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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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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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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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