Background Diabetes-induced chronic hyperglycemia results in the formation and aggregation of advanced glycation end-products (AGEs), which are products of non-enzymatic glycosylation of lipids or proteins. The development of diabetic complications can be accelerated by AGEs. In the current study, we aimed to explore the relationship between AGEs levels and ABC goals of diabetes control (A: Hemoglobin A1C < 7.0%, B: Blood pressure < 140/90 mmHg, and C: low-density lipoprotein cholesterol [LDL] < 100 mg/dL). Methods In the current cross-sectional study, 293 patients with type 2 diabetes mellitus (T2D), were enrolled. Demographic and clinical characteristics of the individuals were collected. AGEs levels were measured using quantitative fluorescence spectroscopy. Finally, the association of AGEs levels with patients' characteristics and ABC goals was assessed. Results Higher serum AGEs concentration was detected in older age, smoking patients and those with higher diastolic blood pressure, lower high-density lipoprotein (HDL) level, lower body mass index (BMI) and retinopathy. Moreover, the T2D patients who achieved higher numbers of ABC goals of diabetes were younger age (P-value = 0.003), with lower hemoglobin A1C (P-value = 0.001), fasting blood sugar (P-value = 0.002) diastolic blood pressure (P-value = 0.001), systolic blood pressure (P-value = 0.001), cholesterol (P-value = 0.001), LDL (P-value = 0.001), and AGEs (P-value = 0.023) levels. Diabetic patients with AGEs levels above 73.9% were about 2.2 times more likely to achieve none of ABC treatment goals (95% CI 1.107–3.616). Conclusion Our results revealed the relationship between AGEs and ABC goal achievement, and microvascular diabetic complications, and imply that AGEs measurement may be valuable in the monitoring of diabetic patients' complications and treatment adjustment.
Introduction: Poor sleep quality is common among hemodialysis patients and can potentially predict morbidity, mortality and quality of life in these patients. On the other hand, hemodialysis patients are encountered with vitamin C deficiency. Objectives: The purpose of this study was to determine the effect of intravenous vitamin C on sleep quality, itching and restless leg syndrome in hemodialysis patients. Patients and Methods: In this double-blind randomized clinical trial, 90 qualified hemodialysis patients were gone under investigation in Sanandaj in 2016. Patients randomly allocated in two equal intervention and control groups. The main measured outcome was the Pittsburg Sleep Quality Index (PSQI) which consists of seven components. At the end of each hemodialysis session, the intervention group received vitamin C vial (500 mg/5 cc) intravenously, three times a week for 8 weeks and the control group received normal saline as placebo in the same way. Data were collected at pretreatment and after 2 months of treatment. Additionally raises questions related to restless leg syndrome and was assessed by VAS scale for determining the incidence of pruritus. Data were analyzed by independent t test, paired t test, Wilcoxon and chi-square tests. Results: Around 52.2% of subjects were female and 47.8% were male and most of them were in the age group above 50 years old. Results showed a notable difference in the value of itching and restless leg syndrome between the two groups as these values decreased significantly in the intervention group (P=0.0001). There was also a great difference in the quality of sleep disorder in subjective sleep quality, sleep latency and daily function between the two groups and those disorders was significantly lower in the intervention group (P=0.0001). Conclusion: This study showed that intravenous vitamin C can effectively improve sleep quality, itching and restless legs syndrome in hemodialysis patients.
Erdheim‐Chester disease (ECD) is a rare non‐Langerhans histiocytosis. ECD is detected more frequently due to increased awareness of healthcare providers and improved diagnostic tools. This report describes a 51‐year‐old woman with a history of weakness, bone pain, xanthelasma palpebrarum, and diabetes insipidus. ECD is a multisystemic condition with a poor prognosis. This disease should be considered in patients with diabetes insipidus, bone pain, and multiorgan involvements.
Hereditary hemochromatosis (HH) is a rare genetic disorder, causing systemic iron overload. High amounts of iron in the bloodstream gradually oversaturate the trans- ferrin which can cause sedimentation of iron in the pancreas, liver, heart, pituitaryand joints, though it can establish multiorgan involvements. We present a case of TFR2 (type 3) HH who had minor α-thalassemia and uncontrolled diabetes mellitus, and discuss the clinical presentation and patient management. A 33-year-old man with type 3 HH and alpha-thalassemia trait, presented with uncon- trolled diabetes mellitus, skin hyperpigmentation and hypogonadism. The patient had high blood glucose ,despite the administration of 80 units of Glargineand 80 units of Aspart insulins per day, but after changing them into human insulins, his diabetes mellitus was surprisingly controlled with only 32 units of NPH and 18 units of Regular insulins. Furthermore, he was treated with testosterone (due to hypogonadism) and Deferasirox (due to iron overload).
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