- MeSH
- Glucagon-Like Peptide 1 * administration & dosage adverse effects MeSH
- Hypoglycemic Agents administration & dosage adverse effects MeSH
- Drug Interactions MeSH
- Drug Prescriptions * MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- General Practice MeSH
- Insurance, Health, Reimbursement MeSH
- Check Tag
- Humans 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, Type 1 * drug therapy blood psychology MeSH
- Adult MeSH
- Hypoglycemic Agents * administration & dosage therapeutic use MeSH
- Injections, Subcutaneous MeSH
- Insulin * administration & dosage therapeutic use MeSH
- Insulin Infusion Systems * MeSH
- Blood Glucose MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Patient Satisfaction * MeSH
- Infusions, Subcutaneous MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
AIM: To determine whether people with type 1 diabetes (T1D) initiating glucose sensor monitoring experience greater improvements in HbA1c when provided with education on carbohydrate counting and flexible insulin dosing than those who do not receive nutrition education. MATERIALS AND METHODS: Our retrospective observational study included 329 people with T1D initiating glucose sensor monitoring between 2015 and 2021. The participants were divided into two groups: one group attended at least one structured educational session with a registered dietitian (n = 126), while the other group did not receive structured education (n = 203). After 12 months of glucose sensor initiation, we compared glycaemic outcomes and CGM metrics between the two groups. RESULTS: At glucose sensor initiation, both groups with and without education had similar HbA1c levels (7.64% [60.0 mmol/mol] vs. 7.66% [60.2 mmol/mol]). After twelve months, the education group demonstrated greater improvement in glycemic outcomes (HbA1c 7.17% [54.9mmol/mol] vs. 7.37% [57.1 mmol/mol], p < 0.05) and spent significantly more time in the target range than did the group without structured education (68.8% vs. 64.1%, p < 0.05). We observed an inverse correlation between the number of completed educational sessions and HbA1c after 12 months, as well as between the number of educational sessions and the change in HbA1c. CONCLUSIONS: People with T1D who initiated glucose sensor monitoring alongside nutrition education showed greater improvements in HbA1c and increased time spent in the target glucose range compared to individuals who did not receive structured education. TRAIL REGISTRATION: ClinicalTrials.gov identifier: NCT06264271.
- MeSH
- Diabetes Mellitus, Type 1 * blood MeSH
- Adult MeSH
- Glycated Hemoglobin * analysis metabolism MeSH
- Hypoglycemic Agents administration & dosage MeSH
- Insulin administration & dosage MeSH
- Blood Glucose * analysis metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Glycemic Control MeSH
- Retrospective Studies MeSH
- Blood Glucose Self-Monitoring * MeSH
- Patient Education as Topic * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
AIMS: To assess the efficacy and safety of switching from premixed insulin to a once-daily, fixed-ratio combination of insulin glargine 100 U/mL + lixisenatide (iGlarLixi) in people with type 2 diabetes (T2D). METHODS: In this phase 4, 24-week, single-arm study, participants switched from once-daily or twice-daily premixed insulin to iGlarLixi (EudraCT number 2021-003711-25). Key inclusion criteria: ≥18 years; premixed insulin therapy for ≥3 months and < 10 years; ± 1-2 oral antidiabetic drugs (OADs); HbA1c ≥7.5% to ≤10.0%. The primary endpoint was the change in HbA1c from baseline to Week 24. Secondary endpoints included: participants achieving HbA1c <7% and change in body weight at Week 24, and safety. RESULTS: Overall, 162 participants switched to iGlarLixi (89.5% from twice-daily premixed insulin); mean duration of diabetes was 15.7 (standard deviation [SD]: 8.3) years. Mean baseline HbA1c (8.5%) reduced by least squares (LS) mean of 1.2% (95% confidence interval [CI]: -1.4, -1.1) at Week 24, and 37.6% of participants had achieved an HbA1c target of <7% (95% CI: 30.0, 45.7). LS mean body weight change from baseline to Week 24 was -1.0 kg (95% CI: -1.6, -0.5). Fasting and post-prandial plasma glucose decreased from baseline to Week 24 by 45.6 mg/dL (SD ± 52.4) and 67.6 mg/dL (SD ± 65.1), respectively. Confirmed symptomatic hypoglycaemia occurred in 38.3% of participants (ADA level 1: 35.8%; level 2: 15.4%; level 3: 0.0%). CONCLUSIONS: iGlarLixi initiation was associated with improved glycaemic control, without body weight gain or increased hypoglycaemia over 24 weeks.
- MeSH
- Diabetes Mellitus, Type 2 * drug therapy blood MeSH
- Adult MeSH
- Drug Combinations MeSH
- Glycated Hemoglobin analysis MeSH
- Hypoglycemia chemically induced MeSH
- Hypoglycemic Agents * administration & dosage adverse effects therapeutic use MeSH
- Insulin Glargine * administration & dosage adverse effects therapeutic use MeSH
- Blood Glucose drug effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Drug Substitution * MeSH
- Peptides * administration & dosage adverse effects therapeutic use MeSH
- Glucagon-Like Peptide-2 Receptor MeSH
- Drug Administration Schedule MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase IV MeSH
- Multicenter Study MeSH
Nealkoholová tuková choroba jater (NAFLD), jež patří mezi nejvýznamnější chronické jaterní choroby a má úzký vztah k metabolickému syndromu, byla v květnu 2023 přejmenována na s metabolismem asociovanou steatotickou chorobu jater (MASLD). Tato choroba v posledních dekádách zažívá celosvětový nárůst prevalence, jež aktuálně činí 32 % především v souvislosti se zvýšením počtu obézních pacientů ve všech regionech a kopíruje nárůst prevalence metabolického syn- dromu. Po této chorobě je potřebné aktivně pátrat a využívat dostupných diagnostických nástrojů, jež tuto nemoc nejen odhalí, ale pomůžou i vyselektovat rizikové pacienty, u kterých hrozí progrese onemocnění do významné jaterní fibrózy a cirhózy. Pacienti s MASLD však nejsou ohroženi jen jaterními komorbiditami, ale v důsledku provázanosti s metabolickým syndromem mají vyšší výskyt jeho jednotlivých komponent a dominují u nich především kardiovaskulární komplikace. Terapeutickým základem jsou především dietní a pohybová opatření, ale hledá se také účinná farmakoterapie. Při selhání konzervativních metod léčby můžeme u obézních pacientů využít možnosti bariatrické chirurgie a endoskopie.
Non-alcoholic fatty liver disease (NAFLD) is one of the most important chronic liver diseases, which is closely related to metabolic syndrome. It was renamed to metabolic-dysfunction-associated steatotic liver disease (MASLD) in May 2023. In recent decades, this disease has experienced a global prevalence increase, which is currently 32 %, mainly in connection with the increase of obese patients in all regions. MASLD prevalence copies the increase of metabolic syndrome. It is necessary to actively search for this disease and use available diagnostic tools, which will detect this disease and also will help with selection of high-risk patients who are at risk of progression of this disease to significant liver fibrosis and cirrhosis. However, patients with MASLD are not only at risk of liver comorbidities, but due to their interconnection with metabolic syndrome, they have a higher incidence of its components. Dominant comorbidities are cardiovascular diseases. The main therapeutic approach is dietary and exercise measures, but we are looking for effective pharmacotherapy. If conservative treatment methods fail, we can use the option of bariatric surgery and endoscopy in obese patients.
- MeSH
- Bariatrics MeSH
- Hypoglycemic Agents administration & dosage pharmacology therapeutic use MeSH
- Liver Cirrhosis diagnosis etiology prevention & control MeSH
- Humans MeSH
- Metabolic Syndrome complications therapy MeSH
- Non-alcoholic Fatty Liver Disease * diagnosis pathology therapy MeSH
- Liver Diseases MeSH
- Healthy Lifestyle MeSH
- Fatty Liver diagnosis etiology therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Canagliflozin * administration & dosage MeSH
- Diabetes Mellitus, Type 2 * drug therapy MeSH
- Sodium-Glucose Transporter 2 Inhibitors administration & dosage MeSH
- Hypoglycemic Agents administration & dosage MeSH
- Cardiovascular Agents MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- Heart Disease Risk Factors MeSH
- Check Tag
- Humans MeSH
Paní V. R., 66 let, od 30 let věku (1988) trvá klidná cholecystolitiáza, od 45 let věku (2003) diabetes mellitus 2. typu (HbA1c v normě, ale oGTT pozitivní), zvýšená koncentrace triacylglycerolů a hypertenze. Zpočátku jí byla doporučena pouze dieta, od roku 2006 do počátku roku 2022 byla léčena metforminem, repaglinidem, fenofibrátem a antihypertoniky, přičemž HbA1c dosahoval 60 mmol/mol a tělesná hmotnost kolísala v rozmezí 74–79 kg. V roce 2021 byla zjištěna steatóza jater vyššího stupně. V únoru 2022 byl místo repaglinidu nasazen agonista inkretinových receptorů semaglutid a v dubnu 2023 přidán atorvastatin. Pacientka začala používat osobní glukometr a od října 2023 kontinuální monitor glykemie FreeStyle Libre 2. Od nasazení semaglutidu do poslední kontroly 13. 5. 2024 se HbA 1c snížil z 58 na 43 mmol/mol, tělesná hmotnost poklesla z 77 na 63 kg a při tranzientní elastografii již známky steatózy jater v regresi. Od doplnění léčby atorvastatinem v dubnu 2022 se hodnota LDL cholesterolu snížila z 3,1 na 2,5 mmol/l. Pacientka se po celou dobu léčby tabletovým semaglutidem cítí dobře. Neobjevily se žádné nežádoucí účinky.
Mrs. V.R., 66 years old, from the age of 30 (1988) suffering from quiescent cholecystolithiasis, from the age of 45 (2003) type 2 diabetes mellitus (HbA 1c normal, but oGTT positive), increased concentration of triacylglycerols and hypertension. Initially, only a diet was recom- mended, then she was treated with metformin, repaglinide, fenofibrate and antihypertonics from 2006 to the beginning of 2022, while HbA1c reached 60 mmol/mol with body weight fluctuating between 74 and 79 kg. In 2021, higher degree of steatosis of the liver was detected. Since February 2022, the incretin receptor agonist semaglutide was used instead of repaglinide, and atorvastatin was added in April 2023. The patient started using a personal glucometer, and from October 2023 the FreeStyle Libre 2 continuous blood glucose monitor. From the initiation of semaglutide treatment to the last check-up on 13/05/2024, HbA1c decreased from 58 to 43 mmol/mol, body weight decreased from 77 to 63 kg, and during transient elastography the signs of liver steatosis have already disappeared. Since the addition of atorvastatin treatment in April 2022, the value of LDL cholesterol decreased from 3.1 to 2.5 mmol/l. The patient feels well throughout the semaglutide tablet treatment. There were no adverse effects.
- MeSH
- Glucagon-Like Peptide-1 Receptor Agonists administration & dosage MeSH
- Diabetes Mellitus, Type 2 * drug therapy MeSH
- Glucagon-Like Peptides * administration & dosage MeSH
- Glycated Hemoglobin MeSH
- Hypoglycemic Agents administration & dosage MeSH
- Carbamates administration & dosage MeSH
- Comorbidity MeSH
- Continuous Glucose Monitoring MeSH
- Humans MeSH
- Drug Substitution methods MeSH
- Non-alcoholic Fatty Liver Disease drug therapy MeSH
- Piperidines administration & dosage MeSH
- Aged MeSH
- Body Weight Changes MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Keywords
- iGlarLixi, SoliSimplify,
- MeSH
- Diabetes Mellitus, Type 2 * drug therapy MeSH
- Insulin, Long-Acting * administration & dosage MeSH
- Drug Combinations MeSH
- Hypoglycemic Agents administration & dosage MeSH
- Insulin administration & dosage MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Observational Study MeSH
- Comparative Study MeSH
- MeSH
- Glucagon-Like Peptide-1 Receptor Agonists administration & dosage pharmacology therapeutic use MeSH
- Diabetes Mellitus drug therapy MeSH
- Sodium-Glucose Transporter 2 Inhibitors administration & dosage pharmacology therapeutic use MeSH
- Hypoglycemic Agents * administration & dosage pharmacology therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Metformin administration & dosage pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
