EMJ Diabetes最新文献

{"title":"Tropical Diabetic Hand Syndrome: A Case Report and Literature Review","authors":"Victor Emanah, Chukwudum Ewelukwa, Oluwatosin Emehinola, Edinen Asuka, Ogochukwu Oputa-Onwusa, Oluwakemi Olalude","doi":"10.33590/emjdiabet/10160953","DOIUrl":"https://doi.org/10.33590/emjdiabet/10160953","url":null,"abstract":"Tropical diabetic hand syndrome (THDS) is an acute complication that mainly affects patients with diabetes living in the tropics. The cause is usually unknown, but it is often preceded by minor trauma to the hand. Other risk factors for TDHS are poor glycaemic control, poorly treated wounds, malnutrition, and diabetic neuropathy. Early signs include swelling and ulceration of the hand. It can rapidly progress to sepsis and may further worsen, leading to deformity, disability, and amputation. If not treated promptly, death may occur. Unlike diabetic foot ulcer, TDHS often goes unreported. Here is a case of a 39-year-old female and a known patient with diabetes who presented to the outpatient department with swelling and tenderness of the left hand, along with foul-smelling purulent discharge. It began after the patient peeled off a patch of scaly, thickened skin over the distal part of their middle finger. Investigations showed high blood sugar and slightly increased leukocyte count. The patient was started on antihyperglycaemic medications and intravenous antibiotics. Urgent surgical debridement was done, which led to amputation of the middle finger. Thereafter, the patient showed significant improvement and was discharged with follow-up instructions. This case report emphasises the importance of timely intervention in cases of tropical diabetic hand syndrome, and the need for adequate patient education on this issue.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121481493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting to Telemedicine in Diabetes","authors":"Anaya Malik","doi":"10.33590/emjdiabet/10013792","DOIUrl":"https://doi.org/10.33590/emjdiabet/10013792","url":null,"abstract":"THIS year’s European Association for the Study of Diabetes (EASD) Annual\u0000Meeting 2022 was a hybrid congress, which focused on inclusion and\u0000interaction within the global diabetes community whether participants\u0000attended in person in Stockholm, Sweden, or virtually.\u0000In front of a live audience, Richard Holt, Professor in Diabetes and Endocrinology\u0000at University of Southampton, UK, delivered the presentation, ‘“I just called to say\u0000I love you...” Diabetes tools for telemedicine: What we learned from COVID-19 and\u0000beyond?’ Holt spoke on how telemedicine has become increasingly popular in\u0000diabetes consultations, and how there has been a major rise in its use as a\u0000result of the pandemic. Holt reviewed the evidence on telemedicine for diabetes\u0000care, before exploring the practical issues experienced by patients and healthcare\u0000professionals during the pandemic, taking these as lessons to better inform how\u0000we can use telemedicine going forward. The COVID-19 pandemic has led to a rapid\u0000expansion of the use of telemedicine, and many have had to adapt to the use of this\u0000in diabetes care.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123673743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Management, Micronutrients, and Supplements in Diabetes","authors":"E. Roberts, J. Mechanick","doi":"10.33590/emjdiabet/10153468","DOIUrl":"https://doi.org/10.33590/emjdiabet/10153468","url":null,"abstract":"This year’s 39th International Symposium on Diabetes and Nutrition in Anavyssos, Greece, hosted a series of presentations and plenary lectures with a focus on the effects of weight loss, micronutrients, nutritional supplements, and alternative dietary patterns in the prevention and management of Type 2 diabetes (T2D) and cardiovascular risk reduction. Michael Lean discussed how diabetes remission can be achieved through weight loss using a low-energy diet (LED) or very low-energy diet (VLED), accompanied by continued long-term support from specialised healthcare professionals. Jeffrey Mechanick discussed the importance and impact of early intervention on T2D and cardiovascular disease (CVD). He emphasised that T2D should be seen not just at the point of disease, but on a spectrum from prediabetes to complications, with early interventions having significant impact on not only the progression of T2D, but also into the latter stages.Simin Liu presented an integrative multilevel framework for causal inference to personalise cardiometabolic health, highlighting recent work investigating the roles of dietary minerals, environment metals, and genomics in relation to cardiovascular disease and diabetes. \u0000\u0000Several of the presentations included discussion of specific interventions. Daniel West discussed the use of whey protein (WP) and how it can help control postprandial glycaemic excursions (PGE) in people with T2D controlled on oral antihyperglycaemic drugs. Following this, Andrea Hawkinson discussed how a new supplement, mulberry leaf (Morus alba) extract (MLE), can significantly lower postprandial glucose response, as well as early insulin response, highlighting the need for further studies to evaluate its efficacy in people with T2D. Philip Atherton showed studies providing evidence that protein and essential amino acid (EAA) supplementation can help support muscle mass, which is especially essential for older people with T2D and sarcopenia. Finally, Jose-María López-Pedrosa spoke about how a supplement containing slow digestible carbohydrates (SDC), arginine, lysine, and β-hydroxy-β-methylbutyric acid (HMB) can help preserve muscle mass, as well as improve insulin resistance, in a rat model of diabetes.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117179654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the European Association for the Study of Diabetes (EASD) Annual Meeting","authors":"Noémie Fouarge, Darcy Richards, Natasha Meunier-McVey, Jaki Smith, Kirsty Hewitt","doi":"10.33590/emjdiabet/10054752","DOIUrl":"https://doi.org/10.33590/emjdiabet/10054752","url":null,"abstract":"AFTER 2 years of virtual meetings, the 58th European Association for the Study of Diabetes (EASD) Annual Meeting took a hybrid form, with 7,716 participants onsite in Stockholm, Sweden, as well as 3,291 participants online. The programme of the congress was developed to cover the most recent developments and breaking news relating to diabetes research, covering the latest innovations and developments in the treatment of Type 1 and Type 2 diabetes (T2D), as well as their complications. Through symposia, debates, prize lectures, oral discussion sessions, and a dedicated e-learning track, a range of topics were discussed.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"336 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127577597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EASD 2022 Abstract Highlights","authors":"T. Wolf, Jaki Smith, Kirsty Hewitt, Noémie Fouarge, Darcy Richards","doi":"10.33590/emjdiabet/10198260","DOIUrl":"https://doi.org/10.33590/emjdiabet/10198260","url":null,"abstract":"The following highlights spotlight several standout abstracts presented at the 58th European Association for the Study of Diabetes (EASD) Annual Meeting, covering topics such as the effects of extended overnight fasting, the incidence of congenital heart defects in the offspring of females diagnosed with pregestational diabetes, and telehealth for the metabolic control of Type 1 diabetes.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123304187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of Elevated Postprandial Glucose and Nutritional Approaches for Postprandial Glucose Management with a Focus on Whey Proteins","authors":"Jennifer Taylor","doi":"10.33590//emjdiabet/10047523","DOIUrl":"https://doi.org/10.33590//emjdiabet/10047523","url":null,"abstract":"This symposium took place at the 58th Annual Meeting of the European Association for the Study of Diabetes (EASD) in Stockholm, Sweden. The first speaker was John L. Sievenpiper, who discussed the pathophysiology of postprandial hyperglycaemia and how it may impact the risk of cardiovascular disease (CVD), peripheral vascular disease, insulin resistance, and other comorbidities in patients with Type 2 diabetes (T2D). Sievenpiper then reviewed various pharmacological interventions that target postprandial glucose (PPG) and insulin levels, including incretin therapies and α-glucosidase inhibitors, such as acarbose. Data presented showed that a low glycaemic index (GI) diet can improve glycaemic control and reduce cardiometabolic risk factors in patients with Type 1 diabetes (T1D) and T2D. Sievenpiper then presented data on novel non-pharmacological approaches that target PPG, including mulberry leaf (Morus alba L) extract (MLE), which has α-glucosidase inhibitor activity, reducing PPG and insulin responses to sucrose. The second speaker, Bo Ahrén, presented data on the effects of whey protein (WP) and branched-chain amino acids (BCAA) on PPG management and as a potential intervention for postprandial hyperglycaemia. They also discussed the mechanisms underlying the effects of WP, and highlighted data presented at the 2022 58th Annual EASD meeting by Johansen and colleagues on a novel micelle microgel technology. WP microgels (WPM) deliver highly concentrated and lower calorie doses of WP, with the potential to be developed clinically as therapeutics for T2D. The symposium concluded with a question and answer session between panel members and the audience. Ian J. Neeland was the meeting moderator.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"os-13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127687414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unexpected Post-ocrelizumab Improvement in Glycaemic Control in a Patient with Multiple Sclerosis","authors":"O. Duz, Şebnem Bektaş, Abdullah Emre Askin, Erkingül Birday","doi":"10.33590/emjdiabet/10089148","DOIUrl":"https://doi.org/10.33590/emjdiabet/10089148","url":null,"abstract":"Ocrelizumab, a novel member of disease-modifying therapies for multiple sclerosis (MS), is a humanised monoclonal antibody against the CD20 molecule on the surface of B cells. Reports on possible effects of this molecule in MS therapy have attracted a lot attention since its approval in 2017.\u0000\u0000The authors present a 31-year-old female patient who was diagnosed with MS in 2008, with a concomitant disease of Type 1 diabetes (T1D). The patient’s MS treatment included interferon-β1a and fingolimod prior to ocrelizumab initiation in 2019. In regard to the patient’s T1D course, they had poor glycaemic control despite regular follow-ups and strict treatment plans. Subsequent to the commencement of ocrelizumab therapy, a significant improvement was observed in their glycaemic control.\u0000\u0000The authors’ case study aims to raise motivation for further investigation and studies to evaluate this unexpected potential impact of ocrelizumab on T1D control.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"147 1-2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132983565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview: David Leslie","authors":"D. Leslie","doi":"10.33590/emjdiabet/10012264","DOIUrl":"https://doi.org/10.33590/emjdiabet/10012264","url":null,"abstract":"David Leslie shared insights into his career, research, and the future of the diabetes field.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115410607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis in Pregnancy: An Overview of Pathophysiology, Management, and Pregnancy Outcomes","authors":"M. Dhanasekaran, S. Mohan, A. Egan","doi":"10.33590/emjdiabet/10194487","DOIUrl":"https://doi.org/10.33590/emjdiabet/10194487","url":null,"abstract":"Diabetic ketoacidosis (DKA) is an obstetrical emergency that is associated with an elevated risk of adverse pregnancy outcomes. This includes pregnancy loss in up to 1 in 3 cases. Due to the normal metabolic changes that occur during pregnancy, females who are pregnant are more vulnerable to DKA, and it can occur at lesser than expected degrees of hyperglycaemia. Presenting symptoms can be non-specific and include nausea and vomiting, fatigue, polydipsia, and polyuria. DKA may be the first presentation of previously undiagnosed diabetes. Therefore, high index of suspicion, along with prompt diagnosis and management, is essential. The cornerstones of management include intravenous insulin, intravenous fluids, and electrolyte replacement. Treatment generally follows the principles for DKA management outside of pregnancy, with some additional considerations. Close maternal and fetal monitoring is essential, and intensive care unit admission is typically required to adequately achieve this goal. In all situations, a thorough investigation should occur to address the underlying cause of the DKA and prevent further episodes. This review article outlines the potential etiopathogenesis, clinical presentation, and management of DKA in pregnancy.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"2 11-12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114038618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next Step in Incretin-Based Therapy: From Single to Dual Agonism","authors":"Subhodip Pramanik, S. Ray","doi":"10.33590/emjdiabet/22-00140","DOIUrl":"https://doi.org/10.33590/emjdiabet/22-00140","url":null,"abstract":"The twin epidemics of Type 2 diabetes (T2D) and obesity will continue to bring significant health challenges in the coming decades. Randomised controlled trials of glucagon-like peptide 1 (GLP-1)-based therapies showed high glycaemic efficacy with clinically meaningful weight loss, and have been considered as game-changers in the diabesity population. Emerging evidence has demonstrated that co-administration of glucose-dependent insulinotropic peptide (GIP) and GLP-1 results in enhanced insulinotropic effect in an additive way with significant glucagonostatic response, compared with the administration of each hormone separately. These findings have driven the choice to pursue incretin-based dual agonist therapies, known as ‘twincretin’. Observations from the global registration Phase III trials suggest that tirzepatide (a novel dual GIP/GLP-1 receptor agonist) represent advancement over current GLP-1 analogues, providing enhanced glycaemic and weight benefits with similar gastrointestinal tolerability. However, data are limited from patients with a range of ethnicities, and several questions remain unanswered.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123189798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}