Evaluation of cognitive functions in diabetic patients

Background: Diabetes Mellitus is an independent risk factor for cognitive impairment and dementia. In this study, authors investigated cognitive functions in the diabetes and control group with Mini Mental State Examination (MMSE). Authors analyzed the association of cognitive status with age, sex, duration of diabetes, insulin use and HbA1c in diabetic patients.Methods: Fifty patients with diabetes diagnosed between the ages of 50 and 70 who applied to this Diabetes and General Internal Medicine Clinics between January 2017 and September 2017 were included. Fifty patients with nondiabetes diagnosed with similar age and demographic characteristics were included in the control group. MMSE was applied to both groups. In the diabetic group, cognitive functions were investigated in relation with age, gender, duration of diabetes, insulin usage and HbA1c.Results: The MMSE score in diabetic patients was lower than the control group (p<0.05). In addition, cognitive impairment in diabetic patients was associated with duration of diabetes and HbA1c level. There wasn't significant difference was found between cognitive impairment and age, sex, insulin use.Conclusions: Diabetes Mellitus is a risk factor for cognitive impairment and dementia with many possible mechanisms. In the routine, there is no screening for cognitive impairment and dementia in diabetic patients; but if authors detect early cognitive impairment, authors can prevent cognitive impairment progression to dementia with medical treatment and cognitive exercises

Relationship between MPV and paraoxonase-1 activity, brachial artery diameter and IMT in patients with diabetes mellitus

Aims: Higher mean platelet volume (MPV) in diabetic patients has been considered as an emerging risk factor for diabetes related micro- and macrovascular complications. Human paraoxonase 1/arylesterase (PON1), which has antioxidant and antiatherogenic properties, is documented in high oxidative stress conditions like uncontrolled diabetes. The present study aimed to evaluate the relationship between mean platelet volume (MPV) and paraoxonase-1 (PON-1) activity, brachial artery diameter (BAd) and intima media thickness (BA-IMT), in diabetic patients with regard to obesity and diabetic complications.Methods: Two-hundred and one diabetic patients (mean age: 52.4 ± 13.4 years, 73.6% females) were grouped according to obesity and diabetic complications (microvascular and macrovascular). Data on demographics, anthropometrics, diabetic complications, MPV levels, BAd and BA-IMT, and serum paraoxonase and arylesterase activities were recorded. The correlation of MPV values to paraoxonase and arylesterase activities, BAd and BA-IMT was evaluated.Results: Paraoxonase and arylesterase values were 119.8 ± 37.5 U/L and 149.0 ± 39.9 U/L, respectively, with no significant difference in respect of obesity and macrovascular complications. Significantly lower values for paraoxonase (107.5 ± 30.7 vs. 123.9 ± 38.8 U/L, p = 0.007) and arylesterase (132.1 ± 30.2 vs. 154.7 ± 41.2, U/L, p = 0.001) were noted in patients with microvascular complications. MPV values were 9.10 ± 0.87 fL, with no significant difference across the groups and no significant correlation with other parameters.Conclusion: In conclusion, PON-1 activity is more significantly decreased in diabetic patients with microvascular than macrovascular complications with no effects on MPV values. On the other hand, no relationship was found between thrombogenic activity and PON-1 activity, BAd and BA-IMT regardless of obesity and diabetic complications.Keywords: cardiovascular, diabetes, insulin resistance, obesity, vasculatur

Comparison of Survival Rates, Tumor Stages, and Localization in between Obese and Nonobese Patients with Gastric Cancer

Purpose. In this study we tried to determine the association between body-mass index (BMI), survival rate, and the stage of tumor at the time of diagnosis in patients with gastric cancer. Methods. A total of 270 gastric cancer patients’ hospital records were retrospectively evaluated. Patients were grouped according to their BMI at the time of tumor diagnosis. Tumor stages at admission were compared according to their BMI values. Results. There were no differences in OS among BMI subgroups (p=0.230). The percent of patients with stage III tumor was significantly higher in nonobese while the percent of stage IV tumor was surprisingly higher in obese patients (p was 0.011 and 0.004, resp.). Percent of patients who did not have any surgical intervention was significantly lower in overweight and obese patients than normal and/or underweight patients. Conclusions. At the time of diagnosis, obese patients had significantly higher percent of stage IV tumor than nonobese patients. Despite of that, there were no differences in survival rates among BMI subgroups. Our study results are consistent with “obesity paradox” in gastric cancer patients. We also did not find any relationship between BMI and localization of gastric tumor

Comparison of insulin resistance in the various stages of chronic kidney disease and inflammation

Objective: In this study, we compared predialysis and dialysis patients with the controls in terms of insulin resistance and evaluated the association with inflammation that is a risk factor for cardiovascular disease. Materials and methods: A total of 134 non-diabetic patients with controls (n = 33), predialysis (n = 29) and dialysis patient group (n = 72) were included in the study. Fasting blood glucose, insulin, C-peptide, albumin, CRP (C-reactive protein) and homocysteine plasma levels were simultaneously analyzed in all the patients. HOMA-IR index was calculated to show existence of insulin resistance. Results: Mean insulin and HOMA-IR index values were found to be higher in the predialysis and dialysis patient groups than in the control group (p = 0.019, p = 0.014; respectively). When three groups were compared in terms of C-peptide levels; these values were found to be statistically significantly higher in the predialysis patients than in controls (p = 0.017) and in the dialysis group than in the predialysis patients and controls (p = 0.0001, p = 0.0001; respectively). CRP and homocysteine levels were found to be statistically higher (p = 0.0001, p = 0.0001; respectively), while albumin levels were significantly lower (p = 0.0001) in the dialysis patient group. Conclusion: In our study, we demonstrated that insulin resistance was higher in patients in the various stages of chronic kidney disease compared to healthy population. We found that insulin resistance, C-peptid and inflammation related cardiovascular risk factors increased

Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients

OBJECTIVE:In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.METHODS:Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student&#8217;s t test, the chi-square test and the Mann-Whitney U test, as appropriate.RESULTS:No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).CONCLUSION:In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients

Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients

OBJECTIVE: In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients. METHODS: Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student’s t test, the chi-square test and the Mann-Whitney U test, as appropriate. RESULTS: No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively). CONCLUSION: In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients

A rare cause of hypoglycemia in elderly: Insulinoma

Insulinoma is rare pancreatic neuroendocrine tumor that is usually described as benign and sporadic. It is seen mostly in women at the ages between 40 and 60 years. Insulinoma can cause hypoglycemic attacks which may lead to serious consequences. Here we report a case of an 82 years old woman with the diagnosis of insulinoma presented by cerebrovascular disease due to severe hypoglycemia. Early diagnosis of the disease is essential to prevent lethal hypoglycemia. The first choice of treatment is surgery. However in the elderly, medical treatments may be preferred as primary treatment due to the existing comorbidities. For this case, it was possible to control the hypoglycemic attacks by using diazoxide and octreotide treatment. So that continous dextrose infusion is not necessary

Serum paraoxonase and arylesterase can be useful markers to predict neoadjuvant chemotherapy requirement in patients with breast cancer

Aim: The aims of this study are to evaluate the serum levels of paraoxonase (PON) and arylesterase (ARE) in breast cancer (BC) patients; to determine their relationship with chemotherapy requirements in BC; and to find a cut-off value to assess subjects with a higher risk of BC