Background Chronic kidney disease (CKD) is a global public health concern and diabetes is one of the main risk factors for its occurrence and progression. The aim of this research is to determine the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes in primary health centers in North West Bank. Methods Patient data including patient characteristics, creatinine level, blood pressure, HbA1c, and hypertension and period of diabetes were obtained from primary health care centers. The eGFR has been determined using the CKD-EPI equation. CKD was staged according to the 2012 Kidney Disease Improving Global Outcomes Framework (KDIGO) guideline. Both univariable and multivariable statistical analysis was conducted using SPSS. Results The prevalence of chronic kidney disease among diabetic adults in North West Bank was found to be 23.6% (95% CI: 19.4–28.1%) divided as follows: 19.7% had stage 3 CKD, 2.6% had stage 4 CKD and 1.3% had stage 5 CKD. In multivariable logistic regression, CKD was significantly associated with Age ≥ 60 years [adjusted OR: 3.2, 95% CI: 1.8–5.9], hypertension [adjusted OR: 5.7, 95% CI: 2.2–15.2], and smoking [adjusted OR: 2.3, 95% CI: 1.3–4.2]. Conclusions CKD is very prevalent among diabetic adults in Palestine. Co-morbid hypertension, smoking and older age has been shown to increase the risk of developing CKD. Extensive screening for diabetic patients to diagnose CKD at an early stage and to follow more aggressive treatment methods for diabetes as well as other important risk factors, especially hypertension and smoking, is recommended.
Alpelisib, a phosphatidylinositol-3-kinase (PI3K) inhibitor, is a new drug approved for metastatic breast cancer. Hyperglycemia is a known side effect of this medication, however diabetic ketoacidosis is rarely described. We are presenting a 64-year-old female with a known case of Type 2 diabetes mellitus (hemoglobin A1c [HbA1c] 5.6% ) controlled by metformin alone. She was also diagnosed with metastatic breast cancer. She received radiotherapy, trastuzumab and letrozole. Then, she was started on alpelisib as she failed other previous modalities. She presented to the emergency department with a two-week history of polyuria and polydipsia, and laboratory investigation results showed high anion gap metabolic acidosis, ketonemia, and hyperglycemia. She was treated for diabetic ketoacidosis (DKA). After the resolution of DKA, she was kept on daily insulin subcutaneous injections. She was restarted on a reduced dose of alpelisib, but despite this, her blood sugar readings continued to rise, requiring discontinuation of the medication with a resolution of hyperglycemia. The goal of our case report is to emphasize the importance of close glucose monitoring when starting alpelisib to avoid serious complications like DKA.
Coronavirus disease 2019 (COVID-19) is a widespread disease. Hyponatremia in the setting of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was described with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nonetheless, seizure as a prominent manifestation of hyponatremia associated with COVID-19 is rare. We present a case of a middle-aged man with mild COVID-19 pneumonia, who developed a seizure due to SIADH-related severe hyponatremia.
Burns are complex injuries that lead to hyperglycemia as a stress response. Diabetes Mellitus (DM) is a hormonal and metabolic disorder categorized by impaired insulin secretion and yielding to elevate plasma glucose levels and therefore complicates the therapy of burns, it is also developed via uncontrolled stress reaction to the burn. Also, DM will impact on nutrition and lifestyle of burn patients. This review provides pathophysiology, difficulties and managements of burns related to the patients with DM to offer evidence-based care to seriously ill people. Performing a treatment for diabetic burn patient is difficult for healthcare professionals. Traumatic burn in non-diabetic people may develop stress-induced hyperglycemia which ends up with DM due to endocrine complications from their injury. The higher risk for burn injuries is found in pre-existing DM. Special medical plan should be employed to control burns. Additionally, treatments for present burn must be reformed to avoid diabetes mellitus, management of glucose level, and help healing process in diabetic foot ulcer.
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