Psycho-social and clinical aspects of diabeto-criticare

Abstract

A progressive rise in the number of diabetes mellitus (DM) patients has been observed globally with India becoming a new diabetic capital. In spite of numerous advancements in the pharmacotherapeutics, diabetes is still difficult to manage and control. Besides clinical management of DM, an increasing need is felt to manage the psycho-social aspects related to DM, which have not been given adequate attention. Similar trends can be observed in the critically ill diabetic patients in intensive care units (ICU), which is treated on the lines of evidence based clinical medicine. The psycho-social management of diabetes is somewhat a newer concept for the intensivist that was being practiced occasionally, but unknowingly. The newer psycho-social guidelines to manage DM can be of immense help in ICU if such guidelines are modified to suit the needs of the intensivists and critically ill patients. The current review is aimed at analyzing the clinical, biological, social and psychological aspects of critically ill DM patients and the possible therapeutics measures and modifications in the current regimens so as to effectively treat the rising epidemic of DM.

Critical care - critically ill - diabetes mellitus - diabetic foot - psycho-social

• References

• 1 Chinenye S, Ogbera AO. Socio-cultural aspects of diabetes mellitus in Nigeria. J Soc Health Diabetes 2013; 1: 15-21
• 2 Bajwa SJ. Intensive care management of critically sick diabetic patients. Indian J Endocrinol Metab 2011; 15: 349-350
• 3 Bajwa SJ, Jindal R. Endocrine emergencies in critically ill patients: Challenges in diagnosis and management. Indian J Endocrinol Metab 2012; 16: 722-727
• 4 Das AK, Kalra S. Diabetes: Exploring social and psychological domain. J Soc Health Diabetes 2013; 1: 1-2
• 5 Peyrot M, Rubin RR, Lauritzen T, Snoek FJ, Matthews DR, Skovlund SE. Psychosocial problems and barriers to improved diabetes management: Results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22: 1379-1385
• 6 Chinenye S, Young EE. State of diabetes care in Nigeria: A review. Niger Health J 2011; 11: 101-109
• 7 Hart JT. Rule of halves: Implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care. Br J Gen Pract 1992; 42: 116-119
• 8 Bajwa SS, Kalra S. Logical empiricism in anesthesia: A step forward in modern day clinical practice. J Anaesthesiol Clin Pharmacol 2013 [In press].
• 9 Kalra S. Logical empiricism and diabetes management. Int J Clin Cases Invest 2012; 4: 1-2
• 10 Kalra S, Megallaa MH, Jawad F. Patient-centered care in diabetology: From eminence-based, to evidence-based, to end user-based medicine. Indian J Endocrinol Metab 2012; 16: 871-872
• 11 Bajwa SJ, Kalra S. Diabeto-anaesthesia: A subspecialty needing endocrine introspection. Indian J Anaesth 2012; 56: 513-517
• 12 Awah P. Diabetes and traditional medicine in Africa. Diabetes Voice 2006; 51: 25-26
• 13 Bajwa SS, Panda A. Alternative medicine and anesthesia: Implications and considerations in daily practice. AYU 2012; 33: 475-480
• 14 Bajwa SS, Kalra S. Glycaemic control in ICU. In: Bajaj S. et al. Endocrine Society of India Manual of Clinical Endocrinology. 1 2012; 115-123
• 15 Kalra S, Sridhar GR, Balhara YP, Sahay RK. National recommendations: Psychosocial management of diabetes in India. In: Murugnathan A. Medicine Update 23 API; 2013; 209-214
• 16 Glesne C. Becoming Qualitative Researchers: An Introduction. Boston, USA: Pearson; 2011
• 17 Creswell JW, Clark VL. Designing and conducting mixed methods research. Thousand Oaks, USA: Sage; 2011
• 18 Conference Report: 2^nd International DAWN Summit; A call-to-action to improve psychosocial care for people with diabetes. Pract Diabetes Int 2004; 21: 201-208
• 19 Shetty R, Jena B, Kadithi A. Can social scientists be the change agents for diabetes prevention? diabetes-related knowledge, attitude, and practice among social scientists. J Soc Health Diabetes 2013; 1: 32-36
• 20 Manzanares W, Aramendi I. Stress hyperglycemia and its control with insulin in critically ill patients: Current evidence. Med Intensiva 2010; 34: 273-281
• 21 Lemineur T, Deby-Dupont G, Preiser JC. Biomarkers of oxidative stress in critically ill patients: What should be measured, when and how?. Curr Opin Clin Nutr Metab Care 2006; 9: 704-710
• 22 Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab 2011; 15: 18-22