Keyword: Obesity

ABSTRACT: Background: The rising prevalence of childhood obesity and sedentary lifestyles has blurred the traditional distinction between type 1 and type 2 diabetes. Double diabetes represents the coexistence of autoimmune β-cell destruction and insulin resistance, posing diagnostic and therapeutic challenges, particularly in adolescents.
Case presentation: We report the case of a 17-year-old obese female with a three-year history of type 1 diabetes who developed marked insulin resistance and metabolic syndrome features. Despite high insulin requirements (1.6 U/kg/day), glycemic control remained poor (HbA1c 12.8%). Clinical examination revealed obesity (BMI 32.4 kg/m²) and acanthosis nigricans. Laboratory evaluation showed preserved C-peptide secretion, dyslipidemia, elevated leptin and homocysteine levels, and positivity for anti-GAD65 and islet cell antibodies, supporting the diagnosis of double diabetes.
Management and Outcomes: A combined therapeutic strategy including optimization of basal-bolus insulin therapy, adjunctive metformin, structured nutritional intervention, and regular physical activity was implemented. Six months later, and at the stage of her transition, HbA1c decreased to 7.8%, body weight was reduced by 8 kg, daily insulin requirements decreased by 35%, and lipid parameters improved significantly.
Conclusion: This case highlights the importance of early recognition of double diabetes in youth and demonstrates that integrated metabolic and autoimmune-targeted management can significantly improve glycemic control and cardiometabolic risk.

ABSTRACT: Background: Controlled ovarian hyperstimulation and oocyte retrieval are key stages in the in vitro fertilization process. If developing follicles are difficult to access or visualize using the preferred imaging method (transvaginal ultrasound scan), careful monitoring with transabdominal ultrasound and oocyte retrieval may be required to avoid cycle cancellation and enhance in vitro fertilization (IVF) treatment success.
This study aimed to assess the feasibility, pregnancy outcomes and presence of risk factors among a cohort of women who had transabdominal oocyte retrieval during their IVF treatment process
Methods: This was a retrospective cross-sectional study carried out at Kingswill Specialist Hospital, Lagos Nigeria from January 2020 to December 2023. Medical records of women who had transabdominal oocyte retrieval (TAOR) were retrieved and variables such as socio-demographic variables, indications and pregnancy outcomes were analysed. 
Results: Fifty-seven women had TAOR during the study period. The mean age of the women was 36.2 ± 4.28 SD years. Their mean weight was 86.0kg ± 14.79 SD.  Twenty-six (45.6%) had pelvic masses, 50.9% had previous pelvic surgeries. 
There were 21 (36.8%) conceptions, 38 (66%) live births and 5.2% miscarriages. 
Conclusion: Couples’ desire to conceive continues to pose a significant challenge in sub-Saharan Africa, where wealth and strength are sometimes equated to family size, often accompanied by substantial social, psychological, and economic consequences for affected individuals. When IVF treatment cycles are cancelled due to inaccessible oocytes, these burdens are further intensified, sometimes with severe psychological and financial repercussions. To improve outcomes and enhance patient satisfaction and safety, it is essential to prioritize careful patient selection, thorough evaluation of key clinical factors, and the customization of care. In this context, transabdominal oocyte retrieval has been observed to be a potentially safe and necessary intervention. However, the small sample size of 57 patients limits the ability to draw definitive conclusions about its safety and efficacy, and the absence of a control group restricts the ability to compare outcomes relative to transvaginal oocyte retrieval (TVOR) patients.