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Neurophysiological evaluation in newly diagnosed Diabetes Mellitus type 1

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Matanovic D. , Popovic S. , Parapid B. , Petronic I. , Nikolic D.

nr 4

503-508

The aim of the study was to evaluate the effects of hyperglycemia on nerve conduction in patients with newly diagnosed diabetes mellitus type 1, and to investigate the significance of early electrophysiological diagnostics in these patients. The study included 85 newly disclosed patients with type 1 diabetes mellitus, in the first three months after the disease. Nerve conduction velocities (NCV) of further nerves were evaluated: median, peroneal, tibial and sural nerve as well as late responses (F-wave and H-reflex). Metabolic control parameters that were evaluated included: glycemia rate on the day of investigation and HbA1c. All patients had poor metabolic control parameters. We found NCV slowing predominantly in the tibial nerve (in 82.4% of patients). Prolonged F-wave latency was disclosed in 72.9% of patients, while H-reflex was evoked in 27.1% of patients only. The most sensitive parameter in the early neurophysiologic diagnostics was the measurement of F-wave latency. Our study underline the significance of early neurophysiological diagnosis, since hyperglycemia can play an acute role in NCV slowing, despite the absence of clinical symptoms, particularly in the first three months after the diagnosis has been confirmed.

Acute cholecystitis in patients with diabetes mellitus - systematic review

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Łącka M. , Spychalski P. , Dobrzycka M. , Rostkowska O. , Kobiela J.

nr 2

71-79

Introduction According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes Results Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.

StudHeart-diabetes mellitus t.2 risk factors in senior medical students

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Morawiec R. , Janikowski K. , Zawisza J. , Lelonek M.

nr 5

608-617

Introduction. StudHeart research was performed to evaluate the risk of diabetes mellitus type 2 (T2DM) amongst the senior medical students. Material and methods. The research involved 506 students aged 22–27 (mean age 23.96±1.52 yrs) in their 5th and 6th year of the medical faculties at the Medical University of Lodz. Each of the examined students has filled out an anonymous survey comprising 12 questions, which enabled us to use the FINDRISC scale in estimation of the risk for T2DM. Analysis was performed in relation to gender. Results. Overall in 16.80% of respondents the body mass index (BMI) was >25 kg/m2. Almost all students (93.48%) admitted to drinking alcohol and 9.68% smoked cigarettes. Only 13.64% of participants exercised daily (women 8.16% vs. men 21.30%; P=0.000). Everyday consumption of fruit and vegetables was reported by 55.34% of the respondents whereas 6.92% of them (women 4.42% vs. men 10.40%; P=0.026) ate fast-food 2–3 times a week. The overall risk for T2DM was elevated in 17.2% of examined students. It is predicted that by the time participants will reach age of 45, 40.52% of them (mostly men) will have their risk of T2DM elevated. Conclusion. Despite the awareness of risk factors for T2DM among senior medical students, their lifestyle remains unchanged. In the given population it is predicted that the risk of T2DM will enhance about 2.5-fold in the next 20 years.