No abstract

BackgroundThe discovery of vitamin D is one of medicine’s great achievements. Despite all the positive evidence emerging about the beneficial effect of vitamin D, we still find many are vitamin D deficient. The purposes of this study were to examine the association between serum 25-hydroxyvitamin D (25(OH)D) and glycosylated hemoglobin (HbA1c) levels, to test the hypothesis that lower 25(OH)D levels are associated with poorer glucose control in diabetes mellitus (DM) patients and to investigate the effect of vitamin D supplementation on HbA1c levels.MethodsThis was a prospective observational cohort study of all patients with type 1 and type 2 diabetes (above 12 years) who attended the outpatient clinics of a tertiary center in Riyadh. HbA1c and vitamin D levels were recorded prior to supplementation and after 9 months of supplementation with vitamin D. All patients were divided into four groups according to their vitamin D level and an association between 25(OH)D and HbA1c was tested.ResultsResults showed that 73.1% of the patients had 25(OH)D levels < 50 nmol/L. We observed lowering of HbA1c after vitamin D supplementation (from mean HbA1c of 10.55 to 7.70). We found HbA1c to be inversely related to serum vitamin D levels (r = -0.14 (P < 0.0000002) before supplementation and -0.16 (P < 0.000001) after supplementation with vitamin D).ConclusionsAdvising patients with higher HbA1c to test their vitamin D level and correct any deficiency will result in better blood glucose control and benefit the patient’s overall health.

Diabetes is the fifth leading cause of death worldwide. Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes. The aim of this study is to investigate the clinical and biochemical characteristics of DKA among 400 patients admitted to hospital, most of whom had type 1 diabetes (n = 372; 93%). Vomiting (n = 319; 79.8%), nausea (n = 282; 70.5%), and abdominal pain (n = 303; 75.8%) were the presenting symptoms most commonly experienced by the patients. Tachycardia was the most common clinical sign noted in the patients on admission (n = 243; 61.8%). The predominant precipitating cause of DKA was noncompliance to an insulin regimen (n = 215; 54.2%). Recurrent DKA admissions in type 1 diabetes patients was higher than those with type 2 diabetes (n = 232 versus n = 9, respectively; P = 0.002). Recurrent DKA admissions in female patients were higher than in male patients (n = 167 versus n = 74, respectively; P = 0.002). Continued diabetic education (given to n = 384; 94%) and counseling on the importance of adhering to the recommended medical regime, addressing the social and cultural barriers that precipitate DKA, as well as the provision of timely medical attention may greatly reduce DKA episodes and their associated complications.

BackgroundSub-clinical hypothyroid dysfunction, a relatively understudied disorder in the Kingdom of Saudi Arabia (KSA), has significant clinical implications if not properly monitored. Also from KSA, more than 50% of the population suffer from hypovitaminosis D (<50 nmol/l). In this cross-sectional case-control study, we described the differences and associations in the metabolic patterns of adult Saudis with and without hypothyroid dysfunction in relation to their vitamin D status, PTH, calcium and lipid profile.MethodsA total of 94 consenting adult Saudis [52 controls (without subclinical hypothyroidism), 42 cases (previously diagnosed subjects)] were included in this cross-sectional study. Anthropometrics were obtained and fasting blood samples were taken for ascertaining lipid and thyroid profile, as well as measuring PTH, 25(OH) vitamin D and calcium.ResultsCases had a significantly higher body mass index than the controls (p < 0.001). Circulating triglycerides was also significantly higher in cases than the controls (p = 0.001). A significant positive association between HDL-cholesterol and PTH (R = 0.56; p = 0.001), as well as a negative and modestly significant negative association between LDL-cholesterol and PTH (R = - 20.0; p = 0.04) were observed. FT3 was inversely associated with circulating 25 (OH) vitamin D (R = -0.25; p = 0.01).ConclusionsPatients with hypothyroid dysfunction possess several cardiometabolic risk factors that include obesity and dyslipidemia. The association between PTH and cholesterol levels as well as the inverse association between vitamin D status and FT3 needs to be reassessed prospectively on a larger scale to confirm these findings.

Findings indicate that cabergoline provides dramatic clinical improvements with excellent safety profile. Cabergoline should therefore be considered as the primary therapy for giant prolactinomas.