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PREVELANCE OF METFORMIN-INDUCED GASTROINTESTINAL PROBLEMS

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Sadeeqa S., Fatima M., Latif S., Afzal H., Nazir S. U. R., Saeed H.
Acta Poloniae Pharmaceutica - Drug Research
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2019
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vol. 76
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issue 6
1073-1077
EN
Metformin is used as an anti-diabetic drug among oral hypoglycemic drugs, which produces many gastrointestinal problems. Study aims to investigate the effect of metformin induced gastrointestinal problems and its prevalence. A cross-sectional study design was adapted using convenience sampling technique, at different Diabetic Centers of Lahore and Faisalabad, Pakistan from, June-2017 to November-2017. A total of 300 male and female patients participated in the study between 26 to 85 years and diagnosed with type-II diabetes. Data was directly collected from the patients and prevalence of metformin-induced gastrointestinal intolerance was determined by the symptoms of the patients. Data was analyzed by SPSS version 21. Results showed a significant difference between gender and symptoms (p=0.029). Moreover, the gastrointestinal problems were found to be dose related. A significant difference existed between patients who were taking 500mg and those taking 850 mg of metformin (p=0.006), patients who were taking 500mg and those taking 1000mg of metformin (p=0.000) and patients who were taking 850mg with those taking 1000mg of metformin (p=0.022). The prevelance of metformin-induced gastrointestinal symptoms was 45.8%. Most commonly occurring symptoms were, constipation (41.35%) followed by dyspepsia (27.89%), abdominal pain (26.92%), bloating and heart burn (25%), indigestion (15.38%), anorexia (11.54%), diarrhea (6.58%), flatulence (7.69%), nausea (6.73%) and vomiting (2.88%). It was concluded that gastrointestinal intolerance was more in females as compared to males. The gastrointestinal problems increased with the increase in dose. The side effects occurred were irrespective of the age and the most common gastrointestinal symptom was found to be constipation.
2
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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.
Open Medicine
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2013
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vol. 8
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issue 4
503-508
EN
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.
3
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Acute cholecystitis in patients with diabetes mellitus - systematic review

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Łącka M., Spychalski P., Dobrzycka M., Rostkowska O., Kobiela J.
European Journal of Translational and Clinical Medicine
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2020
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vol. 2
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issue 2
71-79
EN
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.
4
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Acute cholecystitis in patients with diabetes mellitus - systematic review

100%
Łącka M., Spychalski P., Dobrzycka M., Rostkowska O., Kobiela J.
|
2019
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vol. 2
|
issue 2
71-79
EN
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.
5
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StudHeart-diabetes mellitus t.2 risk factors in senior medical students

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Morawiec R., Janikowski K., Zawisza J., Lelonek M.
Open Medicine
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2013
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vol. 8
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issue 5
608-617
EN
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.
6
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Endocrine disorders in patients with hereditary hemochromatosis

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Banaszkiewicz K., Sikorska K., Sworczak K.
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2019
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vol. 1
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issue 2
72-76
EN
Hereditary hemochromatosis (HH) is a rare genetic disorder, developing secondary to the accumulation of iron in tissues, which may lead to multiple organ failure. If untreated, it may result in liver cirrhosis or cardiomyopathy. The damage to the pancreas and the anterior pituitary, on the other hand, leads to a decreased production and secretion of hormones that are essential to life. Common symptoms of HH, that are distressing for patients, include joint pain, particularly involving hands and wrists, as well as the chronic fatigue syndrome. Iron overload affects the skeletal system, leading to osteoporosis. The pathological accumulation of iron in the anterior pituitary impairs the gonadotropin synthesis, resulting in reduced serum levels of testosterone in men and estrogens in women. This, however, contributes to lower bone mass. In vivo tests have also revealed that abnormal iron accumulation is related to an increased activity and number of osteoclasts, as well as the influence on the differentiation and activity of osteoblast-lineage cells. Based on a systematic review of literature, hereditary hemochromatosis (HH) will be presented as a chronic disease, affecting most of the endocrine glands.
7
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Content available

Endocrine disorders in patients with hereditary hemochromatosis

88%
Banaszkiewicz K., Sikorska K., Sworczak K.
|
EN
Hereditary hemochromatosis (HH) is a rare genetic disorder, developing secondary to the accumulation of iron in tissues, which may lead to multiple organ failure. If untreated, it may result in liver cirrhosis or cardiomyopathy. The damage to the pancreas and the anterior pituitary, on the other hand, leads to a decreased production and secretion of hormones that are essential to life. Common symptoms of HH, that are distressing for patients, include joint pain, particularly involving hands and wrists, as well as the chronic fatigue syndrome. Iron overload affects the skeletal system, leading to osteoporosis. The pathological accumulation of iron in the anterior pituitary impairs the gonadotropin synthesis, resulting in reduced serum levels of testosterone in men and estrogens in women. This, however, contributes to lower bone mass. In vivo tests have also revealed that abnormal iron accumulation is related to an increased activity and number of osteoclasts, as well as the influence on the differentiation and activity of osteoblast-lineage cells. Based on a systematic review of literature, hereditary hemochromatosis (HH) will be presented as a chronic disease, affecting most of the endocrine glands.
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