The prevalence of hypoglycemia and its impact on the quality of life (QoL) of type 2 diabetes mellitus patients (The HYPO Study)

Objective: to estimate the impact of hypoglycemia on the Quality of Life (QoL) and its prevalence in patients with type 2 diabetes mellitus (t2DM) in Greece. Design: A cross-sectional epidemiological study was conducted in 6631 patients with t2DM. QoL was assessed with the patient self-administered ADDQoL-19. reliability analysis of patients' outcomes was performed to assess internal consistency of the ADDQoL-19. Patients were categorized according to hypoglycemia experience and diabetes control. controlled patients were considered as having Hb1Ac <7% (53mmol/mol) and hypoglycemic episodes were defined as laboratory-confirmed clinical symptomatic events. Results: In total, 59% of the sample had HbA1c >7% (53mmol/mol) and 20.4% of patients had a history of laboratory-confirmed hypoglycemia. the mean age was 60 years and the mean t2DM duration was 10 years. The mean QoL score was -3.09±1.9 for the total sample and the mean score of non-hypoglycemic patients was -3.05±2, while the respective score of hypoglycemic patients was -3.26 ±1.8, (p≤0.001). similar results were observed in the group of controlled and uncontrolled patients, who scored -2.73±1.7 and -3.33±1.9, respectively (p≤0.001). Comparable results were identified in the majority of the ADDQoL-19 instrument dimensions. Conclusions: the QoL of t2DM patients is affected significantly by hypoglycemia and the level of disease control. In diabetes treatment, the ultimate goal should be optimal glycemic control without debilitating hypoglycemic episodes which compromise patients' QoL

Glucose metabolism, insulin secretion and insulin sensitivity in juvenile hemochromatosis. A case report and review of the literature

Among specific diabetes subtypes secondary to pancreatopathies, hereditary hemochromatosis is an inherited disorder of iron metabolism resulting in excessive iron overload and tissue damage in various organs. We here report the case of a man with the young-onset form of the disease and describe his glycaemic status before and during venesection therapy. A 25-year old man visited our clinic in Athens, Greece, with hypogonadotropic hypogonadism due to hereditary hemochromatosis. Genetic analysis revealed that he was suffering from the juvenile aggressive form and treatment was initiated with frequent phlebotomies in conjunction with androgen substitution. Within 18 months of therapy ferritin level was normalized and hypogonadism was fully restored. Despite severe iron overload, glucose tolerance remained normal during the various stages of the disease, although alterations in both insulin secretion and sensitivity were detected. Present data indicate that in juvenile hemochromatosis, the efficacy of the chelation therapy and probably the chronic interval required to restore normal iron concentration both play important roles in the formation of glucose metabolism characteristics. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart