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Hypoglycemic and hyperglycemic states of prehospital care
TOLINGER, Daniel
Diabetes mellitus is a frequently discussed lifestyle disease in today's society. Therefore, I decided to create this bachelor's thesis, which focuses on acute diabetic states in emergency medicine and pre-hospital care by the emergency medical service. The aim of the thesis is to provide an overview of standardized therapy in pre-hospital care and the most common causes of acute diabetic complications that can lead to hospitalization and even life-threatening situations for patients with diabetes. This goal was achieved by collecting data from emergency medical responders from the Emergency Medical Service. The knowledge gained from this work shows that the majority of acute diabetic states were caused by patient errors, whether in inappropriate increases in physical exertion or application of exogenous insulin outside of the prescribed regimen. For successful treatment of acute diabetic states, proper and quick diagnosis is crucial, based on a well-taken medical history and the use of available techniques. Targeted therapeutic procedures help manage these conditions without serious health consequences for patients. The scientific contribution of this work lies in its comprehensive and up-to-date approach to the topic, which enables a better understanding of the issue of acute diabetic states and provides a comprehensive view of current diagnosis and therapy in pre-hospital care. This work may be useful for physicians and nurses working in emergency medicine or emergency medical responders who encounter these conditions in practice. In conclusion, this bachelor's thesis serves primarily to improve the care of patients with acute diabetic states.
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Tolerogenic dendritic cells in immunotherapy of type 1 diabetes
Grohová, Anna ; Špíšek, Radek (advisor) ; Černý, Jan (referee) ; Hrdý, Jiří (referee)
Type 1 diabetes is characterized by chronic hyperglycaemia leading to life-threatening complication. The pathogenetic mechanism of T1D is the abnormal immune reaction destroying β-cell mass in pancreas. The current therapy is based on the administration of subcutaneous insulin. However, this therapy can not prevent the episodes of transient hyperglycaemia. Thus, the high blood glucose influences negatively cellular metabolism and progressively leads to tissue damage. The cellular therapy brings the new strategy allowing the direct modulation of the abnormal autoimmune reaction. This strategy promises more targeting therapy with less adverse effects. In this thesis we discuss two types of immune-suppressive cells which are candidates for cellular therapy in autoimmune diseases. The first part describes the tolerogenic dendritic cells (tDC) and their stable suppressive phenotype in proinflammatory condition. tDC maintain their stable inhibitory phenotype and are able to suppress antigen- specific T-cell proliferation together with the induction of T-regulatory cells. These properties of tDC are very important for potential clinical application. The thesis also reveals the relation between laboratory parameters of T1D patients and suppressive properties of tDC. The second part of the thesis is focused...
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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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New trends in perioperative monitoring and glycaemic control.
Lipš, Michal ; Kunstýř, Jan (advisor) ; Bešík, Josef (referee) ; Beneš, Jan (referee)
Glycaemic control in critically ill patients has been a topic of considerable attention for the past 20 years. In literature and at scientific meetings, there have been ongoing debates regarding the efficacy of glycaemic control in these patients with frequently entirely opposite opinions. These range from a strict invasive approach with target glycaemia 4-6 mmol/l to a liberal approach tolerating even values higher than 12 mmol/l. In the preview of this PhD thesis we have analysed so far published literature and describe the reasons for this inconsistency. According to the results of recent studies, the most significant efficacy of tight glycaemic control has been observed in cardiac surgical patients. If we consider the concept of tight glycaemic control as efficient strategy, there are three important questions remaining unanswered as follow. Does the specific algorithm-protocol play a key part in the concept of tight glycaemic control alongside the knowledge and skills of nursing staff in safe and efficient blood glucose control? What is the ideal timing of starting the strategy of tight glycaemic control (TGC) in cardiac surgical patient? And is there any benefit in outcome respect to mortality or morbidity? Do we have any more safe and efficient option or add-on to standard perioperative...
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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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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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Pathobiochemistry of diabetes mellitus and its complications - oxidative stress, microinflammation and genetic predisposition.
Škrha, Jan ; Kalousová, Marta (advisor) ; Rybka, Jaroslav (referee) ; Bendlová, Běla (referee)
Diabetes is a chronic disease with high prevalence and significant morbidity. Chronic changes in the wall of small and large vessels lead to main diabetes complications. Apart from long- term hyperglycemia, several factors are involved in the development of diabetes vasculopathy. The aim of this work was to describe new early biomarkers of these vascular changes, to identify risky patients. Alongside, gene polymorphisms involved in protective pathways of glucose metabolism were studied. In three human studies with Type 1 (T1D) and Type 2 (T2D) diabetes patients special biochemical parameters of receptor for advanced glycation endproducts (RAGE) and its ligands, deglycation enzyme glyoxalase 1 (GLO1) and fructosamine 3-kinase (FN3K) gene polymorphisms were analyzed. Non-invasive measurement of glycation by skin autofluorescence (SAF) was assessed in all subjects. Soluble RAGE, HMGB1 and endothelial dysfunction markers were increased in patients with diabetes as compared with controls, however the differences between T1D and T2D were not significant. For the first time, an association between FN3K (rs1056534) and (rs3848403) polymorphism and sRAGE concentration in diabetes was shown. GLO1 (rs4746) polymorphism was associated with changes in endothelial dysfunction. Patients with diabetes had higher...
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