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Effect of nutritional intervention on compensation of diabetes mellitus type 2 in patients treated with insulin
Hes, Filip ; Flekač, Milan (advisor) ; Pehr, Martin (referee)
Introduction: The topic of the bachelor's thesis is ,,Effect of nutritional intervention on the compensation of type 2 diabetes mellitus in patients treated with insulin". Diabetes mellitus is a chronic civilization disease, the incidence increases every year. Nutritional education of patients is one of the effective ways to help better compensation of diabetes. Aim of thesis: The aim of the work was to determine the effect of individual nutritional education on the compensation of T2DM in patients treated with an intensified insulin regimem. Methods: For the research were selected 14 patients with T2DM who are treated with intensified insulin therapy. These patients are visiting the Third Department of Internal Medicine of the General Hospital in Prague. All patients completed the study. They were divided into two groups. Group A was individually educated. Group B patients served as the control group. Glycated hemoglobin results were recorded at the beginning of the study and after approximately three months at the next follow-up with a diabetologist. Results: An improvement in glycated hemoglobin values was observed in the group individually educated group compared to the control group. At the same time, education had a positive effect on answers to most questions related to diabetes. In group A,...
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Analysis of hypoglycemia by Continuous Glucose Monitoring in patients with Type 1 diabetes
Hrubantová, Tereza ; Šoupal, Jan (advisor) ; Flekač, Milan (referee)
This bachelor's thesis presents an analysis of type 1 diabetes patients' hypoglycemia using continuous glucose monitoring. The thesis aims to evaluate the occurrence of hypoglycemia, the prevalence of impaired awareness of hypoglycemia and to investigate how patients treat hypoglycemia. The theoretical part of the thesis presents a summary of the general knowledge of type 1 diabetes diagnosis, focusing on the hypoglycemic issues and diabetes compensation improvements using continuos glucose monitoring. The practical part analyses hypoglycemia frequency and duration using continuous glucose monitoring. Occurrences of the impaired awareness of hypoglycemia, as well as the ways in which patients treat hypoglycemia, are evaluated according to a modified Clark Method. The research shows that the actual occurrence of hypoglycemia is significantly higher than its occurrence as perceived by the patients. Continuous one-week blind glucose monitoring shows that hypoglycemia occurs in 85 % of patients at night and 95 % of patients during the day. In total, patients suffered hypoglycemia 7.2 % of the week, i.e. approx. 12 hours, of which 4 hours and 40 minutes occurred at night while 7 hours and 21 minutes they were experiencing hypoglycemia during the day. The impaired awareness of hypoglycemia prevalence...
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Education of diabetes mellitus type 1 patients about carbohydrates calculation
Hanzlíčková, Květa ; Flekač, Milan (advisor) ; Mikeš, Ondřej (referee)
Introduction Many patients diagnosed with type 1 diabetes mellitus (type 1 DM) do not have consistently satisfactory glycaemic control. This may be associated with inadequate education of patients about diet, carbohydrate counting, and insulin dose adjustment based on their carbohydrate intake. Goals My paper aims to survey the awareness, motivation and daily routines of type 1 DM patients and to assess the adequacy of their knowledge in this area. Methods used I conducted the research using anonymous questionnaires designed for type 1 DM patients in two different groups. The first group consisted of patients from a diabetological outpatient clinic in Kutná Hora. The questionnaire in paper form was distributed only to patients diagnosed with type 1 diabetes. The second group consisted of members of groups on social media (Facebook). There were 424 responses in the form of electronic questionnaires. Results The main outcome of this study is the finding that 72 % of patients are not regularly re-educated. Another important finding is that 63 % of respondents do not count the amount of carbohydrates in their food and are confident in their estimates despite the fact that there was considerable variance in the answers to questions regarding the amount of carbohydrates. Conclusion Although most patients...
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Dietary prevention of type 2 diabetes mellitus
Kafková, Tereza ; Flekač, Milan (advisor) ; Pelcl, Tomáš (referee)
This bachelor thesis deals with a dietary prevention of type 2 diabetes mellitus. This thesis is split into two parts: a theoretical part and a practical part. The theoretical part covers the topic of type 2 diabetes mellitus with a focus on a dietary prevention. The first chapters are more general, dealing with type 2 diabetes mellitus, its characteristics, complications and treatment. A chapter about obesity and metabolic syndrome is also included for a better understanding of the whole issue. The practical part of the thesis is focused on an awareness survey and approach to the prevention of type 2 diabetes mellitus for people having a higher risk of developing this disease. Individuals with a positive family history of type 2 diabetes mellitus and patients suffering from overweight or obesity, were selected as those having a higher risk of developing the disease. The research is based on a quantitative questionnaire survey. A total number of 108 respondents participated in this survey. For the purposes of the research, the respondents were divided into two groups based on the mentioned risk factors. Based on the research results, a significant number of respondents (84 % in total) were aware that there was some sort of prevention of this disease possible. The respondents considered the...
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Dietary prevention of type 2 diabetes mellitus
Nováková, Veronika ; Flekač, Milan (advisor) ; Mikeš, Ondřej (referee)
This thesis deals with dietary prevention of type 2 diabetes mellitus. The first chapters of the thesis deal with general information about diabetes mellitus. The chapters focus on the classification, epidemiology, clinical manifestation, complications, diagnostics of diabetes mellitus and pathogenesis of type 2 diabetes mellitus. The subsequent chapters describe prediabetes, obesity and metabolic syndrome. The conclusion of the theoretical section is devoted to the prevention of type 2 diabetes mellitus. The prevention is focused on non-pharmacological measures with an emphasis on dietary influences. The practical part is based on anonymous quantitative research in the form of an Internet quastionaire survey, which focuses on the prevention of type 2 diabetes mellitus. The main goal was to find out about the public's awareness of dietary effects on type 2 diabetes mellitus. The secondary objectives examine the awareness of the worlwide increase of diabetics and whether the respondents consider sugar to be the cause of type 2 diabetes mellitus and attach greater importance to healthy lifestyle or pharmacological measures in prevention. The survey results relating to dietary influences were not very satisfactory and respondents' poor awareness regarding prevention was reflected, for example in...
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Nutrition in pregnancy with type 1 diabetes mellitus
Dolejšová, Lenka ; Flekač, Milan (advisor) ; Polák, Jan (referee)
Pregnancy is a very important period in every woman's life, especially for women with type 1 diabetes mellitus. It brings many changes that affect the level of blood glucose, whose stabilization is the main point of a successful pregnancy. Glycemic stabilization should ideally occur at least three months before conception. Its achievement is mainly due to a properly composed diet, which also has an irreplaceable influence on healthy fetal development. Insufficiently compensated diabetes may be associated with complications for both the baby and the mother. The aim of this bachelor thesis was to summarize available information and find out the knowledge of women with type 1 diabetes mellitus in the topics of nutrition and diabetes compensation during pregnancy. Thereafter to compare the found knowledge of women with the recommendations and depending on the relationship of the respondents to pregnancy, ie whether they were pregnant, do or do not plan pregnancy. The theoretical part of the thesis summarizes the basic facts about relation of diabetes to pregnancy - recommendation for treatment in the period before conception and during pregnancy and related complications for mother and child. It also provides an overview of essential nutrients and micronutrients affecting maternal and fetal health. In...
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Flexible dosage of insulin and a diet
Panfilova, Sofia ; Flekač, Milan (advisor) ; Pelcl, Tomáš (referee)
This bachelor thesis describes diabetes mellitus and the possibility of introducing a new flexible treatment of insulin therapy in people with intensive insulin regimen. The theoretical part is intended to describe diabetes mellitus, causes of illness, treatment, principles of proper eating, the relationship between carbohydrate metabolism and insulin hormone and also discuss flexible dosage of insulin, history and ways of flexible treatment. The practical part of the work was aimed at monitoring the effect of regular patient education on the transition from intensive to flexible dosing of insulin. Within six weeks, patients attended educational meetings where they tried to learn how to work with the new regime. Results from glucometers and changes in glycated haemoglobin values were then used to evaluate the underlying research. Research has made it possible to determine to what extent flexible insulin dosing and proper diet can positively influence diabetes compensation, as well as the effect of motivation and regular patient education on final results. The follow-up patients showed great willingness and motivation to work together and adopt new insulin dosage regime. The results of the research have shown that even in such a short period of time the new treatment is able to positively change the...
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Vitamin D and Its Determination in Patients with Type 1 Diabetes Mellitus
Kosheleva, Svetlana ; Kytnarová, Jitka (advisor) ; Flekač, Milan (referee)
Type 1 diabetes mellitus (DM1T) is a chronic autoimmune disease that leads to progressive loss of pancreatic β-cells. The incidence of this disease is effected by genetic factors and external environment. One of the possible non-genetic factors associated with the risk of DM1T is vitamin D deficiency. The purpose of this bachelor thesis was to determine the possible connections between serum levels of glycated hemoglobin-HbA1c and 25OH Vitamin D in pediatric and adult patients of the Clinic of Pediatric and Adolescent Medicine and 3rd Medical Department of the 1st Faculty of Medicine Charles University and General Fakulty hospital in Prague with diagnosis of diabetes mellitus 1.The group consisted of 57 patients: 17 pediatric patients with DM1T, 20 adult patients with DM1T and a control group of 20 adult patients with DM2T. Patients were randomly assigned to regular checkups as part of ongoing clinical examination. Serum levels of 25-OH vitamin D <10 ng/ml were evaluated as deficient, 10-30 ng/ml as insufficient and 30-80 ng/ml is sufficient. The results showed that vitamin D insufficiency occurs in all groups of the monitored patient population. The mean value of 25OH Vitamin D (25(OH)D) was 18.01±5.23 ng /ml in DM1T pediatric patients, 20.15±10.83 ng /ml in adult patients with DM1T and T...
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Flexible dosage of insulin and diet
Jeníčková, Eliška ; Flekač, Milan (advisor) ; Trachta, Pavel (referee)
This bachelor thesis describes the connection between insulin and carbohydrates in the context of metabolism and the most significant disorder of these physiological processes in form of diabetes mellitus. It also discusses insulin treatment options with an emphasis on the nutritional aspect. The theoretical part is divided into three complex units. The first represents description of carbohydrate metabolism in a healthy person and introduction of insulin as an essential substance in this process. The second part is devoted to the representation of pathophysiological disorder, its causes and risk factors. There are also in detail described two basic types of the disease - type 1 and 2. The third part provides information about treatment. It focuses on possibilities of nutritional and pharmacological therapy. The last part of the theoretical part leads to research work, which examines the influence of education and change of insulin therapy from fixed to flexible dosing in patients with type 2 diabetes mellitus. Patients were observed for six weeks and during this time they were repeatedly educated. The relevant evaluation was made based on changes in glycated haemoglobin values and records from blood glucose meters. This research found how much this change has the potential to improve control of...
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The effectiveness of diabetes camp as a treatment for diabetes type 1
Hásková, Aneta ; Šoupal, Jan (advisor) ; Flekač, Milan (referee)
Introduction: Majority of type I diabetes (type I DM) patients do not reach satisfactory levels of compensation regardless of the advances made in the available treatment. One of the basic pillars of successful type I DM treatment is thorough education. Objective: The aim of this thesis was to describe changes in glycosylated haemoglobin (HbA1c) in patients that completed a four day long educational program. Method: The retrospective analysis evaluated 40 patients with type I DM (age 32 y.o. ± 13, HbA1c before the program 67,1 mmol/mol ± 11,75, diagnosed with DM for 12,5 years ± 7,01). HbA1c was measured before the educational program and then again in a period of 3, 6, 12 and 24 months after the program completion. The program provided the patients with classes focusing on carb counting, flexible insulin dosing, effective ways to manage hypoglycemia and physical activity. Statistical data were obtained by non-parametric tests. (Kruskal-Wallis, ANOVA-repeated measures). Results: Three months after the program completion, a significant drop in HbA1 levels could be observed (67,1 mmol/mol ± 11,75 vs. 60,2 mmol/mol ± 9,52; p=0,0093). This improvement was consistently observed after the period of 6 (59,7 mmol/mol ± 9,59; p=0,0174), 12 (56,5 mmol/mol ± 9,02; p=0,0006) and 24 (57,6 mmol/mol ± 8,43;...
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