Endocrine Abstracts

Objective: Of this study is to evaluate if a pharmaceutical care program could improve glycaemic control in patients with diabetes.Aim: The aims of the study are: i) to reinforce the lifestyle advice given to patients with diabetes at annual and other reviews. ii) to improve glycaemic control in patients with diabetes and improve patients adherence to medication. iii) to encourage participation to structured group education for diabetes patients.<p c...

Objective: To study the usage of oral antidiabetic drug (OAD)s prescribed to T2DM patients by General Practitioners and to compare overall glycaemic status of different OAD users at the time of referral to a tertiary care clinic.Methodology: T2DM patients attending a referral clinic underwent a proforma-based interview on their first visit. Data regarding subjects’ ongoing prescription (at least for preceding 3 months with a compliance rate ≥8...

Background: Worsening hyperglycemia in type 2 diabetes may be due to continuous decline in insulin secretion secondary to β-cell dysfunction and decreased insulin sensitivity. The purpose of this prospective cohort study was to evaluate whether early insulin therapy is more advantageous in achieving long-term optimal glycemic control with improved B cell function than oral drugs in the recently diagnosed type 2 diabetes mellitus.Methods: Sixty conse...

Objective: Our aim is to evaluate the effect of exenatide treatment on body weight, HbA1c and compliance to treatment.Material and method: A total of 36 (five M and 31 F) type 2 diabetic patients who were prescribed exenatide were evaluated for this study. Body weight, BMI, HbA1c parameters and side effects were noted from the outpatient clinic records.Result: The median age of our patients was 52 years of old (19–79 years). M...

Introduction: Previous data shows that weight reduction decreases serum retinol binding protein-4 (RBP4) level. But it is not yet clear whether decreases in body weight resulted from exercise, will be accompanied by the changes of RBP4 protein expression in liver and adipose tissues in type 2 diabetes. Thus we designed this study to evaluate the ability of 7 weeks exercise to reverse the changes in body weight, insulin resistance (IR), serum RBP4 and its expression in liver an...

Introduction: Diabetic ketoacidosis (DKA) remains a life threatening complication in type 1 diabetes. Appropiate initial management is crucial in the evolution of this complex condition, and mistakes in the treatment are not uncommon.Medical simulation technology is a powerful tool for training physicians but papers dealing with DKA simulators are scarce.We introduce a new simulator designed in our institution aimed to junior docto...

While statins which are used safely to treat dyslipidemia, and improve cardiovascular mortality, recent articles claim that they also impairs glycaemic control in type 2 diabetes patients. Meta-analysis of larger scale studies indicate that use of statins is associated with an increase of 9% in diabetes onset. Despite that, we know not much about their effect on glucose regulation in patients already diagnosed with diabetes. Therefore, we aimed to investigate the effect of sta...

Experimental and clinical studies suggest that blocking the effects of angiotensin II increases insulin sensitivity, skeletal muscle glucose transport, and pancreatic blood flow which may contribute to the prevention of diabetes mellitus. Although large scale studies and meta-analysis reveal that the new onset of diabetes could be significantly decreased by ARBs in both hypertensive and normotensive patients, their effect on glucose regulation in patients already diagnosed wit...

Large scale clinical studies and meta-analysis suggest that treatment with angiotensin receptor blockers (ARBs) and angiotensin converting enzyme inhibitors (ACEIs) could have protective effect against diabetes development. While diuretics and β-blockers have some well known adverse effect on glycaemic regulation, ARBs/ACEIs’ effect on glucose regulation in patients already diagnosed with diabetes has not been investigated well enough. Also to the best of our knowled...

It was proved that zinc complexes of both metformin and phenformin could act as protease inhibitors with potency at therapeutic concentrations. Biguanide-metal complexes turned out to be more potent cysteine protease inhibitors than either the biguanide or zinc ions alone, i.e. showed synergistic effect. It can be assumed that changes in state of metabolism of zinc induced by ageing, genetic predispositions, accompanying diseases, and some other drugs administered to diabetic ...

Introduction: A successfull diabetes management is not only restricted to medical therapy but also includes a difficult and new life style adoptation. Errors frequently observed in patients such as not complying with their diet program, wrong way of doing insulin injections and insufficient insulin doses, hinder the adequate metabolic control of the disease. Also, physco-social status and different education levels complicate the effectiveness of the first training of the pati...

The work was initiated to comparatively study pregnancy outcomes in patients with type I diabetes mellitus (DMI) with self-control skills and without them.We examined 50 patients with DMI aged from 20 to 29 (mean age 24±3.2 years) ranging from those with newly diagnosed disease to those with DMI duration under 12 years. Glycemia and HBA1c levels were measured to assess carbohydrate metabolism.40 patients with planned pregnancy...

Introduction: To date, psychological research on pancreatic transplantation has focused mainly on illness and quality of life. Research has been predominantly quantitative rendering it impossible to identify specific psychological issues faced by patients. Uniquely, this work considered post-transplant issues in the context of the pre-transplant psychological burden of patients with T1DM.Methods: 21 individuals with T1DM were interviewed (11 males; five ...

Aim: Primary goal was to determine whether the improvement of HbA1c, observed in inefficiently insulin-treated diabetes mellitus (DM) patients on a telemonitoring system, had a lasting effect following its discontinuation.Methods: Forty-seven DM patients (mean age 56.15±15.86 years, mean BMI 29.44±6.69 kg/m2, mean HbA1c 9.9±2.62%) and 25 insulin-treated matched controls (mean age 56.16±20.11 years, mean BMI 27.6±5.18 k...

Introduction: Some data suggest a favorable effect of glucagon-like peptide 1 (GLP1) on steato-hepatitis (SH) in type 2 diabetes. We report here a case of improvement of SH in a patient treated by liraglutide.Patients and methods: A 31-year-old woman presented type 2 diabetes. Her weight was 80 kg for 1.58 m (BMI=32 kg/m2). A treatment by liraglutide was initiated at 1.2 mg/day, percutaneously. A regular follow-up was performed with the record...

Introduction: β cells are a major target of therapeutic strategies to treat diabetes and are extensively studied in terms of their differentiation, function, and maintenance. β cell mass dynamically changes in response to altered metabolic demands in an organism. Many therapies are suggested including transplantation of pancreas or islet cells for type 1 diabetes patients, however these procedures are associated with significant risks and costs. Hence, search for new...

Background: Hypogonadism is associated with cardiometabolic risk. Studies suggest that hypogonadism increases the risk of all-cause and cardiovascular mortality. While some short-term studies have been performed in men with CVD, there are no data on long-term effects of testosterone replacement therapy (TRT) in men with CVD.Methods: In a prospective, cumulative, observational registry study from a single urologist’s office, 300 men with testosterone...

Introduction: We present preliminary results of the treatment with DIAMOND system – novel method of therapy of type 2 diabetes (T2DM) associated with obesity, based on new technology – gastric contractility modulation (GCM).Material and methods: In 23 overweight/obese patients with T2DM enrolled into the polish arm of the multicenter, prospective, randomized study device modulating gastric contractility was implanted. We present data from nine ...

Introduction: Seip–Berardinelli congenital lipodystrophy (SBCL) is an extremely rare autosomal recessive disorder characterized by a congenital absence of adipose tissue. Hepatic steatosis, splenomegaly, skeletal muscle hypertrophy, hypertrophic cardiomyopathy, insulin-resistance and diabetes mellitus (DM) are some of the features of these patients.Case report: A 20-year-old caucasian-male patient was referred to pediatric endocrinology unit at 6-mo...

Introduction: Type 2 diabetes represents an important health problem and is designated by a progressive course, and the subsequent long-term insulin therapy to achieve optimal glucose control. It is important to stress that a substantial number of patients do not achieve optimal glucose control despite the usage of two doses of premixed insulin. Detemir insulin, along with a low pharmacodynamic coefficient of variability, exhibits anorexigenic features, through its effects on ...

Diet and physical activity are éssensiels in support of diabetes mellitus (DM) as well as medical treatment.Aim: Evaluate the results of diet and physical activity on anthropometric and metabolic parameters of T2DM patients untreated population and methodology. 30 newly diagnosed T2DM patients (20W and 10 M; mean age 56.23±0.96 years were placed under hygienodietetic rules. Each patient underwent a clinical examination specifying TT, BMI, and m...

Aims: Self-monitoring of blood glucose (SMBG) is a necessary component of diabetes management but many patients with diabetes do not follow their healthcare proffesionals’ recommendations for self-monitoring. The aims of this study were to determine the proportion of patients with diabetes who perform SMBG in general practice and to identify patient-reported obstacles for SMBG.Methods: The study included 372 patients with type 1 or type 2 diabetes m...

Aim: Metformin is usually well-tolerated and commonly used oral-antidiabetic in type-2 diabetes and pre-diabetes. The most common side effects are gastrointestinal (GI) ones. It is proposed that, extended-release form of metformin has less gastrointestinal side effects. We aimed to compare the extended-release and normal-release form metformin in type-2 diabetic and prediabetic patients for gastrointestinal tolerability, weight effect and glycemic control.<p class="abstext...

The Republic of Belarus gained 20 years of experience in teaching patients self-control of diabetes mellitus and hypothyroidism.Learning technique consists of work in small groups (5 to 6 people). Patients with newly diagnosed disease are subjects to training (one step). Then weekly at outpatient clinics they attend classes on specific subjects (duration of class is 1 hr). Each class consists of a short lecture, analysis of clinical cases, a class discus...

Aim: Recent reports of adverse skin reactions in patients receiving dipeptidyl peptidase-4 (DPP-4) inhibitors have increased awareness towards skin-targeting side effects. Bullous pemphigoid (BP) is an autoimmune blistering dermatosis with significant morbidity and mortality. We report the development of BP in patients with type 2 diabetes mellitus (T2DM) treated with DPP-4 inhibitors.Method: Evaluation of the temporal distribution of the frequency of BP...

DHEAS, an adrenal steroid which displays antiatherogenic and cardioprotective actions, has been pointed as a marker of insulin sensivity (IS). No studies have inquired the effects of liraglutide on DHEAS levels and its relatioship with IS in patients with type 2 diabetes.Methods: We have studied 12 diabetic male patients (aged 48.6±10.4 years), before and after 6 months of liraglutide therapy. Liraglutide was initiated at 0.6 mg/day for a week and 1...

Current guidelines recommend pre-meal blood glucose (BG) levels of <140 mg/dl in the hospital. The aim of this analysis was to compare two versions of a workflow-integrated algorithm for basal-bolus insulin therapy (REACTION algorithm) for glycemic management in patients with diabetes mellitus type 2 (T2D) hospitalized at the general ward.For both algorithms BG measurements were performed four times daily (pre-breakfast, pre-lunch, pre-dinner, and at...

Objective: To evaluate the impact of different modes of insulin therapy (continuous subcutaneous insulin infusion (CSII) using insulin pump or multiple insulin injections (MII)) on carbohydrate metabolism, the state of the transplant, cardiovascular system, calcium and phosphorus metabolism in patients with type 1 diabetes (DM1) during the 1st year after kidney transplantation (KT).Materials and methods: The study included patients with DM1 after transpl...

Introduction: It has been shown that type 2 diabetes mellitus (T2DM) could affect bone metabolism through several mechanism and it may increases risk for osteoporosis. Glucose lowering therapies including metformin has also been reported to may effect on bone turnover. This study aimed to evaluate the effects of metformin therapy on bone resorption and formation markers in newly diagnosed patients with T2DM.Method/design: Study population consisted of 37...

Objective: Autologous hematopoietic stem cell transplantation (AHSCT) is a promising treatment to reverse type 1 diabetes (T1D) in patients with significantly improved β-cell function. This study was designed to investigate the potential immunological mechanisms involved.Design and methods: 18 newly-diagnosed T1D were divided into two groups, the AHSCT group and the insulin therapy group. Blood mononuclear cells (PBMCs) of the patients at the baseli...

Background and aims: Fetal, maternal and perinatal complications are increased in pregnant women with type 1 diabetes mellitus (T1DM). In this study, we aimed to evaluate the effects of CSII on pregnancy outcomes, glycemic control and acute complications in pregnant women with T1DM.Materials and methods: We retrospectively analyzed the data of women with T1DM, who were on CSII therapy during their pregnancy, followed at our clinic between 2008 and 2012. ...

Background: Omega-3 polyunsaturated fatty acids are found in fish oil and they have been shown to mitigate the risk of cardiovascular disease. The mechanisms of which are not only improvement of triglycerides and various lipid parameters, but also beneficial effects on arrhythmia, inflammation. There are animal experimental results that omega-3 fatty acid can improve insulin resistance related to obesity and non-alcoholic steatohepatitis. The mechanism can be activation of PPA...

Diabetes mellitus (diabetes) can now be called the disease of modern times due to its increasing incidence especially in the more developed parts of the world. It is characterized by the inability of the body to produce and/or properly use insulin. In our work we engaged in research of type 1 diabetes in NOD animal model. The focus of our study was relatively recently discovered SGLT time in the small intestine, which are actively inhibited by Ca2+ zeolite. SGLT1 tr...

Introduction: Although alpha-glucosidase inhibitors (aGIs), including acarbose, are recommended in several international guidelines, they are not widely used worldwide due to a perception that they are less effective in Caucasians than Asians. A study was undertaken to investigate whether differences between ethnicity/region populations exist.Methods/design: We pooled data from 10 non-interventional and post-marketing studies from 21 countries, provinces...

Objective: To evaluate changes of ambulatory blood pressure monitoring (ABPM) parameters in normotensive and normoalbuminuric patients with type 1 diabetes (TDM1) after 7 years.Methods: A longitudinal study conducted in normotensive and normoalbuminuric patients with TDM1. ABPM (Spacelabs 90217) basal was performed. Altered ABPM was considered when: i) Mean systolic pressure (sBP) was ≥130 mmHg in the 24 h and daytime periods and ≥120 mmHg in...

Introduction: CSII is considered to be a more comfortable therapy and provide the best glycemic control. However, studies concerning of the long-term effects of pump therapy yield conflicting results, some of them reported beneficial long-term effect on metabolic control (reduction of HbA1c), whilst others have shown effects for a short period of time, not exceeded 1 year.The aim of the study was evaluation of the long-term effect of insulin pump therapy...

Objective: To evaluate the response to treatment with insulin infusion pumps by the evolution of HbA1c over 8 years of experience.Methods: Observational retrospective study. We evaluated the response to treatment in 122 patients with type 1 diabetes recruited between 2004 and 2012 in our area.Results: Between 2004 and 2012, 122 pumps have been implemented (average of 17.4 pumps/year). The number decreased to only four in 2012. Pres...

Background: Peptide-YY is synthesised and secreted by specialised cells in the ileum and colon. Levels increase following food intake, having a satiety effect. Baseline and postprandial levels of PYY were found to be lower in obese subjects compared to lean, negatively correlating with the subjects BMI, however obese subjects were sensitive to the anorectic effects of PYY when given exogenous PYY.Hypothesis: We have recently demonstrated that another pra...

Objective: To evaluate the efficacy of liraglutide, a new glucagon-like peptide 1 analogue, on glycaemic control, body weight, blood pressure and lipid profile in obese patients with type 2 diabetes mellitus (T2DM).Material and methods: Patients attending a tertiary Endocrinology Unit who were prescribed liraglutide (January 2013–December 2013) and assessed both at baseline and first post-initiation visit were included in the analysis. The primary e...

Introduction: Diabetes is characterized by an increase in abdominal fat. This results in a decrease in lean body mass and increase in insulin resistance. In this study, we aimed to evaluate the possible relationship between body composition and insulin regimen modality in type 1 diabetic patients.Materials and methods: Ninety-two type 1 diabetic patient followed in our institution were included in the study. Patients were classified into two groups accor...