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Brodina, S., Krejčí, R. Charcot osteoarthropathy.
Kazuistiky v diabetologii 6, č. 4: 4–6, 2008. |
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Charcot osteoarthropathy is a chronic bone and joint
disease caused by neuropathy, most often in feet.
Treatment is complicated by many pitfalls, as the disease is often
diagnosed in the chronic stage with an extensive impairment of foot
skeleton and a destruction of soft tissues.
A patient with long-standing type 2 diabetes mellitus and severe
peripheral neuropathy was treated in our department. He came with an
advanced, undiagnosed chronic stage of the disease with a large defect
of soft tissues on the sole of the foot.
Following the assessment of the local finding and X-ray we placed
classic Ilizarov external fixator enabling us at least partial
correction of the skeleton impairment as well as daily bandaging and
monitoring of the sole defect that was successfully healed by the method
of wet healing.
Key words: Charcot osteoarthropathy, type 2 diabetes mellitus,
external fixator, wet wound healing
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Piťhová, P. The
influence of the change of basal insulin on body weight in an obese
patient with type 1 diabetes mellitus. Kazuistiky v diabetologii 6,
č. 4: 7–10, 2008. |
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Our paper presents a not optimally controlled
obese female patient with type 1 diabetes mellitus. Although the
parameters of metabolic control following the treatment with
continuous subcutaneous infusion of insulin were improved, the
patient significantly gained her weight and developed
hypoglycemias. The hypoglycemias required a treatment
adjustment. Following the setting of the basal/bolus insulin
regimen using insulin analogues, we achieved a reduction of
hypoglycemic episodes and weight loss without a significant
effect on the metabolic compensation and total daily dose of the
insulin. The case demonstrates the need of an individual
approach to the insulin treatment in patients with type 1
diabetes mellitus.
Key words: type 1 diabetes mellitus, continuous
subcutaneous infusion of insulin, detemir, insulinotherapy, body
weight
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Sosna, T. Sero venientibus – retinopathia diabetica!
Kazuistiky v diabetologii 6, č. 4: 11–13, 2008. |
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The paper presents young male with type 1 diabetes
mellitus who had not been examined by the ophtalmologist for four years
and who was referred to our department with an advanced stage
proliferative diabetic retinopathy. The discussion analyses in detail
the preventive care that enables to prevent similar errors in the
screening of the diabetic retinopathy.
Key words: type 1 diabetes mellitus, proliferative diabetic
retinopathy, screening
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