Healthcare resource use, direct and indirect costs of hypoglycemia in type 1 and type 2 diabetes, and nationwide projections. Results of the HYPOS-1 study.

BACKGROUND AND AIMS: To obtain an accurate picture of the total costs of hypoglycemia, including the indirect costs and comparing the differences between type 1 (T1DM) and type 2 diabetes mellitus (T2DM). METHODS AND RESULTS: HYPOS-1 was a multicenter, retrospective cohort study which analyzed the data of 2229 consecutive patients seen at 18 diabetes clinics. Data on healthcare resource use and indirect costs by diabetes type were collected via a questionnaire. The domains of inpatient admission and hospital stay, work days lost, and third-party assistance were also explored. Resource utilization was reported as estimated incidence rates (IRs) of hypoglycemic episodes per 100 person-years and estimated costs as IRs per person-years. For every 100 patients with T1DM, 9 emergency room (ER) visits and 6 emergency medical service calls for hypoglycemia were required per year; for every 100 patients with T2DM, 3 ER visits and 1 inpatient admission were required, with over 3 nights spent in hospital. Hypoglycemia led to 58 work days per 100 person-years lost by the patient or a family member in T1DM versus 19 in T2DM. The costs in T1DM totaled €90.99 per person-year and €62.04 in T2DM. Direct and indirect costs making up the total differed by type of diabetes (60% indirect costs in T1DM versus 43% in T2DM). The total cost associated with hypoglycemia in Italy is estimated to be €107 million per year. CONCLUSIONS: Indirect costs meaningfully contribute to the total costs associated with hypoglycemia. As compared with T1DM, T2DM requires fewer ER visits and incurs lower indirect costs but more frequent hospital use.

A degradation product of circulating luteinizing hormone (beta-hCG subunit) in human semen.

Levels of beta-human chorionic gonadotropin (beta-hCG) were detected in semen under basal conditions. No significant correlation to levels of luteinizing hormone (LH) in blood was found. The beta-hCG level did not increase within 3-7 days after a 5000 IU dose of hCG was injected intramuscularly. Human chorionic gonadotropin was detected in semen only after injection. beta-Human chorionic gonadotropin in the semen represents a degradation product of circulating LH.

Hormones in the seminal fluid. The transport proteins of the thyroid hormones.

The study of the retention of titrated T3 on columns of Sephadex G-25, (Resin T3 Uptake), in the presence of untreated plasma, or plasma treated with charcoal, indicates that there are very small quantities of protein-hormone compounds present in the seminal fluid. In cases of phlogosis of the genital tract, the increase of albumin in the seminal fluid might determine an increase in the binding capacity with titrated T3. This would therefore give the possibility of a further test in the diagnostics of male infertility.

Male fertility and thyroid hormones.

On the basis of the results in vitro, it seems that the testicle does not respond to the action of the thyroid hormones. The study of the relationship between the blood concentrations of these hormones and the reproductive function of the organ is being made by the Authors as a means of verifying this in vivo. The total blood concentrations of T4, (triioothyronine), and the index of free Thyroxine (IT4L) were therefore evaluated both in normal and infertile subjects. The concentrations of T4 showed a correlation both with the sperm count (r = 0.43, p = less than 0.02), and with the percentage of motile spermatozoa, (r = 0.48, p = less than 0.01). This type of correlation is not found, however, either for the T3 or for the IT4L. These data indicate that the function of the thyroid gland is linked to that of the hypothalamo-hypophyseotesticular axis. It would appear that the peripheric metabolism of the circulating hormones is not involved.