Romanian Journal of Diabetes Nutrition and Metabolic Diseases <p>The <strong>Romanian Journal of Diabetes Nutrition and Metabolic Diseases</strong> is the journal of the <strong>Romanian Society of Diabetes Nutrition and Metabolic Diseases</strong>.</p> <p>It appeared for the first time in 1992, in Romanian language and beginning with 2006 it was published entirely in English. It is a peer reviewed journal, therefore the accepted articles were peer-reviewed by <strong>at least two scientific experts</strong> in the field.</p> <p>It contains <strong>original papers</strong>, including fundamental and clinical research, <strong>literature reviews</strong>, <strong>clinical reports</strong>, <strong>editorials</strong>, articles that contain the <strong>results of the most important clinical studies</strong>, reports from the important congresses and <strong>book reviews</strong>.&nbsp;</p> <p>In Romanian Journal of Diabetes Nutrition and Metabolic Diseases there may be published only papers exclusively sent to this journal, not published previously. The authors should include possible conflicts of interest and financing sources. The laws of copyright and international rules of scientific research are respected.</p> <p>The Romanian Journal of Diabetes Nutrition and Metabolic Diseases <strong>strictly requires</strong> for all the scientific work published <strong>to be 100% compliant</strong> with the&nbsp;<a title="ICMJE.ORG" href="" target="_blank" rel="noopener">Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals</a>&nbsp;and with the&nbsp;<a title="Best Practices" href="" target="_blank" rel="noopener">Principles of Transparency and Best Practice in Scholarly Publishing</a> (joint statement by COPE, DOAJ, WAME, and OASPA).</p> <p>This journal appears trimestrially (four numbers/year). 650-800 copies are printed on each number.</p> <p>ILEX Printing House, Bucharest, has the exclusivity for the typesetting, printing and distribution of the Romanian Journal of Diabetes, Nutrition and Metabolic Diseases.</p> <p>Our journal is recognized by the Romanian National University Research Council (CNCSIS - 2009) to be part in the B+ category, Code 322.</p> <p>The Romanian Journal of Diabetes Nutrition and Metabolic Diseases is currently indexed in:</p> <p>- Index Copernicus<br>- Get Cited<br>- SCOPUS<br>- Scirus<br>- Celdes<br>- CNKI Scholar (China National Knowledge Infrastucture)<br>- CNPIEC<br>- EBSCO - TOC Premier<br>- EBSCO Discovery Service<br>- Google Scholar<br>- J-Gate<br>- Naviga (Softweco)<br>- Primo Central (ExLibris)<br>- SCImago (SJR)<br>- Summon (Serials Solutions/ProQuest)<br>- TDOne (TDNet)<br>- Ulrich's Periodicals Directory/ulrichsweb<br>- WorldCat (OCLC)</p> en-US (Dragoș Crețoiu) (Dragoș Crețoiu) Tue, 27 Apr 2021 09:37:46 +0300 OJS 60 Transforming diabetes care – the Lancet Commission on Diabetes: comments and suggestions for Romania – a position of the Romanian Federation of Diabetes, Nutrition and Metabolic Diseases – Executive Summary <p>In the last four decades, diabetes has become epidemiologically aggressive, threatening the health of millions of people and challenging&nbsp;health systems by increasing costs. Significant changes have been made in many areas of medical and socio-economic life&nbsp;that have become the new world of diabetes. The mission of the lancet commission report is to stimulate the beneficial transformation&nbsp;of diabetes through four major actions. 1. Digital collection of essential data on epidemiology and on the quality of care. 2.&nbsp;Increasing the level of knowledge of doctors and educators. 3. Optimizing the quality of care that can be achieved through adherence<br>to quality standards and the co-participation/activation of patients. It is necessary to gradually approach “precise diabetes”&nbsp;through “personalized management for the right phenotype”, where the care of the disease becomes the care of the person with&nbsp;diabetes. 4. Prevention of diabetes and its complications is the last but not the least condition of transformation. The benefits&nbsp;are estimated in terms of increasing the quality of life of people with diabetes, reducing the aggressiveness of the disease, and&nbsp;increasing life expectancy. Conclusion: The transformation of diabetes is necessary and possible and the benefits are huge. Let’s&nbsp;participate in its achievement.</p> Cornelia Bala, Gabriela Roman, Nicolae Hâncu ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Shoulder disorders in patients with diabetes mellitus <p>Background and Aims: Shoulder disorders are common manifestations of musculoskeletal issues affecting patients with diabetes,but get relatively little attention. The aim of the study was to evaluate prevalence of shoulder disorders and its association&nbsp;with glycemic control, duration, and certain epidemiological factors in a section of population with type II diabetes. Material and&nbsp;Method: We conducted a prospective study including 32 consecutive patients with type II diabetes and 32 consecutive patients&nbsp;without diabetes attending the outpatient department for shoulder symptoms. Patients underwent physical examination and the&nbsp;proforma and UCLA-m (modified University of California at Los Angeles) Shoulder Rating Scale form were filled. Data was compiled&nbsp;on frequency and contingency tables. Central tendency was measured by mean and standard deviation. For determining&nbsp;the co-relation unpaired t test and chi-square test were used. Results: We observed that as the fasting blood glucose and HbA1c&nbsp;values decrease, the UCLA scores increase. Hence, proper glycemic control may help in reducing shoulder pain and complications.&nbsp;There was no relation between the UCLA score and diabetic duration or the age of the patient. Conclusions: We conclude&nbsp;frozen shoulder was the most common shoulder disorder in the diabetic group. It is more prevalent in diabetics when compared<br>to non-diabetics. Evaluation of upper limb manifestations in diabetics must include estimation of glycemic control and an examination&nbsp;for other diabetic complications.</p> Krithika Kamath, Surendra Umesh Kamath ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Alternative antibacterial therapy of Methicillin-resistant Staphylococcus aureusin patients with diabetic foot and sepsis <p>A total of 210 patients with diabetic foot and sepsis who were treated in the purulent-septic center of Zaporizhzhya, Ukraine, were&nbsp;examined for the period of 2007–2020. All patients had type II diabetes mellitus, with a duration of 12.6 ± 2.7 years and an age&nbsp;of 56.8 ± 2.5 years. The diagnosis of sepsis is established according to the criteria of Sepsis-3 (2016). The complex of therapeutic&nbsp;measures included the mandatory use of antibacterial drugs, which was preceded by a microbiological study of biological material&nbsp;(blood and wound discharge). Gram-positive flora was detected in 118 (56.2%) patients and prevailed over gram-negative 81&nbsp;(38.6%), anaerobes were detected in six (2, 8%) patients, and fungal flora in five (2.4%). Among patients diagnosed with Staphylococcus&nbsp;aureus 52 (100%), Methicillin-resistant Staphylococcus aureus (MRSA) prevailed with 38 (73.0%) (p &lt; 0.05). We have&nbsp;identified a pattern that allowed us to categorize patients with MRSA into four groups according to similar sensitivity to antibacterial&nbsp;drugs, which received the conventional designations MRSA type 1; MRSA type 2; MRSA type 3; MRSA type 4. Moreover,&nbsp;MRSA type 4–3 (7, 9%) of the patient is pan-resistant. The most universal drugs in the presence of MRSA in patients with sepsis&nbsp;caused by complicated DFS are daptomycin, linezolid, teicoplanin, vancomycin, and tigecycline. In patients with MRSA type 1 and&nbsp;MRSA type 2, except standard anti - MRSA antibiotics, aminoglycosides, fluoroquinolones and macrolides can be effectively used&nbsp;as first-line drugs.</p> Igor Leonidovich Savon, Sergiy Dmytrovich Shapoval, Olga Olegivna Maksymova, Michael Mykhailovich Sofilkanych, Michael Ivanovich Sheremet, Oleksandr Viktorovich Shidlovskyi, Oleksandr Volodimirovich Lazaruk ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Complete blood count and cardiovascular risk markers in type 2 diabetes mellitus – findings from a cross-sectional study in south India <p>Background and Aim: Poorly controlled diabetes leads to various micro and macro vascular complications. Hematological indices&nbsp;can be an independent predictor of cardio vascular diseases risk ratios and associated with a high white blood cell count are&nbsp;comparable to other inflammatory markers. The main aim of the current work was to evaluate the correlation between cardiovascular&nbsp;risk markers with the complete blood count among type2 diabetes mellitus (T2DM). Material and Methods: Study population&nbsp;included 105 subjects with T2DM. Age group of the study participants was 40–60 years. Complete blood count and markers&nbsp;such as HsCRP, lipid profile, and Hepatic Enzymes were estimated. Data analysis was performed with SPSS 17. Differences among&nbsp;groups were calculated using t test and/or Mann-Whitney Test for parametric and nonparametric variables, respectively. Chi&nbsp;square test was used. The correlation analysis was performed by Pearson correlation/Kendall’s tau method for parametric and&nbsp;nonparametric variables respectively. Results and Conclusion: On analysis, hematological parameter shows significance with&nbsp;various cardio vascular risk markers and can be used as biomarker to assess the severity of cardio vascular diseases.</p> Ramya Samidurai, Sureka varaLakshmi Venkatesan, Chandan Bala Kataria, Ganesh Mano, Manikandan Sundaramalingham, Umamaheswari karmegam ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 1-Hour post-load glycemic value in risk population: a better tool for type 2 diabetes screening? <p>Background and Aims: Type 2 diabetes mellitus (T2DM) is a chronic disease with a negative impact by decreasing the life quality&nbsp;and expectancy of patients. The PREDATORR study, which started in 2013 in our country showed double prevalence to previous&nbsp;data. In 2000, the World Health Organization drew attention to the fact that it is the first time that a non-infectious disease has&nbsp;become epidemic, replacing the major health problems of the last century. The study evaluates the usefulness of measuring one&nbsp;hour post-load blood glucose during an oral glucose tolerance test in T2DM risk population. Material and Method: The subjects&nbsp;included in the study were selected over a period of two years from the patients’ families of the Diabetes, Nutrition, and Metabolic&nbsp;Diseases Outpatient Unit of the “St. Andrew” Emergency Clinical County Hospital of Constanta. The assessment was made based&nbsp;on the risk score for diabetes (FIND RISC), anthropometric indices, and glucose metabolism parameters. The statistical analysis&nbsp;was performed in SPSS 27.0, STATA and Microsoft Excel. Results: The studied population consisted of 112 subjects, 38.4% being<br>included in the control group and 61.6% in the study group. In the analysis of risk factors present in the study group, pre-diabetes&nbsp;was identified in 36.2% of patients, exclusively characterized by impaired fasting glucose. The values of FIND RISC score were&nbsp;much higher in the study group than in the control group. The BMI was higher in the study group compared to the control group.&nbsp;In 65.8% of patients regarding basal glycemia and 80% regarding glycated hemoglobin, the values did not exceed the pathological&nbsp;threshold. In the study group, 1-hour post-load blood glucose identified more patients at risk for T2DM than 2-hour post-load&nbsp;glycemic value. Conclusions: Evaluation of glucose metabolism parameters through the oral glucose tolerance test may be useful&nbsp;in screening for T2DM and the measurement of 1-hour post-load blood glucose can be used successfully among patients at risk.&nbsp;</p> Sorina-Alina Chelaru, Doina Catrinoiu, Ileana Ion ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Nutritional label use among patients with type 1 diabetes mellitus <p>Background and Aims: In this study, it was aimed to evaluate the nutritional label use of individuals with type 1 DM. Material&nbsp;and Method: This cross-sectional descriptive study was conducted in November 2017 - June 2018. Diabetic individuals were&nbsp;reached through hospitals and social networks. The study was conducted with 105 (64 female, 41 male) individuals with type 1&nbsp;DM living in Istanbul. A questionnaire about sociodemographic characteristics, biochemical parameters, medical treatment, food&nbsp;label reading status, food label reading reasons were applied in the study. Data were analyzed using SPSS V 16.0 program. Results:&nbsp;85.7% of the participants read the food label. No significant difference was found when age group and nutritional label reading&nbsp;status were examined (p &gt; 0.05). Besides, information was given to 67.6% of the participants about reading the nutritional label. A&nbsp;significant association was found between nutritional label reading knowledge and carbohydrate counting application and stages&nbsp;(P=0.0001). However, there was no significant difference between biochemical parameters and reading label status (p&gt;0.05).&nbsp;Conclusions: Nutritional label reading should be mentioned more in the medical nutrition therapy and diabetes education.</p> Aybike Cebeci, Sule Aktac, Safiye Keskin, Seda Senguzel, Fatma Esra Gunes ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Colorectal cancer in patients with diabetes mellitus <p>Background and Aims: Diabetes mellitus (DM) and colorectal cancer are two common diseases, with a growing trend and the&nbsp;major causes of mortality and morbidity, with a negative impact on life expectancy and quality of life, with socio-economic&nbsp;impact, which makes them a major public health problem. DM is the etiopathogenic factor involved in several diseases, including&nbsp;cancer. There are numerous studies on DM as a risk factor for breast, endometrial, pancreatic, liver cancer, non-Hodgkin’s&nbsp;lymphoma, but also colorectal cancer. Material and Method: The study includes patients hospitalized in the Gastroenterology&nbsp;Department for digestive symptoms who after a colonoscopic and bioptic examination were diagnosed with colon/rectal adenocarcinoma&nbsp;and who were subsequently hospitalized in the General Surgery Department for surgery. Patients were divided into<br>two groups: with and without diabetes mellitus. All patients in the study followed the same oncological protocol and were monitored&nbsp;dynamically at 3-6-9-12 months after diagnosis. Results: Diabetic patients were frequently associated with obesity and a&nbsp;more advanced stage of the oncological disease (DM – stage I:20%, stage II: 24%, stage III: 36%, stage IV: 20%; non-DM – stage I:&nbsp;23%, stage II 28.2%, stage III: 34.7%, stage IV: 14.1%). No major differences were observed among diabetic patients regarding the&nbsp;type of antidiabetic treatment and the stage of the disease. Postoperative complications were more common in diabetic patients&nbsp;(24%), and the survival rate was slightly lower among patients with DM (80%). Conclusions: The long-term survival of colorectal&nbsp;cancer patients who have received surgical treatment depends on the stage of the disease, the patient’s age, and the associated&nbsp;pathologies. DM brings additional contributions to oncological risk, being a risk factor for the oncological process in general and&nbsp;for colorectal cancer in particular.</p> Nicoleta Leopa, Andrei Dumitru, Anca Florentina Mitroi, Cristina Tocia, Razvan Catalin Popescu ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Nutritional status and risk of diabetes mellitus type 2 among medical students <p>Background and Aims: The phenomenon of the 21st century is a significant predominance of obesity in most countries. The metabolic&nbsp;effects of obesity (impaired glucose tolerance, type 2 diabetes mellitus (T2DM), hyperlipidemia, and hypertension) correlate&nbsp;more closely with abdominal obesity. Purpose is to investigate the features of nutritional status and the risk factors of the&nbsp;developing of T2DM in medical students. Material and Methods: 200 young medical students I-VI courses (according to WHO&nbsp;classification) were investigated. There were 140 Ukrainians and 60 - foreigners (Arabian). Physical examination (anthropometry),&nbsp;tonometry, anamnesis assessing, including data on the risks of the development of diabetes mellitus (DM) (Findrisk scale),<br>and statistical methods were used. Results: Among the risk factors there are violations of the nutritional status, despite the students&nbsp;being sufficiently informed about the harmfulness of the use of fast food, alcohol consumption, insufficient physical activity&nbsp;(especially in Ukrainians), family history of type 2 diabetes mellitus (T2DM) (especially in foreigners) and having continuous&nbsp;stress were found to be the most significant. Almost most of foreign students consume alcohol and are smokers. That is a fairly&nbsp;high rate for medical students who are well aware of the harmfulness and consequences of alcohol abuse and smoking. Reducing&nbsp;the risk of developing T2DMand CVD is possible when changing modifiable risk factors, such as nutrition, physical activity,<br>stress and deliverance of bad habits, such as smoking and drinking alcohol. Conclusions: 1. Most Ukrainian and foreign medical&nbsp;students have various risk factors of developing T2DM. Despite medical students being sufficiently informed about the harmfulness&nbsp;of consuming fast food, the risk factors were found to be one of the most significant. 3. Among risk factors of T2DMare excess&nbsp;weight and obesity as result of violations of the nutritional status, alcohol consumption, smoking (especially in foreign students),&nbsp;insufficient physical activity (especially in Ukrainian students) and family history of T2DM (especially in foreign students).</p> Natalia Pertseva, Mariia Rokutova, Samir Shehadeh, Roder Saido ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Dietary pattern of long-distance runners and its effect on their body composition and performance <p>Background and Aims: Evaluation of a player’s dietary intake is important both for training and research. Along with body composition&nbsp;it provides an insight into their positive adaptation to training. This study aimed at assessing the effect of the nutritional&nbsp;profile of Indian long-distance runners on their body composition and performance. Material and Method: Dietary intake of 53&nbsp;Indian long-distance runners was assessed using 24 hours dietary recall method. Body composition was analyzed using bioelectrical&nbsp;impedance analysis. Performance was assessed through indirect measurement of VO2 max using Astrand protocol. Results:<br>BMI was correlated positively with energy and fat intake (p &lt; 0.05). Sum of skinfolds was correlated positively with fat intake and&nbsp;energy intake (only among males) (p &lt; 0.05). Fat % was correlated positively with energy intake, carbohydrate intake, fat intake&nbsp;(only among females) (p &lt; 0.05) and negatively with VO2 max though not significant. Fat free mass % was negatively associated&nbsp;with energy and carbohydrate intake (p &lt; 0.05). Association of VO2 max was significantly positive with protein, calcium and iron&nbsp;intake and negative with carbohydrate intake (p &gt; 0.05). Energy intake was significantly positively correlated with carbohydrate<br>intake for the group as a whole and with fat intake specifically in females (p &lt; 0.05). Fat free mass had significant negative correlation&nbsp;with energy, carbohydrate intake, and fat intake in females. Inverse association of fat free mass % and VO2 max was also&nbsp;observed though non-significant in both males and females. Conclusions: Dietary intake has an impact on both body composition&nbsp;and VO2 max. Body weight, fat, and fat free mass distribution in long distance runners can be managed through diet and can<br>form an important part of athletic development.</p> Alisha Khan, Meenu Dhingra, N.K. Mungreiphy ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Association between night eating syndrome in overweight and obese children 10-17 years of age and dyslipidemia <p>Background and Aims: Night eating syndrome (NES) is one of the reasons for increased prevalence of obesity. Nevertheless,&nbsp;there is lack of knowledge about the influence of NES on lipid metabolism in children. The objective of the study was to determine&nbsp;the influence of NES on the lipid profile in overweight and obese children 10–17 years of age. Material and Method: A population&nbsp;of 110 children with excess weight and obesity was enrolled in the study. NES was diagnosed based on existing criteria. Anthropometric&nbsp;measurements were performed for all participants. Lipid profile assessments included detection of TC, HDL-C, and TG&nbsp;with an enzymatic method and formula assessment for LDL-C, VLDL-C, and non-HDL-C levels. Results: NES was diagnosed in&nbsp;21.82% of children. Dyslipidemia was detected in 70.83% of children with NES and in 44.19% subjects in the group without NES&nbsp;(p = 0.04). Atherogenic level of HDL-C was diagnosed in 45.83% subjects with NES compared with children without NES 15.12%&nbsp;(p = 0.001). Multivariate regression analysis has found significant association between NES and evidence of dyslipidemia and&nbsp;HDL-C level in the population of obese and overweight children (p &lt; 0.05). Conclusions: NES is one of the reasons for changes in&nbsp;lipid profile in children; therefore, screening for eating disorders in overweight and obese children must be implemented in routine&nbsp;practice to reduce the risk of dyslipidemia and its consequences.</p> Halyna Pavlyshyn, Kateryna Kozak, Mariya Marushchak ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Dietary intake and glutathione s-transferase (m1 and t1) variants in type 2 diabetes mellitus at USU hospital, Medan, Indonesia <p>Background and Aims: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease caused by multifactorial, such as genetic&nbsp;and external factors, i.e. diet and lifestyle. This study aims to observe the differences of dietary intake T2DM patients in Universitas&nbsp;Sumatera Utara Hospital (USU) Hospital, Medan, Indonesia based on glutathione S-transferase M1 (GSTM1) and T1 (GSTT1)&nbsp;variants. Material and Method: This study was conducted on T2DM patients that were recruited at USU Hospital, Medan, Indonesia.&nbsp;Dietary intake was recorded by 24-hours food recall and analyzed with Nutrisurvey 2007. Multiplex PCR was performed to&nbsp;analyze GSTM1 and GSTT1 variants. Results: This study showed mean of lipid intake (g), Recommended Dietary Allowance (RDA)<br>lipid (%), % lipid (%), and protein intake (g), RDA protein (%), % protein (%) in GSTM1 null were greater than GSTM1 positive&nbsp;(37.02 ± 2.77 vs 23.68 ± 4.3, p &lt; 0.05; 53.6 ± 4.01 vs 34.2 ± 6.23, p &lt; 0.05; 26.17 ± 1.22 vs 16.33 ± 2.23, p &lt; 0.05; and 50.11 ± 3.64 vs&nbsp;49.86 ± 11.79, p &gt; 0.05; 83.3 ± 6.04 vs 82.94 ± 19.61, p &gt; 0.05; 16.8 ± 0.69 vs 14.6 ± 1.37, p &gt; 0.05). In GSTT1 gene, the mean of lipid&nbsp;intake (g), RDA lipid (%), % lipid (%) was greater in GSTT1 null than GSTT1 positive (33.32 ± 3.92 vs 32.66 ± 2.84, p &gt; 0.05; 48.24&nbsp;± 5.68 vs 47.24 ± 4.12, p &gt; 0.05; 23.69 ± 1.78 vs 22.81 ± 1.77, p &gt; 0.05). Conclusions: Lipid intake, RDA lipid, % lipids, carbohydrate&nbsp;intake in GSTM1 positive and null or mean of energy intake in GSTT1 positive and null were significant differences in T2DM&nbsp;patients at USU Hospital, Medan, Indonesia.</p> Mutiara Indah Sari, Zaimah Zulkarnaini Tala, Milahayati Daulay ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Comparison of nerve conduction parameters in type 2 diabetic subjects: recently diagnosed versus chronic diabetes <p>Introduction: Diabetes mellitus (DM) is one of the major non-communicable diseases and may cause blindness, renal failure,&nbsp;and non-traumatic limb amputations in chronic condition. Periodic clinical assessment with supportive electrophysiological&nbsp;tests is highly recommended for early diagnosis of peripheral neuropathy in diabetic patients. Materials and Methods: In order&nbsp;to compare the nerve conduction study parameters on diabetes with two different durations of the disease, the recruited diabetic&nbsp;patients were divided into two groups, Group I - Recently diagnosed type 2 diabetes (within 1–2 years) and Group II -chronic&nbsp;diabetic patients with more than 5 years of disease. Nerve conduction study was done with RMS-EMG machine and latency,&nbsp;duration, and amplitude parameters of sural nerve conduction recordings were measured. The significance of study parameters&nbsp;between groups was analyzed by using independent sample “t” test. Results: There is no statistically significant change in the&nbsp;latency, amplitude, and conduction velocity of the sural nerve among the aforesaid study groups.</p> Senthamil selvi Kaliaperumal, Padmaavathy Prabakar, Mangani Mangalavalli Shanmugarajah ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 A not so common syndrome in Europe – Hirata disease <p>Insulin autoimmune syndrome (IAS) known as Hirata disease, is a rare cause of hyperinsulinemic hypoglycemia, characterised&nbsp;by recurrent spontaneous postprandial hypoglycemia with elevated insulin levels. It is defined by the presence of high&nbsp;titres of insulin auto-antibodies, with no prior exposure to exogenous insulin and no pathological abnormalities of the pancreatic&nbsp;islets. A 73-year-old Caucasian woman presented with one year history of intermittent hypoglycemia episodes, which had&nbsp;gradually worsened in the past two weeks. Biochemical measurements showed remarkably high fasting insulinemia with levels&nbsp;&gt;1000 uUi/ml and post prandial plasma glucose levels (PG) between 40 and 32 mg/dl, glycated hemoglobin concentration was<br>5.8 % (pre-diabetes)&nbsp;and the abdominal computer tomography (CT) did not show abnormalities. The 72 hours fasting test was&nbsp;negative. Four hours after mixed meal, the patient developed hypoglycemia with glucose levels (PG) of 34 mg/dL. Fasting insulin&nbsp;levels were 495 Ui/l and insulin autoantibodies (IAA) were positive 1900 u/ml (normal range &lt;0.4) leading to the diagnosis of&nbsp;Hirata disease. Conclusion: We report a case of spontaneous postprandial hypoglycemic episodes with highly elevated levels of&nbsp;insulin and insulin auto-antibodies (Hirata disease) in a Caucasian patient.</p> Sorana Lucia Vasilescu, Cristina Iancu, Marinela Andreea Blidar, Ariel George Florențiu ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Metabolic changes of lipids in patient with subclinical hypothyroidism <p>Background and Aims: the effect of subclinical hypothyroidism on the dynamics of lipid spectrum during lipid-tolerance test&nbsp;was studied. Subclinical hypothyroidism (SH) is the earliest thyroid dysfunction and is the most common. However, data on&nbsp;the presence of dyslipidemia in subclinical hypothyroidism are controversial. The aim of this study was the early detection of&nbsp;lipid metabolism disorders in patients with subclinical hypothyroidism on the basis of lipid-tolerance testing. Materials and&nbsp;Methods:&nbsp;the study involved 96 people. The main group included 37 patients with subclinical hypothyroidism, but seven of them&nbsp;had fasting hypercholesterolemia, dyslipidemia, and they were excluded from further study. Thus, 30 patients with SH formed&nbsp;the main group 1. Two comparison groups were presented by 59 comparisons by main characteristics (age, sex, exclusion criteria)&nbsp;of individuals without thyroid pathology (group 2) - 30 people, and with overt hypothyroidism (group 3) - 29 people. An oral fat&nbsp;tolerance test was used to evaluate postprandial lipemia. Results and Conclusions: As a result of the study, data were obtained&nbsp;according to which fat load stimulated the development of different levels of postprandial hyperlipidemia, depending on the thyroid&nbsp;status of patients. Patients with subclinical hypothyroidism had postprandial hypertriglyceridemia, which was combined<br>with an increase in low-density lipoprotein levels and a decrease in high-density lipoprotein levels. The proposed method allows&nbsp;the detection of early disorders of lipid metabolism in patients with subclinical hypothyroidism.</p> Natalia Pertseva, Xeniya Einer ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 New-onset type 1 diabetes mellitus in an adolescent boy with glucose-6-phosphate dehydrogenase deficiency <p>Background and Aims: Glucose-6-phosphate dehydrogenase (G6PD) deficiency and diabetes mellitus could aggravate each&nbsp;other when they co-exist.The aim of this report is to raise the awareness of clinicians regarding the possibility of co-existence of&nbsp;diabetes mellitus and G6PD deficiency in adolescents with an additional history of passage of dark-colored urine. Case Report:&nbsp;We report a case of a 16-year-old Nigerian boy with newly-diagnosed type 1 diabetes mellitus (T1DM) co-existing with glucose-&nbsp;6-phosphate dehydrogenase deficiency which manifested as hemoglobinuria. Conclusion: The index case suggests that in&nbsp;the initial period of T1DM, even without ketoacidosis, patients with G6PD deficiency are predisposed to hemolysis, manifesting as&nbsp;hemoglobinuria. Additionally, patients with T1DM, presenting with hemoglobunuria should be investigated for G6PD deficiency.</p> Alphonsus Ndidi Onyiriuka, Ekiye Ayinbuomwan, Emmanuel Uyiosa Eyo-Ita ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Type 2 diabetes in young adults, can we do more for them? – case presentation <p>Type 2 diabetes mellitus (T2DM), once considered a disease of old age, now occurs not uncommonly in children and young adults.&nbsp;Youth-onset type 2 diabetes is on the rise, and trends in childhood obesity only partially explain the recent appearance of a condition&nbsp;that was previously confined to adults. The difficulty in T2DM in young adults highlights the critical need to promote healthy&nbsp;lifestyle to prevent or postpone the development of T2DM in those at risk. For individuals with early onset T2DM, glycemic control&nbsp;must be carefully monitored and treated. We reported here a case that provides a successful management and treatment of&nbsp;the use of metformin, liraglutide, and most important lifestyle modifications to reduce body weight in young obese patient with&nbsp;poorly controlled and new diagnosed T2DM.</p> Ivana Trajkovska, Daniela Buklioska Ilievska, Taner Hasan ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Patterns used in weight loss in patients with obesity: A literature review <p>Background and Aims: Obesity is one of the most common co-morbidities in the world and is on the rise. This article aims to&nbsp;analyze the nutritional approaches of these patients, analyzing as many food patterns as possible. Material and Method: We&nbsp;analyzed the literature available in the fields of PubMed and Scopus using the following filters: obesity management, dietary patterns&nbsp;in obesity management, diets for weight loss, and lifestyle intervention among obese patients. We have selected articles&nbsp;published exclusively in English, between 2014 and 2020. Results: A multitude of dietary patterns are published in order to help&nbsp;obese patients lose weight, but the difficulty of this process and cardiovascular risk can be influenced by severe diets, intense&nbsp;hyper lipidic. Conclusions: The implementation of a healthy diet, through food re-education, could lead to a weight loss similar&nbsp;to different food patterns, not only without increasing mortality but with increasing the health status of the patient.</p> Alexandra Alexescu, Rusu Emilia, Gabriela Radulian ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300 Obesity, a disease of the modern society <p>Background: Nowadays, the aging of society, the lifestyle changes at the population level, the modern dietary pattern, and the&nbsp;low level of physical activity have an adverse effect on the waist line and the Body Mass Index (BMI). Methods: Based on scientific&nbsp;literature, we have drafted a review on excess weight and obesity around the world. The mean BMI is an important determinant&nbsp;of health at the population level. We used the WHO database for the years 1975–2016 as starting point and we predicted the&nbsp;average BMI around the world until the year 2100 using Microsoft Excel trendline equation. Results: Our findings are the first&nbsp;that estimate excess weight and obesity trends globally until 2100. This study adds growing evidence that the weight status will<br>significantly affect all continents. We identified regions known with a low rate of obesity : East Mediterranean, South-East Asia,&nbsp;Western Pacific, and Africa will encounter severe weight issues. Generally, our data shows that the underdeveloped countries&nbsp;are less likely to report significantly higher rates of obesity by 2100, compared to the developed countries. Conclusions: There is&nbsp;growing evidence that weight gain at the population level is associated with a modern lifestyle and the psychosocial environment.</p> Mariana Spătărelu, Amorin Remus Popa ##submission.copyrightStatement## Wed, 31 Mar 2021 00:00:00 +0300