Disorders of thyroid hormones in non-insulin-dependent diabetes mellitus

INTRODUCTION: In a previous study of patients with non-insulin-dependent diabetes mellitus (NIDDM) of less than 5 years' duration at the HCQ "Hermanos Ameijeiras", Cuba, we found abnormal values of T3 at iniitial evaluation. It was proved that the cause was an increase in the activity of the enzyme catalysing the process of peripheral deiodination of T4 to T3. OBJECTIVE: To examine these variables in a larger sample. SUBJECTS AND METHODS: One hundred and forty patients with NIDDM of 1-25 years' duration being treated by diet, and/or oral hypoglycaemic agents, were studied T3, T4, and insulin were measured by radio-immunoassay; glucose, by glucose-oxidase; cholesterol, triglycerides and HDL-cholestrol by the Trinder method; LDL and VLDL by the Ellefson formula; glycosylated haemoglobin by ion exchange chromatography, and microalbuminuria by an immuno-colorimetric semiquantitative method. The sample was divided into 5 groups: 1-2 years, 3-4 years, 5-6 years, 7-15 years, and more than 15 years' duration of diabetes mellitus. RESULTS: The results confirmed the previous findings that there was a marked increase in T3 (4.87, 4.49, 3.1, 2.8, 2.9 mmol/l, respectively) in the time of evolution but diminishing progressively as the time of evolution increases and normalizing in the 5-6 year group. There were no notable differences in T4 in the 5 groups of healthy controls (102, 113, 96, 94, 99 mmol/l). The blood glucose levels were higher than in the healthy population but a point of inflection was noted in the 5th -6th year of evolution (8.6, 8.2. 7.02, 8.4, 8.3 mmol/l). The insulin values were noted to have a greater variation between 1-2 years and 3-4 years, supposedly a treatment effect as in the 1-2 year group. There were patients who had not started treatment but the insulin in the 3-4 year group decreased with the introduction of treatment (48.7, 17.9, 32.1, 36.6, 39.5 mU/ml). Glycosylated haemoglobin showed a point of inflection in the 5th-6th year (7.2, 6.3, 8.2, 7.9, 8.5 percent). Lipid metabolism indicators, cholesterol (4.7, 5.2, 5.6, 5.74, 5.5 mmol/l), triglyceride (1.34, 2.01, 1.33, 1.95, 1.65 mmol/l) and low density lipoprotein (2.99, 3.14, 3.97, 3.95, 3.63 mmol/l) progressively increased with time of evolution. Microalbuminuria behaved the same (25, 12.4, 14.5, 33.4, 27.3 mg/l), showing a higher value at 1-2 years and diminishing between 3 and 6 years but increasing thereafter.(Au)

Yoga exercise versus traditional exercise in the control of non-insulin diabetes mellitus - Poster presentation

The sample population was selected from 3 municipals of Havana City. The population size was selected using the programme EP16 with the option statcalc. From a population size of 17,068 diabetics, a sample size of 100 diabetics was calculated as the minimum population size required to obtain a confidence level of 95 percent. Patients were divided into two groups (yoga and traditional group) and were matched according to the following criteria: Age +/- 5 years, Sex, Type of treatment, Evolution of NIDDM, BMI. The two groups of 63 diabetics were matched according to the criteria described above and were then grouped as "yoga exercise group" and "traditional exercise group". Biochemical analysis was done at the start of the investigation, and included: HDL - C Tryglyceride, LDL - C, Total cholesterol, Glycated haemoglobin, Insulinic receptors, Microalbuminuria, Blood glucose, quantification of T3, T4 Insulin, GH, and TSH, Oxidative stress enzymes serum, creatinine. The Second Stage: Both groups had similar diet and practised their respective physical exercise at the same duration and frequency for periods of 3 and 6 months. The biomedical analysis was done at these intervals. The biochemical analysis at the start showed: In most cases there were alterations in lipid metabolism, renal function as seen as hyperlipidaemia and hypercortisolaemia and a reduction in the union and internalization of insulin in the receptors of lymphocytes. There was a correlation between GH and T4. These findings show that it is necessary to deepen the investigation of these patients as there exists a difference in the laboratory results and the clinical manifestations of endocrine metabolc diseases.(AU)