Gestačný diabetes mellitus (GDM) je jednou z najčastejších komplikácií v tehotenstve, ktorá vážne ovplyvňuje zdravie matky aj dieťaťa. Cieľom štúdie bolo z dát zdravotnej poisťovne Dôvera (DZP) zistiť prevalenciu GDM v jej kmeni, zmapovať skríning GDM počas tehotenstva a popôrodnú kontrolu pacientok s GDM. V období 2015–2022 bola prevalencia GDM v poistnom kmeni DZP v priemere 12,5 %, pričom za sledované obdobie došlo k signifikantnému nárastu prevalencie GDM z 11,6 % na 13,3 %. Prevalencia GDM signifikantne stúpala aj s vekom tehotných žien. Boli tiež pozorované významné rozdiely v prevalencii v jednotlivých krajoch Slovenska. Pre včasnú diagnostiku GDM sa na Slovensku realizuje skríning prostredníctvom orálneho glukózového tolerančného testu (oGTT), ktorý sa obvykle vykonáva medzi 24.-28. týždňom gravidity. Z analýzy dát DZP vyplýva, že v sledovanom období (2015–2022) bolo počas tehotenstva skrínovaných 58,9 % poisteniek. Ženy s anamnézou GDM majú tiež vyššie riziko rozvoja diabetu 2. typu (DM2T), preto je potrebné u takýchto žien vykonať kontrolu glykémie najneskôr do 6 mesiacov od pôrodu. Popôrodnú kontrolu absolvovala v kmeni DZP do 7 mesiacov od pôrodu necelá štvrtina poisteniek (21,7 %) a do roka po pôrode malo skontrolovanú glykémiu 32,9 % poisteniek.
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy, seriously affecting the health of both mother and baby. The aim of the study was to find out the prevalence of GDM in its tribe, to map the screening of GDM during pregnancy and postpartum follow-up of patients with GDM from data of Dôvera Health Insurance Company (DZP). Between 2015 and 2022, the prevalence of GDM in the DZP among insurees averaged 12.5%, with a significant increase in the prevalence of GDM from 11.6% to 13.3% over the study period. The prevalence of GDM also increased significantly with the age of pregnant women. Significant differences in prevalence were also observed in different regions of Slovakia. For early diagnosis of GDM, screening by oral glucose tolerance test (oGTT) is performed in Slovakia, which is usually performed between 24–28 weeks of gestation. The analysis of DZP data shows that 58.9% of insured women were screened during pregnancy in the study period (2015–2022). Women with a history of GDM also have a higher risk of developing type 2 diabetes mellitus; therefore, glycemic control should be performed in such women no later than 6 months after delivery. Less than one-quarter of insured women (21.7%) in the GDM tribe had a postpartum check within 7 months of delivery, and 32.9% of insured women had their glycemia checked within a year after delivery.
- MeSH
- diabetes mellitus 2. typu etiologie MeSH
- gestační diabetes * diagnóza etiologie prevence a kontrola MeSH
- glukózový toleranční test metody MeSH
- klinická studie jako téma MeSH
- komplikace těhotenství diagnóza MeSH
- krevní glukóza MeSH
- lidé MeSH
- plošný screening metody MeSH
- postnatální péče MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
Cystická fibróza (CF) je autozomálně recesivně dědičné onemocnění. Příčinou jsou mutace CFTR genu, které vedou k dysfunkci chloridového kanálu. Tím dochází ke změně složení a vlastnosti sekretů, v klinickém obraze dominuje hlavně postižení plic a pankreatu. V posledních letech se díky novým terapiím výrazně prodlužuje střední doba života pacientů s CF, ale zároveň stoupá i výskyt komplikací. Jednou z nich je diabetes mellitus vázaný na cystickou fibrózu (cystic fibrosis-related diabetes, CFRD). V současné době má po 30. roce věku problém s porušenou glukózovou tolerancí či přímo s CFRD až 50 % pacientů. Proto je indikován pravidelný screening pomocí oGTT, roli ve včasné diagnostice budou hrát i nové technologie, jako je kontinuální monitorování glukózy pomocí senzorů. Dle současných doporučení je lékem volby při CFRD jednoznačně inzulin, v pokročilých stadiích využíváme léčbu inzulinovou pumpou spolu se senzorem (hybridní uzavřená smyčka). Dieta u CFRD je odlišná od ostatních typů diabetu. Neomezujeme energetický příjem ani příjem tuků. Konzumace sacharidů je limitována pouze částečně, omezení platí zejména pro sladké nápoje.
Cystic fibrosis (CF) is an autosomal recessive disorder. It is caused by mutations in CFTR gene that lead to chloride channel dysfunction and consequent changes in composition and properties of the secrets. The clinical presentation is dominated by the involvement of the lungs and pancreas. Thanks to novel therapies, the life expectancy of CF patients has improved significantly within the past years; anyway, the complication rate has also increased. One of them is cystic fibrosis-related diabetes (CFRD). After the age of 30 years old, up to 50 % of patients are currently developing impaired glucose tolerance or overt CFRD. Therefore regular screening is provided using oGTT, and new technologies such as continuous glucose monitoring (sensor) will also be employed in the near future. According to current guidelines, early insulin treatment is recommended. In advanced stages, insulin pump treatment linked with a sensor (hybrid closed loop system) is helpful. The CFRD diet differs from diets in other types of diabetes. Neither energy nor fat intake is reduced. Carbohydrate consumption is only partially restricted, especially the pop drinks.
Článok prezentuje výsledky štúdie hypoglykemických vlastností medzi 1,2,4-triazolovými derivátmi syntetizovanými na Katedre fyzikálnej a koloidnej chémie Štátnej lekárskej univerzity v Zaporizhzhia. V súčasnosti má veľké množstvo ľudí sedavý spôsob života, aj väčšina ich stravy obsahuje často používané produkty, ktoré zvyšujú hladinu glukózy v krvi, čo môže vyvolať rozvoj závažných ochorení. Preto do dnešného dňa zostáva vytvorenie liekov, ktoré vykazujú hypoglykemickú aktivitu a majú nízku úroveň toxicity, naliehavou úlohou pre lekárne. V prvej fáze nášho výskumu bola vykonaná predpoveď akútnej toxicity. Hypoglykemická aktivita syntetizovaných zlúčenín bola hodnotená vykonaním intraperitoneálneho glukózového tolerančného testu (IPGTT) so zmenou koncentrácie glukózy v krvi zvieraťa po jeho jednorazovom intraperitoneálnom podaní vo forme 40 % roztoku v dávke 2 g/kg telesnej hmotnosti potkana. Zlúčeniny (38) rôznych tried boli študované na hypoglykemickú aktivitu. 2-{5-[(3,4-dimetoxyfenyl)-3H-1,2,4-triazol-3-yl]sulfanyl}acetát zinočnatý (3.18) vykazoval najvyššiu účinnosť z hľadiska schopnosti znižovať krv hladiny glukózy, a to o 27,3 % (približne 1,3-krát).
This article presents the study results of the hypoglycemic properties among 1,2,4-triazole derivatives synthesized at the Department of Physical and Colloidal Chemistry of the Zaporizhzhia State Medical University. Today, many people have a sedentary way of life, also most of their diet contains products that they frequently use, which increase the level of glucose in the blood, which can provoke the development of serious diseases. Therefore, to date, the creation of drugs that exhibit hypoglycemic activity and have a low level of toxicity remains an urgent task for medicine and pharmacy. In the first stage of our research, acute toxicity prediction was performed. The hypoglycemic activity of the synthesized compounds was assessed by performing an intraperitoneal glucose tolerance test (IPGTT) with a change in the blood glucose concentration of the animal after its single intraperitoneal administration in the form of a 40% solution at a dose of 2 g/kg of rat body weight. Thirty-eight compounds of the different classes were studied for hypoglycemic activity. Zinc (II) 2-{5-[(3,4-methoxyphenyl)-3H-1,2,4-triazole-3-yl]thio} acetate (3.18) showed the highest efficiency in terms of the ability to lower blood glucose levels, namely, by 27.3% (approximately 1.3 times).
BACKGROUND/OBJECTIVES: The orexigenic peptide hormone ghrelin has been implicated in the pathophysiology of obesity and type 2 diabetes mellitus through its effects on nutrient homeostasis. Ghrelin is subject to a unique post-translational acyl modification regulating its biochemical activity. SUBJECTS/METHODS: In this study we aimed to investigate the relation of acylated (AcG) as well as unacylated ghrelin (UnG) with body weight and insulin resistance in the fasting (n = 545) and post-oral glucose tolerance test (oGTT) state (n = 245) in a metabolically well characterized cohort covering a broad range of BMI (17.95 kg/m2-76.25 kg/m2). RESULTS: Fasting AcG (median 94.2 pg/ml) and UnG (median 175.3 pg/ml) were negatively and the AcG/UnG ratio was positively correlated with BMI (all p < 0.0001). Insulin sensitivity (ISI) correlated positively with AcG (p = 0.0014) and UnG (p = 0.0004) but not with the AcG/UnG ratio. In a multivariate analysis, including ISI and BMI, only BMI, but not ISI was independently associated with AcG and UnG concentrations. Significant changes of AcG and UnG concentrations were detectable after oGTT stimulation, with slight decreases after 30 min and increases after 90-120 min. Subject stratification into BMI-divergent groups revealed more pronounced AcG increases in the two groups with BMI < 40 kg/m2. CONCLUSION: Our data demonstrate lower concentrations for both AcG and UnG with increasing BMI as well as an increased proportion of the biologically active, acylated form of ghrelin giving point to pharmacologic intervention in ghrelin acylation and/or increase in UnG for treatment of obesity despite decreased absolute AcG levels.
Cieľ práce: Zhodnotenie efektu aplikácie nových odporúčaných postupov pre diagnostiku a skríning gestačného diabetes mellitus (GDM), ktoré vznikli na podklade výsledkov štúdie HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) publikovanej v roku 2008 a iniciovanej IADPSG (International Association of the Diabetes and Pregnancy Study Groups) a ktoré boli akceptované WHO v roku 2013. Metodika a klinický súbor: Prospektívna kohortová štúdia u 1 414 žien s jednoplodovou graviditou podstúpilo kompletný skríning GDM v 1. trimestri a medzi 24.– 28. týždňom v období 3 rokov (2016–2018). Na analýzu výsledkov sme použili dva typy skríningových kritérií (podľa Vestníka MZ SR 2011 a IADPSG). V jednotlivých skupinách sme porovnávali výskyt špecifických materských a perinatálnych komplikácií. Výsledky: V sledovanom súbore bola incidencia GDM pri použití nových kritérií signifikantne vyššia v porovnaní so súborom, u ktorého sme použili súčasné kritériá (n = 144; 10,18 %; resp. n = 68; 4,8 %; p < 0,0001). Po zahrnutí fakultatívneho vyšetrenia v 60. minúte orálneho glykemického tolerančného testu (oGTT) sme GDM diagnostikovali u ďalších 5,52 % (n = 78) žien. Použitím súčasných kritérií sme najvyšší počet pozitívnych tehotných diagnostikovali stanovením glykémie v 120. minúte oGTT (n = 66; 97,1 %), naopak, aplikáciou IADPSG kritérií vyšetrením glykémie nalačno (FPG – Fasting Plasma Glucose) v 1. trimestri (n = 68; 47,2 %) a medzi 24.-28. týždňom (n = 58; 40,3 %). Porovnaním výskytu komplikácií sme zistili štatisticky signifikantný rozdiel medzi súbormi v počte krvných transfúzií (n = 10; 6,9 %; resp. n = 10; 14,7 %; p = 0,0411) a poranení matky a plodu (n = 10; 6,94 %; resp. n = 8; 11,7 %; p = 0,0155). Najčastejšou komplikáciou v oboch súboroch bol sekundárny cisársky rez (n = 52; 36,11 %; resp. n = 30; 44,11 %; p = 0,0084). Záver: Po zavedení nových medzinárodných kritérií pre skríning GDM možno očakávať zvýšenie počtu a odlišné spektrum tehotných žien s GDM, pričom väčšina bude diagnostikovaná na podklade glykémie nalačno. Otázne je, či zvýšenie počtu takto diagnostikovaných a liečených žien po prijatí nových kritérií bude vyvážené adekvátnym poklesom tehotenských komplikácií.
Study aims: Assessment of the effect of new recommended procedure application for a diagnosis and screening of gestational diabetes mellitus, which originated based on the results of the study HAPO (Hyperglycaemia and Adverse Pregnancy Outcomes) published in 2008 and initiated by IADPSG (International Association of the Diabetes and Pregnancy Study Groups), and which were accepted by WHO in 2013. Design and methods: Prospective cohort study in 1414 women with singe-foetal gravidity underwent the complete GDM screening in the first trimester and between 24–28th week in 3 years (2016–1018). We used two types of screening criteria for result analysis (according to the Bulletin of MH SR 2011 and IADPSG). In the particular groups, we compared the incidence of specific maternal and perinatal complications. Results: In the monitored population of patients, the incidence of gestational diabetes with the use of new criteria was significantly higher in comparison with the group where we used present criteria (n – 144, 10.18 %; or n – 68, 4.8 %, p < 0.0001). After inclusion of a facultative examination in the 60th minute of oGTT we diagnosed GDM in other 5.55 % (n – 78) women. Using the present criteria, we diagnosed the highest number of positive pregnant women with the determination of glycaemia in the 120th minute of oGTT (n-66.97 %), on the contrary with the application of IADPSG criteria examining FPG in the first trimester (n=68, 47.2 %) and between the 24–28th week (n = 58, 40.3 %). In comparison of the complication incidence, we detected statistically significant difference between the groups in the number of blood transfusions (n-10, 6.9 %; or n-10, 14.7 %, p – 0.0411) and mother and foetus injury (n – 10, 6.94 %; or n – 8, 11.7 %, p = 0.0155). The Caesarean section was the most frequent complication in both groups (n – 52, 36.11 %; or n=30, 44.11 %, p = 0.0084). Conclusion: After the implementation of new international criteria for GDM screening one can expect an increased number and different spectrum of GDM diagnosed pregnant women, with the majority being detected based on fasting glycaemia. The question is if the increased number of diagnosed and treated women following the new criteria would result in an adequate decrease of pregnancy complications.
Stručné shrnutí doporučeného postupu screeningu gestačního diabetes mellitus v těhotenství.
A brief summarization of guidelines for screening for gestational diabetes mellitus in pregancy.
- MeSH
- gestační diabetes * diagnóza MeSH
- glukózový toleranční test MeSH
- krevní glukóza MeSH
- lidé MeSH
- plošný screening * normy MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
Glucose tolerance represents a complex phenotype in which many tissues play important roles and interact to regulate metabolic homeostasis. Here, we perform an analysis of 13C6-glucose tissue distribution, which maps the metabolome and lipidome across 12 metabolically relevant mouse organs and plasma, with integrated 13C6-glucose-derived carbon tracing during oral glucose tolerance test (OGTT). We measure time profiles of water-soluble metabolites and lipids and integrate the global metabolite response into metabolic pathways. During the OGTT, glucose use is turned on with specific kinetics at the organ level, but fasting substrates like β-hydroxybutyrate are switched off in all organs simultaneously. Timeline profiling of 13C-labeled fatty acids and triacylglycerols across tissues suggests that brown adipose tissue may contribute to the circulating fatty acid pool at maximal plasma glucose levels. The GTTAtlas interactive web application serves as a unique resource for the exploration of whole-body glucose metabolism and time profiles of tissue and plasma metabolites during the OGTT.
- MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- chromatografie kapalinová MeSH
- energetický metabolismus * MeSH
- glukózový toleranční test * MeSH
- hmotnostní spektrometrie s elektrosprejovou ionizací MeSH
- krevní glukóza metabolismus MeSH
- lipidomika MeSH
- lipidy krev MeSH
- metabolom * MeSH
- metabolomika * MeSH
- myši inbrední C57BL MeSH
- tandemová hmotnostní spektrometrie MeSH
- tkáňová distribuce MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Aim: The goal of this study was to establish the level of awareness amongst pregnant women in terms of preparation for an oral glucose tolerance test (oGTT), compare the results of two waves of data collection, and identify the most frequent preanalytical mistakes made in connection to the oGTT. Design: Comparison of 2 cross-sectional studies. Methods: From 2013-2017 two independent questionnaire studies were performed on a total of 477 pregnant women in the Olomouc and Zlín regions. A total of 225 respondents took part in Study 1 (2013-2014), and a total of 252 in Study 2 (2016-2017). Acquired data was analysed using descriptive statistics focused on the substantive significance of the results, as well as inference statistics. Results: Based on the sum index, the overall level of awareness had increased slightly amongst the women in Study 2 (by 0.41 points out of 5), Cohen's d = 0.3 suggests the effect was only mediocre. Fifteen erroneous processes were found. However, these had a decreasing trend once the guidelines had been unified. Conclusion: A more reliable performance of the oGTT in certified laboratories was declared by the respondents in Study 2. The level of awareness, and checking on their adherence to the regime before and during the course of measuring the oGTT in pregnant women was still inadequate. It is necessary to improve pregnant women's awareness of how to perform the oGTT correctly to ensure the least possible distortion of the results.
