Mediastinal widening can be caused by numerous conditions including type 2 diabetes. If accompanied by chest pain, breathlessness or dysphagia, it has a grave prognosis and requires immediate attention. However, mediastinal lipomatosis is a benign condition leading to accumulation of fat within the mediastinum. Computed tomography (CT) is the definitive imaging modality for evaluating widened mediastinum. We hereby report a case of type 1 diabetes mellitus patient presenting with mediastinal widening on chest radiograph and diagnosed to have mediastinal lipomatosis on thoracic computed tomography.

This study was designed to investigate the prevalence and risk factors associated with erectile dysfunction (ED) in men with type 1 and type 2 diabetes mellitus attending treatment clinics in Kingston, Jamaica. A cross sectional study was conducted via standardized face to face questionnaires (92 participants). The presence of ED was established as defined by the International Index of Erectile Dysfunction (IIEF-5 score). Chi-square test with statistical significance of p < 0.05 was applied to determine the relationship between risk factors, social demographics and severity of ED. The mean age of the participants was 60.23 years and mean duration of diabetes was 10.12 years. ED was found in 64 % of the participants. The prevalence and severity of ED increased with age for both type 1 and type 2 diabetes; from 36 % in 50-59 years age group to 90 % in 70-75 years age group. Duration of diabetes, hypertension, profession, smoking and education were found to correlate significantly (p < 0.05) with ED while marital status, alcohol consumption and exercise did not show any direct correlation (p > 0.05). No significant relationship between random blood glucose and severity of ED was observed. The findings indicate that ED is highly prevalent among Jamaican men with diabetes and increases with the duration of diabetes, age and social demographics. The prevalence rate of 64 % in Jamaican men underscores the need for targeted measures to treat and control the progression of the condition.

Patients with chronic hepatitis C often have diabetes mellitus. However, it is unknown whether diabetes mellitus affects patient's response to interferon plus ribavirin therapy. The aim of this study was to examine the influence of diabetes mellitus on the outcome of pegylated interferon alpha -2a plus ribavirin therapy in chronic hepatitis C virus genotype 4 infected patients. In a cohort of 40 treatment naive patients with chronic hepatitis C genotype 4 infection (20 patients with well controlled type 2 diabetes mellitus and 20 patients without diabetes), the outcome of pegylated interferon alpha -2a plus ribavirin therapy was evaluated by comparing patients with and without diabetes mellitus. Statistically non-significant differences were observed between patients with and without diabetes in early virologic response, end of treatment response and sustained virologic response. Well controlled diabetes mellitus seems not to reduce sustained virologic response rate to pegylated interferon alpha -2a plus ribavirin therapy in chronic hepatitis C genotype 4 infected patients.

Diabetes mellitus (DM), a chronic disease is frequently comorbid with psychiatric problems/disorders. Identification and management of comorbid psychiatric problems are important for the management of diabetes itself. We lack studies in this regard though we have many patients with diabetes in Nepal. This study aims to determine the prevalence of psychiatric disorders in patients suffering from and seeking help from diabetes clinic. This is a hospital-clinic based prevalence study. The study analyzed response to "General health questionnaire GHQ-12" in 200 (calculated sample size) consecutive patients with diabetes attending a diabetes clinic. Diabetes mellitus diagnosis was made based on „American Diabetic Association‟ (ADA) guidelines, 2009. Psychiatric disorders were screened with self-response questionnaire „GHQ-12‟ which provides overall score, the score of 2 or more considered as achieving „psychiatric caseness‟ indicating overall psychiatric disorder. Among 200 clinic diabetes patients, 136 (68%) had GHQ-12 score of 2 or more, i.e. „psychiatric caseness‟. By alternate scoring, 15 (7.5%) had severe (25-36), 105 (52.5%) moderate (13-24), 71 (35.5%) mild (1-12) and the rest 9 (4.5%) had nil symptomatology. Among GHQ-12 items, „felt that you couldn‟t overcome your difficulties‟ was the most scored (39.0%), followed by „felt constantly under strain‟ (37.5%). Psychiatric problem is common among patients with diabetes. Diabetes management should involve diagnosis and treatment of comorbid psychiatric disorders.

The aim of this systematic review was to evaluate the effectiveness of well-structured interventions which promote physical activity in high risk individuals with type 2 diabetes. Using ISI web of knowledge and PubMed data bases in addition to snowballing, a total of 19 articles met the inclusion and exclusion criteria. Five articles were related to diabetes prevention interventions in USA. Four articles were related to diabetes prevention interventions in the UK. Five were related to diabetes prevention interventions in Finland. Five interventions were identified in Netherlands, India, China, Brazil and Australia. The review found strong evidence regarding the effectiveness of well-structured physical activity interventions in reducing the incidence of type 2 diabetes. Moreover, well-structured interventions were also found to be effective in restoring glucose measures including fasting plasma glucose and 2h plasma glucose. However, there was weak evidence regarding the effectiveness of well-structured interventions in increasing the level of physical activity. The review suggests using well-structured lifestyle interventions which include both physical activity and dietary advice. More research regarding the effectiveness of single physical activity interventions in preventing type 2 diabetes is recommended.