[Diabetic foot syndrome is an array of symptoms with a complex pathomechanism, the complications of which (if treated late) can make it necessary to amputate the limb. Approximately 15% of diabetes patients can expect foot sores to develop in the course of their illness. The author presents the vascular complications of diabetic that underpin the development of diabetic foot syndrome, the tests serving to diagnose them, and the typical clinical manifestations and complications of diabetic foot ulcers. The most important factors in the successful treatment of diabetic foot sores are summarised: normalisation of the general medical condition; alleviation of chronic pressure points; ensuring arterial circulation; infection control; regular and appropriate mechanical debridement; wound treatment in keeping with the given phase of healing; patient education; prevention of relapse. The author places particular emphasis on the screening tests, treatment methods and patient education tasks that can be performed by specialist nurses. ]

[The authors briefly present the role of the physiotherapist in the treatment of osteoporosis. Primary, secondary, and tertiary prevention of locomotion system problems is analyzed. The authors’ specific focus is the complex physiotherapeutic treatment of osteoporotic hip fractures. They propose a prevention program involving locomotion exercises for the prevention of falls. Analyzing the physiotherapists’ activities, the authors describe the most important aspects of patient education and patient information.]

[In patients with chronic kidney failure, especially diabetic haemodialysis patients, the risk of lower-limb complications increases. Through the early recognition of changes in the leg, the definition of risk factors and timely intervention, the prevalence of ulcers and amputations can be reduced. The author aims, through a review of the specialist literature, to provide skills for the recognition of lower-limb complications occurring in chronic kidney patients, and to summarise the most common factors leading to amputation, and the opportunities for prevention. It gives guidance for the definition of risk factors, briefly describes the procedure for assessing the condition of the leg, and the basic principles and options relating to patient education. ]

[INTRODUCTION - Knowing the pharmacokinetic properties of different insulins, useful treatment algorithms can be set up for the majority of our insulin-treated patients. When planning either a human or an analogue basal-bolus regimen, the first task is to determine the daily insulin requirement, followed by determination of the optimal rate of basal and bolus insulins. CASE REPORT - In a 33-year old, moderately obese man with type 1 diabetes who received 180 U daily insulin doses, accumulated hypoglycaemic episodes with neuroglycopenic symptoms occured. After cessation of the original insulin therapy and starting an analogue basal-bolus treatment regimen, both the carbohydrate metabolism and the overall quality of life of the patient have significantly improved. Optimal metabolic control was achieved by a basal insulin ratio above 50%. CONCLUSION - Using elements of the analogue basal-bolus regimen - one of the state-of-the-art forms of insulin treatment - at the appropriate dose and dose ratio, it is possible to comply with the therapeutic requirements of our age. However, if this weapon is used inappropriately, it might actually harm patients.]

[INTRODUCTION - Observational studies have verified that even in routine diabetes care, up to 1.3% reduction in HbA1c can be achieved with the initiation of a long-acting basal insulin analogue. We can get the same results in our patients using an insulin titration algorithm and close diabetological control. CASE REPORT - Metformin therapy of a 68-year old, moderately obese woman with type 2 diabetes was complemented by a long-acting basal insulin analogue (insulin glargine). Before initiation of insulin therapy, the patient received thorough dietetic and diabetic education by a qualified dietician and a diabetes nurse. The starting dose of insulin was 10 U, and then the patient was asked to increase the dose by 2 U every 3rd day depending on the mean of self-monitored fasting plasma glucose values in the previous 2 days. With the aid of a titration algorithm, optimal carbohydrate metabolism has been verified by laboratory parameters assessed 3 months later. CONCLUSION - Insulin self-titration based on appropriate patient education and close professional control makes a relatively simple therapeutic system the optimal decision in terms of a rapid and chronic normalisation of glucose control in a large patient group.]