Danger of multiple use of insulin pen needles for diabetic patients

Aim. To evaluate the risk of multiple use of BD Micro-Fine Plus insulin pen needles in terms of their contamination with microflora, pain and localreaction at the injection site. Materials and methods. The study included 45 patients aged above 18 yr with type 1 and 2 diabetes mellitus (DM1 and DM2) treated with shortorultrashort-acting insulins TID. Account was taken of the time each needle was used (once, for 4 and 7 days). Microbiological analysis was madeat the respective time points. Pain sensation after injection was evaluated by patients themselves using a visual-analog scale and severity of local reactionsby the physician. Results. Microbial growth was documented in 20 and 33,3% of the patients who used needles ones or many times respectively. Patients of the lattergroup more frequently complained of pain after injection (on day 4, p=0,08) compared with those of the former one (on day 7, p=0,03). Hyperemicfoci at injection sites developed only in case of using the same needle for 4 and 7 days (13,3 and 26,6% respectively). Conclusion. Multiple use of insulin pen needles by patients with DM should be avoided since it leads to hyperemia at injection sites, pain sensation,and risk of microbial contamination

Leptin secretion and severity of glycemic disorders in women with body weight excess

Aim. To characterize leptin secretion in fasting state and upon intravenous glucose administration in patients with type 2 diabetes mel- litus (T2DM), prediabetes and obesity. Materials and methods. 59 female patients took part in this study: 12 had no signs of glycemic disorder, 18 were diagnosed with prediabetes and 30 ? with newly diagnosed T2DM. Median age was 54 [48.6?60] years, median BMI ? 33.2 [29.0?37.2] kg/m2. All participants were tested for fasting leptin, fasting insulin and blood glucose levels. Prediabetic and diabetic subjects also received a bolus intravenous injection of 40% glucose solution (0.75 g/kg of body mass) with subsequent additional measurement of insulin levels at 2, 70 and 120 min upon injection, and leptin levels ? at 120 min. Results. Median fasting leptin in obese and patients with weight excess was 42.0 [22?60] ng/mL, which is about 2 times higher than normal reference maximum (27.6 ng/mL). Subjects with prediabetes and T2DM showed significantly lower median fasting leptin levels of 29.1 ng/mL [13.5?45.7] and 21.3 [14.3?42.2], respectively (

Metformin effects to carbohydrate and lipids metabolism in impaired glucose tolerance patients.

Aim of this study was to investigate the effect metformin to carbohydrate, lipids metabolism and leptin level in impaired glucose tolerance (IGT)patients.Methods. 16 patients with IGT were studied. Age of participant was 55.1?8.2 yrs. All patients was divide into two groups: treatment group (bagomet1700 a day and diet) and control group (only diet). Effect of therapy was access in HbA1c, fasting glucose (FG), HOMA, lipids, liver glucose production(LGP) and leptin, which investigate in intravenous glucose tolerance test (IVGTT). Results. Normalization of carbohydrate metabolism was discover in 37.5% in treatment group and in 12.5% in control group. HbA1c was decreasefrom 6.4 to 5.9 % (

Algoritm podbora effektivnoy dozy mikronizirovannogo Maninila v nachal'noy stadii sakharnogo diabeta 2 tipa

Актуальность К активно действующим сахароснижающим сульфаниламидам (СС) относится Манинил* (Берлин-Хеми, Германия), назначение которого ведет к снижению гликемии у большинства больных. Манинил нередко нормализует гликемию в тех случаях, когда другие СС оказываются неэффективны. Цель работы Разработка оптимального алгоритма подбора сахароснижающией терапии микронизированным Манинилом, нормализующей углеводный обмен у больных с недавно диагностированным СД 2 типа, при неэффективности монотерапии диетой. Материалы и методы Гликемию плазмы натощак определяли глюкозооксидазным методом исходно и в конце исследования. В процессе наблюдения осуществлялся контроль гликемии натощак с помощью пор?тативного глюкометра (One-Touch, фирмы Лайф-скэн) 1 раз в 2 недели. Гликированный гемоглобин фракции А1с определяли методом ионообменной хроматографии. Больным назначали микронизированный Манинил, в одной таблетке которого содержится 1,75 или 3,5 мг действующего вещества. Результаты. Снижение уровня HbA1c в конце периода наблюдения отмечалось в обеих группах: в 1-й группе его уровень снизился на 2 % по сравнению с исходным, во 2-й снижение было более значительным. В обеих группах отмечена низкая частота гипогликемических реакций. ИМТ не увеличился в обеих группах. При анализе липидного спектра крови больных в обеих группах отмечена тенденция к снижению уровня общего холестерина за счет холестерина ЛПНП и уровня триглицеридов. Выводы Микронизированный Манинил может рассматриваться как препарат первого выбора у больных СД 2 типа при неэффективности диетотерапии, так как его назначение существенно улучшает показатели углеводного обмена при низкой частоте гипогликемических реакций. Компенсация углеводного обмена у большинства больных с недавно выявленным СД 2 типа может быть достигнута на фоне приема доз микронизированного Манинила, не превышающих половину максимальной

Initial glucose-lowering therapy and risks of overall and cardiovascular mortality, myocardial infarction and stroke in patients with type2 diabetes

Цель. Оценить риски развития общей и сосудистой смертности, а также риски фатальных и нефатальных инфарктов миокарда (ИМ) и острых нарушений мозгового кровообращения (ОНМК) у больных сахарным диабетом 2 типа (СД2) в зависимости от вида пероральной сахароснижающей терапии (ПССП), назначенной после установления диагноза диабета. Материалы и методы. На основании результатов ретроспективного открытого когортного исследования проведен анализ пятилетнего риска общей и сердечно-сосудистой смертности, а также ИМ и ОНМК у лиц, заболевших СД2 в 2004 году и получавших терапию раз- личными ПССП. Для оценки рисков смерти от любых причин, смерти от сердечно-сосудистых заболеваний, ИМ и ОНМК был использован Cox-регрессионный анализ. Результаты. У больных, которым после установления диагноза ?СД2? были назначены препараты сульфонилмочевины (СМ), по сравнению с группой метформина отмечено достоверное повышение риска общей и сердечно-сосудистой смертности в два раза (

Significance of HbA1c targets based on an individual approach to the treatment of patients with type 2 diabetes mellitus

Background. Over the past few years, special attention has been paid to achieving glycaemic control for type 2 diabetes mellitus (T2DM) patients, since it is a factor for determining the risk of developing macro- and microvascular complications of diabetes. Certain modern guidelines suggest an individual approach to the choice of HbA1c target. Objective. Objective.  . of this study was to estimate the percentage of T2DM patients who have reached the HbA1c levels. This was determined based on their age and the presence of severe complications. Materials and Methods. A total of 2195 patients with T2DM were studied. The patients were divided into the following age groups

Incidence of sleep apnea in patients with various types of glycemic disturbances

Aims. To assess the risk for sleep apnea in patients with various types of glycemic disorders by means of Epworth Sleepiness Scale andSleep Apnea Screening Questionnaire. Materials and Methods. We examined 744 residents of Mozhaisk Region, that were considered to have high risk for development of type2 diabetes mellitus (T2DM), as estimated by FINDRISK Questionnaire. Patients, who scored 12+ were cleared for participation in this study. Combined score from Epworth Sleepiness Scale and Sleep Apnea Screening Questionnaire was applied for diagnosis of sleep apnea, supplemented with specific questions about snoring and episodes of apnea. Glycemic disorders were diagnosed with standard glucose tolerance test. Results. 42.7% of examined patients (n=318) were diagnosed with various types of glucose disorders. Prevalence of abdominal obe- sity (according to waist circumference measurement) comprised 59.3% in male patients and 54.1% in females. We observed positive correlation between body mass index (BMI) and snoring ? 0.3 (p=0.0001), BMI and apnea ? 0.2 (p=0.0001), BMI and daytime sleepiness ? 0.1 (p=0.007); we also observed direct correlation between age and snoring ? 0.2 (p=0.0001), as well as age and sleep apnea ? 0.1 (p=0.028). Risk for sleep apnea was found to be 4.7 times higher in patients with arterial hypertension. After adjustment71Диагностика, контроль и лечениеСахарный диабет. 2013;(1):71?77Сахар ный диабетfor age risk of apnea remained 2.8 times higher in patients with T2DM, 1.9 times higher in subjects with impaired glucose tolerance and1.6 times higher in subjects with impaired fasting glycaemia. Relative risk for snoring in patients with various types of glycemic disorders was 1.1-1.2 against normoglycemic controls. We estimated that all types of glycemic disorders increase risk for apnea 1.2?1.6 times. Conclusion. Glycemic disorders, body weight excess, obesity and arterial hypertension are risk factors for snoring and sleep apnea. Corresponding patient categories should be screened for sleep apnea by questionnaire survey to identify those in need of further complex examination and treatment

Optimizing screening procedures for early detection of glycemic disorders

Aim. To estimate the actual prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in individuals at high risk for T2DM and to develop an optimized stepwise screening procedure. Materials and Methods. A mobile diagnostic unit conducted outpatient screening for glycemic disorders. First stage of the survey included distribution of the FINDRISK questionnaire within the target subpopulation. At the second stage, study groups were formed based on the acquired data. Third stage involved clinical evaluation of glucose homeostasis by testing HbA1c levels and performing oral glucose tolerance test (OGTT). Individuals considered at high risk for development of T2DM were referred to specialized educational programs. A total of 2200 subjects were included in the present survey. In 1377 cases OGTT was supplemented with the testing of HbA1c. Statistical processing of the data was performed with Microsoft Excel software utility. Results. The interpretation of OGTT results identified 53.5% (n=1176) of study subjects as positive for glycemic disorders: 26.7% (n=587) with T2DM and 26.8% (n=589) with prediabetes, respectively. Impaired glucose tolerance was detected in 12.1% (n=266), impaired fasting glucose ? in 9.1% (n=199), and the combination of these two conditions ? in 5.6% (n=124) of examined individuals, respectively. In 235 subjects (17.1%) T2DM was diagnosed by means of HbA1c testing. 45% of examined individuals (n=620) had HbA1