diabetic

Diabetic Ketoacidosis (DKA) is a life-threatening medical emergency. Euglycemic Diabetic Ketoacidosis (EDKA) is a condition that is relatively rare but if missed out can have grave consequences. The primary difference between the two conditions lies in the extent of hyperglycemia in both conditions. In EDKA, the blood glucose levels can be near normoglycemia as well. The clinical features are similar. Good glycemic control in pregnancy is an effective method of preventing complications of EDKA in pregnancy. For EDKA, the glucose levels in blood can be mildly raised, it poses a significant challenge to diagnose EDKA. Therefore, a high index of suspicion is the cornerstone of management of EDKA in pregnancy. The key diagnostic tests are serum electrolytes, arterial blood gas analysis, and ketone level measurements. The treatment includes fluid resuscitation, insulin therapy, acidosis correction, electrolyte monitoring and treating the underlying root cause. Continuous monitoring of both maternal and fetal well-being is crucial throughout treatment. A multidisciplinary and systematic approach to diagnosis and treatment is essential for an optimized outcome.

Wound healing is a major problem in diabetic patient. Sildenafil citrate was earlier reported as a pro-angiogenic agent found to stimulate angiogenesis. We decided to investigate if oral administrations of sildenafil citrate in type I diabetic rats will enhance wound healing. The study was performed using fourty two rats (42) weighing between 139-225 grams. The rats were grouped A-G, six (6) rats per group. Wound area of 1.5 by 1.5 cm2 was created at the dorsal surface of each rat under sedation with ketamine and local anaesthetic (lignocaine). Type I diabetes was induced using Alloxan monohydrate at dose rate of 130 mg/kg. Sildenafil citrate was administered at a dose rate of 50 mg/kg orally daily for 21 days and 10 international units of insulin was administered intraperitoneally to the control group once. Blood glucose and platelet count were significantly (p<0.05) decrease compared to pre-diabetic period. The wound size contraction did not significantly (p>0.05) decrease as compared to day 3 in diabetic rats. We concluded that oral administration of sildenafil citrate at dose rate of 50 mg/kg did not significantly enhance wound healing in diabetic rats.