Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients?

Purpose

Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue.

Patients and Methods

All patients aged 18-65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination.

Results

The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems.

Conclusion

This study presents empirical findings that shed light on the inadequacies in healthcare providers' approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients' effective communication of these concerns.

Vitamin B12, folic acid, vitamin D, iron, ferritin, magnesium, and HbA1c levels in patients with diabetes mellitus and dental prosthesis

OBJECTIVE

Diabetic patients may have vitamin deficiencies, which are important in the follow-up and complications of diabetes for various reasons. It may be beneficial to include the use of dental prosthesis among the parameters that should be investigated as a cause of vitamin deficiency during the management and follow-up of diabetes mellitus. We aimed to investigate the association between serum vitamin B12, folic acid, 25-hydroxyvitamin D, ferritin, iron, magnesium, and HbA1c levels in diabetic patients with and without removable dental prosthesis and in non-diabetic patients with prosthesis.

PATIENTS AND METHODS

This study is a single-center case-control study. Participants were classified into the following groups: 1) Diabetic patients (n = 528) with prosthesis, 2) non-diabetic patients with prosthesis (n = 121) and 3) diabetic patients without prosthesis (n = 100). Vitamin B12, 25-hydroxyvitamin D, folic acid, ferritin, iron, magnesium, and HbA1c levels were measured and compared across the groups.

RESULTS

A significant difference was observed between the groups with respect to the above parameters. Vitamin B12 levels were determined to be higher in the diabetic group without prosthesis. 25-hydroxyvitamin D levels were found to be significantly higher in the non-diabetic group with a prosthesis than in the other two groups. There was no statistical difference in the iron levels between the groups. Ferritin levels were observed to be significantly higher in the diabetic group with prosthesis compared to the other two groups. Magnesium levels were significantly different between all the three groups. The highest magnesium levels were found in the non-diabetic group with prosthesis. HbA1c levels were found to be higher in the diabetic group with prosthesis. Magnesium levels were correlated with 25-hydroxyvitamin D levels, but a negative correlation was observed between these and HbA1c.

CONCLUSIONS

Serum vitamin B12 levels were lower in the diabetic and non-diabetic groups with prosthesis compared to the diabetic group without prosthesis. 25-hydroxyvitamin D levels were lower and ferritin was higher in the diabetic groups with and without prosthesis. Magnesium levels were significantly lower in the diabetic group with a prosthesis than in the other two groups. The mean HbA1c level was higher in the diabetic group with prosthesis. The comparison of diabetic patients receiving metformin revealed a higher pronounced vitamin B12 deficiency in the diabetic group with prosthesis. These findings show that those diabetic patients with prosthesis should be evaluated for vitamin B12, 25-hydroxyvitamin D, and magnesium deficiency.

Investigation on the prevalence of thyroid cancer in Graves' patients in northeastern part of Turkey: is surgery a better option for patients with Graves' disease who develop antithyroid drug-related major adverse events?

OBJECTIVE

To determine the prevalence of thyroid cancer in Graves' patients who underwent surgical intervention with and without a history of anti-thyroid drug related major adverse events.

PATIENTS AND METHODS

The data of 530 patients with Graves' disease between 2015 and 2020 were retrospectively reviewed. Preoperative ultrasonography reports and thyroid-stimulating hormone receptor antibody values and postoperative histopathological findings were available for 94 patients that had undergone total thyroidectomy procedure. We compared the prevalence of thyroid cancer between patients with and without a history of anti-thyroid drug related major adverse events.

RESULTS

Thyroid cancer was detected in 31 of 94 patients that had undergone total thyroidectomy. Of these patients, 18 had at least one nodule; however, thyroid cancer was incidentally detected in 13 patients without nodule. The 31 patients had the following cancer subtypes: 22 had papillary microcarcinoma, 8 papillary carcinoma and 1 noninvasive follicular thyroid neoplasm with papillary-like nuclear features. While thyroid cancer was present in half of the patients operated owing to anti-thyroid drug-related major adverse event, it was detected in 30% of the patients operated due to other reasons.

CONCLUSIONS

In the present study, the prevalence of thyroid cancer among patients with Graves' disease was found to be much higher than those of other studies in the literature, suggesting that surgery can be considered primarily for the treatment of Graves' disease. Considering the surgical option in the first plan instead of radioactive iodine therapy appears to be reasonable in patients who develop anti-thyroid drug-related major adverse events.