Introduction: Current education on diabetes self-management is time-consuming as it is conducted face-to-face. This study aimed to evaluate the effectiveness of diabetes education via mobile application on hemoglobin A1c (HbA1c). Methodology: This was a double-blinded randomized controlled study conducted in the Department of Endocrinology, Hospital Pulau Pinang and Hospital Raja Permaisuri Bainun. Participants were stratified randomized according to HbA1c to intervention group (using T-Manis) and control group. The primary objective was to assess the difference in HbA1c between the groups. Secondary objectives were to assess the difference in body weight, hospitalization related to diabetes, diabetes knowledge between groups and usability and satisfaction of T-Manis. Laboratory investigations and questionnaires were conducted at baseline, 4 months and 8 months. Results: A total of 112 participants were randomized into two groups each with 56 participants. Mean age was 51 years with similar diabetes duration of 16 years in both groups. Participants comprised of 61.6% females with ethnic distribution of 49.1% Malay, 30.4% Chinese, 19.6% Indian and 0.9% Siamese. Baseline HbA1c levels were comparable between intervention and control groups (10.04% versus 9.91%; mean difference 0.13%; 95% CI −0.56 to 0.81; p = 0.718). At 4 months, HbA1c of the intervention group demonstrated a significant reduction compared to the control group (8.93% versus 9.80%; mean difference −0.86; 95% CI −1.59 to −0.14; p = 0.02). Sustained reduction of HbA1c in the intervention group was observed at 8 months (mean difference −1.01; 95% CI −1.85 to −0.16; p = 0.02). Baseline body weight was 77 kg, with no betweengroup differences in body weight, hospitalization related to diabetes and diabetes knowledge scores, although diabetes knowledge scores improved at 4 months in the intervention group. 89.3% of participants reported satisfaction with T-Manis Conclusion The T-Manis mobile application aided in significantly improving glycemic control with high user satisfaction, supporting its feasibility as an adjunct to standard diabetes care.
Diabetes Mellitus, Type 2 ; Glycemic Control ; Mobile Applications ; Pangolins

Introduction: Pituitary apoplexy is a rare but potentially life-threatening endocrine emergency caused by hemorrhage or infarction of the pituitary gland. Its presentation often mimics other acute neurological conditions, posing diagnostic and management challenges. We report a case series of three patients presenting with similar neuro-ophthalmic complaints but differing in symptom onset and radiological features. Cases: The first case was a 25-year-old obese female who presented with acute headache, fever, and right eye ptosis with complete ophthalmoplegia for 2 days. Imaging demonstrated a heterogeneous pituitary macroadenoma with superimposed hemorrhage. Cortisol, prolactin, and insulin-like growth factor-1 levels were low. She received hydrocortisone replacement and underwent left pterional craniotomy with tumor debulking, resulting in marked visual improvement. The second case involved a 59-year-old male who presented with headache and bilateral blurred vision for 1 week, followed by acute right-sided ptosis. Imaging showed a heterogeneous sellar-suprasellar mass compressing the optic chiasm. He had central hypocortisolism, hypothyroidism, and hyponatremia. Surgical intervention was declined, and outpatient follow-up showed stable neuro-ophthalmic findings. The third case was a 30-year-old female who presented with a 2-week history of headache and right-sided blurred vision with temporal hemianopia. Imaging revealed a sellar-suprasellar mass with fluid-fluid levels compressing the optic chiasm. She had central hypocortisolism, hypothyroidism, and hypogonadism. Hydrocortisone replacement was initiated, followed by transsphenoidal surgery with tumor debulking. Her vision improved after the surgery. Conclusion Pituitary apoplexy may present with similar clinical features despite differing onset and radiological characteristics. Early corticosteroid therapy is essential, while surgical intervention should be reserved for patients with severe or progressive neuro-ophthalmic deficits. This case series highlights the importance of individualized, multidisciplinary management to achieve favorable outcomes.
Pituitary Apoplexy