ABSTRACT
INTRODUCTION: Pre-impaired glucose tolerance (pre-IGT) or compensated hyperinsulinemia, is defined as normal glucose, and elevated insulin two hours after a 75-gram oral glucose load. It is characteristic of the early stages of diabetes mellitus (DM), where beta cells compensate for insulin resistance by increasing insulin secretion to maintain normoglycemia. With continuing beta cell failure, insulin secretion eventually fails, leading to the progression to diabetes. Nonalcoholic fatty liver disease (NAFLD), a common feature of insulin resistance, is found in 50-75% and 42-55% of DM and pre-diabetes patients. We determined if NAFLD was present in patients with pre-IGT.METHOD: A study on the determination of NAFLD - diagnosed by liver ultrasound in pre-IGT patients at a university hospital.Descriptive statistics, Chi square test of independence, 2x2 Fischer Exact test, Z test of difference in proportion, were used for statistical analysis with a p-value set at 0.05?.IBMSPSS ver 21 was used as software.RESULTS:The mean age of 22 patients was 29.95 years, with average BMI of 25.73 kg/m2;77.3% were female. Average lipid panels were within optimal limits; kidney and liver functions were normal. The mean insulin level was 58.36 uIU/mL. NAFLD was identified in eight of the subjects. CONCLUSION: Although pre-IGT is a subclinical phase in the diabetes spectrum, 36% already have NAFLD.This prevalence was lower compared to diabetics and pre-diabetics, but higher compared to the general population.There was a noticeable trend of increasing insulin levels with increasing severity of fatty liver.
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Adult , Glucose Intolerance , Insulin Resistance , Non-alcoholic Fatty Liver Disease , Hyperinsulinism , Prediabetic State , Insulin-Secreting Cells , Insulins , Glucose , LipidsABSTRACT
INTRODUCTION:Radioactive iodine(I131) therapy is an established definitive treatment for Graves' hyperthyroidism.However,the optimal method of determining the radioiodine treatment dose remains controversial.OBJECTIVE: To compare the efficacy of fixed dose versus calculated dose regimen in the treatment of Graves' hyperthyroidism among Filipinos METHODOLOGY: Diagnosed Graves' disease patients underwent thyroid ultrasound to estimate thyroid size. Patients were randomized to either fixed or calculated dose of radioiodine treatment. For fixed dose group,the WHO goiter grading was utilized: Grade 0 (5mCi), Grade 1 (7mCi), Grade2 (10mCi), Grade 3 (15mCi). For calculated dose group the following formula was used: Dose(mCi)= 160uCi/g thyroid x thyroid gland weight in grams x 100 / 24-hour RAIU(%)Thyroid function test (TSH,FT4) was monitored every three months for one year. RESULTS: Of the 60 patients enrolled, 45 (fixed dose; n= 27, calculated dose; n= 18) completed the six months follow-up study. Analysis was done by application of the intention-to-treat principle. The percentage failure rate at third month in the fixed vs. calculated dose group was: 26 v. 28% with a relative risk (RR) value of 0.93. At six months post-therapy, there was a noted reduction in the failure rates for both study groups (11 vs. 22%, respectively), with a further reduction in the relative risk value (0.67), favoring the fixed dose group.CONCLUSION: Fixed dose radioiodine therapy for Graves' disease is observed to have a lower risk of treatment failure (persistent hyperthyroidism) at three and six months post-therapy compared to the calculated dose.