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Belgrade, Serbia

Ziegler D.,Heinrich Heine University Dusseldorf | Strom A.,Heinrich Heine University Dusseldorf | Lobmann R.,Clinic for Endocrinology | Reiners K.,University of Wurzburg | And 2 more authors.
Journal of Diabetes and its Complications | Year: 2015

Aims Since neuropathy screening may be underutilized in primary care practice, we conducted a nationwide educational initiative to determine the prevalence of diagnosed and previously undiagnosed polyneuropathy. Methods Among 1017 individuals participating in the initiative, 983 with complete data were analyzed, 359 of whom had no diabetes by history (ND), 80 had type 1 diabetes, and 544 had type 2 diabetes. Polyneuropathy was assessed by history and foot examination including pressure, temperature, and vibration perception and was classified as possible, probable, and severe. Foot pulses and HbA1c were determined in subsets of participants. Results Polyneuropathy was detected in 53.8% of ND, 43.8% of type 1, and 55.6% of type 2 diabetes subjects and was associated with higher age. In a subset of participants with polyneuropathy, the latter was declared as previously undiagnosed by 79.1% of ND, 35.7% of type 1, and 61.5% of type 2 diabetes participants. After adjustment for age and sex, prevalent polyneuropathy was associated with peripheral arterial disease. Conclusions More than half of subjects with and without diabetes participating in an educational initiative had polyneuropathy which was reported as previously undiagnosed by two thirds. Effective strategies to avoid underdiagnosis of neuropathy and to improve preventive foot care should be implemented. © 2015 Elsevier Inc. All rights reserved. Source

Schumm-Draeger P.-M.,Clinic for Endocrinology | Burgess L.,Stellenbosch University | Koranyi L.,Clinical Pharmacology Unit | Hruba V.,Astrazeneca | And 2 more authors.
Diabetes, Obesity and Metabolism | Year: 2015

To evaluate the efficacy and safety of twice-daily dosing of dapagliflozin and metformin, exploring the feasibility of a fixed-dose combination. Methods: In this 16-week, phase III, randomized, double-blind placebo-controlled study, adults who were receiving metformin administered twice daily (≥1500mg/day) and had inadequate glycaemic control were randomized 1:1:1:1 to receive dapagliflozin twice daily (2.5 or 5mg), placebo or dapagliflozin 10mg once daily (which was included as a benchmark). The primary endpoint was change from baseline glycated haemoglobin (HbA1c) level. Secondary endpoints included changes in fasting plasma glucose (FPG) level and body weight. Results: Four hundred adults were randomized to dapagliflozin (2.5mg twice daily, 5mg twice daily, 10mg once daily) or placebo co-administered with metformin twice daily. At 16 weeks, the adjusted mean change in HbA1c from baseline was significantly reduced in the dapagliflozin 2.5mg twice daily and 5mg twice daily groups versus placebo (-0.52 vs. -0.30%, p=0.0106 and -0.65% vs. -0.30%, p<0.0001). There were also significantly greater improvements for dapagliflozin twice daily groups versus placebo in FPG body weight and achievement of HbA1c level of <7%. Efficacy outcomes for dapagliflozin twice daily were numerically similar to those for dapagliflozin once daily. Dapagliflozin twice daily was well tolerated. Conclusions: Dapagliflozin 2.5 or 5mg twice daily added to metformin was effective in reducing glycaemic levels in patients with type 2 diabetes inadequately controlled with metformin alone. This study supports the development of a fixed-dose combination regimen. © 2014 John Wiley & Sons Ltd. Source

Turkusic E.,University of Sarajevo | Kahrovic E.,University of Sarajevo | Heljic B.,Clinic for Endocrinology | Kudumovic A.,Herzegovina University | Kalcher K.,University of Graz
HealthMED | Year: 2011

There are several U.S. EPA approved methodologies for the determination of arsenic in ground water. Different determination methods of inorganic arsenic have been developed over 40 years providing timely and efficient risk assessments of inorganic arsenic contamination worldwide. The new 10 μg L-1 (10 ppb) arsenic standard in drinking water according the WHO guideline value for arsenic in drinking water, has been a spur to the search for reliable routine analytical methods with a limit of detection at the 1 μg L-1 level. This paper reports the results obtained with a simple procedure for determination of total arsenic in ground water samples using the spectrometric field device Supralab SD which was initially designed for the determination of arsenic in drinking water. The 3s detection limit of the developed method was 0.1μg L-1. The time of As determination in the solution is about 5min. To validate the results obtained with the field device, inductively coupled plasma mass spectrometry (ICPMS) was used as a reference method. Very good agreement between results was obtained. Source

Burekovic A.,Clinic for Endocrinology
HealthMED | Year: 2011

Introduction: Diabetes mellitus (DM) is the most frequent metabolic disorder and is one of the most common endocrine diseases. Chronic complications of diabetes are caused by prolonged poorly regulated diabetes, the duration of diabetes, and other risk factors of atherosclerosis (obesity, hyperlipidemia, hypertension, smoking, lack of physical inactivity, blood hypercoagulability, immunological factors, in-fammatory factors and genetic predisposition). Aim of the study: Aim of this study was to determine the incidence of diabetic patients compared to nondiabetics in the Department of Emergency Medical Service. We have monitored the incidence of diabetic patients due to acute and chronic complications of diabetes, compared to nondiabetics and cardiovascular disease. Patients and methods: We monitored the diabetic and nondiabetic patients over the period of two years based on the protocol of disease, the reasons for reporting to the Department of Emergency Medical Services, and sorted them by age, sex, cardiovascular disease, height, blood sugar level, blood pressure level and ECG fndings, and verif-ed the diabetics with late macroangiopathic complications. Results: in 2008. there was signifcant difference in the incidence of diabetic patients in the Department of Emergency Medical Services as compared to nondiabetics followed for all diagnoses, except for heart failure. In 2009. there was signifcant difference in the appearance of diabetic patients in Department of Emergency Medical Services compared to nondiabetics except for hypertension and heart failure. Conclusion: This study demonstrated that diabetics are more likely to report due to the acu-tisation of late complications, as opposed to the acute complications of diabetes. Also, we showed that diabetics often require medical check-up for cardiovascular disease compared to nondiabetics. Source

Volmer-Thole M.,Clinic for Endocrinology | Lobmann R.,Clinic for Endocrinology
International Journal of Molecular Sciences | Year: 2016

Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature; in the pathophysiology of diabetic foot ulceration polyneuropathy is important. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the still high rates of major amputations. © 2016 by the authors; licensee MDPI, Basel, Switzerland. Source

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