BackgroundThe risk of several types of cancer is increased in type 2 diabetes mellitus. The earliest possible diagnosis of cancer – difficult within regular outpatient diabetes care - is of utmost importance for patients’ survival. The aim of this multicenter, retrospective (years 1998–2015), case-control study was to identify risk factors associated with malignancy in subjects with diabetes treated in a typical outpatient setting.MethodsIn the databases of 3 diabetic and 1 primary care clinics 203 patients (115 women) with type 2 diabetes mellitus who developed malignancy while treated for diabetes were identified. The control group consisted of 203 strictly age- and gender matched subjects with type 2 diabetes without cancer. Factors associated with diabetes: disease duration, antidiabetic medications use and metabolic control of diabetes were analyzed. Also other variables: BMI (body mass index), smoking habits, place of residence and comorbidities were included into analysis.ResultsThe most prevalent malignancies in men and women together were breast cancer (20.7 %) and colorectal cancer (16.3 %). HbA1c (hemoglobin A1c) level ≥8.5 %, obesity and insulin treatment in dose-dependent and time-varying manner demonstrated significant association with increased risk of malignancy, while metformin use was associated with a lower risk of cancer. Diabetes duration, comorbidities, smoking habits, place of residence and aspirin use did not show significant association with risk of malignancy.ConclusionsIn the outpatient setting the obese patients with poorly controlled insulin treated type 2 diabetes mellitus should be rigorously assessed towards malignancies, particularly breast cancer in women and colorectal cancer in men.

IntroductIon Pharmaco logical treatment options for nonalcoholic fatty liver disease (NAFLD) are limited. It has been suggested that thiazolidinediones may be useful in NAFLD treatment. objEctIvEs An open-label prospective study was conducted to assess the efficacy and safety of rosiglitazone treatment in nondiabetic subjects with NAFLD. PAtIEnts And mEthods A total of 27 subjects (mean age 44 ±11 years, body mass index 29.2 ±3.1 kg/m 2), with bio psy-confirmed NAFLD and no other complaints, were treated with rosiglitazone 4 mg daily for 6 months.

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Anecdotal evidence suggests that high pitched voice may be a clinical symptom of hypoglycemia. We conducted a pioneer study aiming at assessing voice variables during hypoglycemia and hyperglycemia. We recruited 10 non-smoking individuals with type 1 diabetes (4 women, 6 men; mean [±SD] age 40.2±10.4 years, diabetes duration 21.4±9.9 years, HbA1c 8.0±1.8%) who were using real time continuous glucose monitoring system (rt-CGM, Guardian Connect, Medtronic) for mean 5.2±0.6 days in controlled hospital setting. At regular intervals during normoglycemia and additionally at blood glucose <70 mg/dl or >200 mg/dl each patient was instructed to record with a professional voice recorder (LS-14, Olympus) a standardized sentence and the sound of vowel ‘a’ for 3 seconds. The voice samples (n=177) were analyzed against CGMS data with the DiagnoScope software (DiagNova, Wroclaw, Poland). Number of fundamental PERiods (PER), time of fundamental PERiods (PERTime), fundamental frequency (F0), energy (E), amplitude of fundamental frequency (AF0), indicator of voiced/phonation probability (Voiced), simple voice quality (SimpleQ), relative average perturbation (RAP), shimmer (Shimm), amplitude perturbation quotient (APQ), four formant frequencies (F1-F4), harmonic perturbation quotients (HPQ), residual to harmonic ratio (R2H), unharmonic to harmonic ratios (U2H), subharmonic to harmonic ratio (S2H), noise to harmonics ratio (NHR), 1st to 4th harmonic to all energy ratio (Fx1-Fx4) were analyzed. In women during hypoglycemia E, AF0, Voiced, F1, F4, R2H, Fx3, Fx4, while in hyperglycemia - RAP and F2 were significantly altered when compared to normoglycemia. In men in hypoglycemia the differences were found in PER, PERTime, Voiced, SimpleQ, Shimm, APQ, F2, U2H, S2H, Fx2, NHR, while in hyperglycemia - PERTime, F1, HPQ, U2H, Fx2 (all p<0.05). We report for the first time that hypoglycemia and hyperglycemia modulate human voice. This phenomenon may offer potential for early detection and prevention of hypoglycemia. Disclosure L. Czupryniak: None. E. Sielska-Badurek: None. A. Niebisz: None. M. Sobol: None. M. Kmiecik: None. K. Jedra: None. E. Szymanska-Garbacz: None. K. Niemczyk: None. Funding Polish Ministry of Science and Higher Education

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