In euthyroid subjects, small differences in free T4 are associated with differences in BMI. This relationship is not present in current smokers. We speculate that this may be relevant to weight changes associated with smoking cessation.

BackgroundThe few studies that have examined the relationship between diabetes and bacterial infections have utilized administrative databases and/or have had limited/incomplete data including recognized infection risk factors. The aim of this study was to determine the incidence and associates of bacterial infection severe enough to require hospitalization in well-characterized community-based patients with type 2 diabetes.Methods and FindingsWe studied a cohort of 1,294 patients (mean±SD age 64.1±11.3 years) from the longitudinal observational Fremantle Diabetes Study Phase I (FDS1) and 5,156 age-, gender- and zip-code-matched non-diabetic controls. The main outcome measure was incident hospitalization for bacterial infection as principal diagnosis between 1993 and 2010. We also examined differences in statin use in 52 FDS1 pairs hospitalized with pneumonia (cases) or a contemporaneous non-infection-related cause (controls). During 12.0±5.4 years of follow-up, 251 (19.4%) patients were hospitalized on 368 occasions for infection (23.7/1,000 patient-years). This was more than double the rate in matched controls (incident rate ratio (IRR) (95% CI), 2.13 (1.88–2.42), P<0.001). IRRs for pneumonia, cellulitis, and septicemia/bacteremia were 1.86 (1.55–2.21), 2.45 (1.92–3.12), and 2.08 (1.41–3.04), respectively (P<0.001). Among the diabetic patients, older age, male sex, prior recent infection-related hospitalization, obesity, albuminuria, retinopathy and Aboriginal ethnicity were baseline variables independently associated with risk of first hospitalization with any infection (P≤0.005). After adjustment for these variables, baseline statin treatment was not significant (hazard ratio (95% CI), 0.70 (0.39–1.25), P = 0.22). Statin use at hospitalization for pneumonia among the case-control pairs was similar (23.1% vs. 13.5%, P = 0.27).ConclusionsThe risk of severe infection is increased among type 2 diabetic patients and is not reduced by statin therapy. There are a number of other easily-accessible sociodemographic and clinical variables that could be used to optimize infection-related education, prevention and management in type 2 diabetes.

Approximately 1 in 20 Australians has diabetes. Although most have type 2 diabetes, one in seven has other types that may require more specialised diagnosis and/or management.

One in 280 Australians diagnosed with diabetes have a monogenic form; most are of European ethnicity. Diagnosing MODY and neonatal diabetes is important because their management (including family screening) and prognosis can differ significantly from those for types 1 and 2 diabetes.

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To examine the incidence and predictors of carpal tunnel decompression (CTD) in communitybased patients with type 2 diabetes, we studied 1,284 type 2 diabetic participants (mean Ϯ SD age 64.1 Ϯ 6.1 years, 49.1% male) in the longitudinal observational Fremantle Diabetes Study who had no history of CTD. A total of 67 participants (5.8%) had a first CTD during 12,109 years (mean 9.4 Ϯ 3.7) of follow-up, an incidence of 5.5 per 1,000 patient-years. This was at least 4.2 times the incidence in the general population (P Ͻ 0.001). In Cox proportional hazards analysis, significant independent determinants of first-ever CTD were higher BMI, taking lipid-lowering medication, and being in a stable relationship (P Յ 0.021). The crude incidence of first CTD is increased in type 2 diabetes and is associated with obesity and sociodemographic/treatment factors that could indicate treatment-seeking behavior including CTD in symptomatic patients. Diabetes Care 31:498-500, 2008

These data provide some support for the general conventional serum testosterone <10 nmol/l cut-point in identifying an increased risk of anaemia and the subsequent death in men with type 2 diabetes, but indicate that high-normal levels are also an adverse prognostic indicator.

We investigated pulse-temperature relationships in 66 children with enteric fever (group 1) and in 76 with other infections (group 2). Group 1 children were older than group 2 children (mean age +/- SD, 91 +/- 36 vs. 66 +/- 32 months, respectively; P < .001) and had mean oral temperatures +/- SD similar to those of group 2 children (38.3 +/- 1.0 vs. 38.3 +/- 0.9 degrees C, respectively; P > .2); however, group 1 children had lower mean baseline pulse rates +/- SD than did group 2 children (119 +/- 25 vs. 127 +/- 28 beats/min, respectively; P < .001). In a multiple linear regression model, pulse rate was independently associated with age (inversely; P < .001) and oral temperature (positively; P < .006) but not with diagnostic group or gender (P > .5). After adjustment of the mean initial pulse rate +/- SD to age of 72 months, there was no difference between group 1 and group 2 children (126 +/- 24 vs. 126 +/- 20 beats/min, respectively; P > .5). From 4 to 72 hours after commencement of treatment, the mean oral temperature in group 1 patients was approximately 0.3 degrees C higher than that in group 2 patients, and the age-adjusted pulse rate was 5 beats/min higher in group 1 children than in group 2 children. These data suggest that relative bradycardia is not characteristic of enteric fever in children.