Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.

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Background:Vitamin D was shown to be related to autoimmune thyroid diseases (AITDs) in the previous studies. We aimed to investigate the relationship between Vitamin D and thyroid autoimmunity.Materials and Methods:Eighty-two patients, diagnosed with AITD by the endocrinology outpatient clinic, were included in this prospective study. All of the patients had both AITD and Vitamin D deficiency, defined as serum values <20 ng/mL. They were randomly assigned into two groups. The first group included 46 patients and the second one included 36 patients. The first group was treated with Vitamin D for 1 month at 1000 IU/day. The second group served as the control group and was not treated with Vitamin D replacement. Serum thyroid-stimulating hormone, free T4 (fT4), thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TgAb), and Vitamin D levels were measured at the initiation of the study and again at 1 month in all patients.Results:Two groups were similar with regard to age, sex, and type of thyroid disease. Whereas TPO-Ab (before; 278.3 ± 218.4 IU/ml and after; 267.9 ± 200.7 IU/ml) and TgAb (before; 331.9 ± 268.1 IU/ml and after; 275.4 ± 187.3 IU/ml) levels were significantly decreased by the Vitamin D replacement therapy in group 1 (P = 0.02, P = 0.03, respectively), the evaluated parameters in the control group did not significantly change (P = 0.869, P = 0.530, respectively). In addition, thyroid function tests did not significantly change with Vitamin D replacement in two groups.Conclusion:Vitamin D deficiency may contribute to the pathogenesis of AITDs. Since supplementation of the Vitamin D decreased thyroid antibody titers in this study in Vitamin D deficient subjects, in the future Vitamin D may become a part of AITDs' treatment, especially in those with Vitamin D insufficiency. Further clinical and experimental studies are required to understand the effect of Vitamin D on AITD.

Purpose:The aim of this study was to investigate the effect of insulin detemir and glargine on glycemic variability as determined by capillary blood glucose measurements in Type 2 diabetics treated with oral antidiabetic drugs. Material and Method: A total of 64 insulin-naive type 2 diabetics with a HbA1c level of 7.5%-10% were included in the study. The patients were randomized into 3 groups according to the basal insulin analog started; Group 1 (n=22) was started on once-daily detemir, Group 2 (n=22) twicedaily detemir, and Group 3 (n=20) insulin glargine. Basal insulin doses were titrated according to the morning/evening fasting capillary blood glucose levels. Standard deviations of the 8-point intraday fasting and postprandial blood glucose values were compared. Results: The fasting blood glucose intraday standard deviation values showed an improvement of 22.4% in Group 1, 21.4% in Group 2, and 26.4% in Group 3, while the intraday standard deviation for the postprandial values showed an improvement of 14.4%, 15.2%, and 38.7%, respectively (p>0.05). The standard deviation values did not show statistical significance when the groups were compared with each other. Baseline HbA1c values and insulin doses negatively correlated with the glycemic variability. Dicussion: Basal insulin added to treatment in Type 2 diabetics provided an improvement of 14.4% to 38.7% in glycemic variability. There was no significant difference between insulin glargine and detemir regarding this effect. Turk Jem 2014; 2: 33-38 Key words: Type 2 Diabetes, glycemic variability, basal insulin therapy Amaç: Bu çalışmanın amacı, oral antidiyabetik ilaçlar ile tedavi edilen Tip 2 diyabet hastalarında insülin detemir ve glarjinin, kapiller kan glukoz ölçümleri ile tespit edilen glisemik dalgalanmalar üzerine etkilerinin incelenmesidir. Gereç ve Yöntem: Daha önce hiç insulin kullanmamış ve HbA1c düzeyi %7,5-%10 arasında olan toplam 64 Tip 2 diyabetik hasta çalışmaya dahil edilmiştir. Hastalar başlanan bazal insulin analoguna göre 3 gruba randomize edildi; Grup 1'deki (n=22) hastalara günde tek doz insülin detemir, Grup 2'deki (n=22) hastalara günde iki doz detemir ve Grup 3'deki (n=20) hastalara insulin glarjin başlandı. Bazal insulin dozları sabah/ akşam açlık kapiller glukoz ölçüm düzeylerine göre titre edildi. Gün içi 8 nokta açlık ve öğün sonrası kan glukoz ölçümlerinin standart deviasyon değerleri karşılaştırıldı. Bulgular: Gün içi açlık kan glukoz ölçümlerinin gün içi standart sapma değerlerinde Grup 1'de %22,4, Grup 2'de %21,4 ve Grup 3'te %26,4 düzelme gözlenirken, öğün sonrası değerlerin standart sapma değerlerinde ise sırası ile %14,4, %15,2 ve %38,7 (p>0,05) düzelme tesbit edildi. Standart sapma değerleri her üç grup birebir karşılaştırıldığında istatistiksel olarak anlamlı fark tesbit edilmedi. Başlangıç HbA1c değerleri ve insulin dozları ile glisemik değişkenlik arasında negatif korelasyon tesbit edildi. Tartışma: Tip 2 diayebtiklerde tedaviye bazal insulin eklenmesi, glisemik dalgalanmalarda %14,4'ten %38,7'ye kadar iyileşme sağla...

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