-
1دورية أكاديمية
المؤلفون: Shridhar N. Iyer, Almond J. Drake, R. Lee West, Robert J. Tanenberg
المصدر: Case Reports in Medicine, Vol 2011 (2011)
مصطلحات موضوعية: Medicine
الوصف: Objective. To report a case of diabetic muscle infarction (DMI), a rare complication of long-standing poorly controlled diabetes mellitus. Methods. We describe a case of a 45-year-old male with an approximately 8-year history of poorly controlled type 2 diabetes mellitus with multiple microvascular complications who presented with the sudden onset of left thigh pain and swelling. He had a swollen left thigh and a CK of 1670 U/L. He was initially treated with intravenous antibiotics for a presumptive diagnosis of pyomyositis or necrotizing fasciitis with no improvement. A diagnosis of diabetic muscle infarction was considered. Results. An MRI of the thigh demonstrated diffuse edema in the anterior compartment. A muscle biopsy demonstrated coagulation necrosis in skeletal muscle and inflammation and infarction in the walls of small blood vessels. These studies confirmed the final diagnosis of DMI. He was treated with supportive care and gradually improved. Conclusion. DMI is a rare complication of diabetes that is often mistaken for infections such as pyomyositis and necrotizing fasciitis or thrombophlebitis. Treatment is supportive. Although the short-term prognosis is good in these patients, the long-term prognosis is poor.
وصف الملف: electronic resource
-
2دورية أكاديمية
المؤلفون: Carlos E Mendez, Robert J Tanenberg, Walter Pories
المصدر: Diabetes, Metabolic Syndrome and Obesity, Vol 2010, Iss default, Pp 281-283 (2010)
مصطلحات موضوعية: Specialties of internal medicine, RC581-951
الوصف: Carlos E Mendez, Robert J Tanenberg, Walter PoriesDiabetes and Obesity Institute, East Carolina University, Greenville, NC, USAAbstract: Roux-en-Y gastric bypass surgery (RYGB) reverses type 2 diabetes (DM2) in approximately 83% of patients with morbid or severe obesity. This procedure has been performed in small numbers of severely obese patients with type 1 diabetes (DM1), but the impact on glycemic control and insulin requirement in this population has not been widely described. We report three patients with DM1 and severe obesity that underwent RYGB. Weight, glycemic control, and insulin requirements before and one year after the procedure were compared. Significant weight loss was achieved by all three patients but insulin requirements decreased in only 2 patients. In contrast, glycemic control (A1C) remained suboptimal in all three patients up to one year after the surgery. These findings suggest that RYGB leads to important weight loss and positively affects insulin sensitivity. However, reaching optimal glycemic control in patients with DM1 diabetes remains challenging due to persisting insulin deficiency.Keywords: gastric bypass, Roux-en-Y, obesity, diabetes, insulin
وصف الملف: electronic resource
النص الكامل