Diabetology Department Research Articles

Concentric remodeling and the metabolic-associated steatotic liver disease in patients with type 1 diabetes: an exploratory study.

Diabetic cardiomyopathy in young patients with type 1 diabetes (T1D) usually presents as asymptomatic diastolic heart dysfunction with left ventricle (LV) remodeling. Its prevalence seems to be underestimated. One of the factors seemingly influencing LV remodeling is a metabolic-associated steatotic liver disease (MASLD), which was extensively investigated in patients with type 2 diabetes but not with T1D. This study aimed to describe the correlation between MASLD risk and relative wall thickness (RWT) in young patients with T1D without heart failure symptoms or treatment. Study participants were recruited at the inpatient diabetology department, in admission order. Patients underwent a set of laboratory tests and echocardiographic examinations. The risk of MASLD was estimated using fatty liver index (FLI). Acquired data was then statistically analyzed. The study group consisted of 55 patients. 25 participants had RWT > 0.42, suggesting LV remodeling. Study participants did not differ in HbA1c, NT-proBNP, HDL, LDL, non-HDL, and uric acid concentrations. However, patients with RWT > 0.42 had higher FLI (40.97 vs. 13.82, p < 0.01) and BMI (27.3 vs. 22.5, p < 0.01) and differed in transaminase concentrations. Moreover, patients with RWT > 0.42 had significantly higher LV mass index (85.6 vs. 68.2g/m2) and altered mitral ring velocities. In univariable logistic regression, FLI correlated with LV remodeling risk (OR 1.028, p = 0.05). The optimal cutoff point for FLI predicting the RWT > 0.42 was 26.38 (OR 10.6, p = 0.04, sensitivity 0.857, specificity 0.657). FLI correlates with RWT in patients with T1D independently of diabetes metabolic control and hypothetically may support recognizing T1D patients with a higher risk of LV remodeling.

Management of the diabetic foot: experience of the diabetology department of the army central hospital. about 282 cases

Management of the diabetic foot: experience of the diabetology department of the army central hospital. about 282 cases

Artériopathie oblitérante des membres inférieurs chez le sujet diabétique noir africain : profil épidémioclinique, ultrasonographique et facteurs déterminants

BackgroundDiabetes can lead to micro and macro-angiopathies. The peripheral arterial disease (PAD) is a serious and an incapacitating disease. It is still under-estimated and under-treated throughout the world, particularly in sub-Saharan Africa. Doppler ultrasound, and in particular ankle brachial index (ABI), can be used to detect it. The aim was to determine the prevalence of PAD to study the clinical and ultrasonographic aspects and to identify the determining factors. Patients and methodsThis was a descriptive and analytical study over a period of 5 years, including a total of 782 diabetic patients hospitalised in the diabetology department of the CHU la Reference Nationale. ResultsAmong the 782 patients, 166 (21.2%) had an ABI < 0.9 reflected the PAD and 72 (9.2%) had an ABI > 1.3, suggestive of mediacalcosis. PAD of the lower limb was mild in 102 patients (61.4%), moderate in (26.3%) and severe in (12.3%). The mean age of the arteritic patients was 56.4 ± 10.2 years. Male gender predominated (59.6%) with a sex ratio of 1.6. All patients had type 2 diabetes (100%). The mean duration of diabetes was 13 ± 5.9 years. The majority of our patients with arterial disease had diabetes for at least 10 years (54.2%). The other cardiovascular in this population were obesity (45.2%), followed by hypertension and dyslipidaemia (32.5%). Diabetes was unbalanced (HbA ≥7%) in the majority of cases (75.3%). Clinically, the majority of patients had a trophic disorder (68%). Asymptomatic patients accounted for 24.6% of cases and those with intermittent claudication for 7.4%. Duplex doppler of the lower limbs showed that all patients with PAD had atheromatous lesions. The distal location was predominantly in the tibial arteries (54.8%). The determinants of PAD in this diabetic population were hypertension (p = 0.01) and obesity (p = 0.01). ConclusionIn our series, PAD was often discovered at an advanced stage, with a non-negligible prevalence. The determining factors found were hypertension and obesity. Screening and control of major cardiovascular risk factors is a priority in the management of this disease.

Evaluation of the Quality of Life in Moroccan Patients Diagnosed with Hypoparathyroidism.

Hypoparathyroidism (HPt) is a rare endocrine disorder often of postsurgical origin, resulting in hypocalcaemia. Several complications have been described including impairment of quality of life (QoL). Our study aims to evaluate the effect of hypoparathyroidism on the QoL of patients diagnosed with HPt. A cross-sectional study was conducted in the Department of Endocrinology, Diabetology, Metabolic Diseases and Nutrition of the Hassan II University Hospital of Fez. We included in our study all patients followed for chronic HPt. Well-being was assessed using the WHO 5 index, and QoL was assessed by the SF-36 questionnaire in its validated Arabic version. Data were entered into Excel and analysed using SPSS 26. Multiple linear regression was utilized to ascertain the variables linked to the QoL in individuals diagnosed with HPt. A total of 143 patients with HPt were included in the study, 86.7% of whom were female. The mean age of the patients was 44.6 ± 17.3 years. 89.9% were of postsurgical etiology. The assessment of well-being by the WHO 5 index showed a low score (<50), meaning poor well-being in 44.8%. Regarding the QoL, the assessment showed low scores in the areas of general health (41.7), limitations due to physical condition (40.5), vitality (41.4), and limitations due to psychological condition (42.6). The multiple linear regression model revealed a noteworthy association between low SF-36 score and advanced age (β = -5.91; p < 0.001), surgical etiology (β = 8.71; p < 0.001), low education level (β = -10.1; p < 0.001), and poor compliance with medication (β = -11.3; p < 0.001). However, the relationship between impaired QoL and achievement of normocalcemia was nonsignificant (p=0.69). Our work objective is that patients with HPt have a reduced and multifactorial QoL. Despite normocalcemia, it is hypothesized that parathyroid hormone directly influences QoL. These results could serve as a basis for future research.

Artificial intelligence-based prediction of diabetic retinopathy evolution (EviRed): protocol for a prospective cohort

IntroductionAn important obstacle in the fight against diabetic retinopathy (DR) is the use of a classification system based on old imaging techniques and insufficient data to accurately predict its evolution....

Metabolic Disorders During Prolactinomas.

The metabolic profile during prolactinoma may be subject to significant changes. We aimed to describe the different metabolic aspects in patients monitored for prolactinoma and to study the correlations between the size of the prolactinoma and the metabolic parameters. We conducted a retrospective, descriptive, and analytical study of 77 cases of prolactinomas collected and monitored at the endocrinology and diabetology department of the Hedi Chaker Hospital in Sfax between 2000 and 2017. Our patients were divided into three groups according to the size of their prolactinomas. Statistical correlations were sought between tumor size and clinical and biological parameters. The mean age of our patients was 38.3 ± 14.2 years. They were divided into 51 women (66.2%) and 26 men (33.7%). Pituitary tumor syndrome was the most common circumstance of discovery in our population (62.3%). The clinical examination revealed an average waist circumference of 95.71 cm. Android fat distribution was observed in 25 women (49%) and 12 men (46.1%). A statistically significant positive correlation was objectified between waist circumference and tumor size (r = 0.29 and P = 0.019). The average body mass index was 28.08 kg/m2. Obesity was noted in 56 cases (72.7%). Glucose tolerance disorders and hypertriglyceridemia were also more evident each time prolactinoma size increased in contrast to the level of high-density lipoprotein cholesterol which decreased with adenoma size. Our study highlighted the metabolic and hormonal repercussions of prolactinomas. Metabolic syndrome was more common in patients with larger prolactinoma. These results should guide the initial assessment and therapeutic management of prolactin adenomas.

Enhancing Angioinvasion Assessment in Papillary Thyroid Cancer Via a Biomarker Panel Involving TAC, 8-OHdG, and Sortilin.

Papillary thyroid cancer (PTC) aggressiveness and metastatic potential are closely associated with angioinvasion. Identifying angioinvasion accurately is imperative for treatment planning and prognosis. This study explores serum biomarkers, including 8-hydroxydeoxyguanosine (8-OHdG) and oxidative status markers (total oxidative capacity, total antioxidant capacity [TAC], and sortilin), as potential indicators of angioinvasion in PTC. A cross-sectional study involving 50 angioinvasive patients with PTC (study group) and 30 patients with PTC with low-risk features (reference group). Serum levels of biomarkers were analyzed to determine their association with angioinvasion. Patients were recruited from Department of Endocrinology, Diabetology, and Internal Diseases, Medical University of Bialystok, Poland, ensuring representation from a diverse clinical context. Participants included patients with PTC, with 50 in the study group and 30 in the reference group. Selection criteria, matching characteristics, and participant completion rates were duly recorded. Serum biomarkers were measured to evaluate their association with PTC angioinvasion. Primary outcome measures included serum levels of 8-OHdG, total oxidative capacity, TAC, and sortilin. Serum levels of 8-OHdG and sortilin were significantly elevated in angioinvasive PTC, whereas TAC showed a notable decrease (all P < .01). A regression panel combining TAC, 8-OHdG, and sortilin demonstrated a high area under the curve value (0.963) for angioinvasion discernment. Measuring TAC, 8-OHdG, and sortilin levels may serve as potential biomarkers for identifying angioinvasion in PTC. The combined assessment of these biomarkers enhances angioinvasion discernment, aiding risk stratification and personalized treatment decisions. Further validation studies are required before integrating these biomarkers into routine clinical practice. The study adheres to the provided structure, providing concise and supported conclusions based on the results.

Prevalence and Risk Factors of Retinopathy in Type 1 Diabetes: A Cross-Sectional Study.

Introduction Diabetic retinopathy (DR) is a severe complication of diabetes. It remains a major cause of visual impairment and blindness, especially in young people. It is a silent affection that only becomes symptomatic at the onset of complications. Our study aimed to estimate the prevalence of retinopathy in patients with type 1 diabetes mellitus (T1DM) and evaluate the associated risk factors in our population. Materials and methods A descriptive and analytical study, with a cross-sectional study involving 359 patients with type 1 diabetes, was followed up in the Department of Endocrinology, Diabetology, and Nutrition of the University Hospital Center Mohammed VI Oujda, Morocco. Data were collected from medical records and analyzed by binary logistic regression using IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Results The average age of our patients was 24.2 ± 11.4 years. The mean duration of diabetes was 11.8±4.4 years. The average glycated hemoglobin (HbA1c) at admission was 10.1 ± 2.4%. DR was found in 30% of patients, including 28.6% with minimal non-proliferative diabetic retinopathy (NPDR), 19.1% with moderate NPDR, 19.1% with severe NPDR, and 33.3% with proliferative DR. Patients with diabetic retinopathy appear to have a longer duration of diabetes (13.05±9.05 vs. 10.6±8.07 years). The longer duration of diabetes, neuropathy, and nephropathy was significantly associated with diabetic retinopathy (p=0.02, p=0.002, and p=0.0001, respectively). Conclusion The frequency of diabetic retinopathy increases with age, poor glycemic control, and the duration of diabetes. Therefore, cooperation between diabetologists and ophthalmologists is essential for making an early diagnosis and providing early treatment.

Inflammatory Markers Used as Predictors of Subclinical Atherosclerosis in Patients with Diabetic Polyneuropathy.

peripheral arterial disease (PAD) is identified late in diabetic patients because, in the majority of cases, it is associated with diabetic peripheral neuropathy, resulting in little or no symptoms, or symptoms that are completely neglected. In this study were enrolled all patients over 18 years of age, with diabetes mellitus type II for more than a year with poor glycemic control, diagnosed with diabetic polyneuropathy admitted to the Diabetology Department, Emergency County Hospital of Targu Mures, Romania between January 2020 and March 2023. We divided the patients into two groups, based on the presence or absence of subclinical atherosclerosis in the lower limb, named "SA" and "non-SA". Patients in the SA group were older (p = 0.01) and had a higher incidence of IHD (p = 0.03), history of MI (p = 0.02), and diabetic nephropathy (p = 0.01). Moreover, patients with subclinical atherosclerosis had a higher BMI (p < 0.0001) and a longer duration of diabetes (p < 0.0001). Among all patients, the systemic inflammatory markers, MLR (r = 0.331, p < 0.001), NLR (r = 0.517, p < 0.001), PLR (r = 0.296, p < 0.001), SII (r = 0.413, p < 0.001), as well as BMI (r = 0.241, p < 0.001) and HbA1C (r = 0.489, p < 0.001), demonstrated a strong positive correlation with the diabetes duration. The multivariate logistic regression analysis showed that older patients (OR: 2.58, p < 0.001), the male gender (OR: 2.30, p = 0.006), a higher baseline levels of BMI (OR: 7.71, p < 0.001), and the duration of diabetes (OR: 8.65, p < 0.001) are predictors of subclinical atherosclerosis in DN patients. Additionally, the high baseline levels of all systemic inflammatory markers (for all: p < 0.001) and poor diabetes management (OR: 10.4, p < 0.001 for HbA1C; OR: 10.78, p < 0.001 for admission glucose) are independent predictors of SA. the inflammatory markers, NLR, MLR, PLR, and SII, being cheap and easy to collect in routine medical practice from the standard blood tests, could be an important step in predicting vascular outcomes in diabetic patients and the disease's progression, playing a key role in follow-up visits in type-2 diabetic patients and PAD patients.

Uncovering the alarming rise of diabetic ketoacidosis during COVID-19 pandemic: a pioneer African study and review of literature.

Reports around the world indicate that COVID-19 pandemic may be contributing to an increase in the incidence of new onset diabetic ketoacidosis (DKA). This has yet to be studied in Africa. We aimed to compare the incidence trend of new onset DKA before and during the COVID-19 pandemic, with a focus on the type of diabetes mellitus (DM).Materials and methodsThis was a cross sectional analytical study, over a 4-year period, between March 2018 until February 2022 conducted in the referral center: diabetology department of university hospital Farhat Hached Sousse, Tunisia. The study population included patients hospitalized for new onset DKA divided in two groups: G1: before COVID-19 pandemic and G2: during COVID-19 pandemic. Patients younger than 14, new onset DM not presenting with DKA, other types of diabetes (monogenic, secondary or pancreatic diabetes) were not included. A statistical analysis of the monthly incidence trend was conducted using the Jointpoint software providing the average monthly percentage of change (AMPC). a total of 340 patients were included:137 registered before the pandemic and 203 during the pandemic, representing a 48.17% increase. The mean monthly incidence of new onset DKA during COVID-19 pandemic was statistically higher than that before COVID-19 pandemic (8.42 ± 4.87 vs 5.75 ± 4.29 DKA per month) (p=0.049). The temporal trend of DKA during the 4-year study showed a significant upward trend with a change in AMPC of +0.2% (p=0.037). The incidence of type 1 diabetes (T1D) and type 2 diabetes (T2D) increased by 50% and 44% respectively during COVID-19 pandemic. Anti-glutamic acid decarboxylase (anti-GAD) antibodies' titers significantly increased in G2 compared with G1 (median of 330[Q1-Q3]=[58.5-1795]vs 92.5[Q1-Q3]=[22.5-1074] respectively)(p=0.021). The incidence trend of DKA showed an increase during the COVID-19 pandemic along with an increase of T1D and T2D implying that the pandemic may have been the underlying factor of this upward trend.

Profiling of patients with type 2 diabetes based on medication adherence data.

Type 2 diabetes mellitus (T2DM) is a complex, chronic disease affecting multiple organs with varying symptoms and comorbidities. Profiling patients helps identify those with unfavorable disease progression, allowing for tailored therapy and addressing special needs. This study aims to uncover different T2DM profiles based on medication intake records and laboratory measurements, with a focus on how individuals with diabetes move through disease phases. We use medical records from databases of the last 20 years from the Department of Endocrinology and Diabetology of the University Medical Center in Maribor. Using the standard ATC medication classification system, we created a patient-specific drug profile, created using advanced natural language processing methods combined with data mining and hierarchical clustering. Our results show a well-structured profile distribution characterizing different age groups of individuals with diabetes. Interestingly, only two main profiles characterize the early 40-50 age group, and the same is true for the last 80+ age group. One of these profiles includes individuals with diabetes with very low use of various medications, while the other profile includes individuals with diabetes with much higher use. The number in both groups is reciprocal. Conversely, the middle-aged groups are characterized by several distinct profiles with a wide range of medications that are associated with the distinct concomitant complications of T2DM. It is intuitive that the number of profiles increases in the later age groups, but it is not obvious why it is reduced later in the 80+ age group. In this context, further studies are needed to evaluate the contributions of a range of factors, such as drug development, drug adoption, and the impact of mortality associated with all T2DM-related diseases, which characterize these middle-aged groups, particularly those aged 55-75. Our approach aligns with existing studies and can be widely implemented without complex or expensive analyses. Treatment and drug use data are readily available in healthcare facilities worldwide, allowing for profiling insights into individuals with diabetes. Integrating data from other departments, such as cardiology and renal disease, may provide a more sophisticated understanding of T2DM patient profiles.

Acquired prolonged QT interval in patients with Type 2 diabetes: Prevalence a risk factor

The QT interval on the electrocardiogram (ECG) represents the total duration of depolarization and repolarization of the ventricles, its lengthening is associated with rhythm disturbances and increased mortality. QT interval prolongation occurs in approximately 26% of type 2 diabetics. The objective of this study was to assess the prevalence and risk factors of QTc prolongation in patients with type 2 diabetes in a 3-day cross-sectional study conducted at the Department of Endocrinology and Diabetology, Mohammed VI University Hospital, Marrakech, including volunteer type 2 diabetes patients admitted out of emergency. The QT interval was measured manually on ECG tracings. QTc was calculated using Bazett's formula, a QTc interval at the ECG &gt; 440 ms for men and women was considered pathological. Demographic and biological data were also collected. Potential risk factors for prolonged QTc interval were evaluated. Results: We included 126 patients. The mean age of the patients was 57.59 years. The mean duration of diabetes progression was 8.26 years. Mean glycated hemoglobin (HbA1c) was 8.04%, 5.55% were smokers, 2.38% were on diuretics and mean QTc was 432.65 ms. The prevalence of prolonged QTc interval in our patients was 27.77% (21.42% of women and 6.35% of men (p=0.645). Smoking (p=0.025), diuretics (p=0.046) and duration of diabetes (p=0.02) were the significant risk factors in our study.

Papillary Thyroid Carcinoma and Pregnancy: What Impact on Prognosis?

Introduction: The impact of pregnancy on the prognosis of papillary thyroid carcinoma (PTC) has been debated for several decades; however, no definitive conclusions have been reached. The main objective of this study is to demonstrate the short-term influence of pregnancy on the evolution and prognosis of PTC. Materials and Methods: A prospective descriptive and analytical study was conducted in the Endocrinology and Diabetology Department at the Hassan II University Hospital in Fez, including patients followed for papillary thyroid carcinoma presenting with a pregnancy during the year 2019 and 2020. The follow-up of these patients was continued until 1 year postpartum. We studied the clinical, paraclinical and therapeutic factors that could influence the prognosis of the disease. Results: We included 26 patients. Our study showed a significant correlation between recurrence and the presence of unfavorable histological signs (p = 0.02) as well as the initial Tg level (0.01). However, pregnancy was not an influencing factor (p = 0.41). Conclusion: Pregnancy does not seem to be a factor aggravating the prognosis of differentiated thyroid cancers.

Study of risk factors and prevalence of hypertension among type 2 diabetes patients

According to the World Health Organization, hypertension is responsible for 13% of all deaths worldwide, making it a critical public health problem in developing and developed countries. Economic development, affluence, urbanization, and dietary westernization have contributed to a rise in the prevalence of type 2 diabetes mellitus (DM) and hypertension in South Asian countries. To study the prevalence of hypertension among adult type 2 diabetic patients and identify risk factors that may affect the development of hypertension in those patients. A cross-sectional study was conducted from May 2009 to May 2010 at the Department of Diabetology and Medicine Vinayaka Mission's Medical College &amp; Hospital, Karaikal. 100 patients with Type 2 Diabetes of age 35 and above were screened and included in the study. Out of 100 patients with Diabetes Mellitus, 54 patients were hypertensive, and 46 were non-hypertensive. Hypertension was found to be more common in people aged 45 to 64.Our study reported that hypertension was present in 29% of males and 25% of females. Complications like neuropathy (9.3%) non-proliferative diabetic retinopathy (46.51%); proliferative diabetic retinopathy (4.65%); hypertensive retinopathy (2.33%); nephropathy (2.33%); ulcer foot (4.65%); coronary artery disease (27.9%) and stroke (2.33%) were observed in Diabetic patients and were identified as an independent risk factor for hypertension. It was also found that 31.94% of study populations were in the pre-hypertensive stage and 22.22% were in the second stage of hypertension. The prevalence of hypertension in patients with DM is high. Duration of diabetes was also one of the contributing factors for hypertension in Type 2 diabetes mellitus. It also concluded that the prevalence of hypertension increases with age advancement in DM.

Reversible Gynecomastia in HIV-Infected Man Treated With Triple Antiretroviral Therapy Containing Efavirenz: A Case Report

Gynecomastia is benign hypertrophy of male breast glandular tissue, either unilateral or bilateral, secondary to increased estrogen/testosterone ratio (elevated estrogen level, decreased testosterone levels, or both). The condition can be related to a medical disease or caused by some drugs.Since the introduction of triple antiretroviral therapy (TAT), we have seen an improvement in the prognosis of human immunodeficiency virus (HIV) infection.Here we report the case of a 53-year-old man receiving follow-up care in Internal Medicine for HIV infection receiving TAT (tenofovir/efavirenz/emtricitabine). After one year, the patient presented in the Department of Endocrinology, Diabetology, Metabolic Diseases, and Nutrition of Hassan II University Hospital Center, Fez, with bilateral gynecomastia. Hormonal exploration did not reveal any abnormality, so the gynecomastia was attributed to efavirenz use. The regimen was replaced by tenofovir, lamivudine, and dolutegravir. The gynecomastia was resolved within two months of discontinuing efavirenz.In summary, we think that secondary gynecomastia should be suspected and screened in HIV patients receiving efavirenz-containing regimens.

Influence of the FTO polymorphism rs17817449 on the risk of obesity, type 2 diabetes, and cardiovascular diseases in Upper Silesian population — a preliminary, cross-sectional study

Introduction: Obesity is considered to be one of the most prevalent health problems which lead to diabetes and cardiovascular diseases thus increasing mortality rate and decreasing life expectancy, particularly in western countries. The variants within the FTO gene were identified to be associated with adiposity and diabetes in genome-wide association studies (GWAS). Aim of the study: To investigate the association between FTO rs17817449 polymorphism and risk of obesity, type 2 diabetes, lipid disorders, and cardiovascular diseases: arterial hypertension and coronary artery disease (CAD). Material and methods: Study group consisted of 295 patients (159 women and 136 men). Collected venous blood samples were stored at minus 70 C until the study group was completed. In the laboratory of the Department and Clinic of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia in Zabrze the DNA material was isolated, proper concentration of the DNA (15 ng/μL) were prepared and quality and quantity were checked by spectrophotometry. Allelic discrimination was performed in Roche Lightcycler96 thermocycler with the use of fluorescent-labeled TaqMan Pre-designed SNP Genotyping Assay probes. Results: BMI, body fat percentage, and waist circumference did not differ by rs17817449 genotype. There were no significant differences in genotypes distribution between patients with obesity and normal body weight. We found a significant association of GT, but not GG genotype with lower risk of arterial hypertension (OR, 0.55; 95% CI, 0.325–0.940; p = 0.003) and coronary artery disease (OR, 0.3; 95% CI, 0.145–0.620); p = 0.001). The frequencies of the FTO genotypes did not differ significantly between individuals with and without diabetes. Parameters of lipid profile (total cholesterol, HDL, LDL, TAG) and carbohydrate metabolism (fasting glucose, fasting insulin, HOMA-IR, QUICKI) did not differ by s17817449 genotype. Conclusion: The association between the FTO polymorphism in rs17817449 and increased risk of obesity and type 2 diabetes mellitus in the Upper Silesian population was not confirmed in this study. The rs17817449 variant of FTO gene may be related to decreased risk of arterial hypertension and coronary artery disease. Further studies in a larger cohort are required to confirm the association between FTO polymorphism in rs17817449 or/and in other FTO gene polymorphisms and diabetes and cardiovascular diseases.

Medication errors in type 2 diabetes from patients' perspective.

IntroductionDrug errors pose a major health hazard to a number of patient populations. However, patients with type 2 diabetes mellitus seem especially vulnerable to this risk as diabetes mellitus is usually concomitant with various comorbidities and polypharmacy, which present significant risk factors for the occurrence of drug errors. Despite this fact, there is little data on drug errors from patients’ perspective. The present survey aimed to examine the viewpoints of patients with type 2 diabetes mellitus regarding their experiences with medication errors, the overall treatment satisfaction, and their perceptions on how a medication error was handled in daily hospital routine.Materials and methodsInpatients at the Department of Endocrinology and Diabetology of the University Hospital of Graz were included in the survey. Out of 100 patients, one-half had insulin therapy before hospitalization while the other half had no insulin therapy prior to admission. After giving informed consent, patients filled out a questionnaire with 22 items.ResultsIndependent of their preexisting therapy, 25% of patients already suffered at least one drug error, whereby prescribing a wrong dose seemed to be the most common type of error. Furthermore, 26% of patients in the non-insulin versus 50% in the insulin group (p = 0.084) were convinced that drug errors were addressed honestly by the medical staff, while 54% in the non-insulin versus 80% in the insulin-group (p = 0.061) assumed that adequate measures were taken to prevent drug errors. Finally, 9 out of 10 patients seemed satisfied with their treatment regardless of their diabetes therapy.Discussion/conclusionThe results of the survey clearly showed that patients experienced at least one medication error during hospitalization. However, these errors only rarely led to patient harm. The survey also revealed the value of an honest and respectful doctor-patient relationship regarding patient perception of medication errors and general complaints. Increasing patient awareness on the existing in-hospital error management systems could eliminate treatment-related concerns and create a climate of trust that is essential for effective treatment.

Erectile Dysfunction in Individuals with Type 1 Diabetes is Associated with Long-term Metabolic Control and Diabetic Complications: A Cross-Sectional Study.

Background Erectile dysfunction (ED) affects approximately 38% of individuals with type 1 diabetes (T1DM). Skin autofluorescence (AF) reflects skin advanced glycation end product (AGE) deposits and is a marker of long-term glycemia control. Objective The study investigates the relationship between ED and diabetes control in patients with T1DM. Methods Adult patients with T1DM visiting the Diabetology Department were cross-sectionally investigated. Medical history, anthropometric features, and laboratory findings were collected. All individuals filled the International Index of Erectile Function (IIEF-5). IIEF-5 total score < 22 represented the presence of ED. AF was measured on the volar aspect of the forearm using AGE Reader. Insulin resistance (IR) was assessed by the estimated glucose disposal rate. Descriptive statistics and multivariate logistic regression analyses were performed. The adjusted covariates were general risk factors of ED. Results Of a total of n = 70 patients, n = 30 (42.9%) suffered from ED. The presence of ED was associated with higher glycated hemoglobin level (OR, 95% CI; 1.62, 1.02-2.60; p = 0.043), presence of at least one diabetic complication (3.49, 1.10-11.03; p = 0.03), and skin AF (9.20, 1.60-52.94; p = 0.01), but not with IR (0.78, 0.57-2.60; p = 0.12). Skin AF values ≥ 2.2 indicates presence of ED with a sensitivity of 70.0% and a specificity of 77.5%. Area under the curve was equal to 0.72 (95% CI: 0.60-0.85). Conclusions The presence of ED in individuals with T1DM is associated with HbA1c, the presence of at least one diabetic complication, and skin AF.

Primary hyperparathyroidism: Correlation between cervical ultrasound and MIBI scan.

Introduction:The standard gold treatment of primary hyperparathyroidism (PHP) is parathyroidectomy. Imaging in particular, cervical ultrasound (US) and technetium-99 m- méthoxyisobutylisonitrileparathyroid scintigraphy using the single-photon emission computed tomography (TC-99 m-MIBI-SPECT) are always indicated prior to parathyroid surgery, allowing the location of parathyroid adenomas. The objective of our study is to evaluate the contribution of TC-99 m-MIBI-SPECT and US in the preoperative topographic diagnosis of PHP.Materials and Methods:this is a descriptive and analytical retrospective study, conducted in our department of Endocrinology, Diabetology and Metabolic Diseases in Hassan II University Hospital of Fez between 2009 and 2018. All patients who received a para-thyroidectomy for PHP were recruited. All patients had received a cervical US and a TC-99 m-MIBI-SPECT. We compared imaging data before surgery with data from intraoperative exploration and anatomopathological findings of surgical samples.Results:Forty-eight patients were collected. US correctly identified parathyroid adenoma in 85.40% of patients with PHP versus 89.50% in TC-99 m-MIBI-SPECT. US correctly predicted surgical outecomes in 97.60% of patients and TC-99 m-MIBI-SPECT in 97.72% of cases. Their combination had better results in sensitivity and positive predictive value.Conclusion:TC-99 m-MIBI-parathyroid scintigraphy SPECT had a higher probability for solitary parathyroid adenoma compared to cervical US. Its use coupled with the TC-99 m-MIBI-parathyroid scintigraphy SPECT allows reliable preoperative tracking.

Vitamin D, calcium and phosphorus status in children with short stature - effect of growth hormone therapy.

The aim of the study was to assess the level of calcium, phosphorus and vitamin D in the blood of patients treated for short stature (SS). The study encompassed 110 children treated for somatotropin hypopituitarism (SHP) in the Department of Paediatric Endocrinology and Diabetology at the Medical University of Lublin. The levels of calcium, phosphorus and vitamin D were marked for both groups in the peripheral blood collected on a routine basis for diagnostic examinations. The parameters were compared within the group of children with SHP, both the patients who were about to start the therapy and those in the course of the therapy as well as between the research group (110 children) and the control group. The results obtained were compared with the results in the control group that comprised 41 children with a general good health status, although with nasal septum deviation treated in the Department of Paediatric Otolaryngology at the Medical University of Lublin. On the basis of the research performed, the following conclusions were drawn: 1) children with SHP were characterised with calcium-phosphorus imbalance. The level of calcium, phosphorus and vitamin D was diminished. The values did not change due to a several-year hormone growth treatment (HGT). 2) the level of calcium and phosphorus was appropriate in the control group children, but the vitamin D level was considerably lowered. This shows the necessity for vitamin D control and supplementation, not only in children with SS.