Effects of short term metformin administration on androgens in diabetic men.

Metformin, an oral hypoglycemic agent, has several other metabolic and hormonal effects. This study aims at identifying the metabolic effect of metformin on androgens in diabetic men. The study was conducted at The National Center for Diabetes Endocrinology and Genetics, Jordan University Hospital, Amman, Jordan from April 2001 to September 2001. We studied 15 men with type 2 diabetes mellitus by measuring fasting serum glucose, insulin, glycosylated hemoglobin, total and free testosterone, sex hormone binding globulin, dehydroepiandrosterone sulphate, 17-OH progesterone, luteinizing hormone, and follicle stimulating hormone before and after a short course of metformin. There was a significant decrease in fasting serum glucose and glycosylated hemoglobin and increase in the level of 17-OH progesterone. The remainder of the measured parameters did not show any significant change. Although serum glucose and glycosylated hemoglobin decreased insulin levels were not changed. In contrast to normal men there was no change in androgen levels in diabetics but the 17-OH progesterone was elevated

Thyroid function and thyroid autoimmunity in patients with type 1 diabetes mellitus

An association between diabetes mellitus and autoimmune thyroid disease is well known. We have investigated the prevalence of thyroid dysfunction and autoimmunity in type 1 diabetic patients. Seventy-nine type 1 diabetic patients were recruited in the study, and underwent complete investigations for thyroid function, which included free thyroxine, free tri-iodothyronine, and thyroid stimulating hormone, of those only 64 patients had performed thyroid autoantibodies [TAb]; anti- thyroid peroxidase antibodies [TPOAb] or antimicrosomal antibodies and thyroglobulin antibodies [TgAb]. They were compared with 127 healthy subjects matched for sex and age. This study was carried out at the National Center for Diabetes, Endocrinology and Genetics, Jordan University, Amman, Jordan between 2000 and 2001. In the diabetic group, 7 cases [8.9%] of thyroid dysfunction were detected, 4 of these were diagnosed as subclinical hypothyroidism, whereas the other 3 had overt hypothyroidism and were on thyroxine replacement therapy. In the control group, 6 [4.7%] subjects were diagnosed as subclinical hyperthyroidism. There was a significant difference in thyroid function variables between diabetics and controls. Among type 1 diabetic patients, 7 [9.2%] had thyroid autoantibodies, 5 with positive TPOAb only and 2 with positive TAb; TPOAb or antimicrosomal antibodies and TgAb; compared with 8 [6.3%] in the control group, 4 with positive TPOAb only and 4 with positive TAb; TPOAb or antimicrosomal antibodies and TgAb P=0.68. Biochemical thyroid dysfunction and thyroid autoimmunity were evident in type 1 diabetics who were apparently euthyroid, with no significant difference between diabetics and controls

Prevalence and predictors of diabetic foot syndrome in type 2 diabetes mellitus in Jordan

To detect feet changes and to identify risk factors leading to amputation among type 2 diabetics. A total of 1142 patients with type 2 diabetes mellitus; 595 males [52%], and 547 females [48%] were seen between January and December 2001 at the National Center for Diabetes, Endocrinology, and Genetics [NCDG] Amman, Jordan. The mean age was 56.1 years [SD=10.2] and the mean duration of diabetes was 9 years [SD=7.1]. All patients had a complete medical assessment including history, physical examination, glycosylated hemoglobin [HbA1c] [the mean of the last 4 readings] and microalbuminuria. Statistical analysis were performed to identify significant risk factors leading to amputation using Epi info, version 6 software. Mean HbA1c was 7.4% [SD=1.4]. The prevalence of hypertension was 52%, retinopathy 45% and microalbuminuria 33%. Impaired vibration, position and protective sense were found in 19%, 13%, and 18%. The prevalence of all amputations was 5%. The following were strong predictors of amputation; duration of diabetes [P= 0.04], smoking [P=0.01], microalbuminuria [P=0.02], retinopathy [P=0.008], legs hair loss [P=0.003], neurological deficit [P=0.0001], ulceration [P=0.00001] absent dorsalis pedis [P=0.0006] and insulin therapy [P=0.0001]. The rate of amputation was directly proportional to high HbA1c >= 8% [P=0.01]. Age and gender were not found to have an impact on prevalence of amputation. Prevalence of amputation correlates with duration of diabetes, poor glycemic control, smoking, neurological impairment, peripheral vascular disease and microalbuminuria