Standard (75 g) oral glucose tolerance tests were performed at two different ambient temperatures (23 and 33 degrees C) in random order in 16 (eight obese) diabetic and 16 (eight obese) non-diabetic Nigerian subjects. Consistently higher plasma glucose values were found 120 min post-glucose ingestion at 33 degrees C, with mean differences of 0.5 (SE 0.3) and 4.5 (SE 1.5) mmol l-1 in the non-diabetic and diabetic subjects, respectively. This caused reclassification of two of the non-diabetic subjects as Impaired Glucose Tolerance at 33 degrees C, applying the WHO criteria. The difference was consistently greater (p less than 0.01) in the non-obese subjects (non-diabetic 0.8 (0.4), diabetic 6.9 (2.8) mmol l-1) than in the obese (non-diabetic 0.2 (0.4), diabetic 2.1 (0.9) mmol l-1). In the diabetic subjects, a negative correlation (r = -0.50, p less than 0.01) was established between the difference and the body mass index. This variability in responses to ambient temperature between the obese and non-obese subjects could be due to a variable influence of heat on arm blood flow consequent on differences in amounts of subcutaneous fat. The ambient temperature for the conduct of the oral glucose tolerance test is important.

Introduction: The non-communicable eye diseases such as diabetic retinopathy have become significant threats to vision and require lifelong management. The development of ocular complications of diabetes has been associated with longstanding and/or poorly controlled disease. Early detection and prevention are keys to reduce this scourge, but this largely depends on the existing knowledge. Objective: This study is aimed at determining the knowledge, attitude and practice regarding eye care among patients living with diabetes with a view to making recommendations for a multidisciplinary patient-centered approach to ophthalmic care. Methods: One hundred and three respondents were interviewed using a structured questionnaire in a cross sectional study carried out in the Endocrinology Clinic of Federal Medical Centre, Owerri, Imo State, Nigeria. Results: There was a female preponderance with a male to female ratio of 1:1.3. Of these respondents, 68.9% had been diabetic for 5 years or less; 56.4% could define diabetes; but only 40.77% could mention some ocular complications of diabetes. Only 31.1% had had their eyes examined; the rest had not been to an eye clinic due to lack of funds, time, no ocular problems and not having been referred to an eye doctor. This attitude and practice were not significantly associated with age, sex, occupation or duration of illness. Conclusion: Though more than half of the respondents could define diabetes, there is still a poor knowledge of the ocular complications of diabetes and a poor attitude and practice regarding eye care among these patients. An interdisciplinary patient-centred approach to the management of diabetic eye diseases is recommended so as to reduce the burden of visual impairment from diabetes.

Key Clinical MessageWhile chronic pulmonary aspergillosis (CPA), pulmonary tuberculosis (PTB), and Klebsiella pneumoniae pneumonia co‐infection is rare, we present a 50‐year‐old woman with uncontrolled diabetes who presented with these three diseases. There is considerable overlap in symptoms of PTB and CPA. Treatment with antifungals, anti‐tuberculosis therapy, and antibiotics is beneficial.

No abstract

Erectile dysfunction (ED) is the persistent inability to attain /or maintain an erection of the penis adequate for satisfactory sexual intercourse. This condition has been found to be more common, to occur earlier and to be more difficult to treat in men with Diabetes mellitus (DM) than those without DM. However, recent developments have led to improvement in the treatment of this condition with attendant reduction in associated psychosocial problems. This review article discusses the various treatment strategies for ED in men with DM, brings to fore the need for prior assessment of cardiovascular status of such patients before commencement of treatment for ED as well as the need for adequate glycaemic control and treatment of other co-morbidities in these patients.