Search

Objectives: To assess the relationship between selected parameters of the mental state and the quality of life of patients with diabetes., Methods: The study included 51 patients with type 1 diabetes and 52 patients with type 2 diabetes. The following scales were used in the study: quality of life SF-36, Acceptance of llness Scale (AIS), Hospital Anxiety and Depression Scale (HADS) and Satisfaction with Life Scale (SWLS)., Results: Patients with type 2 diabetes achieved lower values than patients with type 1 diabetes only in the domain of physical functioning of the SF-36 scale (p = 0.001). Assessing the relationship between the studied parameters, it was shown that the duration of the disease was associated with a worse overall health rating (p = 0.036) among patients with type 1 diabetes. However, among patients with type 2 diabetes the duration of the disease correlated negatively with physical functioning (p = 0.002), physical functioning in social roles (p = 0.001) and physical pain (p = 0.047) as well as life satisfaction (p = 0.012) and positively with the results of glycated haemoglobin (p = 0.04). Among patients with type 1 diabetes, the level of depression negatively correlated with the level of acceptance of the disease (p = 0.0009) and life satisfaction (p = 0.006), while the level of anxiety only with the level of acceptance of the disease (p = 0.0004), and a greater severity of anxiety was associated with worse metabolic control (p = 0.02). In the group of patients with type 2 diabetes, the level of anxiety negatively correlated with the level of acceptance of the disease (p = 0.003)., Conclusions: Due to the numerous limitations of chronic disease, more attention should be paid to the quality of life and mental state of patients diagnosed with diabetes, and assessment of the above parameters should be included in the therapeutic process.

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder, affecting 5-10% women of reproductive age. It is one of the most common causes of functional infertility and a clinical problem that can be faced by doctors of many specialities. PCOS is characterized by hyperandrogenism, oligoovulations and metabolic disorders. ESHRE/ASRM (2003) or AES (2006) criteria are used to diagnose a patient with polycystic ovary syndrome. Although a lot of studies are carried out, ethiology and pathogenesis of PCOS is still not clear. The treatment must be long-term, causal and depending on the patient's expectations. The fundamental part of the therapy are lifestyle modifications and weight loss. Losing as little as 5% of body mass increases frequency of ovulations, chances of pregnancy and improves hormonal profile. First-line therapy is clomiphene citrate and for hyperandrogenism reduction combined oral contraceptive pill is frequently used. Metformin, not only improves carbohydrate metabolism, but also increases ovulations' frequency and chances of pregnancy. Metabolic syndrome, diabetes mellitus type 2, hypertension and higher risk of endometrial cancer are characteristic for patients with PCOS., (© 2018 MEDPRESS.)

Objective: The aim: We aimed at assessing the prognostic significance of diabetes mellitus in patients with NSTEMI treated with PCI as well as determining the independent predictors of worse prognosis., Patients and Methods: Materials and methods: We performed a retrospective analysis of 830 patients hospitalized between January 2006 and December 2012 with diagnoses of NSTEMI and undergoing angiography and percutaneous coronary interventions. Patients were divided into two groups: with diabetes mellitus (246 patients) and without diabetes mellitus (584 patients). All patients were followed up at 30 days, 12 months, and 24 months., Results: Results: Diabetes mellitus was an independent risk factor for the occurrence of complex endpoints (HR, 1.64) at the 24-month follow-up visit: myocardial infarction not ending with death analyzed alone (HR, 1.82), death analyzed together with myocardial infarction not ending with death (HR, 1.65), and repeated revascularization performed due to the presence of ischemia (HR, 1.63) Moreover, diabetes mellitus was one of the factors influencing 24-month mortality, but its independent influence was at the threshold of significance (HR, 1.46; p=0.08). In the multiple factor analysis the independent risk factors for death at the 24-month follow-up were: creatinine concentration on admission, LVEF, age, and cardiogenic shock during hospitalization., Conclusion: Conclusions: Despite similar efficacy of percutaneous coronary intervention, diabetes mellitus was associated with a worse in-hospital and long-term outcomes. Diabetes mellitus did not affect long-term mortality.

Elderly people more often suffer from vitamin D insufficiency. It is caused by insufficient supply with diet and scarce sun exposure, due to life style. This is a very common situation in Poland and worldwide. Vitamin D influences functioning of many various organs. Its deficiency may cause bone mineralization disorders, osteomalacia, osteoporosis, muscle weakening, which can result in higher risk of falls. Its influence on cardiovascular diseases, type 2 diabetes and cognitive functions is widely discussed. Supplementation is crucial in elderly population. It should be administrated all year, with adjustement of dose to age and weight. Initial blood concentration is not required. An appropriate sun exposure is recommended. Treatment of vitamin D deficiency should be intensive and last for several months. Although the doses are high, no adverse effects were observed.

Anemia is the most common disorder of the blood with iron deficiency being the predominant cause. On the other hand, diabetes prevalence is increasing rapidly. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves. Diabetic kidney disease (DKD) may be present in both types 1 and type 2 diabetes mellitus. Anemia is one of the common feature of chronic kidney disease. The epidemiological data on anemia prevalence are limited. In this review data on epidemiology, pathogenesis, complication and treatment of anemia in diabetic kidney disease are presented.

With the obesity epidemic, we observe increase in the number of people suffering from diabetes mellitus type 2. This illness is considered cardiovascular disease equivalent, so influence of drugs used to manage diabetes on cardiovascular outcomes is important. Below we present review of main class of drugs used in diabetes treatment and summingup of trials conducted with their use to evaluate cardiovascular risk during treatment.

Cardiovascular diseases (CVD) are the most common cause of mortality in the world. Acetylsalicylic acid (ASA) is a widely used medicine in primary and secondary prevention of cardiovascular diseases. About 1-60% patients taking aspirin have high platelet reactivity (HOPR) despite aspirin treatment. HOPR is significantly more frequent in patients with chronic kidney disease (CKD) and it increases the risk of adverse cardiovascular events in these patients. The cause of HOPR in patients with CKD may be oxidative stress and inflammation. To the risk factors belong diabetes, female sex or decreased HDL cholesterol level.

New antidiabetic drugs let optimize the treatment of diabetes. In clinical practice the use of glitazone, incretin drugs (including GLP-1 receptor agonists and DPP-4 dipeptidyl peptidase inhibitors) or glucose-2-cotransporter (SGLT-2) inhibitors is increased. The potential use of these drugs in patients with renal insufficiency is limited both to impaired renal function (and the associated risk of drug or metabolite accumulation in the body), and due to limited clinical data assessing the safety of their use in this group of patients. However, previous experience has allowed us to formulate recommendations for the use of some of the new antidiabetic agents in patients with renal impairment. This provides an opportunity to improve the management of diabetes mellitus and to reduce the complications associated with diabetes (especially cardiovascular disease) in diabetic patients with renal disease.

Diabetes mellitus is the leading cause of end-stage renal disease in patients beginning renal replacement therapy. The epidemic of type 2 diabetes contributed to a new approach for diabetic kidney disease, one of the most common complications of diabetes type 1 and 2. The current recommendations of the management in diabetic kidney disease developed by an international group of experts based on analysis of clinical trials and expert opinion have been reviewed in this article. The guidelines concern several issues as renal replacement modality selection, glycaemic control, the choice of glycaemia controlling drugs and cardiovascular risk management aiming to improve the quality of life of the patients, as well as to reduce the costs of the medical care.

Purulent infection of the neck is a serious condition, which can occur at any age and regardless of any factors. It often leads to the serious complications, including death. A case report. The authors present a case of a 56-year-old patient who reported to the emergency department because of the severe neck pain, fever and progressive weakness. Physical examination revealed an extensive inflammation involving skin and subcutaneous tissue surrounding suboccipital area and neck. Palpation of the thyroid gland showed tumor of the left lobe. Due to deteriorating condition, it was decided to admit the patient to the hospital, along with urgent surgery. It was necessary to perform a repeated removal of the necrotic tissues of the nuchal area. Diabetes mellitus type II was diagnosed during hospitalisation. Long and laborious extensive wound care enabled to perform a skin graft and full recovery. The patient was discharged in good general and local condition in the 11th week of the hospitalization., (© 2015 MEDPRESS.)

Diabetics with stage V chronic kidney disease (CKD) on hemodialysis (HD) are considered as "difficult patients", because of problems with creation of the vascular access. There is controversy regarding the results and recommendations for preparation of the vascular access in these patients. The aim of this retrospective study was to evaluate the results of creating different types of arteriovenous fistula (AVFs) in consecutive series of patients starting dialysis treatment. The analysis was performed in 741 patients (385 females and 356 males), average age 61.4±7 years, who started dialysis treatment in our department between January 2005 and December 2012. Native AVFs were created in all patients. No patients received an AVF requiring synthetic graft material. The number of patients with diabetic nephropathy was 166 (22.4%). Among them, 30 (18%) had type 1 diabetes and 136 (82%) type 2. In this group the occurrence of calcification in the forearm artery was estimated on the basis of physical examination, Allan's test, Doppler ultrasound and forearm X-ray. In a subgroup of patients with atherosclerotic changes in the arterial system the frequency of failed AVFs was analyzed. These results were compared with the group without diabetes. The number of procedures necessary for successfu AVF creation and type of access was counted in both groups. The assessment of the procedure frequency and AVF location in diabetic and in non-diabetic patients was made by χ² test with Yates correction. In the group of 166 patients with diabetes, in 100 cases (60%) atherosclerotic changes in forearm arteries were observed. In a subgroup of 30 patients with type 1 diabetes atherosclerosis was observed in 17 adults (57%). In this subgroup creation of a suitable forearm AVF in the first procedure in 9 patients was possible and in the other 8 cases the atherosclerotic changes necessitated repeated procedures and were an important obstacle to create the AVF. In the subgroup of 136 patients with type 2 diabetes, atherosclerosis in the forearm artery was observed in 83 cases (61%). In this subgroup the creation of a native AVF was possible in 40 patients during the first procedure and in 43 cases additional intervention was needed, but only in 8 cases was atherosclerosis the cause of fistula failure. Generally, among 166 patients only in 16 cases (10%) did atherosclerosis present an important obstacle for AVF creation, but the number of necessary procedures to create one functioning AVF was significantly greater in this population (2 v 2.7, p=0.0001). A functioning AVF in patients with diabetes was found significantly frequently in the arm localization in comparison to non-diabetic patients (4.3 v 2%, p=0.0478). Atherosclerotic changes in forearm arteries in diabetic patients appear in 60% of hemodialysis patients and make it difficult to create an AVF only in 10% of diabetic patients, but it is possible to create a native AVF in 90% of diabetic patients, although this requires more procedures. In patients with diabetes, AVF in the wrist region should be preferred.

Aim: To compare quality of life, symptoms of depression and strategies of coping with stress among individuals with type 2 diabetes and healthy individuals in their middle age, and also to verify the correlation of the aforementioned variables., Methods: 87 persons took part in the study: 42 persons with type 2 diabetes and 45 healthy persons. There were used 4 questionnaires with recognized psychometric properties., Results: The results showed significant differences in the level of global quality of life, satisfaction with health and physical domain, symptoms of depression, and also in terms of reactive coping with stress, which focuses on emotions and avoidance., Conclusions: Individuals with diabetes have lower global perceived quality of life and satisfaction with health and physical domain. In this group, the intensity of depressive symptoms is higher. Both groups use a task-oriented style with the same frequency in times of stress. Persons with diabetes use an emotion-oriented style more often than healthy persons, whereas the latter use an avoidance-oriented style. Both groups use various proactive coping strategies with the same frequency.

Background: Asymptomatic systolic dysfunction of the left ventricle (LV) refers to patients without current clinical symptoms of heart failure., Aim: 1. Analysis of echocardiographic parameters in patients with stable angina pectoris without symptoms of heart failure and their changes in two years time 2. Determine the importance of NT-proBNP for early detection of asymptomatic heart dysfunction in patients with stable angina pectoris and its influence on the prognosis in two years 3. Analysis of the relationship between the degree of the left ventricular diastolic dysfunction and co-morbidities and selected echocardiographic parameters 4. Significance of prognostic selected echocardiographic parameters (E/ Vp, E/E', Ar) in patients with stable angina pectoris without any symptoms of heart failure., Patients: The study included 57 patients with stable ischemic heart disease, no history of myocardial infarction: including 35 men (61.4%) aged 35-56 years (mean 51.08 +/- 4.01 years) hospitalized in the Department of Coronary Artery Disease, Institute of Cardiology, Jagiellonian University in Krakow. Analysis after two years involved 56 patients (1 patient died after a year of observation)., Methods: Patients were evaluated 2x: before and after 2 years (assessment of clinical status: physical examination, the severity of angina and physical examination, atherosclerotic risk factors, ECG, lipid profile, plasma NT-proBNP). Patients were divided into three groups: Group A, patients with LV normal function (32 patients), Group B - with impaired diastolic function (22), Group C - with impaired systolic and diastolic function (EF < or = 50%, as measured by Simpson; 3 patients)., Results: Subgroups of respondents ABC did not differ significantly with respect to age, sex and risk fac- tors of atherosclerosis. There was a significant correlation between the type of LV dysfunction and indicators of elevated end diastolic pressure in LV: E/Vp (p = 0.0002), E/E' (p = 0.0006), Ar (p = 0.034) and the propagation velocity Vp (0 = 0.001). There was a significant correlation between systolic and diastolic heart dysfunction and the levels of NT-proBNP (p = 0.018). After 2 years, patients with deterioration of heart function in group A noticed a significant correlation between occurrence of diastolic dysfunction and presence of diabetes mellitus type II (p = 0.01). Conclusions: 1. Elevated levels of NT-proBNP indicates the impairment of systolic andlor diastolic asymptomatic patients. NT-proBNP is therefore important for early detection of asymptomatic cardiac dysfunction in patients with stable angina pectoris. 2. In patients with stable angina pectoris without symptoms of heart failure: the value of E/Vp > or = 1.5 and E/E '> or = 8 can be the marker of more advanced coronary atherosclerosis, manifested by three-vessel disease or stenosis of the left main coronary artery.

Obesity, defined as abnormal or excessive fat accumulation, is currently believed to be a major public health problem worldwide. Over the past 20 years, the prevalence of obesity has increased rapidly in both industrialized and developing countries, resulting in a considerably increased risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome. Although the exact pathophysiological mechanisms underlying these diseases remain unclear, clinical and epidemiological studies support the existence of a relationship between obesity-induced inflammation and insulin resistance linked with the development and progression of metabolic diseases. Adipokines, produced and released by adipose tissue, are considered as factors linking obesity-induced inflammation with insulin resistance, and their regulation through peroxisome proliferator-activated receptors γ (PPARγ also known as NR1C3) is essential in these processes. PPARγ are transcriptional factors belonging to the ligand-activated nuclear receptor superfamily which directly regulate the expression of a large number of genes involved in adipocyte differentiation, lipid and carbohydrate metabolism as well as adipokine synthesis; thereby they are implicated in various metabolic disorders, including obesity, insulin resistance, dyslipidemia, and hypertension. This review summarizes the current literature on a functional relationship of PPARγ with obesity and insulin resistance and, moreover, highlights the significance of synthetic ligands of these receptors in the mentioned metabolic disorders.

Treatment of cancer involves not only appropriate pharmacological or psychological therapy and rehabilitation, but also diet aimed at prevention of the process of cachexia. Postprandial hyperglycemia exerts a significant effect on the growth and proliferation of tumor cells. It promotes formation of a number of metabolic changes in every tissue of the organism. Chronic postprandial hyperglycemia, occurring in type 2 diabetes, enhances all these changes. Although the results of epidemiological studies on the relationship between the overall risk of cancer development, or tumors in different parts of the organism, are heterogeneous, most of them indicate that the risk increases with an increase in glycemic load of the examined population's diets. Researchers also suggest a beneficial effect of limiting the amount of easily assimilable carbohydrate in the diet to stabilize the disease and for better tolerance of chemo or radiation therapy. However, further studies are required.

Type 2 diabetes mellitus (T2DM) is a metabolic disease caused by insulin resistance that leads to changes in glucose metabolism. Importantly, both insulin resistance and hyperglycemia are present in T2DM patients as a hallmarks of metabolic syndrome. They negatively affect functions of many cells, for example endothelial cells. Endothelial progenitor cells (EPC) is a population of mononuclear cells that expresses endothelial and progenitor markers. EPC are also characterized by ability to form tubes on matrigel, outgrowth into mature endothelial cells, produce proangiogenic factors or take part in the blood vessels formation. Upon injury endothelial progenitor cells are mobilized from bone marrow, home to injured site and take part in vessels formation. It was shown however, that functions of EPC in T2DM patients are impaired. In this review we focused on the T2DM and its detrimental effects on EPC biology. taking also into account the beneficiary role of anti-diabetic drugs. Decreased number and impaired functions of EPC in T2DM patients might lead to increased frequency of cardiovascular incidents and development of micro- or macroangiopathies.

Unlabelled: Albuminuria is an early marker of the microvascular and macrovascular complications in patients with type 2 diabetes mellitus. Metabolic complication accompanying the disease, especially hyperglicaemia, have significant influence on the range of albumin excretion. The aim of the study was to evaluate urinary albumin excretion and percentage of glycated hemoglobin (HbA1c), in relation to fasting and postprandial glycaemia., Material and Methods: Research was made in two groups of patients with confirmed albuminuria: in the 1st group with good glycemic control with HbA1c > or = 6,1%-< or = 6,5%, and in the 2-nd group with poor glycemic control with HbA1c > 6,5%-< or = 10%. The control group consisted of 21 patients with essential hypertension and coexisted albuminuria, not suffering from diabetes. The average fasting and postprandial glycemic were calculated for each patient on the basis of the last three values of glycaemia from the patient's self-control test. The extent of albuminuria and the percentage of HbA1c were determined by the immunoturbidimetric test., Results: The highest albumin excretion in urine was noticed in the group with poor glycemic control, a slightly lower level of albuminuria was found in the group with good glycemic control, however the lowest level of albumin excretion was noticed in the control group. The differences were not statistically significant. The fasting glycaemia as well as postprandial glycaemia were increased in the group with higher percentage of HbA1c (p < 0,001) with comparison to the group with good glycemic control. The average percentage of HbA1c was 7,54% in the group with poor glycemic control and was significantly connected with larger glycaemia with comparison to the 2nd group with average percentage of HbA1c 6,3%., Conclusions: The excretion of albumin in urine rises with increased glycaemia and percentage of glycosylated hemoglobin. Fasting glycaemia as well as postprandial glycaemia have influence on the percentage of glycated hemoglobin.

Proinsulin C-peptide, released in equimolar amounts with insulin by pancreatic β cells, since its discovery in 1967 has been thought to be devoid of biological functions apart from correct insulin processing and formation of disulfide bonds between A and B chains. However, in the last two decades research has brought a substantial amount of data indicating a crucial role of C-peptide in regulating various processes in different types of cells and organs. C-peptide acts presumably via either G-protein-coupled receptor or directly inside the cell, after being internalized. However, a receptor binding this peptide has not been identified yet. This peptide ameliorates pathological changes induced by type 1 diabetes mellitus, including glomerular hyperfiltration, vessel endothelium inflammation and neuron demyelinization. In diabetic patients and diabetic animal models, C-peptide substitution in physiological doses improves the functional and structural properties of peripheral neurons and protects against hyperglycemia-induced apoptosis, promoting neuronal development, regeneration and cell survival. Moreover, it affects glycogen synthesis in skeletal muscles. In vitro C-peptide promotes disaggregation of insulin oligomers, thus enhancing its bioavailability and effects on metabolism. There are controversies concerning the biological action of C-peptide, particularly with respect to its effect on Na⁺/K⁺-ATPase activity. Surprisingly, the excess of circulating peptide associated with diabetes type 2 contributes to atherosclerosis development. In view of these observations, long-term, large-scale clinical investigations using C-peptide physiological doses need to be conducted in order to determine safety and health outcomes of long-term administration of C-peptide to diabetic patients.

Unlabelled: Diabetic nephropathy is one of the most common complications of diabetes. Symptom of nephropathy is albuminuria, in which the mechanism of formation may participates CRP and IL-6. The aim of the study was to evaluate the concentrations of CRP and IL-6 depending on the irregularity of metabolic patients with type 2 diabetes and their impact on the occurrence of albuminuria., Material and Methods: The study was conducted among 68 patients with type 2 diabetes with albuminuria. Patients were divided into groups: group I - patients with type 2 diabetes with HbA1c > or = 6.1 - < or = 6.5%, group II - patients with type 2 diabetes with HbA1c > 6.5 - < or = 10.0%, K - control group, 21 patients with essential hypertension with albuminuria. The material was consisted of venal extracted for clot drawn from the basilic vain. IL 6 concentration was assessed using the ELISA method. The percentage of hemoglobin A1c (HbA1c), CRP, the extent of albuminuria was determined by immunoturbidimetric method., Results: The mean urinary albumin excretion was highest in the second study group, lowerin the test group, the lowest in the control group. The average concentration of IL-6 and CRP was highest in group I, lower in group II, the lowest in the control group (p > 0.05). It has been shown a positive correlation between serum CRP and the magnitude of albuminuria in the test group of patients with type 2 diabetes with HbA1c > or = 6.1 - < or = 6.5% (p < 0.037). The relationship between serum CRP and the magnitude of albuminuria in the control group of patients with essential hypertension were at the border of statistical significance (p < 0.057). Not shown a positive correlation between these parameters in the second group of patients with type 2 diabetes with HbA1c >6.5 - < or = 10.0%., Conclusions: In patients with type 2 diabetes with better metabolic control, protein CRP is a sensitive marker of albuminuria.

Due to increasing availability of methyl alcohol, methanol poisoning becomes more common. Consumption of even relatively small amounts can lead to very serious consequences, including irreversible damage to the eye and death. Quickly implemented proper treatment can alleviate the course of poisoning. Since the victims of poisoning often come to medical facilities unconscious, unresponsive, with unknown or incomplete medical history, it is crucial, both for toxicologists and emergency physicians, to consider the possibility of methanol or ethylene glycol poisoning. It is important to be able to recognize the symptoms of such a poisoning and to order appropriate laboratory tests, especially arterial blood gas and if necessary serum concentrations of methanol and ethylene glycol. The article discusses the course of methanol poisoning, various diagnostic methods of detecting methyl alcohol and factors that affect the methanol concentration in serum. Two clinical cases of patients with non-respiratory acidosis and hyperglycemia, the presence of methanol determined by spectrophotometric method and no methanol intake in anamnesis were also presented. We are considering the possibility of false positive results of methanol determination in the course of diabetic ketoacidosis and significant hyperglycemia.

Background and Aim: In this study, we aimed to evaluate myocardial functions in patients with diabetes mellitus (DM) and impaired glucose tolerance (IGT). We also aimed to investigate the relationship between B-type natriuretic peptide (BNP) levels and myocardial performance index (Tei index) in these patients., Methods: A total of 38 patients with DM, 34 patients with IGT, and 40 healthy volunteers were recruited to the study. Basal clinical and laboratory findings were recorded. BNP levels of all individuals were measured. Both conventional transthoracic and tissue Doppler echocardiogaphy were performed to all study participants., Results: B-type natriuretic peptide levels of the diabetic group were greater than in patients with IGT and the control group. BNP levels of the IGT group were also higher than the control group. Myocardial performance index values, measured by both the conventional method and tissue Doppler echocardiography, were significantly higher in the diabetic group than in the control group. There was a significant relationship between myocardial performance index and BNP levels., Conclusions: Myocardial functions are disturbed in patients with DM and also in patients with IGT. BNP and myocardial performance index can be used in diabetic patients and in patients with IGT to define myocardial dysfunction.

Purpose: To answer the question whether biometric parameters of anterior segment of the eyeball are influenced by type 2 diabetes, at the stage when the lens is still transparent, so before cataract development., Material and Methods: Fifty subjects (28 women and 22 men), at the age of 63.3 +/- 11.3 years were enrolled in this prospective study. They were divided in 2 groups: patients with type 2 diabetes (24 subjects) and analogous age group in good general health - control group (26 subjects). None of the tested individuals presented lens opacities. The planned biometric measurements included: central corneal thickness, anterior chamber depth and axial lens thickness. The data were statistically analyzed., Results: There was no difference between the groups of both proven and potential parameters that are associated with biometric measurements of the anterior segment of the eyeball, such as: gender, age, smoking and axial length of the eye. In diabetic patients, as opposed to the subjects in the control group, statistically significantly increased lens thickness (4.78 +/- 0.50 mm vs 4.43 +/- 0.50; p = 0.016), central corneal thickness (561.5 +/- 31.6 microm vs 542.2 +/- 35.2; p = 0.047), and the tendency for shallow anterior chamber (3.06 +/- 0.40 mm vs 3.22 +/- 0.38; p = 0.159), were observed. In patients with diabetes there was no association of the biometric parameters values with the duration of diabetes and presence of diabetic retinopathy., Conclusions: Type 2 diabetes contributes to increased axial corneal and lens thickness at the stage when the lens is transparent, albeit it does not significantly affect anterior chamber depth.

The plague of obesity afflicts an increasing group of people. Moreover type 2 diabetes, which is the most serious illness accompanying excessive weight, is becoming more and more common. Traditional methods of obesity treatment, such as diet and physical exercise, fail. This applies especially to people with class III obesity. The only successful way of treating obesity in their case is bariatric surgery. There are three types of bariatric surgery: restrictive procedures (reducing stomach volume), malabsorptive procedures, and mixed procedures, which combine both methods. In spite of the risk connected with the surgery and complications after it, bariatric procedures are advised to patients with class III obesity and class II with an accompanying illness which increases the probability of death. It has been proved that bariatric surgery not only eliminates obesity but also very frequently (in 90% of cases) leads to the remission of type 2 diabetes. Moreover, the remission occurs very fast--it takes place a long time before the patients reduce their weight, even within a few days after surgery. Detailed studies have shown that the remission of diabetes is caused mostly by the change of the gastro-intestinal hormones' profile, resulting from the surgery. These hormones include GLP-1, GIP, peptide YY, ghrelin and oxyntomodulin. Additionally, the change of the amount of adipose tissue after the surgery influences the level of adipokines, i.e. the hormones of the adipose tissue, among which the most important are leptin, adiponectin and resistin. Thus, bariatric surgery not only changes the shape of the gastrointestinal tract but it also modulates the hormonal activity. Bariatric surgery is considered as therapy not only for the obese but also for diabetic patients.

The increased number of subjects with type 2 diabetes and putting into clinical practice further new hypoglycemic agents and also aspiring to achieve the bettest glycemic control using a few medications may cause that undesirable actions of these agents may be observed more frequently. One undesirable effect of hypoglycemic drugs is acute pancreatitis; therefore the aim of the present paper is to review data concerning the development of this complication during type 2 diabetes pharmacotherapy.

Hormones have influence on many tissues and organs including the cardiovascular system. This article analyzes fluctuations that happen in a child's cardiovascular system in selected endocrinopathies. We are pointing out the higher risk, in the course of diabetes, of development of arterial hypertension and atherosclerosis including participating mechanisms in their pathogenesis - disorders of the lipid metabolism, hiperinsulinaemia, insulin resistance or/and autonomic neuropathy. We are describing how the increased and reduced action of thyroid hormones on certain molecular pathways in the heart and vasculature causes relevant cardiovascular derangement. In the article, we are signaling also that the cardiovascular consequences of cortisol excess are elevation of blood pressure, obesity, hyperinsulinemia and/or dyslipidemia. This review analyzes the relationship of cortisol excess to these cardiovascular risk factors and to putative mechanisms for hypertension. In reference to clinical studies we are describing how the deficiency of the growth hormone is connected with a development of risk factors of cardiovascular diseases. In conclusion we underlined that early diagnosis and proper treatment of illnesses of the endocrine system can protect our pediatric patients from serious cardiac complications in later years.

The recent years have brought about a marked increase in the number of people suffering from carbohydrate metabolism disturbances. This is primarily due to adverse changes in lifestyle, which consists of an improper diet, rich in simple carbohydrates and fats, and low physical activity. An increasing number of patients with diabetes resulted in the growth of a number of individuals suffering from diabetes-related complications, including cardiovascular diseases. Although, the first line treatment of cardiovascular disorders are beta-blockers, for many years their use in diabetic patients was questioned to the extent that diabetes was one of the major contraindication to these agents. These concerns stemmed primarily from the proven negative impact of first generation beta-blockers on carbohydrate metabolism. The aim of this study was to summarize the possibility of beta-blocker applications in type 2 diabetic patients suffering from cardiovascular disorders, which, in a non-diabetic population, are commonly treated with these agents, taking into account the diversity between various classes of beta-blockers. On the basis of published clinical trials and meta-analyses we discuss the impact of this group of agents on the development of new-onset diabetes, worsening of existing diabetes control, and the development and progression of diabetes-induced complications.

Unlabelled: Diabetes is a chronic disease that leads to several complications. In this group patient with impaired cognitive functioning were determined., The Aim of the Study: To evaluate the effectiveness of working memory and executive functions in patients diagnosed with type 2 diabetes., Material and Methods: Study included 68 people (men n=42; 61.76%) aged 18-55 years. Subjects were divided into 2 groups: group 1--healthy (n=37; n=19 males, 51.35%; mean age = 31.52 years; SD = 9.30) and group 2--treated for type 2 diabetes (n=31; male n=23, 74.2%; mean age = 46.74 years; SD = 7.88). The study used the Card Sorting Test performance in Wisconsin (Wisconsin Card Sorting Test-WCST), designed to assess the effectiveness of working memory and executive functions. Results. Statistically significant differences between the two groups in the Card Sorting Test performance in Wisconsin were observed., Conclusions: Patients with type 2 diabetes achieve poorer results in the Card Sorting Test performance in Wisconsin compared to healthy subjects. The obtained results suggest the weakening of the effectiveness of working memory and executive functions in patients with insulin-independent diabetes.

Introduction: Reports point to the significant role of inflammatory mechanisms in stroke. These mechanisms are activated in peripheral blood in response to acute ischemic injury of cerebral tissues. The aim of this study was to determine whether peripheral inflammatory response to acute ischemia of the nervous tissue develops during the first twenty-four hours of ischemic stroke., Material and Methods: We studied 53 persons divided into three groups: 25 patients with ischemic stroke, arterial hypertension, and/or type 2 diabetes mellitus, and/or dyslipidemia (group I); 17 patients with arterial hypertension, and/or type 2 diabetes mellitus, and/or dyslipidemia but without stroke (group II); 11 young, healthy individuals (group III). TNF-alpha concentrations in peripheral blood were measured in each group using a sandwich enzyme-linked immunosorbent assay (ELISA). Other markers of inflammation in peripheral blood--C-reactive protein, fibrinogen, and leukocyte count--were assayed as well. The results were analyzed in relation to age, gender, co-morbidities, and blood-brain barrier injury., Results: TNF-alpha concentrations in peripheral blood of stroke patients were similar as in the other two groups. No associations between TNF-alpha and other inflammatory parameters were found. Injury of the blood-brain barrier was not accompanied by a significant change in the concentration of TNF-alpha., Conclusion: No significant peripheral inflammatory response to brain ischemia develops during the first twenty-four hours of ischemic stroke. This finding suggests that early anti-inflammatory prevention protocols can be devised to limit further injury of ischemic nervous tissue caused by activation of inflammatory processes.

Background: The most common infection following surgical treatment, when mechanical ventilation and tracheal intubation are used, is ventilator-associated pneumonia (VAP) induced by Gram-negative and Gram-positive bacteria. Its treatment is difficult due to increasingly high antimicrobial drug resistance observed recently., Case Report: A 73-year-old patient was admitted to undergo coronary artery bypass grafting and cardiac aneurysm excision. Additionally, chronic circulatory insufficiency (NYHA 2) with ejection fraction of 30% together with hypertension and type 2 diabetes were diagnosed. After extracorporeal circulation, she was given adrenaline/noradrenaline and intra-aortic balloon pump. Postoperatively, elevated levels of CRP (70 mg L(-1)) and of procalcitonin (22.4 ng mL(-1)) were detected. Empiric therapy with cefepime 1 g x 2 iv was started. X-ray revealed atelectasis in the middle left lung lobe and Enterobacter cloacae was isolated from the bronchial tree. Patient was intubated and mechanically ventilated. Antibiotic therapy with cefepime was continued for 10 days and resulted in improvement of patient's general condition. On postoperative day 7, she was transferred from ITU to the cardiac surgery ward., Conclusion: Cefepime applied empirically to a VAP patient can effectively treat the lung infection and improve his/her general condition.

Background: According to the data obtained from the country-wide NATPOL III research, the prevalence of diabetes in Poland stands at 5,6% The objective of the work was to assess the heart function of patients with type 2 diabetes by means of echocardiography., Material and Methods: 106 patients were examined: 44 people with type 2 diabetes (gr D) and 62 healthy subjects, constituting the control group (gr C). Using the criteria of diabetes control, the first group was divided into 2 subgroups: 17 patients with controlled diabetes (gr cD) and 27 patients with uncontrolled diabetes (gr uD). Next, 2 subgroups were formed according to the duration of the disease: 23 patients suffering from diabetes >or= 10 years (gr mD) and 21 people suffering from diabetes < 10 years (gr lD). The examinations of the patients included electrocardiography and assessments of myocardial size and contractibility and diastolic activity of the left ventricle., Results: The echocardiographic examination revealed statistically significant differences between the groups D and C, between the groups mD, lD, and C, and between the groups cD, uD, and C. Moreover, group D additionally exhibited positive linear dependences between the duration of the disease and the diastolic interventricular septum thickness and between the duration of the disease and the mass index of the left ventricle., Conclusions: Myocardial differences observed in the echocardiographic image of a diabetic compared to a healthy person suggest myocardial dysfunction caused by diabetes. The existing differences between the group with controlled diabetes and the group with uncontrolled diabetes indicate that development of organic complications in diabetic patients can only be slowed down with procedures to normalise carbohydrate and lipid metabolic parameters and the arterial blood pressure.

Introduction: Abnormalities in calcium phosphate (Ca-P) metabolism and Ca-P related hormones are well documented in patients with essential hypertension (EH), but less in patients with non insulin dependent diabetes mellitus (NIDDM). The present study was designed to assess the responsiveness of parathormone (PTH) secretion to an oral phosphate (Pi) load (100 mmol) in patients with EH - NTS and hypertensive patients with NIDDM - CNT., Material and Methods: In 29 patients in NTS group (45.6 +/- 1.3 y), 32 in CNT group (48.4 +/- 0.9 y) and in 23 healthy subjects-GK (42.7 +/- 2.7 y) - 25-OH-D(3), intact PTH, ionized (Ca(2+)) and phosphate (P) were estimated in blood serum before and PTH in 4, 8, 12, 18 and 24 hours, Ca(2+) and P in 2, 4, 6, 8, 10, 12, 18 and 24 hours after an oral administration of Pi. Urinary excretion of calcium and phosphate were also estimated on day before and at the day of an oral Pi load., Results: In NTS group lower basal 25-OH-D(3) serum levels (22.9 +/- 1.7 vs. 30.9 +/- 2 ng/ml; p = 0.02), while in CNT group higher PTH (22.7 +/- +/- 2.2 vs. 15.6 +/- 1.9 pg/ml; p < 0.05) levels were found. Both NTS and CNT patients showed an exaggerated response of PTH secretion to the Pi load (as expressed as the AUC) as compared with GK [757 +/- 51.7 vs. 790 +/- 53.8 vs. 600 +/- 39 (pg/ml)*24 h]. In addition patients in groups NTS and CNT showed a higher calciuria than GK (2.48 +/- 0.2 and 2.42 +/- 0,2 vs. 1.77 +/- 0.2 mmol/d.) and a delayed normalization of plasma P at the day of the Pi load., Conclusions: 1. Both NTS and CNT groups are characterized by an abnormal calcium and phosphate metabolism and exaggerated response of PTH secretion to an oral phosphate load as compared with GK controls. 2. Probably hypertension and not NIDDM seems to be the leading cause of calcium-phosphate abnormalities in hypertensive diabetic patients.

Diabetes mellitus (DM) is the metabolic disorder, which is characterised by persistent hyperglycaemia and abnormal metabolism of carbohydrates, proteins and lipids. These metabolic disorders result from impaired insulin secretion, altered tissue sensitivity to insulin or the coexistence of both these mechanisms. Chronic DM usually results in micro- and macroangiopathy, which in turn may have a negative impact on the function of internal organs. Microangiopathy specifically affects eyes (retinopathy), kidney (nephropathy) and peripheral nervous system (neuropathy). Little is known about the influence of diabetic microangiopathy on lung function. A few available papers describe lung function and lung diffusing capacity for carbon monoxide (DLCO) impairment in patients with both DM type 1 and type 2. Reduction of DLCO can indicate, however, that DM leads to alveolar-capillary barrier damage in the lung. In this paper authors review available literature on microangiopathy and its influence on the lung function.

Unlabelled: Both metabolic and heamodynamic disorders accompany diabetes. Inadequate control of glycaemia, glication proteins and oxidative stress causes chronic thromboembolic and atherothrombosis complications. Disorders which are observed in diabetes induce intravascular platelets activation and changes with platelets' morphologic parameters. It is interesting if this process depends on glycaemic control diabetes? The aim of our study was to investigate in patients with type 2 diabetes the level of beta-thromboglobulin as the platelets activation marker and platelet count (PLT), mean platelet volume (MPV), which depend on diabetes control., Material and Methods: The study group included 58 patients with type 2 diabetes (middle ages was 58) with long-term anamnesis and treated only with insulin. The control group was composed by 36 healthy people (middle ages was 54). The study group was categorized into two subgroups, in depending on percent of glycosylated haemoglobin (HbA1c) which is a marker of diabetes control: B1--HbA1c < 7,5%--(13 people), B2--HbA1c > or = 7,5%--(45 people). Identical set research (beta-TG, PLT MPV and HbA1c) were carried out in both study group and the control group. Blood samples were collected from elbow vein, with no staza use and were put to test- tubes with disodium versenate (EDTA-K2) and to vacuum test- tubes Vacutainer with anticoagulant CTAD., Results: We didn't observe significantly important differences in the research parameters: B-TG, MPV and PLT between subgroups with good diabetes control and worse diabetes control. The level of beta-thromboglobulin and the mean platelet volume was significantly important higher in the study group than in the control subjects. However, PLT--platelet count, in the blood collected from patients with type 2 diabetes was slightly lower than in the control group., Conclusion: Increased activation of platelets in patients with type 2 diabetes does not depend on glycaemic control diabetes.

We describe a case of a 56 year old man with myopericarditis complicated with cardiogenic shock within first 3 days, mimicking on admission acute myocardial infarction with ST elevation in inferior ECG leads. Additionally, patient presented hyperthyroidism and totally decompensated diabetes mellitus. He required during the first 3 days intravenous infusion of inotropic agents. Cardiac enzymes levels were elevated. Akinesia in mid-inferior and mid-posterior regions in ECHO was observed. On the 10th day ST segment elevation in I, II, V3-V6 and ST depression in aVR was observed in ECG. After stabilisation patient underwent coronarography which showed normal coronary arteries. The final diagnosis was acute myopericarditis complicated with acute heart failure and cardiogenic shock.

Pharmacological inhibition of the renin-angiotensin-aldosteron system (RAAS) constitutes a cornerstone strategy in the management of patients with chronic nephropaties and proteinuria. Angiotensin converting enzyme inhibitors (ACEI) as well as angiotensin II subtype 1 receptor antagonists (ARA) have been shown to decrease proteinuria, reduce the local renal inflammatory processes and slow the progression of renal insufficiency. Despite recent progress, there is still no optimal therapy which inhibits progression of renal disease. It is possible that pentoxifilline (PTX) an old medication which is still used to treat peripheral vascular disease will be the new adjunct to RAAS blockade. In addition, PTX has been shown to decrease the production of pro inflammatory cytokines and reactive oxygen species. 61-Year-old man with nephrotic proteinuria, diabetes type 2, hypertension, chronic viral hepatitis type C and slightly impaired renal function was desribed. Proteinuria as daily urine protein excretion (DPE), serum creatinine and eGFR (MDRD mode) were measured. Proteinuria was diagnosed in 2003 (DPE 3.5 g), creatinine 1.3-1.5 mg/dl. The patient had been examined in Department of Nephrology but exact reason of nephrotic syndrome was not recognized because he refused kidney biopsy. Therapy was started with ACEI and temporary effect as decrease of DPE to 0.2 g, eGFR was about 60 ml/min. and serum creatinine in normal range. In 2004 DPE increased to 8.98-9.42 g, serum creatinine 1.1-1.3 mg/dl. The dose of ACEI was increased and after then ARA was added. After one month of combined therapy DPE fell to 7.7 g, next the doses of both drugs were increased to maximum (losartan 100 mg and lisinopril 40 mg) and DPE fell to 6.8 g, serum creatinine was 1.4 mg/dl and potassium 5.4 mmol/l. Next PTF 800 mg/day was added and DPE fell to 0.55 g after 2 months' therapy. Similar DPE was after 6 months (0.53 g) since we started with combination of IKA, ARA and PTF.

Megacolon is a state of pathological extension of the large bowel. In this paper diagnostic process and both: conservative and operative treatment of 76 years old female patient suffering from megacolon were described. The main causes of the disease were probably in this patient: chronic constipation, diabetes, and cardiovascular problems. In summary, methods of treatment of different forms of megacolon were discussed.

Diabetic patient with the stroke h is the more and more frequent patient of the neurologist. This results from increasing prevalence of the diabetes at keeping morbidity on the stroke. The management with patient in the acute stroke does not deviate considerably from the diagnostics and the therapy of remaining patients. It is proper however to mind about necessaries of the precise monitoring level of blood glucose, intensive insulin therapy and contraindications to using of the thrombolysis at some patients with the diabetes. The primary and secondary prevention of the stroke at patients with the diabetes is based on similar bases. At patient with the diabetes one ought to trend to the optimization of the glycemy, lower values of the hypertension and lipids than in the population without the diabetes. Some data speak too the greater advantage from using clopidogrel vs aspirin in the secondary prevention at patients with the diabetes.

Introduction: Metabolic disorders developing in diabetes are associated with impaired endothelial function and the presence of subclinical inflammation, in consequence leading to generalized atherosclerosis. Vasoprotective factors include adiponectin, a cytokine with a diverse antiatherosclerotic activity., Objectives: Evaluation of adiponectin concentrations and activity of the inflammatory process and endothelial dysfunction in patients with type 2 diabetes and acute coronary syndrome (ACS) with ST elevation (STEMI) in relation to the severity of lesions in the coronary arteries., Patients and Methods: This study included 72 patients (24 women, 48 men) with type 2 diabetes, treated with sulphonylurea derivatives, diagnosed with STEMI, who underwent percutaneous coronary angioplasty. The treated group consisted of 41 patients, mean age (+/- standard deviation) was 64 +/-9.6 years, the Gensini score (GS) >32 points (more advanced lesions in the coronary vessels). The control group consisted of 31 patients, a mean age of 63 +/-10 years, GS <32 points (less advanced lesions). Within 12 hours after the ACS, serum troponin T activity (TnT), creatine kinase MB isoenzyme (CK-MB), C-reactive protein (CRP), fibrinogen, two adhesion molecules - soluble vascular adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesive molecule-1 (sICAM-1) were evaluated in serum of the patients. Leucocytosis, glucose and insulin levels, and lipid profiles were obtained after overnight fast conditions., Results: Patients in group I demonstrated a significantly higher TnT and CK-MB (1.39 +/-1.3 vs 0.83 +/-0.74 ng/ml, p <0.05; 139.6 +/-178.5 vs 57.48+/-52.1 IU/I p <0.05, respectively), higher concentrations of CRP (12.06 +/-14.3 vs 3.59 +/-4.1mg/l, p <0.05) fibrinogen (4.59 +/-1.93 vs 3.62 +/-1.36 g/l, p <0.05), sVCAM-1 (1393.4 +/-865.4 vs 863.9+/-425.2 ng/ml, p <0.05) and sICAM-1 (735.1+/-316.3 vs 573.3 +/-226.1 ng/ml, p <0.05), higher leucocytosis (11,430 +/-3680 vs 9750+/-3100/microl, p <0.05) and lower adiponectin concentrations (5.8 +/-5.2 vs 8.3 +/-2.9 8 microg/ml, p <0.05) as compared to the control group., Conclusions: Hypoadiponectinaemia, severity of the inflammatory process and endothelial dysfunction could be factors contributing to the progression of atherosclerotic lesions in the coronary arteries in patients with type 2 diabetes.

Unlabelled: Colon carcinogenesis is a multi-steps process in which many growth factors are involved. In some studies the increased risk of colon cancer development was observed in patients with diabetes mellitus type 2 with accompanying hyperinsulinemia. It is also known that insulin-like growth factor I (IGF-I) plays an important role in proliferation, growth, differentiation and inhibiting apoptosis of both epithelial and carcinoma cells. The aim of the study was to evaluate the serum concentration of insulin, C-peptide and IGF-I in patients with colon adenomas and colorectal cancer., Materials and Methods: In 17 patients with colon cancer, 32 patients with colon adenomas and in 12 healthy persons the serum concentration of insulin, C-peptide and IGF-I was determined using ELISA kits., Results: In patients with colon cancer significantly higher serum IGF-I concentration comparing to the control group was observed (85.66 ng/ml vs. 60.96 ng/ml; p < 0.05). Higher IGF-I concentration was also observed in patients with distal tumors comparing to the proximal localisation (95.40 ng/ml vs. 64,65 ng/ml, p < 0.05) and in more differentiated tumors (84.36 ng/ml vs. 75.24 ng/ml). Similarly, higher C-peptide concentrations were observed in distal tumors (635.64 pmol/ I vs. 578.69 pmol/l) and in well-differentiated carcinoma (671.32 pmol/ I vs. 575.66 pmol/l). In patients with colon adenomatous polyps we also observed higher serum IGF-I concentrations I comparing to the control group (82.1 ng/ml vs. 60.96 ng/ml), in high dysplasia adenomas (84.12 ng/ml vs. 79.67 ng/ml) and in smaller adenomas to 1 cm diameter (97.98 ng/ml vs. 73.28 ng/ml), but the differences were not significant. We also observed higher concentration of C-peptide in patients with low grade dysplasia adenomas (665.24 pmol/l vs. 498.13 pmol/l) and with small polyps (611.51 pmol/l vs. 514.89 pmol/l). There were no differences in serum concentration of IGF-I and C-peptide between patients with tubular and villous adenomas. There was no statistical difference observed in insulin serum concentration in all groups of patients., Conclusions: IGF-I is probably involved particularly in the early stage of colon carcinogenesis.

The aim of the study to assess the efficacy diet therapy recommended for patients who were recently found to have type 2 diabetes mellitus as well as the influence of the diet on metabolic control of the subjects. The study involved 35 patients of the Dietary Counseling Section of the Central Clinical Hospital of the Ministry of Internal Affairs and Administration in Warsaw. During the course of a 6-month observation, the following parameters were analyzed: body weight, BMI, WHR, indices of metabolic control, such as fasting and post-prandial glycemia, and the level of glycated hemoglobin (HbA1(c)). 6-month dietary intervention brought a decrease in body weight, and improvement in glycemia

The activation of the immunologic system plays an immportant role in the initiation of atherogenesis, as shown in numerous studies. However the role of infectious agents in this process still remains controversial. The aim of this study was to investigate the involvement of heat shock protein as a link between infection and peripheral arterial disease. 31 patients suffering from lower limb ischemia were enrolled in the study. Patients were divided into 2 groups. Group I - patients with peripheral arterial disease, group II patients with diabetic macroangiopathy. The control group consisted of 11 healthy volunteers. Blood samples were taken from each participant in order to determine serum concentrations of anti Chlamydia pneumoniae, CMV and HSP 60/65 antibodies. Statistic analysis showed anti-C. pneumoniae IgG (p< 0.025) and anti-CMV IgG (p<0.0157) antibodies were significantly more frequent in both study groups in comparison with healthy controls. Antibodie levels were also found significantly higher than in controls. Mean concentration of anti-C. pneumoniae IgG in the study group was 69.67574 vs. 18.59722 [AU/ml] in the control group (p<0.01). Analogical anti CMV IgG levels in the study group were 337.6516 vs 121.3778 [AU/ml] in controls (p<0.025). Similar changes in antibody concentration were noticed for the C. pneumoniae IgA index. 0.835258 vs. 0.176333 (p< 0.005). Antibodies against HSP 60/65 were present in significantly higher titre (p<0.005). No significant differences in antibody levels were detected beteween groups I and II. The positive correlation between anti-C. pneumoniae Ig A (r=0.3910; p<0.03) and anti HSP 60/65 antibodies titre, as well as anti-C. pneumoniae Ig G (r= 0.7151; p<0.00009) and anti HSP 60/65 speaks for the heat shock protein involvement in atherosclerotic plaque development.

Introduction: The peroxisome proliferator-activated receptor gamma (PPARgamma), a transcriptor factor, regulates immunological and metabolic processes, which are important for carbohydrate and lipid metabolism. Various polymorphic forms of PPARgamma may promote diabetes mellitus and diabetic complications., Aim of the Work: The assessment of TNFalpha gene expression in peripheral blood monocytes, serum TNFalpha concentration and anti-GAD and ICA antibodies in relation to the polymorphism Pro12Ala in patients with 2 diabetes., Patients and Methods: 58 patients with type 2 diabetes (average age 59.0 +/- 11 years) and 18 healthy people were examined. The Pro12Ala polymorphism of PPARy gene were assessed using mini-sequence technic SnaPshot [ABIPRISM-310]. The TNFalpha gene expression were estimated using real-time PCR [Applied Bio-systems]. The TNFalpha concentration [Quantikin Immunoassay, R&D Systems] and ICA and GAD antibodies [immunofluorescence method, DRG] were evaluated in venous blood., Results: A heterozygotous genotype Pro12Ala was estimated in 32 patients and a homozygotous genotype Pro12Pro in 21. Only 6 patients were positive for GAD antibodies and only 6 patients for ICA antibodies. The TNFalpha concentration in serum and the TNFalpha gene expression in monocytes did not refer to the Pro12ala polymorphism of PPARy and neither to antibodies., Conclusion: 1) The TNFalpha concentration in serum and the TNFalpha gene expression in monocytes do not refer to the Pro12ala polymorphism of PPARgamma in patients with type 2 diabetes. 2) The Pro12Ala genotype do not influence autoimmunologic processes of diabetes.

Unlabelled: The aim of this study was to comprise the efficacy of chronic therapy with fosfomycin, co-trimoxazole and nitrofurantoin in the treatment and prevention of recurrent urinary tract infections (UTI) in type 2 diabetic women., Materials and Methods: The study comprised 90 women aged 50-70 years, who suffered from the UTI (isolated bacterial uropathogen sensitive to fosfomycin, co-trimoxazole and nitrofurantoin). Women were divided into 3 groups. Group I comprised patients, who have been treated with fosfomycin, group II with co-tromixazole and group III with nitrofurantoin. Observation period lasted 9 months and for the 6 months patients were treated with antimicrobial agents. Efficacy of antimicrobial treatment was estimated when both clinical cure and bacteriological eradication of uropathogens were achieved., Results: There were no significant differences in the percentage of patients between study groups, who achieved therapeutic successes after 3 and 6 months of the antimicrobial treatment (NS). Three months after discontinuation of treatment episodes of UTI were observed significantly rarely in group treated with fosfomycin in comparison with the group treated with nitrofurantoin (p = 0.01) and co-trimoxazole (p = 0.02)., Conclusion: Fosfomycin, co-trimoxazole and nitrofurantoin are safe and effective antimicrobial methods to cure and prevent UTI. Fosfomycin is associated with rarely recurrence of UTI than nitrofurantoin and co-trimoxazole in the period without its taking.