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EN
This study was aimed at determining the effects of implementing a medium-term (six-month) exercise and/or a diet program on the kinanthropometric and metabolic parameters of obese children. The participants were 42 subjects (27 boys, 15 girls), whose ages were between 8 and 11, divided into three groups according to the program they followed. The E group followed a physical exercise program (three 90-minute sessions per week), the D group a low calorie diet, and the E+D group both interventions. A repeated-measure ANOVA was used to compare measurements of the participants' kinanthropometric and metabolic parameters at different times of the program, with the means being compared using the Tukey post-hoc test. It was found that medium-term intervention based on the combination of exercise and low calorie diet improved the obese children's kinanthropometric and metabolic parameters, especially those related to the lipid profile. Also, this combined program was more effective in controlling weight than the exercise or low calorie diet interventions alone.
EN
Pregnancy increases metabolic demand for insulin and may lead to the exhaustion of intraportally transplanted islets and post-gestational hyperglycemia. To prevent these complications, we implemented preemptive insulin supplementation during two subsequent pregnancies in an insulin-independent islet transplant recipient. This strategy resulted in optimal blood glucose control during the pregnancies, the preservation of the optimal islet graft function and the postpartum maintenance of long-term insulin independence.
EN
Diabetes is a common and severe complication of cystic fibrosis. If unrecognized, the condition not only causes deterioration of pulmonary function and failure to gain weight, but also a six-fold increase in mortality. Aim: 1. To evaluate the course of abnormal glucose tolerance and cystic fibrosis-related diabetes (CFRD), as well as the effects of treating these conditions in children with cystic fibrosis. 2. To analyze the association between the classes of mutations in both alleles of the CFTR gene and glucose intolerance. Materials and methods: analysis was undertaken of the clinical records of 12 children (from the years 2002 to 2014), who were under the care of the Diabetes Outpatient Clinic at the Medical University of Warsaw and the Cystic Fibrosis Centre of the Institute of Mother and Child in Warsaw. The patients were divided into groups based on glucose tolerance categories in the Oral Glucose Tolerance Test (impaired glucose tolerance - IGT, cystic fibrosis related diabetes without fasting hyperglycemia − CFRD FH(-) or with fasting hyperglycemia – CFRD FH (+)). The mean age of the children who were referred to the Diabetes Outpatient Clinic was 12.09±3.57 years and the mean HbA1c at the baseline versus the end of the follow up was 6.16±1,77% versus 6.03±1.05%, respectively. We used the continuous glucose monitoring system (CGMS) for the diagnostics of 4 patients. The mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene were investigated in all the patients. All the children had mutations in at least one allele of the CFTR gene belonging to class I or II. Six (6/12) patients were homozygous, and 3 (3/12) patients heterozygous for the Phe508del (former F508del) mutation. Three children had other mutations (1717-1G>A/2183AA-G, R553X/3380delGAAG, G542X/2143delT). Results: In our study group we recognized impaired glucose tolerance (IGT) in 7 (7/12) patients and cystic fibrosis-related diabetes (CFRD) in 5 (5/12) patients; there were 4 patients with CFRD FH(+) and 1 patient with CFRD FH(-). During follow up we observed IGT deterioration of glucose tolerance towards CFRD FH(-) in 4(4/7) patients. Eight (8/12) patients were on functional insulin therapy, five of them (5/8) used insulin pumps. The remaining patients (4 individuals - 4/12), who were in good condition and on a high-glycemic index product restricted diet, did not require insulin. In the group treated with insulin we observed improvement in BMI z-scores (from-1.14 to -0.70). Conclusions: Glucose tolerance in children with cystic fibrosis deteriorates with age. Patients in a good condition and with good compliance to a low-glycemic index product diet, start insulin therapy later. Patients with a severe course of cystic fibrosis and diabetes require immediate insulin implementation. Insulin treatment improves their nutritional status. A continuous glucose monitoring system is a useful diagnostic tool which can be taken into account in therapeutic decisions. Prospective studies on the pediatric population with cystic fibrosis are needed in Poland for a better analysis of the associations between abnormal glucose tolerance, the class of mutation in the CFTR gene and the impact of glucose intolerance treatment on the clinical status of the patients.
PL
Cukrzyca jest częstym i ciężkim powikłaniem mukowiscydozy. Nierozpoznana nie tylko prowadzi do pogorszenia czynności płuc i słabszych przyrostów masy ciała, lecz również zwiększa 6-krotnie śmiertelność. Cel: 1. Ocena przebiegu zaburzeń tolerancji glukozy i cukrzycy u dzieci z mukowiscydozą oraz efekty ich leczenia. 2. Ocena związku pomiędzy klasą mutacji w genie CFTR i nietolerancją glukozy. Materiały i metody: Przeanalizowano retrospektywnie dokumentację medyczną 12 dzieci (z lat 2002- -2014), będących pod opieką Poradni Diabetologicznej Kliniki Pediatrii Warszawskiego Uniwersytetu Medycznego i Zakładu Mukowiscydozy Instytutu Matki i Dziecka w Warszawie. Pacjentów podzielono według kategorii zaburzeń tolerancji glukozy w teście doustnego obciążenia glukozą (nieprawidłowa tolerancja glukozy, cukrzyca związana z mukowiscydozą bez hiperglikemii na czczo, cukrzyca związana z mukowiscydozą z hiperglikemią na czczo). Średni wiek dziecka w momencie skierowania do Poradni Diabetologicznej wynosił 12,09±3,57 lat, średnia wartość HbA1c na początku i na końcu obserwacji wynosiła 6,16±1,77% versus 6,03±1,05. U 4 pacjentów w trakcie diagnostyki zaburzeń przemiany węglowodanowej zastosowano ciągły monitoring glikemii. U wszystkich dzieci oznaczono klasy mutacji w genie CFTR. Wszyscy pacjenci mieli przynajmniej w jednym allelu genu CFTR mutacje należące do I lub II klasy. Sześcioro (6/12) pacjentów było homozygotami a troje (3/12) pacjentów heterozygotami mutacji Phe508del (dawniej F508del). Troje dzieci miało inne mutacje (1717-1G>A/2183AA-G, R553X/3380delGAAG, G542X/2143delT). Wyniki: U 7 (7/12) pacjentów z badanej grupy rozpoznano nieprawidłową tolerancję glukozy, u 5 (5/12) pacjentów cukrzycę związaną z mukowiscydozą w tym u 4 pacjentów z hiperglikemią na czczo a u jednego bez hiperglikemii na czczo. W trakcie obserwacji stwierdziliśmy u 4 (4/7) pacjentów z nieprawidłową tolerancją glukozy pogorszenie jej przebiegu w kierunku cukrzycy bez hiperglikemii na czczo. U 8 (8/12) pacjentów zastosowano insulinoterapię, u większości (5/8) pacjentów przy pomocy pompy insulinowej. Pozostali pacjenci (4 osoby -4/12), którzy byli w dobrym stanie klinicznym i przestrzegali diety z ograniczeniem produktów o wysokim indeksie glikemicznym, nie wymagali insulinoterapii. U pacjentów leczonych insuliną obserwowano wzrost BMI z-scores (z -1,14 do -0,70). Wnioski: Tolerancja glukozy u dzieci z mukowiscydozą pogarsza się z wiekiem. Pacjenci w dobrym stanie klinicznym i przestrzegający diety z ograniczeniem produktów o wysokim indeksie glikemicznym wymagają insulinoterapii w późniejszym okresie. Pacjenci z ciężkim przebiegiem mukowiscydozy i cukrzycą wymagają natychmiastowej insulinoterapii. Leczenie insuliną poprawia stan odżywienia. Ciągły monitoring glikemii jest przydatnym narzędziem diagnostycznym, który należy brać pod uwagę przy podejmowaniu decyzji terapeutycznych. Prospektywne badania większej populacji pediatrycznej chorych na mukowiscydozę w Polsce są potrzebne, celem lepszego poznania związku pomiędzy zaburzeniami tolerancji glukozy, klasą mutacji w genie CFTR, wpływu metody leczenia zaburzeń tolerancji glukozy na stan kliniczny pacjentów.
EN
Type 1 diabetes is a metabolic disorder whose treatment depends not only on the administration of insulin and diabetic control,but also on properly applied physical activity to improve insulin sensitivity and thus the patient’s condition. In order to fulfill this role,physical exercise must be systematic and properly administered. An adequate intensity depends on the physical fitness level of thepatient, which may be determined in a six-minute walk test. Before a training cycle, the patient should be subjected to basic clinical tests. The intensity of training may be determined by the Karvonen or Strunz formula to precisely specify the training heart rate (60–75% of maximum heart rate, depending on the condition of the indivi dual). Blood sugar levels should be measured before and after the training session, while during exercise a heart rate monitor should be used. All these measures should help prevent the occurrence of adverse effects such as hypoglycemia.
Acta Physica Polonica A
|
2018
|
vol. 133
|
issue 5
1261-1265
EN
Insulin is an important peptide hormone for the glucose metabolism. The structural flexibility of insulin B chain attracts a lot of our attention for understanding the biological activity. Our work carried out the extensive sampling to statistically clarify the structural changes of isolated T_{6} human insulin B chain. We introduced the Landau free energy to describe the isolated insulin B chain whose experimental structure locates a local energy minimum. Its trained model was subjected to thousands of heating and cooling circles between the high and low temperatures. Six typical structure clusters were found by classifying the final generated structures with RMSD and radius of gyration. The structures in clusters indicate the potential deformations of insulin B chain at residues 5-8 of N-terminus, residues 9-12 of central helix and residues 24-29 of C-terminus, which agrees with the experimental results.
EN
Resistin is still a little known hormone of the adipose tissue. The potential role of resistin in the development of DM2 has been currently investigated. The aim of our study was to detect the resistin blood level in patients with DM2, depending on the duration of the disease. In so doing, a determination of resistin and insulin blood level was conducted in 305 patients with DM2, and in a control group of 32 persons. Before testing, the patients were placed into four groups, depending on the duration of type 2 diabetes. Our results indicate that the resistin level was significantly lower in the control group of patients, in comparison with the DM2 patients groups. Moreover, a significantly lower resistin level was found in group I (firstly diagnosed DM2), in comparison with the groups of patients with a different duration of DM2. No correlation between resistin level and BMI, and between resistin and insulin blood level was found. However, a tendency towards increase of resistin blood level is noticeably evident in co-relation with increment of DM2 duration. In addition, the resistin level was considerably lower in patients with no DM2, when compared with patients with diagnosed DM2. Yet, there was no significant difference in the resistin blood level depending on the sex of the patients at the same duration of DM2
EN
The negative pressure wound therapy in the treatment of diabetic foot ulcers was used successfully for many years. In the case of complications associated with infection by this type of wound treatment to give very good results. From many years of sustained research on a device that could combine the advantages of the negative pressure wound therapy and drainage flow. Finally, in the last year, the first V.A.C. Ulta (KCI, USA) devices were included to the Polish hospital departments. In this paper we present a case of a patient of successfully using a negative pressure wound therapy with installation via a set of V.A.C. Ulta in the ischemic diabetic foot syndrome complicated by phlegmon and tissue necrosis. The patient was treated in stages. In first stage was performed angioplasty of critically stenosis of the superficial femoral artery segment. Secondly, the resection of the necrotic bone revised fingers and forefoot was conducted, and in the third step the negative pressure wound therapy with installation was used. Finally, the wound was closed by the intermediate thickness skin graft. The total duration of treatment was 21 days. The patient in good general condition with a completely healed wound was discharged. Currently, after the supply with orthopedic equipment, patient regained full mobility.
EN
Our study was aimed at the evaluation of relationships between thyroid stimulating hormone (TSH) within the normal range and metabolic risk factors (glucose, insulin, HOMA-IR and lipoprotein profile) in physically active male and female students. In 219 students circulating TSH, glucose, insulin and lipoproteins were measured in blood under fasting conditions. Insulin resistance was expressed as HOMA-IR (homeostasis model assessment for insulin resistance). For further procedures 99 males and 97 regularly menstruating females with TSH 0.4–4.0 μIU/ml were accepted. In male students no correlations between circulating TSH, anthropometric and biochemical variables were noted. In females TSH within the normal range was slightly but significantly correlated with the triglyceride (TG) level (p < 0.03). However, step-wise multiple regression analysis revealed that the effect of TSH was small (p < 0.046) in relation to that found for HOMA-IR ( p < 0.0009). No relationships between biochemical variables and normal levels of TSH were noted in male students. However, surprisingly normal range TSH in males was slightly but significantly correlated with the percentage of body fat and this issue needs further studies concerning measurements of different fat depots. The above data suggests that in active females TG synthesis and export from the liver is more sensitive to TSH action than in active male counterparts.
EN
In The present study, the aims was to investigate and compare the effect of insulin and embryonic stem cells (ESC) loaded nanoparticle formulations (NPs) on pancreatic-beta-TC-cell regeneration. Characterization studies of NPs were performed. Permeability of insulin and the effect of ESC on pancreatic beta cells were investigated. by the determination of Insulin or glucose levels were determined and histologic investigations were also performed. ESC encapsulation efficiency was calculated by western blot analysis. The particle sizes of insulin and ESC-loaded-NPs were determined as 0.665±0.202 µm and 0.650 ±0.310 µm. The mean zeta potentials of insulin and ESC-loaded-NPs nanoparticles were found as 6.88±0.729 mV, 5.13±0.631 mV. The polydispersity index of insulin and ESC nanoparticles were 0.660±0.175, 0.620±0.205 respectively. Encapsulation efficiency of insulin and ESC-loaded-NPs were found to be 50±1.53% and 51%. Insulin release from nanoparticles was found to be 72.8% over 48h. The gGlucose concentrations wasere decreased to 201 and 202.7 mg/dl from 250 mg/dl in streptozocin (STZ) induced diabetic mice group after insulin and ESC-loaded-NPs administration. Insulin and ESC-loaded-NPs improved the blood insulin levels in all experimental groups. These NPs may be used for repairing of pancreatic cells. Healing or some degree of regeneration was observed when insulin and ESC-loaded-NPs were administered to the mice ip. ESC-loaded-NPs can be a potential source for cell replacement therapy in the treatment of diabetes.
EN
The purpose of the study is to analyze the act of substitution between biological products. Diabetes mellitus notes the greatest increase in the projected causes of deaths globally till 2030. The proper drug substitution process may help to increase the control over the disease management. In this paper authors try to identify and explain the challenges for the health policies and legislations in emerging markets and low- and middle-income countries. Analysis of retrospective data covering prescribed-dispensed insulin products was performed. The study is based on the law and economics approach with the application of the planning theory and modeling. The study shows the scope of substitution process of insulin and highlights the necessity of univocal legal approach profiled for this therapy area. Prognosis of created base model indicates at constant presence of substitution process of insulin. Substitution is to bring financial savings for patients, it is yet however unknown whether savings arising from the act of purchase will still have positive impact on undertaken therapy process in long-term period. These findings may inform about important factors and how emerging markets and low- and middle-income countries can increase progress of the substitution process.
EN
In diabetes several aspects of immunity are altered, including the immunomodulatory action of adenosine. Our study was undertaken to investigate the effect of different glucose and insulin concentrations on activities of adenosine metabolizing enzymes in human B lymphocytes line SKW 6.4. The activity of adenosine deaminase in the cytosolic fraction was very low and was not affected by different glucose concentration, but in the membrane fraction of cells cultured with 25 mM glucose it was decreased by about 35% comparing to the activity in cells maintained in 5 mM glucose, irrespective of insulin concentration. The activities of 5'-nucleotidase (5'-NT) and ecto-5'-NT in SKW 6.4 cells depended on insulin concentration, but not on glucose. Cells cultured with 10-8 M insulin displayed an about 60% lower activity of cytosolic 5'-NT comparing to cells maintained at 10-11 M insulin. The activity of ecto-5'-NT was decreased by about 70% in cells cultured with 10-8 M insulin comparing to cells grown in 10-11 M insulin. Neither insulin nor glucose had an effect on adenosine kinase (AK) activity in SKW 6.4 cells or in human B cells isolated from peripheral blood. The extracellular level of adenosine and inosine during accelerated catabolism of cellular ATP depended on glucose, but not on insulin concentration. Concluding, our study demonstrates that glucose and insulin differentially affect the activities of adenosine metabolizing enzymes in human B lymphocytes, but changes in those activities do not correlate with the adenosine level in cell media during accelerated ATP catabolism, implying that nucleoside transport is the primary factor determining the extracellular level of adenosine.
EN
Recent medical advances suggest that the cellular natriuretic peptide/cGMP and NO/cGMP effector systems represent important signal transduction pathways especially in the cardiovascular system. These pathways also appear to be very interesting targets for the possible prevention of cardiovascular diseases. Exciting candidates for prevention include cGMP-dependent signaling networks initiated by natriuretic peptides (NP) and nitric oxide (NO) which are currently explored for their diagnostic and therapeutic potential. cGMP signaling contributes to the function and interaction of several vascular cell types, and its dysfunction is involved in the progression of major cardiovascular diseases such as atherosclerosis, hypertension and diabetic complications. This review will take a focussed look at key elements of the cGMP signaling cascade in vascular tissue. Recent advances in our knowledge of cGMP-dependent protein kinases (cGK, also known as PKG), the potential for assessing the functional status of cGMP signaling and the possible cross talk with insulin signaling will be reviewed.
EN
The effect of insulin, wheat germ agglutinin (WGA), peanut agglutinin (PNA) and concanavalin A (ConA) on [3H]glucosamine incorporation into pericellular glycosaminoglycans (GAGs) was investigated in two lines of cultured human dermal fibroblasts. Insulin and WGA stimulated [3H]glucosamine incorporation into hyaluronic acid (HA) and heparan sulphate (HS) without any alteration of chondroitin sulphate (CS) and dermatan sulphate (DS) contents. ConA increased [3H]glucosamine incorporation into HS, CS and DS, but had no effect on [3H]glucosamine incorporation into HA. PNA affected neither the content, nor the composition of GAGs. In contrast to PNA, ConA and WGA stimulated glycolysis and demonstrated an evident antiproliferative effect on dermal fibroblasts. Thus, both the insulin-like action of WGA and ConA on cultured dermal fibroblasts and the differences between the effects of lectins on modulation of GAGs synthesis appear to be determined by their chemical structure.
EN
Glyconeogenesis, the synthesis of glycogen from carbohydrate precursors like lactate, seems to be an important pathway participating in replenishing glycogen in cardiomyocytes. Fructose-1,6-bisphosphatase (FBPase), an indispensible enzyme of glyconeogenesis, has been found in cardiomyocytes on the Z-line, in the nuclei and in the intercalated discs. Glyconeogenesis may proceed only when FBPase accumulates on the Z-line. Searching for the mechanism of a FBPase regulation we investigated the effects of the calcium ionophore A23187, a muscle relaxant dantrolene, glucagon, insulin and medium without glucose on the subcellular localization of this enzyme in primary culture of neonatal rat cardiomyocytes. Immunofluorescence was used for protein localization and the intracellular calcium concentration was measured with Fura. We found that the concentration of calcium ions was the decisive factor determining the localization of muscle FBPase on the Z-line. Calcium ions had no effect on the localization of the enzyme in the intercalated discs or in the nuclei, but accumulation of FBPase in the nuclei was induced by insulin.
EN
In pancreatic β-cells, although H2O2 is a metabolic signal for glucose stimulated insulin secretion, it may induce injury in the presence of increased oxidative stress (OS) as in the case of diabetic chronic hyperglycemia. Olea europea L. (olive) leaves contain polyphenolic compounds that may protect insulin-secreting cells against OS. The major polyphenolic compound in ethanolic olive leaf extract (OLE) is oleuropein (about 20 %), thus we compared the effects of OLE with the effects of standard oleuropein on INS-1 cells. The cells were incubated with increasing concentrations of OLE or oleuropein for 24 h followed by exposure to H2O2 (0.035 mM) for 45 min. H2O2 alone resulted in a significantly decreased viability (MTT assay), depressed glucose-stimulated insulin secretion, increased apoptotic and necrotic cell death (AO/EB staining), inhibited glutathione peroxidase activity (GPx) and stimulated catalase activity that were associated with increased intracellular generation of reactive oxygen species (ROS) (fluorescence DCF). OLE and oleuropein partly improved the viability, attenuated necrotic and apoptotic death, inhibited the ROS generation and improved insulin secretion in H2O2-exposed cells. The effects of oleuropein on insulin secretion were more pronounced than those of OLE, while OLE exerted a stronger anti-cytotoxic effect than oleuropein. Unlike OLE, oleuropein had no significant preserving effect on GPx; however, both compounds stimulated the activity of catalase in H2O2-exposed cells. These findings indicate different modulatory roles of polyphenolic constituents of olive leaves on redox homeostasis that may have a role in the maintenance of β-cell physiology against OS.
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