Faculty of Medicine

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    Item type:Publication,
    IMPACT OF METABOLIC CONTROL IN PREULCERATIVE PHASE OF DIABETIC FOOT
    (SHMSHM / AAMD, 2011-06)
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    Milco Bogoev
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    Gordana Pemovska
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    Aim. To estimate impact of metabolic disturbances in type 2 diabetic patients (T2DM) and risk for ulceration in preulcerative phase of diabetic foot syndrome (DFS). Material and methods. In this prospective study following parameters are estimated: duration, smoking, BMI, BP, HbA1c, TG, HDL, LDL, fundoscopy and measurements for risk score of DFS. Groups were stratified according measurements : 0–low risk, 1–medium risk, 2-high risk, and 3–very high risk. Results. From 100 patients, 53% were female and 47% male. Mean duration of T2DM 10, 47 ±4, 77 year. Smokers are registered to have 43%, Results of measurements for risk score stratifications have been in V1: score 0-29 %, 1–3%, 2-18% and 3–18% and in V2 in score 0-17 %, 1–39%, 2-19% and 3–25%. BMI was recorded as follows: normal (18-25 kg/m2) 14%, overweighed (25-30 kg/m2) 71% and obese (>30 kg/m2) 15%. Mean HbA1c in V1 was recorded: 0-7,6%, 1-7,9%, 2-8,5% and 3-8,2% (p<0,005), and in V2: score 0-7.26%, 1-7.46%, 2-7, 54% and 3-7, 54%. Systolic BP divided regarding scores is measured: score 0–136 mmHg, 1–142 mmHg, 2–145 mmHg, 3–142 mmHg. Mean levels of TG were: 0-1,97 mmol/L, 1-2,37 mmol/L, 2-2,3 mmol/L, 3-2,6 mmol/L. Mean levels of HDL: 0–1,06 mmol/L, 1–1,02 mmol/L, 2–0.97 mmol/L, 3–1,00 mmol/L. Mean levels of LDL: 0–3,69 mmol/L, 1–4,27 mmol/L, 2–4,05 mmol/L 3–4,09 mmol/L. Conclusion: Bad management of T2DM have impact in early appearance of DFS and early progression from low to high score for foot ulceration.
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    Item type:Publication,
    Effects of Structured Diabetes Education Program on diabetes knowledge and metabolic control in insulin-treated diabetes patients from Republic of Macedonia
    (v/b/z, 2017-03-30)
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    Smokovski, Ivica
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    Bozhinovska, Nadica
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    Rahelić, Dario
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    Background and Aims: We aimed to compare the diabetes knowledge and metabolic control between insulin-treated diabetes patients who completed structured and those who completed unstructured diabetes education at diagnosis and to evaluate the effects of structured diabetes education program (SDEP) on diabetes knowledge and metabolic control. Subjects and Methods: Prospective, observational study of 59 insulin-treated diabetes patients invited for SDEP at University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Skopje, in the period from March 2013 to December 2014 and divided into two groups if they completed SDEP at diagnosis. Patients were tested for their diabetes knowledge (scale of 0 to 100 points) before SDEP and immediately after SDEP and evaluated for their metabolic control. Patients were invited 1 year after completion of SDEP for evaluation of their diabetes knowledge and metabolic parameters. Results: Groups were not significantly different in diabetes knowledge before SDEP (67.3 ± 11.1 vs. 68.0 ± 13.1 points, P = 0.835), and results improved in both groups after completion of SDEP (Group 1: 19.6 ± 8.9 points, P < 0.001; Group 2: 16.9 ± 7.8 points, P < 0.001) with no significant difference between groups. Diabetes knowledge 1 year after SDEP was significantly higher in Group 2 (82.9 ± 7.8 vs. 76.6 ± 11.1 points, P = 0.014). Significant reduction in glycated hemoglobin was obtained 1 year after SDEP within both groups with no significant difference between groups. Conclusion: Continuous SDEP results in sustainable increase in diabetes knowledge and improved glycemic control, thus avoiding or delaying diabetes complications, and reducing the burden on the society.