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Mechanisms of insulin resistance and β - cell failure in type 2 diabetes. Effective diet against o minous octet
Kahleová, Hana ; Pelikánová, Terezie (advisor) ; Haluzík, Martin (referee) ; Vondra, Karel (referee)
Background and Aims: Dietary intervention is one of the key components in type 2 diabetes (T2D) management. Vegetarian diet is a promising alternative in the nutritional treatment of T2D. The aims of our study were: 1. To compare the effects of vegetarian and conventional diabetic diet with the same caloric restriction on insulin resistance, volume of visceral fat and plasma concentrations of oxidative stress markers after a 12-weeks-diet-intervention and subsequent 12-weeks of diet plus aerobic exercise training in subjects with T2D. 2. To explore the effect of 12 weeks of diet intervention and subsequent 12 weeks of diet combined with aerobic exercise training on -cell function and to evaluate the role of gastrointestinal peptides in subjects with T2D. 3. To study quality of life, Beck depression score and changes in eating behaviour in response to a vegetarian and a conventional diabetic diet. 4. To explore the role of changes in fatty acid composition of serum phospholipids in diet-induced changes in insulin sensitivity in subjects with T2D. 5. To follow-up our patients 1 year from the end of the intervention.
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The effect of transplantation therapy on diabetic complications
Bouček, Petr ; Pelikánová, Terezie (advisor) ; Vondra, Karel (referee) ; Rychlík, Ivan (referee)
Microangiopathic (retinopathy, nephropathy, and neuropathy) and macroangiopathic complications are the major causes of morbidity and mortality of diabetic patients. The main aims of the thesis were the assessment of the effect of pancreas transplantation with long-term normoglycemia on the course of small fibre diabetic neuropathy in type 1 diabetic patients and the comparison of the effect of kidney transplantation on the prognosis of type 2 diabetic and non-diabetic patients. Selected parameters of autonomic nerve function (cardiovascular reflex tests and spectral analysis of heart rate variability) and intraepidermal nerve fibre density in skin biopsies were assessed prospectively following simultaneous kidney and pancreas transplantation in type 1 diabetic patients. In type 2 diabetic patients, patient and graft survival and the occurrence of complications following kidney transplantation were retrospectively compared to matched non-diabetic controls. Advanced stages of diabetic neuropathy were present in type 1 diabetic patients at the time of transplantation and no significant improvement was seen in any of the assessed parameters following pancreas transplantation with long-term normoglycemia, which is indicative of the presence of irreversible structural small nerve fibre changes. Following kidney...
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Insulin Resistance and Metabolic inFlexibility : the Influence of Renin Angiotensin System Inhibition
Wohl, Petr ; Pelikánová, Terezie (advisor) ; Prázný, Martin (referee) ; Vondra, Karel (referee)
Insulin resistance (IR) is considered to be an important factor influencing the progression of atherosclerosis and is associated with higher morbidity and mortality. IR is a common feature of diabetes mellitus Type 2 and obesity. Many authors consider IR being the crucial abnormality of the metabolic syndrome which is characterized by the essential hypertension, hyperliproteinemia, visceral obesity, endothel dysfunction and many other abnormalities. Impaired insulin action (IR) is also described in diabetes mellitus Type 1, however this phenomenon has not been fully explained. The subjects of dissertation thesis was directed on the IR importance in diabetic Type 1 patients as well as on the renin angiotensin system inhibition in patients with IR and metabolic syndrome with impaired glucose homeostasis. Hyperinsulinemic euglycemic clamp is used in combination with indirect calorimetry to estimate the IR in vivo in humans. In our project we focused on a) the existence of the metabolic inflexibility phenomenon in type 1 diabetic patients b) the methodological evaluation of the hyperinsulinemic euglycemic clamp procedure in the same group c) the influence of renin angiotensin system inhibition with angiotensin II type 1 receptor inhibitor telmisartan in patients with metabolic syndrome and impaired glucose...
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Mechanisms of insulin resistance in humans with focus on adipose tissue
Švehlíková, Eva ; Pelikánová, Terezie (advisor) ; Vondra, Karel (referee) ; Prázný, Martin (referee)
Endocrine activity of adipose tissue is implicated in the development of insulin resistance (IR). The thesis aimed to extend the knowledge of mechanisms contributing to IR. Study I - To investigate the effect of acute hyperinsulinaemia and acute angiotensin II type 1 receptor blockade (ARB) on plasma concentrations and subcutaneous adipose tissue (SAT) expressions of selected adipokines in patients with type 2 diabetes and healthy controls Study II - To investigate the effect of 3-week telmisartan treatment on insulin resistance and plasma concentrations and SAT expressions of selected adipokines in subjects with metabolic syndrome and impaired fasting glucose (IFG) Study III - To investigate the effect of prolonged hypertriglyceridaemia on plasma concentrations and SAT expressions of selected adipokines in patients with type 2 diabetes and healthy control subjects Study IV - To assess the plasma concentrations and SAT expressions of selected adipokines in subjects with different categories of glucose intolerance Methodology: Hyperinsulinaemic-euglycaemic clamp, Intralipid infusion and saline infusion were used to simulate specific metabolic conditions in vivo in 4 groups: 8 young healthy men, 11 overweight/obese patients with type 2 diabetes, 12 age-matched healthy controls and 12 overweight/obese patients...
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