Diabetic Nephropathy(DN) is a complex disease manifested by persistence microalbuminuria   occurring due to the interaction between hemodynamic and metabolic pathway that activates the local renin-angiotensin-aldosterone system resulting in a decline in renal functions. This study aimed to quantify the associations between serum aldosterone concentration and fetuin- A as a marker of calcification in type 2 diabetic patients with and without microalbuminuria from one side, and study the possible relationship between aldosterone and fetuin-A with glycemic indices, serum electrolyte, renal function and microalbuminuria and body mass index from the other side. A case-control study involved eighty-six adult subjects classified into three groups after testing urine microalbumin including thirty-two diabetics type 2 patients with positive microalbuminuria and twenty-eight diabetics type 2 patients with negative microalbuminuria and 26 healthy subjects during their visit to AL kindy specialized Center for Endocrinology and Diabetes / Baghdad. Those patients were compared to control group of 26 apparently healthy subjects, fasting blood samples was obtained from each of them in one occasion only to measure: fasting serum glucose, electrolyte, aldosterone,  fetuin-A, urea, and creatinine. In addition to glycoheamoglobin, glomerular filtration rate and body mass index. Despite the presence of microalbuminuria in  thirty-two of the studied diabetics, there was no positive correlation between aldosterone and fetuin- A, besides that no significant variations in serum aldosterone ,glomerular filtration rate(GFR) values, while both groups showed a significant increase in fasting serum glucose and glycaoheamoglobin ,significant decrease in serum sodium and chloride in comparison with the control group , significant increase was detected  in serum fetuin-A mean  values in microalbuminuric diabetics. Whereas, negative microalbuminuric diabetics measures expressed a positive correlation between both serum sodium and chloride levels and fetuin -A. The conclusion of this study diabetic patient are prone to vascular calcification (VC)  might be due to increase in aldosterone level or due to diabetic itself  from this study we can conclude microalbuminuria can occur without a decline in renal function or a change in estimated GFR ,no definite correlation occur between aldosterone and fetuin- A, fetuin- A mean values are higher in diabetic patient with microalbuminuria compared to diabetic patients without microalbuminuria and control group and this referred to uncontrolled diabetes ,aldosterone show a correlation with  weight and body mass index while fetuin- A does not show  such correlation. In general, electrolyte disturbances (hypernatremia) is more obvious in this study  , and its occurrence is due to diabetic (osmotic diuresis) or drugs, while sodium retention which is a sign of aldosterone increment does not occur.  Hypochloremia that occur in this study is due to chloride and it is in parallel with sodium level.  

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Background: Acromegaly is an uncommon, chronic, debilitating condition characterized by hyperinsulinism, insulin resistance, diabetes and prediabetes. One possibility for managing acromegaly's questionable influence on glucose homeostasis is the somatostatin analogues. Aim: To analyze the frequency and risk factors for impaired glucose homeostasis in acromegaly patients treated with depot long-acting octreotide (octreotide LAR), as well as the relationship between risk and treatment duration. Methods: The study included 52 Iraqi adults with acromegaly receiving octreotide LAR. Demographic, anthropometric, and clinical data were collected, as well as the duration of Octreotide LAR administration. Growth hormone, IGF-1, and adenoma size were reported retrospectively from patient data. The glycemic state was assessed and classified as DM, prediabetes, or normal. Results: The prevalence of DM was 39% and prediabetes was 40%, with the exception of being male, which was substantially related with prediabetes. DM and octreotide LAR use had a non-significant correlation. However, octreotide use altered 13% of patients from normal glycemic to prediabetes, with no correlation to treatment duration. Other than hypertension and a family history of diabetes, no other variables were found to be significant. Conclusion: Acromegaly patients have abnormal glucose metabolism, which is associated with prediabetes owing to octreotide LAR medication. Hypertension and family history of diabetes are risk factors.

Background: Type 2 diabetes mellitus (T2DM) is a metabolic syndrome that affects a large proportion of the population, if not well controlled; this will lead to serious metabolic problems, including atherosclerosis, predominantly coronary artery disease (CAD).Irisin is a peptide hormone, secreted mainly by the heart and skeletal muscle. It has a role in converting white adipose tissue to brown adipose tissue. It is one of the novel biochemical markers that link diabetes with CAD.Objective : To explore the relationship between serum Irisin level and duration of diabetes, in cases of presence and absence of CAD, As well as the possibility of using it as a marker for the assessment of the severity of the disease. Method: One hundred sixty-one volunteers aged [(40-60 year), body mass index (20-25Kg/m 2 )], with normal blood pressure. They divided into six groups, that distributed as [(I a = control (negative catheterization without DM), I b = control (apparently healthy), II a = DM (with negative catheterization) II b = DM (diagnosed by history and clinical examination), III a = CAD (without DM, positive catheterization), III b = CAD + DM (positive catheterization)]. The diabetic groups with and without CAD had been divided depending on the duration of the diabetic onset into three periods (<5, 5-10, and > 10 years). The parameters that measured were FPG, HbA1c and fasting serum (Irisin, lipid profile). Results:The present findings showed the Means (± SD) value of Irisin levels was a significant decrease in (II a , II b , III a , III b ) groups as compared with control groups (I a , I b ). In addition, there is an inverse relationship between serum Irisin and the duration of DM in the total DM groups (II a +II b ) and the CAD + DM group (III b ). Moreover, higher statistical decrease in mean serum level of Irisin with duration of DM was found in CAD + DM group as compared with the total DM group. Also, there was a significant decrease in mean serum level of HDL-C for (II a , II b , III a , III b ) groups than in (I a , I b ) groups. Besides, there was a significant decrease in the mean of serum HDL level in CAD groups (III a , III b ) than in DM groups (II a , II b ). While the means of FPG level, HbA1c, serum cholesterol level, were significantly elevated in groups (II a , II b , III b ) as compared with (I a , I b ) groups. Also, there was a significant increase in the mean serum levels of triglyceride, VLDL-C and LDL-C for (II a , II b , III a , III b ) groups than in the control groups. Conclusion:Irisin was lower among patients with long-standing diabetes (with or without CAD) as compared to those with short duration of T2DM that can be included as a marker for assessment the severity of diabetes and prediction of CAD.

Low serum total adiponectin is associated with a high incidence of type 2 diabetes or coronary artery disease in the general population. Paradoxically, serum total adiponectin is elevated in patients with chronic kidney disease (CKD), such as overt diabetic nephropathy. The current study aimed to investigate whether or not  anemia to be dependently associated with serum level of total adiponectin in  non-albuminuric male patients with type 2 diabetes . The study included 42 type 2 diabetic male patients. Anemia was defined as hemoglobin (Hb) below 14.0g/dL. All the patients were without microalbuminuria, to exclude diabetic nephropathy. The diabetic patients were divided into 2 groups according to the hemoglobin level in addition to 16 healthy control group. Serum total adiponectin levels were measured by a sandwich enzyme-linked immunosorbent assay. In all 42 patients with type 2 diabetes, serum total adiponectin levels were correlated positively with serum creatinine and age, whereas, negative correlations were found with Hb. A stepwise regression analysis demonstrated that among several significant variables, Hb had the strongest independent influence on total adiponectin (β = -0.512, at P < 0.01). In conclusion, anemia could be associated with a marked elevation in serum total adiponectin levels of diabetic patients without a detectable nephropathy (-ve microalbuminuria). Key words: Type2 Diabetes, Adiponectin, Hemoglobin,Microalbuminuria.