Nutrigenomics, angiogenesis and obesity

W niniejszej pracy omówiono poznane mechanizmy i związek zachodzący między angiogenezą, wybranymi składnikami pokarmu - nutrientami - a mechanizmami prowadzącymi do rozwoju tkanki tłuszczowej.A review concerning the possible connection between the angiogenesis, nutrients and development and remodelling of adipose tissue

Assessment of selected food intake frequency in patients with type 1 diabetes treated with personal insulin pumps

Wprowadzenie. Uważa się, że w cukrzycy typu 1 (T1DM), niezależnie od zastosowanego modelu insulinoterapii, dieta i prawidłowe nawyki żywieniowe są kluczowe w leczeniu cukrzycy. Stosowanie odpowiedniej diety ma na celu utrzymanie prawidłowej masy ciała, uzyskanie prawidłowego poziomu glukozy we krwi po posiłku, optymalnego profil lipidowy i prawidłowe wartości ciśnienia krwi. Cel. Celem badania była ocena diety i kontrola metaboliczna w homogennej grupie osób dorosłych z T1DM leczonych osobistymi pompami insulinowymi. Materiał i metody: Badaniem objęto 141 dorosłych pacjentów (57% kobiet) z cukrzycą typu 1 leczonych osobistymi pompami insulinowymi. Badana populacja charakteryzowała się średnim wiekiem 25,8 ± 6,2 lat, średnim czasem trwania cukrzycy 13,9 ± 6,9 lat oraz średnim czasem leczenia osobistą pompą przez 8,2 ± 4,1 lat i średnim BMI 23,0 ± 2,8 g / m2. Wszyscy byli mieszkańcami południowo-wschodniej Polski. Walidowany kwestionariusz KomPAN wykorzystano do oceny częstotliwości spożycia poszczególnych produktów spożywczych. Wyniki. Średni odsetek HbA1c w grupie badanej wynosił 7,3% [56 mmol/mol]. Średni poziom całkowitego cholesterolu wynosił 4,4 mmol / l, HDL - 1,7 mmol / l, LDL - 2,3 mmol / l i triglicerydów - 0,8 mmol / l. W modelu regresji wielorakiej nie stwierdzono korelacji między wskaźnikami diety i wyrównaniem metabolicznym mierzonym za pomocą HbA1c lub lipidogramu oraz miejscem zamieszkania (wieś, małe miasteczko, duże miasto). Jednak różnice w jakości diety zależały od płci. Kobiety charakteryzowały się wyższym wskaźnikiem zdrowej diety (pHDI-10) (26,3 vs 21,4, p = 0,005) i niższym wskaźnikiem niezdrowej diety (nHDI-14) (13,3 vs 18,6, p <0,001) niż mężczyźni. Wnioski: Wyniki tego badania wyraźnie wskazują, że pomimo dobrej kontroli metabolicznej pacjenci wymagają większej edukacji w zakresie wyboru zdrowych grup produktów.Background. It has been established that in Type 1 Diabetes Mellitus (T1DM), regardless of the insulin therapy model used, diet and proper eating habits are still important in the treatment of the disease. The dietary intervention in these patients is aimed at maintaining proper body weight, obtaining target fasting and post meal blood glucose levels, optimizing lipid profiles. Objective. The aim of the study was to assess dietary habits in a homogeneous group of adults with T1DM treated with personal insulin pumps. Material and methods. The study included 141 adult patients (57% women) with type 1 diabetes treated with personal insulin pumps. The surveyed population was characterized by an average age of 25.8 ± 6.2 years, an average duration of diabetes 13.9 ± 6.9 years, and treatment with a personal pump for 8.2 ± 4.1 years and mean BMI 23.0 ± 2.8 g/m2 . All were dwellers of south-eastern Poland. The validated KomPAN questionnaire was used to assess the frequency of consumption of individual food products. Results. The mean percentage of HbA1c in the study group was 7.3% [56 mmol/mol]. The mean total cholesterol level was 4.4 mmol/l, HDL - 1.7 mmol/l, LDL - 2.3 mmol/l and triglycerides - 0.8 mmol/l. In the multivariate regression model, no correlation was found between dietary quality parameters and metabolic compensation measured with HbA1c or lipidogram and the place of residence (village, small town, big city). However, there were differences in the quality of the diet depending on the sex. Women were characterized by higher index of a healthy diet (pHDI-10) (26.3 vs 21.4, p=0.005) and lower index of unhealthy diet (nHDI-14) (13.3 vs 18.6, p <0.001) than men. Conclusions. The results of this study clearly suggest, that despite good metabolic control, patients require more education on the choice of healthy product groups

Is treatment of type 1 diabetes mellitus (insulin therapy, metabolic control) optimal for preventing cardiovascular autonomic neuropathy?

Introduction: Long-term poor metabolic control promotes the occurrence of microvascular complications, such as cardiovascular autonomic neuropathy (CAN) and atherogenic hyperlipidaemia, which translates into increased mortality in patients with type 1 diabetes mellitus (T1DM). The aim of the study was to assess the prevalence of CAN in patients with T1DM in relation to treatment method (continuous subcutaneous insulin infusion, CSII, versus multiple daily injections using pens, MDI) and metabolic control. Material and methods: The study group comprised 93 adults (60 women, 33 men), mean age 31 years, with T1DM being treated at a local clinical centre from 2011 to 2015. The presence of CAN, the results of laboratory tests, and anthropometric data were analysed. The subjects were divided into two groups according to treatment method (CSII, MDI). Results: The median duration of diabetes was 16 years. 61% of the subjects used MDI and 39% used CSII. 41% of the subjects presented with CAN (confirmed with the Ewing test using ProSciCard apparatus), with a significantly lower prevalence in the group of patients treated with CSII (15.4% vs. 60.4%; p &lt; 0.001). The mean HbA1c level in the CSII-treated group was noticeably lower (7.44 ± 1.67% vs. 8.55 ± 1.1%, p &lt; 0.001), and these patients also had lower triglyceride levels (0.71 vs. 1.32 mmol/L, p &lt; 0.001). Regardless of the treatment method, 72% of all patients under 40 years of age achieved their therapeutic target of LDL cholesterol level &lt; 2.6 mmol/L, whereas only 13% of all those over 40 years old achieved an LDL cholesterol level &lt; 1.8 mmol/L. Conclusions: The presented results draw attention to the high prevalence of CAN among T1DM patients. The study reveals the need for more intensive monitoring and treatment of hyperlipidaemia, despite good glycaemic control, especially in those over the age of 40 years.

Clinical factors affecting the perception of hypoglycemia in type 1 diabetes patients treated with personal insulin pumps

Introduction and Objective. The ability to perceive the symptoms of hypoglycemia during the early decrease in plasma glucose concentration may be critical for the safety of T1DM patients treated with intensive insulin therapy, including those treated with continuous subcutaneous insulin infusion (CSII). In the presented observational study an attempt was made to asses clinical factors that might affect subjective awareness of hypoglycemia in CSII-treated T1DM patients, with special attention to factors specific for this mode of treatment. Materials and Methods. For the purpose of the study, data of 110 CSII-treated T1DM patients were collected (78 females and 32 males). The records were analyzed from glucose meters (200-300 measurements/download, depending on meter type) and insulin pumps (total insulin dose, basal/bolus ratio, number of boluses/day, bolus calculator and dual wave/square bolus usage, continuous glucose monitoring data) from the last 3 years. Results. It was found that the level of subjective hypoglycemia perception inversely correlated with the number of hypoglycemic episodes per 100 measurements, age, duration of diabetes, time on insulin pump, and positively correlated with mean glycemia (n = 98; r = 0.22; p = 0.0286). With respect to CSII-related factors, hypoglycemia perception inversely correlated with the percentage of basal insulin (n = 106; r = -0.20; p = 0.0354). In stepwise regression analysis, independent predictors for impaired hypoglycemia perception were: age β = -0.29 (p = 0.023), duration of diabetes β = -0.24 (p = 0.029) and number of the hypoglycemia episodes for 100 measurements β = -0.33 (p = 0.0005). Conclusions. Risk factors for impaired hypoglycemia perception in CSII-treated patients include those identified previously for the general population of T1DM individuals. In addition, the presented results suggest that a higher basal/bolus ratio may lead to impairment of the ability to perceive early symptoms of hypoglycemia

Are late-night eating habits and sleep duration associated with glycemic control in adult type 1 diabetes patients treated with insulin pumps?

AIMS/INTRODUCTION: Little is known about the impact of sleep duration and late-night snacking on glycemic control in patients with type 1 diabetes using insulin pumps. The aim of the present study was to examine whether late-night eating habits and short sleep duration are associated with glycemic control in continuous subcutaneous insulin infusion-treated type 1 diabetic patients. MATERIALS AND METHODS: We included 148 consecutive adult type 1 diabetic subjects using an insulin pump (100 women and 48 men). Participants completed a questionnaire regarding sleep duration (classified as short if ≤6 h) and late-night snacking. Other sources of information included medical records and data from blood glucose meters. Glycemic control was assessed by glycated hemoglobin (HbA1c) levels and mean self-monitoring of blood glucose (SMBG) readings. RESULTS: The mean age of patients was 26 years, mean type 1 diabetes duration was 13.4 years and mean HbA1c level was 7.2%. In a univariate regression analysis, sleep duration was a predictor of both HbA1c (β = 0.51, P = 0.01) and SMBG levels (β = 11.4, P = 0.02). Additionally, an association was found between frequent late-night snacking and higher SMBG readings (often snacking β = 18.1, P = 0.05), but not with increased HbA1c levels. In the multivariate linear regression, independent predictors for HbA1c and SMBG were sleep duration and patient age. In a univariate logistic regression, sleep duration and frequency of late-night snacking were not predictors of whether HbA1c target levels were achieved. CONCLUSIONS: Short sleep duration, but not late-night snacking, seems to be associated with poorer glycemic control in type 1 diabetic patients treated with continuous subcutaneous insulin infusion