Indian Journal of Diabetes and Endocrinology

Diabetic foot complications represent a significant global health burden, leading to lower-extremity amputations, increased mortality, and substantial healthcare costs. Effective nursing care is paramount in mitigating these adverse outcomes, encompassing a continuum from primary prevention to advanced wound management and patient education. This article provides a comprehensive overview of the critical role of nursing professionals in diabetic foot care, outlining key strategies derived from current evidence-based practices. It details the essential components of holistic nursing intervention, including risk assessment, patient education, meticulous foot examination, early detection of complications, advanced wound care techniques, and the promotion of interdisciplinary collaboration. The overarching aim is to underscore the indispensable contribution of nursing to reducing the incidence and severity of diabetic foot complications, thereby improving the quality of life for individuals living with diabetes.

Type 2 diabetes mellitus (T2DM) is increasingly recognized as a condition influenced by microbiome composition and function. The gut and pancreatic microbiomes regulate metabolic processes, insulin sensitivity, and inflammation through mechanisms involving Short-Chain Fatty Acids (SCFAs), bile acid metabolism, and intestinal permeability. Dysbiosis characterized by reduced microbial diversity and increased gut permeability exacerbates insulin resistance and beta-cell dysfunction. Emerging therapies, including probiotics, prebiotics, dietary interventions, and Fecal Microbiota Transplantation (FMT), hold promise for restoring microbial balance and improving metabolic health. While microbiome targeted approaches present opportunities for personalized T2DM management, challenges such as methodological inconsistencies, regulatory concerns, and interindividual variability must be addressed to optimize clinical applications.

Type 5 diabetes, recently recognized by the International Diabetes Federation (IDF), represents a distinct form of diabetes mellitus primarily affecting lean and undernourished individuals in low and middle income countries. Unlike Type 1 and Type 2 diabetes, Type 5 diabetes is characterized by malnutrition induced pancreatic beta-cell dysfunction leading to insufficient insulin production without autoimmune or genetic causes. This review article explores the historical context, pathophysiology, clinical features, diagnosis, treatment approaches, and public health implications of Type 5 diabetes, emphasizing the need for tailored strategies to address this neglected condition.

Diabetic ketoacidosis (DKA) is the most serious hyperglycaemic emergency seen in patients with type 1 diabetes mellitus (T1DM). Treatment associated complications such as cerebral edema, acute renal failure, rhabdomyolysis, and dyselectrolytemia further increase the risk of morbidity and mortality. Cerebral edema is the principal cause of mortality in DKA (in children) while rhabdomyolysis with acute renal failure is rarely reported, particularly in adults. Lack of awareness of these complications leads to delays in therapeutic intervention. We herein report the successful management of a 20-year-old male who presented with Severe DKA with cerebral edema, hypophosphatemia, rhabdomyolysis, acute renal failure, and persistent metabolic acidosis.