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Nursing care of a paediatric patient with diabetes mellitus type I.
PETŘÍČKOVÁ, Jana
The bachelor thesis is focused on the care of children with type I diabetes mellitus by nuirses working in diabetes clinics. In the theoretical part, there are characteristics of diabetes mellitus, its classification causes, symptoms, diagnosis, complications, treatment, and also the specific needs of paediatric patients diagnosed with type I diabetes mellitus. The first aim of this bachelor thesis was to evaluete the current state of nursing care of paediatric patients with type I diabetes mellitus. The second aim was to find out and identify the specific needs of paediatric patients with type I diabetes mellitu. The third aim was to try to suggest improvements in nursing practices and strategies for paediatric patients with type I diabetes mellitus based on the findings. The pactical part of the bachelor thesis was elaborated by using a qualitative research method. We used a questionnaire method and a semi-structured interview technique to collect the data. The research file consisted of nine nurses working in the Children's Hospital in Brno in diabetes outpatient surgeries with different length of experience. After transcribing the interviews with the respondents verbatim, we analyzed the results by using open coding using the pencil and paper method, where we esstablished a total of seven categories: age of children with type I diabetes mellitus, initial symptoms of children with type I diabetes mellitus, education, violation of treatment regimen, improvement of treatment regimen, limitations of diabetes in personal life, and visit to the diabetes clinic. The results of the research are presented in the various tables and charts of the empirical part of this paper. The research shows that the most common age of children with type I diabetes mellitus is preschool age. Initial symptoms in children with type I diabetes mellitus were most commonly reported by the respondents as frequent urination, excessive thirst, abdominal pain, and lack of appetite. Only one respondent stated that she did not observe any symptoms. Insulin administration was the most frequently reported educational intervention. Within the treatment regimen violation, not applying insulin and improving the treatment regimen, educating the children resulted the most. Limitations of diabetes in personal life most of the respondents said that they do not have any limitations. According to the most frequent answers of the respondents, the visit to the diabetes clinic is regularly once in three months. We believe that the results of this bachelor thesis could be used as educational material in diabetes clinics for paediatric patients to extend information about proper diet and lifestyle.
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Modes of regime measure and their adherence in pacients with diabetes mellitus
MAURICOVÁ, Barbora
Introduction: The bachelor's thesis focuses on the methods of regimen measures and their adherence in patients with diabetes mellitus. The theoretical part deals with the disease diabetes mellitus and its regimen measures. Diabetes mellitus is currently a widespread chronic disease and its incidence is increasing. Research is therefore important to conduct to improve education, awareness and support diabetics in adhering to the measures. Aim: The aim of the study was to find out how patients adhere to the regimen. Methodology: For this thesis, data collection was carried out using a quantitative survey method. The data was collected using a customized non-standardized questionnaire. Data collection took place were in the South Bohemian hospital in standard and intesive care wards. The questionnaire consisted of 23 questions containing identification data and focused on adherence to regimen measures in diabetic patients. The data obtained were subsequently processed into tables and graphs, on the basis of which the hypotheses were evaluated. Results: The research sample was made up by 82 respondents (100 %). The results show that 17,1 % people follow a diabetic diet, 79,3 % take isnulin regularly, 82,9 % see their doctor regularly and 45,1 % keep a diary of their glucose levels, while 50 % don´t. The results show that adherence to the regimen is influenced by educational level and also by gender. Conclusion: Adherence to regimen measures in diabetics is a very important factor for a proper quality of life and to influence the treatment of this disease. Nutrition and exercise are essential components of the regimen. The results of our research have shown that diabetics do not follow a diabetic diet very well. Adequate awareness, education and motivation are essential for better adherence. This bachelor thesis offers material summarizing the findings on the disease itself, diet, physical activity and more.
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Strategies and results in the development of insulin derivatives for the treatment of diabetes
Pokorný, Štěpán ; Jiráček, Jiří (advisor) ; Hlouchová, Klára (referee)
The aim of this bachelor's thesis is to present insulin analogs and to analyse the direction of development of these organic compounds. The text contains basic information on this subject (e.g. the history of Diabetes Mellitus, the first treatment, the discovery of insulin (1921) and the experiments that preceded this discovery...). The thesis also explains the basic differences between type 1 and type 2 Diabetes Mellitus and the resulting differences in treatment. It mainly summarizes, the specific types of analogs, their chemical composition and the nature of their action. The main contribution of this work lies in the analysis of insulin analogs and the overview of the course in which the development of these analogues is proceeding or what innovations we can expect in diabetes therapy in the upcoming years. The thesis draws primarily from peer-reviewed scientific papers, articles and books (older as well as more recent ones) and from the expertise of the IOCB laboratory. All sources are well cited at the end of the work.
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The role of orexins in food intake and chosen pathological phenomena
Zelená, Anna ; Sumová, Alena (advisor) ; Balounová, Kateřina (referee)
Orexins are neuropeptides produced in the lateral hypothalamus in the brain and peripheral organs. These neuropeptides are essential in regulating arousal and energy balance. They also participate in the reward system and secure water homeostasis. Orexins bind to the orexin receptors differently expressed in various tissues. The binding of orexins to their receptors couples with downstream signalling pathways, e.g., Ca2+ , diacylglycerol and protein kinase C pathways. Low concentration of adenosine triphosphate leads to the inactivation of orexin-expressing neurons and the reduction of energy expenditure. On the contrary, high intracellular concertation of adenosine triphosphate activates energy expenditure. Food intake is regulated by orexins and glucose, sirtuin 1, forkhead box transcription factor 2, and leptin. This thesis aims to find connections between the role of orexins in regulating food intake and the development of some pathological phenomena, e.g., hypertension, obesity, and anorexia nervosa. Keywords orexin, obesity, anorexia nervosa, glucose, insulin, stress
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Targeting insulin storage forms in pancreatic β-cell secretory granules
Asai, Seiya ; Jiráček, Jiří (advisor) ; Skořepa, Ondřej (referee) ; Koblas, Tomáš (referee)
In this dissertation, we focused on a comprehensive investigation of insulin production, storage and secretion by pancreatic -cells. We successfully developed a new assay for the rapid and sensitive determination of insulin concentration in biological samples. This assay, based on the competition of the measured sample with a radioligand for the insulin receptor, helped us to determine the influence of several low molecular weight compounds, as well as peptides, on insulin secretion. We found that arginine and ornithine have a dose-dependent stimulatory effect on glucose- stimulated insulin secretion from -cells, but that dopamine inhibits insulin secretion. The effect of serotonin on insulin secretion was ambiguous. We also studied the effects of the bone protein osteocalcin and its fragments on insulin secretion. We found that these peptides do not stimulate insulin secretion from -cells, but that osteocalcin may have proliferative properties. We also tested the effect of tryptophan and its metabolites and found that these compounds do not stimulate insulin secretion but that some of them may inhibit secretion at higher concentrations. An important result of the study is the experimental confirmation of the presence of crystalline insulin in the secretory granules of -cells. This is the first...
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Preparation and characterization of vesiculin, a two-chain protein derived from IGF-2
Mrzílková, Karolína ; Žáková, Lenka (advisor) ; Pačesová, Andrea (referee)
Hormones of insulin family are one of the most studied groups of proteins due to their connection to large number of diseases including type two diabetes mellitus, tumorigenesis and some neurodegenerative diseases. The newest member of this superfamily is a two-chain analogue of IGF-2 called vesiculin. This peptide was originally isolated from secretory granules of mouse βTC6-F7 cell line and is currently believed to have a endocrine or paracrine effect on pancreatic β-cells. Its sequence homology with IGF-2 and structural similarity to insulin foreshadows vesiculin's potential metabolic, proliferation and growth properties and further secures its place as scientifically interesting and clinically lucrative topic. The insulin theme is corelated with insulin resistance, pathological state present primarily in early stages of development of type two diabetes mellitus. Vesiculin is able to stimulate glucose uptake and glycogen synthesis even in this condition which differentiates it form insulin and IGF-2 whose glucoregulatory activity is blunted in face of insulin resistance. Further research of vesiculin and insulin family receptor interaction, including dimeric tyrosinekinase receptor for IGF-1 and insulin, but also monomeric IGF-2 receptor, can provide more knowledge on character of this binding...
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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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Role of Arginine 717 in insulin receptor respective Arginine 704 in IGF-1 receptor for the interaction with ligands
Kertisová, Anna ; Selicharová, Irena (advisor) ; Ryšlavá, Helena (referee)
Insulin and insulin-like growth factor 1 (IGF-1) are peptide hormones that are important regulators of cellular metabolism, proliferation and apoptosis. Disruptions in signalling pathways may cause a whole range of diseases from diabetes mellitus type 1 and type 2 to cancer or neurodegenerative diseases. The cellular response to these hormones is mediated by insulin (IR) and IGF-1 receptors (IGF-1R) with a tyrosin-kinase activity. Receptors are created as hetero-tetramers of two extracellular α-subunits and two intracellular β-subunits. Studies of receptor structures try to elucidate the basic principles of the interaction of receptors with their ligands. However, the role of some amino-acid residues in binding remains unclear. It was suggested that the arginine 704 of IGF-1R may interact with Glu58 IGF-1. In comparison with IGF-1R, the equivalent arginine 717 IR was not associated with an important role in insulin binding in previous studies. This thesis is focused on clarifying the role of Arg704 IGF-1R and for comparison analogically on Arg717 IR isoform A (IR-A) in ligand binding to the receptors. Therefore, mutant variants of IGF-1R in positions His697 and Arg704 and variants IR-A in positions His710 and Arg717 were created. The role of histidines 697 IGF-1R and 710 IR was already elucidated...
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