The most common comorbidities in patients with diabetes mellitus are cardiovascular diseases, obesity, dyslipidemia, thyroid disorders but other associated diseases may frequently occur. Laboratory tests are useful investigation methods that may reveal the subclinical manifestations of the disease but they are also essential for patient monitoring. The aim of the study was to assess laboratory parameters and associated diseases in diabetic subjects and to implement a scoring system with a predictive role in the evolution of the cases. Material and methods: The study group consisted of 195 subjects with documented type 1 or type 2 diabetes. About half of the cases were collected from the Procardia outpatient unit, and the rest were patients admitted to the Diabetology Clinic in T�rgu Mure�. The study was performed between January - June 2017. The results of the laboratory tests, as well as the information regarding comorbidities and treatment, was collected and patients� body mass index was calculated. Based on the clinical data, a scoring system, called Diabetes Complication Severity Index (DCSI) with a predictive role, was implemented. The diabetic outpatients presented significantly better carbohydrate metabolic balance compared to the hospitalized subjects. No significant differences could be observed regarding kidney function, hepatic status and lipid profile of the two subgroups of diabetic subjects. The most important comorbidity observed in both patient groups was arterial hypertension. The hospitalized diabetic subjects had significantly higher incidence of ischemic heart disease and significantly lower incidence of thyroid disorders compared to the outpatients. The DCSI scoring system revealed that comorbidities are more frequently present in the hospitalized patients compared to the ambulant diabetic subjects. Evaluation of clinical status and laboratory results in diabetic patients followed by implementation of a scoring system based on the data obtained regarding comorbidities could help clinicians to set up an individual treatment plan for these patients, focusing on preventing other complications.

Insulin resistance is a heterogenous condition with high prevalence in medical practice. As diabesity reaches epidemic levels worldwide, the role of insulin resistance is getting great importance. Contribution of risk factors like sedentary lifestyle, diets high in saturated fats and refined carbohydrates leads to this state with significant consequences. Besides its role in diabetes, insulin resistance is also associated with other several endocrine diseases, having not only a role in their development, but also to their treatment approach, evolution and even prognosis. The present review summarizes the current literature on the clinical significance of insulin resistance, as well as the possible underlying mechanisms and treatment options in order to achieve a high quality of life of these categories of patients. Deepening the role of inflammatory cytokines involved in insulin resistance paves the way for future research findings in this continuously evolving field.

Surgical interventions represent an important stress for the organism. Metabolic parameters can exhibit important changes in a short period of time related to surgery. Differences might occur between normal weight and obese patients. Weight excess represents a risk factor for osteoarthritis.The aim of the study was to assess metabolic parameters before and after total hip and knee replacement in patients with osteoarthritis. The study was performed during 2016-2017 at the Clinic of Orthopedics and Traumatology of the Emergency County Hospital in Tirgu Mures. The study group was divided, based on body mass index values, in normal weight (43 patients) and obese individuals (52 patients). Plasma uric acid level, glycemia and lipid profile (triglycerides, total cholesterol) were determined for each patient before surgery and one day after the intervention, the values being compared. Differences between the metabolic parameters of the two subgroups were also determined. In case of obese individuals, all followed metabolic parameters were significantly different one day after the intervention compared to the values obtained before the surgery: plasma uric acid, cholesterol and triglyceride values decreased, glycemia increased. In the group of normal weight subjects the level of plasma lipids and uric acid differed significantly between the first and second sample, mean values being decreased in the second one. Comparing the two subgroups, significant difference occured regarding plasma glucose levels one day after the intervention, the mean value being higher in case of obese patients, also a higher percentage of hyperuricemia has been found in the group of obese patients. Dynamics of the followed metabolic parameters shows important changes on short term following surgical intervention. Hyperglycemia and hyperuricemia was most common in obese patients, plasma glucose showing increasing tendency after surgery.

Latent autoimmune diabetes in adults (LADA) is a frequently encountered condition in medical practice. It should be suspected in patients where the type of the diabetes mellitus is not certain. LADA consists of features from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), being a condition which is often unnoticed. Considered as type 1.5 diabetes mellitus, the lack of insulin requirement at disease onset makes it initially to be included in T2DM in terms of therapeutic management. The improvement of the screening methods allows the detection of LADA at an early stage, therefore medical intervention should be effective in preserving beta-cell function and to delay the progression of the disease.

Ketoacidosis is a life-threatening complication of diabetes mellitus, especially type 1 diabetic patients being predisposed to this condition. Ketoacidosis might occur also in other types of diabetes triggered by circumstances leading to shortage of insulin. The aim of the study was the assessment of metabolic, hydroelectrolytic disturbances and the relationship between different parameters in patients hospitalized with diabetic ketoacidosis. We evaluated the clinical state, parameters of blood-gas analyzer, biochemistry and hematology laboratory results of 32 patients admitted with diabetic ketoacidosis between January-November 2018 at the Department of Diabetology, Nutrition and Metabolic Diseases of the Emergency County Hospital in T�rgu Mureș. Demographic data, associated diseases, body mass index were also evaluated. The considered threshold of significance was 0.05. The distribution of type 1 and 2 diabetes was 40.6 and 46.9% in the studied group, 53.1% being male patients. Positive correlation could be observed between pH and base excess and between pH and bicarbonate values, while negative correlation could be found between triglyceridemia and body mass index (BMI). Severe hyperglycemia, very low pH values, glucosuria, ketonuria and electrolytic imbalances were very common in the studied patients. Pancreatitis, respiratory tract and urinary infections could be found in the background of ketoacidotic manifestations in the majority of the patients, dehydration occured in each of the cases. Many severe metabolic and hydroelectrolytic disturbances could be observed in the studied patients presenting diabetic ketoacidosis. Infectious diseases are the most common triggers of metabolic imbalance in diabetic patients.