Celiac disease is an autoimmune disorder and in patients with diabetes mellitus type 1 can be seen significantly more frequently than in non-diabetic population. More than two-thirds of all affected subjects, however, suffer from only unspecific symptoms that make the early diagnosis of this disorder more difficult. Clinically evident form of the celiac disease with diarrhea is not frequent. Chronic diarrhea in patients with long-lasting diabetes is commonly considered to be a consequence of digestive tract impairment caused by diabetes. Authors present a case of a female patient with diabetes type 1 and chronic diarrhea that was considered to be a manifestation of diabetic gastroenteropathy for a long time. The correct causative diagnosis of the celiac disease was only made after the development of malabsorption syndrome.

Key words: celiac disease, diabetes mellitus, malabsorption, gluten

A case history deals with nonalcoholic steatohepatitis issue. A patient with long-term treatment of diabetes mellitus type 2 was diagnosed with hepatomegaly and alteration of hepatic functional tests. The differentially diagnostic process of hepatopathy in diabetic patient finished with hepatic biopsy resulting in nonalcoholic steatohepatitis transforming into hepatic cirrhosis is presented.

Key words: diabetes mellitus, nonalcoholic steatohepatitis

Metformin is a first choice drug in obese type 2 diabetic patients; in a case of its insufficient efficacy sulphonylurea derivatives use to be added. The author presents two case histories of patients with type 2 diabetes mellitus to demonstrate that adding the sulphonylurea derivates of third generation – gliclazide with modified release (MR) – to metformin monotherapy has not been only effective but also safe. After six months of a treatment, glycated hemoglobin (HbA_1c) decreased by more than 1 % (1,3 respective 1,1 %) in both patients. During a 6 months follow-up of gliclazide MR treatment there were not seen any significant changes in a body mass index, a blood count, hepatic and renal parameters nor in a lipid status. In both patients there was no incidence of hypoglycemia. Gliclazide MR treatment did not worsen concurrent coronary heart disease in both patients. 

Key words: diabetes mellitus type 2, gliclazide with modified release, efficacy, safety

We present a case history of 31 years old female patient with gestational diabetes that was diagnosed in the 12^th week of pregnancy. The patient had a hypophysectomy due to adenoma in childhood and she used to take corticosteroid and thyroidal supplementation. She was highly compliant and she followed the diabetic diet and regimen carefully. Despite of that it was necessary to use a short term insulin treatment administered 30 minutes before main meals to control hyperglycemias from the 16^th week of pregnancy. Since 23^rd week of pregnancy the effort to achieve proper control of diabetes was complicated by frequent hypoglycemias developing clinically very fast. The patient had low morning plasmatic corticosteroid level therefore it was necessary to adjust hydrocorticosteriod dosing. It was necessary to increase dosage of thyroxin as well. 
The satisfactory control of unstable diabetes with common doses of short-term acting insulin using intensified insulin regimen was achieved by regimen measures and by dietary regimen corrections based on dividing the total amount of carbohydrates into multiple portions and by prolonging the interval between insulin administration and meals.

Key words: gestational diabetes mellitus, hypoglycemia, hypophysectomy, glucocorticosteroids, thyroxin

This casework describes a 37-years-old out-patient diagnosed with primary hyperparathyroidism caused by a parathyroid adenoma.

Key words: parathyroid gland, primary hyperparathyroidism, parathyroid adenoma, hypercalcaemia, hypophosphatemia, parathyroid hormone