"NR7825" Dotaz Zobrazit nápovědu
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
Přeruš. str. : tab., il. ; 30 cm
The study concentrates on defining the food glycacaemic index (GI) by healthy person, type 1 and 2 diabetics. The GI compares the hyperglycaemic ability of certain food and the standard,which is an important characteristic of food. For defining GI we will use sensor continual glucose concentration measurement in the intersticious fluid. The results will be compared with the old method using the 7 values of P-glucose within 120 minutes after food intake. 5 selected foods (bread, yogurt,granola,a mixtureof yogurt and biscuits) will be tested in the group of 20 non diabetic,20 type 1 diabetics,20 type 2 diabetics.Each food will be tested 3 times within 7 days - breakfast, dinner. We will define the GI and it's reliability, GI inter and intraindividual variability. We can compare the GI with the values by the non diabetics and the diabetics. The results will influence the opinion about the optimal diet.
Studie se soustřeďuje na stanovení glykemického indexu (GI) potravin u zdravých osob a u diabetiků 1. a 2. typu. Glykemický index srovnává hyperglykemizující schopnost určité potraviny se standardem (bílý chléb)a je důležitou charakteristikou potraviny.Pro stanovení GI bude použito nové metody pomocí kontinuálního měření koncentrace glukózy v intersticiální tekutině senzorem CGMS, jejíž výsledky budou srovnány s klasickou metodou využívající 7 hodnot P-glukózy v době do 120 min po jídle. Ve skupině 20nediabetiků, 20 diabetiků 1. typu léčených inzulínovou pumpou a 20 diabetiků 2. typu bez významných komplikací bude testováno 5 vybraných potravin (chléb-stand.,jogurt,musli,směs jogurt/musli,sušenky), každá 3x během 7 dnů (snídaně,večeře). Vedle zjištění GI nových potravin bude možno posoudit spolehlivost nové metody GI, inter- a intraindividuální variabilitu GI a porovnat GI při snídani a při večeři a hodnoty GI u zdravých a diabetiků.Výsledky upřesní názor na optimální stravu.
- MeSH
- diabetes mellitus 1. typu MeSH
- diabetes mellitus 2. typu MeSH
- diabetická dieta MeSH
- glykemický index MeSH
- hypolipoproteinemie MeSH
- inzulinové infuzní systémy MeSH
- krevní glukóza analýza MeSH
- nutriční stav MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- diabetologie
- vnitřní lékařství
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
BACKGROUND: Absorption rates of the phosphate-buffered insulin analogs aspart, lispro, and glulisine prevail over that of regular human insulin. The aim of this prospective observational open-label controlled study was to compare the effects of aspart and human regular insulin resulting from their sequential long-lasting routine administration in small preprandial boluses to individuals with type 2 diabetes according to identical algorithms. METHODS: Fifty-seven individuals with type 2 diabetes 64.0 +/- 1.29 (mean +/- SE) years old with diabetes' duration of 12.4 +/- 1.06 years, treated with human regular insulin for 5.2 +/- 0.44 years, and a serum C-peptide level of 1.1 +/- 0.10 nmol/L were enrolled into the study. Following two checkups performed in the course of the 364 +/- 17.9-day baseline period, human regular insulin was replaced with aspart in equivalent boluses, and two checkups in the course of 330 +/- 11.1-day sequential period were performed. The control group consisted of 17 individuals with type 2 diabetes 68.4 +/- 2.36 years old with diabetes' duration of 9.9 +/- 1.57 years, treated with insulin for 4.2 +/- 0.57 years, and a C-peptide level of 1.1 +/- 0.11 nmol/L. Data were analyzed using the statistical program SPSS version 10.1. (SPSS, Inc., Chicago, IL). RESULTS: Following the switch from human regular insulin to aspart, hemoglobin A1c (HbA1c) decreased from 8.4 +/- 0.23% at baseline to 7.9 +/- 0.17% (P = 0.031), and thereafter to 7.5 +/- 0.20% (P < 0.001), while plasma glucose concentrations in 10-point profiles, daily insulin dose (37.1 +/- 1.39 IU/day), body mass index (BMI) (30.5 +/- 0.82 kg/m(2)), and frequency of hypo- and hyperglycemic episodes did not change (P > 0.05). Patients quote satisfaction was good. No adverse events were recorded. In the control group, no significant change of baseline HbA1c (8.4 +/- 0.54%), insulin dose (33.1 +/- 3.17 IU/day), and BMI (32.1 +/- 1.12 kg/m(2)) was found. CONCLUSION: Aspart appears to be more effective than human regular insulin for complementary insulin treatment in individuals with type 2 diabetes.
- MeSH
- C-peptid krev MeSH
- diabetes mellitus 2. typu farmakoterapie krev MeSH
- financování organizované MeSH
- glykovaný hemoglobin metabolismus MeSH
- hypoglykemika terapeutické užití MeSH
- index tělesné hmotnosti MeSH
- inzulin analogy a deriváty terapeutické užití MeSH
- krevní glukóza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipidy krev MeSH
- prospektivní studie MeSH
- senioři MeSH
- spokojenost pacientů MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinické zkoušky kontrolované MeSH
- Publikační typ
- abstrakt z konference MeSH
BACKGROUND: The sensor of the Continuous Glucose Monitoring System (CGMS, Medtronic Minimed, Northridge, CA) is labeled to expire 6 months following its production and to measure the glucose concentration in interstitial fluid up to 3 days after insertion. The purpose of this study was to demonstrate potential possibilities of sensors when used beyond their expiry date. METHODS: Twenty sensors, each between 3 to 18 months after the expiry date, were assessed in a 7-day period after insertion. Twenty healthy volunteers 23.4 +/- 2.92 (mean +/- SD) years old were trained in handling the CGMS and the Hypoguard (Woodbridge, UK) Advance glucometer system to measure their capillary plasma glucose concentration 18 times a day. Sensor function was estimated according to the number of readings per day, the accuracy according to the mean absolute difference (MAD), and correlation coefficient (r) between glucometer and sensor resulting from paired values. RESULTS: Uninterrupted sensor function was found in 117 of 140 sensor-days (83.6%). A reduction of readings in 23 sensor-days (16.4%) was caused by user error (5 sensor-days, 3.6%), connecting cable (7 sensor-days, 5%), sensor failure (8 sensor-days, 5.7%), or uncertain factors (3 sensor-days, 2.1%). MAD was always < 28%, and r = 0.79. CONCLUSIONS: Neither the expiry date nor the 3-day period of use limits the reliable function of a CGMS sensor. Sensors were found to function as long as 18 months after the expiry date, mostly for at least 7 days. There were no serious local adverse reactions. Prolongation of shelflife label and insertion time appears to be reasonable. Further studies are in progress.
The glycaemic index (GI) is a measure of the food power to raise plasma glucose (PG) concentration after a meal. For its determination, classical methods register the development of glucose concentration in capillary plasma or whole blood. The aim of this prospective open-label trial was to compare the GI of selected foods obtained by means of the Continuous Glucose Monitoring System (CGMS) (Minimed Medtronic, Northridge, USA) which has not been applied for this purpose until now, with the respective GI determined by a conventional method using the Glucometer Advance System (GAS) (Hypoguard, Woodbridge, United Kingdom), and to assess the advantages of each approach. METHODS: Portions of tested foods containing 50 g of carbohydrates were eaten for breakfast and for dinner after 10 and 4 h fast, respectively, by 20 healthy volunteers. Using GAS, PG-curves were constructed from 9 PG values at time 0, 15, 30, 45, 60, 75, 90, 105 and 120 min after the meal, and, using CGMS, from 25 values of interstitial fluid glucose concentration (ISFG) stored within 120 min in 5-minute intervals in CGMS memory. The GI was calculated (for GAS and CGMS separately) by dividing the incremental area under the curve for the tested food by the average area of 3 tests performed with the standard. Having excluded tests with missing glucose values, there remained 285 GAS- and 290 CGMS tests for further analysis. In each volunteer, each food was tested 3 times within one week so that 1 to 3 GI's were obtained and averaged. The GI for each tested food was calculated as the mean from the respective average GI's of 20 volunteers. The GI-variability was assessed according to the respective SD. The preference of GAS vs. CGMS in the persons tested was explored by means of a questionnaire. MS Excel and the statistical program SPSS v. 10.1 were used to analyze the data. RESULTS: The GI values (mean +/- SD) measured by GAS/CGMS were for dark chocolate 43.6 +/- 22.13 %/44.0 +/- 21.71 % (p > 0.01); for apple baby food 46.1 +/- 21.38 %/53.8 +/- 37.69 % (p > 0.01); for puffed rice squares 76.5 +/- 20.24 %/76.9 +/- 27.62 % (p > 0.01); for yogurt 43.2 +/- 20.17 %/37.7 +/- 21.55 % (p > 0.01). The GI's of dark chocolate, apple baby food and yogurt, determined by either method, were significantly lower than the GI of puffed rice squares (p < 0.01). CGMS was preferred by 12 of 20 volunteers (60 %). CONCLUSIONS: No significant difference could be seen between the GI's determined by conventional method (GAS) and by CGMS (p > 0.01). The method with CGMS is reliable and comfortable for both tested persons and investigators. Hence, it appears to become a sophisticated approach to determine the GI.
- MeSH
- ambulantní monitorování MeSH
- C-peptid krev MeSH
- diabetická dieta MeSH
- dieta MeSH
- financování organizované MeSH
- glykemický index MeSH
- glykovaný hemoglobin analýza MeSH
- HDL-cholesterol krev MeSH
- index tělesné hmotnosti MeSH
- inzulin krev MeSH
- krevní glukóza metabolismus MeSH
- krevní tlak MeSH
- LDL-cholesterol krev MeSH
- lidé MeSH
- postprandiální období MeSH
- referenční hodnoty MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Článek pojednává o moderních přístupech k samostatnému měření glykemie pomocí proužků a glukometrů i pomocí systémů pro kontinuální monitorování koncentrace glukózy v intersticiu. Je zmíněno i monitorování glykosurie a ketonurie. Selfmonitoring má význam pro kontrolu léčby diabetu může být využit i ke stanovení individuálních glykemických indexů potravin.
Jsou uvedeny základní informace o pomůckách k podkožní aplikaci inzulinu, k nimž v praxi patří klasické jednorázové inzulinové stříkačky, dávkovače inzulinu a inzulinové pumpy.
- MeSH
- diabetes mellitus ošetřování MeSH
- diabetická dieta metody trendy MeSH
- fyziologie výživy fyziologie MeSH
- glykemický index fyziologie MeSH
- krevní glukóza fyziologie metabolismus MeSH
- lidé MeSH
- metabolismus sacharidů MeSH
- metody výživy ošetřování trendy MeSH
- péče o sebe metody MeSH
- sacharidy MeSH
- Check Tag
- lidé MeSH
Příspěvek seznamuje zdravotnické profesionály s edukační prací výzkumného týmu (lékaře, vysokoškolsky vzdělané sestry – edukátorky a technika) v rámci projektu DEGIF (Determination of Glycemic Index of selected Foods in healthy persons and in persons with type 1 or type 2 diabetes mellitus. Cílem příspěvku je seznámit zdravotníky s méně známou metodou pro kontinuální sledování koncentrace glukózy v intersticiální tekutině (CGMS Continuous Glucose Monitoring System), která je používána v rámci této studie, uvést postup při ambulantním zavádění CGMS, zhodnotit časovou náročnost edukace a také zmapovat chování probandů v souvislosti s dodržováním režimu v průběhu studie.
