• MeSH
• Diabetes Mellitus, Type 1 diagnosis   drug therapy   immunology   pathology   MeSH
• Adult MeSH
• Hospitalization MeSH
• Hyperglycemia drug therapy   prevention & control   MeSH
• Insulin therapeutic use   MeSH
• Continuous Glucose Monitoring * instrumentation   MeSH
• Humans MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

S vývojom imunosupresívnych režimov a operačných techník sa zlepšilo prežívanie pacientov po transplantácii (Tx) solídnych orgánov, následkom čoho sa zvýšil rozvoj metabolických komplikácií. Potransplantačný diabetes mellitus (PTDM) je závažná a častá metabolická komplikácia po Tx solídnych orgánov. Okrem typických rizikových faktorov, ktoré sa spolupodieľajú na vzniku diabetes mellitus, významnú úlohu zohrávajú pri PTDM aj faktory späté s Tx a nasledujúcou liečbou. Ochorenie je spojené s rozvojom komplikácií, a tým so zvýšením nákladov na liečbu pacienta. Identifikácia rizikových jedincov, prevencia vzniku ochorenia, skorá diagnostika v prípade rozvoja PTDM a následná optimálna liečba pomáhajú zlepšiť kvalitu a dĺžku života transplantovaným pacientom.

With the development of immunosuppressive regimens and surgical techniques, the survival of patients after solid organ transplantation (Tx) has improved, resulting in an increase in the development of metabolic complications. Post-transplant diabetes mellitus (PTDM) is a serious and frequent metabolic complication after solid organ Tx. In addition to the typical risk factors that contribute to the development of diabetes mellitus, factors associated with Tx and subsequent treatment play a significant role in PTDM. The disease is associated with the development of complications and thus increased cost of treatment for the patient. Identification of at-risk individuals, prevention of disease development, early diagnosis if PTDM develops, and subsequent optimal treatment help to improve the quality and length of life of transplanted patients.

• MeSH
• Diabetes Mellitus * drug therapy   prevention & control   MeSH
• Hyperglycemia drug therapy   complications   MeSH
• Hypoglycemic Agents administration & dosage   therapeutic use   MeSH
• Immunosuppression Therapy MeSH
• Insulin administration & dosage   therapeutic use   MeSH
• Humans MeSH
• Risk Factors MeSH
• Organ Transplantation adverse effects   MeSH
• Check Tag
• Humans MeSH

• MeSH
• Hyperglycemia complications   MeSH
• Hypoglycemia complications   MeSH
• Humans MeSH
• Nutritional Requirements physiology   MeSH
• Parenteral Nutrition, Total * classification   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Enteral Nutrition * methods   adverse effects   MeSH
• Hyperglycemia * complications   MeSH
• Insulins administration & dosage   pharmacology   MeSH
• Humans MeSH
• Nutritional Requirements physiology   MeSH
• Parenteral Nutrition * methods   standards   adverse effects   MeSH
• Patient Care Team MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Metabolism of fibronectin, the protein that plays a key role in the healing of wounds, is changed in the patients with diabetes mellitus. Fibronectin can interact with other proteins and proteoglycans and organise them to form the extracellular matrix, the basis of the granulation tissue in healing wounds. However, diabetic foot ulcers (DFUs) suffer from inadequate deposition of this protein. Degradation prevails over fibronectin synthesis in the proteolytic inflammatory environment in the ulcers. Because of the lack of fibronectin in the wound bed, the assembly of the extracellular matrix and the deposition of the granulation tissue cannot be started. A number of methods have been designed that prevents fibronectin degradation, replace lacking fibronectin or support its formation in non-healing wounds in animal models of diabetes. The aim of this article is to review the metabolism of fibronectin in DFUs and to emphasise that it would be useful to pay more attention to fibronectin matrix assembly in the ulcers when laboratory methods are translated to clinical practice.

• MeSH
• Diabetes Mellitus * metabolism   MeSH
• Diabetic Foot * therapy   MeSH
• Extracellular Matrix MeSH
• Fibronectins MeSH
• Wound Healing MeSH
• Hyperglycemia * metabolism   MeSH
• Animals MeSH
• Check Tag
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

• MeSH
• Diabetes Mellitus, Type 1 * complications   MeSH
• Epidemiologic Studies MeSH
• Hyperglycemia * epidemiology   MeSH
• Hypoglycemia * epidemiology   MeSH
• Humans MeSH
• Check Tag
• Humans MeSH
• Publication type
• Comment MeSH
• Overall MeSH
• Geographicals
• United States MeSH

INTRODUCTION: Poor adoption of stroke guidelines is a problem internationally. The Quality in Acute Stroke Care (QASC) trial demonstrated significant reduction in death and disability with facilitated implementation of nurse-initiated. METHODS: This was a multi-country, multi-centre, pre-test/post-test study (2017-2021) comparing post implementation data with historically collected pre-implementation data. Hospital clinical champions, supported by the Angels Initiative conducted multidisciplinary workshops discussing pre-implementation medical record audit results, barriers and facilitators to FeSS Protocol implementation, developed action plans and provided education, with ongoing support co-ordinated remotely from Australia. Prospective audits were conducted 3-month after FeSS Protocol introduction. Pre-to-post analysis and country income classification comparisons were adjusted for clustering by hospital and country controlling for age/sex/stroke severity. RESULTS: Data from 64 hospitals in 17 countries (3464 patients pre-implementation and 3257 patients post-implementation) showed improvement pre-to-post implementation in measurement recording of all three FeSS components, all p < 0.0001: fever elements (pre: 17%, post: 51%; absolute difference 33%, 95% CI 30%, 37%); hyperglycaemia elements (pre: 18%, post: 52%; absolute difference 34%; 95% CI 31%, 36%); swallowing elements (pre: 39%, post: 67%; absolute difference 29%, 95% CI 26%, 31%) and thus in overall FeSS Protocol adherence (pre: 3.4%, post: 35%; absolute difference 33%, 95% CI 24%, 42%). In exploratory analysis of FeSS adherence by countries' economic status, high-income versus middle-income countries improved to a comparable extent. DISCUSSION AND CONCLUSION: Our collaboration resulted in successful rapid implementation and scale-up of FeSS Protocols into countries with vastly different healthcare systems.

• MeSH
• Stroke * diagnosis   MeSH
• Fever diagnosis   MeSH
• Hyperglycemia * diagnosis   MeSH
• Humans MeSH
• Deglutition MeSH
• Deglutition Disorders * diagnosis   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Australia MeSH

• MeSH
• Bisoprolol pharmacology   therapeutic use   MeSH
• Diabetes Mellitus, Type 2 complications   therapy   MeSH
• Drug Combinations MeSH
• Hyperglycemia * prevention & control   therapy   MeSH
• Hypoglycemic Agents adverse effects   therapeutic use   MeSH
• Cardiovascular Diseases etiology   mortality   MeSH
• Humans MeSH
• Perindopril pharmacology   therapeutic use   MeSH
• Randomized Controlled Trials as Topic MeSH
• Check Tag
• Humans MeSH

• MeSH
• Acanthosis Nigricans diagnosis   etiology   MeSH
• Androgens MeSH
• Anovulation etiology   MeSH
• Hormonal Contraception MeSH
• Hyperandrogenism diagnosis   etiology   drug therapy   MeSH
• Humans MeSH
• Menstrual Cycle MeSH
• Metabolic Syndrome etiology   complications   MeSH
• Metformin administration & dosage   therapeutic use   MeSH
• Glucose Intolerance diagnosis   MeSH
• Polycystic Ovary Syndrome * diagnosis   etiology   complications   therapy   MeSH
• Ultrasonography MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

BACKGROUND: COVID-19, an infectious disease caused by SARS-CoV-2, was shown to be associated with an increased risk of new-onset diabetes. Mechanisms contributing to the development of hyperglycemia are still unclear. We aimed to study whether hyperglycemia is related to insulin resistance and/or beta cell dysfunction. MATERIALS AND METHODS: Survivors of severe COVID-19 but without a known history of diabetes were examined at baseline (T0) and after 3 (T3) and 6 (T6) months: corticosteroids use, indirect calorimetry, and OGTT. Insulin response and sensitivity (IS) were expressed as insulinogenic (IGI), disposition (DI), and Matsuda insulin sensitivity index (ISI). Resting energy expenditure (REE) and respiratory quotient (RQ) was calculated from the gas exchange and nitrogen losses. RESULTS: 26 patients (out of 37) with complete outcome data were included in the analysis (age ~59.0 years; BMI ~ 30.4, 35% women). Patients were hypermetabolic at T0 (30.3 ± 4.0 kcal/kg lean mass/day, ~120% predicted) but REE declined over 6 months (ΔT6-T0 mean dif. T6-T0 (95% CI): -5.4 (-6.8, -4.1) kcal/kg FFM/day, p < 0.0001). 17 patients at T0 and 13 patients at T6 had hyperglycemia. None of the patients had positive islet autoantibodies. Insulin sensitivity in T0 was similarly low in hyperglycemic (H) and normoglycemic patients (N) (T0 ISIH = 3.12 ± 1.23, ISIN = 3.47 ± 1.78, p = 0.44), whereas insulin response was lower in the H group (DIH = 3.05 ± 1.79 vs DIN = 8.40 ± 5.42, p = 0.003). Over 6 months ISI (ΔT6-T0 mean dif. T6-T0 for ISI (95% CI): 1.84 (0.45, 3.24), p = 0.01)) increased in the H group only. CONCLUSIONS: Patients with severe COVID-19 had increased REE and insulin resistance during the acute phase due to the infection and corticosteroid use, but these effects do not persist during the follow-up period. Only patients with insufficient insulin response developed hyperglycemia, indicating that beta cell dysfunction, rather than insulin resistance, was responsible for its occurrence.

• MeSH
• COVID-19 * complications   MeSH
• Hyperglycemia * MeSH
• Insulin MeSH
• Insulin Resistance * physiology   MeSH
• Blood Glucose MeSH
• Middle Aged MeSH
• Humans MeSH
• Prospective Studies MeSH
• SARS-CoV-2 MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH