Clinical Notes Hypoglycemia and Safe Driving

Hypogl ycemia and hypoglycemia unawareness is a real issue for diabetic patients and a real challenge for their health care providers. This review addresses the issue of road traffic accidents and drivers with Type 1 diabetes mellitus (T1DM ) exploring the effects of hypoglycemia, its awareness state and the appropriate response by the driver and the doctor under such circumstances. The regulations surrounding this issue are also briefly discussed. This is a simulation of a diabetologist's evidence in court. A diabetologist had been called to be an expert witness in a trial of a young man with T1DM who was accused of causing death by dangerous driving. Give a short but clear outline of the physiological and psychological effects of hypoglycemia linking it to the relevant literature. This paper addresses hypoglycemia, medico-legal aspects and looks into the legislation in different countries in relation to diabetes and driving. It presents itself as a pocket manual for giving evidence in court. Recently the effects of hypoglycemia on mental status and the issue of relationship between diabetes and driving have been raised for discussion. Investigations into the effect of glucose on the performance have been conducted in humans. Some studies explored the effect of glucose on learning, memory and mood in school children, attention, memory and decision making in college students, and memory in adults. Benton et al. provided a useful overall review of the effect of blood glucose on cognitive functioning

Glycemic Control in Diabetes

One of the central issues in the treatment of patients with diabetes is whether tight glycemic control will reduce Cardio-vascular Disease (CVD) morbidity and mortality. The Diabetes control and complications trial (DCCT) conclusively showed that the greater the average blood glucose in patients with type 1 diabetes, the greater the risk of developing neuropathy, retinopathy and nephropath

Open access publishing The Journal of Diabetic Foot Complications 40 Risk factors for diabetic foot ulceration among patients attending primary health care services

Diabetes mellitus is a global health problem with rising prevalence worldwide. Diabetes mellitus is a multi-system disease affecting many systems and tissues. Foot problems, including foot ulcerations, are common with diabetes. Foot ulceration risk factors are based on many factors and may differ from community to community. The objective of the study was to determine diabetic foot ulceration risk factors among Saudi patients with Type 2 diabetes in primary care centers. We designed a cross-sectional study and randomly selected 400 patients. Of the 400, 350 participated and completed a standard assessment form. Of the 350 subjects who participated, 57% were male and 43% were female. The prevalence of peripheral vascular disease was 15%, hallux valgus was 22.5%, inappropriate foot wear was 41%, and peripheral neuropathy was 47.5%. Peripheral neuropathy and inappropriate foot wear were the most common risk factors for foot ulceration