Main finding of our study was the presence of increased oxidative DNA damage in lean normoglycemic offspring of Type 2 diabetic patients. There is a need for further clinical studies in order to explain whether oxidative stress is present in genetically predisposed subjects and induces the insulin resistance.

Intralesional recombinant epidermal growth factor (EGF) is a new treatment approach for diabetic foot ulcer, approved in 2006. EGF therapy is given as an adjunct to the standard treatment regimen of antibiotics, surgery, and hyperbaric oxygen. EGF accelerates the healing of diabetic foot ulcers and reduces healing time. This single-center study was conducted to evaluate the outcomes of intralesional EGF therapy in patients with diabetic foot ulcers. Materials and methods:We present the data of the follow-up patients treated in our clinics. Fifteen patients with diabetic foot ulcers or infections, who had been followed up and treated in our clinics, were included in this retrospective study. All patients were administered intralesional injections of 75 µg of EGF after treatment for infection on their diabetic foot ulcers, three times a week on alternate days. The patients were monitored with respect to treatment response and side effects of EGF.Results: Thirteen patients (86.7%) developed new granulation tissue, 10 patients (66.7%) had complete wound closure, and three patients (20%) showed partial wound closure. No serious side effects requiring discontinuation of EGF therapy were observed. A total of twenty-one bacterial agents were isolated in thirteen patients, and no bacterial growth was observed in the tissue cultures of two patients. Pseudomonas aeruginosa was the most common isolated infectious agent in the tissue cultures (n: 6, 28%). Conclusion:Intralesional injection of EGF on top of the standard treatment regimen appears to be a useful adjuvant therapy option in selected patients.

An adequate diet provides good metabolic control in diabetics. Since 1981 when Jenkins showed that complex carbohydrates are digested more slowly and raise blood glucose less than simple sugars, many studies have been performed in this field. In this study, seven kinds of carbohydrate-rich food were compared with glucose in 52 Type 2 diabetic patients and 31 normal volunteers. The subject consumed either macaroni, white rice, potatoes, tarhana soup (tarhana includes wheat flour, yoghurt, tomato and green pepper), noodle soup, white or whole wheat bread, or glucose at one-week intervals after an overnight fast. The glycaemic index (GI) of each food was calculated from the area under its glycaemic response curve (AUC) expressed as a percentage of the mean response to glucose. The results showed that the foods ranked from the highest to the lowest GI as follows: white bread; whole wheat bread; macaroni; tarhana soup; white rice; potatoes; noodle soup.

Background: Targeting better HbA1c and blood pressure (BP) goals may endanger older adults with type 2 diabetes mellitus (T2DM) for a number of risks. Overtreatment of T2DM and hypertension (HTN) is a trending issue but awareness and attitudes of physicians need to be explored. Objective: To assess the rates and predictors of overtreatment and undertreatment of glycemia and blood pressure in older adults with T2DM. Treatment deintensification or intensification by the physicians were also investigated. Method: Data from older adults (≥65 years) enrolled in a large nationwide T2DM survey in 2017 across Turkey were analyzed. Overtreatment was defined as HbA1c <6.5% plus use of ≥2 oral hypoglycemics or insulin, and systolic BP <120 mmHg or diastolic BP <65 mmHg plus use of ≥2 drugs). Undertreatment was defined as HbA1c >9% at all, and SBP >140 mmHg or DBP >90 mmHg plus use of <3 drugs. Deintensification or intensification rates were calculated according to treatment modification by the physicians. Results: A total of 1276 patients were included. The overtreatment rates for glycemia and BP were 9.8% and 5.9%, whereas undertreatment rates were 14.2% and 17.7%, respectively. In the adjusted model, use of oral hypoglycemics only (OR:3.1, 95% CI:1.9-5.3) and follow-up at a private clinic (OR:2.2, 95% CI:1.2-3.9) were the predictors of glycemia overtreatment. Presence of microvascular complications (OR:2.0, 95% CI:1.1-3.5) was the only predictor of BP overtreatment. The deintensification and intensification rates for glycemia were 25% and 75.7% respectively, and for the BP 10.9% and 9.0% respectively. Conclusion: The overtreatment rates of diabetes and BP in Turkish older adults with T2DM were consistent with the previous studies, while the undertreatment rates were much higher. Doctors seem to feel more comfortable to intensify glycemic management and largely ignore BP control. The results warrant enforced measures to improve care of older adults with T2DM. Disclosure A. Sonmez: None. I. Tasci: None. I. Demirci: None. C. Haymana: None. C. Barcin: None. H. Aydin: None. S. Cetinkalp: None. F. Yener Ozturk: None. K. Gul: None. T. Sabuncu: None. I. Satman: None. F. Bayram: None.

Background/aim: High triglyceride (TG) levels are associated with increases in atherosclerotic cardiovascular disease (CVD), hepatic steatosis, and pancreatitis. Acute pancreatitis is a condition with high mortality. Therapeutic plasma exchange (TPE) in the treatment of hypertriglyceridemic pancreatitis (HTGP) is a rapid and effective treatment modality. In this study, the results of TPE were evaluated and the frequency of lipoprotein lipase (LPL) mutation in these patients was determined.Materials and methods: TPE was performed in 31 patients with HTGP at the Adult Therapeutic Apheresis Center.Results: A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2-2, min 1, max 6) in the 31 cases. LPL mutation was detected in 8 (25.8%) of the 31 hypertriglyceridemia cases. When TG levels before and after TPE were evaluated, the mean TG level before TPE was significantly higher (3132 ± 1472 mg/dL) than the mean TG level afterwards (948 ± 465 mg/dL, P < 0.001). This result represented a decrease of 69.7% TG after TPE. Conclusion:TPE is a safe, fast, and effective treatment modality in experienced centers.