Clinical Course of 53 Previously Vaccinated Patients Admitted to the National Hospital in Warsaw, Poland with COVID-19 Between November 2021 and March 2022.

BACKGROUND Current vaccines against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and vaccine booster programs aim to reduce hospitalizations due to severe COVID-19 (coronavirus disease 2019). It is now accepted that vaccination does not completely prevent infection and that breakthrough COVID-19 does occur. This study included 53 vaccinated patients who were hospitalized at a single center in Poland with breakthrough COVID-19 and aimed to evaluate the factors associated with their clinical course. MATERIAL AND METHODS This study covered the period 26 November 2021 to 11 March 2022. All patients had been vaccinated against COVID-19 with one of the following 4 vaccines: the mRNA-1273 (Moderna) mRNA vaccine (Spikevax); the BNT162b2 (Pfizer-BioNTech) mRNA vaccine (nucleoside-modified) (Comirnaty); the Ad26.COV2.S (Janssen/J0ohnson & Johnson) recombinant vaccine (Jcovden); and the AZD1222 (ChAdOx1) (Oxford/AstraZeneca) recombinant vaccine (Vaxzevria). RESULTS The course of COVID-19 in vaccinated patients was relatively similar. The patients vaccinated more than 24 weeks earlier rarely needed a stay in the Intensive Care Unit (ICU) (P=0.021), and the occurrence of deaths was significantly lower in this group (P=0.046). Women remained in hospital considerably longer than men (P=0.011). Age and comorbidities did not affect the course of this infection. CONCLUSIONS Despite the many advantages of the COVID-19 vaccination, our observations indicate a potential risk of infection after vaccination. The assessment of the course of COVID-19 in vaccinated patients gives the possibility to compare different vaccines and indicate factors that can reduce immunity.

The Course of COVID-19 among Unvaccinated Patients-Data from the National Hospital in Warsaw, Poland.

INTRODUCTION: Studies to date indicate the relatively high effectiveness of vaccinations in preventing severe COVID-19 symptoms. However, in Poland, 40% of the population remains unvaccinated. OBJECTIVE: The objective of this study was to describe the natural history of COVID-19 in unvaccinated hospital patients in Warsaw, Poland. MATERIAL AND METHODS: This study evaluated data from 50 adult patients from the National Hospital in Warsaw, Poland, in the period 26 November 2021 to 11 March 2022. None of these patients had been vaccinated against COVID-19. RESULTS: Analysis showed that the average hospitalisation time for these unvaccinated COVID-19 patients was 13 days. Clinical deterioration was observed in 70% of these patients, 40% required the intensive care unit, and 34% subsequently died prior to the end of the study. CONCLUSIONS: There was a significant deterioration and high mortality rate in the unvaccinated patients. For this reason, it seems prudent to take measures to increase the vaccination coverage level of the population against COVID-19.

Falsified Medicines Directive in a Secondary Care Environment-Impact on Supply Chain.

The Falsified Medicines Directive (FMD) and the Delegated Regulation (DR) impact the pharmaceutical supply chain. Ahead of the deadline for implementation, in February 2019, every entity of the supply chain had to adapt its operations to the regulatory requirements to be compliant with the directive. This paper analyzes the supply chain of a hospital pharmacy and the impact of the FMD implementation. Furthermore, a cost analysis was performed demonstrating that the FMD increases expenditure in the secondary care environment dispensing operations. Governments should be aware that this regulation will certainly impact public healthcare institutions in the long term.

Public Perception of Pharmacists in Poland.

BACKGROUND: Pharmacists constitute one of the largest groups of medical professionals and play a significant role in public health. Pharmaceutical care in community pharmacies is one of the key elements that impact the clinical outcomes of patients. The main objective of this study was to evaluate the public perception of pharmacists in Poland, as well as the knowledge of and willingness of Polish people to use pharmaceutical care services. METHODS: This study was carried out in 2017 on 1435 people. The research tool was an anonymous online questionnaire. RESULTS: Of the participants, 61% considered pharmacists to have a position of public trust, and 25% trusted pharmacists to a lesser extent than representatives of other medical professions. The participants stated that pharmacists were kind (74%) and helpful (69%). For 52% of the participants, pharmacists were fully competent to provide information on medications. Twenty-eight percent of the participants ask pharmacists for advice related to medicinal products. Poles' knowledge on pharmaceutical care was low (44% of the respondents knew this notion). Sixty-six percent of the participants were willing to use pharmaceutical consultations (43% free of charge, and 23% for a nominal fee). CONCLUSIONS: Although the overall perception of patients towards pharmacists was positive in Poland, it is essential to educate patients on the possibilities of using pharmaceutical services, and to promote the role of pharmacists in healthcare systems.

Time efficiency of direct anterior hip arthroplasty compared to postero-lateral approach in elderly patients.

INTRODUCTION: Primary arthroplasty of the hip joint is currently one of the most commonly performed procedures in orthopedics. In Poland we are observing significant changes in the age structure. With the prolonged life more and more elderly patients require musculoskeletal surgery to maintain comfortable and painless mobility. Reducing the duration of the procedure reduces the costs of anesthesiology, surgical and instrument teams, as well as the operating room technical team. The aim of the study was to compare the time required to perform hip joint arthroplasty by the direct anterior approach (DAA) with the postero-lateral approach (PLA) in our hospital. MATERIAL AND METHODS: A retrospective analysis of 559 total and bipolar cemented and cementless hip replacement procedures based on two operative approaches - the minimally invasive DAA over the course of 2 years, and the standard PLA over the course of 3 years - was performed. RESULTS: Statistically significant differences were observed between the approaches used for cementless total arthroplasty with regard to the mean treatment times: 51.9 min for the 272 DAA cases, and 78.3 min for the 190 PLA cases (p < 0.0001). For the cementless hemi-arthroplasty procedure, the mean treatment times were 46.9 min in 36 patients for DAA, and 48.2 min for 61 patients for PLA (p = 0.57). CONCLUSIONS: Minimally invasive DAA significantly shortens the time of the procedure in elderly patients compared to PLA. Further study is needed to analyze other aspects of those two approaches.

First nation-wide study of diabetic retinopathy in Poland in the years 2013-2017.

AIMS: To assess the prevalence and time trends of diabetic retinopathy (DR) in the overall population of Poland from 2013 to 2017 and diagnose the risk factors of occurring DR among patients with diabetes mellitus (DM). METHODS: Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify DM type 1 and type 2 patients, DR and treatment procedures including laser photocoagulation, pars plana vitrectomy (PPV), anti-VEGF and steroid intravitreal injections. RESULTS: The overall registered prevalence of DR in the entire population of Poland was 0.81%. The mean prevalence of DR was 20.01% in the population with type 1 DM and 9.70% in the population with type 2 DM. In the study period, women represented 56.36% of all individuals registered with DR and 55.09% of all DM patients. In Poland, only 6.34% of all DM patients with DR received specific treatment with laser photocoagulation of the retina (82.32%), PPV (11.56%), anti-VEGF or steroid injections (5.15% and 0.97%, respectively). Cox regression hazard analysis showed that the risk of DR was associated with DM treatment only by GPs, female sex, coexisting systemic diseases and urban residence in both type 1 and type 2 DM. CONCLUSIONS: A 5-year retrospective analysis reveals the mean prevalence of DR in the population with type 1 and type 2 DM in Poland was rather low.

Age at onset of obesity, transcription factor 7-like 2 (TCF7L2) rs7903146 polymorphism, adiponectin levels and the risk of type 2 diabetes in obese patients.

INTRODUCTION: Interaction between obesity and genetic factors involved in the regulatory pathways of glucose homeostasis may play a significant role in diabetes development in the obese. The aim of this study was to investigate the associations between the TCF7L2 rs7903146 polymorphism, adiponectin levels, age at onset of obesity and the occurrence of type 2 diabetes (T2D) in a sample of obese Polish adults. MATERIAL AND METHODS: A total of 474 unrelated obese subjects were included in this study. Real-time PCR was used to detect the TCF7L2 rs7903146 polymorphism. Serum level of adiponectin was determined by the ELISA method. Standard assays were used to measure total cholesterol, HDL cholesterol, triglycerides, glucose and HbA1c concentrations. We used multiple logistic regression to identify factors associated with type 2 diabetes. RESULTS: We found that the T allele of rs7903146 was significantly associated with T2D risk (odds ratio of 1.59 for T allele, p = 0.005). This association persisted after adjusting for confounders in the recessive model (odds ratio of 3.54 for TT genotype, p = 0.011). Serum adiponectin levels were significantly lower in diabetic subjects than in nondiabetic individuals (3.6 vs. 5.6 µg/ml, p < 0.001). Participants who were obese at age ≥ 20 years had significantly higher odds of having T2D (OR = 4.94) than those with the onset of obesity before 20 years (p < 0.001). CONCLUSIONS: Our study highlights the significance of the relationship between the TCF7L2 polymorphism, a person's age at onset of obesity and the prevalence of T2D, and confirms lower adiponectin levels in obese diabetics in comparison to obese nondiabetics.

The Giant Geriatric Syndromes Are Intensified by Diabetic Complications.

By 2015, diabetes has affected more than 415 million people over the world. It is anticipated that 640 million adults will suffer from diabetes in 2040. The elongation of the life expectancy, as the result of better general health care, extends also the time when diabetic complications may develop together with other senility-specific problems. The Giant Geriatric Syndromes (Geriatric Giants) have been qualified by the original Nascher's criteria defined more than 100 years ago, but they are becoming more and more relevant in connection with the aging of societies. The criteria comprise the older age, commonness of the health problem, multifactorial etiology, functional or cognitive impairment, worsened outcome, and increased morbidity and mortality. We described the impact of diabetes on Geriatric Giants including cognitive dysfunction, depression, malnutrition, incontinence, falls and fractures, chronic pain, and the loss of senses. The association of diabetes with Geriatric Giants reveals as a vicious circle with the background of neurovascular complications. However, diabetes influence on the incidence of cancer in elderly was also discussed, since neoplastic diseases associate with Geriatric Giants, for example, chronic pain and depression. The knowledge about these aspects of functional decline in geriatric population is crucial to improve patient care.

Retinal Photoreceptors and Microvascular Changes in Prediabetes Measured with Adaptive Optics (rtx1™): A Case-Control Study.

BACKGROUND: Patients with prediabetes are at risk for diabetes, cardiovascular events, and microvascular complications. The rtx1 (Imagine Eyes, France) permits early detection of changes in the retinal photoreceptors and vessels. OBJECTIVE: Cone parameters and retinal microvasculature were analyzed with the rtx1 in 12 prediabetic patients and 22 healthy subjects. The analysis was based on cone density (DM), interphotoreceptor distance (SM), cone packing regularity, and retinal vessel parameters: wall thickness, lumen diameter (LD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall. RESULTS: DM in the prediabetic group was not significantly lower than that in the control group (18,935 ± 1713 cells/mm2 and 19,900 ± 2375 cells/mm2, respectively; p = 0.0928). The LD and WLR means differed significantly between the prediabetic and the control groups (LD 94.3 ± 10.9 versus 101.2 ± 15, p = 0.022; WLR 0.29 ± 0.05 versus 0.22 ± 0.03, p < 0.05). A multivariate regression analysis showed that the WLR was significantly correlated with BMI and total cholesterol. CONCLUSIONS: Abnormalities found in rtx1 examinations indicated early signs of arteriolar dysfunction, prior to impaired glucose tolerance progressing to diabetes. The rtx1 retinal image analysis offers noninvasive measurement of early changes in the vasculature that routine clinical examination cannot detect.

An association between bone mineral density and anabolic hormones in middle-aged and elderly men with prediabetes.

INTRODUCTION: Prediabetes (PD) leads to reduced testosterone (T) in males, but the association between the anabolic hormones and bone mineral density (BMD) remains unknown. OBJECTIVES: We investigated an association between the anabolic hormones and BMD in middle-aged and elderly men with PD. METHODS: We investigated 84 prediabetic and 56 control men. Total T (TT), calculated free T (cFT), and dehydroepiandrosterone sulfate (DHEAS) were measured, and BMD was assessed using DXA methods. RESULTS: Patients with PD had lower TT (p < .001), cFT (p < .005), and DHEAS (p < .02) than control group. BMD values of the lower lumbar spine (p < .02) and total body (p < .05) in prediabetic men were lower than in control group. Lumbar spine BMD correlated with TT (r = 0.376), cFT (r = 0.235), and HbA1c (r = -0.368); femoral neck BMD correlated with TT (r = 0.412) and cFT (r = 0.421). The high lumbar spine and femur neck BMD was associated with high TT, cFT, and low HbA1c, while the high total body BMD with high TT, cFT, and low HbA1c. CONCLUSION: The anabolic hormones significantly affect BMD in male with PD, and screening for low BMD is necessary in these patients.

NK cell count and glucotransporter 4 (GLUT4) expression in subjects with type 2 diabetes and colon cancer.

BACKGROUND: Type 2 diabetes (T2D) and colon cancer (CC) are numbered among the most common diseases in the world. The decreased activity of natural killer (NK) cells previously revealed in both mentioned pathological states may be correlated with impaired expression of GLUT4 as the major insulin-dependent glucose transporter in these cells. METHODS: The aim of this study was to evaluate GLUT4 expression and NK cells number in subjects with T2D and/or CC in comparison with control group. We evaluated 78 individuals divided into four groups: (1) patients with CC and T2DM, (2) patients with CC, (3) patients with T2DM (4) healthy control. GLUT4 expression on the surface of NK cells was measured using flow cytometry and phenotyping of NK cell was performed by immunofluorescent method. RESULTS: Subjects with diabetes had the highest GLUT4 expression (21.35 ± 7.2 %) in comparison with other groups (P < 0.01). The mean values of GLUT4 expression in group with CC and in patients with both T2D and CC were similar (1.4 ± 0.4 % vs 1.5 ± 1.0 %; respectively). These values were significantly lower than in control group (12.6 ± 2.9 %; P < 0.01). In patients with T2D and CC the number of NK cells (20.15 ± 6.6 %) was significantly higher than in other groups, i.e. in group with T2D (14.08 ± 5.7 %), in group with CC (9.21 ± 3.6 %) and in control group (9.48 ± 4.7 %), respectively (P < 0.01). CONCLUSIONS: It seems that there is a need to pay more attention to the high incidence of colon cancer among patients with type 2 diabetes. Decreased GLUT4 expression observed on NK cells in patients with colon cancer may be responsible for dysfunction of these cells and the higher carcinogenic risk in type 2 diabetic subjects.

The Relationships between Anabolic Hormones and Body Composition in Middle-Aged and Elderly Men with Prediabetes: A Cross-Sectional Study.

The influence of anabolic hormones and body composition in men with prediabetes (PD) is unknown. In a cross-sectional study we investigated the relationships between total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) and body composition assessed using dual-energy X-ray absorptiometry (DXA) method in 84 patients with PD (40-80 years) and 56 men in control group. Patients with PD had lower TT, cFT, and DHEAS levels but similar IGF-1 levels in both groups. Patients with PD presented the higher total and abdominal fat as well as the lower total and abdominal lean than control (p < 0.02, p < 0.01, p < 0.05, and p < 0.02, resp.). We observed negative relationship between TT and total fat (p = 0.014) and positive with abdominal lean mass (p = 0.034), while cFT was negatively associated with abdominal (p = 0.02), trunk (p = 0.024), and leg fat (p = 0.037) and positively associated with total (p = 0.022) and trunk lean (p = 0.024). DHEAS were negatively associated with total fat (p = 0.045), and IGF-1 were positively associated with abdominal (p = 0.003) and leg lean (p = 0.015). In conclusion, the lowered anabolic hormones are involved in body composition rearrangement in men with PD. Further studies are needed to establish whether the androgen replacement therapy would be beneficial in men with PD.

Severe hypoglycaemia in elderly patients with type 2 diabetes and coexistence of cardiovascular history.

BACKGROUND: Hypoglycaemia is a condition that occurs when blood glucose levels fall below 3.9 mmol/L (70 mg/dL), while hypoglycaemic coma is usually associated with glycaemia around 1.1 mmol/L (20 mg/dL). Recurrent severe hypoglycaemia may result in permanent neurological disorders and also has a negative impact on the cardiovascular system. AIM: To evaluate the causes of severe hypoglycaemia in elderly patients with type 2 diabetes and coexistence of cardiovascular history. METHODS: We analysed retrospectively the history of 33 elderly patients with type 2 diabetes and coexistence of cardiovascular history, who were admitted to our clinic due to severe hypoglycaemia with loss of consciousness. The mean age of the patients was 76.0 ± 11.1 years, and the mean duration of diabetes was 12.0 ± 9.8 years. Glycated haemoglobin (HbA1c) was measured and the prevalence of cardiovascular diseases and therapeutic procedures were evaluated. RESULTS: In the group of patients with severe hypoglycaemia, the mean value of HbA1c was 6.3 ± 1.2% (44 ± 13.1 mmol/mol), which indicates a mean glucose value below 7.8 mmol/L (140 mg/dL). Ischaemic heart disease was diagnosed in 18 patients (eight had a history of myocardial infarction), and 22 patients had arterial hypertension. Severe hypoglycaemia requiring hospitalisation in elderly patients with type 2 diabetes and coexistence of cardiovascular history was related to insulin or sulfonylurea therapy. CONCLUSIONS: A low HbA1c level indicates inappropriate intensification of therapy and was associated with high risk of severe hypoglycaemic episodes in older people. The majority of severe hypoglycaemic episodes were observed in sulphonylurea or insulin-treated type 2 diabetic patients.

Prevalence of ocular abnormalities in prediabetic patients.

AIM: The aim of our study was to evaluate the prevalence of ocular abnormalities in prediabetic individuals. MATERIAL AND METHODS: 61 subjects aged 37-78 (41 women, 20 men), with impaired fasting glucose and/or impaired glucose tolerance, were enrolled in the study and compared to 30 healthy volunteers, aged 39-75 (20 women, 10 men), without prediabetes and history of previous ocular diseases. Both groups of patients underwent a complete physical examination, biochemical tests and ophthalmic examination: visual acuity testing, intraocular pressure measurement, anterior and posterior segment evaluation, fundus photographs, optical coherence tomography, colour vision and letter contrast sensitivity tests. RESULTS: The prevalence rates of various ocular abnormalities in prediabetic subjects as compared to healthy controls were as follows: acquired colour vision impairment 8.2% vs. 0% (p<0.05), signs of retinopathy: 9.8% vs. 0% (p<0.05), cataract: 32.8%/ vs. 6.7% (p<0.05), and corneal surface disorders: 19.7% vs. 3.3% (p<0.05). Optical coherence tomography revealed increased prevalence of posterior vitreous detachments and epiretinal membranes in prediabetic individuals as compared to healthy controls. There were no statistically significant differences in central retinal thickness, mean visual acuity and mean intraocular pressure between the two groups. CONCLUSION: Patients with prediabetes present with numerous ocular abnormalities. The prevalence of ocular disorders in prediabetic subjects is significantly higher as compared to healthy population. Regular ophthalmic monitoring seems to be essential at this stage of hyperglycemic disorders. A dedicated prevention and screening programs should be implemented in prediabetic population in order to early detect ocular abnormalities and identify individuals at risk of other diabetic complications.

Hormonal determinants of erectile dysfunction and lower urinary tract symptoms in middle-aged and elderly men with prediabetes.

OBJECTIVES: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) are common in diabetic men. The aim of this study was to investigate hormonal determinants, the prevalence and severity of ED and LUTS in middle-aged and elderly men with prediabetes (PD). METHODS: We investigated 176 men with PD and 184 healthy peers. PD was defined according American Diabetes Association. ED according IIEF scale and LUTS according IPSS scale were assessed. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) were measured. RESULTS: The prevalence of ED in patients with PD was higher than in control group (30 versus 24%) as well as the prevalence and severity of ED and LUTS in elderly (60-80 years) and middle-aged (40-59 years) men with PD was higher than in healthy peers. In middle-aged pre-diabetic men, the more severe LUTS symptoms were associated with low TT and DHEAS, while in elderly men with low cFT and DHEAS. The higher prevalence of ED in middle-aged men with PD was associated with cFT and DHEAS, while in elderly pre-diabetic men with TT and IGF-1. CONCLUSIONS: The prevalence and severity of LUTS and ED symptoms were higher in pre-diabetic men than in healthy peers. Hormonal determinants of these symptoms are different in middle-aged and elderly patients with PD.

Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes.

Andropausal and depressive symptoms are common in aging males and may be associated with hormone deficiency. We investigated the severity of andropausal and depressive symptoms, as well as their hormonal determinants, in 196 middle-aged and elderly men (age range: 40-80 years) with prediabetes (PD) and in 184 healthy peers. PD was diagnosed according to the definition of the American Diabetes Association. The severity of andropausal and depressive symptoms was assessed using the Aging Males' Symptoms Rating Scale and the Self-Rating Depression Scale. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured. The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively). In men with PD aged 40-59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60-80 years), only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar. The higher prevalence of andropausal symptoms was independently associated with cFT and IGF-1 in middle-aged men and with TT and DHEAS in elderly men with PD. The more severe depression symptoms were associated with low TT and DHEAS in middle-aged men and with low cFT and DHEAS in elderly men with PD. In conclusion, the prevalence of andropausal symptoms, especially psychological, was higher in prediabetic patients as compared to healthy men, while the severity of depressive symptoms was higher only in middle-aged men with PD. Hormonal determinants of andropausal and depressive symptoms are different in middle-aged and elderly patients, but endocrine tests are necessary in all men with PD.

Late-onset hypogonadism among old and middle-aged males with prediabetes in Polish population.

OBJECTIVES: Around 40% of diabetic men have lowered testosterone and symptoms of hypogonadism but the prevalence of hypogonadism among prediabetic men is unknown. The aim of this study was to investigate the prevalence of late-onset hypogonadism (LOH) in population of Polish men with prediabetes. METHODS: This study was performed in 196 prediabetic men and in 184 normoglycemic, control group. Prediabetes was defined as impaired fasting glucose, impaired glucose tolerance and/or HbA1c 5.7-6.4%. LOH was defined as low libido, diminished frequency of morning erections and erectile dysfunctions in men with total testosterone <12 nmol/l. RESULTS: Total testosterone (TT) level in prediabetes group was 11.78 ± 1.76 and 16.37 ± 1.6 nmol/l in control group (p < 0.001). LOH was diagnosed in 30% prediabetic men and in 13.6% control men. There were negative relationships between calculated free testosterone (cFT) and HbA1c (r = -0.3856; p < 0.005). In prediabetic group, TT and cFT levels were lower in patients with impaired glucose tolerance than impaired fasting glucose (p < 0.05 and p < 0.02, respectively). We showed inverse relationships between IIEF-5 score and cFT (r = -0.414, p < 0.005) and between IIEF-5 and HbA1c (r = -0.395, p < 0.002). CONCLUSIONS: In population of Polish men with prediabetes we observed high prevalence of LOH. Routine testosterone screening should be performed in all prediabetic men.

The prevalence of prediabetes in population of Polish men with late-onset hypogonadism.

OBJECTIVE: Prediabetes patients are likely to develop type 2 diabetes (T2DM). Low testosterone is a risk factor for impaired glucose tolerance (IGT) in men. The aim of this study was to investigate the prevalence of prediabetes in population of Polish men with late-onset hypogonadism (LOH). METHODS: This study was performed in 246 men with LOH and in 184 eugonadal control group. Prediabetes was diagnosed in patients with impaired fasting glucose (IFG), IGT or with HbA1c from 5.7 to 6.4%. Sex hormones and metabolic parameters were measured. RESULTS: The mean TT concentration in the LOH group was 9.55 ± 1.5 nmol/l and 16.45 ± 1.8 nmol/l in the control group (p < 0.001). We observed negative relationships between cFT and HbA1c (r = -0.336; p < 0.005) and between TT and HbA1c (r = -0.366, p < 0.002), In the LOH group, prediabetes was diagnosed in 41.5% men. In the control group, prediabetes was diagnosed in 13% of patients. In the LOH group, TT and cFT levels were lower in prediabetic patients, when compared with normoglycemic patients and patients with IGT had lower TT levels than subgroups with IFG or elevated HbA1c. CONCLUSIONS: In a population of Polish men with LOH, we observed high prevalence of prediabetes and routine fasting glucose and glucose tolerance test should be performed in these patients.

[Ocular abnormalities in patients with prediabetes]. / Zmiany w narzadzie wzroku u osób, u których rozpoznano stan przedcukrzycowy.

Prediabetes is recognized as the major risk factor for type 2 diabetes. Nearly 7% of adults worldwide are estimated to have prediabetes and the prevalence is increasing. There is evidence of microvascular and macrovascular complications in patients with prediabetes. Early detection of prediabetes and lifestyle modification could therefore contribute to the prevention of type 2 diabetes and its complications. Many reports indicate the possibility of ocular abnormalities in prediabetes. A number of studies show associations between prediabetes and early forms of retinopathy. There is also evidence that colour vision and contrast sensitivity are impaired in these patients. Our study analyses data regarding ocular abnormalities in prediabetes.

The incidence of hypogonadotropic hypogonadism in type 2 diabetic men in Polish population.

The aim of this study was to investigate the incidence of hypogonadotropic hypogonadism (HH) in type 2 diabetic men (T2DM) in population of Polish men and examine the possible influence of estradiol levels and glycemic control. We evaluated TT, cfT, estradiol, and glycemic control (HbA1c) in 184 diabetic men and in 149 nondiabetic control group. The mean HbA1c was 8.6 ± 0.2% and 6.1 ± 0.3% and cfT concentration was 0.315 ± 0.08 nmol/L and 0.382 ± 0.07 nmol/L, respectively. T2DM had higher E2 concentration than nonobese control men (29.4 ± 3.7 pg/mL versus 24.5 ± 2.9 pg/mL). Forty-six percent of T2DM were hypogonadal and 93% had HH. We observed inverse relationship between BMI and cfT (r = -0.341, P < 0.01) and positive between BMI and E2 (r = 0.329, P < 0.01). E2 concentration was higher in T2DM with HH versus T2DM with normal TT/cfT concentration (34.5 ± 5.2 versus 27.4 ± 3.4 pg/mL). We observed negative correlation between HbA1c and cfT (r = -0.336, P < 0.005) but positive between HbA1c and E2 levels (r = 0.337, P < 0.002). The prevalence of obesity, hypertension, and CVD was higher in men with hypogonadism. High incidence of hypogonadotropic hypogonadism in type 2 diabetic men in Polish population is associated with poor glycemic control and can be secondary to an increase in estradiol concentrations.