Diet-Related Knowledge and Physical Activity in a Large Cohort of Insulin-Treated Type 2 Diabetes Patients: PROGENS ARENA Study

There is no doubt that behavioral intervention is crucial for type 2 diabetes mellitus (T2DM) prevention and management. We aimed to estimate dietary habits and diet-oriented knowledge as well as the level of physical activity in 2500 insulin-treated Polish type 2 diabetes mellitus (T2DM) patients (55.4% women). The mean age of the study participants was 64.9 ± 9.3 years, mean BMI was 31.4 kg/m2 ± 4.5, mean diabetes duration was 12.4 ± 6.9 years, and mean baseline HbA1c was 8.5%  ± 1.2. At the study onset, all the patients completed a questionnaire concerning health-oriented behavior. Results showed a significant lack of diet-related knowledge. For example, only 37.5% recognized that buckwheat contains carbohydrates; the percentage of correct answers in questions about fruit drinks and pasta was 56.4% and 61.2%, respectively. As for the physical activity, only 57.4% of examined T2DM patients declared any form of deliberate physical activity. To conclude, the cohort of poorly controlled insulin-treated T2DM patients studied by us is characterized by insufficient diet-related knowledge and by a very low level of physical activity. Further studies on other populations of insulin-treated T2DM patients are required to confirm these findings

Ghrelin — a multifunctional activities hormone

Grelinę po raz pierwszy wyizolowano z komórek błony śluzowej żołądka szczurów w 1999 roku. Jest ona 28-aminokwasowym peptydem, wykazującym wielokierunkową aktywność, działającym zarówno endokrynnie, jak i parakrynnie. Obecnie wiadomo, że grelina stymuluje między innymi wydzielanie hormonu wzrostu, prolaktyny, adrenokortykotropiny, wpływa na procesy steroidogenezy i na metabolizm węglowodanów. Ponadto działa na czynność zewnątrz- i wewnątrzwydzielniczą trzustki oraz na układ sercowo-naczyniowy. Pobudza również motorykę żołądka, zwiększa wydzielanie kwasu żołądkowego, bierze udział w kontroli równowagi energetycznej oraz w utrzymaniu prawidłowego stanu fizjologicznego snu i czuwania. Obecnie uważa się, że grelina wykazuje również działanie antyproliferacyjne wobec niektórych komórek linii nowotworowych oraz posiada właściwości modulujące system immunologiczny. Grelina jest produkowana głównie w komórkach błony śluzowej przewodu pokarmowego.Ghrelin was isolated in 1999 from rat stomach. Ghrelin is identified as the 28-amino-acid peptide. It is a hormone secreted into the circulation from the stomach but also synthestised in a number of tissues, suggesting both endocrine and paracrine effects. Ghrelin recently identified as the natural ligand for the growth hormone secretagogue receptor, has multiple activities in addition to stimulation of GH secretion, including stimulation of feeding and weight gain. These include: prolactin and ACTH secretion; an increase in appetite; a diabetogenic effect on carbohydrate metabolism; positive inotropic effects on heart; vasodilatation; and effects on cell proliferation. The possibility of chronic manipulation of the ghrelin system on body weight, growth and appetite remains an exciting new field of exploration. Ghrelin has been reported to regulate energy homeostasis. Ghrelin is mostly produced by the stomach, although its production has been proved in various tissues