Endocrine Abstracts

Introduction: Therapeutic education is very important in any patient with a chronic disease such as diabetes. The objective of our study is to evaluate the knowledge of diabetic patients already educated about hypoglycemia.Materials and methods: This is a prospective study conducted on 50 diabetic patients hospitalized for equilibration of their diabetes in the “C” service of the Tunis National Institute of Nutrition and who were educated befor...

Introduction: Primary mitochondrial disease is a heterogeneous group of disorders of mitochondrial energy metabolism. Neuromuscular symptoms are the main features, but diabetes mellitus (DM) is present in many patients. DM is related to a deficient energy production, which leads to decreased insulin secretion and ultimately to β-cell apoptosis. In most cases, DM has an insidious onset with requirement of insulin 2-4 years after diagnosis. About 20% of cases present with a...

Background: The central distribution of body fat has been identified as a significant risk factor for development of macrovascular complications in type 2 diabetes mellitus (T2D) in particular. The aim of the study was the features of fat mass distribution in T2D patients using insulin.Materials and methods: We studied 138 T2D patients with insulin in therapy (31 men and 107 women; mean age 51.43+8.41 yrs; disease duration 6.40+2.01 yrs...

Background: Hepatitis C virus is common in Egypt and its prevalence varies from 10 to 17%. Beside its harmful effect on the liver, it can lead to variable other effects on various organs and tissues known as the extrahepatic manifestations of HCV. hepatitis C virus induced thyroid diseases in the form of thyroiditis resulting in hypofunction or even hyperfunction of the gland. thyroid disease was found to be of immune nature. Also diabetes which is often termed hepatogenous di...

Introduction: Type 2 diabetes (T2D) and obesity are currently among the most common non-communicable diseases in the world. According to IDF experts in 2015, 415 million people suffered from diabetes, more than 90% of them are in T2D, and half of the disease is hidden and not timely diagnosed.Aim: To determine risk factors and ten-year T2D risk with FINDRISK questionnare.Materials and methods: We included 566 people who were propos...

Introduction: Vitamin D deficiency is a health problem related to cardiovascular diseases, autoimmune diseases and cancers. Several studies have shown a significant prevalence of vitamin D deficiency in T1D with positive impact of supplementation on glycemic control. The objective of our work is to evaluate vitamin D status in our T1D patientsPatients and methods: Our study has included 35 patients followed for T1D, vitamin D status was ordered in all pa...

Introduction: Sick or tired subject, just like the diabetic patient, is exempted from fasting during Ramadan, when it can jeopardize health or well being. Nonetheless, many people want to keep holding onto this practice. However, diabetes can be revealed in this context. The aim of the study is to evaluate the characteristics of the diabetic ketosis during this month by comparing them to data far from this period.Patients et methods: Descriptive, retrosp...

Laser Doppler fluorometry (LDF) is not an invasive method for diagnosing microcirculation in patients with diabetes mellitus, but the method needs to be improved. Evaluation of the LDF method in patients with diabetic neuropathy (DN) before and after the appointment of vitamin D (VD). Included patients with DM and VD deficiency, DM duration more then 5 years, HbA1c up to 9.0%, non-smokers, signed IC. LAKK-M was used. The value of perfusion was measured-M, σ- average modul...

Vitamin B12 or cobalamin is mainly found in animal origin food products. The frequency of vitamin B12 deficiency varies between 3 and 40% in different populations. Metformin is the first-choice therapy for type 2 diabetics having some side effects, one of them being vitamin B12 malabsorption. The study aimed to evaluate serum levels of vitamin B12 in diabetic and non-diabetic patients with cobalamin deficiency.Methods: Medical records of subjects having ...

We aimed to observe the association between degree of obesity and metabolic syndrome and plasma thyrotropin levels in obese, euthyroid patients. 947 obese and overweight patients who admitted to our outpatient clinic were assessed retrospectively. 150 healthy euthyroid cases were also recruited as the control group. Cases with metabolic syndrome were determined. Patients were divided into various subgroups as overweight, obese, morbid obese, men, and women. No statistical sign...

Craniopharyngiomas are rare tumors that in a high percentage of patients leads to damage of periventricular nucleus and suprachiasmatic nucleus, what leads to the development of hypothalamic obesity. Hypotalamic obesity is associated with numerous metabolic disorders. Regardless of the numerous studies of new therapeutic approaches, there is still no official approved effective (phramacological or bariatric) treatment for hypotalamic obesity. Liraglutide is an GLP-1 analogue t...

We analyzed the eating behavior and physical activity in patients operated in our obesity surgery center and their relation to weight loss. We mailed to patients a simple self-questionnaire to assess the use of eating or physical activity advices given from our stuff during the preoperative period. Patients had a bariatric surgery from September 1, 2013 to August 2016 Questionnaires were collected during their follow-up (September 2017). One hundred forty four out of 750 patie...

Aim: The aim of our study was to evaluate the impact of sleeve gastectomy on weight loss 6 months after surgery.Methodology: This was a prospective study including 30 obese patients undergoing sleeve gastrectomy. Their weight,height, BMI, fat mass index and waist circumfernce, were measured at baseline and 6 months after surgery.Results: Mean patient age was 36.77±7.82 .80% of the study patients were women. There were signific...

Diabetes in paraneoplastic Cushing is often severe with a risk of acute metabolic complications.Observation n° 1: A 36-year-old patient, with no medical history, was hospitalized for inaugural diabetic ketoacidosis with no intercurrent infection. The physical examination found facio-truncal obesity, amyotrophy of extremities, melanoderma, arterial hypertension and severe psychiatric disorders. The blood tests showed an hypokalemia at 1.9 mmol/l. Hig...

Endogenous Cushing’s syndrome comes generally with permanent hypercorticism often complicated by diabetes which can be difficult to control. However, the cortisol’s excessive production may be cyclic or intermittent, and, therefore, complications may have a specific course which leads to diagnostic and therapeutic delay.Observation: We report the case of a 28-year-old woman with no previous medical history who was hospitalized for a Cushing&#14...

Acute pancreatitis in kidney transplant recipients is an infrequent complication with complex etiology. However, there was no enough data about chronic pancreatitis after kidney transplantation. Glucose intolerance occurs with some frequency in chronic pancreatitis, but overt diabetes mellitus usually occurs late in the course of the disease. We presented long-term course of a kidney transplant recipient who developed recurrent acute pancreatitis.Case re...

Background: Familial chylomicronemia is a rare disorder of lipoprotein metabolism characterized by severe fasting hypertriglyceridemia. We present here a case of severe familial chylomicronemia with multiple complications.Case presentation: A 35-year-old Tunisian woman was suffering from chylomicronemia (Fredrickson type I hyperlipoproteinemia) since the age of 10 years old. Her dyslipidemia was caused by a lipoprotein lipase deficiency. Since her childh...

A 46-year old male patient, living in Giza, father of 4, used to work as a baker. He is an ex-smoker. He has diabetes on insulin for 4 years, not hypertensive.He was diagnosed to have colonic carcinoma upon which surgical intervention was done in the form of right hemicolectomy with splenectomy and cholecystectomy. Postoperative pathology report revealed invasive moderately differentiated adenocarcinoma. He received postoperative chemotherapy, twelve sessions over the past one...

Introduction: Consultations are a common practice among different units of a hospital. In particular, those from the Vascular Surgery Service (VS) to the medical units are some of the most frequent.Objectives: Analyze the total number of consultations performed from the Vascular Surgery Service (VS) service to a medical team (T) specifically assigned to the control of decompensated medical conditions in surgical areas, in relation to the number of total ...

Objectives: To analyze the most frequent consultations on patients admitted to VS sent to a medical team (T).Material and methods: Descriptive analysis of consultations on patients admitted to the VS who suffered any medical decompensation that needed to be notified to Internal Medicine, Cardiology, Endocrinology, Nephrology or Pneumology.Results: From February 2011 to November 2014, 173 consultations were sent from the VS Service ...

The aim: To evaluate the risk factors for symptomatic hypoglycemia (SG) over 4 years of intensive insulin treatment (IIT) and combined therapy (CT) in type 2 diabetes.Material and methods: Under our supervision in the departments of the Center of Endocrinology of PH Ministry of RUz in the period from September 2016 for December, to 2017, 20 patients were observed with DM 2, men – 9, women – 11; 54.5±1.5 m/61.6±1.8 w years old. The rem...

Objective: Diabetic mastopathy (DMP) is an uncommon fibrous disease of the breast, most commonly found in premenopausal women with type 1 diabetes exposed to long-standing insulin therapy. Often mimicking breast cancer clinically and on imaging, this condition poses a diagnostic challenge requiring pathological confirmation.Case presentation: A 68-year-old woman with type 1 DM and a family history of breast cancer in paternal aunt had an abnormal screeni...

A broad spectrum of cutaneous disorders may be diagnosed in patients with type 1 and type 2 diabetes mellitus. Some of dermatologic lesions may precede any clinical or biochemical evidence for diabetes, while others are considered well known complications of the metabolic disorder. We highlight typical, rare dermatological manifestations of diabetes, excluding infectious, disorders related to complications of diabetes mellitus and skin conditions induced by treatment of diabet...

Background: Vitamin D deficiency has been shown to be a risk factor related to diabetes mellitus (DM). Some studies suggest an association between diabetic kidney disease (DKD) and vitamin D (VD).Aim: To evaluate the effect of the vitamin D therapy on albuminuria in type 2 DM patients.Methods: There was a 4-month study (January – April 2017) of 48 participants on stable antihyperglycemic (metformin and/or sulfonylurea) and ant...

Introduction: There are known biological differences between men and women in coronary heart disease. It is important to know these differences in order to avoid inequalities in prevention, diagnosis and treatment of this pathology.Methods: We designed a retrospective, descriptive study in which we included all diabetic patients admitted to the hospital with acute coronary syndrome in 2016. Demographic data and degree of control of risk factors were regi...

Foot ulceration in diabetes is known to represent a major cause of morbidity and mortality, and carry considerable financial implications for healthcare organisations. Little research has studied the outcomes for patients with foot ulcer in Eastern India. We identified 717 patients aged 18 years and over with Type 2 diabetes mellitus (T2DM) who presented for management of their diabetic foot ulcers from February 2013-February 2016 with mean follow up of 2 years. Methods: Of th...

Introduction: The diabetic foot is a public health problem in Tunisia. The objective of our study is to evaluate the knowledge of diabetic patients on this entity.Material and method: This is a prospective study involving 60 diabetic patients hospitalized at C service of diabetology and nutritional diseases at the National Institute of Nutrition of Tunis. The knowledge of these diabetics was assessed using a pre-established questionnaire.<p class="ab...

Introduction: Hyperuricemia is common in type 2 diabetics particularly in patients with very high cardiovascular risk.Objective: To evaluate the relationship between hyperuricemia and type 2 diabetes, and to determine its predictive factors in this population.Patients and methods: A retrospective cross-sectional study including168 patients with type 2 diabetes who were hospitalized in the endocrinology department of Ibn Rochd Unive...

Results: Main clinical, analytical and polygraphic data: 58.1±6.4 years, body mass index 32.4±5.4 kg/m2, 70.4% female, HbA1c 8.0±1.9%, AIH 27.4 events/hour (in the range of severe sleep apnea and hypoapnea index), and CT90% 32.9%. Nocturnal concentration of urine total metanephrines were higher than diurnal levels (226±12 vs 98±13 μg/l; P=0.085). In addition, its nocturnal concentration was significantly associated, in a positi...

Introduction: The prevalence of Gestational diabetes mellitus (GDM) has been increasing recently. Educating women of childbearing age about GDM, its risk factors and complications may help its prevention and improve its outcomes. Hence, the aim of this study was to assess the level of knowledge of Tunisian pregnant women about gestational diabetes, its risk factors and its consequences.Methods: We conducted a cross-sectional study among pregnant women wh...

Introduction: Diabetes in the elderly is a major public health problem in Tunisia. Its prevalence increases with aging population. The aim of this study was to determine the particularities of insulin-requiring diabetes in elderly patients in hospitals.Methods: This was a retrospective cross study about insulin-treated diabetics admitted in our institute between August and October 2016 for uncontrolled diabetes. Was considered as elderly diabetic any pat...

Type 1 diabetes mellitus (T1DM) is one of the most frequent autoimmune disorders in childhood, adolescence and youth, developing due to autoimmune destruction of pancreatic β-cells, which leads to an absolute insulin deficiency. Gut microbiota (GM) is associated with the functions of the body’s immune system, and immune-mediated diseases, including T1DM. However, the exact mechanisms by which GM is involved in the T1DM are still unknown. Accumulating data suggest tha...

The routine approach to evaluating the effectiveness of diabetes treatment based on the level of glycated hemoglobin (HbA1c) accounts for the average glucose level but does not consider its fluctuations. However, recent data indicate that the development of late complications of diabetes is associated with the degree of variability in glycemia. (GV).Clinical case: Patient F. is 54-year-old woman with a 33-year history of type 1 diabetes with multiple chr...

Introduction: Dapagliflozin is an oral antidiabetic drug, recently approved for type 2 diabetes and is a sodium-glucose cotransporter type 2 inhibitor (iSGLT2). Its mechanism of action is glycosuria induction, associated with lowering glycemia. The effects of SGLT2 inhibition are insulin-independent, and efficacy is not affected by declining β-cell function or insulin resistance. Additional benefits: weight loss, reduction in blood pressure, lower inciden...

Introduction: Insulin is not an optimal treatment in obese type 2 diabetic patients with insulin resistance. We often introduce it as a last resort hoping to improve the metabolic control of our patients. However it is not always effective, and tends to increase body weight, worsen the global cardiovascular risk and cause hypoglycemias. New drugs such as the GLP-1 agonist receptors can be a better alternative and sometimes allow withdrawal of insulin.Cli...

Introduction: Prader-Willi syndrome (PWS) is a neurobehavioral imprinting disorder, which arises due to an absence of paternally expressed genes within the 15q11.2-q13 region. It is the most common syndromic form of obesity, with an estimated prevalence of about 1 in 25,000 individuals.Case report: we report the case of two monozygotic twins, 20-year-old, naturally conceived, both affected by PWS. They were born by eutocic delivery at 34 weeks of gestati...

Introduction: Diabetes is a real problem of public health. One of the main preoccupations that arises from it are the cardiovascular complications that are associated to it. In our context, the socioeconomic conditions and the isolation of certain regions constitute a brake that cannot be neglected in the diagnosis, the observance of the treatments and the regular supervision. The aim of this study is to raise the particularities related to the cardiovascular risk factors in t...

We report a case of a well 40 year old gentleman who self-referred for confirmation of diagnosis of diabetes. On further history he had been informed by other healthcare professionals the possibility of diabetes based on his elevated fasting serum glucose of 13.8 mmol/L and HbA1c of 81mmol/mol with no osmotic symptoms. His triglyceride was also elevated at 12.26 with rather variable compliance to statin. Examination of all systems were unremarkable, however on neck examination...

Patient Z., 13 years old, transferres to the ICU with diagnosis: Diabetes mellitus newly diagnosed. Diabetic ketoacidotic coma II. Concomitant: Left-sided pneumonia.Objective: Cussmaul’s breath, 36/minute. Pulse 128/min. BP 100/60 mm Hg. Glycemia 30.4 mmol/l, ketones in urine: ++++. CBC, urine, biochemical analysis of blood had not any special features. In the dynamics of the phenomenon of increasing respiratory failure and falling hemodynamics, the...

Physicians and dentists have long known that the health of an individual’s mouth can have significant effects on the health of the rest of the body. Researchers are finding more medical reasons to maintain good oral hygiene. Numerous recent scientific studies indicate association between oral health and a variety of general health conditions including diabetes and obesity. Studies have suggested a bidirectional relationship between periodontitis and diabetes and periodont...

Introduction: Mucormycosis is a serious fungal infection, It is frequently observed in immunocompromised patients such as diabetes mellitus. The most common clinical presentation of mucormycosis is rhino-orbita- cerebral infection.Case presentation: A seventy three-years- old man with diabetes mellitus who was operated due to orbital trauma a mounth ago. Periorbital cellulitis and diabetic ketosis developed during post-operative period and the patient wa...

Introduction: Metformin is recommended as the first-line pharmacological agent for patients with diabetes mellitus type 2. Its most feared adverse effect is the metformin-associated lactic acidosis (MALA), which appears rarely, but the mortality risk reaches almost 50 percent. This case report describes a story of a severely metformin intoxicated patient with several rare complications and uneven outcome.Case-report: A 74-year-old man was found at home, ...

A 68-year-old lady was admitted with constipation, epigastric pain, vomiting, occasional coffee ground emesis and melena. She had no chest pain, osmotic symptoms or weight changes. Past medical history was significant for peptic ulcer disease and she was not taking any medications apart from over the counter cod liver oil. She did not have diabetes or cardiovascular risk factors. Her sister had type 1 diabetes. Examination was remarkable for dehydration, mild tachycardia and m...

Ganuloma annulare (GA) is a self-limited inflammatory dermatosis, clinically characterized by the presence of papules arranged in annular or circinate pattern, mostly on the extremities. GA has rarely been reported in childhood, although is a not a rare condition seen in adulthood. Aetiology and pathogenesis of GA are still unknown, although variable associations have been reported, during last decades, with diabetes mellitus, thyroid disorders, HIV infection, malignancies, tu...

Introduction: Parapharyngeal abscesses develop at the pharyngeal lateral wall. It is a rare infectious complication. The starting point is most often a pharyngeal infection that extends through the fibers of the upper constrictor muscles of the pharynx. The dental origin is more rare. It raises the problem of therapeutic management. The aim of this presentation was to detail the clinical diagnostic aspects of parapharyngeal abscesses in diabetics and to detail the therapeutic ...

Background: Managing mental health patients with Diabetes Mellitus can be challenging. Patients with mental health problems are poorly compliant with both antipsychotic and diabetes treatment. Literature has suggested that some psychiatric illnesses can be independent risk factors for diabetes. Furthermore, diabetic patients have a higher incidence of psychiatric disorders. There is a causal relationship between newer antipsychotic medications and metabolic abnormalities.<...

Introduction: High blood pressure (HBP) is a public health problem because it is a major cause of global morbidity and mortality. Antihypertensive therapy has evolved significantly in recent years to reduce the number of tablets to improve adherence therapy.Purpose of our work: The purpose of our work was to estimate the risk of non-compliance with antihypertensive treatments for a population of hypertensive and diabetic patients, by using a validated ca...

Introduction: Deep abscess represent infectious emergencies. The aim of our study was to evaluate the clinical, biological, radiological and evolutionary of deep abscess in diabetic patients.Patients and methods: A prospective descriptive study was conducted over a period of 12 months in 2017, including 52 diabetic patients hospitalized in the University Hospital with a our patients deep abscess.Results: The average age of 52.4 yea...

Introduction: Hypoglycemia in diabetic patient is susceptible to infection incidence (abscesses). The aim of our study was to evaluate the clinical, biological, radiological and bacteriological abscesses in diabetic patients.Patients and methods: We conducted a study prospective, including 74 diabetic patients with a confirmed abscess admitted our hospital, from January to December, 2017. Variables studied were epidemiological, clinical, paraclinical and...

Introduction: Maturity-onset diabetes of young (MODY) type 2 is caused by mutation of the glucokinase gene. It is characterized by mild fasting hyperglicemia and absence of vascular complications. It is estimated that the incidence of gestational diabetes is 3%. We aimed to present a pregestational diabetic case with MODY-type 2 in pregnancy.Case report: A 38-year-old pregnant woman was referred to our clinic for glycemic regulation at 22th week of gesta...

Introduction: The magnesium deficiency is frequently associated with diabetes mellitus, it is also incriminated in the occurrence of diabetic complications (micro and macrovascular). Our objective was to study the correlation between magnesium deficiency (Mg) and the presence of chronic diabetic complications.Material and methods: Prospective study that concerned type 2 diabetics (T2D). Our patients were subdivided into 2 groups G1 and G2: G1 including 1...

Case report: 21-year-old female patient visited the emergency department with repeated attacks of vomiting accompanied with continuous non radiating epigastric pain diagnosed as acute pancreatitis. She had three plasmapheresis sessions. She gave history of recurrent similar attacks for the last 5 years with frequent hospitalization she is known diabetic since the age of 15.Hypertensive for 1 year. Menarche at age of 14 with only one cycle. Upon admission, the patient was alert...

Introduction: Diabetic ketoacidosis (DKA) is a feature of type 1 diabetes mellitus, but it can develop in people with type 2 diabetes (T2DM) in the presence of precipitating factors. Antipsychotics have been associated with pancreatitis without DKA or hyperglycemia or acidosis with no evidence of pancreatitis. To our knowledge, there are few reports of patients who developed pancreatitis and DKA during treatment with antipsychotis. We present a case of a patient who developed ...

Diabetic ketoacidosis (DKA) is a state of absolute or relative insulin deficiency characterized by hyperglycemia, metabolic acidosis and ketosis and occurs mainly in type 1 diabetes mellitus (DM). While enhanced lipolysis and inhibition of lipoprotein lipase in DKA lead to typically not severe elevation of triglyceride (TG) level, extreme hypertriglyceridemia (HTG) is rarely seen. If complicated with acute pancreatitis (AP), DKA and HTG form a scarcely reported triad, controve...

The prevalence of depressive symptoms in patients suffering from type 2 diabetes is commonly acknowledged. Even mild depression is recognized as clinically relevant for the general health outcomes in this vulnerable patient group. Research in this area has been focused on biochemical markers reflecting common pathological processes of insulin resistance, inflammation and oxidative damage, all being assumed to be interconnected in both diabetes and depression. Most of the studi...

Introduction: Although psychiatric manifestations in the form of delirium, confusional states, and psychosis have been commonly reported in relation to hypoglycemia, association of hyperglycemia with psychiatric manifestations has been less commonly reported. Acute hyperglycemia is known to alter mood state and impairs cognitive performance in patients with diabetes mellitus. However, association of acute psychosis (in the absence of cognitive disturbances) with hyperglycemia ...