Self blood glucose monitoring among diabetic patients in Port Harcourt, Nigeria

Self blood glucose monitoring (SBGM) is important in the management of people living with diabetes. This study set out to evaluate the knowledge and practice of SBGM in diabetic patients at our clinic in Port Harcourt, Nigeria. Ninety (90) diabetic patients attending the clinic were assessed with self-administered questionnaires. There were 36 (40%) males and 54 (60%) females with a mean age of 54±23 years, and a mean duration of diabetes of 8 years. Eighty-one (90%) had type 2 diabetes while nine (10%) had type 1 diabetes. Eighteen type 2 patients (20%) were on insulin alone, 52 (58%) on oral drugs, and 20 (22%) were on a combination. Fifty-two patients knew only about using glucose meters for SBGM, 30 knew about using both meters and urine dipsticks, and 4 did not know of any method. Only 24 (27%) patients had glucose meters and no type 1 patient had a meter. The highest frequency of monitoring was once daily in six patients. None of the patients practised urine monitoring. In conclusion, this study has shown that the practice of SBGM in our patients is inadequate despite reasonable knowledge of the technique. This is most likely due to scarce resources. The importance of SBGM should be emphasised more in our practice, especially in patients with type 1 diabetes, and there should be motivation for improved self-monitoring resources

Thyrotoxicosis - a Review

"Background: Thyrotoxicosis is the clinical and biochemical manifestations of exposure of tissues to excessive quantities of thyroid hormones; specifically free thyroxine (T4 ); tri-iodothyronine (T3) or both. The terms ""thyrotoxicosis""; ""hyperthyroidism"" and ""Graves' disease"" are used interchangeably because hyperthyroidism due to Graves' disease is the commonest cause of thyrotoxicosis. Studies in most countries reveal an increasing incidence of thyrotoxicosis. Aim: To present an update on the causes and management of thyrotoxicosis with emphasis on Graves' disease. Methods: A review of publications obtained from medline search and Google on ""thyrotoxicosis"" or ""Graves' disease"" or ""hyperthyroidism"" was done. Results: Graves' disease constitutes about 70of cases of thyrotoxicosis.The common clinical features include weight loss despite enhanced appetite; hyperactivity and heat intolerance etc. Features specific to Graves' disease include ophthalmopathy; pretibial myxoedema and thyroid acropachy. Thyrotoxicosis affects about 1of women and 0.1of men globally. It is indicated in most cases by an elevated serum concentration of total T4 and T3 and a suppressed thyroid stimulating hormone (TSH). Thyroid imaging and radiotracer uptake measurements combined with serological data enable specific aetiological diagnosis. The three treatment modalites for Graves' disease are antithyroid drugs; 131I therapy and thyroidectomy. Conclusion: The incidence of thyrotoxicosis is increasing globally. Optimal clinical and laboratory evaluation of the patient is necessary to identify the cause and institute appropriate therapy. There is need for prospective studies to identify the factors for the observed increasing incidence of thyrotoxicosis in our population"