50 pack years, mycardial infarction (x2)

Mother - deceased at 84 due to chronic heart failure (CHF) -Glaucoma, asthma, CHF

Sister - Sports induced asthma, hypothyroidism

Negative family history of diabetes, hypertension, and cancer

SH

Smokes - 30 pack years

Drinks regularly - 4-5 hard liquor each weekend; 1 glass of whiskey occasionally

Physically active - Enjoys recreational activities such as hiking, swimming, and biking

Has 1 dog, currently under the care of pt's younger sister

History of monogynous long term relationships, currently single

Medication list + indications

Amoxicillin/Clavulanic acid 625mg - Infection

Morphine 15mg + Ketamine 3mg - IV - Pain

Paracetamol 750mg - Pain

Buproprion SR 150mg - Smoking cessation - not-taking est 2004

Allergies

Aspirin allergy - Reaction: hives and asthma - ONLY PRESCRIBE PARACETAMOL

No environmental, food, or animal allergies

Notes

Patient has denied smoking cessation options

Soap

PMH

Height: 1.88 m (6' 2'')

Weight: 91 kg (200 lbs)

Blood type: O+

7x stab wound - 6 required antibiotics for recurrent infection, 2 MRSA resistant

2x bullet wound - 2x in lower extremities, healed with no complication

6x abrasion collar

2x broken collar bone - healed, with no complication

Lactose sensitivity - Recurrent IBS if ingested

Chipped first left molar following opening a beer with teeth

FH

Father deceased at 68 due to heart failure - Type 2 Diabetes Mellitus, high cholesterol

Mother - Stage I HTN (hypertension)

Sister #1 - Postpartum depression, generalized anxiety disorder

Sister #2 - Elevated cholesterol/triglycerides

Brother - No known chronic health issues

Positive family history of diabetes and hypertension, but no cancer

SH

Drinks regularly and heavily - 8-12 beers and 2-3 glasses of hard liquor each weekend; 1 glass of scotch occasionally

Smokes socially - 5 pack years

Physically active

Close relationship with family, has 4 dogs at home under the care of pt's mothers

Avid fan of The Glasgow Football Club

Medication list + indications

Clindamycin 300mg with ciprofloxacin 400mg - Infection

Amoxicillin/Clauvanic acid 625mg - Infection

Vancomycin 18mg/kg - MRSA resistant infection

Paracetamol 500mg - Pain

Morphine 15mg IV - Pain

Doxycycline 100mg - Acne discontinued in 2004

Allergies

Insect stings - Observed anaphylaxis to childhood bee sting

Notes

Patient demonstrates medication non-adherence, counsel ESPECIALLY with antibiotics

Scored 6 on Alcohol use disorders identification test for consumption (AUDIT C)

Gaz

PMH

Height: 1.86 m (6' 1'')

Weight: 93 kg (205 lbs)

Blood type: B-

3x stab wound - healed, no complications

1x broken collar bone

2x broken femur

Diagnosed concussion - evaluated in Oct. '19

FH

Father - Type 1 Diabetes, high cholesterol

Mother - Vitiligo, Stage 3 breast cancer

Positive family history of maternal cancer and diabetes, but no hypertension

SH

Social drinker - 3-4 beers each weekend

Does not smoke

Physically active - Enjoys morning and evening runs

Enjoys spicy food and tries to introduce into diet

When on leave, enjoys attending concerts and music festivals

Medication list + indications

Piriteze 10mg - Allergic rhinitis

Fluticasone Propionate - 93 mcg/actuation - Allergic rhinitis

Paracetamol 500mg - Pain

Allergies

Seasonal - Pollen and pet dander

β-Lactam allergy - Reaction: anaphylaxis evaluated in '19

Notes

Organ donor

Ghost

PMH

Height: Weight: 1.93 m (6' 4'')

WeighT: 100 kg (220 lbs)

Blood type: AB-

Extensive cuts and scarring to entire body

4+ stab wounds - healed, no complications

Gun shot to lower abdomen - healed, no complications, evaluated in Nov. '22

13+ collar abrasion

2x broken nose

Childhood injury of broken tibia and large toe

Psych eval - History of depression and post traumatic stress disorder, childhood history indicates emotional and physical abuse

FH

Father - status unknown Diagnosed alcohol use disorder

Brother - deceased, cause of death non-contributory - Substance use disorder

Mother - deceased, cause of death non-contributory - Hypertension, thrombophilia (blood clotting disorder)

Positive family history of hypertension, but no diabetes or cancer

SH

Social drinker - 3-4 glasses of hard liquor each weekend

Smokes socially - 10 pack years

Physically active - Enjoys nightly walks

Psych eval - Other squad members act as his emotional support

Expressed interest in cats and tattoo art (FLAGGED: Further input and comments from other medical professionals would be appreciated)

Medication list + indications

Paracetamol 1000mg - Pain

Amoxicillin/Clavulanic acid 625mg - Infection

Morphine 20mg + Ketamine 4.5mg IV - Pain

Mafenide acetate 5% topical - Antimicrobial, burn wounds

Fluoxetine 20mg twice daily - Depression - not taking est 2001

Allergies

NKDA - No known drug allergies

No environmental, food, or animal allergies

Psych recommends evaluation of a pet, such as cat, for pt while on leave

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[tteessiiee]

Feedism health - Diabetes Mellitus

TW: feederism, feedism reality, medical issues, explicitly explained medical conditions

Hi! This post gonna be long, it is a bit more medical again. We are feedists, right. Many of us are overweight or obese, some also have high blood pressure and many other comorbidities. We overeat a lot, stuffing so much sugar and fat into our bellis or bellies of our feedees so that we gain as much as we want. Therefore we are at HIGH risk of developing diabetes.

I am a student of physical therapy, NOT A DOCTOR. But I kinda feel the need to educate our community a bit 📚. So there are some facts (from medical literature which i study for my exames) about diabetes that I think should be commonly known. It may scare you, it may make you horny (we are weird, especially death feedists, hi guys 🖤), I just want you to know this, if you feel strong enough:

What it is and important vocabulary:

It is a disease caused by malfunction of insulin secretion from pancreas, or by insulin resistence of target tissue (such as muscles) or combination -> in every case you have a problem with insulin and glucose in your body.

There are two types, type I (DMI) that is caused by autoimunne reactions and you can not prevent it. And type II (DMII) which is hella important for our community because you can literally eat yourself into it. The more you over eat, the more you weight, the less you move, the higher the probability of developing that disease. This post is mainly about DMII.

Glycaemia = how much glucose (form of sugar) is in your blood

Norm is 3,9-5,5 mmol/l. After eating usually max 7,8 mmol/l

Hypoglycemia = less than 3,3 mmol/l

Hyperglycemia = over 11 mmol/l

Insulin causes that glucose goes from blood to your cells so it can become part of your metabolism. On the other hand there are hormones that causes the opposite - more sugar in your blood (by various mechanisms) and those are adrenaline, kortisol, growth hormone and glukagon.

How to get diagnosis of diabetes mellitus type II:

Doctor takes a sample of your blood plasma and tests its glycaemia:

If it is done in two different days and in both cases your glycaemia is over 11 mmol/l

OR if it is over 7 mmol/l after not eating for at least 8 hours*

OR if you undergo oral glucose tolerancy test and it is positive (you drink 75 g of glucose in 200 ml of water, wait for 2 hours and your glycaemia is over 11 mmol/l)

...in any of these cases they probably give you a diagnosis of Diabetes Mellitus. This apllies for my country in the middle of Europe, idk about your countries but it could be very similiar.

OR! I know that in USA they are also supposed to measure glucated hemoglobin (HbA1c) and diagnose you with DM if it is over 48 mmol/l.

*if your results are between 5,6 to 6,9 mmol/l, you are prediabetic which means that your body already suffers but you can stop it and go back to full health by changing your lifestyle (read more bellow).

Smyptoms of DMII:

I gonna explain them in "normal" language. You may have just some or all of them:

you are thirsty a lot, you drink a lot, you pee a lot, you are still thirsty though

there is glucose in your urine which definitely should not (you will not notice it, lab will)

you lose weight, you feel tired

your vission is blurred

you have some of acute or chronical complications (more bellow)

Complications of diabetes AKA what may happen to you:

They are usually devided into two groups - acute that actually can kill you pretty quickly and chronic that deteriorate your quality of life. (In the worst hypothetical case you can become blind, with neurological pain, amputated leg and close to a stroke that may kill your ability to move and speak. Nice, isnt it? 🤢) So lets get a closer look into that. These things happen when you do not treat your diabetes well or ignore it at all (for example continue in overeating and gaining even after being diagnosed):

Acute complications:

Hypoglycemia - may occur in patients that are treated with insulin (or glinids or derivates of sulfonylurey), also after drinking alcohol (even when you eat with it or dink juice etc). You do not have enough glucose in your blood so your brain cells become to die and in the worst case you will fall "asleep" (into coma) in the evening at party and will not wake up in the morning because you simply die. Your body fights hypoglycemie by making more glucose from storages in your liver, muscle and fat mass. Symptoms are anxiety, blurred vision, inability to concentrate but also seizure and coma.

Diabetic ketoacidosis - occurs in patients with DMI, very dangerous, also can lead to death. If you dont aplicate insulin when you should, you become hyperglycemic, dehydrated and your body catabolise fat into ketone bodies.

If you overdo it with your stuffing session while you are diabetic you may hypothetically cause yourself a hyperglycemic hyperosmolar coma. You are dehydrated, pee a lot, your blood pressure is very low, so low that it can reach hypovolemic shock and you faint. Also you kinda damage your kidneys.

Cronic complications:

Instability between insulin and glucose causes damage to your blood vessels and nerves which may result in

Retinopathy - you slowly lose your vision or even become completely blind

Nephropathy - if you ignore that you have diabetes, you damage your kidneys, it is asymptomatic for a long time but may result in need of dialysis or even transplantation if not treated.

Neuropathies - very common and very annoying. Harms your nerves - all kinds of nerves which means motor (problems with movement), sensoric (problems with feeling anything - touch, pressure, pain, cold, warmth, vibrations etc. and "problems" means you feel it less, more or differently so for example contant pain tha cannot be stopped) and autonomus (causes erectile dysfunction and decrease of libido, slows down motility in your stomach and gut, makes you feel sick, causes vomiting, constipation and diarrhoea and many more)

Diabetic foot - tissues in your leg are so damaged that it may literally start to rot and in the worst cases leads to amputations. This complication is related to many things from little injuries to ulcerations to gangrenes with bacterias that kinda eats your fat, muscles and bones.

Aterosclerosis - higher risk for ischemic heart disease (angina pectoris, heart attack), lower limb ischemia (may cause pulmonary embolism) and stroke.

Other problems such as: inflamation of thyroid gland, celiac disease (you can not eat anything with wheat, barley and others), diseases of skin, mycotic infections, urological infections etc.

Treatment:

I hope you are at least a bit frightened now... So what can we do when we are prediabetic or even diabetic? Three things!

Diet - if you are overweight or obese then it is weight-loss diet plus diet counting how many carbohydrates and fat you eat. Losing weight really works honestly.

Physical activity - helps so much!!! In general you should walk at least 10k steps per day and do some aerobic exercise for at least 30 minutes 3-4 times per week. And it should be on 75 % of your maximal heart rate (how to count that at home: "220 - your age = ideal load") plus ofc any sport you like. If you do have diabetes, be very careful about any injuries because it can lead to the diabetic foot.

Meds - DMI insulin for sure. DMII usually gets first oral antidiabetics and only in some cases insulin. But over all meds are only part of the treatment, it reallly does not work well without taking care of your food or exercising. You need to change your lifestyle if you wanna get better (I know that some of you don't).

______________________________________

I hope this post gave you something, tought you something new and you know the risks of our kink better now. I do not want to tell you not to do it - I have that kink too and love it, gonna continue gaining. Just be aware about the consequences 💕

Uffff... that was long and complicated, I actually did my research for that and spent few hours making that post 😂. But it is still possible that i did some mistakes, did not understand something well etc - I am NOT a doctor, please believe more your health proffesionals than me, thank you. Im sorry if anything does not make sense or if I use some words in a strange way - english is not my native language and I do not know many medical terms and phrases, know them only in czech and latin so I translate it somehow based on that XD

Enjoy the candy that our kink brings to our life and stay as healthy as you wish 💕💕💕

~ Your Tessie

[mcatmemoranda]

CDC recommends everyone ages 75 and older get an RSV vaccine.

CDC recommends adults ages 60–74 who are at increased risk of severe RSV disease get an RSV vaccine.

The RSV vaccine is not currently an annual vaccine. If you have received an RSV vaccine already (including last year), you should not get another RSV vaccine at this time.

You can get one at any time, but the best time to get vaccinated is in late summer and early fall.

Conditions that increase your risk for severe illness include:

Chronic heart or lung disease

Weakened immune system

Certain other medical conditions

Living in a nursing home

To protect infants and some young children, CDC recommends the maternal vaccine (Pfizer’s Abrysvo) for pregnant people during weeks 32–36 of pregnancy, or an RSV monoclonal antibody (nirsevimab) for babies given after birth and for some young children ages 8–19 months.

Adults who get RSV usually have mild or no symptoms. Symptoms are usually consistent with an upper respiratory tract infection, which can include rhinorrhea, pharyngitis, cough, headache, fatigue, and fever. Milder illness in adults typically resolves in 1–2 weeks. However, RSV can also cause severe disease and hospitalization in adults.

RSV can sometimes also lead to exacerbation of serious conditions such as:

Asthma

Chronic obstructive pulmonary disease (COPD)

Heart failure

Epidemiologic evidence indicates that all adults ages 75 or older and adults ages 60–74 with certain risk factors are at increased risk of severe RSV.

Conditions that increase the risk for severe RSV

The following conditions increase the risk of severe RSV:* 

Chronic cardiovascular disease (e.g., heart failure, coronary artery disease, or congenital heart disease [excluding isolated hypertension])

Chronic lung or respiratory disease (e.g., chronic obstructive pulmonary disease, emphysema, asthma, interstitial lung disease, or cystic fibrosis)

End-stage renal disease or dependence on hemodialysis or other renal replacement therapy

Diabetes mellitus complicated by chronic kidney disease, neuropathy, retinopathy, or other end-organ damage, or requiring treatment with insulin or sodium-glucose cotransporter-2 (SGLT2) inhibitor

Neurologic or neuromuscular conditions causing impaired airway clearance or respiratory muscle weakness (e.g., poststroke dysphagia, amyotrophic lateral sclerosis, or muscular dystrophy [excluding history of stroke without impaired airway clearance])

Chronic liver disease (e.g., cirrhosis)

Chronic hematologic conditions (e.g., sickle cell disease or thalassemia)

Severe obesity (body mass index ≥40 kg/m2)

Moderate or severe immune compromise†

Residence in a nursing home

Other chronic medical conditions or risk factors that a health care provider determines would increase the risk for severe disease due to viral respiratory infection (e.g., frailty,§ situations in which health care providers have concern for presence of undiagnosed chronic medical conditions, or residence in a remote or rural community where transportation of patients with severe RSV disease for escalation of medical care is challenging¶)

Source

[jcsmicasereports]

Decreased erythrocyte glyoxalase 1 (GLO1) activity in patients with diabetes with reduced estimated glomerular filtration rate by Dr. Mohsen Kerkeni in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Background: The glyoxalase enzymes are located in the cytosol of all cells, including erythrocytes, and prevent advanced glycation end products (AGEs) production through the detoxification of the methylglyoxal (MGO). The present study was made to evaluate the GLO1 activity in diabetic patients and it relationship with estimated glomerular filtration rate (eGFR).

Patients and methods: GLO1 activity was measured spectrophotometrically in erythrocytes of 123 participants: 35 healthy subjects and 88 patients with diabetes. Biochemical parameters were measured and eGFR was calculated using the MDRD (Modification of Diet in Renal Disease) formula.

Results: We found no difference in GLO1 activity in patients with diabetes compared to healthy subjects. However GLO1 activity tended to be reduced in diabetic patients with loss renal function. A significant decrease was shown in patients with moderate to severe loss renal function. GLO1 activity was correlated with eGFR, creatinine and urea. Multivariate analysis showed that GLO1 activity was independently associated with eGFR.

Conclusion: GLO1 activity was related with loss renal function in patients with diabetes according glomerular filtration rate.

Keywords: glyoxalase 1, diabetes mellitus, glomerular filtration rate

Introduction

Diabetes is the most important disease in the wild words including type 1 diabetes, type 2 diabetes as known as diabetes mellitus (DM), and gestational diabetes [1-3]. DM is defined by chronic hyperglycemia and affected sugars metabolism caused by impaired insulin secretion [4]. Overweight and obesity are two risk factors or metabolic syndrome for developing DM. Indeed, obesity is characterized by excess body fat which is harmful to health, thus generating significant oxidative stress than chronic inflammation [5]. DM, as chronic hyperglycemia, promotes protein glycation and leads to the formation of advanced glycation end products (AGEs).

AGEs are formed by prolonged duration of hyperglycemia in diabetics and they have long-term toxicity in the body. Indeed, AGEs come from the attachment of sugar to a protein, an amino acid, or a lipid. These toxic products accumulate in all the organs leading to the activation of its RAGE receptors. A high number of publications have reported the AGEs involvement in the development of diabetes complications such as nephropathy, retinopathy, and atherosclerosis [6-8]. These products are not only present, but they also contribute to the severity of the pathology [9, 10]. The pathophysiological mechanisms of the increase in these products are still unidentified, but the formation of these products is done through the precursors of AGEs, also known as highly reactive dicarbonyl stress, the α-oxoaldehydes, such as the methylglyoxal (MGO) has a key role in detrimental effects on cellular function and has a key factor in vascular complications leading to oxidative stress. MGO is metabolized to lactate or acetol [11]. The MGO was detoxified by the glyoxalase system [12]. The glyoxalase system has two enzymes, glyoxalase 1 (EC 4.4.1.5, S-D-lactoylglutathione lyase; GLO1) and glyoxalase 2 (EC 3.1.2.6, D-hydroxyacylglutathione hydrolase; GLO2) [12]. Reduced glutathione is an essential cofactor. GLO1 catalyzes the conversion of the hemithioacetal to the thioester S-D-lactoylglutathione. The GLO2 enzyme catalyzes the hydrolysis of S-D-lactoylglutathione to form the lactate. Reduced glutathione is important for the detoxification of reactive dicarbonyls, especially methylglyoxal [13]. Therefore, we aimed to go deeper in the relation between renal function impairment and the MGO system in patients with type 2 diabetes. So, we measured the enzyme activity of glyoxalase 1 in patients with diabetes according their renal function using estimated glomerular filtration rate.

Materials and Methods

Study population

In a cross-sectional study, we recruited 123 participants (88 with type 2 diabetes) between 2019 and 2021 from CHU Taher Sfar in Mahdia-Tunisia. Data included age, weight, and height, history of diseases, smoking, and alcohol consumption. Patients were asked if they used any medication, and blood was taken. Plasma and erythrocytes cells were stored at -80°C. This study was approved by the ethics committee.

Assessments of biochemical parameters

All the analyzes of the biochemical parameters were carried out in the biochemistry department of the CHU Taher Sfar of Mahdia, These parameters were measured directly after collecting blood samples using enzymatic kits. Estimated glomerular filtration rate (eGFR) was calculated by the MDRD (Modification of Diet in Renal Disease) formula.

Measurement of GLO1 activity

GLO1 activity was measured according to Thornalley et al. [14]. Briefly, hemithioacetal was produced by incubation of MG (20mM) and GSH (20mM) for 30 minutes in an appropriate volume of sodium phosphate buffer (100mM, pH 6.6) at 37°C. The GLO1 activity was calculated and was expressed in Units/mL. One unit was defined as the amount of enzyme that catalyzes the formation of 1 µmol of S-D lactoylglutathione/min under the mentioned assay conditions.

Statistical analysis

Statistical analyzes are carried out by SPSS analysis software. Data were given as mean or median in the case of non-normally distributed data. Group comparisons were performed using the Student’s t-test or Mann-Whitney test, and the correlation coefficient was estimated using the Pearson or Spearman rank-order correlation analysis. Multivariate analysis was performed, and subgroups comparisons were performed by ANOVA test.  A P-value < 0.05 was used.

Results

Clinical parameters and GLO1 activity between healthy and diabetic subjects

Clinical parameters and GLO1 activity are shown in Table 1. Patients with diabetes had duration of diabetes between 5 and 17 years and had a high body mass index (BMI) which indicates moderate obesity in most patients. Patients with diabetes showed 48% of hypertension, and 31% of hyperlipidemia. In addition, a significant decrease of renal function, including serum creatinine and eGFR, was shown in patients with diabetes. However, GLO1 activity did not differ between the healthy subjects and patients with diabetes.

Biochemical parameters and GLO1 activity according the loss of renal function

Clinical parameters and GLO1 activity in patients subgroups according eGFR were shown in Table 2 and Figure 1. Patients with diabetes were classified in four subgroup as normal, mild, mild to moderate, and, moderate to severe according eGFR. Duration of diabetes, glucose, and HbA1c did not differ between subgroups. As expected, eGFR was deceased from normal to severe subgroups (P < 0.001). For the GLO1 activity there was no difference between normal and mild group, however, a significant decrease was observed between mild to severe subgroups (P < 0.001).

Data are shown as the mean (SD) or median (range), or number (percentage). **Significantly decreased between each group; P < 0.001 * Significantly decreased between Mild to severe group; P < 0.001

Correlation of GLO1 activity with eGFR and other variables

The GLO1 activity was correlated to eGFR (r = 0.257; P = 0.015) as shown in Figure 2. GLO1 activity was also correlated with serum creatinine (r= -0.328, p=0.002) and urea      (r = - 0.300, P = 0.020,). Multivariate analysis showed that GLO1 activity was independently associated with eGFR (b = 0.129, P = 0.038). However, GLO1 activity did not shown any correlation with glucose, HbA1c, cholesterol, and triglyceride.

Discussion

In this study, we examined the activity of GLO1 in patients with diabetes having normal to severe loss of renal function. According to our results, the GLO1 activity profile did not show a significant difference in healthy and patients. The GLO1 activity tended to be decreased with loss of renal function. We found a reduction of GLO1 activity in mild to severe loss of renal function, and was independently correlated to eGFR.

Most studies showed the role of AGEs and their interaction with their receptors, but there are a few studies about the relationships between glyoxalase system, as a antiglycation, and the loss of renal function. The first old study was done by Thornally et al. showed no significant difference in the glyoxalase enzymes between patients with dibetes and controls. However, Thornally et al. showed an increase of methylglyoxal and S-D-lactolglutathione in diabetic patients vs. controls [14]. Data concerning erythrocytes GLO1 activity in diabetes and diabetes complications are relatively scarce, and the results are controversial. Hamoudane et al. showed significantly lower GLO1 activity and glutathione levels in diabetic patients compared to controls. The levels of GLO1 activity were markedly lower in patients with diabetic complications, especially in diabetic patients with nephropathy [15]. In a study by Pacal et al. GLO1 activity was significantly increased in diabetic patients compared to controls, and was higher in nephropathy patients in stages 1-2, and remained decreased in nephropathy patients in stages 3-4 [16].  Our present study confirms the findings of Thornally et al. [14], Pacal et al. [16], Sakhi et al. [17], and Peters et al. [18]. Furthermore, Peters et al. found that GLO1 activity was lower in atherosclerotic carotid artery lesions, and the effects observed are related to the microenvironment of the damaged tissue [18]. We hypothesize that GLO1 activity may affects also the microenvironment location in glomerular and its vascular tissues under chronic hyperglycemia that induce much production of AGEs precursors such as MGO and may inhibits GLO1 enzyme activity. This AGE accumulation has been closely associated with kidney diseases, and aging. Accumulating evidence demonstrates that the progression of renal tubular damage and tubular aging are often correlated with activation of the receptor for the AGE (RAGE)-AGE pathway or decreased activity of glyoxalase 1 [19].

To our knowledge, this is the first study showing the relationships between erythrocytes GLO1 activity and the estimated glomerular filtration rate in patients with diabetes with normal, mild, moderate and severe loss of renal function. The GLO1 activity decreased markedly with patients when they have moderate to severe loss of renal function. The direct pathogenic role of MGO/glyoxalase system in the development of diabetic nephropathy is strongly supported by animal experiments. Overexpression of GLO1 in diabetic rats reduced the production of AGEs, endothelial dysfunction, and also expression of early markers of kidney damage [20].  Interestingly, knockdown of GLO1 in nondiabetic mice induces kidney pathology very similar to diabetic nephropathy [21]. The reduced levels in GLO1 activity may result also from the deceased of glutathione levels but the most biomarker that affects GLO1 activity was the tissues accumulation of α-oxoaldehydes, especially MGO that are formed during cellular metabolic reactions [14]. Recently, it was well described in a review by Schalkwijk and Stehouwer the involvement of the MGO in many diseases [22]. Lowering the MGO levels can provide new therapeutic to reduce AGEs precursors and their accumulation [23-26]. Recent interesting studies are focused on GLO1 inducers as a new therapy [27-29].

Our study has obvious limitations. We have not measured MGO or MGO-derived AGEs due to the lack of technologies in our laboratory. Furthermore, healthy subjects and patients with moderate to severe loss of renal function subgroup showed small size samples.

In conclusion, GLO1 activity in erythrocytes was independently correlated in patients with diabetes having a decreased estimated glomerular filtration rate.

Abbreviations

AGEs: Advanced glycation end products; BMI: Body mass index; DM: Diabetes Mellitus; GLO1: glyoxalase enzyme; HTA: Hypertension; MGO: methylglyoxal

Authors’ contributions

RS, HH, and AM: determined the GLO1 activity measurement, Clinical data, and wrote the manuscript. MK, SA, and AL contributed to the design and the concept of the study. HB measured the biochemical parameters. HZ: provided blood sampling. All authors read and approved the final manuscript.

Declarations

The protocol has been approved by the ethics committees at the CHU Hospital Tahar Sfar Mahdia. All participants signed the informed consent in writing before inclusion in the study.

Competing interests

The authors declare no conflict of interest.

[wishesmsg]

Acromegaly

Overview

Acromegaly is a rare hormonal disorder that results from excessive production of growth hormone (GH) by the pituitary gland. This condition usually develops slowly over several years and is often not diagnosed until later stages. In most cases, acromegaly is caused by a benign tumor in the pituitary gland, called pituitary adenoma, that produces too much GH. Rarely, acromegaly can also be caused by tumors in other parts of the body that produce GH-releasing hormone (GHRH) or by non-tumor-related causes. The excess GH in acromegaly leads to an overgrowth of bones and tissues in the body, especially in the hands, feet, face, and internal organs. This results in a range of symptoms that can include: - Enlarged hands and feet - Coarse facial features - Increased sweating - Fatigue - Headaches - Joint pain - Carpal tunnel syndrome - Sleep apnea - Vision problems - Hypertension - Diabetes mellitus Acromegaly can also increase the risk of certain health problems, such as heart disease, stroke, and colon polyps. Treatment options for acromegaly include surgery to remove the pituitary tumor, medications to reduce GH production or block its effects, and radiation therapy. Treatment can improve symptoms, prevent complications, and reduce the risk of long-term health problems. Regular monitoring and follow-up care are important for managing this condition.

Symptoms

The symptoms of acromegaly can vary widely from person to person and can develop slowly over several years. Some of the common signs and symptoms of acromegaly include: - Enlarged hands and feet: The bones in the hands and feet grow larger, and the fingers and toes become thicker and wider. - Coarse facial features: The bones in the face, especially the jaw and forehead, become more prominent, and the nose and lips may also increase in size. - Increased sweating: People with acromegaly often experience excessive sweating, particularly at night. - Fatigue: People with acromegaly may feel tired or lack energy, even after a good night's sleep. - Headaches: Chronic headaches are a common symptom of acromegaly, and they can be severe. - Joint pain: The growth of bones and tissues can cause joint pain and stiffness, particularly in the hips, knees, and shoulders. - Carpal tunnel syndrome: The growth of tissues in the wrist can compress the median nerve, causing carpal tunnel syndrome. - Sleep apnea: Enlargement of the soft tissues in the throat can cause sleep apnea, a condition in which breathing stops briefly during sleep. - Vision problems: The enlarged pituitary gland can press against the optic nerves, causing vision problems or even vision loss. - Hypertension: Excessive growth hormone can cause high blood pressure. - Diabetes mellitus: The excess growth hormone can also cause insulin resistance, leading to high blood sugar levels and an increased risk of diabetes mellitus. It's important to note that not all people with acromegaly experience all of these symptoms. Some people may have mild or no symptoms, while others may experience more severe symptoms. If you're experiencing any of these symptoms, it's important to see a doctor for an evaluation.

When to see a doctor

If you have any symptoms of acromegaly, it's important to see a doctor for an evaluation. Some of the common symptoms include enlarged hands and feet, coarse facial features, excessive sweating, fatigue, chronic headaches, joint pain, carpal tunnel syndrome, sleep apnea, vision problems, hypertension, and diabetes mellitus. In addition, if you have a family history of acromegaly or have a condition that increases your risk of developing this disorder, such as multiple endocrine neoplasia type 1 (MEN1) or Carney complex, you should talk to your doctor about screening for acromegaly. Early diagnosis and treatment of acromegaly can prevent or minimize the development of complications associated with this disorder, such as heart disease, stroke, and colon polyps. If you suspect that you or a loved one may have acromegaly, it's important to see a doctor as soon as possible. Your doctor can order blood tests to check for elevated levels of growth hormone and insulin-like growth factor-1 (IGF-1), which are markers of acromegaly. Imaging tests, such as magnetic resonance imaging (MRI), may also be ordered to visualize any pituitary tumors. Treatment options for acromegaly are available and can help manage the symptoms and reduce the risk of complications.

Causes

Acromegaly is caused by the overproduction of growth hormone (GH) by the pituitary gland, which is a small gland located at the base of the brain. The excess GH is usually caused by a benign tumor, called a pituitary adenoma, that grows on the pituitary gland and produces too much GH. In rare cases, acromegaly can also be caused by tumors in other parts of the body that produce GH-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH. These tumors are usually found in the pancreas, lungs, or adrenal glands. Other less common causes of acromegaly include: - Familial acromegaly: In rare cases, acromegaly can be inherited in an autosomal dominant pattern, which means that a person only needs to inherit one copy of the abnormal gene from one parent to develop the disorder. - Non-tumor-related causes: In very rare cases, acromegaly can be caused by certain medical conditions, such as McCune-Albright syndrome, which is a rare genetic disorder that causes abnormal bone growth and hormonal imbalances. Acromegaly usually develops slowly over several years, and the symptoms may not be noticeable for a long time. Early diagnosis and treatment are important to prevent complications associated with this disorder. If you suspect that you may have acromegaly or have a family history of the disorder, it's important to talk to your doctor about screening and testing for this condition.

Risk factors

There are several risk factors associated with the development of acromegaly, including: - Age: Acromegaly can occur at any age, but it is more common in middle-aged adults. - Gender: Acromegaly affects both men and women equally. - Family history: People with a family history of acromegaly or multiple endocrine neoplasia type 1 (MEN1) or Carney complex have an increased risk of developing the disorder. - Medical history: People who have had radiation therapy to the head or neck or have a history of pituitary tumors are at an increased risk of developing acromegaly. - Genetics: Some genetic mutations have been associated with an increased risk of developing pituitary tumors, which can lead to acromegaly. - Insulin resistance: People with insulin resistance, which can occur in conditions such as obesity or type 2 diabetes, may be at an increased risk of developing acromegaly. It's important to note that having one or more of these risk factors does not necessarily mean that you will develop acromegaly. However, if you have one or more of these risk factors, it's important to be aware of the signs and symptoms of acromegaly and to talk to your doctor about screening and testing for the disorder. Early diagnosis and treatment are important to prevent complications associated with this disorder.

Complications

Acromegaly can lead to a number of complications if left untreated or poorly managed, including: - Cardiovascular disease: Excess growth hormone can cause the heart to work harder, leading to an increased risk of hypertension, heart disease, and stroke. - Diabetes: Acromegaly can lead to insulin resistance, which can increase the risk of developing type 2 diabetes. - Sleep apnea: Enlarged soft tissues in the mouth and throat can obstruct breathing during sleep, leading to sleep apnea and poor quality sleep. - Joint problems: Excess growth hormone can cause bones and cartilage to grow abnormally, leading to joint pain and arthritis. - Carpal tunnel syndrome: Enlarged bones and tissues in the hands can compress the median nerve, causing numbness, tingling, and weakness in the hands and wrists. - Vision problems: Enlarged pituitary tumors can compress the optic nerve, leading to vision problems and even blindness. - Colorectal polyps and cancer: People with acromegaly are at an increased risk of developing polyps in the colon, which can lead to colorectal cancer if left untreated. - Increased risk of infections: People with acromegaly are at an increased risk of developing infections due to the effects of excess growth hormone on the immune system. - Psychosocial problems: People with acromegaly may experience depression, anxiety, and social isolation due to the physical and emotional effects of the disorder. It's important for people with acromegaly to receive early and appropriate treatment to prevent or manage these complications. Treatment options for acromegaly may include surgery, radiation therapy, and medication, depending on the underlying cause and severity of the disorder. Read the full article

[mavacare]

Understanding UTI ICD 10 Codes: Key for Accurate Diagnosis

UTIs (Urinary Tract Infections) can be easily treated in a doctor's office if caught early, but they are much more challenging to address as an infection. Infections of the urinary tract are extremely prevalent especially in women, the elderly, and anyone with a poorly functioning immune system.

Untreated UTIs can lead to kidneys' bladder, or ureter infections. The management of urinary tract infections treatment relies heavily on precise diagnosis and treatment which makes the appropriate application of diagnostic codes so important for health care providers.

In case the UTI ICD 10 becomes too complicated an assessment can be done with this (UTI) or without these codes being used. Appropriate reimbursement is also very important so the right codes make billing simple and minimize audit scrutiny.

This article helps healthcare administrators and providers understand UTI ICD 10 better and how improper diagnosis coding and treatment can negatively impact audit processes. We will further show how proper coding can impact the costs associated with patients and help in reimbursements for the clinicians and healthcare providers.

We aim to finalize why these parties must understand the intricacies associated with this code while trying to administratively move information in an efficient manner.

What Is UTI ICD 10 Code? 

Urinary Tract Infections (UTI) has its assigned ICD 10 code, which is part of the International Classification of Diseases (ICD). It is a system utilized by the world over health care providers to record and rank diseases, symptoms and medical conditions.

ICD 10 codes are also used by healthcare practitioners for clinical diagnoses, and as the basis of medical billing procedures, insurance claims, and reimbursement. The introduction of the ICD 10 system addresses the need for more vivid depiction of the ever growing complexities of medical conditions.

Therefore, with the new system, codes are standardized and made more specific.

The type and location of the infection contributes to determining the ICD 10 code for UTIs. Some of the more common codes used for UTIs are: 

N39.0: Urinary tract infection, site not specified. 

N30.0: Acute cystitis. 

N34.0: Urethritis, not elsewhere classified. 

N15.9: Renal tuberculosis, unspecified.

They solve clinical challenges associated with defining the condition and associated risks to which the medical treatment and relevant interventions have to be undertaken. The proper application of UTI ICD 10 code resolves reimbursement difficulties, claim denials, and medical malpractice concerns.

Significance of UTI ICD 10 Codes for Health Providers

Taking Advantage of a Patient’s History and Evaluating Treatment Options. First Contact, Diagnosis  C14

C14E

It is essential to keep it in mind that improper ICD coding leads to misallocation of resources within the health system. In other words, if the wrong UTI ICD 10 code is provided, the reimbursement will not correspond to the type and extent of care that has actually been rendered.

For example, it is possible to undertake a more extensive examination of the patient’s medical records to understand if they have been diagnosed with either diabetes or kidney stones. Such preamble may help prevent inaccurate diagnostic code allocation, which results in reimbursement claim denial or retusion. 

The ICD 10 provides further specification detail by distinguishing between, for example, E10.9: Type 1 diabetes mellitus without complications or other health problems and E10.8: With other specified complications. These ten markers give ample opportunities for chronic UTI complications to be accurately defined.

Following Regulations

The healthcare sector is very complex, which requires precise coding in order to adhere to laws and insurance requirements. The medical industry and treatment protocols are continuously evolving, which means that the ICD 10 coding system has to adjust accordingly.

Providers who code incorrectly or with outdated codes could violate the billing guidelines, making them susceptible to audits, fines, or even legal action. Using the most updated ICD 10 codes for UTI's ensures that healthcare providers are compliant with regulations and stays up to date. 

Improved Maintenance of Records and Reporting

ICD 10 codes go beyond serving as a reimbursement tool as they provide the foundation for enhanced record keeping. Healthcare facilities can efficiently document precise patient histories, treatment results, and reports of the clinical audits or research.

Accurate documentation of UTIs through proper ICD 10 codes helps in maintaining the continuity of care and improving patient outcomes over time.

Most Frequently Used UTI ICD 10 Codes and Their Uses Descriptions Explained.

Like most Medical procedures, the accounting aspect that invoice these services by utilizing the diagnosis and the proper codes need to be precise. This outline summarizes the most frequently used codes and the diagnosis correlated with coding for UTIs.

N39.0 Urinary tract infection, site not specified 

This diagnosis is used under the circumstances that a UTI infection has been determined, however, the specific details e.g. bladder or kidneys is unidentified. For instance, it can be used in cases where diagnosis details are undetermined or unclear.

N30.0 Acute cystitis

Acute cystitis code in ICD 10 refers to a type of bladder inflammation, which is an infection of the bladder caused by bacteria. This code is for certified chronic Types 1 of UTI and onwards.

N34.0 Urethritis, not elsewhere classified

This code is allocated to a diagnosed patient with urinary tract infection which causes inflammation of urethra, but there is no cause and effect any further classification or specific cause.

N15.9 - Tuberculosis of kidney, unspecified

Sometimes, renal tuberculosis–an infection of the kidney–can result in a urinary tract infection. This code applies when a diagnosis is made but the particulars of the infection are unknown.

Healthcare workers should understand these codes and precise documentation of UTI cases. However, with the difficulty of the UTI diagnosis increasing, there is a need to examine the entire gamut of ICD 10 diagnosis codes for a proper treatment strategy.

Importance of Medical coding and billing in UTI ICD 10 Reimbursement

Medical billing services, as every healthcare professional knows, complete and submit medical claims, obtaining reimbursement on behalf of healthcare providers in a fast and efficient manner. Correct medical billing starts with proper ICD 10 coding, more so concerning billing for the allowed codes like UTI codes.

Incorrectly coded diagnosis or incomplete diagnosis can result in claim rejections, late payment, and poor reimbursement amount to the providers.

Getting specialized companies to handle medical coding billing can reduce mistakes as well as increase compliance to the coding standards. Mava Care Medical Billing Company, for example, claims to code certain medical billing processes such as UTIs using appropriate ICD 10 standards, which helps to reduce claim denials and improve revenue for healthcare providers.

Health care providers can concentrate more on other aspects of service delivery as they are assured that the billing and coding processes are in competent hands.

Certified medical coding companies assign the tasks to trained medical coders who are constantly informed of the developments within the industry and always ensure the appropriate codes are used for any diagnosis made.

How Effective UTI ICD 10 Coding Is Achieved

Enhanced Billing Accuracy

Billing accurately and precisely coding UTIs in the system makes certain that there is no chance of incurring billing discrepancies. Such actions lead to claims being processed without confusion or incomplete records to delay the reimbursement, improving cash and financial position for them.

Increased Quality of Health Services Offered to Patients

Caregivers are able to use the appropriate ICD 10 codes for UTIs allowing them to provide better follow-up patient care. Proper monitoring of the patient’s condition makes sure that best treatment options to meet their particular needs are administered.

Streamlined Insurance Claims

Having the right codes incorporated into the system enables faster claims submission, which leads to less time spent by healthcare professionals chasing after outstanding claims. Quicker reimbursement and lower administrative costs are gained as a result. 

Regulatory Compliance

ICD 10 codes are crucial for correct compliance like all other coding metrics. Using the right codes reduces the chances of audits and penalties that may create trouble for the provider's reputation as well as their business processes. 

Conclusion

For patients, coding brings together effective healthcare delivery, billing processes, and reimbursement. For healthcare organizations, applying the right codes is just one more measure to prevent mishandling of funds, compliance problems, or complicated operational processes.

Inaccurate coding and gross billing would have the opposite of the intended cash flow and thus results in regulatory concerns. For timely reimbursement and trouble free operation of the practice, UTI diagnosis have to be accurately coded and for this reason medical billing needs to be outsourced to professionals at Mava Care Medical Billing Company.

With accurate coding, healthcare practitioners can provide the utmost care to the patients while ensuring that the billing and coding are structured correctly.

[deepwitchconnoisseur]

Best General Surgery Hospital in Bangalore

Best General Medicine Hospital, Sapthagiri Hospitals, Bangalore.

If I compare the health care facilities in , one hospital stands out from the rest. I can proudly say from my experience as a health visitor that the best general medicine hospital in Bangalore is Sapthagiri Hospitals. Though it may be a new setup, in such a short time, it has acquired a name for constant reliable care, complete medical solution and patients-friendly services that really differ from others.

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Infrastructural Facilities

The architecture and latest technological advancements have made Sapthagiri Hospitals state-of-the-art. This will allow the management of the health care problems to the full extent of this hospital's infrastructure. A well-planned general medical ward with detailed consideration will even diagnose complex health issues and provide treatments based on the case. From consultation rooms to high-tech diagnostic laboratories, all the facilities that this hospital provides will ensure the right diagnosis and suitable treatment in a very pleasant environment.

This place has the best team of well-trained general physicians, who are excellent in their practices. They can treat acute diseases, chronic conditions, preventive care, and complicated cases. These medical professionals are fully aware of all advancements in general medicine, which means they can carry out evidence-based treatment with proper patient care.

General Medicine Treatment at Sapthagiri Hospitals

The list of general medicine services is not limited to the following:

Infectious diseases diagnosis and treatment Palliative care of chronic diseases; Diabetes mellitus, hypertension, asthma Preventive visits concerning different illnesses seasonal illnesses checks. Allergenic conditions treatment . Nutrition Counseling and Life Coaches As every patient responds differently to some form of hospital treatment, hospital care is customized in a holistic fashion. Therefore a patient will be given proper treatment at all times. Philosophy Patient Centered Care

The hospitals are patient-centric. Since the time a patient enters into the hospitals, he or she is treated with dignity and respect. The patient is fully trained in empathetic communication so that right decision is taken by him or her at every point of time regarding the treatment process. Quality care is maintained, but the result for the patient improves due to proper coordination among departments.

Accessibility and Affordability

Quality, top-class healthcare for a very moderate price at Sapthagiri Hospitals; the billing transparency is nowhere to be seen and they don't hesitate even for financial help which makes easy health care at Hesarghatta and to all the surroundings of the places to live at. Location wise it lies in the very center so one can reach through easily.

In addition to enriching the scenario of community health through the provision of clinical services, Sapthagiri Hospitals contribute to people being healthy and wellness-conscious within society through free health camps, spreading, and preventive screenings, which are fairly done often.

Surely, the best general medicine hospital is available in which offers great general medicine treatments. You may look towards such a hospital, for you want some kind of treatment for even minor ailments, chronic conditions' management, prevention health services of many others with high-tech facility with good medic teams who make themselves patient friendly in delivering a quality care based on compassion and, above all, experience the best medical attention that you wish for at Sapthagiri Hospitals.

[abhishek2024]

Best General Medicine Hospital In Hesarghatta

If I compare the healthcare facilities in Hesarghatta, one hospital stands out from the rest. I can proudly say from my experience as a health visitor that the best general medicine hospital in Hesarghatta is Sapthagiri Hospital. Though it may be a new setup, in such a short time, it has acquired a name for constant reliable care, complete medical solution and patient-friendly services that differ from others. Infrastructural Facilities.

The architecture and latest technological advancements have made Sapthagiri Hospital state-of-the-art. This will allow the management of the health care problems to the full extent of this hospital’s infrastructure. A well-planned general medical ward with detailed consideration will even diagnose complex health issues and provide treatments based on the case. From consultation rooms to high-tech diagnostic laboratories, all the facilities that this hospital provides will ensure the right diagnosis and suitable treatment in a very pleasant environment.

This place has the best team of well-trained general physicians, who are excellent in their practices. They can treat acute diseases, chronic conditions, preventive care, and complicated cases. These medical professionals are fully aware of all advancements in general medicine, which means they can carry out evidence-based treatment with proper patient care.

General Medicine Treatment at Sapthagiri Hospitals

The list of general medicine services is not limited to the following:

Infectious diseases diagnosis and treatment Palliative care of chronic diseases; Diabetes mellitus, hypertension, asthma Preventive visits concerning different illnesses seasonal illnesses checks. Allergenic conditions treatment. Nutrition Counseling and Life Coaches As every patient responds differently to some form of hospital treatment, hospital care is customized holistically. Therefore a patient will be given proper treatment at all times. Philosophy patient-centred Care

The hospitals are patient-centric. Since the time a patient enters the hospitals, he or she is treated with dignity and respect. The patient is fully trained in empathetic communication so that right decision is taken by him or her at every point of time regarding the treatment process. Quality care is maintained, but the result for the patient improves due to proper coordination among departments.

Accessibility and Affordability

Quality, top-class healthcare for a very moderate price at Sapthagiri Hospitals; the billing transparency is nowhere to be seen and they don’t hesitate even for financial help which makes easy health care at Hesarghatta and to all the surroundings of the places to live at. Location wise it lies in the very center so one can reach through easily.

In addition to enriching the scenario of community health through the provision of clinical services, Sapthagiri Hospitals contribute to people being healthy and wellness-conscious within society through free health camps, spreading, and preventive screenings, which are fairly done often.

Surely, the best general medicine hospital in Hesarghatta which offers great general medicine treatments. You may look towards such a hospital, if you want some kind of treatment for even minor ailments, chronic conditions management, prevention health services of many others with high-tech facilities with good medic teams who make themselves patient-friendly in delivering quality care based on compassion and, above all, experience the best medical attention that you wish for at Sapthagiri Hospitals.

[diabetes-health-corner]

Long term Complications of Diabetes

Consistently high or low blood sugar, as we all know is an indicator of diabetes. And this high blood sugar if left unchecked will inevitably result in a number of long-term medical conditions that can seriously compromise health. Failure to control blood sugar will damage the body’s blood vessels, and this damage leads to complications of diabetes. These problems do not happen overnight, but their very insidious nature makes them all the more dangerous.

Read more to know facts: https://www.freedomfromdiabetes.org/blog/post/long-term-complications-of-diabetes-mellitus/394

[cerificatecoursegma]

Online Fellowship in Diabetes Mellitus in India for MBBS Doctors

Diabetes Mellitus (DM) is one of the most common chronic diseases globally, with India witnessing an alarming increase in the number of cases over the past few decades. The nation is now considered the “Diabetes Capital of the World,” with millions suffering from this condition. Given the prevalence of the disease and its potential complications, medical practitioners in India are increasingly seeking specialized training in diabetes management. For MBBS doctors, this growing demand for diabetes expertise presents an opportunity to advance their careers and contribute more effectively to healthcare. One of the most popular and flexible ways for doctors to pursue specialized training in diabetes mellitus is through online fellowship programs.

Importance of Specialization in Diabetes Mellitus

The impact of diabetes extends beyond high blood sugar levels, often leading to complications such as cardiovascular disease, kidney failure, vision problems, and neuropathy. Given the long-term nature of the disease, patients require continual monitoring and tailored treatment plans. General practitioners, though equipped with a broad medical background, may lack in-depth knowledge of managing complex diabetic cases. This gap in expertise can affect the quality of care and the ability to mitigate complications effectively.

For MBBS doctors, obtaining a fellowship in diabetes mellitus enables them to acquire the latest knowledge on diabetes care, develop practical skills in patient management, and stay updated with evolving treatment guidelines. Specializing in diabetes also opens new career pathways, from setting up a dedicated diabetes clinic to working in specialty hospitals and healthcare centers focusing on endocrinology and metabolic diseases.

Why Choose an Online Fellowship?

With the increasing demands of clinical practice, many doctors find it challenging to enroll in full-time courses or take extended time off to pursue additional qualifications. This is where online fellowship programs serve as an ideal solution. They offer flexible learning schedules that allow doctors to continue their practice while pursuing higher education.

The key benefits of enrolling in an online fellowship in diabetes mellitus include:

Flexibility: Doctors can complete the course at their own pace, balancing their clinical duties with study time. This flexibility is crucial for professionals who cannot take extended breaks from their practice.

Accessibility: These online programs are accessible from any location, meaning that doctors practicing in remote areas or smaller cities can gain access to the same high-quality education as their peers in urban centers.

Cost-effectiveness: Online courses tend to be more affordable than traditional on-campus programs, reducing the financial burden on doctors.

Quality Learning: Many of these programs are designed and led by leading endocrinologists, diabetologists, and healthcare institutions. They often include multimedia resources, case studies, webinars, and interactive sessions, ensuring a comprehensive learning experience.

Certification and Recognition: Most fellowship programs culminate in a recognized certification, adding significant value to a doctor’s professional credentials and enhancing their career prospects.

Structure of Online Fellowship Programs in Diabetes Mellitus

Though the exact structure may vary depending on the institution offering the fellowship, most online programs for diabetes mellitus specialization include the following components:

Core Curriculum: The syllabus usually covers various aspects of diabetes mellitus, including its pathophysiology, diagnostic criteria, classification (type 1, type 2, and gestational diabetes), and prevention strategies. It also explores complications of diabetes, such as diabetic neuropathy, nephropathy, retinopathy, and cardiovascular complications.

Diabetes Management: A significant portion of the course focuses on clinical management, including pharmacotherapy (insulin, oral hypoglycemics, etc.), lifestyle modifications (diet, exercise), and modern therapies such as continuous glucose monitoring and insulin pumps.

Research and Evidence-Based Practice: The program often emphasizes evidence-based practices in diabetes care, encouraging doctors to stay updated on recent studies, treatment guidelines, and clinical trials.

Case Studies and Practical Application: Many online fellowship programs incorporate real-life case discussions, allowing doctors to analyze, interpret, and apply knowledge to complex diabetes cases. This practical component equips participants with the clinical acumen needed to manage diabetes patients effectively.

Assignments and Examinations: Periodic assessments, including assignments and online examinations, help in tracking progress and ensure that participants are grasping key concepts.

Clinical Attachments (Optional): Some fellowship programs may offer optional clinical attachments or observerships in diabetes centers, where participants can gain hands-on experience in a clinical setting.

Duration: The duration of most online fellowship programs ranges from 6 to 12 months, depending on the intensity of the course and the time commitment of the participants.

Eligibility Criteria and Enrollment Process

Typically, the eligibility criteria for enrolling in an online fellowship in diabetes mellitus in India include:

A MBBS degree from a recognized institution.

Medical Council of India (MCI) registration or its equivalent.

Some programs may require a minimum number of years of clinical experience.

The enrollment process is generally straightforward and involves:

Filling out an online application form through the institution's official website.

Providing academic and professional documents, including MBBS certificates and MCI registration.

Some programs may require candidates to submit a statement of purpose or attend a brief interview.

Career Prospects After Fellowship

Completing an online fellowship in diabetes mellitus opens several career opportunities for MBBS doctors. Some potential career pathways include:

Specialized Diabetes Clinics: Doctors can establish their own diabetes care centers, providing dedicated and personalized care to diabetic patients.

Consulting Diabetologist: Graduates can work as diabetologists in hospitals, clinics, and specialty diabetes centers.

Public Health: Doctors with an interest in public health can work on diabetes prevention programs, policy development, and community outreach initiatives.

Research and Academia: Those inclined towards research can contribute to clinical trials, diabetes research, or take on teaching roles in medical colleges and institutions.

Endocrinology Training: The fellowship can also serve as a stepping stone for further specialization in endocrinology.

Conclusion

An online fellowship in diabetes mellitus offers a valuable opportunity for MBBS doctors in India to enhance their knowledge, skills, and career prospects in the field of diabetes care. With flexible learning options, accessible programs, and recognized certification, this form of higher education is ideally suited for medical professionals who want to make a significant impact on diabetes management while continuing their clinical practice. As diabetes continues to rise across India, specialized training in its management is not only a career advancement opportunity but also a step toward improving healthcare outcomes in the country.

[nephrotic-syndrome-specialist]

Nephrotic Syndrome Specialist in Delhi: Expert Care and Treatment

Comprehensive Nephrotic Syndrome Care in Delhi by Experts

Consult a Nephrotic Syndrome Specialist in Delhi for advanced diagnosis, personalized treatments, and expert care. Ensure optimal management of nephrotic syndrome.

Nephrotic Syndrome Specialist in Delhi: Comprehensive and Advanced Care

Nephrotic syndrome is a multifaceted renal disorder marked by significant proteinuria, hypoalbuminemia, hyperlipidemia, and widespread edema. This condition, rooted in disruptions to the glomerular filtration barrier, necessitates specialized medical care to address its complexity. Consulting a Nephrotic Syndrome Specialist in Delhi ensures access to state-of-the-art diagnostics, evidence-based treatment modalities, and a multidisciplinary approach to care. This article delves into the intricate aspects of nephrotic syndrome, emphasizing its diagnosis and management.

Pathophysiology and Clinical Manifestations

Understanding Nephrotic Syndrome

Nephrotic syndrome is characterized by a unique set of clinical and biochemical markers:

Proteinuria: Excretion exceeding 3.5 grams of protein per day in urine.

Hypoalbuminemia: Albumin levels below 3.0 g/dL, leading to diminished oncotic pressure.

Edema: Fluid retention manifesting as periorbital swelling and dependent edema.

Hyperlipidemia: Elevated serum cholesterol and triglycerides due to hepatic overproduction.

Disruptions in the glomerular filtration barrier, involving podocytes, the glomerular basement membrane, and endothelial cells, form the cornerstone of this pathology.

Clinical Features

Edema: A hallmark feature resulting from hypoalbuminemia, initially presenting in dependent areas and progressing to generalized fluid accumulation.

Proteinuria: Detected as frothy or foamy urine.

Dyslipidemia: Marked by high cholesterol and triglyceride levels.

Fatigue: Due to systemic protein depletion and its impact on muscle function.

Etiological Classification

Primary Causes: Minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy.

Secondary Causes: Conditions such as diabetes mellitus, systemic lupus erythematosus, amyloidosis, infections, and malignancies.

Precise identification of these causes by a Nephrotic Syndrome Specialist in Delhi enables tailored treatment strategies and improved outcomes.

Diagnostic and Therapeutic Framework

Advanced Diagnostics

Laboratory Investigations:

Serum albumin, lipid profiles, and renal function tests.

Quantitative assessment of proteinuria through spot urine protein-to-creatinine ratio or 24-hour urine collection.

Urinalysis:

Identification of protein levels and sediment abnormalities.

Imaging and Biopsy:

Renal ultrasound to evaluate kidney structure.

Percutaneous renal biopsy for histopathological confirmation and immunofluorescence analysis.

Therapeutic Interventions

Pharmacological Management:

Glucocorticoids: Primary therapy for minimal change disease.

Immunosuppressants: Such as calcineurin inhibitors (e.g., cyclosporine) and mycophenolate mofetil for resistant cases.

RAAS Inhibitors: ACE inhibitors or ARBs to reduce proteinuria and manage hypertension.

Dietary and Lifestyle Modifications:

Sodium restriction (<2 g/day) to manage edema.

Balanced protein intake to minimize renal strain while preventing malnutrition.

Lipid-lowering medications (e.g., statins) to address hyperlipidemia.

Long-Term Monitoring:

Regular follow-ups to detect complications, such as thromboembolism or progression to chronic kidney disease (CKD).

Selecting a Specialist in Delhi

Attributes to Consider

Expertise: Specialists with advanced training in nephrology and significant experience in treating nephrotic syndrome.

Infrastructure: Access to cutting-edge diagnostic tools and therapeutic options in tertiary care centers.

Patient-Centric Care: Focus on individualized treatment plans that address the unique needs of each patient.

Frequently Asked Questions

When Should a Specialist Be Consulted?

Immediate consultation is advised for symptoms such as persistent edema, frothy urine, or unexplained fatigue. Early diagnosis can significantly improve outcomes.

Is Nephrotic Syndrome Curable?

While some forms achieve complete remission, especially with appropriate treatment, others require ongoing management to prevent complications and maintain renal function.

What Are the Costs of Treatment?

Delhi offers cost-effective care, with expenses varying based on the complexity of diagnostics and therapy. Specialists ensure a balance between affordability and quality.

Conclusion

Nephrotic syndrome demands a highly specialized approach, integrating advanced diagnostics, tailored treatments, and comprehensive care frameworks. Consulting a Nephrotic Syndrome Specialist in Delhi provides access to unparalleled expertise, ensuring optimal management and improved quality of life for affected individuals. Early and precise intervention remains critical in preserving renal health and mitigating long-term complications.

[leanstooneside]

Perpetually chasing after some new bauble

- Penn Badgley's shoulder (Physical restraint status)

- Stephanie Pratt's shoulder (Juvenile arthritis, unspecified, left hand)

- Beyonce Knowles's shoulder (Angiodysplasia of colon)

- Jane Lynch's shoulder (Chronic inflammatory disorders of orbit)

- Julian McMahon's shoulder (Unspecified juvenile rheumatoid arthritis, hip)

- Ryan Cabrera's shoulder (Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema)

- Elle Fanning's shoulder (Otosclerosis involving oval window, obliterative, bilateral)

- Travis Barker's shoulder (Unspecified complication following infusion and therapeutic injection)

- Idina Menzel's shoulder (Osteophyte, left hand)

- Elizabeth Olsen's shoulder (Other combined immunodeficiencies)

- Mark Salling's shoulder (Chronic superficial gastritis without bleeding)

- Naomi Campbell's shoulder (Striatonigral degeneration)

- AnnaSophia Robb's shoulder (Kernicterus, unspecified)

- Patrick Dempsey's shoulder (Other specified injury of intrinsic muscle and tendon at ankle and foot level, left foot)

- Adam Duritz's shoulder (Osteophyte, left hand)

- Cristiano Ronaldo's shoulder (Injury of unspecified nerve at lower leg level)

- Gareth Bale's shoulder (Corrosion of second degree of unspecified shoulder)

- Arnold Schwarzenegger's shoulder (Other acute osteomyelitis, right shoulder)

- Janelle Monae's shoulder (Placenta previa with hemorrhage, second trimester)

[earlystagediabeticfootulcers]

Early Stage Diabetic Foot Ulcers: A Call to Action for Early Diagnosis and Management

Diabetes mellitus is a chronic metabolic condition that affects millions worldwide, with India bearing a significant burden. One of the most concerning complications of diabetes is diabetic foot ulcers (DFUs), which pose a severe threat to mobility and overall quality of life. Early-stage diabetic foot ulcers (DFUs) are a critical yet often overlooked phase of this condition. Addressing them at the earliest stage can significantly reduce complications, improve patient outcomes, and lower healthcare costs.

Understanding Early-Stage Diabetic Foot Ulcers

Early-stage diabetic foot ulcers are superficial, non-infected wounds primarily affecting the skin’s outermost layers. They are often the result of repetitive trauma, poor glycemic control, and underlying neuropathy or vascular compromise. Identifying and addressing these ulcers early can prevent progression to deeper, infected, or gangrenous wounds that may require invasive interventions.

Key Features of Early-Stage DFUs:

Redness or discoloration of the affected area.

Superficial breaks in the skin with minimal discharge.

Absence of systemic infection or deep tissue involvement.

Associated neuropathy leading to reduced pain perception.

Risk Factors for Early-Stage DFUs

Peripheral Neuropathy: Reduced sensation increases the likelihood of unnoticed trauma.

Peripheral Arterial Disease (PAD): Compromised blood flow delays wound healing.

Hyperglycemia: Prolonged high blood sugar levels impair immune function and tissue repair.

Improper Footwear: Shoes that cause pressure points or friction.

Poor Foot Hygiene: Increased risk of infection and skin breakdown.

Importance of Early Diagnosis

Timely identification of early-stage DFUs is essential to prevent complications. Screening for neuropathy, vascular insufficiency, and skin integrity should be a routine practice for individuals with diabetes. Vascular specialists play a pivotal role in assessing arterial health through non-invasive techniques like ankle-brachial index (ABI) and Doppler studies.

Management Strategies for Early-Stage DFUs

Glycemic Control: Maintaining blood sugar levels within target ranges promotes effective wound healing and reduces the risk of infection.

Wound Care:

Regular cleansing with sterile solutions.

Application of non-adherent, moist wound dressings.

Debridement of calluses and necrotic tissue as needed.

Pressure Offloading: Using custom orthotics or offloading devices to reduce pressure on the ulcerated area.

Infection Prevention:

Use of topical antibiotics for superficial infections.

Close monitoring for signs of systemic infection.

Vascular Health Optimization:

Addressing PAD with pharmacological or interventional treatments.

Ensuring adequate circulation to promote healing.

Preventive Measures

Routine Foot Exams: Patients with diabetes should inspect their feet daily and undergo regular professional foot evaluations.

Education on Foot Care:

Proper cleaning and moisturizing of feet.

Avoiding barefoot walking.

Appropriate Footwear: Shoes should provide cushioning and prevent pressure points.

Regular Vascular Assessments: Periodic evaluation of arterial health, especially for those with a history of PAD or ulcers.

The Role of Multidisciplinary Care

Managing early-stage diabetic foot ulcers requires a coordinated approach involving diabetologists, vascular surgeons, podiatrists, and wound care specialists. Early referral to vascular specialists is crucial for patients with signs of compromised circulation or non-healing wounds.

Conclusion

Early-stage diabetic foot ulcers present an opportunity for intervention before complications arise. Proactive measures, including education, regular screenings, and timely treatment, are essential to curb the progression of DFUs. The Vascular Society of India is uniquely positioned to lead efforts in raising awareness, promoting research, and developing clinical guidelines to improve the lives of patients living with diabetes and its complications.

[jcsmicasereports]

ABSTRACT

Charcot Arthropathy is a serious complication of Diabetic neuropathy, usually affecting foot or ankle. It causes widespread destruction of affected joints and bones around them leading to severe deformities that may require major amputation. Here, we report the case of a 62 year-old male who presented with severe left foot deformities and swelling on the left big toe that developped over a short period of time. His primary presentation raised the suspicion for a bone tumor or cellulitis which then revealed by X-Ray that it's a Charcot foot necessitating foot fixation, strict glycemic control and treatment with Biphosphonates. This report will therefore serve as a reminder for clinicians to keep in mind Charot Arthropathy in diabetic patients with peripheral neuropathy even if it doesn’t present in a typical manner.

Keywords: Charcot, arthropathy, diabetes, trauma, destruction, joints, deformity, sensation, neuropathy, inflammation, chronic, Fixation, Osteodegenerative, ambulation, uncontrolled.

INTRODUCTION

Charcot Arthropathy is a serious but rare progressive condition that can affect 0.15 – 2.5% of diabetic patients especially those who developed peripheral neuropathy. Despite the voluminous work reported in literature on CA, very few studies mention the prevalence of this disabling disease. The actual incidence of CA may be greater than what is reported, as in many cases, the clinicians fail to diagnose or are late to diagnose this serious complication. Charcot affects the bones, joints, and soft tissues of the foot or ankle. Whilst the exact pathophysiology remains debated, a multifactorial pathogenesis seems likely predominating. This involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels leading to bones deformities. Clinical features include signs of inflammation, profound unilateral swelling, an increase in local skin temperature and bone resorption in an insensate foot may be present.

In advanced cases with considerable mid-foot destruction, a typical "rocker bottom" appearance is seen. In most cases, progression of deformity takes a more chronic form and is seen over a period of months, to years.

This case report describes a case of a chronic destructive Charcot foot in a patient with uncontrolled diabetes, which was initially managed as a case of bone tumor.

Case Report

A 62 year old male with a background of Type 2 Diabetes Mellitus, peripheral neuropathy and obesity presented with complain of numbness and decreased sensation of forefoots and a mass in the arch of left foot. Eight days prior, he sustained a fall whilst walking but denied any injury, swelling or pain at that time. He said his left big toe was totally straight but now has deformed (into Morton) and his 2nd toe looks bigger due to big toe deformation and often remains bend in shoes which he doesn’t feel, but when removing the shoes he often finds it bent. The patient denies any pain in the deformed toe but a little feeling of warmth in the pathological area.

Examination revealed a warm, swollen left foot with a 2 mm healing ulceration on the plantar surface and a lumpy sensation on the left big toe. Blood tests showed normal white blood cells count, elevated C-reactive Protein (CRP-67) and a thrombocytosis. His fasting blood glucose level was 221 mg/dl with features of uncontrolled diabetes.

Plain film X-Ray revealed complete fracture dislocations of the 1st , second and fifth tarsometatarsal joints with large bone deformity on the left arch of the foot as well as another deformity on the right arch and lower calcaneus {Figure.2}. This was correlated with bone CT (computed tomography) and MRI (Magnetic Resonance) imaging, with interval changes noted to be of chronic onset.

Discussion

Charcot foot is a well-documented complication of diabetic neuropathy. The mechanism of this is not fully understood but two theories exist – namely, the neurovascular and neurotraumatic theories. In the neurovascular theory, an underlying autonomic neuropathy leads to hypervascularity, osteolytic changes and demineralization. However, the neurotraumatic hypothesis indicates that unperceived trauma to an insensate extremity leads to continued bony destruction on ambulation, which worsens and progresses. These theories imply that a sufficient time frame is required for established Charcot foot destruction to develop.

Typical progression of Charcot foot occurs over months to years, although rare acute onsets have been reported. However, the progression seen in our patient, from normal X-Ray appearances to established, acute Charcot foot with considerable mid-foot destruction over a period of just 10 days is a rarely described progression of Charcot arthropathy. The combination of local skin warmth with decreased sensation in the left foot and feeling of a bony lump on the left arch raised the suspicion of a bone tumor, but X-Rays as well as CT Scan of the foot beside the uncontrolled diabetes in this patient made Charcot foot a more possible diagnosis.

Early recognition of Charcot Arthropathy is a mandatory to ensure improved outcomes. It is important to differentiate between acute Charcot foot, infection and bone tumors through clinical investigations as well as patient medical history. The presence of ulcers should raise the suspicion of infection or osteomyelitis, and therefore, the importance of early imaging cannot be overstated. Modestly raised inflammatory markers (CRP-68) in this diabetic patient along with left foot deformities suggest an acute Charcot foot than an infectious process. The latter frequently presents with high laboratory values.

The initial management of the patient was fixation with a total contact leg cast, followed by open reduction and internal fixation (ORIF) with locking plates, combined with lengthening of Achilles tendon to permit full dorsiflexion and subsequent re-casting.

Due to osteodegenerative nature of CN, all attempts at pharmacological treatment have focused on anti-osteoporotic drugs so we started the patient on an Alindronate beside a more strict control of his diabetes. His post-operative progress was satisfactory and he is currently non-weight bearing for 6 months post-ORIF.

Conclusions

The case highlights an important clinical scenario that can be misdiagnosed in a diabetic patient. A clinical presentation of unilateral foot swelling, erythema, warmth and decreased sensation should raise suspicion for Charcot Arthropathy even in the absence of trauma history. I hope this will be a helpful reminder to clinicians when dealing with similar presentations.

[motivelinks]

ECG Services for Diabetic Patients at World Diabetes Centre

Diabetes mellitus is a chronic condition that affects millions of people worldwide, and its complications can impact virtually every organ in the body. One of the most significant concerns for people with diabetes is cardiovascular health. Diabetic patients are at a higher risk of developing heart disease, including coronary artery disease, arrhythmias, and other heart conditions. As a result, monitoring heart health is a vital part of diabetes management. One of the most effective tools for assessing heart function is an Electrocardiogram (ECG), a non-invasive test that measures the electrical activity of the heart.

At the World Diabetes Centre, ECG services play a crucial role in monitoring and managing the cardiovascular health of diabetic patients. Given that diabetes often leads to increased risk of heart disease, regular ECG assessments are integral to early detection, prevention, and treatment. The following outlines the importance and benefits of ECG services for diabetic patients at the World Diabetes Centre.

Understanding ECG and Its Role in Diabetic Care

An Electrocardiogram (ECG or EKG) is a test that records the electrical signals of the heart. It provides a detailed view of the heart's rhythm, the size of the heart chambers, and the overall health of the heart. The test is performed by placing small electrodes on the patient's chest, arms, and legs, which detect the electrical impulses generated by the heart as it beats.

For diabetic patients, ECGs are particularly important because diabetes can damage the heart and blood vessels over time. The high blood sugar levels associated with diabetes contribute to the thickening of the blood vessels, which can lead to reduced blood flow and an increased risk of heart attack, stroke, and heart failure. Regular ECG testing allows healthcare professionals at the World Diabetes Centre to detect early signs of heart disease, monitor the effects of diabetes on the heart, and make timely interventions.

Importance of ECG Services for Diabetic Patients

Early Detection of Cardiovascular ComplicationsDiabetic patients often experience cardiovascular complications without exhibiting noticeable symptoms. This is especially true for those with long-standing diabetes or poorly controlled blood sugar levels. An ECG can detect abnormal heart rhythms (arrhythmias), signs of reduced blood flow to the heart (ischemia), or even damage to the heart muscle (myocardial infarction). Early detection through ECG testing can lead to prompt treatment and prevent the progression of heart disease.At the World Diabetes Centre, ECG services are available as part of routine screenings for diabetic patients, particularly for those with additional risk factors such as high blood pressure, high cholesterol, or a family history of heart disease. By identifying potential heart issues early, healthcare providers can initiate preventive measures and help patients manage their cardiovascular health more effectively.

Monitoring Heart Function and Glycemic ControlDiabetes management is a dynamic process, with blood sugar levels fluctuating over time. Poor glycemic control can contribute to a variety of heart-related problems. Regular ECG testing at the World Diabetes Centre allows healthcare providers to assess how well the patient's heart is functioning in relation to their diabetes management plan. If a diabetic patient’s blood sugar levels are not well controlled, ECG results may show signs of strain on the heart, such as irregular rhythms or evidence of previous heart attacks.This insight allows doctors to adjust treatment plans accordingly, optimizing blood sugar management while also addressing any cardiovascular concerns. For example, patients who show signs of arrhythmias on their ECG may benefit from a combination of medications, lifestyle changes, and further cardiovascular testing.

Assessing the Impact of Diabetes on the HeartOne of the primary reasons diabetic patients need regular ECG monitoring is the impact diabetes has on the cardiovascular system. High blood sugar levels can lead to the thickening and narrowing of the arteries, a condition known as atherosclerosis, which increases the risk of heart attacks and strokes. Additionally, diabetes can contribute to autonomic neuropathy, which affects the nervous system and can lead to abnormal heart rhythms.Through ECG services, the World Diabetes Centre can closely monitor how these changes manifest in the heart. The test can detect changes in heart rate variability, signs of ischemia, and other indicators that may suggest the heart is being affected by the long-term effects of diabetes. Identifying these issues early allows healthcare professionals to take preventive actions, including recommending medications to reduce blood pressure, cholesterol, and blood sugar levels, as well as advising patients on lifestyle changes.

Guiding Treatment Plans and InterventionsECG testing provides valuable data that can help guide treatment decisions. For diabetic patients who experience symptoms like chest pain, shortness of breath, or dizziness, an ECG can offer immediate insights into the underlying cause. If an ECG reveals significant issues such as arrhythmias or ischemia, the patient may be referred to a cardiologist for further evaluation and treatment.In some cases, patients may require interventions such as the use of anti-arrhythmic medications, angioplasty, or even surgery. For less severe findings, lifestyle modifications, blood sugar management, and medications may suffice. Regular ECGs at the World Diabetes Centre ensure that diabetic patients receive the most appropriate treatment tailored to their unique cardiovascular health needs.

Comprehensive, Multidisciplinary CareAt the World Diabetes Centre, ECG services are part of a broader multidisciplinary approach to diabetes care. Diabetic patients are often seen by a team of specialists, including endocrinologists, cardiologists, dietitians, and diabetes educators. ECGs help facilitate communication between these specialists, ensuring that cardiovascular health is adequately managed alongside other aspects of diabetes care.The results of ECG tests are reviewed by cardiologists, who work in close collaboration with diabetes specialists to adjust the patient's overall treatment plan. This holistic approach improves patient outcomes by addressing both the metabolic and cardiovascular aspects of diabetes simultaneously.

Conclusion

ECG services for Diabetes Patients are an essential component of diabetic care at the World Diabetes Centre. Regular ECG testing allows for the early detection of heart disease, monitoring of heart function in relation to glycemic control, and provides valuable information for guiding treatment decisions. By integrating ECG testing into routine diabetes management, the World Diabetes Centre ensures that patients receive comprehensive, personalized care that reduces the risk of cardiovascular complications and improves overall health outcomes. As part of a multidisciplinary team, ECG services contribute to the long-term health and well-being of diabetic patients, enabling them to live healthier, more fulfilling lives.

Visit us at: Opp Octroi Post, Hambran Road, Ludhiana-141004, Punjab

Call us today to book your session: +91(+91) 709 830 0000