Nonsevere hypoglycemia in people with diabetes is usually treated with rapid-acting carbohydrate, of which glucose is the most suitable form. A quantity of 15 g is recommended and repeated after 15 min if hypoglycemia persists. This recommendation has not changed for several years despite the introduction of continuous glucose monitoring, newer and more flexible insulin regimens and improved insulin delivery. The present review has examined published studies that have explored how effectively defined amounts of carbohydrate treat nonsevere hypoglycemia in adults with insulin-treated diabetes. For most nonsevere episodes of hypoglycemia, the optimal treatment is 15 to 20 g of oral glucose. However, this dose may not be appropriate with many current insulins and insulin pump therapy, where doses of glucose may have to be individualized, and based on body weight or the type of insulin delivery system. Current guidelines on hypoglycemia treatment for newer glucose-lowering therapies may require re-evaluation.

• Klíčová slova
• diabète traité par insuline, fast-acting carbohydrate, glucides à absorption rapide, glucose, hypoglycemia, hypoglycémie, insulin-treated diabetes, traitement de l’hypoglycémie, treatment of hypoglycemia,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Dead fungal biomass is an abundant source of nutrition in both litter and soil of temperate forests largely decomposed by bacteria. Here, we have examined the utilization of dead fungal biomass by the five dominant bacteria isolated from the in situ decomposition of fungal mycelia using a multiOMIC approach. The genomes of the isolates encoded a broad suite of carbohydrate-active enzymes, peptidases and transporters. In the extracellular proteome, only Ewingella americana expressed chitinases while the two Pseudomonas isolates attacked chitin by lytic chitin monooxygenase, deacetylation and deamination. Variovorax sp. expressed enzymes acting on the side-chains of various glucans and the chitin backbone. Surprisingly, despite its genomic potential, Pedobacter sp. did not produce extracellular proteins to decompose fungal mycelia but presumably feeds on simple substrates. The ecological roles of the five individual strains exhibited complementary features for a fast and efficient decomposition of dead fungal biomass by the entire bacterial community.

• MeSH
• Actinobacteria genetika   izolace a purifikace   metabolismus   MeSH
• biomasa MeSH
• chitin metabolismus   MeSH
• Comamonadaceae genetika   izolace a purifikace   metabolismus   MeSH
• Enterobacteriaceae genetika   izolace a purifikace   metabolismus   MeSH
• genom bakteriální genetika   MeSH
• houby metabolismus   MeSH
• lesy MeSH
• mycelium metabolismus   MeSH
• Pedobacter genetika   izolace a purifikace   metabolismus   MeSH
• Proteobacteria genetika   izolace a purifikace   metabolismus   MeSH
• proteomika MeSH
• Pseudomonas genetika   izolace a purifikace   metabolismus   MeSH
• půda chemie   MeSH
• půdní mikrobiologie MeSH
• RNA ribozomální 16S genetika   MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• chitin MeSH
• půda MeSH
• RNA ribozomální 16S MeSH

Backgroung: Type 1 diabetes is a disease that adversely affects the daily life of a large percentage of people worldwide. Daily glucose levels regulation and useful advices provided to patients regarding their diet are essential for diabetes treatment. For this reason, the interest of the academic community has focused on developing innovative systems, such as decision support systems, based on glucose prediction algorithms. The present work presents the predictive capabilities of ensemble methods compared to individual algorithms while combining each method with compartment models for fast acting insulin absorption simulation. Methods: An approach of combining widely used glycemia prediction algorithms is proposed and three different ensemble methods (Linear, Bagging and Boosting metaregressor) are applied and evaluated on their ability to provide accurate predictions for 30, 45 and 60 minutes ahead prediction horizon. Moreover, glycemia levels, long and short acting insulin dosages and consumed carbohydrates from six type one people with diabetes are used as input data and the results are evaluated in terms of root-mean square error and Clarke error grid analysis. Results: According to results, ensemble methods can provide more accurate glucose concentration in comparison to individual algorithms. Bagging metaregressor, specifically, performed better than individual algorithms in all prediction horizons for small datasets. Bagging ensemble method improved the percentage in zone A according to Clarkes error grid analysis by 4% and in some cases by 9%. Moreover, compartment models are proved to improve results in combination with any method at any prediction horizon. This strengthen the potential practical usefulness of the ensemble methods and the importance of building accurate compartment models.

• Klíčová slova
• Compartment models, Continuous glucose monitoring, Decision support systems, Diabetes mellitus, Ensemble method, Glucose prediction, Insulin pumps,
• MeSH
• algoritmy MeSH
• diabetes mellitus 1. typu * farmakoterapie   MeSH
• inzulin MeSH
• krevní glukóza MeSH
• lidé MeSH
• selfmonitoring glykemie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• inzulin MeSH
• krevní glukóza MeSH

In evolution, genes survived that could code for metabolic pathways, promoting long term survival during famines or fasting when suffering from trauma, disease or during physiological growth. This requires utilization of substrates, already present in some form in the body. Carbohydrate stores are limited and to survive long, their utilization is restricted to survival pathways, by inhibiting glucose oxidation and glycogen synthesis. This leads to insulin resistance and spares muscle protein, because being the main supplier of carbon for new glucose production. In these survival pathways, part of the glucose is degraded in glycolysis in peripheral (muscle) tissues to pyruvate and lactate (Warburg effect), which are partly reutilized for glucose formation in liver and kidney, completing the Cori-cycle. Another part of the glucose taken up by muscle contributes, together with muscle derived amino acids, to the production of substrates consisting of a complete amino acid mix but extra non-essential amino acids like glutamine, alanine, glycine and proline. These support cell proliferation, matrix deposition and redox regulation in tissues, specifically active in host response and during growth. In these tissues, also glucose is taken up delivering glycolytic intermediates, that branch off and act as building blocks and produce reducing equivalents. Lactate is also produced and released in the circulation, adding to the lactate released by muscle in the Cori-cycle and completing secondary glucose cycles. Increased fluxes through these cycles lead to modest hyperglycemia and hyperlactatemia in states of healthy growth and disease and are often misinterpreted as induced by hypoxia.

• Klíčová slova
• Cori-cycle, Growth, Inflammation, Insulin resistance, Trauma/Disease, Warburg effect,
• MeSH
• glukosa metabolismus   MeSH
• glykolýza fyziologie   MeSH
• játra metabolismus   MeSH
• kosterní svaly metabolismus   MeSH
• kyselina mléčná metabolismus   MeSH
• kyselina pyrohroznová metabolismus   MeSH
• ledviny metabolismus   MeSH
• lidé MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• glukosa MeSH
• kyselina mléčná MeSH
• kyselina pyrohroznová MeSH

BACKGROUND: Treatment of obesity with strict reducing diets is as a rule associated with the development of energetic efficiency manifested among others also by a decline of energy expenditure. The objective of the trial was to test whether addition of oils containing triacylglycerols with medium-chain fatty acid can prevent this decline and whether their administration can affect the lipid spectrum. METHODS AND RESULTS: Sixty obese patients were served for a four-week period of hospitalization at the obesitology unit a low-energy diet REDITA (Promil Co., N. Bydzov) providing 1596 kJ, 37 g protein, 50 g carbohydrate and 3 g fat. Part of the treatment was regular aerobic exercise, behavioural therapy to teach correct dietary habits and physical activity; physical activity was monitored by means of pedometers. From this group during the 3rd and 4th week 11 patients with similar characteristics were separated (age, body weight, BMI and energy expenditure at rest) as in the basic group. These patients were given daily 15 ml oil containing triacylglycerols with medium-chain fatty acids, MCT OIL (Mead Johnson, Evansville), providing 545 kJ. The resting energy expenditure was assessed in all patients every morning on fasting, immediately after awakening, using indirect calorimetry and it was corrected with regard to the respiratory quotient and excretion of catabolic nitrogen. The body composition was assessed at the beginning and at the end of the trial by hydrostatic weighing. Administration of oil containing triacylglycerols with medium-chain fatty acids (MCT OIL) prevented the decline of the resting energy expenditure (130.0 +/- 9.2 kJ/kg lean body mass/day, as compared with 126.5 +/- 7.2 kJ/kg lean body mass/day in the basic group: the difference is statistically not significant). Although addition of oil increased the energy intake by 545 kJ/day, the drop of body weight and BMI was comparable with that in the group of obese patients who did not receive the oil (10.3 +/- 1.1 kg vs. 10.6 +/- 0.5 kg). While during administration of the oil the resting energy expenditure did not change (5.97 +/- 0.30 kJ/min. vs. 5.24 +/- 0.58 kJ/min.), in obese patients who were only on the strict reducing diet it declined from 5.45 +/- 0.18 kJ/min. to 4.44 +/- 0.22 kJ/min. (p < 0.01). The significant drop of total cholesterol achieved by dietotherapy alone (5.41 +/- 0.21 mmol/l vs. 6.26 0.20 mmol/l before treatment) was not affected by administration of oil (4.86 +/- 0.28 mmol/l vs. 5.69 +/- 0.35 mmol/l before treatment). HDL-cholesterol, on the other hand, declined only in obese patients with dietotherapy (1.40 +/- 0.04 mmol/vs. 1.22 +/- 0.04 mmol/l after treatment, p < 0.01). The triacylglycerol values declined significantly in both groups (p < 0.01). CONCLUSIONS: It appears that administration of thermogenetically acting triacylglycerols with medium-chain fatty acids can prevent diet-induced energetic efficiency and can improve the long-term success of dietotherapy of obese patients.

• MeSH
• dietní proteiny aplikace a dávkování   MeSH
• dietní tuky nenasycené farmakologie   MeSH
• dospělí MeSH
• energetický metabolismus * MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy krev   MeSH
• mastné kyseliny farmakologie   MeSH
• obezita dietoterapie   metabolismus   MeSH
• redukční dieta * MeSH
• triglyceridy farmakologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• klinické zkoušky MeSH
• Názvy látek
• dietní proteiny MeSH
• dietní tuky nenasycené MeSH
• lipidy MeSH
• mastné kyseliny MeSH
• triglyceridy MeSH