BACKGROUND: Hyperkalaemia is a life-threatening electrolyte disturbance and also a potential cause of cardiac arrest. The objective was to assess the effects of acute pharmacological interventions for the treatment of hyperkalaemia in patients with and without cardiac arrest. METHODS: The review was reported according to PRISMA guidelines and registered on PROSPERO (CRD42023440553). We searched OVID Medline, EMBASE, and CENTRAL on September 9, 2024 for randomized trials, non-randomized trials, observational studies, and experimental animal studies. Two investigators performed abstract screening, full-text review, data extraction, and bias assessment. Outcomes included potassium levels, ECG findings, and clinical outcomes. Certainty of evidence was evaluated using GRADE. RESULTS: A total of 101 studies were included, with two studies including patients with cardiac arrest. In meta-analyses including adult patients without cardiac arrest, treated with insulin in combination with glucose, inhaled salbutamol, intravenous salbutamol dissolved in glucose, or a combination, the average reduction in potassium was between 0.7 and 1.2 mmol/l (very low to low certainty of evidence). The use of bicarbonate had no effect on potassium levels (very low certainty of evidence). In neonatal and paediatric populations, inhaled salbutamol and intravenous salbutamol reduced the average potassium between 0.9 and 1.0 mmol/l (very low to low certainty of evidence). There was no evidence to support a clinical beneficial effect of calcium for treatment of hyperkalemia. CONCLUSIONS: Evidence supports treatment with insulin in combination with glucose, inhaled or intravenous sal-butamol, or the combination. No evidence supporting a clinical effect of calcium or bicarbonate for hyperkalaemia was identified.

• MeSH
• albuterol * aplikace a dávkování   terapeutické užití   MeSH
• aplikace inhalační MeSH
• draslík krev   MeSH
• glukosa aplikace a dávkování   MeSH
• hydrogenuhličitany aplikace a dávkování   MeSH
• hyperkalemie * farmakoterapie   MeSH
• inzulin * aplikace a dávkování   terapeutické užití   MeSH
• lidé MeSH
• srdeční zástava farmakoterapie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

BACKGROUND: Since many acutely admitted older adults display signs of dehydration, treatment using balanced crystalloids is an important part of medical care. Additionally, many of these patients suffer from chronic malnutrition. We speculated that the early addition of glucose might ameliorate the hospital-related drop of caloric intake and modify their catabolic status. METHODS: We included patients 78 years and older, admitted acutely for non-traumatic illnesses. The patients were randomized into either receiving balanced crystalloid (PlasmaLyte; group P) or balanced crystalloid enriched with 100 g of glucose per liter (group G). The information about fluid balance and levels of minerals were collected longitudinally. RESULTS: In the G group, a significantly higher proportion of patients developed signs of refeeding syndrome, i.e., drops in phosphates, potassium and/or magnesium when compared to group P (83.3 vs. 16.7%, p < 0.01). The drop in phosphate levels was the most pronounced. The urinalysis showed no differences in the levels of these minerals in the urine, suggesting their uptake into the cells. There were no differences in the in-hospital mortality or in the 1-year mortality. CONCLUSION: The short-term administration of balanced crystalloids with glucose induced an anabolic shift of electrolytes in acutely admitted older adults.

• MeSH
• dehydratace terapie   MeSH
• glukosa * metabolismus   aplikace a dávkování   MeSH
• krystaloidní roztoky aplikace a dávkování   MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• potravní doplňky MeSH
• realimentační syndrom prevence a kontrola   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tekutinová terapie * metody   MeSH
• vodní a elektrolytová rovnováha MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Správná koncentrace glukózy v krvi – glykémie je životně důležitá pro řadu orgánů. Nejdůležitějším je mozek. Glykémii ovlivňuje řada hormonů a buněčných signalizačních působků. Hypoglykémie je pro organismus potentní stresový faktor, proti kterému se brání akutní regulační a dlouhodobou adaptační reakcí. Rychlou změnou hypoglykémie na hyperglykémii sice zvrátíme život ohrožující stav pacienta, ale reperfuze mozku krví bohatou na glukózu působí na neurony do jisté míry ještě více negativně. Léčba hypoglykémie by měla z tohoto hlediska být pozvolná a opatrná.

The optimal concentration of glucose in the blood – glycemia is vital for many organs. The most important is the brain. Glycemia is affected by several hormones and cellular signaling molecules. Hypoglycemia is a potent stress factor for the body which is prevented by an acute regulatory and long–term adaptation reaction. By rapidly changing hypoglycemia to hyperglycemia, we reverse the patient’s life-threatening condition, but reperfusion of the brain with glucose-rich blood has a somewhat even more negative effect on neurons. Treatment of hypoglycemia should be gradual and careful from this point of view.

• MeSH
• glukosa aplikace a dávkování   terapeutické užití   MeSH
• hypoglykemie * patofyziologie   terapie   MeSH
• lidé MeSH
• urgentní zdravotnické služby MeSH
• Check Tag
• lidé MeSH

The glycemic response to ingested glucose for the treatment of hypoglycemia following exercise in type 1 diabetes patients has never been studied. Therefore, we aimed to characterize glucose dynamics during a standardized bout of hypoglycemia-inducing exercise and the subsequent hypoglycemia treatment with the oral ingestion of glucose. Ten male patients with type 1 diabetes performed a standardized bout of cycling exercise using an electrically braked ergometer at a target heart rate (THR) of 50% of the individual heart rate reserve, determined using the Karvonen equation. Exercise was terminated when hypoglycemia was reached, followed by immediate hypoglycemia treatment with the oral ingestion of 20 g of glucose. Arterialized blood glucose (ABG) levels were monitored at 5 min intervals during exercise and for 60 min during recovery. During exercise, ABG decreased at a mean rate of 0.11 ± 0.03 mmol/L·min-1 (minimum: 0.07, maximum: 0.17 mmol/L·min-1). During recovery, ABG increased at a mean rate of 0.13 ± 0.05 mmol/L·min-1 (minimum: 0.06, maximum: 0.19 mmol/L·min-1). Moreover, 20 g of glucose maintained recovery from hypoglycemia throughout the 60 min postexercise observation window.

• MeSH
• aplikace orální MeSH
• cvičení * MeSH
• cyklistika MeSH
• diabetes mellitus 1. typu krev   farmakoterapie   MeSH
• dospělí MeSH
• glukosa aplikace a dávkování   MeSH
• hypoglykemie farmakoterapie   MeSH
• inzulin krev   MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• pilotní projekty MeSH
• srdeční frekvence MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

We have recently demonstrated that a high-fat load can induce immediate increase in hepatic fat content (HFC) and that such an effect can be modified differently by co-administration of fructose or glucose in healthy subjects. Therefore, we addressed the question how consumption of these nutrients affects changes in HFC in subjects with non-alcoholic fatty liver disease (NAFLD). Eight male non-obese non-diabetic patients with NAFLD underwent 6 experiments each lasting 8 hours: 1. fasting, 2. high-fat load (150 g of fat (dairy cream) at time 0), 3. glucose (three doses of 50 g at 0, 2, and 4 hours), 4. high-fat load with three doses of 50 g of glucose, 5. fructose (three doses of 50 g at 0, 2, and 4 hours), 6. high-fat load with three doses of 50 g of fructose. HFC was measured using magnetic resonance spectroscopy prior to meal administration and 3 and 6 hours later. Plasma triglycerides, non-esterified fatty acids, glucose and insulin were monitored throughout each experiment. HFC increased by 10.4 ± 6.9% six hours after a high-fat load and by 15.2 ± 12.5% after high-fat load with fructose. When co-administering glucose with fat, HFC rose only transiently to return to baseline at 6 hours. Importantly, NAFLD subjects accumulated almost five times more fat in their livers than healthy subjects with normal HFC. Consumption of a high-fat load results in fat accumulation in the liver of NAFLD patients. Fat accumulation after a fat load is diminished by glucose but not fructose co-administration.

• MeSH
• dieta s vysokým obsahem tuků škodlivé účinky   MeSH
• fruktosa aplikace a dávkování   metabolismus   MeSH
• glukosa aplikace a dávkování   metabolismus   MeSH
• inzulin krev   MeSH
• játra metabolismus   patofyziologie   MeSH
• krevní glukóza analýza   MeSH
• kyseliny mastné neesterifikované krev   MeSH
• lidé MeSH
• magnetická rezonanční spektroskopie MeSH
• nealkoholová steatóza jater patofyziologie   MeSH
• triglyceridy krev   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

• Klíčová slova
• Baqsimi (nosní aplikace glukagonu),
• MeSH
• dítě MeSH
• glukagon aplikace a dávkování   MeSH
• glukosa aplikace a dávkování   MeSH
• hypoglykemie * etiologie   farmakoterapie   klasifikace   MeSH
• lidé MeSH
• Check Tag
• dítě MeSH
• lidé MeSH

Transcript levels for selected ATP synthase membrane FO-subunits-including DAPIT-in INS-1E cells were found to be sensitive to lowering glucose down from 11 mM, in which these cells are routinely cultured. Depending on conditions, the diminished mRNA levels recovered when glucose was restored to 11 mM; or were elevated during further 120 min incubations with 20-mM glucose. Asking whether DAPIT expression may be elevated by hyperglycemia in vivo, we studied mice with hyaluronic acid implants delivering glucose for up to 14 days. Such continuous two-week glucose stimulations in mice increased DAPIT mRNA by >5-fold in isolated pancreatic islets (ATP synthase F1α mRNA by 1.5-fold). In INS-1E cells, the glucose-induced ATP increment vanished with DAPIT silencing (6% of ATP rise), likewise a portion of the mtDNA-copy number increment. With 20 and 11-mM glucose the phosphorylating/non-phosphorylating respiration rate ratio diminished to ~70% and 96%, respectively, upon DAPIT silencing, whereas net GSIS rates accounted for 80% and 90% in USMG5/DAPIT-deficient cells. Consequently, the sufficient DAPIT expression and complete ATP synthase assembly is required for maximum ATP synthesis and mitochondrial biogenesis, but not for insulin secretion as such. Elevated DAPIT expression at high glucose further increases the ATP synthesis efficiency.

• MeSH
• adenosintrifosfát metabolismus   MeSH
• beta-buňky cytologie   účinky léků   metabolismus   MeSH
• buněčné kultury MeSH
• buněčné linie MeSH
• glukosa aplikace a dávkování   farmakologie   MeSH
• konformace proteinů MeSH
• krysa rodu rattus MeSH
• kyselina hyaluronová chemie   MeSH
• membránové proteiny chemie   genetika   metabolismus   MeSH
• mitochondriální DNA účinky léků   genetika   MeSH
• mitochondrie účinky léků   genetika   metabolismus   MeSH
• molekulární modely MeSH
• myši MeSH
• upregulace * MeSH
• variabilita počtu kopií segmentů DNA účinky léků   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Our study aim was to assess how the macronutrient intake during total parenteral nutrition (TPN) modulates plasma total free fatty acids (FFAs) levels and individual fatty acids in critically ill patients. METHOD: Adult patients aged 18-80, admitted to the intensive care unit (ICU), who were indicated for TPN, with an expected duration of more than three days, were included in the study. Isoenergetic and isonitrogenous TPN solutions were given with a major non-protein energy source, which was glucose (group G) or glucose and lipid emulsions (Smof lipid; group L). Blood samples were collected on days 0, 1, 3, 6, 9, 14, and 28. RESULTS: A significant decrease (p < 0.001) in total FFAs occurred in both groups with a bigger decrease in group G (p < 0.001) from day 0 (0.41 ± 0.19 mmol∙L-1) to day 28 (0.10 ± 0.07 mmol∙L-1). Increased palmitooleic acid and decreased linoleic and docosahexaenoic acids, with a trend of increased mead acid to arachidonic acid ratio, on day 28 were observed in group G in comparison with group L. Group G had an insignificant increase in leptin with no differences in the concentrations of vitamin E, triacylglycerides, and plasminogen activator inhibitor-1. CONCLUSION: Decreased plasma FFA in critically ill patients who receive TPN may result from increased insulin sensitivity with a better effect in group G, owing to higher insulin and glucose dosing and no lipid emulsions. It is advisable to include a lipid emulsion at the latest from three weeks of TPN to prevent essential fatty acid deficiency.

• MeSH
• alfa-tokoferol krev   MeSH
• emulze aplikace a dávkování   MeSH
• esenciální mastné kyseliny krev   nedostatek   MeSH
• glukosa aplikace a dávkování   MeSH
• inzulinová rezistence fyziologie   MeSH
• jednotky intenzivní péče MeSH
• kritický stav terapie   MeSH
• kyseliny mastné neesterifikované krev   MeSH
• leptin krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy aplikace a dávkování   MeSH
• parenterální výživa úplná metody   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

• MeSH
• enterální výživa metody   MeSH
• glukosa aplikace a dávkování   terapeutické užití   MeSH
• lidé MeSH
• metabolismus sacharidů MeSH
• nutriční podpora metody   MeSH
• parenterální výživa metody   MeSH
• sacharidy * aplikace a dávkování   terapeutické užití   MeSH
• Check Tag
• lidé MeSH

Hypoglykemie u diabetes mellitus je spojena především s terapií inzulinem, deriváty sulfonylurey a glinidů. Její léčba je založena na včasném podání sacharidů, v ideálním případě glukózy. Za optimální množství je považováno 15–20 g, některé současné studie naznačují oprávněnost podávání množství glukózy přepočtené na kilogram hmotnosti. Pro léčbu těžké hypoglykemie je v laickém provedení určen glukagon, v profesionálním především intravenózně podaná glukóza.

Hypoglycemia is a side effect of the therapy primarily with insulin, sulphonylurea derivates and glinides. Its therapy is based on the immediate ingestion of sacharides, preferably glucose. Amount of 15–20 g is recommended as its optimal dose, although several recent studies are suggesting amount related to the patient´s weight. The therapy of severe hypoglycemia in the non-professional settings is based on glucagon injection, in the professional ones intravenous administration of glucose is preferable option.

• MeSH
• diabetes mellitus 1. typu komplikace   MeSH
• diabetes mellitus 2. typu komplikace   MeSH
• glukagon aplikace a dávkování   terapeutické užití   MeSH
• glukosa aplikace a dávkování   terapeutické užití   MeSH
• hypoglykemie * terapie   MeSH
• komplikace diabetu terapie   MeSH
• lidé MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH