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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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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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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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Obesity and type 1 diabetes mellitus
Zábranská, Klára ; Matoulek, Martin (advisor) ; Sadílková, Aneta (referee)
Even though patients with the diabetes mellitus type 1 disease were considered slim individuals, the occurrence of overweight and obesity is a more common issue which is not given enough attention. Thus, the topic of obesity, diabetes mellitus, the unheatlhy obese individuals with the diabetes mellitus dissease is becoming more current. The goal of the bachelor thesis is to collect basic data, evaulate compensation of diabetes mellites and to compare BMI of tracked patients with the mellitus type 1 diagnosis, who visited the diabetic department in the span of one month: 1. - 30. November 2019 versus general population. The data were collected from doctors' documents of the patients. One of the monitored parameters was the presence of overweight and obesity with the patients. The theoretical part of the thesis provides basic information about the diabetes mellitus following information about obesity. The final chapter connects these two diseases. The practical part of the thesis consists of a provision of the basic information of the group of patients, a comparison of BMI between the followed sample and general population, a compartion of t HbA1c (glycated hemoglobin) between patients with CGM/FGM (a sensor for continual monitoring of glycemia) and those without it, a comparison of medial BMI (body...
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Utilization of modern technologies in diabetology
Navrátilová, Vendula ; Matoulek, Martin (advisor) ; Vařeka, Tomáš (referee)
Introduction: The main goal of the diabetes mellitus type 1 (DM type 1) therapy is the achievement of the best compensation of this disease. One of the tools to attain this compensation is the correctly carried out self-monitoring, from which can be the right dose of the Insulin derived. To estimate the correct dose of the Insulin is the essential knowledge of the actual dietary records, especially the amount of the carbohydrates. The thorough dietary record is in this case another tool how to significantly improve the compensation of DM type 1. Objective: The main objective of this thesis was the description of the influence of the dietary record for the compensation of DM type 1. As the evaluating parameters were set the value of HbA1c before-and-after the observation and the glycemia variability during the observation. The observation had been provided during one month where in the beginning of the observation all patients took part in the educative stay. Methods: The examined sample included in total 34 persons, but 2 of them were excluded for health reasons. The final examined sample was consist of 32 persons, out of them 18 females and 14 males, which suffer from DM type 1. The average age of these patients was 36,6 years ± 12,6, where the average lasting of DM type 1 was 14,9 years ± 9,9. In...
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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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Monitoring of blood glucose level in patients with diabetes in patients with diabetes in specific situations
Kuntová, Vendula ; Matoulek, Martin (advisor) ; Váchová, Alena (referee)
The correct providing of the selfmonitoring by the diabetic patients can lead to the sufficient offset of the diabetes. Continuous monitoring of the glycaemia belongs among its most modern methods and thank to it is possible to detect even four times more serious glycaemia deviations than if we use the standard glucose measure methods. This bachelor thesis deals with the continuous glycaemia monitoring of the first type diabetes female patient. Main goal of this thesis is to describe the glycaemia changes in the case of the specific physical activities depending on the diet and daily regime providing the analysis of changes and prediction of the glycaemia. The theoretical part of my thesis summarizes the basic information regarding the diabetes mellitus disease. Subsequently, thesis is mainly focused on the acute complications of diabetes, glycaemia monitoring and options of the insuline modes. The practical part is dedicated to the evaluation of the female patient diet, physical activities and sensors records. The evaluation is provided through the organized tables and charts. The detail analysis of glycaemia was performed during the thirteen days. In the thesis were described causes of the outbreak of hyperglycaemia and hypoglycaemia depending on the nutrition, physical activities and daily...
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Biomarkers in the diagnosis and treatment of diabetic complications
Šoupal, Jan ; Prázný, Martin (advisor) ; Rušavý, Zdeněk (referee) ; Rybka, Jaroslav (referee)
The main objective of this study was research on biomarkers used in both diagnosis and therapy of diabetic complications. The main focus of our work came to be on one of these biomarkers - glycemic variability (GV). High GV is linked with more frequent occurance of hypoglycemia. There are even indications it might contribute to development of diabetic complications. With modern technology - continuous glucose monitoring (CGM), we are now able to reliably describe, calculate and reduce GV. So far it is unclear whether increased GV can contribute to the development of microvascular complications (MVC) in type 1 diabetes (T1D). Studies published so far have assessed GV primarily from routine self-monitoring of blood glucose (SMBG) using glucometers. In the light of this uncertaity, the first part of this work compares GV calculated from CGM with the presence of MVC in T1D patients. GV calculated from CGM, but not from SMBG, proved to be significantly higher in T1D patients with MVC, even though there was no significant difference in glycated hemoglobin (HbA1c). This finding supports the hypothesis that higher GV is related to higher risk of MVC and that HbA1c does not describe diabetes control completely. Moreover, it was shown that GV calculated from SMBG is insufficient. There is still no fully...
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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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Continuous Glucose Monitoring by Real Time Sensor in Interstitial Fluid
Honsová, Š. ; Navrátil, Tomáš
The aim of this contribution is to compare the differences between accuracy claimed by the manufacturer in continuous glucose monitoring using the MiniMed Paradigm REAL-Time system with the results obtained in a patient during physical activity. Electrochemical glucose sensor measures the glucose oxidase reaction products. Measurement accuracy was determined using Clarke Error Grid analysis. It can be concluded that in the normal glucose range (4.4 to 10.0 mmol/ l) was more accurate than the measurements given by the manufacturer, in the opposite case; hyperglycemia is less precise than declared.
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