ABSTRACT
Objective@#To determine the association between serum 25-hydroxyvitamin D (25(OH)D) and measures of glycemic control, hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG), in adult patients with diabetes mellitus.@*Methodology@#This is an analytical cross-sectional study of 270 patients with diabetes admitted to a tertiary hospital. Serum 25(OH)D levels were categorized as follows: sufficient (>30 ng/mL), insufficient (20 to 30 ng/mL), and deficient (<20 ng/mL). The correlation of HbA1c and FPG with serum 25(OH)D and other variables was determined using Spearman’s rho (ρ) coefficient. The risk factors associated with HbA1c ≥7% and FPG ≥126 mg/dL were determined using logistic regression analysis to generate crude and adjusted odds ratios. The null hypothesis was rejected at 0.05 α-level of significance.@*Results@#The median serum 25(OH)D was 18.92 (range 3.56–56.3) ng/mL. Ninety percent (245 patients) had vitamin D levels below 30 ng/mL. This study showed that vitamin D level is significantly but weakly correlated with patient’s age (ρ=0.339) and duration of diabetes (ρ=0.147), whereas it had inverse correlations with BMI (ρ=-0.134), HbA1c (ρ=-0.261), and FPG (ρ=-0.198).@*Conclusion@#In this study, we found a possible association between vitamin D levels and measures of glycemic control among this group of adult Filipino patients with diabetes mellitus, but further investigations in other cohorts of individuals with diabetes are needed.
Subject(s)
Vitamin D , Diabetes Mellitus , Glycemic ControlABSTRACT
Objective@#To identify factors independently associated with incomplete response to therapy based on the 2015 ATA guidelines in surgically treated Filipino patients with papillary thyroid carcinoma (PTC).@*Methodology@#This is a retrospective cohort study of adults aged 21-74 years with papillary thyroid carcinoma (PTC) treated with surgery with or without radioactive iodine therapy (RAI) in Makati Medical Center from 2013 to 2017. We collected the following factors through a review of charts: age at diagnosis, gender, family history of thyroid cancer, date of surgery, tumor size, capsular/lymphovascular invasion, lymph node/distant metastases, stage, risk of recurrence, dose of post-surgical RAI therapy, initial post-treatment serum Thyroglobulin (Tg) and anti-Tg antibody levels (Negative Tg level: suppressed non-stimulated Tg <0.2 ng/mL or TSH-stimulated Tg <1 ng/mL; Positive Tg level: suppressed Tg ≥1 ng/mL or a TSH-stimulated Tg ≥10 ng/mL or rising anti-Tg antibody levels), thyroid stimulating hormone suppression, post-operative imaging studies and levothyroxine dose. Response to therapy was checked 6-24 months post-therapy.@*Results@#We analyzed a total of 115 patients with PTC who underwent thyroidectomy. Patients who had family history of thyroid cancer were less likely to have an incomplete or indeterminate response (p=0.045). None of the patients with excellent response had lymphovascular invasion. Having a positive Tg (p=0.001) and positive anti-Tg postoperatively (p<0.001) were strongly associated with incomplete or indeterminate response.@*Conclusion@#Patients who were positive for thyroglobulin and anti-thyroglobulin post-operatively were strongly associated with incomplete or indeterminate response to therapy in PTC.
Subject(s)
Thyroid Cancer, PapillaryABSTRACT
@#INTRODUCTION: Dietary intervention remains an important factor in the management of diabetes mellitus, and many patients have employed herbs and oils to help manage their chronic diseases. Extra virgin olive oil (EVOO) is widely known for its cardio-vascular benefits. However, its effect on the blood glucose of type 2 diabetes mellitus patients has not been extensively studied. In this study, we aimed to determine if the addition of EVOO to meals results in a lower postprandial blood glucose among type 2 diabetes mellitus patients. METHODS: Thirteen patients were included in this randomized controlled cross-over trial. They were randomized to receive a meal with or without EVOO followed by a one week washout period, where they were given the other intervention. The primary outcome is the trans-meal blood glucose, which was calculated as the percent change in two-hour postprandial blood glucose. RESULTS: In group A, there was a noted 88.55% increase in two-hour postprandial blood glucose in taking meals with EVOO, versus 72.11% change in meals without EVOO. The same was observed in Group B, with a 71.08% and 49.22% increase in two-hour postprandial blood glucose in meals with EVOO and without EVOO, respectively. The difference was significant with a p-value of 0.044. Free fatty acids inhibit glucose transport and insulin secretion, this effect may be more predominant in asian type 2 diabetes mellitus patients. CONCLUSION: This study found that adding extra virgin olive oil on top of meals provided no additional benefit in terms of post-prandial glucose excursion.
Subject(s)
Diet, DiabeticABSTRACT
@#A 19-year-old Filipino male presents with recurrent respiratory tract symptoms every 4 to 5 months since childhood and sudden onset of diabetes type 1 with ketoacidosis. He had patchy hair loss which started at 7 years old, and was diagnosed with alopecia universalis. Thyroid antibodies and 21-hydroxylase antibody were normal. Common Variable Immunodeficiency with Polyglandular Autoimmune Syndrome IV was considered. The patient is on monthly intravenousimmunoglobulin therapy and basal bolus insulin regimen.