[Obesity as a factor in the development of cancer in type 2 diabetes]. / Otylosc jako czynnik rozwoju nowotworów w cukrzycy typu 2.

AIM: The aim of this study was to evaluate the prevalence of malignant tumors in patients with type 2 diabetes and the factors contributing to the development of cancer. MATERIALS AND METHODS: Medical records of 1087 patients with type 2 diabetes were retrospectively analyzed and a group of 74 (6.8%) patients with malignant tumor were found during treatment of diabetes. RESULTS: The most common sites of malignancies in patients with type 2 diabetes were: kidney (33.3%) and colorectal cancer (26.7%). The highest mean body mass index (BMI) was in the group of patients with uterus cancer and amounted to 36.1 kg/m². The next highest BMI recorded in the case of breast cancer - 32.6 kg/m², cancer of the kidney - 31.6 kg/m² and colorectal cancer - 31.3 kg/m². The lowest BMI values were observed in gallbladder cancer - 25.2 kg/m² and lung cancer - 26.4 kg/m². BMI in the various types of cancer were not statistically significant. In the group with normal BMI prostate cancer was most common. In the group of overweight and obesity patients kidney and colon cancers occurred more frequently, while in obese women - breast and uterus tumors. More than 80% of patients with type 2 diabetes who were diagnosed with cancer were overweight or obese. In the group of obese patients the highest average glycated hemoglobin was observed and if compared to those with normal weight it was significantly higher (p = 0.01). CONCLUSIONS: In the group of obese patients, the most common tumors were renal and colorectal cancer, and cancer of the breast and uterus in a group of obese women. The use of metformin in the presence of other risk factors do not protect against the development of cancer.

[Serious course of sepsis in diabetic patients]. / Ciezszy przebieg posocznicy u pacjentów z cukrzyca.

UNLABELLED: The aim of the study was to evaluate the frequency and the course of sepsis in the patients treated in our ward. Retrospective evaluation was conducted on a group of 7418 patients hospitalized in 2001-2005. Serious sepsis was found in 15 patients (0.2%). Analysis was conducted on two groups of patients: diabetic (group A) and non-diabetic (group B). The majority of patients had community-acquired infection (93.3%). Critical course of sepsis was observed in 53.3% of patients. Mortality was higher in group A (83.3%) compared to B (33.3%). In group A other, pre-existing diseases were more frequent. The most frequent focus of infection was urinary tract, followed by respiratory system. In group A the focus of infection was in 33.3% each urinary tract, respiratory tract and diabetic foot. Only in 66.7% of patients pathogens were cultured from body fluid. Multiple pathogens were more frequent in group B. Co-existing fungal infections were more frequent in group A (16.6%) than in B (11.1%). The empirical therapy was ineffective in 75% of diabetic and 50% of non-diabetic patients. CONCLUSIONS: 1) In severe sepsis mortality is high, and in diabetic patients it amounts to 80%. 2) In > 30% patients bacteriological tests did not confirm the type of pathogen. 3) In diabetic patients fungal infections were more frequent. 4) Critical course of sepsis may result from co-existing morbidity.