WCIM 2014 SEOUL KOREA 87
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0158 Diabetes
Effect of Diabetes on Postoperative Ambulation Fol- lowing Below Knee Amputation
Amit SARAF1
Swami Vivekanand Hospital, India1
Background: Ambulation forms an important part of rehabilitation program after lower limb amputations. Diabetes Mellitus and its complications are commonly asso- ciated with amputation. Inspite of this, there is an absence of studies on the effect of diabetes on the post operative ambulation of an amputee. This study analyses the role of diabetes as an independent factor affecting post operative ambulation and com- pares it with non diabetics
Methods: The present study followed 105 patients; 48 diabetics and 57 non diabetic amputees. Their post operative ambulatory level was compared by using Pinzur et al ambulation scale. Both groups were age, sex and BMI matched.
Results: There was a worsening of ambulatory level in 33.3% diabetics as compared to 10.7% in non diabetics postoperatively. Of the prosthetic users, 78.4% were in non diabetic group and 21.6% were in diabetic group. 17.6% of prosthetic users required additional support, of whom 66.7% were diabetics.
Conclusions: Diabetes Mellitus is an independent factor which has an adverse effect on the functional outcome of a patient after below knee amputation.
PS 0159 Diabetes
A Case of Limbic System Atrophy in a Patient with Type 2 Diabetes Mellitus
Masayuki KITAGAWA1, Jiro AKIBA1, Yukihiro SHIKAMA1, Ikuro OHTA1 Yamagata Prefectural Kahoku Hospital, Japan1
Background: It is thought that there is close relation in glucose metabolism and brain damage. It is presumed that brain damage is caused for hypoglycemia. A limbic sys- tem exists in the inside of the cerebral cortex. It has been reported that limbic system atrophy tends to receive damage with hypoglycemia. We evaluated brain MR imaging changes of limbic system in a patient with type 2 diabetes mellitus with hypoglyce- mia. This case was considered to be a precious case when considering the relevance of glucose metabolism and brain damage.
Case Report: The patient was 86-year-old female diagnosed with type 2 diabetes mellitus 20 years ago. She was brought to the emergency department in our hospital due to consciousness disturbance. In the emergency room, the blood glucose level was 16 mg/dl, and consciousness disorder was not recovered although intravenous in- jection of glucose was performed. It was presumed that the badness of a general state and unsuitable use of the oral hypoglycemic agent caused unstable glycemic control.
Evaluation of change of brain MRI was made for 98 days.
Results: Evaluation of change of brain MRI was made for 98 days. The appearance of limbic system atrophy was observed. Limbic system atrophy advanced gradually. It was thought that this case was a precious case in which picture change of the limbic system was able to be caught.
Conclusions: It is presumed that hypoglycemia brings about activation of a glutamic acid receptor, and causes oxidant stress, and it is presumed that they make brain dam- age induce. Also in this case, we thought the damage of the limbic system was based on hypoglycemia. This case was considered to be a precious case when considering the relevance of glucose metabolism and brain damage.
PS 0160 Diabetes
Qt Dispersion: Comparison Between Type 2 Diabetic with Microalbuminuria Positive and Negative Patients
Esma ALTUNOGLU1, Mustafa BOZ1, Cuneyt MUDERRISOGLU1, Fusun ERDENEN1, Ender ULGEN1, Mustafa DURAN1, Nurcan OZBAS1
Istanbul Education and Research Hospital, Turkey1
Background: It is shown that the variability of distance between QT derivations in twelve derivation ECG; is risk factor for sudden death as a predictor of cardiovascular mortality in both diabetic and general population. Diabetic nephropathy is one of the most common complication of diabetes. The purpose was to investigate the relation- ship between QT parameters and microalbumin/creatinine ratio; as an indicator of endothelial function and a cardiovascular risk factor.
Methods: 100 patients were included our study who were follow up Istanbul Educa- tion and Research Hospital Diabetes Outpatient Clinic. 50 patients whose microalbu- min/ creatinine ratio less than 30 mg/dl and ages between 36 and 77 years were cho- sen as control group; 50 patients whose microalbumin/ creatinine ratio between 30- 300 mg/dl and ages between 36 and 79 years were chosen as patient group. The QT interval was measured on the 12-lead resting ECG. QTd was calculated automatically using special software.
Results: In patients group QTC min median value was higher; 380,63(361,44-397,30), (p=0,042),QTC max median value was significantly higher; 439,63(420,17-460,22), (p=0,005) and microalbumin/creatinine value 82(60-300), (p=0,0001) was very signifi cantly higher than control group. There was no signifi cant difference QTC dispersion median value 61,25(49,91-81,70, (p=0,066) in both groups. Also a good correlation in positive direction between QTC dispersion values and microalbumin/creatinine value was determined.
Conclusions: We researched the relation between microalbumin/creatinine ratio and QTd levels in type 2 diabetic patients. QTc max period was determined signifi cantly high in the group with microalbumin/creatinine between 30-300 mg/dl (p<0,05). As a result of this correlation QT prolongation can be use as a contributory parameter for prediction of cardiovascular risk. This study make us that QTd can be used as early indicator of cardiovascular risk in diabetic patients who aren’t in microalbuminuric stage yet.
