Incretins: the novel therapy of type 2 diabetes.

Type 2 diabetes mellitus is a worldwide health problem. Adequate glycemic control can help to prevent many chronic diabetic complications. Despite the availability of several classes of oral hypoglycemic agents and insulin, many patients fail to achieve adequate glycemic control. Incretins are gut hormones produced in response to ingestion of nutrients. Glucagon-like peptide-1 (GLP-1), one of the incretin hormones, has pleiotropic actions on the control of blood glucose. Clinical trials with the incretin mimetic and Dipeptidyl peptidase-IV inhibitors demonstrate promising results in the improvement of glucose homeostasis.

Improved glycemic control among Thai children and young adults with type 1 diabetes participating in the diabetes camp.

Diabetes Education Program, Faculty of Medicine Siriraj Hospital has provided summer camps for Thai children with type 1 diabetes since 1990. The objective of this study was to evaluate the effectiveness of the diabetes camp in glycemic control. Twenty male and forty-two female patients participated in the 5-day diabetes camp held in Karnchanaburi, Thailand in 2003. The mean age was 14.1 +/- 4.3 years and the mean duration of disease was 4.5 +/- 3.5 years. Fifty out of sixty-two patients returned for a 3-month-postcamp visit. The glycemic control improved significantly. The mean precamp and postcamp HbA1c levels were 10.0 +/- 3.1% and 9.0 +/- 2.6% (p = 0.008) respectively. The diabetes camp is a valuable program for patients to learn diabetes-self management skills, especially in countries where the diabetes education programs are not always available.

A man with chronic recurrent ulcers at the axillac and groins.

Langerhans cell histiocytosis is an uncommon disease. There are various skin manifestations of this disorder. We report a 15 year-old patient with Langerhams cell histiocytosis, who first presented with polyuria, polydipsia and right elbow pain. A few years later, he developed chronic recurrent ulcers at his axillae and groins, simulating hidradenitis suppurativa. Histopathology and ultramicroscopic study showed Langerhans cells infiltrating the lesions. He also had fingernail changes without any evidence of fungal infection. Hidradenitis suppurative-like lesions with nail changes are rare manifestations of this disorder.