D-vitamin es neuropathia.

Diabetes is a widespread disease and, therefore, studies dealing with diabetes and its complications are very important for public health. Numerous reports link vitamin D deficiency to the increased risk of diabetes mellitus and complications such as neuropathy. However, there are limited and conflicting data available on vitamin D deficiency in patients with diabetic peripheral neuropathy. Studies in type 2 diabetics confirmed the relationship between vitamin D deficiency and incidence of neuropathy. Recent reports suggest a relationship between the incidence of plantar ulcers and vitamin D deficiency. Orv. Hetil., 2013, 154(51), 2012-2015

A public health threat in Hungary: obesity, 2013

Background: In Hungary, the last wide-range evaluation about nutritional status of the population was completed in 1988. Since then, only limited data were available. Our aim was to collect, analyze and present updated prevalence data. Methods. Anthropometric, educational and morbidity data of persons above 18 y were registered in all geographical regions of Hungary, at primary care encounters and within community settings. Results: Data (BMI, waist circumference, educational level) of 40,331 individuals (16,544 men, 23,787 women) were analyzed. Overall prevalence for overweight was 40.4% among men, 31.3% among women, while for obesity 32.0% and 31.5%, respectively. Abdominal obesity was 37.1% in males, 60.9% in females. Among men, the prevalence of overweight-obesity was: under 35 y = 32.5%-16.2%, between 35-60 y = 40.6%-34.7%, over 60 y = 44.3%-36.7%. Among women, in the same age categories were: 17.8%-13.8%, 29.7%-29.0%, and 36.9%-39.0%. Data were presented according to age by decades as well. The highest odds ratio of overweight (OR: 1.079; 95% CI [1.026-1.135]) was registered by middle educational level, the lowest odds ratio of obesity (OR: 0.500; 95% CI [0.463-0.539]) by the highest educational level. The highest proportion of obese people lived in villages (35.4%) and in Budapest (28.9%). Distribution of overweighed persons were: Budapest (37.1%), other cities (35.8%), villages (33.8%). Registered metabolic morbidities were strongly correlated with BMIs and both were inversely related to the level of urbanization. Over the previous decades, there has been a shift in the distribution of population toward being overweight and moreover obese, it was most prominent among males, mainly in younger generation. Conclusions: Evaluation covered 0.53% of the total population over 18 y and could be very close to the proper national representativeness. The threat of obesity and related morbidities require higher public awareness and interventions

A diabeteses neuropathia klinikai jelentősége és újabb kezelési lehetőségei

A Teljes szövegben nem a végleges cím és oldalszám látható

Országos Táplálkozás- és Tápláltsági Állapot Vizsgálat – OTÁP2009 : IV. A magyar lakosság makroelem-bevitele = Hungarian Diet and Nutritional Status Survey – The OTAP2009 Study : IV. Macroelement Intake of the Hungarian Population

Az egészséges táplálkozás egyik fontos tényezője a megfelelő ásványianyag-bevitel. Célkitűzés és módszer: Az Országos Táplálkozás-és Tápláltsági Állapot Vizsgálat 2009 (OTÁP2009) – kapcsolódva az Európai Lakossági Egészségfelméréshez – a lakosság táplálkozási szokásait vizsgálta. Jelen közlemény a makroelem-beviteli adatokat mutatja be. Eredmények: A magyar lakosság sóbevitele kiemelkedően magas (férfiak 17,2 g, nők 12,0 g), káliumbevitele azonban elmarad az ajánlástól, ezek együttesen növelik a szív- és érrendszeri betegségek, ezen belül a magas vérnyomás kockázatát. A kalciumbevitel a legfiatalabb férfi korosztály kivételével nem éri el az ajánlott értéket, a legidősebb korcsoport mindkét nemben jelentősen veszélyeztetett ebből a szempontból. A magnéziumbevitel megfelel az ajánlásoknak, a foszforbevitel az ajánlottnak csaknem kétszerese. Következtetések: A makroelemek vonatkozásában legnagyobb közegészségügyi kockázata a kiemelkedően nagy nátrium- (só-) bevitelnek van. A lakossági sóbevitel csökkentését célzó STOP SÓ! Nemzeti Sócsökkentő Program végrehajtása, a feldolgozott élelmiszerek sótartalmának csökkentése és a lakosság felvilágosítása a sóbevitel kedvező irányú változását, ezzel a népegészségügyi helyzet javulását eredményezi. The adequate intake of minerals is basically important for healthy nutrition. Aim and method: The Hungarian Diet and Nutritional Status Survey – joining to the European Health Interview Survey – studied the dietary habits of the Hungarian population. The present publication describes the macroelement intake. Results: The salt intake is unusually high (17.2 g in men and 12.0 g in women), the potassium intake remains well below the recommendation. These factors substantially increase the risk of cardiovascular diseases including high blood-pressure. The calcium intake stays below the recommendation except in the youngest males, the oldest men and women are at risk from this point of view. While magnesium intake suited the recommendation, the intake of phosphorus exceeded it twice. Conclusions: Focusing on marcroelements, high sodium/salt intake represents the highest public health risk. The implementation of STOP SALT! National Salt Reducing Programme, i.e. decrease the salt content of processed food and provide proper information to the population about excessive salt consumption, should result in a beneficial change of salt intake and ameliorate the public health conditions

Advances in the management of diabetic neuropathy

The authors review current advances in the therapy of diabetic neuropathy. The role of glycaemic control and management of cardiovascular risk factors in the prevention and treatment of neuropathic complications are discussed. As further options of pathogenetic ally oriented treatment, recent knowledge on benfotiamine and alpha-lipoic acid is comprehensively reviewed. Alpha-lipoic acid is a powerful antioxidant and clinical trials have proven its efficacy in ameliorating neuropathic signs and symptoms. Benfotiamine acts via the activation of transketolase and thereby inhibits alternative pathways triggered by uncontrolled glucose influx in the cells comprising polyol, hexosamine, protein-kinase-C pathways and formation of advanced glycation end products. Beyond additional forms of causal treatment, choices of symptomatic treatment will be summarized. The latter is mostly represented by the anticonvulsive agents pregabalin and gabapentin as well as duloxetine widely acknowledged as antidepressant. Finally, non-pharmacological therapeutic alternatives are summarized. The authors conclude that combination therapy should be more often suggested to our patients; especially the combination of pathogenetic and symptomatic agents

Heart rate variability is severely impaired among type 2 diabetic patients with hypertension.

INTRODUCTION: The aim of our study was to evaluate the relative effect of diabetes and hypertension on heart rate variability. RESEARCH DESIGN AND METHODS: Four age-matched groups including type 2 diabetic patients with and without hypertension, non-diabetic patients with essential hypertension and healthy control subjects were studied. Autonomic function was evaluated by the standard cardiovascular reflex tests and 24-hour heart rate variability measurement. Heart rate variability was characterized by the triangular index value and by the spectral components of the frequency domain analysis. RESULTS: According to the two-way analysis of variance on ranks, all parameters were influenced negatively by diabetes (heart rate variability triangular index: p < 0.001; low-frequency component: p < 0.0001; high-frequency component: p < 0.001; and total power: p < 0.0001), whereas hypertension had a negative effect only on the low-frequency component (p < 0.05). The interaction between hypertension and diabetes was not significant, indicating that their effects on the heart rate variability parameters are additive. Beat-to-beat variation upon deep breathing, the most sensitive cardiovascular reflex test was also negatively influenced by both diabetes (p < 0.001) and hypertension, (p < 0.05), and their effects were additive. CONCLUSIONS: Diabetes appears to have a greater effect on autonomic dysfunction compared with hypertension. Patients suffering from both diabetes and hypertension are at the highest risk of reduced heart rate variability. Early assessment of the autonomic nerve function is suggested in diabetic patients with hypertension

Is there an association between diabetic neuropathy and low vitamin d levels?

In the past few years, the effects of vitamin D that go beyond its relationship with bone metabolism have come into the focus of scientific attention. Research concerning diabetes and its complications has become a public health priority. An increasing number of reports link vitamin D deficiency to diabetes; however, so far, there has only been limited and contradictory data available on the correlation between diabetic peripheral neuropathy and vitamin D. Studies of people with type 2 diabetes confirmed the relationship between vitamin D deficiency and neuropathy incidence as well as the severity of the symptoms caused by neuropathy. The latest studies are also suggesting a relationship between the incidence of plantar ulcers and vitamin D deficiency