The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Ramazan Geyik - One of the best experts on this subject based on the ideXlab platform.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus urine specific gravity in differential diagnosis
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolaity normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
Ersin Akarsu - One of the best experts on this subject based on the ideXlab platform.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus urine specific gravity in differential diagnosis
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolaity normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
Sebnem Aktaran - One of the best experts on this subject based on the ideXlab platform.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus urine specific gravity in differential diagnosis
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolaity normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
Hakan Buyukhatipoglu - One of the best experts on this subject based on the ideXlab platform.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus urine specific gravity in differential diagnosis
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
-
the value of urine specific gravity in detecting Diabetes insipidus in a Patient with uncontrolled Diabetes mellitus
Journal of General Internal Medicine, 2006Co-Authors: Ersin Akarsu, Hakan Buyukhatipoglu, Sebnem Aktaran, Ramazan GeyikAbstract:When a Patient with Diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 Diabetes mellitus and Diabetes insipidus. A 46-year-old woman with poorly controlled type 2 Diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, Diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, Diabetes insipidus was confirmed when urine specific gravity and urine osmolaity normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in Patients with polyuria and Diabetes mellitus to detect Diabetes insipidus.
J J Van Netten - One of the best experts on this subject based on the ideXlab platform.
-
prevention of foot ulcers in the at risk Patient with Diabetes a systematic review
Diabetes-metabolism Research and Reviews, 2016Co-Authors: J J Van Netten, Lawrence A Lavery, Matilde Monteirosoares, Anne Rasmussen, Anita Raspovic, Isabel C N Sacco, Sicco A BusAbstract:Prevention of foot ulcers in Patients with Diabetes is important to help reduce the substantial burden on both Patient and health resources. A comprehensive analysis of reported interventions is needed to better inform healthcare professionals about effective prevention. The aim of this systematic review is to investigate the effectiveness of interventions to help prevent both first and recurrent foot ulcers in persons with Diabetes who are at risk for this complication. We searched the available medical scientific literature in PubMed, EMBASE, CINAHL, and the Cochrane databases for original research studies on preventative interventions. We screened trial registries for additional studies not found in our search and unpublished trials. Two independent reviewers assessed data from controlled studies for methodological quality, and extracted and presented this in evidence and risk of bias tables. From the 13,490 records screened, 35 controlled studies and 46 non-controlled studies were included. Few controlled studies, which were of generally low to moderate quality, were identified on the prevention of a first foot ulcer. For the prevention of recurrent plantar foot ulcers, there is benefit for the use of daily foot skin temperature measurements, and for therapeutic footwear with demonstrated plantar pressure relief, provided it is consistently worn by the Patient. For prevention of ulcer recurrence, there is some evidence for providing integrated foot care, and no evidence for a single session of education.Surgical interventions have been shown effective in selected Patients, but the evidence base is small. Foot-related exercises do not appear to prevent a first foot ulcer. A small increase in the level of weight-bearing daily activities does not seem to increase the risk for foot ulceration. The evidence base to support the use of specific self-management and footwear interventions for the prevention of recurrent plantar foot ulcers is quite strong. The evidence is weak for the use of other, sometimes widely applied, interventions, and is practically non-existent for the prevention of a first foot ulcer and non-plantar foot ulcer.
-
iwgdf guidance on the prevention of foot ulcers in at risk Patients with Diabetes
Faculty of Health, 2016Co-Authors: Sicco A Bus, J J Van Netten, Lawrence A Lavery, Matilde Monteirosoares, Anne Rasmussen, Y Jubiz, Patricia Elaine PriceAbstract:Recommendations - 1 To identify a person with Diabetes at risk for foot ulceration, examine the feet annually to seek evidence for signs or symptoms of peripheral neuropathy and peripheral artery disease. (GRADE strength of recommendation: strong; Quality of evidence: low) - 2 In a person with Diabetes who has peripheral neuropathy, screen for a history of foot ulceration or lower-extremity amputation, peripheral artery disease, foot deformity, pre-ulcerative signs on the foot, poor foot hygiene and ill-fitting or inadequate footwear. (Strong; Low) - 3 Treat any pre-ulcerative sign on the foot of a Patient with Diabetes. This includes removing callus, protecting blisters and draining when necessary, treating ingrown or thickened toe nails, treating haemorrhage when necessary and prescribing antifungal treatment for fungal infections. (Strong; Low) - 4 To protect their feet, instruct an at-risk Patient with Diabetes not to walk barefoot, in socks only, or in thin-soled standard slippers, whether at home or when outside. (Strong; Low) - 5 Instruct an at-risk Patient with Diabetes to daily inspect their feet and the inside of their shoes, daily wash their feet (with careful drying particularly between the toes), avoid using chemical agents or plasters to remove callus or corns, use emollients to lubricate dry skin and cut toe nails straight across. (Weak; Low) - 6 Instruct an at-risk Patient with Diabetes to wear properly fitting footwear to prevent a first foot ulcer, either plantar or non-plantar, or a recurrent non-plantar foot ulcer. When a foot deformity or a pre-ulcerative sign is present, consider prescribing therapeutic shoes, custom-made insoles or toe orthosis. (Strong; Low) - 7 To prevent a recurrent plantar foot ulcer in an at-risk Patient with Diabetes, prescribe therapeutic footwear that has a demonstrated plantar pressure-relieving effect during walking (i.e. 30% relief compared with plantar pressure in standard of care therapeutic footwear) and encourage the Patient to wear this footwear. (Strong; Moderate) - 8 To prevent a first foot ulcer in an at-risk Patient with Diabetes, provide education aimed at improving foot care knowledge and behaviour, as well as encouraging the Patient to adhere to this foot care advice. (Weak; Low) - 9 To prevent a recurrent foot ulcer in an at-risk Patient with Diabetes, provide integrated foot care, which includes professional foot treatment, adequate footwear and education. This should be repeated or re-evaluated once every 1 to 3 months as necessary. (Strong; Low) - 10 Instruct a high-risk Patient with Diabetes to monitor foot skin temperature at home to prevent a first or recurrent plantar foot ulcer. This aims at identifying the early signs of inflammation, followed by action taken by the Patient and care provider to resolve the cause of inflammation. (Weak; Moderate) - 11 Consider digital flexor tenotomy to prevent a toe ulcer when conservative treatment fails in a high-risk Patient with Diabetes, hammertoes and either a pre-ulcerative sign or an ulcer on the distal toe. (Weak; Low) - 12 Consider Achilles tendon lengthening, joint arthroplasty, single or pan metatarsal head resection, or osteotomy to prevent a recurrent foot ulcer when conservative treatment fails in a high-risk Patient with Diabetes and a plantar forefoot ulcer. (Weak; Low) - 13 Do not use a nerve decompression procedure in an effort to prevent a foot ulcer in an at-risk Patient with Diabetes, in preference to accepted standards of good quality care. (Weak; Low)