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Complicated Urinary Tract Infections Associated With Diabetes Mellitus: Pathogenesis, Diagnosis And Management

Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management

Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management


Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management
Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
Corresponding Author: Dr. Mahdi Kamoun, Department of Endocrinology, Hedi Chaker Hospital, Magida Boulila Avenue, 3029 Sfax, Tunisia. E-mail: [email protected]_idham
Author information Copyright and License information Disclaimer
Copyright : Indian Journal of Endocrinology and Metabolism
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC.
Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections (UTIs) in the patient with diabetes mellitus. Complicated UTIs are also common and potentially life-threatening conditions. They include emphysematous pyelonephritis, emphysematous pyelitis/cystitis, xanthogranulomatous pyelonephritis, renal/perirenal abscess, and renal papillary necrosis. Improved outcomes of these entities may be achieved by early diagnosis, knowledge of common predisposing factors, appropriate clinical and radiological assessment, and prompt management. Herein we review complicated UTIs associated with diabetes mellitus in terms of pathogenesis, clinical manifestations, radiological features, and current management options.
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The UK Prospective Diabetes Study (UKPDS): clinical and therapeutic implications for type 2 diabetes

The UK Prospective Diabetes Study (UKPDS): clinical and therapeutic implications for type 2 diabetes


The UK Prospective Diabetes Study (UKPDS): clinical and therapeutic implications for type 2 diabetes
1Jenny ONeill Diabetes Centre, Derbyshire Royal Infirmary, Derby, UK
2Division of Vascular Medicine, School of Medical and Surgical Sciences, University of Nottingham, UK
1Jenny ONeill Diabetes Centre, Derbyshire Royal Infirmary, Derby, UK
2Division of Vascular Medicine, School of Medical and Surgical Sciences, University of Nottingham, UK
Correspondence: Dr I. Peacock, Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, UK.
Note added in proof We wish to pay tribute to Robert Turner whose recent untimely death is such a tragedy.
Received 1999 Mar 15; Accepted 1999 Aug 24.
Keywords: antihypertensives, diabetic complications, glycaemic control, oral hypoglycaemic agents, type 2 diabetes, UKPDS
This article has been cited by other articles in PMC.
Diabetes was first recognized 3500 years ago by the Ancient Egyptians. One of the first clinical descriptions was by Aretaeus, who practised in Cappadocia around 120 AD. He wrote that the condition was fortunately rare, but short will be the life of the man in whom the disease is fully developed [ 1 ].
In modern society, the first statement is far from true. The incidence of diabetes has doubled every 20 years since 1945 [ 2 ]. In 1994 the world wide prevalence of type 2 (non-insulin dependent) diabetes was 99 million (1.8% of the population); by 2010 it is estimated that this figure will rise to 215 million (3.8%) [ 3 ].
The second statement is as true today as it was almost 2000 years ago. In the West, 44% of pat Continue reading

Diabetes Patients Seeing Better Outcomes Through Technology

Diabetes Patients Seeing Better Outcomes Through Technology


Tuesday, June 06, 2017 |by Paul Wynn, special to AAMCNews
Diabetes Patients Seeing Better Outcomes Through Technology
When David Klonoff, MD, started practicing endocrinology more than 35 years ago, urine tests were the standard for diabetes screenings. We had to mix chemicals with the urine to get a resultand it wasnt very accurate, said Klonoff, a clinical professor at the University of California, San Francisco (UCSF), School of Medicine and founding editor in chief of the Journal of Diabetes Science and Technology.
Fast-forward to 2017. Continuous glucose monitoring systems can measure blood glucose every five minutes or up to 300 times a day. Sensors built into advanced systems enable patients to sidestep the need to prick their fingers to collect blood. Klonoff, a specialist in diabetes technology, coauthored a study on the first-generation system of an artificial pancreas that can automatically send information to an insulin pump to adjust unhealthy blood glucose levels. He was lead investigator for the first in-home pivotal trial of a closed-loop product for managing type 1 diabetes, and he participated in developing the first dedicated diabetes telemedicine system cleared by the Food and Drug Administration. The system increases access to expertise for people in remote areas or without transportation.
"The new technologies for the testing and treatment of diabetes in the past few decades have been astounding and are making a major difference in improving the outcomes.
Academic medical centersUCSF and othersare uniquely positioned to bring together technology Continue reading

Screening for neonatal diabetes at day 5 of life using dried blood spot glucose measurement

Screening for neonatal diabetes at day 5 of life using dried blood spot glucose measurement


, Volume 60, Issue11 , pp 21682173 | Cite as
Screening for neonatal diabetes at day 5 of life using dried blood spot glucose measurement
The majority of infants with neonatal diabetes mellitus present with severe ketoacidosis at a median of 6weeks. The treatment is very challenging and can result in severe neurological sequelae or death. The genetic defects that cause neonatal diabetes are present from birth. We aimed to assess if neonatal diabetes could be diagnosed earlier by measuring glucose in a dried blood spot collected on day 5 of life.
In this retrospective casecontrol study we retrieved blood spot cards from 11 infants with genetically confirmed neonatal diabetes (median age of diagnosis 6 [range 2112] days). For each case we also obtained one (n=5) or two (n=6) control blood spot cards collected on the same day. Glucose was measured on case and control blood spot cards. We established a normal range for random glucose at day 5 of life in 687 non-diabetic neonates.
All 11 neonates with diabetes had hyperglycaemia present on day 5 of life, with blood glucose levels ranging from 10.2mmol/l to >30mmol/l (normal range 3.26.0mmol/l). In six of these neonates the diagnosis of diabetes was made after screening at day 5, with the latest diagnosis made at 16weeks.
Neonatal diabetes can be detected on day 5 of life, preceding conventional diagnosis in most cases. Earlier diagnosis by systematic screening could lead to prompt genetic diagnosis and targeted treatment, thereby avoiding the most severe sequelae of hyperglycaemia in neonates.
Blood spotsGlucoseNeonatal d Continue reading

Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus

Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus


#Springer Science+Business Media New York 2016
Abstract Medical nutrition therapy (MNT) plays an impor-
tant role in the management of gestational diabetes mellitus
(GDM), and accordingly, it has a significant impact on women
and newborns. The primary objective of MNT is to ensure
adequate pregnancy weight gain and fetus growth while main-
taining euglycemia and avoiding ketones. However, the opti-
mal diet (energy content, macronutrient distribution, its qual-
ity and amount, among others) remains an outstanding ques-
tion. Overall, the nutritional requirements of GDM are similar
for all pregnancies, but special attention is paid to carbohy-
drates. Despite the classical intervention of restricting carbo-
hydrates, the latest evidence, although limited, seems to favor
a low-glycemic index diet. There is general agreement in the
literature about caloric restrictions in the case of being over-
weight or obese. Randomized controlled trials are necessary to
investigate the optimal MNT for GDM; this knowledge could
Keywords Carbohydrates .Diet .Gestational diabetes .
Gestational diabetes mellitus .Medical nutrition therapy .
Gestational diabetes mellitus (GDM) is a frequent metabolic
condition associated with pregnancy that leads to substantial
maternal and perinatal complications. Medical nutrition ther-
apy (MNT) remains the main strategy for the treatment of
gestational diabetes [1]. However, there is still insufficient
evidence as to which is the optimal type of dietary advice.
This paper revises the available evidence from studies on this
matter Continue reading

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