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      Scleredema Diabeticorum: A Rare Metabolic Connective Tissue Manifestation of Type 2 Diabetes Mellitus Causing External Restrictive Lung Disease

      case-report

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          Abstract

          Scleredema diabeticorum (SD) is a rare metabolic connective tissue manifestation of diabetes mellitus (DM). SD commonly manifests in male patients with poorly controlled prolonged DM with obesity. In SD, the skin gets stiffened, thickened, and leathery in texture with a peau d’orange appearance commonly involving the posterior aspect of the neck and chest wall. Extensive chest wall skin involvement restricts lung movement, causing external restrictive lung disease and hypoventilation. In this case report, we present a 50-year-old male patient with poorly controlled type 2 DM for 10 years, complicated with established diabetic microvascular complications and extensive involvement of SD over the back of the neck and chest with external restrictive lung disease.

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          Reliability and Reproducibility of Chest Wall Expansion Measurement in Young Healthy Adults

          The purposes of this study were to (1) evaluate the reliability and reproducibility of chest expansion (CE) measurement on 2 different levels and (2) observe relationships between upper and lower CE measurements and lung function.
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            Prevalence of diabetes and pre-diabetes in Sri Lanka: a new global hotspot–estimates from the Sri Lanka Health and Ageing Survey 2018/2019

            Introduction This study’s objective was to produce robust, comparable estimates of the prevalence of diabetes and pre-diabetes in the Sri Lankan adult population, where previous studies suggest the highest prevalence in South Asia. Research design and methods We used data on 6661 adults from the nationally representative 2018/2019 first wave of the Sri Lanka Health and Ageing Study (SLHAS). We classified glycemic status based on previous diabetes diagnosis, and either fasting plasma glucose (FPG), or FPG and 2-hour plasma glucose (2-h PG). We estimated crude and age-standardized prevalence of pre-diabetes and diabetes and by major individual characteristics weighting the data to account for study design and subject participation. Results Crude prevalence of diabetes in adults was 23.0% (95% CI 21.2% to 24.7%) using both 2-h PG and FPG, and age-standardized prevalence was 21.8% (95% CI 20.1% to 23.5%). Using only FPG, prevalence was 18.5% (95% CI 7.1% to 19.8%). Previously diagnosed prevalence was 14.3% (95% CI 13.1% to 15.5%) of all adults. The prevalence of pre-diabetes was 30.5% (95% CI 28.2% to 32.7%). Diabetes prevalence increased with age until ages ≥70 years and was more prevalent in female, urban, more affluent, and Muslim adults. Diabetes and pre-diabetes prevalence increased with body mass index (BMI) but was as high as 21% and 29%, respectively, in those of normal weight. Conclusions Study limitations included using only a single visit to assess diabetes, relying on self-reported fasting times, and unavailability of glycated hemoglobin for most participants. Our results indicate that Sri Lanka has a very high diabetes prevalence, significantly higher than previous estimates of 8%–15% and higher than current global estimates for any other Asian country. Our results have implications for other populations of South Asian origin, and the high prevalence of diabetes and dysglycemia at normal body weight indicates the need for further research to understand the underlying drivers.
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              Using and interpreting carbon monoxide diffusing capacity (Dlco) correctly

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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                15 May 2024
                May 2024
                : 16
                : 5
                : e60374
                Affiliations
                [1 ] Medicine, Postgraduate Institute of Medicine, University of Colombo, Anuradhapura, LKA
                [2 ] Pathology, Teaching Hospital Anuradhapura, Anuradhapura, LKA
                [3 ] Pulmonary Medicine, Teaching Hospital Anuradhapura, Anuradhapura, LKA
                [4 ] Medicine, Faculty of Medicine, University of Rajarata, Anuradhapura, LKA
                Author notes
                Article
                10.7759/cureus.60374
                11178434
                38882981
                0e8a5901-df9e-41df-8004-0233962a0b66
                Copyright © 2024, Ranabahu et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 May 2024
                Categories
                Endocrinology/Diabetes/Metabolism
                Pathology
                Pulmonology

                advanced glycation end products,collagen fiber,spirometry,obesity,diabetes mellitus

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