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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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Epigenetic regulation of HLA class II genes and their role in autoimmune diseases.
Čepek, Pavel ; Kotrbová - Kozak, Anna Katarzyna (advisor) ; Horníková, Lenka (referee)
Abstract Background: Type 1 diabetes (T1D) is a multifactorial autoimmune disease. Its incidence in Europe is continuously rising. The highest T1D risk is associated with HLA (human leukocyte antigen) class II genes. HLA class II molecules play a key role in regulation of immune response. They contribute to the selection of T cell repertoire by presenting antigenic peptides to the CD4+ T lymphocytes. HLA class II expression is controlled by regulatory module that is situated 150 - 300 base pairs upstream of the transcription- initiation site in all HLA class II genes. Polymorphisms in this region are linked to some autoimmune diseases. There were identified several promoter alleles (named QAP) in the HLA DQA1 gene promoter region. Most of the polymorphisms appear to be conserved within haplotype. Individual QAP alleles may have a different promoter strength by which they influence expression of HLA DQA1 gene alleles. Promoter strength can be modulated by DNA methylation. Aims:Our aim was to define methylation profile of HLA DQA1 promoters and determine the mRNA expression of individual alleles of HLA DQA1 gene in T1D patients. The mRNA expression level of HLA DQA1 gene alleles was determined using quantitative PCR. Methods: 30 diabetic pacients (age range 21 to 76 years), were included in this pilot...
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The effect of gluten-free diet on β-cell residual capacity, immune function and gut microbiome in children with newly diagnosed type 1. diabetes
Neuman, Vít ; Šumník, Zdeněk (advisor) ; Pelikánová, Terezie (referee) ; Škvor, Jaroslav (referee)
The effect of gluten-free diet on β-cell residual capacity, immune function and gut microbiome in children with newly diagnosed type 1. diabetes Abstract The pathophysiology of the onset and progression of type 1 diabetes (T1D) is not fully understood. Gluten has a proinflammatory effect on the immune system and is therefore considered as one of the factors affecting the onset and progression of T1D. The aim of the thesis is to allow a complex insight into the role of the GFD on the residual β-cell capacity, T1D control, gut microbiome, gut permeability, subtypes of immune cells and the effect of gut microbiome transfer into germ-free non-obese diabetic (NOD) mice on the incidence of diabetes. On the group of 45 children with T1D (26 intervention group, 19 control group) we proved the association of the GFD with slower decrease of β-cell residual capacity (the difference in the trend of C-peptide decrease 409 pmol/l/year; p = 0,04) and lower HbA1c (by 7,8 mmol/mol; p=0,02). We also described the changes in the gut bacteria that were differentially abundant after the administration of the GFD and the changes in abundance of the regulatory and effector immune cells. We showed there was no change in the gut permeability with respect to the study group. We also proved that the transfer of human gut microbiota...
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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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Factors influencing the compensation of type 1 diabetes mellitus in pregnant women
Dolejšová, Lenka ; Anderlová, Kateřina (advisor) ; Krejčí, Hana (referee)
Introduction: The diploma thesis deals with the issue of compensation of type 1 diabetes mellitus during pregnancy and its relation to the health of mother and child. It further summarizes and describes the variable factors that may have a direct effect on current glycemic variability and long- term compensation of diabetes. Aims: The theoretical part describes the characteristics of type 1 diabetes mellitus and the possibilities of therapy in pregnancy. Subsequently, factors influencing the compensation of diabetes in this period are summarized and described in more detail, especially food composition and possibilities of influencing postprandial glycemia, effects of type and intensity of physical activity and psychosocial aspects related mainly to stress from potential negative effects of glycaemia on the fetus. At the end of the theoretical part, the risks and complications for the mother and the fetus arising from long-term unsatisfactory compensation of diabetes are presented. The aim of the practical part of the thesis was to determine the extent of women's knowledge about the compensation of diabetes in pregnancy, followed by determining the effect of the extent of knowledge on long-term compensation, expressed by glycated hemoglobin. Methods: Data for the diploma thesis were obtained on the...
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Attitudes of parents and teachers in the education of a pupil with a chronic disease at the 1 st stage of a regular primary school
Vopatová, Kristina ; Zulić, Marija (advisor) ; Hájková, Vanda (referee)
The diploma thesis deals with the attitude of parents and teachers of pupils with chronic diseases in the attenuation of compulsory school attendance at the 1st stage of ordinary primary school. The objective of the work is to identify the problems that parents and teachers of chronically ill students encounter during the educational process. From this basis, the purpose is also to find the basis for the best possible cooperation between parents and teachers. The theoretical idea is represented by individual chronic diseases, namely asthma, cystic fibrosis, pediatric oncological diseases, type 1 diabetes mellitus and epilepsy. In addition, the legislative framework for the education of pupils with these diseases, the methodology of working with pupils with chronic diseases and a search of domestic and foreign research conducted on a similar topic are addressed. The methodological part is devoted to qualitative research, the main goal of which is to find out the attitudes of teachers and parents to the educational process of pupils suffering from the above diseases. Using a questionnaire survey and a semi-structured interview, it is ascertained what are the attitudes of parents and teachers towards the education of pupils with the above-mentioned types of chronic diseases in ordinary primary school....
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Diagnostic contribution to the evaluation of intervention models in the treatment of type 1 diabetes
Zacharovová, Klára ; Saudek, František (advisor) ; Plecitá, Lydie (referee) ; Mandys, Václav (referee)
During treatment of diabetes mellitus by immunointervention or transplantation, it is necessary to monitor the markers of immune destruction or rejection of surviving insulin producing cells. An aim of this thesis is to improve the possibilities of following autoimmunity and to detect the survival of transplanted pancreatic islet in vivo. Partial aims included vitality testing of isolated islets for transplantation by measurement of respiration activity, observing the process of in vitro labeling of isolated islets with superparamagnetic iron oxide (SPIO) contrast agent for subsequent magnetic resonance imaging (MRI) of islets and observing SPIO particles transport after transplantation. We also studied a new dual paramagnetic contrast agent combined with fluorescein intended for identification of the MRI contrast agent in samples for histology. Further, we assessed autoimmune reaction by evaluation of cytokine response to specific stimulation with auto-antigens. We tried to affect beta-cells destruction by polyclonal anti- thymocyte antibodies in a mouse experimental model. A new method of the islet respiration measurement correlated with other methods of islet quality testing and it was suggested as a diagnostic test before clinical transplantation. Results obtained studying the intercellular...
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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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