BackgroundOwing to its impact on weight loss, remission of diabetes mellitus and metabolic syndrome, bariatric surgery has offered hope for grossly obese individuals. In recent years, obesity has increased in the UAE and the use of bariatric surgery has increased in-line with this trend. However, data regarding bariatric surgery outcomes in diabetic Emirati people is scarce.ObjectiveTo evaluate the effect of bariatric surgery in patients with diabetes mellitus.MethodsThis is a retrospective analysis of diabetic patients treated with bariatric surgery with a minimal follow-up of 1 year and extended for some patients (21) to 2 years follow up. A total of 80 patients underwent bariatric surgery. Two surgical procedures were used; laparoscopic sleeve gastrectomy (n=53) or mini-gastric bypass between January 1, 2015, and July 20, 2017.ResultsMean baseline weight was 119.2±31.2 kg, this has significantly dropped to 100.1±23.1, 91.2±22.3, 82.3±17.5, and 81.3±15.3 kg at 3, 6, 12, and 24 months respectively, and this change was statistically significant P<0.001 at each time point. Mean baseline HbA1c was 8.6% ± 2.3% and this dropped significantly to 6.5±1.7, 5.9±1.2, 5.6±0.8, and 5.4±0.7 at 3, 6, 12, and 24 months respectively (P<0.000). In 49 (61.3%) we considered fatty liver based on ultrasound features either with or without elevation in alanine aminotransferase (ALT). We noticed a significant decrease in ALT at 3, 6, and 12 months after surgery. Furthermore, 11 patients (22.4%) showed sonographic features of improvement in fatty liver in addition to normalization of ALT.ConclusionsBariatric surgery was effective over a follow-up period of 2 years in achieving significant weight loss as well as resulting in improvements in glycemic control, blood pressure, and fatty liver.

Background: By 2025, it is projected that one billion adults will be classified as having obesity worldwide. Unfortunately, the disease of obesity remains vastly undertreated. As an example, in the United States, nearly half of the adults meet recommendations for anti-obesity pharmacotherapy (defined as having a BMI ≥ 30, or a BMI ≥ 27 with weight-related diseases). Owing to its impact on weight loss, remission of diabetes mellitus, and metabolic syndrome, treatment of obesity with medical therapy like Liraglutide 3.0 mg injection has offered hope for obese individuals. In recent years, obesity has increased in the UAE and the use of medical treatment for obesity has increased in-line with this trend. However, data regarding medical treatment for obesity outcomes in diabetic and non-diabetic Emirati people is scarce. Objectives:  The primary objective of the study is to evaluate the effect of Liraglutide 3.0 mg injection for weight management in patients with diabetes mellitus. In addition, we evaluated the impact of weight reduction in improving the metabolic parameters (HbA1c and LDL-c for a patient living with type2 diabetes). Secondary objectives include improvement of infertility in females with PCOS and improvement of psychological well-being, functional capacity and quality of life. Also, we evaluated the response post-bariatric group who received Liraglutide 3.0 mg to treat their post-bariatric weight regain. Results: In terms of weight changes, the average weight at baseline was 100.98 kg and had decreased to 97.54 kg, 96.00 kg, and 96.37 kg at 3, 6, and 12 months, respectively. Males experienced a greater rate of weight reduction than females, while diabetic patients had a lower percentage of weight loss than non-diabetic patients. Additionally, patients with PCOS were able to conceive after reducing 10% of their body weight after using Liraglutide, while the remaining 15 patients who were married but unable to conceive had an improvement in their menstrual cycle and hirsutism. Conclusion: The results demonstrated that Liraglutide helps to induce and sustain weight loss in patients with obesity. It is an effective treatment for weight reduction and offers the unique benefit of improved glycaemic control. In addition, the study identified a correlation between weight reduction and improvements in psychological health, quality of life, and fertility in females with PCOS. Additional studies are needed to determine its long-term efficacy and safety profile.

Background: Pituitary apoplexy is a clinical problem resulting from abrupt pituitary ischemia or hemorrhage. A small proportion of pituitary adenomas manifest as an apoplectic crisis, with pan hypopituitarism, vomiting, nausea, headache, ophthalmoplegia, and visual impairment being the most common symptoms. Case Report: A 32-year-old diabetic Asian male presented to the emergency department with symptoms of polyuria, polydipsia, persistent vomiting, and diffused abdominal pain. He also reported a recent fever and severe headache, as well as self-limited episodes of blurring of vision and diplopia three months prior. Upon admission, his vitals were stable and he was fully conscious and oriented, though irritable and anxious. On examination, he was found to have third cranial nerve palsy and a dilated pupil with no light reflex. Laboratory tests revealed diabetic ketoacidosis (DKA). A CT scan of the brain revealed a possible invasive pituitary macro adenoma and the patient was referred for further evaluation. He also tested positive for COVID-19. Treatment for DKA was initiated and an MRI scan was scheduled for further evaluation. However, the patient's condition worsened and he was transferred to the ICU, where he was intubated and an MRI indicated a hemorrhagic mass in the pituitary gland. The patient was diagnosed with pituitary apoplexy, and he also received treatment with antibiotics and antiviral medication for suspected encephalitis. Conclusion: Pituitary apoplexy is a serious condition that requires immediate evaluation and treatment. It can cause permanent damage or death if left untreated. Treatment options include surgery and conservative management with frequent monitoring.