[Insulin: alfa and omega]
KIS János Tibor1, BALOGH Bernadett1, KISS Zsófia2, SCHANDL László1
DECEMBER 17, 2021
Lege Artis Medicinae - 2021;31(12)
DOI: https://doi.org/10.33616/lam.31.044
Review
KIS János Tibor1, BALOGH Bernadett1, KISS Zsófia2, SCHANDL László1
DECEMBER 17, 2021
Lege Artis Medicinae - 2021;31(12)
DOI: https://doi.org/10.33616/lam.31.044
Review
[Type 1 diabetes (T1DM) is caused by the autoimmune death of insulin-producing β-cells. In the background there is by all probability the primary antigen (if the theory of primary antigen is correct) the insulin itself or the proinsulin. However, treatment of T1DM is virtually equivalent to the insulin treatment. The earlier we recognize T1DM and start treatment, the better glycaemic results we achieve, the more likely we can maintain all functional β-cell stocks. Insulin also plays a key role in the immunopathogenesis, development and treatment of T1DM, thus insulin is the alpha and omega in this condition.]
Lege Artis Medicinae
[While 11 out of the 15 first European countries with highest COVID-19 mortality rates are Post-Socialist countries (73%), and only 9 out of the 31 countries on place 16-46 (29%) are Post-Socialist. All of the top 17 European countries with the highest cumulative excess-mortality since the beginning of the COVID-19 pandemic era, are Post-Socialist countries (100%) as well as 19 out of the top 20 (95%). The dividing line between high and low COVID-19 mortality of European countries follows exactly the path of the former Iron Curtain. In addition, out of the 43 data reporting European countries, all the 18 with the lowest vaccination rate (100%) are Post-Socialist. The main cause of these differences in European COVID-19 mortality may be the traditionally disadvantageous physical and mental condition of the population of Post-Socialist countries, but this problem needs further, more intense investigations.]
Lege Artis Medicinae
[Insulin is 100 years old. Concerning this anniversary, this study reviews the main events before and after the insulin era, the wider range of insulin products and the chronology of main clinical innovations related to the insulin administration. It also presents the history of related devices as delivery pens, insulin pumps and automated treatment systems. It points out that, although insulin dosing is an external replacement for missing or insufficient endogenous hormone production as related to the actual demand, it is to this date the general treatment available for all types and stages of this condition.]
Lege Artis Medicinae
[In August 2021, the European Society of Cardiology (ESC) published its practical guidelines for cardiovascular prevention. In Part 1 of our publication, we discussed cardiovascular risk factors, risk assessment, cardiovascular risk assessment in presumably healthy individuals of different ages, people with proven atherosclerotic cardiovascular disease, people with diabetes mellitus, and factors influencing risk. In Part 2, conditions that influence cardiovascular risk were detailed. In the current Part 3 of this publication, we review personalised cardiovascular prevention, non-pharmaceutical and pharmaceutical treatment of specific risk factors, emerging treatment options, and participation in cardiovascular rehabilitation and prevention programmes based on ESC guidelines.]
Lege Artis Medicinae
[Insulin was discovered 100 years ago. At this anniversary the present study concerns the applications of insulin pumps and sensors, emphasising the latest options in Hungary. Since January 1, 2020 the above devices are provided with 98% coverage by the National Health Insurance Fund for underage Type 1 diabetics and high school students up to 24 years. Adults with Type 1 diabetes may also obtain an insulin pump and sensor with 80% coverage of the social health insurance. A sensor distributed by an independent local company will also be available in the upcoming months. It should be suggested that more and more unstable Type 1 diabetics use the insulin pump and sensors since this treatment stabilise the metabolism reduces the glucose level excesses and minimise the glucose variability. All these measures are lowering the probability of diabetes related complications.]
Lege Artis Medicinae
[Self-monitoring of blood sugar levels is an essential element in the treatment of diabetes, it provides an insight to the success of treatment and self-management, the development of metabolic processes, and ensures the early recognition and treatment of significant blood sugar fluctuations. The aim of this study was to evaluate the habits of self-monitoring of sugar levels in patients with type 2 diabetes, and among them the frequency, recognition and treatment of hypo- and hyperglycemia. The research was conducted as a cross-sectional study in 2018 in the Health Centre in Subotica/Serbia. The sample included 107 patients diagnosed with type 2 diabetes. Data were collected through interviews with patients using a customized questionnaire, during the regular control examinations. The patients’ level of blood sugar in the capillary blood was measured by glucometer. The statistical package IBM-SPSS 20.0 and descriptive analytic methods were used for data analysis. The mean age of the sample was 63.7 ± 7.7 years. Two-thirds of them performed opportunistic self-monitoring mostly before breakfast. A large number of patients never recognized variations of blood glucose (in 65% hyperglycemia and in 51% hypoglycemia). However, a month before 81% of patients had hyper- and 31% hypoglycemic episodes respectively. 12% of patients did not take any action in such cases. It is recommended to emphasize again and again the importance and way of self-monitoring at each follow-up examination. The shortcomings identified in the study provide guidelines what to focus on when caring for diabetic patients.]
Journal of Nursing Theory and Practice
[Delirium is defined as a disturbance of consciousness and cognition that develops over a short period of time and fluctuates over time. During the last decade, the number of publications dealing with different aspects of delirium have been grown. The key points in most articles are pharmacological prevention and treatment, but because the rise of health care expenditures, all activities, which cost-effectively support the care process, is getting more and more important. The aim of the study: The aim of this research is to review the non-pharmacological prevention and treatment possibilities of delirium in elderly patients undergoing hip surgery. Systematic review, using articles published between 1999 and 2019 in PubMed and Wiley Online Libraries. Non-pharmacologic treatments significantly reduced the incidence (p=0.003–0.045) and duration (p=0.009–0.03) of delirium. The interventions also contributed to decrease the number of episodes (p=0.03), and to make the symptoms lighter. Early mobilisation and adequate fluid and electrolyte intake are key factors in reducing the incidence of delirium. Measuring oxygen saturation and support, appropriate nutrition, effective pain treatment, minimizing drug-interactions, maintaining good sleep and managing sensory dysfunctions have an effect on incidence, duration and severity of delirium.]
Lege Artis Medicinae
[Osteoarthrosis is a major burden on our society, both in terms of health affairs and health economy. The increasing strain on joints by competitive sports and the growing prevalence of sedentary lifestyle are coupled main factors behind the increasing occurence of osteoarthritis in younger generations. Its pathomechanism is recently recognised to be a combination of inflammatory and degenerative processes. Concerning the serious and even quality of life worsening outcomes and its growing and spreading prevalence, the role of prevention has become crucial. This study reviews the preventive options, emphasizing the importance of recreational sport and physical activities, while presenting also the new generation of chondroprotective agents. ]
Lege Artis Medicinae
[This study presents the results and expert opinions about the most important, amply evidence based, most widespread and affordable therapeutic procedures and supplementary preparations, which may support or and possibly replace conventional treatments. Traditional, complementary, and integrative medicine offers a number of options to enhance physical, psychic and mental resilience that may also be useful in the prevention and treatment of COVID-19 patients. It will be worthwhile to analyse the evidences of clinical experiences on potential benefits. This brief summary might serve as a useful starting point for further research on this topic.]
Hypertension and nephrology
[The lupus nephritis (LN) is one of the most frequent manifestation of SLE which causes higher morbiditiy and mortalitiy of the patients if it appears. Although the use of glucocorticoides, cyclophosphamide and mycofenolat mofetil and the protection of the kidney with conservative therapy has significantly improved the outcome of the disease, but the long-term renal outcome and risk of death from LN have not changes over the last 20 years. Furthermore, the side effect of our medications used as part of the standard immunomodulatory therapy are not negligible. The better understanding of the pathomechanism of different medical conditions (hypertension, diabetes mellitus etc.) has helped to combine medications with different therapeutic targets which result more effective and favorable side-effect profile therapy. Therefore, it is not suprising that, in parallel with improvement of the immunology, with better knowlege about the patomechanism of SLE can lead to the new combined, targeted treatments which have broadened the therapeutic options. In addition to the immunmodulatory therapy, a drug with new mechanism of action has become available to slow the progression of chronic kidney diseases. The purpose of this summary is to briefly summarize the current knowledge available and assist clinicians in the daily practice of patients with LN to give suggestion for more effective and personalized therapeutic options.]
Hypertension and nephrology
[Using our mobile public health screening system, we examined the changes in systolic blood pressure averages and systolic pressure distribution between 2010 and 2018 by analyzing the data of 72,857 women (mean age 42.3±13.9 years) and 61,563 mén (mean age 42.2±13.9 years) in three consecutive time periods. The SBP averages have been gradually and significantly decreased since 2010 in all age groups. The parametric and non-parametric characteristics of the systolic distribution curves alsó showed a favorable change during the indicated period. The observed changes may indicate that the primary and secondary prevention, as well as the treatment of hypertension and the physician-patient cooperation in Hungarywere successful in the indicated period.]
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Journal of Nursing Theory and Practice
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