Biomedical subjects

Z Metelko

Publications and source records attributed to Z Metelko.

26 records · Page 2Linked to original sources

PubMed1993

Effect of war-induced prolonged stress on cortisol of persons with type II diabetes mellitus.

The study was designed to assess the impact of protracted, war-induced stress on cortisol levels and glycemic control in persons with Type II diabetes mellitus. A randomly selected sample of 44 displaced Type II diabetic persons was compared with a group of diabetic persons matched for sex, age, weight, duration of diabetes, and type of treatment who had not been forced to leave their homes. The self-reported stress, depression level, serum cortisol, fasting blood glucose, and glycosylated hemoglobin were compared. The two groups were found to be significantly different in scores for self-reported stress and depression level. Passive coping patterns prevailed in the displaced group. The serum cortisol levels correlated positively with self-reported stress, negatively with active coping patterns, and were significantly higher in the displaced persons group. No significant differences were found between the group on the variables measuring glycemic control. The results indicate that prolonged stress need not worsen glycemic control in Type II diabetic patients.

Adaptation, Psychological↗

PubMed1993

Effect of war on glycemic control in type II diabetic patients.

OBJECTIVE: To determine the effect of war-related, protracted stress on glycemic control in type II diabetic patients. RESEARCH DESIGN AND METHODS: We examined 35 patients with type II diabetes as part of their routine control in October 1990. We reexamined them in October 1991, 3 mo after the war in Croatia began. We also administered a questionnaire to assess the patients' exposure to stress and changes in diet and exercise. RESULTS: The patients were exposed to considerable stressors. The wartime diet differed from the prewar diet. We found significant changes in total serum cholesterol and TG values (P < 0.01), but we observed no significant changes in body weight, FBG, postprandial blood glucose, and HbA1c values. Insulin and glibenclamide dosages did not change. CONCLUSIONS: We detected no significant impact of stress on glycemic control, probably because of differences in individual stress responsiveness. Changes in the lipid status probably were attributable to changes in dietary habits caused by specific circumstances.

Adult↗

PubMed1992

Diabetes in time of armed conflict: the Croatian experience.

During the summer of 1991, armed conflict broke out in the Republic of Croatia. This resulted in many deaths and the displacement of many persons, with population loss in some communities and additional population burden in others. Registration of diabetic persons has been compulsory in Croatia since 1975 and from available statistics compiled by the Vuk Vrhovac Institute for Diabetes in Zagreb it was known that in 1991 there were 111,096 diabetic persons in Croatia, 16% requiring insulin, 46% treated with oral agents and 38% using dietary treatment only. This information helped to plan adequate supplies during the emergency. Contacts with international organizations and friends were of value in overcoming shortages, the most useful gifts being battery-operated blood glucose measuring devices. A study in Zagreb failed to demonstrate an association between the stress of displacement and metabolic control. Somewhat unexpectedly, diabetes and its complications did not present a major public health problem during the first 8 months of the armed conflict, but the long-term effects of these events remain to be seen.

Adolescent↗

PubMedDate not supplied

The application of insulin using the jet injector DG-77.

UNLABELLED: To avoid soreness and psychic stress following insulin injections by needle and syringe, the new jet injector DG-77 was used. It is a portable percutaneous pressure device with a spring, simple to operate which can be used to apply two different types of insulin. Thirty type 1 and type 2a diabetic patients participated in the study (10 females, 20 males). Insulin was applied using a needle and the DG-77 device in the same region of the body. A standardized questionnaire was compiled concerning simplicity of application, soreness, wish to possess the device and the possibility of acquiring it. The results obtained regarding the type of application were as follows: traditional way: glycemia: at 07(00)-8.5, 10(00)-10.5, 13(00)-7.4 mmol/l; insulinemia: at 07(00)-7.5, 10(00)-20.2, 13(00)-21.0 mU/l; jet injector: glycemia - at 07(00)-8.4, 10(00)-10.4, 13(00)-8.4 mmol/l; insulinemia: at 07(00)-2.8, 10(00)-12.3, 13(00)-20.0 mU/l, which was not statistically significant; for glycemia: at 10(00), t = 0.110, p greater than 0.05, at 13(00), t = 1.88, p greater than 0.05, and for insulinemia at 10(00), t = 0.82, p greater than 0.05, and at 13(00), t = 1.23, p greater than 0.05. IN CONCLUSION: 1) blood glucose and insulin control with the jet injector administration of insulin was equally successful as with the standard insulin application; 2) incidence of hematoma was not significant; 3) eighty-five percent of patients prefer the injector due to its simplicity of application, reduced soreness and would wish to possess the device.

Adult↗

PubMedDate not supplied

Relationship between autonomic function, 24-h blood pressure, and albuminuria in normotensive, normoalbuminuric patients with Type 1 diabetes.

We performed a battery of cardiovascular reflex tests, 24-h ambulatory blood pressure (AMBP) and 24-h urinary albumin excretion (UAE) in 116 normoalbuminuric and normotensive patients with Type 1 diabetes. Tests of heart rate variation (HRV) included the coefficient of variation (CV) and the low-frequency (LF), mid-frequency (MF), and high-frequency (HF) bands of spectral analysis at rest, HRV during deep breathing (CV, mean circular resultant--MCR), Valsalva ratio, and maximum/minimum 30:15 ratio. Autonomic neuropathy, characterized as an abnormality of more than two tests, was found in 33 patients. Patients with neuropathy compared to those without neuropathy showed significantly higher mean day and night diastolic blood pressure (dBP), mean systolic night blood pressure (sBP), and mean day and night heart rate (HR). Mean night dBP was inversely related to MF, HF, and HRV during deep breathing; mean day dBP and mean night sBP to HF; mean night HR to CV at rest, MF, HF, HRV during deep breathing, 30:15 ratio; mean day HR to HF, HRV during deep breathing, Valsalva, and 30:15 ratio. Mean 24-h UAE was not significantly different in neuropathic than in nonneuropathic patients. UAE was inversely related to CV at rest and HF. In the stepwise multiple regression analysis, reduced MF, HF, HRV during deep breathing, and high levels of UAE and HbA1c were associated with high night dBP. Autonomic neuropathy is already present in normotensive Type 1 diabetic patients at the normoalbuminuric stage and related to BP and albuminuria.

Adult↗

PubMedDate not supplied

Insulin allergy.

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

[New diagnostic criteria and classification of diabetes mellitus].

World Health Organisation (WHO) has recently proposed new diagnostic criteria and classification of diabetes mellitus. A major change in diagnostic criteria is lowering of diagnostic fasting plasma glucose level: level of 7.0 mM/L or more in two separate samples is sufficient for the diagnosis. Diagnostic criteria for plasma glucose in 120-min. of oral glucose tolerance test are unchanged. Newly recommended fasting level seems to correlate better with 120-min. value and to be a good marker of increased cardiovascular risk. The new classification describes impaired glucose regulation with two stages: impaired fasting glycaemia (plasma glucose of 6.1-7.0 mM/L) which is a new category and impaired glucose tolerance. Both subcategories are not real clinical entities, but markers of diabetic and cardiovascular risk. Diabetes mellitus, as a clinical entity, is separated in four classes: type 1, type 2, other specific types and gestational diabetes. Gestational diabetes includes any glucose intolerance in pregnancy. The Croatian Board for Diabetes Mellitus recommends acceptance of these criteria and classification for clinical use in the country and suggests that OGTT be performed for metabolic syndrome detection in cases of impaired fasting glycaemia.

Blood Glucose↗

PubMedDate not supplied

[National organization of health care in diabetes based on the "Croatian model"].

This review article shows the development and organization of the "Croatian Model" of organization of health care for diabetic patients from Professor Vuk Vrhovac to this day, and its inclusion in the St. Vincent Declaration-a group of recommendations agreed upon in 1989 with the aim to decrease the morbidity and mortality of diabetes and its complications. The Model is organized on primary, secondary and terciary levels of health care. After the administrative changes of 1993, specialized health care for diabetic patients is delivered through County and Regional Centres for Diabetes and the Diabetes Reference Centre (the Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases), a scientific and educational institution and a WHO Collaborating Centre. Mention is made of the Croatian Diabetes Registry and statistical data on the morbidity (the prevalence of diabetes in Croatia is 2.37%) and mortality of diabetes mellitus and its complications, of organization of health care for diabetic patients, their medical treatment and care in Croatia.

Croatia↗