<i>Background</i>. Diabetes mellitus and thyroid diseases are common endocrine disorders in the general population and found to exist simultaneously. This study aimed to establish the prevalence of thyroid dysfunction among Omani type 2 diabetics and its association with glycemic control.<i> Methodology</i>. A retrospective cross-sectional randomized primary and secondary care based study of 285 Omani type 2 diabetics, &#x2265; 30 years of age with known thyroid function. The following parameters were examined: age, sex, duration of diabetes, duration of thyroid disease, thyroid morphology, thyroid function, thyroid antibodies, and the mean glycated hemoglobin (mean HbA1C). The prevalence of thyroid dysfunction was compared to an independent control group of randomly selected healthy individuals with known thyroid function.<i> Results</i>. Thyroid dysfunction was found in 12.6&#x25; of the diabetic patients compared to 4.9&#x25; in the control group. The prevalence was higher among the diabetic females (86&#x25;) compared to diabetic males (14&#x25;). The commonest thyroid dysfunction among diabetics was overt hypothyroidism (4.6&#x25;). Subclinical hypothyroidism was the commonest thyroid dysfunction seen in less controlled diabetics at a mean HbA1c of 7.8 (&#xb1; 0.7).<i> Conclusion</i>. Screening for thyroid dysfunction in patients with type 2 diabetes mellitus should be routinely performed considering the higher prevalence of thyroid diseases in this group compared to the general population.

Sanaa Al-Sumry

Thuraya Al-Ghelani

Huda Al-Badi

Mohammed Al-Azri

Kawther Elshafie

Thyroid Diseases in Omani Type 2 Diabetics: A Retrospective Cross-Sectional Study

This study demonstrates that mean platelet volume (MPV) levels decrease after radioiodine (RAI) ablation therapy in hyperthyroid patients. Regarding the fact that large platelets are hemostatically more active, we suggest that hyperthyroid patients are at risk of cardiovascular disease despite all other cardiovascular risk factors. After RAI ablation therapy as MPV levels return to normal, cardiovascular risk for hyperthyroid patients reduces.

Eda Simsek

Ozge Timur

Ayse Carlioglu

Senay Arikan Durmaz

Munir Demirci

Hakan Sevimli

Mean Platelet Volume in Hyperthyroid Toxic Adenoma Patients after Radioactive <sup>131</sup>I Treatment

Mothers are often discharged within 24 hours in most Asian countries. Therefore, our screening programs for congenital hypothyroidism (CH) must consider the value of cord blood TSH. Our objectives were to compare the incidence of CH, positive predictive values, and recall rates using different cord blood TSH values. We also reviewed the results of the second-screening program for premature babies. 99.7&#x25; (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-1.583039pt" id="M1" height="9.86661pt" version="1.1" viewBox="-0.0498162 -8.28357 54.5606 9.86661" width="54.5606pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-111" d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="502" vert-adv-y="502" /></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path id="g190-243" d="M411 139C381 76 368 73 314 73H129L267 224C351 317 400 380 400 469C400 574 322 635 233 635C176 635 128 610 98 576L40 495L63 476C89 515 130 568 198 568C274 568 316 519 316 436C316 347 251 264 191 192C142 134 85 76 30 21V0H403C415 45 425 89 438 131L411 139Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="465" vert-adv-y="465" /></g><g transform="matrix(.013,0,0,-0.013,27.596,0)"><path id="g190-161" d="M130 550H367L393 615L386 623H101L63 323C82 331 123 342 165 342C275 342 328 277 328 188C328 107 283 40 201 40C141 40 99 72 78 91C69 99 59 98 51 91C39 81 30 67 29 58C28 48 33 37 46 24C60 10 104 -12 149 -12C203 -11 269 14 323 59C384 109 412 165 412 225C412 308 347 399 219 399C193 399 146 382 104 367L130 550Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="454" vert-adv-y="454" /></g><g transform="matrix(.013,0,0,-0.013,33.498,0)"><path id="g190-45" d="M95 130C70 130 46 113 46 88C46 72 54 64 59 64C93 55 121 33 121 -3C121 -41 93 -68 44 -88L55 -117C117 -98 186 -56 186 22C186 91 131 130 95 130Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="228" vert-adv-y="228" /></g><g transform="matrix(.013,0,0,-0.013,36.462,0)"><path id="g190-223" d="M430 623H48C43 580 39 534 30 478H57C80 544 84 550 152 550H369C286 366 187 178 74 -1L81 -12L156 -2C249 201 343 408 438 611L430 623Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="464" vert-adv-y="464" /></g><g transform="matrix(.013,0,0,-0.013,42.351,0)"><path id="g190-161" d="M130 550H367L393 615L386 623H101L63 323C82 331 123 342 165 342C275 342 328 277 328 188C328 107 283 40 201 40C141 40 99 72 78 91C69 99 59 98 51 91C39 81 30 67 29 58C28 48 33 37 46 24C60 10 104 -12 149 -12C203 -11 269 14 323 59C384 109 412 165 412 225C412 308 347 399 219 399C193 399 146 382 104 367L130 550Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="454" vert-adv-y="454" /></g><g transform="matrix(.013,0,0,-0.013,48.253,0)"><path id="g190-223" d="M430 623H48C43 580 39 534 30 478H57C80 544 84 550 152 550H369C286 366 187 178 74 -1L81 -12L156 -2C249 201 343 408 438 611L430 623Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="464" vert-adv-y="464" /></g></svg>) of all newborns were screened from 1st January 2009 to 31st December 2013. Babies with cord blood TSH &#x3e; 25&#x2009;mIU/L or 20&#x2013;25&#x2009;mIU/L and <svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-0.6370001pt" id="M2" height="9.39034pt" version="1.1" viewBox="-0.0498162 -8.75334 48.9889 9.39034" width="48.9889pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-71" d="M493 503C489 551 484 614 483 650H43V622C120 616 128 611 128 525V126C128 40 120 34 40 28V0H312V28C221 34 213 40 213 126V307H316C407 307 412 296 424 227H453V420H424C412 355 407 346 316 346H213V584C213 613 216 616 246 616H322C398 616 419 607 436 579C449 559 455 539 464 499L493 503Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="529" vert-adv-y="529" /></g><g transform="matrix(.013,0,0,-0.013,6.877,0)"><path id="g190-85" d="M592 498C586 556 582 629 581 675H560C545 656 537 650 510 650H115C87 650 74 652 60 675H40C38 620 33 555 28 495H57C69 539 77 568 89 585C102 607 122 616 205 616H267V123C267 44 259 34 168 28V0H454V28C360 34 352 44 352 123V616H422C498 616 514 608 531 584C542 568 552 543 562 495L592 498Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="617" vert-adv-y="617" /></g><g transform="matrix(.013,0,0,-0.013,14.898,0)"><path id="g190-166" d="M465 179V225H369V632H330C227 497 124 346 29 205V179H289V107C289 37 284 33 198 26V0H454V26C374 33 369 37 369 107V179H465ZM289 225H92C156 335 222 430 287 520H289V225Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="497" vert-adv-y="497" /></g><g transform="matrix(.013,0,0,-0.013,25.071,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,36.334,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,42.574,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>&#x2009;pmol/L were recalled for a repeat venous TSH and FT4 on days 3&#x2013;5 of life to confirm CH. Twenty-two babies were confirmed to have CH, an incidence of 1:1170. Five were premature. Eleven term babies had cord blood <svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-0.6370001pt" id="M3" height="9.39034pt" version="1.1" viewBox="-0.0498162 -8.75334 51.7421 9.39034" width="51.7421pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-85" d="M592 498C586 556 582 629 581 675H560C545 656 537 650 510 650H115C87 650 74 652 60 675H40C38 620 33 555 28 495H57C69 539 77 568 89 585C102 607 122 616 205 616H267V123C267 44 259 34 168 28V0H454V28C360 34 352 44 352 123V616H422C498 616 514 608 531 584C542 568 552 543 562 495L592 498Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="617" vert-adv-y="617" /></g><g transform="matrix(.013,0,0,-0.013,8.138,0)"><path id="g190-84" d="M409 504C401 567 396 607 392 642C354 654 312 665 266 665C137 665 60 583 60 487C60 374 161 325 225 290C300 250 355 215 355 141C355 68 311 21 235 21C131 21 86 122 71 183L41 176C48 128 61 42 68 21C78 16 93 8 118 0C142 -7 175 -15 216 -15C349 -15 438 69 438 174C438 287 344 333 265 374C186 414 138 449 138 522C138 576 172 631 249 631C336 631 363 562 380 499L409 504Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="474" vert-adv-y="474" /></g><g transform="matrix(.013,0,0,-0.013,14.144,0)"><path id="g190-73" d="M729 650H468V622C546 615 554 610 554 527V365H213V527C213 610 221 616 297 622V650H38V622C120 616 128 611 128 527V123C128 39 120 34 40 28V0H303V28C221 34 213 40 213 123V322H554V123C554 39 546 34 460 28V0H728V28C647 34 639 39 639 123V527C639 610 647 615 729 622V650Z" /><glyph.data ascent="989" descent="-360" horiz-adv-x="766" vert-adv-y="766" /></g><g transform="matrix(.013,0,0,-0.013,27.824,0)"><path id="g117-92" d="M512 230V281L75 514V456L453 256V254L75 55V-3L512 230Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,39.087,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,45.327,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>&#x2009;mIU/L and six had values 25.1&#x2013;30&#x2009;mIU/L. Lowering the recall cut-off value to 20&#x2009;mIU/L would double the recall rate from 0.63&#x25; (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-0.2063904pt" id="M4" height="8.55521pt" version="1.1" viewBox="-0.0498162 -8.34882 40.3636 8.55521" width="40.3636pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-111" d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="502" vert-adv-y="502" /></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,27.661,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,33.901,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>) to 1.3&#x25; (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-0.2063904pt" id="M5" height="8.55521pt" version="1.1" viewBox="-0.0498162 -8.34882 40.3636 8.55521" width="40.3636pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-111" d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="502" vert-adv-y="502" /></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,27.661,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,33.902,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>) with no additional cases detected, whereas using 30&#x2009;mIU/L would have missed 35&#x25; of cases. The incidence of CH was similar, 1:1515, when using either cut-off 20&#x2009;mIU/L or cut-off  25&#x2009;mIU/L but lower, 1:2380, when using 30&#x2009;mIU/L. We recommend the screening cord blood TSH cut-off should be 25&#x2009;mIU/L and screening for premature babies should be continued.

Sze Lyn Jeanne Wong

Muhammad Yazid Jalaludin

Azriyanti Anuar Zaini

Nurshadia Samingan

Fatimah Harun

Congenital Hypothyroidism: An Audit and Study of Different Cord Blood Screening TSH Values in a Tertiary Medical Centre in Malaysia

This study was performed to see how pioglitazone at low doses could affect blood biomarkers related to atherosclerosis and aging. The effects of an add-on treatment with pioglitazone (15&#x2009;mg for males and 7.5&#x2009;mg for females) for 6 months were assessed in 24 outpatients (12 males, 12 females) with type 2 diabetes aged &#x2265; 70 years. As doses of sulfonylurea were reduced in 10 patients, no significant differences in HbA1c and glucose levels were seen. After the treatment, serum levels of HDL cholesterol, arachidonic acid (predominant in males), and high-molecular-weight adiponectin significantly increased. The level of dehydroepiandrosterone sulfate significantly decreased. No significant changes were seen in those of small dense LDL cholesterol, high-sensitivity C-reactive protein, and amyloid beta peptides 1&#x2013;40 and 1&#x2013;42. There was a slight but significant increase in body weight, but apparent adverse effects were not observed. In conclusion, pioglitazone at low doses increased serum adiponectin, HDL cholesterol, and arachidonic acid levels but decreased serum dehydroepiandrosterone level, not associated with glycemia, in elderly Japanese people with type 2 diabetes. An optimal dose of pioglitazone should be sought for to minimize its adverse effects and to fully exert its pleiotropic effects such as antiatherosclerotic and antiaging effects.

Yuji Aoki

Effects of Low-Dose Pioglitazone on Serum Levels of Adiponectin, Dehydroepiandrosterone, Amyloid Beta Peptide, and Lipid Profile in Elderly Japanese People with Type 2 Diabetes

Diabetes mellitus is a metabolic disease possible to treat via several different therapeutic approaches. Since the advent of insulin in 1922, type 1 diabetes mellitus has become a chronic treatable disease. Nonetheless, type 1 diabetes mellitus can be a devastating disease when the macro- and microangiopathic complications take place after several years of illness. Starting from the eighties, pancreas/islet transplantation has become a potential innovative treatment of diabetes mellitus. The major advantage of pancreas/islet transplantation is the restoration of c-peptide cosecretion along with insulin; the major disadvantage is the need to administer immunosuppressive drugs which are diabetogenic themselves. Islet transplantation is the progenitor of more recent forms of cellular and stem cell therapies which will be reviewed herein. Cellular therapies for diabetes mellitus are still an experimental procedure. Herein we present the actual current achievements and an outlook of close future possible advancements in the area of cellular transplantation for the cure of diabetes mellitus.

Livio Luzi

Stefano Benedini

Andrea Caumo

Ileana Terruzzi

Overview of Cellular Transplantation in Diabetes Mellitus: Focus on the Metabolic Outcome

Diabetes mellitus is the commonest cause of CKD. It is the leading cause of new patients requiring renal replacement therapy, accounting for 40&#x25;, 34&#x25;, and 30&#x25; of cases in United States, Germany, and Australia, respectively. Recent studies have shown that a low-molecular weight protein, cystatin C, freely filtered by the kidneys is a novel biomarker that may be used for detection of early renal dysfunction in patients with type 1 or type 2 diabetes. Cystatin C has also been shown to detect cardiovascular disease in patients with diabetes and it may also be linked with incident type 2 diabetes in obese patients. We aim to review current evidence based literature on use of cystatin C for early detection of diabetic nephropathy due to type 1 and type 2 diabetes in comparison to conventional methods and explore its association with other comorbidities.

Alaaeldin M. Bashier

Ayman Aly Seddik Fadlallah

Nada Alhashemi

Puja Murli Thadani

Elamin Abdelgadir

Fauzia Rashid

Cystatin C and Its Role in Patients with Type 1 and Type 2 Diabetes Mellitus

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Advances in Endocrinology