Thoracic Epidural Anesthesia and Blood Glucose Levels in Diabetic Patients Undergoing Cardiopulmonary Bypass Under Insulin Infusion According to the Portland Protocol

2009 ◽  
Vol 118 (03) ◽  
pp. 190-194 ◽  
Author(s):  
M. Sener ◽  
E. Caliskan ◽  
N. Bozdogan ◽  
A. Kocum ◽  
S. O. Oner ◽  
...  
2016 ◽  
Vol 8 (9) ◽  
pp. 159
Author(s):  
Muhammad Bilal ◽  
Abdul Haseeb ◽  
Mohammad Hassaan Khan ◽  
Akash Khetpal ◽  
Muhammad Saad ◽  
...  

<p><strong>INTRODUCTION: </strong>Perioperative hyperglycemia has been shown to be related to higher levels of morbidity and mortality in patients on cardiopulmonary bypass (CPB) undergoing coronary artery bypass grafting (CABG), both diabetic and non-diabetic. Blood electrolytes, like sodium, potassium, calcium, and chloride play a very important role in the normal functioning of the body and can lead to a variety of clinical disorders if they become deficient. A minimal number of studies have been conducted on the simultaneous perioperative changes in both blood glucose and electrolyte levels during CPB in Pakistan. Therefore, our aim is to record and compare the changes in blood glucose and electrolyte levels during CPB in diabetic and non-diabetic patients.</p><p><strong>MATERIALS &amp; METHODS: </strong>This was a prospective, observational study conducted on 200 patients who underwent CABG with CPB, from October 2014 to March 2015. The patients were recruited from the Cardiac Surgery Ward, Civil Hospital Karachi after they complied with the inclusion criteria. Repeated-measures analysis of variance (ANOVA) was used to compare the trend of the changes perioperatively for the two groups.</p><p><strong>RESULTS: </strong>There was no significant difference in changes in blood glucose between the two groups (<em>P</em> = 0.62). The only significant difference detected between the two groups was for PaCO<sub>2</sub> (<em>P</em> = 0.001). Besides, further analysis revealed insignificant group differences for the trend changes in other blood electrolytes (<em>P</em> &gt; 0.05).</p><p><strong>CONCLUSION: </strong>Our findings highlighted that there is no significant difference in blood electrolytes changes and the increase in blood glucose levels between diabetic and non-diabetic patients.</p>


Perfusion ◽  
2002 ◽  
Vol 17 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Patricia A Gustafson ◽  
Debra L Zarro ◽  
David A Palanzo ◽  
Norman J Manley ◽  
Ralph M Montesano ◽  
...  

Continuous insulin infusion was not an effective mode of treatment in maintaining safe blood glucose levels (<200 mg/dl) during the intraoperative period of diabetic patients requiring open-heart surgery. The two modifications investigated to gain better control of the blood glucose were a change in the base solution of the cardioplegia and the use of a sliding insulin scale. Fifty patients including Type I and Type II diabetics were selected for the purpose of this study. The patients were then randomly divided into two groups categorized by the type of cardioplegic solution administered and the mode of insulin treatment. Group I patients received a dextrose 5%-based cardioplegic solution and blood glucose was treated via continuous intravenous insulin infusion. Group II patients received normal saline 0.9%-based cardioplegic solution and blood glucose was treated via sliding scale. Blood glucose levels were monitored pre- and postcardio- pulmonary bypass (CPB) and every 30 min while on CPB. Glucose values were analyzed by group t test. A p value of < 0.05 was considered statistically significant. When comparing Group I (mean=258 mg/dl) with Group II (mean= 158 mg/dl), there was a statistically significant difference between the glucose values at each of the time intervals when the glucose values were recorded. In conclusion, Group II maintained an acceptable blood glucose level (<200 mg/dl) throughout the entire intra- operative period, which suggests that the combination of the sliding insulin scale and modification of the base cardioplegic solution was an effective mode of treatment.


2020 ◽  
Vol 16 (4) ◽  
pp. 301-312 ◽  
Author(s):  
Jyoti Singh ◽  
Prasad Rasane ◽  
Sawinder Kaur ◽  
Vikas Kumar ◽  
Kajal Dhawan ◽  
...  

Diabetes is a globally prevalent chronic metabolic disease characterized by blood glucose levels higher than the normal levels. Sugar, a common constituent of diet, is also a major factor often responsible for elevating the glucose level in diabetic patients. However, diabetic patients are more prone to eat sweets amongst the human population. Therefore, we find a popular consumption of zero or low-calorie sweeteners, both natural and artificial. But, the uses of these sweeteners have proved to be controversial. Thus, the purpose of this review was to critically analyze and highlight the considerations needed for the development of sugar-free or low-calorie products for diabetic patients. For this purpose, various measures are taken such as avoiding sugary foods, using natural nectar, artificial sweeteners, etc. It cannot be ignored that many health hazards are associated with the overconsumption of artificial sweeteners only. These sweeteners are high-risk compounds and a properly balanced consideration needs to be given while making a diet plan for diabetic patients.


Author(s):  
Sylvain Mathieu ◽  
Marion Couderc ◽  
Sandrine Malochet-Guinamand ◽  
Jean-Jacques Dubost ◽  
Anne Tournadre ◽  
...  

Author(s):  
Karim Zahed ◽  
Farzan Sasangohar ◽  
Ranjana Mehta ◽  
Madhav Erraguntla ◽  
Mark Lawley ◽  
...  

Diabetes is a prevalent condition affecting millions of patients globally. Some diabetic patients suffer from a deadly condition called Hypoglycemia (sudden drop in blood glucose levels). Continuous Glucose Monitors (CGMs) have been the most pervasive tool used to track blood glucose levels but these tools are invasive and costly. While early detection of hypoglycemia has been studied, current approaches do not leverage tremors; which are a primary symptom of hypoglycemia. A scoping review was conducted to understand the relationship between tremors and hypoglycemia, and to document any efforts that utilized tremor signatures non-invasively to detect hypoglycemic events. Findings suggest that hypoglycemic tremors are a medium frequency tremor, more resistant to hypoglycemic impairment than other symptoms, and have not been fully explored yet. This paper also documents the work in progress to utilize a novel wearable device that predicts the onsets of hypoglycemia using hand tremor sensing.


2018 ◽  
Vol 3 (2) ◽  
pp. 72
Author(s):  
Setyoadi Setyoadi ◽  
Heri Kristianto ◽  
Siti Nur Afifah

Diabetes mellitus is a disease that required good self-management. Noncompliance in diet and meal plans cause the instability of blood glucose levels. Nutrition education calendar method can improve knowledge and ability to consume food that matches the number, hours and types with dietary adjustments listed in the calendar diet. This study aimed to determine the effect of nutrition education calendar method on blood glucose levels of patients with type 2 diabetes mellitus in Community Health Center Pakis Malang. Pre-experimental design one group pretest-posttest with purposive sampling was conducted in this study and sample obtained as many as 21 people. Blood glucose levels were measured before and after the nutrition education calendar methods. Compliance in using calendar method with the observation sheet. Statistical analysis values obtained by Wilcoxon, the p-value of 0.007 (p <0.05). The results of the analysis, 16 respondents showed a decrease in blood glucose levels and 5 respondents experienced an increase in blood glucose levels after the given intervention. It can be concluded that there are differences between blood glucose levels before and after nutrition education calendar method. Differences in blood glucose levels can be influenced by controlling diet respondent in accordance with the calendar method in education, but also antidiabetic drugs, and sports. Should be added to the control group to determine objectively the effect of nutrition education on the calendar method.


2019 ◽  
Vol 6 (3) ◽  
pp. 786
Author(s):  
Eda Dayakar ◽  
C. Sathya Sree ◽  
E. Sanjay

Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients.  Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.


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