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Aims A meta-analysis concluded that depression is associated with poor glycaemic control in Type 2 diabetes (DM2). In DM2 patients with deteriorating glycaemic control, the initiation of insulin therapy is often postponed. The aim of the present study was to determine whether symptoms of depression and diabetes-specific emotional distress are associated with a more negative appraisal of insulin therapy. MethodsWe collected cross-sectional data in two outpatient university clinics in Istanbul, Turkey. The study sample consisted of 154 insulin-naïve patients with DM2. A self-report questionnaire was used to obtain demographic and clinical data. Main instruments were the Centre for Epidemiologic Studies Depression Scale, (CES-D), the Problem Areas In Diabetes scale (PAID) and the Insulin Treatment Appraisal Scale (ITAS).Results Analysis of variance revealed that patients with a higher depression score rated insulin therapy significantly more negative then patients with lower depression scores. Moreover, 47% of patients with a high depression score had a negative appraisal of insulin therapy on 7 or more of the 20 ITAS-items, compared to 25 to 29% of those with lowmoderate depression scores. Multiple regression analyses showed that a negative appraisal of insulin therapy was significantly associated with higher depression and diabetes-distress scores and low education, but not with sex, age or duration of diabetes.Conclusions Our results suggest that in insulin-naïve Type 2 diabetes patients, higher levels of depression and diabetesdistress tend to be associated with more negative beliefs about insulin. Whether these negative attitudes translate into postponing initiation of insulin therapy needs to be tested in longitudinal research.Diabet. Med. 26, 28-33 (2009)

The aim of the study was to screen the malignancy in an acromegalic patient group and to determine whether there was any increased risk and the incidence of malignancy and its association with disease characteristics such as duration of disease, latency in diagnosis, and GH and IGF-1 levels. One hundred-five (65 female, 40 male) patients with acromegaly followed and treated at Cerrahpasa Medical School, Endocrinology and Metabolism outpatient clinic between 1983 and 2007 were included in this study. The patients were screened with colonoscopy, mammography, and thyroid and prostate ultrasonography (US). Malignancy was detected in 16 (15%) patients. Thyroid cancer was found in 5 patients (4.7%), breast cancer in 3 (2.8%), colon cancer in 2 (1.9%), lung cancer in 2 (1.9%), cervix cancer in 1 (0.9%), myelodysplastic syndrome (MDS) in 1 (0.9%), cholangiocarcinoma in 1 (0.9%), and multiple endocrine neoplasm (MEN) type 1 in 1 patient (0.9%). Cancer was more common in the male patients (P = 0.046) and high levels of GH increased the risk of cancer development (P = 0.046). In this series, the most commonly detected cancer types were thyroid followed by breast and colon cancers. Although high levels of initial GH seemed to increase the risk of cancer development in acromegalic patients, age, gender, age at the time of diagnosis, duration of disease, and initial IGF-I levels were not associated with cancer development.

group 3 ( > 40). All women were evaluated with Female Sexual Function Index (FSFI) questionnaire and Beck Depression Inventory (BDI). In addition, serum levels of follicle-stimulating hormone, luteinizing hormone, prolactin, dehydroepiandrosterone-SO 4 , free testosterone, 17 α -hydroxyprogestrone, androstenedione, oestradiol, free thyroxine and thyrotropin were determined. RESULTSThe mean FSFI scores were not statistically significant between control and obese patients ( P = 0.29). FSD was diagnosed in 50% (32/64) and 41% (11/27) of the patients in the obese and control groups, respectively ( P = 0.34). There were no differences between total FSFI and FSFI domain scores among BMI categories. BDI scores were significantly higher in the obese groups than in healthy controls, and negatively correlated with total FSFI and all FSFI domain scores. Among hormonal analyses, only free testosterone levels were negatively correlated with total FSFI scores. CONCLUSIONThis study showed that obesity has no significant relationship with FSD, but obese patients were found to be in a more depressive mood than age-matched normal counterparts.

Introduction Obstructive sleep apnea-hypopnea syndrome (OSAHS) may have a significant negative effect on sexual function. Aim To evaluate female sexual function in women with OSAHS. Methods Twenty-six patients with OSAHS were evaluated in two groups according to apnea-hypopnea index as mild (5–15, Group I, N = 16) or moderate-severe (≥15, Group II, N = 10). A third group (N = 10) of patients suspected of sleeping disorders other than OSAHS who also underwent polysomnographic studies served as the control group. All women were evaluated with a detailed sexual history including Female Sexual Function Index (FSFI) questionnaire and Beck Depression Inventory (BDI). Meanwhile, serum levels of estradiol, prolactin, total and free testosterone and dihydroepiandrostenedione-S were determined. Main Outcome Measures FSFI, BDI, and serum hormonal levels. Results The mean ages and total FSFI scores of Group I, Group II and the control group were 46 ± 7.1, 45 ± 3.8, and 41 ± 5.4 (P > 0.05); 24.7 ± 5.3, 24.5 ± 6.3, and 30.0 ± 2.5 (P < 0.05), respectively. The mean FSFI domain scores were not statistically different between Groups I and II (P > 0.05) (desire, 3.18 ± 1.2 vs. 2.92 ± 1.6; arousal, 3.96 ± 1.1 vs. 3.67 ± 1.2; lubrication, 4.83 ± 1.0 vs. 4.12 ± 1.1; orgasm 4.0 ± 1.1 vs. 5.15 ± 2.9; satisfaction 3.96 ± 1.1 vs. 4.05 ± 1.4 pain; 4.84 ± 1.2 vs. 4.65 ± 1.3). However, the mean scores of desire (3.18 ± 1.2 vs. 3.96 ± 0.7), orgasm (4.0 ± 1.1 vs. 5.0 ± 1.1), and satisfaction (3.96 ± 1.1 vs. 4.76 ± 1.0) domains of Group I were significantly lower than the control group. Meanwhile, the mean scores of desire (2.92 ± 1.6 vs. 3.96 ± 0.7) and lubrication (4.12 ± 1.1 vs. 5.22 ± 0.9) domains were statistically different between Group II and the control group. The mean BDI scores of patients in Group I, Group II and the control group were 19.3 ± 6.3, 20.2 ± 6.6, and 11.0 ± 7.1, respectively (P < 0.01). In addition, the mean levels of hormonal parameters were not significantly different from the control group (P > 0.05). Conclusions OSAHS is associated with a significant decrease in female sexual function. However, severity of OSAHS is not related with the degree of female sexual dysfunction (FSD). This situation reveals that both organic and psychogenic issues are being involved in FSD related with OSAHS.