PURPOSE: Obesity and its related severe comorbidities are increasing rapidly. The duodenal-jejunal bypass is an endoscopically implanted device (mimicking the Roux-en-Y gastric bypass) developed to support weight reduction and improve type 2 diabetes control. MATERIALS AND METHODS: Retrospective data analysis of consecutive patients undergoing duodenal-jejunal bypass (EndoBarrier®, DJB) implantation between 2013 and 2017 was performed to evaluate safety as well as short- and long-term efficacy. RESULTS: One hundred and twenty-one patients (mean BMI of 43.1 ± 7.2 kg/m2 and weight of 138.2 ± 28.6 kg) underwent DJB implantation. The mean dwelling time was 15.5 months, the mean total body weight loss (%TBWL) after explantation was 10.3% ± 7.9% (14.2 kg, p < 0.0001), and the mean BMI was 39.5 ± 7.3 kg/m2 (p < 0.0001). There was no significant weight gain 24 months after the explantation. Seventy-seven patients had type 2 diabetes mellitus (T2DM) with a mean HbA1c before implantation of 5.6% (n = 52). The mean HbA1c after explantation was 5.1% (p = 0.0001). Significant reductions in transaminase and lipid levels before and after explantation were observed. One complication occurred during implantation and another during explantation. In 16 patients, the device had to be extracted earlier than expected (7 for severe adverse events and 9 for adverse events; 13.2%). CONCLUSION: Despite an evident rate of adverse events, the DJB shows promise as a weight-loss procedure. Our results show that some patients implanted with the device maintained reduced weight even 24 months after explantation, while many improved T2DM control.
- MeSH
- diabetes mellitus 2. typu * chirurgie komplikace MeSH
- duodenum chirurgie MeSH
- glykovaný hemoglobin MeSH
- hmotnostní úbytek MeSH
- jejunum chirurgie MeSH
- lidé MeSH
- morbidní obezita * chirurgie MeSH
- obezita chirurgie komplikace MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- žaludeční bypass * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Inhibítory sodíko-glukózového kotransportéra 2 (SGLT2i), resp. gliflozíny sú modernou skupinou antidiabetických liekov v liečbe pacientov s diabetes mellitus 2. typu (DM2T). Kanagliflozín okrem dobrej glykemickej kontroly, nízkeho rizika hypoglykémie a poklesu telesnej hmotnosti vykazuje signifikantný kardiovaskulárny a nefroprotektívny benefit v liečbe pacientov s DM2T porovnateľný s ostatnými gliflozínmi (empagliflozín, dapagliflozín). Liečba kanagliflozínom sa môže potenciálne spájať s nižším rizikom cievnej mozgovej príhody dôsledkom inhibície SGLT1. Výskyt nežiaducich účinkov, ako sú zvýšené riziko infekcie močových ciest, najmä vaginálne kandidózy u žien, euglykemická ketoacidóza a deplécia objemu spojená s hypotenziou, je porovnateľný v celej skupine gliflozínov.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors, gliflozins are a modern class of diabetic medications in the treatment of patients with type 2 diabetes mellitus (T2DM). Apart from good glycemic control, low risk of hypoglycemia and weight loss, canagliflozin has been shown to provide significant cardiovascular and nephroprotective benefit in patients with T2DM co-equal to other gliflozines (empagliflozin, dapagliflozin). Treatment with canagliflozin is potentially associated with lower risk of stroke due to inhibition of SGLT1. Incidence of adverse side effects such as increased risk of urinary infections, mainly vaginal candidosis in female, euglycemic ketoacidosis and volume depletion with hypotension is comparable in whole group of gliflozines.
- MeSH
- canagliflozin * aplikace a dávkování farmakologie terapeutické užití MeSH
- chronická renální insuficience farmakoterapie prevence a kontrola MeSH
- diabetes mellitus 2. typu farmakoterapie MeSH
- diabetické nefropatie farmakoterapie prevence a kontrola MeSH
- glifloziny farmakologie terapeutické užití MeSH
- kardiovaskulární nemoci farmakoterapie prevence a kontrola MeSH
- lidé MeSH
- nemoci ledvin farmakoterapie prevence a kontrola MeSH
- Check Tag
- lidé MeSH
Introduction: Olive (Olea uropeae) is a traditional plant containing oleuropein and hydroxytyrosol, which are useful and used empirically for treating diabetes mellitus.Objective: To review the potential of oleuropein and hydroxytyrosol as an evidence base for diabetes potential treatment and safety.Methods: This chapter summarizes several studies available on Pubmed and Google Scholar regarding the characteristic method and extraction method as well as the effectiveness and toxicity of oleuropein and hydroxytyrosol in vitro and in vivo.Result: Oleuropein and hydroxytyrosol are effective antihyperglycemics for treating T2D. They can reduce body weight, basal glycemia, and insulin resistance by stopping the liver from making glucose and stopping the body from absorbing glucose. Several studies have shown that both isolates can control glycemic levels equivalent to free fatty acids and are safe to use.Conclusion: Oleuropein and hydroxytyrosol are extracted by several methods and can be used as potential anti-diabetics with obesity risk factors. Evidence shows that both isolates are safe for both acute and chronic use.
- Klíčová slova
- oleuropein, hydroxytyrosol,
- MeSH
- diabetes mellitus 2. typu farmakoterapie metabolismus MeSH
- hypoglykemika * farmakologie terapeutické užití MeSH
- inzulinová rezistence MeSH
- iridoidy farmakologie terapeutické užití MeSH
- lidé MeSH
- Olea * fyziologie MeSH
- rostlinné extrakty * farmakologie terapeutické užití MeSH
- testy toxicity metody MeSH
- Check Tag
- lidé MeSH
- MeSH
- bariatrická chirurgie * metody škodlivé účinky MeSH
- diabetes mellitus 2. typu terapie MeSH
- léčba obezity MeSH
- lidé MeSH
- obezita komplikace terapie MeSH
- pooperační péče MeSH
- týmová péče o pacienty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- agonisté receptoru pro glukagonu podobný peptid 1 aplikace a dávkování farmakologie terapeutické užití MeSH
- diabetes mellitus 2. typu farmakoterapie MeSH
- glifloziny aplikace a dávkování farmakologie terapeutické užití MeSH
- hypoglykemika aplikace a dávkování farmakologie terapeutické užití MeSH
- látky proti obezitě aplikace a dávkování farmakologie škodlivé účinky terapeutické užití MeSH
- léčba obezity MeSH
- lidé MeSH
- obezita * farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- semaglutid,
- MeSH
- agonisté receptoru pro glukagonu podobný peptid 1 * aplikace a dávkování MeSH
- chronická renální insuficience * komplikace MeSH
- diabetes mellitus 2. typu farmakoterapie komplikace MeSH
- hodnoty glomerulární filtrace účinky léků MeSH
- kardiovaskulární nemoci komplikace mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
Significance: Glucose-induced lipid metabolism is essential for preserving functional β-cells, and its disruption is linked to type 2 diabetes (T2D) development. Lipids are an integral part of the cells playing an indispensable role as structural components, energy storage molecules, and signals. Recent Advances: Glucose presence significantly impacts lipid metabolism in β-cells, where fatty acids are primarily synthesized de novo and/or are transported from the bloodstream. This process is regulated by the glycerolipid/free fatty acid cycle, which includes lipogenic and lipolytic reactions producing metabolic coupling factors crucial for insulin secretion. Disrupted lipid metabolism involving oxidative stress and inflammation is a hallmark of T2D. Critical Issues: Lipid metabolism in β-cells is complex involving multiple simultaneous processes. Exact compartmentalization and quantification of lipid metabolism and its intermediates, especially in response to glucose or chronic hyperglycemia, are essential. Current research often uses non-physiological conditions, which may not accurately reflect in vivo situations. Future Directions: Identifying and quantifying individual steps and their signaling, including redox, within the complex fatty acid and lipid metabolic pathways as well as the metabolites formed during acute versus chronic glucose stimulation, will uncover the detailed mechanisms of glucose-stimulated insulin secretion. This knowledge is crucial for understanding T2D pathogenesis and identifying pharmacological targets to prevent this disease. Antioxid. Redox Signal. 41, 865-889.
- Klíčová slova
- bimekizumab,
- MeSH
- biologická terapie * metody MeSH
- diabetes mellitus 2. typu komplikace MeSH
- humanizované monoklonální protilátky terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- methotrexát aplikace a dávkování škodlivé účinky MeSH
- progrese nemoci MeSH
- psoriáza * farmakoterapie komplikace MeSH
- terapie neúspěšná MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH