INTRODUCTION: Depression therapy has been linked to negative effects on energy metabolism, which can be attributed to various factors, including an ongoing inflammatory process commonly seen in metabolic disorders. Unhealthy lifestyle choices of patients and the impact of antidepressants on body weight and lipid and glucose metabolism also contribute to these metabolic side effects. Although not as pronounced as other psychopharmaceuticals, the increasing use of antidepressants raises concerns about their potential impact on public health. The study aimed to evaluate the short- and long-term effects of the antidepressant citalopram and its long-term combination with a special diet on metabolic parameters in mice. METHODS: Animals were randomly divided into 5 groups - control, control + special diet, citalopram (10 mg/kg for 35 days), citalopram + special diet (10 mg/kg for 35 days), and citalopram (10 mg/kg for 7 days). After a described time of administration, animals were anesthetized, blood and fat and liver tissues were collected. Biochemical parameters of lipid metabolism (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and glucose were analyzed using spectrophotometry and relevant adipokines and cytokines were evaluated by ELISA. RESULTS: After a week of application of citalopram, we observed dyslipidemia that persisted even at the end of the 5-week experiment. Furthermore, after 5 weeks of citalopram administration, we observed a significant decrease in body weight gain and decreased leptin levels. Changes in lipid metabolism, higher levels of adipokines leptin and PAI-1 were observed due to the special diet after 5 weeks. CONCLUSIONS: Our research suggests that the effects of citalopram and a diet on the metabolism of mice can be significant, both in the short term (1 week) and in the long term (5 weeks).
- Klíčová slova
- Adipokines, Citalopram, Dyslipidemia, Leptin, Metabolic syndrome, Mouse,
- MeSH
- citalopram * škodlivé účinky aplikace a dávkování farmakologie MeSH
- dieta s vysokým obsahem tuků škodlivé účinky MeSH
- dyslipidemie * chemicky indukované krev metabolismus MeSH
- glukosa * metabolismus MeSH
- játra metabolismus účinky léků MeSH
- krevní glukóza metabolismus účinky léků MeSH
- leptin * krev metabolismus MeSH
- lipidy * krev MeSH
- metabolismus lipidů * účinky léků MeSH
- myši MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- citalopram * MeSH
- glukosa * MeSH
- krevní glukóza MeSH
- leptin * MeSH
- lipidy * 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.
- Klíčová slova
- Continuous subcutaneous insulin infusion, Insulin delivery system rating questionnaire, Multiple daily injection, Regression analysis, Type 1 diabetes mellitus,
- MeSH
- diabetes mellitus 1. typu * farmakoterapie krev psychologie MeSH
- dospělí MeSH
- hypoglykemika * aplikace a dávkování terapeutické užití MeSH
- injekce subkutánní MeSH
- inzulin * aplikace a dávkování terapeutické užití MeSH
- inzulinové infuzní systémy * MeSH
- krevní glukóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- spokojenost pacientů * MeSH
- subkutánní infuze MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- hypoglykemika * MeSH
- inzulin * MeSH
- krevní glukóza MeSH
Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) plays a crucial role in regulation of metabolic homeostasis. To understand the role of the catalytic α2 subunit of AMPK in skeletal muscle energy metabolism, myotube cultures were established from AMPKα2+/+ and AMPKα2-/- mice. Myotubes from AMPKα2-/- mice had lower basal oleic acid and glucose oxidation compared to myotubes from AMPKα2+/+ mice. However, the relative response to mitochondrial uncoupling was increased for oleic acid oxidation. Incorporation of acetate into lipids was also lower in myotubes from AMPKα2-/- mice. Proteomics analysis revealed that AMPKα2-/- myotubes had upregulated pathways related to mitochondrial function and fatty acid oxidation, and decreased pathways related to fatty acid biosynthesis. In conclusion, ablation of AMPKα2 catalytic subunit in skeletal muscle cells resulted in reduced basal oxidation of glucose and fatty acids, however upregulated pathways related to mitochondrial function and fatty acid oxidation and reduced lipid formation.
- Klíčová slova
- AMPK, energy metabolism, oxidative phosphorylation, skeletal muscle,
- MeSH
- energetický metabolismus MeSH
- glukosa * metabolismus MeSH
- kosterní svalová vlákna * metabolismus cytologie MeSH
- kosterní svaly metabolismus MeSH
- kultivované buňky MeSH
- mastné kyseliny metabolismus MeSH
- metabolismus lipidů * MeSH
- mitochondrie metabolismus MeSH
- myši knockoutované MeSH
- myši MeSH
- oxidace-redukce MeSH
- proteinkinasy aktivované AMP * genetika metabolismus nedostatek MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- glukosa * MeSH
- mastné kyseliny MeSH
- Prkaa2 protein, mouse MeSH Prohlížeč
- proteinkinasy aktivované AMP * 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.
- Klíčová slova
- clinical trial, iGlarLixi, insulin glargine, lixisenatide, phase IV study, type 2 diabetes,
- MeSH
- diabetes mellitus 2. typu * farmakoterapie krev MeSH
- dospělí MeSH
- fixní kombinace léků MeSH
- glykovaný hemoglobin analýza MeSH
- hypoglykemie chemicky indukované MeSH
- hypoglykemika * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- inzulin glargin * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- krevní glukóza účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhrada léků * MeSH
- peptidy * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- receptor pro glukagonu podobný peptid 2 MeSH
- rozvrh dávkování léků MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze IV MeSH
- multicentrická studie MeSH
- Názvy látek
- fixní kombinace léků MeSH
- glykovaný hemoglobin MeSH
- hemoglobin A1c protein, human MeSH Prohlížeč
- hypoglykemika * MeSH
- inzulin glargin * MeSH
- krevní glukóza MeSH
- lixisenatide MeSH Prohlížeč
- peptidy * MeSH
- receptor pro glukagonu podobný peptid 2 MeSH
OBJECTIVE: Early hypoglycaemia at the time of neonatal intensive care unit (NICU) admission is common in very/extreme preterm infants. This study aimed to determine whether buccal dextrose gel in the delivery room (DR) would improve rates of early hypoglycaemia in this population. DESIGN: Randomised, blinded, placebo-controlled trial. SETTING: Four level-3 and one level-2 neonatal units. PATIENTS: Inborn infants≤32+0 weeks gestational age (GA). INTERVENTIONS: Infants were randomised to 40% dextrose or placebo gel in the DR (≤29+0 GA: 0.5 mL gel, ≥29+1 GA: 1 mL gel). MAIN OUTCOME MEASURE: Hypoglycaemia (<1.8 mmol/L) measured at the time of first intravenous access at NICU admission. RESULTS: Between November 2020 and August 2022, the recruitment rate was slow (impacted by the requirement for antenatal consent). This fact, coupled with finite research resources, led to a decision to end recruitment early. Data analysis of 169 newborns (33% of target sample size) showed no significant difference in the frequency of the primary outcome between dextrose 24/84 (29%) and placebo 25/85 (29%) groups (OR 0.95; 95% CI 0.49 to 1.86; p=0.88). A post-hoc analysis indicated that the trial had a low (47% conditional power) chance of detecting a statistically significant benefit from the intervention (had the target sample been achieved). CONCLUSIONS: This study showed no evidence of benefit of 40% dextrose gel on rates of hypoglycaemia at NICU admission. Management of these vulnerable newborns should continue to focus on vascular access and commencement of dextrose-containing intravenous fluids as early as possible. TRIAL REGISTRATION NUMBER: NCT04353713.
- Klíčová slova
- Endocrinology, Intensive Care Units, Neonatal, Neonatology, Physiology,
- MeSH
- aplikace bukální MeSH
- gely MeSH
- gestační stáří MeSH
- glukosa * aplikace a dávkování MeSH
- hypoglykemie * farmakoterapie prevence a kontrola MeSH
- jednotky intenzivní péče o novorozence MeSH
- krevní glukóza analýza MeSH
- lidé MeSH
- nemoci nedonošenců * farmakoterapie MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- porodní sály MeSH
- sladidla aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- gely MeSH
- glukosa * MeSH
- krevní glukóza MeSH
- sladidla MeSH
Diabetes requires precise insulin management to maintain glycemic control and prevent severe complications. Glucose-responsive delivery systems envision an autonomous approach to improve insulin therapy. Here, a glucose-sensitive insulin delivery system comprising hyaluronic acid conjugated with a diboronate glucose binder as a carrier for diol-modified insulin is shown. This approach seeks improved precision in insulin delivery, leveraging bidentate glucose binding to achieve enhanced glucose affinity and specificity. Modification of insulin with a diol motif preserves its native conformation and function. These insulin formulations correct blood glucose in diabetic mice, including glucose-responsive function when subjected to a glucose challenge. However, the absence of secondary interactions, such as electrostatic complexation, ultimately limits the duration of function relative to that of previous platforms. Integrating complementary interactions alongside dynamic-covalent glucose binders therefore enhances the functional duration and therapeutic efficacy in the design of glucose-responsive polymeric carriers, offering design insights into the development of new carriers for glucose-responsive insulin delivery.
- MeSH
- experimentální diabetes mellitus * farmakoterapie MeSH
- glukosa * metabolismus MeSH
- hypoglykemika * aplikace a dávkování chemie MeSH
- inzulin * aplikace a dávkování chemie farmakologie MeSH
- krevní glukóza účinky léků MeSH
- kyselina hyaluronová * chemie MeSH
- kyseliny boronové * chemie MeSH
- lékové transportní systémy * MeSH
- myši MeSH
- nosiče léků * chemie MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- glukosa * MeSH
- hypoglykemika * MeSH
- inzulin * MeSH
- krevní glukóza MeSH
- kyselina hyaluronová * MeSH
- kyseliny boronové * MeSH
- nosiče léků * MeSH
Previous reports provided recommendations for familial renal glucosuria diagnosis without complex view on differential diagnosis of glucosuria. The aim of this review was to provide an overview of the causes of glucosuria and to create an evidence-based diagnostic approach for children with glucosuria. We searched the current literature with a focus to identify the possible etiology of glucosuria, gaining insight into the pathophysiology of glucosuria. Urinary glucose is completely reabsorbed in the proximal tubule of kidneys. It only appears in the urine if the plasma glucose concentration exceeds the renal threshold for glucose or in the case of insufficient renal glucose reabsorption. The proteins that provide glucose reabsorption are SGLT2 and SGLT1 - sodium-dependent co-transporters that transport glucose from the lumen into epithelial cells - and GLUT2 - a passive transporter providing facilitative glucose transport from epithelial cells to plasma. Renal glucose reabsorption is affected in case of acquired or inherited complex dysfunction of proximal tubule called Fanconi Syndrome or due to pathogenic variants of genes encoding glucose transporters. Prior to diagnosing any of these, diabetes mellitus must be excluded together with other conditions leading to hyperglycemia. In conclusion, glucosuria is always an abnormal finding. The review provides a simple evidence-based diagnostic approach to navigate the differential diagnosis of glucosuria.
- MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- Fanconiho syndrom diagnóza komplikace MeSH
- glukosa * metabolismus MeSH
- glykosurie * diagnóza etiologie MeSH
- lidé MeSH
- přenašeč glukosy typ 2 metabolismus MeSH
- proximální tubuly ledvin metabolismus MeSH
- renální glykosurie * diagnóza etiologie patofyziologie MeSH
- transportér 1 pro sodík a glukosu metabolismus MeSH
- transportér 2 pro sodík a glukózu metabolismus MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- glukosa * MeSH
- přenašeč glukosy typ 2 MeSH
- transportér 1 pro sodík a glukosu MeSH
- transportér 2 pro sodík a glukózu MeSH
High-salt diets (HSDs) are known to impact blood pressure and cardiovascular health, but their effects on glucose metabolism, liver function, and gut microbiota remain poorly understood. This study investigates how long-term HSD affects these physiological processes and evaluates the potential therapeutic effects of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). Male Sprague-Dawley rats were fed a normal salt diet (0.3% NaCl), a moderate salt diet (2% NaCl), or a high-salt diet (8% NaCl) for 12 wk. Two subgroups in the HSD condition received telmisartan or enalapril. We assessed blood pressure, glucose homeostasis, liver inflammation, pancreatic function, and gut microbiota composition. HSD rats exhibited significantly higher blood pressure [130 ± 2 mmHg in normal diet (ND) vs. 144 ± 4 mmHg in HSD; P < 0.01], reduced fasting insulin (1.33 ± 0.14 ng/mL in ND vs. 0.60 ± 0.05 ng/mL in HSD; P < 0.01), and gut microbiota dysbiosis, with a 71% reduction in Ruminococcus species (P = 0.018). Liver inflammation, indicated by an increase in CD68+ macrophages, was also observed in the HSD group. Telmisartan treatment significantly reduced liver inflammation but did not fully restore metabolic homeostasis. HSD disrupts multiple physiological systems, including glucose metabolism and liver function, partly through gut microbiota alterations. ACEIs and ARBs provided partial protection, highlighting the need for multitargeted interventions to mitigate high-salt diet effects.NEW & NOTEWORTHY High-salt diet induces multisystem disruptions, including liver inflammation, reduced insulin levels, and gut microbiota imbalance. ACEIs and ARBs showed limited efficacy, highlighting the need for comprehensive therapeutic approaches.
- Klíčová slova
- ACE inhibitor, angiotensin II receptor blocker, high-salt diet, rat physiology,
- MeSH
- antagonisté receptorů pro angiotenzin * farmakologie MeSH
- enalapril farmakologie MeSH
- glukosa * metabolismus MeSH
- inhibitory ACE * farmakologie MeSH
- játra * účinky léků metabolismus MeSH
- krevní glukóza metabolismus účinky léků MeSH
- krevní tlak účinky léků MeSH
- krysa rodu Rattus MeSH
- kuchyňská sůl * škodlivé účinky MeSH
- potkani Sprague-Dawley MeSH
- střevní mikroflóra * účinky léků MeSH
- telmisartan farmakologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antagonisté receptorů pro angiotenzin * MeSH
- enalapril MeSH
- glukosa * MeSH
- inhibitory ACE * MeSH
- krevní glukóza MeSH
- kuchyňská sůl * MeSH
- telmisartan MeSH
Significance: Type 2 diabetes as a world-wide epidemic is characterized by the insulin resistance concomitant to a gradual impairment of β-cell mass and function (prominently declining insulin secretion) with dysregulated fatty acids (FAs) and lipids, all involved in multiple pathological development. Recent Advances: Recently, redox signaling was recognized to be essential for insulin secretion stimulated with glucose (GSIS), branched-chain keto-acids, and FAs. FA-stimulated insulin secretion (FASIS) is a normal physiological event upon postprandial incoming chylomicrons. This contrasts with the frequent lipotoxicity observed in rodents. Critical Issues: Overfeeding causes FASIS to overlap with GSIS providing repeating hyperinsulinemia, initiates prediabetic states by lipotoxic effects and low-grade inflammation. In contrast the protective effects of lipid droplets in human β-cells counteract excessive lipids. Insulin by FASIS allows FATP1 recruitment into adipocyte plasma membranes when postprandial chylomicrons come late at already low glycemia. Future Directions: Impaired states of pancreatic β-cells and peripheral organs at prediabetes and type 2 diabetes should be revealed, including the inter-organ crosstalk by extracellular vesicles. Details of FA/lipid molecular physiology are yet to be uncovered, such as complex phenomena of FA uptake into cells, postabsorptive inactivity of G-protein-coupled receptor 40, carnitine carrier substrate specificity, the role of carnitine-O-acetyltransferase in β-cells, and lipid droplet interactions with mitochondria. Antioxid. Redox Signal. 42, 566-622.
- Klíčová slova
- fatty acid-stimulated insulin secretion, insulin resistance, lipotoxicity, pancreatic beta cells, type-2 diabetes,
- MeSH
- beta-buňky metabolismus MeSH
- diabetes mellitus 2. typu metabolismus MeSH
- glukosa metabolismus MeSH
- inzulin * metabolismus MeSH
- inzulinová rezistence MeSH
- lidé MeSH
- mastné kyseliny * metabolismus MeSH
- metabolismus lipidů MeSH
- oxidace-redukce MeSH
- sekrece inzulinu MeSH
- signální transdukce * MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- glukosa MeSH
- inzulin * MeSH
- mastné kyseliny * MeSH
Objective: The recommended threshold for the time spent on continuous glucose monitoring (CGM) is established at 70%. However, glucose outcomes in children with type 1 diabetes (CwD) using CGM for a different proportion of time within this threshold have not been evaluated yet. The study aims to compare glycemic parameters among CwD who spent 70%-89% and ≥90% on CGM using the population-wide data from the Czech national pediatric diabetes registry ČENDA. Methods: CwD aged <19 years who used real-time CGM >70% of the time and did not change the type of therapy throughout the year 2023 were included and divided into two groups based on the time they spent on CGM-70%-89% versus ≥90%. HbA1c, times in standard glycemic ranges, mean glucose, and coefficient of variability (CV) were compared between the groups and by treatment modalities. Results: Data from 1977 CwD (1035 males and 942 females) were evaluated. Among them, 404 participants (20.4%) used CGM 70%-89% of the time, and 1573 participants (79.6%) ≥90% of the time. Compared with the 70-89% group, the ≥90% CGM users achieved significantly lower HbA1c levels (51 mmol/mol, 6.8% vs. 58 mmol/mol, 7.4%, P < 0.001), higher time in range (72% vs. 60%, P < 0.001), and lower mean glucose and CV (8.1 mmol/L, 146 mg/dL vs. 9.1 mmol/L, 164 mg/dL and 37% vs. 40%, respectively, both P < 0.001). Analogous results were seen irrespective of the treatment modality. The differences persisted after propensity score adjustment. Conclusion: CGM use for ≥90% is associated with tighter glycemic control compared with 70%-89% use. Therefore, it is essential to motivate CwD to use CGM for the longest possible time and search for suitable options to overcome barriers in uninterrupted CGM monitoring.
- Klíčová slova
- CGM, glucose monitoring, pediatrics, registry, type 1 diabetes,
- MeSH
- časové faktory MeSH
- diabetes mellitus 1. typu * krev farmakoterapie MeSH
- dítě MeSH
- glykovaný hemoglobin analýza MeSH
- hypoglykemika terapeutické užití MeSH
- kontinuální monitorování glukózy MeSH
- krevní glukóza * analýza MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- registrace MeSH
- regulace glykemie * metody MeSH
- selfmonitoring glykemie * metody MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- glykovaný hemoglobin MeSH
- hemoglobin A1c protein, human MeSH Prohlížeč
- hypoglykemika MeSH
- krevní glukóza * MeSH