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Tip 2 diyabet ve atriyal fibrilasyon geçici iskemik atağa neden olabilir

Year 2022, Volume: 47 Issue: 4, 1787 - 1789, 28.12.2022
https://doi.org/10.17826/cumj.1170881

Abstract

Diabetes Mellitus (DM), sadece kırsal kesimde değil, kentlerde de yaygın olan kronik sorunlardan biri olmaya devam etmektedir. Kan şekeri metabolizmasının düzenlenmesi hedef noktalardan biri iken, DM ile yaşamak birinci basamak hekimlerini zorlayabilir.
En az 5 yıldır DM ve hipertansiyon tanısı almış 64 yaşında kadın hasta halsizlik ve dizüri nedeni ile kliniğe başvurmuştur. Bakteriüri tespit edilmiş ve kan şekeri 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % olarak bulgulandı. İdrar kaçırma dışında nörolojik muayenesi normaldi. DM, HT ve sistit tanısıyla hastaneye yatırıldı. Metformin 2x1gr, 1x40 mg, seftriakson 2x1gr, insülin glarjin verildi. Diyabetik hasta eğitimi verildi. İzlemde kan şekeri regülasyonu düzeldi ancak çarpıntı şikayeti ile EKG çekildi ve AF (atriyal fibrilasyon) teşhisi kondu. Tansiyonu 120/80 idi ve metoprolol infüzyonu yapıldı. INR: 1,44 sn PT=17sn kreatin=0,9 mg/dl. Kontrol EKG sinüs ritmindeydi. İyileştiği sırada dahiliye konsültasyonu yapıldı ve taburcu olması planlandı. Taburculuk işlemleri planlanırken "konuşamıyorum" diye şikayet etti. Nörolojik muayenesin sırasında, de sol kolunda kuvvet kaybı (3/5) olan hasta, söylenenleri duyabiliyor, anlayabiliyor ancak konuşamıyordu. Geçici İskemik Atak (GİA) ön tanısıyla tileri tanı ve tedavi için başka bir sağlık merkezine nakledildi.
DM asla yalnız yürümez. Birinci basamak sağlık merkezlerinde hekimler, yönetilecek yeni başlangıçlı sorunların yanı sıra kronik durumların da farkında olmalıdır

Supporting Institution

yok

Project Number

yok

References

  • Referans1 Aung WP, Htet AS, Bjertness E, Stigum H, Chongsuvivatwong V, Kjøllesdal MKR. Urban-rural differences in the prevalence of diabetes mellitus among 25-74 year-old adults of the Yangon Region, Myanmar: Two cross-sectional studies. BMJ Open. 2018;8(3):1–9.
  • Referans2 Gokdemir O, Ersil Soysal D. Brittle Diabetes Needs Patient Centered Treatment and Lifestyle Modification in the Rural. Gazi Med J. 2022;33(3):270–2.
  • Referans3 Harris SB, Ekoé JM, Zdanowicz Y, Webster-Bogaert S. Glycemic control and morbidity in the Canadian primary care setting (results of the diabetes in Canada evaluation study). Diabetes Res Clin Pract. 2005;70(1):90–7.
  • Referans4 Riordan F, McHugh SM, O’Donovan C, Mtshede MN, Kearney PM. The Role of Physician and Practice Characteristics in the Quality of Diabetes Management in Primary Care: Systematic Review and Meta-analysis. J Gen Intern Med. 2020;35(6):1836–48.
  • Referans5 Pham TB, Nguyen TT, Truong HT, Trinh CH, Du HNT, Ngo TT, et al. Effects of Diabetic Complications on Health-Related Quality of Life Impairment in Vietnamese Patients with Type 2 Diabetes. J Diabetes Res. 2020;2020.
  • Referans6 Isaman DJM, Herman WH, Ye W. Prediction of transient ischemic attack and minor stroke in people with type 2 diabetes mellitus. J Diabetes Complications [Internet]. 2021;35(7):107911. Available from: https://doi.org/10.1016/j.jdiacomp.2021.107911
  • Referans7 Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022;18(September).
  • Referans8 Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci. 2016;351(4):380–6.
  • Referans9 Care D, Suppl SS. 5. Lifestyle management: Standards of medical care in diabetesd2019. Diabetes Care. 2019;42(January):S46–60.
  • Referans10 Baska A, Kurpas D, Kenkre J, Vidal-Alaball J, Petrazzuoli F, Dolan M, et al. Social prescribing and lifestyle medicine—a remedy to chronic health problems? Int J Environ Res Public Health. 2021;18(19):1–9.
  • Referans11 Duvekot MHC, Kerkhoff H, Venema E, Bos HWDJC, Smeekes D, Buijck BI, et al. Medical attention seeking by suspected stroke patients: Emergency medical services or general practitioner? Clin Neurol Neurosurg. 2022;218(January):107297.
  • Referans12 Aroor S, Singh R, Goldstein LB. BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic. Stroke. 2017;48(2):479–81.

Type 2 diabetes and atrial fibrillation could cause transient ischemic attack

Year 2022, Volume: 47 Issue: 4, 1787 - 1789, 28.12.2022
https://doi.org/10.17826/cumj.1170881

Abstract

Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the urban cities. While the regulation of blood sugar metabolism is one of the target points, living with DM can trammel primary care physicians.
64 years old female patient who was diagnosed with DM and hypertension for at least 5 years has attended the surgery for nuisance and dysuria. Bacteriuria has detected and blood sugar was 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % Her neurologic examination was normal except she has got urinary incontinence. She was hospitalized with a diagnosis of DM, HT, and cystitis. Metformin 2x1gr, 1x 40 mg, ceftriaxone 2x1gr, and insulin glargine were ordered. Diabetic patient education has been performed. During follow-up, her blood sugar regulation has been settled but she complained of palpitation, ECG has been performed and diagnosed as AF (atrial fibrillation). Her blood pressure was 120/80 and metoprolol infusion was made. INR: 1,44 sec PT=17sn creatine=0,9 mg/dl. Control ECG was at sinus rhythm. While she was in time of recovery, internal medicine consultation has performed and she was planned to discharge. She complained about "could not talk". In her neurologic examination, her left arm has lost strength (3/5) and she could hear and understand what was told but couldn't speak. She was transferred to another health center for detection and treatment as pre-diagnose of Transient Ischemic Attack (TIA).
DM never walks alone. At primary health care centers physicians should be aware of chronic conditions as well as the new onset problems to manage.

Project Number

yok

References

  • Referans1 Aung WP, Htet AS, Bjertness E, Stigum H, Chongsuvivatwong V, Kjøllesdal MKR. Urban-rural differences in the prevalence of diabetes mellitus among 25-74 year-old adults of the Yangon Region, Myanmar: Two cross-sectional studies. BMJ Open. 2018;8(3):1–9.
  • Referans2 Gokdemir O, Ersil Soysal D. Brittle Diabetes Needs Patient Centered Treatment and Lifestyle Modification in the Rural. Gazi Med J. 2022;33(3):270–2.
  • Referans3 Harris SB, Ekoé JM, Zdanowicz Y, Webster-Bogaert S. Glycemic control and morbidity in the Canadian primary care setting (results of the diabetes in Canada evaluation study). Diabetes Res Clin Pract. 2005;70(1):90–7.
  • Referans4 Riordan F, McHugh SM, O’Donovan C, Mtshede MN, Kearney PM. The Role of Physician and Practice Characteristics in the Quality of Diabetes Management in Primary Care: Systematic Review and Meta-analysis. J Gen Intern Med. 2020;35(6):1836–48.
  • Referans5 Pham TB, Nguyen TT, Truong HT, Trinh CH, Du HNT, Ngo TT, et al. Effects of Diabetic Complications on Health-Related Quality of Life Impairment in Vietnamese Patients with Type 2 Diabetes. J Diabetes Res. 2020;2020.
  • Referans6 Isaman DJM, Herman WH, Ye W. Prediction of transient ischemic attack and minor stroke in people with type 2 diabetes mellitus. J Diabetes Complications [Internet]. 2021;35(7):107911. Available from: https://doi.org/10.1016/j.jdiacomp.2021.107911
  • Referans7 Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022;18(September).
  • Referans8 Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci. 2016;351(4):380–6.
  • Referans9 Care D, Suppl SS. 5. Lifestyle management: Standards of medical care in diabetesd2019. Diabetes Care. 2019;42(January):S46–60.
  • Referans10 Baska A, Kurpas D, Kenkre J, Vidal-Alaball J, Petrazzuoli F, Dolan M, et al. Social prescribing and lifestyle medicine—a remedy to chronic health problems? Int J Environ Res Public Health. 2021;18(19):1–9.
  • Referans11 Duvekot MHC, Kerkhoff H, Venema E, Bos HWDJC, Smeekes D, Buijck BI, et al. Medical attention seeking by suspected stroke patients: Emergency medical services or general practitioner? Clin Neurol Neurosurg. 2022;218(January):107297.
  • Referans12 Aroor S, Singh R, Goldstein LB. BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic. Stroke. 2017;48(2):479–81.
There are 12 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Letter to the Editor
Authors

Ozden Gokdemır 0000-0002-0542-5767

Ülkü Bulut Batur 0000-0003-3011-0924

Anıl Gürkan 0000-0002-9858-212X

Project Number yok
Publication Date December 28, 2022
Acceptance Date November 2, 2022
Published in Issue Year 2022 Volume: 47 Issue: 4

Cite

MLA Gokdemır, Ozden et al. “Type 2 Diabetes and Atrial Fibrillation Could Cause Transient Ischemic Attack”. Cukurova Medical Journal, vol. 47, no. 4, 2022, pp. 1787-9, doi:10.17826/cumj.1170881.