Diabetic ketoacidosis (DKA) is the most common emergency complication of diabetes. Euglycemic DKA (EDKA), on the other hand, has been known for many years but is a rare and under-recognized condition and constitutes a very small proportion of DKA cases. However, in recent years, an increase in the incidence of EDKA has been observed with the widespread use of sodium–glucose co-transporter 2 inhibitors, which have proven benefits in the treatment of diabetes mellitus and its cardiorenal complications, heart failure, and chronic kidney disease. Unlike classical DKA, these patients without significant hyperglycemia can easily be missed in emergency departments. EDKA should be kept in mind in patients with diabetes presenting with DKA but with a blood glucose level <250 mg/dL. The diagnostic and therapeutic approach after clinical suspicion in these patients is similar to classical DKA and is briefly summarized in this review. The most important point in treatment is that these patients are normoglycemic but have a significant insulin deficiency (relative or absolute). Therefore, insulin is the mainstay of the treatment and should be given together with dextrose solutions to avoid hypoglycemia.

Objective The aim of the present study was to evaluate whether arterial stiffness is affected in the patients with hypoparathyroidism through pulse wave analysis (PWA). Subjects and methods Sixty-three patients diagnosed with hypoparathyroidism and sixty volunteers were evaluated for the study. When 21 patients were excluded in the hypoparathyroidism group due to exclusion criteria, the research continued with 42 patients and 60 volunteers who are similar to the patients in terms of age, gender and body mass index (BMI). Fasting plasma glucose after 10 hours of fasting, creatinine, thyroid stimulating hormone (TSH), free thyroxine (fT4), albumin, calcium, phosphorus, magnesium, 25-OH vitamin D, parathormone (PTH) and urine calcium results in 24-hour urine for the patients in the hypoparathyroidism group were recorded. Evaluation of arterial stiffness was performed by Mobil-O-Graph 24h PWA device. Results Systolic blood pressure (SBP) (p = 0.01), diastolic blood pressure (DBP) (p = 0.005), mean blood pressure (p = 0.009), central SBP (p = 0.004), central DBP (p = 0.01) and pulse wave velocity (PWV) (p = 0.02) were found higher in the hypoparathyroidism group. A positive correlation was detected between phosphorus level and SBP [(p = 0.03. r = 0.327)], central SBP [(p = 0.04, r = 0.324)] and PWV [(p = 0.003, r = 0.449)]. We detected that age and serum phosphorus levels were independent predictor variables for PWV (B = 0.014, p < 0.001 and B = 0.035, p < 0.001, respectively). Conclusion We detected that hypoparathyroidism causes an increase in blood pressure and arterial stiffness. The most significant determinant factors were detected as advanced age and hyperphosphatemia. The patients diagnosed with hypoparathyroidism should be closely monitored and treatment planning should include to prevent the patients from hyperphosphatemia.

Amaç: Çalışmamızın amacı; obeziteli bireylerin sağlık okuryazarlığı düzeylerini ölçmek, sağlıklı beslenmeye ilişkin tutumlarını değerlendirmek ve bunlar arasında herhangi bir ilişki olup olmadığını ortaya koymaktır.Yöntem: Çalışmamız, kesitsel ve tanımlayıcı bir araştırmadır. Çalışmaya 284 obeziteli gönüllü dahil edildi. Çalışmaya katılanların sosyo-demografik verileri toplandıktan sonra sağlık okuryazarlığı düzeyleri Avrupa Sağlık Okuryazarlığı Ölçeği Türkiye uyarlaması (ASOY-TR) ile değerlendirildi. Bununla beraber, katılımcıların sağlıklı beslenmeye ilişkin tutumunu değerlendirmek için Sağlıklı Beslenmeye İlişkin Tutum Ölçeği (SBİTÖ) uygulandı.Bulgular: Çalışmaya katılan 284 gönüllünün 174’ü (%61,3) kadın, 110’u (%38,7) erkekti. Katılımcıların sağlık okuryazarlığı düzeyleri kategorize edildiğinde; %31’inin sağlık okuryazarlığı “yetersiz” seviyede, %37,7’sinin “sorunlu/sınırlı” seviyede, %21,1’inin “yeterli” seviyede ve %10,2’sinin “mükemmel” seviyede olduğu görüldü. Katılımcıların sağlıklı beslenmeye ilişkin tutum ölçeğinden aldıkları toplam puan ortalamaları 72,1±11,2 idi ve sağlıklı beslenmeye ilişkin tutum “yüksek” düzeyde idi. Katılımcıların obezite sınıflarına göre SBİTÖ toplam puan ortalamaları karşılaştırıldığında istatistiksel olarak anlamlı bir fark bulunmadı (p>0,05). Obezite sınıflarına göre sağlık okuryazarlığı düzeyleri karşılaştırıldığında sınıf 3 obeziteli bireylerin sağlık okuryazarlığı toplam puanlarının (32,0±9,5) sınıf 2 obeziteli bireylerin puanlarından (28,0±8,2) anlamlı yüksek olduğu görüldü.Sonuç: Çalışmamızda obeziteli bireylerde sağlık okuryazarlığı düzeylerinin düşük olduğu, sağlıklı beslenmeye ilişkin tutumlarının ise yüksek olduğu görüldü. Ayrıca beden kitle indeksi, eğitim durumu, daha önce kilo vermek için diyet yapma durumu ve SBİTÖ toplam puanlarının sağlık okuryazarlığını arttırmada anlamlı bir fark oluşturdukları görüldü.

Background/aim: There are not many studies conducted to detect and recognize the symptoms during the prediabetes period. In our study, we aimed to determine the symptoms that can be seen in prediabetes and diabetes and their prevalence and to determine the similarities and differences between the two groups. Materials and methods: Individuals who were diagnosed with prediabetes or diabetes, over the age of 18, literate, and accepted to collaborate were included in our study. The "Diabetes Symptoms Checklist Scale" was used by interviewing 321 participants, 161 prediabetic and 160 diabetic, face-to-face. Results: It has been found that the most common symptom in both the prediabetes and the diabetes group is "fatigue" (88.2% prediabetes, 89.4% diabetes). The symptoms seen in the dimensions of neurology and hyperglycemia are more common in individuals with diabetes than in individuals with prediabetes [neurology score: 1.85 ± 0.84 vs. 1.66 ± 0.64 (p = 0.02), respectively; hyperglycemia score: 2.39 ± 0.94 vs. 2.08 ± 0.83 (p = 0.002), respectively]. It was observed that the symptom burden increased in all subdimensions with the long duration of illness, being a female, not working, having a family history, and not doing exercise, and high fasting blood glucose and high HbA1c values. The level of education, family history, accompanying hyperlipidemia, neurology, and hyperglycemia symptoms are associated with diabetes; and it has been determined that cardiology symptoms are associated with prediabetes. Conclusion: Especially; during the follow-up of patients with prediabetes who have a low education level and diabetic family history and concomitant hyperlipidemia, there may be an increase in neurological and hyperglycemic symptoms at the point of development of type 2 diabetes. In this respect, we recommend that these factors, which we found to be predictive of diabetes compared to prediabetes, should be questioned more carefully during patient visits.