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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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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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Analysis of hypoglycemia by Continuous Glucose Monitoring in patients with Type 1 diabetes
Hrubantová, Tereza ; Šoupal, Jan (advisor) ; Flekač, Milan (referee)
This bachelor's thesis presents an analysis of type 1 diabetes patients' hypoglycemia using continuous glucose monitoring. The thesis aims to evaluate the occurrence of hypoglycemia, the prevalence of impaired awareness of hypoglycemia and to investigate how patients treat hypoglycemia. The theoretical part of the thesis presents a summary of the general knowledge of type 1 diabetes diagnosis, focusing on the hypoglycemic issues and diabetes compensation improvements using continuos glucose monitoring. The practical part analyses hypoglycemia frequency and duration using continuous glucose monitoring. Occurrences of the impaired awareness of hypoglycemia, as well as the ways in which patients treat hypoglycemia, are evaluated according to a modified Clark Method. The research shows that the actual occurrence of hypoglycemia is significantly higher than its occurrence as perceived by the patients. Continuous one-week blind glucose monitoring shows that hypoglycemia occurs in 85 % of patients at night and 95 % of patients during the day. In total, patients suffered hypoglycemia 7.2 % of the week, i.e. approx. 12 hours, of which 4 hours and 40 minutes occurred at night while 7 hours and 21 minutes they were experiencing hypoglycemia during the day. The impaired awareness of hypoglycemia prevalence...
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Prevention of complications of 2nd type insulin-dependent diabetes mellitus
Fabianová, Monika ; Eislerová, Iva (advisor) ; Kvasnička, Tomáš (referee)
Bachelor thesis is focused at preventing complications in patients with 2nd type insulin-dependent diabetes mellitus. The aim of the final work was to determine complications associated with the basic disease, prevention of complications, patient education and awareness about diabetes and regime measures. Research was conducted in outpatient clinics for diabetics and subjects of research were 100 adult patients with 2nd type insulin-dependent diabetes mellitus. Research conducted on the basis of a questionnaire survey. The theoretical part focused on basic information about diabetes mellitus in particular classification, diagnosis, treatment, complications, prevention and treatment of disease complications. The practical part was focused on patients with diabetes and activity based on the questionnaire the data were analyzed and graphically processed using tables and graphs. The work showed the results of many research deficiencies in patient awareness and proper education. Many patients do not realize the severity of the disease and the consequences of underestimating the preventive measures. Key words: 2nd type diabetes mellitus, diabetic complications, hypoglycaemia, diabetic foot, prevention of complications, treatment of diabetes, risk factors, insulin treatment.
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Fear of hypoglycemia in adults with diabetes I. type in nursing process
Tomanová, Iva ; Javůrková, Alena (advisor) ; Raudenská, Jaroslava (referee)
This bachelor thesis discusses the fear of hypoglycemia at patients who have diagnosed diabetes mellitus of first type. This thesis is divided into two parts. There is a theoretical part, which deals with problematic of diabetes mellitus, with its characteristic, symptoms, diagnostic, treatment and complications. Next theme of this theoretical part is deals with fear, anxiety, depression and emotional structure or attachments. Empirical part of this bachelor thesis is dedicated to fear of low level sugar in blood in relation to depression, anxiety, emotional attachments and other demographic and clinic factors. The conclusion of the practical part describes the sample of respondents and determines the results of the research. The research for this thesis was based on six questionnaires, which respondents received in this order - a non-standardized anamnesis questionnaire, research of low level of sugar in blood at adults (HFS - II), Beck's self-judged scale of anxiety (BAI), Beck's Depression Scale (BDI- II), Experiences in close relationships (ECR) and Generalized Anxiety Disorder - 7 (GAD - 7). After evaluating the questionnaire according to their scoring manual, were used statistical tools. The methods that were used were based on established hypotheses about a relationship between the given...
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Special needs of children with Type 1 diabetes at primary school
Polnická, Veronika ; Hanušová, Jaroslava (advisor) ; Váchová, Alena (referee)
This thesis, entitled The Specific Needs of a Child with Type 1 Diabetes Mellitus in Primary School, is divided into two main parts. The theoretical part deals with the disease of diabetes mellitus, mainly type 1 diabetes mellitus and the specifics of childhood diabetes. In the practical part I focus on identifying the specific needs of children with type 1 diabetes mellitus attending the first level of primary school. Research information was obtained through interviews with parents of these children. The aim of the research was also to determine the level of satisfaction of parents with the schools' approach and whether and what they would like to change about the schools' approach. According to the responses, all school staff should know that a child is diabetic and be able to help them with hypoglycaemia. The child should be able to tell their classmates about the illness, respond to glycaemia at any time and contact parents if necessary. A negative experience associated with diabetes in the school environment was reported by 6 out of 15 children. In contrast, the same number of parents were satisfied with the approach and found nothing they wished to change. Parents would like teachers to be more empathetic and better educated. As a didactic output, an educational lecture was developed for...
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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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