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Agani Z, Ahmedi J, Ademi Abdyli R, Prekazi Loxha M, Hamiti‐Krasniqi V, Rexhepi A, Stubljar D. The changes in levels of blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction. Clin Exp Dent Res 2022; 8:1449-1455. [PMID: 35909305 PMCID: PMC9760155 DOI: 10.1002/cre2.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The extraction of a tooth exacerbates the stress in diabetic patients leading to diabetic complications so the aim was to evaluate the changes in blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction to pay special attention during a routine surgical procedure. MATERIALS AND METHODS The research included 40 patients with type 2 diabetes with indications of tooth extraction. They were divided into two subgroups by 20 participants and split according to local anesthesia (lidocaine with additional adrenaline or lidocaine only). Cortisol, blood sugar, blood pressure, arterial pulse, and blood oxygen saturation were measured. Patients were also evaluated for their sensitivity to pain through the Visual Analog Scale (VAS). RESULTS Cortisol and glucose levels scientifically increased throughout the procedure. Meanwhile, systolic, and diastolic blood pressure and saturation showed no difference between the measurements during and after tooth extraction (p = .280; p = .090; p = .590, respectively). Most patients (60.0%) felt no pain during/after the procedure. None of the subjects was feeling more pain than 30 points by VAS. The comparison between groups receiving lidocaine showed no statistical differences when adding adrenaline to lidocaine. Evaluation of pain by VAS showed that more patients felt pain when they were receiving lidocaine without adrenaline. CONCLUSIONS Diabetic patients require a more cautious approach when undergoing teeth extractions despite it being a routine procedure.
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Affiliation(s)
- Zana Agani
- Department of Oral SurgeryUniversity of PrishtinaPrishtinaKosovo
| | - Jehona Ahmedi
- Department of Oral SurgeryUniversity of PrishtinaPrishtinaKosovo
| | | | | | | | - Aida Rexhepi
- UBT CollegeHigher Education InstitutionPrishtinaKosovo
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Kashif RR, D’Cunha NM, Mellor DD, Alexopoulos NI, Sergi D, Naumovski N. Prickly Pear Cacti (Opuntia spp.) Cladodes as a Functional Ingredient for Hyperglycemia Management: A Brief Narrative Review. Medicina (B Aires) 2022; 58:medicina58020300. [PMID: 35208623 PMCID: PMC8874358 DOI: 10.3390/medicina58020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
The worldwide prevalence of obesity is increasing along with its comorbidities, including type 2 diabetes mellitus (T2DM). From a pathophysiological perspective, T2DM arises as a consequence of insulin resistance and pancreatic β-cell dysfunction, which together induce chronic hyperglycemia. The pharmacological treatment of T2DM specifically focuses on its management, rather than remission, with a lack of pharmacological agents to prevent the onset of the disease. Considering the role of unhealthy dietary patterns on the development of T2DM, identifying novel food ingredients and bioactive substances may provide new avenues by which to address the T2DM epidemic. In this brief review, we have summarized the latest findings on the consumption of the prickly pear (PP; Opuntia spp.) cladode as a potential nutritional tool for the management of hyperglycemia. The consumption of prickly pear cladodes was reported to exert hypoglycemic effects, making it a potential cost-effective nutritional intervention for the management of T2DM. Several studies have demonstrated that the consumption of prickly pear cladodes and the related products reduced post-prandial glucose levels. The cladodes’ high fiber content may be implicated in improving glycemic control, by affecting glucose absorption and effectively slowing its release into the blood circulation. Given these potential hypoglycemic effects, prickly pear cladodes may represent a potential functional food ingredient to improve glycemic control and counter the negative metabolic effects of the modern Western diet. Nonetheless, in consideration of the lack of evidence on the chronic effects of the prickly pear cladode, future research aimed at evaluating its long-term effects on glycemic control is warranted.
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Affiliation(s)
- Rao Raahim Kashif
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (R.R.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Nathan M. D’Cunha
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (R.R.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Duane D. Mellor
- Aston Medical School, Aston University, Birmingham B4 7ET, UK;
| | | | - Domenico Sergi
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy;
| | - Nenad Naumovski
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (R.R.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
- Correspondence: ; Tel.: +61-2-6206-8719
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Lira JAC, Nogueira LT, Oliveira BMAD, Soares DDR, Santos AMRD, Araújo TMED. Factors associated with the risk of diabetic foot in patients with diabetes mellitus in Primary Care. Rev Esc Enferm USP 2021; 55:e03757. [PMID: 34320142 DOI: 10.1590/s1980-220x2020019503757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 01/01/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze factors associated with diabetic foot risk in patients with diabetes mellitus assisted in Primary Care. METHOD Observational, analytic, and transversal study took place in Teresina, Piauí, with diabetic patients who are assisted in Primary Care. Data collection took place through interviews, foot clinical exams, and medical record analysis. We used the Mann-Whitney, Pearson's Chi-square and multiple logistic regression statistics tests to analyze the data. The association power among categorical variables was measured by Odds Ratio . RESULTS 322 patients participated. Marital status with a partner presented a protection factor (p = 0.007). Risk factors for the development of the diabetic foot are: arterial hypertension (p = 0.045), obesity (p = 0.011), smoking (p = 0.027), not being submitted to follow ups (p = 0.046), inadequate control of capillary blood glucose (p < 0.001), indisposition to the care of the foot (p=0.014), and foot self-exam less frequently (p = 0.040). CONCLUSION Sociodemographic, clinical, and self-care aspects interfere in diabetic foot development, highlighting the necessity of effective follow up tracking and educational interventions for patients with diabetes mellitus in Primary Care.
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Davari M, Moghaddam HR, Soola AH. Identifying the Predictors of Self-Management Behaviors in Patients with Diabetes Based on Ecological Approach: A Systematic Review. Curr Diabetes Rev 2021; 17:e102620187197. [PMID: 33106146 DOI: 10.2174/1573399816666201026161009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Recognizing and promoting the factors that affect the self-management behaviors of diabetes lead to a reduction in the number of patients and an improvement in the quality of care. The ecological approach focuses on the nature of people's interactions with their physical and socio-cultural environments. OBJECTIVE The purpose of this study was to identify the predictors of self-management behaviors with a comprehensive approach in these patients. METHODS The keywords were investigated in the relevant national and international databases, including PubMed, Google Scholar, Science Direct, Scopus, and Scientific Information Database, Magiran, and Iran Medex, to obtain the articles published from 2009 to 2019. The search and article selection strategy was developed based on the Prisma checklist and was carried out in three steps. RESULTS Most studies have shown that personal factors had the highest prediction power for the self-management of diabetes. The interpersonal factors, society and policy-making factors, and group and organization factors were then the most frequently reported predictors of self-management behaviors in diabetic patients. CONCLUSION Self-management of diabetes is necessary for controlling it because 95% of care is done by the patient. When designing self-management interventions, factors are based on the individual level that is to increase self-management behaviors.
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Affiliation(s)
- Mahnaz Davari
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Aghil Habibi Soola
- Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
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Al-Saleh Y, Al Motairi F, Hassan E, Al Sohaim A, Al Anazi I, Al Masoud A, Al Wohabe R, Al Anazi S, Al Shahrani A, Al-Daghri NM. Insulin Pump Therapy Issues Among Adults with Type 1 Diabetes Mellitus in Saudi Arabia: A Retrospective Study. Diabetes Ther 2020; 11:2993-3001. [PMID: 33068258 PMCID: PMC7644598 DOI: 10.1007/s13300-020-00946-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/06/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Type 1 diabetes mellitus (T1DM) is on the rise in Saudi Arabia. Management of T1DM is crucial in curbing the economic burden of this disease. Studies on insulin pump issues are scarce in the region. The present study aims to fill this gap. METHODS In this single-centre, retrospective study done in King Abdulaziz Medical City (KAMC) from March 2018 to March 2019, a total of 118 known Saudi T1DM adults (34 males and 84 females) were included. Data on demographics, glycated haemoglobin (HbA1c) and CSII use were collected. RESULTS The most common problem encountered by the patients on CSII was breaking down of the pump (30.0%), relocation of the cannula or tubing (22%) and air bubbles affecting delivery (16.1%). Eighty-one subjects (68.6%) claimed to have been admitted for DM management while on CSII. The use of CSII led to a significant reduction in HbA1c in all subjects (p < 0.001), but levels remain suboptimal. Only 53 subjects (44.9%) reported no significant problems in their CSII experience. CONCLUSION There is a high prevalence of T1DM adult patients experiencing device malfunctions and other issues while on CSII therapy. This may account for suboptimal improvement in the glycaemic control among T1DM Saudi patients. Issues on adherence and device malfunctions should be investigated further.
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Affiliation(s)
- Yousef Al-Saleh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 22490, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia.
- Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, RiyadhRiyadh, 14611, Saudi Arabia.
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Fajr Al Motairi
- Department of Nursing, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Esra Hassan
- King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, RiyadhRiyadh, 14611, Saudi Arabia
| | - Abdullah Al Sohaim
- King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, RiyadhRiyadh, 14611, Saudi Arabia
| | - Ibtisam Al Anazi
- Department of Nursing, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Ashwag Al Masoud
- Department of Nursing, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Rasha Al Wohabe
- Department of Nursing, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Sultana Al Anazi
- Department of Nursing, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia
| | - Awad Al Shahrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 22490, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, RiyadhRiyadh, 14611, Saudi Arabia
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
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Gazal G. Management of an emergency tooth extraction in diabetic patients on the dental chair. Saudi Dent J 2020; 32:1-6. [PMID: 31920272 PMCID: PMC6950840 DOI: 10.1016/j.sdentj.2019.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/04/2019] [Accepted: 07/27/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Approximately 75% of diabetic patients in Saudi Arabia had poor glycaemic control. A high proportion of these patients will attend dental surgery clinics for treatment. Therefore, dentists should be well-prepared to control any complications they might arise on the dental chair during the dental procedures. Management of the associated risk factors is important to limit disease complications and improve the health of patients with diabetes.The objectives of this review were to determine the maximum acceptable level of blood glucose for tooth removal in diabetics, show a systematic technique for the management of patients with diabetes on the dental chair. By using PRISMA guidelines, analysis of the published articles and reports across the world is considered one of the most appropriate available methods to obtain strong evidence about the acceptable levels of blood glucose where teeth extraction can be done safely. RESULTS A total of 1080 studies were retrieved using the search strategy. After screening 185 titles, abstracts and 85 full-text articles, 36 studies were included. The outcome of this systematic review revealed that fasting blood glucose level of 240 mg/dl is a critical point for any dental treatment because the warning signs of diabetes start coming out. Maximum acceptable levels of blood glucose for removal of teeth in diabetics are 180 mg/dl (before meal) and 234 mg/dl (2 h after a meal). High blood glucose levels reduce the secretion of nitric oxide (powerful vasodilator) in the body which leads to poor circulation and slow-healing socket. Uncontrolled diabetics are at high risk of infection because of the high ketone levels in the blood. CONCLUSION Fasting blood glucose level of 180 mg/dl is a cut-off point for any selective dental extraction. However, Random blood glucose level of 234 mg/dl (13 mmol/l) is a cut-off point for an emergency tooth extraction. Tightly controlled diabetic patients (blood glucose level below 70 mg/dl) are susceptible to hypoglycemia.
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