Relation of Asymmetric Dimethylarginine Levels to Macrovascular Disease and Inflammation Markers in Type 2 Diabetic Patients

Aim. We aimed to determine the relation of asymmetric dimethyl arginine (ADMA) levels to atherosclerotic vascular disease and inflammation markers in type 2 diabetes. Methods. We recruited 50 type 2 diabetic patients with atherosclerosis, 50 type 2 diabetic patients without atherosclerosis, and 31 healthy control patients into our study. We obtained fasting serum and plasma samples and measured HbA1c, fasting blood glucose, C-peptide, creatinine, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, hsCRP, fibrinogen, erythrocyte sedimentation rate, total homocysteine, and ADMA levels. In addition, all of the patients were evaluated for carotid artery intima media thickness by ultrasound. We evaluated ADMA levels in healthy controls, diabetic patients with macrovascular complications, and diabetic patients without macrovascular complications and evaluated the relationship between ADMA levels and total homocysteine, inflammation markers, and macrovascular disease. Results. Mean ADMA values in non-MVD and control groups were significantly lower than in MVD group (0.39±0.16, 0.32±0.13, 0.52±0.23, P<0.05, resp.). These three variables (carotid intima-media thickness, inflammatory markers, and ADMA levels) were significantly higher in diabetes group than control (P<0.05). Conclusion. There is a relationship between ADMA and macrovascular disease in type 2 diabetes, but further studies are needed to understand whether increased ADMA levels are a cause of macrovascular disease or a result of macrovascular disease

Hypokalemic paralysis due to primary hyperaldosteronism simulating gitelman&#x2032;s syndrome

Some diseases, such as Gitelman&#x2032;s syndrome, Bartter&#x2032;s syndrome, and primary hyperaldosteronism (Conn&#x2032;s syndrome), may bear some similar clinical and laboratory findings. Their treatment modalities being different from one another, the need for a scrupulous diagnostic evaluation arises as far as clinical practice is concerned. In this report, we present a patient with Conn&#x2032;s syndrome who was initially considered to have Gitelman&#x2032;s syndrome due to displaying a few overlapping features of both diseases. We also give an account of the hardships encountered during the diagnostic evaluation

Hypoglobulinemia and Nonsecretory Myeloma as a Rare Cause of Osteoporosis in a Young Man

A 27-year-old man was admitted to our hospital with the complaint of back pain. Bone mineral density evaluation revealed severe osteoporosis. The causes for secondary osteoporosis, such as thyrotoxicosis, glucocorticoid therapy, hypercortisolemia, hypercalciuria, and hyperparathyroidism were excluded. Laboratory examination revealed hypoglobulinemia. Further evaluation of the immunoglobulin levels was compatible with panhypoglobulinemia. The patient's vitamin D level was also low. The patient was first suspected of having a common variable immune deficiency, but he had not not experienced frequent infections. By carefully evaluating his chest x ray, a lytic lesion in his left humerus was observed. He did not have anemia and elevated sedimentation rate was not observed. Protein electrophoresis showed hypoglobulinemia. Haematology consultation was requested and a bone marrow aspiration was performed. Bone marrow examination revealed multiple myeloma with a myeloma cell increase of 70 to 80%. The patient was diagnosed as having nonsecretory myeloma which explained his hypoglobulinemia. Myeloma may cause severe osteoporosis, pain and hypercalcemia. A chemotherapy regimen (vincristine, adriablastina, dexamethasone) was initiated and further autologous stem cell transplantation was planned. The patient had also chromosome 13 abnormality. Osteoporosis at a young age especially in young men should always be extensively evaluated

Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

Objective. The results from Diabetes Control and Complications Trial (DCCT) have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM). During this study, we tried to inquire carbohydrate (Kh) count method’s positive effects on the type 1 DM treatment’s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method

Clinical Study Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

Objective. The results from Diabetes Control and Complications Trial (DCCT) have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM). During this study, we tried to inquire carbohydrate (Kh) count method&apos;s positive effects on the type 1 DM treatment&apos;s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method