Fatih Salman

Sexual Dysfunction in Type II Diabetic Females: A Comparative Study

Diabetes Mellitus (DM) is considered to play a principle role in the etiopathogenesis of sexual dysfunction both in men and women. The aim of this study is to evaluate sexual function in Type II diabetic women. A total of 72 young diabetic women (mean age: 38.8 years) with no other systemic diseases and 60 age-matched healthy women were enrolled in our study. We sought from them a detailed medical and sexual history and used the Index of Female Sexual function (IFSF) questionnaire (Kaplan et al., 1999). The mean IFSF score of diabetic women was 29.3 - 6.4 and was 37,7 - 3.5 in normal cases ( p < 0.05). Lack of libido was the most common symptom in diabetics and was observed in 77% of the women. Diminished clitoral sensation was observed in 62.5% of the women, 37.5% complained of vaginal dryness and 41.6% had vaginal discomfort. Orgasmic dysfunction was found in 49% of the women. The incidence of all these related symptoms were significantly higher when compared to controls. We concluded that significant percentage of diabetic women that we observed experience sexual dysfunction of varying degrees that diminishes their quality of life.

Influence of earthquake on the quality of life of patients with type 1 diabetes

We read with great interest the article by Wang et al.1 We would like to draw your attention to the results of our study which evaluated the impact of Marmara earthquakes (Turkey) on 17 August and 12 November 1999, on the quality of life (QoL) of our type 1 diabetic patients using the WHO Well Being Questionnaire (W-BQ). The study included a group of patients (n = 77; males 47%; age 24.2 ± 8.5 years) who had participated in a previous QoL study in October 1998 and they were affected by at least one of the quakes. For the new study, data were collected in the third month following the second quake and compared to results of the previous ones. In addition, metabolic control (HbA1c), body mass index and daily insulin requirement were assessed before and after earthquakes. In the meanwhile, the type of effect by the earthquake, socioeconomically and/or physically, was investigated via a questionnaire which was completed by the patients. According to our results,W-BQ scores were affected inversely by the quake. Mean total W-BQ score was decreased from 69 ± 13 to 44 ± 14 (P < 0.001). However, depression and anxiety scores increased significantly (prior and after the quake; 34 ± 14 vs 54 ± 13; P < 0.001 and 41 ± 18 vs 70 ± 19; P < 0.001, respectively). Our results also revealed the scores for positive well-being and energy decreased from 64 ± 21 to 36 ± 20 (P < 0.001) and from 73 ± 18 to 62 ± 20 (P = 0.008), respectively. When the data were compared before and after the quakes there was no difference for body mass index (23 ± 1.4 vs 23 ± 2.8 kg/m2). However, HbA1c (7.4 ± 1.5 vs 8.8 ± 2.5%; P < 0.001) and daily insulin requirement (0.58 ± 0.3 vs 0.75 ± 0.3 IU/kg per day; P < 0.001) were increased. Moreover, physical and/or socioeconomic impacts of the quake obtained from the questionnaire were not found to be changed in parallel to the psychological impact (DW-BQ scores) of the quake. Finally, we did not find any meaningful difference in W-BQ scores of the subgroups of those who were affected seriously or those who were affected minimally by the earthquake in terms of physical and socioeconomical levels. The fact may be explained by the limited number of injured people in the study cohort. Those who were not seriously affected still have a strong fear of a new quake.

Changes in Prooxidant–Antioxidant Balance in Tissues of Rats Following Long-term Hyperglycemic Status

Introduction. Reactive oxygen species play an important role in the pathogenesis of organ damage in diabetes mellitus. Streptozotosin (STZ) is a commonly employed compound to produce diabetes mellitus and these animals exhibit most of diabetic complications. Methods. In our study, diabetes was induced by a single intraperitoneal injection of STZ at a dose of 50 mg/kg in rats and they were killed 12 weeks after STZ. Endogenous lipid peroxide levels, enzymatic and non-enzymatic antioxidants were measured in liver, heart, kidney, brain, and testis tissues to investigate the effect of long-term hyperglycemic state. The susceptibility of diabetic tissues to oxidative stress was also examined in in vitro oxidizing system containing ascorbic acid and iron. Results. We found that prooxidant and antioxidant balance has changed in favor of prooxidation in the tissues of diabetic rats. The susceptibility of liver to oxidative stress increased; however, this susceptibility did not change in heart, kidney, brain, and testis of diabetic rats. Conclusion. Our results indicate that long-term hyperglycemic state disturbs hepatic prooxidant–antioxidant balance at an earlier period and more pronouncedly than other tissues.

Diabetes education: a chance to improve well-being of Turkish people with type 2 diabetes

To examine the influence of diabetes education on well-being, 255 patients with type 2 diabetes were recruited according to whether they attended a diabetes education program (n=126) or not (n=129). In patients who had participated in the program, the mean anxiety score was significantly lower, whereas positive well-being and general well-being scores were significantly higher than for patients who had not participated. Factors related to lower well-being included: being female, taking insulin, not attending a diabetes education program and having HbA(1c) level greater than 8%. The odds of having better well-being were two-fold higher in patients participating the diabetes education program compared with those who had not. Diabetes education has a crucial role in improving the well-being of patients with type 2 diabetes. All patients with diabetes should be encouraged to attend a diabetes education program.

The Relation Between Serum Leptin Levels and Max VO2 in Male Patients with Type I Diabetes and Healthy Sedentary Males

This study aimed at investigating leptin levels in male diabetes type I patients who were on insulin treatment and also healthy sedentary males. The study included 10 male type I diabetes patients and 17 healthy sedentary males. Leptin levels of type I diabetes patients and healthy sedentary males with body mass index (BMI) over 25 kg/m2 were evaluated separately. The relation between serum leptin, max VO2, blood lactic acid levels before and after exercise, and effort durations of participants were investigated. At the end of the tests, no difference was found between leptin levels, max VO2 values, lactic acid values before exercise, and test durations of male type I diabetes patients and healthy sedentary males (p > .05), whereas lactic acid levels after exercise were found to be lower in healthy sedentary males (p < .05). Leptin levels in the group with BMI above 25 kg/m2 were higher than those in the group with BMI below 25 kg/m2 (p < .001). It was also seen that max VO2 values and test durations were higher in the group with BMI below 25 kg/m2 (p < .05). In conclusion, leptin levels of male type I diabetes patients are close to those of healthy sedentary males. The increase in leptin levels in both groups is in proportion to the BMI of individuals.

Factors affecting therapeutic response of adhesive capsulitis in type II diabetes mellitus

Forty-eight patients with type II diabetes mellitus were recruited for the study. Fifty-one shoulder joints with adhesive capsulitis were treated in this population. A physical therapy protocol including Transcutaneous Electrical Nerve Stimulation, pulsed ultrasound and exercises was applied to each patient. The patients were assessed on entry and termination of treatment and at 3 months post-treatment by Visual Analogue Scale for rest and activity pain intensity, active and passive range of motion of shoulder and Constant scores. The scores were compared between 18 patients with good glycemic control and no neuropathy and 30 patients with insufficient glycemic control and neuropathy. The results indicate that glycemia levels and neuropathy have no effect on response to physical therapy.