effect of erythromycin and metoclopramide on improvement of constipation and glycenic control in type 2 diabetic patients: a comparative study

Constipation is the most common gastrointestinal complication in diabetic patients. Erythromycin mimics the effects of the gastrointestinal hormone Motilin in gastric contractile activity and insulin secretion. In this study, we compared the effects of Erythromycin and Metoclopramide on glycemic control and constipation in type 2 diabetic patients. As a clinical trial, thirty-nine type 2 diabetic patients with constipation were divided into two groups. Patients in group 1 [n=24] were treated with erythromycin [400 mg/day before sleep] and participants in the second group [n=15] received metoclopramide [10mg 3 times / day before each meal] for 3 months. FBS, 2hPP BS, HbA1c and the frequency of defecations during a week were measured and compared before and after the intervention. In Erythromycin treated group, 2hPP BS decreased from 199.7 +/- 47.0 before treatment to 174.0 +/- 46.3 after intervention [P=0.01] and a significant improvement in constipational symptoms was observed in both groups. It seems that Erythromycin not only can improve symptoms of constipation but may have a role in glycemic control in type 2 diabetic patients

Iodine repletion thyrotoxicosis and atrial fibrillation in Isfahan, Iran

Iodized salt was reintroduced in Iran in 1989. Just before distribution of iodized salt, thyrotoxicosis was observed in 3.7% of the patients with atrial fibrillation [AF] in university teaching hospitals in Isfahan, a centrally located city in Iran. As repletion of iodine may increase the rate of autoimmune thyroid diseases and toxic multinodular goiter, this study was designed to evaluate the rate of thyrotoxicosis in patients with AF in the same hospitals after about a decade of iodized salt consumption. In a case-control study with convenience sampling, 100 patients with AF and an equal number of age- and sex-matched subjects taking the same medications were selected as case and control groups, respectively, in university hospitals in 1997. Eight% of patients with atrial fibrillation had overt thyrotoxicosis versus one% in the control group [odds ratio=8.6, 95% CI= 6.5 to 10.7, P<0.02]. Thyrotoxicosis in patients with AF was 8 times higher than in the control group without AF. In comparison with the period before use of iodized salt, AF more than doubled [8% vs. 3.7%]. Conclusion:Thyroid function should be evaluated in all patients older than 40 years of age with AF. The benefits of iodine supplementation are great, but more attention should be paid to the complications of iodine repletion, including thyrotoxicosis and its frequent accompaniment, AF

[Relationship between pancreas echogenisity and insulin sensitivity during the course of OGTT in children with beta-thalassemia major aged 10-20 years]

Background: increased echogenicity of pancreas, due to hemosiderosis, is a frequent finding in beta thalassemic paitents. Hemosiderosis also leads to beta - cell dysfunction. So diabetes and glucose intolerance are common consequences of hemosiderosis. The aim of this study was to investigate the association of increased pancreas. echogenicity [IPE] with insulin sensitivity in beta - thalassemic children aged 10-20 years

Methods: after exclusion of thalassemic paitents with diabetes or familial history of diabetes, pancreas ultrasonography was performed in 42 beta-thalassemic children and they were divided into 2 groups with normal [21] and increased [21] pancreas echogenicity. Serum ferritin was measured, as well as serum insulin and glucose values, during an OGTT, at 0, 30, 60 and 120 minutes. A control group was selected randomly [n= 23]. Insulin Sensitivity Index and Fasting Glucose/Insulin Ratio were calculated and the data were analysed using t-test and ANOVA statistical methods

Results: serum feritin differed significantly between 2 groups of thalassemic paitents [P<0.005], but the insulin and glucose values were not significantly different among studied population [P>0.05]. Serum feritin was inversely correllated with ISI in patients IPE and 28.6% of them had IFG, as compared to patients with normal echogenicity [P<0.05]

Conclusion: regarding the detection of all IFG cases among thalassemic paitents with IPE and the relation of feritin with IS1 in this group, pancreas ultrasonography may be used to investigate the early stages of diabetes in these patients. however after conducting further studies with larger sample size and on older paitents are recommended