Diagnostic étiologique du diabète insipide central: à propos de 41 cas

La survenue d'un syndrome polyuro-polydipsiqueavec des urines hypotoniques nécessite une stratégie diagnostique rigoureuse. Le but de cette étude était d’étudier les modalités de diagnostic du diabète insipide central. A travers une étude rétrospective de 41 cas de diabète insipide central(DIC) colligés au service d’Endocrinologie à l’hôpital de la Rabta de Tunis, allant de l’année 1990 à l’an 2013,nous avons relevé les circonstances de découverte du DIC, les anomalies du bilan anté-hypophysaire etde l’imagerie hypophysaire. Le DIC était post opératoire chez 20 patients. La diurèse moyenne de 24 heures était significativement plus élevée chez les patients ayant un DIC en dehors d’un contexte chirurgical. L’épreuve de restriction hydrique était concluante chez tous les patients qui en ont bénéficié. En dehors d’un contexte neurochirurgical, les causes infiltratives étaient retrouvées chez 6 patientset les causes tumorales chez 6 patients. Le DIC était associé à une selle turcique vide dans 1 cas et idiopathique chez 3 malades. L’imagerie par résonnance magnétique hypothalamo-hypophysaire et le bilan anté-hypophysaire sont systématiques en dehors d’un contexte de chirurgie hypophysaire et d’une polydipsie primaire évidente. The Pan African Medical Journal 2016;2

Effect of Lupinus albus on Glycaemic Control, Plasma Insulin Levels, Lipid Profile and Liver Enzymes in Type 2 Diabetics

Abstract Lupinus species and their derivatives are good candidates to be used as hypoglycaemic agents. The aim of this study was to evaluate the effects of supplementation with Lupinus albus dry extract in type 2 diabetic patients. The study included 47 adult patients (21 men and 26 women) with type 2 diabetes. While consuming their usual medication, patients received a daily dose of 400 mg of Lupinus albus dry extract during 12 weeks. Fasting and post meal test glucose and insulin were measured at baseline and after 2 and 12 weeks. Plasma lipids, Alanine and Aspartate aminotransferases activities and glycated haemoglobin were assessed at baseline and at the end of the supplementation period. Compared to baseline values, fasting and postprandial plasma glucose levels were decreased at 2 and 12 weeks. Blood glucose area under the curve significantly decreased after 2 weeks (p<0.01) and 12 weeks (p<0.05) of lupine administration. Fasting insulin concentrations (10.3±5.34 vs. 11.9±6.58; p<0.05) and homeostasis model assessment of insulin resistance (3.50±2.01 vs. 4.40±2.80; p<0.01) were significantly lower at 12 weeks, but not at 2 weeks. The area under the curve for insulin response did not differ from the baseline. After 12 weeks of Lupinus albus administration, glycated haemoglobin (-5.71%), plasma total cholesterol (-8.12%), LDL cholesterol (-5%), triglycerides (-23.2%), and Alanine aminotransferase activity (-21.1%) were significantly decreased compared to baseline. The study showed that administration of Lupinus albus results in a hypoglycaemic effect and an improvement of diabetes control, but does not affect insulin secretion. These findings suggest that Lupinus albus has insulin mimetic action

Lack of association between FokI polymorphism in vitamin D receptor gene (VDR) & type 2 diabetes mellitus in the Tunisian population

Background & objectives: The impact of several environmental and genetic factors on diabetes is well documented. Though the association between the vitamin D receptor (VDR) gene polymorphisms and type 2 diabetes mellitus (T2DM) has been analyzed in different ethnic groups, the results have been inconsistent. The aim of this study was to evaluate the possible association between VDR FokI polymorphism and genetic susceptibility to T2DM in Tunisian population. Methods: A total of 439 unrelated patients with T2DM and 302 healthy controls were included in the study. Genomic DNA was extracted from blood and genotyped for the single nucleotide polymorphism (SNP) of FokI (T/C: (rs2228570) by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) analysis. Results: The genotype distribution and the relative allelic frequencies for the FokI polymorphism were not significantly different between T2DM and controls: in T2DM patients the frequencies of the CC, CT, and TT genotypes were 52.6, 41.0, and 6.1 per cent, respectively, and in controls the genotype frequencies were 55.6, 38.7, and 5.6 per cent, respectively. In our study, the TT genotype of the FokI polymorphism was not associated with T2DM (OR =1.19, 95% CI 0.63 - 2.25, P=0.577). Interpretation & conclusions: Our study showed no significant association of the FokI polymorphism in the vitamin D receptor gene with type 2 diabetes mellitus in Tunisian population

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk