UNLABELLED: 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
• dospělí 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
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• C-peptid MeSH
• glykovaný hemoglobin MeSH
• HDL-cholesterol MeSH
• inzulin MeSH
• krevní glukóza MeSH
• LDL-cholesterol MeSH

AIMS: Glycaemic variability (GV) has been hypothesized to increase the risk of diabetes complications; however, results of clinical studies are contradictory. The effect of GV on cell phenotypes has been investigated in vitro showing that GV may have more deleterious effect on cells that high glucose itself. However, methodology used to study GV in vitro differs significantly between studies and does not reflect in vivo situation. Therefore we aimed to establish clinically relevant an in vitro experimental approach for the study of GV that reflects intra-day glucose fluctuations of subjects with type 1 diabetes mellitus (T1DM) and of healthy subjects and to test how low and high GV affect expression of genes that protects cells from hyperglycaemia-induced damage. METHODS: Human umbilical vein endothelial cells (HUVEC) were cultured 24h in medium with different glucose profiles: high GV, low GV and GV of healthy subjects-profiles created according to CGM of T1DM patients and healthy subjects. These profiles were compared to commonly used 5.5 and 25mmol/l glucose concentrations. Gene expression was determined using quantitative PCR. RESULTS: Our results showed general down-regulation of enzymes that are involved in the protection against hyperglycaemia-induced intracellular changes in both low and high GV compared to normal glycaemia similarly to the decrease induced by continuous hyperglycaemia. Gene expressions did not differ between high and low GV. CONCLUSION: Our data indicate that GV may have similar or even greater effect than continuous hyperglycaemia on the expression of several genes relevant to pathogenesis of diabetes microvascular complications.

• Klíčová slova
• Continuous glucose monitoring, Diabetes complications, Glycaemic variability, Hyperglycaemia, Hypoglycaemia, Pentose phosphate pathway,
• MeSH
• apoptóza účinky léků   MeSH
• biologické markery metabolismus   MeSH
• diabetes mellitus 1. typu komplikace   farmakoterapie   patofyziologie   MeSH
• endoteliální buňky pupečníkové žíly (lidské) účinky léků   metabolismus   MeSH
• glukosa škodlivé účinky   MeSH
• hyperglykemie etiologie   patologie   MeSH
• hypoglykemie etiologie   patologie   MeSH
• krevní glukóza metabolismus   MeSH
• kultivované buňky MeSH
• kvantitativní polymerázová řetězová reakce MeSH
• lidé MeSH
• messenger RNA genetika   MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• proliferace buněk účinky léků   MeSH
• sekvenční analýza hybridizací s uspořádaným souborem oligonukleotidů MeSH
• stanovení celkové genové exprese MeSH
• studie případů a kontrol MeSH
• techniky in vitro MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• biologické markery MeSH
• glukosa MeSH
• krevní glukóza MeSH
• messenger RNA MeSH

UNLABELLED: The glycaemic index (GI) is a measure of the food power to raise blood glucose (B-glucose) concentration after a meal. For healthy eating, foods with low GI are recommended. However, for many foods in the European Union the GI has not been defined yet. The aims of this prospective open-label study were: (1) to determine the GI of white bread and juicy cereal bars FIT (Usovsko, Czech Republic) by means of the glucometer Optium (Abbott/Medisense); (2) to compare the GI of tested foods determined in the morning and in the evening hours; (3) to compare the GI of tested foods in men and women and (4) to assess the variability of the GI. METHODS: To determine the GI, measured portions of food containing 50 g of carbohydrates were eaten by 11 healthy volunteers. B-glucose curves were constructed from B-glucose values at time 0, 15, 30, 45, 60, 60, 120 min after the meal. The GI was calculated by dividing the incremental area under the curve (IAUC) for the tested food by that for the standard food (IAUCS). In each volunteer each food was tested 5 times so that 5 GI's was obtained and the average was calculated. The GI for each tested food was calculated as the mean from the respective average GI's of the 11 volunteers. MS Excel and the statistical program SPSS v. 10.1 were used to analyze the data. RESULTS: (1) The mean values of the GI for white bread was 70.3 % and for juicy cereal bars was 101.0 %, as determined in a total of 139 tests in the whole group of 11 volunteers. There was a difference when comparing white bread vs. glucose (p = 0.012) and white bread vs. cereal bars (p = 0.026) but no difference between glucose and cereal bars. (2) There was no significant difference between the GI determined in the morning and in the evening hours either for the total of 139 tests or for the individual tested foods. (3) No significant difference could be seen between the GI in men and women when comparing glucose, cereal bars and white bread. (4) There was a wide variability of GI in all tested foods: the standard deviation of GI for white bread was 30.7 %, for juicy cereal bars 38.0 %. CONCLUSIONS: The GI's for white bread and juicy cereal bars were determined. There was no difference either between the GI values determined in the morning vs. the evening hours or between the values in men vs. women. The results show wide variability. An accurate standard method for the determination of GI needs to be defined, carefully used and re-evaluated to enable a comparison of the results with various methods of other working groups.

• MeSH
• chléb * MeSH
• dospělí MeSH
• glykemický index * MeSH
• jedlá semena * MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• krevní glukóza MeSH

Type 1 diabetic (T1D) patients suffer from insulinopenia and hyperglycaemia. Studies have shown that if a patient's hyperglycaemic environment is not compensated, it leads to complex immune dysfunctions. Similarly, T1D mothers with poor glycaemic control exert a negative impact on the immune responses of their newborns. However, questions concerning the impact of other metabolic disturbances on the immune system of T1D mothers (and their newborns) have been raised. To address these questions, we examined 28 T1D women in reproductive age for the relationship between various metabolic, clinical, and immune parameters. Our study revealed several unexpected correlations which are indicative of a much more complex relationship between glucose and lipid factors (namely, glycosylated haemoglobin Hb1Ac, the presence of one but not multiple chronic diabetic complications, and atherogenic indexes) and proinflammatory cytokines (IL-1alpha and TNF-alpha). Regulatory T cell counts correlated with HbA1c, diabetic neuropathy, lipid spectra parameters, and IL-6 levels. Total T-helper cell count was interconnected with BMI and glycaemia variability correlated with lipid spectra parameters, insulin dose, and vitamin D levels. These and other correlations revealed in this study provide broader insight into the association of various metabolic abnormalities with immune parameters that may impact T1D mothers or their developing child.

• MeSH
• cytokiny imunologie   MeSH
• diabetes mellitus 1. typu komplikace   farmakoterapie   imunologie   metabolismus   MeSH
• diabetické neuropatie etiologie   imunologie   MeSH
• dospělí MeSH
• glykovaný hemoglobin metabolismus   MeSH
• HDL-cholesterol metabolismus   MeSH
• hypoglykemika aplikace a dávkování   MeSH
• interleukin-1alfa imunologie   MeSH
• interleukin-6 imunologie   MeSH
• inzulin aplikace a dávkování   MeSH
• LDL-cholesterol metabolismus   MeSH
• lidé MeSH
• mladý dospělý MeSH
• počet lymfocytů MeSH
• produkty pokročilé glykace metabolismus   MeSH
• regulační T-lymfocyty imunologie   MeSH
• T-lymfocyty pomocné-indukující imunologie   MeSH
• TNF-alfa imunologie   MeSH
• triglyceridy metabolismus   MeSH
• vitamin D metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• cytokiny MeSH
• glykovaný hemoglobin MeSH
• HDL-cholesterol MeSH
• hemoglobin A1c protein, human MeSH Prohlížeč
• hypoglykemika MeSH
• IL1A protein, human MeSH Prohlížeč
• IL6 protein, human MeSH Prohlížeč
• interleukin-1alfa MeSH
• interleukin-6 MeSH
• inzulin MeSH
• LDL-cholesterol MeSH
• produkty pokročilé glykace MeSH
• TNF protein, human MeSH Prohlížeč
• TNF-alfa MeSH
• triglyceridy MeSH
• vitamin D MeSH

Previous measurements of acetone concentrations in the exhaled breath of healthy individuals and the small amount of comparable data for individuals suffering from diabetes are briefly reviewed as a prelude to the presentation of new data on the sporadic and wide variations of breath acetone that occur in ostensibly healthy individuals. Data are also presented which show that following a ketogenic diet taken by eight healthy individuals their breath acetone concentrations increased up to five times over the subsequent 6 h. Similarly, the breath acetone increased six and nine times when a low carbohydrate diet was taken by two volunteers and remained high for the several days for which the diet was continued. These new data, together with the previous data, clearly indicate that diet and natural intra-individual biological and diurnal variability result in wide variations in breath acetone concentration. This places an uncertainty in the use of breath acetone alone to monitor blood glucose and glycaemic control, except and unless the individual acts as their own control and is cognizant of the need for dietary control.

• MeSH
• aceton analýza   MeSH
• dechové testy metody   MeSH
• dietní sacharidy MeSH
• dospělí MeSH
• hmotnostní spektrometrie MeSH
• ketogenní dieta * MeSH
• lidé MeSH
• senioři MeSH
• vydechnutí MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• aceton MeSH
• dietní sacharidy MeSH

BACKGROUND: The endoscopically implanted duodenal-jejunal bypass liner (DJBL) is an attractive alternative to bariatric surgery for obese diabetic patients. This article aims to study dynamical aspects of the glycaemic profile that may influence DJBL effects. METHODS: Thirty patients underwent DJBL implantation and were followed for 10 months. Continuous glucose monitoring (CGM) was performed before implantation and at month 10. Dynamical variables from CGM were measured: coefficient of variation of glycaemia, mean amplitude of glycaemic excursions (MAGE), detrended fluctuation analysis (DFA), % of time with glycaemia under 6.1 mmol/L (TU6.1), area over 7.8 mmol/L (AO7.8) and time in range. We analysed the correlation between changes in both anthropometric (body mass index, BMI and waist circumference) and metabolic (fasting blood glucose, FBG and HbA1c) variables and dynamical CGM-derived metrics and searched for variables in the basal CGM that could predict successful outcomes. RESULTS: There was a poor correlation between anthropometric and metabolic outcomes. There was a strong correlation between anthropometric changes and changes in glycaemic tonic control (∆BMI-∆TU6.1: rho = - 0.67, P < .01) and between metabolic outcomes and glycaemic phasic control (∆FBG-∆AO7.8: r = .60, P < .01). Basal AO7.8 was a powerful predictor of successful metabolic outcome (0.85 in patients with AO7.8 above the median vs 0.31 in patients with AO7.8 below the median: Chi-squared = 5.67, P = .02). CONCLUSIONS: In our population, anthropometric outcomes of DJBL correlate with improvement in tonic control of glycaemia, while metabolic outcomes correlate preferentially with improvement in phasic control. Assessment of basal phasic control may help in candidate profiling for DJBL implantation.

• Klíčová slova
• continuous glucose monitoring, detrended fluctuation analysis (DFA), diabesity, duodenal-jejunal bypass liner (DJBL), metabolic surgery, type 2 diabetes mellitus,
• MeSH
• biologické markery analýza   MeSH
• diabetes mellitus 2. typu komplikace   chirurgie   MeSH
• dospělí MeSH
• duodenum chirurgie   MeSH
• glykovaný hemoglobin analýza   MeSH
• hmotnostní úbytek MeSH
• jejunum chirurgie   MeSH
• krevní glukóza analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolický syndrom etiologie   prevence a kontrola   MeSH
• morbidní obezita patofyziologie   chirurgie   MeSH
• následné studie MeSH
• prognóza MeSH
• senioři MeSH
• žaludeční bypass metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• glykovaný hemoglobin MeSH
• hemoglobin A1c protein, human MeSH Prohlížeč
• krevní glukóza MeSH

AIM: The aim of this pilot study was to acquire insight into the parameters of glycaemic control, especially, (1) the time delay (lag phase) between plasma and tissue glucose concentrations in relation to rise and fall in glucose levels and (2) the rate of glucose increase and decrease. METHODS: Four healthy people (HP), 4 people with type 1diabetes (DM1) and 4 with type 2 diabetes (DM2) underwent concurrent glucose measurements by means of (1) the continuous glucose monitoring system (CGMS-Medtronic), Medtronic-Minimed, CA, USA, calibrated by the glucometer Calla, Wellion, Austria, and, (2) the Beckman II analyser to measure glucose concentrations in venous plasma. Samples were taken on 4 consecutive days in the fasting state and 4 times after consumption of 50 g glucose. Carelink Personal, MS Excel, Maple and Mat lab were applied to plot the evolution of glucose concentration and analyse the results. The time difference between increase and decrease was calculated for HP, DM 1 and DM 2. RESULTS: In DM1and DM2, glucose tolerance testing (GTT) resulted in slower transport of glucose into subcutaneous tissue than in HP where the lag phase lasted up to 12 min. The maximum increase/decrease rates in DM1 and DM2 vs HP were 0.25 vs < 0.1 mmol/L/min. CONCLUSION: CGMS is shown to provide reliable plasma glucose concentrations provided the system is calibrated during a steady state. The analysis of glucose change rates improves understanding of metabolic processes better than standard GTT.

• Klíčová slova
• calibration, continuous glucose monitoring, diabetes mellitus, glucose transport, lag phase,
• MeSH
• časové faktory MeSH
• diabetes mellitus 1. typu metabolismus   MeSH
• diabetes mellitus 2. typu metabolismus   MeSH
• krevní glukóza metabolismus   MeSH
• lidé MeSH
• omezení příjmu potravy metabolismus   MeSH
• pilotní projekty MeSH
• průřezové studie MeSH
• selfmonitoring glykemie MeSH
• subkutánní tkáň metabolismus   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• práce podpořená grantem MeSH
• Názvy látek
• krevní glukóza MeSH

AIMS: To evaluate the efficacy and safety of oral semaglutide versus comparators by patient characteristic subgroups in patients with type 2 diabetes. MATERIALS AND METHODS: Change from baseline in glycated haemoglobin (HbA1c) and body weight, and achievement of HbA1c <7.0% with oral semaglutide 7 mg, oral semaglutide 14 mg, flexibly dosed oral semaglutide (flex) and comparators were assessed across baseline subgroups (age, race, ethnicity, diabetes duration, body mass index and HbA1c) from the PIONEER programme. Treatment differences were analysed using a mixed model for repeated measurements for continuous variables and a logistic regression model for the binary endpoint. Pooled safety data were analysed descriptively. RESULTS: Changes from baseline in HbA1c and body weight, and the odds of achieving HbA1c <7.0%, were greater with oral semaglutide 14 mg/flex (n = 1934) and higher or similar with oral semaglutide 7 mg (n = 823) versus comparators (n = 2077) across most subgroups. Changes in HbA1c with oral semaglutide 14 mg/flex were greater for patients with higher baseline HbA1c (HbA1c >9.0%: -1.7% to -2.6%; HbA1c <8.0%: -0.7% to -1.2%). In some trials, Asian patients experienced greater HbA1c reductions with oral semaglutide 14 mg/flex (-1.5% to -1.8%) than other racial groups (-0.6% to -1.6%). The overall incidence of adverse events (AEs) with oral semaglutide was similar to that with comparators and was consistent across subgroups. More gastrointestinal AEs were observed with oral semaglutide, versus comparators, across subgroups. CONCLUSIONS: Oral semaglutide demonstrated consistently greater HbA1c and body weight reductions across a range of patient characteristics, with greater HbA1c reductions seen at higher baseline HbA1c levels.

• Klíčová slova
• GLP-1 analogue, antidiabetic drug, glycaemic control, incretin therapy, type 2 diabetes, weight control,
• MeSH
• diabetes mellitus 2. typu * chemicky indukované   farmakoterapie   MeSH
• glukagonu podobné peptidy škodlivé účinky   MeSH
• glykovaný hemoglobin analýza   MeSH
• hypoglykemika škodlivé účinky   MeSH
• lidé MeSH
• tělesná hmotnost MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• glukagonu podobné peptidy MeSH
• glykovaný hemoglobin MeSH
• hypoglykemika MeSH
• semaglutide MeSH Prohlížeč

AIMS: To investigate whether the proven benefits of insulin degludec (IDeg) combined with insulin aspart (IAsp), known as IDegAsp, given twice daily, extend across a wide spectrum of patients with diabetes. MATERIALS AND METHODS: This was a post hoc pooled analysis of 5 phase III randomized, 26-week, open-label, treat-to-target trials comparing IDegAsp twice daily (n = 1111) with one of two comparators: premixed insulin (biphasic insulin aspart 30 [BIAsp 30]) twice daily (n = 561) or IDeg once daily + IAsp (n = 136). Patient data were stratified according to baseline glycated haemoglobin (HbA1c) or fasting plasma glucose (FPG) categories, as well as by baseline duration of diabetes or body mass index (BMI) categories. RESULTS: We conducted a meta-analysis of 5 clinical trials: NCT01513590, NCT01009580, NCT01059812, NCT01680341 and NCT01713530. End-of-trial results were broadly consistent, with differences between IDegAsp and comparators observed in phase III trials. HbA1c results were similar for IDegAsp and the comparators in all baseline characteristic (HbA1c, duration of diabetes or BMI) and category groups (number ranges). Significantly lower FPG level was observed with IDegAsp vs comparators in all baseline characteristic and most category groups (excluding FPG <5.5 mmol/L). Significantly lower insulin doses were observed with IDegAsp vs comparators in all baseline characteristic and half of the category groups, and significantly lower rates of confirmed and nocturnal confirmed hypoglycaemia were observed with IDegAsp vs comparators in all baseline variable and category groups. CONCLUSIONS: IDegAsp retains a consistent safety and efficacy profile in patients with different baseline characteristics.

• Klíčová slova
• glycaemic control, hypoglycaemia, insulin analogues, meta-analysis, randomized trial, type 2 diabetes,
• MeSH
• činnosti denního života * MeSH
• diabetes mellitus 2. typu krev   komplikace   farmakoterapie   patofyziologie   MeSH
• dlouhodobě působící inzulin aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• fixní kombinace léků MeSH
• glykovaný hemoglobin analýza   MeSH
• hyperglykemie chemicky indukované   prevence a kontrola   MeSH
• hypoglykemie prevence a kontrola   MeSH
• hypoglykemika aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• index tělesné hmotnosti MeSH
• klinické zkoušky, fáze III jako téma MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• obezita komplikace   MeSH
• progrese nemoci MeSH
• randomizované kontrolované studie jako téma MeSH
• rozvrh dávkování léků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• Názvy látek
• dlouhodobě působící inzulin MeSH
• fixní kombinace léků MeSH
• glykovaný hemoglobin MeSH
• hemoglobin A1c protein, human MeSH Prohlížeč
• hypoglykemika MeSH
• insulin degludec, insulin aspart drug combination MeSH Prohlížeč
• krevní glukóza MeSH