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Possibilities of prediction and immunointervention in type 1 diabetes
Sklenářová, Jana ; Štechová, Kateřina (advisor) ; Saudek, František (referee) ; Pavlínková, Gabriela (referee)
Type 1 diabetes mellitus (T1D) is an organ-specific autoimmune disease characterised by autoimmune destruction of insulin-producing beta cells in the islets of Langerhans. It is a long-term process initiated months or even years prior to the clinical onset. The main role in the pathogenesis is played by T lymphocytes but other cell types are involved as well. The presence of autoantibodies in the circulation is typical even before the disease onset. Nowadays, intensive research is focused on finding individuals at risk and developing an effective prevention. During my postgraduate studies I was involved mainly in the research of T1D prediction and prevention. We investigated the relationship of established autoimmune markers - autoantibodies - and the cellular reactivity to GAD65 and IA2 autoantigens. We discovered that the reaction to autoantigens is very individual and it is influenced by the patient's autoantibody profile. These results could be relevant in planning antigen-specific immunointervention studies and improving their efficacy. We also made an attempt to improve specificity and sensitivity of a beta cell destruction marker (specifically demethylated DNA), which would enable better understanding of the beta cell decline and identification of individuals at risk of T1D development. In...
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Active lifestyle with type 1 diabetes mellitus
Votroubková, Eliška ; Bunc, Václav (advisor) ; Hošková, Blanka (referee)
Title: Active lifestyle with type 1 diabetes mellitus Objectives: The aim of my work was to find out whether and how young people with type 1 diabetes mellitus are restricted. The work summarizes the basic knowledge of this disease with respect to the use of movement in curative. Defines rules for physical activity in diabetics. Methods: To obtain the data, I used an anonymous survey, which was attended by 36 respondents aged 3 to 19 years from a diabetic counseling center in Svitavy and from the civic association Cukříci in Ústí nad Orlicí. The survey will provide data on basic physical parameters, the length of the disease, the way of treatment of individual patients and their approach and limitations with respect to physical activities. For most questions, only one answer can be selected as it is mutually exclusive. Individual answers were entered into tables and the data was subsequently processed and presented using graphs. Results: Using a survey I found out that more respondents are inclined to be treated with insulin pens in front of an insulin pump. More than a quarter of the respondents have already experienced hypoglycaemic shock. 16.7% of the respondents do sports at the racing level. There were other issues associated with physical activity, including the value at which individuals no...
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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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Searching for and Evaluating the Severity of Endothelial Dysfunction in Children with Chronic Autoimmune Disease
Sýkorová, Aneta ; Jehlička, Petr (advisor) ; Urbanová, Zuzana (referee) ; Klásková, Eva (referee)
We aimed to evaluate the endothelial function by combining RHI measurements and specific biochemical markers in the children with possible risk of premature manifestation of atherosclerosis and in the control group of healthy children. In all, 124 children (of which 106 patients divided into five groups according to diagnosis - type 1 diabetes mellitus, Crohn's disease, cystic fibrosis, familial hypercholesterolemia and acute lymphoblastic leukemia and 18 healthy controls) were enrolled in the study. During the study, we measured RHI using a new plethysmographic method and further evaluated biochemical markers of endothelial dysfunction (ADMA, E-selectin, hsCRP and VCAM) and lipidogram in individual groups of children. The primary objective of our study was the determination of RHI and biochemical parameters in healthy subjects and in selected risk groups of children (type 1 diabetes mellitus, Crohn's disease, cystic fibrosis, familial hypercholesterolemia and children after successful treatment of acute lymphoblastic leukemia). At the same time, we compared patients from individual groups with the control group. We found significantly elevated RHI values in groups of children with type 1 diabetes, Crohn's disease, cystic fibrosis, and children after successful treatment of acute lymphoblastic leukemia....
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Specific needs of a child with type 1 diabetes mellitus in pre-primary and primary education
PRAGEROVÁ, Kateřina
This bachelor thesis deals with the issue of children and pupil´s education and with type 1 diabetes mellitus. It focuses on the ways to meet the specific health disadvantages needs and how the child with diabetes is integrated into the school activities. At the beginning of this work, the substance of this chronic disease, its treatment and methods of compensation using the latest technologies in blood glucose monitoring and insulin administration is characterized. Furthermore, the possible risky situations that can be encountered during the child's educational process and how to respond to these situations are described. The practical part is based on the direct experience of parents whose diabetic children attend a kindergarten and a primary school.
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The effect of regular physical activity on a long-term control of Type 1 Diabetes Mellitus
Schöppelová, Lucie ; Pelcl, Tomáš (advisor) ; Prázný, Martin (referee)
Introduction: Physical activity should be part of our everyday life. However, for people with Type 1 Diabetes Mellitus it is the most common cause of hypoglycemia. To control diabetes in the right way, it is therefore necessary to follow certain rules and recommendations that help preventing hypoglycemia while the physical activity remains beneficial at the same time. Aim of the work: The main aim of this study is to clarify the influence of physical activity in connection to long-term control of Type 1 Diabetes Mellitus. Methods: 102 respondents with diagnosed Type 1 Diabetes Mellitus in the age of 19-69 years participated in a quantitative analysis. This research was conducted in a form of multicentric examination at two independent medical centers. The data collection was done through questionnaires focused on physical activity and daily regime. The data from questionnaires were then compared to the values of glycated hemoglobin (HbA1C), HDL cholesterol and the total daily dose of insulin of certain patients. For statistical evaluation, analytical tools of Microsoft Office program were used (F-test and t-test). Results: We found correlation between HbA1C values in patients physically active for less than 2 hours/week compared to those who are physically active for more than 2 hours/week (62,72...
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Acute Complications of Type 1 Diabetes Mellitus
Pošustová, Kristýna ; Malá, Michaela (advisor) ; Vilikus, Zdeněk (referee)
Title: Acute Complications of Type 1 Diabetes Mellitus Objectives: The main aim of my thesis was to gather information from a group of young diabetics, suffering from type 1 Diabetes mellitus, about acute complications they have suffered. In the research I inquired about occurrence, frequency, the most common causes, symptoms and first aid during the state of the acute complications. Methods: The research method of gathering information was an anonymous questionnaire comprising of 25 closed questions divided into 3 thematic areas. The target group was made up of 40 respondents, at the age between 10 and 26 years, from whom 32 were children and 8 were adults. The questionnaire was distributed in cooperation with The Civil Association of Parents of Children Suffering from Diabetes and Celiac Disease (Diacel) based in Pisek. The collected data are presented using tables and graphs. Results: Based on the collected data I found out that the most common acute complication among the respondents is hypoglycaemia. More than half of the respondents experienced a severe attack of hypoglycaemia at least once in their life. Furthemore, it was found that the respondents not always had a source of sugar on them to stop the progression of hypoglycaemia. None of the cases of hyperglycaemia was so severe that an...
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Mountain trekking in diabetic patients treated with an insulin pump
Bytelová, Sophie ; Daďová, Klára (advisor) ; Majorová, Simona (referee)
Title: Mountain tourism for diabetics with an insulin pump Objectives: The aim of this study is to find out whether it is suitable for patients with type 1 diabetes mellitus treated with an insulin pump to undergo physical activity in the form of mountain tourism, as the more intense physical aktivity affects blood glucose levels and whether patients are able to work with advanced insulin pump functions. Methods: The work is conceived as an observational study of the Medtronic educational project. One day mountain hike trip of a distance about 30 km was attended by 40 patients (men and women) with diabetes aged 15-25 years. Non-invasive methods were used. The data was obtained by monitoring insulin pump probes, glucometers and continuous monitoring, which were further evaluated using the CareLink Pro software. Results: Physical activity in the form of mountain tourism is suitable for patients with DM1 treated on an insulin pump. 80% of the probands did not have a risk status of hypoglycaemia, and even though the determined normoglycemia for research was performed by a larger number of adults as opposed to children, this FA has a demonstrable effect on blood glucose levels. It also brings positive benefits for patients because they learn how to work better with advanced insulin pump functions....
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Epigenetic regulation of DQB1 gene in patients with type 1 diabetes mellitus
Gécová, Dominika ; Kotrbová - Kozak, Anna Katarzyna (advisor) ; Holá, Dana (referee)
Background: Type 1 diabetes mellitus is a multifactorial disease caused by beta cell destruction of Langerhans pancreatic islets. From the genetic aspect the main predisposition lays on HLA class II genes (40 - 50%), molecules of which present exogenous peptides to CD4+ T lymphocytes. Enviromental factors play a crucial role in the etiopathogenesis of T1DM. Through epigenetic regulation (e.g. DNA methylation) the genetic and enviromental factors communicate. The level of methylation in the regulatory regions can significantly affect expression of these genes. Aims: The aim of the diploma thesis was to define methylation profile of HLA DQB1 alleles in type 1 diabetes mellitus patients and determine their expression. Methods: The genotyping of HLA class II genes (HLA-DRB1, HLA-DQA1, HLA-DQB1) was performed using sequence specific primers. DNA was treated with sodium bisulfite, regulatory region of HLA DQB1 was amplified and cloned into E.coli, strain DH5α/XL1-Blue. Positive clones were sent for sequencing and results analyzed. RNA was transcribed to cDNA by reverse transcription and the level of expression was analyzed by quantitative PCR. Results: Statistically significant differences were found in total methylation of DQB1*0201 and *0302 alleles in the B section of DQB1 gene. Difference in...
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