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Aim: Several studies have assessed the association between personality traits and metabolic outcomes in children and adolescents with type 1 diabetes (T1DM). The aim of this observational single-visit study was to investigate whether specific personality traits were related to the degree of metabolic control/diabetes duration in adult T1DM patients., Method: Data were collected from 56 adults (40 men) with T1DM treated in a tertiary care center. "Big Five" personality traits were assessed using the NEO-Five Factor Inventory questionnaire. Several variables were obtained from the insulin pumps, glucometers and blinded continuous glucose monitoring system., Results: All personality traits but neuroticism (low level of the trait) showed average intensity. Agreeableness was associated with most variables from CGMS data. Higher conscientiousness was associated with longer diabetes duration. Higher neuroticism was correlated with greater glycemic variability (GV), while high Extraversion was associated with lower GV. Lower Openness was associated with prolonged time in clinically significant hypoglycaemia., Conclusions: Our study suggest that personality traits manifest in individual approach to diabetes management and emotion regulation, translating also into the attitude to treatment. On the other hand, T1DM patients' overall trait scores were consistent with healthy nonpsychiatric norms, which debunks myths and stereotypes suggesting that chronic disease is usually associated with psychopathology.

Objectives: Assessment of mental state of patients with T1DM - the level of anxiety, stress and general mental health in the stressful conditions of an epidemic. Moreover, it was checked whether the stress response to the epidemic in the T1DM group differed from that in the control group. This is the first study to address these questions in the type 1 diabetes population in Poland., Methods: An e-mail was sent to all T1DM patients under the care of a diabetes clinic with information about the possibility of online consultation with a psychologist / psychiatrist, with a set of psychological tests attached. The study included 49 patients with T1DM who responded within the first month and agreed to participate in the study. 38 people from the control group were randomly recruited. Each person completed a set of psychological tools., Results: In both groups, the level of stress was higher than typical for the general population in the situation without stressor. T1DM patients who have been ill for over 10 years more often cope with stress through a task-oriented approach. Patients who have been ill for less than 10 years use avoidance strategies. In the first phase of the epidemic,women with T1DM used avoidance strategies. Patients with diabetes and mental disorders react more anxiously and thus require special care in coping with diabetes., Conclusions: In a situation of stress such as a epidemic, patients suffering from T1DM require optimization of treatment and cooperation of specialists in the field of diabetes and psychology / psychiatry.

Introduction: Leptin and soluble form of leptin receptor play a great role in both carbohydrate and fat metabolism which is very important in diabetes mellitus type (DMT1) patients., Aim of the Study: To asses leptin and soluble leptin receptor levels in children with DMT1 and to analyze correlation with anthropometric parameters, metabolic control and the influence of various kinds of insulin therapy., Material and Methods: 67 patients, aged from 3.71 to 14.81 years, mean ± SD: 10.33 ± 2.21) and 15 age-matched healthy children were included into the study. All children were prepubertal (T <2), suffering for DMT1 for more than two years, without any coexisting diseases. All patients were divided into subgroups according to the kind of therapy. There were no statistically significant differentials between groups as to the metabolic control, age, weight, height and BMI., Results: Leptin levels in the study group range from 1.27 to 59.90 ng/ml (mean ± SD: 11.34 ± 9.42 ng/ml) and were higher than in control group: from 1.46 to 26, ng/ml (mean ± SD: 8.23 ± 7.62 ng/ml) (p >0.05). The highest leptin levels were observed in multiple insulin injection group, lower in pump group and the lowest conventional insulin therapy group. Soluble leptin receptor levels in study group range from 30.50 to 101.00 ng/ml (mean ± SD: 48.65 ± 13.26 ng/ ml) and were significantly higher than in control group: 27.50 to 61.00 ng/ml (mean ± SD: 39.37 ± 9.23 ng/ml) (p <0.01). The highest soluble leptin receptor levels were observed in the multiple insulin injection group, lower in pump group and the lowest conventional insulin therapy group., Conclusions: leptin levels are higher in DMT1 children, correlate with anthropometrics parameters, age, age at the beginning of diabetes and depend on the kind of insulin therapy. Soluble leptin receptor levels are significantly higher in children with DMT1, correlate with anthropometrics parameters, metabolic control, age, age at the beginning of diabetes, duration of diabetes and depend on the kind of insulin therapy.

Non-alcoholic fatty liver disease (NAFLD) is a complex of a wide spectrum of liver pathology--from steatosis alone, to cirrhosis and liver cancer. The pathogenic concept of NAFLD covers overnutrition with fatty acids, underactivity. Insulin resistance is believed to play the main role in this process. NAFLD is mostly related to visceral adiposity, metabolic syndrome and type 2 diabetes melitus. The presented work is a review of in vitro and in vivo modern studies, as well as clinical observations on molecular mechanisms leading to development and progress of NAFLD. Up till today their is no treatment od NAFLD, and this pathology is not benign--it may lead to patients' death in 10 years. The clinical approach to NAFLD is prevention of it's development. The manuscript is a review of new biochemical markers allowing for early detection of metabolic disorders leading to NAFLD development, thus to sufficient prevention of this pathology in patients.

Activating mutations in the KCNJ11 gene encoding the ATP-sensitive potassium-channel subunit of Kir6.2 result in the phenotype of permanent neonatal diabetes (PNDM). Patients with PNDM can be successfully transferred from insulin to sulphonylurea. It is not clear, however, whether the type of diet may play a role in the metabolic control in PNDM patients. This report describes two cases of patients with PNDM due to the R201H mutation coming from the Polish Nationwide Registry of PNDM treated with the same sulphonylurea (glipizide GITS). In one of them, diet was practically free (Pol1), the other one (Pol2) avoided high glycemic-index products. Both mutation carriers were submitted to a 72 h continuous glucose monitoring system (CGMS) (Medtronic, CA). Before the CGMS record, families were encouraged not to alter their usual pattern of food intake during recording periods and to use food diaries. The postprandial glycemia in Poll reached the maximal level of 9.5 mmo/l, 5 episodes of glycemia above 8.0 mmol/l lasting overall for about 6 hours followed the ingestion of high-glycemic-index (>70) meals. Patient Pol2 did not use high-glycaemic-index-products and his postprandial blood glucose did not exceed 7.0 mmol/l. Following the CGMS record, an additional diet-oriented educational session with patient Poll and his parents was performed, Poll declared to avoid the intake of high-glycemic-index products. He remained on the same dose of Glipizide GITS. Results of home blood glucose monitoring performed 2 months later showed normoglycemia. We conclude that to achieve normoglycemia, patients with PNDM who are on sulphonylurea should refrain from eating high glycemic-index products.

Insulin pump therapy is a diabetes management tool that can significantly aid in achieving treatment goals in children, adolescents and adults with type 1 diabetes mellitus. These goals include optimal glycaemic control, lifestyle flexibility, quality-of-life improvement, and independence. Successful implementation of CSII requires a motivated, conscientious patient with a range of technical skills and self-management capabilities. Patients develop this knowledge through the program of education provided by a healthcare team including diabetologists, diabetes educator, dietietian, pump manufacturer representative, and in some cases, mental health professionals. Training of the patient to use a pump includes three basic steps: 1 - pre-pump education, 2 - pump start-up, 3 - evaluation, independence assessment and re-education. It is a relatively long process that can range from a few weeks to several months. Insulin pump therapy checklist, included in this paper, is a useful tool in planning and providing education for insulin pump users.

Background: Genetics and environmental factors play a role in the pathogenesis of the complex disease, type 2 diabetes mellitus. Two major pathophysiological defects coexist in this disease: impairment of insulin secretion by beta-cells and decreased insulin sensitivity in peripheral tissues. The aim of the study was to examine whether two polymorphisms: the -308 G/A substitution in the promoter region of TNF-alpha gene and the K121Q amino acid variant of the PC-1 gene; influence insulin resistance in individuals with positive family history of type 2 diabetes mellitus., Methods: Sixty individuals were included into this study: 28 women and 32 men, all of them with normal glucose tolerance. Insulin and glucose serum levels were were assessed during the OGTT on fasting and at 30 and 120 minutes. Secondary indices of insulin resistance were calculated based on these measurements. Genotyping of the both examined polymorphisms was performed using the restriction fragment length polymorphism method (RFLP)., Results: Homozygous and heterozygous carriers of the A allele in position -308 of the TNF-alpha gene promoter showed higher plasma insulin levels at 120 min OGTT versus GG carriers (44.77 microliters/ml; SD 40.4 vs. 26.82; SD 19.9; p = 0.04) and a higher ratio of the 30 min increment in insulin to the 30 min increment in glucose (35.4; SD 21.5 vs. 22.6: SD 21.5; p = 0.03). In addition, homo- and heterozygous carriers of the Q allele at residue 121 of the PC-1 gene showed higher plasma glucose levels at 120 min OGTT compared to the KK subjects (5.38 mmol/l, SD 1.19 vs. 4.48, SD 1.11; p = 0.03)., Conclusion: Our study suggests that both examined polymorphisms: the -308 G/A in the promoter region of TNF-alpha and K121Q amino acid variant of the PC-1; influence the development of insulin resistance as a prediabetic quantitative trait in a Polish population.

Apoptosis-programmed cell death--is a process which has long been neglected in clinical thinking. Now we realize that it offers an understanding of a number of pathological conditions which otherwise cannot be explained. Moreover the analysis of the highly specific mechanisms of programmed cell death might aid in the development of new treatment strategies. In this paper we give the examples of the importance of apoptosis in the selected fields of clinical medicine. The knowledge of apoptosis in oncology, cardiology, endocrine diseases and others has achieved the level which enables its practical use. This is why we believe that apoptosis should attract attention of clinical practitioners.

Unlabelled: There is very few data on the prevalence of reactive gastritis (RG) in diabetes mellitus (DM). The typical histological findings in RG are foveolar hyperplasia, oedema with apparent diminution in glands, telangiectasia of lamina propria, a paucity of inflammatory cells. RG has been connected so far with a long term use of non-steroidal anti-inflammatory drugs (NSAIDs) or bile reflux, which is particularly frequent after cholecystectomy. RG is regarded as less frequently associated with the Helicobacter pylori (Hp) infection. The aim of the study was to define: 1. The prevalence of RG in diabetics with dyspeptic symptoms as compared with the non-diabetic group. 2. The prevalence of Hp infection in RG as compared with chronic active gastritis (CAG) in DM. 3. The association of these types of gastritis with autonomic neuropathy (AN)., Study Design: Gastroscopy was performed in 152 patients with symptoms related to upper alimentary tract disorders-52 with DM (13 with IDDM and 39 with NIDDM) and 100 without DM. The presence of RG, CAG and Hp infection was analysed in 3 biopsies. AN was evaluated in 35 diabetics in 4 cardiovascular tests using ProSciCard., Results: RG was significantly more frequent in DM than in control group (10/52, 19.2% vs. 3/100, 3%, respectively, p < 0.01). This difference was preserved after excluding all patients with NSAIDs use or being after cholecystectomy (8/36, 22.2% vs. 2/81, 2.5%, respectively, p < 0.001). Hp infection in diabetics with RG was significantly lower than diabetics with CAG (2/10, 20% vs. 16/23, 69.5%, respectively, p < 0.05). AN was more frequent in diabetics with RG than with CAG (7/10, 70% vs. 6/15, 40%, respectively, p < 0.001). Hp infection in diabetics with RG was significantly lower than diabetics with CAG (2/10, 20% vs. 16/23, 69.5%, respectively, p < 0.05). AN was more frequent in diabetics with RG than with CAG (7/10, 70% vs. 6/15, 40%, respectively), the difference was not significant with this sample size., Conclusions: 1. RG seems to be more frequent in DM than in general population. 2. Hp infection is less frequent in RG than in CAG in DM. 3. The higher prevalence of RG in DM may result from impaired motility and reflux of bile caused by AN.

Unlabelled: Our objective was the analysis of the utility of the corrected QT interval (QTc) for the assessment of severity of cardiac autonomic neuropathy. Fourty nine patients with insulin-dependent diabetes mellitus/IDDM/were enrolled in the study. Their ages ranged between 16 and 58 years, and the duration of IDDM ranged between 1 and 38 years. Patients were tested for cardiac autonomic neuropathy using ProSciCard system. We carried out four tests: resting pulse deep breathing pulse Ewing test Valsalva maneuver Our results showed the relationship between the QTc interval lengthening and the occurance of cardiac autonomic neuropathy. No correlation was found between the QTc interval and the extend of cardiac autonomic neuropathy., Conclusions: The QTc interval measurement is a good routine test for the diagnosis of cardiac autonomic neuropathy. The corrected QT interval is not a reliable indicator of the extend of cardiac autonomic neuropathy.