Diabetology

Lege Artis Medicinae

OCTOBER 07, 2024

[Continuous glusose monitoring in application of insulin glargine plus lixisenatide fixed ratio combination ]

HERMÁNYI Zsolt, JANKOVEC Zdenek , MAULE Petr , TAYBANI Zoltán Jamal, VESELÁ Alica , BONNEMAIRE Mireille , FÜLÖP Rita

[The effectiveness of the fixed-ratio combination of insulin glargine and lixisenatide (iGlarLixi) has been confirmed by several clinical trials in people with type 2 diabetes (T2DM). The aim of this study was to demonstrate the effectiveness of iGlarLixi treatment in improvement glycemic control in participants who were inadequately controlled on basal insulin using continuous glucose monitoring (CGM) data.

The primary endpoint of this 18-week, single-arm, open-label, phase 4 clinical trial was the change of blood glucose level time in range (TIR). The inclu­sion criteria were at least 3-year T2DM and 6-month treatment with basal insulin, HbA1c level ≥7.5% and ≤10% and fasting blood glucose level ≤7.8 mmol/l. CGM data recording was performed before the switch to iGlarLixi and at the 18th week. Dose titration of iGlarLixi was based on self-monitoring of blood glucose levels.

Overall 51 participants were treated with iGlarLixi and 34 participants had baseline and end-of-study CGM recordings (“per-protocol population”). The per-protocol population’s mean (SD) age was 66.4 (7.01) years and they have had T2DM for 16.6 (9.06) years at inclusion. The percentage of TIR increased from 71.8% (18.08) to 78.3% (12.36) (p=0.066), while the time above range (TAR) decreased significantly from 24.0% (18.96) to 9.9% (9.85; p<0.001). The percentage of time-below-range (TBR) increased from 4.2% (7.23) to 11.8% (13.48; p<0.001). The HbA1c level decreased from 8.4% (0.63) to 7.1% (0.91), and the fasting blood glucose levels also decreased.

This study confirmed the effectiveness of iGlarLixi using CGM data and provided numerous learnings for designing future CGM studies.]

HUN 2024;34(9)

Lege Artis Medicinae

OCTOBER 07, 2024

[Prevalence and dietary treatment of the most common diseases and gastrointestinal symptoms in pregnancy   ]

HULMAN Anita, VARGA Katalin, KECZELI Viola, PAKAI Annamária

[A pregnant woman’s diet defines her own health as well as the healthy development and growth of the child in the womb. During pregnancy, a significant proportion of women experience some kind of unpleasant gastrointestinal symptom or illness, and most of them try to relieve those with dietary changes. 

The quantitative, cross-sectional research was performed between Ja­nuary 2020 and May 2020. During the non-random convenience sampling, the tar­get group consisted of Hungarian pregnant women (n = 721). In the self-administered, anonymous, online available questionnaire, sociodemographic, pregnancy and nutrition- related questions were used. The signifi­cance level was determined at p<0.05.

Nine out of ten pregnant women experienced at least one unpleasant symptom during their pregnancy. The highest proportion of pregnant women reported dieting due to illness, and the largest proportion tried to treat the symptoms by nutrition. We discovered a significant difference in terms of educational level and problem-specific dieting in case of illness, as well as income status and following a special diet due to food intolerance. Pregnant women mostly request advice from a doctor and then from a dietician to design a suitable diet, however, there was no statistically detectable difference in terms of higher education, higher income status and obtaining information from a dietician.

The education of pregnant women plays an important role in the effective dietary treatment of diseases and symptoms, which are experienced most often during pregnancy and can be relieved with proper nutrition.

 ]

HUN 2024;34(9)

Clinical Neuroscience

SEPTEMBER 30, 2024

Role of the video head impulse test in the evaluation of vestibulo-ocular reflex in individuals with Parkinson’s disease

RIZA SONKAYA, ERCAN KARABABA, HATICE Kübra BOZKURT, BÜLENT SATAR

Parkinson’s disease (PD) is the most common movement disorder and the second most common neurodegenerative disease of the central nervous system. Dizziness is frequently reported by PD patients, yet there is a paucity of research focusing on the vestibulo-ocular reflex (VOR) in this population using highfrequency vestibular testing. This study aims to investigate the VOR in individuals with PD using the video head thrust test with and without suppression.

ENG 2024;77(9-10)

Clinical Neuroscience

SEPTEMBER 30, 2024

The effect of body position, leg dominance, and automatic releasing mechanism on quadriceps muscle tone assessed by Pendulum Test in able-bodied persons

MAYER Petra , BODOR András , SZABÓ Dorottya , LACZKÓ József , ZENTAI Norbert

Quadriceps femoris muscle spasticity is commonly measured by the Wartenberg pendulum test. It is generally assumed that lower values of the number of swings of the leg and lower relaxation indexes are associated with higher muscle tone and more spasticity. Still, there is incoherence regarding the test’s applications with various body positions and starting mechanisms. This study aims to investigate the influence of body position, leg dominance, and automatic leg-releasing mechanism on muscle tone measured by pendulum test in healthy population whose muscle tone is often compared to the spastic muscle tone of patients with neurologic disorders.

ENG 2024;77(9-10)

Clinical Neuroscience

SEPTEMBER 30, 2024

Effect of inflammatory response before mechanical thrombectomy on prognosis in stroke patients

EMRAH AYTAÇ, FERHAT BALGETİR, ŞULE Kavak Genç, MURAT Gönen, HASAN DOGAN, CETIN Kursad AKPINAR

Mechanical thrombectomy is the most important treatment modality in acute stroke; despite successful thrombectomy, good functional outcome is not achieved in a significant proportion of patients. This study examined the effect of neutrophil lymphocyte ratio (NLR) values at admission on functional outcomes in successfully recanalized patients.

ENG 2024;77(9-10)

Clinical Neuroscience

SEPTEMBER 30, 2024

Predictors of pneumonia in stroke patients with dysphagia: A Turkish study

HALIM Ömer KAŞIKÇI, ELIF ÜÇGÜL ERÇİN , RAHŞAN KARACI, MUSTAFA ÜLKER, FÜSUN DOMAÇ MAYDA

Dysphagia, characterized by difficulty in swallowing due to neurological deficits, stands out as the foremost contributor to stroke asso­ciated pneumonia (SAP) development. Recent investigations have explored the utility of blood tests, including parameters like neutrophil count, leukocyte count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the CRP to albumin ratio (CAR), at the time of admission as potential markers for predicting SAP development. This study is set out to assess predictors of SAP in patients with acute ischemic stroke and dysphagia. 

This retrospective cross-sectio­nal study, conducted at the University of Health Sciences, Neurology Department of Erenkoy Mental Health Neurological Disor­ders in Istanbul, Turkey, between January 2021 and January 2023, assessed 65 indivi­duals with acute ischemic stroke and dysphagia. Excluding specific criteria, clinical and laboratory data were collected. Patients were categorized into SAP and non-SAP groups based on diagnostic criteria. Results provide insights into risk factors of SAP.

In this study of 65 stroke patients with dysphagia, 27 (41.5%) developed SAP within the first week. No significant differences in age, gender, comorbidities, or infarct size were observed between the pneumonia-positive and pneumonia-negative groups (p > 0.05). HbA1c levels were significantly lower in the pneumonia-positive group (p = 0.02). Logistic regression revealed that NLR, CAR levels, and the presence of atrial fibrillation (AF) were significant predictors of pneumonia development (p < 0.001).

Dysphagia is considered one of the most significant risk factors for SAP. However not all ischemic stroke patients with dysphagia develop SAP; that is the reason we think NLR, CAR, and AF might be predictors of SAP in acute ischemic stroke patients with dysphagia.

ENG 2024;77(9-10)