Screening for Diabetes among Roma People Living in Serbia

Aim To investigate the prevalence of diabetes in the Roma population in Serbia. Methods We screened 11 urban and 8 rural Roma communities from October 2006 to May 2008 for the presence of diabetes. Blood glucose values, name, age, sex, presence of diabetes, family history, and obesity were recorded. Results We analyzed the data from 1465 Roma people, 953 women and 512 men (785 in urban and 680 in rural communities), with mean age of 42.42 ± 15.69 years. Abdominal obesity was present in 600 (41%) participants. Eighty seven participants (5.9%) already had diabetes and there were 76 (5.2%) newly discovered cases of diabetes type 2. Participants with diabetes were significantly older (F = 28.33; P < 0.01). Family history for diabetes was positive in a third of participants. The risk for diabetes was 3.48 times higher in participants with positive family history (odds ratio [OR], 3.47; 95% confidence interval [CI], 2.37-5.1; P < 0.01). Abdominal obesity was less frequent in healthy participants than in participants with diabetes (X2 = 32.55; P < 0.01). The risk of diabetes in participants with abdominal obesity was 2 times higher than in the non-obese (OR, 2.11; 95% CI, 1.24-3.55; P < 0.01). Diabetes was significantly more present in urban communities (X2 = 25.20; P < 0.01). The risk of developing diabetes was 3.65 times higher in participants from urban settlements (OR, 3.64; 95% CI, 1.99- 6.66; P < 0.01). Conclusion Prevalence of diabetes in the Roma people living in Serbia may possibly be higher than in the general population of Serbia and needs further investigation

Screening for Diabetes among Roma People Living in Serbia

Aim To investigate the prevalence of diabetes in the Roma population in Serbia. Methods We screened 11 urban and 8 rural Roma communities from October 2006 to May 2008 for the presence of diabetes. Blood glucose values, name, age, sex, presence of diabetes, family history, and obesity were recorded. Results We analyzed the data from 1465 Roma people, 953 women and 512 men (785 in urban and 680 in rural communities), with mean age of 42.42 ± 15.69 years. Abdominal obesity was present in 600 (41%) participants. Eighty seven participants (5.9%) already had diabetes and there were 76 (5.2%) newly discovered cases of diabetes type 2. Participants with diabetes were significantly older (F = 28.33; P < 0.01). Family history for diabetes was positive in a third of participants. The risk for diabetes was 3.48 times higher in participants with positive family history (odds ratio [OR], 3.47; 95% confidence interval [CI], 2.37-5.1; P < 0.01). Abdominal obesity was less frequent in healthy participants than in participants with diabetes (X2 = 32.55; P < 0.01). The risk of diabetes in participants with abdominal obesity was 2 times higher than in the non-obese (OR, 2.11; 95% CI, 1.24-3.55; P < 0.01). Diabetes was significantly more present in urban communities (X2 = 25.20; P < 0.01). The risk of developing diabetes was 3.65 times higher in participants from urban settlements (OR, 3.64; 95% CI, 1.99- 6.66; P < 0.01). Conclusion Prevalence of diabetes in the Roma people living in Serbia may possibly be higher than in the general population of Serbia and needs further investigation

Značaj određivanja produkata uznapredovale glikacije i biomarkera lipidnog i redoks statusa kod pacijenata sa dijabetes melitusom

Non-enzymatic glycation, oxidative stress (OS) and dyslipidemia are the main metabolic alterations behind the development of macrovascular complications (cardiovascular diseases) of diabetes mellitus (DM). However, clinical relevance of biomarkers of these processes in patients with microvascular complications (nephropathy, neuropathy, retinopathy) is less understood. Therefore, the aim of this study was to examine advanced glycation products (AGEs), biomarkers of OS, and dyslipidemia in 100 DM patients (33 without microvascular complications and 77 with complications) and 30 subjects without DM. AGEs levels were higher in patients with complications than in those without complications (median: 5.72; interquartile range: 4.60- 6.54 U/mL vs. median: 4.84; interquartile range: 4.10-5.40 U/L; P<0.05). In addition to AGEs, the group with diabetic retinopathy had higher plasma total antioxidant capacity (P<0.05), while the group with diabetic nephropathy had smaller LDL size than the patients without these complications (25.48±1.26 nm vs. 26.21±1.19 nm; P<0.05). The patients with co-existing cardiovascular disease were further characterized by dysfunctional HDL particles, as evidenced by increased small HDL particles (P<0.05) and reduced paraoxonase- 1 activities. Significant increase in both pro-oxidant-antioxidant balance and ischemia- modified albumin (P<0.05), with simultaneously decreased activity of superoxide-dismutase (P<0.05) was found in patients with progressive diabetic neuropathy, indicating the highest degree of oxidative damage. It can be concluded that patients with microvascular complications of DM have aggravated redox imbalance and lipid profile alterations. In addition to metabolic control, strategies aimed at lowering OS and correcting dyslipidemia can contribute to the prevention of microvascular complications of diabetes.Neenzimska glikacija, oksidativni stres (OS) i dislipidemija su glavni metabolički procesi koji dovode do razvoja makrovaskularnih komplikacija (kardiovaskularnih bolesti) dijabetesa melitusa (DM). Međutim, klinički značaj određivanja biomarkera ovih procesa kod pacijenata sa mikrovaskularnim komplikacijama (retinopatija, nefropatija, neuropatija) nije dovoljno razjašnjen. Cilj ovog istraživanja je bio ispitivanje produkata uznapredovale glikacije (AGE), biomarkera OS i dislipidemije kod 100 pacijenata sa DM (33 bez mikrovaskularnih komplikacija i 77 sa komplikacijama) i 30 ispitanika bez DM. Nivo cirkulišućih AGE je bio značajno viši u grupi pacijenata sa komplikacijama (medijana: 5,72; interkvartilni raspon: 4,60-6,54 U/mL) u odnosu na pacijente bez komplikacija (medijana: 4,84; interkvartilni raspon 4,10-5,40 U/L; P<0,05). Pored povišenih koncentracija AGE, pacijenti sa dijabetesnom retinopatijom su imali i povišene vrednosti totalnog oksidativnog statusa (P<0,05), a pacijenti sa dijabetesnom nefropatijom manje dijametre LDL čestica (25,48±1,26 nm) u poređenju sa sa pacijentima bez komplikacija (26,21±1,19 nm; P<0,05). Nadalje, kod pacijenata sa pridruženim makrovaskularnim komplikacijama (kardiovaskularnim bolestima) utvrđeno je prisustvo disfunkcionalnih HDL čestica, na osnovu povećanog udela malih HDL čestica (P<0.05) i smanjene aktivnosti paroksonaze- 1. Pacijenti sa progresivnom dijabetesnom neuropatijom su imali značajno povišene vrednosti prooksidativno-antioksidativnog balansa i ishemijom modifikovanog albumina (P<0,05), uz istovremeno sniženje aktivnosti superoksid-dismutaze (P<0,05), što ukazuje da je stepen oksidativnog oštećenja u ovoj grupi bio najveći. Može se zaključiti da, pored adekvatne metaboliče kontrole, strategije usmerene ka sniženju OS i korekciji dislipidemije, mogu doprineti prevenciji razvoja mikrovaskularnih komplikacija dijabetesa.VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Capture the fracture - use of bone turnover markers in clinical practice

Bone is a living tissue, metabolically very active, with the level of turnover of about 10% per year. Bone remodeling is a well-balanced process of bone resorption, induced by osteoclasts and bone formation maintained osteoblasts. Loss of bone remodeling balance, with increased bone resorption, leads to osteoporosis. Bone turnover markers are classified as markers of bone formation and of bone resorption. During the growth and development of skeleton, bone turnover markers show higher levels of activity than in the adult period. The increase in biochemical markers peaks again in the postmenopausal period, indicating accelerated bone remodeling. Bone mineral density is an important predictor of an osteoporotic fracture. Timely assessment of risk factors of osteoporosis and bone markers can detect subjects with accelerated bone remodeling and osteoporosis. This may introduce adequate therapy and prevent fracture

Clinical Benefit of Basal Insulin Analogue Treatment in Persons with Type 2 Diabetes Inadequately Controlled on Prior Insulin Therapy: A Prospective, Non-Interventional, Multicentre Study

<p><b>Article full text</b></p><p><br></p><p>The full text of this article can be found here<b>.</b> <a href="https://link.springer.com/article/10.1007/s13300-018-0378-4">https://link.springer.com/article/10.1007/s13300-018-0378-4</a></p><p></p><p><br></p><p><b>Provide enhanced content for this article</b></p><p><br></p><p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p><p> </p><p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p><p><br></p><p>Other enhanced features include, but are not limited to:</p><p><br></p><p>• Slide decks</p><p>• Videos and animations</p><p>• Audio abstracts</p><p> </p><p>• Audio slides</p><ul> </ul

The effect of combination therapy of insulin glargine, metformin, and sitagliptin on insulin secretion, insulin resistance, and metabolic parameters in obese subjects with type 2 diabetes

Introduction. A combination of drugs is required for treatment of obese subjects with diabetes, due to multiple pathogenic mechanisms implicated in the development of both diabetes and obesity. Objective. Assessment of the effect of sitagliptin added to insulin glargine and metformin, in obese subjects with type 2 diabetes. Methods. A total of 23 obese subjects on metformin and insulin glargine participated in the study. Titration of insulin glargine during a one-month period preceded the addition of 100 mg of sitagliptin daily. Body mass index, waist circumference, fasting, and prandial glucose were measured monthly, lipids and hemoglobin A1c (HbA1c) every three months, insulin, c-peptide and glucagon at the start and after six months of treatment. Homeostatic models for insulin secretion (HOMA B) and insulin resistance (HOMA IR) were calculated. Results. Participants were 58.65 Ѓ} 7.62 years of age with a body mass index of 35.06 Ѓ} 5.15 kg/m2, waist circumference of 115.04 Ѓ} 15.5 cm, and the duration of diabetes of 4.11 Ѓ} 2.57 years. With the titration of insulin glargine, target fasting glucose levels were not achieved. Waist circumference and body mass index decreased during three months of sitagliptin treatment, thereafter remaining stable. HbA1c decreased significantly after three and six months of therapy. C-peptide increased significantly, while glucagon level fell. HOMA indexes were unchanged. Conclusion. Sitagliptin can improve diabetes control and induce modest weight loss in obese subjects poorly controlled on insulin glargine and metformin. Titration of insulin glargine to optimal fasting glucose values is a prerequisite of success of this combination therapy