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A Czech

Publications and source records attributed to A Czech.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

How recombinant insulin analogs improve insulin therapy of diabetes mellitus: pathophysiology, clinical practice and recommendations.

According to the latest prognoses, 300 million people are expected to suffer from diabetes (particularly type 2) in 2025; diabetes will become a new epidemics of the coming century. Therefore it is so important to get acquainted with the pathomechanism of diabetes-related disorders and the possibilities of effective treatment. During the last decade, numerous prospective epidemiological studies have been completed, which have considerably extended our knowledge of the pathomechanism of disturbances and their effect on late complications of diabetes. Resistance to insulin has an important role in the etiology of type 2 diabetes. However, there is substantial evidence indicating that impairment or regression of rapid insulin secretion phase at the early stage of the disease is a factor of no lesser importance. The lack of appropriate insulin concentration after the stimulation by food ingestion (first 30 min after the meal), leads to permanent, treatment-resistant hyperglycemia. The postulated attempts to obtain a 'nearly normoglycemic' condition, as well as the results of prospective epidemiological studies proving that achieving this aim improves the prognosis of diabetic patients, prompt the researchers to search for the drugs or treatment schedules, which could effectively restore the impaired insulin secretion, and its early phase in particular, in type 2 diabetes. Human insulin analogs and their pre-formulated commercially available mixtures seem very promising in this respect.

Adolescent↗
PubMedDate not supplied

[Relative effectiveness of tolbutamide, chlorpropamide and gliclazide].

In clinical practice of hypoglycemic therapy of diabetes mellitus the problem of the optimal selection of oral hypoglycemic agent, corresponding to the individual patterns of regulatory and metabolic disturbances is of primary importance. The individual, pathophysiological basis should be met as much as possible by the pharmacodynamic properties of the selected, hypoglycemic drug. For this reason group of 23 diabetics type II underwent a prolonged, open trial of controlled pharmacotherapy with 4 sulphonylurea derivatives. Pertinent clinical and metabolic parameters were assessed before, during and after planned periods of therapy with Tolbutamide or Chlorpropamide to Gliclazide and Gliclazide to Glibenclamide. In the same time the levels of serum insulin fasting and after breakfast were determined. Also the comparative efficacy of the exchange of the drug in a subgroup of diabetics with fasting glycemia below and above 160 mg% was assessed. It was shown, that the change of Tolbutamide or Chlorpropamide to Gliclazide or Glibenclamide improved the therapeutical effectiveness in general. The individual responses to such a change were however individually differentiated. The change of Tolbutamide or Chlorpropamide to Gliclazide increased the therapeutical efficacy only in these patients, in whom such a change was associated with an increase of prandial, reactive serum insulin level (IRI). In practice they were patients with the fasting glycemia lower than 160 mg%. In patients with fasting glycemia higher than 160 mg% the change of oral compounds under study was not connected with an increase of prandial serum insulin. The metabolic parameters have not improved either. Perhaps they were patients with diabetes mellitus type II, who should be primarily qualified to insulin.

Administration, Oral↗
PubMedDate not supplied

[Multiple insulin injections with the help of a subcutaneous catheter or metered syringe (Pen)].

Multiple, daily injections of insulin in intensified insulin therapy of diabetes mellitus has many important advantages. From the technical point of view however it requires new instruments, which could further limit the trauma of injection and facilitate the necessary manipulations. For these reasons a combination of typical insulin syringe (Novo-Noraisk Pen) and a special subcutaneous insulin catheter (Vigo-Spectramed Insuflon) was examined in a systematic way. Insuflon was inserted for 7 days. Insulin injection was made with a syringe through the head of the Insuflon. The needle of a syringe easily penetrated the membrane inside the Insuflon 4 times daily for 7 days without any damage. The acceptance of this method was high. It increased the compliance in general. The parameters of diabetes mellitus control changed positively. No side-effects of such procedure were noted.

Adult↗
PubMedDate not supplied

[Pathophysiologic basis of arterial hypertension in diabetic patients].

UNLABELLED: Analysing the already large scope of research dealing with the pathophysiological basis for the increased morbidity due to arterial hypertension in a diabetic subpopulation one may find a mosaics of different mechanisms and proposed hypotheses. Hypertensive diabetics differ in this respect just as te diabetes mellitus and arterial hypertension are differentiated. In this review as the main lines of understanding the hypertensive regulatory abnormalities in IDDM the following possibilities were discussed: 1) genetic predisposition; 2) diabetic nephropathy; 3) influence of hyperglycemia and of the exchangeable Na pool increase; 4) iatrogenic (IDDM) and natural dysinsulinismus (NIDDM), insulin-resistance; 5) hyperreactivity of small vessels related to microangiopathy and autonomic neuropathy to adrenergic impulsation, infusions of catecholamines, angiotensin II, static physical exercise. As probably secondary pathogenetic mechanisms one may consider perturbations in R-A-A functional status, in ANP, PGI2 and PGE2 and kinins secretion and action. The loss of elastic properties by arteries is also an important secondary factor in systolic blood pressure elevation. IN CONCLUSION: arterial hypertension in diabetic patient needs the individual, pathophysiological differentiation. This may create better therapeutical approach.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

[Statistical-clinical analysis of arterial blood pressure in the outpatient clinic population of patients with diabetes mellitus].

The level of morbidity due to arterial blood hypertension was determined in a cohort of 2,492 diabetic patients, including 1,996 NIDDM and 496 IDDM cases treated at Warsaw Voiévodship Diabetic Out-Patient Clinic. In the same time, its correlation with several, selected clinical parameters was analysed statistically. It was found that: 1. Arterial hypertension morbidity rate in the whole cohort was 48.0% being significantly higher than that in the general population of Warsaw aged between 35 and 64 years and amounting to 37.4% for male and 30.9% for female patients. 2. Morbidity index from the present study was significantly higher in NIDDM cases (53.3%) than that for IDDM cases (26.6%). 3. In case of NIDDM the highest morbidity was seen in female patients (57.9%) whereas in male patients it has reached 48.1%. It was closely related to age and in lower degree to the existence of microangiopathic syndromes. 4. In IDDM morbidity for arterial hypertension was strongly affected by microangiopathic symptoms, duration of diabetes mellitus and age. 5. Borderline, systolic-diastolic hypertension was encountered in the majority of cases.

Adult↗