Metabolic control in type 1 diabetes patients practicing combat sports : at least two-year follow-up study

Background: It is well recognized that physical activity should be an integral part of the management of diabetes. It remains controversial, however, whether combat sports, often preferred by young individuals type 1 diabetes mellitus (T1DM), may be performed without high risk of metabolic decompensation. The aim of this observational study was to summarize a two-year follow-up period of five young male patients with T1DM practicing combat sports under the care of a physical-activity oriented specialist diabetes outpatient clinic. Of the five patients, three mixed martial arts and two kick-boxing competitors were included in the study. To control glucose in each patient, an individual approach was used that took into consideration the type of training, the sequence of the exercises, and the relative proportion of different forms of exercise. Findings: During the follow-up, glycemic control was improved and maintained in all individuals. Neither an episode of hospitalization-requiring diabetic ketoacidosis nor severe hypoglycemia occurred in these patients during the follow-up. Conclusions: In conclusion, an individual approach for T1DM patients practicing combat sports may result in achieving and maintaining satisfactory glycemic control without increased risk of metabolic decompensation

Projekt „5000 metrów nad poziomem cukru”

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Physiological characteristics of type 1 diabetes patients during high mountain trekking

In this study, the aim was to provide observational data from an ascent to the summit of Mount Damavand (5670 meters above sea level (m.a.s.l), Iran) by a group of people with type 1 diabetes (T1DM), with a focus on their physiological characteristics. After a 3-day expedition, 18 T1DM patients, all treated with personal insulin pumps, successfully climbed Mount Damavand. Information was collected on their physiological and dietary behaviors, as well as medical parameters, such as carbohydrate consumption, glucose patterns, insulin dosing, and the number of hypo- and hyperglycemic episodes during this time frame. The participants consumed significantly less carbohydrates on day 3 compared to day 1 (16.4 vs. 23.1 carbohydrate units; p=0.037). Despite this, a gradual rise in the mean daily glucose concentration as measured with a glucometer was observed. Interestingly, the patients did not fully respond to higher insulin delivery as there was no significant difference in mean daily insulin dose during the expedition. There were more hyperglycemic episodes (≥180 mg/dL) per patient on day 3 vs. day 1 (p250 mg/dL) per patient on days 2 (p<0.05) and 3 (p<0.05) vs. day 1. In summary, high mountain trekking is feasible for T1DM patients with good glycemic control and no chronic complications. However, some changes in dietary preferences and an observable rise in glucose levels may occur. This requires an adequate therapeutic response

ADVANCE : how to optimize the prevention of diabetic complications : the results of pooled analysis of glucose-lowering and blood pressure arms of the ADVANCE study

Wyniki badania ADVANCE ukazały korzyści dotyczące licznych punktów końcowych, w tym naczyniowych powikłań cukrzycy i śmiertelności, wynikające z obniżania wartości ciśnienia tętniczego u chorych na cukrzycę typu 2 z zastosowaniem Noliprelu oraz intensywnego obniżania glikemii z użyciem preparatu Diaprel MR. Badanie ADVANCE było największą przeprowadzoną dotąd próbą u chorych na cukrzycę typu 2 (n = 11 140). Ostatnio opublikowano analizę dotyczącą łącznej oceny korzyści wynikających z randomizacji do obu grup interwencyjnych; niniejszy artykuł stanowi krótkie podsumowanie tych rezultatów. W łącznej analizie ramion hipoglikemizującego i hipotensyjnego badania ADVANCE wykazano, że ich wpływ jest niezależny dla wszystkich incydentów (brak interakcji); łączny efekt leczenia zapewnia chorym istotne korzyści w postaci 18-procentowej redukcji śmiertelności całkowitej, zmniejszenia śmiertelności sercowo-naczyniowej o 24% oraz 33-procentowego spadku częstości nefropatii i incydentów nerkowych. Wyniki badania wskazują więc, że efekty leczenia hipotensyjnego z zastosowaniem Noliprelu i intensywnej kontroli glikemii opartej na terapii z użyciem preparatu Diaprelu MR były niezależne dla wszystkich punktów końcowych. Łączne stosowanie obu rodzajów leczenia może przynieść chorym na cukrzycę szczególne korzyści kliniczne.The recently published results of ADVANCE trial demonstrated the separate benefits of blood pressure lowering with the fixed combination of perindopril- -indapamide and of intensive glucose control with a gliclazide MR-based regimen on a range of outcomes including vascular complications of diabetes and mortality. The study was the biggest so far prospective trial on type 2 diabetes mellitus (n = 11,140). Separate analysis of both treatment arms of ADVANCE trial was recently followed by the assassement of magnitude and independence of both, hypoglycemic and hypotensive, effects. This article summarizes main results of combined analysis. The was no interaction between blood pressure lowering and intensive glucose control for any endpoints. Individuals randomized to Perindopril/Indapamide and Diaprel MR-based intensive blood glucose lowering, were characterized by reduction of risk of all-cause mortality by 18%, cardiovascular death by 24%, development or worsening of nephropathy by 33%. These results indicate that the separate effects of Perindopril/Indapamide and intensive glucose control with Diaprel MR were independent for all outcomes, combined use of these treatments should be of substantial benefis for T2DM patients

Cenniejsze niż złoto? Metale ziem rzadkich w światowej strategii gospodarczej

Next to oil and gas there are which have increasing importance for industrial development – rare earth elements. Without them, much of the world’s modern technology would be vastly different and many applications would not be possible. They are key component of in a large assortment of advanced military and civilian technologies and key to the emergence of green technology such as the new generation of wind powered turbines and plug-in hybrid vehicles. There are 17 rare earth elements which moderately are abundant in the earth’s crust, some even more abundant than copper, lead, gold, and platinum. Although they are not concentrated enough to make them easily exploitable economically. 97 percent of the world’s rare earth elements are produced in China. Increasing global demand and Chinese reductions in export quotas over the past six years have led to international concerns about future supply shortages. China’s request for rare earths is also growing, what causes even more problems for importers of these resources. Even those countries which were largely self-sufficient in these critical materials over the past decade have become dependent upon imports from Beijing. In addition, this monopoly over rare earths has led to fears of China using its dominance as leverage to influence other nations’ foreign policies. Considering example of Japan, these anxieties are not groundless. This paper is designed to present te phenomenon of rare earth elements and their importance for international economy. It also explores ways of facing Chinese monopoly by other states.Next to oil and gas there are which have increasing importance for industrial development – rare earth elements. Without them, much of the world’s modern technology would be vastly different and many applications would not be possible. They are key component of in a large assortment of advanced military and civilian technologies and key to the emergence of green technology such as the new generation of wind powered turbines and plug-in hybrid vehicles. There are 17 rare earth elements which moderately are abundant in the earth’s crust, some even more abundant than copper, lead, gold, and platinum. Although they are not concentrated enough to make them easily exploitable economically. 97 percent of the world’s rare earth elements are produced in China. Increasing global demand and Chinese reductions in export quotas over the past six years have led to international concerns about future supply shortages. China’s request for rare earths is also growing, what causes even more problems for importers of these resources. Even those countries which were largely self-sufficient in these critical materials over the past decade have become dependent upon imports from Beijing. In addition, this monopoly over rare earths has led to fears of China using its dominance as leverage to influence other nations’ foreign policies. Considering example of Japan, these anxieties are not groundless. This paper is designed to present te phenomenon of rare earth elements and their importance for international economy. It also explores ways of facing Chinese monopoly by other states

ADVANCE - how to optimize the prevention of diabetic complications. The results of pooled analysis of glucose-lowering and blood pressure arms of the ADVANCE study

Wyniki badania ADVANCE ukazały korzyści dotyczące licznych punktów końcowych, w tym naczyniowych powikłań cukrzycy i śmiertelności, wynikające z obniżania wartości ciśnienia tętniczego u chorych na cukrzycę typu 2 z zastosowaniem Noliprelu oraz intensywnego obniżania glikemii z użyciem preparatu Diaprel MR. Badanie ADVANCE było największą przeprowadzoną dotąd próbą u chorych na cukrzycę typu 2 (n = 11 140). Ostatnio opublikowano analizę dotyczącą łącznej oceny korzyści wynikających z randomizacji do obu grup interwencyjnych; niniejszy artykuł stanowi krótkie podsumowanie tych rezultatów. W łącznej analizie ramion hipoglikemizującego i hipotensyjnego badania ADVANCE wykazano, że ich wpływ jest niezależny dla wszystkich incydentów (brak interakcji); łączny efekt leczenia zapewnia chorym istotne korzyści w postaci 18-procentowej redukcji śmiertelności całkowitej, zmniejszenia śmiertelności sercowo-naczyniowej o 24% oraz 33-procentowego spadku częstości nefropatii i incydentów nerkowych. Wyniki badania wskazują więc, że efekty leczenia hipotensyjnego z zastosowaniem Noliprelu i intensywnej kontroli glikemii opartej na terapii z użyciem preparatu Diaprelu MR były niezależne dla wszystkich punktów końcowych. Łączne stosowanie obu rodzajów leczenia może przynieść chorym na cukrzycę szczególne korzyści kliniczne.The recently published results of ADVANCE trial demonstrated the separate benefits of blood pressure lowering with the fixed combination of perindopril- -indapamide and of intensive glucose control with a gliclazide MR-based regimen on a range of outcomes including vascular complications of diabetes and mortality. The study was the biggest so far prospective trial on type 2 diabetes mellitus (n = 11,140). Separate analysis of both treatment arms of ADVANCE trial was recently followed by the assassement of magnitude and independence of both, hypoglycemic and hypotensive, effects. This article summarizes main results of combined analysis. The was no interaction between blood pressure lowering and intensive glucose control for any endpoints. Individuals randomized to Perindopril/Indapamide and Diaprel MR-based intensive blood glucose lowering, were characterized by reduction of risk of all-cause mortality by 18%, cardiovascular death by 24%, development or worsening of nephropathy by 33%. These results indicate that the separate effects of Perindopril/ Indapamide and intensive glucose control with Diaprel MR were independent for all outcomes, combined use of these treatments should be of substantial benefis for T2DM patients

Proposal of an electronic system for registering participants in inspection days at the construction site during a pandemic

Diplomová práce se zabývá návrhem elektronického „systému“ evidence účastníků kontrolních dnů na stavbě a splnění povinností koordinátora BOZP na stavbě v době pandemie. V souvislosti s aktuální situací v podobě pandemie onemocnění Covid-19 si diplomová práce dává za hlavní cíl, navrhnout řešení ke splnění povinností koordinátora BOZP na staveništi při zamezení styku více osob. Práce vychází z osobních zkušeností výkonu činnosti koordinátora BOZP na staveništi na středně velkém stavebním projektu v Praze.The thesis deals with the design of an electronic "system" of registering participants on control days at the construction site and meeting the responsibilities of an OSH coordinator at the construction site at the time of the pandemic. In the context of the current situation of the Covid-19 disease pandemic, the thesis aims to propose a solution to fulfilling the responsibilities of the OSH coordinator on the construction site, while preventing multiple contacts. The work is based on personal experience of working as an OSH coordinator on a construction site on a medium-sized construction project in Prague.040 - Katedra bezpečnosti práce a procesůvelmi dobř

The association between the level of baseline daily physical activity and selected clinical and biochemical parameters during mountain trekking in patients with type 1 diabetes

Introduction. There is a general agreement that regular physical activity should be recommended for patients with type 1 diabetes mellitus (T1DM), as it positively affects blood pressure and lipid levels and diminishes the risk of T1DM complications. Aim of this study was to search for a correlation between lactate level, de­gree of fatigue, and patient-reported physical activity in T1DM patients while trekking up to 3000 meters above sea level (masl). Material and methods. Study group consisted of 19 participants (2 women) in mean age of 31 years with T1DM who summited 3000 masl in Alps. Clinical infor­mation was taken from patient questionnaire, personal insulin pumps and blood analysis (glucose, lactate level). Additionally patient self-assessment of physical activity and fatigue (Borg scale) was used. Results. Declared physical activity in the last six months correlated with the initial, second, and final ratings of fatigue according to the Borg Scale during the expedition day, p = 0.02, r = –0.65; p = 0.02, r = –0.54; p = 0.01, r = –0.61, respectively. Blood lactate levels tended to increase with duration of exercise and altitude. Also, the average level of lactate on the expedition correlated with the average level of fatigue (p = 0.02, r = 0.57). Conclusion. Before undertaking day-long mountain trekking, T1DM patients with a sedentary lifestyle should improve their fitness. The measurement of lactate levels can be a useful tool to predict fatigue as measured with the Borg Scale. (Clin Diabetol 2017; 6, 3: 77–80)Introduction. There is a general agreement that regular physical activity should be recommended for patients with type 1 diabetes mellitus (T1DM), as it positively affects blood pressure and lipid levels and diminishes the risk of T1DM complications. Aim of this study was to search for a correlation between lactate level, de­gree of fatigue, and patient-reported physical activity in T1DM patients while trekking up to 3000 meters above sea level (masl). Material and methods. Study group consisted of 19 participants (2 women) in mean age of 31 years with T1DM who summited 3000 masl in Alps. Clinical infor­mation was taken from patient questionnaire, personal insulin pumps and blood analysis (glucose, lactate level). Additionally patient self-assessment of physical activity and fatigue (Borg scale) was used. Results. Declared physical activity in the last six months correlated with the initial, second, and final ratings of fatigue according to the Borg Scale during the expedition day, p = 0.02, r = –0.65; p = 0.02, r = –0.54; p = 0.01, r = –0.61, respectively. Blood lactate levels tended to increase with duration of exercise and altitude. Also, the average level of lactate on the expedition correlated with the average level of fatigue (p = 0.02, r = 0.57). Conclusion. Before undertaking day-long mountain trekking, T1DM patients with a sedentary lifestyle should improve their fitness. The measurement of lactate levels can be a useful tool to predict fatigue as measured with the Borg Scale. (Clin Diabetol 2017; 6, 3: 77–80