Hospital treatment for type 2 diabetes treatment,hospital laboratory errors yii,diabetes treatment new technology youtube - 2016 Feature

In diabetic dogs, the main treatment for regulating blood glucose is the administration of insulin by injection. Initially, your dog may be hospitalized for a few days to deal with any immediate crisis and to begin the insulin regulation process.
Insulin is a hormone that will lose its effectiveness if exposed to direct sunlight or high temperatures. Insulin comes in an airtight bottle that is labeled with the insulin type and the concentration. Before injecting your dog with the insulin, check that there are no air bubbles in the syringe. 4)  To inject the insulin, place your thumb on the plunger and push it all the way into the syringe barrel.
2)  Due to the nature of the thick hair coat and the type of bacteria that live near the skin of dogs, brief swabbing with alcohol or any other antiseptic is not effective.
3)  Because a small amount of alcohol can be carried through the skin by the needle, it may actually carry bacteria with it into the skin. 4)  If you have accidentally injected the insulin onto the surface of the skin, you will not know it. Although the above procedures may at first seem complicated and somewhat overwhelming, they will very quickly become second nature.
The most likely time that a dog will become hypoglycemic is the time of peak insulin effect (5-8 hours after an insulin injection). Read and reread this material so that you understand the specifics of proper regulation and how to recognize and treat hypoglycemia.
Background: The objective was to determine the risk factors, ulcer grade, and management outcome of patients with diabetic foot ulcers (DFU) managed in a tropical tertiary hospital.
14.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33).
21.Almoznino-Sarafian D, Shteinshnaider M, Tzur I, Bar-Chaim A, Iskhakov E, Berman S et al. In the dog, diabetes mellitus is usually Insulin Dependent Diabetes Mellitus (also called Type 2 Diabetes).
Dogs with diabetes mellitus require one or more daily insulin injections, and almost all require some sort of dietary change. Your dog needs consistent administration of insulin, consistent feeding, and a stable, stress-free lifestyle. However, this fear is unfounded, since the disposable injection needles are extremely sharp and cause minimal pain, the insulin does not sting or otherwise hurt on injection, and the injections are given under the skin in areas where it is impossible to damage internal structures. It is important to make sure you match the insulin concentration with the proper insulin needles.
When you have finished mixing the insulin, turn the bottle upside down to see if any white powder adheres to the bottom of the bottle.
Immediately place the needle guard over the needle and place the used needle and syringe into a puncture-resistant container. If you do not use alcohol and the skin or hair is wet following an injection, the injection was not done properly. Your dog will soon learn that once or twice each day it has to sit still for a few minutes. Although most dogs will require the same dose of insulin for long periods of time, it is possible for the dog's insulin requirements to suddenly change. This can occur because the insulin was not properly measured in the syringe or because two doses were given.
If glucose is not detected, measure the glucose two consecutive days every other week or as directed. Materials and Methods: This is a prospective observational study of all consecutive diabetes mellitus (DM) patients with DFU admitted in the University of Benin Teaching Hospital, Benin City, Nigeria over a 26-month period.
Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital.
Pattern of presentation and outcomes of treatment of diabetic foot ulcers in Benin City, Nigeria. Risk factors and prevalence of diabetic foot ulcers at Kenyatta National Hospital, Nairobi.
Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus-review and meta-analysis.


Assessment of risk factors in diabetic foot ulceration and their impact on the outcome of the disease. Self-reported visual impairment among persons with diagnosed diabetes --- United States, 1997--2010. Diabetes foot ulceration in a Nigeria hospital: in-hospital mortality in relation to the presenting demographic, clinical and laboratory features.
Anemia in diabetic patients at an internal medicine ward: clinical correlates and prognostic significance.
This type of diabetes usually results from destruction of most or all of the beta-cells that produce insulin in the pancreas. Dogs in this state, called diabetic ketoacidosis, may require a several days of intensive care. Although it is not essential, your dog should live indoors to minimize uncontrollable variables that can disrupt regulation. Once you are shown how to give them, you may be pleasantly surprised at how easy it is and how well your dog tolerates the injections.
If you have any doubt about the storage of your pet's insulin, it is safer to replace it rather than risk using ineffective insulin. The reason you do not shake insulin is to prevent foam formation, which will make accurate measuring difficult due to the tiny air bubbles. Then withdraw the needle from the insulin bottle and tap the side of the barrel of the syringe with your fingernail to make the air bubble rise to the tip of the syringe. However, take care to push the needle through only one layer of skin and not into your finger or through two layers of skin and out the other side. Simply resume your normal schedule and give the next insulin injection at the regular time. Be aware that some communities have strict rules about disposal of medical waste material so don't throw the needle and syringe into the garbage until you know if this is permissible. In most cases, a reward of stroking results in a fully cooperative dog that eventually may not even need to be held.
However, the most common causes for change are a reduction in food intake and an increase in exercise or activity. You may forget that you gave it and repeat it, or two people in the family may each give a dose.
If there is still no response, contact your veterinarian immediately for further instructions. If two injections are given each day, be sure the test is done before the evening injection. Data documented included age, gender, type of DM, duration of DM, risk factors of DFU, duration of DFU, Wagner's ulcer grade, and the blood glucose at presentation and management outcome. Foot lesions in DM are associated with significant morbidity and mortality [2],[3],[4],[5],[6] yet they are one of the most preventable long -term complications of DM. As the name implies, dogs with this type of diabetes require insulin injections to stabilize blood sugar levels.
This means that you, as the dog's owner, must make both a financial commitment and a personal commitment to treat your dog. Otherwise, the initial hospitalization may be only for a day or two while the dog's initial response to insulin injections is evaluated. Insulin is safe as long as it is used as directed, but it should be kept out of the reach of children.
The latter will result in injecting the insulin onto your dog's haircoat or onto the floor.
It is usually preferable to take the used needles and syringes to your veterinary clinic or local pharmacy for disposal. If it occurs during office hours, take your dog to the veterinarian's office immediately. On investigations his blood sugar levels were elevated and patient was not willing to get into hospital for treatment. If are out of town or go on vacation, your dog must receive proper treatment in your absence. Your veterinarian will instruct you on which type of insulin you are using and which type of syringe you should use. When you have removed all of the air bubbles, double-check that you have the correct amount of insulin in the syringe.


If it occurs at night or on the weekend, call your veterinarian's emergency phone number for instructions. Patient was treated on out patient basis to get good control of diabetes and then admitted for a day in hospital for surgical procedure.
Always remember that it is better in the short term for the blood sugar to be too high than too low. There is shortage of trained diabetes care specialists for the ever-increasing population of diabetic patients in primary and secondary health care centres.
Most patients will seek treatment from health care providers with little or no training in managing diabetic foot ulcers. Your veterinarian will work with you to try to achieve consistent regulation, but some dogs are difficult to keep regulated. Availability and affordability of facilities for rehabilitation of amputees are scarce in Nigeria.
Hence there is the need to identify the risk factors for diabetic foot ulcer, factors associated with LEA, and management outcomes of patients with DFUs in order to put preventive measures in place that will reduce burden of DFU and the incidence of LEA. Patients admitted into the Medical Wards of the University of Benin Teaching Hospital, Benin City with diagnosis of diabetic foot ulcer between December 2007 and February 2010 were consecutively recruited into the study after obtaining informed consent. Conclusions: Spontaneous blisters, peripheral vascular disease, peripheral neuropathy,and visual impairment are common risk factors of DFUs. Data documented after taking a detailed history and doing a clinical examination included age, gender, type of DM, duration of DM, duration of foot ulcer before presentation to hospital, ulcer grade at presentation using Wagner's grading [7] (this system was used for ulcer classification as in most Nigerian studies for ease of comparison), blood glucose at presentation and the presence of hypertension, risk and precipitating factors of DFU, history of foot care and footwear education, season when DFU occurred, and findings on plain X-rays of the feet were documented.
Many of our patients with DFUs presented with grade IV and V ulcers with the resultant high rate of lower extremity amputations (LEAs). Patients with incomplete data such as age and duration of diabetes mellitus, and those whose treatment outcomes could not be ascertained because of missing medical records (case notes) were excluded from the analysis.Patients with DFUs are managed by a multidisciplinary team comprising the endocrinologists, orthopaedic surgeons, ophthalmologists, nutritionists and nurses.
Patients are admitted under the care of the endocrinologists who evaluate and investigate the patients.
Wound debridement, incision and drainage, and amputations were done by orthopaedic surgeons. Peripheral vascular disease was defined as the presence of diminished or absent lower limb arterial pulsation on palpation. Visual impairment was defined as diminished vision resulting from refractive errors, cataracts or diabetic retinopathy, assessed by direct fundoscopy. Comparison of means was done using a t-test for continuous data and a chi-square test for categorical data.
Logistic regression analysis was performed to examine the association of some risk factors for LEA (age, sex, duration of diabetes mellitus, and type of DM, ulcer grade, ulcer duration, peripheral vascular disease, peripheral neuropathy, and hypertension) with LEA.
The risk factors and comorbidites of diabetic foot ulcers in our patients are documented in [Table 2].
The radiograph of the feet showed evidence of one or more of osteomyelitis, osteopenia, and osteolysis in 21 (34.4%). Gender, type of diabetes mellitus, PVD, and hypertension were not significantly associated with the risk of amputation. A total of 45.9% of our patients with DFUs presented to the hospital with Wagner grade IV and V ulcers with the resultant need for some form of amputation.
This late presentation was further confirmed by the fact that less than 10% of our patients presented to hospital within 7 days of developing a foot ulcer. Ulcers were present for up to 3 weeks in over 50% of patients before they came to the hospital for treatment.
Similar presentation with limb threatening ulcers was reported by Dagogo-Jack [2] in Port Harcourt, Nigeria. Lagos and Port Harcourt are more cosmopolitan and economically more endowed than Benin City. Patients with DFU in these locales are thus more likely to report early to hospitals for treatment of their DFUs when compared to patients in Benin City.



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