Previous reports provided recommendations for familial renal glucosuria diagnosis without complex view on differential diagnosis of glucosuria. The aim of this review was to provide an overview of the causes of glucosuria and to create an evidence-based diagnostic approach for children with glucosuria. We searched the current literature with a focus to identify the possible etiology of glucosuria, gaining insight into the pathophysiology of glucosuria. Urinary glucose is completely reabsorbed in the proximal tubule of kidneys. It only appears in the urine if the plasma glucose concentration exceeds the renal threshold for glucose or in the case of insufficient renal glucose reabsorption. The proteins that provide glucose reabsorption are SGLT2 and SGLT1 - sodium-dependent co-transporters that transport glucose from the lumen into epithelial cells - and GLUT2 - a passive transporter providing facilitative glucose transport from epithelial cells to plasma. Renal glucose reabsorption is affected in case of acquired or inherited complex dysfunction of proximal tubule called Fanconi Syndrome or due to pathogenic variants of genes encoding glucose transporters. Prior to diagnosing any of these, diabetes mellitus must be excluded together with other conditions leading to hyperglycemia. In conclusion, glucosuria is always an abnormal finding. The review provides a simple evidence-based diagnostic approach to navigate the differential diagnosis of glucosuria.
- MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- Fanconiho syndrom diagnóza komplikace MeSH
- glukosa * metabolismus MeSH
- glykosurie * diagnóza etiologie MeSH
- lidé MeSH
- přenašeč glukosy typ 2 metabolismus MeSH
- proximální tubuly ledvin metabolismus MeSH
- renální glykosurie * diagnóza etiologie patofyziologie MeSH
- transportér 1 pro sodík a glukosu metabolismus MeSH
- transportér 2 pro sodík a glukózu metabolismus MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Advances in paediatric type 1 diabetes management and increased use of diabetes technology have led to improvements in glycaemia, reduced risk of severe hypoglycaemia, and improved quality of life. Since 1993, progressively lower HbA1c targets have been set. The aim of this study was to perform a longitudinal analysis of HbA1c, treatment regimens, and acute complications between 2013 and 2022 using data from eight national and one international paediatric diabetes registries. METHODS: In this longitudinal analysis, we obtained data from the Australasian Diabetes Data Network, Czech National Childhood Diabetes Register, Danish Registry of Childhood and Adolescent Diabetes, Diabetes Prospective Follow-up Registry, Norwegian Childhood Diabetes Registry, England and Wales' National Paediatric Diabetes Audit, Swedish Childhood Diabetes Registry, T1D Exchange Quality Improvement Collaborative, and the SWEET initiative. All children (aged ≤18 years) with type 1 diabetes with a duration of longer than 3 months were included. Investigators compared data from 2013 to 2022; analyses performed on data were pre-defined and conducted separately by each respective registry. Data on demographics, HbA1c, treatment regimen, and event rates of diabetic ketoacidosis and severe hypoglycaemia were collected. ANOVA was performed to compare means between registries and years. Joinpoint regression analysis was used to study significant breakpoints in temporal trends. FINDINGS: In 2022, data were available for 109 494 children from the national registries and 35 590 from SWEET. Between 2013 and 2022, the aggregated mean HbA1c decreased from 8·2% (95% CI 8·1-8·3%; 66·5 mmol/mol [65·2-67·7]) to 7·6% (7·5-7·7; 59·4mmol/mol [58·2-60·5]), and the proportion of participants who had achieved HbA1c targets of less than 7% (<53 mmol/mol) increased from 19·0% to 38·8% (p<0·0001). In 2013, the aggregate event rate of severe hypoglycaemia rate was 3·0 events per 100 person-years (95% CI 2·0-4·9) compared with 1·7 events per 100 person-years (1·0-2·7) in 2022. In 2013, the aggregate event rate of diabetic ketoacidosis was 3·1 events per 100 person-years (95% CI 2·0-4·8) compared with 2·2 events per 100 person-years (1·4-3·4) in 2022. The proportion of participants with insulin pump use increased from 42·9% (95% CI 40·4-45·5) in 2013 to 60·2% (95% CI 57·9-62·6) in 2022 (mean difference 17·3% [13·8-20·7]; p<0·0001), and the proportion of participants using continuous glucose monitoring (CGM) increased from 18·7% (95% CI 9·5-28·0) in 2016 to 81·7% (73·0-90·4) in 2022 (mean difference 63·0% [50·3-75·7]; p<0·0001). INTERPRETATION: Between 2013 and 2022, glycaemic outcomes have improved, parallel to increased use of diabetes technology. Many children had HbA1c higher than the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2022 target. Reassuringly, despite targeting lower HbA1c, severe hypoglycaemia event rates are decreasing. Even for children with type 1 diabetes who have access to specialised diabetes care and diabetes technology, further advances in diabetes management are required to assist with achieving ISPAD glycaemic targets. FUNDING: None. TRANSLATIONS: For the Norwegian, German, Czech, Danish and Swedish translations of the abstract see Supplementary Materials section.
- MeSH
- diabetes mellitus 1. typu * epidemiologie krev farmakoterapie MeSH
- dítě MeSH
- glykovaný hemoglobin * analýza MeSH
- hypoglykemie epidemiologie MeSH
- hypoglykemika * terapeutické užití MeSH
- kojenec MeSH
- krevní glukóza * analýza MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladiství MeSH
- předškolní dítě MeSH
- registrace * statistika a číselné údaje MeSH
- regulace glykemie statistika a číselné údaje metody MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Fructobacillus, a Gram-positive, non-spore-forming, facultative anaerobic bacterium, belongs to the fructophilic lactic acid bacteria (FLAB) group. The group's name originates from fructose, the favored carbon source for its members. Fructobacillus spp. are noteworthy for their distinctive traits, captivating the interest of scientists. However, there have been relatively few publications regarding the isolation and potential utilization of these microorganisms in the industry. In recent years, F. tropaeoli has garnered interest for its promising role in the food and pharmaceutical sectors, although the availability of isolates is rather limited. A more comprehensive understanding of Fructobacillus is imperative to evaluate their functionality in the industry, given their unique and exceptional properties. Our in vitro study on Fructobacillus tropaeoli KKP 3032 confirmed its fructophilic nature and high osmotolerance. This strain thrives in a 30% sugar concentration, shows resistance to low pH and bile salts, and exhibits robust autoaggregation. Additionally, it displays significant antimicrobial activity against foodborne pathogens. Evaluating its probiotic potential, it aligns with EFSA recommendations in antibiotic resistance, except for kanamycin, to which it is resistant. Further research is necessary, but preliminary analyses confirm the high probiotic potential of F. tropaeoli KKP 3032 and its ability to thrive in the presence of high concentrations of fructose. The results indicate that the isolate F. tropaeoli KKP 3032 could potentially be used in the future as a fructophilic probiotic, protective culture, and/or active ingredient in fructose-rich food.
- MeSH
- antibakteriální látky farmakologie MeSH
- fruktosa metabolismus MeSH
- koncentrace vodíkových iontů MeSH
- ovocné a zeleninové šťávy * mikrobiologie MeSH
- pomerančovník čínský mikrobiologie chemie MeSH
- potravinářská mikrobiologie MeSH
- probiotika * izolace a purifikace MeSH
- RNA ribozomální 16S genetika MeSH
- žlučové kyseliny a soli metabolismus MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Depression therapy has been linked to negative effects on energy metabolism, which can be attributed to various factors, including an ongoing inflammatory process commonly seen in metabolic disorders. Unhealthy lifestyle choices of patients and the impact of antidepressants on body weight and lipid and glucose metabolism also contribute to these metabolic side effects. Although not as pronounced as other psychopharmaceuticals, the increasing use of antidepressants raises concerns about their potential impact on public health. The study aimed to evaluate the short- and long-term effects of the antidepressant citalopram and its long-term combination with a special diet on metabolic parameters in mice. METHODS: Animals were randomly divided into 5 groups - control, control + special diet, citalopram (10 mg/kg for 35 days), citalopram + special diet (10 mg/kg for 35 days), and citalopram (10 mg/kg for 7 days). After a described time of administration, animals were anesthetized, blood and fat and liver tissues were collected. Biochemical parameters of lipid metabolism (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and glucose were analyzed using spectrophotometry and relevant adipokines and cytokines were evaluated by ELISA. RESULTS: After a week of application of citalopram, we observed dyslipidemia that persisted even at the end of the 5-week experiment. Furthermore, after 5 weeks of citalopram administration, we observed a significant decrease in body weight gain and decreased leptin levels. Changes in lipid metabolism, higher levels of adipokines leptin and PAI-1 were observed due to the special diet after 5 weeks. CONCLUSIONS: Our research suggests that the effects of citalopram and a diet on the metabolism of mice can be significant, both in the short term (1 week) and in the long term (5 weeks).
- MeSH
- citalopram * škodlivé účinky aplikace a dávkování farmakologie MeSH
- dieta s vysokým obsahem tuků škodlivé účinky MeSH
- dyslipidemie * chemicky indukované krev metabolismus MeSH
- glukosa * metabolismus MeSH
- játra metabolismus účinky léků MeSH
- krevní glukóza metabolismus účinky léků MeSH
- leptin * krev metabolismus MeSH
- lipidy * krev MeSH
- metabolismus lipidů * účinky léků MeSH
- myši MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
This report presents a fatal case of a young female Type I diabetic patient who developed convulsions and loss of consciousness after taking methamphetamine and spending some time in a dance club. During the convulsions, she was given sugar and when no response occurred, her boyfriend who was not experienced in the use of insulin administered a dose of insulin to her. The woman lost consciousness and died despite the efforts of the emergency service. A biochemical analysis revealed a high level of insulin (196.67 mU/L) and low levels of glucose (2.96 mmol/L) and C-peptide (26 pmol/L). Toxicological analysis revealed a methamphetamine concentration of 389 ng/mL and an amphetamine concentration of 19 ng/mL. The forensic perspective of the difficult determination of the contribution of each of the factors to the death, i.e., the pre-existing medical condition (Type I diabetes), the use of methamphetamine, the physical exertion at the dance club, and, finally, the non-indicated administration of insulin, is discussed. The ruling of the court is also reported.
- MeSH
- bezvědomí chemicky indukované MeSH
- C-peptid krev MeSH
- diabetes mellitus 1. typu * MeSH
- dospělí MeSH
- fatální výsledek MeSH
- hypoglykemika škodlivé účinky MeSH
- inzulin * aplikace a dávkování MeSH
- krevní glukóza analýza MeSH
- lidé MeSH
- methamfetamin * škodlivé účinky MeSH
- poruchy spojené s užíváním amfetaminu komplikace MeSH
- stimulanty centrálního nervového systému * škodlivé účinky MeSH
- tanec MeSH
- tělesná námaha MeSH
- záchvaty MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Stres je často opisovaný ako rizikový faktor pre rozvoj širokého spektra ochorení. Pomerne menej preskúmanou oblasťou je však vplyv stresu na hladinu glukózy, a tým potenciálne na riziko rozvoja ochorenia diabetes mellitus 2. typu u všeobecne zdravých mladých jedincov, ktorí sú stresu vystavovaní na pravidelnej báze. Kazuistika opisuje vývoj glykémie v priebehu 14 dní u 23-ročnej študentky medicíny počas prípravy na skúšku ako aj samotnej skúšky z dermatológie. Hodnoty namerané zariadením FreeStyle Libre 2 sa väčšinu času pohybovali vo fyziologickom rozmedzí s očakávanými zvýšeniami po jedle a fyzickej aktivite. Inak mala glykémia relatívne stabilný vývoj v rámci normálnych hodnôt, až na okamih pár hodín pred skúškou, keď začala stúpať. U pozorovanej študentky došlo k zvýšeniu glykémie až na hodnotu 8,2 mmol/l najpravdepodobnejšie v reakcii na akútny stres.
Stress is often described as a risk factor for developing various diseases. However, a relatively less explored area is the effect of stress on glucose levels, and thus potentially on the risk of developing type 2 diabetes mellitus, in generally healthy young individuals who are exposed to stress regularly. This case report describes the glycaemic trends over 14 days in a 23-year-old medical student while preparing for an exam and the dermatology exam itself. Values measured by the FreeStyle Libre 2 device were within the physiological range most of the time, with expected increases after meals and physical activity. Otherwise, glycaemia had a relatively stable trend within expected values, except for a few hours before the exam when it began to rise. The observed student experienced an increase in glycaemia up to 8,2 mmol/l, most likely in response to acute stress.
Background: Type 2 diabetes is a common condition that causes the level of sugar (glucose) in the blood to become too high. It can cause symptoms relative insulin deficit, whether due to beta-cell damage, insulin resistance. The study of carnitine and LDH levels in diabetic patients is significant because both play important roles in the metabolism of glucose and fatty acids. Carnitine is a compound that transports fatty acids into the mitochondria for energy production, while LDH (lactate dehydrogenase) is an enzyme involved in the conversion of glucose to lactate. Humans with type 2 diabetes develop lipid accumulation due to carnitine depletion. LDH is an essential physiological molecule in the glycolytic pathway, and its concentration may be indicative of the condition of cellular metabolism.Aim: For measuring and evaluating the levels of serum carnitine and LDH in all study groups.Method: A case-control study was done in the Al-Zahraa Teaching Hospital, Kut, Iraq on 150 Iraqi males and females as patients and control between (April 2022 and January 2023). Their ages ranged between 44 and 77 years. Among them were 120 patients divided into 4 groups 30 type 2 diabetes mellitus; 30 diabetic cardiomyopathies; 30 diabetic nephropathies; 30 diabetic retinopathies and 30 control group where control group's age and gender matched those of the patient groups. All patients gave written informed consent to participate in the clinical study. ELISA was used to measure carnitine and LDH.Result: In present study, it was confirmed that carnitine was significantly lower than the control group and that LDH was significantly higher than the control group. the study demonstrated significant differences in fasting blood sugar and HbA1C levels among the control group, DM2, DCM, DNP, and DRP groups.Conclusion: This case-control study revealed significant differences in carnitine levels, LDH, FBS, and HbA1C levels among patients with Type 2 diabetes mellitus (T2DM) and their complications compared to the control group. These findings suggest alterations in energy metabolism and cellular damage in patients, indicating poorer glycemic control, and supporting the presence of uncontrolled diabetes.
- MeSH
- diabetes mellitus 2. typu * diagnóza komplikace krev MeSH
- dospělí MeSH
- energetický metabolismus fyziologie MeSH
- karnitin * krev MeSH
- komplikace diabetu diagnóza klasifikace krev MeSH
- krevní glukóza metabolismus MeSH
- laktátdehydrogenasy * krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- mastné kyseliny metabolismus MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Irák MeSH
BACKGROUND: Diabetes mellitus (DM) is a chronic disease with prevalence increasing worldwide. The aim of this study was to investigate satisfaction with the current method of insulin delivery (INS) amongst patient with type 1 diabetes mellitus (T1DM) using multiple daily injection (MDI) or continuous subcutaneous insulin infusion (CSII). Furthermore, a sub-aim was to test the effect of selected variables on patient satisfaction with MDI or CSII using regression analysis. METHODS: A cross-sectional study carried out in the territory of Moravia in the Czech Republic. A quantitative approach using the Insulin Delivery System Rating Questionnaire (IDSRQ) among 197 respondents with T1DM with INS delivery with MDI or CSII for at least 1 year. Statistical methods used were descriptive statistics, Student's t-tests and regression analysis. RESULTS: Highly significant differences were found between CSII and MDI patients in satisfaction with the current method of INS delivery (p < 0.001), in how the current method of delivery helps patients maintain stable blood glucose values, prevent high blood glucose (p < 0.001), and in overall satisfaction with the current method of INS delivery (p < 0.001). The average overall satisfaction score was 56.19 points for MDI and 62.08 points for CSII. Regression analysis revealed predictors of overall satisfaction on the mean score on how the current method of INS delivery helps MDI patients (p < 0.01). The effect of other selected variables was not confirmed. CONCLUSION: The results of the study showed higher overall satisfaction with the method of INS delivery in CSII patients. The current method of INS delivery does not interfere with daily life and activities in most patients.
- MeSH
- diabetes mellitus 1. typu * farmakoterapie krev psychologie MeSH
- dospělí MeSH
- hypoglykemika * aplikace a dávkování terapeutické užití MeSH
- injekce subkutánní MeSH
- inzulin * aplikace a dávkování terapeutické užití MeSH
- inzulinové infuzní systémy * MeSH
- krevní glukóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- spokojenost pacientů * MeSH
- subkutánní infuze MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Diabetes mellitus (DM) je jedním z výrazně progredujících chronických onemocnění s vysokou celosvětovou prevalencí. Nehledě na typ diabetu je hlavním cílem zdravotnického týmu efektivní kompenzace metabolických abnormalit s cílem zabránit rozvoji pozdních komplikací či zpomalit jejich progresi do stádií výrazně snižujících kvalitu pacientova života. V posledních letech začíná stoupat počet odborných publikací podporujících domněnku, že stabilizace glykemie může mít zdravotní benefity i u zdravých nediabetiků. Tato práce sledovala vliv složení stravy (glykemické nálože) na glykemický profil a subjektivní parametry u mladých zdravých dobrovolníků pomocí kontinuální monitorace glykemie. Dospěli jsme k závěru, že ačkoliv subjektivní dotazníkové hodnocení ukazuje vyšší pocit útlumu po jídle nebo zhoršení dermatologických problémů ve skupině s vyšší glykemickou náloží, objektivní parametry kontinuální glykemické monitorace neukazují žádné významné rozdíly mezi skupinami podle glykemické nálože stravy. Závěrem můžeme předpokládat výraznou kompenzační schopnost regulačních systémů, které udrží glykemii v optimálním rozmezí i při vysoko-glykemické dietě.
Diabetes mellitus (DM) is one of the significantly progressive chronic diseases with high global prevalence. Regardless of the type of diabetes, the primary goal of the healthcare team is the effective management of the patient’s condition. In recent years, the number of scientific publications supporting the assertion that glycemic stabilization can have health benefits even for healthy non-diabetics has been increasing. In this study, we monitored the effect of diet composition (glycemic load) on the glycemic profile and subjective parameters in young healthy non-diabetic patients. We considered the significance of continuous monitoring on the health status of the participants. We concluded that while subjective questionnaire assessments show a higher feeling of postprandial lethargy and worsening of dermatological issues in the group with a higher glycemic load, the objective parameters of continuous glucose monitoring do not indicate any significant differences between the groups based on the glycemic load of their diet. In conclusion, we can assume a significant compensatory ability of regulatory systems to maintain glycemia within an optimal range even with a high-glycemic diet.
- MeSH
- dieta s omezením sacharidů MeSH
- dospělí MeSH
- klinická studie jako téma MeSH
- krevní glukóza analýza MeSH
- lidé MeSH
- mladý dospělý MeSH
- průzkumy a dotazníky MeSH
- regulace glykemie * MeSH
- sacharidová dieta MeSH
- selfmonitoring glykemie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
Infekce močových cest se řadí k častým onemocněním zejména u žen. Jedná se o bakteriální zánět, proto jsou lékem volby antibiotika. V rámci prevence u recidivujících IMC je doporučována dlouhodobá profylaxe pomocí nízkých dávek těchto látek. Při užívání antibiotik mohou pacientky obtěžovat vedlejší nežádoucí účinky, a navíc se zvyšuje riziko nárůstu bakteriální rezistence. V rámci neantibiotické profylaxe je doporučována intravezikální instilace kyseliny hyaluronové, případně peroprálně užívaných preparátů účinkujících proti bakteriím přímo v močovém měchýři, mezi které se řadí i D‐manóza.
Urinary tract infections are common, especially in women. It is a bacterial inflammation, therefore antibiotics are the drug of choice. Long-term prophylaxis with low doses of these agents is recommended for the prevention of recurrent IMC. When taking antibiotics, patients may be bothered by side effects and, in addition, the risk of increasing bacterial resistance increases. As part of non-antibiotic prophylaxis, intravesical instillation of hyaluronic acid or peroral preparations acting against bacteria directly in the bladder, including D-mannose, is recommended.
- Klíčová slova
- D-manóza,
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- cystitida farmakoterapie MeSH
- hexosy * aplikace a dávkování farmakologie metabolismus MeSH
- infekce močového ústrojí * farmakoterapie prevence a kontrola MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
