ISSN:1357-8170    

DOI:10.1002/pdi.1960090102

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractTo clarify the cause of their impotence, 20 diabetic patients underwent detailed assessments of: diabetic autonomic neuropathy (acetylcholine sweatspot test, pupil test‐PD%, five cardiovascular tests); vascular disease (radioisotope phallogram, response to intracorporeal papaverine); nocturnal penile rigidity; psychiatric disturbance (General Health Questionnaire). Results suggested cause as: vascular 7/20 (35%), vascular and autonomic neuropathy 7/20 (35%), autonomic neuropathy 3/20 (15%), psychiatric disturbance 2/20 (10%), beta‐blockers 1/20 (5%). The sweatspot test appeared to be the most sensitive assessment of autonomic neuropathy. Investigations suggested an alternative aetiology in all cases with a normal sweatspot test. In one patient with autonomic neuropathy, high deep‐artery velocity on Doppler but loss of papaverine‐induced erection, dynamic cavernosography revealed venous leakage; impotence was improved by surgical venous ligation. The results suggest that most impotence in diabetics has an organic basis. The sweatspot test (ideally in conjunction with cardiovascular tests and pupil test) and response to intracorporeal papaverine may identify and categorise most of these patients. Those with normal tests are unlikely to have organic disease and could be referred for psychosexual/psychiatric counselling. Doppler studies may identify those who need investigating for venous leakage. The others could then, in the first instance, be offered one of the recently described non‐invasive devices for overcoming diabetic impotence. Self‐administered intracorporeal papaverine may also be considered, but only a minority of diabetic patients seem

ISSN:1357-8170    

DOI:10.1002/pdi.1960090103

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractTo investigate the problem of diabetic clinic defaulting, we studied patients who had lapsed from follow‐up for at least 12 months and were referred back during one calendar year. Of the 37 investigated in detail, sex distribution, age, diabetes duration, treatment and BMI were not significantly different from a control group of regular clinic attenders. However, defaulters had a higher HbA1(10.0 ± 2.5% v 8.5 ± 2.0%, p<0.01) and more micro‐and macrovascular complications (20 v 11, p<0.05). Most complications had not been present at the time of default from clinic (mean period of lapse was 26 ± 14 months).Reasons given for default included: overcrowded clinic; prolonged waiting; seeing different doctors; and not seeing the consultant often enough. Defaulting is thus a common problem and is associated with poor glycaemic control and increased complication rates. Better education and more “user‐friendly” clinics may reduce

ISSN:1357-8170    

DOI:10.1002/pdi.1960090104

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractTreatment for hypoglycaemia with glucagon and IV glucose improved consciousness in a 28‐year‐old male diabetic. He remained confused, however, which was thought to be the result of prolonged hypoglycaemia and he was treated with mannitol and IV insulin. Twenty‐four hours after admission he was lucid and a CT scan performed 24 hours later was n

ISSN:1357-8170    

DOI:10.1002/pdi.1960090105

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960090106

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960090107

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960090108

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960090111

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960090112

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960090113

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY