Psychological Care as an Interdisciplinary Approach in the Management of Diabetes: A Narrative Review of Literature

Objective: Diabetes, a serious chronic disease, demands a lot of patients in terms of daily self-care and often complicated treatment. Psychological problems are prevalent among people with diabetes. Burden with daily restrictions to diet and activity, risks of the treatment, fear of losing metabolic control and disease progression may furthermore reduce quality of life and aggravate psychological condition. This paper provides a current overview of prevalence, screening and general psychological managements in diabetes according to the worldwide recommendations. In addiction it updates the medical literature refer to Poland. Materials and methods: The search was conducted in Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect. The final set of 75 articles, include 33 papers that refer to psychological condition assessmenttools. Results: The analysis for this review has been packaged into themes in order to generate a very useful and practical tool for all health professionals. It summarized in systematic and comprehensive way all psychological states that can appear in patients with diabetes. The most prevalent and important problems are: diabetes distress, depression, anxiety disorders, disordered eating behavior, and cognitive impairment/dementia. Conclusions: All worldwide guidelines strongly recommendpsychological and social care as integrated part of the management of the diabetes. Healthy psychological state with proper screening, monitoring and the management could help in reaching therapeutic success and better quality of life

sICAM-1 w surowicy chorych na alergiczny nieżyt nosa leczonych feksofenadyną lub flutykazonem

The aim of the study was to examine the level of sICAM-1in serum of patients suffering from allergic rhinitis treated with fexofenadine or fluticasone. The study was performed after two weeks duration of the pollen season. Thirty -eight patients sensitized to grass pollen were participated in this study: 15 patients were treated for 10 days with oral fexofenadine (dose: 120 mg/d), 13 patients were treated with intranasal fluticasone (dose:200mcg/d), 10 patients were given oral placebo. Blood sample were collected both in the first and the last day of the treatment. The efficacy was evaluated with the use of symptom score. sICAM-1l level in serum was measured with ELISA method. The results: Mean sICAM-1 level in serum was: in group treated with fexofenadine- 224,5 ng/ml before treatment, 228 ng/ml – after treatment; in group treated with fluticasone-212ng/ml before treatment, 214ng/ml– after treatment; in placebo group- 226 ng/ml before treatment, 229 ng/ml– after treatment. There was no difference in statistical analysis between sICAM-1 values. (p>0,05). In 7 patients treated with fexofenadine serum levels of sICAM-1 significantly decreased from 212ng/ml to 185ng/ml(

Inflammatory Markers: Exhaled Nitric Oxide and Carbon Monoxide During the Ovarian Cycle

Nitric oxide (NO) production and carbon monoxide (CO) production are increased in inflammatory lung diseases. Although there are some pieces of evidence for hormonal modulation by estrogen, little is known about exhaled NO and CO during the ovarian cycle. In 23 subjects, we measured exhaled NO and CO by an online analyzer. Significantly higher levels of exhaled NO were found at the midcycle compared with those in the premenstrual period or during menstruation. Higher levels of CO were after ovulation and reached a peak in the premenstrual phase. The lowest levels of CO were observed in the first days of the estrogen phase. In males, there was no significant variation in exhaled NO and CO. Exhaled NO and CO levels vary during the ovarian cycle in women, and this fact should be taken into account during serial measurements of these markers in the female population

Mild Cognitive Impairment and Depressive Symptoms in Elderly Patients with Diabetes: Prevalence, Risk Factors, and Comorbidity

The aim of the study was to estimate the prevalence of mild cognitive impairment (MCI), depressive syndrome cases, and its comorbidity, and to identify predictors of these conditions. Methods. 276 diabetics elders were screened for MCI and depressive symptoms. Detailed information of history of diabetes, and data of BMI, HbA1c, and blood lipids were collected. Results. The prevalence of MCI was 31.5%, depressive syndrome was 29.7%, and MCI with coexisting depressive mood was 9.1%. The logistic regression analysis revealed that variables which increased the likelihood of having been diagnosed with MCI were: higher HbA1c level, previous CVD, hypertension, retinopathy, increased number of comorbidities, and less years of formal education. Significant predictors of having a depressive mood included female gender, single marital status, current and past smoking status, lack of physical activity, higher BMI and total cholesterol level, increased number of comorbidities, history of hypoglycemia, and insulin treatment. Factors associated with both MCI and depressive syndrome were female gender, single marital status, past smoking status, retinopathy, previous CVD or stroke, increased number of comorbidities, and insulin treatment. Conclusions. Depressive symptoms, MCI, and its comorbidity are common in elderly subjects with type 2 diabetes. Systematic screening could result in the identification of high-risk patients

Eicosanoids in Exhaled Breath Condensate and Bronchoalveolar Lavage Fluid of Patients with Primary Lung Cancer

Although eicosanoids are involved in lung carcinogenesis they were poorly investigated in exhaled breath condensate (EBC) and bronchoalveolar lavage fluid (BALf) in patients with primary lung cancer. In this study 17 patients with diagnosed non-small cell lung cancer, 10 healthy smokers and 12 healthy nonsmokers were included. The levels of cys-LTs, 8-isoprostane, LTB4 and PGE2 were measured before any treatment in the EBC of all patients and in BALf of patients with lung cancer by enzyme linked immunosorbent assay. 8-isoprostane, LTB4, cys-LTs and PGE2 were detectable in the EBC and BALf. There were no significant differences between healthy smokers and nonsmokers in concentrations of all measured mediators. Compared with both healthy controls, patients with diagnosed lung cancer displayed higher concentrations of cys-LTs (p < 0.05) and LTB4 (p < 0.05) in EBC. In patients with lung cancer, the mean concentrations of all measured mediators were significantly higher in BALf compared with EBC and there was a significant, positive correlation between concentration of cys-LTs, LTB4 and 8-isoprostane in BALf and their concentrations in the EBC (r = 0.64, p < 0.05, r = 0.59, p < 0.05, r = 0.53, p < 0.05 respectively). Since cys-LT, LTB4 and 8-isoprostane concentrations in EBC from patients with lung cancer reflect their concentrations in BALf, they may serve as a possible non-invasive method to monitor the disease and to assess the effectiveness of therapy