Insulin therapy: Side effects and their management

Insulin has an important and vital role in control of blood glucose for all diabetic patients. With increasing the prevalence of diabetes mellitus, insulin consumption will be increased too. Different types of insulin are available, i.e. short, rapid, intermediate and long acting insulin and also mixed insulins. The side effects of insulin may lead to the lack of a desirable control of blood sugar or discontinuing insulin injection by the patients. On the other hand sometimes the side effects of insulin can be serious and fatal. Therefore, information about these complications and how to deal with them are very important. Hypoglycemia, weight gain, antibody-mediated insulin resistance, lipodystrophy [atrophy or hypertrophy], edema, postural hypotension and allergic reactions to insulin are major side effects of insulin therapy

Correlation between amputation of diabetic foot and nephropathy

A diabetic foot lesion remains a major cause of morbidity in diabetic patients with chronic kidney disease. We studied the relation between kidney function and the risk of amputation in patients with diabetic foot. We reviewed retrospectively the charts of 244 patients admitted to Imam Khomeini Hospital of Sari, Iran, for diabetic foot from 1996 to 2005. Their clinical characteristics and kidney function indicators, including urine protein excretion and serum creatinine were analyzed and compared between amputees and nonamputees. There were 244 patients with diabetic foot who were admitted to our center during the studied period. The duration of being affected by DM was between 3 months and 34 years [mean, 11.80 +/- 6.81 years]. Sixty-six patients [27.0%] underwent amputation. The amputees were older than the nonamputees [61.1 +/- 11.5 years versus 55.6 +/- 12.5 years, P < .001]. There were 20 patients [30.3%] in the amputee group and 44 [24.7%] in the nonamputee group who had proteinuria [P = .38]. The mean creatinine level was significantly higher in the amputees compared to the nonamputees [1.78 +/- 1.36 mg/dL versus 1.28 +/- 1.23 mg/dL, P - .03]. Lower extremity amputations in our patients with diabetic foot were strongly associated with elevated serum creatinine levels. The presence of this complication necessitates intensifying actions in order to prevent amputations

[Evaluation of levothyroxine effect on pulmonary function in hypothyroidism]

Hypothyroidism is one of the most common diseases in endocrinology Thyroid hormone deficiency effects on nerve and muscle fibers, pulmonary system and alveolar ventilation. The aim of this study was to evaluate the effect of Levothyroxine therapy on pulmonary function in hypothyroidism patients in Imam Hospital. This study was performed on 50 patients with hypothyroidism in Imam Hospital, Sari, Iran, 2006-2007. After a detailed clinical history and systemic examination, level of TSH, T4 and ABG test, chest radiography and spirometery was performed in all patients. The spirometery indexes including FVC, FEV1, FEV1/FVC, FEF 25-75, PEF were recorded. All patients treated with Levothyroxine 1.6 microg/kg. After that all systemic and clinical examination, and chest radiography and spirometery performed again. Results analyzed by means of SPSS [11] software and paired t test. The p value less than 0.05 was considered to be significant statistically. 50 female patients, with mean age of 34.98 +/- 13.4 years were studied. The mean of TSH, T4 before treatment were 51.44 +/- 25.3 mIu/l and 2.8 +/- 0.9 microg/dl and after treatment were 3.64 +/- 2.4 mIu/l and 9.80 +/- 4.9 microg/dl respectively [P= 0.0001]. The ABG parameters were in normal range and there was no statistically significant difference between before and after treatment. Statistical analysis demonstrated significant differences between mean of FVC, FEV1, FEV1/FVC, FEF 25-75, and PEF before and after treatment. Our study demonstrates that treatment of hypothyroidism with Levothyroxine can improves the pulmonary function according to spirometery findings

[ study on 6-18 years-old girl students about weight and height in Sari]

Measurement of height and weight of children and adolescents are important sources of information and the best index for evaluation of their growth and nutritional and health status of society. This study performed to evaluate weight, height and pubertal stage of girls in sari. This cross - sectional study was performed on 1320 6-18 years old school girls in elementary guidance and high school of Sari. Their height, weight and pubertal stage were evaluated and recorded by educated personas. Also Body Mass Index was calculated and recorded. Then Z score [SDS] of weight, height and the Body Mass Index studied people was compared by using calculated standard curve and findings in NCHS curve and findings of 1997 in Sari. For analyzing data, descriptive statistics, Mean +/- SD, Frequency and percent were used. By using NCHS curve 1256 persons [95.2%] from total persons that were studied, had normal height [5 - 95 percentile] and the weight of 1254 persons [95%] were in 5 - 95 percentile. 2/5 centemers increasing in height and 2.5 Kg increasing in weight were seen in comparison to 1997 study. BMI of persons in all age groups [expect 17 year old with +/- 0.05 SD] were over than 50 percentile and mean age of beginning of menarche was 11.4 +/- 1.1. Our study in Sari shows the improvement in growth index in comparison to 1997 study which become near to standard curve in developed country