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Hypoglycemia as a limitation of treatment of diabetes mellitus
Brož, Jan ; Kvapil, Milan (advisor) ; Češka, Richard (referee) ; Karásek, David (referee)
BROŽ, Jan. Hypoglycemia as a limitation of treatment of diabetes mellitus. Prague, 2022. 100 pages. Dissertation thesis. Charles University in Prague, 2nd Faculty of Medicine, Department of Internal Medicine. Supervisor Kvapil, Milan. In diabetes mellitus, hypoglycaemia is defined as a condition that is associated with abnormally low blood glucose levels (≤ 3.9 mmol/l), which puts the body at potential risk. The first part of the work is devoted to the treatment of hypoglycaemia associated with physical activity in patients with type 1 diabetes mellitus. The results showed that standardized moderate-intensity body movement without pre-agreed preventive measures led to hypoglycaemia in all participants. During exercise, the rate of ABG decline ranged from 0.7 mmol/l to 1.7 mmol/l in 10 minutes. During recovery after ingestion of 20 g of carbohydrates, the rate of increase in ABG ranged from 0.6 mmol/l to 1.9 mmol/l in 10 minutes. The amount of glucose administered resulted in recovery from hypoglycaemia in all study participants and maintained glycemia above this level for an additional rest period of 60 minutes after glucose ingestion. The second part of the work was devoted to comparing the characteristics of the results on the one hand of treatment in the same group of patients with type 2...
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Relationship of oxidative stress to parameters of diabetes control in development of vascular complications.
Pelcl, Tomáš ; Prázný, Martin (advisor) ; Rušavý, Zdeněk (referee) ; Šmahelová, Alena (referee)
The aim of this thesis is to contribute to the clarification of the pathogenesis of chronic complications of diabetes mellitus. The main goal of the research was glycaemic variability, its contribution to the activation of oxidative stress and its possible role in the process of advanced glycation, all beyond the scope of persistent hyperglycaemia itself. Another aim of the work is to contribute to the clarification of a possible relationship between glycaemic variability and vascular complications of diabetes. We were the first to describe the association between the concentrations of reactive aldehydes formed during lipid peroxidation and disorders of skin microvascular reactivity in patients with type 1 diabetes (DM1). Elevated markers of oxidative stress were found in this group, furthermore during the 3 years of follow-up higher plasma antioxidant activity was observed. These findings were not dependent of the method of glucose monitoring and glucose variability, which was lower in a subgroup of patients using real-time continuous glucose monitoring (rt-CGM), compared to a subgroup using conventional glucometers. However, it is clear, that hyperglycaemia alone induces increased oxidative stress in patients with diabetes. Simultaneously we observed the opposite process of oxidative stress...
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