Selfmonitoring of blood glucose practices by people living with diabetes who use their personal glucometers in Port Harcourt, Niger Delta Region, Nigeria

Self-monitoring of blood glucose (SMBG) assists persons living with diabetes with the day-to-day behavioral and therapeutic adjustments to their diabetes care. It is a cheaper and more available alternative to glycated haemoglobin (HbA1c) in Nigeria for monitoring glycaemic control. Information on SMBG practices of Nigerians living with diabetes using their personal glucometers is scanty. The aim of the study is to assess the intensity and frequency of SMBG by glucometer owners, and the extent the patients and/or the health care providers (HCP) utilize SMBG to achieve personalized treatment goals via behavioral/treatment adjustments. This was a cross sectional study carried out among persons living with diabetes that accessed diabetes care at the diabetes clinic of the University of Port Harcourt Teaching Hospital (UPTH) and using their personal glucometers. They were consecutively recruited. Data obtained by using interviewer-administered questionnaires were analyzed using SPSS version 20.0, and pvalue <0.05 was considered significant. A total of 128 persons living with diabetes participated in the study of which 40 (31%) were males and 88 (69%) were females; the mean age of the subjects was 52.05 ± 11.24 years with a range of 26­70 years. The majority of the study subjects (72%) were in the active working age group (25­60years). The highest frequency of glucometer use was in the 26 subjects (20%) who checked their blood glucose every morning while 62 (48%) of the subjects checked their blood glucose any morning they felt like. Most of the subjects (60%) did not have any recording device. Glucometer owners were not just the insulin-requiring people living with diabetes as more than half of the subjects, 66 (52%) were on oral anti diabetic drugs (OAD) only. Glucometer ownership was mainly by those that were in the working age group. SMBG protocol (frequency) was variable and SMBG data were not maximally utilized

Thyrotoxicosis - a Review

"Background: Thyrotoxicosis is the clinical and biochemical manifestations of exposure of tissues to excessive quantities of thyroid hormones; specifically free thyroxine (T4 ); tri-iodothyronine (T3) or both. The terms ""thyrotoxicosis""; ""hyperthyroidism"" and ""Graves' disease"" are used interchangeably because hyperthyroidism due to Graves' disease is the commonest cause of thyrotoxicosis. Studies in most countries reveal an increasing incidence of thyrotoxicosis. Aim: To present an update on the causes and management of thyrotoxicosis with emphasis on Graves' disease. Methods: A review of publications obtained from medline search and Google on ""thyrotoxicosis"" or ""Graves' disease"" or ""hyperthyroidism"" was done. Results: Graves' disease constitutes about 70of cases of thyrotoxicosis.The common clinical features include weight loss despite enhanced appetite; hyperactivity and heat intolerance etc. Features specific to Graves' disease include ophthalmopathy; pretibial myxoedema and thyroid acropachy. Thyrotoxicosis affects about 1of women and 0.1of men globally. It is indicated in most cases by an elevated serum concentration of total T4 and T3 and a suppressed thyroid stimulating hormone (TSH). Thyroid imaging and radiotracer uptake measurements combined with serological data enable specific aetiological diagnosis. The three treatment modalites for Graves' disease are antithyroid drugs; 131I therapy and thyroidectomy. Conclusion: The incidence of thyrotoxicosis is increasing globally. Optimal clinical and laboratory evaluation of the patient is necessary to identify the cause and institute appropriate therapy. There is need for prospective studies to identify the factors for the observed increasing incidence of thyrotoxicosis in our population"