Insulin resistance (IR) is one of the common features of the polycystic ovary syndrome (PCOS), and recent studies indicate the possible role of vitamin D in the pathogenesis of IR and glucose metabolism. Aim of this study was aimed to determine the effect of vitamin D replacement therapy on glucose metabolism, insulin, and androgen levels in obese, insulin-resistant women with PCOS. Eleven women with PCOS were included in the study. Mean age of the patients was 23.6±5.7 yr, body mass index 33.9±5.1 kg/m2. Six patients (54.5%) had acantosis nigricans and 10 (90.9%) oligoamenorrhea. The mean Ferriman Gallwey score was 14.1 ±4.6. Only 2 women were within the normal limits of vitamin D levels as >20 ng/ml. Three weeks after the administration of the single dose of 300,000 units of vitamin D3 orally, 25-hydroxyvitamin D3 significantly increased from 16.9±16 ng/ml to 37.1 ±14.6 ng/ml (p: 0.027) and only 2 women were detected to have vitamin D3 levels <20 ng/ml. Although glucose and insulin levels were decreased non-significantly, homeostasis model assesment (HOMA)-IR significantly decreased from 4.41 ±1.38 to 3.67±1.48 (p: 0.043). No significant alterations were witnessed at the levels of DHEAS, total and free testosterone, androstenedione. No correlation was found between vitamin D with HOMA and other hormonal parameters. In conclusion, women with PCOS have mostly insufficient vitamin D levels, and vitamin D replacement therapy may have a benefical effect on IR in obese women with PCOS.

Combinations of insulin and oral antidiabetic drugs (OAD) are often prescribed instead of insulin alone. In this study, the effects of insulin glargine (IG) in combination with repaglinide or acarbose on glycemic parameters were investigated. Obese Type 2 diabetic patients with fasting blood glucose (FBG) levels ≥ mmol/l and hemoglobin glycated (A1C) ≥9% under maximal OAD combination therapy were enrolled. Previous therapies were discontinued, and patients were randomized into 2 groups. The combinations of IG and repaglinide were administered to group 1, and of IG and acarbose to group 2 for 13 weeks. Twenty patients in group 1 and 18 patients in group 2 completed the study. A1C levels were significantly decreased from 10.9±1.4% to 7.7±1.1% in group 1 and 11.0±1.4% to 8.1±1.4% in group 2. FBG levels were significantly decreased from 11.9±2.7 to 7.1 ±2.3 mmol/l in group 1 and 11.1 ±2.5 to 6.8±1.4 mmol/l in group 2. Post-prandial glucose levels were significantly decreased from 15.3±3.8 to 10.3±3.0 mmol/l in group 1 and 14.0±3.1 to 8.9±2.2 mmol/l in group 2. Intergroup comparisons indicated no significant differences. More weight gain was detected in group 1, compared to the baseline. Syptomatic hypoglycemia incidence was similar in both groups. Severe hypoglycemic attacks were seen in two patients in group 1. Flatulance incidence was higher in acarbose group. Conclusively, repaglinide and acarbose were equally effective when combined with IG for obese Type 2 diabetic patients controlled inadequately with OAD alone. Furthermore, acarbose seems to have advantages over repaglinide concerning weight gain and severe hypoglycemic attacks.

Papillary thyroid carcinoma is one of the differentiated cancers of the thyroid. Hypothyroidism occuring after total thyroidectomy and ablative dose of radioactive iodine should be treated with L-thyroxine to prevent clinical symptoms and signs of hypothyroidism and occasional tumor growth. A 50-year-old female patient with a history of total thyroidectomy 15 years ago due to papillary thyroid carcinoma with capsule invasion followed by ablative dose of radioactive iodine and received no hormone replacement treatment from then-on since she was lost to follow-up was admitted with dyspnea on excursion and chest pain. Although she had laboratory findings of hypothyroidism, there was no remarkable clinical sign or symptom related to hypothyroidism other than isolated pericardial effusion. Her thyroglobulin (Tg) level was low but a halo image was observed in the pericardiac region with no other activity in the rest of the body in I131 scan. Differential diagnosis indicated that isolated pericardial effusion was due to hypothyroidism rather than recurrence of the papillary thyroid carcinoma. The importance of thyroid status evaluation in suspected individuals for the differential diagnosis of complications due to the recurrence of the underlying thyroid cancer or hypothyroidism and the reliability of Tg to rule out metastasis in cases with a false positive I131 scan are discussed on behalf of our case in the view of the literature.

Aim: Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients. Methods: Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test. Results: Patients’ mean age were similar in diabetic patients and controls (28.2±8.9 and 28.1±5.2 yr; respectively). In skin-prick test. the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy. Conclusion: We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.