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Impact of the Gastrointestinal System on Metabolic Control in Children with Type 1 Diabetes Mellitus - Gut Peptide Hormones
Huml, Michal ; Sýkora, Josef (advisor) ; Dědek, Petr (referee) ; Rušavý, Zdeněk (referee)
Our objective was to evaluate plasma levels of gut hormones and hormones associated with glucose metabolism in children with type 1 diabetes mellitus (T1DM), and to correlate plasma concentrations of gut hormones with blood biochemistry, markers of metabolic control and anthropometric parameters. A multiplex assay kit (LINCOplex® ) was used for the determina- tion of postprandial plasma levels of specific gut peptide hormones. Amylin, glucose- dependent insulinotropic polypeptide (GIP), active glucagon-like peptide 1 (GLP-1), active ghrelin, insulin, leptin, pancreatic polypeptide (PP), and polypeptide YY (PYY) were assessed prospectively in 55 subjects including 19 T1DM children (mean age: 13.4 years) and 21 healthy reference controls (mean age: 13. 4 years) and 15 patients with functional abdominal pain (FAP) (mean age: 10.5 years). In total, 440 plasma hormones samples were assessed in 55 patients. Entered data were examined using a non-parametric Wilcoxon's test. Further- more, statistically significant correlations were assessed by stepwise regression analysis. Our study demonstrated that the determination of specific postprandial gut hormones with the multiplex assay kit (LINCOplex® ) was highly efficient. Not only was a small amount of plasma sample (25µl) required for analysis, but also a...
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Factors influencing the metabolism of homocysteine in selected diseases with complex etiopathogenesis
Veselá, Kamila ; Anděl, Michal (advisor) ; Nečas, Emanuel (referee) ; Rušavý, Zdeněk (referee) ; Poledne, Rudolf (referee)
At present, the great medicine to develop molecular genetic techniques, which significantly help to explain the causes of illnesses. In some diseases the genetic basis is well known. These are primarily contingent on monogenic diseases. Unfortunately, many diseases remain the genetic cause is still unknown. The largest group is the so-called complex diseases, where the origin and development of disease involving both genetic and nongenetic factors. These diseases include atherosclerosis, diabetes mellitus, orofacial clefts, preeclampsia, neural tube defects, and many others. Complex diseases are serious health and social problem in developed countries. Clasification of risk factors is the subject of much attention, because knowledge of these factors offer opportunities for effective prevention and treatment. The aim of my work was to obtain new knowledge of factors affecting homocysteine metabolism with regard to the formation of some complex diseases in the Czech population.
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Optimalisation of insulin treatment - continuous subcutaneous insulin infusion
Jankovec, Zdeněk ; Rušavý, Zdeněk (advisor) ; Jirkovská, Alexandra (referee) ; Vondra, Karel (referee) ; Prázný, Martin (referee)
Introduction: To be able to prove the efficiency and benefit of the treatment including its safety on a wide range of patients (as opposed to more or less strictly selected groups form clinical studies), we started to gather data about patients in the Czech register of patients treated with continuous subcutaneous insulin infusion (CSII) - further referred to as Register. The obtained data not only represent an effective feedback on our clinical practice and treatment, but also they serve as an important argument for promotion of the CSII efficacy during the negotiations of reimbursement from the health insurance system (the CSII treatment is significantly more expensive compared to other MDI regimens). Aim of study: The aim of the first study were to present data on current situation and treatment results of CSII on wide unselected population of patients with diabetes mellitus in the Czech Republic. In the second study patients were evaluated to compare treatment indication, efficacy and safety with specific regard to the type of diabetes. Patient and methods: The national register of patients treated with CSII exists in the Czech Republic since 1998. We gather data from 52 departments of diabetology in the Czech Republic from patients with diabetes of all types treated with CSII. The data were...
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Examination methods of skin microcirculation in diabetes foot syndrome
Krčma, Michal ; Rušavý, Zdeněk (advisor) ; Filipovský, Jan (referee) ; Horký, Karel (referee) ; Prázný, Martin (referee)
Introduction: Since the mid 1980s, a lot of attention has been dedicated to the importance of microcirculation; a part of arterial bed including arterioles, precapillary sphincters, capillaries, venules and arteriovenous shunts. It is a structure of decisive importance for an organism; in its domain an exchange of blood gases and metabolic products takes place and it contributes to thermoregulation. Mediation of vasomotor reaction and vasoarterial reflex maintaining a stable hydrostatic pressure is also an important function. Microcirculation is for its dimensions (capillary diameter approx. 5 x 10-5 mm2, blood flow velocity around 0.4 mm.s-1) relatively difficult to access for more detailed examination, yet its impairments are very severe and dominate in many metabolic disorders. Microcirculation impairment is crucial in diabetes mellitus, where arteriovenous shunts open at the expense of nutritive bed due to a loss of sympathetic tone in peripheral circulation in diabetic neuropathy (Netten, Houben). Blood flow is therefore seemingly sufficient, but the affected tissue undergoes ischemia (warm ischemia). To what extent hyperinsulinemia contributes to this effect is not yet clearly known, one of the possible explanations may be a stimulation of sympathetic activity. Not a few studies are dealing with...
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Significance of Assessment of Glycemic Index of Foods in the Treatment of Insulin Resistance Syndrome
Víšek, Jakub ; Rušavý, Zdeněk (advisor) ; Rosolová, Hana (referee) ; Blaha, Vladimír (referee) ; Prázný, Martin (referee)
OBJECTIVE - The aim of this study was to compare the impact effectiveness of a diet with a low glycemic index versus a common diabetic diet in selected metabolic and anthropometric parameters. RESEARCH DESIGN AND METHODS - 20 volunteers with the type 2 diabetes treated only with metformin were randomly split into two groups. Each group was advised to follow a common diabetic diet (DD) or a diet with a low glycemic index (GI) for a period of 3 months in a crossover design. The effectiveness of the two diets was evaluated according to the selected metabolic and anthropometric parameters using a hyperinsulinemic euglycemic clamp with endogenous glucose production measurement, indirect calorimetry and bioimpedance analysis. RESULTS - Body weight after 3 months following DD was 93kg (83-104) vs. GI 92kg (85- 104) p<0.05, BMI DD 31.3 kg/m2 (27.5-35.9) vs. GI 30.7 kg/m2 (27-35.3) p<0.05, body fat DD 28% (25.5-43) vs. GI 27% (23-43) p<0.05. The diets did not differ in effects on glycosylated hemoglobin, fasting glucose, lipid profile, insulin sensitivity or hepatic glucose production. CONCLUSIONS - In comparison with a common diabetic diet, the diet with low GI leads to a slight weight loss, as well as the BMI and body fat reduction. No significant differences regarding glycemic control, lipid profile, insulin...
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